Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071643120180101Subtypes of Benign Breast Disease as a Risk Factor for Breast Cancer: A Systematic Review and Meta-Analysis Protocol184049910.30476/ijms.2018.40499ENManooshZendehdelResearch Vice-Chancellorship, Guilan University of Medical Sciences, Rasht, IranBabakNiakanGuilan University of Medical Sciences, Rasht, IranAbbasaliKeshtkarDepartment of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, IranElaheRafieiResearch Vice-Chancellorship, Guilan University of Medical Sciences, Rasht, IranFatemehSalamatResearch Vice-Chancellorship, Guilan University of Medical Sciences, Rasht, IranJournal Article20160504AbstractBreast cancer is a multifactorial disease. Benign breast disease (BBD) is one of the most important risk factors for breast cancer. The etiology of BBD is unknown. It is divided into nonproliferative and proliferative diseases. The selection of studies will be based on titles, abstract screening, inclusion and exclusion criteria, and quality assessment. Previous studies have shown that all types of BBD increase the risk of breast cancer, but the risk degree is different for each one. Accurate risk estimation of breast cancer in each category can be very important for proper clinical management. This systematic review and meta-analysis will be conducted on observational studies (traditional case control, nested case control, case cohort, and cohort) published in the Web of Science (ISI), PubMed (MEDLINE), Scopus, Google Scholar, and the key journals of this field such as Breast Cancer Research and Treatment and Cancer Research from January 2000 to June 2015. Reference lists and gray literature will be reviewed too. All the initial retrievals will be performed by 2 researchers independently. The data extraction form will consist of general information concerning the studies, study eligibility, method, risk of bias assessment, and results—including odds ratios, risk ratios, rate ratios, and hazard ratios. The PRISMA and MOOSE guidelines will be used to report our findings.Registration Details: PROSPERO-42016035243https://ijms.sums.ac.ir/article_40499_166a899a79f3850d57a1ba165e0e6d05.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071643120180101Effects of Folic Acid on Appetite in Children with Attention Deficit Hyperactivity Disorder (ADHD) Treated with Methylphenidate: A Randomized Double-Blind Clinical Trial9174050010.30476/ijms.2018.40500ENForoughRiahiDepartment of Psychiatry, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranAshrafTashakoriDepartment of Psychiatry, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranGhazalSalehi VananiDepartment of Psychiatry, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranJournal Article20160824Background: The highly effective medications in treating attention deficit hyperactivity disorder (ADHD) symptoms are stimulants like methylphenidate. However, they have adverse effects like reduced appetite. We investigated the effects of folic acid on reduced appetite caused by the use of methylphenidate in children with ADHD.Methods: This randomized double-blind clinical trial evaluated 70 outpatients, aged between 6 and 12 years, with a diagnosis of ADHD. The children were recruited from the Outpatient Child and Adolescent Psychiatric Clinic of Golestan Hospital (Ahwaz, Iran) between 2016 and 2017. The study subjects were randomly assigned to 2 groups: Group 1 received an average dose of methylphenidate (1 mg/kg) plus folic acid (5 mg/d) and Group 2 received an average dose of methylphenidate (1 mg/kg) plus a placebo (5 mg of sucrose) for 8 weeks. Assessments, comprising the Conners Parent Questionnaire, anthropometric measurements, and appetite questionnaire, were conducted by a psychiatrist at baseline and then at 2, 4, 6, and 8 weeks after the medication was started using repeated measure analysis. The data were analyzed with the Mann–Whitney U and ANOVA tests using the SPSS statistical software (v. 18.0).Results: Age and gender were not associated with the groups. Weight, height, and the body mass index were not changed during the study in both groups. ADHD symptoms significantly decreased in both groups during the trial; however, no difference was observed between the groups. Moreover, appetite was significantly improved in Group 1. Both medications were well tolerated.Conclusion: It seems that folic acid improved the reduced appetite caused by the use of methylphenidate in our children with ADHD.Trial Registration Number: IRCT2016040927304N1https://ijms.sums.ac.ir/article_40500_a1bdfa38199269f8ce7058b2ac361021.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071643120180101Inhibition of the CatSper Channel and NOX5 Enzyme Activity Affects the Functions of the Progesterone-Stimulated Human Sperm18254050510.30476/ijms.2018.40505ENHamidehGhanbariDepartment of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranSaraKeshtgarDepartment of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-5358-2679MarjanehKazeroniShiraz Infertility Center, Shiraz, IranJournal Article20161009Background: Low levels of reactive oxygen species (ROS) and calcium are necessary for sperm function. NADPH oxidase 5 (NOX5) is a membrane enzyme which produces ROS. This enzyme is dependent on calcium for its activity. We investigated the importance of NOX5 and an important calcium channel (CatSper) on sperm function.Methods: This laboratory in-vitro study was done in Shiraz, Iran, 2016. Normal semen samples (n=24) were washed and diluted to 20×106 sperm/mL. The diluted samples were divided into 8 groups, containing Ham’s F-10 (control group), 2 µM of NNC (CatSper channel inhibitor), 1 µM DPI (NOX5 inhibitor), and NNC+DPI. The other 4 groups were the same as the 1st ones, except that they contained 1 µM of progesterone. Motility assessment was done by VT–Sperm 3.1. Acrosome status was monitored with acrosome-specific FITC-PSA using fluorescent microscopy. Sperm viability was assessed by Eosin Y. Statistical analysis was performed using SPSS 16 software. The comparison between the groups was done using the one-way ANOVA, followed by Tukey. A Phttps://ijms.sums.ac.ir/article_40505_46d93a83f4a4a64c1839b13432a26e5d.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071643120180101Regression of Nonalcoholic Fatty Liver Disease with Zinc and Selenium Co-supplementation after Disease Progression in Rats26314050810.30476/ijms.2018.40508ENFarzadShidfarIran National Science Foundation, Tehran, Iran; Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran;
and Colorectal Research Center, Iran University of Medical Sciences, Tehran, IranAmirhoseinFaghihiIran National Science Foundation, Tehran, Iran; and Colorectal Research Center, Iran University of Medical Sciences, Tehran, IranHamidLorvand AmiriIran National Science Foundation, Tehran, Iran; and Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, IranSeyedeh NedaMousaviIran National Science Foundation, Tehran, Iran; and Department of Biochemistry and Nutrition, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran0000-0003-2075-1306Journal Article20160830Background: Studies have shown that zinc and selenium deficiency is common in nonalcoholic fatty liver disease (NAFLD). However, the effects of zinc and selenium co-supplementation before and/or after disease progression on NAFLD are not clear enough. The aim of this study was to compare the effects of zinc and selenium co-supplementation before and/or after disease progression on NAFLD prognosis.Methods: Forty male Sprague–Dawley rats (197±4 g) were randomly assigned to 4 dietary groups: normal-fat diet (NFD; receiving 9% of calories as fat), high-fat diet (HFD; receiving 82% of calories as fat), supplementation before disease progression (S+HFD), and supplementation after disease progression (HFD+S). The diets were implemented over a 20-week period in all the groups. Biochemical and histologic parameters were compared between the 4 groups, and between-group comparisons were also carried out.Results: There were significant differences in the average food dietary intake (Phttps://ijms.sums.ac.ir/article_40508_3283036811d7fdd92b9c6ebc5b5a2530.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071643120180101Effects of the Oral Ingestion of Probiotics on Brain Damage in a Transient Model of Focal Cerebral Ischemia in Mice32404051110.30476/ijms.2018.40511ENKobraAkhoundzadehResearch Center and Department
of Physiology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, IranAbedinVakiliResearch Center and Department
of Physiology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, IranMahdiShadnoushResearch Center and Department
of Physiology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran; and Department of Clinical Nutrition Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0000-0000-0000JafarSadeghzadehResearch Center and Department
of Physiology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, IranJournal Article20160921Background: Probiotics are microorganisms that may influence brain function via altering brain neurochemistry. New research evidence suggests that probiotic bacteria might protect tissue damage through diminishing the production of free radicals and/or inflammatory cytokines. Therefore, this study was designed to evaluate the effects of probiotic bacteria on the prevention or reduction of brain damage in an experimental model of stroke in mice.Methods: In this study, 30 male BLC57 mice were randomly divided into 6 equal groups. Focal cerebral ischemia was induced via middle cerebral artery occlusion for 45 minutes, followed by 24 hours of reperfusion, in the mice. Probiotics at a concentration of 107 CFU/mL were administered by oral gavage daily for 14 days before ischemia. Infarct size, neurological outcome, and biochemical markers were measured 24 hours after brain ischemia. Statistical analysis were performed using the one-way ANOVA and/or Kruskal–Wallis ANOVA on rank by Sigma Stat (2.0; Jandel Scientific) software.Results: Our results indicated that pretreatment with probiotics significantly reduced infarct size by 52% (P=0.001) but could not improve neurological function (P=0.26). Moreover, the administration of probiotics significantly decreased the malondialdehyde content (P=0.001) and the tumor necrosis factor-alpha level (P=0.004) in the ischemic brain tissue. Conclusion: The findings of the present study showed that probiotic supplements might be useful in the prevention or attenuation of brain ischemic injury in patients at risk of stroke. Probiotics may open new therapeutic alternatives for the prevention of stroke. More preclinical and clinical studies are, however, needed to clarify their efficacy in cerebral stroke.https://ijms.sums.ac.ir/article_40511_4c4e507c33a996d89cdd58187bf021c8.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071643120180101Radioprotective Efficacy of Lutein in Ameliorating Electron Beam Radiation-induced Oxidative Injury in Swiss Albino Mice41514051210.30476/ijms.2018.40512ENVidyaVasudevaCentral Research Laboratory(CRL), K S Hegde Medical Academy, Nitte University, Mangalore, KarnatakaYogish SomayajiTenkanidiyoorCentral Research Laboratory(CRL), K S Hegde Medical Academy, Nitte University, Mangalore, KarnatakaAlex JohnPeterDepartment of Oncology, Nitte Leela Narayana Shetty Memorial Cancer Institute, Mangalore, KarnatakaJayaramShettyDepartment of Oncology, Nitte Leela Narayana Shetty Memorial Cancer Institute, Mangalore, KarnatakaSrikant PatilLakshmanDepartment of Physiology, K S Hegde Medical Academy, Nitte University, Mangalore, KarnatakaRonaldFernandesDepartment of Biochemistry, Nitte Gulabi Shetty Memorial Institute
of Pharmaceutical Sciences, Nitte University, Mangalore, KarnatakaKrishna AnanthapuraPataliDepartment of Physiology, K S Hegde Medical Academy, Nitte University, Mangalore, KarnatakaJournal Article20160808Background: Lutein, a carotenoid compound, has previously been studied for its antioxidant and medicinal properties as well as the moderate protection it confers against gamma radiation. This study aimed at evaluating the effects of lutein against radiation-induced hematological and biochemical changes in mice.Methods: The optimized dose of the compound was orally administered for 15 days, and the mice were irradiated (6 Gy) on day 15 after the administration of the compound. The groups were divided (6 mice in each group) into normal control, radiation control, gallic acid control, 10% DMSO control, lutein control, and irradiated groups pretreated with gallic acid, 10% DMSO, and lutein. Gallic acid was used to maintain a standard since it is a proven radioprotector. Within 24 hours post irradiation, the animals were anesthetized and sacrificed. The hematological, biochemical, and antioxidant changes were determined using suitable methods. Data were analyzed by the Kaplan–Meier curve (log-rank test) and ANOVA (the Tukey test). The independent t test was used to compare the independent groups. SPSS (ver. 16) was employed. Results: Maximum survival was observed with a dose of 250 mg/kg b.wt lutein. The total leukocyte count and the percentage lymphocyte count exhibited a significant decline in the irradiated groups pretreated with gallic acid and lutein in comparison to their controls, whereas the percentage granulocyte count showed a significant rise. Antioxidant activity had markedly declined in the irradiated groups, indicating oxidative stress. Lutein pretreatment reduced the damage and maintained the antioxidant system.Conclusion: The present study suggests a protective role for lutein in palliating radiation-induced oxidative changes and maintaining the antioxidant system in vivo.https://ijms.sums.ac.ir/article_40512_b345e02411a89df535b251c73d324c4e.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071643120180101Antiproliferative Effects of Pancratium Maritimum Extracts on Normal and Cancerous Cells52644051310.30476/ijms.2018.40513ENGhalebTayoubDepartment of Molecular Biology
and Biotechnology, Atomic Energy Commission of Syria, Damascus, SyriaMohmadAl-OdatDepartment of Radiation Protection and Safety, Atomic Energy Commission of Syria, Damascus, SyriaAmalAmerDepartment of Molecular Biology
and Biotechnology, Atomic Energy Commission of Syria, Damascus, SyriaAbdulmunimAljapaweDepartment of Molecular Biology
and Biotechnology, Atomic Energy Commission of Syria, Damascus, SyriaAdnanEkhtiarDepartment of Molecular Biology
and Biotechnology, Atomic Energy Commission of Syria, Damascus, SyriaJournal Article20160829Background: Plants are an important natural source of compounds used in cancer therapy. Pancratium maritimum contains potential anti-cancer agents such as alkaloids. In this study, we investigated the anti-proliferative effects of P. maritimum extracts on MDA-MB-231 human epithelial adenocarcinoma cell line and on normal lymphocytes in vitro. Methods: Leaves, flowers, roots, and bulbs of P. maritimum were collected and their contents were extracted and diluted to different concentrations that were applied on MDA-MB-231 cells and normal human lymphocytes in vitro for different intervals. Cells viability, proliferation, cell cycle distribution, apoptosis, and growth were evaluated by flow cytometry and microscopy. Parametric unpaired t-test was used to compare effects of plant extracts on treated cell cultures with untreated control cell cultures. IC50 was also calculated.Results: P. maritimum extract had profound effects on MDA-MB-321 cells. It inhibited cell proliferation in a dose- and time-dependent manner. The IC50 values were 0.039, 0.035, and 0.026 mg/ml after 48, 72, and 96 hours of treatment with 0.1 mg/ml concentration of bulb extract, respectively. Those values were 0.051 and 0.03 mg/ml after 72 and 96 hours for root extract, respectively, and 0.048 mg/ml after 96 hours for flower extract. There were no significant effects of P. maritimum bulb extracts on normal lymphocytes proliferation.Conclusion: P. maritimum extract has anti-proliferative effects on MDA-MB-231 cell line in vitro. The effects imply the involvement of mechanisms that inhibits cell growth and arresting cells at S and G2/M phases. Cyclin B1, Bcl-2, and Ki67 expression was also affected. https://ijms.sums.ac.ir/article_40513_4c3d6101d7b64425cde052e4e60b347f.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071643120180101Evaluation of Psychopathology and Quality of Life in Patients with Anogenital Wart Compared to Control Group65694050210.30476/ijms.2018.40502ENMahsaNahidiPsychiatry and Behavioural Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, IranYaldaNahidiCutaneous Leishmaniasis Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, IranAliSaghebiPsychiatry and Behavioural Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-4103-8713GolsanKardanCutaneous Leishmaniasis Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, IranLidaJarahiDepartment of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0001-7753-6610BehzadAminzadehDepartment of Radiology, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranPardisShojaeiDepartment of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMohammad RezaFayyazi BordbarPsychiatry and Behavioural Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-4916-1775Journal Article20170303Anogenital warts (AGW) are one of the most common venereal diseases. Psychosocial complications and quality of life (QoL) of AGW patients have been considered only in recent years. Herein, the QoL and psychopathology in patients with AGW are evaluated. In total, 37 AGW patients and 37 healthy controls were recruited in the present cross-sectional study. All participants were provided with the symptom checklist 90-R (SCL-90-R) and short-form (SF-36) questionnaires. All analyses were performed using the SPSS software, version 16.0.1 for Windows. QoL was not significantly different between the study groups (P=0.12). The data showed that mental health, general health, and social functioning were significantly decreased in AGW patients (P<0.05). In addition, AGW patients were significantly more depressed and anxious than the control group (P=0.01 and P=0.04, respectively). AGW has adverse effects on psychological and QoL elements of the infected individuals. Psychological factors should be carefully considered when treating a patient with the HPV virus; hence, referral to a psychiatrist seems mandatory in these cases.https://ijms.sums.ac.ir/article_40502_8fdd6e85d1e744c64dba9492ba2ea0d2.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071643120180101The Effect of Prophylactic Infusion of Combined Ephedrin and Phenylephrine on Maternal Hemodynamic after Spinal Anesthesia for Cesarean Section: A Randomized Clinical Trial70744050610.30476/ijms.2018.40506ENSiminAtashkhoieAnesthesiology and Intensive Care Medicine, Tabriz University of Medical Sciences, Tabriz, IranHojatPourfathiAnesthesiology and Intensive Care Medicine, Tabriz University of Medical Sciences, Tabriz, IranBahmanNaghipourAnesthesia department, Madani Heart Hospital, University Street, Tabriz, IranShahlaMeshgiMedical Student, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, IranJournal Article20170408Several techniques have been proposed to prevent hypotension in obstetric patients. Ephedrine and phenylephrine are individually used to prevent maternal hypotension; however, each has its own drawbacks. Some researchers have reported that the infusion of combined ephedrine and phenylephrine immediately after spinal anesthesia for cesarean delivery reduces the incidence of maternal hypotension. Other studies have indicated that the combination is not superior to the infusion of an individual agent. The present study aimed to evaluate the effect of prophylactic infusion of ephedrine and phenylephrine before the induction of spinal anesthesia for cesarean section on maternal hemodynamic. In a randomized, double-blinded clinical trial study, 90 pregnant women that underwent elective cesarean delivery under spinal anesthesia were recruited. Before the spinal anesthesia, the infusion of combined ephedrine and phenylephrine during 15 minutes (study group) or serum NaCl 0.9% (placebo group) was performed. Hemodynamic parameters and fetal blood gas were recorded. The data were analyzed using the SPSS software, version 16.0. The results showed that hypotension and bradycardia after spinal anesthesia were less in the study group. The need for vasopressors and inotropes to treat hypotension, nausea, and vomiting were higher in the placebo group. First- and fifth-minute Apgar scores were higher in the study group. The prophylactic infusion of low-dose ephedrine and phenylephrine before spinal anesthesia for cesarean delivery can be used to decrease the frequency and severity of maternal hypotension and its side effects to the mother and neonate. Trial Registration Number: IRCT201401277013N6https://ijms.sums.ac.ir/article_40506_45e1bf590ff7c584fb24c25dddda90b0.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071643120180101Classic versus Inguinal Approach for Obturator Nerve Block in Transurethral Resection of Bladder Cancer under Spinal Anesthesia: A Randomized Controlled Trial75804050910.30476/ijms.2018.40509ENDawoodAghamohammadiPain and Palliative Center, Tabriz University of Medical Sciences,
Tabriz, IranRezaMovassaghi GargariPain and Palliative Center, Tabriz University of Medical Sciences,
Tabriz, IranSolmazFakhariPain and Palliative Center, Tabriz University of Medical Sciences,
Tabriz, IranEissaBilehjaniDepartment of Anesthesiology, Madani Heart Hospital, Tabriz University of Medical Sciences, Tabriz, Iran0000-0002-3196-2865SepidehPoorsadeghFaculty of Medicine, Tabriz University of Medical Sciences, Tabriz, IranJournal Article20170112Single spinal anesthesia in transurethral resection of bladder tumor (TURBT) has been reported to be unable to prevent obturator nerve stimulation and adductor muscle contraction, which can cause complications like bladder perforation. The present study aimed to compare the effectiveness of the classic and inguinal approaches for obturator nerve block (ONB). Seventy patients with cancers of the lateral wall of the bladder, scheduled to undergo TURBT at Imam Reza Hospital (Tabriz, Iran) during a 6-month period as of June 2016, were randomly allocated to groups of inguinal and classic methods (n=35). After the infusion of 500 mL of normal saline, spinal anesthesia was commenced using 3 mL (15 mg) of bupivacaine. Then ONB was performed using 10 mL of 1% lidocaine via the inguinal or classic approach in the inguinal group or the classic group, respectively. The success rate, defined as lack of post-block contraction with stimulation or during surgery, number of puncture attempts, time of block onset, and patient and surgeon satisfaction, was compared between the 2 methods using SPSS, version 19. The success rate of ONB was significantly higher in the inguinal group (97.1% vs. 71.4%; P=0.003). The number of puncture attempts in the classic group was more than that in the inguinal group (3.71±1.10 vs. 1.66±0.68, respectively; P<0.001). The block onset time was shorter in the inguinal group (1.5±0.66 min vs. 2.9±1.18 min; P<0.001). Dissatisfaction of the patient (19 cases vs. 2 cases) and the surgeon (10 cases vs. no case) was higher in the classic group (P<0.001).Compared to the classic approach, the inguinal approach for ONB appeared to be an easily performable, effective block with a high success rate, rapid onset, and good patient and surgeon satisfaction.Trial Registration Number: IRCT 201608171772N21https://ijms.sums.ac.ir/article_40509_9ff319e3656a74c64bbe317464d22575.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071643120180101Pachydermoperiostosis in a Patient with Crohn’s Disease: Treatment and Literature Review81854050110.30476/ijms.2018.40501ENMaryamMobiniDepartment of Internal Medicine, Diabetes Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran0000-0002-2751-5907OzraAkhaDepartment of Internal Medicine, Diabetes Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, IranHafezFakheriDepartment of Gastroenterology, Inflammatory Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, IranHadiMajidiDepartment of Radiology, Orthopedic Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, IranSanamFattahiMedical Student, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, IranJournal Article20161104Pachydermoperiostosis (PDP) is a rare disorder characterized by pachydermia, digital clubbing, periostitis, and an excess of affected males. It is the primary form of hypertrophic osteoarthropathy (HOA) and there are some rare associations of PDP with other disorders. Here we describe a patient with Crohn’s disease associated with PDP. A 26-year-old man, who was a known case of Crohn’s disease, referred with diffuse swelling in the upper and lower limbs and cutis verticis gyrata since 7 years ago. PDP was suspected and endocrinological and radiological studies were conducted for the evaluation of underlying disease. He was prescribed celecoxib, low-dose prednisolone, and pamidronate to control the swelling, periostitis, azathiopurine, and mesalazine according to gastrointestinal involvement. In conclusion, it is important to identify this condition since a misdiagnosis might subject the patient to unnecessary investigations.https://ijms.sums.ac.ir/article_40501_3c17d8b252ea364f3a560c8fececc43b.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071643120180101Atypical Kawasaki Disease Presenting with Hemiparesis and Aphasia: A Case Report86894050410.30476/ijms.2018.40504ENAliNikkhahDepartment of Pediatric Neurology, Mazandaran University of Medical Sciences, Sari, IranJournal Article20160909Kawasaki disease (KD) is an inflammatory vasculitis. KD is classified into two groups based on clinical characteristics criteria, namely classic and incomplete. Cerebral vascular abnormality, especially arterial ischemic stroke (AIS) is very rare and unusual in KD. Here, we report a 4-year-old boy who was referred to our tertiary pediatric center with abrupt right hemiparesis and aphasia. At admission time, he had febrile illness and was toxic. On physical examination, we found unilateral left submandibular lymphadenopathy. On neurologic examination, we obtained right sided hemiparesis with hemiparetic gait and aphasia. His deep tendon reflexes (DTRs) of right extremities were exaggerated and his sensory system was intact. Based on these features, some differential diagnoses were suggested, such as acute encephalitis with focal signs, brain abscess, cerebral vasculitis, hemorrhagic insults, and ischemic stroke, etc. After a complete evaluation, especially brain MRI and MRA, our diagnosis was arterial ischemic stroke (AIS) following atypical KD. Based on these findings, we administered intravenous immunoglobulin (IVIG 2 gm/kg) and oral high dose aspirin (100 mg/kg/d). He responded to these anti-inflammatory treatments dramatically.https://ijms.sums.ac.ir/article_40504_cb74996a1a2c7743da54d8a177f80603.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071643120180101Papillary Carcinoma of Thyroid with Nasal Cavity Metastases: A Case Report90934050710.30476/ijms.2018.40507ENSaeidPourseirafiDepartment of Ear, Nose, Throat, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, IranMahmoodShishehgarDepartment of Ear, Nose, Throat, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, IranMohammad JavadAshrafDepartment of Pathology, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, IranMohammadFaramarziDepartment of Ear, Nose, Throat, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20160805Papillary thyroid carcinoma (PTC) is one of the most commonly diagnosed types of differentiated carcinoma of the thyroid. It is stated that lung is the most common site of metastasis followed by bone. The incidence of paranasal sinus (PNS) metastasis is fairly uncommon in case of thyroid carcinoma. To the best of our knowledge, no case of metastatic PTC to nasal cavity has been reported. In this case report, we present the first case of papillary carcinoma of the thyroid with nasal cavity metastases in a 55-year-old female. The patient underwent surgical treatment and the mass was completely removed and sent for pathology. The pathology report revealed that it was metastatic papillary cell carcinoma. Surgical approach is usually difficult in view of the cosmetic and functional concerns, but may be considered in selected cases. As described herein, this rare type of metastasis was successfully removed and the patient was symptoms free after 1-year follow-up.https://ijms.sums.ac.ir/article_40507_5e22682cddc65431710b2ab206ad613d.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071643120180101Tubercular Mycobacterial Spindle Cell Pseudotumour: A Case Report94964051010.30476/ijms.2018.40510ENDeba PrasadDhibarDepartment of Internal Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, IndiaKamal KantSahuDepartment of Internal Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, IndiaSurjitSinghDepartment of Internal Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, IndiaAmanjitBalDepartment of Histopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, IndiaAbhijitChougaleDepartment of Histopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, IndiaVarunDhirDepartment of Internal Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, IndiaJournal Article20160713Pseudotumour is a benign inflammatory lesion. Mycobacterial spindle cell pseudotumour (MSP) is a rare pseudotumour. It is a benign proliferation of spindle-shaped histiocytes containing acid-fast mycobacterium, commonly reported in immunocompromised patients. MSP is usually associated with mycobacterium avium complex (MAC). Here, we present the case of a 38-year-old gentleman with acquired immune deficiency syndrome (AIDS) who presented with low-grade fever for 1-month duration. Clinically, he had generalised lymphadenopathy. Chest X-ray showed miliary infiltration in bilateral lung fields. Lymph nodal biopsy showed spindle-shaped histiocytes filled with acid-fast bacilli on Ziehl-Neelsen (ZN) stain, suggestive of MSP. Immunohistochemical (IHC) stains were positive for CD68, S-100 and negative for CD31, which are consistent with MSP. Polymerase chain reaction (PCR) of the biopsy tissue was positive for MTB. Highly active antiretroviral therapy (HAART) was continued and anti-tubercular therapy (ATT) was started. The fever resolved within two weeks and there was a resolution of lymph nodal swelling by 6 weeks. The diagnosis of MSP associated with mycobacterium tuberculosis (MTB) makes our case interesting. It is of utmost importance to differentiate MSP from Kaposi’s sarcoma (KS) and other pseudotumours and to know whether it is of tubercular or non-tubercular origin, as the treatment is entirely different.https://ijms.sums.ac.ir/article_40510_eca6fe4447719322fab88090ff7814ac.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071643120180101Primordial Odontogenic Tumor of Mandible; A Case with Proposed Diagnostic Criteria97994050310.30476/ijms.2018.40503ENNileshPardheDepartment of Oral and Maxillofacial Pathology, NIMS Dental College, Jaipur, IndiaManasBajpaiDepartment of Oral and Maxillofacial Pathology, NIMS Dental College, Jaipur, IndiaJournal Article20170621https://ijms.sums.ac.ir/article_40503_68255b363eaaee80452a8c3a25d8d6ff.pdf