Publications by authors named "Mohammad Ashouri"

13 Publications

  • Page 1 of 1

Albendazole ameliorates inflammatory response in a rat model of acute mesenteric ischemia reperfusion injury.

Biomed Pharmacother 2022 Jun 22;153:113320. Epub 2022 Jun 22.

Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Acute mesenteric ischemia is known as a life threatening condition. Re-establishment of blood flow in this condition can lead to mesenteric ischemia reperfusion (MIR) injury which is accompanied by inflammatory response. Still, clear blueprint of inflammatory mechanism underlying MIR injury has not been provided. Interestingly, Albendazole has exhibited notable effects on inflammation and cytokine production. In this study, we aimed to evaluate outcomes of MIR injury following pretreatment with Albendazole with respect to assessment of mesenteric inflammation and ischemia threshold.

Methods: Male rats were randomly divided into sham operated, vehicle treated, Albendazole 100 mg/kg and Albendazole 200 mg/kg groups. MIR injury was induced by occlusion of superior mesenteric artery for 30 min followed by 120 min of reperfusion. Samples were utilized for assessment of epithelial survival and villous height. Immunohistochemistry study revealed intestinal expression of TNF-α and HIF-1-α. Gene expression of NF-κB/TLR4/TNF-α/IL-6 was measured using RTPCR. Also protein levels of inflammatory cytokines in serum and intestine were assessed by ELISA method.

Results: Histopathological study demonstrated that pretreatment with Albendazole could ameliorate decline in villous height and epithelial survival following MIR injury. Also, systemic inflammation was suppressed after administration of Albendazole. Analysis of possible participating inflammatory pathway could demonstrate that intestinal expression of NF-κB/TLR4/TNF-α/IL-6 is significantly attenuated in treated groups. Eventually, IHC study illustrated concordant decline in mesenteric expression of HIF-1-α/TNF-α.

Conclusion: Single dose pretreatment with Albendazole could ameliorate inflammatory response and enhance ischemia threshold following induction of MIR injury. More studies would clarify existing causality in this phenomenon.
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http://dx.doi.org/10.1016/j.biopha.2022.113320DOI Listing
June 2022

A huge preperitoneal collection following acute necrotizing pancreatitis: A case report and the management approach.

Ann Med Surg (Lond) 2022 Jun 23;78:103843. Epub 2022 May 23.

Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Introduction And Importance: Fluid collection is a critical complication of acute necrotizing pancreatitis. It is usually formed near the pancreas, but unusual collection sites have also been reported. Anterior extraperitoneal or preperitoneal collections following acute pancreatitis are rare and must be differentiated from pancreatic ascites, which is a collection of fluid in peritoneal cavity.

Case Presentation: A 68-year-old man with a suspected pancreatic mass presented to the emergency department, complaining of abdominal pain and gradual abdominal distention. He had experienced epigastric pain, nausea, vomiting, progressive abdominal distention, and icterus for two weeks prior to admission. An abdominopelvic CT scan revealed extensive necrotizing pancreatitis with a prominent extraperitoneal collection. The collection had extended from the retroperitoneal space to the anterior extraperitoneal or preperitoneal space and had pushed the abdominal viscera backward. We managed the patient with the "Step-up" approach, and the patient was discharged after four weeks.

Clinical Discussion & Conclusion: Preperitoneal fluid collection can rarely occur following acute necrotizing pancreatitis. Here, we suggested two possible routes for fluid migration from the retroperitoneum to the preperitoneal space. Using minimally invasive techniques such as percutaneous drainage of peripancreatic collections could reduce morbidity and mortality in critically ill patients diagnosed with necrotizing pancreatitis.
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http://dx.doi.org/10.1016/j.amsu.2022.103843DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207096PMC
June 2022

Rectus Sheath Hematoma in COVID-19 Patients as a Mortal Complication: A Retrospective Report.

Int J Clin Pract 2022 12;2022:7436827. Epub 2022 Feb 12.

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

Background: Rectus sheath hematoma is a rare self-limited presentation that has become a concern in hospitalized COVID-19 patients receiving anticoagulant therapies.

Method: A retrospective multicentric study was conducted in referral hospitals affiliated with the Tehran University of Medical Science, Tehran, Iran, between June and August 2021. Patients with a confirmed diagnosis of COVID-19 that were complicated with rectus sheath hematoma during hospitalization were included. Median (lower quartile to upper quartile) was used to report the distribution of the results.

Result: This study was conducted on nine patients with confirmed COVID-19 pneumonia, including eight females and one male. The severity of viral pneumonia was above average in eight patients. The median age and median body mass index were 65 (55.5 to 78) years and 29.38 (23.97 to 31.71) kg/m. The duration of anticoagulant therapy was 10 (6 to 14) days, and the median length of hospital stay was 20 (10 to 23.5) days. Rectus sheath hematoma occurred after a median reduction of 4 (2.7 to 6.6) units in blood hemoglobin. Although 66.7% received ICU care and all of them were under full observation in well-equipped hospitals, the mortality rate was 55.6%.

Conclusion: In summary, increased levels of inflammatory markers such as lactic acid dehydrogenase along with an abrupt decrease in blood hemoglobin in COVID-19 patients should be considered as predisposing factors for rectus sheath hematoma, especially in patients with moderate to severe COVID-19 pneumonia under anticoagulant therapy. This complication had been considered a self-limited condition; however, it seems to be fatal in patients with COVID-19 pneumonia. Further studies in larger sample sizes should be conducted to find out suitable management for this complication.
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http://dx.doi.org/10.1155/2022/7436827DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9159132PMC
June 2022

Problem-based learning as an effective method for teaching theoretical surgery courses to medical students.

J Educ Health Promot 2021 31;10:477. Epub 2021 Dec 31.

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

Background: This study was designed to assess the clinical judgment of medical students in surgery clinical decision-making by a standard examination after lecture-based learning (LBL) or problem-based learning (PBL).

Materials And Methods: A prospective randomized trial study on 175 medical students whom were randomly allocated to three groups was performed during November 2017 and January 2018. LBL group ( = 103), PBL group led by an attending ( = 39), and PBL group ( = 33) led by an intern. Chi-squared test and independent student -test were used to compare between the two groups. All the analyses were performed by the two-sided method using the Statistical Package for the Social Sciences software (SPSS version 22; SPSS, Inc., Chicago, IL, USA), and a < 0.05 set as statistically significant.

Results: The students in the PBL group scored significantly higher on the posttraining multiple-choice examination, compared to the LBL group ( = 0.048). However, there was no significant difference between the PBL group led by an attending and the PBL group led by an intern ( = 0.892).

Conclusion: We concluded that PBL remarkably increased the students' scores in the problem-solving examination, as compared to the conventional method. We found no significant differences in PBL facilitated by an attending or an intern.
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http://dx.doi.org/10.4103/jehp.jehp_266_21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8826769PMC
December 2021

Colosplenic fistula presentation in the context of undiagnosed colon cancer: Case report and review of literature.

Int J Surg Case Rep 2022 Mar 12;92:106828. Epub 2022 Feb 12.

General Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Introduction And Importance: Enteric fistulas commonly arise from inflammatory, infectious, or neoplastic processes. Colosplenic fistulas are rare with only several reported worldwide.

Case Presentation: Herein, we present a case of colosplenic fistula in a 39-year-old gentleman with past history of rectal cancer previously in remission. He was admitted with severe abdominal pain and hemodynamic instability due to septic shock. The erect chest x-ray revealed pneumoperitoneum under the diaphragm.

Clinical Discussion: Laparotomy was performed and ileum perforation was managed by resection and anastomosis. The post-op recovery was complicated by a febrile episode. To locate the source of infection a contrasted abdominal computed tomography was ordered, confirming the presence of a splenic abscess, suggestive of colosplenic fistula. We proceeded with laparotomy for drainage of the abscess, with splenectomy and splenic flexure resections. He was discharged 40 days post-op at a pre-morbid state.

Conclusion: Due to the high prevalence of colon cancer worldwide, novel complications such as the one reported here, are important to be reflected on. We hope this case can exemplify the significance of higher index of suspicion in at risk patient groups by the surgical teams and appropriate training on acute management of this rare complication.
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http://dx.doi.org/10.1016/j.ijscr.2022.106828DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881410PMC
March 2022

A novel surgical solution to impossible fascial closure due to contaminated abdominal cavities: A case report.

Int J Surg Case Rep 2021 Oct 6;87:106487. Epub 2021 Oct 6.

Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Introduction: Chronic, large, and old incisional hernias often lead to surgical complications and major hindrances during emergent laparotomies. The most challenging stages of the laparotomy in such cases occur during opening and fascial closure.

Case Presentation: This article explains the novel surgical technique employed for the complex abdominal closure upon concluding an emergent laparotomy on a 68-year-old female patient. This innovative technique is appropriate for patients with contaminated abdominal cavities and scant fascia who require abdominal operations in cases where biological mesh is not available or is not a viable option.

Conclusion: This surgical technique can help surgeons restrict abdominal contents and organs (particularly the bowel loops) and prevent migration out of the abdominal cavity during the early post-operative stages, hence, reducing post-surgical complications. The discussed surgical technique ensures that the abdominal fascia defect is limited using skin flaps. This defect later develops into a small hernia sac within a few weeks. Patients then need to have a secondary delayed elective operation on this significantly smaller sized hernia for repair using synthetic mesh.
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http://dx.doi.org/10.1016/j.ijscr.2021.106487DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8501507PMC
October 2021

Jejunogastric intussusception: a case report of rare complication of gastrojejunostomy.

J Surg Case Rep 2021 Jul 8;2021(7):rjaa612. Epub 2021 Jul 8.

Department of Internal Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Jejunogastric intussusception (JGI) is a rare complication of gastrojejunostomy surgery (<0.1% of cases), yet requires an urgent diagnosis. Mortality rate ranging from 10% to 50% based on delay in diagnosis and surgical intervention. Vomiting, abdominal pain and hematemesis are the most common symptoms. We report a 60 years old man admitted to the emergency department, complaining of epigastric pain and recurrent hematemesis for 3 days. Emergent upper GI endoscopy was done, and gastroenterologist reported a protruded edematous jejunal mucosa with bleeding, which formed a mass-like lesion. Abdominopelvic computed tomography scan also showed a target sign in favor of jejunal intussusception. Midline laparotomy and reduction of jejunal loop was performed and the patient was discharged without any further complications. In patients presented with hematemesis and abdominal pain and history of gastrectomy, JGI must considered as a possible cause because early diagnosis and treatment are necessary to prevent further complications.
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http://dx.doi.org/10.1093/jscr/rjaa612DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8271038PMC
July 2021

Continuous epidural catheter for anaesthesia management and post-op pain relief in colorectal surgery, complicated by epidural haematoma and bilateral paraplegia: A case report.

Int J Surg Case Rep 2021 Jun 26;83:106039. Epub 2021 May 26.

Department of Surgery, Imam Khomeini Hospital Complex, Iran. Electronic address:

Introduction: Utilising epidural analgesia (EA) during major abdominal surgery in combination with general anaesthetic, is a proven approach to decrease anaesthetic requirement in patients with severe comorbidities, enhance recovery and improve pain management.

Case Presentation: Herein we report a case of an 81-years-old female with bilateral lower limb sensory loss, saddle paraesthesia, paraplegia, and incontinence following a thoracic epidural catheterisation required for low anterior resection of rectal adenocarcinoma. The complication was reported by the patient on the third day of post-op.

Clinical Discussion: The magnetic resonance imaging results revealed an extradural extramedullary hyperintense haematoma in the spinal cord at T12-L2 vertebral level. The neurological deficit was addressed urgently with laminectomy; and following implementation of intensive inpatient physiotherapy and rehabilitation regiment the patient restored mild motor function.

Conclusion: We believe the culprit of the acute focal neurology deficits in this patient could be due to the epidural catheterisation and the post-op local anaesthetic injections. From this case, we anecdotally recommend performing thoracolumbar MRI as part of pre-op workup in patients with long standing back issues or claudication, considering x-ray guided catheterisation in higher risk patients for epidural hematoma, and early and repeated neurological examination and rapid investigation for any mild neurological deficits.
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http://dx.doi.org/10.1016/j.ijscr.2021.106039DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8188378PMC
June 2021

[Comparison of post-operative nausea and vomiting with intravenous versus inhalational anesthesia in laparotomic abdominal surgery: a randomized clinical trial].

Braz J Anesthesiol 2020 Sep - Oct;70(5):471-476. Epub 2020 Sep 6.

Tehran University of Medical Sciences, Imam Khomini Hospital Complex, Tehran, Irã.

Background: Postoperative Nausea and Vomiting (PONV) is a multifactorial surgical complication with an unclear underlying cause. Anesthetic methods, patients' characteristics and the type of surgery are considered as factors affecting PONV. This study was designed to compare the effect of inhalational and intravenous anesthesia in abdominal surgery on the incidence and severity of PONV.

Methods: A single-blinded prospective randomized clinical trial on 105 patients aged 18-65 years was carried out. Patients were divided in two groups of Total Intravenous Anesthesia (TIVA) and Inhalational anesthesia. The incidence and severity of PONV were examined at 0, 2, 6, 12, and 24hours after the surgery. The use of a rescue antiemetic was also evaluated.

Results: Fifty point nine percent of the patients in the inhalation group and 17.3% of the patients in the intravenous group developed PONV (p <0.001). The incidence of vomiting was reported in 11.3% of the Inhalational group and 3.8% of the TIVA group (p=0.15), and 24.5% of patients in the Inhalation group and 9.6% of patients in the intravenous group needed an antiemetic medication (p=0.043).

Conclusion: The incidence of postoperative nausea and vomiting and the need for administration of an antiemetic rescue drug, and the severity of nausea in patients were significantly lower in the TIVA group.
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http://dx.doi.org/10.1016/j.bjan.2020.04.019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9373333PMC
September 2021

Acute Gastric Dilation Following Trauma: A Case Report.

Adv J Emerg Med 2020 4;4(1):e13. Epub 2019 Aug 4.

Department of Emergency Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Acute gastric dilation following trauma is an unusual event that can occur in different settings, and can cause gastric necrosis as a rare though fatal condition. The present report involves a case of acute gastric dilation following multiple traumas, which caused gastric necrosis and total gastrectomy.

Case Presentation: A 19-year-old morbid obese male presented to the emergency department (ED) following a motor vehicle accident.He had a left lower extremity crash injury. In his serial examinations, he was complaining of upper abdominal pain with epigastric tenderness. After nasogastric tube (NGT) reinsertion, due to detecting coffee ground secretions in the drained fluid, the patient was transferred to the operating room.A midline laparotomy was performed that revealed dilation and discoloration of the stomach. Gastric decompression was performed. All the discoloration then disappeared except for that of certain suspicious areas, which necessitated evaluations. On the following day, given the lack of improvement in the patient`s condition, he was transferred to the operating room for a second laparotomy.

Conclusion: The present report emphasized on the importance of NGT insertion in multiple-trauma patients, which is, however, neglected in many cases. Moreover, acute gastric dilation is recommended to be considered in the differential diagnosis of patients with multiple or abdominal trauma and complaints of vomiting or abdominal pains.
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http://dx.doi.org/10.22114/ajem.v0i0.192DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6955027PMC
August 2019

Analysis of asymmetries in air pollution with water resources, and energy consumption in Iran.

Environ Sci Pollut Res Int 2018 Jun 17;25(18):17590-17601. Epub 2018 Apr 17.

Department of Economics, Kharazmi University, Tehran, Iran.

Iran should pay special attention to its excessive consumption of energy and air pollution due to the limited availability of water resources. This study explores the effects of the consumption of energy and water resources on air pollution in Iran from 1971 to 2014. It utilizes the non-linear autoregressive distributed lag approach to establish a robust relationship between the variables which show that both long- and short-run coefficients are asymmetrical. The positive and negative aspects of the long-run coefficients of energy consumption and water resources were found to be 0.19, - 1.63, 0.18, and 2.36, respectively, while only the negative ones were significant for energy consumption. Based on the cumulative effects, it can be established that there are important and significant differences in the responses of air pollution to positive and negative changes in water productivity and energy consumption. In particular, CO gas emissions are affected by negative changes in HO productivity both in terms of the total and the GDP per unit of energy use in Iran. In regard to short-run results, considerable asymmetric effects occur on all the variables for CO emissions. Based on the results obtained, some recommendations are presented, which policymakers can adopt in efforts to address the issues of pollution and consumption.
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http://dx.doi.org/10.1007/s11356-018-1825-5DOI Listing
June 2018

Neutrophil-Lymphocyte Ratio in Different Stages of Breast Cancer.

Acta Med Iran 2017 Apr;55(4):228-232

Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Research, Kaviani Breast Diseases Institute, Tehran, Iran.

Despite many advances in the treatment of breast cancer, it is still the second most common cause of death in women in the United States. It has been shown that inflammation plays a major role in the treatment of these cancers and inflammatory factors enhance tumor growth, invasion, metastasis, and vascularization. In this study, we would like to analyze peripheral blood neutrophil-lymphocyte ratio (NLR) in breast cancer patients and its correlation with disease staging. This cross-sectional analytic study was conducted in Imam Hospital, affiliated with Tehran University of Medical Sciences; a total of 195 female patients with breast cancer met the inclusion criteria. All of the patients had a complete blood count with leukocyte differential performed before chemotherapy. Medical records including pathology reports were also available. Data for all patients were collected prior to any surgical intervention. Exclusion criteria included clinical evidence of active infection, presence of hematological disorders, acute as well as chronic inflammatory or autoimmune diseases, or prior steroid therapy. Higher platelet count was significantly associated with the higher stage. The stage was not associated with the hemoglobin level. There was no association between the tumor size and age of patients with NLR. There was a significant relationship between NLR and IDC. There was a significant relationship between IDC and NLRs of less than 8.1 and greater than 3.3. There was a significant relationship between NLR and vascular invasion. There was no association between NLR and estrogen receptor and HER2. There was no significant relationship between the PLR and the cancer stage. In this study, NLR showed a significant relation with the disease staging. As the NLR increases the stage increases as well. Therefore, this ratio may be helpful in the preoperative evaluation of patients with breast cancer.
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April 2017

Co-expressional conservation in virulence and stress related genes of three Gammaproteobacterial species: Escherichia coli, Salmonella enterica and Pseudomonas aeruginosa.

Mol Biosyst 2015 Nov;11(11):3137-48

Laboratory of Systems Biology and Bioinformatics (LBB), Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran.

Gene co-expression analysis is one of the main aspects of systems biology that uses high-throughput gene expression data. In the present study we applied cross-species co-expressional analysis on a module of biofilm and stress response associated genes. We addressed different kinds of stresses in three most intensively studied members of Gammaproteobacteria including Escherichia coli K12, Pseudomonas aeruginosa PAO1 and Salmonella enterica for which large sets of gene expression data are available. Our aim was to evaluate the presence of common stress response strategies adopted by these microorganisms that may be assigned to the other members of Gammaproteobacteria. Results of functional annotation analysis revealed distinct categories among co-expressed genes, most of which concerned biological processes associated with virulence and stress response. Transcriptional regulatory analysis of genes present in co-expressed modules showed that the global stress sigma factor, RpoS, besides several local transcription factors accounts for the observed co-expressional response, and that several cases of feed-forward loops exist between global regulators, local transcription factors and their targets. Our results lend partial support to our underlying assumption of the conservation of core biological processes and regulatory interactions among these related Gammaproteobacteria members. This has led to the implementation of transferring gene function annotations from well-studied Gammaproteobacterial species to less-characterized members. These findings can shed light on the discovery of new drug targets capable of controlling severe infections caused by these groups of bacteria.
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http://dx.doi.org/10.1039/c5mb00353aDOI Listing
November 2015
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