Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071642420170517A Narrative Review of Acute Adult Poisoning in Iran3273464046010.30476/ijms.2017.40460ENSamiraAlinejadMedical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, IranNasimZamaniDepartment of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranMohammadAbdollahiToxicology and Diseases Group, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, IranOmidMehrpourMedical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, IranJournal Article20160826Poisoning is a frequent cause of referral to medical emergencies and a major health problem around the world, especially in developing countries. We aimed to review the epidemiology and pattern of adult poisoning in Iran in order to facilitate the early diagnosis and management of poisoning. The pattern of poisoning is different in various parts of Iran. Pharmaceutical compounds were the most common cause of poisoning in most parts of Iran. Pesticide-related toxicities were more common in northern agricultural regions, whereas bites and stings were seen more commonly in southern Iran. Carbon monoxide poisoning was common in cities with many motor vehicles such as Tehran and in colder climates such as in northern and western regions due to inadequately vented gas appliances such as stoves and heaters. Majoon Birjandi (containing cannabis) is a unique substance used in eastern Iran. Poisoning by opioids, tramadol, and pesticides (organophosphate and aluminum phosphide) has remained a common hazard in Iran. Poisoning-associated morbidity and mortality rates vary by region and have changed over time due to the introduction of new drugs and chemicals. Early diagnosis and proper treatment may be lifesaving; thus, understanding the general pattern of poisoning in different regions is important.https://ijms.sums.ac.ir/article_40460_3848ca244c896de308c8f9e6b31f5a1e.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071642420170114A Prospective Study of Altered Inflammatory Response and Its Clinical Outcome Following Laparoscopic and Open Cholecystectomy34735340456ENSayyed Ehtesham HussainNaqviDepartment of General Surgery,
JN Medical College and Hospital Aligarh Muslim University, Aligarh, IndiaAtiaZaka-ur-RabDepartment of General Surgery,
JN Medical College and Hospital Aligarh Muslim University, Aligarh, IndiaNajmulIslamDepartment of Biochemistry, JN Medical College and Hospital Aligarh Muslim University, Aligarh, IndiaEramAliDepartment of Obstetrics and Gynecology, JN Medical College and Hospital Aligarh Muslim University, Aligarh, IndiaJournal Article20160514Background: Inflammatory response following surgical trauma has long been a matter of study. Results, however, have been varied. We sought to assess changes in the levels of proinflammatory and anti-inflammatory cytokines in patients undergoing laparoscopic and open cholecystectomy and their impact on the clinical outcome of patients concerning the postoperative pain score.Methods: The study involved 90 cholecystectomies (55 laparoscopic and 35 open) for chronic cholecystitis. Blood samples were collected 2 hours preoperatively and at 4 and 24 hours post surgery. Sera were evaluated for the levels of interleukin-1β, interleukin-10, and tumor necrosis factor-alpha. The independent sample t-test was used to compare the means of a variable between the 2 groups. Statistical analysis was done using SPSS, version 17.Results: The rise in the levels of interleukin-1β, interleukin-10, and tumor necrosis factor-alpha was significantly more in the open cholecystectomy group at 4 hours (P<0.00). At the 24th postoperative hour, the levels of all 3 cytokines were also higher in the open cholecystectomy group (P<0.001 for interleukin-1β, P=0.185 for interleukin-10, and P<0.001 for tumor necrosis factor-alpha). At the 4th postoperative hour, the patients in the laparoscopic cholecystectomy group had a significantly lower pain score (P<0.001) than the open group. Conclusion: Both laparoscopic and open cholecystectomy procedures altered the inflammatory milieu of our patients in the postoperative period. Inflammation caused by the laparoscopic procedure was significantly less. More research is needed to target specific inflammatory and anti-inflammatory cytokines to reduce surgical stress and improve patient outcomes.https://ijms.sums.ac.ir/article_40456_d43ecec4ab324e21940b46d90f507ec5.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071642420170129The Impact of Methylphenidate on Motor Performance in Children with both Attention Deficit Hyperactivity Disorder and Developmental Coordination Disorder: A Randomized Double-Blind Crossover Clinical Trial35436140463ENRobabehSoleimaniDepartment of Psychiatry, Cognitive and Addiction Research Center, Shafa Hospital, Guilan University of Medical Sciences, Guilan, Iran0000-0003-1463-0380MaryamKoushaDepartment of Child Psychiatry, Shafa Hospital, Guilan University of Medical Sciences, Guilan, Iran;HomaZarrabiDepartment of Psychiatry, Shafa Hospital, Guilan University of Medical Sciences, Guilan, IranSeyede MahnazTavafzadeh-haghiDepartment of Psychiatry, Shafa Hospital, Guilan University of Medical Sciences, Guilan, IranMir MohammadJalaliSchool of Medicine, Guilan University of Medical Sciences, Guilan, IranJournal Article20160423Background: Children with attention deficit hyperactivity disorder/developmental coordination disorder (ADHD/DCD) suffer from problems associated with gross and fine motor skills. There is no effective pharmacological therapy for such patients. We aimed to assess the impact of methylphenidate (MPH) on motor performance of children with ADHD/DCD.Methods: In this double-blind placebo-controlled, 17 children (12 boys) with ADHD/DCD with a mean age of 7 years 6 months were recruited in Shafa Hospital, Rasht, Iran. The response was defined as ≥25% reduction in the total score of ADHD rating scale-IV from the baseline. Sixteen boys entered phase 2 of the study in which the impact of MPH on motor function was determined through a crossover randomized clinical trial. Eligible individuals were scheduled for baseline and two assessment visits after a one-week period of intervention. We used the short form of Bruininks-Oseretsky test (BOT-2) to identify the disability of motor function. Children were randomly assigned to receive MPH or inert ingredients (placebo). In the second period, medication (MPH/placebo) was crossed over. The effects of MPH were analyzed using χ2 test for related samples to compare the performance during baseline, placebo, and MPH trials. The results were analyzed using the SPSS software version 16.0. Results: The mean minimal effective dose of MPH per day was 17.3 mg (0.85 mg/kg). Children with higher ADHD rating scale had a significantly lower standard score in BOT-2 (P=0.03). Following MPH intake, 26.6% of the children showed clinically significant improvement in motor function. However, the improvement was not statistically different between the MPH and placebo.Conclusion: Although MPH improved ADHD symptoms, problems with motor performance still remained. Further work is required to determine the probable effects of MPH in a higher dosage or in different subtypes of ADHD.Trial Registration Number: IRCT201107071483N2https://ijms.sums.ac.ir/article_40463_828480f35f8d89cb56d6bed4c403a61d.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071642420170124Admission Test and Pregnancy Outcome36236840465ENSetarehAkhavanDepartment of Gynecology, Tehran University of Medical Sciences, Tehran, IranParvanehLakDepartment of Obstetrics and Gynaecology, Shaheed Chamran Hospital, Iran University of Medical Sciences, Tehran, IranFatemehRahimi-SharbafDepartment of Gynecology, Tehran University of Medical Sciences, Tehran, IranSeyed RahimMohammadiTehran University of Medical Sciences, Tehran, IranMahboobehShiraziMaternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, IranJournal Article20160112Background: The admission test (AT) has been carried out for many years, but there are still debates about the prognostic value of the test. Therefore, we aimed to examine the value of the AT in predicting the adverse outcome in neonates.Methods: In this cross-sectional study, 425 pregnant women with normal vaginal delivery were studied between2009 and 2014at Vali-e-Asr Hospital. Based on the results, the women were divided into 2groups of normal and abnormal ATs. All the patients were followed up until the birth of their baby, when the status of mother and neonate was determined. The main outcomes of the study were cesarean rate, neonatal intensive care unit (NICU) admission, fetus demise, neonatal acidosis, and Apgar score. The independent t-test, chi-square test, Fisher exact test, and logistic regression were used for statistical analysis. The data were analyzed using SPSS (version 17). Results: Of 425 pregnant women studied, 142 (33.4%) had abnormal ATs with a mean age of 29 (±4.5) years. Multivariate analysis showed that an abnormal AT was able to predict the incidence of cesarean section, intrauterine growth restriction, turned cord, and Apgar<7, but it could not predict neonatal death and hypoxia.Conclusion: The AT was shown to be a useful screening test with risk factors such as oligohydramnios, bloody amniotic fluid, meconium amniotic fluid, intrauterine growth restriction, and turned cord. Additionally, the test was also able to predict NICU admission and the need for cesarean section, but it could not predict the occurrence of neonatal death.https://ijms.sums.ac.ir/article_40465_819fba6127438e03531c7d251f044620.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071642420170517Inhibitory Effect of Bunium Persicum Hydroalcoholic Extract on Glucose-Induced Albumin Glycation, Oxidation, and Aggregation In Vitro36937640467ENArmanSeriSchool of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IranMarjanKhorsandDiagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, IranZahraRezaeiSchool of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IranAzadehHamediSchool of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IranMohammad AliTakhshidDiagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-3506-7753Journal Article20161020Background: Glucose-induced protein glycation has been implicated in the progression of diabetic complications and age-related diseases. The anti-glycation potential of polyphenol-rich plant extracts has been shown previously. Bunium Persicum has been demonstrated to possess a high level of polyphenols. The aim of current in vitro study was to determine the possible inhibitory effect of Bunium Persicum hydroalcoholic extract (BPE) on glucose-induced bovine serum albumin (BSA) glycation, oxidation, and aggregation.Methods: Folin-Ciocalteu assay was used to measure the content of total phenolic compounds of BPE. To test the in vitro effect of BPE on the formation of glycated BSA, thiol group oxidation, and protein aggregation of BSA, various concentrations of BPE were incubated with BSA and glucose at 37 °C for 72 hr. Glycation, thiol group oxidation, and aggregation of BSA were then measured using thiobarbituric acid, 2, 4-dinitrophenylhydrazine, and Congo red colorimetric methods, respectively. Data were analyzed using the SPSS software (version 16.0). One-way ANOVA followed by Tukey’s post hoc test was used to compare group means. P<0.05 was accepted as the statistically significant difference between groups.Results: The results demonstrated that the content of total phenolics of BPE was 122.41 mg gallic acid equivalents per gram dried extract. BPE (10, 15, and 30 μg/ml) significantly inhibited the formation of GA in a concentration-dependent manner. BPE also significantly decreased the levels of thiol group oxidation and BSA aggregation.Conclusion: The results showed that BPE has anti-glycation and antioxidant properties and might have therapeutic potentials in the prevention of glycation-mediated diabetic complications.https://ijms.sums.ac.ir/article_40467_01dd68fdcf094acf94f3e0d9ca71e2be.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071642420170128Isolation and Detection of Erysipelothrix rhusiopathiae and Its Distribution in Humans and Animals by Phenotypical and Molecular Methods in Ahvaz-Iran in 201537738340468ENPariyaAhmadi BalootakiDepartment of Microbiology, Kerman Branch, Islamic Azad University, Kerman, Iran; and Department of Microbiology, Kerman Science and Research Branch, Islamic Azad University, Kerman, IranMansourAminHealth Research Institute, Infectious and Tropical Diseases Research Center and Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranFarkhondehHaghparastiHealth Research Institute, Infectious and Tropical Diseases Research Center and Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranFarokhRokhbakhsh-ZaminDepartment of Microbiology, Kerman Branch, Islamic Azad University, Kerman, IranJournal Article20160509Background: Erysipelothrix rhusiopathiae (E. rhusiopathiae) is generally transmitted into the gastrointestinal tract of animals by the intake of contaminated food or water and causes great economic loss in agriculture worldwide. Some of the Erysipelothrix spp. are the causative agents of erysipeloid, which is an occupational infection in humans. The aim of the present study was to isolate E. rhusiopathiae from animals as well as the hands of the butchers working in Ahvaz, Iran, and to determine their susceptibility to antibiotics.Methods: Totally, 150 samples were taken from slaughterhouse workers, fishermen, and livers and hearts of sheep and calves by the swabbing method. Phenotypical methods and polymerase chain reaction (PCR) were used for the isolation and identification of E. rhusiopathiae. The isolates were tested for their susceptibility to commonly used antimicrobial agents using the disk diffusion protocol described by the Clinical and Laboratory Standards Institute.Results: Out of the 150 samples examined via phenotypical and biochemical tests, 16 samples were positive as putative Erysipelothrix spp. twelve cases out of the 16 putative Erysipelothrix spp. were confirmed by PCR. The tested isolates were highly sensitive to the antibiotics used. The results of the sensitivity and specificity of PCR revealed that the sensitivity and specificity of indirect PCR were higher than those of direct PCR.Conclusion: E. rhusiopathiae is widely distributed on seafood and presents as a commensal pathogen in nature and animals. Infection with this microorganism should be emphasized because it is a rare organism causing severe infections such as infectious endocarditis and polyarthritis following localized infections.https://ijms.sums.ac.ir/article_40468_d4aefbaab74ba6c23d0e40e16d66e61a.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071642420170125Pain Relief with Wet Cupping Therapy in Rats is Mediated by Heat Shock Protein 70 and ß-Endorphin38439140469ENImamSubadiDepartment of Physical Medicine and Rehabilitation, Faculty of Medicine, Airlangga University, Surabaya, IndonesiaBoyaNugrahaDepartment of Rehabilitation Medicine, Hannover Medical School, Hannover, GermanyHeningLaswatiDepartment of Physical Medicine and Rehabilitation, Faculty of Medicine, Airlangga University, Surabaya, IndonesiaHarjantoJosomuljonoDepartmentof Physiology, Faculty
of Medicine, Airlangga University, Surabaya, IndonesiaJournal Article20160117Background: Wet cupping therapy is a complementary therapy in pain management. The mechanism of this therapy, however, needs further elucidation. Cells injured by wet cupping therapy seem to stimulate the expression of heat shock protein 70 (HSP70). Its benefit in pain reduction could be mediated by the expression of ß-endorphin. This study aimed at determining the correlation between HSP70 and ß-endorphin after wet cupping therapy.Methods: Sixteen male Wistar rats were divided into control (CG; n=8) and treatment (TG; n=8) groups. The rats in both groups were injected with complete Freund’s adjuvant (CFA) at the footpad. In the TG, wet cupping therapy was done at the left and right paralumbar regions 48 hours after the CFA injection. Twenty-four hours after therapy, the hot plate test was done to assess pain threshold. Thereafter, immunohistochemistry from the skin subjected to wet cupping therapy was conducted for HSP70 and ß-endorphin.Results: The expression of HSP70 was significantly higher in the keratinocytes of the TG (20.25±3.53; p <0.001) than in the keratinocytes of the CG (10.50±2.44; p <0.001). The expression of ß-endorphin was significantly higher in the keratinocytes of the TG (22.37±3.52; p <0.001) than in the keratinocytes of the CG (5.12±1.72; p <0.001). The results also revealed a high correlation between HSP70 and ß-endorphin (β=0.864; p <0.001). Pain threshold after wet cupping therapy was significantly higher in the TG (22.81±6.34 s; P=0.003) than in the CG (11.78±3.56 s).Conclusions: The benefit of wet cupping therapy in terms of pain reduction in rats could be mediated by the expression of HSP70 and ß-endorphin.https://ijms.sums.ac.ir/article_40469_2ad950fe1db3af68d7664291902edfc1.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071642420170228Comparative Dermatoglyphic Study between Autistic Patients and Normal People in Iran39239640458ENMansourehKazemiDepartment of Biology, Mashhad Branch, Islamic Azad University, Mashhad, IranMohammad RezaFayyazi-BordbarPsychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, IranNasserMahdavi-ShahriDepartment of Biology, Kavian Institute of Education, Mashhad, IranJournal Article20160511Autism is a neurodevelopmental disorder originating from early childhood; nevertheless, its diagnosis is in older ages. In addition to heredity, environmental factors are also of great significance in the etiology of the disease. Dermatoglyphic patterns, albeit varied, remain stable for a lifetime and yield a large number of patterns upon examination. Studies have shown a significant association between dermatoglyphics and some diseases, especially genetic ones. We compared fingerprints between patients with autism and normal individuals in a Fars population living in Khorasan-Razavi Province, Iran, in 2015. The right and left hand fingerprints of 104 autistic individuals (case group; age range=5–15 y) were collected using a fingerprint scanner. The same process was performed for 102 healthy individuals, in the age range of 6 to 25 years. All dermatoglyphic patterns and ridge counts were determined. The data were analyzed using the Mann–Whitney nonparametric test and binomial distribution. There was a significant difference in the distribution of the dermatoglyphic patterns on the right and left thumbs and the index fingers between the case and control groups (P<0.05). The patients had a significantly higher count of loops on their right and left thumbs and their index fingers. A significant decrease in ridge counts for the right and left thumbs and the index fingers was observed in the patients compared to the controls. The results suggested that the patterns were associated with the risk of autism. The patterns may be drawn upon as biometric parameters in the screening of children with autism.https://ijms.sums.ac.ir/article_40458_abdff87f593da7267f4cc9edb6c17e3d.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071642420170123Importance of RIFLE (Risk, Injury, Failure, Loss, and End-Stage Renal Failure) and AKIN (Acute Kidney Injury Network) in Hemodialysis Initiation and Intensive Care Unit Mortality39740340461ENIskenderKaraDepartment of Anesthesiology and Reanimation, Gazi University Faculty of Medicine, Intensive Care Training Program, Anlara, TurkeyFatmaYildirimDepartment of Pulmonology, Intensive Care Training Program, Gazi University Faculty of Medicine, Anlara, TurkeyEsraKayacanDepartment of Internal Medicine, Gazi University Faculty of Medicine, Anlara, TurkeyBurcuBilaloğluDepartment of Internal Medicine, Gazi University Faculty of Medicine, Anlara, TurkeyMeldaTurkogluDepartment of Internal Medicine, Intensive Care Unit, Gazi University Faculty of Medicine, Anlara, TurkeyGülbinAygencelDepartment of Internal Medicine, Intensive Care Unit, Gazi University Faculty of Medicine, Anlara, TurkeyJournal Article20160302Our study evaluated the differences between early and late hemodialysis (HD) initiation in the intensive care unit (ICU) according to the RIFLE (Risk, Injury, Failure, Loss, and End-stage renal failure) and AKIN (Acute Kidney Injury Network) classifications. On the assumption that early initiation of HD in critical patients according to the RIFLE and AKIN criteria decreases mortality, we retrospectively evaluated the medical records of 68 patients in our medical ICU and divided the patients into 2 groups: those undergoing HD in no risk, risk, or injury stage according to RIFLE and in stage 0, I, or II according to AKIN were defined as early HD and those in failure stage according to RIFLE and in stage III according to AKIN were defined as late HD. The median age of the patients was 66.5 years, and 56.5% were male. HD was started in 25% and 39.7% of the patients in the early stage in the RIFLE and AKIN classification, respectively. According to RIFLE, HD was started in 61.5% of the surviving patients in the early stage; this rate was 16.4% in the deceased patients (P=0.001). HD was commenced in 69.2% of the surviving patients in AKIN stages 0, I, and II and in 32.7% of the deceased patients (P=0.026). Sepsis (61.5% vs. 94.5%; P=0.001) and mechanical ventilation (30.8% vs. 87.3%; p <0.001) during HD increased ICU mortality, whereas HD initiation in the early stages according to RIFLE decreased ICU mortality (61.5% vs. 16.4%; P=0.001). In conclusion, in critically ill patients, HD initiation in the early stages according to the RIFLE classification decreased our ICU mortality.https://ijms.sums.ac.ir/article_40461_60e3ea6064f9ce6576388e3950a83209.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071642420170124Sudden Bilateral Sensorineural Hearing Loss Following Postpartum Hemorrhage: A Case Report40440640457ENSaraMirzaeianDepartment of Obstetrics and Gynecology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranSedighehAyatiDepartment of Obstetrics and Gynecology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranAsiehMalekiDepartment of Obstetrics and Gynecology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20160106AbstractThe prevalence of bilateral sudden sensorineural hearing loss (SSNHL) is less than 5% and the etiology of most cases is unknown. Due to many structural and functional similarities between the kidney and inner ear, many conditions, diseases, and drugs have both renal and cochlear effects and toxicities. There are several reports of SSNHL in patients with CRF, uraemic patient, hemodialysis treatment, and ARF. Here, we report a rare manifestation of SSNHL following severe postpartum hemorrhage that has simultaneous renal failure and cochlear impairment. The patient was a 22-year-old primigravida woman with term pregnancy who after delivery and episiotomy hematoma and postpartum hemorrhage subsequently suffered from kidney failure, oliguria, and SSNHL that occurred after 3 days of delivery. In conditions such as severe postpartum bleeding leading to acute renal involvement, the possibility of simultaneous involvement of cochlea due to hypoxia or received drugs should be considered.https://ijms.sums.ac.ir/article_40457_c29af12f2df5ffb2e66ab8e449b7d5e7.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071642420170123Extranodal Non-Hodgkin’s Lymphoma of the Oral Cavity: A Case Report40741140462ENBabyamma RaghavanVarunDepartment of Oral and Maxillofacial Pathology, PMS Institute of Dental Science and Research, Vattapara, Trivandrum, IndiaNettiyat OommenVargheseDepartment of Conservative Dentistry, PMS Institute of Dental Science and Research, Vattapara, Trivandrum, IndiaTrivandrum ThanappanSivakumarDepartment of Oral and Maxillofacial Pathology, PMS Institute of Dental Science and Research, Vattapara, Trivandrum, IndiaAnna PalliathJosephDepartment of Oral and Maxillofacial Pathology, PMS Institute of Dental Science and Research, Vattapara, Trivandrum, IndiaJournal Article20160107Lymphomas are solid malignant tumors having a wide spectrum of clinical and pathological features. Non-Hodgkin’s lymphoma (NHL) is a subtype of lymphoma with two-thirds of the cases presenting as lymph node enlargement. The remaining one third of NHL cases has been reported in the extranodal sites, including the gastro intestinal tract, Waldeyer’s ring, bone, skin, and brain. Intraoral non-Hodgkin’s lymphoma is uncommon and may affect either the jaw bones or occur within the soft tissues of the oral cavity. Here we report a case of non-Hodgkin’s lymphoma in a 65-year-old male patient who presented with a growth from the extraction socket. Non-Hodgkin’s lymphoma presenting as a growth from the extraction socket is unusual. An orthopantamograph (OPG) was taken which revealed a diffuse radiolucent defect in relation to the extraction socket of the left lower molar region. Routine hemogram, urine analysis, and chest radiograph were normal. Incisional biopsy was performed and the tissue was subjected to histopathological examination. Histopathological and immunohistochemical analysis confirmed the diagnosis of B-cell lymphoma. The patient was referred to a regional cancer institute for further management, where chemotherapy was planned. However, prior to chemotherapy, the patient was diagnosed with brain metastasis and he expired in hospital within one month. https://ijms.sums.ac.ir/article_40462_aafe70a4e620640a417de515e689eac8.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071642420170123Bilateral Hyperplasia of Bartholin’s Gland: A Case Report41241540464ENLadanHaghighiDepartment of Obstetrics and Gynecology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran;MansoorehShaabani ZanjaniDepartment of Obstetrics and Gynecology, Shahid Akbarabadi Hospital, Iran University of Medical Sciences, Tehran, IranZahraNajmiDepartment of Obstetrics and Gynecology, Zanjan University of Medical Sciences, Zanjan, IranNedaHashemiDepartment of Obstetrics and Gynecology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran;Journal Article20151111A 37-year-old woman underwent surgery to remove bilateral vulvar masses. The masses were firm, non-tender, and immobile. Pathologic finding was a well-delineated creamy grayish mass with a homogenous grayish solid surface and mild edema, chronic inflammatory infiltration, and focal dilation of the ducts with squamous metaplasia. The diagnosis was hyperplastic and hypertrophied Bartholin’s gland. Hyperplasia is a rare etiology for an enlarged Bartholin’s gland. Clinical presentation of Bartholin’s gland nodular hyperplasia is rather specific, although inflammatory lesion is the most common cause of swelling of the Bartholin’s gland in all age groups. Bartholin’s hyperplasia should be considered in cases with a solid mass. Total surgical excision is required for diagnosis. Only a few cases of Bartholin’s gland hyperplasia have been reported in the literature. Our patient has been receiving regular follow-up examination and there is no evidence of dyspareunia, perineal pain, and recurrent disease 12 months after surgery.https://ijms.sums.ac.ir/article_40464_6ab430d76ec3eb727243200d6dcbbec8.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071642420170124Holt-Oram Syndrome: A Rare Variant41641940466ENBinoyShankarDepartment of Neonatology and Paediatric Medicine, PGIMER,
Dr. RML Hospital, New Delhi, IndiaEudenBhutiaDepartment of Neonatology and Paediatric Medicine, PGIMER,
Dr. RML Hospital, New Delhi, IndiaDineshKumarDepartment of Neonatology and Paediatric Medicine, PGIMER,
Dr. RML Hospital, New Delhi, IndiaSunilKishoreDepartment of Neonatology and Paediatric Medicine, PGIMER,
Dr. RML Hospital, New Delhi, IndiaShakti PadDasDepartment of Neonatology and Paediatric Medicine, PGIMER,
Dr. RML Hospital, New Delhi, IndiaJournal Article20151217Holt-Oram syndrome is an autosomal dominant disorder, characterised by skeletal abnormalities of the upper limb associated with congenital heart defect, mainly atrial and ventricular septal defects. Skeletal defects exclusively affect the upper limbs in the preaxial radial ray distribution and are bilateral and asymmetrical. They range from clinodactyly, absent or digitalised thumb, hypoplastic or absent radii, and first metacarpal to hypoplastic ulna and carpal bone anomalies. Cardiac involvement ranges from asymptomatic conduction disturbances to multiple structural defects. Structural defects are seen in 75% of the cases and include both atrial and ventricular septal defect. More complex cardiac lesions such as Tetrology of Fallot, endocardial cushion defects, double outlet right ventricle, and total anomalous pulmonary venous return are observed uncommonly. An aneurysm of the interatrium septum is an infrequent finding in infants. It has been speculated that atrial septal aneurysm (ASA) is a direct source of thrombus formation. Paradoxical embolism of venous thrombi across a right to left shunt is possibly responsible for the cryptogenic stroke in a patient with ASA. However, coagulopathy associated with cyanotic congenital heart defect may also be contributory. Our patient had a rare association of complex cardiac lesion (tricuspid atresia, pulmonary stenosis, atrial septal aneurysm) with cardiac conductive defects and left parietal infarct along with the usual skeletal abnormalities.https://ijms.sums.ac.ir/article_40466_95c18b5fb48f12b60f084d493e59a49d.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071642420170418Adherence to Hypoglycemic Medication among Insulin-Treated Patients with Type 2 Diabetes42042140459ENParisaZarei-SharghStudent Research Committee, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranAtiehMehdizadeh-HakkakStudent Research Committee, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMohammadBagherniyaStudent Research Committee, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranLidaJarahiDepartment of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0001-7753-6610ZohrehMousaviEndocrine Research Center, Mashhad University of Medical Sciences, Mashhad, IranMohammadSafarianMetabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20161109https://ijms.sums.ac.ir/article_40459_72a6702b5795caacae84ebe921fb7fee.pdf