Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 218 227 EN Alipasha Meysamie Department of Community and Preventive Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Saeed Ghodsi Department of Community and Preventive Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Reza Ghalehtaki Department of Community and Preventive Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Alireza Esteghamati Endocrinology and Metabolism Research Center (EMRC), Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran. Fereshteh Asgari 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. 2016 05 10 2017 01 06 The present study aimed to evaluate the distributions of High-Sensitivity C-reactive protein, TC-HDL ratio and 10-year risk of cardiovascular diseases among Iranian adult population. We conducted a cross-sectional study on a total of 2125 adults aged 25 to 65. Data of the Third National Surveillance of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007) was used. Anthropometric indices, blood pressure and biochemical measurements had been obtained. Ten-year risk of cardiovascular events was also calculated using different models. Median (interquartile range) and geometric means (95% CI) of hs-CRP were 5.1(3.9) and 4.1(4.38-4.85), respectively. Mean TC-HDL ratio±(SD) was 5.94±2.84 in men and 5.37±1.97 in women (P<0.001). In spite of risk scores (FRS and SCORE), no significant gender and age-related differences were observed in hs-CRP levels. Exclusion of CRP levels≥10 did not change the results. The proportion of high-risk categories using SCORE and FRS models were 3.6 % and 8.8 %, respectively. In comparison with other published data, greater means and median values of High-Sensitivity C-reactive protein were observed. Higher TC-HDL ratio and cardiovascular risk in men than in women were also demonstrated. The issue of screening for cardiovascular diseases has yet to be addressed due to considerable prevalence of elevated CRP and increased risk of cardiovascular events among various subgroups. https://acta.tums.ac.ir/index.php/acta/article/view/5625 https://acta.tums.ac.ir/index.php/acta/article/download/5625/4920

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 259 264 EN Soheil Peiman Department of Internal Medicine, School of Medicine, Tehran University of Medical Sciences. Tehran, Iran. Azim Mirzazadeh Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Internal Medicine, Health Professions Education Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Maryam Alizadeh Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Sara Mortaz Hejri Department of Medical Education, Health Professions Education Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammad-Taghi Najafi Department of Nephrology, Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Abbas Tafakhori Department of Neurology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Neurology, Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran. Farnoosh Larti Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Besharat Rahimi Department of Pulmonary and Critical Care Medicine, Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran. Babak Geraiely Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Parichehr Pasbakhsh Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Gholamreza Hassanzadeh Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Nabavizadeh Rafsanjani Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Ansari Department of Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Seyed Farshad Allameh Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2016 03 14 2017 03 02 To present a multiple-instructor, active-learning strategy in the undergraduate medical curriculum. This educational research is a descriptive one. Shared teaching sessions, were designed for undergraduate medical students in six organ-system based courses. Sessions that involved in-class discussions of integrated clinical cases were designed implemented and moderated by at least 3 faculties (clinicians and basic scientists). The participants in this study include the basic sciences medical students of The Tehran University of Medical Sciences. Students’ reactions were assessed using an immediate post-session evaluation form on a 5-point Likert scale. Six two-hour sessions for 2 cohorts of students, 2013 and 2014 medical students during their two first years of study were implemented from April 2014 to March 2015. 17 faculty members participated in the program, 21 cases were designed, and participation average was 60 % at 6 sessions. Students were highly appreciative of this strategy. The majority of students in each course strongly agreed that this learning practice positively contributed to their learning (78%) and provided better understanding and application of the material learned in an integrated classroom course (74%). They believed that the sessions affected their view about medicine (73%), and should be continued in future courses (80%). The percentage demonstrates the average of all courses. The program helped the students learn how to apply basic sciences concepts to clinical medicine. Evaluation of the program indicated that students found the sessions beneficial to their learning. https://acta.tums.ac.ir/index.php/acta/article/view/5513 https://acta.tums.ac.ir/index.php/acta/article/download/5513/4926

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 280 281 EN Fateme Sepehri Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Health Information Technology, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran. Mostafa Langarizadeh Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. Laleh Sharifi Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Gholamreza Azizi Department of Laboratory Medicine, Imam Hassan Mojtaba Hospital, Alborz University of Medical Sciences, Karaj, Iran. Reza Safdari Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran. Asghar Aghamohammadi Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. AND Primary Immunodeficiency Diseases Network (PIDNeT), Universal Scientific Education and Research Network (USERN), Tehran, Iran. 2016 01 03 2016 08 04 Primary immunodeficiency diseases (PIDs) are a genetically  heterogeneous group disorders that affect distinct components of both humoral and cellular arms of the immune system (1,2). Overlapping signs and symptoms of these diseases is a challenge for diagnosis and treatment (3,4). Awareness of the  symptoms and considering   the   possibility   of   PID   in   differential diagnosis help to rapid recognition and more appropriate treatment   (2,5).   Timely   recognition   and   treatment reduced mortality and increased lifespan and quality of life of the patients (6). Memorization of all effective criteria to diagnosis is difficult, so developing a computerized program based on diagnosis criteria, improves significantly the quality of care (7,8).To develop the inference model to the diagnosis of PIDs, ontology has been used in this study. The study focused on eight common diseases of PIDs include Common Variable Immune Deficiency (CVID), X- Linked Agammaglobulinemia (Bruton’s) (XLA), Selective IgA Deficiency (SIgA), CD40L deficiency, UNG deficiency, Isolated immunoglobulin (Ig) G Subclass deficiency, Specific antibody deficiency (SAD) with normal Ig concentrations and normal numbers of B cells, Transient Hypogammaglobulinemia of infancy (THI) with normal numbers of B cells. Based on clinical guidelines  and   medical   literature   in   PID   (9),   we designed a checklist to extract and classified most important signs and symptoms, family history, and laboratory data for eight main type of primary antibody deficiencies   (PADs).   To   evaluate   the   quality   of checklist, data for 100 cases in a different type of PADs were tested. Using frame-based ontology modeling to create the inference model and "Noy and McGuinness" method to develop the inference model. "Noy and McGuinness" method includes seven stages (10). Below we describe each stage of the method: https://acta.tums.ac.ir/index.php/acta/article/view/5333 https://acta.tums.ac.ir/index.php/acta/article/download/5333/4931

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 265 267 EN Farzaneh Motamed Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Rita Bagherian Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Gholamhossin Adalat Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Hassan Moradinejad Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Nilofar Hajizadeh Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Vasei Department of Pathology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Mehrzad Mehdizadeh Department of Radiology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 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), Tehran, Iran. 2015 12 15 2016 03 16 Systemic amyloidosis is a very rare complication of inflammatory bowel disease (IBD). The reported cases of secondary amyloidosis in children with IBD are much fewer than those reported in adults. Herein, a teenage boy with Crohn’s disease is presented who developed nephrotic syndrome due to renal involvement secondary to amyloidosis, whereas the patient was under treatment with corticosteroid and 6-mercaptopurine. To our best knowledge, this is the first reported case of secondary amyloidosis in a teenage Iranian boy with Crohn’s disease. https://acta.tums.ac.ir/index.php/acta/article/view/5274 https://acta.tums.ac.ir/index.php/acta/article/download/5274/4927

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 228 232 EN Fezzeh Elyasinia Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Reza Keramati Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran. Farham Ahmadi Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran. Susan Rezaei Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Ashouri Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran. Reza Parsaei Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran. Maryam Yaghoubi Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran. Fahimeh Elyasinia Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran. Armita Aboutorabi Department of Research, Kaviani Breast Diseases Institute, Tehran, Iran. Ahmad Kaviani Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Research, Kaviani Breast Diseases Institute, Tehran, Iran. 2016 06 13 2017 01 02 Despite many advances in the treatment of breast cancer, it is still the second most common cause of death in women in the United States. It has been shown that inflammation plays a major role in the treatment of these cancers and inflammatory factors enhance tumor growth, invasion, metastasis, and vascularization. In this study, we would like to analyze peripheral blood neutrophil-lymphocyte ratio (NLR) in breast cancer patients and its correlation with disease staging. This cross-sectional analytic study was conducted in Imam Hospital, affiliated with Tehran University of Medical Sciences; a total of 195 female patients with breast cancer met the inclusion criteria. All of the patients had a complete blood count with leukocyte differential performed before chemotherapy. Medical records including pathology reports were also available. Data for all patients were collected prior to any surgical intervention. Exclusion criteria included clinical evidence of active infection, presence of hematological disorders, acute as well as chronic inflammatory or autoimmune diseases, or prior steroid therapy. Higher platelet count was significantly associated with the higher stage. The stage was not associated with the hemoglobin level. There was no association between the tumor size and age of patients with NLR. There was a significant relationship between NLR and IDC. There was a significant relationship between IDC and NLRs of less than 8.1 and greater than 3.3. There was a significant relationship between NLR and vascular invasion. There was no association between NLR and estrogen receptor and HER2. There was no significant relationship between the PLR and the cancer stage. In this study, NLR showed a significant relation with the disease staging. As the NLR increases the stage increases as well. Therefore, this ratio may be helpful in the preoperative evaluation of patients with breast cancer. https://acta.tums.ac.ir/index.php/acta/article/view/5704 https://acta.tums.ac.ir/index.php/acta/article/download/5704/4921

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 268 271 EN Bahram Mofid Department of Clinical Oncology, Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zeinab Shankayi Department of Medical Physics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Kambiz Novin Department of Clinical Oncology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Sadegh Dehghani Department of Medical Physics, Tehran University of Medical Sciences, Tehran, Iran. Morteza Shankayi Department of Mechanic, School of Engineering, Tarbiat Modares University, Tehran, Iran. Hamidreza Haghighatkhah Department of Radiology, Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. S. Mohammad Firoozabadi Department of Medical Physics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran. 2015 10 04 2016 09 05 Electrochemotherapy (ECT) is a new local treatment method for solid and superficial tumors. During this new technique, patients experience an unpleasant sensation and slight edema. Most unpleasant and painful is mainly attributed to muscle contractions provoked by high amplitude and low repetition frequency pulses. Recently, we showed that electrochemotherapy using low voltage and higher repetition frequency (LVHF ECT) is an effective tool for inhibiting tumor growth and inducing cell permeabilization. Low voltage high-frequency electrochemotherapy was developed and optimized in vitro and in vivo which and can be used in the clinic. In the present study, we report a case of cervical lymph node metastasis of breast cancer treated by the technique. In our case, LVHF ECT was successful in reducing the size and palliating the symptoms of cervical lymph node metastasis in clinical conditions, whereas other approaches were inefficient. Our electrochemotherapy technique shows good clinical results. However, more studies on this new method are necessary to prove that LVHF ECT can be considered as a standard treatment modality. https://acta.tums.ac.ir/index.php/acta/article/view/4259 https://acta.tums.ac.ir/index.php/acta/article/download/4259/4932

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 233 240 EN Mehrnaz Rasooli-Nejad Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Infectious Diseases, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Maryam Khazaee-Pool Department of Health Education and Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran. Ladan Abbasian Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Zahra Bayat Jozani Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Sara Ahsani-Nasab Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. Banafsheh Moradmand Badie Discipline of Public Health, School of Medicine, Flinders University, Flinders, South Australia. Afsaneh Pargar Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Infectious Diseases, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Gholamreza Esmaeeli Djavid Academic Member of Academic Center for Education, Culture and Research, Tehran, Iran. 2015 10 25 2016 03 04 There are limited documents about HIV patients switched to second-line antiretroviral therapy (ART) in resource-limited countries. We aimed to assess the efficacy of second-line ART for HIV patients following first-line ART failure. This was a cohort study of HIV/AIDS patients with first-line ART treatment failure switched to second-line ART between January 2004 and March 2014, who followed for at least 12 months after switching. Fifty of studied patients (85%) were treated with regimens containing lopinavir/ritonavir (Kaletra) and nine of them (15%) treated with other regimes. Seven patients were experienced opportunistic infections in accordance with stage III and IV WHO classification. In this way, 11.8% of patients had aclinicalfailure, and 37 of them (62%) had immunological responses. Weight gain was evident in these patients, and there was a significant correlation between theincrease in CD4 and weight gain (P=0.007). Only 13 patients achieved HIV viral load testing that 6 of them had avirological response after 12 months on second-line ART. No significant associations were found between virological or immunological response and gender, age, and lopinavir/ritonavir regimens (P>0.05).With counselling and supporting in those failing first-line ART, inessential switching to more costly second-line ART can be prevented in the majority of patients. However, patients' need to second-line ART drugs has increased, for which national ART programmes and regular follow-up should be organized. The high cost of these drugs and limited access to viral load testing are main barriers to proper management of patients switched to second-line ART regimens. https://acta.tums.ac.ir/index.php/acta/article/view/5060 https://acta.tums.ac.ir/index.php/acta/article/download/5060/4922

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 272 276 EN Anju Bansal Department of Pathology, National Institute of Pathology (ICMR), Safdarjang Hospital Campus, New Delhi, India. Manveen Kaur Department of Pathology, National Institute of Pathology (ICMR), Safdarjang Hospital Campus, New Delhi, India. Varsha Dalal Department of Pathology, National Institute of Pathology (ICMR), Safdarjang Hospital Campus, New Delhi, India. 2015 10 13 2016 05 01 Sarcomas account for less than 1% of all primary breast malignancies, pleomorphic sarcoma of the breast being even rarer. We present two cases of pleomorphic sarcoma of the breast in a 35-year-old and a 43-year-old female. An extensive review of the available literature with evaluation of the etiology, changing terminologies and histopathologic features of pleomorphic sarcoma of the breast are discussed. The prognostic factors and treatment modalities have also been reviewed. https://acta.tums.ac.ir/index.php/acta/article/view/4970 https://acta.tums.ac.ir/index.php/acta/article/download/4970/4929

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 241 248 EN Fatemeh Pouya Department of Anatomy, Medicine Faculty, Kerman University of Medical Sciences, Kerman, Iran. AND Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran. Seyed Hassan Eftekhar-Vaghefi Department of Anatomy, Medicine Faculty, Kerman University of Medical Sciences, Kerman, Iran. Parvin Salehinejad Department of Anatomy, Medicine Faculty, Kerman University of Medical Sciences, Kerman, Iran. AND Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran. 2016 02 09 2017 01 30 The human body dimensions are affected by ecological, biological, geographical, racial, sex, and age factors. Craniofacial measurements can be considered to be one of the important tools for determination of the morphological characteristics of the head and face. In this study, which was conducted on Persian adolescents living in Kerman/Iran, different forms of head and face were determined for using in various aspects of medicine. The study was conducted on 732 participants including 366 males and 366 females in the age of 18-20-year-old. In addition to the height and weight of the participants, cephalofacial sizes of them were measured and then cephalic, facial, and brain indices were calculated. Among the cephalofacial sizes, cranial length and breadth, cranial circumference, prosopic length and prosopic breadth were significantly greater in males compared to females (P<0.005). Also, volume and weight of brain were significantly greater in male comparing to female participants (P<0.005). The predominant type of head was meso-cephal, and the predominant type of face was meso-prosopic in both sexes.  https://acta.tums.ac.ir/index.php/acta/article/view/5421 https://acta.tums.ac.ir/index.php/acta/article/download/5421/4923

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 277 279 EN Mohammad Ali Mohagheghi Department of Surgical Oncology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Ramesh Omranipur Department of Surgical Oncology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Fereshteh Ensani Department of Pathology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Alireza Ghannadan Department of Pathology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Shahriar Shahriaran Department of Radiology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Farhad Samiee Radiation Oncology, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. Zahra Sedighi Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 12 2016 07 02 We present here a 32-year-old male with advanced lately diagnosed, right sided retroperitoneal mass, which had been already treated due to progressive muco-cutaneous lesions clinically consistent with psoriasis, during recent four years. The advanced retroperitoneal mass resected surgically and reported as hyaline-vascular castleman disease with a dense focus of coarse calcification, on histopathology. Association of psoriasis and castlman disease is discussed in this case report.  https://acta.tums.ac.ir/index.php/acta/article/view/4951 https://acta.tums.ac.ir/index.php/acta/article/download/4951/4930

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 249 253 EN Gholamreza Pourmand Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Shahram Gooran Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Reza Hossieni Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Fateme Guitynavard Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Majid Safavi Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Amirsina Sharifi Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Ehsan Mokhtari Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2016 04 22 2017 01 05 Preoperative Gleason score (GS) obtained from Trans Rectal Ultra Sonography (TRUS) is the most common grading system to evaluate the appropriate treatment for patients with clinically localized prostate cancer. But this method showed upgraded and downgraded results in comparison to Gleason score obtained from radical prostatectomy. The current study aimed to determine clinical or pathological variables to reduce the differences between biopsy and radical prostatectomy Gleason scores.Through retrospective review of 52 patients with radical prostatectomy, this study examined the correlations of preoperative Gleason score with age, prostate volume, PSA level, PSA density, digital rectal exam findings and percentage of positive core needle biopsies across two groups, including patients with preoperative GS≤6 (i.e. group one) and patients with preoperative GS≥7 (group two). The discordance between biopsy GS and radical prostatectomy GS was observed to be 52% in the current study. Among patients with preoperative GS≤6, prostate volume (P=0.026), PSA density (P=0.032) and percentage of positive core needle biopsies (P=0.042) were found to be significant predictors for upgrade. There was no significant predictor for downgrade in patients with preoperative GS≥7. Findings of this study revealed that in patients with preoperative GS≤6, smaller prostate volume, higher prostate density and higher positive results of core needle biopsies were associated with theupgrade of GS. Therefore, it should be considered when selecting treatment modalities among these patients. https://acta.tums.ac.ir/index.php/acta/article/view/5588 https://acta.tums.ac.ir/index.php/acta/article/download/5588/4924

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 4 2017 05 16 254 258 EN Khatereh Isazadehfar Department of Community and Preventive Medicine, Ardabil University of Medical Sciences, Ardabil, Iran. Masoud Entezariasl Department of Anesthesiology, Ardabil University of Medical Sciences, Ardabil, Iran. Bita Shahbazzadegan Department of Nursing, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran. AND Department of Public Health, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zahra Nourani General Practitioner, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran. Yousef Shafaee Department of Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. 2016 08 10 2017 01 02 Postoperative nausea and vomiting (PONV) are one of the most common complications of anesthesia and without prophylactic intervention occurs by about one-third of patients under general anesthesia. The aim of this study was to compare the efficacy of ondansetron and metoclopramide in reducing PONV after laparoscopic cholecystectomy. In this study, 60 patients undergoing laparoscopic cholecystectomy were randomly allocated into two equal groups (n=30), and in the first group 10 mg metoclopramide and in the second group 4 mg ondansetron preoperatively were injected. Nausea and vomiting and the need for rescue antiemetic treatment in recovery and 6 hr. and 6-24 hrs. After surgery were evaluated. Data were analyzed by SPSS software with chi-square test and analysis of variance (ANOVA). The incidence of nausea in metoclopramide was 43.3 % and in ondansetron was 33.3 %. The difference between two groups was not significant (P=0.6). The incidence of vomiting in metoclopramide was 20% and in ondansetron was 26.7%, and there was not any significant difference between intervention groups (P=0.12). For prevention of PONV after laparoscopic cholecystectomy, both metoclopramide and ondansetron are effective, and in preventing of nausea, ondansetron is more effective than metoclopramide, whereas there was not any significant difference between two drugs in preventing of vomiting. https://acta.tums.ac.ir/index.php/acta/article/view/5813 https://acta.tums.ac.ir/index.php/acta/article/download/5813/4925