Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 3 2018 03 06 140 150 EN Mohammad Reza Dehghani Department of Molecular Medicine, School of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran. Reza Ahangari Cohan Department of Pilot Nanobiotechnology, New Technologies Research Group, Pasteur Institute of Iran, Tehran, Iran. Kobra Omidfar Biosensor Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Hossein Ghahremani Department of Molecular Medicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Pharmacology-Toxicology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. 2017 02 23 2017 07 02 Tri-functional antibodies, as an effective novel tumor targeting agents, are composed of anti-CD3 rat IgG2b and an anti-tumor antigen antibody. We have intended to develop a novel drug system to induce the apoptosis of HER2-expressing tumor cells, activate and engage cytotoxic T lymphocytes, natural killer cells, and macrophages. In addition, the drug can  inhibit programmed death ligand 1 (PDL-1)-expressing tumor cells. We have designed a mammalian vector system suitable to express the trifunctional antibody composed of antiHER2×human-CD80: human-IgG1Fc antibody. This antibody contains four chains of anti-HER2/CL, anti-HER2/CH1-3, B7.1/CL, and B7.1/CH1-3 within the human IgG1 framework and so the vector system will simultaneously express the four chains. The amino acid/nucleotide sequences datasets were retrieved from the GenBank, UniProtKB and PDB databases. The heavy and light chains variable domain framework regions and complementarity determining regions of scA21 antibody were determined by IMGT/V-QUEST and Paratome software. The amino acid sequences of tri-functional antibody chains manually were assembled and converted to DNA sequences by sequence manipulation suite software. The adapting codon usage of these DNA sequences was performed by JCAT software. Finally, the secondary structures of obtained RNAs from the DNAs were individually analyzed by RNAfold program. The Prodigy equilibrium dissociation constant, a ratio of koff/kon, between the antibody and its antigen for hantiHER2VHCH-HER2, hantiHER2VLCL-HER2, CD80CH-CD28, and CD80CL-CD28 were equal to 3.60E-10, 3.10E-9, 1.10E-8 and 2.70E-10; respectively. These findings were confirmed the composition and nano-molar affinity of the respective constructs. A single specific no-cloning expression vector, pHuchiTriomAb, was designed in silico with a desirable length of 8.292 Kbps and bidirectional expression potential for the four chimeric antibody chains. This construct was designed, and gene codon usage adapted to be expressed within CHO cells and secreted a trifunctional antibody into the cell culture medium by interleukin 21 signal peptide.This robust expression system for rapid production of tri-functional antibody has been designed to substitute hybrid hybridoma technology (quadroma and trioma) with the facilitated purification of the trifunctional antibody from the antibody variants. https://acta.tums.ac.ir/index.php/acta/article/view/6262 https://acta.tums.ac.ir/index.php/acta/article/download/6262/5060

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 3 2018 03 06 204 207 EN Fariba Binesh Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Hassan Ali Vahedian Department of Oncology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Masoud Shabani Department of Radiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Saeedeh Zare Department of Radiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Seyed Hossein Shahcheraghi Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. AND Infectious Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. 2016 11 26 2017 04 16 Breast plasmacytoma is a rare neoplasm. Here we present a case of extramedullary plasmacytoma of the breast in a 41-year-old Iranian lady who was a known case of spine plasmacytoma. Two years ago study case was presented with severe back pain. At that time, MRI revealed an expansile and destructive lesion in the body of S1 which was suggestive of metastasis. The patient underwent incisional biopsy that was a representative of a plasmacytoma. Skeletal survey, bone marrow aspiration, and serum protein electrophoresis were negative. The patient received radiation therapy. This year (2 years later) she detected a mass in her right breast. A mammography revealed a 30 mm high-density mass with an ill-defined border in the right breast. The mass was excised, and histological examination confirmed the diagnosis of plasmacytoma. Although plasmacytoma of the breast is rare, this tumor should be considered as a differential diagnosis of a breast mass, especially in patients with plasma cell dyscrasias. https://acta.tums.ac.ir/index.php/acta/article/view/6035 https://acta.tums.ac.ir/index.php/acta/article/download/6035/5069

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 3 2018 03 06 151 160 EN Azar Aghazadeh Khasraghi Department of Pharmacology and Toxicology, International Campus (TUMS-IC), School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Maryam Baeeri Department of Pharmacology and Toxicology, International Campus (TUMS-IC), School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Borna Payandemehr Department of Pharmacology and Toxicology, International Campus (TUMS-IC), School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mahshid Rezaeiroushan Department of Pharmacology and Toxicology, International Campus (TUMS-IC), School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Gelareh Vakilzadeh Department of Pharmacology and Toxicology, International Campus (TUMS-IC), School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Shokoufeh Hassani Department of Pharmacology and Toxicology, International Campus (TUMS-IC), School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Asieh Hosseini Razi Drug Research Center, Iran University of Medical Sciences, Tehran, Iran. Gholamreza Hassanzadeh Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Reza Dehpour Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Sharifzadeh Department of Pharmacology and Toxicology, International Campus (TUMS-IC), School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. 2017 04 26 2017 12 18 One of the most frequent complications of diabetes is diabetic peripheral neuropathy. Hyperglycemia would result in the advancement of this condition over a period of time. The most effective way in preventing diabetic neuropathy is regular control of glucose. In this study; we evaluated the effects of lithium onstreptozocin (STZ)-induced diabetic neuropathy in rats. Diabetic neuropathy was created 7 weeks after administration of STZ (45 mg/kg). Lithium was added to drinking water (450 mg/l) for 7 weeks and its plasma level after this period of time was 0.17±0.02 mmol/l. Levels of adenosine triphosphate (ATP) in dorsal root ganglion (DRG) neurons, oxidative stress parameters, open-field activity test and morphological analysis were assessed in this investigation. Currentresults showed significant elevation of oxidative stress biomarkers, reduction of ATP, abnormal morphology of DRG neurons and decrease of total distance moved in rats with STZ-induced diabetic neuropathy. The alterations in mentioned parameters were considerably restored by lithium treatment. These findings provide evidence for protective effects of lithium on STZ-induced diabetic neuropathy. https://acta.tums.ac.ir/index.php/acta/article/view/6405 https://acta.tums.ac.ir/index.php/acta/article/download/6405/5061

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 3 2018 03 06 208 209 EN Sadegh Asadi Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran. Mahmood Hosseinzadeh Maleki Department of Cardiovascular Surgery, Birjand Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran. Bibi Fatemeh Shakhs Emampour Department of Anesthesiology, Birjand Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran. Morteza Hajihosseini Birjand CardioVascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran. Majid Jafarnejad Birjand Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran. 2016 11 27 2017 04 16 Vascular access for dialysis is essential for these patients with end-stage renal disease, improvements in hemodialysis managment have lead to extended life expectancy. The creation and maintenance of hemoaccess occupies a significant portion of most vascular and general surgery practices.Venous hypertension due to arteriovenous fistula is usually secondary to venous outlet obstruction. Side to side proximal artery arteriovenous fistula serves as a certain cause of hemodialysis, but it is rarely reported as a peripheral venous hypertension cause. We are reporting a case with developed venous hypertension having dermal injuries in the arm. The patient underwent successful side-to-side radio cephalic fistula creation in the snuffbox a year ago. https://acta.tums.ac.ir/index.php/acta/article/view/6028 https://acta.tums.ac.ir/index.php/acta/article/download/6028/5070

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 3 2018 03 06 161 165 EN Ramin Azarhoush Clinical Research Development Unit (CRDU), 5 Azar Hospital, Golestan University of Medical Sciences, Gorgan, Iran. Khatoun Heidari Clinical Research Development Unit (CRDU), 5 Azar Hospital, Golestan University of Medical Sciences, Gorgan, Iran. Soheila Samadzadeh Clinical Research Development Unit (CRDU), 5 Azar Hospital, Golestan University of Medical Sciences, Gorgan, Iran. Ahmad Heidari Clinical Research Development Unit (CRDU), 5 Azar Hospital, Golestan University of Medical Sciences, Gorgan, Iran. Fatemeh Mehravar Clinical Research Development Unit (CRDU), 5 Azar Hospital, Golestan University of Medical Sciences, Gorgan, Iran. 2017 07 04 2017 12 18 Colorectal cancer (CRC) is one of the most prevalent cancers in the world. The p53 protein is the most commonly mutated protein in human cancer, and it is a frequent abnormality in colorectal cancers. In this study, we evaluated the expression of p53 protein and its association with clinicopathological findings as prognostic factors and mortality rate in 95 colorectal cancer patients’ in Northeast Iran, over a 5 years period (2010-2015). In this retrospective study, the method of immunohistochemistry (IHC) was applied to determine the expression of the p53 protein and pathological features of tumors and mortality rate were examined between 2010 and 2015 at Gorgan City (IRAN). Multiple logistic regression models were used to estimate odds ratios and confidence intervals between clinicopathological and mortality rate as the outcome variable, adjusted for potential confounders. Immunoreactivity was found in 58.9% of specimens from 95 patients with colorectal cancer, and the mortality rate was estimated 14.7 percent. The mortality rate of patients with colorectal cancer is significant, and findings indicate that it relates to pathologic factors such as vascular involvement [OR=0.02, CI95%: 0.006-0.11], lymph node involvement [OR=0.17, CI95%: 0.05-0.56], round neural invasion, depth of invasion, tumor size and grade. The findings confirmed that the P53 gene mutation could be considered as a prognostic factor affecting mortality in cancer and specifically colorectal cancer. Although the P53 protein expression shows no relationship with histopathological features, the mortality rate of the patients demonstrated a strong association. https://acta.tums.ac.ir/index.php/acta/article/view/6583 https://acta.tums.ac.ir/index.php/acta/article/download/6583/5062

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 3 2018 03 06 210 213 EN Aghygh Heidari Department of Anesthesiology, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran Feridoun Sabzi Department of Cardiovascular Surgery, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. 2016 09 29 2017 04 30 Here we report a case of postoperative thrombocytopenia (TTP) in a 77-year-old case that has been undergoing  mitral valve replacement with combined coronary  artery bypass grafting. In the 5th days of operation, his platelet count was reduced and despite platelet transfusion, his platelet count reaches to a minimum level of 15000 µg/mL on the 34th day of surgery. Despite platelet transfusion and plasmapheresis, platelet count continues to decrease and signs and symptoms of disseminated intravascular coagulation appeared by unexpectable renal and pulmonary bleeding.  Finally high dose, steroid therapy was started and after some days, platelets count raised to 80000 µg/mL. DIC was recovered, but  acute renal failure  did not respond to medical and hemodialysis and the case expired with sudden cardiac arrest and ventricular fibrillation.we conclude that if  the  diagnosis of TTP was made earlier in the course of disease by consulting internist  and steroids was instituted  it might prevent  ARF and its poor outcome. https://acta.tums.ac.ir/index.php/acta/article/view/5906 https://acta.tums.ac.ir/index.php/acta/article/download/5906/5071

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 3 2018 03 06 166 169 EN Alireza 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. Marjan Sohrabi Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Mahnaz Zarei Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Hamed Mohammadi 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 05 20 2017 02 01 Smoking may modify the appetite, and consequently affect nutrient intake and serum micronutrients. The effect of smoking on vitamin B12 status has been considered in several studies. The research proposed that organic nitrites, nitro oxide, cyanides, and isocyanides of cigarette smoke interfere with vitamin B12 metabolism, and convert it to inactive forms. This research was carried out to determine the serum level of active and inactive forms of vitamin B12 in male smokers in comparison with male nonsmokers. This is a case-control study, in which the participants were 85 male smokers and 85 male nonsmokers. The serum levels of total and active form of vitamin B12 were measured. Dietary intake was recorded by a quantitative food frequency questionnaire and one-day 24-hour dietary recall method. Independent two sample T test was used to compare quantitative variables between the case and control groups. The serum level of total vitamin B12 was not significantly different between two groups, but serum level of active form of vitamin B12 in the smoking group was significantly lower than non-smoking group (P<0.001). This is one of the first studies that evaluated the serum level of active form of vitamin B12 in smokers in the Iranian community. The results of this study identified that serum level of total vitamin B12 might be not different between smoking and non-smoking people, but the function of this vitamin is disturbed in the body of smokers through the reduction of serum level of active form of vitamin B12. https://acta.tums.ac.ir/index.php/acta/article/view/5648 https://acta.tums.ac.ir/index.php/acta/article/download/5648/4950

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 6 2017 08 19 395 398 EN Ali Mazouri Department of Neonatology, Akbarabadi Hospital, Iran University of Medical Sciences, Tehran, Iran. Nastaran Khosravi Department of Neonatology, Ali Asghar Hospital, Iran University of Medical Sciences, Tehran, Iran. Arash Bordbar Department of Neonatology, Akbarabadi Hospital, Iran University of Medical Sciences, Tehran, Iran. Nasrin Khalesi Department of Neonatology, Ali Asghar Hospital, Iran University of Medical Sciences, Tehran, Iran. Maryam Saboute Department of Neonatology, Akbarabadi Hospital, Iran University of Medical Sciences, Tehran, Iran. Pegah Taherifard Department of Anesthesiology, Imam Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran. Marjan Mirzababaee Department of Nuclear Medicine, Akbarabadi Hospital, Iran University of Medical Sciences, Tehran, Iran. Mehran Ebrahimi Department of Asthma, Allergy and Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 2017 01 30 2017 02 27 The use of parenteral nutritional supplementation of phosphorus may lead to exhibit higher plasma phosphate concentrations and less radiological features in premature neonates susceptible to osteopenia. The present study aimed to assess the beneficial effects of adding intravenous phosphorus to total parenteral nutrition (TPN) on calcium and phosphorus metabolism in preterm neonates by measuring bone mineral content. This open-labeled randomized clinical trial was conducted on premature neonates who were hospitalized at NICU. The neonates were randomly assigned to two groups received TPN with intravenous sodium glycerophosphate or Glycophos (1.5 mmol/kg/day) or TPN without sodium glycerophosphate. At the end of the four weeks of treatment, the presence of osteopenia was examined using DEXA Scan. After completing treatment protocols, the group received TPN with intravenous Glycophos had significantly lower serum alkaline phosphatase (360±60 versus 762±71, P<0.001), as well as higher serum calcium to creatinine ratio (1.6±0.3 versus 0.44±0.13, P<0.001) compared to the control group received TPN without Glycophos. Those who received TPN with intravenous Glycophos experienced more increase in bone mineral density than those in control group (0.13±0.01 versus 0.10±0.02, P<0.001). There was no significant difference in serum calcium and serum vitamin D between the case and control groups. Adding intravenous sodium glycerophosphate to TPN in premature neonates can compensate the lack of bone mineral content and help to prevent osteopenia. https://acta.tums.ac.ir/index.php/acta/article/view/6190 https://acta.tums.ac.ir/index.php/acta/article/download/6190/4951

Tehran University of Medical Sciences