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 Arash Aghajani Nargesi Department of Endocrinology, Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences, Tehran, Iran Mirataollah Salabati Department of Endocrinology, Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences, Tehran, Iran Raziyeh Mahmoudzadeh Department of Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Afsaneh Morteza Department of Endocrinology, Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences, Tehran, Iran Behnam Heidari Department of Endocrinology, Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences, Tehran, Iran Alireza Esteghamati Department of Endocrinology, Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences, Tehran, Iran 2015 10 06 2015 10 06 Recent studies suggested the role of white blood cells (WBCs) in the pathogenesis and complications of type 2 diabetes. Increased WBC counts predict mortality in patients with chronic kidney disease (CKD). In this study alterations in WBC subpopulations in diabetic patients with non-dialysis dependent CKD are investigated. This was a cross-sectional study  on 376 participants, including   272 diabetic  patients  and  104  healthy  controls.  Total  and  differential  WBC  counts  were  compared  among diabetics with CKD, diabetics without CKD and controls. Among patients with type 2 diabetes, there was no significant difference in total WBC count between those with and without CKD. Diabetic patients with CKD had higher neutrophil, monocyte and eosinophil and lower lymphocyte count compared with both diabetic patients without CKD and healthy controls. Except for monocytes, a significant association was observed between GFR and differential WBC counts, which persisted after adjustment for conventional diabetes riskfactors (R2=0.272, P < 0.001 for regression model). Neutrophil/lymphocyte ratio was the best predictor ofGFR in total study population (beta= -1.995 ± 0.45, P https://acta.tums.ac.ir/index.php/acta/article/view/4282 https://acta.tums.ac.ir/index.php/acta/article/download/4282/4237

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 7 2015 10 06 432 438 EN Abolfazl Mozafari Department of Medical Sciences, Qom Branch, Islamic Azad University, Qom, Iran Mostafa Vahedian Department of Epidemiology, Clinical Development Research Center, Qom University of Medical Sciences, Qom, Iran Siamak Mohebi Health Policy and Promotion Research Center, Qom University of Medical Sciences, Qom, Iran Mohsen Najafi Department of Medical Sciences, Qom Branch, Islamic Azad University, Qom, Iran 2015 10 06 2015 10 06 Work-related musculoskeletal disorders (WMSDs) are common among drivers and official workers. Musculoskeletal disorders are frequent causes of absenteeism in many countries. The aim of this study was to determine the prevalence of musculoskeletal disorders and risk factors associated with these symptoms. A total of 346 workers and truck drivers were participated in this case-control study. All the participants were interviewed using a self- administered questionnaire containing demographic data and a Nordic questionnaire about presence site and characteristics of pain. Then the data were gathered, and the prevalence of the mentioned parameters and the relationship between variables in the questionnaire were analyzed statistically. The results of this study revealed that 78.6% out of truck drivers and 55.5% out of official workers had musculoskeletal disorders in on-year and there was a significant difference between two groups in this regard (P<0.001). On the whole, the most common symptoms were neck 47 (27.2%), followed by lumbar pain 42 (24.3%) in truck drivers and knee 63 (36.4%) and lumbar symptom 21 (12.1%) in one-year in official workers. In this study, musculoskeletal disorders showed statistically significant association with work duration, age and BMI (P<0.001). Within the limits of this study, it can be concluded that the musculoskeletal troubles have a high frequency among the drivers and official workers. Both groups usually remain on a prolonged uncomfortable postures and high static muscle load which may imply a risk for development of the troubles. https://acta.tums.ac.ir/index.php/acta/article/view/4283 https://acta.tums.ac.ir/index.php/acta/article/download/4283/4238

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 7 2015 10 06 439 443 EN Farzaneh Agha-Hosseini Department of Oral and Maxillofacial Medicine, Dental Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Oral Maxillofacial Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Oral Maxillofacial Medicine, The Academy of Medical Sciences, Tehran, Iran Iraj Mirzaii-Dizgah Department of Physiology, School of Medicine, Aja University of Medical Sciences, Tehran, Iran Najmeh-Sadaat Miri-Zarandi Department of Oral and Maxillofacial Medicine, Dental Research Center, Tehran University of Medical Sciences, Tehran, Iran 2015 10 06 2015 10 06 Unstimulated whole salivary p53 was evaluated in non-involved subjects, in patients suffering from oral lichen planus (OLP) and squamous cell carcinoma (SCC). A total of 34 patients with OLP, 24 patients suffering from oral SCC and 41 non-involved participants were enrolled. The unstimulated whole saliva p53 level was assayed by ELISA. Data was analyzed by ANOVA followed by the Tukey post hoc test. Saliva  p53  concentration  in  patients  with  SCC  (5.36±1.08)  was  significantly  higher  than  in  healthy participants (0.41±0.04) and in patients suffering from OLP (0.94±0.31). This study could not confirm the precancerous nature of OLP based on the relatively low p53 expressions in comparison to SCC. https://acta.tums.ac.ir/index.php/acta/article/view/4284 https://acta.tums.ac.ir/index.php/acta/article/download/4284/4239

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 7 2015 10 06 444 447 EN Feridoun Sabzi Department of Cardiovascular Surgery, Imam Ali Heart Center, Kermanshah University of Medical Sciences, Kermanshah, Iran Donya Khosravi Department of Gynecology and Obstetrics, Preventive Gynecology Research center, Imam Hussein Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran 2015 10 06 2015 10 06 We report a unique case of chronic dissection of the ascending aorta complicated with huge and thrombotic pseudoaneurysm in a patient with coarctation of descending aorta. Preoperative investigations such as transesophageal echocardiography (TEE) confirmed the diagnosis of dissection. Intraoperative findings included a12 cm eccentric bulge of the right lateral side of dilated the ascending aorta filled with the clot and a circular shaped intimal tear communicating with an extended hematoma and dissection of the media layer. The rarity of the report is an association of the chronic dissection with huge pseudoaneurysm and coarctation. The patient underwent staged repair of an aneurysm and coarctation and had an uneventful postoperative recovery period. https://acta.tums.ac.ir/index.php/acta/article/view/4285 https://acta.tums.ac.ir/index.php/acta/article/download/4285/4240

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 7 2015 10 06 448 451 EN Afak Yusuf Sherwani Department of Urology, Sher I Kashmir Institute of Medical Sciences SGR, Kashmir, India Arif Hussain Sarmast Department of Neurosurgery, Sher I Kashmir Institute of Medical Sciences SGR, Kashmir, India Ajaz Ahmad Malik Department of General Surgery, Sher I Kashmir Institute of Medical Sciences SGR, Kashmir, India Mubashir Shah Department of General Surgery, Sher I Kashmir Institute of Medical Sciences SGR, Kashmir, India Fazl Q-Parray Department of General Surgery, Sher I Kashmir Institute of Medical Sciences SGR, Kashmir, India Muneer A-Wani Department of General Surgery, Sher I Kashmir Institute of Medical Sciences SGR, Kashmir, India Sajad Dangroo Department of Urology, Sher I Kashmir Institute of Medical Sciences SGR, Kashmir, India 2015 10 06 2015 10 06 Hydatid disease is a parasitic tapeworm infestation that usually involves liver and lungs. Primary retroperitoneal hydatid without liver and lung involvement is very rare. Surgery is the principle method of treatment for large retroperitoneal hydatid, whenever feasible. We report a case of primary retroperitoneal hydatid cyst in 29-year-old male patient. https://acta.tums.ac.ir/index.php/acta/article/view/4286 https://acta.tums.ac.ir/index.php/acta/article/download/4286/4241

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 7 2015 10 06 452 453 EN Selahattin Ozyurek Department of Orthopaedics and Traumatology, Aksaz Military Hospital, Marmaris, Mugla, Turkey Aziz Atik Department of Orthopaedics and Traumatology, Balikesir University Hospital, Balikesir, Turkey Hasan Turgut Department of Orthopaedics and Traumatology, Bursa Military Hospital, Bursa, Turkey Faruk Akyildiz Department of Orthopaedics and Traumatology, Malatya Military Hospital, Malatya, Turkey 2015 10 06 2015 10 06 No Absrract https://acta.tums.ac.ir/index.php/acta/article/view/4287 https://acta.tums.ac.ir/index.php/acta/article/download/4287/4242