Mohsen Ebrahimi; Mohammadreza Shirzadeh; Mohsen Foroughipour; Hamid Zamani Moghadam; Mona Najaf Najafi; Mahdi Foroughian
Abstract
Background: According to statistics, at least four percent of people experience one or more nonfebrile seizures in their life span. Continuous Electroencephalography (cEEG) Monitoring is a useful diagnostic tool for seizure detection. The purpose of this study was to investigate EEG findings in first-time ...
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Background: According to statistics, at least four percent of people experience one or more nonfebrile seizures in their life span. Continuous Electroencephalography (cEEG) Monitoring is a useful diagnostic tool for seizure detection. The purpose of this study was to investigate EEG findings in first-time seizure patients referred to emergency department (ED). Methods: The present cross-sectional study was conducted on 80 first-time seizure patients admitted to ED, who were selected by convenience sampling method. The inclusion criteria were all patients aged more than 17 years with first-time seizure and informed written consent to participate in the study, and the exclusion criteria were cases where the seizure was not confirmed by a neurologist. An EEG was taken in the ED from the patient within 24 hours of the first attack. Finally, the frequency of pathological changes in EEG findings was determined in these patients. The statistical data were analyzed by SPSS software using descriptive statistics (measures of central tendency and dispersion and frequency distribution) and inferential statistics. Results: The patients consisted of 35 (43.8%) males and 45 (56.2%) females. The patients had a mean age of 52.54±19.33 years and a median of 53 years. Among the patients, 46 (57.5%) had normal EEG findings, and 34 (42.5%) had abnormal (pathological) EEG findings. Conclusion: According to the results of this study, 42.5% of patients had abnormal EEG findings, but it seems that accurate examination would require the use of other diagnostic tools along with EEG to diagnose patients with epilepsy and seizure more precisely.
Ideh Ghafour; Forouzan Elyasi
Abstract
Thyroiditis is the most common inflammatory disorder that affects thyroid gland.The diagnosis is mainly based on clinical findings, in particular the degree of pain and tenderness of thyroid. Confirmatory laboratory test includes presence of thyroid specific autoantibodies. Treatment is based on the ...
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Thyroiditis is the most common inflammatory disorder that affects thyroid gland.The diagnosis is mainly based on clinical findings, in particular the degree of pain and tenderness of thyroid. Confirmatory laboratory test includes presence of thyroid specific autoantibodies. Treatment is based on the severity of symptoms (pain and redness) and aims to restore the normal function of thyroid. Drug-induced thyroiditis has been described previously in the literature. Venlafaxine is an antidepressant agent with an efficacy similar to that of selective serotonin reuptake inhibitors. The dose of this medicine can be adjusted up to 150 mg/day one year after initiation. However, usage of venlafaxine may be limited due to the dose-dependent side effects. Here we describe a patient diagnosed with generalized anxiety disorder and migraine headache who developed venlafaxine-induced thyroiditis following dose adjustment to the maximum of 150 mg/day. The diagnosis was made based on the clinical symptoms and confirmatory laboratory tests according to the Naranjo Adverse Drug Reaction Probability Scale. Thyroiditis symptoms subsided after reducing venlafaxine dose and initiating prednisolone therapy. It should be noted that thyroid function was fully restored to normal only after cessation of venlafaxine administration.
Mohammad Reza Safdari
Abstract
Introduction: This exhaustive literature review aimed to find articles in relation to blood loss prevention in TKA via searching in databases such as PubMed and Google Scholar during 2005-2015.Methods: In this study, we included all the articles focusing on the evaluation of blood loss during TKA using ...
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Introduction: This exhaustive literature review aimed to find articles in relation to blood loss prevention in TKA via searching in databases such as PubMed and Google Scholar during 2005-2015.Methods: In this study, we included all the articles focusing on the evaluation of blood loss during TKA using specific treatment methods to reduce blood loss. We explored the studies with control groups and placebo subjects, and other studies were excluded from this review. The obtained results of each surveyed articles were summarized and evaluated based on the objectives of this study.Results: In total, 68 studies performed on 8,355 patients were included in this review, 18 of which were double-blinded, and 40 were open-label. A significant difference was observed in the transfusion thresholds of all the reviewed studies. According to our findings, frequency of prophylactic deep venous thrombosis (DVT) varied in the reviewed studies due to the use of different techniques to prevent blood loss after TKA; the incidence of DVT was reported in 15 articles.Conclusion: Since ABT involves high risks and even morbidity, new techniques should be applied to prevent blood loss. Although several techniques are available to reduce blood loss in TKA, ABT is frequently practiced and might lead to anemia in TKA patients. On the other hand, the effectiveness of new methods used to prevent blood loss remains a matter of question since all these methods are associated with certain adverse side effects.
Maral Sadrolodabaei; Behrouz Davachi; Mahdi Silanian Toosi
Abstract
Liver metastatic disorders usually occur in patients with stomach, pancreas, breast, colon, and lung and etc tumor. About 30 percent of patients die because of malignancies, have liver metastases. Liver imaging examination is a fundamental preclinical test to predict patient’s prognosis and is ...
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Liver metastatic disorders usually occur in patients with stomach, pancreas, breast, colon, and lung and etc tumor. About 30 percent of patients die because of malignancies, have liver metastases. Liver imaging examination is a fundamental preclinical test to predict patient’s prognosis and is required to monitor treatment. Despite recent advances in radiologic examination, liver metastases are still remaining as a challenge in human oncology. It seems that US is a reliable alternate for CT scan in metastases detection. CT scan should be considered in patients are highly suspension for liver metastases, who have normal or undetermined US findings. The aim of this study was a brief review of radiologic assessment in liver metastases.
Negareh Yazdani; Nasrin Moghadas Sharif; Maliheh Karimpour; Asieh Ehsaei
Abstract
Introduction: This study aimed to determine the influence of age and gender on pupil size under different illuminance conditions in emmetropic and myopic healthy eyes using Keratograph 4 topography. Methods: This study investigated 221 eyes of 221 subjects. After complete ocular examination, the undilated ...
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Introduction: This study aimed to determine the influence of age and gender on pupil size under different illuminance conditions in emmetropic and myopic healthy eyes using Keratograph 4 topography. Methods: This study investigated 221 eyes of 221 subjects. After complete ocular examination, the undilated pupil diameters were measured using a pupilometer and Keratograph 4 software (OCULUS, Wetzlar, Germany) with a sequence of 9.8 seconds of the scotopic stimulus (0.1 lux) and 0.2 seconds of the photopic stimulus (150 lux) repeated 5 times automatically. At the end of the procedure, the software provided maximum and minimum values (scotopic and photopic) of the pupil diameter. The age, gender, and refraction related changes of the pupil size were evaluated in different illuminance conditions. Results: Out of 221 participants in this study, 122 (85 female) and 99 (66 female) cases were myopes (MSE: -2.18±1.69 D, age: 26.03±6.98 years) and emmetropes (MSE: -0.11±0.27 D, age: 28.05±10.17 years), respectively. Considering refractive groups, pupil size was larger in myopes, compared to the emmetropes in both illuminance conditions (p <0.001). Moreover, the pupil size was found to be independent of gender in both photopic and scotopic conditions (P=0.71 and P=0.55, respectively). Additionally, a significant decrease was observed in pupil size with increasing age (p <0.001). Conclusion: This study showed that pupil size is influenced by age, illumination levels, and refractive status. These findings are important in both the optical industry and clinical decision-making process regarding treatment management.
Seyede Zahra Ghaemi; Ali Khakshour; Zohreh Abasi; Nayereh Azam Hajikhani Golchin
Abstract
Mental health disorders are prevalent in children in all societies. The onset of most mental disorders is in youth (12–24 years of age), but most of the time they are first detected later in life. Poor mental health is strongly related to other health and development concerns so it is common to ...
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Mental health disorders are prevalent in children in all societies. The onset of most mental disorders is in youth (12–24 years of age), but most of the time they are first detected later in life. Poor mental health is strongly related to other health and development concerns so it is common to show high grade of stress, substance use, violence, and depression. The effectiveness of some interventions has been strongly established, although more researches are needed to improve the range of affordable and feasible interventions. The shortage of educational and fiscal policies and the fairly low attention to this subject is the main challenge addressing mental-health needs. Therefore, universal or early intervention programs are needed to develop protective factors by increasing competence or skills, to reduce existing negative behaviors. Moreover child discipline problems can be reduced by school multicomponent intervention strategies and as a result promotion in student’s achievement becomes evident.
Massoud Hajia
Abstract
Human brucellosis and its prevalence are directly correlated with the presence of animal infections in various regions. The infections associated with Brucella species have been reported in numerous animals. The incidence of these infections has recently increased in the endemic regions in Iran, including ...
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Human brucellosis and its prevalence are directly correlated with the presence of animal infections in various regions. The infections associated with Brucella species have been reported in numerous animals. The incidence of these infections has recently increased in the endemic regions in Iran, including Zagros areas and the northeast of the country. Therefore, there have been difficulties in the diagnosis of the infectious cases since there is the possibility of encountering resistant strains. Furthermore, the spread of immerging strains is among the challenges that rapidly affect animals, even vaccinated livestock. Antibiotic-resistant strains are important in livestock since drug resistance may rapidly spread to humans. Therefore, continuous investigation is required in the case of drug resistance or immerging strains. Conventional typing procedures are no longer used due to several difficulties. Identifying the type of Brucella could provide adequate data on epidemiological surveillance, investigation of the infection outbreaks, tracking the diseases, identifying the immerging types, reviewing the success rate of eradicating the infections, and examining the outbreaks in the endemic areas. The reports regarding the application of molecular typing methods are still under development. Extensive research has been focused on the typing of brucellosis, proposing controversial results and aiming to improve the applied procedures. This review aimed to assess the ability of the introduced molecular methods and their status for identification and typing procedures. In addition, the frequency and distribution of Brucella species and subspecies have been investigated.
Kobra Salimiyan rizi; Kiarash Ghazvini; Hadi Farsiani
Abstract
Enterobacter spp. is a gram-negative environmental bacterium, which belongs to the Enterobacteriaceae family and is found in water, sewage, soil, and plants. These bacteria are common among humans and animals, and the most frequently isolated species is Enterobacter cloacae. The species of this genus ...
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Enterobacter spp. is a gram-negative environmental bacterium, which belongs to the Enterobacteriaceae family and is found in water, sewage, soil, and plants. These bacteria are common among humans and animals, and the most frequently isolated species is Enterobacter cloacae. The species of this genus are often opportunistic pathogens with expanding significance in nosocomial infections, particularly in neonates, immunocompromised patients in intensive care units, emergency sections, skin and soft tissue infection wards, and urology wards. With the unexpected and rapid increase in antibiotic resistance in various bacterial species, there has been a new alarm for the health of the human community. Enterobacter species cause pneumonitis, bacteremia, post-neurosurgical meningitis, neonatal meningitis, skin and soft tissue infections, and urinary tract infections. Some of the main risk factors for the occurrence and dissemination of Enterobacter spp. infections are poor hand hygiene, crowding, low birth weight, premature birth, intubation of patients, prolonged hospital stay, contaminated infant formula, intravenous feeding, use of extended-spectrum antibiotics and use of intravenous catheters.
Mohammad Mardani; Mohammad Javad Saeedi Borujeni; Ebrahim Esfandiary
Abstract
Congenital fusion of cervical vertebrae is a rare anomaly. In this condition, two fused vertebrae appear structurally and functionally as one. This anomaly may be symptomatic or asymptomatic. Myelopathy, limitation in neck movement, muscular atrophy and regional sensory loss are examples of probable ...
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Congenital fusion of cervical vertebrae is a rare anomaly. In this condition, two fused vertebrae appear structurally and functionally as one. This anomaly may be symptomatic or asymptomatic. Myelopathy, limitation in neck movement, muscular atrophy and regional sensory loss are examples of probable morbidity associated with this anomaly. Combination of genetic and environmental factors are involved in pathogenesis of this anomaly. Malformation of notochord, poor performance of retinoids, decreased local blood supply of spine and alteration in genes expression, especially members of Hox and Pax family genes are some of the proposed reasons of congenital fusion of cervical vertebrae. Diagnosis of this congenital anomaly in childhood seems to have an important role in prevention of probable secondary disorders in adulthood. We offer to clinicians that after performing careful physical tests and noticing the presence of signs and symptoms that mentioned in this paper, if a patient suspected to have congenital fusion of cervical vertebrae, genetic tests ought to be performed.
Mandana Kashaki; Ladan Younesi; Marjan Esmaeili; Hasan Otoukesh; Mohammad Esmaeili
Abstract
Introduction: Ultrasonographic assessment of the kidney size in newborns is essential to the diagnosis of renal diseases during the neonatal period. According to the literature, altered renal dimensions may lead to changes in the kidney echotexture in certain renal pathologies. This systematic review ...
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Introduction: Ultrasonographic assessment of the kidney size in newborns is essential to the diagnosis of renal diseases during the neonatal period. According to the literature, altered renal dimensions may lead to changes in the kidney echotexture in certain renal pathologies. This systematic review aimed to evaluate the renal dimensions in premature and term neonates.Methods: This systematic review was conducted to identify the English articles on the renal dimensions of children and premature/term neonates via searching in databases such as PubMed, Google Scholar, and Scopus. In total, 74 studies were retrieved from the electronic databases. After reviewing the titles and abstracts, 10 articles that were in line with the study objectives were selected in full text and evaluated.Result: The studies on the renal dimensions of newborns had been performed on various populations. Some studies had compared kidney diameters with the body weight and length of the neonates within the first days of birth, while some others had compared the gestational age of neonates with their kidney size. However, no conclusive results were proposed. In addition, several studies were found on kidney size during the fetal period and childhood, while limited investigation was available regarding the neonatal period. In the present study, we analyzed the correlations between the renal dimensions of neonates and their gestational age, length, weight, and body surface area by reviewing the current literature.Conclusion: Although renal volume is considered to be the most precise index of the kidney size, renal length is evidently the most practical indicator of renal dimensions, which is correlated with the anthropometric indices and gestational age of neonates.
Anoush Azarfar; Yalda Ravanshad; Mohammad Esmaeili; Fatemeh Ghane Sharbaf; Mitra Naseri; Fahime Noferesti
Abstract
Introduction:Pyelonephritis is known as kidney inflammation due to bacterial infection which should be diagnosed and treated promptly. In this article, we decided to systematically review the diagnostic value and reliability of evaluating urine excretion low molecular weight protein alpha-1-microglobulin ...
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Introduction:Pyelonephritis is known as kidney inflammation due to bacterial infection which should be diagnosed and treated promptly. In this article, we decided to systematically review the diagnostic value and reliability of evaluating urine excretion low molecular weight protein alpha-1-microglobulin (A1M). Methods: PubMed and Scopus were searched for the relevant articles about the efficacy of urine alpha-1-micriglobulin assays in the diagnosis of pyelonephritis in children. The search strategy was microglobulin AND pyelonephritis. No language and date limitations were included in this review. Results: A total of 16 articles were retrieved from PubMed and 23 articles from Scopus. After studying the abstracts, only 5 articles were selected, which specifically studied the efficacy of alpha-1-micrglobulin in the diagnosis of pyelonephritis in children.Discussion: A1M is not an acute phase protein but its concentration alters in several clinical conditions. Conclusion: Evaluating the urine concentration of A1M is a noninvasive and cost effective strategy with the diagnostic capability for urinary tract disorders such as early recognition of tubular damages during pyelonephritis.
Naser Shoeibi; Mehran Mahdizadeh; Masoud Shafiee
Abstract
Drug delivery to the inner part of the eye is still a problem in treatment of ocular disease. Iontophoresis has been used in the field of medicine for many years. This technique consists of applying a weak electrical current to drive charged drug molecules across tissue barriers. Transcorneal iontophoresis ...
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Drug delivery to the inner part of the eye is still a problem in treatment of ocular disease. Iontophoresis has been used in the field of medicine for many years. This technique consists of applying a weak electrical current to drive charged drug molecules across tissue barriers. Transcorneal iontophoresis delivers a high concentration of drug to the anterior segment of the eye (cornea, aqueous humor, ciliary body, iris, and lens), for the treatment of anterior segment diseases. There are different types of iontophoresis such as ophthalmic, transdermal, transungual, oral, buccal, and transnasal. The benefit of iontophoretic drug delivery in ophthalmology lays in its capacity to provide high drug tissue concentration safely, while minimizing the systemic drug exposure. This review summarizes basics of ocular iontophoresis and iontophoretic device, trans corneal and transscleral iontophoresis, and the applications of iontophoresis in ophthalmology.
Mohammad Hassan Aelami; Sepideh Bagheri; Seyed Morteza Rasti Sani
Abstract
Non-traumatic coma is a medical emergency and should be evaluated as soon as possible. Pediatric coma is more serious because of patient’s capacity of pathological stressor tolerance is limited especially in neonates.Several etiologies could be listed for loss of consciousness (LOC) and coma in ...
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Non-traumatic coma is a medical emergency and should be evaluated as soon as possible. Pediatric coma is more serious because of patient’s capacity of pathological stressor tolerance is limited especially in neonates.Several etiologies could be listed for loss of consciousness (LOC) and coma in childhood. According to the epidemiological studies, causes of coma are different all around the world. Glasgow Coma Scale has been used for coma scaling. In this review, we focused on some highlight causes of coma in pediatric medicine.
Negar Khalighi; Rahim Vakili; Mohammad Ali kiani; Seyed Ali Jafari; Hamid Reza Kianifar
Abstract
Introduction: Cystic fibrosis is one of the most common autosomal recessive diseases that affects sweat glands and mucosa. CF is a hereditary disease with annual incidence of about 2500 new cases in United Kingdom. Insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 ...
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Introduction: Cystic fibrosis is one of the most common autosomal recessive diseases that affects sweat glands and mucosa. CF is a hereditary disease with annual incidence of about 2500 new cases in United Kingdom. Insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 levels decrease in CF. The aim of this study was to assess the role of growth peptides in patients with CF. Method: We searched PubMed, Google scholar, IranMedex, and Scientific Information Database (SID) in September 2012 to April 2014. We included clinical studies with available abstracts and full texts that were in English or Persian languages. Manual searching was conducted within the reference lists of articles. Two reviewers independently applied eligibility criteria, assessed quality, and extracted data.Result: The earliest study was published in 1997 and the most recent one was in 2014. Study participants were adults in 3 studies (20%) and 12 studies (80%) were conducted in children. Patients with CF have lower levels of IGF-1 and there is a significant correlation between IGF-1 levels and growth index in patients with CF.Conclusions: IGF-1 decreases in children with CF and might be the cause of poor growth and low body mass index in these children.
Ameneh Movahedian; Nayereh Ghomian; Samaneh Soltani; Nushin Chalakinia
Abstract
Complications related to pregnancy and childbirth are the leading causes of disability and death among women of reproductive age in developing countries, constituting at least 18% of the global burden of disease in this age-group. Preeclampsia is a serious, pregnancy-specific disorder that affects up ...
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Complications related to pregnancy and childbirth are the leading causes of disability and death among women of reproductive age in developing countries, constituting at least 18% of the global burden of disease in this age-group. Preeclampsia is a serious, pregnancy-specific disorder that affects up to 8% of pregnant women. Preeclampsia may lead to maternal and offspring mortality and it increases the risk of premature birth and fetal growth restriction. Vitamin D is a potent immunomodulatory agent. There is an evidence pointing toward an association between the vitamin D status and preeclampsia risk. The purpose of the present study is to review the available literature investigating the role of serum levels of vitamin D in preeclampsia.The study findings further highlight the possibility that vitamin D deficiency is a strong, independent risk factor for preeclampsia and vitamin D supplementation may be a simple step to reduce the risk of adverse pregnancy outcomes providing lifelong benefits both to the mother and her developing child.
Alireza Ahmadi; Sepideh Namdar; Sajjad Daneshyar
Abstract
Occasionally, lymphoma involves the adrenal glands; however, primary adrenal lymphoma (PAL) is rare and only few cases have been reported. We report a case of a 59-year-old female with primary adrenal diffuse large B-cell lymphoma (DLBCL) manifested by weakness, fatigue, anorexia, and hyper pigmentation ...
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Occasionally, lymphoma involves the adrenal glands; however, primary adrenal lymphoma (PAL) is rare and only few cases have been reported. We report a case of a 59-year-old female with primary adrenal diffuse large B-cell lymphoma (DLBCL) manifested by weakness, fatigue, anorexia, and hyper pigmentation of skin. The patient initially responded to intravenous hydrocortisone in large doses by total remission of the symptoms. An abdominal computed tomography scan showed a hypodense mass in the right subdiaphragmatic space, which was suggestive of an adrenal gland tumor with adjacent liver involvement. Additionally, a smaller lesion with similar characteristics was found in the left adrenal gland. The results obtained from adrenal gland needle biopsy confirmed the diagnosis of DLBCL. Moreover, primary laboratory findings demonstrated hyponatremia, hyperkalemia, fasting blood sugar level of 153 mg/dl, and alkaline phosphatase level of 663 U/L. The mentioned symptoms and laboratory findings were indicative of adrenal insufficiency. After about 2 months, her level of consciousness decreased and urinary and fecal incontinence occurred. Therefore, brain involvement was suspected, and magnetic resonance imaging of the brain showed heterogeneous enhancement (24.8 mm) in the posterior aspect of the left temporal lobe together with patchy foci of enhancement in around the ventricular areas of the brain that showed metastatic lesions of PAL. This case should remind clinicians that PAL may be a cause of adrenal incidentaloma, especially when the patient presents with the symptoms of adrenal insufficiency.
Mohammad Reza Rouhbakhsh Zahmatkesh; Saman Soleimanpour; Zahra Mirfeizi; Nasrin Milani
Abstract
The coronavirus disease 2019 (COVID-19), which has spread to many countries, is so severe that it progresses rapidly to acute respiratory failure. Therefore, in our paper, we aimed to describe and evaluate the most practical laboratory pro-inflammatory factors to predict the course of severe COVID-19 ...
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The coronavirus disease 2019 (COVID-19), which has spread to many countries, is so severe that it progresses rapidly to acute respiratory failure. Therefore, in our paper, we aimed to describe and evaluate the most practical laboratory pro-inflammatory factors to predict the course of severe COVID-19 cases.Given the physiopathology of COVID-19 and the consequent immune system hyperactivity, we started to investigate the background pathology of these occurrences aiming to find the prognostic laboratory factors in COVID-19 cases. All reviews focused on the potential cellular and molecular mechanisms causing the cytokine storm in viral diseases, and several studies approved applicable laboratory parameters for COVID-19 patients. Based on our data, increased CRP level, LDH, serum ferritin, creatine kinase (CK), higher D-dimer and FDP levels, IL-6, cardiac troponin I and longer PT can be potential markers for predicting the course of infection; particularly, D-dimer, which was elevated to five times the original count in severe cases. Apart from that, the severe cases showed lymphopenia, neutrophilia, thrombocytopenia, and prolonged PTT. However, there was contradictory evidence about AST, ALT, BUN, and serum creatinine.The major cause of COVID-19 in critical patients was a cytokine storm; therefore, prognostic factors in the cytokine storm can also predict the prognosis of COVID-19. Thus, severe cases can be solved by early detection of these laboratory parameters.
Gholamreza Bahadorkhan; Omid Daneshvarfard
Abstract
Introduction: Previous studies have indicated that administering erythropoietin (EPO) can have a beneficial impact on the clinical outcomes of patients with severe traumatic brain injury (TBI). This review examines the possible therapeutic effects EPO can have neuronal functions, neurological performance, ...
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Introduction: Previous studies have indicated that administering erythropoietin (EPO) can have a beneficial impact on the clinical outcomes of patients with severe traumatic brain injury (TBI). This review examines the possible therapeutic effects EPO can have neuronal functions, neurological performance, and neurological recovery. Methods: The PubMed and Scopus databases were systematically searched on the 5th June, 2015, using the following search strategy: (“traumatic brain injury” OR “brain trauma”) AND (erythropoietin OR EPO) to identify relevant articles in which the effect of erythropoietin on patients with TBI was assessed. No time limitation was defined as the inclusion criteria. All available studies were extracted and categorized based on the purpose of this study.Result: Of the 908 articles in total that were identified during the initial database search, 901 documents were excluded from further examination because they did not meet the predefined inclusion/exclusion criteria. The total number of patients enrolled in the selected literature was 798. Of these, the use of EPO failed to show significant improvement in 113 patients.Discussion: Previous studies have shown that EPO may represent a valuable neuroprotectant that is useful in the treatment of neonatal brain injury, neurodegeneration, and TBI. Studies on animal TBI models have also found that recombinant human erythropoietin (rhEPO) reduces the development of post-traumatic brain edema.Conclusion: EPO may represent a potential therapeutic approach for the treatment of TBI. In addition, it can improve the patients› recovery prospects and reduce in-hospital mortality and morbidity.
Javad Ramezani; Hamid Hoseinikhah; Kayhan Mizani; Mohamadreza Akbari; Mahsa Moallemi; Maryam Argi; Aliasghar Moeinipour
Abstract
Controlled intraoperative cardioplegia is indispensable to pediatric cardiac surgery procedures. Several preservation techniques have been proposed for such purposes, with varying application by different surgeons. The custodiol cardioplegia is a recent approach that is considered to be a safe and effective ...
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Controlled intraoperative cardioplegia is indispensable to pediatric cardiac surgery procedures. Several preservation techniques have been proposed for such purposes, with varying application by different surgeons. The custodiol cardioplegia is a recent approach that is considered to be a safe and effective cardiac protector. This narrative review was conducted via searching in four databases, including PubMed, Scopus, Embase, and ScienceDirect. The studies focused on the efficacy and safety of custodiol cardioplegia reviewed, especially in pediatric cardiac surgeries and relevant procedures. In total, 21 articles were eligible, and the findings highlighted the controversies regarding the use of various cardioplegic solutions and the variability of their application by surgeons. However, data were inadequate regarding the optimal cardioplegic solutions in this regard. Some of the studies performed on adults suggested that custodiol cardioplegia may be equivalent to conventional blood cardioplegia. Most of the reviewed articles showed a consensus on the safety and efficacy of custodiol cardioplegia in adult and pediatric cardiac surgeries. It is believed that custodiol procedures are not only easily delivered, but they are also convenient and less time-consuming and provide long-lasting motion and bloodless fields for the surgeon to perform the operation. Therefore, use of custodiol cardioplegia has been reported to be safe, effective, and cost-efficient compared to conventional cardioplegic solutions. However, different findings have also been denoted in some of the studies in this regard, implying the equal effectiveness of these techniques.
Narendra Kumar; Syed Sahil Ali; Deepak Kumar Sharma; Anmol Kankane
Abstract
Introduction: Routinely used inflammatory markers such as ESR and CRP are suggested to suspect post-operative infection at an early stage. Therefore their normal trend after arthroplasty surgeries need to be known and their variation from that trend need to be understood.Methods: A prospective observational ...
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Introduction: Routinely used inflammatory markers such as ESR and CRP are suggested to suspect post-operative infection at an early stage. Therefore their normal trend after arthroplasty surgeries need to be known and their variation from that trend need to be understood.Methods: A prospective observational study was conducted. 75 patients undergoing THR or HRA surgeries of hip or TKR surgeries fulfilling the inclusion and exclusion criteria were considered for the study. Blood samples were collected preoperatively and postoperatively on day 1, 3, 5, 7 and 15 after surgery and sent to measure ESR and CRP values. Surgical site was assessed for presence of any discharge, which was sent for culture. Presence of any growth after 48 hours of incubation was diagnosed as infection.Result: Values of both ESR and CRP raised after surgery. ESR reached its peak value on POD 5 while CRP reached its peak value on POD 3. Both ESR and CRP declined thereafter. On correlating these trends with infected cases, we reported a statistically significant correlation of CRP with infection on POD 15. However, ESR values did not show any significant correlation with infection in starting 15 days post-operatively.Conclusion: There is a significant variation in levels of ESR and CRP after arthroplasty surgeries of lower limb. In infected cases, there is a deviation from this normal trend, that can be used to suspect post-operative infection. However, none of these parameters can be used to suspect it in starting 7 days after surgery.
Mahmoud Reza Ashrafi; Morteza Heidari
Abstract
The primary aim of epilepsy treatment is seizure control, and the treatment is principally prophylactic. Although complete seizure control is the most important predictor of improved quality of life, antiepileptic drugs (AEDs) could cause severe side effects in the patients. Therefore, the risk-benefit ...
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The primary aim of epilepsy treatment is seizure control, and the treatment is principally prophylactic. Although complete seizure control is the most important predictor of improved quality of life, antiepileptic drugs (AEDs) could cause severe side effects in the patients. Therefore, the risk-benefit ratio must be considered before the initiation of AED treatment. Accurate recognition and differentiation of epileptic and non-epileptic paroxysmal events and the diagnosis of the seizure type and epilepsy syndrome are essential procedures before AED treatment. It is often recommended that AED treatment start after two seizures, and being seizure-free for a minimum of two years is a prerequisite for treatment withdrawal. The AED treatment process must be initiated with a single drug at a low maintenance dose, along with further upward titration. Overall, the first attempt in AED treatment has been reported to effectively control seizures in 50-70% of the cases. Moreover, there is a consensus that being seizure-free for two years is the most valid approach to discontinue AED treatment. Approximately 50% of the children with epilepsy outgrow their disease. The present study aimed to provide a systematic method for the treatment and management of epilepsy in children.
Leila Bigdelu; Afsoon Fazlinejad; Ali Azari; Somaye Bakefayat; Marzie Farazandeh
Abstract
Introduction: Atrial fibrillation (AF) is a common dysrhythmia postoperatively after coronary artery bypass grafting (CABG). Myocardial strain and strain-rate imaging is used for the assessment of postoperative atrial fibrillation (POAF) as a new echocardiographic method. Methods: PubMed and Scopus were ...
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Introduction: Atrial fibrillation (AF) is a common dysrhythmia postoperatively after coronary artery bypass grafting (CABG). Myocardial strain and strain-rate imaging is used for the assessment of postoperative atrial fibrillation (POAF) as a new echocardiographic method. Methods: PubMed and Scopus were searched thoroughly using the following search terms: (strain and strain rate) AND (atrial fibrillation OR AF) on March 2015 to find English articles in which the strain and strain-rate echocardiographic imaging had been used for the evaluation of AF in patients undergone CABG. Full text of the relevant papers was fully reviewed for data extraction.Result: Of overall 6 articles found in PubMed, 10 records found in Scopus and 4 articles found through reference list search, only 6 papers fully met the inclusion criteria for further assessment and data extraction. The results of strain and strain-rate assessment showed that in total of 542 patients undergoing CABG, POAF occurred in 106 patients. Studies showed that the reduction of left atrial (LA) strain rate is correlated with AF. Consistently, the results of present review showed that LA strain and strain-rate in patients who developed AF postoperatively after CABG are significantly reduced, suggesting that strain and strain-rate could be a predictor of POAF.Conclusion: Based on the obtained results, strain and strain-rate is a suitable and accurate echocardiographic technique in the assessment of left atrial function , and it might be helpful to detect the patients who are at high risk of POAF.
Milad Ashrafizadeh; Zahra Ahmadi
Abstract
Statins are the inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A, which are extensively used to decrease the concentration of cholesterol in patients with hyperlipidemia. Statins are divided into two categories based on their own unique properties. Considering the pleiotropic effects of statins, they ...
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Statins are the inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A, which are extensively used to decrease the concentration of cholesterol in patients with hyperlipidemia. Statins are divided into two categories based on their own unique properties. Considering the pleiotropic effects of statins, they are applied as antioxidant, anti-inflammatory, anti-thrombotic, immunomodulatory, and plaque-stabilizing agents. In addition, statins affect the diversity and population of gut microbiota, which is a complicated microbial community remarkably involved in the regulation of metabolic responses, immune system, and human health. This community is also associated with age-related health problems, allergy, asthma, and inflammatory intestinal diseases. Therefore, evaluation of the interactions between statins and gut microbiota is essential to predicting the outcomes of these agents. The present study aimed to review the properties and pleiotropic effects of statins. Furthermore, the role of gut microbiota in health was discussed, and the significant effects of statins on gut microbiota and their interactions were described based on clinical and animal studies.
Farhad Heidarian; Tahereh Ansarinezhad
Abstract
One of the major causes of mortality in children younger than 5 years old is acute lower respiratory tract infections (ALRI). ALRI clinical features are cough, tachypnea, fever, coryza, chest retraction, crackles and wheeze. Increased white blood cell count with left shift might happen in pneumonia. ...
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One of the major causes of mortality in children younger than 5 years old is acute lower respiratory tract infections (ALRI). ALRI clinical features are cough, tachypnea, fever, coryza, chest retraction, crackles and wheeze. Increased white blood cell count with left shift might happen in pneumonia. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) might rise in children with respiratory tract infections. Vitamin A deficiency is associated with severe childhood infections. The effect of vitamin A supplementation in childhood pneumonia depends on the prevalence and the level of vitamin A deficiency in the population. Some studies confirmed that retinol levels were significantly higher after recovery from acute pneumonia compared to acute phase. But there were no significant association between serum retinol level and the clinical manifestation.
Najmeh Malekzadeh
Abstract
Rheumatoid arthritis (RA) is a common inflammatory disease affecting approximately 1% of the adult population worldwide. Before new treatments were available, unchecked RA caused notable inability and mortality .It is now accepted that primary diagnosis and treatment are essential and useful. Progress ...
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Rheumatoid arthritis (RA) is a common inflammatory disease affecting approximately 1% of the adult population worldwide. Before new treatments were available, unchecked RA caused notable inability and mortality .It is now accepted that primary diagnosis and treatment are essential and useful. Progress in therapy of RA has made it possible to deeply influence signs and symptoms as the period that joint destructed in inflammatory arthritis. Earlier and more efficient treatment becomes visible to significantly improve the prognosis of this disease. In this article, the old and new methods for treatment rheumatoid arthritis and their limitation and benefits were reviewed. These methods include nonsteroidal anti-inflammatory drug (NSAIDs), glucocorticoids(GC) that are a class of steroid hormones, disease-modifying anti-rheumatic drugs (DMARDs), biological agents that can be divided in two groups of monoclonal antibodies and teeny molecules, bisphosphonate therapy, nanotechnology, oral tolerance, photodynamic therapy, gene therapy, bone marrow transplantation, liposomes, superparamagnetic iron oxide nano particles (SPIONs).