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Showing 24 results for Heydar
Effects of lead on ultrastructural charactristics of sinusoidal endothelial cell of fetal rat's spleen
Z Heydari , B Minaiy Zangi , M Noori , M Akbari ,
Volume 55, Issue 5 (1 1997)
Abstract
Amount of environmental lead pollution is increased with progression of industry. This pollution is able to damage the living beings in many ways. Blood and Immune systems are more sensitive to toxic effects of lead. 30 female and 6 male rats from Sprague dawley race are chosen by simple random sampling. After copulation and vaginal plug observation, expectant rats are calssified in test and control groups. Since the first day of pregnancy, test group is given a drink containing lead acetate 0.13% in distilled water and control group is given distilled water. After delivery, for ultrastrectural studies, spleen specimens of newborn rats are fixed in glutaraldehyde solution 2% and after processing are studied by T.E.M. Sinusoidal endothelial cell show: morphological changes in mitochondria, appearance of primary & secondary lysosomes and multivesicular bodies and swelling in ER. It seems that these changes are caused by interaction of lead with enzymathic functions or lead accumulation in these cellular organels.
Blood Culture Contamination In Children’s Medical Center Of Tehran From April To July 2004
Chitsaz M, Khotaee G, Shhcheraghi F, Poorheydaree N,
Volume 63, Issue 2 (12 2005)
Abstract

Background: Blood culture is the criterion standard for identifying children with bacteremia. However, elevated false-positive rates are common and are associated with substantial health care costs. The aims of this prospective study were to: 1) determine the rate of blood culture contamination 2) determine variety and frequency of contaminant bacteria 3) compare the duration of hospital stay and antibiotic administration in patients with true bacteremia vs those have false positive blood culture.

Materials and Methods: Cross-sectional study conducted April through July 2004 among patients aged 14 years or younger who were admitted at Doctor Garib Children Medical Center of Tehran and had a blood culture obtained as part of their care. Bacterial isolates were identified to species level and medical records were reviewed in all cases with a positive blood culture. A number of clinical and laboratory criteria were used to deciding whether a blood isolate is a pathogen or a contaminant. These include the identify of the micro-organism itself, clinical features such as fever and leukocytosis the proportion of blood culture sets positive as a function of the number of sets obtained and to have an indwelling vascular catheter or prosthetic device.

Results: During the study period, 2877 sets of blood culture were evaluated and the rates of positive blood cultures associated with significant bacteremia and contamination were 1.04% and 5.4% respectively. Among the positive blood cultures, over the 84% of isolates were due to contamination and only 15.95% of isolated strains associated with true infection. The frequency of isolated bacteria with respect to true infection and contamination are as following: S. Aureus (infect: 9.0%, contam: 0.0%), S. Epidemidis (infec: 0.0%, contam: 13.3%), Micrococcus sp. (infec: 0.0%, contam: 4.3%), pseudomonas and related species other than P. aeruginosa (infec: 2.1%, contam: 60.6%), viridans group of streptococci (infec: 1.1%, contam: 2.1%), E.coli (infec: 1.06%, contam: 0.0%), Klebsiella pneumoniae (infec: 0.53%, contam: 0.0%), Enterobacter cloacae (infec: 0.53%, contam: 0.0%), and Acinetobacter baumannii (infec: 0.25%, contam: 0.53%). The mean of hospital stay for patients with true bacteremia, 14.83 days, was not significantly higher than that for patients with false-positive blood cultures (10.08 days). 43 patients had administrated one to three antibiotics after false-positive blood cultures.

Conclusion: The findings indicate that blood culture contamination rate in studied hospital is higher than standard levels, and very high rate of contamination with environmental pseudomonas species shows an unusuall epidemic condition. The findings also suggests high resource utilization and prolong patients stay due to pseudobacteremia.


Evaluation Of Ankle Brachial Index As A Predictive Factor For Diagnosis Of Coronary Artery Disease
E Nematipor , B Heydari,
Volume 64, Issue 1 (30 2006)
Abstract

Background and Aim: Cardiovascular disease is one of the main causes of mortality and morbidity around the world and because of insidious and chronic progression of arterioscleroses and coronary artery disease (CAD) and also correlation between peripheral arterial disease and CAD we evaluated ankle brachial index (ABI) as a predictive factor for early diagnosis of CAD.

Materials and Methods: Evaluation of ABI performed in patients who referred to cardiology department of Imam Khomeini Hospital for coronary angiography from April 2003 to May 2004. 100 patients selected for the study, 50 patients with CAD (at least one vessel significantly involved) and 50 patients with normal coronary arteries as control cases. Relation between ABI and CAD studied in the patients, also other variables such as age, sex, family history of CAD, diabetes mellitus, hypertension, hyperlipidemia, cigarette smoking and claudication were evaluated.

Results: The mean age in patients with coronary artery disease was 56±16 years old (66% male, 34% female) and in normal coronary patients was 52+15 years old (48% male, 52% female). The mean ABI in patients with abnormal coronary arteries was 1.07±0.028 and in cases with normal coronary arteries was 1.12±0.016 that was not significant (P= 0.128). In addition there was no significant value between ABI and other variables mentioned above. All patients with ABI≤ 0.9 (14% of patients) had CAD.

Conclusion: This study revealed that although an ABI≤ 0.9 has a high predictive value for CAD, the ABI itself can not be a sensitive predictor of CAD diagnosis because a large numbers of CAD patients had ABI more than 0.9. Hence this level of ABI can not rule out the presence of CAD in many patients.


Couples’ knowledge and attitude about sexuality in pregnancy
Heydari M, Kiani Asiabar A, Faghih Zade S,
Volume 64, Issue 9 (1 2006)
Abstract
Background: Alteration in pattern of sexuality is known to be impressed by couples’ believes about women’s physical and psychological changes during pregnancy. The objective of this study is to evaluate the knowledge and attitudes of couples about sexual relations during pregnancy.
Methods: In a descriptive study from February to April 2005, two hundred sixty six consecutive pregnant women referring to a university hospital were asked to answer a questionnaire containing questions their sexual status and some demographic data. In 122 cases the answers of the spouses was collected also. The answers were compared in divided groups according to age range, duration of marriage, parity and educational status.
Results: Fifty five percent of men and fifty eight percent of women had a negative attitude about sexual relations during pregnancy, and 60% of men and 75% of women presented incorrect knowledge about sexuality during pregnancy. Main reasons for decreased sexual relations in pregnancy were mentioned to be dysparaunia, and the fear of trauma to the baby, abortion, membrane rapture, preterm labor and infection.
Conclusion: As couples’ knowledge and attitudes about sexuality affect their general sexual behavior during pregnancy it is crucial to provide proper consultation regarding sexual relations in prenatal care services.
Functional outcome of lower limb following anterior cruciate ligament reconstruction a prospective clinical study
Olyaei G.r, Jamshidi A.a, Heydarian K, Talebian S,
Volume 65, Issue 2 (8 2008)
Abstract
Background: Both isokinetic testing and functional tests are commonly used to evaluate anterior cruciate ligament reconstructed (ACLR) patients. The object of this study was to evaluate motor performance of the knee and determine the relationship of isokinetic test scores to scores on a variety of lower extremity functional tests.
Methods: Ten healthy subjects and eleven ACLR patients at least six months after surgery performed the following: knee isokinetic tests at 60 and 180 deg/sec three functional tests including leg vertical jump, single hop, and triple cross-over hop for distance. The International Knee Document Committee Subjective Knee Evaluation Form (IKDCSKEF) was used to score the self-assessment of each study participant. Paired T-test was used to compare the involved and uninvolved knee. Pearson correlation coefficients were used to determine the relationship between the scores on the isokinetic test and functional tests. Significance was determined by P<0.05.
Results: IKDCSKEF score was significantly lower in patients than control subjects. Quadriceps peak torque and functional test scores were significantly lower in the involved knee of the ACLR subjects compared to the uninvolved knee. Correlation coefficients of isokinetic peak torque to body weight and functional testing were not significant in patients or control subjects, whi1e the limb symmetry index (LSI) of the quadriceps isokinetics peak torque to body weight and the LSI of the functional tests were significant (r = 0.54 to 0.97).
Conclusion: These results indicate a significant relationship between the LSI of various functional tests and the LSI of isokinetic testing among ACLR patients. Thus, in situations where an isokinetic dynamometer is not available, the LSI of functional tests can be used to estimate quadriceps deficiency for ACLR patients.
Relationship between ELA2 gene mutations, clinical and laboratory parameters in severe congenital and cyclic neutropenia
Farhoodi A, Ahangari Gh, Chavoshzadeh Z, Ramyar A, Movahedi M, Ghareghozlou M, Heydarzadeh M, Fazlolahi M, Bemanian M H, Zandieh F, Mansori M,
Volume 65, Issue 7 (4 2007)
Abstract
Background: Mutations of ELA2, the gene encoding neutrophil elastase (NE) are known to be associated with cyclic neutropenia (CN) and severe congenital neutropenia (SCN). However, high variability of these mutations has been reported. This study was designed to describe the analysis of the ELA2 gene, clinical manifestations and demographic characteristics in patients with CN and SCN.
Methods: A series of 21 patients with CN or SCN were selected, based on SCINR criteria, from the immunology ward of the Pediatric Medicine Center, Tehran, Iran, from March 2004 to August 2005. The ELA2 gene, isolated from blood samples, was analyzed using RT-PCR and automated capillary sequencing. Informed consent was obtained under the tenets of the Helsinki Declaration and the Ethical Committee of the Tehran University of Medical Sciences.
Results: Kostmann's syndrome and CN was diagnosed in three and 18 patients respectively. Of all the patients, one or two mutations were found in 18 cases (85.7%), including all three patients with SCN and 15 of the patients with CN. Exons two and four had the most mutations (eight and seven cases, respectively). Seven patients had double mutations in two distinct exons. Overall, 16 different mutations were found. At the time of presentation, the mean age of patients was 13.4 ±17.6 months, ranging from one month to seven years. Overall, 61.9% of patients had consanguineous parents. The mean absolute neutrophil count was 830.5 ±419.4 (150-2000)/mm3. On average, each patient had been admitted to the hospital 2.2 ±1.6 times. The neutrophil counts of the SCN patients were significantly higher than those of the CN patients. However, there was no significant difference in the neutrophil counts between patients with mutations and those without mutations. All patients with SCN had two or more infectious complications, although the prevalence of infectious or non-infectious complications did not correlate with ELA2 mutations or the neutropenic disorders.
Conclusion: Mutations in ELA2 appear to play an important role in the phatogenetic mechanisms of CN and SCN. Patients with CN had significantly higher neutrophil counts than SCN patients with CN. Although it possible for the gene encoding neutrophil elastase to have more than one mutation in distinct exons, we found no association between the mutations in ELA2 and their complications in CN and SCN patients.
  Plasma ascorbic acid levels in senile cataract patients and in normal individuals: a comparative study 
Derkhshandeh J, Fooladsaz K, Heydarpour F,
Volume 67, Issue 8 (6 2009)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Dietary antioxidant vitamins, in particular vitamin C, can play a role in preventing the onset or progression of age-related visual impairment. The aim of this study was to determine the plasma ascorbic acid levels in normal individuals and in senile cataract patients.
Methods: The test group included fifty cataract patients, while the control group members were selected among medical staff and patients' companions after age matching with test group. The use questionnaire contained age, sex and location of residency (Urban or Rural). Five milliliter of drawn blood centrifuged and plasma ascorbic acid level was measured by spectrophotometry. Statistical analysis of plasma ascorbic acid concentrations were done using paired t-test.
Results: The mean plasma ascorbic acid level intest group and incotral group was 0.96±0.08 and 1.12±0.15mg/dl respectively. Plasma ascorbic acid level in test group was significantly lower than control group (p<0.0001). Aging was associated with a reduction in plasma ascorbic acid level in male while it showed no significant alteration in females. Rural and the female gender showed higher plasma ascorbic acid level.
Conclusions: This study revealed plasma ascorbic acid level in patients with senile cataract was lower than normal individuals. Antioxidant vitamins, in particular vitamin C, found in Mediterranean fruits and vegetables could be probably used in the prevention of cataracts, which is a major health service burden in many countries.


End tidal CO2 versus arterial CO2 monitoring in patients undergoing coronary artery bypass graft
Ebrahim Hassani , Rasoul Farasatkish , Evaz Heydarpour , Mohammadzia Totoonchi , Alireza Mahoori ,
Volume 67, Issue 9 (6 2009)
Abstract
Background: Measuring end tidal carbon dioxide (ETCo2) is one of the methods used for estimating arterial carbon dioxide (PaCo2) during general anesthesia. ETCo2 measurements maybe obviate the need for repeating arterial puncture for determination of arterial PaCo2. This study performed to determine the accuracy of ETCo2 levels as a measure of PaCo2 levels in patients undergoing coronary artery bypass graft and also to evaluate variation of the gradient between PaCo2 and ETCo2, peri- cardiopulmonary bypass operation. Methods: In a prospective, cross-sectional study, a total of 40 patients with age 57±11 (35-73) years old undergoing coronary artery bypass graft were enrolled. ETCo2 levels (mmHg) were recorded using side stream capnography at the time of arterial blood gas sampling, before (T0) and after (T1) cardiopulmonary bypass. Results: Mean P(a-ET)Co2 at T0 was 4.3±4.4mmHg, with the mean PaCo2, 33±6mmHg and mean ETCo2, 29±5mmHg and these values at T1 were 4.5±4.1mmHg, 33±5mmHg and 29±2mmHg respectively. There was no variation of the mean gradient (PaCo2-PETCo2) during, before and after cardiopulmonary bypass (p>0.870). Significant correlation was found between ETCo2 and PaCo2 at T0 and T1 (r=0.754 and 0.685respectively and p=0.001). Conclusion: Capnography is a non- invasive and a safe technique for determining arterial PCo2 and for measurements of ETCo2 that correlate well with PaCo2 values in healthy patients undergoing coronary artery bypass graft. ETCo2 measurements maybe sufficient measures of PaCo2 in selected patients and obviate the need for repeatingarterial blood gas determination. Further study is warranted.
Determining the interobserver reproducibility of Pap smears in the diagnosis of epithelial cell abnormalities
Izadi-Mood N, Sarmadi S, Heydari-Farzan F, Haeri H, Forouhesh-Tehrani Z,
Volume 69, Issue 4 (6 2011)
Abstract

800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Cancer of uterine cervix is the second cause of death in women in the world and the most common cause in developing countries. Because the majority of women with invasive cervical cancer of the uterine have not previously undergone screening, many clinicians assume that Pap smear has a high degree of accuracy but problems such as false positive and false negative interpretations, as well as interobserver variability have questioned its validity.
Methods : We retrieved 162 positive cervical smears that had been originally interpreted as ASC-US, ASC-H, LSIL, HSIL, SCC, AGC and adenocarcinoma from the cytology archives of Women's Hospital in Tehran, Iran. The slides were rescreened by an experienced pathologist and reclassified in the mentioned categories. All the 162 slides were reviewed by three more pathologists in a blind study using interpretative criteria utilized in their daily routine to evaluate interobserver reproducibility. To increase the level of interobserver agreement, the diagnostic categories were reduced to squamous Vs. glandular abnormalities and invasive (SCC and adenocarcinoma) Vs. non-invasive abnormalities.
Results : The results obtained in this study indicated slight interobserver agreement (k=0.26). The most reproducible category was the invasive category (SCC in addition to adenocarcinoma) and the least agreement was seen for HSIL (k=0.19).
Conclusion: This study showed that reproducibility of cytological interpretation of conventional Pap smears varies among interpretive categories and the overall interobserver agreement is slight. Since convening on the reduction of interobserver discrepancy in Pap smear interpretations necessitates more reliable information of interpretative variability, larger studies need to be undertaken.


The effects of tranexamic acid on postoperative bleeding in coronary artery bypass graft surgery
Hassani Ebrahim, Mahoori Alireza, Mehdizadeh Hamid, Noroozinia Heydar, Aghdashi Mir Mousa, Saeidi Mohammad,
Volume 70, Issue 3 (4 2012)
Abstract

Background: Perioperative administration of tranexamic acid (TA), decreases bleeding and the need for transfusion after cardiac procedures. Hence, the results may vary in different clinical settings and the most appropriate timing to get the best results is unclear. The primary objectives of the present study were to determine the efficacy of TA in decreasing chest tube drainage, the need for perioperative allogeneic transfusions and the best timing for TA administration following primary, elective, coronary artery bypass grafting (CABG) in patients with a low baseline risk of postoperative bleeding.

Methods: In this double-blind, prospective, placebo-controlled clinical trial in Seiedoshohada Hospital during 2011-2012, we evaluated 150 patients scheduled for elective, primary coronary revascularization. They were randomly divided into three groups. Group B received tranexamic 10 mg/kg prior to, Group A received tranexamic acid 10 mg/kg after cardiopulmonary bypass and group C received an equivalent volume of saline solution. Blood requirement and postoperative chest tube drainage were recorded.

Results: The placebo group (group C) had a greater postoperative blood loss 12 h after surgery (501±288 vs. 395±184 in group B and 353±181 mL in group A, P=0.004). The placebo group also had greater postoperative total blood loss (800±347 vs. 614±276 in group B and 577±228 mL in group A, P=0.001). There was a significant increase in allogeneic blood requirement in the placebo group (P=0.001).

Conclusion: For elective, first time coronary artery bypass surgery, a single dose of tranexamic acid before or after cardiopulmonary bypass is equally effective.


Factors related to extubation failure and post pulmonary complications in intracranial surgery in 254 patients: a brief report
Heydari Sv, Ramak Hashemi Sm, Abasnejad Ea, Abbasi Gravnd F, Ghorbani Yekta B,
Volume 70, Issue 5 (5 2012)
Abstract

Background: The purpose of this study was to determine the prevalence and associated factors for postoperative pulmonary complications (PPCs) and extubation failure in patients having undergone intracranial surgery.

Methods: In this retrospective study done in Firozgar Hospital during 2008-2010, we followed up 254 patients through a clinical questionnaire and observation of the clinical course of participants in pre- and post-operative periods.

Results: Overall, 40 (15.74%) patients had postoperative pulmonary complications. The most common PPC was pneumonia, which was seen in 24 patients (60% of complications). The average duration of ventilation in patients with PPC was significantly higher (16.8.±10 vs. 5.09±4.5 days P=0.001) than patients without the complication. The mean Glasgow coma scale (GCS) after surgery in patients with PPC was significantly lower (11.±4 vs. 13.2±3 P=0.001) than the rest of the patients. Moreover, the mean age of patients with PPC was significantly higher (64.02±14 vs. 41.6.±17 years P=0.001). Average duration of stay in ICU in patients with PPC was also higher (24.±27 vs. 8.7±0.5 P=0.001).

Conclusion: GCS before surgery and failed extubation independently of other variables were significantly associated with pulmonary complications independent of other variables.


Comparison of pulseoximetry oxygen saturation and arterial oxygen saturation in open heart intensive care unit
Alireza Mahoori , Ebrahim Hassani , Heydar Noroozinia , Behzad Sinaei , Elham Esmaeili ,
Volume 71, Issue 5 (August 2013)
Abstract
Background: Pulseoximetry is widely used in the critical care setting, currently used to guide therapeutic interventions. Few studies have evaluated the accuracy of SPO2 (puls-eoximetry oxygen saturation) in intensive care unit after cardiac surgery. Our objective was to compare pulseoximetry with arterial oxygen saturation (SaO2) during clinical routine in such patients, and to examine the effect of mild acidosis on this relationship.
Methods: In an observational prospective study 80 patients were evaluated in intensive care unit after cardiac surgery. SPO2 was recorded and compared with SaO2 obtained by blood gas analysis. One or serial arterial blood gas analyses (ABGs) were performed via a radial artery line while a reliable pulseoximeter signal was present. One hundred thirty seven samples were collected and for each blood gas analyses, SaO2 and SPO2 we recorded.
Results: O2 saturation as a marker of peripheral perfusion was measured by Pulseoxim-etry (SPO2). The mean difference between arterial oxygen saturation and pulseoximetry oxygen saturation was 0.12%±1.6%. A total of 137 paired readings demonstrated good correlation (r=0.754 P<0.0001) between changes in SPO2 and those in SaO2 in samples with normal hemoglobin. Also in forty seven samples with mild acidosis, paired readings demonstrated good correlation (r=0.799 P<0.0001) and the mean difference between SaO2 and SPO2 was 0.05%±1.5%.
Conclusion: Data showed that in patients with stable hemodynamic and good signal quality, changes in pulseoximetry oxygen saturation reliably predict equivalent changes in arterial oxygen saturation. Mild acidosis doesn’t alter the relation between SPO2 and SaO2 to any clinically important extent. In conclusion, the pulse oximeter is useful to monitor oxygen saturation in patients with stable hemodynamic.

Letrozole and misoprostol versus misoprostol alone for termination of pregnancy: a randomized clinical trial
Zahra Rezai , Seydeh Sareh Heydari Bazardehi , Azizeh Ghasemi Nezhad , Amir Saeid Sadeghi , Batool Ghorbani Yekta ,
Volume 71, Issue 11 (February 2014)
Abstract
Background: To compare the success rate and side effects of letrozole and misoprostol versus misoprostol alone for medical termination of early pregnancy. Methods: The patients requesting termination of pregnancy up to 63 days of gestation were randomized into two groups. The letrozole group received letrozole 10 mg daily for 3 days followed by 800 micrograms of vaginal misoprostol, while the placebo group received placebo for 3 days followed by the same dosage of misoprostol. The complete abortion rate and the side effects profiles of the two groups were compared. The primary outcome measure was the abortion rate. Results: A total of 214 women were recruited. Overal complete abortion rate was 81.3%, complete abortion rate in the letrozole group was not significantly higher than that of the placebo group (84.1% compared 78.5%). After receiving 800 mcg misoprostol, 37 case (17.3%) had complete abortion that 13 cases (12%) of the misoprostol group and 24 patients (22.5%) of the cominabtion group and after receiving 1600 mcg, misoprostol, in 137 cases (77.4%) had complete abortion that 71 patients (75.5%) of the misoprostol group and 66 cases (79.5%) was obtained for the combination group. This difference was not statistically significant (P> 0.05). D & C in 40 cases (18.7%) reported that was not significantly different in the two groups, 17 cases (15.9 %) in the combination group versus 23 (21.5%) in the misoprostol group. Side effects such as fever, tachycardia, diarrhea and pain were similar in the two groups there were not significantly fewer women complaining of side effects in the letrozole group than those in the placebo group (P> 0.05). Conclusion: Combination of letrozole and misoprostol is as effective as misoprostol alone in complete abortion rate. Based on these results, the use of misoprostol in combination with letrozole is safe and not expensive.
Neonatal varicella pneumonia, surfactant replacement therapy
Mousa Ahmadpour-Kacho , Yadollah Zahed Pasha , Hojatollah Ehteshammanesh , Alireza Yahyaei Shahandashti , Fatemeh Heydari , Tahereh Jahangir , Faezeh Aghajanpour ,
Volume 73, Issue 9 (December 2015)
Abstract

Background: Chickenpox is a very contagious viral disease that caused by varicella-zoster virus, which appears in the first week of life secondary to transplacental transmission of infection from the affected mother. When mother catches the disease five days before and up to two days after the delivery, the chance of varicella in neonate in first week of life is 17%. A generalized papulovesicular lesion is the most common clinical feature. Respiratory involvement may lead to giant cell pneumonia and respiratory failure. The mortality rate is up to 30% in the case of no treatment, often due to pneumonia. Treatment includes hospitalization, isolation and administration of intravenous acyclovir. The aim of this case report is to introduce the exogenous surfactant replacement therapy after intubation and mechanical ventilation for respiratory failure in neonatal chickenpox pneumonia and respiratory distress.

Case Presentation: A seven-day-old neonate boy was admitted to the Neonatal Intensive Care Unit at Amirkola Children’s Hospital, Babol, north of Iran, with generalized papulovesicular lesions and respiratory distress. His mother has had a history of Varicella 4 days before delivery. He was isolated and given supportive care, intravenous acyclovir and antibiotics. On the second day, he was intubated and connected to mechanical ventilator due to severe pneumonia and respiratory failure. Because of sever pulmonary involvement evidenced by Chest X-Ray and high ventilators set-up requirement, intratracheal surfactant was administered in two doses separated by 12 hours. He was discharged after 14 days without any complication with good general condition.

Conclusion: Exogenous surfactant replacement therapy can be useful as an adjunctive therapy for the treatment of respiratory failure due to neonatal chickenpox.


Cardiac systolic function in cirrhotic patients’ candidate of liver trans-plantation compared with control group
Roya Sattarzadeh-Badkoubeh , Babak Geraiely , Mohsen Nassiri-Toosi , Ali Jafarian, Kazem Heydari ,
Volume 74, Issue 11 (February 2017)
Abstract

Background: We assessed different systolic cardiac indices to describe left and right ventricular dysfunction in cirrhotic patients before liver transplantation.

Methods: In this case-control study, eighty-one consecutive individuals with the confirmed hepatic cirrhosis and candidate for liver transplantation in the Imam Khomeini Hospital between March 2008 and March 2010 were selected. Thirty-two age and gender cross-matched healthy volunteers were also selected as the control group. A detailed two-dimensional and Doppler echocardiography was obtained in all patients and controls performed by the same operator on the day of admission.

Results: Dimensions of both left and right atriums as well as left ventricular end-diastolic volume and basal right ventricular dimension in the cirrhotic group were significantly higher than control group. Left ventricular end-systolic dimensions as well as aortic annulus diameter were not different between the two study groups. Left ventricular outflow tract velocity time integral, isovolumic pre-ejection time, isovolumic relaxation time, stroke volume, left ventricular ejection fraction, IVCT+IVRT+ET, systolic velocity of tricuspid annulus, systolic velocity of basal segment of RV free wall, systolic velocity of basal segment of septal wall, peak strain of septal margin (base), peak strain of septal margin (midpoint), peak strain of lateral margin (midpoint), strain rate of septal margin (base), strain rate of septal margin (midpoint), strain rate of lateral margin (base), strain rate of lateral margin (midpoint), Tei index (left and right ventricles), systolic time interval and tricuspid annular plane systolic excursion were higher in cirrhotic group, significantly, (P< 0.05). Left ventricular ejection time and systolic velocity of mid segment of lateral wall were lower in cirrhotic group, significantly, (P< 0.05).

Conclusion: In this study, the effects of liver on heart were volume overload, hyperdynamic state and systolic dysfunction in cirrhotic patients. These effects were due to chamber enlargement and we cannot use the most of cardiac indices for evaluation systolic function in cirrhotic patients. So, we suggest that systolic time interval and Tei index are useful indices in evaluation of systolic function in cirrhotic patients.


Influence of the contrast agents on dose-volume histograms in radiotherapy treatment planning based on CT-scan
Sahel Heydarheydari , Negin Farshchian , Abbas Haghparast , Seyed Masoud Rezaeijo,
Volume 75, Issue 11 (February 2018)
Abstract
Background: In three-dimensional conformal radiation therapy (3D-CRT), contrast-enhanced CT (CECT) image is commonly used to assist radiation oncologists in diagnosing regions of interest, so that normal and target tissues can be better delineated. CECT causes the temporary increase in the CT number and the corresponding electron density (ρe). Administrated contrast agents (CA) during CT simulation and altering the ρe of structures can be effective on radiation calculations and dose-volume histograms (DVHs) in radiotherapy treatment planning. Therefore, present study was designed and performed to determine the influence of the administrated CA on DVHs.
Methods: Current study performed as a self-controlled clinical trial study with before/after method at Imam Reza Hospital, Kermanshah City, during the period from June 2015 till August 2016. Ten patients with pelvic cancer included in this study through simple sampling. Cases with prior reactions to CA, diabetes, renal diseases, and asthma were excluded. Two sets of CT-scans were taken for each patient in the same position and coordinates. Primary study sets contained pre-contrast images and secondary study sets were performed post-contrast. Both sets of CT images were transferred to the treatment planning system (ISOgray® software, Version 4.1.3.23 L, DOSIsoft®, Cachan, France). All treatment plans were generated on pre-contrast and subsequently copied to the post-contrast CT. Quantitative calculations were performed in treatment planning including the difference in ρe before and after CA administration.
Results: The prostate (1.27%), the bladder (0.62-0.79%) and the rectum (0.43-0.56%) showed the largest changes in average ρe increase. The results confirm the expected relationship of increasing attenuation, CT number, and ρe with increased tissue density due to the CA. However, the DVHs showed insignificant difference between pre-and post-contrast CTs for 18 MV photon beam.
Conclusion: The results showed statistical insignificant difference between with and without CA CTs treatment plan in pelvic field for targets and OARs. These results may serve as a reference to justify the use of CECT data sets for 3D-CRT planning of pelvic region cancers using DosiSoft ISOgray system.

Investigating the causes of skin rashes in children admitted to Hospital
Seyed Mohammad Reza Shokrollahi, Hosein Heydari , Sajad Rezvan, Akram Barati, Mohammad Hassan Nikkhah ,
Volume 76, Issue 3 (June 2018)
Abstract
Background: Rash is a common complaint in children that has many causes and the various differential diagnoses. Therefore, urgent and appropriate clinical diagnosis is necessary to provide immediate medical intervention. Therefore, the purpose of this study was to investigate the causes of skin rash in children hospitalized due to rash.
Methods: This descriptive-analytic study was performed on all patients admitted for skin rashes in Hazrat Masoumeh Hospital in Qom, Iran from 2010 to 2015. In this study, the data of 317 patients who were admitted to the early diagnosis of rash were collected from patients' files and recorded in the checklist.
Results: According to our study, the most common causes of skin rashes in children were viruses with a share of 40.69% (129 cases), allergic causes being as prevalent as 21.77% (69 cases) and drug induced rashes that accounted for 20.50% (65 cases). Based on the site and type of rashes, the most common type of rashes were maculopapular rashes with 42% and hives with 31.9% prevalence, and the most common site of involvement was diffuse involvement that would account for 84% of the cases. In terms of drug use history, 35.6% had a history of antibiotic use prior to admission, and 14.5% had an antiepileptic drug use history. There was a significant relationship between the cause of rashes and the season of presentation (P< 0.05) as well as the age of presentation (P< 0.05).
Conclusion: This study showed that there is a significant relationship between the season and age of occurrence, but the use of these factors as a benchmark for the diagnosis of rash requires more studies. Paying attention to the causes of rash in children, knowing about these factors, and continuous evaluation of these patients can help in advancing a proper management of the problem of patients. The most frequent factors were viruses and then allergic and pharmaceutical agents, and the most common type was maculopapular.

Intraveneous fluconazole in prevention of infection in neonates under 1200 grams admitted to NICU
Parvaneh Sadeghi-Moghaddam , Elham Farasat, Hosein Heydari , Zahra Movahedi, Mohammad Aghaali,
Volume 77, Issue 2 (May 2019)
Abstract
Background: With the increase in the number of premature neonates, there are concerns about the complications of this group. One of the common complications of preterm neonates is fungal sepsis. Therefore, this study was conducted to evaluate the efficacy of intravenous fluconazole on fungal sepsis and other complications related to premature newborns under 1200 g in a neonatal intensive care unit.
Methods: The study was conducted by field trial. The intervention included intravenous injection of fluconazole (3 mg/kg, twice per week for 6 weeks) in neonates weighing less than 1200 gr in the Izadi Hospital in Qom, Iran. The intervention was conducted on September 2016 in entire population of the study. The control group was retrospective and from neonates admitted to Izadi Hospital, which were hospitalized before intervention. The outcomes (such as the need for amphotericin injection, death, fungal sepsis, time taken to reach enteral feeding and length of stay) were compared between the two groups.
Results: There was no significant difference between the two groups regarding their sex ratio (P=0.139), gestational age (P=0.834), type of delivery (P=0.841) and birth weight (P=0.458). After the intervention, fungal sepsis (from 65% to 48.3%) and the need for amphotericin injection (from 27.1% to 5%) were significantly reduced, and the mortality rate decreased from 40% to 28.3%, but this decline was not statistically significant (P=0.178). After the intervention, the length of stay in hospital (P=0.142) and neonatal intensive care unit (P=0.422), time to reach the weight of 1500 gr (P=0.717), and time taken to reach enteral feeding (P=0.289) did not change significantly. Proportion of pneumothorax, apnea, necrotizing enterocolitis, retinopathy of prematurity and need for respiratory support did not change significantly.
Conclusion: The present study showed that administration of venous fluconazole could reduce fungal sepsis in neonates weighing less than 1200 grams in the intensive care unit. However, this study failed to demonstrate the effect of fluconazole on death, pneumothorax, apnea and need for respiratory support.

The effect of oral Aphanizomenon flos-aquae extract on excisional wound healing
Maria Zahiri , Khalil Pourkhalili , Sadegh Darvishi , Hossein Heydari , Zahra Akbari,
Volume 77, Issue 10 (January 2020)
Abstract
Background: Aphanizomenon flos-aquae (AFA) is a type of blue-green algae and contains a source of biological compounds. These microalgae have many beneficial health effects. Recently, fucoidan, known sulfated polysaccharide component of AFA algae, has been claimed to stimulate stem-cell mobilization in animal models. Stem cells play an essential role in tissue repair process. In this study, we use excisional full thickness wound model to investigate the effectiveness of trademark AFA extract on skin wound repair process.
Methods: In this experimental study, 21 adult male Wistar rats (weighing 200-250 g) were used and under general anesthesia (intraperitoneally with a ketamine/xylazine solution), two round excisional wounds were created under sterile conditions by a 6 mm punch on the dorsum (paravertebral area) of all rats. Animals were randomly assigned into 3 groups. In groups 1 and 2 (SE-200, SE-400), StemEnhance© (StemTech Health Sciences Inc. British Columbia, Canada) were given respectively 200 or 400 mg/kg by oral gavage once daily and in group 3 (Sham), distilled water (DW) was given to all subjects. Post-wounding gavage of StemEnhance or DW started from 1st day and continued to 7th day. The wound surface area was monitored daily by digital camera and assessed by Image Tool™ software, version 3.5 (UTHSCSA, San Antonio, TX, USA). At 9th day post-wounding animals were sacrificed and repaired tissues were harvested by and assessed by a 8 mm punch. Repaired skin areas were processed for hematoxylin and eosin (H&E). Histopathological parameters of healing including inflammatory cell infiltration, angiogenesis, and fibroblast count were assessed by pathologist. Our study was conducted in the Physiology Department of Medical School, Bushehr University of Medical Sciences, Iran, from October 2016 to March 2016.
Results: Macroscopic imaging of wound area revealed that there was statistically significant difference in wound area reduction between SE-200 group and sham group on day 6 post wounding (P=0.032). Moreover, histological findings showed that the number of neutrophils, macrophages, fibroblasts, and microvessel density decreased in both StemEnhace-treated groups. There were no significant differences between two treatment groups.
Conclusion: According to the obtained results it seems that the extract of Aphanizomenon flos-aquae algae positively affects wound healing process by ameliorating inflammatory response in early healing phases.

Evaluation of the melatonin effect on sleep quality in cancer patients
Negin Farshchian , Maryam Shirzadi , Firouzeh Farshchian , Sepideh Tanhaye , Sahel Heydarheydari , Nasrin Amirifard ,
Volume 78, Issue 1 (April 2020)
Abstract
Background: Melatonin is one of the drugs which are used in the treatment of sleep problems, including insomnia and sleep deprivation. The aim of the present study was to evaluate the melatonin effect on sleep quality in patients with cancer.
Methods: This quasi-experimental study was performed on cancer patients with trouble sleeping who were treated with melatonin (3 mg per day) for a month. Sleep quality according to the Pittsburgh sleep quality index (PSQI) questionnaire was evaluated before and after taking melatonin. This study was conducted in the Oncology Clinic of Imam Reza Hospital, Kermanshah City in Iran from August 2016 to February 2018.
Results: There was a significant difference between the sleep quality of patients with cancer before and after taking melatonin (P<0.05). In other words, before taking melatonin, sleep quality of none of the patients was not optimal but after taking melatonin, the sleep quality of 52% of patients was satisfactory. Also, there was a significant difference between the components of subjective sleep quality (P<0.001), sleep latency (P<0.001), sleep duration (P<0.001), sleep efficiency rate (P<0.001), sleep disturbances (P=0.001), and daytime dysfunction (P<0.001) of patients with cancer before and after taking melatonin. There was no significant difference between the components of subjective sleep quality, sleep latency, sleep duration, sleep efficiency rate, sleep disturbances, and daytime dysfunction of cancer patients with age, sex, kind of cancer, and kind of metastasis before and after taking melatonin (P˃0.05).
Conclusion: According to the mentioned findings, it seems that the administration of melatonin to enhance sleep quality in patients with cancer is effective.

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