Showing 11 results for Eskandari
Movafegh A, Mir Eskandari M, Eghtesadi Araghi P,
Volume 61, Issue 4 (15 2003)
Abstract
One of the disturbing complications of propofol is pain on injection and the incidence ranges from 28% to 90%. Metoclopromide is commonly used as an anti emetic drug. Some investigators reported that this drug could reduce the pain on injection of propofol. The aim of this study was to assess and comparison of the efficacy of propofol pretreatment with metoclopromide in incidence and severity of its pain on injection.
Materials and Methods: In a randomized, prospective, double-blinded, placebo-controlled trail, 150 patients 18 to 40 yr old were randomly allocated in one three groups. C group (2ml of normal saline), L group (40mg lidocaine in 2ml), M group (l0mg metoclopromide in 2ml). Immediately after injection of study or placebo drugs, 10 mg of propofol with injection rate of 0.5 ml/s (In 4 Seconds) were injected in to the same vein that was inserted to the most prominent dorsal hand vein. Pain severity was measured using Visual Analogue Pain Scale that were educated to the patients before the trail (0 for no pain and 100 for the most aggressive pain in life) and values other than zero was encountered pain appearance. Patients with signs of sedation were excluded.
Results: There was no statistically significant difference between patients in three groups in number of men and women (P = 0.66), age (P = 0.29) and weight (P = 0.49). Furthermore severity (P = differences (C = 41.18, L - 25.4 and M = 13.1, P < 0.001) and patients in metoclopromide group experiences lower pain than other two groups (P < 0.001). Pain incidence in Control group was 77.1% and it was significantly reduced in lidocaine and metoclopromide group (P = 0.002), but there were no significant difference between them (P = 0.051). The 0.69) and incidence (P ~ 0.29) of pain has no significant difference between men and women. Pain severity between three groups has significant results showed that metoclopromide could significantly reduce the seventy of pain on injection of propofol more than lidocaine (opposite to diazepam), but they had no difference in pain incidence. It might lie on the different mechanisms that they produce pain. Pain on injection of diazepam is primarily attributed to propylene glycol, as a vehicle, but the pain mechanism in propofol is remaining unknown.
Conclusion: Finally as regards to other useful effects of metoclopromide including postoperative nausea and vomiting and propofol induction dose reduction, especially when there is a medical condition where lidocaine is contraindicated, it may be a reasonable alternative before injection of propofol.
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.
Khalili D, Hadaegh F, Tohidi M, Fahimfar N, Eskandari F, Azizi F,
Volume 67, Issue 11 (4 2010)
Abstract
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Background: Diabetes and dysglycemia have a high prevalence in
Iranian population but the information about their impact on the cardiovascular
disease (CVD) risk is scarce in this population. This study aimed
to determine the risk of CVD according to glucose tolerance status.
Methods: We ascertained cases with incident CVD in a
population of 1752 men and 2273 women, 40 years old and over and free of CVD at the
beginning of study, during a follow up with a median of 7.6 years. To
calculate hazard ratio (HR) for CVD, we controlled traditional risk factors, including
age, body mass index, waist, total cholesterol, HDL-cholesterol, triglycerides,
systolic blood pressure, diastolic blood pressure, education, smoking,
hypertension medication, lipid lowering medication and family history of
premature CVD and diabetes.
Results: Cardiovascular events
occurred in 197 men and 143 women. Its incidence density was 11.8 per 1000 person-years
(95%
confidence interval: 10.6 to 13.1) totally. Multiple adjusted HR in women with
known diabetes was 3.88 (95%CI: 2.40 to 6.27) and with newly diagnosed was 2.34 (95%CI: 1.39 to 3.95) and the
corresponding values for men were 1.72 (95%CI: 1.00- 2.95) and 1.52 (95%CI: 1.01- 2.31) respectively. Impaired fasting glucose and impaired
glucose tolerance increased 56% the risk of CVD in women (HR:
1.56 with 95% CI, 1.00 to 2.45), just in
the age adjusted model.
Conclusion: All diabetic patients should receive primary
prevention for CVD
intensively, regardless of whether they are newly diagnosed or are known cases
specially, females who have abnormal glucose metabolism.
Hussain Khan Z, Eskandari Sh, Rahimi M, Makarem J, Meysamie A, Khorasani Am, Zebardast J,
Volume 70, Issue 6 (5 2012)
Abstract
Background: Inadequate ventilation, esophageal intubation and difficult intubation are the most common adverse respiratory outcomes in patient undergoing anesthesia .The aim of this study was to compare Mallampati test in supine and sitting positions in traditional approach and during phonation for predicting difficult laryngoscopy and intubation.
Methods: In this study performed in Imam Khomeini Hospital in Tehran, Iran, Mallampati test was performed on 661 patients who met the inclusion criteria for the study. The test was done in supine and sitting positions with and without phonation by a rater who was blind to Mallampati test. Subsequently, laryngoscopy view and difficult intubation were evaluated in the four aforesaid positions by Mallampati test for predicting difficult laryngoscopy and intubation. For each situations, sensitivity, specificity, positive and negative predictive values and accuracy were calculated.
Results: Overall, 28 (4.2%) patients had difficult laryngoscopy and 9 (1.4%) patients had difficult intubation. The highest sensitivity for Mallampati test in predicting difficult laryngoscopy and intubation was in supine and sitting positions without phonation, and the highest specificity was seen in sitting position with phonation. Negative predictive values were more than 95% in all different positions for Mallampati tests and the highest positive predictive value was seen in supine position with phonation.
Conclusion: According to our findings, the highest correlation between Mallampati test and different positions in predicting difficult laryngoscopy and intubation was seen in supine position with phonation. Phonation improved Mallampati score in supine rather than sitting position.
Ahmad Joneidi Jafari , Ebrahim Sahebdel , Asghar Hajipour , Mihan Jafari Javid , Seyed Mohammad Mireskandari , Kasra Karvandian , Afshin Jafarzadeh , Shahram Samadi ,
Volume 71, Issue 11 (February 2014)
Abstract
Background: Surgeons and anesthesiologists working in orthopedic operating theatres are exposed to significant noise pollution due to the use of powered instruments. This may carry a risk of noise-induced hearing loss. The present study was designed to quantify the noise pollution experienced by anesthesiologists at Imam Khomeini Hospital which is one of the largest Iranian hospitals.
Methods: Prior to beginning of any operation a sound level meter was worn by the anesthesiologist at the level of chest pocket. Basal sound level was recorded. All changes in the sound level of 25 operation rooms and two related pass ways were recorded and the mean sound level along with maximum sound level were noted. These data were analyzed by SPSS version 17. For comparing the mean values, the One way ANOVA and Post-Hoc analysis was used. Noise exposures were compared with occupational health guidelines.
Results: Our comparative data showed that orthopedic operation room had the highest level of noise, indicating that orthopedic operation room is significantly suffered by the most types of noise with the P value of 0.002. This is contrast to the sound levels at the other operation rooms which were at same range and were not significantly different. Comparison of the maximum sound level between these 27 places showed that orthopedic and one of general surgery room had top two maximum sound levels.
Conclusion: Overall total noise dose during all types of surgeries was measured as twice of permitted dose and also orthopedic and general operation rooms experience brief periods of noise exposure in excess.
Fatemeh Eskandari , Masoud Soleimani , Nasim Kalantari , Mehdi Azad , Amir Allahverdi ,
Volume 72, Issue 11 (February 2015)
Abstract
Background: Hematopoietic stem cell transplantation (HSCT) is a therapeutic approach in treatment of hematologic malignancies and incompatibility of bone marrow. Umbilical cord blood (UCB) known as an alternative for hematopoietic stem/ progenitor cells (HPSC) for in allogenic transplantation. The main hindrance in application of HPSC derived from umbilical cord blood is the low volume of collected samples. So, ex vivo expansion of HPSCs is the useful approach to overcome this restriction. Synthetic biomaterials such as nanofibers is used to produce synthetic niches. The aim of this study was the ex vivo expansion of hematopoietic stem cells on biocompatible nanofiber scaffolds.
Methods: This study was done at Tarbiat Modares University from November 2012 to June 2013 and was a research study. Umbilical cord blood CD133+ hematopoietic stem cells were separated using MidiMacs (positive selection) system by means of monocolonal antibody (microbeads) CD133. Flow cytometry was used to assess the purity of cells. Cell culture was done on plate (2 Dimensional) and fibronectin conjougated polyether sulfone nanofiber scaffold (3 Dimensional). Colony assay test was used to asses the ability of colonization of cells.
Results: Cell count analysis revealed the expansion of hematopoietic stem cells in cell culture plate (2D environment) and on nanofiber scaffold (3D environment) after 2 weeks. Expansion of cells in 2D environment was greater than 3D condition. Colony assay test revealed that the colonization ability of cells decreased after 2 weeks, but this decrease was lower in scaffold culture than plate culture.
Conclusion: This study demonstrated that umbilical cord blood CD133+ hematopoietic stem cells can expand on fibronectin conjugated polyether sulfone scaffold and we can use this system for expanding of cells in vitro situation.
Samaneh Asgari , Davood Khalili , Fereidoun Azizi , Fatemeh Eskandari , Narges Sarbazi , Farzad Hadaegh ,
Volume 72, Issue 12 (March 2015)
Abstract
Background: In Nov 2013, the instruction for controlling high cholesterol has been released by the American College of Cardiology (ACC) and the American Heart Association (AHA) which need to be assessed in the different communities.
Methods: Of total 6275 individual aged 40-75 years who entered at the Tehran Lipids and Glucose Study from March 1999 to 20 March 2010 in first examination cycle, 5153 with the median follow-up of more than ten years were eligible to enter in this study. The 10-year risk of hard cardiovascular disease (Hard CVD) for Statin therapy based on ACC/AHA clinical guideline was calculated and this risk was calculated for each subgroup of the guideline who recommended for statin therapy comparing to the risk in individuals with prevalent CVD.
Results: Of nearly 6.5 million urban population of Iran (according to the 1996 census) about 4 million individuals (2.55 million men and 1.4 million women) were eligible for statin therapy. With respect to the urban population growth from the 1996 to the 2011 census (about 2.5 percent increases) the number of individuals for receiving statin increased by 50% (5 million men and 3 million women). Also, the risk in non-diabetic men with calculated risk of 5-7.5% and diabetic women with calculated risk of <5% for hard CVD was lower than 0.2. By removing these people from total eligible population, the burden of statin therapy will reduced about 8% which is about 540.752 persons, according to the Census 1996 and 1.155.079 individuals based on the census 2011.
Conclusion: The new guideline of ACC/AHA for statin therapy is relatively reasonable except for some subgroups. To reduce the burden of medical expenses, statin prescription can be ignored by physicians in these subgroups. Of course further research is required to calculate the net benefit for estimating the clinical usefulness of statin therapy in recommended guideline subgroups.
Arash Salmaninejad , Zahra Golchehre , Mohammad Bagher Eskandari , Eskandar Taghizadeh , Abbas Shakoori ,
Volume 76, Issue 1 (April 2018)
Abstract
Cancer/testis antigens (CTAs) are a kind of antigens that their expression mostly is restricted in testis and female’s genital organs. Tumor cells often express antigens whose expression is normally limited to germ cells. CTAs are composed of a vast gene family of closely related members and are commonly classified into two groups: the CT-X antigens that are encoded by the X chromosome and the non-X CTAs that are encoded by the autosomes. CTA are extensively and variably dispersed between tumors of diverse histotypes. CTA are broadly expressed in tumors, but not in normal tissue except for testis that is not available to the immune system, actually, the blood-testis barrier and the lack of HLA class I expression on the surface of germ cells avoid the immune system from the interaction with CTA proteins to be identified as non-self-structures. Consequently, CTA can be regarded as fundamentally tumor-specific targets. With extensive investigations on the function of this important biological molecules, their functions are somewhat revealed. Because of their high immunogenicity, tumor-limited, and biased expression, detection of these molecules provides unprecedented chances for further research and clinical development in the field of immunotherapy and cancer diagnosis. Also, growing evidence discloses that a number of CTAs stimulate epithelial mesenchymal transition (EMT) and generation of cancer stem-like cells, increasing metastasis, invasion and tumorigenesis. According to recent clinical attention, more features of CTA regulation are explored. CTA expression has been confirmed in a variety of human cancer tissues and some of them have been discovered to cause humoral and/or cellular immune responses in cancer patients, likewise, they displayed intertumor and intratumor heterogeneity in expression levels. CTAs are excellent targets for targeted tumor therapy, anticancer drug discovery, and diagnostic biomarkers, similarly, appreciated genes in the study of promoting tumorigenesis, immunotherapy, and malignant progression. This review summaries and classifies our current understanding of the complex and biased process of CTAs mRNA and protein expression in cancer, and provide the most current information on their function and regulation.
Hasan Asadi Gandomani , Abdorreza Naser Moghadasi , Mohammad Ali Sahraian , Sharareh Eskandarieh,
Volume 79, Issue 12 (March 2022)
Abstract
Background: The onset of primary progressive multiple sclerosis (PPMS) can be triggered by sun exposure and physical activity. The present study aimed to determine the risk of sun exposure and physical activity in PPMS development.
Methods: The case-control study recruited PPMS cases and healthy controls from the general population from September 2019 to September 2020 in Tehran, Iran. The selection of sex-matched controls from the same source population of cases was performed. Sun exposure was assessed in terms of exposure time in two age groups of 13-19 years and over 20 years in winter and summer.
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Results: This study examined 146 PPMS cases and 294 controls. The sun exposure in summer in the age group 13-19 was negatively associated with the incidence of the disease (OR=0.68 (CI=0.57-0.82)). This relationship was also observed in the groups of men (OR=0.55 (CI=0.40-0.74)) and women (OR=0.70 (CI=0.53-0.91)). Exposure to sunlight in winter in the age group 13-19 was negatively associated with the incidence of the disease (OR=0.28 (CI=0.19-0.42)). In the group over 20 years, sun exposure was negatively associated with disease incidence in summer (OR=0.49 (CI=0.36-0.66)). Exposure to sunlight on average in winter in the age group over 20 years was negatively associated with the incidence of the disease (OR=0.14 (CI=0.07-0.28)) which in the male group OR=0.12 (0.04-0.32)) and women (OR=0.06 (CI=0.02-0.21)) were seen. Regarding physical activity, only physical activity above 4000 MET per week in the group of women was negatively associated with the incidence of the disease (OR=5.30 (CI=1.05-26.59), but in other groups, this negative relationship was not observed.
Conclusion: Exposure to sunlight in winter and summer had a negative relationship with the incidence of the disease. Physical activity was only negatively associated with the incidence of the disease in very high doses and women.
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Nazanin Razazian, Mohammad-Ali Sahraian, Sharareh Eskandarieh, Nooshin Jafari, Mansour Rezaei, Negin Fakhri,
Volume 80, Issue 6 (September 2022)
Abstract
Background: People with chronic diseases of the immune system, such as multiple sclerosis (MS), are at risk for Covid-19 disease. However, more research is needed with long-term follow-up. The aim of the study was to follow up people with MS (PwMS) for up to three months after AstraZeneca vaccination for the recurrence of MS and Covid-19 infection.
Methods: This study was a case study (descriptive-analytical) of follow-up type. The study population was PwMS over 18 years of age in Kermanshah province who received both doses of the AstraZeneca vaccine. This study was conducted from August to November 2021. Sampling was done with existing methods based on the National MS Registry of Iran (NMSRI). Demographic information of patients was extracted from NMSRI. A researcher-made form was used to collect information by telephone three months after vaccination about clinical characteristics, Covid-19 infection, and recurrence of MS. Data were analyzed using SPSS-25 software.
Results: Study participants were 40 MS patients with a mean (SD) age of 39.27 (8.8) years, including 32 (80.0%) women. A mean of 9.39 (4.6) years had passed since The patients were diagnosed with MS, and 29 (76.4%) had RR type MS. Four patients (10%) relapsed between the second dose and three months later, of whom two (50%) had sensory symptoms, one (25%) had optic nerve involvement, and one (25%) had motor symptoms and pyramidal pathway involvement. The symptoms of Covid-19 were mild in three patients (10%), while severe symptoms developed in one patient (10%) who received rituximab. Among the patients, no cases of thrombosis were observed. Infusion therapy, a leg fracture, and kidney stones were the only hospitalized cases.
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Conclusion: Covid-19 and MS relapse prevalence did not differ significantly in the three months before and after vaccination. There is a need for further studies with a longer follow-up period.
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Hossein Eskandari, Faramarz Sohrabi , Adeleh Rezagholizadeh Shirvan , Mohammad Asgari , Neda Shahvaroughi Farahani ,
Volume 81, Issue 12 (March 2024)
Abstract
Background: The experience of existential distress, along with other forms of distress, is one of the common experiences in end-of-life patients. Therefore, the purpose of this research is to review related studies and conceptualize existential distress in palliative care of cancer patients.
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Methods: This study was a systematic review, which was conducted from May 1 to July 31, 1402 at Allameh Tabatabai University and search strategy was written and performed in MEDLINE, Web of Science/PubMed and Scopus databases from the beginning of 2003 to the end of 2022. The inclusion criteria included all quantitative, qualitative, mixed and review studies that focused on the experience of adult patients. Lack of access to the full text of the article and studies in non-English language, clinical trial (randomized and non-randomized), letter to the editor, case report and protocol were excluded from the list of studies. After removing duplicate articles, two research authors reviewed the studies independently according to the inclusion and exclusion criteria, and the differences between them were resolved by discussion.
Results: After searching, screening and selecting articles based on inclusion and exclusion criteria, finally 22 articles were included in the study, of which three were review articles, eight were quantitative and 11 were qualitative. Terminally cancer patients experience existential distress, and the data are significant for estimating the prevalence of these symptoms, especially in the severe category. In addition to examining the prevalence of this symptom, patients have described their experience of existential distress in several categories: Feelings of loneliness and isolation (or loss of support system), relationship concerns (concerns about family, changes in relationships, and conflictual relationships), loss of control/autonomy (physical control, cognitive and emotional control), burden on others, loss of sense of continuity (loss of roles, pleasurable activities and sense of self), uncompleted life tasks, hopelessness/helplessness, dissolving of the future, uncertainty and frightening ambiguity, feeling guilt/ regret about the past, lack of meaning, inevitable thoughts of death.
Conclusion: It seems that the themes raised beyond cultural differences show the universal human suffering, whose accurate conceptualization can help to develop effective therapeutic interventions to reduce existential distress.
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