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Showing 23 results for Arad
A therapeutic experience on Port Wine hemangiomas with Argon Laser
M Farahvash , P Mansoori , S Arad ,
Volume 55, Issue 6 (1 1997)
Abstract
Port wine stains are benign but cosmetically devasting congenital angiomas. The argon laser is a therapeutic device newly applied to this condition. Our program was begun 6 years ago. From the beginning, the study was conceived as a clinical investigation of both the port wine stain and its argon laser therapy. A total of 218 patients with port wine stains have been studied and many aspects of their clinical condition detailed. Employing the Argon laser, test spots have been carried out in patients and the results have been analyzed with clinical aspects of the lesions. Altogether, 501 treatments were performed in 218 patients. Good to excellent results were obtained in 81 patients. Moderate Result was obtained in 31 weak result in 65 patients. Most common complication were hyperpigmentation and depressed scar.
Plexiform neurofibroma tumor in the parapharyngeal neck space
Baradaran Far Mh, Binesh F, Fani Sm,
Volume 59, Issue 1 (7 2001)
Abstract
A 4.5 years old boy with left postero superior lateral neck mass admitted to Shahid Rahnemoon hospital in Yazd. The mass had been noticed 2 years ago and there was no improvement after three times antibiotic therapy. On physical examination there were two masses on the neck. One of them was approximately 3×4 cm and the other was 2×2 cm. On of the masses was located in the left posterior auricular area and the other one in anterosuperior border of SCM. Both masses were mobile, non adhesive, with slight tenderness and without inflammatory signs (ie, redness, warmness etc). In surgery, the parapharyngeal deep neck space was filled by the yellowish-white color tumor with it's «worm-like» projections, extended into the jugular foramen superiorly, lateral oropharyngeal wall medially and supra clavicular area inferiorly. Total resection of tumor was done. The patient was discharged after 5 days with good general conditions. Pathologic report was «Plexiform neurofibroma».
Diagnostic value of frozen section study for thyroid nodules in patients referred to Shariati Hospital 1997-2000
M Shirzad, A Hedayat, N Kamalian, B Larijani, R Baradar Jalily,
Volume 59, Issue 6 (11-2001)
Abstract
Frozen section is a useful method in the diagnosis of different malignancies including those of thyroid origin. However, there are still controversies about its application, sensitivity and specificity for thyroid neoplasm. In this study, diagnostic value of frozen section (FS) was compared with permanent histopathologic and Fine Needle Aspiration (FNA). In this study, which was conducted in process research method, permanent sample, FNA, and frozen section results in 214 patients was compared. All of these 214 patients had been seeking medical evaluation for thyroid nodules between years 1997 and 1999 in Shariati hospital. All pathologic evaluations were performed by pathology staff of this hospital. Permanent pathology was considered as the gold standard so the specificity, sensitivity and diagnostic precision of FNA and FS were evaluated on the basis of its results. We use Macnemar test for this purpose. The number of patients during this period were 214 (160 women and 54 men). Mean age of our patients was 42.3±5.4 and their age ranged between 12 to 84 years. Pathologic results revealed that 163 of the patients (76 percent) had benign lesions, and 51 of them (24 percent) had malignant lesions. Thyroid malignancies comparised papillary carcinoma (70 percent), follicular carcinoma (13.5 percent), papilofollicular carcinoma (6 percent), medulary carcinoma (6 percent), Hurtle cell carcinoma (4 percent) and anaplastic carcinoma (5 percent). FNA was done in all of the patients before surgery and was able to determine the status of nodules in 150 patients. Sensitivity, specificity and precision of FNA in these 150 patients were 72, 96 and 90 percents respectively. When FNA was unable to determine the status of a nodule (64 remaining patients), FS was applied to do the job. A sensitivity of 36 percent, specificity of 85 percent and precision of 73 percent was found in this group of patients. Macnemar test showed that there is no significant difference between FNA and FS methods. This study showed: when FNA is not conclusive, FS will not bring any further benefit. It seems that only in suspicious cases of papillary, undifferentiated and medulary carcinomas, FS can be useful in certifying the results of FNA and choosing the appropriate surgical plan. We should wait for permanent sample reports in the case of follicular or Hurtle cell carcinoma.
Results Of Endoscopic Transnasal Resection Of Sinonasal Inverted Papiloma
Baradaranfar M H,
Volume 61, Issue 3 (14 2003)
Abstract
Inverted papilloma is an uncommon benign neoplasm originating from lateral nasal wall. It commonly invades paranasal sinuses and sometimes invasion to orbit and intracranial structures are seen. There are many surgical methods for its treatment, one of them is endoscopic transnasal approach.
Materials and Methods: Between 1997 and 2001, 11 patients with this tumor were operated in Amiralam hospital in Tehran and Shahid Rahnemun in Yazd. Nine patients were operated by endoscopic transnasal route and two patients by combined Caldwell-luc and endoscopic transnasal routes.
Results: Tumors were on the right side in 3 patients, on the left side in 7 patients, and bilateral in one patient. There were no intracranial or orbital extensions. No pathologic report of malignancy was made. Surgical technique included complete tumor resection, anterior and posterior ethomidectomies, sphenoidectomy, frontal recess tumor resection and wide maxillary antrostomy, in cases in whom tumor was attached to lamina papyracea, the lamina was removed without any manipulation to orbital periosteum. Mean follow-up time was 29.8 months. There was no recurrence in 82% of cases. Tumor recurred in 18% of cases. No complications were seen.
Conclusion: Although the standard treatment for this tumor is medial maxillectomy but endoscopic resection is an effective method in surgery of this tumor. It seems that if tumor does not extend to areas unreachable by endoscopic surgery, due to lower morbidity and excellent visualization of tumor, this method is preferable.
M.h Baradarn Far, F Dodange,
Volume 62, Issue 4 (11 2004)
Abstract

Evaluation Of Humoral And Cellular Immunity Of Children Before And After Adenotonsillectomy
M.h Baradaran-Fard, Sh Taghipoor-Zahir, F Dodangeh , M Attar,
Volume 64, Issue 1 (30 2006)
Abstract

Background and Aim: Adenoids and tonsils are active lymphoid organs and playing an important role against invading antigens of upper aero digestive tract in children. The purpose of this study is observing the changes in cellular and humoral immunity of children six months after adenotonsillectomy.

Materials and Methods: The study population consisted of 30 children (aged 4-10 years) with chronic adenotonsillar hypertrophy and 30 age- matched healthy children. In all children serum level of IgM and IgG, percentage of T lymphocytes (CD3) , T helper (CD4) , T (CD8) and B lymphocytes (CD20) were measured. These parameters were re-measured in patients 6 months after adenotonsillectomy.

Results: Before the operation, a reduction in percentage of T lymphocytes (CD3) , TCD4, TCD8 and B CD20 was seen compared with control group. This reduction was only significant in T lymphocytes (CD3) (P.Value=0.03). The serum IgM level was not different in two groups and IgG level was elevated in two groups but not significantly different. Six months after operation the percentage of lymphocytes T CD3+, TCD8+, TCD4+ and BCD20+ was increased and reached the control group. The IgG level was also significently decreased in patients after operation (P.Value=0.00).               

Conclusion: Our results indicate that cellular and humoral immunity decreases in children with chronic adenotonsillar hypertrophy preoperatively and increases to healthy children level, six months postoperatively. It means that chronic adenotosillar hypertrophy affects some parameters of cellular and humoral immunity and adenotonsillectomy by removing chronic stimulations reverses these changes without any negative effect on immune function of patients.


Evaluation Of The Effects Of Diabetes Mellitus On Hearing In 30-50 Years Old Type II Diabetic Patients
M.h Baradaranfar, M Afkhami , A Mahmmodi,
Volume 64, Issue 2 (30 2006)
Abstract

Background and Aim: It seems that diabetes mellitus affects hearing system by several mechanisms including microangiopathy ,sorbitol deposition and glycosilation ,dealing to progressive bilateral sensorineural hearing loss which is related duration of diabetes.

Materials and Methods: This is a descriptive cross-sectional study performed on 300 patients with type 2 diabetes mellitus aged 30 to 50 years and a control group of 300 persons matched regarding age and gender .The cases were selected randomly and they were assessed by a quastionaire before performing audiogram. The exclusion criteria were conductive hearing loss sensorineural hearing loss with any other cause and other metabolic diseases .Audiometric test battery consisting of pure tone audiogram (PTA) and impedance were perfumed on both case and control groups.            

Reasults: In this study the hearing threshold in low and high frequencies in case group was higher than control group. In different age groups, the mean high and low frequencies hearing threshold in case group was higher than control groups. Based on duration of diabetes , the mean hearing threshold in the group with 8 to 18 years duration of diabetes was higher than the other two groups with 1 to 3 years and 4 to 7 years diabetes duration. The hearing level of hypertensive and normotensive diabetic patients were not significantly different. The mean hearing threshold was not significantly different between male and female diabetic patients.

Conclusion: In general, diabetic patients have a poorer hearing compared with normal population and there is a significant relationship between duration of diabetes and incidence of sensorineural learning loss.


Radiologists’ intra-rater agreement and category distinguishability in diagnosis of ovarian mass by ultrasonography
A Akbarzadeh Bagheban, G Babaei, A Kazemnejad, S Faghihzadeh, F Baradaran Anaraki, Z Elahipanah,
Volume 64, Issue 3 (1 2006)
Abstract

Background: Intra-rater agreement in observing and decision making in diagnosis of any disease is of great importance.This investigation is to observe and read ultrasound pictures of ovarian cysts and distinguish its category for any radiologist. Distinguishability is one of the related entities in this matter and radiologists&apos ability in correct diagnosis is of great concern. In this study, we evaluated radiologist’s distinguishability of ordered categories of ovarian cyst diseases (benign, borderline and malignant) in ultrasonography. To do this, we measured intra-rater agreement of radiologists by Weighted Kappa coefficient, and then by the help of “square scores association model” and “agreement plus square scores association model” we evaluated their distinguishability in diagnosis of the severity of the ovarian cyst’s diseases.

Methods: In this analytical cross-sectional study, two radiologists and three radiology residents assessed ultrasounds of 40 patients separately and independently in two periods (with the interval of one week). Patients selected from those who were referred to Mirza Koochak Khan Hospital in January 2005. Ultrasounds were performed by an expert radiologist and by a single apparatus.

Result: Data from radiologists was evaluated by “square scores association model” due to their superior results of distinguishability. Mean of Weighted Kappa coefficient was 0.81 and intra-rater agreement was 0.99 for our radiologists, but due to weaker results of our residents, we used “agreement plus square scores association model” for analyzing and mean of Weighted Kappa coefficient was 0.65 and intra-rater agreement was 0.97 for them.

Conclusion: Although radiologists had a better function than their residents, all of them showed appropriate distinguishability and intra-rater agreement in diagnosis and categorizing of the ovarian cyst’s disease. To distinguish benign category from borderline was more difficult than to distinguish malignant category from borderline and radiologists showed better results in this than their residents did.


Assessment of spontaneous healing rate of traumatic tympanic membrane perforations and three months follow up Yazd Forensic Medicine
Mirvakili S.a, Baradaranfar M.h, Karimi Gh, Labibi M,
Volume 65, Issue 2 (8 2008)
Abstract
Background: Traumatic tympanic membrane (TM) perforation is a common injury of the ear with a high rate of spontaneous healing if the patients strictly adhere to water precautions. The purpose of this study was to determine the factors involved in the spontaneous healing of traumatic TM perforations in order to ascertain the best treatment plan including observation, paper patch and finally surgery.
Methods: In this correlative–descriptive study, we recorded the outcome of each patient with three-month follow up. Included in this study were a total of 202 forensic medicine patients from the Dept. of Otolaryngology Head & Neck Surgery at the Yazd University of Medical Sciences, Yazd, Iran. All patients included in this study had traumatic TM perforation. Based on otoscopic examination, the perforations were classified as pinpoint or large. All patients received an audiometry exam and were followed for three months. The data was collected using a special form and analyzed by chi-square test, Fisher exact test and ANOVA.
Results: This study consisted of 118 male and 84 female patients with a mean age of 23.6 years (6-48 years). The types of trauma included compression injury (104 patients), instrumental injury (59 patients), burn–slag injury (2 patients) and blast injury (1 patient). One hundred and eighty patients had pinpoint TM perforations, 99.4% of which healed spontaneously by the second month, and 32 patients had large TM perforations, 50% of which healed spontaneously by the second month. During the first month, 87.3% of the patients observing water precautions had healed, however the healing rate was only 5.6% in patients not adhering to water precautions, who suffered from otorrhea. Therefore, during this study, 185 (91.58%) patients had spontaneous healing by two months and only 6 patients of remaining 17 patients healed with paper patch. The mean hearing loss at 500, 1000 and 2000 Hz was 10.55 dB (5-30 dB).
Conclusion: In our experience, patients with traumatic TM perforations have higher spontaneous healing rate when observing water precautions. Furthermore, we recommend observation and paper patching for three months before attempting any surgical intervention in such patients.
The effect of intravenous Dexamethasone and local Bupivacaine in post -tonsillectomy vomiting and pain
Dabirmoghaddam P, Baradarnfar M H, Ayatallahi V, Shakibapoor M,
Volume 65, Issue 5 (3 2007)
Abstract
Background: Tonsillectomy is the second most common pediatric surgery. Despite improvements in anesthetic and surgical technique, post-tonsillectomy pain continues to be a significant clinical concern for the patient, family, and physician. Young patients undergoing tonsillectomy experience postoperative pain and vomiting resulting in delays in oral feeding and in discharge from the hospital. Reduction of these side effects will lead to the improved quality of postoperative care. This study was performed to compare the efficacies of local Bupivacaine and intravenous Dexamethasone with that of a placebo on post-tonsillectomy pain and vomiting.
Methods: This clinical trial included 120 ASA I children, aged 3-15 years, undergoing tonsillectomy. The patients were randomly categorized into three groups: 1- local infiltration of 2 ml normal saline into the tonsillar pillar as a placebo 2- IV Dexamethasone (0.5 mg/kg, with a maximum of 16 mg) 3- local infiltration of 2 ml 0.5% Bupivacaine into the tonsillar pillar. After the operation, patients were observed regarding vomiting and pain at 0.5, 4, 24, 120 hours postextubation.
Results: Of 120 patients, 70 were male and 50 were female. The mean age of patients was 8.4 years. Three patients were missed in follow up. The questionnaire was completed for 117 patients. The mean duration of operation was longest in the placebo group (55 minutes) and shortest in Dexamethasone group (50 minutes). We noticed significant reduction in postoperative pain only in the Bupivacaine group and at the fourth postoperative hour. In the Dexamethasone group, during the first 24 hours, we could not statistically analyze the effect on vomiting. Since Bupivacaine and Dexamethasone reduce postoperative pain and vomiting, respectively, and are safe, cost-effective and available, we recommend using these drugs for tonsillectomy patients.
Conclusion: Considering the greater efficacy of Dexamethasone in the reduction of vomiting and that of Bupivacaine in pain reduction in other studies, we recommend further study to assess the use of these two drugs together.
The effect of intravenous dexamethasone in reducing periorbital edema, ecchymosis and intraoperative bleeding in rhinoplasty patients
Dabirmoghaddam P, Baradaranfar Mh, Gouinee F, Ayatallahi V,
Volume 65, Issue 8 (3 2007)
Abstract

Background: In rhinoplasty, periorbital edema and ecchymosis is due to soft tissue trauma and small vessel injury with subsequent exudation and bleeding. The main purpose of this study is to determine the effect of dexamethasone in reducing periorbital edema and ecchymosis and intraoperative bleeding in rhinoplasty patients.

Methods: This double-blind study included 90 patients who underwent rhinoplasty from October 2004 to March 2005. In group A, 8 mg of intravenous dexamethasone was administered only preoperatively. In group B, 8 mg of dexamethasone was administered preoperatively and continued every 8 hours postoperatively. Group C, the control group, received no dexamethasone.

Results: The degree of upper lid edema in groups A and B was significantly less than that of group C. During the first and second day the severity of upper lid edema in group B was less than that of group A, but the difference was not significant. The degree of lower lid edema during the first and second days in groups A and B was significantly less than that of group C, although it was identical in all groups during the fifth and seventh days. The degree of upper lid ecchymosis during the first and fifth days in group C was significantly more than that of groups A and B, but it was similar on the seventh day in all groups. The degree of lower lid ecchymosis on the first day in groups A and B was significantly less than that of group C however, it was similar in all groups during the second, fifth and seventh days. The volume of intraoperative bleeding in the three groups was similar. The mean period of recovery (12 days) was comparable in all groups.

Conclusions: Dexamethasone administration leads to the reduction of upper lid edema, ecchymosis and lower lid edema during the first and second postoperative days, and reduction of lower lid ecchymosis on the first postoperative day.


Correlation between superoxide dismutase 1 gene expression with lactate dehydrogenase enzyme and free radicals in female athletes: effects of incremental intensity exercises
Baradaran B, Tartibian B, Baghaiee B, Monfaredan A,
Volume 70, Issue 4 (5 2012)
Abstract

Background: Inflammatory enzymes and free radicals are important factors affecting the immune system. However, there seems to be no detailed information about the extent to which these factors can affect superoxide dismutase 1 gene expression in female athletes, especially in incremental exercises. Therefore, the aim of the present study was to investigate the correlation between superoxide dismutase 1 gene expression with lactate dehydrogenase (LDH) and free radicals in female athletes after an incremental intensity exercise.

Methods: Fifteen 22-24 year old female athletes from Urmia, Iran voluntarily participated in the study after completing an informed consent form in 2010. Venous blood samples were collected in three stages: prior to, immediately and 3 h after an incremental exercise (12 km/h at a 5% gradient for 20 min). Real-time PCR was used to assess superoxide dismutase1 (SOD-1) gene expression as was an autoanalyzer for hydrogen peroxide (H2O2) and LDH concentrations.

Results: LDH concentration significantly increased in both stages of the exercise (immediately and 3 h after the exercise), (respectively, P=0.009 and P=0.026), but H2O2 concentration significantly increased only in the recovery phase (P=0.002). SOD-1 mRNA did not significantly increase in any stage of the exercise (P=0.05). Moreover, there was only a significant correlation between SOD-1 mRNA and H2O2 increase (P=0.014).

Conclusion: Incremental exercise increased H2O2 and LDH levels in female athletes but only free radicals had a significant effect on SOD-1 gene expression.


Germline mutation at codon 1309 of the adenomatous polyposis coli gene and exteracolonic manifestations in familial adenomatous polyposis
Faegheh Behboudi Farahbakhsh, Hossein Maghsoudi, Hamid Asadzadeh Aghdaei , Ehsan Nazemalhosseini-Mojarad,
Volume 75, Issue 4 (July 2017)
Abstract
Background: Familial adenomatous polyposis (FAP) is the most common components polyposis syndromes. It incidence is for less than 1 percent of colorectal cancer cases. FAP is characterized by germline mutations in the adenomatous polyposis coli (APC) gene. Generally, there are hundreds to thousands of adenomatous polyps in colon and rectum of patients. The aim of the current study was to evaluate the germline mutation at codon 1309 of the APC gene and its association with extracolonic manifestations in Iranian patients with FAP.
Methods: This Cross-sectional study was conducted at the Gastroenterology and Liver Diseases Research Center, Taleghani Hospital, Tehran, Iran from July 2012 to February 2015. In this study, thirty-three patient with FAP was examined. Demographic and clinical data were gathered from patients. In addition, peripheral blood samples were collected to study the most common mutations of the APC gene and bidirectional sequencing was carried out after genomic DNA extraction by salting out method. Primers were designed by GeneRunner version 5.0.4 (http://www.generunner.com). The samples were run on an applied biosystems 3130XL genetic analyzer. The results were analyzed by SPSS software, version 23 (IBM, Armonk, NY, USA).
Results: After analyzing the mutation cluster region (MCR), we have identified five germline mutations with 5bp deletion at codon 1309 of the APC gene (c.3927_3931delAAAGA), that it is equivalent to 15.2% (5.33). This mutation has been known as a small deletion, that it is a variant of frameshift mutation. Mutation at codon 1309 has significant association with clinical and pathological features including the number of polyps (P=0.001), duodenum demonstration (P=0.008), fundic gland polyp (P=0.002) and congenital hypertrophy of the retinal pigment epithelium (P=0.021).
Conclusion: The analysis of the findings has shown that mutation in Codon 1309 of adenomatous polyposis coli gene may be associated with severe polyposis and extracolonic manifestations. In conclusion, there may be a correlation between a specific germline mutation and the extracolonic manifestations.

Relative quantification of AXIN2 mRNA expression in different pathological types of colorectal polyps
Mina Golmohammadi , Hamid Asadzadeh Aghdaei , Hossein Maghsoudi , Ehsan Nazemalhosseini Mojarad,
Volume 75, Issue 5 (August 2017)
Abstract
Background: Most of colorectal cancers (CRC) have originated from intestinal polyps. Evaluating of the expression level of genes that are involved in tumors growth and development, may consider as diagnostic factor of malignancy in the polyps. AXIN2 regulates the level of nuclear β-catenin in a negative-feedback loop there by being a negative regulator and target gene at the same time. The aims of current study were to examine the expression level of the AXIN2 in the colonic polyps and its linkage with the pathological features of the polyps.
Methods: In the present analytical-descriptive study, the investigated population was chosen from the cases with colonic polyps that referred to the Gastroenterology and Liver Diseases Research Center, Taleghani Hospital, Tehran, Iran, from October 2014 to April 2015. Forty four biopsy polyp samples and 10 normal tissue samples were collected, as well as the demographic and clinical properties of the patients and the expression level of AXIN2 gene was quantified by Real-time PCR. The outcomes were analyzed by the ABI Prism 7500 Sequence Detection System (SDS) software, version 2.1.0 (Applied Biosystems Inc., Foster City, CA, USA) and GraphPad Prism, version 3 (GraphPad Software Inc., La Jolla, CA, USA) Also, the expression changes of the intended gene in target groups were compared with the normal tissues using the 2-ΔΔCt equation.
Results: The data showed enhanced level of the expression of AXIN2 gene in the colonic polyps in comparison to the normal tissues (RQ>2), which was significantly upper in adenoma polyps compared to the hyperplastic group (P=0.015). Also, unlike the rectum, the AXIN2 gene activity in colon area was higher than normal tissue.
Conclusion: The results of the current study show that the expression pattern of AXIN2 gene, was markedly changed during the transformation of the normal tissue to polyp. The increased expression level of this gene could be applied as a diagnostic marker in dissociation of the adenoma polyps from hyperplastic ones. On the other hand, the location of the polyps modulates the AXIN2 gene function. Taking together, evaluating the changes of AXIN2, has a precise diagnostic value in the CRC related studies.

A case report of pyoderma gangrenosum after genital surgery: case report
Mohammad Javad Yazdanpanah , Zohreh Yousefi , Amir Hosein Jafarian , Laya Shirinzadeh , Mina Baradaran ,
Volume 75, Issue 6 (September 2017)
Abstract
Background: Pyoderma gangrenosum (PG) (ulcerating neutrophilic dermatosis) is a rare disease that about of half of these patients have a systemic disorder, particularly Crohn's and ulcerative colitis. In addition, inflammatory lesions play key role in its pathogenesis. In early diagnosis of disease, we will further prevent of serious consequences of the disease. In this report, a case of PG after the vaginal surgery with history of ulcerative colitis was introduced.
Case presentation: A 37-years old woman was admitted in an University Hospital of Mashhad University of Medical Sciences, Iran, in 2016 two weeks after genital surgery. The chief complaints were fever, painful tenderness, ulcerative lesion and inflammatory papule on surgical site and thigh. She suffered of fever despite received oral and then wide spectrum intravenous antibiotic therapy. Blood cultures and wound culture were negative. In addition to two deferent intravenous antibiotics, topical wound debridement was performed. Despite this course of treatment which did not improve the lesion, biopsy was performed. Histopathology features of biopsy specimen indicated prominent neutrophils mixed inflammation and lymphocytic vasculitis indicated as pyoderma gangrenous. The patient's medical history included associated ulcerative colitis from 18 years ago and she was under irregular oral receiving of Asacol (mesalamine). Intravenous corticosteroid therapy was administered which led to response of skin of right thigh and surgical site inflammation. After 6-months follow-up, the patient is still in good condition.
Conclusion: Based on major variable clinical manifestations and no diagnostic serologic test of pyoderma gangrenosum, diagnosis of this disease is difficult. Increased awareness about PG and exclusion of other etiologies such as inflammatory and immunologic disease will aid in prompting of pyoderma gangrenosum diagnosis and proper management of the disease.

High-risk pregnancy due to thyroid storm: case report
Malihe Hasanzadeh , Mina Baradaran Khalkhale , Akram Behroznea, Leila Musavi ,
Volume 75, Issue 12 (March 2018)
Abstract
Background: Graves' disease is the most common cause (85% of all cases) of thyrotoxicosis in women in childbearing age. Many of the symptoms are similar to hyper-metabolic status during pregnancy. The cause of the disease is autoantibodies that stimulate the thyroid-stimulating hormone (TSH) receptor. Hyperthyroidism is uncommon in pregnancy and its prevalence is 0.1-%0.4. In this paper we introduce a patient who was admitted with a primary diagnosis of pulmonary embolism and treatment with final diagnosis of thyroid storm and was discharged with good condition.
Case presentation: In the first pregnancy of a 29-year-old woman with gestation age of 31 weeks was referred to obstetric emergency unit Ghaem Hospital, Mashhad, Iran in March 2015. She had Grave’s disease in her past medical history which was treated with methimazole before pregnancy and propylthiouracil (PTU) during pregnancy. In admission, she presented with tachycardia and tachypnea and hypertension and lower extremity edema. During pregnancy, she used propantheline instead of propylthiouracil due to pharmacy mistake. She admitted in Intensive care unit. After rule out of pulmonary embolism, ultrasonography showed a fetus with 30 weeks of gestational age with an approximate weight of 1680 grams. The amniotic fluid was reduced. She was treated with thyroid storm diagnosis due to a medication error. In serial obstetric visits fetal heart rate was not detected. Due to the fetal death, the pregnancy was terminated. Hyperthyroid therapy continued with PTU after delivery. She was discharged with a good general condition.
Conclusion: Despite the rarity of thyroid storm during pregnancy, in the event of unstable hemodynamic condition and cardiac dysfunction in pregnant women, rule out of thyroid disorders should be considered. Clinician should be paid attention to past drug history and underline disease of patient.

A quantitative investigation of the Bid gene expression in biopsies from colorectal adenomas
Fateme Sadat Kia , Ehsan Nazemalhosseini-Mojarad, Flora Forouzesh,
Volume 76, Issue 2 (May 2018)
Abstract
Background: Most of colorectal cancers arise from intestinal polyps. Evaluating of the expression level of genes that are involved in tumors growth and development, may consider as diagnostic factor of malignancy in the polyps. Failure of apoptosis is one of the causes of cancers. One of the key molecules in this pathway is Bid gene which connects the extrinsic to the intrinsic apoptosis pathways. The aim of this study was to investigate the quantitative expression of Bid gene in colorectal adenomatous polyps compared to control group.
Methods: The investigated population was chosen from the cases with colonic polyps that referred to the Taleghani Hospital, Tehran, Iran, from April 2014 to May 2016. 22 biopsy samples from patients with adenomatous polyps and 10 samples from healthy individuals as control group were selected. Demographic and clinical properties were collected from patients' files. The Bid gene expression was evaluated using Real-time PCR by ABI 7500 (Applied Biosystems Inc., Foster City, CA, USA). Results were analyzed by the ABI 7500 system SDS version 2.3 and GraphPad Prism, version 5 (GraphPad Software Inc., La Jolla, CA, USA). the expression changes of the intended gene in target groups were compared with the normal tissues using the 2-∆∆CT equation.
Results: Based on the quantitative real-time PCR, the gene expression of Bid gene significantly increased in adenomatous polyps in comparison with the control group (healthy individuals) (RQ>2). Also, polyps were seen in ascending colon, transverse colon, descending colon and rectum showed increased expression compared to control group, but in the sigmoid section of the intestine, there was no change in expression of Bid gene compared to control group.
Conclusion: According to the present study, the expression of Bid gene increased in adenomatous polyps, compared with the normal tissue (healthy group). It suggests that Bid gene by increasing the expression in response to the onset of dysplasia and disruption of the apoptotic cycle, it tries to compensate for the apoptosis.

Investigating the number of Lactobaccilus, Escherichia coli and Prevotella in fecal microbiota of adenomatous polyposis and colorectal cancer patients
Sama Rezasoltani , Hamid Asadzadeh Aghdaei , Hossein Dabiri , Abbas Akhavan Sepahi , Mohammad Hossein Modarressi , Ehsan Nazemalhosseini Mojarad ,
Volume 78, Issue 3 (June 2020)
Abstract
Background: Colorectal cancer is the second most common cancer in the world which is mainly caused by epigenetic and environmental factors. Among these epigenetic factors, gut microbiota is an important one. Although it has not been proved a unique group of bacteria correlated with colorectal cancer, these findings have generally demonstrated differences between healthy and disease gut microbiome in population. Actually, the identification and investigation of intestinal microbiota in early detection of colorectal cancer have been highlighted in new researches and studies. Herein, in the current study, we aimed to evaluate the number of selected gut bacteria including Lactobacillus and Escherichia coli and Prevotella in the fecal specimens of adenomatous polyposis patients, colorectal cancerous cases in compared to normal participants in terms of estimating important role of gut microbiota during colorectal cancer initiation and progression.
Methods: The current research was a case-control study. Fecal samples were provided from 31 healthy individuals, 42 adenomatous polyposis patients and 20 colorectal cancer cases that were referred to Taleghani Hospital, Tehran, Iran, from August 2016 to August 2017 for colorectal cancer screening tests. Fecal samples were collected to analyze intestinal bacteria including, Lactobacillus, Escherichia coli, and Prevotella by absolute quantitative real-time polymerase chain reaction (PCR). The number of these gut bacteria was precisely determined by this method of real-time PCR.
Results: Higher number of Prevotella with 24.6 CT number (P<0.005) and E.coli with 20.4 CT number (P<0.015) were achieved in colorectal cancer cases and adenomatous polyposis patients in contrast to samples from normal individuals. On the contrary, the opposite range was observed for the quantification of Lactobacillus and greater numbers of bacteria (CT=28.6) were detected in normal, compared to the colorectal cancer cases and adenomatous polyposis (P<0.001).
Conclusion: The gut microbiota composition of individuals with colorectal cancer and adenomatous polyposis differs from that of healthy individuals, and the higher numbers of pathogenic microbiota versus beneficial microbiota present in those with colorectal cancer and adenomatous polyposis. In contrast, healthy individuals have higher numbers of beneficial gut microbiota than pathogenic microbes. These findings need more experimental analysis and investigation to better clarify.

Doppler ultrasonography in children with acute pyelonephritis in diagnosis of renal scar compared to DMSA scintigraphy
Fatemeh Khanali , Mahdokht Mehramiz, Reza Dalirani , Elnaz Parsarad, Banafsheh Arad,
Volume 78, Issue 10 (January 2021)
Abstract
Background: Urinary tract infection (UTI) is one of the most important pediatric health problems, which is occasionally associated with irreversible renal damage. Dimercapto-succinic acid (DMSA) scan is a diagnostic standard for the renal scar. Doppler ultrasonography (D.S) has been considered as a less invasive method. The purpose of this study was to determine the sensitivity and specificity of D.S in the diagnosis of renal scarring in children with a history of acute pyelonephritis (APN).
Methods: The present cross-sectional study was conducted on 120 children with APN, aged six months to twelve years in the University Pediatric Hospital of Qazvin, Iran, between August 2017 and August 2018. DMSA scan was performed in the acute phase of pyelonephritis for all patients. Half of the children with acute pyelonephritis had decreased radionuclide uptake in the first DMSA scan of whom thirty patients had kidney scarring in the second scan, six months later. Then renal vascular D.S was performed for these patients. Simultaneously, twenty children with a normal DMSA scan, assigned for D.S.
Results: The mean age of children was 5.30(3.50-11.8), and 4.80(2.50-10.09) in the scar and control group. Most of the patients in both groups were female, 25(83.8%) in renal scar, and 15(75.0%) in control. The scar group showed a greater rate of vesicoureteral reflux, 17(56.6%), of whom 11(36.7%) were bilateral. Among 30 patients with a renal scar, 2(6.7%) had first-time acute pyelonephritis, 11(36.7%) had second, and 17(56.7%) had more than two attacks of pyelonephritis. The frequency of renal scarring was 25% based on DMSA scan and 14% based on D.S. Accordingly, the sensitivity and specificity of D.S in the detection of renal scarring in children with APN was 23.3% and 100%.
Conclusion: Doppler ultrasonography is not a suitable method for diagnosis of renal scarring in children, due to the low sensitivity and negative predictive value of this device in the detection of renal scarring in children with UTI. However, normal Doppler sonography can predict that the patient did not have a kidney scar.
 

Spontaneous rupture of accessory spleen 16 years after splenectomy: a case report
Seyed Hassan Seyed Sharifi , Mansoureh Baradaran,
Volume 81, Issue 2 (May 2023)
Abstract
Background: In most patients, the accessory spleen (AS) is small in size. However, in patients who have undergone splenectomy, AS may hypertrophy. This manuscript presents a rare case of spontaneous AS rupture nearly two decades after a prior splenectomy due to trauma. After searching multiple databases, only a few similar cases have been reported to date. In any acute abdominal patient with a history of previous splenectomy who presents with a mass in the anatomical location of the spleen, along with evidence of hematoma and free abdominal fluid on imaging, the possibility of AS rupture should be considered.
Case Presentation: In February 2022, a 36-year-old man who had undergone splenectomy due to trauma 16 years ago was referred to the emergency department at Imam Ali Hospital in Bojnord. He complained of sudden onset of severe abdominal pain, preferably in the upper region of the abdomen. The patient denied having any recent issues. Based on the patient's history and examination, at perforated stomach ulcer and pancreatitis were initially suspected. However, except for leukocytosis, no other abnormalities were observed in the laboratory tests. Ultrasound revealed a low-echo mass-like lesion in the anatomical location of the spleen. Another low-echo mass-like lesion, indicating a hematoma with abundant free fluid in the abdomen and pelvis, was also observed near the aforementioned mass. CT scan confirmed these findings. Open surgical and re splenectomy procedures were performed, and the diagnosis of spontaneous AS rupture was made based on clinical examination and imaging findings.
Conclusion: In any patient with a history of previous splenectomy who presents to the emergency room with diffuse and acute abdominal pain, even without recent trauma, if a mass-like lesion is observed in the anatomically suspicious location of the spleen in the left subphrenic space, along with other evidence of rupture such as hematoma/laceration and free fluid in the abdominal cavity, accessory spleen rupture should be considered as the main differential diagnosis.

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