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Item type: Item , Zinc supplementation during pregnancy: A randomized controlled trial(2009) Aminisani, N; Ehdaivand, F; Shamshirgaran, SM; Mohajery, M; Pourfarzi, F; Sadeghiyeh Ahari, MDZinc deficiency during pregnancy has been related to adverse pregnancy outcomes. However, the results of zinc-supplementation trials have not been consistent in improvement of pregnancies outcomes. This study was undertaken to investigate whether zinc supplementation was associated with pregnancy complications in Iranian women during the last 2 trimesters. It also assessed the anthropometric measurements of infants at birth. A double-blind placebo-controlled trial was conducted in Ardabil Province located in northwest of Iran. One-hundred ninty-six pregnant women between 16-20 weeks of gestation were recruited from urban healthcare centres. These women had no evidence of hypertension, diabetes, renal disease, history of prematurity, premature rupture of membranes (PROM) or low birth weight (LBW) infants. They were randomly assigned to receive zinc (50 mg daily) or placebo until delivery. Basic information was collected on socioeconomic status, reproductive and disease histories before randomization. The subjects were monthly followed during pregnancy and maternal complications were carefully recorded. The weight, length and head circumference of each infant was measured within 24h of birth. Of the 196 women, 17 were excluded from the study (9 in the zinc group and 8 in the placebo group, NS). The supplementation had no significant effect on prematurity, preeclampcia, PROM and stillbirth as well as gestational age, infant length and head circumference. The incidence of low birth weight was significantly lower in those under Zinc than placebo (p = 0.01). Meanwhile, pregnancy-induced hypertension and intrauterine growth retardation (IUGR) were observed only in the placebo group. The birth weight was also higher in the zinc group than that in the placebo group (p = 0.03). Supplementation with 50mg elemental zinc during pregnancy improved birth weight but did not reduce maternal complications. © 2009 by Razi Institute for Drug Research.Item type: Item , Women victims of self-inflicted burns in Tabriz, Iran(2004) Maghsoudi, H; Garadagi, A; Jafary, GA; Azarmir, G; Aali, N; Karimian, B; Tabrizi, MFrom 20 March 1998 through 20 March 2002, a total of 412 cases of self-burning were admitted to the burn center of East Azarbaijan, located in the city of Tabriz, Iran. The average age was 25.5 years; 99% of self-burning cases were female. A total of 76.5% of those patients were in the 15-19 and 20-29 year age groups. Most cases were married, housekeepers and illiterate and poor. Seventy-five percent of the patients had impulsive suicidal intention. The major motive was marital conflict. The mortality rate was 79.6%. The mean burned surface area was 65.5%. Kerosene was used by 77% of the patients as a burning agent. © 2003 Elsevier Ltd and ISBI. All rights reserved.Item type: Item , Wavefront-guided versus cross-cylinder photorefractive keratectomy in moderate-to-high astigmatism: A cohort of two consecutive clinical trials(2012) Sedghipour, MR; Sorkhabi, R; Mostafaei, ABackground: Although there have been many studies of the efficacy and safety of wavefront- guided (WF) and cross-cylinder photorefractive keratectomy (PRK), there are few studies on moderate-to-high astigmatism cases. The aim of this study was to assess and compare the efficacy of WF and cross-cylinder PRK in moderate-to-high astigmatism. Methods: In a comparative cohort, the results of two before-and-after clinical trials conducted on moderate-to-high astigmatism were studied. In the first trial, 50 eyes of 25 patients with stable refraction were enrolled in a before-and-after clinical trial to undergo WF PRK using the VISXأ¢â€آ¢ (VISX Inc, Santa Clara, CA) system. The second clinical trial enrolled 48 eyes of 24 patients with stable refraction and moderate-to-high astigmatism to undergo PRK by the cross-cylinder method using a NIDEK EC-5000 excimer laser system (NIDEK Co Ltd, Gamagori, Japan). Results: After 6 months, 80% of the eyes in the WF group had uncorrected visual acuity of 20/20 or better compared to 40% in the cross-cylinder group. Only one eye in the cross-cylinder group and no eyes in the WF group lost more than one line of best corrected visual acuity (BCVA) after 6 months of treatment. No treated eyes in either group lost more than two lines of BCVA. The percentage of eyes with no change in BCVA was 54% and 58.3% in the WF and crosscylinder groups, respectively. Mean postoperative absolute changes in total root-mean-square higher order aberrations in the WF group and cross-cylinder group were 0.05 ط¢آ± 0.22 ?m and 0.17 ط¢آ± 0.20 ?m, respectively (P, 0.001). Conclusion: Both methods of PRK, using the NIDEK EC-5000 and VISX excimer laser systems, are effective for correcting moderate-to-high astigmatism. The WF approach appeared more successful in improving the refractive results. ط¢آ© 2012 Sedghipour et al.Item type: Item , Warfarin maintenance dose in Iranian patients: A cross sectional study in 5 cities of Iran(2011) Tayyebikhosroshahi, H; Sanaat, Z; Farhoudi, M; Keyani, S; Khoshjoo, F; Tayyebikhosroshahi, MObjective: To determine the warfarin maintenance dose in Iranian patients.Methods: This multicenter study was conducted between January 2007 and January 2008 in 5 different large cities of Iran. Patients older than 12 years receiving warfarin were included. During the first days of warfarin use, international normalized ratio (INR) was measured daily and after that every 1-2 weeks, with a duration of at least one month. The warfarin dose was considered to be stabilized if the INR remained unchanged on 3 consecutive measurements at a level between 2-3. Then mean dose of the last 3 warfarin doses was calculated. Results: One hundred and fifty patients receiving warfarin took part in this study. No significant differences were noted in the mean warfarin dosage among the 5 cities, and between men and women (p=0.228). The warfarin daily dose and INR did not shown any statistical difference between men and women. The warfarin dose statistically decreased in patients older than 60 years old (p=0.004 versus 45-60 years, and p=0.002 versus 30-45 years). This study showed that the required mean warfarin dose in Iranian patients was approximately 4 mg to achieve an INR between 2-3. Conclusion: Considering geographic and ethnic differences of Iranian patients, attention to the dose determination of warfarin is of importance.Item type: Item , V-M plasty and double Z-plasty: Two versatile flaps for treatment of postburn syndactyly(2009) Davami, BThe release of postburn contractures in the hand is one of the most commonly performed procedures in burn injuries. Various local flaps have been described for release of severe postburn contractures. As the largest burn center covering north and northwest of Iran, we always needed acceptable reliable methods to reconstruct postburn syndactyly and make it as a standard treatment. We used double Z-plasties for the first web in severe contractures (23 patients) and V-M plasties for the second, third, and fourth webs and minor first web contractures (V for the dorsal aspect and M for the volar aspect of the webs). A total of 50 patients from September 2005 to June 2007 with 130 web contractures were operated. Their age ranged from 1 to 75 years. In a 1-year follow-up, all of the patients had good mobility of the fingers with no recurrence. Three cases of necrosis of tip of Z-plasties and 2 cases of necrosis of tip of V-M plasties occurred which were under 3mm and resolved gradually. Double Z-plasty in first web and V-M plasty in second to fourth webs are considered good choices for release and reconstruction of postburn syndactyly. They are straightforward in technique and can be carried out with little complications Copyright © 2009 by Lippincott Williams & Wilkins.Item type: Item , Vitamin E-selenium supplement and clinical responses of active pulmonary tuberculosis(2006) Seyedrezazadeh, E; Ostadrahimi, AR; Mahboob, SA; Assadi, Y; Ansarin, K; Shakoori, P; Pourmoghaddam, MBackground: It has been suggested that some micronutrients have antioxidant and immunomodulating effects on the treatment of mycobacterial disease. In this study, we investigated the effect of vitamin E and selenium supplementation on clinical responses in tuberculosis patients. Materials and Methods: Thirty-five patients with pulmonary tuberculosis diagnosed on the basis of a positive sputum smear for acid fast bacilli or culture for Mycobacterium tuberculosis were selected. Serial sputum examinations were performed before the diagnosis and at the end of every 15 days, during two months of therapy; chest X-ray of all patients were also evaluated. In a setting of double-blind, placebo-controlled trial, the patients were divided into two groups. Group I(n=17) received combination of vitamin E and selenium which composed of 140 mg of ?-TE and 200 ?g selenium per day, and group II received placebo. All patients in both groups received the same antituberculosis standard therapy. Clinical examination and assessment of micronutrient levels were carried out before and after 2 months of intervention. Results: In group I, elimination of tubercle bacilli from sputum occurred earlier than in group II (6 weeks versus 8 weeks, respectively, p= 0.001). At the end of the 2nd and 6th month of therapy, the median reduction in cavity surface area on chest X-ray in group I was significantly more than group II (2nd month: 1.5(0.0-4.5 versus 9.0(4.0-18.0);p= 0.03, and 6th month: 0.0(0.0-2.3) versus 6.3(1.0-15.8); p<0.05, respectively). Conclusion: Vitamin E plus selenium supplementation may improve the microbiological and radiological outcomes of the treatment in patients with pulmonary tuberculosis. © 2006 NRITLD, National Research Institute of Tuberculosis and Lung Disease, Iran.Item type: Item , Vitamin D deficiency and secondary hyperparathyroidism in pediatrics obesity(2010) Ghergherehchi, R; Tabrizi, AObesity is one of the health problems in the developing and developed countries. Obesity subjects the individuals with metabolic and endocrine disorders. It is obvious that vitamin D deficiency or insufficiency may lead to secondary hyperparathyroidism. Thus, obesity increases the risk of vitamin D deficiency. Considering the high prevalence of vitamin D deficiency in children and adolescents with overweight or obesity, it seems logical to have treatment and prevention from vitamin D deficiency. This is similar to a study in adult vitamin D deficiency related with adiposity which also demonstrates the importance of vitamin D deficiency screening in children and adolescent obesity. Vitamin D replacement can reduce many complications in childhood (skeletal disorder, secondary hyperparathyroidism) and decreases metabolic disorder and cardiovascular disease incidence in later childhood. On the other hand, calcium has a key role in weight regulation, useful in replacement therapy, but there is a need for a further study to reveal exactly the effects in children obesity or overweight.Item type: Item , Vitamin A Supplementation and Serum Th1- and Th2-Associated Cytokine Response in Women(2013) Farhangi, MA; Keshavarz, SA; Eshraghian, M; Ostadrahimi, A; Saboor-Yaraghi, A-AAims and Background: T helper (Th)1/Th2 immune response has been linked to obesity-related immune disorders. It has been proven that retinoid active derivates improve immunity via regulating Th1/Th2 balance. However, there is not a well-identified report of direct effect of vitamin A on Th1/Th2 balance in obesity. The present study aimed to investigate the possible role of vitamin A on serum Th1/Th2 response in obese women. Materials and Methods: A randomized double-blind placebo-controlled trial was conducted on 84 obese (n = 56; body mass index [BMI] 30-39.9 kg/m2) and nonobese (n = 28; BMI 18.5-24.9 kg/m2) women. Obese women were randomly allocated to receive either vitamin A (retinyl palmitate 25,000 IU/d) or placebo. Nonobese women also received 25,000 IU/d retinyl palmitate. Anthropometric variables were assessed and serum interleukin (IL)-1?, tumor necrosis factor (TNF)-?, IL-4, and IL-13 were analyzed before and 4 months after intervention. Results: Vitamin A treatment significantly reduced serum concentrations of IL-1? in obese vitamin A-treated subjects (from 3.58 ± 0.36 to 2.45 ± 0.23 pg/ml, p < 0.006). Serum concentrations of IL-4 and IL-13 were also reduced in obese and nonobese vitamin A-treated subjects (p < 0.05). A significant reduction in IL-1?/IL-4 ratio in the obese vitamin A-treated group was also observed (p = 0.03). Conclusions: Decline in serum concentrations of IL-1? and IL-1?/IL-4 ratio in obese women suggests that vitamin A is capable of regulating the immune system and possibly reducing the risk of autoimmune disease in this group. Further studies are needed to explore the possible underlying mechanisms. © 2013 Copyright Taylor and Francis Group, LLC.Item type: Item , Virulence and antimicrobial resistance in enterococci isolated from urinary tract infections(2013) Sharifi, Y; Hasani, A; Ghotaslou, R; Naghili, B; Aghazadeh, M; Milani, M; Bazmani, APurpose: Urinary tract infection (UTI) is the most common nosocomial infection among hospitalized patients. Meanwhile, most frequent infections involving enterococci affect the urinary tract. The aims of this study were to investigate the susceptibility pattern of isolated enterococci from UTI and the prevalence of virulence genes. Methods: The study used enterococci isolated from urinary tract infections obtained from 3 university teaching hospitals in Northwest Iran. The antimicrobial susceptibility of the strains was determined using the disc diffusion method. Multiplex PCR was performed for the detection of genus- species specific targets, and potential virulence genes. Results: Of 188 enterococcal isolates, 138 (73.4%) and 50 (26.6%) were Enterococcus faecalis and E. faecium, respectively. Antibiotic susceptibility testing showed high resistance to amikacin (86.2%), rifampicin (86.2%) and erythromycin (73.9%), irrespective of species. In total, 68.1% were positive for gelE, and 57.4%, 53.2%, 56.4%, and 52.1% of isolates were positive for cpd, asa1, ace, and esp, respectively. Conclusion: The study revealed that most of UTI isolates were multidrug resistance against the antibiotics tested and antibiotic resistance was more common among E. faecium isolates than E. faecalis. A significant correlation was found between UTI and the presence of gelE among E. faecalis strains (p < 0.001). ط¢آ© 2013 by Tabriz University of Medical Sciences.Item type: Item , Views of patients undergo hematopoietic stem cell transplantation on their basic needs(2013) Sayadi, L; Jafaraghaee, F; Jeddian, A; Atrian, MK; Akbari, A; Tootoonchian, FBackground: Today, hematopoietic stem cells transplantation (HSCT) has been accepted as a therapeutic approach and is widely applied in many patients with disorders of hematopoietic systems or patients with malignancies. Concomitant use of this therapeutic approach with long term chemotherapeutic procedures and hospitalization requires special care. This study was conducted to examine basic needs of patients after HSCT. Methods: In this study, 171 hospitalized patients were selected after transplantation, using convenience sampling method. They completed a questionnaire formulated on the basis of Yura and Walsh Theory of Basic Needs. Results: Most of the needs reported in the areas of vital functions, functional health status, and reaction to functional health status were chills (76.8%), insomnia (68.5%), and dissatisfaction with changes of lifestyle/habits (53.6%), respectively. Furthermore, 94.1% of the patients were aware of their disease. Conclusion: This study identified a broad spectrum of the needs in HSCT patients. Given the importance of determining needs to reach a thorough nursing care, paying attention to the provided list can facilitate the achievement of the goals of the care program for these patients.