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Showing 29 results for Vahedi

M Moeen , M Movahedi , A Farhoodi ,
Volume 55, Issue 3 (30 1997)
Abstract

HIE is a primary immunodeficiency characterized by recurrent staphylococcal abscesses and markedly elevated serum IgE concentrations. These abcesses involve the skin, lungs, joints, and other sites, and there is a unique tendency to form pneumatoceles following staphylococcal pneumonias. Although, there is as yet no clearly defined immunologic cause for this rare syndrome, but some form of T-Cell defect may be cause, leading to matkedly elevation of IgE and eosinophillia. In this study clinical and immunopathological aspects of HIE syndrome in 11 patients have been evaluated
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.
Tajbakhsh E, Yaghobi R, Vahedi Ar,
Volume 65, Issue 8 (3 2007)
Abstract

Background: Hepatitis type C virus (HCV) is one of the important threatened infectious blood born viruses in different populations. More than 300 million people were suffered form different HCV clinical complications all around the world. It is estimated that only 20% of HCV infected individuals will recover from this viral infection, while the rest become chronically infected. The majority of chronically infected individuals never exhibit symptoms, but approximately 10-/30% of these patients will eventually develop severe liver complications. In this research the prevalence of HCV Ab and the role of some demographic data in HCV incidence and clinical outcomes were determined.

Methods: In this retrospective study 11472 blood samples from, Iranian blood donors, Shahrekord city were collected for one year. The frequency of HCV Ab was analyzed with a third generation EIA method. The statistical relationships of different possible risk factors of HCV infection were analyzed by Instat software.

Results: The HCV Ab was diagnosed in 69 of 11472 (0.6%) serum samples. Significant correlations were detected between the history of HCV infection with marriage, tattooing, and doubtful sexual contact. Significant relationships were not defined between HCV infection with age, history of liver disease, and record of travel to abroad.

Conclusions: Significant relationships were find between HCV infection with marital status, history of tattooing and sexual contact, but significant correlations were not find between HCV infections with sex, history of liver disease and traveling to other countries.


Fazlollahi Mr, Pourpak Z, Yeganeh M, Kardor Gh, Kazemnejad A, Movahedi M, Gharagozlou M, Farid Hosseini R, Farhoudi A,
Volume 65, Issue 8 (3 2007)
Abstract

Background: Plant-origin foods are among the most important sources of food allergic reactions. An increase in the incidence of sesame seed allergy among children and adults has been reported in recent years. The aim of this preliminary study was to investigate the prevalence, importance and clinical manifestations of sesame allergy among Iranian patients.

Methods: In a cross-sectional survey, 250 patients with suspected IgE-mediated food allergies completed a questionnaire and underwent skin prick tests with sesame extract as well as cross-reacting foods (walnut, soya and peanut). Total IgE and sesame-specific IgE levels were measured. Patients with positive skin test reactions and/or IgE specific for sesame without clinical symptoms were considered sensitive to sesame. The patients who also had clinical symptoms with sesame consumption were diagnosed as allergic to sesame.

Results: Of the 250 patients enrolled in this study, 129 were male and 121 female, with a mean age of 11.7 years. The most common food allergens were cow's milk, egg, curry, tomato and sesame. Sesame sensitivity was found in 35 patients (14.1%). Only five patients (2%) had sesame allergy. Sesame-sensitive patients had a significantly higher frequency of positive prick test to cross-reacting foods when compared to non-sensitized patients (p=0.00). The type of symptom was independent of gender and age of the patients, but urticaria and dermatitis-eczema were significantly more frequent in sensitized patients (p=0.008).

Conclusions: This is the first study addressing the prevalence of sesame seed allergy in Iranian population. We found sesame to be a common and important cause of food allergy. The panel of foods recommended for use in diagnostic allergy tests should be adjusted.


Sharifi L, Pourpak Z, Bokaie S, Karimi A, Movahedi M, Gharaghozlou M, Moin M,
Volume 67, Issue 9 (6 2009)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Asthma prevalence has increased in developed and developing countries in several last decades. Although cigarette smoking is an identified risk factor for many diseases such as coronary Heart disease and chronic obstructive lung disease, its effect on asthma is controversial. The aim of this study was to determine the odds ratio and its confidence interval for asthma morbidity among children referred to the Immunology and Allergy department of children medical center according to their parents' smoking and daily cigarette consumption.
Methods: A case-control study was conducted during two years period on the asthmatic patients who referred to Immunology and Allergy department of children medical center. Demographic information and parents' smoking and daily cigarette consumption assessed by a questionnaire. Healthy children with same age and sex were entered to the study as the control group. Statistical analysis was performed to calculate odds ratio.
Results: Among 215 patients who entered the study 63 patients were exposed the cigarette smoke. Odds ratio for asthma morbidity among children whose parents smoke more than five cigarettes per day in comparison with whose smoke less than five or do not smoke was 2.38 (p<0.01).
Conclusion: Parent's cigarette smoking is a risk factor for childhood asthma and could increase the risk of asthma to 2.38 folds in children whose parents smoke more than five cigarettes. Increasing in parents' knowledge level that probably relate to their education results in cigarette consumption decline.


Mehrnaz Mesdaghi, Mohammad Vodjgani, Eisa Salehi, Jamshid Hadjati, Abdolfattah Sarrafnejad, Masoud Movahedi, Farideh Berjisian, Tahereh Shahrestani,
Volume 68, Issue 1 (4 2010)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Allergic rhinitis is a common disorder with great morbidity. Its prevalence has increased during recent years, therefore attracting attentions to its mechanisms. Type 2 cytokines play a major role in allergies. It has been proposed that Natural killer (NK) cells may be able to produce type 2 cytokines. This study was done to evaluate NK cells number and subtypes in patients with allergic rhinitis, comparing healthy subjects.
Methods: In a case control study, patients with allergic rhinitis were compared to healthy non-atopic subjects. Allergic rhinitis was diagnosed according to ARIA guidelines. NK cells quantity was studied by staining of peripheral blood mono nuclear cells with anti-CD16-FITC and anti-CD56-PE and evaluated by two color flowcytometry. Intracellular cytokines were evaluated by tri-color flowcytometry. NK cells were separated by magnetic beads, and cultured for 72 hours. Secretion of IL-4, IL-5, IL-10, IL-13, and IFN-γ was measured by ELISA, in stimulated and unstimulated conditions.
Results: Patients had more CD16+ CD56+ NK cells than control group. IL-4+ NK cells were significantly higher in patients (p<0.001), but the number of IFN-γ+ NK cells was not different. Cytokine secretion of NK cells was similar in case and control groups. Although IL-13 level after stimulation seemed higher in patients, the difference was not significant.
Conclusion: NK cells number is increased in patients with allergic rhinitis and a considerable number of them produce IL-4.


Lotfinia I, Ghavami M, Haddadi K, Vahedi P,
Volume 68, Issue 2 (5 2010)
Abstract

Background: Pedicular screws are currently the gold standard of internal fixation of spinal column. Pedicular screws have their own complications, however the surgeon should be aware of morphometery of pedicles, as well as the anatomy of surrounding neural structures to minimize these risks. No national study has ever examined the physical characteristics of lumbar pedicles and this study is unique for this purpose.Methods: This study covers the patients undergoing lumbar spinal CT-scanning due to variable causes. 25 vertebrae were selected in either gender, 18 years or older and EFilm computer software was employed to measure different diameters of pedicle and the results were analyzed with p≤0.05 regarded as significant.Results: L5 pedicle was the widest (16.8 mm), while L1 was the narrowest (8.25 mm).this figure was 8.82, 10.48 and 12.86 mm for L2, L3, L4 respectively. Longitudinal depth of pedicle was 47.98, 48.68, 50.42, 48.32 and 47.8 mm for L1, L2, L3, L4, L5 respectively.Statistically significant differences were found between some dimensions detected in our study and similar studies. Conclusions: The advantages of pedicular screws and rods to stabilize spinal column are well known. To avoid neurological complications, an understanding of anatomy and pedicle orientation is mandatory. The shape and diameters of pedicles are different base on races. Some differences were found in our study regarding pedicle dimensions.
Lotfinia I, Vahedi P, Gavame M, Vahedi A,
Volume 68, Issue 10 (5 2011)
Abstract

Background: Osteochondroma is a common tumor of the skeletal bone and is a common benign tumor of the bone constitutes 10-15% of all and 20-50% of the benign bone tumors. The lesion is an exophytic bony protrusion covered by a cartilaginous cap. It is most commonly found in long bones, and especially at the epiphysis. Nearly 40% of cases are seen around the knee joint. Osteochondroma rarely affect skull bones, occurrence of an intracranial osteochondroma is a rarity in the neurosurgical literature and only anecdotal reports are available in the literature. To our knowledge no case arising from foramen magnum has been reported.
Case presentation: We present a 73 years old male with gait problem and limb paresis. Imaging investigation showed a bony mass in the foramen magnum, that compresses neural elements. The patient also complained of persistent headache in his occipitocervical region. There was no history of previous trauma. The patient underwent surgery and histopathological examination confirmed the lesion to be osteochondroma.
Conclusion: Many types of lesion may be seen in foramen magnum area, and in differential diagnosis of such lesion rare, osseous tumors such as osteochondroma should be considered.


Ghadir Mr, Habibinejad H, Heidari A, Vahedi H,
Volume 69, Issue 6 (6 2011)
Abstract

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


Firooz Esmaeilzadeh, Nahid Hatam , Zhila Esmaeilzadeh , Abdolhalim Rajabi , Meysam Anami , Sajad Vahedi , Hossien Mirzaei,
Volume 72, Issue 9 (December 2014)
Abstract

Background: The rabies is a deadly disease and if its symptoms break out in a person, he will certainly die. However, the deaths caused rabies can be prevented by post-exposure prophylaxis (PEP). Methods: In this study, subjects were recruited through census and with respect to in-formation which gathered from Fars Province health centers, Pasteur institution and previous studies In Iran. The mortalities for age groups and by sex type have been cal-culated. The decision tree model using probabilities, which the effectiveness of PEP treatment after getting bitten by an animal suspected, persons to receive specified. Dis-ability adjusted life year score (DALY) was applied to estimate the DALYs saved from PEP. In this study it was assumed that if a person suffering with rabies, a few days af-ter the onset of symptoms, death is compulsory. Therefore YLD rabies was considered zero. Finally, to increasing the accuracy and because inherent uncertainty of the data, and the increase the power of analysis, one-way sensitivity analysis was used. Results: From March 2011 to March 2012, in Fars Province, total cases of animal bites were reported and received PEP treatment. The cases were 5394 (75.85%) male and 1717 (24.15%) female. PEP generally prevented from 177.076 deaths which 134.096 (75.72%) were men and 42.98 (24.27%) of them were women. The age distribution of suspected animal bites in youth more than adults, and in men higher than women. Also due to prevented mortality caused by PEP, it is prevented from 4455.71 DALYs. Based on the sensitivity analysis DALY prevented, except for dogs and cats, there was no change in the other animals. Conclusion: The implementation of PEP for animal bitten people remarkably reduced the burden of disease in community. Calculations with primitive cost estimations im-plicitly revealed that this intervention is a most cost-effectiveness program.
Ali Fakhr-Movahedi , Abbasali Ebrahimian , Majid Mirmohammadkhani , Saeedeh Ghasemi ,
Volume 74, Issue 2 (May 2016)
Abstract

Background: Coronary artery disease is considered as main factor for patients’ hospitalization. Chest pain is the most common symptoms of patients and its assessment is an important factor in coronary artery disease. So, this study aimed to determine the relationship between the severity of chest pain with physiological indexes in patients with coronary artery disease.

Methods: This study was a descriptive-analytical design that performed on 80 patients with that were hospitalized in coronary care unit of Shahid Mofatteh Hospital in Varamin city, Iran, from March to September, 2014. In this study, the relationship between the chest pain severity and blood pressure, pulse rate, respiratory rate, O2 saturation and ST segment alterations were assessed. Finally, the gathered data were analyzed by descriptive and inferential statistics.

Results: The mean of chest pain severity was 6.51±2.14 in patients. Patients’ age was between 26 to 85 years old and the mean of age was 60.79±13.79 and there was no significant correlation between age and chest pain severity (P=0.985). Also male and female patients were equal. There was no significant difference between chest pain severity of men and women (P=0.471). The findings of study showed no correlation between chest pain severity and heart rate (r=-0.174 and P=0.122), respiratory rate (r=-0.013 and P=0.909), O2 saturation (r=0.051 and P=0.651), ST segment alterations (r=0.07 and P=0.539). Also, there was no significant difference between chest pain severity and systolic pressure (P=0.353), diastolic blood pressure (P=0.312) and body mass index (P=0.256) among patients.

Conclusion: In this study, there were not enough evidences for relation between chest pain and physiological indexes in patients with coronary artery disease. So performing more studies in another settings and conditions recommended.


Hoda Keshmiri-Neghab , Bahram Goliaei , Ali Akbar Saboury, Ali Akbar Moosavi-Movahedi,
Volume 74, Issue 5 (August 2016)
Abstract

Background: Cancer is the most common cause of death in the world, and it incidence has been increasing for many years in economically developed countries. Early detection of cancers greatly increases the chances for successful treatment. So finding cancers before they start to cause symptoms is a most effective treatment. Recent studies have proposed that blood plasma contains a rich source of disease biomarkers for detecting, diagnosing and monitoring diseases. While some researchers have dismissed the low molecular weight serum peptidome as biological trash, recent work using differential scanning calorimetry has indicated that the peptidome may reflect biological event and contain diagnostic biomarkers.

Methods: Differential scanning calorimetry (DSC), a highly sensitive tool for analysis of blood plasma and other biofluids has recently been reported. Louisville Bioscience, Inc. (LBIdx™), The Plasma Thermogram™ (pT™) company has made a significant breakthrough in the analysis of blood plasma using differential scanning calorimetry for clinical monitoring and diagnostic applications.

Results: DSC analysis of plasma from diseased individuals revealed significant changes in the thermogram which are suggested to result not from changes in the concentration of the major plasma proteins but from interactions of small molecules or peptides with these proteins. The difference in plasma thermograms between healthy and disease individuals caused this method was recognized as a novel technique for disease diagnosis and monitoring.

Conclusion: Measurement of plasma proteins is a powerful clinical is standard medical practice which hope revolutionizes strategies for early cancer detection.


Elham Shakiba , Monireh Movahedi , Ahmad Majd , Mehdi Hedayati ,
Volume 75, Issue 12 (March 2018)
Abstract

Thyroid cancer is one of the most common endocrine malignancies and in the last two decades the number of involved people in the world has been increased. Thyroid cancer in Iran is the seventh most common cancer in women and 14th in men. In recent years many achievements regarding to molecular pathogenic factors such as the substantial role of signaling pathways and molecular abnormalities have been made. Nowadays there is no efficient treatment for progressed thyroid cancer that does not respond to radioiodine therapy which are included poorly differentiated, anaplastic and metastatic or recurrent differentiated thyroid cancer. Although the results of some clinical trials in phase II for treatment of progressed thyroid cancer are rewarding but none of the treated patients responded to treatment and only a few of them responded partially to the treatment which indicates that the treatment can only control the condition of patients with advanced disease, therefore it is needed to consider other alternative solutions which would be helpful in controlling the disease. Epigenetic is referred to study of heritable changes in gene expression without changes in primary DNA sequence. The main mechanisms of genetic and epigenetic alterations are including mutations, increasing the gene copy number and aberrant gene methylation. Epigenetic defects are prevalent in different types of cancers. Aberrant methylation of genes that control cell proliferation and invasion (p16INK4A, RASSF1A, PTEN, Rap1GAP, TIMP3, DAPK, RARβ2, E-cadherin, and CITED1), as well as specific genes involved in differentiation of thyroid cancer (Na+/I- symport, TSH receptor, pendrin, SL5A8, and TTF-1) in association with genetic alterations, leads to tumor progression. Growing evidence shows that acquired epigenetic abnormalities participate with genetic alterations to cause altered patterns of gene expression or function. Many of these molecular changes can be used as molecular markers for prognosis, diagnosis and new therapeutic targets for thyroid cancer. This article is about the most common genetic and epigenetic alterations in thyroid cancer which can be complementary together in recognition of new treatments for the disease.

Azadeh Vahedi , Akram Baghani , Zohre Baseri , Mohammad Reza Pourmand ,
Volume 75, Issue 12 (March 2018)
Abstract

Background: Bloodstream infections are the most important causes of morbidity and mortality in hospitalized patients. Blood culture plays an important role in identifying most of bacterial agents of bloodstream infections. Knowledge about bacterial agents of bloodstream infections and also antibiotic resistance of these bacteria are important. Antibiotic resistance among bacterial agents of bloodstream infection including Acinetobacter, Klebisella, Pseudomonas, Escherichia coli, Enterobacter, Enterococcus, Staphylococcus aureus and Staphylococcus coagulase negative (CoNS) is one of the major challenges faced by physicians in treating. Therefore, this study was aimed to determine the frequency and antibiotic resistant patterns of bacterial isolates from hospitalized patient's blood cultured samples in the hospital, Tehran, Iran.
Methods: This research is a descriptive and retrospective study based on recorded data in Shariati hospital laboratory and under the supervision of Tehran University of Medical Sciences. The bacterial isolates were collected from positive blood cultures from October 2013 to March 2014. The frequency of bacterial isolates were determined by phenotypic and biochemical tests. The antibiotic resistance patterns of isolated bacteria were found by disk diffusion agar method. The diameters of inhibition zone were recorded and interpreted according to Clinical and Laboratory Standards Institute (CLSI) 2013.
Results: The frequency of bacterial isolates was determined among 595 positive blood cultures as followed: 41% Pseudomonas, 20% Staphylococcus epidermidis, 10% Escherichia coli, 6% Acinetobacter lwoffii, 6% Staphylococcus aureus, 5% Stenotrophomonas, 3% Acinetobacter baumannii. The antibiogram test showed that 96.2% of Acinetobacter lwoffii, 92.8% of Acinetobacter baumannii, 66% of Pseudomonas aeruginosa, 85.7% of Staphylococcus epidermidis, 65% of Staphylococcus aureus, 75% of Klebsiella, 73.7% of Escherichia coli, and 50% of Stenotrophomonas were resistant to imipenem, piperacillin, piperacillin, erythromycin, erythromycin, ciprofloxacin, trimethoprim-sulfamethoxazole, and ceftazidime respectively.
Conclusion: The most prevalent bacterial isolate among the blood cultures of patients was Pseudomonas. The patients more than 50 years were more susceptible to blood stream infections. The most bacteria were isolated from the internal medicine department of hospital. The antibiotic resistance was also increasing especially in Acinetobacter, Staphylococcus coagulase negative, Escherichia coil and Klebsiella

Abbasali Ebrahimian , Ali Fakhr-Movahedi , Raheb Ghorbani , Hossein Ghasemian-Nik,
Volume 76, Issue 7 (October 2018)
Abstract

Background: Hospital bed capacity is one of problems in intensive care unit during at the time of crisis, emergencies and disasters. At this regard, it seems reverse triage can resolve this issue by using predictive score systems. This study was purposed to develop a reverse triage system in intensive care unit using APACHE II scoring system for crisis, emergencies and disasters situations.
Methods: This study was performed by a prospective longitudinal design that lasted from March 2016 to February 2017. Research population were 420 internal patients that were admitted in intensive care units of Imam Reza Hospital in Mashhad, Iran. Data were collected and documented for each patient by demographic questionnaire and APACHE II scoring system daily until discharging time from intensive care units. The patient’s status after discharge from the intensive care unit was used as a criterion for statistical tests.
Results: APACHE II mean score in first day of admission was 18.9±16.20. Risk ratio of patients’ discharging from intensive care unit was 1.034. The patients were placed in four levels of inverse triage according to mortality rate and risk ratio. The scores of four levels were including: 0-10 (first level and green color), 11-16 (second level and yellow color), 27-71 (third level and black color) and 17-26 (fourth level and red color).
Conclusion: The Apache II system can be used as a tool for reverse triage in intensive care units during at the time of crisis, emergencies and disasters. When using this system for reverse triage, patients at the first to third levels can be discharged from intensive care unit. However, patients on the fourth level should not be discharged from intensive care units under any circumstances.

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.

Amir Hosein Movahedian , Mohammad Jahangiri , Mona Nabovati, Mohammad Reza Sharif , Raheleh Moradi , Ziba Mosayebi ,
Volume 77, Issue 9 (December 2019)
Abstract

Background: Congenital heart diseases are the second group of congenital anomalies in infants. These disorders are a major cause of death in the first year of a child's life. Early detection helps to treat these diseases better. In this study cardiology consultations of hospitalized infants in the neonatal intensive care unit were evaluated.
Methods: In this cross-sectional study, two hundred and fifty pediatric cardiology consultations conducted in Shahid Beheshti Hospital in the year 2012 were reviewed. Information such as the cause of consulting, delivery type, age of parents, relative couples, family history of congenital heart disease, maternal medications, maternal background diseases, the final diagnosis, and prognosis follow-up of the patients were recorded in a designed questionnaire. Finally, the data were entered into the SPSS software, version 16 (IBM SPSS, Armonk, NY, USA) and analyzed using descriptive statistics and chi-square test. P-value of less than 0.05 was considered significant.
Results: The mean age of the consulted neonates was 4.845±5.14 days with a gestational age of 33.933±3.65 weeks. Male sex and cesarean section were the most frequent. Fifty-six percent of consulted infants were male. The present study revealed that prematurity (76%), murmurs (30.8%), respiratory distress syndrome (14.4%) and cyanosis (13.2%) were the most common causes of the cardiac consultation seeking among infants. Seventy-six percent of infants were consulted due to prematurity. Eighty-four percent of infants had a normal conditions. Septal defects (ventricular or atrial septal defect) and patent ductus arteriosus were the most common disease diagnosed with the prevalence of 27.5 and 17.5%, respectively. There was a significant relationship between preterm labor and congenital heart disease (P<0.001). Additionally, prematurity associated with respiratory distress syndrome and using assisted reproductive techniques.
Conclusion: The higher prevalence of congenital heart disease in the present study, compared with other studies, reflects the fact that cardiology consultation based on clinical suspicion leads to the more identification of congenital heart disease that means the right referral of newborns for consultation was accompanied with a higher incidence of heart failure.

Narges Zaeemzadeh , Shahideh Jahanian Sadatmahalleh , Saeideh Ziaei , Azadeh Mottaghi , Maryam Movahedinejad , Neda Mohamadzadeh , Anoshirvan Kazemnejad ,
Volume 77, Issue 9 (December 2019)
Abstract

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive age women. The prevalence of PCOS among Iranian women is 14.6% based on the Rotterdam definition. PCOS can increase the risk of chronic metabolic complications. Metabolic syndrome (MetS) is one of the most important of them. Insulin resistance is fundamental in PCOS and MetS pathophysiology. MetS is a collection of chronic metabolic derangements, which promotes the risk of serious diseases such as cardiovascular disturbances and diabetes. The quality of diet is inversely correlated with obesity, which is one of the consequences of PCOS and it is a risk factor for metabolic syndrome. As the first study, the present study aimed to compare the dietary intake of macronutrients in PCOS women with and without MetS.
Methods: In this nested case-control study, the convenience sampling method was used to select participants. The case group included 14 PCOS patients with MetS and the control group included 28 PCOS patients without MetS. The investigated macronutrients included fats (total fat, saturated fatty acids, mono and polyunsaturated fats, trans fatty acids), carbohydrate, protein, and fibers (total and soluble). The dietary intake assessment was carried out by a 168-item semi-quantitative food frequency questionnaire (FFQ). This study was performed on Arash Women's Hospital under support of Tarbiat Modares University, Tehran, Iran, from August 2014 to September 2015.
Results: Dietary intake of total fat was significantly higher in PCOS women with MetS than the control group (P<0.001, 146.62±45.17 vs. 59.91±32.79 g/d). Dietary intake of saturated fatty acids (P=0.004, 11.44±11.08 vs. 19.73±6.76 g/d), monounsaturated fats (P<0.001, 14.15±12.66 vs. 26.16±7.76 g/d), polyunsaturated fats (P=0.002, 9.02±9.18 vs. 17.22±6.45 g/d), carbohydrate (P<0.001, 182.34±121.08 vs. 365.64±77.11 g/d), protein (P=0.001, 42.74±42.85 vs. 78.06±24.04 g/d), total fiber (P<0.001, 17.77±15.09 vs. 35.97±22.64 g/d) was significantly lower in PCOS women with MetS than the control group. All results are expressed in terms of grams consumed per day.
Conclusion: Our results demonstrated that dietary intake of macronutrients was significantly different in polycystic ovary syndrome patients with and without metabolic syndrome.

Ahmad Kachoie, Mostafa Vahedian, Farrokh Savaddar, Mohsen Eshraghi, Enayatollah Noori, Sajad Rezvan, Zahra Moeini,
Volume 78, Issue 6 (September 2020)
Abstract

Background: Identifying risk factors for conversion to open surgery laparoscopic cholecystectomy and factors are difficult to predict cholecystectomy surgery is required. The aim of this study was to evaluate the findings of preoperative ultrasound in predicting the length of laparoscopic cholecystectomy surgery.
Methods: The present study was performed cross-sectional on 122 patients who underwent laparoscopic cholecystectomy in Shahid Beheshti, Forghani and Nekoei’s Hospital in Qom from September 2016 to September 2017.
Inclusion criteria: All cases of acute cholecystitis, chronic cholecystitis, symptomatic gallstones and biliary pancreatitis underwent laparoscopic cholecystectomy. The exclusion criteria included patients undergoing laparoscopic cholecystectomy at the same time were other procedures. Before surgery patients' information such as age, sex, ultrasound findings including gallbladder wall thickness, compressed stone and the presence of fluid around the gallbladder were recorded in the checklist. Finally, the duration of cholecystectomy was divided into two degrees of easy operation (less than 60 minutes and without complications) and difficult operation (above 60 minutes with complications) according to the mentioned variables. Data were analyzed by SPSS software, version 22 (IBM SPSS, Armonk, NY, USA). In this study, a significance level of less than 0.05 was considered.
Results: 28 (22.4 percent) males and 97 (77.6 percent) females with a mean age of 44.66 13 13.85 years were studied. There were 35 difficult cases (28 percent) and 90 easy cases (72 percent). Conversion to open surgery occurred in three cases. Among the sonographic findings, there was a significant relationship between the increase in gallbladder wall thickness and Impacted stone with the duration of operation (P≤0.05). But no significant relationship was found between the findings of Presence of pericholecystic fluid and the duration of operation (P>0.05).
Conclusion: Overall, the findings of this study showed that preoperative ultrasound is able to provide valuable data in predicting the duration of laparoscopic cholecystectomy.

Enayatollah Noori, Mostafa Vahedian, Farrokh Savaddar, Ahmad Kachoie, Mohsen Eshraghi, Neda Minaei,
Volume 78, Issue 11 (February 2021)
Abstract

Background: Knowing the conversion risk factors of laparoscopic cholecystectomy to open surgery, helps the surgeon to plan for surgery accordingly. This study aimed to determine the risk factors for converting laparoscopic cholecystectomy to open surgery.
Methods: In this analytical study, the case information of 1104 patients who underwent laparoscopic cholecystectomy in Shahid Beheshti Hospital in Qom from April 2013 to April 2017 was evaluated. Inclusion criteria were all cases of acute cholecystitis, chronic cholecystitis, symptomatic gallstones, and biliary pancreatitis who underwent laparoscopic cholecystectomy. The exclusion criteria were patients who underwent laparoscopic cholecystectomy at the same time with other procedures. Data of all patients including age, sex, history of abdominal surgery, emergency or elective surgery, blood transaminase level, blood bilirubin level, white blood cell count, amylase level, and serum alkaline phosphatase were recorded. Finally, potential risk factors were compared between the two groups. Average, standard deviation, frequency and percentage indices were used to describe the data. Independent samples t‐test and Mann-Whitney U test were used for quantitative data analysis and Chi-square test was used for qualitative data analysis. P<0.05 is considered significant.
Results: 1104 patients were studied. 765 patients were female (69.3%) and 339 patients were male (30.7%). In 104 cases, open surgery was performed. The mean age of patients in the method change group was 49.45±8.9 years. Among the studied variables, between sex (P=0.26), age (P=0.056), process of cholecystitis (P=0.65), previous history of abdominal surgery (P=0.62), alanine transaminase (P=0.10) aspartate transaminase (P=0.95) showed no statistically significant relationship with the conversion of laparoscopic surgery to open surgery. However, abnormal ultrasound (P=0.000), emergency surgery (P=0.000), white blood cell count (P=0.008), total bilirubin and alkaline phosphatase (P=0.000) had a statistically significant relationship with the conversion of laparoscopic to open surgery
Conclusion: Due to the high complications and mortality of open cholecystectomy, the detection of these risk factors helps to reduce the rate of open surgery and address these factors before surgery.


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