Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 2 2015 02 15 78 88 EN Reza Karbasi-Afshar Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. AND 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. Morteza Izadi Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. 2015 10 11 Helicobacter pylori (H. pylori) is a spiral-shaped gram negative bacterium that naturally colonizes the human gastric epithelium. In recent years, large evidence has come to the literature strongly proposing causal link between H. pylori and extra gastric disorders. Cardiovascular system is one of the extra gastric organs that can be affected by H. pylori infection. The first evidence suggestive of such an association comes from seroepidemiological evaluations, but histopathological and eradication studies have strongly confirmed existence of a causal association between H. pylori infection and cardiovascular events. https://acta.tums.ac.ir/index.php/acta/article/view/4931 https://acta.tums.ac.ir/index.php/acta/article/download/4931/4309

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 2 2015 02 15 89 96 EN Masoumeh Emamghoreishi Department of Pharmacology, School of Medicine, Shiraz University of Medical Sciences, Fars, Iran. AND Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Fars, Iran. AND Psychiatric Research Centre, School of Medicine, Shiraz University of Medical Sciences, Fars, Iran. Mojtaba Keshavarz Department of Pharmacology, School of Medicine, Shiraz University of Medical Sciences, Fars, Iran. Ali Akbar Nekooeian Department of Pharmacology, School of Medicine, Shiraz University of Medical Sciences, Fars, Iran. 2015 10 11 S100ß a neurotrophic factor mainly released by astrocytes, has been implicated in the pathogenesis of bipolar disorder. Thus, lithium may exert its neuroprotective effects to some extent through S100ß. Furthermore, the possible effects of lithium on astrocytes as well as on interactions between neurons and astrocytes as a part of its mechanisms of actions are unknown. This study was undertaken to determine the effect of lithium on S100β in neurons, astrocytes and a mixture of neurons and astrocytes. Rat primary astrocyte, neuronal and mixed neuro-astroglia cultures were prepared from cortices of 18-day's embryos. Cell cultures were exposed to lithium (1mM) or vehicle for 1day (acute) or 7 days (chronic). RT-PCR and ELISA determined S100β mRNA and intra- and extracellular protein levels. Chronic lithium treatment significantly increased intracellular S100β in neuronal and neuro-astroglia cultures in comparison to control cultures (P<0.05). Acute and chronic lithium treatments exerted no significant effects on intracellular S100β protein levels in astrocytes, and extracellular S100β protein levels in three studied cultures as compared to control cultures. Acute and chronic lithium treatments did not significantly alter S100β mRNA levels in three studied cultures, compared to control cultures. Chronic lithium treatment increased intracellular S100ß protein levels in a cell-type specific manner which may favor its neuroprotective action. The findings of this study suggest that lithium may exert its neuroprotective action, at least partly, by increasing neuronal S100ß level, with no effect on astrocytes or interaction between neurons and astrocytes. https://acta.tums.ac.ir/index.php/acta/article/view/4930 https://acta.tums.ac.ir/index.php/acta/article/download/4930/4310

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 2 2015 02 15 97 103 EN Masoomeh Mirzamoradi Department of Prenatology, Mahdieh Hospital, Infertility and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zahra Heidar Department of Infertility, Mahdieh Hospital, Infertility and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Ziba Faalpoor Department of Gynecology, Mahdieh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zahra Naeiji Department of Gynecology, Mahdieh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Razyeh Jamali Department of Medicine, School of Medicine, Shahed University of Medical Sciences, Tehran, Iran. 2015 10 11 Insulin is currently the drug of choice in treating patients with gestational diabetes mellitus but insulin is expensive, inconvenient to store and use and probably associated with more risks of asymptomatic hypoglycemia in comparison with some oral agents. This randomized clinical trial was conducted to evaluate the efficacy and safety of glyburide in patients with gestational diabetes mellitus in comparison with insulin therapy. Pregnant women aged between 18-45 years with singleton pregnancies and in their 24-36 weeks of gestation were assessed for eligibility. Women with gestational diabetes mellitus were randomly allocated to two insulin and glyburide groups and compared with maternal and neonatal outcome. Ninety-six women with gestational diabetes mellitus enrolled in the study. At screen and treated fasting and post-prandial blood glucose levels were similar in both groups. Time for beginning the treatment to control the glycemic index was 28.30 (±20.60) days in the insulin group and 22.56 (±18.86) in the glyburide group. There was no statistically significant difference in time-to-control the blood glucose level in two studied group. Time, between beginning the treatment of GDM and delivery, was 53.22 (±28.96) days in the insulin group and 56.67 (±30.47) in the glyburide group. There was no statistically significant difference between the times of treatment-to-delivery in two studied groups. There were no statistically significant differences between maternal and neonatal outcomes in two studied groups. Glyburide can effectively and safely control the glycemic index in women with gestational diabetes mellitus in comparison with insulin. https://acta.tums.ac.ir/index.php/acta/article/view/4929 https://acta.tums.ac.ir/index.php/acta/article/download/4929/4312

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 2 2015 02 15 104 111 EN Abbas Ghiasi Department of Anesthaesiology and Critical Care, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Akbar Shafiee Department of Cardiovascular Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Abbas Salehi Omran Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Neda Ghaffari-Marandi Department of Cardiovascular Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mahmood Shirzad Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Khosro Barkhordari Department of Cardiovascular Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 This trial was performed to determine if a continuous low-dose infusion of methylprednisolone is as effective as its bolus of high-dose in reducing inflammatory response. The study was single-center, double-blinded randomized clinical trial and performed in a surgical intensive care unit of an academic hospital. In this study, 72 consecutive patients undergoing elective coronary artery bypass grafting (CABG) were assigned to receive either a methylprednisolone loading dose (1mg/kg) followed by continuous infusion (2mg/Kg/24 hours for 1 day) (low-dose regime) or a single dose of methylprednisolone (15 mg/kg) before cardiopulmonary bypass (high dose regime). Serum concentrations of IL-6 and C- reactive protein (CRP) were measured preoperatively and 6, 24 and 48 hours after surgery, and serum creatinine was measured before the operation and 24, 48 and 72 hours postoperatively. The measurements were then compared between the groups to evaluate the efficacy of each regimen. The basic characteristics and measurements were not different between the study groups. There was no significant difference in IL-6 and CRP elevation (P=0.52 and P=0.46, respectively). Early outcomes such as the length of stay in the intensive care unit, intubation time, changes in serum creatinine and blood glucose levels, inotropic support, insulin requirements, and rate of infection were also similar in both groups. A continuous low dose infusion of methylprednisolone was as effective as a single high dose methylprednisolone in reducing the inflammatory response after CABG with extracorporeal circulation with no significant difference in the postoperative measurements and outcomes. https://acta.tums.ac.ir/index.php/acta/article/view/4928 https://acta.tums.ac.ir/index.php/acta/article/download/4928/4313

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 2 2015 02 15 112 116 EN Fatemeh Kazemi Safa Department of Health Sciences, School of Health, Kermanshah University of Medical Science, Kermanshah, Iran Gholamreza Shahsavari Department of Biochemistry, School of Medicine, Lorestan University of Medical Science, Khorramabad, Iran Arezou Miraftabi Department of Ophthalmology, School of Medicine, Tehran University of Medical Science, Tehran, Iran 2015 10 11 Glutathione S-transferases (GSTs) are members of multigenic family which have the essential functionin cells as an antioxidant. In the present study we studied the polymorphism of GSTT1 and GSTM1 deletion genotypes in Iranian patients with primary closed angle glaucoma (PCAG) compared to healthy subjects. We conducted a study of 41 PCAG patients (24 women, 17 men) and 100 healthy participants (57 women, 43 men) to determine the prevalence of GSTT1 and GSTM1 deletion genotypes and the risk of PCAG, which were determined by multiplex polymerase chain reaction. Genotypes of GSTM1 and GSTT1 null deletions were determined in 22 (53.7%) and 7 (17.1%) patients with PCAG and 34 (34%) and 15 (15%) in healthy participants. Comparison of patients and healthy ones regarding GSTM1 and GSTT1 genotypes revealed increase of GSTM1 null deletions genotypes’ in patients with PCAG (P=0.03). It was concluded that the increased frequencies of GSTM1 null in patients with PCAG could be associated with a risk factor for incidence of PCAG in the Iranian population. https://acta.tums.ac.ir/index.php/acta/article/view/4927 https://acta.tums.ac.ir/index.php/acta/article/download/4927/4314

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 2 2015 02 15 117 121 EN Javad Eftekhari Department of Anesthesiology, Tizro Surgical Center, Urmia, Iran. Behzad Kazemi Haki Department of Anesthesiology, Tizro Surgical Center, Urmia, Iran. Parasto Tizro Department of Medicine, Tizro Surgical Center, Urmia, Iran. Vahid Alizadeh Department of Anesthesiology, Tizro Surgical Center, Urmia, Iran. 2015 10 11 Laryngeal mask is a supraglothic instrument for ventilation of patients who are under anesthesia. Insertion of laryngeal mask requires maintaining sufficient depth of anesthesia to avoid airway reflex (gagging, coughing and spasms). The present study investigated two techniques of anesthesia with propofol-atracurium and thiopental-atracurium to facilitate insertion of the laryngeal mask, term of recovery and postoperative nausea and vomiting. In this prospective, randomized and double-blinded clinical trial, 224 patients undergoing elective laparoscopic class ASA one and two were studied.  Patients were divided into two groups of 112 patients - one group with propofol anesthetic and thiopental-atracurium. Then after the induction of anesthesia neuromuscular hemodynamic changes, airway reflex (gagging, coughing and spasms), the ease of insertion of laryngeal mask and the frequency of patient movements' were recorded. The data were analyzed by SPSS V.18. Results indicated that anesthetic technique with propofol-atracurium provides better and more comfortable condition for insertion of laryngeal mask significantly (P<0.05). Hemodynamic changes during induction of anesthesia and five minutes after insertion of the laryngeal mask in first group was more than second one (P<0.05),  and nausea and vomiting during recovery in propofol group was significantly lower than  thiopental group (P<0.05). Using techniques of anesthesia with propofol - atracurium in inserting laryngeal mask airway in patients who have an indication for the use of this technique is better than anesthesia with thiopental -atracurium. https://acta.tums.ac.ir/index.php/acta/article/view/4926 https://acta.tums.ac.ir/index.php/acta/article/download/4926/4317

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 2 2015 02 15 122 124 EN Abbas Shapouri Moghadam Department of Immunology, Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Mohammad Safarian Department of Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran. Rahim Vakili Department of Pediatrics Endocrinology and Metabolism, Mashhad University of Medical Sciences, Mashhad, Iran. Seyed Morteza Ehteshamfar Department of Immunology, Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 2015 10 11 Socioeconomic basis of children obesity is of high importance for preventive policies. This study aimed to compare the prevalence of obesity among children living in two different levels of welfare regions in Mashhad northeast of Iran. A total of 625 primary school girls and boys aged 78-127 months were randomly selected, and values of their body mass index (BMI) were measured. The prevalence of both overweight and obesity were higher among students of enriched area in comparison with that of resource restricted (P<0.05).The prevalence of overweight concerns in urban and rural areas. These results highlight the relation between socio-economic status and prevalence of obesity among children. https://acta.tums.ac.ir/index.php/acta/article/view/4925 https://acta.tums.ac.ir/index.php/acta/article/download/4925/4318

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 2 2015 02 15 633 637 EN Ghazaleh Eslamian Student Research Committee, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Kevan Jacobson Divisions of Gastroenterology, Department of Pediatrics, British Columbia Institute for Children's and Women's Health, University of British Columbia, Vancouver, British Columbia, Canada. Azita Hekmatdoost Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2015 10 11 Despite the increased emphasis on chronic non-communicable diseases, there are notable deficits about nutrition education in many medicine training programs particularly gastroenterology fellowship programs. In the present cross-sectional study, we examined the nutritional knowledge related to clinical nutrition among Iranian gastroenterology fellows. Thirty-six gastroenterology fellows currently enrolled in a gastroenterology fellowship program completed a questionnaire, including two sections. The first of which assessed the gastroenterology fellows experience about nutrition training, nutrition management of patients with gastrointestinal (GI) disorders and evaluating perceived nutrition education needs. The second section consisted of multiple choice questions that assessed nutritional knowledge. A total of 32 gastroenterology fellows completed the first section. The majority of gastroenterology fellows failed to partake in any nutrition education during their fellowship training particularly for inpatients despite the availability to participate in the nutrition training especially for the purpose of nutrition support. Mean correct response rates for the second section was 38%. The highest mean score was seen in nutrition assessment (48.1%), followed by scores of 40.5% in nutrition support, 37.0% nutrition in GI disease, and 25.0% in micro and macronutrients. Iranian gastroenterology fellows have serious deficits in their nutrition knowledge. This study paves the way for the development of an education program to improve nutritional knowledge of gastroenterology fellows. https://acta.tums.ac.ir/index.php/acta/article/view/4362 https://acta.tums.ac.ir/index.php/acta/article/download/4362/4373

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 9 2013 09 15 638 641 EN Mehrdad Hasibi Department of Infectious Diseases, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran. Nasrin Yazdani Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran. Marjan Asadollahi Department of Neurology, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mohammad Sharafi Department of Infectious Diseases, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran. Seyed Ali Dehghan Manshadi Department of Infectious Diseases, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Tuberculosis is a major health problem in Iran and its laryngeal involvement is not uncommon. Laryngeal tuberculosis is so infectious and delay in diagnosis and treatment could result spread of disease and causes divesting complications. We reviewed clinical and para-clinical characteristics of patients with laryngeal tuberculosis in Iran. In a cross sectional study, patients with laryngeal tuberculosis were studied and followed. All patients admitted from May 2000 to Dec 2011 in Amir-Alam hospital, a referral center for laryngeal diseases in Tehran. We studied 19 cases of laryngeal tuberculosis with typical histopathology (chronic granulomatous inflammation with caseous necrosis and langhans-type giant cells) and 6 cases of laryngeal tuberculosis with atypical histopathology (chronic granulomatous inflammation or chronic inflammation without necrosis). They had laryngeal symptoms and signs from 2 to 12 months before definitive diagnosis. Macroscopic appearances of laryngeal lesions were exophytic in 11 cases and ulcerative in 14 cases. True vocal cords were involved in 22 cases. The primary clinical diagnosis was malignancy in 17 cases, tuberculosis in 5 cases, and nonspecific inflammation in 3 cases. The chest x-ray findings were compatible with tuberculosis in 14 patients. The response to anti-tuberculosis therapy was desirable in all patients. In endemic area, tuberculosis should be considered as an important diagnosis in patients with laryngeal lesions even when histopathology of laryngeal lesions is not typical. Association with pulmonary tuberculosis helps for diagnosis. https://acta.tums.ac.ir/index.php/acta/article/view/4361 https://acta.tums.ac.ir/index.php/acta/article/download/4361/4377

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 9 2013 09 15 642 651 EN Mostafa Hosseini Department of Epidemiology and Biostatistics, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran. Mahmoud Yousefifard Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Shervin Taslimi Department of Epidemiology and Biostatistics, School of Public Health and Institute of Public Health Research,m Tehran University of Medical Sciences, Tehran, Iran. Hamid Sohanaki Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Keramat Nourijelyani Department of Epidemiology and Biostatistics, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran. Fereshteh Asgari Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran. Koorosh Etemad Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran. Jalil Koohpayehzadeh Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran. AND Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran. Hamid Heidarian Miri Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran. Ali Rafei Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran. Mohammad Mehdi Gouya Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran. Kazem Mohammad Department of Epidemiology and Biostatistics, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Trends in cholesterol level of different populations have been investigated in several studies. This study is conducted to determine the trend of cholesterol level of Iranian adults from 1990 to 2007. Data on cholesterol measurements of four national health surveys that have been carried out in Iran used in this study. Cholesterol level of 12728 adults aged 25-64 were measured in 1990-1 survey. Also in 1999, 2005, and 2007 surveys, blood cholesterol level of 18398, 52344 and 19630 have been sampled, respectively. The median of cholesterol were modeled with age for men and women separately for the four surveys using fractional polynomials. Then, trends in the median of cholesterol across these four surveys were studied. The analysis of cholesterol data over four national health surveys showed that the change in males' cholesterol level had a decreasing trend. This decreasing trend was more pronounced in ages younger than 45 years. However, the medians of cholesterol of females during 16 years of four national surveys had a varying trend. It was decreasing in ages younger than 45; but increasing in ages over 45 years. The median of the cholesterol level of males and females in 2005 survey was on average about 10 mg/dl higher in comparison with the other surveys. Our findings showed that the pattern of trend in cholesterol level of Iranian men and women adults have a considerable difference with those of the other developing and developed countries. https://acta.tums.ac.ir/index.php/acta/article/view/4360 https://acta.tums.ac.ir/index.php/acta/article/download/4360/4381

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 9 2013 09 15 652 654 EN Fereshteh Fakor Reproductive Health Research Center, Department of Gynecology and Oncology, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran. Hadi Hajizadeh Falah Department of Pathology, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran. Sina Khajeh Jahromi Student Research Committee, Guilan University of Medical Sciences, Rasht, Iran. 2015 10 11 Endometrial cancer generally carries a good prognosis. Endom