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Background and Purpose: An important factor involved in infertility is reactive oxygen species (ROS). ROS can damage sperm DNA, and involve lipid per-oxidation. ROS elevation is under the influence of leukocyte activation. The objective of this study was to evaluate the level of ROS as well as leukocyte, in normozoospermic (NO) and ologoasthenoteratozoospermic (OAT) ejaculates.
Materials and Methods: The study population consisted of 75 individuals who were referred to the Research and Clinical Center, regarding infertility in Yazd, for semen analysis. Fifty (50) out of Seventy-Five (75) men were NO, and the remaining was OAT. ROS was measured with laminator, while leukocyte concentration was analyzed with the ENDTZ test
Results: The results showed that ROS levels in OAT was significantly higher compared with NO (1253.49±200.95 vs. 75.64±149.52 P=0.00). Furthermore, men with OAT were divided into 2 groups, with sperm morphology and motility >5% and <5%. In group >5%, ROS level was significantly higher than the group with <5% (3627.55±407.79 vs. 81.29±100.48 P=0.007). In addition, leukocyte concentration in NO was 0.07±0.22x106 while it was 0.12±0.20x106 in OAT samples P=0.35).
Conclusion: The results indicate although ROS is present in normal seminal samples, it is significantly higher in OAT. This shows the vital role of antioxidants, which may improve the sperm quality. Further clinical studies will pinpoint the antioxidant capacity in improving the seminal contents.

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Background and purpose: Platelet concentrates (PCs) are used in treatment of quantitative and qualitative platelet defects. In some cases it can cause complications in recipients. In PC, white blood cells, some mediators, cytokines and microparticles can contribute to adverse reactions in recipients. In this study, the effects of platelet-derived microparticles (PMP) were surveyed in the stimulation and activation of neutrophils. Materials and methods: In this experimental study, PC units were prepared from Iranian Blood Transfusion Organization and sampling of the bags was carried out. PMPs were separated from PCs and treated with neutrophils. After the incubation time, the respiratory burst of neutrophils was evaluated by flow cytometry using Dihydrorhodamine 123. Finally, data was analyzed using the Wilcoxon non- parametric test. Results: This study revealed that PMPs were able to stimulate and activate neutrophils (P ≤0.05). This effect depended on the final concentration of PMPs. On the other hand, the expression of CD40L molecules on PMPs showed no significant differences in the studied days during storage. Conclusion: According to this study PMPs in PC could play a role in activation of neutrophils.

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Endometriosis is a painful chronic disorder in premenopausal period that causes severe pelvic pain. It could be problematic for both the patient and physician since routine analgesic drugs may not resolve the symptoms. Therefore, various destructive surgical treatments are used in these patients and presacral neurectomy is one of the best and most recommended surgical methods. This paper reports pre sacral neurectomy operation that was performed in Sari Imam Khomeini Hospital for the first time on a 31-year-old woman suffering from severe mid pelvic pain. She was resistant to treatment but favorable results were observed after the operation.

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Background and purpose: Preeclampsia is a pregnancy complication with multiorgan involvement caused by the loss of mother's immune tolerance to the placenta and fetus antigen or the wrong adjustment. HLA-G is an immune-modulatory molecule and this study aimed at investigating the levels of HLA-G and its association with incidence and severity of preeclampsia in pregnant women in third trimester.
Materials and methods: A case-control study was performed in pregnant women attending Sari Imam Khomeini Hospital and Baqban Clinic, 2015-2016. A total of 71 subjects (in third trimester) was selected meeting the study inclusion criteria. They were divided into two groups; a group with preeclampsia (n=34) and a group of pregnant women without preeclampsia (n= 37, controls). Pregnancy routine lab tests were done and demographic information, blood pressure levels, and incidence of preeclampsia were recorded in both groups. Then, blood sample (5 ml) was collected from all cases and HLA-G levels were measured in serum samples.
Results: The mean serum levels of HLA-G were significantly lower in women with preeclampsia (0.58±0.18 ng/L) compared to that of other group (0.78±0.45 ng/L) (P=0.02). Also, the mean serum levels of HLA-G in those with mild preeclampsia was significantly higher than that of cases with severe preeclampsia (P=0.04).
Conclusion: Decrease in production of HLA-G molecule is believed to be one of the decisive factors in development and progression of preeclampsia which could be due to abnormalities in gene expression. Therefore, HLA-G molecule and its mechanism should be further studied to prevent this condition.
 

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Background and purpose: Kidney transplantation is still the most important and main treatment for advanced kidney failure. However, some patients reject the transplant through an immune system reaction. Improvement of immunosuppression with drugs such as rituximab and bortezomib allows these patients to be eligible for transplantation. This study aims to determine the cost-effectiveness of rituximab versus bortezomib in kidney transplant patients at Farhikhtegan Hospital, Tehran.
Materials and methods: The target statistical population in this research was inpatients receiving rituximab and bortezomib in 2022 in Farhikhtegan Hospital. Rituximab with a minimum dose of 375 mg/m2 was administered one day before transplantation. Bortezomib was administered at a dose of 1.3 mg/m2 on four occasions (usually days 1, 4, 8, and 11). The indicators related to the calculation of the cost of the disease and the parameters indicating the effectiveness were determined through library studies and interviews with experts, and finally, the aforementioned information was collected through the examination of the patient's records (hospital database). Cost indicators include the cost of a physician visit (first day, second day, general practitioner, emergency department, discharge day), medicine (main medicine, complementary medicine), hospital hoteling (nursing services, consumables, bed, radiology, ECG, critical care, physiotherapy, preparation of nutrition formulary, examination, and burial permit) and tests (all tests necessary to evaluate and monitor the patient). Efficacy indices included IgG class I, IgG class II, IgM class I, and IgM class II. The data analysis was conducted by SPSS software.
Results: 77 kidney transplant patients including 53 treated with bortezomib and 24 receiving rituximab with an average age of 41.01±8.50 years were studied. Our findings showed that the average cost of the bortezomib group was 19,548,230.86 tomans. Before taking bortezomib, the average level of class I and class II IgG was 68.16±6.34 and 67.11±4.96, respectively, which significantly decreased to 17.28±15.73 and 18.13±16.75 after treatment with bortezomib (P=0.000). The average IgM class I and class II before taking medicine were 5.69±1.30 and 5.54±0.95, respectively, which reached 5.43±0.79 and 5.13±0.39 after taking Bortezomib, respectively. This decrease was significant for IgM class II (P=0.000), but not significant for IgM class I (P=0.223). In patients receiving rituximab, before taking the drug, the average level of class I and class II IgG was 71.66±7.86 and 67.83±4.53, respectively, which significantly decreased to 13.95±13.82 and 15.83±14.15 after treatment with rituximab (P=0.000). The average IgM class I and class II before taking rituximab was 5.70±1.23 and 5.45±0.97, respectively, after taking the drug, it decreased to 5.41±0.65 and 5.16±0.38, respectively, and this decrease was not statistically significant (P>0.05). The average cost of the rituximab group was 28,261,539.29 Tomans and caused a significant decrease in the average level of IgG class I and II. The incremental cost-effectiveness rate (ICER) was 1770997.65, which was lower than the threshold defined by WHO.
Conclusion: The results of our study showed that rituximab is cost-effective compared to bortezomib

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Background and purpose: Antibiotics are crucial in various scientific fields, including human and veterinary medicine, and are widely utilized medicinal compounds. Ciprofloxacin is a widely used antibiotic in the treatment of infections, most of which is excreted unmetabolized and finally enters water sources through the discharge of sewage and effluents. Even at low concentrations, ciprofloxacin in sewage and effluents can cause ecological harm and pose significant risks to human health. It is crucial to devise effective solutions for the removal of this antibiotic. Advanced Oxidation Processes (AOPs) are a promising method for the future removal of antibiotics, particularly in aquatic solutions, due to their potential to effectively remove ciprofloxacin. This study investigated the antibacterial and catalytic activity of synthesized magnetite nanoparticles (MNPs) (Fe3O4) in removing ciprofloxacin.
Materials and methods: In this experimental research, Fe3O4 magnetic nanoparticles (MNPs) were prepared using the co-precipitation method. The nanoparticles were then examined for their physical and structural characteristics using scanning electron microscopy(SEM), X-ray powder diffraction (XRD), transmission electron microscopy (TEM), and BET technique. Fe3O4 magnetic nanoparticles (MNPs) were initially synthesized, and their properties were determined. We performed separate investigations to assess the effectiveness of various methods for removing ciprofloxacin. This included evaluating ultrasound alone (US), hydrogen peroxide alone, magnetite nanoparticles alone (MNPs), and combinations such as ultrasound with hydrogen peroxide, hydrogen peroxide with magnetite nanoparticles, and magnetite nanoparticles with ultrasound. All tests were conducted under the same conditions. The first step assessed the catalytic activity of synthesized nanoparticles for ciprofloxacin through the Fenton process. In this study, experimental parameters such as Fe3O4 catalyst dosage, initial pH of the solution, Hydrogen peroxide concentration, reaction time, and initial antibiotic concentration were investigated. In the second step, the antibacterial efficacy of synthesized nanoparticles against Escherichia coli and Staphylococcus aureus was determined via the Broth Macro dilution method.
Results: The examination of the characteristics of synthesized nanoparticles showed that the average size of magnetite nanoparticles is approximately 20-30 nm. TEM results confirmed that the synthesized nanoparticles have a uniform size and structure. The combined process of MNPs/hydrogen peroxide/US exhibited the highest removal efficiency at 88.36%. This high efficiency can be attributed to the direct effect of the reaction between Fenton agents and ultrasonic waves, leading to the generation of numerous hydroxyl radicals. The maximum removal of ciprofloxacin was achieved in 0.5 g/L catalyst, pH=3, five mM hydrogen peroxide concentration, 550 W ultrasonic power, and 60 min reaction time. For Escherichia coli and Staphylococcus aureus, the Minimum Inhibitory and Minimum bactericidal concentrations were 3.125, 6.25, and 1.56, 3.125 μg/mL, respectively.
Conclusion: Synthesized iron magnetite nanoparticles have high antibacterial properties against bacterial strains and many catalytic properties in the Sono Fenton process to remove ciprofloxacin, so this process can be an effective method for eliminating hospital and pharmaceutical wastewater.
 

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Background and purpose: Oral lichen planus (OLP) is a chronic inflammatory autoimmune disease that, although not typically life-threatening, can lead to significant psychosocial consequences. Due to its persistent nature and the lack of effective treatments to prevent its progression, OLP can severely impact quality of life. The aim of the present study is to investigate the effectiveness of mindfulness-based stress reduction therapy in alleviating symptoms and signs of the disease, as well as reducing stress, anxiety, and depression in women with oral lichen planus.
Materials and methods: This study is a controlled clinical trial with a pre-test/post-test design. The sample comprised 36 women diagnosed with oral lichen planus, who were selected using purposive sampling and were then randomly assigned to either the control or experimental group. Data were collected using the DASS-21 questionnaire, Visual Analog Scale (VAS), and Thongprasom Scale. The experimental group received 8 sessions of Mindfulness-Based Stress Reduction (MBSR) therapy, while the control group received no interventions. Data were analyzed using SPSS software (version 22).
Results: In the experimental group, the mean scores for stress, anxiety, and depression in the post-test phase were 9.29±4.22, 5.94±3.92, and 7.00±5.55, respectively. In the control group, these scores were 10.94±4.84, 7.71±4.70, and 9.65±5.44, respectively. After adjusting for pre-test scores, the results of covariance analysis showed that the mean scores of the experimental and control groups differed significantly for these variables in the post-test phase (P<0.05). The mean intensity of pain or burning sensation in the experimental group during the post-test phase was 2.94±1.85, compared to 3.65±1.69
in the control group; however, this difference was not statistically significant. Similarly, there was
no statistically significant difference in the frequency of lesions between the experimental and control groups (P>0.05).
Conclusion: The results of this study indicate that MBSR can be an effective approach to reducing psychological distress in patients with oral lichen planus.

(Clinical Trials Registry Number: IRCT20221204056709N1)