Showing 19 results for Arabi
Razmpa E, Sadeghi Hasanabadi. M, Asefi N, Arabi M,
Volume 65, Issue 2 (8 2008)
Abstract
Background: Thyroid cancer is a rare disease which includes less than 1%
percent of all human cancers. The aim of this study is to evaluate the
demographic characteristics and risk factors among patients with thyroid
malignancy at the Cancer institute and Imam Khomeini hospital in Tehran
Iran.
Methods: This is a retrospective descriptive study of the charts of 320
patients admitted with the diagnosis of thyroid malignancy based on
pathologic reports in the above- mentioned hospitals from 1992 to 2002.
Results: From the 320 patients diagnosed with thyroid malignancy 68.1%
were papillary cancer, 10.9% were follicular cancer, 10.6% were anaplastic
cancer, 9.06% were medullary cancer and 1.2% were lymphoma.
The average of the patients was 50.2 years, ranging from 12 to 98 years
60.6% were female and 39.4 %were male 22.8% of the patients had
histories of thyroid nodule and 5% had received radiation therapy.
From the anatomic point of view 57.5% of the cancers were in the right lobe
of thyroid, 38.1% were in left lobe and 4.4% in the isthmus. None of the
patients had positive family history of thyroid malignancy.
Conclusion:
Thyroid malignancy is more prevalent in the fifth decade of life and more
common among females. Therefore, among patients in this group, alarming
symptoms, such as anterior neck mass, thyroid nodule and voice change,
should be evaluated more seriously.
Aarabi M.u, Meraji M, Mortezaeian H,
Volume 65, Issue 4 (3 2007)
Abstract
Background: Tetralogy of Fallot is the most common cyanotic congenital heart disease. The systolic and diastolic function in both ventricles is altered even after successful corrective surgery for this defect with a transannular patch. Pulmonary regurgitation, a common complication after this treatment, is usually well tolerated in childhood. The aim of this study was to assess the combined diastolic and systolic function of both ventricles using the Doppler-derived myocardial performance index (Tei index) in patients who underwent surgical repair of tetralogy of Fallot using a transannular patch. In this article we discuss the impact of pulmonary regurgitation on right ventricular function and clinical outcome, the role of echocardiographic imaging, and current management strategies for patients with pulmonary regurgitation after this treatment.
Methods: Sixty eight patients with tetralogy Fallot were studied in Shahid Rajaie referral Cardiovascular Center during 2003-2005. The studied population, 36 male and 32 female with a mean age of 7.5±4 years and a history of corrective surgery for tetralogy of Fallot using a transannular patch. These patients were randomly selected and assessed by Doppler echocardiography.
Results: Fifty-seven patients (84%) had mild to moderate pulmonary regurgitation, whereas 11 patients (16%) had severe pulmonary regurgitation. Right ventricular Tei index was significantly increased in patients with severe pulmonary regurgitation compared those with mild to moderate pulmonary regurgitation (0.54±0.18 vs 0.24±0.11, P<0.01). Left ventricular Tei index was increased in patients with severe pulmonary regurgitation compared those with mild to moderate pulmonary regurgitation (0.46±0.22 vs 0.32±0.14, P<0.05).
Conclusions: The findings of this study suggest that pulmonary regurgitation is a serious complication after repair of tetralogy of Fallot with a transannular patch. Delaying surgery in such patients risks irreversible ventricular function.
Darabi M.a, Mireskandari S.m, Sadeghi M,
Volume 65, Issue 6 (3 2007)
Abstract
Background: Invasive procedures such as bone marrow aspiration in children with oncologic malignancies are painful and may produce anxiety for both patients and their parents. Various pharmacologic treatments have been used to sedate children undergoing bone marrow aspiration. This prospective randomized study was designed to compare the effectiveness of these combinations, as well as their associated hemodynamic and respiratory side-effects and recovery in pediatric patients undergoing bone marrow aspiration.
Methods: Fifty children with oncologic malignancies whose ages ranged between 2-12 years were enrolled in this study. Patients were randomly assigned either to the Propofol- Alfentanyl group or the Midazolam- Ketamine group for analgesia and sedation during bone marrow aspiration in the operating room. Time to induce sedation, sedation score and recovery time were recorded.
Results: There were no statistical differences between groups in weight, age, sex and duration of procedures. Procedures were completed with satisfactory sedation levels in all patients in the study groups according to the modified Ramsay score. Induction and recovery times in the Propofol- Alfentanyl group were significantly shorter than in the Midazolam- Ketamine group (p<0.001). After Midazolam- Ketamine sedation, a statistically significant increase in systolic blood pressure and heart rate were seen, however the opposite was observed after Propofol- Alfentanyl sedation. Other side effects, such as nausea and vomiting, agitation myoclonus and aspiration, were not seen in our patients.
Conclusion: Both Propofol- Alfentanyl and Midazalam-Ketamine combinations can be used safely and effectively for sedation and analgesia during bone marrow aspiration in the pediatric patient group.
Noorbakhsh S, Shekarabi M, Kalbasi Z, Tabatabaei A, Tonekaboni H, Afsharkhas L, Vafaei-Shahi M,
Volume 68, Issue 5 (6 2010)
Abstract
Background: M. pneumoniae infection in children is usual and diagnosis of its neurologic complications for rapid treatment is very important. To compare the CSF- M. pneumoniae antibody level between febrile children with acute neurologic signs (Menigoencephalitis, Guillan Barre Syndrome (GBS), Transverse myelitis, Ataxia and so on) with unaffected ones.
Methods: A cross sectional/ case control study in pediatric wards of Rasoul-e-Akram & Mofid hospitals (2007-2009) was done. The amount of Specific M. pneumoniae IgG (ELISA) antibody level determined in CSF of 55 cases and in 10 controls. Chi square values (CI 95%, p< 0.05) calculated for all categorical variables. Sensitivity specificity Positive Predictive Value (PPV) Negative Predictive Value (NPV) of CSF antibody level determined by using the Area under the ROC Curve.
Results: Cases (n= 55) aged between five month to 13 years with mean age of 3.84±3.43 years. Area Under Curve (AUC) in ROC was 0.876 (%95 CI, 0.78- 0.96 p< 0.0001). Cut off level for antibody was 0.0025 with 73% sensitivity 90% specificity 100% PPV 28.8% NPV. CSF antibody level had significant difference between cases and controls [0.08± 0.26 Versus 0.001± 0.001 p: 0.02] It had poor agreement between cases and controls (Kappa= 0.27). Lowest amount seen in cases with aseptic meningitis highest amount observed in cases with GBS and cases with focal neurologic signs.
Conclusion: The presence of very low amount (0.0025) of M. pneumoniae antibody in CSF of febrile children with acute neurologic signs had 70% sensitivity and 90% specificity 100% PPV but had low (28.8%) NPV. M. pneumoniae would be a rare cause in cases with aseptic meningitis. Finding the M. pneumoniae-DNAs in CSF are not so frequent (2%) but in high suspicious cases adding this test to determining the CSF antibody level might be helpful.
Mortezaeian Langroodi H, Rad Goodarzi M, Nakhostin Davari P, Shahmohammadi Aa, Mearaji Sm, Aarabi Moghadam My,
Volume 68, Issue 6 (6 2010)
Abstract
Background: Coarctation of aorta is narrowing of proximal descending aorta. Interventional procedures such as balloon angioplasty & stent implantation has been progressively in use as alternatives for surgery in increasing number of children with diagnosis of coarctation of aorta. The aim of this study was to evaluate the use of endovascular stent in children with coarctation of aorta.
Methods: We evaluated effectiveness and safety of stenting in all patients younger than 18 years old with coarctation and re-coarctation of aorta which treated by stenting between years 2004-9 at rajaei - heart centre in Tehran, Iran.
Results: we studied 53 patients younger than 18 years old with a follow up of six months. Totally 54 stents were implanted. Mean (±SD) age of the patients was 11.6±4.2yrs. Seventeen cases (32%) were younger than 10 years old, and 36 cases (68%) were 10 years and older. Mean (±SD) weight was 39.24±18kg. 16 cases weighting less than 25kg. Peak systolic pressure gradient (SPG) decreased from 46.26±17.07 to 1.03±0.19mmHg after procedure (p<0.001). There was no significant difference (p<0.001) in the gradient before and after stenting in the patients with native coarctation (Vs re-coarctation cases), less than 25 kg and under 10 years old groups. Complications developed in 44% of cases while dominantly were minor except in two cases re-dilatation of stent was not needed during six month of follow-up of the patients.
Conclusions: Stenting of coarctation of aorta can decrease complications and can be used safely in children weighing bellow 25kg and in children below 10yrs old.
Zarabi V, Noorbakhsh S, Rahim Zadeh N, Samimi K, Ghafori M, Jafarian A, Tabatabaei A,
Volume 69, Issue 2 (5 2011)
Abstract
Background: Urinary tract infection 0 in children causes renal scarring and permanent damage to the organ. In this study, we compared the diagnostic value of magnetic resonance urogram for urinary tract anomalies with other conventional imaging methods in children with UTI.
Methods: In this case-control study, 190 children (mean age 3.23±3.59 yrs) with UTI were recruited from the Pediatric Ward of Rasul-e-Akram Hospital during 2007-2009. The patients were divided into two groups based on the applied imaging technique: MRU (cases) and conventional imaging groups (controls).
Results: Abnormal imaging detection rates for Ultrasonography were 32%, X-ray of kidneys, ureters and bladder (KUB) 9%, Intravenous Pyelogram (IVP) 26%, Voiding Cystoure therogram (VCUG) 54%, Dimercaptosuccinic Acid scan (DMSA) indicating
non-obstructive (reflux) uropathy in 76% (mean age 3.5 yrs) and MRU 43% (mean age
1.6 yrs), respectively. A meaningful correlation was observed between MRU and DMSA scan with IVP results (Kappa=0.75). KUB and Ultrasonography had similar results in cases with abnormal MRU and DMSA scan (P=0.121). MRU had strong agreement with VCUG and IVP for the detection of obstructive uropathy and scar due to congenital malformation even during intrauterine life but not with sonography results.
Conclusion: Sonography had poor results for the diagnosis of urinary tract anomalies in comparison with MRU. Use of dynamic MRU for the diagnosis of congenital anomalies (hydronephrosis, obstruction, pyelonephritis, renal scar) in children with UTI seems to be of better help, although higher costs and the need for sedation during MRU still are its disadvantages
Farhadi M, Tabatabaee A, Shekarabi M, Noorbaksh S, Khatib M, Javadinia Sh,
Volume 69, Issue 9 (6 2011)
Abstract
Normal
0
false
false
false
EN-US
X-NONE
AR-SA
MicrosoftInternetExplorer4
Background: Too many studies are in the process
of determining the probable role of immune system in the etiopathogenesis of
nasal polyposis. This study was designed to identify the probable participation
of Th1, Th2 lymphocytes in the induction and progression
of nasal polyposis.
Methods: Seventy-five patients, 42 male and 33 female, with
nasal polyposis were examined for total serum IgE, specific serum IgE and reaction to skin test for differentiating allergic from
non-allergic participants in Rasoul Akram Hospital during 2010. To determine the possible correlation of allergic
reactions in the upper respiratory tract and nasal polyposis, cytokine gene
expression was evaluated on the extracted RNA by
RT-PCR. The data were analyzed by using c2, independent t-test, correlation and
Receiver operating characteristic (ROC)
curve.
Results: The mean
age of participants was 38 years (18-81 years). IFN-γ
and IL-4 gene expressions were more prevalent
in allergic than non-allergic individuals (IFN-γ:
39.5% vs. 14.2%, P=0.3 and IL-4: 44.7% vs. 18.9%, P=0.02, respectively). IL-10 and IL-12 (P35 and P40 fractions) genes were not
significantly different between the two groups. IL-10 and IL-12 (P35, P40) genes did not differ significantly either.
Conclusion: This research suggests that overproduction of
cytokines and an imbalance of Th1
and Th2 cell production may
play an important role in the pathophysiology of allergic or non-allergic nasal
polyp formation. Thus, although nasal polyposis is a multifactorial disease
with several different etiological factors, chronic persistent inflammation is
undoubtedly a major factor irrespective of the etiology.
Ghaleiha Ali, Seyedian Azadeh , Mazdeh Mehrdokht , Seife Rabiee Mehrdokht , Zarabian Mohammad ,
Volume 69, Issue 12 (5 2012)
Abstract
Background: Migraine is the most common cause of headache which affects 15% of female and 6% of male populations. Patients with migraine may have psychological problems, thus, association of migraine with depression, anxiety and other psychological disorders should be considered for choosing the best management approach.
Methods: In this case-control analytical study, one hundred and twenty patients with migraine were recruited among patients who attended the Psychiatry Clinic of Farshchian Hospital in Hamedan, Iran during 2008- 2009. The patients met the IHS criteria for migraine and none had disorders, such as Huntington disease, that are associated with obsessive-compulsive disorder (OCD). The people who accompanied patients attending the Internal Medicine Clinic of the Hospital and had no history of migraine headaches were recruited as the controls. Maudsley's inventory was used for the diagnosis of OCD. Finally, the data were analyzed by SPSS software.
Results: In the control group, 3 (2.5%) and in the case group 11 (9.17%) people had OCD (P=0.024). All of those with OCD in the control group and 9 out of 11 in the case group were female. There were no cases of OCD among patients with mild migraine. Among 36 patients with moderate headache 5 (13.89%) people had OCD and among 62 people with severe migraine 6 (9.68%) had OCD (P=0.510).
Conclusion: The prevalence of OCD in patients with migraine was significantly higher than the normal population. Special attention to comorbid conditions such as OCD is necessary in the management of migraine headaches.
Farhadi M, Tabatabaee A, Shekarabi M, Noorbakhsh S, Javadi Nia Sh, Ghavami Gh,
Volume 70, Issue 7 (6 2012)
Abstract
Background: Staphylococcus aureus secretes numerous superantigenes which trigger the inflammatory mechanisms of sinus mucosa and cause chronic rhino-sinusitis. This study was designed to evaluate the role of staphylococcus aureus superantigens in polyp tissues of patients with chronic rhino-sinusitis in comparison with a control group.
Methods: Polyp tissue samples of 28 patients and mucosal specimens of 19 healthy individuals were evaluated for staphylococcus aureus bacterium superantigens, exotoxins A, B, C and D and TSST-1 with RT-PCR and ELISA methods Rasoul Akram Hospital during 2 years.
Results: Polymerase chain reaction (PCR) results revealed that 88.2% of the patients and 45.5% of the controls had at least one type of superantigen (P=0.03). Evaluation of superantigens using ELISA method showed presence of at least one type of superantigen in the nasal samples of all patients and in 35.3% of the controls (P<0.001).
Conclusion: A relationship between staphylococcal superantigens and nasal polyps is concluded from this study which indicates the probable role of these superantigens in the pathogenesis of nasal polyposis.
Farhadi M, Tabatabaei A, Shekarabi M, Noorbakhsh S, Shokrollahi Mr, Javadi Nia Sh, Faramarzi M,
Volume 71, Issue 1 (4 2013)
Abstract
Background: Tonsils and adenoid hypertrophy is a major respiratory symptom in children which is partly due to recruitment of inflammatory cells in upper airway lymph nodes as a result of the effects of synthesis and release of different inflammatory cytokines. It seems that infections play role in concert with these cytokines leading to tonsilar hypertrophy and other pathologic consequences. It is proposed that cellular infiltrate of tonsils and adenoids may secrete different quantities of these cytokines compared with peripheral blood mononuclear cells (PBMC) cultures.
Methods: Among patients who were admitted for adenotonsillectomy to the ENT ward, 37 patients, under 1-12 years old patients with fulfill criteria selected to include the study. Excised adenoid and tonsils cultured and inflammatory cytokines Interferon-γ (INF-γ), Interlukine-1 (IL-1), IL-6, IL-8 and tumor necrosis factor-α (TNF-α) measured in cellular culture supernatant. The same cytokines measured in PBMC cultures.
Results: The data shows that there is a significant difference between IFN-γ and IL-8 amounts in adenoid tissue culture supernatant and PBMC culture of our patients. Furth-ermore, the amounts of IFN-γ, IL-1 and IL-8 showed considerable difference between tonsilar tissue culture supernatant and PBMC culture of these patients. Although there is a significant correlation between IL-6 amounts in tissue culture supernatant and PBMC culture (P=0.02), the respective data for TNF is only almost significant.
Conclusion: Inflammatory cytokines may have significant role in the early provoke of inflammation occurred in hypertrophied tonsils and adenoid. The majority of these cyt-okines increase the expression of adhesion molecules on epithelial cells and influence the recruitment of leucocytes and inflamed tonsils. On the other hand lack of sufficient cytokine release may lead to persistent infections and may cause chronic inflammation and hypertrophied tissue.
Mohammad Farhadi, Mehdi Shekarabi, Shima Javadinia, Samileh Noorbaksh, Mahmood Faramarzi, Mohammad Reza Shokrollahi, Azardokht Tabatabaee,
Volume 71, Issue 8 (November 2013)
Abstract
Background: Nasal polyp (NP) is a benign mucosal mass located in both sinuses and nares which is mostly seen in association with cystic fibrosis, asthma or oversensitivity to aspirin. The prominent histological feature of NP is inflammatory cell infiltration with eosinophil predominance. Superantigens role in causing NP complications is already proven. Superantigens, which are mostly originated from Streptococci and Staphylococci, activate T cells strongly and increase the process of production and release of cytokines, and secretion of IgE from B cells, which in turn directly affects proinflammatory cells such as eosinophils, both in their tissues infiltration and functions.
Methods: The samples are collected from patients referring to ENT clinic in Rasoul Akram training Hospital in Tehran after thorough clinical and paraclinical examinations. For control group the samples collected from patients undergoing rhinoplasty. All the samples kept frozen and sent to immunology lab. The DNA of the excised tissues extracted and amplified by using the superantigens specific primers and PCR product detected by gel electrophoresis. The date analyzed by using mean and SD and χ2 analytical tools.
Results: Fifteen healthy individuals, 25 patients with rhinosinusitis and 24 with polyposis entered this trial. Group A Streptococcus toxin detection was significantly more frequent in those with nasal polyp and rhinosinusitis compared to healthy individuals (P=0.001 and 0.005, respectively), but the results were almost the same for those with nasal polyp and rhinosinusitis (P=0.4).
Conclusion: Streptococci may play an important role in induction or clinical exacerbation of polyposis and group A Streptococcus pyogenes exotoxin (SPEs) with superantigenic effects may have a crucial role in etiology and pathogenesis of polyps with or without rhinosinusitis. It is postulated that, T cells polyclonal activation by SPEs may cause recruitment of inflammatory cells in nasal mucosa. These inflammatory cells include IgE producing B cells laeding to allergic and inflammatory reactions in NP.
Mehdi Ghaderian , Mahmood Meraji , Mohammad-Yoosef Arabi Moghadam, Mojtaba Keikha,
Volume 72, Issue 5 (August 2014)
Abstract
Background: Pulmonary valve stenosis (PS) is one of the most common congenital heart disease in children. Isolated pulmonary stenosis is the most common form of pulmonary stenosis. Isolated Pulmonary stenosis is responsible for 8 to 10 percent of congenital heart disease. Balloon valvuloplasty is the choice of treatment for this cardiac disease. One of the most important complications of this disease is pulmonary regurgitation in follow-up. The purpose of this study was to characterize the status of pulmonary regurgitation on follow-up after pulmonary valvuloplasty by balloon. Methods: We studied pulmonary regurgitation after balloon valvuloplasty retrospectively in children less than 14 years old age and isolated pulmonary stenosis. These patients had not complex congenital heart disease and admitted for balloon valvuloplasty during period of September 2001 to September 2011 in Shahid Rajaee Cardiovascular
Research Center. The mean time of follow-up was 7±2.5 years.
Results: Four hundred and fifty-eight patients with mean age of 10.3±8.6 months were studied. Two hundred and fifty-five patients were male and 230 were female. Right ventricular pressure was decreased from 82.3±42.2 mmHg before procedure to 45.2±22.4 mmHg after procedure (P= 0.043). Pressure gradient between right ventricle and pulmonary artery was decreased from 75.4±18.2 mmHg to 25.7±15.13 mmHg during procedure (P= 0.032). The day after procedure, 180 (37.1%) patients had no pulmonary regurgitation echocardiographic evaluation, 175 (36.08%) had mild, and 118
(24.3%) had moderate pulmonary regurgitation. In patients with moderate pulmonary regurgitation, 7 (0.14%) of those improve to severe pulmonary regurgitation. In echocardiographic exam, 12 (2.4%) patients had severe regurgitation the day after balloon valvuloplasty. During long-term follow-up (7±2.5 years) for 3 patient pulmonary valve replacement were performed. In our study, balloon to annulus ratio in three groups of pulmonary regurgitation (mild, moderate and sever) had significant correlation (P=0.012).
Conclusion: Pulmonary regurgitation was seen after balloon valvuloplasty in some patients.In most patients it had no symptoms and long-term follow-up is necessary
Zohreh Sarabinejad , Davoud Nouri Inanlou , Shahram Teimourian ,
Volume 74, Issue 1 (April 2016)
Abstract
Background: Infeliximab is a form of chimeric antibody which neutralizes the most important inflammatory cytokine, TNF-a, in inflammatory disorders. The aim of current study was to pilot expression of chimeric infliximab in Chinese Hamster ovary (CHO) cells.
Methods: In this research study, pVITRO2-neo-mcs vector that consist of infliximab light chain and heavy chain was used to transform into the E.coli by CaCl2 method. The plasmid was then purified and transfected to cultured CHO cells by Lipofectamine 2000® (Invitrogen GmbH, Germany). Transfected cells were selected upon G-418 treatment after 2 weeks and the level of expression, based on standard curve, was measured using IgG ELISA kit after 48 hours for each clone. High level expressed clone was then cultured in roller bottles and recombinant chimeric product was purified by protein A affinity chromatography. The purity of the product was analyzed by 10% gel SDS-PAGE from eluted samples. The efficacy of the purification was analyzed by ELISA before and after purification step. This article is a master's student thesis from February 2015 to August 2016 in pharmaceutical technology development center, Tehran University of Medical Sciences, Tehran, Iran.
Results: The purified plasmid was analyzed on 2% agarose gel. After selective pressure of G-418, 10 stable transfect clones were assessed for infliximab secretion by IgG ELISA kit at 450 nm. The maximum and minimum expression which detected by ELISA were 23 ng/ml and 6 ng/ml, respectively. The band width of infliximab fraction during purification procedure was observed at 0.7-0.8 min. The efficiency of the purification by ELISA was 70%. On SDS-PAGE analysis, two bands, 25 and 50 kDa, respect to light and heavy chains of Infliximab, was confirmed the expression of recombinant protein.
Conclusion: In the current study, the construct for infliximab monoclonal antibody production was designed using genetic engineering techniques and the expression was confirmed by conventional molecular biology methods. The high yield production was carried out in semi-industrial scale using roller bottles with a 70 percentage of purification efficiency.
Reza Ebrahimi Rad, Mohammad Reza Zarbakhsh Bahri , Samira Sarabi ,
Volume 75, Issue 1 (April 2017)
Abstract
|
Background: Nowadays, stroke can be considered as the one of the major causes of disability and mortality worldwide. However, relationship between serum C-reactive protein (CRP) level with stroke early prognosis has not been well studied, especially in Iran. Therefore, the present study aimed to study the relationship between CRP level of serum in patients with acute stroke at first 24h of admission and stroke early prognosis.
Methods: This prospective cross-sectional study was performed on 50 patients with acute stroke who were admitted at Emergency Ward of Shahid Rajaie Hospital, in Tonekabon City, Iran, between May 2013 to July 2014. In first step, valid clinical diagnosis was made based on CT scan and magnetic resonance imaging (MRI) of the patients. The ethical observations were considered for all patients. The serum level of CRP was measured by standard method, at first 24h of the admission. Clinical information and risk factors (age, gender, type of stroke, high blood pressure, diabetes mellitus) was detected for each patient. On discharge, early prognosis by modified Rankin Scale (mRS) (mRS< 3= good and mRS≥ 3= bad) was also recognized. In this study, statistical analysis was performed using SPSS software, and logistic regression method was used (P< 0.05).
Results: The results of this study showed that 38% of the patients were 70-80 years old. Also, 52% of the patients were male and 48% were female. The serum CRP level of patients at the first 24h of admission increased in all studied patients. The mean of the serum CRP level was 12.82 that were higher than the normal range. The statistical analysis showed that there was no significant relationship between the serum CRP level and the stroke early prognosis.
Conclusion: Although the serum CRP level was not recognized as an anticipator factor for stroke prognosis at this study, it is recommended to performance of more studies by case-study method on this setting.
|
Sajad Rezvan, Mohammad Aghaali, Behnam Fallah Bafekr Lialestani, Leili Iranirad, Fariba Pirsarabi,
Volume 75, Issue 10 (January 2018)
Abstract
Background: Blood pressure decreases during sleep and is markedly increased in the morning in healthy individuals. Lack of nocturnal blood pressure fall (non-dipping) has been associated with cardiovascular morbidity, mortality and other organ damage. However, their importance in chronic renal failure is unclear. This study aimed to investigate relationship between circadian rhythm of blood pressure and renal failure severity in patients with chronic kidney disease.
Methods: This cross-section study was done in April 2016. The study population was 95 patients, more than 30 year old with hypertension and chronic renal failure. Patients were selected from clinics of two private and university hospitals affiliated to Qom University of Medical Sciences Shahid Beheshti Hospital and Vali-e-Asr Hospital, Iran. Checklist containing data such as age, sex, duration of renal failure and cause of renal failure were filled. Serum creatinine and serum urea levels were measured and entered in the checklist. The circadian rhythm of blood pressure in all patients was assessed by Holter monitoring. patients who had less than 10% decrease in blood pressure overnight were considered non-dipper and those who had 10% or more decrease in blood pressure overnight were considered dipper.
Results: Average (SD) 24-hour ambulatory systolic and diastolic of blood pressure was 136.56 (16.66) and 84.84 (10.86) mmHg, respectively. 70 patients (73.7%) had non-dipper blood pressure pattern and 25 patients (26.3%) had dipper blood pressure pattern. There was no significant difference between two groups (dipper and non-dipper) based on distribution of gender (P=0.744), age (P=0.407), serum creatinine (P=0.569), serum urea (P=0.689) and renal failure duration (P=0.812). Mean of glomerular filtration rate in dipper group was 68.64±4.13 and in non-dipper group was 65.09±16.27 (P=0.337).
Conclusion: The results of this study did not show a significant relationship between circadian rhythm of blood pressure and renal failure severity. In addition, patients with chronic renal failure showed higher rates of non-dipping pattern of blood pressure.
Alireza Mahoori, Nazli Karami , Seyedeh Zahra Karimi Sarabi ,
Volume 77, Issue 9 (December 2019)
Abstract
Background: Emergence from general anesthesia and removing of tracheal tube can be associated with coughing, agitation, and hemodynamic disturbances. Dexmedetomidine is an alpha two adrenoceptor agonist that has effective sedation with less cardiovascular unstability and respiratory depression and may be useful for extubation and prevention of hemodynamic response during tracheal tube removing. The aim of this study was to evaluate the effect of dexmedetomidine on hemodynamic responses during endotracheal extubation and sedation level in recovery room.
Methods: In an analytical study, fifty women aged 20-50 years old candidate to cholecystectomy under general anesthesia and tracheal intubation were entered randomly to this study in two groups (no. 25) at Imam Khomeini Hospital, Urmia, Iran, and under support of Urmia University of Medical Sciences Urmia, Iran, from May 2017 to May 2018. Ten minutes before end of surgery, 0.8 µg/kg dexmedetomidine in the study group and for the other patients in control group normal saline as placebo were infused over ten minutes. During the emergence phase, blood pressure, heart rate and oxygen saturation were recorded at 0,1,2,3 and 5 minutes after extubation. Also, sedation index was evaluated via the Ramsay sedation score and recorded at recovery room.
Results: Heart rate, systolic blood pressure and diastolic blood pressure in patient with infusion of dexmedetomidine were lower significantly at 1,2,3 and 5 minutes after extubation than control group. Data for heart rate, systolic and diastolic pressure, at min 1 after extubation were 81±6 vs. 88±9, 120.64±13.21 vs. 137.52±11.06, 72.84±8.32 vs. 81.36±9.26 in dexmedetomidine and control groups respectively. Data for heart rate, systolic and diastolic pressure, at min 5 after extubation were 73±6 vs. 80±8, 110.64±10.68 vs. 119.88±10.01, 69.84±8.32 vs. 73.48±5.13 in study and control groups, respectively. As well as 80% of the patients in dexmedetomidine group had satisfactory sedation and cooperation in compare to the 28% in control group (P=0.001).
Conclusion: Intravenous infusion of 0.8 µg/kg dexmedetomidine 10 minutes before extubation of endotracheal tube and during emergence, facilitate extubation and lead to hemodynamic stability and satisfactory sedation.
Hossein Shakeri , Aliasghar Arabi Mianroodi , Mohammadali Haghbin , Narges Khanjani ,
Volume 78, Issue 3 (June 2020)
Abstract
Background: A major problem in surgical procedures is postoperative pain. The effectiveness of prescribing preoperative tizanidine in reducing postoperative pain is not clear. The aim of this study was to determine the efficacy of tizanidine as a premedication in reducing pain after septoplasty.
Methods: This double blind clinical trial study was performed in 71 patients aged from 18 to 50 years, undergoing septoplastic surgery for the first time, who were classified in ASA (American Society of Anesthesiologists) classes 1 and 2 in the Ear, Nose, and Throat (ENT) Department of Shafa Hospital, in Kerman, Iran from April 2014 to March 2015. Patients were randomly assigned into two groups using numbers from a randomization table. A dosage of 4 mg of tizanidine was administered orally to the patients two hours before the surgery (septoplasty) in the intervention group. In the control group, placebo pills which were 100 mg vitamin B1 were prescribed. The severity of pain was measured and recorded after 4 and 8 hours, and the morning after the surgery.
Results: 62 patients (87.32%) were male and 9 (12.68%) were female. The mean age of the subjects was 24.6±7.5 years. The two groups were similar in regard to age (P=0.54), but the duration of surgery was different in the two groups (P=0.038) and was longer in the group that received tizanidine. The mean of pain was different between the two groups, after 4 hours and was significantly higher in the group that received tizanidine (P=0.043). The mean of pain was not significantly different between the two groups after 8 hours (P=0.95) or one day after surgery (P=0.79).
Conclusion: Although some researchers have reported that taking tizanidine before some surgeries may reduce postoperative pain, in this study the administration of tizanidine before surgery was not effective in reducing pain after septoplasty.
Nasrin Moazzen, Hamid Ahanchian, Mehrdad Sarabi, Abdolreza Malek, Zahra Abbasi Shaye ,
Volume 79, Issue 2 (May 2021)
Abstract
Primary Immune Deficiencies are a group of heterogeneous disorders that involve the innate or acquired immune system, or a combination of them. The underlying disorder may be related to decreased levels or function, or a complete lack of one or more components of the immune system in general. These diseases can occur with a prevalence of about 1 in 10000 live births. According to the fourth update on the Iranian national registry of Primary Immune Deficiency in October 2018, the total number of registered PIDs in Iran are 3056 patients. However, it is supposed to be more prevalent and it seems increasing awareness shall reveal many new cases, especially in societies with prevalent consanguineous marriages like Iran. These disorders predispose patients to recurrent infections, autoimmunity and malignancy and can cause a huge burden on health care systems. This group of diseases has a wide range of symptoms, which quick recognition and timely treatment of them, can greatly reduce the complications of the disease. These symptoms may include recurrent or severe infections, failure to thrive, autoimmune disorders, as well as articular-skeletal manifestations. A variety of skeletal manifestations are seen in patients with primary immunodeficiency, among which septic arthritis caused by pyogenic bacteria or mycoplasma arthritis is the most common joint-bone manifestation. Joint and skeletal involvement is less commonly seen as a sign of primary immune defects. This issue is importance in reducing the cost of diseases and improving the patients’ quality of life. Our review attempted to introduce the most common manifestations of bone and joint in patients with primary immunodeficiency and available treatments for these manifestations. Because of the wide range of symptoms in these patients, it is recommended to observe the rare and suspicious manifestations in the patients with any atypical bone and joint presentations such as: recurrent septic arthritis, infection with unusual germs, immunodeficiency in their relatives, and any history of well-known red flags of PIDs. The Rheumatologist should consider these manifestations and think about the possibility of deficiency disorder.
Mohamadreza Arabi, Simin Najafgholian , Morteza Gharibi, Fateme Rafiaee, Mehran Azami , Mojtaba Ahmadlou,
Volume 79, Issue 6 (September 2021)
Abstract
Background: Acute compartment syndrome is considered a debilitating complication of limb trauma. Early detection of this compartment syndrome helps us in the early initiation of treatment which will result in preventing its subsequent complications reported in these cases.
Methods: This research was an analytical cross-sectional study. Patients with direct trauma to extremities, who were referred to the emergency department of Valiasr and Amir Al-Momenin hospitals were studied from October 2018 to April 2019 in Arak, Iran. Patients were selected if they met all of the inclusion criteria and none of the exclusion criteria. Vital signs were measured and recorded for each patient. Also, the results of physical examination, intra-compartmental pressure measurement by a wick catheter and the level of the creatine phosphokinase were recorded. All data analyses were performed with the use of SPSS v21 software.
Results: A total number of 70 subjects were included in this study, comprising 65 males (93.1%) and 5 females (6.9%). The results showed that there is a significant relationship between intra-compartment pressure and the level of creatine phosphokinase enzyme. The higher the intracompartmental pressure, the higher the creatine phosphokinase level. Statistically significant associations were observed between intracompartmental pressure and pallor, edema, lack of limb pulse, and diastolic blood pressure. No significant relationship was found between intracompartmental pressure and limb pain, numbness, inability to move the injured limbs, and systolic blood pressure. In addition, our findings indicated that creatine phosphokinase is significantly associated with edema and lack of limb pulse. No significant relationship was found between creatine phosphokinase with pain, pallor, numbness, inability to move limbs, and systolic and diastolic blood pressure.
Conclusion: The study findings suggest that measurement of intracompartmental pressure could be considered as an effective alternative approach to creatine phosphokinase levels to diagnose compartment syndrome. So, this will prevent irreparable damage to the extremities and is of great importance.
|
