A novel mutation in CYP17A1 gene leads to congenital adrenal hyperplasia: A case report

Background: Congenital adrenal hyperplasia is a rare autosomal recessive disorder where the mutation in P450 family 17 subfamily A member 1 gene (CYP17A1) is involved in its etiology. The disorder represents itself with low blood levels of estrogens, androgens, and cortisol that generally couples with hypertension, Hypokalemia, sexual primary amenorrhea, infantilism and in affected individuals. Case: In this study, the CYP17A1 gene in a 14-year-old female was examined. The karyotype of the patient was 46, XX, and the analysis of the CYP17A1 gene by Sanger sequencing revealed a novel homozygous deletion c.1052-1054CCT which led to isolated 17,20-lyase deficiency. Conclusion: In conclusion, this study report an in-frame deletion which results in isolated 17, 20-lyase deficiency, and the mutation might be used for diagnosis in other patients with distinctive clinical symptoms

Prioritized Criteria for Casualty Distribution following Trauma-related Mass Incidents; a Modified Delphi Study

Introduction: In the aftermath of mass casualty incidents (MCIs), many decisions need to be made in a fast and influential manner in a high pressure environment to distribute the limited resources among the numerous demands. This study was planned to rank the criteria influencing distribution of casualties following trauma-related MCI. Methods: This study utilized a modified Delphi methodology, concentrating on extracted criteria attained from preceding systematic literature reviews. The 114 extracted criteria were classified into eight sections including space, staff, equipment, system and structures, triage, treatment, transport, and uncategorized criteria and were imported into an online survey tool. In the first round, experts were asked to rank each criterion on a five-point Likert scale. The second round incorporated feedbacks from the first round, stating percent and median scores from the panel as a whole. Experts were then called upon to reassess their initial opinions regarding uncertain remarks from the first round, and once again prioritize the presented criteria. Results: Fifty-seven criteria were regarded as relevant to the following sections: space: 70% (7/10); staff: 44% (4/9); system / structure: 80% (4/5); equipment: 39.1% (9/23); treatment; 66.7% (6/9); triage: 73.7% (14/19); transport: 38.7% (12/31) and other sections: 12.5% (1/8). The first round achieved nearly 98% (n=48) response rate. Of the 114 criteria given to the experts, 68 (almost 60%) were approved. The highest percentage of approval belonged to the system and structures sections (4/5=80%). The response rate for the second round was about 86% (n=42). A consensus could be reached about nearly 84% (57) of the 68 criteria presented to experts. Conclusion: "Casualty Level of Triage on the Scene" and "Number of Available Ambulances" were the two criteria that obtained the highest level of consensus. On the other hand, "gender of casualty", "Number of Non-Medical staff in each Hospital" and "Desire to transport family members together" got lowest level of consensus. This sorted list could be used as a catalogue for developing a decision support system or tool for distribution of victims following mass casualty incidents. KEYWORDS:Mass casualty incidents; decision making; supply and distribution; wounds and injurie

Fetal radiation doses and subsequent risks from X-ray examinations: Should we be concerned?

Background: Pregnant women are sometimes exposed to ionizing radiation in radiology examinations for various reasons. In such cases, the radiation dose to the conceptus and subsequent risks should be estimated.\ud Objective: The purpose of this study was the calculation and presentation of fetal dose and subsequent risks resulted from different X-ray examinations.\ud Materials and Methods: An analytical simulation study was conducted and six common radiographies in different views and three types of special examinations were evaluated. The entrance skin exposure (ESE) was measured using a solid-state dosimeter. A Monte Carlo program was used in order to simulate different views of X-ray examinations and calculate the radiation doses received by the conceptus for every view of each examination. Then the risk of childhood cancer and small head size were calculated for different radiographies.\ud Results: The fetal doses and consequence risks of the small head size and childhood cancer for the radiographs of chest, skull, and sinuses were negligible but the risks of childhood cancer and small head size due to radiographies of abdomen, lumbar spine, and pelvis areas were ponderable.\ud Conclusion: Results of this study can be used for the pregnant women radiographies manageme

Borzuya, The physician: A curriculum output of Khosravani Education

Introduction: Borzuya, the physician, a sage as well, is one of the prominent figures of Shahnameh in Sassanid era especially in Nushirvan court. In seeking of the immortality tree, he made a voyage to India. Such a burden to bear for memorization and its translation to Pahlavi and then dedication the work made him immortal owing to the allocation of the first chapter as Borzuya, the sage. Methods: Regarding a method fusion of history, analysis, and education, the germane sources were reflected upon and some presuppositions were critically pondered as the similarity of Borzuya and Bozorgmehr. However, these names are two distinguished figures in Shahnameh, a physician and a minister, respectively. Regarding, the concept of development is not allocated to one facet, but it is multifaceted. Also it must be noted that the true outreach won’t come but with comprehensive and true thinking, design, edit, execution and assessment. Results: First, the education of Ancient Persia is categorized as an educational archetype due to interaction of Iranian civilization with its east and west civilizations. Second, the educational implications of Shahnameh can be represented in different levels; basic (art and wisdom education) and supreme (intuition and immortality education). Conclusion:  One of the principles of education including medical education is allocated to the role model presentation for the students. Owing to the personality of Bozuya who was a famous physician and furthermore he was an expert in philosophy, linguistics, literature, and logic, he can be presented as an appropriate role model for any contemporary learner

The Prevalence of Intestinal Parasites in Children Attending Day–Care Centers in Yazd City, Iran

Introduction: Intestinal parasitic infections are very common in developing countries and affect mostly children. Day care centers are places where children are more susceptible to acquire intestinal parasites. Material and Methods: This cross-sectional study was conducted to determine the prevalence of intestinal parasites among children who attend to day care centers in Yazd city. Eighty hundred children under six years old were selected by cluster sampling. Fresh faecal samples were collected from each child and examined by direct wet mount and formalin-ether techniques. Demography data and anthropometric indicators of children were also recorded. The obtained data were analyzed using SPSS software. Results: In total 10 % of children harbored at least one type of intestinal parasite. The rates of infection were as follows: Blastocystis hominis 2.8%, Giardia lamblia 2.8%, Entamoeba coli 1.1%, Chilomastix mesnili 1.7%, Dientamoeba fragilis 1.1.%. Infection rate in male was 12.9% and in female it was 6.9%. The relationship between sex, age, anthropometric indicators, and parasitic infection was not statistically significant. A statistically significant difference was observed between infection, parents’ education and mothers' job (P<0.005). Conclusion: The results of this study, showed a considerable decrease in the rate of intestinal parasitic infections in comparison with other studies. This may be owing to the improvements in personal environment, and health which have occurred through public education campaigns, health information raising, sanitation facilities improvement, proper waste and wastewater disposal, control of drinking-water, and food safety

Basic Sciences Faculties’ Teaching Quality Questionnaire Evaluation: the Case of English Credit

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Depressive Symptom Level, Sleep Quality, and Internet Addiction among Medical Students in Home Quarantine during the COVID-19 Pandemic

The COVID-19 pandemic has a major impact on the mental health of people around the world. Due to the possible impact of quarantine conditions on mental health, we decided to assess internet addiction, depressive symptom level (DSL), and sleep disorders among medical students during the quarantine of COVID-19. This cross-sectional study was performed among medical students during the COVID-19 quarantine in Iran. Participants were selected using the available sampling method. Sleep quality, internet addiction, and depression were assessed using an online survey of the Pittsburgh Sleep Quality Index (PSQI), Internet Addiction Test (IAT), and Patient Health Questionnaire-9 (PHQ-9), respectively. Also, sociodemographic data including age, gender, marital status, smoking status, living circumstances, and educational status were asked. Participants were asked to share the link in their class social media groups. SPSS (version 16) was used for statistical analysis. Students participated; 64.9% of whom were female (n=564), and the mean age of participants was 21.3 years. 74.1% of students’ educational status was not mainly clinical. 48.2%, 28.6%, and 27.1% had poor sleep quality, DSL, and internet addiction, respectively. Smoking (AOR: 3.49, 95% CI: 1.56-7.76), living with family (AOR: 1.75, 95% CI: 1.16-2.66), and using social media for more than 2 hours were defined as predictive factors for depression. 165 participants (19%) were diagnosed with both poor sleep quality and DSL. There was a positive correlation between PSQI and PHQ-9 (r: 0.51, P value <0.001). A positive correlation was observed between IAT and PHQ-9 (r: 0.56, P value <0.001). The rate of DSL, internet addiction, and poor sleep quality were increased and strong correlations between them were concluded. Variables of gender, GPA, and smoking status were the most important associated variables