Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 4 2004 08 15 235 239 M. H. Harirchian A. Sarrafnejhad M. Ghaffarpour H. Mojhdehipanah 2015 09 28 Oligoclonal bands (OCB) can be detected in a significant percentage (90%) of patients with multiple sclerosis (MS), however, a much lower percentage has been reported in some studies, mainly from oriental countries. On the other hand, OCB have been detected in other neurological disorders (OND), even in diseases without any definite evidence for inflammation in CSF such as myasthenia gravis. This study was undertaken to evaluate the sensitivity and specificity of OCB detection in cerebrospinal fluid (CSF) in diagnosis of MS and to compare the clinical history of patients with and without OCB. CSF and serum of 80 patients, 40 with the diagnosis of MS and 40 with OND, were collected and analyzed for presence of OCB, using SDS-PAGE method. OCB were found in CSF in 28 (70%) of MS patients and in 8 (20%) of OND group. There was a significant statistical correlation between detection of OCB in CSF and MS diagnosis (P https://acta.tums.ac.ir/index.php/acta/article/view/2727 https://acta.tums.ac.ir/index.php/acta/article/download/2727/2709

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 4 2004 08 15 240 247 H. Vatandosst N. Borhani 2015 09 28 The rational use of insecticides largely depends on a broad knowledge of the susceptibility and irritability levels of malaria vectors to currently used insecticides especially pyrethroids. In this study the susceptibility and irritability levels of Anopheles stephensi and An.culicifacies to DDT 4%,malathion 5%, propoxur 0.1%, deltamethrin 0.025%, lambdacyhalothrin 0.1%, cyfluthrin 0.1% and permethrin 0.25% were determined. Susceptibility and irritability tests on adult mosquitoes were carried out according to WHO methods. The results showed that An.stephensi was resistant to DDT 4% and mortality rates to this insecticide in Gavdary and Abtar areas were 64.2%±3.9 and 61.8%±4.36, respectively. An.stephensi was assumed susceptible to other insecticides. An.culicifacies was found susceptible to all the tested insecticides. The irritability tests carried out with pyrethroids exhibited that permethrin 0.25% had the highest irritancy effect against both species. Lambdacyhalothrin 0.1% and deltamethrin 0.025% had the least irritancy effect against An.stephensi and An.culicifacies, respectively. Average numbers of take offs/females/minute of An.stephensi to permethrin, deltamethrin, cyfluthrin and lambdacyhalothrin were 6.64±1.04, 3.11±0.67, 2.73±0.61 and 2.57±0.67, respectively. These figures for An.culicifacies were 2.24±0.37, 1.44±0.38, 1.59±0.35 and 1.46±0.5, respectively. Irritancy effect of pyrethroids should come in consideration while they are used for control of malaria vectors. https://acta.tums.ac.ir/index.php/acta/article/view/2728 https://acta.tums.ac.ir/index.php/acta/article/download/2728/2710

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 4 2004 08 15 248 255 A. Kazemi Khaledi 2015 09 28 Rheumatic mitral valve stenosis is the most common form of organic heart disease encountered during pregnancy and continues to cause maternal and fetal mortality. Medically refractory congestive heart failure due to mitral stenosis is a clinical challenge and its optimal management remains controversial. On the other hand due to hazard of x-ray to mother and fetus, there are some limitations for perceutaneous balloon mitral valvotomy (PBMV) with fluoroscopy. Therefore, we performed PBMV with the guide of transesophageal echocardiography (TEE) with Inoue method in 18 pregnant women with NYHA class 3 or 4 due to mitral stenosis during pregnancy. The average procedure time was 29.9 (20-40) min and the average fluoroscopy time was 51.7 (28-101) seconds. The average NYHA class decreased from 3.11 to 1.33. There was no maternal or fetal complication or mortality and no premature delivery occurred. Overall risk to fetus was lower than previous reports of surgical commisurotomy performed during pregnancy. PBMV can be performed safely during pregnancy with the guide of TEE and is effective in reliving symptoms of severe congestive heart failure. It offers an effective alternative for the pregnant patients with severe mitral stenosis when congestive heart failure is not controlled by conventional medical treatment. https://acta.tums.ac.ir/index.php/acta/article/view/2729 https://acta.tums.ac.ir/index.php/acta/article/download/2729/2711

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 4 2004 08 15 256 258 F. Z MR. Razavizadeh S. Azemati 2015 09 28 Local anesthetic solutions are frequently mixed to take advantage of the useful properties of each drug but the medical literature is surprisingly deficient in well controlled studies about the onset and duration of action of these mixtures for epidural anesthesia. A total of 32 patients scheduled for elective operation were enrolled in this prospective randomized controlled study; in group I, 16 patients received 15 ml solution containing bupivacaine 0.5% and lidocaine 2% as a single injection epidural anesthesia after 3 ml test dose containing 15 mcg epinephrine; in group II, 16 patients received 15 ml bupivacaine 0.5% with the same technique. The times from injection of the test dose to the onset of sensory anesthesia at inguinal ligament and umbilicus and the time of termination of anesthesia at the maximum sensory level and two levels regression of anesthesia level were checked with pinprick test. The results were compared with two sample t test. Times to onset of sensory block in L1 and T10 levels (mean±SD) were 14.87±3.1 min and 21±3.37 min in group I and 17.12±2.18 min and 24.9±2.54 min in group II, respectively (P< 0.025 and P< 0.001, respectively). Times to termination of sensory anesthesia at the maximum level of anesthesia and two dermatomes regression were 75.12±8.26 min and 87.8±7.01 min in group I and 116.37±22.4 min and 134.87±21.64 min in group II, respectively ( P= 0 and P=0,respectively). Mixing lidocaine 2% with bupivacaine 0.5% in a 1:1 ratio compared to 0.5% bupivacaine solution results in significantly more rapid initiation and termination of sensory block. https://acta.tums.ac.ir/index.php/acta/article/view/2730 https://acta.tums.ac.ir/index.php/acta/article/download/2730/2712

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 4 2004 08 15 259 262 H. Ghelichnia M. Ghaffarpour M. Asadpour 2015 09 28 Lamotrigine has been used widely in the treatment of partial and secondary generalized seizures. In this study use of lamotrigine as monotherapy for the newly diagnosed primary generalized tonic–clonic seizure has been investigated and compared with carbamazepine. After dose escalation (3 weeks for carbamazepine and 6 weeks for lamotrigin), patients were followed every 4 weeks for the first 16 weeks and then every 8 weeks for the next 32 weeks. Total number of patients was 91, randomly divided in two groups, 46 patients in lamotrigine group and 45 patients in carbamazepine group. The efficacy of the two drugs against primary generalized tonic clonic seizure was almost the same. The proportion of patients with seizure episodes in the last 40 weeks of treatment in both groups was similar (24.2% versus 24.6%). Overall, fewer patients in lamotrigine group than in the carbamazepine group withdrew because of adverse events (6.5% vs. 24.5%, P = 0.0216). The commonest side effect leading to withdrawal with lamotrigine was rash and with carbamazepine was drowsiness. More lamotrigine than carbamazepine recipients completed the study (88.9% vs. 73.3%, P = 0.0961). Lamotrigine and carbamazepine showed similar efficacy against primary eneralized tonic clonic seizure in newly diagnosed epilepsy. Lamotrigine, however, was better tolerated. https://acta.tums.ac.ir/index.php/acta/article/view/2731 https://acta.tums.ac.ir/index.php/acta/article/download/2731/2713

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 4 2004 08 15 263 266 H. Rezvan F. Rahimi H. Darvish 2015 09 28 Lipoprotein(a), an LDL variant, has been claimed to have a role in atherogenesis and therefore coronary artery disease (CAD). However, its production and atherogenecity seems to vary among ethnic groups. In order to study the possible correlation between levels of Lp(a) and CAD in Iranian patients who suffered myocardial infarction (MI), a case-control study was carried out on 120 MI patients and 120 matched healthy subjects. Levels of Lp(a) were significantly higher in the MI patients than the control group (P < 0.0001), which demonstrates a possible correlation between levels of Lp(a) and CAD. Estimation of Lp (a) may be helpful in evaluating the risk of CAD, particularly in those patients with borderline levels of triglycerides and cholesterol. https://acta.tums.ac.ir/index.php/acta/article/view/2732 https://acta.tums.ac.ir/index.php/acta/article/download/2732/2714

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 4 2004 08 15 267 271 H. Moayeri A. Rabbani 2015 09 28 Type I diabetes mellitus (DM) is frequently associated with autoimmune thyroid disease (ATD). Association of ATD and type I DM has been described with varying frequencies but there is still debate about the situation in the Iranian population. We investigated the prevalence of anti thyroid peroxidase (anti-TPO) antibodies and ATD in children and adolescents with type I DM. A total of 145 patients with type I DM were participated in this study. They were screened for anti-TPO antibodies and TSH levels. Signs and symptoms of hypothyroidism and hyperthyroidism and the presence of goiter were sought. A group of 50 healthy unrelated girls and boys aged 11-16 years served as controls. Anti-TPO antibodies were found in 34 (23.4%) diabetic patients and 1 subject (2%) in the control group (P https://acta.tums.ac.ir/index.php/acta/article/view/2733 https://acta.tums.ac.ir/index.php/acta/article/download/2733/2715

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 4 2004 08 15 272 276 "A. Aghamohammadi A. Farhoudi H. Hosseini Nik Sh. Khazali Z. Pourpak F. Khosravi A. Sarrafnezhad AA. Amir-Zargar N. Rezaei K. Abolmaali D. Mansouri B. Nikbin" 2015 09 28 Common variable immunodeficiency (CVID) is a heterogeneous heritable disease characterized by arrest in B cell differentiation. An association between CVID and two HLA haplotypes, haplotype I (HLA-A1, HLA-B8, HLA-DR3) and haplotype II (HLA-A29, HLA-B44, HLADR7)has been previously documented. In the present study, we have attempted to find an association between susceptibility to CVID and HLA class I and II antigens in Iranian population. Seventeen Iranian patients with CVID (mean age 17, range 3-28 years; 12 male and 5 female), including two couples of brothers and 100 healthy controls were studied. All subjects were typed for HLA class 1, and 12 patients and all controls were typed for HLA class II, using microdroplet lymphocytotoxicity technique. Out of 12 CVID patients typed for HLA-DR and DQ specificities, five patients presented DR-1, which showed an increased frequency in patient (41.6% vs. 12% in controls), and 3 presented DQ-2, which also showed an increased frequency (25% vs. 4% in controls), both of which reached statistical significance (P = 0.018 and P = 0.026, respectively). HLA-DR10 was present in 2 patients (16.6%), which was markedly more frequent compared to controls, but this difference was not significant statistically. Our results suggest that HLA-DR1 and DQ-2 may contribute to susceptibility to CVID. We did not find any significant association between HLA-A1, B8 and DR3 that has been previously reported to be associated with CVID. https://acta.tums.ac.ir/index.php/acta/article/view/2734 https://acta.tums.ac.ir/index.php/acta/article/download/2734/2716

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 4 2004 08 15 277 280 M. H. Baradaranfar P. Dabirmoghaddam 2015 09 28 Otosclerosis is the most frequent cause of conductive hearing loss in patients with intact tympanic membrane. It can be treated by surgery with various techniques. Because of limited manipulation and comparably similar results, stapedotomy at present is preferred over other surgical techniques by most surgeons. Here we present the operative results of 114 otosclerotic patients who underwent stapedotomy between 1997-2002 in Rahnemoom hospital, Yazd and Amiralam hospital, Tehran. The aim of this study is to evaluate the efficacy and safety of stapedotomy in otosclerosis surgery. The average air-bone gaps of patients improved significantly from 41.82 db to 14.23 db after operation. Other hearing parameters of patients (including air conduction, bone conduction and speech discrimination score) also improved significantly. Permanent vertigo did not occur after operation and preoperative tinnitus resolved in 56 of 78 patients. Stapedotomy is a safe and effective modality for improving conductive hearing loss in otosclerotic patients. https://acta.tums.ac.ir/index.php/acta/article/view/2735 https://acta.tums.ac.ir/index.php/acta/article/download/2735/2717

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 42 4 2004 08 15 281 284 A.A. Rahbarimanesh S. Karimi Sh. Modarres Gilani 15 46 48 M. Shayani-Nasab S. A. Safavi Naiianni M. R. Fathol Alolomi A. Makaremi 2015 09 28 The exposure to electromagnetic field emitted by mobile telephones is increasing rapidly worldwide that causes side effects, including thermal and non thermal side effects. Ear proximity to electromagnetic source may lead to greater damage and side effects, including hearing loss. This study was performed to assess the chronic effect of exposure to electromagnetic field of mobile telephones on hearing by audiometric measurements. A total of 200 subjects (100 users and 100 non-users) were studied, using historic cohort method. The subjects did not have history of any clinical condition possibly implicated in hearing loss, history of ear disease or pathology in otoscopic examination. Only the users dominant ears were studied (right side 75% and left side 25%). Pure tone threshold of all subjects were in the normal range but there was a significant difference between mean pure tone threshold of user and non-users, +0.12 ± 5.93dB and -3 ± 4.73dB, respectively. Duration of use was also related to threshold changes. This investigation showed that mobile sets may cause increase of the pure ton threshold. We suggest further studies to find out potential hazards of using mobile telephones and to develop guidelines for the mobile telephone users. https://acta.tums.ac.ir/index.php/acta/article/view/3137 https://acta.tums.ac.ir/index.php/acta/article/download/3137/3117

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 1 2006 02 15 49 52 "A. Delrobaee M. H. Mirdamadi M. T. Yasamy Y. Kheirish B. Mohabbati H. Delrobaie H. R. Jamaati" 2015 09 28 Telemedicine is an indispensable tool in the hands of doctors to accelerate and facilitate the process of data interchange. To publicize and distribute the culture of utilizing this technology and providing the necessary equipment for this purpose and also to commence some useful activities in this field of science in Iran, the researchers group have designed and performed a telemedicine internet site with the goal of medical consultation. Software was designed and prepared, which is accessible to three groups of users with definite level of access for each one: normal users, doctors and site administrators. There are four main forums on this website with the following titles: medical consultation (Q&A), doctors’ special forum, scientific and research centers and also special disease groups, and the forum of graduates and medical students. Ultimately, we could achieve a new horizon to expand telemedicine activities in the field of medical consultation. A free web-based system was developed through the address of www.teleteb.com with the aim of remote medical consultation, developing the public health services and creating a powerful scientific and research link in the society of medicine. https://acta.tums.ac.ir/index.php/acta/article/view/3138 https://acta.tums.ac.ir/index.php/acta/article/download/3138/3118

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 1 2006 02 15 53 58 M. Razzaghy-Azar M. Nourbakhsh F. Hajighasemi 2015 09 28 Primary growth hormone insensitivity syndrome (GHIS) is a rare entity which can be due to defects in growth hormone (GH) receptor that is called type 1 Laron syndrome (T1LS) or post receptor defects (type 2 Laron syndrome ). The aim of study was determining the clinical and hormonal milieu of the patients with primary GHIS and their response to IGF-I (insulin like growth factor-I) generation test (IGT). GH, IGF-I, IGF-II, IGF binding protein 1 and 3 (BP-1 and BP-3), GH binding protein (GHBP) and anti-GH antibody were detected by ELISA and RIA methods. IGF-I and BP-3 were measured before and after IGT. Nine patients (8 males, 1 female) (mean age ± SD, 6.4 ± 5 years) with severe short stature and high GH level were studied. Height SDS was - 8.5 ± 2.6. In 7 patients GHBP was zero, IGF-I and BP-3 were low and did not increase after IGT, so they had T1LS. Two brothers did not show the hormonal milieu of GH receptor defect, and were called non Laron syndrome (NLS). Birth weight in patients with T1LS and NLS was 3.65 ± 0.2 Kg and 1.65 ± 0.2 Kg, respectively (P = 0.001). All of the patients had typical clinical feature of GH-deficiency, but nasal bridge depression and microphallus were not seen in NLS. GH treatment of NLS, normalized their growth velocity, but without catch up growth. In conclusion IGT can differentiate Laron syndrome from other types of short stature. GH and IGF-I of fetus have no role in intrauterine growth. https://acta.tums.ac.ir/index.php/acta/article/view/3139 https://acta.tums.ac.ir/index.php/acta/article/download/3139/3119

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 1 2006 02 15 59 62 N. Eshghyar N. Jalayer-Nadery R. Ashery 2015 09 28 The term calcifying odontogenic cyst (COC) was first introduced by Gorlin in 1962. COC occurs mainly as an intra-osseous lesion in mandible or maxilla but the peripheral variation of COC has also been reported. The confusion about COC nature as cyst or tumor has not been resolved and a vast diversity has been shown in clinicopathologic aspects of COC. The purpose of this study was the review and analysis of COC variables such as age, gender and location and reclassification of histopathologic features of cases. The study was a retrospective review, cross sectional and case series one. The records of 36 patients were obtained and the clinical characteristics such as age, gender and location of COC were registered. The histopathologic features of cases were reviewed and reclassified. The data showed that 38.3% of cases occurred in the fifth decade and beyond; 67.6% were in males and 32.4% in females. Considering location, 51.5% of COCs were found in mandible and 48.5% in maxilla; 65.6% were located in posterior part of jaws. Of the 36 cases diagnosed as COC, 32 (88.8%) had cystic features and 4 (11.11%) were tumoral. For better determination of histopathologic and biologic features of COC, more investigations are needed. https://acta.tums.ac.ir/index.php/acta/article/view/3140 https://acta.tums.ac.ir/index.php/acta/article/download/3140/3120

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 1 2006 02 15 59 62 G. Iravanlo Z. Nozarian 2015 09 28 Perivascular epithelioid cell tumor (PEComa) is composed of HMB45+ epithelioid cells with clear to granular cytoplasm and perivascular distribution. We describe a uterine PEComa in a 33 years old woman where tumor cells were positive for HMB45 but negative for epithelial markers and negative or positive for smooth muscles markers. https://acta.tums.ac.ir/index.php/acta/article/view/3141 https://acta.tums.ac.ir/index.php/acta/article/download/3141/3121

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 1 2006 02 15 59 62 F. Asgarani M. Keyhani R. A. Sharifian G. R. Toogeh R. Aghanouri H. Jalaeekhoo 2015 09 28 Castleman’s disease (angiofollicular lymphoid hyperplasia) includes a heterogeneous group of lymphoproliferative disorders. The cause of this disease remains uncertain. There are two types of localized Castleman’s disease: the more common hyaline vascular and the plasma cell types. Mixed variant is an uncommon localized lesion in general population. The lesions can occur in any part of the body that contains lymphoid tissue, although seventy percent are found in the anterior mediastinum. We report a thirty years old boy with Castleman’s disease who presented with fever, anorexia, weight loss,sweating, anemia and abdominal mass. The histologic examination of the biopsy specimens revealed a mixed hyaline vascular and plasma cell type of Castleman’s disease. https://acta.tums.ac.ir/index.php/acta/article/view/3142 https://acta.tums.ac.ir/index.php/acta/article/download/3142/3122

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 44 1 2006 02 15