فهرست مطالب

Research in Medical Sciences - Volume:23 Issue: 3, Mar 2018

Journal of Research in Medical Sciences
Volume:23 Issue: 3, Mar 2018

  • تاریخ انتشار: 1397/02/31
  • تعداد عناوین: 10
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  • Atousa Adibi, Farbod Ferasat *, Mohammad Mehdi Baradaran Mahdavi, Kimia Kazemi, Sina Sadeghian Page 1
    Background
    Spleen is the most common viscera that may be hurt in blunt abdominal trauma. Operative or nonoperative management of splenic injury is a dilemma. The American Association for the Surgery of Trauma (AAST) is the most common grading system which has been used for the management of blunt splenic injuries. The new recommended grading system assesses other aspects of splenic injury such as contrast extravasation, pseudoaneurysm, arteriovenous fistula, and severity of hemoperitoneum, as well. The aim of this study is to compare and prioritize the cutoff of AAST grading system with the new recommended one.
    Materials And Methods
    This is a cross‑sectional study on patients with splenic injury caused by abdominal blunt trauma referred to Isfahan University of Medical Sciences affiliated Hospitals, Iran, in 2013–2016. All patients underwent abdominopelvic computed tomography scanning with intravenous (IV) contrast. All images were reported by a single expert radiologist, and splenic injury grading was reported based on AAST and the new recommended system. Then, all patients were followed to see if they needed surgical or nonsurgical management.
    Results
    Based on the findings of this study conducted on 68 patients, cutoff point of Grade 2, in AAST system, had 90.3% (95% confidence interval [CI]: 0.73–0.97) specificity, 51.4% (95% CI: 0.34–0.67) sensitivity, 86.4% (95% CI: 0.64–0.95) positive predictive value (PPV), and 60.9% (95% CI: 0.45–0.74) negative predictive value (NPV) for prediction of surgical management requirement, while it was 90.3% (95% CI: 0.73–0.97) specificity, 45.9% (95% CI: 0.29–0.63) sensitivity, 85% (95% CI: 0.61–0.96) PPV, and 58.3% (95% CI: 0.43–0.72) NPV for the new system (P = 0.816).
    Conclusion
    In contrast to the previous studies, the new splenic injury grading method was not superior to AAST. Further studies with larger populations are recommended.
    Keywords: Blunt abdominal trauma, injury grading system(s), splenic injury
  • Hamid Kalantari, Hadi Karimzadeh, Saeed Kalantari, Majid Talebi, Majid Yaran, Javad Golpayegani * Page 2
    Background
    Chronic hepatitis type?C virus (HCV) infection is one of the most common worldwide viral disorders, which leads to various clinical complications as well as extrahepatic manifestations. Furthermore, Vitamin D3 has also been reported to have relationship with the mentioned complications. Te aim is to evaluate the correlation between Vitamin D3 level and extrahepatic manifestation in chronic HCV patients.
    Materials And Methods
    Tis cross?sectional study has been carried out on 90 patients with chronic hepatitis C. Te level of Vitamin D3 was assessed in plasma of 90 patients with chronic HCV. Genotyping was done and clinical and sign and symptoms of recruited patients were gathered. Extrahepatic anifestations were evaluated and the correlation of blood, hepatic, and immunological factors and the level of Vitamin D3 were assessed.
    Results
    Most of our patients were male (92% vs. 8%). Twenty?nine percent had the insufcient amount of Vitamin D3 (21–30 ng/ml), and the remains had the Vitamin D3 level between 13–20 ng/ml. Furthermore, our assessment demonstrated that defciency of Vitamin D3 was associated with the extrahepatic manifestations such as purpura (odds radio [OR] [95% confdence interval (CI) 95%] = 8.80 [1.74–44.47], P = 0.004), vasculitis (OR [95% CI] = 11.70 [3.01–45.41], P
    Conclusions
    According to our results, the extrahepatic manifestation in the patients with sufcient levels of Vitamin D3 would be less possible. In fact, it could be stated that defciency in the Vitamin D3 can have a signifcant relationship with these manifestations.
    Keywords: 25 hydroxy Vitamin D3_extrahepatic manifestations_hepatitis type C virus
  • Matin Shariati *, Mojgan Mokhtari Page 3
    Background
    Oral lichen planus (OLP) is a common mucocutaneous disease with malignant transformation potential. Several etiologies such as humoral, autoimmunity, and viral infections might play a role, but still there is no defnite etiology for this disease. Te aim of this study was to investigate the presence of Epstein–Barr virus (EBV) genome in Iranian patients with OLP as compared to people with normal mucosa.
    Materials And Methods
    Te study was carried out on a case group including 38 tissue specimens of patients with histopathological confrmation of OLP and a control group including 38 samples of healthy mucosa. All samples were examined by nested polymerase chain reaction (PCR) method to determine the DNA of EBV.
    Results
    Twenty?two (57.9%) female samples and 16 (42.1%) male samples with OLP were randomly selected as the case group, and 20 (52.6%) female samples and 18 (47.4%) male samples with healthy mucosa as the control group. Tere was a statistically signifcant di?erence in the percentage of EBV positivity between the case (15.8%) and the control groups (P
    Conclusion
    Results emphasized that EBV genome was signifcantly higher among Iranian patients with OLP so antiviral therapy might be helpful.
    Keywords: Epstein–Barr virus infections, oral lichen planus, polymerase chain reaction
  • Ahmad Yazdekhasti, Alireza Firouzfar *, Parisa Hajheidari, Arash Havaei, Golchehreh Tavakol, Fereshteh Karbasian Page 4
    Background
    According to increasing rate of using assisted reproductive technology (ART) which result in higher rates of multiple birth and natal difculties, we aimed to determine the prevalence rate of multiple birth pregnancies.
    Materials And Methods
    A descriptive cross?sectional study evaluating birth fles in 2009–2010 of main hospitals of Isfahan, Iran.
    Results
    Among 31640 fles’ studies, 614 cases of multiple birth pregnancies were investigated. Te product of these pregnancies were 1286 (50.2% females) infants including 557 twins (17.6/1000), 56 triplets (1.8/1000), and one case of quadruple (0.03/1000). Infants weigh
    Discussion
    Te prevalence of multiple birth pregnancies is growing. Te need for more mother and child care is important.
    Keywords: Epidemiology, multiple birth, prevalence, triplet, twin
  • Mehri Salari, Emad Fayyazi, Omid Mirmosayyeb * Page 5
    Wilson disease (WD) is a rare autosomal recessive disorder characterized by excessive copper deposition in the body, principally in the liver and the brain. Tere is a wide spectrum of clinical presentations, but the most signifcant and basic symptoms of the diseasecan be divided into hepatic, neurologic, and psychiatric manifestations. Magnetic resonance imaging (MRI) provides more detailedanatomical information than computed tomography of the brain, especially of the structure of the basal ganglia and brain stem. Inthis review, we want to evaluate the correlation between MRI fndings and clinical features of WD.
    Keywords: Hepatocerebral degeneration, magnetic resonance imaging, Wilson disease
  • Adel Ghorani Azam, Samaneh Sepahi, Bamdad RiahiZanjani, Anahita Alizadeh Ghamsari, Seyed Ahmad Mohajeri, Mahdi BalaliMood Page 6
    For many years, medicinal plants and herbal therapy have been widely used in di?erent societies for the treatment of various diseases. Besides their therapeutic potency, some of the medicinal plants have strong toxicity in human, especially in children and elderly. Despite common beliefs that natural products are safe, there have been few reports on their toxicities. In the present study, we aimed to systematically review the literature wherein acute plant poisoning and herbal intoxication have been reported in pediatric patients. After literature search and selection of the appropriate documents, the desired data were extracted and described qualitatively. A total of 127 articles with overall 1453 intoxicated cases were collected. Te results of this study showed that some medicinal plants can cause acute poisoning and complications such as hepatic and renal failure in children. Te fndings of this survey showed that acute plant poisoning can be life?threatening in children, and since a single?ingested dose of toxic plants can cause acute poisoning, parents should be aware of these toxic e?ects and compare the side e?ects of self?medication with its potential benefts.
    Keywords: Herbal medicine, medicinal plant, pediatrics, poisoning, toxicology
  • Jafar Salimian, Hamed Mirzaei, Abdullah Moridikia, Asghar Beigi Harchegani, Amirhossein Sahebkar, Hossein Salehi Page 7
    Chronic obstructive pulmonary disease (COPD) is known as a progressive lung disease and the fourth leading cause of death worldwide. Despite valuable efforts, there is still no accurate diagnostic and prognostic tool for COPD. Hence, it seems that finding new biomarkers could contribute to provide better therapeutic platforms for COPD patients. Among various biomarkers, microRNAs (miRNAs) have emerged as new biomarkers for the prognosis and diagnosis of patients with COPD. It has been shown that deregulation of miRNAs targeting a variety of cellular and molecular pathways such as Notch, Wnt, hypoxia‑inducible factor‑1α, transforming growth factor, Kras, and Smad could be involved in COPD pathogenesis. Multiple lines of evidence have indicated that extracellular vesicles such as exosomes could carry a variety of cargos (i.e., mRNAs, miRNAs, and proteins) which transfer various cellular and molecular signals to recipient cells. Here, we summarized various miRNAs which could be applied as diagnostic and prognostic biomarkers in the treatment of patients with COPD. Moreover, we highlighted the role of extracellular vesicles containing miRNAs as diagnostic and prognostic biomarkers in COPD patients.
    Keywords: Biomarker, chronic obstructive pulmonary disease, diagnosis, exosome, microRNA, therapy
  • Anahita Alizadeh, Maryam Vahabzadeh, Anoush Azarfar, Yalda Ravanshad Page 8
    Abdominal pain is a common complaint among children with a vast di?erential diagnosis. Hip pain is also a nonspecifc sign. Here, we present a case of a 3?year?old boy with a complaint of abdominal pain and pain in both hips, much on the right one. After evaluations, the diagnosis was a spider bite.
    Keywords: Abdominal pain, children, spider bite
  • Saurabh R. Shrivastava, Prateek S. Shrivastava, Jegadeesh Ramasamy Page 10