Publications by authors named "Mohammad-Kazem Shahmoradi"

6 Publications

  • Page 1 of 1

Posttraumatic bronchobiliary fistulae due to foreign body remnants after  a road traffic injury: a case report.

J Med Case Rep 2021 May 22;15(1):291. Epub 2021 May 22.

Colorectal Research Center, Department of Surgery, Shiraz University of Medical Sciences, Zand Avenue, P.O. Box 71345-1744, Shiraz, Iran.

Background: Bronchobiliary fistula is an extremely rare disease that involves abnormal communication between a hepatic segment and bronchial tree. It is mostly caused by untreated hydatid cyst, liver abscess, iatrogenic stenosis, and, rarely, trauma.

Case Presentation: We experienced an extremely rare case of bronchobiliary fistula after motor vehicle accident. A 15-year-old Persian boy visited our clinic with chief complaints of persistent pleuritic chest pain, productive cough, weight loss, and fever for 2 months. Coronavirus disease 2019 reverse transcription polymerase chain reaction test was negative. Chest X-ray revealed hazy opacification of right lower lobe. Bronchoalveolar lavage for acid-fast bacillus came back negative. Thoracoabdominal computed tomography scan revealed a collection in segment VIII of the liver communicating with another 13 × 5 cm multiloculated collection in the lower lobe of the right lung, with air foci within the collection. Right posterolateral thoracotomy was performed with the impression of bronchobiliary fistula. Drainage of hepatic collection with debridement, diaphragmatic repair, and open decortication of lung followed by resection of the involved segment of the right lung was performed. Histopathologic evaluations revealed abscess formation in pulmonary tissue, and many multinucleated giant cells were seen that appear to be due to foreign body remnants after previous laparotomy surgery. The foreign body seemed to be the remnants of Surgicel absorbable hemostat.

Conclusions: Herein, we report an extremely rare case of a posttraumatic bronchobiliary fistula caused by remnants of Surgicel hemostatic agent. Bronchobiliary fistula is mainly caused by untreated hydatid cyst, liver abscess, iatrogenic stenosis, and, rarely, trauma. Migration and erosion of oxidized regenerated cellulose through the diaphragm seems to be the causative factor of bronchobiliary fistula in this patient.
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http://dx.doi.org/10.1186/s13256-021-02859-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8139863PMC
May 2021

Evaluating outcomes of primary anastomosis versus Hartmann's procedure in sigmoid volvulus: A retrospective-cohort study.

Ann Med Surg (Lond) 2021 Feb 19;62:160-163. Epub 2021 Jan 19.

Department of General Surgery, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.

Background: The aim of this study is to compare the short outcomes of two methods of sigmoid resection and primary anastomosis with sigmoid resection and end colostomy (Hartmann's procedure) for sigmoid volvulus.

Methods: This retrospective study included 102, of which 56 patients underwent end colostomy (Hartmann's procedure) and 46 patients underwent resection and primary anastomosis for sigmoid volvulus. The medical records of the patients were reviewed to evaluate the patients' characteristics, operative data, short-term postoperative outcomes and mortality.

Results: The mean age of patients in the groups of Hartmann's procedure and primary anastomosis were 68.23 ± 13.42 and 70.10 ± 12.71, respectively. From the 46 patients who had primary colorectal anastomosis, 2 patients (4.3%) suffered from anastomosis leakage, which was not significantly different. This study showed that anastomosis leakage, prolonged ileus, bleeding, surgical site infection and fascial dehiscence were not different between Hartmann's procedure and primary anastomosis, significantly, p < 0.05. Hospital stay in the Hartmann group was less than primary anastomosis group in the same admission, p = 0.04. The mortality rate was not statistically different among the two groups, p = 0.549.

Conclusions: Postoperative complications and mortality rate do not different among the two groups however, the duration of hospitalization was lesser in Hartmann's procedure group.
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http://dx.doi.org/10.1016/j.amsu.2021.01.019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7820798PMC
February 2021

Iranian Herbal Medicines Against Hydatid Cyst Protoscoleces: A Systematic Review.

Infect Disord Drug Targets 2021 ;21(5):e270421188119

Department of Surgery, Lorestan University of Medical Sciences, Khorramabad, Iran.

Background: In recent years, more attention has been focused in the practice of both crude extract of medicinal plants, and the screening plant-derived compounds as substitute scolicidal agents during hydatid cyst surgery. The present study was designed to review the protoscolicidal effects of some Iranian herbal medicines against hydatid cyst protoscoleces.

Methods: English databases, including PubMed, Google Scholar, Web of Science, EBSCO, Science Direct, and Scopus were searched for publications worldwide related to protoscolicidal effects of Iranian herbal medicines without date limitation so that identify all published articles (in vitro, in vivo, clinical and case-control) have studied. Keywords included "Protoscolicidal", "Scolicidal", "Herbal medicines", "Extract", "Essential oil", "Plant", "In vitro", and "Iran". Moreover, the language of data collection was limited to English.

Results: In total, 40 papers up to 2020 were included in the present systematic review. The most studies were conducted on protoscolicidal activity of methanolic extracts (17 studies) followed by essential oils (15 studies), and aqueous extract (3 studies). The most commonly used part of herbs were leaves (21 herbs), seeds (8 herbs), and fruit (6 herbs), respectively. Moreover, the most prevalent herbal family was Lamiaceae (6 studies), followed by Apiaceae (5 studies) and Liliaceae (5 studies).

Conclusion: Considering the high efficacy of Iranian herbal medicines against hydatid cyst protoscoleces, it can be concluded that Iranian herbal medicines have ability to consider as new alternative protoscolicidal agents during hydatid cyst surgery; however, more clinical studies are required to discover the precise protoscolicida activity of Iranian medicines in animal and human subjects.
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http://dx.doi.org/10.2174/1871526520666201117145733DOI Listing
October 2021

In vitro and Ex vivo Antiparasitic Effect of Rheum ribes L. Extract Against the Hydatid Cyst Protoscoleces.

Infect Disord Drug Targets 2021 ;21(6):e170721187993

Department of Surgery, Lorestan University of Medical Sciences, Khorramabad, Iran.

Background: Cystic echinococcosis is a zoonotic infection in humans and herbivorous animals occurring worldwide, which is caused by the larva stage of Echinococcus granulosus. Rhubarb (Rheum ribes L.) as an herbal medicine has various therapeutic properties such as antioxidant, anticancer, and antimicrobial. With respect to the potential of the biological activities of this plant in traditional and modern medicine, we aim to examine its protoscolicidal effects against E. granulosus protoscoleces in vitro and ex vivo.

Methods: Collected protoscoleces from liver hydatid cysts of infected sheep were exposed to the different concentrations of the extract (225, 450, 900 mg/mL) for 5-60 min in vitro and ex vivo. Then, by using the eosin exclusion assay, the viability of protoscoleces was studied.

Results: R. ribes extract had a potent protoscolicidal activity in vitro ; at 450 and 900 mg/ml, it killed 56.3 and 100% of protoscoleces, respectively, after 10 min of exposure. In ex vivo assay, the extract needed more time to kill the protoscoleces than the in vitro; so that at the concentration of 900 mg/mL, all protoscoleces were killed after 15 minutes.

Conclusion: The obtained results exhibited the potent protoscolicidal effects of R. ribes extract, particularly at the concentration of 900 mg/ml, which completely killed the parasite after <15 min of exposure. However, more supplementary studies are required to verify these findings by assessing animal models and clinical subjects.
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http://dx.doi.org/10.2174/1871526520666201116094851DOI Listing
October 2021

Evaluation of colonoscopy data for colorectal polyps and associated histopathological findings.

Ann Med Surg (Lond) 2020 Sep 11;57:7-10. Epub 2020 Jul 11.

Department of General Surgery, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.

Background: Adenomas of colon and rectal are frequent colonoscopically found benign lesions. The aim of this study is to evaluate the incidence of polyps among patients referred for colonoscopy and associated histopathological findings.

Methods: In this retrospective study, patients referred for colonoscopy at Shahid Madani Hospital from were enrolled. The records of the patients were evaluated for demographic data, polyp status along with size and location and type and histopathological findings of the polyps. The data obtained were statistically analyzed using SPSSv22.

Results: Among 1600 patients who underwent colonoscopy, 260 were positive with polyps. The main symptom among these patients was lower gastrointestinal bleeding 44.2%. The average size of the polyps was 5.68 ± 2.66 and the incidence was significantly greatest among the age group of 51-65 years, p < 0.01. The commonest sites polyps were sigmoid and descending colon, 28.6% and 23.2%, respectively. Adenomatous polyps were the most frequent type, 58.3%. The morphology and pathology of the polyps were significantly associated with each other, p < 0.01.

Conclusion: Our study evaluates the retrospective data for polyp findings among colonoscopy patients. Early diagnosis of polyps can provide better therapeutic outcomes.
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http://dx.doi.org/10.1016/j.amsu.2020.07.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358369PMC
September 2020

The economic evaluation of screening for colorectal cancer: Case of Iran.

Clin Lab 2013 ;59(5-6):667-74

Research Center for Health Services Management, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Background: Given increasing rates of colorectal cancer (CRC) in countries with intermediate incidence rates, the decision to implement population-based screening must consider the trade-off between high costs and a relatively low yield. We estimated the incremental cost-effectiveness ratio of 10 strategies for colorectal cancer screening, as well as no screening, incorporating quality of life, noncompliance, and data on the costs and benefits of chemotherapy in Iran.

Methods: We used a Markov model to measure the costs and quality-adjusted life expectancy of 50-year-old average-risk Iranian without screening and with screening by each test. In this study, we populated the model with data from the ministry of health and published literature. We considered costs from the perspective of a health insurance organization, with inflation to the 2011 Iranian Rial converted to US dollars. We focused on three tests of the 10 strategies considered, currently being used for population screening in some Iranian provinces (Mazandaran Kerman, Golestan, Ardabil, and Tehran): low-sensitivity guaiac fecal occult blood test, performed annually; fecal immunochemical test, performed annually; and colonoscopy, performed every 10 years.

Results: These strategies reduced the incidence of colorectal cancer by 39%, 60%, and 76% and mortality by 50%, 69%, and 78%, respectively, compared with no screening. These strategies generated ICER (incremental cost-effectiveness ratios) of $9067, $654, and $8700 per QALY (quality-adjusted life year), respectively. Sensitivity analyses were performed to evaluate the influence of various parameters on the cost-effectiveness of screening. The results were robust to probabilistic sensitivity analysis. Colonoscopy every 10 years yielded the greatest net health benefit.

Conclusions: Screening for colorectal cancer is cost-effective over conventional levels of WTP (Willingness to Pay). Annual high-sensitivity fecal occult blood testing, such as a fecal immunochemical test, or colonoscopy every 10 years offer the best value for the money in Iran.
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http://dx.doi.org/10.7754/clin.lab.2012.120812DOI Listing
August 2013
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