Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 8 2017 10 07 482 485 EN Meletios Kanakis Department of Experimental Physiology, School of Medicine, University of Athens, Athens, Greece. Aristeides Vaiopoulos Department of Experimental Physiology, School of Medicine, University of Athens, Athens, Greec. George Vaiopoulos Department of Experimental Physiology, School of Medicine, University of Athens, Athens, Greece. Phaedon Kaklamanis Department of Rheumatology, Athens Medical Center, Athens, Greece. 2016 08 04 2017 04 13  Behçet’s disease is a chronic, recurrent, inflammatory disorder characterized by orogenital ulcers and skin lesions; serious manifestations also include ocular, large vessel, gastrointestinal and neurological involvement. Genetic and unknown environmental factors modify the wide clinical spectrum of the disease. During the long clinical course of the disease, testicular and epididymal involvement has been reported, with scrotal pain and swelling being the most common symptoms. In this review, we discuss the various aspects of epididymo-orchitis in Behcet’s disease patients, and we evaluate the diagnostic approaches as well as the empirical therapeutic modalities of this entity.   https://acta.tums.ac.ir/index.php/acta/article/view/5798 https://acta.tums.ac.ir/index.php/acta/article/download/5798/4970

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 8 2017 10 07 486 495 EN Mohammad Hassan Golzari Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran Saeed Hosseini Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Fariba Koohdani Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Ali-Akbar Saboor Yaraghi Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Hassan Javanbakht Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Niyaz Mohammadzadeh-Honarvar Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Mahmoud Djalali Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. 2016 12 24 2017 02 01 Paraoxonase 1 is known as one of the most important ant oxidative enzymes associated with HDL-c, and because of its antioxidant and antiinflammatory activities. EPA has the antioxidant, anti inflammatory, antithrombogenic, and antiarteriosclerotic properties. Therefore, we investigated the effect of EPA supplementation on the serum levels and activity of PON1 in type 2 diabetic patients. This study was designed as a randomized, double-blind, and placebo-controlled clinical trial. Thirty-six patients with type 2 diabetes were given written; informed consent randomly was classified into 2 groups. They were supplemented with 2 g/day of the capsules of EPA or placebo for eight weeks. Blood sample was given for measurement of the serum levels of lipids, the activity of PON1, FBS and HbA1c. The patients supplemented with EPA showed a significant increase in the serum levels and activity of PON1 and the serum ratio of PON1/HDL-c. There were no significant differences between the two groups regarding any demographic, clinical or biochemical data, total energy intake, and macronutrient intake at the baseline during the intervention, except for a significant increase of protein intake and the levels of HbA1c in the placebo group, and a significant increase of HDL-c, as well as a slight reduction of total cholesterol, LDL-c, TG and FBS in the supplement group. EPA is atheroprotective via increase in the serum levels and activity of PON1, as well as change in the serum levels of lipids, FBS and HbA1c. https://acta.tums.ac.ir/index.php/acta/article/view/6087 https://acta.tums.ac.ir/index.php/acta/article/download/6087/4971

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 8 2017 10 07 521 524 EN Amirhossein Jahanshir Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Maryam Bahreini Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mohsen Banaie Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Jallili Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Shahram Hariri Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Rasooli Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Hamed Sotoodehnia Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Javad Seyed Hosseini Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Arash Safaie Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Ehsan Karimi Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Ali Labaf Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Hadi Mir Fazaelian Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Elnaz Vahidi Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2016 07 27 2017 05 09 Applying simulation in medical education is becoming more and more popular. The use of simulation in medical training has led to effective learning and safer care for patients. Nowadays educators have confronted with the challenge of respecting patient safety or bedside teaching. There is widespread evidence, supported by robust research, systematic reviews and meta-analysis, on how much effective simulation is. Simulation supports the acquisition of procedural, technical and non-technical skills through repetitive practice with feedbacks. Our plan was to induct simulation in emergency medicine residency program in order to ameliorate our defects in clinical bedside training. Our residents believed that simulation could be effective in their real medical practice. They mentioned that facilitators’ expertise and good medical knowledge, was the strongest point of the program and lack of proper facilities was the weakest. https://acta.tums.ac.ir/index.php/acta/article/view/5792 https://acta.tums.ac.ir/index.php/acta/article/download/5792/4976

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 8 2017 10 07 525 529 EN Mauro Chiarito Department of Cardio Thoracic Vascular, San Raffaele Scientific Institute, Milan, Italy. Andrea Scotti Department of Cardio Thoracic Vascular, San Raffaele Scientific Institute, Milan, Italy. Carlo A Pivato Department of Cardio Thoracic Vascular, San Raffaele Scientific Institute, Milan, Italy. Giuseppe Cottone Department of Cardio Thoracic Vascular, San Raffaele Scientific Institute, Milan, Italy. Carlo Ballarotto Department of Cardio Thoracic Vascular, San Raffaele Scientific Institute, Milan, Italy. Cosmo Godino Department of Cardio Thoracic Vascular, San Raffaele Scientific Institute, Milan, Italy. Alberto Margonato Department of Cardio Thoracic Vascular, San Raffaele Scientific Institute, Milan, Italy. 2016 02 16 2016 07 03 A 47-year-old woman presented with a history of resistant arterial hypertension, associated with disabling headache. She was subjected to an enormous number of tests in order to identify an underlying cause of secondary hypertension, such as pheochromocytoma or Cushing syndrome, but all the most common causes of secondary hypertension were investigated and gradually excluded. Factitious use of amphetamine or cocaine was excluded, and therapy compliance was verified by witnessed ingestion of drug therapy, in order to rule out Munchausen syndrome. The patient underwent a first transcatheter renal denervation (RDN) with poor effect on blood pressure (BP) at long term follow up. Because of extremely poor control of BP values, a second RDN was performed two years later, again with inadequate long term efficacy. Despite an uncontrollable pre-procedural BP, RDN had an excessive BP lowering effect in this patient, but only for few months. In conclusion, a definitive diagnosis was not performed in our patient, despite an extremely deepened examination of the most common cause of refractory hypertension. https://acta.tums.ac.ir/index.php/acta/article/view/5444 https://acta.tums.ac.ir/index.php/acta/article/download/5444/4983

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 8 2017 10 07 538 538 EN Fausto Fama’ Department of Human Pathology, University Hospital of Messina, Messina, Italy. Maria Gioffrè-Florio Department of Human Pathology, University Hospital of Messina, Messina, Italy. 2016 10 25 2017 04 10 No Abstract https://acta.tums.ac.ir/index.php/acta/article/view/5972 https://acta.tums.ac.ir/index.php/acta/article/download/5972/4982

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 8 2017 10 07 496 501 EN Mohammad Reza Emad Department of Physical Medicine and Rehabilitation, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Leila Zeinali Department of Physical Medicine and Rehabilitation, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Alireza Nikseresht Department of Neurology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Mahshid Naseri Department of Physical Medicine and Rehabilitation, Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Hajar Karimian Department of Physical Medicine and Rehabilitation, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. 2016 08 05 2017 05 15 Multiple sclerosis (MS) is the most common cause of disability after trauma in young adults in Northern Hemisphere; it imposes a major burden on the affected young people. A significant association between MS and demyelinating peripheral neuropathy which might be due to common pathogenesis for the central and peripheral nerves demyelination has been reported in several studies. We aimed to assess if there is any peripheral nervous system involvement in a sample of Iranian MS population. Extensive nerve conduction studies (NCS) were conducted in 20 MS patients according to McDonald criteria, and 20 age and gender matched healthy appearing controls. The F-wave ratio was calculated through placing the minimum amount of F-wave proximal latency after 10 stimuli and median or tibial nerves compound motor action potential (CMAP) proximal latency in the corresponding formula. Data were compared between groups. Finally, we found the significantly lower median and tibial nerves conduction velocities (NCV) in MS patients than healthy controls (P=0.008 and 0.003 respectively, Independent Samples t-test). Also, tibial NCV had a significant statistical correlation with Kurtzke’s expanded disability scale score (EDSS) as patients with higher EDSS had lower tibial NCV (Pearson's correlation coefficient, r2=0.8). No statistical relationship was found between MS subtypes and NCS parameters. Although we found some electrodiagnostic abnormalities in Iranian MS patients in comparison to the healthy participants, these differences were small and inconclusive. More extensive well-designed electrodiagnostic studies for evaluation of peripheral nervous system involvement and its probable pattern in these patients seems to be needed. https://acta.tums.ac.ir/index.php/acta/article/view/5805 https://acta.tums.ac.ir/index.php/acta/article/download/5805/4972

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 8 2017 10 07 530 532 EN Masoud Fallahi Motlagh Department of Oral and Maxillofacial Surgery, Urmia University of Medical Sciences, Urmia, Iran. Hamid Janghi Aghdam Department of Neurosurgery, Azarbayjan Hospital, Urmia, Iran. Behzad Fallahi Motlagh Department of Ophthalmology, Tabriz University of Medical Sciences, Tabriz, Iran. 2016 01 02 2016

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 10 2019 01 13 660 664 EN Mehrdad Goodarzi Department of Anesthesiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Hossein Ali Khazaei Department of Clinical Immunology, Clinical Immunology Research Center (CIRC), Zahedan University of Medical Sciences, Zahedan, Iran. Bahar Ashjaei Department of Surgery, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran . Maryam Ghavami Department of Surgery, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran . Mansour Mollaeian Department of Surgery, School of Medicine, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran. Nora Bigdeli Department of Surgery, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran . Ali Talebi Department of Surgery, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Azita Parvizizadeh Department of Surgery, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Gholamreza Badfar Department of Pediatric, School of Medicine, Ahvaz University of Medical Sciences, Ahvaz, Iran. Alireza Ebrahim Soltani Department of Anesthesiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Alireza Nahvi Department of Biomedical Engineering, School of Engineering, Shahed University, Tehran, Iran. Valiullah Mehrabi Department of Surgery, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Hedayatollah Nahvi Department of Surgery, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran . 2018 03 17 2018 08 10 Esophageal atresia (EA) is a rare congenital anomaly that may be isolated or associated with other anomalies requiring prompt medical and surgical planning for optimal result. This study was conducted to show our recent experience on the outcome of treated patients in two hospitals affiliated to Tehran University of Medical Sciences (TUMS). From January 2008 to May 2013 records of 43 neonates patients (23 male) with EA admitted in 2 children centers and all related data including demographic, diagnostic associated anomalies, surgical approaches, birth weight, mortality, and complications were collected. Inability of feeding and swallowing was the most common symptoms (in 90,6%), associated CHD (44%), and Type C (EA) was the most common type of EA observed in 86% patients, The mortality rate was 4.7% and most common complication was anastomotic stricture (AS) in 60% of patients. Our study showed that despite improvements in management and survival of an infant with (EA), still sepsis, aspiration pneumonia, prematurity, and low birth weight and severe Congenital Heart Disease (CHD) were independent etiology of death and birth weight < 2.500 gr  has a significant  effect on the occurrence of postoperative complications. https://acta.tums.ac.ir/index.php/acta/article/view/7127 https://acta.tums.ac.ir/index.php/acta/article/download/7127/5171

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 10 2019 01 13 665 670 EN Taraneh Dormohammadi Toosi Department of Rheumatology, University of San Diego, CA, USA. AND Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran, Iran. Abodolrahman Rostamiyan Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran, Iran. Khatereh Moharrami Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran, Iran. Shafieh Movassaghi Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran, Iran. Manouchehr Nakhjavani Endocrine and Metabolic Research Center, Tehran University of Medical Sciences, Tehran, Iran.and Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran, Iran Amir Hossein Norooznezhad Regenerative Medicine Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. 2018 08 02 2018 11 10 It has been proved that rheumatoid arthritis (RA) is linked to dyslipidemia and the risk of cardiovascular complications is higher in these patients. The aim of this study was to evaluate dyslipidemia in RA patients. In this study, RA patients were enrolled regarding the inclusion and exclusion criteria. Their demographic information and medication profiles were evaluated. Clinical assessments were performed by evaluation of disease activity score (DAS28) and visual analogue scale. Moreover, laboratory investigations of lipid profile including triglycerides (TG), total cholesterol (Chol), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were performed. From a total of 150 patients with the mean age of 54.9±16.8 years, 65.3% were diagnosed with dyslipidemia. Females in menopausal ages had a higher prevalence of dyslipidemia as well as patients with longer disease duration. Mean serum HDL, LDL, Chol, and TG were 52.76±13.8, 96.65±21.6, 177.26±38.9, and 128.04±33.9, respectively. Considering DAS28, 100% of the patients with high disease activity were diagnosed with dyslipidemia. In the moderate and low disease activity groups and also patients in remission the ratio was 77.02%, 66.66%, and 43.75%, respectively. According to the results, patients under treatment with prednisolone and methotrexate were more affected by dyslipidemia than those with prednisolone, methotrexate, and hydroxychloroquine. Moreover, in the patients under prednisolone, methotrexate, and leflunomide treatment, the prevalence of dyslipidemia was significantly lower than those used only prednisolone and methotrexate. Altogether, it is necessary to have more clinical suspicion towards dyslipidemia and its complications in the patients with greater number of affecting factors. https://acta.tums.ac.ir/index.php/acta/article/view/7419 https://acta.tums.ac.ir/index.php/acta/article/download/7419/5172

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 10 2019 01 13 671 676 EN Mohaddeseh Azadvari Department of Physical Medicine and Rehabilitation, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Seyede Zahra Emami Razavi Department of Physical Medicine and Rehabilitation, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Farid Rezaiee-Moghaddam Department of Physical Medicine and Rehabilitation, Emam Reza Hospital, Aja University of Medical Sciences, Tehran, Iran. Zahra Reza-Soltani Department of Physical Medicine and Rehabilitation, Emam Reza Hospital, Aja University of Medical Sciences, Tehran, Iran. Sirus Azizi Department of Physical Medicine and Rehabilitation, Emam Reza Hospital, Aja University of Medical Sciences, Tehran, Iran. Amir Rakhshan Department of Foreign Languages, Tehran University of Medical Sciences, Tehran, Iran. 2017 12 20 2018 11 14 Spinal manipulation is a manual technique commonly used for the treatment of low back pain. The physiologic mechanisms of the spinal manipulation are largely unknown. One basic physiologic response for spinal manipulation is an alteration in motoneuronal activity, as assessed by the Hoffmann reflex (H-reflex) technique. The purpose of this study was to determine the effect of spinal manipulation on the amplitude and onset latency of H-reflex and on H/M amplitude ratio in patients with low back pain. Fifty-Eight patients with low back pain aged between 20-60 years, who had no exclusion criteria were included. Tibial nerve H-reflex and M wave were recorded before and after Lumbosacral spinal manipulation. Lumbosacral manipulation significantly decreased the amplitude of the H-reflex and H/M amplitude ratio (P<0.05). It had no significant effect on H-reflex  latency or M wave amplitude and latency (P>0.05). Lumbosacral manipulation produces attenuation of alpha motoneuronal excitability. These findings support this theory that manual spinal therapy can lead to a reduction in muscle tone. https://acta.tums.ac.ir/index.php/acta/article/view/6902 https://acta.tums.ac.ir/index.php/acta/article/download/6902/5173

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 10 2019 01 13 677 680 EN Amene Saghazadeh Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. AND Meta Cognition Interest Group (MCIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran Seyed Hassan Tonekaboni Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Hossein Najmabadi Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Evin, Tehran, Iran. AND Kariminejad-Najmabaadi Pathology and Genetics Laboratory, 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 Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran. 2018 03 31 2018 11 05 The ATP8A2 protein is mainly located in the brain and takes part in the lipid flipping process. Mutations in the ATP8A2 gene and chromosomal translocations that interfere with the ATP8A2 gene product have been reported in association with global developmental delay and hypotonia. Here, we will report a three-year-old male presented with major phenotypic features of dysequilibrium syndrome (DES), including severe hypotonia, global developmental delay, speech problem, and strabismus. Whole exome sequencing revealed a homozygous in-frame deletion in the ATP8A2 gene (c.1286_1288delAGA, p.Lys429del). This ATP8A2 variant has not been reported yet and seems to be linked to the phenotypic features of dysequilibrium syndrome. https://acta.tums.ac.ir/index.php/acta/article/view/7153