Publications by authors named "Amirsina Sharifi"

21 Publications

  • Page 1 of 1

The effect of fibrin glue on the postoperative lymphatic leakage after D2-lymphadenectomy and gastrectomy in patients with gastric cancer.

BMC Surg 2021 Mar 21;21(1):155. Epub 2021 Mar 21.

Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Disturbance in the lymphatic drainage during D2 dissection is associated with significant morbidity. We aimed to assess the effect of fibrin glue on the reduction of postoperative lymphatic leakage.

Methods: Prospective double-blinded randomized clinical trial with forty patients in each study arm was conducted. All patients diagnosed, staged, and became a candidate for D2 dissection based on NCCN 2019 guideline for gastric cancer. The intervention group received 1 cc of IFABOND® applied to the surgical bed.

Results: The difference between study groups regarding age, gender, tumor stage was insignificant. (All p-values > 0.05). The median daily drainage volume was 120 ml with the first and the third interquartile being 75 and 210 ml, respectively for the intervention group. The control group had median, the first, and the third interquartile of 350, 290, and 420 ml. The difference between daily drainage volumes was statistically significant (p-value < 0.001). The length of hospital stay was significantly different between the two groups. Notably, the intervention group was discharged sooner (median of 7 Vs 9 days, p-value: 0.001).

Conclusion: This study showed the possible role of fibrin glue in reducing postoperative lymphatic leakage after gastrectomy and D2 dissection. Registration trial number: IRCT20200710048071N1, 2020.08.16.
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http://dx.doi.org/10.1186/s12893-021-01168-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983227PMC
March 2021

Prophylactic postoperative condom sheet placement: A randomized clinical trial to test a new concept.

Ann Med Surg (Lond) 2021 Feb 19;62:415-418. Epub 2021 Jan 19.

Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Objective: Postoperative urinary retention (POUR) is one of the most common complications after surgery with several risk factors. However, its precise etiology is not completely understood. So far, the effect of prophylactic condom sheet placement on the prevention of POUR has not been addressed. This study was designed to understand whether preventive condom sheet decreases the rate of POUR.

Materials And Methods: This randomized clinical trial was carried out in an educational hospital during 2018-2019. All male patients, who underwent anorectal surgery with spinal anesthesia, were included and randomly allocated into two groups (with and without postoperative condom sheet placement).

Results: A total of 172 patients were included in this study (86 patients per group). Twenty-three (13.4%) patients developed POUR. The incidence of POUR was 15.1% among patients with condom sheets and 11.6% in patients without condom sheets, which was not significantly different (P > 0.5). POUR development had a significant correlation with the use of morphine and history of hypertension in both univariate and multivariate analyses.

Conclusion: Based on the present results, it seems that condom sheet placement did not effectively prevent POUR in patients; therefore, ambulation of patients after surgery is a more effective strategy for these patients.
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http://dx.doi.org/10.1016/j.amsu.2021.01.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7858678PMC
February 2021

Neuroendocrine tumor of the common bile duct: A case report of extremely rare cause for obstructive jaundice.

Int J Surg Case Rep 2020 8;77:303-306. Epub 2020 Nov 8.

Research Associate, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran Iran.

Introduction: Neuroendocrine tumors (NET) of common bile duct are rare. There have been less than 100 cases reported worldwide.

Presentation Of Case: A 37-year-old female patient was referred to our center after six months of abdominal pain with no definite diagnosis. At initial presentation, she complained of increased abdominal pain, nausea, vomiting, oral intolerance to food and icteric sclera. Physical examination and laboratory tests were indicative of pancreatitis. At day four, she took retrograde cholangiopancreatography (ERCP) and a mid CBD stenosis or impacted stone was found. In order to locally investigate the lesion, Endoscopic Ultrasound (EUS) examination was performed which reported 16 × 12 mm isoechoic tumoral lesion at the middle of the CBD. In this regard we decided to perform ERCP-guided brushing biopsy of the lesion. The pathology report was highly suggestive for malignancy. She underwent resection of the mid portion of the CBD with Roux-en-Y hepaticojejunostomy, cholecystectomy and portahepatis lymph node dissection. The pathology report indicated that the CBD lesion was well-differentiated neuroendocrine tumor grade II.

Discussion: The exact etiology of developing NET in the bile duct tissues is not clear however cholelithiasis and congenital malformation of the biliary tract has been proposed to cause chronic inflammation with subsequent metaplasia which ultimately transforms into NET.

Conclusion: As there are very few cases of NETs of the CBD, no definite surgical or medical treatment is proposed. Currently, combination of radical surgical resection and lymph node dissection followed by chemotherapy is the treatment of choice.
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http://dx.doi.org/10.1016/j.ijscr.2020.11.027DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7677652PMC
November 2020

Primary rectal choriocarcinoma associated with rectal adenocarcinoma in a woman with a history of ulcerative colitis: Case report.

Int J Surg Case Rep 2020 5;77:256-259. Epub 2020 Nov 5.

Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Primary rectal choriocarcinoma is an extremely rare malignancy. The association of these neoplasms in patients with inflammatory bowel disease (IBD) has not been reported.

Presentation Of Case: A 34-year-old female with history of Ulcerative Colitis (UC) gave birth to a male fetus. She had postpartum bleeding and high level of beta-human chorionic gonadotropin (βhCG) was detected. Although initial investigations failed to confirm molar pregnancy, abnormal uterine bleeding and high βhCG level necessitate chemotherapy administration. She did not respond to chemotherapy sessions accordingly. Meanwhile, the patient experienced rectorrhagia and colonoscopy revealed a firm submucosal polypoid lesion 8-10 cm from the anal verge. The multidisciplinary team candidate the patient for total proctocolectomy and ileal pouch anal anastomosis. Although postoperative course was uneventful and βhCG level dropped but it showed a rising pattern in follow ups. Chemotherapy was planned but there was not suitable response. Unfortunately, the patient passed away 20 months after the initial diagnosis.

Discussion: Pathology report indicated the coexistence of moderately differentiated tubular adenocarcinoma and choriocarcinoma. We assume previous history of UC might have put her at higher susceptibility to develop carcinoma and this poorly differentiated carcinoma has led to choriocarcinoma. Considering the fact that in most cases of colorectal choriocarcinoma, choriocarcinomatous differentiation was found alongside colonic adenocarcinoma made dedifferentiation theory to be the most acceptable explanation.

Conclusion: The adenocarcinoma of the colon and rectum in the setting of IBD may become so dedifferentiated that gain some characteristics of germ cell tumors.
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http://dx.doi.org/10.1016/j.ijscr.2020.10.143DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7658567PMC
November 2020

Approach to Acute Abdominal Pain: Practical Algorithms.

Adv J Emerg Med 2020 8;4(2):e29. Epub 2019 Nov 8.

International Campus, Tehran University of Medical Sciences, Tehran, Iran.

Context: Acute abdominal pain is one of the most common complaints of patients admitted to emergency units. This study aimed to propose a new approach to abdominal pain by designing a more structured diagnostic workup for physicians.

Evidence Acquisition: A comprehensive review of relevant articles and algorithms presented in books and websites was conducted. Approaches which were relevant to the study concept, were selected.

Results: Seven algorithms were introduced with respect to the site of abdominal tenderness. The mainstay of these algorithms was differential diagnosis of the tenderness site.

Conclusion: Based on the findings, the designed approach can prevent confusion among physicians and reduce requests for many unnecessary paraclinical tests, which delay the final diagnosis and impose unacceptable costs on patients and healthcare systems.
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http://dx.doi.org/10.22114/ajem.v0i0.272DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7163264PMC
November 2019

Surgical Approaches to Benign Parapharyngeal Space Tumors-5-Year Experience.

Iran J Otorhinolaryngol 2020 Jan;32(108):43-48

Students' Scientific Research Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Various surgical approaches to parapharyngeal space (PPS) tumors are introduced to obtain complete removal with the preservation of the surrounding structures in parapharyngealneoplasms. Here, we will discuss the main techniques and their outcome.

Materials And Methods: This retrospective study was conducted on 78 patients undergone either transoral, transcervical or a combination of these two approaches for the resection of PSS tumors from January 2010 to January 2015.

Results: A number of 33 male and 45 female patients with the mean age of 40.9 ± 9.1 were evaluated. 42.3% of the patients were asymptomatic at the initial presentation. Pleomorphic adenoma and schwannoma were a permanent diagnosis in 61(78.2%) and 11(14.1%) patients, respectively. PPS tumors were resected using transoral, transcervical and combined approaches in 35(44.8%), 33(42.3%) and 10 (12.9%) cases, respectively. Recurrence occurred in 10 patients all of whom had apre-styloid pleomorphic adenoma, operated transcervical (P< 0.0001).Three cases of tenth nerve palsy occurred in schwannomas which were operatedtranscervically (P=0.04). Mean hospital stays were 2.11,3.69, and 4.9 days after transoral, transcervical and combined approaches, respectively (P= 0.001).

Conclusion: Transoral, transcervical and combined approaches are all able to provide adequate visualization with comparable outcomes.
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http://dx.doi.org/10.22038/ijorl.2019.38350.2268DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7007997PMC
January 2020

Granulosa Cell Tumor of the Ovary Accompanying with Ollier's Disease: First Case of Contralateral Presentations.

J Obstet Gynaecol India 2020 Feb 12;70(1):81-85. Epub 2019 Jun 12.

3Tehran University of Medical Sciences, Tehran, Iran.

Objective: Granulosa cell tumor (GCT) is a rare entity of ovarian malignancies. Juvenile GCT is considered a malignant tumor with an indolent course and tendency toward late recurrence. However, the association of this tumor and multiple enchondromas has been reported.

Case Presentation: A 17-year-old female with abnormal uterine bleeding was referred to our center. Ultrasonographic evaluation revealed a mass with origin in right ovary. Patient was worked up to undergo salpingo-oophorectomy, she felt a dull pain in her left lower limb. X-ray imaging was indicative for Ollier's disease at the distal part of femur and proximal part of tibia. Postoperative pathological review was compatible with juvenile granulosa tumor of the right ovary.

Conclusion: This case was the first of its kind that ovarian tumor was contralateral to the side involved by enchondromatosis.
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http://dx.doi.org/10.1007/s13224-019-01243-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6982646PMC
February 2020

Assessment of Admission Time Cell Blood Count (CBC) Parameters in Predicting Post-primary Percutaneous Coronary Intervention TIMI Frame Count in Patients with ST-segment Elevation Myocardial Infarction.

Cardiovasc Hematol Disord Drug Targets 2020 ;20(3):191-197

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Objectives: In this study, we aimed to assess the value of admission time CBC parameters in predicting post-primary PCI corrected TIMI frame count.

Background: Recent years have witnessed a large series of studies evaluating different laboratory variables to predict no-reflow phenomenon following primary PCI (PPCI) in patients with STEMI. However, a general agreement about the most reliable predictor of the no-reflow phenomenon is challenging and also intriguing.

Methods: The current study concluded 208 consecutive patients who underwent primary PCI for ST-Elevation Myocardial Infarction (STEMI) from January 2014 to February 2016. Blood samples were obtained after taking ECG. Complete blood samples were collected and analyzed within 5 minutes from sampling. Post-PCI corrected Thrombolysis in Myocardial Infarction (TIMI) frame count was determined by one interventional cardiologist blinded to patients' clinical data. The correlation between admission time blood parameters and post-primary PCI corrected TIMI frame count in patients with STEMI were assessed.

Results: Corrected TIMI frame count was positively correlated with WBC count (R: 0.18, P-value: <0.01), neutrophil count (R: 0.34, P-value: <0.01), and platelet count (R: 0.23, P-value: <0.01) and negatively correlated with lymphocyte count (R: -0.2, P-value: <0.01). Multiple linear regression results demonstrated that corrected TIMI frame count was positively correlated with neutrophil count (P < 0·001) and platelet count (P < 0·001) and negatively correlated with lymphocyte count (p=0.004).

Conclusion: High counts of WBC, neutrophil, and platelet and low count of lymphocyte may be predictors of no-reflow in STEMI patients undergoing PPCI. The clinical significance of such predictive parameters becomes clear as we consider the treatment approach in STEMI patients. Appropriate risk stratification leads to better treatment planning and allocation of resources.
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http://dx.doi.org/10.2174/1871529X20666200206123118DOI Listing
January 2020

Papillary Thyroid Carcinoma with Cervical Lymph Node Metastasis Arising from Lingual Thyroid.

Indian J Otolaryngol Head Neck Surg 2019 Oct 8;71(Suppl 1):762-765. Epub 2019 Feb 8.

3Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Although lingual thyroid is the most common site for ectopic thyroid gland but carcinomas originating from lingual thyroid are extremely rare, accounting only for 1% of all ectopic thyroids. Here we represent a young female with a bleeding mass at the base of her tongue and review the diagnostic approach towards papillary thyroid carcinoma of lingual thyroid. The surgical treatment and follow up are discussed. A combination of radiological studies and histological evaluation should be deployed to investigate suspicious lingual thyroids. The perspective of diagnostic and therapeutic approaches for carcinomas of lingual thyroid is the same as orthotopic thyroid tissue.
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http://dx.doi.org/10.1007/s12070-018-1539-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848510PMC
October 2019

Home-Based Rehabilitation Programs: Promising Field to Maximize Function of Patients with Traumatic Spinal Cord Injury.

Asian J Neurosurg 2019 Jul-Sep;14(3):634-640

Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Traumatic spinal cord injury (TSCI) has profound effects on the patient's health condition and function. However current treatment strategies fail in terms of cure. Thus, rehabilitative management has become the main gadget to promote patients' residual function. The most challenging aspect of rehabilitation is high costs of inpatient rehabilitation programs and poor continuity of care while patients are transferred to home. In this regard, numerous home based rehabilitation programs have been introduced.

Objectives: This review is an attempt to better introduce and classify different aspects of home care programs for patients with TSCI all around the world.

Methods: A literature search was conducted in the PubMed, Medline, and Google Scholar database. Studies that addressed rehabilitative programs for patients with TSCI in their home or home-like facilities were reviewed. Reference lists from retrieved articles were also reviewed.

Results: Home based rehabilitation can be categorized in five different but naturally relevant fields: home aids/modification, home nursing and family help, social support, home based primary care (multidisciplinary physician groups), and novel models/methods (e.g. "transitional rehabilitation" or telemedicine).

Conclusion: Since most investigators in TSCI home based rehabilitation have only introduced their findings, there are no comparative studies available. Thus future studies should be dedicated to clinical trials evaluating clinical efficacy of different strategies. A comprehensive integrated strategy with consideration to financial and other limitations should be applied to each specific area.
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http://dx.doi.org/10.4103/ajns.AJNS_86_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6703054PMC
September 2019

A Preliminary Survey of Autism Knowledge and Attitude among Health Care Workers and Pediatricians in Tehran, Iran.

Iran J Child Neurol 2019 ;13(2):29-35

Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Objective: Autism spectrum disease (ASD) is not a common diagnosis for children presenting with neurodevelopmental delay before 36 months in Iran. Although recent years have witnessed improvements in diagnosis of pediatrics psychological disorders the role of referral system starting with health care workers (HCW) is not clear. Therefore, we aimed to investigate the common concepts about ASD among pediatricians and HCW.

Materials & Methods: Pediatricians were randomly selected from four teaching hospital of Tehran University of Medical Sciences, Tehran, Iran in 2012-13. HCW were randomly selected from 3 urban health care centers in Tehran, Iran. DSM-IV TR criteria for ASD was used to assess knowledge. Participants were asked to rate sixteen statements on beliefs about autism to assess attitude.

Results: Overall, 122 pediatricians and 90 HCWs with mean ± SD age of 36±4.7 yr and 76.4% being female recruited. Pediatricians had significantly higher encounter with autistic patients (18% vs. 10%, value=0.06) and parents of autistic child (17% vs. 12%, -value=0.07). But generally, 209 participants (98.6%) declared that they were familiar with autism. There was no statistically significant difference between study groups in rating DSM-IV TR criteria for ASD as "necessary for diagnosis". Age, gender and working experience, did not differ between pediatricians or HCW answers (all -values >0.05). Among HCW participants, higher educational level was associated with higher disagreement about "autistic children is schizophrenic" (=0.01). Moreover, HCW with higher working experience had higher agreement rate with "autistic children needs special education" statement (= 0.04).

Conclusion: There are still misconceptions about ASD regarding developmental, cognitive and emotional features in both HCW and pediatricians needed to be educated through national program.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451856PMC
January 2019

Lipid profile change after bariatric surgeries: laparoscopic gastric plication versus mini gastric bypass.

Acta Chir Belg 2019 Jun 19;119(3):146-151. Epub 2018 Nov 19.

d Students' Scientific Research Center, Tehran University of Medical Sciences , Tehran , Iran.

Introduction: Bariatric surgeries are known to have profound effects on lipid profile. Laparoscopic gastric plication (LGP) has been shown to have a comparable effect on weight loss rather than Roux-en-Y gastric bypass (RYGB) and mini gastric bypass (MGB). But the post-operative effect on lipid profile is not well-compared. We aimed to compare post-operative lipid profile change after LGP and MGB.

Methods: In a retrospective analysis, we reviewed 91 patients for at least 12 months. Patients were assigned to undergo either LGP (71 patients) or MGB (20 patients). Preoperative and postoperative visits were accomplished and weight, BMI, fasting blood glucose (FBG) and lipid profile including triglyceride (TG), and total cholesterol (TC) levels were repeatedly measured. Follow up rate for the first year was 100%.

Results: LGP significantly decreased both TG and TC levels in each follow up (all p values < .05). The same trends were observed in BMI reduction, total body weight loss percentage, and FBG. When comparing either TC or TG level between LGP and MGB, there was just one statistically significant result in TG reduction at 6 months (p value = .042) while MGB showed more reduction. All other variables in different follow up visits were not significantly different between two techniques.

Conclusions: LGP would result in lipid profile improvement lasting at least for one year. Lipid-lowering effect seems to be similar between LGP and MGB. This lipid-lowering property and weight reduction might be indicative that LGP is an alternative for RYGB and MGB in selective patients.
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http://dx.doi.org/10.1080/00015458.2018.1479022DOI Listing
June 2019

Predictors of Thyroid Gland Invasion in Laryngeal Squamous Cell Carcinoma.

Iran J Otorhinolaryngol 2018 May;30(98):153-158

Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Laryngeal squamous cell carcinoma (SCC) can invade the thyroid gland leading to unnecessary thyroidectomies with subsequent hypothyroidism and hyperparathyroidism. Thus, clinicopathological variables should be defined in order to predict thyroid gland invasion preoperatively.

Materials And Methods: We performed a retrospective analysis of 1,465 patients with laryngeal SCC referred to our center between March 2009 and January 2016. Among these patients, 60 individuals underwent total laryngectomy and either thyroid lobectomy and isthmectomy or total thyroidectomy.

Results: Thyroid gland invasion was observed in 20% of samples. The following variables were associated with thyroid gland invasion: transglottic spread of the tumor (odds ratio [OR]: 2.04, 95% confidence interval [CI]: 1.15-5.81, P=0.004), thyroid cartilage involvement (OR: 1.53, 95% CI: 0.94-2.50, P=0.02), and anterior commissure involvement (OR: 5.75, 95% CI: 0.86-38.42, P=0.01). In addition, the largest dimension of the tumor was significantly associated with thyroid gland involvement (r=0.36, 95% CI 0.05-0.67, P=0.004). Multivariate linear regression analysis confirmed these findings.

Conclusion: The rate of thyroidectomies performed in cases of laryngeal SCC is much higher than the actual rate of thyroid gland invasion. Thus, preoperative evaluation to find transglottic spread of the tumor, thyroid cartilage, and anterior commissure involvement should be considered.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5985617PMC
May 2018

The association between exposure to air pollutants including PM, PM, ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide concentration and the relative risk of developing STEMI: A case-crossover design.

Environ Res 2018 02 24;161:299-303. Epub 2017 Nov 24.

Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Modarres Hospital, Kaj square, Sa'adat Abad Ave, Tehran 1998734383, Iran.

Background: Unfavorable associations between air pollution and myocardial infarction are broadly investigated in recent studies and some of them revealed considerable associations; however, controversies exists between these investigations with regard to culprit components of air pollution and significance of correlation between myocardial infarction risk and air pollution.

Methods: The association between exposure to PM, PM, ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide concentration of background air that residents of Tehran, the capital city of Iran, which is ranked as the most air polluted city of Iran and the relative risk of developing ST-elevation myocardial infarction (STEMI) were investigated by a case-crossover design. Our study included 208 patients admitted with a diagnosis of STEMI and undergone primary percutaneous intervention. Air pollutant concentration was averaged in 24-h windows preceding the time of onset of myocardial infarction for the case period. Besides, the mean level of each element of air pollution of the corresponding time in one week, two weeks and three weeks before onset of myocardial infarction, was averaged separately for each day as one control periods. Thus, 624 control periods were included in our investigation such that. Each patient is matched and compared with him/herself.

Results: The mean level of PM in case periods (61.47µg/m) was significantly higher than its level in control periods (57.86µg/m) (P-value = 0.019, 95% CI: 1.002-1.018, RR = 1.010). Also, the mean level of PM in case periods (95.40µg/m) was significantly higher than that in control days (90.88µg/m) (P-value = 0.044, 95% CI: 1.001-1.011, RR = 1.006). The level of other components including NO, SO, CO and O showed no significant differences between case and control periods. A 10µg/m increase in PM and PM would result in 10.10% and 10.06% increase in STEMI event, respectively. Furthermore, the results of sub-group analysis showed that older patients (equal or more than 60 year-old), diabetic patients, non-hypertensive ones and patients with more than one diseased vessel may be more vulnerable to the harmful effect of particular matters including PM and PM on development of STEMI.

Conclusion: Air pollution is a worldwide pandemic with great potential to cause terrible events especially cardiovascular ones. PM and PM are amongst ambient air pollutant with a high risk of developing STEMI. Thus, more restrictive legislations should be applied to define a safe level of indoor and outdoor air pollutant production.
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http://dx.doi.org/10.1016/j.envres.2017.11.020DOI Listing
February 2018

Comparison of Short-Term Effectiveness and Postoperative Complications: Laparoscopic Gastric Plication vs Laparoscopic Sleeve Gastrectomy.

Obes Surg 2018 04;28(4):996-1001

Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Bariatric surgeries are the only effective long-term treatment in obese patients. The innovation of laparoscopic gastric plication (LGP) raised some questions about its effectiveness compared to traditionally used techniques such as laparoscopic sleeve gastrectomy (LSG). We tried to answer some of these questions.

Materials And Methods: We investigated 70 patients in a randomized clinical trial (IRCT2013123012294N5) from 2012 to 2015. Thirty-five patients were randomly assigned to each LSG or LGP group, using sealed envelope method. The body mass index (BMI) reduction and the percentage of excess weight loss (%EWL) along with %total body weight loss (%TWL) were primary endpoint and were assessed at follow-up periods. We recorded postoperative complications, as well.

Results: Two-year follow-up rate was 100%. There were no statistically significant differences between the two groups in means of preoperative BMI. Also, postoperative follow-ups were not suggestive for a significant difference in BMI (all p values > 0.05). The mean %EWL at follow-ups showed no significant difference at any point, except for 3 and 6 months after surgery (p value = 0.002 and 0.017, respectively). This finding was confirmed by %TWL trend in 12 months after surgery. LSG patients were readmitted more than LGP patients (seven cases vs one case, p value = 0.024). Postoperative complications such as nausea and vomiting, hair loss, iron deficiency, vitamin D deficiency, and cholelithiasis were not different between the two groups. There was one death in the LGP group due to pulmonary thromboembolism.

Conclusions: LGP showed to be efficient regarding %EWL and %TWL reduction in short-term follow-ups with comparable postoperative complications to LSG.
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http://dx.doi.org/10.1007/s11695-017-2951-8DOI Listing
April 2018

Correlation of Preoperative and Radical Prostatectomy Gleason Score: Examining the Predictors of Upgrade and Downgrade Results.

Acta Med Iran 2017 Apr;55(4):249-253

Department of Urology, Sina Hospital, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Preoperative Gleason score (GS) obtained from Trans Rectal Ultra Sonography (TRUS) is the most common grading system to evaluate the appropriate treatment for patients with clinically localized prostate cancer. But this method showed upgraded and downgraded results in comparison to Gleason score obtained from radical prostatectomy. The current study aimed to determine clinical or pathological variables to reduce the differences between biopsy and radical prostatectomy Gleason scores.Through retrospective review of 52 patients with radical prostatectomy, this study examined the correlations of preoperative Gleason score with age, prostate volume, PSA level, PSA density, digital rectal exam findings and percentage of positive core needle biopsies across two groups, including patients with preoperative GS≤6 (i.e. group one) and patients with preoperative GS≥7 (group two). The discordance between biopsy GS and radical prostatectomy GS was observed to be 52% in the current study. Among patients with preoperative GS≤6, prostate volume (P=0.026), PSA density (P=0.032) and percentage of positive core needle biopsies (P=0.042) were found to be significant predictors for upgrade. There was no significant predictor for downgrade in patients with preoperative GS≥7. Findings of this study revealed that in patients with preoperative GS≤6, smaller prostate volume, higher prostate density and higher positive results of core needle biopsies were associated with theupgrade of GS. Therefore, it should be considered when selecting treatment modalities among these patients.
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April 2017

What Do We Know about Anthracofibrosis? A Literature Review.

Tanaffos 2017 ;16(3):175-189

Virology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Recently, the significance of anthracosis in the tracheobronchial tree, lung parenchyma, and even non-respiratory organs has been postulated and discussed in association with other diseases, especially tuberculosis. We reviewed the current literature by using the following key words in Medline/PubMed, Embase, and Google Scholar databases: anthracosis, anthracofibrosis, anthracotic bronchitis, biomass fuels, and mixed-dust pneumoconiosis. The bibliographies of eligible papers were also reviewed for further relevant articles. A total of 37 studies were assessed. The content of these studies was then divided into specific categories. Considering the pathogenesis, along with histopathological, radiological, and bronchoscopic results regarding anthracotic lesions, we suggest these findings be defined as "ANTHRACOSIS SYNDROME". For the first time, we describe a syndrome involving black pigmentation, which was previously thought to involve only the tracheobronchial tree. Until recently, it was not considered to be a single syndrome with different sites of involvement.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960222PMC
January 2017

Predictors of Regional Lymph Node Recurrence after Initial Thyroidectomy in Patients with Thyroid Cancer.

J Thyroid Res 2016 14;2016:4127278. Epub 2016 Jun 14.

Department of General Surgery, Shariati Hospital, North Kargar Street, Tehran, Iran.

Background. Regional lymph node recurrence (RLNR) is common in patients with thyroid cancer but clinicopathological predictors are unclear. We aimed to clarify these predictors and identify patients who would benefit from prophylactic lymph node dissection the most. Method. 343 patients with different types of thyroid cancer were analyzed retrospectively. All patients underwent total thyroidectomy between 2007 and 2013. Results. The median ± interquartile range of patients' age was 40 ± 25 years. 245 (71.4%) patients were female. Regarding the risk of regional lymph node recurrence, we found that male gender, age ≥45 years, non-PTC (i.e., medullary, follicular, and anaplastic types) histopathology, T3 (i.e., tumor size >4 cm in the greatest dimension limited to the thyroid or any tumor with minimal extrathyroid extension), stage IVa, and isolated cervical lymphadenopathy as initial manifestation (ICL) are significant risk factors. T3 (p < 0.001; odds ratio = 156.41, 95% CI [55.72-439.1]) and ICL (p < 0.001; odds ratio = 77.79, 95% CI [31.55-191.81]) were the strongest predictors of regional lymph node recurrence. Conclusion. We found easily achievable risk factors for RLNR in thyroid cancers patients. We suggested that patients with specific clinicopathological features like male gender, age ≥45 years, larger tumor size, and extrathyroidal extension be considered as prophylactic lymphadenectomy candidates.
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http://dx.doi.org/10.1155/2016/4127278DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923602PMC
July 2016

Comparing the length of penile mucosa in men with and without premature ejaculation.

Urologia 2016 Jan-Mar;83(1):36-9. Epub 2015 Oct 30.

Urology and Nephrology Research Center, Department of Urology and Renal Transplantation, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran - Iran.

Background: Premature ejaculation is one of the prevalent disorders in men; almost one out of three men between 18 and 59 years old have this disorder with its leading sequel such as lack of self-confidence, anxiety, depression and unsatisfactory intercourse in men and their partners. This study aimed to compare the length of penile mucosa in men with and without premature ejaculation.

Method: Three hundred and eighty patients referring to our hospital from March 2009 to March 2010 were enrolled in the study. First group comprised 190 men with premature ejaculation and second group included 190 men without premature ejaculation as control group that were chosen randomly. A questionnaire was designed to collect data and was completed for both groups. Height, weight, body mass index (BMI), length of penile mucosa, length of penis and intravaginal ejaculation latency time (IELT) were measured.

Results: The mean IELT in premature ejaculation group and control group were 47.58 ± 29.55 and 410.38 ± 190.2 s, respectively (p = 0.001). The mean penis length in premature ejaculation group and control group were 127.25 ± 16.23 and 127.03 ± 17.42 mm, respectively (p = 0.901, with nonsignificant difference); the mean penile mucosa in premature ejaculation group was 33.83 ± 11.54 mm and in control group was 31.40 ± 11.97 mm (p = 0.014, with significant difference).

Conclusion: Longer penile mucosa can be one of the factors in causing premature ejaculation.
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http://dx.doi.org/10.5301/uro.5000158DOI Listing
April 2017

Seizure-Control Effect of Levatiracetam on Juvenile Myoclonic Epilepsy and Other Epileptic Syndromes: Literature Review of Recent Studies.

Iran J Child Neurol 2015 ;9(2):1-8

Iranian center of Neurological research, Imam Khomeini Hospital, Tehran University of Medical Sciences.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515334PMC
July 2015

Gadolinium Enhanced MR-angiography Results in Patients With Peripheral Arterial Disease: Positive Predictive Value Compared to Surgery.

Iran Red Crescent Med J 2014 Dec 25;16(12):e26033. Epub 2014 Dec 25.

Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, IR Iran.

Background: Peripheral arterial disease (PAD) represents systematic atherosclerosis of great vessels. PAD affects approximately 10-20 % of patients older than 60 years and is associated with high mortality and morbidity rate debilitating individuals' life.

Objectives: To compare the results of Gadolinium enhanced MR-Angiography and surgery in patients suspected to have peripheral arterial disease.

Materials And Methods: In this prospective cohort study, 30 consecutive patients matching the inclusion criteria were enrolled and MR-Angiography was performed prior to surgery for each one.

Results: 22 patients were male (73.3%) and the mean age was 60.3 ± 10.6 years in our study group. The most common artery for cut off and run off was superior femoral artery in both assessments. Proximal section of each artery was the most common anatomical section for cut off and run off. There was a same report of cut off artery by MR-Angiography and surgery (kappa coefficient of agreement was 0.96, P value < 0.001) and positive predictive value was 0.97 (95% CI: 0.83-0.99).

Conclusions: According to our findings MR-angiography is an appropriate alternative imaging modality for patients suspected to have peripheral arterial disease and it facilitates the early diagnosis proposed by the clinical findings. Also beneficial characteristics of this method such as low exposure to ionizing radiation, repeatability, and low risk of contrast agent-induced nephropathy make it a modality of choice in patients with renal impairment.
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http://dx.doi.org/10.5812/ircmj.26033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4341249PMC
December 2014