Publications by authors named "Hamid Salehi"

11 Publications

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A comparison on the scar development when done through overlapping versus approximating seams techniques - A clinical trial.

Burns 2021 Nov 3;47(7):1602-1607. Epub 2021 Feb 3.

Department of General Surgery, School of Medicine, Burn Research Center, Shahid Motahari Burns Hospital, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Introduction: Skin autografting is performed widely for deep burn wounds as an ideal coverage. Scaring at the site of grafting has been always a challenge for surgeons. Many methods have been proposed to lessen the probability of scaring, but conflicting results have been obtained. It is said that the suture type is important in the development of scaring. Seams technique has also been introduced to decrease scar after autografting.

Objective: We sought to compare two approximating (AP) and overlapping (OV) Seams technique to compare the development of scars.

Methods And Materials: Patients with deep burns of 10% to 50% TBSA who were candidates for grafting entered this double-blind randomized trial. One side of the graft was fixed with a stapler using the "approximating" technique and the other side was fixed by the "overlapping" technique with a 1-2 mm margin overlap. The Vancouver Scar Scale (VSS) standard was used to evaluate scar formation at the graft edges at six months. Data entered SPSS 16 and analyzed. A P-value below 0.05 was considered as statistically significant.

Results: Thirty-six patients entered. Two (5.6%) were females and 34 (94.4%) males. The mean age of patients was 39.14 ± 8.53 years. The mean burn surface area percentage was 15.2 ± 2.84. Vascularity Scar index had no statistically significant difference between the overlapping and approximating techniques (P = 0.564). However, pigmentation (P = 0.014), pliability (P = 0.008) and the height indices (P < 0.001) were statistically significantly better in the approximating technique. The mean of total score of Vancouver was better in the approximating technique as well (P < 0.001).

Conclusion: We compared two techniques of Seams between the normal skin and the graft edge for the first time. We showed that the AP method had a better Vancouver score compared to the OV regarding pigmentation, height, and pliability indices.
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http://dx.doi.org/10.1016/j.burns.2021.01.007DOI Listing
November 2021

Understanding flow properties of mannitol powder at a range of temperature and humidity.

Int J Pharm 2021 Mar 21;596:120244. Epub 2021 Jan 21.

Wolfson Centre for Bulk Solids Handling Technology, Faculty of Engineering & Science, University of Greenwich, Chatham, United Kingdom.

Inadequate flowability of powders in industries during handling can cause many problems. For example, lack of flow from hoppers, poor tablet weight consistency, and low production rate in tableting. Many factors are known to commonly affect flow properties of powders, such as temperature, humidity and conditioning duration. In this paper, flow properties of a mannitol powder, which was conditioned between 24 and 72 h at various high relative humidities and temperature, were measured using a shear tester. A statistical model was developed to investigate the relative importance of these variables on the mannitol flow properties. The developed model showed all independent variables are significant in estimating bulk cohesion. Two separate approaches were used to evaluate inter-particle forces in the bulk, and how these changed with environmental conditions. First, inter-particle forces were inferred from the measured bulk properties using the Rumpf model approach. Secondly, inter-particle forces were predicted based on a model of moisture present on the particle surface using a combination of Kelvin model with the Laplace-Young (KLY) equation. The second approach also involved a new method to measure surface energy of mannitol powder based on measurements using Finite Dilution Inverse Gas Chromatography (FD-IGC). The surface energies of the mannitol powder were measured at high temperature (35 °C) and at different range of relative humidities. In spite of the fundamentally different approaches to the two ways of inferring inter-particles forces, these forces came out within less than 1.5:1 in magnitude. The Rumpf approach from bulk behaviour data obviously reflected the measured change in behaviour with humidity in particular, but this was not predicted from the KLY approach, however the likely reasons for this are postulated and recommendations for improvement are made.
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http://dx.doi.org/10.1016/j.ijpharm.2021.120244DOI Listing
March 2021

The effects of easy goals versus difficult goals on acquisition and retention of a sport skill in children with intellectual disability.

J Intellect Disabil 2020 Nov 18:1744629520970076. Epub 2020 Nov 18.

48437University of Isfahan, Iran.

The purpose of the present study was to examine the effects of easy goals versus difficult goals on acquisition and retention of basketball free throws in children with intellectual disability. Twenty-one children with intellectual disability were randomly assigned to an easy goals or difficult goals group. The participants were required to improve their basketball free throws according to their own scores in the previous exercise session. More difficult goals were set for the difficult goals group than for the easy goals group. The groups exercised the task for nine sessions. Both groups performed pretest, acquisition, and retention tests. Results showed that participants with easy goals improved their performance while the participants with difficult goals failed to improve their performance. These findings indicate that providing children with intellectual disability with easy goals facilitates the process of sport skill learning.
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http://dx.doi.org/10.1177/1744629520970076DOI Listing
November 2020

Inducible Left Ventricular Outflow Tract Obstruction in Patients Undergoing Liver Transplantation: Prevalence, Predictors, and Association With Cardiovascular Events.

Transplantation 2021 02;105(2):354-362

Department of Cardiology, Austin Health, The University of Melbourne Clinical School, Melbourne, VIC, Australia.

Background: Inducible left ventricular outflow tract obstruction (LVOTO) is often encountered in liver transplantation (LT) candidates during cardiac workup. While the impact of LVOTO on adverse cardiovascular hemodynamics is well reported, it is unclear whether it predisposes to perioperative cardiovascular complications.

Methods: Consecutive patients with end-stage liver disease undergoing dobutamine stress echocardiography (DSE) were evaluated at an LT center between 2010 and 2017. Perioperative major adverse cardiovascular events (MACEs) at 30 days and all-cause death were recorded from a prospectively maintained LT database.

Results: We evaluated 560 patients who underwent DSE during LT workup, with LVOTO identified in 24.3% (n = 136). Of these, 309 patients progressed to transplant. Patients with LVOTO demonstrated a lower peak systolic blood pressure (SBP) and an overall reduction in SBP on DSE. A total of 85 MACEs were recorded in 72 patients (23.3%) including 3 deaths, 19 cases of heart failure, 11 cardiac arrests, 8 acute coronary syndromes, and 44 arrhythmias. MACE occurred in 15/64 patients (23.4%) with LVOTO and 57/245 (23.3%) without (P = 0.92). There was an increased risk of perioperative cardiac arrest in patients with LVOTO (7.4% versus 2.4%, P = 0.04). Intraoperatively, patients with LVOTO required higher doses of vasopressors (P = 0.01) and received greater volumes of fluid (10.5 ± 8.1 versus 8.4 ± 6.4 L, P = 0.03).

Conclusions: Patients with end-stage liver disease and LVOTO demonstrate a reduction in SBP during physiological stress that may translate to hemodynamic instability during LT. LVOTO was not associated with an increased rate of perioperative MACE or death.
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http://dx.doi.org/10.1097/TP.0000000000003245DOI Listing
February 2021

Impaired Cardiac Reserve on Dobutamine Stress Echocardiography Predicts the Development of Hepatorenal Syndrome.

Am J Gastroenterol 2020 03;115(3):388-397

The University of Melbourne, Parkville, Victoria, Australia.

Objectives: Cardiac dysfunction has been implicated in the genesis of hepatorenal syndrome (HRS). It is unclear whether a low cardiac output (CO) or attenuated contractile response to hemodynamic stress can predict its occurrence. We studied cardiovascular hemodynamics in cirrhosis and assessed whether a diminished cardiac reserve with stress testing predicted the development of HRS on follow-up.

Methods: Consecutive patients undergoing liver transplant workup with dobutamine stress echocardiography (DSE) were included. CO was measured at baseline and during low-dose dobutamine infusion at 10 μg/kg/min. HRS was diagnosed using guideline-based criteria.

Results: A total of 560 patients underwent DSE, of whom 488 were included after preliminary assessment. There were 64 (13.1%) patients with established HRS. The HRS cohort had a higher baseline CO (8.0 ± 2 vs 6.9 ± 2 L/min; P < 0.001) and demonstrated a blunted response to low-dose dobutamine (ΔCO 29 ± 22% vs 44 ± 32%, P < 0.001) driven primarily by inotropic incompetence. Optimal cutpoint for ΔCO in patients with HRS was determined to be <25% and was used to define a low cardiac reserve. Among the 424 patients without HRS initially, 94 (22.1%) developed HRS over a mean follow-up of 1.5 years. Higher proportion with a low cardiac reserve developed HRS (52 [55.0%] vs 56 [16.9%]; hazard ratio 4.5; 95% confidence interval 3.0-6.7; P < 0.001). In a Cox multivariable model, low cardiac reserve remained the strongest predictor for the development of HRS (hazard ratio 3.9; 95% confidence interval 2.2-7.0; P < 0.001).

Discussion: Patients with HRS demonstrated a higher resting CO and an attenuated cardiac reserve on stress testing. On longitudinal follow-up, low cardiac reserve was an independent predictor for the development of HRS. Assessment of cardiac reserve with DSE may provide a novel noninvasive risk marker for developing HRS in patients with advanced liver disease.HRS is a life-threatening complication of liver disease. We studied whether an inability to increase cardiac contraction in response to stress can assist in the prediction of HRS. We demonstrate that patients with liver disease who exhibit cardiac dysfunction during stress testing had a 4-fold increased risk of developing HRS. This may improve our ability for early diagnosis and treatment of patients at a higher risk of developing HRS.
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http://dx.doi.org/10.14309/ajg.0000000000000462DOI Listing
March 2020

Determinants of Mortality and the Lethal Area 50 Index (LA50) in Burn Patients Admitted to a Large Burn Center; A Single Center Experience.

Bull Emerg Trauma 2017 Jul;5(3):184-189

Department of Neurology, Isfahan University of Medical Sciences and Health Services, Isfahan, Iran.

Objectives: To investigate the determinants of mortality and the lethal area 50 (LA50) in large series of Iranian burn patients admitted to a single burn center.

Methods: This cross-sectional study was conducted in Shahid Motahari burn center of Tehran, Iran during a 1-year period from 2011 to 2012. We included all the burn patients who were admitted to our center during the study period. Those with incomplete medical records and those referred to other centers were excluded from the study. The medical records of the included patients were reviewed and the demographic, clinical, laboratory and outcome measures were recorded. The mortality rate was recorded and the determinants of LA50 were analyzed in a univariate and stepwise multivariate model.

Result: Overall we included a total number of 1200 subjects with mean age of 30.8 ±18 years. There were 907 (75.6%) men and 293 (24.4%) women among the patients. The total LA50 was 55.5% (95% CI: 52.98%-58.3 %). There was a significant difference between age group >61 years and two 11-20 and 21-30 groups regarding LA50. The advanced age (<0.001), female gender (=0.002), inhalational injury (<0.001) and burn extension determined by TBSA% (<0.001) were significantly associated with mortality. In addition, male gender (=0.087), flame (=0.156), scald (=0.088) and chemical injuries (=0.071) were not associated with mortality.

Conclusion: The LA50 determine din our study is still much lower than that reported in developed countries, as a result, the quality of medical care is lower. Female gender, age, inhalational injury and extension of burn determined by TBSA% were found to be the independent risk factors of mortality in burn patients in our series.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5547206PMC
July 2017

Special communication: Biotechnology from the perspective of Iranian law.

J Bioeth Inq 2014 Jun 6;11(2):125-30. Epub 2014 May 6.

Department of Law, Payame Noor University, Tehran, Islamic Republic of Iran,

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http://dx.doi.org/10.1007/s11673-014-9527-2DOI Listing
June 2014

The effect of levamisole on mortality rate among patients with severe burn injuries.

J Res Med Sci 2013 Sep;18(9):795-800

Psychologist, Shahid Lavasani Hospital, Social Security Organization, Tehran, Iran.

Background: Burn injuries are one of the main causes of mortality and morbidity throughout the world and burn patients have higher chances for infection due to their decreased immune resistance. Levamisole, as an immunomodulation agent, stimulates the immune response against infection.

Materials And Methods: This randomized clinical trial was conducted in Motahari Burn Center, Tehran, Iran. Patients who had second- or third-degree burn with involvement of more than 50% of total body surface area (TBSA) were studied. The levamisole group received levamisole tablet, 100 mg per day. Meantime, both the levamisole and control groups received the standard therapy of the Burn Center, based on a standard protocol. Then, the outcome of the patients was evaluated.

Results: 237 patients entered the study. After excluding 42 patients with inhalation injury, electrical and chemical burns, and the patients who died in the first 72 h, 195 patients remained in the study, including 110 patients in the control group and 85 in the treatment group. The mean age of all patients (between 13 to 64 years) was 33.29 ± 11.39 years (Mean ± SD), and it was 33.86 ± 11.45 years in the control group and 32.57 ± 11.32 years in the treatment group. The mean percentage of TBSA burn was 64.50 ± 14.34 and 68.58 ± 14.55 for the levamisole and control groups, respectively, with the range of 50-100% and 50-95% TBSA. The mortality rate was 68 (61.8%) patients in the control group and 50 (58.8%) patients in the treatment group (P = 0.8).

Conclusion: According to this study, there was no significant relationship between improvement of mortality and levamisole consumption.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872590PMC
September 2013

Specificity of learning a sport skill to the visual condition of acquisition.

J Mot Behav 2014 28;46(1):17-23. Epub 2013 Oct 28.

a Department of Physical Education and Sport Sciences, Sanandaj Branch , Islamic Azad University , Sanandaj , Iran.

The authors' main purpose was to determine whether learning of a real-world sport skill (basketball free throws) is specific to the sources of afferent visual information available during practice. Twenty-eight male high school students (inexperienced in the experimental task) were randomly assigned to a full vision or target only vision group. Participants trained under full vision or target only condition for 15 sessions. Following training, in immediate tests, they were examined under full vision and then under target only conditions. Ten days later, in delayed tests, they performed the task under full vision and then under target only conditions. Results showed both groups performed the task similarly across the experimental period. Interestingly, it was found that immediate and delayed retention performance is specific to the training visual context. The groups' performances dropped significantly when we tested them at a visual condition that differed from what they had experienced while learning the task. Performance of the task seemed to have integrated with the visual information available during the task acquisition. These findings provide evidence for the specificity of practice hypothesis in the field of motor learning and control.
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http://dx.doi.org/10.1080/00222895.2013.838935DOI Listing
August 2014

Human dignity from the viewpoint of Iranian law.

J Bioeth Inq 2013 Jun 14;10(2):135-6. Epub 2013 Jun 14.

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http://dx.doi.org/10.1007/s11673-013-9437-8DOI Listing
June 2013

Subacute sclerosing panencephalitis with atypical features.

Pediatr Neurol 2005 Oct;33(4):280-2

Department of Neurology, Comprehensive Epilepsy Management Center, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10461, USA.

The incidence of subacute sclerosing panencephalitis may be rising. This report describes three patients identified in New York City with atypical features including age of onset, prolonged prodrome, and lack of specific electroencephalographic changes. The diagnosis was confirmed with the identification of measles antibodies in the cerebrospinal fluid. Awareness of the possibility that the clinical presentation of subacute sclerosing panencephalitis may be changing may increase its timely diagnosis.
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http://dx.doi.org/10.1016/j.pediatrneurol.2005.04.009DOI Listing
October 2005
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