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Showing 29 results for Tabatabaei

Sa Fakhr Tabatabaei , M Shirani ,
Volume 54, Issue 1 (30 1996)
Abstract

Failed back surgery syndrome (FBSS) is many a times an intractable problem confronted in patients with surgical disease of lumbar spine and at the same time is a pressing problem for the physicians as well. This clinical entity is defined as continuation of pain in the lumbar region and lower extremities following surgery of the lumbar spine. Knowledge of the etiological factors and their prevention is the best line of treatment to overcome the evolution of this syndrome. During this study, which was conducted in Imam Khomeini hospital Tehran from the year 1989 till 1990, 43 out of 114 patients developed "FBSS". 23 cases responded to conservative treatment and psychotherapy whereas medical treatment failed to achieve fruitful results in the rest. The latter underwent extensive radiological investigations and repeat surgery. According to this study, we recommend that in the initial management of these patients. The surgeon should observe the dictum of "5-mis" to overcome and minimize the "FBSS" entity


P Tabatabaei ,
Volume 57, Issue 2 (8 1999)
Abstract

Results of a twelve-year (1987-1998) prospective study of Visceral Leishmaniasis in 103 patients admitted to the Ahari Children's Hospital Medical Center indicate that IFA (Indirect immunofluorescence antibody test) is highly specific and cheap. Finally we found that 86 patients (84%) were IFA positive and bone marrow aspiration of 34 (79%) of these patients were negative. 59 cases had positive bone marrow aspiration (57%) of which 52 cases had positive IFA (P<0.001). Visceral Leishmaniasis usually responds to fifteen days treatment with Glucantime (Megalumine antimonate). The pediatric dose is 20 mg/kg daily, administered intramuscularly. The treatment can be repeated.
Sheikh Rezaei A, Fakhr Tabatabaei Sa, Khoshnevisan A, Marzban H, Nikbakht M, Barbarestani M, Asadi F,
Volume 59, Issue 3 (8 2001)
Abstract

There are many studies about epidural fibrosis after surgical manipulation of the spine. We have studied formation of the post laminectomy epidural fibrosis after application of two materials (Silicone and Teflon) in this report. This expriment is on two groups of rats. Two separated laminectomies were done in each rat, one serving as control while in the other laminectomy spaces Silicone was used in group A and Teflon in group B. Laminectomy spaces were evaluated with gross dissection and histologic studies after 6 weeks. Silicone decreased intermuscular scar, deep scar, dural adhesion and collagen fiber density in epidural space. Teflon decreased dural adhesion and collagen fiber density but did not decrease intermuscular and deep scar formation in epidural space.


Tabatabaei P,
Volume 60, Issue 2 (14 2002)
Abstract

Background: Bacterial infections are seen in patients with visceral leishmaniasis. This study was conducted to determine the incidence of such infections and the more common infections agents.

Materials and Methods: During the 15-years period in a prospective study from 1986 to 2000, 123 patients with visceral leishmaniasis were studied in the Children Medical Center.

Results: From all the cases, 41 (33 percent) patients had Also bacterial infections. Respiratory tract, urinary system, Middle ear were the most common sites of infection.

Conclusion: When bacterial Infection is suspected in these patients, empiric antibiotic therapy should be started immediately after appropriate diagnostic procedures are taken.


Fakhr Tabatabaei Sa, Hossein Khan Z, Hamidi S ,
Volume 60, Issue 3 (14 2002)
Abstract

Introduction: As spinal cholinergic receptors exhibit an action against somatic pain, this effect could be potentiated by intrathecal injection of cholinesterase inhibitor-neostigmine. This study was designed to evaluate the role of interathecal neostigmine on local back pain relief after single level lumbar disc surgery.

Methods and Materials: In an interventional-expremental study (Imam Khomeini Hospital, Jun. 2000 to sep. 2001), sixty-six patient with unilateral herniated lumbr disc at one lumber space were randomely allocated into two groups including, control (C) group and Neostigmine (N) group. Both groups underwent fenestration employing same anesthetic techniques. At the end of surgery 2 ml normal saline in groups C and 100 micrograms neostigmine methylsulfate (0.2 ml combined with 1.8 ml normal saline) in group N were injected intrathecally postoperative local back pain was measured with 10 cm chart method using Visual Analogue Scale (VAS) at 1, 4, 8 and 12 hours. Total dosage of morphine, as an analgesic rescue, used during the first 24 hours following surgery and observed complications were recorded.

Results: Mean VAS score postoperatively at 1st and 4th hours were 2.24 (Standard Error Mean, SEM=0.36) and 1.82 (SEM=0.28) in group N and 5.36 (SEM=0.39) and 5.61 (SEM=0.37) in group C respectively. Mean morphine used in the first 24 hours was 0.9 (SEM=0.4) in group N and 4.7 (SEM=0.65) mg in group C. All result were found to be statistically different in the two group (P<0.05). There was no neurologic deficit or CSF leakage in both groups postoperatively. Regarding nausea and vomiting, the difference between two groups C (15 percent) and N (24.2 percent) were not significant statistically.

Conclusion: In this study, we have found that injection of 100 micrograms hyperbaric neostigmine intrathecally is a safe and effective method with minimal complications or side effect for pain relief and curtails postoperative opiate demand.


A.r Dorosty , M Tabatabaei ,
Volume 63, Issue 1 (5 2005)
Abstract

Background: Increase in obesity prevalence in recent years are associated to genetics as well environmental and behavioral factors. Change in dietary patterns including fatty and high density energy foods consumption have been reported to be very important. This study aimed to determine dietary factors (daily energy and macronutrient intakes, energy percentage of macronutrient, energy and macronutrient intakes per kilogram body weight, frequency of cola, natural fruit juice drinking, dairy products except cheese, tomato chips, puff, chocolate and fast food consumption and eating speed) associated to obesity in Ahwaz primary school pupils.

Materials and Methods: Using two stage cluster sampling from 35 Ahwaz primary schools, all 10-11y students who had a BMI 95th percentile of Hosseini et al. (1999) reference, were identified as obese (n=150) and 150 same age and gender pupils (having BMI<85 percentile) were studied. Data on daily energy and macronutrient intakes were collected using 24 hour recall. Frequency of cola, natural fruite juice, dairy products except cheese, tomato chips, puff, chocolate and fast food consumption were obtained by food frequency questionnaire. Eating speed was asked from the pupil mother.

Results: Results indicated that daily energy, protein and carbohydrate intakes were significantly higher in obese students (p<0.05), but daily fat intake and energy percentage of macronutrient had no significant difference between two groups (p>0.05). macronutrient intakes per kilogram body weight were significantly lower in obese group (p<0.001). obese students had significantly higher potato chips and puff consumption (p<0.05). There was no significant difference between other foods consumption (p>0.05). Obese students used to eat faster (p<0.05).

Conclusion: In conclusion, high intakes of energy, protein, carbohydrate, tomato chips and puff and high eating speed were associated to obesity in Ahwaz primary school pupils.


Noorbakhsh S, Tabatabaei A, Parvaresh M, Tonekaboni H,
Volume 66, Issue 10 (4 2009)
Abstract

Background: In recent years, many ill cases with cytomegalovirus reactivation in non-immuno compromised persons reported. Goal of study: to determine the CMV infection in cerebrospinal fluid of aseptic meningoencephalitis children hospitalized in Rasul & Mofid hospital (2005-2007).

Methods: In a cross sectional study 132 cases selected with simple sampling. CMV-DNA in their Cerebro spinal fluids searched by qualitative PCR.

Results: The age range of the study patients was 5 month- 13 years, median age= 2±3.7 years 87(65.9%) male and 45(34.1%) was female. The presenting signs and symptoms were convulsion 77(69.4%) meningitis 25(18.8%), loss of consciousness 47(37%) neurologic defects 15.9%. DNA extrated in 11 cases. Mycoplasma- DNA in 2cases DNA-CMV detected 2(1.5%). Positive DNA HSV found in 7(15.3%) of patients. DNA- HSV type- 15.3% (7/132) cases. An infant 5 month age with developmental delay, microcephaly and recurrent convulsions. A 1 year girl with brain atrophy and progressive hydrocephaly with intracranial shunt

Conclusions: Differentiation between herpes meningoencephalitis and other encephalopathy based on clinical signs in children is too difficult. CMV (1.5%) has lower rate than herpes simplex type-1 (5.7%). In addition to CMV and HSV1 all of herpes family viruses (varicella, herpes 6, 7, Epstein barr virus) could have role in  children with meningoencephalitis. In recent years a sensitive, rapid, simple diagnostic  test "Single tube Multiplex PCR" in cerebro spinal fluid recommend. Rapid diagnosis and faster treatment is necessary for decreasing mortality and morbidity in all of herpes meningoencephalitis cases


Kamrani Rs, Haj Zargarbashi R, Mehrpour Sr, Sharafat Vaziri A, Tabatabaeiyan M,
Volume 67, Issue 7 (7 2009)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Flexor tendon injury is one of the unanswered problems in reconstructive surgery of the hand. Although pull out method is one of the best reconstructive approaches but still is controversial. Surgeons prefer immobilization to prevent laceration at the site of the suture but it may cause adhesion and lead to surgical failure. The aim of this study was to perform a new surgical method to achieve a tendon repair without these problems.
Methods: In this case-series study, 80 fingers with flexor tendon impairment selected and divided into four groups (tendon laceration & avulsion, tendon graft reconstructed in 1 & 2 stages) then patients were surgically treated by the new technique. The most important aspect of the technique is the placement of the suture in the direction of strength therefore, following any tension the suture would be tighter and this point help us to mobilize the injured tendon immediately after the surgery then we analyzed the results depends on the patient's group.
Results: The pull out and surgical (functional) results were evaluated. 97% of the pull out results were good and 3% were poor and surgical results were 23.9% excellent, 52.2% good, 17.9% fair and 6% poor.
Conclusion: Depend on the acceptable results, immobilization in these patients is unnecessary & active and passive range of motion would be gradually increased as soon as possible. However biomechanical studies would be beneficial to evaluate this suture influence and designing future studies to compare this technique with old methods would be essential.


Noorbakhsh S, Shekarabi M, Kalbasi Z, Tabatabaei A, Tonekaboni H, Afsharkhas L, Vafaei-Shahi M,
Volume 68, Issue 5 (6 2010)
Abstract

Background: M. pneumoniae infection in children is usual and diagnosis of its neurologic complications for rapid treatment is very important. To compare the CSF- M. pneumoniae antibody level between febrile children with acute neurologic signs (Menigoencephalitis, Guillan Barre Syndrome (GBS), Transverse myelitis, Ataxia and so on) with unaffected ones.

Methods: A cross sectional/ case control study in pediatric wards of Rasoul-e-Akram & Mofid hospitals (2007-2009) was done. The amount of Specific M. pneumoniae IgG (ELISA) antibody level determined in CSF of 55 cases and in 10 controls. Chi square values (CI 95%, p< 0.05) calculated for all categorical variables. Sensitivity specificity Positive Predictive Value (PPV) Negative Predictive Value (NPV) of CSF antibody level determined by using the Area under the ROC Curve.

Results: Cases (n= 55) aged between five month to 13 years with mean age of 3.84±3.43 years. Area Under Curve (AUC) in ROC was 0.876 (%95 CI, 0.78- 0.96 p< 0.0001). Cut off level for antibody was 0.0025 with 73% sensitivity 90% specificity 100% PPV 28.8% NPV. CSF antibody level had significant difference between cases and controls [0.08± 0.26 Versus 0.001± 0.001 p: 0.02] It had poor agreement between cases and controls (Kappa= 0.27). Lowest amount seen in cases with aseptic meningitis highest amount observed in cases with GBS and cases with focal neurologic signs.

Conclusion: The presence of very low amount (0.0025) of M. pneumoniae antibody in CSF of febrile children with acute neurologic signs had 70% sensitivity and 90% specificity 100% PPV but had low (28.8%) NPV. M. pneumoniae would be a rare cause in cases with aseptic meningitis. Finding the M. pneumoniae-DNAs in CSF are not so frequent (2%) but in high suspicious cases adding this test to determining the CSF antibody level might be helpful.
Samileh Noorbakhsh , Mohammad Farhadi , Farideh Ebrahimi Taj, Zahra Hojaji , Azardokht Tabatabaei ,
Volume 68, Issue 8 (November 2010)
Abstract

Background: Streptococcus pneumoniae is a common cause of respiratory infection. Pneumococcal upper respiratory tract infection (URTI) in children is seldom bacteremic. Determination the prevalence of S.pneumoniae infections in children with URTI using rapid urinary antigen test (BINAX now) and titration of serum pneumolysin antibody (added to conventional culture) was the object of this study.
Methods: A cross sectional, case-control study done in ENT & pediatric departments of Rasoul Hospital in Tehran, Iran, (2008 -2010) upon 133 cases with upper respiratory tract infection (otitis media, sinusitis and tracheitis). The nosocomial infection omitted in first step. 60 remaining cases followed for S.pneumoniae infection by culture and rapid urinary antigen test (Binax Now). Serum pneumolysin antibody titers compared between 45 cases and 66 controls.
Results: Positive culture (S.pneumoniae, H.influenza) obtained in 4/60 URTI cases. Positive urinary S.pneumoniae antigen detected in 50% (30/60) of cases and 6% (4/66) of controls (p=0.01). The pneumolysin antibody level with cut-off level 525pg/ml was higher in URTI cases than controls (982±441 Vs. 525±42, p<0.0001). Area under the ROC curve for pneumolysin antibody was 0.923 (95%CI 0.86-0.97, p<0.0001) and had 87% sensitivity and 82% specificity for differentiation between cases and controls.
Conclusions: The high pneumolysin antibody level in cases with URTI strongly indicates the pneumococcal infection. Pneumolysin antibody level even in little amounts (525pg/ml) with 87% sensitivity and 82% specificity is a suitable test for diagnosis of pneumococcal infection in children with URTI, but this test should be added to conventional culture (gold standard) and rapid urinary antigen test.

Noorbakhsh S, Jalili B, Shamshiri Ar, Shirazi E, Tabatabaei A, Taghipour R, Modares Fathi A,
Volume 68, Issue 9 (6 2010)
Abstract

Background: Recently, many cases diagnosed as pediatric autoimmune neuropsy-chiatric disorders associated with group A beta hemolytic streptococcus infection (PANDAS) due to production of autoimmune antibodies. Object of this study was comparison the titer of antibodies against group A beta hemolytic streptococcus (ASOT, Anti-DNase B, and Anti streptokinase) between children with movement disorders (tic and tourett's disorders pediatric autoimmune psychiatric disorders) and healthy control.
Methods: A cross sectional/ cases control study in pediatric neuropsychology ward and clinics in two referral hospitals (Rasoul & Aliasghar) affiliated by IUMS had done in Tehran, Iran (2008-2010). We selected 53 children with tic disorder and 76 healthy controls (age matched children). The antibody titers (IU/ml) in their area were compared and analyzed statistically. The area under ROC, sensitivity, specificity and positive predictive value of tests calculated.
Results: Age of cases was between 4-16 years. All antibody titers had significant difference between two groups (p<0.0001 p=0.05 p=0.002 for ASOT, Anti-DNase and Antihyaloronidase respectively). ASOT (cut off level> 200IU/ml) had 75% sensitivity 84% specificity and 80% PPV Anti- streptokinase (cut off level> 332IU/ml) had 34% sensitivity 85% specificity, and 90% PPV Anti-DNase (cut off level> 140IU/ml) had 70% sensitivity 99% specificity and PPV 90%.
Conclusion: Patients with tic disorder had a significant high antibody titer against streptococcal infection in comparison with healthy children. It presents possible role for streptococcal infection in tic disorders. Treatment of streptococcal infection is achievable by using of long acting Penicillin in our country. Use of aggressive treatment like plasmaphresis etc needs future RCT studies.


Zarabi V, Noorbakhsh S, Rahim Zadeh N, Samimi K, Ghafori M, Jafarian A, Tabatabaei A,
Volume 69, Issue 2 (5 2011)
Abstract

Background: Urinary tract infection 0 in children causes renal scarring and permanent damage to the organ. In this study, we compared the diagnostic value of magnetic resonance urogram for urinary tract anomalies with other conventional imaging methods in children with UTI. Methods: In this case-control study, 190 children (mean age 3.23±3.59 yrs) with UTI were recruited from the Pediatric Ward of Rasul-e-Akram Hospital during 2007-2009. The patients were divided into two groups based on the applied imaging technique: MRU (cases) and conventional imaging groups (controls). Results: Abnormal imaging detection rates for Ultrasonography were 32%, X-ray of kidneys, ureters and bladder (KUB) 9%, Intravenous Pyelogram (IVP) 26%, Voiding Cystoure therogram (VCUG) 54%, Dimercaptosuccinic Acid scan (DMSA) indicating non-obstructive (reflux) uropathy in 76% (mean age 3.5 yrs) and MRU 43% (mean age 1.6 yrs), respectively. A meaningful correlation was observed between MRU and DMSA scan with IVP results (Kappa=0.75). KUB and Ultrasonography had similar results in cases with abnormal MRU and DMSA scan (P=0.121). MRU had strong agreement with VCUG and IVP for the detection of obstructive uropathy and scar due to congenital malformation even during intrauterine life but not with sonography results. Conclusion: Sonography had poor results for the diagnosis of urinary tract anomalies in comparison with MRU. Use of dynamic MRU for the diagnosis of congenital anomalies (hydronephrosis, obstruction, pyelonephritis, renal scar) in children with UTI seems to be of better help, although higher costs and the need for sedation during MRU still are its disadvantages
Noorbakhsh S, Ebrahimi Taj F, Shirazi E, Shamshiri Ar, Tabatabaei A,
Volume 69, Issue 10 (5 2012)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Recent evidence suggest that group A ß-hemolytic streptococcal (GABHS) infection may increase the risk of pediatric autoimmune neuropsychiatric disorders (PANDAS) composed of the clinical signs of obsessive-compulsive and attention deficit hyperactivity disorders. The objective of this study was to compare the titer of antibodies against GABHS between children with PANDS and the controls.
Methods : This cross-sectional, case-control study was done in Hazrat Rasoul Hospital, in Tehran, Iran during 2008-2010. We compared serum antibodies streptolysin O, deoxyribonuclease B, and streptokinase against GABHS quantitatively in 79 cases with PANDAS and 39 age-matched controls. The area under ROC curve, sensitivity, specificity and positive predictive value (PPV) of tests were calculated.
Results : Most cases were studied in summer (57%) and spring (23%). The three aforesaid antibodies were higher in the cases (P=0.001). Antisterptolysin O (cut-off point 195) had a 90% sensitivity, 82% specificity and a 92% PPV, (CI=95%, 0.99-0.91). Anti streptokinase (cut-off point 223) had an 82% sensitivity, 82% specificity and a 95% PPV, (CI=95%, 0.934-0.735). Anti-DNase (cut-off point 140) had an 82% sensitivity, 82% specificity and a 95% PPV, (CI=95%, 0.99-0.91).
Conclusion: The study demonstrated a possible role for streptococcal infection in PANDAS. We found a significantly higher antibody titer against GABHS in OCD and ADHD cases in comparison with healthy children. Treatment of streptococcal infection is achievable by the use of long-acting penicillin. Use of aggressive treatment schedules like plasmaphresis, IVIG, etc needs further RCT studies.


Sedghipour M, Tabatabaei Sah, Sadadi F, Kamal Hedayat D, Nikdoost F, Sate H, Ghorbani Yekta B,
Volume 69, Issue 11 (4 2012)
Abstract

Background: Persistence of left ventricular hypertrophy (LVH) in renal transplant recipients is associated with unfavorable outcomes. Calcineurin-inhibitor (CNI) nephrotoxicity is a major cause of morbidity and mortality after kidney transplantation. In this study we compared sirolimus (SRL) with calcineurin-inhibitor as primary immunosuppressants for the attenuation of left ventricular hypertrophy in renal transplantation recipients.

Methods: In this prospective cohort study done in Shariati Hospital in 2010, we evaluated the effects of sirolimus and CNI on LVH of 55 renal transplant recipients. The cases (19) received sirolimus while the controls (36) received CNI while being matched for age and duration of transplantation. Data regarding blood pressure (BP), hemoglobin, serum creatinine, uric acid and lipid concentrations were assessed and changes in left ventricular (LV) mass were evaluated by echocardiography over a one-year follow-up.

Results: Left ventricular mass significantly decreased (P=0.0001) in the SRL group but blood pressure did not differ between the two groups. LV mass and LV mass index both decreased significantly (P≤0.05) but the difference was not associated with changes in BP. The difference in interventricular septal thickness at end diastole (IVSD) and posterior wall diameter (PWD) were significant (P≤0.05) in the SRL group but the difference in end diastolic diameter (EDD) was not significant.

Conclusion: Conversion from CNI to SRL-based immunosuppressive therapy in RTRs is safe and SRL may decrease LVH. SRL seems to be safe and improve renal function without cardiac compromise in kidney transplant recipients.


Noorbakhsh S, Talebi-Taher M, Tabatabaei A,
Volume 70, Issue 1 (3 2012)
Abstract

Background: Determining the etiologic causes of septic arthritis is of the most importance. Goal of this study was to investigate presence of staphylococcal enterotoxins A, B, C and Toxic Shock Staphylococcal toxin-1 in the synovial fluid of patients with arthritis.

Methods: This cross-sectional study was performed in the Pediatric and Orthopedic Wards of Hazrat Rasoul Hospital in Tehran, Iran during 2008- 2010. Gram stains, conventional cultures, direct detection of soluble bacterial antigens were used to detect H. influenza, S. pneumonia, group B streptococci, and N. meningitidis while Latex particle agglutination test was used for staphylococcal supper antigens (by enzyme immunoassays) upon synovial fluid tapping of 62 individuals (5 mo to 16 yrs, mean=113.8 yrs). P<0.05 was considered statistically significant.

Results: Positive SF cultures (n=11): 5 positive cases of S. aureus 5 S. pneumonia 1 H. influenza, and 1 Klebsiella. Positive gram stains: 10% and positive LPA: 4%. Staphylococcal arthritis was diagnosed in 7 (39%) cases upon positive culture or positive gram stain. The most common type was TSST-1 (47%) and the least common was enterotoxin B (18%). Isolation of S. aureus (positive culture) was correlated to presence of enterotoxin A in synovial fluid but not to enterotoxins B, C or TSST-1.

Conclusion: Staph. aureus had a prominent role in arthritis. 47% of cases with negative culture for S. aureus had at least one type of staphylococcal super antigens in the synovial fluid. Searching for antigens of usual organisms or staphylococcal supper antigens could be helpful for diagnosis and


Razaghy-Azar M, Tabatabaei F,
Volume 70, Issue 7 (6 2012)
Abstract

Background: Gitelman syndrome is a rare autosomal recessive disorder that typically presents with recurrent muscle cramps, carpopedal spasms, hypokalemic metabolic alkalosis, hypocalciuria and hypomagnesemia and high urine magnesium during adolescence. Mutation in the gene encoding for sodium chloride co-transporter in distal convoluted tubule causes electrolyte imbalance.
Case presentation: We present a 10-year-old boy complaining of carpopedal spasms, tingling of fingers and facial parestesia for three years prior to his admission in endocrinology clinic of H. Ali-Asghar Pediatric Hospital. The patient had metabolic alkalosis, hypokalemia, hypocalciuria, increased urine fraction excretion of Mg, serum magnesium of 1.8 mg/dl, normal serum calcium and phosphorus and normal blood pressure. His clinical manifestations recovered after potassium and magnesium administration.
Conclusion: A patient with Gitelman syndrome with normal serum Mg. is presented.


Khosravi N, Noorbakhsh S, Tabatabaei A, Ghavami Y,
Volume 70, Issue 11 (3 2013)
Abstract

Background: Infection with group B streptococcus (GBS) can present with respiratory distress, Pneumonia, meningitis and Osteomyelitis in neonates. The aim of this study was to determine the prevalence of GBS colonization in trachea of intubated neonates.
Methods: This observational analytic study was performed upon 33 intubated neonates due to respiratory distress in neonatal intensive care unit (NICU) Rasoul Hospital in Tehran, Iran during 2010-2012. Tracheal secretions cultured upon TODD-HEWITT BROTH and sheep blood agar 5%., chi-square test was used for compare the qualitative variables. P<0.05 was considered meaningful.
Results: Three cases had positive streptococcal culture (9.1%) and four cases had posi-tive culture for non-streptococcal organisms. no meaningful relation observed between positive GBS culture and neonatal gender, kind of delivery, PROM.
Conclusion: Prevalence of GBS positive results (9%) in present study is very close to GBS colonization in pregnant women although the higher colonization rate of pregnant women are expected.


Noorbakhsh S, Farhadi M, Tabatabaei A,
Volume 70, Issue 12 (5 2013)
Abstract

Background: Staphylococcal superantigens (SAg&aposs) may have some role in otitis media with effusion (OME). The aim of this study was the search of staphylococcal SAg&aposs in middle ear effusion of children with OME. 
Methods: This cross sectional-analytic study was done in ENT & pediatric wards upon 64 children with otitis media with effusion (OME) between 1-15 years, (mean age=7.42+4 years) of Rasoul Akram University Hospital, Tehran, Iran in 2009-2011. Fifty six percent (36) of cases were male, 43.8% (28) were female. Staphylococcal SAg&aposs Toxic Shock Syndrome Toxin-1 (TSST-1), Staphylococcal enterotoxin A, B, C, D (Enzyme immune assay, AB Cam, USA) were detected in middle ear effusion samples after conventional culture.
Results: None type of SAg&aposs found in 39% of OME cases, enterotoxin B found in: 22% enterotoxin A: 17%, enterotoxin C: 15.6%, enterotoxin D: 12.5%, Toxic Shock Syndrome Toxin-1 (TSST-1): 7.8% Mean age of cases with positive TSST-1, enterotoxin A, B, C, and D was: 1, 5, 8.6, 9.6 and 9.6 years respectively. Positive TSST had no agreement with positive enterotoxin A and C but had weak agreement with type B and D. Mean age of cases with positive TSST was one years which had significant difference with (7.9 years) in cases with negative TSST test (P<0.0001).
Conclusion: At least one or more type of staphylococcal toxins had found in middle ear effusion of 70% of OME cases with negative culture for Staphylococcus aureus. Even in culture negative cases, staphylococcal toxins might have some immunologic role in middle ear effusion forming. Finding the SAg&aposs (at least one type) are important for treatment of immunosuppressive or corticosteroid in cases with resistant OME.


Farhadi M, Tabatabaei A, Shekarabi M, Noorbakhsh S, Shokrollahi Mr, Javadi Nia Sh, Faramarzi M,
Volume 71, Issue 1 (4 2013)
Abstract

Background: Tonsils and adenoid hypertrophy is a major respiratory symptom in children which is partly due to recruitment of inflammatory cells in upper airway lymph nodes as a result of the effects of synthesis and release of different inflammatory cytokines. It seems that infections play role in concert with these cytokines leading to tonsilar hypertrophy and other pathologic consequences. It is proposed that cellular infiltrate of tonsils and adenoids may secrete different quantities of these cytokines compared with peripheral blood mononuclear cells (PBMC) cultures.
Methods: Among patients who were admitted for adenotonsillectomy to the ENT ward, 37 patients, under 1-12 years old patients with fulfill criteria selected to include the study. Excised adenoid and tonsils cultured and inflammatory cytokines Interferon-γ (INF-γ), Interlukine-1 (IL-1), IL-6, IL-8 and tumor necrosis factor-α (TNF-α) measured in cellular culture supernatant. The same cytokines measured in PBMC cultures.
Results: The data shows that there is a significant difference between IFN-γ and IL-8 amounts in adenoid tissue culture supernatant and PBMC culture of our patients. Furth-ermore, the amounts of IFN-γ, IL-1 and IL-8 showed considerable difference between tonsilar tissue culture supernatant and PBMC culture of these patients. Although there is a significant correlation between IL-6 amounts in tissue culture supernatant and PBMC culture (P=0.02), the respective data for TNF is only almost significant.
Conclusion: Inflammatory cytokines may have significant role in the early provoke of inflammation occurred in hypertrophied tonsils and adenoid. The majority of these cyt-okines increase the expression of adhesion molecules on epithelial cells and influence the recruitment of leucocytes and inflamed tonsils. On the other hand lack of sufficient cytokine release may lead to persistent infections and may cause chronic inflammation and hypertrophied tissue.


Shima Javadi Nia, Samileh Noorbakhsh , Anahita Izadi , Fahimeh Soheyli Pour , Azardokht Tabatabaei , Mohammad Reza Shokrollahi ,
Volume 71, Issue 4 (July 2013)
Abstract

Background: Urinary tract infection (UTI) is one of the most common infections in infants and children, especially in their first decade of life. These patients are more susceptible to renal scars and other possible complications like growth retardation, arterial hypertension, proteinuria, isostenuria, and finally chronic renal failure. Trace elements like vitamins and minerals are essential for efficient metabolism and proper function of various body systems namely immune system. In this trial we compared the relation between serum levels of zinc, vitamins A and D in children inflicted with UTI and control group.
Methods: This was a cross-sectional study on 25 patients with UTI admitted to pediatric wards of Rasul Akram Hospital and Bahrami Hospital. They were compared to 40 other patients admitted in surgical wards for elective surgery. Serum levels of zinc, vitamins A and D were measured in both groups.
Results: Seventy two percent of the patients were male and 28% female. The average age was 2.17. Despite the lower levels of vitamins A and D in cases than controls, the difference was not significant (P=0.4 and P=0.9, respectively). However, serum levels of zinc were significantly lower in cases than controls (P<0.05).
Conclusion: Vitamins A and D may play some role in patients’ vulnerability to UTI, but this supposition needs more research on larger samples, considering differences among patients of various age groups and their nutritional status.
According to the study, lower levels of zinc were associated with susceptibility to UTI thence, its administration might be helpful.


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