Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 5 2011 05 15 275 276 EN Mehrdad Jalalian Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400 UPM Serdang, Selangor D.E., Malaysia. AND Department of Research, Research Center of Iranian Blood Transfusion Organization, Khorasan-e Razavi Blood Center, Mashhad, Iran. Latiffah Latiff Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400 UPM Serdang, Selangor D.E., Malaysia. Saeed Niazmand Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Parichehr Hanachi Department of Biomedical, Women Research Center, Alzahra University, Tehran, Iran. Seyed Tajuddin Seyed Hassan Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400 UPM Serdang, Selangor D.E., Malaysia. 2015 09 28 No Abstract https://acta.tums.ac.ir/index.php/acta/article/view/3738 https://acta.tums.ac.ir/index.php/acta/article/download/3738/3713

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 5 2011 05 15 277 283 EN Mohammd Reza Shahraki Department of Physiology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran. Mehdi Harati Departments of Biochemistry, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran. Ahamd Reza Shahraki Faculty of Medicine, Zahedan University of Medical Sciences, Member of Young Researches Club of Zahedan Azad University, Zahedan, Iran. 2015 09 28 Tamarindus indica is used as a traditional treatment for diabetes. To elucidate whether Tamarindus indica seed aqueous extract (TSE) ameliorates metabolic syndrome in hyperinsulinemic rats, we evaluated serum insulin, dehydroepiandrosterone sulfate (DHEAS), triglyceride (TG), total cholesterol (TC), very low density lipoprotein (VLDL), low density lipoprotein (LDL), high density lipoprotein (HDL), and glucose levels in fructose-fed rats. Animals were divided into three groups; control (C) receiving tap water, fructose-fed (F) and TSE-treated fructose-fed rats (F-T) both receiving tap water supplemented with 10% (w/v) fructose. Water was prepared every day for a period of 8 weeks for all three groups. F-T rats were fed with TSE via gavage feeding at the dose of 20 mg/0.5 ml distilled water/100 g body weight per day. Fasting serum glucose levels of three groups were comparable. TSE treatment prevented the increase in fasting serum insulin, TG, TC, VLDL, and LDL in the F-T group (P<0.01) when comparing with the F group. Fructose feeding led to a decrease in fasting serum DHEAS, and HDL levels in the F group (P<0.01) compared with the control. TSE treatment prevented the decrease in fasting serum DHEAS, and HDL levels in the F-T group (P<0.01) while these results were not seen in control rats. It is indicated that the hyperinsulinemia in fructosefed insulin resistant rats are associated with low levels of DHEAS, and HDL; and high levels of TC, VLDL, LDL, and TG. TSE supplementation probably ameliorates metabolic syndrome due to the improved insulin action. https://acta.tums.ac.ir/index.php/acta/article/view/3739 https://acta.tums.ac.ir/index.php/acta/article/download/3739/3714

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 5 2011 05 15 284 287 EN Parvin Zareian Department of Physiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran. Mohammad Vahid Karimi Department of Physiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran. Gita Dorneyani Department of Physiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran. 2015 09 28 The aim of this study was to investigate the effect of acute swimming stress on plasma corticosterone and leptin levels in female and male rats. Thirty- seven adult male (n=20) and female (n=20) Sprague Dawley rats (200-250 g weight) were used. The leptin and corticosterone levels were measured following swimming stress (10 minutes) or no stress. Plasma leptin and corticosterone were measured by ELISA system. The plasma leptin and corticosterone levels were significantly increased in female and male rats by swimming stress. Plasma leptin level was not correlated significantly with plasma corticosterone in all groups. There were no sex differences in leptin level among stressed and non stressed rats. The results suggest that changes in plasma leptin level could not be associated with stimulation of corticosterone secretion from adrenal glands and leptin secretion is not sex dependent. https://acta.tums.ac.ir/index.php/acta/article/view/3740 https://acta.tums.ac.ir/index.php/acta/article/download/3740/3715

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 5 2011 05 15 288 292 EN Seyed Jalil Mirhosseini Department of Cardiovascular Surgery, Afshar Hospital, Shahid Sadoughi University of medical sciences, Yazd, Iran. Seyed Khalil Forouzannia Department of Cardiovascular Surgery, Afshar Hospital, Shahid Sadoughi University of medical sciences, Yazd, Iran. Ali Hassan Sayegh Medical Student and Researcher of Cardiac Surgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mehdi Sanatkar Department of Cardiovascular Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Atrial fibrillation (AF) is the most common arrhythmia after cardiothoracic surgery. AF following coronary artery bypass graft (CABG) is associated with an increase in morbidity, mortality, hemodynamic instability, thromboembolic events, severity of heart failure and ICU and hospital stay. Corticosteroids have a variety of beneficial effects on recovery after elective surgery. This study was designed to test the hypothesis that low dose of Methylprednisolone (MP) can affect post-CABG AF and early complications in patients with severe left ventricle dysfunction who underwent elective off-pump coronary artery bypass. A total of 120 patients with LV dysfunction undergoing elective off- pump CABG randomly received either MP or placebo. Diabetic patients and those who were receiving corticosteroids were excluded. The MP group received 5mg/kg of MP intravenously after induction of anesthesia and the placebo group received an equal volume of normal saline. We evaluated Post-CABG variables including incidence, duration and frequency of AF recurrence and early morbidity such as bleeding, infection, vomiting, renal and respiratory dysfunctions, ICU or hospital stay and early mortality. The mean age of patients was 62.11 ± 12.34 years with the 2.4 male to female ratio. AF occurred in 23(19.2%) patients. No significant difference in the incidence of new AF was found between the placebo (21.7%) and MP group (16.7%) (P=0.47). MP did not affect postoperative bleeding, infection, vomiting, renal and respiratory dysfunction and mortality; however, MP significantly reduced ICU and hospital length of stay. MP did not affect the incidence, duration and frequency of AF recurrence in patients with severe LV dysfunction undergoing off-pump CABG. However, MP could reduce ICU and hospital stay significantly in these patients. https://acta.tums.ac.ir/index.php/acta/article/view/3741 https://acta.tums.ac.ir/index.php/acta/article/download/3741/3716

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 5 2011 05 15 293 295 EN Mohammad Alshara Department of Pharmacology, Faculty of Nursing, Irbid National University, Irbid, Jordan. 2015 09 28 The present study was conducted to investigate antimicrobial resistant pattern of Escherichia coli (E. coli) strains isolated from clinical specimens of Jordanian pediatric patients during the period from January to December 2008. A total of 444 E. coli strains were isolated from clinical specimens and tested for their susceptibility to different antimicrobial drugs. Overall, high resistance rate was observed for ampicillin (84%), followed by amoxicillin-clavulanic acid (74.3%), cotrimoxazole (71%), nalidixic acid (47.3%), cephalothin (41%). Lower resistance rates were observed for amikacin (0%) followed by Cefotaxime (11%), Ceftriaxone (11.7%), ciprofloxacin (14.5%), Norfloxacin (16.5%), gentamicin (17.3%) cephalexin (20.9%), Ceftazidime (22.5%), cefixime (29.6%), and cefaclor (32.8%). Ampicillin, amoxicillin-clavulanic acid and cotrimoxazole were found to be ineffective at in vitro inhibition of the E. coli of pediatric origin. Amikacin was highly effective for E. coli with susceptibility rate of 100%. The majority of E. coli strains were susceptible to third generation cephalosporins and fluoroquinolones. https://acta.tums.ac.ir/index.php/acta/article/view/3742 https://acta.tums.ac.ir/index.php/acta/article/download/3742/3717

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 5 2011 05 15 296 301 EN Neda Mehrdad Nursing and Midwifery School , Tehran University of Medical Sciences, Tehran, Iran. Mitra Zolfaghari Nursing and Midwifery Care Research Center, Nursing and Midwifery School , Tehran University of Medical Sciences, Tehran, Iran. Naser Bahrani Department of Statistic, Shahid Sattary University, Tehran, Iran. Sana Eybpoosh Department of Epidemiology & Biostatistics, Kerman University of Medical Sciences, Kerman, Iran. 2015 09 28 Traditional teaching methods used in medical education couldn't meet the need for keeping pace with up to date information. Present study has conducted in order to compare the effect of lecture and e-learning methods on nursing students' learning outcomes in the context of Iran. A cross-over design was applied. Study sample was consisted of 32 students which were in third semester of nursing bachelor program and were passing Maternal Child nursing course. The first part of the course was taught using lecture method during first four weeks; an e-learning method was the technique used to educate the remained part of the course during the second four weeks. Students' learning outcomes in each method, opinion toward and participation with both educational methods was assessed. No significant difference was found between students exam scores in both methods. Considering students' opinion toward educational methods, no significant difference was found between two methods in general but students reported better "capability" and "independency" in e-learning method while lecture was obtained higher scores in "effectiveness on learning" and "motivation" characteristics. E-learning can be used in teaching some nursing courses. It is recommended to use e-learning method with appropriate interactive strategies and attractive virtual environments to motivate students. https://acta.tums.ac.ir/index.php/acta/article/view/3743 https://acta.tums.ac.ir/index.php/acta/article/download/3743/3718

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 5 2011 05 15 302 304 EN Reza Nafisi Moghadam Department of Radiology, Shahid adoughi University of Medical Sciences, Yazd, Iran. Ahmad Shajari Department of Pediatric Nephrology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mohammad Afkhami-Ardekani Department of Endocrinology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. 2015 09 28 According to its superficial anatomical location, the thyroid gland is easily accessible by sonography. Sonography allows an exact documentation of the size and thyroid volume. The relationship between thyroid volume and anthropometric characteristics is a matter of controversy. The aim of this study was to investigate thyroid volume and its determinants in healthy adult. A cross-sectional study was performed from June2003 until April 2005 in 314 healthy adults aged over 18 years old in Yazd, Iran. Data were collected on age, sex, and weight and thyroid size by sonoraphy. Mean of thyroid volume in male and female was 9.08 ± 2.49 and 7.93 ± 3.2 milliliter which the differences was significant (P<0.003).Differences between thyroid volume and weight was significant (P=0.001). Mean of female weight and proportion of thyroid volume to their weight was 61.83 ± 12.09kg and 0.130 ± 0.33. Mean of male weight and proportion of thyroid volume to their weight was 71.41 ± 9.05kg and 0.126 ± 0.028 (P<0.003). Results of study is similar to other studies .Mean of thyroid volume in Yazd citizens is not differ from other Iranian but is different from other countries. This difference could be related to food intake habit, geographical region and daily oral iodine consumption https://acta.tums.ac.ir/index.php/acta/article/view/3744 https://acta.tums.ac.ir/index.php/acta/article/download/3744/3719

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 5 2011 05 15 305 306 EN Shafaat Davoodreza Department of ENT, ENT Clinic of Razi Hospital, School of Medicine, Tehran University of Medical Sciences. Tehran, Iran. 2015 09 28 We aimed to investigate the correlation of tonsillectomy with palatine tonsil size and to compare the differences of tonsil size and the need for surgery in children and adults. Also we can predict the outcome of tonsillectomy. We measured tonsil sizes in (height and width) in 150 children and 35 adults with hypertrophy of palatine tonsils and we measured the mass of tonsils and then the data analysis. In both groups of children and adults, tonsil sizes were significantly correlated with the rate of tonsillectomy. Tonsil size of grade 3 and 4 were with a high tonsillectomy rate in adults but tonsil size grade 2, 3 and 4 had a high tonsillectomy rate in children. Tonsillectomy correlated with tonsil size in both groups children and adults. The rate of tonsillectomy increased proportionally with tonsil sizes in both groups children and adults. https://acta.tums.ac.ir/index.php/acta/article/view/3745 https://acta.tums.ac.ir/index.php/acta/article/download/3745/3720

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 5 2011 05 15 307 309 EN ls and Gandy Center of Surgery between 2003-2008 were evaluated. Forty three of 87 patients finally undertaken intravenous regional sympatholytic block according to therapeutic protocol. 37 patients (86%) received one block, 2 of them (4.75%) received 2 repetitions of blocks and finally repeated block for three times occurred in 4 patients (9.3%). A week after block pain relief outcomes was recorded as following; excellent in 7 patients (16.3%), good in the 32 patients (74.4%) and moderate in the 4 patients (9.3%). After a month, 8 patients (18.5%) showed excellent relief and it was good and moderate in 32 (78%) and one case (2.4%), respectively. Pain relief after three months was excellent, good and moderate in the 13 patients (31.7%), 25 patients (61%) and 3 patients (7.3%), respectively. In this study level of pain relief was significant in various intervals and it showed significant difference in relief three months after block (P=0.04). CRPS due to SMP(sympathetically maintained pain) is thought to be alleviated by phentolamine. Intravenous phentolamine infusion is potentially a new significant option for the therapy of CRPS. https://acta.tums.ac.ir/index.php/acta/article/view/3788 https://acta.tums.ac.ir/index.php/acta/article/download/3788/3763

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 8 2011 08 15 527 530 EN Hassan Anari Department of Radiology. Ardebil University of Medical Sciences, Ardebil, Iran. Bahman Bashardoust Department of Dialysis, Ardebil University of Medical Sciences, Ardebil, Iran. Masoud Pourissa Department of Radiology, Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Soheila Refahi Department of Medical Physics, Faculty of Medicine. Ardebil University of Medical Sciences, Ardebil, Iran. AND Departments of Physics and Medical Engineering, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Ultrasound is one of the preferred modalities for evaluation of the parathyroid glands. This study was undertaken to determine the accuracy of high resolution ultrasound for secondary hyperparathyroidism in patients with chronic renal failure. From March 2008 to March 2009, ninety-one hemodialysis patients were examined by high resolution ultrasound (14 MHz) of the parathyroid glands in comparison to parathyroid hormone level. 43.9% of patients showed enlarged parathyroid glands with an average of 8.7 mm. The mean parathyroid hormone level of patients with enlarged parathyroid glands on sonography was 503 ± 450 pg/ml. We observed a significant correlation between parathyroid hormone level and enlarged parathyroid glands (P<0.0001). Sensitivity and specificity of sonography for detection of secondary hyperparathyroidism were 62.5% and 85.7% respectively. In conclusion, our study showed that high resolution sonography is a useful noninvasive method for the evaluation of secondary hyperparathyroidism in patients on hemodialysis and that sonographically enlarged glands may be a measure of severity of secondary hyperparathyroidism. https://acta.tums.ac.ir/index.php/acta/article/view/3789 https://acta.tums.ac.ir/index.php/acta/article/download/3789/3764

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 8 2011 08 15 531 535 EN Younes Nozari Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Babak Geraiely Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Recent studies show that, Inflammation plays an important role in the initiation and progression of atherosclerosis and in the pathogenesis of acute cardiovascular events. There is a possible association between ventricular dysfunction following acute myocardial infarction and high Sensitivity C-reactive protein (HS-CRP) and uric acid. In this study we assessed the relationship between HS-CRP and uric acid with LVEF and Killip Class in patients with acute myocardial infarction (AMI). In a cross sectional study, 188 patients (63 females and 125 males) with AMI (STEMI) who were admitted in CCU ward in Emam Khomeini Hospital, Tehran/Iran, were entered. Uric acid and HS-CRP were measured within first day of admission. We measured ejection fraction (LVEF) and used Killip classification system. The mean age of patients was 60.4±9.2 years. The mean of uric acid was 5.9±1.6, 6.6±2.1, 7.1±2.1 and 9.4±1.3 in patients with Killip Class I, II, III and IV, respectively (P=0.005). The mean of HS-CRP was 1.9±1.4, 14.2±10.9, 12.2±10.9 and 15.7±6.7 in patients with Killip Class I, II, III and IV, respectively (P=0.005). There was a relationship between HS-CRP and LVEF (Correlation coefficient= -0.788, P<0.001), but there was not between uric acid and LVEF (Correlation coefficient= -0.111, P=0.129), The plasma concentration of C-reactive protein correlated with LVEF and Killip Class in patients with AMI but serum uric acid was just correlated with Killip Class IV. It seems that plasma concentrations of HS-CRP and uric acid are useful for prediction of development of heart failure in AMI patients. More future studies are necessary for final judgment. https://acta.tums.ac.ir/index.php/acta/article/view/3790 https://acta.tums.ac.ir/index.php/acta/article/download/3790/3765

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 8 2011 08 15 536 542 EN Kaveh Bashti Department of Orthopaedic Surgeon, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Issa Navab Department of Orthopaedic Surgeon, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 The current study was conducted in order to examine the effectiveness of shelf procedure in symptomatic adult patients due to hip dysplasia. This study is retrospective and was performed on patients who had undergone surgery by one orthopaedic surgical team during the past 20 years. Twenty-three men and twenty-three women were enrolled in the study with a mean age of 29.3 years at the time of operation and they were followed up for a mean of 9.3 years. Shelf acetabuloplasty was performed unilateral in 30 patients and bilateral in 16 patients. Results demonstrated that mean Harris Hip Score and CE Angle significantly improved after the operation, while osteoarthritis got more severe post-operatively. The severity of osteoarthritis and the Harris Hip Score respectively significantly increased and decreased 14 years after the operation. Results also demonstrated that as the age of the patient was less, and the patient was more satisfied and the degree of osteoarthritis was less at the time of the operation, the mean change of the Harris Hip Score would be higher and the results of the operation would be more favorable. The preoperative osteoarthritis was significantly worse in to-be-operated hips than their control hips, this difference was not significant after the operation. And finally, although Harris Hip Score has been lower in to-be-operated hips before the operation, it was higher in these very same hips than the control hips after the operation. In short, according to this study although the shelf acetabuloplasty is a salvage procedure and cannot cover the femoral head concentrically like the modern redirectional osteotomies , but it is an effective procedure for a young patient to postpone the progression of the hip osteoarthritis (OA) once it occurs in order to perform reconstructive surgeries later when justified. https://acta.tums.ac.ir/index.php/acta/article/view/3791 https://acta.tums.ac.ir/index.php/acta/article/download/3791/3766

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 8 2011 08 15 543 546 EN Hamideh Shajari Department of Neonatology, Shariati Hospital, School of Medicine, Tehran University of Medical Science, Tehran, Iran. Neda Rashidiranjbar Department of Neonatology, Shariati Hospital, School of Medicine, Tehran University of Medical Science, Tehran, Iran. Mahmoodreza Ashrafi Department of Neurology, Children’s Medical Center, School of Medicine ,Tehran University of Medical Science ,Tehran, Iran. 2015 09 28 There is limited data in the literature on the normal size of the anterior fontanelle. This crosssectional study was to determine normal values of anterior fontanelle size on the first day of life, using standard methods. Anterior fontanelle size was measured in 400 term and healthy neonates delivered at the Shariati Hospital, Tehran, Iran. Examination included assessment of head circumference, anterior fontanelle size, weight, length. Type of delivery was also recorded. The mean size of anterior fontanelle was 25.34 ± 13.27 mm, and it was established in both genders, 26.70 ± 13.19 mm in boys, and 23.67 ± 13.20mm in girls. A significant difference between the mean anterior fontanelle size in boys and girls was found (P=0.023). There was no significant difference in anterior fontanelle size between the infants born with a normal vaginal delivery and those with cesarean-section (P=0.08). There was found a significant negative correlation between the mean size of anterior fontanelle size with both weight and height (P<0.05). No significant correlation was found between mean size of anterior fontanelle and head circumference or with gestational age of infant (P≥0.05). Our results proved possible to define a references range and centile chart. The method used is simple and accurate and easy used in the routine neonatal examination. https://acta.tums.ac.ir/index.php/acta/article/view/3792 https://acta.tums.ac.ir/index.php/acta/article/download/3792/3767

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 8 2011 08 15 547 550 EN Laleh Eslamian Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Khatereh Tooba Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 The umbilical vein (UV) has a non pulsating and even pattern in normal fetuses. Pulsation of UV has been described in severely growth restricted fetuses with chronic hypoxia. We wanted to see whether UV pulsations could also be seen in fetuses with heart deceleration during labor, as an adjunctive measure to assess the intra partum hypoxia. In a prospective study Doppler examination was performed on 34 fetuses with normal cardiotocography (CGT) and 26 fetuses with abnormal CTGs (GA>37w and cervical dilatation>3cm). Perinatal outcome was assessed according to presence or absence of UV pulsations. The 2 groups were similar regarding gestational age, cervical dilatation, Umbilical artery blood pH, S/D ratio,Pulsatility Index( PI) and Resistance Index (RI). Intraabdominal UV pulsation were present in 6 (23.1%) of abnormal CTG group but no case were seen in normal CTG group (P= 0.005). Five of 6 (83.3%) fetuses with UV pulsation underwent cesarean delivery. The rate of cesarean delivery was 90% in abnormal CTG group without pulsation and 14.7% in normal CTG group. The frequency of Apgar score <7 was more in fetuses with UV pulsations (16.7% vs 5%) although not statistically significant. NICU admission was considerably more in UV pulsation group (33% vs 5%, P= 0.123). After exclusion of LBW fetuses the UV pulsation was present in 4 (19%) of abnormal CTG group, who 3 of them underwent cesarean section. Neither umbilical artery pH<7 nor Apger score <7 or NICU admission were seen in these 4 neonates. Pulsation in UV was seen in 23% of fetuses with abnormal CTG during intra partum period. Cesarean delivery and NICU admission was increased in fetuses with UV pulsations, although not statistically significant. When LBW fetuses were excluded no case of UA pH<7, Apgar sore <7or NICU admission were seen. https://acta.tums.ac.ir/index.php/acta/article/view/3793 https://acta.tums.ac.ir/index.php/acta/article/download/3793/3768

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