Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 2 2018 02 17 74 76 EN Sara Rashid Chehreh Bragh Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND NeuroImmunology Research Association (NIRA), Universal Scientific Education and Research Network (USERN), Tehran, Iran. Farzaneh Rahmani NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran. AND Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Nima Rezaei Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND Research Center for Immunodeficiencies, Children’s Medical Center, 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. 2017 11 01 2017 12 11 No Abstract https://acta.tums.ac.ir/index.php/acta/article/view/6819 https://acta.tums.ac.ir/index.php/acta/article/download/6819/5048

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 2 2018 02 17 77 83 EN Ateke Mousavi Nasl-khameneh Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, International Campus, Tehran University of Medical Sciences, Tehran, Iran. Abbas Mirshafiey Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Abdorreza Naser Moghadasi MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Reza Shiri-Shahsavar Department of Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran. Mohammad Reza Eshraghian Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Maryam Shadanian Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Mina Abdolahi 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, International Campus, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 2017 03 12 2017 04 30 Multiple sclerosis (MS) is an autoimmune disease with the impaired balance of CD4+T cells. This trial is a descriptive study to evaluate the expression of CD4+T cell cytokines, interleukin (IL) ‑2, IL‑4, IL‑17, TGF‑β, and respectively related transcription factors, including T-bet, GATA3, RORγt and FoxP3 in MS patients. Sixteen relapsing-remitting MS (RRMS) patients receiving interferon beta (IFN-β)-1a in the stable phase of the disease and 14 healthy control volunteers (HCs) were enrolled in this study. The expression of cytokines and transcription factors was evaluated in peripheral blood mononuclear cells (PBMCs) of patients using real time PCR. The results of this study showed that the expression of IL-2 (P≤0.05), IL-4 (P≤0.05), IL-17 (P≤0.05) and RORγt (P≤0.01) in PBMCs of RRMS patients were significantly higher than those in HCs. The expression of TGF‑β, GATA3, and FoxP3 were higher but the RORγt expression was lower in the patients than HCs without reaching significant value. Observed results indicated differences in immune system cytokines of healthy volunteers and the patients that were in the stable phase and under immunomodulatory therapy especially in proinflammatory mediators. Therefore, any therapeutic strategy to restore the immune system balance is desirable in RRMS patients. https://acta.tums.ac.ir/index.php/acta/article/view/6298 https://acta.tums.ac.ir/index.php/acta/article/download/6298/5049

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 2 2018 02 17 127 131 EN Gholamreza Sivandzadeh Department of Gastroenterology, Gastroenterology and Hepatology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. Alimohammad Banazadeh Department of Surgery, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. Amir Anushiravani Department of Gastroenterology and Hepatology, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2016 11 24 2017 05 07 Foreign bodies are commonly ingested and usually pass through the gastrointestinal tract, but in less than 1% complications can be seen. We aimed to report a very rare case of multiple hepatic abscesses caused by perforation of the sigmoid colon due to a chicken bone. An 82-year-old man presented with a 5-day history of abdominal pain, fever, and coffee ground vomiting. He was febrile and tachycardic and had a mild localized abdominal tenderness in the left lower quadrant. Laboratory findings revealed a lymphocyte dominant leukocytosis with an elevated erythrocyte sedimentation rate. Multiple abscesses were shown in the right lobe of the liver in abdominal computed tomography. Colonoscopy showed a chicken bone perforating both walls of the sigmoid colon. He received broad-spectrum antibiotics and underwent surgery for a complete recovery. Chronic lymphocytic leukemia was diagnosed by flow cytometry phenotyping. Mortality and morbidity of hepatic sepsis caused by foreign body-induced colon perforation depend on a rapid diagnosis.  We presented a very rare condition that should always be kept in mind when dealing with a case of liver abscess and even while confronting septic shock with an unknown origin. https://acta.tums.ac.ir/index.php/acta/article/view/6031 https://acta.tums.ac.ir/index.php/acta/article/download/6031/5057

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 2 2018 02 17 84 89 EN Mehran Zarei-Ghanavati Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Reza Ghaffari Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Hoda Abedkhojasteh Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Kasra Raoufian Department of General Surgery, Sina Hospital, Mashhad, Iran. Reza Raoofian Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran. Masoumehe Mohebbi Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mansour Heidari Department of Molecular Biology and Genetics, Islamic Azad University, Bushehr Branch, Bushehr, Iran. AND Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2017 06 01 2017 11 08 Non-syndromic aniridia (iris hypoplasia) as an autosomal dominant eye disorder results from the chromosomal abnormalities and mutations within the paired box gene 6 (PAX6). The aim of this study was to investigate on the clinical and the underlying genetic alteration in PAX6 gene in a large pedigree with five generations of Iranian family with an autosomal dominant aniridia. Here, we reported unique clinical features in terms of presenting nystagmus, ptosis, minimal iris abnormality, foveal hypoplasia and late-onset clinical limbal stem cell deficiency. Genomic DNA was extracted from the affected members and polymerase chain reaction (PCR) was conducted using specific primers to amplify coding sequence of PAX6. Then, PCR products were subjected to bidirectional dye terminator sequencing. A heterozygous transversion mutation A→T (c.1268A>T, p.*423Lext*15) in exon 13 of PAX6 was identified in all affected individuals, but not in the healthy members. This is the first report of non-stop mutation in PAX6 gene in an Iranian family accompanied with an isolated form of unusual congenital aniridia running within this family. https://acta.tums.ac.ir/index.php/acta/article/view/6500 https://acta.tums.ac.ir/index.php/acta/article/download/6500/5050

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 2 2018 02 17 132 136 EN Seyed Hossein Fattahi Masoum Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Azadeh Jabbari Nooghabi Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Reza Rezaei Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 2016 05 17 2016 12 31 Castleman’s disease (CD) is a rare benign lymphoproliferative disorder with unknown etiology and pathogenesis. It presents in two identified clinical forms of unicentric or multicentric. The disease is usually found incidentally in the mediastinal or hilar region in asymptomatic patients. In unicentric CD, constitutional symptoms are uncommon, and they can be misdiagnosed as lung infections or malignancy. Although imaging studies are helpful, but definitive diagnosis can be made with pathologic examination. Complete surgical resection is the method of choice for treatment of localized CD, and the prognosis is excellent. In this study, we elucidate clinical features and therapeutic consequences of four cases of unicentric CD referred to our department and review the literature on the diagnosis and management of this relatively rare disorder. Because of the rarity of the disease and nonspecific signs and symptoms of CD it must be considered in differential diagnosis of pulmonary and mediastinal masses. https://acta.tums.ac.ir/index.php/acta/article/view/5640 https://acta.tums.ac.ir/index.php/acta/article/download/5640/5058

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 2 2018 02 17 90 94 EN Shabnam Baniasadian Department of Cellular and Molecular Biology, Ahar Branch, Islamic Azad University, Ahar, Iran. AND Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Safar Farajnia Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Behboud Jafari Department of Microbiology, Ahar Branch, Islamic Azad University, Ahar, Iran. 2017 06 07 2017 10 21 Genome-wide association studies in Asian population for the first time identified common variants in the KCNQ1 gene to be associated with type 2 diabetes in Japanese populations, recently. This result has been replied in some other East Asian population but, still now, there is no any report about this subject in Iranian population. The aim of this study was to investigate the frequency of KCNQ1 variants in type 2 diabetes in East Azerbaijan population, northwest of Iran. A total of 75 T2D and 90 normal East Azerbaijan subjects were entered the study. A demographic date was recorded for all subjects. Genomic DNA was extracted from the whole blood, and the KCNQ1 single nucleotide polymorphisms (SNPs) rs2237892 were genotyped with PCR-RFLP technique. The results of the study indicated an increased level of FBS and HbA1C among T2D cases (P<0/0001), as expected. Screening for KCNQ1 rs237892 among T2D case group revealed that the genotype frequencies of CC, CT and TT were 87.0% (67/77), 10.4% (8/77) and 2.6% (2/77), respectively. The allelic frequencies of C and T in case subjects were 92.21% (142/154) and 7.79% (12/154), respectively. Analysis of the normal control subjects showed the genotype frequencies of CC, CT and TT were 94.4% (85/90), 3.3% (3/90) 2/2% (2/90), respectively. The allelic frequencies of C and T among controls were 96.11% (173/180) and 3.89% (7/180), respectively. In conclusion, the results of our study indicated that there are no any significant differences in frequency of KCNQ1 rs237892 alleles between T2D and control subjects. https://acta.tums.ac.ir/index.php/acta/article/view/6514 https://acta.tums.ac.ir/index.php/acta/article/download/6514/5051

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 2 2018 02 17 137 139 EN Ebrahim Ghayem Hasankhani Department of Orthopedics and Spine Surgery, Orthopedic Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Farzad Omidi-Kashani Department of Orthopedics and Spine Surgery, Orthopedic Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Seyed Reza Habibzadeh Shojaie Department of Orthopedics and Spine Surgery, Orthopedic Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Golnaz Ghayem Hasankhani Department of Orthopedics and Spine Surgery, Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. 2016 12 07 2017 04 15 Myositis ossificans progressiva is a rare inherited disease characterized by progressive ectopic ossifications associated with thumb and big toe anomalies. Ossification usually progresses from central to the peripheral, proximal to distal, cranial to caudal, and from dorsal to ventral directions and leading to activity limitation, significant eating disability, recurrent pulmonary infection, and atelectasis. In this report, we present a 7-year-old boy with a total spine stiffness (wooden spine) seriously limited his activity of daily living. https://acta.tums.ac.ir/index.php/acta/article/view/6050 https://acta.tums.ac.ir/index.php/acta/article/download/6050/5059

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 2 20 Pourfakhr Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Seyed Hashem Ziaei Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Farhad Etezadi Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza Khajavi Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohamad Reza Sharifnia Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran 2019 02 27 2019 06 17 Fentanyl-induced cough (FIC) is a known complication, and many studies have been conducted to prevent it. The aim of this study was to evaluate the effectiveness of Diphenhydramine as an antihistamine in suppressing of FIC during induction of anesthesia. In a prospective, double-blind, randomized controlled trial, a total of 100 patients, ASA Class I and II, scheduled for elective laparoscopy surgery were randomly assigned into two equally sized groups (n=50). Diphenhydramine diluted with distilled water as 10 mg/ml. Then, patients in Group D, received diphenhydramine 30 mg (3 ml) through peripheral IV line within 1 min and Group C received the same volume normal saline 0.9% as placebo. Two min later, fentanyl 2 µg/kg was administered through the peripheral IV line within 5 sec in all patients. The occurrence and intensity of cough within 2 min after the fentanyl injection were observed and recorded by a resident who was blinded to the study groups. The frequency of PONV, analgesic requirement in the recovery room and as a secondary outcome were recorded. The incidences of FIC were 47% in the control group, and there is no cough in the diphenhydramine group (P=0.02). The frequency of PONV was also reduced in diphenhydramine group (16% vs. 40%) and less number of patients in diphenhydramine group was needed to analgesia in the recovery room (60% vs. 82%). Our study determines that diphenhydramine (30 mg, IV) bolus injection 2 min before fentanyl injection can prevent FIC and PONV and also reduce analgesic requirement inthe recovery room.     https://acta.tums.ac.ir/index.php/acta/article/view/7735 https://acta.tums.ac.ir/index.php/acta/article/download/7735/5260

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 5 2019 09 30 320 327 EN Abolfazl Ghoreishi Department of Psychiatry, Social Determinant of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran. AND Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran. Lila Dashtaki Department of Psychiatry, Shahid Beheshti Hospital, Zanjan University of Medical Sciences, Zanjan, Iran. Bahareh Hajisalimi Department of Internal Medicine, Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran. 2018 12 29 2019 08 30 Sexual dysfunction is a common complication among male patients with chronic kidney disease. Common disturbances include erectile dysfunction, decreased libido, and infertility. Sexual dysfunction is a multifactorial problem, and the treatment options are limited, it associated with lower quality of life scores in patients. Chronic kidney disease also has a critically impairing effect on the quality of life. To investigate the efficacy of bupropion on sexual dysfunction and quality of life in men with chronic kidney disease, a single-blind placebo-controlled trial was conducted. A total of 40 male patients with chronic kidney disease suffering from erectile dysfunction (Mean age 41/25±8/8) were randomly assigned to receive 10 weeks of treatment with either bupropion or placebo. Sexual function and quality of life were assessed by IIEF5 and WHOQOL-BREF questionnaires, respectively. Baseline demographic and clinical features were similar in both groups. The results showed a significant difference between the intervention and control groups in sexual function (P=0/005) and total quality of life (P=0/001); also the difference was significant in physical health (P=0/012), psychological health (P<0/001) and social relationship (P<0/001) domains. Our findings suggest that Bupropion is effective and safe for treating sexual dysfunction in men with chronic kidney disease and also could positively affect the quality of life among the patients. https://acta.tums.ac.ir/index.php/acta/article/view/7649 https://acta.tums.ac.ir/index.php/acta/article/download/7649/5267

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 5 2019 09 30 328 331 EN Sanaz Mehrabani Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. Mohammad Pornasrollah Clinical Research Development Center, Amirkola Children's Hospital, Babol University of Medical Sciences, Babol, Iran. Leila Moslemi Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. 2018 04 15 2018 12 16 Eosinophilic gastroenteritis (EG) is a rare inflammatory disorder affecting both children and adults. The exact etiology of the disease is not clear. A child presented with episodic generalized abdominal pain since a year ago without fever at first. After endoscopic and colonoscopic examinations, histopathological examination showed an increased number of eosinophils and diagnosis of EG was made. After elimination of dairy products from his regimen, abdominal pain attacks was reduced, but he got a fever. Familial Mediterranean Fever (FMF) diagnosis was made by genetic evaluation which showed MEV gene mutation. Symptoms were resolved with the treatment of colchicine which confirmed FMF diagnosis.  https://acta.tums.ac.ir/index.php/acta/article/view/7193 https://acta.tums.ac.ir/index.php/acta/article/download/7193/5268

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 5 2019 09 30 332 334 EN Arsalan Azizi Department of Pathology, Imam Sajad Hospital, Yasuj University of Medical Sciences, Yasuj, Iran. Moslem Sedaghattalab Department of Internal Medicine, Imam Sajad Hospital, Yasuj University of Medical Sciences, Yasuj, Iran. 2018 03 05 2021 08 06 Reye's syndrome (RS) is a rare disease, usually associated with consumption of salicylates during viral illness. In 1965, the first case of association between RS and salicylates was described in United Kingdom (UK). The incidence of RS decreased dramatically after warnings of UK and US health agencies against using aspirin in children. Patients with RS presented with neurologic compromise, cerebral edema, acute hepatitis, and liver failure-especially in the children.  In this paper, a four-month-old boy with diagnosis of RS was described, who presented with malaise, cyanosis and decreased level of consciousness, but the history of salicylates consumption was negative for him and his mother. https://acta.tums.ac.ir/index.php/acta/article/view/7089 https://acta.tums.ac.ir/index.php/acta/article/download/7089/5269

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 5 2019 09 30 335 337 EN Mohammad Ebrahimzadeh Ardakani Department of Dermatology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Narges Ghanei Department of Dermatology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mitra Shafihosseini Department of Dermatology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. 2018 06 14 2018 12 19 Unilateral Nevoid Acanthosis Nigricans (UNAN) is a rare, benign, autosomal dominant form of Acanthosis Nigricans (AN), which is a disorder of keratinization. Unlike AN, the lesions of UNAN are distributed unilaterally while the histopathological findings are similar to the common form of AN. The first description of UNAN was given by Krishnaram in 1991, and following that report, very few cases have been reported. Herein, we present another case of UNAN localized over the back, in a young adult female. https://acta.tums.ac.ir/index.php/acta/article/view/7315 https://acta.tums.ac.ir/index.php/acta/article/download/7315/5270

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 5 2019 09 30 338 340 ENGLISH Raziyeh Kheirjou Department of Anatomical Sciences, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Kobra Velaei Department of Anatomical Sciences, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Maryam Ezzati Department of Anatomical Sciences, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 2018 11 15 2018 12 28 Anatomical muscles’ variation may face clinician and surgeon with some dilemmas. Obviously, reporting a rare case of variations could explore some unexplained and unexpected clinical symptoms. Bilateral three head biceps, which had a supernumerary head with different origins in both right and left arms, is reported in this case report article. The crucial importance of arm muscles variations’ is because of their adjacent location to brachial nerve plexus and brachial vessels. Every single alteration in the direction of anatomical elements could result in pressure on nerve or vessels with clinical symptoms. Taken together, investigation and popularization of variations make a well-knowledged background for clinicians and surgeons.     https://acta.tums.ac.ir/index.php/acta/article/view/7583 https://acta.tums.ac.ir/index.php/acta/article/download/7583/5265

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 5 2019 10 01 341 341 Matineh Barati Bagherabad Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. AND Department of Biology, Ashkezar Branch, Islamic Azad University, Ashkezar, Yazd, Iran. Sahar Tavakolian Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. AND Department of Biology, University of Sistan and Balouchestan, Sistan and Balouchestan, Iran. Mohammad Reza Abbaszadegan Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. AND Department of Medical Genetics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. AND Department of Human Genetics, Immunology Research Center, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran. Mohammad Amin Kerachian Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. AND Department of Medical Genetics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. AND Cancer Genetics Research Unit, Reza Radiotherapy and Oncology Center, Mashhad, Iran.