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Showing 43 results for Rezaei
Effects of aspirin on renal cortical and medullary tissues in rat embryos
Seyed Homayoon Sadraie , Fatemeh Rezaei , Mahnaz Azarnia , Gholamreza Kaka , Soheila Jahani , Zahra Shabani ,
Volume 71, Issue 9 (December 2013)
Abstract

Background: Aspirin is the drug of the century, and is a multifunctional drug and one of the most prescribed drugs in the world. Aspirin is a safe drug at low doses but also it has life-threatening side effects when administered at high doses. This study investi-gates the effects of aspirin on renal cortical and medullary tissue in rat embryos.
Methods: In this study, 30 pregnant female rats were randomly divided into 6 groups. Control group with no intervention, sham group received 2 ml distilled water (as a sol-vent of aspirin) received from days 8 to 20 of pregnancy, and four experimental groups received different doses of 75, 100, 200 and 300 mg/kg of aspirin by gavage. Pregnant rats were sacrificed on the twenty days of pregnancy and the fetuses were removed. Weight of the fetuses and placenta and Crown-Rump length were measured. Fetal kid-neys were fixed in formalin processed, sectioned and stained with Hematoxylin- Eosin. Thickness of renal cortical and medullary tissue by using a Motic hardware and soft-ware system were measured and recorded. A significance level of 0.05 was predeter-mined for all statistical analyses.
Results: No apparent fetal anomalies were observed in experimental groups. In addi-tion, no significant differences were shown in the mean of fetal weight, placental weight, mean of Crown-Rump length in experimental groups 75, 200 and 300 mg/kg compared to control and sham groups. Mean fetal and placental weight in experimental group 100 significantly increased compared to control and sham groups. Mean ratio of renal cortex to renal medulla in experimental group 75, 100 and 300 were significantly decreased compared to control and sham groups (respectively P= 0.03, P= 0.013, P= 0.03).
Conclusion: It seems that maternal use of aspirin during pregnancy can not cause fetal abnormalities. However, it can cause some changes in renal cortical and medullary tis-sue of rat embryos.


Role of the immune cells, mediators and cytokines in pathogenesis of asthma: a review article
Sedigheh Bahrami Mahne, Seyed Alireza Mahdaviani , Nima Rezaei ,
Volume 72, Issue 5 (August 2014)
Abstract
Asthma is a chronic inflammatory disorder of the airways, associated with airway re-modeling and hyperresponsiveness. It is expressed that asthma influences about 300 million people around the world, which is estimated to increase to about 400 million by 2025. The prevalence rate is 15 to 20 percent in children and 5 to 10 percent in adults, while its trend is still increasing. Inflammation plays an important role in the patho-physiology of asthma, which involves an interaction of different types of the immune cells and mediators. It leads to a number of pathophysiology changes, including bron-chial inflammation, airway obstruction, and clinical episodes such as cough, wheeze and shortness of breath. Asthma is now greatly being introduced as a heterogeneous disorder and it is pointed out to the role of T cells, including Th1, Th2, Th17, and regu-latory T cells. Other immune cells, especially neutrophils, macrophages and dendritic cells, as well structural cells such as epithelial and airway smooth muscle cells also pro-duce disease-associated cytokines in asthma. Increased levels of these immune cells and cytokines have been recognized in clinical samples and mouse models of asthma. Different cytokines, including pro-inflammatory cytokines (such as TNFα, IL-1, and IL-6), T helper 2 cytokines (such as IL-4, IL-5, IL-9, IL-13), and growth factors (such as GM-CSF, PDGF) play a role in the pathogenesis of asthma. Indeed chemokines (such as MPC-1, RANTES , MIP-1) and the chemokine receptors (such as CCR3, CCR4, CCL11, CCL24, and CCL26) play an important role in the recruitment of circu-lating inflammatory cells into the airways in asthmatic patients and also is related with increased T helper 2 cytokines after inhaled allergens. Among new approaches, treat-ment of asthma with anti-cytokine drugs such as antibodies blocking IL-4, IL-5, IL-9 could reduce recruitment inflammatory cells into the airways and remodeling. The final perspective of asthma treatments would be to alter from the symptomatic treatments to disease modifying.
Sensitivity and specificity of endoscopy in diagnosis for Barrett's esophagus
Alireza Sharifi, Shahab Dolatshahi , Atefeh Rezaeifar , Tayeb Ramim ,
Volume 72, Issue 6 (September 2014)
Abstract
Background: Lack of precise diagnostic criteria and sufficient findings in support of biopsy sampling during upper gastrointestinal endoscopy is one of the special challenge in endoscopy assessment in Barrett's esophagus. The aim of this study was to evaluate the mucosa in the distal esophagus tissues through a biopsy during upper gastrointesti- nal endoscopy in gastroesophogeal reflux disease patients whose symptoms don't im- prove or only partially resolve with treatment. Methods: A cross-sectional study was done in patients with gastroesophogeal reflux disease medically resistant to treatment. The patients were assessed by gastroenterology department in Sina Hospital, Tehran, Iran, since September 2012 to September 2013. Patients with coagulopathy, esophageal varicose, esophageal cancer, earlier detection of developing Barrett's esophagus, history of irritable bowel syndrome, psychological dis- orders and using of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, were excluded. Esophageal squamous epithelium and cylindrical tissue of stomach was carefully checked by endoscope. Then 2 to 4 biopsy of the Z-line above the gastroe- sophageal mucosa were obtained. Results: One hundred and fifty three patients included 78 men (51%) and 75 females (49%) with a mean age of 47.92±17.57 years participated in the study. The mean of body mass index of patients was 25.05±4.17 kg/m2 and body mass index in 45.8 % of the patients more than 230 kg/m2. Biopsy specimens were taken in 31 cases were not enough for histological examination. In other patients, 25 cases (20.5%) were normal and 97 cases (79.5%) had the following pathological diagnosis: mild esophagitis (49 cases 40.2%), moderate esophagitis (24 cases 19.7%), severe esophagitis (14 cases 11.5%), Barrett's esophagus (8 cases, 6.5%), fungal esophagitis (1 cases, 0.8%), and eosinophilic esophagitis (1 cases 0.8%). 117 patients (76.5%) had H. pylori infection. Sensitivity and specifity of endoscopy for detection of Barrett's esophagus during upper gastrointestinal endoscopy were 100% and 84.13% (CI 95%:78.53-89.09%), respec- tively. Conclusion: Our data showed that doing of accurate and adequate biopsy samples from lesions in upper GI endoscopy can be helpful in the diagnosis of Barrett's esophagus
Evaluation of IL-17 gene expression in peripheral blood and sputum of asthma patients and healthy individuals
Reza Yazdani , Mazdak Ganjalikhani Hakemi, Roya Sherkat , Abbas Rezaei , Rahim Farahani , Behrouz Beiranvand ,
Volume 72, Issue 9 (December 2014)
Abstract
Background: Asthma as an airway disease is identified by increase network respon-siveness of the trachea and bronchus to a specific stimulus. Th17 cells through produc-tion of IL-17 have important role in inflammation and autoimmune diseases .In some studies has been shown which IL-17 as major cytokine of Th17 probably has im-portant role in the pathogenesis of allergy and asthma. Methods: Total mRNA extracted from whole blood samples and sputum of 23 asthma patients and 23 normal controls. Then, total RNA was converted into cDNA according to the manufacturer’s instructions. Finally, the transcript levels of IL-17 were quanti-fied by the real-time quantitative PCR. Twenty-three patients with asthma were diag-nosed and selected according to the global initiative for asthma (GINA) and none of the patients had taken the medication at least three week before sampling. Healthy in-dividuals did not have any history of allergy, asthma and other inflammatory diseases at the time of sampling. All of experiments have done in Isfahan University of Medical Sciences, Iran during May to February, 2013. Results: This study showed a significant increase in transcript levels of IL-17 in the blood (287±79 versus 1/18±0/13) and sputum samples of the patients (64±28 versus 0/9±0/1) in comparison with normal individuals (P= 0.000, P= 0.029 respectively). It al-so revealed that the expression levels of the cytokines in the serum samples of the asthmatics were significantly more than their levels in patient’s sputum samples (P= 0.000). However, there was no significant difference between the cytokines expression levels in serum samples and sputum samples of the controls (P> 0.05). Conclusion: In this study, we showed which the expression of IL-17 was increased in serum and sputum of asthmatic patients compared to healthy controls, this could re-sult in elevation of neutrophils population and activation of pulmonary neutrophil.
The role of cytokines in systemic lupus erythematosis: review article
Shideh Namazi , Vahid Ziaee , Nima Rezaei ,
Volume 73, Issue 6 (September 2015)
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, involves almost all organs such as skin, heart, kidneys and central nervous system. The disease is characterized by vascular and connective tissue inflammation in a recurring pattern of remission and flare. Although the exact pathophysiology of disease has not been fully understood yet, the fundamental defect in SLE is attributed to dysfunction of T lymphocytes in controlling of B-cell that leads to polyclonal activation of B lymphocytes and production a large quantity of autoantibodies against nuclear and cytoplasmic components. These autoantibodies can damage tissues either directly or as a result of immune complex deposits. Several factors are involved in pathogenesis of SLE which can be divided into three major groups, environmental factors, genetic components, and immunological disturbances. They could breakdown body tolerance towards endogenous antigens and cause abnormal immunologic response to the healthy tissue, resulting in tissue damage. SLE occurs more frequently in female than male. It seems that immunological factors have important role in SLE. Inflammation and vascular endothelium irregularities are a number of main pathologies seen in SLE. Cytokines are protein mediators that play an essential role as regulator of innate and adaptive immune response against microbial agents or self-antigens. Influences of cytokines in autoimmune diseases such as SLE are poorly understood. Studies in both experimental animal models of lupus and patients with SLE have revealed a number of cytokine pathways that are important in the disease process. These studies showed that overexpression of inflammatory cytokines increases the proliferation of auto reactive B-cells and results in higher production of autoantibodies. Among them, the role of B-cell activating factor (BAFF), a proliferation-inducing ligand (APRIL), TNF-α, IFN-α, IL-6, IFN-γ, IL-23/IL-17, IL-10, IL-21 are prominent, which is associated with the generation of pathogenic autoantibodies and formation of immune complexes. In this paper, the role of cytokines and their encoding genes are described, while therapeutic applications are also briefly presented.
Health impact caused by exposure to particulate matter in the air of Tehran in the past decade
Majid Kermani , Mohsen Dowlati , Ahmad Jonidi Jafari , Roshanak Rezaei Kalantari ,
Volume 74, Issue 12 (March 2017)
Abstract

Background: Air pollution, especially the phenomenon of dust and particulate matter can cause mortality of many civilians, and causes various diseases including cardiovascular and respiratory diseases. One of the major pollutants in the air is particulate matter that concentration has increased over recent years. So, present study with aim of Quantification Health Endpoints Attributed to particulate matter in Tehran, Capital of Iran during the past decade (2005-2014) by AirQ software, version 2.2.3 (WHO European Centre for Environment and Health) was performed.

Methods: This study is a descriptive-analytic investigation. The process of performance this study lasted 12 months. Subject of this the study and research was in Environmental Health Engineering Department of Iran University of Medical Sciences. Exact data of every hour pollutants were taken from Department of environmental (DOE) Islamic Republic Iran and Air Quality Control Company of Tehran. Then validated according to the World Health Organization (WHO) guidelines and Statistical parameters for quantifying health effects were calculated in excel software. Finally, assessment of cases total mortality, cardiovascular mortality, respiratory mortality and cardiovascular disease and respiratory disease, with AirQ software was performed.

Results: The results of this study showed that the number of total mortality, cardiovascular mortality and respiratory mortality caused by exposure to Particulate matter smaller than 10 microns (PM10) in the past decade is 11776, 12121 and 33066 cases respectively. Also the total number of hospital admission due to cardiovascular disease and respiratory disease in the past decade is 20990 and 54352 cases in 2005-2014 years.

Conclusion: According to the results of this study, during the last decade the level of air pollution and Concentration of pollutants in Tehran Increased. Effects and health consequences due to exposure to Particulate matter smaller than 10 microns (PM10) in Tehran Metropolis Is very severe and increased mortality and cardiovascular and respiratory diseases among the citizens of Tehran.

Influence of the contrast agents on dose-volume histograms in radiotherapy treatment planning based on CT-scan
Sahel Heydarheydari , Negin Farshchian , Abbas Haghparast , Seyed Masoud Rezaeijo,
Volume 75, Issue 11 (February 2018)
Abstract
Background: In three-dimensional conformal radiation therapy (3D-CRT), contrast-enhanced CT (CECT) image is commonly used to assist radiation oncologists in diagnosing regions of interest, so that normal and target tissues can be better delineated. CECT causes the temporary increase in the CT number and the corresponding electron density (ρe). Administrated contrast agents (CA) during CT simulation and altering the ρe of structures can be effective on radiation calculations and dose-volume histograms (DVHs) in radiotherapy treatment planning. Therefore, present study was designed and performed to determine the influence of the administrated CA on DVHs.
Methods: Current study performed as a self-controlled clinical trial study with before/after method at Imam Reza Hospital, Kermanshah City, during the period from June 2015 till August 2016. Ten patients with pelvic cancer included in this study through simple sampling. Cases with prior reactions to CA, diabetes, renal diseases, and asthma were excluded. Two sets of CT-scans were taken for each patient in the same position and coordinates. Primary study sets contained pre-contrast images and secondary study sets were performed post-contrast. Both sets of CT images were transferred to the treatment planning system (ISOgray® software, Version 4.1.3.23 L, DOSIsoft®, Cachan, France). All treatment plans were generated on pre-contrast and subsequently copied to the post-contrast CT. Quantitative calculations were performed in treatment planning including the difference in ρe before and after CA administration.
Results: The prostate (1.27%), the bladder (0.62-0.79%) and the rectum (0.43-0.56%) showed the largest changes in average ρe increase. The results confirm the expected relationship of increasing attenuation, CT number, and ρe with increased tissue density due to the CA. However, the DVHs showed insignificant difference between pre-and post-contrast CTs for 18 MV photon beam.
Conclusion: The results showed statistical insignificant difference between with and without CA CTs treatment plan in pelvic field for targets and OARs. These results may serve as a reference to justify the use of CECT data sets for 3D-CRT planning of pelvic region cancers using DosiSoft ISOgray system.

Detection of Alzheimer's disease based on magnetic resonance imaging of the brain using support vector machine model
Mansour Rezaei , Ehsan Zereshki , Hamid Sharini , Mohamad Gharib Salehi , Farhad Naleini ,
Volume 76, Issue 6 (September 2018)
Abstract
Background: Alzheimer's disease (AD) is the most common disorder of dementia, which has not been cured after its occurrence. AD progresses indiscernible, first destroy the structure of the brain and subsequently becomes clinically evident. Therefore, the timely and correct diagnosis of these structural changes in the brain is very important and it can prevent the disease or stop its progress. Nowadays, remark to this fact that magnetic resonance imaging (MRI) provides very useful and detailed information, and due to non-invasiveness, this method has been great interest to the researchers. The aim of this study was diagnosis of AD with MRI by support vector machine model (SVM).
Methods: This is an analytical and modeling research which done in School of Public Health, Kermanshah University of Medical Science, Iran, from February 2017 to November 2017. The data used in this study was a database named Miriad containing brain MRI of 69 individuals (46 Alzheimer's disease and 23 healthy subjects) that was collected at the central hospital in London. Individuals were categorized into two groups of healthy and Alzheimer's disease with two criteria: NINCDS-ADRAD and MMSE (as the golden standard). In this paper SVM model with three linear, binomial and Gaussian kernels was used to distinguish Alzheimer`s disease from healthy individuals.
Results: Finally, SVM model with Gaussian kernel, separated AD and healthy subjects with 88.34% accuracy. The most important Areas for Alzheimer were three Area: Right para hippocampal gyrus, Left para hippocampal gyrus and Right hippocampus. The clinical result of this study is to identify the most important ROI for the diagnosis of Alzheimer's by a clinical specialist. Experts should focus on atrophy in the three Areas.
Conclusion: This study showed that the SVM model with Gaussian RBF kernel can separated AD from healthy subjects by high accuracy. Based on results of this study, can make a software to use in MRI centers for screening AD test by people over the age of 50 years.

Spatial structure of breast cancer using Poisson generalized linear mixed model in Iran
Mansour Rezaei , Abdullah Jalilian , Behzad Mahaki , Maryam Veismoradi ,
Volume 77, Issue 3 (June 2019)
Abstract
Background: Breast cancer is one of the most common diseases in women and causes more deaths rather than other cancers. The increasing trend of breast cancer in Iran makes clear the need of extensive breast cancer research in this area. Some studies showed that in the variety countries and even in the different areas in one country has different risk of breast cancer incidence and this is a reason that there is a correlation between region of life and risk of breast cancer. The purpose of this study was to determine the spatial structure associated with the incidence of breast cancer based on statistical models and identification of areas with high incidence of breast cancer in Iran.
Methods: This ecological study was conducted in Kermanshah University of Medical Sciences, Iran, from February to July 2018. Data on breast cancer patients in all provinces of Iran (30 provinces) were investigated since 2004 to 2009. Risk factors in this study included fruit and vegetable consumption, physical activity, overweight or obesity, and human development index. In this study, we have used routine and spatial Poisson's generalized linear mixed models for data analysis.
Results: In both routine and spatial models, direct and significant correlation was found between the incidence of breast cancer and the human development index (P<0.05). In addition to human development index, overweight or obesity factors were also had direct and significant relationship to the incidence of breast cancer in the spatial Poisson's generalized linear mixed model (P<0.05). In the spatial Poisson's generalized linear mixed model with correlation structure of Besag Yorg Molie (BYM), two provinces of Gilan and East Azerbaijan had the highest risk of breast cancer incidence and province of Kohgiluyeh and Boyer Ahmad had the lowest risk of breast cancer incidence.
Conclusion: The results showed that the distribution of breast cancer incidence in Iran has a spatial structure. That is, the adjacent provinces have similar incidences of this disease.

Relationship between body mass index and gestational diabetes mellitus
Mansour Rezaei , Fateme Rajati , Negin Fakhri ,
Volume 77, Issue 4 (July 2019)
Abstract
Background: Gestational diabetes mellitus (GDM) is one of the most common medical complications in pregnancy, which is associated with many serious consequences for mother and her fetus. Body mass index (BMI) in pregnant women is considered as one of most effective factor for the incidence of GDM. The aim of this study was to determine the relationship between BMI at pregnant women in the early months of pregnancy and the incidence of GDM.
Methods: In this retrospective cohort study, the case of six hundred fifty-nine pregnant women who referred to health centers in Kermanshah City from September 2010 to September 2012 by convenience sampling method were selected and investigated. This study was sponsored by Kermanshah University of Medical Sciences. Height and weight were measured for each woman at the beginning of pregnancy and maternal body mass index (BMI) was calculated based on height and weight measurements. Then the pregnant women were divided into four groups based on BMI: thin (BMI less than 18.9 kg/m2), normal (BMI between 19 kg/m2 and 24.9 kg/m2), overweight (BMI between 25 kg/m2 and 29.9 kg/m2) and obese (BMI more than 30 kg/m2). Those women who had diabetes at the beginning of pregnancy were excluded from the study. GDM was considered as fasting blood glucose ≥92 between 26-30 weeks of gestation.
Results: The mean±SD age of pregnant women was 27.7±5.85 year and the mean of BMI was 24.4±4.0 kg/m2. The GDM was shown in 30.7% of women. Association between BMI and GDM were statistically significant (P<0.001). The risk of GDM onset was 1.24 times, for each unit increased in BMI, (P<0.001). The risk of GDM was significantly higher in overweight [OR=2.97, CI (2.01-4.39)] and obese [OR=16.89, CI (8.46-33.70)] women. Being underweight increased the risk of GDM onset up to 1.19 times, but not significant.
Conclusion: There is a significant relationship between maternal BMI in pregnant women at the beginning of pregnancy with GDM onset. Increased BMI is correlated with an increase in the incidence of GDM.

Comparison of gestational diabetes prediction with artificial neural network and decision tree models
Mansour Rezaei, Negin Fakhri , Fateme Rajati , Soodeh Shahsavari ,
Volume 77, Issue 6 (September 2019)
Abstract
Background: Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders in pregnancy, which is associated with serious complications. In the event of early diagnosis of this disease, some of the maternal and fetal complications can be prevented. The aim of this study was to early predict gestational diabetes mellitus by two statistical models including artificial neural network (ANN) and decision tree and also comparing these models in the diagnosis of GDM.
Methods: In this modeling study, among the cases of pregnant women who were monitored by health care centers of Kermanshah City, Iran, from 2010 to 2012, four hundred cases were selected, therefore the information in these cases was analyzed in this study. Demographic information, mother's maternal pregnancy rating, having diabetes at the beginning of pregnancy, fertility parameters and biochemical test results of mothers was collected from their records. Perceptron ANN and decision tree with CART algorithm models were fitted to the data and those performances were compared. According to the accuracy, sensitivity, specificity criteria and surface under the receiver operating characteristic (ROC) curve (AUC), the superior model was introduced.
Results: Following the fitting of an artificial neural network and decision tree models to data set, the following results were obtained. The accuracy, sensitivity, specificity and area under the ROC curve were calculated for both models. All of these values were more in the neural network model than the decision tree model. The accuracy criterion for these models was 0.83, 0.77, the sensitivity 0.62, 0.56 and specificity 0.95, 0.87, respectively. The surface under the ROC curve in ANN model was significantly higher than decision tree (0.79, 0.74, P=0.03).
Conclusion: In predicting and categorizing the presence and absence of gestational diabetes mellitus, the artificial neural network model had a higher accuracy, sensitivity, specificity, and surface under the receiver operating characteristic curve than the decision tree model. It can be concluded that the perceptron artificial neural network model has better predictions and closer to reality than the decision tree model.

Establishment of national primary immunodeficiency network, requisite of health organization and final stage of polio eradication: review article
Asghar Aghamohammadi , Mohammadreza Shaghaghi , Hassan Abolhassani , Reza Yazdani , Seyed Mohsen Zahraie , Mohammad Mehdi Goya , Susan Mahmoudi , Nima Rezaei , Shohreh Shahmahmoodi ,
Volume 78, Issue 1 (April 2020)
Abstract
Primary immunodeficiency diseases (PIDs) is a diverse group of diseases, characterized by a defect in the immune system. These patients are susceptible to recurrent respiratory infections, gastrointestinal problems, autoimmune diseases, and malignancies. In most cases, patients with primary immunodeficiency disorders have genetic defects and are monogenic disorders that follow a simple Mendelian inheritance, however, some PIDs recognize a more complex polygenic origin. Overall, almost 70 to 90 percent of patients with primary immunodeficiency are undiagnosed. Given that these patients are exposing to respiratory infectious agents and some live-attenuated vaccines, thus they have a high risk to some clinical complications. The administration of oral polio vaccine in patients with PIDs especially can increase the possibility of acute flaccid paralysis. These patients will excrete the poliovirus for a long time through their feces, even though they are not paralyzed. Long-term virus proliferation in the vaccinated individuals causes a mutation in the poliovirus and creates a vaccine-derived polioviruses (VDPVs), which is a major challenge to the final stages of the worldwide eradication of polio. 
To increase the diagnosis and identification of patients with immunodeficiency and carrying out a national plan for screening patients with immunodeficiency from the fecal excretion of the poliovirus, a possible polio epidemic can be prevented during post-eradication. Development of laboratory facilities in provincial and city centers, improvement of communications among physicians regarding medical consultation and establishment of referring systems for patients by national network lead to improve status of diagnosis and treatment of patients with primary immunodefiicencies. In this context, launching and activating the national network of immunodeficiency diseases is essential for improving the health of children and reducing the cost of the health system of the country. A national network of immunodeficiency can lead to increase awareness of physicians regarding primary immunodeficiency disorders, improve collaboration among physicians about genetic consultation and establish a practical referral system in Iran that results in increased diagnosis and improve treatment of patients with primary immunodeficiency disorders.

Comparison of disability score estimation in multiple sclerosis patients with artificial neural network and decision tree models
Mansour Rezaei , Daryush Afshari, Negin Fakhri, Nazanin Razazian,
Volume 79, Issue 4 (July 2021)
Abstract
Background: Multiple Sclerosis (MS) is one of the most debilitating disease among young adults. Understanding the disability score (Expanded Disability Status Scale (EDSS)) of these patients is helpful in choosing their treatment process. Calculating EDSS takes a lot of time for Neurologists, so having a way to estimate EDSS can be helpful. This study aimed to estimate the EDSS score of MS patients using statistical models including Artificial Neural Network (ANN) and Decision Tree (DT) models.
Methods: This cross-sectional study was performed on MS registry study data of Kermanshah province from April 2017 to November 2018. From the total data available in the registry system, The 12 variables including demographic information, information about MS disease and their EDSS score were extracted. EDSS scores were also estimated using ANN and DT models. The performance of the models was compared in terms of estimation error, correlation and mean of an estimated score. Data were analyzed using Weka software version 3.9.2 and SPSS software version 25 with a significance level of 0.05.
Results: In this study, 353 people were studied. The mean age of the patients was 36.47±9.1 years, the mean age of onset was 9.2±30.34 years, the mean duration of the disease was 6.20±5.7 years and the mean EDSS score was 2.46±1.8. Estimation errors in the DT model were lower than in the ANN model. The real EDSS score was significantly correlated with scores estimated by DT (r=0.571) and ANN (r=0.623). The mean EDSS estimated by the DT model (2.46±1.1) was not significantly different from the real EDSS mean (P=0.621) but the mean EDSS estimated by the ANN model (2.87±1.3) was significantly higher than the real EDSS mean. (P<0.05).
Conclusion: The DT model could better estimate the EDSS score of MS patients than the ANN model and made predictions that were closer to the actual EDSS scores. Therefore, the DT model can accurately estimate the EDSS score of MS patients.

Evaluation of the difference in surgical margin values in excisional skin lesions during surgery and after formalin fixation
Ezzatollah Rezaei, Mahmoud Reza Kalantari , Sahar Fereydouni, Kamrooz Pouryousef,
Volume 79, Issue 8 (November 2021)
Abstract
Background: Surgical margin determination in malignant lesions is essential and has a direct impact on the choice of postoperative treatments and patient follow-up. Therefore, the processes affecting this variable are worth exploring. This study aimed to evaluate the difference in surgical margin values in excisional skin samples during surgery and after formalin fixation.
Methods: A cross-sectional study was performed on forty randomly selected patients with benign and malignant skin lesions who were referred to the plastic surgery ward of Ghaem Hospital in Mashhad from November 2018 to January 2019. Malignant and benign skin lesions were excised with a healthy margin, then the specimens were sent to the pathologist in a formalin-containing container. The amount of tissue shrinkage and the factors affecting them were compared.
Results: Among all 40 participants about 57.5% of the them were male and 42.5% were female. The mean age of the patients was 66.55±14.53 years. Surgical margin was evaluated in three patterns: before surgical incision and after surgical incision (P<0.001), before surgical incision and after formalin fixation (P<0.001), after surgical incision and after formalin fixation (P=0.02). In this study, the relationship between the age and initial length of the skin lesion with sample shrinkage was not statistically significant.
Conclusion: The results of this study showed that tissue shrinkage occurs both after incision and after formalin fixation. The highest rate of shrinkage was seen after surgical excision, which was due to the elasticity of the tissue itself. Increasing age and initial length of skin lesion did not affect this shrinkage. Also tumoral tissue contracted less than healthy tissue due to flexibility of fatty tissue and water and lipid content.

Study of knee range of motion after soft tissue repair in both flexion and extension during total knee arthroplasty: a randomized clinical trial
Kiavash Hushmandi, Mohsen Heidari , Seyedeh Omolbanin Seyed Rezaei, Alireza Bahonar, Mehdi Motififard, Hamed Gholizadeh, Mehdi Raei,
Volume 79, Issue 11 (February 2022)
Abstract
Background: The patient's position during the recovery time after arthroplasty surgery can be a factor in reducing complications and improving patients’ condition. Therefore, this study was performed to compare the knee range of motion after soft tissue repair in both flexion and extension positions of total knee arthroplasty.
Methods: This study is a double-blind clinical trial. The study population was all candidates for total knee arthroplasty surgery in Al-Zahra and Kashani hospitals in Isfahan from July 2011 to September 2012. The sample size was selected using the statistical formula of 88 patients and randomly divided into two groups of flexion and extension. In the first group during the knee soft tissue repair, the knee was in flexion and in the second group it was in extension and then it was repaired. Information such as age, sex, body mass index and surgical position were recorded in the checklist. The knee range of motion was measured at the end of the first, second, fourth, eighth and twelfth weeks and recorded in a checklist. In order to compare the pattern of changes in mean knee range of motion over time in the two groups, mixed linear models and conventional marginal models to generalized estimator equations were used by STATA software.
Results: The results showed that there was no significant difference between the flexion and extension groups in knee range of motion. In both groups, the mean knee range of motion increased with time (P<0.001). The mean scores of knee function after the end of the twelfth week in the flexion and extension groups were 141.04±23.19 and 143.09±22.34, respectively, and this difference was not significant.
Conclusion: Soft tissue repair in a particular position is not so effective on the outcome that we want to institutionalize it by spending a considerable amount of budget for training surgeons.

Evaluation of Combination Treatment of BM-MSCs And Lotion containing honey, Aloe, propolis in the Healing of Second Degree Burns in Animal Models.
Tahere Abbasi Moayyer, Aziz Ghahhari,, Tayebeh Rastegar, Fateme Malek, Farzane Rezaei Yazdi, Kamyar Ghaffari Dafchahi, Nasrin Takzaree,
Volume 80, Issue 3 (June 2022)
Abstract
Background: One of the most important issues in medical science is the healing of burn wounds. The use of medicinal plants has been common for many years and today cell therapy offers new approaches to the management of skin wound healing. The present study aimed to evaluate the the combination treatment of lotion containing honey, Aloe, and propolis with BM-MSCs in the healing of second-degree burns in animal models.
Methods: this experimental study from October 2020 to November 2020, was performed in the animal house of Tehran University of Medical Sciences. 72 rats with an age range of 3-4 months and a weight of about 200-250 gr, after burns were randomly divided into 6 groups of 12 with study periods of 7, 14 and 21 days. The groups were as following: control (no treatment), Positive control (SSD1%), First experimental (Stem cells), Second experimental(lotion), Third experimental(Stem cells and lotion), and Fourth experimental (DMEM). To measure the percentage of healing from the wound surface on days 0, 4, 7, 10, 14, 17, and 21 photos were taken and the wound surface area was calculated by Image J software. After sacrificing rats, tissue samples were taken on days 7, 14 and 21 after burning induction. Samples were prepared for staining H&E and Trichrome Masson’s, as well as RT-PCR examination. The results were analyzed using Graph Pad Prism8 software and Tukey and one-way variance tests.
Results: Treatment preference was with the combination therapy group and then with the lotion group. According to macroscopic and microscopic images of H&E and Trichrome Mason, the highest amount of wound coverage and the presence of mature collagen fibers were also observed in the combination therapy group. The results of statistical analysis and scoring also showed increased epithelization, granulation tissue formation, collagen deposition, angiogenesis and fibroblast cell proliferation, and decreased inflammation in the combination therapy group. The combination therapy group also had the highest expression of the TGF-β gene. (P<0/05)
Conclusion: Due to its epithelialization, anti-inflammatory and angiogenesis properties, the lotion has healing properties in second-degree burn wounds and its simultaneous use with mesenchymal stem cells leads to healing and acceleration of burn wound healing.

Costs of services covered by the global payment system in Tehran University of Medical Sciences
Jalal Saeedpour , Mehdi Rezaei , Shamsi Ekhteyar, Sara Akhavan Rezayat , Soheila Damiri , Faezeh Fartaj, Maryam Radin Manesh ,
Volume 80, Issue 4 (July 2022)
Abstract
Background: In Iran, a combination of three methods of budget payment, fee for service and case-based payment (known as the global payment system) is used to reimburse the cost of hospital services. The aim of this study was to investigate the costs of 90 services of the Global Hospital Reimbursement System at Tehran University of Medical Sciences.
Methods: This descriptive cross-sectional applied study was performed from March  2017 to March 2019 in the hospitals of Tehran University of Medical Sciences. The billing and record data of all patients whose services were reimbursed on a global payment system basis were extracted from hospital information systems. Data were analyzed using descriptive statistics (frequency mean. std deviation, maximum & minimum) in SPSS 21 and Excel 2016.
Results: During two years in TUMS, the costs of services provided to 143,866 patients have been reimbursed based on the global payment system., which had a cost of 2300 billion rials. 80% of the total services and costs were related to 10 services. 78.46% of the cases were related to two specialized groups of ophthalmology and obstetrics and gynecology. 83.17% of the total costs of services reimbursed globally at the TUMS were related to these two specialized groups. The average cost per service was about 16 million Rials, but varied greatly for different services, ranging from about 1.8 million Rials to 67 million Rials. On average, for a global service, the share of each of the cost subgroups of diagnostic services, hoteling and nursing services, medicine and consumables, operating room and surgery, physician's visit and consultation, respectively 3.1%, 11.6%, 21.4%, 49.9% and 13.9%.
Conclusion: Managers need to focus on high-frequency and high-cost services to reduce the cost and financial losses for services that are under the global payment system. Depending on the specific cost pattern of each service, the strategies adopted to control the costs of that service should also be different.

Evaluation of the one-year effectiveness and side effects of rituximab in patients with multiple sclerosis in Kermanshah
Nazanin Razazian, Mansour Rezaei, Poona Ahmadi, Negin Fakhri,
Volume 80, Issue 4 (July 2022)
Abstract
Background: Multiple sclerosis (MS) is an inflammatory disease affecting the central nervous system. Rituximab (Zytux) is a type of monoclonal antibody against B cells with CD20 antigen that reduces B cells. The present study examined the one-year effectiveness and side effects of Rituximab.
Methods: This quasi-experimental clinical trial was conducted from September 2018 to September 2019 in Imam Reza Hospital in Kermanshah. 44 eligible patients were selected by the available sampling method and entered the study after evaluation in terms of inclusion and exclusion criteria. Patients were treated with rituximab for one year. At the beginning of the study and at the end of the year, the disability score based on the Expanded Disability Status Scale (EDSS) and active lesions based on MRI for patients were evaluated. Also, the patients were followed up in terms of relapse and medication side effects throughout the year. This study was performed with the support of Kermanshah University of Medical Sciences. Informed consent was obtained from all participants. The data were analyzed by SPSS-25 software.
Results: 44 patients with MS including 29 (65.9%) female and 15 (34.1%) male were studied. 22 patients had RRMS and 22 patients had progressive-relapsing MS (PRMS). In patients with RRMS, the EDSS score at the end of the study was significantly reduced compared to the beginning of the study (P=0.010) but in PRMS patients EDSS was increased but this increase was not significant (P=0.148). In both RRMS and PRMS patients, the number of MRI lesions at the end of the study was lower than the beginning of the study and this decrease was not significant (P>0.05). More Immediate side effects occurred in RRMS patients (13.6% vs. 4.5%) and more delayed side effects were observed in PRMS patients (54.5% vs. 36.3%).
Conclusion: rituximab caused a greater reduction in EDSS in the treatment of RRMS than PRMS and its use had few side effects.

Outcomes of AstraZeneca vaccine for relapse and Covid-19 infection in people with multiple sclerosis
Nazanin Razazian, Mohammad-Ali Sahraian, Sharareh Eskandarieh, Nooshin Jafari, Mansour Rezaei, Negin Fakhri,
Volume 80, Issue 6 (September 2022)
Abstract
Background: People with chronic diseases of the immune system, such as multiple sclerosis (MS), are at risk for Covid-19 disease. However, more research is needed with long-term follow-up. The aim of the study was to follow up people with MS (PwMS) for up to three months after AstraZeneca vaccination for the recurrence of MS and Covid-19 infection.
Methods: This study was a case study (descriptive-analytical) of follow-up type. The study population was PwMS over 18 years of age in Kermanshah province who received both doses of the AstraZeneca vaccine. This study was conducted from August to November 2021. Sampling was done with existing methods based on the National MS Registry of Iran (NMSRI). Demographic information of patients was extracted from NMSRI. A researcher-made form was used to collect information by telephone three months after vaccination about clinical characteristics, Covid-19 infection, and recurrence of MS. Data were analyzed using SPSS-25 software.
Results: Study participants were 40 MS patients with a mean (SD) age of 39.27 (8.8) years, including 32 (80.0%) women. A mean of 9.39 (4.6) years had passed since The patients were diagnosed with MS, and 29 (76.4%) had RR type MS. Four patients (10%) relapsed between the second dose and three months later, of whom two (50%) had sensory symptoms, one (25%) had optic nerve involvement, and one (25%) had motor symptoms and pyramidal pathway involvement. The symptoms of Covid-19 were mild in three patients (10%), while severe symptoms developed in one patient (10%) who received rituximab. Among the patients, no cases of thrombosis were observed. Infusion therapy, a leg fracture, and kidney stones were the only hospitalized cases.
Conclusion: Covid-19 and MS relapse prevalence did not differ significantly in the three months before and after vaccination. There is a need for further studies with a longer follow-up period.

The effect of hip joint position on knee joint isokinetic dynamometry indices in football and track and field athletes
Mandana Rezaei, Nader Sadri-Aghdam , Mahmood Reza Azghani, Fariba Ghaderi, Hakimeh Adigozali,
Volume 80, Issue 8 (November 2022)
Abstract
Background: Isokinetic dynamometry is a golden standard test to estimate lower extremity sport related injuries in the athlete assessment. Dynamometry is also commonly used to design preventive protocols. The aim of this study was to explore the effects of hip joint positioning in seated and lying positions on knee joint dynamometry indices, including extensor and flexor peak torques in football and track and field athletes.
Methods: Forty four male athletes (including 22 football players and 22 track and field athletes) have participated in this descriptive-analytic study. The sampling method was simple nonrandom sampling. This study was conducted in the Biomechanics laboratory of the Rehabilitation Sciences, Faculty of Tabriz University of Medical Sciences since October 2019 to October 2020. Knee joint dynamometry indices were consisted of concentric and eccentric flexor and extensor peak torques at 60 degrees per second velocity. Optimum length, angle of crossover, and the muscle balance ratios (concentric extensor peak torque/concentric flexor peak torque and eccentric extensor peak torque/concentric flexor peak torque) were also evaluated. All assessments were performed in both seated and lying positions. The indices were compared between football players and track and field athletes.
Results: The interaction effect of group and hip joint was not significant (P<0.05). Further, concentric and eccentric flexor and extensor peak torques and conventional flexor to extensor ratio were higher meaningfully in the seated position compared to the lying (P<0.05). Optimum length was significantly higher in the lying position, but the angle of crossover was higher in the seated position (P<0.05). The hip joint position was not effective on the functional flexor to extensor ratio (P>0.05). Also, dynamometry indices were not different between football and track and field groups (P<0.05).
Conclusion: Findings revealed the effects of hip joint position on strength measurements in football and track and field athletes. This factor should be considered to design strengthening exercises for athletes and also to estimate the sport injury risk.

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