Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 10 2016 11 19 683 685 EN Maryam Mobini Department of Rheumatology, Diabetes Research Center, Mazandaran University of Medical Sciences, Mazandaran, Iran. Roya Ghasemian Department of Infectious Diseases, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Mazandaran, Iran. Fatemeh Zameni Department of Infectious Diseases, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Mazandaran, Iran. 2016 11 05 2016 11 05 Adult-onset Still’s disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology. There is not currently any specific serological markers for AOSD , and  diagnosis still relying on the exclusion of other likely diagnoses. Yamaguchi’s criteria are used as a diagnostic criterion which contains negative serologic markers for other collagen vascular diseases including systemic lupus erythematosus and rheumatoid arthritis. Here we report a 28-year-old woman with arthralgia, fever, rash, leukocytosis, lymphadenopathy, sore throat, abnormal liver function and negative rheumatoid factor and ANA but  seropositive for anti-CCP, anti-dsDNA, and C-ANCA. It seems that despite AOSD is considered as a seronegativedisorder; it should be remembered in patients with compatible findings who are seropositive. https://acta.tums.ac.ir/index.php/acta/article/view/5998 https://acta.tums.ac.ir/index.php/acta/article/download/5998/4855

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 10 2016 11 19 678 682 EN Rita Rezaee Quality Improvement in Clinical Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Neda Moadeb Shiraz University of Medical Sciences, Shiraz, Iran. Nasrin shokrpour English Department, Shiraz University of Medical Sciences, Shiraz, Iran. 2016 01 15 2016 05 10 Team-based learning is designed to provide students with both conceptual and procedural knowledge, aiming to enhance active learning and critical thinking. In the present study, team-based learning and lecture methods in teaching the “hospital organization and management” course among hospital management students were compared. This quasi-experimental study was conducted on 25 undergraduate students of management. Teaching sessions were divided into two parts. The first part was taught with interactive lectures and the second part with team-based learning method. The students' knowledge was measured before, immediately and two months (late post-test) after teaching. Finally, the mean scores of the final exam and students' satisfaction towards the methods of teaching were measured. There was an improvement in test scores of the students after the TBL sessions when compared to the test scores after lecture sessions (P<0.001). Also, TBL group had significantly a higher amount of knowledge retention compared to the lecture group (P<0.001), but no significant relationship was found between the mean scores of the final exam in the TBL and lecture groups (P=0.116). Finally, the majority of the respondents were more satisfied with TBL sessions compared to the ones held through lecture (P=0.037). The results indicated that TBL provides a better outcome for students. We found that the TBL approach allowed us to create an active learning environment that contributed to the improvement of the students’ performances. https://acta.tums.ac.ir/index.php/acta/article/view/5366 https://acta.tums.ac.ir/index.php/acta/article/download/5366/4853

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 10 2016 11 19 620 623 EN Sima Shokri Department of Allergy and Clinical Immunology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Mohammad Nabavi Department of Allergy and Clinical Immunology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Tatjana Hirschmugl CeMM Research Center for Molecular Medicine, Austrian Academy of Sciences, Vienna, Austria. Asghar Aghamohammadi Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Saba Arshi Department of Allergy and Clinical Immunology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Mohamad Hassan Bemanian Department of Allergy and Clinical Immunology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Morteza Fallahpour Department of Allergy and Clinical Immunology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Rasool Molatefi Department of Allergy and Clinical Immunology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Mahsa Rekabi Department of Allergy and Clinical Immunology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Narges Eslami Department of Allergy and Clinical Immunology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Javad Ahmadian Department of Allergy and Clinical Immunology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Kian Darabi Department of Allergy and Clinical Immunology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Gholam Reza Sedighi Department of Allergy and Clinical Immunology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Maryam Monajemzadeh Pediatrics Center for Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammadreza Modaresi Pediatrics Center for Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. AND Pediatric Respiratory Diseases Education and Research Network (PRDERN), Universal Scientific Education and Research Network (USERN), Tehran, Iran. Nima Parvaneh Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Kaan Boztug CeMM Research Center for Molecular Medicine, Austrian Academy of Sciences, Vienna, Austria. AND Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria. Nima Rezaei Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Boston, MA, USA. 2016 07 13 2016 07 28 LPS-Responsive Beige-like Anchor (LRBA) deficiency is a disease which has recently been described in a group of patients with common variable immunodeficiency (CVID) in association with autoimmunity and/or inflammatory bowel disease (IBD)-like phenotype. We here describe a 10-year-old boy who experienced recurrent infections, mainly in the respiratory system, associated with thrombocytopenia and anemia. Immunological workup showed low numbers of B cells and low IgG, but normal IgM levels. In spite of therapeutic doses of antibiotics, antivirals, and antifungal agents, in addition to immunoglobulin replacement therapy, he developed disseminated involvement of both lungs with peripheral nodules; transbronchial lung biopsy revealed possible bronchiolitis obliterans organizing pneumonia (BOOP). Combined homozygosity mapping and exome sequencing identified a homozygous LRBA mutation in this patient (p.Asp248Glufs*2). Such clinical and immunological findings have not been described to date and illustrate the broad and variable clinical phenotype of human LRBA deficiency. https://acta.tums.ac.ir/index.php/acta/article/view/5773 https://acta.tums.ac.ir/index.php/acta/article/download/5773/4844

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 10 2016 11 19 686 689 EN Rekha Lalwani Department of Anatomy, All India Institutes of Medical Sciences, Bhopal (M.P.), India. Sunita Athavale Department of Anatomy, All India Institutes of Medical Sciences, Bhopal (M.P.), India. Sheetal Kotgirwar Department of Anatomy, All India Institutes of Medical Sciences, Bhopal (M.P.), India. 2016 11 05 2016 11 05   Anatomical variations of duodenum such as atresia, stenosis, and variations in shape have been described by various authors, but the existence of a gross anomaly in shape and position of midgut segment of the duodenum is rare. Few reported cases of duodenal anomalies date back to early twentieth century. In the wake of advancement of imaging techniques and minimal access surgeries, authors report a case of a rare duodenal anomaly. The reported case assumes significance because of thepossibility of misinterpretation of radiological images which has been discussed while citing such references. The present case reports an anomaly of the position of the midgut segment of the duodenum in an adult female cadaver. It was observed that the lower half of second part of duodenum was coiled like a serpent on the upper pole of right kidney. This part coursed initially upwards running parallel and to the right of the upper half of the second part of the duodenum. The third part coursed downwards and to the left, posterior to head and neck of pancreas, in its course sandwiching the commencement of portal vein. https://acta.tums.ac.ir/index.php/acta/article/view/5997 https://acta.tums.ac.ir/index.php/acta/article/download/5997/4854

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 10 2016 11 19 624 630 EN Shokofeh Banaei Department of Physiology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran. Nasser Ahmadiasl Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Alireza Alihemmati Department of Histology and Embryology, Tabriz University of Medical Sciences, Tabriz, Iran. 2015 10 31 2016 04 17 Renal ischemia-reperfusion (IR) contributes to the development of acute renal failure (ARF). Oxygen free radicals are considered to be principal components involved in the pathophysiological tissue alterations observed during renal IR. The purpose of this study was to investigate the combination effect of melatonin (MEL) and erythropoietin (EPO), which are a potent antioxidant and anti-apoptotic agents, in IR-induced renal injury in rats. Wistar Albino rats were unilaterally nephrectomized and subjected to 45 min of renal pedicle occlusion followed by 24 h reperfusion. MEL (10 mg/kg, i.p) and EPO (5000 U/kg, i.p) were administered prior to ischemia. After 24 h reperfusion, following decapitation, blood samples were collected for the determination of superoxide dismutase (SOD), glutathione peroxidase (GPx), and malondialdehyde (MDA) levels. Also, renal samples were taken for histological evaluation and apoptosis assay. Ischemia-reperfusion increased SOD, GPx, MDA levels, and TUNEL positive cells. Histopathological findings of the IR group confirmed that there was renal impairment in the tubular epithelium. Treatment with EPO and MEL decreased SOD, GPx, and MDA levels, histopathological changes, and TUNEL positive cells. These results indicated that the combination of MEL and EPO could not exert more nephroprotective and anti-apoptotic effects than MEL treatment in renal ischemia-reperfusion injury. https://acta.tums.ac.ir/index.php/acta/article/view/5095 https://acta.tums.ac.ir/index.php/acta/article/download/5095/4856

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 10 2016 11 19 631 639 EN Fatemeh Sarhadi Kholari Department of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Reza Dehpour Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mitra Nourbakhsh Department of Clinical Biochemistry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. AND Metabolic Disorders Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Amir Hossein Doustimotlagh Department of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Molood Bagherieh Department of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Abolfazl Golestani Department of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 11 25 2016 02 04 Cirrhosis is the consequence of chronic liver disease. Deleterious effects of oxidative stress on hepatocytes may be reflected in the erythrocyte membrane. Naltrexone (NTX) has been shown to attenuate hepatocellular injury in fibrotic animal models. The aim of this study was to investigate the progressive effect of CCl4 on the liver and whether the improvement of liver cirrhosis can be monitored through alterations in the erythrocyte membrane. In this study, 84 male Wistar rats were divided into 4 groups and received reagents (i.p.) as follows: 1- CCl₄, 2- NTX + CCl₄, 3- Mineral Oil (M), and 4- NTX + M. After 2, 6 and 8 weeks, the blood and liver tissue samples were collected. Plasma enzyme activities, the content of erythrocyte GSH and some membrane compositions, including protein carbonyl, protein sulfhydryl, and malondialdehyde were assessed. After 6 and 8 weeks, plasma enzyme activities and the content of protein carbonyl were higher in CCl4 group significantly, as compared to other groups (P<0.001). NTX significantly diminished protein carbonyl and plasma enzyme activities (P<0.001). GSH did not change until the 6th week. However, CCl4+NTX increased it significantly as compared to CCl₄ group (P<0.05). Protein sulfhydryl showed changes in NTX+CCl₄ group which indicated a significant increase in protein sulfhydryl content in a 6th week compared to CCl4 group (P<0.05). MDA did not, Iran. Ali Gholaminejad Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran. Kazem Amanzadeh Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran. Maryam Hashemi Department of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Khabazkhoob Department of Epidemiology, Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2015 10 11 The objective of the present study was to compare single segment and double segment INTACS rings in the treatment of post-LASIK ectasia. In this interventional study, 26 eyes with post-LASIK ectasia were assessed. Ectasia was defined as progressive myopia regardless of astigmatism, along with topographic evidence of inferior steepening of the cornea after LASIK. We excluded those with a history of intraocular surgery, certain eye conditions, and immune disorders, as well as monocular, pregnant and lactating patients. A total of 11 eyes had double ring and 15 eyes had single ring implantation. Visual and refractive outcomes were compared with preoperative values based on the number of implanted INTACS rings. Pre and postoperative spherical equivalent were -3.92 and -2.29 diopter (P=0.007). The spherical equivalent decreased by 1 ± 3.2 diopter in the single-segment group and 2.56 ± 1.58 diopter in the double-segment group (P=0.165). Mean preoperative astigmatism was 2.38 ± 1.93 diopter which decreased to 2.14 ± 1.1 diopter after surgery (P=0.508); 0.87 ± 1.98 diopter decrease in the single-segment group and 0.67 ± 1.2 diopter increase in the double-segment group (P=0.025). Nineteen patients (75%) gained one or two lines, and only three, who were all in the double-segment group, lost one or two lines of best corrected visual acuity. The spherical equivalent and vision significantly decreased in all patients. In these post-LASIK ectasia patients, the spherical equivalent was corrected better with two segments compared to single segment implantation; nonetheless, the level of astigmatism in the single-segment group was significantly better than that in the double-segment group. https://acta.tums.ac.ir/index.php/acta/article/view/4660 https://acta.tums.ac.ir/index.php/acta/article/download/4660/4629

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 9 2014 09 15 687 689 EN Nasrin Khalessi Department of Neonatology, Aliasghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran. Zahra Farahani Family Health Institute, Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mamak Shariat Family Health Institute, Maternal Fetal & Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran. Golnaz Rezaeizadeh Family Health Institute, Maternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Intraventricular hemorrhage (IVH) is an important cause of brain injury in premature neonates. Current study tries to define associated risk factors of IVH in preterm neonates in Aliasghar Children Hospital during 2008 to 2011. In this study, the risk factors have been evaluated in premature neonates with IVH, who had at least one brain sonography since their admission in NICU. A total of 63 premature neonates with IVH were assessed. Mean gestational age was 29.81 (24-34) weeks and mean birth weight was 1290.83±382.96 gr. Other risk factors such as sex, mode of delivery, history of using infertility drugs, maternal disease, maternal hypertension and preeclampsia, lumbar puncture, ventilator therapy and pneumothorax were considered. Because no absolute treatment for IVH is available, identifying risk factors is important in prevention and management of IVH. https://acta.tums.ac.ir/index.php/acta/article/view/4647 https://acta.tums.ac.ir/index.php/acta/article/download/4647/4630

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 9 2014 09 15 690 693 EN Rozita Jalilian Department of Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mahsa Ghajarzadeh Department of Neurology, Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. Rouzbeh Fateh Children's Hospital Boston, Mental Health and Neuro developmental Disabilities, Boston, Massachusetts, USA. Mansoureh Togha Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Ali Sahraian Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Amirreza Azimi Department of Neurology, Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Multiple sclerosis (MS) and migraine are two common neurological disorders affecting women more than men. Sleep quality impairment has been reported in both diseases. The goal of this study was to compare sleep quality and depression between women with MS and migraine. Seventy women with migraine and 75 women with MS were enrolled in this study. Participants were asked to fill-out valid and reliable Persian versions of Pittsburg Sleep Questionnaire (PSQI) and Beck Depression Inventory (BDI). Mean age and duration of disease for MS group was 31.1 ± 7.6, 4.8 ± 5 and for second group 31.4 ± 5.6, 5.2 ± 4 years, respectively. Mean BDI score and number of patients with poor sleep (PSQI ≥5) were significantly higher in patients with migraine. There was significant positive correlation between PSQI and BDI scores in all participants (r=0.32, P<0.001), while correlation coefficient was 0.39, P=0.001 in patients with migraine and 0.35, P=0.002 in MS cases. Multiple linear regression analysis between the PSQI as a dependent variable and age, BDI and education level as independent variables showed that BDI is the independent predictors of PSQI in both groups. This study shows that patients with migraine suffer from poor sleep and depression more frequently than MS cases. https://acta.tums.ac.ir/index.php/acta/article/view/4645 https://acta.tums.ac.ir/index.php/acta/article/download/4645/4631

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 9 2014 09 15 694 696 EN Khadijeh Raeisi Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mamak Shariat Maternal Fetal & Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Nayeri Maternal Fetal & Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran. Farima Raji Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran. Hosein Dalili Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Constant breastfeeding that depends on the family support. Fathers' involvement is as an important factor of successful breastfeeding. The aim of this study was to evaluate the influence of fathers' participation in constant breastfeeding in Vali-E-Asr Hospital, Tehran, Iran. This interventional study was piloted on spouses of pregnant women participating in pregnancy courses. The case group consisted of fathers attending training courses of breastfeeding during pregnancy (Group A), and the control group was made up of fathers who did not take part in training courses (Group B). The courses were held three times from the 30th week of gestation to the end of pregnancy in a family health research center. Fathers attended three training sessions where they were trained by brochures. After delivery newborns were weighted and examined for jaundice (3-5 days, 30 days, three and six months after birth). According to mothers' views, spouses' participation, encouragement and support in group A, was 11 times more than group B. It means that 47 (94%) of spouses in the group A participated in mothers' constant breastfeeding, but fathers' participation in group B was 60% (30 spouses). This study showed that breastfeeding was more constant in the group that fathers participated in breastfeeding training course. One of the reasons for such a significant difference was spouses' participation, encouragement and support in the trained group. This study showed that fathers' involvement in training programs may influence constancy of breastfeeding. https://acta.tums.ac.ir/index.php/acta/article/view/4643 https://acta.tums.ac.ir/index.php/acta/article/download/4643/4632

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 9 2014 09 15 697 702 EN Amir Alireza Rasouli Ghahroudi Department of Periodontology, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Afshin Khorsand Department of Periodontology, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Siamak Yaghobee Department of Periodontology, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Periodontology, Dental Implants Research Center, Tehran University of Medical Sciences, Tehran, Iran. Farideh Haghighati Department of Periodontology, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 The biologic width (BW) includes attached epithelial cells and connective tissue attachment complex being very important in the periodontal health during prosthetic treatments as invading this zone can cause bone resorption and gingival recession. The present study investigated biologic width values in the normal periodontium in anterior and posterior teeth. 30 patients that referred from restorative department to periodontics department of Tehran University of medical sciences who need crown lengthening procedure on their teeth with no history of orthodontic, prosthodontic and periodontal treatment were randomly enrolled in this cross-sectional trial. Sulcus depths (SD) as well as the distance between free gingival margin and the bone crest (FB) of anterior and posterior teeth were measured by UNC-15 probe and compared. periodontium thickness was also assessed. The data were subjected to Student t test. Mean BW in the 43 anterior and 47 posterior teeth was measured and not significantly different (1.4651±0.39 mm vs. 1.6312±0.49 mm) was observed; however, BW was significantly more in the teeth with thick periodontium compared to those with thin periodontium (1.703±0.5 vs. 1.408±0.35; P=0.002). BW not only is different in individuals but also could be dissimilar in different teeth and should be calculated independently prior to restorative treatments. https://acta.tums.ac.ir/index.php/acta/article/view/4659 https://acta.tums.ac.ir/index.php/acta/article/download/4659/4633

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 9 2014 09 15 703 709 EN Farhad Najmeddin Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Arezoo Ahmadi Department of Anesthesiology and Critical Care Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Laleh Mahmoudi Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Fars, Iran. Kourosh Sadeghi Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Hossein Khalili Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Alireza Ahmadvand Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran. Atabak Najafi Department of Anesthesiology and Critical Care Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mojtaba Mojtahedzadeh Department of Clinical Pharmacy, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 High-dose extended-interval dosage (HDED) regimen of aminoglycosides is now considered as the standard dosage strategy in sepsis. Although safety and efficacy of this dosing regimen is well studied, but new experiments show increased the risk of resistance development associated with %T>MIC less than 60% of the dosing interval following extended interval dosing. Moreover, limited information is available about safety of more frequent administration of high dose aminoglycosides. Authors studied nephrotoxicity following seven days' exposure to more frequent administration of higher doses of amikacin comparing with HDED regimen. In addition to Serum Creatinine (SrCr) and estimated glomerular filtration rate (eGFR), nephrotoxicity was studied with Neutrophil gelatinase-associated lipocalin (NGAL), a direct marker of tubular injury. A total of 40 patients with sepsis were quasi-randomized in two groups. Seven days' course of treatment with a moderate dose of amikacin (12.5 mg/Kg) was administered every 12 hours, known as the moderate-dose non-liberal-interval dosage (MDNLD) regimen compared with the high-dose extended-interval dosage (HDED) regimen (25 mg/Kg every 24 hours). The pharmacokinetic/pharmacodynamic (PK/PD) goal of the MDNLD regimen was the Cmax>40 and the %T>MIC more than 60% during the PK/PD goal for the HDED regimen was the Cmax>60. The eGFR change from the baseline was the primary outcome of the study with a minimum clinical significance of 20 ml/min (estimated SD of 20, Power>90%, P40 and %T>MIC more than 60% of the dosing interval. This dosing regimen would be considered as an alternative to minimize the resistance development associated with the extended-interval dosing in septic patients with multi-drug resistant gram-negative organisms. https://acta.tums.ac.ir/index.php/acta/article/view/4657 https://acta.tums.ac.ir/index.php/acta/article/download/4657/4634

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 9 2014 09 15 710 716 EN Azim Mirzazadeh Department of Internal Medicine, Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran. Sara Mortaz Hejri Department of Medical Education, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Jalili Department of Medical Education, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Emergency Medicine, Clinical Skill Center, Tehran University of Medical Sciences, Tehran, Iran. Fariba Asghari Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Ali Labaf Department of Emergency Medicine, Clinical Skill Center, Tehran University of Medical Sciences, Tehran, Iran. Mojtaba Sedaghat Siyahkal Department of Community Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Ali Afshari Department of Internal Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Narges Saleh