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P Jabal Ameli , H Hal Ataei,
Volume 53, Issue 2 (5-1995)
Abstract

We report our experience with 124 patients were referred 70 our urology clinic in Sina hospital for urinary retention. Serum PSA analyzed by using a monoclonal assay. All patients underwent digital rectal examination. The patients devided in 3 groups: Group 1 (87 men) with a serum PSA level less than 4 ng/ml, group 2 (26 men) with a serum PSA level 4-10 ng/ml and group 3 (11 men) with a serum PSA level greater than 10 ng/ml. After prostate biopsy and trans urethral resection or open prostatectomy, of the 87 men in group 1, one man had cancer of the prostate, of the 26 men in group 2, 2 men had cancer of the prostate and of the 11 men in group 3, 9 men had prostate cancer.
Farzan M, Attaei H,
Volume 59, Issue 3 (8 2001)
Abstract

Cleft hand deformity is a rare congenital anomaly of the hand with an incidence rate about 1/90,000. It has two clinical types Typical and Atypical. In this paper we are representing ten cases of this anomaly admitted during seven years from 1992 in Emam Khomeini Hospital. Some of the patients especially those with typical cleft hand deformity achieved good functional results after surgical correction of the deformity. In the younger age group we observed better functional results.


Madani A, Ataei N, Esfahani St, Mortezavi Fs, Mohseni P,
Volume 60, Issue 2 (14 2002)
Abstract

Background: Cyclosporin A (CsA) is now commonly used in the management of children with steroid-dependent and steroid resistant nephoitic syndrome. It has been reported to be effective in maintaining remission in 70-100 percent of patients with SDNS but somewhat SRNS 0-100 percent. The aim of this study was to evaluate the efficacy of long-term (CsA) in children with refractory nephrotic syndrome (RNS) and steroid dependent nephrotic syndrome (SDNS).

Materials and Methods: The long-term effect of (CsA) in 91 Iranian children aged 3 months to 11 years (54 with RNS and 37 with SDNS) was assessed between 1984 and 1999. Eighty of 91 children received renal biopsy prior to introduction of (CsA), and the other 11 patients had not consent for kidney biopsy. If the patients did not show remission aftre receiving 3-6 months of (CsA), the medication was discontinued.

Results: All patient were treated with (CsA) in combination with low dose alternate day prednisolone. In children with RNS and SDNS, therapy with (CsA) induced, remission in 25 of 54 (46.2 percent) and 27 of 37 (73 percent) respectively (P<0.02). Of the 32 patients with minimal change disease (MCD), 23 (72 percent) responded to therapy, compared with 4 of 18 (22 percent) with focal segmental glomerulosclerosis (FSGS) (P<0.005). Twenty-four (48 percent) of 50 who entered complete remission, had relapse 1-12 months after cessation of (CsA). The duration between the onset of nephrotic syndrome (NS) and administration of (CsA) and sexuality of patients had no effect in result of treatment. Side effects occurred in 25 patients (27.4 percent). No patients exhibited raised transaminases, 8 (8.7 percent) of the children developed hirsutism, 7 (7.6 percent) hypertension, 7 (7.6 percent) gingival hyperplasia, (2.2 percent) neurological toxicity and 1 (1 percent) increase in serum creatinine.

Conclusion: Our findings suggest that (CsA) can be used to induce a complete remission in a significant proportion of patients with RNS and SDNS, and patients with SDNS have areasonable potential for remission than children with RNS. Resistant to steroid and cyclophosphamid.


Ataei N, Compani F, Madani A, Rezaei N ,
Volume 60, Issue 3 (14 2002)
Abstract

Background: Urinary tract infection is a common bacterial infection in children and may lead to irreversible renal damage. TC 99-m Dimercaptosuccinic acid renal scintigraphy is the most sensitive method for diagnosing acute pyelonephritis. We designed a study to evaluate the ability of DMSA scan and ultrasonography to detect renal paranchymal lesion.

Materials and Methods: 62 children 1 month to 12 years of age with the first episode of acute pyelonephritis were prospectively studied with DMSA scan and ultrasonography during acute phase of infection. A Voiding Cystourethrogram was performed in 60 children when urine culture became negative. Children with renal paranchymal changes were older at the time of acute pyelonephritis (P=0.04) but no difference was found between the groups with regard to levels of CRP, ESR (P>0.05).

Results: Changes on the DMSA scan were found in 106 (85.5 percent) kidneys of 62 children but ultrasonography showed renal changes in 19.4 percent (sensitivity=20 percent, specificity=83 percent) (Kappa=0.06). Vesicoureteric reflux was found in 14 children (23.3 percent) but 83 percent of the affected kidneys were drained by non-refluxing ureters.

Conclusion: It is concluded that DMSA scan is more sensitive than ultrasonography in detecting renal paranchymal changes in acute pyelonephritis and we found out that renal paranchymal changes after acute pyelonephritis is common, even in those without VUR.


Ataei N, Milanii Housaini Sm, Compani F,
Volume 61, Issue 2 (14 2003)
Abstract

Early diagnosis, treatment, investigation and follow up of children with urinary tract infection (UTI) are needed to minimize renal scarring. The aims of this study were 1) to evaluate the ability of DMSA scintigraphy, ultrasound and biological parameters in detecting renal parenchymal involvement in children with acute pyelonephritis (APN) 2) to assess the relation between renal parenchymal changes and creatinine clearance 3) to determine the incidence of renal scarring after APN.
Materials and Methods: We prospectively studied 54 children (median age 4.02± 3.41 range 1 month to 12 years) with first time symptomaticUTI. All patients had DMSA scan and ultrasonography within 5 days of admission. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), white blood cell (WBC), was measured at the time of infection, and voiding cystourethrography was performed in all children within 10 days. When scintigraphy showed renal parenchymal changes, repeat DMSA scan was done at least 3 months after initial infection.
Results: Changes on the DMSA scan were found in 93/108 (85.5 percent) renal units in 54 children during acute pyelonephritis. Among 42 children who had underwent repeat scintigraphy , renal scars were found in 9 of 16 (56.25 percent ) renal units in 8 infants under 1 year ,23 of 32 (71.87 percent) in 16 children aged 1-5 years, and 33 of 36(91 percent ) in 18 patients older than 5 years. Ultrasonography showed renal changes in 20 of 108 (18.5 percent) kidneys. Reflux was seen in 21 of 108 (19.44 percent ) renal units. The sensitivity of ESR, CRP, WBC, and ultrasonography was 78.5 percent , 64.5 percent , 69.9 percent , 18.5 percent respectively, and the specificity of them was 40 percent, 33.3 percent, 13.3 percent,
80 percent respectively. There was a positive correlation between renal parenchymal involvement and creatinine clearance level (p<0.001).
We found no difference between groups with or without scars with respect to levels of ESR, CRP, and WBC.
Conclusion: The present study suggest that DMSA scan may be a more reliable method of investigation than ultrasonography and biological parameters for identifying children at risk of permanent renal lesion. Additionally we found positive correlation between renal parenchymal change and creatinine clearance level. In order to detect persistent changes, it is suggested that DMSA scintigraphy should be performed at least three months after UTI.


 


Ataei N, Madani A, Falakolaflaki B,
Volume 61, Issue 4 (15 2003)
Abstract

The nephrotic syndrome is the most common chronic renal disease of childhood.
Materials and Methods: In this study the clinical course, risk factors for relapse and the predictors of long-term outcome of 502 patients (median age 5 years)with primary nephrotic syndrome were followed for an average of 60 months (3.5 to 240 months) from 1981 to 2000.
Results: Among the 502 patients 5 (1%) achieved spontaneous remission and 313 children were initial responder. One hundred eighty four patients received at least 1 kidney biopsy (78 prior and 106 after initiation of treatment). Of 104 children with frequently relapsing steroid sensitive and steroid dependent nephrotic syndrome, levamisole induced prolong remission in 33 ( 31.7%) of patients. Cyclophosphamid and cyclosporine A induced prolong remission in 49 (50%) of 98 and 28 (41.3%) of 68 patients respectively. At the time of the final clinical evaluation, 73 patients (14.5%) were on remission 301 (59.9%) had relapsing 43 (8.6%) had persistent nephrotic syndrome 33 (6.6%) of patients evolving to end-stage renal disease (ESRD) and 6 (1.2%) of them with chronic renal failure died (infection and cardio respiratory were the cause of death in 5 and 1 patient respectively). Young age (1-5 y) at onset of disease and atopy were identified as an independent risk factors for relapse (P0.05). Patients with steroid dependent nephrotic syndrome (SDNS) or MCNS had better response to cyclophosphamide or cyclosporin than children with steroid resistance nephrotic syndrome (SRNS) or FSGS (P0.05). Persistent proteinuria, hypertension, microscopic or macroscopic hematuia, glucosuria were associated with progression to chronic renal failure (PO.05).
Conclusion: Steroid dependency and histopathology of MCNS in patients with nephrotic syndrome were significantly associated with good long-term prognosis. In contrast persistent proteinuria, histopatholoy of FSGS, hypertension, macroscopic or microscopic hematuria, and glucosoria were significantly correlated with unfavorable long-term outcome. Additionally our study showed a positive correlation between young age and atopy with higher rate of relapse.
A Madani , M Shakiba , N Taei , T Esfehani , P Mohseni ,
Volume 63, Issue 1 (5 2005)
Abstract

Background: Chronic renal failure defines as progressive and irreversible dysfunction of kidneys that could eventually terminated to end stage renal disease (GFR< 10% NL). Because of therapeutic problem and high mortality and morbidity and it &aposs implication quality of life , ESRD is one of the important dilemma of pediatric medicine .

Materials and Methods: In our study 216 patients evaluated .

Results: Male to female ratio was 1.1 . The peak of the presenting age of ESRD was 10 years old (8-12 y). Congenital urological malformation (30%) , glomerulopathies (20%) , hereditary nephropathies (14.3%) , multisystem diseases (7%) and nephrolithiasis (6.2%) are the most common etiologies of ESRD . VUR in 21% and congenital obstructive disease in 8.5% are the etiology of ESRD. In patients with age five years old and lesser common causes of ESRD are congenital urologic malformation and glomerulopathies. In other age groups , urologic malformation is the most common cause of ESRD. In etiologic assessment of two separate 7 years interval , (1988-1993) and (1996-2003) , there was not any significant change in frequency of etiologies but frequency of congenital obstructive uropathy decreased from 10 % to 5.7%. Total amount of VUR (VUR ± Neuropathic bladder) has not any change but frequency of primary reflux nephropathy decreased from 14.2% to 8%. In this study , in 145 patients hemodialysis continued and 28 cases had unsuccessful renal transplant (13.8%) . 7.4 % of patients had successful renal replacement therapy (RRT) and mortality rate was 7.4% . B

Conclusion: Based on that the most common cause of ESRD is all ages in congenital urologic malformations , early diagnosis and appropriate management of these cases are effective in decreasing incidence of ESRD and with respect to few cases of renal transplant and unsuccessful results in 65% of RRT , the approach of this problem should be revised.


Ataei N, Madani A, A Hossain,
Volume 63, Issue 3 (12 2005)
Abstract

Background: Despite several years of intensive investigation, relatively few studies have been made of children with lupus nephritis. The prognosis of children with lupus nephritis is poor for those with diffuse proliferative glomerulonephritis and active interstitial inflammation. As newer treatment modalities become available for patients with severe lupus nephritis, it become increasingly important to identify patients at risk for renal failure. The aim of this study was to evaluate the clinical course, histopathology, serologic features and prognostic significance of some parameters, to identify the risk factors for renal failure and mortality in children with lupus nephritis.

Materials and Methods: Retrospectively 30 children under 16 years of age with lupus nephritis from 1989 to 1999 were studied. All patients received renal biopsy and follow-up biopsies were performed in 3 children. Lupus nephritis was classified by the World Health Organization (WHO) criteria. The clinical and serologic parameters at the time of renal biopsy were recorded.

Results: All children underwent renal biopsy within 1 year of disease onset. There were 1 (3.3%) patients with class II, 5 (16.7%) with class III, 21 (%70) with class IV, and 3 (%10) with class V nephritis based on initial biopsy according to the WHO classification. The mean follow-up time was 60 months. Follow-up biopsies were histologically stationary in 2 patients and progressive in one. The overall renal and patient 5- year survival rates were 46.66% (14/30) and 93.33 %( 2/30) respectively. They were 47.61% (10/21) and 95.21 %( 20/21), respectively, of patients with class IV proliferative glomerulonephritis. Children with renal pathology (class V in the WHO classification system) at initial biopsy, were at high risk for renal failure 66.66% (2/3) or morality %33.33 (1/3) despite aggressive treatment. The results revealed that those with persistent hypertension, anemia, and decreased creatinine clearance rate, nephrotic proteinuria, at initial biopsy were more prone to develop renal failure (P<0.01).

Conclusion: The prognosis of children with class IV nephritis in our study was better than reported in other series in recent years. However, those with class V disease, persistent hypertension, anemia, low creatinine clearance and nephrotic proteinuria at the time of diagnosis are at increased risk for renal failure. The improved results may be due to initial histological classification, better supportive care and selective use of aggressive therapy such as methylprednisolone pulse therapy and intravenous cyclophosphamide for those with high risk factors.


Ghabaae M, Qelichnia Omrani H, Roostaeizadeh M,
Volume 65, Issue 5 (3 2007)
Abstract

Background: Multiple sclerosis is the most common demyelinating disease of central nervous system. We prepared this study to find its epidemiologic pattern in the Iranian society.
Methods: This case-series study involved 70 patients diagnosed with multiple sclerosis according to the McDonald criteria and admitted to the Iranian Center of Neurological Research at Imam Khomeini Hospital from 2002 to 2004. Informed consent was obtained prior to patients completing a questionnaire, which included age, gender, age of onset of clinical symptoms, home location, familial history, education level, smoking habits and the season during which the disease occurred, was exacerbated or relapsed. SPSS 11 statistical software was used to analyze the data.
Results: The mean age of the patients was 32.6 years. Approximately one-third of our patients were male, 92.9% resided in urban areas, 14.3% had an academic education, and 14.3% were cigarette smokers. The average age of onset of disease was 27.55±10.42 years, and 8.6% had positive a familial history for multiple sclerosis. The symptoms most commonly started in the spring (31.4%).
Conclusion: The alternation of temperature and sunlight may be one reason for the high incidence of multiple sclerosis in spring and autumn. It seems that multiple sclerosis epidemiologic patterns in Iran are the same as those of other countries. Thus, applying the common diagnostic and treatment methods in used in other countries may raise our patients' quality of life.
Ataei N, Safaian B, Madani A, Esfahani St, Ataei F,
Volume 67, Issue 2 (5 2009)
Abstract

Background: Early diagnosis of renal parenchymal involvement in children with acute pyelonephritis (APN) using isotope scan and early treatment may decrease or prevent development of renal parenchymal lesions. We designed this study to assess the diagnostic value of certain biologic parameters in children with first- episode of acute pyelonephritis (APN) documented by 99m Tc-dimercaptosuccinic acid (DMSA) scintigraphy.
Methods: We compared the laboratory findings of leukocyte count, erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) levels with the results of the DMSA scans obtained within three days of admission. One hundred-two children (93 girls and 9 boys aged 1 month–12 years (mean 2.85±2.92 years) were enrolled in the study. Of these patients, 203 renal units, were investigated using scintigraphy. Voiding cystourethrography (VCUG) was performed in 98 children (195 renal unit) when urine culture became negative.
Results: In all children one or both of kidneys had parenchymal involvement on scintigraphy. Changes on the DMSA scan were found in 178(88%) renal units during the acute phase. The extent of changes in DMSA scan were mild in 113/178(55.7%) renal units, moderate in 40/178(19.7%) and severe in 25/178(12.3%). When inflammatory markers were correlated with the development of the severe renal lesions, as assessed with DMSA scan, a highly significant correlation with both ESR (p=0.007) and leukocyte counts (p=0.02) were found.
conclusions: We conclude that the incidence of renal parenchymal involvement in Iranian children with APN is very high. Although increased ESR and leucocytosis may be valuable markers for determination of severe renal parenchymal involvement, but these parameters and also CRP, were inadequate in distinguishing mild to moderate renal parenchymal involvement.
Ataei B, Nokhodian Z, Babak A, Shoaei P, Mohhammadzadeh M, Sadeghi R,
Volume 67, Issue 11 (4 2010)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: There are millions of children around the world living on the street. They are at higher risk of physical, sexual and drug abuse, and have no access to health care facilities. Therefore they are at risk of viral infections such as HCV and HIV. The aim of this study was determining the prevalence of HCV and HIV infection in Isfahan street children (2005-2007).
Methods: The cross-sectional study was taken place on 386 street children through a nonprobable-convenience sampling method. They were requested to answer a questionnaire (demographic and behavioral data), and then they were tested for anti HCV and anti HIV antibodies.
Results: Among 386 street children, 270 (70%) were boys and the mean age was 12.62±3.23 years. The majority of them, 267 cases (69%), were on the street for financial reasons. 353 (91.7%), 366 (94.8%) and 375 (97.2%) of them had no history of smoking, using alcohol or substance addiction, respectively. 40 (34.5%) of girls and 12 (4.4%) of boys (p<0.0001) were engaged in sex and 79 (68%) of girls and 46 (17%) of boys (p<0.0001) were involved in physical fighting. All of the children had negative serology for HIV infection. Nevertheless, four of them (1%) were positive for HCV Ab.
Conclusion: The knowledge of street children about high risk behaviors and the infectious diseases should be improved through educational programs. They need also legal, social and health support.


Mehdi Amini , Mehrdad Roghani , Peymaneh Shirinbayan , Mohammad Taghi Joghataei , Ali Farhoudian , Mohsen Roshanpajouh , Morteza Koruji ,
Volume 71, Issue 5 (August 2013)
Abstract

Background: Infertility is one of the most serious social problems. Illicit drug use can be an important cause of male factor infertility. Kerack which its use is rising up in Iran refers to a high purity street-level heroin (heroin Kerack). Heroin Kerack used in Iran is an opioid and has harmful effects on body organs. The aim of this study is to investigate the effects of Kerack used in Iran on fertility adult mice.
Methods: In this study, 25 male mice were divided into five groups (control, sham and three experimental). Experimental groups of Kerack-dependent mice (received ascend-ing dose of Kerack for seven days) were divided into three categories, experimental I, II and III. Experimental I was given Kerack at a dose of 5 mg/kg, experimental II 35 mg/kg and experimental III 70 mg/kg, intraperitoneally twice a day for a period of 35 days. The sham group received normal saline and lemon juice (2.6 µl/ml) whilst the control group just received water and food. Mice were then scarified and sperm removed from cauda epididymis were analyzed for sperm count, motility, morphology (normal/abnormal) and viability. Testes were also removed, weighed and processed for light microscopic studies.
Results: The results showed that fertility were significantly decreased in addicted mice compared with control groups (P≤0.05). Epididymal sperm parameters and thickness of seminiferous epithelium were significantly decreased in experimental groups (dose-dependent) compared with sham and control groups (P≤0.05). Gonadosomatic index was significantly reduced with high dose Kerack injected (70 mg/kg) in comparison with control testes (P≤0.05).
Conclusion: This study has shown the deleterious effects of Kerack used in addicted Iranian people on fertility for the first time. This effect is especially on epididymal sperm parameters in adult mice.

Safiyeh Abbasi , Sassan Taei , Behnam Zamanzad ,
Volume 73, Issue 11 (February 2016)
Abstract

Background: Staphylococcus aureus is a gram positive coccus which is able to cause different kinds of infection in certain condition. The function of this bacteria is to provide the conditions for the invasion of it to the host with the secretion of different sorts of toxins such as Staphylococcus aureus enterotoxin, including important virulence factors that super antigens are all factors digestive inconvenience. Staphylococcus aureus enterotoxin-secreting toxins such conditions provides invasion of host genes. There are different types of SE, but type A enterotoxin (SEA) and type B enterotoxin (SEB) are the most important types. Therefore, in this study, the prevalence of Staphylococcus aureus toxin-producing enterotoxin genes (SEB, SEA) in clinical strains isolated from patients in teaching hospitals of Shahrekord city, Iran, were studied.

Methods: This cross-sectional and descriptive study, which was conducted from May 2014 to December 2014. A hundred and ten isolates of Staphylococcus aureus from patients collected over a period of 8 months and were first identified using standard biochemical methods and laboratory. Using standard methods and laboratory tests were identified and compared with the antibiotic oxacillin minimum inhibitory concentration were determined by broth micro dilution, and then they were assessed by polymerase chain reaction (PCR) technique.

Results: The results indicated that, 110 samples of dairy products infected by Staphylococcus aureus were detected. Two cases (1.8%) of these infected samples were carrying both enterotoxin A and enterotoxin B genes. The frequencies of enterotoxin A genes were twenty-six cases (23/6%) and The frequencies of enterotoxin B genes were two cases (1/8%), respectively.

Conclusion: The detection of enterotoxin A and enterotoxin B genes, shows the most important role they have in bringing about superinfection. The detection of enterotoxin A and B genes, shows the most important role they have in bringing about superinfection. Enterotoxins SEA and SEB are heat stable; therefore heating has no effect on dairy products contaminated by enterotoxins and gastritis may occur in a short period of time. As PCR is a rapid, sensitive, specific and inexpensive method, we suggest that it can be replaced to traditionally assays for detecting Staphylococcus aureus enterotoxin.


Behrooz Ataei , Morteza Pourahmad , Ali Fotoohi , Katayoun Tayeri , Majid Yaran ,
Volume 75, Issue 11 (February 2018)
Abstract

Background: Hepatitis E virus (HEV) is from Hepeviridae family and genus Hepevirus. This virus is in 4 genotypes. These 4 genotypes are classified in 2 classes. In first class there are genotypes 1 and 2 which are specific for human. Genotypes 1 and 2 are not developed to chronic hepatitis is spite to genotypes 3 and 4 which may develop to chronic hepatitis in immunocompromised patients. It should say that in middle east genotypes 3 and 4 are not frequent. One of the immunodeficiency syndrome is human immunodeficiency virus (HIV) infection in which in the late phases of the disease the power of the immunity will be severely decreased in the patients. Therefore, in patients with HIV infection, HEV (specially genotypes 3 and 4) may be a problem and it may progress to a chronic viral hepatitis which may lead to liver failure. Therefore, it may need treatment and prophylactic strategies in some areas. The aim of this study was to evaluate the frequency of HEV infection in HIV patients by molecular assay.
Methods: This descriptive, cross-sectional study was conducted on 111 random selected, known HIV infection patients in 2016 in Isfahan, Iran. This study was done under supervision of Immunodeficiency Research Center of Isfahan University of Medical Sciences. The criteria for enrolling in the study, was positivity of HIV infection, and samples were selected from all known HIV infected patients in Isfahan. After blood sampling from the selected patients, HEV RNA was surveyed by RealStar® HEV RT-PCR Kit 1.0 (Altona Diagnostics, Hamburg, Germany). At the end, after isolation of HEV RNA, the cDNA was prepared and evaluated.
Results: Patients were between 5 to 68 years old and mean of the patients age was 38.5±11.5 years. 75 (67.6%) and 36 (32.4%) of the patients were men and women respectively. Mean count of the CD4 cells in these patients was 317.2±187.8. HBsAg and HCVAb was positive in 6 (5.4%) and 39 (35.1%) of them. No one of the studied patients were positive for HEV infection.
Conclusion: On the results of this study, there is no chance for having hepatitis E infection in Iranian HIV patients. Therefore, it seems that, hepatitis E is not an important problem in this group of patients in Iran.

Ahmad Tavakoli , Maryam Esghaei , Angila Ataei-Pirkooh , Mohsen Moghoofei , Hadi Ghaffari , Farah Bokharaei-Salim ,
Volume 77, Issue 5 (August 2019)
Abstract

Currently, there are about 37 million people worldwide living with human immunodeficiency virus (HIV) /AIDS, with an estimated two million new cases per year globally. According to estimates from the World Health Organization (WHO), only 75% of the population with HIV know their status. Initially, HIV infection was associated with significantly increased rates of mortality and morbidity. However, the rapid advances in treatment and the advent of different classes of antiretroviral drugs over time have led to change the face of HIV/AIDS from a deadly infection to chronic and manageable disease. There is strong evidence that HIV-infected patients undergoing antiretroviral therapy have longer lives and are less likely to transmit infection to their sexual partners. Since the introduction of zidovudine in 1987 as the first antiretroviral drug, significant strides have been made in antiretroviral therapy. The introduction of potent antiretroviral drugs for the treatment of HIV infection has been one of the significant events in the evolution of modern medicine. Antiretroviral therapy refers to the use of drugs in the treatment of HIV. Generally, these drugs are categorized based on the steps of the HIV life cycle suppressed by them. There are six main classes of antiretroviral agents including nucleoside/ nucleotide reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, fusion inhibitors, co-receptor inhibitors, and integrase inhibitors. Combination antiretroviral therapy should be considered for HIV patients to achieve the highest viral suppression rate, and to reduce the risk of resistance development and morbidity and mortality associated with AIDS. Achieving and maintaining HIV viral load suppression among treated patients has remarkably increased over the last years due to the development of potent and well-tolerated agents which can be co-formulated as a once-daily single-tablet or fixed-dose combination for simplification. However, there are some limitations preventing patients to benefit from this treatment. The main goals of HIV therapy in the future are to overcome the limitations of current treatment, including side effects. This review will provide an overview of advances in the current antiretroviral drugs by focusing on their pharmacokinetics, mechanism of action, dosing recommendations, and adverse events for each drug class.

Homayoon Yektaei, Mohammad Manthouri,
Volume 78, Issue 6 (September 2020)
Abstract

Breast cancer is the most common cancer among women and the earlier it is diagnosed, the easier it is to treat. The most common way to diagnose breast cancer is mammography. Mammography is a simple chest x-ray and a tool for early detection of non-palpable breast cancers and tumors. However, due to some limitations of this method such as low sensitivity especially in dense breasts, other methods such as 3d mammography, ultrasound and magnetic resonance imaging are often suggested to obtain additional useful information. Recently, computer-aided diagnostic or intelligent diagnostic have been developed to assist radiologists to improve diagnostic accuracy. In general, a computer system consists of four steps: pre-processing, dividing areas of interest, extracting and selecting features, and finally classification. Nowadays, the use of imaging techniques in the identification of patterns for diagnosis and automatic determination of breast cancer by mammography and even digital pathology (which is one of the emerging trends in modern medicine) reduces human errors and speeds up the diagnosis. In this article, We reviewed recent findings and their disadvantages and benefits in the diagnosis of breast cancer by neural networks, especially the artificial neural network, which is widely used in the diagnosis of cancers and intelligent breast cancers. This literature review shows that hybrid algorithms have been better at improving classification and detection accuracy. Providing a convenient way to diagnose tumors in the breast by computer-assisted diagnosis systems will be of great help to the physicians. Much work has been done in recent years to diagnose breast cancer, and many advances have been made in improving and diagnosing breast cancer by computer. All methods have a significant error percentage and are different depending on the type of breast, but compared to other types of neural networks, convolution and combining methods with convo have better results. Another advantage of the convoluted network is the automatic extraction of desirable features. Today, the best percentages of accuracy in detecting benign or malignant cancerous mass are achieved by convolution.
Sajad Ataei, Masoud Zeinali, Azim Motamedfar, Maryam Moradi, Hossein Jafari Marandi ,
Volume 80, Issue 9 (December 2022)
Abstract

Background: Chronic low back pain (CLBP) is one of the most common spine disorders, which is seen in 65-80% of people. Knowing the normal patterns of spine and pelvic parameters is very helpful in determining the susceptible subjects for CLBP.
Methods: This study was conducted in healthy people during April 2017 until April 2018 in Golestan hospital of Ahvaz. Inclusion criteria include; Age group 20-65 years, no history of surgery, spine disorders, and having normal radiographs were performed. People who have complained of back pain in the last three months, neuromuscular disease, lumbosacral anomalies, kyphosis and obvious scoliosis, history of spine surgery and vertebral fracture, were excluded. A 36-inch radiology stereotype was prepared in the standing position. Pelvic and spine parameters that were investigated in this research included the following, Pelvic incidence, Pelvic tilt, Sagittal Vertical Axis, T9 Sagittal Angle, Thoracic Kyphosis, Lumbar Lordosis, and Sacral Slope. All data were analyzed with SPSS software, version 24 (SPSS Inc., Chicago, IL, USA).
Results: 50 participants including 27(54%) men and 23(46%) women with an average age of 33±12.5 years and BMI of 25±5.5 kg/m2 were examined. After examining the vertebral and pelvic parameters, it was found that PI is significantly higher in women than in men (P=0.02). It was also found that with increasing age, the amount of Pelvic incidence also increases (P=0.043), so that in people over 60 years of age, the amount of pelvic incidence is significantly higher than other people (P<0.05). Further analyzes showed that BMI has a direct effect on the amount of Thoracic Kyphosis (P=0.03) and Lumbar Lordosis (P=0.04). Thus, the highest amount of Lumbar Lordosis and Thoracic Kyphosis was seen in people with BMI 30-34.9 Kg/m2.
Conclusion: The findings of the present study showed that spine and pelvis indices have an important effect on the occurrence of CLBP. Hence, it is highly recommended to check these parameters in asymptomatic people, especially in older people.

Mehdi Ghobakhlou, Hamidreza Ghasemi Basir , Ahmad Jahdari , Elnaz Ataei, Ali Saadatmand,
Volume 80, Issue 9 (December 2022)
Abstract

Background: Intestinal metaplasia in the stomach is one of the precancerous lesions of gastric tissue. If the lesions are diagnosed early before invasive cancer develops, it is possible to prevent the progression to malignant lesions. Therefore, this study was performed to evaluate the prevalence and risk factors of intestinal metaplasia in patients with dyspepsia.
Methods: This descriptive cross-sectional study was performed on patients who were referred to Shahid Beheshti Hospital in Hamadan, Iran from the beginning of 2019 to the end of 2020. A total of 250 patients over 16 years of age who complained of dyspepsia for at least more than three months were included in the study. Examination was performed for patients along with the completion of a pre-designed questionnaire including demographic information and metaplasia risk factors. Also, endoscopy and biopsy specimen of gastric mucosa were performed for histological examination. Finally, the data were analyzed using SPSS software version 16 with related statistical tests.
Results:  There was no significant relationship between job type, level of education, marital status and family history of gastric cancer, smoking, alcohol, high salt, dairy products and high-nitrate diet with the disease. There was a significant relationship between body mass index and the presence of intestinal metaplasia in men (P=0.032). The average age of men with metaplasia was about 13 years older than those without the disease. Also gastric ulcer (84%) and pan gastritis (40.4%) were the most common cases in endoscopic results. The number of female patients with epigastric pain was about 14% higher than male patients. Gastric ulcer was significantly associated with gender, with about 12% more gastric ulcers observed in men than women (P=0.014). Also, no significant relationship was observed between the presence of Helicobacter pylori and the severity of its colonization with intestinal metaplasia. (P=0.230)
Conclusion: In this study, no significant relationship was observed between the presence of Helicobacter pylori and the severity of its colonization simultaneously with intestinal metaplasia. Apart from the two factors of increasing age and type of sex, no serious risk factors for intestinal metaplasia were seen.


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