Shiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071647320220501The Impact of the Pandemic on Critical Care in Resource-limited Countries1711724832910.30476/ijms.2022.48329ENFaridZandEditor-in-Chief, Iranian Journal of Medical Sciences, Shiraz University of Medical Sciences, Shiraz, IranAnesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0003-3489-3372Journal Article20220420The world has come to its knees by COVID-19 during the last two years, and the end of the catastrophe is yet unknown. This disaster, although deeply tragic with more than six million casualties, has made different medical disciplines to reconsider outdated, time-consuming methods for reacting to a new problem in medicine. We have never been under such pressure to respond immediately to a destructive and fatal minatory. However, some branches of the health care system such as preventive medicine, emergency medicine, pulmonary disease, infectious disease, anesthesiology, pharmaceutical sciences, and in particular, the critical care, were on the front lines of this onrush.https://ijms.sums.ac.ir/article_48329_438186b64bcd1eb76da358e03ece8172.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071647320220501The Efficacy and Safety of Selective Serotonin Reuptake Inhibitors and Serotonin-Norepinephrine Reuptake Inhibitors in the Treatment of Menopausal Hot Flashes: A Systematic Review of Clinical Trials1731934754010.30476/ijms.2020.87687.1817ENMarziehAziziStudent Research Committee, Mazandaran University of Medical Sciences, Sari, IranDepartment of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran0000-0002-0835-3201SoghraKhaniSexual and Reproductive Health Research Center, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran0000-0001-6958-8234MahsaKamaliDepartment of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, IranForouzanElyasiDepartment of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Sexual and Reproductive Health Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran0000-0002-6872-481XJournal Article20200817Background: Hot flashes (HF) are a common symptom during the menopausal transition. It is therefore important to identify effective drugs that can alleviate HF. This study aimed to systematically review published clinical trials on the efficacy and safety of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) in the treatment of HF in healthy menopausal women.<br />Methods: In this systematic review, articles published during 2003-2019 in PubMed, MEDLINE, Web of Science, Scopus, Science Direct, PsycINFO, CINAHL, the Cochrane Central Register of Controlled Trials, and Google Scholar as well as Iranian databases such as SID, and Magiran were searched. The quality of the selected articles was assessed using the Jadad score calculation. <br />Results: Thirty-six articles on randomized controlled trials were included in this study, out of which 27 articles had acceptable, and nine had weak methodological quality. Findings on SSRIs class of drugs indicated that escitalopram, paroxetine, and fluoxetine have higher efficacy and safety in the treatment of menopausal HF than other drugs. Studies on the effectiveness of sertraline, citalopram, and fluvoxamine are limited in number or show inconsistent results. Therefore, further high-quality studies are required to confirm their effectiveness in alleviating HF. Within the SNRIs class, venlafaxine and desvenlafaxine showed significant efficacy in the treatment of menopausal HF. However, studies on the effectiveness of duloxetine are also limited, which requires further research. <br />Conclusion: Most studies have indicated the efficacy and safety of some antidepressants, such as SSRIs and SNRIs, in decreasing the frequency and severity of HF. These drugs are therefore recommended for the treatment of menopausal HF.https://ijms.sums.ac.ir/article_47540_e258687af1cac9779223eab77dddcd97.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071647320220501Various Aspects of Non-Invasive Ventilation in COVID-19 Patients: A Narrative Review1942094824610.30476/ijms.2021.91753.2291ENZahidHussain KhanDepartment of Anesthesiology and Critical Care, Imam Khomeini Medical Complex, Tehran University of Medical Sciences, Tehran, Iran0000-0002-5017-6819AhmedMaki AldulaimiAl-furat Al-awsat Hospital, Al-furat Al-awsat Technical University, Health and Medical Technical College, Department of Anesthesia and Critical Care, Kufa, Iraq0000-0002-8250-8793Hesam AldinVarpaeiDepartment of Nursing and Midwifery, School of Nursing, Islamic Azad University Tehran Medical Sciences, Tehran, Iran0000-0002-6923-2040MostafaMohammadiDepartment of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Tehran. Iran0000-0002-7084-0182Journal Article20210703Non-invasive ventilation (NIV) is primarily used to treat acute respiratory failure. However, it has broad applications to manage a range of other diseases successfully. The main advantage of NIV lies in its capability to provide the same physiological effects as invasive ventilation while avoiding the placement of an artificial airway and its associated life-threatening complications. <br />The war on the COVID-19 pandemic is far from over. The present narrative review aimed at identifying various aspects of NIV usage, in COVID-19 and other patients, such as the onset time, mode, setting, positioning, sedation, and types of interface. A search for articles published from May 2020 to April 2021 was conducted using MEDLINE, PMC central, Scopus, Web of Science, Cochrane Library, and Embase databases. Of the initially identified 5,450 articles, 73 studies and 24 guidelines on the use of NIV were included. The search was limited to studies involving human cases and English language articles. Despite several reported benefits of NIV, the evidence on the use of NIV in COVID-19 patients does not yet fully support its routine use.https://ijms.sums.ac.ir/article_48246_684e685ced872f354b23af6388348777.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071647320220501Effect of COVID-19 Epidemic on Life Expectancy and Years of Life Lost in Iran: A Secondary Data Analysis2102184802110.30476/ijms.2021.90269.2111ENHajiieh BibiRazeghi NasrabadNational Institute of Population Research, Tehran, Iran0000-0002-0990-9689MohamadSasanipourNational Institute of Population Research, Tehran, Iran0000-0003-3807-9132Journal Article20210222Background: The COVID-19 pandemic has caused a significant number of deaths in many countries around the world. This study provides an estimate of the effect of the COVID-19 epidemic on life expectancy and years of life lost (YLL) in Iran.<br />Methods: This study is a secondary data analysis carried out in 2020. Mortality data from COVID-19 were obtained from the Ministry of Health and Medical Education. Since the calculation of mortality rates requires the number of people at risk of death, this data was obtained from the Statistics Center of Iran and was used after a detailed evaluation. The effect of COVID-19 on mortality is evaluated using the techniques of a multi-decrement life table and the corresponding single-reduction life table. The YLL is calculated using the standard method provided by the World Health Organization.<br />Results: Analysis of mortality data showed that deaths due to COVID-19 could reduce life expectancy at birth by 1.4 years in 2020. Therefore, life expectancy at birth declined from 75.1 years to 73.7 years. Furthermore, the deaths due to COVID-19 from the outbreak to early February 2021 have caused about 800,000 years of YLL, which is almost as much as the YLL caused by cancers and tumors. <br />Conclusion: A decrease in life expectancy at birth by more than one year in countries with a life expectancy of over 70 years, such as Iran, can delay the increase in life expectancy for several years.https://ijms.sums.ac.ir/article_48021_8b952edbaa2cb14b2a247f9898a9e510.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071647320220501Epidemiological Study of Infection and Death Due to COVID-19 in Fars Province, Iran, From February to September 20202192264799910.30476/ijms.2021.90768.2174ENAliSematiNon-Communicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0001-6322-7876MarjanZareNon-Communicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-0199-3230AlirezaMirahmadizadehNon-Communicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, IranAbdulrasoolHemmatiNon-Communicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0001-9951-8341MostafaEbrahimiCommunicable Disease Control Center, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20210413Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has entered our lives with the fear of outbreak, death, and recurrence. Our objective in this study is to evaluate the epidemiological features of Coronavirus Disease 2019 (COVID-19) infection and death in Fars province, Iran. <br />Methods: A cross-sectional study was conducted from February 18th to September 30th, 2020, where age, history of underlying diseases, sex, community-wide quarantine, nationality, close contact, pregnancy, medical staff job, traveling , and residency were compared between alive and deceased groups. Data were analyzed using IBM SPSS software, version 22.0, and the significance level was set at 0.05.<br />Results: Regarding 57958 new cases of COVID-19, the basic reproduction number (R0) was estimated as 2.8, requiring a minimum of 65% immunization to reach herd immunity. Moreover, an R0=0.36 was required to reach the endemic state in the region. The incidence, mortality, fatality, and recurrence rates of COVID-19 were estimated as 1347.9 per 100,000 dwellers, 209.5 per 1000,000 dwellers, 1.6 %, and 3.1 per 100,000 dwellers, respectively. Age, history of underlying diseases, urban residency, and the male sex were significantly higher in the deceased group (OR=1.09, 5.48, 1.24, and 1.32; All Ps<0.001, <0.001, 0.005, and <0.001, respectively). In addition, the recurrence rate among positive cases was estimated as 0.23% with a median±inter-quartile range equal to 84±46.25 days. Community-wide quarantine was shown to be a protective factor for death due to COVID-19 (OR=0.58, P=0.005). <br />Conclusion: Community-wide quarantine blocks the transmission of COVID-19 effectively. COVID-19 enjoys no solid immunity. History of underlying diseases, the male sex, urban residency, and age were among the most significant causes of death due to COVID-19. Further investigations are recommended on the genetic structure of SARS-CoV-2, treatments, and vaccination.https://ijms.sums.ac.ir/article_47999_72bab24cf9ab79ea59630472ebe68663.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071647320220501Quality of Life and Its Determinants in Liver Transplantation Candidates: A Missed Link in Liver Care Program during the Waiting Time for Liver Transplantation2272354791910.30476/ijms.2021.88302.1895ENKamranBagheri LankaraniHealth Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-7524-9017BehnamHonarvarHealth Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-1081-5778MahsaAkbariHealth Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, IranNaghmehBozorgniaHealth Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, IranMaryamRabiey FaradonbehHealth Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, IranMortezaBagherpourDepartment of Industrial Engineering, Iran University of Science and Technology, Tehran, IranSamanNikeghbalianShiraz Organ Transplant Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0003-4530-8829AlirezaShamsaeefarShiraz Organ Transplant Center, Shiraz University of Medical Sciences, Shiraz, IranSeyed AliMalekhosseiniShiraz Organ Transplant Center, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20201004Background: The health-related quality of life (HRQOL) in the before liver transplantation (LT) stage has not been studied as much as that after the LT stage. We aimed to assess HRQOL and its determinants before the LT stage. <br />Methods: As a cross-sectional study, HRQOL of all adult patients (n=632) referred to the LT center of Shiraz, Iran in 2018-2019 were assessed. Demographic, socioeconomic, medical, and paraclinical data were requested. Physical (PCS) and mental (MCS) aspects of HRQOL were assessed using the SF36 questionnaire. Univariable, multivariable (linear regression), and confirmatory factor analysis were performed utilizing SPSS 20 and Mplus 6.1 software. p Results: The mean age of the patients was 47.6±12.3 years, while 414 (65.6%) were men, and the mean, score of the model for end-stage liver disease (MELD) was 18.36±5.58. The mean score of QOL, PCS, and MCS was 50.01±21.73, 46.23±23.23, and 53.78±23.91 (out of 100), respectively. Vitality had the most association with HRQOL, while role limitations had the lowest. The multivariable analysis revealed that unemployment (p <0.001), anemia (P=0.005), weight loss (P=0.005), diabetes mellitus (DM) (P=0.009), low MELD score (P=0.027), and drug use (P=0.03) were the significant determinants of HRQOL, respectively.<br />Conclusion: The present study showed that HRQOL in the LT candidates was at the intermediate level, while their PCS and MCS are at the low and moderate levels, respectively. Furthermore, physical performance, job status, anemia, weight loss, MELD score, DM, and drug use should be considered as the significant determinants of HRQOL in the LT candidates.https://ijms.sums.ac.ir/article_47919_1fcd6d3b444cf8089073895d74f61233.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071647320220501Psychometric Properties of the Persian Version of Adult Eating Behavior Questionnaire in Patients with Epilepsy2362474800910.30476/ijms.2021.89396.2011ENAbbasShamsaliniaNursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran0000-0003-0731-0215RezaGhadimiSocial Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran0000-0002-4296-2836RezaEbrahimi RadDepartment of Medicine, Islamic Azad University, Tonekabon Branch, Tonekabon, Mazandaran, IranKhadijeJahangasht GhoozluDepartment of Nursing, Tarbiat Modares University, Tehran, IranAmanehMahmoudianNursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran0000-0003-1855-8208MozhganMoradiDepartment of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, IranRezaMasoudiDepartment of Nursing, School of Nursing and Midwifery, Shahr-e-Kord University of Medical Sciences Shahr-e-kord, IranFatemehGhaffariNursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran0000-0003-1940-1579Journal Article20201218Background: Adult eating behavior questionnaire (AEBQ) is an age upward extension tool that measures appetite traits in individuals. This instrument was developed by Hunot in 2016. The present study aimed to determine the psychometric properties of the Persian version of AEBQ in adults with epilepsy.<br />Methods: The current research is a cross-sectional study conducted in 2019 in Iran. 700 adults with epilepsy completed the 35-item AEBQ. Qualitative face validity, qualitative content and structure validity (exploratory factor analysis [EFA], N=400, and confirmatory factor analysis [CFA], N=300) appetitive traits were evaluated. Reliability was also measured using Cronbach’s alpha, Construct reliability (CR), and Intra-Class Correlation (ICC). The SPSS 26-AMOS24 software was employed to analyze the data with a significance level of 0.05. <br />Results: The EFA and CFA results comprised eight factors, <br />namely enjoyment of food, emotional over-eating, food responsiveness, hunger, satiety responsiveness, emotional under-eating, food fussiness, and eating slowly. Indices of root mean square error of approximation=0.068, parsimonious normed fit index=0.644, parsimonious comparative fit index=0.671, adjusted goodness of fit index=0.618, goodness of fit index=0.911, and Chi square degree-of-freedom ratio (normalized Chi square CMIN/DF=2.842) confirmed the fitness of the final model. Convergent and divergent validity was acceptable for all the factors. The results revealed that the internal stability>0.8 and CR>0.7 of the eight extracted AEBQ structures are confirmed. The ICC was 0.899 (95% CI: 0.878-0.917; p <0.001). The results also showed that AEBQ has acceptable convergent and divergent validity.<br />Conclusion: The eight-factor structure of AEBQ can measure eating behavior traits and is of good validity and reliability for assessing the eating behavior of Iranian adults with epilepsy.https://ijms.sums.ac.ir/article_48009_e50df735c6bfcf53d0f06340163f5e84.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071647320220501New Modification of Smell Identification Test for the Detection of Malingerers: A Pilot Experimental Study2482554791410.30476/ijms.2021.89049.1977ENRezaErfanianOtorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0001-8147-5320SafaTaherkhaniDepartment of Biomedical Engineering (Center of Excellence), Amirkabir University of Technology, Tehran, IranHakimaAbdullahOtorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, IranSaeedSohrabpourOtorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, IranHamedEmamiOtorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, IranMehdiHoorangHealth Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, IranBehroozAmirzargarOtorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0001-9084-241XJournal Article20201124Background: A major problem with the University of Pennsylvania Smell Identification Test (UPSIT) is its poor sensitivity for malingering detection in a group of people familiar with the test mechanism. This study aimed to evaluate the modification of UPSIT to detect anosmia malingering. <br />Methods: This was a pilot experimental study conducted in 2019 in Tehran. The participants were 60 healthy subjects classified into two groups of 30 people. The first group was requested to deliberately feign a negative result on the Iranian version of UPSIT, Iran Smell Identification Test (ISIT) (malingering group). The second group consisted of participants, who did not scratch the odorant part of ISIT during the tests (anosmia group). ISIT was modified in two steps. At each step, one incorrect option was deleted from the available choices. The number of each group’s answers, altered away from the correct choice, was then calculated and compared. <br />Results: The coached malingering group participants were able to feign anosmia in the original ISIT exam. In the modified ISIT, the number of answers changed from correct to wrong during the second stage (from three available choices to two choices) was significantly higher in the anosmia group (p <0.001). In the ROC analysis, the area under the curve was 0.92 (p <0.001). The cut-off of 4.5 for this test showed 93% sensitivity, 82% specificity, and 90% PPV and NPV. <br />Conclusion: The ISIT is not capable of detecting malingering in the coached participants, yet by deleting the choices step-by-step, the sensitivity and specificity of the test increased.https://ijms.sums.ac.ir/article_47914_54f5f6ceda3e0008d51ccd0b23f011a9.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071647320220501Association of Abnormal Serum L-Carnitine Levels with Idiopathic Changes in Left Ventricular Geometry in Pediatric and Adolescent Patients2562634795210.30476/ijms.2021.88464.1919ENMohsenShahidiDepartment of Pediatric Cardiology, Rajaiee Heart Center, Tehran, Iran0000-0003-1393-3574KhaledRahmaniLiver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran0000-0002-0860-8040AbdorrahimAfkhamzadehSocial Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran0000-0003-4496-2466Journal Article20201014Background: There is no compelling evidence to prove an association between serum free L-carnitine levels and changes in left ventricular (LV) geometry. The present study aimed to evaluate a possible association between these parameters. <br />Methods: In a cross-sectional study, 504 outpatients were randomly selected among those registered at Sanandaj Pediatric Heart Clinic (Sanandaj, Iran) during 2014-2020. The patients aged one to 25 years and were presented with cardiac complaints. The serum L-carnitine levels of all patients were evaluated and associated with changes in LV geometry measured by echocardiography. The association was assessed using the Chi squared test, Fisher’s exact test, and one-way ANOVA with post hoc Tukey test. Data were analyzed using SPSS software (version 22.0). P≤0.05 was considered statistically significant.<br />Results: The mean serum L-carnitine levels in the normal, low, and high serum groups were 52.69, 14.16, and 178.67 nmol/dL, respectively. There was a significant statistical association between abnormal serum levels of free L-carnitine and changes in LV geometry (p <0.001). <br />Conclusion: Our findings are indicative of an association between abnormal serum L-carnitine levels and changes in LV geometry in pediatric and adolescent patients.https://ijms.sums.ac.ir/article_47952_e410a83190872b2580ba63fb77126afc.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071647320220501Startup-Based Learning as an Innovative Method for Pharmacy Education: Medicinal Plants Course Model2642714803010.30476/ijms.2021.89794.2075ENEhsanAmiri-ArdekaniDepartment of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IranStudent Association of Indigenous Knowledge, Shiraz University of Medical Sciences, Shiraz, IranStudent Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran0000-0001-8948-9153Mohammad HasanKeshavarziClinical Education Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranSeyed AliakbarFaghihiClinical Education Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranParmisBadrPharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0001-9136-6785Mohammad MehdiZarshenasDepartment of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-8185-4993ZohrehAbolhassanzadehMedical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, IranAbdolaliMohagheghzadehDepartment of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IranStudent Association of Indigenous Knowledge, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-4873-1449Journal Article20210130Background: Familiarizing students with knowledge-based businesses is one of the goals emphasized in the developed educational systems worldwide. This study aimed to design a startup-based learning model )SBL(.<br />Methods: As a qualitative research study, startup teams were formed by the pharmacy students of Shiraz University of Medical Sciences in 2020. This model was used to train 120 students as pharmaceutical entrepreneurs through related lectures, simulations, and field activities. We employed this model for students to become familiar with the various stages of examining market needs, knowledge-based company registration, intellectual property, logo design, and even pharmaceutical product development. Students’ feedback was assessed with a questionnaire designed by the team of researchers, and its results were used to analyze the course and improve the quality of the proposed model. <br />Results: Most of the studied indices revealed that the students rated this model as good or excellent. Satisfaction with more important indices includes student creativity and ideation in educational activity (60.7%), attractive presentation (60.4%), teamwork among learners (62.2%), appropriateness of evaluation method (65.4%), understanding how to make herbal remedies (49.1%), learner participation in the educational activity (74.8%), entrepreneurial motivation (60.7%), and applicability (64.4%).<br />Conclusion: We found this model effective in boosting students’ satisfaction, creativity, and entrepreneurial spirit. Lecturers also play a facilitator role in addition to specialized training. Therefore, in this model, both lecturers and students can grow more and make education more attractive. This study, for the first time, demonstrated that SBL could be applied in education systems and make the students more interested in educational content and help them to prepare for the job market.https://ijms.sums.ac.ir/article_48030_71573b1419f69794fe5c21d8b41f0045.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071647320220501Central Nucleus of Amygdala Mediate Pressor Response Elicited by Microinjection of Angiotensin II into the Parvocellular Paraventricular Nucleus in Rats2722794810210.30476/ijms.2021.90015.2080ENBaharRostamiDepartment of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran0000-0003-4088-4210MasoumehHatamDepartment of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran0000-0001-8139-5232Journal Article20210207Background: The Paraventricular Hypothalamic Nucleus (PVN) coordinates autonomic and neuroendocrine systems to maintain homeostasis. Microinjection of angiotensin II (AngII) into the PVN has been previously shown to produce pressor and bradycardia responses. Anatomical evidence has indicated that a substantial proportion of PVN neurons is connected with the neurons in the central amygdala (CeA). The present study aimed to examine the possible contribution of the CeA in cardiovascular responses evoked by microinjection of AngII into the parvocellular portion of PVN (PVNp) before and after microinjection of cobalt chloride (CoCl2) into the CeA.<br />Methods: The experiments were conducted at the Department of Physiology of Shiraz University of Medical Sciences, from April 2019 to November 2019. There were two groups of 21 eight-week-old urethane anesthetized male rats, namely saline (n=9 rats) and AngII (n=12 rats) groups. Drugs (100 nL) were microinjected via a single-glass micropipette into the PVNp and CeA. Their blood pressure (BP) and heart rate (HR) were recorded throughout the experiments. The mean arterial pressure (MAP) and heart rate (HR) were compared to the pre-injection values using paired t test, and to those of the saline group using independent t test.<br />Results: Microinjection of AngII into the PVNp produced pressor response (p <0.0001) with no significant changes in HR (P=0.70). Blockade of CeA with CoCl2 attenuated the pressor response to microinjection of AngII into the PVNp (p <0.001).<br />Conclusion: In the PVNp, Ang II increased the rats’ blood pressure. This response was in part mediated by the CeA. Our study suggested that these two nuclei cooperate to perform their cardiovascular functions.https://ijms.sums.ac.ir/article_48102_703278458846160900a878234bbe77ce.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071647320220501A Large Primary Retroperitoneal Synovial Sarcoma: A Case Report of a Huge Malignant Tumor2802844795310.30476/ijms.2021.90470.2141ENAnahitaAnsari DjafariDepartment of Urology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0001-6392-1323MohammadrezaRazzaghiDepartment of Urology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0002-3022-1547AzadehRakhshanDepartment of Pathology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0003-2208-4244SabaFarajiDepartment of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran0000-0002-2494-3762Amir HosseinRahavianAndrology Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran0000-0003-4173-2673Seyyed AliHojjatiDepartment of Urology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0002-3403-612XJournal Article20210314Synovial Sarcoma (SS) is a rare soft-tissue malignancy. Only about 15% of SS originates from the retroperitoneum. Retroperitoneal SS (RSS) is usually diagnosed incidentally due to the anatomy of the retroperitoneum. The most common complaints of patients are abdominal and low back pain. Other common symptoms of RSS are palpable abdominal mass, weight loss, and anemia. In this study, we will describe a 29-year-old white Asian man with a diagnosis of RSS after radical nephrectomy. He was admitted to the Urology Department of Shohada-e Tajrish hospital, Tehran, Iran in March 2019. The distinguishing feature of this case is the size of the mass, which has never been reported so much for retroperitoneal synovial sarcoma. Radiologic imaging showed a huge retroperitoneal mass originating from the kidney. Based on the pathologic features and immunohistochemistry (IHC) study, the diagnosis was consistent with synovial sarcoma. Accurate diagnosis of RSS is usually based on the pathological findings. Therefore, in case of doubt, a biopsy can be employed. Surgical resection of the tumor and lymph nodes dissection is the main and most important part of the treatment. Aggressive resection with free margin is recommended. The role of adjuvant and neoadjuvant chemotherapy in RSS is not certain to date, but it is recommended according to the patient’s condition.https://ijms.sums.ac.ir/article_47953_208ea9948fc69085671d14a8ff02faa9.pdfShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-071647320220501Avicenna’s Viewpoints on Dysphonia2852874830810.30476/ijms.2022.92775.2407ENMostafaSolatiDepartment of Traditional Medicine, School of Persian Medicine, Iran University of Medical Sciences, Tehran, IranResearch Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, IranStudent Research Committee, Iran University of Medical Sciences, Tehran, Iran0000-0003-2903-3642MajidDadmehrDepartment of Traditional Medicine, School of Persian Medicine, Iran University of Medical Sciences, Tehran, IranResearch Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran0000-0002-7032-8648AbdolghaderBahrainiDepartment of Traditional Medicine, School of Medicine, Abadan University of Medical Sciences, Abadan, Iran0000-0002-2847-3331RezaSamareiDepartment of Otorhinolaryngology, School of Medicine, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran0000-0001-8421-5049Hamid RezaKhalkhaliPatient Safety Research Center, Department of Biostatistics and Epidemiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran0000-0003-2837-0735OmidSadeghpourResearch Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, IranDepartment of Traditional Pharmacy, School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran0000-0003-1680-0443Journal Article20210918Dysphonia is a common voice disorder that affects about one-third of the population at some point in their lives.1 The terms dysphonia and hoarseness are frequently used interchangeably. However, dysphonia is a disorder characterized by changes in vocal quality, pitch, and loudness or vocal effort. Patients with dysphonia are unable to communicate properly, and their voice-related quality of life (VR-QOL) is negatively affected. https://ijms.sums.ac.ir/article_48308_c4e2155ffc72545b008674871bfe8344.pdf