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Shima Javadi-Nia , Samileh Noorbakhsh , Anahita Izadi , Mohammad Reza Shokrollahi , Ramin Asgarian , Azardokht Tabatabaei ,
Volume 71, Issue 12 (March 2014)
Abstract

Background: Severity of respiratory infection in children is depended on various fac-tors such as causative organism and the host immunologic response to the organism. Vitamins and micronutrients play an important role in this response with supporting the immune system and therefore, the response to infections. Nutritional deprivations in children, especially vitamins and micronutrients such as zinc, vitamin A and vitamin D are very common in middle east and other countries in Asia, which is due to inappro-priate diet and nutrient loss in recurrent infections. This study aimed to evaluate the se-rum levels of vitamins A, D and zinc in hospitalized children aged six months to five years. Methods: This analytic cross-sectional study was performed in 65 children aged six months to five years who were hospitalized in pediatric and surgical wards of Rasul Akram Hospital and Bahrami Hospital in Tehran. All of samples were evaluated ac-cording to WHO cri-teria for acute respiratory infection, and underwent measurement of serum vitamin A, vitamin D and zinc levels by using Atomic, Elisa and spectropho-tometer methods. Results: Serum levels of vitamins A in patients with acute respiratory infection was 0.27±0.16 µg/ml and in children without infection was 0.41±0.2 µg/ml, that different wasn’t statistically significant (P=0.4). Serum levels of vitamins D in patients with acute respiratory infection was 35.37±34.68 ng/ml and in children without infection was 45.78±21.05 ng/ml, that different wasn’t statistically significant (P=0.1). Serum levels of zinc in patients with acute respiratory infection was 87.93±23.34 µg/dl and in chil-dren without infection was 106.95±23.70 µg/dl, the difference was statistically signifi-cant (P=0.002). Conclusion: According to finding in this trial, there is a correlation between lower levels of zinc in serum, and chance of respiratory tract infection in children. Future larger studies could provide the correlation between serum levels of vitamins A & D and chance of respiratory tract infection.
Roghayyeh Borji , Mohammad Reza Khatami, Mohammad Reza Abbasi , Alipasha Meysamie , Khosro Barkhordari , Farah Ayatollah Esfahani, Mina Pashang, Laleh Ghadirian ,
Volume 71, Issue 12 (March 2014)
Abstract

Background: The mortality due to Coronary Artery Bypass Graft (CABG) in patients with chronic renal failure is more common than normal population. This study evalu-ates the impacts of prophylactic dialysis on decreasing mortality and morbidity of non- dialysis-dependent patients with renal failure after CABG surgery. Methods: In this study, fifty non-dialysis-dependent patients who were suffering from renal failure and needed to CABG, were selected by convenience sampling method. Se-quentially, they were allocated to prophylactic dialysis (n=20) and no prophylactic dialysis (n=30) groups, using a randomized block design. Exclusion criteria were under 18 year old patients and doing CABG for second time. Mortality rate and some complications such as acute renal failure, brain accident and atrial arrhythmias were compared between two groups after CABG. All cardiac surgeries were performed in a single centre and through a median sternotomy. P value less than 0.05 was considered as significant. Results: The mean age of patients was (65.3±9.9). The patients included %16 (n.8) of women and %84 (n.42) of men. There were 20 patients in intervention and 30 patients in control groups. Baseline characteristics were similar in two groups. Comparison be-tween intervention and control groups after surgery did not show any difference in mortality (P=0.14), acute renal failure (P=0.4), cerebrovascular accidents (P=1) and atrial arrhythmias (P=0.3), need to second surgery due to bleeding (P=1), need to dialysis (P=0.14), need to rehospitalization (P=1), duration of ventilator use (P=0.4), duration of need to hospitalization (P=0.11), duration of a patients stay in the Intensive Care Unit (P=0.4) and deep sternal infection (P=0.7) rates. Conclusion: According the results of this study, prophylactic dialysis, before conduct-ing CABG, does not have any significant effect on mortality and other complications. The only exception is lung complications in non-dialysis-dependent patients with renal failure.
Parinaz Ahangar , Mohammad Reza Sam, Vahid Nejati ,
Volume 71, Issue 12 (March 2014)
Abstract

Background: In advanced stages, Colorectal cancer remains often refractory to classic therapies. In consequence, search for new therapeutic modalities with minimal toxicity is of particular interest in colon cancer management. In this regard, powerful growth-inhibitory effect has been shown for fish-oil derived Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA) against cancer cells. In the present study, we evaluated the anti-cancer effect of EPA and DHA (n3-polyunsaturated fatty acids, n3-PUFAs) on the human colorectal cancer cell line (LS174T) on a dose-response and time-course ba-sis. Methods: LS174T cells were cultured in RPMI-1640 medium supplemented with 10% fetal bovine serum at 37 ºC in a humidified incubator. Cancer cells were treated to vari-ous concentrations of EPA and DHA (50, 100, 150 µM/L) and incubated for 24-72 hours. Following treatments, dose-response and time-course cytotoxicity using viability and MTT assays were performed. Results: Viability analysis showed that 150 µM/L PUFAs decreased significantly the proliferation of treated cells, as compared to untreated cells. In this regard, cell viabil-ities were found to be %31±%5.1 and %30±%2.6 for DHA and EPA respectively. Moreover, treatment of cells with increasing concentrations of EPA and DHA signifi-cantly decreased growth rates in a dose-and time-dependent manner. Following 72 hours treatments with 150 µM/L PUFAs, growth rates were found to be %19±%5.5 and %20±%5 for DHA and EPA relative to untreated cells respectively. Conclusion: The results of this study indicate that n3-PUFAs decrease cell proliferation and could provide new approaches in malignant tumor therapeutic strategies.
Ali Ghasemi , Abdollah Banihashem , Nosrat Ghaemi , Saghi Elmi , Habibollah Esmaeili , Reza Erfani Sayyar, Sam Elmi ,
Volume 72, Issue 1 (April 2014)
Abstract

Background: In most children with Acute Lymphoblastic Leukemia (ALL) and Non Hodgkin’s Lymphoma (NHL) who have received chemotherapy with and without radi-otherapy, some late effects due to treatment may occur such as endocrinopathies. Methods: We evaluated growth criteria (including short stature, obesity) and thyroid test function in 50 children with ALL (n= 25) and NHL (n= 25) 3-17 year-old in remis-sion period who randomly received chemotherapy with (n= 25) or without (n= 25) radi-ation such as our treatment groups. The values for height, weight and BMI in less than 5th or more than 95 th percentile considers abnormal. Results: Six (12%) patients were in less than 5th percentile height (short stature). Two patients (4.0%) had over-weight and 48 (96%) were in normal range of BMI. Six (12%) patients were in less than 5th and 3 (6%) were in more than 95 th weight percentile. There was no significant difference between two different treatment groups for TSH (P= 0.662 (but there was a significant difference between these groups in case of T4 (P= 0.049(. Mean and SD for T4 in patients with chemotherapy alone was less than in whom received chemotherapy plus radiotherapy. There was no significant difference between ALL and NHL groups for TSH, T4 (P= 0.567, 0.528 respectively). Two boys with ALL without history of radiation had hypothyroidism that had based on their la-boratory data. Conclusion: Regarding to effects of thyroid dysfunction on short stature and obesity in adolescent with ALL and NHL, we suggest to have more attention about growth, thy-roid test to avoid late side effect of malignancy treatment.
Shima Javadinia , Ramin Asgarian , Samileh Noorbaksh , Behnam Soboti , Mohammad Reza Shokrollahi , Azardokht Tabatabaee ,
Volume 72, Issue 2 (May 2014)
Abstract

Background: Toxic shock syndrome (TSS), a dangerous consequence of Toxic shock syndrome toxin-1 (TSST-1) caused by Staphylococcus aureus. The early detection for infections of Staphylococcus aureus in burned children is very important, also the pre-vention for consequences of TSST-1. Fever is one of the most noticeable sign in burned children. On the other hand, fever is one of the important consequences of TSST-1 pro-duction. Methods: This study aimed to assess the toxic shock syndrome toxin-1 level in the wound’s specimens of two groups febrile and afebrile in the hospitalized burned chil-dren in Motahari hospital Tehran, Iran in the year 2013. In this case-control study, 90 children who admitted to the burn unit, divided in two groups of 45 patients: febrile (cases group) and afebrile (control group). All of burned children under went wound biopsy, and then all of wound’s specimens were tested by PCR for specific primer of toxin producing genome. Finally all of data collected and statistically analyzed. This data include group febrile and afebrile, demographic characteristics, percentage of burned surface severity and result of PCR. Results: The positive result for PCR test, production of TSST-1 in febrile burned chil-dren (cases group) was 37.7% and in afebrile burned children (control group) was 11.1% that this different was statistically significant (P=0.003). The mean and stan-dard deviation for percentage of burned surface (severity) in samples with positive re-sult for PCR test was 30.9±16.93 and in samples with negative result for PCR test was 20.09±11.02 that this different was statistically significant (P=0.01). There was no dif-ference between positive PCR result and negative PCR result of age and sex. Conclusion: Direct association was approved between the production of TSST-1 and the occurrence of fever in burned children. Increased surface severity of burns also re-lated to the production of TSST-1. Further research is recommended.
Shahram Savad , Niusha Samadaian , Roza Azam , Vahid Nikoui , Mohammad Hossein Modarressi ,
Volume 72, Issue 2 (May 2014)
Abstract

Background: A balanced reciprocal translocation is a structural abnormality, which at least consist of breakage of two non-homologous chromosomes along with pieces exchange and form quadrivalant structure that can produce unbalanced chromosomes during meiosis I and result in a fetus abortion. The aim of the present study is to offer using preimplantation genetic diagnosis (PGD) 24sure array, which delivers aneuploidy screening of 24 chromosomes, within a few hours to increase fertility and bearing a child without chromosomal abnormality of this couple. This technique could replace embryo donation for child bearing of this couple. Case presentation: A young couple with recurrent pregnancy loss in 6th and 7th week of pregnancy without family history of recurrent miscarriage and any clinical signs had conferred. All laboratory tests including hormonal, infections, semen and hysterosalpingography were normal except karyotype that showed balanced reciprocal translocation between chromosomes 5 and 18 in male. Chromosomal study of male parents showed normal karyotype. Conclusion: A balanced reciprocal translocation carrier is phenotypically normal, but during meiosis І, carrier chromosomes cant pair normally and form quadrivalant instead of bivalant that depend on type of their segregation (alternate, adjacent 1, adjacent 2,3:1,4:0), produce gametes that are chromosomally unbalanced which can result in early fetus abortion. Considering the number of abnormal gametes, the most effective way to help couples with this problem seems to be PGD 24sure, since it can identify reciprocal and Robertsonian translocation and allows concurrent screening of all chromosomes for aneuploidy. Another technique that can be compared with PGD 24sure is fluorescence in situ hybridization (FISH), but it has several technical limitations such as it is expensive and complexity, in addition it has only few probes (for chromosomes 21, 13, 18, X, Y) so sometimes necessary to create patient specific protocols.
Farideh Hosseini, Mohammad Reza Sam , Nasrollah Jabbari ,
Volume 72, Issue 3 (June 2014)
Abstract

Background: Radiotherapy has been used to treat many types of cancers over the past years. Radiotherapy generates side effects on normal tissues. Radiosensitizer products provide decrease in tumor proliferation and reduce radiation dose in radiotherapy. Docosahexaenoic Acid (DHA) as an omega-3 polyunsaturated fatty acid has anti-proliferative effects on malignant cells. In this study, the effects of DHA accompanied by ionizing radiation on growth rate and survival fraction of HT29 colorectal cancer cells were evaluated. Methods: The present study was performed at the Institute of Biotechnology, affiliated to Urmia University, Urmia, Iran in the year 2013. In this laboratory experiment, ma-lignant cells were cultured in RPMI-1640 supplemented with 10% fetal bovine serum. HT-29 cells were cultured at 5105 cells/well into 6-well culture plates for overnight. Thereafter, the cells were pretreated with either 50 or 100 µM DHA for 4 hours and malignant cells were irradiated with either dose of 2 or 10 Gy. Cell viability was evalu-ated by trypan blue staining after 48 hours. Moreover, malignant cells were pretreated with either 50 or 100 µM DHA for 48 hours and irradiated with dose of 2 to 10 Gy. Thereafter, survival rate was evaluated by 3-(4,5-Dimethylthiazol-2-Yl)-2,5-Diphenyltetrazolium Bromide (MTT) assay after 6 days. Results: Cell viabilities were found to be 59.8% and 17.5% for 50 µM DHA in combi-nation with doses of 2 and 10 Gy respectively. Using 100 µM DHA diminished cell vi-ability up to 47% and 13.9% following doses of 2 and 10 Gy respectively. Treatment of cells with DHA accompanied by increasing doses of γ-rays significantly diminished survival rate. In treated cells with 50 and 100 µM DHA, survival rate were measured to be 79.1%, 57.6%, 42.8%, 40.5%, 34% and 55.8%, 43.7%, 33.6%, 27.9%, 23.5% for doses of 2, 4, 6, 8 and 10 Gy respectively. Conclusion: Our study indicates that DHA decreases colorectal cancer cells prolifera-tion and could provide a new radiosensitizer drug to enhance the efficacy of colorectal cancer radiotherapy.
Mehdi Mohebi , Khalil Pourkhalili , Mahnaz Kesmati , Samad Akbarzadeh , Zahra Akbari ,
Volume 72, Issue 3 (June 2014)
Abstract

Background: Anabolic-Androgenic Steroids (AAS) are mainly abused by athletes for improvement of muscle performance. Data suggest that the effect of AAS on neurobiochemicals related to behavioral response, may be underlies psychological adverse effects. Physical activity has beneficial psychophysiological effects, which may be related to increased serum levels of endogenous opioid peptides during exercise. In the present study we aimed to study the effect of chronic administration of nandrolone decanoate on beta-endorphin and met-enkephalin level in exercising rats. Methods: In this experimental study, forty male Wistar rats were randomly assigned in two main groups of sedentary and trained (2 weeks swimming exercise). Animals in each group were divided in two subgroups of control (received nandrolone solvent) and drug treatment (received nandrolone 15 mg/kg, 5 times/week). After two weeks of swimming exercise and drug treatment, serum levels of beta-endorphin and met-enkephalin were measured using ELIZA. Results: Our data showed that two weeks of swimming exercise training significantly increased serum beta-endorphin (114±5 vs. 98±5 ng/l in control group, P= 0.038) and met-enkephalin levels (1556±42 vs. 1475±27 ng/l in control group, P= 0.25). However, chronic administration of nandrolone decanoate in trained group considerably de-creased beta-endorphin (84±4 vs. 114±5 ng/l in control group, P= 0.002) and met-enkephalin levels (1378±36 vs. 1556±42 ng/l in control group, P= 0.011). The effect of supraphysiologic doses of nandrolone decanoate in control sedentary group was not statistically significant. Conclusion: In the present study we show that chronic nandrolone decanoate admin-istration attenuates effects of two weeks swimming exercise on serum opioid peptide and reduces the level of beta-endorphin and met-enkephalin. Keeping in mind that opi-oidergic system play an important role in behavior, athletes abusing anabolic steroid drugs may potentially experience changes in mood and behavior.
Niusha Samadaian , Mohammad Hossein Modaresi , Maryam Mobasheri , Reza Ebrahim Zadeh Vesal , Seyed Mohammad Akrami ,
Volume 72, Issue 5 (August 2014)
Abstract

Background: Colorectal cancer is the third most common cancer in the world. Non-coding RNA especially miRNAs have important regulatory roles in cancer. miRNAs are small non coding RNA 21-23 nucleotides long which have different levels of expression between tumors and normal tissues. This study was designed to compare expression level of miRNA-21 between Iranian population colorectal cancer tissues and normal tissue. Methods: This case-control study has performed in medical genetics department of Tehran University of Medical Sciences from January to November 2013. We used 35 samples. The samples were isolated from tumor and adjacent normal tissues of colon. Thirty-five samples were divided into different groups according to cliniopathologic features including tumor size (>4 and <4 cm), metastasis (+ and -) and stage. After small RNA extraction from tissues by small RNA purification kit the quality and quan-tity of extracted RNA was determined using spectrophotometry. cDNAs were synthe-sized and real-time polymerase chain reaction carried out. Finally expression levels were statistically analyzed by LinRegPCR and REST software. Results: miRNA-21 expression ratio in stages I, II and III were 1/804 and 4/574, re-spectively, the increase from stage III was statistically significant (P= 0.037). The ex-pression were also studied according to different clinicopathologic status of colon can-cer, tumor size (>4 and <4 cm) and metastatic (+ and -), miRNA-21 over expressed in both groups, however the increase was not statistically significant. Conclusion: In this study, we found miR-21 over-expression in advanced stage in tu-moral tissue comparing with normal adjacent tissue. This means perhaps in the future it would be possible to use miRNA-21 as an informative prognostic biomarker to guide for better treatment strategies for colorectal cancer patients. Our findings also indicate that miRNA-21 is a promising new molecular target for designing novel therapeutic strategies to control colorectal cancer.
Reza Beiranvand, Ali Delpisheh , Samira Solymani , Kourosh Sayehmiri , Keywan Weysi , Shahnaz Ghalavandi ,
Volume 72, Issue 6 (September 2014)
Abstract

Background: Distribution of Tuberculosis (TB) has a special template affected by geographic and social factors. Nowadays Geographical Information System (GIS) software is one of the most important and useful epidemiologic devise for identifying geographic areas and high risk population for infection by TB. Aim of this study was assessment of Tuberculosis distribution by GIS in Khuzestan province, Iran. Methods: In this retrospective cohort study, documents of 6363 TB patients identified in Khuzestan province at the beginning of 2005 until the end of the September of 2012 were assessed and sampling method was census. The data was gathered by TB-Register Center. TB incidence was evaluated by GIS maps according to climatic and vegetation with 1:25,000 scale. The data was analyzed in SPSS software and means plot and Independent’s t-test, ANOVA with a significance level of less than 5% and Eta Correlation. Results: Spread of Tuberculosis in climatic and vegetation were plotted in GIS maps, cumulative incidence rate was calculated separately for each area. There was a statistical significant relationship between cumulative incidence rate of disease and climatic (P=0.017) and the Eta correlation coefficient was 0.379 (P=0.011). There was a statistical significant relationship between cumulative incidence rate of TB and vegetation (P=0.004) and the Eta correlation coefficient was 0.388 (P=0.188). Mean age and median age of patients were 39.3±18 and 35±6.5 years respectively. For women, mean age was 2.1 years older than men and this difference was statistically significant. (P=0.0001). Conclusion: The risk of TB infection is closely associated with the climatic and vegetation. So the risk of TB in extra-dry climate and vegetation of highland meadows is more than other areas. Special care and services to high-risk areas is recommended.
Fariba Jafari , Mohammad-Ali Nilforooshzade , Samane Porajam , Motahar Heidari-Beni ,
Volume 72, Issue 6 (September 2014)
Abstract

Background: Insulin resistant is important risk factors of diabetes and leads to development of chronic diseases such as diabetes and cardiovascular disease. Recent studies showed association between androgenic alopecia and insulin resistant. However, findings are controversial. Alopecia in women is a common heritable hair loss in central part of head. Aim of this study was investigation of androgenic alopecia distribution in type II diabetes and healthy women and hypothesis testing of relationship between diabetes and androgenic alopecia. Methods: This is a case-control study. Case and control groups were selected from type II diabetes and healthy women respectively that were refered to clinics of Alzahra, Noor and Amin Hospitals in Isfahan City, Iran in 2011. Participants were selected based on random sampling. Sample size was estimated 141 subjects in each group. Participants were visited by doctor and severity of androgenic alopecia was determined based on Ludwish criteria. Data were analyzed with SPSS software and 2 test. P<0.05 was considered as significant. Results: Mean age and body mass index were 58.96±12.8 year and 25.6±4.15 kg/m2 respectively in whole population. Findings not show any significant association between type II diabetes and androgenic alopecia (P<0.05). Comparison of distribution of alopecia severity according to Ludwish criteria separately showed similar result. In addition to, there was not any significant relationship between diabetes and alopecia after adjusting with body mass index as confounding factor (P<0.05). Conclusion: In the present study, there was not any significant relationship between type II diabetes and androgenic alopecia among diabetes and healthy women. However, more researches need to investigate this relationship in both gender and assess insulin resistant indices as homeostasis model assessment-estimated insulin resistance and androgenic alopecia.
Leyla Soleymani , Rahim Hobbenaghi , Aram Mokarizadeh , Samad Zare , Nowruz Delirezh ,
Volume 72, Issue 7 (October 2014)
Abstract

Background: Recently, bone-marrow-derived cells have introduced new therapeutic approaches to the management of wound healing in severe skin injuries. Bone marrow-derived stromal cells are described as a heterogeneous population, including mesenchymal stem cells, hematopoietic stem cells, and fibro-blast cells. Results derived from several studies indicate that these cells may contribute to tissue regeneration whether through producing variety of bioactive growth factors and/or by differentiation into mesoderm lineage. The aim of the present study was to investigate the effect of subcutaneous administration of bone marrow-derived stromal cells in repairing or regeneration of skin wounds induced by third-degree burn in a mouse model. Methods: In an experimental study that was performed in Urmia University research center from December 2011 to June 2012, The third-degree skin burn was induced on the shaved backs of healthy 7-8 week old male mice (N=18) using a metal rods heated in boiling water. After 1 hour, based on the equal physical condition mice were randomly divided into two separate groups and then subcutaneously administered with phosphate buffered saline (PBS 400 µl) or bone marrow-derived stromal cells (106 cell in 400µl PBS) at the burn site. 7, 14 and 21 days after induction of burn injury, biopsies were taken from burn wounds and then the sections were prepared. Subsequently the prepared sections were stained with hematoxylin/eosin and Masson's trichrome to explore histopathological changes evoke by administration of bone marrow derived stromal cells in comparison with control subjects. Results: Considering investigated parameters including formation of granulation tissue (respectively on days 7, 14 and 21 P≤ 0/007, P≤ 0/0013 and P≤ 0/001), angiogenesis (on day 21 P≤ 0/002) and collagen deposition, in mice treated with bone marrow-derived stromal cells the rate of healing of third-degree thermal burns was significantly accelerated when compared to the PBS-treated mice. Conclusion: This experimental modulation of wound healing suggests that bone marrow-derived stromal cells can significantly enhance the rate of wound healing possibly through stimulation of granulation tissue, angiogenesis, fibroblast proliferation and collagen deposition.
Nastaran Khosravi , Nasrin Khalesi , Samileh Noorbakhsh , Azardokht Tabatabaei , Bahman Ahmadi , Ramin Asgarian , Shima Javadi-Nia,
Volume 72, Issue 8 (November 2014)
Abstract

Background: Assessment of the serum lead’s concentration in the newborn immediately after birth can be effective for the detection of lead poisoning in the early stages and prevent of developmental disorders and neuropsychiatric behaviors. This study aimed to assess the serum lead levels of cord blood in some of the hospitalized newborns. Methods: This cross-sectional analytic study conducted in the newborns ward of two hospitals (Rasoul Akram and Akbar Abadi) From December 2011 to October 2012 in Tehran, Iran. After non-probability sampling, 60 newborns in the first days after birth, underwent the cord blood sampling and the cord blood lead levels were measured by atomic absorption spectrophotometer. Then all of data were collected and analyzed. The serum lead concentration greater than 5 μg/dl was considered valuable. Results: In total, 61.4% of samples were boys. The mean (±SD) of gestational age was 37.4±2.64 weeks and mean (±SD) of birth weight was 2701±642.8g. The mean (±SD) of maternal age was 29.20±6.73 years. 70% of mothers were urban. 13% of mothers had a history of drug use, and 5% were current smokers. The mean (±SD) of the serum lead level of cord blood was 2.97±2.24 μg/dl. This level was not associated with fetal gender, place of residence, drug history and current smoking. This level in the 16.7% of samples was greater than 5 μg/dl (high risk cases). High risk level was associated with maternal age, weight and fetal age (P=0.02, P=0.004, P=0.03), but this level was not associated with fetal gender, place of residence, drug history and current smoking. Conclusion: Serum lead level of cord blood was relatively higher than other studies, although the prevalence of the high risk newborns (serum blood lead levels greater than 5 μg/dl) was low. Further research has recommended assessing the serum lead level in other newborns in the different areas to identify risk factors of neuromotor outcome in infants to prevent.
Firooz Esmaeilzadeh, Nahid Hatam , Zhila Esmaeilzadeh , Abdolhalim Rajabi , Meysam Anami , Sajad Vahedi , Hossien Mirzaei,
Volume 72, Issue 9 (December 2014)
Abstract

Background: The rabies is a deadly disease and if its symptoms break out in a person, he will certainly die. However, the deaths caused rabies can be prevented by post-exposure prophylaxis (PEP). Methods: In this study, subjects were recruited through census and with respect to in-formation which gathered from Fars Province health centers, Pasteur institution and previous studies In Iran. The mortalities for age groups and by sex type have been cal-culated. The decision tree model using probabilities, which the effectiveness of PEP treatment after getting bitten by an animal suspected, persons to receive specified. Dis-ability adjusted life year score (DALY) was applied to estimate the DALYs saved from PEP. In this study it was assumed that if a person suffering with rabies, a few days af-ter the onset of symptoms, death is compulsory. Therefore YLD rabies was considered zero. Finally, to increasing the accuracy and because inherent uncertainty of the data, and the increase the power of analysis, one-way sensitivity analysis was used. Results: From March 2011 to March 2012, in Fars Province, total cases of animal bites were reported and received PEP treatment. The cases were 5394 (75.85%) male and 1717 (24.15%) female. PEP generally prevented from 177.076 deaths which 134.096 (75.72%) were men and 42.98 (24.27%) of them were women. The age distribution of suspected animal bites in youth more than adults, and in men higher than women. Also due to prevented mortality caused by PEP, it is prevented from 4455.71 DALYs. Based on the sensitivity analysis DALY prevented, except for dogs and cats, there was no change in the other animals. Conclusion: The implementation of PEP for animal bitten people remarkably reduced the burden of disease in community. Calculations with primitive cost estimations im-plicitly revealed that this intervention is a most cost-effectiveness program.
Shahrbanoo Nakhaei , Yasamin Mohammadzadeh , Reza Behmadi , Ozra Ebrahimi Nasab, Leila Asgarzadeh ,
Volume 72, Issue 11 (February 2015)
Abstract

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.
Mohammad Mehdi Soltan Dallal , Samaneh Motalebi Motalebi , Hossein Masoumi Asl , Abbas Rahimi Forushani , Mohammad Kazem Sharifi Yazdi, Zahra Rajabi , Nooshin Aghili ,
Volume 72, Issue 11 (February 2015)
Abstract

Background: Diarrhea is the most common bacterial infections, and the main cause of death in the children. Worldwide, food and waterborne diseases are estimated to cause more than two million deaths per year. Foodborne diseases and resistance to antimicrobial agents are two problems worldwide and are increasing. However, standard surveillance systems do not routinely collect information on controls. The aim of this study was to analysis epidemiological data of foodborne outbreaks at the country level. Methods: This is a descriptive study, in total 305 fecal swab samples from 73 outbreaks during one year from April 2012 to March 2013 in different provinces of Iran, were collected and transferred to the microbiology laboratory of Public Health School of Tehran University of Medical Sciences to identify the cause’s diarrhea. The patterns of antibiotic-resistance were determined by using Kirby Bauer method. Results: In total 73 food borne outbreaks that were studied, the largest number 26 (35.6%) were found in Hamadan province with 103 samples (34.2%). Out of 73 outbreaks 40 (54.79%) of were related to foods, 6 (8.22%) to water, and 27 (36.98%) were unspecified (P< 0.0001). Fifty seven outbreaks (78.08%) in the city and 16 outbreaks (21.92%) occurred in rural areas (P< 0.0001). The most dominated Gram-negative isolated organisms were Shigella (6.9%) and Gram-positive bacteria Staphylococcus aureus (12.8%). The dominated age group was under five years (16.4%), and dominant gender group was men 186 (61.8%) (P< 0.0001). In total 69 (22.9%) were hospitalized and 11 deaths were reported. Most clinical symptoms of abdominal cramping (82%), nausea and vomiting (68.4%), bloody diarrhea (23.3%), and non-bloody diarrhea (76.7%). All the isolated gram-negative were sensitive to ciprofloxacin and resistant to clindamycin. The gram-positive were sensitive to cephalexin and resistant to penicillin. Conclusion: The knowledge of bacterial agent of foodborne diseases and determination of antimicrobial resistance pattern are helpful to reduce the rate of foodborne outbreaks, the cost of treatment. The prevention control of outbreaks is also very important.
Samaneh Asgari , Davood Khalili , Fereidoun Azizi , Fatemeh Eskandari , Narges Sarbazi , Farzad Hadaegh ,
Volume 72, Issue 12 (March 2015)
Abstract

Background: In Nov 2013, the instruction for controlling high cholesterol has been released by the American College of Cardiology (ACC) and the American Heart Association (AHA) which need to be assessed in the different communities. Methods: Of total 6275 individual aged 40-75 years who entered at the Tehran Lipids and Glucose Study from March 1999 to 20 March 2010 in first examination cycle, 5153 with the median follow-up of more than ten years were eligible to enter in this study. The 10-year risk of hard cardiovascular disease (Hard CVD) for Statin therapy based on ACC/AHA clinical guideline was calculated and this risk was calculated for each subgroup of the guideline who recommended for statin therapy comparing to the risk in individuals with prevalent CVD. Results: Of nearly 6.5 million urban population of Iran (according to the 1996 census) about 4 million individuals (2.55 million men and 1.4 million women) were eligible for statin therapy. With respect to the urban population growth from the 1996 to the 2011 census (about 2.5 percent increases) the number of individuals for receiving statin increased by 50% (5 million men and 3 million women). Also, the risk in non-diabetic men with calculated risk of 5-7.5% and diabetic women with calculated risk of <5% for hard CVD was lower than 0.2. By removing these people from total eligible population, the burden of statin therapy will reduced about 8% which is about 540.752 persons, according to the Census 1996 and 1.155.079 individuals based on the census 2011. Conclusion: The new guideline of ACC/AHA for statin therapy is relatively reasonable except for some subgroups. To reduce the burden of medical expenses, statin prescription can be ignored by physicians in these subgroups. Of course further research is required to calculate the net benefit for estimating the clinical usefulness of statin therapy in recommended guideline subgroups.
Amir Keshvari , Mohammad-Sadegh Fazeli , Alireza Kazemeni , Alipasha Meisami , Mohammad-Kazem Nouri-Taromloo,
Volume 72, Issue 12 (March 2015)
Abstract

Background: Sacrococcygel region is the most common site for pilonidal sinus and surgery is the most common treatment for it. Numerous operative techniques have been described for management of this disease but a technique with low recurrence and complication rates is the best treatment option. Karydakis has been introduced as a method with less recurrence rate, but it seems that surgeons debate on complications and it is not a common technique in our country. In this article, we will discuss Karydakis procedure and its results after a prospective follow-up in our patients. Methods: This is a prospective single cohort study on the patients with sacrococcygeal pilonidal disease. Cases evaluated in this study included patients underwent Karydakis procedure for their pilonidal sinus from 23 September 2006 to 22 September 2013. Patients were followed-up prospectively after their discharge within the first week, first month and third month for early complications and then annually for recurrence. The length of follow-up ranged from 3 to 77 months (median 36 months). Results: Of 141 patients, 119 (84.4%) were male and mean operating time was 55.52 (35-120) minutes. Mean time to healing wound with no need to dressing was 15.92 (range: 2-120) days and mean time to return to work was 14.44 (range, 1-35) days. Overall rate of early post-operative complications was 21.3% that most of them treated conservatively. Wound breakdown within the caudal part was the most common complication detected in 12.1% of patients and infection was detected in 5.8%. Hematoma, seroma and complete wound breakdown were seen in one patient each. The mean score of patient's satisfaction after one year was 4.91 out of 5. Recurrence was appeared in 1.42% of patients. Conclusion: Karydakis procedure for sacrococcygeal pilonidal disease is associated with low complications, short healing time and return to work, and reasonable recurrence rate.
Behnam Soboti , Shima Javadinia , Samileh Noorbaksh , Ramin Asgarian , Nastaran Khosravi , Azardokht Tabatabaee ,
Volume 72, Issue 12 (March 2015)
Abstract

Background: Cerebrospinal Fluid (CSF) culture for distinction between aseptic and bacterial meningitis can be difficult and long-term, and other diagnostic methods are under studying. This study aimed to assess the diagnostic value for the levels of Interleukin 1 (IL-1), IL-6 and IL-8 of CSF in the children and adolescent with meningitis. Methods: Fifty-one patient with meningitis between one month and 18 year included in a Cross-Sectional Studies in the Rasul Hospital, Tehran, from 2012 to 2014. All of samples underwent aspiration of CSF. The routine tests performed that include culture coloring and biochemical of CSF. The concentrations of IL-1, IL-6 and IL-8 were determined by Enzyme-linked immunosorbant assay (ELISA) method and all of data were analyzed. Results: Frequency of bacterial and aseptic meningitis was equal (49%). 64.7% of samples were boys and gender had not different between two bacterial and aseptic group (P=0.7). Mean (±SD) of the age in total was 358.46±858.40, and bacterial group had a higher mean of age than aseptic group (P=0.047). The level of IL-1 was 10.87±37.04 pg/ml in bacterial and 0.55±1.64 pg/ml in aseptic group, that had not different (P=0.168). The level of IL-6 was 90.51±139.3 pg/ml in bacterial and 21.36±67.84 pg/ml in aseptic group, that had significant different (P=0.030). The level of IL-8 was 365.40±765.52 pg/ml in bacterial and 50.66±59.34 pg/ml in aseptic group, that had significant different (P=0.047). Diagnostic value of IL-1 was noted in the 80.77% of bacterial and 68.00% of aseptic group that had not different (P=0.349). Diagnostic value of IL-6 was noted in the 53.85% of bacterial and 64.00% of aseptic group that had not different (P=0.572). Diagnostic value of IL-8 was noted in the 80.77% of bacterial and 28.00% of aseptic group that had significant different (P=0.000). There was not different between two group of CSF variables include coloring degree, WBC and RBC index, glucose and protein. Conclusion: Although the concentration of IL-6 and IL-8 was higher in bacterial meningitis than in aseptic patients, only IL-8 had suitable diagnostic value for distinction between different types of meningitis.
Samila Farokhimanesh , Mahdi Forouzandeh Moghadam , Marzieh Ebrahimi ,
Volume 73, Issue 1 (April 2015)
Abstract

Background: Metastasis associated miRNA (metastamiR) opened a new field of anti-metastatic therapy which have a great potential of treatment for the most lethal aspect of cancer, metastasis. The pleiotropic nature of gene regulation exhibited by certain miRNAs that showed that miRNAs might be endowed with a capacity to function as crucial modulators of tumor metastasis. MiR-31 is a pleiotropic anti-metastatic miRNA whose expression decreased significantly in metastatic breast cancer cells. MiR-31 has multiple roles in metastasis cascade. Therefore, using the miR-31-restoration based therapy could be an efficient anti-metastatic strategy for cancer therapy. Methods: This research was performed from May 2014 to October 2015 in Tarbiat Modares University in Tehran, Iran. The double-strand oligo of mature miR-31 was cloned into pcDNA 6.2gw/EmGFP according to the manufacturer instruction. The MDA-MB231, MCF-7 breast cancer cell lines were cultured and their miRNAs have been extracted. The expression of miR-31 has been quantified by Real time-PCR be-fore transfection of construct contained miR-31 into two cell lines and in normal breast cells. Then the constructs contain miR-31 have been transfected in to two cell lines. The expression of miR-31 has been quantified after 48 hours. Scratch and invasion as-say have been carried out for assessing the level of migration and invasion. Results: The result of Real time-PCR before transfection of constructs contained miR-31 have been shown 4 fold and more than 100 fold reduction in expression of miR-31 in MCF-7 and MDA-MB231 respectively in comparison to miR-31 expression in nor-mal breast cells, but after transfection of miR-31 construct to MDA-MB231 the quan-tification of expression showed the significant increase in mir-31 expression and 20 fold reduction in invasive and 10 fold reduction in migratory characteristics of MDA-MB231 in comparison to MCF-7. Conclusion: Metastasis associated miRNA have been represented a promising candi-dates in the field of anti-metastatic therapy and miR-31 as a powerful member of this family can function very effectively in order to inhibit the metastasis and introduce the new possibility of metastasis inhibition.

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