Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639320140501Treatment of Hepatitis C Virus Infection and Associated Vascular Complications: A Literature Review23824639659ENRezaKarbasi-AfsharAtherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, IranJournal Article20140514Interferon (IFN)-based therapy, the cornerstone for treatment of hepatitis C virus (HCV) infection, is generally considered to be the single most effective treatment strategy for this infection. Although most adverse effects of IFN therapy respond very well to the cessation of this drug, there are reports of serious irreversible adverse effects. This review article evaluates the adverse effects of IFN therapy in HCV-infected patients. We have undertaken an extensive search for articles regarding IFN and pegylated-IFN (PEG-IFN) therapy and their vascular complications using multiple sources that include PubMed, publishers’ websites, and Google Scholar. The prevalence of ocular disorders in the early period (first 8 weeks) after IFN administration was high with over half of the patients experiencing these adverse effects. Several authors strongly propose screening programs for retinopathy in the early period after IFN administration. Pulmonary hypertension due to IFN therapy is a serious side effect due to its irreversible nature in most patients. Patients who develop signs of acute abdomen up to months after IFN administration should be rapidly assessed for potential adverse effects of IFN. The literature suggests a broad spectrum of vascular injuries to different organs in humans as adverse effects of IFN therapy in HCV-infected patients.https://ijms.sums.ac.ir/article_39659_5723034a9deb7985bd5b5b137b7fa699.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639320140501The Effect of Intraoperative Restricted Normal Saline during Orthotopic Liver Transplantation on Amount of Administered Sodium Bicarbonate24725339657ENMohammad AliSahmeddiniShiraz Anesthesiology and Critical Care Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran0000-0003-1510-0103FarahzadJanatmakanDepartment of Anesthesiology and Critical Care, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranMohammad BagherKhosraviShiraz Anesthesiology and Critical Care Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran0000-0003-1223-2346SinaGhaffaripourShiraz Anesthesiology and Critical Care Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranMohammad HosseinEghbalShiraz Anesthesiology and Critical Care Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranSakineShokrizadehShiraz Anesthesiology and Critical Care Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20130803Background: Severe metabolic acidosis occurs during orthotopic liver transplantation (OLT) particularly during the anhepatic phase. Although NaHCO3 is considered as the current standard therapy, there are numerous adverse effects. The aim of this study was to determine whether the restricted use of normal saline during anesthesia could reduce the need for NaHCO3.Methods: In this study we enrolled 75 patients with end-stage liver disease who underwent OLT from February 2010 until September 2010 at the Shiraz Organ Transplantation Center. Fluid management of two different transplant anesthetics were compared. The effect of restricted normal saline fluid was compared with non-restricted normal saline fluid on hemodynamic and acid-base parameters at three times during OLT: after the skin incision (T1), 15 min before reperfusion (T2), and 5 min after reperfusion (T3). Results: There were no significant differences in demographic characteristics of the donors and recipients (P>0.05). In the restricted normal saline group there was significantly lower central venous pressure (CVP) than in the non-restricted normal saline group (P=0.002). No significant differences were noted in the other hemodynamic parameters between the two groups (P>0.05). In the non-restricted normal saline group arterial blood pH (P=0.01) and HCO3 (P=0.0001) were significantly less than the restricted normal saline group. The NaHCO3 requirement before reperfusion was significantly more than with the restricted normal saline group (P=0.001).Conclusion: Restricted normal saline administration during OLT reduced the severity of metabolic acidosis and the need for NaHCO3 during the anhepatic phase.Trial Registration Number: IRCT2013110711662N5https://ijms.sums.ac.ir/article_39657_04e6199f0a9b8e749df46dace5c1fba9.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639320140501Risk Factors of Dystocia in Nulliparous Women25426039666ENRaheleAlijahanProvince Health Center, Ardebil, IranMasoumehKordiDepartment of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-9123-3103Journal Article20140514Background: Detection of women at risk for dystocia will allow physicians to make preparations and treatment decisions that can minimize maternal and neonatal morbidity. We aimed to determine the risk factors for dystocia in nulliparous women. Methods: This case series enrolled 447 nulliparous women who presented with a single pregnancy in the vertex presentation and gestational age of 38-42 weeks. Maternal anthropometric measurements were obtained upon admission. We defined dystocia as a cesarean section or vacuum delivery for abnormal progression of labor as evidenced by the presence of effective uterine contractions, cervical dilation of less than 1 cm/h in the active phase for 2 h, duration of the second stage beyond 2 h, or fetal head descent less than 1 cm/h. Data were analyzed by SPSS software version 11.5. Kruskal-Wallis, logistic regression, chi-square, Student’s t test and the Mann-Whitney tests were used as appropriated.Results: The state anxiety score (OR=10.58, CI: 1.97-56.0), posterior head position (OR=9.53, CI: 4.68-19.36), fetal head swelling in the second stage of labor (OR=6.85, CI: 2.60-18.01), transverse diagonal of Michaelis sacral ≤9.6 cm (OR=6.19, CI: 2.49-15.40), and height to fundal ratiohttps://ijms.sums.ac.ir/article_39666_ac55e39ddde2a6a0a1678bb6be72ec7f.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639320140501Morphine Reduces Expression of TRPV1 Receptors in the Amygdala but not in the Hippocampus of Male Rats26126739667ENElhamHakimizadehPhysiology-Pharmacology Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, IranMohammadKazemi ArababadiImmunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, IranAliShamsizadehPhysiology-Pharmacology Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran0000-0001-8329-9156MohammadAllahtavakoliPhysiology-Pharmacology Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, IranMohammad EbrahimRezvaniDepartment of Physiology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranAliRoohbakhshPharmaceutical Research Center, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140511Background: Chronic use of opioids usually results in physical dependence. The underlying mechanisms for this dependence are still being evaluated. Transient receptor potential vanilloid type 1 (TRPV1) are important receptors of pain perception. Their role during opioid dependence has not been studied well. The aim of this study was to evaluate the effect of morphine-dependence on the expression of TRPV1 receptors in the amygdala and CA1 region of the hippocampus. Methods: This study used four groups of rats. Two groups of rats (morphine and morphine+naloxone) received morphine based on the following protocol: 10 mg/kg (twice daily, 3 days) followed by 20, 30, 40 and 50 mg/kg (twice daily), respectively, for 4 consecutive days. Another group received vehicle (1 ml/kg) instead of morphine given using the same schedule. The morphine+naloxone group of rats additionally received naloxone (5 mg/kg) at the end of the protocol. The control group rats received no injections or intervention. The amygdala and CA1 regions of the morphine, saline-treated and intact animals were isolated and prepared for real-time PCR analysis. Results: Administration of naloxone induced withdrawal signs in morphine-treated animals. The results showed a significant decrease in TRPV1 gene expression in the amygdala (P<0.05) but not the CA1 region of morphine dependent rats. Conclusion: TRPV1 receptors may be involved in morphine-induced dependence.https://ijms.sums.ac.ir/article_39667_c1cb8bd052108fab1c14e870b14697bf.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639320140501The Study of DNA Methyltransferase-3B Promoter Variant Genotype among Iranian Sporadic Breast Cancer Patients26827439668ENEbrahimEftekharDeparment of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;and Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; and Department of Biochemistry, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, IranMozhganRastiDeparment of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranFakhraddinNahgibalhossainiDeparment of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranYasamanSadeghiStudent Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20140514Background: DNA methyltransferase-3B (DNMT3B) is an important enzyme responsible for maintaining the DNA methylation pattern in eukaryotic cells. In this study we have investigated the correlation between the 46359C→T polymorphism in the DNMT3B gene and the risk of breast cancer incidence among sporadic breast cancer patients in Fars Province, Southern Iran.Methods: In this case-control study, 100 breast cancer patients and 138 healthy control subjects were genotyped for the DNMT3B gene by the polymerase chain reaction-restriction fragment length polymorphism method.Results: The genotype frequency in the case (CC 27%, CT 47%, TT 26%) group significantly (P=0.008) differed from the control (CC 19.56%, CT 67.3%, TT 13%) group. We observed a decreased association between the CT genotype and lymph node involvement in breast cancer patients. Our results have shown that in comparison to the homozygous CC genotype carriers the DNMT3B-CT genotype has a significantly lower risk for breast cancer (OR=0.515, 95% CI=0.267-0.994, P=0.048).Conclusion: Our case-control study showed that the CT genotype was significantly associated with decreased breast cancer risk. Consistent with these results, a significant decrease of CT genotype among lymph node positive breast cancer patients was observed. However, a larger study population with more clinical data is needed to confirm these results.https://ijms.sums.ac.ir/article_39668_bc8d2203b00d2de4b60749ae47cdfba8.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639320140501Sustained Hypoxic Pulmonary Vasoconstriction in the Isolated Perfused Rat Lung: Effect of α1-adrenergic Receptor Agonist27528139669ENFarzanehKetabchiDepartment of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-1157-3299ZinabKarimiDepartment of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranSeyed Mostafa S.MoosaviDepartment of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20140514Background: Alveolar hypoxia induces monophasic pulmonary vasoconstriction in vivo, biphasic vasoconstriction in the isolated pulmonary artery, and controversial responses in the isolated perfused lung. Pulmonary vascular responses to sustained alveolar hypoxia have not been addressed in the isolated perfused rat lung. In this study, we investigated the effect of sustained hypoxic ventilation on pulmonary artery pressure in the present of phenylephrine, an α1-receptor agonist, under the above condition.Methods: We performed this study in the isolated perfused rat lung. After preparation, the lungs were divided randomly into five groups of normoxic-normocapnia, hypoxic-normocapnia, phenylephrine pre- or post-treated hypoxic-normocapnia and phenylephrine pre-treated normoxic-normocapnia. Pulmonary hemodynamic, airway pressure and lung weight were measured during 60 min of the experiment for each group.Results: In the phenylephrine-pre-treated hypoxic-normocapnia group we observed a gradual increase in pulmonary artery pressure which approximated the results seen in the phenylephrine-pre-treated normoxic-normocapnia group. In contrast, in the phenylephrine-post-treated hypoxic-normcapnic group, pulmonary artery pressure did not change during the first 3 min of hypoxic-normocapnia. However at 1.5 min after administration of phenylephrine, this pressure began to increase sharply and continued until the end of the experiment. This response was biphasic (0-10 min: acute phase, 10-60 min: sustained phase) with significantly higher pulmonary artery pressure compared to the other groups. Conclusion: This study, for the first time, showed biphasic hypoxic pulmonary vasoconstriction in the isolated perfused rat lung with the sole administration of phenylephrine after but not before hypoxic gas ventilation. This finding suggested a facilitative role of alveolar hypoxia on pulmonary vasoconstriction induced by an α1-receptor agonist.https://ijms.sums.ac.ir/article_39669_81da2c50e1f6cfa2f2482e05afc8a058.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639320140501Optimization of RNA Extraction from Rat Pancreatic Tissue28228839670ENSanazDastgheibDepartment of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; and Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranCambyzIrajieDepartment of Resource Development and Management, Shiraz University of Medical Sciences, Shiraz, IranRahelehAssaeiEndocrinology and Metabolism Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranFarhadKoohpeimaEndocrinology and Metabolism Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranPoonehMokarramDepartment of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; and Gasteroenterohepatology Research Center, Nemazee Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;and
Faculty for Advanced Biomedical Sciences, School of Medicine, Shiraz University of Medical Sciences,
Shiraz, IranJournal Article20140514Background: Optimized RNA extraction from tissues and cell lines consists of four main stages regardless of the method of extraction: 1) homogenizing, 2) effective denaturation of proteins from RNA, 3) inactivation of ribonuclease, and 4) removal of any DNA, protein, and carbohydrate contamination. Isolation of undamaged intact RNA is challenging when the related tissue contains high levels of RNase. Various technical difficulties occur during extraction of RNA from pancreatic tissue due to spontaneous autolysis. Since standard routine protocols yield unacceptable results in pancrease, we have designed a simple method for RNA extraction by comparing different protocols.Methods: We obtained 20-30 mg pancreatic tissues in less than 2 min from 30 rats. Several methods were performed to extract RNA from pancreatic tissue and evaluate its integrity. All methods were performed three times to obtain reproducible results. Results: Immersing pancreatic tissue in RNA-later for 24 h at -80ºC yielded high quality RNA by using the TriPure reagent which was comparable to the commercial RNeasy Micro Kit. The quality of RNA was evaluated by spectrophotometer, electrophoresis and RT-PCR. We separated intact 28S and 18S ribosomal RNA (rRNA) when our procedure was compared with the RNeasy Micro Kit. Finally, full length of the actin gene was amplified by RT-PCR. Conclusion: We designed a simple, fast, cost-effective method for complete RNA extraction from the least amount of quantitatively intact pancreatic tissue.https://ijms.sums.ac.ir/article_39670_2bcfc62dba7ffd8c287b217204a544bd.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639320140501Evaluation of Thymic Changes after Median Sternotomy in Children28929239660ENKarmellaKamaliMedical Imaging Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranMohammadGhahartarsMedical Imaging Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranAhmad AliAmirghofranMedical Imaging Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran0000-0003-1588-2539Journal Article20140514In patients who undergo median sternotomy to treat congenital heart diseases, a thymectomy is performed to yield better access to the cardiac system. In this study we have used MRI to evaluate the changes in size, shape and location of the thymus after midsternatomy. This case-control study was performed during 2011-2012 in Shiraz, Iran. Eligible participants between 5-17 years of age were divided into case and control groups (n=13 per group). Each participant underwent a median sternotomy at least one year prior to study entry. Participants were initially examined by a cardiologist and then referred for MRI. A radiologist examined all MRI images. The thymus was observed in all control group patients and in only 7 (53.8%) patients in the case group. There was a significant relationship noted in terms of mean age in the group whose thymus was visible and the group in which the thymus was not visible. We have observed no significant difference in thymic visibility between these two groups based on the mean age at midsternatomy. In pediatric patients undergoing cardiac surgery the possibility of remaining or regenerated thymic tissues may be evaluated by MRI. The remaining portion of the thymus may have any shape, size or location. Therefore, it can be misinterpreted as a mass if a patient’s previous surgical history and age at the time of surgery are not taken into consideration.https://ijms.sums.ac.ir/article_39660_7dd85ef4447ea0348614b115294ece3a.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639320140501Medical Students’ Knowledge of Indications for Imaging Modalities and Cost Analysis of Incorrect Requests, Shiraz, Iran 2011-201229329739664ENParisaIslami Parkoohi1Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; and Shiraz Anesthesiology and Critical Care Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranRezaJalliMedical Imaging Research Center, Department of Radiology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranMinaDanaei1Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; and Shiraz Anesthesiology and Critical Care Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranShivaKhajavianStudent Research Committee, Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranMehrdadAskarian1Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; and Shiraz Anesthesiology and Critical Care Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran0000-0003-4163-7414Journal Article20140514Medical imaging has a remarkable role in the practice of clinical medicine. This study intends to evaluate the knowledge of indications of five common medical imaging modalities and estimation of the imposed cost of their non-indicated requests among medical students who attend Shiraz University of Medical Sciences, Shiraz, Iran. We conducted across-sectional survey using a self-administered questionnaire to assess the knowledge of indications of a number of medical imaging modalities among 270 medical students during their externship or internship periods. Knowledge scoring was performed according to a descriptive international grade conversion (fail to excellent) using Iranian academic grading (0 to 20). In addition, we estimated the cost for incorrect selection of those modalities according to public and private tariffs in US dollars.The participation and response rate was 200/270 (74%). The mean knowledge score was fair for all modalities. Similar scores were excellent for X-ray, acceptable for Doppler ultrasonography, and fair for ultrasonography, CT scan and MRI. The total cost for non-indicated requests of those modalities equaled $104303 (public tariff) and $205581 (private tariff).Medical students at Shiraz University of Medical Sciences lacked favorable knowledge about indications for common medical imaging modalities. The results of this study have shown a significant cost for non-indicated requests of medical imaging. Of note, the present radiology curriculum is in need of a major revision with regards to evidence-based radiology and health economy concerns.https://ijms.sums.ac.ir/article_39664_d4f45aceb7e665b4c10d658d71d75a07.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639320140501Non-Diethylstilbestrol-Associated Primary Clear Cell Carcinoma of the Vagina: Two Case Reports with Immunohistochemical Studies and Literature Review29830339658ENShagufta T.MuftiDepartment of Anatomic Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaHiba HassanAliDepartment of Anatomic Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaJournal Article20140514Primary clear cell adenocarcinomas most commonly involve the genitourinary system, including the vagina. Previously, primary clear cell adenocarcinomas of the vagina have been discussed within the context of prenatal exposure to diethylstilbestrol. Due to its widely proven role in the development of this carcinoma, administration of diethylstilbestrol is prohibited. We present two cases of non-diethylstilbestrol-associated primary clear cell adenocarcinoma of the vagina from the archives of the Anatomical Pathology Department at King Abdulaziz University in order to improve our understanding of its biological behavior. Our findings suggest that primary clear cell adenocarcinoma of the vagina may be unrelated to diethylstilbestrol exposure and that non-diethylstilbestrol-associated primary clear cell adenocarcinoma of the vagina, when present at a younger age, may have a worse prognosis.https://ijms.sums.ac.ir/article_39658_2b702d66fb2c9f4b646bb0fd4f145e68.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639320140501Nevus Lipomatosus Cutaneous Superficialis: A Rare Case Report30430739663ENSunita BPatilDepartment of Pathology, D.Y. Patil Medical College and Research Centre, Kolhapur, IndiaShilpaNarchalDepartment of Pathology, D.Y. Patil Medical College and Research Centre, Kolhapur, IndiaMadhuraParicharakDepartment of Pathology, D.Y. Patil Medical College and Research Centre, Kolhapur, IndiaSSMoreDepartment of Pathology, D.Y. Patil Medical College and Research Centre, Kolhapur, IndiaJournal Article20140514Nevus lipomatosus cutaneous superficialis is a rare idiopathic hamartomatous anomaly of the skin characterized by the presence of clusters of mature fat cells among the collagen bundles of the dermis. The classic, or solitary type, presents with asymptomatic soft, skin-colored to yellow papules or nodules. We report the case of a 12-year-old boy with congenital, classical nevus lipomatosus cutaneous superficialis that started as a single painless nodule. Over time, the nodule developed into lesions that presented as skin-colored, well-defined, soft sessile growths with a cerebriform surface centered by comedo-like plugs that increased in size and spread over a large area (approximately 12×4 cm) over the right gluteal region. We report this case as it is an uncommon condition with the intent to highlight its clinical and histopathological features, and differential diagnosis.https://ijms.sums.ac.ir/article_39663_09b77065396825eb39a040d007cbe7ab.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639320140501A New Brace for Maintaining the Neck in a Suitable Position Following Tracheal Reconstruction30831039662ENBizhanZiaianDepartment of Thoracic Surgery, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranAliForoutanDepartment of General Surgery, Fagihi Hospital, Shiraz University of Medical Sciences, Shiraz, IranMaryamTahamtanDepartment of Internal Medicine, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran0000-0001-8129-1337SamMoslemiDepartment of General Surgery, Fagihi Hospital, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20140514Segmental resection and end-to-end anastomosis is the treatment of choice for patients suffering from tracheal stenosis for whom conservative management is not planned. A complication of this procedure is tension-induced anastomotic failure. To prevent this complication, maintaining the neck in full flexion by means of a suture between the chin and upper chest is a traditional approach. We have designed a new brace (Shiraz brace) that securely supports the neck in this position and decreases the bothersome use of the suture alone.https://ijms.sums.ac.ir/article_39662_54e2978f097a5dec3073d67798b321ce.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639320140501What about Memory, Consciousness, Recall, and Awareness in Anesthesia?31131239661ENMarcoCascellaDepartment of Anesthesia, Endoscopy and Cardiology, Division of Anesthesia, Pain Relief and Intensive Care Unit;
National Cancer Institute, Pascale Foundation, Naples, ItalyJournal Article20140514https://ijms.sums.ac.ir/article_39661_c4434a0bf1adc07d9325fc2973598ac4.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639320140501The Authors’ Reply31339665ENSayed Mohammad RezaHadaviAnesthesiology and Critical Care Research Center, Department of Anesthesiology, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, IranElahehAllahyaryAnesthesiology and Critical Care Research Center, Department of Anesthesiology, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, IranSamanAsadiAnesthesiology and Critical Care Research Center, Department of Anesthesiology, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20140514https://ijms.sums.ac.ir/article_39665_e63ad0b5e668a490ce0e3dbd02f89c77.pdf