Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639March Supplement20140317Peripheral Lymphadenopathy: Approach and Diagnostic Tools1581704410810.30476/ijms.2014.44108ENShahrzadMohseniDepartment of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IranAbolfazlShojaiefardResearch Center for Improvement of Surgical Outcomes and Procedures, Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IranZhamakKhorgamiResearch Center for Improvement of Surgical Outcomes and Procedures, Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IranShahriarAlinejadDepartment of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IranAliGhorbaniResearch Center for Improvement of Surgical Outcomes and Procedures, Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iranhttps://orcid.org/0000-0002-4817-7476AliGhafouriResearch Center for Improvement of Surgical Outcomes and Procedures, Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IranJournal Article20140317Peripheral lymph nodes, located deep in the subcutaneous tissue, clean antigens from the extracellular fluid. Generally, a normal sized lymph node is less than one cm in diameter. Peripheral lymphadenopathy (LAP) is frequently due to a local or systemic, benign, self-limited, infectious disease. However, it could be a manifestation of underlying malignancy. Seventy-five percent of all LAPs are localized, with more than 50% being seen in the head and neck area. LAP may be localized or generalized. Cervical lymph nodes are involved more often than the other lymphatic regions. Generally, it is due to infections, but most of the supraclavicular lymphadenopathies are associated with malignancy. Based on different geographical areas, the etiology is various. For example, in tropical areas, tuberculosis (TB) is a main benign cause of LAP in adults and children. Complete history taking and physical examination are mandatory for diagnosis; however, laboratory tests, imaging diagnostic methods, and tissue samplings are the next steps. Tissue diagnosis by fine needle aspiration biopsy or excisional biopsy is the gold standard evaluation for LAP. We concluded that in patients with peripheral LAP, the patient’s age and environmental exposures along with a careful history taking and physical examination can help the physician to request step by step further work-up when required, including laboratory tests, imaging modalities, and tissue diagnosis, to reach an appropriate diagnosis.https://ijms.sums.ac.ir/article_44108_e2c79dfc713ff78829dd4d74dbebec99.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639March Supplement20140317Comparison between Intravenous Sodium Valproate and Subcutaneous Sumatriptan for Treatment of Acute Migraine Attacks; Double-Blind Randomized Clinical Trial17117744109ENAbolghasemRahimdelDepartment of Neurology, Yazd University of Medical Science, Yazd, IranAliMellatDepartment of Neurology, Yazd University of Medical Science, Yazd, IranAhmadZeinaliDepartment of Neurology, Yazd University of Medical Science, Yazd, IranElaheJafariDepartment of Neurology, Yazd University of Medical Science, Yazd, IranParisaAyatollahiDepartment of Neurology, Yazd University of Medical Science, Yazd, IranJournal Article20140317Background: Sodium valproate (SV) has been approved for migraine prophylaxis and its intravenous form is used to treat acute migraine attacks. We compared the efficacy and safety of intravenous SV and subcutaneous Sumatriptan in managing acute migraine attacks. Methods: This double-blind randomized clinical trial divided 90 patients into two groups: one group received 400 mg of intravenous SV and the second group received 6 mg of subcutaneous Sumatriptan. Headache severity before treatment and half an hour, one hour, and two hours after treatment was measured based on the VNRS in the groups. Associated symptoms, i.e., photophobia, phonophobia, nausea, and vomiting, were assayed on admission and 2 hours after treatment. Side effects of the drugs were checked 2 hours after injection. Obtained data from the groups were compared.Results: In both groups, pain decrement at the mentioned time points was significant (P<0.001), but had no significant difference (P>0.05), indicating the similar effect of both drugs on pain improvement. In the SV group, photophobia, phonophobia, nausea, and vomiting were improved significantly, while in the Sumatriptan group, only photophobia and vomiting were decreased significantly, indicating the advantage of SV in improving the associated symptoms. Nausea, vomiting, facial paresthesia, and hypotension were more significantly frequent in the Sumatriptan group than in the SV group (P<0.05). Conclusion: Intravenous SV (400 mg) was as effective as subcutaneous Sumatriptan in the treatment of acute migraine attacks, but with more improvement in associated symptoms and with fewer side effects.Trial Registration Number: IRCT201108025943N4https://ijms.sums.ac.ir/article_44109_bcdfc04deb9969b56d2f94a6dc0ad859.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639March Supplement20140317Comparison between Topical and Oral Tranexamic Acid in Management of Traumatic Hyphema17818344110ENSeyed Hamid RezaJahadi HosseiniPoostchi Eye Research Center, Poostchi Clinic, Shiraz University of Medical Sciences, Shiraz, Iran;
Department of Ophthalmology, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, IranMohammad RezaKhaliliPoostchi Eye Research Center, Poostchi Clinic, Shiraz University of Medical Sciences, Shiraz, Iran;
Department of Ophthalmology, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, IranMahmoudMotallebiPoostchi Eye Research Center, Poostchi Clinic, Shiraz University of Medical Sciences, Shiraz, Iran;
Department of Ophthalmology, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20140317Background: We sought to determine the efficacy of topical tranexamic acid (5%) in the management of traumatic hyphema.Methods: Thirty eyes with gross traumatic hyphema were enrolled in this study. The patients were treated with tranexamic acid (5%) eye drop every 6 hours for 5 days. The main outcome measures were best corrected visual acuity (BCVA), Intra-ocular pressure (IOP), day of clot absorption, and rate of rebleeding. These parameters were evaluated daily for 4 days and thereafter at the 8th and 14th days after treatment. The patients were also compared with two historical control groups of patients (80 eyes) with traumatic hyphema; the first control group was treated with oral placebo and the other group was treated with oral tranexamic acid at our department.Result: Prior to treatment, the mean logarithm of the minimum angle of resolution (logMAR) BCVA was 0.59±0.62. BCVA was increased to 0.08±0.14 at day 14 (P<0.001) and the mean IOP before treatment was 13.7±3.9 mm Hg, which was reduced to 11.4±1.8 mm Hg at day 14 (P=0.004). Rebleeding occurred in one (3.3%) patient on the 4th day post treatment. Comparison between the case group and the other two historical control groups with respect to the rebleeding rate demonstrated statistically significant differences between the case group and the first control group (P=0.008) but no statistically significant differences between the case group and the second control group (P=0.25). Conclusion: Topical tranexamic acid seems promising in the management of traumatic hyphema. However, the small sample size of the present study precludes the conclusion that topical tranexamic acid can replace the oral tranexamic acid.https://ijms.sums.ac.ir/article_44110_20f7015c28a8315de95d81dfadc0349e.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639March Supplement20140317Slums’ Access to and Coverage of Primary Health Care Services: A Cross-Sectional Study in Shiraz, a Metropolis in Southern Iran18419044111ENHassanJoulaeiHIV/AIDS Research Centre,
Shiraz University of Medical Sciences, Shiraz, IranAzad RBhuiyanDepartment of Epidemiology and Biostatistics, Jackson State University, Mississippi, USAMehrabSayadiStatistics and Information Technology Unit, Shiraz University of Medical Sciences, Shiraz, IranFaribaMoradyShiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, IranParvinAfsar KazerooniControl and Surveillance of Diseases Unit, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20140317Background: The United Nations has predicted that the population of slum dwellers will have grown from one billion people worldwide to 2 billion by 2030. This trend is also predictable in Iran. In the Iranian metropolis of Shiraz, more than 10% of the residents live in slum areas. There are several problems regarding the delivery of social services in these areas. The aim of this study was to evaluate slums dwellers’ access to and coverage of health care. Methods: This cross-sectional face-to-face study included 380 household of slum dwellers via stratified random sampling. Demographics, accessibility of health services, coverage of health care, and route of receiving health services were recorded through interviews. Results: Approximately, 21.6% of the households had no physical access to health centers. The coverage rate of family planning programs for safe methods was 51.4% (95% CI: 48.86-53.9%). Vaccination coverage among children under 5 years old was 98% (95% CI: 97-99%). Furthermore, 34% of pregnant women had not received standard health care due to a lack of access to health centers.Conclusion: Limited access to health services along with inadequate knowledge of slum residents about health care facilities was the main barrier to the utilization of the health care in the slums.https://ijms.sums.ac.ir/article_44111_2b13b88cd86fce4097ac7c37546ed664.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639March Supplement20140317Association between HLA-Class I and HLA-Class II Alleles and Mycobacterium Tuberculosis Infection in Iraqi Patients from Baghdad City19119544112ENNidhal AbdulmohaimenMohammedDepartment of Microbiology, Al-Nahrain College of Medicine, Al-Nahrain University, Baghdad, IraqHaithamQassemMicrobiologist, College of Pharmacy, Al Mustansiyria University, Baghdad, IraqFaroukHassenDepartment of Microbiology, College of Medicine, Al Mustansiyria University, Baghdad, IraqJournal Article20140317Background: Pulmonary tuberculosis (PT) is one of the endemic diseases in Iraq, and among the suggested predisposing factors are alleles of the human leukocyte antigen (HLA) system. We sought to investigate the association between HLA-class I (A and B) and -class II (DR and DQ) alleles in a sample of PT Iraqi patients.Methods: lymphocytes of 105 PT patients and 40 controls were phenotyped for HLA-A, -B, -DR, and -DQ alleles by means of the microlymphocytotoxicity test using a panel of monoclonal antisera. Results: HLA frequencies of B18 (16.2 vs. 2.5%; OD=7.53) and DR1 (51.4 vs. 10.0%; OD=9.53) alleles were significantly increased in the patients as compared with the controls, while B5 (6.7 vs. 25.0%), DR8 (1.9 vs. 17.5%), and DQ3 (11.4 vs. 45.0%) alleles were significantly decreased. However, a significant corrected level was maintained for only DR1, DR8, and DQ3 alleles (Pc=1.9×10-5, 0.02 and 1.0×10-4, respectively).Conclusion: The results confirm the predisposing and protecting roles of HLA alleles in PT.https://ijms.sums.ac.ir/article_44112_11866d12954e5903e6441e5ea8e126bf.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639March Supplement20140317Expression Status of UBE2Q2 in Colorectal Primary Tumors and Cell Lines19620244113ENSayed MohammadShafieeDepartment of Biochemistry-Recombinant Protein Laboratory, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranAtefehSeghatoleslamDepartment of Biochemistry-Recombinant Protein Laboratory, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranMohsenNiksereshtCellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, IranSeyed VahidHosseiniColorectal Research Center, Shahid Faghihi Hospital, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-9228-3567MahvashAlizadeh-NaeeniDepartment of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranAkbarSafaeiDepartment of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranAli AkbarOwjiDepartment of Biochemistry-Recombinant Protein Laboratory, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, and
Endocrine and Metabolism Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20140317Background: Activation of the ubiquitin-proteasome pathway in various malignancies, including colorectal cancer, is established. This pathway mediates the degradation of damaged proteins and regulates growth and stress response. The novel human gene, UBE2Q2, with a putative ubiquitin-conjugating enzyme activity, is reported to be overexpressed in some malignancies. We sought to investigate the expression levels of the UBE2Q2 gene in colorectal cell lines as well as in cancerous and normal tissues from patients with colorectal cancer. Methods: Levels of UBE2Q2 mRNA in cell lines were assessed by Real-Time PCR. Western blotting was employed to investigate the levels of the UBE2Q2 protein in 8 colorectal cell lines and 43 colorectal tumor samples. Results: Expression of UBE2Q2 was observed at the level of both mRNA and protein in colorectal cell lines, HT29/219, LS180, SW742, Caco2, HTC116, SW48, SW480, and SW1116. Increased levels of UBE2Q2 immunoreactivity was observed in the 65.11% (28 out of 43) of the colorectal carcinoma tissues when compared with their corresponding normal tissues. Difference between the mean intensities of UBE2Q2 bands from cancerous and normal tissues was statistically significant at Phttps://ijms.sums.ac.ir/article_44113_6a3c6d053b12dc73f4645ce118af0e83.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639March Supplement20140317Cardiomyocyte Marker Expression in Mouse Embryonic Fibroblasts by Cell-Free Cardiomyocyte Extract and Epigenetic Manipulation20321244114ENTaherehTalaei-KhozaniLaboratory for Stem Cell Research, Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, and Department of Tissue Engineering, School of Advance Sciences and Technology, Shiraz University of Medical Sciences, Shiraz, IranFatemehHeidariLaboratory for Stem Cell Research, Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranTaherehEsmaeilpourLaboratory for Stem Cell Research, Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranZahraVojdaniLaboratory for Stem Cell Research, Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran0000-0001-8214-2309ZohrahMostafavi-PourDepartment of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranLeiliRohaniLaboratory for Stem Cell Research, Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20140317Background: The regenerative capacity of the mammalian heart is quite limited. Recent reports have focused on reprogramming mesenchymal stem cells into cardiomyocytes. We investigated whether fibroblasts could transdifferentiate into myocardium.Methods: Mouse embryonic fibroblasts were treated with Trichostatin A (TSA) and 5-Aza-2-Deoxycytidine (5-aza-dC). The treated cells were permeabilized with streptolysin O and exposed to the mouse cardiomyocyte extract and cultured for 1, 10, and 21 days. Cardiomyocyte markers were detected by immunohistochemistry. Alkaline phosphatase activity and OCT4 were also detected in cells treated by chromatin-modifying agents.Results: The cells exposed to a combination of 5-aza-dC and TSA and permeabilized in the presence of the cardiomyocyte extract showed morphological changes. The cells were unable to express cardiomyocyte markers after 24 h. Immunocytochemical assays showed a notable degree of myosin heavy chain and α-actinin expressions after 10 days. The expression of the natriuretic factor and troponin T occurred after 21 days in these cells. The cells exposed to chromatin-modifying agents also expressed cardiomyocyte markers; however, the proportion of reprogrammed cells was clearly smaller than that in the cultures exposed to 5-aza-dC , TSA, and extract. Conclusion: It seems that the fibroblasts were able to eliminate the previous epigenetic markers and form new ones according to the factors existing in the extract. Since no beating was observed, at least up to 21 days, the cells may need an appropriate extracellular matrix for their function.https://ijms.sums.ac.ir/article_44114_45ecd065495ee2ac7233d6c533947a10.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639March Supplement20140317Indicators Developed to Evaluate the International Framework Convention on Tobacco Control in Iran; A Grounded Theory Study21321744115ENNizalSarrafzadeganCardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranKatayounRabieiRehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranHeidaraliAbediDepartment of Nursing, Faculty of Nursing and Midwifery, Khorasgan (Isfahan) Branch, Islamic Azad University, Isfahan, IranRoyaKelishadiCardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranKhadijehFereydoun MohaseliDirector, National Tobacco Control Secretariat, Ministry of Health,
Tehran, IranMousaAlaviNursing Research Center, Isfahan University of Medical Sciences,
Isfahan, IranHamidrezaRoohafzaRehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20140317This study aimed to develop indicators for evaluating the implementation of The Framework Convention on Tobacco Control (FCTC) in Iran. We used the “grounded theory” framework. Totally, 265 policy-makers, stakeholders, and community members were recruited by purposeful sampling in 2008. After analyzing the gathered data, 251 indicators, including 82 indicators as “applied indicators”, were derived from second-level codes for three groups. A suitable evaluation questionnaire can be designed based on the extracted indicators for policy makers, stakeholders, and the community to follow the implementation of the FCTC in Iran.https://ijms.sums.ac.ir/article_44115_3d62826f7b5ff196caf0eb90f2db4a02.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639March Supplement20140317Safety of a Trivalent Inactivated Influenza Vaccine in Health Care Workers in Kurdistan Province, Western Iran; A Longitudinal Follow-up Study21822244116ENJafarSoltaniDepartment of Pediatrics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, IranMohamadJamil AmjadiSanandaj Center for Disease Control and Prevention, Kurdistan University of Medical Sciences, Sanandaj, IranJournal Article20140317We studied the safety of a trivalent inactivated surface antigen (split virion, inactivated) influenza vaccine, Begrivac® (Novartis Company), widely used in health care workers in Kurdistan. A longitudinal follow-up study was performed in Sanandaj city, west of Iran, recruiting 936 people. A questionnaire was completed for each participant, and all symptoms or abnormal physical findings were recorded. In part 1 of the study, the post-vaccination complaints were headache (5.3%), fever (7.9%), weakness (9.6%), chills (10.1%), sweating (10.5%), arthralgia (20.2%), and malaise (21.5%). Swelling of the injection site was seen in 267 (30.3%) participants, and pruritus of the injection site was seen in 290 (32.9%) participants. Redness and induration were also reported in 42.5% of the participants. Local reactions were mainly mild and lasted for 1-2 days. No systemic reactions were reported in the second part of the study. None of the participants experienced any inconvenience. We concluded that local adverse reactions after the trivalent inactivated split influenza vaccine, Begrivac®, in health care workers were far more common than expected. Continuous surveillance is needed to assess the potential risks and benefits of newly produced influenza vaccines.https://ijms.sums.ac.ir/article_44116_b4b920b75022a249c134640421cecec9.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639March Supplement20140317Prolonged Hemoptysis Caused by Primary Pulmonary Epithelioid Hemangioendothelioma; A Case Report and Review of the Literature22322744117ENBitaGeramizadehTransplant Research Center, Department of Pathology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranBejanZiyaianDepartment of Surgery, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranMehdiDehghaniDepartment of Internal Medicine, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-2979-0865KamranTahmasebiTransplant Research Center, Department of Pathology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20140317Epithelioid hemangioendothelioma is a vascular tumor with an intermediate malignant potential. This tumor is very rare in the lung parenchyma, and most of the previously reported cases have been asymptomatic. There is no standard therapy for this tumor and prognosis in the previous reports has been variable.Herein we report our experience with a 60-year-old woman presenting with hemoptysis and multiple lung consolidation, leading to a diagnosis of epithelioid hemangioendothelioma after surgical resection and pathological examination. After surgery and chemotherapy, the patient had an acceptable course.https://ijms.sums.ac.ir/article_44117_ea70ee5e396c0f8bbd99842ced495001.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639March Supplement20140317Gastric Duplication Cyst in a man Presenting with Elevated Liver Enzymes and Icterus22823144118ENSeyed AliMalekhosseiniTransplant Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IranFaridMoradianDepartment of Surgery, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20140317Gastric duplication cysts comprise 2-7% of gastrointestinal duplications, rare congenital malformations that can be present at almost any part of the alimentary tract. They mostly present with gastrointestinal obstruction symptoms, ulceration, and painless hemorrhage. Symptoms include nausea, vomiting, and fullness sensation. Gastric duplications are mostly cystic in shape. Herein, we present a 58-year-old man with a gastric duplication cyst, 70×30×35 mm in size, with the initial presentation of abdominal pain, icterus, and elevated liver enzymes. The patient provided informed consent for this report.https://ijms.sums.ac.ir/article_44118_eaa58e49a1c33c1cb07b32ba16c54a67.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071639March Supplement20140317Month of Birth and the Incidence of Multiple Sclerosis in Southern Iran23223344119ENAlirezaNiksereshtDepartment of Neurology, Motahari Clinic, Shiraz University of Medical Sciences, Shiraz, IranMaryamSharifianDepartment of Neurology, Motahari Clinic, Shiraz University of Medical Sciences, Shiraz, Iran, and Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IranAlirezaHamidian JahromiDepartment of Surgery, Louisiana State University Health Sciences Center, Shreveport, LA, USAJournal Article20140317https://ijms.sums.ac.ir/article_44119_7b0b6015951be21f62f117987f1d7651.pdf