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Showing 17 results for Hekmat
Vestibular Schwannoma or acoustic neuroma
M Hekmatara ,
Volume 55, Issue 1 (30 1997)
Abstract
Vestibular schwannoma is the most common tumor of the posterior fossa of the skull. Patients referred with the primary otologic symptoms such as hearing loss, tinnitus, vertigo, imbalance, and the cranial nerve palsy. Thirty-three patients were operated and treated by a team of otolaryngologist and neurosurgeon, anudiometrist, and internist. Patients'chiefcomplaint was due to 94% hearing loss and 27% tinnitus. They scarcely complain of vertigo. If a patient refers with the palsy or paralysis of facial nerve preoperation, we must think of the facial nerve schwannoma or hemangioma or congential cholestoma or malignant metastases rather than acoustic neuroma. The best way for preoperative diagnosis is audiometry, ABR (Auditory Brain Response), and SDS (speech discrimination score) with 90% success, but computer Tomography (CT) scan and MRI (Magnetic Resonance Image) are the valuable anatomic diagnostic radiographic devices. The best method of operation is translabirynthine approach (TLA), since it has the advantages such as an easy access to nerve paths and being the nearest path to CPA (Cerebellopontine Angle). Physicians ought to talk to patients about the importance of the microscopic surgery, surgical methods, and their probable diverse effects such as hearing loss, facial nerve palsy, and intracranial problems.
Petrous apex lesions outcome in 21 cases
Mh Hekmatara ,
Volume 55, Issue 6 (1 1997)
Abstract
Petrous apex lesions of temporal bone progress slowly. Most of the time not only destruct this area but also involve neighbouring element. The symptoms of the neighbouring neuro-vasculare involvement we can recognize these lesions. The most common symptoms of involvement of the petrous apex are: headache, conductive hearing loss or sensorineural type, paresthesia and anesthesia of the trigeminal nerve, paresia and paralysis of the facial nerve, abducent nerve. In retrospective study which has been in the ENT and HNS wards of Amiralam hospital, 148 patients have been operated due to temporal bone tumor from these numbers, 21 (13.6%) patients had petrous apex lesions of temporal bone. Eleven (52.9%) patients of these 21 persons were men and the remaining 10 (47-6%) were women. The average age of the patients was 37 years. The common pathology of these patients were glomus jugulare tumors, hemangioma, schwannoma, meningioma, congenital cholesteatoma, giant cell granuloma. The kind of operations that have been done on these patients were: infratemporal, translabyrinthine and middle fossa approaches. The conclusion of this study shows that petrous apex area is an occult site. The symptoms of this lesion are not characteristic, meticulous attention to the history and physical examination are very helpful to recognition of these lesions and it's extention.
The effect of low dose steroid (Physiologic dose) and Chloroquine in the treatment of rheumatoid arthritis
F Gharibdoost , S Hekmat , F Jalali ,
Volume 57, Issue 1 (7 1999)
Abstract
Introduction: The regulation of neuroendocrine axis is one of the most important goals in the treatment of Rheumatoid Arthritis. Disease modifying drugs such as chloroquine with low dose steroid is the first choice in clinical practice by some physicians. This combination therapy is evaluated by this study. Methods: This survey is a prospective study on furty patients. Variables for determining the activity index of disease were joint tenderness, joint swelling, morning stiffness and erythrocytes sedimentation rate in two years follow up. Results: Decrementation of disease activity index was statistically significant before and after treatment, joint tenderness (X²=7.205, P=0.007), morning stiffness (X²=19.253, P=0.00001), joint swelling (X²=14.107, P=0.0001), ESR (T=2.428, P=0.02). Conclusion: The combination of chloroquine with low dose steroid is beneficial in the treatment of Rheumatoid arthritis
Effect of volume reduction on diastolic echocardiographic parameters in hemodialyzed patients
Hekmat R, Talebi S, Mohebati M,
Volume 65, Issue 5 (3 2007)
Abstract

Background: Cardiovascular problems including arterial hypertension, coronary artery diseases, congestive heart failure are prevalent among chronic hemodialyzed patients. Ultrafiltration of hemodialyzed patient's serum, which culminating in intravascular volume reduction, is frequently used during hemodialysis. One of the restrictions of the echocardiographic evaluation of the diastolic heart function is the intravascular volume dependency of some echocardiographic parameters. In this study we have evaluated the volume dependency of certain echocardiography parameters in chronically hemodialyzed patients.

Methods: Thirteen patients undergoing chronic hemodialysis in Ghaem Hospital Hemodialysis Center in Mashhad, Iran, were evaluated one hour before and immediately after hemodialysis for the following: all diastolic echocardiographic parameters, left ventricular function, left ventricular systolic function, inferior vena cava (IVC) diameter and IVC collapsibility with inspiration, and systolic and diastolic blood pressure. The echocardiographic parameters were analyzed using the paired Student's t-test.

Results: With hemodialysis, there was no significant change in left ventricular function, A wave amplitude and E/F slope, however, there was a significant reduction of the E wave amplitude, increment in E wave deceleration time (p= 0.001, t=-4.14) and a decrease in the E/A ratio (p=0.03, t=2.46). Tissue Doppler echocardiography showed no significant change in mitral annular diastolic motion, E'/A' waves, with hemodialysis (p=0.728, t= - 0.356), although there was a reduction of the E/E' ratio.

Conclusion: Tissue Doppler imaging and color M-mode echocardiographic parameters are independent of the intravascular value status. With no change associated with hemodialysis, these parameters can be used as reliable criteria for evaluating ventricular diastolic function even when the volume status varies.


Antiphospholipid Antibodies and Cerebrovascular Accidents in patients under 50 years old
Owlia M.b, Hekmati-Moghadam S.h, Dehghani Z, Fallah F, Salimzadeh A.,
Volume 65, Issue 11 (1 2008)
Abstract
Background: Major clinical manifestations of antiphospholipid syndrome (APS) in the central nervous system are generally arterial thrombotic events and a number of non-thrombotic neurologic syndromes. Antiphospholipid antibodies (APAs) are one of the important risk factors for cerebrovascular accidents (CVA). The aim of present study was to assess the relationship between APA titers and CVA in this clinically important age group.
Methods: This case-control study was carried out on patients under 50 years old who had CVA (stroke or transient ischemic attack) in Shahid Sadoughi Hospital in Yazd (central Iran) from Dec 2003 until March 2005. In this study, 61 patients with CVA were compared with 68 age- and gender-matched control subjects. Lupus anticoagulant assay results and APA titers were assessed in both groups.
Results: The mean value of IgM APA titers in patients with cerebrovascular accidents was 6.492 MPL (IgM antiphospholipid units) and 1.846 MPL in the control group. The difference between the two groups was significant (p-value: 0.000). In 12 (20%) of the patients with cerebrovascular accidents, IgM titers were higher than 10 MPL, one of whom had an IgM titer higher than 40 MPL. The mean value of IgG titers in the case group was 5.50 GPL (IgG antiphospholipid units) and 3.51 GPL in the control group. The difference between the two groups was significant (p-value: 0.012). Thirteen (21%) patients with cerebrovascular accidents had IgG titers higher than 10 GPL. The difference between the LA assay results was not significant between the two groups (p-value: 0.311).
Conclusion: The present study showed a positive relationship between APL (IgM and IgG) titers and CVA in patients under 50 years old.
The effect of hemodialysis solution buffer on the control of blood pressure and efficacy of hemodialysis in chronic hemodialysis patients
Hekmat R, Mojahedi M J, Garevani H,
Volume 65, Issue 13 (Vol 65, Supplement 1 2008)
Abstract
Background: The effect of kind of dialysis solution on the control of blood pressure and adequacy and efficacy of hemodialysis is a most debated and controversial issue.
Methods: Twenty six chronic hemodialized patients in Ghaem hemodialysis center, Mashhad, Iran, in winter of the year 2004, enrolled this study for one month. The patients were dialyzed with bicarbonate buffer and were dialyzed in the next month with acetate. The kind of membranes and the dialysis machines were the same in both months. Systolic and diastolic pressures were measured before and after hemodialysis in at least three hemodialysis sessions, and he means recorded. The mean of the body weight were also recorded. In the same sessions of hemodialysis by measuring the urea, before and after hemodialysis, urea reduction ratio (URR), was also calculated. Statistical analysis was done with paired student t test for paired measurement, and independent t test for evaluating the effect of the kind of dialysate buffer on the measured parameters.
Results: There were no significant statistical differences between acetate and bicarbonate dialysis solution buffers in the control of diastolic blood pressure. But use of acetate buffer resulted in more significant systolic blood pressure reduction compared with bicarbonate buffer (p=0.045). When adequacy of hemodialysis were compared between two kinds of buffers there were no significant statistical differences between them. When the effect of dialysate sodium concentration in the range utilized in two buffers, was evaluated on the systolic and diastolic pressure reduction, no significant differences, between two types of buffers attributable to the difference between dialysates sodium concentrations were found.
Conclusion: Hemodialysis with both, acetate and bicarbonate buffers results in significant reductions in systolic and diastolic blood pressure, weight and urea ratio. Use of acetate buffer is more significantly associated with systolic blood pressure reduction compared to bicarbonate buffer (p=0.045), this effect is independent of the dialysate buffer sodium concentration.
Hemodialysis versus peritoneal dialysis: epidemiologic and  demographic characteristics
Hekmat R, Mojahedi Mj, Ahmadnia H,
Volume 66, Issue 7 (6 2008)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: The preferred modality of dialysis is a controversial issue in nephrology. In this study we compare some demographic and epidemiological characteristics of hemodialysis and peritoneal dialysis patients in an attempt to analyze this issue.
Methods: The results of the research protocol "A survey of the epidemiological characteristics of chronic dialyzed patients in Khorassan province", was used to compare some demographic and epidemiological aspects of chronic hemodialysis and peritoneal dialysis patients in search of any statistically significant difference.
Results: A total of 836 chronic dialysis patients entered this study, 802 (95.9%) of which were under chronic hemodialysis, and 34 (4.1%) patients were undergoing peritoneal dialysis, with 339 (42.3%) and 12 (35.3%) being female, respectively. The mean age for each group was 47.57 and 46.75 years, respectively. The causes of end-stage renal disease in hemodialzed patients were most commonly hypertension (32.2%), followed by diabetes mellitus (22.3%), unknown causes (19.6%) and chronic glomeru-lonephritis (10.2%). In the peritoneal dialysis group, chronic glomerulonephritis (32.4%) was the most common reason for dialysis, followed by diabetes mellitus (26.5%) and unknown causes (11.8%). The mean serum hemoglobin creatinine, calcium, and phosphorus levels for hemodialysis patients were 10.42, 8.5, 8.93, and 6.03 mg/dL, respectively, and those for peritoneal dialysis patients were 11.28, 8.52, 9.41 and 5.40 mg/dL. There were no statistical differences between the median age, sexual distribution and mean levels of Hgb, Ca, phosphorus, creatinine, HCV antibody and HbsAg of the hemodialysis patients and those of the peritoneal dialysis patients.
Conclusions: The results of our study show that hemodialysis and peritoneal dialysis are similarly effective treatments.


The evaluation of anti-UV effect of silymarin cream based on clinical and pathological findings
Ahmadi-Ashtiani Hr, Hekmat-Nazemi N, Rezazadeh Sh, Gholamhoseini B, Baghaei M, Houshang Ehsani A, Rastegar H,
Volume 68, Issue 6 (6 2010)
Abstract

Background: Nowadays skin damages caused by ultraviolet (U.V.) radiation from the sun were increased accordingly necessity for safe and inexpensive protective products for reducing the harmful effects of this ray is unassailable. The antiradical, anti irritation and anti-cancer properties of silymarin make it a suitable option for use in cream formulation to investigate its effect on skin disorders caused by U.V. radiation. In this research effect of local application of a cream containing silymarin in prevention of the harmful effects of U.V. radiation on the guinea pig skin were studied and evaluated by using histopathologic and clinical findings.

Methods: 75 albino guinea pigs were randomly divided into five groups of fifteens. 2cm2 of the back hair was shaven. In the first group no treatment was applied, in the second group vaseline, in group 3 base cream without silymarin extract, in group 4 silymarin extract and in group 5 cream containing silymarin extract were used.

Results: In clinical assessment, skin scaling, skin irregularity, erythema, skin hyperpigmentation, and edema were observed and in histopathological observation epidermal hyper keratosis, hyperpigmentation, exocytosis, acanthosis, chromatin discoloration in nucleus of epidermal squamous cells, perifolliculitis, dermal vascular hyperemia, edema and dermal thickness, infiltration of plasma cell lymphocytes and eosinophyls into dermis were detected. The statistical comparison of group 1 and group 5 shows statistically significant difference in most indices (p<0.01).

Conclusions: Clinical and histopathologic examinations showed that local application of a cream containing silymarin is effective in prevention of skin damage caused by U.V. radiation in guinea pig's skin also the results of the clinical and histopathologic observation in this study confirm the enzymatic results in other researches.


Ten-year evaluation of cardiac myxoma in Shahid Modarres Hospital
Seyed Masoud Majidi Tehrani, Hamid Ghaderi , Mahnoosh Foroughi , Manouchehr Hekmat, Mahmoud Beheshti Monfared, Hassan Tatari , Seyed Mohsen Mirhosseini , Zargham Hossein Ahmadi, Zahra Ansari Aval, Seyedeh Adeleh Mirjafari,
Volume 72, Issue 2 (May 2014)
Abstract
Background: Primary cardiac tumors are rare tumors which should be operated urgently. In this study, cardiac myxoma have been evaluated from diagnosis until dis-charge in a 10 years period and then results including presenting symptoms, approach to the patients were compared with similar study in this center a decade ago. Methods: Patients who underwent operation for myxoma from year 2003 until 2013 in the Shahid Modarres Hospital were included in this study. Results: Eighteen patients included in the study, 11 female and seven male. Patients’ ages were in the range of 13 to 76 years (mean 53 years). Mean time from diagnosis to operation was 5.8 days and mean time from surgery to discharge was 8.6±6.1 days. Most common presenting symptoms were first clinical presentation in four patients. In all patents echocardiography was the main diagnostic modality. In addition to trans thoracic echocardiography (TTE), in five patients TEE was used and in 13 patients coronary angiography was used to rule out concomitant coronary artery disease. 94.4% of all tumors (17 cases) were primary cardiac tumors and only one tumor (5.6%) was recurrent. In 16 patients (88.9%) tumor were found in the Left Atrium (L.A) and in one case, tumor was found in both atria and in another case, tumor was in the ventricle. After tumor excision, atrial septum was repaired primarily in seven cases (38.9%) and with pericardial patch in 9 cases. One patient underwent concomitant coronary artery bypass graft (CABG) and another patient underwent concomitant pulmonary valve repair. 14 patients (77.8%) discharged from hospital without any post operative complication. Heart block occurred in one patient and cerebral emboli with secondary cerebrovascular accident (CVA) developed in two patients. One patient died (5.6%). Conclusion: Comparing results from two similar studies in two consecutive decades revealed that mean time from diagnosis to operation obviously was reduced but ad-vances in diagnostic modalities were unable to change clinical presentation or reduce age of tumor diagnosis or complications or size.
The effect of consolidation treatment with intraperitoneal carboplatin in advanced epithelial ovarian cancers
Azamsadat Mousavi , Mojgan Karimi-Zarchi , Nadereh Behtash , Mahnaz Mokhtari-Gorgani , Nili Mehrdad , Mitra Rouhi , Seyedhossein Hekmatimoghaddam,
Volume 72, Issue 4 (July 2014)
Abstract
Background: The aim of this study was to assess the role of consolidative intraperito-neal chemotherapy with carboplatin in decreasing relapse and increasing survival in advanced epithelial ovarian cancers, as well as evaluation of its toxicity. Methods: In this clinical trial 30 patients with epithelial ovarian cancer in stages II-IV who had complete surgery (optimal debulking surgery) received six standard cycles of intravenous carboplatin and paclitaxel. They were enrolled through non-random se-quential selection. The control patients were similar to case group in stage (II-IV) and pathology (epithelial ovarian cancer). The control group was evaluated retrospectively through hospital files. This clinical trial performed in Gynecology Oncology department in Tehran Valiasr University Hospital, during 2005-2010. They including 18 cases as the intervention group receiving intraperitoneal chemotherapy and 12 patients as the control group with only retrospective follow-up. The cases received 3 cycles of 400 mg/m2 intraperitoneal carboplatin every 21 days following intravenous chemotherapy. Relapse of disease was diagnosed as increasing or even doubling CA125 serum titer during one month, or any CA125 above 100 IU, or an abdominal or pelvic mass in ul-trasound or physical exam. Mean survival of two and five years, progression-free inter-val (PFI), overall survival (OS), relapse, demographic parameters, drug toxicities, path-ologic types of cancers in two groups were coded and compared using SPSS 14. Any P<0.05 was considered as a significant difference. Results: The mean ages of cases and controls were 52.4±8.6 and 55.1±11.5 years. The mean duration of relapse-free survival was 13±8.6 months for the cases and 9.5±4.3 months for the control patients (not statistically different, P>0.05). The mean overall survival for cases and controls were 39±16.5 and 30.8±16.2 months, respectively (no significant difference, P>0.05). The frequency of drug toxicities in the cases was 5.6%, and consisted of mild-to-moderate abdominal pain, nausea and vomiting. Conclusion: It seems that consolidation therapy with intraperitoneal carboplatin may not increase overall survival, reduce relapse rate or decrease mortality, though it does not induce considerable side effects. Since the mean survival in the intervention group was nine months more than controls, this difference may be clinically significant.
The effects of lactobacillus suppositories in the recovery and recur-rence of bacterial vaginosis: a double-blind randomized clinical trial
Soror Roozafzay , Khadijeh Hekmat , Kobra Shojaei , Pourandokht Afshari , Mohammad Bahadoram ,
Volume 72, Issue 5 (August 2014)
Abstract
Background: Bacterial vaginosis (BV) is the most prevalent causes of abnormal secre-tion in women at fertility age. Also, Bacterial vaginosis is one of the most common dis-eases in women who refer to gynecology clinic. The main cause of the pathogenesis is increasing pH of vagina due to reduced number of lactobacillus and growth of anaero-bic bacteria. Prevalence of BV varies between 10 to 30 percent in different societies. Amsel criteria is used as diagnostic test in BV. This interventional study was designed to assess the impact of vaginal lactobacillus suppository and metronidazole compared to metronidazole alone on the recovery and recurrence of bacterial vaginosis. Methods: This study was a prospective, randomized, double-blind clinical trial which was conducted on 130 women with bacterial vaginosis to compare the effects of vagi-nal lactobacillus suppository and metronidazole. Bacterial vaginosis was diagnosed us-ing Amsel criteria that based on some clinical symptoms. Patients were divided into two groups, first group were treated with oral metronidazole plus lactobacillus and second group were treated with metronidazole alone. Patients were followed-up one week and four weeks after initiation of the treatment. Results: One hundred and thirty women completed the study. Patients were followed at one and four weeks after initiation of intervention. Amsel criteria and recovery rate in both groups compared before treatment one and four weeks after treatment. The crite-ria and treatment were significantly improved, but this improvement was higher and statistically significant in the metronidazole plus Lactobacillus group compared to sec-ond group (P< 0.0001). Conclusion: The protective effects of lactobacillus in dealing with anaerobic patho-gens as well as the negative impact of metronidazole on lactobacillus of vaginal flora, use of lactobacillus along with metronidazole especially in patients with recurrent infec-tions is recommended. In other words, using lactobacillus with metronidazole for treatment of bacterial vaginosis is more effective than metronidazole alone.
Mitral valve Z value in Iranian patients with tetralogy of Fallot
Manouchehr Hekmat , Hamid Ghaderi , Seyedeh Adeleh Mirjafari , Shahram Rajaei Behbahani , Mehran Shahzamani , Gholamreza Masoumi ,
Volume 75, Issue 9 (December 2017)
Abstract
Background: Tetralogy of Fallot (TOF) refers to a condition in which left ventricular volume is normal or slightly less than normal. Given the differences observed in some Asian patients with TOF, the present study was conducted to investigate left heart by determining Z-scores for the mitral valve in Iranian patients with TOF.
Methods: Eligible subjects in this prospective descriptive study comprised all patients with TOF presenting to Shahid Modarres Hospital in Tehran from March 2012 to March 2015 and diagnosed as the candidates for surgery. After determining the need for surgery and the therapeutic method required, the mitral valve size and Z-scores were calculated. We analyzed sex, age, body surface area (BSA), mitral size (in 2-chamber and 4-chamber view), mitral Z-score, other cardiac anomalies, number of surgery and previous surgery.
Results: Of a total of 80 patients included in the study over 3 years, 29 (36.3%) were male and 51 (63.8%) were female. The mean age of the patients was 7.15±3.37 years and their mitral size was found to be 10-27 mm (16.2±5.99 mm) using echocardiography. Z-scores of the mitral valve were also obtained as -3.09±2.11, ranging between -7.1 SD and +1.3 SD. 58 (72.5%) patients have only TOF and 22 (27.5%) with other cardiac anomalies. 45 patients were for first time underwent surgery and 22 patients for second time, 12 patients for three time and 1 for forth. Of a total of 35 patients had previous surgery, the most common were shunt 15 (42.9%) and then tetralogy of Fallot total correction (TFTC) in 12 (34.3%). Of a total of 80 patients, 59 (73.8%) underwent TFTC, 17 (21.3%) under pulmonary valve replacement and 4 (5%) shunt.
Conclusion: Z-scores of the mitral valve were found to be significantly below the normal value, (i.e. 0±2 SD), in the study patients, suggesting the risk of hypoplastic left heart syndrome in Iranian patients with TOF, nevertheless, the type of TOF examined in these patients might have been different from those observed in other races and regions.
 

Short term effects of ginger on quality of life, disease activity index, inflammatory and oxidative stress factors in ulcerative colitis
Mehrnaz Nikkhah Bodaghi , Iradj Maleki , Shahram Agah , Azita Hekmatdoost ,
Volume 76, Issue 11 (February 2019)
Abstract
Background: Chronic inflammation and oxidative stress are the two essential factors determining ulcerative colitis (UC) onset and severity status. In present study, we aimed to investigate short-term effects of ginger (Zingiber officinale) as a well-known antioxidant and anti-inflammatory agent on the quality of life, disease activity index and some of inflammatory and oxidative stress factors in patients with active mild to moderate UC.
Methods: This study was a double blind placebo controlled randomized clinical trial conducted in nutrition and diet therapy clinic of Shahid Beheshti University of Medical Science, Tehran, Iran, from October 2017 to June 2018. Forty-six patients with active mild to moderate UC daily consumed four capsules of 500 mg dried ginger powder or similar placebo through eating their meals for 6 weeks. Before and after intervention, we analyzed patient´s scores of disease activity index, by simple clinical colitis activity index questionnaire (SCCAIQ) as well as their quality of life using inflammatory bowel disease questionnaire-9 (IBDQ-9). We also measured serum concentrations of total antioxidant capacity (TAC), malondialdehyde (MDA), tumor necrosis factor (TNF-α), high sensitive (hs)-CRP and nuclear factor κB (NF-κB) in fasted blood samples of each participant. Additionally, anthropometric and dietary intake values of energy, macro/micronutrients and minerals of all of participants were assessed at the same time.
Results: While the mean of anthropometric measures and dietary intake values remained unchanged during the study, MDA level decreased in ginger group (P=0.04) compared with placebo group. Additionally, ginger supplementation successfully lowered serum levels of TNF-α and disease activity index after 6 weeks of intervention compared with baseline in ginger consumer group, however the increase of quality of life score was not statistically significant in mentioned group versus baseline values. No significant change in other study outcomes was observed at the end of 6 weeks within and between groups.
Conclusion: Our data indicates that two grams per day supplementation with dried ginger powder can reduce oxidative stress level of patients with active mild to moderate UC.

The survey on the amount of scientific productions in the field of obstetrics and gynecology before and after the health reform plan, based on the Web of Science database: a sciento-metrics study
Mohammadreza Cheshmyazdan, Reza Dehnavieh , Mousa Bamir , Atousa Poursheikhali , Somayeh Noori Hekmat ,
Volume 77, Issue 8 (November 2019)
Abstract
Background: The position of each subject area in scientific production can indicate the ability of the scientific performance of that subject field. Since obstetrics and gynecology is one of the most important clinical sciences discipline of medical science, this study aimed to evaluate the scientific production in the field of obstetrics and gynecology before and after the Iran health reform plan.
Methods: This study is a scientometrics, time interval in the study was from 2008 to 2017 on Iranian articles based on the indexes of the number of documents, the number of citations received, the number of citations to each article, and the H-index of obstetrics and gynecology field based on the Web of Science database. It Indicators investigated, was extracted separately from the analysis section of the database.
Results: The average citation per article, the number of documents and the number of citations in the 5 years before the health reform plan respectively in the field of obstetrics and gynecology equal to 10.44, 196.6, 1750.6 and after the implementation of the health reform plan, equal to 3.89, 282.6, 1031.4. Also, the level of international collaboration before and after the project is 13.06 and 13.25, respectively. Also in the field of gynecology and obstetrics, Ramezani Tehrani, with 1.91% of all articles was the most reproductive writer, and Tehran University of Medical Sciences, with the highest scientific productions in the field of obstetrics and gynecology by 23.77% of all productions. Finally, the field of obstetrics and gynecology had the highest share of scientific production by 66.88%.
Conclusion: The findings showed that the scientific production of obstetrics and gynecology, in terms of quantity (number of documents), after the health reform plan, has been growing, but the quality (citation, H-index) is decreasing. Also, international collaboration has grown after the health reform plan. The findings also showed that before and after the health reform plan, the most cooperation was with the United States and the rate has been lower with Asian countries.

Hygiene protocols during the coronavirus pandemic for athletes: biref report
Amir Hossein Ahmadi Hekmatikar, Sadegh Amani Shalamzari , Mahdieh Molanouri Shamsi ,
Volume 79, Issue 4 (July 2021)
Abstract
Background: Long-term and intensive physical exercise can change the function of different cells in the immune system in athletes, predisposing them to viral infections such as coronavirus disease (COVID-19). The purpose of this brief report was to provide protocols related to the immune system in athletes to prevent infectious diseases.
Methods: To examine immune system responses to sports activities, articles were collected from all databases: Science Direct, PubMed, Scopus, Web of Science, Springer, Google Scholar, SID, and the most recent articles were selected.
Results: High-intensity and long-term physical exercise can be effective in suppressing immune responses. Therefore, moderate-intensity exercise can be an effective strategy. Maintaining the function of the immune system in athletes was dependent on nutritional strategies, sleep control, stress management, and strict adherence to proper exercise principles and health protocols. Athletes are more prone to viral infections in the early hours after strenuous, prolonged physical exercise; and they should be limited in contact with people who may increase their risk of infectious diseases. We should mention that moderate-intensity physical exercise can improve the function of immunoglobulins, anti-inflammatory cytokines, neutrophils, natural killer cells, cytotoxic T cells, and immature B cells. Maintaining social distance, especially immediately after strenuous exercise, is also recommended for athletes due to the increased risk of infectious diseases. The immune system has been considered an effective part of sports activities in athletes in recent years. The prevalence of viral diseases such as COVID-19 has not been and will not be for the first and last time in life. Therefore, using questionnaires and initial monitoring (adherence to diets, corona testing, adherence to health protocols) can be the first step.
Conclusion: Finally Due to the pandemic of coronary heart disease and its unknowingness, providing some health and nutrition guidelines for starting exercises and sports competitions to prevent the transmission of this disease is on the agenda of this article.

Evaluation role of beta-2 adrenoceptor agonist and antagonist in the expression of gap junction genes (connexin 37/43) in cumulus cells of women with poor ovarian response
Farideh Zafari Zangeneh , Samad Muhammadnejad, Mohammad Mehdi Naghizadeh, Maryam Bagheri, Elnaz Hekmat,
Volume 79, Issue 11 (February 2022)
Abstract
Background: Connexon is a membrane structural protein in the gap junctions. These cellular connections are responsible for transporting ions and messenger molecules to the oocyte. This study aimed to investigate the role of beta-2-adrenoceptors in the process of follicle growth based on the expression of the two connexins 37/43 in the gap junctions that have a primary role in the mitotic resumption and oocyte maturation.
Methods: This case-control study was conducted from April 2019 to November 2020 at the Reproductive Health Research Center of Tehran Imam Khomeini Hospital was performed on women with the poor ovarian response (POR) and control (women donate eggs) groups. Both groups had entry criteria with a body mass index under 28 m2/kg and 20-45 years old. Exit criteria were including no drug use except ovarian stimulants and no illness. The diagnosis was made agreeing to the Bologna model criterion. Ovulation stimulation cycle was performed, and then after the puncture, cumulus cells were isolated by enzyme and were freezing in -80 centigrade until the time of inserting into the cell culture medium. Isoproterenol (agonist) and propranolol (antagonist) at a concentration of 100 nM were added to the culture medium as the beta-2 adrenoceptors selective drugs. After culture, RNA extraction was performed and the concentration was read by Nanodrop, and then cDNA was synthesized. Gene expression was determined by real-time PCR.
Results: The findings of connexin expression in the three study groups: without the drug (P<0.001), propranolol (P<0.001), and isoproterenol (P<0.001) were significant compared to the control group. Isoproterenol decreased expression but propranolol increased it (P<0.001).
Conclusion: These findings confirm the important role of connexins 37 and 43 in cumulus cleft junctions that propranolol was able to increase its expression. Therefore, we suggest firstly these two connexins can be an effective target for oocyte growth and maturation. Secondly, propranolol could be a new treatment for women with POR and be effective in assisted reproductive technology (ART).
 

Appendicovesical fistula presenting as a bladder mass in a girl with cystic fibrosis: a case report
Hamid Arshadi, Pooya Hekmati, Hojatollah Raji, Mohammad Vasei , Mehrzad Mehdizadeh,
Volume 80, Issue 1 (April 2022)
Abstract
Background: Appendicovesical fistula in patients suffering from cystic fibrosis is a rare condition. Although this situation is so rare it should be considered in the differential diagnosis, dealing with a patient with cystic fibrosis and chronic abdominal pain with no response to primary management. To the best of our knowledge, this is the third case of appendicovesical fistula in a patient with cystic fibrosis.
Case presentation: In this paper, we are reporting a bladder lesion of a nine-year-old Iranian girl, a known case of cystic fibrosis, who was referred to pediatric urology clinic, Children’s Medical Center, Tehran University of Medical Sciences. The girl is a known case of cystic fibrosis on regular follow-up who had chronic abdominal pain for about one year. While primary management had been failed for her, further workups were done by her pediatric pulmonologist. In her pelvic sonography, the radiologist reported a bladder lesion so she was referred to our clinic. Cystoscopy was done for her, but transurethral biopsy/resection was impossible according to the lesion location. The non-papillary nature of the lesion raised our concern about the possibility of genital rhabdomyosarcoma with bladder invasion. So, an Abdominopelvic CT scan and a pelvic MRI were also done for her. Intact uterus and vagina with an enhancing lesion at the dome of the bladder with some degree of inflammation/attachment around the adjacent GI tract were detected on her images. The urachal inflammatory/tumoral process could not be ruled out. So open surgical exploration was planned. During the attempt for surgical exploration and partial cystectomy, at the Children’s Medical Center in December 2021, we found that the mass, is actually her appendix which has invaded the urinary bladder, and presented as a bladder lesion.
Conclusion: Abdominal pain is a relatively common complaint of patients with cystic fibrosis. Every caregiver or physician should consider rare conditions, dealing with a cystic fibrosis patient whose abdominal pain does not respond to common management.

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