Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 5 2013 05 15 279 283 EN Seyyed Mohammad Bagher Fazljou Department of Iranian Traditional Medicine, School of Iranian Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mansoureh Togha Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran. Kamyar Ghabili Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Mahdi Alizadeh Department of Iranian Traditional Medicine, School of Iranian Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mansoor Keshavarz Department of Iranian Traditional Medicine, School of Iranian Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Although the connection between head and stomach and hence the condition known as "gastric headache" was well known to the ancients, it has received little attention since the early 20th century. Herein, we review the teachings of the medieval Persian physicians about the gastric headache along with the related signs, symptoms, types and causes. The medieval Persian scholars adopted the main ideas of the gastric headache from predecessors in the ancient Greece and Rome, added substantial sub-categories and details to the earlier descriptions and therapeutic options. The medieval Persian physicians' contributions to the concept of gastric headache influenced beyond doubt the later accounts of this condition. https://acta.tums.ac.ir/index.php/acta/article/view/4447 https://acta.tums.ac.ir/index.php/acta/article/download/4447/4567

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 5 2013 05 15 284 288 EN Saeid Abediankenari Department of Immunology, Immonogenetic Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Ghasem Janbabaei Mollae Department of Hematology and Oncology, Mazandaran University of Medical Sciences, Sari, Iran. Maryam Ghasemi Department of Pathology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Yousef Yousefzadeh Department of Immunology, Immonogenetic Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Masoud Bahrami Department of Orthopedic, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran. Kamran Alimoghaddam Department of Hematology and Oncology, Transplantation Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Dendritic cells (DCs) are professional antigen presenting cells that have a potential role in the initiating of immune responses. The cell vaccination is a new strategy in treatment of infectious diseases and cancers. In this study, we have generated monocyte-derived dendritic cells of lymphoma patient's peripheral blood mononuclear cells then; these cells were used as vaccine in lymphoma patients. We generated dendritic cell vaccine from lymphoma patient's blood monocytes with human interleukin-4, granulocyte monocyte colony stimulating factor and then, antigen-primed Dcs were administrated subcutaneously close to the inguinal lymph nodes after maturation of dendritic cells. After 7 days, we analyzed immune response in lymphoma patients with determining of LDH, Beta 2 Microglobulin, CD4+T cell percent, CD8+ Tcell percent and Tumor size before and after vaccination. Furthermore, phenotypic and functional analysis of dendritic cells was performed using anti CD83-FITC monoclonal antibodies. Before vaccination, the mean ± SD of LDH was 530.62±140.65 but after vaccination it was 459±109.45 that significantly different between experimental groups (P=0.002). In addition, the CD8+ T cells percentage significantly different between two groups (P=0.002). We concluded that the use of dendritic cell probably is one of the suitable noninvasive treatments for lymphoma patients that they have not response to chemical drugs. https://acta.tums.ac.ir/index.php/acta/article/view/4446 https://acta.tums.ac.ir/index.php/acta/article/download/4446/4570

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 5 2013 05 15 289 292 EN Mehrdokht Mazdeh Department of Neurology, Hamadan University of Medical Sciences, Hamadan, Iran. Soroush Seifirad Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran. Niloofar Kazemi Medical Student, Hamadan University of Medical Sciences, Hamadan, Iran. Mohammad Ali Seifrabie Department of Social Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. Arash Dehghan Department of Pathology, Hamadan University of Medical Sciences, Hamadan, Iran. Hamidreza Abbasi Medical Student, Hamadan University of Medical Sciences, Hamadan, Iran. 2015 10 11 Multiple risk factors are introduced for Multiple Sclerosis (MS). Recent studies have suggested a possible correlation between vitamin D deficiency and an increase risk of MS. This study was therefore undertaken to compare vitamin D levels in new cases of MS and their relatives as healthy controls. Seventy five new diagnosed MS patients and 100 matched healthy controls among their relatives were enrolled in this study. Two groups were matched for gender, age, season in which serum level of vitamin D was checked and region and diet. Serum levels of 25-hydroxy vitamin D was measured, recorded and analyzed. Seventy five patients (57 female and 18 male) and 100 healthy subjects (75 female and 25 male) were enrolled in this study. The mean serum levels of 25-hydroxy vitamin D in case and control groups were 11.31 and 17.9 ng/ml, respectively (P=0.003). Compared to the healthy subject, serum levels of vitamin D were significantly lower in patients with MS. This difference was only significant in women. Observed difference of vitamin D levels of both groups were significant in summer. This study continues to support the role of vitamin D deficiency in MS. https://acta.tums.ac.ir/index.php/acta/article/view/4445 https://acta.tums.ac.ir/index.php/acta/article/download/4445/4578

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 5 2013 05 15 293 296 EN Rokhsareh Aghili Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran. Faria Jafarzadeh Department of Internal Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran. Raheb Ghorbani Research Center for Social Determinants of Health, Semnan University of Medical Sciences, Semnan, Iran. Mohammad Ebrahim Khamseh Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran. Maryam Alsadat Salami Department of Endocrinology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mojtaba Malek Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran. 2015 10 11 Autoimmune thyroid diseases (ATD) are multifactorial conditions that result from genetic predisposition in combination with environmental risk factors. Helicobacter pylori infection as an environmental risk factor has been proposed to imitate the antigenic components of the thyroid cell membrane and may play a leading role in the onset of the autoimmune diseases, such as Hashimoto thyroiditis. The aim of this study was to investigate the association between Helicobacter pylori (HP) infection and Hashimoto's thyroiditis (HT). The participants in this case-control study included 43 patients affected by Hashimoto's thyroiditis, and 40 healthy individuals without history of autoimmune disease as the control group. Anti HP IgG and anti-TPO antibodies were determined using ELISA method. Results were considered positive when the IgG anti-HP value was higher than 30 IU/ml and the anti-TPO autoantibody value was higher than 75 IU/ml. The mean TSH level was 18.3±16.8 IU/ml for patients and 2.8±1.2 IU/ml for the control group (P<0.001). 46.5% of the patient group and 10.8% of the control group were infected with HP. The association between HP and Hashimoto's thyroiditis was statistically significant (Odds Ratio=7.2, 95%, Confidence Interval: 2.0- 28.8, P<0.001). The findings show that, there is an association between HP and Hashimoto's thyroiditis. To establish a definite correlation between them, more detailed studies with a more specialized examination and precise consideration regarding species of HP, genetic polymorphism of the host and investigation of environmental factors are needed. https://acta.tums.ac.ir/index.php/acta/article/view/4444 https://acta.tums.ac.ir/index.php/acta/article/download/4444/4579

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 5 2013 05 15 297 302 EN Fatemeh Nayeri Neonatologist, Maternal-Fetal-Neonatal Research Center ,Tehran University of Medical Sciences, Tehran, Iran. Hosein Dalili Neonatologist, Breastfeeding Research Center ,Tehran University of Medical Sciences, Tehran, Iran. Firoozeh Nili Neonatologist, Maternal-Fetal-Neonatal Research Center ,Tehran University of Medical Sciences, Tehran, Iran. Elaheh Amini Neonatologist, Breastfeeding Research Center ,Tehran University of Medical Sciences, Tehran, Iran. Ali Ardehali General Physician, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Babak Khoshkrood Mansoori General Physician, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mamak Shariat Maternal & Child Health Specialist, Maternal-Fetal-Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 The objective of this study is to determine risk factors causing increase in very low birth way (VLBW) neonatal mortality. The medical files of all neonates weighing ≤1500 g, born in Vali-e-Asr hospital (2001-2004) were studied. Two groups of neonates (living and dead) were compared up to the time of hospital discharge or death. A total of 317 neonates were enrolled. A meaningful relationship existed between occurrence of death and low gestational age (P=0.02), low birth weight, lower than 1000 g (P=0.001), Apgar score <6 at 5th minutes (P=0.001), resuscitation at birth (P=0.001), respiratory distress syndrome (P=0.001) need for mechanical ventilation (P=0.001), neurological complications (P=0.001) and intraventricular hemorrhage (P=0.001). Regression analysis indicated that each 250 g weight increase up to 1250 g had protective effect, and reduced mortality rate. The causes of death of those neonates weighting over 1250 g should be sought in factors other than weight. Survival rate was calculated to be 80.4% for neonates weighing more than 1000 g. The most important high risk factors affecting mortality of neonates are: low birth weight, need for resuscitation at birth, need for ventilator use and intraventricular hemorrhage. https://acta.tums.ac.ir/index.php/acta/article/view/4443 https://acta.tums.ac.ir/index.php/acta/article/download/4443/4580

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 5 2013 05 15 303 306 EN Farrokh Seilanian Toosi Department of Radiology, Quaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Hossein Rezaie-Delui Department of Radiology, Quaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. 2015 10 11 A true estimation of gestational age (GA) plays an important role in quality maternity care and scheduling the labor date. This study aimed to evaluate the normal fetal kidney length (KL) and its correlation with GA. A cross-sectional study on 92 pregnant women between 8th and 10th week of gestation with normal singleton pregnancy underwent standard ultrasound fetal biometry and kidney length measurement. univariate and multivariate linear regression analysis was used to create a predictive equation to estimate GA on the KL and fetobiometry parameters. A significant correlation was found between GA and KL (r=0.83, P<0.002). The best GA predictor was obtained by combining head circumference, fetal biparietal diameter, femur length and KL with a standard error (SE) about 14.2 days. Our findings showed that KL measurements combination with other fetal biometric parameters could predict age of pregnancy with a better precision. https://acta.tums.ac.ir/index.php/acta/article/view/4442 https://acta.tums.ac.ir/index.php/acta/article/download/4442/4582

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 5 2013 05 15 307 313 EN Mohammad Ebrahim Ghamar-Chehreh Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran, Iran. Hossein Khedmat Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran, Iran. Mohsen Amini Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran, Iran. Saeed Taheri Taheri Medical Research Group, Baqiyatallah University of Medical Sciences, Tehran, Iran. 2015 10 11 In the present study, we examined the relationship between family history of cardiovascular diseases (CVD), dyslipidemia, hypertension, and diabetes with laboratorial abnormalities and syndromes in Iranian patients with non-alcoholic fatty liver disease (NAFLD). A total of 332 NAFLD patients from our outpatient clinic were consecutively entered into analysis. Exclusion criteria were having diabetes mellitus and fasting blood glucose over 126, active hepatitis B virus infection, having HCV positive serology, and to be under corticosteroid therapy. Family history of CVD, diabetes, dyslipidemia, and hypertension were taken from patients and related to the study variables. Family history of cardiovascular diseases (CVD) wa9;s Medical Center, Tehran, Iran. Javad Sabery nejad Department of Pediatrics, Army University of Medical Science, Tehran, Iran. Narjes Mehrvar Cancer Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran. 2015 10 10 2015 12 15 Acute Myeloblastic Leukemia is one of the important malignancies in children. For better managing the prognosis of this disease, there should be enough information about common features of this malignancy. The aim of this study was to evaluate these common features in children with Acute Myeloblastic Leukemia. A total of 104 eligible children less than 15-year-old have been referred from 2007-2011 to two referral centers for childhood malignancies. Basic epidemiological information recorded in checklists for each individual. Analyzes have been done by SPSS version 22. Out of patients, 57 cases were males (54.8%). The male/female ratio was 1.2. The mean age of patients was 6.5 ± 4.3 years. The majority subtypes of patients were M3, M4, non-M3, and M2, respectively. The common molecular abnormalities were t (15;17) and inv (16). Of patients, 19.2% had an early relapse. The mean age of relapse in patients was 6.7 ± 3.9 years. Sixty patients (57.7%) were alive, and 44 cases (42.3%) died during or after therapy. The three years overall survival rate of patients was 42% in this study. According to our data, AML has the same frequency as compared with data from developing countries. But different epidemiological characteristic was a lower rate of three years overall survival in patients. These data may serve the health authorities for more effective environmental and preventive measurements, purposeful allocation of resources for facilitating up-to-date diagnostic and treatment modalities, psychological support programs for respective family members and educational purposes. https://acta.tums.ac.ir/index.php/acta/article/view/4314 https://acta.tums.ac.ir/index.php/acta/article/download/4314/4729

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 12 2015 12 22 793 795 EN Pratiksha Gupta Department of Gynecology and Obstetrics, Post Graduate Institute of Medical Sciences and Research ESIC, Basaidarapur, New Delhi, India. Sangeeta Gupta Department of Gynecology and Obstetrics, Post Graduate Institute of Medical Sciences and Research ESIC, Basaidarapur, New Delhi, India. 2015 12 22 Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity. Endometriosis can sometimes occur in a previous surgical scar. Scar endometriosis is rare and difficult to diagnose. It mostly follows obstetrical and gynecological surgeries. This condition is often confused with other surgical conditions. We are reporting one case of scar endometriosis involving rectus sheath following cesarean section. The patient required wide surgical excision of the lesion. The pathogenesis, diagnosis, and treatment of this rare condition are being discussed. https://acta.tums.ac.ir/index.php/acta/article/view/5301 https://acta.tums.ac.ir/index.php/acta/article/download/5301/4728

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 12 2015 12 22 753 763 EN Vahid Eslami Department of Neurology, Albert Einstein College of Medicine, New York, USA. AND Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. Faezeh Dehghan Department of Occupational Medicine, AJA University of Medical Sciences, Tehran, Iran. Vafa Rahimi-Movaghar Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. AND Research Centre for Neural Repair, University of Tehran, Tehran, Iran. 2015 12 21 The purpose of this study was to shed light on the identification of themes and sub-themes of the quality of life (QOL) in Iranian veterans with spinal cord injury (SCI). Studies have reported decreased QOL in SCI patients which encompass all aspects of their life. Little is known about QOL in SCI veterans from Iran. The aim of this qualitative study was to identify related aspects of such patients through in-depth patient interviews. The present study was a qualitative study of content analysis. Sampling took place in the Veterans Department of Khatam-Al-Anbia Hospital and was objective focused in accordance with qualitative studies. The participants were 11 SCI veterans and 4 veteran spouses. The data was collected by means of in-depth interviews and the use of the constant comparison method. The five themes of QOL included social, economic, cultural, medical, and environmental resulted from 7530 primary codes. We noted 29 QOL sub-themes. This article addresses different dimensions of QOL for SCI veterans. The current study suggests that the main aspects that should be evaluated in SCI veterans are the social, economic, cultural, medical, and environmental issues which affect their QOL. Moreover, participants put the most weight on their financial situation. https://acta.tums.ac.ir/index.php/acta/article/view/5294 https://acta.tums.ac.ir/index.php/acta/article/download/5294/4723

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 12 2015 12 22 764 769 EN Manoochehr Mahram Department of Pediatrics, Children Growth Research Center, Qazvin University of Medical Science, Qazvin, Iran. Sonia Oveisi Department of Community of Medicine, Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran. Najmeh Jaberi School of Medicine, Qazvin University of Medical Science, Qazvin, Iran. 2015 12 21 Hyperbilirubinemia is a common problem in neonates and causes serious complications. Thus, serial measurements of bilirubin should be done. This assessment is done through two methods of laboratory measurement in serum sample and transcutaneous bilirubinometer. This descriptive study compared transcutaneous bilirubin assessment and laboratory serum bilirubin. Bilirubin level was assessed among 256 neonates admitted to the Qods Children’s Hospital in Qazvin- Iran, because of neonatal indirect jaundice, through two methods of transcutaneous bilirubinometery from two sites of forehead and sternum and laboratory measurement of bilirubin in serum. The cases were non-hemolytic icteric term neonates weighing 2500 gram or more and had not received phototherapy or other treatments. Neonates with hemolytic forms of jaundice, sepsis and suspicious to metabolic disorders were excluded. Assessments by means of KJ-8000 transcutaneous bilirubinometer from two sites of forehead and sternum and through laboratory measurement of serum bilirubin were registered and analyzed. The results of the current study showed that there was a correlation of 0.82 between serum bilirubin and transcutaneous forehead bilirubin assessment and for the used device sensitivity of 0.844; specificity of 0.842, Youden Index of 0.709 and Shortest of 0.042 for a cut-off of 12.4 in bilirubin of participants. Furthermore, Likelihood Ratio positive and negative (LR) were 5.665 and 0.164, respectively and diagnostic Odds Ratio (LR+/LR-) was 34.56. Transcutaneous bilirubinometery can be considered as a reliable tool to assess bilirubin for the screening of neonatal jaundice in term neonates. https://acta.tums.ac.ir/index.php/acta/article/view/5295 https://acta.tums.ac.ir/index.php/acta/article/download/5295/4724

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 12 2015 12 22 770 777 EN Mozhgan Moogooei Department of Immunology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. Masoud Shamaei Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Hossein Khorramdelazad Molecular Medicine Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. Shirin Fattahpour Department of Biochemistry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. Seyed Mohammad Seyedmehdi Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Maryam Moogooei Department of Immunology, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Gholamhossein Hassanshahi Molecular Medicine Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. Behjat Kalantari Khandani Department of Internal Medicine, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran. 2015 12 22 Chemokines are biologically active peptides involved in the pathogenesis of various pathologies including brain malignancies. They are amongst primitive regulators of the development of immune responses against malignant glial tumors. The present study aimed to examine the expression of CC chemokines in anaplastic astrocytoma and glioblastoma multiform patients at both mRNA and protein levels. Blood specimens in parallel with stereotactic biopsy specimens were obtained from 123 patients suffering from glial tumors and 100 healthy participants as a control. The serum levels of CCL2, CCL5, and CCL11 were measured by ELISA and stereotactic samples subjected to western and northern blotting methods for protein and mRNA, respectively. Demographic characteristics were also collected by a researcher-designed questionnaire. Results of the present study indicated that, however,CCL2 andCCL5 are elevated in serum and tumor tissues of patients suffering from a glial tumor at both mRNA and protein levels, theCCL11 was almost undetectable. According to the findings of the present investigation, it could presumably be reasonable to conclude that chemokines are good predictive molecules for expecting disease severity, metastasis, and response to treatment. https://acta.tums.ac.ir/index.php/acta/article/view/5296 https://acta.tums.ac.ir/index.php/acta/article/download/5296/4725

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 12 2015 of Emergency Medicine, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Jalili Department of Emergency Medicine, Center for Educational Research in Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran. Hamid R Baradaran Center for Educational Research in Medical Sciences, Iran University of Medical Sciences, Tehran, Iran. Parisa Eizadi Department of Emergency Medicine, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 To evaluate the effect of frequent feedback on residents' communication skills as measured by a standardized checklist. Five medical students were recruited in order to assess twelve emergency medicine residents' communication skills during a one-year period. Students employed a modified checklist based on Calgary-Cambridge observation guide. The checklist was designed by faculty members of Tehran University of Medical Science, used for assessment of students' communication skills. 24 items from 71 items of observational guide were selected, considering study setting and objects. Every two months an expert faculty, based on descriptive results of observation, gave structured feedback to each resident during a 15-minute private session. Total mean score for baseline observation standing at 20.58 was increased significantly to 28.75 after feedbacks. Results markedly improved on "gathering information" (T1=5.5, T6=8.33, P=0.001), "building relationship" (T1=1.5, T6=4.25, P<0.001) and "closing the session" (T1=0.75, T6=2.5, P=0.001) and it mildly dropped on "understanding patients view" (T1=3, T6=2.33, P=0.007) and "providing structure" (T1=4.17, T6=4.00, P=0.034). Changes in result of "initiating the session" and "explanation and planning" dimensions are not statically significant (P=0.159, P=0.415 respectively). Frequent feedback provided by faculty member can improve residents' communication skills. Feedback can affect communication skills educational programs, and it can be more effective if it is combined with other educational methods. https://acta.tums.ac.ir/index.php/acta/article/view/4576 https://acta.tums.ac.ir/index.php/acta/article/download/4576/4514

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 7 2014 07 15 562 564 EN Nasser Janmohammadi Department of Orthopedics, Mobility Impairment Research Center, Babol Medical Sciences Center, Babol, Iran. 2015 10 11 Numerous causes are reported for ulnar nerve compression at the wrist, known as Guyon's tunnel syndrome. In the present article, a patient with Guyon's tunnel syndrome during pregnancy concomitant with an anomaly of ulnar nerve is described. A 29-year-old Iranian woman presented with clinical features of Guyon's tunnel syndrome (pain and paresthesia in the fifth finger of the left hand and atrophy of the first dorsal interosseus muscle). Symptoms of the patient appeared during the third trimester of pregnancy. Electro diagnostic studies confirmed Guyon's tunnel syndrome. Surgical exploration revealed an anomalous arch of the ulnar nerve passing through the flexor carpi ulnaris (FCU) tendon. The anomalous arch of the ulnar nerve was released by resection of the segment of FCU tendon passing through the ulnar nerve arch. Therefore, in patients with Guyon's tunnel syndrome, the ulnar nerve anomaly should be kept in mind as a cause. Moreover, pregnancy may have a provocative effect on Guyon's tunnel syndrome similar to carpal tunnel syndrome (CTS). https://acta.tums.ac.ir/index.php/acta/article/view/4575 https://acta.tums.ac.ir/index.php/acta/article/download/4575/4515

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 7 2014 07 15 565 568 EN Hamid Reza Davari Department of Thoracic Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Sahar Latifi Department of Thoracic Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11