Showing 83 results for Arian
Nastaran Khosravi , Nasrin Khalesi , Samileh Noorbakhsh , Shima Javadinia , Ramin Asgarian , Azardokht Tabatabai ,
Volume 71, Issue 11 (February 2014)
Abstract
Background: Meningitis is one of the serious and dangerous infections in the infancy and childhood and rapid diagnosis of meningococcal disease is important, especially in infants. C-reactive protein (CRP) is a protein found in blood and is an acute phase protein. CRP sensitive reactive that used for diagnosis of infection. This study conducted to assessment of the relationship between cerebrospinal fluid C-reactive protein, and neonatal meningitis, as well as diagnostic value of test.
Methods: Forty nine hospitalized infant that suspected to meningitis were enrolled in this analytic cross sectional research via non probable accessible sampling. 28 patients (52.7%) of all the patients were male and 21 patients (42.8%) were female. The average age of the patients was 22.6±11.88 days. Data from clinical examinations and laboratory tests entered in a questionnaire and all of samples divided in two bacterial (septic) and non-bactria (aseptic) meningitis group. All data including cerebrospinal fluid CRP of newborns were statistically analyzed.
Results: In total, the mean and standard deviation of age was 22.6±11.88 days. 57.2% of infants were male and 42.8% were female. In total, 40.82% of infants were diagnosed with septic meningitis. There was no significant difference between septic and aseptic groups in terms of sex (P= 1.00) also in terms of age (P= 0.1). The mean and standard deviation of CRP level in septic meningitis group was 0.95±0.68 mg/L and in aseptic group was 0.16±0.36 mg/L. The CRP level difference in septic meningitis group compare with aseptic group was statistically significant (P<0.000). The finding showed that cut off point for CRP level as a diagnostic test was 0.17 mg/L, sensitivity was 95% and specificity was 86%.
Conclusion: In the present study, newborns with septic meningitis had higher cerebrospinal fluid CRP level than newborns with aseptic meningitis, and CSF-CRP can be used in rapid diagnosis of septic and aseptic meningitis. Although this result has been seen in many studies, but more research is needed.
Azam Bakhtiarian , Sattar Ostadhadi, Masoumeh Jorjani , Sepideh Hashempour , Shahrbanoo Oryan , Vahid Nikoui ,
Volume 71, Issue 12 (March 2014)
Abstract
Background: Calcium channel blockers have an important role in treatment of various cardiovascular diseases including hypertension, angina pectoris and cardiac arrhythmias, so study of cardiovascular effects of derivatives of these drugs are useful. Nifedipine is one of these drugs that used widely to treat hypertension and other cardiovascular diseases. The aim of the present study was to evaluate the central effects of synthesized dihydropyridine derivatives on systolic blood pressure and heart rate of rats and comparison to nifedipine.
Methods: Sixty four male rats, after induction of anesthesia and intracerebral ventricu-lar cannulation using stereotaxis method, were divided into eight equal groups. One week after the stereotaxis surgery, the systolic blood pressure and heart rate were eval-uated in times 15 to 60 minutes after intracerebral ventricular injection of DMSO (di-methylsulfoxide) and nifedipine in doses of 80 to 320 microgram/rat and also three synthesized dihydropyridine derivatives (A, B and C) in dose of 240 microgram/rat. Effects of these drugs on systolic blood pressure and heart rate were analyzed using two way repeated measure ANOVA statistical test, followed by Bonferroni posthoc test. All data were considered significant at P<0.05.
Results: The inhibitory effects of derivative B on systolic blood pressure and heart rate in dose of 240 microgram/rat in times of 15 and 30 minutes after injection were more potent than nifedipine (P<0.001), while A and C derivatives showed weaker inhibitory properties, compared with nifedipine. Also the inhibitory effects of derivative B on heart rate in dose of 240 microgram/rat were stronger than nifedipine in times of 15 to 60 minutes after injection (P<0.05).
Conclusion: Novel dihydropyridine derivatives can possess more potent and stable in-hibitory effects on systolic blood pressure and heart rate, and some part of these properties at least, can be attributed to their direct inhibitory effects on brain neurons.
Shima Javadi-Nia , Samileh Noorbakhsh , Anahita Izadi , Mohammad Reza Shokrollahi , Ramin Asgarian , Azardokht Tabatabaei ,
Volume 71, Issue 12 (March 2014)
Abstract
Background: Severity of respiratory infection in children is depended on various fac-tors such as causative organism and the host immunologic response to the organism. Vitamins and micronutrients play an important role in this response with supporting the immune system and therefore, the response to infections. Nutritional deprivations in children, especially vitamins and micronutrients such as zinc, vitamin A and vitamin D are very common in middle east and other countries in Asia, which is due to inappro-priate diet and nutrient loss in recurrent infections. This study aimed to evaluate the se-rum levels of vitamins A, D and zinc in hospitalized children aged six months to five years.
Methods: This analytic cross-sectional study was performed in 65 children aged six months to five years who were hospitalized in pediatric and surgical wards of Rasul Akram Hospital and Bahrami Hospital in Tehran. All of samples were evaluated ac-cording to WHO cri-teria for acute respiratory infection, and underwent measurement of serum vitamin A, vitamin D and zinc levels by using Atomic, Elisa and spectropho-tometer methods.
Results: Serum levels of vitamins A in patients with acute respiratory infection was 0.27±0.16 µg/ml and in children without infection was 0.41±0.2 µg/ml, that different wasn’t statistically significant (P=0.4). Serum levels of vitamins D in patients with acute respiratory infection was 35.37±34.68 ng/ml and in children without infection was 45.78±21.05 ng/ml, that different wasn’t statistically significant (P=0.1). Serum levels of zinc in patients with acute respiratory infection was 87.93±23.34 µg/dl and in chil-dren without infection was 106.95±23.70 µg/dl, the difference was statistically signifi-cant (P=0.002).
Conclusion: According to finding in this trial, there is a correlation between lower levels of zinc in serum, and chance of respiratory tract infection in children. Future larger studies could provide the correlation between serum levels of vitamins A & D and chance of respiratory tract infection.
Jila Yavarian , Nazanin Zahra Shafiei Jandaghi, Farhad Rezeai , Talat Mokhtari Azad,
Volume 72, Issue 1 (April 2014)
Abstract
Background: Influenza viruses are one of the most important etiological agents of res-piratory disease in humans and cause epidemics and pandemics with substantial mor-bidity and mortality worldwide. Vaccination and antiviral treatments are the sole and essential way for the prevention and control of influenza infection. During an influenza epidemic before the production of effective vaccine, antiviral treatments are the first step for the prevention and treatment of influenza infection. Adamantanes and neuraminidase inhibitors are influenza antiviral drugs. Because of the increase of drug resistant viruses, the aim of this study was the evaluation of the antiviral drug resistance in influenza A/H3N2 viruses from 2005-2013 in Iran.
Methods: In this study 50 influenza A/H3N2 viruses isolated in cell culture were tested. All samples were subjected to M and NA gene sequencing at the National Influenza Center, School of Public Health, Tehran University of Medical Sciences. RNA was ex-tracted from 200 µl of cell culture supernatants using the Roche high pure viral nucleic acid kit. RT-PCR with the Qiagen one step RT-PCR kit was done. The expected size of the PCR products were analyzed by electrophoresis using 1% agarose gels. The PCR products were sequenced for finding the drug resistant mutants.
Results: All influenza A/H3N2 viruses except four viruses circulating during 2005-2006 had Ser31Asn mutation at M2 channel protein. In the analysis of neuraminidase gene none of the A/H3N2 viruses had K292R, E119V and N294S mutations responsible for drug resistant strains.
Conclusion: This study showed circulating A/H3N2 viruses was resistant to adaman-tanes but susceptible to neuraminidase inhibitors. The national data analyzed in this re-search may help increase knowledge about influenza virus antiviral drug resistance, which is a global public health concern. The authors suggested continuing this study and also the investigation of antiviral drug resistance of influenza A/H1N1 and B viruses.
Ashraf Tavanaee Sani , Abdol Majid Fata , Mahnaz Arian ,
Volume 72, Issue 1 (April 2014)
Abstract
Background: This study was done to determine presenting features and treatment out-come of Rhino-Orbital-Cerebral Mucormycosis (ROCM).
Methods: This cross sectional study was conducted during 14 years (from 1998-2012) in two educational hospitals of Mashhad University of Medical Sciences in patients with rhino-orbital-cerebral mucormycosis. Clinical symptoms, predisposing factors, demografic parameter and treatment outcome were collected by SPSS and analyzed by cox regression model.
Results: A total of 123 cases were (92 proven, 1 probable, 30 possible). From 92 cases of proven rhino-orbital-cerebral mucormycosis, 52% men and 48% women were rec-orded. The most risk factor were diabet 42.4% and immune deficiency 38%. From which 32 patients have hematologic malignancy (50% ALL, 37.5% AML, 6.3% aplas-tic anemia, 6.3% other). Mean time of admission in hospital were 30.1±29.3 days (1-230 days). The sign and symptoms were fever 41.3%, nasal ulceration or necrosis of palate 54.3%, orbital sign 59.7%, Headache 55.4%, central nervous system sign 28.2% and facial sign 53.2%. Median time between first symptoms and start of amphotricin B was 8.2±8.6 days. Treatment consist of both surgery and amphotricin B was done in 70.5% of patients. Mean number of surgery were 1.8±1.5. The mean time of mortality was 60.3±83 day. Thirty seven percent of patients survived with a 6 months follow up.
Conclusion: Initial symptoms of sinus invasion by mucormycosis are indistinguishable from other more common causes of sinusitis. We must consider these diseases if there is nasal ulceration or necrosis of palate with fever and orbital sign. Diabet and immune deficiency are the most risk factor for rhino-orbito-cerebral mucormycosis. There is no relationship between age, predisposing factors and adverse effect of drugs with surviv-al. Progression to central nervous system in imaging pattern are related with hospital mortality. Treatment modality and number of surgery affect to mortality P= 0.001, P= 0.033. Survival was affected with the total dose of amphotericin B (P= 0.026).
Shima Javadinia , Ramin Asgarian , Samileh Noorbaksh , Behnam Soboti , Mohammad Reza Shokrollahi , Azardokht Tabatabaee ,
Volume 72, Issue 2 (May 2014)
Abstract
Background: Toxic shock syndrome (TSS), a dangerous consequence of Toxic shock syndrome toxin-1 (TSST-1) caused by Staphylococcus aureus. The early detection for infections of Staphylococcus aureus in burned children is very important, also the pre-vention for consequences of TSST-1. Fever is one of the most noticeable sign in burned children. On the other hand, fever is one of the important consequences of TSST-1 pro-duction.
Methods: This study aimed to assess the toxic shock syndrome toxin-1 level in the wound’s specimens of two groups febrile and afebrile in the hospitalized burned chil-dren in Motahari hospital Tehran, Iran in the year 2013. In this case-control study, 90 children who admitted to the burn unit, divided in two groups of 45 patients: febrile (cases group) and afebrile (control group). All of burned children under went wound biopsy, and then all of wound’s specimens were tested by PCR for specific primer of toxin producing genome. Finally all of data collected and statistically analyzed. This data include group febrile and afebrile, demographic characteristics, percentage of burned surface severity and result of PCR.
Results: The positive result for PCR test, production of TSST-1 in febrile burned chil-dren (cases group) was 37.7% and in afebrile burned children (control group) was 11.1% that this different was statistically significant (P=0.003). The mean and stan-dard deviation for percentage of burned surface (severity) in samples with positive re-sult for PCR test was 30.9±16.93 and in samples with negative result for PCR test was 20.09±11.02 that this different was statistically significant (P=0.01). There was no dif-ference between positive PCR result and negative PCR result of age and sex.
Conclusion: Direct association was approved between the production of TSST-1 and the occurrence of fever in burned children. Increased surface severity of burns also re-lated to the production of TSST-1. Further research is recommended.
Nastaran Khosravi , Nasrin Khalesi , Samileh Noorbakhsh , Azardokht Tabatabaei , Bahman Ahmadi , Ramin Asgarian , Shima Javadi-Nia,
Volume 72, Issue 8 (November 2014)
Abstract
Background: Assessment of the serum lead’s concentration in the newborn immediately after birth can be effective for the detection of lead poisoning in the early stages and prevent of developmental disorders and neuropsychiatric behaviors. This study aimed to assess the serum lead levels of cord blood in some of the hospitalized newborns.
Methods: This cross-sectional analytic study conducted in the newborns ward of two hospitals (Rasoul Akram and Akbar Abadi) From December 2011 to October 2012 in Tehran, Iran. After non-probability sampling, 60 newborns in the first days after birth, underwent the cord blood sampling and the cord blood lead levels were measured by atomic absorption spectrophotometer. Then all of data were collected and analyzed. The serum lead concentration greater than 5 μg/dl was considered valuable.
Results: In total, 61.4% of samples were boys. The mean (±SD) of gestational age was 37.4±2.64 weeks and mean (±SD) of birth weight was 2701±642.8g. The mean (±SD) of maternal age was 29.20±6.73 years. 70% of mothers were urban. 13% of mothers had a history of drug use, and 5% were current smokers. The mean (±SD) of the serum lead level of cord blood was 2.97±2.24 μg/dl. This level was not associated with fetal gender, place of residence, drug history and current smoking. This level in the 16.7% of samples was greater than 5 μg/dl (high risk cases). High risk level was associated with maternal age, weight and fetal age (P=0.02, P=0.004, P=0.03), but this level was not associated with fetal gender, place of residence, drug history and current smoking.
Conclusion: Serum lead level of cord blood was relatively higher than other studies, although the prevalence of the high risk newborns (serum blood lead levels greater than 5 μg/dl) was low. Further research has recommended assessing the serum lead level in other newborns in the different areas to identify risk factors of neuromotor outcome in infants to prevent.
Behnam Soboti , Shima Javadinia , Samileh Noorbaksh , Ramin Asgarian , Nastaran Khosravi , Azardokht Tabatabaee ,
Volume 72, Issue 12 (March 2015)
Abstract
Background: Cerebrospinal Fluid (CSF) culture for distinction between aseptic and bacterial meningitis can be difficult and long-term, and other diagnostic methods are under studying. This study aimed to assess the diagnostic value for the levels of Interleukin 1 (IL-1), IL-6 and IL-8 of CSF in the children and adolescent with meningitis.
Methods: Fifty-one patient with meningitis between one month and 18 year included in a Cross-Sectional Studies in the Rasul Hospital, Tehran, from 2012 to 2014. All of samples underwent aspiration of CSF. The routine tests performed that include culture coloring and biochemical of CSF. The concentrations of IL-1, IL-6 and IL-8 were determined by Enzyme-linked immunosorbant assay (ELISA) method and all of data were analyzed.
Results: Frequency of bacterial and aseptic meningitis was equal (49%). 64.7% of samples were boys and gender had not different between two bacterial and aseptic group (P=0.7). Mean (±SD) of the age in total was 358.46±858.40, and bacterial group had a higher mean of age than aseptic group (P=0.047). The level of IL-1 was 10.87±37.04 pg/ml in bacterial and 0.55±1.64 pg/ml in aseptic group, that had not different (P=0.168). The level of IL-6 was 90.51±139.3 pg/ml in bacterial and 21.36±67.84 pg/ml in aseptic group, that had significant different (P=0.030). The level of IL-8 was 365.40±765.52 pg/ml in bacterial and 50.66±59.34 pg/ml in aseptic group, that had significant different (P=0.047). Diagnostic value of IL-1 was noted in the 80.77% of bacterial and 68.00% of aseptic group that had not different (P=0.349). Diagnostic value of IL-6 was noted in the 53.85% of bacterial and 64.00% of aseptic group that had not different (P=0.572). Diagnostic value of IL-8 was noted in the 80.77% of bacterial and 28.00% of aseptic group that had significant different (P=0.000). There was not different between two group of CSF variables include coloring degree, WBC and RBC index, glucose and protein.
Conclusion: Although the concentration of IL-6 and IL-8 was higher in bacterial meningitis than in aseptic patients, only IL-8 had suitable diagnostic value for distinction between different types of meningitis.
Mohammad Farhadi , Ahmad Daneshi , Shima Javadi-Nia, Mohammad Nabavi , Ramin Asgarian, Mahmood Faramarzi , Azardokh Tabatabaie ,
Volume 73, Issue 2 (May 2015)
Abstract
Background: Helicobacter pylori (H. pylori) cause various diseases especially gastrointestinal disorders. Clinical diagnosis of H. pylori infection can be done in different ways, and new diagnostic methods are under study .This study aimed to assess the levels of interleukin (IL) 6, 17 and 23 in the middle ear effusion of patients with otitis media, and the association between these levels with H. pylori infection.
Methods: This cross-sectional study conducted in 40 patients who nominated for ventilation tube (VT) placement due to otitis media with effusion, and admitted to ear, nose, and throat (ENT) clinics of Tehran University of Medical Sciences from March 2012 to August 2013. All of patients underwent myringotomy with VT insertion, and then aspirated effusion sample was tested. H. pylori infection diagnosed by polymerase chain reaction (PCR) and bacterial culture. The concentration of IL-6, IL-17 and IL-23 measured by enzyme-linked immunosorbent assay (ELISA). The levels of each interleukins were compared between the two positive and negative PCR groups.
Results: In all of samples, PCR test result was positive in 22.5%. The mean and standard deviation of IL-6 level was 10.11±2.95, IL-17 was 5.89±0.91 and IL-23 was 4.07±1.34. The mean±standard deviation (SD) of IL-6 level in patients with a positive PCR (H. pylori) was 22.29±6.40 and in patients with a negative PCR was 6.16±3.88 that difference was significant (P=0.01). The mean±SD of IL-17 level in patients with a positive PCR was 6.16±1.29 and in patients with a negative PCR was 5.81±1.13 that difference was not significant (P=0.42). The mean±SD of IL-23 level in patients with a positive PCR was 6.15±3.77 and in patients with a negative PCR was 3.42±1.33 that difference was not significant (P=0.27).
Conclusion: According to finding, association between H. pylori infection and increased levels of IL-6 in the middle ear effusion was approved. It is recommended to conduct researches aimed to identify other cytokines as inflammatory markers.
Azadeh Meamarian , Shayesteh Ashrafi Esfahani , Shahrokh Mehrpisheh , Atoosa Mahdavi Saeedi , Kamran Aghakhani ,
Volume 73, Issue 3 (June 2015)
Abstract
Background: The relationship of the base of appendix to the cecum remains constant, whereas the tip can be found in a retrocecal, pelvic, subcecal, preileal, or right pericolic position. These anatomic considerations have significant clinical importance in the context of acute appendicitis. The knowledge about the correct anatomical position of appendix may facilitate in generating an accurate diagnosis of appendicitis as well as assist in achieving a better prognosis and early treatment. The present study aimed to determine the anatomical location of the appendix in Iranian cadavers.
Methods: This descriptive cross-sectional study was conducted on 200 cadavers who were referred to the Forensic Center of Tehran from March to September 2013. The data including age, sex, weight, and appendix length and position were collected and analyzed using SPSS software, version 16 (SPSS, Inc., Chicago, IL, USA).
Results: In the present study, 200 cadavers were evaluated accidentally, of which 173 (86.5%) were males and 26 (13%) were females, and the mean age was 39.96 years±16.31 (SD). The mean wall thickness of the appendix was 9.78 cm±16.31 (SD). The mean appendix length was 9.86 cm±1.79 (SD) in men and 9.30 cm±1.56 (SD) in women. The appendix height was long in 20 cadavers (10%), short in 3 cadavers (1.5%), and moderate in 177 cadavers (88.55%) cadavers. The appendix position was posterior in 120 (60%), ectopic in 32 (16%), and pelvic in 48 (24%) cadavers.
Conclusion: Majority of appendices examined in the present study were positioned at the posterior (Retrocecal) of pelvis. According to different positions of appendices in different populations and different races, the knowledge of appendix position in various populations is necessary for early diagnosis and treatment and fewer complications for related disease.
Mahmoud Akbarian , Khadijeh Paydar, Sharareh R Ostam Niakan Kalhori , Abbas Sheikhtaheri ,
Volume 73, Issue 4 (July 2015)
Abstract
Background: Pregnancy in women with systemic lupus erythematosus (SLE) is still introduced as a major challenge. Consulting before pregnancy in these patients is essential in order to estimating the risk of undesirable maternal and fetal outcomes by using appropriate information. The purpose of this study was to develop an artificial neural network for prediction of pregnancy outcomes including spontaneous abortion and live birth in SLE.
Methods: In a retrospective study, forty-five variables were identified as effective factors for prediction of pregnancy outcomes in systemic lupus erythematosus. Data of 104 pregnancies in women with systemic lupus erythematosus in Shariati Hospital and 45 pregnancies in a private specialized center in Tehran from 1982 to 2014 in August and September, 2014 were collected and analyzed. For feature selection, information of the 149 pregnancies was analyzed with a binary logistic regression model in SPSS software, version 20 (SPSS, Inc., Chicago, IL, USA). These selected variables were used for inputs of neural networks in MATLAB software, version R2013b (MathWorks Inc., Natick, MA, USA). A Multi-Layer Perceptron (MLP) network with scaled conjugate gradient (trainscg) back propagation learning algorithm has been designed and evaluated for this purpose. We used confusion matrix for evaluation. The accuracy, sensitivity and specificity were calculated from the confusion matrix.
Results: Twelve features with P<0.05 and four features with P<0.1 were identified by using binary logistic regression as effective features. These sixteen features were used as input variables in artificial neural networks. The accuracy, sensitivity and specificity of the test data for the MLP network were 90.9%, 80.0%, and 94.1% respectively and for the total data were 97.3%, 93.5%, and 99.0% respectively.
Conclusion: According to the results, we concluded that feed-forward Multi-Layer Perceptron (MLP) neural network with scaled conjugate gradient (trainscg) back propagation learning algorithm can help physicians to predict the pregnancy outcomes (spontaneous abortion and live birth) among pregnant women with lupus by using identified effective variables.
Arian Rahimi , Arash Arashkia , Amir Mirzaie , Hassan Noorbazargan , Seyed Ataollah Sadat Shandiz , Roghayeh Rahimi , Mehdi Mahdavi ,
Volume 73, Issue 9 (December 2015)
Abstract
Background: Human papilloma virus is a DNA virus from the papillomavirus family that is most prevalent in human cervical cancers and many studies showed the E6 and E7 proteins are present in the majority of cervical cancer cases. Development of universal HPV peptide-based vaccine with more serotypes coverage has considerable value. The aim of the study was to design a multi-epitope universal vaccine for major HPV based on E6 and E7 proteins and optimization the expression of polytopic construct contains E6 and E7 genes from different genotypes of human papilloma virus as a candid vaccine.
Methods: In this experimental study that was carried out in Pasteur Institute of Iran, Virology Department from October 2013 to November 2014. In order to design the polytypic construct, we predicted the most probable immunogenic epitopes of E6 and E7 from common high risk HPV16, 18, 31, 45 along with high prevalent type 6 and 11 using bioinformatics methods. The synthetic pET28a expression vector harboring E6 and E7 protein was transformed into Escherichia coli hosts and its expression was analyzed by SDS-PAGE and western blotting. Finally, in order to expression optimization of recombinant protein, cell density, induction time, growth temperature, IPTG (Isopropyl &beta-D-1-thiogalactopyranoside) concentration and cultures media were studied.
Results: In the present study the recombinant fusion protein was expressed successfully and the highest expression of target protein was achieved in super broth medium containing 0.1% glucose and 0.2% L-arabinose. In Super broth medium, the optimum condition for recombinant protein expression was occurred at OD600 of 0.8, 0.1mM IPTG, one hour’s incubation time at 37 °C and BL21 (A1) host.
Conclusion: The results of this study show that the optimum expression of E6 and E7 proteins from different genotypes of human papilloma virus can be performed. Moreover, by purification of recombinant protein and evaluation of its immunogenicity in mice, it can be used as a vaccine candidate against the human papilloma virus.
Zohreh Yousefi , Sima Kadkhodayan , Shohre Saeed , Amirhossein Jafarian , Fatemeh Mirzamarjani ,
Volume 74, Issue 3 (June 2016)
Abstract
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Background: Swyer syndrome is a type of hypogonadism with 46,XY karyotype. This syndrome was named by Gerald Swyer, an endocrinologist. It leads to a female with normal internal genitalia (uterus, fallopian tubes, cervix, vagina), but instead of ovaries, they have non functional ovary (streak gonads). Also, they have absence of puberty because of gonadal digenesis. The current practice is to proceed gonadectomy once the diagnosis is made due to the fact that the risk of malignant transformation is high in dysgenetic gonad. In addition, hormonal replacement therapy after surgery is acceptable.
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Case Presentation: We present a case of gonadoblastom in right ovary in a Swyer syndrome who referred to the department of Gynecology Oncology at Ghaem Hospital, Mashhad University, Iran in 2015 for evaluation of abdomino-pelvic distention. She was a 18-year-old female with 46, XY karyotype and poor secondary sexual character and normal external genitalia. She suffered of abdominal pain. In palpation of the abdomen, an irregular mobile mass was detected in left lower quadrant. The ultrasound revealed uterine size approximate dimensions 3×2 cm (infantile) and a 19 cm pelvic mass heterogeneous and multi-loculated in left side of the pelvic cavity with possible origin of the left ovary. In addition, in right pelvic fossa, a mass about 6 cm was detected. CT-Scan showed a pelvic mass with overall dimensions of 10 cm with vicinity to the left iliac vessels, modest amounts of ascities along with evidence of peritoneal dissemination (seeding). In laparotomy we observed massive ascities and a 20 cm solid mass in left ovary and a small mass in right ovary and involvement para aortic lymph node. Pathological report indicated as stage III of dysgerminoma in left ovary and gonadoblastom in right ovary.
Conclusion: This case is presented because it could have excellent prognosis if not missed opportunities of early recognizing and furthermore adequate treatment with gonadectomy.
Roya Sattarzadeh-Badkoubeh , Babak Geraiely , Mohsen Nassiri-Toosi , Ali Jafarian, Kazem Heydari ,
Volume 74, Issue 11 (February 2017)
Abstract
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Background: We assessed different systolic cardiac indices to describe left and right ventricular dysfunction in cirrhotic patients before liver transplantation.
Methods: In this case-control study, eighty-one consecutive individuals with the confirmed hepatic cirrhosis and candidate for liver transplantation in the Imam Khomeini Hospital between March 2008 and March 2010 were selected. Thirty-two age and gender cross-matched healthy volunteers were also selected as the control group. A detailed two-dimensional and Doppler echocardiography was obtained in all patients and controls performed by the same operator on the day of admission.
Results: Dimensions of both left and right atriums as well as left ventricular end-diastolic volume and basal right ventricular dimension in the cirrhotic group were significantly higher than control group. Left ventricular end-systolic dimensions as well as aortic annulus diameter were not different between the two study groups. Left ventricular outflow tract velocity time integral, isovolumic pre-ejection time, isovolumic relaxation time, stroke volume, left ventricular ejection fraction, IVCT+IVRT+ET, systolic velocity of tricuspid annulus, systolic velocity of basal segment of RV free wall, systolic velocity of basal segment of septal wall, peak strain of septal margin (base), peak strain of septal margin (midpoint), peak strain of lateral margin (midpoint), strain rate of septal margin (base), strain rate of septal margin (midpoint), strain rate of lateral margin (base), strain rate of lateral margin (midpoint), Tei index (left and right ventricles), systolic time interval and tricuspid annular plane systolic excursion were higher in cirrhotic group, significantly, (P< 0.05). Left ventricular ejection time and systolic velocity of mid segment of lateral wall were lower in cirrhotic group, significantly, (P< 0.05).
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Conclusion: In this study, the effects of liver on heart were volume overload, hyperdynamic state and systolic dysfunction in cirrhotic patients. These effects were due to chamber enlargement and we cannot use the most of cardiac indices for evaluation systolic function in cirrhotic patients. So, we suggest that systolic time interval and Tei index are useful indices in evaluation of systolic function in cirrhotic patients.
Farid Suleimani Mohammadi , Abbas Rahimi Foroushani , Mohsen Rokni , Mohammad Farahmand , Kazem Ahmadi Kia , Azadeh Shadab , Hamidreza Ahmadkhaniha, Jila Yavarian ,
Volume 74, Issue 11 (February 2017)
Abstract
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Background: Schizophrenia (SC) and bipolar disorder (BD) are two chronic psychiatric illnesses with worldwide distribution. People could be involved at any age, particularly in early adolescence. Main symptoms of SC are non- affective symptoms such as auditory hallucination and illogical thinking. In contrast, BD represents affective symptoms such as depression and mania. Although the main cause of these mood disorders has been remained elusive, there are some potential contributing factors that could be considered in the pathogenesis of mentioned illnesses including, genetic and environmental factors. Cytomegalovirus (CMV) is one of the probable contributing factors in SC and BD. CMV is a prototype of herpesviridae family which may infect different cell types such as endothelial and differentiated hematopoietic cells. CMV infections in immunocompromised patients as well as congenitally infected children represent CNS complication such as microcephaly and hearing loss. This virus has capability to impair the limbic structures in brain.
Methods: This descriptive study was designed to evaluate the role of CMV in these illnesses. We investigated the level of serum IgG antibody and the presence of CMV DNA in serum and peripheral blood mononuclear cells (PBMCs) samples of 46 SC and BD patients admitted to Iran Psychiatry Hospital Tehran, Iran from 2014 to 2015 as well as 46 healthy control groups at Tehran University of Medical Sciences. First, the level of CMV IgG antibody was evaluated in serum samples, by enzyme-linked immunosorbent assay (ELISA). Then, DNA extraction conducted by using the high pure viral nucleic acid kit (Roche, Germany). Serologically positive sera along with PBMC samples were tested by Real-time PCR, to investigate the presence of CMV DNA.
Results: Results indicated higher levels of CMV IgG antibody in psychiatric patients, compared with a healthy control group. Afterward, we did not observe the presence of CMV DNA in either case or control groups.
Conclusion: According to the CNS impairment mediated by CMV infection, this virus has been supposed to play an important role in pathogenesis of mental disorders such as SC and BD. We suggest further investigation to be conducted, particularly on other samples such as cerebrospinal fluid.
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Zohreh Yousefi , Laya Shirinzadeh , Marjaneh Farazestanian , Amir Hossein Jafarian , Roya Jalali,
Volume 74, Issue 11 (February 2017)
Abstract
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Background: The most common symptom of patients with gestational trophoblastic neoplasia is abnormal vaginal bleeding. Despite repeated visits of patients with postpartum choriocarcinoma and abnormal postpartum hemorrhage, delayed diagnosis leads to advanced disease with widespread metastasis. Therefore, occurrence of choriocarcinoma with variable patterns in different diagnosis of late onset postpartum hemorrhage should be considered. Early diagnosis of choriocarcinoma after term pregnancy is important that resulted in decrease of maternal morbidity. Therefor late onset postpartum hemorrhage should have an awareness. The aim of this study was to report a case of choriocarcinoma after caesarian section.
Case Presentation: A 33-years-old woman one month after antecedent caesarian section in her second pregnancy admitted with abnormal vaginal bleeding. Based on raised titer concentration of β-hCG was 187000 u, with clinical suspicious of choriocarcinoma she was referred to oncology department of Ghaem Hospital, Mashhad University of Medical Sciences, Iran, in 2016. Vaginal exam revealed an enlarged uterus about 10 weeks of pregnancy. Transvaginal sonography showed an intracavitary heterogeneous mass with irregular surface in fundus without myometrium invasion. Extra pelvic metastasis excluded via vaginal exam, pulmonary X-ray and, ultrasonography and computed tomography scan. Due to early stage of gestational trophoblastic neoplasia and diagnosis of this condition, single agent chemotherapy (methotrexate) was recommended, but because of unresponsive disease, subsequently, she was treated with combination chemotherapy (etoposide, methotrexate, and actinomycin, followed by cyclophosphamide and vincristine) that led to remarkable response. After three courses of therapy, normal level of β-hCG was observed and now the patient is free of disease and under-serial follow-up visit for choriocarcinoma.
Conclusion: Diagnosis of choriocarcinoma should be considered in any postpartum woman with abnormal vaginal bleeding.
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Mohammad Javad Yazdanpanah , Zohreh Yousefi , Amir Hosein Jafarian , Laya Shirinzadeh , Mina Baradaran ,
Volume 75, Issue 6 (September 2017)
Abstract
Background: Pyoderma gangrenosum (PG) (ulcerating neutrophilic dermatosis) is a rare disease that about of half of these patients have a systemic disorder, particularly Crohn's and ulcerative colitis. In addition, inflammatory lesions play key role in its pathogenesis. In early diagnosis of disease, we will further prevent of serious consequences of the disease. In this report, a case of PG after the vaginal surgery with history of ulcerative colitis was introduced.
Case presentation: A 37-years old woman was admitted in an University Hospital of Mashhad University of Medical Sciences, Iran, in 2016 two weeks after genital surgery. The chief complaints were fever, painful tenderness, ulcerative lesion and inflammatory papule on surgical site and thigh. She suffered of fever despite received oral and then wide spectrum intravenous antibiotic therapy. Blood cultures and wound culture were negative. In addition to two deferent intravenous antibiotics, topical wound debridement was performed. Despite this course of treatment which did not improve the lesion, biopsy was performed. Histopathology features of biopsy specimen indicated prominent neutrophils mixed inflammation and lymphocytic vasculitis indicated as pyoderma gangrenous. The patient's medical history included associated ulcerative colitis from 18 years ago and she was under irregular oral receiving of Asacol (mesalamine). Intravenous corticosteroid therapy was administered which led to response of skin of right thigh and surgical site inflammation. After 6-months follow-up, the patient is still in good condition.
| Conclusion: Based on major variable clinical manifestations and no diagnostic serologic test of pyoderma gangrenosum, diagnosis of this disease is difficult. Increased awareness about PG and exclusion of other etiologies such as inflammatory and immunologic disease will aid in prompting of pyoderma gangrenosum diagnosis and proper management of the disease. |
Mohsen Haghshenas Mojaveri , Zahra Akbarian Rad , Zeynab Shafipour , Somayeh Alizadeh Rokni , Fatemeh Valizadeh ,
Volume 75, Issue 11 (February 2018)
Abstract
Background: One of the important effects of kangaroo mother care (KMC) in preterm baby is improvement in weight gain and so shortening in hospitalization, but it is not clear that how long of kangaroo mother care is effective in weight gain. The aim of this study was to determine the least effective duration of kangaroo mother care in weight gain in very low birth weights.
Methods: Preterm babies with birth weight less than 1500 gr, without chronic cardiopulmonary disease, congenital anomaly and other medical problem when receiving to 140 ml/kg/d enteral feeding enrolled the study. KMC was started when the baby has been stabled, on the mother’s appetency and ability at bedside. The mean daily weight gain in KMC period was compared with expected that (15 mg/kg/d) for the same baby. The babies with KMC≥ 7 days were divided in three groups on the basis of mean daily KMC duration (< 30 min, 30-60 min and> 60). Statistical study performed by using SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) and P values of less than 0.05 were considered to be significant.
Results: In this study, 103 preterm baby (47 boys, 56 girls) less than 1500 gr were enrolled, with mean birth weight 1107.85±190.87 gr. Mean weight gain of boys in KMC period and expected that were 324.78±162.66 gr Vs. 127.46±54.66 gr (P< 0.001). In eighty-seven babies who received KMC (7-40 days) mean daily weight gain was 26.69±15.55 gr (P< 0.001). Mean weight gain in KMC period for group with< 30 min (n=19), 402.63±126.29 gr Vs. 167.21±74.20 (P< 0.001), group with 30-60 min (n=54) were 338.79±182.60 gr Vs. 220.36±66.98 (P< 0.001) and group with 60< (n=14) 352.14±236.02 gr Vs. 259.96±112.23 (P= 0.09).
Conclusion: On the basis of this study KMC less than 1 hour per day is effective in weight gain of very low birth weight preterm babies.
Farzaneh Naserian , Fatemeh Heshmati , Maryam Mehdizadeh Omrani, Reza Salarian ,
Volume 76, Issue 4 (July 2018)
Abstract
Today, nanoscience has grown and developed in various medical and therapeutic areas, including cancer treatment. On the other hand, cancer and its types have been rumored and inclusive and many people suffer from this fatal and deadly disease. Currently, existing therapeutic method, including chemotherapy, radiotherapy, and etc., along with the therapeutic effect, cause complications that are unpleasant for patients. Hence, scientists and researchers are looking to develop and improve treatment options and methods to deal with this serious disease. Today, nanoscience and nanotechnology have become widespread, and its various fields, including nanoparticles, are widely used for a variety of applications, especially for delivery of drugs and diagnostic items and imaging cases. Nanotechnology-based release systems have a significant impact on the release of cancer drugs. Advances in bio-materials and bio-engineering are contributing to new approaches to nanoparticles that may create a new way for the improvement of cancer patients. Nano-technology in the drug release system has had a great impact on the selection of cancer cells, the release of a targeted drug, and overcoming the limitations of conventional chemotherapy. At the present many drug delivery systems are now made of nanoparticles, and various substances have been used as drug-stimulating agents or as a reinforcing agent to improve the efficacy of the treatment and durability and stability and also the safety of anticancer drugs. The materials used to release cancer drugs are divided into various categories such as polymer, magnetic, biomolecules. In the meantime, polymer nanoparticles have been organized in the carriers of anti-cancer nanoparticles due to the process of easy production, biocompatibility, and biodegradability. Although the loading of hydrophilic compounds is still confronted with limitations, due to the diversity of nanoparticle structures, it is possible to encapsulate various molecules. Also, surface changes and modification such as binding to antibodies and target ligands can also be applied to these materials, to act as target drug delivery to increase the effectiveness of treatment process. In this article, we will have an overview of cancer disease and cancer drugs and also nanoparticles and their contribution to cancer treatment.
Leila Pourali, Amir Hosein Jafarian , Atiyeh Vatanchi, Mojgan Soltani , Ali Moghimi Roudi ,
Volume 76, Issue 11 (February 2019)
Abstract
Background: Hydatid cyst is an endemic disease in Iran and many middle eastern countries. The clinical presentation of Echinococcus granulosus infection depends upon the site of the cysts and their size. Small and/or calcified cysts may remain asymptomatic indefinitely. However, symptoms due to mass effect within organs, obstruction of blood or lymphatic flow, or complications such as rupture or secondary bacterial infections can result. The most common involved organs with this parasite are the liver and lung. Unusual areas of the disease include breast, adrenal, appendix, peritoneum, omentum and mesenteric. The purpose of this study was to report a rare case of abdominal hydatid cyst with presentation of ovarian cyst in ultrasonography.
Case Presentation: A 26-year-old virgin woman with abdominal pain in the hypogastric region and lower and right quadrant of the abdomen, with gastric fullness and without nausea and vomiting referred to an emergent unit of Ghaem Hospital (an academic hospital of Mashhad University of Medical Sciences) in June 2017. In an ultrasound, a cyst of 95×105 mm in right adnexa of uterus was seen. Due to continued abdominal pain, laparotomy was performed for the patient. At the time of laparotomy, the ovaries, uterus and adnexa were completely normal. A 10×15 cm cyst was seen with a thin wall which adhering to the omentum and the small end of the stomach. Frozen section biopsy reported hydatid cyst.
Conclusion: Considering that hydatid cyst is endemic in Iran, the presence of cystic mass in the peritoneal cavity, hydatid cyst should be considered. To prevent complications and relapse, it is best to avoid cyst rupture during surgery as much as possible.