Archives of Iranian Medicine
Volume:14 Issue: 6, Nov 2011

Scientific progress is an important indicator for the social and economic developments of any country. According to various reports, worldwide, Iran during the past decade has the most growth in the field of science due to a high increase in the numbers of publications. The aim of this study is to assess not only the quantity, but also the quality of publications of indexed Iranian journals and compare them to Turkey, as an Islamic neighboring country, in addition to the contributions of these two countries to the world of science. A number of international journals with high impact factors were selected to assess the contributions of scientists from Iran and Turkey to the world of science. English medical journals from Iran and Turkey indexed by the ISI Web of Sciences with known impact factors (IF) announced at the beginning of 2010 were included for evaluation. We calculated the number of all articles published from the beginning of 2007 until the present, the number of total citations, and citations from authors outside both countries for each journal. In addition, we selected all articles cited at least six times by authors outside of both countries and discussed their content with regard to originality and novelty, as well as their contributions to current knowledge. Furthermore, 60 international journals in basic or clinical research with IF greater than 6 were selected for the magnitude of contributions of both countries to the world of science. In 2010, out of a total of 21 Iranian journals indexed in ISI since 2007, only 12 have a known IF with a mean of 0.39 (range: 0.07 – 0.97), whereas out of 28 Turkish medical journals indexed in ISI, 15 have a known IF (mean: 0.35, range: 0.05 – 0.82). The total number of articles published since 2007 from Iran, total citations and total citations by authors from outside Iran were 2080, 1218, and 463, respectively. The same data related to Turkish journals were 4876, 2036, and 1331, respectively. Indeed, the mean citations per article by foreign authors for Iranian and Turkish researchers were 0.19 and 0.3, respectively. Of the total articles during this period, only seven from Iran and nine from Turkey have been cited at least six times by authors outside the two countries. Iran had 23 and Turkey 37 original publications in highly reputable international journals. Turkey was more represented in basic research and clinical observational studies than Iran. Despite high numbers of published articles, both countries have medical journals with very low comparable citation rates and IF. Only one out of three Turkish articles is cited once by authors outside of Turkey and one of five Iranian articles is cited by authors outside Iran. The few high-cited articles address new therapies and interventional studies or diseases commonly encountered regionally, and are the results of the efforts of a few individuals in highly specialized fields.Turkish scientists are inclined to publish their scientific works more than Iranians in distinguished international journals. These articles deal more with regional diseases that are not common in Western countries. Developing countries can only contribute to world science when they focus their efforts on teamwork in order to research ways to solve country-specific diseases and their own health problems.

The present study reported a six-year follow up of patients with chronic myeloid leukemia who were on imatinib therapy. We performed a retrospective study on a total of 417 patients diagnosed with chronic-phase, Philadelphia-positive (Ph+) chronic myeloid leukemia within six months before study entry. Patients were eligible for the study if they were between 18 and 70 years of age. Enrolled patients were treated at an initial dose of 400 mg of imatinib. The mean age of 417 patients was 40.9±14.5 years; 220 (52%) were men and 197 (47.2%) were women. Complete hematologic response at three months occurred in 99% of patients, 221 (53%) before four weeks and 196 (47%) after four weeks. Adverse events occurred in 17 (4.1%) of patients, relapse in 46 (11%) and death in 31 (7.4%) of our studied population. At 72 months, the estimated rate of overall survival rate was 89%. Our findings showed the efficacy and safety of imatinib mesylate among Iranian patients with chronic myeloid leukemia by hematological and molecular response.

The signs and symptoms associated with fungal meningitis are similar to those seen with more common bacterial infections. In this study, we investigate whether Aspergillus or Candida DNA can be detected in cerebrospinal fluid (CSF) samples from patients suspected of fungal meningitis using real-time PCR assay. From April 2007 to November 2009, we evaluated CSF samples and sera from patients with risk factors for cerebral fungal meningitis in Nemazi Hospital, Shiraz University of Medical Sciences, Iran, by real-time PCR assay and routine mycological studies (direct microscopy examination and culture). Two CSF and two serum samples from each patient were examined. CSF and serum samples from 38 patients (total: 152) suspected of fungal meningitis were examined. India ink staining and KOH smear were negative for all patients. C. albicans was isolated from two CSF samples. There were ten patients with positive real-time PCR results in their CSF samples: three patients had C. albicans, one with C. glabrata, four with Aspergillus species and two with both C. albicans and Aspergillus species DNA. Four patients had positive serum results for Aspergillus or Candida infections. Considering the findings, it seems that molecular examination can help in the diagnosis of fungal meningitis in patients with clinical and radiological presentations. Further studies should be conducted in other regions and settings to confirm these findings.

We investigated the association between apolipoprotein E polymorphism and ischemic heart disease with or without type 2 diabetes in Kuwait and examined the impact of apolipoprotein E polymorphism in diabetic patients. The present study was conducted from January 2005 to June 2006 in the Diabetic Clinic of Al-Amiri and Al-Sabah Hospitals in Kuwait City. Apolipoprotein E polymorphism was assessed in 250 subjects of which 83 were ischemic heart disease patients (41 diabetic and 42 non-diabetic) and 105 were diabetic patients without ischemic heart disease. Results were compared with 62 healthy controls. Apolipoprotein E polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism. Apolipoprotein E3 allele was the most commonly occurring form. The frequency of apolipoprotein E4 was higher in ischemic heart disease patients with type 2 diabetes (39%) and the non-diabetic (31%) group, but lower in the diabetic (20%) and control groups (16%). Apolipoprotein E4 allele may be related to the development of ischemic heart disease in patients with or without type 2 diabetes in Kuwait. However, future studies with larger population sizes are needed to establish such relationship.

An overlapping distribution of α2-adrenergic receptors with cannabinoid receptors has been reported in certain brain structures such as the dorsal hippocampus. Thus, functional interactions between cannabinoid and α2-adrenergic systems in cognitive control seem possible. In the present study, we examine the possible role of α2-adrenergic receptors of the dorsal hippocampus on WIN55,212-2 state-dependent learning. Adult male Wistar rats were bilaterally implanted with chronic cannulae in the CA1 regions of their dorsal hippocampi trained in a step-down type inhibitory avoidance task and tested 24 hr after training, to measure step-down latency. Post-training or pre-test intra-CA1 administration of the cannabinoid receptor agonist, WIN 55,212-2 (0.25 and 0.5µg/rat) induced amnesia. Amnesia produced by post-training WIN55,212-2 (0.5 µg/rat) was reversed by pre-test administration of WIN55,212-2, that was due to a state-dependent effect. Pre-test intra-CA1 microinjections of clonidine (0.25, 0.5 and 1 μg/rat) or yohimbine (0.5, 0.75, and 1 μg/rat) did not affect memory retrieval per se. Pre-test intra-CA1 administration of clonidine (0.5 and 1 μg/rat) or clonidine (0.25, 0.5, and 1 μg/rat) with an ineffective dose of WIN 55,212-2 (0.25 µg/rat) reversed post-training WIN55,212-2 (0.5 µg/rat,intra-CA1) induced memory impairment. Pre-test intra-CA1 microinjection of yohimbine (1 μg/rat) before administration of WIN55,212-2 (0.5 µg/rat, intra-CA1), however, dose-dependently inhibited WIN55,212-2 state-dependent memory. Modulation of α2-adrenergic receptors in the dorsal hippocampal CA1 regions can influence WIN55,212-2 induced amnesia and WIN55,212-2 state-dependent learning of an inhibitory avoidance task by pre- or post-synaptic mechanism(s).

We intend to design and validate a low-cost assay for the detection of hepatitis C virus (HCV) RNA using rapid-cycle RT-PCR. The procedure is performed in a closed system with little risk of contamination allowing PCR and product identification to be performed within one or two hours. A SYBR Green-based real-time RT-PCR for rapid detection of HCV. Amplicon synthesis was monitored continuously by SYBR Green I, which binds to double stranded DNA during PCR. The PCR products were identified by melting curve analysis. Standard sera with known concentrations of HCV RNA and 150 clinical samples were used to validate our assay. The minimum detection level of our assay was less than 50 IU/mL. The results on 100 plasma samples were comparable with commercial assays. This method is useful for rapid qualitative detection of HCV infection and particularly suitable for routine diagnostic applications.

Arterial and venous thrombosis are interrelated disorders at the interplay of platelets and fibrin. Arterial thrombi are platelet-rich and occur at sites vulnerable to atherosclerotic plaque rupture where blood shear rates are high; on the contrary, venous thrombi occur in association with slow blood flow and shear rates. These differences may underlie why anti-platelet agents are more effective in prevention of arterial thrombosis, while anticoagulants are preferred for venous thrombosis. Although some common thrombophilic disorders (e.g., Factor V Leiden, prothrombin gene mutation, etc.) are almost exclusively associated with venous thromboembolism, there are several disorders that are important to consider when caring for patients with both arterial and venous thromboembolism. This article will review the evidence-based management of heparin induced thrombocytopenia with thrombosis, anti-phospholipid antibody syndrome and catastrophic anti-phospholipid antibody syndrome, thrombohemorrhagic manifestations of Philadelphia chromosome-negative chronic myeloproliferative neoplasms including polycythemia vera, essential thrombocythemia and primary myelofibrosis, as well as paroxysmal nocturnal hemoglobinuria.

This study evaluated some risk factors for pre-eclampsia, which is one of the most problematic complications of pregnancy. This was a retrospective case control study conducted on 318 pre-eclamptic women (case group) and 318 women who were normotensive at the time of delivery as the control group. Evaluated factors were: maternal age, gestational age, nuliparity, mother’s educational status, maternal body mass index (BMI), maternal hemoglobin and blood Rh, familial history of pre-eclampsia, history of pre-eclampsia in a previous pregnancy, marital relations, urinary infection (UTI) during the present pregnancy, season of delivery, and method of contraception. Risk factors for pre-eclampsia were: UTI (P=0.04); history of pre-eclampsia during previous pregnancy (P=0.003), and winter season (P=0.001). Maternal age of more than 20 years, high educational status of mother, parity more than one, and oral contraceptive pills were protective for pre-eclampsia. After adjusting for all possible confounding factors using multiple logistic regression, only preexisting pre-eclampsia (P=0.004) was a risk factor, whereas parity more than three (P=0.007) and anemia (P=0.01) were protective for pre-eclampsia. The rate of cesarean delivery was more common in the pre-eclamptic group (245 cases, 77%) than the control group (85 cases, 26.7%). The one minute Apgar score of neonates less than 8 was more common in the case group (28.6% vs. 47.4%, P<0.001). Gestational age at the time of delivery was lower in the case group (36.48±3.4 weeks vs. 37.12±3.3 weeks, P<0.001). Awareness of risk factors of pre-eclampsia can help to monitor patients, ensure earlier diagnosis and predict which patients are more likely to develop pre-eclampsia.

The glandular odontogenic cyst is an uncommon developmental odontogenic cyst described as a distinct entity by Gardner et al. in 1988. The Glandular odontogenic cyst occurs more commonly in middle-aged people and has a predilection for the mandible. Only histopathological examinations allow for certain diagnosis of the cyst. The increased recurrence rate can be due to its multilocularity and incomplete removal of the lining following conservative treatment. This article presents a case of glandular odontogenic cyst in a 28-year-old male patient in the posterior region of the maxilla, which is quite rare.

This was an unusual case of a primary leiomyoma tumor of the adrenal gland in a 26-year-old woman incidentally found during workup for mild, dull abdominal pain.

From ancient time leprosy has been regarded as a terrifying, stigmatized disease; nevertheless, its cause remained unidentified up to the late 19th century. For centuries numerous leprosy victims worldwide suffered from its morbidity and were socially isolated. The afflicted individuals were segregated because they were considered ‘unclean’ and had to live in leper colonies, generally under very poor conditions. Physicians believed that leprosy was an incurable, highly contagious, and hereditary disease. In 1873 the Norwegian physician, Gerhard Armauer Hansen (1841 – 1912), ended the myth of leprosy and discovered its causative agent, known as Mycobacterium leprae. Hansen’s discovery was a great triumph in the fight against leprosy. In the 1930’s, the first effective antileprosy drug, dapsone, was introduced and in the early 1980’s multi-drug therapy was popularized because of high efficacy in resistant cases. Here, we have presented a brief look at the history of leprosy in the world with special focus on the historical account of leprosy in Iran, particularly during the 19th and 20th centuries.