Publications by authors named "Saeed Abkhiz"

7 Publications

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Preventing potential drug-drug interactions through alerting decision support systems: A clinical context based methodology.

Int J Med Inform 2019 07 13;127:18-26. Epub 2019 Apr 13.

Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Rotterdam, the Netherlands.

Background: The effectiveness of the clinical decision support systems (CDSSs) is hampered by frequent workflow interruptions and alert fatigue because of alerts with little or no clinical relevance. In this paper, we reported a methodology through which we applied knowledge from the clinical context and the international recommendations to develop a potential drug-drug interaction (pDDI) CDSS in the field of kidney transplantation.

Methods: Prescriptions of five nephrologists were prospectively recorded through non-participatory observations for two months. The Medscape multi-drug interaction checker tool was used to detect pDDIs. Alongside the Stockley's drug interactions reference, our clinicians were consulted with respect to the clinical relevance of detected pDDIs. We performed semi-structured interviews with five nephrologists and one informant nurse. Our clinically relevant pDDIs were checked with the Dutch "G-Standard". A multidisciplinary team decided the design characteristics of pDDI-alerts in a CDSS considering the international recommendations and the inputs from our clinical context. Finally, the performance of the CDSS in detecting DDIs was evaluated iteratively by a multidisciplinary research team.

Results: Medication data of 595 patients with 788 visits were collected and analyzed. Fifty-two types of interactions were most common, comprising 90% of all pDDIs. Among them 33 interactions (comprising 77% of all pDDIs) were rated as clinically relevant and were included in the CDSS's knowledge-base. Of these pDDIs, 73% were recognized as either pseudoduplication of drugs or not a pDDI when checked with the Dutch G-standard. Thirty-three alerts were developed and physicians were allowed to customize the appearance of pDDI-alerts based on a proposed algorithm.

Conclusion: Clinical practice contexts should be studied to understand the complexities of clinical work and to learn the type, severity and frequency of pDDIs. In order to make the alerts more effective, clinicians' points of view concerning the clinical relevance of pDDIs are critical. Moreover, flexibility should be built into a pDDI-CDSS to allow clinicians to customize the appearance of pDDI-alerts based on their clinical context.
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http://dx.doi.org/10.1016/j.ijmedinf.2019.04.006DOI Listing
July 2019

Analysis of Interleukin-17 mRNA Level in the Urinary Cells of Kidney Transplant Recipients with Stable Function.

Maedica (Bucur) 2017 Dec;12(4):242-245

Nephrology and Kidney Transplant Research Center, Urmia University of Medical Sciences, Urmia, Iran.

Objectives: Kidney transplantation supports patients with end-stage kidney diseases. Many factors control the allograft function in kidney transplant recipients. Interleukin-17 (IL-17) can be used as a non-invasive diagnostic biomarker of rejection. The aim of this study was to evaluate the expression of IL-17 mRNA in urinary cells of kidney transplant recipients with stable function.

Material And Methods: A total of 40 renal transplant recipients who were admitted for surgery and 30 healthy controls were enrolled in the study. From each patient, 30 mL urine samples were collected in 50 mL tubes on days 3 and 5 after renal transplantation; also, 30 mL urine samples were obtained from controls. Quantitative Real-Time PCR (qRT-PCR) technique was used for analysis of IL-17 mRNA level in the tested groups; 2-ÄÄCT method was performed for determining the relative gene expression between tested groups.

Results: The mRNA expression mean ± SE of fold in patients and controls were 3.58±1.61 fold and 2.85±1.37 fold, respectively. The mRNA expression mean of IL-17 (fold) was not statistically different in tested groups (P-value = 0.63).

Conclusions: In kidney transplant recipients, urinary IL-17 expression provides informative data in relation to the allograft function regardless of allograft pathology.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5879584PMC
December 2017

Evaluation of the Effect of Statins on Post-Surgical Patients with Acute Kidney Injury.

Maedica (Bucur) 2017 Jun;12(2):95-100

Nursery of Urmia University of Medical Sciences.

Introduction: Acute kidney injury is the sudden and almost complete loss of renal function with reduced glomerular filtration rate, and it occurs whenever the kidneys are unable to excrete metabolic waste products.

Method: This randomized double-blinded clinical trial was performed in an intensive care unit (ICU) of a university educational hospital. After randomization with a random assigning table of numbers, patients were divided into two groups: an intervention group and a control group. The patients' daily blood urea nitrogen and creatinine levels were measured and changes were recorded. The statin group received a tablet of atorvastatin 40 mg daily (Abidi Pharmacy Production). Moreover, patients' baseline vital signs and changes in serum blood urea nitrogen, creatinine, mechanical ventilation requirement, need for dialysis, ICU stays, and mortality were recorded in both groups. SPSS version 20 software was used for data analysis. P value <0.05 was considered significant.

Results: The mean intubation time for the intervention and control groups was 4.44±1.8 and 3.46±2.02, respectively, and the mean mechanical ventilation time was 2.14±2.15 and 2.34±2.07 days, respectively. The mean ICU stay was 4.91±3.3 days for the intervention group and 4.67±2.67 days for the control group. Throughout the study duration, the mean dialysis requirement frequency was 4.66±1.2 times in the intervention group and 5.54 ±1.75 times in the control group. Two patients in the intervention group and three patients in the control group died. There was no statistically significant difference in mortality between the two groups (P >0.05).

Discussion And Conclusion: The effects of statins on the different stages of acute kidney injury and its outcomes are yet challengeable, so we recommend conducting further studies with larger sample sizes.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5649040PMC
June 2017

PRIMARY HYPERPARATHYROIDISM: COMPARING BETWEEN SOLID AND CYSTIC ADENOMAS AND THE EFFICACY OF ULTRASOUND AND SINGLE-PHOTON EMISSION COMPUTED TOMOGRAPHY IN THEIR DIAGNOSIS.

Endocr Pract 2015 Nov 26;21(11):1277-81. Epub 2015 Aug 26.

Objective: Primary hyperparathyroidism (PHPT) is a disorder that results from abnormal functioning of the parathyroid glands. The purpose of this study was to compare cystic and solid adenomas by analyzing different variables associated with PHPT and parathyroid adenomas (age, calcium, phosphorus, and parathyroid hormone [PTH] levels, adenoma volume) while comparing the efficacy of ultrasound and single-photon emission computed tomography in differentiating between both types of adenoma.

Methods: From 152 patients diagnosed with PHPT between January 2013 and 2014, only 109 patients who had positive ultrasonographic findings for single parathyroid adenoma were included in the study.

Results: A total of 26 patients had cystic adenomas and 83 patients had solid adenomas. Sestamibi (MIBI) was negative in 50% of the cystic adenoma group and 27.7% of the solid adenoma group, with an overall technetium-MIBI efficacy of 67%. Age, phosphorus level, and adenoma volume were significantly higher in patients with cystic adenomas (P = .001, P = .02, and P = .02, respectively), whereas calcium and PTH levels were significantly higher in patients with solid adenomas (P = .02, P = .038, respectively). MIBI had a significant correlation with PTH levels (P = .031) and adenoma volume (P = .05) only in patients with solid adenomas. No significant correlation was found between sex and type of parathyroid adenoma.

Conclusion: The current study is the first to compare age, PTH levels, and adenoma volume between cystic and solid adenoma patients, providing more information for the poorly understood pathology of cystic adenomas. Our findings showed that age and calcium and PTH levels are significantly higher in patients with solid adenomas, whereas adenoma volume and phosphorus levels are significantly higher in patients with cystic adenomas.
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http://dx.doi.org/10.4158/EP15789.ORDOI Listing
November 2015

Recurrent idiopathic membranous glomerulonephritis after kidney transplantation and successful treatment with rituximab.

Iran J Kidney Dis 2015 Mar;9(2):158-62

Nephrology and Renal Transplant Center, Urmia University of Medical Sciences, Urmia, Iran.

After renal transplantation approximately forty percent of patients with membranous glomerolunephritis (MGN) had a recurrence, most commonly during the first year.We present two cases with recurrent MGN after kidney transplantation who successfully treated with ritoximab.
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March 2015

Successful treatment of Chronic Myelogenic Leukemia (CML) with imatinib after renal transplantation.

Arch Iran Med 2014 May;17(5):388-90

Resident of Internal Medicine, Uromia University of Medical Sciences, Iran.

Chronic Myelogenic Leukemia (CML) is a rare malignant disorder after solid organ transplantation, especially in renal transplant recipients. Imatinib Mesylate is currently approved as first line treatment of CML. Most reports on CML are from kidney recipients who received azathioprine  in combination with cyclosporine and prednisolone as immunosuppressive therapy. We report a case with CML who was treated with Mycophenolate Mofetil.
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http://dx.doi.org/0141705/AIM.0015DOI Listing
May 2014

Tribulus terrestris-induced severe nephrotoxicity in a young healthy male.

Nephrol Dial Transplant 2010 Nov 28;25(11):3792-3. Epub 2010 Jul 28.

Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

Herbal medications are being progressively utilized all over the world. Nevertheless, herbal remedies are not without hazards and several cases of adverse reactions have been described. Tribulus terrestris is traditionally used because of its aphrodisiac and antiurolithiatic activities with almost complete inhibition of stone formation. We report a case of T. terrestris-induced hepatotoxicity, nephrotoxicity and neurotoxicity in an Iranian male patient who used the plant's extract to prevent kidney stone formation. He presented with seizure and very high serum aminotransferases and creatinine after consuming herbal water for 2 days. Discontinuation of the herbal remedy resulted in improvement in symptoms and normalization of his liver enzymes.
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http://dx.doi.org/10.1093/ndt/gfq457DOI Listing
November 2010