Tehran University Medical Journal

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Abnormal iron homeostasis such as iron deficiency or iron excess is associated with the pathogenesis of many chronic diseases including diabetes and cardiovascular disease (CVD). Iron may stimulate the progression of atherosclerosis by increasing the oxidative stress. Changes in carotid intima-media thickness (CIMT) have been validated as a vascular indicator of atherosclerosis progression. The purpose of this study was to apply CIMT to investigate the association between iron status and the initial stages of atherosclerosis.
Methods: 140 healthy premenopausal women aged 18 to 50 years who had no chronic or acute disease were selected randomly from one of the Tabriz university sub specialized clinics. Blood samples were taken to assay iron status parameters. CIMT was measured noninvasively by ultrasonography. Based on CIMT results, the subjects were classified as "healthy" (CIMT ≤0.8 mm) or "at risk" (CIMT >0.8 mm). Student's t-test was used to determine the mean differences between the two groups.
Results: The mean±SD age of the participants was 32.76±8.1 years. The mean iron, ferritin, hematocrit and mean corpuscular volume (MCV) were significantly higher and the total iron binding capacity (TIBC) was lower (P<0.05) among the "at risk" group. However, there was no significant differences in red blood cell count or hemoglobin levels between the two groups (P>0.05).
Conclusion: Results of this study showed a relative correlation between iron status parameters and CIMT as the initial indicator of CVD. Regarding the contradictions found in the literature, more research is needed to clarify the situation.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Hemorrhoid is among the most common anorectal diseases and patients with high-grade disease conditions need surgical treatment. Many surgical procedures are available to treat the disease. The aim of this study was to compare the operative time and outcomes, (post-operative pain and complications) of LigaSure hemorrhoidectomy with those of the open conventional method.
Methods : This randomized single-blind clinical trial included 57 patients (28 in LigaSure and 29 in the open group). The primary variable was the operative time for the excision of a single hemorrhoidal packet. The other variables were post-operative pain measured by morphine doses administered to control pain, scores of visual analogue scale (VAS) used to measure pain severity, pain during home stay measured by doses of oral ibuprofen and the mean daily VAS scores, early complications including bleeding and urinary retention, longer-term complications and time to return to work.
Results : The demographic data were comparatively the same between the two groups. The average time to excise a single packet of hemorrhoid was significantly shorter in the LigaSure group (8.91 min vs. 17.35 min, P<0.001). Post-operative pain measurements (morphine doses and VAS scores) were lower in the LigaSure group, but the differences were not statistically significant (P=0.055 and 0.077, respectively). Complications of the two procedures were also comparable. Neither of the groups returned to work in a shorter time.
Conclusion: LigaSure hemorrhoidectomy seems to be a safe method and it can reduce the operative time significantly. It may also have a modest effect on post-operative pain.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Human amniotic membrane (HAM) forms the inner wall of the membranous sac that surrounds and protects the embryo during gestation. The main advantages of amniotic membrane transplantation (AMT) in the treatment of bacterial keratitis are its epithelial bandage properties. Previous studies have documented the presence of some antimicrobial proteins and peptides in amniotic fluid such as lactoferrin, lysozyme, bactericidal or permeability increasing protein, calprotectin (MRP8/14 protein complex), LL37, and neutrophil defensins (Human Neutrophil Peptides, HNP 1-3). Furthermore, the amniotic membrane does not express HLA-A, B, C or DR surface antigens, which may help avoid rejection after its transplantation. Thus, it can be used as a biological immune barrier. The purpose of this study was to evaluate the effectiveness of the amniotic membrane's healing properties in rabbits with pseudomonas keratitis.
Methods : By using an animal model, 14 rabbits were divided into two groups of controls and cases. A syringe was used to inoculate the corneal stroma of the animals by Pseudomonas aeruginosa ATCC27853. After 20 hours pseudomonas keratitis was created and amniotic membrane was transplanted to the cornea of the case group. The infiltration size were observed on the first, third and seventh days after the experiment.
Results : Corneal perforation was seen in the controls (P<0.001) but amniotic membrane prevented perforation in the case group (P=0.02).
Conclusion: Transplantation of amniotic membrane in the primary stages of pseudomonas keratitis treatment remarkably prevents corneal perforation and it can be used to control the disease process.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Recent evidence suggest that group A ß-hemolytic streptococcal (GABHS) infection may increase the risk of pediatric autoimmune neuropsychiatric disorders (PANDAS) composed of the clinical signs of obsessive-compulsive and attention deficit hyperactivity disorders. The objective of this study was to compare the titer of antibodies against GABHS between children with PANDS and the controls.
Methods : This cross-sectional, case-control study was done in Hazrat Rasoul Hospital, in Tehran, Iran during 2008-2010. We compared serum antibodies streptolysin O, deoxyribonuclease B, and streptokinase against GABHS quantitatively in 79 cases with PANDAS and 39 age-matched controls. The area under ROC curve, sensitivity, specificity and positive predictive value (PPV) of tests were calculated.
Results : Most cases were studied in summer (57%) and spring (23%). The three aforesaid antibodies were higher in the cases (P=0.001). Antisterptolysin O (cut-off point 195) had a 90% sensitivity, 82% specificity and a 92% PPV, (CI=95%, 0.99-0.91). Anti streptokinase (cut-off point 223) had an 82% sensitivity, 82% specificity and a 95% PPV, (CI=95%, 0.934-0.735). Anti-DNase (cut-off point 140) had an 82% sensitivity, 82% specificity and a 95% PPV, (CI=95%, 0.99-0.91).
Conclusion: The study demonstrated a possible role for streptococcal infection in PANDAS. We found a significantly higher antibody titer against GABHS in OCD and ADHD cases in comparison with healthy children. Treatment of streptococcal infection is achievable by the use of long-acting penicillin. Use of aggressive treatment schedules like plasmaphresis, IVIG, etc needs further RCT studies.

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Background: Human embryonic stem cells (hESCs) are capable of self-renewal and large-scale expansion. They also have the capacity to differentiate into a variety of cell types including liver, cardiac and neuron cells. However, it is not yet clear whether hESCs can differentiate to hemangioblasts under in-vitro conditions. Hemangioblasts are bipotential progenitors that can generate hematopoietic lineages and endothelial cells. The aim of this study was to identify the potential of human Royan H5 embryonic stem cells in differentiating into hemangioblast cells.

Methods: HESCs were cultured at suspension system in DMEM/F12 supplemented with bFGF. 7-day old cells differentiated into blast cells under defined condition consisting of hematopoietic cytokines including BMP4, VEGF, etc. Blast cell markers kinase insert domain receptor (KDR), CD31, and CD34 were evaluated by flow cytometry and blast gene expressions (TAL-1, Runx-1 and CD34) were detected by qRT-PCR. Clonogenic assays were performed in semisolid medium by colony forming unit-assays.

Results: The hESCs (Royan H5) had the capacity of differentiating into hemangioblast cells. We could detect colonies that expressed 79%±12.5 KDR+, 5.6%±2.8 CD31+-CD34+ and 6%±2.12 KDR+-CD31+ on day 8 in the hESCs. Up-regulation of TAL-1, Runx-1 and CD34 occurred during hemangioblast commitment (P≤0.05 and P≤0.01, respectively). Moreover, hemangioblast cells generated mixed-type and endothelial-like colonies in semi-solid media.

Conclusion: Our results showed that hESCs (Royan H5) were able to differentiate into hemangioblasts under in-vitro conditions. The hemangioblasts had the potential to generate two non-adherent (Mixed-type) and adherent (endothelial-like) cell populations.

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Background: Inadequate ventilation, esophageal intubation and difficult intubation are the most common adverse respiratory outcomes in patient undergoing anesthesia .The aim of this study was to compare Mallampati test in supine and sitting positions in traditional approach and during phonation for predicting difficult laryngoscopy and intubation.
Methods: In this study performed in Imam Khomeini Hospital in Tehran, Iran, Mallampati test was performed on 661 patients who met the inclusion criteria for the study. The test was done in supine and sitting positions with and without phonation by a rater who was blind to Mallampati test. Subsequently, laryngoscopy view and difficult intubation were evaluated in the four aforesaid positions by Mallampati test for predicting difficult laryngoscopy and intubation. For each situations, sensitivity, specificity, positive and negative predictive values and accuracy were calculated.
Results: Overall, 28 (4.2%) patients had difficult laryngoscopy and 9 (1.4%) patients had difficult intubation. The highest sensitivity for Mallampati test in predicting difficult laryngoscopy and intubation was in supine and sitting positions without phonation, and the highest specificity was seen in sitting position with phonation. Negative predictive values were more than 95% in all different positions for Mallampati tests and the highest positive predictive value was seen in supine position with phonation.
Conclusion: According to our findings, the highest correlation between Mallampati test and different positions in predicting difficult laryngoscopy and intubation was seen in supine position with phonation. Phonation improved Mallampati score in supine rather than sitting position.

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Background: Several reports indicate that the probiotics can increase body resistance against malignant tumors. The aim of this study is to evaluate the effect of Lactobaci-llus reuteri Persian type culture collection (PTCC) 1655 in preventing tumor growth, improving weight and survival rate in mice with breast cancer.
Methods: Twenty mice, the BALB/c at six weeks age, weighing approximately 17 gram were divided into two groups. Oral administration of 500 micro liters of Lactobacillus reuteri suspension performed for the first group 14 days before tumor transplantation. The second group (control) received the same volume of phosphate buffer saline (PBS). Then the mice had tumor transplantation surgery. Lactobacillus reuteri was prescribed in the first group in seven-day period and three-day interruption pattern. At the same time the second group (control) received PBS. This process was continued until 45 day. The tumor growth, histology and body weight were evaluated in both group and the mortality of mice was recorded.
Results: In the mice transplanted tumors that had received probiotics, tumor growth decreased in comparison with control group. In this group the body weight increased (P>0/05). In addition, the survival of these mice had significantly increased compared to control group (P=0.002). The evaluation of tumor tissue also showed increased immune system function in mice receiving the probiotic (P>0/05).
Conclusion: Lactobacillus reuteri can improve immune system function and have an important role to help treatment of cancer.

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Background: Biliary cirrhosis is a chronic disease marked by the progressive destruct-tion of liver. There is no known cure for this disease however, medications may slow its progression. The present study was designed to investigate the effect of quercetin as a plant derived flavonoid on the hepatic injury reduction of biliary cirrhotic rats.
Methods: Thirty male Sprague-Dawley rats aged 6-7 months were randomized into three groups of ten each. One group served as control (sham operated), while the other two groups underwent a complete bile-duct ligation (BDL). Four weeks after the opera-tion, serum bilirubin, alkaline phosphatase (ALP), alanine amino-transferase (ALT), and aspartate amino-transferase (AST) were measured in two BDL groups to confirm the occurrence of cirrhosis. Then one of the BDL groups received placebo and the other one injected intraperitoneally with 50mg/kg of quercetin once a day for a period of four weeks. At the end of the study, hepatic enzymes and serum bilirubin were measured again. Liver species were tested for histological characteristics.
Results: Quercetin could decrease serum level of bilirubin (7.4±0.9 vs. 8.9±1.6 mg/dL P<0.05), ALP (1387±76.9 vs. 2273±65.3 IU/L P<0.001) and ALT (601.9±38.1 vs. 644.8±37.4 IU/L P<0.05) compared to cirrhotic group. AST was higher in cirrhotic groups compared to control both in the 4th and 8th week. However, the difference between BDL and BDL+Q groups was not statistically significant. Quercetin decreased ALT/AST ratio, as an indicator of liver damage. No significant histological changes were observed in quercetin group.
Conclusion: These data suggest that although quercetin did not change histological characteristics of liver, it could significantly decrease bilirubin, alkaline phosphatase and alanine amino-transferase, indicating less liver injury.

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Background: Primary culture takes place following the cell isolation from tissues. Isolation and culture of melanocytes based on their roll in the protection of body against hazardous sun rays, production of skin, cornea and hair color is really important. This study was done to set isolation, culture and proliferation of melanocytes from children foreskin and adult eyelashes, and also comparison of two types of melanocyte culture medium.
Methods: Human foreskin and eyelash samples were used for melanocyte isolation and culture. After isolation of epidermis from dermis, epidermis cell suspensions were prepared by enzymatic digestion. The isolated cells were cultured in two melanocyte selective culture media. Immunocytochemistary and reverse transcription-polymerase chain reaction (RT-PCR) assays were used for confirmation of isolated and cultured melanocytes.
Results: Our results indicated that isolated melanocyte cultured in the selective medium without phorbol esters is better than the melanocytes cultured in selective medium cont-aining phorbol esters not only morphologically but also physiologically and from the aspect of cell adhesion. In addition, the results showed that isolated melanocyte from adult eyelashes are more dendritic than melanocytes isolated from children foreskin. Conversely, our results indicated that the number of cell passages in melanocyte isolat-ed from foreskin is more than melanocytes isolated from adult eyelashes.
Conclusion: Melanocytes cultured in selective medium containing convenient growth factors in absence of phorbol esters show more native physiological and adhesive properties. In addition, melanocyte isolated from younger tissues such as foreskin have better proliferative and sub-culturing properties so we suggest isolation and culture of younger tissues.

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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.

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Background: Adipokines are peptides secreted by adipose tissue that affect whole-body energy metabolism. Exercise training exerts beneficial effects on adipose tissue. However, less is known regarding visfatin’s, IL-6 & TNF-α response to an interval acute training. Therefore, we investigated the effects of acute interval exercise on plasma visfatin, TNF-α and IL-6 levels, in healthy female rats. Furthermore, correlate between changes probably these factors were also assessed.
Methods: This study was conducted experimentally. Forty five female sprague dawley rat were randomly divided into three groups: pre test (n= 15), treadmill exercise (n= 15) and sedentary controls (n= 15). The acute alternative exercise consisted of treadmill running: 3 session/ week for 8 week. The changes of plasma IL-6, TNF-α and Visfatin levels were measured by ELISA analysis. Data were analyzed using analysis of variance with measures (ANOVA) and post hoc Tukey test.
Results: Acute interval treadmill exercise led to significant decreases in visfatin (P= 0/036), IL-6 (P= 0/009) and TNF-α (P= 0/022) plasma levels between the groups. Also, this study no significant correlations between the changes in adipokines were observed.
Conclusion: Decreased levels of TNF-α and IL-6 correlated with intensity and duration exercise. Furthermore, probably there were some factors except weight decreasing that affects on visfatin decrease. Therefore, the reduction of this factor may cause in preventing metabolic disease.

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Background: Nonalcoholic Fatty Liver Disease (NAFLD) is one of the most wide-spread human diseases that can impair liver function and sometimes progresses to cir-rhosis. Recently NAFLD has been identified as an independent risk factor for cardio-vascular disease. The aim of this study was to investigate the correlation of fatty liver disease and its sonographic severity on the resistance of the intracranial arteries. Methods: This study was a cross-sectional study of 55 patients referred from Gastroen-trology clinic with diagnosis of NAFLD to Sonodoppler department of Iranian Center of Neurological Research. Pulsaltile index as a Hemodynamic parameter of Middle Cerebral (MCA) and basilar Arteries of NAFLD Patients was measured by Trans Cra-nial Doppler (TCD) sonography and the measurements were compared with normal values. Also the association of these indices with serum liver enzymes and sonographic grading of liver involvement was assessed. The analysis was done by SPSS 16. Fre-quency distribution, mean and standard deviation were used in descriptive analysis and statistical test 2 to compare qualitative variables. Results: Pulsatile Index (PI) were normal (MCA, P= 0.166, Basilar, P= 0.053) and there was no significant difference with relation to severity of fatty liver based on so-nography findings (P= 0.789), but serum liver enzyme levels were inversely correlated with basilar artery PI (P= 0.014). Conclusion: Considering the increase of cerebral arteries PI in advanced liver disease, absence of increase in vascular PI of patients in the present study could be attributed to the short duration of disease from diagnosis to perform TCD, lack of advanced liver involvement (absence of liver dysfunction) and the response effect to treatment before the TCD. Therefore, to assess vascular changes over time, repeating the TCD with assess other parameters such as Fibroscan and K18 factor that has more compatibility of liver function, could help to understand the pathophysiology of liver diseases and its effect on vascular resistance.

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Background: Complex of Burkholderia cepacia is one of the main and serious causes of infections in cystic fibrosis patients that can be highly transmissible. Small hospital outbreaks are frequent and are usually due to a single contaminated environmental source. The pulsed-field gel electrophoresis (PFGE) is widely used to identify the strain emission sources in cystic fibrosis patients. The aim of this research was to study genotyping of Burkholderia cepacia using PFGE method, and to evaluate diversity complex of clinical strains isolated from cystic fibrosis patients. Methods: This is a descriptive study, in which 100 pulmonary secretion specimens of cystic fibrosis patients admitted in Masih Daneshvari Hospital, Tehran Iran in period of 12 months 2012 to 2013 were collected. The specimens were cultured on BCSA plate’s. After incubation suspected colonies were isolated and identified by biochemical and phenotypic method. All samples were checked by API system (API20NE) and by specific PCR method for genus Bulkhorderia and Bcc as well. DNA was extracted by alkaline lysis method and confirmed by PCR analysis of recA genes. Genetic diversity of isolate was performed by PFGE analysis according to Pulsenet guideline by using XbaI, SpeI as restriction enzyme which digests infrequently among the Burkholderia cepacia genome. Results: Out of 100 samples five were identified as Burkholderia cepacia. It is obviously different at variously reports. The electrophoresis data of PCR products and comparison of band in samples from patients with standard strain ATCC 25416 Burkholderia cepacia and compare and analyse the PFGE size marker bands of Salmonella choleransuis serotype Braenderup H9812 strain, were the same. Conclusion: Application of PFGE and identification of pulse-type is a potential tool to enhance the investigation of apparent nosocomial outbreaks of B.cepacia. Similar type of pulse patterns was observed in this study means that all of infection has been from one source therefore the hypothesis of transferring person to person will be rejected. Base on these results environmental sources sampling should be considered in future investigation.

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Background: With introduction of intracytoplasmic sperm injection with testicular sperm extraction or precutaneouse epididymal sperm aspiration, effective treatment was provided for azoospermic men. The aim of present study was to compare clinical outcome following intracytoplasmic sperm injection using extracted testicular/epididymal sperm or ejaculated severe oligoasthenoteratozoospermic sperm. Methods: After retrospective evaluation of more than four hundred medical records of patients undergoing intracytoplasmic sperm injection Mehr medical institute (between 2011-2012), 45 cycles with severe eligoasthenoteratozoospermia and 34 cycles with azoospermia were included. Patients were treated with gonadotropin releasing hormone agonist. The clinical characteristics and intracytoplasmic sperm injection outcome such as the rate of fertilization, implantation and clinical pregnancy were compared between the two groups. Results were presented as mean±standard deviation and number (percent). Differences between variables were analyzed using student's t test and the chi-square test was used to examine differences between categorical variables. P value less than 0.05 were considered as statistically significant. Results: Mean of female age (29±4.9 vs. 30.2±5.8), body mass index (26.9±5.3 vs. 26.9±3.8), estradiol level on human chorionic gonadotropin administration day (1375.6±843.9 vs. 1181.8±673.1), total number of retrieved oocytes (9.7±5.3 vs. 9.2±5.9) and metaphase II oocytes (7.7±5.1 vs. 7.5±5.4) were similar between the two groups. Of 436 and 313 retrieved oocytes, respectively 232 and 163 oocytes were ferti-lized in oligoasthenoteratozoospermic and azoospermic groups (53.2% vs. 52.1%, P=0.214). There were not statistical differences between groups in number of trans-ferred top quality embryos (1.5±1.2 vs. 1±1.2, P=0.09), implantation rate (22.7% vs. 16.9%, P=0.238) and clinical pregnancy rate (21 (47.7%) vs. 11 (35.4%), P=0.199). Conclusion: Intracytoplasmic sperm injection with precutaneouse epididymal sperm aspiration and testicular sperm extraction are effective methods to treat azoospermic men and its clinical outcome were comparable to ejaculated sever oligoasthenoterato-zoospermic cycles. It can be concluded that the influence of sperm quality and origin on intracytoplasmic sperm injection outcome are the same.

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Background: Hormonal, physical, and psychological fluctuations occur during the menstrual cycle. Previous studies have shown that hormonal changes during the normal menstrual cycle affect anesthesia and analgesia. The limitation of previous studies are that they did not measure luteal hormone (LH), Follicular stimulating hormone (FSH), estradiol, progesterone and cortisol levels. Our goal was to find more suitable conditions in menstrual periods for intubation of patient. Methods: American Society of Anesthesiologists physical status I patients, 16 to 40 years, undergoing general anesthesia for elective surgery were enrolled in this study and conducted at Imam Khomeini Medical Center in 2013. The patients were assigned into two groups according to the phase of their menstrual cycle. Levels of sex hormones and hemodynamic variables were recorded for all the patients and statistical analysis performed. Results: In 77 patients, 38 women were in the luteal phase (49.4%) and 39 women were in the follicular phase (50.6%). All tracheal intubations were successful on the first attempt with a mean duration of 2558±5.07 and 25.84±5.32 seconds in groups F and L, respectively (P=0.489). None of the patients were excluded for long tracheal intubation time. Systolic blood pressure after intubation in the follicular phase (138.4±20 mm Hg) was significantly higher vs. the luteal phase (127.7±18 mm Hg) (P<0.01), as well as the women’s heart rate after intubation in the luteal phase (90.7±12 beats per minute), was significantly higher than in the follicular phase (85.3±11 beats per minute) (P=0.05). Heart rate was higher in the luteal group than the follicular group thus the women’s heart rate after intubation in the luteal phase (90.7±12 bpm) was significantly greater than the follicular phase (85.3±11 bpm) (P=0.05). Conclusion: Reviewing and comparing the results show that elective surgeries are bet-ter to be done in the luteal phase because of stable hemodynamic conditions.

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Background: Cardiotoxicity of anthracyclines (ANTs) in medium and high doses (more than 350 mg/m2) has been already known but it is still unclear whether or not minimal doses (lower than 350 mg/m2) can also affect cardiac function. The goal of this study was to assess the cardiotoxicity of ANTs in children under minimal doses and evaluation the association of this toxicity with probable risk factors such as age at beginning of regimen, gender or type of malignancy. Methods: In a prospective study 50 children suffering from different malignancies ad-mitted in pediatric oncology department of Besat Hospital of Sanandaj City in 2010 to 2012, under ANTs regimen (Daunorubicin, Doxorubicin) in doses lower than 350 mg/m2 were followed by serial echocardiography for 1-3 years. The deviation from normal values of echocardiographic parameters was measured for all patients in this period and even one parameter's deviation was considered as cardiac dysfunction and ANTs cardi-otoxicity. The association of this toxicity and probable risk factors was analyzed by proper statistical methods in SPSS 18th version. Results: In 22% of patients, mostly children older than 11, at least one of echocardio-graphic parameters including: ejection fraction (EF), left ventricular end systolic diame-ter (LVESD), left ventricular end diastolic diameter (LVEDD), left ventricular mass (LVM) and left ventricular posterior wall diameter (LVPWD) changed during our follow up. The most important risk factor for cardiotoxicity in this study was age at beginning of ANTs regimen. Acute myeloid leukemia (AML) had the most abnormal values among all types of malignancies. In this study there was no statistically significant as-sociation between cardiotoxicity and gender or duration of follow up. Conclusion: Anthracyclines even in doses lower than 350 mg/m2 can induce cardiac dysfunction and alter echocardiographic parameters, although these changes are not always accompanied by clinical signs or symptoms as they were in this study. So long term echocardiographic follow up and cardioprotective techniques are recommended in prescription any doses of these cardiotoxic drugs.

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Background: Stem cells are applied in the treatment of wide range of diseases and can be separated from different tissues of the body. These cells can treat diseases by cytokine and growth factor secretion and also cell differentiation. Burn wound is a challenging problem of reconstructive surgery and stem cells may help wound healing process. We designed this study to evaluate the beneficial effect of fat derived stem cells for coverage of 3rd degree burn wound. Methods: This study was experimental and has been done in Burn Research Center of Iran University of Medical Sciences during January 2012 to April 2013. Thirty rats randomly divided to three equal groups. Inguinal fat of 10 rats (one group) were used for preparation of autologous adipose-derived mesenchymal stem cells. Acellular amnion was used as a scaffold for stem cell transfer. Each of the thirty rats had been exposed to a cm deep 3rd degree burn on back area. 24 hours after surgery, the wound was excised and it had been covered by three methods: conventional dressing in the first group, acellular amnion in the second group and acellular amnion seeded with adipose-derived stem cell in the third group. The rate of wound healing and pathologic characteristics was compared in all three groups. Results: Healing rate and decrease in wounds size was significantly better in acellular amnion seeded with adipose-derived stem cells compared with other two groups at 3rd and 15th days after surgery P<0.01. Also in histopathology examination, fibroplasia and neovascularization of wounds were significantly better in stem cells group than the other two groups P<0.001. Conclusion: Acellular amnion seeded with adipose-derived stem cell can result in faster wound healing and better histopathology characteristic. The amnion as a scaffold and the fat derived stem cells as healing accelerator are recommended for coverage of the 3rd degree burn wounds after excision and it may reduce the need for skin graft.

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Background: Uterine leiomyoma is one of the most common benign smooth muscle tumors occurring in 20-40% of women worldwide in their reproductive years. Recent studies revealed that estrogen plays an important role in the pathogenesis of this disease. Since glutathione S-transferase (GST) gene family are involved in the biosynthesis of estrogen, the prior probability that variants at this locus are associated with uterine leiomyoma is likely to be above the null. Therefore, this study was carried out to examine whether GSTP1 polymorphism (Ile105Val) is associated with increased risk of uterine leiomyoma in Iranian population. Methods: In this case-control study, 50 women diagnosed with uterine leiomyoma and 50 healthy controls were recruited from subjects referred to the Pasteur Institute of Iran from November 2012 to September 2013. The genomic DNA was extracted from peripheral blood leucocytes using the standard phenol-chloroform method and subsequently the GSTP1 polymorphism was genotyped using amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Logistic regression analysis was applied to estimate odds ratios and 95% confidence intervals after age adjustment using the SPSS statistical software package, version 18.0. Results: The results showed significant differences between case and control groups in terms of genotype frequency (P<0.0001). In addition, the results indicated that the presence of the valine allele significantly increased risk of uterine leiomyoma about three times more in individuals carrying the mutant allele compared to control group (Odds Ratio: 3.34 95%CI: 1.82-6.15 P<0.0001). Conclusion: To our knowledge, this is the first study performed in Iranian population assessing the association between GSTP1 Ile105Val polymorphism and risk of uterine leiomyoma. However, further extensive studies with a large number of samples from different populations and ethnicities are required to validate the results obtained in this study.

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Background: Uterine myomas are benign tumors of the uterus and the most common solid pelvic tumors causing symptoms in approximately 25% of women in their reproductive years. However, its etiology and pathogenesis remain obscure there is increasing evidence that endometriosis is inherited as a complex genetic trait. Recent studies indicated the involvement of glutathione S-transferase M1 (GSTM1) gene in the pathogenesis of this disease and current investigations are devoted to the other members of phase II detoxification system genes such as glutathione S-transferase T1 (GSTT1). Therefore, current study was carried out to investigate the distribution of GSTM1 and GSTT1polymorphisms in Iranian population in order to estimate possible impact of null-alleles of each gene in development of this disease. Methods: In this study, 50 patients with endometriosis diagnosed by both pathology and laparoscopic findings according to the revised American Fertility Society classification of endometriosis were recruited from subjects referred to the Pasteur Institute of Iran between November 2012 to September 2013. Accordingly, controls (n=50) were subjects without any of aforementioned gynecologic conditions. The genomic DNA was extracted from peripheral blood leucocytes using the salting out method and GSTM1 and GSTT1 genotyping for gene deletions were carried out using Gap-polymerase chain re-action. Logistic regression analysis was applied to assess whether there was any significant risk increase between the case group with higher null genotypes compared to control group. The level of statistical significance was set at 0.05 and all analyses were conducted using the SPSS version 18.0 (SPSS Inc., Chicago, IL). Results: There was significant evidence that the distribution of the GSTM1 and GSTT1 genotypes differed between the patients and the controls with an allelic odds ratio (OR) of 3.56 (95%CI: 1.35-9.37, P=0.01) and 3.92 (95%CI: 1.4-10 P=0.009) respectively. Data analysis also revealed that individuals with both GSTM1 and GSTT1 null genotypes (-/-) had higher risk to develop the disease in comparison to the people with the both present (+/+) genotype (OR:19.23, P=0.007). Conclusion: The findings suggest that the GSTM1 and GSTT1 genetic polymorphisms are associated with the development of endometriosis in Iranian women which is in agreement with previous results obtained in other populations. However, the ethnic variations of polymorphisms should be evaluated in detail and differences should be incorporated into investigations of susceptibility variants for this disease.

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Background: Functional constipation and gastroesophageal reflux disease (GERD) are two common childhood digestive disorders which can cause a lot of complications among them if untreated. Since an overlap and relationship between functional gastrointestinal disorders have been shown in some studies, so present study was performed to investigate the frequency of functional constipation among children with reflux in compare with children without reflux. Methods: A cross-sectional study was conducted on all children who referred to digestive diseases clinic of Ali-Asghar Hospital in Tehran, Iran, from April 2008 to January 2010. Patients that referred for follow up were excluded from study and a total of 474 children were included in this study. A questionnaire including symptoms of reflux and functional constipation was completed for all subjects by design’s executer after parental consent. Other data related to history, physical examination and results of paraclinic investigations for functional constipation diagnosis were also collected. Results: In general 247 children (52%) were male and 227 children (48%) were female. Nineteen children (4%) had gastroesophageal reflux disease in this study which 6 of them (31.5%) were less than 1 year old and 13 of them (68.5%) were greater than 1 year old. Opisthotonic posturing, abdominal pain, heartburn and recurrent vomiting were the most common symptoms in children with reflux. There was also functional constipation in 60 children. Twelve patients (63.2%) had functional constipation among 19 children with reflux, whereas 48 patients (10.5%) had functional constipation among 455 children without reflux. This different frequency ranges of functional constipation among children with and without gastroesophageal reflux was statistically significant (P= 0.001). Conclusion: The frequency of functional constipation in children with gastroesophageal reflux was significantly more than normal children. Further studies are recommended to investigate the relationship between functional constipation and gastroesophageal reflux in children.