@article{ author = {Adib, A. and Abbaszadeh, A. and Yahyavi, A.}, title = {Evaluation of the Association Between AV Block and Initial ECG in Patients with Acute Inferior Myocardial Infarction}, abstract ={    Background and Aim: Presence of ischemic changes on the anterior surface of heart and AV block worsen the prognosis of acute Inferior Mycocardial Infarction (MI). The rate of mortality increases with the occurrence of AV block in inferior MI.The aim of this study was to predict and diagnose acute Inferior MI in patients with AV block based on ECG and clinical features.Patients and Methods: In this cross sectional study that was conducted retrospectively, we reviewed the medical records of 500 patients with acute Inferior myocardial infarction admitted in Ardabil Bu Ali hospital during 2006-2007.196 patients were excluded because of non ST segment elevation in the inferior leads and/or lack of substantial data. In the other patients presence of artrioventricular block, diabetes melitus, hypertension, smoking, thrombolytic therapy, initial ischemic pattern (J point / R wave < 50% - pattern 1, J point / R wave ≥ 50% - pattern 2 in inferior leads II, III, avF and ischemia in anterior leads) and gender were recorded. The Chi square test was applied to compare differences between discrete variables. P value < 0.05 was considered as statistically significant.Results: The study population included 304 patients. AV block occurred in 75 patients (24.7%) and 299 patients (75.3%) were without AV block.AV block occurred in only 17 patients (11.5%) of 148 patients with initial pattern 1 compared to 58 patients (37.2%) of 156 patients with initial pattern 2 (Pv=0.0001). 50 patients (30.7%) of the 163 patients with ischemic changes, had AV block. While AV block occurred in 25 patients of the total 141 patients without ischemic changes (17.7%) (Pv=0.011).Therefore ECG pattern 2 and ischemic changes in anterior leads were associated significantly with AV block. However significant statistical association between AV block and hypertension, diabetes melitus, smoking, thrombolytic therapy and gender was not detected.Conclusion: In this study, it was demonstrated that the occurrence of atrioventricular block is associated with pattern 2 in the inferior leads and anterior ischemia on initial electrocardiogram. There- fore these patients need extensive care and monitoring.}, Keywords = { Atrioventricular block, Electrocardiography,Mycocardial Infarction}, volume = {16}, Number = {0}, pages = {7-12}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1158-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1158-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Azarkeivan, A. and Mehrvar, A. and Vousugh, P. and Sohrabpoor, H. and Mehrvar, N.}, title = {Evaluation of Respiratory Problems in Patients With β Thalassemia}, abstract ={  Background and Aim: Thalassemia is a hereditary anemia with treatment of lifelong blood transfusion. Iron overload in vital organs is the consequence of this treatment. According to recent studies Iron could deposit in lung without causing any symptoms and signs in the patients. Our goal in this study was to evaluate the pulmonary abnormalities by Pulmonary function test (PFT) in patients with β- thalassemia.   Patients and Methods: In this descriptive study 139 patients with β thalassemia were evaluated. History was obtained in regard to blood transfusion and clinical features. Physical examination, chestX ray, ABG and pulmonary function tests (PFT) were performed. Results were analyzed by SPSS software V. 11.5 and Chi square test.   Results: 139 patients were enrolled in this study there were 85 (62%) males and 54 (38%) females. Meanwhile 104 Patients (75%) had thalassemia major and 35 (25%) had thalassemia intermedia .Mean age was 21.1 yr and mean duration of treatment was 18 yr. In history of 128 (95.5%) patients, no respiratory problem was noticed. Chest X- ray was done for 112 patients 100 (89.2%) had normal pattern while 12 (10.7%) patients had abnormal patterns on their chest x- rays. In ABG, mean PO2 was 73.5% and mean O2 saturation was 90.6%. Mean ferritin level was 1800 ng/dl.   According to PFT results 101 patients (72.7%) had restrictive patterns, 35 patients (25.1%) had normal pattern and 3 (2.2%) had combined pattern. There was significant between PFT results and duration of blood transfusion (Pvalue = 0.05). However there was negative statistical correlation between PFT results and ferritin (Pvalue = 0.62).   Conclusion: In our results restrictive pattern was the most common finding(72.7%) in PFT 95% of patients did not have any respiratory complaints and on chest x- ray 89% had normal pattern. Thus lung can be considered as a site for iron deposition during blood transfusion. However despite PFT abnormalities, clinical features are not demonstrated in thalassemic patients because of the high lung capacity / reserves. A healthy lung cannot be assurred by a single physical examination and negative history. Thus, in addition to well chelation, PFT must be performed in patients in order to prevent from any respiratory disorder at the older ages.}, Keywords = {Beta thalassemia, Pulmonary function test,Iron deposition,Respiratory problems}, volume = {16}, Number = {0}, pages = {13-20}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1159-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1159-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Ehsanipour, F. and VahidHarandi, N. and Jalali, K.}, title = {The Survey of Serum Zinc Level in Children with Pneumonia}, abstract ={    Background and Aim: Pneumonia is now one of the most important causes of childhood mortality in developing countries like Iran. The increased susceptibility to pneumonia, particularly in malnourished children of developing countries, is postulated to be due to reduction in cellular immunity. One of the reasons for reduced immunological competence in malnourished children may be zinc deficiency. However, relatively well nourished children of developing countries also suffer from pneumonia and it is possible that they have impaired immunity due to zinc deficiency. This study was done to investigate the zinc status of well nourished Iranian children with pneumonia in comparision with control group.Patients and Methods: In this case control study, estimation of serum zinc was performed in 142 well nourished children, aged 3-60 months suffering from pneumonia and compared with 142 normal matched controls.Results: Serum zinc was low in children suffering from pneumonia as compared to control (437/1±39/65 mmol/l vs 511/23±36/931mmol/l)Conclusion: We conclude that children suffering from pneumonia, have significantly decreased levels of serum zinc (P=0.0075).}, Keywords = {Pneumonia, Children, Zinc}, volume = {16}, Number = {0}, pages = {21-25}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1160-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1160-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Ahmadi, F. and Bozorgmehr, R. and Razeghi, E.}, title = {Evaluation of the Correlation Between Serum Leptin Level and Laboratory and Anthropometric Parameters of Malnutrition in Hemodialysis Patients}, abstract ={  Background and Aim: Protein- energy malnutrition is a major problem and one of the risk factors in increasing mortality in hemodialysis patients. Since there is not any single index in the evaluation of nutritional status in these patients, leptin can be used as one of the parameters in this process. In this study, the correlation between serum leptin and biochemical and anthropometric parameters of malnutrition has been evaluated.   Patients and Methods: This cross- sectional study was performed on 60 hemodialysis patients(32 males and 28 females) in 2006. Patients with hemodialysis duration of less than one year, history of consumption of lipid reducing drugs or glucocorticoids or an infectious or inflammatory disease were excluded. Malnutrition laboratory parameters and serum leptin levels were measured before hemodialysis. Serum leptin was measured by ELISA method with direct dbc kit and malnutrition laboratory parameters were measured with standard laboratory methods patients anthropometric parameters were evaluated after hemodialysis. All of the measured datas were compared with serum leptin. The data were analyzed by SPSS V. 11.5. Parametric (T-test, ANOVA and Pearson Tests) and non-parametric (Spearman’s rho test, Mann Whitney test) tests were used for the evaluation of the results.   Results: The mean age of patients was 47.5±16.1 years and the range of serum leptin level was 0.6-64.8 ng/mL. Mean serum leptin level was 22.64±19.54 ng/ml in females and 16.74±20.16ng/ml in males on hemodialysis. Inspite of higher levels of leptin in females, there was not any statistically significant difference between females and males serum leptin. Absolute value of correlation coefficient of serum leptin with anthropometric parameters was lower than 0.25 (except height and weight in males which was between 0.25-0.50). It was also lower than 0.25 with most laboratory parameters (except ferritin, iron and phosphorous in males and total protein, hemoglobin, urea and creatinin in females which was between 0.25-0.50).   Conclusion: Our results suggest that increased serum leptin level does not have a major and first role in the cause and diagnosis of malnutrition in hemodialysis patients and there is a poor correlation between malnutrition parameters and serum leptin level.}, Keywords = {Leptin , Malnutrition,Hemodialysis,Anthropometric parameters}, volume = {16}, Number = {0}, pages = {27-37}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1161-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1161-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Amani, R. and Shoyoei, R. and Kazemi, H. and Seraj, M.S and Haghighizadeh, M.H.}, title = {Dietary Intake of Antioxidants and Nutritional Factors Affecting the Illness in Women with Rheumatoid Arthritis}, abstract ={     Background and Aim: Rheumatoid arthritis (RA) is a chronic autoimmune disease in which stiffness, pain, and inflammation of joints are common. It has been observed that some dietary factors can ameliorate or woren the disease. Vegetarian diets and dairy products have had useful effects, while allergic foods tend to aggravate the condition. The main objective of this study was to assess dietary intake of antioxidants and nutritional factors affecting the illness in women with rheumatoid arthritis.  Patients and Methods: In this case-control study, 40 RA diagnosed female patients that had referred to the University clinic and 40 sex and age matched women from the patients relatives were selected as the case and control groups, respectively. Subjects’ dietary pattern was evaluated through food frequency questionnaire (FFQ) on daily, weekly and rarely intake of the main antioxidant sources. Data were analyzed with t and chi-square tests using SPSS software version number 13.  Results: Daily intake of tomato and fruits in controls was respectively 3 (P<0.02) and 1.7 (P<0.04) times more than that of patients. Number of healthy subjects who ate tuna fish and fruit juices on weekly basis was 4.3 (P<0.01) and 4.6 (P<0.02) times more than patients, respectively. Consumption of peanut in patients was 5 times more than that of healthy subjects. Eggplant and cucumber were reported to worsen the symptoms of disease in about 30 and 20 percent of patients, respectively. While consumption of fish and garlic was associated with amelioration of symptoms in about one-forth of patients.   Prevalence of obesity (based on body fat percent) was 4 times higher in patients compared to the controls (P < 0.05).  Conclusion: Intake of tomato, fresh fruits and fruit juices, as the main sources of dietary antioxidants, was lower while intake of peanut-as one of the main allergic foods-was higher in patients compared with the control group. Eggplant and cucumber aggravated, but fish and garlic lessened the severity of RA. Higher rate of obesity was prevalent in RA patients. Considering the above points, weight reduction and consumption of antioxidant rich foods is highly recommended.}, Keywords = {Rheumatoid arthritis,Dietary antioxidants,Nutritional factors}, volume = {16}, Number = {0}, pages = {39-46}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1162-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1162-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Amirmozafari, N. and ForouheshTehrani, H. and Saedii, M.}, title = {Minimal Inhibitory Concentration of Vancomycin in Staphylococcus aureus strains Isolated from Hospitalized Patients Versus Those Recovered from Out Patients}, abstract ={    Background and Aim:�Staphylococcus aureus (S.aureus) is one of the most prevalent causes of nosocomial infections. It is also involved in community acquired infections. The resistance of this bacterium towards methicillin which has been reported since 1961, made Vancomycin the last choice for treatment of Staphylococcal infections.Considering the reduced sensitivity or resistance to vancomycin which has been observed since 1996, this study was conducted with the aim of evaluating the vancomycin MIC values (Minimun Inhibitory Concentration) of S. aureus cells isolated from hospitalized patients and compared with those recovered from outpatients.Materials and Methods: A cross sectional – analytic survey was conducted from 2006 till 2007. A total of 200 S.aureus strains were isolated from various clinical sources including blood, sputum, urine and sinus secretions. Their susceptibilities to vancomycin were initially surveyed by disk diffusion method. Subsequently, the MIC values of each individual strain towards vancomycin were determined by E-test strips, and the obtained data was analyzed by SPSS (V. 11) software. For statistical analysis, t-test was used.Results: In 125 S. aureus strains isolated from hospitalized patients, the growth inhibition zones were 14-18 mm and the MIC values were 1-2mg/ml. In 75 S. aureus strains isolated from outpatients, the growth inhibition zones were 16-20 mm and the MIC values were 0.75-1.5 mg/ml.Conclusion: The result of this survey shows increased MIC values for vancomycin in hospitalized patients as compared to outpatients.}, Keywords = {Vancomycin, Minimum Inhibitory Concentration (MIC),Staphylococcus aureus}, volume = {16}, Number = {0}, pages = {47-52}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1163-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1163-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Aminpour, M. and Alamrajabi, M. and Movahhed, M. and Fereshtehnejad, S.M.}, title = {Report of a Case of Open Abdomen Using Zipper Locked Method}, abstract ={   Introduction: The use of abdominal zippers for temporary abdominal closure was devised to facilitate repeated explorations, allowing multiple cleansing of the peritoneal cavity and the detection and management of septic complications. In our study, an open abdomen using a sterile zip in a patient with gangrenous bowels and reanastomosis derived infection is reported.  Case report: In this study a patient with a history of appendectomy one year before referral (had referred to the physician with a one month complaint of abdominal pain) is presented. The patient underwent laparatomy twice. Most of his small intestine was resected due to the gangrene and primary anastomosis was performed. Finally after three days, the patient underwent multiple cleansing of the abdominal cavity following purulent discharge from the incision, acute respiratory distress syndrome and sepsis with diagnosis of discharge from the site of anastomosis. Zipper locked method was used for temporary closure of abdomen wall in order to facilitate multiple access of abdominal cavity. Finally, abdominal wall was closed constantly.  Conclusion: Temporary closure of the abdomen by means of devices such as zip gives the opportunity of rapid, easy and safe assessment, management and treatment of these patients to the surgeons.}, Keywords = {Open abdomen, Zip , Damage control surgery}, volume = {16}, Number = {0}, pages = {53-58}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1164-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1164-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Entezari, S.R. and Mirdehghan, S. M.H. and Imani, F. and Hassani, V. and Bazargani, B.}, title = {Comparison of the Routine and New Methods of Intubation with Laryngeal Mask Airway}, abstract ={      Background and Aim: The laryngeal mask airway (LMA) maintains the airway under anesthesia through spontaneous breathing technique without the need of endotracheal intubations. Although routine LMA supports an adequate tracheal airway, the classic method had some limitations and problems. In this study, we compared the results of the two methods of (new and classic) LMA.  Patients and Methods: The study was a double blind randomized clinical trial. Patients who were candidates for ophthalmology surgery were enrolled in the study. The patients were randomly divided in to two groups: routine (classic) and new LMA methods of intubation approach. Ease of insertion, local bleeding, postoperative sore throat and hemodynamic changes during operation in the two groups were assessed. In this study Chi-square and t-tests were used for comparing the two groups. SPSS V.13 was used for statistical analysis.   Results: The results showed that there was no significant difference between the two methods in regard to the ease of insertion. Also sore throat and bleeding were not seen in any of the two groups. Hemodynamic changes during operation between the groups were not significant. Systolic and diastolic blood pressures did not show any significant differences in the two groups.   Conclusion: Our finding showed that the new method of LMA was similar in regard to complications and ease of insertion to the classic method and can be used for reducing contamination with discharges and secretions of patients}, Keywords = {LMA, Insertion ,Laryngeal mask ,Classic method}, volume = {16}, Number = {0}, pages = {59-64}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1165-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1165-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Ansari, Sh. and Azarkivan, A. and Salahmand, M. and Lotfi, P.}, title = {Assessment of Alloimmunization in Multi Transfuse (Thalassemia) Patients Admitted in Ali Asghar Children’s Hospital During 2004-05}, abstract ={    Background and Aim: Life long red blood transfusion remains the main treatment for severe thalassemia. The development of anti–RBC antibodies can significantly complicate transfusion therapy. Microtyping (Gel method) is the method which is recommended at present for screening and typing of antibodies. The aim of this study is to screen antibodies by Gel method and to replace the tube method (Indirect coomb’s test) if suitable responses are observed.Materials and Methods: A cross-sectional study was conducted on 458 transfused thalassemia patients in Ali Asghar Children’s Hospital. Data were analyzed with SPSS V. 11.5. For parametric data, Chi–square test was used and for relation data Pearson chi- square was used. P values less than 0.05 were considered significant.Results: In our study, there were 221 males 48.3%, and 237 females 51.7% with the mean age of 16.96 Yr. (SD±9.021) and age range of 1-60 years. Among the patients 11 (2.4%) had hemolytic reaction, 53 (11.6%) had allergic reaction and 88 cases (19.2%) had febrile reaction during the transfusion.Alloantibody in 49 (11.8%) patients was positive (by microtube method), among which 40 (81/6%) patients had anti Kell or Rh (anti C,D,E,c,d,e) antibodies and 9 (18.3%) had unknown blood group antibodies or auto antibodies.In our study alloantibody with tube method (indirect coomb’s test) was positive in 28 patients.Conclusion: Mismatched RBC phenotype was found for Rh (c,C,E) and Kell, Kidd and Duffy (Fyb, Fya) antigens. Our data showed that screening anti-RBC antibody with the new microtyping method (Gel method) is better than tube method.}, Keywords = {Transfusion, Thalassemia, Alloimmunization}, volume = {16}, Number = {0}, pages = {65-72}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1166-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1166-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Imani, F. and Hasani, V. and Bazargani, B. and Entezari, S.R. and Mirdehghan, M.H.}, title = {Evaluation of Oral Gabapentin Premedication on Postoperative Pain After Thoracotomy}, abstract ={     Background and Aim: Gabapentin is one of the anticonvulsive drugs which can be effective for the management of painful situations such as neuropathies, post herpetic neuralgias and perioperative pains. In the present study, we evaluated the efficacy of 600 mg oral gabapentin administered as a premedication on post thoracotomy pain and total morphine consumption. Patients and Methods: In this randomized placebo controlled clinical trial study, eighty patients who were candidates for thoracotomy were enrolled in two groups: gabapentine and control. In gabapentin group, the patients received oral gabapentin (600 mg) as a single dose before operation. Patient sampling was by simple and random method. All of the patients had the same general anesthesia protocol (TIVA, infusion of propofol and remifentanil). For postoperative pain control, intravenous Patient Controlled Analgesia (PCA) with morphine was used. After the operation the pain score in recovery and 1, 6, 12 and 24 hours after surgery was assessed by Visual Analogue Scale (VAS). The amount of morphine consumption and side effects during the first 24 hours after surgery were also evaluated. In this study we used Chi-square, † and repeated measurement tests for data analysis. SPSS V.13 was also used for data analysis.Results: Average morphine consumption in gabapentin group was 21.9±9.2 mg and in control group was 24.5±4.5 mg that had statistical significant difference (p=0.003). The pain score (VAS) during the recovery time and the first hour after operation in gabapentin group was significantly lower than the patients in control group (p<0.001), but in the next hours it was not significant. Demographic data were not significantly different between the two groups. Also, significant difference was not detected in regard to other complications.Conclusion: Our data showed that a single dose of 600 mg oral gabapentin as a premedication could reduce first hour postoperative pain and total morphine consumption in patients undergoing thoracotomy without having any significant side effects.}, Keywords = {Gabapentin ,Post thoracotomy pain, Pain score}, volume = {16}, Number = {0}, pages = {73-79}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1167-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1167-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Barati, M. and Noorbaksh, S. and Tabatabaee, A. and EbrahimiTaj, F. and TalebiTaher, M.}, title = {Evaluation of Frequency of Adeno, Influenza A, B and Respiratory Syncytial Viruses in Pharyngeal Secretion of Children (3 months to 15 years old) with Upper Respiratory Tract Infection by Rapid Immunochromatographic Test}, abstract ={    Background and Aim: Respiratory tract infections are one of the important causes of death among children in developing countries. Although their frequency is similar in both developed and developing countries, mortality due to them is 10-50 times higher in developing countries. Viruses are common causes of these infections among children and Influenza, adeno and respiratory syncytial virus (RSV) are some of them. The aim of this survey was to evaluate of frequency of Adeno, Influenza A, B and Respiratory Syncytial virues in the pharyngeal secretion of children (3 months to 15 years old) with upper respiratory tract infection by rapid Immunochromatographic test.Materials and Methods: A descriptive cross sectional study was carried out on children from3 months to 15 years old with upper respiratory infection who visited the OPD of Hazrat Rasool-e-Akram hospital in one year (2006). Direct smear of patient’s throat was evaluated by rapid chromatography test for adenovirus, RSV and influenza A and B virus infection. SPSS V. 13 software was used to analyze the data t-test was used for data analysis.Results: 160 children with upper respiratory tract infection with a mean age of 61.5 months were evaluated. 57.5% were boys and 42.5% were girls. 77.4% had fever, 66% had sore throat, 16.4% had abdominal pain, 10% had diarrhea, 15.7% had vomiting, 37.4% had cough, sneeze and nasal discharge, 13.8% had cevical lymphadenopathy, 27% pharyngeal exudate, 5.7% had petechea on palate and 1.9% had conjunctivitis. They were admitted: 24% in spring, 14.1% in summer, 23.1% in fall and 38.5% in winter.Influenza infection was detected in 7 cases (4.4%) with mean age of 82.3 (SD ± 47.6) months. They were detected 28.6% in spring, 14.3% in summer and 57.1% in winter. Adenovirus infection was detected in 10(6.3%) cases with mean age of 83.7 (SD ± 58.5) months. They were detected 20% in spring, 30% in summer, 30% in fall and 20% in winter. RSV infection was detected in 9 (5.7%) cases with mean age of54.7 months (SD ±50.7). They were detected 44.4% in spring, 44.4% in fall and 11.1% in winter.Conclusion: In this study Adenoviruses were the most prevalent, followed by RSV and Influenza viruses. Fever was the most common clinical sign but in RSV sore throat, in Influenza cough, petechea and vomiting and in Adenovirus infection, cervical lymphadenopathy was the most prevalent symptom. Influenza in winter and RSV in spring and fall were the most prevalent infections, but Adenovirus did not obey seasonal pattern.}, Keywords = {Adenovirus ,Influenza virus ,Respiratory syncytial virus,Upper respiratory tract infection}, volume = {16}, Number = {0}, pages = {81-88}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1168-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1168-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Poormoghim, H. and Shekarabi, M. and Golnari, P. and Yazdipoor, N. and Nozari, B. and FarjamNia, A. and Falak, R.}, title = {Evaluation of the Diagnostic Accuracy of Anti-Citrulline Antibody in Rheumatoid Arthritis Patients and its Comparison with other Rheumatic Disorders and Normal Individuals}, abstract ={    Background and Aim: Rheumatoid arthritis (RA) is the most common autoimmune rheumatic disease, which requires specific diagnostic tests for it’s’ diagnosis. However specific and practical tests for its diagnosis are lacking. We evaluated the diagnostic accuracy of Anti-cyclic citrullinated peptide antibodies (Anti-CCP) in the diagnosis, prognosis and determination of the severity of RA.Materials and Methods: In a descriptive-cross sectional study Anti-CCP antibodies were determined in 140 serum samples: 82 from RA patients and 58 from controls, including samples of 30 healthy individuals and 28 patients with connective tissue diseases. Anti-CCP was detected by ELISA in the serum samples of patients, Rheumatoid factor of IgA, IgM and IgG classes was determined by ELISA and Anti-Nuclear Antibody was detected by Immunoflourescent method results were compared in the three groups. For comparison of differences between groups t (quantitative variables) and chi-square tests (qualititative variable) tests were used. Correlation between titer of IgM-RF and Anti-CCP was assessed by Pearson’s Correlation test. In addition, Receiver Operating Characteristics (ROC) analysis was carried out to compare sensitivity and specificity of various tests. For data analysis SPSS V. 15 was used.Results: Mean concentration of Anti-CCP in RA patients that had Anti-CCP levels greater than normal was 95.1 IU/ml (range: 7.1-249 IU/ml). While mean concentration of Anti-CCP in RA patients that had Anti-CCP levels less than normal was 2.1 IU/m (range: 1.2-4.9 IU/ml).Controls had a mean Anti-CCP level of 7.35 IU/ml (range: 2.44-13.26 IU/ml)Diagnostic sensitivity and specificity of RF was reported as 81.7% and 44.6% respectively in the patients. Conclusion: As a screening method for rheumatoid arthritis IgM-RF, Anti-CCP antibody assays are superior to other RF isotypes assessments. Anti-CCP proved to be a powerful and specific diagnostic tool, especially in patients with undiagnosed rheumatoid arthritis.}, Keywords = {Anti-Citrulline Antibody, Rheumatoid arthritis,Rheumatoid factor}, volume = {16}, Number = {0}, pages = {89-98}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1171-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1171-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Jafarzadeh, A. and EsmaeliNadimi, A. and Nough, H. and Golshiri, A. and Nakhaei, M. and Dalir, B. and Rezayati, M.T and HassanShahi, Gh.H. and Sayyadi, A.R.}, title = {Serum Levels of Interleukin (IL)-17 in Patients with Acute Myocardial Infarction and Unstable Angina}, abstract ={    Background and Aim: Recent evidences suggest new risk factors especially inflammatory reactions and immunologic factors may play an important role in the pathogenesis of cardiovascular diseases. The aim of this study was to evaluate the serum levels of IL-17 in patients with acute myocardial infarction and unstable angina.Materials and Methods: In this descriptive study serum samples were obtained from 30 patients with Acute Mycrordial Infarction (MI), 30 patients with Unstable Angina (UA) and 30 sex and age matched healthy subjects. Serum samples of participants were tested for the levels of IL-17 by the use of ELISA. Statistical analyses have been done using ANOVA and t-test. Results: The mean serum levels of IL-17 were 6.68±1.2 pg/ml in AMI group, 5.48±1.01 pg/ml in UA group and 2.07±0.60 pg/ml in healthy control group. Statistical analyses showed that the mean serum concentrations of IL-17 in AMI and UA groups was significantly higher than that observed in healthy control group (P<0.005 and P<0.04, respectively). Moreover, the mean serum levels of IL-17 in total IHD (Ischemic Heart Disease) patients (6.08±0.79 pg/ml) was significantly higher than that observed in healthy subjects (P<0.002). No significant difference was observed between AMI and UA groups regarding the mean serum concentrations of IL-17.Conclusion: These results demonstrated higher serum levels of IL-17 in patients with AMI and UA than the control group. Accordingly, IL 17-associated mechanisms may participate in the pathogenesis of IHD.}, Keywords = {Acute myocardial infarction,Unstable angina, IL-17}, volume = {16}, Number = {0}, pages = {99-104}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1172-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1172-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {HaghiAshtiani, B. and Sina, F. and Habibi, A.H. and Moghadasi, M.}, title = {Comparison of Vasomotor Reactivity in Diabetic Mellitus and Non - Diabetic Mellitus Patients}, abstract ={    Background and Aim: Diabetes Mellitus (DM) increases the risk of ischemic cerebrovascular diseases two- to four folds as compared to people without diabetes. Macrovascular disease is the leading cause of death among patients with diabetes mellitus. Transcranial Doppler (TCD) is a noninvasive procedure used to assess the hemodynamic changes in Middle Cerebral Artery (MCA). Knowing the influence of diabetes on brain hemodynamics, is essential for the proper management of cerebrovascular complications in these patients.   The aim of this study was to evaluate and compare cerebral vasomotor reactivity in diabetic and non- diabetic patients.Patients and Methods: In this cross-sectional study, Transcranial Doppler ultrasound was used to measure Peak Systolic Velocity (PSV), End-Diastolic Velocity (EDV), Mean flow velocityes (MV) and Pulsatility Index (PI) in the Middle Cerebral Arteries (MCA) of 53 Diabetic (confirmed as DM by positive laboratory investigations) and 51 non-diabetic patients. Cerebral Vasomotor Reactivity (VMR) was measured as percentage of changes in peak flow velocity in MCA after inhalation of 5% CO2 for 1-2 minutes. Statistical analysis was done via Independent t-Test and Fischers Exact Test.Results: Non-diabetic patients had higher mean flow velocity as compared to diabetic (53.34±16.7cm/s, 42.47±29cm/s, respectively) which showed significant statistical difference (p=0.021). Also, diabetic group had significantly decreased VMR compared with non diabetics (%5.31±2.6, %6.66±2, respectively) which showed significant statistical difference (p=0.022).Conclusion: According to the results of this study, mean VMR in diabetics was significantly lower than the non-diabetics (%5.31±%2.6 versus %6.66±2 respectively). This means decrease in cerebrovascular reversal capacity and increase risk of cerebrovascular disease in diabetic patients. However, whether diabetes alone is a risk factor for cerebral vascular disease or not, needs more investigations.}, Keywords = {Diabetes mellitus , Cerebral vasomotor reactivity,Transcranial doppler}, volume = {16}, Number = {0}, pages = {105-111}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1173-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1173-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Haghighi, A. and Hadaegh, F. and Ghoreifinegadian, A. R.}, title = {Evaluation of Bone Mineral Density in Postmenopausal Women With Type 2 Diabetes Mellitus}, abstract ={    Background and Aim: Association between type 2 Diabetes mellitus and osteoporosis has been an attractive subject for many researchers, because both of them are very frequent and occure in the same age group. However there are controversial reports on the effect of the type 2 Diabetes mellitus on bone mineral density. Bone mineral density (BMD) of diabetic patients is reported to be equal, more or less than the normal population. The aim of this study was to evaluate the bone mineral density in postmenopausal women with type 2 diabetes mellitus.Patients and Methods: In this cross-sectional study, 50 diabetic and 50 nondiabetic postmenopausal patients that had referred to Bandar abbas Milad Bone Mineral Densitometry Centre were enrolled. BMD was measured in the lumbar vertebrae (L2-L4) and hip (femoral neck) using DXA method. Exclusion criteria were endocrine or rheumatologic diseases and use of confounding drugs specially steroids. The study population was selected randomly. T-test using Minitab software was used for statistical analysis and P<0.05 was considered as significant.Results: Age, weight, height and BMI were similar between both groups, but menopausal age was higher in the case group (48.26±4.89 yr vs 45.20±5.75 yr). The mean femoral neck BMD was similar between two groups (0.732 g/cm2 in cases and 0.773 g/cm2 in controls) (P=0.16).There were no statistically significant differences in BMD of lumber spine in both groups (0.875 g/cm2 vs 0.876 g/cm2, p=0.97). No significant difference was noted in regard to prevalence of osteopenia and osteoporosis.The mean femoral neck T-score was lower in the case group (-2.18 vs -1.83), but this was not significant (P= 0.16). There were no statistically significant differences in the lumbar spine in this regard as well (-1.40 vs -1.39, p=0.98). The mean Z-score of both sites was also similar in the two groups. The incidence of fracture was similar between two groups. Also there were no significant differences in the T-score and Z-score between patients receiving oral anti-diabetic medication and those receiving insulin.Conclusion: It seems that type 2 diabetes mellitus is not a risk factor for osteoporosis and does not increase the risk of fracture. So evaluation of BMD is not recommended routinely for prophylaxis of osteoporosis in this patient group.}, Keywords = {Osteoporosis, Bone mineral density, Diabetes mellitus}, volume = {16}, Number = {0}, pages = {113-119}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1174-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1174-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Rahimi, H. and Farajollahi, M.M. and Yazdanparast, S.A. and Azizi, M. and Khalaj, V.}, title = {Cellular Localization of AnnexinC3.1 and the Effect of its Overexpression on Growth and Protein Secretion in Aspergillus niger}, abstract ={    Background and Aim: Annexins are a large family of calcium-phospholipid binding proteins which are distributed among nearly all eukaryotes. These proteins have been found in a wide range of fungi including ascomycetes, basidiomycetes and oomycetes. The aim of present study has been the investigation of cellular localization of ANXC3.1 in filamentous fungus Aspergillus niger (A. niger). The effect of ANXC3.1 overexpression on growth rate and protein secretion of A. niger has also been investigated. Materials and Methods: In this experimental study, the annexin C3.1 gene was PCR-amplified using genomic DNA of Aspergillus niger as a template. Following the confirmation of gene sequence, it was used in the preparation of two inducible gene constructs. In the first construct, annexinC3.1 was cloned in PGEM–Egfp expression vector as a GFP fusion and under the control of glucoamylase promoter. In the second construct, the gene was cloned in pMJB104 expression vector, driven by cbhB (cellobiohydrolase B) promoter. These constructs, then were transformed into A. niger N402 using a standard method. Overexpression of each construct was induced by an inducer carbon source and the effect of annexinC3.1 overexpression on radial growth rate and protein secretion was analysed in transformants. Comparisons of radial growth rates, as well as protein secretion level, between wild type and transformants was performed using t test. Cellular localization of annexinC3.1 was investigated in annexin-GFP expressing transformant by fluorescent microscopy. Results: The effect of annexinC3.1 overexpression on growth rate and protein secretion was investigated in Aspergillus niger. No significance difference was observed in growth rate or level of protein secretion when transformants and wild type were compared (α <0.05). Microscopic examination of annexin C3.1-GFP fusion protein demonstrated that annexinC3.1 is a cytosolic protein which is distributed along the fungal mycelium. Conclusion: This is the first report on annexinC3.1 cellular localization. Annexin C3.1 is a cytosolic protein and its overexpression in A. niger does not increase the protein secretion level.}, Keywords = {Aspergillus niger, Annexin C3.1 , Cellobiohydrolase B (cbhB),Glucoamylase, Cytosolic protein}, volume = {16}, Number = {0}, pages = {121-129}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1175-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1175-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Shahhosaini, Gh.R. and Yegane, A. and Moghtadie, M. and Lotfaliani, A.R.}, title = {Comparison of the Surgical Results of Retrograde Intramedullary Nail (RIN) and Locking Condylar Plate (LCP) in the Treatment of Distal Femoral Fracture.}, abstract ={    Background and Aim: Femoral fractures occur in 37 per 100,000 people per year. Distal femoral fractures are one of the challenging therapeutic facts, because of its high complications. So, many techniques have been introduced for its treatment. Up till know, there is no comparative study on Retrograde Intramedullary Nailing (RIN) and Locking Condylar Plate (LCP) in Iran and the results of this study may help surgeons to evaluate the real success in these procedures.Patients and Methods: In this observational-analytic-cross-sectional study, 38 patients who had undergone RIN or LCP during 2005-2007 were evaluated. The patients were called to come to clinic for re-evaluation of mobility and any possible deformity. For statistical analysis Pearson's correlation, dependent t-test and Chi-sqaure test was used. SPSS V. 16 was also used for data analysis.Results: The distribution of age and gender were the same in two groups. The means of range of motion (ROM), duration of :::union::: and reoperation were similar as well. The frequencies of knee pain and septic knee were higher in patients who underwent RIN, but mal:::union::: was higher in LCP group.Conclusion: According to results of this and previous studies, LCP is the recommended technique in distal femoral fractures. We found that the result of RIN was poorer in Iran than other countries. We suggest further prospective studies with more sample size in this regard.}, Keywords = {Distal femoral fracture, Locking plate,Intramedullary Nail}, volume = {16}, Number = {0}, pages = {131-139}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1176-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1176-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Ghasemi, Sh. and Ranjbar, M. and Afsari, A.}, title = {Evaluation of the Effect of Helicobacter Pylori in Induction of Hyperemesis Gravidarum}, abstract ={    Background and Aim: Several factors, including abrupt rise of HCG or female sex hormone has been suggested in the development of Hyperemesis gravidarum (HG). However some authors believe that infectious agents, especially Helicobacter pylori (H.pylori) are responsible for HG. In this study, frequency of H.Pylori antibody was compared between HG and non-HG pregnant women.Patients and Methods: In this case-control study, 30 pregnant women with HG and 30 non-HG pregnant women who had referred to the clinics of Iran University of Medical Sciences were studied. IgG anti- H.Pylori antibody was evaluated among the two groups. Statistical anatylis was carried out using t-test, Chi-square test and Fischer’s exact test.Results: Mean (±SD) age of case and control groups was 24±5 years and 26.8±5.1 years, respectively (NS). There were no significant differences between two groups regarding age, gravity and parity. Fifteen (50%) pregnant women with HG and 7 (23.3%) non-HG women were anti H.pylori positive which was statistically significant.Conclusion: H.pylori may have potential role in developoing HG. So, it is recommended that those women who like to get pregnant in the near future, should be evaluated for HP and to be treated if tests are positive.}, Keywords = {Hyperemesis gravidarum, Helicobacter pylori,Pregnant woman}, volume = {16}, Number = {0}, pages = {141-145}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1177-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1177-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Kadivar, M. and Askarzadeh, P. and Shayanfar, N. and Sadeghipour, A.R. and Bahraminejad, M.}, title = {Interpretation of Immunohistochemistry Results of HER2/neu Expression in Invasive Breast Cancer: Evaluation of Interobserver and Intraobserver Agreement}, abstract ={    Background and Aim: The accurate determination of HER-2 in invasive breast cancer has become a critical issue, particularly in context of the results of Herceptin adjuvant therapy. The aim of this study was to evaluate inter- and intraobserver reproducibility of assessment of HER2/neu immunostaining in invasive breast cancerMaterials and Methods: This study was cross sectional and the convenience sampling method was applied. IHC for HER2/neu was performed on 107 archival invasive breast carcinoma tissues. Protein overexpression was scored independently by 4 pathologists using the criteria recommended by DAKO (0 to 3+ reflecting the intensity and pattern of the immunohistochemical signal present in 10% or more of tumor cells.). After a session in order to train for better evaluation and standardization of the scoring criteria, the samples were evaluated for the second time. A minimum of two months elapsed between the two examinations. The discrepancies in scoring results were reviewed by the 4 observers using a multihead microscope to obtain consensus. The inter- and intraobserver agreements were calculated by kappa statistics. Results: Complete agreement was achieved in 33 (31%) and 40 (37%) of 107 cases in the first and second examinations, respectively. Generally, interobserver agreement was moderate (Kappa=0.44 in the first examination and 0.51 in the second one), with intermediate categories (1+, 2+) showing fair agreement and extreme categories (0, 3+) showing moderate agreement. Intraobserver agreement was also moderate (from the minimum kappa=0.55 to the maximum of 0.60). Considering three groups as negative (0/1+), weakly positive (2+) and strongly positive (3+), interobserver agreement improved but still staying in the moderate level (kappa=0.54 and 0.60 in the first and second time, respectively) with score 2+ group showing the least level of agreement. However, with dividing the cases into two groups as negative (0/1+) and positive (2+/3+), interobserver agreement improved to substantial level (kappa=0.68 and 0.75 in the first and second time, respectively).Also, with this consideration, intraobserver agreement improved to substantial level (0.71 to 0.84). By consensus there were 42 cases (39.2%) that were scored 0, 19 cases (17.8%) scored 1+, 27 cases (25.2%) scored 2+, and 11 cases (10.3%) scored 3+. For 8 cases (7.5%) no consensus was achieved in 6 of them the problem was placing them into 2+ or 3+ category  and in 2 cases the problem was placing them into 0 or 1+ category.Conclusion: Our study showed that reproducibility (interobserver agreement) is moderate for evaluation of HER2 status in invasive breast carcinoma by IHC using DAKO criteria. However, for discrimination between negative and positive state, reproducibility (that is in substantial level) is better.}, Keywords = {HER2/neu, Interobserver agreement ,Invasive breast cancer}, volume = {16}, Number = {0}, pages = {147-155}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1178-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1178-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Kamali, K. and Fereshtehnejad, S.M. and Hafezi, R. and Kamali, N.}, title = {Evaluation of the Effect of Viral Hepatitis B and C on Graft Survival in Renal Transplant Recipients}, abstract ={    Background and Aim: Chronic liver disease and its complications are major problems in renal transplant recipients. Hepatitis B and C virus infections are currently the main causes of chronic liver disease in this group, and these may affect allograft outcome. Whether hepatitis B and C virus infections after renal transplantation adversely affect graft and patient survival, remains controversial. Therefore, the aim of present study was to determine the effects of viral hepatitis B and C on graft and patient survival who underwent renal transplantation.Patients and methods: In this historical cohort study all 1615 patients who received renal transplants between 1986 and 2003 at Hashemi-Nejad hospital in Tehran, Iran were assessed. In addition to demographic data, the presence of HBsAg and/or Anti-HCV antibody, the incidence of acute rejection, graft loss and patient's mortality were recorded. Short term and long term survival rates of the transplanted kidney and the patient itself were analyzed and compared using Kaplan–Meier survival analysis and Log rank test by SPSS V.11. Chi sqaure and Independent t-tests were also used for data analysis.Results: Viral hepatitis B and C were detected in 49(3.03%) of the patients. The mean survival time of the patients and transplanted kidney was 168(SEM=7.36) and 126.50(SEM=11.50) months, respectively. The graft survival rate was 98% and 92%, at 1 and 5 years after transplantation in patients with HBsAg positivity and 100% and 100% at 1 and 5 years after transplantation in patients with anti-HCV antibody positivity.Conclusion: The results of our study showed that HBV or HCV infection is not a contraindication for kidney transplantation in patients with end-stage renal disease. However, it should be noted that HBV and HCV-infected patients who are candidates for renal transplantation should be carefully evaluated both before and after renal transplantation.}, Keywords = {Renal transplantation , Viral hepatitis B , Viral hepatitis C,Survival}, volume = {16}, Number = {0}, pages = {157-165}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1179-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1179-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Mazdak, H. and Mirkheshti, N. and Movahedian, A. and Yazdekhasti, F. and Behzad, E. and Shafieian, M.}, title = {Study of the Oxidative Stress Markers in Bladder Cancer Patients in Comparison with Healthy Subjects}, abstract ={    Background and Aim: Despite many researches done on the relationship between oxidative stress and cellular antioxidant defenses in different cancers, there are limited researches about the role of oxidative stress in bladder cancer. So we decided to study the serum MDA and total antioxidant capacity in patients with bladder cancer in comparison with healthy individuals. Materials and Methods: During this case – control study, 51 patients with bladder cancer and 58 normal subjects were selected (considering the inclusion and exclusion criteria) by simple sampling. After obtaining write consent from them, blood samples were prepared after 8 hours of fasting. MDA and total antioxidant capacity was measured in all samples. Finally data were compared with student t test between two groups. SPSS V.13 was used for data analysis.Results: There was a significant increase in serum MDA concentration (P < 0.001) and significant decrease in total antioxidant capacity (P < 0.001) in case subjects in comparison with control group.Conclusion: The results of the present study confirm this hypothesis that oxidative reactions and cellular damages induced by such reactions and insufficient antioxidant capacity can be two of the more important mechanisms in bladder cancer induction.}, Keywords = {Bladder cancer,Total antioxidant capacity, Malon dialdehyde,Oxidative stress}, volume = {16}, Number = {0}, pages = {167-172}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1180-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1180-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Moshkgoo, M. and ShamsAkhtary, A.}, title = {Case Report of Morgagni Hernia}, abstract ={    Intoduction: Morgagni hernia is a herniation through the costosternal portion of diaphragm. Morgagni's defect usually occurs on the right side. Morgagni hernia is a rare hernia and occurs more commonly in adults.Case report: A 4 years old child was referred to office for recurrent pneumonias. The patient was under treatment for his pneumonias since 2 years ago. On chest CT scan, transverse colonic segment and air fluid level was seen in the right hemi thorax.Conclusion: With the diagnosis of Morgagni hernia, the patient was prepared for operation. Surgical approach was right thoracotomy. Herniated colon through morgagni defect was observed. The hernial sac was set free from a 2.5x2.5 cm defect in the anterior part of diaphragm. The colon was moved in to abdomen. The defect was repaired by 1-0 nylon sutures. After operation and often 1.5 years follow up, the patient is well with no complications.}, Keywords = {Morgagni hernia, Recurrent pneumonia,Thoracotomy}, volume = {16}, Number = {0}, pages = {173-177}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1181-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1181-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Mollahoseini, R. and Ghorbani, M. and MoradiLakeh, M.}, title = {Risk Factor for Surgical Site Infection in Neurosurgery Patients with Antibiotic Prophylaxis}, abstract ={    Background and Aim: Surgical site infection (SSI) is one of the most common complications in patients undergoing surgery, increasing the mortality and morbidity rates in surgical wards. This prospective study aimed to determine the incidence and the main risk factors of SSI after neurosurgical procedures in patients on antibiotic prophylaxis in a teaching hospital at Tehran, Iran.Patients and Methods: In this prospective study 543 consecutive patients undergoing neurosurgery were enrolled. All patients were followed for a minimum of 2 weeks postoperatively and all SSIs were recorded. The complete medical records of each case were extracted. Statistical analyses were performed to identify the risk factors for SSIs by odds ratio and Chi-Square test. Statistical analysis was performed by SPSS V. 13.Results: A total of 41 patients suffered from postoperative SSIs among 543 cases included in the study, with a resulting overall infection rate of 7.6%. The risk of SSI was increased by operation type such as "shunt operations", presence of foreign body, presence of diabetes mellitus, CSF leakage, frequent LP, operation time of more than 3 hr and admission in ICU.Conclusion: SSIs remain an important problem in neurosurgery. Identification of the risk factors for SSI will help physicians to improve patient care and may decrease mortality, morbidity, and health care costs of neurosurgery patients.}, Keywords = {Surgical Site Infection, Neurosurgery, Risk Factor}, volume = {16}, Number = {0}, pages = {179-185}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1182-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1182-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Naseripour, M. and Akbarzadeh, S. and Bakhtiari, P. and Vosough, P. and Ahadian, A. and ZareMoghadam, A. and Almasi, M. and Salimi, Sh.}, title = {Adjuvant Effects of Periocular Chemotherapy in Treatment of Advanced Intraocular Retinoblastoma}, abstract ={    Background and Aim: Although combined "Chemotherapy and Focal therapy" is very efficient in the treatment of the low grade forms of Retinoblastoma (Rb), more effective therapeutic measures are required to control the spread of the disease into vitreous and subretinal areas.This study was conducted with the aim of evaluating the effectiveness of chemotherapy combined with perioricular injection of carboplatin in the treatment of advanced of intraocular Retinoblastoma.Patients and Methods: In this prospective interventional case series, 16 eyes from 16 patients with groups C or D retinoblastoma (Rb) (case group) and 18 eyes from  17 patients with groups C or D retinoblastoma (control group) were investigated. Systemic chemotherapy by VEC protocol and focal treatments were done in both groups. In case group, periocular injection of Carboplatin was done as an adjuvant treatment. Examination under general anesthesia and fundus photography by Ret-Cam was done for all patients before entering the study. The mean volume of Carboplatin injections in each session was 15 mg. SPSS V. 15 was used. For statistical analyses Fischers exact, Chi-square and Mann-Whitney tests were used.Results: Mean age was 28.6 months in case group and 26.6 months in control group. There were7 males and 9 females in case group and 7 males and 10 females in control group. The mean of chemotherapy sessions were 9 cycles in case group and 9.3 in control group. In case group, the mean number of Carbolatin injections in each eye was 3 times (1 to 5 times). Distribution of other focal treatments (cryotherapy, brachytherapy and transpupillary thermotherapy) was almost the same in both groups.In case group, 9 eyes were in group C and 7 eyes were in group D. In control group, 9 eyes were in group C and 9 eyes were in group D. The mean of follow up period was 27 months.At the end of study, in case group 5 eyes (31%) were enucleated 10 eyes were in complete regression and 1 eye was controlled by brachytherapy. Finally 69% of eyes were in complete regression in case group. In control group 10 eyes (55%) were enucleated and 8 eyes (45%) were in regression. Conclusion: Although adjuvant periocular carboplatin injection associated with systemic chemotherapy and focal treatment resulted in more preservation of globe in patients with advanced Rb, the difference however between case group and control group was not significant statistically. So, a prospective randomized clinical trial with larger sample size and longer follow up period is recommended.}, Keywords = {Retinoblastoma,Intraocular Tumor,Systemic Chemotherapy,Periocular carboplatin injection}, volume = {16}, Number = {0}, pages = {187-193}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1183-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1183-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Hooman, N. and TaheriDerakhsh, N. and Samaii, H. and ArabMohammadHoseini, A.}, title = {Blood Level and Urinary Excretion of Calcium in Neonates with Nonphysiological Hyperbilirubinemia Under Phototherapy}, abstract ={    Background and Aim: Hypocalcaemia has been reported as a complication of phototherapy especially in premature neonates. However, the cause is unknown. The aim of this study was to evaluate the relation between serum and urinary levels of calcium in neonates under phototherapy and to answer the question that whether phototherapy-related hypocalcemia is associated with hypercalicuria or not.Patients and Methods: In a prospective cross sectional study, 50 icteric newborns (30 males and 20 females) that were treated by phototherapy entered the study through non accidental sampling. The consent was taken from parents on admission. All were breastfed. Weight was checked. Serum samples for calcium and bilirubin and urine samples for calcium, creatinine and osmolality measurements were sent on arrival (group I), after 48 hours of starting phototherapy (group II) and 24 hours after discontinuing phototherapy (group III). Hypercalciuria was defined as Uca/Ucr >0.8 mg/dl/mg/dl, hypocalcemia was defined by serum calcium less than 8 mg/dl in the term and less than 7 mg/dl in the premature neonates. Chi square test, Repeated measure test, Wilcoxon signed rank test and multivariate were used to compare frequency, means, median and correlation, respectively. P < 0.05 was considered significant.Results: Between 2004 and 2005, 50 healthy newborns (27 premature and 23 term) with mean age of 7.42 days (range 2 days – 28 days), gestational age 36.8 weaks (range 29 wks – 40 wks), weight 3051 gram (range 1500 – 4300 gr), serum bilirubin 19.7 mg/dl (8.5 – 28 mg/dl) and serum calcium of 8.8 mg/dl (range 7-11 mg/dl) were included in study. Mean serum calcium levels in groups I, II and III were respectively 9, 8.65 and 8.7 mg/dl. Also mean of Uca/Ucr in groups I, II and III was 0.03, 0.85 and 0.60 mg/dl/mg/dl, respectively. Similarly mean of Uca to Urinary Osmolality (mg/dl) in groups I, II and III was 0.05, 0.09 and 0.07 mg/dl/mosmol/kg/H2O respectively. Hypercalciuria was detected in 6% in group I, 52% in group II and 32.7% of group III. None of them showed hypocalcemia. Based on Wilcoxon Signed Rank test, there were significant statistical disperences inregard to the median of Uca/Ucr between groups I and II, I and III and II and III (P0.05). Conclusion: According to the results of this study, neonates who are treated by phototherapy are at the risk of hypercalciuria. Further investigations for example follow up renal sonography, clarifying the importance of this phenomenon is highly recommended.}, Keywords = {Phototherapy, Hypercalciuria , Neonate,Calcium to creatinine ratio,Icterus}, volume = {16}, Number = {0}, pages = {195-202}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1184-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1184-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Hashemi, M. and GhasemiFalavarjani, Kh. and AliakbarNavahi, R. and Mirfallah, K. and Bakhtiari, P.}, title = {Comparison of the Results of Intravitreal Injection of Triamcinolone Acetonide and Bevacizumab (Avastin) in Patients with Clinically Significant Macular Edema Unresponsive to Standard Treatment}, abstract ={    Background & Aim: Macular photocoagulation is the standard treatment for clinically significant macular edema (CSME), but some of patients do not respond to it. The aim of this study was to compare the results of intravitreal injection of triamcinolone acetonide (IVTA) and bevacizumab (IVB) in patients with CSME. Patients and Method: In this prospective randomized double-blind clinical trial, 51 eyes with CSME with at least one session of MPC (Macular Photocoagulation) and without response to it were included. The patients were randomly assigned to one injection of either 4 mg of IVTA or 1. 25 mg of IVB. Visual acuity (VA), intraocular pressure (IOP) and cataract were checked before and 1, 3 and 6 months after injection. Fluorescein angiography was performed before and 3 and 6 months after injection to evaluate macular integrity and leakage. Data were analyzed using Chi-square, Students' t-test and Friedman tests. Results: No significant change in VA was seen in either group in the first, third and sixth months of follow-up. There was no significant difference between the two groups in terms of VA 1, 3 and 6 months after injection. Although the measurements taken during the follow-up revealed an increase in IOP in IVTA group, the difference between the two groups was not significant. There was no increase in cataract formation in IVB group however, the incidence of posterior subcapsular cataract significantly increased in IVTA group 6 months after injection (P<0. 001). Macular leakage and angiographic resolution were improved significantly in the two groups (P<0.001), but no significant change was noted in foveal avascular zone visualization. Overall, the measurements taken after 3 and 6 months showed no significant difference between the two groups in terms of angiographic features. Conclusion: According to this study, the efficacy of IVB is the same as IVTA in the treatment of CSME unresponsive to standard treatment.  }, Keywords = { Bevacizumab, Triamcinolone Acetonide,Clinically Significant Macular Edema , Diabetic Retinopathy}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1261-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1261-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Vakili, M. and Forooghan, M. and Nojomi, M. and GhalehBandi, M. F. and Khodabandeloo, N.}, title = {A Survey on Serum Levels of B12, Folate and Homocysteine in Healthy Elderly Tehranis}, abstract ={     Background & Aim: Owing to decreased absorption of cobalamin in the elderly, cobalamin deficiency is a common problem in these subjects. On the other hand, insufficient vitamin B12 status may increase the incidence of atherosclerotic and neurodegenerative disorders. Recently investigators have recommended B12 monitoring in the elderly and detecting at risk subjects in the early stages of deficiency. The purpose of this study is to assess serum levels of B12, folate and homocysteine in the healthy Iranian elderly and to find a probable relation between them.  Patients and Method: This project was conducted as a cross-sectional study in Tehran. A total of 232 people aged 65-90 years, with a mean of 73 years, were recruited and data was gathered by measuring serum levels of homocysteine, folate, and vitamin B12, interview and physical examination. Blood samples were gathered and analyzed according to standard methods. Statistical analysis was done using SPSS 11. 5 software. Comparison of values were made using Chi-square and Students' t-test. The p-value of less than 0. 05 was determined significant.  Results: The variables were assessed in 102(44%) male and 130(56%) female subjects. The mean of serum B12 was 295 pg/ml (SD±170). 10% of cases had B12 levels less than 119 and 18% less than 160 pg/ml. B12 deficiency increased with ageing (p=0. 000),but there was not a significant relation with sex (p=0. 85). The mean of folate level was 8 ng/ml (SD±4. 9). 9. 5% of cases had folate levels below normal range without a significant relation to age (p=0. 06) or sex (p=0. 31). The mean of homocysteine (Hcy) concentration was 19. 3 μmol/l (SD±7. 1). Homocysteine values were more than 20 μmol/l in 33. 6% and more than 15 μmol/l in 67% of the subjects with no relation to ageing (p=0. 23). 42. 2% of males and 27. 7% of females had homocysteine values more than 15 μmol/l (p=0. 005),which was statistically significant. Correlation coefficients between the levels of homocysteine, serum B12 and folate indicated a significant inverse correlation (r = -0. 33, p= 0. 000 r = -0. 20, p=0. 002 respectively).  Conclusion: The results of this study show that the incidence of hyperhomocysteinemia, B12 and folate deficiency in the elderly is not lower than developed countries, and B12 deficiency seems to be functionally higher than western countries. It is suggested that the elderly use vitamin B group as medication or as fortified foods regularly.  }, Keywords = {Homocysteine, Vitamin B12, Folate, Elderly}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1260-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1260-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {AbdNikfarjam, B. and Amirghofran, Z. and Aflaki, E. and KamaliSarvestani, E.}, title = {Study of NOS2A Gene Polymorphism in Rheumatoid Arthritis Patients and Normal Individuals}, abstract ={  Backhground & Aim: Several lines of evidence have indicated that NO might be important in the pathogenesis of RA. NO could be synthesized by an enzyme called inducible nitric oxide synthase (iNOS). iNOS is expressed in the synovium, cartilage and lymphomononuclear cells of synovial fluid and lymphocytes and monocytes of peripheral blood of RA patients. Several studies have shown that iNOS gene (NOS2A) polymorphisms have been associated with a number of inflammatory and autoimmune diseases. In the present study the frequency of NOS2A gene polymorphism at positions -1659 C/T and +150 C/T was investigated in patients with RA and control subjects.   Material and Method: In the present case- control study the frequency of NOS2A gene polymorphisms at positions -1659 C/T and +150 C/T was investigated in 176 patients with RA and 232 control subjects using PCR-Allele specific and PCR-RFLP methods, respectively. SPSS version 10,Chi-square and Fisher's exact tests were used to study the differences in genotype and allele frequencies between patients and controls.   Results: The results of the present study showed a significant difference in NOS2A -1659 C/T polymorphism between the patients and controls (P=0.03). Wild type homozygote (CC) was significantly higher in normal subjects (75%) than patients (64.2%). No significant difference was observed between RA patients and controls in NOS2A +150 C/T polymorphism (P=0.33). Furthermore, there was no significant association between different clinical and paraclinical findings including erosion, deformity of joints, rheumatoid nodules, extra articular manifestations, CRP, RF and age of onset and -1659 C/T and +150 C/T NOS2A gene polymorphisms.   Conclusion: To the best of our knowledge this study was the first research on the NOS2A gene polymorphisms in RA patients. Our results revealing the significant correlation between -1659 C/T genotypes and RA, indicates the importance of iNOS polymorphism in the patients and suggest further studies in other ethnic groups.  }, Keywords = {Rheumatoid Arthritis (RA),Inducible Nitric Oxide Synthase,Nitric Oxide Synthase 2A Gene Polymorphism}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1259-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1259-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Nikeghbali, A. and GhasemiFalavarjani, Kh. and Modarreszadeh, M. and Hashemi, M. and Parvaresh, M. M. and Naseripour, M.}, title = {Long-term Results of Scleral Fixation of Dislocated Intraocular Lenses Using Haptic Externalization through a Small Corneal Incision}, abstract ={    Background & Aim: Several methods have been reported for refixation of dislocated intraocular lenses (IOLs). However, these methods are associated with some disadvantages including vitreous prolaps, vitreous traction, ocular collapse, intraocular hemorrhage, high astigmatism, and the need for complex intraocular maneuvers. The aim of this study was to evaluate the results of transscleral fixation of dislocated intraocular lenses (IOLs) by externalizing the haptics through a small corneal incision. Patients and Method:This retrospective, non-comparative, interventional study comprised 28 eyes (28 patients) in which IOLs were dislocated into the vitreous cavity. After bringing the IOL to the anterior chamber, a suture was introduced into the eye via scleral flap and retrieved via another flap. Then the thread was pulled out through a small clear corneal incision. The suture was tied to the externalized haptic, and the tied haptic was placed back in the anterior chamber and dialed to externalize the second haptic. After the second externalized haptic was tied, the IOL was reimplanted behind the iris. Data was analyzed using t-test. Results: Through the mean follow-up of 34.5 ± 23.8 months, the PC IOL remained well centered in all eyes and no tilt or dislocation was observed. The difference between the mean of best corrected visual acuity before IOL dislocation (0.35 ± 0.21 logMAR) and the mean after IOL refixation (0.38 ± 0.19 logMAR) was not statistically significant (P=0.2). In addition, the difference between the mean astigmatism at the final examination (1.35 ± 0.64 diopters) and the mean astigmatism before IOL dislocation (1.25 ± 0.69 D) was not statistically significant (P=0.19).Conclusion: Scleral fixation of dislocated IOLs using temporary haptic externalization through a clear corneal incision minimized the need for complicated intraocular maneuvers, and provided an easy and effective way to reposition dislocated IOLs. Long-term results are promising.  }, Keywords = {Scleral Fixation,Dislocated Intraocular Lens,Haptic Externalization}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1258-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1258-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Niazmand, S. and ErfanianAhmadpoor, M. and Hajzadeh, M. and Hosseini, Kh.}, title = {Inhibitory Effect of Ziziphora Clinopodioides Lam. on Rat’s Gastric Acid Secretion in Basal, Vagotomized and Vagal Stimulated Conditions}, abstract ={    Background & Aim: Ziziphora clinopodioides Lam. is a plant widely used in Iranian traditional medicine. Several reports have demonstrated antibacterial, antioxidant and anti-inflammatory properties of Ziziphora clinopodioides. The aim of this study is to investigate the effects of aqueous-ethanol extract of Ziziphora clinopodioides on rat’s gastric acid secretion and its probable mechanism.Material and Method: In this interventional experimental study, 24 Wistar rats weighing 200-250g were randomly divided into two groups: test and control. Tracheostomy and gastroduodenostomy procedures were performed on each rat. Gastric content was collected for 15 minutes by washout technique. 1 ml of three dosages (0. 5, 1 and 2 mg/kg) was introduced into the stomach of each rat in the test group and the same volume of saline was used in the control group. Total titratable acid was measured by a titrator. Data were shown as mean±SEM and analyzed by unpaired t-test. P<0. 05 was considered significant.Results: The extract inhibited acid secretion significantly in basal condition, but in vagotomized condition this inhibitory effect on acid secretion disappeared and the extract showed a stimulatory effect at the dose of 2mg/kg. Also,the extract showed an inhibitory effect at the dose of 1mg/kg in vagal stimulation condition.Conclusion: The extract exerted an inhibitory effect on acid secretion in basal and vagal stimulation conditions. The inhibitory effect of the extract was exerted via gastric vagal parasympathetic nerve.}, Keywords = {Ziziphora Clinopodioides Lam, Gastric Acid, Vagotomy,Vagous Nerve}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1257-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1257-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Nojomi, M. and Baharvand, P. and Kashanian, M.}, title = {Validation of Incontinence Quality of Life Questionnaire (I-QOL) in Incontinent Women}, abstract ={    Background & Aim: Urinary incontinence has a negative effect on physical, social, psychological and occupational aspects of health in women. The aim of current study was to assess the validity and reliability of the Persian version of urinary incontinence quality of life instrument (I-QOL) in order to determine quality of life in women with urinary incontinence and to promote the quality of medical cares and services.Patients and Method: Through studying evaluative diagnostic procedures and in order to assess the validity and reliability, I-QOL, psychological general well-being (PGWB) and Persian version of SF-36 questionnaires were offered to 373 eligible women with stress, mixed and urge urinary incontinence who were referred to educational hospitals of medical universities of Iran,, Hamedan, and Lorestan during six months. In order to measure the reliability, translated I-QOL questionnaires were completed by the patients 3 weeks later in the same clinics. We used Pearson correlation analysis, Cronbach’s-alpha, confirmatory factor analysis, and intraclass correlation coefficient to assess the validity and reliability ofI-QOL questionnaire. Results: Confirmatory factor analysis confirmed structural validity of I-QOL. The internal consistency (Cronbach’s-alpha) was 0.96. The range of internal consistency was between 0.78 and 0.93 for domains of I-QOL questionnaire. Reproducibility by intraclass correlation coefficient (ICC) was 0.96. The correlation between total I-QOL and the subscales of PGWB and SF36 ranged from 0.53 to 0. 61 and 0.47 to 0.59 respectively. I-QOL scores were found to be more closely related to well-being of PGWB (r=0.6) and social function of SF36 (r= 0.55).Conclusion: The obtained results showed I-QOL questionnaire has good reliability, validity and internal consistency for Iranian patients.}, Keywords = {Urinary Incontinence,Quality of Life, Validity,Reliability}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1255-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1255-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {MomenHeravi, M. and Sharif, A. R.}, title = {A Case Report of Leprosy of the Larynx}, abstract ={    Introduction: Leprosy is an ancient deforming disease caused by Mycobacterium leprae, which is still poorly understood and often feared by the general public and even by some in the health care professions. Fortunately, the outlook for patients has dramatically improved over the last three decades with the introduction of multi-drug treatment and management strategies that have somewhat diminished the stigma of this diagnosis. Here we report a case of leprosy of larynx. Case Report: A 45-year-old Afghan man who had presented with cough,dyspnea and hoarseness since many years ago was referred to our clinic due to worsening complaints. Because of the demonstration of acid fast bacilli in the smear of his sputum,diagnosis of tuberculosis was made and anti-tuberculosis treatment was initiated. However, he developed fever and his symptoms worsened,which led to his admission. On examination, there was a tender erythematous nodule in the right supraclavicular region, loss of eyebrows and eyelashes,and disseminated hyper-and-hypo pigmented cutaneous lesions on the abdomen, thorax and back. Chest x-ray was normal. In order to rule out laryngeal tuberculosis, laryngoscopy was done and granulomatous lesions were seen. Laryngeal and skin biopsy was performed. Both specimens revealed numerous acid fast bacilli, macrophages and foamy cells which were suggestive of lepromatous leprosy. Treatment was started based on multibacillary regime of WHO multidrug therapy. Conclusion: In conclusion, this report highlights the importance of systemic involvement in lepromatous leprosy, especially when the initial presentation is laryngitis or respiratory symptoms. Laryngeal leprosy may be mistaken with tuberculosis or laryngitis due to respiratory problems and the existence of acid fast bacilli in respiratory secretions.}, Keywords = {Leprosy, Larynx, Laryngitis , Mycobacterium leprae}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1253-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1253-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Morteza, N. and EbrahimiTakamjani, E. and Abdollah, V. and Jamshidi, A. A. and Kamali, M.}, title = {The Effects of Prophylactic Knee Braces on Athletes\' Performance}, abstract ={    Background & Aim: Knee injury is one of the major problems in sports medicine, and the use of prophylactic knee braces is an attempt to reduce the occurrence or severity of injuries to the knee joint. In addition to providing protection, a prophylactic knee brace should not inhibit normal joint function. The objectives of the present study were to examine the effect of three prophylactic knee braces upon athletes' performance. Patients and Method: This study was a randomized clinical trial in which 31 healthy male collegiate athletes volunteered as subjects to examine the effect of these braces on their knee function through isokinetic and functional tests in four sets: 1-without brace (control) 2- wearing knee sleeve without stays 3- wearing knee sleeve with four bilateral stays 4-with prefabricated brace. The order of sets was randomized and the domain limb was evaluated. The test protocol consisted of cross-over hop and vertical jump tests, in which the best jump distance of three trials was recorded. Then the subjects were administered an isokinetic knee flexion and extension test at 60deg/sec, 180 deg/sec and 300deg/sec, and the following isokinetic variables were recorded: peak torque to body weight ratio and average power. Repeated measures analysis of variance was used to evaluate the differences between 4 conditions. Results: Repeated measures analysis of variance revealed no significant difference between three trials in terms of peak torque to body weight ratio, average power, vertical jump and hop measurements,as they were tested within the three experimental conditions and one control condition (p>0. 05). Conclusion: These findings suggest that the selected brace/sleeves did not significantly inhibit athletic performance. Inasmuch as the function of knee joint was not impaired while wearing the neoprene sleeve without stays and knee sleeves are supposed to ameliorate knee joint position sense. it seems beneficial to use neoprene sleeves as the main structure of prophylactic knee braces.}, Keywords = { Prophylactic Knee Brace, Knee Performance , Isokinetics}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1252-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1252-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Moradi, S. and Darvishi, N.}, title = {Evaluation of the Prevalence of Metabolic Syndrome in Women with Polycystic Ovary Syndrome Referred to the Institute of Endocrine and Metabolism}, abstract ={    Background & Aim: Polycystic ovary syndrome (PCO) is characterized by insulin resistance with compensatory hyperinsulinemia. Insulin resistance also plays a role in the metabolic syndrome (MBS). So, we hypothesized that the MBS should be more prevalent in PCOS. Patients and Method: We conducted a cross-sectional study of all women with PCOS seen over a one-year period at the endocrinology clinic. 151 cases met the inclusion criteria for PCOS. The women were divided into two groups:1- women with PCO and the MBS (n=70) and 2- women with PCO lacking the MBS (n=81).Results: The mean age of the cases was 28 ±8 years,ranging from 16 to 48. The frequency of the MBS was 70 (46. 4%). The frequency of abnormal findings in all cases was as follows in descending order: Low HDL:71%, Increased waist circumference:55. 6%, High triglyceride:48%, High blood pressure:22. 6% and FBS>110mg/dl: 7. 3%. Conclusion: It is concluded that the MBS and its components are common in women with PCOS, placing them at increased risk for diabetes mellitus and cardiovascular diseases.}, Keywords = {Polycystic Ovary Syndrome , Metabolic Syndrome,Cardiovascular Disease, Insulin Resistance}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1251-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1251-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Modarreszadeh, M. and GhasemiFalavarjani, Kh. and Salehian, M. and SoltanSanjari, M. and Seddigh, N.}, title = {Evaluation of the Prevalence of Systemic Diseases in Patients with Anterior Ischemic Optic Neuropathy in Rassoul-e-Akram Hospital}, abstract ={    Background & Aim: Several risk factors have been postulated to be associated with nonarteritic anterior ischemic optic neuropathy (NAION) however, the main cause of it has remained unknown. Considering the absence of similar study in Iran, the aim of this study was to evaluate the prevalence of systemic diseases in patients with NAION in Rassoul-e-Akram Hospital.   Patients and Method: In this retrospective cross-sectional study, all patients with the diagnosis of NAION who were referred to Rassoul-e-Akram Hospital between April 2003 and 2005 participated. Demographic data and the prevalence of systemic diseases, including diabetes, hypertension, hyperlipidemia, renal disease and rheumatic disease were evaluated. The information was gathered from the records of the patients and analyzed by SPSS software. Internal comparison and comparison of the prevalence of diabetes and hypertension in our cases with corresponding data in Iran's population were drawn. Data was analyzed using Chi-square test.   Results: A total number of 51 patients with a mean age of 51. 08 ±9. 93 years were included. Bilateral involvement of eyes was present in 21. 6% of the cases. Male to female ratio was equal to 1. The most common systemic disorders were diabetes mellitus, hypertension, hyperlipidemia and renal disease (39. 2%, 37. 3%, 35. 5%, 3. 9% respectively). The prevalence of hypertension in age group of >45 years was significantly higher than normal population (p=0.004). The prevalence of diabetes mellitus was also higher than its prevalence in Tehran's population (p<0.001).   Conclusion: Diabetes mellitus, hypertension, hyperlipidemia and renal disease are the most common systemic diseases associated with NAION,and should be considered in the evaluation of NAION.  }, Keywords = { Nonarteritic Anterior Ischemic Optic Neuropathy (NAION),Systemic Disease , Risk Factor}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1250-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1250-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Mohammadi, Sh. and Kadivar, M. and Hassannia, F.}, title = {A Case Report of Giant Cell Reparative Granuloma in the Nasal Cavity}, abstract ={     Introduction: Giant cell reparative granuloma (GCRG) is a rare benign fibrous-osseous neoplasm that mostly involves maxilla and mandible. Only a few cases of GCRG in the nasal cavity have been reported so far.   Case Report: A 37-year-old man was referred to the otolaryngology clinic with the symptoms of left-sided nasal obstruction and bloody discharge since 3 years ago and proptosis since 3 months ago. CT-scan and MRI showed a heterogeneous mass with fluid-fluid level that had caused severe bony destruction. Biopsy confirmed the diagnosis of GCRG.   Conclusion: Although GCRG is rare, its clinical and radiologic characteristics should be studied. This lesion should be considered in differential diagnosis when clinical data, CT-scan and MRI findings show a fibrous-osseous lesion in the nasal cavity.}, Keywords = {Granuloma,Giant Cell, Neoplasm, Surgical Excision}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1249-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1249-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Motevalian, M. and Otukesh, H. and HosseiniShamsabadi, R. and Chalian, M.}, title = {Therapeutic Drug Monitoring of Cyclosporine-A in Iranian Children with Kidney Transplant}, abstract ={  Background & Aim: Cyclosporine-A (CsA) is an immunosuppressant with a narrow therapeutic window. Inter-and-intrapatient variability in cyclosporine pharmacokinetics necessitates frequent blood level monitoring in transplant patients and total blood cyclosporine concentration used to allow dosage adjustment in transplant patients. The purpose of the present study was, first of all, to develop a precise and suitable method for therapeutic drug monitoring (TDM) of cyclosporine in children with renal transplant and to evaluate CsA blood concentrations in patients in order to find out the best time for sampling Iranian children with kidney transplant for TDM of cyclosporine. This can also help us achieve the best immunosuppressant with the least side effects for renal transplant patients.   Patients and Method: In this experimental study, 29 pediatric transplant recipients (16 boys and 13 girls) who had received renal transplant at least six months prior to the study participated. The mean age of the patients was 14. 5 ±2. 3 years (ranging from 8 to 20 years),and they all showed stable renal function. The patients were also receiving other drugs such as prednisolone, mycophenolate mofetil, iron and folic acid. The clinical status of the patients was recorded. The CsA blood levels were determined using radioimmunoassay (RIA) 0, 0. 5, 1, 1. 5 and 2 hours after drug administration. The data analysis was performed using Pearson correlation coefficient.   Results: Our results are indicative of good precision and�reproducibility of the method. Minimum detection limit of cyclosporine-A was 5 ng/ml and percentage yield was 86-109%. Inter-and-intraday variability for three cyclosporine-A blood concentrations were 8% and 5. 8% respectively. The mean blood concentrations 0. 5 and 1 hour after drug administration were 100 ± 3. 0 and 515± 19. 2 μ g/dl respectively. The mean serum creatinine level was 0. 9 (0. 1-1. 9) mg/dl. There was a high correlation between CsA dose, serum creatinin and C1. 5, while there was no correlation between age, serum creatinine and C1. 5 level. Also, there was no correlation between C0 and any of the above-mentioned parameters. These results show that C1. 5 level is the best indicator for TDM of cyclosporine-A in Iranian children and has the best correlation with dose and creatinin level.   Conclusion: The developed method is precise,sensitive and suitable for therapeutic drug monitoring of cyclosporine-A. Using single point monitoring can help to improve the cooperation of patients during TDM procedure, and for this purpose C1. 5 level seems more accurate than C0 level in pediatric transplant patients.}, Keywords = {Cyclosporine-A , Therapeutic Drug Monitoring (TDM),Blood Concentration}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1248-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1248-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Kashefi, F. and Ziyadlou, S. and Fadaee, A. and Ashraf, A. and Jafari, P.}, title = {The Effect of SP6 Acupressure on Primary Dysmenorrhea in Medical Univesity Students in Birjand, 2006-2007}, abstract ={    Background & Aim: Dysmenorrhea is one of the most common problems in gynecology. Almost 50% of all girls suffer from dysmenorrhea and about 10% of reproductive girls are absent from their work for 1-3 days due to dysmenorrhea.Dysmenorrhea accounts for 600 million lost work hours and $2 billion lost productivity annually. Due to the bad effets of severe dysmenorrhea on girls, relieving the pain is important. One of the nonpharmacological methods to relieve dysmenorrhea is acupressure. This study aims to determine the effects of SP6 acupressure on primary dysmenorrhea in medical university students in Birjand between 2006 and 2007. Patients and Method: In a single-blind, randomized, clinical trial, 86 single students with regular menstruation and primary dysmenorrhea were chosen based on the history, interview and observation forms and divided into two groups of real acupressure and pelacebo acupressure. In the acupressure group, at the initial 24 hours of menstruation acupressure at the acupoint was applied to both sides. In the placebo group, at the initial 24 hours of menstruation the subjects were given placebo acupressure twice. The force applied to the acupoint was initially 1/21 kg increasing to 3/53 kg at the end of the therapy. SP6 was pressed with the thumb for 6 seconds and released for 2 seconds without pressure. Two complete cycles of pressure were performed on each leg for a total of 30 minutes. After that, the intensity of dysmenorrhea was measured by visual analog scale, including the rating from 0-10 cm, immediately, 30, 60, 120 and 180 minutes after the intervention. Data were analyzed using statistical tests called repeated measure analysis of variance and general linear model. Results: The results showed that the mean intensity of dysmenorrhea was statistically different between the two groups after the intervention (p<0. 001). Also, the mean intensity of dysmenorrhea immediately, 30, 60, 120 and 180 minutes after the intervention in the acupressure group was lower than that in the placebo group. Conclusion: SP6 acupressure decreased the intensity of dysmenorrhea without any side effects. Therefore, it can be used as an easy, cheap and non-invasive method for dysmenorrhea relief.}, Keywords = {Dysmenorrhea, Nonpharmacological Dysmenorrhea Relief Methods,Acupressure , SP6 Acupoint}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1247-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1247-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Azizjalali, M. H. and Behrangi, E.}, title = {Study of the Prevalence of Tinea Pedis in Swimmers of the West Pools of Tehran in 2007}, abstract ={      Background & Aim: Tinea pedis is one of the most prevalent fungus infections in humans. Since moist conditions probably favor growth of the fungus, the role of swimming pools has been well established in the propagation of dermatophytic foot infections.   Since swimming pools are the most important places for flare-up of clinical symptoms in asymptomatic persons and propagation of infections,and also the treatment of tinea pedis is time-consuming and expensive therefore, it is better to try for prevention of infections. The aim of this study was to determine the prevalence of tinea pedis in swimmers of the west pools of Tehran city in 2007. Yet preventive measures were taken by detecting and referring infected swimmers to medical centers.   Patients and Method: This cross-sectional study was carried out in 2007, in ten swimming pools selected randomly from the swimming pools of regions under the supervision of Iran University of medical sciences. Feet and toe clefts of 2500 regular swimmers, who went to the swimming pool at least once a week, were examined by a dermatologist and from the lesions clinically suspected to be tinea pedis, samples were taken and sent to the laboratory of mycology for direct smear and culture.   Results: Of the 2500 swimmers(1850 males and 650 females) ranging from 5 to 70 years of age, 16 individuals (0. 64%) including 12 males (0. 65%) and 4 females (0. 62%) showed positive culture for dermatophytes The infection was more prevalent in swimmers with an age range of 46-55 years. The main dermatophytes involved in tinea pedis in swimmers were: Epidermophyton floccosum 8 cases (50%), Trichophyton mentagrophyte, var. interdigital 4 cases (25%), and Trichophyton rubrum 4 cases (25%). Other organisms isolated from culture media included Candida, Corynebacterium minutissimum, Aspergillus niger, bactiria and saprophytes.   Conclusion: Our study revealed that tinea pedis was not frequent among swimmers.}, Keywords = {Infection , Tinea Pedis , Swimming}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1246-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1246-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Taheri, H. and Jafari, D. and Shariatzadeh, H. and NajdMazhar, F.}, title = {Introducing a New Pathophysiology of Congenital Clasped Thumb – A Rare Case Report}, abstract ={   Introduction: Congenital clasped thumb refers to spectrum of thumb anomalies with diversity of very mild cases with deficiency in extensor mechanism to severe abnormality in soft tissue and thenar muscles. Hypoplasia and absence of extensor pollicis brevis are usual and the patient is unable to extend the metacarpophalangeal joint of thumb.   Case Report: The present patient is a 12-year-old left-handed boy who has been referred due to bilateral deformity in his thumbs. General physical examination was normal except in his thumbs. The first web space was narrow bilaterally. In spite of full passive range of motion in the joints of thumbs, he was unable to extend the metacarpophalangeal joint of thumbs but he could extend the interphalangeal and carpometacarpal joints. During surgical treatment it became clear that the cause of inability to extend the metacarpophalangeal joint of thumb was not hypoplasia or aplasia of extensor pollicis brevis but abnormal insertion of this tendon. Both extensor pollicis brevis and longus tendons were inserted to the distal phalanx. Reinsertion of extensor pollicis brevis to the base of proximal phalanx was done in the right hand.   Conclusion: This report presents a new pathophysiology for congenital clasped thumb for the first time. According to these findings, in addition to aplasia or hypoplasia of extensor pollicis brevis tendon, abnormal insertion of extensor pollicis brevis to the distal phalanx can be an underlying causative factor in congenital clasped thumb.}, Keywords = {Clasped Thumb , Congenital Malformation, Extensor Pollicis Brevis , Abnormal Insertion}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1245-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1245-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Soleimani, M. J. and ZargarShoushtari, M. A. and Shahrokh, H. and HabibAkhyari, H. and KaffashNayyeri, R. and Fereshtehnejad, S. M. and Asgari, M.}, title = {Comparison Study of the Diagnostic Values of Serum Cystatin C and Creatinine in the Assessment of Renal Function in the Early Follow-up of Renal Transplant Patients}, abstract ={   Background ;Aim: Early detection of decreasing glomerular filtration rate (GFR) is critical to prevent graft rejection in post-transplantation period. Serum creatinine has several drawbacks as a marker of GFR, so serum cystatin C has been proposed as an alternative GFR marker. Thus, we prospectively evaluated the diagnostic value of cystatin C measurements compared with serum creatinine in the early postoperative phase.   Patients and Method: In 78 renal recipients, serum creatinine and cystatin C were measured on the 3rd, 7th and 14th days of post-transplantation period. GFR was established by creatinine clearance with the cut-off point of 80 ml/min/1. 73 m2. The correlation between serum creatinine and cystatin C with GFR was determined. Sensitivity and specificity of these markers were analyzed by ROC procedures.   Results: There were 78 renal recipients (51 males and 27 females) with the mean age of 34. 56± 13. 36 years and mean body mass index (BMI) of 22. 36± 3. 46 kg/m2. Serum cystatin C was not influenced by gender, age and BMI. There was a significant correlation between serum creatinine and cystatin C levels with GFR on the 3rd, 7th, and 14th days (P< 0. 001). Analysis with ROC procedures showed a decrease in GFR (GFR< 80 ml/min/ 1. 73 m2) on the 7th day (P= 0. 023, AUC= 0. 694). Sensitivity and specificity of serum cystatin C were 67. 7% and 77. 9% respectively with the cut-off point of 2264 ng/ml.   Conclusion: Cystatin C has good sensitivity to estimate the renal function in the early post-transplantation period, but its value as a marker of GFR is decreased at the end of the first week.}, Keywords = { Cystatin C , Creatinine , Transplanted Kidney}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1244-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1244-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Rafiee, Sh. and Taghizadeh, Gh. and Karimi, H. and RahimzadehRahbar, S.}, title = {Body Part Identification in 1 to 4-year-old Children Living in South of Tehran}, abstract ={    Background & Aim:�The purpose of this study was to examine the development of body part identification in very young children. Body part identification is defined as the ability to point to body parts on a doll. The second part of this study compared body part identification on a doll with body part identification on the self in 1 to 4-year-old children. There are so many evaluations carried out in western countries,but they aren’t useful for different races, and if some of them are,there is no sufficient information available. Therefore, we decided to survey body part identification in our own country. Patients and Method: This cross-sectional study was performed on 90 children in the south of Tehran. The evaluated children were 1 to 4-year-old,including 46 girls and 44 boys. The nursery chief ,first,completed demographic parts of questionnaires and then the second section of questionnaires which consisted of body part names in order to determine the number of parts indicated for obtaining total grade of the survey. Results: The findings showed that there were significant differences between three age groups (p<.001). There was no significant difference between two gender groups,i. e. boys and girls, in mean scores of body identification on the self in all age groups(p<0. 05),but there was a significant difference between two gender groups in body identification on a doll in 2-3 and 3-4 year-olds(p<0. 05). Finally, there was no significant difference between body identification on the self and on a doll(p<0. 05). Conclusion: These results have several implications for the assessment of body part identification in young children. First, since 1-4-year-old children appear to be able to point to body parts both on a doll and on themselves, they can be asked to point to body parts either on a doll or, if they are reluctant,on themselves. Second,the children who are unable to point to body parts may be at risk for delays in language, cognition, and body scheme developmenttherefore,they should be screened or evaluated further.}, Keywords = {Body Image, Body Part Identification,Child Development}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1243-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1243-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Delshad, S.}, title = {Evaluation and Comparison of One-stage Surgery versus Two-stage Surgery in Children with Intersex Conditions due to Adrenal Hyperplasia}, abstract ={  Background & Aim:Many factors such as chromosomes, gonads, hormones and enzymes influence the development and differentiation of embryonic external genitalia. Any defect in these factors leads to intersex condition, a term used to describe discrepancy between external and internal genitals. Physical and emotional complications arising from genital ambiguity may be prevented by appropriate assessment and planning. This study investigated methods of treating patients with genital ambiguity and compared the results of two-stage surgery with one-stage surgery in the more common form of disorders of sexual differentiation that is female pseudohermaphroditism due to adrenal hyperplasia.   Patients and Method: A retrospective study was employed to evaluate the records of 65 patients undergone genital reconstructive surgery in Ali Asghar Children's Hospital, Tehran Children's Hospital, and Seyed-al-Shohada charity Hospital. 50 patients had female pseudohermaphroditism with adrenal hyperplasia origin and 15 patients had other types of intersex disorders. The timing of performing one-stage surgery was between 3 and 6 months of age and for the two-stage type of surgery, the second procedure was performed when the patient was between 5 and 6 years of age. Forty-eight patients with female pseudohermaphroditism underwent clitoroplasty, labioplasty and vaginoplasty to change the masculine external genitalia to feminine. In one-stage group, these procedures were completed concurrently, while in two-stage type, clitoroplasty and labioplasty were done at the age of 3 to 6 months and vaginoplasty was performed when the patient was 5 to 6 years of age.   Results: 36 out of 48 cases of female pseudohermaphroditism due to the adrenal gland hyperplasia underwent one-stage surgery. 12 cases had a two-stage surgery in which clitoroplasty and labioplasty were performed at the age of 3-6 months and vaginoplasty when the patient was between 5 and 6 years of age. Vaginal opening stenosis being the most common post-surgical complication was not observed in 41. 7% of one-stage surgery group and 75% of two-stage type. The obtained difference was statistically significant (p-value=0. 047).   Conclusion: In comparison to one-stage surgery, vaginal opening stenosis was not observed in two-stage surgery therefore, two-stage surgery is considered a better method to treat patients with genital ambiguity.}, Keywords = {Genital Ambiguity, Intersex ,Adrenal Hyperplasia}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1238-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1238-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {JabalAmeli, M. and Yeganeh, A. and Nojomi, M.}, title = {Axial Alignment of Lower Extremity in Adults}, abstract ={  Background & Aim: Normal axial alignment restoration in lower extremities is very important for surgeons that perform reconstructive surgeries. Since normal values of axial alignment in Iranian population aren't available, normal values in western countries are used in practice.   In this study axial alignment norms in Iranian adults were determined and the results were compared with those of the studies in China and America.   Patients and Method: Through a cross-sectional design, axial alignment view of lower extremities was taken in 68 volunteers (34 males & 34 females) between 18 and 32 years old. The. average of axial alignment angles was measured. Data analysis was done by t-test and the existence of correlation was examined by using SPSS software. Then the results were compared to those obtained by the studies in China and America.   Results: The average angle between anatomical axis of femur and tibia was 5. 10 ,which was different from 60 in western countries studies.   Medial proximal tibial angle was 86. 30 ,which was different from Chinese and American studies.   The angle between mechanical axis of femur and tibia was 178. 50,which was not different from past studies. Tibia, in this study, had 0. 9 degrees tibia vara. and ankle was of 1. 7 degrees in valgus.   Conclusion: Lower extremity axial alignment angles in Iranian adults are different from those in Chinese and American adults. Based on the angle between anatomical axis of tibia and femur, women's knee has 1. 60 more valgus than men's. No correlation was found between axial alignment and height, weight, tibia and femur length.  �}, Keywords = {Lower Extremity Alignment , Femoral Axial Alignment,TibiaL Axial Alignment}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1237-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1237-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Jalesi, M. and Kamrava, K. and Doroudinia, A. and SahraneshinSamani, Sh. and Hamdarsi, N. and Pousti, B. and Izadi, F.}, title = {Mortality Rate in Patients Admitted to Otolaryngology Ward of Hazrat Rasoul-e-Akram Hospital between 1992 and 2003}, abstract ={    Background & Aim: Mortality statistics can be used in assessing course of diseases at the level of a hospital, a city or a country in order to evaluate the quality of health care systems. The aim of this study is to define the prevalence and common causes of otolaryngology-related deaths in otolaryngology ward of Hazrat Rasoul-Akram Hospital during an 11-year period. Patients and Method: In this retrospective study, all patients who had been hospitalized in ENT Ward and died thereafter were included. The individual medical records were then reviewed and information such as demographic data (age and sex), primary complaint, root and duration of hospitalization, diagnosis, treatment modalities, and place of death was recorded ethically and mentioned as descriptive statistics. Results:Among a total of 19266 admitted patients, 25 fatalities were recorded, showing an average of 1. 29 per 1000 admissions. Female to male ratio was 1. 27:1. The highest and the lowest mortality rates belonged to the age groups of over 50 and under 30. Malignancy was the first cause of death (28%) followed by severe infection or abscess of head and neck (24%). Conclusion: Compared to hospitals in other countries,the prevalence of mortality due to ENT causes in this teaching hospital showed a better health care condition in this ward. The most common causes of death in ENT Ward were malignant neoplasms and head & neck infections respectively.}, Keywords = { Mortality, Era, Nose and Throat (ENT), Prevalence}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1236-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1236-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Meratan, A. A. and Bigdeli, M. R.}, title = {Study of Prolonged and Intermittent Effects of Normobaric Hyperoxia Preconditioning on Glutathione Peroxidase Activity in Rat Stroke Model}, abstract ={  Background & Aim: Ischemic preconditioning (IPC) is an endogenous phenomenon that can induce ischemic tolerance (IT) in a variety of organs such as brain. In this study, we examined the intermittent and prolonged effects of normobaric hyperoxia (HO) on neurologic deficit scores, infarct volume, and glutathione peroxidase activity.   Material and Method: This experimental study was done in Shahid Beheshti University. The rats were divided into four main groups. The first two main groups were exposed to HO in prolonged (24hrs PrHO) and intermittent (4hrs×6days InHO) ways and the second two groups acted as controls and were exposed to 21% oxygen in the same chamber (room air, RA) continuously (24hrs PrRA) and discontinuously (4hrs×6days InRA). Each group was divided into three subgroups. After 24 hours,the first subgroup was subjected to a 60-minute MCAO followed by 24hrs of reperfusion. Then,the IT induced by InHO and PrHO was measured through neurologic deficit scores and infarct volume. The second and third subgroups were called sham __ operated and intact subgroups __ and used for the assessment of the effect of HO on glutathione peroxidase activity. Enzyme activities, arterial blood gases, and infarct volume were compared using one-way ANOVA test. The neurologic deficit scores were analyzed using the Mann-Whitney U test.   Results: Our findings indicate that InHO and PrHO are involved in the induction of IT. Pretreatment with InHO and PrHO can reduce neurologic deficit scores and infarct volume and increase glutathione peroxidase activity significantly. The catalase activity of prolonged HO groups was significantly more than that of intermittent HO groups.   Conclusion: Although further studies are needed to clarify the mechanisms of ischemic tolerance, InHO and PrHO seem to partly exert their effects via increasing glutathione peroxidase activity.}, Keywords = {Preconditioning,Ischemia,Glutathione Peroxidase,Stroke ,Normobaric Hyperoxia}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1235-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1235-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Imani, F. and Entezary, S. R. and TaghipourAnvari, Z. and MoradiLakeh, M.}, title = {Comparison of Remifentanil with Alfentanil for Endotracheal Intubation}, abstract ={  Background & Aim: Opioids, such as alfentanil, are used without neuromuscular blocking agents to facilitate endotracheal intubation in patients undergoing elective surgery. The goal of this study was to evaluate the possibility of endotracheal intubation with propofol and remifentanil and compare it to propofol and alfentanil, without neuromuscular blocking agents.   Patients and Method: A hundred ASA I patients undergoing elective inpatient surgery were scheduled in this prospective, randomized, double-blind study. The patients were divided into two groups: alfentanil (control group) and remifentanil (study group). In the control group, 50 μg/kg alfentanil was IV injected over 10 seconds, and after 45 seconds or occurrence of apnea, 2 mg/kg propofol was IV injected over 5 seconds. Thirty seconds after the administration of propofol, laryngoscopy and tracheal intubation were attempted. In the study group, only 5 μg/kg remifentanil was administered instead of alfentanil. Intubating conditions were assessed on the basis of ease of laryngoscopy, vocal cords opening, jaw relaxation, and limb movement (1 - 4 score). Intubation scores were analyzed by nonparametric tests and compared between the two groups.   Results: There were no demographic differences such as age,weight and sex between the groups. Although, laryngoscopy, jaw relaxation, and limb movement scores were similar in both groups and there were no significant differences, vocal cord opening was significantly wider in the study group than the control group(P = 0. 028).   Conclusion: This study revealed that the use of propofol and remifentanil provided excellent conditions for tracheal intubation in most patients in the same way as propofol and alfentanil, and the score of vocal cord opening in the study group was better than alfentanil group. Therefore, to avoid administering muscle relaxants , remifentanil and propofol can be used for laryngoscopy and endotracheal intubation in healthy young patients.  }, Keywords = { Alfentanil, Remifentanil, Propofol}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1234-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1234-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Izadi, F. and Iravani, K. and Abdolmotalebi, F.}, title = {Efficacy of Surgical Managements in Patients with Subglottic Stenosis Referred to Rasoul-e-Akram Hospital}, abstract ={    Background & Aim: Subglottic stenosis affects the quality of life greatly and on occasion may compromise to life. There are multiple surgical managements for it,and each has its own advantages and disadvantages. The aim of the present research was to define success of surgical techniques in patients with subglottic stenosis referred to Rasoul-e-Akram Hospital. Patients and Method: This cross-sectional study was performed on 42 patients referred to otolaryngology department of Rasoul-e-Akram Hospital between 2000 and 2007. Before performing operation,the degree and length of stenosis was defined by direct laryngoscopy and endoscopic examination. Based on the success of decannulation and direct laryngoscopy, the efficacy of operation was evaluated. Statistical analysis was done by t-test and Chi-square. Results: The mean age of the patients was 23. 3 years with standard deviation of 11. 2. 32 patients (76%) had history of prolonged endotracheal intubation. In 23 patients, endoscopic surgery was done with laser or cold microsurgery or bugienage. 19 patients underwent open surgery which included 16 cases of laryngofissure with stent and 3 cases of resection with end-to-end anastomosis. The overall success of operations was 73%. Conclusion: Selection of proper method and technique in successful management of these patients is very important. In our study, the highest percentage of success was through resection and anastomosis and then with laryngofissure.}, Keywords = {Subglottic Stenosis , Laryngofissure, Laryngeal Stent}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1233-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1233-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Ansari, Sh. and Vossogh, P. and Dahanzadeh, M.}, title = {Outcome of Treatment and Survival Analysis in Pediatric AML Non APL in Ali Asghar Children’s Hospital (1988-2003)}, abstract ={     Background & Aim: AML accounts for about 15% of all childhood leukemia. The improvement has been seen over the past decades after treating with chemotherapy alone. The outcome has been better for children and it has had long term survival for all patients treated with BFM protocol chemotherapy. The aim of the present study was to investigate long-term survival in patients referred to Ali Asghar Children's Hospital.   Patients and Method: The study was carried out on all 83 children with nonAPL AML who had been treated based on BFM protocol from 1988 to 2003 in Ali Asghar Children’s Hospital and did not receive blood or a marrow transplant. Through this study, information about sex, age, type of subgroup, clinical signs, treatment and survival (event free survival) was gathered in order to have better treatment and follow-up. This study was carried out as Cohort survey and the obtained data was analyzed via SPSS software.   Results: Of 83 patients, 55 were male and 28 were female. The mean age of the cases was 7. 3 years old, ranging from 6 months to 13 years. 4% of the patients died during remission from complications of therapy. 10 patients (12%) did not respond to treatment after chemotherapy. 69 of the cases (83. 1%) gave complete response to therapy. Mean duration of follow-up was 5. 5 years. 36. 1% (30 cases) of the patients suffered relapse. EFS (event free survival) of the patients was 53. 62 ± 6%, and 5-year survival was 44. 58 ± 5. 46%.   Conclusion: 30-50% of the patients treated with BFM protocol chemotherapy had long-term survival,while bone marrow transplant could raise long-term survival to 60-70%.  }, Keywords = {AML (acute myeloid leukemia) , Long-term Survival,Bone Marrow Transplant , Chemotherapy,BFM Protocol}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1232-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1232-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Ehsanipoor, F. and Ardalan, M.}, title = {Study of the Correlation between Acetaminophen Consumption and CSF Glucose in Febrile Convulsion}, abstract ={   Background & Aim : Hyperglycemia and hyperglycorrha ch ia are common associations of febrile seizures. Rapid release of cortisol and adrenaline after seizures as a stress reaction induces elevated glucose concentration. During fever release of interleukin-1 beta, an endogenous pyrogenic cytokine, inhibits insulin release and stimulates the secretion of cortisol. This may explain the correlation between CSF glucose concentration and body temperature in the present report . The purpose of our study was to assess the correlation between acetaminophen consumption and CSF glucose in febrile convulsion.   Patients and Method : In this cross-sectional analytic study ,we analyzed CSF samples taken from 63 children with febrile convulsion whose ages ranged from 3 to18 months. Comaprisons between the mean CSF glucose concentrations in the children who had taken and not taken acetaminophen within 6 hours before convulsion were made using Students' t-test and Mann-whitney test.   Results: CSF glucose levels were significantly higher (P =0. . 0001) in children who had not taken acetaminophen (82±8 mg/dL, n =) as compared with children who had taken acetaminophen (53±4 mg/dL, n=).   Conclusion: The use of acetaminophen decreases CSF glucose concentration in febrile convulsive children.}, Keywords = {CSF Glucose, Acetaminophen, Febrile Convulsion}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1231-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1231-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Nakhaiy, B. and Motabar, A.R. and Haghighi, S.}, title = {Primary liposarcoma of liver : A case report & literature review}, abstract ={     Introduction: Liver neoplasm is not an uncommon disease in Asian countries. Liposarcoma is a rare mesenchymal malignant tumor which usually originates in the retroperitoneum and extremities .From 1973 uptil now about 10 cases of primary liver liposarcoma have been reported.In this article we present the eleventh case in a young adult female.   Case report: The patient was a 21 year old female who presented with fever, dyspnea and abdominal pain.She suffered from huge mass in the right lobe of liver with constitutional symptoms and respiratory distress. Despite aggressive surgery, the tumor recurred after six months and led to her death after a year.   Conclusion: Hepatectomy is the best strategy to achieve a long term survival in these patients, as the tumor is highly invasive, has an increased rate of recurrence and the effect of radiotherapy and chemotherapy is unclear.}, Keywords = {Liver , Liposarcoma , Hepatectomy}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1269-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1269-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Jabbari, M. and TalebiTaher, M. and Jaffari, F. and Jenabi, A.}, title = {The Relation Between Bone Density and Sexual Hormone in Men with Chronic Renal Failure}, abstract ={   Background and Aim: Patients with Chronic Renal Failure (CRF) are at high risk of renal osteodystrophy, and this condition develops at the early stages of chronic renal failure and covers a spectrum of bone changes such as osteoporosis. Hypogonadism is common among men with CRF. Many of the manifestations of hypogonadism such as bone disease, are also frequently seen among dialysis patients. The goal of this study was to determine the levels of testosterone, PTH, LH, BUN, Cr, and Alkaline phosphatase (Alk.p) in men with CRF in two groups with normal and abnormal bone densitometry.   Patients and Methods: In this cross-sectional study, 63 patients with CRF were evaluated. Bone mineral densitometries (BMD) by DEXA method were requested for all patients. The level of testosterone, PTH, BUN, Cr, Alk.p and LH were compared in two groups with normal and abnormal densitometry. The results were analyzed by Pearson, T and Chi-square tests. A p value of <0.05 was regarded as a significant level.   Results: Sixty three patients were studied in this research. The average age of the patients was 50.58±13.32 years. We found significant relation between age, level of testosterone and PTH between patients with normal and abnormal BMD(p value<0.05).   Conclusion: Osteoporosis is an important finding in CRF patients and another study to determine the beneficial results of testosterone replacement therapy is recommended.}, Keywords = {Chronic Renal Failure (CRF), Bone density,Male sexual hormone}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1268-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1268-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Nourozi, M. and Naderi, M.N. and Mahdavi, S.M. and Jaafari, D. and Khosravi, A.}, title = {Study of the Surgical Treatment Outcomes of Distal Intra-articular Humerus Fractures: Evaluation of 46 cases}, abstract ={    Background and Aim: Intra-articular fractures of distal humerus in adults present a controversial challenge for orthopedic surgeons. Minor irregularities of the joint surface of the elbow usually cause some loss of function. This can usually be minimized by early, accurate open reduction with sufficiently rigid fixation to permit immediate motion. The posterior approach combined with Olecranon osteotomy and fixation with the two plates at right angles, a medial plate on the medial column and a posterior plate on the lateral column, is considered the standard of care of displaced intra-articular distal humeral fractures (AO type C). The purpose of this study was to evaluate the results of the treatment of intra-articular fractures of distal humerus. Patients and Methods: In this descriptive –croos sectional study we evaluated 46 patients (18 females & 28 males) with a mean age of 31.22 years, who had intra-articular fractures of distal humerus (Type C1- 17 and C2 & C3-17) and were operatively treated between 2000 and 2005. After a standard posterior approach with Olecranon osteotomy, internal fixation was achieved with unilateral or bilateral plates and screws. The outcome measured variables were pain scale, range of motion, the ability of daily activities, infections, nerve injuries, radiological assessments (mal:::union:::, non-:::union:::, malalignment, …), joint stiffness, osteoarthritis, recurrent bursitis, instability and need for fixation.�We used the SPSS software for statistical analysis of data. The main indices that we used were frequency and percent.For statistical analysis Kendall's and Fisher's exact tests were used. p<0.05 was considered as statistically significant.Results: There was no pain after surgery in 16 patients (34.8%). Mild pain in 17(37%), moderate pain in 11(23.9%) and severe pain was reported in 2(4.3%). The range of motion in 24 patients (52.2%) was more than 100 degree. It was 50 to 100 degree in 18(39.1%) and less than 50 degree in 4(8.7%). The ability to perform�previous daily activity was "as before" in 14 patients (30.4%). It was "partially as before" in 26(56.5%) and "decreased activity" in 6(13%). Superficial infection was detected in only 2 (4.3%). None of the cases had deep infection.Only 2 of patients (4.3%) had ulnar nerve injury. Meanwhile 3 (6.5%) had non :::union:::.Conclusion: The surgical repair of an intra-articular distal humerus fracture (especially the transolecranon approach for good visualization, routine ulnar nerve exploration and rigid internal fixation) is an effective procedure that permits early rehabilitation in these complicated fractures.}, Keywords = {Distal humerus, Intra-articular fracture,Olecranon osteotomy}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1267-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1267-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Ehsanipour, F. and Shayanfar, N. and Salariyan, K.}, title = {Surveying of Protective Antibody against Varicella zoster Virus (VZV) Infection in Children Referring to Hazrat-e- Rasool Akram Hospital (2005)}, abstract ={  Background and Aim: Varicella is a common, highly contagious disease. It is usually benign, but has potentially serious complications especially in the infants, adults, pregnant women and immunodeficient patients. This study was planned to evaluate the protective antibody against Varicella zoster virus infection (VZV) in children that had referred to Hazrat-e- Rasool Akram Hospital.   Materials and Methods: In this cross-sectional study, VZV infection was studied by determining the presence of IgG and IgM antibody using EIA method. One hundred twenty serum samples were collected from children that referred to Hazrat-e- Rasool Akram Hospital. Individuals' age ranged between   1-16 years (4/5±3/71 yr). The results were analyzed by t-test and Chi-square test.   Results: VZV infection was 42.5% (51 out of 120). Seroprevalence rate for protective antibody against VZV in different age groups was 30.66% (1-4 years), 55.55 %( 5-8 years), 66.66 %   ( 9-12 years) and 83.33% (13-16years).   Conclusion: There was a correlation between age and the presence of anti-VZV antibody in the serum (p<0.05). We recommend VZV vaccination to be ideally administered to children 12 months of age and older.}, Keywords = {Varicella ,Protective antibody, Pediatrics}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1266-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1266-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Razavi, S.M. and RezaeeSalim, M. and Attarian, H. and Rafat, J. and Mortazavizadeh, S.M. and Shirali, A. and Sharifipour, E.}, title = {Comparison of the Effect of Standard Chemotherapy and its Combination with Cetuximab on the Survival of Patients with Progressive Colon Cancer}, abstract ={  Background and Aim: Recent advances in molecular and cellular biology and the importance of Epidermal growth factor receptor(EGFR) in the development and progression of many solid malignancies such as Colorectal Cancer (CRC) and non- small cell lung cancer have allowed rapid advances in rational drug design and targeted therapies for malignancies.Cetuximab or Erbitux, an IgG1 monoclonal antibody that targets the EGFR,is one of the most recent treatments for advanced colorectal cancer.   The aim of this study is the comparison of "standard chemotherapy" with "combination of standard chemotherapy and Cetuximab" in the survival of advanced colon cancer patients.At the time of this trial, the K –ras mutation wasn’t defined as a cause of response to monoclonal antibody.   Patients and Methods: Ninty-one patients with relapsed advanced CRC were enrolled in this semi -experimental trial.The age of patients was between 20 to 80 years. We randomly selected 47 patients to receive standard chemotherapy and 44 patients to receive chemotherapy and Cetuximab(combined therapy). Duration of treatment was based on the factors such as serious drug reactions to, death or reaching therapy allotted time of the treatment. Thus survival was measured in the two groups.   After gathering the information, they were presented in the form of statistic and numeral tables. We used Kaplan Meier table to evaluate the survival analysis and Logmar and Breslow tests for the comparison between the survival time of two groups .We also evaluated the number of deaths with Chi square and Fisher's exact tests.The p-value was defined as 5% and all the analyses were done with SPSS V.15.   Results: Since June 2004 to November 2007, 91 patients aged 20-76 years and kf>60% with refractory advanced CRC were evaluated. Forty –four patients (48%) received combination therapy and 47 (52%)cases received combined monotherapy with chemotherapy regimen. Among the 47 patients on standard therapy, 18 (38.3%) and among 44 patients on combination therapy 13 (29.5%) expired. Median survival in standard therapy was 236 + 20 days and in combination therapy was 301 + 27 days(p=0.2011).   Conclusion: Although Cetuximab improves the response rate and disease progression as compared to standard chemotherapy,combination therapy (cetuximab and standard chemotherapy) does not have any significant difference in regard to survival of patients with advanced CRC.}, Keywords = {Monoclonal antibody, Colon cancer,Survival}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1265-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1265-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Alboeh, M.R. and Tabasi, M. and Emani, F. and Entezry, S.R.}, title = {The Effect of Adding Dexamethasone to Sodium bicarbonate and Lidocaine 1.5% on the Onset and Duration of Axillary Block as well as Post Operative Analgesia in the Upper Extremity Procedures}, abstract ={  Background and Aim: Many different routes have been introduced for prolonging the duration of axillary block in upper extremity procedures. In this study the effect of adding dexamethasone to lidocaine during axillary plexus block has been studied.   Patients and Methods: This study was designed and performed as a double blind randomized clinical trial.The patients candidated for upper extremity procedures in Hazrat Fatemeh Hospital operation room, entered the study based on inclusive and exclusive criteria.The patients were divided in to two 30-person groups randomly. For axillary block in the first group (control or lidocaine group), a combination of 34cc lidocaine1.5 %, 2cc sodium bicarbonate and 2cc distilled water was used in the second group(dexamethasone group) the utilized solution was similar to that used in the first group but with 2cc of dexamethasone (8 mg) used instead of distilled water. The onset of sensory, motor and sympathetic block, duration of sensory and intensity of post operative pain was measured and recorded.The data was analysed with SPSS V.13.The quantitative data was displayed with mean and standard deviation. The qualitative data was displayed with frequency.The Chi square and t-tests were used for quality data quantity data, respectively.   Results: The onset of sensory, motor and sympathetic block was similar in both groups and no significant statistical difference was present.The duration of the block and the time of the first request for analgesia post operatively were meaningfully longer in the dexamethasone group than lidocaine group(control group). Also the intensity of post operative pain from recovery to 6th hour after operation was meaningfully less in dexamethasone group than in control group.   Conclusion: This study revealed that addition of dexamethasone to the combination of sodium bicarbonate and lidocaine for axillary plexus block can prolong the duration of block.Increase in the duration is more prominent for sensory than motor block. Meanwhile the post operative analgesia in this group was more than lidocaine group.}, Keywords = {Axillary plexus block ,Lidocaine,Dexamethasone,Sensory block, Motor block}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1264-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1264-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Tajik, N. and Jafari, M. and Nasiri, M.R. and Mousavi, T. and Farnia, P. and Salekmogaddam, A.}, title = {The Study of the Association Between Vitamin D Receptor Common Genetic Polymorphisms and Susceptibility to Pulmonary Tuberculosis}, abstract ={  Background and Aim: In addition to exposure to Mycobacterium tuberculosis (MTB), development of tuberculosis is influenced by environmental and host genetic factors, and clinical disease only occurs in less than 10% of the infected individuals. Vitamin D metabolism leads to activation of macrophages and restricts the intracellular growth of mycobacterium. This effect may be influenced by polymorphisms in the vitamin D receptor (VDR) gene. In the present study we investigated the impact of VDR gene variation in susceptibility to pulmonary tuberculosis.   Materials and Methods: This study was a case-control analysis in an Iranian population. We evaluated four VDR gene polymorphisms [defined by the presence of restriction endonuclease sites for FokI (F/f), BsmI (B/b), TaqI (T/t), and ApaI (A/a)] in 96 patients with tuberculosis and 122 matched healthy controls. A modified polymerase chain reaction with sequence-specific primers (PCR-SSP) technique was used to identify these polymorphisms in VDR gene simultaneously.Chi square was used for data analysis.   Results: Comparison of allele and genotype frequencies for the above VDR gene polymorphic sites revealed no significant difference between patient and control groups.   Conclusion: This data may rule out the importance of VDR gene polymorphisms in susceptibility to tuberculosis among Iranian population.}, Keywords = {Pulmonary tuberculosis,Vitamin D,Vitamin D receptor,Genetic polymorphism}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1263-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1263-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Sharafi, A.A. and Khoshgard, K. and Nikoofar, A.R.}, title = {Measurement of the Absorbed Dose by Bladder and Rectum in the Radiation Therapy of Prostate Cancer by Thermoluminescent Dosimetry Method}, abstract ={Background and Aim: Increased mortality rate�due to prostate cancer shows the growth of this disease.Prostate cancer is the second most widespread malignancy after lung cancer in men.It is important to use new methods in the radiation therapy of prostate cancer that are associated with lower exposure of the normal tissues. Nowadays, in most of the radiotherapy centers in our country, the Co-60 Unit with 2-dimensional treatment planning system is used for radiotherapy of prostate cancer. Therefore, it is essential to evaluate and verify the absorbed dose in the�critical organs such as bladder and rectum to prevent the side effects.In this study, the absorbed dose by these organs was measured in the process of radiotherapy of prostate cancer. Materials and Methods: In this experimental study the received dose by rectum and bladder, in the 2-dimensional treatment planning for radiotherapy of prostate cancer, was measured on tissue-equivalent and anthropomorphic phantom using Thermoluminescent dosimeters (TLD-100). The results were compared with the calculated values in the treatment planning software by t-test statistical method. One-sample Kolmogorov-Smirnov was also used for data analysis. SPSS V.15 was used for data evluation.Results: The measured values of the absorbed dose by bladder and rectum were 236.8±14.9 cGy and 257.3±17.5 cGy, respectively. Results showed the measured absorbed doses in the phantom were significantly higher than estimated values (bladder: 162.4±2.2 cGy and rectum: 158.9±2.4 cGy)than from the treatment planning software (p <0.05). Conclusion: As the results show, the absorbed doses of bladder and rectum are higher than the calculated values by the software. In practice in the 2D treatment planning, one slice of CT-scan image is used for drawing.Meanwhile the tissue inhomogeneties in the body are 3-dimensional therefore the calculated volume of the target and organs at risk will be unprecise. This will lead to uncertainty in the calculation of the absorbed dose. In addition the effect of scattering due to tissue inhomogenities is added to this uncertainty.Thus, when using the�2D treatment planning, it is recommended to remember that the absorbed doses of bladder and rectum are significantly higher than those calculated on software.}, Keywords = {Radiation therapy, Prostate cancer,Thermoluminescent dosimetry,Absorbed dose of bladder and rectum}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1262-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1262-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Salehi, H. and AnjomRooz, S.H. and Zare, R. and Soltanpour, N.}, title = {A Case Report of Stump Appendicitis}, abstract ={    Introduction: Although rare, inflammation of the appendiceal stump can occur and is still an important clinical entity. Recently there has been an increase in stump appendicitis.Case report: In this study, appendiceal stump was observed in an 18-year-old man who had presented with right lower quadrant abdominal pain and had history of appendicectomy 7 months earlier. Recurrent appendicitis was noted in the appendiceal stump.Discussion: Stump appendicitis should be considered by the surgeon when presented with a patient with acute abdominal pain and a past history of appendectomy.}, Keywords = {Stump appendicitis, Appendectomy, Abdominal pain}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1280-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1280-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Sarookhani, M.R. and Ahmadi, M.H. and Amirizadeh, N.}, title = {Rare and Unexpected Beta Thalassemic Mutations in Qazvin Province of Iran}, abstract ={   Background and Aim: About 13 beta-globin mutations encompass 70-90% of the mutation spectrum in Iran. These mutations are called common beta-globin mutations. The rest are rare or unknown mutations. The objective of this study was to identify the rare or unknown beta-globin mutations in Qazvin province.   Materials and Methods: In this descriptive-analytic study, EDTA-containing venous blood samples were collected from 100 patients with transfusion-dependent beta-thalassemia referring to Qods hospital of Qazvin. Age, sex, ethnicity, history and consanguinity between parents were recorded by reviewing the patients files. Screening for causal mutations was carried out on DNA isolated from WBCs of the patients by using ARMS technique. To explore the other mutations in the beta globin gene, direct sequencing analysis was applied for DNA samples when no mutation was detected with ARMS. For data analysis SPSS V. 13.5 was used.   Results: Based on the results, 85.9% of alleles were identified by ARMS technique, while direct sequencing uncovered the remaining alleles (14.1%). Total 20 different mutations discovered by this two-step approach (11 mutations with ARMS and 9 mutations with sequencing). Abundant alleles   (IVS-II-1, IVS-I-110, FSC8/9) accounted for 59.3 % of the mutations. IVS-II-1 with a frequency of   31.3% was the most common, while nt-30, IVS-I-6, Cd5, IVS-II-745, 5´ UTR, Cd15, Cd39, IVS-I-130, Cd24, Cd74/75, HbS and Hb Monroe mutations were observed with the least frequency (each about 1% or less).   Conclusion: Molecular analysis of beta thalassemia has shown that in addition to the common mutations, many rare beta-globin mutations responsible for the disease are present in the Qazvin population.We have revealed the existence of 8 rare mutations from Qazvin, two of which (Cd74/75 and Hb Monroe) are the first reported in Iran.}, Keywords = {Rare thalassemia mutations , Beta globin gene,Direct sequencing }, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1279-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1279-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Mehrsai, A.R. and Afsharpad, M. and Naderi, F. and Shekarpour, L. and Hosseinejad, K. and Pourmand, Gh.R.}, title = {Evaluation of the Underlying Risk Factors for the Delay in Referring Children with Urologic Infections to Sina and Bahrami Hospitals From 2001-2007}, abstract ={  Background and Aim: Urologic infections are common infections, among which pyelonephritis is the most common. Only in United States of America they cause more than 1.1 million patient referral annually. Treatment costs for these infections are about 180 million dollars a year. Although mortality and morbidity caused by theses diseases are high, but the treatment, if done on time, is not hard and could prevent from irreversible complications such as chronic renal failure and scar.   The aim of this study was to identify the reasons of delayed referral and underlying risk factors for this delay in children with urinary tract infection, in order to find a solution and decrease the associated complications and cost fees.   Patients and Methods: This study is a case series study. Our target groups were children with urinary tract infections that had referred to Sina and Bahrami Hospitals. Inclusion criteria included: 1- age between 1-10 years, 2- no functional complications of urinary tract, 3- a positive urine culture.   Then questioned variants (age, sex, pathogen, etc) were gathered and later analyzed and the results were reported. To analyze our data we used SPSS V. 11.5. Descriptive data were shown as mean and standard deviation. To compare the data we used Chi2 and t test. p= 0.05 was considered as meaningful.   Results: Among our 185 patients with age range of 1 to 10 years (mean age of 5.4 yr), 57% were females and 43% were male. Meanwhile 15.9% of our patients had referred to hospital with symptoms of sepsis and 2.2% with septic shock. Our results did not suggest sex as a risk factor for referral delay. We observed that 2.2% of the children in our study were hospitalized with septic shock. Other results are shown in tables.   Conclusion: Generally, the most useful method in preventing referral delays of children to hospitals and care centers are parental and prenatal education, education through mass media and informing them of the complications due to referral delay of a simple infections such as UTI.These methods can easily lessen the number of referral delay among children and thus decrease the complications and hospital costs.  }, Keywords = {Urologic infection , Pyelonephritis , Referral delay}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1278-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1278-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {HassanpourOnji, S. H. and Ghofrani, M. and TaheriDeraksh, N. and Ziaee, A. R.}, title = {Determining the Risk Factors of Recurrent Febrile Seizure in Children Referring to Hazrat-e-Ali Asghar Childrens Hospital}, abstract ={    Background and Aim: Febrile convulsion is one of the common problems in children aged between5 months to 6 years old.While some areas have a prevalence rate of 10%, world prevalence is only2-4%. Although world wide studies show that the use of anticonvulsive drugs like Phenobarbital may decrease the rate of seizure attacks, but it may be associated with multiple complication such as behavior disorders, learning disability, drowsiness, dizziness and ataxia. Positive family history, severity and frequency of seizure, degree of fever, age of onset of seizure, developmental delay, and abnormal neurological exam are the factors that influence the recurrence of seizure. The goal of this study is the evaluation of the risk factors for recurrence of febrile convulsion, its correct management, prevention of the future attacks and its complication.   Materials and Methods: This is a prospective discretional study. Out of 432 patients aged under 15 yrs that had referred with febrile convulsions to the Neurology clinic of Hazrat-e Ali Asghar Hospital in a period from December 2003- December 2005, 103 children with "recurrent febrile convulsion" were selected on the basis of history, physical examination, clinical and paraclinical findings recorded in a questionnaire especially prepared for the recognition of risk factors for recurrence of febrile convulsion.   Results: In this study, 62% were males and 34% (39) were girls.As the tables show, patients under the age of one year made up most of the cases (37 patients, 35%).Meanwhile, 48 patients had temperatures between 38 to 39 ° c at the onset of the seizure and time duration between the fever and oset of seizure in 44% of the cases was more than 1 hour. In 24(23.5%) of cases, the first episode of seizure lasted for 15-20 minutes and in less than 10% of patients the duration of the seizure was less than 5 minutes. Also, 57.5 % of the patients had generalized tonic-clonic seizures and in 68.5% seizure attacks recurred twice.The most frequent causes of fever in this study were upper respiratory tract infections (31.75%) and lower respiratory tract infection (14.5%), respectively. In paraclinical evaluation, 72% of the EEGs, 41% of the MRIs and 34% of the CTscans were abnormal. Forty eight patients (46.5%) had problems such as asphyxia and meconium aspiration at the time of birth, 25% had developmental delay and 42% has abnormal neurological examination. Finally, 37.8% of the children were the result of familial marriage.   Conclusion: This study shows that positive family history of febrile seizure, young age, short duration between fever and onset of seizure, abnormal neurological examination, developmental delay, and abnormal EEG can be risk factors in recurrence of febrile convulsion, and it is necessary to consider these factors in children with febrile convulsion.}, Keywords = {Febrile convulsion, Risk factor, Recurrent seizure, Children}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1277-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1277-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Falahati, M. and Sharifinia, S. and Foroumadi, A. R. and Bolouri, F. and Akhlagh, L. and YazdanParast, A. and Haghani, H.}, title = {Drug Resistance Pattern in Candida Species Isolated from Vaginitis}, abstract ={  Background and Aim: Candidial vulvovaginitis (CVV) is a female genital system infection that occurs due to the overgrowth of Candida species,especially with Candida albicans.This condition may become recurrent.The long administration of the current antifungal drugs may cause resistance. Therefore it is essential to understand the efficacy pattern of therapeutic agents against the isolated Candida species from vaginitis. The aim of this research was the investigation of the antifungal drug resistance pattern in Candida species isolated from vaginitis against azole current drugs.   Materials and Methods: This was an experimental-descriptive study that was performed on 150 suspected patients.All specimens were examined under direct microscopy and culturing. Furthermore, complimentary tests such as culture on candida chrom agar, corn meal agar, germ tube test, susceptibility to cycloheximide, temperature test and sugar assimilation test (with API 20 kit) were performed to differentiate the Candida species from each other.The effect of the current azole drugs by micro dilution broth method was also tested.   Results: Out of 150 specimens, 80 cases of vaginal candidiasis were diagnosed. In order of frequency the isolated pathogens were Candida albicans, Candida glabrata, Candida parapsilosis, Candida krusei and Candida giullermondi, respectively.From "drug effect" point of view, Imidazoles (Ketoconazole, Clotrimazole, Miconazole) were more effective than Triazoles (Fluconazole).   Conclusion: Drug resistance pattern of various Candida species isolated from patients was different.}, Keywords = {Candidal vulvovaginitis , Drug resistance pattern,Candida species}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1276-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1276-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {ZarifYeganeh, M. and Eghtesadi, Sh. and Vakili, M. and Faghih, A.H. and Haghani, H. and Noormohammadi, I. and Golshaian, A.}, title = {Nutritional Assessment of Cancer Patients during Chemotherapy in Iran University of Medical Sciences Affiliated Hospitals, 2006-2007}, abstract ={     Background and Aim: Cancer associated malnutrition and depletion of nutritional reserves can lead to an increased risk of morbidity, reduced response to anticancer therapies and shorter survival in patients with cancer. The aim of this study was to assess the nutritional status of cancer patients during chemotherapy in hospitals affiliated to Iran University of Medical Sciences.   Materials and Methods: In this longitudinal study 71 adult patients with different kinds of malignancies were selected through a stratified sampling method from Hazrat-e-Rasool Akram and Firoozgar hospitals. Nutritional status was evaluated by anthropometric indices (BMI, MAC, AMA, and TSF), biochemical parameters (Albumin, Total Protein), nutritional intake (24hours-Food Recall Questionnaire and 3days-Food Record) and Ottery’s PG-SGA questionnaire at the beginning, middle and end of chemotherapy period. Data were analyzed by Repeated Measure ANOVA, Wilcoxon and Kruskal-Wallis tests of SPSS V.12 software.   Results: A nonsignificant increasing trend was observed for the anthropometric and biochemical data and a nonsignificant decreasing trend was observed in macronutrients and energy consumption of 50 patients who successfully finished the treatment duration. Twenty one patients who expired during the treatment period had a significant decreasing trend for BMI and MAC (p=0.01 and p=0.02, respectively).The frequency of malnutrition varied from 0 to 100% according to different indices that used to identify the nutritional status. According to the Ottery’s PG-SGA questionnaire, 80% of the survived cases and 100% of the deceased patients required nutritional intervention.   Conclusions: Our results demonstrate that the highest rate of malnutrition prevailed among patients who died during the treatment period had stage IV of the disease, Malignancy with Unknown Origin (MUO), upper GI and/or lung cancers. The frequency of malnutrition depends on stage and kind of malignancy and the methods used to assess the patients. Appropriate and early nutritional assessment is critical after the diagnosis of cancer and during anticancer treatments with the aim of using proper nutritional recommendations/interventions for cancer patients.}, Keywords = { Nutritional assessment, Cancer ,Malnutrition}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1273-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1273-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Farahini, H. and Akbarian, E. and Zangi, M.}, title = {Evaluating Probable Factors Influencing the Outcome of High Tibial Osteotomy in Osteoarthritis of Medial Compartment of the Knee}, abstract ={    Introduction: Excellent results are obtained with high tibial osteotomy in patients suffering from the osteoarthritis of the medial compartment of the knee however, poor results have been reported in 10 to 50 percent of the cases. The aim of this study was to evaluate the probable factors influencing the outcome of high tibial osteotomy to let us select the proper cases for this surgery. Patients and Methods: In this retrospective case – control study,57 high tibial osteotomies were performed by the open wedge method in 43 patients (16 males and 27 females, mean age = 54.5±7.8 years) between 2005 and 2007 as the treatment of medial compartment osteoarthritis of the knee. Mean follow-up time was 25±5 months. Factors including age, sex, previous lower limb surgery, history of long-term pain of the knee, obesity, smoking, widening of the medial compartment, tibial exophyte, complete tibial chondral destruction, medial meniscus damage, varus angle of more than 10 degrees, severe instability of the medial collateral ligament, and concurrent lateral compartment osteoarthritis were assessed and recorded before and after the surgery. Comparison between pre-operative and post-operative situations were performed using statistical analysis by scores obtained from KOOS in patients with or without the said factors. Data analysis was done using One-way ANOVA, independent samples t-test, and Mann-Whitney U-test.The difference between outcomes (with KOOS score) due to probable predicting factors was evaluated in patients with high tibial osteotomies. Results: Eight complications were seen due to the surgery in one case reoperation was needed and one case underwent total knee replacement due to sustained severe pain. Mean angle of correction was 8.8±3.4 degree and mean time for healing of the osteotomy was 3.1±1.4 months. History of knee pain of more than 2 years and concurrent lateral compartment osteoarthritis were present along with many other factors in patients with poor results. Conclusion: Choosing high tibial osteotomy as a method of treatment for osteoarthritis in cases which are predicted to have poor results, is only a costly decision and a delay in the correct therapeutic procedure. In this study we identified several factors that would influence the outcome.In this way, it could be used to screen patients and in case poor results are predicted, it would be better to carry out total knee replacement to prevent costly procedures and the burden of several surgeries.  }, Keywords = {Osteotomy,Osteoarthritis, Medial compartment of knee}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1272-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1272-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Zaman, B. and Hemati, K. and Hasani, V. and Dariaie, P. and Faezipour, H.}, title = {Comparison of the Efficacy of Transdermal Fentanyl in the Treatment of Chronic Soft Tissue Cancer Pain with Placebo in a Double Blind Randomized Clinical Trial}, abstract ={  Background and Aim: Pain due to cancer is one of the major problems of patients affected by malignancies. There are many methods for management of cancer pain and opioid consumption is the most important method. Fentanyl is a synthetic opioid which is represented as a transdermal patch used for chronic cancer pain relief. In this study we evaluated the effectiveness of transdermal fentanyl patch as compared to placebo in cancer pain.   Patients and Methods: This study was designed and performed as a double blind randomized clinical trial. Patients affected by soft tissue tumors with chronic pain who had referred to Cancer institute of Imam Khomini Hospital during 2006-07 were included and divided randomly into transdermal fentanyl patch and placebo groups. The appearance of the patches in both groups was the same. Pain severity was measured with Visual Analogue Scale(VAS) 24, 48 and 72 hours after the initiation of treatment. Data analysis was done by SPSS V. 13 software.Quantitative data were shown with mean(SD) and qualitative data were presented with frequency. Chi- square and t-tests were used for comparison of the data between the two groups.Repeated measurement analysis of variance was used for evaluating the effect of time and its relation with the medicine. p<0.05 was considerd as statistically significant.   Results: A sum of 166 patients affected by cancer were divided in two groups –transderamal group(86 patient) and placebo group(80 patients).There was the same age and sex distribution in both the groups. According to repeated measurement analysis, the pain severity was significantly reduced in the transdermal fentanyl group as compared to the placebo group(p=0.07).   The incidence of side effects was observed in 62 patients (72%) in fentanyl patch group and 31 patients (39%) in placebo group emphasizing the fact that the side effects were significantly more in the transdermal fentanyl patch group as compared to the placebo group (p=0.001)   Conclusion: The data suggest that transdermal fentanyl patch is an effective and safe method in reducing pain in patients affected by soft tissue tumors.Also it can improve the quality of life in this group of patients.  }, Keywords = {Transdermal fentanyl patch, Chronic pain,Soft tissue malignancy}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1271-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1271-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Mottaghi, A. and Mohammadi, M. A.}, title = {Simultaneous Anterior Fracture-Dislocation of the Shoulder and Fracture of the Ipsilateral Humeral Shaft: Case Report}, abstract ={  Introduction: Simultaneous anterior fracture-dislocation of the shoulder and fracture of the ipsilateral humeral shaft results from severe trauma and is very rare. In this report we present such an injury and its treatment.   Case Report: A 48-year old man was brought to hospital after a motor bike accident with anterior dislocation of the shoulder and fracture of the ipsilateral humeral shaft and greater tuberosity.Both injuries were treated by open reduction and internal fixation   Conclusion: By timely diagnosis of this rare and disabling injury, full treatment can be given. Thus, performing an accurate examination and obtaining the essential x-rays are mandatory.}, Keywords = {Dislocation of shoulder, Fracture of ipsilateral humeral shaft,Greater tuberosity fracture}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1288-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1288-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Aslanabadi, S. and Mofidi, M. and YosefNezhad, O. and Maghsoodi, H.}, title = {Diagnostic Value of C-Reactive Protein for Detection of Acute Appendicitis in Adults}, abstract ={  Background and Aim: Acute appendicitis is a common cause of abdominal pain and it can be difficult to diagnose, especially during the early stages. The role of inflammatory markers in the diagnosis of acute appendicitis has not been clearly defined. The aims of this prospective audit were to define the role of C-reactive protein and the other serum markers of inflammation, total white cell and neutrophil count in the diagnosis of acute appendicitis in adult.   Patients and Methods: In a prospective analytic setting, 100 patients with the probable diagnosis of acute appendicitis (Alvarado score ≤5) that had referred to Tabriz Pediatric Hospital during 2007-08 were studied. The CRP, WBC count and neutrophil percentage were checked on admission in all patients and were compared between the patients with and without definite diagnosis of acute appendicitis according to the result of histopathologic study or follow up (as the gold standard methods) via Student t-test, Mann-Whitney U test, Chi-Square test and Fisher’s Exact test.   Results: A total of 52 males and 48 females with the mean age of 20.6±4.1 years were recruited. Fifty four (54%) patients revealed to have definite acute appendicitis. Patients with final diagnosis of acute appendicitis had significantly greater values of inflammatory markers. Elevated CRP had sensitivity (62.7%), specificity (68.3%), positive predictive value (74%) and negative predictive value (56%) which are not enough for diagnosis. Only 2 patients with normal markers had acute appendicitis.   Conclusion: This study showed that despite the elevation of these inflammatory markers in patients with acute appendicitis, mere reliance on laboratory findings in managing the patients with equivocal appendicitis would not make sense. Combination of the clinical suspicion with these laboratory data is recommended. Normal values of all of these markers are very unlikely in pathologically confirmed appendicitis in adult.}, Keywords = {Appendicitis ,C-reactive protein, Neutrophil}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1287-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1287-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Nateghian, A.R. and Parvin, M. and Rohani, P. and Tabrizi, M.}, title = {Incidence and Risk Factors for Gentamicin and Ceftriaxone Resistant E.coli Causing Urinary Tract Infection in Children Admitted in Hazrat-e-Ali Asghar Hospital}, abstract ={  Background and Aim: There are increasing concerns regarding antimicrobial resistance in Iran. Data are limited on the prevalence and risk factors associated with resistant organisms, including Escherichia coli (E.coli) which is the most common cause of urinary tract infection (UTI). The aim of this study was to evaluate the prevalence of resistance and risk factors for resistance to gentamycin (GEN) , ceftriaxone (CFX) and a combination of both of them in E. coli strains isolated from hospitalized patients with acute UTIs in Tehran,Iran.   Materials and Methods: We performed a prospective descriptive case –control study from March 2005 to March 2008 among all cases of UTI in children from 1 month up to 12 years of age who were admitted to Ali Asghar Childrens Hospital (a referral pediatric center in Iran). Positive urine cultures with E.coli were further classified to sensitive, intermediate and resistant strains according to standard NCCLS method. Evaluated risk factors were checked within case control groups and the results were analyzed first by Chi square and then Logistic regression tests using SSPS V.15 software.   Results: A total of 125 E. coli were isolated. Resistance rates were 38.4% for CFX , 24% for GEN and 20% for CFX+GEN. Univariate analyses selected the following factors as being significantly associated with E. coli resistance: I) for resistance to GEN: prophylactic antibiotic (OR=3.5, p=0.006), urologic disorder (OR=2.4 , p=0.04), resistance to CFX (OR=15.7 , p=0.000), Vesicourethral reflux (VUR)(OR=2.7 , p=0.021) , with a trend toward significance for prior (1 year) urinary catheter (OR=2.5,p=0.052), and prior (6 months) hospitalization (OR=2.2 , p=0.055) II) for resistance to CFX: prior(1 year) UTI (OR=2.6 , p=0.012) , prophylactic antibiotic (OR=4.2 , p=0.001), urinary catheter (at present) (OR=4.8 , p=0.007) , prior (1 year) urinary catheter (OR=3.3 , p=0.006), urologic disorder (OR=2.7 , p=0.007) , prior (1 month) surgery (OR=8.8 , p=0.03) , prior (6 months) hospitalization(OR=4.2 , p=0.000) , resistance to GEN (OR=15.7 , p=0.000) , VUR (OR=2.2 , p=0.04) and NB(OR=3.9 , p=0.003) III) for resistance to CFX+GEN: age < 4 years (OR=3.9 , p=0.025) , prior (1 year) UTI(OR=2.5 , p=0.038) , prophylactic antibiotic (OR=4.1 , p=0.002) , prior (1 year) urinary catheter (OR=2.7 , p=0.036) , urologic disorder (OR=2.9 , p=0.02) , prior (6 months) hospitalization (OR=2.5 ,   p=0.037) , and VUR (OR=2.8 , p=0.022).   We also used Logistic regression analyses for risk factors which had p<0.05 in univariate analyses. The results were: I) for resistance to GEN: resistance to CFX (Sig. = 0.000, EXP (B) = 13.5) II) for resistance to CFX: Prior (6 months) hospitalization (Sig.= 0.047, EXP (B) = 2.9) , resistance to GEN (Sig. = 0.000 , EXP (B) = 15.6) III) for resistance to CFX + GEN: age (<4 years) (Sig. = 0.040 , EXP (B) = 4.3)   Conclusion: Recognized risk factors must be considered when deciding for empiric therapy in children especially in referral centers. We hope that our results will contribute to the development of strategies aimed at limiting the evolution of antimicrobial resistance in Iran.}, Keywords = { Escherichia coli , Antimicrobial resistance, Urinary Tract Infection,Gentamicin , Ceftriaxone}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1286-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1286-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Yazdanparast, S.A. and Rahimi, H. and Farnoodian, M.}, title = {Molecular Strain Typing of Trichophyton mentagrophytes Isolated from Patients with Dermatophytosis by Random Amplified Polymorphic DNA}, abstract ={  Background and Aim: Dermatophytes are the group of keratinophilic fungi that can cause diseases and infection in skin and other keratinized parts such as nail and hairs. The most important genus among keratinophilic fungi is Trichophyton which can be the most probable cause of tinea pedis in the world. There are 24 recognized species of this genus. Additionally, molecular strain typing of Trichophyton mentagrophytes isolates within skin specimens from patients with dermatophytosis indicates involvement of multiple strains. The aim of this study was the determination of strains of Trichophyton mentagrophytes in order to prevent the dissemination of infection,which is very important epidemiologically.   Materials and Methods: The study was of descriptive – analytic type. Skin specimens from 100 patients who had dermatophytosis by Trichophyton mentagrophytes were cultured and plates which had 5 colonies were selected. Deoxyribonucleic acid (DNA) was extracted from the isolates. According to PCR-based typing method that analysed variations in the numbers of repeats in the non-transcribed spacer(NTS) region of the ribosomal ribonucleic acid(rRNA) gene repeats, data were described. All the results were analyzed by (± SD) , Chi –square and t-student tests.   Results: In 20 out of 100 specimens of Trichophyton mentagrophytes , there were 2 or more strain types in a variety of Trichophyton mentagrophytes .   Conclusion: These results suggest that in the most cases of fungal infections caused by Trichophyton mentagrophytes, multiple strains are involved. These results have important implications in epidemiological studies,treatment and drug resistance in fungal infection.  }, Keywords = { Trichophyton mentagrophytes , Dermatophytosis,Molecular strain typing, Random amplified polymorphic DNA}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1285-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1285-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Karamouzian, S. and Eskandary, H. and Safizadeh, H. and MalekpourAfshar, R. and Adabi, S. and Gholamhosseinian, A.}, title = {The Effect of Methylprednisolone on the Therapeutic Window of Systemic Hypothermia for the Treatment of Experimental Mild Traumatic Spinal Cord Injury in Rat}, abstract ={    Background and Aim: Many studies have shown the neuroprotective effect of systemic hypothermia in the treatment of spinal cord injury. But the effect of delay hypothermia is not known.The goal of this study was to evaluate the effects of Methylprednisolone on the therapeutic window of hypothermia treatment following experimental Spinal Cord Injury (SCI) by measuring the accumulation of Polymorphonuclear leukocytes(PMN) at the traumatic site.Materials and Methods : In an experimental study, twenty-four Wistar albino rats (260–300 g) were divided in to six groups of four each: A(only laminectomy), B(Trauma laminectomy + cord injury),C(methylprednisolone laminectomy + cord injury + methylprednisolone), D(early hypothermia laminectomy + cord injury + early hypothermia), E(late hypothermia laminectomy + cord injury + late hypothermia), and F(late hypothermia + Methylprednisolone laminectomy + cord injury + late hypothermia +MP). Traumatic spinal cord injury (SCI) was induced by using Weight drop method(30 g.cm) on the anesthetized animals at T9 level. Tissue samples from the spinal cord were harvested 7 hours after laminectomy. PMNs counting was performed by light microscope and the data were analyzed using One-way ANOVA.Results: Early hypothermia and methylprednisolone inhibited PMN accumulation, but late hypothermia (induced 3 hours after trauma) did not show significant effect on PMN count.  Delay hypothermia and Methylprednisolone decreased the number of PMN, but  it seemes that this effect was related to methylprednisolone.  Adding methylprednisolone to delay hypothermia, did have significant beneficial effect, but it was not more than "methylprednisolone alone" group. Conclusion: Methylprednisolone can not extend the Therapeutic window of systemic moderate hypothermia for the treatment of experimental mild traumatic spinal cord injury in rat.}, Keywords = { Delay hypothermia,Spinal cord injury, Methylprednisolone}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1284-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1284-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {TaghipourAnvari, Z. and Shahabbasi, A.}, title = {A Comparison of the Analgesic Effects of Oral Clonidine as Premedication with that of Adding Clonidine to Lidocaine Solution in Bier’s Block for Upper Extremity Surgery}, abstract ={    Background and Aim: Clonidine has been found to decrease the tourniquet pain and enhance analgesia, when added to lidocaine in Intravenous Regional Anesthesia (IVRA) for upper extremity surgery. Our study evaluates the efficacy of oral clonidine as premedication before IVRA with that of lidocaine for upper extremity surgery and compares it to that of clonidine added as adjunct to lidocaine solution for IVRA.Patients and Materials: We conducted a prospective randomized double-blinded study on 60 patients undergoing upper extremity surgery under IVRA. Patients were randomized to receive plain lidocaine, 200 mg in 41 ml for IVRA(group IVRA), lidocaine 200 mg in 40 ml plus clonidine 2 µg/kg in 1 ml (group IVRA–C), or plain lidocaine, 200 mg in 41 ml for IVRA plus oral clonidine 2mg as premedication 1.5 hrs before surgery (group IVRA-OC). Patients in the first two groups received a placebo as premedication. Times of proximal tourniquet deflation and distal tourniquet inflation(T1), time of first intraoperative request for analgesics(T2) , time of first postoperative request for analgesics(T3), and the total analgesic consumption were recorded.SPSS V. 13 was used for statistical analysis. Quantitative data are shown as mean+/- SD and qualitative data are presented with frequency. Chi square and ANOVA tests were used for data analysis. p<0.05 was considered as significant.Results: In this study 60 patients were divided in to three groups of 20 each. The groups were IVRA, IVRA-C and IVRA–OC. There were no significant differences among the three groups in regard to the demographic characteristics and the duration of surgery. Time duration of proximal cuff deflation and distal cuff inflation was 49.5 +/_ 10.5 minutes in group IVRA–C, which was almost twice that of the other two groups (p= 0.0001). Time for first intraoperative request for analgesics was significantly different (longer) in group IVRA–C as compared to group IVRA p= 0.01). Time for first postoperative request for analgesics and the total analgesic consumption were significantly longer and lower, respectively in group IVRA-OC  (p = 0.0001).Conclusion: The addition of clonidine to lidocaine for IVRA, delays the onset of tourniquet pain and decreases analgesic consumption for tourniquet pain relief intraoperatively. Oral clonidine, on the other hand, is mostly effective in postoperative pain relief. }, Keywords = {IV clonidine , Oral clonidine, Bier’s block}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1283-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1283-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Yazdani, R. and Mousavi, S.A. and Fereshtehnejad, S.M. and Rezaei, M.}, title = {Comparison of the Diagnostic Values of Pleural Fluid Tumor Markers with Pleural Cytology and Biopsy in Detecting Malignancy}, abstract ={    Introduction: Cancers are the most prevalent causes of exudative pleural effusions after para-pneumonic pleural effusions. Despite the combination of the pleural fluid cytological studies and pleural biopsy, diagnosis could not be reached in an important number of cases. In an attempt to improve the value of pleural fluid analysis in the diagnosis of malignant pleural effusion, some studies have focused on the evaluation of different tumor markers. In this study we decided to determine diagnostic value of tumor marker assay in pleural effusions versus cytology and biopsy.   Materials and Methods: This analytical cross-sectional study was performed in Hazrat-e-Rasool Akram Hospital. Forty patients with lymphocyte dominant pleural effusion and negative pleural fluid smears and cultures for tuberculosis were enrolled in this study. Cytology, biopsy and thoracoscopy (if needed) were done. Levels of the six selected tumor markers (αFP, CEA, CA 19-9, CA 15-3, CA 125 and β-hCG) were measured in the pleural fluid. Sensitivity, specificity, positive and negative predictive values were calculated regarding the results of cytology, biopsy and thoracoscopy. Also, t-test and Chi2 were used in data analyses.   Results: The sensitivity of the six measured tumor markers in pleural effusion was: 4% AFP, 52% ß-hCG, 35% CA 19-9, 65% CEA, 95% CA 125 and 65% CA 15-3. The specificity of all tumor markers was 100%, except CA 125 which was calculated as 25%. The combination of markers including CA15-3, CA 19-9, CEA and β-hCG had sensitivity and specificity of 95.6% and 100% and PPV and NPV of 100% and 80%, respectively.   Conclusion: Using tumor markers could possibly be a suitable substitute for invasive and expensive methods such as thoracoscopy and thoracotomy. It seems that applying the combination of numerous tumor markers, increases the sensitivity and helps us to make better differential diagnoses.}, Keywords = {Tumor marker, Diagnostic value, Malignancy,Pleural effusion}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1282-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1282-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Jabbari, M. and Nattagh, F. and Jenabi, A. and Zahedi-Shoolami, L.}, title = {Comparison of the Serum ACE Activity withUrine and Serum NAG in Patients Receiving L-Carnitine and Gentamicin}, abstract ={  Background and Aim: Nephrotoxicity is the most important and the most frequent adverse effect of Aminoglycosides, which restricts its usage despite its availability and effectiveness. It seems that   L-carnitine with an inhibitory effect on free radical production and some antioxidant effect, may have a supportive role against the potential renal damage due to ischemia. The recent study was designed to compare the serum ACE and serum and urine NAG activities in patients on L-carnitine and Gentamicin treatment with the control group.   Materials and Methods: The recent study is a randomized clinical trial conducted on patients admitted in the Orthopedic ward of Hazrat-e-Rasool Akram hospital in 2006. Sixty-four patients were allocated randomly to the case and control groups. The control group received 80 mg of intravenous (IV) Gentamicin, three times a day for 3 days. The case group was under the same treatment plus 1 gram of oral L-carnitine, for 3 days, three times a day. Serum ACE and serum and urine NAG activities were compared within the two groups. Data were analyzed using SPSS V.11.05 software ,Paired sample t-test, Independent sample t-test and ANOVA.   Results: Serum and urine NAG activity on the first day showed no significant difference among the two groups, but there were significant differences at the end of the treatment period (4th day). Serum ACE activity in both the case and control groups showed no significant differences prior and after the treatment period.   Conclusion: The results of the recent study showed significant changes in serum and urine NAG activity during the short course of the treatment. These may show early renal tubular injury prior to any BUN and creatinine changes. On the other hand, although urine NAG activity in patients receiving L-carnitine showed an increase on the fourth day of treatment, but the increase is less than the control group. The above findings may support the supportive role of L-carnitine in tubular damages.}, Keywords = {ACE, NAG , L-carnitine , Gentamicin}, volume = {16}, Number = {0}, pages = {0-0}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1281-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1281-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Entezari, S.R and Salarian, S}, title = {Evaluation of Gabapentine Effects on Anxiety and Pain after Ocular Surgery under Local Anesthesia by Tetracaine}, abstract ={     Background & Aim: Pain is a significant aspect of post-operative patient morbidity. In this study, we evaluated the efficacy of oral gabapentin administration as premedication in the management of postoperative pain in patients undergone local anesthesia for cataract surgery.   Patients and Method: The study was a randomized, double–blind, controlled trial. Sixty-one patients who were candidates for eye surgery under local tetracaine anesthesia were enrolled in this study and divided into two gabapentin (n=32) and placebo (n=29) groups. In gabapentin group, the patients received oral gabapentin (300 mg) the night before surgery and the morning of surgery before operation. The pain and sedation scores were evaluated 20, 40, 60 and 120 minutes after surgery by visual analogue scale (VAS) and Ramsay score, respectively.   Results: In gabapentin group,the pain score (VAS) during follow-up period was significantly lower than the patients who received placebo (p<0.001). Ramsay score increased significantly in gabapentin group during the follow-up period (p<0.001).   Conclusion: Our study showed that gabapentin could reduce postoperative pain. In addition, total amount of opioid consumption for relieving pain in patients undergone local anesthesia for eye surgery was reduced.}, Keywords = {Key Words: 1)Gabapentin 2)Local Anesthesia by Tetracaine 3)Post Operative Sedation}, volume = {16}, Number = {0}, pages = {7-13}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1504-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1504-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {GhahramanAsl, R and Bolouri, B and Nedaee, H and Arbabi, A}, title = {Application of MAGIC Normoxic Polymer Gel to Electron Beam Dosimetry in Homogeneous Phantom}, abstract ={  Background & Aim: Nowadays, radiosensitive polymer gels are used as a reliable dosimetry tool for verification of 3D dose distributions. Polymer gel dosimeters consist of an aqueous mixture of monomers and a gelling agent, which after irradiation, 3D dose distribution is acquired by using imaging techniques. The aim of this study is to evaluate the application and capability of normoxic polymer gel to determine electron 3D dose distributions at depths of 1 and 4cm beneath the homogenous phantom at 8 and 15 MeV energies.   Material and Method: In this descriptive study, we used MAGIC-type gel dosimeter to measure dose distribution at depths of 1 and 4cm underneath homogeneous slab phantoms by using MRI. The homogenous phantoms were irradiated by 8MeV and 15MeV electron beams. Paired sample t-test and Pearson correlation coefficient were used to analyze the results.   Results: Dose resolution at the range of 0 to 10Gy was 0.23 to 1.55Gy. The mean dose differences and the maximum distance to agreement (DTA) of dose profiles for two diode and gel measurements were 2.5% and less than 2mm, respectively. In addition, 3D dose distribution was obtained at two orientations: transverse and axial.   Conclusion: This study shows the feasibility of using gel dosimeters to evaluate dose distribution for different electron beams.}, Keywords = {Key Words: 1) Polymer Gel Dosimetry 2) Electron Beam 3) Homogeneous Slab Phantom 4) MRI Method}, volume = {16}, Number = {0}, pages = {14-22}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1373-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1373-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Ghasemi, A and Fallah, S and Firoozrai, M and HosseiniGohari, L}, title = {Comparative Study of the Frequency of Paraoxonase1 Gln/Arg192 Polymorphism in Patients with Coronary Artery Stenosis and Control Subjects}, abstract ={  Background & Aim: Serum paraoxonase (PON1) is an HDL (high density lipoprotein) associated esterase that prevents the oxidation of LDL (low density lipoprotein). A common polymorphism in coding region of the paraoxonase gene involving a Gln (Q) to Arg (R) interchange at position 192 has been demonstrated to affect PON1 activity. It has been shown that R alloenzyme is less efficient at preventing LDL from oxidation and this finding may explain why in some studies the paraoxonase RR genotype has been found at an increased frequency in coronary artery disease (CAD) therefore, to investigate the significance of this polymorphism in pathogenesis of CAD, we performed a comparative study of the frequency of this polymorphism in patients with stenosis and control subjects.   Patients and Method: In the present case-control study, PON1 genotypes were determined in 174 subjects who underwent coronary angiography. CAD (>50% stenosis) was detected in 99 subjects (patients) and 75 subjects with <10% stenosis served as controls. PON1 genotypes were determined by PCR and AlwI restriction enzyme digestion. Students’ t-test was used to compare age, BMI, and lipid profile in control and patient groups. Genotype frequencies were compared by Chi-square test. The relationship between PON1 genotypes and the severity of disease in patient group was evaluated by Chi-square test.   Results: The frequencies of the QQ, QR and RR genotypes were found as 28.3%,50.5% and 21.2% in patient group and 45.3% , 42,7% and 12% in control subjects respectively ( c 2=6.12 p=0.046). The association of this polymorphism with the severity of stenosis was also evaluated,but according to the results of the distribution of PON1 genotypes and compared with the severity of stenosis,it was not statistically significant ( c 2=2.67 p=0.27). Conclusion: These results suggest that Gln/Arg 192 genotype is a risk factor for stenosis but does not have any effects on the severity of this disease.}, Keywords = {Key Words: 1) CAD (coronary artery disease) 2) PON1 (paraoxonase1) 3) Polymorphism }, volume = {16}, Number = {0}, pages = {23-31}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1374-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1374-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Azarkeivan, A and Eslami, M and Ghazizadeh, SH and Afradi, H and HajiBeigi, B and NasiriToosi, M}, title = {Evaluation of Immune Response to Hepatitis B Vaccination and Effects of Booster Dose in Chronic Transfusion Patients}, abstract ={  Background & Aim: Hepatitis B vaccine is in national vaccination programs. In healthy individuals the immune response is complete d by three-dose injections in 95% of cases and remains complete with time. However, in patients with chronic transfusion this immune response may be incomplete . In such patients, it is advised to check HBs antibody periodically, and use booster dose in cases with low titer of HBs antibody. In the present study we studied the immune status of thalassemic patients for Hepatitis B Virus (HBV) and the booster effects of vaccine.   Patients and Method: Our cross-sectional study was conducted in Adult Thalassemia Clinic in Tehran.We checked Hepatitis B surface antigen (HBsAg), Hepatitis B surface antibody (HBsAb),and Hepatitis B core antibody (HBcAb). We classified the immune status of patients into four categories: 1) immune to HBV via the vaccination (positively vaccinated) if HBsAg:negative, HBsAb:positive, HBcAb:negative2) immune to HBV via the natural disease (past infection) if HBsAg:negative, HBsAb:positive, HBcAb:positive3) non-immune to HBV (negative) if all three parameters were negative4) carrier of HBV (carrier state) if HBsAg was positive and HBsAb and HBcAb were both negative.   We had grading of immunity to HBV vaccine through antibody (HBsAb) titration as below: positive if antibody level was more than 100 IU/mL,negative if antibody level was less than 10 IU/mL, and weakly positive if antibody level was 10-100 IU/mL. SPSS statistical software (version 10) was used for the analysis. We analyzed and compared variables using Pearson and Chi-square tests and p-value for meaningful correlations.   Results: We studied 416 patients including 302 (72.5 %) thalassemia major , 104 (25 %) thalassemia intermediate, 7 sickle thalassemia, and 3 Hb H disease. There were 247 (58.4 %) males and 169 (40.6 %) females with a mean age of 25.6. According to our classification, 289 (69.4%) were positively vaccinated, 80 (19.2 %) were immune to HBV from past infection, 40 (10.5 %) were negative and 3 (0.7 %) were carrier state of HBV. We had 319 (76.6%) cases of HBsAb level more than 100 IU/ml (positive), 77 (18.5 %) between 10-100 IU/mL (weakly positive) and 20 (4.8 %) less than 10 IU/mL (negative).   Conclusion: HBV is one of transfusion transmmitted infections with a high rate of infectivity via tear ,saliva, urine , semen, in addition to blood transfusion. HBV vaccination is obligatory for thalassemics and has been in national vaccination program since 1993. Response rate with vaccination is complete and it is not needed to use booster in healthy people, but for thalassemics it is advised to check the antibody level and administer booster dose for patients with low titer of HbsAb.This protocol can maintain immunity and prevent the decrease in antibody titer in the patients.}, Keywords = {Key Words : 1) Thalassemia 2) Hepatitis B 3) Immune Response 4) Vaccination 5) Booster Dose}, volume = {16}, Number = {0}, pages = {32-39}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1505-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1505-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Khalesi, N and Taghipour, R and Aflatoonian, M}, title = {A Case Report of Cerebral Nocardiosis in a Patient with Crohn\'s Disease}, abstract ={  Introduction : Cerebral nocardiosis is a rare complication in patients who receive immunosuppressants, those with malignancy , AIDS, and transplant recipients.   Case Report : Herein we present a case of Crohn’s disease who was being treated with prednisolone, salazine and azathioprine but suddenly faced a decrease in the level of consciousness and presented with the signs of focal neurologic deficit. Imaging studies revealed brain abscess and the patient underwent a surgery. Bacterial cultivation and histologic examination indicated cerebral nocardiosis and the patient was successfully treated with antibiotics.   Conclusion :As far as we know, this was the first case of cerebral nocardiosis in a patient with Crohn’s disease who was receiving salazine, prednisolone and azathioprine. So far no similar case has been reported in English articles.}, Keywords = {Key Words: 1) Nocardiosis 2) Crohn’s Disease 3) Brain Abscess}, volume = {16}, Number = {0}, pages = {40-63}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1376-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1376-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Hasani, A and Zaheri, M.M and Abbasi, M and Saeedi, H and Hosseini, M and Fathi, M}, title = {Incidence Rate of Physical and Verbal Violence Inflicted by Patients and Their Companions on the Emergency Department Staff of Hazrate-e-Rasoul Hospital in the Fourth Trimester of the year 1385}, abstract ={  Background & Aim: The stressful environment of the emergency department exposes the staff to the hazards posed by physical and verbal violence.This can affect not only the job security and satisfaction among the personnel but also the service and care offered to the patients. This study has been designed to determine the incidence rate of physical and verbal violence inflicted by patients and their companions on the emergency department personnel of Hazrate-e-Rasoul Hospital in the fourth trimester of the year 1385.   Patients and Method: In this cross-sectional descriptive study, all the emergency department staff of Hazrat-e-Rasoul Hospital were asked to fill in a questionnaire about experiencing physical and verbal violence in the last trimester of the year 1385. 166 respondents included 17 attending physicians, 33 residents, 15 interns, 32 nurses, 15 ancillary staff, 20 laboratory technicians, 10 radiology technicians, 18 security guards and 6 orderlies. Data were collected and analyzed using SPSS software version 15 , t-test and Chi-square.   Results: The mean age of the staff was 32.20‌±7.67 years. 39% of the subjects were female and 61% were male. 77.5% had experienced verbal or physical violence at least once.The mean rate of verbal violence in the fourth trimester of the year 1385 was 31.1 times. 74% of verbal assaults were committed by men and 26% by women. 15.93% of the emergency department staff had experiences of physical violence in this trimester, and in 78% of the cases the violent person was a man and in 22% of the cases a woman. 13% of the emergency staff felt a high degree of security during their shift work, 52% felt a moderate degree of security, 27% felt a low grade of security and 8% felt no security during their shift work. 96.15% of the staff had received no education in this regard, and 87.4% reported that they think security measures provided to decrease violence in emergency department are insufficient.   Conclusion: This study shows that the incidence of violence in emergency department is high and this is a concern for the emergency department staff. Most of the violent behaviors which were displayed by patients’ companions can be controled by considering a good waiting area for them and avoiding their crowding in the ward.}, Keywords = {Key Words: 1) Verbal Violence 2) Physical Violence 3) Emergency Department Staff}, volume = {16}, Number = {0}, pages = {46-51}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1377-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1377-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Tavalla, M and Akhlaghi, L and Ourmazdi, H and Sarvi, SH and Razmjoo, E and Shokrabi, M and Siavoshi, M.R and Beiromvand, M}, title = {Using Dot-ELISA Method to Study the Prevalence of Human Hydatidosis in People Referred to Blood Transfusion Center in Tehran, 2005-2006}, abstract ={  Background & Aim: Hydatidosis, which is seen in human and other hosts, is caused by the infective larval stage of Echinococcus granulosus. In most cases, diagnosis of hydatid cyst is not easy due to a long term incubation period and lack of specific clinical symptoms, and remains asymptomatic for years in some patients. The aim of this study was using the easy and sensitive serologic technique of Dot-ELISA to determine the prevalence of hydatid cyst in individuals referred to Blood Transfusion Center in Tehran between 2005 and 2006.   Patients and Method: This cross-sectional study was done on 1100 people who were referred to Blood Transfusion Center and the results were analyzed by running t-test and Chi-square test. B antigen is one of the principal specific and heat resistant compounds of hydatid cyst. To perform Dot-ELISA test,this antigen was purified from the sheep hydatid fluid. In addition, by using SDS-PAGE method, the 8-12 kDa molecular weight proteins of this antigen were determined. 1gµ of purified B antigen was dotted on the nitrocellulose disk and 1/250 diluted serum samples were added. Then, the incubation was performed against the HRP conjugated antihuman. In the final step, DAB stain was added as an indicator. Brown sediment indicated a positive result.   Results: From 1100 tested blood samples, 18 (1.63%) were hydatid positive, which can indicate the cryptic hydatid cyst infection in the ordinary people of Tehran. The observed rate of hydatid infected individuals is statistically significant, considering the studied population as a representative of Tehran's population. Owing to the long incubation period of the disease, the cyst is usually diagnosed in old patients at the stage when surgical treatment is necessary. The surgery complications might be unendurable in old age patients. Consequently, it is suggested that screening programs be run to detect and treat the patients at the primary stage of the infection.   Conclusion: This study shows 1.63% of people referred to Blood Transfusion Center in Tehran have positive serum for hydatid cyst.}, Keywords = {Key Words: 1) Hydatidosis 2) Dot-ELISA 3) Echinococcus granulosus}, volume = {16}, Number = {0}, pages = {52-58}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1378-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1378-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {ZareMirzaee, A and Shayanfar, N and OstadaliMakhmalbaf, A}, title = {A Case Report of Cerebral Nocardiosis in a Patient with Crohn\'s Disease}, abstract ={  Introduction : Cerebral nocardiosis is a rare complication in patients who receive immunosuppressants, those with malignancy , AIDS, and transplant recipients.   Case Report : Herein we present a case of Crohn’s disease who was being treated with prednisolone, salazine and azathioprine but suddenly faced a decrease in the level of consciousness and presented with the signs of focal neurologic deficit. Imaging studies revealed brain abscess and the patient underwent a surgery. Bacterial cultivation and histologic examination indicated cerebral nocardiosis and the patient was successfully treated with antibiotics.   Conclusion :As far as we know, this was the first case of cerebral nocardiosis in a patient with Crohn’s disease who was receiving salazine, prednisolone and azathioprine. So far no similar case has been reported in English articles.}, Keywords = {Key Words: 1) Nocardiosis 2) Crohn’s Disease 3) Brain Abscess}, volume = {16}, Number = {0}, pages = {59-63}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1379-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1379-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Afshar, M and Hasanzadeh, M.M and Mo'allem, A and Tamizi, A and Golalipour, J}, title = {Comparative Study of Teratogenic Effects of Gabapentin Administration via Peritoneum and Gavages on Skeletal System of Mice Fetuses Using Alizarin-red S and Alcian-blue Staining Techniques}, abstract ={  Background & Aim: Gabapentin is a novel antiepileptic drug that is used for the treatment of partial and secondary generalized seizures. There are few and sometimes contradictory reports concerning the teratogenic effects of this drug. This study was done to compare teratogenic effects of gabapentin on skeletal system when it is used intraperitoneally and via gavages.   Material and Method: In an experimental research, 60 mature female Balb/c mice were chosen and randomly divided into six groups: two experimental groups which received 25mg/kg (I), and 50 mg/kg (II) of gabapentin intraperitoneally from the initiation of pregnancy for the first 15 days of pregnancy. The other two experimental groups,i.e. III and IV, received the same doses at the same periods but via gavages. Two control groups,i.e. V and VI, received normal saline at the same time intraperitoneally and via gavages. Dams were dissected under deep anesthesia by eter inhalation on the 18th gestational day and embryos were harvested. The macroscopic observation was performed by a stereomicroscope. Then the embryos' weights, resorption and the number of dead and alive fetuses were determined and registered. Finally, malformed fetuses were double strained for bone and cartilage and their skeletons were examined. Data were analyzed by ANOVA and Chi-square tests using SPSS software. Differences less than 0.05 (P < 0.05) were considered significant.   Results: Both experimental groups I and II revealed similar malformations which can be categorized as three sets: 1- Decreased fetal body weight and increased fetal resorption 2-Macroscopic external malformations 3- Skeletal malformations.The mean fetal body weight in group I (0.98 0.063 g) and group II (0.91 0/06 g) was lower in comparison to the control group (1.17 0.033 g). Also, an increase in resorbed fetuses was observed in both experimental groups as compared to the fetuses in the control group. Macroscopic malformations in both experimental groups included exencephaly, limbs defects, brachygnathia, vertebral column deformity and generally malformed fetuses. Skeletal malformations included delayed ossification, scoliosis, calvaria deformity and mandibular hypoplasia. In the experimental groups III and IV only delayed ossification was observed.No malformation was found in the control groups. Conclusion: This study revealed that the route of gabapentin administration may induce different teratogenic effects on mice fetuses.}, Keywords = {Key Words: 1) Gabapentin 2) Teratogenic Effects 3) Skeletal Malformation 4) Alizarin-red S Alcian-blue Staining}, volume = {16}, Number = {0}, pages = {7-18}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1391-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1391-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Tajik, N and Nasiri, M.R and Jafari, M and Mousavi, T and Farnia, P and Salekmoghaddam, A.R and Sankian, M}, title = {Association between Toll-like Receptor 4 (TLR4) Genetic Polymorphisms and Susceptibility to Pulmonary Tuberculosis}, abstract ={  Background & Aim: Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) are the members of the Toll-like receptor family and play important roles in recognition and subsequent immune response against mycobacteria. Two functional polymorphisms for TLR2 (Arg677Trp, C à T Arg753Gln, G à A) and TLR4 (Asp299Gly, A à G Thr399Ile, C à T) genes have been associated with a negative influence on their function, which may affect the innate host response to mycobacteria. The aim of this study was to investigate TLR2 and TLR4 genetic variants in a sample of Iranian patients with pulmonary tuberculosis compared to healthy controls.   Patients and Method : A case-control study was carried out on 96 patients and 122 ethnically matched healthy controls. Genotyping protocol was based on a novel polymerase chain reaction sequence-specific primers (PCR-SSP) method. Allelic and genotypic distribution of mentioned polymorphisms were compared by using Fischer’s exact test between patient and control groups.   Results : The prevalence of TLR4 variant alleles (Gly299 and Ile399) was significantly higher among patients compared to control individuals (Gly299: 7.2% vs. 2.9%, OR=2.66, P=0.028 and Ile399: 4.2% vs. 0.8%, OR= 5.26, P value = 0.022). Regarding TLR2 Arg753Gln polymorphism, no significant difference was observed between patient and control groups (0% vs.0.8%, P>0.05). The other TLR2 polymorphism (Arg677Trp) was not found in any of the studied subjects.   Conclusion: Our data demonstrates that TLR4 genetic polymorphisms may influence the risk of developing tuberculosis after exposure to mycobacterium. In addition, very low frequency of TLR2 genetic variants is revealed in Iranian population.}, Keywords = {Key Words: 1) Tuberculosis 2) Genetic Polymorphism 3)Toll-like Receptors 4) Iranian Population}, volume = {16}, Number = {0}, pages = {19-26}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1392-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1392-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Jelodar, G.A and Roodashtian, M}, title = {Effect of Radiation Leakage of Microwave Oven on Hematological Parameters of Female Mice at Pre and Post Pubertal Stages}, abstract ={  Background & Aim: High frequency waves are widely used in telecommunication and cooking. The biological effects of these waves are in great attention. Increased hematological problems proposed their possible relation to the use of microwaves. Bone marrow and blood cells are the body tissues which can be affected by these waves. Ladies are more in touch with microwave oven.The age of exposure may also be an important factor. This study was carried out to evaluate hematological parameters in female mice exposed to microwave radiation at pre and post pubertal stages.   Material and Method : For this study 20 adult (2 months old, 25-28 g) and 20 immature (7 days old, 3-4 g) female mice were selected and each group was randomly divided into two groups: control and test group. Test groups were exposed to 2450 MHZ microwaves produced by microwave oven three times a day, 30 minutes each time. After 60 days blood was collected by heart puncture and hematological parameters including Hb, MCHC, MCV,total number of platelets, RBC and WBC were evaluated.   Results: In immature group, Hb, MCHC,and total number of PLT and WBC decreased significantly compared to controls, while the number of RBC did not change in both test groups. In mature group, only the number of WBC decreased and the number of platelets increased significantly compared to control group (P<0.05).   Conclusion: Exposure to radiation leakage of microwave oven significantly affected hematological parameters in both mature and immature female mice. These changes were more severe in immature group. These effects may be attributed to direct effect of waves on bone marrow or peripheral blood cells.}, Keywords = {Key Words: 1) Microwaves 2) Hematological Parameters 3) Female Mice}, volume = {16}, Number = {0}, pages = {27-34}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1393-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1393-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Fooladsaz, K and Kalantari, S and Sharifi, F}, title = {Evaluation of Renal Function in Patients with Hyperthyroidism and Normal Individuals Referred to Bu Ali Laboratory in Zanjan}, abstract ={  Background & Aim: Hyperthyroidism is one of the important and common diseases of endocrine glands.Since nowadays many people in the world suffer from hyperthyroidism, it imposes economic load upon societies. According to epidemiological studies and existing evidence and papers, hyperthyroidism has significant effects on the metabolism of various organs especially renal function.Therefore, the main purpose of this study is that we believe evaluation of renal function which has an important role in filtering metabolic waste can be clinically useful.This research has been done to evaluate renal function in patients with hyperthyroidism and normal individuals referred to Bu Ali laboratory in Zanjan city.   Patients and Method: In this case-control study, BUN & creatinine indices in two groups of patients with hyperthyroidism and control subjects were evaluated and compared by calorimetric method. Also, complete urinalysis was performed in both groups. 50 patients with hyperthyroidism (mostly female and aged 26-66 years) who were confirmed by an endocrinologist were compared to an equal number of subjects in the control group (mostly female and aged 12-75 years).The collected data was analyzed by independent sample t-test.   Results: Statistical analysis by t-test indicated that BUN concentration of serum in normal persons (14.32±3.48) and that of patients (14.89±2.49) had no significant difference(P=0.670 for men and P=0.089 for women), while creatinine concentration of serum in patients compared to normal persons showed significant differences in all sex and age groups( P=0.004 for men and P=0.0001 for women).   Conclusion: According to the obtained results, this study indicates that in hyperthyroidism because of an increase in heart output and consequently an increase in GFR and also muscular atrophy , the serum creatinine concentrations have increased significantly but serum BUN concentrations show no significant difference in both groups. Besides, hyperthyroidism has no influence on urine analysis test.}, Keywords = {Key Words: 1) Hyperthyroidism 2) Creatinine 3)Blood Urea Nitrogen(BUN) 4) Endocrine Glands 5)Kidney}, volume = {16}, Number = {0}, pages = {35-41}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1394-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1394-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {KarimzadehGhassab, R and HosseiniGohari, L and Firoozrai, M and Zavareii, A and Basiri, H.A.}, title = {Levels of Small Dense LDL, Lipids and Lipoproteins in Patients with Coronary Artery Stenosis and Healthy Individuals}, abstract ={  Background & Aim :Low density lipoprotein (LDL) particles are heterogenous with respect to their size,density and lipid composition. Among LDL particles ,the smaller and denser LDLs (small dense (sd)LDL) are believed to be atherogenic since these particles are taken up more easily by arterial wall.They are readily oxidized and have reduced affinity for LDL receptor and increased affinity for arterial proteoglicans. Therefore, they are strongly associated with development of coronary artery disease(CAD).The aim of this study was to compare sdLDL levels in CAD patients and healthy individuals.   Patients and Method: In this comparative cross-sectional and case-control study, the sdLDL levels were determined in 86 patients with coronary stenosis,35 patients without coronary stenosis confirmed by angiography, and 30 healthy individuals. SdLDL was measured by a direct homogenous LDL-C assay in the supernatant of serum that remained after heparin-magnesium precipitation.   Results: The results of ANOVA test showed that the sdLDL levels were higher in patients with coronary stenosis than patients without coronary stenosis and healthy individuals(21.54±7.1 mg/dl,16.88±4.4 mg/dl and 15.45±5 mg/dl respectively, p=0.001). In addition, linear regression analysis and Pearson correlation coefficient revealed that sdLDL levels were positively correlated with serum triglyceride (r=0.494),total cholesterol(r=0.354) and LDL-C(r=0.749) and were inversely correlated with HDL-C(r=-0.586) (p<0.01).   Conclusion: The results suggest that patients with increased levels of sdLDL are at high risk for coronary artery stenosis.}, Keywords = {Key Words: 1)Small Dense LDL 2) Coronary Artery Stenosis 3)Lipoprotein}, volume = {16}, Number = {0}, pages = {42-48}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1395-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1395-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Soltansanjari, M and GhasemiFalavarjani, KH and Shokrollahi, S and Foroutan, A.R and Bakhtiyari, P and Ghaempanah, M.J}, title = {Refractive and Corneal Topographic Changes after Hangback Strabismus Surgery}, abstract ={  Background & Aim: Refractive change after strabismus surgery is a known phenomenon which may be attributed to the extraocular muscle traction.Since previous studies were often done by conventional methods,accompanied by a short follow-up, and without considering simultaneous evaluation of both refractive and topographic changes, this study was organized to evaluate refractive and topographic changes after strabismus surgery by hangback method.   Patients and Method : In this prospective, interventional,and case series study, 53 eyes of 33 patients undergoing hangback strabismus surgery were studied. Cyclorefraction with autorefractometer and topographic evaluation were done before and 2 weeks, 2 months, and 6 months after the operation. Data were analyzed by SPSS software version 15 using t- test and Chi-square test.   Results :The mean age of the subjects was 17.7 ± 10.2 years. We performed medial rectus recession on 18 eyes, lateral rectus recession on other 18 eyes, and simultaneous recession-resection on the remaining cases. In comparison to preoperative astigmatism, mean surgically induced astigmatism evaluated by cyclorefraction 2 weeks, 2 months, and 6 months postoperatively was 0.17± 0.52, 0.35±0.62 and 0.11±0.27 diopters ,respectively. The overall axis shift was toward 180 (2, 24, and 15 degrees respectively)(in all cases p<0.05). Mean surgically induced astigmatism evaluated by topographic data was 16±0.97, 0.53±1.2, and 0.29±0.63 diopters (in all cases p<0.05). The overall flat meridional shift was toward 180 (30, 25, and 7 degrees respectively). Comparing astigmatic changes in topography with those in cyclorefraction revealed a statistically significant difference in the second week measurements and not in other measurement times.   Conclusion: Hangback surgery can induce refractive changes and astigmatism, which may be due to corneal changes. Surgically induced changes reach a maximum amount in 2 months, and despite shifting toward baseline, will persist for 6 months.}, Keywords = {Key Words: 1) Refractive Error 2) Strabismus 3) Topography}, volume = {16}, Number = {0}, pages = {49-55}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1396-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1396-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Ehsanipoor, F and Khosravi, N and Amin, R}, title = {Prevalence of Hypocalcemia due to Phototherapy in Icteric Neonates t Admitted to Shahid Akbarabadi Hospital}, abstract ={  Background & Aim: Phototherapy plays a significant role in the treatment and prevention of hyperbilirubinemia. However, this treatment modality may itself result in the development of some complications. A lesser Known complication of phototherapy is hypocalcemia. The aim of the present study was to determine the prevalence of phototherapy-induced hypocalcemia in icteric neonates admitted to the hospital.   Patients and Method: In a cross-sectional analytical study, 150 icteric neonates undergoing phototherapy were evaluated. All of them were full term and >2500 gram. These neonates were completely normal on physical examination. Serum bilirubin and calcium were checked on arrival and 48 hours after starting phototherapy. Patients' information was analyzed by Chi-square and Mann-Whitney tests.   Results:123 neonates( 82%) developed hypocalcemia 48 hours after starting phototherapy. The difference between pre and post phototherapy plasma calcium was found to be statistically significant (p=0.001). Conclusion: The study showed that hypocalcemia is common in neonates under phototherapy.}, Keywords = {Key Words: 1) Hypocalcemia 2) Phototherpy 3) Icter 4) Neonate}, volume = {16}, Number = {0}, pages = {56-60}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1397-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1397-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Farahini, H and Moghtadaee, M and Jahansooz, A and ZahediSholmi, L and Malekpoor, S and Malekpoor, K}, title = {Long-term Results of Tibial Plateau Fractures Treatment in Patients Referred to Rasool-e-Akram Hospital between 2001 and 2006}, abstract ={   Background & Aim: Tibial plateau fractures are among the most important fractures which involve knee, as one of the most important weight-bearing articulates, whose injuries may lead to major functional disorders.   Patients and Method : This descriptive cross-sectional study was performed on 54 patients with tibial plateau fractures who were referred to Hazrat Rasool-e-Akram Hospital between 2001 and 2006.It was performed to evaluate the outcome of tibial plateau fractures treatment and compare the results obtained by visual analogue scale & Lysholm knee score. Hospital documents of patients were used for data collection. To analyze the data, K.S test ,Kruskal-Wallis, and Chi-square tests were used.   Results: The mean Lysholm score was 79.7 (± 12.3) . The minimum score was 48 in three patients and the maximum score was 94 in nine patients (16.7%). According to scores gained by patients, the result of treatment was excellent in 8 cases(14.8%), good in 19 (35.1%), fair in 17 (31.4%) and poor in 10 (18.6%). The mean VAS score was 2.77 (± 1.14). Conclusion: According to the findings of the recent study and previous studies, it seems that the treatment of tibial plateau fractures is challenging. Proper and accurate pre-operative evaluations with proper anatomic reconstruction of the articular surfaces with stable fixation may lead to better functional outcomes.}, Keywords = {Key Words: 1) Tibial Plateau Fracture 2) Lysholm Score 3) Visual Analogue Score (VAS)}, volume = {16}, Number = {0}, pages = {61-67}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1398-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1398-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {AllahVeisi, F and Boloori, B and Shooshtarizadeh, T}, title = {Investigating the Effects of Pulsed 217Hz Magnetic Field on the Growth and Development of a Transplanted Fibrosarcoma Tumor in Balb/c Mice}, abstract ={    Background & Aim: With regard to the reported biological effects of different frequencies of ELF as window effect and also the use of 217 Hz frequencies as  modulating radiofrequency waves of 900 MHz in global system for mobile(GSM), the purpose of this study was to investigate the effect of magnetic field of 217 Hz frequency on the growth of tumor cells.Material and Method: Forty-nine male mice of Balb/c race aged  6-8 weeks were randomly divided into 7 groups (3 test groups, 3 sham groups, and a control group), and 100%, 75%, and 30% of minimum required cells in order to cause tumor were subcutaneously injected into them respectively. On the second day after injecting cells, test groups were exposed to the homogenous field of a pair of Helmholtz Coil for 150 minutes every day for 19 successive days.  The formation of tumors was observed after 6-10 days. On the twentieth day of the experiment, the mice were anesthetized and the tumors were extracted.Tissue samples were also gathered for histological comparison.Results: This study was conducted experimentally and one-way ANOVA and SPSS-12 software were used to analyze and compare the weight and size of tumors in test groups in relation to sham groups. The study revealed that there was a significant difference (p<0.05) between test and sham groups regarding the size and weight of tumors. In terms of tumor formation, there was a significant difference between test and sham groups,too. Histological comparison did not show a significant difference regarding  mitosis and metastasis into other organs. However, mitosis in test groups was higher in comparison to sham groups, which is indicative of the presence of more active tumors in these groups. In addition, test groups' tumors had larger necrosis areas.Discussion: The obtained results of this study show that exposure to  pulsed 217 Hz magnetic field can increase the development of the fibrosarcoma tumors in Balb/c mice, which is indicative of window effect according to the reports about other EFL frequencies. }, Keywords = {Key Words: 1)Extremely Low Frequency (ELF) 2)Global System for Mobile (GSM) 3) Fibrosarcoma 4) Balb/c 5) Window Effect}, volume = {16}, Number = {0}, pages = {7-16}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1408-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1408-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Agah, SH and Fatali, S and Ashayeri, N}, title = {Treatment of Diarrhea Predominant Irritable Bowel Syndrome (IBS-D) Using Plantagel:a Random Double-blind Clinical Trial}, abstract ={    Background & Aim: Despite the frequency with which IBS is encountered in clinical practice, it remains an important medical problem for both health care providers and patients. Unfortunately,so far no single treatment option has been effective for managing IBS.Therefore, we decided to evaluate  the effects of Plantagel on relieving IBS symptoms.Patients and Method: This double-blind clinical study was conducted from April 2006 to December 2007. 70 patients with diarrhea predominant IBS (IBS-D) enrolled in our study.The subjects were divided into two equal groups of 35. First, all the participants were monitored for two weeks prior to drug administration.Then 35 patients in the study group received Plantagel and 35 patients in the control group received placebo for two weeks. The patients were called at the end of the second week of  treatment period and 3 weeks after the end of treatment in order to evaluate the clinical severity of  IBS symptoms.SPSS software v.15, paired t-test, Chi-square and independent sample t-test were used to analyze the data. Results: The entire study population improved significantly over 2 weeks of treatment in terms of all  studied parameters. However, severity of bloating, feeling of incomplete emptying, presence of mucous in stool and urgency tended to decrease further in Plantagel group in comparison with placebo group.Three weeks after completion of the course of treatment, severity of abdominal pain, frequency of defecation, bloating and urgency returned to primary levels in placebo group and the benefits of treatment diminished over time in this group,while the severity of all symptoms in Plantagel group statistically improved compared with before treatment.Conclusion: The present study is the first clinical trial to evaluate the effects of Plantago Major on IBS-D symptoms. Our study demonstrated that Plantagel is effective in the management of IBS-D symptoms and its effects last 3 weeks after completion of treatment. According to these findings, IBS-D patients can use Plantagel intermittently to improve their complaints and decrease treatment costs.  }, Keywords = {Key Words: 1) Diarrhea 2) Irritable Bowel Syndrome (IBS) 3) Plantago Major}, volume = {16}, Number = {0}, pages = {17-23}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1409-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1409-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Shekarabi, M and Laribi, B and Zarnani, A.H and Ghaffarpour, M and Ghabaee, M and Nourbakhsh, S and Bakhshayesh, M}, title = {Evaluation of Serum Levels of Anti-Epstein Barr Virus Antibodies and Production of IFN-γ, IL-4 and IL-12 by Mitogen-activated Peripheral Blood Mononuclear Cells in Patients with Multiple Sclerosis}, abstract ={    Background & Aim: Multiple sclerosis(MS) is the most common inflammatory disease of central nervous system which is caused by an autoimmune process leading to destruction of myelin sheath. In this disease, CD4+ T–lymphocytes, mostly of TH1 phenotype, play important roles in destruction of neuronal tissues.  Because of the probable etiologic participation of EBV virus in immunopathogenesis of MS, the aim of this study was to evaluate the relationship between serum levels of anti-Epstein Barr virus antibodies and production of TH1 and TH2 cytokines.Patients and Method: A descriptive study was performed on 68 MS patients in different stages of the disease and 20 healthy individuals. Blood samples were taken and plasma levels of anti-EBNA-1 and VCA antibodies were determined by ELISA method. Then, peripheral blood mononuclear cells (PBMC) were isolated by Ficoll Hipaque separation and stimulated with PHA in optimal culture conditions. Concentrations of IFN-γ, IL-12 and IL-4 in culture supernatants were then measured by ELISA. Statistical analysis was performed by using SPSS version 16. Mann-Whitney,  t-test,and Pearson correlation coefficient were used to compare  the  variables and find the correlation between them. P<0.005 was considered  statistically significant. Results: The mean levels of anti EBNA-1 and VCA antibodies were significantly higher in patients compared to controls (P=0.04, P=0.001 respectively). Concentrations of IFN-γ, IL-4 and  IL-12 were also significantly higher in MS patients than healthy individuals (P=0.001, P=0.005, p=0.002 respectively). Although the ratios of IFN-γ to IL-4 and IL-12 to IL-4 were higher in MS patients than healthy individuals, this increase did not reach a significant level (P>0.05). A statistically significant correlation was found between anti EBNA-1 and VCA antibodies and IL-12 production (P =0.02, r=0.27; P=0.04, r=0.25 respectively) whereas no significant correlation was found between these antibodies and production of IFN-γ and IL-4 in MS patients. Conclusion: The significant correlation between the level of anti-Epstein Barr virus antibodies and  IL-12 production in MS patients implies the probable role of this cytokine in skewing immune responses toward  TH1 phenotype. It is possible that this putative viral agent in combination with other etiological agents is involved in the etiology and progression of the disease.}, Keywords = {Key Words: 1) Epstein Barr Virus 2) Multiple Sclerosis 3) Cytokine}, volume = {16}, Number = {0}, pages = {24-31}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1410-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1410-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Ansarin, H and Shekarabi, M and Behrangi, E}, title = {Investigation of the Relationship between Serum Levels of Cytokines Secreted from Th1 and Th2 Cells, IL8 and ICAM-1 and Psoriasis Severity Based on PASI}, abstract ={    Background & Aim: Psoriasis is a common chronic inflammatory skin disease that affects 1-3% of the world's population. It can cause significant distress to the patient and ultimately the reduction of the patient's life quality. From the clinical perspective, it can create bright, red, elevated, and scaly plaques. Psoriasis is now recognized as a T-cell mediated disease with epidermal hyperplasia being a consequence of the activation of the immune system and cytokines release. No definite cure has been found for this lesion and existing treatments have high rates of relapse. Further recognition of immunopathogenesis and cytokines contributing to the severity of the disease can help to discover more specific and efficient treatments for this disease.The aim of the present study is to determine the relationship between serum levels of cytokines secreted from Th1 and Th2 cells, IL8 and ICAM-1 and psoriasis severity based on PASI in order to distinguish the possible role of cytokines in the immunopathogenesis of psoriasis.Patients and Method: This study was performed on 40 patients with psoriasis vulgaris referred to Rasool-e-Akram Hospital between 2007 and 2008. In order to determine the severity of the disease based on PASI, each patient was examined clinically. Then 3 cc of vein blood sample was taken and serum sample was separated through centrifuge and stored at -70°C until the final examination. Next, through ELIZA method, serum levels of the above-mentioned cytokines were measured and by using  Spearman correlation coefficient, the relationship between serum levels of the above-mentioned cytokines and the severity of the disease was evaluated.Results: According to this study, there is a meaningful statistical relationship between the serum level of  interferon ɣ (p=0.001, r=0.50), interleukine 8(p=0.018, r=0.37), and ICAM-1 (P=0.047, R=0.31) and the severity of psoriasis based on PASI. However, such a relationship was not observed between the serum level of interleukine 4 and the severity of the disease (p=0.24, r=0.18).Conclusion: Based on our study, interferone ɣ , interleukine 8, and ICAM-1 are related to the severity of psoriasis. Therefore, the treatments which selectively target the above-mentioned cytokines, are more reliable and efficient. It is strongly recommended that further studies and researches be conducted to investigate the effects of the above-mentioned biological treatments on psoriasis.}, Keywords = {Key Words: 1) Cytokine 2) Psoriasis Severity 3) Immunopathogenesis}, volume = {16}, Number = {0}, pages = {32-39}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1417-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1417-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Kashanian, M and Akbari, Z and Alizadeh, M.H}, title = {The Effect of Exercise on Back Pain and Lordosis in Pregnant Women}, abstract ={    Background & Aim: Low back pain and lordosis are among the most frequent complaints of pregnancy, and one of the methods to reduce them is physical exercise. The purpose of the present study is to evaluate the effect of exercise on low back pain severity and lordosis in pregnant women.Patients and Method: A randomized clinical trial was performed on 30 pregnant women with a gestational age of 16 weeks who had low back pain.The patients were randomly assigned into  two groups. In the case group (n=15) exercise and in the control group (n=15) nothing was done. To find the severity of back pain, the pregnant women were asked to fill in Roland-Morris questionnaire once  at the beginning of the study and again in the 20th and 24th weeks of pregnancy. Lordosis was measured by a flexible ruler at the beginning of the study and again in the 20th and 24th weeks of pregnancy. Statistical analysis was performed using SPSS v.11. Paired t-test and  Students' t-test were used to  compare the results. P value less than 0.05 was considered significant.Results: In comparison with the control group, the case group showed a significant reduction in the severity of back pain 2 months after intervention (26.13± 2.41 VS 31.93 ±4.9, P=0.001), and the reduction in the intensity of back pain 2 months after intervention was less in the control group than the case group (-3.42± 0.44 VS 17.76± 0.936, P= 0.001). In both groups, lordosis was significantly increased (40.26± 7.1 VS 42.6±7.16, P=0.001 in the case group, and 39.63±5.21 VS 41.9±5.84, P=0.001 in the control group), but the rate of increase was higher in the control group. Conclusion: Exercise may be a good method to reduce low back pain and lordosis in pregnant women.}, Keywords = {Key Words: 1) Pregnancy 2) Exercise 3) Lordosis 4) Back Pain }, volume = {16}, Number = {0}, pages = {40-45}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1418-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1418-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Kadivar, M and Esmaili, A and Joolaee, A}, title = {Evaluation of Microvessel Density and Vascular Endothelial Growth Factor in Invasive Breast Carcinoma via Immunohistochemistry and their Correlation with Clinicopathologic Parameters}, abstract ={    Background & Aim: Angiogenesis has an important role in the progression and metastasis of breast cancer and is a predictor of patient's survival.  This process is regulated by vascular endothelial growth factors (VEGF). The purpose of the present study is to determine the angiogenesis process through the evaluation of the  relationship between MVD and VEGF based on immunohistochemistry in patients with invasive breast carcinoma and study their correlation with grading, staging, age, lymph node involvement and biomarkers including estrogen receptor(ER), progestron receptor (PR), Ki-67, HER2 and P53.Patients and Method: In this analytical cross-sectional study, after searching among paraffin embedded blocks in Pathology Ward of Hazrat Rasool-e-Akram and Atieh hospitals between 2004 and 2007, 74 blocks were included in the study and immunohistochemistry staining for biomarkers VEGF and CD31 were done, and the results were compared with ER, PR, Ki-67, HER2 and P53, age, lymph node involvement, histologic grade, and stage. Demographic  information was gathered from the patients' files. Data was analyzed by SPSS v.12 software.Results: The mean age of the  patients was 49.4±11.94 years.The mean of CD31 was between 5.6 and 106.6(37.39±17.95) and the median of CD31 was 34.3, which was assumed as cut-off. Based on this value, 37cases(52.1%) were considered as low MVD and 34 cases(47.9%) as high MVD. 57 cases (7%) were VEGF positive and 17 cases (23%) were VEGF negative. Between mean MVD and VEGF was a significant correlation (Spearman r=0.24 and P=0.041) ,which  means  VEGF as an angiogenesis factor plays a role in increasing MVD. There was no significant relation between VEGF and MVD and age, histologic grade, nuclear grade, lymph node involvement, tumor size, stage, ER, PR, HER2/Neu, Ki-67 and P53.Conclusion: Based on the results of this study, VEGF plays a role in  promoting angiogenesis. With respect to the results of this study, there is no significant relationship between VEGF and MVD and histopathological prognostic factors, age, and biomarkers of ER, PR, HER2/Neu, Ki-67 and P53.}, Keywords = {Key Words:1) Invasive Breast Carcinoma 2) CD31 3)Vascular Endothelial Growth Factor (VEGF) 4)Microvessel Density (MVD)}, volume = {16}, Number = {0}, pages = {46-55}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1415-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1415-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Amouzadeh, KH and Abrotan, S and Montazeri, M and Montazeri, M}, title = {Comparison of Serum Level of LP(a) with LDL, VLDL and HDL in Patients with Myocardial Infarction and Unstable Angina}, abstract ={    Background & Aim: Stable and unstable angina and acute MI  happen due to atherosclerosis of coronary artery. The purpose of this study is comparing  the level of LP(a) with LDL-C, VLDL-C and HDL-C in patients with MI and unstable angina.Patients and Method: This cross-sectional study was performed on patients suffering from MI or unstable angina who were admitted to  Yahyanejad Hospital in Babol between 2006 and 2007.The  patients were divided into MI group and unstable angina group based on the positive or negative result of troponin test. After  lipid profile test, information was recorded in a questionnaire. Then the data were analyzed by spss14, Chi-square and t-test. p<0.05 was considered significant.Results: Among 218 patients in this study, 188 patients suffered from unstable angina and 30 patients suffered from MI.The mean of serum lipids was: LDL-C= 145.19±3.05,  VLDL-C= 30.89±1.48, Lp(a)= 65.15±5.31, TG= 154.41±7.41, CHOL= 221.41±3.68,and HDL-C= 44.48±0.69. Comparing the means of serum lipids in both groups of MI and unstable angina revealed a significant difference between levels of LDL-C, Lp(a), cholesterol ,and HDL-C (p<0.05), but in terms of VLDL-C and TG the difference  was not significant (p>0.05).Conclusion: It can be concluded that a significant correlation exists between LDL-C,  cholesterol, low HDL and high Lp(a) in patients with unstable angina and AMI.}, Keywords = {Key Words: 1)Acute Myocardial Infarction (AMI) 2)Unstable Angina 3)Lp(a)}, volume = {16}, Number = {0}, pages = {56-62}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1419-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1419-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} } @article{ author = {Homaee, M.M and Mehrbanian, M.J and Hasani, V and Mirdehghan, M.H}, title = {Evaluation of Pain after Vitrectomy in Patients Receiving Rectal Diclofenac as Pre-emptive Analgesia}, abstract ={    Background & Aim: Post-operative pain is a frequent complication after surgery which can increase the risk of other post-operation complications and also the duration of hospital stay. In this study, we have tried to assess the effect of rectal diclofenac as pre-emptive analgesia to reduce post-operative  pain after ophthalmic surgeries(vitrectomy).Patients and Method: This study was designed and performed as a double-blind clinical trial. The patients who were candidates for vitrectomy in Rasool-e-Akram Hospital were included in the study according to some exclusion and inclusion criteria and divided into two groups of diclofenac and control. In diclofenac group,patients received a single dose of 100mg 2 hours before surgery.The pain scores were assessed in recovery room,4 and 12 hours after vitrectomy using the visual analogue scale(VAS). To compare qualitative and quantitative data of the two groups, provided that normal distribution  existed, we used Chi-square test for qualitative variables and t-test for quantitative variables. Also, in order to determine confounding factors exactly and assess the effect of time , multiple regression analysis was used.Results: A total of 97 patients were divided into two groups:51 persons in diclofenac group and 46 persons in the control group. The mean of pain intensity at the 4th hour after surgery in diclofenac group was lower than the control group(p<0.001). Pain intensity at the12th hour after surgery in diclofenac group was 2± 0.6 and in the control group was 3.3±0.8, which was statistically lower in diclofenac group than the control group(p<0.001). Multiple regression  analysis revealed that two factors,i.e. increasing age and using diclofenac, were effective in reducing pain(p<0.05).Conclusion: Single dose of rectal diclofenac as pre-emptive analgesia is effective in reducing post-vitrectomy pain.}, Keywords = {Key Words: 1)Rectal Diclofenac 2) Pain Severity 3)Vitrectomy 4) Pre-emptive Analgesia}, volume = {16}, Number = {0}, pages = {63-69}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1420-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1420-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2010} }