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Volume 66, Issue 7 (6 2008)
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Methods: A
total of 115 catheters (two-cuff, swan-necked, coiled) were
inserted into the peritoneal cavity of 109
patients with end-stage chronic renal failure during a 16-month
period. The method of insertion was a two-port laparoscopic technique with
local anesthesia and sedation. All patients were followed for 12
to 28 months. We prospectively evaluated mechanical
and infectious complications and survival rates of the catheters.
Results: The
average age of the patients was 51.5 years (range: 15-84
years) 54.8% of these patients were female. The overall
one-year and two-year catheter survival rates using this approach were 88%
and 73%, respectively. Event-free catheter survival
was 35%. The most common infectious and mechanical
complications were peritonitis in 52
cases (45.2%) and temporary dialysate leakage in 10
cases (8.7%) respectively.
Conclusion: Laparoscopic insertion of
peritoneal dialysis catheter with local anesthesia is a safe and simple
procedure, giving reasonable rates of catheter survival and complications.
Volume 66, Issue 10 (4 2009)
Background: Preeclampsia is a disorder of pregnancy with increased maternal and perinatal morbidity and mortality. An imbalance between free radical induced lipid peroxidation and antioxidant system has been suggested as possible pathogenesis of preeclapsia. It has been shown correlation of some serum antioxidant agents (for example ceruloplasmin) with preeclampsia and its severity. The purpose of this study was to evaluate of this correlation.
Methods: In a analytic case-control study, in clinic and delivery unit of Mirza Koochak Khan university hospital, Tehran, we evaluated 90 pregnant women of 19-38 years old with gestational age higher than 20 weeks in two groups, case (preeclampsia) and control (healty mother). Case group was devided into two groups mild preeclampsia (n=30) and severe preeclampsia (n=30). Patients with preeclampsia (n=60) had either early (n=41) or late preeclampsia (n=19). Control group included 30 normotensive pregnant women. Serum Ceruroplasmin level was measured. Then relationship between this factor and preeclampsia was studied.
Results: The mean level of serum ceruloplasmin in women with severe preeclampsia (390.83mg/dl) and mild preeclampsia (319.43mg/dl) was higher than control group (212.7mg/dl). Likewise it was significantly higher in severe preeclampsia than mild (P<0.001) and higher in early (373.28mg/dl) than late preeclampsi (298.34mg/dl) (P<0.01).
Conclusions: Our data suggest that serum ceruroplasmin level may predict preeclampsia occurrance and its severity. Likewise antioxidant theryapy before the onset of preeclampsia in an attempt to decrease its frequency should be considered.
Volume 68, Issue 4 (6 2010)
Background: Patients with chronic renal disease, if not treated appropriately, will be usually terminated into an irreversible stage known as End Stage Renal Disease (ESRD), the final stage of kidney disease. End stage renal disease patients cannot excrete the appropriately potassium ion through the kidney. Among the crystalloid solutions, normal saline is devoid of potassium so it is used in a widespread manner in renal transplant patients. High doses of this solution may cause hyperchloremic metabolic acidosis that is accompanied by extracellular potassium shift and impaired splanchnic perfusion. The aim of this study was to assess the effects of two types of solutions, normal saline vs. lactated ringer in these patients during the perioperative period. Methods: In a double blind clinical trial, 108 patients were randomly assigned in two groups (54 in each), while were assimilated regarding all aspects except for the type of the crystalloid solution. Age, weight, duration of the surgery, total volume of the infused crystalloid, central venous pressure and sex were all assessed. Results: The two groups were the same regarding the results gained for pre- and post- operative parameters. Follow up assessments did not show any difference between the two groups regarding above variables. Conclusions: The results of this study demonstrated that both of the crystalloid solutions assessed, normal saline and lactated ringer solution, are safe for using in patients undergoing surgical operation and there is not a risk of hyperkalemia in renal transplant patients receiving lactated ringer. This study was performed on live kidney transplants and the results were not applicable to cadaver transplants.
Volume 71, Issue 10 (January 2014)
Background: Colorectal carcinoma is considering as a curable disease. Treatment of recurrent cases is hard and sometimes impossible. Evaluation of the rate and affecting factors of recurrence in each hospital would help to decreasing recurrent cases. The aim of this study is evaluation of the rate, clinical and pathologic features, and outcome of recurrent colorectal carcinoma in a referral teaching hospital in Tehran. Methods: Clinical data of 166 curative resections of colorectal carcinoma who were operated between Mehr 1384 and Mehr 1388 (between 23 September 2005 and 23 September 2009) in Imam Khomeini Hospital and were accessible for follow up was collected. Follow up data was collected prospectively up to Farvardin 1391 (19 April 2012). Forty nine recurrences were happened in this period. We compared recurrent and non-recurrent cases for different variables Results: Average age of the patients was 53.5 years, and 47% of them were female. The median time to the diagnosis of recurrent disease was 12 months (range 1 months to 54 months). There were no significant differences between recurrent and non-recurrent patients about age, sex, sub-site of the tumor and sub-type of primary operation. Rate of overall recurrence, local recurrence and distant metastasis were 29.5%, 15.7% and 12.1% respectively. Local recurrence rate was higher in colon cancer (16.44% vs. 15.05%) but distant metastasis rate was higher in rectal cancer (12.9% vs. 10/96%). Rate of curative re-resection was about 25%. Overall survival of the recurrent patients who underwent surgery was better than who underwent chemo or radiotherapy (66.7% vs. 56.8%). Median survival time of recurrent patients after primary surgery was 28 months, and after diagnosis was 12 months (9.28- 14.72,95% CI). Conclusion: In this study the rate of overall recurrence was 29.5%. Local recurrence rate was higher in colon cancer (16.44% vs. 15.05%) but distant metastasis rate was higher in rectal cancer (12.9% vs. 10/96%).
Volume 72, Issue 7 (October 2014)
Background: Controlling parenchymal hemorrhage especially in liver parenchyma, despite all the progress in surgical science, is still one of the challenges surgeons face saving patients’ lives and there is a research challenge among researchers in this field to introduce a more effective method. This study attempts to determine the haemostatic effect of aluminum chloride and compare it with that of the standard method (simple suturing technique) in controlling bleeding from liver parenchymal tissue. Methods: This is an experimental study. In this animal model study 60 male Wistar rats were randomly allocated into six groups and each of which contains 10 mouse. An incision, two centimeters (cm) long and half a cm deep, was made on each rat’s liver and the hemostasis time was measured once using aluminum chloride with different concentrations (5%, 10%, 15%, 25%, and 50%) and then using the control method (i.e. controlling bleeding by simple suturing). The liver tissue was examined for pathological changes. Finally, the obtained data were entered into SPSS software and analyzed using Kruskal- wallis test, Mann- Whitney, Kolmogorov- Smirnov test. Results: The mean time to hemostasis in groups of aluminum chloride concentration of 50%, 25%, 15%, 10% and 5% were respectively, 8.90, 13.10, 23.30, 30.30 and 37.8 seconds, also in the control group (suture) mean time of hemostasis was 60/81 seconds. The haemostatic times of different concentrations of aluminum chloride were significantly less than that of the control group (P< 0.001). There was a statistically significant difference between every two haemostatic times (P< 0.001). The pathologic examination showed the highest frequency of low grade inflammation based on the defined pathological grading. Conclusion: Aluminum chloride compare to the control method (i.e. controlling liver bleeding by simple suturing) needs less time to control liver bleeding. Aluminum chloride is an effective agent in controlling liver hemorrhage in an animal model.
Volume 72, Issue 8 (November 2014)
Background: Mycosis fungoides (MF) is the commonest T-Cell lymphoma (CTCL) involving skin and its appendages to variable degrees. Nail involvement is one of multiple dermatologic manifestation of this disorder and could have negative impact on psychological status of patients and producing therapeutic challenge to physician. We aimed to evaluate prevalence and subtypes of nail involvement in MF patients attending dermatology clinic, Razi Hospital in Tehran, Iran. Methods: All patients having MF confirmed via histopathology, visiting Razi Hospital Dermatology Clinic, Phototherapy and follow-up on inpatient wards from 2010 to 2011, were included. Patients examined by dermatologist researcher focusing on nail changes and all detected nail changes including onycholysis, longitudinal ridges and 11 more other changes, recorded in appropriated questionnaires. Treatment regimen prescribed to the patients also recorded as well as clinical CTCL staging. Results: A total of 60 patients, including 28 (46.7%) males and 32 (53.3%) females entered the study. 18 patients (12 males and 6 females) had different nail changes including longitudinal ridging, leukonychia, pitting and nine more morphological changes in decrescendo order. Ten patients had smoking history including four patients with nail changes. The commonest used treatment was local bath Psoralen and UVA light therapy (PUVA). Overall nail involvement in our study was approximately 30%. There was no significant relationship between prevalence of nail changes, demographic and clinical specification of underlying CTCL disorder especially tumor stage. Also, no significant relationship between prevalence and type of nail involvement with prescribed therapeutic regimen was found. Conclusion: We found about 30% prevalence that is a little higher than previously shown. It seems that nail changes in CTCL have no relationship to CTCL staging or other specifications including demographic specifications.
Volume 72, Issue 12 (March 2015)
Background: Sacrococcygel region is the most common site for pilonidal sinus and surgery is the most common treatment for it. Numerous operative techniques have been described for management of this disease but a technique with low recurrence and complication rates is the best treatment option. Karydakis has been introduced as a method with less recurrence rate, but it seems that surgeons debate on complications and it is not a common technique in our country. In this article, we will discuss Karydakis procedure and its results after a prospective follow-up in our patients. Methods: This is a prospective single cohort study on the patients with sacrococcygeal pilonidal disease. Cases evaluated in this study included patients underwent Karydakis procedure for their pilonidal sinus from 23 September 2006 to 22 September 2013. Patients were followed-up prospectively after their discharge within the first week, first month and third month for early complications and then annually for recurrence. The length of follow-up ranged from 3 to 77 months (median 36 months). Results: Of 141 patients, 119 (84.4%) were male and mean operating time was 55.52 (35-120) minutes. Mean time to healing wound with no need to dressing was 15.92 (range: 2-120) days and mean time to return to work was 14.44 (range, 1-35) days. Overall rate of early post-operative complications was 21.3% that most of them treated conservatively. Wound breakdown within the caudal part was the most common complication detected in 12.1% of patients and infection was detected in 5.8%. Hematoma, seroma and complete wound breakdown were seen in one patient each. The mean score of patient's satisfaction after one year was 4.91 out of 5. Recurrence was appeared in 1.42% of patients. Conclusion: Karydakis procedure for sacrococcygeal pilonidal disease is associated with low complications, short healing time and return to work, and reasonable recurrence rate.
Volume 73, Issue 11 (February 2016)
Background: Graft survival has been considered the major problem in reconstructive surgery. Clinical studies have helped us to understand the role of PRP in increasing skin survival. Our goal in this study was to examine the treatment effects of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) on autologous full thickness skin graft survival in male rats.
Methods: This experimental study was performed on 36 rats of Sprague-Dawley race with weighing approximately 250 to 300 gr on May 2015 in animal laboratory of Hazrat Fatima Hospital. After anesthesia, rats were divided into 3 groups. We injected platelet-rich plasma (PRP) in the first group, platelet-rich fibrin (PRF) in the second and saline in the third group after removing the skin. Microscopic analysis was performed with camera (Canon powershot SX200, Tokyo, Japan) on days 7, 14, 21 and 28 after surgery. We used image analysis system (ImageJ, ver. 1.45) to examine necrosis and survival rate. Samples were studied with H&E staining on day 28 microscopically for histological analysis of vascular density and angiogenesis.
Results: Our findings showed the area of necrosis in animals injected with PRP on days 7 and 14, was meaningfully less than control group (P= 0.0001). There was no meaningful difference between control and PRP groups (P> 0.05). The area of necrosis in animals injected with PRF did not have any significant difference with control group from beginning to 21st day (P< 0.0001). there was no meaningful difference in vascular density between control and PRP group, whereas in animals injected with PRF the vascular density was significantly less than control group (P= 0.002).
Conclusion: According to our results in this study, we can conclude that using autologous PRP can enhance the process of healing soft tissue injury and be affective at increasing graft survival. This method is suggested to be conducted for patients highly at risk of graft loss and also for those who are in need of early treatments.
Volume 74, Issue 1 (April 2016)
Background: Infeliximab is a form of chimeric antibody which neutralizes the most important inflammatory cytokine, TNF-a, in inflammatory disorders. The aim of current study was to pilot expression of chimeric infliximab in Chinese Hamster ovary (CHO) cells.
Methods: In this research study, pVITRO2-neo-mcs vector that consist of infliximab light chain and heavy chain was used to transform into the E.coli by CaCl2 method. The plasmid was then purified and transfected to cultured CHO cells by Lipofectamine 2000® (Invitrogen GmbH, Germany). Transfected cells were selected upon G-418 treatment after 2 weeks and the level of expression, based on standard curve, was measured using IgG ELISA kit after 48 hours for each clone. High level expressed clone was then cultured in roller bottles and recombinant chimeric product was purified by protein A affinity chromatography. The purity of the product was analyzed by 10% gel SDS-PAGE from eluted samples. The efficacy of the purification was analyzed by ELISA before and after purification step. This article is a master's student thesis from February 2015 to August 2016 in pharmaceutical technology development center, Tehran University of Medical Sciences, Tehran, Iran.
Results: The purified plasmid was analyzed on 2% agarose gel. After selective pressure of G-418, 10 stable transfect clones were assessed for infliximab secretion by IgG ELISA kit at 450 nm. The maximum and minimum expression which detected by ELISA were 23 ng/ml and 6 ng/ml, respectively. The band width of infliximab fraction during purification procedure was observed at 0.7-0.8 min. The efficiency of the purification by ELISA was 70%. On SDS-PAGE analysis, two bands, 25 and 50 kDa, respect to light and heavy chains of Infliximab, was confirmed the expression of recombinant protein.
Conclusion: In the current study, the construct for infliximab monoclonal antibody production was designed using genetic engineering techniques and the expression was confirmed by conventional molecular biology methods. The high yield production was carried out in semi-industrial scale using roller bottles with a 70 percentage of purification efficiency.
Volume 76, Issue 2 (May 2018)
Methods: This experimental study was carried out in Tarbiat Modares University during May to October 2016. 32 BALB/c mice were divided into 4 groups: control, vaccine, vaccine plus an acute exercise in first injection and vaccine plus an acute endurance exercise in first injection and booster shots. Mice without or with access to acute endurance exercise were immunized intramuscularly with inactivated KOS strain of HSV-1. Two weeks after three booster shots of vaccine, interleukin-10 and granzyme B levels were determined in spleen cell culture with enzyme-linked immunosorbent assay (ELISA) method.
Results: This study was undertaken to test the hypothesis that an acute endurance exercise as an adjuvant in herpes simplex virus 1 vaccine can change interleukin-10 cytokine and granzyme B levels in mouse model. The result of this study showed significant differences between groups in interleukin-10 and granzyme B levels (P=0.001). Increasing in granzyme B levels with concurrent decreases in interleukin-10 levels was observed following using vaccine plus acute exercise in first injection of vaccine and booster shots.
Conclusion: It is suggested that exercise may stimulate parameters related to cellular immunity and hence decrease the risk of infection decreased levels of interleukin-10 in experimental group that had vaccine plus acute exercise in the first injection of vaccine and booster shots as an adjuvant was observed. These results demonstrate alternation of T helper 2 cells function and improve of cell immunity for protection against herpes simplex virus 1 infections.
Volume 76, Issue 7 (October 2018)
Methods: In this descriptive study, which was conducted from March 2016 to February 2017 in Loghman Hakim Hospital in Tehran, ninety patients were evaluated using convenient sampling method for lead and thyroid hormones levels. The levels of lead and thyroid hormones were evaluated using standard laboratory method, in thirty male patients with lead poisoning, thirty male patients with opioid addiction referring to addiction treatment center and thirty healthy male referring to a blood donation center who were matched for age. Thyroid function parameters in patients with lead toxicity were compared with those of control groups.
Results: The lead level in the lead toxicity group was 57.5±23.5 µg/dl, in the first control group with opium addiction 7.8±3.8 µg/dl and in the healthy male referring to a blood donation center, 5.9±9 µg/dl. Thyroid stimulating hormone (TSH) was significantly lower in patients with lead poisoning (0.2±0.01 Milli-International Units Per Liter (mIU/L) than in the patients with opioid addiction (2.4±1/05 mIU/L) and healthy male referring to a blood donation center (2.3±0.01 mIU/L) (P= 0.04), and thyroxine hormone (T4) was significantly higher in patients with lead poisoning (17.8±2.6 µg/dl) than in the patients with opioid addiction (8.8±1/9 µg/dl) and healthy male referring to a blood donation center (7.4±3.5 µg/dl) (P= 0.02).
Conclusion: Lead toxicity has an effect on thyroid function and it reduces thyroid stimulating hormone and increases thyroxin levels. Clinicians should be aware of the potential hazardous effects of lead on the thyroid and mechanisms through which lead causes these effects on thyroid function need to be elucidated.
Volume 76, Issue 12 (March 2019)
Methods: In this fundamental study, data were collected from 127 keratoconus patients referred to the contact lens clinic at Farabi Eye Hospital, Tehran, Iran during the period of March 2013 to July 2014. Five parameters in the contact lens prescribing process were investigated. Parameters were collected as follows. “Lens vertical position”, “vertical movement of the lens during blinking” and “width of the rim” in the fluorescein pattern were obtained by recording videos of the patients while wearing the lens. “Fluorescein dye concentration” under the lens was evaluated by the physician and “patient comfort” was obtained by asking the patient to fill a simple scoring system. Approved and disapproved lenses were judged and recorded based on the decision of an expert contact lens practitioner. The decision support system was designed using artificial neural networks with the mentioned variables as inputs. Approved and disapproved lenses are considered as system outputs. Artificial neural network was developed using MATLAB® software, version 8.3 (Mathworks Inc., Natick, MA, USA). Eighty percent of the data was used to train the support vector machine and the rest of the data (20%) to test the system's performance.
Results: Accuracy, sensitivity and specificity, calculated using the confusion matrix, were 91.3%, 89.8% and 92.6% respectively. The results indicate that the designed decision support system could assist contact lens prescription with high precision.
Conclusion: According to the results, we conclude that hard contact lens fitness could be evaluated properly using an artificial neural network as a decision support system. The proposed system detected approved and disapproved contact lenses with high accuracy.
Volume 79, Issue 4 (July 2021)
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Methods: To examine immune system responses to sports activities, articles were collected from all databases: Science Direct, PubMed, Scopus, Web of Science, Springer, Google Scholar, SID, and the most recent articles were selected.
Results: High-intensity and long-term physical exercise can be effective in suppressing immune responses. Therefore, moderate-intensity exercise can be an effective strategy. Maintaining the function of the immune system in athletes was dependent on nutritional strategies, sleep control, stress management, and strict adherence to proper exercise principles and health protocols. Athletes are more prone to viral infections in the early hours after strenuous, prolonged physical exercise; and they should be limited in contact with people who may increase their risk of infectious diseases. We should mention that moderate-intensity physical exercise can improve the function of immunoglobulins, anti-inflammatory cytokines, neutrophils, natural killer cells, cytotoxic T cells, and immature B cells. Maintaining social distance, especially immediately after strenuous exercise, is also recommended for athletes due to the increased risk of infectious diseases. The immune system has been considered an effective part of sports activities in athletes in recent years. The prevalence of viral diseases such as COVID-19 has not been and will not be for the first and last time in life. Therefore, using questionnaires and initial monitoring (adherence to diets, corona testing, adherence to health protocols) can be the first step. Conclusion: Finally Due to the pandemic of coronary heart disease and its unknowingness, providing some health and nutrition guidelines for starting exercises and sports competitions to prevent the transmission of this disease is on the agenda of this article. |
Volume 81, Issue 3 (June 2023)
Methods: This retrospective study evaluated the medical records of 500 breast cancer patients at two hospitals in Mashhad, Iran during April 2006 to March 2016. We used SPSS software, version 16 (SPSS Inc., Chicago, IL, USA) to analyze data. A P value less than 0.05 means that the results are considered statistically significant.
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Results: We included 230 women with breast cancer. The average overall survival was 130.7 months, with 83.2% of people surviving for five years and 78.8% surviving for 10 years. The stage of the disease is strongly linked to the recurrence (P=0.000). Additionally, the specific type of disease is also strongly related to disease recurrence (P=0.01) or metastasis (P=0.01). Patients who have the triple-negative subtype had the highest chance of the cancer spreading and recurrence compared to patients with other subtypes.
Conclusion: The different types of breast cancer are strongly linked to the disease recurrence or metastasis. Patients with triple-negative subtypes had the most cases of cancer spreading to other parts of the body and coming back again, compared to other subtypes. Our findings also showed that patients with the triple-negative disease had the worst overall and disease-free survivals. |
Volume 81, Issue 11 (February 2024)
Volume 82, Issue 2 (May 2024)
Methods: This descriptive cross-sectional study investigated the factors affecting the interest of 261 specialized assistants to continue their studies in subspecialized fields from March 2021 to March 2022. All the specialized assistants of Kerman University of Medical Sciences (KMU), whose assistantship continued until the end of March 2022, were included in the study by census method. The data collection tool was a 4-part questionnaire. 1) demographic information including 13 questions (age, gender, marital status, city where the family lives, place of residence to complete the residency course, specialized field, level of education, grade point average, parents' education, parents' occupation and having first-degree relatives with subspecialized degrees), 2) the willingness or unwillingness to continue studying in subspecialized fields and the field of interest, 3) the reasons for the assistants' interest in continuing their education, included 14 questions, and 4) the reasons for the assistants' lack of interest in continuing their education, included 14 questions.
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Results: The average age of the assistants was 31.53±3.90 years old. Most of the assistants were women (57.9%). 57.5 percent of the assistants were interested in continuing their studies in subspecialized fields. The most important reason for residents' interest in continuing their studies was "increasing practical-clinical knowledge" (80.1%). The most interest in continuing education was observed in internal assistants (17.33%). The assistant's age, specialist field and having first-degree relatives with a subspecialist degree had a significant relationship with the interest of the assistants to continue studying in subspecialist fields.
Conclusion: The results showed that a significant percentage of assistants were interested in continuing their studies in subspecialized fields. Age, the assistant's specialty and having first-degree relatives with a subspecialist degree had a significant effect on this interest. |
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