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Background and purpose:We evaluated outcome of transplantation in donors MRAs that underwent multiple anastomosis in recipient, according to graft function, survey of graft and recipient, hypertension before and after transplantation, and surgical complications, comparable with single renal artery and MRA that was converted to a single artery before transplantation.
Materials and methods:In this case series study, from March 2003 to March 2009 in our kidney transplantation center, 7 renal grafts with MRAs underwent multiple anastomosis between renal arteries and recipient internal and external iliac and inferior epigasteric arteries. Single renal artery and multiple renal arteries that were converted to a single artery before transplantation, were excluded.
Results:Excellent perfusion was observed in renal graft after removal of vascular clamps in all cases. Convenient diuresis with average of 13444 cc in first day after transplantation was instituted. Post transplantation hypertension did not occur. All of recipients had a normal serum creatinin level with mean range 1.3 mg%. We observed perinephric collections in 2 recipients. One of collections was lymphocele and second one reported degenerated hematoma. Both collections were treated with aspiration. Isotopic scan and grafts ultrasonography indicated good survey and function of allografts.
Conclusion:We observed graft function, graft and recipient survival, intra and post operative complication, preoperative and post transplantation hypertension in our procedure similar to renal transplantation with single renal artery and MRA that was converted to single artery, because total ischemic time (TIT) was decreased in our option. We believe our procedure is a good alternative for bench surgery in MRA.

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Background and purpose: Diazinon is an oregano-phosphate insecticide used for pest control in the agricultural fields and gardens. It is easily absorbed through intestine, respiratory system and skin and is metabolized in the liver to diazoxon which is more toxic. This study aimed at examining the effect of diazinon on superoxide dismutase enzyme activity in rat erythrocyte and investigating the effect of antioxidant vitamins. Materials and methods: In this study, Wistar rats were divided into 9 groups. The groups were administered normal saline, soybean oil, diazinon (30 mg/kg), vitamins E, C, A (100 mg/kg, 500 mg/kg, 400 IU/kg, respectively) and combination of diazinon with the mentioned doses of each vitamin intraperitoneally (IP) for 14 days. Seven days after the last injection, the rats were anesthetized and one ml of blood was taken from their heart erythrocytes were aspirated and lysed. Hemolysis was used to measure superoxide dismutase enzyme activity. Data analysis was run using SPSS and the differences between the groups were analyzed applying Kruskal-Wallis and Mann Whitney tests at the significance level of 0.05 Results: The activity of superoxide dismutase enzymes was significantly higher in the diazinon-exposed group in comparison to the control group (P= 0.008). Diazinon/vitamin groups displayed a significantly increased level of enzyme activity compared to the control group (P= 0.005), as well. Conclusion: Diazinon increases the production of superoxide free radicals which in turn leads to oxidative stress. Vitamins, as non-enzymatic antioxidants, are probably effective in reducing the levels of free radicals and restoring antioxidants enzymes.

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Background and purpose: Based on the epidemiologic studies, stroke has become one of the fundamental problems in the Middle East. Considering to the role of serum paraoxonase (PON1) in stroke, the present study designed to evaluate the prognostic importance of paraoxonase to arylesterase activity ratio (Para/Aryl) and ratios of the activities to HDL in nondiabetic patients with ischemic stroke. Materials and methods: In this case-control study, 85 patients with ischemic stroke (46 men and 39 women) and 71 control individuals (38 men and 33 women) were enrolled. Paraoxonase and arylesterase activities were determined spectrophotometrically using paraoxon and phenylacetate as the substrates, respectively. Lipid profile was assayed using laboratory kits. The statistical analysis was performed by t-test, Chi-square and Spearman Correlation tests. Results: Compared with the control group, apo A1 levels were significantly decreased (P=0.000). Among three ratios of Para/Aryl, Para/HDL and Aryl/HDL, the greatest statistical difference belonged to Para/Aryl (P=0.016). Para/HDL and Aryl/HDL ratios were higher in patients than controls (P=0.097 and P=0.57, respectively). There was a significant positive correlation (r= 0.268, P= 0.015) between arylesterase activity and apo A1 levels in patients. Conclusion: It concluded that in the evaluation of PON1 status in nondiabetic patients with ischemic stroke, the assay of Para/Aryl and Para/HDL ratios are better indicators of measuring the activity alone. Increased amounts of Para/Aryl, Para/HDL and Aryl/HDL and reduced levels of Aryl may be considered as prognostic biomarkers in the study patients.

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Background and purpose: Pain and fatigue are among the complications after coronary artery bypass graft surgery (CABG). Non- pharmacological methods are more favorable than pharmacological agents. This study assessed the effects of foot reflexology massage on pain and fatigue in patients after CABG. Materials and methods: A randomized controlled clinical trial was conducted in 80 patients hospitalized in Mazandaran Heart Center, 2011. The samples were allocated based on their accessibility. They were age and gender matched and then divided randomly into two groups of case and control. The case group received reflexology massage on left foot for 20 minutes from the second day after surgery for four consecutive days. In control group, the left foot of the patients was moisturized for one minute without applying any pressure. The intensity of pain and fatigue were recorded before and after the intervention using visual analogue scale. Descriptive and inferential statistics were used to analyze the data. Results: Results showed significant differences in pain and fatigue levels after the intervention among both groups (P= 0.0001). Conclusion: According to this study, foot reflexology massage, is a useful nursing intervention to relieve fatigue and pain in CABG patients. Since this low-cost method is easy to apply we recommend it to ease the pain and fatigue in patients after CABG.

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Background and purpose: Acetaminophen is one of the most popular analgesic and antipyretic drugs and its overdose can cause severe damage to liver and kidneys in human and animals. Renal dysfunction and acute renal injury can occur without damage in the liver. Unlike kidney damage, mechanisms of liver damage are poorly understood. The aim of present study was to investigate the protective effect of curcumin, derived from Curcuma longa, on acetaminophen-induced kidney damage. Materials and methods: This study was performed in rats that were divided into five groups. Group I as control, group II was i.p. injected with curcumin (200 mg/kg b.w). Group III received DMSO as vehicle control. Group IV was treated with a single dose of acetaminophen (1000 mg/kg b.w, i.p.), and group V that received acetaminophen+Curcumin. After 24 hours, all rats were sacrificed with mild anesthesia. Urea and creatinine levels were measured in the plasma, and the levels of lipid peroxidation (TBARS) and superoxide dismutase (SOD) and catalase (CAT) activity in the kidney and total antioxidant capacity of plasma (TAC) were determined. Data analysis was done using SPSS and the differences between the groups were analyzed applying t-test and Mann Whitney tests at the significance level of 0.05. Results: Administration of acetaminophen caused elevated level of urea and creatinine in plasma and TBARS in kidney. While the activities of SOD and CAT decreased in kidney tissue. Curcumin with acetaminophen decreased the urea, creatinine and TBARS levels significantly but it significantly increased the activity of SOD, CAT, TAC. Conclusion: Our results showed curcumin as the potent protective agent against acetaminophen induced biochemical alterations and oxidative damage in rats. However, further studies are necessary to identify the curcumin’s mechanism of biochemical reaction before clinical application.

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Background and purpose: Diazinon is an organophosphate insecticide used mainly in agriculture, horticulture, and animal husbandry. Exposure to diazinon affects the redox process, the activity of antioxidant enzymes and could increase the lipid peroxidation in many organs. This study aimed at examining the chronic effect of diazinone on cell membrane lipid peroxidation and the protective effect of l-carnitin on this process. Materials and methods: In this study, male Wistar rats were divided into 8 groups. The groups were administrated normal saline (control group), diazinon (20 mg/kg), l-carnitine (50,100,150 mg/kg), and a combination of diazinon with the mentioned doses of l-carnitine, intraperitonealy (IP) for 4 weeks. The rats were anesthetized with ketamine 24 hours after the last injection and 2 ml blood was taken from their heart. Then, Lappena method was used to measure the serum concentrations of malodialdehiyde (MDA). The data was analyzed using SPSS and the differences between the groups were analyzed applying cruskal-wallis and Mann-Whitney test at the significance level of 0.05. Results: The serum concentration of MDA was significantly higher in rats exposed to diazinon compared with the control group (P= 0.009). A significant decrease was seen in the serum concentration of MDA in the groups exposed to diazinone/l-carnitine (P= 0.014). Conclusion: Diazinon induce the production of free radicals and oxidative stress. Probably, l-carnitine can reduce diazinon-induced lipid peroxidation in cell membrane by scavenging free radicals.

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Background and purpose: E. coli bacteria is detected by culture, serology and molecular methods. In molecular methods PCR products are created using little random primers. The main purpose of this research was to study the genetic diversity of Escherichia coli bacteria. Also, the propinquity of isolated bacteria with two common strains of EnteroPathogenic E. coli (St.₁) and EnteroHaemorrhagic E. coli (St.₂) was studied.

Materials and methods: An experimental study was performed in which 50 E. coli bacteria were isolated from urine samples and re-identified using biochemical tests. DNA was extracted by a kit and PCR products were evaluated after electrophoresis. The matrix of one/zero of bands was entered in Excel and studied by NTSYS_PC2.02 and MVSP 3.2 programs.

Results: Eight primers were used from which 129 bands were produced. The highest number of bands were produced by primer 2 (n=24). We observed 42 polymorphic bands, 10 common bands in all primers, and 22 special bands in each primer. The largest band appeared in primer 1 (17.3 kb) and the smallest band was observed in primers 7 and 8 (80 bp). Based on UPGMA dendrogram pattern and PCoA 3D ordination, four isolates including 33, 47, 48 and 50 showed relative genetic propinquity with St.₁ and St.₂.

Conclusion: Drawing PCoA 3D ordination showed high genetic diversity in isolates, indicating different pollution centers in spreading the bacteria. Fingerprinting of isolates showed high repeatability in technique illustrating its high degree of accuracy and reliability.

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Background and purpose: Some patients need to repeat certain tests. However, despite a peripheral vein catheter in the patients usually phlebotomy is done. This study examined the biochemical and hematological test results of the two methods of usual blood sampling and blood sampling through peripheral vein catheter.

Materials and methods: A case-control study was carried out in 96 patients admitted to the intensive care unit in Sari Imam Khomeini Hospital, 2014. Each patient was considered as a control group. Blood samples were taken in the usual way (control) and peripheral venous catheter (case). To obtain a blood sample, peripheral venous catheters were washed by 2cc of normal saline. After 5 minutes, 0.5 CC blood was discarded and sampling was performed again. In all samples the levels of hemoglobin, hematocrit, sodium, potassium, BUN, Cr and FBS were investigated. Results were analyzed using Chi-square test, t-test, Wilcoxon, and Fisher’s exact test in SPSS V.18.

Results: The patients were 56.2% male (n= 54). Mean age of the participants was 47.58±17.83 years. The results showed no significant difference in the values of hemoglobin (P=0.452), hematocrit (P=0.718), potassium (P=0.282), BUN (P=0.239), Cr (P=0.247) and FBS (P=0.074) between the two methods. But a significant difference was found between the values determined for sodium levels (P= 0.034).

Conclusion: Blood sampling through peripheral venous catheter while the patient is receiving liquid, is a reliable method for the analysis of hematocrit, hemoglobin, BUN and Cr.

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Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been a major concern since it first emerged. Prevention of Coronavirus 2019 disease (COVID-19) and slowing the epidemic and prevalence of the disease are the main goals of health institutions all over the world. it is very difficult to control the disease and predict its prevalence due to the continuous changes in the form of single nucleotide polymorphism (SNP) and mutations in this virus. In fact, some changes and mutations in Corona 2019 virus directly affect the pathogenicity and its transmission. The most important mutations that occur in the spike or RBD part of the SARS-CoV-2 virus, change the function of the virus, its severity of pathogenesis, and creates new variants. Mutations in these variants change the ability of the virus in binding to human cells, the rate of transmission, and make it easier to escape the immune system which plays a role in the effectiveness or ineffectiveness of vaccines. This study reviews eight major mutations in the spike or RBD region, their presence in different variants of Corona 2019 virus, and their relationship with response rate in infected people. Search keywords included COVID-19, mutation, variant, coronavirus, and respiratory infection in Google Scholar, PubMed, Springer, ScienceDirect, and Scopus databases. The main variations made from SARS-CoV-2 are Alfa (B.1.1.7), Beta (B.1.351), and Delta (B.1.617.2) that cause the infection to spread faster and the adequacy of vaccination on these variations have not been conclusively analyzed at this point.

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Background and purpose: Acetaminophen is a common analgesic and antipyretic medication that cause poisoning and damage liver and kidney in case of overdose. In this study, we investigated the effects of alcoholic extract of Eryngium caucasicum Trautv. against acetaminophen-induced oxidative stress in plasma and kidney tissue in BALB/C mice.
Materials and methods: The animals were randomly divided into 8 groups: control (saline), acetaminophen (400 mg/kg body weight) and different doses of extract (200, 400, and 600 mg/kg body weight)+ acetaminophen, and the extract at 200, 400, and 600 mg/kg body weight without acetaminophen administered by gavage for a week. Twenty four hours after last treatment, plasma levels of urea, creatinine, plasma antioxidant capacity, malondialdehyde, and tissue glutathione were measured. The effects of extract in experimental groups and the control group were compared using SPSS software.
Results: Alcoholic extract of Eryngium caucasicum Trautv. in acetaminophen-treated mice significantly decreased plasma urea, creatinine and lipid peroxidation (MDA) levels in kidney tissue and increased antioxidant capacity of plasma and tissue glutathione (P<0.001).
Conclusion: The study showed protective effects of the alcoholic extract of Eryngium caucasicum Trautv. against acetaminophen-induced renal toxicity which could be associated with antioxidant properties and scavenging of free radicals of the extract.
 

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Background and purpose: Cyclophosphamide (CP) is an alkylating anticancer drug and one of the most successful drugs with a wide range of clinical activities. This drug has toxic effects on most organs, especially kidney tissue. Piperine, as a flavonoid, has antioxidant, anti-inflammatory, and anti-apoptotic properties. The purpose of the present study is to investigate the antioxidant effect of piperine (PIP) on nephrotoxicity following cyclophosphamide (CP) by tissue, serum, and histopathological biochemical evaluation.
Materials and methods: In this experimental study, 48 adult male BALB/c mice aged 6-8 weeks and weighing 30-35 grams were divided into 6 groups, the control group (C), the group receiving cyclophosphamide (CP) with a dose of 200mg/kg, the group receiving piperine (Pip) with a dose of 5mg/kg, the group receiving piperine (Pip) with a dose of 10mg/kg, the group receiving cyclophosphamide and piperine at a dose of 5mg/kg (CP+Pip) and the group receiving cyclophosphamide and piperine with A dose of 10mg/kg (CP+Pip) was used. CP was administered on the third day of the study. Piperine was prescribed for 7 days in the form of pre-treatment and post-treatment. On the eighth day of the study, histochemical (GSH and MDA), histopathology, and serum biochemical evaluations were performed. Then, the data were analyzed with GraphPad Prism software one-way ANOVA and Tukey's post hoc tests.
Results: CP induced oxidative stress with a significant decrease in GSH level (P<0.001) and increased MDA level (P<0.0001). On the other hand, administration of PIP with two doses of 5 and 10 mg/kg in mice receiving CP could significantly reduce the amount of MDA (respectively: P˂0.001, P˂0.001) and increase the amount of GSH compared to the mice that only received CP (respectively: P˂0.05, P˂0.05). In mice receiving CP, a significant increase (P<0.05) in the amount of urea and creatinine was shown compared to mice in the control group. In contrast, groups treated with piperine (5 and 10 mg/kg body weight) before and after CP administration significantly (P<0.0001) improved the kidney damage towards normalization compared to mice treated with CP alone and histopathological evaluation confirmed this finding. The effect of piperine was seen in a dose-dependent manner in this study. Thus, in the group treated with cyclophosphamide, the loss of epithelial cells and the widening of the lumen of the distal and proximal convoluted tubules, the contraction of the glomerular network, and the expansion of Bowman's capsule between the visceral and parietal layers were seen. The administration of piperine improved these changes, and the 5 mg/kg dose showed a more effective role.
Conclusion: The general results of the present study showed that before and after the administration of piperine in rats treated with CP, it reduces nephrotoxicity caused by CP and has a positive effect on improving kidney function in connection with its antioxidant effect. Piperine can be suggested as a potential candidate for cancer patients undergoing chemotherapy.