Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 7 2020 01 22 405 411 Mojdeh Habibi Zoham Department of Pediatric Intensive Care Unit, Bahrami Children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Zafar Department of Pediatric, Bahrami Children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran. Armen Malekiantaghi Department of Pediatric, Pediatric Gastroenterology and Hepatology Research Center, Bahrami Children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran. Reyhaneh Ettehadi Department of Pediatric, Bahrami Children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran. Seyed Behnam Jazayeri General practitioner, Department of Pediatric Intensive Care Unit, Bahrami children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran Kambiz Eftekhari Associate professor of pediatric gastroenterology, Pediatric gastroenterology and hepatology research center, Department of Pediatric, Bahrami children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran 2019 06 27 2019 10 31 The infantile colic is one of the most common complaints in the infancy; however, limited therapeutic approaches are described in the literature. Recently probiotics have been suggested as a potential strategy in the treatment of infantile colic. We conducted this study to investigate the efficacy of probiotics in relieving colic symptoms in Iranian infants. This double-blind clinical trial was performed among 70 infants aged 3 to 16 weeks with the presumed diagnosis of infantile colic according to Wessel criteria who were breastfed or formula fed. They were assigned at random to receive Pedilact® (Bifidobacterium infantis, Lactobacillus reuteri, and Lactobacillus rhamnosus) (N=33) or placebo (N=32). Demographic data were recorded in the questionnaires at the beginning of the study. The number of daily episodes of crying and fussiness, number of weekly crying days, and duration of crying were separately analyzed on 7, 21, and 30th  days of investigation. Baseline demographic data showed no statistically significant difference between intervention and placebo groups. Infants given Pedilact® showed a significant reduction in daily episodes of crying, duration of crying, and the weekly number of crying days at the end of the treatment period compared with those receiving placebo (P=0.000). On 21th day of the study, daily episodes of fuss and crying (P=0.032) and duration of crying reduced significantly in the intervention group in comparison to the placebo group (P=0.000). Administration of Pedilact® drop significantly improved colic symptoms by reducing crying and fussing times in breastfed or formula fed in Iranian infants with colic. https://acta.tums.ac.ir/index.php/acta/article/view/7966 https://acta.tums.ac.ir/index.php/acta/article/download/7966/5283

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 7 2020 01 26 412 415 Abdolreza Medghalchi Department of Eye, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. AND Eye Research Center, Guilan University of Medical Sciences, Rasht, Iran. Mitra Akbari Department of Eye, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. AND Eye Research Center, Guilan University of Medical Sciences, Rasht, Iran. Reza Soltani Moghadam Department of Eye, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. AND Eye Research Center, Guilan University of Medical Sciences, Rasht, Iran. Yousef Alizadeh Department of Eye, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. AND Eye Research Center, Guilan University of Medical Sciences, Rasht, Iran. Abtin Heirati Department of Eye, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. AND Eye Research Center, Guilan University of Medical Sciences, Rasht, Iran. 2019 07 18 2019 10 02 Topical anesthesia (TA) may accompany more discomfort for some patients during cataract surgery. We aimed to evaluate the potential factors that can be used for predicting patient’s cooperation during phacoemulsification surgery under TA. One hundred sixty consecutive cases that were candidate for phacoemulsification surgery were enrolled in this prospective study. Patients’ sex, age, place of residence (urban or rural), education level (literate and illiterate) and physical examination variables (visual acuity, reaction to eye drop, cooperation during tonometry, and reaction to press on the lacrimal sac before surgery) evaluated. Patients’ cooperation during surgery was classified as successful (good and satisfactory) or failed (weak) groups. In this study, 103(64.4%) cases showed good or satisfactory cooperation, and others had weak cooperation. There was no correlation between patients’ cooperation during surgery and sex (P=0.2), age (P=0.7), place of residency (P=0.3), and education level (P=0.3). The successful group showed a higher rate of non-reaction to eye drop (P=0.0001), good cooperation during tonometry (P=0.0001), non-reaction to press on lacrimal sac (P=0.0001), and lower visual acuity (P=0.045). In the multi-logistic regression, non-reaction to eye drop (OR=66.4), good cooperation during tonometry (OR=21.2, good vs. bad and OR=7.2, satisfactory vs. bad), lower visual acuity (OR=7, <0.1 vs. 0.1-0.4 d) are the significant predictors for the success of TA. This study showed that some ocular examination tests before surgery (visual acuity, reaction to eye drop, cooperation during tonometry, and reaction to press on the lacrimal sac) could predict patients’ cooperation during phacoemulsification surgery under TA. https://acta.tums.ac.ir/index.php/acta/article/view/7996 https://acta.tums.ac.ir/index.php/acta/article/download/7996/5294

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 7 2020 01 22 416 423 Babak Alikiaii Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Behzad Nazemroaya Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Alireza Jabbari Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. 2019 06 30 2019 10 31 Mechanical ventilation (MV) is among the main basics of supportive treatment for respiratory failure in the intensive care unit (ICU). This supportive treatment may cause undesirable complications that led to the introduction of various MV modes. The current study was aimed to assess and compare outcomes of volume support ventilation (VSV) and pressure support ventilation (PSV) regarding spontaneous breath return, weaning and hemodynamic changes among patients admitted at ICU following surgical procedures. This single-blinded randomized-clinical-trial (RCT) was conducted on 100 patients admitted at ICU in 2018-2019. Patients were randomly divided into two fifty-member groups treated with PSV and VSV modes. Oxygen saturation, systolic (SBP) and diastolic blood pressure (DBP), mean arterial pressure (MAP), arterial blood gas (ABG), extubation and MV time and sedation based on RAMSY criteria were recorded and compared. Mean age (P=0.79) and gender distribution (P=0.57) were not statistically different in the two groups. Time has no effect on patients' hemodynamic (P>0.05) while hemodynamic stability was superior in VSV (P<0.05). ABG showed no statistical difference between groups (P>0.05) except for arterial oxygen pressure that was higher in the VSV group (P<0.001). The duration of MV, extubation time and duration of ICU admission was significantly lower in the VSV group. Furthermore, sedation based on RAMSY criteria showed the superiority of VSV (P<0.05). Use of VSV mode was accompanied with superior outcomes in four entities including earlier and easier weaning, shorter duration of ICU admission, least hemodynamic instabilities and least sedation requirement in comparison to PSV mode. https://acta.tums.ac.ir/index.php/acta/article/view/7969 https://acta.tums.ac.ir/index.php/acta/article/download/7969/5287

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 7 2020 01 26 424 429 Abdollah Jafarzadeh Department of Immunology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran. AND Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. Maryam Hadavi Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. AND Department of Anesthesiology, School of Paramedical, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. Gholamhossein Hassanshahi Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. ANDDepartment of Immunology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. Mohsen Rezaeian Department of Epidemiology and Biostatistics, School of Medicine, Occupational Environmental Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. Reza Vazirinejad Department of Social Medicine, Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. Fariba Aminzadeh Department of Gynecology and Obstetrics, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. Ali Sarkoohi Department of Anesthesiology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. 2019 05 11 2019 09 08 The severity of postoperative pain and hemodynamic changes during and post-cesarean section have a direct effect on the neonatal and maternal condition. This study aimed to compare pain severity, hemodynamic changes, and patient satisfaction following two anesthesia techniques in elective cesarean section. In this blinded study, 60 women who were candidate for cesarean section were allocated into two equal groups of general anesthesia (GA) and spinal anesthesia (SA). Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and O2 Saturation at pre cesarean (T0), the uterine incision time (T1), end of surgery (T2), 6h (T3), 12h (T4), and 24 hours post-cesarean (T5) were measured. A Visual Analog Scale assessed post-cesarean pain, 6, 12, and 24 hours post-cesarean. Gender, birth weight, first- and fifth- minutes’ apgar score was recorded in the checklists. The VAS score was significantly higher in the GA group at 6h, 12h, and 24 hours post-cesarean (P=0.014, P=0.002, P=0.017, respectively). SBP and DBP at T1 in the GA group were significantly higher than in the S.A group (P<0.001). The heart rate at T0 and T1 in the GA group was lower than the SA group (P=0.001, P=0.045 respectively). The difference between the apgar scores of the two groups was not significant. SA for cesarean section was associated with lower postoperative pain, systolic and diastolic blood pressure. However, the two groups had no significant difference in terms of patients’ satisfaction and apgar scores. https://acta.tums.ac.ir/index.php/acta/article/view/7869 https://acta.tums.ac.ir/index.php/acta/article/download/7869/5295

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 7 2020 01 22 430 434 Nazanin Izadi Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran. Omid Aminian Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran. Pegah Estakhrian Center for Research on Occupational Diseases, Tehran University of medical sciences, Tehran, Iran. Samaneh Akbarpour Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mahin Ahmadi Pishkuhi Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran. Maryam Saraei Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran. 2019 06 23 2019 11 04 Gestational hypertension or pregnancy-induced hypertension is the emergence of hypertension in a pregnant women after 20 weeks of gestation. This study aimed to evaluate the job-related factors associated with pregnancy-induced hypertension. This cross-sectional study was conducted on 560 pregnant women who referred to the Nursing Clinic of Imam Khomeini Hospital in 2017; of all studied cases, 210 pregnant women with pregnancy-induced hypertension were selected as cases and 350 women without pregnancy-induced hypertension were selected as controls. The data on demographic characteristics, occupational characteristics, and ergonomic dangers were collected by the researchers. Finally, the relationship between job variables and the probability of developing hypertension in pregnant women was measured. The results of the logistic regression analysis showed that the variables of body mass index, fertility, shift work, and service works had a significant relationship with pregnancy-induced hypertension. Women with service work were 2.32 times more likely to develop hypertension than women with other types of jobs (P=0.013). The people who had a shift work were 2.28 times more likely to develop pregnancy-induced hypertension than those who did not have shift work. Based on the results of this study, there was no relationship between ergonomic risks and pregnancy-induced hypertension. It seems that due to the higher frequency of pregnancy-induced hypertension in highly demanding jobs, it is necessary to pay more attention to the assessment of related risk factors, such as psychological variables. https://acta.tums.ac.ir/index.php/acta/article/view/7960 https://acta.tums.ac.ir/index.php/acta/article/download/7960/5288

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 7 2020 01 22 435 441 Behrouz Attarbashi Moghadam Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Hasan Tamartash Department of Physiotherapy, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Sara Fereydunnia Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran . Mahdieh Ravand Department of Physiotherapy, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2019 02 23 2019 10 31 The Minnesota Living with Heart Failure Questionnaire (MLHFQ) has been developed to measure health-related quality of life (HRQoL) status of Heart Failure (HF) patients. The aim of this study was to translate MLHFQ into the Persian version and assess the validity and reliability of the translated version. We used a forward-backward procedure for translation. In a cross-sectional study, 105 HF patients and 50 healthy subjects were selected to assess the reliability and construct validity of the instrument. The face and content validity were used to assess the questionnaire validity. Validity was examined on the HF patients group, using the Persian version of the Short form-36 health survey (SF-36) Questionnaire. In order to assess the questionnaire’s reliability, the Intraclass correlation coefficient (ICC) and Cronbach’s alpha were calculated. Test-retest reliability was examined by re-administering the MLHFQ after 2 weeks. Test-retest results demonstrated that the Persian version has excellent reliability (ICC for all 2 domains were higher than 0.91, P≤0.000). Internal consistency for Physical domain (PD), emotional domain (ED) and total scores using Cronbach’s alpha were 0.90, 0.84 and 0.92, respectively. ICC for PD, ED and total scores were 0.95, 0.94, and 0.97, respectively. Good and very good Pearson's Correlation Coefficient was seen between MLHFQ and SF-36 (r= -0.47 to -0.775, P≤0.000 for PD; r= -0.47 to -0.65, P≤0.000 for ED). The Persian version of the MLHFQ had satisfactory reliability and validity for assessing HRQoL status of Iranian HF patients. https://acta.tums.ac.ir/index.php/acta/article/view/7770 https://acta.tums.ac.ir/index.php/acta/article/download/7770/5289

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 7 2020 01 25 442 447 Arezou Karampouian Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran. AND Departments of Health in Emergencies and Disasters, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zohreh Ghomian Departments of Health in Emergencies and Disasters, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran. AND Workplace Health Promotion Research Center (WHPRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Davoud Khorasani-Zavareh Workplace Health Promotion Research Center (WHPRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2019 06 01 2019 11 04 Participating in mass gatherings puts people at risk of incidents. The distribution of resources should be based on need. The purpose of this study was to investigate the distribution of trauma care facilities based on need and access at a religious mass gathering in Iran. This national cross-sectional study is based on obtained data including the number of visits to health centers (NVHC) and the number of injuries visits health center (NIVHC) as needs and the number of physicians, paramedic, ambulance, and treatment center as access in border cities of Iran and Iraq in 2016. Gini coefficient, Lorenz curve and the Pearson correlation coefficient were applied to measure the level of equality in the distribution of trauma care and the correlation between access and need. The facilities were relatively distributed equally at the border towns in Iran; however, were not equally distributed in Iraq. There is no significant association between the paramedic for NIVHC and ambulance for NIVHC and NVHC. Moreover, there was a significant association between physician for NIVHC and NVHC, a paramedic for NVHC, and treatment centers for NIVHC and NVHC. The consequences of incidents could be reduced if distributing trauma care facilities equals at mass gatherings. https://acta.tums.ac.ir/index.php/acta/article/view/7930 https://acta.tums.ac.ir/index.php/acta/article/download/7930/5290

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 7 2020 01 25 448 454 EN Zoleikha Ranjbar-Pirmousa Deputy of Research and Technology, Guilan University of Medical Sciences, Rasht, Iran. Narges Borji-Zemeidani Deputy of Research and Technology, Guilan University of Medical Sciences, Rasht, Iran. Mirsaeed Attarchi Medical Education Research Center, Guilan University of Medical Sciences, Rasht, Iran. Shadman Nemati Deputy of Research and Technology, Guilan University of Medical Sciences, Rasht, Iran. AND Medical Education Research Center, Guilan University of Medical Sciences, Rasht, Iran. Farzaneh Aminpour Department of Research and Technology, Tehran University of Medical Sciences, Tehran, Iran. 2019 05 31 2019 11 04 Evaluation of the research status of the academic institution provides it with the possibility of accurate research policymaking. Scientometric indicators are important tools for evaluating scientific activities of individuals, groups, and institutions. The current research aims to analysis the research performance of medical universities in Northern Iran based on quantitative and qualitative scientometric indicators. In this cross-sectional descriptive study, the Scopus-indexed scientific documents provided by medical universities in the Northern Iran have been studied in terms of number of publications, number of citations, average number of Citations per Publication (C/P), Field-Weighted Citation Impact (FWCI), scientific collaborations, the number of in top 10% citation percentile, and the number of publications in top 10% journal percentile according to CiteScore, Source Normalized Impact per Paper (SNIP), and SCImagoJournal Rank (SJR) indicators during a five years period. According to the findings, Mazandaran University of Medical Sciences has gained the highest position in terms of the number of publications and citations, number of publications with international and national collaborations, and  academic-industrial collaborations., while Golestan University of Medical Sciences has gained a higher position in terms of scientific outputs in top 10% citation percentile and journal percentile, CiteScore, SNIP, SJR and C/P. In terms of the FWCI indicator, Golestan University of Medical Sciences has achieved the highest value. Considering academic status and research capabilities of medical universities in the Northern Iran, increasing academic-industrial collaboration, expanding academic collaboration with superior universities and institutions around the world can be effective in increasing the quality of research and upgrading academic ranks of universities at national, regional and international levels. https://acta.tums.ac.ir/index.php/acta/article/view/7943 https://acta.tums.ac.ir/index.php/acta/article/download/7943/5299

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 7 2020 01 25 456 460 Azadehzeinab Titidej Department of Oral and Maxillofacial Pathology, School of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran. Maryam Jolehar Department of Oral and Maxillofacial Pathology, School of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran. 2019 04 16 2019 10 02 Desmoplastic fibroma is a rare, benign fibrous tumor of bone which is locally aggressive. The mandible is the most prevalent affected of the facial bones. Nevertheless, reports of desmoplastic fibroma affecting the mandible are seldom in the literature. It causes bone destruction and has a high tendency for local recurrence. In this case report, we report a case of desmoplastic fibroma which is located in mandibular angle and extended to coronoid process, in 20-year-old female patient. https://acta.tums.ac.ir/index.php/acta/article/view/7837 https://acta.tums.ac.ir/index.php/acta/article/download/7837/5291

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 7 2020 01 25 461 463 EN Amirhossein Larijani Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran . Amirhossein Darvishi Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Kourosh Karimi-Yarandi Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Seyed Ali Ahmadi Department of Pathology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Maysam Alimohamadi Brain and spinal cord injury research center, Neuroscience institute, Tehran University of Medical Sciences 2018 12 29 2019 09 08 The immunosuppressive state after organ transplantation leads to infectious complications responsible for high mortality rate. Fungal infections account for 5% of all infections in Renal Transplantation (RT) recipients. A 53-year-old man was admitted with acute loss of consciousness. He had a history of renal transplantation 1 month before admission. Brain CT showed acute hydrocephalus with periventricular edema. A right frontal external ventricular drain was inserted urgently. One day later the consciousness further decreased, and CT scan showed unilateral left lateral ventricle dilatation and a hyperdense mass at the septum pellucidum. The patient was operated via endoscopic trans-middle frontal sulcus approach. The interventricular septum was pushed contralaterally, and a very adherent mesh-like thick layer covered the surface of lateral ventricle and foramen of Moro. The Monro foramen was opened, and septostomy was done. The mass inside the septum was found posterior to the foramen, punctured, and partially removed. Histopathological study revealed aspergillus infection of the lateral ventricles. CNS Aspergillosis should be considered in the differential diagnosis of altered consciousness among immunocompromised hosts. This report further implies that isolated ventricular involvement by aspergillus infection may be considered as the cause of hydrocephalus in immunocompromised patients. https://acta.tums.ac.ir/index.php/acta/article/view/7650 https://acta.tums.ac.ir/index.php/acta/article/download/7650/5292

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 7 2020 01 26 464 467 EN Masoud Mohebbi Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Shohreh Vojouhi Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Seyed Alireza Javadinia Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran. Faeze Keihanian Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran AND Department of Cardiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. AND Ghaem Hospitals, Mashhad University of Medical Sciences, Mashhad, Iran.AND Pharmaceutical Research Center, Booali Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Mohammad Ali Yaghoubi Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Ali Motamedzadeh Torghabeh Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran. 2019 01 01 2019 09 08 Ectopic increase of adrenocorticotropic hormone (ACTH) or ectopic Cushing syndrome is a rare initial presentation of small cell carcinoma and carcinoid tumor of the lung. Here, we reported a 36-year-old male with atypical symptoms of Cushing syndrome managed by Etomidate that had a central pulmonary nodule, and pathologic evaluation of pulmonary lobectomy revealed the diagnosis of well-differentiated, low-grade typical carcinoids of lung. https://acta.tums.ac.ir/index.php/acta/article/view/7664 https://acta.tums.ac.ir/index.php/acta/article/download/7664/5293

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 7 2020 01 26 468 470 Ahmad Hormati Department of Internal Medicine, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran. AND Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran. Faezeh Alemi Department of Internal Medicine, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran. Rouhollah Taghavi Department of Surgery, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran. Mohammadreza Ghasemian Department of Radiology, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran. Mahsa Besharati Department of Internal Medicine, Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran. 2019 06 24 2019 10 02 Mesenteric ischemia is a rare disease with a high rate of mortality because of the non-specific symptoms which leads to delay in diagnosis and intervention. The main symptom is abdominal pain; which has a broad list of differential diagnosis. This study introduces a 17 years old girl who presents to the emergency department with severe abdominal pain and hematemesis. Further evaluations revealed thrombosis in the mesenteric vein which leads to ischemia and gangrene of the small intestine. Her past medical history and drug history was negative, except she was taking Levonorgestrel and cyproterone acetate for a 5 months period. Since long-term treatment with oral contraceptive pills, counts as a risk factor for venous thrombosis, this case seems to be uncommon. https://acta.tums.ac.ir/index.php/acta/article/view/7961 https://acta.tums.ac.ir/index.php/acta/article/download/7961/5296

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 7 2020 01 26 8297 8297 Parisa Sarkhail Department of Bioactive Natural Products, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mona Salimi Department of Physiology and Pharmacology, Pasteur Institute of Iran, Tehran, Iran. Pantea Sarkheil Department of Bioactive Natural Products, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran. Hirsa Mostafapour Kandelous Department of Physiology and Pharmacology, Pasteur Institute of Iran, Tehran, Iran. 2020 01 26 2020 01 26 No Abstract  https://acta.tums.ac.ir/index.php/acta/article/view/8297 https://acta.tums.ac.ir/index.php/acta/article/download/8297/5297