Background: Previous studies have shown that morphine negatively effects male fertility while Phoenix dactylifera (dates) could cure male infertility by the exhibition of antagonist effects. This study was conducted to assess the possible ameliorating effects of dates on the histological features of morphine-induced male rat reproductive organs. Materials and Methods: Adult male Sprague Dawley rats age 7–9 weeks old, 200–250 g body weight (BW) were divided into six rats per each group: Group 1, force-fed with distilled water, 1 ml/kg BW for 35 days (control); Group 2, intramuscularly (IM) injected with morphine, 20 mg/kg BW for 7 days followed by force-fed with distilled water for 28 days; Group 3, force-fed with distilled water for 7 days followed by crude P. dactylifera extract, 200 mg/kg for 28 days; Group 4, injected (IM) with morphine, 20 mg/kg BW for 7 days followed by force-fed of crude P. dactylifera extract, 200 mg/kg for 28 days. Rats were sacrificed on day 36. The seminal vesicle (SV) and prostate gland (PG) were removed and fixed before histological processes. Results: In morphine-treated rats, the SV showed the absence of honeycomb-like appearance with flattened columnar cells while in the PG, eosinophilic secretion was noted to be absent from glandular lumina as compared to the control group. Administration of P. dactylifera extract in Group 4 showed improvement in histoarchitecture of the SV and PG with complex mucosal infoldings and glands luminal filled with secretion. Conclusion: P. dactylifera extract has a protective effect against the adverse effects of morphine on the male rat reproductive organs.

Background: Accumulating evidence suggests that diet is associated with kidney function. This study was carried out to examine the association between a posteriori dietary patterns and kidney function in older adults. Materials and Methods: In a cross-sectional study, 266 older adults, aged 60–83 years, were included. Anthropometric measures were recorded. Biochemical measurements of blood and urine samples were measured. Information on diet was collected using a validated semi-quantified food frequency questionnaire with 168 food items and factor analysis performed to derive major dietary patterns. Estimated glomerular filtration rate (eGFR) was calculated using the chronic kidney disease (CKD) Epidemiology Collaboration equation. Results: A total of 266 participants with mean body mass index (BMI) 29.75 ± 4.53 kg/m² and age, 66.2 ± 5.3 years, were included in the current study. Three major dietary patterns were identified using factor analysis based on intake data (28% of the total variance of food intake in the population). After adjustment for age, sex, BMI, and energy intake, we found a positive significant relationship between the first pattern and eGFR (P = 0.031). A positive significant association between adherence to the traditional dietary pattern and urine creatinine was also observed (P = 0.035). In addition, in logistic regression model and after control for covariates, a positive association was observed between adherence to traditional dietary pattern with odds of eGFR < 60 ml/min/1.73 m² (P = 0.043) and urinary albumin-to-creatinine ratio ≥ 30 mg/g (P = 0.038). Conclusion: It is concluded that higher adherence to the healthy dietary pattern may improve renal function while Iranian traditional pattern was associated with significantly increased odds of incident CKD and albuminuria.

Background: Primary tumor resection (PTR) in metastatic colorectal cancer (mCRC) has not been suggested by guidelines, since new systemic chemotherapy options have improved overall survival. However, the effect of PTR is still controversial in mCRC. In this study, we aimed to evaluate the effect of PTR on survival in unresectable mCRC. Materials and Methods: Two hundred and fifty-two patients with unresectable mCRC were screened retrospectively between January 2007 and December 2017 and a total of 147 patients who met inclusion criteria were included. The patients with emergency or elective PTR and the patients without surgery were compared for baseline features and overall survival. Results: The median follow-up time was 15.6 months (range; 1.2–78.9) in whole patients. There were 91 patients in nonsurgical (NS) group and 56 patients in PTR group. The median overall survival was significantly longer in PTR group compared NS group (21.8 vs. 17.0 months, P = 0.01), but it was not associated to better overall survival in multivariate Cox analysis (hazard ratio: 0.65, 95% confidence interval: 0.41–1.02, P = 0.06). There was no significant difference in overall survival between emergency and elective surgery subgroups (22.9 vs. 16.1 months, respectively, P = 0.9). Conclusion: PTR did not offer an overall survival benefit in this study. Although it is debated, we think that it is better to start treatment with chemotherapy and biological agent combinations in patients with asymptomatic mCRC. Thus, the patients can be protected from the morbidity and mortality of the surgery.

Background: Currently, it is shown that pregnancy may have an impact on the thyroid that can be leading to pregnancy complications such as abortion, preeclampsia, and preterm delivery. The objective was to compare the thyroid volume, number and characteristics of thyroid nodules, and prevalence of diffuse thyroid diseases in a sample of Iranian pregnant women in the first trimester to nonpregnant women. Materials and Methods: This case–control study was conducted on 298 pregnant and 290 nonpregnant women. Thyroid volume, maximum diameter of thyroid nodules and prevalence of moderate to highly suspicious thyroid nodules, Hashimoto's appearance and goiter were assessed using thyroid ultrasonography. Antithyroperoxidase (TPO) antibodies were measured if the sonographic features were highly suggested for Hashimoto's thyroiditis. Results: The mean of total thyroid volume in pregnant and nonpregnant women was 6 and 6.5 ml, respectively (P = 0.053), and the median (interquartile range) was 6.2 and 5.5, respectively. Nodules were observed in 16.4% of pregnant and 16.6% of nonpregnant women (P = 0.845). Hashimoto's thyroiditis was detected in 6.7% of pregnant and 12.4% of nonpregnant women (P = 0.013). Anti-TPO antibodies were detected in 5% of pregnant and 9.3% of nonpregnant women (P = 0.034). Conclusion: The thyroid volume and nodule characteristics in the first trimester of pregnancy were similar to nonpregnant women. Hashimoto's thyroiditis and anti-TPO antibodies in pregnant women were significantly lower than in nonpregnant women.

Background: There are no studies on the trend of gastric cancer (GC) incidence in Kurdistan, a province in the west of Iran. We aimed to estimate the trend, age-standardized incidence rate (ASR), and annual percentage change (APC) of GC in this province during 2001–2014. Materials and Methods: The data of newly diagnosed GC patients were obtained from the regional Cancer Registering Database. The ASRs were calculated per 100,000 population during 2001–2014. Direct standardization and 95% confidence intervals (CI) were calculated by an efficient method. The temporary changes in ASRs were determined based on the APC by the joinpoint regression model. Results: Overall, 2225 newly diagnosed GC patients were identified. The ASRs ranged from 13.5 (95% CI: 10.4–17.3) to 29.0 (95% CI: 24.5–34.0). The highest ASRs were related to the men and women lived in Divandareh as 32.26 and 13.66, respectively. The respective APC value of GC incidence in women demonstrated a nonsignificant increase during 2001–2008 and a nonsignificant decrease during 2008–2014 (P = 0.1). Accordingly, the incidence of GC in men increased during 2001–2004 (P = 0.1) and decreased during 2004–2014 (P = 0.001). Conclusion: The incidence of GC showed nonsignificant and significant decreasing trends in women and men in Kurdistan province, respectively. Despite such decreasing trends, the Kurdistan province is still considered as one of the regions with high incidence of GC in Iran. Therefore, it is necessary to implement screening programs in the province to early diagnose GC.

Background: Episiotomy is one of the most common surgical interventions performed to facilitate delivery. Anti-inflammatory and antibacterial effects of Persian oak (Quercus persica) and henna (Lawsonia inermis) have been proved in previous studies. The aim of this study is to evaluate the effect of Q. persica and L. inermis ointment on episiotomy wound healing in primiparous women and comparing it with placebo group. Materials and Methods: This was a double-blind clinical trial conducted on 160 primiparous women who underwent episiotomy. The cases were randomly selected and divided into four groups of forty patients including control, placebo, those who consume topical henna, and those who consume topical Persian oak ointment. Pain and recovery assessment was done at baseline and 7^th, 10^th, and 14^th days after birth and measured by Redness, Edema, Ecchymosis, Discharge, and Approximation (REEDA scale) and patients' pain intensity was also measured by a visual analog scale (VAS). The collected data were analyzed using Chi-square test, one-way ANOVA, and repeated measures ANOVA test by SPSS (version 22). Results: The results revealed that according to the reduced score of REEDA till the 14^th day after the delivery, the wound healing in the henna group and the oak group (−2.58 ± 0.29 and − 2.04 ± 0.31, respectively) was higher than the control and placebo groups (−1.62 ± 0.34 and − 1.95 ± 0.32, respectively) (P < 0.05). Furthermore, on the 14^th day, the mean VAS score was not significantly different between henna and oak groups (henna group: 2.58 ± 0.25 and oak group: 2.23 ± 0.18); however, both intervention groups had a significant difference with the placebo and control groups (P < 0.05). Conclusion: The findings showed that the use of henna and oak ointment improves episiotomy wound healing process, so it is recommended for primiparous women.