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Treatment of cutaneous leishmaniasis: cassia fistula fruit gel- intralesional glucantime Vs. placebo gel- intralesional glucantime combination
Fariba Jaffary , Mohammad Ali Nilforoushzadeh , Nazli Ansari , Marzieh Rahimi ,
Volume 67, Issue 10 (1-2010)
Abstract
Background: Cutaneous leishmaniasis is a major health problem in Iran and especially Isfahan province is considered as an endemic area for this disease. Regarding the previous report of positive effects of Cassia fistula boiled extract in the treatment of cutaneous leishmaniasis, this study was designed to evaluate the effect of combination therapy with intralesional meglumine antimoniate and Cassia fistula fruit gel compared to placebo in this disease.
Methods: 140 patients with cutaneous leishmaniasis referring to Skin Disease and Leishmaniasis Research Center of Isfahan (SDLRC) were randomly allocated in two groups. One group received intralesional meglumine antimoniate injection and Cassia fistula fruit gel and the second group were treated with intralesional meglumine antimoniate and placebo gel. Improvement was defined as complete cure, partial cure and treatment failure.
Results: At 12 week, 47 patients treated with intralesional meglumine antimoniate and topical Cassia fistula fruit gel achieved complete cure (67.1%) compared to 29(41.4%) patients in placebo treated group. There was significant difference in cure rate between two treatment groups of this study (p<0.001). Nine patients (19%) in each group suffered from adverse effects of the treatment such as itching and erythema. There was no significant difference in this regard between two groups (p=0.82).
Conclusions: The results of this study shows the efficacy of Cassia fistula fruit gel in increasing the cure rate of cutaneous leishmaniasis lesions achieved by intralesional meglumine antimoniate. Combination therapy of intralesional meglumine antimoniate and Cassia fistula fruit gel could be suggested as a choice for the treatment of acute cutaneous leishmaniasis lesions.

Prevalence of hearing loss among high risk newborns hospitalized in hospitals affiliated to Tehran University of Medical Sciences
Ali Zamani, Alireza Karimi, Mohsen Naseri, Elaheh Amini, Mohammad Milani, Amir Arvin Sazgar, Seyed Mousa Sadr Hosseini, Mohammad Sadeghi Hassan Abadi, Fatemeh Nayeri, Firouzeh Nili, Mamak Shariat, Mostafa Vasigh, Fariba Nasaj, Fatemeh Zamani, Narges Zamani,
Volume 68, Issue 1 (4 2010)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: American pediatric Association proposes to screen all neonates with Oto-Acoustic Emission (OAE). In developing countries, because of several limitations, health policy makers recommend to screen only in high risk patients. This study is performed with the aim to screen hearing loss in 950 high risk newborns hospitalized in hospitals affiliated to Tehran University using the OAE test.
Methods: A total of 950 neonates hospitalized in the Neonatal and NICU wards of Vali-e-Asr, Shariati, Medical Center and Bahrami Hospitals during the years 2004-2006 who showed at least one risk factor using TEOAE hearing test were enrolled into this cross-sectional descriptive analytical study and were diagnosed with mild deafness and total deafness. Blood exchange due to hyperbillirubinemia, septicemia, congenital heart disease, the fifth minute apgar scores below six, PROM more than six hours, epilepsia, need to NICU more than five hours, pneumonia and Oto-Toxic drugs were considered as risk factors. Data was past medical history, current disease, admission cause, sign & symptoms and complications of disease.
Results: Multivariate logistic regression and paired t-test showed that blood exchange, low birth weight and low first minute Apgar scores had the highest independent risk for hearing loss among newborn.
Conclusion: Despite of the low prevalence of neonatal hearing loss, screening of hearing loss at early stages is important.


Resistance pattern of bacterial agents causing ophtalmia neonatorum
Peymaneh Alizadeh Taheri, Fariba Bahmani , Mamak Shariat ,
Volume 71, Issue 5 (August 2013)
Abstract
Background: One of the most common infections in neonatal period is ophthalmia neo-natorum. In this study, the bacterial agents, drug resistance and susceptibility of bacteri-al agents were studied.
Methods: In this study a total of 72 newborns with ophthalmia neonatorum admitted in Bahrami Hospital in Tehran during the years 2008-2011 were continuously enrolled in a case series, descriptive study. Demographic data, including age, sex, cause of admis-sion and culture of discharge from the eyes and its antibiogram, as well as experimental treatments and treatment outcomes were collected.
Results: Forty four infants (61.1%) were males and 28 (38.9%) were females and the mean age on admission was 11.6±7.7 days. In 51 patients (70.8%) the onset of ophthal-mia neonatorum was prior to admission. More than 56% of cases with ophthalmia neonatorum were associated with sepsis. On the other hand, positive blood culture was detected in 15.3% of cases. Among 72 neonates with ophthalmia neonatorum, 26 (36.1%) had a positive culture of the eye discharge. The most common causes of bacterial agents were Staphylococcus aureus (46.1%) (12 of 26 cases). Other causes included streptococcus species (23%), Pseudomonas (15.3%), E-coli (11.5%) and Haemophilus influenza (3.8%). The most frequent causes of drug resistance were Ampicillin, Penici-llin, Cefixime, and Ceftazidime (100% resistance). The most sensiti-ve antibiotics were vancomycin and imipenem (100% sensitivity). Based on the conventional treatment, clinical response to local gentamicin was approximately 60%. Sulfacetamide was associated with no clinical response in 40% of cases.
Conclusion: The antibiogram and clinical response to empiric treatment showed that resistance to ampicillin and some third generation of cephalosporine was 100%. Aminoglycosides’ sensitivity was more than 50% locally and systemically. Our recommendation is performing eye discharge culture before antibiotic treatment. More studies with numerous cases should be done for better definition of bacterial resistance.

A new grading system “two-tier” in clasification of ovarian serous carcinoma and evaluation of P53 gene expression by immunohistochemical staining
Narges Izadi-Mood, Soheila Sarmadi , Banafsheh Rajabian , Fariba Yarandi , Afsaneh Rajabiani ,
Volume 71, Issue 10 (January 2014)
Abstract
Background: Recently the use of “two tier" grading system in which ovarian serous carcinoma was classified as low-grade or high-grade in comparing to preceding system has improved authority in prognosis and survival. This approach is simplistic, reproducible, and based on biologic evidence. In this study, we reclassified ovarian serous carcinoma by a new two-tier system for grading and then evaluation of P53 expression in these tumors by immunohistochemistry method. Methods: We retrospectively reviewed 32 cases of ovarian serous carcinoma with previous diagnosis of well differentiated (eight cases) and moderate to poorly differentiated serous carcinoma (24 cases) and according "two tier" grading system in low-grade vs. high-grade serous carcinoma reclassified. Subsequntly all cases immunostained by P53 marker. Also clinical data related to survival of patients (with or without recurrence of tumor and death) and paraclinical findings such as presurgical blood serum level of CA125 are gathered. Results: Out of total eight patients with previously diagnosis well diferentiated serous carcinoma and of 24 patients with moderate to poorly differentiated serous carcinoma reclassified as low-grade and high-grade ovarian serous carcinoma respectively and a statistically significant difference was found between two groups. (P<0.005) Also of total 24 cases with high grade serous carcinoma, in 12 cases (54%) P53 immunostaining was detected but in non of all low grade serous carcinoma was seen. All 8 low grade serous carcinoma were alive without recurrence of tumor. In 10 and 12 out of 24 cases with high grade serous carcinoma recurrence of tumor and death were seen respectively. Conclusion: Since the presence of P53 negative expression in all of low-grade serous carcinoma by immunostaining and low-grade serous carcinoma accounts for small pupulation of all ovarian serous carcinoma and also few cases in our study, we did not find significant differences between P53 expression and survival in two low-grade vs high-grade serous carcinoma groups.
Serological study of Helicobacter pylori infection in patients with Polycystic Ovary Syndrome
Farnaz Sohrabvand , Mamak Shariat , Mohammad Jafar Farahvash , Fedyeh Haghollahi , Mahnoosh Khosravi , Masoomeh Maasomi , Maryam Bagheri , Alireza Abdollahi , Akram Sarbiyaie , Fariba Bashari ,
Volume 71, Issue 10 (January 2014)
Abstract
Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Chronic infections have been mentioned as one of the different etiologic factors related to PCOS. Due to the high prevalence of Helicobacter pylori infection especially in developing countries, its probable role in the pathogenesis of PCOS and the limited information available in this area, serologic study of H.Pylori infection in patients with PCOS, was performed. Methods: This research was performed as a case control study from Dec 2010 until May 2012 in 82 patients (and their spouses) with polycystic ovary syndrome (case group) and 82 non PCOS patients (control group) with an age range of 20-40 referred to Vali-e-Asr Hospital infertility clinic. Both groups and their husbands filled a questionnaire and were examined by testing their serum H.Pylori IgG and IgA antibody levels. Statistical testing and analysis was performed by t-student and λ2 tests. Results: Mean age of the women and men and also other demographic characteristics except their profession showed no significant difference (P>0.05) in the two groups (PCOS and non PCOS). H.Pylori antibody IgG serum level was positive in 78% and 76.5% and H.Pylori antibody IgA level in 30.5% and 37% of PCOS versus non PCOS patients respectively which showed no statistically significant difference (P>0.05). There was also no significant difference between the H.Pylori antibodies levels in the spouses in the two groups (P>0.05). Conclusion: This study showed no significant difference in serologic examination re-sults in PCOS versus non PCOS patients. The finding of high prevalence of H.Pylori IgG and IgA positive levels in both PCOS and non PCOS patients can be probably re-lated to the high prevalence of H.Pylori infection or exposure in Iranian population and therefore suggest an issue for further investigation.
Influence of GnRH analogue on body mass index in girls with precocious puberty: a prospective study
Heshmat Moaieri , Zeinab Modarresi Mosalla, Mamak Shariat, Zahra Haghshenas, Fariba Naderi ,
Volume 72, Issue 3 (June 2014)
Abstract
Background: Gonadotropin-releasing hormone analog (GnRHa) therapy is used in central precocious puberty (CPP) worldwide and it is the treatment of choice for this condition. Many of the previous studies concerning the effect of gonadotropin-releasing hormone analog (GnRHa) therapy on height. Much less attention has been paid to changes in body weight. However, concerns have been expressed that CPP may be associated with increased body mass index (BMI) both at initial presentation and during GnRH agonist treatment, but it is controversial in some studies. Methods: We have retrospectively reviewed 52 female patients that the majority of them had CPP. We assessed height, height SDS, weight, weight SDS, BMI and BMI SDS. All patients were treated with GnRHa over 12 months. The variables were evalu-ated at 0, 6 and 12 months after initiation of treatment.8 girls received growth hormone concomitantly. Also bone age and sexual maturity were measured. Bone age was assessed according to the Greulich-Pyle method and sexual maturation was classified according to the Marshall-Tanner method. Results: Before the initiation of therapy, the girls had a mean BMI SD score for chronological age of 0.80± 1.18 after 6 months of therapy BMI SDS was 0.82± 1.15 and after 12 months was 0.82± 1.28 the P value is 0.909 and it is not statistically signif-icant. Height SD score for chronological age was 0.41± 1.65 before the initiation of therapy and was 0.41± 1.65 after 6 months and 0.43± 1.60 after 12 months of therapy. The P= 0.66 and it is not statistically significant. Eight girls received growth hormone concomitantly, in this group increasing height SDS is statistically significant P= 0.044 but increasing BMI SDS is not significant. Conclusion: Gonadotropin-releasing hormone analog (GnRHa) therapy in central precocious puberty (CPP) is safe for BMI and increasing of BMI is not significant, long- term follow-up study is required to elucidate whether GnRHa treatment affects adult obesity. Using growth hormone concomitantly, the effect on increasing height is significant.
Comparison of androgenic alopecia distribution among type 2 diabetes and healthy women in Isfahan city: a brief report
Fariba Jafari , Mohammad-Ali Nilforooshzade , Samane Porajam , Motahar Heidari-Beni ,
Volume 72, Issue 6 (September 2014)
Abstract
Background: Insulin resistant is important risk factors of diabetes and leads to development of chronic diseases such as diabetes and cardiovascular disease. Recent studies showed association between androgenic alopecia and insulin resistant. However, findings are controversial. Alopecia in women is a common heritable hair loss in central part of head. Aim of this study was investigation of androgenic alopecia distribution in type II diabetes and healthy women and hypothesis testing of relationship between diabetes and androgenic alopecia. Methods: This is a case-control study. Case and control groups were selected from type II diabetes and healthy women respectively that were refered to clinics of Alzahra, Noor and Amin Hospitals in Isfahan City, Iran in 2011. Participants were selected based on random sampling. Sample size was estimated 141 subjects in each group. Participants were visited by doctor and severity of androgenic alopecia was determined based on Ludwish criteria. Data were analyzed with SPSS software and 2 test. P<0.05 was considered as significant. Results: Mean age and body mass index were 58.96±12.8 year and 25.6±4.15 kg/m2 respectively in whole population. Findings not show any significant association between type II diabetes and androgenic alopecia (P<0.05). Comparison of distribution of alopecia severity according to Ludwish criteria separately showed similar result. In addition to, there was not any significant relationship between diabetes and alopecia after adjusting with body mass index as confounding factor (P<0.05). Conclusion: In the present study, there was not any significant relationship between type II diabetes and androgenic alopecia among diabetes and healthy women. However, more researches need to investigate this relationship in both gender and assess insulin resistant indices as homeostasis model assessment-estimated insulin resistance and androgenic alopecia.
Clinical results of microinjection with long protocol and prednisolone addition
Fariba Nanbakhsh , Behrooz Ilkhanizadeh , Nava Moghadasian Niaki , Sima Oshnouei, Pooya Mazloomi ,
Volume 73, Issue 1 (April 2015)
Abstract
Background: Last decades, we have observed major improvements in treating infertility by using microinjection. However, reduction in abortion or increase in fertility has not been significant. It seems use of corticosteroids improves clinical outcomes during assisted reproductive technology (ART) techniques. Therefore, this study tried to show how corticosteroids therapy improves the results of intracytoplasmic sperm injection (ICSI). Methods: This semi clinical trial study without control group was included infertile women with more than one year’s infertility and were candidate to ICSI which were referred to Kosar Infertility Center, Urmia University of Medical Sciences from April 2011 to September 2013. Patients received prednisolone which was started 20 mg/day from one day before embryo transfer to 7 days, then for 2 days more 1 tablet and stopped. Pregnancy outcomes were chemical and clinical pregnancy, ectopic pregnancy, multiple pregnancy and rate of abortion before 20 weeks. Beta human chorionic gonadotropin (HCG) test was performed. Patients with positive pregnancy test were followed by sonography in 6, 12 weeks and 20 weeks of pregnancy. Results: One hundred and eighty one patients entered to the study. The mean± SD of age and fertility duration were 30.42± 6.07 and 7.69± 5.54 years. The mean± SD of transferred embryo was 4.60± 1.10 and embryo grading was 138 (44.7%) grade A, 124 (40.1%) grade B, 47 (15.2%) grade C, respectively. There were no significant difference between fresh/frozen embryo transfer in pregnancy outcomes (P> 0.05 in all of outcomes comparison). The incidence rate of biochemical pregnancy was 48.1% (87), clinical pregnancy rate with appearance of fetal heart was 44.2% (80), incidence rate of abortion before appearance of fetal heart (6 weeks) in women with intra-uterine pregnancy was 5.9% (5), incidence rate of abortion before 20 weeks was 12.9% (11). Incidence rate of ectopic pregnancy was 2.3% (2) and rate of multiple pregnancies was 32.5% (26). Conclusion: Our study suggests that the infertile patients who receive prednisolone in ICSI cycle, had improved pregnancy outcomes. Additional confirmatory studies are needed.
The effect of pelvic floor physical therapy on sexual function in women complaining dyspareunia
Parvin Bastani , Sakineh Hajebrahimi , Fariba Ghaderi , Zahra Vakilazad , Morteza Ghojazadeh ,
Volume 74, Issue 7 (October 2016)
Abstract

Background: Dyspareunia is a pain that is occurs in the genital area before, during or after intercourse and is an important factor for sexual dysfunction. The aim of this study was to evaluate the effect of pelvic floor physical therapy on sexual function and muscle strength and endurance of pelvic floor (as a non-invasive therapy) in women with dyspareunia.

Methods: In this clinical trial study, 32 women in the age range of 20-50-year-old and sexually active with complaints of dyspareunia, before the investigation were examined in terms of genital health and strength and endurance of the pelvic floor muscles. After the confidence of mental health, patients underwent pelvic floor rehabilitation for 10 sessions during 3 months. After assessment, myofascial release techniques and progressive pelvic floor muscles exercise was performed for patients based on their primary strength. Finally, patients were compared in terms of the severity of dyspareunia, sexual performance status (by using female sexual function index questionnaire), improvement of symptoms, pelvic floor muscle strength and endurance before (first session of physiotherapy) and after (after 3 months) investigation.

Results: In the remaining 32 patients with dyspareunia with a mean age of 38±1.24 years, desire index score 0.95 unit, arousal index score 1.01 unit, lubrication index score 0.67 unit, orgasm index score 0.71 unit, satisfaction index score 1.03 unit, pain index score was increased 1.05 unit, strength index score 2.44 unit, endurance index score 7.06 unit were increased in comparison to before the investigation that showed a significant different with P< 0.0001.

Conclusion: According to obtained results, pelvic floor physical therapy had a significant effect in women with dyspareunia. So that the severity of dyspareunia, pelvic floor muscle strength and endurance had clinically significant improvement after pelvic floor physiotherapy.


The study of dietary patterns and their relationship to anthropometry in female nurses
Karolin Abashzadeh , Fereydoun Siassi , Mostafa Qorbani , Fariba Koohdani , Negin Farasati , Gity Sotoudeh ,
Volume 74, Issue 12 (March 2017)
Abstract

Background: Nurses are prone to continuous stress due to their job situation that lead to many physical and psychological disorders. this job stress also affects their personal life and career. The aim of this study was to evaluate the association between major dietary patterns and anthropometry in nurses.

Methods: We conducted a cross-sectional study from February to October 2014. In this cross-sectional study, 320 female nurses were selected randomly from eight hospitals affiliated to Tehran University of Medical Sciences in 2014. This research project carried out with the code 24371 Tehran University of Medical Sciences in Research Ethics Committee approved. Anthropometry and blood pressure measurement was done. Data on physical activity were obtained using the short version of international physical activity questionnaire.

Results: Three dietary patterns were identified using factor analysis and labeled: healthy, unhealthy and traditional. The healthy dietary pattern score was significantly related to weight and body mass index (BMI) of participants after adjusting for confounders (P=0.05, P=0.01, respectively). There was not significant association between the unhealthy dietary pattern and anthropometry measures. The unhealthy dietary pattern score was inversely related to systolic and diastolic blood pressure after adjusting for confounders (P=0.001, P=0.03, respectively). There was not any significant association between the traditional dietary pattern and anthropometry and blood pressure measures (P>0.05).

Conclusion: According to the result of this study, three dietary patterns including, healthy, unhealthy and traditional were identified in nurses. The healthy dietary pattern was associated with weight and BMI and the unhealthy dietary pattern was inversely associated with blood pressure. The traditional dietary pattern had no effect on anthropometry and blood pressure measures.

Omeprazole versus doxycycline combination therapy with topical erythromycin the treatment of acne vulgaris: a randomized clinical trial
Fariba Jaffary , Mohammad Ali Nilforoushzadeh , Hanieh Sharifian Koupaiee , Gita Faghihi , Seyed Mohsen Hosseini , Fateme Sokhanvari , Nazli Ansari , Giti Sadeghian ,
Volume 75, Issue 1 (April 2017)
Abstract

Background: Acne vulgaris is self-limiting, multifactorial disease involving sebaceous glands. Omeprazole is a proton pump inhibitor with in vitro antibacterial effects against staphylococcus aureus and anti-androgen that can be potential treatment of acne vulgaris. This study was designed to evaluate the efficacy of oral omeprazole and erythromycin 4% compared to doxycycline combination therapy in the treatment of acne vulgaris.

Methods: In this clinical trial study, patients with moderate acne were referred to Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Science, Iran, during August 2014 until November 2015 and were randomized into two groups receiving topical erythromycin 4% plus omeprazole (34 patients) or doxycycline (35 patients) for 3 months. Moderate acne, lack of sensitivity to proton pump inhibitors, lack of warfarin, phenytoin, diazepam consumption, lack of active liver or kidney disease, being older than 12 years, were considered as inclusion criteria. Pregnant or lactating patients, patients with drug allergy history, patients taking oral contraceptives, acne topical medications (including retinoids) or systemic treatment within 30 days of study, patients with oligomenorrhea, hirsutism, acne conglobata, acne fulminant or body acne alone were excluded from the study. All patients were tested for Helicobacter pylori test at the beginning of the study.

Results: Both inflammatory and non-inflammatory lesions decreased in both groups with negative correlation with age (P< 0.05). There was no significant correlation between positive Helicobacter pylori test and inflammatory or non-inflammatory lesion reduction (P= 0.794, P= 0.514). Also, patient satisfaction and rate of total drug side effects was not different between two treatment groups. Rate of skin reactions was 20.58% in omeprazole treated group and 11.42% in doxycycline group. For side effects, other than skin it was 2.94% versus 14.28% respectively.

Conclusion: Omeprazole could be suggested as an alternative for doxycycline in the treatment of patients with moderate acne vulgaris especially in non-inflammatory lesions.

The effects of rope training on Paraoxonase-1 enzyme, insulin resistance and lipid profiles in inactive girls
Bahloul Ghorbanian , Fariba Shokrollahi ,
Volume 75, Issue 4 (July 2017)
Abstract
Background: Paraoxonase-1 (PON1) is one of the most important enzymes for removal of the free radicals, and the main protective factor for lipoproteins against oxidative agents. The purpose of this study was to investigate the effects of eight weeks’ rope training on paraoxonase-1 enzyme, insulin resistance and lipid profiles in inactive overweight and obese girls.
Methods: This quasi-experimental study was conducted in Iranian Azarbaijan Shahid Madani University of Tabriz, from November 2016 to January 2017. In this study, 20 healthy overweight and obese in-active girls (20-25 Yr) volunteered and randomly assigned into exercise (n=10) and control (n=10) groups. Exercise protocol was rope training was 8 week for 4 day per week in 45 minute per day. Some anthropometric indexes of subjects were measured before and after exercise. A fasting blood sample was collected as pre-test and post-test, followed by 48 hours of physical inactivity to measure serum levels of PON1 enzyme, Insulin, lipid profiles and other blood variables. Analysis of the data was performed by paired and independent samples t-tests by using the SPSS software, version 20 (IBM, Armonk, NY, USA). The criterion of statistical significance was set as P<0.05.
Results: The paired samples t-test results showed that after exercise intervention, in exercise group, the values of all variables (except low-density lipoprotein) were significantly changed. Also, to compare with control group, the values of PON1 enzyme (P=0.024) and maximum oxygen consumption (P=0.006) significantly increased and insulin resistance index (P=0.028), triglyceride (P=0.046) and body fat percent (P=0.001) were significantly decreased (P<0.05).
Conclusion: The results of this study showed that performing rope training for 8 weeks induced positive changes in paraoxonase-1 enzyme, insulin resistance index, maximum oxygen consumption and some lipid and anthropometric indices in overweight and obese young girls. Therefore, according to these results, rope training, as an aerobic activity it can be useful for all people especially in overweight and obese to control blood fats, body composition and prevent diseases due to obesity such as cardiovascular disease. 

Review of the prevalence and causes of antimony compounds resistance in different societies review article
Fariba Jaffary , Latifeh Abdellahi , Mohammad Ali Nilforoushzaheh ,
Volume 75, Issue 6 (September 2017)
Abstract
Cutaneous leishmaniasis (CL) is an endemic parasitic disease of major health impact in many parts of the world and is caused by several species of the protozoan parasite Leishmania. Antimonial compounds (i.e glucantime and pentostam) are the first-line treatment for cutaneous leishmaniasis with emerging drug resistance as a problem. The control of Leishmania is further complicated by the emergence of drug-resistant parasites. In the clinical settings, resistance to SbV containing drugs is now well established and it was found to occur in South America, Europe, the Middle East and most notably in India. Clinical resistance to organic pentavalent antimonials, in the form of sodium stibogluconate (pentostam) or N-methylglucamine antimoniate (glucantime), has long been recognized. However, it is unknown whether the clinical failure of chemotherapy is attributable to the development of drug resistance mechanisms in the parasite or to a variety of host factors that might also contribute to low drug response. Reported rate of drug-resistance to antimonial compounds in Iran varies from 9.4% to 94.2% and there is not any comprehensive study on this issue. Indeed, in the endemic region treatment with SbV fails in more cases; thus, in general patients infected with resistant parasites are unresponsive although exceptions have been reported. This article aims to review the mechanisms of drug resistance to these compounds. The main resistance factors include genetical, enzymatic, intracellular (such as apoptosis and cytoskeleton changes) and resistance proteins. Also, mechanisms related to drug transport and intracellular activation are discussed. Various methods of drug resistance detection such as culture and molecular methods (i.e polymerase chain reaction) are reviewed. Although the exact mechanism of action glucantime is not clear, it seems that protein and gene factors involved in cellular drug entry are the main causes of drug resistance. Cross-sectional studies on meglumine antimoniate resistance in endemic areas of cutaneous leishmaniasis in Iran are highly recommended. Also, studies for evaluation of alternatives therapies for antimonial resistant cases are required.   

The effect of wet cupping on serum levels of interferon-gamma in laboratory rats with the disease brucellosis
Mohammad Molavi , Rasoul Yousefi Mashouf , Mohammad Yousef Alikhani , Hassan Mahmoudi , Alireza Zamani , Fariba Keramat , Sara Soleimani Asl ,
Volume 75, Issue 6 (September 2017)
Abstract
Background: Brucellosis is a systemic infection caused by gram-negative coccobacilli and facultative intracellular bacteria of the genus brucella. Brucellosis is a bacterial disease common to humans and livestock. Infection with Brucella spp. continues to pose a human health risk globally despite strides in eradicating the disease from domestic animals. The humoral and cellular immunity plays an important role in brucellosis. The effect of phagocytosis and cellular immunity has been demonstrated in brucellosis. The effect of cupping as a therapeutic method on bacterial diseases has been demonstrated. By considering this fact that cupping is an effective method on host immune system functions and has potential effect to regulate the inflammatory reactions.
Methods: This experimental study was carried out on 48 rats in 6 groups (48 rats were divided into 6 groups) during the first 6 months from January 2015 to July 2016 in the laboratory of microbiology and animal of Hamedan University of Medical Sciences. The rats were infected through the injection of Brucella melitensis with plenty 5×105 (cfu/ml) of bacteria. After a week, in order to approve the accuracy of the infection in the studied rats inoculated with coombos Brucella melitensis, Wright test, 2-Mercaptoethanol test and Coombs' Wright test were used. The rats were then treated with cupping method in their sacral area. IFN-γ was measured using enzyme-linked immunosorbent assay. And the study of tissues using hematoxylin and eosin (H&E) Staining.
Results: The results of this study showed that cupping leads to an increase in the mean serum level of interferon-gamma. The histopathological study of liver tissue showed that the radial arrangement was not observed in the infected group with brucellosis and the cells were acidophilus. While, the radial arrangement was observed in treated rats with cupping, but it was not complete. The number of enlarged sinusoids were reduced. But, cell infiltration was observed.
Conclusion: This study showed that cupping can increase serum level of IFN-γ, and thus help to the clearance of disease and improvement of injury in the brucellosis animals lab.

Wound healing in animal models: review article
Fariba Jaffary , Mohammad Ali Nilforoushzadeh , Hanieh Sharifian , Zahra Mollabashi ,
Volume 75, Issue 7 (October 2017)
Abstract
Wound healing and reduction of its recovery time is one of the most important issues in medicine. Wound is defined as disruption of anatomy and function of normal skin. This injury could be the result of physical elements such as  surgical incision, hit or pressure cut of the skin and gunshot wound. Chemical or caustic burn is another category of wound causes that can be induced by acid or base contact irritation. Healing is a process of cellular and extracellular matrix interactions that occur in the damaged tissue. Wound healing consists of several stages including hemostasis, inflammatory phase, proliferative phase and new tissue formation which reconstructs by new collagen formation. Wounds are divided into acute and chronic types based on their healing time. Acute wounds have sudden onset and in normal individuals usually have healing process of less than 4 weeks without any residual side effects. In contrast, chronic wounds have gradual onset. Their inflammatory phase is prolonged and the healing process is stopped due to some background factors like diabetes, ischemia or local pressure. If the healing process lasts more than 4 weeks it will be classified as chronic wound. Despite major advances in the treatment of wounds, still finding effective modalities for healing wounds in the shortest possible time with the fewest side effects is a current challenge. In this review different phases of wound healing and clinical types of wound such as venous leg ulcer, diabetic foot ulcer and pressure ulcer are discussed. Also acute wound models (i.e burn wounds or incisional wound) and chronic wound models (such as venous leg ulcers, diabetic foot ulcer, pressure ulcers or bedsore) in laboratory animals are presented. This summary can be considered as a preliminary step to facilitate designing of more targeted and applied research in this area.

Sentinel lymph node mapping using methylene blue and Technetium-99 in early endometrial cancer
Fariba Behnamfar , Matina Jafari , Masoud Moslehi ,
Volume 75, Issue 8 (November 2017)
Abstract
Background: Endometrial cancer (EC) is the most prevalent genital related cancer of females. One of the controversial points about endometrial cancer surgery is preserving or dissection of sentinel lymph nodes (SLNs). Lymphatic mapping and sentinel nodes sample has been used widely for diverse solid tumors in order of finding metastasis in lymph nodes. The aim of current study was to evaluate diagnostic value of technetium-99 and methylene blue in diagnosis of sentinel lymph node involvement in low-risk endometrial cancer.
Methods: This cross-sectional study was conducted through 2016 on 14 patients with low-grade endometrial cancer referred to Al-Zahra and Shahid Beheshti Hospitals (affiliated to Isfahan University of Medical Sciences), Iran, in 2016-17. Eighteen and twenty-four hours before operation, patients underwent technetium-99 (Tc-99) injection to uterine cervix. Twenty-four hours prior to surgery, patients were referred to resident of gynecology and filled demographic checklist. In next day during operation, Tc-99 was detected by gamma probe. Methylene blue was injected in operation room and blue nodes were detected by naked eye. All patients underwent total hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. Dissected lymph nodes were sent for frozen section and assessment of positive/negative metastasis. Then data were analyzed with SPSS software, version 20 (SPSS Inc., Chicago, IL, USA).
Results: Mean age of our patients was 60.64±9.18 years. Total number of 80 SLNs was dissected. 18.8% of nodes were detected using methylene blue, 12.5% using tecnethium-99 and 6.3% were in common with both methods. Number of two nodes was metastatic and was detected by blue dye and Tc-99. Sensitivity, negative predictive value and detection rate of Tc-99 alone, methylene blue alone and their combination was 100% and false negativity of all above was 100%.
Conclusion: Due to findings of our study, as sensitivity, detection rate, negative predictive value and false negativity of methods lonely and in combination were similar thus based on higher probability of blue dye adverse effects, use of Tc-99 lonely may be adequate.
 

Relationship between circadian rhythm of blood pressure and renal failure severity in patients with chronic renal failure
Sajad Rezvan, Mohammad Aghaali, Behnam Fallah Bafekr Lialestani, Leili Iranirad, Fariba Pirsarabi,
Volume 75, Issue 10 (January 2018)
Abstract
Background: Blood pressure decreases during sleep and is markedly increased in the morning in healthy individuals. Lack of nocturnal blood pressure fall (non-dipping) has been associated with cardiovascular morbidity, mortality and other organ damage. However, their importance in chronic renal failure is unclear. This study aimed to investigate relationship between circadian rhythm of blood pressure and renal failure severity in patients with chronic kidney disease.
Methods: This cross-section study was done in April 2016. The study population was 95 patients, more than 30 year old with hypertension and chronic renal failure. Patients were selected from clinics of two private and university hospitals affiliated to Qom University of Medical Sciences Shahid Beheshti Hospital and Vali-e-Asr Hospital, Iran. Checklist containing data such as age, sex, duration of renal failure and cause of renal failure were filled. Serum creatinine and serum urea levels were measured and entered in the checklist. The circadian rhythm of blood pressure in all patients was assessed by Holter monitoring. patients who had less than 10% decrease in blood pressure overnight were considered non-dipper and those who had 10% or more decrease in blood pressure overnight were considered dipper.
Results: Average (SD) 24-hour ambulatory systolic and diastolic of blood pressure was 136.56 (16.66) and 84.84 (10.86) mmHg, respectively. 70 patients (73.7%) had non-dipper blood pressure pattern and 25 patients (26.3%) had dipper blood pressure pattern. There was no significant difference between two groups (dipper and non-dipper) based on distribution of gender (P=0.744), age (P=0.407), serum creatinine (P=0.569), serum urea (P=0.689) and renal failure duration (P=0.812). Mean of glomerular filtration rate in dipper group was 68.64±4.13 and in non-dipper group was 65.09±16.27 (P=0.337).
Conclusion: The results of this study did not show a significant relationship between circadian rhythm of blood pressure and renal failure severity. In addition, patients with chronic renal failure showed higher rates of non-dipping pattern of blood pressure.

Study on synergistic effect of 2-phenylethanol and clotrimazole on candida species isolated from patients with chronic vulvovaginal candidiasis
Niloufar Majdabadi, Mehraban Falahati , Fariba Heidarie-Kohan , Shirin Farahyar , Parvaneh Rahimi-Moghaddam, Mahtab Ashrafi-Khozani ,
Volume 75, Issue 11 (February 2018)
Abstract
Background: 2-phenylethanol is a colorless and aromatic compound with antimicrobial effects which is used extensively in perfumes and cosmetics, as well as in the food industry. Chronic vulvovaginal candidiasis is a vulvovaginal inflammation which is caused by Candida spp. Resistance to clotrimazole which is one of the most common drugs in the treatment of this disease was reported in many patients. In order to improve the treatment, the effect of 2-phenyl ethanol was investigated in combination with clotrimazole on Candida species isolated from chronic vulvovaginal candidiasis.
Methods: This interventional study was performed in Iran University of Medical Sciences from February, 2016 until December, 2016 on Candida species isolated from women with chronic candidial vulvovaginitis who had been referred to Lolagar Hospital of Tehran. All specimens were examined by direct microscopy, culturing on Candida CHROMagar medium (to primary identification), sabouraud dextrose agar medium) to preservation the isolates) and determining the internal transcribed spacer (ITS) sequence (in order to final determination of Candida species). Then clotrimazole and 2-phenyl ethanol alone and in combination, was examined on isolated species, according to Clinical and Laboratory Standards Institute (CLSI) M27-A3 protocol (micro-broth dilution method). Finally, findings were analyzed.
Results: From 40 detected strains of Candida species in this study, 95% were Candida albicans and 5% were Candida africana. The mean minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of clotrimazole were 24.73±28.87 µg/ml and 30.18±33.004 µg/ml, respectively and the mean MIC and MFC of 2-phenylethanol were 2580±932.38 µg/ml and 3200±1403.29 µg/ml, respectively. The MIC50 and MIC90 of clotrimazole were 16 and 64 µg/ml, respectively. The MIC50 and MIC90 of 2-phenylethanol were both 3200 µg/ml. Most of the isolates were resistant to clotrimazole (82.5%). In combination test, the mean MIC of 2-phenylethanol and clotrimazole alone were 3200±0 µg/ml and 56±40.16 µg/ml, respectively. The fractional inhibitory concentration index (FICI) range was 0.14-0.37. Also, there was a significant difference between clotrimazole MIC values alone and in combination (P= 0.021).
Conclusion: The synergistic effect was observed in combination of clotrimazole and 2-phenylethanol.

A review on the animal models of seizure: review article
Maysam Havasimehr , Fatemeh Saffarzadeh , Ashkan Divanbeigi , Fariba Karimzadeh ,
Volume 76, Issue 2 (May 2018)
Abstract
Nowadays, there are various animal models of acute and chronic seizures. Some chemical and electrical models such as seizure induced by pentylenetetrazol injection and maximum electric shock has been developed over of six decades and different kinds of chemical, electrical and genetic models have been admitted up to now. Among chemical models of seizure induction penicillin, bicuculline, tetanus toxin, pentylenetetrazol, pilocarpine and kainic acid are the more common chemoconvulsants to induce acute and chronic seizures. Numerous mechanisms involved in different models lead to develop different types of seizures. This variety leads to be confused beginner researchers which model should be carried in a research hypothesis. This study was aimed to illustrate how choose the most proper animal model for a hypothesis as well as different animal models of seizure and epilepsy. Penicillin and bicuculine are most proper models to induce focal seizures. In addition, pilocarpine and kainic acid are able to develop temporal lobe seizures. Pentylenetetrazol and tetanus toxin could develop acute and chronic generalized and tonic-clonic seizures. Furthermore, maximum electric shock has been well known as a proper model for acute seizures induction. Electrical kindling of amygdala could develop repetitive temporal lobe seizures. Hypoxia model of seizure is more used for screening of anti-epileptic drugs, long-term consequences, and epileptogenesis mechanisms. Also, hyperthermic (febrile) models of seizure are reliable for studying epileptogenesis mechanisms and cognitive consequences. Genetic models such as recurrent simultaneous (such as GAERS, WAG/Rij) and reflex seizures (such as GEPR) are more valid in some studies, including absence and audiogenic seizures. WAG/Rij rats have been known as the most valid animal model for absence epilepsy. It should be noted that the animal model is a simple expression of a complex system and it covers only a part of what happens in humans’ body. The most important use of animal models of seizure is developing and finding more effective and new anti-epileptic drugs. Therefore, proper selection of the animal model between numerous animal models of seizure induction is crucial to design an equitable hypothesis. The evidences reviewed in this study made beginner researchers potent to choose the best model.

Antimonial treatment failure rate in patients with cutaneous leishmaniasis
Fariba Jaffary , Mohammad Ali Nilforoushzadeh , Latifeh Abdellahi , Hadis Tahmasebi Poor,
Volume 76, Issue 3 (June 2018)
Abstract
Background: Despite advances in diagnosis and treatment, leishmaniasis is now considered a severe public health problem, particularly in developing countries, such as Iran. Leishmaniasis is among the six most important, parasitic diseases of the world affecting 88 countries in almost every continent. The disease is complex with different clinical presentations such as visceral, cutaneous and mucocutaneous forms. Cutaneous leishmaniasis (CL) is the most common form of the disease in Iran. Antimony compounds are the first line treatment of CL. The treatment of leishmaniasis in endemic areas relies on chemotherapy, and in several parts of the world the mainstay remains the pentavalent antimony (SbV)-containing drugs Pentostam (sodium stibogluconate) and Glucantime (meglumine). There is no comprehensive study on treatment failure rate of this compounds. This study was designed to evaluate treatment failure rate and possible involving factors of antimonial resistance in CL to facilitate and improve treatment strategies of this disease.
Methods: All patients with CL referred to Skin Disease and Leishmaniasis Research Center (SDLRC), from October 2011 to October 2013, treated with antimony compounds were assessed in this study. Patient characteristics (gender, age and place of residence), number, type and location of the lesions, comorbidities and type of treatment were recorded and analyzed.
Results: Rate of treatment failure with Meglusan was 4.3%. Failure rate in men and in patients with previous history of cutaneous leishmaniasis was more than women or patients without CL history (P= 0.000, 0.024 respectively). The results of this study showed that treatment failure was higher in patients with systemic treatment than intralesional (IL) or combination therapy (both IL and systemic treatment) group but this difference was not statistically significant. Also, size and number of the lesions, wound infection, the patient's age, location, education and occupation do not have a significant correlation with treatment failure.
Conclusion: Greater treatment failure rate of Meglusan compared to Glucantime (4.3% versus< 1%, respectively) is an important issue to be considered in CL therapeutic strategy.

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