@article { author = {Rafiee Parhizgar, Arezoo and Tahghighi, Aazr}, title = {Introducing New Antimalarial Analogues of Chloroquine and Amodiaquine: A Narrative Review}, journal = {Iranian Journal of Medical Sciences}, volume = {42}, number = {2}, pages = {115-128}, year = {2017}, publisher = {Shiraz University of Medical Sciences}, issn = {0253-0716}, eissn = {1735-3688}, doi = {10.30476/ijms.2017.40428}, abstract = {Antimalarial drugs with the 4-aminoquinoline scaffold such as the important drugs, chloroquine (CQ) and amodiaquine (AQ), have been used to prevent and treat malaria for many years. The importance of these drugs is related to their simple usage, high efficacy, affordability, and cost-effectiveness of their synthesis. In recent years, with the spread of parasite resistance to CQ and cross-resistance to its other analogues have decreased their consumption in many geographical areas. On the other hand, AQ is an effective antimalarial drug which its usage has been restricted due to hepatic and hematological toxicities. The significance of the quinoline ring at quinoline-based antimalarial drugs has prompted research centers and pharmaceutical companies to focus on the design and synthesis of new analogues of these drugs, especially CQ and AQ analogues. Accordingly, various derivatives have been synthesized and evaluated in vitro and in vivo against the resistant strains of the malaria parasite to solve the problem of drug resistance. Also, the pharmacokinetic properties of these compounds have been evaluated to augment their efficacy and diminish their toxicity. Some of these analogues are currently in clinical and preclinical development. Consequently, the recent researches showed yet 4-aminoquinoline scaffold is active moiety in new compounds with antiplasmodial activity. Hence, the aim of this review article is to introduce of the novel synthetic analogues of CQ and AQ, which may constitute the next generation of antimalarial drugs with the 4-aminoquinoline scaffold. }, keywords = {Malaria,Chloroquine,Amodiaquine,Drug Resistance}, url = {https://ijms.sums.ac.ir/article_40428.html}, eprint = {https://ijms.sums.ac.ir/article_40428_217e5ac418472f8db8e7db4405f1a593.pdf} } @article { author = {Fekri, Mitra Samareh and Hashemi-Bajgani, Seyed Mehdy and Shafahi, Ahmad and Zarshenas, Rozita}, title = {Comparing Adrenaline with Tranexamic Acid to Control Acute Endobronchial Bleeding: A Randomized Controlled Trial}, journal = {Iranian Journal of Medical Sciences}, volume = {42}, number = {2}, pages = {129-135}, year = {2017}, publisher = {Shiraz University of Medical Sciences}, issn = {0253-0716}, eissn = {1735-3688}, doi = {}, abstract = {Background: Hemoptysis occurs due to either pulmonary diseases or bronchoscopy interventions. The aim of the present study was to compare the efficacy of the endobronchial instillation of adrenaline with that of tranexamic acid. Methods: Fifty patients were randomly selected as 2 double-blinded sample groups (n=25). In these patients, bleeding could not be controlled with cold saline lavage during bronchoscopy and they, therefore, required prescription of another medicine. Adrenaline (1 mg) in one group and tranexamic acid (500 mg) in the other group were diluted in 20 mL of normal saline and instilled through the bronchoscope. This technique was repeated 3 times at 90-second intervals, if necessary. In the case of persistent bleeding, 90 seconds after the last dose, a second medicine was given for bleeding control. Observation of clot through the bronchoscope meant that the bleeding had stopped. The efficacy of tranexamic acid and adrenaline was evaluated and then compared using the Mann–Whitney test.Results: The time of bleeding control had no significant difference between tranexamic acid and adrenaline (P=0.908). Another analysis was done to evaluate bleeding control with a second medicine; the results showed that 1 (4%) patient in the tranexamic acid and 8 (32%) in the adrenaline group needed the second medicine and there was no significant difference between the 2 groups (P=0.609).Conclusion: Our results suggested that tranexamic acid by endobronchial instillation was as efficient as adrenaline in controlling hemoptysis and required less frequent use of a second medicine.Trial Registration Number: IRCT2014120220188}, keywords = {Epinephrine,Bronchoscopy,Hemoptysis,Tranexamic acid}, url = {https://ijms.sums.ac.ir/article_40429.html}, eprint = {https://ijms.sums.ac.ir/article_40429_1261e1025ebee458332ce2b15b2ca961.pdf} } @article { author = {Atashkhoei, Simin and Abedini, Naghi and Pourfathi, Hojjat and Bahrami Znoz, Ali and Hatami Marandi, Pouya}, title = {Baricity of Bupivacaine on Maternal Hemodynamics after Spinal Anesthesia for Cesarean Section: A Randomized Controlled Trial}, journal = {Iranian Journal of Medical Sciences}, volume = {42}, number = {2}, pages = {136-143}, year = {2017}, publisher = {Shiraz University of Medical Sciences}, issn = {0253-0716}, eissn = {1735-3688}, doi = {}, abstract = {Background: After spinal anesthesia, patients undergoing cesarean section are more likely to develop hemodynamic changes. The baricity of local anesthetic has an important role on spinal blockade effects. The aim of this study was to compare the isobar and hyperbaric bupivacaine 0.5% plus fentanyl on maternal hemodynamics after spinal anesthesia for C/S.Methods: In this double-blind study, 84 healthy pregnant women undergoing C/S using bupivacaine 0.5% isobar (study group, n=42) or hyperbaric (control group, n=42) for spinal anesthesia were scheduled. The study was conducted from 21 April 2014 to 21 November 2014 at Al-Zahra Hospital, Tabriz, Iran. Parameters such as maternal hemodynamics, block characteristics, side effects, and neonatal Apgar scores were recorded. Data were analyzed using the SPSS software by performing chi-square test, Fisher's exact test, one-way ANOVA, Mann-Whitney U-test, and student's t test.Results: The incidence of hypotension in the isobar group was lower than the hyperbaric group, although it was not statistically significant (40.47% vs. 61.9%, P=0.08). The duration of hypotension was shorter in the study group (1.6±7.8 min vs. 7.4±12.5 min, P=0.004). The dose of ephedrine was lower in the study group (2.4±6.6 mg vs. 5.3±10.7 mg, P=0.006). The main maternal side effect is sustained hypotension that was seen in 0 patients of the isobar and 7 (16.66%) of hyperbaric groups (P=0.006). None of the neonates had Apgar score≤7 at 5 min of delivery (P=1.0). Sensory and motor block duration was shorter in the study group(P=0.01).Conclusion: Isobaric bupivacaine is associated with more hemodynamic stability and shorter sensory and motor blockade in mothers under spinal anesthesia for C/S.Trial Registration Number: IRCT201401287013N7 }, keywords = {}, url = {https://ijms.sums.ac.ir/article_40434.html}, eprint = {https://ijms.sums.ac.ir/article_40434_40c9702897e82706d64bb071ce506975.pdf} } @article { author = {Mahishale, Vinay and Avuthu, Sindhuri and Patil, Bhagyashri and Lolly, Mitchelle and Eti, Ajith and Khan, Sujeer}, title = {Effect of Poor Glycemic Control in Newly Diagnosed Patients with Smear-Positive Pulmonary Tuberculosis and Type-2 Diabetes Mellitus}, journal = {Iranian Journal of Medical Sciences}, volume = {42}, number = {2}, pages = {144-151}, year = {2017}, publisher = {Shiraz University of Medical Sciences}, issn = {0253-0716}, eissn = {1735-3688}, doi = {}, abstract = {Background: There is growing evidence that diabetes mellitus (DM) is an important risk factor for tuberculosis (TB). A significant number of DM patients have poor glycemic control. This study was carried out to find the impact of poor glycemic control on newly diagnosed smear-positive pulmonary tuberculosis patients with type-2 diabetes mellitus in a tertiary care hospital.Methods: In a hospital-based prospective study, newly diagnosed smear-positive pulmonary TB with DM patients were classified as poorly controlled diabetes (HBA1C≥7%) and optimal control diabetics (HbA1c<7%). Patients were started on anti-TB treatment and followed for 2 years for severity and treatment outcome. ANOVA was used for numerical variables in the univariable analysis. Logistic regression analysis was used for multivariable analysis of treatment outcome. The significance level was kept at a P≤0.05.Results: A total of 630 individuals who met the inclusion criteria were analyzed; of which 423 patients had poor glycemic control (PGC) and 207 patients had optimal glycemic control (OGC). The average HbA1c was 10±2.6 and 5±1.50 in the PGC and OGC groups, respectively. The mean symptom score was significantly higher in the PGC group compared with patients in the OGC group (4.55±0.80 vs. 2.70±0.82, p <0.001). PGC was associated with more extensive lung disease, lung cavitation, and positive sputum smear at the baseline. In PGC, sputum smears were significantly more likely to remain positive after 2 months of treatment. PGC patients had significantly higher rates of treatment failure (adj. OR 0.72, 95% CI 0.58-0.74, p <0.001) and relapse (adj. OR 2.83, 95% CI 2.60-2.92, p <0.001)Conclusion: Poor glycemic control is associated with an increased risk of advanced and more severe TB disease in the form of lung cavitations, positive sputum smear, and slower smear conversion. It has a profound negative effect on treatment completion, cure, and relapse rates in patients with pulmonary tuberculosis. }, keywords = {Poor glycemic control,Hemoglobin A,Glycosylated,Tuberculosis,Recurrence,Treatment failure,Drug Resistance,diabetes mellitus}, url = {https://ijms.sums.ac.ir/article_40435.html}, eprint = {https://ijms.sums.ac.ir/article_40435_379f377ca4c7d528a7949176c9a33577.pdf} } @article { author = {Kulkarni, Ajit and Bhat, Rushil and Malik, Mansi and Sane, Suvarna and Kothari, Sweta and Vaidya, Shashikant and Chowdhary, Abhay and Deshmukh, Ranjana}, title = {Neutralizing Antibody Response and Efficacy of Novel Recombinant Tetravalent Dengue DNA Vaccine Comprising Envelope Domain III in Mice}, journal = {Iranian Journal of Medical Sciences}, volume = {42}, number = {2}, pages = {152-160}, year = {2017}, publisher = {Shiraz University of Medical Sciences}, issn = {0253-0716}, eissn = {1735-3688}, doi = {}, abstract = {Background: Dengue is a global arboviral threat to humans; causing 390 million infections per year. The availability of safe and effective tetravalent dengue vaccine is a global requirement to prevent epidemics, morbidity, and mortality associated with it. Methods: Five experimental groups (6 mice per group) each of 5-week-old BALB/c mice were immunized with vaccine and placebo (empty plasmid) (100µg, i.m.) on days 0, 14 and 28. Among these, four groups (one group per serotype) of each were subsequently challenged 3 weeks after the last boost with dengue virus (DENV) serotypes 1-4 (100 LD50, 20 µl intracerebrally) to determine vaccine efficacy. The fifth group of each was used as a control. The PBS immunized group was used as mock control. Serum samples were collected before and after subsequent immunizations. EDIII fusion protein expression was determined by Western blot. Total protein concentration was measured by Bradford assay. Neutralizing antibodies were assessed by TCID50-CPE inhibition assay. Statistical analysis was performed using Stata/IC 10.1 software for Windows. One-way repeated measures ANOVA and Mann-Whitney test were used for neutralizing antibody analysis and vaccine efficacy, respectively.Results: The recombinant EDIII fusion protein was expressed adequately in transfected 293T cells. Total protein concentration was almost 3 times more than the control. Vaccine candidate induced neutralizing antibodies against all four DENV serotypes with a notable increase after subsequent boosters. Vaccine efficacy was 83.3% (DENV-1, -3, -4) and 50% (DENV-2).Conclusion: Our results suggest that vaccine is immunogenic and protective; however, further studies are required to improve the immunogenicity particularly against DENV-2.}, keywords = {Dengue,Envelope domain III (EDIII),Antibodies,Neutralizing,Vaccines}, url = {https://ijms.sums.ac.ir/article_40437.html}, eprint = {https://ijms.sums.ac.ir/article_40437_a0a3263b68d5ba961bace5c4edbf4625.pdf} } @article { author = {Mousavi, Seyedeh Neda and Koohdani, Fariba and Shidfar, Farzad and Baghban Eslaminejad, Mohamadreza and Izadi, Pantea and Eshraghian, Mohamadreza and Shafieineek, Leila and Tohidinik, Hamidreza}, title = {Effects of Maternal Isocaloric Diet Containing Different Amounts of Soy Oil and Extra Virgin Olive Oil on Weight, Serum Glucose, and Lipid Profile of Female Mice Offspring}, journal = {Iranian Journal of Medical Sciences}, volume = {42}, number = {2}, pages = {161-169}, year = {2017}, publisher = {Shiraz University of Medical Sciences}, issn = {0253-0716}, eissn = {1735-3688}, doi = {}, abstract = {Background: Health status of offspring is programmed by maternal diet throughout gestation and lactation. The present study investigates the lasting effects of maternal supplementation with different amounts of soy oil or extra virgin olive oil (EVOO) on weight and biochemical parameters during gestation and lactation of female mice offspring.Methods: Eight weeks old female C57BL/6 mice (n=40) were assigned through simple randomization into four isocaloric dietary groups (16% of calories as soy oil (LSO) or EVOO (LOO) and 45% of calories as soy oil (HSO) or EVOO (HOO)) during three weeks of gestation and lactation. After weaning (at 3 weeks), all offspring received a diet containing 16% of calories as soy oil and were sacrificed at 6 weeks. Two-way ANOVA was used to adjust for confounding variables and repeated measures test for weight gain trend. Statistical analyses were performed with the IBM SPSS package.Results: At birth and adolescence, the weight of offspring was significantly higher in the soy oil than the olive oil groups (P<0.001 and P<0.001, respectively). Adolescence weight was significantly higher in the offspring born to mothers fed with 16% oil than those with 45% oil (P=0.001). Serum glucose, triglyceride and total cholesterol were significantly higher in the LSO than LOO (P<0.001, P<0.001 and P<0.001), LSO than HSO (P<0.001, P=0.03 and P<0.001), and LOO than HOO (P<0.001, P<0.001 and P<0.001) dietary groups, respectively. Serum triglyceride and total cholesterol were significantly higher in the offspring of HSO than HOO fed mothers (P<0.001 and P<0.001, respectively).Conclusion: A maternal diet containing EVOO has better effects on birth weight, as well as weight and serum biochemical parameters in offspring at adolescence.}, keywords = {Diet,Body weight,Lipid profile,Glucose,Multiple birth offspring}, url = {https://ijms.sums.ac.ir/article_40439.html}, eprint = {https://ijms.sums.ac.ir/article_40439_523cd58a02e4faa9843266d92a207f50.pdf} } @article { author = {Sattarinezhad, Elahe and Panjehshahin, Mohammad Reza and Torabinezhad, Simin and Kamali-Sarvestani, Eskandar and Farjadian, Shirin and Pirsalami, Fatema and Moezi, Leila}, title = {Protective Effect of Edaravone Against Cyclosporine-Induced Chronic Nephropathy Through Antioxidant and Nitric Oxide Modulating Pathways in Rats}, journal = {Iranian Journal of Medical Sciences}, volume = {42}, number = {2}, pages = {170-178}, year = {2017}, publisher = {Shiraz University of Medical Sciences}, issn = {0253-0716}, eissn = {1735-3688}, doi = {}, abstract = {Background: Cyclosporine A (CsA) is an immunosuppressant with therapeutic indications in various immunological diseases; however, its use is associated with chronic nephropathy. Oxidative stress has a crucial role in CsA-induced nephrotoxicity. The present study evaluates the protective effect of edaravone on CsA-induced chronic nephropathy and investigates its antioxidant and nitric oxide modulating property.Methods: Male Sprague-Dawley rats (n=66) were distributed into nine groups, including a control (group 1) (n=7). Eight groups received CsA (15 mg/kg) for 28 days while being treated. The groups were categorized as:Group 2: Vehicle (n=10)Groups 3, 4, and 5: Edaravone (1, 5, and 10 mg/kg) (n=7 each)Group 6: Diphenyliodonium chloride, a specific endothelial nitric oxide synthase (eNOS) inhibitor (n=7)Group 7: Aminoguanidine, a specific inducible nitric oxide synthase (iNOS) inhibitor (n=7)Group 8: Edaravone (10 mg/kg) plus diphenyliodonium chloride (n=7)Group 9: Edaravone (10 mg/kg) plus aminoguanidine (n=7)Blood urea nitrogen and serum creatinine levels, malondialdehyde, superoxide dismutase, and glutathione reductase enzyme activities were measured using standard kits. Renal histopathological evaluations and measurements of eNOS and iNOS gene expressions by RT-PCR were also performed. Data were analyzed using one-way analysis of variance (ANOVA) followed by Tukey’s test (SPSS software version 18.0).Results: Edaravone (10 mg/kg) significantly attenuated CsA-induced oxidative stress, renal dysfunction, and kidney tissue injury. Aminoguanidine improved the renoprotective effect of edaravone. Edaravone reduced the elevated mRNA level of iNOS, but could not alter the level of eNOS mRNA significantly.Conclusion: Edaravone protects against CsA-induced chronic nephropathy using antioxidant property and probably through inhibiting iNOS gene expression.}, keywords = {Edaravone,Nitric oxide,iNOS,eNOSe,Kidney diseases,Cyclosporine}, url = {https://ijms.sums.ac.ir/article_40440.html}, eprint = {https://ijms.sums.ac.ir/article_40440_f685b53c72865733dfe88a5ad7be7e90.pdf} } @article { author = {Mousavi Nia, Alireza and Kalantaripour, Taj Pari and Basiri, Mohsen and Vafaee, Farzaneh and Asadi-Shekaari, Majid and Eslami, Azam and Darvish Zadeh, Fatemeh}, title = {Nepeta Dschuparensis Bornm Extract Moderates COX-2 and IL-1β Proteins in a Rat Model of Cerebral Ischemia}, journal = {Iranian Journal of Medical Sciences}, volume = {42}, number = {2}, pages = {179-186}, year = {2017}, publisher = {Shiraz University of Medical Sciences}, issn = {0253-0716}, eissn = {1735-3688}, doi = {}, abstract = {Background: Nepeta dschuparensis Bornm (NP) is used as a medicinal herb in Iran. In traditional medicine, this herb is extensively employed for curing ailments such as cardiovascular diseases. NP has antioxidant and anti-inflammatory properties. This project examined the effects of the NP extract on cyclooxygenase-2 (COX-2) and interleukin-1β (IL-1β) protein levels and its efficacy in neuroprotection in a cerebral ischemia-reperfusion model.Methods: Twenty-six male rats were randomly divided into 3 groups: 1) sham (n=6): no middle cerebral artery occlusion (MCAO) procedure, 2) control (n=10): MCAO procedure and treatment with normal saline, and 3) NP extract (n=10): MCAO procedure and treatment with the NP extract (20 mg/kg, i.p.) at the beginning of reperfusion. To examine the injury caused by cerebral ischemia, we measured motor coordination and the infarct area using the rotarod test and triphenyl tetrazolium chloride staining, respectively. IL-1β and COX-2 protein levels, as inflammatory markers, were measured by immunoblotting assay. The statistical analyses were performed using SPSS, version 16, and the data are expressed as means±SEMs. Statistical difference was evaluated using the one-way ANOVA, followed by the post hoc LSD test (P<0.01).Results: Treatment with the NP extract significantly diminished the infarct volume and alleviated the motor coordination disorder induced by cerebral ischemia. The NP extract administration significantly attenuated the increase in IL-1β and COX-2 protein levels too (P<0.01).Conclusion: The beneficial effects of the NP extract are related to its ability to decrease the levels of IL-1β and COX-2.}, keywords = {Nepeta,Hypoxia-Ischemia,Brain antioxidants,Cyclooxygenase 2,Interleukin-1beta}, url = {https://ijms.sums.ac.ir/article_40441.html}, eprint = {https://ijms.sums.ac.ir/article_40441_39edf7d188f93670c4051c56e6f6cbc7.pdf} } @article { author = {Mirkarimi, Kamal and Kabir, Mohammad Javad and Honarvar, Mohammad Reza and Ozouni-Davaji, Rahman Berdi and Eri, Maryam}, title = {Effect of Motivational Interviewing on Weight Efficacy Lifestyle among Women with Overweight and Obesity: A Randomized Controlled Trial}, journal = {Iranian Journal of Medical Sciences}, volume = {42}, number = {2}, pages = {187-193}, year = {2017}, publisher = {Shiraz University of Medical Sciences}, issn = {0253-0716}, eissn = {1735-3688}, doi = {}, abstract = {Obesity and overweight have become increasingly a major public health problem across the world. This study aimed at exploring the effects of motivational interviewing on weight efficacy lifestyle among women with obesity and overweight. A single-blind randomized clinical trial study was conducted on 100 overweight and obese women who attended a nutrition clinic. The samples were selected based on the clinical records and assigned into two groups, namely motivational interviewing arm (50 samples) and nutrition education arm (50 samples). Data were collected using a standard validated questionnaire entitled “weight efficacy lifestyle”. The intervention was designed according to five motivation sessions and four nutrition education programs, such that the participants of the nutrition education arm were also provided with the nutrition pamphlets related to weight control. Data were finally analyzed using the SPSS statistical software by performing the independent t-test, chi-square, LSD and repeated measures ANOVA tests. P<0.05 were considered statistically significant. The mean age of women was 39.9±9.1 and 36.3±8.9 years in the control and motivational interviewing arms, respectively. Compared with the control group, the score of the motivational interviewing group was statistically significant in terms of weight efficacy lifestyle (P=0.0001) and all subscales including social pressure (P=0.0001), physical discomfort (P=0.005), food accessibility (P=0.0001), positive and entertainment activities (P=0.0001), as well as negative emotions (P=0.003). Motivational interviewing appeared to be effective in increasing weight efficacy lifestyle among women with overweight and obesity.}, keywords = {Motivational Interviewing,Life Style,Motivation,Overweight,Obesity}, url = {https://ijms.sums.ac.ir/article_40426.html}, eprint = {https://ijms.sums.ac.ir/article_40426_7c443cbd1b0f5ef411c80fc4c82f837a.pdf} } @article { author = {Poorjavad, Marziyeh and Talebian, Saeed and Nakhostin Ansari, Noureddin and Soleymani, Zahra}, title = {Surface Electromyographic Assessment of Swallowing Function}, journal = {Iranian Journal of Medical Sciences}, volume = {42}, number = {2}, pages = {194-200}, year = {2017}, publisher = {Shiraz University of Medical Sciences}, issn = {0253-0716}, eissn = {1735-3688}, doi = {}, abstract = {The reliability of surface electromyographic (sEMG) variables during swallowing determines the potential usefulness of these measures in swallowing assessment and treatment. This study aimed to establish the reliability of the sEMG measures of the swallowing function of muscles during different swallowing conditions in healthy young and old volunteers. Two groups of volunteers (24 older adults, 10 younger adults) participated in this cross-sectional study during 2014. The activity of masseter, submental, and infrahyoid groups were measured using sEMG during three repetitions of different swallowing tasks. Both the relative and absolute reliability (characterized respectively by ICC, SEM%, and SRD%) were calculated for the sEMG indices of muscle activity during swallowing events. Statistical analyses were performed by the SPSS 19.0 and Microsoft Excel 2007 software packages. Statistical significance was set at P≤0.05. The relative reliability calculations showed significant agreements between repetitions for the mean and peak amplitude and the average of median frequency (MDF) of the studied muscles function during most swallowing types in both groups. However, the duration and particularly the time to peak of muscle activity showed significant agreements during fewer swallowing conditions. Excluding MDF, we found high SEM% and SRD% for the studied measures (particularly timing measures) of muscles function during most swallowing types in both groups. The reliability of sEMG measures was influenced by the age and swallowing types. Our findings suggest that the MDF of muscle function during almost all studied swallowing types can be a reliable measure for the sEMG assessment of swallowing function in both younger and older adults.}, keywords = {Electromyography,Deglutition,Reproducibility of results}, url = {https://ijms.sums.ac.ir/article_40432.html}, eprint = {https://ijms.sums.ac.ir/article_40432_38a4fa2c22f517ac6fd69b8bd480ed3f.pdf} } @article { author = {Rafie, Shahram and Salmanzadeh, Shokrollah and Mehramiri, Asieh and Nejati, Adel}, title = {Botulism Outbreak in a Family after Ingestion of Locally Produced Cheese}, journal = {Iranian Journal of Medical Sciences}, volume = {42}, number = {2}, pages = {201-204}, year = {2017}, publisher = {Shiraz University of Medical Sciences}, issn = {0253-0716}, eissn = {1735-3688}, doi = {}, abstract = {Botulism is one of the most important foodborne diseases and is caused by Clostridium botulinum toxin. The main manifestations are flaccid muscle paralysis and cranial nerve palsies. Botulism is an essential health problem because of its high mortality. The diagnosis of botulism, especially in sporadic cases, is a medical challenge and a high clinical suspicion is necessary for early recognition. So, every physician should be familiar with its signs and symptoms for early detection and treatment. We describe a family with dysphasia and acute paralysis after the ingestion of locally made cheese. The clinical presentations of the 1st patient were similar to myasthenic crisis and she, therefore, received plasma exchange. After the appearance of similar symptoms in the other family members, they were treated with polyvalent botulinum antitoxin and diagnosis was confirmed by toxicology and detection of serotype A botulinum toxin in cheese and stool samples. Uncommon clinical presentations and unusual sources of botulinum toxin should be kept in mind because of the importance of early diagnosis and treatment. }, keywords = {Botulism,Botulinum toxin A,Cheese}, url = {https://ijms.sums.ac.ir/article_40427.html}, eprint = {https://ijms.sums.ac.ir/article_40427_eddb5ede6a05deb8abe30cadfc9dffdd.pdf} } @article { author = {Jain, Promil and Sen, Rajeev and Sharma, Nisha and Bhargava, Shilpi and Singh, Virender}, title = {Tumefactive Fibroinflammatory Lesion: A Diagnostic Dilemma}, journal = {Iranian Journal of Medical Sciences}, volume = {42}, number = {2}, pages = {205-209}, year = {2017}, publisher = {Shiraz University of Medical Sciences}, issn = {0253-0716}, eissn = {1735-3688}, doi = {}, abstract = {Tumefactive fibroinflammatory lesions (TFLs) are rare idiopathic benign fibrosclerosing lesions that clinically simulate a malignancy. TFLs are seen more frequently in males between 10 and 74 years of age. The usual site of involvement is the head and neck region, but rarely the extremities may be involved. Coexisting fibrosclerotic processes have been reported including retroperitoneal fibrosis, sclerosing cholangitis, sclerosing mediastinal fibrosis, and orbital pseudotumors. The etiology of this poorly understood entity remains unknown. Possible suggestions include exaggerated responses or autoimmune reactions to any chronic infection. The clinical and radiological appearance of TFLs is that of malignancy, but histopathology reveals them to be a benign process broadly classified under non-neoplastic, fibroinflammatory proliferations. The treatment strategies for these lesions are not well defined and variable and include steroids, surgery, and radiotherapy either alone or in combination. TFLs, albeit not fatal, have a high recurrence rate; patients should, therefore, be kept on long-term follow-up. We describe a young female patient presenting with a rapidly developing cheek swelling, which was diagnosed histopathologically as a TFLs.}, keywords = {Tumefactive fibroinflammatory lesion,Sinus,Neoplasms}, url = {https://ijms.sums.ac.ir/article_40433.html}, eprint = {https://ijms.sums.ac.ir/article_40433_030a3dd363906905c64b20c6c45c7e8e.pdf} } @article { author = {Razavi, Zahra and Momtaz, Hossein}, title = {Balanced Reciprocal Translocation t(X;1) in a Girl with Tall Stature and Primary Amenorrhea}, journal = {Iranian Journal of Medical Sciences}, volume = {42}, number = {2}, pages = {210-214}, year = {2017}, publisher = {Shiraz University of Medical Sciences}, issn = {0253-0716}, eissn = {1735-3688}, doi = {}, abstract = {AbstractChromosomal translocations constitute one of the most important, yet uncommon, causes of primary amenorrhea and gonadal dysgenesis. Although X-autosome translocations are frequently associated with streak gonads and clinical features of the Turner syndrome, the majority of X-autosome carriers may present with a variable phenotype, developmental delay, and recognizable X-linked syndrome due to nonrandom X-inactivation. In this article, we describe a healthy 15.5-year-old girl with primary amenorrhea, gonadal dysgenesis, and tall stature without other manifestations of the Turner syndrome. Relevant clinical, biochemical, endocrinological, and cytogenetical evaluations were performed. Initial investigations revealed hypergonadotropic hypogonadism (FSH=134 mIU/mL [normal=10–15 mIU/mL], LH=47.5 [normal=10–15 mIU/mL], and estradiol=24.3 pmol/L). On ultrasound examination of the pelvis, streak ovaries with a hypoplastic uterus were noted. Chromosome study, performed according to routine procedures, revealed an apparently balanced reciprocal translocation involving the short arm of chromosome 1(p2) and the long arm of the X chromosome (q2) in all the cells with the following karyotype: 46,X,t(1;X)(p13;q22). She was placed on hormone replacement therapy. In our patient, X-autosome translocation was associated with gonadal dysgenesis and tall stature. We conclude that t(X;1) may be associated with gonadal dysgenesis without other congenital abnormalities. To our knowledge, normal phenotype with gonadal dysgenesis and tall stature in association with t(X;1) translocation has not been previously reported.}, keywords = {Genetic translocation,Gonadal dysgenesis,Turner syndrome}, url = {https://ijms.sums.ac.ir/article_40436.html}, eprint = {https://ijms.sums.ac.ir/article_40436_0d4501ccc5a68e469b435da01b6af662.pdf} } @article { author = {Çalışkan, Selahattin and Gökçe, Ali and Gümrükçü, Gülistan and Önenerk, Mine}, title = {Renal Medullary Carcinoma; A Rare Entity}, journal = {Iranian Journal of Medical Sciences}, volume = {42}, number = {2}, pages = {215-218}, year = {2017}, publisher = {Shiraz University of Medical Sciences}, issn = {0253-0716}, eissn = {1735-3688}, doi = {}, abstract = {AbstractRenal medullary carcinoma (RMC) is an uncommon aggressive neoplasm of the kidney. RMC is biologically aggressive with a very poor prognosis, and metastasis is seen in up to 95% of the patients at diagnosis or shortly thereafter. The common sites of metastasis are respectively lymph nodes, lungs, livers, and adrenal glands in order of frequency. The presence of poorly differentiated eosinophilic cells in a characteristic fibro-inflammatory stroma is seen in histological examination. The origin and pathogenesis of RMC are unclear. The radiographical and pathological findings suggest that RMC probably originates in the calyceal epithelium in or near the renal papillae, which could be the result of chronic ischemic damage in the renal papillae epithelium by sickled erythrocytes. Positivity of VEGF and HIF-1α supports the chronic hypoxia that may be caused in the pathogenesis of RMC. Other factors such as genetic or environmental factors are important. Although hemoglobinopathy is very common, RMC is very rare. An understanding of the molecular and genetic factors of this rare disease is important for its prevention and treatment. We herein describe an adult Turkish patient, who presented with hematuria. The diagnosis was RMC after pathological examination.}, keywords = {Medullary carcinoma,Kidney neoplasms,Case reports}, url = {https://ijms.sums.ac.ir/article_40438.html}, eprint = {https://ijms.sums.ac.ir/article_40438_7266591e17bf78242ee0c5cd2388de56.pdf} } @article { author = {Ipek, Yonal-Hindilerden and Aynur, Daglar-Aday and Fehmi, Hindilerden and Meliha, Nalcaci and Akif Selim, Yavuz and Deniz, Sargin}, title = {Effects of Mutational Combinations on Philadelphia-Negative Myeloproliferative Neoplasms}, journal = {Iranian Journal of Medical Sciences}, volume = {42}, number = {2}, pages = {219-220}, year = {2017}, publisher = {Shiraz University of Medical Sciences}, issn = {0253-0716}, eissn = {1735-3688}, doi = {}, abstract = {}, keywords = {}, url = {https://ijms.sums.ac.ir/article_40431.html}, eprint = {https://ijms.sums.ac.ir/article_40431_842e7a016128a9a9ba045daddf89d5df.pdf} } @article { author = {Çalışkan, Selahattin}, title = {Cobra-Head Stone in Single-System Ureterocele}, journal = {Iranian Journal of Medical Sciences}, volume = {42}, number = {2}, pages = {221-222}, year = {2017}, publisher = {Shiraz University of Medical Sciences}, issn = {0253-0716}, eissn = {1735-3688}, doi = {}, abstract = {}, keywords = {}, url = {https://ijms.sums.ac.ir/article_40430.html}, eprint = {https://ijms.sums.ac.ir/article_40430_e6b3859ad5aed5b372991532e189d162.pdf} }