Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 3 2019 05 13 147 151 EN Shadi Javan Department of Immunology, Isfahan Medical School, Isfahan University of Medical Sciences, Isfahan, Iran. Alireza Andalib Department of Immunology, Isfahan Medical School, Isfahan University of Medical Sciences, Isfahan, Iran. Ali Hosseini Bereshneh Department of Medical Genetics, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Emami Department of Internal Medicine, Isfahan Medical School, Isfahan University of Medical Sciences, Isfahan, Iran. Rasul Salehi Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Fatemeh Karami Department of Medical Genetics, Applied Biophotonics Research Center, Sciences and Research Branch, Islamic Azad University, Tehran, Iran. 2018 04 28 2018 12 19 Hereditary non-polyposis colorectal cancer (HNPCC) is the most frequent autosomal dominant predisposition for development of colorectal cancer (CRC) caused by germline defects in mismatch repair (MMR) genes. Current study was aimed to find genetic variations in MSH2 and MLH1 genes and their correlation with the serum levels of Carcinoembryonic Antigen (CEA) in seven Iranian HNPCC families. Seven unrelated Iranian families including 11 HNPCC patients and 7 affected family members were selected. They were initially screened for mutations in exons 7 of MSH2 and exon 15 of MLH1 gene through polymerase chain reaction single-strand conformation polymorphism (PCR-SSCP). Positive PCR results were further analyzed through exon sequencing. Serum CEA level was determined using the ELISA test. PCR-SSCP was positive in 8 out of 18 patients (44%) for exons 7 of MSH2 gene, whereas two samples (11%) demonstrated to bear a mutation in exon 15 of the MLH1 gene. Sequencing analysis of both amplified exons in positive and negative samples have confirmed no mutation in negative samples while revealed 5 and 7 novel mutations in exons 7 and 15, respectively. The mean serum concentration of CEA had a significant difference between HNPCC patients and their healthy family members. Our results demonstrated that the PCR-SSCP method has high specificity and sensitivity in the first step of mutation screening of HNPCC families. High frequency of novel alterations found in the current assay may revise the mutation screening of MSH2 and MLH1 genes and abet further assessment of their frequency among individual HNPCC patients. https://acta.tums.ac.ir/index.php/acta/article/view/7223 https://acta.tums.ac.ir/index.php/acta/article/download/7223/5228

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 3 2019 05 13 152 155 EN Seyed Isaac Hashemy Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Ahmad Reza Taheri Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Morteza Behnamfard Department of Dermatology, Mashhad University of Medical Sciences, Mashhad, Iran. Mehrdad Teimourian Department of Dermatology, Mashhad University of Medical Sciences, Mashhad, Iran. Sara Sabouri Rad CCutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 2018 06 27 2018 12 19 Basal cell carcinoma (BCC) is one of the most common types of human cancer. Since oxidative stress is believed to be one of the pathogenic mechanisms involved in BCC formation, understanding the probable relation of inflammatory, oxidative factors, such as serum protein carbonyl and total antioxidant capacity, to BCC can help identify other pathogenic aspects of this tumor. Forty cases of BCC and forty cases of healthy controls without BCC or any other systemic disease were included in this study. After 5-ml venous blood samples were obtained from each patient, the separated serum fractions were stored at -70° C until analysis. Serum protein carbonyl level in the BCC group was significantly higher than that in the healthy controls ((5.86±3.25 µM vs. 0.86±0.20 µM, P<0.001). The average serum total antioxidant capacity was 3.41±0.05 mM in the BCC group and 1.15±0.03 mM in the control group (statistically significant at P<001). Oxidative stress might play a role in the pathogenesis of BCC. https://acta.tums.ac.ir/index.php/acta/article/view/7341 https://acta.tums.ac.ir/index.php/acta/article/download/7341/5229

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 3 2019 05 13 156 159 EN Akram Ghadiri Anari Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Somayeh Gholami Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Elham Sheyda Department of Internal Medicine, Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Shadab Kharazmi Department of General Psychology, Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Nasim Namiranian Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. 2018 01 28 2018 12 28 Due to high prevalence of diabetes in our region (16.3%) and no data on the frequency of gastrointestinal (GI) symptoms in this population, we performed a cross-sectional study to evaluate the frequency of GIsymptoms in diabetic patients and its association between microvascular complications (retinopathy and nephropathy) and gastrointestinal symptoms in diabetic subjects.This analytical cross-sectional study was conducted from 2014 to 2016 on 233 patients with type 2 diabetes mellitus (T2DM), 30-65-year, referred to Yazd diabetic research center. They were selected by convenient sample method. A questionnaire according to Rome III Criteria was used to collect digestive information related to diabetes. Last HbA1c (Since 2-3 months ago) was available in the patient's medical folder. Diabetic nephropathy defines to increased excretion rate of albumin in the urine in the range of above 30 mg/g creatinine. Diabetic retinopathy was examined by an expert ophthalmologist (retinal specialist). For the current study, 233 patients (age 30-65 years with mean age of 57.43±10.49 years, 102 (43.8%) males and 131 (56.2%) females) were included. Among 233 patients, 91 cases (39.1%) had nephropathy,and 111(47.6%) subjects had different degrees of retinopathy. Bloating and early satiety and upper GI symptoms were higher in the subjects with retinopathy than another group. In summary, this study provides evidence that GI symptoms in diabetic subjects are independently linked to diabetic complications, particularly to retinopathy. https://acta.tums.ac.ir/index.php/acta/article/view/6997 https://acta.tums.ac.ir/index.php/acta/article/download/6997/5230

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 3 2019 05 13 160 166 EN Saeed Nazari Soltan Ahmad Department of Biochemistry, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Sajjad Nourollahi Department of Laboratory Medicine, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Manouchehr Nakhjavani Endocrinology and Metabolism Research Center, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mehran Khojastehfard Department of Biochemistry, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Mostafa Mostafazadeh Department of Biochemistry, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Hamed Hajipour Department of Reproductive Biology, School of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran. Davoud Sanajou Department of Biochemistry, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 2018 05 10 2019 01 02 The relation between serum preptin, myostatin, insulin, and also homeostatic model assessment-insulin resistance were examined in pre-diabetes persons and newly diagnosed patients with overt type 2 diabetes mellitus. A total of 84 subjects were included in the study and assigned into three groups: normoglycemic participants (group 1=27), pre-diabetes (group 2=30), and T2DM (group 3=29). Serum insulin, preptin, and myostatin levels were measured with immunoradiometric assay (IRMA), enzyme-linked immunosorbent assay (ELISA), and chemiluminescent immunoassay (CLIA), respectively. Patients with T2DM had higher levels of preptin compared to normoglycemic (461.25±53.90 vs. 407.54±54.78, P<0.001). Furthermore, these patients had elevated levels of myostatin compared with controls (2710.60±559.09 vs. 2246.37±416.40, P<0.001). Preptin and myostatin both positively correlated with serum insulin (r=0.369, P=0.01, and r=0.309, P=0.04, respectively). However, no significant association was found between serum preptin and myostatin levels. Stepwise multiple regression analysis showed that insulin was affected more by preptin, with only a trivial contribution from myostatin. Serum preptin and myostatin levels increase in pre-diabetic subjects and even further in type 2 diabetic patients. The correlation between preptin and insulin evolves when pre-diabetes or overt type 2 diabetes develops. Moreover, serum myostatin increases in association with insulin and not HOMA-IR in diabetic conditions. https://acta.tums.ac.ir/index.php/acta/article/view/7250 https://acta.tums.ac.ir/index.php/acta/article/download/7250/5231

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 3 2019 05 13 167 172 EN Gashtasb Aghasinejad Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran. Mehdi Raei Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, Iran. AND Department of Epidemiology and Biostatistics, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran. Saeid Azad Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran. Bahareh Aghasinejad Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. 2018 03 10 2018 12 15 Many studies were carried out to improve sophisticated approaches to accelerate wound healing processes and also, wound healing is extensively discussed in the medicinal literature. In this study, we aimed to investigate the wound healing of mice with visible radiation (630 nm). In this study, 28 male mice were used and randomly divided into 4 groups. All samples were subjected to a 6 mm skin incision. Four groups were tested as following 10 minutes (First group), 20 minutes (Second group), 30 minutes (Third group) light exposure and no light radiation (control group), respectively. Wound contraction was analyzed by taking photos and Image J software. All mice were sacrificed, and samples were evaluated by Hematoxylin and Eosin staining after one week. The results demonstrated that the experimental group with 20 min.light irradiation had a much faster effect of wound healing than the 10, 30 minute and control group. The results showed that 20 minutes of light exposure group was the best treatment. https://acta.tums.ac.ir/index.php/acta/article/view/7112 https://acta.tums.ac.ir/index.php/acta/article/download/7112/5232

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 3 2019 05 13 173 179 EN Alborz Sherafati Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Maryam Mehrpooya Department of Interventional Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Roya Sattarzadeh Badkoubeh Department of Advanced Echocardiography, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Farnoosh Larti Department of Advanced Echocardiography, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Farhad Shahi Department of Hematology and Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Mehrzad Mirzania Department of Hematology and Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Mohsen Esfandbod Department of Hematology and Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Saadat Tehran University of Medical Sciences, Tehran Heart Center, Tehran, Iran. Massoud Ghasemi Department of Interventional Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. AND Research Center of Endovascular Intervention, Tehran, Iran. Jeyran Zebardast Department of Electronic Learning in Medical Education, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2018 06 12 2018 12 19 Breast cancer is the most common cancer among the female population, and its prevalence is increasing worldwide. Trastuzumab (Herceptin) therapy improves prognosis in HER2 positive patients, but Heart Failure (HF) is one of its known complications. In this study, we aimed to assess the potential benefits of prophylactic carvedilol therapy in patients receiving Herceptin. Sixty five patients with HER2 positive breast cancer were enrolled in the study. All of the patients received Herceptin. Twenty seven patients also received carvedilol 6.25 mg twice daily, and 38 patients had usual care. Echocardiography was performed at baseline, and after three months in both groups and changes in cardiac function, parameters were compared between two groups. After 3 months, LA volume index (P=0.012), TAPSE (P=0.009), Tei index (P=0.015) and Lateral Longitudinal Strain (P=0.024) were significantly better in patients receiving carvedilol. Carvedilol can be effective in the prevention of systolic and diastolic dysfuhran University of Medical Sciences Acta Medica Iranica 0044-6025 56 5 2018 05 20 308 313 EN Ladan Kashani Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mahbobeh Mohamadi Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran. Bentol-Hoda Fattah-Ravandi Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran. Atefeh Zeinoddini Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2017 11 29 2018 02 07 The purpose of the current study was to investigate the impact of a 2-months implementation of GnRH-agonist (prolonged) versus the OCP+long protocol before in-vitro fertilization-embryo transfer (IVF-ET) on IVF outcomes in infertile patients with Grade III-IV endometriosis. A total of 70 infertile patients with endometriosis participated in this randomized clinical trial and randomly received either the prolonged GnRH-agonist protocol (38 patients) as control or the OCP+long protocol (32 patients) as the case group. This was followed by standard controlled ovarian hyperstimulation (COH) in all subjects. The fertilization rate, the implantation rate, and the clinical pregnancy rate were measured and compared between the two groups. A statistically significant trend toward better embryo quality was observed in the control group (P=0.01). In addition, clinical pregnancy rate, implantation rate and fertilization rate did not differ significantly between two groups (P=0.43, P=0.54, P=0.1 respectively). GnRH agonist treatment for 2 months before ART in women with high-grade endometriosis was associated with better embryo quality compared to three weeks of treatment with OCP. OCP before assisted reproductive technology (ART) was as effective as GnRH agonist treatment regarding clinical pregnancy and implantation rates in infertile patients with severe endometriosis. https://acta.tums.ac.ir/index.php/acta/article/view/6867 https://acta.tums.ac.ir/index.php/acta/article/download/6867/5089

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 5 2018 05 20 351 354 EN Mohammad Mehdi Bagheri Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran. AND Department of Pediatrics, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran. Shokouh Arjmand Kerman Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran. Mohammad Hossein Torabinejad Department of Pediatrics, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran. Mina Behzadi Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran. 2016 12 24 2017 03 30 Kawasaki disease (KD) is a self-limited syndrome with serious heart complications, mostly seen in children of age 5-month to 4-year-old. KD needs to be diagnosed soon to start IVIG within 10 days of starting symptoms to lower heart complications to 5 folds. Our case, a 2-year-old boy presented with prolonged fever and pharyngeal erythema. In early evaluation, erythrocyte sedimentation rate (ESR) was elevated, and after that, Color Doppler echocardiography with suspicion for KD was performed and showed aneurysm and thrombosis formation in the left coronary artery (LCA). Hence, intravenous immunoglobulin (IVIG) was started for the patient concurrent with daily check of troponin I level. In this case report, we present remarkable echocardiographic findings of a patient with the delay in diagnosis of KD demonstrating an aneurysm and acute thrombus formation in LCA.    https://acta.tums.ac.ir/index.php/acta/article/view/6086 https://acta.tums.ac.ir/index.php/acta/article/download/6086/5102

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 5 2018 05 20 314 319 EN Mustafa Al-Shamsi Department of Public Health, Iraqi Ministry of Health, Basra, Iraq. Nasih Othman Kurdistan Institution for Strategic Studies and Scientific Research, Sulaimaniyah, Iraq. 2017 10 27 2017 12 19 Suicide by self-burning remains a common method of suicide amongst women in Iraq and some neighboring countries. This study aimed to describe the problem of self-burning in Basra province and investigate the associated factors. A prospective study was undertaken between October 2016 and May 2017 in Al-Fayhaa Burn Center. Data were collected from all patients admitted to the center for a self-inflicted burn. Sociodemographic information and cause of suicide were obtained using an interviewer-administered questionnaire, and clinical data were transcribed from hospital records. There were 62 cases (females 74%, males 26%) of self-burning during the 6 months data collection accounting for 22% of all burn admission. The age ranged from 9-56 years (mean 25.3, SD 10.8 year). The vast majority had no or only basic education (92%), 55% were married, 60% were from outside Basra city and 53% considered themselves from a poor socioeconomic background. The incident mostly occurred at home (84%) while the person was alone (91%) using kerosene as the burning material (82%). The total burn surface area ranged from 20-100% with a median of 80% (IQR 60-95). The median hospital stay was 5 days (IQR 1-12 days). In-hospital mortality rate was 72.6%. Suicide by self-burning seems not to be uncommon in Basra and require more attention from public health and social services. More research is required to provide a better estimation of the problem and in-depth understanding of the factors that contribute to the problem. https://acta.tums.ac.ir/index.php/acta/article/view/6804 https://acta.tums.ac.ir/index.php/acta/article/download/6804/5090

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 5 2018 05 20 320 328 EN Hassan Hashemi Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran. Abbasali Yekta Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Mohammad Saatchi Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran. Raheleh Moravej Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran. Mohamadreza Aghamirsalim Eye Research Center, Rassoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Mehdi Khabazkhoob Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2017 09 02 2017 12 19 To determine the distribution of corneal thickness and its associated factors in the over 5-year-old population in the north and south rural areas in Iran. In this study, samples were selected using multi-stage cluster sampling. After vision and refraction tests and the slit lamp exam, the central corneal thickness (CCT), apical corneal thickness (ACT), and the thickness at four peripheral areas of the cornea were measured using Pentacam. Of the 3851 selected samples, after applying the exclusion criteria, the analysis was done on data from 2681 people. The mean age of the participants was 36.03±18.51 years, ranging from 6 to 90 years, and 58.1% of them were female. Mean CCT and ACT were 533.87 μm (95%CI: 532.05 -535.69) and 536.72 μm (95%CI: 534.9 -538.54), respectively. Mean peripheral corneal thickness was 637.46 μm (95%CI: 635.09 -639.83) in the superior quadrant, and 594.34 μm (95%CI: 592.2 -596.47), 620.81 μm (95%CI: 618.66 -622.97), and 584.55 μm (95%CI: 582.18 -586.93) in the inferior, nasal, and temporal quadrants, respectively. Linear regression analysis showed significant associations between CCT and gender (P=0.001), age (P<0.001), geographical location of residence (P<0.001), the radius of corneal curvature (P<0.001), anterior chamber depth (P<0.001), and corneal volume (P<0.001). This study is one of the few studies describing the distribution of the corneal thickness in a population of over 5-year-olds using Pentacam. Gender, anterior chamber depth, and corneal radius of curvature are some of the factors associated with CCT. https://acta.tums.ac.ir/index.php/acta/article/view/6676 https://acta.tums.ac.ir/index.php/acta/article/download/6676/5091

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 5 2018 05 20 329 333 EN Gholam-Hossein Fallahi Research Center for Pediatric Gastroenterology and Hepatology, Children’s Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran. Gholam-Reza Khatami Research Center for Pediatric Gastroenterology and Hepatology, Children’s Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran. Neda Esmailzadehha Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran. AND Department of Epidemiology, School of Health, Iran University of Medical Sciences, Tehran, Iran. Mehri Najafi Research Center for Pediatric Gastroenterology and Hepatology, Children’s Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Farahmand Research Center for Pediatric Gastroenterology and Hepatology, Children’s Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran. Farzaneh Motamed Research Center for Pediatric Gastroenterology and Hepatology, Children’s Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Khodadad Research Center for Pediatric Gastroenterology and Hepatology, Children’s Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran. Nima Rezaei Research Center for Immunodeficiencies, Children’s Medical Center, Pediatrics Center of Excellence, 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. Mohammad-Reza Modarresi Department of Pediatric Pulmonary Diseases, Tehran University of Medical Sciences, Tehran, Iran. AND Pediatric Respiratory Diseases Education and Research Network (PRDERN), Universal Scientific Education and Research Network (USERN), Tehran, Iran. Mostafa Qorbani Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran. Rita Bagherian Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran. 2017 07 29 2017 12 18 There are controversies on the association of childhood allergic diseases with inflammatory bowel diseases (IBD). The aim of this study was to examine the association between food allergy, cow’s milk allergy (CMA), and asthma with pediatric IBD in Iranian population. This case-control study was conducted on 200 individuals less than 18-year-old (100 with IBD and 100 as control group). Medical records, clinical presentation, and laboratory and para-clinical findings