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Farshid Farhan , Cyrus Azimi , Majid Mahmoodi , Mohammad-Ali Mohagheghi , Farideh Farzanfar , Azam Noor-Mohammadi, Malihea Khaleghian , Abbas Jafari , Mehrangiz Ghaem-Maghami , Kouros Divsalar ,
Volume 74, Issue 1 (April 2016)
Volume 74, Issue 1 (April 2016)
Abstract
Background: It is reported that high frequency of chromosomal aberrations in peripheral blood lymphocytes of individuals is a marker of cancer predisposition. The aim of this study was to investigate the in vitro frequency of chromosomal damage in lymphocytes of patients with head and neck cancer against gamma irradiation compared with those in healthy individuals.
Methods: In a case and control study, peripheral blood lymphocytes of 101 patients with head and neck cancer were collected before the onset of radiotherapy. Lymphocytes of 40 healthy individuals were also collected as controls. Head and neck cancer patients and the control group were consecutively recruited between April 2012 and February 2015 from Clinics of Cancer Institute, Imam Khomeini Hospital, Tehran, Iran. Lymphocytes of patients or control group were cultured and exposed to gamma radiation in G2- and G0- phase of the cell cycle. The induced chromosomal aberrations such as chromosome and chromatid breakages, chromosome and chromatid gaps, chromatid exchanges and micronuclei were scored in one-hundred metaphase cells of each individual. The mean of each chromosomal aberration was compared in patient and control groups. Early and late tissue reactions were scored during radiotherapy treatment or thereafter.
Results: There was no significant difference in demographic characterization between the two study groups. The frequency of radiation- induced G2 aberrations in lymphocytes of patients was significantly higher than in those of healthy donors (P= 0.001 for chromosomal breaks). The frequency of radiation-induced micronuclei in G0 assay was also higher in patients than in those in controls (P= 0.05). The results also indicate that there is no correlation between the two assays. No significant correlation was also observed between aberration frequencies in lymphocytes and the degree of both early and late normal tissue reactions.
Conclusion: The results indicate that the in vitro chromosomal radiosensitivity of peripheral blood lymphocytes of patients with head and neck cancer against gamma irradiation was significantly higher than that in healthy individuals.
Ghasemali Khorasani , Siamak Rakei , Amirhosein Tavakoli ,
Volume 74, Issue 2 (May 2016)
Volume 74, Issue 2 (May 2016)
Abstract
Background: Cartilage grafting is used in rhinoplasty and reconstructive surgeries. Autologous rib and nasal septum cartilage (auto graft) is the preferred source of graft material in rhinoplasty, however, homologous cartilage (allograft) has been extensively used to correct the nasal framework in nasal deformities. Autologous cartilage graft usage is restricted with complication of operation and limiting availability of tissue for extensive deformities. Alternatively, preserved costal cartilage allograft represents a readily available and easily contoured material. The current study was a formal systematic review of complications associated with autologous versus homologous cartilage grafting in rhinoplasty patients.
Methods: In this cohort retrospective study, a total of 124 patients undergone primary or revision rhinoplasty using homologous or autologus grafts with postoperative follow-up ranging from 6 to 60 months were studied. The types of grafts and complications related to the grafts were evaluated. This included evaluation for warping, infection, resorption, mobility and fracture.
Results: The total complications related to the cartilage grafts were 7 cases, which included 1 warped in auto graft group, three cases of graft displacement (two in allograft group and one in auto graft group) and three fractures in allograft group. No infection and resorption was recorded. Complication rate (confidence interval 0.95) in autologous and homologous group were 1.25(0.4-3.88) and 2.08(0.78-5.55) in 1000 months follow up. There was no statistically significant difference between autologous and homologous group complications. Onset of complication in autologous and homologous group were 51.23(49.27-53.19) and 58.7(54.51-62.91) month respectively (P=0.81).
Conclusion: The allograft cartilage has the advantage of avoiding donor-site scar. Moreover, it provides the same benefits as autologous costal cartilage with comparable complication rate. Therefore, it can be a reliable alternative material for rhinoplasty surgeries. A longer follow-up may be necessary to confirm the structural stability of the allograft cartilage grafts.
Maryam Akhtari, Mahdi Kamali , Gholam Reza Javadi , Seyedeh Razieh Hashemi ,
Volume 74, Issue 4 (July 2016)
Volume 74, Issue 4 (July 2016)
Abstract
Background: Human papilloma virus (HPV) is one of the most important factors in cervical cancer. Viral sequences are integrated into the host cell genome. In mild cases the virus causes skin damages, in severe cases it leads to cancer. Like many other cancers, telomerase gene expression was increased in cervical cancer. This enzyme is a reverse transcriptase that contains two common subunits: i) catalytic protein called human telomerase reverse transcriptase (hTERT) and, ii) RNA sequence called hTR. hTERT expression is hardly found in any somatic tissues. Detection of high telomerase activity in human cells, lead to tumor genesis. So hTERT can be used as a diagnostic tool in cancer detection.
Methods: This experimental study was carried out from May 2013 to April 2014 in Nanobiotechnology Research Center, Baqiyatallah University of Medical Sciences in Tehran, Iran. Caski and Hela cancer cell lines were used which contain HPV16 and HPV18 respectively. Cell lines were cultured and total RNA was extracted. Following normalization agent glyceraldehyde-3-phosphate dehydrogenase (GADPH), hTERT expression level was determining by real-time PCR method. For each sample, the expression level of hTERT and GAPDH were quantified as copy numbers (per reaction) using the standard curve. Finally, hTERT levels in Hela and Caski cell lines were compared quantitatively by t-test using GraphPad statistic software version 5 (San Diego, CA, USA).
Results: According to the charts real-time PCR, hTERT gene expression in Hela and Caski cancer cell lines is significantly different (t=0.0319).
Conclusion: All results confirm that hTERT expression levels in Hela and Caski cell lines are significantly different and the level of hTERT expression in the Caski cell line was slightly higher than that of Hela cell line. The significant difference between hTERT mRNA expression levels reported here could be used as a tumor marker for HPV16 and HPV18 in cervical cancer.
Malihe Hasanzadeh , Hossein Ayatollahi , Shahnaz Ahmadi , Shahram Rahimi Namaghi,
Volume 74, Issue 4 (July 2016)
Volume 74, Issue 4 (July 2016)
Abstract
Background: Gestational trophoblastic neoplasia (GTN) consists of a broad spectrum of benign and malignant tumors which are stem in human placental trophoblast. Vitamin D has several biologic rules. Among the effects of vitamin D on cells, we could mention induction of differentiation and apoptosis and also inhibition of proliferation, angiogenesis and metastatic potency. As nutrition plays a pivotal rule in GTN, in this study we compared serum 25-hydroxy-vitamin D [25(OH) vitamin D] in patients with GTN and normal pregnant women.
Methods: In this prospective case-control study, 30 GTN patients and 48 normal pregnant women were considered as control group who referred to Qaem University Hospital, Mashhad, Iran, from July 2013 to October 2015 were included. All included persons to the study had no history of chemotherapy or using vitamin D supplements. After filling informed consent forms and recording demographic data, 25(OH) vitamin D serum level were measured in both group by enzyme-linked immunosorbent assay (ELISA) method.
Results: Age in two groups was the same (P=0.565). There was no significant difference in gestational age between two groups (P=0.887). Pathologic diagnosis in 83.33% (25 patients) was complete hydatidiform mole and in 16.67% (5 patients) was partial hydatidiform mole. 25(OH) vitamin D serum level in 73.3% of GTN patients and 2.1% of normal pregnant women was lower than 10 ng/ml and among all participants, only 6.3% of pregnant patients had 25(OH) vitamin D serum level higher than 30 ng/ml. Mean serum level of 25(OH) vitamin D in GTN patients was significantly lower than pregnant women group (9.09±5.46 vs. 20.06±6.37, P=0.000). 25(OH) vitamin D serum level between complete and partial hydatidiform mole groups had no significant difference (P=0.384).
Conclusion: Altogether, it was observed that 25(OH) vitamin D serum level is significantly lower in women with GTN than normal pregnant women. Modifying serum levels of vitamin D in molar pregnancy with low level of vitamin D may prevent the development of GTN.
Raika Jamali , Ebrahim Mosavi Jahan Abad, Tayeb Ramim ,
Volume 74, Issue 5 (August 2016)
Volume 74, Issue 5 (August 2016)
Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) includes steatosis, nonalcoholic steatohepatitis, fibrosis and liver cirrhosis. The oxidative stress enzymes are the diagnostic markers to prediction of histologic status of liver in nonalcoholic steatohepatitis disease. The aim of the study was to assessment of relationship between serum Zinc (Zn) levels with pathologic manifestation in patients with nonalcoholic steatohepatitis.
Methods: This cohort study was done in patients with nonalcoholic steatohepatitis that had been visited in gastrointestinal clinic of Sina Hospital, Tehran, Iran from April, 2014 to April, 2015. Control group included the patients with no clinical manifestation of nonalcoholic steatohepatitis and normal liver ultrasonography, lab test and liver biopsy. Serum Zn level was measured with atomic absorption spectroscopy. Normal Serum level of Zn was considered 10.7-22.9 µmol/L (70-150 µg/dL) and less than 7 µg/dL was considered as Zn deficiency. Pathological findings were grading according to NAFLD activity score.
Results: One hundred twenty patients were selected for the study in two equal groups. Six and 26 patients were excluded in case and control groups, respectively due to no consent to lab test. Finally, 54 patients (35 male/19 female) and 34 patients (22 male/12 female) in control group were participated in data analysis. The mean age on case and control group was 37.02±9.82 year and 33.24±12.01 year, respectively (P= 0.111). Zn level in case and control groups were 90.82±13.69 and 88.82±13.10, respectively. There were no statistically significant differences between two group in serum Zn level (P= 0.50). Also, there were no statistically significant differences between pathological grading in case group participants (steatosis: P= 0.640; Lobular inflammation: P= 0.882; fibrosis: P= 0.531).
Conclusion: The finding of the study showed no significant association between serum zinc level and hepatic steatosis, lobular inflammation and fibrosis of the liver in nonalcoholic steatohepatitis.
Roya Mahdavi, Mitra Jamali, Mehdi Rostami, Amin Safa, Abdollah Jafarzadeh, Mohsen Naseri,
Volume 74, Issue 6 (September 2016)
Volume 74, Issue 6 (September 2016)
Abstract
Background: Multiple sclerosis (MS) is a chronic inflammatory disorder of the CNS characterized by destruction of the myelin sheath, gliosis and progressive neurological dysfunction. The regulatory T (Treg) cells play a major role in the control of the autoimmunity and inflammation. The forkhead box p3 (FOXP3) is a central molecule in the function of Treg cells that play an important role in the immunoregulation. The aim of this study was to investigation single nucleotide polymorphism (SNP), rs2232365, in FOXP3 gene in patients with multiple sclerosis.
Methods: In a case-control study, peripheral blood samples were collected from 90 patients with MS (46 men and 94 women with different patterns of disease) from January 2014 to April 2015 in the Afzalipoor Hospital, Kerman (a city located in the southeast of Iran). In a total, 90 healthy subjects were also enrolled into the investigation as a control group. The healthy subjects were recruited among blood donations of the Kerman Transfusion Organization and interviewed regarding CNS disease, and none of them had any history of CNS diseases or other relevant disorders. The SNP rs2232365 in FOXP3 gene was assessed by single specific primer-polymerase chain reaction (SSP-PCR) method. Finally, statistical analysis was performed using SPSS version 22 (Chicago, IL, USA).
Results: In both patients and healthy control groups, there was significant difference among subjects with GG, AG, and AA genotypes at rs2232365 in FOXP3 gene. The frequencies of AA and AG genotypes at rs2232365 in the FOXP3 gene were significantly higher in MS group as compared with healthy subjects (P<0.002). Moreover, the frequency of GG genotype was significantly lower in the MS group in comparison with healthy control subjects (P<0.002). The frequency of A allele was significantly higher whereas the frequency of G allele was significantly lower in MS patients as compared with healthy subjects (P<0.001).
Conclusion: The results of the present study suggest that SNP rs2232365 may influence the susceptibility to multiple sclerosis. Therefore, SNP rs3761548 may directly or indirectly alter the level of the FOXP3 protein expression in Treg cells.
Zohreh Yousefi , Sima Kadkhodayan , Maliheh Hasanzadeh Mofrad , Behroz Davachi , Mansoureh Mottaghi , Elham Hoseini , Monavar Afzalaghaee , Asieh Maleki ,
Volume 74, Issue 9 (December 2016)
Volume 74, Issue 9 (December 2016)
Abstract
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Background: Surgical staging is the standard treatment of ovarian cancer. Pelvic and para-aortic lymphadenectomy is the important part of the surgery. The aim of this study was to evaluate the effect of para aortic lymph node dissection in early stage of patients with ovarian cancer. Methods: This descriptive cross-sectional cohort study was performed on all stage I of ovarian cancer patients admitted in department of gynecology oncology of Ghaem Hospital, Mashhad University of Medical Sciences in November 2012 to March 2014. Every patient with clinical early stage of ovarian cancer candidate to surgical treatment selected. All cases underwent surgical staging surgery with concurrent systematic pelvic and para-aortic lymphadenectomy. In laparotomy after identification of left and right iliac artery, all lymph nodes have been properly exposed and dissected as a part of a staging laparotomy. The dissection was continued up to the nodal tissues surrounding the aorta, and inferior vena cava, until inferior mesenteric artery lymphadenectomy level. The procedure performed only by gynecologist oncologist. In addition, we assessed other parameters such as operation time, estimated blood loss, associated mortality and morbidity and vascular injuries. Finally, the effect of para aortic lymph node dissection in early stage of ovarian cancer evaluated. Results: Among a total of 57 ovarian cancer patients, 27 of them apparent stage I disease cases were selected. Surgical staging surgery with concurrent systematic pelvic and para-aortic lymphadenectomy was carried for all of them. Positive para-aortic lymph node was found only in one case. The average number removed para-aortic lymph nodes in the pelvis was 9 and in para aortic was 7, respectively. In addition, 20 minutes increase in total length of operation time was observed duo to para-aortic lymphadenectomy. Also the rate increase in intra-abdominal hemorrhage rate was estimated 60 ml. Conclusion: Lymph node dissection will produce a significant benefit in accurate and complete surgical staging. Staging surgery in addition to systematic pelvic and para aortic lymph adenoctomy in early stage ovarian cancer is preferred in gynecologic oncology centers. |
Rezvan Esmaeili , Tannaz Samadi , Nasrin Abdoli , Keivan Majidzadeh-Ardebili , Leila Farahmand , Malihe Salehi ,
Volume 74, Issue 10 (January 2017)
Volume 74, Issue 10 (January 2017)
Abstract
Background: Researchers are always trying to find specific markers which express specifically in cancer. These specific markers help to diagnose and treat cancer without affecting normal tissues. Cancer-testis antigens are among the new promising biomarkers, especially for targeted therapy. These markers are specially expressed in testis. Various studies have been reported individual expression of these proteins in some tumor tissues. Since testis is an immune privilege organ, abnormal expression of the above mentioned genes raises immune response and the serum antibody against them (CT antigene) can be detected as a marker of cancer. However, understanding their differential role in normal and cancer tissues may introduce them as new candidates of cancer biomarkers. The aim of this study was to evaluate AKAP3 gene expression in breast cancer and its correlation with clinicopathologic features of the disease.
Methods: This study is a case-control study conducted at the Brest Cancer Research Center (BCRC)- Iran, between October 2014 to May 2016. AKAP3 gene expression was investigated with real-time PCR in breast samples including: 74 tumors, 73 normal adjacents and 15 normal tissues. On the other hand the correlation between gene expression, clinicopathologic features of the tumors and treatment regimen were evaluated.
Results: Statistical analysis showed a significant correlation between lack of AKAP3 expression, tumor size (P=0.01) and stage (P=0.04). The association between poor prognosis and the absence of AKAP3 expression in normal adjacent tissues were observed. Kaplan Meier plot showed a significant better disease free survival in the normal adjacent patients group that are expressed AKAP3.
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Conclusion: It was observed that the better free survival in the normal adjacent group is because of the different AKAP3 expression, not treatment variations between two patient groups. As a result, AKAP3 can be a suitable candidate biomarker for breast cancer patients. Also, the study of gene expression in normal tissue of patients may be used to predict response to therapy. |
Aisa Rassoli , Malikeh Nabaei , Nasser Fatouraee , Ghaemeh Nabaei ,
Volume 75, Issue 1 (April 2017)
Volume 75, Issue 1 (April 2017)
Abstract
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Background: Brain hypothermia by reducing the temperature of the cerebrospinal fluid is done by a cooling pad in the thoracic region and protect brain from the ischemic injuries. Along with the spinal cord, the brain is an essential partner in the central nervous system, and similarly, it is surrounded and protected from the bony skull and from shock by cerebrospinal fluid. The brain analyzes information that is both internal and external to the body, transforms the information into sensations, and stores them as memories. So in this study we investigated the brain hypothermia by finite element modeling. Methods: To investigate this phenomenon, in this study a numerical model of the head with respect to the structure of brain tissue and its contribution to heat transfer is presented in the fluid lab of the Amirkabir University of Tehran in January of 2016. In this model, Pennes's bioheat equation and finite element analysis has been used to predict temperature distribution in the brain tissue. The model geometry is designed in two state without considering the ventricles of the brain that are involved in the production of cerebrospinal fluid and with considering cerebrospinal fluid. So, in the second case, the cerebrospinal flow is considered as a heat transfer factor. Results: We concluded that with cooling about 5 °C, in the first model without considering the ventricles, the gray matter temperature is reduced by about 4 °C and there is no change in white matter temperature. In the second model temperature distribution became more asymmetric. The temperature reduced about 3 °C in the corners. However, the temperature reduction at the edge of brain tissue and near cerebrospinal fluid were about 0.5 °C. |
Conclusion: It was observed that in the case of ischemia, the temperature drop was higher than normal. So, during brain injuries to prevent serious damage, the brain metabolism can be reduced by cooling the spinal fluid.
Soraya Ghorbani , Roshanak Daie Ghazvini , Seyyed Jamal Hashemi , Parivash Kordbacheh , Ensieh Zibafar , Zahra Kamali Sarwestani, Heidar Bakhshi , Pegah Ardi ,
Volume 75, Issue 4 (July 2017)
Volume 75, Issue 4 (July 2017)
Abstract
Background: Candida species are opportunistic yeasts that are capable of causing different infections and diseases among immunocompromised patients. Since Candida infections are major causes and frequent of septicemia in Neonatal Intensive Care Units (NICU), and they are associated with high morbidity and mortality rates, so obtaining adequate treatment seems necessary. Low birth weight preterm infants are especially vulnerable to these devastating infections. The aim of this study was to evaluate the drug susceptibility of Candida species colonized on the skin and mucous membrane of neonates to fluconazole, amphotericin B and caspofungin.
Methods: This study was carried out in the laboratory of medical mycology and serology, School of Public Health, Tehran University of Medical Sciences for the period of 7 months from June 2016 to December 2016. In this descriptive cross-sectional study, 23 isolates of Candida species including Candida parapsilosis, Candida albicans, Candida tropicalis, Candida guilliermondii and Candida krusei were studied. These under study isolates were previously isolated from skin and mucous membranes of neonates in NICU of Imam Khomeini Hospital and Children's Medical Center were identified by PCR-RFLP (Polymerase chain reaction-restriction fragment length polymorphism). Evaluation of antifungal drug susceptibility including fluconazole, amphotericin B and caspofungin was carried out. Antifungal susceptibility test was done according to the standard protocol Clinical and Laboratory Standards Institute (CLSI M27-A3) that is specific to the yeast fungi. Statistical analysis was done by using T-test in SPSS version 22 (IBM, Armonk, NY, USA) and P<0.05 was considered statistically significant.
Methods: This study was carried out in the laboratory of medical mycology and serology, School of Public Health, Tehran University of Medical Sciences for the period of 7 months from June 2016 to December 2016. In this descriptive cross-sectional study, 23 isolates of Candida species including Candida parapsilosis, Candida albicans, Candida tropicalis, Candida guilliermondii and Candida krusei were studied. These under study isolates were previously isolated from skin and mucous membranes of neonates in NICU of Imam Khomeini Hospital and Children's Medical Center were identified by PCR-RFLP (Polymerase chain reaction-restriction fragment length polymorphism). Evaluation of antifungal drug susceptibility including fluconazole, amphotericin B and caspofungin was carried out. Antifungal susceptibility test was done according to the standard protocol Clinical and Laboratory Standards Institute (CLSI M27-A3) that is specific to the yeast fungi. Statistical analysis was done by using T-test in SPSS version 22 (IBM, Armonk, NY, USA) and P<0.05 was considered statistically significant.
| Results: In this study, C. parapsilosis, C. albicans and C. tropicalis had the most sensitivity to fluconazole. Clinical Isolates of C. guilliermondii were also sensitive to fluconazole, but in C. krusei sensitivity was dose-dependent. All isolated species were sensitive to amphotericin B and caspofungin. |
Conclusion: According to the results, all isolated Candida species were more sensitive to amphotericin B and caspofungin than other antifungal drugs. In final conclusion, Finally, it is emphasized that antifungal susceptibility testing is necessary to prevent treatment failure or recurrence of disease.
Zahra Kamali Sarwestani , Alireza Dasdar , Setareh Agha Kuchak Afshari , Mohsen Gerami Shoar , Seyyed Jamal Hashemi , Reza Pakzad , Pegah Ardi , Alireza Abdollahi , Mohammad-Taghi Haghi-Ashtiani, Shahram Mahmoudi ,
Volume 75, Issue 4 (July 2017)
Volume 75, Issue 4 (July 2017)
Abstract
Background: Fungi have a worldwide distribution which can cause a broad spectrum of disease ranging from allergic to systemic infections, particularly in immuno-compromised individuals. Fungal spores are an important group of bioaerosols in hospital environment which are an emerging cause of hospital-acquired infection. Nosocomial infections cause significant morbidity and mortality as well as large financial burden on the healthcare system. This study aimed to evaluate the frequency and species distribution of airborne fungi in selected wards of two tertiary hospitals in Tehran, Iran.
Methods: In this cross-sectional study, samples were collected during six months from July 2016 to December 2016 by using of settle plate method. Samples were collected from selected wards of Imam Khomeini Hospital and Children's Medical Center and then incubated at 28 °C for 8-10 days. Fungal isolates were identified using the macroscopic features of colony and microscopic characteristics in slide cultures. Yeast isolates were identified by CHROMagar candida medium. PCR-sequencing of ITS1-5.8 S-ITS2 region of ribosomal DNA was used for identification of unknown isolates.
Results: A total of 202 colonies including 133 colonies from the Imam Khomeini Hospital and 69 colonies from the Children's Medical Center were isolated. Cladosporium spp. were the most common obtained fungi accounted for 30.1% and 47.8% of all isolates in the Imam Khomeini Hospital and the Children's Medical Center, respectively. Penicillium spp. and Aspergillus spp. were other frequent species in two hospitals. Infectious diseases ward in Imam Khomeini hospital and emergency and urology wards in Children's Medical Center had the highest rate of contamination.
Conclusion: According to the results of this study, the frequency and diversity of fungal spores in hospital wards were different. In addition, since the fungal contamination in the hospital environment are affected by various environmental factors and the efficiency of ventilation systems, some of these wards require better ventilation system as well as regular monitoring to remove these fungal bioaerosols in order to maintain the health of patients and health care workers.
Methods: In this cross-sectional study, samples were collected during six months from July 2016 to December 2016 by using of settle plate method. Samples were collected from selected wards of Imam Khomeini Hospital and Children's Medical Center and then incubated at 28 °C for 8-10 days. Fungal isolates were identified using the macroscopic features of colony and microscopic characteristics in slide cultures. Yeast isolates were identified by CHROMagar candida medium. PCR-sequencing of ITS1-5.8 S-ITS2 region of ribosomal DNA was used for identification of unknown isolates.
Results: A total of 202 colonies including 133 colonies from the Imam Khomeini Hospital and 69 colonies from the Children's Medical Center were isolated. Cladosporium spp. were the most common obtained fungi accounted for 30.1% and 47.8% of all isolates in the Imam Khomeini Hospital and the Children's Medical Center, respectively. Penicillium spp. and Aspergillus spp. were other frequent species in two hospitals. Infectious diseases ward in Imam Khomeini hospital and emergency and urology wards in Children's Medical Center had the highest rate of contamination.
Conclusion: According to the results of this study, the frequency and diversity of fungal spores in hospital wards were different. In addition, since the fungal contamination in the hospital environment are affected by various environmental factors and the efficiency of ventilation systems, some of these wards require better ventilation system as well as regular monitoring to remove these fungal bioaerosols in order to maintain the health of patients and health care workers.
Soudabeh Shahid Sales , Malihe Hasanzadeh , Seyyedeh Sania Saggade , Seyed Amir Al Davoud ,
Volume 75, Issue 5 (August 2017)
Volume 75, Issue 5 (August 2017)
Abstract
Background: Breast cancer is the most common cancer in women and can have several profound effects on women’s life. Estrogen and androgens reduction cause sexual problems. Reduction of hormones produce problems such as vaginal dryness, vaginal and vulvar tissue thinning, loss of elasticity of the vagina, hot flashes and other problems. Depression in these patients is also a factor in reducing sexuality. Disruption at any sexual stage can cause sexual problems. In this article; we compare sexual dysfunction in patients with breast cancer and healthy people.
Methods: According to the women’s case-control study with simple un-randomized sampling method a total of 245 patients with breast cancer in Ghaem and Emam Reza and Omid hospital from july 2011 to july 2013 entered the study. All patients were on follow-up after therapy, and had a therapy portfolio. In order to achieve better results, questionnaires were distributed among 126 healthy subjects that matched our patient group in terms of age and other factors and were used as the control group. Female sexual function index (FSFI) questionnaire was filled out by an independent interviewer and all medical, personal and social ethics were applied. The data was then gathered and the score were analyzed with statistical tests.
Methods: According to the women’s case-control study with simple un-randomized sampling method a total of 245 patients with breast cancer in Ghaem and Emam Reza and Omid hospital from july 2011 to july 2013 entered the study. All patients were on follow-up after therapy, and had a therapy portfolio. In order to achieve better results, questionnaires were distributed among 126 healthy subjects that matched our patient group in terms of age and other factors and were used as the control group. Female sexual function index (FSFI) questionnaire was filled out by an independent interviewer and all medical, personal and social ethics were applied. The data was then gathered and the score were analyzed with statistical tests.
| Results: The study was performed on patients 20 to 50 years, mainly in patients aged 35 to 45 years (51.8%). The average age was 41.44±5.87 years. In our study, the most dysfunction was in sexual desire (57.6%), vaginal moisture (53.1%), sexual excitement (48.2%), orgasm (44.1%), and dyspareunia (52.2%) in breast cancer patients. There was significant difference between two group (P<0.001).There is no difference about sexual satisfaction between two groups (P=0.262). Conclusion: Sexual dysfunction is common in breast cancer patients compared to healthy women. Dysfunction in orgasm, dyspareunia, reducing vaginal moisture and sexual desire were common in the breast cancer patient. The results of this study should be used to inform patients and physician about sexual problems. |
Malihe Hasanzadeh , Mina Baradaran Khalkhale , Akram Behroznea, Leila Musavi ,
Volume 75, Issue 12 (March 2018)
Volume 75, Issue 12 (March 2018)
Abstract
Background: Graves' disease is the most common cause (85% of all cases) of thyrotoxicosis in women in childbearing age. Many of the symptoms are similar to hyper-metabolic status during pregnancy. The cause of the disease is autoantibodies that stimulate the thyroid-stimulating hormone (TSH) receptor. Hyperthyroidism is uncommon in pregnancy and its prevalence is 0.1-%0.4. In this paper we introduce a patient who was admitted with a primary diagnosis of pulmonary embolism and treatment with final diagnosis of thyroid storm and was discharged with good condition.
Case presentation: In the first pregnancy of a 29-year-old woman with gestation age of 31 weeks was referred to obstetric emergency unit Ghaem Hospital, Mashhad, Iran in March 2015. She had Grave’s disease in her past medical history which was treated with methimazole before pregnancy and propylthiouracil (PTU) during pregnancy. In admission, she presented with tachycardia and tachypnea and hypertension and lower extremity edema. During pregnancy, she used propantheline instead of propylthiouracil due to pharmacy mistake. She admitted in Intensive care unit. After rule out of pulmonary embolism, ultrasonography showed a fetus with 30 weeks of gestational age with an approximate weight of 1680 grams. The amniotic fluid was reduced. She was treated with thyroid storm diagnosis due to a medication error. In serial obstetric visits fetal heart rate was not detected. Due to the fetal death, the pregnancy was terminated. Hyperthyroid therapy continued with PTU after delivery. She was discharged with a good general condition.
Conclusion: Despite the rarity of thyroid storm during pregnancy, in the event of unstable hemodynamic condition and cardiac dysfunction in pregnant women, rule out of thyroid disorders should be considered. Clinician should be paid attention to past drug history and underline disease of patient.
Case presentation: In the first pregnancy of a 29-year-old woman with gestation age of 31 weeks was referred to obstetric emergency unit Ghaem Hospital, Mashhad, Iran in March 2015. She had Grave’s disease in her past medical history which was treated with methimazole before pregnancy and propylthiouracil (PTU) during pregnancy. In admission, she presented with tachycardia and tachypnea and hypertension and lower extremity edema. During pregnancy, she used propantheline instead of propylthiouracil due to pharmacy mistake. She admitted in Intensive care unit. After rule out of pulmonary embolism, ultrasonography showed a fetus with 30 weeks of gestational age with an approximate weight of 1680 grams. The amniotic fluid was reduced. She was treated with thyroid storm diagnosis due to a medication error. In serial obstetric visits fetal heart rate was not detected. Due to the fetal death, the pregnancy was terminated. Hyperthyroid therapy continued with PTU after delivery. She was discharged with a good general condition.
Conclusion: Despite the rarity of thyroid storm during pregnancy, in the event of unstable hemodynamic condition and cardiac dysfunction in pregnant women, rule out of thyroid disorders should be considered. Clinician should be paid attention to past drug history and underline disease of patient.
Mahdieh Molanouri Shamsi , Afsaneh Jamali,
Volume 76, Issue 2 (May 2018)
Volume 76, Issue 2 (May 2018)
Abstract
Background: The herpes simplex viruses cause a variety of clinical illnesses that are painful and often distressing. To control the infection, the development of an effective vaccine that prevents or reduces the primary and recurrent infections would be of great significance. With considering to immunological changes following an acute endurance exercise, the purpose of this study was to assess adjuvant effects of an acute endurance exercise in first herpes simplex virus 1 vaccine injection and its booster shots on interleukin-10 cytokine and granzyme B levels.
Methods: This experimental study was carried out in Tarbiat Modares University during May to October 2016. 32 BALB/c mice were divided into 4 groups: control, vaccine, vaccine plus an acute exercise in first injection and vaccine plus an acute endurance exercise in first injection and booster shots. Mice without or with access to acute endurance exercise were immunized intramuscularly with inactivated KOS strain of HSV-1. Two weeks after three booster shots of vaccine, interleukin-10 and granzyme B levels were determined in spleen cell culture with enzyme-linked immunosorbent assay (ELISA) method.
Results: This study was undertaken to test the hypothesis that an acute endurance exercise as an adjuvant in herpes simplex virus 1 vaccine can change interleukin-10 cytokine and granzyme B levels in mouse model. The result of this study showed significant differences between groups in interleukin-10 and granzyme B levels (P=0.001). Increasing in granzyme B levels with concurrent decreases in interleukin-10 levels was observed following using vaccine plus acute exercise in first injection of vaccine and booster shots.
Conclusion: It is suggested that exercise may stimulate parameters related to cellular immunity and hence decrease the risk of infection decreased levels of interleukin-10 in experimental group that had vaccine plus acute exercise in the first injection of vaccine and booster shots as an adjuvant was observed. These results demonstrate alternation of T helper 2 cells function and improve of cell immunity for protection against herpes simplex virus 1 infections.
Methods: This experimental study was carried out in Tarbiat Modares University during May to October 2016. 32 BALB/c mice were divided into 4 groups: control, vaccine, vaccine plus an acute exercise in first injection and vaccine plus an acute endurance exercise in first injection and booster shots. Mice without or with access to acute endurance exercise were immunized intramuscularly with inactivated KOS strain of HSV-1. Two weeks after three booster shots of vaccine, interleukin-10 and granzyme B levels were determined in spleen cell culture with enzyme-linked immunosorbent assay (ELISA) method.
Results: This study was undertaken to test the hypothesis that an acute endurance exercise as an adjuvant in herpes simplex virus 1 vaccine can change interleukin-10 cytokine and granzyme B levels in mouse model. The result of this study showed significant differences between groups in interleukin-10 and granzyme B levels (P=0.001). Increasing in granzyme B levels with concurrent decreases in interleukin-10 levels was observed following using vaccine plus acute exercise in first injection of vaccine and booster shots.
Conclusion: It is suggested that exercise may stimulate parameters related to cellular immunity and hence decrease the risk of infection decreased levels of interleukin-10 in experimental group that had vaccine plus acute exercise in the first injection of vaccine and booster shots as an adjuvant was observed. These results demonstrate alternation of T helper 2 cells function and improve of cell immunity for protection against herpes simplex virus 1 infections.
Masoud Ahmadzad-Asl , Shayan Mostafaei , Shahram Rafiefar , Navid Mohammadi , Malihe Farid , Kourosh Kabir ,
Volume 76, Issue 4 (July 2018)
Volume 76, Issue 4 (July 2018)
Abstract
Background: The study of their knowledge, attitude, and behavior toward health is an essential step for health planning. In the urban area, there are several concerns about environmental pollution, health status, the dangers of insecurity, and bad dietary habits. The aim of the study was the determination of knowledge, attitude, and behavior of Tehran citizens in order to plan better municipal services.
Methods: This descriptive, cross-sectional study was conducted on 13000 participants between 15-84 years in 22 districts of Tehran, Iran University of Medical Sciences, in August and September of 2011. Cluster sampling and self-administered reliable and valid questionnaire were used for data gathering. The inclusion criteria are all of citizens of Tehran. Age, sex, marital and job status, obesity, physical activity, hypertension, myocardial infarction, accidents, diabetes, nutrition, stroke, psychological behavior, smoking, addiction and drugs, musculoskeletal, sexual behavior, anemia, physical environment, fat blood, cancer, chronic obstructive pulmonary disease, dietary habits and socioeconomic status were measured under standard protocols and by using calibrated instruments.
Results: From 13000 participants in the study, 11753 (90%) was fulfilled the questioners. Nonresponse rate from 11753 participants was 8.6%. The proportion of obesity/overweight was 50% and 29.5% of people had appropriate physical exercise, 37.6% reported a tobacco consumer in their family and 4.5% reported an experience of substance misuse. Also, 29.2% and 24.8% from these had anomalistic consuming of salt and soft drink, respectively. Of the participants, 44.8%, 89.1% had a good knowledge and attitude, respectively. Cronbach alpha coefficient was 0.82 and 0.79 for knowledge, attitude and behavior, respectively. In additional, the correlation coefficient between test and re-test questions was 0.91.
Conclusion: This study was a comprehensive study to measure the knowledge, attitude and practice of Tehran citizens using reliable and valid questionnaires about general health status. A considerable percentage of Tehran citizens suffering from overweight, obesity, hypertension, diabetes, high blood lipids and smoking consuming and using anomalistic from TV and computer. The results can be used as a framework and guide to prioritize problems and planning health education interventions in Tehran
Methods: This descriptive, cross-sectional study was conducted on 13000 participants between 15-84 years in 22 districts of Tehran, Iran University of Medical Sciences, in August and September of 2011. Cluster sampling and self-administered reliable and valid questionnaire were used for data gathering. The inclusion criteria are all of citizens of Tehran. Age, sex, marital and job status, obesity, physical activity, hypertension, myocardial infarction, accidents, diabetes, nutrition, stroke, psychological behavior, smoking, addiction and drugs, musculoskeletal, sexual behavior, anemia, physical environment, fat blood, cancer, chronic obstructive pulmonary disease, dietary habits and socioeconomic status were measured under standard protocols and by using calibrated instruments.
Results: From 13000 participants in the study, 11753 (90%) was fulfilled the questioners. Nonresponse rate from 11753 participants was 8.6%. The proportion of obesity/overweight was 50% and 29.5% of people had appropriate physical exercise, 37.6% reported a tobacco consumer in their family and 4.5% reported an experience of substance misuse. Also, 29.2% and 24.8% from these had anomalistic consuming of salt and soft drink, respectively. Of the participants, 44.8%, 89.1% had a good knowledge and attitude, respectively. Cronbach alpha coefficient was 0.82 and 0.79 for knowledge, attitude and behavior, respectively. In additional, the correlation coefficient between test and re-test questions was 0.91.
Conclusion: This study was a comprehensive study to measure the knowledge, attitude and practice of Tehran citizens using reliable and valid questionnaires about general health status. A considerable percentage of Tehran citizens suffering from overweight, obesity, hypertension, diabetes, high blood lipids and smoking consuming and using anomalistic from TV and computer. The results can be used as a framework and guide to prioritize problems and planning health education interventions in Tehran
Sima Kadkhodayan , Asieh Maleki , Malihe Hasanzadeh , Zohreh Yousefi,
Volume 76, Issue 5 (August 2018)
Volume 76, Issue 5 (August 2018)
Abstract
Background: Cancer of the endometrium is the most common gynecologic malignancy in western and industrial countries, and is the second most common in developing countries, therefore it is of special importance. Adenocarcinoma of the endometrium is the most common type of uterine cancer. The prevalence of endometrial cancer in young women under the age of 40 in western country is very low and about 5 percent. The aim of this study was to determine the prevalence of endometrial cancer at age ≤40 years in our center during 4 years.
Methods: In a cross-sectional study, all medical records of patients with endometrial cancer in Ghaem University Hospital, Mashhad, Iran was reviewed to identify women <40 years of age with endometrial cancer, over the course of 4 years, (from 2012 to 2015). The risk factors for endometrial cancer, such as obesity, polycystic ovary syndrome (PCO), infertility, and a history of cancer in the family or individual, were collected in each patient. Clinical features, histological type of endometrial carcinoma, and therapeutic action also were gathered.
Results: A total of 119 patients with endometrial cancer that was admitted in our genecology oncology center were evaluated. 19 patients (15.9%) were younger than 40 years old. 16 cases (84.2%) with endometrial adenocarcinoma and 3 (15.7%) had endometrial stromal sarcoma. The youngest patient was 27 years old and the oldest was 39 years. Seven patients (8/36%) had infertility and we don’t know about fertility condition in 3, because they were single. 12 cases (63%) were overweight (BMI≥35) and 6 cases (5/31%) had polycystic ovarian disease (PCOD). In 2 patients, there was concomitant ovarian and endometrial cancer. Histology report of both ovaries was endometrioid and both patients were overweight. Obesity, poly cystic ovary syndrome (PCOD) and Infertility were the most important risk factors for endometrial cancer in young patients.
Conclusion: The prevalence of endometrial cancer in young women under the age of 40 in our country is so higher than the statistics provided in industrial countries.
Methods: In a cross-sectional study, all medical records of patients with endometrial cancer in Ghaem University Hospital, Mashhad, Iran was reviewed to identify women <40 years of age with endometrial cancer, over the course of 4 years, (from 2012 to 2015). The risk factors for endometrial cancer, such as obesity, polycystic ovary syndrome (PCO), infertility, and a history of cancer in the family or individual, were collected in each patient. Clinical features, histological type of endometrial carcinoma, and therapeutic action also were gathered.
Results: A total of 119 patients with endometrial cancer that was admitted in our genecology oncology center were evaluated. 19 patients (15.9%) were younger than 40 years old. 16 cases (84.2%) with endometrial adenocarcinoma and 3 (15.7%) had endometrial stromal sarcoma. The youngest patient was 27 years old and the oldest was 39 years. Seven patients (8/36%) had infertility and we don’t know about fertility condition in 3, because they were single. 12 cases (63%) were overweight (BMI≥35) and 6 cases (5/31%) had polycystic ovarian disease (PCOD). In 2 patients, there was concomitant ovarian and endometrial cancer. Histology report of both ovaries was endometrioid and both patients were overweight. Obesity, poly cystic ovary syndrome (PCOD) and Infertility were the most important risk factors for endometrial cancer in young patients.
Conclusion: The prevalence of endometrial cancer in young women under the age of 40 in our country is so higher than the statistics provided in industrial countries.
Mitra Jamali , Mehdi Rostami Rad , Gholamreza Anani Sarab , Roya Mahdavi ,
Volume 76, Issue 7 (October 2018)
Volume 76, Issue 7 (October 2018)
Abstract
Background: Multiple sclerosis is the most common autoimmune demyelinating disease of the central nervous system (CNS). Interleukin-33 (IL-33) is a cytokine with both pro-inflammatory and anti-inflammatory activities that implicated in the pathogenesis of some autoimmune diseases. The aim of this study was to determine single nucleotide polymorphism (SNP) of IL-33, rs1929992, in patient’s gene with multiple sclerosis (MS) and investigation of this polymorphism with susceptibility to MS.
Methods: In this case-control study, peripheral blood samples were collected from 140 MS patients (patients in the Afzalipur Hospital in Kerman) and blood sample of 140 healthy subjects (people referred to the Blood Transfusion Organization) as a control group from March 2016 to January 2018. SNP at rs1929992 was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.
Results: There was significant difference between healthy control group and patient with multiple sclerosis in the frequency of genotypes. The frequency of AA genotype at rs1929992 was significantly higher in the MS group in comparison with healthy control subjects (P= 0.0001), whereas frequency of AG genotype was significantly higher in the control group as compared with MS group (P= 0.02). There was no significant difference between the MS patients and healthy control group in GG genotype. Moreover, the frequencies of AA genotype at SNP rs1929992 were significantly higher in patients with secondary progressive MS (SP-MS) and primary progressive MS (PP-MS) as compared with control group (P= 0.03). However, the frequencies of AG genotype was significantly lower in patients with relapsing-remitting MS (RRMS) in comparison to the healthy group (P= 0.01). In patients with RR-MS, PP-MS and SP-MS patterns, the frequencies of A allele was significantly higher than that in control group (P= 0.03, P= 0.01, P= 0.001). In patients with RR-MS, PP-MS and SP-MS pattern, the frequency of G allele was significantly lower than control group (P= 0.03, P= 0.01, P= 0.001).
Conclusion: The results of this study suggest that the SNP rs1929992 in IL-33 gene, may be associated with different pattern of MS susceptibility.
Methods: In this case-control study, peripheral blood samples were collected from 140 MS patients (patients in the Afzalipur Hospital in Kerman) and blood sample of 140 healthy subjects (people referred to the Blood Transfusion Organization) as a control group from March 2016 to January 2018. SNP at rs1929992 was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.
Results: There was significant difference between healthy control group and patient with multiple sclerosis in the frequency of genotypes. The frequency of AA genotype at rs1929992 was significantly higher in the MS group in comparison with healthy control subjects (P= 0.0001), whereas frequency of AG genotype was significantly higher in the control group as compared with MS group (P= 0.02). There was no significant difference between the MS patients and healthy control group in GG genotype. Moreover, the frequencies of AA genotype at SNP rs1929992 were significantly higher in patients with secondary progressive MS (SP-MS) and primary progressive MS (PP-MS) as compared with control group (P= 0.03). However, the frequencies of AG genotype was significantly lower in patients with relapsing-remitting MS (RRMS) in comparison to the healthy group (P= 0.01). In patients with RR-MS, PP-MS and SP-MS patterns, the frequencies of A allele was significantly higher than that in control group (P= 0.03, P= 0.01, P= 0.001). In patients with RR-MS, PP-MS and SP-MS pattern, the frequency of G allele was significantly lower than control group (P= 0.03, P= 0.01, P= 0.001).
Conclusion: The results of this study suggest that the SNP rs1929992 in IL-33 gene, may be associated with different pattern of MS susceptibility.
Malihe Hasanzadeh, Lida Jedde , Leila Mousavi Seresht , Khatereh Vatanpoor ,
Volume 76, Issue 9 (December 2018)
Volume 76, Issue 9 (December 2018)
Abstract
Background: Twin pregnancy consist a healthy fetus, and hydatidium molar pregnancy is unusual and very rare. Its incidence is in about 1,22,000 to 1,100,000 of all pregnancies. This type of pregnancy is commonly associated with several obstetric complications requiring early termination of pregnancy. Managing a twin mole pregnancy with normal and live fetuses is controversial, although this unusual type of abnormalities in most cases leads to abortion or intrauterine fetal death. In other hand, due to the high probability of obstetric complications during pregnancy, such as preeclampsia in 25% of cases, metabolic complications such as hyperthyroidism and vaginal bleeding pregnancy is terminated. Survival of the normal coexisting fetus is variable and depends on whether the diagnosis is made, and if so, whether problems from the molar component. Present study reported a case of coexisting mole and live fetus twin pregnancy with successful outcome.
Case presentation: A 35 years old woman, G2ab1 which was diagnosed to have twin pregnancy with mole and coexisting live fetus in 11 weeks of gestational age was referred to obstetric department of Ghaem Hospital, Mashhad University of Medical Sciences, Iran in January 2017. Close follow-up and obstetric surveillance had performed for her and at the last her pregnancy was terminated in gestational age of 36 weeks; a healthy male infant. The β-human chorionic gonadotrophin (BhCG) levels still is undetectable after one year.
Conclusion: Twin pregnancy with one normal fetus and a co-existing molar pregnancy could be continued under close surveillance if the live fetus has normal karyotypes and no structural anomaly and decreasing level of serum BhCG level during the time. Close monitoring necessary even after termination due to increasing risk of persistence trophoblastic disease after termination, what was performed in this case also.
Case presentation: A 35 years old woman, G2ab1 which was diagnosed to have twin pregnancy with mole and coexisting live fetus in 11 weeks of gestational age was referred to obstetric department of Ghaem Hospital, Mashhad University of Medical Sciences, Iran in January 2017. Close follow-up and obstetric surveillance had performed for her and at the last her pregnancy was terminated in gestational age of 36 weeks; a healthy male infant. The β-human chorionic gonadotrophin (BhCG) levels still is undetectable after one year.
Conclusion: Twin pregnancy with one normal fetus and a co-existing molar pregnancy could be continued under close surveillance if the live fetus has normal karyotypes and no structural anomaly and decreasing level of serum BhCG level during the time. Close monitoring necessary even after termination due to increasing risk of persistence trophoblastic disease after termination, what was performed in this case also.
Fatemeh Masaebi , Farid Zayeri , Malihe Nasiri , Mehdi Azizmohammad Looha ,
Volume 76, Issue 11 (February 2019)
Volume 76, Issue 11 (February 2019)
Abstract
Considering the advancement of medical sciences, diagnostic tests have been developed to distinguish patients from healthy population. Therefore, Determining and evaluation of the diagnostic accuracy tests is of great importance. The accuracy of a test under evaluation is determined through the amount of agreement between its results with the results of the gold standard, and this test accuracy can be defined based on sensitivity, specificity, positive predictive value, negative predictive value and the area under the receiver operative characteristic curve (AUC). Gold standard is an accurate and error- free method to determine the presence or absence of disease of interest and classify patients, which is not available in some diseases and situations as this method is costly or invasive. In these cases, reference standard is a best available replacement method to be used by physicians to diagnostic disease. However, in some situation, the acceptable reference standard is invasive or costly and does not exist or unreliable. It can be imperfect and results of the reference standard method are not necessarily error- free and cannot be applied to everyone in the study; all these cases point to the conditions in which the gold standard is not available. The use of reference standard including error causes to incorrect separation of patients from healthy population and thus, it cannot be a comparing measure for other diagnostic tests and its results are inaccurate. Therefore, other alternatives methods are needed for evaluation and determine the diagnostic accuracy tests when the gold standard does not exist. Imputation method, correct imperfect reference standard method, the construct reference standard method, latent class models, differential verification, composite reference standard and discrepant analysis are of these alternative methods. Each of these methods, considering its features, advantages, and limitations can be used to evaluate the accuracy of diagnostic test in the absence of gold standard. The present study gave an overview of methods to evaluation of diagnostic accuracy tests when there is no gold standard and the focus of this study was on explain the concept of these solutions, review and compare them and their strengths and weaknesses.
Azadeh Zahedi, Seyed Mokhtar Esmaeilnejadganji , Sekineh Kamali Ahangar , Rahmatollah Jokar,
Volume 77, Issue 1 (April 2019)
Volume 77, Issue 1 (April 2019)
Abstract
Background: Diabetes Mellitus is a prevalent disease worldwide and foot ulcer is one of the serious complications of chronic uncontrolled diabetes which could lead to various complications such as amputation of the extremity if left untreated. Total contact casting (TCC) is the gold standard in treatment of neuropathic and neuro ischemic diabetic foot ulcers (DFU) on which less emphasize is seen on routine medical practice. The aim of this study was to emphasize on healing effect of this off-loading method and to study the possible influence of variants on the healing rate of this technique.
Methods: In this cohort study, 92 diabetic patients with complaint of plantar foot ulcer grade 0, 1 and 2 according to Wagner classification had participated in Shahid Beheshti Hospital, Babol City, Iran, from March 2014 to February 2016. The demographic and biochemical information along with dimensions of foot ulcers were carefully recorded. After the primary cleansing, surgical debridement and dressing, TCC was applied on foot by the specialist and they were requested to return weekly for changing the TCC and re-evaluation of ulcers. The healing rate was calculated as decline in ulcer surface area per week.
Results: 92 patients of study sample with mean age of 63.9±10.56 year consisted of 76 patients with DM type 2 with BMI of 31.16±3.8 kg/m² and 58 male patients. The average healing rate of ulcers treated with TCC was 0.406 ±0.168 cm²/week. The duration of diabetes on average was 17.23±6.93 years. Most of the patients (n=45) had an ulcer on the forefoot and the healing rate of midfoot ulcers was slower. The average amount of baseline HbA1c was 8.2±0.19%. There was no relation between smoking history (P=0.94) and anti-diabetic regimen used by patients (P=0.754) with the healing rate.
Conclusion: The healing rate is slower in elderly patients and those with longer duration of diabetes. So in these two groups, TCC is to be applied for a longer duration in order to achieve complete healing.
Methods: In this cohort study, 92 diabetic patients with complaint of plantar foot ulcer grade 0, 1 and 2 according to Wagner classification had participated in Shahid Beheshti Hospital, Babol City, Iran, from March 2014 to February 2016. The demographic and biochemical information along with dimensions of foot ulcers were carefully recorded. After the primary cleansing, surgical debridement and dressing, TCC was applied on foot by the specialist and they were requested to return weekly for changing the TCC and re-evaluation of ulcers. The healing rate was calculated as decline in ulcer surface area per week.
Results: 92 patients of study sample with mean age of 63.9±10.56 year consisted of 76 patients with DM type 2 with BMI of 31.16±3.8 kg/m² and 58 male patients. The average healing rate of ulcers treated with TCC was 0.406 ±0.168 cm²/week. The duration of diabetes on average was 17.23±6.93 years. Most of the patients (n=45) had an ulcer on the forefoot and the healing rate of midfoot ulcers was slower. The average amount of baseline HbA1c was 8.2±0.19%. There was no relation between smoking history (P=0.94) and anti-diabetic regimen used by patients (P=0.754) with the healing rate.
Conclusion: The healing rate is slower in elderly patients and those with longer duration of diabetes. So in these two groups, TCC is to be applied for a longer duration in order to achieve complete healing.
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