2024-03-28T18:39:28Z
https://ijms.sums.ac.ir/?_action=export&rf=summon&issue=4615
Iranian Journal of Medical Sciences
0253-0716
0253-0716
2013
38
3
Concept of Atherosclerosis Velocity: Is It a Better Measure of Cardiovascular Risk?
Seyyed Mohammad Reza
Kazemi-Bajestani
Majid
Ghayour-Mobarhan
In most cases atherosclerosis is the underlying cause of vascular diseases, including heart disease and stroke. It is believed that endothelial injury is the earliest change in the artery wall and that this precedes the formation of lesions of atherosclerosis. Recent developments in the field of atherosclerosis have led to a renewed interest in the recognition of the parameter of time in the atherosclerosis process. We believe that the factors determining the time-dependent rate of atherosclerosis progression are important, and it is in this context that we wish to propose for the first time the term “atherosclerosis velocity”. In this review article, we summarize the existing evidence regarding atherosclerosis velocity and discuss the importance of this issue.
Atherosclerosis
Velocity
Plaque
Risk factors
2013
09
01
210
220
https://ijms.sums.ac.ir/article_39464_70fd9ce16519ec22a044be4782a31d7c.pdf
Iranian Journal of Medical Sciences
0253-0716
0253-0716
2013
38
3
The Effect of Hydroxychloroquine on Symptoms of Knee Osteoarthritis: A Double-Blind Randomized Controlled Clinical Trial
Mohammadhassan
Jokar
Zahra
Mirfeizi
Kamran
Keyvanpajouh
Background: Osteoarthritis is a degenerative joint disorder of articular cartilage and is the most common type of arthritis in the elderly. There are only a few reports regarding the use of Hydroxychloroquine in the treatment of osteoarthritis. Methods: To investigate the effects of Hydroxychloroquine on the symptoms of mild to moderate knee osteoarthritis (Kellgren and Lawrence grade II and III), we performed a double-blind, placebo-controlled study in 44 patients. The patients were randomly assigned to two groups: one group received Hydroxychloroquine pills (200 mg twice daily) and the other group received placebo pills. Symptoms were assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline and at the end of weeks 4, 8, 12, 16, 20, and 24.Results: Approximately, 98% of the patients were women at an average age of 47 years. There was no significant difference in the baseline characteristics between the two groups. In the placebo group, maximum improvement occurred at the 4th week; and during the remaining time, there was no significant improvement. In the Hydroxychloroquine group, maximum improvement occurred at the 8th week and persisted over the entire remaining follow-up period. There were significant differences between the two groups regarding the degree of reduction in the WOMAC total score and the WOMAC subscales scores of pain, stiffness, and function at the end of weeks 4, 8, 12, 16, 20, and 24.Conclusion: Hydroxychloroquine conferred significant improvement in the symptoms of mild to moderate knee osteoarthritis in our patients and may, accordingly, be recommended for knee osteoarthritis treatment.Trial Registration Number: IRCT138709121479N1
Osteoarthritis
Knee
Hydroxychloroquine
2013
09
01
221
226
https://ijms.sums.ac.ir/article_39465_aa0575b42406ed8f7c412c70c338f6fc.pdf
Iranian Journal of Medical Sciences
0253-0716
0253-0716
2013
38
3
Effects of Ascorbic Acid on Serum Level of Unconjugated Estriol and Its Relationship with Preterm Premature Rupture of Membrane: A Double-Blind Randomized Controlled Clinical Trial
Mehrangiz
Zamani
Mohammad Taghi
Goodarzi
Navaz Sadat
Lavasani
Abas
Khosravi
Background: Vitamin C is a water-soluble antioxidant that not only stimulates and protects collagen synthesis but also plays an important role in maintaining cellular integrity in a normal pregnancy. This study surveyed the effects of ascorbic acid on the serum level of unconjugated estriol and the relationship between unconjugated estriol and preterm premature rupture of membrane (PPROM).Methods: This double-blind, randomized clinical trial recruited 60 patients with predisposing factors to PPROM. The women were randomly divided into two groups of intervention and control and received vitamin C and placebo, respectively. The intervention group received 250 mg vitamin C twice a day and the controls received the placebo only. Unconjugated estriol was measured using the ELISA. All data were extracted and recorded in a checklist and compared using descriptive statistics as well as the x2, Fisher exact, and t tests.Results: The demographic data showed no difference between the two groups. The mean level of serum unconjugated estriol was significantly lower in the intervention group than in the control group (P=0.044). Also, the frequency of PPROM was lower in the intervention group, but the difference was not significant (P>0.05). Unconjugated estriol levels were not significantly different between the healthy women and the PPROM patients. Conclusion: This study demonstrated that vitamin C administration decreased unconjugated estriol levels in the patients with PPROM. The findings of this study also indicated that administration of ascorbic acid was a safe and effective method to reduce the incidence of PPROM. Alteration in unconjugated estriol is an active mediator for this effect.Trial Registration Number: IRCT201012083580N3
Unconjugated
Estrio
Vitamin C
2013
09
01
227
232
https://ijms.sums.ac.ir/article_39469_2052159070fb7980da67c143461903ba.pdf
Iranian Journal of Medical Sciences
0253-0716
0253-0716
2013
38
3
Evaluation of Homocysteine Level as a Risk Factor among Patients with Ischemic Stroke and Its Subtypes
Nahid
Ashjazadeh
Morteza
Fathi
Abdohamid
Shariat
Background: Epidemiological research has shown that increased total homocysteine (tHcy) levels are associated with an increased risk of thromboembolic disease; however, controversy still exists over which subtype of stroke is allied to hyperhomocysteinemia. This study aimed to investigate whether elevated tHcy is an independent risk factor for ischemic stroke and to compare tHcy levels in patients with ischemic stroke subtypes.Methods: We performed a case-control study, in which 171 ischemic stroke patients aged over 16 years and 86 age and sex-matched controls were eligible to participate and were enrolled from January 2009 to January 2010. The patients’ demographic data, traditional stroke risk factors, and the results of fasting tHcy, vitamin B12, and folate of serum were collected in the first 5 days after ischemic stroke. Stroke subtypes were classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. SPSS software (version 13) was used for the statistical analysis of the data, and a P value smaller than 0.05 was considered statistically significant.Results: The mean fasting Hcy levels was significantly higher in the cases (16.2 μmol/L, 95% CI: 14.8 to 17.5) than in the controls (13.5 μmol/L, 95% CI: 12.4 to 14.6) (P=0.013). The mean Hcy levels was elevated significantly in those with cardioembolic strokes compared with the controls (17.7 μmol/L, 95% CI: 14.8 to 20.5; P=0.010). The plasma Hcy level was associated with an adjusted odds ratio of 2.17 (95% CI: 1.24 to 3.79; P=0.004) for Hcy above 15 μmol/L concentration for all types of stroke.Conclusion: Our data showed that elevated serum Hcy is an independent risk factor for ischemic stroke and it has a strong association with cardioembolic subtype.
Homocysteine
Risk factors
Vascular disease
2013
09
01
233
239
https://ijms.sums.ac.ir/article_39472_fa888112e965a0cfa5453e7d33e9304a.pdf
Iranian Journal of Medical Sciences
0253-0716
0253-0716
2013
38
3
Evaluation of the Adequacy of General Anesthesia in Cesarean Section by Bispectral Index
Sayed Mohammad Reza
Hadavi
Elaheh
Allahyary
Saman
Asadi
Background: Awareness and recall, though not common, are the major hazards of general anesthesia, especially in Cesarean section (C/S) because of the absence of benzodiazepine and opioids for a significant time during anesthesia. In this study, the Bispectral Index (BIS), end-tidal isoflurane, and hemodynamic parameters were examined to evaluate the depth of the routine general anesthetic technique in C/S.Methods: This study was carried out on 60 parturient patients undergoing elective C/S. A standardized anesthetic technique was applied: induction with Thiopental (4-5 mg/kg) and Succinylcholine (1.5-2 mg/kg) as well as maintenance with O2, N2O, and isoflurane. Electrocardiogram, heart rate, blood pressure, Spo2, end-tidal isoflurane concentration, BIS, and any clinical signs of inadequate depth of anesthesia such as movement, sweating, lacrimation, coughing, and jerking were continuously monitored and recorded at 16 fixed time points during anesthesia. Results: A median BIS of less than 70 (range: 42-68) was obtained on all occasions during surgery; however, at each milestone, at least 20% of the patients had BIS values above 60. Hemodynamic parameters increased significantly in some patients, especially during laryngoscopy and intubation. No patient experienced recall or awareness. Conclusion: The currently used general anesthetic technique in our center appears inadequate in some milestones to reliably produce BIS values less than 60, which are associated with lower risk of awareness. Therefore, with respect to such desirable outcomes as good Apgar and clinical status in neonates, we would recommend the application of this method (if confirmed by further studies) through larger dosages of anesthetic agents.
Bispectral index
Awareness
Recall
Cesarean Section
2013
09
01
240
247
https://ijms.sums.ac.ir/article_39474_fede31babb596d9d5e01fcd2a699c762.pdf
Iranian Journal of Medical Sciences
0253-0716
0253-0716
2013
38
3
Effect of Medium pH on Antibiotic Activity against Syrian Brucella spp. Isolates
Ayman
Al-Mariri
Mazen
Safi
Background: Brucellosis is an endemic zoonosis in Syria, affecting large numbers of animals. There are an increasing number of cases in humans. Brucella is a facultative intracellular pathogen, a small, non-motile, Gram-negative coccobacillus, which causes abortion in domestic animals and a febrile illness in humans. Methods: One hundred isolates collected from different Syrian regions were confirmed to be Brucella melitensis by biochemical tests. The minimum inhibitory concentration (MIC) of 6 antibiotics, alone and in combination, was determined at pH 7.0 and pH 5.0. Results: Ciprofloxacin and sparfloxacin were the most effective antibiotics tested at either pH value. In contrast, rifampicin had low activity and streptomycin was ineffective at either pH value. A combination of rifampicin-doxycycline revealed the highest synergistic activity at both test pH values (against 19/24 and 17/24 isolates, respectively) in vitro. Antagonistic activities were observed using a ciprofloxacin-streptomycin combination (against 9/24 and 13/24 isolates, respectively) as well as a ciprofloxacin-tetracycline combination (against 6/24 and 9/24 isolates, respectively). No differences were observed at both test pH values, when combining a Quinolone with rifampicin or doxycycline. Conclusion: Combination of a Quinolone with doxycycline demonstrated good in vitro activity against B. melitensis. Further in vivo studies are necessary to support this suggestion.
Antibacterial
Antibiotics
Brucella
Zoonotic
Quinolone
2013
09
01
248
254
https://ijms.sums.ac.ir/article_39475_2bebae7c1e369ff0619dc13a4ae2e243.pdf
Iranian Journal of Medical Sciences
0253-0716
0253-0716
2013
38
3
The Prevalence of Barrett’s Esophagus in Outpatients with Dyspepsia in Shaheed Beheshti Hospital of Kashan
Tahere
Khamechian
Javad
Alizargar
Tahere
Mazoochi
Gastroesophageal reflux disease (GERD) is the main known etiological factor for Barrett’s esophagus (BE), and BE is the precursor lesion of esophageal adenocarcinoma. The prevalence of BE is reported mostly from gastroenterology centers and there are only a few reported cases from outpatients with dyspepsia. A large number of patients with GERD have degrees of dyspepsia. This study primarily aimed to determine the prevalence of BE in dyspeptic patients. Outpatients with dyspepsia who referred to our Endoscopy Unit for endoscopy were included in this study. Esophageal biopsy was performed by an endoscopist, and BE diagnosis was established based on the abnormal appearance of the distal esophagus in endoscopy and also based on the presence of intestinal metaplasia in pathologic examination. The prevalence of BE was 5.4% (based on endoscopy) and 3.7% (based on pathology). Sixty-nine percent of the patients with confirmed BE were younger than 50 and 31% were over 50 years of age. Eighty-one percent of the patients with confirmed BE reported GERD symptoms as their dominant dyspepsia symptom, whereas only 20.4% of those without BE reported GERD symptoms (P<0.001). Additionally, BE had a relatively high prevalence in our dyspeptic patients. The high prevalence of GERD symptoms in BE underscores the need for endoscopy for dyspeptic patients.
Barrett’s esophagus
Endoscopy
Heartburn
Pathology
2013
09
01
253
266
https://ijms.sums.ac.ir/article_39466_0c342fe21d0ffe45ffd7af0b6f25ff06.pdf
Iranian Journal of Medical Sciences
0253-0716
0253-0716
2013
38
3
Increased bcl-2 Protein Levels in Rat Primary Astrocyte Culture Following Chronic Lithium Treatment
Mojtaba
Keshavarz
Masoumeh
Emamghoreishi
Ali Akbar
Nekooeian
Jerry J.
Warsh
Hamid Reza
Zar
Background: B cell CLL/lymphoma 2 protein, bcl-2, is an important anti-apoptotic factor that has been implicated in lithium’s neuroprotective effect. However, most studies have focused on assessing the effects of lithium in neurons, ignoring examination of bcl-2 in astrocytes, which also influence neuronal survival and are affected in bipolar disorder. The aim of this study was to evaluate whether chronic lithium treatment also elevates bcl-2 expression in astrocytes compared with neuronal and mixed neuron-astrocyte cultures. Methods: Rat primary astrocyte, neuronal, and mixed neuron-astrocyte cultures were prepared from the cerebral cortices of 18-day embryos. The cell cultures were treated with lithium (1 mM) or vehicle for 24 h or 7 days. Thereafter, bcl-2 mRNA and protein levels were determined by RT-PCR and ELISA, respectively. Results: Chronic, but not acute, lithium treatment significantly increased bcl-2 protein levels in the astrocyte cultures compared with the vehicle-treated cultures. While lithium treatment increased bcl-2 protein levels in both neuronal and mixed neuron-astrocyte cultures, the elevations fell short of statistical significance compared with the respective vehicle-treated cultures. However, neither acute nor chronic lithium treatment affected bcl-2 mRNA levels in any of the three cell types studied. Conclusion: Increased bcl-2 levels in rat primary astrocyte cultures following chronic lithium treatment suggest astrocytes are also a target of lithium’s action. In light of the evidence showing decreased numbers of glial cells in the post-mortem brain of patients bipolar disorder with and increased glial numbers following lithium treatment, the findings of this study indicate that lithium’s action on astrocytes may account, at least in part, for its therapeutic effects in bipolar disorder.
Lithium
Bcl-2
Astrocytes
Primary cell culture
Neuron
2013
09
01
255
262
https://ijms.sums.ac.ir/article_39476_422619df109064b4ba6805c0038c941e.pdf
Iranian Journal of Medical Sciences
0253-0716
0253-0716
2013
38
3
Pulmonary Alveolar Microlithiasis: A Rare Case Report
Kaleem
Ahmad
Mukesh Kumar
Gupta
Kanchan
Dhungel
Panna Lal
Sah
Sajid
Ansari
Raj Kumar
Rauniyar
Pulmonary alveolar microlithiasis is an uncommon infiltrative pulmonary disease characterized by deposition of microliths in the alveoli. We present the case of a young adult with complaints of shortness of breath on exertion. Chest radiograph showed innumerable small, dense nodules, diffusely involving both the lungs - predominantly in the lower zones. High-resolution CT scan illustrated widespread intra-alveolar microliths, diffuse ground-glass attenuation areas, septal thickening, and black pleural lines - predominantly in the basal regions. Transbronchial biopsy confirmed the diagnosis.
Pulmonary alveolar microlithiasis
Calcification
Computed Tomography
2013
09
01
267
270
https://ijms.sums.ac.ir/article_39467_792bb28a1e957b810796964941717963.pdf
Iranian Journal of Medical Sciences
0253-0716
0253-0716
2013
38
3
Diffuse Hepatic Calcifications in a Transfusion-Dependent Patient with Beta-Thalassemia: A Case Report
Forough
Saki
Mohammad Reza
Bordbar
Mohammad Hadi
Imanieh
Mehran
Karimi
Hepatic calcification is usually associated with infectious, vascular, or neoplastic processes in the liver. We report the first case of beta-thalassemia major with isolated diffuse hepatic calcification in a 23 year old woman, who had been transfusion-dependent since the age of 6 months. She was referred to our center with a chief complaint of abdominal pain. Computed tomography scan of the abdomen revealed diffuse hepatic calcification in the right, left, and caudate lobes of the liver. Her medical history disclosed hypoparathyroidism as well as chronic hepatitis C virus infection, which was successfully treated but led to early micronodular cirrhosis on liver biopsy. Other studies done to search for the cause of hepatic calcification failed to reveal any abnormalities. We suspect that hypoparathyroidism caused liver calcification, and should be, therefore, considered in the differential diagnosis of hepatic calcification if other causative factors have been ruled out.
Beta-Thalassemia major
Hepatic
Calcification
Hypoparathyroidism
2013
09
01
271
274
https://ijms.sums.ac.ir/article_39470_23c7be61c076ba4dd54c99be9fa2dda4.pdf
Iranian Journal of Medical Sciences
0253-0716
0253-0716
2013
38
3
Infective Stroke
Somsri
Wiwanitit
Viroj
Wiwanitkit
2013
09
01
275
276
https://ijms.sums.ac.ir/article_39468_80e5b5c809bfde8ffe29145cd70a38d1.pdf
Iranian Journal of Medical Sciences
0253-0716
0253-0716
2013
38
3
The Authors’ Reply
Ali
Moghtaderi
Roya
Alavi-Naini
2013
09
01
277
https://ijms.sums.ac.ir/article_39471_f8be54e4b5d66674bcb84a3b38e4ce2a.pdf
Iranian Journal of Medical Sciences
0253-0716
0253-0716
2013
38
3
Quality of Publication Ethics in Instructions to Authors
Viroj
Wiwanitkit
2013
09
01
278
279
https://ijms.sums.ac.ir/article_39473_ef4c4835baca101da1ea159a3c888c21.pdf