Spontaneous bilateral avascular necrosis of knees and hip leading to early bilateral total hip arthroplasty: a case report of an 18-year-old man recently diagnosed with Crohn's disease.

Avascular necrosis (AVN) is linked to considerable morbidity, resulting in severe pain and functional impairment. Herein, for the first time, we reported an 18-year-old patient with Crohn's disease during the remission phase under Azathioprine therapy who presented with articular pain. Although no underlying risk factors, the patient was diagnosed with severe AVN of the bilateral femoral head and both knees simultaneously following pain in involved areas. This case highlights the importance of demand multidisciplinary approach to chronic disease. Moreover, clinicians should be aware of articular manifestations in IBD patients to diagnose and treat these conditions as soon as possible. Patients should be evaluated for their psychologic, gastrointestinal, and extra-gastrointestinal comorbidities during each follow-up visit.

Ethical Considerations in Sexual Health Research: A Narrative Review.

BACKGROUND: There is an assumption that sexual health research has great influence on the quality of human life through elevating sexual health standards, and their results will eliminate the burden of sexual health challenges on family relationships. The aim of this study was to review ethical considerations in sexual health research. MATERIALS AND METHODS: This narrative review was conducted between January 1990 and December 2017 based on the five-step approach of York University. The keywords used to search for the studies included ethical issues, research, sexual health, reproductive health, and sensitive topics. The language of the literatures was English and the search process was performed on PubMed, Elsevier, Ovid, Springer, Google Scholar, ResearchGate, SAGE Publishing, ProQuest, WHO website, Kinsey Confidential, and Worldsexology. RESULTS: After assessing the quality and eligibility of 94 articles, 13 were selected. The results of the present study showed that the most important ethical considerations were protecting the confidentiality and privacy of participants, obtaining informed consent, and paying attention to vulnerable people. CONCLUSIONS: The review of literature exhibited several considerations that sexual health researchers are faced with. In order to manage these considerations, the researcher should have sufficient understanding of them. The important matter is that strategies to manage these challenges should be completely rational and practical according to each context. These strategies can also be applied in other societies with great similarities in their context.

Histological Study of Bone Marrow and Umbilical Cord Stromal Cell Transplantation in Regenerating Rat Peripheral Nerve.

OBJECTIVE: Bone marrow and umbilical cord stromal cells are multipotential stem cells that have the ability to produce growth factors that play an important role in survival and generation of axons. The goal of this study was to evaluate the effects of the two different mesenchymal stem cells on peripheral nerve regeneration. MATERIALS AND METHODS: In this experimental study, a 10 mm segment of the left sciatic nerve of male Wistar rats (250-300 g) was removed with a silicone tube interposed into this nerve gap. Bone marrow stromal cells (BMSCs) and human umbilical cord stromal cells (HUCSCs) were respectively obtained from rat and human. The cells were sepa- rately cultured and transplanted into the nerve gap. The sciatic nerve regeneration was evaluated by immunohistochemistry, and light and electron microscopy. Moreover, histo- morphology of the gastrocnemius muscle was observed. RESULTS: The nerve regeneration in the BMSCs and HUCSCs groups that had received the stem cells was significantly more favorable than the control group. In addition, the BM- SCs group was significantly more favorable than the HUCSCs group (P<0.05). CONCLUSION: The results of this study suggest that both homograft BMSCs and het- erograft HUCSCs may have the potential to regenerate peripheral nerve injury and transplantation of BMSCs may be more effective than HUCSCs in rat.

A constitutive model for mechanical response characterization of pumpkin peel and flesh tissues under tensile and compressive loadings.

Enhancing quality of food products and reducing volume of waste during mechanical operations of food industry requires a comprehensive knowledge of material response under loadings. While research has focused on mechanical response of food material, the volume of waste after harvesting and during processing stages is still considerably high in both developing and developed countries. This research aims to develop and evaluate a constitutive model of mechanical response of tough skinned vegetables under postharvest and processing operations. The model focuses on both tensile and compressive properties of pumpkin flesh and peel tissues where the behaviours of these tissues vary depending on various factors such as rheological response and cellular structure. Both elastic and plastic response of tissue were considered in the modelling process and finite elasticity combined with pseudo elasticity theory was applied to generate the model. The outcomes were then validated using the published results of experimental work on pumpkin flesh and peel under uniaxial tensile and compression. The constitutive coefficients for peel under tensile test was α = 25.66 and ß = -18.48 Mpa and for flesh α = -5.29 and ß = 5.27 Mpa. under compression the constitutive coefficients were α = 4.74 and ß = -1.71 Mpa for peel and α = 0.76 and ß = -1.86 Mpa for flesh samples. Constitutive curves predicted the values of force precisely and close to the experimental values. The curves were fit for whole stress versus strain curve as well as a section of curve up to bio yield point. The modelling outputs had presented good agreement with the empirical values and the constructive curves exhibited a very similar pattern to the experimental curves. The presented constitutive model can be applied next to other agricultural materials under loading in future.

The Relationship between Severity of Premenstrual Syndrome and Psychiatric Symptoms.

OBJECTIVE: Premenstrual syndrome is a common disorder experienced by up to 50% of women during reproductive age. The prevalence of severe form of PMS (PMDD) is 3% to 8 %. Psychiatric disorders in PMS patients have resulted in significant morbidity and in some cases caused resistance to the treatment process. MATERIAL AND METHOD: 390 participants (264 with PMS/PMDD, and 126 healthy students of University of Guilan) who completed the demographic questionnaire, daily symptom rating (DSR) and the checklist 90-revised (SCL-90-R) took part in this study. This study was conducted using a cross sectional method. RESULTS: According to repeated measure variance, the mean scores of psychiatric symptoms (Depression, Anxiety, Aggression, Interpersonal sensitivity) in the PMS group were significantly higher than the healthy group (p< 0/05), and increase in severity of PMS from mild to severe was accompanied by increase in mean score of these subscales. There was a significant difference in mean score of depression, anxiety, aggression and interpersonal sensitivity between the 3rd and the 13th day of the cycle. Significant effect of the DSR grouping (PMS and Healthy group) and time interaction emerged in interpersonal sensitivity and aggression, significant effect on the DSR grouping (Mild, Moderate, Severer) and time interaction demonstrated in interpersonal sensitivity. CONCLUSION: Patients with prospective confirmed PMDD seemed to suffer from psychiatric symptoms. Therefore, recognizing co-morbid psychiatric symptoms in patients with PMDD is of prime importance. All healthcare providers should be sensitive to mental status of women with PMS.

BD PuraMatrix peptide hydrogel as a culture system for human fetal Schwann cells in spinal cord regeneration.

BD PuraMatrix peptide hydrogel, a three-dimensional cell culture model of nanofiber scaffold derived from the self-assembling peptide RADA16, has been applied to regenerative tissue repair in order to develop novel nanomedicine systems. In this study with PuraMatrix, self-assembling nanofiber scaffold (SAPNS) and Schwann cells (SCs) were isolated from human fetal sciatic nerves, cultured within SAPNS, and then transplanted into the spinal cord after injury (SCI) in rats. First, the peptide nanofiber scaffold was evaluated via scanning electron microscopy and atomic force microscopy. With phase-contrast microscopy, the appearance of representative human fetal SCs encapsulated in PuraMatrix on days 3, 5, and 7 in 12-well plates was revealed. The Schwann cells in PuraMatrix were cultured for 2 days, and the SCs had active proliferative potential. Spinal cord injury was induced by placing a 35-g weight on the dura of T9-T10 segments for 15 min, followed by in vivo treatment with SAPNS and human fetal SCs (100,000 cells/10 µl/injection) grafted into spinal cord 7 days after SCI. After treatment, the recovery of motor function was assessed periodically using the Basso, Beattie, and Bresnahan scoring system. Eight weeks after grafting, animals were perfusion fixed, and the survival of implanted cells was analyzed with antibody recognizing SCs. Immunohistochemical analysis of grafted lumber segments at 8 weeks after grafting revealed reduced asterogliosis and considerably increased infiltration of endogenous S100(+) cells into the injury site, suggesting that PuraMatrix may play an important role in the repair observed after SAPNS and human fetal SC transplantation.

The effects of schwann and bone marrow stromal stem cells on sciatic nerve injury in rat: a comparison of functional recovery.

OBJECTIVE: Transplantation of bone marrow stromal cells (BMSCs) or Schwann cells (SCs) can facilitate axonal regeneration in peripheral nerve injuries. The aim of this study was to compare the effects of transplantation of BMSCs and SCs on functional recovery after injury to the sciatic nerve in the rat. MATERIALS AND METHODS: In this experimental research, adult male Wistar rats (n=24, 250-300 g) were used, BMSCs and SCs were cultured, and SCs were confirmed with anti S100 antibody. Rats were randomly divided into 3 groups (n=8 in each group): 1; control group: silicon tube filled with fibrin gel without the cells, 2; BMSCs group: silicon tube filled with fibrin gel seeded with BMSCs and 3; SCs group: silicon tube filled with fibrin gel seeded with SCs. The left sciatic nerve was exposed, a 10 mm segment removed, and a silicone tube interposed into this nerve gap. BMSCs and SCs were separately transplanted into the gap in the two experimental groups and were labeled with anti BrdU and DiI respectively. After 12 weeks electrophysiological and functional assessments were performed and analyzed by one-way analysis of variance (ANOVA). RESULTS: Electrophysiological and functional assessments showed a significant difference between the experimental groups compared with the control group. Electrophysiological measures were significantly better in the SCs transplantation group compared with the BMSCs treatment group (p <0.05). Functional assessments showed no statistically significant difference between the BMSCs and SCs groups (p <0.05). CONCLUSION: Although both BMSCs and SCs have the potential to produce functional recovery after injury to the sciatic nerve in rats, electrophysiological evaluation confirms that the improvement after SCs transplantation is greater than that after BMSCs transplantation.

Depression and Anxiety in a Cardiovascular Outpatient Clinic: A descriptive study.

OBJECTIVE: Cardiac diseases are psycho-somatic disorders, and psychological aspects play an essential role in their initiation and exacerbation. The aim of this study was to gain appropriate knowledge in the epidemiology of co-morbid depression and anxiety disorder in cardiovascular outpatients. METHOD: This study is descriptive with a sample of patients attending a cardio-vascular clinic. 238 individuals were included in this study using a consecutive sampling method. The study instrument was Hospital Anxiety and Depression Scale (HADS) questionnaire, which is a clinical scale for assessing anxiety and depression. RESULTS: Of the 238 participants in this study, 93(38.7%) were male and 146 (61.3%) female. 28.5% of patients suffered from anxiety disorders, and 41.9% had depression. Regarding comorbid diseases such as diabetes mellitus, hyperlipidemia and hypertension, the severity of depression was just related to hypertension. There was a meaningful relationship between gender and symptoms of anxiety so that symptoms were more severe in women. CONCLUSION: Considering the high prevalence of depression and anxiety in patients suffering from cardio-vascular diseases, it is necessary to screen psychological disorders in patients with cardio-vascular diseases and improve their cardio-vascular health and quality of life as mush as possible.