Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 2 2021 02 28 64 78 Samira Karimaei Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Hamid Reza Tohidinik HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Davoud Afshar Department of Microbiology and Virology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. AND Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran. Mohammad Reza Pourmand Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Soheila Habibi Ghahfarokhi Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Narjes Noori Goodarzi Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Azarsa Department of Microbiology, School of Medical Sciences, Khoy University of Medical Sciences, Khoy, Iran. 2020 01 14 2020 05 02 This study aimed to explore the prevalence, antimicrobial resistance levels, and serotype distribution of S. pneumoniae in the Middle East region. We conducted a systematic literature review by searching several databases including PubMed, ISI Web of Science, Scopus, Google scholar through 2000 to 2017 by using the following keywords: “Streptococcus pneumoniae”, “pneumococcus”, “serotype”, “Antibiotic resistance,” and “Middle East “in combination with “OR” and “AND” Boolean Operators within Title/Abstract/Keywords fields. We used a random-effects model to calculate the pooled prevalence and 95% confidence intervals (CIs) for binomial variables. All statistical analyses were done using STATA 12.0 (STATA Corp, College Station, TX). We found 73 articles appropriate, on the word of inclusion and exclusion criteria, for inclusion in this systematic review and meta-analysis. The result revealed that the pooled prevalence of S. pneumoniae carriage was 35% (95% CI: 26-44%). The most frequent pneumococcal serotypes were19, 19F, 6, 23 and 6A/B which were found in 19%,12%, 11%, 10% and 10% of isolates respectively. Pneumococcal resistance reported for azithromycin, cefaclor, clarithromycin, chloramphenicol, erythromycin, and tetracycline were 24%, 37%, 23%, 11%, 26%, and 29% respectively, while vancomycin resistance was not reported. The highest resistant prevalence was reported against co-trimoxazole (Trimethoprim/sulfamethoxazole). For this antibiotic, a pooled resistance prevalence of 43% was identified. The present review demonstrates that the prevalence of S. pneumoniae carriage was high in the Middle East region. Surveillance must be continued in this region to evaluate. The resistance pattern and serotype distribution. https://acta.tums.ac.ir/index.php/acta/article/view/8277

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 2 2021 02 28 79 85 Oski Illiandri Department of Biomedicine, School of Medicine, University of Lambung Mangkurat, Banjarmasin, South Kalimantan, Indonesia. 2020 07 26 2020 10 23 Endothelial cells (EC) have dynamic properties and high plasticity in response to microenvironmental change. A proinflammatory cytokine such as tumor necrotizing factor-α (TNF-α) can induce EC phenotype shift to osteoinduction properties by releasing a potent osteogenic cytokine, namely bone morphogenetic protein 2 (BMP2). Normally BMP2 acts as an osteoblast stimulating factor in bone and cartilage tissue. BMP2 activation in vascular tissue will invite osteoblast recruitment and mineralization and generated pathological vascular stiffening and calcification. Recently, endoplasmic reticulum stress (ERS) has been emerging as a new target therapy in many vascular diseases such as vascular stiffening and calcification. Some short-chain fatty acid like 4-phenyl butyric acid has been shown had anti-ERS properties. However, the role of 4-phenyl butyric acid in BMP2 inhibition in endothelial cells is still poorly understood. Hence, we investigated the role of 4-phenyl butyric acid in inflammation-induced BMP2 expression in human vein derived endothelial cells. Endothelial cells obtained from a baby born umbilical vein were cultured and pre-treated with TNF-α (5 ng/ml) as inflammation precondition. Multiple doses of 4-phenyl butyrate acid (4-PBA) 1 nM/mL, 2 nM/mL, and 3 nM/m were used as ERS inhibitors. The expression of two ERS biomarkers, glucose-related protein-8 (GRP78) and activating transcription factor-6 (ATF6), were measured. Statistical analysis was done using one-way ANOVA and Kruskal Wallis tests, and P<0.01 considered as significant. 4-PBA decrease luminal BMP2 at dose one nM/L, GRP78 at dose 1 nM/L, and translocated ATF6 expression at dose 1 nM/L in endothelial culture dose-dependently. Short-chain fatty acid 4-phenylbutyrate acid decreases luminal ERS marker GRP78 and translocated ATF6 expression in endothelial culture. ERS has a role in osteoinductive phenotype shifting in inflammation endothelial cells, which was the novelty of this research. Further research needs to elucidate ERS inhibition in in vivo experiment https://acta.tums.ac.ir/index.php/acta/article/view/8671

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 2 2021 02 28 86 90 EN Maryam Mardani Oral and Dental Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. AND Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. Azadeh Andisheh-Tadbir Oral and Dental Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. ANDSchool of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. Mahya Haghparast School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. 2020 10 22 2021 01 25 The role of angiogenesis in the development of chronic inflammatory diseases, including oral lichen planus (OLP), is of great concern. The most representative method for the assessment of angiogenesis is the semi-quantification of microvessel density (MVD) using specific markers such as CD105. We aimed to assess the MVD in patients with OLP and find its clinical significance to differentiate the atrophic/erosive forms from reticular ones. This cross-sectional study was conducted on 82 patients with clinically and histopathologically proven cases of OLP, including reticular (n=52) or atrophic/erosive (n=30) lesions. The control group comprised 82 age- and sex-matched subjects without any oral disease. To assess the MVD using CD105, tissue blocks were sliced, and the immunoexpression of CD105 was measured by the standard immunohistochemical staining procedure. The mean value of MVD in OLP patients was significantly higher than that in the controls (14.61±12.48 vs. 8.67±1.76, P<0.0001). Furthermore, there was a significant difference in the mean MVD value between reticular and atrophic/erosive lesions (8.19±7.13 vs. 25.73±12.06, P=0.001). However, no significant difference was observed between the reticular lesions and normal tissues (P=0.58). An increased level of CD105 in OLP patients can improve our knowledge about the causes and mechanisms of the disease. The CD105-MVD assessment might be a useful method for semiquantitative measurement of angiogenesis in OLP patients as well as differentiating its clinical forms; therefore, it can open new vistas for formulating strategies based on antiangiogenic treatments for the management of OLP and other precancerous lesions. https://acta.tums.ac.ir/index.php/acta/article/view/8761

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 2 2021 02 28 91 96 GholamAbbas Roustaei Department of Ophthalmology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran. Fatemeh Shomali Department of Medicine, School of Medicine, Babol University of Medical Sciences, Babol, Iran Hemmat Gholinia Department of Biostatistics, School of Medicine, Babol University of Medical Sciences, Babol, Iran. Maral Farzin Department of Medicine, School of Medicine, Babol University of Medical Sciences, Babol, Iran. Seyed Ahmad Rasoulinejad Department of Ophthalmology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran. 2020 07 08 2020 10 23 Cataract is a multifactorial ocular disease, resulting in turbidity or opacity of the lens of the eyes, which leads to blindness or reduction of visuality. The different environmental, socio-economical, and lifestyle factors indicate as risk factors of age-related cataracts. The aim of this study was the evaluation of daily activity, dietary regimen, residence location and etc., as risk factors of age-related cataracts. In this census, a cross-sectional study was performed on 353 patients with age-related cataract underwent surgery, who referred to Rouhani Hospital in Babol, Iran from 2018 to 2019, and 343 healthy individuals. The lifestyle-related information was collected from all individuals via the designed questionnaire. Our results showed that there were significant correlations between the birth/residence in the village (comparing to city, P<0.001), abnormal sleeping time (P<0.001), daily activity (and being outdoor, P<0.001), and use of solid oil (P<0.001) with increasing in age-related cataracts. Furthermore, the use of antioxidant-containing fruits significantly reduces the risk of age-related cataracts. Our results established that lifestyle clearly has a golden impact on age-related cataracts. The reduction in daily activity, normal sleeping time, and more use of antioxidant-containing dietary regimen play a preventive role in age-related cataracts. https://acta.tums.ac.ir/index.php/acta/article/view/8614

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 2 2021 02 28 97 107 Hameed A. Alhibaly Department of Internal Medicine, College of Medicine, Kerbala University, Imam Al-Hussein Medical City, Kerbala, Iraq Hameed Hussein Al-Jameel Department of Internal Medicine, College of Medicine, Kerbala University, Imam Al-Hussein Medical City, Kerbala, Iraq Ban Waheed Hussein Bdair Department of Medical Microbiology and Immunology, College of Medicine, University of Kerbala, Kerbala, Iraq. Satar Jabbar Rahi Algraittee Department of Medical Microbiology and Immunology, College of Medicine, University of Kerbala, Kerbala, Iraq 2020 03 30 2020 09 21 Abstract-Cardiac abnormalities have been suspected and identified using transthoracic echocardiography in patients with normal electrocardiographic results have been reported. It is however not clear whether these abnormalities are clinically significant or can lead to change in clinical management. The aim of this study was to evaluate the prevalence and clinical significance of cardiac abnormalities found in patients with normal electrocardiographic results. Transthoracic echocardiography was conducted on outpatients on referral despite having normal electrocardiographic results. Clinical symptoms were identified and parameters such as BMI, smoking status, blood pressure, blood glucose levels and hypercholesterolemia status were evaluated. The data obtained from these parameters were compared with findings of cardiac abnormalities in the patients. Out of 552 patients analysed with mean age of 50.53±15.04 years, 412 representing 74% had abnormalities in their transthoracic echocardiographic reports. Significant majority of active smoking patients (82.2%) had cardiac abnormalities. The major findings were valvular heart disease observed in 123 patients, grade I and II diastolic dysfunction in 85 patients, hypertensive heart disease in 76 patients and non-significant valve disease reported in 50 patients. The common symptoms included atypical chest pain, shortness of breath and epigastric pain. Hypertension, hypercholesterolemia and diabetes mellitus were observed among patients with abnormal transthoracic echocardiographic reports. There is high prevalence of clinically significant cardiac abnormalities evaluated using transthoracic echocardiography in patients with normal electrocardiographic results. These cardiac abnormalities are associated with symptoms and cardio-metabolic disease, hence might warrant change in clinical management. Keywords: Transthoracic, echocardiography, Cardiac abnormalities, Cardio-metabolic diseases, Structural heart disease. https://acta.tums.ac.ir/index.php/acta/article/view/8381

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 2 2021 02 28 108 112 Benyamin Mousavi-asl Otorhinolaryngology Research Center, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammadreza Firouzifar Otorhinolaryngology Research Center, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran Leyla Noury Otorhinolaryngology Research Center, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran Parnian Khamushian Internal Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Dina Mousavi-asl School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Farrokh Heidari Otorhinolaryngology Research Center, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran 2020 09 19 2020 10 23 COVID-19, which quickly became a global problem, in addition to its effects on public health, is very important in terms of the effect on mental health and anxiety in health care providers. Job burnout should be considered during such health crises. The study design is a cross-sectional study. A total of 87 health care providers (nurses and physicians) were included in the study. Their general information such as age, gender, years of experience, and hours working in COVID-19 was asked. They all filled Maslach burnout inventory, a questionnaire measuring job burnout with three dimensions: Emotional exhaustion (EE), Depersonalization (DP), and personal accomplishment (PA). We found that in physicians, EE (r:0.54, P<0.001) and DP were correlated with hours working in the COVID-19 ward, but no such correlation was found in nurses. Physicians had a higher DP score (mean 12.66 vs. 8.28, P<0.001) and lower PA score (mean 22.71 vs. 25.62, P:0.004) both of them represent higher burnout levels in physicians. Comparing our results with previous studies show that during the COVID-19 breakout higher level of job burnout could be found in health care workers, especially in physicians. Hours working in COVID-19 special wards can increase the level of burnout. https://acta.tums.ac.ir/index.php/acta/article/view/8810

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 2 2021 02 28 113 117 EN Amir Jalali Nadoushan /acta/article/download/7360/5170

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 10 2019 01 13 660 664 EN Mehrdad Goodarzi Department of Anesthesiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Hossein Ali Khazaei Department of Clinical Immunology, Clinical Immunology Research Center (CIRC), Zahedan University of Medical Sciences, Zahedan, Iran. Bahar Ashjaei Department of Surgery, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran . Maryam Ghavami Department of Surgery, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran . Mansour Mollaeian Department of Surgery, School of Medicine, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran. Nora Bigdeli Department of Surgery, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran . Ali Talebi Department of Surgery, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Azita Parvizizadeh Department of Surgery, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Gholamreza Badfar Department of Pediatric, School of Medicine, Ahvaz University of Medical Sciences, Ahvaz, Iran. Alireza Ebrahim Soltani Department of Anesthesiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Alireza Nahvi Department of Biomedical Engineering, School of Engineering, Shahed University, Tehran, Iran. Valiullah Mehrabi Department of Surgery, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Hedayatollah Nahvi Department of Surgery, School of Medicine, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran . 2018 03 17 2018 08 10 Esophageal atresia (EA) is a rare congenital anomaly that may be isolated or associated with other anomalies requiring prompt medical and surgical planning for optimal result. This study was conducted to show our recent experience on the outcome of treated patients in two hospitals affiliated to Tehran University of Medical Sciences (TUMS). From January 2008 to May 2013 records of 43 neonates patients (23 male) with EA admitted in 2 children centers and all related data including demographic, diagnostic associated anomalies, surgical approaches, birth weight, mortality, and complications were collected. Inability of feeding and swallowing was the most common symptoms (in 90,6%), associated CHD (44%), and Type C (EA) was the most common type of EA observed in 86% patients, The mortality rate was 4.7% and most common complication was anastomotic stricture (AS) in 60% of patients. Our study showed that despite improvements in management and survival of an infant with (EA), still sepsis, aspiration pneumonia, prematurity, and low birth weight and severe Congenital Heart Disease (CHD) were independent etiology of death and birth weight < 2.500 gr  has a significant  effect on the occurrence of postoperative complications. https://acta.tums.ac.ir/index.php/acta/article/view/7127 https://acta.tums.ac.ir/index.php/acta/article/download/7127/5171

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 10 2019 01 13 665 670 EN Taraneh Dormohammadi Toosi Department of Rheumatology, University of San Diego, CA, USA. AND Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran, Iran. Abodolrahman Rostamiyan Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran, Iran. Khatereh Moharrami Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran, Iran. Shafieh Movassaghi Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran, Iran. Manouchehr Nakhjavani Endocrine and Metabolic Research Center, Tehran University of Medical Sciences, Tehran, Iran.and Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran, Iran Amir Hossein Norooznezhad Regenerative Medicine Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. 2018 08 02 2018 11 10 It has been proved that rheumatoid arthritis (RA) is linked to dyslipidemia and the risk of cardiovascular complications is higher in these patients. The aim of this study was to evaluate dyslipidemia in RA patients. In this study, RA patients were enrolled regarding the inclusion and exclusion criteria. Their demographic information and medication profiles were evaluated. Clinical assessments were performed by evaluation of disease activity score (DAS28) and visual analogue scale. Moreover, laboratory investigations of lipid profile including triglycerides (TG), total cholesterol (Chol), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were performed. From a total of 150 patients with the mean age of 54.9±16.8 years, 65.3% were diagnosed with dyslipidemia. Females in menopausal ages had a higher prevalence of dyslipidemia as well as patients with longer disease duration. Mean serum HDL, LDL, Chol, and TG were 52.76±13.8, 96.65±21.6, 177.26±38.9, and 128.04±33.9, respectively. Considering DAS28, 100% of the patients with high disease activity were diagnosed with dyslipidemia. In the moderate and low disease activity groups and also patients in remission the ratio was 77.02%, 66.66%, and 43.75%, respectively. According to the results, patients under treatment with prednisolone and methotrexate were more affected by dyslipidemia than those with prednisolone, methotrexate, and hydroxychloroquine. Moreover, in the patients under prednisolone, methotrexate, and leflunomide treatment, the prevalence of dyslipidemia was significantly lower than those used only prednisolone and methotrexate. Altogether, it is necessary to have more clinical suspicion towards dyslipidemia and its complications in the patients with greater number of affecting factors. https://acta.tums.ac.ir/index.php/acta/article/view/7419 https://acta.tums.ac.ir/index.php/acta/article/download/7419/5172

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 56 10 2019