@article{ author = {Abhari,, R. and Mobini, M. and Fakhri,, M.}, title = {The Effect of Atorvastatin on Clinical and Laboratory Findings in Rheumatoid Arthritis}, abstract ={    Background & Aim: There are many studies about statins showing that these drugs have some anti-inflammatory and immunomodulatory effects and might reduce inflammatory markers in rheumatoid arthritis. The aim of this study is to evaluate atorvastatin effect on clinical and laboratory markers in rheumatoid arthritis. Patients and Method: This study is a randomized, double-blind, clinical trial carried out from March 2005 to July 2006. 66 patients with active rheumatoid arthritis who had been referred to rheumatology clinic in Hazrat Rasool-e-Akram Hospital were selected and divided into two groups to receive atorvastatin or placebo in a double-blind manner. The two groups were similar in terms of disease duration and activity and anti-rheumatoid therapy. Results: 32 patients received atorvastatin and 34 patients received placebo. Patients' data were recorded in the first visit and at the end of the 4th and 24th weeks of therapy. The mean age of the subjets was 51.84 years in atorvastatin group and 47 years in placebo group. Mean duration of the disease was 7.06 years in atorvastatin group and 7.8 years in placebo group. Except for morning stiffness in placebo group, no significant difference was seen in clinical and laboratory findings. Conclusion: This study showed no significant decrease in inflammatory markers in rheumatoid arthritis treated with atorvastatin.}, Keywords = {Key Words: 1) Rheumatoid Arthritis 2) Atorvastatin 3) Statin}, volume = {15}, Number = {0}, pages = {7-13}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-889-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-889-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Otoukesh,, H. and Hosseini,, R. and Fereshtehnejad, S.M. and Faramarzi, Sh. and Basiri,, A. and Simforoosh, N. and Chalian,, M. and Jazayeri,, S. and Chalian,, H and Sharifian,, M.}, title = {Short-Term and Long-Term Effects of Delayed Graft Function (DGF) on Graft Survival in Pediatric Renal Transplantation}, abstract ={    Background & Aim: Delayed graft function(DGF) generally refers to oliguria or the requirement for dialysis in the first week post-transplantation. It is the earliest and most frequent post- transplantation complication that can occur. DGF is an extremely important post- transplantation complication because its occurrence has short-term or long-term consequences for allograft survival. However, limited studies have been conducted on DGF and its complications in pediatric renal transplantation. Therefore, the aim of the present study was to determine short-term and long-term effects of DGF on allograft outcome in kidney transplanted children. Patients and Method: In this historical cohort study, 230 children who received kidney transplants between 1985 and 2005 in Labafi Nejad Hospital in Tehran were assessed through a mean follow-up period of 60.96(SD=40.46) months (ranging from 1 to 180 months). The children were divided into two groups: 183 children in group B(no DGF) as the control group and 47 patients in group A (DGF) as the case group. Risk factors of DGF and the impact of DGF on renal function within the first year, long-term graft survival, and post-transplantation complications were investigated and compared using Logistic regression model and Kaplan–Meier survival analysis. Results: The incidence of graft failure at the end of follow-up period was significantly higher in DGF group(53.2% vs. 22.4%, P<0.001). The mean graft survival length was 134.2(SEM=6.17) months in group B and 76.52(SEM=12.41) months in group A(P<0.001). The graft survival rate was 94.9%, 91.9%, 83.9%, 79.2% and 72% at 1, 3, 5, 7 and 12 years after transplantation in children without DGF versus 75.6%, 53.2%, 47.2%, 31.9% at 1, 3, 5 and 8 years after transplantation in patients with DGF. Dialysis before transplantation(P=0.039), acute rejection(P<0.001), immunosuppressive protocol without celcept(P<0.001) and the presence of DGF(P<0.001) were found as the significant risk factors for the occurrence of graft failure in the future. Conclusion: The results of our study showed that delayed graft function could remarkably and independently affect graft survival and worsen both short-term and long-term transplantation outcomes. This result is in contrast with the studies that only believe in the effect of DGF on short-term graft survival. However, in our study when patients whose grafts had failed during the first year after transplantation were censored, still significant differences were noted in graft survival between patients with and without DGF. Thus, the prevention of DGF is one of the most important issues in graft survival improvement.}, Keywords = { 1) Delayed Graft Function(DGF) 2) Renal Transplantation 3) Children 4) Graft Survival }, volume = {15}, Number = {0}, pages = {15-24}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-890-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-890-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Ehsanipour,, F. and Khosravi,, N. and Jalali,, S.}, title = {The Effect of Hat on Phototherapy-Induced Hypocalcemia in Icteric Newborns}, abstract ={    Background & Aim: Phototherapy plays a significant role in the treatment and prevention of hyperbilirubinemia in neonates. However, this treatment modality may itself result in the development of some complications. A lesser-known complication of the phototherapy is hypocalcemia. Some studies reported hypocalcemia accompanied by a decrease in serum melatonin concentration, yet this effect can be prevented by shielding the occiput. The aim of the present study was determining the prevalence of phototherapy-induced hypocalcemia and comparing its incidence between a group of neonates whose heads were covered during phototherapy and a group of neonates who received phototherapy without hat. Patients and Method: In a randomized clinical trial, 120 icteric neonates were evaluated in two groups of 60. All of the subjects were full term and weighed more than 2500 grams. For group A routine phototherapy was done without shielding the head and the second group(B) used hats that covered occipital area. All neonates were completely normal on physical examination. Serum bilirubin and calcium was checked on arrival, 48 hours after starting phototherapy, and 24 hours after discontinuation of the treatment. Group A was considered as the control group. A comparative study was made between these groups to determine the efficacy of hat for prevention of hypocalcemia. Results: 18 neonates(15%) developed hypocalcemia after starting phototherapy. There was a statistically significant difference between the prevalence of hypocalcemia in group A(77.77%) and group B(22.22%)(p=0.000). None of the hypocalcemic neonates was clinically symptomatic. Serum level of calcium returned to normal 24 hours after discontinuation of phototherapy in almost all hypocalcemic neonates. Conclusion: The study showed that covering neonate's head and occipital area during phototherapy decreases phototherapy-induced hypocalcemia.}, Keywords = { 1) Hat 2) Phototherapy 3) Calcium 4) Icter 5) Newborns }, volume = {15}, Number = {0}, pages = {25-29}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-891-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-891-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {AfkhamEbrahimi, A. and GhaleBandi,, M.F. and Salehi,, M and KafianTafti,, A.R. and Vakili,, Y. and AkhlaghiFarsi,, E.}, title = {Sleep Parameters and the Factors Affecting the Quality of Sleep in Patients Attending Selected Clinics of Rasoul-e-Akram Hospital}, abstract ={    Background & Aim: Almost any medical illness that causes significant pain or discomfort may negatively affect the quality of sleep. Illnesses affecting cardiovascular, respiratory, gastrointestinal, and nervous systems and injuries disrupt the quality of sleep. The objective of this study is to investigate the parameters of sleep and the factors affecting the quality of sleep in medically ill patients. Patients and Method: In a descriptive cross-sectional study, a total of 300 medical patients with various somatic complaints who attended internal, ENT, orthopedic, neurology, urology and surgery clinics were selected. The assessment instrument was Pittsburgh Sleep Quality Index(PSQI) which measures the quality of sleep in 7 major domains. A score of >5 is considered as a significant sleep disturbance. The data were analyzed using descriptive statistics and one-way ANOVA. Results: The mean PSQI score of the patients from all six selected clinics was higher than anchor point(M=8.02). Significant differences were found in sleep duration, sleep disturbances and daytime dysfunction among the clinics. Pain and worry were the major causes of sleep disturbances. Conclusion: Based on the findings of this study, the majority of medical conditions can cause sleep disturbances per se. Because pain and worry may adversely affect the quality of sleep, they should be considered in the assessment and treatment of various medical conditions.}, Keywords = { 1) Sleep Parameters 2) Quality of Sleep 3) Pittsburgh Sleep Index 4) Medical Patients }, volume = {15}, Number = {0}, pages = {31-38}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-892-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-892-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {AmirMozaffari,, N. and Ghazi,, F. and Mostafazadeh,, A. and Mostafaii,, A. and Rajabnia,, R.}, title = {Characterization of Heat Shock Response in Brucella melitensis and Interaction of Heat Shock Protein with Sick and Healthy Sera}, abstract ={    Background & Aim: Brucella is one of the most important zoonotic diseases and is caused by the members of Brucella genus especially B. melitensis. The bacteria begin to synthesize heat shock proteins(hsp) when facing elevated temperatures. In this investigation, clinical isolates of B. melitensis were subjected to heat shocks and the hsps produced were surveyed by SDS-PAGE electrophoresis. The immunogenicity of hsp-60 was then investigated in both sick and healthy sera by Western blot. Material and Method: In this analytical descriptive study, five B. melitensis isolated from sick people were cultured. The bacterial isolates were subjected to 39, 40, and 42˚C heat shocks and after lysing the cells by lysozome, cell proteins were extracted by SDS(sodium dodecyl sulfate). The extracted proteins were exposed to electrophoresis in SDS-PAGE followed by staining with Coomasie Blue. Finally, antibodies against hsp-60 in control as well as sick sera were surveyed by Western blot. Results: SDS-PAGE gels revealed protein bands mainly in the range of 10-100 KDa. The major protein groups were in the range of 45-75, 20-30, and 14-20 KDa. The amount of 60 KDa protein band(hsp-60) was significantly enhanced following heat shock in comparison to unheated cells. The sera from Brucellosis patients reacted with several of these cell-derived protein bands in Western blots, none of which were reactive with the sera from healthy individuals. These reactive proteins were in the range of 10, 60, and 100 KDa. The 60 KDa band was the most significant one and showed strong reactions with all Brucellosis serum samples. Significant differences in protein bands were detected by the electrophoresis of the cells subjected to 39 and 40˚C heat shocks in comparison to unheated bacteria. Conclusion: The SDS-PAGE results indicated that Brucella melitensis begins to synthesize heat shock proteins when facing elevated temperatures. The Western blot protein bands of the heat shocked bacteria incubated with sera from sick and healthy individuals showed striking differences. This observation points to the immunogenic properties of hsps, especially the overwhelming response to hsp-60. Therefore, hsp-60 can be a good antigen candidate for ELISA test development as well as for engineering subunit vaccine against Brucella.}, Keywords = { 1) Brucella melitensis 2) Heat Shock 3) Protein}, volume = {15}, Number = {0}, pages = {39-48}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-893-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-893-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Oormazdi,, H. and Akhlaghi,, L. and Razmjoo,, E. and BeiromVand,, M and Sarvi,, Sh. and Tavalla,, M.}, title = {Investigation of Total IgG and IgA and IgG2 in Adult Subjects with Blastocystis Hominis}, abstract ={    Background & Aim: Blastocystis hominis is an intestinal parasite in humans and animals. Despite extensive studies, pathogenic role of this organism is controversial. Prevalence rate of contamination with this organism varies from 1.5% to 10% in developed countries and reaches up to 50% in developing countries. The purpose of this study was to investigate total IgG, total IgA and IgG2 subclass in adults infected with Blastocystis hominis and compare them with healthy individuals. Patients and Method: In this cross-sectional case-control study, we selected 100 adults infected with Blastocystis hominis and 100 healthy subjects referred to health service sectors of Iran University of Medical Sciences and Milad Hospital. Serum immunoglobulin examinations were performed by means of nephelometry and Minineph human Ig kit made by the Binding Site Ltd., Birmingham, UK. Data analysis was done by SPSS version 12 and independent t-test. Results: According to the obtained results, there was no significant difference in the level of total IgA between the case and control groups(t=409, P=0.683), but the levels of total IgG and IgG2 subclass showed a significant difference between the case and control groups(IgG: t=2.83, P= 0.005 IgG2: t= 2.02, P= 0.002). Conclusion: The results showed that the immune system response to carbohydrate and glycogenic antigens of the central vacuole of this protozoon leads to an increase in the level of serum IgG especially IgG2 subclass.}, Keywords = { 1) Blastocystis Hominis 2) Total IgG 3) Total IgA 4) IgG2 }, volume = {15}, Number = {0}, pages = {49-54}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-894-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-894-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Izadi,, F. and MalekiDelarestaghi,, M. and Pousti,, S.B. and ZanganehKazemi,, A. and Mir,, P.}, title = {A 12-year Survey on the Incidence of Causes and Complications of Pediatric Tracheostomy in Hazrat Rasool-e-Akram Hospital}, abstract ={    Background & Aim: Tracheostomy has a distinct role in dealing with upper airway problems. Due to immaturated physiology and structure of airways and differential causes and complications of tracheostomy in children, obstructions and problems of airways are of great value. Unfortunately, there is not enough information about airway problems of this age group available for physicians and other care givers. Owing to the lack of basic information about causes and complications caused by this kind of surgery in Iran, we developed this study to distinguish existing differences between different centers and detect positive and negative points. Patients and Method: In this retrospective case series, we reviewed the files of all patients who had undergone tracheostomy in Hazrat Rasool-e-Akram Hospital from 1993 to 2004. Results: 365 patients who had undergone tracheostomy were investigated but only the files of 344 cases were reliable. 51 patients were under 12 years old, including 12(23.5%) females and 39(76.5%) males. The most common primary causes of tracheostomy were neurologic disorders(19.6%) and subglottic stenosis(15.7%). 9 patients(17.6%) encountered early and 13 patients(25.5%) faced late complications. 11 patients(21.6%) had died but none of these deaths were related to tracheostomy. Conclusion: Primary causes of tracheostomy, complications and their incidence, and patient's mortality rate in our hospital are similar to other centers. It reveals that information level and management of these patients in this hospital are acceptable.}, Keywords = { 1) Tracheostomy 2) Children 3) Airway Obstruction 4) Tracheotomy 5) Complications }, volume = {15}, Number = {0}, pages = {55-62}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-895-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-895-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Behnam,, H. and Farhat,, F.}, title = {A Case Report of Non-Hodgkin Lymphoma with the Primary Presentation of the Loosening of the Teeth}, abstract ={    Introduction: Maxillary sinus lymphoma, regardless of being primary or secondary, is almost always of B-cell type and in most cases is presented with the symptoms of the involvement of sinus, oral, nasal and orbital cavities. Case Report: The patient was a 20-year-old man with no sinonasal and orbital involvement symptoms who had complaints of having a mass in the hard palate and loosening of the two incisor teeth. Diagnostic procedures such as X-ray and local biopsy confirmed B-cell lymphoma. Conclusion: Although loosening of the teeth is a rare presentation, it can open up the possibility of sinus malignancies specially lymphoma if happening spontaneously and without a vindicating reason.}, Keywords = { 1) Maxillary Sinus Lymphoma 2) Non-Hodgkin Lymphoma 3) B-Cell Lymphoma4) Oral Cavity Involvement 5) Tooth Loosening }, volume = {15}, Number = {0}, pages = {63-67}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-896-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-896-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Panahi, F. and Khatami,, M. and AzizabadiFarahani,, M. and KhoddamiVishteh,, H.R. and Assari,, Sh.}, title = {Time Indices of Pediatric Prehospital Emergency Care in Tehran, 2006}, abstract ={    Background & Aim: A significant part of "Golden Hour" for urgent health care of children is wasted in prehospital setting, and delays in providing health care may be followed by undesirable outcomes. The current study was conducted with the aim of assessing time indices of pediatric prehospital emergency care in Tehran. Patients and Method: In this cross-sectional observational study, 115 calls requesting urgent health care services for children at the age of 15 and less were extracted from all recorded calls between 2005 and 2006. Demographic variables, accident type, very early outcomes, and time indices(Response time, Scene time, Total run time, Transport time, Round trip time) were registered. We described qualitative variables using frequency tables, and mean and standard deviation were used to describe quantitative variables. Independent t-test and Chi-square were applied to analyze the data. Results: Out of 6787 calls, 1052(15.5%) were related to children. 717(68%) of these calls were because of the problems of internal medicine and the rest(32%) were related to trauma. Road accident(18.7%), epilepsy(18.3%), unconsciousness(12.4%) and respiratory disorders(10.4%) were among the most common causes for 115 calls. 21 subjects(5.36%) died before ambulance arrival, but no one died while being taken to the hospital. The means(SD) of response time, scene time, total run time, transport time, round trip time were 14.98±6.72, 20.90±11.12, 52.60±23.98, 18.45±12.10 and 60.79±30.34 respectively. The mean ages of deceased and survived patients were 7.95±5.04 and 10.74±4.41 respectively(p=0.009). Average ambulance response time was 16.75±3.88 vs. 14.23±6.31 in deceased and survived patients respectively(p=0.022), which was indicative of a significant difference. Conclusion: Some of the time indices in this study are at the level of reported standards around the world but some others are not. The rate of very early mortality in our country is higher than other countries. Therefore, careful planning to improve time indices, assessing the causes of prolonged time indices, and making effective interventions are highly recommended. Also, staff training courses should focus on more common problems such as trauma, convulsion, unconsciousness, and respiratory disorders.}, Keywords = { 1) Time Indices 2) Prehospital Emergency Care 3) Children}, volume = {15}, Number = {0}, pages = {69-80}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-898-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-898-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Pourmotabbed,, A. and MehrabiNasab, E. and Soraya, F. and Moradi, S. and Haghighizad,, H. and Tahmassian,, M.}, title = {The Effect of Morphine Dependency on Spatial Learning and Memory in Male Rat}, abstract ={    Background & Aim: Opiates addiction is a phenomenon with complex physiological and social causes and consequences. The exact mechanisms of development of dependency and relapse remain unclear. Among the several possible mechanisms, the role of learning and memory in opiate dependency and relapse has received considerable attention in recent years. Therefore, in the current study the effect of morphine dependency induced by repeated subcutaneous injection of morphine on the above-mentioned parameters was examined. Material and Method: In this experimental study, animals in both dependent and withdrawal groups received morphine sulfate(10 mg/kg, s.c.) and normal saline was given to the control group. The administration of morphine sulfate and normal saline was done twice per day(8:00 AM & 8:00 PM) for 15 consecutive days. Dependent and control groups were observed from the 11th to 15th day but withdrawal animals were studied from the 16th to the 20th day. The animals were tested for four consecutive days(4 trials/day) to evaluate spatial learning process. During these 4 days(training days) the position of the hidden platform was unchanged. On the fifth day(probe trial) the platform was removed from maze to evaluate spatial memory process. The recorded spatial learning and memory parameters were subjected to ANOVA. Results: The data showed that traveled times and distances to find the hidden platform, the mean of swimming speed on training days, and also the percentage of times and distances traveled in the target quarter in the probe trial stage were not statistically different among the studied groups. Conclusion: These findings clearly imply that morphine dependency induced by the current method has no significant effect on spatial learning and memory, which may result from a relative tolerance to morphine in dependent animals.}, Keywords = { 1) Morphine Dependency 2) Morris Water Maze(MWM) 3) Spatial Learning and Memory 4) Rat }, volume = {15}, Number = {0}, pages = {81-90}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-899-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-899-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {JaffarBegloo,, E. and Ziaee,, S. and FaghihZadeh,, S.}, title = {A Comparative Survey of Gastrointestinal Complications Caused by Iron Supplement and Placebo in Pregnant Women with Hb>13.2gr/dl}, abstract ={    Background & Aim: Numerous researches have shown that the consumption of ferrous sulfate pills in non-pregnant women causes gastrointestinal complications. Furthermore, pregnancy itself causes changes in gastrointestinal system and induces gastrointestinal disorders. The aim of this study was evaluation of ferrous sulfate side effects in pregnant women with Hb>13.2gr/dl. Patients and Method: This research was a double-blind clinical trial which was carried out on 139 pregnant women with Hb>13.2gr/dl. 88 persons were placed in the case group and 51 in the control group. In the case group, individuals consumed one ferrous sulfate pill containing 50 mg iron, per day, from the 20th week to the end of pregnancy. The control group consumed one placebo tablet per day from the 20th week to the end of pregnancy. The side effects of iron and placebo were investigated in the 24th and 36th weeks of gestation. Results: The results of this study revealed that there was no statistically significant difference in terms of nausea, vomiting, diarrhea, constipation, heartburn, and abdominal cramp between the two groups in the 24th and 36th weeks of pregnancy. Conclusion: It seems that gastrointestinal complications in pregnancy relate more to pregnancy itself than ferrous sulfate side effects.}, Keywords = {1) Iron Supplement 2) Gastrointestinal Complications 3) High Hb Concentration}, volume = {15}, Number = {0}, pages = {91-96}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-900-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-900-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Jafari,, Z. and Ahmadi,, P. and Ashayeri,, H. and MotesadiZarandi,, M.}, title = {Auditory Steady State Response Findings in Adults with Auditory Neuropathy/Dys-synchrony}, abstract ={    Background & Aim: Auditory steady state response(ASSR) is an auditory evoked response that has received a lot of attention nowadays. At present, ASSR is mostly used to estimate pure-tone thresholds. Clinical evidence of ASSR in combination with findings for auditory middle latency response (AMLR) and 40 Hz response support the assumption that based on stimulus modulation rate, the ASSR anatomic generators are sub-cortical and/or cortical. The goal of the present study was to investigate ASSR findings in a group of young adults with auditory neuropathy/dys-synchrony(AN/AD). Patients and Method: This cross-sectional analytical study was performed on 16 adults with AN/AD (mean age: 20 5.30 years) and 28 subjects with normal hearing(mean age: 22 3.80 years). ASSR test with high rate modulated stimulus was done at four octave frequencies of 500, 1000, 2000 and 4000 Hz on each ear individually in both AN/AD and control groups. Independent t-test was used to compare hearing thresholds obtained by behavioral evaluation and ASSR recording in each studied group individually. Results: Average pure-tone thresholds revealed moderate hearing loss in AN/AD individuals with focus on low frequencies so that the low-tone loss seen in audiograms was observed in almost two-thirds of the subjects, a finding which is common in adults with AN/AD. However, ASSR revealed profound hearing loss at four studied frequencies in all AN/AD patients regardless of behavioral hearing thresholds, and a significant difference was shown between hearing thresholds gained by these two methods, namely PTA and ASSR. Conclusion: Although in clinical setting ASSR is usually used to estimate hearing thresholds in different populations and degrees of hearing loss, its findings are different in AN/AD patients and can be used for differential diagnosis of this disorder. Using high rate modulated stimulus, severe and profound hearing loss or no ASSR is expected in AN/AD. Considering the fact that ABR also leads to the same abnormal results in AN/AD, it seems that the brain generators of both ABR and ASSR are the same and the concordance between their findings can confirm a defect in auditory brainstem function in patients with suspected AN/AD.}, Keywords = { 1) Auditory Neuropathy/Dys-synchrony(AN/AD) 2) Auditory Steady State Response(ASSR) 3) Auditory Brainstem Response(ABR) 4) Pure Tone Audiometry(PTA) }, volume = {15}, Number = {0}, pages = {97-108}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-901-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-901-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Hassani,, V. and Manoochehripour,, M. and Nojoomi,, M.}, title = {Study of the Effects of Intravenous Paracetamol with Different Doses on Opioid Sparing during and after Upper Limb Surgeries}, abstract ={    Background & Aim: The use of opioids to control pain during and after surgeries is a current method in anesthesia, but the side effects of these drugs like nausea, vomiting and respiratory depression have made us decrease their use. One proposal is to use NSAIDs in order to decrease the doses of opioid drugs. One of these drugs is paracetamol which can be used intravenously. In this study we administered two different doses of intravenous paracetamol to help control pain in patients who had upper limb surgeries. The aim of the present study is to investigate whether intravenous paracetamol has a role in decreasing the use of opioids for pain control during and after surgeries. And if the answer is positive, what dose might be effective. Patients and Method: This is a double-blind study which was carried out on 60 ASA(American Society of Anesthesiology) class I patients between the ages of 20 and 40. The subjects were divided into 3 groups, each of which included 20 patients. Group A received 15mg/kg and group B received 30mg/kg intravenous paracetamol before the induction of anesthesia. Group C was the control group. The method of induction and maintenance of anesthesia and pain control during and after surgery was the same in the three groups. The amount of recommended opioids in the three groups was measured and recorded according to a similar protocol. Results: The obtained results were assessed by Chi-square, ANOVA and Scheffe tests. With regard to the amount of administered fentanyl at the time of surgery, the difference between groups A and C and groups A and B was not significant, but the difference between groups B and C was significant(P=0.01). With regard to the amount of administered pethedin for pain control 6 hours after surgery, the difference between groups A and C and groups A and B was not significant, but the difference between groups B and C was significant(P=0.01). Conclusion: It is recommended that 30mg/kg intravenous paracetamol be administered before the induction of anesthesia to decrease the doses of opioids for pain control during and until 6 hours after upper limb surgeries.}, Keywords = { 1) Intravenous Paracetamol 2) Pain Control 3) Upper Limb Surgeries 4) Opioids }, volume = {15}, Number = {0}, pages = {109-115}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-902-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-902-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Rohani,, M. and Sina,, F. and Zamani,, B. and Akbariannia, M.A.}, title = {Comparison of MCA flow Velocity in Preeclampsia and Normal Pregnancy with Transcranial Doppler}, abstract ={    Background & Aim: Preeclampsia is the major cause of maternal and perinatal morbidity and mortality. Transcranial Doppler(TCD) as a noninvasive procedure is used to assess hemodynamic changes in middle cerebral artery(MCA). Knowing the influence of normal pregnancy and preeclampsia on brain hemodynamics is essential for proper management of anesthesia, labor and vasoactive drug usage in these patients. The aim of the present study is to measure and compare MCA flow velocity in preeclamptic and normal pregnant women using transcranial doppler. Patients and Method: In this case-control study, transcranial Doppler ultrasound was used to measure peak systolic velocity(PSV), end-diastolic velocity(EDV), mean flow velocity(MV), and pulsatility index(PI) in the middle cerebral artery(MCA) of 30 preeclamptic and 30 normotensive pregnant women in the third trimester. Preeclamptic subjects matched the normotensive ones for maternal age, gestational age and gravidity. Statistical analysis was done using independent t-test and Fisher Exact test. Results: Preeclamptic women had significantly higher baseline peak(113.3 compared with 76.31cm/s, P<0.001), end-diastolic(59.1 compared with 38.4cm/s, p<0.001) and mean velocity(73.8 compared with 46.1cm/s, P<0.001) in the middle cerebral artery. Conclusion: Preeclamptic patients had elevated baseline peak, end-diastolic and mean velocity in the MCAs. These findings are consistent with a state of vasoconstriction in preeclamptic women which is unresponsive to stimuli that under normal circumstances result in vasodilation.}, Keywords = { 1) TCD(Transcranial Doppler) 2) Preeclampsia 3) MCA(Middle Cerebral Artery) Flow Velocity 4) Normal Pregnancy}, volume = {15}, Number = {0}, pages = {117-122}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-903-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-903-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Zaman,, B. and Hassani,, V. and Alimian,, M. and Sohrabi,, P. and Radmehr,, M.}, title = {Assessment of the Effect of Intravenous Dexamethasone on the Prevention of Post-General Anesthesia Shivering in Patients Undergoing Knee Arthroscopy}, abstract ={    Background & Aim: Although shivering is one of the consequences of perioperative hypothermia and is rarely considered as the most serious complication, it occurs frequently and remains poorly understood. While cold-induced shivering has an obvious etiology, post-general anesthetic shivering is attributed to numerous causes. Until now, dexamethasone has been used for the treatment of post-general anesthetic shivering. The objective of the present study is to evaluate the effects of intravenous dexamethasone on the prevention of post-general anesthetic shivering. Patients and Method: 80 patients who were candidates for elective knee arthroscopic surgery were selected and randomly divided into case and control groups. Immediately after the induction stage of anesthesia, which was the same for both groups, 0.15 mg/kg of intravenous dexamethasone was administered to the case group. The same amount of distilled water was intravenously administered as placebo to the control group. The temperature of the operating room was kept between 20 and 25 degrees centigrade. When the operation ended, shivering score was measured and recorded by a trained nurse in the recovery room. The patients and the nurse were blind to case and control allocation of the patients. Results: The mean age of the patients, the temperature difference between operating room and patient's body, and shivering score were 27.34 years, 9.52 degrees centigrade and 1.76 respectively. Both groups were matched for age, weight, operating room and patient's body temperature difference, surgery time, recovery time, and the amount of administered fluids. There were statistically significant differences in score and incidence of shivering between the two groups. A statistically significant correlation was also found between administered fluid volume and shivering score in both groups. Conclusion: The obtained results revealed that intravenous dexamethasone is effective in the prevention of post-general anesthetic shivering. This confirms previous studies and it seems that this study supports central mechanism of post-general anesthetic shivering rather than peripheral one.}, Keywords = { 1) Post-Anesthetic Shivering 2) Intravenous Dexamethasone 3) Knee Arthroscopy}, volume = {15}, Number = {0}, pages = {123-129}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-904-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-904-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Sina,, F. and Rohani,, M. and Zamani,, B. and Akbariannia,, S.M.A. and Sariri,, E.}, title = {Cerebral Vasomotor Reactivity in Normal Pregnancy and Preeclampsia}, abstract ={    Background & Aim: Preeclampsia is the major cause of maternal and perinatal morbidity and mortality. Transcranial Doppler(TCD) as a noninvasive procedure is used to assess hemodynamic changes in middle cerebral artery(MCA). Knowing the influence of normal pregnancy and preeclampsia on brain hemodynamics is essential for proper management of anesthesia, labor and vasoactive drug usage in these patients. The aim of the present study is to evaluate and compare vasomotor reactivity in normal pregnancy and preeclampsia. Patients and Method: In this case-control study, transcranial Doppler ultrasound was used to measure peak systolic velocity(PSV), end-diastolic velocity(EDV), mean flow velocity(MV), and pulsatility index(PI) in the middle cerebral artery(MCA) of 16 preeclamptic and 15 normotensive pregnant women in the third trimester. Cerebral vasomotor reactivity(VMR) was measured as percentage of changes in peak flow velocity after inhaling 5% co2 for 1-2 minutes. Statistical analysis was done using independent t-test and Fisher Exact test. Results: There was no significant difference in terms of maternal age, gestational age and gravidity between the two groups. Preeclamptic women had higher baseline peak(113.3 compared with 76.31 cm/s, P<0.001), end diastolic(59.1 compared with 38.4cm/s, P<0.001) and mean velocity(73.8 compared with 46.1 cm/s, P<0.001). In comparison to normotensive group, preeclamptic women showed a significant decrease in vasomotor reactivity(4.41% compared with 8.51%, P<0.001). Conclusion: Preeclamptic patients had elevated baseline peak, end-diastolic and mean velocity in the MCAs and decreased VMR in reaction to 5% co2 inhalation. These findings are consistent with a state of vasoconstriction in preeclamptic women which is unresponsive to stimuli that under normal circumstances result in vasodilation. Cerebral edema, hemorrhage, ischemia, and convulsion are all considered as complications developing in preeclampsia or eclampsia. The precise etiology of these complications is unknown but they might be seen due to vascular disturbance. Under normal circumstances, autoregulation maintains the blood flow of the brain subject to a wide range of changes in systemic blood pressure. It seems that autoregulation malfunctions in preeclampsia. Abnormal response given to cerebral perfusion pressure by cerebral vessels might have a role in pathophysiology of cerebral dysfunction which is seen in preeclampsia.}, Keywords = { 1) Pregnancy 2) Cerebral Vasomotor Reactivity 3) Preeclampsia}, volume = {15}, Number = {0}, pages = {131-136}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-905-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-905-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Alishiri,, Gh.H. and Amini,, M. and AhmadzadAsl,, M. and Ghorbani, Gh.A. and Jafari,, A.M. and Salimzadeh,, A.}, title = {Assessment of the Prevalence of Anti H-Pylori Antibody in Patients with Osteoarthritis and Healthy Persons referred to Baqiyatollah Hospital, Tehran 2006}, abstract ={    Background & Aim: Osteoarthritis(OA) is the most frequent disorder seen in the population and imposes a great financial load on the health systems worldwide. This issue necessitates more evaluations to elucidate factors influencing its incidence, severity or clinical presentations. The aim of the present study is to find out whether helicobacter pylori(H.pylori) seropositivity differs significantly in patients suffering from OA in comparison with healthy population. Patients and Method: In an analytic observational cross-sectional study, an enzyme-linked immunosorbent assay(ELISA) was used to detect H.pylori specific immunoglobulin G(IgG), immunoglobulin A(IgA) and antibodies against cytotoxin-associated-protein A(anti-Cag A) in 90 patients with OA referred to Baqiyatollah rheumatology clinic and 95 healthy control individuals. For data analysis independent t-test was used. Results: The average age was 53(±0.64) years for 84 women and 6 men in OA group and 39.67(±1.12) years for 78 women and 17 men in the control group. Mean serum IgA level was 40.3(±3.75) and 27.26(±2.05) for OA and control groups respectively. In our evaluation this disparity was statistically significant(P=0.003). Anti H.pylori IgG serum level was not significantly higher in patients with OA in comparison with healthy individuals(P=0.128). Also, anti-CagA antibody serum level did not show a significant difference between OA and control groups(P>0.05). Conclusion: Serum level of anti H.pylori IgA antibody was significantly higher in patients with OA than healthy individuals(p=0.003). This finding was not true for anti-Cag A and IgG antibodies.}, Keywords = { 1) Prevalence 2) Helicobacter Pylori 3) Osteoarthritis}, volume = {15}, Number = {0}, pages = {137-143}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-906-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-906-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Ghaem,, H. and Jafari,, P. and Moslehi,, Sh}, title = {A Comparison of the Knowledge of Breast Self-Examination in Female Students of Shiraz University of Medical Sciences and Those of Shiraz University of Sciences, 2004}, abstract ={    Background & Aim: Breast cancer is the most common cancer in women. Early detection of breast cancer is effective in reducing its mortality rate, and the best method of its screening is breast self-examination. The purpose of this study was to determine the knowledge of breast self-examination among the female students of Shiraz university of sciences and Shiraz university of medical sciences in 2004. Patients and Method: A cross-sectional study was conducted. The sample contained 198 female students of Shiraz university of sciences and 180 female students of Shiraz university of medical sciences. The subjects were selected through stratified random sampling(the major was strata). Data were collected by a questionnaire with a reliability of more than 80% and analyzed by SPSS 11.5. Results: Judging from the answers given to the total 12 questions on the knowledge of BSE, the results showed that the mean knowledge of BSE in the students of Shiraz university of sciences and Shiraz university of medical sciences was 4.7±7.6 and 5.8±2.9 respectively, which was indicative of a significant association(P<0.049). There was no significant relation between the level of knowledge of BSE and family history of breast cancer, age, educational year, and marital status. However, there was a significant association between the level of knowledge of BSE and major(P<0.000). Conclusion: In conclusion, the students' level of knowledge of BSE was lower than average. Therefore, it is recommended that educational practical workshops on the aforementioned matters be held.}, Keywords = { 1) Knowledge 2) Breast Self-Examination 3) Breast Cancer 4) Students}, volume = {15}, Number = {0}, pages = {145-153}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-907-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-907-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Mohebbi,, A.R. and Mohebbi,, S.}, title = {The Role of Sinonasal Endoscopic Surgery in the Treatment of Sinonasal Headaches}, abstract ={    Background & Aim: Some headaches may originate from sinonasal area and can develop without any inflammation or infection signs. Contact points between lateral nasal walls and the septum may trigger pain via trigeminovascular system. The aim of the present study is to evaluate the role of endonasal endoscopic surgery in the management of sinonasal headaches with special regard for diagnostic criteria and patient's choice. Patients and Method: In this prospective, non-randomized, quasi-experimental study, 36 patients suffering from chronic and refractory headaches were evaluated by examination(rhinoscopy and/or endoscopy), sinus CT scan, anesthetic test and then categorized into four groups according to the diagnostic method. Pain severity prior to and after surgery(with an average follow-up period of 18 months) was assessed by VAS(visual analogus scale) method(0-10 scale) and analyzed by ANOVA. Results: Overall success rate was 83%, including 11% cure and 72% improvement. The best response was noted in patients whose diagnostic criteria were all positive. The response in all patient groups except those who only had positive examination was statistically significant. 39% of the patients had been previously diagnosed with migraine and 78% of them developed improvement. Conclusion: Surgery in cases with more positive evidence of contact points, particularly if medical therapy has failed, could be successful. This issue may be acceptable even in migrainous patients.}, Keywords = { 1) Headache 2) Contact Point 3) Migraine 4) Sinonasal Endoscopic Surgery }, volume = {15}, Number = {0}, pages = {155-162}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-908-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-908-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Moradi,, S. and Ghaffarpour,, Gh.H.}, title = {Thyroid Dysfunction and Thyroid Anti-Bodies in Iranian Patients with Vitiligo}, abstract ={    Background & Aim: Vitiligo is a common skin disorder with unknown origin. An increased prevalence of autoimmune diseases, including thyroid diseases, has been described in patients with vitiligo. The aim of this study was to assess the prevalence of thyroid dysfunction and hypoparathyroidism in patients with vitiligo. Patients and Method: One hundred and nine patients(38 males & 71 females) with vitiligo were studied. Thyroid physical examination and thyroid function tests were done. Thyroid antibodies, calcium and phosphorus were measured. The collected data were analyzed by using SPSS version 11. Results: 30.1% of the patients had thyromegaly. Hypothyroidism was found in 16(15.7%) out of 109 cases. Two of them had clinical and 14 subclinical hypothyroidism. One patient had Graves disease. Anti-body positivity was the most common disorder(anti-TPO & anti-tg were positive in 36.7% & 32.1% respectively). No patient had hypoparathyroidism. Conclusion: According to our study, thyroid dysfunction especially hypothyroidism and thyroid antibodies increase in patients with vitiligo. Therefore, we recommend thyroid antibodies assessment and thyroid function evaluation in these patients.}, Keywords = { 1) Vitiligo 2) Thyroid Dysfunction 3) Thyroid Anti-Bodies}, volume = {15}, Number = {0}, pages = {163-168}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-909-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-909-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Nojoomi,, M. and Anbari,, Kh}, title = {A Comparison of the Quality of Life in HIV/AIDS Patients and Control Group}, abstract ={    Background & Aim: During recent years, the quality of life as one of the important outcomes of chronic diseases has been paid attention to by clinical researchers. The aim of this study was to determine the quality of life of the patients with HIV/AIDS referred to the West consulting center of behavioral diseases in Tehran and to draw a comparison with the quality of life of healthy persons. Patients and Method: Using simple sampling method, this cross-sectional study was carried out on 139 patients and 139 healthy subjects in the control group matching the patients for age and sex. The study made use of the summarized quality of life questionnaire of World Health Organization(WHO-Qol-Brief). Demographic and clinical variables associated with the quality of life of HIV/AIDS patients were assessed. Statistical tests like t-test, Chi-square, One-way ANOVA, and Linear regression were used for data analysis. Results: The majority of the patients(88.5%) were male with secondary education. 28.1% were married and the majority of them were unemployed. The average age of the cases was 35.49 years(6.42 SD). A significant difference was seen between the patients and the control group in all aspects of quality of life(P<0.001). The variables such as sex, marital status, education, job, CD4+ cells count, and the clinical stage of the disease had a significant effect on the quality of life of the patients. In multivariable analysis, the most important predictive factor in the quality of life of the patients was the clinical stage of the disease. Conclusion: Providing psychosocial services with continuous and multidisciplinary care models besides medical interferences can promote the health-related aspect of quality of life in patients suffering from HIV/AIDS.}, Keywords = { 1) Quality of Life 2) AIDS 3) HIV Positive 4) Healthy Control }, volume = {15}, Number = {0}, pages = {169-176}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-910-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-910-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Neshasteh-Riz, A. and Bishesari,, N. and Khoei,, S.}, title = {Evaluation of the Extent of Cytogenetic Damage Induced by Ionizing Radiation at Different Intervals of Cell Incubation with Iudr in Spheroid Model of Glioblastoma Cell Line Using Comet Assay}, abstract ={    Background & Aim: 5-iodo-2-deoxyuridine(Iudr) is a thymidine analog that is known as a radiosensitizer for human cancer cells in in vitro and in vivo studies. The investigations on the spheroid have shown that Iudr uptake of cells increases with the increasing Iudr incubation time. The aim of this study was to evaluate the extent of cytogenetic damage induced by ionizing radiation at different intervals of cell incubation with Iudr using comet assay. Material and Method: In this basic experimental study, U87MG, a Glioblastoma cell line was cultured as spheroid in two different sizes, 100 and 300µm. The spheroids were incubated with Iudr in three different volume doubling times. Then they were irradiated by 2Gy of gamma radiation of cobalt 60. The extent of DNA damage was measured using alkaline comet assay and the data were analyzed by Students' t-test. Results: The results showed the extent of DNA damage induced by gamma radiation in combination with Iudr was greater in spheroids with 300µm of diameter than spheroids with 100µm of diameter. Investigations revealed that the DNA damage after two volume doubling times of incubation with Iudr is significantly more than one volume doubling time of incubation in two different sizes of spheroids, but the extent of damage in spheroids with 300µm of diameter was larger. However, there is no significant difference between the DNA damage after incubation for two and three volume doubling times. Conclusion: As it can be seen, two-volume-doubling-time incubation of cells is more suitable than one or three volume doubling times to develop radiation sensitivities.}, Keywords = { 1) Glioblastoma 2) Spheroid 3) Iudr 4) Comet }, volume = {15}, Number = {0}, pages = {177-186}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-911-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-911-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Vaseghnia,, A and EbrahimiTakamjani,, I. and Sarrafzadeh,, J.}, title = {The Effect of Heel Height on Standing Balance Indices}, abstract ={    Background & Aim: Good balance is essential to do daily activities. Recent studies have focused on the adaptability of balance through previous experiences and training. Study of the balance of people who have had some kind of these experiences can clarify the nature of the adaptability of balance. The aim of the present study is to evaluate balance ability in persons who are exposed to balance perturbations during daily activities for a long time in order to confirm the effects and durability of balance training exercises that are important in rehabilitation. Patients and Method: This is a cross-sectional experimentalloid study conducted on 60 healthy subjects divided into 2 groups, each containing 30 adult women who were selected by simple random sampling and inclusive criteria. Group 1 had no experience of using high-heeled shoes during 6 months prior to the experiment and group 2 had the experience of continuous use of high-heeled shoes(more than 3 cm) for at least 6 months. Using Biodex Stability System, Overall Dynamic Stability Index(ODSI) and Overall Limits of Stability Index(OLSI) were recorded while the subjects were wearing shoes designed at three heel heights(0cm, +3cm, +5cm) in different trials. ODSI and OLSI were dependent variables that were compared in each group by repeated measurement test and between the groups by independent t-test. The data analysis was done by SPSS version 10. Results: In group 1, with increasing heel height to +5cm as compared with 0cm or +3cm, the ability of balance control decreased significantly(p<0.05), but in group 2, with increasing heel height, no significant difference was detected in the ability of balance control. Besides, the two groups were significantly different in terms of ODSI for +5cm heel height(p<0.05). Conclusion: Different biomechanical factors such as changing the position of ankle joint and neural factors such as dependency on feedback system could explain lack of rapid and suitable muscular responses and balance control with increasing heel height in the subjects of group 1. Although there were the same changes in heel height and biomechanical factors in group 2, it seems that the changes in neural factors which are due to the prolonged use of high-heeled shoes might be the reason for the difference between the two groups. Suitable anticipatory responses to control the balance with increasing heel height could explain the results in this group. There might be some kind of adaptation and learning in group 2 due to the prolonged use of high-heeled shoes. The findings support the adaptation in C.N.S and permanent changes in the strategies of balance control during daily motor activities.}, Keywords = { 1) Heel Height 2) Balance 3) Biodex Stability System 4) Anticipatory Response }, volume = {15}, Number = {0}, pages = {187-198}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-912-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-912-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {HashemDabbaghian,, F. and Gooshegir,, S.A. and Siadati,, S.M.}, title = {Assessment of the Frequency of Hejamat Centers and Characteristics of Their Clients, Tehran 2006}, abstract ={    Background & Aim: Cupping therapy(Hejamat) as one of the methods used in traditional Iranian medicine is now progressively applied. Some scholars are seriously against this method of treatment, while some others admit it without questioning. The goal of this study is to assess traditional treatment centers and their clients in Tehran. The study also intended to determine demographic features of the clients, the frequency of illnesses for which the patients were referred to these centers, and the clients' satisfaction with cupping therapeutic effects. Patients and Method: This cross-sectional study was done on 400 clients attending 15 traditional medical centers through a questionnaire and interviews. Random sampling and simple sampling methods were used to select the studied Hejamat centers and the subjects respectively. Mean, SD(standard deviation) and frequencies were reported to describe the data. Chi-square and Kruskalwalis test were used to analyze the obtained results. Results: The results revealed that over 85% of the clients were satisfied with the therapeutic effects of Hejamat. Most of the subjects were men, married, low educated and had a below-average monthly income. 63% believed that this method was less expensive than other methods of treatment. Strong faith in the usefulness of Hejamat and religious beliefs were the most common motivations on the part of the clients. Conclusion: With regard to increasing use of cupping to treat a wide group of illnesses and the clients' satisfaction, presenting suitable and proper use, informing people of its usage, and supervising the above-mentioned centers should be considered by authorities.}, Keywords = {1) Hejamat 2) Blood Letting 3) Cupping Therapy 4) Traditional Medicine }, volume = {15}, Number = {0}, pages = {199-206}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-913-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-913-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Hooman,, N. and Otoukesh,, H. and Madani,, A. and Esfehani,, S.T. and Sharifian,Mohkam, M., M. and Mahdavi,, A. and Ataei,, N. and Mohseni,, P. and Gholikhani,, F. and Latif,, E.}, title = {Epidemiologic Study of Children on Continuous Ambulatory Peritoneal Dialysis in three Children\'s Hospitals(Ali Asghar, Mofid, Markaz Tebi) from 1993 to 2004}, abstract ={    Background & Aim: Infants suffering from chronic renal failure should be treated by peritoneal dialysis, hemodialysis or renal transplantation. Unfortunately, the last two modalities are fraught with too many technical difficulties to be used in very young infants. Therefore, until proper weight and age are achieved, prescribing CAPD(Continuous Ambulatory Peritoneal Dialysis) will be mandatory. Providing national registry in many countries has helped to improve the quality of care provided for the patients on CAPD. For this reason we decided to do a multicentral epidemiological study of Iranian children on CAPD. Patients and Method: The records of children on CAPD referred to three main dialysis centers(Ali Asghar, Markaz Tebi, and Mofid Children's Hospitals) from 1993 to 2004 were collected and reviewed retrospectively. The incidence rate of peritonitis and patients' survival rate were determined. T-test, Chi-Square, and Kaplan Mayer were used to compare means, frequency and survival respectively. Cox regression was applied to determine factors influencing survival and correlation coefficient was calculated to reveal the relation between variables. P<0.05 was considered significant. Results: Between 1993 and 2004, 57 children(27 females, 30 males) with a mean age of 32.3 months(ranging from 0.08 to 156 months) were on CAPD. The etiologies of renal failure were hereditary(10.5%), cystic(22.8%), glomerulopathy(33.2%), uropathy(14.3%), dysplasia(8.7%), and miscellaneous or unknown(10.5%). 99 Tenckhoff catheters were inserted surgically. The most frequent surgical complications were hernia and leakage. Peritonitis rate was 1:4.85 patients' months. The rate of peritonitis was higher in children under 12 months, those with Tenckhoff catheters, and children with a low weight and BMI(Body Mass Index) at the start of CAPD(P=0.01). The results of peritoneal fluid cultures were as follows: gram positive(32%), gram negative(28%), negative(30%), and fungi(10%). There was a significant correlation between fungal peritonitis and peritonitis rate and the first episode of peritonitis(P=0.01). The mean of patients' survival rate was 0.9 years(95% CI 0.61-1.16). The outcomes of children were recovery(10.5%), transplantation(8.8%), switch to hemodialysis(7%), still on CAPD(14%), death(57.9%), and 1.8% were missed out. Conclusion: Due to the high rate of mortality and morbidity in children on CAPD, we recommend tighter nutritional control, periodical re-education to parents, and expert medical staff to improve the prognosis.}, Keywords = {Key Words: 1) Ambulatory Peritoneal Dialysis 2) Peritonitis 3) Epidemiology 4) Pediatric 5) Complications}, volume = {15}, Number = {0}, pages = {207-214}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-914-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-914-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Ehsanipour, F. and Mo'adabi, H. and Shayanfar, N.}, title = {A Comparison of CSF Lactic Dehydrogenase in Children with Simple and Complex Febrile Convulsion}, abstract ={   Background & Aim: The levels of lactic dehydrogenase(LDH) in the cerebrospinal fluid(CSF) have been used to evaluate a variety of neurologic disorders. However, few studies have been performed on CSF LDH in febrile convulsion patients. The aim of this study is to compare CSF LDH in children with simple and complex febrile convulsion.   Patients and Method: In this study, which was prospective, analytic and cross-sectional, CSF samples were collected from 225 children: 75 with simple febrile convulsions(group A), 75 with complex febrile convulsions(group B) and 75 with no neurological or intracranial pathology(controls, group C). Lactic dehydrogenase(LDH) levels in CSF were measured by a Hitachi analyzer. Then CSF LDH was compared between the three groups. The results were analyzed via Students' t-test.   Results: Mean total LDH levels in groups A, B and C were 64.62 ± 12.44, 81.93 ± 21.37, and 51.10 ± 11.82 IU/L respectively. The LDH level in group B was significantly higher(P<0.05) than that in the other two groups. In group A, mean CSF LDH level was also higher than that in group C(P<0.05).   Conclusion: This survey is the second report on the LDH level in the CSF of the patients with simple and complex febrile convulsions. The important finding is that simple and complex febrile convulsions may be associated with cell damage and change in aerobic and anaerobic metabolism, and this damage is greater in complex febrile convulsions.  }, Keywords = { Lactic Dehydrogenase(LDH),Cerebrospinal Fluid(CSF), Children }, volume = {15}, Number = {0}, pages = {7-12}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-996-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-996-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Akhlaghi, L. and Ourmazdi, H. and EhsaniZonooz, A.V. and Tavalla, M. and Khanaliha, KH. and Sarvi, SH. and Beiromvand, M.}, title = {Assessment of the Level of Serum Intestinal Isoenzyme Alkaline Phosphatase in Patients with Giardiasis}, abstract ={   Background & Aim: Giardia Lamblia, a flagellate protozoan, is localized to the small bowel where it causes damage to the mucosa with or without gastrointestinal symptoms. In its life cycle this protozoam goes through two stages: trophozoite or active, motile from and resistant or encysted form, by which the infection is transmitted. A number of reports have described some changes in intestinal alkaline phosphatase in rats infected with giardia. Therefore, we planned to evaluate the level of serum IALP(intestinal alkaline phosphatase) in humans infected with giardia via electrophoresis.   Patients and Method: In this descriptive cross-sectional study, we examined a group of 67 patients infected with giardia as the case group and also a group of 30 normal humans with no giardiasis as the control group. Both groups underwent the following tests: fecal examinations including direct smear and formol-detergent, GPT(glutamic-pyruvic transaminase or also called alanine aminotransferase), γ GT( γ -glutamyltransferase) for liver function, and total ALP. Then we isolated ALP bands in the patients' serum samples by electrophoresis. Pearson correlation coefficient was applied to analyze the data.   Results: The study showed an increase in the level of IALP in patients with severe giardiasis.   Conclusion: Giardia infection causes a reduction in the intestinal absorption of calcium which can subsequently lead to a decrease in the amount of serum calcium. This decrease makes parathyroid gland increase the secretion of PTH. This hormone activates vitamin D3 which, in turn, stimulates intestinal epithelial cells to produce more IALP on the one hand and increases the absorption of calcium on the other hand.  }, Keywords = { Intestinal Alkaline Phosphatase , Isoenzyme ,Giardia Lamblia , Electrophoresis , PTH}, volume = {15}, Number = {0}, pages = {13-20}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-997-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-997-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Eghbalian,, F. and Ranjbar,, M.}, title = {A Comparative Study of Rubella Serology before and after Measles-Rubella Vaccination in Pre-Marriage Women in Hamedan}, abstract ={    Background & Aim: Rubella is an infectious viral disease with a worldwide distribution. Infection during early pregnancy may cause fetal death or congenital rubella syndrome(CRS). The high risk of CRS is found in countries with high susceptibility rates among women of child bearing age. Expanded program of vaccination has increased vaccine coverage and exerted a substantial impact on the reduction of rubella infections such as CRS. This study was done to evaluate rubella serology before and after MR vaccination in women who were going to get married in 2000 and 2006.   Patients and Method: A cross-sectional analytic study was done on 250 pre-marriage women who had already participated in the national program of MR vaccination and now were referred to the health center for pre-marriage screening tests. Being selected at random, the subjects entered the study. Anti-rubella IgG was measured by ELISA. The results of this study were compared with the results of a previous study done in 2000, that is, before the national MR vaccination program. SPSS software version 13 was used to analyze the data.   Results: The present study revealed that 98.4% of the subjects in our studied group were immune against rubella, while the study conducted in 2000 reported that 83.5% of the studied population were so, suggesting a statistically significant difference before and after vaccination(P=0.000).   Conclusion: The national MR vaccination program has resulted in a meaningful increase in anti-rubella immunity level in women who are evaluated for pre-marriage tests.}, Keywords = {Key Words: 1) Measles-Rubella Vaccination 2) Rubella Serology 3) Vaccine}, volume = {15}, Number = {0}, pages = {21-26}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1000-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1000-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Agah,, Sh. and Shirali, A. and Sedigh, N. and Fereshtehnejad, S.M. and Saffarian,, H. and Vaziri,, A.H.}, title = {A Comparative Study of the Effects of Herbal Therapy with Carmint}, abstract ={Background & Aim: stomach or intestine, leading to distension of the organs. Approximately 20% of people aged 65-93 have experiencedabdominal distension, often due to gaseous build-up. A wide range of approaches, including chemical drugs and dietarymodifications, are utilized to treat flatulence. One of the most common therapies for flatulence is dimethicone. On the otherhand, the use of alternative therapies, particularly herbal remedies, is also becoming increasingly common. The aim of thisstudy was to compare the effects of carmint as herbal therapy versus those of dimethicone on flatulence.Flatulence is a condition which is defined as the presence of excessive amounts of air or gas in thePatients and Method: flatulence. After determining appropriate inclusion and exclusion criteria, the patients without any organic disorders wereselected and randomly divided into two groups: 42 patients under herbal therapy with carmint in group A and 40 patientsreceiving dimethicone in group B. Both groups received the treatment for two weeks. Then the patients were followed upwith phone calls one and three weeks after the beginning of the treatment and asked about their gastrointestinalsymptoms. The symptoms were recorded in the checklists provided and the data were analyzed by SPSS version 13 usingChi-square, paired t-test, independent t-test, Mann-Whitney U test, and repeated measures.This double-blind, randomized, controlled, clinical trial was conducted on 82 patients withResults: 1.08) and 1.15(SD=1.00) respectively, suggesting that the difference between the two groups was statistically significant(P=0.019). In addition, the mean changes of distension in group A(1.21, SD=0.97) were significantly higher than group B(0.73, SD=1.06)(P=0.01). However, there were not any significant differences in the relapse of most of their symptomsafter stopping the therapy in the third week of follow-up.At the end of the first week of follow-up, the mean changes of flatulence in groups A and B were 1.73(SD=Conclusion: gastrointestinal diseases. On the other hand, dimethicone is also useful in reducing froth in the lumen of thegastrointestinal tract. Nevertheless, in some studies dimethicone does not exhibit any beneficial effects on the symptomsof intestinal gas. In addition, our results show that the effect of carmint is significantly higher than that of dimethicone onrelieving flatulence symptoms, especially in a short period.Carminatives are among the oldest known remedies and were reportedly used by Hippocrates for}, Keywords = {Key Words: 1) Flatulence 2) Dimethicone 3) Carmint}, volume = {15}, Number = {0}, pages = {27-38}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1001-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1001-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {AmirMozaffari,, N. and ForouheshTehrani,, H. and TavafLangeroodi,, Z. and Abdullahi,, A.}, title = {A Survey of Drug Resistance Due to Extended Spectrum Beta Lactamases (ESBLs) in Escherichia Coli Strains Isolated from Hospitalized Patients}, abstract ={Background & Aim: clinical cases especially from hospitalized patients. Recently multiple drug resistant isolated from clinical cases. Resistances were seen against drugs belonging to different antibiotic families. In thissurvey, drug resistance in clinical isolates was studied with special reference to extended spectrum betalactamases.Escherichia coli is one of the most important and prevalent bacteria isolated fromE.coli strains have beenPatients and Method: for drug resistance by disc diffusion method. The minimal inhibitory concentration (MIC) of isolates resistant todifferent antibiotics was determined by E-test. Beta lactamases production was tested with nitrocephin disc andextended spectrum beta lactamases assays were performed with double disc synergy tests. Finally, Chi-squareand t-tests were used to analyze the data.A total of 113 E. coli strains isolated from hospitalized patients were initially surveyedResults: these MDR strains were positive in nitrocephin test, indicating beta lactamases production. Double disc synergytests results showed production of extended spectrum beta lactamases in all MDR isolates.From the total of 113 E.coli isolates tested, 47 (41.5%) showed multi drug resistant trait. All ofConclusion: Detection of 41.5% MDR trait, especially extended spectrum beta lactamases, in the clinicalE.coli cephalosporins. It also necessitates conduction of a wider study to determine the extent of MDR isolates points to the potential dangers posed by the widespread usage of extended spectrumE.colioccurrence at national level.}, Keywords = {Key Words: 1)Escherichia Coli 2)Extended Spectrum Beta Lactamases (ESBLs) 3)Multiple Drug Resistant (MDR)}, volume = {15}, Number = {0}, pages = {39-46}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1002-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1002-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Izadi,, F. and Pousti,, B. and Noori,, H.R. and Hassannia,, F.}, title = {A Case Report of Typical Laryngeal Carcinoid Tumor}, abstract ={  Introduction: Typical laryngeal carcinoid tumor, only 14 cases of which have been reported so far, is one of the rarest neuroendocrine tumors of the larynx. In all these cases supraglottic area was involved. Wide local excision is the treatment of choice.   Case Report: This article represents a 68-year-old man who presented with progressive hoarseness since 6 months ago. Indirect laryngoscopy showed an exophytic mass in the right supraglottic area. Direct laryngoscopy and biopsy were performed. Pathologic findings were compatible with a typical carcinoid tumor.   Conclusion: Owing to different biological behaviors and special treatment modality, accurate diagnosis of neuroendocrine neoplasms of the larynx is very important. When the surgeon is suspicious about the presence of these tumors, special immunohistochemical staining is essential to confirm the diagnosis.}, Keywords = {Key Words: 1) Typical Carcinoid Tumor 2) Neuroendocrine Neoplasm 3) Atypical Carcinoid Tumor 4) Paraganglioma }, volume = {15}, Number = {0}, pages = {47-50}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1003-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1003-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Hajsadeghi,, Sh. and Afsharian, Sh. and Fereshtehnejad, S.M. and Moghaddasi, M.}, title = {Evaluation of the Level of Serum Cardiac Troponin I (cTnI) in Non-Cardiac Uncomplicated Epileptic Patients}, abstract ={   Background & Aim : Sudden Unexpected Death after Epilepsy (SUDEP) is one of potentially lethal side effects of the seizures. Cardiac arrhythmia and myocardial damage have been postulated as underlying causes. On the other hand, serum cardiac troponin I (cTnI) level is one of the most specific cardiac markers for myocardial damage. Therefore, the aim of the present study was to evaluate the level of troponin I in non-cardiac uncomplicated epileptic patients.  �Patients and Method: This analytical cross-sectional study covered forty-nine 12-65-year-old patients with a history of uncomplicated epileptic seizures and no previous history of cardiac problems following an episode of ictal attack during recent 6 hours to 10 days. The subjects underwent cardiac evaluations including ECG, echocardiography, and serum cTnI level measurement. The number of seizures, the age at the onset of seizures, and the time past the last seizure were recorded as well as demographic variables.   Results: The mean age of the patients was 21.18(SD=8.37) with the male/female ratio of 2.26. The mean of hours past the recent seizure episode was 54(SD=52.97) hours. Serum cTnI values were reported as normal in all the patients with the mean of 0.026(SD=0.015) ng/ml. However, a significant correlation was found between the level of cTnI and the number of seizures (r Spearman=0.743, P<0.001).   Conclusion: Our study showed normal values of serum cTnI following an episode of epileptic seizure attack in 12-65-year-old patients with uncomplicated epileptic seizures and no history of previous cardiac problems. However, the level of cTnI was increased in patients with frequent episodes (>3) of epileptic seizures. An experimental model may be suggested to clarify the correlation between serum cTnI levels and ictal states in uncomplicated epileptic seizures.}, Keywords = {Key Words: 1) Troponin I 2) Epilepsy 3) Sudden Unexpected Death after Epilepsy (SUDEP) 4) Myocardial Damage}, volume = {15}, Number = {0}, pages = {51-58}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1004-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1004-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {KhodaPanahandeh,, F. and VahidHarandi,, N. and Esma'iliJazanabadi,, F.}, title = {Evaluation of Seasonal Variation and Circadian Rhythm of Febrile Seizures in Children Admitted to the Pediatric Ward of Rasoul -e-Akram Hospital}, abstract ={  Background & Aim: Febrile seizures are the most common type of childhood seizures. Despite numerous researches which have been done on various aspects of the problem such as genetic ground, risk factors for the recurrence of seizures, probable development of epilepsy, etc., many aspects of it still remain obscure. Therefore, investigations are being conducted in different centers around the world. Considering many reports about the increased frequency of the occurrence of seizures in special seasons and parts of the day, we conducted this study to find whether any special pattern exists in the occurrence of this event.   Patients and Method: In a descriptive cross-sectional study, the medical files of 221 children aged 6 months to 5 years who were admitted with febrile seizure to the pediatric ward of Rasoul-e-Akram Hospital were reviewed. Patients' data including age, gender, etiology of fever, season and time of seizures were collected. Mean ± SD was used to define quantitative variables. Chi-square, one-way ANOVA and t-tests were used to analyze the data.   Results: The mean age of the children was 29.09(±18.64) months. The occurrence of febrile seizures was as follows: 39 children(17.6%) presented with febrile seizures in spring, 58(26.3%) in summer, 47(21.3%) in autumn, and 77(34.8%) in winter. The occurrence of febrile seizures was significantly more common in winter, especially in January (p<0.015). Considering circadian rhythm, more seizures occurred in the afternoon(12 MD to 5:59 PM) and evening(6 PM to 11:59 PM) than at night(12 MN to 5:59 AM) and in the morning(6 AM to 11:59 AM).   Conclusion: In our study febrile seizures occurred more frequently in winter compared to other seasons of the year. In addition, the frequency of the occurrence of seizures in the evening and afternoon was significantly higher than other parts of the day.}, Keywords = {Key Words: 1) Febrile 2) Seizure 3) Seasonal Variation}, volume = {15}, Number = {0}, pages = {59-66}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1005-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1005-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Khavaninzadeh,, M. and Yadollahzadeh,, M. and Gholipoor, F.}, title = {A Comparison between Complications of Vascular Surgery Procedures with and without aPPT Assessment and Protamin Sulfate Reverse}, abstract ={Background & Aim: clamp and also blood stasis during vascular surgeries. Heparin is administered to prevent thrombosis, and aPTT (activatedPartial Thromboplastin Time) test is used to make sure of anticoagulative effect of heparin. At the end of the operation,heparin is neutralized by protamin sulfate in some centers. In this study we assessed the necessity of aPTT and usingprotamin during vascular surgeries.Thrombosis occurs when blood comes into contact with unepithelialized surfaces after vascularPatients and Method: were matched regarding age and underlying diseases. The subjects were monitored for vascular complications during thefirst postoperative 24 hours. In group A (62 cases), aPTT was determined after 2 minutes of heparin administration butheparin was not neutralized by protamin at the end of the operation. In group B (92 cases), aPTT was not determined afterheparin administration but heparin was neutralized by an appropriate dose of protamin at the end of the operation. Toobtain mean and frequency the data were analyzed descriptively and analytical techniques such as Chi-square and t-testwere implemented using SPSS 14.In this case-control survey, 154 cases of vascular surgery were divided into two groups whichResults: ischemia in 1 case (0.65%), left leg neuropathy in 1 case (0.65%), and hypotension due to protamin in 1 case (0.65%). 3cases were from group A and 1 case was from group B. Nevertheless, the observed difference was not statisticallysignificant although the power was high enough (power=70%).Vascular surgery complications were seen in 4 cases (26%): right leg embolus in 1 case (0.65%), spinalConclusion: principles, there is no need for aPTT assessment and protamin administration. This can reduce the cost, duration andcomplications of operation and prevent adverse effects of protamin.According to our findings, it seems by applying appropriate techniques and accomplishing surgical}, Keywords = {Key Words: 1) Vascular Surgery 2) Complications 3) aPTT(activated Partial Thromboplastin Time) 4) Heparin 5) Protamin}, volume = {15}, Number = {0}, pages = {67-72}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1006-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1006-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Zaker,, F. and Mohammadzadeh,, M. and Aghaeepoor,, M. and RastegarLari,, Gh.}, title = {Study of Mutations in c-kit Exons 8;17 in Iranian Patients with Acute Myeloid Leukemia}, abstract ={   Background & Aim: Mutations in c-kit gene cause autonomously proliferation of leukemic cells with an unfavorable prognosis.These mutations including exon 8 deletion and insertion in the fifth extracellular Ig-like domain and exon 17 point mutation in tyrosine kinase domain of c-kit receptors are important in acute myeloid leukemia. The aim of this study was to set up molecular diagnosis and screening of these mutations in AML patients.   Patients and Method: This observational descriptive study of mutations in c-kit receptors was done on 212 patients with AML . Exon 8 mutations were analyzed by PCR method with specific primers.Then, PCR products were run in 10% CSGE and the results were documented. We also studied exon 17 point mutations with RFLP technique and using AatII enzyme on PCR products of these patients.   Results: Exon 8 mutations were seen in 1.4% of AML patients though, the results were different in different subtypes. Also, 4.7% of the patients showed D816 (exon 17) mutations with different findings in the subtypes of AML .   Conclusion: This study revealed that c-kit mutations constitute a significant percentage of AML (M2;M4 subtypes) cases in Iran. Thus, molecular diagnosis of these mutations could help to select a better treatment.}, Keywords = {Key Words: 1)AML(Acute Myeloid Leukemia) 2)C-Kit Mutations 3)PCR (Polymerase Chain Reaction) 4)RFLP(Restriction Fragment LengthPolymorphism) }, volume = {15}, Number = {0}, pages = {73-80}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1007-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1007-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Ranjbar,, M. and MohammadAlizadeh,, A.H. and Jafari,, M. and Fathali,, L. and Yadollahzadeh,, M. and Karimi,, B. and Fazlian,, M. and ManiKashani,, Kh.}, title = {Assessment of the Factors Related to the Severity of Hepatic Fibrosis in Patients with Chronic Hepatitis B;C}, abstract ={   Background & Aim: Viral hepatitis has existed since the creation of human. The estimated prevalence of hepatitis is about 3-5%. For patients with chronic hepatitis C and moderate to severe liver fibrosis, antiviral therapy is strongly suggested, while the cases without fibrosis or with mild liver fibrosis are often followed up without receiving antiviral therapy. The purpose of the present study was to assess laboratory factors associated with the severity of liver fibrosis in patients with chronic hepatitis B or C, so that the results could be used for the follow-up and management of the disease.   Patients and Method: This cross-sectional study covered 109 patients with chronic hepatitis B or C who attended Hepatitis Clinic in Hamedan between 2000 and 2005. None of the cases had received antihepatitis treatment before the study. Patients suffering from co-infection of two or more types of hepatitis, immunodeficiency and chronic or incurable diseases were not included in the study. The data were analyzed by independent t-test, and correlation and univariant model.   Results: The mean age of the cases was 36.70 years (SD=12.23). The mean duration of hepatitis infection was 3.77 years(SD=1.62). The most common liver fibrosis severity was stage I in 59 cases (54.1%) and then stage II in 24 cases (22%). The mean of liver fibrosis severity was 1.51 (SD= 1.16). There was a relation between liver fibrosis stage and three factors, namely age at the time of infection (Pv=0.034, r=0.203), duration of infection (Pv=0.006, r=-0.259) and platelet count (Pv=0.012, r=-0.24).However, there was no statistically significant relation between liver fibrosis severity and other assessed factors.   Conclusion: Considering the findings of the present study and other reports, it seems that age at the time of infection, duration of infection and platelet count are the three crucial factors which bear a strong relation to liver fibrosis severity and, therefore, could be applied to create prognostic models in other studies.}, Keywords = {Key Words: 1) Chronic Hepatitis B 2)Chronic Hepatitis C 3)Liver Fibrosis Severity }, volume = {15}, Number = {0}, pages = {81-90}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1009-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1009-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {RoostazadehMiandeh,, A. and Firoozrai,, M. and Sha'bani,, M.}, title = {Changes in Erythrocyte Glutathione Peroxidase Activity and Plasma Total Antioxidant Level due to Securigera Securidaca Extract in Diabetic Rats}, abstract ={    Background & Aim: Reactive oxygen species can affect many cellular functions through protein oxidation or initiation of lipid peroxidation cascade. The study was designed to investigate changes in erythrocyte glutathione peroxidase activity and plasma total antioxidant level due to Securigera Securidaca extract in diabetic rats.   Material and Methods: The present experimental study was carried out on 30 male rats scientifically named Ratus Norvegicus, including normal and diabetic groups. In addition , each group was divided into three subgroups (5 rats per each): a control group and two subgroups which received 100mg/kg and200 mg/kg of the extract. The rats received all the injections intraperitoneally for thirty days . After the termination of injection period, blood was drawn from the heart and glutathione peroxidase activity and plasma total antioxidant levels were assessed. Statistical differences were evaluated by ANOVA and Students' t- test .   Results: Glutathione peroxidase activity in diabetic subgroups treated at doses of 100mg/kg and 200mg/kg was heightened in comparison to the diabetic control subgroup(P=0.01 and P=0.004 respectively). Plasma total antioxidant level in diabetic subgroups treated at doses of 100 mg/kg and200mg/kg was increased compared to the diabetic control subgroup (P=0.005and P=0.035 respectively). Conclusion: Securigera Securidaca extract probably increases antioxidant defense in diabetic rats by making changes in glutathione peroxidase activity and plasma total antioxidant level}, Keywords = {Key Words: 1) Securigera Securidaca 2) Glutathione peroxidase 3) Diabetes 4) Total antioxidant }, volume = {15}, Number = {0}, pages = {91-98}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1010-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1010-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Shojamoradi,, M.H. and Alavi,, E. and Zarrabi,, B. and Pilehvari,, Z. and Kaviani,, A.}, title = {Evaluation of the Patients Transported by Tehran Helicopter Emergency Medical Service: the Necessity of Using Appropriate Triage Criteria}, abstract ={  Background & Aim: Helicopter emergency medical services (HEMS) decrease the mortality rate in emergency cases by minimizing rescue time and providing advanced facilities and also medical care. The aim of this study was to determine the prehospital care in patients transported by Tehran HEMS.   Patients and Method: This retrospective cross-sectional study was conducted on the patients transported by Tehran HEMS to Imam Khomeini Hospital from March 2003 to March 2004. All possible data were gathered from the records of Tehran Emergency Data Center. Calculations and analysis were performed by SPSS 11.5.   Results: By conducting 244 missions, 518 patients were transported to Imam Khomeini Hospital. Trauma was the most common cause of patients’ transport (94.8% blunt and 1.9% sharp) and only 3.3% of the patients were transported due to other causes. Most of the missions were carried out between 10 and 11 in the morning and 2 and 5 in the afternoon. The most dangerous point of coverage area was Haraz Road, from which 18.1% of the patients were transported. About one-third of the transports were tertiary. The main emergency treatments given to the victims were serum therapy (84.4%), control of bleeding (53%), orotracheal intubation (22.6%) and chest tube insertion (1.3%). Mean response and rescue times were 17 and 40 minutes respectively. The mean of revised trauma score (RTS) was 7.5 and only 3% of the injured had a score less than 4.   Conclusion: It seems that prehospital care provided for the patients was not satisfactory and only very limited number of drugs have been used by medical crews. High average of RTS indicates that the patients had not been screened by specific triage criteria and there was an exceedingly high over triage in patient selection. More than half of the missions were made just in 7 points of coverage area and this shows that these areas have a high ratio of accidents. Therefore, it seems necessary to pay more attention to dangerous points of coverage area and also to international standards for transporting patients by HEMS. It is also suggested that Tehran HEMS be equipped with facilities such as telemedicine.  }, Keywords = {Key Words: 1) Trauma 2) Helicopter Emergency Medical Service(HEMS) 3) Prehospital Care 4) Triage }, volume = {15}, Number = {0}, pages = {99-106}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1011-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1011-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Shari'atzadeh,, H. and Jafari,, D. and Taheri,, H. and NajdMazhar,, F.}, title = {Closed Injury of Flexor Digitorum Profundus and Superficialis Tendons of Ring Finger -- A Rare Case}, abstract ={     Introduction: The usual causes of flexor tendon injuries in hand are penetrating wounds. Closed injury and avulsion of flexor tendon are rare and mostly occur as avulsion of flexor digitorum profundus tendon of ring finger from its bony insertion at distal phalanx. Closed avulsion of flexor digitorum superficialis is even rarer. The rarest is simultaneous closed avulsion of both flexors in the same finger, only ten cases of which have been reported in the literature.  �Case Report: The patient of the present study was a healthy 23-year-old right-handed male farmer who had fallen down during power lifting in a body building club six weeks prior to being referred to the hospital. After this event he was unable to flex his fourth left finger through interphalangeal joints. There was no injury to the skin of his hand. Six weeks later he had full passive range of motion in interphalangeal joints of that finger without active range of motion. With the impression of closed rupture of both flexors of the ring finger, he underwent two- stage tendon graft because of contracture of pulley system. Conclusion: Closed injury of both flexor tendons should be considered in similar situations, though it is rarely observed.}, Keywords = {Key Words: 1) Flexor Tendons 2)Avulsion 3)Closed Injury }, volume = {15}, Number = {0}, pages = {107-112}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1012-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1012-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {TalebiTaher,, M. and Hassan-Al-Faraji,, M.S.}, title = {Risk Factors for Tuberculosis in 88 Patients Admitted to Firoozgar Hospital}, abstract ={  Background & Aim: Among infectious diseases, tuberculosis(TB) is the second leading cause of death worldwide, killing nearly 2 million people each year. Defining high-risk groups(IDUs= Injection Drug Users), cases of diabetes mellitus(DM), and those having close contact with TB patients) is vital in terms of diagnosis, prevention, and control programs. The aim of this study is to determine the frequency of risk factors for tuberculosis.   Patients and Method: We conducted an observational, descriptive, cross-sectional study. All the files concerning TB patients who were admitted to Firoozgar Hospital between 2002 and 2004 were evaluated. The designed questionnaire contained information about age, sex, nationality, history of smoking, HIV infection, close contact with TB patients, DM, chronic renal failure(CRF), lymphoma, leukemia, and immunosuppressive therapy like glucocorticoid. Statistical analysis was done via SPSS software version 15. Frequency, mean and standard deviation were defined.   Results: Among these 8 patients, the most frequent risk factor was smoking(20.45%) followed by DM(10.22%), close contact(7.95%), IDU(6.81%), CRF(3.4%), HIV infection(2.27%), and leukemia(1.13%). Conclusion: The present study may have shown the marked effects of risk factors on acquiring tuberculosis, so the identification of TB infection in these high-risk groups is very important}, Keywords = {Key Words: 1) Infectious Diseases 2) Tuberculosis 3) Risk Factors}, volume = {15}, Number = {0}, pages = {113-118}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1013-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1013-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {AbdollahiFakhim,, Sh. and Badbarin,, D. and GoljanianTabrizi,, A.}, title = {Study of the Causes of Delayed Diagnosis in Patients with Foreign Body Aspiration}, abstract ={  Background & Aim: Foreign body aspiration commonly involves very young children and taking a precise history and doing a careful physical examination can lead to diagnosis. If the extraction of the object is delayed beyond 24 hours, it will lead to complications such as pneumonia, abscess, and atelectasis. Therefore, the present study tries to investigate the duration and reasons of delayed diagnosis of airway foreign body aspiration in children admitted to pediatric Hospital in Tabriz.  �Patients and Method: This cross-sectional descriptive study was done over a period of 36 months, from 2001 to 2004, in the ENT Department of Children’s Hospital in Tabriz. 155 cases who had been admitted for foreign body aspiration and had undergone successful bronchoscopic removal were studied. The information such as the history of choking, the gap between initiation of symptoms and admission (duration of delayed diagnosis), outpatient visits, the first diagnosis, and the results of bronchoscopy was all recorded in the checklists. To analyze the data, descriptive statistics, and Excell 11.0 were used.   Results: The mean age of the patients was 21.58 (±12.90) months. 81.3% were under 3 years of age and 18.7% were above 3. Protracted cough lasting beyond 3 weeks was the most common symptom found in 73.5% of the cases. The average interval between aspiration and admission was 24.71 (± 8.96) days. Only 24.5% arrived in the first 24 hours. The main causes of delayed diagnosis were lack of notice on the part of parents and incorrect diagnoses made by physicians. Conclusion: 75.5% of the cases with foreign body aspiration were referred after 24 hours and the duration of delayed diagnosis in the present study was longer than that mentioned in the reports of other centers. Parents' unawareness and physicians' insufficient training can delay the diagnosis of airway foreign body aspiration and cause serious complications. Thus, providing proper education is necessary to prevent them}, Keywords = {Key Words: 1) Foreign Body Aspiration 2)Airway 3)Delayed Diagnosis }, volume = {15}, Number = {0}, pages = {119-124}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1014-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1014-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Farsi,, D. and Mofidi,, M. and Kianmehr,, N. and Abbasi,, S. and Zare,, M.A. and Shaker,, H. and Rezaee, M. and Ashayeri, N.}, title = {Assessment of the Role of Bedside Echocardiography in Predicting One-Month Outcome of the Patients with Low Risk Unstable Angina}, abstract ={Background & Aim: departments. Low risk patients can be discharged and receive outpatient treatment if clinical and paraclinical assays arenormal. The recommended pre-discharge evaluations are controversial. However, because of the availability and safety ofbedside echocardiography in emergency departments, we decided to conduct this study.Unstable angina accounts for about 30% of cardiovascular patients referred to emergencyPatients and Method: unstable angina and admitted to the Emergency Department of Hazrat Rasoul-e-Akram Hospital. All of the casesunderwent bedside echocardiography before their discharge. Calling the patients one month after their discharge, theiroutcomes were recorded. Then we made a comparison between echocardiographic findings and their one-monthoutcomes. The data were analyzed via SPSS software using statistical tests such as Fisher, Chi-square and t-test.This cohort study was done on 140 patients with chest pain who were diagnosed with low riskResults: cases) were male. The patients with abnormal echocardiographic findings, i.e. EF(Ejection Fraction)<40% and wall motionabnormality, had a significantly higher rate of re-hospitalization because of chest pain(p=0.000).The mean age of the patients was 51.39(SD=10.13) years. 42.1%(59 cases) were female and 57.9%(81Conclusion: cardiovascular events in low risk unstable angina patients.The study shows that bedside echocardiography before discharge is a reliable method for predicting}, Keywords = {1) Chest Pain 2) Echocardiography 3) Low Risk Unstable Angina}, volume = {15}, Number = {0}, pages = {125-130}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1015-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1015-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Kashanian,, M. and AliMohammadi,, R. and Baradaran,, H.R.}, title = {Evaluation of Some of the Risk Factors for Preeclampsia}, abstract ={    Background & Aim: Preeclampsia is one of the important complications of pregnancy and knowing its risk factors can help us to understant it better. The aim of the present study is to evaluate some of th risk factors for preeclampsia.   Patients and Methods: This retrospective case-control study covered 636 preeclamptic women. 318 preeclamptic women constituted the case group and the other 318 preeclamptic women who were normotensive at the time of delivery were considered as the control group. The following factors were evaluated and compared between the two groups: maternal age, gestational age, nuliparity, occupation, educational status of mother, maternal BMI(Body Mass Index), maternal hemoglobin, blood group and Rh, family history of preeclampsia, history of preeclampsia in the previous pregnancy, being relative to spouse, urinary tract infection(UTI) during the present pregnancy, season in which preeclampsia occurs, neonatal sex, and the method of contraception. The obtained results were analyzed using statistical tests such as Chi-square and Mann-Whitney.   Results: UTI(P=0.027, phi=0.031), history of preeclampsia during the previous pregnancy(P=0.000, phi=0.144), nuliparity(P=0.008, phi=0.108), blood group of A+(P=0.000, phi=0.129), and low educational status of mother(P=0.009, phi=0.007) were significantly more common in the case group. Maternal hemoglobin was also higher in the case group(12.23 ± 1.41gr/dl vs 11.9 ± 1.46gr/dl P=0.014, phi=0.042). The rate of cesarean section was higher in the case group than in the control group[245 cases(77%)vs 85 cases(26.7%), P=0.000]. The Apgar score of less than 8 in the first minute of birth was more commonly seen in the case group(28.6%vs 47.4%, P=0.000). Gestational age at the time of delivery was lower in the case group(36.48 ± 3.4 weeksvs 37.12 ± 3.3 weeks, P=0.000). Conclusion: UTI, history of preeclampsia during the previous pregnancy, nuliparity, blood group of A+, low educational status of mother, and high maternal hemoglobin might be the risk factors for preeclampsia}, Keywords = {Key Words: 1) Preeclampsia 2) Risk Factor 3) Pregnant Women}, volume = {15}, Number = {0}, pages = {131-136}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1016-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1016-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Gelgiri,, F. and Khajooeenia,, Sh.}, title = {Prevalence of Proteinuria in Type II Diabetic Cases Referred to the Institute of Endocrinology and Metabolism between 2004 and 2006}, abstract ={Background & Aim: predictor of diabetic nephropathy. The aim of this study was to determine the prevalence of proteinuria in patients withrecently diagnosed type 2 diabetes mellitus.Diabetic nephropathy is a common cause of end-stage renal disease. Microalbuminuria is aPatients and Method: 2 diabetic patients referred to the Institute of Endocrinology and Metabolism between 2004 and 2006. The patients wereevaluated for age and sex and the following tests were performed: FBS, HbAlc, BUN, Cr, and 24-hour urine microalbumin.The results were compared by t-test.This observational, descriptive, analytical study was carried out on 288 recently diagnosed typeResults: (51%) had microalbuminuria. 64.6% of the subjects were female and 35.4% were male. The sex/age ratio in the twogroups, i.e. with and without diabetic nephropathy, was similar. The mean age of the patients was 52.60(There was no significant difference between the two groups in terms of the mean values of FBS, BUN, age, andsex(p<0.05), but there was a significant correlation between diabetic nephropathy and HbAlc and Cr concentrations(PFrom a total of 288 diabetic patients, 165 cases(57.3%) had diabetic nephropathy. In this group, 147 cases±9.45) years.≤0.05).Conclusion: mellitus was 57.3%. Screening all newly diagnosed type 2 diabetic patients for microalbuminuria is recommended.The overall prevalence of diabetic nephropathy in the patients with recently diagnosed type 2 diabetes}, Keywords = {Key Words: 1) Type II Diabetes Mellitus 2) Nephropathy 3) Microalbuminuria}, volume = {15}, Number = {0}, pages = {137-144}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1017-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1017-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Ganjavian,, M.S. and Behtash,, H. and Fereshtehnejad, S.M. and SalehiSedghiani,, A.A. and Ameri,, E.}, title = {Measurement of Lumbosacral Angle in Individuals Referred to Orthopedic Clinic of Rasoul-e-Akram Hospital in Tehran}, abstract ={ Background & Aimlimitations and problems for the patients and community. Measurements of the curvature of the lumbar spineare useful in the investigations of low back pain. It is unclear whether the degree of lumbosacral angulation isthe same for all normal adults. Therefore, regarding considerable prevalence of back pain in Iranian population,this study was performed to measure lumbosacral angle in Iranian individuals.: Low back pain (LBP) is one of the common ailments which usually lead to considerablePatients and Methodorthopedic clinic of Hazrat-e-Rasoul Hospital in Tehran. Having essential eligible criteria of the study, 130individuals were recruited conveniently by using non-probability sampling. All individuals were evaluated fordemographic variables such as age and sex by using a checklist. In addition, a standing lateral radiograph wasperformed on all to evaluate and measure the lumbosacral angle. The data were collected, described andanalyzed using SPSS software.: This cross-sectional study was performed on individuals who were referred toResults: 13.77°(SD=0.47) whereas the mean lumbosacral angle in men and women was 13.84°(SD=1.8) and13.17°(SD=0.6) respectively. However, the difference was not statistically significant (P>0.05). Additionally, asignificant correlation was found between age and the mean of lumbosacral angle (P=0.025).Out of 130, 70 were female and 60 were male. The total mean lumbosacral angle wasConclusion: However, more studies are needed to evaluate the association between lumbosacral angle and the incidence oflow back painThe results of current study show that lumbosacral angle is about 12-14° in Iranian individuals..}, Keywords = {Key Words: 1) Lumbosacral Angle 2) Normal Value 3) Back Pain}, volume = {15}, Number = {0}, pages = {145-150}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1018-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1018-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Guity,, M.R. and Mottaghi,, A. and BashtiShiraz,, K.}, title = {A Report on Ulnar Dimelia (Mirror Hand): A Very Rare Case}, abstract ={Introduction: cases have been reported worldwide, including 3 with shoulder dislocation.Ulnar dimelia (mirror hand) is a congenital anomaly of upper extremities. Approximately 70Case Report: wrist and hand_with substitution of the radial elements. The patient underwent amputation of the 1st and the3rd digits and their corresponding metacarpus with classic policization of the 2nd digit.Herein we present a 10-month-old boy whose anomaly was duplication of ulnar_half of forearm,Conclusion: Early treatment of this anomaly can prevent future disabilities.}, Keywords = {Key Words: 1) Ulnar Dimelia 2)Mirror Hand 3)Congenital Anomaly 4) Upper Extremities}, volume = {15}, Number = {0}, pages = {151-156}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1019-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1019-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {MoeiniAlishah,, F. and HosseiniGohari,, L. and Shamsian,, B.Sh. and Mosta'an,, L.}, title = {The Separation of Globin Chains by Ion Exchange Chromatography inorder to Identify Hemoglobinopathies}, abstract ={Background & Aim: Since the mutant Hbs do not have any obvious electrical charge, globin chain separation is helpful for the diagnosis ofunknown Hbs. Therefore, the present study was carried out to detect alpha or beta chain variants by cation exchangechromatography.There are several point mutations in hemoglobin(Hb) genes which can cause hemoglobinopathy.Material and Method: count(CBC), HbA2 and HbF percentages were determined by routine methods, and cellulose acetate and citrate agarelectrophoresis were performed on all the samples. For HbS confirmation, solubility test was performed and globin chainswere separated by carboxymethyl cellulose(CMC) chromatography in the presence of 8 M urea. SPSS version 14 was usedfor statistical analysis.In this descriptive study, 20 samples having abnormal Hb were selected. Complete blood cellResults: agar electrophoresis. CMC chromatography revealed that three patients had abnormal beta chains, 15 had abnormal alphachains, and 2 remaining samples had abnormal alpha and beta chains.According to the obtained results, all of the samples had an abnormal band on cellulose acetate and citrateConclusion: helpful guideline for the selection of an appropriate gene for DNA sequencing. Moreover, this method is useful to screen thecases for hemoglobinopathies and beta thalassemia coexistance, which can sometimes lead to severe clinicalmanifestations.Mutant alpha and beta chains can be detected by CMC chromatography and globin chain separation is a}, Keywords = {Key Words: 1) Hemoglobinopathy 2) Ion Exchange Chromatography 3) Variants of Globin Chains}, volume = {15}, Number = {0}, pages = {157-164}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1020-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1020-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Mousavi,, T. and .SalekMoghaddam,, A. R and Falak,, R. and Sadeghipoor,, A.R. and Hejazi,, M.}, title = {Study of the Effects of CpG Oligonucleotides on IFN- γ and IgE Responses to Chenopodium Album Allergen in Murine Model of Asthma}, abstract ={Background & Aim: and achieving safe prophylactic and therapeutic procedures is the main aim of the investigators. CpGoligodeoxynucleotides (CpG ODN) which modulate the immune responses and change the cytokine patterns by severalmechanisms are among these procedures.Worldwide increasing number of allergic disorders is one of the most important health challenges,Material and Method: Chenopodium album (CH.a), a common allergenic plant in Iran, in a murine model of asthma. We used CH. a pollenextract with CpG to sensitize the mice and compared a number of immunologic parameters such as interferon gamma(IFN- lung culture supernatants. Histological studies were also conducted to identify inflammatory cells in lung airways. ANOVAtest was used to analyze the data.In this experimental study we investigated the effects of CpG motif on immune responses toγ) and IgE levels between case and control groups. To do this, IFN-γ and IgE levels were measured in splenocyte andResults: by 80% and have a potent influence to augment both systemic and local levels of IFN- The study showed although CpG ODN cannot reduce IgE levels to the normal range, they can lower IgE levelsγ as a Th1 activity marker (P<0.01)Conclusion: reducing lung inflammatory responses. Since CpG components have potency to shift immune activity from Th2 to Th1responses, it seems that co-administration of CpG/antigen can modulate inflammatory responses to different allergenicantigens.The results of the study have consistency with other reports and confirm the benefits of CpG motifs in}, Keywords = {Key Words: 1) Asthma 2) CpG-ODN 3) Chenopodium Album 4) IgE 5) IFN- γ}, volume = {15}, Number = {0}, pages = {165-172}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1021-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1021-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Nakhaei,, B. and Alamrajabi,, M. and Movahhed,, M. and Fereshtehnejad, S.M.}, title = {Hemorrhagic Adrenal Pseudocyst: A Case Report}, abstract ={Introduction: ultrasound or CT scans (incidentaloma). Among adrenal cysts the most common types are epithelial cystsand pseudocysts. Intracystic hemorrhage is one of the possible complications of adrenal pseudocysts.Adrenal cysts are rare and usually asymptomatic they are occasionally identified duringCase Report: vomiting and acute anemia. CT scan showed a huge mass between the liver and the right kidney.Thereafter, the cyst was resected. It contained 5000 Histopathological examination revealed adrenal pseudocyst with a dense fibrous tissue wall and foci ofchronic inflammation. The patient was fully recovered after the surgery.The patient of the present study was a young woman with right superior abdominal pain,ml of bloody dark and brown thrombotic liquid.Conclusion: like kidney, liver and gallbladder. Intracystic hemorrhage, whether spontaneous or post-traumatic, maylead to acute anemia which, as soon as the diagnosis is confirmed, indicates surgery. The operation isusually laparotomic adrenalectomy, since the laparoscopic approach is not sufficient to control large masseswith active bleeding inside.Adrenal cysts may cause differential diagnostic problems with masses of contiguous organs}, Keywords = {Key Words: 1) Pseudocyst 2) Adrenal 3) Intracystic Hemorrhage}, volume = {15}, Number = {0}, pages = {173-180}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1022-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1022-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Nobakht,, M. and Shafiee,, M. and Tabatabaee,, P. and Rastegar,, T.}, title = {Assessment of Tamoxifen Effects on Nitric Oxide Synthase (NOS) in Rat\'s Developing Hippocampus}, abstract ={Background & Aim: treatment, as an estrogen antagonist, induces cell death in rat's developing hippocampus. Estrogen has avariety of physiological effects on the nervous system, including regulation of cognitive functions, learning,aging, angiogenesis, neurogenesis, and neuroprotective effects. In the present study, we demonstrated theeffects of TAM as an estrogen antagonist on nitric oxide synthase activity in rat's developing hippocampalpyramidal neurons.Maternal steroids modulate various functions in the developing brain. Tamoxifen (TAM)Material and Method: animals were divided randomly into control, experimental and sham groups. Each group contained full termembryo (Egroup received a total of four doses of TAM,i.e. 250 mg/kg TAM in propylene glycole was injectedintraperitoneally twice a day for two days. Their hippocampus was removed 6 hours after the last injection.Animals at the same gestational age were used as shams and controls. The latter received only propyleneglycole. The hippocampus was dissected out and stored in fixative and sucrose. Cryostat sections were thawmountedon gelatin slides. The sections were incubated for NADPH-diaphorase histochemistry by lightmicroscope. Independent sample t-test and SPSS version 11.0 were used to analyze the data.The present experimental study was conducted on twelve groups of adult rats. The22), one-day neonate (P1), one-week neonate (P7), and three -week neonate (P21). The experimentalResults: thickness increases so that the most thickness is seen in the third week after birth. Considering the short halftimeof TAM, it was observed that tamoxifen had its greatest effects on Eestrogen receptors. In the group that didn't receive tamoxifen, due to the presence of estrogen NADPHdiaphoraseactivity, which indicates NOS activity level, strengthened. On the other hand, the animals whichreceived tamoxifen in the early stage showed a decrease in NADPH-diaphorase activity owing to estrogenreceptor blockade. Furthermore, the number of neural cells in CA1 hippocampal region showed a decrease inproportion to the reduction in NOS activity level in this region. The decreased number of neural cells and NOSactivity, which was seen in EWe found that in the early stage of development cellular density decreases and gradually cellular22, P1 and P7 groups and blockaded22, P1 , P7 groups, seems to be due to the short half-time of tamoxifen.Conclusion: oxide-mediated growth and development of hippocampal pyramidal cells.These findings indicate that estrogen and selective estrogen modulators can influence nitric}, Keywords = {Key Words: 1)Tamoxifen 2)Nitric Oxide 3)NADPH-d 4)Hippocampus}, volume = {15}, Number = {0}, pages = {181-190}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1023-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1023-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Ehsanipour, F. and SohaylNader, SH. and BahmaniKashkoli, M.}, title = {The Prevalence of Sinusitis in Children with Orbital and Intracranial Infections Hospitalized at Hazrat Rasool Akram Hospital}, abstract ={    Background and Aimi: Complication of sinusitis is a medical emergency. The purpose of this study was to determine the incidence of sinusitis in patients admitted with orbital and intracranial infections.Patient and Methods: A descriptive-retrospective study was conducted from March 2000 to Feb 2004 on 74 pediatric patients admitted with intracranial and orbital infections. Patient information was analysed by t-test.Results: Out of 74 patients studied, 17 (22.9%) were diagnosed with sinusitis. Sinusitis was observed in 53.85% and 16.39% of children with orbital and intracranial infections, respectively. Meningitis was the most common intracranial complication (80%). The most common involved sinus was Maxillary Sinus (58.8%). The most common age group For association of sinusitis with orbital and introcranial infection was between 5-11 years.Conclusion: Association of sinusitis, especially with orbital infection in clidren is common. We recommend sinus imaging in any pediatric patient with orbital infection.}, Keywords = { Sinusitis , Orbital infection ,Intracranial complication,Pediatrics}, volume = {15}, Number = {0}, pages = {7-11}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1056-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1056-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Agah, SH. and Ghasemi, A. and Rezaei, M. and Ashayeri, N. and Fereshtehnejad, S.M. and MohammadSadeghi, H.}, title = {Frequency Determination of Polyps and Colorectal Tumors Among Patients Who Underwent Colonoscopy in Shariati Hospital}, abstract ={      Background & Aim: Colorectal cancer is the third most common cancer and the third leading cause of cancer death. Most often it is derived from an adenomatous polyp. Therefore, detection and treatment of these baseline polyps could potentially decrease the prevalence and incidence of colorectal cancers. One of these screening procedures is colonoscopy, which is more Precise than others like. Barium enema in detecting primitive and small polyps. In addition, colonoscopy has the added benefit that lesion can be removed during the same procedure. Thus, this study was performed to determine the frequency of polyps and colorectal tumors among patients who underwent colonoscopy in Shariati hospital between November 2000 and November 2002. Patients and Methods: This retrospective analytical cross-sectional study was performed on 993 patients who underwent colonoscopy in Shariati hospital from November 2000 to November 2002. Method of sampling was by census. All patients were evaluated for demographic variables, location and size of polyps and tumors by using a checklist. The data were collected, described and analyzed using SPSS V.11.5 sofware. Chi2 and Student t-test were performed in the data analysis. Results: Among 993 patients who were studied, 529 (53.3%) were males and 464 (46.7%) were females. The frequency of polyps and tumors in this study was 15.4% (153 of 993) and 4.8% (48 of 993), respectively. There was a significant association between the frequency of polyps and its location (P<0.01). The most common location of polyps was sigmoid (76.5%). Also, a significant association was observed between the frequency of tumors and its location (P<0.01). The most common location of tumors was again recto-sigmoid colon (70.8%). Additionally, polyps and tumors were respectively 1.6 and 1.7 times more prevalent in men than women. Conclusion: Regarding the most prevalent location of polyps and tumors, the use of fexible sigmoidoscopy may lead to detection and even treatment of many accessible polyps and tumors which could result in prevention of many colorectal cancers. Also colonoscopy is useful to detect lesions which were not detected by sigmoidoscopy and these inaccessible polyps and tumors can be bilopsied.}, Keywords = {Colorectal,Polyp,Tumor, Colonoscopy}, volume = {15}, Number = {0}, pages = {13-18}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1057-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1057-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Amirmozafari, N. and Jeddi, F. and Masjedian, F. and Haghighi, L.}, title = {Prevalence of Mycoplasma hominis and Ureaplasma urealyticum in Genital Tract Infections}, abstract ={    Background & Aim: Mycoplasmas are the smallest bacteria capable of independent growth in artificial media. Mycoplasma hominis is associated with pre-mature birth, rupture of amniotic membranes and post-delivery fever. Ureaplasma urealyticum is similarly associated with chorioamnionitis and low-birth weight infants. Both of these bacteria can easily get transferred into newborns during childbirth leading to pneumonia, meningitis, cerebral abscesses and other complications. This study was conducted in order to survey the prevalence of these two micro organisms in women suffering from genital infections.Patients and Methods: The study was adescriptive. Endocervical swabs were collected from a total of 205 women with genital tract infections who referred to various hospitals affiliated to Iran University of Medical Sciences in Tehran. The swabs were placed in PPLO broth transport media and immediately sent to laboratory. Following filtration through 0.45 mm pore-size disposable filters, the filtrates were cultured into Arginine broth and Urea broth. In cases of color change, the broth media were sub-cultured into PPLO agar plates. All media were incubated at 35°C under elevated Co2 atmosphere.Results: From the total of 205 endocervical swabs, 64 samples (31.18%) were positive for Ureaplasma urealyticum and 16 samples (7.76%) were positive for Mycoplasma hominis. The highest prevalence of positive cases was among the 29-39 years of age group (34 patients) and belonged to women diagnosed with vaginitis (36 patients).Conclusion: The results of this survey indicate that the prevalence rate of Mycoplasma hominis and Ureaplasma urealyticum infections among symptomatic Iranian women is in the intermediate range. Due to fact that the prevalence rates of these infections are probably on the rise, more attention needs to be paid to their role as an important etiologic factor of urogenital infections. Its prompt culture in routine clinical laboratories and immediate treatment should be considered as a health care priority.}, Keywords = { Mycoplasma hominis,Ureaplasma urealyticum,Genital Tract Infection}, volume = {15}, Number = {0}, pages = {19-25}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1058-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1058-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Imani, F. and MirDehghan, M.H. and Entezary, S.R. and MehdizadehKashi, A.}, title = {Evaluation of Maternal and Neonatal Effects of Adding Midazolam to Bupivacaine under Combined Spinal-Epidural Anesthesia in Elective Cesarean Section}, abstract ={     Background and Aim: Epidural-spinal anesthesia is one of the modern methods used to establish adequate anesthesia in cesarean section. In order to reduce these adverse effects different drugs are added to the anesthetic solution. The main aim of this article is evaluation of maternal and neonatal effects of adding Midazolam to Bupivacaine under combined spinal-epidural anesthesia in elective cesarean section Ptatients and Methods: This study has been designed as a double blind randomized clinical trial. Study population included pregnant females who were admitted to Hazrat Rasool Akram hospital to undergo elective cesarean section. Sampling was simple and nonrandomized. After considering the inclusion and exclusion criteria, and obtaining an informed consent, 90 pregnant women were divided by block randomization into 3 groups. Epidural-spinal anesthesia was achieved by using 2cc of 0.5% Bupivacaine. Based on their groups, group one (A) received only 0.5% Bupivacaine group two 2.5 mg of Midazolam along with 0.5% Bupivacaine and group 3, (C) 5 mg Midazolam with 0.5% Bupivacaine. Time duration of complete motor block, time duration of the highest score of sedation, time duration of required analgesia after surgery as well as, maternal and neonatal side effects were evaluated. To compare the qualitative and quantitalive data between the two groups, Chi sqaure test was used for normal distribution and for quantization variables, One Way ANOVA analysis of variance was used. Level of significance in this study was considered as 0.05. SPSS V. 13 was used for statistical analysis. Results: Time of sensory motor block in Midazolam group was significantly less than Bupivacaine group this time for 5 mg Midazolam group was in the minimal range. The most sedative effects belonged to the midazolam5 mg group. Adding Midazolam decreased significantly the time of requiring additional analgesia in mothers after surgery. The most prevalent complications that was reported by the mothers was nausea and vomiting more than 70% of mothers who received Bupivacaine alone complained of it.   Conclusion: In this study it was shown that addition of Midazolam was associated with rapid onset of motor and sensory blocks along with maximum sedation. It also decreased the incidence of nausea and vomiting due to Bupivacaine. In addition maternal and neonatal side effects are not increased.}, Keywords = {Epidural-spinal anesthesia,Midazolam, Bupivacaine}, volume = {15}, Number = {0}, pages = {27-36}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1059-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1059-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {BehzadianNejad, Q. and Abdollahi, A. and NajarPeerayeh, SH. and ForouheshTehrani, H.}, title = {Evaluation of bla-ctx-m-type Gene in Multi Drug Resistance Klebsiella pneumonia Species Isolated from Clinical Samples}, abstract ={  Background and Aim: Klebsiella pneumoniae (K. Pneumoniae) is one of the prevalent infectious bacteria, especially in hospitalized patients. Recently, its' multi drug resistance (MDR) trait has become more important and regarded as a virulant factor. In this study, we evaluated bla-ctx-m-type gene in clinical isolates of K.pneumoniae with multi drug resistance. Materials and Methods: In this descriptive cross-sectional study, a total of 280 K.pneumoniae strains were isolated from patients. Initially, we evaluated drug sensitivity with disk diffusion method. Then the minimum inhibitory concentration (MIC) of resistant isolates was determined with E-test stripes. The existence of ESBL (Extended Spectrum Beta-Lactamase) enzymes was identified by ESBL disks in Double Disk method. These resistances were evaluated with PCR. Finally, results were analyzed by SPSS software. Results: From total 280 K.pneumoniae, 62 samples (22.14%) showed multi drug resistance trait. 40 strains of these MDR isolates were completely resistant to the experimental cephalosporins, and positive in ESBL production by Double Disk methodology. These results were proved and evaluated with PCR and Sequencing.   Conclusion: Detection of 22.14% MDR trait, especially extended spectrum beta-lactamases in resistant clinical K.pneumoniae isolates, points to the in usage of extended spectrum cephalosporins.}, Keywords = { Klebsiella pneumoniae,Extended Spectrum Beta-Lactamase (ESBL),Multi Drug Resistance (MDR),CTX-M enzyme}, volume = {15}, Number = {0}, pages = {37-45}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1060-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1060-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Parashi, SH. and Kashanian, M. and Niknafs, F.}, title = {Evaluation of the Relationship Between the Mode of First Delivery and Stress Urinary Incontinence After 1 Year}, abstract ={    Background and Aim: Stress urinary incontinence (SUI), is one of the important health problems for women and the knowledge about its risk factors is considerably significant.The purpose of the present study is finding a relationship between the mode of delivery and SUI, one year after first delivery.Patients and Methods: A historical cohort study was performed in Akbarabadi Teaching Hospital, Tehran, Iran, between March 2006- March 2007. One thousand four hundred primiparaous women who had delivered one year ago entered the study and were compared. They were divided into three groups.Patients were diagnosed with incontinence by questionnaire. The patients with internal disorders or chronic high  intra-abdominal pressure and urinary infection were excluded from the study. Statistical analysis was performed using SPSS. t and Chi2 tests were used for comparing the results.Results: The patients were evaluated in 3 groups. Group 1 or vaginal delivery group (400 cases), group 2 or  elective cesarean section group(600 cases), and third group or  emergency cesarean section group(400 case)were compared. 25 women (1.9%) had SUI, 12 of which (3%) were in the vaginal delivery group, 5 (0.83%) were in the elective cesarean group and 8 cases (2%) were in the emergency cesarean group showing a statistically significant difference (p=0.037). There was no significant difference between women in the 3 groups according to age, maternal weight, doing exercise, occupation, race, reason for cesarean section  and neonatal weight. Mean duration of the second stage of labor was longer in patients with SUI (34± 8.1 min vs 25±9.63 min), showing a statistically significant difference (P=0.000).Conclusion: Vaginal delivery in the  first pregnancy is a risk factor for SUI  after one year}, Keywords = {Stress urinary incontinence (SUI),Mode of delivery,Vaginal delivery}, volume = {15}, Number = {0}, pages = {47-53}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1061-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1061-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Pouramjad, S.M. and Egtesadi, SH. and Moosavi, S. A.J. and NourMohammadi, I. and Yazdani, R.}, title = {Study of Zinc Serum Concentration and Effect of Zinc Supplementation on Lung Function in Asthmatic patients}, abstract ={    Background and Aim: Asthma, as the most prevalent disorder of the airways is accompanied with excessive inflammatory, oxidative and apoptotic activity. In asthmatic patients, serum and hair levels of zinc are decreased. Zinc, as an essential micronutrient for human is reported to have anti inflammatory, anti oxidant and anti apoptosis roles. This study was conducted to investigate the effect of zinc supplementation on lung function in asthmatic patients in Hazrat Rasool Akram Hospital.Patients and Materials: A cross sectional clinical trial was conducted on 29 patients with asthma who received 50 mg zinc supplementation every other day for a period of 8 weeks. 10 ml blood sample was drawn prior to initiation of supplementation period. Serum Zinc concentration was measured by Atomic Absorption spectrophotometry and compared with that of 29 non-asthmatic individuals. Respiratory factors such as Forced Expiratory Volume in 1 second (FEV1), Forced Vital Capacity (FVC), Vital Capacity (VC) and FEV1: FVC ratio were measured by Spirometer in asthmatic patients before and after Zinc supplementation. Dietary intake in asthmatic patients was assessed by Dietary recall questionnaire. Data were analysed by Paired t-test and Independent t-test. SPSS V. 10 was used.Results: The serum zinc concentration of treated patients was 0.68±0.16 mg/l, which shows significant difference (P0.05) and the daily food intake of zinc in patients, was 60% of the Recommended Dietary Allowance (RDA).Conclusion: Zinc status of serum in asthmatic patients was significantly lower than non-asthmatic subjects and supplementation with 50 mg zinc taken every other day for 8 weeks did not lead to significant effect on respiratory factors. More interventional trials are recommended.}, Keywords = {Asthma,Zinc supplementation, Serum zinc}, volume = {15}, Number = {0}, pages = {55-61}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1062-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1062-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Khooei, A.R. and Mahmoudi, M. and Farzadnia, M. and Sedaghat, M.}, title = {Association of HTLV-1 Genome with Cervicovaginal cancers}, abstract ={    Background and Aim:Today, several viruses that are responsible for the development of approximately 15% of all human tumors have been characterized.Human T cell leukemia/lymphoma virus type1 (HTLV-1) , one of the human retroviruses which causes Adult T cell leukemia and Tropical spastic myelopathy, is also associated with other diseases and cancers in humans. This virus is endemic in Khorasan province.Considering the association of HTLV-1 with cervicovaginal cancers and the endemic prevalence of the virus in Khorasan, this study was designed to investigate the presence of HTLV-1 genome in the tissue specimens of cervicovaginal cancers.Materials and Methods: In this cross sectional and historical prospective study ,all archived tissue specimens of cervical and vaginal cancers ,diagnosed in a 20 year period(1983-2003) in the Pathology Department of Imam Reza Hospital of Mashhad were elicited and restudied microscopically .Thirty two tissue specimens were tested by PCR , using Tax, Pol and LTR primers and resulted data were analysed by Z test.Results: The results showed that most of the patients were in their fourth or fifth decades of life about one decade younger than the other worldwide reports. Squamous cell carcinoma (SCC) was the most frequent histological subtype. In all tissue specimens studied by PCR method, genome of HTLV-1 was not detected.Conclusion: Despite the endemic prevalence of this virus in Khorasan, no association was noted between HTLV-1 and cervicovaginal cancers in studied Iranian women .}, Keywords = {HTLV-1,Polymerase chain reaction, Cervical cancer}, volume = {15}, Number = {0}, pages = {63-70}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1063-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1063-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {KhavaninZadeh, M. and Omrani, Z. and Shirali, A. and Najmi, N. and MohammadZade, M. and Fereshtehnejad, S.M}, title = {Determination of Prevalence and Survival of Various Types of Vascular Accesses in Patients With End Stage Renal Disease Under Chronic Hemodialysis, in Tehran during 2004}, abstract ={    Background and Aim: Hemodialysis is the most common procedure which is performed for end-stage renal disease (ESRD) patients. Furthermore, vascular access is an important aspect of hemodialysis treatment, provided for patients with ESRD. There are different reports on the prevalence and survival of vascular access. In this study we report the prevalence and survival probability of vascular accesses in hemodialysis patients in Iran.Patients and Methods: This cross-sectional retrospective study was conducted in ESRD patients who underwent hemodialysis in Hemodialysis centers of Tehran, Iran in December 2004. In order to determine the prevalence and survival of different vascular access types, 700 hemodialysis patients and 198 accesses (from 100 patients) were studied, respectively. Data were collected by using recall method, interview and check lists. Life tables, Kaplan Meier procedure, Cox Regression and Log Rank tests were used in survival analysis. Statistical analysis was done with SPSS V. 13.Results: From 700 patients, Arteriovenous Fistula (AVF), Arteriovenous Graft (AVG)and Catheter were used by 93.4%, 3% and 3.6% of Iranian hemodialysis patients, respectively. The mean survival time of AVF was 144.52(95%CI 118.67 to 170.36) months compared with 32.43(95%CI 18.83 to 46.03) months for AVG. The results of Log Rank test demonstrated that this difference is significant (p=0.000). In addition, the estimated one, three and five year survival probability for AVF was 76.42%, 61.54% and 56.86%, respectively. Moreover, AVF survival time was significantly associated with the sites of access (p=0.0038).      Conclusion: Our findings showed greater survival of AVF compared with AVG and catheters. However we suggest that applying highly skilled surgical technique may improve access survival, patients' satisfaction and cost implications.}, Keywords = {Hemodialysis,Survival , Vascular access }, volume = {15}, Number = {0}, pages = {71-77}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1064-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1064-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Zaker, F. and Mohammadi, M.H. and Kazemi, A. and Bakhshayesh, M.}, title = {Diagnosis of FLT3 Mutations Including Internal Tandem Duplication and D835 Aspartic Acid Point Mutation in Patients with Acute Myeloid Leukemia}, abstract ={    Background and Aim: Molecular basis of Acute Myeloid Leukemia (AML) involves mutations in regulatory genes of cellular proliferation and differentiation.Mutation in tyrosine kinase receptor gene of FLT3 occurs in high frequency in AML, resulting in proliferation and abnormal survival of leukemia cells. Mutations in Internal Tandem Duplication (ITD) and D835 of FLT3 gene are associated with poor prognosis .The aim of this study was to diagnose and determine the frequency of this mutation in AML.Materials and Methods: This descriptive - observational study was performed on 101 AML patients for mutations in exon 11,12 and interon 11 of ITD and D835 mutation in exon 20 of FLT3 receptor gene using PCR .Mutation in ITD was observed using PCR products run on acrylamid gel 8% and compared to marker. PCR products of D835 mutation on genomic DNA were studied using ECORV restriction enzyme and RFLP technique.Results: ITD mutation was observed in 18% of AML studied patients with differences in subgroups of FAB. Also 6% of the patients showed D835 mutation with difference in subgroups of FAB.Conclusion:This study revealed that mutations in FLT3 gene occurr in substantial number of AML patients. Therefore ,molecular diagnosis of these mutations prior to treatment leads to a better decision making for the therapeutic protocol.}, Keywords = {AML (Acute Myeloid Leukemia),FLT-3 (Fms Like Tyrosin kinase,ITD (Internal Tandem Duplication),D835 (Aspartic Acid 835),PCR (Polymerase Chain Reaction)}, volume = {15}, Number = {0}, pages = {79-86}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1065-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1065-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Zonoozy, F. and Hashemijam, M.}, title = {A Comparative Study of Transcutaneous Electrical Nerve Stimulation and Pethidine - Promethazine For Pain Relief in Active Phase of Labor}, abstract ={    Background and Aim: Several agents have been used for labor pain relief. Clinical trials have shown pethidine – promethazine combination as an effective mean. Transcutaneous electrical nerve stimulation (TENS) is a new method for pain relief which uses mild electrical stimulation for inhibition of pain signals in nerves. This method has been used successfully for chronic pains such as low back pain, rheumatic pains, acute surgical and traumatic pains. In this study we compared these two methods for reducing labor pain.The aim of this study was to compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) and pethidine-promethazine in reducing labor pain in the active phase of laborPatients and Methods: In this clinical trial study, 100 pregnant women admitted in Shaheed Akbarabadi hospital for labor were included in the study and alternatively were allocated into one of two the groups: TENS group (A) or combined pethidine (50mg, IM) and promethazine (25mg, IM) group (B). Pain intensity during maximum uterus contractions was evaluated with Visual Analogue Scale (VAS) in all of the cases. Four hours after delivery, pain relief and efficacy of the method was asked from the mothers. Demographic data were recorded in all cases. Data analysis was accomplished with SPSS V. 15 software.  For statistical analysis t-test, regression and Chi2 were used. P value under 0.05 was assumed as significant.Results: Mean pain intensity in 3-4cm dilatation in group A was 7.65±1.05 and in group B was 8.16±1.14 and difference was significant (P=0.003). Mean pain intensity in 6-7cm dilatation was 8.55±0.76 and 8.38±0.87, respectively which was not statistically significant (P>0.05). In full dilatation this measure was 8.73±0.84 and 8.54±0.69, respectively which was not statistically significant (P>0.05). Mean number of contractions in full dilatation in group A was significantly higher than group B (6.18±7.22 vs 3.87±66 P=0.02). Mean duration of labor in group A was 3.49±2.64 hrs and in group B was 3.31±1.5hrs which was not statistically significant (P>0.05).Conclusion: With respect to the results of this research and the previous studies, TENS is a side-effect free, cheap and suitable method for controlling labor pain and can be used solely and as adjuvant therapy for this purpose.}, Keywords = { Pain free labor,Transcutaneous Electrical Nerve Stimulation (TENS),Pethidine-Promethazine}, volume = {15}, Number = {0}, pages = {87-93}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1066-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1066-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Saedi, D. and Naroienejad, M. and Ghayenian, M.}, title = {Determination of the Prevalence of Unenhanced Helical Computed Tomography Findings in Patients with Acute Flank Pain Referring to Shaheed Hashemi Nejad Hospital in 2005}, abstract ={    Background and Aim: Unenhanced Helical Computed Tomography (UHCT) has evolved into a well-accepted method in patients with acute flank pain and suspected ureterolithiasis. The purpose of this study was analysis of UHCT findings in patients with acute flank pain.Patients and Methods: This is a prospective descriptive cross sectional study. The results were analyzed by descriptive statistic methods. 118 consecutive patients with acute flank pain were evaluated prospectively with UHCT. The images were interpreted for detection of calculi, size and location of the calculi we also sought for the secondary signs of obstruction.Results: In a total of 118 patients who underwent UHCT, 99 cases had evidence of urinary calculi, 1 patient had appendicitis, 1 patient had ruptured ovarian cyst and 17 had normal UHCT. 81 patients suffered from a solitary stone in the ureter with a mean diameter of 6 mm. 3 cases had two stones one in the ureter and another in the calyx. 15 cases had two stones or more in the calyces. Also secondary signs of obstruction were confirmatory in the interpretation of UHCT. The most reliable secondary signs of ureteral obstruction were respectively hydroureter (73.7%), hydronephrosis (46.6%), periureteric edema (26.3%), perinephric edema (14.1%), and nephromegaly (8%).Conclusion: The highly accurate diagnostic value of UHCT makes it a suitable method in the diagnosis of patient with acute flank pain.}, Keywords = {Unenhanced helical CT scan, Bladder stones,Acute flank pain,Secondary symptoms, Ureterolithiasis}, volume = {15}, Number = {0}, pages = {95-103}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1067-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1067-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Sina, F. and HaghiAshtiani, B. and Rohani, M. and Zamani, B. and AkbarianNia, S.M.A.}, title = {Intensity of Vasomotor Reactivity (VMR) in Thrombosis of Cerebral Venous Sinus in Comparison with Normal Vasoreactivity Using Trans-Cranial Doppler}, abstract ={    Background and Aim: Thrombosis of the cerebral veins and sinuses is a distinct cerebrovascular disorder that most often affects young adults and children. Failure in brain autonomic activity could be provoked because of damage to energy-dependent cellular membrane pumps resulting from cytotoxic edema and cerebral ischemia. Measurement of vasomotor reactivity (VMR) through Trans-cranial Doppler imaging may reveal the extent of brain damage in such conditions. The aim of this study was to evaluate and compare the vasomotor reactivity in patients with cerebral vein thrombosis and in normals individuals.Patient and Methods: In this cross – sectional study, cerebral vasomotor reactivity (CVR) measurement with Trans-cranial Doppler technique was performed in 25 cerebral venous sinus thrombosis patients and 25 age and sex-matched healthy controls. Cerebral Vasomotor Reactivity (VMR) was measured after inhalation of 5% CO2 for 1-2 minutes. CVR was measured as percentage of MCA changes for every mmHg increase in arterial CO2. Statistical analysis was done via student t-test. SPSS V. 11 was also used.Results: There was a statistically significant difference between the mean VMR values in the two groups (P<0.001,4.47 in thrombotic group and 7.62 in controls). Pulsatility index (PI) was 0.77±0.12 and 0.55±0.11 in thrombotic and control groups, respectively. Mean End diastotic volume (EDV) was 56.4±12.23 cm/s and 65.48±12.07 cm/s in thrombotic and control groups, respectively showing significant statistical differences. (P<0.001).Conclusion: These findings are consistent with a state of vasoconstriction in cerebral venous and sinus thrombosis that is unresponsive to stimuli, that under normal circumstances results in vasodilation. Measurement of VMR in patients affected by cerebral venous sinus thrombosis could assist in early diagnosis of cerebral autonomic dysfunction and prevent its serious consequences.}, Keywords = {Cerebral venous sinus thrombosis,Trans-cranial Doppler,Vasomotor reactivity}, volume = {15}, Number = {0}, pages = {105-113}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1068-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1068-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Shaddel, M. and Ormazdi, H. and Akhlaghi, L. and Kazemi, B. and Bandepour, M.}, title = {Evaluating the Cloning of Leishmania Major p4 Gene in Production of Vaccine}, abstract ={    Background and Aim: Leishmania major p4 gene is normally expressed during amastigote form of the parasite and can be a good candidate for producing an effective vaccine. The aim of this study is to clone p4 gene in a suitable vector for further vaccine production studies .Materials and Methods: This is an experimental study. Leishmania promastigote was grown in N.N.N. medium and later in the form of mass culture in RPMI 1640 cell culture medium. Total leishmania genomic DNA was extracted by centrifugation of promastigote and lysed by lysis buffer followed by boiling method. PCR was carried out using p4 gene specific primers. PCR product was detected by agaros gel electrophoresis and cloned into Bluescript plasmid via T/A cloning method. After transformation, the recombinant plasmid was screened  and digested by restriction enzyme Results: PCR reaction and cloning p4 gene in T-vector was done successfully. Recombinant plasmid was extracted and cloned gene was released by restriction enzyme and subcloned into pPQE-30 expression vector and confirmed by restriction analysis and PCR. Conclusion: This newly expressed combination is p4 gene invitro. Production of p4 recombinant antigen is very much useful especially in the field of vaccine production, drug target and immunological studies.}, Keywords = {p4 gene,Cloning,Leishmania major,Vaccine}, volume = {15}, Number = {0}, pages = {115-120}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1069-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1069-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Shariatzadeh, H. and Jafari, D and Taheri, H. and Najdmazhar, F.}, title = {A Rare Case of Congenital Ulnar Bone Deficiency}, abstract ={    Introduction: Ulnar bone deficiency is one of rarest congenital anomalies of upper limb which is classified under longitudinal deficiencies of upper limb. Ulnar bone deficiency is classified to several subgroups and musculoskeletal deformities are very common in this abnormality. Hand always has abnormality in the involved limb. The presenting case has ulnar deficiency with humero-radial synostosis, but interestingly no abnormality in ipsilateral  hand and digits.Case Report: The patient is an 8 year old boy who had referred to the clinic because of short left upper extremity. On examination of the spine, lower extremities and right upper extremity no abnormality was found. The involved left upper limb was shorter than the right upper limb, elbow was in extension and there was no motion at that joint. Left wrist was similar to the right one. In the left hand, thumb was normal and all metacarpal bones were normal. Hand had five digits with three phalanges without any syndactylism and constrictive bonds. On radiographic examination, there was humero - radial synostosis, but no abnormalities in the bones of hand.Conclusion: Presenting report indicates the presence of ulnar bone deficiency without the abnormality of the hand in the involved limb.}, Keywords = {Ulnar Deficiency, Humero-radial synostosis,Upper Limb Congenital Deficiency}, volume = {15}, Number = {0}, pages = {121-124}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1070-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1070-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Sadeghi, H.A. and Zahmatkesh, M.M. and EhteshamiAfshar, A. and Paziraee, N.}, title = {Evaluation of Lung Volume Changes After Correction of Khyphoscoliosis Angle}, abstract ={    Background and Aim: The present studies on kyphoscoliosis operation demonstrate different results on lung volume changes. Some observations show increased, some show decreased and other studies show no changes in the dynamic respiratory flows.In this study we evaluated lung volumes before and after surgery. We also evaluated the correlation of repiratory lung volume changes with mean of Cobb's angle.Patients and Methods: In this observational descriptive study, 18 non smoker patients with idiopathic scoliosis were included. Cobb's angle, lung volume and flow were measured before and after surgery with spirometer. Paired t-test was used for statistical analysis. To consider height and weight changes during the follow ups, we used percentage relative to normal instead of absolute volumes.Results: From 30 patients included in this study we followed 18. Mean follow up duration was 34.5±19.6 months (SD=19.6) Dynamic volume changes were: VC=13.4 SD=8.6 (P<0.005), FVC=9.22 SD=14 (p<0.001) and FEV1=9.8 SD=15 (p<0.001). There was no significant correlation between lung volume changes and Cobb's angle changes. There was weak inverse correlation between mean value of dynamic volume changes and mean changes in Cobb's angle after surgery the greater the cobb's angle changes, the lesser the lung volume changes.Conclusion: In this study there was significant decrement of dynamic lung volumes after corrective surgery for thoracic curve scoliosis. There was no correlation between the degree of corrective angle and the amount of lung volume changes. There was a weak linear correlation between cobb's angle and lung volumes before surgery. Greater the angle changes, lesser the lung volume changes.There was a weak inverse correlation between the mean value of Cobb's angle and changes in dynamic lung volume after surgery.}, Keywords = { Forced vital capacity,Slow vital capacity (SVC),Forced expiratory volume in first second,Cobb\'s Angle,Scoliosis}, volume = {15}, Number = {0}, pages = {125-131}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1071-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1071-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Tabatabaee, A. and Farhadi, M. and Noorbaksh, S. and Shekarabi, M. and Shamshiri, A.R. and Alirezaie, N.S. and VasheghaniFarahani, A.}, title = {Evaluation of Mycoplasma and Chlamydia Infection with PCR Method and Serology in Patients with Nasal Polyps and Normal Subjects}, abstract ={    Background and Aim: Inflammation is relatively a documented pathogenic cause of chronic rhinocynositis and nasal polyps, but the definite causes are still unknown. Among the infective causes, we decided to evaluate Mycoplasma and Chlamydia, the two major pathogens in respiratory tract diseases, as a potential etiologies in nasal polys. Materials and Methods: In a descriptive-analytic cross-sectional study, 51 patients with nasal polyp and 19 healthy persons (with nasal fracture) who had referred to Hazrat-e-Rasool Akram Hospital were enrolled in the study. Blood sample for ELISA and nasal polyp tissue (in control group a specimen from inferior nasal turbinate mucosa) for PCR tests were sent to the laboratory. Descriptive measures, Chi-square and Mac Nemar tests and Kappa agreement statistics were used for statistical analysis.Results: Positive results for IgM, IgG and PCR for Chlamydia were 9.8%, 47.1% and 7.8% in patients and 0%, 47.4% and 0% in control group, respectively. The differences between the groups were not statistically significant. Similarly for Mycoplasma, the above mentioned results were 15.7%, 68.6% and 19.6% in patients and 15.8%, 47.4% and 0% in control group, respectively. According to IgG and PCR results, the differences between two groups seems to be significant (P =0.10 and 0.05 respectively).Conclusion: Between the two evaluated bacteria in this study, mycoplasma may have significant correlation with nasal polyp formation. However further studies with larger sample size and considering more confounding factors are needed.}, Keywords = {Nasal polyp,Mycoplasma,Chlamydia}, volume = {15}, Number = {0}, pages = {133-139}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1072-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1072-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {AzizJalali, M.H. and Ghaffarpour, G.H. and Rezaei, M.R. and HeshmatzadehBehzadi, A.}, title = {Effectiveness of Intralesional Injection of Bleomycin in the Treatment of Resistant Warts}, abstract ={    Background and Aim: Warts are benign tumours of the skin and mucosa and are caused by Human Papilloma viruse (HPV). They are one of the common skin disorders found mainly in children and adolescents.Although most of the warts disappear spontaneously and or respond to the usual therapeutic measures, difficult to treat and persistent forms of warts exist which are a problem in dermatology.Intra lesional injection of Bleomycin has been used in the treatment of resistant warts, and is associated with variable results in different researches. This study assessed the efficacy of intralesional administration in resistant warts and compared it with other simillar studies.Patients and Methods: This was a cross sectional study. A total of 130 warts from 30 patients were injected with (1 mg/ml) intralesional injection of Bleomycin. Patients received one to three times of injection of bleomycin every 4 weeks, and were followed for six months. Response to treatment was as complete resolution, partial resolution and not treated. We used SPSS version 13 and t and Anova tests as statistical methods for analyzing the data.Results: 126 of 130 warts (97%), showed resolution after bleomycin injections 95 warts (73%) showed complete resolution and 31(24%) showed incomplete resolution. The cure rate was better in warts with size less than 20 mm compared to those with lesions greater than 20mm ( 80% vs 46% ). After 6 months follow up, 7 of the 30  patients had recurrence of lesions. Recurrence was more among those with greater number of warts.Conclusion: It is concluded that this form of treatment for resistant warts is reliable, safe and acceptable to patients, if performed undercare and with proper dose and concentration.}, Keywords = {Bleomycin, Intralesional injection, Resistant wart}, volume = {15}, Number = {0}, pages = {141-146}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1073-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1073-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Aghdaii, N. and Faiz, S.H.R.}, title = {With which Anesthetic Regimen, the Hemodynamic Status of Patients Undergoing Coronary Artery Bypass Graft Surgery While on -Blocker Usage, is more stable? Sufentanil-Cis. Atracurium or Sufentanil-Pancuronium?}, abstract ={    Background and Aim: Hemodynamic stability during anesthesia and operation is the most important aim of anesthesiologists. Every anesthetic drug has its own hemodynamic effects. The interaction of these drugs with each other and with preoperative drugs of the patients, may cause critical changes in patient's hemodynamic status. For a perfect anesthesia induction, while using high doses of opioids, we must add an intravenous drug such as etomidat. Selection of a muscle relaxant, when etomidat-sufentanil is used in patients taking β-blocker is very important. In the present study, we evaluated the hemodynamic effects of Pancuronium and Cis-atracurium in combination with a high dose of sufentanil in β-blocker using patients that are undergoing coronary artery bypass graft surgery (CABG).Patients and Methods: A prospective double blind randomized clinical trial analysis was performed on 80 patients undergoing coronary artery bypass graft surgery in Shaheed Rajaei Heart Center. Patients were divided randomly into two groups: Cis-atracurium (n=40) and Pancuronium (n=40).The selection of the type and dose of premedication drugs and intraoperative opioid and anesthetic in the two groups were the same. The systolic and diastolic blood pressures, mean arterial pressure, heart rate , cardiac output, cardiac index, central vein pressure and systemic vascular resistance were measured before  and during induction and operation up to 60 min after induction. Results were analyzed with SPSS V. 13.0 and Repeated Measurement Analysis.Results: The multivariate analysis showed significant reduction (p>0.05) in systolic and mean arterial blood pressures in Cis-atracurium group. There was no statistically significant difference between the two comparative groups according to others indexes. Conclusion:  Although Cis-atracurium reduced significantly the systolic and mean arterial blood pressures in comparison with pancuronium after induction in CABG surgery of patients under treatment with β-blocker agents, there were no statistically and clinically significant changes in the heart rate and cardiac indices.}, Keywords = { Muscle relaxant,Pancuronium, Cis-atracurium,Hemodynamic changes,Coronary artery bypass graft (CABG)}, volume = {15}, Number = {0}, pages = {147-157}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1074-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1074-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Kashanian, M. and Mokhtari, F. and Karimi, M.A.}, title = {Evaluation of the Effects of Intramuscular Dexamethasone on the Induction and Duration of Labor and its Complications}, abstract ={    Background and Aim: One of the proposed ways for enhancement of labor induction is administration of corticosteroids. Although animal studies have shown the importance of cortisole in the initiation of labor, the role of corticosteroids in enhancement of labor process is still uncertainThe aim of the present study was to determine the effects of intramuscular dexamethasone on labor duration and its complications.Patients and Methods: We conducted this randomized clinical trial on 122 nulliparous women with favorable bishope score who were candidates for labor induction. Study group(n=61)received 8 mg intramuscular dexamethasone phosphate 6 hours before induction Induction of labor( without dexamethasone) started after 6 hours for controls (n=61). Following distile water injection. Expected result was initiation of the active phase of labor and duration of labor, that were compared in both groups. Data collection was accomplished by specific forms and data analysis was done by SPSS-15 software. t-test and Chi-square test were used for annalysis.Results:�Patients in both groups did not show significant statistical differences in regard to age, Bishop Score and time of delivery. Mean of time duration between induction and the beginning of active phase of labor was significantly shorter in the case group than the controls (3.09±1.5 hrs. versus 4.21±1.8 hrs) (P<0.001). Mean duration of active phase in the case group (2.46±1.38 hrs) did not show significant difference with that of controls (3.87±5.73hr) (P>0.05). Duration of the second phase of labor was significantly shorter in the cases than that of control group (22.23±16.09 min. versus 29.01±15.32 min) (P=0.014). Duration of the third phase did not differ significantly in the two groups.Also neonatol Apgar score of 1and 5 min. along with maternal and fetal complications including chorio- amnionitis and fetal sepsis, did not show significant differences between the two groups.Conclusion: Dexamethasone can reduce the time interval between induction and active phase and duration of phase 2.}, Keywords = {Dexamethasone , Labor induction, Duration of labor}, volume = {15}, Number = {0}, pages = {159-165}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1075-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1075-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Kamrani, SH.R. and Mottaghi, A. and Hajzargarbashi, R.}, title = {Report of a Case of Tibia Hemimelia and its Operation at the Age of Twenty}, abstract ={    Introduction: Tibia hemimelia is a longitudinal deficiency of tibia bone which is manifested at birth. Limb shortening, severe foot deformity, and knee flexion contracture are presented in this disease. It is usually treated during the early years of life. The goal of treatment is to achieve stable and equal length in both legs.Case report: The mentioned case is a 20 year old man with type IA Tibia hemimelia. The interesting point in this case is the tolerance of severe right lower limb deformity, shortening with an extra thumb and toe on the same side till the age of 20 years.Conclusion: It is best to treat this condition in the first few years of life and as minimum as possible operations should be imposed to the patient.}, Keywords = {Tibia hemimelia,Congenital anomaly,Longitudinal limb deficiency}, volume = {15}, Number = {0}, pages = {167-170}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1076-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1076-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {KadKhodaie, H.R.}, title = {Comparative Study of New Drainage Device (Drainage Bag) and Chest Bottle for Pleural Cavity Drainage}, abstract ={    Background and Aim: Chest tube has been used as a close drainage system for evacuation of pleural cavity after thoracic surgery and in traumatic patients.Today, the chest bottles are made from hard and fragile  material that may be broken easily. Also chest bottle needs sterile saline solution for proper functioning. This causes heaviness with pressure effect on the chest wall, resulting in severe pleuritic pain and interfering with early ambulation and post operative ventilation. The goal of this study is to use a new drainage device that  in addition to draining pleural cavity properly doesnot have the other side-effects of the conventional chest bottle.Patients and Methods: This interventional clinical-trial was designed to compare the efficacy of new drainage device (Drainage bag) and chest bottle for pleural cavity evacuation.In this study, 50 patients that were admitted in the wards of Hazrat Rasool Akram hospital and needed chest tube were selected. After explaining the proceduce and obtaining their consent, they were divided randomly into two groups of 25 each. For one group (25 patients) routine chest bottle was utilized and in the other group (25 patients) new drainge bag was used as close drainage system of pleural cavity. The two groups were compared for severity of pain (by VAS), patient satisfaction and duration of admission. All data were analyzed statistically.Independent samples test was used for quantitative variants and qualitative variants were analyzed by Chi square test.Results: Distribution of mean pain score was 4.2 for drainage bag versus 5.5 for routine chest bottle. Similary, in regard to patients satisfaction for movability and changing of device, the rate was 81% for drainage bag and 43% for routine chest bottle.Duration of hospitalization was the other item that was evaluated in this relation data showed 5.3 days for drainage bag and 8.7 days for the chest bottle group.Conclusion: According to our data it seems that use of new “drainage bag” for evacuation of pleural cavity can be as effective as routine chest bottle with less pain, more patient satisfaction and shorthening of hospitalization period.}, Keywords = {Pleural cavity,Chest tube,Chest bottle,Drainage}, volume = {15}, Number = {0}, pages = {171-176}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1077-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1077-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Motevalian, M. and Souri, E. and Tafreshi, N. and Jalalizadeh, H. and Mahmoudian, M.}, title = {Determination of Thiamin Level by a Sensitive HPLC Method in Plasma of Chronic Hemodialysis Patients}, abstract ={    Background and Aim: Renal replacement therapies are usually associated with changes in trace elements and metabolism of vitamins. Multivitamins are administered routinely to dialysis patients in dialysis centers. Thiamin plasma level is a good indicator of nutritional state of the patient. In this study, a sensitive high-performance liquid chromatography HPLC method for determination of the concentration of thiamin in human plasma has developed by which thiamin level is detected in plasma of hemodialysis patients. The aim of the study was determination of thiamin blood levels in chronic hemodylysis patients in order to evaluate their need for thiamin supplements.Materials and Methods: In this experimental study, the plasma of nine Iranian patients on hemodialysis were analyzed for their thiamin levels and compared to the thiamin levels in a group of healthy Iranian subjects. The procedure was based on pre-column oxidation of thiamin to thiochrome followed by fluorescence detection. Plasma (1ml) was deproteinized with trichloroacetic acid and thiamin was extracted with diethyl ether. Then, cyanogens bromide (0.3 M) was added to convert thiamin to thiochrome. Samples (25µl) were applied to a Novapak C8, 4µm (4.6 × 250 mm) column. The mobile phase consisted of methanol: phosphate buffer (30mM) in the ratio of 45:55 and 0.05% sodium lauryl sulfate. Data were analyzed using SPSS V13. Statistical analysis was done by t-test and One- way Anova test.Results: A precise and reproducible HPLC method was developed for determination of thiamin in plasma. The minimum detection limit was 0.2 ng/ml and percentage recovery was 85%. Inter and Intra day assay variabilities were determined for 1,5 and 15 ng/ml thiamin spikes in plasma and coefficient of variations were in the range 0.2-2.94%. The average plasma thiamin level in 10 healthy Iranian subjects was 3.07±0.95 ng/ml and in Iranian patients was 4.72±1.12 ng/ml and 4.29±0.67 ng/ml before and after hemodialysis, respectively. Our study has shown that the mean plasma thiamin level in Iranian patients on hemodialysis has no significant difference with its level in healthy Iranian subjects. The thiamin level also remained unchanged before and after the hemodialysis.Conclusion: The HPLC method used for determination of thiamin in plasma was sensitive, accurate, reproducible and suitable for kinetic studies of thiamin. According to our findings the thiamin level in patients undergoing hemodialysis has no significant difference with healthy subjects and it seems that dietary vitamin is sufficient for the normal functions of the body, and taking viamin supplementation is not necessary for these patients.}, Keywords = {Thiamin,High Performance Liquid Chromatography (HPLC),Plasma Level,Hemodialysis}, volume = {15}, Number = {0}, pages = {177-185}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1078-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1078-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Nedjadgashti, H. and Sabzghabaie, F. and Saedi, D.}, title = {Rare Response to Nonsurgical Treatment In a Patient with Autosomal Dominant Polycystic Kidney Disease and Bilateral Multiple Pyocysts a Case Report}, abstract ={    Introduction: Autosomal dominant polycystic kidney disease (ADPKD) is the most prevalent inherited disease of kidney in adults. Approximately, 30-50 percent of these patients will have one or more urinary tract infections during their lifetime. Treatment is somewhat more complicated with an infected cyst and if the patient doesn't respond to antimicrobial therapy, surgical nephrectomy is the treatment of last resort.Case report: In this article, we report a 56 year old woman with ADPKD and diabetes. The patient had multiple pyocysts and didn't respond to antimicrobial therapy. The cysts were drained and washed under sonography guidance and the patient was treated.Conclusion: Drainage of pyocysts in ADPKD with sonographic guide and frequent rinsing can be a good replacement for nephrectomy in patients that don't respond to antimicrobial therapy and are candidates for nephrectomy.}, Keywords = {Autosomal dominant polycystic kidney disease,Pyocyst, Percutaneus drainage}, volume = {15}, Number = {0}, pages = {187-191}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1079-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1079-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} } @article{ author = {Nasirinezhad, F. and Saffarpour, S.}, title = {Involvement of NMDA Receptors in Antinociceptive Effect of Ascorbic Acid in a Neuropathic Pain Model}, abstract ={    Background and Aim: Ascorbate (ascorbic acid) is present in high concentration in the nervous system and is released as a result of activation of glutaminergic neurons. Due to high concentration of NMDA receptors in the nervous system, this study investigated the analgesic efficacy of ascorbic acid (AA) in neuropathic pain condition and the role of NMDA receptors in this effect.Materials and Methods: In this experimental study, neuropathic pain was induced by chronic constriction injury of sciatic nerve (CCI, model) in the left hind paw. In the second week after CCI, animals received 1, 5, 10 mg/kg of ascorbic acid or normal saline and pain threshold was determined 15 and 30 minutes later. To determine the role of NMDA receptor in nociceptive effect of AA, separate groups of animals were tested. In these groups in the second week after CCI, 30 min after injection of saline or AA (1mg/kg) animals received intraperitoneal injection of Ketamin (5 mg/kg) or MK-801 (0.01 mg/kg) and were tested 20 min afterwards. Mechanical allodynia was assessed by Von Frey hairs and mechanical and thermal hyperalgesia were determined by Randall Selitto and Radiant Heat tests, respectively. Data were analyzed by ANOVA and Newman Keuls tests. Results: Intraperitoneal injection of 5 and 10 mg/kg but not 1mg/kg ascorbic acid increased mechanical and thermal threshold in the second week after CCI. Ascorbic acid (1mg/kg, i.p.) also produced significant inhibition of MK-801 and ketamin - induced antinociception response. In these groups there was no significant difference in the pain threshold as compared to animals that received normal saline.Conclusion: The results indicate that ascorbic acid produced a dose dependent antinociceptive effect that seems to be mediated through its interaction with NMDA receptors.}, Keywords = { Ascorbic acid, NMDA receptor, Neuropathic pain,Antinociception}, volume = {15}, Number = {0}, pages = {193-204}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-1080-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-1080-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2009} }