فهرست مطالب mahdi ramezani binabaj

Kidney transplantation is the most definitive treatment for end-stage kidney failure. The purpose of this research is to investigate the impact of zero-time histopathological findings on kidney graft function and survival and the opportunity of performing interferences, based on it, in the immunosuppression regime of transplant patients. Patients who underwent kidney transplantation from a deceased donor between 2018 and 2021 in Shariati Hospital were studied. They underwent wedge biopsy of the kidney graft just after reestablishing vascular perfusion, and the samples were subjected to histopathology examination according to the Banff scoring system. Afterward, the patients underwent 1-month, 3-month, and 6-month follow-ups with the serum creatinine levels and estimated glomerular filtration rate. The main findings in the histopathological examination of the biopsies were acute tubular necrosis (62%), mesangial proliferation (2.5%), glomerular thrombosis (7.2%), arteriolar hyalinosis (7.2%), interstitial fibrosis and inflammation (23%).  The score of most of the findings was mild and, C4D was also negative in all patients. Seven patients were affected by the delayed graft function (DGF) and among them, glomerulosclerosis was observed in 57%, arterial intimal fibrosis in 7.1%, and interstitial fibrosis in 8.4%. In the 6-month follow-up, the trend of creatinine and GFR of these patients was not as good as the other patients. Although they were not statistically significant. Statistically, no significant relationship was found between the zero-time biopsy findings and the graft performance in the short and medium term. Although this is not sufficient for the conclusion due to the small volume of samples.

Prostate cancer is one of the leading causes of mortality in Iran and is the third most common cancer in male population.

The present study aimed to evaluate the necessity and efficacy of establishing a specific rehabilitation center for patients with prostate cancer.

In this basic-applied research, we proposed the establishment of a rehabilitation center to support and decrease the complications of various treatments in patients with prostate cancer. After entering the rehabilitation process, a well-educated nurse and general physician trained in one of the similar European centers supported the patients to help themselves cope with unresolvable symptoms. To evaluate the patients’ satisfaction with the services offered by this rehabilitation center, the patients were asked to fill the Prostate Cancer-Related Quality of Life Questionnaire seven months after the first session.

In this study, 133 patients with prostate cancer (71 persons in the control group and 62 persons in the conservative treatment group) underwent the analysis. The participants’ mean age was 62.8 ± 2.31 years in the control group and 63.3 ± 4.54 years in the treatment group (P = 0.613). Moreover, the participants’ mean lifestyle scores were 5.3 ± 2.5 and 5.8 ± 2.8 in the control and treatment groups before the supportive care, respectively (P = 0.460). However, following the intervention, the scores were 5.3 ± 2.1 and 7.6 ± 1.9 in the control and treatment groups, respectively (P = 0.001). The mean lifestyle score was significantly higher after supportive care in the treatment group (P = 0.001).

A prostate cancer-specified rehabilitation center providing supportive care by an educated healthcare professional can significantly improve the quality of life of patients with prostate cancer.

Current hemostatic agents are needed to reduce bleeding and transfusion during several surgery processes. Plant-based absorbable surgical hemostatic agents (microporous polysaccharide hemospheres) are proposed for use in surgical wound sites as an absorbable hemostat and in this study, we checked its efficacy.

This study was run under the Tehran University of Medical Science Ethics Committee observation based on the clinical trial registry criteria (IRCT20190624043991N1). Total numbers of 42 percutaneous nephrolithotomies (PCNL) patients were enrolled, 21 cases hemostatic powder and 21 controls. Hemostatic powder pumped into Amplatz sheath before its extraction.

The mean age of the case and control groups was 42.1±19.5, and 42.1±18.5 years, respectively. The median stone size was 11.3±1.85cm. Overall, the differences between sex, age, stone size, and location were not statistically significant in the two groups (p-value˃0.05). Serum hemoglobin reduction following PCNL was significant in both groups compared to the serum level before surgery (p-value<0.001). However, the difference was not significant between case and control groups postoperatively (p-value=0.727). Yet, postoperative serum creatinine reduction was not significantly different between the two groups compared to preoperative serum levels (p-value>0.05).

The present study showed that microporous polysaccharide hemosphere (MPH) did not affect bleeding reduction, hemoglobin decline, and postoperative blood transfusion, and hospital stay.

Context:Atherosclerosis is considered as the important cause of death worldwide and especially among kidney-transplanted patients. It is said that an aggressive intervention is needed for preventing new atherosclerotic events post kidney transplantation. Our main purpose was to determine the effect of cytomegalovirus (CMV) exposure on the atherosclerotic events among kidney-transplanted patients using a systematic review and meta-analysis.
Evidence Acquisition:Electronic databases (PubMed, Scopus, Science Direct, and Web of Science) were systematically searched to find related studies for the effect of CMV exposure on the atherosclerosis in the kidney transplantation setting. Quality assessment was done and then because of existence of heterogeneity we used random-effect model to calculate risk ratio (RR) and 95% confidence interval (CI) for the CMV effect on the atherosclerosis.
Ten Studies were included in our systematic review. Eight of them proposed CMV as a risk factors for atherosclerosis among kidney-transplanted patients. According to available data for analysis, seven papers were included in our meta-analysis and showed RR of 1.46 (95% CI: 1.15 - 1.85) for the mentioned effect and based on the trim and fill method the corrected RR was as 1.26 (95% CI: 1.01 - 1.65).
Our meta-analysis showed that exposure with CMV can lead to atherosclerosis events among kidney-transplanted patients. However, more original studies are still needed to explore the association between the type of CMV exposure and atherosclerotic events.

This study aimed to evaluate the incidence of ocular hemorrhages in patients with proliferative diabetic retinopathy (PDR) undergoing 20-gauge pars plana vitrectomy (PPV) taking aspirin as an antiplatelet agent versus those who did not take any aspirin.
A total of 180 patients (mean age of 60.5 ± 9.9 years) with PDR referred to Baqiyatallah University Hospital in 2016 were enrolled in aspirin and control groups each group containing 90 patients. All participants underwent a standard 20-gauge diabetic PPV. Laboratory data, including fasting blood sugar, prothrombin time, partial thromboplastin, bleeding time, and platelets count, and intraoperative data, including bleeding and its type (retinal, subretinal, vitreous, conjunctival, sub-conjunctival, and hyphema), were collected and analyzed using SPSS16 software.
Bleeding occurred in 56 patients. There were no significant differences in the incidence of bleeding between aspirin (33 patients) and control groups (23 patients) (P= 0.1). Likewise, no significant differences were observed in the type of bleeding between the two groups (P= 0.11). Age, gender, hypertension, type of operation, and laboratory findings were not significant between patients with and without bleeding.
The results of this study indicated that taking aspirin is not associated with a higher risk of post-PPV surgery bleeding in comparison with the control group. Additionally, the type of bleeding did not significantly differ between the two groups. Hence, there is no urgent need for discontinuation of this medication in diabetic patients undergoing PPV

Occult hepatitis B infection (OBI) is determined by finding hepatitis B virus (HBV) DNA in the liver cells of the patients with negative tests for HBV surface antigen. It is more common in patients with hepatitis C virus (HCV) infection which can be transmitted by blood transfusion and is frequently seen in hemophilia and thalassemia patients..
The aim of this study was to assess the prevalence of OBI among Iranian patients with hematological disorders (thalassemia, hemophilia and other coagulation factor deficiencies) infected with chronic hepatitis C (CHC)..
In this descriptive cross-sectional study, all patients with hematological disorders (thalassemia, hemophilia or other coagulation factor deficiencies) who had simultaneous CHC infection and were referred to the Tehran hepatitis center between 2009 and 2010 were enrolled. Occult hepatitis B infection identification was based on serum HBV-DNA tests. Data analysis was performed with SPSS software..
All patients were HBsAg-negative and HCV RNA-positive. Only 145 patients were evaluated for HBV DNA (126 male and 19 female patients). The mean age (SD) was 28.12 (8.6) years. Thirty-five patients had thalassemia, 95 patients had hemophilia, and 15 patients had coagulation factor deficiencies. Serum HBV-DNA was negative for all cases..
Based on our results, it seems that there were no cases of OBI among chronic HCV-infected patients with thalassemia and bleeding disorders, particularly hemophilia. However, to improve decisions concerning OBI screening, especially in transfusion centers, and concerning the use of comprehensive screening methods, more original studies with more precise laboratory techniques and larger sample sizes are needed..

Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease including simple steatosis to nonalcoholic steatohepatitis (NASH). NASH could progress to cirrhosis and liver cancer. The prevalence of NAFLD is increasing by increasing the prevalence of obesity.. This study was designed to determine the prevalence of NASH in morbidly obese patients undergoing sleeve bariatric surgery and its correlation with other comorbidities..Patients and In this analytical cross-sectional study, 114 morbidly obese patients undergoing sleeve gastrectomy were selected. Liver ultrasonography was performed for all patients before surgery and NAFLD existence and its grade was determined by hyperechoic texture and fatty infiltration. The liver enzymes and lipid profile were also measured. Prevalence of NAFLD in these patients and its correlation with other comorbid conditions (e.g. diabetes mellitus, hyperlipidemia, hypertension, hypothyroidism and ischemic heart disease) were evaluated by SPSS software version 18.. One hundred fourteen patients with a mean age of 33.96 ± 9.92 years and mean BMI of 43.61 ± 5.77 kg/m2 were enrolled (48 males and 66 females). The prevalence of NAFLD was 16.7%. NAFLD existence was associated with systolic blood pressure, hyperlipidemia, hemoglobin, hematocrit, triglyceride, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and potassium (P < 0.05).. According to high prevalence of NAFLD in morbidly obese patients undergoing sleeve gastrectomy in Iran, we suggest using gold standard diagnostic method to determine the exact NAFLD prevalence and evaluation of impact of sleeve surgery on NAFLD in short and long term follow-up periods..

At present, the use of ventilator support is an important part of treatment in ICU patients. However, aside from its wellknown advantages, the use of these devices is also associated with complications, the most important of which is pulmonary infection (PI). PI has a high rate of morbidity and mortality.

This study aimed to evaluate the prevalence of PI in mechanically-ventilated patients and the role that factors, such as age, sex, and duration of intubation, play in this regard.

This descriptive cross-sectional study evaluated the prevalence of PI in mechanically ventilated patients, with no underlying condition which could compromise their immune system. Age, sex, and duration of intubation were assessed. Data were analyzed using SPSS (version 16) software.

A total of 37 ICU patients on ventilators were evaluated, including 21 males (56.8%) and 16 females (43.2%). The mean age of the patients was 54 ± 19 years (range 19 to 86 years), with a mean age of 52 ± 20 years in men, and 56 ± 18 years in women (P = 0.52). The mean duration of ventilation was 6 ± 4 days (range 2 to 20 days). The mean duration of ventilation was 5 ± 2 days in men, and 6 ± 5 days in women (P = 0.42). A total of 16 patients (43.2%) developed ventilator-associated pneumonia (VAP); of whom, 50% were male and 50% female (P = 0.46). Patients who developed a pulmonary infection had a significantly longer duration of ventilation. The mean duration of ventilation was 8 ± 4 days in patients who had developed VAP, while this duration was 4 ± 2 days in the non-affected patients (P = 0.005). Overall, 17 patients died, and 7 of these deaths were attributed to VAP.

The prevalence of VAP in this study was approximately 43%, which is relatively high. In total, the percentage of deaths due to VAP among the patients was 18.91%. Duration of ventilator support was significantly correlated with the prevalence of PI.