Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 3 2009 06 15 161 164 EN Nourieh Sharifi Department of Pathology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Kamran Ghaffarzadegan Department of Pathology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Hossein Ayatollahi Department of Pathology and Hematology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Mohammad Taghi Shakeri Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Mohammad Hadi Sadeghian Department of Pathology and Hematology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Jafar Bordbar Azari Department of Pathology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 2015 09 28 The basic pathogenic step in the process of tumor growth, invasion and metastasis is tumor-induced angiogenesis. The aim of this study was to evaluate the angiogenesis in colorectal carcinoma by microvascular density (MVD) determination with IHC (immunohistochemistry) method and to determine if and how angiogenesis correlates with clinicopathologic parameters. Sixty two archival, paraffin embedded tissue samples of colorectal carcinoma from Omid Hospital (Mashhad, Islamic republic of Iran) were selected. Microvessels were identified immunohistochemically, using monoclonal CD34 antibody. Two investigators examined the microvessel density then the median value of MVD was determined and correlated with clinicopathologic parameters. Tumor-induced angiogenesis of colorectal carcinoma statistically correlated with histological tumor grade (P=0.000). There was no significant correlation between intratumoral microvessel density and sex and age of patients, localization, and stage and histologicalal tumor type (P > 0.1). Intratumoral microvessel density quantification in histologic specimens of colorectal carcinoma reflects the grade of tumors and may be a useful additional prognostic factor. https://acta.tums.ac.ir/index.php/acta/article/view/3567 https://acta.tums.ac.ir/index.php/acta/article/download/3567/3543

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 3 2009 06 15 165 169 EN Zahra Eslami Nejad Department of Microbiology, Afzalipour Medical School, Kerman University of Medical Sciences. Kerman, Iran. Mohammad Ahmadi Nejad Department of Microbiology, Afzalipour Medical School, Kerman University of Medical Sciences. Kerman, Iran. Hamid Mollaii Department of Microbiology, Afzalipour Medical School, Kerman University of Medical Sciences. Kerman, Iran. Nikoo Nik Nafs Department of Microbiology, Afzalipour Medical School, Kerman University of Medical Sciences. Kerman, Iran. 2015 09 28 DNA sequencing is the most conclusive method for emm (M protein gene) typing of Streptococcus pyogenes. This method is not a feasible approach in developing countries where streptococcal infection is widespread among adults and children. Alternatively the PCR-RFLP has the potential for rapid screening of different types of S. pyogenes. To document the emm type distribution of S. pyogenes in a group of patients suffering from pharyngitis, the restriction fragment length polymorphism (RFLP) profile of 50 isolates were analyzed. By using Hae III+ HincII (double digestion) and Dde I restriction enzymes and based on RFLP, the profile patterns of the isolates were compared. The analysis of data identified 15 distinct RFLP patterns for Hae III+ Hinc II and 13 patterns for Dde I. They differ from each other by at least one band. Although the number of isolates was not sufficient to make any epidemiological conclusion, but the finding demonstrated that the S. pyogenes population among pateints was heterogeneous. Regarding the PCR method, we managed to improve the results by modification of CDC protocol in three different ways. This study was conducted in normal circumstances when pharyngitis was at the peak seasonal incident. However emm amplicon restriction digest analysis is a valuable tool for rapid analysis of S. pyogenes infection in more important situation like outbreaks and in selected type of study like consideration of nosocomial infection. https://acta.tums.ac.ir/index.php/acta/article/view/3568 https://acta.tums.ac.ir/index.php/acta/article/download/3568/3544

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 3 2009 06 15 171 174 EN Samileh Noorbakhsh Department of Pediatric, School of Medicine, Research Center of Pediatric Infection Disease, Iran University of Medical Sciences, Tehran, Iran. Naser Javahertrash Department of Pediatric Immunology and Allergy, School of Medicine, Research Center of Pediatric Infection Disease, Iran University of Medical Sciences, Tehran, Iran. Hassan Tonekaboni Department of Pediatric Neurology, School of Medicine, Research Center of Pediatric Infection Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Azardokht Tabatabaei Department of Pediatric, School of Medicine, Research Center of Pediatric Infection Disease, Iran University of Medical Sciences, Tehran, Iran. Mohammad Ali Fatoorechi Department of Pediatric, School of Medicine, Research Center of Pediatric Infection Disease, Iran University of Medical Sciences, Tehran, Iran. 2015 09 28 Mumps infection is endemic in Iran. Our objective was to evaluate the presence of anti mumps antibodies ( IgM & IgG) in cerebrospinal fluid in mumps meningoencephalitic children. A prospective/cross-sectional study was performed in Tehran, Iran (2003 to 2004) and serum anti mumps antibodies (IgM) were detected (quantitive; ELISA) in meningoencephaltis patients. Specific anti mumps antibodies (IgM & IgG) were detected in cerebrospinal fluids of mumps meningoencephalitis cases. 43 meningoencephalitic patients were tested (59.2% male and 40.8% female). The age of patients was 79.96 ± 4.7 month. 23 (78.7%) cases had specific mumps IgM in serum. None of cases had IgM antibodies in CSF. Anti mumps IgG antibody was detected in CSF of 7.5% (2/23) cases. We detected lower than expected frequency of local immunity to mumps virus in CSF of our cases. For better serologic diagnosis we recommend more sensitive methods like virus detection (PCR) or short-term culture of lymphocytes from cerebrospinal fluid in future studies. https://acta.tums.ac.ir/index.php/acta/article/view/3569 https://acta.tums.ac.ir/index.php/acta/article/download/3569/3545

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 3 2009 06 15 175 179 EN Gholamreza Derakhshan Deilami Department of Internal Medicine, Imam Khomeini Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mahmoud Khandashpour Department of Internal Medicine, Imam Khomeini Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Om'albanin Paknejad Department of Pulmonology, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Marzie Pazooki Department of Internal Medicine, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Chronic cough is a common problem in patients visiting physicians and its prevalence in different populations range from 3 to 40%. Postnasal drip, asthma and gastroesophageal reflux are the known cause of chronic cough. Although diagnosis of asthma is usually made by clinical signs and spirometeric results, methacholine challenge test is a good diagnostic test in patients who show normal physical examination and spirometeric results. In this study, the results of methacholine challenge test in chronic cough patients are investigated. This is a cross sectional study performed on patients suffering from chronic cough (over 8 weeks), who went to Pulmonary Disease Clinic of Imam Khomeini Hospital in 2006. Postnasal drip, gastroesophageal reflux was evaluated and ruled out in all patients. Then they were tested by methacholine inhalation using low to high doses of methacholine. The results of test was defined as 20% fall in FEV1 and its relationship with age, sex, history of allergic disease, family history of asthma and smoking status was investigated. 81 patients (36 female and 45 male) entered this study who had mean age of 32.5 ± 13.06 years. 81.5% of patients had never smoked or closed contact with smokers, 6.2% were passive smokers, 8.6% were smokers and 3.7% had quit smoking. 37% had suffered from chronic cough less than 6 months, 11% for 6-11 months and 52% for more than 12 months. In 26% of patients, family history of asthma was present and 34.5% had a history of one type of allergy. In 29.5% the results of methacholine challenge test was positive, among them 45.8% showed an intense response and 54.2% a moderate response. The test results and its intensity had no statistically significant relationship with age, sex, smoking status, the duration of cough and family history of asthma, but the relationship between methacholine challenge test and the history of allergic disease was significant. Methacholine challenge test can be used as a diagnostic test in patients suffering from chronic cough of unknown origin and patients whose clinical and paraclinical finding are normal. A positive test indicates hypersensitivity of airways which can be used for planning their treatment. https://acta.tums.ac.ir/index.php/acta/article/view/3570 https://acta.tums.ac.ir/index.php/acta/article/download/3570/3546

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 3 2009 06 15 181 184 EN Rezvan Moniri Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran. Mitra Behrashi Department of Obstetrics and Gynecology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran. 2015 09 28 Regarding to prevalence of preterm labor and its consequences, there are different reports on relationship between bacterial vaginosis and preterm labor. This study was performed to evaluate the effect of etronidazole therapy on preterm labor in women with bacterial vaginosis. This randomized clinical trial was performed on 120 women suffering from bacterial vaginosis at 20-34 weeks of pregnancy, to evaluate the therapeutic effect of metronidazole to delay preterm labor in Shabih Khani maternity hospital in Kashan, Iran in 2002. Bacterial vaginosis was diagnosed based on clinical and laboratory findings. The patients were randomly divided into two groups. The patients in the case group received 500 mg metronidazole BID for 7 consecutive days, but the control group did not receive it. The demographic characteristics of the patients such as, pregnancy age, educational level and job of the spouse were similar at both case and control groups. Double-blind follow up of the patients at the whole stages of parturition and after delivery with respect to the de-livery method, infection, and fever was done by other practitioner besides the main researcher. The results were analyzed statistically by chi-square, and Fischer's exact tests. 420 patients entered the study, of whom 120 (28.6%) had bacterial vaginosis. The antibiotic and control groups were not significantly different for maternal age, job of the spouse, and education. No difference was observed in spontaneous preterm birth before 37 weeks of gestation in antibiotic-treated compared with control group. Treatment with metronidazole in symptomatic women with a bacterial vaginosis in the late second trimester does not decrease the incidence of preterm delivery. https://acta.tums.ac.ir/index.php/acta/article/view/3571 https://acta.tums.ac.ir/index.php/acta/article/download/3571/3547

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 3 2009 06 15 185 188 EN Javad Shokri-Shirvani Department of Gastroentrology, Imam Khomeini Hospital; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Alireza Arefzadeh Department of Gastroentrology, Imam Khomeini Hospital; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Hosein Foroutan Department of Gastroentrology, Imam Khomeini Hospital; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Hadi Ghofrani Department of Gastroentrology, Imam Khomeini Hospital; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Seyed Amir Mirbagheri Department of Gastroentrology, Imam Khomeini Hospital; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Balloon dilatation of stricture is one of the new treatment methods among patients with gastric outlet obstruction (GOO). However, the prevalence and underlying etiologies of GOO in various populations are different. The goal of the present study was to determine the effectiveness of endoscopic balloon dilatation and factors that would affect its success rate patients with benign etiology for GOO. Forty-five patients with the symptoms of benign GOO were randomly selected. Gastric outlet was delineated using double channel videoendoscopy. The information of initial balloon dilation was collected from recorded files. Balloon dilatation was repeated during the mean follow up of 9.9 ± 5.8 months. The severity of gastric pain was measured immediately before balloon dilatation and one month after procedure and was rated on a 10 cm visual analogue scale. The mean age of patients was 43.7 ± 18.1 years and 86.7% of them were men. Furthermore, 71.1% were H pylori positive. Response rate to endoscopic balloon dilatation was 80% and 8 patients underwent surgical resection. Weight loss was more frequent in non-responding group. The pain severity was significantly reduced more in responding subjects. No meaningful relationships were found between the responses to balloon dilatation and positive H pylori and cigarette smoking. Endoscopic balloon dilation is safe and effective for most patients with benign gastric outlet obstruction and has favorable long-term outcome. https://acta.tums.ac.ir/index.php/acta/article/view/3572 https://acta.tums.ac.ir/index.php/acta/article/download/3572/3548

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 3 2009 06 15 189 191 EN Negar Sajjadian Department of Neonatology, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Hamideh Shajari Department of Neonatology, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. ali Kowsari Department of Dentistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. ali Mosavi Nasub Department of Dentistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 The deciduous teeth play a very important role in proper alige Avicenna laboratory daily. Vaginal specimens were cultured on selective GBS Agar Base medium (ISLAM) for isolation and detection of group B streptococcus. The plates were incubated at 35-37°C under anaerobic condition for 24 hours. Incubated S.agalactiae developed orange/red pigmented colonies in GBS agar plates. Among the 330 women, the results of the culture were positive for GBS in 68 women (20.6%). Statistical analyses showed no significant relationship between demographics, reproductive histories and obstetric characteristics of subjects with the test results. Solely the antibiotic therapy was associated with GBS colonization. The results are indicating that the relatively high maternal GBS colonization rate in pregnant women warrants a routine screening and prophylactic treatment of the infected women. Colonization with group B streptococcus can be identified directly by GBS agar medium and decrease the time to detection of GBS. https://acta.tums.ac.ir/index.php/acta/article/view/3538 https://acta.tums.ac.ir/index.php/acta/article/download/3538/3514

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 1 2009 02 15 31 34 EN Mohammad Mehdi Karambin Department of Pediatrics, School of Medicine, Guilan University of Medical Sciences, Guilan, Iran. Hooman Hashemian Department of Pediatrics, School of Medicine, Guilan University of Medical Sciences, Guilan, Iran. 2015 09 28 To determine the rate of different types of arthritis in children. We prepared a retrospective descriptive study and included the whole 100 cases of arthritis referred to 17-Shahrivar Hospital, Rasht, Guilan during a 3 years period. Using their medical files, data including age, sex, season of admission, history of trauma, signs and symptoms, lab findings and duration of hospitalization were collected. SPSS 13.0 (statistical software) applied for statistical analysis. The most common age of involvement ranged 6-9 years. Septic arthritis, brucellosis, and rheumatoid fever were the most frequent causes of arthritis in our study. Fever and restricted range of motion had the highest rate among different signs and symptoms. Lab data demonstrated leukocytosis, positive CRP, and increased ESR among 74, 79.5, and 73 percent of our patients, respectively. According to the high prevalence of septic arthritis and the arthritis due to brucellosis and rheumatoid fever, it seems that mentioned diseases are still major problems in the issue of hygiene management. https://acta.tums.ac.ir/index.php/acta/article/view/3539 https://acta.tums.ac.ir/index.php/acta/article/download/3539/3515

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 1 2009 02 15 35 40 EN Hasan Hosain Zadegan Department of Microbiology, School of Medicine, Lorestan University of Medical Sciences, Khoramabad, Iran. AND Razi Herbal Medicine Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran. Bahram Delfan Razi Herbal Medicine Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran. AND Department of Pharmacology, School of Medicine, Lorestan University of Medical Sciences, Khoramabad, Iran. 2015 09 28 Biofilm is a community of bacteria which are attaching to a surface. They are responsible for many of catheter related or dental plaque related infectious diseases. Different approaches have been used for preventing biofilm related infections in health care settings. Many of these methods have disadvantages such as chemical based complications, and emergent antibiotic resistant strains. Therefore antibiofilm effect of Dentol was evaluated on two important medical bacterial biofilms in this study. Methods: Minimum inhibitory concentrations (MIC) of Dentol was calculated by serial dilution method by microtiter plates against standard bacteria. Antibiofilm effect of Dentol was evaluated by microtiter plate assay and after measuring absorbance in 550 nm, the difference between groups was calculated by Cruskal-wallis and Mann-withney tests. Results: 1:80 (12.5 μl/ml) & 1:20 (50 μl/ml) dilutions of commercially available Dentol were measured as MICs for S.aureus and P.aeruginosa, respectively. Two-fold dilutions of Dentol MICs completely eradicated and inhibited biofilm formation. Statistical analysis between test groups revealed significant differences. Disscussion: Dentol is a medicinal herbal essential oil derived from Satureja khuzestanica (SKEO). Several in vitro studies have reported its antidiabetic, analgesic, anti-inflammatory, and anti-hyperlipidemic effects. So because of complications that have been encountered in health care settings from routine methods of catheter processing, and biofilm related problems, efficacy of Dentol for destruction of bacterial biofilms as a safe material was studied. https://acta.tums.ac.ir/index.php/acta/article/view/3540 https://acta.tums.ac.ir/index.php/acta/article/download/3540/3516

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 1 2009 02 15 41 45 EN Ebrahim Ameri Department of Orthopedic and Spine Surgery, Shafayahyaiian Hospital, Iran University of Medical Sciences, Tehran, Iran. Hamid Behtash Department of Orthopedic and Spine Surgery, Shafayahyaiian Hospital, Iran University of Medical Sciences, Tehran, Iran. Bahram Mobini Department of Orthopedic and Spine Surgery, Shafayahyaiian Hospital, Iran University of Medical Sciences, Tehran, Iran. Farzad Omidi-Kashani Department of orthopedic Surgery, Qaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Marzieh Nojomi Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. 2015 09 28 Surgery on the skeleton frequently requires harvesting of autogenous bone graft from the pelvis, but this procedure is complicated by problems. The purpose of this retrospective, comparative descriptive study was to compare the efficacy of metal-derived bioactive glass (Novabone) versus autogenous iliac crest bone graft in adolescent idiopathic scoliosis surgery. The study was carried out on forty cases (aged 14-20 years) with 55 total curves fused for AIS. Posterior spinal fusion was performed using local bone grafts combined with autogenous iliac crest bone graft in 20 patients (group 1), and combined with Novabone in another twenty ones (group 2). The patients were observed for a minimum of 24 months after surgery, with a mean postoperative observation time of 34.7 months. The results were assessed clinically and radiologically. In group 1, average preoperative curve was 66° with immediate correction to 24.2° (59.7%) and final follow-up of 27.4° (54.3%), but in group 2 the calculated numbers included 63.8°, 25.8° (59.6%) and 28.4° (55.5 %) respectively. There were 5 indeterminate fusions (3 cases in group 1 and 2 in the other group), 1 acute infection, and 1 hook dislodgement in the synthetic group. These results justify and favor the use of bone substitutes for instrumented posterior spinal fusion in AIS. Potentially hazardous harvesting of pelvic bone is no longer necessary for such operations. https://acta.tums.ac.ir/index.php/acta/article/view/3541 https://acta.tums.ac.ir/index.php/acta/article/download/3541/3517

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 1 2009 02 15 46 50 EN Seyed Taher Esfahani Department of Pediatric Nephrology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Abbas Madani Department of Pediatric Nephrology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Neamatollah Ataei Department of Pediatric Nephrology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mahdi Nadjafi Department of pediatric Gastroenterology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Parvin Mohseni Department of Pediatric Nephrology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Bahar Allahverdi Department of pediatric Gastroenterology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Marzieh Haddadi Department of Pediatric Nephrology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 This study was undertaken to define the prevalence of the upper Gastrointestinal (GI) lesions, dyspeptic symptoms, H.pylori infection, and the impact of duration of dialysis on upper GI symptoms and lesions of children with End-stage renal disease. We studied 69 children with ESRD who were under regular hemodialysis therapy in our department. The age of the patients were between 4-18 years (mean: 11.3). 57(82.6%) of 69 patients had GI symptoms and 12(17.4%) were symptom free, the prevalence of each symptom in 57 symptomatic children was as follows: anorexia 48(84.2%), nausea/vomiting 39 (68.4%), belching/heartburn 20(35%), abdominal distention 15(26.3%), and epigastric pain 8(14%). 65(92.4%) of 69 patients with ESRD had pathologic lesions and the most common lesion was gastritis .There was no case of gastric angiodysplasia in our patients. 15(21.7%) of 69 patients had H. pylori infection. The prevalence of H.pylori infection in non-uremic children with upper GI symptoms is about 27% in our pediatric gastroenterology department, so there was no significant difference in prevalence of H.pylori infection between uremic and non-uremic children in our study (p value = 0.4735). There was no significant relationship between duration of dialysis and dyspeptic symptoms or upper GI lesions (p values were 0.8775 and 0.7435, respectively). Conclusions: Upper GI disorders are very common in children with ESRD, even when they have no upper GI symptoms, the most common lesion is gastritis. The prevalence of H.pylori infection is not different between children with ESRD and non-uremic children with upper GI symptoms, and duration of hemodialysis therapy has no significant effect on prevalence of GI symptoms and lesions. https://acta.tums.ac.ir/index.php/acta/article/view/3542 https://acta.tums.ac.ir/index.php/acta/article/download/3542/3518

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 1 2009 02 15 51 56 EN Zahra Basirat Department of Obstetric and Gynecology, School of Medicine, Babol University of Medical Sciences, Babol, Iran. Ali Moghadamnia Department of Pharmacology, School of Medicine, Babol University of Medical Sciences, Babol, Iran. Mehrdad Kashifard Department of Gastroentrology, School of Medicine, Babol University of Medical Sciences, Babol, Iran. Atena Sarifi-Razavi Department of Obstetric and Gynecology, School of Medicine, Babol University of Medical Sciences, Babol, Iran. 2015 09 28 Nausea and vomiting of pregnancy (NVP) are often alleviated by eating dried biscuits or foods. Natural products such as ginger have been suggested as herbal remedies for its treatment. The purpose of this study was to determine the effectiveness of ginger in biscuit form for the treatment. Sixty-five women with NVP at or before 17 weeks of gestation, who attended the antenatal clinic of Yahyanejad hospital in Babol town, Northern Iran, during 2005-2006 were included in the study. The subjects were randomized in a double-blind design and divided into two groups to take biscuits. 0.5g of ginger as fine powder was incorporated in each biscuit. Subjects received 5 ginger biscuits per day or an identical placebo biscuit for 4 days. They graded their severity of nausea using visual analog scales (VAS) and recorded the number of vomiting episodes in the previous 24 hours and again during 4 consecutive days. Five-item Likert scales were used to assess the severity of their symptoms. The average VAS scores of day 1 to 4 of post-therapy minus baseline nausea was decreased significantly in ginger (2.6±1.77) compared with the placebo group (1.4±1.62) (P=0.01). The number of vomiting episodes was also decreased in ginger (0.96±0.21) and placebo (0.62±0.19), the difference being insignificant. A significant difference was seen in inter-group variations per day in both groups. Likert scale showed an improvement in symptoms in both groups (P=0.43). Therefore, ginger in biscuit form is effective for relieving the severity of nausea and, to some extent, of vomiting in pregnancy. https://acta.tums.ac.ir/index.php/acta/article/view/3543 https://acta.tums.ac.ir/index.php/acta/article/download/3543/3519

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 1 2009 02 15 57 60 EN Shahrokh Yousefzadeh Chabok Trauma Research Center, School of Medicine, Guilan University of Medical Sciences, Guilan, Iran. Masoomeh Ahmadi Dafchahi Trauma Research Center, School of Medicine, Guilan University of Medical Sciences, Guilan, Iran. Hanieh Mohammadi Trauma Research Center, School of Medicine, Guilan University of Medical Sciences, Guilan, Iran. Sakineh Shabbidar Trauma Research Center, School of Medicine, Guilan University of Medical Sciences, Guilan, Iran. 2015 09 28 Hyperglycemia, in trauma patient, is commonly associated with a hyper metabolic stress response. Our objective is to determine the effects of hyperglycemia on the overall outcome of head trauma patients. In this descriptive study data were collected from head trauma patients' admitted to Intensive Care Unit (ICU) of Poursina University Hospital in a one-year period (Jan 2004-Jan 2005), retrospectively. All patients had stayed in the ICU for more than 48 hours post-injuries. They were divided into two groups according to their serum glucose levels at the time of admission (<200mg/dl or >200mg/dl), age, gender and Injury Severity Score (ISS). Patients with diabetes mellitus were excluded .We determined the outcome according to duration of hospitalization and ICU stay as well as mortality rates. Variables were analyzed with t-test and chi square test. Out of 115 patients, 89.6% were men. About 36 % of patients had serum glucose levels ≥ 200 mg/dl over the study period and this group had significantly greater mortality rate but without necessarily longer ICU or hospital stay. In this study we have shown that admission hyperglycemia has significant effect on patient's mortality but it is still unclear whether it can be a cause for longer ICU/hospital stay. https://acta.tums.ac.ir/index.php/acta/article/view/3544 https://acta.tums.ac.ir/index.php/acta/article/download/3544/3520

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 1 2009 02 15 61 64 EN Marjan Laal Department of Surgery, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mousa Khodadadi Department of Surgery, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammad-Reza Zarei Department of Emergency Medicine, Sina Trauma and Surgery Research Center Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 This prospective study, conducted in 8 cities of Iran from 1999 to 2000. Out of total 16,573 trauma patients, 106 (0.63%) included in this study had renal injury. This study aimed at investigation of incidence, etiology and management of renal trauma patients in Iran. They were 87 (82.1%) male and 19 (17.9%) female patients. Renal trauma mechanism was mainly blunt injury (93.4%). Road traffic crashes (61.3%) and falls (22.7%) were the most leading causes of trauma. These patients had different grade of traumas as follow: Sixty-six (62.3%) grade I, 14 (13.2%) grade II, 10 (9.4%) grade III, 8 (7.5%) grade IV and 8 (7.5%) grade V. Out of 106 patients, eighty-three (78.3%) patients managed conservatively, most had grade I injury (P© 2009 Tehran University of Medical Sciences. All rights reserved. https://acta.tums.ac.ir/index.php/acta/article/view/3545 https://acta.tums.ac.ir/index.php/acta/article/download/3545/3521

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 1 2009 02 15 65 70 EN Mehdi Farzadnia Department of Pathology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Hossein Ayatollahi Department of Hematopathology and Blood banking; School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Maliheh Hasan zade Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Mohammad Hadi Sadeghian Department of Hematopathology and Blood banking; School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Naser Tayebi Meybodi Department of Pathology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 2015 09 28 Endothelial dysfunction is thought to be a central pathogenic feature in pre-eclampsia on the basis of elevated adhesion molecules. Soluble forms of these molecules can be detected in plasma, and their concentrations are thought to reflect the degree of activation of a particular cell type. The aim of the present study was to compare the levels of soluble vascular cell adhesion molecule-1 (sVCAM-1) in sera of normal and pre-eclamptic pregnancies. A cross-sectional study was conducted to determine the plasma concentrations of sVCAM-1 in peripheral blood obtained from normal pregnant women (n=40), mild pre-eclampsia (n=37) and severe pre-eclampsia (n=38). Concentrations of soluble adhesion molecule was determined with enzymelinked immunosorbant assay (ELISA). Serum concentration of sVCAM-1 was significantly higher in severe preeclampsia (P<0.05) than normal pregnancy. There was also significant differences in sVCAM- 1 levels between mild and severe pre-eclampsia (P<0.05). There was no difference in the mean plasma log sVCAM1between normal pregnant women and mild pre-eclamptic women. These results suggest soluble vascular cell adhesion molecule-1 are increased in severe pre-eclampsia, and sVCAM-1may be useful in predicting the severity of pre-eclampsia. https://acta.tums.ac.ir/index.php/acta/article/view/3546 https://acta.tums.ac.ir/index.php/acta/article/download/3546/3522

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 1 2009 02 15 71 74 EN Ali Reza Mirshemirani Department of Pediatric Surgery, Mofid Children's Hospital, School of Medicine, Shaheed Beheshti University of Medical Sciences, Tehran Iran. Sina Sadeghian Department of Pediatric Surgery, Mofid Children's Hospital, School of Medicine, Shaheed Beheshti University of Medical Sciences, Tehran Iran. Jafar Kouranloo Department of Pediatric Surgery, Mofid Children's Hospital, School of Medicine, Shaheed Beheshti University of Medical Sciences, Tehran Iran. 2015 09 28 To access the surgical progress of patients with long segment aganglionosis and long-term evaluation. During the past 15 years, we reviewed the therapy and outcome of 15 patients with Long-Segment Agangelionosis (LSA) in Mofid children's hospital. 2 with Agangelionosis to the midtransvers colon (MTA(, 8 to the ascendant and cecum (A/CA), 4 with total colonic and distal ileum involvement (TCA), and one child with total intestinal Agangelionosis (TIA). The patient with TIA had only laparatomy and staged biopsies. 12 were treated by Swenson technique and 2 patients by other procedures. All patients received total parenteral nutrition up to 10 days postoperative to ensure appropriate fluid and electrolyte status. The patients with TCA needed supplementary therapies (Diet, Drugs) up to 4 months to reduce the stool frequency. 2 patients died. The patient with TIA died 6 months after Biopsies. Another one died 5 months after pull-through: small bowel ileus with total intestinal necrosis. 9 Of the 13 alive patients have normal stool pattern: 1-3 times per day. 2 patients have 3-6 stools per day with 1-2 soiling per week. An adolescent patient has occasionally nightly soiling (1- 2 per month). No actual data about one patient (A/CA). One TCA patient doing well immediately postoperative becomes obstipated 3 months later (after having Entrocolitis). He had washout enemas for 9 months. Now stools regularly. Awareness of long-segment Agangelionosis should lead to earlier diagnosis. Appropriate surgery and improvements in supportive care led to a significantly increased rate of survival. Patients with LSA even involving ileum (but no more than 50 cm of ileum) should attain a normal stooling behavior. Long-term outcome is quite favorable. https://acta.tums.ac.ir/index.php/acta/article/view/3547 https://acta.tums.ac.ir/index.php/acta/article/download/3547/3523

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 1 2009 02 15 75 78 EN Fatemeh Rajabi Department of Community Medicine, Center for Academic and Health Policy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Soheila Dabiran Department of Community Medicine, Center for Academic and Health Policy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Zinat Nadia Hatmi Department of Community Medicine, Center for Academic and Health Policy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Gholam Reza Zamani Department of Neurology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Epilepsy is a chronic disease that affects different aspects of life; so we studied the quality of life of epileptic patients and compared it with general population of Tehran. We collected clinical and demographic data and studied quality of life by using the Iranian translation of Short Form 36 questionnaire version 2 (SF-36). The questionnaires were filled out by 200 patients with epilepsy referred to the Epilepsy Institute as outpatients. The mean age of our patients was 32.6 years. 54.5% were male. More than 60% of our patients had generalized tonic colonic seizures and seizure frequency was more than once a month in about 40% of them. Patients had lower scores in all subscales of SF-36, which were significantly lower than the general population. Mental health and vitality were the most affected by the disease and physical functioning was the least. Age, marital status, number of children, type of seizure and duration of disease had no effect on quality of life, but gender, educational level, occupation and income did influence quality of life. Clinical factors with significant effects on quality of life were as follows: number of taken drugs, number of adverse effects of drugs, frequency of seizures, and the time passed from last seizure. So we recommend treating patients using least number of drugs with minimum side effects. Striving for seizure free patients is very important and it is vital that we regard quality of life as an important factor in selecting appropriate treatment for patients. https://acta.tums.ac.ir/index.php/acta/article/view/3548 https://acta.tums.ac.ir/index.php/acta/article/download/3548/3524

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 1 2009 02 15 79 80 EN Fatemeh Davari Tanha Department of Obstetric and Gynecology, Mirza Kochak-Khan Hospital, Tehran University of Medical Sciences, Tehran, Iran. Farzaneh Mirzaaghaee Department of Obstetric and Gynecology, Mirza Kochak-Khan Hospital, Tehran University of Medical Sciences, Tehran, Iran. Marzie Karimi Khezri Department of Obstetric and Gynecology, Mirza Kochak-Khan Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mahbod Kaveh Department of Obstetric and Gynecology, Mirza Kochak-Khan Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Limb bud first appears during the third week of gestation with the upper limb buds appearing a few days before the lower limb buds. Complete absence of one or more limbs, called Amelia, occurs prior to the eighth week of gestation. We report a case of Amelia in a twin gestation. https://acta.tums.ac.ir/index.php/acta/article/view/3549 https://acta.tums.ac.ir/index.php/acta/article/download/3549/3525

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 47 1 2009 02 15 81 82 EN Ahmad Hashemzadeh Department of Pediatrics, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Farhad Heydarian Department of Pediatrics, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 2015 09 28 It is an autosomal recessive, and occasionally autosomal dominant muta