aghigh ziaee-mehr
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Background
During the gathering of demographic data for the biobank on Buerger’s Disease (BD), we found that, after the clinical manifestation of BD, the patients usually became infertile, and the age of their last child was compatible with the time of disease diagnosis. The aim of this study was to evaluate the underlying cause of secondary infertility in BD patients.
MethodsAnti-sperm antibodies (ASA), testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) in the sera of 39 male BD patients were measured and compared with 39 age-matched Caucasian male controls.
ResultsSix patients declared that they suffered from impotency. The ASA level was positive in 25.6% of the patients and 2.4% of the controls (p= 0.003, CC= 6.96). The mean levels of testosterone in the patients and controls were 393.12±32.9 ng/dl and 354.37±30.9 ng/dl, respectively. The mean levels of LH in the patients and controls were 0.88±0.12 mIU/r and 0.85±0.1 mIU/r, respectively. The mean levels of FSH in the patients and controls were 4.1± 0.35 mIU/r and 3.56±0.33 mIU/r, respectively. No significant difference in the serum levels of testosterone, LH, or FSH was found between the patients and controls (p> 0.05). The spermograms of three ASA-negative patients demonstrated impaired sperm motility.
ConclusionsAnti-sperm antibodies, disturbed genital circulation, autonomic dysfunction and sperm motility may be responsible for secondary infertility in Buerger’s Disease.
Keywords: Anti-sperm antibody, Buerger’s Disease, Infertility, Thromboangiitis Obliterans -
In this report we have discussed our experience with a special home-made platelet-rich plasma (PRP)-fibrin glue (FG) as a last resort for treatment of a challenging case of postoperative CA. A 25 years old, ill woman was admitted with severe ascites and hepatic encephalopathy in our center. She was a known case of autoimmune hepatitis and cirrhosis who had undergone liver transplantation 5 years ago and developed chronic rejection. During the surgery an old organized thrombosis in the portal vein was detected, accordingly an iliac vein graft was used to bypass the superior mesenteric vein. After surgery the patient developed chylous ascites. Having no other choice, based on our experience with PRP-FG in similar situations, we decided to use this method as a last resort to treat postoperative chylous ascites. It can be concluded that when conservative management is not working for the treatment of postoperative chylous ascites in intractable cases, PRP-FG can be considered as a last resort treatment. A special home-made PRP-FG was prepared for the patient and of that, 90 mL was injected to the abdominal cavity via the drainage tube fol - lowed by a 25 mL of isotonic saline solution to prevent clot formation within the tube. Few days after treatment, chylous secretion decreased and then completely ceased. It can be concluded that when conservative management is not working for the treatment of postoperative chylous ascites in intractable cases, PRP-FG can be considered as a last resort treatment.
Keywords: Chylous ascites, Liver transplantation, Rejection, Fibrin glue, Platelet-rich plasma -
Background
The reliable laboratory tests, co-infection with other tumor viruses, and determining the genetic types are very important for therapy and monitoring of the clinical status of human immunodeficiency virus (HIV)-infected subjects.
ObjectivesThis study evaluated the co-infection of HIV with hepatitis B virus (HBV), hepatitis C virus (HCV), and human T-cell leukemia virus type 1 (HTLV-1), the viral load, the progression of infection, and its correlation with the clinical status.
MethodsTwenty HIV-infected cases were assessed for T cell subpopulations, HBV, HCV, and HTLV-1 co-infection, as well as the viral load. For phylogenetic relationships analysis, the HIV-c2-v5 fragment and p17 of gag were amplified, sequenced, and then clustered using phylogenetic analysis by MEGA software with maximum-likelihood.
ResultsThe quantity of HIV viral load by qRT-PCR (TaqMan) and Cobas-Amplicor monitor test had a very strong correlation (R = 0.881, P < 0.0001). A significant negative correlation was also found between CD4+ cell count and Cobas-Amplicor (R = -0.41, P = 0.06). A significant negative correlation was also found between CD4+ cell count and Cobas-Amplicor (R = -0.41, P = 0.06) with HIV monitor test results (R = -0.41, P = 0.06). The phylogenetic analysis for p17 regions in gag and c2-v5 in env genes showed that all subjects had AD genotype. The co-infection of the HIV subjects with HBV, HCV, and HTLV-1 was 75%, 75%, and 15%, respectively. A direct correlation was observed between CD8+ and HIV-HTLV-1 co-infection.
ConclusionsThe results showed that HIV CRF35-AD, (M group) is more frequent in the northeast of Iran, and both real-time quantification methods were reliable for monitoring the HIV-1 viral load. In addition, the transmission rate of HTLV-1 is lower than HBV and HCV among drug abusers.
Keywords: HIV, Phylogenies, Subtype, Coinfection, Iran -
Appendicitis is one of the main causes of acute abdominal surgery; however, the accurate diagnosis of appendicitis has remained uncertain. This study aimed to investigate the serum calprotectin as a diagnostic indicator for acute appendicitis. This prospective study was conducted on 79 patients suspected of acute appendicitis who underwent an appendectomy and 70 healthy volunteers. The correlation of serum calprotectin level and histopathological results was investigated. Screening performance characteristics of calprotectin (CP) were calculated on patients suspected with acute appendicitis. The mean serum calprotectin level in the patients was 0.791±0.148 mg/dl with a minimum of 0.567 mg/dl and a maximum of 1.26 mg/dl. The serum calprotectin ranged from 0.10 mg/dl to 0.50 mg/l in the healthy group. The AUC of CP was 0.58 (95% CI: 0.43-0.73). At a 0.72 mg/dl cutoff value, CP had 70% (95% CI: 58-82) sensitivity and 50% (95% CI: 39-61) specificity. According to the main finding of our study, the accuracy and sensitivity of serum CP in the detection of patients with acute appendicitis is good, and it seems that it can be used beside clinical symptoms for the diagnosis of acute appendicitis.
Keywords: Acute appendicitis, Calprotectin, Diagnosis, Accuracy, Sensitivity, Specificity -
BackgroundBreast cancer is the first leading cause of cancer-related deaths in women. Ki-67 is being used for evaluation of the prognosis of patients with breast cancer.ObjectivesThe aim of the current study was to explore the association of the involvement of axillary lymph nodes status with the expression of Ki-67 in patients with breast cancer.MethodsA total of 449 patients were enrolled followed by evaluation of the association of Ki67 levels with demographic, pathologic, and survival data of patients, using Chi-square, logistic regression models, student t test and Mann-Whitney.ResultsWe observed a significant relationship between the expression level of Ki-67 and stage of tumor (P = 0.012), positive progesterone receptor (P = 0.003), and subtype pathologic features (P < 0.05). Also, a significant difference was detected between Her2 and expression level of Ki-67 (P = 0.015). Survival analysis showed the association for Ki-67 (P = 0.02), age (P = 0.005), stage of tumor (P < 0.05), lymph node involvement (P = 0.001), and the Her2 (P = 0.024) with clinical outcome (e.g., overall survival or disease free survival) of patients with breast cancer.ConclusionsThe results of this study demonstrated that the overexpression of Ki-67 was associated with large tumors, progesterone receptor expression, and stage of tumor, but it was not related with lymph node involvement.Keywords: Breast Cancer, Ki-67, Lymph Node Involvement
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Background And ObjectivesOptimal surgical management of the neonate with imperforate anus (IA) depends on determining accurate location of muscle complex, pouch of rectum and urethral fistula. The aim of this study was to investigate a novel minimally invasive technique of anorectoplasty assisted by intraoperative sonography pull-through for repair of anorectal malformation and rectourinary fistula.
Patients andMethodsEight male patients with imperforate anus aged under 48 h had undergone colostomy. Any associated anomalies were evaluated in cases. After 5-8 weeks, neonates were prepared for anoplasty. After catheterization, sonography of perinea was carried out. Patients were placed in lithotomy position. The accurate position of each required point was determined by this procedure.ResultsIn all cases, the pouch of rectum to skin distance was in range 1.5-1.8 mm and entrance distance of wire to fistula was maximally 6 mm, just in one patient this value was 7 mm. Anomalies associated with some patients were Down Syndrome, cardiac anomalies, kidney disease .6 out of 8 patients removed urinary catheter after two days and discharged home. Colostomy of all patients was closed after sonography of prinea. After one week and one month follow- up, all patients had an acceptable fecal frequency about 3- 5 times a day.ConclusionIntra-operative sonography is an applicable procedure to determine correct location of muscle complex, pouch of rectum and uretral fistula to treat IA patients non- invasively. Another interesting point of this study is the ability of non invasive surgery and novel procedure with perfect result.Keywords: Anorectal malformations, Children, Clinical Trial Study, sonography -
BackgroundHydatidosis is a conventional health public problem in most parts of the world. Safe treatment of patients with hydatidosis has been a topic of debate for a long time. Surgical treatment always was associated with high morbidity and mortality. Medical treatment is also controversial. In this study, alternative procedure named Percutaneous, Aspiration and hypertonic Saline Instillation (PAHSI) was applied to treat patients with hydatidosis.
Materials and MethodsIn this single-blind clinical trial, thirty-eight patients, ranging in age between 6 months and 16 years, with 81 hepatic hydatid cysts underwent PAHSI treatment. The consecutive steps including sonographic guidance, aspiration of cyst content and injection of 15% saline hypertonic were carried out in this method. Patients with multiple cysts also were treated by this procedure.
ResultsParticipants were 18 boys (47.3%) and 20 girls (52.6%) with mean age of 8.08 3.92 years. Almost half of the patients had single cyst (52.63%). During 2- year follow- up, no recurrences were observed; therefore, re-hospitalization and possible complications reduced considerably. Furthermore, this method was applicable to cure multiple cysts.
Conclusion In PAHSI strategy, it seems that the complications of surgery (laparotomy and anesthesia) decreased since no complications observed after procedure, and cosmetic results in future are much better due to avoidance of incision.Keywords: Children, Clinical Trial Study, Hydatidosis, Iran, Treatment -
Objective(s)Tuberculosis is one of the most important infectious diseases with high mortality rates worldwide, especially in developing countries. Interleukin17 (IL-17) is an important acquired immunity cytokine, which is mainly produced by CD4䱽 cells. It can recruit neutrophils and macrophages to the infected site in the lungs. IL-23 is one of the most important inducers of IL-17. In the present study, the expressions of IL-23 and IL-17 were examined in the pathogenesis of tuberculosis.Materials And MethodsPeripheral blood mononuclear cells (PBMCs) were isolated from subjects with latent tuberculosis infection (LTB) and newly diagnosed active tuberculosis patients (ATB).
PBMCs were activated with purified protein derivative (PPD) for 72 hr. Activated cells were harvested, RNA was extracted, and cDNA was synthesized. IL-17 and IL-23 mRNA expressions were evaluated by real-time PCR. The frequency of Th17 cells was examined by flowcytometry.ResultsThe expressions of IL-17 and IL-23 mRNA were lower in patients than subjects with LTB (PConclusionThe results of the present study might suggest that IL-17 and IL-23 play critical roles in the immune response against TB.Keywords: Flowcytometry_Interleukin 23_Mycobacterium – tuberculosis_Purified protein – derivative_Th17 -
IntroductionLimited data are available on the relationship between nutritional status and tuberculosis. The aim of this study was to evaluate and compare the body mass index (BMI) and serum albumin level in patients with active tuberculosis (ATB) and latent tuberculosis (LTB).Materials And MethodsA cross-sectional study was conducted on 17 patients newly diagnosed with pulmonary TB who were referred in Iran, during September 2011 to March 2012 and 17 latent tuberculosis infection individuals. Standard method was performed to collect an early morning fasting blood sample for albumin (by the bromocresolgreen method). Also (BMI) was calculated as body weight divided by height squared (kg/m2).ResultsOne-sample Kolmogorov-Smirnov test was used to check normal distribution data The mean ± Standard deviation(SD) for albumin in the patients and controls were 3.62±0/56 and 4.68±0.25, respectively. BMI in the patients and controls were 19.46±2.79 and 25.4±3.46, respectively. The serum albumin level was significantly lower in the patient group, compared to the control group (PConclusionOur findings demonstrated that BMI and serum Albumin were significantly lower in the active tuberculosis patients than latent tuberculosis groups.Keywords: Albumin, Body mass index, Tuberculosis
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