Mohsen Sabermoghaddam; Elham Bakhtiari; Mohammad Alipour
Abstract
Intoduction: Sore throat is a common postoperative complication in patients undergoing general anesthesia. Several factors contribute to this complication, and the airway management method plays a pivotal role in this regard. The present study aimed to assess the effect of diphenhydramine gargling on ...
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Intoduction: Sore throat is a common postoperative complication in patients undergoing general anesthesia. Several factors contribute to this complication, and the airway management method plays a pivotal role in this regard. The present study aimed to assess the effect of diphenhydramine gargling on sore throat in patients undergoing cataract surgery with laryngeal mask insertion. Methods: This placebo-controlled, double-blind, clinical trial was conducted on two groups of intervention and control. The patients in the intervention group gargled 8 cc (20 mg) of diphenhydramine diluted to 20 cc with normal saline 20 minutes before anesthesia induction. The control group patients gargled 20 cc of normal saline 20 minutes before anesthesia induction. The score of sore throat severity was determined based on the visual analogue scale during recovery three, six, 12, and 24 hours postoperatively. Results: Initially, 176 candidates of eye surgery using laryngeal mask airway (LMA) were enrolled in the study, and three patients were excluded from the intervention group due to withdrawal. In the intervention group, 36 patients (42.9%) were female, and 48 patients (57.1%) were male. In the control group, 46 patients (52.3%) were female, and 42 patients (47.7%) were male. The mean age of the subjects was 59.5±16.74 and 57.94±15.74 years in the intervention and controls groups, respectively. No significant differences were observed between the groups in terms of age and gender (P=0.53 and P=0.29, respectively). The mean score of pain severity was 0.3±0.14 and 1.7±0.14 in the intervention and control groups, respectively, which indicated a significant difference between the groups at each measurement point (P<0.001). However, the reported pain severity scores were not correlated with age, gender, mask size, and duration of surgery. Conclusion: Gargling 20 milligrams of diphenhydramine suspension 20 minutes prior to LMA insertion in the patients undergoing eye surgery significantly reduced the post-anesthesia sore throat compared to the control group. Moreover, sore throat had no associations with the age, gender, duration of surgery, and mask size of the patients.
Mohammad Faraji-rad; Hadi Tohidi; Elnaz Faraji-rad
Abstract
This study aimed to assess the efficacy of magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) in localizing epileptic foci in children with temporal lobe epilepsy (TLE). This prospective study was conducted on 12 patients including five males and seven females aged ...
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This study aimed to assess the efficacy of magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) in localizing epileptic foci in children with temporal lobe epilepsy (TLE). This prospective study was conducted on 12 patients including five males and seven females aged between 2 and 16 years old with a clinical diagnosis of TLE. All the patients underwent high-resolution MRI and if no abnormality was identified, SPECT was used for further assessment. In all the patients, visual inspection identified unilateral mesial temporal sclerosis, and the patients underwent craniotomy and lesionectomy.According to the results, eight patients were categorized in class I and two cases were classifies as class II, and all the patients survived. About 25% of the patients showed adequate memory function on the non-operated temporal lobe, and general intelligence quotient increased by 10% in 50% of the patients.According to the results, in patients with clinically suspected TLE, MRI alone is not able to localize the epileptic foci correctly, and SPECT can be helpful to localize these lesions.
Amin Rahpeyma; Saeedeh Khajehahmadi; Ali Ghasemi
Abstract
Introduction: Dermoid/Epidermoid cysts are rare pathologic lesions that may involve the floor of the mouth. Infection and inflammation of the cyst can produce a clinical picture very similar to the submandibular and submental abscesses with odontogenic origin. Dermoid/epidermoid cysts are on the floor ...
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Introduction: Dermoid/Epidermoid cysts are rare pathologic lesions that may involve the floor of the mouth. Infection and inflammation of the cyst can produce a clinical picture very similar to the submandibular and submental abscesses with odontogenic origin. Dermoid/epidermoid cysts are on the floor of the mouth with submental or submandibular component can be mistaken for odontogenic infections. Methods: Four biopsy proven dermoid/epidermoid cysts operated in the Mashhad University of Medical Sciences, Ghaem hospital (2012-2013), were reviewed. Results: Four patients, including two classic cases and two infected dermoid/epidermoid cysts, were erroneously diagnosed as odontogenic infection. Discussion: The lesions located solely below mylohyoid muscle need to be removed through anextraoral approach but the lesions above the mylohyoid muscle or those that have both supra- and infra-mylohyoid components can be removed through an intraoral incision.Conclusion: Dermoid/epidermoid cysts should be considered in the differential diagnosis of submental/submandibular swellings. In the absence of an odontogenic cause of infection, fine-needle aspiration biopsy and appropriate imaging evaluation techniques with sonography, CT or MRI are mandatory for correct diagnosis and surgical treatment planning. The clinicians should be very cautious to differentiate odontogenic infections from infected dermoid/epidermoid cysts.
Mirnaghi Moosavi; Mahdi Mokhtari; Masoud Shafiee
Abstract
Central serous chorioretinopathy is a common cause of visual morbidity. It is characterized by idiopathic serous retinal detachment in macular or paramacular regions. The symptoms of the CSC include decreased vision, micropsia and metamorphopsia. The prognosis of the disease is good and almost 90% of ...
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Central serous chorioretinopathy is a common cause of visual morbidity. It is characterized by idiopathic serous retinal detachment in macular or paramacular regions. The symptoms of the CSC include decreased vision, micropsia and metamorphopsia. The prognosis of the disease is good and almost 90% of patients obtain visual recovery in a few months. However, in less than 5% of patients the chronic disease with poor prognosis is developed. The acceptable approach is to observe patients with acute central serous chorioretinopathy, because central serous chorioretinopathy is self-limited. The pathophysiology of central serous chorioretinopathy is not clear and not well understood. Therefore, various medical treatments have been suggested such as propranolol, indomethacin, bevacizumab, acetazolamide, mifepristone, labetalol, etc. However, wait and watch would be the most recommended management of the central serous chorioretinopathy.
Seyed Ebrahim Mansoorinejad; Farah Ashrafzadeh; Javad Akhondian; Mehran Beiraghi Toosi
Abstract
Epilepsy is described as a heterogeneous clinical syndrome results from various cerebral destructions. It is categorized to partial and generalized forms. Degree of neural system impairment and affected area determine the severity and pattern of symptoms. Patients might experience sensory, motor, or ...
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Epilepsy is described as a heterogeneous clinical syndrome results from various cerebral destructions. It is categorized to partial and generalized forms. Degree of neural system impairment and affected area determine the severity and pattern of symptoms. Patients might experience sensory, motor, or both signs and symptoms. About 60% of epileptic patients suffer from partial type. It is estimated that up to 30% of epilepsy cases would not be controlled adequately despite sufficient and proper management. Anacyclus pyrethrum, Citrus aurantium var. amara, Paeonia officinalis, Rosa Damascena and Nigella Sativa are some of herbal drugs which have antiepileptic effect. Natural agents are valuable sources to treat chronic diseases and a huge number of world`s population believe herbs are effective and safe for daily primary health care needs. There is not enough evidence about their efficacy and safety obtained from randomized control trials.
Hamideh khorrampazouh; Seyed Musa al-Reza Hosseini; Mohammadreza Noras
Abstract
Introduction: Enema or ‘hoqne’ is a therapeutic approach used for a wide range of diseases in the Iranian traditional medicine. The use of this method dates back to thousands of years to Hippocrates and Galen. The aim of this study was to review the history of enema and its methods and indices ...
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Introduction: Enema or ‘hoqne’ is a therapeutic approach used for a wide range of diseases in the Iranian traditional medicine. The use of this method dates back to thousands of years to Hippocrates and Galen. The aim of this study was to review the history of enema and its methods and indices in the Iranian medicine and other complementary medicine.Methods: This review study was conducted on the Iranian medicine textbooks and articles published in the international databases, including Google Scholar, PubMed, Embase, and Scopus, as well as the Iranian databases, such as SID and Magiran. The searching process was performed using the following keywords: ‘Hoqne’, ‘Enema’, ‘Vasta’, ‘Basta’, and ‘Complementary and Alternative Medicine (CAM)’. There was no limitation regarding the publication data of the included studies.Result: In the Iranian medicine, the term “hoqne” is equivalent to enema. Enema is used in various diseases of the brain, respiratory system, digestive system, urogenital system, and musculoskeletal system, as well as systemic diseases. Enema is one of the five main therapies in the Indian medicine or Ayurveda. In other types of complementary medicine, including Chinese medicine, this procedure has therapeutic applications. Although enema has been recognized as a diagnostic method in modern medicine, it has been considered as a therapeutic approach in the recent years.Conclusion: According to the findings of the reviewed studies, enema is a major therapeutic focus in complementary medicine, part of which has been confirmed in the recent studies. Given the low side effects and high success rate of this treatment, it can be used as a supplemental therapy for the management of poisoning, febrile seizures, prolonged functional constipation, and chronic kidney disease, as well as the prevention of swelling. However, this theory requires further investigation and targeted clinical trials. This method has been recently identified and updated as a preventive and therapeutic modality.
Mahmoud Ebrahimi; Azamat Sabouri Arteh; Hamid Reza Rahimi
Abstract
Coronary artery disease (CAD) is a major global problem. In addition, it is higher risk of mortality for women more than men are when develop in female gender Atherosclerotic plaques consist of deposits of fatty material in the tunica intima. The role of inflammatory process in CAD has been known from ...
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Coronary artery disease (CAD) is a major global problem. In addition, it is higher risk of mortality for women more than men are when develop in female gender Atherosclerotic plaques consist of deposits of fatty material in the tunica intima. The role of inflammatory process in CAD has been known from 1980’s. Several studies investigated the innate immunity and adaptive immunity roles in atherosclerosis and they concluded that it plays a key role in atherosclerosis. Coronary artery bypass grafting (CABG) is a widely used method for the treatment of CAD. Based on the literature, CABG is the most common surgical operation done worldwide. In During the first 10 years after CABG, up to 50% of saphenous grafts will occlude. Graft restenosis is beginning with acute thrombosis, intima hyperplasia, and plaque formation. In this review, some molecular pathways of graft failure and restenosis such as apoptosis and nuclear factor kappa B (NF-ĸB) are described.
Ali Rahdari; Reza Jalaeian Taghaddomi; Alireza Sabzevari; Shabnam Imannezhad; Mohsen Akhondi
Abstract
Introduction: Cardiopulmonary bypass is associated with higher risk of mortality and morbidity, thus it should be investigated regarding the major risk factors. Temperature management have a significant role in postoperative cerebral and neurological complications; however the optimum temperature during ...
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Introduction: Cardiopulmonary bypass is associated with higher risk of mortality and morbidity, thus it should be investigated regarding the major risk factors. Temperature management have a significant role in postoperative cerebral and neurological complications; however the optimum temperature during cardiopulmonary surgery is not certainly detected. This systematic review has investigated the differences between hypothermia and normothermia regarding postoperative mortality. Method: PubMed was searched for the relevant articles. Only English language articles were included with no time limitation. Data regarding in-hospital patient deaths provided in each article mostly within 30 days after the surgery, were extracted and compared based on relative risk reduction (RRR), absolute risk reduction (ARR), and number needed to treat (NNT).Result: Totally, 28 articles were retrieved and extracted. The mortality rate was zero in hypothermic and normotehrmic groups of 8/28 included studies, thus the RRR, ARR, and NNT could not be calculated. There were no significant differences between investigated groups of each included studies regarding the patients’ age, gender, and preoperative conditions.Conclusions: No significant difference was obtained between two studied groups. Similar prevalence of death observed between hypothermic and normothermic groups might be due to the sample size of studies, or the subsequent cares performed in intensive care units that assist to reduce the postoperative mortality rate. According to the obtained results, both of these procedures might be similarly safe regarding mortality rate.
Kobra Salimiyan Rizi; Hadi Farsiani; Kiarash Ghazvini; Masoud Youssefi
Abstract
Rothia dentocariosa (R. dentocariosa) is a gram-positive bacterium, which is a microorganism that normally resides in the mouth and respiratory tract. R. dentocariosa is known to involve in dental plaques and periodontal diseases. However, it is considered an organism with low pathogenicity and is associated ...
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Rothia dentocariosa (R. dentocariosa) is a gram-positive bacterium, which is a microorganism that normally resides in the mouth and respiratory tract. R. dentocariosa is known to involve in dental plaques and periodontal diseases. However, it is considered an organism with low pathogenicity and is associated with opportunistic infections. Originally thought not to be pathogenic in humans, R. dentocariosa was first described to cause infections in a 19-year-old female with periappendiceal abscess in 1975. The most prevalent human infections caused by R. dentocariosa include infective endocarditis, bacteremia, endophthalmitis, corneal ulcer, septic arthritis, pneumonia, and peritonitis associated with continuous ambulatory peritoneal dialysis. Three main factors have been reported to increase the risk of the cardiac and extra-cardiac infections caused by R. dentocariosa, including immunocompromised conditions, pre-existing cardiac disorders, and poor oral hygiene. Peritoneal dialysis (PD) may induce peritonitis presumably due to hematogenous spread from gingival or periodontal sources. This case study aimed to describe a former PD patient presenting with peritonitis. Oral hygiene is a basic principle in PD patients for the prevention of peritonitis. It is speculated that our patient might have had an occult oral source of R. dentocariosa.
Bentolhoda Sahebnasagh; Mohammad Javad Hosseinzadeh-Attar; Amrollah Sharifi
Abstract
Findings have shown that low serum 25-hydroxy vitamin D level is a possible risk factor for incidence of preeclampsia during pregnancy. Vitamin D has important effects on multiple biological pathways, including angiogenesis. Some studies have shown that vitamin D deficiency is highly prevalent among ...
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Findings have shown that low serum 25-hydroxy vitamin D level is a possible risk factor for incidence of preeclampsia during pregnancy. Vitamin D has important effects on multiple biological pathways, including angiogenesis. Some studies have shown that vitamin D deficiency is highly prevalent among women suffering from preeclampsia, influencing immune modulation and vascular function. Evidence has shown that an imbalance of pro-antigenic and anti-angiogenic proteins can be considered as a possible etiological factor in the development of preeclampsia. Besides, there is a series of studies linking the renin–angiotensin aldosterone system (RAAS) with preeclampsia. In this article, we review the current studies evaluating the association between maternal vitamin D status and vascular health, metabolism, placental immune function and the risk of preeclampsia. We provided evidence of the different factor involved in the metabolism of vitamin D and vitamin D receptor (VDR) expression, gene regulations, immune function, and chronic disease when vitamin D is used optimally.
Mahbobeh Khammar; Sepideh Hassanzadeh; Fatemeh Tara; Malihe Siahsar; Fatemeh Tahmasbi; Masoud Keikha; Kiarash Ghazvini
Abstract
Introduction:In the present study, we evaluated the 4-year antimicrobial resistance trends of several nosocomial pathogens during 2018-2021 in a reffereal Mashhad hospital, Mashhad, Iran.
Methods:In this study, we reviewed the data of 70,234 clinical isolates were registred Infection Control Data of ...
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Introduction:In the present study, we evaluated the 4-year antimicrobial resistance trends of several nosocomial pathogens during 2018-2021 in a reffereal Mashhad hospital, Mashhad, Iran.
Methods:In this study, we reviewed the data of 70,234 clinical isolates were registred Infection Control Data of Ghaem Hospital, Mashhad, Iran. The antimicrobial susceptibility testing was performed using Kirby-Bauer disk diffusion method according to clinical and laboratory standard institute (CLSI) instructions to evaluate trends of antimicrobial resistance over the times.
Results: There were identified (A. baumannii: n = 19,374; K. pneumonia n = 17,206; E. coli n = 23,777; S. epidermidis: n = 9,877). We did not find any significant difference in changes of antimicrobial trends over the time except in minor cases . However, The pattern of antimicrobial drug resistance was gradually differed except E. coli.
Conclusion: our results suggested the overall antimicrobial resistance trends was remins the same level during 2018-2021. It seems that in accessibility and stop prescribing of antibiotics can lead to decreasing antibiotic resistance rate.
Babak Ganjeifar; Mohammad Ali Abouei Mehrizi
Abstract
Meningioma is one of the most common primary brain tumors in adults. The literature indicates a higher prevalence of multiple meningiomas in women, which might be attributed to the hormonal factors, such as expression of progesterone receptor.Here we report a 58-year-old woman with a 4-year history of ...
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Meningioma is one of the most common primary brain tumors in adults. The literature indicates a higher prevalence of multiple meningiomas in women, which might be attributed to the hormonal factors, such as expression of progesterone receptor.Here we report a 58-year-old woman with a 4-year history of headache, which was aggravated during the few months before her admission. The patient was diagnosed with multiple meningiomas based on her brain magnetic resonance imaging. Therefore, she underwent surgical excision of the tumor and had no complications or signs of recurrence in the site of surgery, after a 3-year follow-up.Although multiple meningioma is not frequent, it does not differ from solitary tumors in terms of prognosis and management. Our experience shows that complete removal of the tumors is not possible in all cases of multiple meningioma and resection of the largest tumors results in favorable outcomes.
Ehsan Bolvardi; Roohie Farzaneh
Abstract
Introduction: Echocardiography or cardiac imaging is proposed as a gold standard method for identifying high risk patients for cardiac arrest. In this systematic review, we studied the prognostic value of cardiac sonography in patients with cardiac arrest. Methods: PubMed was searched for the relevant ...
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Introduction: Echocardiography or cardiac imaging is proposed as a gold standard method for identifying high risk patients for cardiac arrest. In this systematic review, we studied the prognostic value of cardiac sonography in patients with cardiac arrest. Methods: PubMed was searched for the relevant articles. Case reports were not included. Inclusion criteria were all the studies applied transthorasic echocardiography in patients with cardiac arrest arrived at emergency department that studied the efficacy of this modality on patients survived to emergency discharge and returned to spontaneous circulation.Result: Overall, 870 articles were obtained through initial search and only nine articles were included after the evaluation of the title, abstract, and the full text. Echocardiography has high sensitivity and specificity in predicting the return of spontaneous circulation.Conclusion: Cardiac sonography is a fairly effective (not definitive) modality in predicting death in patients with lack of cardiac activity during resuscitation. Echocardiography should not be the sole basis for the decision to cease resuscitative efforts.
Navid Nourizadeh; Mohammad Reza Majidi; Amir Rezaei Ardani; Bashir Rasoulian; Fariborz Rezaeitalab; Hadi Asadpour; Kamran Khazaeni
Abstract
One of the factors, which is involved in obstructive sleep apnea, is anatomic or inflammatory pathologies of nasal airway obstruction. Thus, it is logical to observe improvement of polysomnographic parameters of sleep-disordered breathing after nasal surgery. The authors performed a review of the literature, ...
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One of the factors, which is involved in obstructive sleep apnea, is anatomic or inflammatory pathologies of nasal airway obstruction. Thus, it is logical to observe improvement of polysomnographic parameters of sleep-disordered breathing after nasal surgery. The authors performed a review of the literature, up to 2013, to determine the impact of nasal surgery on obstructive sleep apnea. Most current idea in this field is based on case series studies while randomized controlled trials evaluating the effect of surgery for nasal obstruction on sleep apnea are few and far between. According to these studies, surgery for nasal obstruction does not improve objective parameters of sleep apnea. Although nasal obstruction is one of the factors involved in obstructive apnea, one has to keep in mind that surgery will not result in major reduction of obstructive sleep apnea severity to relieve nasal obstruction. Detailed upper airway analysis has to be considered when surgery is an option for obstructive sleep apnea. Thus, nasal surgeries are beneficial when they are part of a multilevel approach in obstructive sleep apnea treatment.
Tim Paterick
Abstract
The phenotypic expressions of the bicuspid aortic valve (BAV) are unpredictable and difficult to compartmentalize. In the modern era, BAV has been reported to account for approximately 50% of the cases with severe aortic stenosis requiring surgery and has also been associated with aortic regurgitation, ...
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The phenotypic expressions of the bicuspid aortic valve (BAV) are unpredictable and difficult to compartmentalize. In the modern era, BAV has been reported to account for approximately 50% of the cases with severe aortic stenosis requiring surgery and has also been associated with aortic regurgitation, bacterial endocarditis, and aortic dissection. Echocardiography is the diagnostic tool used to identify BAV. The clinical associations and high prevalence rate of BAV have added to the importance of this clinical inquiry. The present study aimed to explore the multifaceted challenges associated with BAV, as well as the current knowledge on this complex entity.
Aliasghar Moeinipour; Mohamad Abbassi Teshnizi; Babak Manafi; Hadi Yavari; Yasamin Moeinipour; Hamid Hoseinikhah
Abstract
Herbal medicine is usually safe and popular in Iranian communities. Peppermint herbal products may interact with warfarin, which is an essential lifelong drug used in patients with prosthetic heart valves. Herein, we report a case of possible interaction between warfarin and peppermint herbal tea.We ...
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Herbal medicine is usually safe and popular in Iranian communities. Peppermint herbal products may interact with warfarin, which is an essential lifelong drug used in patients with prosthetic heart valves. Herein, we report a case of possible interaction between warfarin and peppermint herbal tea.We described a 68-year-old woman who was on warfarin treatment due to bileaflet mechanical aortic valve, and mitral valve replacement presented with severe dyspnea in the setting of large obstructive prosthetic mitral valve thrombosis diagnosed by echocardiography. Therefore, cardiac surgery was conducted in the emergent setting. Warfarin was started the day after the procedure. She developed melena with a volatile and elevated international normalized ratio (INR) of 4.8 and prothrombin time > 30 s on the 7th post-operation day. She reported no changes in drug or dietary habits except for drinking high amounts of peppermint tea the day before. After the discontinuation of warfarin and medical consultation for gastrointestinal bleeding, the INR level decreased to 1.8 within two days.Consumption of peppermint herbal products are usually safe; however, caution should be taken with patients under warfarin treatment. Full disclosure for patients on anticoagulant treatment is necessary before discharge and during clinical follow-up
Samira Zabihyan; Humain Baharvahdat; Sirous Nekooei; Amir Reza Sabah
Abstract
Subarachnoid hemorrhage is one of the most important and dangerous neurologic emergencies worldwide. It is characterized by a sudden and severe headache caused most commonly by the rupture of intracranial aneurysm. Cerebral vasospasm is the most important cause of disability and death in whom survived ...
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Subarachnoid hemorrhage is one of the most important and dangerous neurologic emergencies worldwide. It is characterized by a sudden and severe headache caused most commonly by the rupture of intracranial aneurysm. Cerebral vasospasm is the most important cause of disability and death in whom survived from the first event. Early diagnosis and management of cerebral vasospasm could prevent and reduce its morbidity and mortality. Thus, an ideal technique must be able to detect the vasospasm before the occurrence of neurological deficits. Perfusion computed tomography could assess vascularity of brain including cerebral blood flow, cerebral blood volume, time to peak and mean transit time. For this application, perfusion computed tomography and computed tomography angiography techniques offer significant advantages and can result in early diagnosis of vasospasm. In this review, we discuss the utility of these two techniques and their safety in the diagnosis and the management of vasospasm following subarachnoid hemorrhage.
Farhad Heydarian; Neda Fakhr Ghasemi; Elham Bakhtiari; Hasan Golmakani; Mohammad Heidarian
Abstract
Introduction: Febrile seizure (FS) is a highly frequent presenting complaint in children. It is defined as a seizure that occurs in children between 6 to 60 months related to a fever of 38°C or more without any other explanatory causes of seizure such as evidence of central nervous system (CNS) infection ...
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Introduction: Febrile seizure (FS) is a highly frequent presenting complaint in children. It is defined as a seizure that occurs in children between 6 to 60 months related to a fever of 38°C or more without any other explanatory causes of seizure such as evidence of central nervous system (CNS) infection or a previous seizure without fever. The aim od study is to evaluate mean folic acid serum levels in febrile children with or without seizures.Methods: The mean folic acid serum levels and demographic data of 100 children aged 6 to 60 months, admitted to the Ghaem Hospital of Mashhad, Iran in 2018-2019, were collected, where the patients with febrile seizure were considered as the case group and the febrile ones without seizure as the control group. The inclusion criteria were children aged 6 to 60 months with febrile seizures who were admitted to the pediatric ward. The exclusion criteria were having a past medical history of seizure, meningitis, or encephalitis.Results: There were 49 febrile convulsive children (cases) and 51 febrile children without a seizure (controls). The mean serum folic acid level was 7.07 and 9.89 ng/ml for cases and controls respectively (P-value < 0.001).Conclusion: Children with febrile seizures had significantly lower serum folic acid levels than febrile children without a seizure.
Amir Ghaderi; Anna Bussu; Catherine Tsang; Sadegh Jafarnejad
Abstract
Background and objective: N-acetylcysteine (NAC), a precursor of L-cysteine with antioxidant, anti-inflammatory and neurotropic effects, is a promising agent in alleviating symptoms associated with schizophrenia. However, the role of NAC on parameters of Positive and Negative Syndrome Scale (PANSS) ...
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Background and objective: N-acetylcysteine (NAC), a precursor of L-cysteine with antioxidant, anti-inflammatory and neurotropic effects, is a promising agent in alleviating symptoms associated with schizophrenia. However, the role of NAC on parameters of Positive and Negative Syndrome Scale (PANSS) remain uncertain. This systematic review and meta-analysis explored the effect of NAC on parameters of PANSS in patients with chronic schizophrenia. Methods: We searchedPubmed/MEDLINE™, PsycNET™, PsycLIT™, Scopus™ and Google Scholar™ for studies on the effect of NAC on PANSS in patients with schizophrenia from inception to March 2019. We adopted medical and non-medical subjects headings (MeSH, non-MeSH) and several keywords, including “NAC”, “N-acetylcysteine”, “N-acetyl cysteine”, “Acetylcysteine”, “N-Acetyl-L-cysteine”, “schizophrenia”, “psychotic disorder”, “psychosis”, “schizoaffective” and “dementia praecox”. Results: We identified seven trials with274 patients meeting the inclusion criteria, with follow up between 8-52 weeks, and NAC supplementation between 1200-3600 mg/day. Significant improvements in PANSS were identified following NAC for total (SMD=-0.61, 95% CI = -0.91, -0.31 ; p <0.001), general (SMD = -0.58; 95% CI = -0.90, -0.26; P=0.0004); and negative (SMD = -0.56; 95% CI = -0.92, -0.21; P = 0.001) scores, respectively. No significant heterogeneity was found among studies. Significant reductions were observed following sub-group analysis in trials ≤ 24 weeks duration, with appreciable effect size for total (SMD= -0.83), general (SMD= -0.67) and negative (SMD=-1.09) scores. Conclusion: Supplementation of NAC was effective in alleviating PANSS symptoms associated with schizophrenia in trials ≤ 24 weeks duration. The use of NAC as an adjunct seems promising and further investigation is warranted to determine its precise role.
Payam Izadpanahi; Kazem Anvari; Mitra Fazl Ersi
Abstract
In this research Glioblastoma has been studied as one of the most common brain tumors and a short review of the available therapeutic methods have presented including surgery, radiotherapy, chemotherapy and particularly adjuvant chemotherapy with temozolomide, as the most effective developed treatment. ...
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In this research Glioblastoma has been studied as one of the most common brain tumors and a short review of the available therapeutic methods have presented including surgery, radiotherapy, chemotherapy and particularly adjuvant chemotherapy with temozolomide, as the most effective developed treatment. Moreover, MGMT gene promoter methylation has been introduced as an important predictive factor of treatment response to temozolamide. The different mechanisms of methylation and the available literature on its association with patient survival and disease recurrence have been summarized. Taken together, Glioblastoma is a tumor in which the MGMT gene expression can potentially deliver the highest amount of data in comparison to other tumors; as almost every related study has emphasized on the direct association between MGMT methylation and patient survival. Regarding this debate, the pseudoprogression pattern in Glioblastoma patients and the laboratory methods studying MGMT gene methylation have been examined. At the end of this review, the obstacles to its development have been briefly mentioned.
Yasamin Daoudi; Leila Ameri; Bita Dadpour
Abstract
Heroin has physical effects on many parts of the body, for example, respiratory and digestive system, muscles, and nervous system. Neurologic complications include brain abscess, neuropathy, transverse myelitis, and leukoencephalopathy.Magnetic resonance image is more sensitive in detecting lesions with ...
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Heroin has physical effects on many parts of the body, for example, respiratory and digestive system, muscles, and nervous system. Neurologic complications include brain abscess, neuropathy, transverse myelitis, and leukoencephalopathy.Magnetic resonance image is more sensitive in detecting lesions with low signal on T1W and high signal on T2W, and FLAIR images in the white matter and other areas of brain. Imaging findings are similar to other leukoencephalopathies (hereditary diseases, abnormal metabolic diseases, and intoxications).In the course of finding ways to differentiate heroin-induced spongiform leukoencephalopathy from other leukoencephalopathies, attention has been changed to diffusion magnetic resonance imaging in recent years.Nevertheless, studies do not verify that diffusion-weighted image is a valuable tool in establishing the diagnosis.
Seyed Reza Habibzadeh; Mahdi Foroughian; Esmaeil Rayat Dost
Abstract
Medial collateral ligament (MCL) injury is highly common in athletes and the elderly. This ligament is in the knee region and is often at the risk of injury. Severe pain and motor limitation are the most important signs in the acute phase of the injury. In patients receiving anticoagulants, damage to ...
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Medial collateral ligament (MCL) injury is highly common in athletes and the elderly. This ligament is in the knee region and is often at the risk of injury. Severe pain and motor limitation are the most important signs in the acute phase of the injury. In patients receiving anticoagulants, damage to the knee joint may lead to intra-articular bleeding, which exacerbates the symptoms and prolongs the recovery period. The present study aimed to describe the case of a 76-year-old woman with a sudden spin on the left knee while getting off a car. After a few minutes of walking, the patients felt pain, heard a pop-like sound on the injured knee, and was unable to walk, experiencing pain in the knee. The patient was transferred to the emergency department by the caregivers. The present case report was focused on the MCL injury in a patient receiving an anticoagulant due to atrial fibrillation.
Hassan Mehrad-Majd; Javad Akhtari; Yalda Ravanshad
Abstract
Metabolic syndrome and its various manifestations are considered to be a significant health epidemic in the developed and developing countries across the world. Metabolic syndrome is characterized by a series of metabolic abnormalities, such as central adiposity, insulin resistance, hypertension, glucose ...
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Metabolic syndrome and its various manifestations are considered to be a significant health epidemic in the developed and developing countries across the world. Metabolic syndrome is characterized by a series of metabolic abnormalities, such as central adiposity, insulin resistance, hypertension, glucose intolerance, and dyslipidemia. Patients with metabolic syndrome are at a higher risk of major complications, including fatty liver, type II diabetes mellitus, and cardiovascular diseases. Nuclear receptors are the key regulators of gene transcription, as well as several metabolic pathways. Among these receptors, LXRα and β play a major role in the regulation of lipogenesis, cholesterol/glucose homoeostasis, and inflammatory pathways through the induction or repression of target genes. In addition to metabolic homeostasis and diseases, lipogenesis and hypertriglyceridemia are regarded as the most significant adverse effects of liver X receptor (LXR) activation. Given the importance of lipid and carbohydrate metabolism and inflammation in the development of metabolic disorders, the present study aimed to review the impact of LXR signaling on the risk of metabolic syndrome and its phenotypes, with an emphasis on their potential therapeutic applications in the treatment of metabolic syndrome. In general, growing evidence supports the notion that LXRs may represent the potential drug targets for the treatment of metabolic syndrome.
Mahnaz Hushmand; Fatemeh Behmanesh; Hamid Ahanchian; Maryam Khalesi; Alireza Ataei
Abstract
The active form of vitamin D is synthesized in some body organs following sun exposure and dietary intake. Vitamin D exhibits its major and critical effects not only through regulation of calcium and phosphate metabolism but also by influencing on respiratory and immune system. Serum concentrations of ...
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The active form of vitamin D is synthesized in some body organs following sun exposure and dietary intake. Vitamin D exhibits its major and critical effects not only through regulation of calcium and phosphate metabolism but also by influencing on respiratory and immune system. Serum concentrations of 25-hydroxyvitamin D below the optimum limit lead to vitamin D insufficiency or maybe deficiency. These inappropriate concentrations of vitamin D lead to different types of pulmonary diseases such as viral and bacterial respiratory infection, asthma, chronic obstructive pulmonary disease, and cancer. In this review we described the association between vitamin D deficiency and severe therapy resistant asthma. We also reviewed the underlying molecular mechanism of vitamin D deficiency in children with severe- therapy resistant asthma. Based on current information, future clinical trial are needed to study the role of vitamin D supplementation on different groups of patients with severe asthma including infants, children of school age, and ethnic minorities.
Somayeh Tafaghodi Yousefi; Mohammad Etezad Razavi; Alireza Eslampour
Abstract
Amblyopia is one of the most important reversible eye disorders in children and different treatments are suggested. Early diagnosis and effective treatment in amblyogenic age are important criteria. These critical periods correspond to the period when the child’s developing visual system is sensitive ...
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Amblyopia is one of the most important reversible eye disorders in children and different treatments are suggested. Early diagnosis and effective treatment in amblyogenic age are important criteria. These critical periods correspond to the period when the child’s developing visual system is sensitive to abnormal input caused by stimulus deprivation, strabismus or significant refractive errors. Traditional treatments such as glass wearing, contact lens used with patch therapy have limitations. Laser corneal refractive surgeries introduce an alternative for the treatment of anisometropic amblyopia. Current indications for refractive surgery include anisometropia, bilateral high myopia and accommodative esotropia. Several reports confirmed that with recent development in keratorefractive surgery, it could be a safe method to be used in children. The goal of the permanent surgical treatment is to reduce refractive errors, treat amblyopia and make better the binocular function. Corneal haze is certainly a major concern in children receiving surface ablation, especially in high myopic treatments. However, controversies still exist on whether it could be done in this population or not. This article reviews the available data about refractive surgery for treating anisometropic amblyopia.