Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 4 2005 08 15 233 242 F. Davatchi F. Shahram C. Chams H. Chams A. Nadji 2015 09 28 Behçet’s disease (BD) which is classified among vasculitides is a systemic disease with various manifestations. Its clinical course is characterized by attacks and remissions. Till now, two nationwide surveys of BD from Iran and Japan and 4 major case series from Turkey, Korea, Morocco and England have been reported. Clinical picture of BD is dominated by mucous membrane manifestations, including oral aphthosis - seen in 96.8% of patients in Iran, 98.2% in Japan, 100% in Turkey, 97.5% in Korea, 100% in Morocco and 100% in England- and genital aphthosis which is seen less frequently- 65.3% in Iran, 73.2% in Japan, 88.2% in Turkey, 56.7% in Korea, 83.5% in Morocco and 89% in England. Skin aphthosis is not frequent but it is the most characteristic lesion of BD. Ocular manifestations include anterior uveitis, posterior uveitis and retinal vasculitis. Joint manifestations include arthralgia, monoarthritis, oligo/poly arthritis, and ankylosing spondylitis. Other manifestations include neurological, gastrointestinal and cardiopulmonary manifestations, vascular involvement, orchitis and epididymitis. Erythrocyte sedimentation rate is usually elevated. Urinary abnormalities are infrequent and transient. Positive pathergy test has been reported in 57.4% of patients in Iran, 44% in Japan, 57% in Turkey, 40% in Korea, 68% in Morocco and 32% in England. Lesions usually heal without sequela, except for lesions of eyes, brain and vascular system. The major cause of morbidity is the ocular lesion, which could lead to severe loss of vision or blindness. https://acta.tums.ac.ir/index.php/acta/article/view/3001 https://acta.tums.ac.ir/index.php/acta/article/download/3001/2982

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 4 2005 08 15 243 248 M. Eslami F. Baghaee M. Alaeddini 2015 09 28 It is sometimes difficult to recognize a jaw lesion as osteosarcoma, ossifying fibroma or ‎fibrous dysplasia in routine hematoxylin and ‎eosin staining and a more accurate technique is needed to differentiate these ‎lesions. ‎Many studies have shown the potential usefulness of silver-stained nucleolar organizer region (AgNOR) parameters for the diagnosis of various neoplasms. This study was carried out on 42 archival biopsy specimens of jaw lesions including 14 fibrous dysplasias, 14 ossifying fibromas and 14 ‎osteosarcomas (10 well differentiated and 4 poorly differentiated). Number of AgNORs was evaluated on formalin-fixed, paraffin embedded sections. The mean AgNOR counts showed significant differences between these lesions. The mean counts of AgNORs were < 1 ‎for fibrous dysplasia, 1 to 2.5 for ossifying fibroma and well differentiated osteosarcoma, and > 6 for poorly ‎differentiated osteosarcoma. By considering a cutoff point of 1.81-2.5 for well differentiated osteosarcoma and 1-1.8 ‎for ossifying fibroma, well differentiated osteosarcoma can be differentiated from ossifying fibroma with a sensitivity of ‎90% and a specificity of 64.3%. The area under the ROC curve was 0.84. ‎The results in this study indicate that AgNOR staining is a useful technique for differential diagnosis of osteosarcoma, ossifying fibroma and fibrous dysplasia of jaws when it is difficult to recognize these lesions in routine hematoxylin and ‎eosin staining. https://acta.tums.ac.ir/index.php/acta/article/view/3002 https://acta.tums.ac.ir/index.php/acta/article/download/3002/2983

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 4 2005 08 15 249 252 A. A. Ketabchi M. Ahmadinejad M. Ehsan 2015 09 28 Many studies with different results have been conducted regarding varicocelectomy in patients with subclinical varicocele and its effect on semen parameters. This clinical trial was aimed at assessing the effect of varicocelectomy on the spermiogram of patients with subclinical varicocele. A total of 142 patients with varicocele (79 clinical and 63 subclinical) took part in the study. Two spermiograms were taken from the patients, one before and the other 3 to 6 months after varicocelectomy. ‎Although the spermiogram results of the patients with subclinical varicocele did not show a significant change after operation, the spermiogram of the patients with clinical varicocele improved significantly (P < 0.05). In patients with subclinical varicocele, bilateral and right varicoceles were more prevalent compared to group with clinical varicocele (P < 0.05). In addition, incidence of secondary infertility in the patients with subclinical varicoceles was higher in comparison with the other group (P < 0.05). ‎Considering ineffectiveness of operation in patients with subclinical varicoceles and considerable clinical differences between these patients and patients with clinical varicocele, we recommend avoiding surgery in these patients unless no other causes of semen abnormality, such as hormonal abnormality, internal urogenital abnormality or immunological disorders can be found. https://acta.tums.ac.ir/index.php/acta/article/view/3003 https://acta.tums.ac.ir/index.php/acta/article/download/3003/2984

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 4 2005 08 15 253 258 M. Zahraie K. Goodarzvand H. R. Sadeghpour A. Kiani 2015 09 28 Tobacco smoke contains numerous compounds, many ‎of which are oxidants and capable of producing free radical and enhancing ‎the oxidative stress. The aim of this study was to investigate the effect of cigarette smoking on the erythrocyte antioxidative enzyme activities and the plasma ‎concentration of their cofactors. ‎Sixty eight healthy men were enrolled, 32 of whom had never smoked and 36 had smoked at least 10 cigarettes per day for ‎at least one year. Hemolysate superoxide dismutase (Cu-Zn SOD), glutathione peroxidase (GSH-Px) and ‎catalase (CAT) activities were measured using spectrophotometer. Plasma copper, zinc and selenium concentrations were determined ‎using atomic absorption spectrophotometer. Plasma iron concentration was determined by colorimetric ‎method. We found that erythrocyte Cu-Zn SOD activity was significantly higher in tobacco smokers ‎compared with non-smokers (1294 ± 206.7 U/gHb in smokers vs. 1121.6 ± 237.8 U/gHb in non-‎smokers, P < 0.01). While plasma selenium concentration was significantly lower in tobacco ‎smokers (62.7±14.8 μg/L in smokers vs. 92.1 ± 17.5 μg/L in non-smokers, P < 0.01), there were no significant ‎differences in erythrocyte GSH-Px and CAT activities and plasma copper, zinc and iron concentrations between the two groups. ‎It seems that cigarette smoking can alter antioxidative enzymes activity and plasma concentration of some trace elements. https://acta.tums.ac.ir/index.php/acta/article/view/3004 https://acta.tums.ac.ir/index.php/acta/article/download/3004/2985

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 4 2005 08 15 259 262 ‎M. Valadan S. Niroomanesh K. Noori S. Khalilian M. Tehrani 2015 09 28 Role of labor induction has increased in the last decade due to the ‎early detection of fetal jeopardy. Although very useful, oxytocin alone is not always successful for induction of ‎labor. In a randomized clinical ‎trial we compared vaginal dinoprostone plus oxytocin with oxytocin alone for ‎induction of labor in 91 ‎pregnant women at 40 weeks or greater gestation with Bishop scores ≤ 4. Forty six patients ‎assigned to the dinoprostone group received 3 mg intravaginal dinoprostone. Six ‎hours later the Bishop score was evaluated and if the patient had not at least 3 contractions in ‎10 minutes lasting for more than 40 seconds, intravenous oxytocin was started at a dose of 6 mu/min and ‎increased by 6 mu/min at 40 minute intervals until adequate uterine activity. Forty five patients ‎assigned to the oxytocin group underwent oxytocin induction from the start of labor induction. ‎Although the Bishop score change after 6 hours of receiving vaginal dinoprostone from 2.54 ‎to 4.97 was statistically significant, the oxytocin only group had a much better response with a change from ‎2.60 to 6.28. Median time between induction to the start of active labor was significantly ‎shorter in the oxytocin alone group (P = 0.04). Median time between ‎induction to delivery and the rate of cesarean did not differ significantly in two groups (P > ‎0.05). It was concluded that single dose of ‎dinoprostone is effective for initiating labor in patients with an unfavorable cervix and ‎appears safe but it is not as effective as oxytocin. https://acta.tums.ac.ir/index.php/acta/article/view/3005 https://acta.tums.ac.ir/index.php/acta/article/download/3005/2986

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 4 2005 08 15 263 267 F. Akhlaghi A. B. Hamedi 2015 09 28 Presence of maternal diabetes mellitus (DM) during pregnancy has important consequences for both mother and child. To determine maternal and fetal/neonatal complications of gestational DM and compare them with pre-gestational DM, a prospective study was performed in 100 diabetic women delivered in our hospital from January 2001 to April 2002. Pregnancy outcome in 27 women with gestational DM and 73 women with pre-gestational DM and their offspring were studied and analyzed. The mean age of women was 28 years, women with gestational DM being slightly older than women with pre-gestational DM. Mothers with gestational DM were at increased risk of presenting with pre-eclampsia and preterm labor compared to pre-gestational DM. Frequency of Cesarean section was higher in mothers with pre-gestational DM. Frequencies of abortion and hypoglycemic episodes were similar in gestational DM and pre-gestational DM. Infants born to mothers with pre-gestational DM were at increased risk of suffering from respiratory distress syndrome and congenital malformations but rates of unexplained intrauterine fetal death and large for gestational age were higher in infant of mothers with gestational DM. Gestational and pre-gestational DM are associated with increased risk of maternal and neonatal morbidity. Pregnant women with gestational and pre-gestational DM and their offsprings should be monitored and managed carefully. https://acta.tums.ac.ir/index.php/acta/article/view/3006 https://acta.tums.ac.ir/index.php/acta/article/download/3006/2987

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 4 2005 08 15 268 272 E. Nadi F. Zeraati 2015 09 28 Poor inhaler technique is a common problem both in asthmatic patients and healthcare providers, which contributes to poor asthma control. This study was performed to evaluate the adequacy of metered-dose inhaler (MDI) technique in a sample of physicians and nurses practicing in hospitals of Hamadan University of Medical Sciences. A total of 173 healthcare providers voluntary participated in this study. After the participants answered a questionnaire aimed at identifying their involvement in MDI prescribing and counseling, a trained observer assessed their MDI technique using a checklist of nine steps. Of the 173 participants, 35 (20.2%) were physicians and 138 (79.8%) were nurses. Only 12 participants (6.93%) performed all steps correctly. Physicians performed essential steps significantly better than nurses (85.7% vs. 63.8%, P < 0.05). The majority of healthcare providers responsible for instructing patients on the correct MDI technique were unable to perform this technique correctly, indicating the need for regular formal training programs on inhaler techniques. https://acta.tums.ac.ir/index.php/acta/article/view/3007 https://acta.tums.ac.ir/index.php/acta/article/download/3007/2988

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 4 2005 08 15 273 278 A A. Jafari 2015 09 28 After using 3 different generations of antibodies including human and non-human hyperimmune sera, monoclonal antibodies and chimeric antibodies, more recently a newer approach has been developed in which the antibody genes are cloned directly from a patient peripheral B-lymphocytes and expressed in a host like E. coli. In this study the Candida albicans serotype A (NCTC 3153) mannan was purified using a modified Fehling method and used for selection of human recombinant antibody from a C. albicans phage antibody library. After four rounds of affinity selecting (panning), 2 predominant clones were chosen by DNA fingerprinting and ELISA. A 248 amino acid DNA fragment coding for anti-C. albicans mannan scFv was sequenced and cloned in a pBAD-TOPO cloning vector to produce a soluble and phage free antibody. The analysis of antibody sequences by V base Index (DNAPLOT) confirmed the human antibody origin with the VH4 family in V segment of heavy variable chain and VL3 (Lambda 3) in J segment of the light variable chain. This antibody fragment was purified using immobilized metal affinity chromatography and inmmunoblotted as a 31kDa recombinant protein. https://acta.tums.ac.ir/index.php/acta/article/view/3008 https://acta.tums.ac.ir/index.php/acta/article/download/3008/2989

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 4 2005 08 15 279 281 M. Razavi M. Sadeghi-Hasanabadi P. Salamati 2015 09 28 Prolonged cough occurs in a large proportion of the 2 million pilgrims who participate in the annual Hajj in Saudi Arabia. There is no unique cause for pilgrims’ respiratory involvement, but several studies suggest a high incidence of influenza as a cause of the disease. To determine influenza vaccine efficacy against respiratory disease in pilgrims, we conducted two similar cohort studies on 51100 Iranian pilgrims who had participated in the annual Hajj in the years 2003 and 2004. We calculated vaccine efficacy in these two years with the use of “1- odd’s ratio” formula and compared the results. The vaccine efficacy for prevention of influenza like illness in the year 2003 was 51% but the vaccine was not efficient in the year 2004. It was concluded that etiologic agents other than influenza virus should be considered as the cause of respiratory disease in Hajj. Bacterial infections superimposed on chronic respiratory diseases, and allergic or toxic conditions are suggested caourses for more investigation. https://acta.tums.ac.ir/index.php/acta/article/view/3009 https://acta.tums.ac.ir/index.php/acta/article/download/cle>

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 3 2005 06 15 209 211 ‎A. Farahnak H. Ghobadi F. Bagheri 2015 09 28 Schistosomiasis is the second most common parasitic cause of death, after malaria. Biomphalaria glabrata is a fresh water snail with medical importance since it is the intermediate host of Schistosoma mansoni, an agent of schistosomiasis. The internal defense system of B. glabrata snails is mostly represented by circulating elements of the hemolymph, hemocytes, which are important factors in fighting against infections in snails. The purpose of this study was morphological study of B. glabrata hemocytes and their interaction with miracidia of Schistosoma mansoni. B. glabrata hemolymph was collected by heart puncture and a differential count of hemocytes was done in dyed preparations. Dyeing with Giemsa revealed two cell types: type 1, hemocytes with basophilic nucleus, little cytoplasm and sub-spherical shape and type 2, nucleated hemocytes, uniformly basophilic and spherical shape. Hemocytes showed cytoadherence and encapsulation after 1 h of miracidium-hemocyte incubation. These results could be of concern in the control programs of schistosomiasis. https://acta.tums.ac.ir/index.php/acta/article/view/2994 https://acta.tums.ac.ir/index.php/acta/article/download/2994/2975

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 3 2005 06 15 212 214 H. R. Hatamian M. R. Imamhadi 2015 09 28 Determination of F-wave latency is a simple and valuable method in evaluating proximal part of peripheral nerves. The aim of this study was to determine the mean minimal peroneal F wave (F min) in healthy individuals. A total of 282 individuals were studied. The mean age was 45.6 years. The F min (± SD) for 564 peroneal nerves was 47.09 ± 4.51 ms. The F min for the age group of 20-45 and height group of 160-180 cm were 47.63 ± 4.50 and 49.77 ± 3.76, respectively. This study demonstrates that the mean F min of our samples was not significantly different from other important similar studies. Age and particularly height had a major role in determination of F min value and these two parameters must be considered in clinical evaluation of patients. https://acta.tums.ac.ir/index.php/acta/article/view/2995 https://acta.tums.ac.ir/index.php/acta/article/download/2995/2976

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 3 2005 06 15 215 217 K. Ghandehari Z. Izadimoud 2015 09 28 Microembolic signals (MES) are frequently observed in transcranial ‎Doppler (TCD) recordings of patients with mechanical heart valve (MHV). If gaseous bubbles are the underlying cause, number of MES produced by MHV could be reduced with oxygen ‎inhalation. From September 2003 to September ‎2004, a consecutive series of 14 patients ‎with St Jude aortic valve visited in the cardiology clinic were referred to ‎neurosonology unit, Valie Asr Hospital, Khorasan. TCD monitoring of MES was performed with an ultrasound device and a 2 MHz probe. The MES counts were recorded during 30 ‎minutes breathing room air and thereafter 30 minutes breathing through a facial mask ‎with reservoir bag (6 liter O2 per minute). The criteria of MES detection were ‎characteristic chirping sound, unidirectional signal, random appearance within cardiac ‎cycle and intensity increase ≥ 3dB above background. The MES counts in two periods ‎of monitoring were compared with paired t test and significance was declared at P ‎< 0.05. Twelve patients (8 females and 4 males) were investigated. Oxygen ventilation ‎caused a significant decrease of MES counts in the patients in comparison to breathing ‎room air (P = 0.001). It seems that MES in patients with MHV are mainly gaseous bubbles ‎caused by blood agitation with MHV. The quantity of MES in patients with MHV is ‎not related to the risk of thromboembolic complications in these patients. https://acta.tums.ac.ir/index.php/acta/article/view/2996 https://acta.tums.ac.ir/index.php/acta/article/download/2996/2977

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 3 2005 06 15 218 222 "S. M. Sadr Bafghi M. Rafiei L. Bahadorzadeh S. M. Namayeh M. H. Soltani M. Motafaker A. Andishmand 2015 09 28 There is a misconception among our people that opioids may prevent or have ameliorating effects in the occurrence of cardiovascular diseases. In this study we evaluated 556 consecutive male patients hospitalized due to acute myocardial infarction (MI) in city of Yazd, from May 2000 to October 2001 and compared the characteristics of opium addicts to non opium users. Prevalence of opium addiction in MI patients was 19% in comparison with 2-2.8% in general population. There were not any differences in prevalence of traditional risk factors between opium users and non-users. Overall, in-hospital mortality was 18.6 percent among opium users and 6.2 percent among non-opium users (unadjusted odd ratio, 1.3; 95% confidence interval, 0.7 to 2.7, P = 0.2). After adjustment for the differences in the baseline features (age and other risk factors), odds ratio increased to 2.2 (95 percent confidence interval, 0.9 to 5.1). It seems that opium addiction may work as a risk factor in cardiovascular disease. https://acta.tums.ac.ir/index.php/acta/article/view/2997 https://acta.tums.ac.ir/index.php/acta/article/download/2997/2978

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 3 2005 06 15 223 226 M. Nikanfar M. A. Arami L. Mansourpoor S. Najmi 2015 09 28 Frequency of common etiologies of adult onset epilepsy is different in various studies. The aim of this study is to evaluate the frequency of common ‎etiologies of late adult onset epilepsies. ‎ All patients referred to Razi and Imam Khomeini Hospitals ‎in the year 2003 with at least two seizure attacks beginning after age of 50 were evaluated. In the majority of cases neuroimaging, electroencephalography and ‎echocardiography were done and risk factors for atherosclerosis and cerebrovascular ‎diseases were investigated. All medical records and previous medical histories ‎were reviewed. ‎A total of 97 patients were included. We found hemorrhagic stroke in 10 (10.3%), ‎ischemic stroke in 43 (44.3%) and space-occupying lesion (all of them were ‎tumors) in 19 patients (19.6%). In 24 (24.7%) cases we could not find a clear ‎cause for seizure attacks. ‎In conclusion, since seizures were associated with a central nervous system ‎disease in about 75% of the patients, careful investigation is necessary. We ‎also recommend better control of risk factors for cerebrovascular diseases in our country. https://acta.tums.ac.ir/index.php/acta/article/view/2998 https://acta.tums.ac.ir/index.php/acta/article/download/2998/2979

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 43 3 2005 06 15 227 229 D. Akbari Z. Naraghi N. Emadi H. Ghaninejad 2015 09 28 Sebaceous carcinoma is a relatively rare cutaneous tumor that is most commonly derived from the sebaceous glands located in periorbital area. The extraocular occurrence of this tumor is very rare. We report a case of an 85 years old woman who presented with a slowly enlarging mass on the right temporal region. Histological examination of the lesion revealed a malignant sebaceous carcinoma occurring in conjunction with nevus sebaceous. The lesion was surgically excised completely. https://acta.tums.ac.ir/index.php/acta/article/view/2999 https://acta.tums.ac.ir/index.php/acta/article/download/2999/2980