فهرست مطالب mohammad reza lashkarizadeh

Cystic echinococcosis (CE) or hydatid disease is a global public health concern which imposes considerable economic costs on the communities in endemic regions. CE surveillance data are not adequately reliable. The present study reports the development and outcomes of a CE registry in Iran.

Hydatid Registry (HydatidReg) was initially established as a single-center registry in 2014 after the ethical approval of KMU. Following a call from MoHME to promote registry of different diseases and health outcomes, a call for participation was announced and all the Iranian Universities of Medical Sciences were requested to contribute to the registry. Subsequently, a nation-wide registry of hydatid disease was established in 2016. With a global perspective, HydatidReg joined the European Register of Cystic Echinococcosis (ERCE). A data collection form based on minimum dataset was designed and standard operating procedures (SOPs) were prepared to ensure standardized patient enrolment in the registry. A biobank system with two-dimensional barcoding was established along with HydatidReg for management and organization of biological specimens.

As of March 2021, a total of 690 patients were enrolled in the registry. HydatidReg registered 362 (17.3%) out of the total 2097 patients enrolled in ERCE. Quality control (QC) of the data demonstrated 91.2% completeness and 80% timeliness. In the biobank, 322 biological specimens from 184 CE patients have been deposited including 70 blood, 96 sera and 156 parasite materials.

High-quality data in the HydatidReg registry provided opportunities for health professionals to improve quality of care and organize meaningful research.

Malignant pleural effusion have significant impacts on patients live. This study was designed to determine the effect of Ethanolamine, Povidone-iodine, and talcum powder on pleurodesis in rats.

This experimental study was conducted in 36 adult male rats in Neuroscience Research Center affiliated to Kerman University of Medical Sciences, Iran 2018. The rats were randomly divided into four groups: Ethanolamine, Povidone-iodine, talcum Powder, and Salin (control group). The sclerosing agent was injected in each group. Then, microscopic and macroscopic effects of the drugs were compared. Data were analyzed applying Fisher’s exact test and multivariate analysis in SPSS.

The most severe fibrosis was seen in groups that had received Ethanolamine (85.6% severe fibrosis), while the group that received Povidone-iodine and talcum powder showed moderate fibrosis (61.5% and 38.5%, respectively). The rate of fibrosis was significantly higher in control group (72.7% mild fibrosis, P<0.001). Compared with the control group, more chronic inflammation was seen in the group that received Ethanolamine (P=0.004).

According to this study Ethanolamine and Povidone-iodine could be used as effective agents for inducing pleurodesis. Their low cost and availability make them good alternatives to other materials.

Breast cancer is the leading cause of cancer related death in females. Sphingosine kinase 1 (SPHK1) and its product sphingosine-1-phosphate (S1P) are the essential key regulator molecules in breast cancer through their ability to promote cell proliferation, angiogenesis, cell proliferation, and lymphagiogenesis. SPHK1 is overexpressed in multiple types of cancer including breast cancer and is associated with resistance to treatment. The current study aimed at investigating the expression of SPHK1 in estrogen and progesterone receptors (ER, PR) negative in comparison to ER, and PR positive breast cancer and their normal controls, and also finding the relationship between SPHK1 expression and high body index (BMI) in the selected groups with breast cancer.
A total of 120 human breast cancer tissue specimens were analyzed for SPHK1 expression using quantitative real–time polymerase chain reaction (q RT-PCR) assay. Detection of hormonal status of breast cancer tissue samples was conducted by immunohistochemical assay.
The current study findings showed that the level of SPHK1expression in the breast cancer tissue was significantly higher in patients with estrogen and progesterone negative receptors, compared to the ones without them (P-value 25).
The current study showed that expression of SPHK1gene was higher in the patients with ER and PR negative breast cancer and high BMI, compared with other groups.

Hydatid cyst disease is one of the most common parasitic zoonotic diseases in Iran and the most common involved sites, are lungs and liver. The best treatment of this disease is surgery. The aim of this study was to evaluate the epidemiology and early complications of surgery of hydatid cyst of lung and liver in patients referred to Afzalipour Hospital afiliated to Kerman University of Medical Sciences during 2003-2013.
In this cross-sectional study, 85 patients with lung or liver hydatid cyst who were referred to Afzalipour hospital during 2003-2013 were evaluated retrospectively. Data related to epidemiologic variables and surgery complications were obtained from patient’s documents.
From 85 patients with hydatid cyst of lung and liver, 48.23% were male and 51.76% were female. Among patients, 69.4 % had lung hydatid cyst, 24.7% had liver hydatid cyst and 5.8% had both simultaneously. Cough, dyspnea and fever were dominant symptoms and almost all the surgeries were done through cystectomy with open drainage or cystectomy with capitonage. In whole, 12 cases (14%) had been complicated. There was no significant relation between the method of surgery and complications.
in the present study, the results of epidemiologic variables such as age, sex, prevalence of pulmonary and hepatic involvement and clinical manifestations were similar to the studies that were done in other cities of Iran and also previous studies in Kerman. From 85 surgeries, 12 cases were complicated and there was no significant relation between the method of surgery and complications. Method of surgery, result and complications were similar to other parts of the world and surgery is recommended to prevent hydatid cyst complications such as abscess, opening to the pleural cavity and anaphylactic shock.

Opium addiction alters immune responses to stresses such as an injury due to changing the secretion of cytokines. The present study assessed the effect of opium addiction on the cytokines [tumor necrosis factor α (TNFα), interferon-γ (IFN-γ), interleukin-4 (IL-4), and IL-10] before and after laparotomy.
Male rats were randomly divided into control and opium addicted (n = 20). Then, cytokines were measured before surgery, immediately after surgery (within 30-60 minutes) and 24 hours after surgery.
Findings: IFN-γ was raised in an addicted group in three phases of the study as compared to that of the control group. IL-4 in opium addicted group decreased in two phases after surgery compared to the control group. IL-4 was lower after surgery in comparison to before surgery in the opium addicted group. The difference in IL-10 and TNFα levels was not statistically significant in the all groups measured in three phases of the investigation.
The results revealed that opium addiction can increase plasma level of IFN-γ in rats and decrease plasma level of IL-4 after surgical stress. It seems that opium addicted rats are a more susceptible to increased inflammation.

Opium addiction can change immune response to Types of stress such as injury or trauma due to alterations in the in secretion status of cytokines in the body. In this study, effects of opium addiction on wound healing and post-operative adhesion bands were assessed after laparotomy. Male rats (n=20) were randomly divided into opium addicted (documented with Naloxone test) and control group. Three weeks after surgery, site of abdominal incision was excised elliptically and sent for wound healing grading assessment by pathologist and an intra-abdominal adhesion band assessment was done. The concentrations of three cytokines (TNF, IFN and IL10) were also measured before, immediately after surgery and 24 hour after surgery. Post-operative intra-abdominal adhesion was decreased in opium addicted group in comparison to control group (p value = 0.014). No statistically significant difference was found in the wound healing phase in two groups (P value = 0.057). Our findings showed that serum level of TNF, IFN and IL10 in two groups measured in all phases of examination (before surgery, within 30-60 min after surgery and 24h after surgery), were not statistically different/significant (p>0.05). Since opium addiction can decrease post-operative intra-abdominal adhesions in rats, they may be susceptible to increased inflammation and these effects may be due to decreased post-operative pain.

Surgery is the preferred treatment for hydatid cyst (cystic echinococ­cosis, CE). At present, various scolicidal agents have been used for inactiva­tion of protoscoleces during surgery, but they are associated with adverse side effects. The aim of the present study was to evaluate the scolicidal effects of amphotricin B, Silver nano particles, Foeniculum vulgare Mill, essential oil and hyper­tonic saline against protoscoleces of hydatid cyst on an in vitro model. Protoscoleces were aseptically aspirated from the naturally infected livers of sheep and goats. Various concentrations of AmB (2.5-20 mg/ml), Ag-NPs (0.5-4 mg/ml), F. vulgare essential oil (0.125- 1 mg/ml) and hypertonic saline (10-20%) were used for 5-60 min. Eosin exclusion test was used to determine the viabil­ity of protoscoleces. Maximum protoscolicidal effect of AmB and Ag-NPs was found at concen­trations of 20 and 4 mg/mL, resulting in only 82.3% and 71.6% of the proto­scoleces after 60 min of incubation, respectively. In contrast, F. vul­gare essential oil at concentration of 1 mg/ml and hypertonic saline 20% killed 100% protoscoleces after 5 and 10 min of exposure, respectively. The results indicated weak scolicidal activity of AmB and Ag-NPs; whereas F. vulgare essential oil had potent scolicidal activity against protoscoleces of hydatid cyst that revealed the potential of F. vulgare as a natural source for the produc­tion of new scolicidal agent for use in hydatid cyst surgery. However, fur­ther studies will be needed to confirm these results by checking the essential oil and its active component in the in vivo model.

Tracheostomy site infection can cause numerous problems. Absorbent foam dressing may be able to prevent proliferation of infectious microorganisms by absorbing the tracheostomy stoma exudate. This study aimed to compare the efficacy of absorbent foam with gauze dressing for prevention of tracheostomy site infection. In this double-blind randomized clinical trial, 80 patients (18 to 60 years) hospitalized in the intensive care unit (ICU) due to severe head injury were randomly divided into two groups and early tracheostomy was done for them during the first 2 days. In the first group, gauze was used as tracheostomy site dressing, while in the second, absorbent foam, was placed. Tracheostomy site was checked daily for any sign of infection and samples were taken from the stoma for culture in case of presence of any sign of infection. Of a total of 80, 11 had tracheostomy site infection (13.75%), including 7 (17.5%) in the gauze group and 4 (10%) in the foam group. The difference in this regard between the two groups was not significant (P=0.051). Also, the dominant strains in the culture of gauze group were hospital-acquired Gram-negative bacteria (particularly Acinetobacter), while in the foam group, Gram-positives and more commonly Staphylococcus epidermidis were found. Absorbent foam dressing is not superior to gauze dressings for prevention of tracheostomy site infection.

Rubber band ligation is one of the most worldwide used treatments of hemorrhoids because of its effectiveness and low complication rate. Hemorrhoidectomy is the procedure of choice for treatment of grade four hemorrhoids which is a painful method for a relatively benign disease. There are a few studies available analyzing the effectiveness of RBL as an initial treatment for grade four symptomatic internal hemorrhoids.. This study aimed to analyze the efficacy of the staging rubber band ligation in treatment of grade four hemorrhoids and comparing to hemorrhoidectomy..Patients and A prospective randomized clinical trial was performed on all patients diagnosed with grade four symptomatic internal hemorrhoids from August 2011 to March 2013. Sixty four patients with grade four hemorrhoids were divided into two groups and underwent hemorrhoidectomy (H group) and rubber band ligation (R group).These patients were compared for any complications and recurrence in a six month period.. Pain existed in 100% of the H group and 67.7% of the R group in the first visit one week postoperation (P < 0.05). There was a statistically significant difference between the two groups regarding the days off work. Patients’ satisfaction and recurrence were similar in both groups after a period of six months.. This study showed that staging rubber band ligation is effective for treating grade four hemorrhoids. Few complication and low recurrence rate were noted which enable us to recommend this modality as the procedure of choice for the management of selected patients with grade four symptomatic hemorrhoids..

Objective (s): Gastroesophageal Reflux Disease (GERD) is one of the most common digestive disorders that frequently lead to pulmonary complications due to gastric fluid aspiration. In the present experimental study، chronic aspiration of gastric fluid، its components and bile salts in rat lung was performed to find out the main factor (s) causing pulmonary complications of gastric fluid aspiration. Forty eight male rats weighted 250-300 g were selected in six groups. After anesthesia and tracheal cannulation، the animals received 0. 5 ml/kg normal saline، 0. 5 ml/kg of whole gastric fluid، 0. 5 ml/kg pepsin (2. 5 μg/ml)، 0. 5 ml/kg hydrochloric acid (pH=1. 5) or 0. 5 ml/kg bile salts (2. 5 μg/ml) by injection into their trachea and lungs. In sham group nothing was injected. Parenchymal and airways inflammation and fibrosis of bronchi، bronchioles and parenchyma were significantly more in the test groups compared to saline and sham groups (P<0. 001); also inflammation in pepsin and bile salts groups (histopathology scores: 2. 87±0. 35 and 3. 0±0. 0 for bronchial، 2. 87±0. 35 and 2. 87±0. 35 for bronchioles، 2. 87±0. 35 and 2. 87±0. 35 for parenchymal inflammation) were more than hydrochloric acid and gastric fluid groups (1. 75±0. 46 and 2. 5±0. 53 for bronchial، 2. 0±0. 0 and 2. 0±0. 0 for bronchioles، 2. 0±0. 0 and 2. 0±0. 0 for parenchymal inflammation) (P<0. 05). The same results were found for fibrosis، so that the fibrosis in pepsin and bile salts groups were more than hydrochloric acid and gastric fluid groups (P<0. 05). The present results suggested that pulmonary complications causing from bile salts and pepsin might be more than gastric juice and hydrochloric acid.

Fibroadenoma is a common benign tumor observed during the second and third decades of life. Malignancy transformation in the epithelial component of a fibroadenoma is rare and can occur 20 years after its diagnosis. Mammographic findings in this phenomenon include indistinct margins and microcalcifications. Here we present a 58-year-old woman with a mobile, lateral upper quadrant mass that was rather firm when palpated. The mammography showed a lobulated mass without calcification suggestive of a benign process, most probably fibroadenoma. However the excisional biopsy contained both an intracanalicular fibroadenoma and invasive ductal carcinoma with mucinous components.

Myasthenia gravis is a neurological disorder characterized by muscle weakness. The role of thoracoscopic thymectomy in the treatment of this disease is controversial, but has some advantages that include less pain, shorter hospital stays, and better cosmetic results. After the introduction of video-assisted thoracoscopic surgery (VATS) thymectomy, there has been increased interest in the use of this technique for myasthenia gravis. We conducted a retrospective study to assess the safety and efficacy of VATS thymectomy in treatment of myasthenia gravis.Patients and The medical records of 50 patients who underwent VATS thymectomy for the treatment of myasthenia gravis between May 2005 and June 2010 in Afzalipour Hospital, (affiliated to Kerman Medical University of Sciences, Iran) were reviewed. The patients were examined for response to treatment; for patients who were not available for examination, data was obtained through telephone conversations. Forty-three of 50 patients were accessible. Of these, 34 were female and 16 were male, with a mean age of 34.8 years. The treatment responses were remission, 6 (16%); improvement, 30 (70%); and without change, 7 (16%). The total positive response to treatment was 84 percent. VATS thymectomy has been considered as a safe and effective treatment in myasthenia gravis and was associated with low mortality and morbidity. VATS thymectomy is recommended for the treatment of myasthenia gravis.

Disclosing the diagnosis of cancer to a patient could impact various aspects of their life. The present study was performed to evaluate the views of cancer patients about disclosure of the diagnosis of disease to them. The present study was conducted on 385 cancer patients in three teaching hospitals (Afzalipour, Shafa, and Bahonar) affiliated to Kerman University of Medical Sciences between 2010 and 2011. These patients were evaluated for their views on revealing the diagnosis to them using a questionnaire that included the type of cancer, demographic information and their preferred manner of being informed of the diagnosis.Out of 385 cancer patients, 155 patients (%40) were aware of the diagnosis of their disease. The majority of patients who were aware of their diagnosis (%89) said they would like to know the diagnosis before treatment. Almost all patients who knew the diagnosis preferred to be aware of the prognosis of the disease and the complications of treatment. The only significant demographic variable was sex; men were more eager to know the diagnosis of the disease (P value< 0.05). This study showed that the majority of cancer patients would like to be aware of the diagnosis, even though most of them were unaware that they had cancer.

Solid pseudopapillary tumors of the pancreas (SPT) are rare tumors of the pancreas with low malignancy potential and a very good prognostic outcome after surgery. The outcome after radical resection is favourable. A case of solid-pseudopapillary tumor (SPT) of the pancreas in a 20-year-old woman is presented. The patient underwent resection of the mass in the pancreatic head and pancreaticoduodenectomy (Whipple procedure) with jejunostomy tube placement. We focus on the clinical features, imaging, and histopathological characteristics of solid-pseudopapillary tumors (SPT) of the pancreas.

Early tracheostomy can reduce the time required for mechanical ventilation, the duration of ICU stay, and treatment expenses. Choosing the optimal time for tracheostomy in patients with severe head injury is therefore important. The purpose of this study was to find the optimal time for tracheostomy according to Glasgow Coma Scale (GCS). In this prospective study, patients with severe head injury (GCS<8) admitted to the ICU of Kerman Shahid Bahonar Hospital were evaluated every day according to their GCS, and possible need for tracheostomy. Seventy-four patients were enrolled. The GCS of 49 patients on day 5 following ICU admission was <9. Forty-two patients (85.7%) eventually needed tracheostomy, and tracheostomy was not required in the remainder (14.3%). The prevalence of tracheostomy in patients with GCS >9 was 50%, and this difference was statistically significant. The present study showed that GCS of patients with severe head injury on day 5 following ICU admission may be used for decision-making regarding the time of tracheostomy. Tracheostomy should be carried out on day 5 following ICU admission if the GCS is ≤8, but it can be delayed if the GCS on the 5th day is >9.