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Background and purpose: Vesico-ureteral reflux (VUR) is one of the most common diseases encountered by urologists. Ureteral re-implant has been the only method of surgery for VUR correction. In recent years endoscopic injection of several agents (bulking agents) has been proposed as a treatment. The aim of this study was to evaluate the therapeutic efficacy of endoscopic subureteric injection of total blood nucleated cells and platelet.

Materials and methods: A clinical trial was done in 17 patients with VUR aging 18-35 years old in Mashhad Imam Reza Hospital, Iran, 2012-2015. The participants were randomly selected and placed under endoscopic injection following voiding cystourethrography (VCUG). Three months later the patients were evaluated using clinical findings, urine culture and VCUG. If the VUR persisted, the second injection was performed three months after the first one.

Results: There were 17 patients including 13 females and 4 males, mean age 22.8 ± 4.9 years. The procedure achieved success in 89% of renal units after the first injection and 94% after the second one. We observed no major complications.

Conclusion: Our pilot interventional clinical trial showed that endoscopic injection of total blood nucleated cells and platelets is an effective method for treatment of VUR in adult patients.  

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 Background and purpose: Stroke is the most common neurological disease. This study aimed to investigate the relationship between serum C-reactive protein (CRP) as a prognostic factor and ischemic and hemorrhagic cerebrovascular accident (CVA).
Materials and methods: This cohort study was performed in patients over 18 years of age with symptoms of ischemic and hemorrhagic CVA attending the emergency department in Mashhad Ghaem Hospital during the first 6 hours of the onset of symptoms. CRP levels and prognosis of serum CRP levels were determined in diagnosing the severity of ischemic and hemorrhagic lesions in CVA patients. The severity of CVA was determined based on MRS and NIHSS scales. Patients' follow-up was considered 6 months later.
Results: There were no significant differences between gender and age in study groups (P> 0.05). The median scores for MRS and NIHSS were significantly higher in hemorrhagic patients than ischemic patients. Analysis of CRP level in univariate regression model showed that CRP level is a bad prognosis for stroke (β = 0.149, P= 0.027). Mean age, gender distribution, type of stroke, symptoms, and underlying diseases were not significantly different between the group with and without stroke (P> 0.05). There were significant differences in CRP level and recurrence of stroke after 6 months between the groups studied (P= 0.009).
Conclusion: Monitoring of CRP levels can be effective in early diagnosis and control of recurrent stroke.

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 Background and purpose: Candidiasis is one of the most serious problems in adult and neonatal intensive care units. Molecular techniques play a key role in identifying invasive fungal infections and could be of great benefit beside other mycological diagnostic methods such as smear preparation and blood culture. The aim of this study was to detect candida species isolated from patients in oncology unit and intensive care unit in Zanjan Valiasr Hospital, Iran.
Materials and methods: In this cross-sectional descriptive study, we examined 154 patients between November 2017 and May 2018. Blood culture was done and PCR was carried out after DNA extraction.
Results: In this study, Candidemia was found to be considerably higher in men with a mean age of 72 years old compared with women. Also, more than one procedure in a patient, fever, and antibiotic treatments were the main underlying factors causing Candidemia. In this study, blood cultures were positive for yeast growth in 2.6% of the patients (C. albicans in 1.3%, C. tropicalis in 0.65%, and C. glabrata in 0.65 %(. 
Conclusion: Candida species are among the main causes of blood infection in patients admitted to intensive care units and death rate of the condition can approach 100% in case of late diagnosis.
 

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Background and purpose: Psoriasis is an autoimmune inflammatory disease with major skin involvement. Calcipotriol as a vitamin-D analogue is one of the common drugs for topical treatment of psoriasis. Local drug delivery, due to higher concentration of drug at the sites of inflammation, is more effective and causes fewer systemic side effects. Limited skin penetration and durability of common topical formulations reduce the efficacy of treatment. In this study, we aimed to investigate the effect of solid lipid nanoparticles loaded with calcipotriol on local drug delivery.
Materials and methods: In the present study, which is an interventional in vivo study, Solid Lipid Nanoparticle (SLN) was prepared by melting method and mixed with semi-solid base (cream). Then the effectiveness of the final formulation was investigated on the psoriasis model induced by imiquimod 5% in BALB/c mice. Three groups were included in this investigation: negative control (no treatment), positive control (conventional calcipotriol cream), and SLN (SLN cream with calcipotriol).
Results: The results of the present study showed that, the SLN cream significantly reduced inflammatory scores compared to the other two groups on day five (P<0.0001). In addition, drug loading into SLN significantly increased the rate of healing and reduced inflammation.
Conclusion: This study showed that calcipotriol loading with SLN can improve the quality and the rate of treatment of skin lesions caused by psoriasis.
 

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Background and purpose: Coronavirus disease 2019 (COVID-19) is a multi-organ illness characterized by significant involvement of the coagulation cascade, immune response, and inflammation. This investigation aimed to explore the significance of various biomarkers, such as interleukin 6 (IL-6), lactate dehydrogenase (LDH), D-dimer, and N-terminal prohormone of brain natriuretic peptide (NT-proBNP), concerning lung complications in COVID-19 patients.
Materials and methods: This retrospective study was conducted at Imam-Sajjad Hospital in Ramsar, Mazandaran, from May to August 2021 and focused on all COVID-19 patients with lung involvement who were admitted. An experienced radiologist assessed each patient's computed tomography (CT) scans and assigned a lung involvement score ranging from zero to 10 for each lung. These scores were categorized as mild (0-10), moderate (10-15), or severe (15-20). In addition to demographic data, serum levels of IL-6, LDH, D-dimer, and NT-proBNP were obtained from patient records, and all the achieved data were statistically analyzed.
Results: A total of 154 patients were included. The distribution across mild (27.3%), moderate (33.7%), and severe (39%) lung involvement in COVID-19 was observed. Notably, levels of IL-6 (P=0.002), D-dimer (P=0.035), and LDH (P<0.001) exhibited variations among these three groups of COVID-19 lung involvement. Furthermore, statistically significant positive correlations were observed between the calculated lung involvement score and plasma levels of IL-6 (P=0.008, r= 0.280), D-dimer (P=0.008, r= 0.307), and LDH (P<0.001, r= 0.320).
Conclusion: This study suggests that plasma levels of biomarkers, including IL-6, D-dimer, and LDH, may be associated with lung involvement in COVID-19 patients.

 

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Background and purpose: Constipation is a significant health issue among children, requiring prompt screening and early diagnosis due to its substantial contribution to disease burden. Probiotics, which colonize the bowel, are known to exert positive effects on the gut microbiota. While probiotics have been extensively studied in relation to various gastrointestinal disorders, there is limited research specifically addressing their efficacy in managing pediatric constipation. To address this gap, we designed a study to evaluate the impact of probiotics on the treatment of constipation in children attending the Imam Sajad hospital clinic in Ramsar, Iran.
Materials and methods: This double-blind clinical trial involved 90 children diagnosed with constipation, who were randomly assigned to either an intervention or a control group. For each child, a checklist was first completed, and all children received toilet training conducted by the researcher. The control group received standard treatment for constipation, which included 0.7-1.5 grams per kilogram of Polyethylene Glycol (PEG) powder (Pidrolox). The intervention group received the same standard treatment in addition to a probiotic supplement (Kidy Lact). The study duration was four weeks and all the patients were clinically examined at two and four weeks after the intervention. The primary assessment criteria included stool consistency, the frequency of incontinence episodes per week, the presence of abdominal pain, and painful bowel movements. Secondary evaluations focused on treatment success and any adverse effects, such as diarrhea and vomiting.
Results: After two weeks, no significant differences were observed between the intervention
and control groups regarding stool frequency, painful defecation, incontinence, and abdominal pain (P=0.30, P=0.85, P=0.53, and P=0.23, respectively). Furthermore, after four weeks, stool frequency and incontinence did not show significant differences between the two groups (P=0.22 and P=0.53, respectively). However, the frequency of painful bowel movements in the intervention group was significantly lower than in the control group (P=0.04).
Conclusion: Based on the findings of this study, adding probiotics to the standard treatment for functional constipation, such as Polyethylene Glycol powder, may be beneficial for children. To obtain more precise results, it is recommended that long-term studies be conducted using probiotics.

(Clinical Trials Registry Number: IRCT20230107057070N2)