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Eslami M, Mehrpooya M, Broumand B, Seifi S,
Volume 67, Issue 1 (4 2009)
Volume 67, Issue 1 (4 2009)
Abstract
Background: Uric acid as a final product of purine metabolism has a role of risk factor for cardiovascular disease with less clear mechanism in general population. The aim of this study was Assessing and finding association between uric acid levels and CAD as a risk factor in renal transplant candidates and if we can predict need to revascularization according to uric acid level as an important measure.
Methods: This is a cross-sectional study that has been studied since April 2007 up to December 2008, in imam Khomeini and pars hospitals in Tehran. Inclusion criteria were patients with ESRD, more than 40 years who were candidates for renal transplantations. They underwent coronary angiography without regarding clinical cardiac symptom or results of noninvasive tests (for avoiding referral bias) and simultaneous analysis of serum uric acid level and results of this two producers were analyzed. Excluding criteria were patients who didn't tend to coronary angiography, those who hadn't adequate artery access, or potential co morbidity so that angiography was impossible and life expectancy less than 6 month.
Results: 56 (24 females and 32 males) were constituted. 89.3% (50) of patients had coronary artery disease. The average of uric acid level was significantly different in patients with and without CAD [7.62±1.07mg/dl and 5.95±1.29mg/dl respectively] (p=0.0024). Moreover, there was statistically significant difference in serum uric level between patients who were candidate for revascularization and the others [7.89±0.79mg/dl and 6.2±1.27mg/dl respectively] (p<0.001).
Conclusion: It seems that serum uric acid can be considered as a cardiovascular risk factor in renal transplant candidates and also as a predictor for related treatment.
Samiee H, Tavoli Z, Ghanbari Z, Poormand Gh, Taslimi Sh, Eslami B, Tavoli A,
Volume 67, Issue 9 (6 2009)
Volume 67, Issue 9 (6 2009)
Abstract
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Background: Stress incontinence
is the most common type of urinary incontinence which has been treated by
different surgical techniques. The objectives of our study were to compare the
laparoscopic Burch colposuspension with Trans- obturator Tape (TOT) procedure.
Methods: This randomized clinical trial was conducted on 40 patients with stress incontinence referred to Arash
hospital from 2007 to 2009. All patients were randomly divided in two groups (laparoscopic Burch and TOT). Patient information was using obtained demographic,
I-QOL (Which contained 22 questions), UDI-6 (urinary symptoms), ISI (Severity of urinary
incontinence) questionnaires and urodynamic test.
Results: The data collected from 19 patients in TOT group and 16 patients in laparoscopic Burch groups. The objective cure rate which was
determined by no urinary leakage during stress and were analyzed urodynamic evaluation
was 75% in laparoscopic and 84.2% in TOT (p=0.53). Result of ISI questionnaire with showing the subjective cure rate following surgery had
no significant difference between two groups (p=0.23). UDI-6 questionnaire was used to compare the
result of both groups before and after surgery and showed that the improvement
in Urgency was significant in TOT in compare to Burch
(p=0.04). I-QOL score significantly increased in both groups after six months of operation
(p<0.05). But the
differences were not statistically significant.
Conclusion: Based on our results subjective
and objective cure rate were not significantly different between TOT and laparoscopic Burch
colposuspension.
Tanaray B, Eslami M, Salehi M, Jahanzad I, Emami M,
Volume 68, Issue 7 (7 2010)
Volume 68, Issue 7 (7 2010)
Abstract
Background: Studies of the association between post operative AF and Plasma level of NT- Pro BNP have reported conflicting findings. The aim of the present study was evaluation of the association between post coronary bypass graft- Atrial Fibrillation (AF) and Plasma level of NT- ProBNP as an independent risk factor of AF development in patients undergoing coronary artery bypass graft.
Methods: In a cohort study, 79 patients with sinus rhythm who admitted in Imam Khomeini Hospital in Tehran, Iran, during February 2009 and February 2010 for CABG are included the study and followed for developing post operative AF rhythm.
Results: Post operative AF was found in 17.7% of patients. The peak time from the operation to the first AF episode was in second post op day in ten patients (71.4%). The serum level of ProBNP in patients with AF was significantly higher (1624± 647 versus 221± 238 pg/ml, p< 0/0001). Increased age, Increased LA size and high plasma level of ProBNP were associated with increased risk for post op AF. After adjustment of risk factors, plasma level of ProBNP was the most important risk factor with odds ratio of 15.34 with CI 95% 1.77-132.95 and then LA diameter with odds ratio of 6.11 with CI 95% 0.99-37.42 was independently correlated with post op AF. Correlation between plasma level of ProBNP with age and LA size was seen too (LA size r = 0.0281, p= 0.012). Between age and ProBNP (r= 0.337, p= 0.002). The best cut off point for plasma ProBNP as a predictor of post op AF was 854 pg/ml.
Conclusion: Increased level of preoperative ProBNP levels could be an independent predictor of post operative Atrial Fibrillation.
Nabiuni M, Parivar K, Zeynali B, Karimzadeh L, Sheikholeslami A,
Volume 69, Issue 9 (6 2011)
Volume 69, Issue 9 (6 2011)
Abstract
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Background: Cyclooxygenase 2 is a key enzyme which converts arachidonic acid into
prostaglandins. Cyclooxygenase 2 is triggered by
inflammatory stimuli, such as cytokines. Its expression increases in tumors and
Alzheimer's disease and ovarian hyperstimulation syndrome. Polycystic ovarian
syndrome is a heterogeneous disease characterized by pathological angiogenesis
and chronic anovulation. In the present study, the probable role of
cyclooxygenase 2 in Wistar rats with polycystic
ovarian syndrome was investigated.
Methods: Thirty
female Wistar rats (170-200 gr)
were equally divided into three groups: 2 mg
estradiol valerate was intramuscularly administered to each rat in the
experiment group or group 1 the rats in group 2 were regarded as the sham group and received sesame oil
injections and group 3 or the control group received no
injections. After 60 days of treatment, animals were
anaesthetized with chloroform and killed by decapitation. Ovaries were
collected for histological and immunohistochemical evaluations. All the
experiments were repeated three times.
Results: Morphologically, ovaries from the
control group exhibited follicles in various stages of development and many
fresh corpus luteum. In estradiol valerate group small follicles in early
development were observed in addition to follicles showing evidence of atresia
and many large cysts with thickened theca cell layer. Corpus luteum was rare or
absent in group 2. The immunohistochemical analysis
for cyclooxygenase 2 expression showed an increased
expression of cyclooxygenase 2 enzyme in group 1.
Conclusion: The results suggested the involvement of
cyclooxygenase 2 in
the progression to polycystic ovarian syndrome in a rat model.
Jabar Lotfi , Mohammad Taghikhani , Marjan Zarif Yeganeh , Sara Sheikholeslami , Mehdi Hedayati ,
Volume 72, Issue 1 (April 2014)
Volume 72, Issue 1 (April 2014)
Abstract
Background: Thyroid carcinoma is the most frequent malignant tumor of the endocrine system in human body and accounts for nearly 1% of all cancers. Medullary thyroid carcinoma is the third frequent of thyroid cancer and accounts about 5-8% of thyroid cancer. Osteocalcin, known as a Bone Gamma-carboxyglutamic Acid-containing Protein (BGLAP), is the most non collagenous protein. Retinol binding proteins are the family of proteins that have diverse actions but mainly transport retinol in human body. In this study to evaluate effect of existence medullary thyroid carcinoma on metabolism of bone and adipose tissue, plasma level of two mentioned proteins had analyzed. Methods: Population in this study consists of 46 individuals with medullary thyroid carcinoma and 44 healthy subjects referred individuals to Research Institute for Endo-crine Sciences, Shahid Beheshti University of Medical Sciences. People with the disease after diagnosis of medullary thyroid carcinoma and pathologically confirmed by biopsy in the initial stages of the study were called. After informed consent, 10 ml of blood from the antecubital vein of left hand in sitting position obtained and after cen-trifugation, plasma was isolated from all samples until analyzed kept in the freezer. Plasma levels of hormones were measured by sandwich type ELISA method. Obtained results were analyzed by SPSS version 16 with independent t-test method. Results: Mean plasma level of osteocalcin in patients was 33.1±3.5 and in healthy sub-jects was 12.5±1.2 ng/ml (Mean±SD) and Odds Ratio (OR) value was 1.04. In patients, mean plasma level of retinol binding protein was 82.5±2.7 and in healthy subjects was 22.8±1.6 μg/ml and OR value was 2.1. The confidence level considered at 95%. These differences of plasma levels were statistically significant (P= 0.001). Conclusion: According to difference between plasma levels of osteocalcin and retinol binding protein-4 in patients suffered of medullary thyroid carcinoma comparison with normal subjects, it can be said that, probably medullary thyroid carcinoma has effect on bone and adipose tissue metabolism, so osteocalcin and retinol binding protein-4 hormones have potential to be used for confirmation of diagnosis or following treatment of medullary thyroid carcinoma.
Mehrnaz Tayebi Kamardi , Arash Pourgholaminejad , Mohammadreza Baghban Eslaminejad, Fattah Sotoodehnejadnematalahi,
Volume 72, Issue 6 (September 2014)
Volume 72, Issue 6 (September 2014)
Abstract
Mesenchymal Stem Cells (MSCs) are well known as the regulator of the immune system. These multipotent non-hematopoietic progenitor cells have been originally isolated from bone marrow, and later on found in several other tissues, such as skeletal muscle, umbilical cord blood, adipose and fetal liver tissues. Immunomodulatory effects of MSCs on a variety of immune cells such as T and B lymphocytes, Natural Killer cells (NK), neutrophils, macrophages and dendritic cells, has made a good candidate of them for the treatment of inflammatory disorders, particularly autoimmune diseases such as multiple sclerosis and rheumatoid arthritis. In addition, several studies have indicated mechanisms by which MSCs could reduce immune cell proliferation and activation leading to immune tolerance induction. Since T lymphocytes are considered as the most important immune cells, effect of MSCs on the activity of these cells has a very special significance to direct immune response. Under various conditions, T-lymphocytes have different phenotype and performance and can be differentiated into particular subtype such as regulatory T cells. Both in vitro and in vivo studies have indicated that MSCs modulate innate and adaptive immune system by promoting generation of CD4+CD25+ T regulatory cells which have important role in immune tolerance induction and autoimmune disease prevention. MSCs are able to block pro-inflammatory and increase anti-inflammatory cytokines secretion. So such unique immunomodulatory features make MSCs ideal candidates for clinical application as immunosuppressants which can be considered for autoimmune diseases treatment. Therefore, in this short-review, we attempt to focus mainly on the existing information about MSCs in association with immunomodulatory function of them on the immune system. In addition, the possible mechanisms and the performance impact of MSCs in autoimmune diseases improvement are discussed here. However, increasing knowledge of how MSCs will influence on the immune system suppression, leading us to better use of these cells as a promising tool in the treatment of autoimmune diseases.
Sara Sheikholeslami , Marjan Zarif Yeganeh, Laleh Hoghooghi Rad, Maryam Sadat Daneshpour, Mehdi Hedayati ,
Volume 72, Issue 8 (November 2014)
Volume 72, Issue 8 (November 2014)
Abstract
Background: Medullary thyroid carcinoma (MTC) occurs in both sporadic (75%) and hereditary (25%) forms. The missense mutations of the rearranged during transfection (RET) proto-oncogene in MTC development have been well demonstrated. Several studies have been published that indicate the molecular analysis of RET gene may offer early identification of those patients at high risk to develop MTC and may provide the opportunity for early intervention. The aim of this study was to investigate frequency of G691S/S904S haplotype in MTC patients and their relatives. Methods: From 2004 to 2014, 358 participants were studied, including 213 patients (119 female, 94 male) and 145 their relatives (79 female, 66 male) in cellular and molecular research center of Shahid Beheshti Research Institute for Endocrine Sciences, Tehran, Iran. Genomic DNA was extracted from peripheral blood leucocytes using the standard Salting Out/Proteinase K method. Nucleotide change detection was performed using PCR and direct DNA sequencing methods. The RET mutations and SNPs, sequences were analyzed. Results: According to DNA sequencing results, 189 individuals (119 patients, 70 relatives) had both G691S (rs1799939) missense mutation in exon11 and S904S (rs1800863) synonymous mutation in exon 15 of RET proto-oncogene. The allele frequency of G691S/S904S haplotype was 35.02% in patients and 29.92% in their relatives. Conclusion: The obtained data showed the frequency of G691S/S904S RET gene haplotype among Iranian MTC patients and their relatives. The G691S and S904S nucleotide changes were in complete linkage disequilibrium, so the results were grouped together and referred to as G691S/S904S haplotype. This haplotype are not considered as oncogenic mutations at this time, its functional role should be investigated. Further analysis is needed to demonstrate the association between this haplotype and MTC development.
Akbar Eslami , Mohammad Hossien Saghi , Ayob Rastegar,
Volume 73, Issue 10 (January 2016)
Volume 73, Issue 10 (January 2016)
Abstract
Background: Background gamma radiation levels vary in different locations and depended on many factors such as radiation properties of soil, building materials as well as construction types which human lives on it. People are always exposed to ionizing radiation, which could badly influence their health. The aim of this study was to evaluate the background gamma-ray dose rate and the estimated annual effective dose equivalent and determination of excess lifetime cancer risk in Sabzevar City, Iran.
Methods: The aim of this cross-sectional study was to determine the dose rate of background gamma radiation in outdoor an indoor areas, 26 stations were selected using the map of the Sabzevar City. The amount of gamma radiation was measured at 4 months (September to January) in 2014 year. The dosimeter used in this study was a survey meter, that is designed for monitoring radiation of x, gamma and beta rays.
Results: The obtained results show that there are significant differences between the indoor and outdoor exposures (P> 0.05). We did not observe significant differences between the time of sampling and sampling locations, (P<0.05). The minimum and maximum values of dose rate were found 66±20 nSvh-1 and 198±28 nSvh-1. The annual effective dose for Sabzevar residents was estimated to be 0.85 mSv and also the amount of excess lifetime cancer risk was estimated 3.39×10-3.
Conclusion: According to the results, the excess lifetime cancer risk and the annual effective dose for the Sabzavar City residents due to the background gamma radiation was higher than the global average (0.5 mSv). The epidemiological studies have been proposed to evaluate the risk of chronic diseases associated with natural radiation exposure among residents.
Marjan Zarif Yeganeh , Samira Kabiri , Sara Sheikholeslami , Hosna Hesanmanesh , Mehdi Hedayati ,
Volume 74, Issue 12 (March 2017)
Volume 74, Issue 12 (March 2017)
Abstract
Background: Thyroid carcinoma is the most common endocrine malignancy. Medullary thyroid carcinoma (MTC) approximately accounts for 5-10% of all thyroid carcinoma. Nowadays, it is obviously, the mutations in REarranged during transfection (RET) proto-oncogene, especially, mutations in exons 10, 11 and 16 are associated with MTC pathogenesis and occurrence. Thus, early diagnosis of MTC by mutation detection in RET proto-oncogene allows to identify patients who do not have any developed symptoms. The aim of this study was to screening of germline mutations in RET proto-oncogene exons 17 and 18 in MTC patients and their first degree relatives in Iranian population.
Methods: In this cross-sectional study, three hundred eleven participates (190 patients, 121 their relatives) were referred to endocrine research center, Shahid Beheshti University of Medical Science during September 2013 until September 2015. The inclusion criteria were pathological and clinical diagnosis. After whole blood sampling, genomic DNA was extracted from peripheral blood leucocytes using the standard Salting Out/Proteinase K method. Nucleotide change detection in exons 17 and 18 was performed using PCR and direct DNA sequencing methods.
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Results: In this study, twenty missense mutations [CGC>TGC, c.2944C>T, p.Arg982Cys (rs17158558)] which included 16 heterozygote and 4 homozygote mutations were found in codon 982 (exon 18). In the present study, 154 G>A (rs2742236) and 4 C>T (rs370072408) nucleotide changes were detected in exons 18 and intron 17 respectively. There was no mutation in exon 17. Conclusion: It seems that because of arginine to cysteine substitutions in RET tyrosine kinase protein structure and its polyphen score (0.955) and SIFT score (0.01) the mutation in codon 982 (exon 18) could be have pathogenic effects. On the other hands, the mentioned mutation frequency was 6.4% among MTC patients, so this mutation of exon 18 could be checked in genetic screening tests of RET proto-oncogene. Although this needs more study. |
Hamed Tabasizadeh , Foroud Salehi , Marzieh Eslami Moayyed, Marieh Eslami Moayyed ,
Volume 75, Issue 3 (June 2017)
Volume 75, Issue 3 (June 2017)
Abstract
Background: Cerebral arteriovenous malformations are rare congenital anomalies presenting as different symptoms depending on their size and the age of patient. Congestive heart failure is a rare condition in neonatal period and is most common due to structural heart defects, but rarely may be a result of peripheral shunts such as cerebral arteriovenous malformation.
Case presentation: A term male newborn infant who was delivered by Caesarean Section in Chamran Hospital, Ferdows, South Khorasan Province, June 2016. The infant was admitted to neonatal care unit due to nonreactive nonstress (NST) with normal Apgar score. In first postpartum visit, a systolic heart murmur was detected. Echocardiography showed small atrial septal defect secundum type and patent foramen ovale (PFO). He presented clinical manifestations of heart failure after 72 hours of birth. Antibiotic and treatment of heart failure was started. Following excluding most common etiologies of heart failure such as sepsis, anemia and arrhythmias, for detecting less common conditions such as cerebral vascular aneurism a transfontanelle ultrasonography was performed which showed dilated cerebral venous system. Magnetic resonance imaging (MRI) and Magnetic resonance venography (MRV) revealed a large congenital cerebral arterio-venous malformation (CAVM), in right cerebral hemisphere. Finally, he was expired 9 days after birth due to severe heart failure before any definitive treatment for closing CAVM could be done.
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Conclusion: CAVM are extremely rare vascular anomalies in newborns which may present occasionally as congestive heart failure in neonatal period. So after excluding other most common etiologies of heart failure such as structural heart defects, screening CAVMs should be done. Inspite of early diagnosis, usually they have extremely poor prognosis. |
Samira Ehyayi , Mehdi Hedayati , Marjan Zarif Yeganeh , Sara Sheikholeslami , Sayed Asadollah Amini,
Volume 75, Issue 6 (September 2017)
Volume 75, Issue 6 (September 2017)
Abstract
Background: Thyroid carcinoma is the most common endocrine malignancy and approximately accounts 2% of all cancer cases. Medullary thyroid cancer (MTC) is an endocrine tumor with differentiation of Parafollicular or C-cells and is categorized into hereditary or sporadic types. Medullary thyroid carcinoma approximately accounts for 5-10% of all thyroid carcinoma. Germ-line and somatic mutations in exons 10 and 11 RET (Rearranged during Transfection) proto-oncogene are responsible for the occurrence of the familial and sporadic types, respectively. Calcitonin is a key marker in MTC diagnose and has been demonstrated to be highly sensitive for differential diagnosis prognostic assessment, follow-up and evaluation of MTC treatment. The aim of this study was to investigate the relationship between plasma levels of calcitonin in MTC patients with or without RET mutation.
Methods: In this cross-sectional study, the population consist of MTC patients who have referred to the endocrine and metabolism research center of Shahid Beheshti University of medical sciences since October 2013 till October 2016. Genomic DNA was extracted from peripheral blood leucocytes using the standard salting out/proteinase K method. Nucleotide change detection in exons 10 and 11 was performed using polymerase chain reaction (PCR) and direct DNA sequencing methods. Participants were then divided into two groups with or without mutation (43 individuals in each group). Plasma calcitonin levels were determined by enzyme-linked immunosorbent assay (ELISA) method in both groups.
Results: Evaluation of the level of plasma calcitonin in 43 patients with a molecular mutation in RET proto-oncogene (mean age 31 years) and 43 patients without molecular mutations in RET proto-oncogene (mean age 43 years) were 7.6 pmol/mL and 3.07 pmol/mL respectively. This difference is statistically significant (P=0.0014).
Conclusion: Routine measurement of calcitonin has been investigated as a screening method for the diagnosis of medullary thyroid carcinoma patients. Nevertheless, additional data are required to definitely support routine measurement of calcitonin due to the role of RET proto-oncogene.
Methods: In this cross-sectional study, the population consist of MTC patients who have referred to the endocrine and metabolism research center of Shahid Beheshti University of medical sciences since October 2013 till October 2016. Genomic DNA was extracted from peripheral blood leucocytes using the standard salting out/proteinase K method. Nucleotide change detection in exons 10 and 11 was performed using polymerase chain reaction (PCR) and direct DNA sequencing methods. Participants were then divided into two groups with or without mutation (43 individuals in each group). Plasma calcitonin levels were determined by enzyme-linked immunosorbent assay (ELISA) method in both groups.
Results: Evaluation of the level of plasma calcitonin in 43 patients with a molecular mutation in RET proto-oncogene (mean age 31 years) and 43 patients without molecular mutations in RET proto-oncogene (mean age 43 years) were 7.6 pmol/mL and 3.07 pmol/mL respectively. This difference is statistically significant (P=0.0014).
Conclusion: Routine measurement of calcitonin has been investigated as a screening method for the diagnosis of medullary thyroid carcinoma patients. Nevertheless, additional data are required to definitely support routine measurement of calcitonin due to the role of RET proto-oncogene.
Alireza Atashi , Shahram Amini , Erfan Ghasemi , Shima Sheybani , Saeid Eslami ,
Volume 76, Issue 4 (July 2018)
Volume 76, Issue 4 (July 2018)
Abstract
Background: Various prediction models have been developed aiming to estimate risk-adjusted mortality, morbidity and length of intensive care unit stay following cardiac surgeries. The European system for cardiac operative risk evaluation II (EuroSCORE II) is a prediction model which maps 18 predictors to a 30-day post-operative risk of death. The objective of this study was to evaluate the performance of the EuroSCORE II risk-analysis predictions among patients who underwent heart surgeries.
Methods: A prospective cross-sectional study was conducted to collect required variables for all consecutive patients underwent heart surgeries in Emam Reza hospital, Mashhad, Iran, from March 2014 to March 2015. Once the patient was hospitalized a cardiologist or a general physician evaluated pre- peri- and post-operative state to fill out the pre-designed structural paper form. Comparing the observed and expected mortality, the sensitivity, specificity, area under the receiver operating characteristic curve (AUC) and finally the discrimination power of the model for our patients were calculated and reported. The model value was calculated using the online tool.
Results: A total of 1337 patients (60% males) were included, the observed mortality rate was 3.2%. Although the overall performance was acceptable, the model showed poor discriminatory power (AUC=0.667, CI 95%: 0.648-0.685) and accuracy with sensitivity=61.88% and specificity=66.23%.
Conclusion: Our single-center study, based on consecutive patients who underwent cardiac surgery showed that EuroSCORE II demonstrated a moderate statistical overall performance with poor discrimination and calibration measures remain as concerning issues regarding 30-day post-operative mortality prediction after adult cardiac surgery. Poor performance measures for this system show the need for reformulating this risk stratification tool aiming to improve post cardiac surgery outcome predictions in Iran.
Methods: A prospective cross-sectional study was conducted to collect required variables for all consecutive patients underwent heart surgeries in Emam Reza hospital, Mashhad, Iran, from March 2014 to March 2015. Once the patient was hospitalized a cardiologist or a general physician evaluated pre- peri- and post-operative state to fill out the pre-designed structural paper form. Comparing the observed and expected mortality, the sensitivity, specificity, area under the receiver operating characteristic curve (AUC) and finally the discrimination power of the model for our patients were calculated and reported. The model value was calculated using the online tool.
Results: A total of 1337 patients (60% males) were included, the observed mortality rate was 3.2%. Although the overall performance was acceptable, the model showed poor discriminatory power (AUC=0.667, CI 95%: 0.648-0.685) and accuracy with sensitivity=61.88% and specificity=66.23%.
Conclusion: Our single-center study, based on consecutive patients who underwent cardiac surgery showed that EuroSCORE II demonstrated a moderate statistical overall performance with poor discrimination and calibration measures remain as concerning issues regarding 30-day post-operative mortality prediction after adult cardiac surgery. Poor performance measures for this system show the need for reformulating this risk stratification tool aiming to improve post cardiac surgery outcome predictions in Iran.
Kamran Aghakhani , Seyyed Hossein Eslami , Afshin Khara , Mohsen Bijandi ,
Volume 76, Issue 7 (October 2018)
Volume 76, Issue 7 (October 2018)
Abstract
Head injury is one of the most important types of injury and is responsible for most of the deaths due to trauma. Low-income and middle-income countries face with more risk factors, but they still lack adequate health-care capacity to deal with complications. Trauma literally means the damage and injury, and head injury was defined as physical damage to the brain or skull caused by external forces. Head trauma is an important event. Anyone can fall including toddlers, adults and elders. There are several mechanisms for head injury, including motor vehicle accidents, falls, assault and violence. After the motor vehicle accidents, fall is the second most important cause of head injury. Deaths from falling in countries with lower socioeconomic conditions are higher. To collect the information for this study, the PubMed, Scopus and Google Scholar databases were used. Sixty-four related articles were reviewed from 1980 to 2018. The keywords including "head injury", "head trauma", "brain damage", "fall mechanism", "Iran" and "epidemiology" were used to search the articles. According to the findings of this review fall is the second most common head injury mechanism in Iran. The fall mechanism is more common in the age group of young children and elderly. Also, the incidence of fall mechanism is more in males with head injury than women. In most other countries in the world, fall is the first and the second head injury mechanism. Also, falling from lower altitudes is a more common mechanism than a fall from higher altitude in injury to the head. Falling from lower level is a more common mechanism than fall from higher level in head injuries. In addition, the outbreak of the fall mechanism in children and the elderly with head injuries is more. Despite the efforts that have been made in the past years to determine the pattern of epidemiology of head trauma and its results in Iran, there is not enough information on fall-related head injury. Considering that the head traumatic injury is one of the most common and most dangerous outcomes of fall, the purpose of this review study is to investigate epidemiologic fall-related head injury.
Sepehr Eslami , Seyed Hamid Mousavi, Keyvan Ghadimi ,
Volume 77, Issue 9 (December 2019)
Volume 77, Issue 9 (December 2019)
Abstract
Background: Recently, the surgical methods are used in patients with anterior cruciate ligament rupture and have been associated with successful results. There are different results in the term of using of the surgical methods for anterior cruciate ligament that often is associated with some complications such as infection, static laxity, remaining the pain, need to recurrence surgery, and limitation in the range of motion. Therefore, in this study, we aimed to compare outcomes of anterior cruciate ligament reconstruction with the fixed loop and the adjustable loop.
Methods: This cross-sectional study was done on 60 patients undergoing anterior cruciate ligament reconstruction referred to Kashani Hospital of Isfahan, Iran, from March 2017 to February 2019. Also, this study was approved in the Isfahan University of Medical Sciences, Isfahan, Iran. 30 patients were assigned to a fixed loop and 30 patients under the adjustable loop method. Postoperative outcomes were compared with the fixed loop group and the adjustable loop group.
Results: The frequency of static laxity below 8 mm in the fixed loop group was 83.3% and the frequency of static laxity below 8 mm in the adjustable loop was 76.7%. There was no significant difference between the fixed loop group and the adjustable loop group based on static laxity. Also, no infection was seen in the fixed loop group and the adjustable loop group. There was no significant difference between the fixed loop group and the adjustable loop group in terms of range of motion and knee score before and after surgery. After surgery, 96.7% of the fixed loop group and 86.7% of the adjustable loop group returned to normal activity. There was no significant difference between the fixed loop group and the adjustable loop group in terms of return to normal activity and satisfaction.
Conclusion: Using the fixed loop is effective, useful, and with low-complication for the patients with anterior cruciate ligament and also using the adjustable loop grafts is effective, useful, and with low-complication for the patients with the anterior cruciate ligament rupture.
Methods: This cross-sectional study was done on 60 patients undergoing anterior cruciate ligament reconstruction referred to Kashani Hospital of Isfahan, Iran, from March 2017 to February 2019. Also, this study was approved in the Isfahan University of Medical Sciences, Isfahan, Iran. 30 patients were assigned to a fixed loop and 30 patients under the adjustable loop method. Postoperative outcomes were compared with the fixed loop group and the adjustable loop group.
Results: The frequency of static laxity below 8 mm in the fixed loop group was 83.3% and the frequency of static laxity below 8 mm in the adjustable loop was 76.7%. There was no significant difference between the fixed loop group and the adjustable loop group based on static laxity. Also, no infection was seen in the fixed loop group and the adjustable loop group. There was no significant difference between the fixed loop group and the adjustable loop group in terms of range of motion and knee score before and after surgery. After surgery, 96.7% of the fixed loop group and 86.7% of the adjustable loop group returned to normal activity. There was no significant difference between the fixed loop group and the adjustable loop group in terms of return to normal activity and satisfaction.
Conclusion: Using the fixed loop is effective, useful, and with low-complication for the patients with anterior cruciate ligament and also using the adjustable loop grafts is effective, useful, and with low-complication for the patients with the anterior cruciate ligament rupture.
Farzaneh Sheikholeslami , Safoora Gharibzadeh , Gharibzadeh , Nargess Miyandehi , Farzaneh Ahmadnejad , Saeed Godeyri Eslami , Javad Vaez , Ali Moradi ,
Volume 77, Issue 12 (March 2020)
Volume 77, Issue 12 (March 2020)
Abstract
Background: Potency evaluation of rabies vaccine is a cheap, fast, high precision and consistent with ethical values is critical, so researchers have modified a variety of methods such as: National Institute of Health (NIH) method, Single Radial Immunodiffusion (SRID) and so on. The purpose of the present study was to replace an in vitro method consistent with medical ethics criteria instead of an in vivo method. By recognizing that the potency of the rabies vaccine depends on the amount of glycoprotein antigen content and the monoclonal antibody detect the correct folding of antigen of the rabies virus, then the glycoprotein content could be represent of vaccine potency.
Methods: In this study, we designed an immune-capture enzyme-linked immunosorbent assay (ELISA) with three antibodies (capture, primary and secondary) to determine the existent amount of viral glycoprotein in different rabies vaccines, and compared the results at the same time with measuring potency of those vaccines using the NIH method. This applied study was conducted from September 2016 to September 2018 at the Research Laboratory of the World Health Organization Collaborating Center for reference and research on rabies at the Pasteur Institute of Iran in Tehran.
Results: The slope of the standard line was calculated to R2=0.98 (P=0.0013). In the humans’ vaccines, the mean lied between 5.554-7.336 (SD=0.0463-0.1039) and the coefficient of variation was 0.778-2.436 (SD=0.0041-0.2724), at the same time in the animals’ vaccines the mean were 2.293-5.993 (SD=0.0041-0.2724) and the coefficient of variation was calculated 0.182-4.546. For animal vaccines the Pearson correlation coefficient is 0.99 and for the human vaccines this coefficient was 0.95. Also, the concordance correlation coefficient for animal vaccines was 0.98 and for human vaccines is 0.95, indicating a moderate to high concordance in both animals and humans vaccines.
Conclusion: The designed Immuno-capture ELISA kit had a proper acceptance criterion, intermediate precision, good linearity and robustness for measuring the glycoprotein level of the vaccine, which was directly related to the vaccine potency.
Methods: In this study, we designed an immune-capture enzyme-linked immunosorbent assay (ELISA) with three antibodies (capture, primary and secondary) to determine the existent amount of viral glycoprotein in different rabies vaccines, and compared the results at the same time with measuring potency of those vaccines using the NIH method. This applied study was conducted from September 2016 to September 2018 at the Research Laboratory of the World Health Organization Collaborating Center for reference and research on rabies at the Pasteur Institute of Iran in Tehran.
Results: The slope of the standard line was calculated to R2=0.98 (P=0.0013). In the humans’ vaccines, the mean lied between 5.554-7.336 (SD=0.0463-0.1039) and the coefficient of variation was 0.778-2.436 (SD=0.0041-0.2724), at the same time in the animals’ vaccines the mean were 2.293-5.993 (SD=0.0041-0.2724) and the coefficient of variation was calculated 0.182-4.546. For animal vaccines the Pearson correlation coefficient is 0.99 and for the human vaccines this coefficient was 0.95. Also, the concordance correlation coefficient for animal vaccines was 0.98 and for human vaccines is 0.95, indicating a moderate to high concordance in both animals and humans vaccines.
Conclusion: The designed Immuno-capture ELISA kit had a proper acceptance criterion, intermediate precision, good linearity and robustness for measuring the glycoprotein level of the vaccine, which was directly related to the vaccine potency.
Vahid Eslami, Azin Gheymati,
Volume 78, Issue 8 (November 2020)
Volume 78, Issue 8 (November 2020)
Abstract
Background: Clopidogrel is an effective anti-platelet drug that is commonly prescribed for patients with atherosclerotic coronary and peripheral vascular diseases, especially after angioplasty and coronary artery bypass graft surgery. Even though this drug seems safe, there are case reports of important side effects with its use.
Case Presentation: The patient was 67 years old male admitted with a diagnosis of inferior myocardial infarction who underwent angioplasty on RCA with a drug-eluting stent and was discharged with an uneventful course from hospital with medical treatment, including Clopidogrel. The patient came back to the clinic 30 days later with icter, nausea and loss of appetite. The lab data showed: Bilirubin (total= 5, direct=4), ALT=220, AST=100, Gama GT=830, Alk.phop=445. Virologic and imaging studies were normal. With a possible diagnosis of drug-induced hepatic injury all possible Prescribed drugs were held stepwise but bilirubin and the patient’s symptoms did not relieve until Clopidogrel has been changed. After 10 days bilirubin and his symptom relieved.
Case Presentation: The patient was 67 years old male admitted with a diagnosis of inferior myocardial infarction who underwent angioplasty on RCA with a drug-eluting stent and was discharged with an uneventful course from hospital with medical treatment, including Clopidogrel. The patient came back to the clinic 30 days later with icter, nausea and loss of appetite. The lab data showed: Bilirubin (total= 5, direct=4), ALT=220, AST=100, Gama GT=830, Alk.phop=445. Virologic and imaging studies were normal. With a possible diagnosis of drug-induced hepatic injury all possible Prescribed drugs were held stepwise but bilirubin and the patient’s symptoms did not relieve until Clopidogrel has been changed. After 10 days bilirubin and his symptom relieved.
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Conclusion: Clopidogrel is a common and partially safe drug, but it may cause hepatic injury. Considering Clopidogrel side effects and its interactions seem necessary for patient management.
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Bita Eslami, Ramesh Omranipour , Bahare Hesamifar, Zahra Behboodi Moghadam , Amirmohsen Jalaeefar,
Volume 78, Issue 11 (February 2021)
Volume 78, Issue 11 (February 2021)
Abstract
Background: Breast cancer is the most common cancer in women and its treatment includes various surgeries. Breast-Q is a new patient-reported outcome instrument for breast surgery and it should be validated appropriately for clinical research. This study aimed to develop the Persian version of the Breast-Q and validate the reconstruction module to evaluate the quality of life and satisfaction of Iranian women with a previous history of breast reconstruction.
Methods: This study was descriptive and analytical cross-sectional. The study population consisted of women with a previous history of breast cancer and various breast surgeries referred to the outpatient clinic of Cancer Institute, Imam Khomeini Hospital from September 2017 to October 2019, using convenience sampling. After obtaining permission from the MAPI institute and translating all questionnaires into Persian, the validity, and reliability of the breast reconstruction module were evaluated. To confirm face validity, a questionnaire was given to patients to judge each item. To confirm the content validity of the questionnaire, two qualitative and quantitative methods were used. Content validity ratio (CVR) was calculated based on the expert opinion (Lawshe formula). Waltz & Bausell’s method was used to examine the content validity index (CVI). Finally, a new version of the questionnaire was assessed in 20 women who had undergone TRAM flap breast reconstruction at least 6 months ago.
| Results: After translation of the questionnaire into Persian, and face and content validation process, the 116 items of the first questionnaire converted to 72 with an acceptable impact score greater than 1.5 and CVR and CVI. The internal validity of the breast reconstruction module was approved by Cronbach's alpha value of 0.94. Conclusion: Considering the limitation of the specific questionnaires for various breast surgery procedures, the Breast-Q questionnaire can be an efficient tool for the evaluation of the quality of life and satisfaction in patients. Since the translation of the questionnaire has become valid and reliable, it can be used for future research by other researchers. |
Rojin Hemmati, Maryam Naseroleslami, Nahid Aboutaleb, Neda Mousavi Niri ,
Volume 79, Issue 5 (August 2021)
Volume 79, Issue 5 (August 2021)
Abstract
Background: Heart failure is one of the most common cardiovascular disorders and is considered a chronic, progressive and debilitating disorder. The medical treatment of this disease is accompanied by many problems. Today, stem cells are being used increasingly to reduce the problems of heart failure treatments. Since pro-inflammatory cytokines play an important role in the prognosis and progression of cardiovascular disease, the present study aimed to investigate the effect of intravenous injection of human amniotic membrane mesenchymal stem cells on the levels of interleukins 4 and 12 in the serum of male rats in the heart failure model.
Methods: This is an experimental study that was conducted from October 2018 to May 2019 in the Physiology Research Center of Iran University of Medical Sciences. In this study, 28 male wistar rats (180-200 gr) were randomly divided into four groups: control group, heart failure group, heart failure group that received culture medium and heart failure group that received mesenchymal stem cells by intravenous injection. After 30 days, echocardiography was done and then serum levels of interleukin 4 and 12 were measured in these groups by Elisa test.
Results: The results of this study showed that intravenous injection of human amniotic membrane mesenchymal stem cells into male rats with heart failure, improved echocardiographic parameters such as ejection fraction (EF) and fractional shortening (FS) in the cell injection group compared to the heart failure group (P<0.05). Also, the levels of inflammatory cytokines IL-4 and IL-12 were significantly reduced in the cell injection group compared to rats with the heart failure group (P<0.05).
| Conclusion: Due to the improvement of cardiac parameters and the reduction level of inflammatory cytokines in this study, it seems that human amniotic membrane mesenchymal stem cells play an important role in improving heart failure by reducing the level of inflammation. |
Saeedeh Parvaresh, Mahin Eslami Shahrbabaki , Elaheh Hayatbakhsh , Maedeh Jafari, Fatemeh Karami Robati ,
Volume 80, Issue 2 (May 2022)
Volume 80, Issue 2 (May 2022)
Abstract
Background: Tic disturbances are a group of developmental neurological disorders that often occur in childhood because of abrupt and automatic constrictions of muscles. This study aimed to evaluate the serum levels of 25-hydroxyvitamin D in children with a tic disorders.
Methods: This present case-control research was performed on 63 children with tic disorders and 63 children who were healthy and were referred to Besat clinics in Kerman, Iran from October 2019 to October 2020. The clinical information of patients with tic disorders was collected using a questionnaire. Serum vitamin 25(OH) D3 levels were assessed in patients with tic disturbances after identifying tic disorder.
Methods: This present case-control research was performed on 63 children with tic disorders and 63 children who were healthy and were referred to Besat clinics in Kerman, Iran from October 2019 to October 2020. The clinical information of patients with tic disorders was collected using a questionnaire. Serum vitamin 25(OH) D3 levels were assessed in patients with tic disturbances after identifying tic disorder.
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Results: In the group of children with tic disorders, the highest number of patients were girls and in the group of children who were healthy, the highest number of patients were girls. The average age of patients in the case group was 10.37±0.31 years old and the average age of patients in the control group was 10.06±0.41 years old. The average age difference between the children with tic disorders and healthy children was not statistically significant (P=0.971). The average body mass index (BMI) in the case group was 16.98±0.35 and the average BMI in the control group was 16.0±84.56. The average body mass index difference between the children with tic and healthy children was not statistically significant (P=0.838). The mean serum Vit 25(OH) D3 levels in the control group were higher than the average serum level of vitamin D in the case group. The mean serum vitamin D level difference between the children with tic disorders and healthy children was statistically considerable (P=0.036).
Conclusion: The results showed that the average serum level of vitamin D in children with tic disorders was significantly lower than in children who were healthy. To investigate and confirm this relationship, more long-term studies with a larger number of patients are needed. |
Samaneh Eslami, Iman Mousaei, Masoumeh Andish, Ensieh Tavana , Amin Moradi, Ali Taghipour, Ehsan Mosa Farkhani ,
Volume 81, Issue 6 (September 2023)
Volume 81, Issue 6 (September 2023)
Abstract
Background: Alkaptonuria is a rare disorder that leads to excessive production and accumulation of homogentisic acid in body tissues, and this increase causes tissue degeneration and organ dysfunction through a process called achromasia. Due to very few studies in the field of this disease and access to epidemiological data for the first time in Iran, the present study was conducted with the aim of epidemiological investigation of the mortality rate of patients with alkaptonuria during the years 2013 to 2022 in Iran.
Methods: The design of the present study was cross-sectional (descriptive-analytical). The data related to the deceased registered according to the international coding system of diseases (ICD-10) were extracted from the system of registration and classification of the causes of death of Iran for death due to alkaptonuria disease. The variables investigated in this study included: age, gender and residence status of the deceased. Chi-square and Fisher's exact test were also used to analyze the data.
Methods: The design of the present study was cross-sectional (descriptive-analytical). The data related to the deceased registered according to the international coding system of diseases (ICD-10) were extracted from the system of registration and classification of the causes of death of Iran for death due to alkaptonuria disease. The variables investigated in this study included: age, gender and residence status of the deceased. Chi-square and Fisher's exact test were also used to analyze the data.
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Results: The specific death rate was calculated as 0.31 per one million people of the population. In this study, 90% of the deaths occurred at the age of less than five years. The age variable included two groups of less than five years and more than five years, where 90% of deaths occurred at the age of less than five years. 60% of the deceased were men and 40% were women. Regarding the residence status variable, 82% of the cases were urban and the rest were rural. Finally, there was no significant difference between the incidence of death due to alkaptonuria disease and the investigated variables, which are age (P=0.291), gender (P=0.958) and residence status (P=0.273).
Conclusion: According to the findings in the present study, although no significant difference was observed between age and the number of cases of death due to alkaptonuria; But most cases of death have occurred in young age groups, which seems that more studies are needed to understand the different dimensions of this disease |
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