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)tases were evaluated. The 5 -year survival probability of patients was 28 %, and median survival time was 25.69 months. Univariate tests showed that sex, cancer site, and pathologic type have no significant effects on patient’s survival. But the probability of 5-year survival significantly decreases with increasing age, and as it is expected, those with metastases were significantly less likely to have 5-year survival, and disease stage was significantly effective on patients’ life (P<0.001). Simultaneous evaluation of different variables’ effects on the probability of survival using the multiple Cox proportional hazards models showed that age and stage disease variables were effective on the survival of patients. The 5-year survival of patients with gastric cancer is low in Iran, although it is improved compared to the past. It seems that one of the main reasons for low survival rate of these patients is a late referral of patients for diagnosis and treatment. Most patients refer in the final stages of the disease, at this stage most patients are affected by lymph nodes metastases, liver and as the result, their treatment will be more difficult. https://acta.tums.ac.ir/index.php/acta/article/view/5115 https://acta.tums.ac.ir/index.php/acta/article/download/5115/4752

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 2 2016 03 12 119 123 EN Singh Brijendra Department of Anatomy, Jodhpur Medical College, India. Gupta Renu Department of Anatomy, Jodhpur Medical College, India. Agrawal Dushyant Department of Anatomy, Jodhpur Medical College, India. Garg Rajneesh Department of Orthopeadics, Jodhpur Medical College, Hamdard Institute of Medical Sciences & Research New Delhi, India. Katri Sunil Saraswati Hospital, Jodhpur, Rajiv Gandhi Super Speciality Hospital Tahirpur, New Delhi, India. 2016 03 09 Various dermatoglyphic parameters like finger print pattern, atd angle, absolute ridge count & ab, bc ,cd, and ad ridge counts were observed in 150 cases of congenital cardiac disease, comprising of 72 cases of Ventricular Septal Defects (VSD), 60 cases of Atrial Septal Defects (ASD), 9 cases of Coarctation of Aorta (COA) & 9 cases of Tetralogy of Fallot’s (TOF). Same dermatoglyphic parameters were also studied in 300 controls and statistical comparison of cases and controls was done. In our study it was observed that the congenital cardiac disease cases exhibited preponderance of whorls (55.8%) with decrease in loop pattern (36.2%) as compared to those of controls and the difference was highly significant (P<0.001). The difference in the mean total finger ridge count (TFRC) of the controls and of the cases of Congenital Cardiac Diseases (CCD) was found to be highly significant (P<0.001), while the  mean atd angle in the cases of Congenital Cardiac Disease (CCD) was widen up and was statistically significant too. The mean ab, the mean bc ridge, the mean cd ridge and the mean ad ridge counts were also higher in the various type of CCD as compared to that controls and on statistical comparison, the difference was found to be highly significant. https://acta.tums.ac.ir/index.php/acta/article/view/5497 https://acta.tums.ac.ir/index.php/acta/article/download/5497/4753

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 2 2016 03 12 124 133 EN Amin Torabipour Department of Health Services Management, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. AND Department of Health Economics & Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Arab Department of Health Economics & Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Hojjat Zeraati Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Arash Rashidian Department of Health Economics & Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Ali Akbari Sari Department of Health Economics & Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mahmuod Reza Sarzaiem Department of Cardiac Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2016 03 09 Length of hospital stay (LOS) is a key indicator for hospital management. Reducing hospital stay is a priority for all health systems. We aimed to determine the length of hospital stay following Coronary Artery Bypass Surgery (CABG) based on its clinical and non-clinical factors. A cross-sectional study of 649 consecutive patients who underwent coronary artery bypass graft surgery was conducted in Imam Khomeini and Shariati university hospitals, Tehran, Iran. Data was analyzed by using non-parametric univariate tests and multiple linier regression models. Thirty seven independent variables including pre-operative, intra-operative and post-operative variables were analyzed. Finally, an appropriate model was constructed based on the associated factors. The results showed that 70.3% of the patients were male, and the mean age of the patients was 59.3 ± 10.4 years. The Mean (±SD) and median of the LOS were 11.7 ± 7.1 and 9 days, respectively. Of 37 investigated variables, 24 qualitative and quantitative variables were significantly associated with length of stay (p<0.05). Multiple linear regression analysis showed that independent variables including age, medical insurance type, body mass index, and prior myocardial infarction; admission day, admission season, Cross-clamp time, pump usage, admission type, the number of laboratory tests and the number of specialty consultation had more effect on the hospital stay. We concluded that some significant factors influencing hospital stay after CABG were predictable and modifiable by hospital managers and decision makers to manage hospital beds. https://acta.tums.ac.ir/index.php/acta/article/view/5498 https://acta.tums.ac.ir/index.php/acta/article/download/5498/4754

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 2 2016 03 12 134 139 EN Seyedeh Hajar Shahrami Department of Obstetrics and Gynecology, Reproductive Health Research Center, Guilan University of Medical Sciences, Iran. Zahra Abbasi Ranjbar Department of Endocrinology and Metabolism, Reproductive Health Research Center, Guilan University of Medical Sciences, Iran Forozan Milani Department of Obstetrics and Gynecology, Reproductive Health Research Center, Guilan University of Medical Sciences, Iran. Ehsan Kezem-Nejad Department of Statistically, Guilan University of Medical Sciences, Iran. Afagh Hassanzadeh Rad Pediatric Growth Disorders Research Center, Guilan University of Medical Sciences, Iran. Seyedeh Fatemeh Dalil Heirat Reproductive Health Research Center, Guilan University of Medical Sciences, Iran. 2016 03 09 Critical issue regarding to variation of findings based on different phenotypes led investigators to define whether they are distinct features or overlapping ones. Therefore, we aimed to investigate the association between diverse phenotypes of PCOS (Poly Cystic Ovary Syndrome) with clinical manifestations, anthropometric indices, and metabolic characteristics. This was a descriptive cross-sectional study conducted in 15-39 years old women with PCOS referred to infertility clinics in the north part of Iran, Rasht during 2010-2011. Data were gathered through an interview by a form consisted of demographic characteristics, laboratory findings, ovarian volume and anthropometric indices. A total of 214 patients consisted of 161 PCOS (cases) and 53 normal women (controls) participated in this study. The most prevalent phenotype in PCOS population was IM/PCO/HA (54%), followed by IM/HA (28%) and IM/PCO (13%). PCO/HA was present only in 6 PCOS patients (5%). PCOS patients were significantly younger than controls (P=0.07). Results showed that increased ovarian volume were higher in PCOS group in comparison with controls and IM/PCO/HA, and IM/PCO had respectively the largest ovarian volumes. Also, a significant relation was observed based on Cholesterol, 17OHP, LH, TG, 2hpp, and LH/FSH between patients with PCOS and control groups. There were significant differences in demographic, anthropometric, hormonal and ultrasound findings between PCOS and controls. Therefore, it seems that classification of the characteristics of each phenotype could offer an appropriate guide for screening risks of PCOS and may facilitate performing most favorable treatment for these complications. https://acta.tums.ac.ir/index.php/acta/article/view/5499 https://acta.tums.ac.ir/index.php/acta/article/download/5499/4755

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 2 2016 03 12 140 145 EN Simin Mahdikhani Pharmaceutical Care Center (Related to Food and Drug Department), Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran. AND Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran. Fatemeh Dabaghzadeh Pharmaceutical Care Center (Related to Food and Drug Department), Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran. AND Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran. 2016 03 09 This study was performed to assess the incidence of medication errors and irrational use of human albumin in two wards of our hospital and also aimed to evaluate the ability of pharmaceutical care center and pharmacists in improving patient care. Albumin administration was evaluated for patients who received albumin during the study period, in gastroenterology and general surgery wards. The indications for Albumin administration were evaluated on the basis of reliable guidelines. The prescribing errors were simultaneously evaluated by reviewing patients’ medical records. Prescribing errors were defined as selecting improper drug (based on indications, contraindications, known allergies, drug-class duplications and drug-drug interactions), dose, dosage form, and route of administration. It was found that 465 containers of human albumin solution 20 % were used for 54 patients treated in gastroenterology and general surgery wards of our hospital. A total of 306 (65.81%) vials of the albumin administrations were in concordance with the reliable protocol. The cost of irrational use of this drug (159 vials) for patients is equivalent to $ 8215. From 609 reviewed cases, 81 prescribing errors were detected in 64 patients. This study showed that the pharmacists were effective in identifying irrational drug use and medication errors. https://acta.tums.ac.ir/index.php/acta/article/view/5500 https://acta.tums.ac.ir/index.php/acta/article/download/5500/4756

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 2 2016 03 12 146 150 EN Hamid Rajebi Department of Radiology, SUNY Upstate Medical University, Syracuse, NY, USA. Ahmad Khodadad Department of Gastroenterology, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Golshan Fahimi School of Medicine, Urmia University of Medical Sciences, Urmia, Iran. Hassan Abolhassani Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 15 2016 01 18 Vitamin D deficiency is one of the most preventable challenges worldwide. The aim of this study was to determine the prevalence of vitamin D deficiency among female nurses working at Children’s Medical Center Hospital in Tehran, Iran, due to the risk factor of being a notably long period indoors and the fact that their health status may have consequences on the process of patients’ treatment. A total of 114 female nurses who were at least 20 years old entered the study voluntarily, and a questionnaire was applied to collect information on lifestyle and other factors associated with vitamin D deficiency. A sample of blood was taken to measure 25-hydroxyvitamin D (25-OHD) and cut off value to indicate deficiency was considered below 10ng/ml, and the amounts of 10-29ng/ml were declared insufficient. The mean of 25-OHD was 11.7±9.3ng/ml. A total of 79 subjects (69.3%) had a deficient level of vitamin D, 28 subjects (24.6%) had an insufficient level and only 7 subjects (6.1%) had sufficient level of vitamin D. The deficiency was more noticeable in the age group of 26-