Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences
0253-0716
1735-3688
43
3
2018
05
01
Delayed Complications and Long-Term Management of Sulfur Mustard Poisoning: A Narrative Review of Recent Advances by Iranian Researchers Part ІІ: Clinical Management and Therapy
235
247
EN
Leila
Etemad
Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
etemad@mums.ac.ir
Mohammad
Moshiri
Medical Toxicology Research Centre, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Mahdi
Balali-Mood
Medical Toxicology Research Centre, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
balalimmahdi@mums.ac.ir
10.30476/ijms.2018.40532
The present study aimed to review and discuss the recommended and recently suggested protocols by Iranian researchers for a long-term treatment of delayed complications of sulfur mustard (DCSM) in veterans. As indicated clinically, patients who suffer from delayed ocular complications of sulfur mustard (DOCS) benefit from treatments for dry eyes, therapeutic contact lenses, amniotic membrane transplantation; blepharorrhaphy, tarsorrhaphy, limbal stem cell transplantation; corneal transplantation, topical steroids, and immunosuppressive. In spite of penetrating keratoplasty, lamellar keratoplasty and keratolimbal allograft had a good long-term survival.Delayed respiratory complications (DRCS) are the most common effects and life-threatening in Iranian veterans. The recommended treatment protocols include regular clinical evaluations, respiratory physiotherapy and rehabilitation, N-acetyl cysteine; warm humidified air, long-acting β2-agonists, and inhaled corticosteroids. Azithromycin has also been effective in improving clinical conditions, pulmonary function tests, inflammatory indexes, and life quality of the veterans. Interferon gamma (IFN-γ) and helium: oxygen combination were also used in severe DRCS with good results. Some of the delayed cutaneous complications (DCCS) such as itching affects the quality of life of victims. Regular but not frequent showering and bathing, applying sunscreen compounds, topical corticosteroids, and systemic antihistamines reduce the problems of DCCS patients. Several compounds such as capsaicin cream, pimecrolimus, IFN-γ, phenol-menthol; Aloe vera/olive oil cream, cetirizine, doxepine, and hydroxyzine were evaluated in DCCS patients with some benefits. The physicians in charge of veterans emphasize the importance of a healthy lifestyle, appropriate financial/social/cultural supports, and a degree of reassurance and supportive care on the clinical improvement of patients.
Chemical warfare agents,Sulfur mustard,Vision, ocular,Respiratory system
https://ijms.sums.ac.ir/article_40532.html
https://ijms.sums.ac.ir/article_40532_e4376c7d658ec467ba6eda5b25fe0a3a.pdf
Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences
0253-0716
1735-3688
43
3
2018
05
01
Ovarian Hyperstimulation Syndrome: A Narrative Review of Its Pathophysiology, Risk Factors, Prevention, Classification, and Management
248
260
EN
Bahia
Namavar Jahromi
Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; and Department of Obstetrics and Gynecology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
namavarb@sums.ac.ir
Mohammad Ebrahim
Parsanezhad
Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; and Department of Obstetrics and Gynecology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
parsame@rogers.com
Zahra
Shomali
Department of Obstetrics and Gynecology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran; and Student Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
shomaliz57@yahoo.com
Pardis
Bakhshai
Department of Obstetrics and Gynecology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran; and Student Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
pardis.bakhshaie287@gmail.com
Mahshid
Alborzi
0000-0003-4803-6654
Department of Obstetrics and Gynecology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran; and Student Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
alborzimah@gmail.com
Najmeh
Moin Vaziri
Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
nmvstar@gmail.com
Zahra
Anvar
Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
zahraanvar2000@yahoo.com
10.30476/ijms.2018.40535
Ovarian hyperstimulation syndrome (OHSS) is a serious complication of ovulation induction that usually occurs after gonadotropin stimulation, followed by human chorionic gonadotropin administration, for infertility treatment. The existing knowledge about the pathophysiology, risk factors, and primary and secondary methods for the prevention of OHSS is reviewed in this manuscript. The clinical manifestations and characteristics of mild, moderate, severe, and critical forms of the syndrome are defined. The methods of handling affected cases as outpatient or in-hospital management methods as well as indications for hospitalization are summarized in this review. The clinical and biochemical routes of assessing and monitoring hospitalized patients with OHSS, various drugs and medical treatment strategies including indications for aspiration of the ascitic fluid and pleural effusion, and also rare indications for surgery are briefly explained in this article. Severe OHSS, which two decades ago was considered an iatrogenic life-threatening condition, can now be effectively prevented or managed during the early stages. An OHSS-free clinic can be established nowadays by carefully considering the endocrinology of ovulation and using appropriate and dose-adjusted pharmaceutical agents, which are summarized and discussed in this review.
Ovarian hyperstimulation syndrome,Pathophysiology,Risk factors,Prevention,Classification,Fertilization in vitro
https://ijms.sums.ac.ir/article_40535.html
https://ijms.sums.ac.ir/article_40535_b4fdb096cc196d0a89cac48afb2d807b.pdf
Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences
0253-0716
1735-3688
43
3
2018
05
01
Patient Assessment of Constipation Quality of Life Questionnaire: Translation, Cultural Adaptation, Reliability, and Validity of the Persian Version
261
268
EN
Afsaneh
Nikjooy
Department of Physical Therapy, Faculty of Rehabilitation Sciences, Colorectal Research Center (CRRC), Iran University of Medical Sciences, Tehran, Iran
afsanehnikjooy@yahoo.com
Hassan
Jafari
Health Psychology Group, University of Leuven (KU Leuven), Leuven, Belgium
hassan.jfry@gmail.com
Maryam A.
Saba
Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
maryamsaba.pt32@gmail.com
Naghmeh
Ebrahimi
Student Research Committee,
Shiraz University of Medical Sciences, Shiraz, Iran
n_ebrahimi@razi.tums.ac.ir
Rezvan
Mirzaei
Department of Colorectal Surgery, Colorectal Research Center (CRRC), Iran University of Medical Sciences, Tehran, Iran
rezvanmirzaei@yahoo.com
10.30476/ijms.2018.40530
Background: The Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire is the most validated and the most specific tool for measuring the quality of life of patients with constipation. Over 120 million people live in countries whose official language is Persian. There is no reported Persian version of the PAC-QOL questionnaire yet. The aim of this study was to translate and culturally adapt the PAC-QOL questionnaire and to assess its reliability and validity among Persian patients with chronic constipation.Methods: Following the translation and cultural adaptation of the PAC-QOL questionnaire to Persian, 100 patients (mean±SD age=40.51±13.67) with constipation were recruited for validity measurement and 20 patients were re-examined for reliability. Content validity was assessed based on the opinions of an expert committee and the floor/ceiling effect. Construct validity was evaluated according to the hypothesis test. The SF-36 questionnaire was used for concurrent criterion validity, intra-class correlation coefficient for reliability, and Cronbach’s alpha for internal consistency.Results: The content validity of the PAC-QOL questionnaire was proven, and there was no floor/ceiling effect. Construct validity also was confirmed based on the hypothesis test. The overall Cronbach’s alpha of the PAC-QOL questionnaire was 0.92 (range=0.72–0.92), and the overall intra-class correlation coefficient of the questionnaire was 0.88 (range=0.69–0.87). The correlation between the SF-36 and PAC-QOL questionnaires was moderate.Conclusion: The Persian version of the PAC-QOL questionnaire demonstrated good validity and reliability properties in chronic constipation. Accordingly, Persian researchers and clinicians can benefit from this questionnaire in further research and assessment of treatment outcomes.
Constipation,Quality of life,Questionnaire,reliability,Validity
https://ijms.sums.ac.ir/article_40530.html
https://ijms.sums.ac.ir/article_40530_e4e1b625e3fa071f395a0cd48215be53.pdf
Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences
0253-0716
1735-3688
43
3
2018
05
01
Frequency of Smear-Negative Tuberculosis in Northwest Iran
269
275
EN
Mahya
Pourostadi
Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
mpourostadi@gmail.com
Jalil
Rashedi
0000-0002-9627-1491
Department of Laboratory Science, Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran; and Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran;
rashedijalil@gmail.com
Behroz
Mahdavi Poor
0000-0002-8856-3750
Department of Laboratory Science, Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran; and Department of Medical Parasitology, School of Medical Sciences, Tarbiat Modarres University, Tehran, Iran
behroz.mahdavi@gmail.com
Hossein
Samadi Kafil
0000-0001-6026-8795
Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
kafilhs@tbzmed.ac.ir
Maral
Hariri-Akbari
Adjunct Lecturer, Faculty of Health and Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
haririmaral@gmail.com
Mohammad
Asgharzadeh
0000-0003-3386-4342
Biotechnology Research Center and Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran
asgharzadehmo@yahoo.com
10.30476/ijms.2018.40536
Background: Microscopic smear examination is the most common test in tuberculosis (TB) detection. It is, however, not strong enough to identify TB in the majority of afflicted individuals; thus, a significant number of TB patients are smear negative and capable of transmitting the infection. The aim of this study was to evaluate the rate of smear-negative TB in northwest Iran.Methods: In this cross-sectional study, 329 TB-confirmed patients were evaluated through culture up to March 1, 2015, in northwest Iran. The demographic and clinical features of the smear-negative and smear-positive TB patients were compared. The χ2 test was used to compare the frequency of the variables. All the statistical analyses were conducted using SPSS, version 16 (Chicago, IL, USA).Results: Seventy-five cases were smear negative and 254 were smear positive. Smokers, asthmatics, and extra-pulmonary TB patients were primarily among the smear-negative cases. The rate of mortality was also relatively higher among the smear-negative TB patients.Conclusion: Totally, 22.8% of the TB cases in northwest Iran were smear negative, with a relatively higher rate of mortality than those with positive smears. A delay in these patients’ return to TB diagnosis and treatment centers increases the chance of transmission to others. This is a very sensitive issue in centers where there is no equipment for TB cultivation. Thus, it is essential to equip centers without TB cultivation facilities and to use appropriate diagnostic techniques in centers with those facilities to help rapidly detect smear-negative cases.
culture,diagnosis,Epidemiology,Smear,Tuberculosis
https://ijms.sums.ac.ir/article_40536.html
https://ijms.sums.ac.ir/article_40536_9156c3375a67590550ff73106fd3f6e6.pdf
Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences
0253-0716
1735-3688
43
3
2018
05
01
Validation of the Persian Version of Spiritual Well-Being Questionnaires
276
285
EN
Mrayam
Biglari Abhari
Community Medicine Specialist, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
John W.
Fisher
Faculty of Education and Arts, Federation University Australia; Institute of Health, Medical Sciences and Society, University of Glyndŵr, Wales, Hon; Rural Health Academic Centre, Faculty of Medicine, University of Melbourne, Australia;
mnojomi@iums.ac.ir
Azita
Kheiltash
Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Marzieh
Nojomi
Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; and Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
drnojomi@iums.ac.ir
10.30476/ijms.2018.40539
Background: Spiritual well-being is an important issue in health sciences, hence the need for validated instruments to assess this aspect of health in the Iranian population. The aim of the current study was to determine the validity of the Persian versions of 2 most common measures of spiritual health (Spiritual Well-Being Questionnaire [SWBQ] or Spiritual Health and Life-Orientation Measure [SHALOM] and Spiritual Well-Being Scale [SWBS]). Methods: This was a cross-sectional study via a convenience sampling method in Iran University of Medical Sciences with 170 participants aged above 18 years comprising students, teachers, and administrative staff and managers. The study was conducted from September 7, 2014 to September 20, 2015 in Tehran. Four questionnaires, namely the SWBQ, SWBS, General Health Questionnaire (GHQ-12), and Oxford Happiness Questionnaire (OHQ), were used. Statistical analysis was done using SPSS 18 and LISREL (version 8.2). Cronbach’s alpha, intra-class correlation coefficient, Pearson correlation, and confirmatory factor analysis were employed to assess the validity and reliability of the questionnaires.Results: Cronbach’s alpha for the SWBQ and the SWBS was greater than 0.85. The repeatability of both questionnaires was between 0.88 and 0.98. The Pearson correlation for the SWBQ and the SWBS ranged from 0.33 to 0.53; and all the correlations were significant. The respondents who indicated a higher spiritual well-being also reported better general health and happiness.Conclusion: The Persian versions of the SWBS and the SWBQ have good reliability, repeatability, and validity to assess spiritual health in the Iranian population.
Spirituality,Well-being,Validity and reliability,Surveys and questionnaires
https://ijms.sums.ac.ir/article_40539.html
https://ijms.sums.ac.ir/article_40539_2a065811375a833482140f70cb8ddb9a.pdf
Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences
0253-0716
1735-3688
43
3
2018
05
01
Upregulation of Endothelin-1/Endothelin A Receptor Expression Correlates with Heparanase Expression in Ovarian Carcinoma
286
295
EN
Nungki
Anggorowati
Department of Anatomical Pathology, Universitas Gadjah Mada/Sardjito Hospital, Yogyakarta, Indonesia
nungki@ugm.ac.id
Ahmad
Ghozali
Department of Anatomical Pathology, Universitas Gadjah Mada/Sardjito Hospital, Yogyakarta, Indonesia
ahmad.ghozali@ugm.ac.id
Irianiwati
Widodo
Department of Anatomical Pathology, Universitas Gadjah Mada/Sardjito Hospital, Yogyakarta, Indonesia
irianiwati@ugm.ac.id
Dwi Cahyani Ratna
Sari
Department of Anatomy, Universitas Gadjah Mada/Sardjito Hospital, Yoyakarta, Indonesia
Muhammad Mansyur
Romi
Department of Anatomy, Universitas Gadjah Mada/Sardjito Hospital, Yoyakarta, Indonesia
romi.mm@ugm.ac.id
Nur
Arfian
0000-0003-1694-2054
Department of Anatomy, Universitas Gadjah Mada/Sardjito Hospital, Yoyakarta, Indonesia
nur_arfian@ugm.ac.id
10.30476/ijms.2018.40541
Background: Heparanase and endothelin-1/endothelin A receptor (ET-1/ETAR) expressions increase in cancer. This condition enhances tumor progression and correlates with poor survival. Limited data are documented regarding the role of heparanase and ET-1/ETAR in epithelial ovarian cancer (EOC). We sought to characterize the correlation between heparanase and ET-1/ETAR in EOC.Methods: Thirty patients with benign and malignant ovarian neoplasms were recruited in this study. Neoplasm subtypes were diagnosed by pathologists. RNA extraction was done in fresh frozen neoplasms while immunohistochemical (IHC) staining was done on ETAR, heparanase, and proliferation (Ki-67 antigen) in paraffin sections. Reverse transcriptase PCR was done to quantify the expression of preproET-1 (ppET-1), ETAR, and heparanase. ETAR and heparanase histoscores were done based on IHC staining. The Independent Samples t Test, ANOVA, and correlations were used for statistical analysis. Results: Heparanase and ETAR histoscores, ppET-1 and ETAR mRNA levels, and Ki-67 were significantly higher in the group with EOC than in the benign or borderline group, regardless of the histopathological types. The heparanase histoscore correlated with the ETAR histoscore (r=0.484, P=0.007) and the ETAR mRNA level (r=0.551, P=0.003). The level of ppET-1 mRNA correlated with both ETAR mRNA level and ETAR histoscore (r=0.603, P=0.001 and r=0.455, P=028, respectively). The ovarian neoplasms with high ppET-1 mRNA levels also tended to have high heparanase mRNA levels; however, the correlation was weak (r=0.354, P=0.07). Ki-67 correlated with the heparanase and ETAR histoscores (r=0.381, P=0.038 and r=0.477, P=0.008, respectively).Conclusion: Heparanase and ETAR were upregulated in EOC, and the correlation between heparanase and ETAR expressions was also elucidated in the current study.
Ovarian neoplasms,Endothelin-1,Receptor,Endothelin A,Heparanase,Ki-67 antigen
https://ijms.sums.ac.ir/article_40541.html
https://ijms.sums.ac.ir/article_40541_2319f62e2ff6e2f8b9d1aac26d2133e9.pdf
Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences
0253-0716
1735-3688
43
3
2018
05
01
In Vivo Comparative Evaluation of the Pomegranate (Punica granatum) Peel Extract as an Alternative Agent to Nystatin against Oral Candidiasis
296
304
EN
Shahindokht
Bassiri-Jahromi
Department of Medical Mycology, Pasteur Institute of Iran, Tehran, Iran
basiri@pasteur.ac.ir
Mohammad Reza
Pourshafie
Department of Microbiology, Pasteur Institute of Iran, Tehran, Iran
pour62@pasteur.ac.ir
Esmat
Mirabzade Ardakani
Biotechnology Research Center, Pasteur Institute of Iran, Molecular Medicine Group, Tehran, Iran
mirabzadeh@pasteur.ac.ir
Amir Hooshang
Ehsani
Department of Dermatology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
ehsania2000@yahoo.com
Aida
Doostkam
Department of Pharmacology, Medical school, Shiraz University of Medical Science, Shiraz, Iran
aidoostkam@yahoo.com
Farzad
Katirae
Department of Pathobiology,
Section of Mycology, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
katirae_f@yahoo.com
Ehsan
Mostafavi
Department of Epidemiology,
Pasteur Institute of Iran, Tehran, Iran
mostafavi@pasteur.ac.ir
10.30476/ijms.2018.40542
Background: The pomegranate peel extract is a rich source of natural antioxidant and antimicrobial activity. The aim of the present investigation was to evaluate the in vivo antifungal activity of the pomegranate peel extract and to compare it with nystatin against oral candidiasis in Wistar rats.Methods: Thirty-five male Wistar rats, 6 to 8 weeks old and 220 to 250 g in weight, were used for animal studies. The rats were randomly divided into 7 groups. All the rats, except the control group, were immunosuppressed with cyclosporine (40 mg/kg/d) and hydrocortisone acetate (500 µg/kg/d). Then oral candidiasis was induced via the oral administration of a suspension of Candida albicans (ATCC 10231) (2×107 cell/mL) in PBS on the palate and tongue of the animals on days 3 and 5. Treatment was initiated by using 3 different concentrations of the pomegranate peel extract (125, 250, and 500 µg/mL/kg) and nystatin 100000 U/mL/kg by gavage daily. The statistical analysis was performed using the SPSS, version 22.0. In this study, generalized estimating equations were used for data analysis to determine the effects of the pomegranate peel extract and nystatin on oral candidiasis.Results: Regardless of the concentration of the pomegranate peel extract used for the treatment of oral candidiasis, a significant improvement was seen after 15 days of treatment. All the doses of the pomegranate peel were effective against candidiasis after 15 days; the pomegranate peel extract had no adverse effects following administration in the rats.Conclusion: Our results indicated that the pomegranate peel extract is a promising approach to oral candidiasis treatment, and it may serve as a natural alternative prospect due to its potency against oral candidiasis.
Candidiasis,Mouth,Antifungal agents,Animal experimentation,Pomegranate
https://ijms.sums.ac.ir/article_40542.html
https://ijms.sums.ac.ir/article_40542_bea7752937c9c519ae75f2cdf048774f.pdf
Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences
0253-0716
1735-3688
43
3
2018
05
01
Protective Effects of Eugenol against Hepatotoxicity Induced by Arsenic Trioxide: An Antileukemic Drug
305
312
EN
Prakash
Binu
binu77gprakash@gmail.com
Nellikunnath
Priya
nkpriyavasudevan@gmail.com
Surendran
Abhilash
abicool1986@gmail.com
Radhakrishnan Chandraprabha
Vineetha
vineetharc@gmail.com
Harikumaran
Nair
harinair@mgu.ac.in
harinair@mgu.ac.in
10.30476/ijms.2018.40543
Background: Arsenic trioxide (As2O3) has shown effectiveness in the treatment of leukemia, but it is also associated with hepatotoxicity. Given antileukemic drug-induced oxidative stress and toxicity, this study focused on the mitigatory role of eugenol, a monoterpene compound from clove oil, in the hepatic tissue of Wistar rats.Methods: Twenty-four male Wistar rats (180–250 g) were randomly divided into 4 groups (6 rats per group): normal control rats, rats treated with As2O3 (4 mg/kg bwt), rats treated with eugenol (5 mg/kg bwt), and rats receiving co-treatment with As2O3 (4 mg/kg bwt) and eugenol (5 mg/kg bwt), all of which orally administered for a period of 30 days. The Tukey test (Origin version 7, Origin Lab Corporation, Northampton, USA) was applied to analyze the one-way analysis of variance (ANOVA) between the different groups. A P value less than 0.05 was considered significant.Result: Oral administration of As2O3 significantly induced hepatic damage, evident from increased levels of aspartate transaminase and alanine transaminase (P=0.01 and p <0.001, respectively). Moreover, a decrease in the activities of enzymatic and nonenzymatic antioxidants altered electrolyte concentration and increased the rate of lipid peroxidation (P=0.04) and the level of nitric oxide (P=0.01). Accumulation studies and histopathological analyses confirmed the biochemical variations. Co-treatment with eugenol (5 mg/kg bwt) exhibited hepatoprotective effects as manifested by the decreased rate of arsenic accumulation, lipid peroxidation, and nitric oxide level along with normalized levels of antioxidants and maintained histology of the liver.Conclusion: Eugenol may be used in combination with arsenic trioxide in chemotherapy to reduce oxidative damage to the hepatic system.
Arsenic trioxide,Antioxidants,Eugenol,Hepatotoxicity,Oxidative stress
https://ijms.sums.ac.ir/article_40543.html
https://ijms.sums.ac.ir/article_40543_ef160e1c602b17e7cfbbfe9d15fb8aea.pdf
Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences
0253-0716
1735-3688
43
3
2018
05
01
A Preliminary Study on the Estimation of the Number of Cancer Patients Eligible for Hadron Therapy in Iran and Fars Province
313
317
EN
Mohammad Amin
Hosseini
Ionizing and Non-Ionizing Radiation Protection Research Center (INIRPRC), Shiraz University of Medical Sciences, Shiraz, Iran
Mohammad
Mohamadianpanah
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; and Department of Radiotherapy and Oncology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
Mohammad
Zare-Bandeamiri
Department of Radiotherapy and Oncology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
mohammad_mr83@yahoo.com
Mohammad Amin
Mosleh-Shirazi
Ionizing and Non-Ionizing Radiation Protection Research Center (INIRPRC), Shiraz University of Medical Sciences, Shiraz, Iran; and Department of Radiotherapy and Oncology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
amosleh@sums.ac.ir
10.30476/ijms.2018.40531
Hadron therapy (HT) with protons and carbon ions is an advanced radiotherapy technique. As the first report addressing this topic, the present study aimed to estimate the number of patients eligible for HT in Fars province and the whole of Iran. The data were collected through direct inspection of medical records of the patients treated at the Radiotherapy Department, Namazi Hospital, Shiraz, Iran in 2014. The patients who were treated with external-beam radiotherapy and declared to be a resident of Fars province were extracted from the medical records. After classification based on appropriate indications and factors, the number of eligible patients in Iran was calculated by scaling (Iran: Fars population). Of the 2,932 medical records, 1,943 patients were treated with external-beam radiotherapy, among which 1,536 were from Fars. The total number of patients eligible for HT in Fars was >351 cases/year (22.9% of the treated patients). The cancer site distribution of the eligible Fars residents was central nervous system primary tumors (n=31), brain metastases (n=64), eye (n=7), head and neck (n=28); thyroid (n=4), lung (n=17), breast (n=56), esophagus (n=5); pancreas (n=5), gastric (n=32), liver and bile duct (n=0), rectum and anus (n=26); prostate (n=27), bladder (n=8), cervix (n=6), soft tissue (n=17); kidney (n=1), Hodgkin lymphoma (n=9), non-Hodgkin lymphoma (n=4), and bone metastases (n=4). A total number of 5,756 cases/year was estimated for the entire country. Considering the experiences of other countries, these results suggest that establishing at least two HT centers (covering the northern and southern parts of Iran) is justified based on the total number of patients. Further accurate estimations and cost evaluations are recommended.
Proton therapy,Carbon ion radiotherapy,Patient selection, Treatment costs,Hospitals
https://ijms.sums.ac.ir/article_40531.html
https://ijms.sums.ac.ir/article_40531_f62a61cda64ad7e6945585e400d87706.pdf
Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences
0253-0716
1735-3688
43
3
2018
05
01
Spectrum of Phenylalanine Hydroxylase Gene Mutations in Hamadan and Lorestan Provinces of Iran and Their Associations with Variable Number of Tandem Repeat Alleles
318
323
EN
Reza
Alibakhshi
Department of Biochemistry, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
ralibakhshi@kums.ac.ir
Keivan
Moradi
Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
keivanmoradi84@yahoo.com
Mostafa
Biglari
Medical genetics laboratory, Kermanshah University of Medical Sciences, Kermanshah, Iran
biglarimostafa@yahoo.com
Samaneh
Shafieenia
Medical genetics laboratory, Kermanshah University of Medical Sciences, Kermanshah, Iran
shafieenia.s@yahoo.com
10.30476/ijms.2018.40537
Phenylketonuria (PKU) is one of the most common known inherited metabolic diseases. The present study aimed to investigate the status of molecular defects in phenylalanine hydroxylase (PAH) gene in western Iranian PKU patients (predominantly from Kermanshah, Hamadan, and Lorestan provinces) during 2014-2016. Additionally, the results were compared with similar studies in Iran. Nucleotide sequence analysis of all 13 exons and their flanking intronic regions of the PAH gene was performed in 18 western Iranian PKU patients. Moreover, a variable number of tandem repeat (VNTR) located in the PAH gene was studied. The results revealed a mutational spectrum encompassing 11 distinct mutations distributed along the PAH gene sequence on 34 of the 36 mutant alleles (diagnostic efficiency of 94.4%). Also, four PAH VNTR alleles (with repeats of 3, 7, 8 and 9) were detected. The three most frequent mutations were IVS9+5G>A, IVS7-5T>C, and p.P281L with the frequency of 27.8%, 11%, and 11%, respectively. The results showed that there is not only a consanguineous relation, but also a difference in PAH characters of mutations between Kermanshah and the other two parts of western Iran (Hamadan and Lorestan). Also, it seems that the spectrum of mutations in western Iran is relatively distinct from other parts of the country, suggesting that this region might be a special PAH gene distribution region. Moreover, our findings can be useful in the identification of genotype to phenotype relationship in patients, and provide future abilities for confirmatory diagnostic testing, prognosis, and predict the severity of PKU patients.
Phenylketonurias,Phenylalanine hydroxylase,Variable number of tandem repeats,Iran
https://ijms.sums.ac.ir/article_40537.html
https://ijms.sums.ac.ir/article_40537_dd7549217fea3191565414d231ae16b4.pdf
Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences
0253-0716
1735-3688
43
3
2018
05
01
Occurrence of Mycosis Fungoides in an Iranian Chemical Victim of the Iran–Iraq War with a Long-term Follow-Up: A Case Report and Review of Literature
324
327
EN
Hossein
Mortazavi
Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
mortazavikerman@gmail.com
Leila
Izadi Firouzabadi
Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
lilaizadi@yahoo.com
Alireza
Ghanadan
Department of Pathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
ghannadan@sina.tums.ac.ir
Hassan
Seirafi
Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
hassanseirafi@yahoo.com
Seyed Naser
Emadi
Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
naseremad@yahoo.com
Safoura
Shakoei
0000-0001-6790-7633
Department of Dermatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
dr.shakoei@gmail.com
10.30476/ijms.2018.40529
Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma. Persistent antigenic stimulation has been claimed to play a role in the development of this malignancy. We aimed to show the role of sulfur mustard in the pathogenesis of MF. A 45-year-old man with MF is introduced herein. He was a victim of chemical exposure in 1987 during the Iran–Iraq war. He developed skin lesions 3 years after exposure to sulfur mustard gas at the age of 21. Seven years after his exposure to sulfur mustard gas, a biopsy from the posterior distal part of his calf, which was injured and had bulla, revealed MF. Later, he developed more lesions on his extremities, trunk, and abdomen. On his previous admission, his left eyebrow was involved. A punch biopsy specimen was obtained from his eyebrow lesion, which rendered diffuse infiltration of atypical lymphocyte cells with some convoluted nuclei and scant cytoplasm admixed with lymphocytes, histiocytes, and mast cells compatible with the nodular stage of MF. At his last admission, a biopsy was obtained from the plaque lesions on his left thigh, and a TCR-γ gene rearrangement of the paraffin block of the plaque lesions revealed positive monoclonality. All the findings supported the MF diagnosis. We concluded that sulfur mustard could be a risk factor for MF development.
Mycosis fungoides,Lymphoma, T-Cell, Cutaneous,Environmental exposure,Sulfur mustard
https://ijms.sums.ac.ir/article_40529.html
https://ijms.sums.ac.ir/article_40529_3f48766f687a07ae0c76b31818841105.pdf
Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences
0253-0716
1735-3688
43
3
2018
05
01
Neonatal Presentation of Unremitting Inflammatory Bowel Disease
328
331
EN
Sara
Ebrahimi
Motahari Hospital, Jahrom University of Medical Sciences, Jahrom, Iran
saraebrahimi123@gmail.com
Gholamreza
Khademi
Department of Pediatrics– PICU,
Dr. Sheikh Hospital, Mashhad University of Medical Sciences, Mashhad, Iran;
khademigh@mums.ac.ir
Seyed Ali
Jafari
Department of Pediatrics, Faculty
of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Nona
Zaboli Nejad
Department of Pathology, Faculty
of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Abdolreza
Norouzy
0000-0000-0000-0000
Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
norouzya@mums.ac.ir
Bahareh
Imani
Department of Pediatrics, Faculty
of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
imanib@mums.ac.ir
10.30476/ijms.2018.40534
Very-early-onset inflammatory bowel disease (VEO-IBD) has a distinct phenotype and should be considered a specific entity. VEO-IBD presents with very severe clinical pictures and is frequently known by an indeterminate colitis whose clinical remission is unmanageable. This study examines the case of a neonate with VEO-IBD, not responding to medical and surgical treatment. A 7-day-old Iranian female neonate presented with severe bloody diarrhea, poor feeding, abdominal distention, and dehydration suggesting severe proctocolitis due to an allergy to the protein in cow’s milk. The condition did not respond to the elimination of diet for 1 month. Infections, celiac disease, and cystic fibrosis were excluded. Immunological investigations were negative, but antineutrophil cytoplasmic antibodies were positive. Due to the neonate’s persistent symptoms and failure to thrive, upper and lower endoscopies were performed, showing ulcerative colitis. At the age of 4 months, she presented with signs and symptoms of toxic colitis and acute intestinal perforation, which prompted an emergency laparotomy. Due to the necrosis of the colon, hemicolectomy and colostomy were done. The patient was resuscitated and rehabilitated and was given glucocorticoid and mesalamine. We believe that the incidence of this problem is increasing, as is shown by the rise in the number of children under 10 years old being diagnosed. These patients require more aggressive therapeutic interventions than older IBD patients to achieve complete remission because they are more likely to have extensive colonic disease.
Infant,Inflammatory bowel diseases,Necrosis
https://ijms.sums.ac.ir/article_40534.html
https://ijms.sums.ac.ir/article_40534_b3536c4f5de99f5307391019630435c4.pdf
Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences
0253-0716
1735-3688
43
3
2018
05
01
Eosinophilic Granulomatosis with Polyangiitis Manifested by Cholecystitis and Mononeuritis Multiplex: A Case Report
332
335
EN
Maryam
Mobini
0000-0002-2751-5907
Diabetes Research Center, Department of Internal Medicine, Mazandaran University of Medical Sciences, Sari, Iran
mmobini50@yahoo.com
Hamed
Cheraghmakani
Department of Neurology, Bu Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, Iran
h_cheraghmakani@yahoo.com
Zhila
Torabizadeh
Department of Pathology, Mazandaran University of Medical Sciences, Sari, Iran
zhtorabi@yahoo.com
Omid
Emadian
Department of Pathology, Mazandaran University of Medical Sciences, Sari, Iran
oemadian@yahoo.com
Fatemeh
Nezhadi Kelarijani
Resident in Internal Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
kelarijani.liv.tra@gmail.com
10.30476/ijms.2018.40538
Eosinophilic granulomatosis with polyangiitis formerly named “Churg-Strauss syndrome (CSS)” is a systemic disease with bronchial asthma, hypereosinophilia, and systemic vasculitis. We report a case of CSS with cholecystitis and mononeuritis multiplex. A 50-year-old woman with a history of sinusitis and bronchial asthma of 8 years’ duration was referred with a complaint of left-hand deformity and difficulty in walking. The laboratory findings included remarkable eosinophilia, an elevated erythrocyte sedimentation rate, and a marked eosinophilic infiltration in the gallbladder biopsy. Based on the clinical features and histopathological findings, she was diagnosed with CSS and subsequently treated with prednisolone and cyclophosphamide.
Churg-Strauss syndrome,Cholecystitis,Mononeuropathies
https://ijms.sums.ac.ir/article_40538.html
https://ijms.sums.ac.ir/article_40538_3f11b45a699a3bf962932a4028eb2c1a.pdf
Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences
0253-0716
1735-3688
43
3
2018
05
01
Masson’s Hemangioma of the Urethra: A Case Report
336
339
EN
Khadijeh
Abdal
Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Ilam University of Medical Sciences, Ilam, Iran
dr.faribaabdal@yahoo.com
Mohammadreza
Hafezi Ahmadi
Department of Pathology, Ilam University of Medical Sciences, Ilam, Iran
fariba4479@yahoo.com
10.30476/ijms.2018.40540
Intravascular papillary endothelial hyperplasia (IPEH) is an uncommon benign vascular disease characterized by endothelial cell proliferation and papillary formation within the lumen of blood vessels arising from an organizing thrombus. The occurrence of this uncommon lesion is about 2% of all vascular tumors. IPEH mostly occurs in the 5th decade of life, and there is no gender or age predilection. Nevertheless, some studies have suggested that IPEH is more common in women than in men. The clinical features are mostly asymptomatic, and the lesion is typically characterized as a small, firm, slightly elevated mass with red to blue discoloration of the overlying skin. The main diagnosis of the lesion is based on histological examination. The most common locations of IPEH are head and neck, fingers, and trunk. The occurrence of IPEH in the urethra is extremely rare, with only a few cases having been reported in the literature. We describe a 70-year-old woman with a complaint of dysuria and urethral bleeding of 3 days’ duration. Clinically, the lesion was a palpable firm mass in the urethra. Urethrocystoscopy illustrated a dark mass, a few millimeters in size, with bleeding. Histologic findings revealed dilated blood vessels with multiple papillary projections into the lumen. Thus, based on these findings, a final diagnosis of Masson’s tumor was confirmed. According to clinical and radiographic findings, this lesion is similar to malignant lesions and its accurate diagnosis is based on microscopic findings. Therefore, awareness of the microscopic characteristics of this tumor is very important for clinicians to rule out the presence of malignant vascular lesions and to avoid unnecessarily aggressive therapy.
Thrombosis,Endothelial hyperplasia,Urethra,Endothelial cells
https://ijms.sums.ac.ir/article_40540.html
https://ijms.sums.ac.ir/article_40540_41ddb467528f842c389d510eba45b46f.pdf
Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences
0253-0716
1735-3688
43
3
2018
05
01
Multivisceral Hydatidosis in a 5-Year-Old Boy
340
341
EN
Mohamed
Zouari
Department of Pediatric Surgery, Hedi Chaker Hospital, Sfax, Tunisia
zouarimohamed.1982@yahoo.fr
Ahmed Khalil
Ben Abdallah
Department of Pediatric Surgery, Hedi Chaker Hospital, Sfax, Tunisia
zouari2010@gmail.com
Saloua
Ammar
Department of Pediatric Surgery, Hedi Chaker Hospital, Sfax, Tunisia
ammar_ss@gmail.com
Riadh
Mhiri
Department of Pediatric Surgery, Hedi Chaker Hospital, Sfax, Tunisia
mhiri_r@gmail.com
10.30476/ijms.2018.40533
https://ijms.sums.ac.ir/article_40533.html
https://ijms.sums.ac.ir/article_40533_754b8f35cbceb550ecad0d015e86fefe.pdf