Purpose: The aim of the study was to elucidate the prognostic impacts of pretreatment hematology markers, such as neutrophil-to-lymphocyte ratio (NLR), albumin (ALB), carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) in esophageal cancer (EC) patients. 
Methods: Data of 127 esophageal cancer patients who didn’t receive chemotherapy between 2015 and 2017 were retrospectively documented. Based on the optimal cut-off value of NLR and ALB identified by generating receiver operating characteristics (ROC) curve, we classiŸed the patients into two groups respectively. The clinicopathological parameters were compared between the two groups of NLR and ALB. 
Results: Kaplan-Meier analysis demonstrated overall survival (OS) was significantly longer in NLR<1.992 group than NLR≥ 1.992 group (31 months vs. 13 months, P < 0.001) and in ALB≥39.95 g/L group than ALB<39.95 g/L group (31 months vs. 15 months, P = 0.002). NLR and ALB were independent prognostic factors for OS in the multivariate Cox regression model (HR = 2.82, 95%CI: 1.59-5.01, P < 0.001 for NLR; HR = 0.59, 95%CI: 0.3-1.01, P = 0.055 for ALB). 
Conclusion: Pretreatment NLR and ALB could be independent prognostic biomarkers for OS in esophageal cancer patients.

Purpose: This study aimed to assess socio-economic status (SES) and psychological factors affecting maternal lifestyle and its correlation with adverse pregnancy outcomes among pregnant women. 
Methods: This prospective cross-sectional study was conducted in Tehran from August 2016 to July 2017. 400 eligible vulnerable pregnant women living in five poor regions of Tehran and attending referral hospitals for prenatal care were randomly selected. Data was collected through personal interviews, anthropometric measures, and medical records at 26-30 gestational weeks. 
Significant findings: There was a high prevalence of obesity (43.8%) among vulnerable women. Women with lower education level and income was significantly associated with more than 5-7 daily serving carbohydrate, sedentary life (OR = 2.25, 95%CI: 0.93-4.57) and being obese (OR = 2.01, 95%CI: 0.4-3.30). Participants with lower income was significantly associated with ≥ 5-7 daily serving carbohydrate (OR = 2.81, 95%CI: 0.002-5.4) and sedentary life. Also, higher perceived stress are positively associated with ≥5-7 daily serving carbohydrate, more intake of caffeine, and smoking compared to mothers with lower psychosocial score. Unhealthy lifestyle, higher body mass index (BMI) and lower social support were significantly associated with risk of maternal and neonatal complications. 
Conclusion: Multiple unhealthy lifestyles during pregnancy were consistently associated with SES and increased risk of adverse perinatal outcomes.

Objective: To investigate whether there is a correlation between nonalcoholic fatty liver disease (NAFLD) and arrhythmia on electrocardiogram. 
Methods: A retrospective controlled study was performed on the electrocardiogram of 200 patients admitted to our department of cardiology. The study excluded patients with smoking history, drinking history, congenital heart disease, and malignant tumors. According to the ultrasound examination criteria, NAFLD was diagnosed by abdominal ultrasound examination and electrocardiogram (ECG) examination, which was analyzed by cardiovascular experts to assess NAFLD and baseline characteristics, clinical features, drug use, and arrhythmia ECG changes by univariate logistic regression analysis. Multivariate logistic regression was used to determine whether NAFLD is one of the most important factors affecting arrhythmia.
Results: Of the 200 patients, 116 were found to have NAFLD and 84 were without NAFLD. Among them, a total of 91 arrhythmias occurred in 76 patients, as follows: 30.2% (23 cases) sporadic atrial premature beats, 51.3% (39 cases) occasional ventricular premature beats, 19.7% (15 cases) frequent ventricular premature beats, 10.5% (8 cases) multi-source atrial premature beats complicated with short-term atrial tachycardia, 3.9% (3 cases) atrial fibrillation and 3.9% (3 cases) short-term ventricular tachycardia. Univariate logistic regression analysis found that including gender (male), coronary artery disease, hypertension, diabetes, arrhythmia ECG changes (occasion of premature atrial premature beats, occasional premature ventricular contractions, frequent ventricular premature beats, multi-source atrial premature beats Short-term atrial tachycardia, atrial fibrillation, and short-term ventricular tachycardia were positively correlated with NAFLD. Five risk factors for the following arrhythmias were identified using multivariate regression model analysis: NAFLD (OR = 2.35; 95%CI: 1.46-3.83, P < 0.001), coronary artery disease (OR = 2.56; 95%CI: 1.58-4.11, P < 0.001), hypertension (OR = 2.98; 95%CI: 1.52-6.31, P < 0.001), male (OR = 1.78; 95%CI: 1.18-2.70, P < 0.001) and age (OR = 1.04; 95%CI: 1.02-1.06, P < 0.001). 
Conclusion: NAFLD is associated with arrhythmia ECG changes.

Purpose: This study was conducted to determine the direct effect of vitamin D (vit-D) on mononuclear cells of the blood, mainly T-lymphocytes, in allergic asthma and healthy subjects. 
Materials and methods: Isolated peripheral blood mononuclear cells from patients and healthy people were cultured 24-hours in 4 groups of treated with vit-D at 10-7 M, 10-6 M concentrations, dexamethasone, and control. Aer extraction of RNA, their cDNA was used for evaluating Foxp3 and RORγt genes expression by Real-time PCR technique. 
Results: There was a significant difference between the control group and the asthma group in terms of FOXP3 expression (P = 0.019). The treatment with dexamethasone significantly increased the expression of FOXP3 gene of the patient with no treatment (P = 0.023) and treatment with vit-D 10-7 M significantly reduced the FOXP3 gene expression in the same group (P = 0.027). There was no significant difference in RORγt gene expression between case and control groups (P = 0.805). All treatments significantly reduced RORγt gene expression in both case and control groups (P < 0.001). 
Conclusion: Vit-D decreased the expression of FOXP3 and RORγt genes. As RORγt gene increases the severity of the disease, then vit-D can improve the course of the disease.

Aim: The aim of the present study was to assess the relationship of sexual dysfunctions (SD) and mental health among young males was conscripted into the military service in Iran. 
Methods: This cross-sectional study was conducted on the married male aged above 18 years who were conscripted into the military service in Iran from January 2015 to March 2016. Military service is mandatory for all Iranian males. The data were obtained using demographic data questionnaire, a questionnaire evaluating male sexual function index (IIEF), and general health questionnaire (GHQ-28). 
Results: This sample consisted of 300 Iranian males conscripted to the military service. The mean (±SD) age of the participants was 23.10 (±2.69) years. The mean of Overall sexual dysfunction (SD) was 43.11 (±16.24). Mean scores for items on the ED ranged from 0 to 30, with an overall mean total score of 17.16 (±7.23). Correlation analyses showed that there was a negative relationship between SD and the somatic symptoms, anxiety, and insomnia and depression. Conclusion: High prevalence rates in SD among young males conscripted in military service in Iran. Also, young males conscripted in military service with physical and mental health disorder diagnoses had an increased risk of receiving an SD diagnosis.

Objective: To investigate the effectiveness and clinical value of preoperative femoral nerve block in relieving pain of femoral neck fracture in the elderly patients. Methods: A total of 186 patients who underwent surgical treatment for femoral neck fractures in our hospital from January 2012 to December 2016 were randomly divided into intervention group (treated with femoral nerve block, 95 cases) and control group (treated with oral opioid drugs, 91 cases), and the visual analogue scale (VAS) was used to assess the degree of pain relief at each time point after treatment. 
Results: A total of 186 patients were enrolled in the study, with an average age of (78.31 ± 6.44) years, of which 54.84% were women. Compared with the control group, the VAS score of the intervention group was significantly lower than that of the control group at the 12th hour after treatment, and the two groups were statistically significant (P < 0.05). The VAS score of the intervention group decreased from baseline to 12 hours after surgery. The value was also significantly higher than that of the control group (P < 0.05). The opioid analgesic dose in the intervention group was significantly lower than that in the control group, and the two groups were statistically significant [(2.3 ± 4.0) mg vs. (5.7 ± 5.2) mg, P < 0.001]. 
Conclusion: Preoperative femoral nerve block can relieve pain of elderly patients with femoral neck fracture and reduce the dose of opioids. Femoral nerve block may be a feasible analgesia for patients with femoral neck fracture in the elderly patients.

The medical instrument is one of the first tools that human make it to relieve of pain. Medical also is the ancient human practice which has been developed by trial and error, and transfer of scientific knowledge of research and innovation in this area. The medical instruments in the Qajar period was simple but had a good shape with different patterns. The use of art in traditional medicine devices was a healing and learning approach and provided solace in the patient. Our aim is to show the relation between medical and art and the influence of art in medicine. This study also aims to understand the companionship of traditional arts and ancient medical instruments and to rehabilitate them. In addition, the construction, decorations and forms of medical tools in Qajar period have been reviewed. In this paper, related documents have been collected based on observation in medical instruments available in Tehran museums and libraries. The design and metal carving patterns on these instruments may cause a mental and spiritual aspect and feel of peace in the patient.

The aim of root canal treatment was to clean the resident microbiota through proper shaping, disinfection and obturation of the root canal system in order to achieve periapical healing, Calcification of the pulp chamber and root lumen can compromise access and thus complicate the root canal therapy. The process of calcific metamorphosis, also known as root canal obliteration was very common in elder people or young permanent teeth with trauma. With the help of dental operating microscope (DOM), ultrasonic techniques, C-Pilot files, ethylenediaminetetraacetic acid (EDTA), and other novel instruments, it became possible to locate the canal orifices and negotiate the root cavity in severe calcified root canal systems, leaving the dentist with a promising technical prospect of clinical skills. Accordingly, it is necessary to get known to different clinical techniques, choose selectively in different cases, that may led to good results, even in difficult situation.

Aim:  The aim of this case report was to report the clinical characteristics of post-surgical pyoderma gangrenosum aer cesarean section in a patient with Behçet's disease. 
Case report: The patient was a 34-year old woman, who has been suffering from Behçet's disease, but she didn’t know that she was affected. So she didn’t give us any history of her previous complications at the admission time, and at first we misdiagnosed the presentations of pyoderma gangrenosum with wound infection and necrotizing fasciitis. But with emerging pathergy phenomenon in her legs, and by taking a more accurate and careful history we recognized the signs of Behçet's disease in her history, which was established with histopathological findings and positive HLA-B5. After starting hydrocortisone all the signs and symptoms were disappeared, and the patient was discharged with oral methylprednisolone without any remarkable complication. 
Conclusion:  The diagnosis of post-surgical pyoderma gangrenosum can be difficult, and it should be considered in patients with unexplained skin dehiscence with negative microbial culture.

A 67-year-old man presented with asymptomatic gross hematuria for one year. The results of routine laboratory examinations and urinalysis suggested that mild anemia, hematuria and urinary tract infection. An enlarged right kidney was found by abdominal enhanced computed tomography (CT) and magnetic resonance imaging scan, which revealed inhomogeneous enhanced renal masses in the upper pole and pelvis of right kidney with extension into the right renal vein and inferior vena cava (IVC). Chest CT showed several nodular masses. According to the radiographic imaging findings, we suggested the diagnosis to be metastatic renal carcinoma with extension to renal pelvis, vein and IVC. Then, the patient underwent open right radical nephrectomy and thrombectomy without regional lymphadenectomy. The pathologic report was consistent with a high-grade urothelial carcinoma, with squamous epithelial differentiation involving the renal vein and IVC. Thus, this was a rare case of upper tract urothelial carcinoma (UTUC). To our knowledge, this is one of 51 UTUC with venous invasion reported worldwide.