Publications by authors named "Ali Khalili"

30 Publications

  • Page 1 of 1

Under-expression of microRNA-146a and 21 and their association with Crohn's disease.

Indian J Gastroenterol 2020 08 19;39(4):405-410. Epub 2020 Sep 19.

Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Ganjafrooz Street, Babol, IR, Iran.

MicroRNAs (miRNAs) can post-transcriptionally regulate gene expression and are involved in the immune response. Excessive immune response to the gut microbiota plays a major role in the pathogenesis of Crohn's disease (CD). Regarding the role of miRNAs in immune response, this study aimed to investigate the contribution of miRNAs in the pathogenesis of CD. A total of 53 participants, including 23 CD patients and 30 healthy controls (HCs) were enrolled in this study. miRNAs, including miR-21, miR-29a, miR-29b, miR-31, miR-146a, miR-155, miR-181a, and miR-181c were evaluated via TaqMan MicroRNA Assays. Among the eight miRNAs, the amounts of miR-146a and miR-21 were significantly decreased in the CD patients relative to HC subjects. Moreover, we showed that there was a negative correlation between miR-146a and Harvey-Bradshaw index (HBI), as well as a positive correlation of miR-21 and miR-29b with HBI. Under-expression of miR-146a and miR-21, which are critical for the regulatory function of regulatory T cells (Tregs), is remarkably associated with CD.
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http://dx.doi.org/10.1007/s12664-020-01059-2DOI Listing
August 2020

A comparative study of the analgesic effects of intravenous ketorolac, paracetamol, and morphine in patients undergoing video-assisted thoracoscopic surgery: A double-blind, active-controlled, randomized clinical trial.

Ann Card Anaesth 2020 Apr-Jun;23(2):177-182

Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Opioids are traditionally used as the drug of choice for the management of postoperative pain. However, their use is limited in patients undergoing Video-assisted thoracic surgery (VATS), due to their side effects, such as respiratory depression, nausea, and vomiting.

Aim: In this double-blind active-controlled randomized study, we have compared the analgesic effects of ketorolac and paracetamol to morphine.

Methods: Patients were randomly chosen from a pool of candidates who were undergoing VATS and were divided into three groups. During the first 24 h postsurgery, patients in the control group received a cumulative dose of morphine 20 mg, while patients in two treatment groups received ketorolac 120 mg and paracetamol 4 g in total. Doses were administered as bolus immediately after surgery and infusion during the first 24 h. Patients' pain severity was evaluated by visual analogue scale rating (VAS) at rest and during coughing episodes.

Results: The average pain score at recovery time was 2.29 ± 2.13 and 2.26 ± 2.16 for ketorolac and paracetamol, respectively, and it was significantly lower than the morphine group with an average pain score of 3.87 (P = 0.003). Additionally, the VAS score during cough episodes was significantly higher in the control group throughout the study period compared to study groups. Comparison of mean morphine dose utilized as liberation analgesic (in case of patients had VAS >3) between three groups was not significantly different (P = 0.17).

Conclusion: Our study demonstrates the non-inferiority of ketorolac and paracetamol to morphine in controlling post-VATS pain without causing any significant side effects. We also show that ketorolac and paracetamol are superior to morphine in controlling pain during 2 h postsurgery.
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http://dx.doi.org/10.4103/aca.ACA_239_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336963PMC
March 2021

Biological and physiological characteristics of human cumulus cells in adherent culture condition.

Int J Reprod Biomed 2019 Apr 27;18(1):1-10. Epub 2020 Jan 27.

Stem Cell Biology Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Background: Cumulus cells, as oocyte nurse cells, provide a suitable microenvironment with growth factors and cellular interactions required for oocyte maturation. Thus, these cells may serve as a natural niche for studies of female germ cell development. Cumulus cells may help attain a better understanding of the causes of infertility in women and eventually improve the outcomes of cases that respond poorly to standard infertility treatment.

Objective: The aim of this study was to isolate, culture, and investigate the biological characteristics of human cumulus cells.

Materials And Methods: In this experimental study, cumulus cells were isolated, cultured, and characterized using reverse transcription-polymerase chain reaction analyses of specific genes including , , , , and The presence of vimentin, a structural protein, was examined via immunofluorescent staining. Moreover, levels of anti-mullerian hormone (AMH) and progesterone secretion by cumulus cells were measured with ELISA after 2, 4, 12, 24, and 48 hr of culture.

Results: In adherent culture, human cumulus cells expressed specific genes and markers as well as secreted AMH and progesterone into the medium.

Conclusion: Cumulus cells secrete AMH and progesterone in an adherent culture and might be applicable for maturation (IVM) and gametogenesis (IVG) studies.
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http://dx.doi.org/10.18502/ijrm.v18i1.6189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996122PMC
April 2019

Thermo-mechanical contact problems and elastic behaviour of single and double sides functionally graded brake disks with temperature-dependent material properties.

Sci Rep 2019 Oct 25;9(1):15317. Epub 2019 Oct 25.

Division of Computational Physics, Institute for Computational Science, Ton Duc Thang University, Ho Chi Minh City, Vietnam.

A thermo-elastic contact problem of functionally graded materials (FGMs) rotating brake disk with different pure brake pad areas under temperature dependent material properties is solved by Finite Element Method (FEM). The properties of brake disk change gradually from metal to ceramic by power-law distribution along the radial direction from the inner to the outer surface. Areas of the pure pad are changing while the vertical force is constant. The ratio of brake pad thickness to FGMs brake disk thickness is assumed 0.66. Two sources of thermal loads are considered: (1) Heat generation between the pad and brake disk due to contact friction, and (2) External thermal load due to a constant temperature at inner and outer surfaces. Mechanical responses of FGMs disk are compared with several pad contact areas. The results for temperature-dependent and temperature-independent material properties are investigated and presented. The results show that the absolute value of the shear stress in temperature-dependent material can be greater than that for temperature-independent material. The radial stress for some specific grading index (n = 1.5) is compressive near the inner surface for double contact while it is tensile for a single contact. It is concluded that the radial strain for some specific value of grading index (n = 1) is lower than other FGMs and pure double side contact brake disks.
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http://dx.doi.org/10.1038/s41598-019-51450-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6814861PMC
October 2019

Safety and Efficacy of Intravenous Iron Sucrose for Iron-Deficiency Anemia in Children and Adolescents With Inflammatory Bowel Disease.

Glob Pediatr Health 2019 18;6:2333794X19870981. Epub 2019 Aug 18.

UH Rainbow Babies and Children's Hospital, Pediatric Gastroenterology, Hepatology, and Nutrition, Cleveland, OH, USA.

. Anemia is common in inflammatory bowel disease (IBD). Oral iron is widely used but efficacy can be reduced by poor compliance and insufficient absorption. Intravenous iron is safe and effective in adults but is not well studied in children. . To assess safety and efficacy of intravenous iron sucrose (IVIS) in children with IBD. . We reviewed medical records of IBD patients <22 years of age who received IVIS at our institution between 2009 and 2014. Anemia was defined as hemoglobin (Hgb) level below normal for age and gender and iron-deficiency anemia as serum iron studies and red cell mean corpuscular volume below normal ranges. Each IVIS infusion was evaluated for safety. Efficacy was defined as ≥2 g/dL increase in Hgb ≤12 weeks from IVIS initiation. . We identified 88 patients (Crohn's disease, n = 52; ulcerative colitis, n = 33; IBD-unclassified, n = 3) who underwent 329 IVIS infusions over 121 courses. No patient developed anaphylaxis. Six patients developed minor adverse reactions. Of the 121 IVIS courses, 80 were included in the efficacy evaluation. There was a significant rise in Hgb (mean 9.1 ±1.4 to 11.9 ± 1.8 g/dL; < .0001, paired test). Overall, 58.7% (47/80 courses) resulted in goal Hgb increase. . IVIS is safe and effective in treating iron-deficiency anemia in pediatric IBD. There were only minor adverse events, and the observed rise in Hgb was clinically significant, with the majority achieving goal Hgb.
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http://dx.doi.org/10.1177/2333794X19870981DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700850PMC
August 2019

Vitrification has detrimental effects on maturation, viability, and subcellular quality of oocytes post IVM in cancerous women: An experimental study.

Int J Reprod Biomed 2019 Mar 5;17(3). Epub 2019 May 5.

Department of Obstetrics and Gynecology, Shahid Sadoughi Hospital, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Background: In vitro maturation (IVM) of immature oocytes retrieved from ovarian tissue has been considered as a valuable approach for fertility preservation in cancerous patients.

Objective: To evaluate the efficacy of vitrification on oocyte maturation, survival rates, as well as the subcellular oocyte quality post IVM.

Materials And Methods: The ovarian cortexes from 19 women with cervix and uterine malignancy aged 21-39 yr were collected. Cumulus-oocyte complexes were aspirated from all visible antral follicles. 102 immature oocytes were collected, and 43 oocytes were detected appropriately for IVM (control group). Also, 59 immature oocytes were vitrified, then matured in vitro (IVM) in two groups: with (GDF9) (group 1) and without GDF9 (group 2) supplementation. Rates of oocytes viability, maturation, and survival along with meiotic spindle visualization and zona pellucida birefringence were assessed with Polyscope.

Results: The rate of maturation was significantly higher in controls (55.8%) compared to the other groups. Maturation rate was 23.3% in oocytes cultured in IVM medium enriched with GDF9, and 27.6% in those cultured in IVM medium lacking GDF9 (p = 0.86). Also, the meiotic spindle was present in 74.4% of control oocytes which was significantly higher than the other groups. The proportion of high zona pellucida birefringence was higher in the controls when compared with group 1 (51.2% vs. 23.3%, respectively, p = 0.04).

Conclusion: Vitrification had a detrimental effect on oocyte maturation, viability as well as the subcellular quality of the oocytes after IVM in cancerous women.
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http://dx.doi.org/10.18502/ijrm.v17i3.4516DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6661134PMC
March 2019

Retraction notice to "Impact of vitrification on human oocytes before and after in vitro maturation: A systematic review and meta-analysis" [Eur. J. Obstet. Gynecol. Reprod. Biol. 227 (August) (2018), 19-26].

Eur J Obstet Gynecol Reprod Biol 2019 05 16;236:265. Epub 2019 Mar 16.

Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

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http://dx.doi.org/10.1016/j.ejogrb.2019.02.019DOI Listing
May 2019

Pearson Syndrome: A Rare Cause of Failure to Thrive in Infants.

Clin Pediatr (Phila) 2019 06 7;58(7):819-824. Epub 2019 Mar 7.

1 University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

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http://dx.doi.org/10.1177/0009922819834285DOI Listing
June 2019

Evaluation of cerebral oxygen saturation during hypotensive anesthesia in functional endoscopic sinus surgery.

J Anaesthesiol Clin Pharmacol 2018 Oct-Dec;34(4):503-506

Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background And Aims: Controlled hypotensive anesthesia in endoscopic sinus surgery would provide a clean surgical field. Cerebral oxygen saturation (ScO) is important in endoscopic sinus surgery patients and it may be low during controlled hypotension. The aim of the present study was to assess ScO in these patients.

Material And Methods: In this observational study, 41 patients who underwent endoscopic sinus surgery with hypotensive anesthesia were enrolled for the study and all of the patients received the same anesthetic medication, nitroglycerin for controlled hypotension. Variables were measured prior to surgery, after induction of anesthesia, 5 min, and every 30 min after controlled hypotension. Near-infrared spectroscopy was used for ScO evaluation. Mean arterial blood pressure (MAP) was maintained at 55-60 mmHg in the surgical duration. We used -test, Wilcoxon, and repeated measures analysis of variance (ANOVA). We examined the cross-correlation functions of the time series data between end-tidal carbon dioxide (ETCO)/MAP and ScO.

Results: The mean of intraoperative ScO was not significantly different from the baseline evaluation ( > 0.05). ETCO was cross correlated with current ScO [: 0.618, confidence interval (CI) 95%: 0.46-0.78]. We found moderate cross correlation between the MAP and current ScO (: 0.728, CI 95%: 0.56-0.88). About 92% of the patients recovered within 30 min. Recovery time was associated with intraoperative MAP (: 0.004, : 0.438), intraoperative ETCO (: 0.003, : 0.450), and ScO (: 0.026, : 0.348).

Conclusions: Based on our findings, the assessment of ScO and maintained MAP >55 mmHg may provide safe conditions for endoscopic sinus surgery.
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http://dx.doi.org/10.4103/joacp.JOACP_248_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360878PMC
February 2019

Enterourachal Fistula as an Initial Presentation in Crohn Disease.

Pediatr Gastroenterol Hepatol Nutr 2019 Jan 10;22(1):90-97. Epub 2019 Jan 10.

Division of Pediatric Gastroenterology, Department of Pediatrics, UH Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, United States.

Crohn disease has a wide spectrum of clinical presentations and rarely can present with complications such as a bowel stricture or fistula. In this case report, we describe a 17-year-old male who presented with a history of recurrent anterior abdominal wall abscesses and dysuria. He was diagnosed with Crohn disease and also found to have a fistulous communication between the terminal ileum and a patent urachus. An ileocecectomy with primary anastomosis and complete resection of the abscess cavity was performed. He is on azathioprine for maintenance therapy and currently in remission. Clinicians should have a high index of suspicion for this complication in Crohn disease patients presenting with symptoms suggestive of urachal anomalies such as suprapubic abdominal pain, dysuria, umbilical discharge, and periumbilical mass.
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http://dx.doi.org/10.5223/pghn.2019.22.1.90DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333586PMC
January 2019

Reversal of Immunogenicity in Pediatric Inflammatory Bowel Disease Patients Receiving Anti-Tumor Necrosis Factor Medications.

Pediatr Gastroenterol Hepatol Nutr 2018 Oct 10;21(4):329-335. Epub 2018 Oct 10.

Division of Pediatric Gastroenterology, Hepatology and Nutrition, University Hospitals/Rainbow Babies & Children's Hospital, Cleveland, OH, United States.

Loss of response to anti-tumor necrosis factor (anti-TNF) agents in the treatment of inflammatory bowel disease (IBD) is a major consideration to maintain sustained response. Reversal of immunogenicity can re-establish response and increase the durability of these agents. Strategies to reverse immunogenicity include dose-intensification and/or the addition of an immunomodulator. However, there is a relative paucity of data on the efficacy of such interventions in pediatric IBD patients. Available reports have not strictly utilized homogenous mobility shift assay, which reports on anti-drug antibodies even in the presence of detectable drug, whereas prior studies have been confounded by the use of drug sensitive assays. We report four pediatric inflammatory bowel disease patients with successful reversal of immunogenicity on an anti-TNF agent using dose intensification and/or addition of an immunomodulator.
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http://dx.doi.org/10.5223/pghn.2018.21.4.329DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6182480PMC
October 2018

High-Frequency Jet Ventilation in Nonintubated Patients.

Turk Thorac J 2018 Jul 1;19(3):127-131. Epub 2018 Jul 1.

Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Objectives: High-frequency jet ventilation (HFJV) is a convenient method for providing ventilation during fiberoptic bronchoscopy. We describe an incipient approach of high-frequency jet ventilation via the working channel of a flexible bronchoscope for nonintubated patients who suffer from hypoxemia during bronchoscopy. The aim of this study was to test the efficacy of this incipient approach and determine the possible complications related to it.

Materials And Methods: Sixteen patients who had oxygen saturation below 70% that did not resolve with nasal oxygen for 20 s during interventional bronchoscopy were included in the study. High-frequency jet ventilation was administrated via the working channel of a bronchoscope for 3 min. Arterial blood gas circumscriptions were compared before and after jet ventilation.

Results: Oxygen saturation increased to >90% in all patients 30 s after jet ventilation. Mean arterial oxygen saturation pressure increased from 54.84 to 111.98 mmHg with jet ventilation (p=0.0001). Arterial carbon dioxide tension decreased after jet ventilation. The body mass index had no consequential effect on arterial carbon dioxide pressure after jet ventilation in our patients (p=0.1). Complications such as pneumothorax and working channel damage were not observed.

Conclusion: High-frequency jet ventilation via the working channel of the bronchoscope is a novel method that can provide optimal ventilation with minimal complications to nonintubated patients suffering from hypoxemia during bronchoscopy. This method also reduces the duration of bronchoscopy procedures.
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http://dx.doi.org/10.5152/TurkThoracJ.2018.17025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077008PMC
July 2018

Effect of Adding Magnesium Sulphate to Epidural Bupivacaine and Morphine on Post-Thoracotomy Pain Management: A Randomized, Double-Blind, Clinical Trial.

Basic Clin Pharmacol Toxicol 2018 Nov 9;123(5):602-606. Epub 2018 Jul 9.

Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Post-thoracotomy pain is very severe and may cause pulmonary complications. Thoracic epidural analgesia can greatly decrease the pain experience and its consequences. However, finding new methods to decrease the amount of administered opioids is an important issue of research. We aimed to evaluate the effect of adding epidural magnesium sulphate to bupivacaine and morphine on pain control and the amount of opioid consumption after thoracotomy. Eighty patients undergoing thoracotomy at a tertiary cardiothoracic referral centre were enrolled in a randomized, double-blind trial. Patients were randomly allocated to two groups. Bupivacaine (12.5 mg) and morphine (2 mg) were administered epidurally to all patients at the end of operation. Patients in the magnesium (Mg) group received epidural magnesium sulphate (50 mg), and patients in the control (C) group received normal saline as an adjuvant. Visual analogue scale (VAS) score and the amount of morphine consumption were measured during 24 hr post-operation. Thirty-nine patients in the Mg group and 41 patients in the C group completed the study. Patients in the Mg group had significantly less VAS score at recovery time (p < 0.05), 2 hr (p < 0.01) and 4 hr (p < 0.05) after surgery. The patient-controlled analgesia pump was started earlier in the C group than in the Mg group (p < 0.05). The amount of morphine needed in the Mg group was significantly lower than in the C group (5.64 ± 1.69 mg/24 hr versus 8.44 ± 3.98 mg/24 hr; p < 0.001). Pruritus was seen in the C group (9.7%) and absent in the Mg group (p < 0.05). Co-administration of magnesium sulphate with bupivacaine and morphine for thoracic epidural analgesia after thoracotomy leads to a reduction in post-operative pain score and the need for opioid administration.
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http://dx.doi.org/10.1111/bcpt.13047DOI Listing
November 2018

CD4+CD25+CD127low FoxP3+ regulatory T cells in Crohn's disease.

Rom J Intern Med 2018 Sep;56(3):158-166

Department of Immunology, School of Medicine, Babol University of Medical Sciences, Babol, I.R. Iran.

Background: Regulatory T (Treg) cell plays a key role in autoimmune diseases. We evaluated the regulatory function and frequency of Treg cells and secreted IL-10, IL-35 concentration in Crohn's disease (CD).

Methods: Twenty-three patients with CD and 25 healthy controls (HC) were included in this study. We analysed the alteration of Tregs frequency using flow cytometry for CD4, CD25, CD127 and FoxP3 markers. Surface expression of CD4, CD25 and CD127 markers were used for isolation of relatively pure Treg cells. Suppressive activity of Tregs was determined by measuring their ability to inhibit the proliferation of T responder (Tres) cells. In addition, the amounts of IL-10 and IL-35 cytokines in co-culture supernatants were measured by ELISA assay after stimulation with anti-CD2/CD3/CD28.

Results: CD patients had significantly lower frequency of CD4+ CD25+ CD127low FoxP3+ Treg cells in comparison with controls (2.17 ± 1.04 vs. 2.83 ± 1.07, p = 0.0352). Additionally, Treg cells mediated suppression was not significantly different in CD patients compared to controls. There was a significant difference in IL-10 secretion in response to anti-CD2/CD3/CD28 stimulation compared with HC (p = 0.0074).

Conclusion: The frequency of CD4+ CD25+ CD127low FoxP3+ Tregs decreased in active stage of CD but there was no impaired suppressive function of CD4+ CD25+ CD127low FoxP3+ Treg cells. We suggest that an alteration in the balance of Tregs and T effectors may contribute to pathogenesis of CD.
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http://dx.doi.org/10.2478/rjim-2018-0006DOI Listing
September 2018

A Rare Case of Megaduodenum Associated With a Duodenal Trichobezoar.

J Pediatr Gastroenterol Nutr 2017 02;64(2):e50-e51

*Department of Surgery, University Hospitals Case Medical Center †Pediatric Gastroenterology, University Hospitals Rainbow Babies and Children's Hospital ‡Division of Pediatric Surgery, University Hospitals Rainbow Babies and Children's Hospital, Cleveland, OH §Cleveland Clinic Children's, Pediatric General Surgery, Cleveland, OH.

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http://dx.doi.org/10.1097/MPG.0000000000000583DOI Listing
February 2017

Right Ventricular Perforation with the Body of Swan-Ganz Catheter during Lung Transplantation by ECMO Support: A Case Report.

Tanaffos 2017 ;16(3):240-244

Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

A 46-year-old woman with a 12-year history of lymphangiomyomatosis (LAM) was admitted for lung transplantation in January 2017. We decided to apply veno-arterial extracorporeal membrane oxygenation (ECMO) to manage arrhythmia and hypotension during lung transplantation, since it was not controllable with inotropic drugs. After transplanting the right (first) lung and at the time of left pneumonectomy, the body of the Swan-Ganz catheter was suddenly observed to be protruding from the right ventricular (RV) wall. The catheter was found folded at part of its body and ran out 0.5 cm from the RV. The protruding part of the catheter was inserted before the perforated part of the cardiac muscle was repaired in order to control the bleeding. ECMO was used throughout the rest of the procedure and the patient was transferred to the intensive care unit (ICU) in good condition before being weaned from the ventilator after 16 hours. It seems that gentle manipulation, concurrent use of transesophageal echocardiography (TEE), insertion of the appropriate length of the catheter into the heart chambers, and a softer material in the structure of the catheters would be helpful to prevent these kinds of potentially fatal complications.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960229PMC
January 2017

Paracetamol Instead of Ketorolac in Post-Video-Assisted Thoracic Surgery Pain Management: A Randomized Trial.

Anesth Pain Med 2016 Dec 21;6(6):e39175. Epub 2016 Aug 21.

Chronic Respiratory Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Video-assisted thoracic surgery (VATS) is a minimally invasive procedure that is growing more common around the world. Despite causing less pain compared open thoracic surgery, postoperative pain management is still important.

Objectives: The aim of the present study was to compare the analgesic effects of paracetamol and ketorolac in VATS patients.

Methods: This was a double-blinded randomized clinical trial conducted on 70 patients undergoing lobectomy or segmentectomy due to lung masses, using video-assisted methods. The patients were randomly divided into two groups (each n = 35): the ketorolac (K) group and the paracetamol (P) group. The K group received ketorolac 30 mg IV stat at the end of surgery and then a 90 mg/24 h infusion. The P group received paracetamol 1 g IV stat at the end of surgery and then a 3 g/24 h infusion. Pain scores were recorded during recovery and 2, 4, 8, 12, and 24 hours after drug administration. Pain scores, total doses of rescue analgesics, and patient satisfaction levels were compared between the groups.

Results: There was no significant difference between the K and P groups in pain scores in any of the evaluations. Seventeen (48.6 %) and 9 (25.7 %) patients in the K and P groups, respectively, did not require any rescue analgesia (P = 0.047). The mean doses of rescue analgesia in the K and P groups were 3.129 ± 4.27 mg and 4.38 ± 3.69 mg, respectively, which were similar (P = 0.144). There was no significant difference between the groups in satisfaction scores (P = 0.175).

Conclusions: Paracetamol 1 g stat + 3 g/24 h infusion is as effective as ketorolac 30 mg stat + 90 mg/24 h infusion in post-VATS pain management, with good tolerability and a low incidence of adverse effects.
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http://dx.doi.org/10.5812/aapm.39175DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5560568PMC
December 2016

Outpatient pleuroscopy: Report of an experience in a referral hospital.

Pneumologia 2016 Jul-Sep;65(3):142-5

Pleuroscopy is a safe diagnostic procedure for evaluation of pleural diseases, with minimum complications. This procedure has been recently conducted on outpatient basis. Results support its safety, especially in busy referral hospitals. We aimed to report our experience on performing outpatient pleuroscopy at Masih Daneshvari hospital; Tehran, Iran. All eligible patients referred to Masih Daneshvari Hospital for pleuroscopy between May 2015 and May 2016 were enrolled. Air evacuation was conducted in operating room though a thin Nelaton catheter attached to low pressure suction. Compression dressing using Vaseline gauze was done after air leak terminated. Patients were discharged if first chest x-ray was negative for pneumothorax and were advised to stay in touch and return 12 hours later for second chest radiograph. Baseline characteristics, radiographic and pathologic reports were reviewed. Outpatient pleuroscopy was conducted on 10 patients. Average procedure time was 22±9 minutes. All patients were discharged after 4 hours. Eight of the patients remained free of complications after 12 hours, and 2 patients presented with pneumothorax (both who had massive pleural effusion) and were successfully managed by our team. Considering pathologic diagnosis, pleural tuberculosis was as common diagnosis as malignancy in our patients (4 patients), adenocarcinoma was the most malignancy reported (3 out of 4 patients). Chronic nonspecific inflammation was reported by our pathologist in 2 cases. Outpatient pleuroscopy can be conducted safely and effectively, reducing the number of unnecessary hospitalizations in a referral center. Closed follow up, patient education and proper patient selection are necessary for minimizing complications.
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April 2018

Altered microRNA Expression and Immunosuppressive Cytokine Production by Regulatory T Cells of Ulcerative Colitis Patients.

Immunol Invest 2016 ;45(1):63-74

b Department of Immunology , Mazandaran University of Medical Sciences , Sari , Iran.

Regulatory T (Treg) cells are essential for maintenance of peripheral tolerance and prevention of autoimmune diseases in part by producing immunosuppressive cytokines. Recently, microRNAs (miRNAs) have also been involved in autoimmune disorders, not least for their crucial role in the regulation of Treg biology and function. We simultaneously investigated the concentration of IL-35, IL-10, TGF-β, and sCD25 in supernatant of cell culture and the expression patterns of several miRNAs in CD4(+)CD25(+) CD127(-/low) FoxP3(+) Tregs of ulcerative colitis (UC) patients. Significantly lower levels of IL-10 and IL-35 were observed in Treg cultures of UC patients. miR-21, miR-146a, and miR-155 levels were downregulated and miR-31 level was upregulated in Tregs of patients. Our results suggest that microRNAs may serve as a novel regulator in function and homoeostasis of UC Treg cells, providing a key role for them in pathophysiology of UC.
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http://dx.doi.org/10.3109/08820139.2015.1103749DOI Listing
October 2016

Decrease of CD4(+) CD25(+) CD127(low) FoxP3(+) regulatory T cells with impaired suppressive function in untreated ulcerative colitis patients.

Autoimmunity 2015 31;48(8):556-61. Epub 2015 Aug 31.

c Gut and Liver Research Center, Mazandaran University of Medical Sciences , Sari , Iran.

Regulatory T (Treg) cells take part in immune homeostasis and play a pivotal role in maintaining peripheral tolerance. The aim of this study was to evaluate the frequency and function of Treg cells in active and untreated ulcerative colitis (UC) patients. Thirty-two subjects with newly diagnosed UC and 31 age-matched healthy controls were included in this survey. The frequency of Tregs was analyzed with flow cytometry using CD4, CD25, CD127 and FoxP3 markers. We used surface expression of CD4(+), CD25(+) and CD127(low) markers for isolation of a relatively pure Treg population. Suppressive activity of Tregs was determined by measuring their ability to inhibit the proliferation of T responder cells. UC patients had a lower frequency of CD4(+) CD25(+) CD127(low) FoxP3(+) Treg cells. Additionally, Treg cell-mediated suppression was lower in UC patients compared to controls. The frequency and suppressive capacity of Tregs and MFI of FoxP3 were inversely correlated with disease activity. These results suggest that CD4(+) CD25(+) CD127(low) FoxP3(+) Treg cells may contribute to immunopathogenesis of UC, and assessment of Treg cell frequency and function may have clinical value.
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http://dx.doi.org/10.3109/08916934.2015.1070835DOI Listing
September 2016

Comparing Nigella sativa Oil and Fish Oil in Treatment of Vitiligo.

Iran Red Crescent Med J 2014 Jun 5;16(6):e4515. Epub 2014 Jun 5.

Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.

Background: Vitiligo is one of the autoimmune skin diseases that destroy the melanocytes of the skin. Moreover, its prevalence varies in different countries and regions.

Objectives: The aim of this study was to compare the effect of Nigella sativa and fish oil on vitiligo lesions of the patients referred to a dermatology clinic.

Materials And Methods: This randomized, double blind clinical trial was conducted in the dermatology clinic of the Imam Khomeini Hospital Ahvaz, Iran, from June to December 2011. We used a randomized simple sampling. From 96 patients with vitiligo, 52 eligible patients were selected and allocated to two groups with equal size. The study medications were applied twice a day by patients on their lesions. After six months, the improvement rate of lesions was assessed by the Vitiligo Area Scoring Index (VASI). Data were analyzed using SPSS v. 15; P value < 0.05 was considered as statistically significant.

Results: After six months, a mean score of VASI decreased from 4.98 to 3.75 in patients applying topical Nigella sativa and from 4.98 to 4.62 in those using topical fish oil. Most of the percent improvement observed in upper extremities, trunk, head, and neck of those who received Nigella sativa and head, neck, trunk, and feet of those who received fish oil. No adverse effect was reported by the patients.

Conclusions: Nigella sativa oil and fish oil were effective in reduction the size of patient's lesions; however, Nigella sativa was more effective in comparison to the fish oil. Therefore, using Nigella sativa with the major drugs in the treatment of vitiligo is recommended.
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http://dx.doi.org/10.5812/ircmj.4515DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4102993PMC
June 2014

The efficacy of stinging nettle (urtica dioica) in patients with benign prostatic hyperplasia: a randomized double-blind study in 100 patients.

Iran Red Crescent Med J 2013 Jan 5;15(1):9-10. Epub 2013 Jan 5.

Department of Nursing and Midwifery, Gachsaran Branch, Islamic Azad University, Gachsaran, IR Iran.

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http://dx.doi.org/10.5812/ircmj.2386DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589769PMC
January 2013

The effect of immature oocytes quantity on the rates of oocytes maturity and morphology, fertilization, and embryo development in ICSI cycles.

J Assist Reprod Genet 2012 Aug 30;29(8):803-10. Epub 2012 May 30.

Yazd Institute for Reproductive Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Purpose: The goal was to evaluate the role of the number of retrieved immature oocytes on mature oocyte counts and morphology, and also the rates of fertilization and embryo development in ICSI cycles.

Methods: 101 ICSI cycles were included in this prospective evaluation. Patients were divided into 2 groups of A (≤ 2 immature oocytes) and B (> 2 immature oocytes). In sub-analysis, the impacts of the number of GV and MI oocytes were assessed on the rates of fertilization and embryo development. Also, correlations between the numbers of immature and mature oocytes, as well as maternal age between two groups were analyzed. Assessments of oocyte morphology, fertilization, embryo quality and development were done accordingly.

Results: There was no correlation between the immature oocytes quantity with the number of mature ones. There were insignificant differences for embryo development between two groups, but fertilization rate was higher in group A (P = 0.03). In sub-analysis, insignificant differences were observed between two groups of ≤ and >2 GV and MI oocytes for rates of fertilization and embryo development. Also, the rates of clinical pregnancy and delivery were insignificant between groups. The rate of morphologically abnormal oocytes had no significant difference between two groups, except for wide perivitelline space (PVS) which was higher in group A (P = 0.03). There was no significant difference for maternal age between two groups.

Conclusions: In cases with few retrieved immature oocytes, rates of fertilization and incidence of wide PVS may increase, although immature oocytes may not have any negative impacts on early embryo development, or the rates on number of mature oocytes.
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http://dx.doi.org/10.1007/s10815-012-9799-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430773PMC
August 2012

Angiotensin II regulates growth of the developing papillas ex vivo.

Am J Physiol Renal Physiol 2012 May 1;302(9):F1112-20. Epub 2012 Feb 1.

Division of Pediatric Nephrology, Department of Pediatrics, Hypertension, and Renal Center of Excellence, Tulane University Health Sciences Center, New Orleans, LA 70112, USA.

We tested the hypothesis that lack of angiotensin (ANG) II production in angiotensinogen (AGT)-deficient mice or pharmacologic antagonism of ANG II AT(1) receptor (AT(1)R) impairs growth of the developing papillas ex vivo, thus contributing to the hypoplastic renal medulla phenotype observed in AGT- or AT(1)R-null mice. Papillas were dissected from Hoxb7(GFP+) or AGT(+/+), (+/-), (-/-) mouse metanephroi on postnatal day P3 and grown in three-dimentional collagen matrix gels in the presence of media (control), ANG II (10(-5) M), or the specific AT(1)R antagonist candesartan (10(-6) M) for 24 h. Percent reduction in papillary length was attenuated in AGT(+/+) and in AGT(+/-) compared with AGT(-/-) (-18.4 ± 1.3 vs. -32.2 ± 1.6%, P < 0.05, -22.8 ± 1.3 vs. -32.2 ± 1.6%, P < 0.05, respectively). ANG II blunted the decrease in papilla length observed in respective media-treated controls in Hoxb7(GFP+) (-1.5 ± 0.3 vs. -10.0 ± 1.4%, P < 0.05) or AGT(+/+), (+/-), and (-/-) papillas (-12.8 ± 0.7 vs. -18.4 ± 1.3%, P < 0.05, -16.8 ± 1.1 vs. -23 ± 1.2%, P < 0.05; -26.2 ± 1.6 vs. -32.2 ± 1.6%, P < 0.05, respectively). In contrast, percent decrease in the length of Hoxb7(GFP+) papillas in the presence of the AT(1)R antagonist candesartan was higher compared with control (-24.3 ± 2.1 vs. -10.5 ± 1.8%, P < 0.05). The number of proliferating phospho-histone H3 (pH3)-positive collecting duct cells was lower, whereas the number of caspase 3-positive cells undergoing apoptosis was higher in candesartan- vs. media-treated papillas (pH3: 12 ± 1.4 vs. 21 ± 2.1, P < 0.01; caspase 3: 3.8 ± 0.5 vs. 1.7 ± 0.2, P < 0.01). Using quantitative RT-PCR, we demonstrate that AT(1)R signaling regulates the expression of genes implicated in morphogenesis of the renal medulla. We conclude that AT(1)R prevents shrinkage of the developing papillas observed ex vivo via control of Wnt7b, FGF7, β-catenin, calcineurin B1, and α3 integrin gene expression, collecting duct cell proliferation, and survival.
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http://dx.doi.org/10.1152/ajprenal.00435.2011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3362172PMC
May 2012

Prevalence of undiagnosed diabetes and quality of care in diabetic patients followed at primary and tertiary clinics in Abu Dhabi, United Arab Emirates.

Rev Diabet Stud 2010 10;7(4):293-302. Epub 2011 Feb 10.

Department of Internal Medicine, UAE University, Al Ain, United Arab Emirates.

Aims: To investigate the prevalence of undiagnosed type 2 diabetes (T2D) at primary health care (PHC) clinics, and to assess the quality of care of diabetic patients followed at a tertiary hospital diabetes center in Abu Dhabi, United Arab Emirates (UAE).

Methods: Between May 2009 and October 2010, adult patients attending two PHC clinics, and adult diabetic patients attending the diabetes center, were invited to participate in the study. After overnight fast, participants returned for interview and laboratory tests. Undiagnosed T2D was defined by FPG ≥ 7.0 mmol/l or HbA1c ≥ 6.5%. Quality of care was assessed by reported care practices and achievement of internationally recognized targets.

Results: Out of 239 patients at PHC clinics without history of T2D, 14.6% had undiagnosed T2D, and 31% had increased risk of diabetes (FPG 5.6-7.0 mmol/l or HbA1c 5.7-6.5%). The independent predictors of undiagnosed T2D were age (adjusted OR per year 1.07, 95% CI 1.04-1.11, p < 0.001) and BMI ≥ 25 (adjusted OR 4.2, 95% CI 0.91-19.7, p = 0.033). Amongst all 275 diagnosed T2D patients, including those attending PHC clinics and those followed at the diabetes center, it was found that 40.1% followed dietary recommendations, 12% reported visiting a diabetes educator, 28.2% walked for exercise, and 13.5% attained recognized targets of HbA1c < 7%, blood pressure < 130/80 mmHg, and LDL cholesterol < 2.6 mmol/l.

Conclusions: Almost half of the adult patients attending PHC clinics had undiagnosed T2D, or increased diabetes risk. Care practices, and achievement of treatment targets, were suboptimal.
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http://dx.doi.org/10.1900/RDS.2010.7.293DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3143544PMC
October 2011

Whole and strip nitrocellulose membrane as well as a new-line-immunoblotting of antigen using the chemiluminescence technique.

Methods Mol Biol 2009 ;536:417-32

Oklahoma Medical Research Foundation, 825 NE 13th St, Arthritis and Immunology Department, MS #24, Oklahoma City, OK, 73104, USA.

There are a number of techniques in the scientific world that researchers use to detect specific antigens. One such technique that has provided many advantages over typical immunochemical staining is chemiluminescence. The emission of visible radiation by compounds once exposed to sunlight has been known for centuries and currently is the main principle for chemiluminescence. Here, we introduce three different chemiluminescence techniques that are widely used in immunodetection of antigens: (a) whole membrane chemiluminescence detection, (b) strip membrane chemiluminescence detection, and (c) new line blotting chemiluminescence.
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http://dx.doi.org/10.1007/978-1-59745-542-8_42DOI Listing
June 2009

Correlation of sulfur mustard exposure and tobacco use with expression (immunoreactivity) of p53 protein in bronchial epithelium of Iranian "mustard lung" patients.

Mil Med 2007 Jan;172(1):70-4

Baqiyatallah Medical Sciences University, Research Center of Chemical Injuries, Tehran, Iran.

A unique chronic obstructive pulmonary disease (COPD), provisionally called "mustard lung", which occurs as a late complication of sulfur mustard (SM) exposure among SM-exposed Iranians, is presently poorly characterized. This investigation evaluates p53 immunoreactivity in bronchial epithelium of individuals with histories of tobacco use and/or SM exposure, as a tool to help define mustard lung. In this study, 68 COPD patients were segregated into two groups, 35 mustard-exposed patients (including 8 smokers) and 33 unexposed patients (including 16 smokers). Disease severity was assessed with pulmonary function tests. p53 protein in bronchial tissue obtained as biopsies was quantitated by immunostaining. Among nonsmokers, 41.2% of unexposed subjects and 14.8% of exposed subjects expressed p53. Among smokers, 25% of the unexposed group and 50% of the exposed group expressed the protein. Initial data trends suggest an additive contribution of SM exposure and smoking to p53 immunoreactivity. These results illustrate the use of p53 immunoreactivity in the characterization of COPD, including mustard lung.
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http://dx.doi.org/10.7205/milmed.172.1.70DOI Listing
January 2007

Diagnostic and therapeutic value of short-term corticosteroid therapy in exacerbation of mustard gas-induced chronic bronchitis.

Basic Clin Pharmacol Toxicol 2005 Nov;97(5):302-5

Baqiyatallah Medical Sciences University, Research Center of Chemical Injuries. Tehran, Iran.

Chronic bronchitis is the most frequent late respiratory disease among Iranians exposed to mustard gas during the Iraq-Iran war. The aim of this study was to investigate efficacy of oral and intravenous corticosteroid therapy in improving lung function in mustard gas induced chronic bronchitis patients. 65 mustard gas-exposed chronic bronchitis patients, who were not responsive to standard treatments in exacerbation occasions, were randomly divided into two groups: an intravenous group (39 patients) receiving 500 mg intravenous methylprednisolone daily, and an oral group (26 patients) receiving 1 mg/kg oral prednisolone daily. Corticosteroid was tapered over the study period in both groups. Spirometery was performed on admission and on day 8 of therapy for assessment of effectiveness of therapy. There was significant improvement in spirometery indexes of both groups in approximately half of the patients over the study period. Furthermore, there was no difference between the pulse corticosteroid versus oral corticosteroid therapy in these patients. Since short-term corticosteroid therapy has a significant effect on lung function of almost fifty percent of patients with mustard gas-induced chronic bronchitis in exacerbation occasions, we suggest a short-term bolus steroid treatment to triage the patients into responders and non-responders for subsequent treatment.
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http://dx.doi.org/10.1111/j.1742-7843.2005.pto_187.xDOI Listing
November 2005

Effect of gamma interferon on lung function of mustard gas exposed patients, after 15 years.

Pulm Pharmacol Ther 2006 30;19(2):148-53. Epub 2005 Aug 30.

Research Center of Chemical Injuries, Baqiyatallah Medical Sciences University, Tehran, Iran.

Background: Bronchiolitis has been known to be among the main the pathological features of lung lesions in Mustard Gas (MG) exposed patients. The purpose of this research was to evaluate the efficacy of interferon gamma-1b on the lung function in MG exposed patients with bronchiolitis.

Method: Thirty-six bronchiolitis patients, whose lung lesion had been diagnosed through High Resolution Computerized Tomography (HRCT) of the chest and also pathological study, were divided into two 18-member case and control groups. Both groups were receiving their conventional treatment (inhaled Felixotide and Servent). The case group were treated for 6 months with a combination of 200 microg of interferon gamma-1b (given three times per week subcutaneously) plus 7.5 mg of prednisolone (given once a day), while the control group received their previous conventional medications. Lung function was measured at base line and after 1, 3 and 6 months of treatment.

Results: In case and control groups, Forced Expiratory Volume in first second (FEV1) did not have statistical differences at the base line (49.3 +/- 2.9 and 48.7 +/- 4.1, respectively = 0.6), whereas a significant increase was seen in the case group (66.3 +/- 5.4) compared control group (57.3 +/- 8.6) at the subsequent months (P = 0.001 for the difference between the groups). Similar pattern of increase was observed in Forced Vital Capacity (FVC).

Conclusion: The findings of this study indicate that a 6-month treatment with interferon gamma-1b plus a low-dose prednisolone is associated with an improvement in the lung function in mustard-gas exposed patients with bronchiolitis.
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http://dx.doi.org/10.1016/j.pupt.2005.07.003DOI Listing
April 2006