Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 11 2012 11 15 723 728 EN Mohammad-Reza Mohammadi Psychiatric Research Centre, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. Poopak Hafezi Psychiatric Research Centre, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ali Galeiha Research Center for Behavioral isorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran. Reza Hajiaghaee Institute of Medicinal Plants (ACECR), Tehran, Iran. Shahin Akhondzadeh Psychiatric Research Centre, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 A recent randomized clinical trial showed buspirone efficacy in the treatment of attention-deficit/hyperactivity disorder (ADHD) in children. However, results from a recent multi-site controlled clinical trial of transdermal buspirone failed to separate it from placebo in a large sample of children with ADHD. Therefore, due to these inconsistent findings, this study was designed to assess the efficacy of buspirone in the treatment of children with ADHD compared to methylphenidate in a double blind randomized clinical trial. Forty outpatients with a DSM-IV-TR diagnosis of ADHD were study population of this trial. Subjects were recruited from an outpatient child and adolescent clinic for a 6 week double blind, randomized clinical trial. All study subjects were randomly assigned to receive treatment using tablet of buspirone at a dose of 20-30 mg/day depending on weight (20 mg/day for < 30kg and 30 mg/day for > 30kg) (group 1) or methylphenidate at a dose of 20-30 mg/day depending on weight (20 mg/day for < 30kg and 30 mg/day for > 30kg (group 2) for a 6 week double blind, randomized clinical trial. The principal measure of outcome was the Teacher and Parent ADHD Rating Scale IV. Patients were assessed at baseline and at 21 and 42 days after the medication started. Significant differences were observed between the two groups on the Parent and Teacher Rating Scale scores. The changes at the endpoint compared to baseline were: -8.95±8.73 (mean±SD) and -15.60±7.81 (mean±SD) for buspirone and methyphenidate, for Parent ADHD Rating Scale. The changes at the endpoint compared to baseline were: -9.80 ±7.06 (mean±SD) and -22.40±9.90 (mean±SD) for buspirone and methyphenidate, respectively for Teacher ADHD Rating Scale. The difference between the buspirone and methylphenidate groups in the frequency of side effects was not significant except for decreased appetite, headache and insomnia that were observed more frequently in the methylphenidate group. The results of this study suggest that administration of buspirone was less effective than methylphenidate in the treatment of ADHD. https://acta.tums.ac.ir/index.php/acta/article/view/3983 https://acta.tums.ac.ir/index.php/acta/article/download/3983/3958

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 11 2012 11 15 729 734 EN Ehsan Arasteh Department of Plastic and Reconstructive Surgery, 15 Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Masoud Yavari Department of Plastic and Reconstructive Surgery, 15 Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2015 09 28 Linear and cord-like burn scar contractures are commonly treated by severing the scar in a transverse direction and skin grafting or performing Z-plasties. However, skin grafts may result in suboptimal take and contract gradually and the Z-plasty requires undermining flaps in scarred skin which may lead to the distal tip necrosis. In this article the authors present their experience with multiple Y-V plasty technique. From May 2005 to September 2009, 44 linear and narrow cord-like burn contractures in various regions of upper and lower extremities of 32 patients were treated by multiple Y-V plasty technique. The contracted scars were treated successfully in all of the patients. No major post-operative complications or contracture recurrence were observed during the follow up period of 6 to 24 months in this series of patients. By creating a longer length, running Y-V plasty can relax the contracted scar. Considering the advantages and excellent results in the treated patients in this study group, and also other presented series, multiple Y-V plasty can be recommended as a very useful and safe technique for the treatment of linear and cordlike burn contractures. https://acta.tums.ac.ir/index.php/acta/article/view/3984 https://acta.tums.ac.ir/index.php/acta/article/download/3984/3959

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 11 2012 11 15 735 739 EN Setila Dalili Guilan Health Center, Guilan University of Medical Sciences, Guilan, Iran. Seyed Mahmood Rezvany Guilan Health Center, Guilan University of Medical Sciences, Guilan, Iran. Arsalan Dadashi Guilan Health Center, Guilan University of Medical Sciences, Guilan, Iran. Abdolreza Medghalchi Guilan Health Center, Guilan University of Medical Sciences, Guilan, Iran. Hamid Mohammadi Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran. Hosein Dalili Department of Pediatrics, Breastfeeding Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mostafa Mirzanejad Guilan Health Center, Guilan University of Medical Sciences, Guilan, Iran. Hajar Gholamnezhad Guilan Health Center, Guilan University of Medical Sciences, Guilan, Iran. Anis Amirhakimi Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran. 2015 09 28 This study was aimed to evaluate the situation of congenital hypothyroidism (CH) in Guilan using the screening program and determine the correlation of CH with birth weight, gestational age and seasonality. During 2006 to 2010, in Guilan province, neonatal screening for CH by measurement of serum TSH level was performed in 3-5 days after birth. All neonates with TSH level ≥ 5mu/l were referred to endocrinologists and serum TSH, T3 and T4 were measured. Based on public health data and profiles, total number of newborns, gestational age, route of delivery, birth season and birth weight in all screened neonates was reviewed and for ones with CH, their TSH measurements was also recorded. During 5 years, 119701 neonates were screened and CH was confirmed in 10.8% (221) of the referral cases (prevalence=1:542). No significant statistical difference was seen between gender and birth season among patients with CH and the rest of the population. Interestingly, low birth weight (LBW) (31% vs. 4.9%, P<0.01), postdate delivery (1.4% vs. 0.2%, P<0.01) and macrosomia were more prevalent in CH versus normal population (Odds ratio for post-date delivery was 6.9 and for LBW was 3.2). Rate of normal vaginal delivery (NVD) was significantly higher in neonates with CH compared to normal population (39.2% vs. 29.2%, P=0.01). LBW, postdate delivery and macrosomia are risk factors for CH. No association between sex, birth season or caesarian section delivery was seen. https://acta.tums.ac.ir/index.php/acta/article/view/3985 https://acta.tums.ac.ir/index.php/acta/article/download/3985/3960

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 11 2012 11 15 740 745 EN Nassrin Khalesi Department of Pediatrics, Ali Asghar Hospital, Tehran University of Medical Sciences, Tehran, Iran. Seyed Mohsen Bahaeddini Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mamak Shariat Maternal, Fetal & Neonatal Research Center-Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Maternal vitamin D deficiency is one of the major risk factors for neonatal vitamin D deficiency followed by neonatal hypocalcaemia. The aim of this study is to determine the relationship between delayed neonatal hypocalcaemia and maternal vitamin D deficiency. This is a descriptive cross-sectional study. Target population of this study included all term and preterm neonates with delayed hypocalcaemia (after the first 72 hours of birth) admitted to Ali-Asghar Hospital. The sample size was 100 neonates included in the study. Demographic, clinical and paraclinical data including Ca, P, PTH and level of maternal and neonatal vitamin D were recorded according to patients records. 67 neonates (67%) were term and 33(33%) were preterm neonates. The mean of serum calcium in neonates was 6.49± 0.68mg/dL (in the range of 4.3-7.8 mg/dL). 85% of neonates and 74% of mothers had vitamin D deficiency. 100% of neonates born to mothers with vitamin D deficiency were hypocalcaemia. A statistically significant difference was seen between the mean values of serum Ca (6.67 in term vs. 6.12 in preterm neonates) and vitamin D in term and preterm neonates was 16.34 vs. 20.18 (P= 0.0001 and P=0.01 respectively). Also, a significant correlation was seen between maternal and neonatal level of vitamin D (P=0.0001, r=0.789). With regard to the socio-cultural status in Iran besides women's clothing style and nutritional deficiencies before and during pregnancy, health authorities and policy makers are responsible to focus their serious attention on hypocalcaemia and hypovitaminosis D in neonates. https://acta.tums.ac.ir/index.php/acta/article/view/3986 https://acta.tums.ac.ir/index.php/acta/article/download/3986/3961

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 11 2012 11 15 746 754 EN Asghar Mohammadpoorasl Department of Public Health, School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran. Sahrnaz Nedjat Department of Epidemiology and Biostatistics, School of Public Health, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran. Ali Fakhari Clinical Psychiatry Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Kamran Yazdani Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Abbas Rahimi Foroushani Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Akbar Fotouhi Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 The aim of this study is determining the prevalence of smoking stages in adolescents of Tabriz city (northwest of Iran) and identifying the personal, environmental, and psychological factors relating to cigarette smoking. Fifty-seven high schools were randomly selected, and 4903 students were completed a self-administered questionnaire about cigarette smoking and the related risk factors. The association of independent variables with cigarette smoking was evaluated using the ordinal logistic regression model. In total, 17.3% of the participants were experimenters (95% CI: 15.8-18.9) and 5.0% were regular smokers (95% CI: 3.7-6.2). The results showed that the male gender (OR=2.92; CI: 1.94-4.77), age (OR=1.27; CI: 1.02-1.64), having general risk taking behavior (OR=1.50; CI: 1.02-2.21), presence of a cigarette smoker in the family (OR=1.78; CI: 1.23-2.54), friendship with close cigarette smoker friends (OR=2.52; CI: 1.65-3.86), substance abuse experience (OR=8.27; CI: 2.61-25.61), attitude toward cigarette smoking (OR=1.22; CI: 1.10-1.27) and positive thinking about cigarette smoking (OR=1.05; CI: 1.01-1.14) are associated to cigarette smoking in adolescents. The cigarette smoking prevalence is minimal in Tabriz city adolescents, especially in girls; but the experimenter prevalence is considerable. Findings of this study justifies adopting more serious measures in the pre-adolescence and adolescence period. https://acta.tums.ac.ir/index.php/acta/article/view/3987 https://acta.tums.ac.ir/index.php/acta/article/download/3987/3962

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 11 2012 11 15 755 759 EN Ali Abdolahinia Iranian Traditional Medicine, Clinical Trial Research Center, Shahed University, Tehran, Iran. AND Research Unit, Iranian Anti Tobacco Association, Tehran, Iran. Makan Sadr Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zahra Hessami Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2015 09 28 Many factors affect tobacco quit rate. In this study we investigated the abstinence rate after 5 years based on the age of smoking initiation. This pre-post field trial study was conducted on 398 smokers who participated voluntarily in a smoking cessation clinic in 2005. They were followed for 5 years and their success or failure in continuous abstinence was evaluated and recorded in 2010. Three hundred and five participants (76.6%) succeeded at the end of the course. Follow up at the end of 2010 revealed that 111 (27.8%) cases were still maintaining their continuous abstinence after 5 years including 64 men and 47 women. The mean age of smoking initiation in successful and failed subjects was 21.9 and 20.7 years respectively. The age of smoking initiation could be a predictor of maintaining abstinence in the future. Starting smoking at an earlier age could have a negative effect on long-term abstinence. https://acta.tums.ac.ir/index.php/acta/article/view/3988 https://acta.tums.ac.ir/index.php/acta/article/download/3988/3963

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 11 2012 11 15 760 764 EN Afsaneh Sadeghian Department of Pediatrics, Fatemieh Hospital, Shahrood University of Medical Sciences, Shahrood, Semnan, Iran. Maryam Damghanian Department of Pediatrics, Shahrood University of Medical Sciences, Shahrood, Semnan, Iran. Mohammad Shariati Department of Social Medicine, Shahrood University of Medical Sciences, Shahrood, Semnan, Iran. 2015 09 28 Current study determined the overall incidence, common causes as well as main predictors of this final diagnosis among neonates admitted to a rural district hospital in Iran. This study was conducted on 699 neonates who were candidate for admission to the NICU. Study population was categorized in the case group, including patients exposed to final diagnosis of neonatal seizures and the control group without this diagnosis. Neonatal seizure was reported as final diagnosis in 25 (3.6%) of neonates. The most frequent discharge diagnosis in the seizure group was neonatal sepsis and in the non-seizuelation between desmin loss and temperature changes during (r = 0.886, P< 0.05) and a weak correlation between desmin loss and temperature changes after (r= 0.699, P<0.05) eccentric contractions was observed. Our results suggest that cooling during eccentric contractions may decrease desmin loss but temperature changes after eccentric contractions have no effect on desmin loss. https://acta.tums.ac.ir/index.php/acta/article/view/3728 https://acta.tums.ac.ir/index.php/acta/article/download/3728/3703

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 4 2011 04 15 233 236 EN Fakhreddin Taghaddosinejad Department of Forensic Medicine, Tehran University of Medical Sciences, Tehran, Iran. Amir Farshid Fayyaz Department of Forensic Medicine, Tehran University of Medical Sciences, Tehran, Iran. Behnam Behnoush Department of Forensic Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Sulfur mustard gas is one of the chemical warfare gases that roughly about 45000 soldiers continue to suffer long-lasting consequences of exposure during the Iran-Iraq war between 1980 and 1988. According to the common pulmonary lesions due to this gas exposure, we studied gross and microscopic pulmonary lesions in cadavers and also assessed the main causes of mortality caused by mustard gas exposure. A case-series study was performed on hospital record files of 100 cadavers that were exposed with documented sulfur mustard gas during the Iran-Iraq war from 1979 to 1988 and autopsied in legal medicine organization In Tehran between 2005 and 2007 and gross and microscopic pathological findings of autopsied organs such as hematological, pulmonary, hepatic, and renal changes were evaluated. All cases were male with the mean age of 43 years. The time interval between the gas exposure and death was almost 20years. The most frequent pulmonary complication was chronic bronchitis in 81% of autopsied cadavers. Other pulmonary findings were progressive pulmonary fibrosis (9%), pulmonary infections and tuberculosis (29%), malignant cellular infiltration (4%), and aspergilloma (1%). According to the chronic progressive lesions caused by mustard gas exposure such as pulmonary lesions and also its high mortality rate, suitable programming for protection of the gas exposed persons and prohibiting chemical warfare are recommended. https://acta.tums.ac.ir/index.php/acta/article/view/3729 https://acta.tums.ac.ir/index.php/acta/article/download/3729/3704

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 4 2011 04 15 237 240 EN Mahdi Fathi Department of Plastic Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mohsen Hassanzad Azar Department of Plastic Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ali Arab Kheradmand Department of Plastic Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Shahin Shahidi Department of Plastic Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Soft tissue defects of the lower limb are a challenge to the plastic surgeon but a soleus muscle flap often provides the solution. Various types of soleus muscle flap have been described, based mainly on the vascular supply. This study has been conducted as a descriptive study. The arterial blood supply of the soleus muscle was studied in 45 cadaveric lower limbs. The blood vessels and their branches to the muscle were dissected. The mean length of the soleus muscle was 37 ± 2.2 Cm. In 66.7% of the limbs at least two branches arose from the popliteal artery trunk. The average distance of the first branch was 2.61 ± 1.75 Cm distal to the fibular head. And the second branch was 3.88 ± 0.7 Cm distal to the fibular head. The average number of branches to the soleus muscle from the posterior tibial trunk was 4.3 ± 0.7. The average distance of the first branch was 9.4 ± 2.3 Cm from medial malleolus and second branch was 15 ± 3.4 Cm. The average number of branches to soleus arising from the proneal artery was 3.8 ± 0.8. The proneal artery gave 2-5 branches to the soleus muscle in the limbs that in 95.6% of the limbs were found three branches from proneal artery trunk to soleus muscle. In this study have been shown, the distribution of the arteries entering the soleus muscle and how the information may be used in the design of soleus muscle flaps. However, clinical application of distal pedicle soleus muscle flaps in Iranian population is not beneficial and we do not recommend it to the surgeons. https://acta.tums.ac.ir/index.php/acta/article/view/3730 https://acta.tums.ac.ir/index.php/acta/article/download/3730/3705

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 4 2011 04 15 241 245 EN Sirous Momenzadeh Department of Anesthesiology & Pain, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Hedayatollah Elyasi Research Center of Anesthesiology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Naser Valaie Department of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Badiozaman Radpey Department of Anesthesiology, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Azizollah Abbasi Department of Thoracocic Surgery, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Fatemeh Nematollahi Department of Anesthesiology & Pain, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Hossein Mohammadinasab Research Center of Anesthesiology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2015 09 28 We prepared this study to determine the effect of cryoanalgesia on post-thoracotomy pain. In this double-blinded randomized clinical trial, 60 patients who underwent thoracotomy were divided into two groups (control and cryoanalgesia). Visual Analogue Scale (VAS, 0-10) was used for the measurement of severity of post-thoracotomy pain. It was classified into three categories: 0-1 (mild), 2-3 (moderate), and 4-10 (severe). Pethidine (0.5-1 mg/kg) was administered in case of need for both groups. Patients were visited at the hospital a week later, and were contacted by phone at the first, second, and third months post-operatively. Intensity of pain in the control group was higher than the cryoanalgesia group in all visits the follow-up period. On the second day, the frequencies of severe pain (4-10) were 33.3% and 0 in the control and cryoanalgesia groups, respectively. The mild pain on the seventh day was 13.3% and 83.3% in the control and cryoanalgesia groups, respectively (P < 0.01). Pethidine consumption was 151.6 ± 27 mg in the control group and 87.5 ±48 mg in the cryoanalgesia group on the first day post-operation (P < 0.001). Cryoanalgesia is a useful technique with not serious side effects in order to alleviate post-thoracotomy pain and reduce the need for opiate consumption. https://acta.tums.ac.ir/index.php/acta/article/view/3731 https://acta.tums.ac.ir/index.php/acta/article/download/3731/3706

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 4 2011 04 15 246 251 EN Alireza Shahab Jahanlou Health Education Unit, Cardiovascular research center, Hormozgan University of Medical Sciences, Hormozgan, Iran. Fazlollah Ghofranipour Department of Health Education, Tarbiat Modares University of Medical Sciences, Tehran, Iran. Masoud Kimmiagar Department of Human Nutrition, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Maryam Vafaei Department of Psychology Tarbiat Modares University, Tehran, Iran. Alireza Heydarnia Department of Health Education, Tarbiat Modares University of Medical Sciences, Tehran, Iran. Alireza Sobhani Department of Pathology, Hormozgan University of Medical Sciences, Hormozgan, Iran. 2015 09 28 Over the past few decades, quality of life (QOL) has become an important concept in medical researches and treatments. Different meaningful reasons are given for this development. In the current research two standard questionnaires for evaluating of QOL were selected. First one, was a questionnaire from The World Health Organization (WHOQOL-BREF 26) and the second one, The Iranian Diabetics’ Quality of Life (IRDQOL). The goal of this study is to assess the relation between different domains of these questionnaires and HbA1c in diabetics. A random sample of Iranian adult outpatient diabetics (n=76) was selected and they completed the WHOQOL and IRDQOL assessment instruments. In addition HbA1c was measured in these patients by calorimetric method. Comparisons were made between scores of “questionnaires’ domains” and “HbA1c”. Data analysis was carried out by the use of T-test, Spearman correlation coefficient, Pearson’s correlation coefficient, and non-parametric statistical methods including Spearman correlation coefficient. Data analysis shows Psychological domain score in IRDQOL is lower than in WHOQOL and it is significant (P<0.0001). Physical domain score in IRDQOL is lower than WHOQOL and it is significant (P<0.0001). In WHOQOL questionnaire, analysis data showed when the patient’s age increased, physical and psychological domain’s score decreased. There is probably no relation between questionnaire domains and HbA1c in diabetics. Based on the findings in this research, there was obviously almost no difference between the two questionnaires for checking the QOL, but in IRDQOL spiritual domain is a very unreliable domain. https://acta.tums.ac.ir/index.php/acta/article/view/3732 https://acta.tums.ac.ir/index.php/acta/article/download/3732/3707

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 49 4 2011 04 15 252 257 EN SeyedAhmad SeyedAlinaghi Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran. Sara Jam Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran. Farhad Mehrkhani Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Fattahi Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran. AND Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Duman Sabzvari Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran. Zahra Kourorian Iranian Research Center for HIV/AIDS, Tehran Univer