Search published articles


Showing 10 results for Igm
Comparison of Anti-CMV (IgG, IgM) Prevelence and Serum p2-MG (Beta-2 Microglobulin) in Heomodialysed Patients and Blood Donors
Tarabadi Fa, Shayegan M, Babaeie G, Talebian A,
Volume 60, Issue 1 (4-2002)
Abstract
CMV belongs to herpes viridea family and it is the largest human virus. Prevalence of CMV depends on age, race, geographic and socioeconomic factors. CMV infection has been a recognized complication of transfusion for about three decades, in an immature or compromised immune system situation. If a transplant candidate has not been infected with CMV and no CMV specific antibodies can be detected by serology, a primary infection could be transmitted via transfusion or transplantation. Patient who are under dialysis are susceptible to CMV infection, in addition of increase serum levels of p2-MG(Beta-2 Microglobulin).
Materials and Methods: we detected anti CMV (IgM -IgG) antibodies for 128 renal transplant candidates who were under intermittent heamodialysis and 1040 blood donors, as controls and compared serum p2-MG levels in 48 of the patients with 35 controls with ELISA technique. For 15 patients, R5 (Cuprophan) and for 7 patients S2 (Polysulphone) filters were used.
Results: Our data showed:
1-90 percent of normal blood donors and 89.8 percent of the patients were IgG positive. Statistical analysis showed no significant difference between these two groups (pO.Ol). This reflected high prevalence of CMV .
2- 0.2 percent of normal individuals and 2.3 percent of the patients were positive for IgM. There was significant difference in IgM between these two groups (p<0.01).
3- p2-MG levels in patient group were elevated and there was a significant differences between two groups (P <0.05 ) and no differences between common used dialysis filter in this study.
The effect of intrathecal Neostigmine on control of local back pain after lumbar disc surgery
Fakhr Tabatabaei Sa, Hossein Khan Z, Hamidi S ,
Volume 60, Issue 3 (6-2002)
Abstract

Introduction: As spinal cholinergic receptors exhibit an action against somatic pain, this effect could be potentiated by intrathecal injection of cholinesterase inhibitor-neostigmine. This study was designed to evaluate the role of interathecal neostigmine on local back pain relief after single level lumbar disc surgery.

Methods and Materials: In an interventional-expremental study (Imam Khomeini Hospital, Jun. 2000 to sep. 2001), sixty-six patient with unilateral herniated lumbr disc at one lumber space were randomely allocated into two groups including, control (C) group and Neostigmine (N) group. Both groups underwent fenestration employing same anesthetic techniques. At the end of surgery 2 ml normal saline in groups C and 100 micrograms neostigmine methylsulfate (0.2 ml combined with 1.8 ml normal saline) in group N were injected intrathecally postoperative local back pain was measured with 10 cm chart method using Visual Analogue Scale (VAS) at 1, 4, 8 and 12 hours. Total dosage of morphine, as an analgesic rescue, used during the first 24 hours following surgery and observed complications were recorded.

Results: Mean VAS score postoperatively at 1st and 4th hours were 2.24 (Standard Error Mean, SEM=0.36) and 1.82 (SEM=0.28) in group N and 5.36 (SEM=0.39) and 5.61 (SEM=0.37) in group C respectively. Mean morphine used in the first 24 hours was 0.9 (SEM=0.4) in group N and 4.7 (SEM=0.65) mg in group C. All result were found to be statistically different in the two group (P<0.05). There was no neurologic deficit or CSF leakage in both groups postoperatively. Regarding nausea and vomiting, the difference between two groups C (15 percent) and N (24.2 percent) were not significant statistically.

Conclusion: In this study, we have found that injection of 100 micrograms hyperbaric neostigmine intrathecally is a safe and effective method with minimal complications or side effect for pain relief and curtails postoperative opiate demand.


Oral and parenteral pyridostigmine in preparing Myasthenia Gravis patients for thymectomy a randomized clinical trial
Tadjeddein A, Khorgami Zh,
Volume 65, Issue 1 (3-2008)
Abstract
Background: Respiratory failure and crisis is one of major complications of thymectomy in myasthenia gravis patients. There are different medication regimes for preparing these patients for surgery and reducing post-operative side effects. The goal of this study is to compare respiratory complications of oral vs. Parenteral preoperative administration of anticholinesterase agents for thymectomy in myasthenia gravis patients.
Methods: This randomized controlled trial included 101 patients in class IIA or IIB of myasthenia gravis according to the Osserman classification system. The control group fasted for eight hours before surgery and oral anticholines-terase agents were replaced with parenteral ones. The case group also fasted for 8 hours before surgery, but pyridostigmine was continued at its usual dose until the time of operation and the last dose was given to patients with a small amount of water in the operating room on the operating bed.
Results: There was no statistically meaningful difference between the two groups in terms of age, sex and pathologic findings. In comparison, the mean hospital stay for the case group was 3.98 days and 6.34 for the control group (p value = 0.003). There were eight cases of respiratory crisis or failure (16%) in the control group but only 1 case (2%) was observed in case group (p value = 0.014). Only one patient in the case group required re-intubation after the surgery however, six patients in control group were re-intubated (p value = 0.053). Plasmapheresis was required for five patients in the control group and one patient in the case group (p value = 0.098). Tracheostomy was performed on two patients in the control group to accommodate prolonged intubation, but none of the case group required this procedure.
Conclusion: This study shows that continuing oral anticholinesterase agents up to the time of operation, with the last dose at the operative theater, lowers the incidence of postoperative myasthenia crisis and respiratory failure, need for plasmapheresis and shortens the hospital stay. This method may also decrease the need for re-intubation, mechanical ventilation and tracheostomy, thus decreasing the chance of death resulting from complications of the thymectomy.
Chlamydial IgG and IgM assessment in patients with non infectious ophthalmic diseases
Asadi Amoli F, Akbarzadeh Jahromi M, Attar M, Azadbakht F,
Volume 66, Issue 8 (11-2008)
Abstract

Background: Chlamydia Trachomatis is the most common cause of trachoma and subsequently give rise to neonatal chlamydial conjunctivitis (NCC), adult ophthalmic inclusion infection, sexually transmitted diseases (STD) and pneumonia. The goal of this study was to access the incidence of chlamydia trachomatis in the normal (ophthalmic infection free) population.

Methods: In a cross sectional study 250 patients referring to Farabi Eye university Hospital Tehran, Iran for non infectious ophthalmic disease in different age categories were selected and accessed for chlamydial IgM and IgG by ELISA method.

Results: 250 patients (50% men and 50% women) with the mean age of 40 (ranging from one to 83 years old) were tested. IgG was detected in 11 (five females and six males) patients (4.4%) All of them had more than 31 years old. IgM was detected in 18 (13 females and 5 males) patients (7.2%). No test revealed simultaneous high IgG and IgM titre in the same patient.

Conclusions: There was a low grade of chlamydial infection in our study population. So it is recommended to use serological methods for screening of ophthalmic infections in centers where no other test methods are available and in case of positive results confirmatory antigen tests to be used.


Dyskeratosis congenita: a case repot
Mina Mirnezami , Behfar Pakbaz , Zeinab Saidinejad ,
Volume 71, Issue 10 (1-2014)
Abstract
Background: Dyskeratosis Congenita (DC) is a rare inherited disease with an incidence of approximately one case per million population. The disease is characterized by a classic triad: nail changes, color reticulated skin and oral leukoplakia. In these patients, premature death is often associated with bone marrow failure, infections, pulmonary complications, or malignancy. Three patterns of inheritance for dyskeratosis congenita have been reports, X-linked recessive trait, autosomal dominant and recessive trait. The present study is a case report of an adoloscent patient with dyskeratosis congenita. Case presentation: The patient is a 16 year old boy living in Arak without history of any illness was referred with fever, chills, malaise and admitted to Vali-e-Asr Hospital with initial diagnosis of sepsis. The patient was treated with broad-spectrum antibiotics. In tests, showed pancytopenia. Bone marrow biopsy was performed. Blood and urine culture were negative, rheumatologic lab test and other tests were normal. Ultrsonography of abdomen and pelvis showed splenomegaly. In physical examination, diffuse hypopigmented lesions on the trunk and extermities, nails dystrophy and oral mucosal leukoplakia were observed. Skin biopsy was consistent with DC. Conclusion: The skin and oral mucosal lesions have an impact role in the diagnosis of systemic disease. Early diagnosis and treatment of patients with DC are important in improving clinical outcomes.
Intense pulsed light in treatment of nevus spilus: brief report of a clinical trial
Amir Houshang Ehsani , Fatemeh Gholamali , Mahboubeh Sadat Hosseini , Nahid Hassanpour , Pedram Noormohammadpour ,
Volume 72, Issue 7 (10-2014)
Abstract
Background: Intense Pulsed Light (IPL) technology is one of our new measures in treating dermatologic disorders including undesirable skin pigmentation. In contrast with lentigines and freckling of the skin, few reports about nevus spilus treatment using intense pulsed light have been published. The aim of current study was to evaluate efficacy and safety of nevus spilus treatment with an intense pulsed light device (Palomar Max-G IPL). Methods: Patients with diagnosed nevus spilus confirmed via histopathology, were treated by an intense pulsed light source using parameters according to the skin type and location of lesions in one to three consecutive treatment sessions at 14-21 day intervals for three month. Palomar Max-G ® IPL hand piece is optimized for pigmented skin lesions and we used no additional filter. After each session, Photographs were taken from lesions with 10 mega pixel camera. Two months after finishing the treatment, the effect was evaluated base on close-up photographs. Results: Fourteen female patients were included. Significant improvement (76-100%) in one patient, good improvement (51-75%) in eight patients and fair to poor improvement (0-25%) in five patients were achieved. The commonest side effect of treatment was transient erythema resolved after six to eight hours. No permanent complication was reported. Younger patients and patients with shorter duration of lesion had better response to treatment however the differences were not statistically significant. Only one recurrence has been seen. No significant relationship between age, gender, anatomical site of lesions and skin type with response rate was found. Conclusion: Intense pulsed light is seemed an effective and safe treatment for nevus spilus Treatment however randomized control trials with longer follow-up periods are required to evaluate the efficacy and safety.
The relationship between Helicobacter pylori infection and hyperemesis gravidarum in pregnant woman
Leila Ghasempour Shirazi, Shirin Rafie Tari,
Volume 73, Issue 3 (6-2015)
Abstract
Background: Hyperemesis gravidarum (HG) starts between four and seven weeks after the first day of the last period, and ends at twenty weeks of pregnancy. The etiology of HG, is unknown. Recent studies worldwide show the Helicobacter pylori (H. pylori) infection as a possible cause of the severe nausea and vomiting in pregnancy, recent studies showed H. pylori to have a role in occurrence of it during pregnancy. The current study assessed the immunoglobulin G (IgG) and immunoglobulin M (IgM) titer to H. pylori in pregnant women with HG. Methods: This is a case-control study of the pregnant patients of a gynecologist's office in the Marvdasht city from April to September 2013. One hundred and twenty three patients were randomly chosen based on their conditions and were divided into two groups (case n1= sixty three and control n0= sixty). The IgG and IgM titers against H. pylori were measured by ELISA method. Data analysis was performed using Chi-square test, Mann-Whitney U-test, and T-test in SPSS software, version 20 (SPSS, Inc., Chicago, IL, USA). The significant level of the test was considered (P= 0.05). Results: Totally, 123 pregnant women were evaluated 63 women with hypermesis gravidarum and 60 without HG. Forty nine women out of 63 in HG group and 48 women in the control group were IgG positive for H. pylori. Also, mean serum level of IgG was 51.6 in the HG group (P= 0.685). Twelve women out of 63 in HG group and 20 women in the control group were IgM positive for HP. Also, mean serum level of IgM was 27.7 in the HG group (P= 0.675) Except for the mother's blood type, there were no other statistically significant differences found between the two types of antibodies against H. pylori. Conclusion: There is no relationship between helicobacter pylori and hyperemesis gravidarum in pregnant woman. Considering the high prevalence of H. pylori infection in our country, there is a need for studies with more samples and more diagnostic methods.
Melanoma detection with a deep learning model
Ali Ameri ,
Volume 78, Issue 3 (6-2020)
Abstract
Background: Skin cancer is one of the most common forms of cancer in the world and melanoma is the deadliest type of skin cancer. Both melanoma and melanocytic nevi begin in melanocytes (cells that produce melanin). However, melanocytic nevi are benign whereas melanoma is malignant. This work proposes a deep learning model for classification of these two lesions.   
Methods: In this analytic study, the database of HAM10000 (human against machine with 10000 training images) dermoscopy images, 1000 melanocytic nevi and 1000 melanoma images were employed, where in each category 900 images were selected randomly and were designated as the training set. The remaining 100 images in each category were considered as the test set. A deep learning convolutional neural network  (CNN) was deployed with AlexNet (Krizhevsky et al., 2012) as a pretrained model. The network was trained with 1800 dermoscope images and subsequently was validated with 200 test images. The proposed method removes the need for cumbersome tasks of lesion segmentation and feature extraction. Instead, the CNN can automatically learn and extract useful features from the raw images. Therefore, no image preprocessing is required. Study was conducted at Shahid Beheshti University of Medical Sciences, Tehran, Iran from January to February, 2020.
Results: The proposed model achieved an area under the receiver operating characteristic (ROC) curve of 0.98. Using a confidence score threshold of 0.5, a classification accuracy of 93%, sensitivity of 94%, and specificity of 92% was attained. The user can adjust the threshold to change the model performance according to preference. For example, if sensitivity is the main concern; i.e. false negative is to be avoided, then the threshold must be reduced to improve sensitivity at the cost of specificity. The ROC curve shows that to achieve sensitivity of 100%, specificity is decreased to 83%.
Conclusion: The results show the strength of convolutional neural networks in melanoma detection in dermoscopy images. The proposed method can be deployed to help dermatologists in identifying melanoma. It can also be implemented for self diagnosis of photographs taken from skin lesions. This may facilitate early detection of melanoma, and hence substantially reduce the mortality chance of this dangerous malignancy.

Effect of intravenous administration of atropine-neostigmine versus ondansetron in prevention postdural puncture headache in cesarean section under spinal: a randomized clinical trial
Atefeh Ghosouri, Mitra Jabalameli , Behzad Nazemroaya, Roxana Najafian ,
Volume 81, Issue 7 (10-2023)
Abstract
Background: More than one-third of women develop headaches in the first week after childbirth. Approximately 75% are benign primary headaches such as migraines or tension headaches. Others are secondary and include headaches of vascular origin or from hypertensive disease, infection, space-occupying lesions and dural puncture. Postdural Puncture Headache (PDPH) is a common and annoying complication of spinal anesthesia, especially in cesarean section. This study compares the impress of an Atropine-Neostigmine mixture and Ondansetron on Post Spinal Puncture Headaches in Cesarean sec.
Methods: This triple-blinded controlled randomized clinical trial was conducted on 60 pregnant women candidates for cesarean section under spinal anesthesia, that was carried out from May 2021 to August 2021 at Behshti Medical and Education Center affiliated with Isfahan University of Medical Sciences. The study was approved by the Ethics Committee of the University (IR.MUI.REC.1400.009) and informed consent was obtained from the patients/legal guardians. This clinical trial was registered at www.irct.ir with identification code IRCT 20160307026950N39.
 People were randomly assigned into three groups. A mixture of neostigmine (20 micrograms per kilogram) and atropine (10 micrograms per kilogram) in the first group and 4 mg of Ondansetron in the second group and a similar volume of normal saline in the control group were administered before surgery. Patients were followed up for headaches up to seven days after surgery. The severity of the headache was measured using the VAS scale. One-way analysis of variance (ANOVA) and non-parametric equivalent, Kruskal-Wallis, chi-square test, and repeated measure test were used to measure the relationship between the variables.
Results:  Analysis of the data did not show a significant difference between the three groups in terms of headache severity (P=0.788), headache duration, (P=0.723), the time elapsed from lumbar puncturing to the occurrence of the first headache (P=0.653), and the frequency of attempts for correct spinal tap (P=0.685).
Conclusion: none of our considered interventions had a noticeable impress on preventing or reducing PDPH in Cesarean section.

Cost-effectiveness analysis of colonoscopy compared to sigmoidoscopy for colorectal cancer screening in high-risk individuals in Iran
Ahmad Tahmasebi-Ghorrabi , Zahra Heydarifard, Behrouz Nemati, Majid Davari, Alireza Delavari, Hamideh Salimzadeh , Ali Akbari Sari ,
Volume 81, Issue 9 (12-2023)
Abstract
Background: Screening is a cost-effective method for prevention, early detection of the disease and reducing the burden of the third deadliest cancer in the world, i.e. colorectal cancer. This study aimed to analyze the cost-effectiveness of colonoscopy screening compared to sigmoidoscopy for colorectal cancer in high-risk individuals in Iran.
Methods: This economic evaluation study was conducted using the cost-effectiveness method between July 2016 and February 2017. Evaluation of the effectiveness of screening methods was done using a systematic review. Cost evaluation was also done using the costs obtained from the tariff approved by the Iranian Ministry of Health in 2015 for colonoscopy and sigmoidoscopy. Finally, the combined model of decision tree and Markov was used to evaluate the cost effectiveness. Incremental Cost Effectiveness Ratio (ICER) formula was used for cost effectiveness analysis considering the final outcome of 5-year survival of high-risk individuals. Excel and TreeAge software were used for data analysis.
Results: The effectiveness of sigmoidoscopy and colonoscopy in increasing 5-year survival is 11 and 15.7%, respectively, and colonoscopy screening is 4.7% more than sigmoidoscopy. The cost of colonoscopy and sigmoidoscopy screening was calculated as 1000 and 19920 billion Rials, respectively. Based on cost-effectiveness analysis, the cost of treating patients in the case of screening with colonoscopy and sigmoidoscopy is lower than without screening. The ICER ratio of colonoscopy and sigmoidoscopy compared to no screening was -4/441/389/160 and -4/757/954/940 Rials respectively, and colonoscopy compared to sigmoidoscopy was -3/699/785/880 Rials, respectively. Finally, the use of colonoscopy leads to spending 3/699/785/880 Rials less in exchange for obtaining 4722 additional survivals with the prevention of colorectal cancer compared to sigmoidoscopy.
Conclusion: Screening by colonoscopy and sigmoidoscopy methods are effective in reducing the incidence and death of colorectal cancer compared to no screening. Screening by colonoscopy is a dominant option for the high-risk population in Iran. Colonoscopy screening is more cost effective compared to sigmoidoscopy. However, decisions about colorectal cancer screening and screening methods depend on local resources and personal preferences.

Page 1 from 1     

© 2024 , Tehran University of Medical Sciences, CC BY-NC 4.0

Designed & Developed by : Yektaweb