Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 10 2017 12 02 604 611 EN Haideh Nadmdari Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Mohsen Keshavarz Department of Medical Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Talat Mokhtari-Azad Department of Virology, School of Public Health, National Influenza Center, Tehran University of Medical Sciences, Tehran, Iran. Farhad Rezaei Department of Virology, School of Public Health, National Influenza Center, Tehran University of Medical Sciences, Tehran, Iran. 2016 12 17 2017 04 10 We previously developed an influenza virus like particle with HA, M, and NA proteins using Bac-to-Bac expression system and SF9 cell line. To evaluate the immunogenicity of our construct, we assessed the humoral, cytokine induced by H1N1-VLP in BALB/c mice immunized intranasally and intramuscularly. Enzyme-linked immunosorbent assay and Relative quantitative real-time PCR were used to evaluate the antibody (IgG and IgA) and mRNA levels of IL-6, IL-4, IL-10 and IFN-g in PBMCs. Our results showed that VLP was capable of intranasal (I.N.) and intramuscular (I.M.) induction of serum IgG and IgA responses. Interestingly, I.N. route induced higher IgG and IgA titer than I.M. route, which was statistically significant. Moreover, mRNA levels of IL-6 (4.2-4.5 folds), IFN-g (5.5-5.7 folds), and the anti-inflammatory cytokine IL-10 (2.5-3 folds) and IL-4 (2.4-2.8 folds) were significantly elevated in mice immunized I.N. and I.M. with H1N1-VLP compared to the control group. Our findings indicated that a non-infectious genome-less VLP approach mimics parenteral virus with multiple viral antigens and epitopes that stimulate a diverse set of immune responses such as innate immunity, specific serum IgG antibody, cell-mediated immunity, and local antibodies. https://acta.tums.ac.ir/index.php/acta/article/view/6069 https://acta.tums.ac.ir/index.php/acta/article/download/6069/4997

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 10 2017 12 02 650 654 EN Mehrdad Noruzinia Department of Medical Genetics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Mohammad Ahmadvand Hematology, Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Oranous Bashti Department of Medical Genetics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Ahmad Reza Salehi Chaleshtori Department of Medical Genetics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran. 2016 05 31 2016 08 15 Kleefstra Syndrome is characterized by severe mental retardation, brachycephaly, microcephaly, epileptic seizures, distinct facial features, and infantile weak muscle tone and heart defects. Deletion of EHMT1 is the main player in 75% of cases. Because of blurriness in genotype-phenotype correlation through clinical and molecular features of both 9q34.3 microdeletion patients and those with an intragenic EHMT1 mutation in Kleefstra Syndrome, genetic characterization of patients with clinical symptoms of such spectrum is desirable. We report the first Kleefstra Syndrome patient in Iran characterized through genetic approaches. Our report could improve KS diagnosis in Iran and prepare PND and PGs options for involved families. https://acta.tums.ac.ir/index.php/acta/article/view/5676 https://acta.tums.ac.ir/index.php/acta/article/download/5676/5003

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 10 2017 12 02 664 664 EN 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. Amene Saghazadeh Research Center for Immunodeficiencies, Children’s Medical Center, 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. 2016 12 19 2017 04 10 No Abstract   https://acta.tums.ac.ir/index.php/acta/article/view/6074 https://acta.tums.ac.ir/index.php/acta/article/download/6074/5006

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 10 2017 12 02 612 615 EN Reza Shahmirzai Department of Cardiology, Arak University of Medical Sciences, Arak, Iran. Mohammadreza Firouzifar Department of Otorhinolaryngology, Otorhinolaryngology Research Center, Amir A’alam Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2016 10 04 2017 04 15 Idiopathic leg edema is subject to a lot of debates among physicians. Recently sleep apnea was stated to be the cause. We sought to investigate this matter in a sample of Iranian patients with idiopathic leg edema. In this case-control study, 110 patients were selected based on our inclusion/exclusion criteria and allocated to the case (with idiopathic edema, n=55) and control (without edema, n=55) groups. Sex, age, weight, height, and body mass index (BMI) of all subjects were recorded. We evaluated daytime somnolence of all patients using Epworth sleepiness scale and then calculated Apnea, hypopnea index (AHI) using ResMed ApneaLink and AHI≥15 were considered as sleep apnea. Age and sex of both groups were not significantly different. Cases had higher BMI than control groups (P=0.03), but they were not significantly different for obesity (P=0.197). AHI was significantly higher in cases (17.85±24.31 vs. 9±7.37 P=0.012). Daytime somnolence (cases 8.18±5.3 vs. controls 6.5±3.3) was also higher in cases. Overall Odds ratio of leg edema and sleep apnea was 3.068 (P=0.025), but it wasn’t significant in the two genders. Idiopathic bilateral leg edema is strongly associated with sleep apnea. Routine sleep apnea assessment in patients with idiopathic bilateral leg edema is recommended for both genders. https://acta.tums.ac.ir/index.php/acta/article/view/5935 https://acta.tums.ac.ir/index.php/acta/article/download/5935/4998

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 10 2017 12 02 655 657 EN Arya Sotoudeh Growth and Development Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Pediatric Endocrinology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Parastoo Rostami Growth and Development Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Pediatric Endocrinology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Maryam Nakhaeimoghadam Growth and Development Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Pediatric Endocrinology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Reihaneh Mohsenipour Growth and Development Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Pediatric Endocrinology, 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. 2016 06 11 2017 04 10 Pericentric inversion of Chromosome 9 is one of the most common chromosomal abnormalities, which could be associated with various manifestations in some cases. Herein, a patient is presented with ambiguous genitalia that karyotyping revealed pericentric inversion of Chromosome 9 (p12,q13). Pericentric inversion of Chromosome 9 could be considered in the list of differential diagnosis of those with ambiguous genitalia, while chromosomal karyotype and culture could be recommended in children with ambiguous genitalia. https://acta.tums.ac.ir/index.php/acta/article/view/5693 https://acta.tums.ac.ir/index.php/acta/article/download/5693/5004

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 10 2017 12 02 616 620 EN Khadije Najafi Student Research Committee, School of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran. Sajad Ahmadi Student Research Committee, School of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran. Mahdi Rahpeyma Student Research Committee, School of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran. Habibolah Khazaie Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. Asad Vaisi-Raygani Department of Biochemistry, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran. Ali Moini Department of Internal Medicine, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. Amir Kiani Regenerative Medicine Research Center (RMRC), Kermanshah University of Medical Sciences, Kermanshah, Iran. 2017 02 21 2017 05 17 Opioid compound and methamphetamine are commonly used in drug abuse; these can disrupt the normal function of cellular and molecular systems, leading to several events such as oxidative stress, aging, apoptosis, and necrosis. Malondialdehyde (MDA) is the most important biomarker for evaluation of oxidative stress and determination of lipid peroxidation. In this study, 42 drug abusers and 22 healthy persons participated as case and control groups, respectively. MDA in volunteer sera was determined by high-performance liquid chromatography (HPLC) with fluorescence detection after pre-column derivatization using thiobarbituric acid. The analysis was performed on a ODS column by spectrofluorometer detection, operated at excitation of 515 nm and emission of 535 nm. A mixture of phosphate buffer (0.05 M, pH 6.8), containing potassium monobasic phosphate and methanol (60:40, v/v) at a flow rate of 1 ml/min, was used as the mobile phase. The retention time of MDA-TBA was 3.2 min. Our findings showed that the MDA level increased in the opioid and methamphetamine abusers when compared to the control group (P<0.05); however, no significant difference was observed between the opioid and methamphetamine groups. A state of oxidative stress during biological processes leads to lipid peroxidation, DNA damage, biomolecule dysfunctions, and many other diseases. Since it is impossible to eradicate the drug addiction, we should reduce the side effects of drug abuse, such as oxidative stress, by intake of proper nutrition and antioxidants. https://acta.tums.ac.ir/index.php/acta/article/view/6250 https://acta.tums.ac.ir/index.php/acta/article/download/6250/4999

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 10 2017 12 02 658 660 EN Stepan Kutilek Department of Pediatrics, Pardubice Hospital, Pardubice, Czech Republic. 2016 06 23 2017 03 21 Denosumab is a fully human recombinant monoclonal antibody to the receptor activator of nuclear factor-κB ligand. Denosumab is used in the treatment of postmenopausal osteoporosis and cancer-related bone disorders. There are only very scarce data on denosumab treatment in children. 14-year-old boy with spinal muscular atrophy (SMA) and severe disuse osteoporosis (spinal bone mineral density L1-L4 BMD-6.2SD Z-score) and two prevalent fragility fractures was treated with denosumab. He received 60 mg  subcutaneous injection at the baseline and seven months later. Six months after the initial injection there was a 19% increase in L1-L4 BMD. The injections were well tolerated without any adverse reactions. Calcemia remained stable (2.3-2.4 mmol/L). He was scheduled for the third denosumab injection six months later. Prior to this date, he acquired pneumonia and died due to respiratory failure, which is a frequent cause of death in patients with SMA. There was no relation to the denosumab treatment. In conclusion, one dose of denosumab significantly increased BMD in a child with severe osteoporosis. https://acta.tums.ac.ir/index.php/acta/article/view/5707 https://acta.tums.ac.ir/index.php/acta/article/download/5707/5008

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 10 2017 12 02 661 663 EN Şule Yıldırım Department of Pediatrics, School of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey. Naci Topaloğlu Department of Pediatrics, School of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey. Mustafa Tekin Department of Pediatrics, School of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey. Fatma Sılan Department of Medical Genetics, School of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey. 2017 09 16 2017 09 24 We report a case of 11-year-old girl with growth retardation and 46, XX, Xq27-qter deletion. The endocrinologic evaluation revealed growth hormone deficiency. an University of Medical Sciences, Tehran, Iran. Moloud Payab Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Gholamreza Pourmand Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2017 03 13 2017 03 15 Stress urinary incontinence is a common medical problem among women. The urethral closure complex and/or the supportive mechanisms are responsible for incontinence in the majority of patients. Several surgical procedures with different degrees of invasiveness and outcomes have been reported to treat the problem. Although most of these procedures are reasonably effective, a general trend towards the study of natural and biocompatible tissues is emerging over popular synthetic materials. Here we report our experience of autologous adipose-derived stem cells transplantation into the periurethral region as a new method of stress urinary incontinence treatment. Ten women with symptoms of stress urinary incontinence were treated by injections of autologous adipose-derived stem cells into the periurethral region via transurethral and transvaginal approach under urethroscopic observation. This report presents the short-term outcome of the patients. The outcome measured by pad test results, ICIQ-SF scores, and Qmax. The mean age of the participants was 45.8±8.7 years. Urinary incontinence significantly decreased through the first two, 6 and 24 weeks after the injection therapy. The difference was significant in pad test results (P<0.001) and ICIQ-SF scores (P<0.001), especially comparing results between 2 and 6 weeks and among 6 and 24 weeks, but not for 2 and 6 weeks compared to each other. Surprisingly, Qmax showed improvement after the study period (means 32.6 vs. 35.7; P=0.002). This study showed that injection of the autologous adipose-derived stem cells to the periurethral region is a safe, yet short-term effective treatment option for stress urinary incontinence. Further studies with longer follow up are needed to confirm its long term efficacy. https://acta.tums.ac.ir/index.php/acta/article/view/6295 https://acta.tums.ac.ir/index.php/acta/article/download/6295/4947

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 6 2017 08 19 411 413 EN Raheleh Aliabadi Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran. Hassan Riahi Beni Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran. Jila Nadjafi East Surrey Associate Hospital for Brighton University, London, Uk. Morteza Hassanzade Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran. Mehrnaz Tabrizi Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran. Mohsen Nasiri Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran. Gandom Sedehi Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran. Ali Pourmojarab Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran. 2015 10 28 2016 04 17 Streptokinase is a fibrinolytic agent that enhances plasmin activation and is used in selected patients with acute ST elevation myocardial infarction (STEMI). Similar to the other thrombolytics, a common side effect is bleeding, especially from venous puncture sites. Here, we present a case of acute anterior wall STEMI complicated by large spontaneous iliopsoas hematoma after streptokinase administration. With conservative management, the course of the disease was uneventful, and the patient was discharged with no symptom and no clinically important sequel. https://acta.tums.ac.ir/index.php/acta/article/view/5087 https://acta.tums.ac.ir/index.php/acta/article/download/5087/4955

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 6 2017 08 19 375 380 EN Abbas Darjani Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran. Nahid Nickhah Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran. Mohammad Hassan Hedayati Emami Department of Internal Medicine, Endocrinology and Metabolism Research Center, Guilan University of Medical Sciences, Rasht, Iran. Narges Alizadeh Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran. Rana Rafiei Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran. Hojat Eftekhari Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran. Kaveh Gharaei Nejad Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran. 2016 04 07 2017 02 01 Pemphigus vulgaris is a chronic autoimmune disease and glucocorticoids are one of the main treatments. Our study investigates the prevalence and associated factors of glucocorticoid-induced diabetes mellitus in these patients under different glucocorticoid regimens. 36 patients with first diagnosed Pemphigus vulgaris based on pathological and direct immunofluorescence findings who had received different glucocorticoid regimens (1-2 mg/kg oral or 1-2 mg/kg oral with 1g methylprednisolone pulse daily for 3 consecutive days with or without azathioprine) were evaluated during 2014-2016. Our study found that 22.2% of patients had impaired fasting glucose and incidence of corticosteroid-induced diabetes mellitus was 22.2% with no difference between oral and pulse therapy of corticosteroid. The first day after pulse therapy 19 patients of 21 had post bolus hyperglycemia that 36% of them became diabetic after 8 weeks. None of the variables, including age, BMI, HbA1c, LDL, HDL, TG, cholesterol, family history and blood pressure were associated with diabetes. Pretreatment FBS was the factor that would increase the likelihood of glucocorticoid-induced diabetes mellitus, 42.2% of patients with pretreatment FBS 100-126 developed diabetes in comparison with 17.2% in normal pretreatment FBS. Although the group who received azathioprine was associated with increased incidence of diabetes, the overall corticosteroid dose in this group was significantly higher than the other group (P=0.012), and controversy with other studies could be because of difference in corticosteroid dosage and small number of patients. The incidence of diabetes was not different between the group with glucocorticoid pulses and oral prednisolone without pulse therapy. Higher pretreatment FBS can be related to increased incidence of diabetes, but results from this study due to small number of patients are preliminary and multicenter studies are needed. https://acta.tums.ac.ir/index.php/acta/article/view/5561 https://acta.tums.ac.ir/index.php/acta/article/download/5561/4948

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 6 2017 08 19 381 388 EN Ata Pourabbasi Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Tehrani-Doost Department of Psychiatry, Rouzbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. Soqra Ebrahimi Qavam Department of Educational Psychology, Faculty of Psychology and Education, Allameh Tabataba’ee University, Tehran, Iran. Jalal Farzami Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modarres University, Tehran, Iran. Bagher Larijani Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 2017 01 31 2017 02 07 Diabetes in children and adolescents is a chronic condition with an expanding trend in the community. Several studies have shown cognitive dysfunctions are the most important side effects of diabetes among individuals of younger ages. Due to cultural differences and their impact on cognitive issues, the authors decided to assess the cognitive functions of Iranian children and adolescents with diabetes. Cognitive functions including memory, attention and executive functions were evaluated in 62 diabetic children and adolescents and healthy peers using CANTAB cognitive tests. Other data such as demographic, school performance and medical information were collected by questionnaires. Except in the case of few variables in RVP, SSP and SST, no significant difference exists between diabetic children and the control group in terms of different cognitive domains. But cognitive variables, especially in PRM, SWM and SOC test, has been shown to be deteriorated with increasing HbA1C values in serum levels. Diabetes has no impact on the cognitive functioning of children provided by maintaining a glycemic control. It is proposed that the adoption of appropriate parenting styles and family and social support can prevent cognitive changes in children with diabetes. https://acta.tums.ac.ir/index.php/acta/article/view/6197 https://acta.tums.ac.ir/index.php/acta/article/download/6197/4949

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 6 2017 08 19 389 394 EN Niloofar Shekoohi 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.