Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 4 2022 04 19 202 209 Arun Kumar Pradhan Centre for Biotechnology, Siksha O Anusandhan (Deemed to be University), Bhubaneswar, India. Manoranjan Arakha Centre for Biotechnology, Siksha O Anusandhan (Deemed to be University), Bhubaneswar, India Binay Kumar Sahoo Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan Debapriya Bhattacharya Centre for Biotechnology, Siksha O Anusandhan (Deemed to be University), Bhubaneswar, India. 2020 07 06 2021 11 08 The coronavirus disease 2019 (COVID-19) is a single-stranded RNA (+) virus and causes infectious disease by the viral strain "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2). Now, COVID-19 has become pandemic, and there are neither potential vaccines nor drugs discovered. Its RNA contains genes for structural (S, E, M, N) and non-structural proteins (PLpro, 3CLpro, RdRp, Hel). Interaction between the S protein of SARS-CoV-2 and the ACE 2 receptor of the host cell plays a vital role in the entry of the virus into the cell. Favipiravir, ribavirin, remdesivir, galidesivir, lopinavir, ritonavir, chloroquine, and hydroxychloroquine are the few effective drugs against SARS-CoV-2. Live attenuated virus (mutant MERS-CoV and SARS-CoV or recombination with another live attenuated virus) can act as vaccine platforms against SARS CoV-2 along with DNA vaccine and subunit vaccine. https://acta.tums.ac.ir/index.php/acta/article/view/8604

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 4 2022 04 19 210 214 Laya Amoozadeh Department of Anesthesiology and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Mohammadtaghi Beigmohammadi Department of Anesthesiology and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. AND Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran, Iran. 2022 02 15 2022 03 14 Patients with COVID-19 frequently experience neurological symptoms. Headaches and dizziness are common but non-specific symptoms. Both peripheral and central nervous systems can be impacted in severe stages. We focused on the neurological manifestations of COVID-19 patients in critical care. A cohort study evaluated the acute neurological manifestations in 204 patients admitted to intensive care units (ICU) tertiary Imam Khomeini hospital complex, Tehran, Iran. Patients with positive COVID-19 tests and severe clinical symptoms in both sexes, older than 16 years, were included in the study. Two groups of patients with positive or negative neurologic complications were compared by chi-square or Fisher exact test for categorical variables. The differences in continuous variables between the two groups were investigated using an independent sample t-test. The Kolmogorov-Simonov test was used to verify the normality assumption. A P less than 0.05 was considered statistically significant. The study included 204 individuals (130 males and 74 females) out of 270 ICU patients. Ninety (44.1%) patients were discharged, while 114 (55.9%) died. Overall, 17 (8.3%) patients had neurological complications, while 187 (91%) did not (P=0.005). The two groups did not have significantly different mean age (P=0.325) and sex (P=.793). The ventilation support was significantly different in the two groups (P=0.002). The death group had a higher incidence of loss of consciousness (P=0.003). COVID-19 causes neurological symptoms, especially during the inflammatory phase, and clinicians should be alert for neurological issues. https://acta.tums.ac.ir/index.php/acta/article/view/9995

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 4 2022 04 24 249 253 Riza Azeri Department of Physical Therapy and Rehabilitation, Liv Hospital, Istanbul, Turkey . AND Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Istinye University, Istanbul, Turkey. Eda Sun Department of Histology and Embryology, Faculty of Medicine, Istinye University, Istanbul, Turkey . AND Center for Stem Cell and Tissue Engineering Research and Practice, Istinye University, Istanbul, Turkey. Erdal Karaoz Department of Histology and Embryology, Faculty of Medicine, Istinye University, Istanbul, Turkey. AND Center for Stem Cell and Tissue Engineering Research and Practice, Istinye University, Istanbul, Turkey. AND Center for Regenerative Medicine and Stem Cell Research and Manufacturing, Liv Hospital, Istanbul, Turkey. 2020 10 30 2021 12 26 Non-Progressive Congenital Myopathy is a disease characterized by muscle weakness, and unfortunately, there is no conventional treatment. In the last decade, regenerative medicine practices have become a rising value, and Mesenchymal Stem Cells (MSCs) have fascinating outcomes in regenerative medicine with their high regenerative capacities, their ability to regulate with paracrine secretions, and their immunological properties. Based on our experience in our previous clinical studies, Wharton's-Jelly-derived (WJ-)MSCs are the most suitable source for muscle diseases among all MSC sources. In this study, we evaluated the outcomes of 10 doses of WJ-MSC transplantation to the patient diagnosed with Non-Progressive Congenital Myopathy. A 17-year-old female with a SPEN-1 mutation, Non-Progressive Congenital Myopathy patient received 10 times as 1×10⁶/kg in the intra-arterial, intramuscular and intravenous administration of allogenic WJ-MSC. Before and after the treatment, the patient was followed-up with the upper extremity scale, Vignos lower extremity scale, muscle strength scale, functional independence measure, and evaluation of Serum creatine kinase (CK) levels. Improvement in both upper extremity scale and Vignos lower extremity scales, increasing in muscle strength, and decreasing in CK-level were detected. Although transplantation of WJ-MSC cannot treat any genetic-based diseases, they may benefit in alleviating clinical outcomes of disease. More importantly, WJ-MSC transplantation may offer a better quality of life by alleviating the symptoms of this rare disease with no treatment option that can be provided in conventional methods. https://acta.tums.ac.ir/index.php/acta/article/view/8910

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 4 2022 04 24 215 222 Soujanya Bhavani Shankar Department of Paediatrics, K.S Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore–575018, India Kudethoor Magandadi Dhrithiman Shetty Department of Paediatrics, K.S Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore–575018, India Uppoor Raghuraj Department of Radiology, K.S Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore–575018, India Vijaya Shenoy Department of Paediatrics, K.S Hegde Medical Academy, Nitte (Deemed to be University), Deralakatte, Mangalore–575018, India 2020 07 25 2021 12 07 Seizure disorder in children is commonly seen in clinical practice and in the assessment of these patients. Magnetic Resonance Imaging (MRI) is found to be the ideal and first imaging modality of choice for pediatric seizure disorder because of lack of radiation exposure. This work aims to assess the role of MRI of the brain in the evaluation of pediatric seizure disorder. Before undergoing MRI, all of the patients received EEG to detect the epileptogenic center. On the superconductive 1.5-Tesla Siemens Avanto Magnetom MR system, patients underwent a brain MRI scan. Percentages and proportions were used in the statistical analysis. Around 70% of children with seizures were found to be controlled by the use of a single antiepileptic drug (AED). Electroencephalogram (EEG) findings were abnormal in 82% of patients. The MRI findings were normal in 45 patients (45%) and abnormal in 55 patients (55%). The common abnormalities were gliosis (45.4%), periventricular leukomalacia (12.7%), neurodegenerative changes in white/grey matter (7.3%), focal cortical dysplasia (FCD) (7.3%), arteriovenous malformations (AVM) (7.3%), polymicrogyria (5.5%), mesial temporal sclerosis (MTS) (5.5%), abnormal spectroscopy (3.6%), space-occupying lesion (SOL) (3.6%) and megalencephaly (1.8%). Our study showed about 55% of children with seizures had MRI abnormalities and common abnormalities were gliosis and periventricular leukomalacia. Improvements in perinatal care, hygiene, and socio-economic status can help in reducing the incidence and thus morbidity associated with a seizure disorder. Thus, MRI plays a pivotal role in the workup of pediatric patients with a seizure disorder. https://acta.tums.ac.ir/index.php/acta/article/view/8666

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 4 2022 04 24 254 255 Hamed Aminiahidashti Department of Emergency Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Mohammad Aminiahidashti Department of Emergency Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran 2021 07 13 2021 12 26 Fecaloma is a very hard stool often located in the rectum of the sigmoid colon. A 63-year-old man with abdominal distention and urinary retention was admitted to an emergency department. Abdominal CT scans showed a urinary bladder displaced by fecaloma. Fecaloma is an infrequent cause of acute urinary retention, especially in bedridden patients with underlying diseases. https://acta.tums.ac.ir/index.php/acta/article/view/9536

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 4 2022 04 24 223 228 Payman Dabirmoghaddam Otolaryngology Research Center, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran Nafiseh Khaksar Otolaryngology Research Center, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran 2020 10 17 2021 12 09 In patients with supraglottic carcinoma (SGLC), lymphatic metastasis is frequent and can cause a significant reduction in local control rate and survival. Currently, the preferred method of neck treatment in patients with supraglottic cancer is prophylactic bilateral neck dissection that could result in overtreatment in at least two thirds of patients. The purpose of this study is to evaluate factors influencing neck metastasis and to determine whether routine elective neck dissection is necessary for the management of all SGLCs. 66 patients with SGLCs who underwent transoral laser surgery and neck dissection were included in this study. The rate of overall and occult lymphatic involvement was 29% and 20%, respectively. The most common involvement site was level II, and factors such as T category, tumor grade, epilarynx involvement, and extension of tumor to the medial wall of pyriform sinus were significantly related to cervical lymph node metastasis. In conclusion, our results suggest that in selected patients with SGLC (such as small T1 or lateralized tumors), elective neck treatment could be ignored, and instead, close follow-up be considered. https://acta.tums.ac.ir/index.php/acta/article/view/8875

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 4 2022 04 24 256 258 Shogeta Ramanathan Department of Surgery, Hospital Universiti Sains Malaysia, Kubang, Kerian, Kelantan, Malaysia 2. AND Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia Ikhwan Sani Mohamad Department of Surgery, Hospital Universiti Sains Malaysia, Kubang, Kerian, Kelantan, Malaysia . AND Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia Mohammad Zawawi Ya’acob Department of Surgery, Hospital Universiti Sains Malaysia, Kubang, Kerian, Kelantan, Malaysia . AND Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia Rosnelifaizur Ramely Department of Surgery, Hospital Universiti Sains Malaysia, Kubang, Kerian, Kelantan, Malaysia. ANDHospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia Zhan Huai Teoh Department of Surgery, Hospital Universiti Sains Malaysia, Kubang, Kerian, Kelantan, Malaysia. AND Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia Chandran Nadarajan Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. AND Department of Radiology, Hospital Universiti Sains Malaysia, Kubang, Kerian, Kelantan, Malaysia. 2021 07 22 2021 12 26 Traumatic liver injury can be classified by grading using American Association with Surgery Trauma (AAST). We presented a case of a 22-year-old female who had a motor vehicle accident and sustained a stable Grade 4 liver injury. An angioembolization was performed by the interventional radiologist team, which successfully occluded all the extravasation of the bleed. If the patient is hemodynamically stable in high grade or bleeding liver injury, a non-invasive technique such as angioembolization could be practiced at the bleeding site to minimize or stop the bleeding.   https://acta.tums.ac.ir/index.php/acta/article/view/9555

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 4 2022 04 24 229 234 Reza Ghasemi Department of Cardiology, 9 Dey Educational Hospital, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran Saeideh Imani Moghaddam Department of Critical Care, Razavi Hospital, Imam Reza International University, Mashhad, Iran Fatemeh Ramezani Department of Critical Care, Razavi Hospital, Imam Reza International University, Mashhad, Iran Mohsen Yaghubi Department of Extra-Corporeal Circulation (ECC), Razavi Hospital, Imam Reza International University, Mashhad, Iran. 2020 10 20 2021 12 11 Early administration of thrombolytic agents is the standard treatment and crucial for the outcome for patients presenting with acute myocardial infarction (armacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Ahmad Reza Dehpour Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Hamed Shafaroodi Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2022 01 12 2022 05 16 Macrophages and glial activation contribute to the pathophysiology of spinal cord injury (SCI). Some preclinical studies have shown the anti-inflammatory effects of aripiprazole (ARP). In the current study, we evaluated the anti-inflammatory effects of ARP in a rat SCI model. Forty male Wistar rats underwent either T9 vertebra laminectomy or were used as a sham-operated group without laminectomy. There were four major groups in this study: a sham-operated, three treatments (normal saline [vehicle] control versus ARP 10 and 20 mg/kg/day for three days after surgery, first dose 30 minutes post-surgery) SCI groups. We evaluated locomotor scaling and neuropathic pain behavioral tests over 28 days. On Day 28, tissue samples were investigated for neuroinflammatory and histopathology changes through flow cytometry and ELISA. ARP (10 and 20 mg/kg/day, 3 days) treatment significantly reduced locomotors disability (P<0.01) and mechanical (P<0.01) and thermal allodynia (P<0.001) scores. Additionally, Levels of tumor necrosis factor (TNF)-α level and interleukin (IL)-10 were significantly altered in ARP-treated spinal cord tissues 28 days after SCI (P<0.01). Moreover, spinal cord tissue expression of M1 and M2 macrophages, as well as M1/M2 ratio, were reduced in ARP-treated SCI animals, concurrent with decreased M1 and increased M2 and M1/M2 in dorsal root ganglion (P<0.001). Our study indicates that ARP has therapeutic effects on SCI via the reduction of neuroinflammation and SCI sensory and locomotor abnormalities. https://acta.tums.ac.ir/index.php/acta/article/view/9921

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 9 2022 11 08 594 598 Tahereh Abdolahinia Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran Hassan Hashemi Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran Ebrahim Jafarzadehpur Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Abbasaali Yekta Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Mahshid Saffarpour Department of Restorative Dentistry, School of Dentistry, Alborz University of Medical Sciences, Tehran, Iran Abolfazl Jafarzadehpour Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran Effat Shanbezadeh Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran Mehdi Khabazkhoob Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2021 03 14 2022 06 09 To compare Modulation Transform Function (MTF) between standard monofocal spherical hydrophobic acrylic Alcon SA60AT (Bausch and Lomb) and hydrophilic acrylic Rayner Superflex (620H) (Rayner) intra-ocular lenses (IOLs). This cross-sectional study was conducted on 68 patients who underwent cataract surgery. The hydrophobic Alcon SA60AT IOL was implanted in 39, and the hydrophilic Rayner Superflex (620H) was implanted in 29 eyes. The OPD Scan III (Nidek) was used to assess MTF in normal pupils under mesopic light conditions 1 and 3 months after the surgery. t-test showed no significant difference in mean MTF between the two IOLs in the 2 follow-ups (P=0.788). The results of repeated measure ANOVA for each type of IOL indicated that MTF increased significantly in the hydrophilic group versus the hydrophobic group in the 3rd month (P=0.033). Moreover, the results of repeated measure ANOVA showed that MTF was affected by the type of IOL and refractive error in the 3rd month (P=0.029, P=0.025). It seems that the material of IOL and post-surgical residual refractive error can affect the visual acuity of pseudophakic patients. Although the hydrophilic IOL provided a better MTF three months after the surgery, studies with longer follow-ups are required to confirm the results. https://acta.tums.ac.ir/index.php/acta/article/view/9236

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 9 2022 11 08 599 603 Shahin Koomanaee Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran