Publications by authors named "Ali Saffaei"

47 Publications

No clinical benefit of high dose corticosteroid administration in patients with COVID-19: A preliminary report of a randomized clinical trial.

Eur J Pharmacol 2021 Apr 16;897:173947. Epub 2021 Feb 16.

Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

The aim of this study was to evaluate the clinical effects of dexamethasone administration in patients with mild to moderate acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19). The study included 50 patients who were randomly assigned to the dexamethasone group or control group. Dexamethasone was administered at a dose of 20 mg/day from day 1-5 and then at 10 mg/day from day 6-10. The need for invasive mechanical ventilation, death rate, duration of clinical improvement, length of hospital stay, and radiological changes in the computed tomography scan were assessed. The results revealed that 92% and 96% of patients in the dexamethasone and control groups, respectively, required noninvasive ventilation (P = 0.500). Among them, 52% and 44% of patients in the dexamethasone and control groups, respectively, required invasive mechanical ventilation (P = 0.389). At the end of the study, 64% of patients in the dexamethasone group and 60% of patients in the control group died (P = 0.500); the remaining patients were discharged from the hospital during the 28-day follow-up period. The median length of hospital stay was 11 days in the dexamethasone group and 6 days in the control group (P = 0.036) and the median length of hospital stay was 7 days in the dexamethasone group and 3 days in the control group (P < 0.001). No significant differences were observed in the other outcomes. This study showed that corticosteroid administration had no clinical benefit in patients with COVID-19-induced mild to moderate ARDS.
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http://dx.doi.org/10.1016/j.ejphar.2021.173947DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885705PMC
April 2021

Evaluating the effects of Intravenous Immunoglobulin (IVIg) on the management of severe COVID-19 cases: A randomized controlled trial.

Int Immunopharmacol 2021 Jan 13;90:107205. Epub 2020 Nov 13.

Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

Background: The newly discovered coronavirus has turned into coronavirus disease 2019 (COVID-19) pandemic and it rages at an unprecedented rate. Considering the findings of previous studies on the use of Intravenous Immunoglobulin (IVIg) for treating severe HN infection and the satisfying results for reducing viral load and mortality, this study aimed to investigate the potential usefulness of IVIg for the management of severe cases.

Methods: In this randomized controlled trial, 84 patients were included: 52 in the IVIg group and 32 in the control group. The intervention group received IVIg at a dose of 400 mg/kg, IV, daily for three days. Both groups received hydroxychloroquine, lopinavir/ritonavir and supportive care. The demographic data, mortality rate, the need for mechanical ventilation, length of stay in hospital and in Intensive Care Unit (ICU), and imaging findings were recorded and compared in terms of the mentioned factors.

Results: The mean time from admission to IVIg initiation was 3.84 ± 3.35 days. There was no significant difference between the two groups in terms of mortality rate (P-value = 0.8) and the need for mechanical ventilation (P-value = 0.39). The length of hospital stay was significantly lower for the control group than that of the intervention group (P-value = 0.003). There was a significant positive relationship between the time from hospital admission to IVIg initiation and the length of stay in the hospital and ICU among the survivors (P-value < 0.001 and =0.01, respectively).

Conclusions: Our findings did not support the use of IVIg in combination with hydroxychloroquine and lopinavir/ritonavir in treatment of severe COVID-19 cases.
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http://dx.doi.org/10.1016/j.intimp.2020.107205DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7665876PMC
January 2021

A Fourteen-day Experience with Coronavirus Disease 2019 (COVID-19) Induced Acute Respiratory Distress Syndrome (ARDS): An Iranian Treatment Protocol.

Iran J Pharm Res 2020 ;19(1):31-36

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

COVID-19 is currently causing concern in the medical community as the virus is spreading around the world. It has a heavy global burden, particularly in low-income countries. The clinical spectrum of COVID-19 pneumonia ranges from mild to critically ill cases and Acute Respiratory Distress Syndrome. An expert panel was held and an internal protocol was developed to manage the COVID-19 induced ARDS according to WHO recommendations and NIH guidelines. Different therapeutic regimens were employed on this protocol based on the ARDS severity and the patients' special characteristics. The mortality rate, the rate of survivors, and non-survivors were reported. Of the 231 suspected cases of COVID-19 admitted to the hospital during two weeks, 72 patients were admitted to ICU with diagnosis confirmed by RT-PCR. In total, mortality in the ICU was 25% (n = 18) among ARDS patients over two weeks. COVID-19 induced ARDS is a major concern. The rapid progression of ARDS needs specific protocol based on patients' characteristics and rapid action.
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http://dx.doi.org/10.22037/ijpr.2020.113337.14239DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462513PMC
January 2020

Thalidomide against Coronavirus Disease 2019 (COVID-19): A Medicine with a Thousand Faces.

Iran J Pharm Res 2020 ;19(1):1-2

Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.22037/ijpr.2020.113369.14259DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462477PMC
January 2020

Promising effects of tocilizumab in COVID-19: A non-controlled, prospective clinical trial.

Int Immunopharmacol 2020 Nov 4;88:106869. Epub 2020 Aug 4.

Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

Background: The clinical presentation of SARS-CoV-2 infection ranges from mild symptoms to severe complications, including acute respiratory distress syndrome. In this syndrome, inflammatory cytokines are released after activation of the inflammatory cascade, with the predominant role of interleukin (IL)-6. The aim of this study was to evaluate the effects of tocilizumab, as an IL-6 antagonist, in patients with severe or critical SARS-CoV-2 infection.

Methods: In this prospective clinical trial, 76 patients with severe or critical SARS-CoV-2 infection were evaluated for eligibility, and ultimately, 42 patients were included. Tocilizumab was administered at a dose of 400 mg as a single dose via intravenous infusion. Primary outcomes included changes in oxygenation support, need for invasive mechanical ventilation, and death. Secondary outcomes included radiological changes in the lungs, IL-6 plasma levels, C-reactive protein levels, and adverse drug reactions. The data were analyzed using SPSS software.

Results: Of the 42 included patients, 20 (48%) patients presented the severe infection stage and 22 (52%) were in the critical stage. The median age of patients was 56 years, and the median IL-6 level was 28.55 pg/mL. After tocilizumab administration, only 6 patients (14%) required invasive ventilation. Additionally, 35 patients (83.33%) showed clinical improvement. By day 28, a total of 7 patients died (6 patients in the critical stage and 1 patient in the severe stage). Neurological adverse effects were observed in 3 patients.

Conclusions: Based on the current results, tocilizumab may be a promising agent for patients with severe or critical SARS-CoV-2 infection, if promptly initiated during the severe stage.
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http://dx.doi.org/10.1016/j.intimp.2020.106869DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7402206PMC
November 2020

Extracorporeal membrane oxygenation and COVID-19: The causes of failure.

J Card Surg 2020 Oct 17;35(10):2838-2843. Epub 2020 Jul 17.

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

Introduction: Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a therapeutic strategy for the coronavirus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS). There are inconclusive data in this regard and causes of VV-ECMO failure are not yet understood well.

Case Series: Here, seven patients with COVID-19-induced ARDS who underwent VV-ECMO introduced and causes of VV-ECMO failure discussed. Medical records of seven COVID-19 patients treated with VV-ECMO were retrospectively evaluated to determine the clinical outcomes of VV-ECMO. Oxygenator failure occurred in four patients whom needed to oxygenator replacement. Successful VV-ECMO decannulation was done in three patients, however finally one patient survived.

Conclusions: Hypercoagulability state and oxygenator failure were the most main etiologies for VV-ECMO failure in our study. All patients with COVID-19 undergoing VV-ECMO should be monitored for such problems and highly specialized healthcare team should monitor the patients during VV-ECMO.
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http://dx.doi.org/10.1111/jocs.14867DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7404852PMC
October 2020

COVID-19 and elective cosmetic procedures: Asymptomatic transmission in epidemic area and subsequent burdens.

J Cosmet Dermatol 2020 Aug 20;19(8):1838-1839. Epub 2020 Jun 20.

Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.1111/jocd.13535DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323017PMC
August 2020

Subcutaneous administration of interferon beta-1a for COVID-19: A non-controlled prospective trial.

Int Immunopharmacol 2020 Aug 7;85:106688. Epub 2020 Jun 7.

Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Recently, a new coronavirus spreads rapidly throughout the countries and resulted in a worldwide epidemic. Interferons have direct antiviral and immunomodulatory effects. Antiviral effects may include inhibition of viral replication, protein synthesis, virus maturation, or virus release from infected cells. Previous studies have shown that some coronaviruses are susceptible to interferons. The aim of this study was to evaluate the therapeutic effects of IFN-β-1a administration in COVID-19.

Methods: In this prospective non-controlled trial, 20 patients included. They received IFN-β-1a at a dose of 44 µg subcutaneously every other day up to 10 days. All patients received conventional therapy including Hydroxychloroquine, and lopinavir/ritonavir. Demographic data, clinical symptoms, virological clearance, and imaging findings recorded during the study.

Results: The mean age of the patients was 58.55 ± 13.43 years. Fever resolved in all patients during first seven days. Although other symptoms decreased gradually. Virological clearance results showed a significant decrease within 10 days. Imaging studies showed significant recovery after 14-day period in all patients. The mean time of hospitalization was 16.8 ± 3.4 days. There were no deaths or significant adverse drug reactions in the 14-day period.

Conclusions: Our findings support the use of IFN-β-1a in combination with hydroxychloroquine and lopinavir/ritonavir in the management of COVID-19.

Clinical Trial Registration Number: IRCT20151227025726N12.
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http://dx.doi.org/10.1016/j.intimp.2020.106688DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275997PMC
August 2020

Sitagliptin Repositioning in SARS-CoV-2: Effects on ACE-2, CD-26, and Inflammatory Cytokine Storms in the Lung.

Iran J Allergy Asthma Immunol 2020 May 17;19(S1):10-12. Epub 2020 May 17.

Sarem Cell Research Center (SCRC), Sarem Women's Hospital, Tehran, Iran AND Department of Immunology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.

No Abstract.
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http://dx.doi.org/10.18502/ijaai.v19i(s1.r1).2849DOI Listing
May 2020

Tocilizumab administration in a refractory case of COVID-19.

Int J Antimicrob Agents 2020 Aug 2;56(2):106043. Epub 2020 Jun 2.

Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

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http://dx.doi.org/10.1016/j.ijantimicag.2020.106043DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264941PMC
August 2020

Tocilizumab administration in patients with SARS-CoV-2 infection: Subcutaneous injection vs intravenous infusion.

J Med Virol 2021 01 19;93(1):69-70. Epub 2020 Jun 19.

Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.1002/jmv.26124DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300729PMC
January 2021

Continues renal replacement therapy (CRRT) with disposable hemoperfusion cartridge: A promising option for severe COVID-19.

J Glob Antimicrob Resist 2020 06 27;21:340-341. Epub 2020 Apr 27.

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

Cytokine release syndrome is prevalent in severe cases of COVID-19. In this syndrome, an uncontrolled response of immune system occurs. Extracorporeal blood purification has been proven to effectively remove the released inflammatory cytokines. Here, we reported a successful case to represent our experience of extracorporeal blood purification in a patient with severe COVID-19.
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http://dx.doi.org/10.1016/j.jgar.2020.04.024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7185011PMC
June 2020

Jellyfish Stings Rarely Induced Infectious Cellulitis: First Aid Remedies as Double-Edged Sword.

Adv J Emerg Med 2020 29;4(2):e33. Epub 2019 Sep 29.

Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.22114/ajem.v0i0.260DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7163266PMC
September 2019

Comment on "The Effect of Nitroglycerine Infusion on Postoperative Pain in Lower Limb Surgery: A Clinical Double-Blind Study".

Anesth Pain Med 2019 Dec 29;9(6):e98592. Epub 2019 Dec 29.

Department of Critical Care Medicine, Emam Hossein Medical and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.5812/aapm.98592DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7119218PMC
December 2019

Aminoquinolines against coronavirus disease 2019 (COVID-19): chloroquine or hydroxychloroquine.

Int J Antimicrob Agents 2020 04 17;55(4):105945. Epub 2020 Mar 17.

Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

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http://dx.doi.org/10.1016/j.ijantimicag.2020.105945DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156117PMC
April 2020

Glutamine powder-induced hepatotoxicity: it is time to understand the side effects of sports nutritional supplements.

Gastroenterol Hepatol Bed Bench 2020 ;13(1):86-89

Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Glutamine has been considered as a dietary supplement with a non-essential amino acid structure. Some studies have found that liver failure may be associated with a high plasma glutamine level. Consumption of this product may be linked to potential adverse effects. This report describes the first case of glutamine-induced hepatotoxicity. A 35-year-old female athlete with severe abdominal pain and scleral icterus was referred to the hospital. She had been taking glutamine powder for the past three weeks. Impaired liver function test and imaging evaluation suggested hepatotoxicity. Glutamine consumption was discontinued and the patient was closely monitored. Finally, after two weeks, the patient recovered successfully. This novel case was the first report regarding glutamine-induced hepatotoxicity. Health care providers must know that consumption of dietary supplements such as glutamine may be associated with serious side effects. Liver damage is a possible side effect of glutamine. Hence it is necessary to consider hepatotoxicity as an adverse reaction in case of glutamine supplement consumption.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069532PMC
January 2020

Efficacy and Safety of Dulaglutide Compared to Liraglutide: A Systematic Review and Meta-analysis in Patients with Type 2 Diabetes Mellitus.

Iran J Pharm Res 2019 ;18(4):2180-2190

Department of Pharmacoeconomics and Pharmaceutical Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Diabetes mellitus has been always one of the most prevalent chronic diseases in the last decades. There exist a wide range of pharmacological agents for controlling this disease. However, these agents fare differently in terms of efficacy and safety. Hence, the aim of this study was to compare dulaglutide and liraglutide, two glucagon-like peptide-1 receptor agonists, in terms of efficacy and safety, drawing on a systematic review and meta-analysis. A systematic review and meta-analysis were carried out in January 2018. The articles were evaluated by two independent investigators and their quality was evaluated using Jadad scale and the Cochrane Collaboration's tools. Finally, the eligible articles entered the study. HbA1c and FBS were considered as efficacy outcomes. Safety profile was evaluated based on several outcomes such as serious side effects and vital signs. Three articles met the inclusion and exclusion criteria. The results indicated that the mean difference (MD) of HbA1c reduction was -0.10% (95% CI, -0.20% to -0.01%, P=0.03) in the patients who received dulaglutide in comparison with the patients who received liraglutide. In addition, dulaglutide was safer than liraglutide in terms of gastrointestinal problems (RR=0.85, 95% CI, 0.73 to 0.99, P=0.04, I=55%) and heart rate (RR=-1.14, 95% CI, -1.90 to -0.38, P=0.003, I=0%). Once-weekly dulaglutide showed a further reduction in HbA1c compared to once-daily liraglutide. However, comparisons between these regimens indicated no significant difference between groups in either FBS reduction or safety profile. Similarly, no statistically significant difference was observed in treatment discontinuation, hypoglycemia events, and vital signs.
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http://dx.doi.org/10.22037/ijpr.2019.14733.12619DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059053PMC
January 2019

Omega-3 in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis, Effects on Inflammatory Markers and Lipid Profile.

Iran J Kidney Dis 2020 03;14(2):126-132

Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Introduction: CKD is one of the most prevalent entities associated with high morbidity and mortality. Most of the patients with renal diseases, particularly patients undergoing dialysis, suffer from cardiovascular disease and it is necessary to employ appropriate strategies to prevent and manage this complication. The aim of this study was to evaluate the anti-inflammatory effects of omega-3 in patients undergoing CAPD.

Methods: Nineteen CAPD patients with certain inclusion and exclusion criteria enrolled in this study. Omega-3 capsules with a dose of 1 g/d up to three months, were administrated. Some inflammatory markers such as ESR, CRP, HS-CRP, IL-6, MDA, and homocysteine were measured in three phases. In addition, lipid profile including triglyceride, cholesterol, LDL, and HDL were measured.

Results: Results of this study showed that CRP, HS-CRP, and homocysteine levels increased insignificantly (P > .05) whereas, MDA level was increased significantly (P < .05). ESR and IL-6 levels both decreased but did not show any statistically significance (P > .05). Results of lipid profile also suggested that none of the lipid levels changed significantly (P > .05).

Conclusion: It is necessary to design large trials in order to understand clear effects of omega-3 on inflammatory markers in PD patients. In addition, the results of this current pilot study should be interpreted with caution.
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March 2020

Macrolide-resistant Mycoplasma pneumoniae in adults with community acquired pneumonia: challenges and risks.

East Mediterr Health J 2020 02 24;26(2):141-142. Epub 2020 Feb 24.

Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.

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http://dx.doi.org/10.26719/2020.26.2.141DOI Listing
February 2020

Meropenem Induced Skin Drug Eruption in Infectious Mononucleosis: Immunological Phenomena or Non-immunological Phenomena?

Oman Med J 2020 Jan 16;35(1):e102. Epub 2020 Feb 16.

Student Research Committee, Department of Clinical Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.5001/omj.2020.20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7024542PMC
January 2020

Gulucatime versus Glucantime: A Serious Warning on Counterfeit Medicines.

J Res Pharm Pract 2019 Oct-Dec;8(4):228-229. Epub 2019 Dec 27.

Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.4103/jrpp.JRPP_19_84DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952753PMC
December 2019

Blood Glucose Control and Opportunities for Clinical Pharmacists in Infectious Diseases Ward.

J Res Pharm Pract 2019 Oct-Dec;8(4):202-207. Epub 2019 Dec 27.

Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Objective: Increased risk of infection following hyperglycemia has been reported in hospitalized patients. Sliding-scale insulin protocol is an out-of-date method; therefore, it is necessary to examine new approaches in this regard. This study aimed to evaluate the efficacy of sliding-scale protocol versus basal-bolus insulin protocol, which supervised by clinical pharmacists in an infectious disease ward.

Methods: In this prospective randomized clinical trial, 90 hyperglycemic patients who hospitalized in Loghman Hakim Hospital Infectious Disease Ward (Tehran, Iran) were randomized into two groups: sliding-scale insulin protocol (the control group) and the basal-bolus protocol groups that were under supervision clinical pharmacists. Some demographic, laboratory, and clinical variables, as well as patient's blood glucose were measured four times daily.

Findings: The results indicated significant improvement among the patients in the intervention group. General indicators including fever, blood glucose level, the duration of hospitalization, incidence of hypoglycemia, days to achieve normal blood glucose, and leukocyte count improved in intervention group.

Conclusion: According to this study, basal-bolus insulin protocol, which supervised by clinical pharmacy service, showed better blood glucose control and infection remission compared to the sliding-scale protocol.
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http://dx.doi.org/10.4103/jrpp.JRPP_18_109DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952754PMC
December 2019

Systematic Review of Soft-tissue Filler-associated Blindness: A Methodologic Concern Beyond Duplicated Cases.

Plast Reconstr Surg Glob Open 2019 Sep 27;7(9):e2380. Epub 2019 Sep 27.

Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.1097/GOX.0000000000002380DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908371PMC
September 2019

Pharmacist-Physician Organic Cooperation Is an Effective Strategy to Reduce the Medication-related Problems, An Experience in CKD Patients.

Iran J Kidney Dis 2019 11;13(6):419-420

Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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November 2019

Promising Novel Treatment against Keloids: Antivascular Endothelial Growth Factor Agents.

J Res Pharm Pract 2019 Jul-Sep;8(3):178-179. Epub 2019 Oct 16.

Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

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http://dx.doi.org/10.4103/jrpp.JRPP_19_58DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830013PMC
October 2019

Comment on: Efficacy and Safety of Mycophenolate Mofetil versus Intravenous Pulse Cyclophosphamide as Induction Therapy in Proliferative Lupus Nephritis.

Iran J Kidney Dis 2019 09;13(5):346

Student Research Committee, Department of Clinical Pharmacy, Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran..

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September 2019

Cytarabine and Doxorubicin-Induced Palmoplantar Erythrodysesthesia Syndrome: The Possible Role of Voriconazole Interaction.

Eurasian J Med 2019 Oct;51(3):313-315

Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Palmoplantar Erythrodysesthesia Syndrome (PPES) caused by chemotherapeutic agents is rarely life threatening and requires a reduction in dose or discontinuation of chemotherapy. The use of cytarabine and doxorubicin in the treatment of acute myeloid leukemia (AML) along with voriconazole can potentially alter the metabolism of the drugs and cause some interactions. In this study, we presented a case of AML who received cytarabine and doxorubicin as a chemotherapy regimen and voriconazole as a prophylactic anti-fungal. In this combination, voriconazole probably inhibits the P-glycoprotein pump, which leads to an increase in the cytarabine concentration. The emphasis of this report is the awareness of clinicians and pharmacotherapists about these interactions.
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http://dx.doi.org/10.5152/eurasianjmed.2019.18459DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6812918PMC
October 2019

Multiple pigmented macules as a sequel of cosmetic lip micro-pigmentation: New clinical presentation of tattoo reactions.

Niger Postgrad Med J 2019 Oct-Dec;26(4):244-246

Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Cosmetic tattooing using micro-pigmentation has gained popularity in recent years. Tattoos can cause a broad range of clinical and psychosocial problems. Several medical complications may arise after tattooing. A 35-year-old female was referred with an 8-week history of grey-to-smoky hyperpigmentation of permanent makeup of lips and lip lines. Histopathological examination revealed lichenoid lymphocytic infiltrations in the dermis. Clinical and histopathological findings were compatible with the diagnosis of multiple pigmented macules as a sequel of cosmetic lip micro-pigmentation. Here, we report the first case of lichenoid-type tattoo reactions with new presentation as multiple asymptomatic pigmented macules after lip tattooing. The current report emphasises the requirement of a skin biopsy of all tattoo reactions. Considering the new component in the tattoo material, a dermatologist should be aware of the new clinical presentation of tattoo reactions that may occur.
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http://dx.doi.org/10.4103/npmj.npmj_88_19DOI Listing
November 2019

Atropine Challenge Test in Screening the Organophosphorus Poisoning Cases with Atypical Presentation; a Brief Report.

Arch Acad Emerg Med 2019 19;7(1):e46. Epub 2019 Aug 19.

Emergency Department, Imam Reza Hospital, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Introduction: Atropine is not recommended in organophosphorus (OPs) poisoning cases without any obvious clinical signs. This study aimed to evaluate the clinical utility of Atropine challenge test in screening OPs poisoning cases with atypical presentation.

Methods: In this prospective cross sectional study, after primary supportive care, patients with atypical pretentions of OPs poisoning underwent Atropine challenge test (1 mg intravenously) and demographic parameters, clinical presentations, and serum level of cholinesterase enzyme were compared between cases with positive and negative test results.

Results: 20 patients with the mean age of 47.60 ± 13.25 years were studied. The mean time since exposure and initial symptoms was 6.17 ± 2.99 hours. The most common clinical presentations were tachycardia (55%) and flushing (35%). The atropine challenge test was positive in 3 (15.00%) cases. The two groups were the same regarding gender distribution (p = 0.582), mean age (p = 0.957), clinical presentation (p > 0.05), and mean PR interval (p = 0.729). The level of cholinesterase was 220.00 ± 15.52 U/mL and 332.17 ± 143.99 U/mL in patients with positive and negative Atropine challenge test, respectively (p = 0.006).

Conclusion: Patients with positive Atropine challenge test had a significantly lower level of serum cholinesterase and response to Atropine in their therapeutic management. Hence, Atropine challenge test could be considered as a useful clinical test in the setting of acute OPs poising.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785209PMC
August 2019

Cutaneous necrotic lesion: A wonderful delay adverse effect of interferon beta-1b injection for multiple sclerosis treatment.

J Cosmet Dermatol 2020 Apr 22;19(4):951-953. Epub 2019 Aug 22.

Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Multiple sclerosis (MS) is a chronic and inflammatory autoimmune disease. These patients may manifest severe inflammatory cutaneous reactions after using interferon beta-1b. This article describes a 55-year-old man with severe injection site reactions after 10 years administration of interferon beta-1b. The biopsy specimens revealed skin and subcutaneous tissue necrosis. Histologic evaluation revealed nonspecific inflammatory reactions with no evidence of vasculitis or granulomatous reactions. Based on clinical and pathological findings, the diagnosis of skin and soft tissue necrosis due to interferon injection was given. The injection of interferon beta-1b in the affected areas was stopped, and the patient's clinical condition improved by wound care. This report is aimed to increase awareness about severe adverse skin reactions, which may infrequently occur with subcutaneous interferon beta-1b injection after several years. Early diagnosis of this reaction can help to prevent associated complications.
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http://dx.doi.org/10.1111/jocd.13104DOI Listing
April 2020