Vitamin D status in preschool children: should vitamin D supplementation, preventing vitamin D deficiency be continued in children over 2 years?

BACKGROUND: The aim of this study was to determine the prevalence of vitamin D deficiency among preschool children in rural and urban areas of Northern Iran and need for continuing vitamin D supplementation after 2 years of age. METHOD: A sample of 406 children aged 30-72 months was selected from health centres. Serum levels of 25-hydroxyvitamin D (25OHD), demographic data, anthropometric characteristics and total body surface area, were evaluated. RESULTS: Subnormal vitamin D levels were found in 68.94% (269) of children. In multiple logistic regression models, season (P = 0.001) and residency (P = 0.006) were significantly correlated with vitamin D deficiency. Multiple linear regression analysis revealed that age (ß = -0.18, P < 0.001), body mass index (ß = -1.1, P < 0.001) and sun exposure (ß = 0.4, P < 0.001) were significantly associated with 25OHD level. CONCLUSION: Owing to the high prevalence of subnormal vitamin D levels in preschool children, it is recommended that vitamin D deficiency prevention programs are continued in this age group.

The protective effects of melatonin on blood cell counts of rectal cancer patients following radio-chemotherapy: a randomized controlled trial.

PURPOSE: We aimed to examine the radioprotective effects of melatonin on the blood cell counts of patients with rectum cancer undergoing radiotherapy. MATERIALS AND METHODS: This double-blind placebo-controlled study was conducted on 60 rectal cancer patients who were referred to Rajaii Hospital of Babolsar, Iran. An equal number of patients were randomly assigned to the control group which received placebo and study group which received 20 mg melatonin a day as an intervention. The melatonin was administered 5 days a week for 28 days. Blood samples were taken before melatonin received on day 1 and also day 28; then, to measure the changes in blood cell counts representing our primary outcomes, the samples were analyzed by Sysmex K810i auto-analyzer. RESULTS: Our results showed that the platelet, white blood cells, lymphocyte, and neutrophil population reduction induced by radiotherapy were slighter or even insignificant in melatonin recipients compared to control. However, the difference between red blood cells in both groups was not significant. CONCLUSION: Our results are indicating that melatonin could prevent or minimize the unfavorable effects of radiotherapy on blood cell count reductions by attenuating the adverse influence of radiation, probably through stimulation of cellular antioxidant potential as previously reported in animal models. IRANIAN REGISTRY OF CLINICAL TRIALS (IRCT): Registry No. IRCT2016021626586N1.

In vitro and in vivo activity of Artemisia sieberi against Trichomonas gallinae.

In Iranian folk medicine Artemisia sieberi has been used for treatment of parasite infections in human and animals. The present study was designed to evaluate the in vitro and in vivo effects of A. sieberi essential oil (EO) against Trichomonas gallinae. Trichomonas gallinae were recovered by wet mount method from infected native pigeons. The in vitro assays were accomplished in multi-well plates containing metronidazole (MTZ) as a standard antitrichomonal and EO in final concentrations of 2.5, 5, 10, 20, 50, and 100 µg/ml of culture medium containing 104 parasites. The invivo assay was performed on 40 experimentally infected pigeons receiving 25 and 50 mg/kg of MTZ and EO for 7 successive days. Gas chromatographic (GC) analysis was performed to reveal chemical constituents of the EO. At 20 µg/ml, MTZ resulted in no viable trophozoite in culture medium after 24 h incubation period. While the 24 h MIC of EO was 10 µg/ml. Treatment with EO at dose of 50 mg/kg after 4 days led to full recovery of infected pigeons but for MTZ at the same dose 5 days were spent. Major constituents of EO were α-thujone (31.5%) and ß-thujone (11.92%). Data of the present study introduced A. sieberi as a natural potent antitrichomonal agent effective against T. gallinae.

Antitrichomonal activity of Peganum harmala alkaloid extract against trichomoniasis in pigeon (Columba livia domestica).

1. This study was designed to evaluate the antitrichomonal effects of P. harmala alkaloid extract against T. gallinae, both in vitro and in vivo, as well as comparing it to that of metronidazole, conventional antitrichomonal medication and harmine and harmaline, the two alkaloids present in P. harmala. 2. T. gallinae were collected by the wet mount method from infected free-living pigeons. The in vitro assay was performed using multi-well plates containing test compounds in final concentrations of 5, 10, 15, 20, 30, 50 or 100 µg/ml. The in vivo assay was done on 60 experimentally infected pigeons dosed with metronidazole at 50 mg/kg body weight (BW) or alkaloids at 25 mg/kg BW. 3. The 24 h minimum inhibitory concentration (MIC) of alkaloid extract was 15 µg/ml while that of metronidazole was 50 µg/ml. Harmine and harmaline revealed 24 h MIC of 30 and 100 µg/ml, respectively. Treatment of infected pigeons with alkaloids led to a full recovery after 3 d but with metronidazole total eradication of trophozoites was not achieved. 4. In conclusion, data of the present study suggested P. harmala is a potent natural anti-trichomonal agent, effective against T. gallinae.

A comparative study on sealing ability of mineral trioxide aggregate, calcium enriched cement and bone cement in furcal perforations.

AIM: The aim of this study was to compare the bacterial leakage of mineral trioxide aggregate (MTA), calcium enriched cement (CEM), and bone cement (BC) as repair materials in furcal perforations. METHODS: The pulp chambers of 57 human mandibular molar teeth were accessed and the root canal orifices were located. The roots were horizontally sectioned in the middle third. Composite resin was used to fill the root canal orifices and the apical end of the roots. The 1 mm furcation perforations were performed in the center of the pulp chamber floor, using diamond fissure burs. Fifty one teeth were divided into 3 groups. Six teeth were used as controls. Perforation defects were repaired with either MTA, CEM, or BC. A bacterial leakage model utilizing phenol red with 3% lactose broth was used for evaluation. The upper pulp chambers were subsequently filled with 5µL bacterial suspension containing Enterococcus faecalis. Then the top of the assembly was covered with aluminum foil to avoid unintentional contamination. The entire apparatus was incubated at 37°C, and bacterial leakage was evaluated daily by checking the turbidity in the culture medium of the lower part of the chamber. The bacterial inoculation was renewed every day, for 30 days. Leakage was noted when color conversion of the culture media was observed and was statistically analyzed using the Chi-square test with significance set at P< 0.05. RESULTS: Sixteen (94%) of the 17 samples of the MTA group, thirteen (81%) of the 17 samples of the CEM group and sixteen (94%) of the 17 samples in BC group were fully contaminated at 30 days. There was no statistically significant difference between the three study groups (P>0.05). CONCLUSION: According to the present study, in teeth with furcation perforations, the coronal seal produced by MTA preparations was equally to that produced by CEM cement and Bone cement.

A in-vitro comparative study on bacterial leakage of mineral trioxide aggregate, calcium enriched cement and bone cement in furcal perforations.

AIM: The aim of this study was to compare the bacterial leakage of mineral trioxide aggregate (MTA), calciem enriched cement (CEM), and bone cement (BC) as repair materials in furcal perforations. METHODS: The pulp chambers of 57 human mandibular molar teeth were accessed and the root canal orifices were located. The roots were horizontally sectioned in the middle third. Composite resin was used to fill the root canal orifices and the apical end of the roots. The 1mm furcation perforations were performed in the center of the pulp chamber floor, using diamond fissure burs. Fifty one teeth were divided into 3 groups. Six teeth were used as controls.Perforation defects were repaired with either MTA, CEM, or BC. A bacterial leakage model utilizing phenol red with 3% lactose broth was used for evaluation. The upper pulp chambers were subsequently filled with 5µL bacterial suspension containing Enterococcus faecalis. Then the top of the assembly was covered with aluminum foil to avoid unintentional contamination. The entire apparatus was incubated at 37°C, and bacterial leakage was evaluated daily by checking the turbidity in the culture medium of the lower part of the chamber. The bacterial inoculation was renewed every day, for 30 days. Leakage was noted when color conversion of the culture media was observed and was statistically analyzed using the Chi--square test with significance set at P< 0.05. RESULTS: Sixteen (94%) of the 17 samples of the MTA group , thirteen (81%) of the 17 samples of the CEM group and sixteen (94%) of the 17 samples in BC group were fully contaminated at 30 days. There was no statistically significant difference between the three study groups (P > 0.05). CONCLUSION: According to the present study, in teeth with furcation perforations, the coronal seal produced by MTA preparations was equally to that produced by CEM cement and Bone cement.

Evaluation of protective effect of propolis on parotid salivary glands in gamma-irradiated rats.

OBJECTIVE AND BACKGROUND: One of the most significant side effects of radiotherapy for head and neck cancers is xerostomia as a result of salivary gland damage. Considering pharmaco- logical effects of propolis, we evaluated its protective effect on salivary glands subjected to radiotherapy of head and neck cancer patients. MATERIALS AND METHODS: Twenty-one male albino rats (8-11 W, 190 ± 5 gm) were divided into three groups of seven animals. Scintigraphy was performed in all the groups. Then groups 1 (S) and 2 (SR) received normal saline injections and group 3 (PR) received propolis injection over 3 days. After that groups 2 and 3 were exposed to gamma radiation and all the rats underwent scintigraphic assessment on third day and 70th day after irradiation. The lips and tongues of rats in groups 2 and 3 were examined for mucositis daily in first 10 days. At the end, the parotid glands of all rats were examined histologically. RESULTS: Scintigraphy results of third and 70th day after irradiation showed statistically significant differences between PR and SR as well as SR and S. However, there was no significant difference between the PR and S groups. Histopathologic assessment demonstrated significant difference between SR, PR and S. CONCLUSION: These results suggest that propolis has protective effects on salivary gland function in animal models whilst it did not prevent radiation-induced histologic changes in tissues. Further investigations are needed to elucidate mechanisms of propolis actions. Clinical significance: Regarding to the results of this study, propolis may be useful in reduction xerostomia due to radiation to salivary glands and may be helpful for head and neck cancer patients.

Effect of Clupeonella grimmi (anchovy/kilka) fish oil on dysmenorrhoea.

To examine whether dietary supplementation with omega-3 fatty acids from Clupeonella grimmi can relieve symptoms of dysmenorrhoea, we carried out a cross-over clinical trial on 36 girls aged 18-22 years. They were randomly allocated into 2 groups of 18. Group A received 15 mL fish oil daily (550 mg eicosapentaenoic acid; 205 mg decosahexaenoic acid) while Group B received placebo. After 3 months, the treatment regimens were swapped. The treatment groups reported a significant difference after 3 months of supplementation with fish oil (visual analogue scale score 20.9 compared with 61.8 for the placebo (P= 0.001). There was also a marked reduction in low back pain and abdominal pain (P < 0.05), and participants needed significantly fewer rescue doses of ibuprofen while using fish oil.

Effect of Clupeonella grimmi [anchovy/kilka] fish oil on dysmenorrhoea

To examine whether dietary supplementation with omega-3 fatty acids from Clupeonella grimmi can relieve symptoms of dysmenorrhoea, we carried out a cross-over clinical trial on 36 girls aged 18-22 years. They were randomly allocated into 2 groups of 18. Group A received 15 mL fish oil daily [550 mg eicosapentaenoic acid; 205 mg decosahexaenoic acid] while Group B received placebo. After 3 months, the treatment regimens were swapped. The treatment groups reported a significant difference after 3 months of supplementation with fish oil [visual analogue scale score 20.9 compared with 61.8 for the placebo [P = 0.001]. There was also a marked reduction in low back pain and abdominal pain [P < 0.05], and participants needed significantly fewer rescue doses of ibuprofen while using fish oil

Evaluation of the effect of locally administered amitriptyline gel as adjunct to local anesthetics in irreversible pulpitis pain.

BACKGROUND: Amitriptyline is one of the most common tricyclic antidepressants, which binds to pain sensory nerve fibers close to the sodium channel; hence, it could interact to some degree with receptors of local anesthetics. This study was designed to assess the additional analgesic effects of 2% Amitriptyline local gel administration in irreversible pulpitis pain of the molars. MATERIALS AND METHODS: This study was a randomized, double-blind clinical trial that was performed on 56 consented adult patients who did not receive enough analgesia after a lidocaine nerve block for their tooth pulpitis pain. Patients were treated with 0.2 ml of either 2% amitriptyline or placebo, which was directly injected into their mandibular molar pulp chamber after they had received two routine lidocaine injections. Patients were asked to score their pain as a mark on a 10-cm Visual Analogue Scale (VAS) at different timepoints: 0 (just before gel administration), 1, 3, 5, 7, and 9 minutes after the treatments. RESULTS: There was a 92.5% decrease in VAS scores of patients 9 minutes after amitriptyline administration compared to Time 0, while in the placebo group this difference was only 13.5%. Further, in the amitriptyline group, the VAS score at all timepoints was statistically different from Time 0 (P < 0.01). The overall pain reduction and its trend was significantly higher in the amitriptyline group compared with the placebo group (P < 0.001). CONCLUSION: Inter-pulp space administration of amitriptyline 2% gel for completing analgesia in irreversible pulpitis pain could be effective and useful as a conjunctive therapy to injections of local anesthetics.

The efficacy of the bioadhesive patches containing licorice extract in the management of recurrent aphthous stomatitis.

This study evaluated the efficacy of licorice bioadhesive hydrogel patches to control the pain and reduce the healing time of recurrent aphthous ulcer.This study was carried out in three episodes of ulcers: in the first episode of ulcer, all 15 patients were asked to record their baseline individual pain level by a visual analog scale. In the second and third episodes, comparative and consecutive subjective and objective evaluations of the bioadhesive were done. The effects of the following variables were investigated: (1) VAS pain score for 5 consecutive days, (2) profile of aphthous ulcers on days 3 and 5, (3) time to complete relief of pain and healing of the ulcers, (4) diameter of the lesions and necrotic zone.A significant reduction in VAS was recorded following application of the licorice patches on days 2, 3, 4 and 5 compared with the no-treatment group (p < 0.001). Licorice patches caused a significant reduction in the diameter of the inflammatory halo and necrotic center compared with the placebo group (p = 0.03).According to the results of this study, licorice bioadhesive can be effective in the reduction of pain and of the inflammatory halo and necrotic center of aphthous ulcers.

The effects of methanolic extracts of ginger (Zingiber officinale) on human sperm parameters; an in vitro study.

This study was conducted on Zingiber officinale or ginger on motility, grading and morphological aspects of human sperm. Thirty human semen samples were obtained from the local hospital. The samples were swim up by Ham's F10. The samples (0.9 mL) were treated by 0.1 mL of ginger methanolic extracts (0.1, 0.2, 0.4 and 0.6% concentration). Sperm motility, grading and morphology parameters were assessed using light microscope at 0, 2, 4, 8 and 24 h after treatment. Dose and time-dependent decreases in motility accompanied by concomitant decrease in grading 3 and 4 were noticed. Morphologic profiles of the sperms were changed under different doses of ginger on the basis of time of assess. These data indicate that some exhibits a lower percentage of motility and grading when methanolic ginger is added to semen fluid. According to the results it would be concluded that ginger can induce the toxic effects on sperm parameters.

Effect of orange and tangerine juice on cyclosporine levels in renal transplant recipients.

INTRODUCTION: Cyclosporine Neoral is a major immunosuppressive agent widely used in organ transplant populations. Its pharmacokinetics are influenced by various factors. The aim of this study was to investigate the effects of orange or tangerine juice on the pharmacokinetic pattern of cyclosporine Neoral among renal transplanted patients. MATERIALS AND METHODS: Ten renal transplant recipients on cyclosporine Neoral-based immunosuppressive therapy were included in this crossover controlled study. Patients were given their individualized morning dose of cyclosporine with either 250 mL water or 250 mL orange or tangerine juice; 12-hour cyclosporine pharmacokinetic investigations were performed. The three investigation days were separated by at least 7 days. RESULTS: The intake of orange juice did not have any significant influence on the area under the curve in the interval from 0 to 12 hours (AUC 0-12; 95% confidence interval [CI]: -769 to 734, P=.77), or the maximum whole blood concentration (Cmax; 95% CI: 264 to 74; P=.32). Similarly, after coadministration of cyclosporine Neoral with tangerine juice, no significant changes were observed in AUC 0-12 (95% CI: -453 to 1166; P=.28) or Cmax (95% CI: -239 to 179; P=.37). CONCLUSION: Coadministration of orange (var Tampson) or tangerine (var Unshiu) juice with cyclosporine compared with water did not influence exposure to cyclosporine in renal transplant recipients.

Physiologically based modelling of inhibition of metabolism and assessment of the relative potency of drug and metabolite: dextromethorphan vs. dextrorphan using quinidine inhibition.

AIMS: To define the relative antitussive effect of dextromethorphan (DEX) and its primary metabolite dextrorphan (DOR) after administration of DEX. METHODS: Data were analysed from a double-blind, randomized cross-over study in which 22 subjects received the following oral treatments: (i) placebo; (ii) 30 mg DEX hydro-bromide; (iii) 60 mg DEX hydro-bromide; and (iv) 30 mg DEX hydro-bromide preceded at 1 h by quinidine HCl (50 mg). Cough was elicited using citric acid challenge. Pharmacokinetic data from all non-placebo arms of the study were fitted simultaneously. The parameters were then used as covariates in a link PK-PD model of cough suppression using data from all treatment arms. RESULTS: The best-fit PK model assumed two- and one-compartment PK models for DEX and DOR, respectively, and competitive inhibition of DEX metabolism by quinidine. The intrinsic clearance of DEX estimated from the model ranged from 59 to 1536 l x h(-1), which overlapped with that extrapolated from in vitro data (12-261 l x h(-1)) and showed similar variation (26- vs. 21-fold, respectively). The inhibitory effect of quinidine ([I]/Ki) was 19 (95% confidence interval of mean: 18-20) with an estimated average Ki of 0.017 microM. Although DEX and DOR were both active, the potency of the antitussive effect of DOR was 38% that of DEX. A sustained antitussive effect was related to slow removal of DEX/DOR from the effect site (ke0 = 0.07 h(-1)). CONCLUSIONS: Physiologically based PK modelling with perturbation of metabolism using an inhibitor allowed evaluation of the antitussive potency of DOR without the need for separate administration of DOR.

Long-term effects of chemical weapons on respiratory tract in Iraq-Iran war victims living in Babol (North of Iran).

In the Iraq-Iran war (1981-1989), extensive use of chemical weapons such as mustard gas caused high mortality, morbidity, injuries, and chronic side effects in vital organs, especially the respiratory tract. This study was performed to evaluate the long-term effects on respiratory tract of victims. Two hundred and twenty victims were referred from the Mostazafan and Janbazan Foundation of Babol from 1994 to 1998. Complete histories, physical examinations, chest X-rays, and PFTs were performed. Nearly all the victims complained of cough, dyspnea, and suffocation. Hemoptysis was found in 6 victims. In 4 patients, respiratory distress with use of accessory muscles was observed. Two-thirds of the subjects had wheezing and coarse rale. For the other third, physical examination revealed no abnormal finding. Radiographic findings were mostly normal. Spirometry revealed an obstructive pattern in all patients and PFT revealed mostly normal and restrictive patterns. The shortlist time from exposure to study was 7 years and the longest was 13 years. Most patients reported mustard gas exposure and a few of them did not know what type of gas exposure they had. The clinical evaluations, radiography, and PFTs revealed that the most prevalent effects of chemical weapons on respiratory tract were chronic obstructive lung disease, presenting as many types of obstructive involvement.

An epidemiological study of poisoning in northern Islamic Republic of Iran.

We examined the causes and mortality of poisoning in the province of Mazandaran. In all, 1751 poisoning cases referred to four main hospitals over a three-year period (1997-2000) were included. More poisoning cases were females (55.5%) than males (45.5%) but the proportional mortality for males was greater than for females (65% versus 35%). The greatest proportion of poisonings occurred between the ages of 16 and 25 years. Most frequent was intentional poisoning, followed by accidental and occupational poisoning. Medicines were the most common cause, followed by chemicals such as pesticides. Poisoning by opiates, aluminium or zinc phosphide, rodenticides, petroleum and ethanol intoxication was also observed. Pesticide poisoning was most frequently fatal.

General practitioner prescribing patterns in Babol city, Islamic Republic of Iran.

To determine patterns of prescribing in Iranian primary care, we analysed 4000 randomly selected prescriptions from 52 general practitioners (GPs) in Babol city during 1999-2000. The mean number of drugs prescribed per encounter was 4.4 +/- 1.7, with 98% prescribed by generic name. The most commonly prescribed items were non-steroidal anti-inflammatory drugs (62.9% of encounters) and antibiotics (61.9%), followed by central nervous system drugs, gastrointestinal tract drugs, corticosteroids, vitamins and cardiovascular system drugs respectively. Injections were prescribed in 58.0% of encounters. Female and male doctors had significantly different antibiotic prescribing patterns. Our study confirms the tendency of GPs to overprescribe.

General practitioner prescribing patterns in Babol city, Islamic Republic of Iran

To determine patterns of prescribing in Iranian primary care, we analysed 4000 randomly selected prescriptions from 52 general practitioners [GPs] in Babol city during 1999-2000. The mean number of drugs prescribed per encounter was 4.4 +/- 1.7, with 98% prescribed by generic name. The most commonly prescribed items were non-steroidal anti-inflammatory drugs [62.9% of encounters] and antibiotics [61.9%], followed by central nervous system drugs, gastrointestinal tract drugs, corticosteroids, vitamins and cardiovascular system drugs respectively. Injections were prescribed in 58.0% of encounters. Female and male doctors had significantly different antibiotic prescribing patterns. Our study confirms the tendency of GPs to overprescribe

An epidemiological study of poisoning in northern Islamic Republic of Iran

We examined the causes and mortality of poisoning in the province of Mazandaran. In all, 1751 poisoning cases referred to four main hospitals over a three-year period [1997-2000] were included. More poisoning cases were females [55.5%] than males [45.5%] but the proportional mortality for males was greater than for females [65% versus 35%]. The greatest proportion of poisonings occurred between the ages of 16 and 25 years. Most frequent was intentional poisoning, followed by accidental and occupational poisoning. Medicines were the most common cause, followed by chemicals such as pesticides. Poisoning by opiates, aluminium or zinc phosphide, rodenticides, petroleum and ethanol intoxication was also observed. Pesticide poisoning was most frequently fatal

Adenosine receptor agents and conditioned place preference.

1. The effects of different doses of the adenosine agonists N5-ethylcarboxamido-adenosine (NECA), R-isomer of N6-phenylisopropyladenosine (R-PIA), and N6-cyclohexyladenosine (CHA) or of the antagonists theophylline and 8-phenyltheophylline (8-PT) on conditioned place preference (CPP) have been studied. 2. The results show that R-PIA and CHA induced conditioned place aversion (CPA) whereas NECA induced conditioned place preference (CPP). 3. Low doses of theophylline elicit CPP, but high doses of the drug induced CPA. 8-PT also produced the CPP. 4. The responses of R-PIA and CHA but not NECA was decreased by theophylline and 8-PT administration. 5. It is concluded that the induction of CPP an CPA by adenosine antagonsists may be mediated by different adenosine receptors.