Magiran | فهرست مطالب نویسنده: Fatemeh Yourdkhani

Peripheral Nerve Injury: A Review Article

Afsoun Seddighi, Amir Nikouei, Amir Saied Seddighi, Ali Reza Zali, Seyed Mahmood Tabatabaei, Ali Reza Sheykhi, Fatemeh Yourdkhani, Shoayb Naeimian

International Clinical Neuroscience Journal, Volume:3 Issue: 1, Winter 2016, PP 1 -6

Traumatic peripheral nerve injuries are among most important cause of physical disability among young adults. Most partial injuries and some complete injuries recover without operative intervention, with early return of function appearing to be the most significant prognostic factor in these cases. Return of function over time depends to a great extent on the underlying neuropathologic condition of the nerve. Although some nerve injuries recover spontaneously, in some cases surgery is the only therapeutic option for the improvement of neurological deficits or control of neuropathic pain. We aimed to review the classification and management of peripheral nerve injury, with emphasize on clinical aspect.

Keywords: peripheral nerve, injury, repair

A Survey on Cortical Bone Trajectory for Spinal Fusions

Amirsaeed Sedighi, Ali Reza Zali, Afsoun Seddighi, Maryam Sadat Beheshtian, Seyed Ali Reza Sheykhi, Davood Ommi, Shoeib Naimian, Fatemeh Yourdkhani, Mahmood Tabatabaei

International Clinical Neuroscience Journal, Volume:2 Issue: 4, Autumn 2015, PP 117 -120

There have been a number of developments in screw design and implantation techniques over recent years, including proposal of an alternative trajectory entitled as cortical bone trajectory (CBT). Cortical bone trajectory has been investigated in recent medical treatments as an alternative for screw fixation aimed at increasing purchase of pedicle screws in higher density bone. CBT screw insertion follows a lateral path in the transverse plane and caudocephalad path in the sagittal plane. This technique has been advocated because it is reportedly less invasive, improves screw−bone purchase and reduces neurovascular injury. Furthermore CBT pedicle screw fixation provides stabilization to multilevel lumbar segment with low-grade spondylolisthesis comparable to the standard trajectory pedicle screw construct. However, these claims have not been supported by robust clinical evidence. Recent investigations focus on evaluations of CBT as a pioneer method.

Keywords: cortical, trajectory, osteoporosis, fixation, spinal, fusion

Neurocysticercosis: manifestations, diagnosis and treatment

Afsoun Seddighi, Amir Nikouei, Amir Saied Sedighi, Ali Reza Zali, Fatemeh Yourdkhani, Seyed Mahmood Tabatabaei, Ali Reza Sheykhi, Shoayb Naeimian Naeimian, Davood Ommi

International Clinical Neuroscience Journal, Volume:2 Issue: 4, Autumn 2015, PP 121 -127

Neurocysticercosis, is the infection caused by the larval form of the tapeworm Taenia solium. It is considered as the most common parasitic disease of the central nervous system and the most common cause of acquired epilepsy. This has primarily been a disease that remains endemic in countries with poor economy , but because of increased migration neurocysticercosis is being diagnosed more frequently worldwide. During the past decades improved diagnostics, imaging, and treatment have led to more accurate diagnosis and improved prognosis for patients. This article is a review about the current data about neurocysticercosis, including recent diagnostics and treatment developments.

Keywords: Cysricercosis, epilepsy, tapeworm, CNS

Brain Tumors in Elderly

Afsoun Seddighi, Marjan Vaezi, Shoeib Naimian, Fatemeh Yourdkhani, Amir Saied Seddighi, Omid Mellati, Amirhossein Zoherhvand

International Clinical Neuroscience Journal, Volume:2 Issue: 2, Spring 2015, PP 55 -65

Brain tumors in elderly are increasing as the number of people, who comprise the older population, does.About half of the patients with brain tumors appear to be over 60 years of age.In this review article, Glioblastoma multiform, as the most common malignant tumor of the central nervous system in elderly is discussed in details of definition, prognosis, diagnosis, treatment and differential diagnosis. Other tumors such as meningioma, pituitary adenoma, CNS lymphoma and metastasis are also included to be reviewed. Treatment plans, either conservative or aggressive, classic or novel, approved or under investigation, are presented. Furthermore different attitudes of treatment in the past and recently are also argued. Conventional therapy, Surgery, Radiotherapy, chemotherapy radioimmunotherapy, hormonal therapy and some other novel methods of treatments are discussed in details for the glioma.Determining factors which may be associated to the patient''s response to each treatment planare also discussed. Finally, some age related issues are provided to be paid attention to consider an old patient with brain tumor, and planning an optimal treatment in order to make the best management decisions.Until recently, peoplewith brain tumors in elderly, were used to be treated in conservative plans and often were excluded of the clinical trials but now the number of patients who desire and receive more aggressive therapy for brain tumors is increasing.

Keywords: Brain Tumor, elderly, glioblastoma, treatment

Effects of High-Frequency Repetitive Transcranial Magnetic Stimulation on Motor Functions in Patients with Subcortical Stroke

Ashrafi Farzad, Rokni Avid, Sina Asaadi*, Pakdaman Hosein, Fatemeh Yourdkhani

Caspian Journal of Neurological Sciences, Volume:1 Issue: 1, 2015 Mar, PP 1 -6

Background

Motor function impairment occurs in approximately two-thirds of patients with subcortical stroke. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive technique for modulating cortical excitability.

Objectives

The present study was designed for assessing the efficacy of high-frequency rTMS (5 Hz) on ipsilesional primary motor cortex in patients with subcortical stroke.

Materials And Methods

Thirty participants who had subcortical stroke in the previous four weeks to four months were enrolled in this randomized double blinded clinical trial. Participants were divided into experimental and control groups and their motor ability of both upper and lower extremities were assessed using Fugl-Meyer assessment of motor recovery after stroke (FMA) before and after intervention. The study intervention rTMS (5 Hz) was administered in six 10-minute sessions on the ipsilesional primary motor cortex in the experimental group and on the vertex in the control group.

Results

Mean change in FMA score after rTMS sessions was significantly higher in the experimental group than in the control group (p = 0.00). Mean time interval between the stroke and rTMS intervention had a weak and insignificant (ρ = 0.097; p = 0.61) correlation with changes of FMA score.

Conclusions

High-frequency (5 Hz) rTMS effectively improved motor function in patients with subcortical stroke.

Keywords: Transcranial Magnetic Stimulation, Stroke

Prevalence of Occult Celiac Disease in Healthy Iranian School Age Children

Fatemeh Farahmand, Mohammad Mehdi Mir-Nasseri, Touran Shahraki, Fatemeh Yourdkhani, Sayeh Ghotb, Vajiheh Modaresi, Gholam Reza Khatami

Archives of Iranian Medicine, Volume:15 Issue: 6, Jun 2012, P 342

Background

Several studies have shown the prevalence of celiac disease (CD) to be around 1% in Iran, which is similar to the worldwide prevalence. There is scant information on occult CD in apparently healthy school age children. This study, as the first such study in Iran, aims to determine the prevalence of occult CD in healthy Iranian school age children.

Methods

In this cross-sectional study, we screened healthy school age children for CD by serum IgA and IgA anti-tissue transglutaminase antibody (tTG) levels. Measurement of these antibodies was by enzyme linked immunosorbent assay. A recheck of positive tTG tests was performed and patients who tested positive underwent endoscopic duodenal biopsies. The biopsy samples were scored according to the Marsh classification by an experienced pathologist.

Results

A total of 634 children (314 males, 320 females; mean age: 12.8 years) were included in the study. All children and/or their parents completed a questionnaire and children underwent an initial physical examination to determine study eligibility. Positive serum tTG was noted in 3 (0.5%; 2 females) out of 634 patients. Duodenal biopsies were consistent with CD in these 3 subjects. The mean age of patients with CD was 14.3 years (range: 12–17 years). The female to male ratio was 2:1. These cases had no signs and symptoms, but a gluten-free diet was recommended according to pathologic changes in their small bowels and results of the tTG test.

Conclusion

The prevalence of occult CD in these children is 0.5%, which is half of the prevalence of CD in Iranian adults. The anti-tTG concentration at initial serological CD screening is highly informative in determining occult cases of CD. The question is whether all non-symptomatic cases should be treated with a gluten-free diet or not.

Keywords: Celiac disease, children, Iran, serological screening

بررسی ارزش تشخیصی سرولوژی در مقایسه با پاتولوژی برای تشخیص عفونت هلیکوباکترپیلوری

سیدمهدی میرناصری، فاطمه یودخانی، بهار الله وردی، فریده سیاوشی، غلامرضاخاتمی

نشریه گوارش، سال چهاردهم شماره 1 (پیاپی 66، بهار 1388)، صص 23 -26

زمینه و هدف

جایگزینی میکروب هلیکوباکترپیلوری در معده در اوایل کودکی روی می دهد و یکی از شایعترین عوامل عفونی در انسان می باشد که با ایجاد آسیب نسبی در دستگاه گوارش فوقانی باعث مستعد کردن فرد به زخم معده، دئودنوم، لنفوم و کانسر معده می شود. روش های تهاجمی تشخیصی این عفونت از طریق کشت و بررسی پاتولوژی نمونه حاصل ازانجام آندوسکوپی می باشد و روش های غیر تهاجمی آن تست تنفسی با کربن نشاندار و سرولوژی است. با توجه به اینکه کیت های سرولوژی موجود در کشور برای بزرگسالان ساخته شده است، ما تصمیم گرفتیم که مقایسه ای با تستهای استاندارد داشته باشیم تا ارزش تشخیصی آنها را مشخص نمائیم.

روش بررسی

این مطالعه بصورت Cross sectional بر روی 100 کودکان و نوجوانان 18 6 ساله مراجعه کننده به بخش گوارش بیمارستان مرکز طبی کودکان انجام شد. از بیمارانی که در آندوسکوپی آنها، التهاب، زخم و گاستریت ندولر داشته و فاقد سابقه سوختگی، مصرف NSAID و استرس منجر به زخم بودند، نمونه بیوپسی از ناحیه آنتروم معده جهت بررسی و پاتولوژی برداشته شد و در همان زمان 3 سی سی خون وریدی برای انجام آزمون سرولوژی IgG به روش الایزا از ایشان گرفته شد.

یافته ها

100 کودک شامل 60 پسر و 40 دختر به مطالعه وارد شدند. (32) 91% از کودکان مورد مطالعه دارای سابقه بیماری گوارشی و 29% از بیماران سابقه بیماری گوارشی را در خانواده ذکر می نمودند که در 1/17% موارد پدر خانواده سابقه بیماری گوارشی را داشته است. التهاب، زخم واروزیون به ترتیب در 94%، 31% و 34% بیماران مشاهده شد. در 53% موارد التهاب در معده و بصورت ندولر بوده است. محل زخم 17% در معده و محل اروزیون در 23% در دئودنوم بوده است. آزمون اوره آز، سرولوژی و پاتولوژی به ترتیب در57%، 23% و 29% مثبت گزارش شد. حساسیت و اختصاصی بودن تست سرولوژی نسبت به پاتولوژی به ترتیب 55% و 61% بدست آمد.

نتیجه گیری

تست سرولوژی در کودکان از حساسیت و ویژگی پایینی نسبت به تست های تشخیصی استاندارد تهاجمی هلیکوباکترپیلوری برخوردار است.

کلید واژگان: پاتولوژی, سرولوژی, کشت, هلیکوباکترپیلوری

Diagnostic Value of Serology Versus Pathology in Diagnosis of Helicobacter Pylori Infection

Seyedmohammadmehdi Mir, Nasseri, Fatemeh Yourdkhani, Bahar Allahverdi, Farideh Siavoshi, Golamreza Khatami

Govaresh, Volume:14 Issue: 1, 2009, PP 23 -26

Introduction

Helicobacter pylori infection is likely acquired was in childhood. Helicobacter pylori is recognized as a cause of gastritis and peptic ulcer. Our objective to investigate some noninvasive tests, particularly serum H pylori IgG, for the diagnosis of H pylori infection in comparison with the gold-standard invasive test, esophagogastroduodenoscopy with biopsy (histology and rapid urease test).

Materials And Methods

We studied 100 patients (age range: 6-18 years) who underwent esophagogastroduodenoscopy with biopsy (histologic examination) for a suspicious upper gastrointestinal disease, in all of them serum Hpylori immunoglobulin G was measured and result of this were compared with those of the gold standard esopahgogastrodudenoscopy with biopsy.

Results

Of 100 patients (60 males, 40 females), 91% had history of gastrointestinal disease and 29% had positive family history for gastrointestinal disease. gastritis, ulcer and erosion were found respectively in 94%, 31%, 34% of patients. Rapid urease test, serology and histology were positive respectively in 57%, 23%, and 29% of patients. In comparison with histology sensitivity of serology was 45% and it's specificity was 71%.

Conclusion

serum Hpylori IgG test has a low sensitivity and specificity in children in comparison with the gold standard invasive test.

اسکلروتراپی در درمان خونریزی واریس مری در کودکان

مهری نجفی ثانی، سیدمحمدمهدی میرناصری، فاطمه پوردخانی، نازلی پشمینی

نشریه گوارش، سال سیزدهم شماره 3 (پیاپی 64، پاییز 1387)، ص 167

مقدمه

هایپرتنشن پورت از مهمترین علل مرگ و میر کودکان مبتلا به بیماری-های کبدی است. این بیماری، عمدتا به صورت خونریزی گوارشی تظاهر می کند و درمان آن نیز براساس درمان خونریزی واریسی است (1). هدف ما در این مطالعه بررسی پاسخ به اسکلروتراپی در کودکان مراجعه کننده با خونریزی از واریس به اسکلروتراپی و میزان عوارض حاصل از آن می باشد.

روش کار

در فاصله زمانی سه سال، کلیه کودکانی که از شهریور 76 لغایت شهریور 79 به دلیل خونریزی از واریس مری به بخش گوارش بیمارستان مرکز طبی کودکان مراجعه کرده اند. نیاز به اسکلروتراپی داشتند به در این مطالعه وارد شدند. اسکلروتراپی توسط فوق تخصص گوارش با گاستروسکوپ اولیمپوس مدل P230 انجام گرفت. چناچه بعد از اسکلروتراپی تا 72 ساعت بعد بیمار خونریزی نمی کرد کنترل خونریزی حاد صورت گرفته بود. برای انجام اسکلروتراپی ابتدا به بیماران میدازولام وریدی به میزان 0.1 mg/k تزریق می شد. ترومبوار رقیق شده به یک نسبت با الکل و آب بعنوان ماده اسکلروزان مورد استفاده قرار گرفت. نتایج در فایل کامپیوتر وارد و با استفاده از نرم افزار spss تحت آنالیز آماری قرار گرفت.

نتایج

از 79 بیمار مورد مطالعه، 52 نفر (8/ 65%) پسر و 27 نفر (2/ 34%) دختر بودند. در این مطالعه، میزان موفقیت اسکلروتراپی اورژانس در کنترل خونریزی حاد از واریس مری 100% و موفقیت برنامه دراز مدت اسکلروتراپی 7/ 55% بود. 3/ 53% از بیماران مبتلا به درگیری کبدی و 7/ 64% از بیماران مبتلا به درگیری خارج کبدی به اسکلروتراپی دراز مدت پاسخ مناسب دادند. 3/ 58% از موارد Child A، 83/3% از موارد Child B و 3/ 14% از موارد Child C سیروز پاسخ درمانی مثبت داشتند. تغییرات واریسهای فوندوس معده در ضمن اسکلروتراپی دراز مدت واریسهای مری به این صورت بود که 2/ 15% سیر بهبود، 5/ 21% سیر تشدید، 3/ 43% عدم تغییر و 19% پاسخ نامشخص نشان دادند. در طول برنامه درمانی 6/ 31% از بیماران حداقل دچار یکی از عوارض اسکلروتراپی شدند. میزان خونریزی مجدد و مرگ و میر به ترتیب 4/ 54% و 9/ 8% بود.

نتیجه گیری

اسکلروتراپی در درمان خونریزی حاد واریس مری از موفقیت بسیار بالایی برخوردار است (100%) و میزان موفقیت دراز مدت آن نسبی می-باشد.

کلید واژگان: اسکلروتراپی, واریس مری, کودکان

Endoscopic Sclerotherapy on Variceal Bleeding in Children

Mehri Najafi, Sani, Seyedmohammadmahdi Mir, Nasseri, Fatemeh Yourdkhani, Nazli Pashmini

Govaresh, Volume:13 Issue: 3, 2008, P 167

Background

Since variceal bleeding due to portal hypertension is associated with a high mortality rate, effective treatment leads to improved survival. Endoscopic sclerotherapy is an effective treatment for bleeding esophageal varices, but it is associated with significant complications. To determine the efficacy and safety of endoscopic sclerotherapy, we evaluated the patients with variceal bleeding who underwent sclerotherapy in our center.

Materials And Methods

This study was a case-series study in which, we evaluated 79 patients who referred for esophageal variceal bleeding and underwent sclerotherapy and completed the questionnaire.

Results

From79 patients, 52 (65.8%) weremale, and 27 (34.2%) were female. The rate of success (arrest of acute bleeding by endoscopic sclerotherapy) was 100%, but it was 55.7%for long-termsclerotherapy; 53.3%of patients with liver disease, and 64.7%of patients with extraheaptic portal hypertension had suitable response; 58.3%of patients with ChildA, 83.3%of those with Child B and 14.3%of Child C cirrhotic patients demonstrated appropriate response. In fundal varices, 15.2% were improved, 21.5% were accelerated and 43.3% showed no significant changes. During treatment, 31.6%had one of the complications of sclerotherapy. The rates of rebleeding and mortality were 54.4% and 8.9%, respectively.

Conclusion

Although sclerotherapy reduced themortality attributable to acute variceal bleeding, but the long-term effectiveness of sclerotherapy was not very high.

Keywords: Sclerotherapy, Esophageal Varices, Children

Report of Congenital Generalized Lipodystrophy in Children's Medical Center, Tehran, Iran

Fatemeh Farahmand, Fatemeh Yourdkhani, Gholamhosein Fallahi, Gholamreza Khatami

Govaresh, Volume:10 Issue: 4, 2006, P 241

Generalized lipodystrophy is a rare disorder in children characterized by absence of subcutaneous adipose tissue. We evaluated 10 patients with generalized lipodystrophy by skin and liver biopsy. Eight patients with steatohepatitis and cirrhosis were treated with Ursobile (uorsodeoxycholic acid) and vitamin E. In follow-up, serum triglyceride level was decreased.

Keywords: Children, Congenital, Lipodystrophy

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fatemeh yourdkhani