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Showing 113 results for Alireza
Mycoplasma contamination in cell cultures treated with ciprofloxacin and enrofloxacin: brief report
Bita Soltanian , Shiva Irani , Sarvenaz Hashemi , Seyed Hamid Reza Mozhgani , Mehdi Ajorloo, Yoosef Cheraghi , Alireza Gholami ,
Volume 72, Issue 11 (February 2015)
Abstract
Background: Mycoplasma contamination in cell cultures is considered as a major economic, research and production problem. In this study, mycoplasma-infected Vero cell lines were treated by various dilutions of ciprofloxacin and enrofloxacin in a timely manner. Removal of mycoplasma contamination from infected cell cultures was evaluated and demonstrated by polymerase chain reaction (PCR) method. Methods: This study was done from October 2013 to May 2014, in Human Rabies Vaccine Laboratory, Pasteur Institute Production and Research Complex, Tehran, Iran. Different dilutions of ciprofloxacin and enrofloxacin were used in sequential passages for treatment of infected Vero cell line. Based on lowest passages of the cell line, antibiotic treatment with ciprofloxacin and enrofloxacin was done. Amelioration of the infection and removal of mycoplasma contamination was confirmed in each step by PCR method. The technique for order of preference by similarity to ideal solution, TOPSIS method, was used to suggest the most efficient concentration of ciprofloxacin and enrofloxacin. Results: Proposed concentration of ciprofloxacin is 20 μg/ml, and in the second order is 200 μg/ml. For enrofloxacin the best proposed concentrations are 30, 300 and 3 μg/ml respectively. Ciprofloxacin and enrofloxacin and ability of them for removal of mycoplasma and also the time of treatment were verified by evaluation of the recurrence of infection through consecutive subcultures of the treated cell line. Conclusion: Our results showed that 20 μg/ml of ciprofloxacin was the dilution of choice for mycoplasma elimination followed by 200 μg/ml of ciprofloxacin. Concentrations of 3, 30 and 300 of enrofloxacin, respectively, are appropriate for mycoplasma removal. More detailed works would be needed to verify the authenticity of the proposed simple and affordable way of mycoplasma elimination.
Prospective evaluation of outcome of karydakis flap for sacrococcygeal pilonidal disease
Amir Keshvari , Mohammad-Sadegh Fazeli , Alireza Kazemeni , Alipasha Meisami , Mohammad-Kazem Nouri-Taromloo,
Volume 72, Issue 12 (March 2015)
Abstract
Background: Sacrococcygel region is the most common site for pilonidal sinus and surgery is the most common treatment for it. Numerous operative techniques have been described for management of this disease but a technique with low recurrence and complication rates is the best treatment option. Karydakis has been introduced as a method with less recurrence rate, but it seems that surgeons debate on complications and it is not a common technique in our country. In this article, we will discuss Karydakis procedure and its results after a prospective follow-up in our patients. Methods: This is a prospective single cohort study on the patients with sacrococcygeal pilonidal disease. Cases evaluated in this study included patients underwent Karydakis procedure for their pilonidal sinus from 23 September 2006 to 22 September 2013. Patients were followed-up prospectively after their discharge within the first week, first month and third month for early complications and then annually for recurrence. The length of follow-up ranged from 3 to 77 months (median 36 months). Results: Of 141 patients, 119 (84.4%) were male and mean operating time was 55.52 (35-120) minutes. Mean time to healing wound with no need to dressing was 15.92 (range: 2-120) days and mean time to return to work was 14.44 (range, 1-35) days. Overall rate of early post-operative complications was 21.3% that most of them treated conservatively. Wound breakdown within the caudal part was the most common complication detected in 12.1% of patients and infection was detected in 5.8%. Hematoma, seroma and complete wound breakdown were seen in one patient each. The mean score of patient's satisfaction after one year was 4.91 out of 5. Recurrence was appeared in 1.42% of patients. Conclusion: Karydakis procedure for sacrococcygeal pilonidal disease is associated with low complications, short healing time and return to work, and reasonable recurrence rate.
Effects of visual deprivation during brain development on expression of AMPA receptor subunits in rat’s hippocampus
Sayyed Alireza Talaei , Abolfazl Azami , Elham Mahdavi , Mahmoud Salami ,
Volume 73, Issue 3 (June 2015)
Abstract
Background: Environmental signals have an essential role in the maturation of neural circuits during critical period of brain development. It has been shown that, change in visual signals during critical period of brain development changes structure and function of glutamate receptors in the visual cortex. After processing in visual cortex, part of visual signals goes to the hippocampus and makes memories. The aim of this study was evaluating effects of visual deprivation during critical period of brain development on AMPA receptor subunits expression in rats’ hippocampus. Methods: This experimental study was done in Physiology Research Center, Kashan University of Medical Sciences at winter 2014 on male Wistar rats. Animals were divided to 2 groups (n= 36 for each) were kept in standard 12 hours light/12 hours dark condition (light reared, LR) or in complete darkness (dark reared, DR) from birth to the end of the experiments. Using reverse transcription polymerase chain reaction (RT-PCR) and Western blotting techniques respectively, expression of mRNA and protein of GluR1 and GluR2 subunits was evaluated in rats’ hippocampus at ages 2, 4 and 6 weeks in both groups. After quantification of the expressions, the data were compared by two way analysis of variance. Results: The relative expression of GluR1 subunit decreased about 24% (P=0.004) in the hippocampus of 6 WLR rats in comparison to 2 WLR ones. The relative expression of the other AMPA receptor subunit, GluR2, also increased about 190% in the hippocampus of the 6WLR animals when compared to the 2 WLR rats (P< 0.0001). Dark rearing increased the relative expression of both subunits of AMPA receptors, GluR1 and GluR2, about 20 percent (P= 0.01) in the hippocampus of 6 WDR rats in comparison to 2 WLR animals. Conclusion: Dark rearing of rats during critical period of brain development changes the relative expression and also arrangement of both AMPA receptor subunits, GluR1 and GluR2 in the hippocampus, age dependently.
Safety and effectiveness of everolimus compared with sirolimus and tacrolimus in preventing kidney transplantation rejection: a systematic review and meta-analysis
Morteza Arab Zozani , Seyyed Alireza Hosseini , Ali Akbari Sari , Mitra Mahdavi-Mazdeh, Seyyed Reza Majdzadeh , Ashraf Velayati ,
Volume 73, Issue 5 (August 2015)
Abstract
Background: Everolimus is an immunosuppressive agent with a novel mode of action but has a different clinical role with calcineurin inhibitors (CNI). The aim of this study was to evaluate the safety and effectiveness of everolimus compared with sirolimus and tacrolimus in preventing kidney transplantation rejection. Methods: Search was conducted for finding randomized clinical trials (RCT) until the end of 2013 in main databases include Cochrane, Medline and other related databases in February 2014. To find the ongoing trials two databases were searched (Clinicaltrial.gov and irct.ir/fa/). Two independent reviewers checked studies for quality and eligibility and finally extracted the data. Data extraction was performed using Cochrane data extraction form for clinical trial. Discrepancies were resolved via consultation with third person. The studies examined in term of heterogeneity with I2 and Chi-square test. The mata-analysis was carried out using RevMan 5.2 (Wintertree Software Inc, Ontario, Canada) when there was homogeneity. Results: Finally, seven reports from six RCTs included in this study. All reports were in english language and total numbers of participant in these studies were 824. No studies were found in comparison of everolimus and sirolimus and all seven reports were combination of everolimus, tacrolimus and other relative drugs. Follow up time of studies were different from 6 to 36 months. Due to the heterogeneity of included studies, only two studies were entered into meta-analysis. The recorded mean values for glomerular filtration rate, serum creatinine and creatinine clearance were between 60-80 ml/min, 50 to 80 ml/min and 1.2 to 1.9 mg/dl respectively. The results of meta-analysis in three outcomes include serum creatinine, creatinine clearance and glomerular filtration rate were significantly in favor of low dose tacrolimus plus everolimus. Conclusion: In general, everolimus showed better results in combination with tacrolimus. Given the available evidence in this study, everolimus in combination with low dose tacrolimus showed better safety and effectiveness in preventing kidney transplantation rejection.
Modeling trend of the immune system in HIV positive people treated with antiretroviral drugs, using Markov model
Sara Jambarsang , Alireza Akbarzadeh Baghban , Seyed Saeed Hashemi Nazari, Farid Zayeri , Ali Nikfarjam ,
Volume 73, Issue 9 (December 2015)
Abstract

Background: After primary infection, the number of CD4 T-cells decreases with disease progress. The patient’s immunological status could inform by The CD4 T-cell counts over the time. The main purpose of this study is to assess the trend of CD4 cell count in HIV+ patient that received Antiretroviral Therapy (ART) by using a multistate Markov model to estimate transition intensities and transition probabilities among various states.

Methods: A total of 122 HIV+ patients were included in this cohort study who are undergoing Antiretroviral Therapy treatment in the Iran AIDS center in Imam Khomeini Hospital in Tehran that inter during March 1995 to January 2005 and then fallow up to October 2014. All adults with at least two follow-up visits in addition to their pre-ART treatment were considered to be eligible for inclusion in the study. Continuous-time Markov processes are used to describe the evolution of a disease over different states. The mean sojourn time for each state was estimated by multi state Markov model.

Results: Sample included 22 (18%) female with a mean age of 43.32 (standard deviation 8.33) years and 100 (82%) male with a mean age of 45.28 (standard deviation 8.34) year. Age was divided in to two categories, 40 years old and lower than that 66 (54.1) patents and persons older than 40 years old 56 (45.9) patents. A total of 122 patients were included. 29 patients died during follow-up. One year transition probability for staying in state 1 of CD4 cell count was 51%. This probability for six year was 33%. The mean sojourn time for sate 4 was 21 month. The hazard ratio of transition from state 3 to state 4 was 4.4 in men related to women.

Conclusion: The use of antiretroviral therapy in the treatment of HIV infected persons reduce viral replication and increase in CD4 T lymphocyte count, and delay the progression of disease. This paper is shown the progression of this trend.


Neonatal varicella pneumonia, surfactant replacement therapy
Mousa Ahmadpour-Kacho , Yadollah Zahed Pasha , Hojatollah Ehteshammanesh , Alireza Yahyaei Shahandashti , Fatemeh Heydari , Tahereh Jahangir , Faezeh Aghajanpour ,
Volume 73, Issue 9 (December 2015)
Abstract

Background: Chickenpox is a very contagious viral disease that caused by varicella-zoster virus, which appears in the first week of life secondary to transplacental transmission of infection from the affected mother. When mother catches the disease five days before and up to two days after the delivery, the chance of varicella in neonate in first week of life is 17%. A generalized papulovesicular lesion is the most common clinical feature. Respiratory involvement may lead to giant cell pneumonia and respiratory failure. The mortality rate is up to 30% in the case of no treatment, often due to pneumonia. Treatment includes hospitalization, isolation and administration of intravenous acyclovir. The aim of this case report is to introduce the exogenous surfactant replacement therapy after intubation and mechanical ventilation for respiratory failure in neonatal chickenpox pneumonia and respiratory distress.

Case Presentation: A seven-day-old neonate boy was admitted to the Neonatal Intensive Care Unit at Amirkola Children’s Hospital, Babol, north of Iran, with generalized papulovesicular lesions and respiratory distress. His mother has had a history of Varicella 4 days before delivery. He was isolated and given supportive care, intravenous acyclovir and antibiotics. On the second day, he was intubated and connected to mechanical ventilator due to severe pneumonia and respiratory failure. Because of sever pulmonary involvement evidenced by Chest X-Ray and high ventilators set-up requirement, intratracheal surfactant was administered in two doses separated by 12 hours. He was discharged after 14 days without any complication with good general condition.

Conclusion: Exogenous surfactant replacement therapy can be useful as an adjunctive therapy for the treatment of respiratory failure due to neonatal chickenpox.


Effects of resistance training on serum levels of undercarboxylated osteocalcin, adiponectin and insulin sensitivity in obese women
Yasaman Alipour , Asieh Abbassi Daloii , Alireza Barari , Ahmad Abdi ,
Volume 73, Issue 9 (December 2015)
Abstract

Background: Undercarboxylated Osteocalcin (ucOC) may contribute to the regulation of glucose homeostasis. Undercarboxylated osteocalcin is special protein secreted by bone as an endocrine regulation of energy metabolism and glucose. It plays an important role in insulin secretion and sensitivity. The aim of this study was to survey the effect of eight weeks resistance training on serum levels of ucOC, adiponectin and insulin sensitivity in obese women.

Methods: This quasi-experimental study performed on twenty obese women (BMI> 30) in Amol City Sport clubs, Iran, in May 2014. Samples randomly divided into two groups: a control group and an experimental group.  The experimental group consisted of eight weeks of resistance training, three times a week in six stations (including the movements of the leg press, bench press, triceps, biceps, abdominal motion, pull side and half scott) and with an intensity of 55% to 75% of one repetition maximum. Blood samples were collected after 12- 14 hours, fast and before it and also after eight weeks (48 hours after the last training session). Kolmogorov-Smirnov test was performed to confirm that data was normally distributed. The obtained data was analyzed using paired-sample t-test, independent t-tests and one-way ANOVA at the significance level of P< 0.05.

Results: The results showed that resistance training had no significant effect on serum ucOC (P= 0.094) levels and insulin sensitivity (P= 0.178) in obesity. However, the experimental group after resistance training showed significantly higher adiponectin level than the upper limit of normal range (P= 0.003). There was no relationship between adiponectin and ucOC.

Conclusion: Resistance exercise can increase levels of serum undercarboxylated osteocalcin (ucOC) and adiponectin in obese women. It can be said that this type of activity could possibly be effective in glucose hemeostasis.


Defining reference range for TSH, FT4, T4 hormones used in screening neonatal hypothyroidism in a referral center in Tehran
Alireza Abdollahi , Zohreh-Sadat Rozati,
Volume 73, Issue 10 (January 2016)
Abstract

Background: Congenital hypothyroidism is a major but preventable cause of mental backwardness in infants. In case of hypothyroidism in fetuses, certain complications will occur in vital organs like the central nervous system and the skeleton. Before screening programs were introduced, congenital hypothyroidism was diagnosed with delay due to its few and non-specific symptoms during the first days of life. Given the difference in reference range for various races and populations, this study was aimed to determining a natural range for thyroid hormones used in the screening of infants.

Methods: In a descriptive cross-sectional study at Vali-asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran, from March 2013 to 2014. The level of T4, FT4 and TSH hormones was measured in all natural childbirth, without any complications and with one-minute Apgar score above 7 while this study was underway.

Results: A group of 249 infants (male and female), including 35 (14.1%) aged between 0 and 4 days, 102 (41%) aged between 5 and 7 days and 112 (45%) aged between 7 and 30 days, were examined. The average TSH, T4 and FT4 amounts in infants, aged 0 to 30 days, were respectively 5.35 µU/ml, 10.77 µg/dl and 1.33 ng/dl. The interval was 4.76-6.01 µU/ml for TSH, 10.36-11.17 µg/dl for T4 and 1.29-1.37ng/dl for FT4. The difference between age groups with average TSH concentration is not meaningful (P=0.7) and the average T4 amount in different age groups was meaningfully different (P=0.05). The average FT4 in different age groups is meaningfully different (P=0.007). The thyroid hormone amounts calculated for males and females were not significantly different.

Conclusion: Given the difference in the reference range in race, population and geographical zones, it is necessary to determine a range for screening in Iran. According to the findings of the present study, lower cut-offs, compared with western countries, should be envisaged for TSH in congenital hypothyroidism screening programs that could speed up the diagnosis of minor cases of the disease and prevent complications.


Effective feature selection of clinical and genetic to predict warfarin dose using artificial neural network
Mohammad Karim Sohrabi , Alireza Tajik ,
Volume 73, Issue 12 (March 2016)
Abstract

Background: Warfarin is one of the most common oral anticoagulant, which role is to prevent the clots. The dose of this medicine is very important because changes can be dangerous for patients. Diagnosis is difficult for physicians because increase and decrease in use of warfarin is so dangerous for patients. Identifying the clinical and genetic features involved in determining dose could be useful to predict using data mining techniques. The aim of this paper is to provide a convenient way to select the clinical and genetic features to determine the dose of warfarin using artificial neural networks (ANN) and evaluate it in order to predict the dose patients.

Methods: This experimental study, was investigate from April to May 2014 on 552 patients in Tehran Heart Center Hospital (THC) candidates for warfarin anticoagulant therapy within the international normalized ratio (INR) therapeutic target. Factors affecting the dose include clinical characteristics and genetic extracted, and different methods of feature selection based on genetic algorithm and particle swarm optimization (PSO) and evaluation function neural networks in MATLAB (MathWorks, MA, USA), were performed.

Results: Between algorithms used, particle swarm optimization algorithm accuracy was more appropriate, for the mean square error (MSE), root mean square error (RMSE) and mean absolute error (MAE) were 0.0262, 0.1621 and 0.1164, respectively.

Conclusion: In this article, the most important characteristics were identified using methods of feature selection and the stable dose had been predicted based on artificial neural networks. The output is acceptable and with less features, it is possible to achieve the prediction warfarin dose accurately. Since the prescribed dose for the patients is important, the output of the obtained model can be used as a decision support system.


Usage of capillary electrophoresis for common hemoglobinopathies screening
Alireza Ebrahimi , Zohre Niknami , Fahime Nazari , Mahasti Ghavami Adel , Amir Atashi , Abdolfattah Sarrafnejad ,
Volume 74, Issue 3 (June 2016)
Abstract

Hemoglobinopathies are most common inherited disorders in the world; approximately 7 percent of the worldwide population and 5-6 percent of population of Iran are carriers. The hemoglobin disorders inherit as autosomal recessive and are very common in the Mediterranean area and much of the Asia and Africa. The control of this inherited disorders need to genetic counseling and accurate screening by more advanced and more accurate methods. This study explains features of current Iran hemoglobin disorders, nominates the accessible methods for screening them and introduces the capillary zone electrophoresis as a rapid and more accurate method. The required data were extracted of various articles and then for good explanation, current Iran hemoglobinopathies properties were showed in the tables and electropherograms of important hemoglobin disorders in Iran population were provided for help to interpretation results of blood tests by capillary zone electrophoresis method. Hemoglobin disorders are including thalassemias and hemoglobin variants; Disruption in the production and malfunction of globin chains cause types of hemoglobin disorders. We cannot introduce one of clinical laboratory tests as critical and basic method for screening and distinguishing types of inherited hemoglobin disorders as alone. For distinguishing the types of them must be prepared enough information and data of the hemoglobin disorders and for more accurate analysis must be used simultaneously different methods as gel electrophoresis, high performance liquid chromatography, isoelectric focusing, capillary zone electrophoresis or molecular tests. The capillary electrophoresis is an accurate and rapid method for screening types of the hemoglobin disorders. Other side this method cannot analyze all of them, so must be used biochemical, biophysical and molecular methods for confirmation the results. This review showed we can use the capillary electrophoresis and HPLC as two complementary methods for hemoglobinopathies screening. We can analyze by the methods more hemoglobin disorders and decrease more laboratory errors. Moreover, we must have patient history, hematological indices, information and data of types of hemoglobinopathies. The patient history and complete blood count results as red blood cell count, mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration can be useful and helpful in screening the hemoglobin disorders and then distinguishing all of hemoglobin disorders.


Profile of neonatal mortality in Iran in 1391
Mohammad Ali Heidarnia , Alireza Abadi , Mohamad Fsmaeil Motlagh, Mohammad Heidarzadeh , Abbas Habibelahi , Farima Raji ,
Volume 74, Issue 7 (October 2016)
Abstract

Background: The first duty of any government is to ensure the health of its children and neonates. Today's countries are classified as declining mortality in this group. To increase neonatal survival rate, classified causes of newborn mortality are the core strategy and policies. This study was aimed to determine the classification of causes of neonatal death in Iran.

Methods: Neonatal mortality refers to deaths of young children. It is measured by the neonatal mortality rate (NMR), which is the number of deaths of neonates per 1000 live births. This study was used data from 11693 neonatal deaths (from 22 weeks gestational age to neonatal death less than 30 days), in Iran's hospitals in 2012 that registered in the perinatal mortality surveillance system (hospital-based system). Demographic characteristics and other factors associated with neonatal death were investigated. To aid in cause of death analysis, burden of disease analysis, and comparative risk assessment we classified the causes of death according to international statistical classification of diseases version 10 (ICD 10), divided into three cause mortality strata.

Results: Results showed the most common cause of neonatal mortality was "certain conditions originating in the perinatal period" (77.92%) with the highest incidence of "disorders related to length of gestation and fetal growth" (37.7%) in this group. Also it shows that 20.82% of deaths caused by "congenital malformations, deformations and chromosomal abnormalities" and 1.26% cases had occurred as a result of "accidents and injuries". The greatest cause of death in the neonates with weight over one thousand grams was "certain conditions originating in the perinatal period" (71.29%), with the highest percentage in the disorders related to "length of gestation and fetal growth" (29.65%).

Conclusion: According to this study the "certain conditions originating in the perinatal period" special "disorders related to length of gestation and fetal growth" was the main cause of neonatal mortality. Also "congenital malformations, deformations and chromosomal abnormalities" was the second cause of neonatal mortality.


Bone temperature reduction during drilling via alcohol: brief report
Mohammadreza Effatparvar , Nima Jamshidi , Alireza Karimian ,
Volume 74, Issue 8 (November 2016)
Abstract

Background: Cooling is one of the main processes in bone temperature decrement, while drilling. this experiment was conducted for examination of alcohol effect as cooler in prevention of thermal necrosis.

Methods: Bovine femur bone was considered as specimen and inclusions criteria for this study were: femur bone, cortical area and without bone periosteum. Drilling process was conducted by two types of k-wire- Trocar and Diamond, three speeds and three feed rates and in the time of march, 2016 in the place of university of Isfahan, Iran. Two type of thermometer- K-thermocouple and infrared thermometer- were used for temperature measurement, and all data were logged by data logger. Drilling processes were conducted by milling machine with ability of table movement for feed rate parameter. Method of alcohol usage in cooling was in form of conducting alcoholic gauze with k-wire while rotating.

Results: Totally in the cases of trocar and diamond wires, while were cooled by alcohol, the risk of bone necrosis decreased about 44.44% and 66.66%. All temperature data were logged by changing parameters. maximum temperature, 94.5 °C, belonged to trocar wire in a non-cooling condition and after usage of cooler it decreased to 75 °C.  In the usage of diamond wires, the maximum temperature was recorded 71 °C and the temperature while using alcohol was 51 °C. Diamond wire had better result in both conditions of cooling and no cooling, and this is related to geometric differences between two types of wires.

Conclusion: Due to obtained data from examination, utilization alcohol can have an important influence on final bone temperature decreasing. The way of using alcohol was in the style of attrition soaked gauze onto wire while insertion.


Designing the colorectal cancer core dataset in Iran
Sara Dorri , Alireza Atashi , Safoura Dorri , Ebrahim Abbasi , Mohsen Alijani-Zamani , Najme Nazeri ,
Volume 74, Issue 10 (January 2017)
Abstract

Background: There is no need to explain the importance of collection, recording and analyzing the information of disease in any health organization. In this regard, systematic design of standard data sets can be helpful to record uniform and consistent information. It can create interoperability between health care systems. The main purpose of this study was design the core dataset to record colorectal cancer information in Iran.

Methods: For the design of the colorectal cancer core data set, a combination of literature review and expert consensus were used. In the first phase, the draft of the data set was designed based on colorectal cancer literature review and comparative studies. Then, in the second phase, this data set was evaluated by experts from different discipline such as medical informatics, oncology and surgery. Their comments and opinion were taken. In the third phase refined data set, was evaluated again by experts and eventually data set was proposed.

Results: In first phase, based on the literature review, a draft set of 85 data elements was designed. In the second phase this data set was evaluated by experts and supplementary information was offered by professionals in subgroups especially in treatment part. In this phase the number of elements totally were arrived to 93 numbers. In the third phase, evaluation was conducted by experts and finally this dataset was designed in five main parts including: demographic information, diagnostic information, treatment information, clinical status assessment information, and clinical trial information.

Conclusion: In this study the comprehensive core data set of colorectal cancer was designed. This dataset in the field of collecting colorectal cancer information can be useful through facilitating exchange of health information. Designing such data set for similar disease can help providers to collect standard data from patients and can accelerate retrieval from storage systems.

Changes in TFR2 in gene expression in gastric adenocarcinoma and its relationship with simultaneous helicobacter pylori infection
Nazanin Talebabadi , Amirnader Emami-Razavi, Raheleh Safaei-Javan, Hadis Mohammadpour , Alireza Abdollahi ,
Volume 75, Issue 1 (April 2017)
Abstract

Background: As far as the role and amount of Transferrin receptor 2 (TFR2), which is the transferrin receptor gene, studies have been conducted, some of which confirming its relationship with gastric adenocarcinoma. The idea behind this study was to examine changes in the TFR2 gene expression in the tumor cells of gastric adenocarcinoma and comparing with gene expression in the normal tissue adjoining the tumor.

Methods: This case-control study was conducted at the Pathology Section of Cancer Institute of Imam Khomeini University Hospital in Tehran from September 2015 to September 2016. In this study, 30 fresh samples from tumor tissues of patients diagnosed with gastric adenocarcinoma, 30 fresh samples of normal tissue adjoining the tumor and 30 samples of frozen plasma from the same patients were taken. The patients' plasma was examined in terms of existence of helicobacter pylori antibody by enzyme linked immunosorbent assays (ELISA) method and TFR2 gene expression in the tumor tissue and the adjoining normal tissue by applying real-time polymerase chain reaction (Real-Time PCR).

Results: Gene expression (by applying real time polymerase chain reaction) in the tumor tissue was meaningfully higher than in the normal tissue (P= 0.125). The TFR2 expression in patients with stomach cancer, who were at the same time infected with helicobacter pylori, indicated that the gene expression had increased in those with this contamination (P= 0.077). Examining the relationship between this gene expression and the stage of disease showed that the TFR2 gene expression increased significantly in the more advanced stages of the disease (P= 0.396).

Conclusion: The TFR2 gene expression increases in the stomach's tumor tissue. This gene expression is higher in people infected with helicobacter pylori or in those at an advanced stage of the disease. These findings may confirm the direct relationship between gene expression and the occurrence or metastasis of gastric adenocarcinoma.

Analyze of Ortho-SUV™, software base hybrid fixation on three planar femur deformity
Mohammadreza Effatparvar , Nima Jamshidi , Alireza Asghari Ardabili ,
Volume 75, Issue 2 (May 2017)
Abstract

Background: Application of Hybrid 6 degrees of freedom fixation could lead to space motion in each 3 anatomic plates together and decrease the time of complex deformities correction. This study is an investigation on the function of hybrid external fixation and the influence of it on decreasing the treatment time. About this case utilize of Ortho-SUV Frame (OSF) system is explained for the first time in Iran and report of its novel. These robotic systems are divided into two groups: active and passive, about active system all movements are done by actuators in joints and links. And in passive, the system needs an operator or patient to actuates Sturats by hand.

Methods: The femur bone has been investigated was non::::union:::: with deformity in sagittal, frontal and transversal planes. Ilizarov external fixation was applicate firstly, with this condition that the OSF systems jacks were replaced instead of simple rods in side of fracture. Software work was done on February of 2016 in Ayatollah Taleghani Hospital, Tehran, Iran. Fractures were happened in a car accident and some other operating were perforemed for this patient without any result.

Results: The correction of studied deformity needs 3 planar moving. Acting this movement by Ilizarov requirements 33 mm displacement in frontal plane, 12 mm horizontal distraction and 48 mm displacement in sagittal plane. Due to the rate of correction in Ilizarov which is 1 mm per day, this bone needs 93 days for general correction and three times changing in shape of rings connections. While, by using the hybrid external fixation, all displacements were corrected in 46 days and first connection had supported all planes.   

Conclusion: According to that the decreasing of treatment time is one of the main goal, the hybrid external fixation systems could be an appointment choice in complex deformities and replaced with some common fixation. In addition to, using of updated software increases the accuracy of displacement.

Factors affecting the results of lumbar discectomy
Maryam Esmaili , Nahid Tahan , Seyed Mojtaba Miri , Ali Montazeri , Alireza Akbarzade Bagheban ,
Volume 75, Issue 2 (May 2017)
Abstract

Background: Low back pain is one of the most important causes of disability among people around the world. Although only 2-5% of low back pain disorders resulting from herniation of lumbar intervertebral discs but surgery for lumbar disc herniation is a common procedure. The aim of this study was to determine the relation between some bio-psycho-social variables and treatment outcomes in patients who undergo first time single-level lumbar discectomy.

Methods: This is a prospective observational analytic study comprised 100 patients (age range 18-73 years) underwent single-level lumbar disc surgery. The patients who met our inclusion criteria and were willing to participate in the study were recruited from the neurosurgery ward of Logman and Imam Khomaini hospitals in Tehran, Iran, between October 2015 and March 2016. The patient completed SF-36 quality of life Questionnaires before, one and two months after surgery.

Results: In comparison to standard values, before the surgery patients had significantly lower baseline SF-36 (36-Item Short Form Survey) Questionnaire value in all 8 domains. The role limitations due to physical health had greatest impact on quality of life. At the eight weeks’ follow-up SF-36 scores showed significant improvement in both physical and mental scales. Age had no significant impact on mental scales of weeks’ Questionnaire but in age less than 30 years there was a positive relation between the patient’s age at surgery and physical aspects of quality of life. Although there was no significant difference in physical aspects of SF-36 Questionnaire between males and females but males had a significantly higher mean mental health score than females after surgery. Smokers had lower value of mental scales of SF-36 Questionnaire than in nonsmokers.

Conclusion: The result of this study showed that surgery for lumbar disc herniation had a great impact on both physical and mental scales of SF-36 Questionnaire two months after surgery. Factors such as age, sex, smoking and psychological factors can play the role of predictor for patient’s outcomes after lumbar disc surgery.

Relation between vitamin D and calcium and post operation hypocalcemia in total thyroidectomy
Leila Asefkabiri , Abbas Alibakhshi , Seyed-Hassan Emami-Razavi , Mahtab Mohammadifard , Alireza Abdollahi ,
Volume 75, Issue 3 (June 2017)
Abstract

Background: Hypocalcemia is one of the most prevalent complications following total thyroidectomy. Over recent years, in addition to hormone parathyroid hormone (PTH), vitamin D has been also studied as a factor causing post-total thyroidectomy hypocalcemia. This survey seeks to study the relationship between the serum level of vitamin D before surgery and during post-total thyroidectomy hypocalcemia.

Methods: A group of 57 patients volunteering for total thyroidectomy were studied on Vali-e-Asr Hospital, Tehran, Iran, from March 2013 to March 2015. In all these patients, pre-surgery calcium, vitamin D and parathyroid hormone (PTH) as well as the level of calcium during the post-surgery first two days were measured. Based on objectives of this study, the relationship be-tween pre-surgery vitamin D level and post-surgery hypocalcemia was examined.

Results: The average age of patients participating in the survey was 24.1±13.3. They included 19 women (33.3%) and 38 men, total of 40 patients (70.2%). Their average post-surgery calcium level was 9.2±0.77 milligrams per deciliters (mg/dl) and their average vitamin D content before the surgery was 42±12.1 nanomole per liter (nmol/l). The average calcium level before the surgery and the first post-surgery day were meaningfully different in terms of statistics (P<0.001). In terms of vitamin D, 37 patients (64.9%) had pre-surgery vitamin D deficiency and 20 patients (35.1%) had vitamin D insufficiency. Of 37 patients with pre-surgery vitamin D deficiency, 26 were diagnosed with post-surgery first-day hypocalcemia and of 20 patients with vitamin D insufficiency, 14 suffered post-surgery first-day hypocalcemia. This difference was not statistically meaningful (P>0.001). Of 37 patients with pre-surgery vitamin D deficiency, 31 suffered post-surgery second-day hypocalcemia and of 20 patients with vitamin D insufficiency, 18 suffered second-day hypocalcemia. This difference was not statistically meaningful either (P>0.001).

Conclusion: The current study showed that the serum level of vitamin D before total thyroidectomy does not have any role in the occurrence of post-surgery hypocalcemia which is almost common after this type of surgery.

Evaluation of fungal air contamination in selected wards of two tertiary hospitals in Tehran, Iran
Zahra Kamali Sarwestani , Alireza Dasdar , Setareh Agha Kuchak Afshari , Mohsen Gerami Shoar , Seyyed Jamal Hashemi , Reza Pakzad , Pegah Ardi , Alireza Abdollahi , Mohammad-Taghi Haghi-Ashtiani, Shahram Mahmoudi ,
Volume 75, Issue 4 (July 2017)
Abstract
Background: Fungi have a worldwide distribution which can cause a broad spectrum of disease ranging from allergic to systemic infections, particularly in immuno-compromised individuals. Fungal spores are an important group of bioaerosols in hospital environment which are an emerging cause of hospital-acquired infection. Nosocomial infections cause significant morbidity and mortality as well as large financial burden on the healthcare system. This study aimed to evaluate the frequency and species distribution of airborne fungi in selected wards of two tertiary hospitals in Tehran, Iran.
Methods: In this cross-sectional study, samples were collected during six months from July 2016 to December 2016 by using of settle plate method. Samples were collected from selected wards of Imam Khomeini Hospital and Children's Medical Center and then incubated at 28 °C for 8-10 days. Fungal isolates were identified using the macroscopic features of colony and microscopic characteristics in slide cultures. Yeast isolates were identified by CHROMagar candida medium. PCR-sequencing of ITS1-5.8 S-ITS2 region of ribosomal DNA was used for identification of unknown isolates.
Results: A total of 202 colonies including 133 colonies from the Imam Khomeini Hospital and 69 colonies from the Children's Medical Center were isolated. Cladosporium spp. were the most common obtained fungi accounted for 30.1% and 47.8% of all isolates in the Imam Khomeini Hospital and the Children's Medical Center, respectively. Penicillium spp. and Aspergillus spp. were other frequent species in two hospitals. Infectious diseases ward in Imam Khomeini hospital and emergency and urology wards in Children's Medical Center had the highest rate of contamination.
Conclusion: According to the results of this study, the frequency and diversity of fungal spores in hospital wards were different. In addition, since the fungal contamination in the hospital environment are affected by various environmental factors and the efficiency of ventilation systems, some of these wards require better ventilation system as well as regular monitoring to remove these fungal bioaerosols in order to maintain the health of patients and health care workers.

TOX3 Gene polymorphisms and breast cancer; effects and implications of the variations: review article
Amir Tajbakhsh, Fahimeh Afzal Javan , Mostafa Fazeli, Mahdi Rivandi, Mohammad Mahdi Kushyar, Mohammadreza Nassiri, Alireza Pasdar,
Volume 75, Issue 5 (August 2017)
Abstract
Breast carcinoma is the most common cause of cancer mortality among women globally. Primary and secondary prevention through avoiding known risk factors, screening for early detection of tumors with different methods as well as timely treatment, can be effective in reduction of the burden of this devastating disease. This can in turn prevent death and also increase survival in patients with breast cancer. Both environmental and genetic factors are involved in the pathogenesis of breast cancer. Multiple genetic factors can influence the risk and development of breast cancer. Identification of genetic variants including single nucleotide polymorphisms (SNPs), which are associated with the risk of breast cancer development, are mostly done through genetic association studies. It is demonstrated that SNP allele frequencies vary amongst different populations. It has been shown that genetic risk factors like variations in TOX high mobility group box family member 3 (TOX3), which affect the liability for neoplasm, play an important role in the development of breast cancer. Although TOX3 is expressed mainly in the brain, its expression in other tissues especially breast has also been reported. TOX3 maps to chromosome 16q12 and encodes the nuclear high-mobility group (HMG)-box. It has calcium (Ca2+)-dependent transcriptional activities and is a co-factor of cAMP response element (CRE)-binding protein (CREB) and CREB-binding protein (CBP). TOX3, activated with Ca2+, is related with activation of the promoter of some other genes including BCL2 and C3 complement and also CITED1 gene expression. It also induces activation of the c-fos promoter and therefore its expression. Genome-wide association studies (GWAS) in different populations including European, Asian and African-American have demonstrated that a SNP near its 5ʹ end and the promoter of TOX3 gene appears to be significantly associated with breast cancer susceptibility. Furthermore, breast cancer–associated SNPs lead to enhanced FOXA1 bindings and in turn, a reduction in TOX3 gene expression. This review has highlighted the importance of TOX3 function, SNPs and its association with breast cancer risk and also its potential effects on breast cancer treatment; TOX3 plays dual and somehow conflicting roles in cancer initiation and progression which remains to be further investigated.

Comparison of gabapentin, pregabalin and placebo as premedication for attenuation of hemodynamic response to laryngoscopy and endotracheal intubation
Alireza Mahoori , Ebrahim Hassani , Nazli Karami , Mehrdad Azizpoure ,
Volume 75, Issue 5 (August 2017)
Abstract
Background: Tracheal intubation and direct laryngoscopy are powerful noxious stimuli that can elicit sever hemodynamic responses. These hemodynamic responses should be attenuated by appropriate use of premedication, smooth induction of anesthesia and rapid tracheal intubation. Gabapentin and pregabalin have been suggested in several studies to be efficient. Gabapentin is an antiepileptic drug and a structural analogue of gamma-Aminobutyric acid (GABA) but it does not act through GABA receptors and pregabalin, is also an antiepileptic agent. The aim of this study was to compare the effect of gabapentin and pregabalin as premedication for attenuation of hemodynamic response to laryngoscopy and endotracheal intubation.
Methods: In a prospective double blinded randomized clinical trial, during April 2015 to March 2016 in Urmia Imam Khomeini Hospital, a total of ninety normotensive adult consented patients, candidate to elective abdominal surgery aged 20-50 years, American Society of Anesthesiologist (ASA) class I, of both gender were randomized into three groups. Patients in group I received oral placebo, group II received oral gabapentin 900 mg and group III patients received oral pregabalin 150 mg two hours prior to induction of anesthesia. Anesthetic technique was same in three groups and all groups were assessed for hemodynamic changes such as heart rate, systolic blood pressure and diastolic blood pressure, after the premedication, before and after induction of anesthesia, and 1, 3 and 5 minutes. after laryngoscopy and tracheal intubation.
Results: Significant increase in heart rate and systolic blood pressure and diastolic arterial pressure was observed in placebo group after tracheal intubation, while statistically significant attenuation of hemodynamic changes was seen in gabapentin and pregabalin groups. (P=0.001) No adverse outcome was reported in the study groups.
Conclusion: Oral gabapentin premedication is effective for control of hemodynamic pressor response of laryngoscopy and tracheal intubation. The study data showed that the pregabalin have the same effect. Pregabalin and gabapentin are both useful and safe for control of hemodynamic pressor response as premedication.

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