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Showing 14 results for Habibi
Serum magnesium levels and clinical outcome of aneurysmal subarachnoid hemorrhage: a study in 60 patients
Zeinali Zadeh M, Saberi H, Fakhr Tabatabai S A, Tayebi Meybodi A, Habibi Z,
Volume 66, Issue 1 (30 2008)
Abstract

Background: Hypomagnesemia is commonly encountered in patients with a wide variety of diseases including subarachnoid hemorrhage (SAH), cardiovascular emergencies, head trauma, migraine attacks, seizure and preeclampsia. It seems to be associated with a poor clinical outcome. This study considers the prevalence and temporal distribution of hypomagnesemia after aneurysmal SAH and its correlation with the severity of SAH, delayed cerebral ischemia (DCI) as well as the neurological outcome after a period of three months.

Methods: Between 2003 and 2008, 60 patients were admitted to the emergency ward of Imam Khomeini Hospital with acute SAH. Serum magnesium levels were measured during the first 72 hours, days 4-7, and second and third weeks after SAH. The three-month outcome was assessed according to the Glasgow Outcome Scale (GOS). Clinical SAH grading was performed according to the criteria of the World Federation of Neurological Surgeons (WFNS) and the patients were allocated to "Good" (GOS = 4, 5) and "Poor" (GOS= 1-3) outcome groups. The prevalence of hypomagnesemia was assessed in both patient groups. Fisher exact test was used to analyze data.

Results: Hypomagnesemia occurred in 22% of patients during the first 72 hours after SAH. It was associated with more prevalent DCI (p<0.05), whereas low serum magnesium levels during days 4-7 17% of patients) and the second week (22% of patients) after SAH were correlated with poor clinical outcome (p<0.05). No correlation was found between first 72 hour-hypomagnesemia and poor clinical outcome at three months.

Conclusion: Hypomagnesemia occurs after aneurysmal SAH and it may predict the occurrence of DCI, while low serum magnesium levels during days 4-7 and within the second week of event predict poor clinical outcome at three months. Treatment of this electrolyte disturbance may have a favourable effect on the clinical outcome of patients with aneurysmal SAH.


Detection of anti-dsDNA by IgG ELISA test using two different sources of antigens: calf thymus versus E.coli
Mohammadi M, Mirjalili A, Habibi Gh, Falahi Sh, Sarafnejad A, Eatemadi A, Boutorabi Sm,
Volume 67, Issue 1 (4 2009)
Abstract

Background: Anti-dsDNA antibodies frequently found in the sera Systemic Lupus Erythematosus patients, particularly in active disease stage. Nowadays exploit different eukaryotic and prokaryotic dsDNA as antigen source and different reagents as binder. The aim of this study to compared two dsDNA different sources and tow different kinds of reagents for binder in ELISA test.

Methods: In this study bacterial genomic DNA from E.coli (ATCC 25922) and genomic DNA from calf thymus extracted with high purity and were used as antigens for IgG anti-dsDNA detection by ELISA. To coat dsDNA in microtiter wells, tow different kinds of reagents including methylated -BSA and poly-l-lysine (for pre-coating) are used. Sera from systemic lupus erythematosus patients and from normal blood donors are used to assess sensitivity and specificity of our ELISA test in compared with IF test and commercial kits.

Results: Our results displayed pre-coating of microtiter plates with methylated -BSA reduce nonspecific binding reaction and the relative sensitivity and specificity of ELISA increased when calf thymus DNA is employed as antigenic source in compared with IF test and commercial kits 80%, 88% and 100%, 98% respectively, but when E.coli DNA is used 73%, 69% and 85%, 79%, respectively.

Conclusion: The genomic DNA from calf thymus is a potentially useful source of antigen for detection of anti-dsDNA by ELISA. Also the use of methylatted- BSA could have an effective role in reducing of nonspecific binding reactions.


Doxepin is more effective than nortriptyline and placebo for the treatment of diarrhea-predominant irritable bowel syndrome: a randomized triple-blind placebo-controlled trial
Ghadir Mr, Habibinejad H, Heidari A, Vahedi H,
Volume 69, Issue 6 (6 2011)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: The current treatment of IBS is often unsatisfactory and frustrating. Several controlled trials have demonstrated benefits of tricyclic antidepressants for irritable bowel syndrome, especially when pain is a prominent symptom but the efficacy of antidepressants in irritable bowel syndrome is controversial. The aim of this study was to compare the effect of doxepin and nortriptyline on diarrhea-predominant irritable bowel syndrome.
Methods: Seventy-five patients with IBS according to Rome III criteria were treated for two months. The patients were randomly assigned to one of three groups treated with doxepin, nortriptyline or placebo. Subjects were assessed clinically one month and two months after treatment. The symptoms and adverse effects of the drugs were recorded in the questionnaire. The total score was considered as the number of the symptoms for each patient, which ranged between zero and six.
Results: Improvements in abdominal pain and bloating in the doxepin group were significantly higher than the nortriptyline or the placebo groups (P=0.001 and P=0.012, respectively). However, improvement in diarrhea in patients on nortriptyline was significantly higher than the other groups (P=0.018). The average improvement of symptoms in the patients after two months of treatment in doxepin, nortriptyline and placebo groups, respectively were 2.56, 2 and 0.6 (P<0.05).
Conclusion: Both doxepin and nortriptyline are effective for the treatment of diarrhea-predominant irritable bowel syndrome in a period of two months but doxepin seems to be more efficacious than nortriptyline in this regard. However, larger comparative trials are suggested.


Comparison study of memory status in war-PTSD veterans with depression and non- veterans depressed patients
Radfar Shokofeh , Jazayeri Seiede Tahereh , Haghani Hamid , Habibi Mehdi , Anvari Somaieh Sadat ,
Volume 69, Issue 12 (5 2012)
Abstract

Background: Cognitive problems in patients with post-traumatic stress disorder (PTSD) include poor concentration and impaired memory. Prevalence of PTSD in all aspects of life is 8% in USA. Regarding the importance of memory in functional levels, this study was performed to review memory status in these patients.

Methods: Fifty male war veterans with PTSD and major depression and 50 male non-veterans with depression participated in this study performed at psychiatric outpatient ward in Baqiyatallah hospital during 2008-2009. The patients met the DSM-IV diagnostic criteria. Depression severity, sex, age, educational level, and marital status were matched in both groups. A psychologist completed demographic and Mississippi questionnaires, PTSD checklist (PCL), beck depression Inventory and wechsler memory scale. The collected data were analyzed using SPSS software (version 11.0). A P-value smaller than 0.05 was considered significant.

Results: The mean age of the veterans and non-veterans was 43.9±4.7 and 42±9.4 years, respectively. Memory status did not differ between the two groups (P>0.05). There was no statistically significant correlation between duration and severity of PTSD with memory impairment (P>0.05). A negative correlation was found between personal and general information with re-experiencing in the veterans (P<0.05). Impaired memory was correlated with age greater than 45, educational level lower than high school diploma, severity of depression and longer participation in war.

Conclusion: Although both PTSD and major depression affected memory, but memory status did not differ between patients with PTSD and depression and patients with chronic depression.


Changes in IL-6 and interferon gamma levels in induced varicocele in premature rats
Bahareh Habibi , Behjat Seifi , Hamidreza Sadeghipour Roud-Sari, Ali Akbar Amir Zargar , Seyed Mohammad Hossain Noori Mugahi ,
Volume 71, Issue 12 (March 2014)
Abstract
Background: Varicocele is a dilated vein of the pampiniform plexus that cause to det-rimental time-dependent effects so this study describes the effect of varicocele on the level of IL-6 and interferon gamma in serum and testis tissue, number of sertoli and spermatogonia cells, seminiferous tubules diameter and sperm activity in immature rats. Methods: Thirty six immature rats, 5-6 weeks aged were investigated in this study. The sham groups underwent sham operation and varicocele groups underwent partial liga-tion of the renal vein. Serum, testis and sperm samples were collected at 9, 11, and 13 weeks after induction of varicocele or sham operation to evaluate histological parame-ters (seminiferous tubules diameter, number of sertoli and spermatogonia cells), per-centage of sperm motility and viability and levels of cytokines. Testicular morphology was evaluated. Results: Varicocele significantly caused an increase in serum and testis IL-6 and inter-feron gamma, compared to related sham groups and previous varicocele groups (P<0.05). Varicocele significantly caused decreases in sertoli cells and spermatogonia cells number with increasing varicocele time, compared to related sham groups and previous varicocele groups (P<0.05). In the evaluation of seminiferous tubules diameter external, internal and epithelium diameter were decreased compared to sham related groups and previous varicocele groups. In all varicocele groups, all kind of sperm motility and viability decreased compared to the related sham-operated groups (P<0.05). Varicocele had deteriorating effects on testis tissue because our observations in varicocele groups demonstrated that the external, internal and germinal epithelium height was reduced by the time and in the evaluation of testicular cells, sertoli and spermatogonia cells number were decreased by the time compared to sham related groups and previous varicocele groups. Conclusion: This study suggests varicocele had a detrimental time-dependent effect on cytokines levels and decrease in sertoli and spermatogonia cells number, seminiferous tubules diameter and sperm indices.
Effect of mesenchymal stem cells on allergic asthma in mouse model
Reza Habibian , Nowruz Delirezh , Amir Abbas Farshid ,
Volume 73, Issue 5 (August 2015)
Abstract
Background: Allergic Asthma is an inflammatory disease of the respiratory system that is well known by increased inflammatory cells in the airways and causes difficulty in respiration. The prevalence of allergic asthma is increasing worldwide, and it has become a significant cause of health challenge especially in developed countries. Inhaled β2-agonists and Inhaled or oral corticosteroids are common medications for treating the disease, but they cannot be used for long periods of time because of frequently occurring side effects and they can’t change the main pathogenesis of the problem. Deficiency in regulatory system against inflammation could be an important factor in allergic asthma. Mesenchymal stem cells (MSCs) have potential of cellular immunosuppressive therapy of inflammatory disorders. The aim of present study was to evaluate the effects of MSC therapy on mechanisms of allergic asthma in mice model. Methods: This experimental study was conducted from August 2014 to March 2015. The animals were housed and maintained in Biotechnology Center of Urmia University, Iran. Mice were sensitized by intra-peritoneal injection of ovalbumin (OVA) and aluminum hydroxide emulsion and then were challenged intra-nasally with OVA. Before allergen challenge on day 14, experimental mice received tail vein injection of MSCs in PBS. Regulatory T cells of spleen, cytokines and IgE analysis were carried out using lungs wash as well as serum samples. Results: Our results showed that MSCs significantly reduced total cells and eosinophilia, serum OVA-specific IgE concentration in OVA-sensitized and challenged mice. Also results showed that MSCs markedly inhibited expressions of Th2 cytokines and elevated levels of Treg cells and Treg cytokines. Conclusion: In the present study, we demonstrated the inhibitory effect of MSCs on airway inflammation using mice model of allergic asthma. The mice were sensitized with OVA and compared to the results of dexamethasone administration. Our results demonstrated that administration of MSCs could be used as a potential therapeutic approach for the allergic asthma.
Comparison of duloxetine and methylphenidate in the treatment of children with attention-deficit/hyperactivity disorder
Nasrin Dodangi , Nastaran Habibi ,
Volume 74, Issue 3 (June 2016)
Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) is a common and mostly chronic mental health condition that affects children, adolescents, and adults. Stimulants and atomoxetine are first-line agents for the treatment of ADHD. Despite the impressive track record of stimulants in the treatment of ADHD, they fail in 25% of patients due to lack of efficacy or the emergence of unwanted side effects. Accordingly, this study carried out to compare efficacy and safety of duloxetine (a serotonin and norepinephrine reuptake inhibitor) and methylphenidate (a short acting stimulant) in the treatment of children with attention-deficit/hyperactivity disorder.

Methods: Twenty-four children diagnosed with ADHD participated in this 6 weeks open clinical trial. Patients were between 6 to 11 years old that had been referred to psychiatry clinic at Akhavan and Rofide Medical and Rehabilitation Center in Tehran from September 2012 to July 2014. Diagnosis was made by two child psychiatrist according to DSM-IV TR criteria. Thirteen patients received duloxetine and others received methylphenidate. Conner’ parent rating scale-revised-short form (CPRS-RS) and ADHD-rating scale (ADHD-RS) were used at the beginning and then each two weeks to assess efficacy of treatment. Routine laboratory tests and electrocardiogram (ECG) was carried out in the beginning and end of the trial.

Results: Twenty children with ADHD completed the study (Ten in methylphenidate and ten in duloxetine group). In both groups, scales of CPRS-RS and ADHD-RS were reduced from baseline to endpoint, but this reduction in methylphenidate group was significantly greater than duloxetine group (P= 0.000). The most common side effect was gastrointestinal problems in duloxetine group and anorexia in methylphenidate group. No serious side effects and no changes in laboratory and ECG indexes were seen in both groups.

Conclusion: Duloxetine is not efficacious as well as methylphenidate in treatment of children with ADHD. Although more research are needed to achieve more accurate results.

Effects of Iron oxide functionalized by Glutamic acid and 2-pyridinecarboxaldehyde thiosemicarbazone against lung cancer A549 cells and analysis of NDRG1 gene expression
Alireza Habibi, Seyed Ataollah Sadat Shandiz , Ali Salehzadeh, Zeinab Moradi-Shoeili,
Volume 78, Issue 7 (October 2020)
Abstract
Background: Lung cancer is a disease with high mortality rate that conventional drug treatments have not been successful in controlling it. The activity of iron chelators in various studies has been considered by scientists as a new treatment strategy. The primary objective of this study was to synthesize a novel Fe3O4 thiosemicarbazone complex and investigate its anti-proliferative activity against A549 cells of lung cancer.
Methods: This experimental study was carried out in Islamic Azad University of Rasht Branch, from September of 2018 to September 2019. First thiosemicarbazone (PTSC) was synthesized by the method of the condensation reaction of amine and aldehyde groups. Also, the Fe3O4 nanoparticulates were synthesized using the co-precipitation method in the presence of glutamic acid. Then, Fe3O4@Glu complex functionalized with bio-reactive PTSC moiety. Besides, morphological characteristics of Fe3O4@Glu/PTSC complex were determined by scanning electron microscope (SEM) images. The cell viability was detected in 62.5, 125, 250, 500, and 1000 µg/ml for treated cells with Fe3O4@Glu/PTSC complex via MTT assay. Changes of NDRG1 gene expression the level in treated cells were investigated via qRT-PCR analysis. Therefore, total RNA was extracted after culturing the cells and cDNA of NDRG1 and GAPDH genes as the study and control gene was obtained, respectively. Ultimately, the level of NDRG1 gene expression was compared with level of GAPDH mRNA expression via the 2– ΔΔCt method.
Results: SEM images confirmed the sphericality of the Fe3O4 @ Glu / PTSC complex. The size of the nanoparticles was uniform and about 52-23 nm. The cell survival assay (MTT) results revealed the anti-proliferative properties of this complex in a dose-dependent manner (IC50=135.6 µM/ml). In treated cells, the gene expression of NDRG1 was 1.8-fold higher after 12 h. However, after 24 hours of incubation, this gene was showed a 0.67-fold decrease in expression compared to the control group.
Conclusion: The results of the present study suggest that Fe3O4@Glu/PTSC nanoparticulates by a decrease of NDRG1 expression, exhibit effective anti-cancer activity against lung cancer cells.

Clinical guideline of neurosurgical practice during the COVID-19 pandemic
Zohreh Habibi, Seyed Morsal Mosallami Aghili , Seyed Amir Hossein Javadi , Arash Seifi, Kourosh Karimi Yarandi, Seyed Ali Dehghan Manshadi , Fereshteh Naderi Behdani ,
Volume 79, Issue 2 (May 2021)
Abstract
Background: Neurosurgery practice conflicts with many challenges during the COVID-19 pandemic; Including the lack of beds in intensive care units, as well as the use of some methods such as drills and trans-nasal and trans-oral approaches that produce aerosols or are directly in contact with patient discharge. Due to these challenges, developing a clinical guideline to help neurosurgeons and medical staff in decision making and improving patients and medical staff safety during the COVID-19 pandemic is the purpose of this study.
Methods: First, all of the relevant clinical guidelines to neurosurgical practice during the COVID-19 pandemic were extracted from the data centers. Finally, five clinical guidelines were selected. The questions and the items were designed according to these guidelines. The answers to each of the questions were extracted from these guidelines. The complementary evidence was extracted by searching in the data centers again. Finally, the answers were edited and the edited answers were considered as the recommendations. These recommendations were sent to 4 experts in the Neurosurgery field and 2 experts in the infectious diseases field. The appraisers evaluated the recommendations according to the AGREE-REX instrument.  This instrument has 9 items and 3 domains including clinical applicability, values and preferences, and implement ability. Recommendations with above 80% agreement were considered as the final recommendations.
Results: The final recommendations were presented as “Clinical guideline of neurosurgical practice during the COVID-19 pandemic” in the results section.
Conclusion: This clinical guideline was developed by using similar guidelines and available evidence. Proper usage of personal protective equipment, reduction of unnecessary contacts between medical staff and patients, use of Telemedicine for follow-up, proper air conditioning, screening patients for COVID-19, reduction of elective surgery, use of less invasive methods, management of aerosol production and reduction of trans-oral and trans-nasal approaches are the most important recommendations of this clinical guideline.

Preparation of heavy chain polyclonal antibody against zinc transporter SLC39A6 and its diagnostic application
Hajarossadat Ghaderi , Zahra Noormohammadi, Mahdi Habibi-Anbouhi , Fatemeh Kazemi-Lomedasht , Mahdi Behdani,
Volume 79, Issue 4 (July 2021)
Abstract
Background: SLC39A6 Protein (solute carrier family 39) or LIV-1 is a zinc transporter protein that is overexpressed in positive estrogen cancers such as breast cancer. The LIV-1 protein transfer zinc into the cytoplasm through the plasma membrane. Today it is known that just as a decrease in the concentration of zinc in the cell can cause cancer, an excessive increase in the concentration of zinc can also stimulate irregular cell division and caused cancer. Thus, inhibition of zinc transporter protein may play a role in preventing malignancies and metastasis. It can also be used as a diagnostic marker in the diagnosis of cancers in various laboratory methods. The present study was performed to prepare a polyclonal camel antibody for the detection of LIV-1 protein at the cell surface.
Methods: This study was started in the Pasture Institute of Iran in 2018 September and finished in February 2020. An expression construct containing the human LIV-1 gene was prepared and transferred to the E.coli BL21 by chemical (CaCl2) and heat shock method. The expression of the protein was induced by IPTG and then protein was purified by affinity (Ni-NTA) chromatography. After preparing recombinant protein one female camel was immunized, 6 times at two weeks intervals with Freund's adjuvant. After immunization, the isolated polyclonal antibody was evaluated by ELISA, western blotting and flow cytometry in the detection of LIV-1 protein.
Results: The result showed that LIV-1 protein was well purified and also the camel polyclonal antibody was able to detect LIV-1 protein in ELISA, western blot and also it can detect LIV-1 on the cell surface as shown by flow cytometry test.
Conclusion: In recent years, LIV-1 has been shown to be a good candidate as a marker in breast cancer, so polyclonal antibodies against LIV-1 can be used for early detection of breast cancer by various diagnostic methods. In this study, it has been shown that polyclonal camel antibodies can be used in laboratory methods and can be considered for immunological tests and therapeutic applications.

Assessment of TUMS affiliated hospitals’ preparedness for dealing with Covid_19
Ebrahim Jaafaripooyan, Haniye Sadat Sajadi , Maryam Tajvar, Elham Ehsani Chimeh , Iman Falah, Farhad Habibi,
Volume 80, Issue 6 (September 2022)
Abstract
Background: The prevalence of emerging and re-emerging diseases has made the need for basic preparations for all health care organizations more crucial. Strengthening preparedness and formulating crisis strategies will have a great impact on reducing casualties. Given the importance of preparing hospitals to deal with such an outbreak and reduce the resulting mortality, the present study was conducted to assess their readiness against Covid-19.
Methods: The present study is a quantitative and descriptive cross-sectional research conducted from October to March 2019. Data collection used the standard checklists prepared by the European Center for the Prevention and Control of Coronavirus and the Centers for Disease Control and Prevention, consisting of eight domains and 21 components. The minimum score that each hospital could get in this checklist was 143 and the maximum was 429. The sampling method in the present study was a census, and nine reference hospitals for Corona were included in the study. All hospitals’ directors, managers, quality officers and crisis secretaries and others related to hospital readiness during Covid-19 were recruited by the census.
Results: On average, the hospitals scored 391 out of 429, indicating a fairly "high readiness" in dealing with Covid-19. The highest score obtained by the hospitals was 425 and the lowest score was 349. In terms of preparation areas, the hospitals’ readiness was higher than 80% in all areas. The highest readiness of hospitals was in the fifth  domain, i.e. Hand hygiene, personal protective equipment and hospital waste management. The 7th domain namely, patient placement and relocation, and patient visitor access was of the lowest preparation.
Conclusion: The hospitals were of fairly appropriate readiness to deal with Covid-19. This level of preparedness, despite being desirable, might not reflect the real capacity of hospitals to deal with this disease. Regular evaluation of the Covid referral hospitals could help make these hospitals more prepared. Also, the experiences of hospitals that were more prepared should be used to improve the condition of other hospitals.

Frequency and risk factors for GI bleeding in children admitted to the PICU of bahrami children's hospital
Kambiz Eftekhari, Armen Malekiantaghi, Neda Habibi ,
Volume 80, Issue 9 (December 2022)
Abstract
Background: Gastrointestinal bleeding (GIB) associated with stress is an important complication in critically ill children admitted to the Intensive care unit (ICU), which can lead to serious complications and in some cases death. Only a limited number of studies have been conducted on the risk factors of gastrointestinal bleeding in Pediatric Intensive care unit (PICU), most studies have been conducted in the adults and neonates, therefore, the aim of this study was to evaluate the frequency of risk factors related to gastrointestinal bleeding in children admitted to the PICU.
Methods: This was a cross-sectional study. In this study, in a period of three years from (March 2016 to March 2019), all patients admitted to the PICU of Tehran Bahrami Children's Hospital were examined. The sample size was calculated 380. Demographic information, diagnosis during hospitalization, underlying disease, and initial tests during the first 24 hours of hospitalization were recorded in the checklist. To evaluate the demographic findings between patients with and without UGIB, chi-square and Fisher tests were used. A p-value of less than 0.05 was considered significant.
Results: 462 patients were studied, of which about (58%) were male. The mean age of the samples was 48 months and the average length of hospital stay in PICU was ten days. In general, (21.21%) of patients had gastrointestinal bleeding on the first day and (12.12%) on the second day of hospitalization. Gastrointestinal bleeding occurred in 50 patients (10.82%). Use of ventilator, pulmonary diseases, coagulation and blood diseases were significantly more common in patients with gastrointestinal bleeding than in children without gastrointestinal bleeding. Cardiac, neurological, hepatic, and renal disease were not significantly different in patients with gastrointestinal bleeding compared to children without gastrointestinal bleeding.
Conclusion: The occurrence of gastrointestinal bleeding in critically ill patients admitted to the PICU is a serious risk. The most important risk factor for upper gastrointestinal bleeding is mechanical ventilation. Other risk factors of gastrointestinal bleeding are lung disease, coagulation diseases, hematologic and oncologic disease.

Mendelian randomization, a method for inferring causal relationships in observational studies and an alternative to clinical trial studies: a brief report
Mahdi Akbarzadeh, Danial Habibi , Goodarz Kolifarhood , Mohammad Bidkhori, Fereidoun Azizi , Maryam S. Daneshpour,
Volume 80, Issue 11 (February 2023)
Abstract
Background: Mendelian randomization (MR) is a new generation in the statistical method that uses genetic variants as instrumental variables in data from non-experimental studies to evaluate and estimate the causal effects of risk factors.
Methods: The weakness of observational studies to detect causality, the difficulties of conducting clinical trials, the dramatic advancement of Genome-Wide Association Studies (GWAS) have led to the emergence of a new type of study called MR. It is increasingly being used to determine causality MR is an approach based on meta-analysis methods. The main idea of the MR is based on using the instrument variable (IV) to find the causality between exposure and outcome. This variable does not need to adjust the confounding effects found in observational studies.
Results: Data for this study were collected from the beginning of January 2003 to October 2020 in PubMed. Our results showed that MR has an increasing trend. The data used in MR includes summarized statistical data, individual-level data, and meta-analysis. Choosing the suitable IV is essential to successfully conduct an MR. For an unbiased estimate, three main hypotheses should be considered: 1) The IV has a strong relationship with the desired exposure (i.e., potential risk factor), 2) The IV is not related to the confounding variable, and 3) The IV is not directly related to the outcome and should only relate to the outcome through exposure. If these conditions are not met, one solution is to use robust methods. Besides, this research introduced the study designs, estimation methods, limitations, software packages, and some applications of MR in medical research.
Conclusion: When we seek to find a causal relationship, but it is not possible to use a clinical trial as a standard method, the MR design can be used in observational studies. Therefore, it is possible to obtain causal relationships between exposure and outcome using the MR.

Clinical and radiological evaluations in patients with chorea-acanthocytosis referreing to rasool-e-akram hospital
Mohammad Rohani, Seyed Amirhassan Habibi , Elahe Amini, Omid Aryani, Mahdi Dadfar, Hamzeh Zangeneh,
Volume 80, Issue 11 (February 2023)
Abstract
Background: chorea-acanthocytosis is a form of the autosomal recessive disease. The onset of disease symptoms usually starts from the third decade of life and presents with chorea, other abnormal movements such as eating dystonia, tongue and lip biting, vocal and motor tics, seizure, and behavioral impairment. In this study, the clinical presentations and brain imaging of these patients were reported.
Methods: In this descriptive study, information about patients with a specific movement disorder who were referred to a tertiary center in the Rasool Akram hospital (Tehran) from March 2018 to February 2019 were recorded. The inclusion criteria were the presence of chorea (a form of abnormal movement) and the presents of acanthocyte cells higher than 10% in a peripheral blood smear. The exclusion criteria were the evidence of secondary causes of the chorea or endocrine disorders. The clinical symptoms and brain imaging findings were evaluated by two expert neurologists and recorded in the patient's electronic files.
Results: Twenty-seven eligible patients were included. 18 patients were male and 9 were female. Sixteen patients had seizures and 90% of them were categorized as generalized tonic-clonic seizures. 21 patients had eating dystonia (71 percent were male and 29 percent were female) and 18 patients had complex motor and vocal tics, 11 patients presented extra ocular movement disorders, and 11 patients had evidence of tongue and lip biting. The absence of the deep tendon reflex was detected in 23 patients. Considering all the patients' movement disorders, the prevalence of eating dystonia was significantly higher in men than in women. (P=0.049). Other abnormal movements were not different between men and female. All patients had caudate atrophy and increased signal intensity in T2/Flair sequences in caudate nuclei and putamen in the brain imaging.
Conclusion: The most common abnormal movement after chorea was eating dystonia. The male gender was more susceptible to present eating dystonia than the female. However, this superiority was not seen in other movement disorders.

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