Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 3 2015 03 15 144 148 EN Mohammad Reza Ghaffary Tuberculosis and Lung Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Khalil Ansarin Tuberculosis and Lung Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Ebrahim Sakhinia Department of Genetics, Lung Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Ali Reza Khoramifar Tuberculosis and Lung Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 2015 10 11 Thrombophilia increases the incidence of pulmonary thrombosis significantly. Various hereditary and acquired factors are known for thromboembolism. The hereditary factors are two common genetic autosomal mutations including factor V leidan mutation and prothrombin gene mutation. A descriptive- analytical design was conducted on 60 patients with thromboembolism who met the inclusion criteria. Two groups with hereditary and acquired risk factors for thromboembolism (group A, B, each 30 people) were evaluated. All the patients of two groups were evaluated in terms of emboli associated with hereditary and acquired risk factors. Association of thromboembolism risk factors' with pulmonary hypertension were studied at the beginning of the study and six months after the treatment then the results of two groups were compared. Among participants, 31 (56.4%) were men.  The mean age of the patients was 44.4±14 years, ranging between 23-75 years. Significant association was observed between the stability of the blood clot in pulmonary vessel, six months after the treatment with genetic risk factors (P=0.03). However, no significant association was between pulmonary hypertension and hereditary and acquired risk factors (P=0.24). Based on the significant association between the hereditary risk factors and pulmonary emboli, by taking special prevention and therapy measurements (e.g. genetic engineering), some pulmonary and mortality complications can be prevented and the patient himself and health care system would benefit from this issue. https://acta.tums.ac.ir/index.php/acta/article/view/4919 https://acta.tums.ac.ir/index.php/acta/article/download/4919/4345

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 3 2015 03 15 149 157 EN Leila Farsi Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Maryam Naghib Zadeh Electrophysiology Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Khashayar Afshari Electrophysiology Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Abbas Norouzi-Javidan Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Mahsa Ghajarzadeh Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Zeinab Naghshband Electrophysiology Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Mansoor Keshavarz Electrophysiology Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Methylprednisolone (MP) has been widely used as a standard therapeutic agent for the treatment of spinal cord injury (SCI). Because of its controversial useful effects, the combination of MP and other pharmacological agents to enhance neuroprotective effects is desirable. Magnesium sulfate (MgSO4) has been shown to have neuroprotective and antihyperalgesic effects. In the present study, we sought to determine the effect of combining MP and MgSO4, on neuropathic pain and functional recovery following spinal cord injury (SCI) in male rats. A total of 48 adult male rats (weight 300-350 g) were used. After laminectomy, complete SCI was achieved by compression of the spinal cord for one minute with aneurysm clips. Single doses of Magnesium sulfate (MgSO4), (600 mg/kg), Methylprednisolone (MP), (30 mg/kg) or combining MgSO4 and MP were injected intraperitoneally. Prior to surgery and during four weeks of study Tail flick latency (TFL) and BBB (Basso-Beattie-Bresnahan) score and the acetone drop test were evaluated. In mean values of BBB score, a significant difference was observed in SCI+veh compared with other groups (P<0.05). Mean TFL also was significantly higher in SCI+veh compared with other groups (P<0.05). Mean acetone drop test score and weight were significantly different in MgSO4, MP and combining MgSO4 and MP  treated groups compared with SCI+veh group (P<0.05). These findings revealed that MP, MgSO4 and combining MgSO4 and MP treatment can attenuate neuropathic pains following SCI in rats include: thermal hyperalgesia and cold allodynia. They also can yield better improvement in motor function and decrease weight loss after SCI in rats compared with the control group. https://acta.tums.ac.ir/index.php/acta/article/view/4918 https://acta.tums.ac.ir/index.php/acta/article/download/4918/4347

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 3 2015 03 15 158 161 EN Ebrahim Espahbodi Department of Anesthesiology, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Sanatkar Department of Anesthesiology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Hossein Sadrossadat Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Esmaeel Darabi Vafsi Department of Anesthesiology, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mitra Azarshahin Department of Anesthesiology, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mehrdad Shoroughi Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Profound bradycardia during eye surgery is a potentially serious event. In clinical practice oculo-cardiac reflex (OCR) is most often encountered during squint surgery. The objective of this study was to assess the occurrence of OCR and prove the effect of ketamine as an induction drug and anticholinergic premedication (atropine) to prevent OCR. This study comprised 90 patients (aged 4-10 years) operated for squint surgery under general anesthesia. Patients were divided into three groups. Using block randomization, each patient enrolled in one of the three groups based on organized random table prepared by statistician. Group K received ketamine as an induction drug, Group A was premedicated with intravenous injection of atropine and Group C did not receive any premedication. Patients were monitored during operation for any bradycardia or dysrhythmias. The observed data showed occurrence of 63% OCR in Group C as compared to 43% in group A and only 20% in Group K. Current study showed that induction with ketamine in the patients of squint surgery under general anesthesia definitely obtunds OCR and prevents any untoward effects of dysrhythmias during eye surgery. https://acta.tums.ac.ir/index.php/acta/article/view/4917 https://acta.tums.ac.ir/index.php/acta/article/download/4917/4351

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 3 2015 03 15 162 167 EN Leila Javadi Department of Nutrition, Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Bahram Pourghassem Gargari Nutrition Research Center, Department of Biochemistry and Diet Therapy, School of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran. Shabnam Salekzamani Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran. Rana Yousefzadeh Department of Biology, Tabriz University of Medical Sciences, Tabriz, Iran. 2015 10 11 The association between Helicobacter pylori (HP) infection and concentration of folate or homocysteine are still unclear. The aim of the present study was to assess the effect of  HP infection on folate and homocysteine concentrations in patients infected with HP and healthy participants. We also assessed dietary intakes of folate, vitamins B6 and B12 in two groups. In this case-control study, 44 participants with HP-infection and 46 healthy controls were studied. Participants were recruited from those referred to the central laboratory of Tabriz University of Medical Sciences. Blood samples were collected to determine serum folate and homocysteine levels. The presence of both IgG and IgA in serum was considered as HP positive. Dietary intakes were assessed in all participants by 24-hour dietary recalls by trained interviewers for three days. The mean concentration of serum folate was significantly lower in HP-positive patients than in controls (8.49 nmol/L vs. 10.95 nmol/L, respectively; P=0.01). Although the mean concentration of serum homocysteine differed between groups, statistical significance was missed (HP infected patients: 9.35 µmol/L; healthy participants: 8.96 µmol/L; P=0.064). Macro- and micronutrient intakes showed no significant difference between participants with and without HP infection. In logistic regression models, there was a negative correlation between folate concentration and HP infection even after controlling for confounding factors (OR=0.82; CI95%=0.79-0.97). In this study, authors showed that a negative association presents between HP infection and serum  folate concentrations, but the homocysteine status was not differed significantly between HP-positive and HP-negative participants. https://acta.tums.ac.ir/index.php/acta/article/view/4916 https://acta.tums.ac.ir/index.php/acta/article/download/4916/4355

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 3 2015 03 15 168 172 EN Nahid Rahbar Research Center of Abnormal Uterine Bleeding and Semnan University of Medical Sciences, Semnan, Iran. Saeid Vali Zadeh Department of Virology and Bacteriology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran. Raheb Ghorbani Research Center for Social Determinates of Health, Semnan University of Medical Sciences, Semnan, Iran. Pegah Kheradmand Department of Medicine, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran. 2015 10 11 Human parvovirus B19 is a very common viral infection especially in school-aged children. The infection during pregnancy can affect the fetus due to lack of mother's immunity. Although, there is still no evidence of fetal teratogenic effects with parvovirus B19, but non-immune fetal hydrops and abortion may be caused by vertical transmission of the virus during pregnancy. This study was aimed to assess the prevalence of parvovirus B19-specific antibody (IgM) in pregnant women who had a spontaneous abortion. This cross-sectional study was carried out in all pregnant women who referred due to a spontaneous abortion. All demographic information such as age, occupation, and gestational age, last history of abortion, gravity, and presence of children below the age of six was recorded and a blood sample was provided for all the women. Then, the blood samples were tested to assay parvovirus B19-specific antibody (IgM) by EuroImmune ELISA kit. Among 94 pregnant women with the mean age of 28.4 years who had a spontaneous abortion, parvovirus B19 specific antibody (IgM) was detected in 17 participants (18.1%). Meanwhile, 14 women (14.9%) were suspected for presence of the antibody in their blood sample. There was no significant difference between the presence of antibody and age of pregnant women, occupation, gestational age, number of previous abortion, presence of children below the age of six and number of pregnancy. These findings revealed that a high percentage of pregnant women are probably non-immune against parvovirus B19, and also there might be a number of spontaneous abortions in which parvovirus infection caused fetal death.  However, more studies are needed to prove the absolute role of parvovirus B19 in these abortions. https://acta.tums.ac.ir/index.php/acta/article/view/4915 https://acta.tums.ac.ir/index.php/acta/article/download/4915/4357

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 3 2015 03 15 173 176 EN Mohammadhasan Namazi Department of Cardiology, Cardiovascular Research Center, Shahid Beheshti Univercity of Medical Sciences, Tehran, Iran. Morteza Safi Department of Cardiology, Shahid Modarres Hospital, Tehran, Iran. Hosein Vakili Department of Cardiology, Shahid Modarres Hospital, Tehran, Iran. Habibollah Saadat Department of Cardiology, Cardiovascular Research Center, Shahid Beheshti Univercity of Medical Sciences, Tehran, Iran. Saeed Alipour Department of Cardiology, Shahid Modarres Hospital, Tehran, Iran. Parsa Mahjoob Department of Cardiology, Shahid Modarres Hospital, Tehran, Iran. Maryam Taherkhani Department of Cardiology, Cardiovascular Research Center, Shahid Beheshti Univercity of Medical Sciences, Tehran, Iran. AND Department of Cardiology, Shahid Modarres Hospital, Tehran, Iran. Shamseddin Pedari Department of Cardiology, Shahid Modarres Hospital, Tehran, Iran. Mehrdad Taherion Department of Cardiology, Shahid Modarres Hospital, Tehran, Iran. Hasan Rajabi Moghaddam Department of Cardiology, Kashan University of Medical Sciences, Kashan, Iran . Abdolkarim Alhazifi Department of Cardiology, Shahid Modarres Hospital, Tehran, Iran. Masoume Vatanparast Deratment of Nursing, Shahid Modarres Hospital, Tehran, Iran. Saeed Khaligh Deratment of Nursing, Shahid Modarres Hospital, Tehran, Iran. 2015 10 11 Chronic total occlusion (CTO) intervention is still a challenging problem. The aim of this study is to determine factors that affect PCI results.The study was conducted on 72 patients in two centers. CTO angioplasty was done by the antegrade approach from the femoral and/or radial approach. The role of age, gender, anatomical variations such as calcification, length of the lesion, proximal bending, retrograde filling and occluded coronary artery (LAD, CCK or RCA) Sciences, Tehran, Iran. 2015 10 11 High prevalence of asthma and bronchospasm was observed during induction of anesthesia in patients with chronic suppurative otitis mMedia (CSOM) who underwent tympanomastoidectomy. Although several studies have proposed association of allergic diseases with CSOM but no consensus about it has been established. Current study was designed to determine the coincidence of asthma in CSOM patients. In a cross-sectional study, authors investigated medical records of 106 CSOM patients underwent tympanomastoidectomy, aged 15 to 65 years, and 95 controls, which were matched by age and sex. Participants were admitted to Valiasr Hospital, Tehran, Iran, from April of 2011 to March of 2013. Required information, such as demographic characteristics and history of allergic rhinitis (AR) and asthma were obtained from patients' medical records. The prevalence of AR in the CSOM group was higher than controls' group (19.8% and 15.8%, respectively) (P>0.05). Asthma prevalence was significantly higher in patients with CSOM (P=0.03) (OR=7.67, 95% CI:  0.9-62.5). No significant association was found between history of AR and chronic ear infections. However, asthma was significantly more common in CSOM patients. Current study indicates that asthma and risk of bronchospasm need particular attention in patients with CSOM underwent tympanomastoidectomy before and during anesthesia. https://acta.tums.ac.ir/index.php/acta/article/view/4508 https://acta.tums.ac.ir/index.php/acta/article/download/4508/4672

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 12 2014 12 15 909 915 EN Siavash Beiranvand Department of Anesthesiology, Shohadaye Ashayer Hospital, Lorestan University of Medical Sciences, Lorestan, Iran. Morteza Noparast Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Nasrin Eslamizade Department of Obstetrics and Gynecology, Asali Hospital, Lorestan, Iran. Saeed Saeedikia Department of Nursing, Tamin Ejtemaee Hospital, Lorestan, Iran. 2015 10 11 Spiritual elements play an important role in the recovery process from acute postoperative pain. This study was conducted to assess the effect of pray meditation on postoperative pain reduction and physiologic responds among muslim patients who underwent cesarean surgery under spinal anesthesia. This double-blinded randomized clinical trial study was conducted among muslim patients who underwent cesarean surgery under spinal anesthesia during 2011-2013 at tertiary regional and teaching hospital in Lorestan, Iran. The patients were randomly divided into interventional group (n=80) and control group (n=80). For about 20 minutes using a disposable phone mentioned and listened to pray meditation "Ya man esmoho davaa va zekroho shafa, Allahomma salle ala mohammad va ale mohammad" in interventional group and phone off in control group. Before and during pray meditation, 30, 60 minutes, 3 and 6 hours after pray meditation pain intensity, blood pressure, heart rate and respiratory rate were measured. No statistically significant improvement in pain score was found before and during pray meditation, 30, 60 minutes after pray meditation (P>0.05). Statistically significant improvement in pain score was found at 3 and 6 hours after pray meditation than control group (1.5 ± 0.3 vs. 3 ± 1.3, P=0.030) and (1.3 ± 0.8 vs. 3 ± 1.1, P=0.003). However, there was no significant difference in the physiological responses (systolic and diastolic blood pressure, respiration, and heart rate) any time between the groups. Religion and spirituality intervention such as pray meditation could be used as one of non-pharmacological pain management techniques for reducing pain after cesarean surgery. Also, Pray meditation provides less postoperative nausea and vomiting (PONV) and more relaxation. https://acta.tums.ac.ir/index.php/acta/article/view/4507 https://acta.tums.ac.ir/index.php/acta/article/download/4507/4673

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 12 2014 12 15 916 921 EN Alireza Abdollahi Department of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Saeed Shoar Development Association for Clinical Study (DACS), Student Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran. Mehrnaz Rasoulinejad Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Sara Sheikhbahaei Department of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Opportunistic infections are the leading cause of hospitalization and morbidity in human immunodeficiency virus (HIV) positive patients and are the most common cause of death between them. We aimed to measure IgG antibody against EBV viral capsid antigen (EBV-VCA IgG) to determine the seroprevalence of this infection in HIV-positive population. A case-control study between September 2011 and October 2012 was conducted in a teaching hospital enrolling 114 HIV-positive patients as case group and 114 healthy individuals as control with similar age and sex. Enzyme-linked immunosurbant assay (ELISA) technique was used for determination of EBV-VAC IgG in obtained samples. Of 114 serum samples obtained from HIV-positive patients, 103 (90.4%) samples were found positive for EBV-VCA IgG antibody. There was no significant difference in seroprevalence of EBV VCA IgG antibody between patients received antiretroviral therapy and naive patients (91.5% vs. 87.5%, P>0.05). There was no statistically significant difference in EBV-VCA IgG seroprevalence between three groups of CD4+ in HIV positive group. In conclusion current study showed that seroprevalence of EBV in HIV-positive patients is higher than HIV-negative healthy participants; however, administration of HAART and CD4+ lymphocyte count did not reveal a significant effect in seroprevalence of EBV. Due to the significance of this virus in mortality and morbidity and causing certain malignancies in patients with AIDS, these patients are strongly recommended to be tested for this virus. https://acta.tums.ac.ir/index.php/acta/article/view/4506 https://acta.tums.ac.ir/index.php/acta/article/download/4506/4674

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 12 2014 12 15 922 926 EN Shervin Farahmand Department of Emergency Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Seyed Mojtaba Aghili Department of Emergency Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Saharnaz Nedjat Department of Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Epidemiology, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran. Maryam Kia Department of Internal Medicine, Dr. Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran. Rokhsareh Aghili Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran. Behzad Elahi Toronto Western Research Institute, University of Toronto, Toronto, Canada. 2015 10 11 Emergency medicine is a relatively new specialty in Iran. Therefore, the general public and the medical community do not have enough information on its duties, capabilities, its nature, and its work schedule or its degree of occupational difficulty compared to other specialties. Hence, an insight from the early group of residents who selected this specialty can help identify the strengths and weaknesses of this field in order to promote the scientific quality of this field, and attract medical students. It can also help to alleviate deficiencies and strengthen positive aspects of emergency medicine. The aim of this study was to identify the reasons behind choosing emergency medicine as a specialty. A qualitative study was conducted using semi-structured interviews. Maximum variation opportunistic sampling was done, and face-to-face interviews were held with 23 emergency medicine residents and fellows (4 faculty members and 19 residents). Data were analyzed through thematic analysis, and categories and themes were extracted. The main levels extracted were: 1) Individual priorities, 2) the nature of work and the field of study, and 3) professional future. The themes of each main level were extracted and encoded. This study showed that the majority of residents choose emergency medicine specialty to achieve a better social and professional status in one of the most challenging fields of medicine. https://acta.tums.ac.ir/index.php/acta/article/view/4505 https://acta.tums.ac.ir/index.php/acta/article/download/4505/4675

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 12 2014 12 15 927 930 EN Mir Moussa Aghdashi Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran. Framarz Mosaffa Department of Anesthesiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Shahram Shokohi Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran. Rahman Abbasivash Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran. Ebrahim Hassani Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran. 2015 10 11 Injecting local anesthetic at the seeking current would be appealing.It would save time and avoid potentially dangerous manipulations of the needle. This study aimed to test the hypotheses that in vertical infraclavicular block, injecting local anesthetic at a seeking current of 0.8 mA would produce the same quality of block as injecting at ≤0.5mA. A total of sixty ASA I -III adult patients scheduled for elective surgery on the hand, wrist and forearm in two equal groups of 30 patients, were enrolled in this study. The technique described by Kilka & Geiger used in both groups. After eliciting a clear and visible motor response of all fingers in either extension or flexion, injection was performed at a current of 0.8 mA and ≤0.5 mA in study and control groups respectively. Duration of time to analgesia and to anesthesia was evaluated. The mean duration of onset of analgesia in radial, median and ulnar nerves in both groups, were similar. The onset of anesthesia took a mean of 13.5 minutes in the control group and 15.6 minutes in study group (P=0.064).  The onset of analgesia was 4.2 minutes in the control group and 4.3 minutes in study group. (P=0.508). The success rate in both groups was 100%. We had patients in both groups who developed complete anesthesia of the hand within 25 minutes. We conclude that the injection at 0.8 mA would result in a similar quality of block to one injected at ≤0.5 mA. The difference between two groups was not statistically significant. https://acta.tums.ac.ir/index.php/acta/article/view/4504 https://acta.tums.ac.ir/index.php/acta/article/download/4504/4676

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 12 2014 12 15 931 934 EN Seyed Hassan Emami-Razavi Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mahsa Ghajarzadeh Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. Sepehr Aziz School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Amirhossein Keyvan School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. S Adeleh Mirjafari Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. Faezeh Sodagari Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Carbon monoxide (CO) poisoning is still a health problem all over the world. Informing users about symptoms and suggesting annual inspection of CO producing devices will resu