Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 12 2015 10 21 782 784 EN Asieh Mosallanejad Imam Hossein Medical Center, Shahid Beheshti University of Medical Science, Tehran, Iran. Fatemeh Sayarifard Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran. Sima Hosseinverdi Molecular Immunology Research Center, Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Farzaneh Abbasi Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran. Hosein Shabni Mirzaee Department of Pediatric Endocrinology, Bahrami Hospital, Tehran University of Medical Sciences,Tehran, Iran. Nima Rezaei Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medicl Sciences, Tehran, Iran. AND Universal Scientific Education and Research Network (USERN), Tehran, Iran. 2015 10 21 There is a number of syndromes, associated with proptosis, micrognathia, low-set ear and chest deformity. Herein, we report a 9-year-old female with such phenotype who was presented with a vaginal neuroma. The result of karyotype showed 47XX, with extra marker chromosome 22. Although such a manifestation had not been reported in the literature, it should be considered as a very rare manifestation of the disease. https://acta.tums.ac.ir/index.php/acta/article/view/5027 https://acta.tums.ac.ir/index.php/acta/article/download/5027/4694

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 12 2015 12 22 733 737 EN Seyed Mojtaba Marashi Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Seyed Mostafa Saeedinia Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mostafa Sadeghi Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ali Movafegh Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Shaqayeq Marashi Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 12 21 A varieties of medications have been suggested to prevent hemodynamic instabilities following laryngoscopy and endotracheal intubation. This study was conducted to determine the beneficial effects of gabapentin on preventing hemodynamic instabilities associated with intubation in patients who were a candidate for coronary artery bypass surgery (CABG). This double blinded randomized, parallel group clinical trial was carried out on 58 normotensive patients scheduled for elective CABG under general anesthesia with endotracheal intubation in Shariati Hospital. Patients were randomly allocated to two groups of 29 patients that received 1200 mg of gabapentin in two dosages (600 mg, 8 hours before anesthesia induction and 600 mg, 2 hours before anesthesia induction) as gabapentin group or received talc powder as placebo (placebo group). Heart rate, mean arterial pressure, systolic and diastolic blood pressure were measured immediately before intubation, during intubation, immediately after intubation, 1 and 2 minutes after tracheal intubation. Inter-group comparisons significantly showed higher systolic and diastolic blood pressure, mean arterial pressure and heart rate immediately before intubation, during intubation, immediately after intubation, 1 and 2 minutes after tracheal intubation in the placebo group in comparison to gabapentin group. The median of anxiety  verbal analog scale (VAS) at the pre-induction room in gabapentin and placebo groups were 2 and 4,  respectively that was significantly lower in the former group (P. value =0.04 ); however, regarding median of pain score no difference was observed between them (P. value =0.07). Gabapentin (1200mg) given preoperatively can effectively attenuate the hemodynamic response to laryngoscopy, intubation and also reduce preoperative related anxiety in patients who were a candidate for CABG. https://acta.tums.ac.ir/index.php/acta/article/view/5289 https://acta.tums.ac.ir/index.php/acta/article/download/5289/4720

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 12 2015 12 22 785 788 EN Mahsa Ansari Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Farid Azmoodeh Ardalan Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Masoumeh Najafi Department of Surgery, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Azadeh Goodarzi Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Alireza Ghanadan Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Dermatopathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 12 22 Primary cutaneous anaplastic large cell lymphoma is a T-cell malignancy with atypical CD30 positive lymphocytes. Pseudoepitheliomatous hyperplasia is an uncommon finding in primary cutaneous anaplastic large cell lymphoma, and may mimic squamous cell carcinoma as pseudomalignancy. Careful attention of a pathologist to correct diagnosis of pseudoepitheliomatous hyperplasia and its underlying causes will help physicians to avoid inappropriate management. Here, we present a 22-year-old man referred to our hospital with a solitary nodule persistent on his forearm which was diagnosed as squamous cell carcinoma in the first biopsy. The lesion recurred after two months and histopathologic and immunohistochemistry examination revealed anaplastic large cell lymphoma with florid pseudoepitheliomatous hyperplasia which masquerading as well-differentiated squamous cell carcinoma. Diagnosis of pseudoepitheliomatous hyperplasia must guide the pathologist to search for underlying causes, such as primary cutaneous lymphoma. Pseudoepitheliomatous hyperplasia may mimic squamous cell carcinoma and this can result in inappropriate diagnosis and management. https://acta.tums.ac.ir/index.php/acta/article/view/5299 https://acta.tums.ac.ir/index.php/acta/article/download/5299/4727

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 12 2015 12 22 738 742 EN Koorosh Ahmadi Department of Emergency Medicine, Alborz University of Medical Sciences, Karaj, Iran. Mohsen Ebrahimi Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Amir Masoud Hashemian Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Saeed Sarshar Department of Emergency Medicine, Khorramabad University of Medical Sciences, Khorramabad, Iran. Vafa Rahimi-Movaghar Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 12 21 Macintosh direct laryngoscope has been the most widely used device for tracheal intubation. GlideScope video laryngoscope (GVL) has been recently introduced as an alternative device for performing intubation; however, its validity in emergency settings has not been thoroughly evaluated. The aim of this study was to compare Macintosh direct laryngoscope versus GVL for emergency endotracheal intubation. This quasi-randomized clinical trial was performed on 97 patients referred to Imam Reza Hospital whom all needed emergency intubation in 2011. Patients were divided into two groups of the easy airway and difficult airway; intubation was performed for patients with direct laryngoscopy or GVL. Then, the patients were evaluated in terms of demographic characteristics, successful intubation rate and intubation time. Data was analyzed by SPSS software 16. There was no significant difference in demographic characteristics of the patients in both easy airway and difficult airway groups who intubated with direct laryngoscopy and GVL methods (P>0.05). In difficult airway group, a significant difference was found in successful intubation at the first attempt (60.9% vs. 87.5%; P=0.036), overall intubation time (32.7 ± 14.58 vs. 22.5±7.88; P<0.001) and first attempt intubation time (28.43 ± 12.51 vs. 21.48±7.8; P=0.001) between direct laryngoscopy and GVL. These variables were not significantly different between two methods in easy airway group. According to the results, GVL can be a useful alternative to direct laryngoscopy in emergency situations and especially in cases with a difficult airway. https://acta.tums.ac.ir/index.php/acta/article/view/5290 https://acta.tums.ac.ir/index.php/acta/article/download/5290/4721

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 12 2015 10 20 789 792 EN Vitorino Modesto dos Santos Department of Internal Medicine, Armed Forces Hospital and Catholic University, Brasília-DF, Brazil . Christiane Aires Teixeira Department of Pneumology, Armed Forces Hospital, Brasília-DF, Brazil. Ana Carla Andrade Almeida Department of Pneumology, Armed Forces Hospital, Brasília-DF, Brazil. Alessandra Maria Rodrigues Oliveira Santos Department of Internal Medicine, Armed Forces Hospital and Catholic University, Brasília-DF, Brazil . Kátia Rejane Marques Brito Department of Internal Medicine, Hospital of West, Barreiras-BA, Brazil. Valerio Alves Ferreira Department of Radiology, Armed Forces Hospital, Brasília-DF, Brazil. 2015 10 20 Yellow nail syndrome (YNS) is an uncommon condition characterized by nail changes, lymphedema, in addition to pulmonary disorders and pleural effusion. Pericarditis and non-cardiac disorders can evolve with pericardial effusions including autoimmune conditions, hypothyroidism, malignancies, tuberculosis, and uremia. A 72-year-old Brazilian woman under treatment for arterial hypertension and hypothyroidism was admitted with pericarditis and pericardial effusion concomitant with yellow nail syndrome. She denied tobacco smoking, alcohol abuse, and similar disorders in her family. Clinical and complementary evaluation ruled out infectious diseases, malignancies, and autoimmune disorders as etiologic factors in this case. Hypothyroidism is a well-known cause of pericardial effusion, the vast majority in the absence of pericarditis, and has been described as an associated condition in some individuals with YNS. Case studies might contribute to better understanding of these causal or casual relationships. https://acta.tums.ac.ir/index.php/acta/article/view/5016 https://acta.tums.ac.ir/index.php/acta/article/download/5016/4688

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 12 2015 12 22 743 748 EN Shahpoor Maddah School of Medicine, Semnan University of Medical Sciences, Semnan, Iran. Jamileh Mahdizadeh School of Medicine, Semnan University of Medical Sciences, Semnan, Iran. 2015 12 21 The association of obesity and other metabolic conditions with osteoarthritis is under debate; however, a strong link between metabolic disturbances is suggested to contribute to increased incidences and progression of osteoarthritis. We examined the association of metabolic syndrome and its components with the incidence of knee osteoarthritis in Iranian population. A community-based study was conducted on a total of 625 Iranian volunteers with the complaint of knee pain. Weight-bearing and anteroposterior plain radiographs of both knees were taken on the day of admission. Metabolic syndrome was diagnosed using the modified Adult Treatment Panel III of the National Cholesterol Education Program criteria. Prevalence rates of metabolic syndrome were 22.5% in males and 11.6% in females (P=0.002). The prevalence rate of knee osteoarthritis was 20.0% in males and 43.8% of females (P<0.001). In both genders, osteoarthritis group had higher serum levels of triglyceride and systolic blood pressure in comparison with non-osteoarthritis group. Women with osteoarthritis had higher Body Mass Index (BMI), however, this association was not observed in men. In females, the presence of osteoarthritis was significantly associated with the presence of metabolic syndrome, with the risk of metabolic syndrome in the osteoarthritis group at 2.187 fold the risk in the non-osteoarthritis group. But, the presence of osteoarthritis was not associated with metabolic syndrome in males. Metabolic syndrome mainly through high BMI is associated with knee osteoarthritis in the Iranian women, but neither metabolic syndrome nor any related components are associated with knee osteoarthritis in men. https://acta.tums.ac.ir/index.php/acta/article/view/5291 https://acta.tums.ac.ir/index.php/acta/article/download/5291/4722

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 12 2015 12 22 749 752 EN Azim Mehrvar Department of Pediatric Hematology Oncology, MAHAK s’ Pediatric Cancer Treatment and Research Center, Army University of Medical Science, Tehran, Iran. Mohammad Saeid Rahiminejad Department of Pediatric Hematology Oncology, Children’s Medical Center, Tehran, Iran. Amir Abbas Hedayati Asl Department of Pediatric Hematology Oncology, MAHAK s’ Pediatric Cancer Treatment and Research Center, Azad University of Medical Science, Qom Branch, Qom, Iran. Maryam Tashvighi Department of Pediatric Hematology Oncology, MAHAK s’ Pediatric Cancer Treatment and Research Center, MAHAK Hospital, Tehran, Iran. Mohammad Faranoush Department of Pediatric Hematology Oncology, MAHAK s’ Pediatric Cancer Treatment and Research Center, Iran University of Medical Science, Tehran, Iran. Mardawig Alebouyeh Department of Pediatric Hematology Oncology, MAHAK s’ Pediatric Cancer Treatment and Research Center, Azad University of Medical Science, Qom Branch, Qom, Iran. Leili Kuchakzadeh Department of Pediatric Hematology Oncology, Children’s Medical Center, Tehran, Iran. Asghar Ramyar Department of Pediatric Hematology Oncology, Children’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 12 22 778 781 EN Nahid Khosroshahi Department of Pediatric Neurology, Bahrami Hospital, Tehran University of Medical Science, Tehran, Iran. Laleh Ghadirian Department of Community Medicine, Center for Academic and Health Policy, Tehran University of Medical Sciences, Tehran, Iran. Kamyar Kamrani Department of Neonatology, Bahrami Hospital, Tehran University of Medical Science, Tehran, Iran. 2015 12 22 Evaluation of magnesium levels in serum and cerebrospinal fluid of patients with febrile convulsion (FC) hospitalized in Bahrami hospital in Tehran in 2010-2011. In the past, decreased levels of magnesium in serum and CSF of patients with FC were reported. The purpose of this study was to identify the possible role of magnesium in febrile seizures in children. Identifying this condition, we may control seizures and also prevent subsequent convulsion. In this cross-sectional study, inclusion criteria were the existence of convulsion due to fever and exclusion criteria were having a known neurological disease which could induce a seizure, and children younger than one month. In each group (cases include children with febrile convulsion and controls include febrile children without convulsion), Mg was measured in blood, and cerebrospinal fluid of 90 children and then they were compared. The data were analyzed by SPSS (α=0.05). The mean serum and CSF levels of Mg in case and control groups were equal (P<0.87 and P<0.22 respectively). There was no difference between two groups in terms of sex, but mean age was significantly different (P<0.003). There was not an association between serum and CSF levels of magnesium and the presence of FC. Therefore, it’s not suggested to measure the level of magnesium in serum or CSF in children with fever routinely. https://acta.tums.ac.ir/index.php/acta/article/view/5298 https://acta.tums.ac.ir/index.php/acta/article/download/5298/4726