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Determining the specific activity of thymidine phosphorylase in leukocytes of patients with MNGIE and the plasma thymidine level by RP-HPLC
Rezaei Sh, Salehipour M, Golestani A, Vardasbi Joybary I S, Nafisi Sh, Doosti M, Golmohammadi T,
Volume 69, Issue 3 (5 2011)
Abstract

Background: Thymidine phosphorylase (TP) catalyses the conversion of thymidine into thymine. Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is an autosomal recessive disease which is caused by mutations in the nuclear gene encoding TP, bringing about severe impairment of TP-enzyme specific activity and accumulation of thymidine in plasma. The clinical manifestations of MNGIE are recognizable and homogenous, but not in the early stages of the disease. In patients who are suspected of having MNGIE, determination of TP-specific activity in leukocytes and thymidine levels in plasma are diagnostic. The methods that are usually used for the measurement of TP activity and plasma thymidine are not rapid or accurate enough and lack sensitivity.

Methods: The specific activity of TP was measured by RP-HPLC in leukocytes of both the controls and the patients exhibiting clinical features suggestive of MNGIE. Moreover, plasma thymidine was assessed by the same method.

Results: The patients had detectable plasma thymidine (>3 µmol/L) but it was undetectable in the healthy controls. The patients' TP-specific activity decreased to less than 5% relative to the controls (14±4 nmol/h/mg vs. 525±165 nmol/h/mg, P<0.05). A diagnostic algorithm for the definitive diagnosis of MNGIE is suggestible based on the results of this study which relies on the measurement of plasma thymidine, TP-specific activity in leukocytes, or both.

Conclusion: In this study, we set up a sensitive and rapid assay for the evaluation of TP-specific activity by using RP-HPLC in Iran. In addition, we established reference values for TP-specific activity and plasma thymidine in the Iranian patients.


The occurrence and contribution of germline BRCA1/2 sequence alterations in Iranian patients with breast cancer
Keshavarzi F, Nafissi N, Sirati F, Fallah Ms, Salehi R, Harriry Z, Shahab Movahead Z, Vahidi M, Sharifi Z, Sharafi Farzad M, Zeinali S,
Volume 69, Issue 9 (6 2011)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Breast cancer is the most common form of hereditary cancer worldwide and is an important cause of morbidity and mortality. Approximately 5-10% of breast and ovarian cancers are due to the highly penetrating germline mutations in cancer predisposing genes. Two genes, BRCA1 and BRCA2, account for at least half of these cases. The demand for BRCA1 and BRCA2 mutation screening is rapidly increasing as their identification will affect the medical management of people at increased risk for the disease. Therefore, the aim of this study was to investigate BRCA1/2 mutations in 100 high risk Iranian families.
Methods:  One hundred families who met the minimal risk factors for breast/ovarian cancer were screened among the families referred to Kawsar Human Genetics Research Center for the diseases in 2009-2011. The entire coding sequences and each intron/exon boundaries of BRCA1/2 genes were screened for by direct sequencing and MLPA in both patients and the controls.
Results:  In the present study, we could detect the following novel mutations: p.Gly1140Ser, p.Ile26Val, p.Leu1418X, p.Glu23Gln, p.Leu3X, p.Asn1403His, p.Asn1403Asp, p.Lys581X, p.Pro938Arg, p.Thr77Arg, p.Leu6Val, p.Arg7Cys, p.Leu15Ile, p.Ser177Thr, IVS7+83(-TT), IVS8 -70(-CATT), IVS2+9(G>C), IVS1-20(G>A), IVS1-8(A>G), p.Met1Ile, IVS2+24(A>G), IVS5-8 (A>G), IVS2(35-39)TTcctatGAT, IVS13+9 G>C in BRCA1 and p.Glu1391Gly, p. Val1852Ile, IVS6-70(T>G), 1994-1995 (InsA) in BRCA2.
Conclusion: Ten mutations seemed to be pathogenic and the disease-causing mutations were seen in 16% of the families. In addition, from the total number of substitutions and reassortments (42), 80% related to BRCA1 and 20% to mutations in BRCA2 genes.


Effects of probiotic lactobacillus acidophilus and lactobacillus casei on the behavior of colorectal tumor cells
Soltan Dallal Mm, Mojarrad M, Salehipour Z, Atapour Mashhad H, Raoofian R, Rajabi Z,
Volume 70, Issue 4 (5 2012)
Abstract

Background: Probiotic microorganisms are living normal flora of human body that have nutritional value and health benefits when administered in adequate amounts. The health benefits include prevention of bacterial diarrhea, skin eczema and recently understood, prevention and control of various cancers, as well. Different mechanisms such as stimulating the immune system, modifying the composition of gastrointestinal and genitourinary tract normal flora and prevention of the carcinogenic activity of fecal enzymes have been identified for their probiotic activity. Due to the high density of the normal flora in the gut and also preferentially sporadic nature of colorectal cancers, these cancers are among the main candidates of treatment trials with probiotics. In this study, direct effects of probiotic lactobacilli on colon cancer tumor cells were studied.

Methods: Supernatant fluid and bacterial extracts were prepared and CaCo-2 cells were treated by these materials. Subsequently, the effects of the aforesaid elements were evaluated on cell proliferation, cell necrosis and cell apoptosis by MTT assay, LDH assay and caspase-3 activity.

Results: The supernatants of lactobacilli decreased cell proliferation and increased cell apoptosis but they did not have any effect on cell necrosis. In contrast, when cancerous cells were treated by lactobacilli extract, it lead to cell necrosis in addition to reduction in cell proliferation and increase in cell apoptosis.

Conclusion: The use of lactobacillus probiotics may reduce proliferation of tumor cells in the early stages of colorectal cancers.


Ginger effects on control of chemotherapy induced nausea and vomiting
Seyyed Meisam Ebrahimi , Zohreh Parsa-Yekta, Alireza Nikbakht-Nasrabadi, Sayyed Mostafa Hosseini, Sanambar Sedighi , Mohammad-Hossein Salehi-Surmaghi,
Volume 71, Issue 6 (September 2013)
Abstract

Background : Chemotherapy-induced nausea (CIN) in the anticipatory and acute phase is the most common side effect in cancer therapy. The purpose of this study was to investigate the effect of ginger capsules on the alleviation of this problem.

Methods : This randomized, double-blind, placebo-controlled clinical trial was performed on 80 women with breast cancer between August till December 2009 in Imam Khomeini Hospital, Tehran, Iran. These patients underwent one-day chemotherapy regime and suffering from chemotherapy-induced nausea. After obtaining written consent, samples were randomly assigned into intervention and control groups. Two groups were matched based on the age and emetic effects of chemotherapy drugs used. The intervention group received ginger capsules (250 mg, orally) four times a day (1 gr/d) and the same samples from the placebo group received starch capsules (250 mg, orally) for three days before to three days after chemotherapy. To measure the effect of capsules a three-part questionnaire was used, so the samples filled every night out these tools. After collecting the information, the gathered data were analyzed by statistical tests like Fisher’s exact, Kruskal-Wallis and Chi-square using version 8 of STATA software.

Results : The mean ± SD of age in the intervention and placebo groups were 41.8 ± 8.4 and 45.1 ± 10 years, respectively. Results indicated that the severity and number of nausea in the anticipatory phase were significantly lower in the ginger group compared with placebo group (P=0.0008, P=0.0007, respectively). Also, the intensity (P=0.0001) and number (P=0.0001) of nausea in the acute phase were significantly lower in the ginger group. On the other hand, taking ginger capsules compared with placebo did not result in any major complications.

Conclusion: Consuming ginger root powder capsules (1 gr/d) from three days before chemotherapy till three days after it in combination with the standard anti-emetic regimen can help to reduce the anticipatory and acute nausea.
Scolicidal effects of Berberis vulgaris fruit extract on hydatid cyst protoscolices
Nima Salehi , Soheila Rouhani , Mohammad Kamalinejad , Farid Zayeri , Afshin Motaghifar ,
Volume 72, Issue 2 (May 2014)
Abstract
Background: Surgery is one of the best choices for the treatment of hydatidosis. The use of effective scolicidal agents during surgery for hydatid cyst is essential to prevent the secondary infection. Up to now no effective and safe agent has been identified for this purpose. Berberis vulgaris called “Zereshk” in Persian has been traditionally used as herbal remedy for the treatment of complaints and it is widely cultivated in Iran. Many studies have shown that it has antibacterial, antifungal and antiparasitic effect. Methods: In this study the scolicidal effect of Berberis vulgaris aqueous and hydro-alcohol extract for different concentrations (for aqueous: 0.5, 1, 2 and 4 mg/ml and for hydro-alcohol: 0.25, 0.5, 1 and 2 mg/ml) at different exposure times (5, 15 and 30 minutes) was evaluated. For this purpose, we obtained liver hydatid-cysts from a slaughter house. Viability of protoscolices was assessed by 0.1% eosin staining. Normal saline and hypertonic saline were used as negative and positive controls respectively. Results: All the different concentrations of Berberis vulgaris aqueous and hydro-alcoholic extracts had scolicidal effect. An aqueous extract with 4mg/ml concentration acted as positive control and we observed to lead to the death of 100% of protoscolices in the first 5 minutes. The least scolicidal effect (12.3%) was observed in an aqueous extract with 0.5 mg/ml concentration.The scolicidal activity of hydro-alcoholic extract with concentration of 2 mg/ml was 100% after 5 min of application, which was the same as positive control group. We noticed a significant increase in protoscolicidal activity with an increase in concentration in the two extracts of Berberis vulgaris (P<0.001). Conclusion: It is important to mention that all the concentration levels and exposure times applied in this experiment are relatively low, since scolitical activity in both of the extracts is at its highest in this low spectrum. For further experiments, we suggest that the stability of cyst fluid in both of the extracts should be assessed. Therefore, after In vivo examination and additional experiments, it may be used as a suitable and effec-tive scolicidal in surgery.
Comparative study of echocardiographic right ventricular systolic function before and after angioplasty on right coronary artery
Amir Masoud Jafari , Nahid Salehi , Hashem Kazerani , Farid Najafi ,
Volume 72, Issue 4 (July 2014)
Abstract
Background: In patients who undergoing PCI, association between right ventricular function and outcome of the procedure remained unclear. The present study aimed to determine association between echocardiography findings of systolic right ventricular function and functional status of patients following PCI. Methods: In a cross-sectional study conducted at Imam Ali hospital and heart center in Kermanshah, Iran in 2013, 40 patients with history of inferior wall myocardial infarction (Inf MI) according to previous electrocardiography (ECG) in past hospitalization for MI who were candidate for percutaneous coronary intervention (PCI) on right coronary artery (RCA) and had left ventricle ejection fraction (LVEF) less than 40% were included. The subjects underwent echocardiography on admission to assess echocardiography indices of systolic right ventricular function including tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (TASV), Tei-index (Myocardial performance index), and RV fractional area (RVFA) change that was repeated one month later. Baseline functional status was assessed based on the New York Heart Association functional classification score (NYHA score) that divided to 4 grades. Results: NYHA score improved following PCI procedure (from 2.20±0.46 to 1.10±0.30, P<0.001). The mean score of TAPSE significantly increased from 18.68±2.12 to 20.40±2.11 (P<0.001). The mean of TASV also increased from 13.28±1.52 to 14.85±1.90 (P<0.001). Also, Tei-index was improved from 0.52±0.05 to 0.47±0.03 (P<0.001). Moreover, RVFA was significantly increased after PCI (from 35.02±2.40 to 38.25±2.57, P<0.001). There was no significant relationship between the changes in NYHA score and each of right ventricular systolic function indices. Conclusion: Although right ventricular systolic function considerably improved fol-lowing PCI procedure, but the changes in this improvement is not associated with the improvement of function class after the procedure.
Considering the malaria is essential in a patient with suspected Ebola: case report
Mahboobeh Hajabdolbaghi , Hamid Emadi Kochack , Mohammad Reza Salehi , Seyed Ali Dehghan Manshadi, Mehdi Usefipour , Afsaneh Motevalli Haghi ,
Volume 73, Issue 4 (July 2015)
Abstract
Background: One of the main reasons of hemorrhagic fevers is Ebola. The high rate of mortality and lack of definite treatment have been caused this infection to be a serious problem in the world. Ebola, especially in the early stages, when causes symptoms such as fever, anorexia and nausea, can be confused with malaria infection and conversely, severe malaria with Ebola. Plasmodium falciparum is an important cause of severe malaria that more than other types of plasmodium confused with Ebola. Case presentation: The patient is a 54-year-old man who had gone to Sudan about 8 months ago. The patient reported that fever, chills and headache had been started one week before traveling from Sudan to Iran and hematuria was added to his symptoms in third week of illness in Iran. He was referred to the emergency department with probable diagnosis of Ebola. Plasmodium falciparum gametocytes were revealed in his peripheral blood smear. Finally, he was treated with Coartem (artemether/lumefantrine) for malaria and after clinical improvement discharged to home with good condition. Conclusion: Ebola should be suspected in every patient with fever and a history of traveling to endemic areas. Considering the fact that in most areas where Ebola is endemic also malaria is common, lack of clinical suspicion to malaria causes that clinicians mistake malaria with Ebola. Necessary laboratory tests to rule out important differential diagnoses in patients with suspected Ebola virus contains: Peripheral blood smear for malarial parasite and blood culture and blood cell counts to investigate typhoid fever and other bacterial infections. Therefore, malaria should be considered as an important differential diagnosis in every patient suspected with Ebola.
Differences in clinical presentation of ankylosing spondylitis in men and women
Hossain Soleymani Salehabadi , Saeid Salehinejad Kouvei , Mohammad Bagher Owlia , Ali Dehghan , Masoud Mohammadi ,
Volume 74, Issue 7 (October 2016)
Abstract

Background: Ankylosing spondylitis (AS) is an inflammatory disease that mainly affects axial skeleton of the body and ankylosing spondylitis ligaments around the spine at the junction of the spine are inflamed, because the disease is progressive and can lead to significantly cause of disability and the studies could provide a mechanism for the early detection of the disease or help determine when to start treatment, the difference in clinical presentations of AS in men and women is indicative of potential effect of gender on severity of the disease. This study was conducted with the aim to investigate the effect of gender on severity of AS.

Methods: In a cross-sectional study, one hundred and fifteen patients with ankylosing spondylitis who referred to Yazd Rheumatology Clinic between 2001 and 2013 were evaluated. Sampling was performed using non-random convenient method. The most important variables studied included demographic data, clinical presentation, radiographic stage of sacroiliac involvement, and laboratory data extracted from patients’ files and recorded in questionnaires.

Results: Both groups according to age at diagnosis, presence of enteritis, peripheral joint involvement and laboratory data such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and hemoglobin were matched. Inflammatory neck pain was more prevalent in men than in women (77.2% against 51.8%; P< 0.05). Sacroiliac radiographic study revealed stage 1 involvement in 11.3% of men and 37% of women (P= 0.009), and stage 4 in 27.2% of men and 3.7% of women (P< 0.001), with a significant difference.

Conclusion: According to the results of the study, the time between age of onset and age at diagnosis, inflammatory pain in the neck and advanced stage in men than in women was higher. Although these findings suggest that gender may have an impact on the pattern and severity of AS but the time delay in diagnosis as a disease affecting the intensity and pattern should not be overlooked.


The A-kinase anchoring proteins correlation with disease free survival in breast cancer
Rezvan Esmaeili , Tannaz Samadi , Nasrin Abdoli , Keivan Majidzadeh-Ardebili , Leila Farahmand , Malihe Salehi ,
Volume 74, Issue 10 (January 2017)
Abstract

Background: Researchers are always trying to find specific markers which express specifically in cancer. These specific markers help to diagnose and treat cancer without affecting normal tissues. Cancer-testis antigens are among the new promising biomarkers, especially for targeted therapy. These markers are specially expressed in testis. Various studies have been reported individual expression of these proteins in some tumor tissues. Since testis is an immune privilege organ, abnormal expression of the above mentioned genes raises immune response and the serum antibody against them (CT antigene) can be detected as a marker of cancer. However, understanding their differential role in normal and cancer tissues may introduce them as new candidates of cancer biomarkers. The aim of this study was to evaluate AKAP3 gene expression in breast cancer and its correlation with clinicopathologic features of the disease.

Methods: This study is a case-control study conducted at the Brest Cancer Research Center (BCRC)- Iran, between October 2014 to May 2016. AKAP3 gene expression was investigated with real-time PCR in breast samples including: 74 tumors, 73 normal adjacents and 15 normal tissues. On the other hand the correlation between gene expression, clinicopathologic features of the tumors and treatment regimen were evaluated.

Results: Statistical analysis showed a significant correlation between lack of AKAP3 expression, tumor size (P=0.01) and stage (P=0.04). The association between poor prognosis and the absence of AKAP3 expression in normal adjacent tissues were observed. Kaplan Meier plot showed a significant better disease free survival in the normal adjacent patients group that are expressed AKAP3.

Conclusion: It was observed that the better free survival in the normal adjacent group is because of the different AKAP3 expression, not treatment variations between two patient groups. As a result, AKAP3 can be a suitable candidate biomarker for breast cancer patients. Also, the study of gene expression in normal tissue of patients may be used to predict response to therapy.

A newborn infant with congenital cerebral arteriovenous malformation, and congestive heart failure: case report
Hamed Tabasizadeh , Foroud Salehi , Marzieh Eslami Moayyed, Marieh Eslami Moayyed ,
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. 

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.

Drug utilization evaluation of high-dose methotrexate in a cancer center in north of Iran
Shadi Khazaei, Shahrbanoo Keyhanian , Mahila Monajati , Shahram Ala, Ebrahim Salehifar ,
Volume 75, Issue 9 (December 2017)
Abstract
Background: Methotrexate (MTX) is commonly used in the hematology-oncology units and is frequently associated with adverse effects. High-dose methotrexate (HDMTX) is indicated in the treatment of acute lymphoblastic leukemia (ALL), osteosarcoma, systemic non-Hodgkin lymphoma and primary central nervous system (CNS) lymphoma. The side effect profile of MTX varies markedly according to dose. The aim of this study was to evaluate the uses and adverse effects of HDMTX in a cancer center in north of Iran.
Methods: This cross-sectional descriptive study carried out in Emam Sajjad Hospital, Ramsar, Iran from June 2016 to July 2017. Doses more than 500 mg/m2 of MTX was considered as a high-dose. Hydration status, evaluation of the renal and hepatic function, blood tests, urine pH, doses and frequencies of leucovorin administration, measurement of serum levels of MTX and side effects were evaluated. Recommendations of UpToDate 2017 were considered as standards of administration of HDMTX.
Results: Forty-four courses of HDMTX were evaluated in this study. HDMTX were prescribed for lymphoma (30 cases), ALL (8 cases) and osteosarcoma (6 cases). In all patients, hydration was done with 1340.9±894 normal saline plus 25 ml sodium bicarbonate 8.4%, one to two hours before HDMTX. The solution used for dilution of MTX was 5% dextrose (1022.7±105.5 ml). Urine pH was not measured in any patient. The frequency of leucovorin administration was 5.64±3.03 times with doses of 17.6±1.7 mg/m2 every 6 hours. Serum levels of MTX were not measured in any patient. Blood urea nitrogen and creatinine measurement was carried out before administration of HDMTX in all patients. The most common adverse effects were nausea (64.4%), anxiety (44%) and headache (43.2%).
Conclusion: The appropriate aspects of HDMTX usage were good hydration, urine alkalinization with bicarbonate and administration of leucovorin in patients receiving HDMTX, whereas monitoring of serum levels of MTX and administration of bicarbonate based on urinary pH were not done in any of the patients.
 

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

The factors that affect blood and blood products usage in coronary artery graft surgery
Kianoush Saberi , Shahnaz Sharifi, Mehrdad Salehi , Paniz Mihandoost,
Volume 76, Issue 11 (February 2019)
Abstract
Background: Coronary artery bypass surgery is one of the surgeries in which high blood transfusions are needed. About 20% of all surgical operations require a blood transfusion. Packed cell administration increases perioperative morbidity and mortality. In the United States, from every 1000 people, one has undergone a coronary artery bypass graft surgery, and it is estimated that around 800,000 coronary artery bypass grafts undergo each year. Knowledge about relative blood administration during coronary artery bypass graft surgery improves the ability of blood transfusion centers in healthy and adequate blood donations. For this purpose, this study was conducted to determine the effective factors in the need for blood in a coronary artery bypass graft surgery.
Methods: This cross-sectional study was performed on 317 patients undergoing coronary artery bypass graft surgery in the heart surgery operating room of Imam Khomeini Hospital in Tehran, Iran, from September 2017 to February 2018. Sampling method has been available. The data of this study were extracted from patient files. The products analyzed in the study included packed cell, fresh frozen plasma and platelets. Demographic data, type of surgery, transfusion of blood and products, and hemoglobin level have been reported. P-value less than 0.05 was reported as meaningful.
Results: In this study, 317 patients underwent coronary artery bypass graft surgery. 236 cases (74.4%) were male and the rest were women. The mean of administration of packed cell in women was 2.74±1.3 and in men it was 2.29±1.09 (P<0.001). The mean packed cell administration in patients with hemoglobin levels less than 10 g/dl was 3.27±1.8 and in patients with hemoglobin levels greater than 10 g/dl was 0.99±2.25 (P<0.0001).
Conclusion: The present study showed that the mean transfusion of packed cells in women were more than men in coronary artery bypass graft surgery. Also, hemoglobin levels were the only factor that had a significant effect on infusion of packed cells.

Baseline subfoveal choroidal thickness as an indicator for bevacizumab outcomes in central retinal vein occlusion
Ali Salehi , Mohammad-Ali Abtahi , Seyed-Hossein Abtahi , Hasan Razmjou , Mohammad Tohidi , Mojtaba Akbari , Hamidreza Jahanbani-Ardakani ,
Volume 77, Issue 5 (August 2019)
Abstract
Background: Retinal vein occlusions are one of the most common form of retinal vascular disorders and could lead to vision loss due to macular edema, macular ischemia and sequelae from neovascularization. Anti-venous endothelial growth factor (anti-VEGF) treatment is the choice strategy of treatment for patients with macular edema secondary to central retinal vein occlusion (CRVO). There is an evidence of body with the controversies regarding increment of choroidal thickness in CRVO condition. The current study was designed to determine whether baseline subfoveal choroidal thickness may be an indicator for visual and anatomical outcome of bevacizumab in patients with CRVO macular edema.
Methods: This study was a prospective clinical cohort study that enrolled in 23 new cases of treatment-naïve central retinal vein occlusion (CRVO) from February to July 2017 who were visited in Feiz Eye Hospital, Isfahan, Iran. Patients received a single injection of bevacizumab and were followed for 30 days. Ratio of subfoveal choroidal thickness (SFCT) was measured using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT). Ratio of SFCT of the CRVO eye to the fellow healthy eye (SFCT1/F) was taken as independent variable. Changes of best-corrected visual acuity (BCVA) in LogMAR (ΔBCVA, functional response) and secondary to baseline central macular thickness ratio (CMT2/1, anatomical response) in the CRVO eyes were taken for comparative and correlative analytics.
Results: A total of 46 eyes from 23 patients with the mean age of 64.60±10.19 years were included in this study. Baseline SFCT was higher in CRVO eyes (251.91±46.09 µm) in comparison to the fellow eye (206.95±26.62, P<0.0001). Also central macular thickness in CRVO eyes were significantly higher in CRVO eyes in comparison with fellow eye (531.04±38.22 vs 303.30±33.59, respectively, P<0.05). SFCT1/F, correlated moderately with anatomical (CMT2/1) and strongly with functional response (ΔBCVA).
Conclusion: Bilateral evaluation of SFCT by EDI-OCT in all newly diagnosed CRVO cases is recommended to determine if there is a relative increase in choroidal thickness. This may help predict short-term response to anti-VEGF therapy.

Fluoroscopic analysis of anterior tibial translation during eccentric and concentric phase of knee rehabilitation exercises in men with anterior cruciate ligament injury
Sadegh Norouzi , Fateme Esfandiarpour , Ali Shakouri Rad , Nasim Kiani Yousefzadeh , Zeinab Helalat , Reza Salehi , Mehrnoosh Amin , Farzam Farahmand ,
Volume 77, Issue 8 (November 2019)
Abstract
Background: The amount of anterior tibial translation during rehabilitation exercises is a key factor in organizing exercise regimen after anterior cruciate ligament injury. Excessive anterior tibial translation could increase the magnitude of tension imposed on injured and reconstructed anterior cruciate ligament knees. Forward lunge and open-kinetic knee extension exercises are commonly used in anterior cruciate ligament rehabilitation. However, there is insufficient data about the amount of anterior tibial translation in the eccentric and concentric phases of these exercises. This study compared the amount of anterior tibial translation in the eccentric and concentric phase of the lunge and seated knee extension in anterior cruciate ligament deficient and intact knees.
Methods: Using a non-probability sampling method, 14 men with unilateral anterior cruciate ligament rupture were selected for participation in this cross-sectional study. Participants were recruited from the university’s physiotherapy clinics. A uni-plane fluoroscope was used to image the knee joint while participants performed the forward lunge and open-kinetic knee extension exercises with the intact and injured legs in random order. Fluoroscopy imaging was performed in the radiology center at Sina Hospital, Tehran, Iran, from September 2013 to February 2014. Two factorial mixed ANOVA was used to analyze the data.
Results: There were no significant differences in the anterior tibial translation between the limbs and contraction phases during the lunge exercise. During open-kinetic knee extension, the anterior tibial translation in anterior cruciate ligament deficient knees was significantly more than that of healthy knees at 0⁰ (P=0.007). The anterior tibial translation in the eccentric phase of open-kinetic knee extension at flexion angles of 0⁰ (P=0.049) and 15⁰ (P=0.024) was significantly greater than that in the concentric phase.
Conclusion: In the lunge exercise, the amount of anterior tibial translation was similar between the eccentric and concentric phases and the intact and anterior cruciate ligament deficient knees, however, during open-kinetic knee extension exercise, in the eccentric phase was greater than that in concentric, and in the intact knees was greater than that in the intact knees, at 0-15⁰ angles.

The relationship between Tonic-Clonic sizures in children and increased time of ventricular repolarization
Mohammad Radgoodarzi, Sepideh Ammooeian, Hassan Esmaeili, Shima Salehi, Mohammad Nikoocar,
Volume 78, Issue 8 (November 2020)
Abstract
Background: Long QT syndrome (LQTS) is a disorder in which electrical cardiac ventricular repolarization is impaired. It results in an increased risk of an irregular heartbeat which can result in palpitations, fainting, drowning, or sudden death. Long QT Syndrome may present as tonic-clonic seizure or a seizure-like disorder. By taking a superficial electrocardiogram (ECG) and proper diagnosis, Sudden death, one of the most important complications of Long QT syndrome can be easily prevented.
Methods: This is a prospective case-control study that was conducted in the emergency department of Taleghani Children's Hospital of Gorgan University during 2017.
Four hundred and eighty subjects in three groups (two cases and one control groups), were included in this study. These comprised as patients with afebrile convulsion (n: 160), patients with seizures associated with fever (n: 160), and the control group (patients who have been hospitalized for any reason other than seizure (n: 160)). Those with severe cerebral palsy, acute meningitis, prolonged loss of consciousness, severe disturbances of electrolytes and those who were taking drugs that affect the QT interval were excluded. Once admitted with a primary diagnosis of seizure, a 12 leads superficial ECG was performed.
Results:  In the group of patients with febrile convulsion, 123 children were Low probability Long QT syndrome, 33 cases were Intermediate and 4 were high probability Long QT syndrome. Probability of Long QT syndrome in children with afebrile seizures showed that 112 children were in Low probability Long QT syndrome, 42 children in Intermediate and 6 children in High probability Long QT syndrome group. Comparison of Probability of Long QT syndrome among the three evaluated groups showed that children with afebrile seizure (48 children) and subsequently children with febrile seizure (37 children) were more in Intermediate and High categories than others. Only 11 children in the control group were in the Intermediate and High groups. Chi-square test results showed a significant difference with P<0.001.
Conclusion:  The results of this study show that in patients who present with seizure as the initial symptom, it is always mandatory to account Long QT syndrome into differential diagnosis. Doing a simple electrocardiogram makes it easy to distinguish two issues and prevent sudden death.

Evaluation of the reasons of fear in spinal anesthesia during cesarean section
Gita Shoeibi , Milad Salehi , Reza Atef Yekta ,
Volume 79, Issue 7 (October 2021)
Abstract
Background: Spinal anesthesia is a type of neuraxial anesthesia that brings ample benefits. However, due to the fear of this type of anesthesia, many pregnant people refuse to experience it. In this study, we aimed to investigate the levels and causes of fear of spinal anesthesia in candidates for cesarean section.
Methods: The current study is a cross-sctional study performed on 67 patients undergoing cesarean section who were referred to the operation room of Shariati Hospital, in Tehran from September 2018 to September 2019. Matthey questionnaire, which consisted of three sections (demographic information, history of spinal anesthesia and fear of anesthesia), was filled out by candidates and after collecting information, the data were analyzed by SPSS software.
Results: Pain over the surgery showed a significant relationship with the history of spinal anesthesia in 4 pregnant women (12.9%) and in 25 women (65.8%) without a history of anesthesia (P<0.0001). In addition, the fear of being awake and looking at the cesarean section during surgery was significant in 7 patients (22.6%) with a history of spinal anesthesia and 18 patients (47.4%) without a history of disease (P<0.0001). Fear of anesthesia needle was also significantly observed in 7 patients (23.3%) with a history of spinal anesthesia and 23 patients (60.5%) with no history of spinal anesthesia (P<0.0001). Fear of back injury was seen in 9 candidates (29%) of patients with a history of spinal anesthesia and in 23 patients (60.5%) of patients without a history of anesthesia (P<0.033). The results of our study also showed a significant relationship between the history of general anesthesia and fear of nausea and vomiting (P<0.046) as well as fear of anesthesia needles (P<0.001).
Conclusion: Patients with a history of spinal anesthesia were significantly less afraid of feeling pain during surgery, seeing surgery, spinal anesthesia needles, and spinal impairments. Moreover, patients with a history of general anesthesia were significantly more afraid of spinal anesthesia, nausea and vomiting than others.

Ranking the factors affecting the care and provision of health services to patients in medical centers using the VIKOR dempster-shafer method: a brief report
Mahsa Salehinejad Gilchalan , Mehdi Sadeghzadeh,
Volume 79, Issue 12 (March 2022)
Abstract
Background: Determining the rank of important parameters in ranking health care and providing health services to patients in medical centers.
Methods: The research method is descriptive-analytical and applied in terms of classification. The data is from the database of the Faculty of Health and Medicine of the University of Tehran, which was collected as an archive from April 1998 to May 1999. The statistical population were all experts, specialists and experts of the Faculty of Health 29 of whom completed the questionnaire. The weight of the criteria was evaluated using the AHP method and in the next stage, the medical centers were ranked using the DS-VIKOR method. The analysis method in this study consists of the following steps steps:
• Implementing a simple VIKOR method.
• Implementing the Dempster-Shafer and Vicker method.
• Implementing the AHP method
• Implementation of the Topsis method.
• Comparing the proposed methods to review and compare which ones work best.
Results: The weight of medical centers was assessed by AHP method and then the combined centers were ranked by Dempster-Shafer and VIKOR combined methods  using the information of four medical centers, the DS-Vikor approach was implemented. The purpose of six criteria and three experts was used for evaluation. The results show that the effectiveness of care and treatment process is more important from the experts' point of view. Dempester-Schaefer and Vicor The medical centers in question are ranked. For validation, at the end, the medical centers were ranked by TOPSIS method.
The integrated system includes various subsystems giving caring and providing health services to patients in medical centers that can be built and configured and are ranked.
The model can investigate the effectiveness of giving caring and providing health services to patients in medical centers.
Conclusion: By combining the two methods of Dempster-Shafer and Vicker, the confidence in the whole uncertainty is improved and the results are more reliable. This approach can help reduce the uncertainty caused by people's cognition to increase the level of decision-making, allowing us to overcome the problem of choosing the right level of uncertainty and to deal with uncertainty in a practical and justified way.

Evaluation of electrocardiogram changes in obese children and comparing it with normal weight children
Salma Aryanejad , Fatemeh Taheri Bojd , Atiye Riasi, Tayyebeh Chahkandi, Forod Salehi,
Volume 80, Issue 5 (August 2022)
Abstract
Background: Obesity and overweight are one of the components of metabolic syndrome and the cause of cardiovascular disease and sudden cardiac death. Obesity is associated with a wide range of electrocardiogram (ECG) abnormalities.
Methods: This case-control study was performed on 50 children and adolescents aged 9 to 18 years in Birjand from May to October 2020. In the control group, 25 people with normal weight and in the case group, 25 people with obesity or overweight were included in the study. Individuals with a body mass index of 85-95 percent were defined as overweight, ones with a body mass index above the 95th percentile were defined as obese, and individuals with a body mass index below the 85th percentile were defined as normal. After clinical examination, height, weight and electrocardiogram indices were measured and compared by using statistical tests by SPSS (Version 19) software.
Results: There were 15 boys in the control group and 17 boys in the case group. The mean age of the control and case groups was 11.28±2.13 and 10.96±1.97 years, respectively. The mean distance between the peak to the end of the T wave in the case group was 323.72±120.15 and in the control group was 79.20±13.06. The mean difference between the shortest and longest distance of TP-e in case group was 48±23.04 and in control group was 18.44±5.58, respectively. There was a statistically significant difference between the two indices (P<0.001). But in other variables, no statistically significant difference was observed between the two groups.
Conclusion: The results of the present study showed that obesity can have adverse effects on the ECG of children compared to normal-weight individuals. These changes are associated with an increased risk of arrhythmias. Given that these changes can be corrected with weight control, it is recommended to warn families and educate them to prevent and control overweight and obesity.

Primary pyogenic spinal infection: a review article
Seyed Hasan Emami Razavi , Mohammadreza Salehi, Hooshang Saberi , Mohammad Zarei, Babak Mirzashahi, Pegah Afarinesh, Sepideh Khodaparast,
Volume 82, Issue 3 (June 2024)
Abstract
Primary pyogenic spinal infection, also known as spondylodiscitis or vertebral osteomyelitis, is a serious and potentially debilitating condition involving a bacterial or fungal infection of the intervertebral disc space and adjacent vertebral bodies. While relatively uncommon, with an estimated incidence of 2.4 per 100,000 population per year, it is a medical emergency that requires prompt diagnosis and treatment to prevent permanent spinal damage and neurological complications. The most common causative organisms are Staphylococcus aureus, which accounts for up to 50% of cases, followed by Gram-negative bacteria such as Escherichia coli, and mycobacterial infections like Mycobacterium tuberculosis. Risk factors for developing primary pyogenic spinal infection include intravenous drug use, a weakened immune system, recent spinal surgery or instrumentation, and contiguous spread from an infection elsewhere in the body, such as a urinary tract infection or endocarditis. Patients typically present with severe, localized back pain, fever, and general malaise, which can easily be mistaken for more common spinal conditions. Prompt diagnosis is critical and involves a thorough medical history, physical examination, laboratory testing, and advanced imaging studies such as magnetic resonance imaging (MRI). Blood cultures and, in some cases, image-guided biopsy may be necessary to identify the causative organism and guide appropriate antimicrobial therapy. The mainstay of treatment is the prompt initiation of targeted antibiotic or antifungal therapy, often requiring intravenous administration for several weeks. Surgical intervention may be necessary in some cases, such as to drain an abscess or provide spinal stabilization. A multidisciplinary approach involving infectious disease specialists, spine surgeons, and rehabilitation providers is essential for optimal management and outcomes. Despite advances in diagnosis and treatment, primary pyogenic spinal infection remains a challenging condition. Delays in diagnosis and treatment can lead to devastating complications, including permanent spinal deformity, paralysis, and even death. With timely and appropriate management, however, most patients are able to achieve a good clinical outcome, though some may experience residual pain or neurological deficits.

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