Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 4 2019 07 13 208 215 EN Majid Hosseinzadeh Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Parvin Aminoshareah Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mahmoud Mohammadi Department of Pediatric Neurology, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Ali Reza Tavasoli Myelin Disorders Clinic, Pediatric Neurology Division, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Mahdi Zamani Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2018 12 02 2019 01 13 Multiple sclerosis (MS) is a neurodegenerative disease arising from interactions of both environmental and genetic factors. The SNP rs6897932 is located in IL‐7Ra gene associated with MS susceptibility in some population. In this study, we investigated the possible association of SNP rs6897932 with MS susceptibility in 157 Iranian MS patients and 152 healthy controls. We also studied genotype-dependent severity and response to IFN-β in MS. Unlike some previous studies, our results clearly demonstrate that there are no significant differences in distribution of the SNP rs6897932 in our chosen Iranian MS patients and controls. Furthermore our results show, Interferon beta (IFN-β) therapy over a period of two years demonstrated an IL‐7Ra genotype-dependent therapeutic effect in MS population. Patients carrying TT or TC genotypes gave a better response to IFN-β treatment, whereas patients carrying the homozygous CC genotype were the worst responders to IFN-β treatment. In other words, despite the lack of linkage the therapeutic response to the severity and progression of MS was related to the genotype of SNP rs6897932 presented in our patient. Therefore, in light of our findings reported here, to reach higher certainties, further studies are needed to associate IL-7Ra gene with the pathogenesis of MS. https://acta.tums.ac.ir/index.php/acta/article/view/7610 https://acta.tums.ac.ir/index.php/acta/article/download/7610/5240

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 4 2019 07 13 216 223 EN Seyed Hamzeh Mousavie Department of Surgery, Colorectal Research Center (CRRC), Iran University of Medical Sciences, Tehran, Iran. AND Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Rezvan Mirzaie Colorectal Research Center (CRRC), Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Bahar Mahjoubi Colorectal Research Center (CRRC), Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Amir Nahavandi Colorectal Research Center (CRRC), Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. 2018 10 09 2018 11 14 Antegrade colonic irrigation enema (ACIE) is established as an old treatment for child fecal incontinence and recently is approved as a treatment for different causes of adult fecal incontinence (cancer surgery, neurogenic bowel, spinal cord injury, sphincter trauma, etc.). Despite the benefits of emptying the large bowel and prevention of fecal incontinence or constipation, this method is time-consuming and requires thorough instruction and training. The purpose of this study was to innovate and assess novel technique to decrease time-consuming and improve performance of irrigation. We designed and electromechanical pump for colon irrigation and assessed by a randomized crossover clinical trial study, involving two-four weeks treatment phases. 30 patients have included that suffered fecal incontinence and had been managed with appendicostomy antegrade colon irrigation. The results showed that the pump decrease time and volume of irrigation compare with the traditional method. All patients had a reduction in toileting times. Traditional mean toileting time was 67 minutes, versus pump-toileting time that was 24.6 minutes (P:0.00). The volume of water was reduced in 13 patients. Mean of the volume was 1712 ml in the traditional method and 1128 ml in pump method (P:0.279). Mean Cleveland Clinic Florida Fecal Incontinence score (CCF_FIS) for the pump was 5.84 compare 6.24 for traditional method (P:0.000). Our study provides evidence for the first time that our novel method can facilitate and speed-up colon irrigation without any adverse effect on the outcome. https://acta.tums.ac.ir/index.php/acta/article/view/7521 https://acta.tums.ac.ir/index.php/acta/article/download/7521/5241

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 4 2019 07 15 224 229 EN Behdad Ravarian Department of Internal Medicine, AJA University of Medical Sciences, Tehran, Iran. Abbas Esmaeilzadeh Department of Gastroenterology and Hepatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Sandra Saeedi Department of Internal Medicine, AJA University of Medical Sciences, Tehran, Iran. Meysam Moghbeli Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Azita Ganji Department of Gastroenterology and Hepatology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 2018 03 21 2018 12 31 Helicobacter pylori (HBP) is reported as one of the main causes of peptic ulcer disease (PUD) and gastric cancer in the world. The challenge for finding an optimal treatment regimen for HBP eradication is still a matter of concern. The aim of this study was to compare the HBP eradication rate as well as side effects between two 10-days treatments of the standard triple and sequential regimen. This study was performed on patients with dyspepsia and HBP positive. Patients were categorized in two treatment groups including; standard (Omeprazole, Amoxicillin, and Clarithromycin) and sequential treatment (Omeprazole, Amoxicillin, Clarithromycin, and Metronidazole). HBP eradication rate, side effects, and treatment costs were compared between two groups. One hundred thirty-two patients (58 males, 74 females) with a mean age of 42.7±14.2-year-old were studied in two groups of Standard Treatment (n=66) and Sequential Treatment (n=66). There were not any significant differences between two groups regarding baseline features. The overall rate of HBP eradication was estimated to be 79.5%. Although, there was not any significant difference between the observed side effects, the mean cost of treatment in standard was significantly lower than that in the sequential group (P=0.001). It seems that there are not any clinical differences between 10-day treatment plan of the standard triple and sequential therapy in the case of HBP eradication and side effects. However, the sequential treatment might be a better option as the economic point of view. https://acta.tums.ac.ir/index.php/acta/article/view/7135 https://acta.tums.ac.ir/index.php/acta/article/download/7135/5242

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 4 2019 07 13 230 234 EN Seyed Mansoor Rayegani Department of Physical Medicine and Rehabilitation, Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. AND Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Seyed Ahmad Raeissadat Department of Physical Medicine and Rehabilitation, Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. AND Clinical Development Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Elham Loni Department of Physical Medicine and Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Navid Rahimi Department of Physical Medicine and Rehabilitation, Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. AND Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Shahram Rahimi-Dehgolan Department of Physical Medicine and Rehabilitation, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Leyla Sedighipour Department of Physical Medicine and Rehabilitation, Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. AND Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2018 01 20 2018 12 15 Lumbosacral radiculopathy is a challenging diagnosis, and Electrodiagnostic study (EDX) is a good complementary test for Magnetic Resonance Imaging (MRI). Physical examination, MRI and electrodiagnosis have different diagnostic values in this regard. MRI can provide anatomical evidence and is useful in choosing a treatment process, but it could also have false positive results. In this study, we assessed the correlation of clinical and electrodiagnostic findings in patients with positive MRI findings for S1 radiculopathy. EDX was performed for 87 patients referred with clinical and MRI diagnosis of S1 radiculopathy. The consistency between EDX results, MRI, and clinical findings were evaluated by Pearson chi 2 and odds ratio. Fifty-eight percent of patients had disc protrusion, and 42% had extrusion. Physical examination revealed absent Achilles reflex in 83% and decreased S1 dermatome sensation in 65%. In this study, EDX sensitivity was about 92%. The highest consistency among EDX parameters and physical examination findings was between absent H-reflex and decreased Achilles reflex (OR=6.20, P=0.014), but there was no significant consistency between H-reflex and neither muscular weakness nor SLR test result (P>0.05). There was also no relationship between type of disc herniation in MRI and H reflex. There was correlation between H-reflex abnormalities and absent ankle reflex in patients with unilateral L5-S1 disc herniation in MRI. Results of this study showed that in patients with positive MRI for L5-S1 disc protrusion and S1 nerve root compression, it is still beneficial to perform EDX for selected patients. https://acta.tums.ac.ir/index.php/acta/article/view/6977 https://acta.tums.ac.ir/index.php/acta/article/download/6977/5253

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 4 2019 07 13 235 243 EN Hamid Reza Ahmadkhaniha Department of Psychiatry, Mental Health Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Kaveh Alavi Department of Psychiatry, Mental Health Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Fatemeh Hadi Department of Psychiatry, Mental Health Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran 2018 05 17 2018 12 19 The main objective of the present study was to compare the distribution of underlying factors such as neurological soft signs, obstetric complications, and family history of psychiatric disorders between two groups of schizophrenic patients and patients with prolonged methamphetamine-induced psychosis. In a case-control study, 30 patients with prolonged methamphetamine-induced psychosis and 30 patients with schizophrenia were selected. Data were collected through a demographic questionnaire, the Buchanan and Heinrichs’ Neurological Evaluation Scale (NES), the Lewis-Murray’s Obstetric Complications Scale (LMOCS), and the Weissman’s Family History Screen (FHS). Mean scores of the neurological soft signs (±SD) in the two groups of schizophrenic patients and patients with prolonged methamphetamine-induced psychosis were 15.7±8.7 and 11.7±6.2, respectively (P=0.040), and a significant difference was observed in the sensory integration between the two groups (P=0.022). Obstetric complications revealed similar distributions in the two groups. Patients with prolonged methamphetamine-induced psychosis reported higher prevalence of alcohol and other substances use disorders (P=0.003 and P=0.001, respectively) in their close relatives; however, the distributions of other disorders were not statistically different between the two groups’ close relatives. Similarities and differences in certain aspects were observed between the two groups, suggesting susceptibility for psychosis in patients with prolonged methamphetamine-induced psychosis; yet we found diversities that distinguish the two disorders. https://acta.tums.ac.ir/index.php/acta/article/view/7272 https://acta.tums.ac.ir/index.php/acta/article/download/7272/5244

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 4 2019 07 13 244 252 EN Seyed Mansour Gatmiri Nephrology Research Center, Center of Excellence in Nephrology, Tehran University of Medical Sciences, Tehran, Iran Marjan Bordbar Department of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Firoozeh Raisi Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran Anahid Nourian Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran 2018 08 08 2018 12 28 There has been little attention to sexual dysfunction (SD) in women undergoing hemodialysis (HD), therefore few studies are found in this field. The aim of this study was to determine the incidence of SD, assess its association with biochemical factors, employment and educational status, economic situation, depression, anxiety, and medication. End stage renal disease (ESRD) married women aged 18 to 60 years presenting to Tehran University of Medical Sciences (TUMS) hospitals’ (Imam Khomeini, Sina, and Baharloo) from April to September 2017 were included in the study. Female Sexual Function Index (FSFI) questionnaire was used to evaluate SD. Patients were divided into two groups with SD (scores≤28) and without SD (scores˃28). Hospital Anxiety and Depression Scale (HADS) questionnaire was used to investigate anxiety and depression; patients with scores equal to or more than 11 were implied as depressed or anxious. Demographic data, duration of dialysis, ESRD causes and biochemical tests were also collected. Thirty patients (81.1%) out of 37 showed SD who were older, had lower educational and economic status, had higher hemoglobin levels and used erythropoietin products and Venofer® (iron sucrose injection) less; most of these patients were housewives. The incidence of SD among patients was high. Erythropoietin and Venofer use was less frequent in patients with SD compared to the other group. This suggests that these two products have a role in treatment of SD rather than the treatment of anemia. https://acta.tums.ac.ir/index.php/acta/article/view/7424 https://acta.tums.ac.ir/index.php/acta/article/download/7424/5245

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 4 2019 07 13 Mohsen Nasiri Tosi Liver Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2019 07 13 2020 04 23 Quality of life of patients in need of liver transplantation is impaired due to many reasons, and this affects the pre and post outcomes and complications of transplantation. Therefore, the aim of this study was to evaluate the effect of a care program on the quality of life of patients awaiting liver transplantation. This quasi-experimental study was conducted in 2017 on 117 patients awaiting liver transplantation in Imam Khomeini Hospital of Tehran. Based on entry criteria, the samples were selected purposefully, and their quality of life was evaluated. Then, a care program in 6 one-hour-long sessions for 2 months was implemented for them. This program was according to patients' needs, including disease and transplant process education with using multiple educational methods. The data collection tool was a quality of life questionnaire (1999), which was completed before and six weeks after the intervention. The results showed that the overall quality of life and its entire aspects improved after the implementation of care program in patients waiting for liver transplantation, and the most change was related to the aspect of systemic (P<0.01). Also, the demographic variables had no significant relationship with the aspects of quality of life. The results of this study indicated a positive effect of the care program on improving the quality of life of patients awaiting liver transplantation. Eliminating the problems of these patients requires the attention and support of planners and the cooperation of managers in order to develop care programs that can be used by healthcare professionals, especially nurses. https://acta.tums.ac.ir/index.php/acta/article/view/7965 https://acta.tums.ac.ir/index.php/acta/article/download/7965/5363

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 58 1 2020 06 16 27 31 Hossein Yahyazadeh Clinical Cancer Research Center, Milad General Hospital, Tehran, Iran Marzieh Beheshti Clinical Cancer Research Center, Iran University of Medical Sciences, Tehran, Iran. Azita Abdollahinejad Clinical Cancer Research Center, Milad General Hospital, Tehran, Iran. Maria Hashemian Clinical Cancer Research Center, Milad General Hospital, Tehran, Iran. Narges Sistany Allahabadi Clinical Cancer Research Center, Milad General Hospital, Tehran, Iran. Sahel Valadan Tahbaz Clinical Cancer Research Center, Milad General Hospital, Tehran, Iran. 2019 07 12 2020 04 25 Breast cancer is the most prevalent Iranian female malignancy. Breast screening reduces the number of malignant breast diseases. We aimed to assess the results of the pilot breast cancer screening on early detection in female medical staff in Milad Hospital, Tehran, Iran. A cross-sectional study. Female medical staff from Milad Hospital, Tehran, Iran, were examined by a specialist in 2016. A checklist, including demographic data, was completed by the participants. If necessary, they referred to as sonography or mammography. Data were analyzed using SPSS software. Of 746 people enrolled, 137 had no pathological point, 609 had suspicious or positive findings that were referred for further investigation, 449 had normal findings, and 7 had suspicious mass and were biopsied, 6 were benign. One case had primary invasive cancer. Since screening for breast cancer helps to early detection of this disease, the implementation of cancer screening programs should be on the priority of health authorities. https://acta.tums.ac.ir/index.php/acta/article/view/7990 https://acta.tums.ac.ir/index.php/acta/article/download/7990/5364

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 58 1 2020 06 15 32 37 Iman Kadhim Al-Ghizzi Departement of Community Medicine, Faculty of Medicine, University of Kufa, Najaf, Iraq. Israa Abbas Departement of Medicine, Al Sader Teaching Hospital, Najaf, Iraq. Suaad Muhammed Rasheed Departement of Community Medicine, Faculty of Medicine, University of Kufa, Najaf, Iraq . Falah Deli Departement of Medicine, Faculty of Medicine, University of Kufa, Najaf, Iraq. 2019 07 06 2020 04 23 Infection is presumed to have a rule in the promotion of asthma exacerbations, and in deterioration of the course of the disease, Chlamydia pneumoniae (C. pneumoniae) is claimed to be a possible cause for these two issues. To assess the positivity and the titer of C. pneumoniae IgG antibodies in relation to the state of asthma and its severity. 61 asthmatic patients aged 15-85 years (mean of 47.10±14.887), and 29 apparently healthy, nonasthmatic age and gender-matched volunteers (control group) were assessed as at Asthma and Allergy Clinic in Al-Sader Medical City in AL-Najaf province, Chlamydia Pneumoniae IgG ELISA Kit was used for the detection of IgG antibody to C. Pneumoniae in human serum to detect chronic infection, and Spirometric test was done, and the best results for FEV1 and peak expiratory flow rate (PEFR) were taken. IgG antichlamydial antibodies were positive in 21 (34.4%) of patients compared to 4 (13.8%) of controls, and the difference was significant with OR=3.281, the seropositivity in acute exacerbation was more than in stable asthmatic, 43.8% vs. 24.1% (P=0.029), seropositivity was nonsignificantly more in moderate and severe asthma as compared with mild asthma, a significant inverse correlation between IgG titer and pulmonary function test parameters (FEV1, PEFR) was observed as the FEV1 & PEFR values decrease with increase IgG titer. Chronic C. pneumoniae infection is common in adult asthmatics and correlated with exacerbations & increased severity and disturbed lung function.   https://acta.tums.ac.ir/index.php/acta/article/view/7985 https://acta.tums.ac.ir/index.php/acta/article/download/7985/5359

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 58 1 2020 06 15 4 8 Vahid Zand Department of Otorhinolaryngology, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Abolfazl Mollasadeghi Department of Occupational Medicine, Industrial Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mohammad Ansari Department of Otorhinolaryngology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mohammad Hossein Baradaranfar Department of Otorhinolaryngology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Amir Houshang Mehrparvar Department of Occupational Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. 2019 06 21 2020 04 24 Chronic tinnitus is a disturbing condition that may affect different aspects of life. In this study, the therapeutic effect of electrical stimulation on chronic tinnitus was assessed. This was a clinical trial on 49 patients with persistent tinnitus for more than 6 months without a proper response to routine treatments. They were randomly allocated into two groups: the case group was treated with electrical stimulation for 6 sessions over 6 consecutive days, and the control group received a placebo. Before the intervention, one week and three months after the treatment sessions, patients were evaluated by comprehensive audiological assessments and hearing tests. The mean age of the participants was 40.37±9.32 and 41.35±9.24 in treatment and placebo groups, respectively. Tinnitus intensity was significantly decreased in the case group one week and three months after the treatment (P<0.05). Tinnitus handicap inventory score significantly decreased in the treatment group one week and three months after the treatment (P<0.05). There was no significant difference in tinnitus intensity after treatment, considering gender, age, tinnitus duration, and tinnitus type. Electrical stimulation could significantly reduce the severity of the tinnitus regardless of age, gender, duration, and type of tinnitus. https://acta.tums.ac.ir/index.php/acta/article/view/7959 https://acta.tums.ac.ir/index.php/acta/article/download/7959/5362

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 58 1 2020 06 16 38 42 EN Ahmad Bahrami Department of Allergy & Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. AND Ali Asghar Children’s Hospital, Iran University of Medical Sciences, Tehran, Iran. Alireza Nateghian Ali Asghar Children’s Hospital, Iran University of Medical Sciences, Tehran, Iran . AND Infectious Disease Research Center, Iran University of Medical Sciences, Tehran, Iran. Shima Salehi Ali Asghar Children’s Hospital, Iran University of Medical Sciences, Tehran, Iran. AND Department of Rheumatology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Gholamreza Bahoush Department of Hematology, Ali-Asghar Children’s Hospital, Iran University of Medical Sciences, Tehran, Iran. Saeed Talebi Department of Medical Genetics & Molecular Biology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Saeide Ghasemi Department of Allergy & Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. AND Ali Asghar Children’s Hospital, Iran University of Medical Sciences, Tehran, Iran. Sepideh Razi Student Research Committee, School of Medicine, Iran 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. Nima Rezaei Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran. AND Research Center for Immunodeficiencies, Children's Medical Center Hos