Publications by authors named "Latif Gachkar"

73 Publications

Role of interferon therapy in severe COVID-19: the COVIFERON randomized controlled trial.

Sci Rep 2021 04 13;11(1):8059. Epub 2021 Apr 13.

Department of Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Type 1 Interferons (IFNs) have been associated with positive effects on Coronaviruses. Previous studies point towards the superior potency of IFNβ compared to IFNα against viral infections. We conducted a three-armed, individually-randomized, open-label, controlled trial of IFNβ1a and IFNβ1b, comparing them against each other and a control group. Patients were randomly assigned in a 1:1:1 ratio to IFNβ1a (subcutaneous injections of 12,000 IU on days 1, 3, 6), IFNβ1b (subcutaneous injections of 8,000,000 IU on days 1, 3, 6), or the control group. All three arms orally received Lopinavir/Ritonavir (400 mg/100 mg twice a day for ten days) and a single dose of Hydroxychloroquine 400 mg on the first day. Our utilized primary outcome measure was Time To Clinical Improvement (TTCI) defined as the time from enrollment to discharge or a decline of two steps on the clinical seven-step ordinal scale, whichsoever came first. A total of 60 severely ill patients with positive RT-PCR and Chest CT scans underwent randomization (20 patients to each arm). In the Intention-To-Treat population, IFNβ1a was associated with a significant difference against the control group, in the TTCI; (HR; 2.36, 95% CI 1.10-5.17, P-value = 0.031) while the IFNβ1b indicated no significant difference compared with the control; HR; 1.42, (95% CI 0.63-3.16, P-value = 0.395). The median TTCI for both of the intervention groups was five days vs. seven days for the control group. The mortality was numerically lower in both of the intervention groups (20% in the IFNβ1a group and 30% in the IFNβ1b group vs. 45% in the control group). There were no significant differences between the three arms regarding the adverse events. In patients with laboratory-confirmed SARS-CoV-2 infection, as compared with the base therapeutic regiment, the benefit of a significant reduction in TTCI was observed in the IFNβ1a arm. This finding needs further confirmation in larger studies.Trial Registration Number: ClinicalTrials.gov, NCT04343768. (Submitted: 08/04/2020; First Online: 13/04/2020) (Registration Number: NCT04343768).
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http://dx.doi.org/10.1038/s41598-021-86859-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044200PMC
April 2021

CREB-binding protein (CREBBP) and preeclampsia: a new promising target gene.

Mol Biol Rep 2021 Mar 24;48(3):2117-2122. Epub 2021 Feb 24.

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

Preeclampsia (PE) is a major complication of pregnancy and remains a leading cause of neonatal and maternal mortality worldwide. Several studies have revealed that the incidence of preeclampsia is high in mothers who carried a fetus with Rubinstein-Taybi Syndrome due to the mutation in CREBBP. We aimed to compare the expression level of the CERBBP gene between preeclamptic and healthy placenta in our study. The expression level of CREBBP gene was evaluated in a total of one hundred placental biopsies from PE patients and healthy pregnant women after delivery using quantitative real-time polymerase chain reaction (qRT-PCR). Moreover, the differential expression of CREBBP was assessed between the maternal and fetal sides of the placenta. Expression of the CREBBP gene was higher in preeclampsia patients compared with the controls (Fold change = 2.158; P = 0.018). Moreover, the gene expression was slightly higher in the fetal side of the placenta, although it was not significantly different (Fold change = 1.713, P = 0.254). Our findings show a role for CREBBP in the pathogenesis of PE. Due to the important role of CREBBP in angiogenesis and hypoxia, the gene may serve as a promising target in future studies.
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http://dx.doi.org/10.1007/s11033-021-06215-1DOI Listing
March 2021

Prevalence of astrovirus, adenovirus, and sapovirus infections among Iranian children with acute gastroenteritis.

Gastroenterol Hepatol Bed Bench 2020 ;13(Suppl1):S122-S127

Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Aim: This study aimed to determine the prevalence of Human Astroviruses (HAstVs), enteric Adenoviruses (HAdVs), and Sapoviruses (SaVs) in acute diarrhea patients, as well as their relation to age, sex, and season.

Background: Acute gastroenteritis is one of the most common diseases affecting children <5 years old and viral agents with approximately >75% are the major causative agent of acute infectious diarrhea. After Rotavirus and Norovirus, the greater viral agents of acute gastroenteritis include HAstVs, HAdVs, and SaVs. To the best of our knowledge, there are sparse studies in Iran detecting at least three enteric viruses as causative agents of diarrhea simultaneously.

Methods: The sample was collected from children referring to pediatric medical centers in Tehran, Iran; they were tested for Astrovirus, enteric Adenovirus, and Sapovirus by conventional PCR method. The association of incidence of viral enteric agents was evaluated with age, sex and seasonal pattern in children <5 years old.

Results: The positive case number among acute gastroenteritis patients was 17/120 (14.1%). Patients ranged in age within 1-60 months, but 52.9% were aged ≤ 12 months. Males comprised the majority (70.6), and the male: female ratio was 2.4. HAstV was the most frequently detected virus (6.7%), while SaVs were detected only in 2.5% of cases. Mixed infections were not detected in these samples. The highest rate of HAstV was identified in winter (66.7%), HAdV in fall (66.7%), and SaV in winter (33.3%).

Conclusion: These findings underscore the importance of monitoring the epidemiology of HAstV, HAdV, and SaV as causative agents of viral diarrhea infections.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7881414PMC
January 2020

Oral clonazepam versus lorazepam in the treatment of methamphetamine-poisoned children: a pilot clinical trial.

BMC Pediatr 2020 12 3;20(1):543. Epub 2020 Dec 3.

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

Objectives: To evaluate the efficacy of oral clonazepam versus oral lorazepam following initial parenteral benzodiazepine administration to control methamphetamine-induced agitation in children.

Methods: In a single-center clinical trial, intravenous diazepam (0.2 mg/Kg) was initially administered to all methamphetamine-poisoned pediatric patients to control their agitation, followed by a single dose of oral clonazepam (0.05 mg/Kg; n = 15) or oral lorazepam (0.05 mg/Kg; n = 15) to prevent relapse of toxicity.

Results: The median age [IQR] (range) was 15 [10, 36] (6-144) months. The source of poisoning was methamphetamine exposure from oral ingestion in 23 (76.7%) and passive inhalation in 7 (23.3%) patients. The most common symptoms/signs were agitation (29; 96.7%), mydriatic pupils (26; 86.7%), and tachycardia (20; 66.6%). Two in each group (13.3%) needed re-administration of intravenous diazepam due to persistent agitation. There was no report of benzodiazepine complications in either group.

Conclusions: Clonazepam and lorazepam treatment was equally effective at similar doses. However, considering the higher potency of clonazepam, it seems that lorazepam is the safer benzodiazepine for oral maintenance treatment of methamphetamine-induced agitation in children and can be used with minimal complications.

Trial Registration: IRCT20180610040036N2, April 18th, 2020. Retrospectively registered.
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http://dx.doi.org/10.1186/s12887-020-02441-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7713025PMC
December 2020

Early recovery of botulism: one decade of experience.

Clin Toxicol (Phila) 2020 Nov 6:1-5. Epub 2020 Nov 6.

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

Background: Botulism is a rare but serious disease, which appears in different forms. In this study, we reviewed the clinical features, laboratory data, and outcomes of patients who referred to our tertiary center.

Materials And Methods: All confirmed cases of botulism referred to an academic referral center and a teaching hospital during 2009-2019, were retrospectively reviewed.

Results: Fifty-three cases of clinical or laboratory-confirmed botulism were examined in this study. Nineteen patients were confirmed by laboratory data (serotype A (89.5%) and serotype E (10.5%)). In seven cases, the cause of botulism was unclear. In two patients, systemic symptoms emerged after the therapeutic injection of botulinum neurotoxin. The majority of cases (83%) were caused by an obvious food source. In 66% of cases, the initial symptoms emerged within less than 36 h, while in 20.8% of cases, the symptoms developed within or after 36 h; however, in seven patients that their botulism sources were unclear, the onset could not be estimated. All patients showed cranial involvement and generalized manifestation, and 49.1% had gastrointestinal symptoms. Except for two patients who were not treated due to immediate drug reactions who manifested severe hemodynamic instability, the rest of the patients were treated with trivalent antitoxin (A, B, and E). The complete resolution of the symptoms during hospitalization was documented in 50.9% of the patients. About 17% of the patients were intubated. Two patients died due to massive bilateral pulmonary thromboembolism and cardiac asystole following respiratory failure.

Conclusions: Although the complete resolution of the symptoms usually takes several weeks, in our experience, most patients showed at least partial resolution upon discharge. Early treatment results in better outcomes.
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http://dx.doi.org/10.1080/15563650.2020.1844225DOI Listing
November 2020

Effect of topical marshmallow (Althaea officinalis) on atopic dermatitis in children: A pilot double-blind active-controlled clinical trial of an in-silico-analyzed phytomedicine.

Phytother Res 2021 Mar 9;35(3):1389-1398. Epub 2020 Oct 9.

Traditional Medicine Clinical Trial Research Center, Shahed University, Tehran, Iran.

Atopic dermatitis (AD) is a chronic relapsing eczematous skin disease, which primarily affects infants and young children. Due to the side effects of commonly used drugs for its treatment, the development of safer therapeutic strategies is needed. There are many reports on the topical use of marshmallow (Althaea officinalis) for a range of skin diseases in Persian medicine. The main aim of the present investigation was evaluating the efficacy of marshmallow in children with mild-to-moderate atopic dermatitis. Another aim of the study was screening the anti-allergic and anti-inflammatory potential of phytocomponents against target proteins, including TNF-alpha, IL6, and PDEs A, B, and D enzymes with PDB IDs: 2AZ5, 1P9M, 3I8V, 4KP6, and 1Y2K, respectively, along with their respective standard ligands using computational docking analysis. A pilot clinical trial was designed to investigate the safety and efficacy of Althaea officinalis in children with AD. The diagnosis of AD was made according to the criteria of Hanifin and Rajka. Children between 3 months and 12 years old were participated in this trial and randomly allocated into two parallel intervention and control groups. The intervention group used Althaea officinalis 1% ointment while the positive control group used Hydrocortisone 1% ointment twice a day for a week and after that, three times per week for a period of 3 weeks. The severity of AD was measured using the SCORAD score at the end of each assessment visits. A total number of 22 patients completed the study. A significant decrease of the SCORAD score was observed in both groups. At the end of the study, this score change, which indicates the improvement of the patients was significantly higher in the intervention group in comparison to the baseline (p-value = .015) and week 1 (p-value = .018). In the docking analysis of the study, 33 phytochemical compounds were identified, which were docked into the active site of IL6, TNF-alpha, and human PDE4 isoenzymes. Affinity toward the selected enzymes was significantly higher in glycosylated compounds. The results of this pilot study showed that the efficacy of Althaea officinalis 1% ointment in a decrease of disease severity is more than Hydrocortisone 1% in children with AD. However, further studies are needed to confirm this finding. Moreover, the docking analysis revealed that the inhibitory activity of compounds with free hydroxyl groups such as glycosylated compounds was better than others, probably due to the hydrogen bond interaction of hydroxyl groups of the ligands with the enzymes.
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http://dx.doi.org/10.1002/ptr.6899DOI Listing
March 2021

Vitamin D toxicity in a pediatric toxicological referral center; a cross-sectional study from Iran.

BMC Pediatr 2020 07 20;20(1):350. Epub 2020 Jul 20.

Kish Institute of Science and Technology, Tehran, Iran.

Background: Vitamin D is an essential element for body health with its supplements generally administered to prevent vitamin D deficiency. Since these supplements are available in domestic settings, vitamin D toxicity may happen in children.

Methods: All children younger than 12 years who presented to the pediatric emergency department of Loghman Hakim Hospital, Tehran, Iran with history of ingestion of more than 1500 IU/day of vitamin D supplements were enrolled. Patients' demographic data, on-presentation signs and symptoms, laboratory findings, treatments given, and outcome were evaluated.

Result: Fifteen patients presented during the study period. Their mean age was 46.53 ± 10.14 months and 12 (80%) were girls. All of them had unintentionally ingested vitamin D. Mean ingested dose was 406700.7 ± 227400.1 IU. In eight patients (53.3%), 25 hydroxy vitamin D level was more than 100 ng/mL. One patient experienced hypercalcemia while all of them were asymptomatic and discharged without complications. There was no significant difference between patients with and without high levels of 25 OH vitamin D regarding lab tests, toxicity course, and outcome.

Conclusions: It seems that acute vitamin D toxicity is a benign condition in our pediatric population which may be due to high prevalence of vitamin D deficiency in Iran.
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http://dx.doi.org/10.1186/s12887-020-02240-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7370494PMC
July 2020

Efficacy of in Tibia Fracture Repair: A Randomized Double-Blinded Placebo-Controlled Clinical Trial.

J Altern Complement Med 2020 Jun 20;26(6):521-528. Epub 2020 Apr 20.

Faculty of Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

( shilajit, mummy, mumie, or mineral pitch) has been used traditionally in different medical systems for the treatment of a variety of ailments since hundreds of years ago. It is a natural substance found in different rocky parts of the world, formed by plants, mineral, and animal remains gradually. There is also worthwhile evidence supporting its oral use for bone repair in Persian medicine. The aim of this study was to evaluate the efficacy and safety of in tibia fracture healing. This study is a randomized double-blinded controlled trial. Three different hospitals in Tehran, Iran. Patients with age range of 18-60 years admitted due to new tibia fracture were enrolled after meeting the inclusion criteria. The patients were divided into two groups randomly and received two 500 mg capsules of or placebo for 28 days. The process of bone healing was assessed by frequent X-ray radiographies and adverse effects were recorded. Totally, 160 patients participated in the study either in two equal intervention or placebo groups. There was no significant difference between groups in terms of demographic and descriptive data. At the end of the study, the mean time of tibial bone union was 129 days in the experimental group, while it was 153 days in the placebo group ( < 0.049). There was no significant difference in the reported adverse effects between the two groups ( = 0.839). The current study showed that oral consumption of after tibial shaft fracture surgery could be a promising option to reduce the healing time.
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http://dx.doi.org/10.1089/acm.2019.0453DOI Listing
June 2020

Twelve vegetables used for prevention and treatment of hemorrhoids in Persian Medicine.

J Tradit Chin Med 2019 08;39(4):466-473

Department of Traditional Pharmacy, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Objective: To review the role of vegetables to prevent and treat hemorrhoids in Persian Medicine (PM).

Methods: We search main Persian Medicine manuscripts, including the books of Liber Continens, Canon of Medicine, Great Elixir, Akbarie's Medicine, Storehouse of Medicaments and Present for the faithful. Also, it was considered by searching in reference books and published papers with the help of PubMed, Scopus, Google scholar databases.

Results: Twelve vegetables, relating to 8 plant families, have been found in PM that their effectiveness involved in laxative, anti- inflammation, antimicrobial, analgesic and wound healing.

Conclusion: Our findings suggest that 12 Persian Medicine vegetables can be used to prevent and treat hemorrhoids.
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August 2019

High sensitivity versus low level of vancomycin needs to be concern for another alternative anti- Staphylococcus aureus as the first- line antibiotic.

Acta Biomed 2019 12 23;90(4):498-503. Epub 2019 Dec 23.

Toxicological Research Center, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran..

Background And Aim: Vancomycin has been the first-line therapy for MRSA infection disease for many years. According to standard guidelines, the therapeutic vancomycin trough concentration should be above 10 mg/L and optimally between 15-20 mg/L. The aim of this study was to evaluate vancomycin trough level concentration in patients infected with MRSA.

Methods: This cross- sectional study included a sample of 170 patients admitted to the ICU of Loghman hospital. We used a standard questionnaire, then applied appropriate statistical tests. All collected data had been analyzed and interpreted by IBM SPSS Statistics 19.0.

Results: Among this study population, 71.8% was male. Just 20.8% of the patients can reach the therapeutic level trough even after changing the dose. It should be noted that a significant percentage of toxicity was observed after increasing the dose.

Conclusions: Even though high sensitivity against vancomycin disc has been seen in antibiogram tests, sufficient efficiency has not been distinguished, in the sense that, just a few patients by low trough level concentration, reached to therapeutic level after the dose change. Based on some sources, because of the side effects and limited safe range of vancomycin, we should consider a new approach to the alternative antibiotics. (www.actabiomedica.it).
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http://dx.doi.org/10.23750/abm.v90i4.7646DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233789PMC
December 2019

Isolation, identification, and phylogenetic analysis of potentially pathogenic free-living amoebae isolated from nasal and oral mucosa of HIV/AIDS patients in Iran.

Parasitol Res 2019 Oct 9;118(10):3061-3066. Epub 2019 Sep 9.

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

The burden of HIV/AIDS in Iran is not as high as in the other countries with high prevalence; however, the number of cases of HIV/AIDs is increasing in this region. According to a recent report, Iran had 5000 (1400-13,000) new cases of HIV infection with 4000 (2500-6200) AIDS-related deaths. Individuals affected by HIV/AIDS are highly susceptible for developing opportunistic infections, e.g. the cerebral complications related to pathogenic free-living amoebae and colonization of free-living amoebae (FLA) can be a serious hazard for patients living with HIV/AIDS. In the present study, a total of 70 oral and nasal mucosal samples were obtained from HIV/AIDS patients referred to the reference hospitals in Iran and tested for the presence of potentially pathogenic FLA using culture and PCR/sequencing-based methods. To discern the taxonomic status of Acanthamoeba genotypes a maximum likelihood phylogenetic tree was constructed and tolerance assays were performed for the positive Acanthamoeba strains. Among the patients with HIV/AIDS referred to the reference hospitals from 2017 to 2019, 7.1% were found positive for pathogenic free-living amoebae. Three strains (HA3, HA4, and HA5) belonged to the T4 genotype, one strain (HA1) was related to the T5 genotype assigned as A. lenticulata, and another strain (HA2) had high homology to Vermamoeba vermiformis. The tolerance assay used for Acanthamoeba strains (HA1, HA3, and HA4) classified these amoebae as highly pathogenic strains. For the most part, the encephalitis cases occurring in HIV/AIDS patients in Iran remain undiagnosed due to lack of awareness of the practitioners on the available diagnostic tools for this lethal infection; therefore, the true incidence of GAE in this region is unknown. A possible colonization with FLA should be considered in the differential diagnosis of suspected cases of CNS infections among HIV/AIDS patients. This study is the first worldwide comprehensive study attempting to isolate and identify the FLA colonization in HIV/AIDS patients. This study highlights the fact that clinicians should be aware of the differential diagnosis of cerebral disease related to FLA in patients with HIV/AIDS.
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http://dx.doi.org/10.1007/s00436-019-06448-xDOI Listing
October 2019

Effects of L-carnitine on Polycystic Ovary Syndrome.

JBRA Assist Reprod 2019 10 14;23(4):392-395. Epub 2019 Oct 14.

Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Objective: Polycystic ovary syndrome (PCOS) is a common disorder in women of reproductive age. This study investigated the effects of L-carnitine on the clinical and laboratory findings of women with PCOS.

Methods: Eighty women diagnosed with PCOS between 2017 and 2018 by the Rotterdam Criteria were enrolled in the study; six were lost during the study. The participants were given L-carnitine 3 g daily (Pursinapharma, Iran) for three months. Blood samples were taken after overnight fasting at baseline and three months into the study to assess the levels of fasting glucose, insulin, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), free testosterone, dehydroepiandrosterone (DHEA), and the insulin resistance index (HOMA-IR). The patients were weighed before and after treatment and had their body mass index (BMI) calculated. Menstrual cycles and manifestations of hirsutism were also assessed.

Results: The data showed a significant improvement in insulin sensitivity and decreases in serum LDL levels and the BMI after three months of treatment. There was a significant increase in serum HDL levels. More regular menstrual cycles and decreased hirsutism were also observed.

Conclusion: It appears that treatment with L-carnitine might decrease the risk of cardiovascular events by normalizing metabolic profiles and the BMI.
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http://dx.doi.org/10.5935/1518-0557.20190033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6798588PMC
October 2019

Factors Associated With High Blood Lead Levels in a Sample of 100 Children in Tehran.

Clin Med Insights Pediatr 2019 25;13:1179556518825451. Epub 2019 Mar 25.

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

Background: Lead is considered a neurotoxic agent. We aimed to evaluate the blood lead level (BLL) in young population and determine probable risk factors of lead exposure in Iran.

Methods: In a cross-sectional study, a total of 100 children were entered and their BLLs were checked.

Results: In all, 25 and 8 patients had BLLs above 5 and 10 µg/dL, respectively. There was a significant univariate correlation between BLL and place of living, water pipe type, using dairy products, and stature in both cut-offs of 5 and 10 µg/dL. Binary regression analysis showed that pipe type was associated with high BLLs at cut-offs of 5 and 10 µg/dL, respectively. Also, there was an association between 50th percentile of stature for age and cut-off of 5 µg/dL.

Conclusions: Higher BLLs may be seen in short stature pediatric population. Polyvinyl chloride (PVC) and polypropylene water pipes may even cause more release of lead and result in higher absorption of this metal in the pediatric population.
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http://dx.doi.org/10.1177/1179556518825451DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434433PMC
March 2019

Effects of a Novel Barley-Based Formulation on Allergic Rhinitis: A Randomized Controlled Trial.

Endocr Metab Immune Disord Drug Targets 2019 ;19(8):1224-1231

Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Objective: Current treatment options for Allergic Rhinitis (AR) may have their own limitations and side effects. This study aimed to investigate the effects of Ma-al-Shaeer (MS), a novel natural formulation based on Hordeum vulgare, in the treatment of AR compared with Fexofenadine (FX).

Methods: A total of 77 patients with AR were divided into two groups: MS group (n=38) and FX group (n=39). The first group received 15 g of dried MS powder, and the second group received 60 mg of FX twice daily for 14 days. At baseline (week zero) and after the 14-day treatment period (week two), both groups were evaluated for sneezing, rhinorrhea, nasal congestion, nasal itching, post nasal drip, eye, throat, or ear symptoms, headache, cough, mental function, quality of life scores, blood eosinophil count and total IgE levels. Rhinitis control assessment tests were conducted at week zero and again at one week after cessation of treatment (week three) in both groups.

Results: All symptoms of AR except cough were significantly reduced in both groups; for nasal congestion, post nasal drip, and headache, the MS treatment was found to be superior. Rhinitis control was significantly increased after treatment in both groups (p value < 0.001). Both drugs significantly reduced total IgE levels. There was no significant change in eosinophil count in either group.

Conclusion: MS formulation based on H. vulgare may be an effective treatment for AR. Further studies are needed to confirm the effect of MS as an alternative treatment in AR.
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http://dx.doi.org/10.2174/1871530319666190306100611DOI Listing
April 2020

First report of New Delhi metallo-β-lactamase-6 (NDM-6) among Klebsiella pneumoniae ST147 strains isolated from dialysis patients in Iran.

Infect Genet Evol 2019 04 23;69:142-145. Epub 2019 Jan 23.

Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

There has been an alarming health-related concern about the growth of New Delhi metallo-β-lactamase. The aims of this study include the phenotypic detection of β-lactamases and molecular characterization of NDM in Klebsiella pneumoniae isolates in Tehran, Iran. A total of 120 K. pneumoniae isolates were collected from hospitalized haemodialysis patients, Tehran, Iran from March 2014 to February 2017. Antibiotic susceptibility tests were conducted using Kirby-Bauer disc diffusion and Broth Microdilution methods according to Clinical and Laboratory Standards Institute guidelines. Metallo-β-lactamase was detected using the Combined Disc Diffusion Test (CDDT), and production of carbapenemase was screened using the Modified Hodge Test. NDM-producing K. pneumoniae strains were screened for the presence of mcr-1 gene, β-lactamase genes, and 16S rRNA methylase genes by Polymerase Chain Reaction and sequencing. Molecular typing of the strains was determined using Repetitive Sequence Based-PCR and Multilocus Sequence Typing. The bla gene was detected in 3 (2.5%) out of 120 isolates from dialysis patients. Also, the three isolates were positive for blabla extended-spectrum β-lactamase genes, armA type plasmid-mediated 16S rRNA methylase and CMY-type plasmid-mediated AmpC β-lactamase. The isolates were identified as MLST sequence type 147 (ST147). This is the first report of bla in K. pneumoniae strains, isolated in Iran.
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http://dx.doi.org/10.1016/j.meegid.2019.01.030DOI Listing
April 2019

Prevalence of cytomegalovirus infection in patients with ulcerative colitis: a prospective cross-sectional study in Tehran, Iran.

Iran J Microbiol 2018 Oct;10(5):342-347

Department of Pathology, Milad Hospital, Tehran, Iran.

Background And Objectives: Cytomegalovirus (CMV) infection has been reported in ulcerative colitis (UC), but limited data are available on its prevalence in Iran. The aim of this study was to evaluate the prevalence of CMV infection in patients with UC.

Materials And Methods: A prospective, cross-sectional study was conducted in 86 consecutive patients with UC. Prevalence of CMV infection was determined by rectal biopsies for hematoxylin and eosin staining and PCR. CMV-positive specimens was measured for CMV loads by real-time PCR assay.

Results: In six out of 86 (7%) patients with UC, CMV was diagnosed. These patients had detectable CMV DNA in their biopsies as indicated by PCR. In all CMV-positive patients, viral load was more than 250 copy/mg. Histochemical staining did not show any CMV inclusion bodies. No significant demographic and clinical differences existed between patients with and without a CMV infection.

Conclusion: UC and its treatment may put patients at risk of CMV infection. Real-time PCR test for the detection of CMV in UC patients may enable diagnosis of CMV infection with a high sensitivity and allow effective treatment to be administered in these patients. The impact of antiviral therapy on the clinical outcome of the UC patients with CMV remains to be elucidated.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6339997PMC
October 2018

Blood lead levels in pregnant women referring to midwifery clinic in a referral center in Tehran.

J Res Med Sci 2018 26;23:88. Epub 2018 Oct 26.

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

Background: Lead effects on children and pregnant women are grave, and screening tests would be logical to detect high blood lead levels (BLLs) in early stages.

Materials And Methods: Blood samples were taken from the pregnant mothers who referred to midwifery clinic with further phone interview postdelivery.

Results: In 100 patients evaluated, the mean age was 29 ± 5 years (median interquartile range gestational age of 33 [24, 37] weeks). There was a significant correlation between polluted residential area and median BLL ( = 0.044) and substance exposure ( = 0.02). The median BLL was significantly lower in those without a history of lead toxicity in the family ( = 0.003). The only factor that could predict the BLL levels lower than 3.2 and 5 μg/dL was living in the nonindustrial area. All pregnant women delivered full-term live babies.

Conclusion: Positive history of lead toxicity in the family and living in polluted areas may pose a higher BLL in pregnant women.
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http://dx.doi.org/10.4103/jrms.JRMS_72_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6225457PMC
October 2018

Molecular-Based Detection of in Human Blood Samples in a New Focus of Visceral Leishmaniasis in Lorestan Province, Iran.

J Arthropod Borne Dis 2018 Mar 18;12(1):67-75. Epub 2018 Mar 18.

Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: The fatal form of leishmaniasis is visceral form (VL), found in some of the countries in the world. Visceral leishmaniasis has been reported sporadically from all provinces in Iran, including Lorestan. This study aimed to characterize parasite species in DAT positive and some of the DAT negative human blood samples of Delfan district, Lorestan Province, central Iran.

Methods: Blood amples were collected from different geographical areas of Delfan. Serum was used for DAT test and remained part of molecular study. DNA was extracted by using DNG-plus extracted kit (Cinagen, Iran). Polymerase chain reaction amplification of kDNA and PCR-RFLP of ITS1 was done to identify species. Some amplicons were sequenced, submitted to GenBank and analyzed by BLASTn.

Results: Expected band of kDNA for (720bp) was amplified in 16 out of 186 (8.6%) samples which showed previously anti- antibody at different titers or were negative serologically. Using BLASTn, 93% similarity with has been shown. The rDNA-ITS1 was amplified only in 9 samples (4.7%). RFLP pattern was similar to what expected for .

Conclusion: A new emerging hypo-endemic focus, caused by , is going to be established in Delphan District, Lorestan Province. Further studies on vector and reservoirs are necessary for the region and other parts of Lorestan Province.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6046108PMC
March 2018

Anticoagulant Therapy in Atrial Fibrillation for Stroke Prevention: Assessment of Agreement Between Clinicians' Decision and CHA2DS2-VASc and HAS-BLED Scores.

High Blood Press Cardiovasc Prev 2018 Mar 26;25(1):61-64. Epub 2017 Oct 26.

Neuroscience Research Center, Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Introduction: To prevent stroke, anticoagulants should be administered after calculation of CHA2DS2-VASc and HAS-BLED scores in patients with Atrial Fibrillation (AF); nonetheless, these scores are sometimes neglected in clinical settings.

Aim: The present study was designed to assess agreement of anticoagulant therapy according to clinicians and CHA2DS2-VASc and HAS-BLED scores in Iranian AF patients in Moddares Hospital.

Methods: AF patients were diagnosed according to clinical history, clinical examination, and electrocardiogram. Data including the anticoagulant prescription according to clinicians were recorded. CHA2DS2-VASc and HAS-BLED scores were then calculated for each patient. Agreement of anticoagulant therapy according to clinicians and CHA2DS2-VASc and HAS-BLED scores was analyzed using Cohen's kappa coefficient.

Results: 97.5% of the patients (n = 117) were appropriately (according CHA2DS2-VASc and HAS-BLED scores) treated with anticoagulants by clinicians, notwithstanding a 2.5% of patients with inappropriate anticoagulant therapy (n = 3). The Cohen's kappa coefficient was 0.81 (P = 0.0).

Conclusions: The findings of the present study suggest an almost perfect agreement between anticoagulant therapy according to clinicians and that according to CHA2DS2-VASc and HAS-BLED scores in the studied population.
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http://dx.doi.org/10.1007/s40292-017-0237-9DOI Listing
March 2018

Correlation of abdominopelvic computed tomography with clinical manifestations in methamphetamine body stuffers.

Radiol Med 2018 Feb 25;123(2):98-104. Epub 2017 Sep 25.

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

Little is known about methamphetamine body stuffers and correlation of clinical manifestations with imaging studies. Current study was done to determine abdominopelvic computed tomography findings and clinical manifestations in methamphetamine body stuffers. In an IRB-approved routine data base study, demographic characteristics, clinical findings, and CT results of 70 methamphetamine body stuffers were retrieved. According to the clinical manifestations, the patients were categorized into either benign- or severe-outcome group. Also, they were determined to have positive or negative CT results. In the group with positive results, number and place of the baggies were determined, as well. Results of the CT were compared between the two groups. Almost 43% of the patients had positive abdominopelvic CT results. Mean density of the packs was 176.2 ± 152.7 Hounsfield unit. Based on the clinical grounds, 57% of the patients were in the benign- and 33% were in the severe-outcome group. In the benign group, 45% of the patients had positive CTs while in the severe-risk group, this was 40% (p > 0.05). Except variables defined as severe outcome (seizure, intubation, creatinine level, aspartate aminotransferase level, creatine phosphokinase and troponin level), agitation, on-arrival pulse rate, lactate dehydrogenase, bicarbonate, base excess, loss of consciousness and hospitalization period were correlating factors. But in regression analysis, we could not find a significant variable that prognosticate severe outcome. It seems that there is no relationship between the CT findings and clinical manifestations of the methamphetamine body stuffers. Severe outcomes may be observed even in the face of negative CTs.
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http://dx.doi.org/10.1007/s11547-017-0818-7DOI Listing
February 2018

Molecular characterization of Acanthamoeba strains isolated from the oral cavity of hemodialysis patients in Iran.

Parasitol Res 2017 Nov 6;116(11):2965-2969. Epub 2017 Sep 6.

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

Free-living amoebae (FLA) of the genus Acanthamoeba are opportunistic pathogenic agents able to cause life-threatening infections in immunosuppressed patients. Chronic kidney disease impairs adaptive and innate immunity. Thus, patients with chronic kidney disease are prone to opportunistic infections by potentially pathogenic FLA. Therefore, in the present study, the investigation of Acanthamoeba genotypes isolated from the oral cavity of hemodialysis patients of reference hospitals in Iran was aimed, using both morphology and molecular (sequence-based analysis) tools. Furthermore, classification of the strains at the genotype level was performed on the basis of differences in the diagnostic fraction 3 (DF3) region of the 18S rRNA gene. The pathogenic potential of the isolated amoebae was also determined using thermotolerance and osmotolerance assays. Out of the 187 oral cavity samples investigated, nine (4.8%) were positive for FLA. DNA sequencing of the ASA.A1 region of the 18S rRNA gene revealed that the isolated strains belonged to the Acanthamoeba T1 and T4 genotypes. Genotype T1 was isolated for the first time from a patient in Iran. Interestingly, the T1 strain (AN2 strain) exhibits a high pathogenic potential in tolerance assays. The pathogenicity assay revealed that five strains were able to grow at high temperatures (37-40 °C) and high osmolarity (0.5 and 1 M D-mannitol) conditions; thus, they were considered as potentially pathogenic strains. Moreover, two of the patients were positive for Vermamoeba genus. The present study is the first report of genotype T1 isolation in Iran and the first to identify the occurrence of Acanthamoeba and Vermamoeba genera in patients undergoing hemodialysis worldwide. Monitoring hemodialysis and renal failure patients should be a priority for possible control of Acanthamoeba and other FLA-related diseases.
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http://dx.doi.org/10.1007/s00436-017-5605-9DOI Listing
November 2017

Dietary Recommendations in Fracture Healing in Traditional Persian Medicine: A Historical Review of Literature.

J Evid Based Complementary Altern Med 2017 07 11;22(3):513-517. Epub 2017 Jan 11.

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

Background: Fracture repair is a complex process. An inappropriate diet is a contributing risk factor for fracture nonunion. The aim of this study was to extract dietary recommendations for fracture healing according to traditional Persian medicine (TPM) literature.

Method: The contents relevant to diets in fracture healing were selected from main textbooks in TPM like Al Qanon fi Al-teb ( The Canon). Other reference textbooks in traditional medicine were also used for a comprehensive study in this respect. Finally content analysis was used for summarizing and describing the results.

Findings: Food stuffs are classified in TPM according to their nutritive value, their assimilability, and the quality of achieved chyme. Some light meals like chicken soup are recommended for the early days of fracture and high-nutrient and dense foods such as goat's or sheep's head and nuts are advised in following days for fracture healing acceleration and callus formation. Several recommendations are also provided for pacing the healing process.

Conclusion: A comparison of Avicenna and other Persian sage's recommended regimens with the recent evidence revealed the potential positive effects of their regimen for bone healing acceleration. It can shed light on a part of history of orthopedics and add to current knowledge about bone fracture and its management.
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http://dx.doi.org/10.1177/2156587216685509DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871169PMC
July 2017

Diagnostic Yield of a Direct Quantitative Smear of Lower Respiratory Tract Secretions in Patients with Suspected Pneumonia Compared to a Semi-quantitative Culture.

Tanaffos 2017 ;16(1):9-12

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

Background: Microorganism isolation from respiratory tract specimens is the standard of care in patients with suspected nosocomial and ventilator associated pneumonia. However, these methods are time-consuming and are influenced by several factors. A direct quantitative smear (DQS) with proper staining may be an easy, cost-effective, rapid method. We evaluated the diagnostic yield of direct smears compared to semi-quantitative culture methods.

Materials And Methods: Hospitalized, intubated patients with clinically suspected pneumonia and patients who underwent diagnostic bronchoscopic alveolar lavage (BAL) and trans-endotracheal aspiration (TEA) were enrolled in a prospective study. The obtained specimens were Gram stained and microorganisms were computed per 10 high-power fields (HPFs) of light microscopy. All samples were cultured by a standard semi-quantitative method. Colony-forming units (CFU) >10/mL and >10 CFU/mL were reported as culture-positive for BAL and TEA, respectively.

Results: A total of 331 respiratory specimens were analyzed. Based on culture results, the best cut-off point was 35 microorganisms in 10 HPFs of microscopy and provided 90.4% sensitivity and 90.8% specificity. The best cut-off point for 25 microorganisms in 10 fields of light microscopy provided 95.2% sensitivity and 85.7% specificity.

Conclusion: A DQS obtained by BAL and TEA may be a reliable and rapid method to diagnose pneumonia and anticipate semi-quantitative culture results. The sensitivity and specificity of a direct smear have adequate diagnostic yield to recommend it as an adjunct to microorganism-isolation methods.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5473389PMC
January 2017

Resolution of Chest X-Ray Opacities in Patients with Ventilator-associated Pneumonia.

Infect Disord Drug Targets 2018 ;18(1):23-28

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

Background: Chest Radiograph accompanied by clinical and laboratory findings are required for diagnosis and follow-up of patients with suspected ventilatorassociated pneumonia (VAP). However, there are no reliable data whether follow-up chest-X-ray (CXR) is needed or not, moreover, when the physicians request CXR and how many times CXR is required. We aimed to determine association of the clinical improvement with resolution of pulmonary infiltrates as well as time of resolution.

Materials And Methods: The patients with a diagnosis of VAP based on Clinical Pulmonary Infection Score (CPIS) were enrolled in this study. Clinical evaluation and follow-up were continued and CXR was performed sequentially in two-day intervals until clinical improvement or occurrence of other events including death. Fischer test was used to analyze the association of clinical improvement with radiographic resolution.

Results: Out of the seventy -five patients, pneumonia was clinically improved in 48 cases. Mean duration of the clinical improvement was 5.3±4.5 days. Among these patients, pulmonary infiltrations in 44 patients were resolved completely (13.8±5.8 days). Twentyseven patients had no clinical improvement and all of them revealed no infiltration resolution according to the sequential imaging studies. Resolution of radiographic involvement significantly was associated with clinical improvement (p=0.000).

Conclusion: Radiographic resolution occurs in most of patients who survived VAP and there is strong relationship between radiographic resolution and clinical improvement. Moreover, our data revealed that CXR clearance occurred earlier than anticipated previously. Thus, sequential follow-up CXR in VAP had no further clinical value.
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http://dx.doi.org/10.2174/1871526517666170505122057DOI Listing
November 2018

Effect of diet based on the principles of Iranian traditional medicine on cirrhosis (a clinical trial).

Complement Ther Med 2016 Dec 9;29:35-41. Epub 2016 Sep 9.

Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

Objectives: Cirrhosis is associated with morbidity and mortality worldwide. Iranian traditional medicine (ITM) focused on nutritional intervention in order to improve liver function. The aim of this study was to assess the effectiveness of a diet designed based on ITM and current dietary recommendations.

Design: This controlled trial study was performed on 57 subjects with cirrhosis in 5 tertiary hospitals in Teharn, Iran.

Setting: Subjects were included if they were diagnosed with class A or B cirrhosis between October 2013 and December 2014.

Interventions: Subjects were randomly allocated into intervention (28 subjects) who received dietary and lifestyle recommendations based on ITM and controls (29 subjects) who received routine dietary and lifestyle recommendations for 3 months. Subjects were assessed at baseline and at the end of the intervention for anthropometric measures, liver function tests and cirrhosis severity scoring.

Main Outcome Measures: Model for End-Stage Liver Disease (MELD), anthropometric measures, serum albumin, liver function tests, International Normalized Ratio and alkaline phosphatase as well as subjective findings.

Results: Mean age of the subjects was 51.19±11.88years. Weight reduction was observed in 41 subjects (22 subjects in intervention and 19 in control group). Dietary intervention resulted in a significant decrease in alanine aminotransferase (AST) (p=0.04) and significant resolution of icterus in sclera (p=0.02) in weight loss group and increase serum albumin in weight gain group (p=0.02).

Conclusions: ITM recommendations could be beneficial for cirrhotic patients both for the purpose of weight reduction and weight gain.
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http://dx.doi.org/10.1016/j.ctim.2016.09.006DOI Listing
December 2016

The Role of Syndrome Differentiation in the Clinical Efficacy of Punica Granatum on Patients with Ulcerative Colitis.

Iran J Med Sci 2016 May;41(3 Suppl):S15

Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: The present study investigated the difference between therapeutic responses of hot and cold temperament patients (based on traditional Persian medicine) with ulcerative colitis to pomegranate peel extract.

Methods: Seventy-eight patients with moderate ulcerative colitis based on Lichtiger Colitis Activity Index (LCAI) criteria were randomized to receive an aqueous extract of the Punica granatum peel (6 gram per day) or placebo for four weeks. They were assessed before and after the intervention in terms of symptoms by LCAI scoring system. The results were compared in two therapeutic groups based on the patient s' temperament (cold and hot) which were diagnosed based on a previously validated questionnaire.

Results: Therapeutic response was significantly higher in patients with hot temperament compared to patients with cold temperament in the P. granatum group (1.91±0.492 vs. -0.500±0.500, P=0.029).

Conclusion: This study showed the importance of considering syndrome differentiation and temperament in interpreting the effect of P. granatum peel extract on ulcerative colitis.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5103520PMC
May 2016

Psychometric Properties of the Persian Version of the Social Anxiety - Acceptance and Action Questionnaire.

Iran J Psychiatry Behav Sci 2016 Jun 28;10(2):e3753. Epub 2016 May 28.

Professor of Infectious Diseases, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.

Background: Social anxiety disorder is often related to specific impairment or distress in different areas of life, including occupational, social and family settings.

Objective: The purpose of the present study was to examine the psychometric properties of the persian version of the social anxiety-acceptance and action questionnaire (SA-AAQ) in university students.

Materials And Methods: In this descriptive cross-sectional study, 324 students from Shahid Beheshti University of Medical Sciences participated via the cluster sampling method during year 2015. Factor analysis by the principle component analysis method, internal consistency analysis, and convergent and divergent validity were conducted to examine the validity of the SA-AAQ. To calculate the reliability of the SA-AAQ, Cronbach's alpha and test-retest reliability were used.

Results: The results from factor analysis by principle component analysis method yielded three factors that were named acceptance, action and non-judging of experience. The three-factor solution explained 51.82% of the variance. Evidence for the internal consistency of SA-AAQ was obtained via calculating correlations between SA-AAQ and its subscales. Support for convergent and discriminant validity of the SA-AAQ via its correlations with the acceptance and action questionnaire - II, social interaction anxiety scale, cognitive fusion questionnaire, believability of anxious feelings and thoughts questionnaire, valued living questionnaire and WHOQOL- BREF was obtained. The reliability of the SA-AAQ via calculating Cronbach's alpha and test-retest coefficients yielded values of 0.84 and 0.84, respectively.

Conclusions: The Iranian version of the SA-AAQ has acceptable levels of psychometric properties in university students. The SA-AAQ is a valid and reliable measure to be utilized in research investigations and therapeutic interventions.
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http://dx.doi.org/10.17795/ijpbs.3753DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5088572PMC
June 2016

The evaluation of relationship between blood pressure and dialysate Na concentration in chronic hemodialysis patients.

J Renal Inj Prev 2016 9;5(3):118-22. Epub 2016 May 9.

Department of Nephrology, Loghman Hakim Clinical Research Development Center, Shahid Beheshti University of Medical sciences (SBUM), Tehran, Iran.

Introduction: Hypertension is one of the traditional risk factors of cardiovascular disease (CVD). Extra cellular volume expansion and Na retention remain the main cause of hypertension.

Objectives: The aim of this study was to investigate the relation between concentration of Na dialysate and blood pressure (BP) in chronic hemodialysis (HD) patient.

Patients And Methods: This cross-sectional study was performed on 266 adult patients undergoing HD for at least three months. Pre-HD systolic BP (SBP) and post-HD SBP during 4 weeks were measured in relation to Na dialysate concentration. The other main factors affecting the post-dialysis BP, such as body mass index (BMI), pump speed, dialysis solution temperature, duration of dialysis and intradialysis weight gain (IDWG) were also considered. Mean of ΔSBP (post-HD SBP - pre-HD SBP) in each patient in 12 session of HD was measured and statistically analyzed in relation to dialysate Na with SPSS 21. Backward multivariable linear regression analysis and Pearson's correlation coefficients were used to evaluate the correlation between sodium gradient and ΔSBP.

Results: SBP was significantly changed before and after dialysis in relation to dialysate Na (P<0.001). The Pearson's correlation between ΔSBP with dialysate sodium and blood flow rate (pump speed) were statistically significant(P<0.05).

Conclusion: We found that changes in SBP before and after dialysis is significantly associated with dialysate sodium concentration.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039996PMC
http://dx.doi.org/10.15171/jrip.2016.25DOI Listing
October 2016

Association of Plasma Levels of Vitamin D With Chronic Hepatitis B Infection.

Hepat Mon 2016 Jan 16;16(1):e35525. Epub 2016 Jan 16.

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

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http://dx.doi.org/10.5812/hepatmon.35525DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834380PMC
January 2016

Genetic Diversity of Dihydropteroate synthetase Gene (dhps) of Plasmodium vivax in Hormozgan Province, Iran.

Iran J Parasitol 2016 Jan-Mar;11(1):98-103

Sayyad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran.

Background: The present study was formulated in order to determine polymorphism of dihydropteroate synthetase gene (dhps) of Plasmodium vivax (P. vivax) in Hormozgan Province, southern Iran and mutations at codons 382, 383, 512, 553, and 585 associated with resistance of P. vivax to sulfadoxine.

Method: One-hundred eighteen isolates of P. vivax were prepared within 2007-2008 to determine dihydrofolate reductase-thymidylate synthase (dhfr-ts) gene. The isolates were determined in the study of genetic diversity of dihydropteroate synthetase gene (dhps) of P. vivax. The study was performed via PCR test and nucleotide sequencing.

Results: Of 118 blood samples infected by P. vivax, 46 and 72 samples belonged to Minab and Jask, respectively. No mutation was detected at 5 target codons. However, among these 118 samples, three isolates (2.54%) were found to have a mutation at the new codon 421.

Conclusion: Since mutation was detected in dihydrofolate reductase (Pvdhfr) gene in the same samples but no mutation was found at five main codons of Pvdhps gene, it can be concluded that P. vivax, considering their mutations in Pvdhfr, is still susceptible to sulfadoxine and therefore, to fansidar in Hormozgan Province, Southern Iran.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4835476PMC
April 2016