Showing 24 results for Azam
Sa Bazargan , B Fatholahzadeh , B Tabraiie , N Moazammiie ,
Volume 54, Issue 2 (30 1996)
Abstract
In our investigation, rabbit hyper-immune serum to V.cholerae ogawa was absorbed with V.cholerae inaba whole-cells and vice versa. Applying ammonium sulphate precipitation method, mono-specific g globulins were purified and concentrated from the absorbed whole serum. These antibodies were fixed on staphylococcus cowan 1 NCTC-8325 whole-cells, using different chemical fixatives. It was observed that maximum fixation of g globulin to protein-A was achieved by 1-propanol 50% at 3 hours, which revealed through single radial immuno-diffusion techniqe. The rectal swab samples were cultured in an enrichment bile-peptons broth. After 5 hours 37°C while agitations, one drop of each sample was mixed with one drop of vibrio-cholerae bivalent mono-specific coagglutination reagent (VBCR). The results were read after 2 to 3 minutes. Finally though statistical analysis sensitivity and specificity of coagglutination test were calculated to be 95.1% and 99.2% respectively, when compared to positive & negative controls and conventional culture methods. Using VBCR, coagglutination test can be therefore considered as a simple, reliable and rapid method to detect V.cholerae O1 in the stool of patients in endemic area and less equipped laboratories
Shamimi K, Aminian A, Moazami F, Jalali M,
Volume 64, Issue 12 (6 2006)
Abstract
Background: Abdominal compartment syndrome (ACS) is a clinical entity that develops from progressive, acute increases in intra-abdominal pressure (IAP) and adversely affects all vital organ systems In this study, the development of intra-abdominal hypertension (IAH) and ACS in a surgical ICU population is described and examined.
Methods: Over a one-year period (2004), urinary bladder pressure (UBP) was measured prospectively in all surgical patients with abdominal problems admitted to the ICU of the Imam Hospital complex. UBP of >20 cm H2O indicated IAH. ACS was defined as the development of multiple organ dysfunction including peak airway pressure (PAP) >50 cm H2O, Horowitz quotient <150 torr or urine output <0.5 ml/kg/hr in the setting of IAH. Data were gathered on all patients with IAH and ACS.
Results: We evaluated some 353 patients, consisting of 165 elective laparatomies and 188 emergency cases, including 28 trauma patients. The incidence of IAH and ACS was 2 and 1 per cent (7 and 3 patients, respectively). The mean IAP of these seven patients was 29.8 cm H2O. No elevated IAP was observed after elective laparotomy (165 patients), nor in emergency cases with temporary abdominal wall closure (29 patients). APACHE II score, PAP and worst base deficit were significantly higher in patients with elevated IAP. None of the three patients with ACS underwent decompressive laparotomy. The mortality rate for patients with elevated IAP was 85%, significantly higher than the total study population.
Conclusion: IAH is a rare disease of the rarity of IAH, routine measurement of IAP is necessary only in high-risk patients. Prophylactic temporary abdominal wall closure may prevent IAH and ACS in high-risk patients. Patients with elevated IAP have dismal outcomes. Critical care practitioners should become familiar with different aspects of IAH and ACS, including decompressive laparotomy.
Hantoushzadeh S, Shariat M, Azamati F, Abdolmotallebi F,
Volume 65, Issue 7 (4 2007)
Abstract
Background: Over the past two decades we have seen a marked increase in the survival of very low birth weight infants. This increase in survival has been attributed to increased use of corticosteroids, regionalization of perinatal care, improved methods of mechanical ventilation, availability of exogenous surfactant, and improved nutritional therapy. However, the reduction in mortality has not been accompanied by a reduction in neonatal morbidity or long-term handicaps. Preterm labor is a major issue in Iran. Besides various etiologies, preterm labor may be due to a biochemical alteration, such as magnesium. It is known that magnesium plasma levels fall during pregnancy. Since magnesium has an inhibitory role on myometrial contractions attention has been paid to the role of magnesium deficiency in preterm labor. Hypomagnesemia leads to neuromuscular hyperexcitability resulting in muscle cramps and uterine hyperactivity. The aim of this study was to determine the relationship between serum magnesium levels and preterm delivery in order to circumvent the high morbidity of preterm delivery by early diagnosis of this deficiency.
Methods: Serum magnesium was measured in 42 cases of preterm labor of idiopathic etiology (28-37 weeks) and 42 normal pregnancies at the same gestational age.
Results: Hypomagnesemia was variable in preterm labor cases, with only slightly low values in normal pregnant women.
Conclusion: Our study indicates that serum magnesium levels during pregnancy can be a valuable predictive tool for preterm labor. Hypomagnesemia must be considered in all pregnant women with preterm labor and supplementation must be provided effectively.
Mosayeb Shahriar , Azam Sharafi , Abolfazl Emamdadi , Nezarali Molaie ,
Volume 67, Issue 10 (1-2010)
Abstract
Background: Cough is one of the most common symptoms for which outpatient care is sought. Since, a few research evaluated efficacy and therapeutic effect of baclofen in remedy of cough (especially chronic cough), In this study we compared the efficacy of oral Baclofen 20 mg with Dextromethorphan to improvement of cough in two groups.
Methods: In this double blind randomized clinical trial, 120 patients with chronic cough (up to three weeks) that were referred to respiratory diseases clinic of Ali Ebn-e Abitaleb (AS) hospital in Zahedan, Iran at 2007 were randomly devided to two groups. 60 peoples in each, (baclofen recipient group with mean age 32.32±6.51 and dextromethorphan recipient group with mean age 31.54±5.06 year) were evaluated for qualitative decline of severity, period and duration of cough for 14 days.
Results: In baclofen recipient group 73.3% and in dextromethorphan recipient group 65% all patients had decline of severity, period and duration of the cough. Statistically, there were no significant differences between two groups in regard to qualitative decline of severity, period and duration of cough (p>0.05). Also, there were no drug related side effects in the patients.
Conclusions: Baclofen decreased severity, period and duration of cough more than dextromethorphan. Because there were no significant differences between two groups, we needed to do more quantitative researches to compare them.
Aazam Khorassani , Farzad Vaghef Davari ,
Volume 71, Issue 3 (June 2013)
Abstract
Background: Peptic ulcer disease is one of the most common GI disorders. Perforation has the highest mortality rate of any complication of ulcer disease, while early diagno-sis and emergency treatment save patient life.
Case presentation: This paper reports an adolescent boy admitted to the Ziaeian University Hospital. He suffered from severe abdominal pain with dyspnea had been started since past three hours. Periumbilical pain started from past 2-3 days, gradually localized to the right lower quadrant. He had anorexia without nausea and vomiting. He was tachycardic and tachypneic, but he did not have fever. On physical examination, bowel sound was hypoactive, there was generalize tenderness, guarding and rebound tender-ness focused in the right lower quadrant and suprapubic region. Laboratory finding indicated leukocytosis. Chest X-ray showed free air under diaphragm. Once the diagno-sis has been made, the patient was given analgesia and antibiotics, resuscitated with isotonic fluid, and taken to the operating room. Laparotomy was implemented through a midline incision. There was bile secretion in the peritoneal cavity. Appendix was inflamated. Cecum and ileum were normal. A small perforation, 4mm in size was detected in first portion of duodenum. Appendectomy and omental patch repair were done. Ten days later, the patient was discharged in a good state. Serologic test for helicobacter pylori was negative.
Conclusion: Stomach and duodenal perforation should be considered in patients with-out peptic ulcer disease, especially in children and adolescents with sudden and severe abdominal pain who are admitted to the hospital for other diseases. Because some patients present with peptic ulcer complications that are seemingly exacerbated by stressful life events.
Azam Bakhtiarian , Sattar Ostadhadi, Masoumeh Jorjani , Sepideh Hashempour , Shahrbanoo Oryan , Vahid Nikoui ,
Volume 71, Issue 12 (March 2014)
Abstract
Background: Calcium channel blockers have an important role in treatment of various cardiovascular diseases including hypertension, angina pectoris and cardiac arrhythmias, so study of cardiovascular effects of derivatives of these drugs are useful. Nifedipine is one of these drugs that used widely to treat hypertension and other cardiovascular diseases. The aim of the present study was to evaluate the central effects of synthesized dihydropyridine derivatives on systolic blood pressure and heart rate of rats and comparison to nifedipine.
Methods: Sixty four male rats, after induction of anesthesia and intracerebral ventricu-lar cannulation using stereotaxis method, were divided into eight equal groups. One week after the stereotaxis surgery, the systolic blood pressure and heart rate were eval-uated in times 15 to 60 minutes after intracerebral ventricular injection of DMSO (di-methylsulfoxide) and nifedipine in doses of 80 to 320 microgram/rat and also three synthesized dihydropyridine derivatives (A, B and C) in dose of 240 microgram/rat. Effects of these drugs on systolic blood pressure and heart rate were analyzed using two way repeated measure ANOVA statistical test, followed by Bonferroni posthoc test. All data were considered significant at P<0.05.
Results: The inhibitory effects of derivative B on systolic blood pressure and heart rate in dose of 240 microgram/rat in times of 15 and 30 minutes after injection were more potent than nifedipine (P<0.001), while A and C derivatives showed weaker inhibitory properties, compared with nifedipine. Also the inhibitory effects of derivative B on heart rate in dose of 240 microgram/rat were stronger than nifedipine in times of 15 to 60 minutes after injection (P<0.05).
Conclusion: Novel dihydropyridine derivatives can possess more potent and stable in-hibitory effects on systolic blood pressure and heart rate, and some part of these properties at least, can be attributed to their direct inhibitory effects on brain neurons.
Shahram Savad , Niusha Samadaian , Roza Azam , Vahid Nikoui , Mohammad Hossein Modarressi ,
Volume 72, Issue 2 (May 2014)
Abstract
Background: A balanced reciprocal translocation is a structural abnormality, which at least consist of breakage of two non-homologous chromosomes along with pieces exchange and form quadrivalant structure that can produce unbalanced chromosomes during meiosis I and result in a fetus abortion. The aim of the present study is to offer using preimplantation genetic diagnosis (PGD) 24sure array, which delivers aneuploidy screening of 24 chromosomes, within a few hours to increase fertility and bearing a child without chromosomal abnormality of this couple. This technique could replace embryo donation for child bearing of this couple.
Case presentation: A young couple with recurrent pregnancy loss in 6th and 7th week of pregnancy without family history of recurrent miscarriage and any clinical signs had conferred. All laboratory tests including hormonal, infections, semen and hysterosalpingography were normal except karyotype that showed balanced reciprocal translocation between chromosomes 5 and 18 in male. Chromosomal study of male parents showed normal karyotype.
Conclusion: A balanced reciprocal translocation carrier is phenotypically normal, but during meiosis І, carrier chromosomes cant pair normally and form quadrivalant instead of bivalant that depend on type of their segregation (alternate, adjacent 1, adjacent 2,3:1,4:0), produce gametes that are chromosomally unbalanced which can result in early fetus abortion. Considering the number of abnormal gametes, the most effective way to help couples with this problem seems to be PGD 24sure, since it can identify reciprocal and Robertsonian translocation and allows concurrent screening of all chromosomes for aneuploidy. Another technique that can be compared with PGD 24sure is fluorescence in situ hybridization (FISH), but it has several technical limitations such as it is expensive and complexity, in addition it has only few probes (for chromosomes 21, 13, 18, X, Y) so sometimes necessary to create patient specific protocols.
Azamsadat Mousavi , Mojgan Karimi-Zarchi , Nadereh Behtash , Mahnaz Mokhtari-Gorgani , Nili Mehrdad , Mitra Rouhi , Seyedhossein Hekmatimoghaddam,
Volume 72, Issue 4 (July 2014)
Abstract
Background: The aim of this study was to assess the role of consolidative intraperito-neal chemotherapy with carboplatin in decreasing relapse and increasing survival in advanced epithelial ovarian cancers, as well as evaluation of its toxicity.
Methods: In this clinical trial 30 patients with epithelial ovarian cancer in stages II-IV who had complete surgery (optimal debulking surgery) received six standard cycles of intravenous carboplatin and paclitaxel. They were enrolled through non-random se-quential selection. The control patients were similar to case group in stage (II-IV) and pathology (epithelial ovarian cancer). The control group was evaluated retrospectively through hospital files. This clinical trial performed in Gynecology Oncology department in Tehran Valiasr University Hospital, during 2005-2010. They including 18 cases as the intervention group receiving intraperitoneal chemotherapy and 12 patients as the control group with only retrospective follow-up. The cases received 3 cycles of 400 mg/m2 intraperitoneal carboplatin every 21 days following intravenous chemotherapy. Relapse of disease was diagnosed as increasing or even doubling CA125 serum titer during one month, or any CA125 above 100 IU, or an abdominal or pelvic mass in ul-trasound or physical exam. Mean survival of two and five years, progression-free inter-val (PFI), overall survival (OS), relapse, demographic parameters, drug toxicities, path-ologic types of cancers in two groups were coded and compared using SPSS 14. Any P<0.05 was considered as a significant difference.
Results: The mean ages of cases and controls were 52.4±8.6 and 55.1±11.5 years. The mean duration of relapse-free survival was 13±8.6 months for the cases and 9.5±4.3 months for the control patients (not statistically different, P>0.05). The mean overall survival for cases and controls were 39±16.5 and 30.8±16.2 months, respectively (no significant difference, P>0.05). The frequency of drug toxicities in the cases was 5.6%, and consisted of mild-to-moderate abdominal pain, nausea and vomiting.
Conclusion: It seems that consolidation therapy with intraperitoneal carboplatin may not increase overall survival, reduce relapse rate or decrease mortality, though it does not induce considerable side effects. Since the mean survival in the intervention group was nine months more than controls, this difference may be clinically significant.
Azam Azargoon , Raheb Ghorbani , Sahar Mosavi ,
Volume 72, Issue 4 (July 2014)
Abstract
Background: The use of Methotrexate (MTX) is a good and common practice for the treatment of women who were diagnosed early with ectopic pregnancy (EP). The aim of this study is to determine the predictors of treatment failure with a single dose of MTX injection.
Methods: In this quasi-experimental research, we studied 70 women with ectopic preg-nancies who were treated with MTX, according to a single dose protocol from 2010 to 2013. EP was diagnosed whenever an intrauterine gestational sac was not identified by transvaginal ultrasonography (TVUS), accompanied by an abnormal rise or plateau in human chorionic gonadotropin (beta-hCG) concentration. Briefly, women with ectopic pregnancies were considered candidates for MTX treatment if they were hemodynami-cally stable did not desire surgical therapy, agreed to weekly follow-up and did not have hepatic, hematologic, or renal disease. A Patient was considered a treatment suc-cess (group 1) if her beta-hCG levels decreased ≤10 m IU/ml after the first dose of MTX. Treatment failure (group 2) was defined as the need for a second or a third dose of MTX or surgery. The following risk factors were compared between the two groups: serum beta-hCG on the days 1 and 4, a ≥ 15% decrease in serum beta-hCG between the days 1-4 of the treatment, age, parity, gravidity, the size of the ectopic mass and the endometrial thickness.
Results: The success rate of MTX treatment was 77.1%. There were no significant dif-ferences between the two groups in regard to the age, parity, gravidity, the size of ec-topic mass and the endometrial thickness in vaginal sonography, but the mean serum beta-hCG concentration on days 1 and 4 was lower in the success group than the failure group. We also observed a ≥ 15% decrease in serum beta-hCG in 80.9% of the women from the success group and in 38.5% of the cases whose treatment had failed. The presence of fetal heart activity was seen in only one patient and this patient’s treatment failed. Two patients had previous history of ectopic pregnancy and the treatment of both ended in failure.
Conclusion: Among women with ectopic pregnancies who were candidates for MTX treatment, a high serum beta-hCG concentration on the days 1-4 and also a ≤ 15% fall in serum beta-hCG between the days 1-4 treatment, are the most important factors associated with the failure of the treatment with a single dose MTX protocol. It is better to use these factors for making decisions about the initiation of the treatment or the continuation of it.
Parvin Akbari Asbagh , Mohammad Reza Zarkesh , Firoozeh Nili , Fatemeh Sadat Nayeri , Azam Tofighi Naeem ,
Volume 73, Issue 2 (May 2015)
Abstract
Background: The incidence of Patent Ductus Arteriosus (PDA) in premature infants whose birth weight is less than 1500 grams is approximately 30-60%, most of them need medical or surgical interventions. The purpose of this study is to determine the efficacy of prophylactic treatment with oral paracetamol (Acetaminophen- Hakim® Oral Drops 100 mg/ml, Hakim Pharmaceutical Co., Tehran, Iran) for PDA in preterm infants.
Methods: A randomized clinical trial conducted from March 2012 to March 2013. Thirty-two preterm newborns whose gestational age was under 32 weeks and birth weight was 1500 grams or less, admitted in neonatal intensive care unit (NICU) of Vali-Asr Hospital, Tehran were studied prospectively. They were randomly assigned in two groups. The prophylaxis group received oral paracetamol for a period of two days starting during first 24 hours of life. No placebo was given to the control group. Echocardiography was performed 24-36 hours after the last given dose in prophylaxis group and on the 4th and 5th day in control group. A p-value less than 0.05 are considered significant.
Results: There were 16 newborns in each group (20 boys and 12 girls). In 12 newborns of prophylaxis group the ductus arteriosus was closed although in control group in 8 newborns the duct was closed. No significant difference was observed in sex, gestational age, birth weight, mode of delivery, multifetal gestation and birth order between two groups. The rate of ductal closure was 75% and 50% in prophylaxis group and control group respectively (P=0.27).
Conclusion: Our study demonstrated that prophylactic paracetamol is ineffective in PDA closure, although the rate of ductal closure between two groups seems remarkable. Paracetamol as a new strategy for PDA closure because of cost effectiveness and harmlessness may be used in future. However, we presume larger sample size studies are needed to show the efficacy of paracetamol, side effects, and complications in PDA prophylaxis treatment.
Sayyed Alireza Talaei , Abolfazl Azami , Elham Mahdavi , Mahmoud Salami ,
Volume 73, Issue 3 (June 2015)
Abstract
Background: Environmental signals have an essential role in the maturation of neural circuits during critical period of brain development. It has been shown that, change in visual signals during critical period of brain development changes structure and function of glutamate receptors in the visual cortex. After processing in visual cortex, part of visual signals goes to the hippocampus and makes memories. The aim of this study was evaluating effects of visual deprivation during critical period of brain development on AMPA receptor subunits expression in rats’ hippocampus.
Methods: This experimental study was done in Physiology Research Center, Kashan University of Medical Sciences at winter 2014 on male Wistar rats. Animals were divided to 2 groups (n= 36 for each) were kept in standard 12 hours light/12 hours dark condition (light reared, LR) or in complete darkness (dark reared, DR) from birth to the end of the experiments. Using reverse transcription polymerase chain reaction (RT-PCR) and Western blotting techniques respectively, expression of mRNA and protein of GluR1 and GluR2 subunits was evaluated in rats’ hippocampus at ages 2, 4 and 6 weeks in both groups. After quantification of the expressions, the data were compared by two way analysis of variance.
Results: The relative expression of GluR1 subunit decreased about 24% (P=0.004) in the hippocampus of 6 WLR rats in comparison to 2 WLR ones. The relative expression of the other AMPA receptor subunit, GluR2, also increased about 190% in the hippocampus of the 6WLR animals when compared to the 2 WLR rats (P< 0.0001). Dark rearing increased the relative expression of both subunits of AMPA receptors, GluR1 and GluR2, about 20 percent (P= 0.01) in the hippocampus of 6 WDR rats in comparison to 2 WLR animals.
Conclusion: Dark rearing of rats during critical period of brain development changes the relative expression and also arrangement of both AMPA receptor subunits, GluR1 and GluR2 in the hippocampus, age dependently.
Farshid Farhan , Cyrus Azimi , Majid Mahmoodi , Mohammad-Ali Mohagheghi , Farideh Farzanfar , Azam Noor-Mohammadi, Malihea Khaleghian , Abbas Jafari , Mehrangiz Ghaem-Maghami , Kouros Divsalar ,
Volume 74, Issue 1 (April 2016)
Abstract
Background: It is reported that high frequency of chromosomal aberrations in peripheral blood lymphocytes of individuals is a marker of cancer predisposition. The aim of this study was to investigate the in vitro frequency of chromosomal damage in lymphocytes of patients with head and neck cancer against gamma irradiation compared with those in healthy individuals.
Methods: In a case and control study, peripheral blood lymphocytes of 101 patients with head and neck cancer were collected before the onset of radiotherapy. Lymphocytes of 40 healthy individuals were also collected as controls. Head and neck cancer patients and the control group were consecutively recruited between April 2012 and February 2015 from Clinics of Cancer Institute, Imam Khomeini Hospital, Tehran, Iran. Lymphocytes of patients or control group were cultured and exposed to gamma radiation in G2- and G0- phase of the cell cycle. The induced chromosomal aberrations such as chromosome and chromatid breakages, chromosome and chromatid gaps, chromatid exchanges and micronuclei were scored in one-hundred metaphase cells of each individual. The mean of each chromosomal aberration was compared in patient and control groups. Early and late tissue reactions were scored during radiotherapy treatment or thereafter.
Results: There was no significant difference in demographic characterization between the two study groups. The frequency of radiation- induced G2 aberrations in lymphocytes of patients was significantly higher than in those of healthy donors (P= 0.001 for chromosomal breaks). The frequency of radiation-induced micronuclei in G0 assay was also higher in patients than in those in controls (P= 0.05). The results also indicate that there is no correlation between the two assays. No significant correlation was also observed between aberration frequencies in lymphocytes and the degree of both early and late normal tissue reactions.
Conclusion: The results indicate that the in vitro chromosomal radiosensitivity of peripheral blood lymphocytes of patients with head and neck cancer against gamma irradiation was significantly higher than that in healthy individuals.
Homa Mohseni Kouchesfahani , Somayeh Ebrahimi-Barough , Jafar Ai , Azam Rahimi ,
Volume 74, Issue 12 (March 2017)
Abstract
Background: Small molecule Purmorphamin (PMA) is the agonist of smoothened protein in Sonic hedgehog (Shh) signaling pathway. Effect of purmorphamin small molecule on differentiation of mesenchymal cells into bone tissue has been studied previously. Use of Shh causes progression of neural differentiation, and the differentiated cells express specific neural markers. Neurofilament (NF) and acetylcholine esterase (Chat) are specific markers of motor neurons and their expression in differentiated cells indicates their conversion into motor neurons. The aim of this study was to evaluate the ability of PMA to differentiate the human endometrial stem cells (hEnSCs) into motor neurons.
Methods: This analytical study was done in Tehran University of Medical Sciences laboratory on September of 2015. In this study hEnSCs were enzymatically extracted from endometrial tissue. After third passages, the flow cytometry was done for mesenchymal stem cells markers. The mesenchymal stem cells were divided into control and differentiated groups. FBS 10%+DMEM/F12 was added to the culture medium of control group and the differentiating group was treated with differentiating medium containing N2, PMA, DMEM/F12, FBS, B27, IBMX, 2ME, FGF2, RA, BDNF. After 21 days immunocytochemistry (ICC) test was done for the expression of NF and Chat proteins and Real-time PCR analysis for expression of neural markers such as NF, Chat, Nestin and GFAP (as glial marker) at mRNA level.
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Results: The flow cytometry analysis showed that hEnSCs were positive for mesenchymal markers CD90, CD105 and CD146 and negative for endothelial marker CD31, and hematopoietic marker CD34. The immunocytochemistry and Real time-PCR results showed that the cells treated with PMA expressed motor neuron markers of NF and Chat.
Conclusion: According to the results of this study, it can be concluded that small molecule PMA has the potency to induce the differentiation of hEnSCs into neural cells, specifically motor neurons by activating Shh signaling pathway.
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Azam Shiralinezhad , Farzaneh Firoozeh , Mansooreh Momen Heravi, Esmat Aghadavod , Mojtaba Sehat ,
Volume 77, Issue 10 (January 2020)
Abstract
Background: Sepsis or blood stream infection is a clinical lethal syndrome with severe systemic inflammatory response to infection, if not treated quickly, is associated with dangerous consequences and high morbidity and mortality. The traditional and conventional method for identification of sepsis is blood culture method which is so time-consuming and long that it eliminates the possibility of rapid treatment. Although, new molecular methods, due to their high sensitivity, specificity, and speed, lead to the rapid and accurate and exact detection of bacterial sepsis within only a few hours. The aim of this study was diagnosis of bacteremia in patients with suspected sepsis using amplification of 23S rRNA gene by polymerase chain reaction (PCR).
Methods: This cross-sectional study was performed in two clinical and analytical steps at Shahid Beheshti University Hospital in Kashan City, Iran, in twelve months from November 2016 to December 2017. The blood samples of two hundred and fifty-six patients with suspected sepsis admitted to Shahid Beheshti Hospital were studied by PCR method using specific primers of 23S rRNA gene of the bacteria.
Results: The finding of molecular assays using PCR showed that of 256 blood samples that were collected from patients with clinical signs and symptoms of sepsis, 80 (30.2%) diagnosed with bacteremia. Of these patients diagnosed with sepsis, 46 out of 80 (57.5%) were male while 34 out of 80 (42.5%) were female. The most PCR positive results were obtained among patients with diabetes and bedsore as underlying diseases (21.3%). Statistical analysis showed that there was a significant correlation between results of molecular methods by PCR assays and history of antibiotic use.
Conclusion: Overall, the results of the present study showed that the molecular methods such as polymerase chain reaction using universal 23S rRNA primers is an appropriated test for diagnosis of bacteremia in blood samples of patients with suspected sepsis.
Sara Mirzaeian, Seyedeh Azam Pourhoseini , Mona Jafari,
Volume 78, Issue 7 (October 2020)
Abstract
Background: Approximately 3% to 5% of obstetric patients will experience postpartum hemorrhage (PPH). Even though the most common reason for postpartum hemorrhage, as the main cause of maternal death, is uterine atony; other complications such as laceration, hematoma, inversion, rupture; retained tissue or invasive placenta; and coagulopathy may result in PPH. The main cause of retained placenta can be traced to the history of manual placenta removal, violent and numerous curettages, uterus anatomical abnormalities, placenta accreta or placenta previa, and history of cesarean section. Here, we have presented a case of retained placenta and uterus septum.
Case Presentation: The patient, a 36 years old female, multigravid 11 live 3 ,death 1 and abortion 6, with a history of four normal vaginal deliveries, and history of preterm premature rupture of membrane since the 16th week of pregnancy, was admitted to Imam Reza hospital, Mashhad University of Medical Sciences due to labor pain in 29th week of pregnancy. After a vaginal delivery, she was transferred to the operating room due to a retained placenta. During the initial diagnosis, the patient’s cervix was dilated and manual placental removal was not possible. The ultrasound results showed an 80mm heterogeneous tissue in the fundus, extending to the left cornu. There was no sign of accreta. During hysterotomy, the retained placenta was removed from underneath a thick layer of Uterine Septum, using sponge forceps. Five days later, the patient returned with severe pelvic pain and signs of peritonitis. Laparotomy and hysterectomy were performed on account of uterine incision necrosis.
Conclusion: The most crucial step in the treatment of retained placenta lies in the early detection of its cause. The treatment includes manual or Surgical removed of placenta which can result in bleeding, infection, and a lengthy recovery.
Nasibeh Roozbeh, Azam Amirian, Fatemeh Abdi ,
Volume 78, Issue 9 (December 2020)
Abstract
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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.
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Ali Hosseininasab, Fatemeh Karami Robati , Fatemeh Hosseininasab , Azam Dehghani,
Volume 79, Issue 7 (October 2021)
Abstract
Background: Mycoplasma pneumoniae is one of the causes of upper and lower respiratory tract infections especially in children, and antibiotics affecting the cell wall do not affect this type of infection. This study aimed to evaluate the prevalence of Mycoplasma pneumoniae and macrolide resistance in children with community-acquired pneumonia in Kerman city.
Methods: This cross-sectional study was conducted in a selected teaching hospital in Kerman city from July 2018 to July 2019. Fifty-one children hospitalized in the pediatric ward were diagnosed with bacterial pneumonia acquired from the community. These children were included in the study by census method. The data collection tool was a standard checklist. The checklist was completed by parents. Pharynx and nasal swab samples were taken from all patients. PCR was used to identify mycoplasma.
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Results: The highest number of patients with bacterial pneumonia acquired from the community were male (52.9%). The average age of these cases was 5.52±3.93 years and the average weight of these patients was 17.23±10.55 kg. Lung involvement was one-sided in more than half of the patients. The most of lung involvements were lobar (31.4%). More than half of the patients didn’t have any associated involvement (52.9%). The most common type of associated involvement was peribronchial thickening (29.4%). The most commonly used antibiotic was Ceftriaxone (76.5%). The prevalence of Mycoplasma pneumoniae infection in children with pneumonia was 2%. These children had an rRNA gene at position 2063 that had high levels of macrolide resistance.
Conclusion: The results of this study showed very low rates of Mycoplasma pneumoniae infection in children with bacterial pneumonia acquired from the community. Therefore, it can be concluded that in addition to Mycoplasma pneumoniae, other viral and bacterial agents are also involved in respiratory infections that need to be identified and addressed.
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Zahra Asgari, Azam Barkhordarinasab, Reihaneh Hosseini , Alireza Hadizadeh, Venus Chegini, Sara Farzadi,
Volume 79, Issue 11 (February 2022)
Abstract
Background: mechanical bowel preparation (MBP) is a common practice before laparoscopic gynecologic surgeries but the role and efficacy of preparation have been questioned. this study assesses visualization and bowel handling in a group of patients who receive MBP and the control group and thereafter; compares the results.
Methods: We designed and conducted this randomized, single-blinded and controlled trial on patients who underwent advanced gynecologic laparoscopic surgeries. This clinical trial was carried out between July 2020 and January 2021. The patients were enrolled from l the laparoscopic office. 120 women aged 18-65 years undergoing level 2 and 3 benign gynecologic laparoscopic surgeries were randomized to bowel preparation with a normal saline enema (n=60) or non-bowel preparation (n=60) groups. Our patients underwent level 2 and 3 of benign laparoscopic gynecologic surgeries with or without MBP. The visualization and bowel handling were assessed by the primary surgical team and a questionnaire was later obtained. The outcomes included intraoperative surgical view and bowel handling, preoperative and post-operative patient signs and symptoms. The patients were also assessed in respect to discomfort prior and after the surgery, this assessment was obtained using a questionnaire. The gathered data was analyzed using IBM’s SPSS v26 software.
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Results: there was no difference in intraoperative visualization and bowel handling between the two groups. We also found no clinical improvements in respect to discomfort and symptoms. MBP even increased the distention rate amongst patients (P-value=0/04). We tried to evaluate whether MBP had any effects on haemorrhage and blood loss during the surgery and to assess this we compared hemoglobin levels before and after the surgery. We compared the subtracted values between the two groups and found no significant difference (T-test=1.135, P=0/259) (see table 4). However, hospitalization duration was about 5 hours longer in the group who received MBP.
Conclusion: MBP with normal saline enema does not improve intraoperative visualization and bowel handling. And it also does not reduce patient complication rates and post-operative symptoms either. MBP also increases hospitalization duration and puts extra pressure on the healthcare system. Therefore, a normal saline enema is not recommended before benign gynecologic laparoscopic surgeries.
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Mahmoud Parham, Davoud Oulad Dameshghi , Hossein Saghafi, Azam Sarbandy Farahani, Saeed Karimi Matloub, Rasool Karimi Matloub,
Volume 80, Issue 8 (November 2022)
Abstract
Background: Vitamin B12 deficiency is one of the most well-known disorders due to long-term use of metformin due to interference with its absorption.
Methods: This double-blind randomized trial was conducted from June to October 2016 at Shahid Beheshti Hospital in Qom on 60 patients in the age group of 30 to 60 years with a history of type 2 diabetes for one to two years and taking metformin in the amount of one to two grams. Patients were divided into two groups of 30 people. The intervention group received metformin with 1 gram of calcium carbonate daily, and the control group received metformin without calcium. Each of the patients in the intervention group was given 200 calcium carbonate tablets. Vitamin B12 levels of the patients in both groups were measured before the start of the intervention, and they were evaluated in terms of neuropathy according to the Michigan questionnaire. Vitamin B12 of patients and neuropathy in two groups were measured before the intervention and after three months.
Results: There was a difference between the two groups in terms of gender, and no significant difference was observed between the mean ages in the two groups. The mean level of vitamin B12 before receiving calcium in group A (intervention) was lower than group B (control) (P=0.036) and after receiving calcium, the level of vitamin B12 in the intervention group increased (P=0.002). In the control group, the level of vitamin B12 decreased (P=0.030). (P=0.006), and in the control group there was no significant difference in the examination of neuropathy (P=0.2).
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Conclusion: Oral calcium daily intake increases vitamin B12 levels in patients with type 2 diabetes and calcium may be able to moderate the decrease in serum vitamin B12 levels induced by metformin in patients with type 2 diabetes.
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