Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 4 2021 05 18 186 190 Karolina Cięszka Department of Geriatrics, College of Physicians in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland Aleksandra Modlińska Department of Geriatrics, College of Physicians in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland Kornelia Kędziora-Kornatowska Department of Geriatrics, College of Physicians in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland 2020 06 21 2020 10 23 Headaches are a very common ailment in the modern world. Unfortunately, a large number of people are not diagnosed properly, and headaches are underestimated. However, it is worth analyzing this problem to be able to treat the causes of which the headache is only a symptom. The aim of the work was to present various types of headaches and their characteristic features. To this end, a systematic review of the PubMed science base has been carried out. It is possible to distinguish mainly primary and secondary headaches. Particularly noteworthy are secondary headaches, among which, for example, headaches associated with sexual activity can be observed. It can be seen that there is a lack of scientific literature discussing this type of headache. Since there is a stigma surrounding it, this topic is avoided in research and difficult to explore due to low public awareness. In turn, the treatment of headaches does not have to be limited to pharmacological methods. The review presents effective methods of non-pharmacological treatment of headaches. Headaches are a social and economic problem. It is important to educate the patient and their families in the field of headache treatment to increase patients' awareness of the types of headaches. https://acta.tums.ac.ir/index.php/acta/article/view/8556

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 4 2021 05 18 191 196 Primkul Nazirov Republican Specialized Scientific and Practical Medical Center of Tuberculosis and Pulmonology, 100086 Tashkent, Uzbekistan. Alfiya Fakhridinova Republican Specialized Scientific and Practical Medical Center of Tuberculosis and Pulmonology Zulfiya Makhmudova Republican Specialized Scientific and Practical Medical Center of Tuberculosis and Pulmonology Bakhtiyar Djuraev Republican Specialized Scientific and Practical Medical Center of Tuberculosis and Pulmonology 2020 06 26 2021 01 31 The purpose of this study is to generalize the results of a complex clinical-laboratory, radiological and immunological study of patients with spinal tuberculosis. A comprehensive examination analysis was carried out in 192 patients with tuberculous spondylitis who were in the department of surgery for osteoarticular tuberculosis of the Republican Specialized Scientific and Practical Medical Center of Tuberculosis and Pulmonology in Tashkent, Uzbekistan. Severe degrees of spinal disorders were found in 48.7% of patients. Magnetic resonance imaging (MRI) and multi-slice spiral computed tomography (MSCT) allow establishing the stage and activity of a specific process in the spine, as well as complications. Spinal column instability was detected in 143 (74.5%) patients, paravertebral abscesses in 116 (60.4%) patients, and epidural abscesses in 75 (39.0%) patients. Changes in immunological parameters in patients with spinal tuberculosis were associated both with impaired regulation of immunogenetic and with the direct influence of the immune system at various stages of the process. The detection of certain patterns of immune system disorders in patients with tuberculous lesions of the spine allowed us to make a differentiated approach to their treatment in order to increase the effectiveness of the treatment. It can be concluded that at present, tuberculosis of bones and joints, especially the spine, is detected in an advanced stage in 50-80% of cases and has a widespread and complicated character with profound anatomical and functional changes and the presence of severe spinal disorders in 48.7% patients in Uzbekistan. Regarding spondylitis, it is immensely important to make an accurate diagnosis based on the clinical presentations, laboratory, radiological and immunological findings and by periodic assessment of the response to treatment, which is essential in atypical cases. https://acta.tums.ac.ir/index.php/acta/article/view/8580

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 4 2021 05 18 197 202 Roberto Catanzaro Department of Clinical and Experimental Medicine, Gastroenterology Section, Gaspare Rodolico Hospital, University of Catania, Catania, Italy Alfio Maugeri Maugeri Department of Clinical and Experimental Medicine, Gastroenterology Section, Gaspare Rodolico Hospital, University of Catania, Catania, Italy Morena Sciuto Department of Clinical and Experimental Medicine, Gastroenterology Section, Gaspare Rodolico Hospital, University of Catania, Catania, Italy Fang He Department of Nutrition, West China School of Public Health, Sichuan University, Sichuan, China Baskar Balakrishnan Department of Immunology, Mayo Clinic, Rochester, MN, USA Francesco Marotta ReGenera R and D International for Aging Intervention and San Babila Clinic, Milano, Italy 2020 07 03 2021 02 18 The gastrointestinal pathologies have increased over the last years. The clinical pictures of inflammatory and irritable bowel disease might overlap, leading to expensive and invasive tests. Our study aims to investigate fecal calprotectin as an effective tool for differential diagnosis of gastrointestinal disorders. Two hundred fifty-six patients with the diagnosis of the gastrointestinal disorder and subjected to colonoscopy were collected for the statistical analysis of fecal calprotectin. The differential diagnosis of intestinal inflammation or non-inflammation was performed according to the Receiver Operating Characteristic (ROC) curve that outlines the Area Under Curve (AUC), Sensitivity (Se), Specificity (Sp). Fecal calprotectin was significantly elevated in patients with inflammatory bowel disease compared with patients with irritable bowel syndrome. Especially, the mean values of fecal calprotectin were 522 mg/g (IQR=215-975) and 21 mg/g (IQR=14-34.5) in patients with and without inflammation, respectively (P<0.0001). AUC value of fecal calprotectin was 0.958 (Se=88.9%, Sp=91.1%, with a cut-off value of 50 mg/g) for differentiating between inflammatory bowel disease and irritable bowel syndrome. Fecal calprotectin seems to be a non-invasive and inexpensive biomarker useful for the purpose of a differential diagnosis between inflammatory bowel disease and irritable bowel syndrome. https://acta.tums.ac.ir/index.php/acta/article/view/8599

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 4 2021 05 18 208 216 Amir Hoseinpour Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran Parvin Akbariasbagh Department of Pediatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Mohammadzadeh Department of Epidemiology and Biostatistics, School of Health, Gonabad University of Medical Sciences, Gonabad, Iran. AND Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran. Esfandiar Azad Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran Mohsen Saberi Isfeedvajani Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. AND Department of Community Medicine, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran. 2021 01 14 2021 01 21 Life satisfaction can both affect and be affected by occupational factors in military personnel. Perceived stress is considered an important predictor of life satisfaction. The objective of this study is to evaluate the direct and indirect effects of perceived stress on life satisfaction and the mediating role of depression, anxiety, and sleep quality among Iranian military personnel. In this cross-sectional study, a total of 301 military personnel were investigated by using standard self-report questionnaires, consisting of the Revised Symptom Checklist-90 (SCL-90-R), Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), and Satisfaction with Life Scale (SWLS) in our study. Data analysis was conducted using descriptive statistics, the Pearson correlation coefficient, ordinary least square regression, and the bootstrap method. The direct effect of perceived stress on life satisfaction was significant. Perceived stress also affects life satisfaction indirectly through single mediation of sleep quality; serial multiple mediations of anxiety as the first and sleep quality as the second mediator; and the serial multiple mediations of depression, anxiety, and sleep quality, as the first to the third mediator, respectively. Lower levels of perceived stress, depression, and anxiety, along with better sleep quality, are correlated to higher levels of life satisfaction in military personnel. There are several points of prevention and intervention in order to increase the life satisfaction of military personnel, which can improve their quality of life and occupational efficiency. https://acta.tums.ac.ir/index.php/acta/article/view/9091

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 4 2021 05 18 217 222 Nazanin Farshchian Department of Radiology, Imam Reza Hospital, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran. Ali Naghdian Department of Radiology, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran Parisa Bahrami Kamangar Department of Radiology, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran 2020 08 01 2021 01 25 Postdate pregnancy is a pregnancy that pasts more than forty weeks. This can be dangerous for the mother, fetus, and newborn. By knowing the most appropriate ultrasound criteria in predicting the probability of postdate pregnancy, its complications can be reduced by taking timely measures. Therefore, the present study was conducted with the aim of determining the relationship between ultrasound criteria in determining the age of postdate fetuses. This cross-sectional study (descriptive-analytical type) was done in Kermanshah Imam Reza Hospital on 33 pregnant women that, according to LMP and first-trimester ultrasound, pregnancy age was more than 40 weeks. Gestational age was calculated by various ultrasound criteria, including head circumference measurement (HC), Abdominal Circumference (AC), Biparietal Diameter (BPD), femur length (FL), and Transcerebellar Diameter (TCD). The findings were compared with calculated age by LMP. Data were analyzed by SPSS16 software. Correlation rate of pregnancy age based on LMP with FL (R=0.576, P<0.001), AC (R=0.208, P=0.245), BPD (R= -0.200, P=0.264), HC (R= -0.211, P=0.238) and TCD were (R=0.111, P=0.538). The pregnancy age correlation rate based on LMP with ultrasound criteria in general was (R=0.140, P=0.436). There was a direct relationship between gestational age based on LMP with FL, AC, TCD and inversely related to BPD and HC. Among the sonographic criteria, only the FL criterion was significantly correlated with LMP. In general, the correlation between gestational age based on LMP and ultrasound was not statistically significant. https://acta.tums.ac.ir/index.php/acta/article/view/8688

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 4 2021 05 18 223 227 Qader Motarjemizadeh Department of Ophthalmology, School of Medicine, Medical University of Urmia, Urmia, Iran Naser Samadi Aidenloo Department of Ophthalmology, School of Medicine, Medical University of Urmia, Urmia, Iran 2020 12 09 2021 01 31 - Amblyopia (lazy eye) is one of the significant complications of strabismus surgery. It is the most important cause of unilateral visual impairment in both children and adults. The current investigation was achieved to determine the postoperative amblyopia rate and to identify factors predisposing to amblyopia following exotropia surgery among patients who had been referred to Imam Khomeini Hospital in Urmia, Iran. The present investigation is a retrospective study that was conducted over three years (2008-2010). The study consisted of sixty patients who underwent their first strabismus surgery for treatment of horizontal deviation. Patients were followed up for at least 24 months, and the rate of postoperative amblyopia was measured. The preoperative deviation, strabismus type (exotropia vs. esotropia), visual acuity, age at surgery, and the number of operated muscles were analyzed as determining factors of postoperative development of amblyopia. Amblyopia was observed in 50% of cases during the follow-up period. No statistically significant differences were observed between amblyopic and non-amblyopic eyes in terms of sex, age at surgery, strabismus type, and visual acuity. But amblyopic eyes showed higher deviation angles compared to non-amblyopic eyes (<0.001). The Cox hazard model analysis revealed a significant contribution of deviation angle to postoperative development of amblyopia. A larger deviation angle has been identified as a positive predictor of postoperative development of amblyopia in our investigated population. Due to such a high rate of postoperative amblyopia, it seems better to initiate and complete amblyopia therapy before strabismus surgery. https://acta.tums.ac.ir/index.php/acta/article/view/9005

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 4 2021 05 18 203 207 EN Hassan Behboudi Department of Ophthalmology, Eye Research Center, Guilan University of Medical Sciences, Rasht, Iran Abtin Heirati Department of Ophthalmology, Eye Research Center, Guilan University of Medical Sciences, Rasht, Iran Hengameh Behboudi Department of Ophthalmology, Eye Research Center, Guilan University of Medical Sciences, Rasht, Iran Maryam Akbari Department of Otolaryngology and Head and Neck Surgery, Otorhinolaryngology Research Center, Guilan University of Medical Sciences, Rasht, Iran. AND School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Naghi Ramezani Department of Radiology, Sepehr Radiology Center, Guilan University of Medical Sciences, Rasht, Iran. Makan Shalchizadeh Department of Otolaryngology and Head and Neck Surgery, Otorhinolaryngology Research Center, Guilan University of Medical Sciences, Rasht, Iran.ANDSchool of Medicine, Guilan University of Medical Sciences, Rasht, Iran. https://acta.tums.ac.ir/index.php/acta/article/view/10402

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 12 2023 01 30 772 776 Behnaz Bazargani Department of Pediatric Nephrology, Pediatric Chronic Kidney Disease Research Center, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran Zeynab Rajabi Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Mastaneh Moghtaderi Department of Pediatric Nephrology, Pediatric Chronic Kidney Disease Research Center, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran 2022 06 07 2022 06 08 The most common childhood vasculitis is Henoch Schoenlein Purpura (HSP). It occurs at any age peaking at around 4-6 years. The classic manifestations of HSP are skin rash, along with any from a triad of other organ system involvement, including gastrointestinal, musculoskeletal, and renal systems. Renal involvement is much more common in children than in adults. 255 HSP patients attending our tertiary referral hospital enrolled in this 10-year retrospective study from 2009 to 2019. According to our study, HSP was more common in males. Most of the patients were between 1-16 years (mean 7.04 years) old. Of these patients, only 19.22% had proteinuria, 17.25% had increased creatinine, 61.7% of patients had hematuria, 67.06 had a fever, and 69.8% had abdominal pain. 24.31% of them had bloody diarrhea. Skin and joint involvement were recorded in 44.7% and 74.9% of patients, respectively. Children affected by HSP may present with different clinical manifestations. We assessed these clinical presentations and outcomes of patients and compared them with renal pathology findings to reveal any prognostic significance of renal pathologic findings in HSP patients. https://acta.tums.ac.ir/index.php/acta/article/view/10187

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 12 2023 01 30 777 781 Masoud Siyahkamari Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Amir Asharlous Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran Ali Mirzajani Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Hassan Koohian Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Ebrahim Jafarzadepour Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran Hadi Ostadimoghaddam Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Nazereh Babaei Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran Abbasali Yekta Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Mehdi Khabazkhoob Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2021 11 08 2022 06 09 To evaluate the effect of dry eye disease (DED) on the central corneal thickness and anterior corneal surface irregularity parameters using Scheimpflug tomography. In this study, the central corneal thickness and topometric indices of the anterior corneal surface were compared between the right eyes of 43 subjects with dry eye (DE group) and the right eyes of 35 non-dry eye individuals (NDE group). The central corneal thickness (CCT) and the topometric indices of the anterior corneal surface, including IVA, IHA, ISV, and IHD, were measured using the Pentacam HR (Pentacam-HR, Oculus, Wetzlar, Germany). Dry eye was diagnosed using a symptom questionnaire, TBUT, and Schirmer’s test without anesthesia. The mean ISV, IVA, IHA, and IHD were 17.02 3.43, 0.114 0.04, 5.82 4.82, and 0.011 0.01 in the DE group and 14.65 3.10, 0.086 .03, 3.70 3.23, and 0.007 0.00 in the NDE group, respectively. All of the above corneal irregularity indices were significantly higher in the DE group (P<0.05). The mean CCT was 531.19 µ (±34.88 µ) and 540.66 µ (±27.13 µ) in the DE and NDE group, respectively. Based on linear regression analysis, ISV, IVA, IHA, and IHD had a significant association with DED (P<0.05), while CCT had no significant association with DED (P=0.148). DED significantly increases corneal surface irregularity, but it has no significant effects on CCT measured by the Pentacam. https://acta.tums.ac.ir/index.php/acta/article/view/9776

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 12 2023 01 30 782 784 Nadezhda V Maksimova Department of Endocrinology, Pirogov Russian National Research Medical University, Moscow, Russia. AND Central Clinical Hospital of the Administrative Directorate of the President of the Russian Federation, Moscow, Russia Aleksey O Kovylov State Moscow Endocrine Dispensary, Moscow, Russia Mikhail E Krasheninnikov Research and Educational Resource Center for Cellular Technologies, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia Marina V Kovina Research and Educational Resource Center for Cellular Technologies, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia . Alexey V Lyundup Research and Educational Resource Center for Cellular Technologies, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia . AND N.P. Bochkov Research Center for Medical Genetics, Moscow, Russia Denis S Baranovskii Research and Educational Resource Center for Cellular Technologies, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia . AND Department of Regenerative Medicine, National Medical Research Radiological Center, Obninsk, Russia Ilya D Klabukov Research and Educational Resource Center for Cellular Technologies, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia . ANDDepartment of Regenerative Medicine, National Medical Research Radiological Center, Obninsk, Russia. AND Obninsk Institute for Nuclear Power Engineering, National Research Nuclear University MEPhI, Obninsk, Russia 2022 07 18 2022 12 11 Malignant skin ulcerations may mimic diabetic foot ulcers leading to misdiagnosis. In this case report, we discuss an uncommon but severe problem of malignant tumors initially misdiagnosed as diabetic foot ulcers, underlying the need to improve medical awareness, diagnostics, and approaches for therapy once the correct diagnosis is made. We describe the case of an 82-year-old male with diabetes mellitus and melanoma metastases initially misdiagnosed as diabetic foot ulcers. In diabetic patients, several skin disorders may coexist on the same foot, including actual diabetic foot ulcers and skin cancers. Among multiple skin disorders that coexist on the foot of a diabetic patient, the skin metastases may b