Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 7 2015 10 06 393 394 EN Hosein Dalili Department of Neonatology, Breast Feeding Research Center, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Nayeri Department of Neonatology, Breast Feeding Research Center, Tehran University of Medical Sciences, Tehran, Iran Mamak Shariat Department of Maternal and Child Health, Maternal-Fetal-Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran Leila Asgarzadeh Department of Medicine, Breast Feeding Research Center, Tehran University of Medical Sciences, Tehran, Iran 2015 10 06 2015 10 06 Lamotrigine is a safe anti-epileptic drug among pregnant and lactating women. Some concerns exist regarding the safety of lamotrigine during breastfeeding and related neonatal complications. In this brief review, this matter was evaluated and discussed. In this review study, the medical literature available in search databases such as Embase, Scopus, PubMed, and Medline and even also local medical search engines were evaluated. The results indicated that lamotrigine is a safe anti-epileptic drug for breastfeeding women with rare and usually mild adverse effects among neonates exposed to high milk concentration of this drug and its metabolites. However, close periodical monitoring for infants whose mothers are utilizing lamotrigine is recommended to decrease the probability of severe side effects among them. https://acta.tums.ac.ir/index.php/acta/article/view/4264 https://acta.tums.ac.ir/index.php/acta/article/download/4264/4219

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 7 2015 10 06 395 402 EN Behnam Heidari Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. AND Endocrinology and Metabolism Research center, Vali-asr Hospital, School of Medicine,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 Frshad Sharifi Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Kazem Mohammad Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Mohammad Pajouhi Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Koosha Paydary Iranian Research Center for HIV/AIDS (IRCHA), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran Hossein Fakhrzadeh Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran 2015 10 06 2015 10 06 Type 2 diabetes mellitus is associated with increased inflammation and accelerated atherosclerosis. The association of the pro-inflammatory and potentially pro-atherosclerotic molecule, pregnancy associated plasma protein-A (PAPP-A) with diabetes and vascular diseases remains to be further established. A total of 107 patients with type 2 diabetes and 101 healthy controls participated in this study. Serum levels of PAPP-A was measured by Enzyme-linked Immunosorbent Assay (ELISA). We also evaluated the lipid profile, aortic augmentation index, coronary calcium score, ankle brachial index, flow mediated dilation, and carotid intima media thickness. Serum level of PAPP-A was significantly higher in patients with diabetes compared to controls (PPP=0.021) and was negatively associated with coronary calcification (P=0.050). In conclusion, serum levels of PAPP-A were significantly higher in diabetics compared to healthy controls and correlated with aortic augmentation index and coronary calcification. Our study results suggest that PAPP-A can be a marker of subclinical atherosclerosis in patients with diabetes. https://acta.tums.ac.ir/index.php/acta/article/view/4267 https://acta.tums.ac.ir/index.php/acta/article/download/4267/4222

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 7 2015 10 06 403 407 EN Parastoo Tarighi Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza Khorramizadeh Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran Armin Madadkar Sobhani Department of Bioinformatics, Institute of Biochemistry and Biophysics, Tehran University, Tehran, Iran Seyed Nasser Ostad Department of Toxicology-Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Mohammad Hossein Ghahremani Department of Toxicology Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Molecular Medicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran 2015 10 06 2015 10 06 Interaction between urokinase-type plasminogen activator (uPA) and its receptor (uPAR) plays an important role in the progression of numerous cancer types including breast cancer by promoting tumor initiating,  proliferation,  invasion  and  metastasis.  Hence,  disruption  of  this  interaction  inhibits  their downstream cascades and subsequently tumor growth. For this, we created two series of 8 and 10 amino acids linear peptides, derived from uPA binding region to target uPAR and studied the inhibition of proliferation in MDA-MB-231 cell line. Results revealed that all of the 10-mer peptides inhibited breast cancer cell proliferation significantly with maximum 40% inhibition of 103 peptides. Meanwhile, none of the 8-mer peptides showed significant toxicity. Current results indicate that the linear 10-mer peptides which mimic a small part of a sequence of a binding domain of uPA to uPAR could be exploited to design a novel class of anti-cancer agents. https://acta.tums.ac.ir/index.php/acta/article/view/4270 https://acta.tums.ac.ir/index.php/acta/article/download/4270/4683

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 7 2015 10 06 408 411 EN Marjaneh Zarkesh Pediatrics growth disorders research center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Fatemeh Sedaghat Pediatrics growth disorders research center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Abtin Heidarzadeh Department of Social Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Manizheh Tabrizi Pediatrics growth disorders research center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Kobra Bolooki Moghadam Pediatrics growth disorders research center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Soheil Ghesmati Pediatrics growth disorders research center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran 2015 10 06 2015 10 06 Since  clinical  manifestations  of  most  febrile  infants  younger  than  three  months  old  are nonspecific, differentiation of Serious Bacterial Infection (SBI) from self-limiting viral illness is a significant challenge for pediatricians. This study was performed to assess the diagnostic value of white blood cell count (WBC), Absolute Neutrophil Count (ANC), Interleukin -6 (IL-6) and C-reactive protein   (CRP) level to predict SBI in febrile infants younger than three months old who were hospitalized. This was a diagnostic test validation study. In this prospective study, 195 febrile infants admitted to 17 Shahrivar Hospital underwent a full sepsis workup including blood, urine, cerebrospinal fluid cultures and chest radiography. WBC count, ANC and CRP and Il-6 level were measured in all patients. Serum IL-6 concentration was measured by Enzyme-linked Immunosorbent Assay test. Then diagnostic, values of these tests for predicting SBI was compared with each other. Of total cases, 112 (57.4%) infants were male. SBI was diagnosed in 29 (14.9%) patients. The most common type of SBI was Urinary Tract Infection (UTI). Serum IL-6 (³20pg/dl) had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 79/1%, 91.6%,75.4%,  60.3%,  respectively  and  for  CRP  (³  10mg/l)  values  were  81.6%,  89.8%,  78.2%,  and  52%,respectively. The predictive values of CRP and IL-6 were higher than WBC and ANC. IL-6 and CRP are more valid and better diagnostic markers for predicting SBI than WBC count and ANC. CRP level seems to be an accessible and cost-effective marker for early diagnosis of SBI. Since by no marker we can totally rule out SBI in febrile infants < three months of age, it is recommended to administer systemic antibiotics until culture results become available. https://acta.tums.ac.ir/index.php/acta/article/view/4272 https://acta.tums.ac.ir/index.php/acta/article/download/4272/4227

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 7 2015 10 06 412 418 EN Fariba Seighali Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran AND Breast Feeding Research Center, Tehran University of Medical Science, Tehran, Iran Zahra Farahani Department of Physiology, Fetal and Neonatal Research Center, Tehran University of Medical Science, Tehran, Iran Mamak Shariat Family Health Institute, Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Science, Tehran, Iran 2015 10 06 2015 10 06 Health professionals play crucial roles on the self-confidence of nursing mothers and their knowledge of breastfeeding. The aim of this study was a comparison of two different breastfeeding workshops on participants’ knowledge, attitude, practice (KAP) and related factors. A cross-sectional study took place in Fetal and neonatal Research Centre (2011- 2012). The intervention composed of two different training courses in breastfeeding. Two workshops were held during three days in two parts: lectures and practical. Each speech regarded the most important aspects of breastfeeding. In training part, a breastfeeding consultant managed the practical exercises. In the second workshop the lecturers used different methods (didactic, strategies to enhance active involvement, educational devices and so on). A questionnaire was used to evaluate participants' KAP before and after each workshop. Among 40 participants in the first workshop, the average age was 37.78 years old, 32 were midwives-nurses and 8 were GPs-residents.   Twenty six had children from which 19 breastfed successfully. Of 27 participants in a second workshop with an average age of 38.59 years, 19 were midwifes- nurses.   Fourteen reported having children from which 11 breastfed successfully. Our data showed that both workshops improved participants’ KAP scores significantly. No significant differences were seen between two groups’ attitude before workshops (P. Value =0.093) but this difference, after the workshop was noticeable (P. Value =0.000). The pertained background factors in changing KAP were: having children, successful breastfeeding experience and age (P. Value< 0.05). In-service breastfeeding training program improves KAP; however, the interactive, practical method is much more effective in changing attitudes of participants. https://acta.tums.ac.ir/index.php/acta/article/view/4274 https://acta.tums.ac.ir/index.php/acta/article/download/4274/4229

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 7 2015 10 06 419 424 EN Seyyed Kamran Soltani Arabshahi Department of Medical Education, Center for Educational Research in Medical Sciences (CERMS), School of Medicine, Iran University of Medical Sciences, Tehran, Iran Hoorieh Mohammadi Kenari Medical Sciences Education and Development Office, School of Traditional Medicine,Tehran University of Medical Sciences, Tehran, Iran Gholamreza Kordafshari Department of Traditional Medicine, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza Shams Ardakani Department of Traditional Medicine, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran Shoaleh Bigdeli Department of Medical Education, Center for Educational Research in Medical Sciences (CERMS), School of Medicine, Iran University of Medical Sciences, Tehran, Iran 2015 10 06 2015 10 06 The major difference between Iranian traditional medicine and allopathic medicine is in the application  of  evidence  and  documents.  In  this  study,  criteria  for  evidence-based  practice  in  Iranian traditional medicine and its rules of practice were studied. The experts’ views were investigated through in- depth, semi-structured interviews and the results were categorized into four main categories including Designing clinical questions/clinical question-based search, critical appraisal, resource search criteria and clinical prescription appraisal. Although the application of evidence in Iranian traditional medicine follows Evidence Based Medicine (EBM) principles but it benefits from its own rules, regulations, and criteria that are compatible with EBM. https://acta.tums.ac.ir/index.php/acta/article/view/4279 https://acta.tums.ac.ir/index.php/acta/article/download/4279/4234

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 7 2015 10 06 425 431 EN Manouchehr Nakhjavani Department of Endocrinology, Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences, Tehran, Iran nter, Baqiyatallah University of Medical Sciences, Tehran, Iran. Alireza Bolkheir Department of Infectious Diseases, The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran. Katayoun Vahdat Department of Infectious Diseases, The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran. Majid Assadi The Persian Gulf Nuclear Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran. Hossein Darabi Department of Infectious Diseases, The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran. Iraj Nabipour Department of Biochemistry, The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran. 2015 12 08 2016 05 29 Some adipocytokines are cardioprotective or pro-inflammatory for cardiovascular system. Chronic infection with Chlamydia pneumoniae and Helicobacter pylori has been also considered as novel risk factors for atherosclerosis. The main aim of the current population-based study is to investigate the potential link between circulating adipocytokines and Chlamydia pneumoniae or Helicobacter pylori IgG seropositivities. A total of 250 healthy postmenopausal women who participated in a prospective cohort study were evaluated for IgG antibodies directed against C.pneumoniae and H. pylori. Omentin-1, visfatin, adiponectin, and high sensitivity C-reactive protein were measured by highly specific enzyme-linked immunosorbent assay methods. The prevalence of IgG antibodies against C. pneumoniae and H. pylori among the studied population was 20.4% (51 women) and 57.2% (143 women), respectively. There were no significant differences in adipocytokine levels between H. pylori IgG seropositive and H. pylori seronegative subjects. Similar results for visfatin and omentin-1 were found when C. pneumoniae IgG seropositive were compared with C. pneumoniae IgG seronegative subjects. However, in general linear model adjusted for age, body mass index and hs-CRP levels revealed significant difference between C. pneumoniae seropositive and C. pneumoniae seronegative subjects for circulating adiponectin. In conclusion, Chlamydia pneumoniae IgG seropositivity was associated with higher adiponectin levels in postmenopausal women. The elucidation of interaction mechanism of Chlamydia pneumoniae and a cardioprotective adipocytokine (adiponectin) will be useful in future therapeutic strategies. https://acta.tums.ac.ir/index.php/acta/article/view/5247 https://acta.tums.ac.ir/index.php/acta/article/download/5247/4877

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 12 2017 01 14 778 783 EN Masoumeh Mohebi Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Abolfazl Akbari Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran. Nahid Babaei Department of Molecular Cell Biology and Genetics, Bushehr Branch, Islamic Azad University, Bushehr, Iran. Abdolrahim Sadeghi Department of Biochemistry and Genetics, Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran. Mansour Heidari Department of Molecular Cell Biology and Genetics, Bushehr Branch, Islamic Azad University, Bushehr, Iran. AND Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2016 06 11 2016 08 15 Autosomal dominant congenital cataract (ADCC) is the most common form of inherited cataracts and accounts for one-third of congenital cataracts. Heterozygous null mutations in the crystallin genes are the major cause of the ADCC. This study aims to detect the mutational spectrum of four crystallin genes, CRYBA1/A3, CRYBB1, CRYBB2 and CRYGD in an Iranian family. Genomic DNA was isolated from whole blood cells from theproband and other family members. The coding regions and flanking intronicsequences of crystalline genes were analyzed by Sanger sequencing in aproband with ADCC. The identified mutation was further evaluated in available family members. To predict the potential protein partners of CRYBA1/A3, we also used an in-silico analysis. A de novo heterozygous deletion (c.272-274delGAG, p.G91del) in exon 4 of CRYBA1/A3 gene, leading to a deletion of Glycine at codon 91 was found. This genetic variation did not change the reading frame of CRYBA1 protein. In conclusion, we identified a de novo in-frame 3-bp deletion in the proband with an autosomal dominant congenital cataract, but not in her parents, in an Iranian family. This mutation has occurred de novo on a paternal gamete during spermatogenesis. The in-silico results predicted the interaction of CRYBA1 protein with the other CRY as well as proteins responsible for eye cell signaling. https://acta.tums.ac.ir/index.php/acta/article/view/5694 https://acta.tums.ac.ir/index.php/acta/article/download/5694/4878

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 12 2017 01 14 784 787 EN Jamshid Ayatollahi Department of Infectious Diseases, Infectious Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Somayeh Jahanabadi Department of Infectious Diseases, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mohammad Sharifyazdi Department of Infectious Diseases, Infectious Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Roya Hemayati Department of Nephrology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mahmood Vakili Department of Community Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Seyed Hossein Shahcheraghi Department of Infectious Diseases, Infectious Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. AND Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 2016 05 02 2016 07 06 Occult HBV infection of hemodialysis (HD) patients is informative in terms of virus transmission. It may be of clinical importance in HD patients. The aim of this study was to investigate the prevalence of anti-HBc in the HD Patients. Number of 126 patients undergoing hemodialysis were included in this study from main hemodialysis units in Yazd. Hepatitis B surface antigens (HBsAg), hepatitis B core antibody (anti-HBc) were examined in all subjects. Finally, stored serum samples from anti-HBcAb positive, HBsAg negative patients were anonymised and tested for HBV DNA by real time quantitative PCR assay. The age range of the patients was 17-88 years. Of the 126 patients, 123 patients (97.6%) were HBC-Ab negative and 3 (2.4%) were positive. Of 3 patients with Anti-HBC positive, HBV DNA was detected in 1 patient. This study showed a low rate of isolated anti-HBc (2.4%). HBV DNA was also detected in 1 patient. https://acta.tums.ac.ir/index.php/acta/article/view/5609 https://acta.tums.ac.ir/index.php/acta/article/download/5609/4879

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 12 2017 01 14 788 792 EN Majid Kalani Department of Pediatrics, Akbar-Abadi Hospital, Iran University of Medical Sciences, Tehran, Iran. Mamak Shariat Department of Maternal and Child Health, Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran. Nasrin Khalesi Department of Pediatrics, Aliasghar Hospital, Iran University of Medical Sciences, Tehran, Iran. Zahra Farahani Department of Physiology, Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran. Sahar Ahmadi Department of Pediatrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. 2016 07 13 2016 09 14 Intraventricularhemorrhage (IVH) is one of thecommon morbidities among preterm neonates. In thepresentstudy, we set out to evaluate the efficacy of two prophylactic modalities (ibuprofen and indomethacin prophylaxis) for prevention of IVH in our local setting. A prospective study was carried out in Akbar-Abadi Hospital, Tehran-Iran (2013-2014). Ninety-six preterm neonates who cared in closed incubator entered the study. Neonates randomly assigned into 3 groups; control, oral indomethacin (0.2 mg/kg indomethacin daily for 3 days) and oral ibuprofen (10,5,5 mg/kg ibuprofen every 24 hours during 3) administration. For all subjects brain sonography examination was performed in 3rd day, first, 2nd week of life and when infants reached to 36 and 42 weeks of postmenstrual age. The IVH prevalence and the effectiveness of the drugs among groups were statistically assessed. Of all 93 subjects; 14 cases had IVH (15.1%). IVH was significantly more frequent in the controls than in other groups (P=0.049). Prophylactic treatment could significantly decrease the incidence of grade 3 or 4 IVH in experimental groups (P=0.008). There were no significant differences between the three experimental groups with respect to theincidence of GI bleeding, Oliguria, renal dysfunction or NEC (P>0.05). This study demonstrates that low-dose prophylactic indomethacin and ibuprofen are equally associated with a reduction of IVH without any significant side effects like renal dysfunction, GI bleeding or NEC. https://acta.tums.ac.ir/index.php/acta/article/view/5774 https://acta.tums.ac.ir/index.php/acta/article/download/5774/4880

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 12 2017 01 14 793 805 EN Masoumeh Amin-Esmaeili Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran. Afarin Rahimi-Movaghar Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran. Maryam Gholamrezaei Department of Educational and Counseling Psychology, McGill University, Montreal, Quebec, Canada. Emran Mohammad Razaghi Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2016 06 01 2016 07 17 The marked shift in the patterns of drug use in Iran, from opium smoking to injecting drug use, has led to serious health-related outcomes. This