Showing 190 results for Ch
Hatam Ahmadi , Parvin Rostami , Mohammad Reza Zarrindast, Mohammad Nasehi , Homa Mohseni Kochesfehani ,
Volume 71, Issue 3 (June 2013)
Abstract
Background: Nucleus accumbens (NAc) and prefrontal cortex (PFC) dopaminergic and glutamatergic systems are involved in regulating of locomotor activity behaviors. This study has investigated the interaction of NAc shell dopaminergic system and prelimbic glutamatergic systems in regulating locomotor activity and related parameters.
Methods: The aim of this study was the effect the drugs injection interaction in the brain of male Wistar rats on locomotor activity and related parameters, in the order of this purpose, open field apparatus that automatically recorded locomotor activity was employed. Unilateral intra-cerebral injection of drugs was done.
Results: Unilateral intra-prelimbic injection of D-AP7 (N-methyl-D-aspartic acid= NMDA receptor antagonist 0.25, 0.5 and 1μg/μl) did not alter locomotor activity behaviors. However, infusion of NMDA (0.9μg/μl) in this region increased locomotor activity (P<0.01), whereas decreased rearing (P<0.01) and grooming (P<0.01) which was blocked by D-AP7 (0.25μg/μl) (P<0.01). Moreover, unilateral infusion of SCH23390 (dopamine D1 receptor antagonist 0.25, 0.5 and 1μg/μl) into the left NAc shell did not alter locomotor activity. However, injection of SKF38393 (dopamine D1 receptor agonist 4μg/μl) into the left NAc shell increased locomotor activity (P<0.05) which was blocked by SCH23390 (0.25μg/μl) (P<0.01). Furthermore, the subthreshold dose infusion of SCH23390 (0.25μg/μl) into the left NAc shell reduced the effect of intra- prelimbic NMDA on locomotor activity (P<0.01). In addition, intra-NAc shell administration of the subthreshold dose of SKF38393 (1μg/μl) potentiated the middle dose (P<0.05), whereas decreased the higher dose of intra-left prelimbic NMDA response (P<0.05) on locomotor activity.
Conclusion: The results suggested a modulatory effect of the NAc shell dopaminergic system on increased locomotor activity by activating glutamate system in prelimbic.
Mahdi Zareei, Parivash Kordbacheh , Roshanak Daie Ghazvini , Ensieh Zibafar , Mohsen Geramishoar , Zeinab Borjian Borujeni , Mehdi Nazeri, Leila Hossein Pour, Mohammad Mirbulook Jalaly, Seyed Jamal Hashemi ,
Volume 71, Issue 5 (August 2013)
Abstract
Background: Malassezia Species are often commensal of the human skin and scalp that opportunistically in exist of particular predisposing factors, their proliferation increases as, in dandruff and seborrheic dermatitis which both togather affect more than 50% of humans, the excess proliferation of yeast in scalp, leads to scalp-flaking and causes physical and mental disorder in peaple, spacially in youth that their health and hiar hygiene and beauty is more important for them. Thus, this survey has been done for rapid, easy and inexpensive method to diagnosis of abnormal proliferation and invasive condition of Malassezia yeast and can be more benefical for proper treatment.
Methods: Sampling with scalpel scraping from scalp of volunteer persons that had not bathed at least two day ago were done and preparation of direct microscopic slides and staining with methylene blue were accomplished. Then, survey of morpholgic characte-ristics, yeast quantification and mycelium detection were done by direct microscopic examination.
Results: From 140 scalp samples of adult persons of both gender (male and female) with different age groups, observation of malassezia yeast in 93.5% (131) were positive and 6.5% (9) were negative in direct microscopic examination. Results of yeast quanti-fication in positive cases were: mild or normal flora 25.2%, intermediate 24.5%, severe 50.3%. Detection of mycelium in positive cases were 22.9% (30) (P=0.007 df=2).
Conclusion: Application of an accessible, easy and inexpensive method and a determi-nated pattern (yeast quantification with direct microscopic examination) to distinguish normal flora from abnormal condition (excess proliferation and mycelium production) in cases of Malassezia yeasts can be more useful to rapid diagnosis of abnormal pro-liferation and invasive condition in order to initiate a proper antifungal treatment.
Hossein Fakhrzadeh , Farshad Sharifi , Neda Mehrdad , Fatemeh Jafaraghaeii , Zohreh Badamchizadeh , Neda Nazari ,
Volume 71, Issue 7 (October 2013)
Abstract
Background: The aim of this study was to assess the association of serum adiponectin and a set of traditional cardiovascular risk factors with carotid artery intimal-medial thickness (CIMT) and coronary artery calcium score (CACS), as markers of subclinical atherosclerosis in subjects with early type 2 diabetes mellitus.
Methods: Carotid artery intima- media thickness (measured by B-mode ultrsonography), coronary artery calcium score (determined by high resolution computed tomography), serum adiponectin, Fasting blood sugar, serum lipids, body mass index (BMI), systolic blood pressure, diastolic blood pressure and mean arterial pressure were measured in 123 asymptomatic newly diagnosed cases of type 2 diabetes mellituss and 152 age and sex matched healthy control subjects.
Results: Serum adiponectin and lipids were significantly lower in those with type 2 diabetes mellitus (P<0.01). Left, right and mean carotid artery intima- media thickness, coronary artery calcium score, fasting blood sugar, systolic blood pressure, diastolic blood pressure and mean arterial pressure were significantly higher among diabetic patients compared to healthy controls (P<0.05). Mean carotid artery intima- media thickness was positively and independently related to age (P<0.001) and triglyceride (P=0.01) in diabetic group. Coronary artery calcium score was associated positively with age (P=0.004) and inversely with high density lipoprotein (HDL) cholesterol (P=0.002) among diabetics.
Conclusion: Although adiponectin was lower in diabetics compared to controls, it had no significant association with carotid artery intima- media thickness and coronary artery calcium score as markers of subclinical atherosclerosis. In patients with type 2 diabetes in addition to age, serum triglyceride levels are correlated with carotid artery intima- media thickness, while HDL cholesterol is inversely correlated with coronary artery calcium score.
Masomeh Abedini , Nahid Ghotbi , Navid Hadavi , Delnia Chavoshi , Nahid Asgharian ,
Volume 71, Issue 10 (January 2014)
Abstract
Background: Nosocomial infection is one of the major causes of death in neonates. In recent years, the results of nosocomial infection control committee, which carried out, based on a protocol of National Nosocomial Infection Surveillance (NNIS) is not consistent with neonatal review articles. This study was performed to determine the prevalence and incidence of nosocomial infection with an active, prospective method based on definitions and characteristics of Center for Disease Control and prevention (CDC) and comparing it with routine method of NNIS.
Methods: This cross-sectional and prospective study was independent from Beasat Hospital nosocomial infection control committee and preformed by daily active visiting of neonatal ward (that is level-II) for six month period. The results of this study were compared with the results of the NNIS committee of nosocomial infection. Collected data were statistically analyzed by SPSS software.
Results: From all hospitalized neonates, 369 cases (1292 patients / day) were enrolled in the study. The overall rate of nosocomial infection (frequency) was 2.71% and the overall incidence of nosocomial infection was 7.73 cases per 1,000 patients / day. The most common nosocomial infection in this study was skin and soft tissue infections totally 50%. The incidence of Central Line-Associated Bloodstream Infection (CLA-BSI) was 14.2 per 1000 central catheter/day for the six months of study. Nosocomial infection rate preformed by Beasat Hospital nosocomial infection control committee (based on NNIS) was 0.1 % and incidence of nosocomial infection 0.3 per 1,000 patients/ day at the same 6 month study.
Conclusion: It seems that a large part of this considerable differences between the results of this study compared to NNIS based study, is this fact that, for nosocomial infection surveillance in the neonatal field, the presence of a specialist as a performer and leader of the team, is necessary.
Marjan Rismanchi , Pooneh Mokarram , Mahvash Alizadeh Naeeni , Mahdi Paryan , Zohreh Honardar , Soudabeh Kavousipour , Abbas Alipour ,
Volume 71, Issue 12 (March 2014)
Abstract
Background: Colorectal Cancer (CRC) is the third common cancer in the world. One of the pathways in colorectal tumor genesis is Microsatellite Instability (MSI+). MSI is detected in about 15% of all colorectal cancers. Colorectal tumors with MSI have dis-tinctive features compared with Microsatellite Stable (MSS) tumors. Due to the high percentage of MSI+ in patients with CRC in Iran, screening of this type of CRC is im-perative. In current study, two markers (BAT-26 and BAT-25) were used to determine an appropriate screening technique with high sensitivity and specificity to diagnose MSI status in patients with CRC.
Methods: Allelic variation in two markers (BAT-26 and BAT-25) was analyzed in tis-sues and sera of 44 normal volunteers and tumor and matched normal mucosal tissues as well as sera of 44 patients with sporadic colorectal cancer by Real Time PCR (Hy-bridization probe) and High-Performance Liquid Chromatography (HPLC) techniques. The sensitivity and specificity of Real Time PCR and HPLC compared with sequencing as gold standard. The data were statistically analyzed using Student’s t-test and 2 or fisher exact test, where applicable with (P<0.05). Receiver-operating-characteristic (ROC) curves were used to evaluate the sensitivity and specificity.
Results: The sensitivity and specificity of BAT-26 with Real Time PCR method (Hy-bridization probe) were 100% in comparison with gold standard method. Whereas the sensitivity and specificity of BAT-26 and BAT-25 with HPLC were 83%, 100% and 50%, 97%, respectively. Neither HPLC nor Real time PCR could detect circulating DNA with MSI property in sera.
Conclusion: The sensitivity and specificity of real time PCR in MSI detection is the same as sequencing method and more than HPLC. BAT-26 marker is more sensitive than BAT-25 and MSI detection with Real time PCR could be considered as an accu-rate method to diagnose MSI in CRC tissues not sera.
Mahboobeh Haji-Abdolbaghi , Mehrnaz Rasoolinejad , Laden Abbasian , Aliakbar Amir Zargar, Hamid Emadi Koochak, Pardis Moradnejad, Naseh Mohammadi , Ali Pashae Zanjani , Saeed Bayanolhagh , Parisa Sadr Poor,
Volume 72, Issue 1 (April 2014)
Abstract
Background: Abacavir is an anti-retroviral medication used to treat HIV infected/AIDS patients and its efficacy has been proven in randomized clinical trials. The most significant adverse reaction associated with abacavir is the acute hypersensitivity phenomenon which manifests in many forms and in severe cases could result in death. Hypersensitivity reaction to abacavir has been closely linked to the presence of HLA-B*57:01 allele. Avoidance of abacavir initiation in allele-positive patients is the most effective strategy in preventing possible severe hypersensitivity reactions. Previous epidemiologic studies have made great strides toward delineating HLA-B*57:01 allele frequency in different regions of the World and the available results indicate significant discrepancy between geographical regions. Despite these efforts, no study to date has determined the allele frequency among Iranian HIV-positive patients. The aim of the present study was to determine the proportion of allele-positive patients among a group of Iranian HIV-infected patients.
Methods: Between September 2012 and February 2013, 122 HIV-positive patients were selected among patients referred to Imam Khomeini Hospital’s Consultation cen-ter for high risk behaviors using the convenience sampling method. Sampling scheme was designed in a manner to include equal number of infected patients with and without clinical Acquired Immunodeficiency Syndrome (AIDS). Patient data was collected using available records and a blood sample for DNA analysis was also obtained. Presence of HLA-B*57:01 allele was determined using the Polymerase Chain Reaction- Sequence Specific Method (PCR-SSP).
Results: Seventy three patients (59.8%) were male. Co-infection with hepatitis B and C was observed in 1.7% and 40.7% of the patients, respectively. History of addiction and anti-retroviral therapy was positive in 50.0% and 60.7% of the patients, respectively. Overall, three patients were allele-positive which corresponds to a frequency of 2.46% (95% CI: 0.005-7.30). No association between presence of allele and investigated vari-ables were identified.
Conclusion: Frequency of HLA-B*57:01 allele among a group of Iranian HIV-infected patients is estimated to be 2.5%. This rate is comparable to those reported in other Middle-Eastern countries, yet is relatively lower than reports generated from South-Eastern Asia, Europe, and the United States. Future studies with larger sample sizes are needed to corroborate these findings.
Seyed Masoud Majidi Tehrani, Hamid Ghaderi , Mahnoosh Foroughi , Manouchehr Hekmat, Mahmoud Beheshti Monfared, Hassan Tatari , Seyed Mohsen Mirhosseini , Zargham Hossein Ahmadi, Zahra Ansari Aval, Seyedeh Adeleh Mirjafari,
Volume 72, Issue 2 (May 2014)
Abstract
Background: Primary cardiac tumors are rare tumors which should be operated urgently. In this study, cardiac myxoma have been evaluated from diagnosis until dis-charge in a 10 years period and then results including presenting symptoms, approach to the patients were compared with similar study in this center a decade ago.
Methods: Patients who underwent operation for myxoma from year 2003 until 2013 in the Shahid Modarres Hospital were included in this study.
Results: Eighteen patients included in the study, 11 female and seven male. Patients’ ages were in the range of 13 to 76 years (mean 53 years). Mean time from diagnosis to operation was 5.8 days and mean time from surgery to discharge was 8.6±6.1 days. Most common presenting symptoms were first clinical presentation in four patients. In all patents echocardiography was the main diagnostic modality. In addition to trans thoracic echocardiography (TTE), in five patients TEE was used and in 13 patients coronary angiography was used to rule out concomitant coronary artery disease. 94.4% of all tumors (17 cases) were primary cardiac tumors and only one tumor (5.6%) was recurrent. In 16 patients (88.9%) tumor were found in the Left Atrium (L.A) and in one case, tumor was found in both atria and in another case, tumor was in the ventricle. After tumor excision, atrial septum was repaired primarily in seven cases (38.9%) and with pericardial patch in 9 cases. One patient underwent concomitant coronary artery bypass graft (CABG) and another patient underwent concomitant pulmonary valve repair. 14 patients (77.8%) discharged from hospital without any post operative complication. Heart block occurred in one patient and cerebral emboli with secondary cerebrovascular accident (CVA) developed in two patients. One patient died (5.6%).
Conclusion: Comparing results from two similar studies in two consecutive decades revealed that mean time from diagnosis to operation obviously was reduced but ad-vances in diagnostic modalities were unable to change clinical presentation or reduce age of tumor diagnosis or complications or size.
Azamsadat Mousavi , Mojgan Karimi-Zarchi , Nadereh Behtash , Mahnaz Mokhtari-Gorgani , Nili Mehrdad , Mitra Rouhi , Seyedhossein Hekmatimoghaddam,
Volume 72, Issue 4 (July 2014)
Abstract
Background: The aim of this study was to assess the role of consolidative intraperito-neal chemotherapy with carboplatin in decreasing relapse and increasing survival in advanced epithelial ovarian cancers, as well as evaluation of its toxicity.
Methods: In this clinical trial 30 patients with epithelial ovarian cancer in stages II-IV who had complete surgery (optimal debulking surgery) received six standard cycles of intravenous carboplatin and paclitaxel. They were enrolled through non-random se-quential selection. The control patients were similar to case group in stage (II-IV) and pathology (epithelial ovarian cancer). The control group was evaluated retrospectively through hospital files. This clinical trial performed in Gynecology Oncology department in Tehran Valiasr University Hospital, during 2005-2010. They including 18 cases as the intervention group receiving intraperitoneal chemotherapy and 12 patients as the control group with only retrospective follow-up. The cases received 3 cycles of 400 mg/m2 intraperitoneal carboplatin every 21 days following intravenous chemotherapy. Relapse of disease was diagnosed as increasing or even doubling CA125 serum titer during one month, or any CA125 above 100 IU, or an abdominal or pelvic mass in ul-trasound or physical exam. Mean survival of two and five years, progression-free inter-val (PFI), overall survival (OS), relapse, demographic parameters, drug toxicities, path-ologic types of cancers in two groups were coded and compared using SPSS 14. Any P<0.05 was considered as a significant difference.
Results: The mean ages of cases and controls were 52.4±8.6 and 55.1±11.5 years. The mean duration of relapse-free survival was 13±8.6 months for the cases and 9.5±4.3 months for the control patients (not statistically different, P>0.05). The mean overall survival for cases and controls were 39±16.5 and 30.8±16.2 months, respectively (no significant difference, P>0.05). The frequency of drug toxicities in the cases was 5.6%, and consisted of mild-to-moderate abdominal pain, nausea and vomiting.
Conclusion: It seems that consolidation therapy with intraperitoneal carboplatin may not increase overall survival, reduce relapse rate or decrease mortality, though it does not induce considerable side effects. Since the mean survival in the intervention group was nine months more than controls, this difference may be clinically significant.
Leila Sadati , Ehsan Golchini , Abdolreza Pazouki , Fatemeh Jesmi , Mohadeseh Pishgahroudsari ,
Volume 72, Issue 4 (July 2014)
Abstract
Background: Nowadays, new methods are emerging each month for a better operation with fewer complications. Laparoscopic surgery have remarkable advantages, Compared to open, such as smaller incision, less manipulation of the digestive system, less postoperative pain, fewer wound complication and faster discharge from the hospital. Therefore it is preferred by patients and surgeons and is replacing the traditional open surgical methods. However, any operation causes significant panic for patients and lack of knowledge about the surgical method is found to cause poor surgical outcomes, such as recovery time after the surgery we evaluated the effect of preoperative education on the recovery time of laparoscopic cholecystectomy candidates.
Methods: This randomized clinical control trial was performed at Imam Khomeini and Alborz Hospitals in Karaj from February 2010 till January 2011. Using randomized sampling method, 100 female candidates for laparoscopic cholecystectomy were divided into two equal groups of case and control. The case group received detailed information about operating room’s condition, surgical equipment, anesthesia method, advantages and disadvantages of laparoscopic procedures, and patient’s role in self-care at recovery, whilst the control group received no education before the surgery. The two groups were compared regarding recovery time based on Aldrete modified checklist and mean time to reach the Aldrete consciousness score of 9 and the incidence of nausea was assessed among them.
Results: The analysis showed that there was a significant difference between the mean time to reach Aldrete consciousness modified checklist score of 9 between the case and control group (18.04±3.87 vs. 29.66±5.44, respectively, P<0.001), therefore the case group had shorter recovery time than the control group. 10 of the case group (20%) and 3 of the control group (6%) had nausea after recovery (P=0.037, OR=0.255 (CI 95%: 0.066-0.992)).
Conclusion: Preoperative education of patients can significantly decrease the recovery time after laparoscopic cholecystectomy surgery. Therefore, it is strongly recommended to include the preoperative education in routine care of laparoscopic cholecystectomy patients for better surgical outcomes.
Mousa Ahmadpour-Kacho, Yadollah Zahed Pasha, Seyed Ahmad Rasoulinejad, Mahmoud Hajiahmadi, Parisa Pourdad ,
Volume 72, Issue 6 (September 2014)
Abstract
Background: Several risk factors like prematurity, hyperoxia, hyperglycemia, duration of mechanical ventilation and supplemental oxygen use have been attributed to the occurrence of retinopathy of prematurity (ROP) in low birth weight infants. Clinical Risk Index for Babies (CRIB) score have been used to assess the severity of the newborn's disease and neonatal mortality. The relation between the CRIB score and the incidence of retinopathy of prematurity is less assessed. This study was carried out to determine the relation between the CRIB score and retinopathy of prematurity in preterm infants.
Methods: In a cross-sectional study all preterm infants admitted to NICU from March 2009 to November 2012, with a birth weight less than 1500 grams and gestational age less than 28 weeks and other premature infants with birth weight 1500 to 2000 grams and gestational age 29 to 34 weeks with an unstable clinical condition, were included. The CRIB score was recorded in firs 12 hours of admission to the NICU. Ophthalmologic examination was done by a retinologist unaware of CRIB score. ROP classification was done according to the international classification of ROP. The CRIB score compared with presence or non-presence of ROP and its stage, progression or regression of disease. A P-value less than 0.05 are considered significant.
Results: One hundred and eighty (70%) neonates out of 256 neonates developed ROP. In 124 (68.88%) neonates it resolved spontaneously on serial ophthalmologic examination, but fifty-six (31.11%) neonates were required treatment for ROP which 42 (75%) received Avastin and 14 (25%) neonates treated with Laser.
The Mean±SD for CRIB score in ROP group was 4.79±2.74 and in a group without ROP it was 3.78±2.00 (P=0.004). No correlation was found between the severity of ROP and CRIB score (P=0.152).
Conclusion: The CRIB score can predict the occurrence of ROP, but can't predict its severity and progression or regression.
Sanaz Rismanchi , Pejman Mortazavi , Saeid Amanpour,
Volume 72, Issue 7 (October 2014)
Abstract
Background: Colorectal cancer is a major cause of morbidity and mortality throughout the world, and its treatments include surgery, chemo-radiotherapy. Despite improvements in clinical outcomes of patients with this tumor over the past decades, prognosis remains poor with a 5-year survival rate of <10%. Angiogenesis inhibitor agents have been recently added to the treatment regimen of this disease. In the past two decades, it has been recognized that selective inhibitors of the cyclooxygenase -2 (Cox-2) enzyme result in the regression in the size of colorectal tumor, and one of its reasons is attributed to angiogenesis inhibition. The present study aimed at identifying the molecular pathways of angiogenesis inhibition by celecoxib.
Methods: HCT-116, which is one of the cell lines of Colorectal cancer (separated from human colorectal adenocarcinoma) was provided by the National Cell bank of Iran (NCBI) affiliated to Pasteur Institute. It was then cultured in DMEM (high glucose) culture medium containing 10% FBS, and then treated in the active substance of celecoxib at pharmacological concentrations of 50 mM (C50) and 100 mM (C100). Afterwards, RNA was extracted and cDNA was prepared. The oligonucleotide of HIF-1 Alpha gene (angiogenesis initiator) was prepared and the level of HIF-1 alpha gene expression was assessed with a real-time PCR device in three control, C50 and C100 groups.
Results: HIF-1 alpha gene expression significantly decreased in the celecoxib treatment group (compared with control group) with the concentration of C100 (P< 0.001), but no change was observed in the concentration of C50.
Conclusion: Angiogenesis is a key factor in the carcinogenesis process and FDA today approved bevacizumab as a first-line treatment for patients with metastatic colorectal cancer. The results of this study showed one of the causes of angiogenesis reduction in celecoxib-treated colorectal cancer. According to clinical findings and basic studies, celecoxib will be hopefully used as a first-line therapy along with chemotherapy in the near future in colorectal cancer. The advantages of this treatment method include its low cost and low side effects.
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.
Maryam Rahbar , Zahra Chitsazan, Bahram Moslemi , Tayeb Ramim ,
Volume 73, Issue 1 (April 2015)
Abstract
Background: One of the toxins accumulated in the body of hemodialysis patients is beta-2 microglobulin which is caused and increased by various factors. The one of this factors that can affect beta-2 macroglobulin is of membrane type that using in hemodialysis. In the present study, we examined the impact of C-reactive protein (CRP) as an inflammatory factor on beta-2 microglobulin in high-flux membrane hemodialysis patients. Methods: This cross-sectional study was done in 44 hemodialysis patients that have been dialyzed in two academic centers Sina and Amir Alam Hospitals, Tehran, Iran from 2013 to 2014. The patients were hemodialyzed via fistula or permanent catheters three times a week for 4 hours for more than three months. Patients with known infectious disease, hemodialysis with low-flux membrane and dialysis less than three times a week were excluded. All patients were hemodialyzed using Fresenius biocompatible high-flux membrane (FX 100, Fresenius, Massachusetts, USA). Arterial blood sampling was performed. beta-2 microglobulin, CRP, BUN and creatinine tests were conducted for all patients. Results: Forty-four patients among the chronic hemodialysis patients were selected for final analysis. 20 males (44.5%) and 24 females (54.5%) were included in this study. The frequencies of underlying disease in patients participating in the study were as follows: hypertension, 23 cases (52.3%) diabetes mellitus, 11 cases (25%) hypertension and diabetes mellitus, 2 cases (4.5%) obstructive disorder, 2 cases (4.5%). In 23 patients (52.3%), beta-2 macroglobulin was >12 mg/l and in 21 (47.7%), it was <12 mg/l. 29 cases (65.9%) had CRP values less than or equal 6 mg/l. However, there was no significant differences between beta-2 microglobulin and CRP levels (P= 0.460). Also regression analysis of data showed no relationship between beta-2 microglobulin and CRP levels (r= -047, P= 0.763). Conclusion: Although it seems that inflammatory factors can be effective in increasing beta-2 microglobulin, the present study did not find such a relationship between CRP and beta-2 microglobulin.
Masoomeh Mirzamoradi , Zahra Heidar , Parichehr Kimiaee , Masoomeh Saleh , Sepideh Ashrafivand ,
Volume 73, Issue 1 (April 2015)
Abstract
Background: Ondansetron is a 5-hydroxytryptamine receptor antagonist which is a highly effective antiemetic for postoperative and chemotherapy induced nausea and vomiting. It is an off-label drug to treat nausea and vomiting of pregnancy but availa-ble data about its safety is limited. In this study our purpose was to evaluate neonatal outcomes in women who received this treatment. Methods: This study is a descriptive retrospective case series study, included 22 preg-nant women who treated with ondansetron due to repeated nausea and vomiting unre-sponsive to our center's protocol, at Mahdiyeh Hospital, Tehran, Iran from May 2006 to September 2014. We investigated neonatal factors including: gestational age at birth, stillbirth, neonatal birth weight, apgar score, need to NICU admission and major birth defects. Results: The outcomes of 22 pregnancies and 22 newborns are presented here. We had two twin pregnancies and two abortions. Ondansetron was initiated in 18 cases (72%) on average gestational age of 9 weeks, during organogenesis. In 8 cases (32%) on-dansetron continued till third trimester of pregnancy. In primary evaluation, all the pa-tients had ketonuria, 15 cases (60%) had hypokalmia (K< 3.5), 3 cases (12%) had ab-normal TSH that all of them were hyperthyroidism and 5 cases (20%) had abnormal liver function test (LFT) Three patients (12%) had positive urine culture, one patient had hypercalcemia and one patient who was known a case of hypocalcemia had low serum calcium. The mean time of admission due to hyperemesis gravidarum (HG) was 5 days (2-10 sd=1.92). In this study we had only one preterm birth and the mean neo-natal birth weight was 3110 gram, one newborn was low birth weight due to preterm birth. Finally none of newborns had low apgar score, no one needed to NICU admis-sion and no congenital anomaly was seen in neonates. Conclusion: Ondansetron taken during pregnancy was not associated with increased risk of adverse fetal outcomes.
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.
Meysam Jangkhah, Faramarz Farrahi , Abdolhossein Shiravi, Mohammad Ali Sadighi Gilani , Seyed Jalil Hosseini , Farid Dadkhah, Reza Salman Yazdi, Mohammad Chehrazi,
Volume 73, Issue 6 (September 2015)
Abstract
Background: Varicocele is recognized as the most common cause of male factor infertility and is found in 15% of the general population. This prevalence increases to 35% in men presenting with primary infertility and between 70 to 80% in men presenting with secondary infertility. The effect of varicocele on Leydig cell function and testosterone production has been always a question. In this study we examined the effect of varicocelectomy on serum testosterone.
Methods: This research protocol was approved by the institutional review board at Royan Institute in infertility department and also this study has been done in Royan Institute (Tehran, Iran) during one year since September 2012 till October 2013. In this cross-sectional study, Serum levels of total testosterone in 79 men with clinical varicocele and in 70 fertile men who served as a control group were compared. Men aged 23–46 years with clinically palpable varicoceles as determined by physical examination were studied. Three to 6 months, testosterone levels were measured again after varicocelectomy, then testosterone levels were compared before and after varicocelectomy.
Results: The mean of serum testosterone levels before surgery in infertile men with varicocele and fertile men were 590(230) vs. 583(237) ng/dl respectively. No statistically significant changes were noted in serum testosterone levels for any groups. Three month after varicocelectomy mean serum testosterone levels were significantly increased in infertile men with varicocele compared with preoperative levels from 590 (230) to 663 (242) ng/dl (P=0.009). Also the testis volume of patients were examined, which were divided into two groups included the men with testis volume less than 16 ml (<16) and more than 16 ml (≥16).
Conclusion: In infertile men affected with clinical varicocele, varicocelectomy seems to have caused positive impact on the level of serum testosterone increase. It is thought that positive effect is probably caused by improvement of the Leydig cell functions which induce the increase of serum testosterone level.
Zahra Alizadeh , Farzin Halabchi , Mastaneh Rajabian Tabesh,
Volume 73, Issue 6 (September 2015)
Abstract
Background: Today obesity and overweightness are the major health problem all over the world. The relation between decreasing serum level of vitamin D and some chronic diseases such as diabetes and obesity was shown in the available studies. The aim of this study was to determine the prevalence of vitamin D deficiency among obese and overweight Iranian population and its relation with age, sex, occupation, body fat percentage and body weight according to body mass index.
Methods: In a descriptive cross-sectional study, all patients who were referred to obesity clinic of Imam Khomeini Hospital, Tehran, for weight management throughout one year were included to the study. The prevalence of vitamin D deficiency with serum level lower than 30 ng/ml among 107 subjects was evaluated. The data were analyzed by SPSS, ver. 19 (SPSS, Inc., Chicago, IL, USA). Quantitative variables were presented as mean±SD and qualitative variables were presented as relative frequency. The groups were compared with independent samples t-test and Chi-square test. The level of significance for comparing the groups was considered at P<0.05.
Results: In 107 participants, vitamin D deficiency in 81 subjects (75.7%) was reported. The prevalence of deficiency in participants with body mass index between 25 to 29.9, 30 to 34.9 and equal or greater than 35 kg/m2 was 77.3%, 83.7% and 69.4%, respectively. However, the differences between overweight and obese groups were not significant (P=0.193). The prevalence of moderate and severe vitamin D deficiencies among the participants was 50.5% and 25.2 %, respectively. Vitamin D deficiency was more common in participants below 50 years of age compared with those older than fifty (P=0.001).
Conclusion: The prevalence of vitamin D deficiency was high in obese and overweight population especially among individuals younger than 50 years. It seems that, it is necessary to add prevention and management of this deficiency to obesity treatment protocols especially in the young adults.
Somayeh Zamani, Fatemeh Fotouhi Chahouki, Zahra Nourmohammadi , Saeideh Sadeghi Neshat, Vahideh Mazaheri , Ali Torabi , Behrokh Farahmand ,
Volume 73, Issue 7 (October 2015)
Abstract
Background: The influenza virus is one of the most important factors for higher morbidity and mortality in the world. Recently, researchers have been focused on influenza conserved antigenic proteins such as hemagglutinin stalk domain (HA2) for vaccine production and serological studies. The HA2 plays a major role in the fusion of the virus with host cells membrane. The immunity system enables to produce antibody against HA2. The aim of this study is polyclonal antibody production against influenza HA2. Methods: This study was done in the Influenza Research Lab, Pasteur Institute of Iran, Tehran for one year from September 2013 to October 2014. In the present study, recombinant HA2 protein was produced in prokaryotic system and purified using Nickel affinity chromatography. The purified HA2 was mixed with Freund’s adjuvant (complete and incomplete) and injected into two New Zealand white rabbits by intramuscularly and subcutaneously routes. Immunization was continued for several months with two weeks interval. Before each immunization, blood was drawn by venous puncture from the rabbit ear. Function of rabbit's sera was evaluated using radial immunodiffusion (RID) in both forms, Single RID (SRID) and Double RID (DRID). Finally, antiserum activity against HA2 was evaluated using western blotting as serological assay. Results: Sedimentary line and zone was observed in RID assays (SRID and DRID) represent interaction between HA2 protein and anti- HA2 antibody. As well as, western blotting results was positive for HA2 protein. Therefore, these results showed that polyclonal antibody produced against HA2 protein can identify HA2 protein antigenic sites. Conclusion: These findings show that humoral immune responses have properly been stimulated in rabbits and these antibodies can identify HA2 protein and may be suitable for other serological methods.
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.
Anousheh Safarcherati , Masoumeh Amin-Esmaeili , Behrang Shadloo , Minoo Mohraz , Afarin Rahimi-Movaghar ,
Volume 73, Issue 10 (January 2016)
Abstract
HIV/AIDS is among the leading causes of morbidity and mortality in world. There are more than 35 million people living with HIV/AIDS in the world. Although the annual incidence of HIV infection is decreasing globally, HIV prevalence is rising due to development of more effective treatment and higher survival. Iran suffers from concentrated HIV epidemics among injecting and non-injecting drug users. There are more than 27 thousand registered cases of HIV infection and it is estimated that there are above seventy eight thousand cases in the country. Regarding the burden of disease, it is projected that HIV/AIDS will have the highest growth during the next 10 years. The outcome of this epidemics will be determined by human behavior. HIV, psychiatric disorders and substance use disorders are closely correlated and are accompanied by similar risk factors. They also share common consequences such as stigma and discrimination. Correlation of psychiatric disorders, as one of the most influential determinants of our behavior, and HIV/AIDS infection is reviewed in this narrative article. Psychiatric disorders are associated with greater risk of HIV acquisition. Substance use disorders, both injecting and non-injecting, as well as severe mental illnesses put the individual at higher risk of acquiring HIV infection. Impaired judgment, diminished inhibition and control over behaviors, lack of insight and poor self-care have been proposed as the underlying mechanisms. On the other hand, HIV infection may put the individual at greater risk of developing a mental illness. Coping with a chronic and life-threatening illness, fear of stigma and discrimination, CNS invasion of the virus as well as the adverse neuropsychiatric side effects of anti-retroviral medications may all contribute to establishment of a psychiatric disorder. Although there exists a bi-directional correlation between mental health problems and HIV/AIDS infection, this reciprocity goes beyond. Psychiatric disorders can affect the patient’s adherence, access to treatment and care and can worsen the course and clinical outcome of the infection. The clinical importance, underlying mechanism and other implications of this correlation are reviewed in this article.
