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Articles by Mohamad Goldust
Total Records ( 34 ) for Mohamad Goldust
  Alireza Sadeghpour , Ali Sadighi , Hojjat Hoseinipour Feiz , Jafar Ganjpour Sales , Jafar Soleimanpour , Alireza Rouhani , Marouf Ansari and Mohamad Goldust
  The multi-trauma patient has usually sustained multiple traumatic injuries to the body, affecting different organs and body systems. The aim of this study was to assess the reasons for injury concealment in multitrauma patients and provide resolutions to reduce them. In this cross sectional study, 487 patients were evaluated. After collection of needed data, a questionnaire included demographic data, primary diagnosis in emergency ward, graphies conducted in emergency ward, missed injuries, trauma severity was filled for every multitrauma patient who had a missed injury. The relative frequency of multitrauma was 18.51% among all studied trauma patients (487 cases), but 7.6% of included patients had missed injury. Thirty two missed injuries were found in 28 patients. Most injuries were musculoskeletal, involving the distal part of the limbs. Fracture was the most common type of musculoskeletal injury (19 out of 32 missed injuries). Causes that leaded to concealment of injuries were founded to be inadequate physical and/or, radiographic examinations, commonly after severe penetrating injuries which are mostly due to motorcycle accident. Most of the missed injuries have been ultimately diagnosed upon the patient’s complaints in hospital wards, within 1 to 30 days after trauma. Repeating examinations during hospitalization and follow-up periods especially in patients suffering from severe trauma and conscious disorder and those hospitalized at ICU, plays an essential role in discovering the missed injuries.
  Masoud Nemati , Manijeh Mostafa Gharehbaghi , Abolhassan Shakeri , Reza Taei Nobari , Noushin Behravan and Mohamad Goldust
  The aim of this study was to evaluate the incidence and risk factors of umbilical catheter associated thrombosis in newborn infants using color Doppler. In this analytic-descriptive study, 256 newborn infants with umbilical catheters were evaluated during a 15 month. Color Doppler ultrasonography was employed for detection of vascular thrombosis associated with the umbilical catheter placement in the first 24-48 h after admission, weekly until discharge and 72 h after discharge. Among 256 newborns, 12 cases (4.7%) had vascular thrombosis. The rate of thrombosis was 6.9 and 5.7% in the umbilical artery and vein catheters, respectively. Umbilical catheters is accompanied with the risk of thrombosis. Color Doppler ultrasonography is a good way for diagnosis of this thrombosis.
  Hamideh Azimi , Effat Khodaeiani and Mohamad Goldust
  This study aimed at evaluating the efficacy of oral erythromycin in patients with Pityriasis Rosea. Fifty patients were selected which were the divided into 2 groups. In group A (test group) the patients were treated by erythromycin while in group B (plecebo group) the patients received chlorpheniramin or diphenhydramin. Complete response was observed in 16 patients (64%) in the treatment group (A) and none in the second group (B) (p = 0/0001). It is recommended to treat the patients suffering from pityriasis rosea at any time of disease diagnosis using oral erythromycin for a two-week period.
  Zeynab Mayabi , Mahmoud Omrani and Mohamad Goldust
  Spontaneous intracerebral hemorrhage is of relatively prevalent emergency cases of neural system associated with significant rate of mortality. The present study aims at determining radiological symptoms, clinical manifestations and possible risk factors of intracerebral hemorrhages. Clinical and radiological findings (primary CT-scan) of 80 patients with intracranial hemorrhage were retrospectively evaluated. The study was consisted of 300 patients. Pictorial findings considering clot age and brain scan of all patients were studied to determine location and extension of hemorrhage and. There were 160 male and 140 female patients with the mean age of 62. The most prevalent clinical manifestation including decrease of consciousness and headache were seen in 51 and 41.6% of cases and only 8.3% of the patients referred while they were in coma. Hematoma was replaced in 36 of lobar and 32.6% in basal ganglia (lenticular). It was observed in 15, 9% and 7.3% of thalamus, cerebellum and other areas, respectively. Additionally, hypertension and consumption of anticoagulation were, respectively seen in 60.3 and 9% while there was not any specific risk factor in 30.6% of the patients. Hypertension was regarded as main risk factors and hemorrhage was seen in basal ganglia in most cases of hypertensive patients. Headache and extension of hemorrhage into ventricles were often seen in cerebellum and thalamus hemorrhages, respectively. Subarachnoid hemorrhage was often associated with lobar hemorrhage. Most hypertensive patients suffering from intracerebral hemorrhage were older than 45 years. Controlling of risk factors especially hypertension is of high importance in prevention from cerebral hemorrhage.
  Zeynab Mayabi , Yalda Asghar and Mohamad Goldust
  Headache is one of the common complications of patients referring to treatment centers. Application of different neuroimaging methods in patients with headache is still controversial. The present study aims at determining role of neuroimaging in diagnosis and management of patients suffering from headache. This retrospective study was conducted on medical files of 500 patients with headache referring to neurology clinics considering age, gender, type of headache and role of imaging methods in their management and treatment. In this study, 91.6 and 8.4% of the referrals respectively suffered from non-organic (primary) and organic causes of headache. CT-scan was used to examine all patients with secondary headache and 70 subjects suffering primary headache, out of 458 patients. According to CT-scan findings, there were 25 cases of brain tumor, 9 cases of subarachnoid hemorrhage, 4 cases of aneurysm, 3 cases of subdural hematoma and one case of cerebral hydatid cyst in patients with secondary headache. MRI and angiography were requested in 12 and 2 cases, respectively. It seems neuroimaging should be requested for patients with abnormal neural findings or changes in headache quality and severity and increase of intracranial pressure.
  Abolhassan Shakeri , Masoud Nemati , Moslem Shakeri and Mohamad Goldust
  Recently, color Doppler sonography is widely used in evaluating diseases obstructing brain arteries. This study aimed at providing normal rates of hemodynamic parameters in vertebral arteries of older patients using color Doppler sonography. This prospective study conducted on 31 healthy old people ranges from 60 to 96 years. Angle corrected flow velocities and luminal diameters were measured and waveform parameters calculated in all vertebral arteries. It was possible to visualize V2 Segment in 100% and origin of right VA in 72% and origin of left VA in 59% of them. Mean diameter of right VA was 32.4± 0.56 mm while it was 3.52± 0.67 mm for the left VA. The resistance index in right VA was 0.71±0.08 and it was 0.69±0.06 in the left VA. There was no significant differences between the two sides. Peak systolic velocity was 35.77±12.71 cm sec-1 on the right and 36.29±12.71 cm sec-1 on the left. Accordingly, no differences were observed between the two sides. This study and its presented reference values can lead to better differentiation between normal and pathologic findings in vertebral arteries among old people. Nevertheless, further studies are needed to determine the normal and pathologic values of vertebral arteries.
  Ali Sadighi , Asghar Elmi , Mohamad Ali Jafari , Vahid Sadeghifard and Mohamad Goldust
  Tibia fractures are the most common type of long bone fractures in US. This study aimed at comparing the therapeutic results of closed tibial shaft fracture with intramedullary nails inserted with and without reaming. In this randomized clinical trial study, 60 patients with a fracture of the tibia were examined. The patients were randomly divided into two groups. Thirty patients treated through inserting intramedullary nail with reaming technique (group A). The other 30 patients treated through inserting intramedullary nail without reaming technique (group B). After operation physical examination and control radiography were taken up to 6 month and results were compared. Sixty patients suffering from closed tibial diaphysis fractures were studied. Mean age of the group A and B were 40.24±12.32 and 38.42±14.28, respectively. Group A consisted of 24 (80%) males and 6 (20%) females while group B consisted of 24% females and 76% males. Considering fracture based on OTA criteria (p = 0.4) and severity of soft tissue damage based on Tscherne classification (p = 0.6), there was no statistically meaningful difference between groups A and B. The study demonstrated that degree of horizontal displacement, mean time of surgery, post-operation infection, organ shortness at the end of the follow-up period, organ deviation in patients of the group A was significantly more than that of the group B. Time required for callus formation (mean time of union), mean time of full weight bearing time and mean time of return to normal activities in group B was significantly more than that of the group A.
  Jafar Ganjpour Sales , Jafar Soleymaopour , Alireza Sadeghpour , Shabnam Sharifi , Shahin Rouhani and Mohamad Goldust
  Although the fractures of femoral neck are not so common, their accompanying complications are more frequent and important. This research aims at studying the results of reverse triangle screw fixation in patients suffering from femoral neck fractures in two groups with perfect and imperfect position of the mentioned screw. In a cohort study, 51 patients with femoral neck fracture appointed for the so-called reverse triangle screw fixation were divided into two perfect and imperfect groups considering surgeon comment on position of the screws. The patients were followed up for 12 months and the resulted outcomes were compared. There were 34 patients in the perfect group with mean age of 48.7±18.6 (18-80) and 17 patients in the imperfect group with mean age of 50.4±15.9 (19-80) years old. Both groups were the same considering underlying causes and fraction grades. The overall frequency of nonunion and avascular necrosis was 7.8 and 3.9%, respectively. These rates were 2.9 and 0% in the perfect group and 17.6 and 12.5% in the imperfect group, respectively (p>0.05). The mean Harris hip score and motion range of the hip at different directions in the perfect group were substantially higher than those of the imperfect one. According to present results, position of the screws determined by the surgeon after operating the reverse triangle screw fixation in femoral neck fractures may significantly affect the prognosis of patients.
  Masoud Nikanfar , Sheyda Shaafi , Maziyar Hashemilar , Daioush Savadi Oskouii and Mohamad Goldust
  Leukocytosis and increased Erythrocyte Sedimentation Rate (ESR) during the early phases of acute ischemic stroke has been proposed to be related with poor prognosis. The aim of this study was to evaluate these two parameters in patients with ischemic stroke. In this descriptive analytical study, 150 patients with confirmed ischemic stroke were taken under study for a period of 13 month. The White Blood Cell (WBC) count and ESR were determined on admitting and after 3 days. Any history of Diabetes Mellitus (DM), Hypertension (HTN), Heart Disease (HD), Hyperlipidemia (HLP), smoking, CT scan findings, level of consciousness and the condition of patient on admission and discharge (according to Rankin's scale) were assessed. In this study, 150 patients were enrolled, in which 75 were males and 75 were females, with the mean age of 67.3±8.2 years. Leukocytosis on day one was significantly more prevalent in patients passed away during hospitalization or discharged in not-so-well condition. High WBC and ESR levels, altered consciousness, diffused lesions in CT scan and imperfect neurological condition on day one, as well as positive history of DM and HTN were significantly related with higher in-hospital death rate and/or poor condition at discharge. Raised WBC count and ESR just after an ischemic stroke attack might be related with a poor prognosis and necessitate immediate and meticulous monitoring and therapies.
  Amir Vahedi , Rasoul Estakhri , Mohamad Hossein Somi , Ebrahim Abdollah , Mohamad Goldust and Shabnam Samankan
  Early diagnosis of Gastric adenocarcinoma could increase survival of the patients and also remarkably reduce treatment costs. This study aimed at evaluating the diagnostic value of serum P53 in comparison with tissue P53 in gastric adenocarcinoma and their relationship with microscopic prognostic factors. In this descriptive analytical study, 35 patients (74.3% male and 25.7% female with mean age of 63.00±12.75 years with gastric adenocarcinoma were evaluated. Blood samples were taken from all patients before gastrectomy to evaluate serum P53 with ELISA method and after surgery tissue samples were gathered to evaluate tissue P53 with immunohistochemical method. The relation between tissue and serum P53 with severity of the disease and microscopic findings was assessed. Tissue P53 was negative in 57.1%, positive in 22.9% and very positive in 20%. Mean serum P53 was 1.34±0.43 mg dL-1. There was no relation between serum P53 and adenocarcinoma type, tumor grade, vascular and neurological invasion and number of lymph node involved. Serum P53 levels significantly increased by increase in tissue P53 positivity (p = 0.004). There was significant correlation between tissue P53 and adenocarcinoma type (p = 0.006), neurological involvement (p = 0.04) and number of involved lymph nodes (p = 0.001). Although serum P53 level was higher in cases with more lymph node involvement and vascular and neural invasion, the marker was not capable to predict the involvement degree of stomach cancer. In comparison with serum P53, tissue P53 plays more significant role in these cases.
  Samad Hazhir Karzar , Kamaloddin Hasanzadeh , Mohamad Goldust and Nazanin Hazhir Karzar
  Measurement of intravesical residual urine is experimentally a diagnostic, therapeutic and follow-up criterion in patients with benign prostate hyperplasia. The study aims at evaluating sonography accuracy in measuring intravesical residual urine in comparison with standard and accurate way of measurement through bladder catheterization. The study was conducted on 60 patients hospitalized for benign prostate hyperplasia. Mean age of the patients was 67.10±8.33 years. In all patients with full bladder and after urination, the post void residue was initially measured by sonography at supine position and then immediately through bladder catheterization. This study evaluated 60 patients with mean age of 67.10±8.33 years. The difference between measuring through sonography and catheterization was 7.89±0.86, 14.46±1.87 and 32.73±2.99 mL in postvoid residue less than 50, 51-100 and more than 100 mL, respectively. In patients with benign prostate hyperplasia, transabdominal sonography is a non-invasive method to determine postvoid residue amount.
  Mehdi Farhoudi , Aliakbar Taheraghdam , Gholnar Abbasi Farid , Mahnaz Talebi , Ali Pashapou , Jafar Majidi and Mohamad Goldust
  Parkinson disease is a prevalent progressive neurodegenerative disorder, especially in western countries and among the elderly. This study aimed at evaluating serum iron and ferritin in patients with idiopathic Parkinson disease. In this case-control study, 50 patients with clinical diagnosis of idiopathic Parkinson disease (case group) were evaluated during a 12 month period. Fifty healthy persons (control group) recruited as well. Serum iron and ferritin levels were measured by biochemical and quantitative luminance methods, respectively in the case and control group. Fifty patients, 28 males and 22 females with the mean age of 64.53±10.18 (40-84) years and 50 controls were enrolled. Serum iron levels were 70.22±25.18 mg dL-1 and 67.62±39.53 mg dL-1 in case and control group, respectively. Serum ferritin levels were 129.79±137.67 ng dL-1 and 109.87±154.71 ng dL-1 in case and control group, respectively. There was no significant difference between different grades of Parkinson disease considering the serum level of iron or ferritin. The current study showed that generally there is no significant difference between the patients with the idiopathic Parkinson disease and healthy controls in terms of serum iron and ferritin levels. The same results were attributable to different grades of the disease.
  Rezvanie Salehi , Elgar Enamzadeh and Mohamad Goldust
  Atrial fibrillation is associated with cerebral stroke, congestive heart insufficiency and mortality. The present study aimed at evaluating of cognitive disorders in patients with history of atrial fibrillation without cerebral stroke. In a case-control study, 100 patients with first-ever atrial fibrillation seizure without history of cerebral stroke were evaluated. One hundred healthy subjects with normal sinus rhythm matched with the patients in terms of age and gender were regarded as the control group. The case and control groups were followed up for at least one year after occurring of atrial fibrillation. Cognitive disorders were evaluated at the last visit. The case group was consisted of 51 men and 42 women with mean age of 71.08±5.35 years and there were 53 men and 43 women with mean age of 71.34±5.04 years in the control group. Previous history of hypertension, diabetes mellitus, hyperlipidemia, hypercholesterolemia, smoking, consuming of alcohol and warfarin in the case group were 49.5, 23.7, 18.3, 31.2, 14, 7.5 and 9.7% and in the control group 6.4, 35.4, 24, 36.5, 21.9, 13.5 and 12.5%, respectively. In this regard, there was not statistically meaningful difference between these two groups. Dementia was detected in 3 (3.2%) of the case and 1 (1%) of the control group subjects (p = 0.29). Comparing two groups with and without dementia demonstrated that there was not any meaningful risk factor. According to the results, dementia in patients with positive history of atrial fibrillation was more than normal population.
  Rezvanie Salehi , Naser Aslanabadi , Simin Taghavi , Leili Pourafkari , Shahla Imani and Mohamad Goldust
  Rheumatic mitral valve stenosis continues to be the most frequently encountered clinically significant valvular abnormality in pregnant women. We retrospectively studied the fetal outcomes of patients with severe rheumatic Mitral Valve Stenosis (MS) admitted to hospital with heart failure and underwent Percutaneous Balloon Mitral Valvotomy (PBMV) during pregnancy. We identified all of the pregnant cases with rheumatic MS from February 1st 1994 till February 1st 2011 who underwent PBMV from medical records in the tertiary referral center of Madani Heart Hospital in Tabriz, Iran. Follow up was done by phone call and office visit. During this period 24 pregnant patients with mean ages of 29.45±5.05 (19-38) had undergone PBMV for severe MS. Fourteen patients could not be reached and were lost to follow-up. PBMV had been performed during second trimester of pregnancy in 20 cases (83.3%) and during third trimester in 4 patients (16.6%). The success rate of PBMV was 100%. Pulmonary artery pressure reduced from 58.88±21.97 to 38.50±8.87 (p<0.05), peak and mean transmitral valve gradient reduced 25.20±9.71 to 11.03±3.61 (p<0.0001), 14.18±7.60 to 5.00±1.39 (p = 0.004), respectively. We conducted follow up in 10 patients with good fetal outcome in all except in 2 infants who died during follow up with intractable heart failure. Twenty patients were in normal sinus rhythm at the time of procedure (83.3%) and 4 of them (16.7%) had arterial fibrillation. PBMV during pregnancy could be recommended as a relatively safe procedure for mother and fetus.
  Zahra Fardiazar , Mitra Ramin , Elahe Olad Saheb Madarek , Simin Atashkhouei , Reza Torab and Mohamad Goldust
  Severe Preeclampsia may lead to liver and renal failure, Disseminated Intravascular Coagulopathy (DIC) and Central Nervous System (CNS) abnormalities. This study aimed at comparing of infant complication in premature labor between severe preeclampsia and normal pregnancies. In this analytical-descriptive study, one hundred pregnant with severe preeclampsia and premature delivery due to severity of preeclampsia were compared with one hundred cases of premature delivery without preeclampsia to study neonatal fate. The understudy subjects were divided into five age groups of 27-28, 29-30, 31-32, 33-34, 35-36 weeks considering type of delivery, neonate features and neonatal complications related to premature delivery. Mean age of mothers of normal delivery group was 27.28±5.42 mean age of mothers of the second group was 30.56±5.86. There was statistically meaningful difference between two groups of delivery regarding patients’ systolic blood pressure (p<0.001). The study made it clear that there was not statistically meaningful difference between two groups of delivery regarding fetus age (in weeks) at the time of delivery (p = 0.456). According to findings of this study, neonatal complications and mortality is high in preeclampsia due to stressful conditions created for the fetus.
  Mohammad Hossein Daghigh , Seyed Shahram Safavi and Mohamad Goldust
  This research is based on studying MRI signal changes in depressive vertebra fractures in order to determine the time of damages. With this information, difficulty for both clinicians and insurance companies will be resolved. In this descriptive analytical study, the MRI of the patients with vertebral collapse was evaluated. In all cases, during the twelve month study, all fractured vertebras had complete isodense sequences in T1-W and T2-W. This study confirms that any fractured vertebra in contrast with its adjacent normal vertebra has a specific amount of signal change in determined time passing.
  Jafar Soleimanpour , Jafar Ganjpour , Shahin Rouhani and Mohamad Goldust
  Titanium Elastic Nails (TEN) are commonly used to stabilize femoral fractures in school-aged children, but there have been few studies assessing the risk of traditional traction and application of spica cast. The aim of this study was to compare of titanium elastic nails with traction and spica cast in treatment of children’s femoral shaft fractures. A group of thirty children aged 6-12 years with one-sided femoral shaft fracture were randomly allocated either to traction with spica casting group or titanium elastic nails group and were followed up to 1 year. Factors such as age, sex, time needed for walking with aids, time needed for independent walking, time needed for callus formation, time absent from school, time spent in hospital, malunion, malalignment and wound complication were recorded and compared. Fifteen patients (10 boys, 5 girls) with a mean age of 8.33±1.63 years were treated by traction and spica casting. The other 15 (9 boys, 6 girls) with a mean age of 8.73±1.53 years underwent surgery using TEN. Mean absence time from school, length of hospital stay, time needed for walking with and without help and angular deviation (varus or valgus) were significantly lower in the group treated by TEN (p-value<0.05). Time needed for callus formation was significantly lower in spica casting group (p-value<0.001). No statistically significant difference was observed between the two groups regarding malunion wound complications and hospital charges. The results indicated that a child in whom a femoral fracture is treated with TEN achieves recovery milestones significantly faster than a child treated with traction and spica cast.
  Rezvanie Salehi , Simin Taghavi , Shahla Imani and Mohamad Goldust
  Prosthetic mechanical valves have a high risk condition for patients in pregnancy. The aim of this study was to evaluate the safety of pregnancy in mothers with prosthetic heart valves. In this cross sectional study, we compared incidence of thromboembolic attacks abortion and maternal and fetal complications in 19 patients with prosthetic heart valves. We reviewed medical records, also office visit and follow up of these women for 10 years. Between 10 years we studied 19 patients, 13 had mechanical heart valves with mean ages of 28.2±5.43, 4 cases with bioprosthetic valves with mean age of 25.4±4.12 and 2 cases of valve repaired 27.00±7.07. Seven women were uniparous 8 cases were in second pregnancy, one had 3rd and another one were gravid 4th . There was a mean interval between valve surgery and pregnancy of 7.65±6.07(1-23) years. Dominant underling disease for valve replacement was rheumatic. In conclusion bridge anticoagulation during pregnancy is safe for mother and fetus in women with mechanical heart valves.
  Jafar Ganjpour Sales , Jafar Soleymaopour , Maroof Ansari , Farhad Afaghi and Mohamad Goldust
  Tibial condyle fractures affect knee stability and motion. Treatment of bicondylar type of tibial plateau fracture is a challenging problem. This study aimed at evaluating the application of hybrid external fixators with minimum deformation in these patients and the resulted outcomes. In this descriptive analytical study, 28 patients with bicondylar tibial plateau fractures treated by HEF device were evaluated. The surgeon used a semicircular and one circular wire instead of the one or two loop of conventional HEF device for a better range of motion of the knee joint. Treatment outcomes including quality of walking, union condition, knee range of motion, complications and the final outcome according to the knee score (rusmussen) were checked. Twenty-eight male patients, with the mean age of 40.54±13.83 years were enrolled in the study. Complications occurred in 8 (28.6%) patients; 7 cases with superficial infection and 1 patient with deep vein thrombosis. All complications were managed medically with no significant consequences left. All the patients were able to walk with no aid except in one case. In 96.4% and 89.3% of the cases, the clinical and radiological outcomes were good to excellent, respectively according to the knee score. In 85.7% of the patients, the knee range of motion was in normal limits. Application of hybrid external fixator using one and half ring instead of one or two fixator rings in treating bicondylar tibial fractures was associated with desired clinical and radiological results.
  Abolhassan Shakeri , Masoud Pourisa , Abdolreza Deldar and Mohamad Goldust
  There are different variations in the branching pattern of the Aortic Arch (AA). The aim of the present study was to study and evaluation of anatomic variations of aortic arch branches and relationship with diameter of aortic arch by 64-row computed tomography angiography (CT angiography). This descriptive analytical study was performed on 503 human by using of CT Angiography (CTA) to evaluation of anatomic variations of aortic arch. Patients underwent three dimensional restoration of aorta arch images and its branches using MIP and VRT software following intravascular injection of vein material (100 mL) and conducting CT. Then, kind of their divisions were registered. Additionally, diameter of aorta arch was measured at its cross section immediately before and after separation of its first and last branches, respectively. This study was performed on 503 specimen that 269 (53.5%) was male and 234 (46.5%) was female. The most common AA branching pattern was found in 346 (68.8%) of 503 specimens. There was no significant correlation between sex and type of variations (p = 0.073). There was no significant correlation between type of AA variations and AA diameter in the early branching area (p = 0.446) and there is no significant correlation between type of AA variations and AA diameter in the last branching area (p = 0.887). The different branching patterns of the AA observed in this study and the morphometric measurements taken can assist doctors in performing safe and effective surgeries in the superior mediastinum and also a safe interventional procedures.
  Farideh Goforoushan , Hamideh Azimi and Mohamad Goldust
  Acne treatment depends on whether patents have a mild, moderate, or severe type of acne. The aim of this study was to compare the using of Isotretinoin (Rokutan) with and without oral vitamin E in treating acne. This study was performed on 60 patients on 0.5 mg/kg/day isotretinoin treatment for 6 months. The first group received 800 IU day-1 Vit E during treatment and the second group recieved 800 Iu day-1 cod liver oil capsules. All patients were observed for the complications at 1th, 4th and 6th weeks during treatment. Cheilitis was the most common side effect among these patients (69%). Epistaxis was the second side effect in both groups (22%). Other side effects were xerosis, pruritus, epigastric pain and nail fragility. The frequency and the severity of complications were less common at 4th and 6th weeks of treatment. Isotretinoin is a useful and effective drug in treating severe and treatment-resistance acne lesions.
  Parsa Yousefi , Ali Siroos , Fatemeh Darreh , Masoumeh Ahmadi Mohtasham , Farnaz Hafez Qoran and Mohamad Goldust
  This study aimed at evaluating the sacrum index in children suffering from different grades of vesicoureteral reflux. In this case-control study, according to VCUG results, children with grade III, IV and V refluxes entered the study. There were 76 children with history of urinary canal infection and normal VCUG. Sacrum index was measured in both groups and compared. There was a meaningful relationship between these two groups considering abnormality rate of the index (p = 0.001). The factor can be used as a predictive factor in determining prognosis of medical treatment and selecting those children candidate to surgery.
  Shahla Babaee Nejad , Hamideh Herizchi Qadim , Leila Nazeman , Roohollah Fadaii and Mohamad Goldust
  Vitiligo is more common in people with certain autoimmune diseases. Here we studied the association between vitiligo and autoimmune diseases. In this case control study, 86 patients with vitiligo were questioned about the location of vitiligo, family history, treatment and therapeutic response. All patients were examined both clinically and with laboratory tests to detect the presence of autoimmune disorders including autoimmune thyroid disease, pernicious anemia, insulin dependent diabetes, and Systemic Lupus Erythematic (SLE) and Addison disease. We compared the prevalence of autoimmune disorder in vitiligo patients with that in a group of age-and gender-matched normal population. Average age of disease onset was 21.8±11 years; 61% of patients were female and 39% were male. The most common locations of vitiligo were hands (33.7%) and face (32.1%). The most common pattern of onset was vulgaris type (40%). Nearly one-fourth of patients had a positive family history of vitiligo. Prevalence of thyroid disorders in vitiligo patients and control group was 21.1 and 7%, respectively. The difference was statistically significant (p = 0.008). The most common autoimmune disorder in patient with vitiligo was hypothyroidism. Family history had a poor prognostic effect on response to therapy.
  Hamideh Azimi , Jafar Majidi , Rasul Estakhri and Mohamad Goldust
  Pemphigus is defined as a group of chronic self-immune vesicular diseases histologically recognized by inter-epidermic vesicles resulting from acantholysis. The aim of this study was to evaluate the precipitant and circulative IgG antibodies in patients with pemphigus vulgaris before and after treating with immunofluorescence. Sixty-two patients (34 females and 28 males) with clinically and pathologically confirmed P.V. were studied prospectively over a one year period of time during which direct and indirect immunofluorescent tests were performed before and after treatment. They had mild or moderate forms of disease. All patients received prednisolon 1-2 mg/kg/day and Azathioprine 2-3 mg/kg/day or methylpredisolon (1 g day-1 for 4 days) and cyclophosphamide (500 mg/first day) pulse therapy due to general condition. Thirty- four females and 28 males enrolled, the mean age were 39.5 years (SD = 12.7). Before treatment, 10 and 52 cases were positive for skin depositing +or++) and circulatory IgG (1/20 -1/60), respectively. Two to 3 month later, 37 were IgG positive with titers 1/20 to 1/160. The correlation between circulatory IgG before and after treatment was weakly positive (p = 0.05, r = 0.415). In the present study, treatment methods used for patients suffering from pemphigus vulgaris were not successful in significantly decreasing the circulative autoantibodies levels.
  Shahla Babaei Nejad , Effat Khodaeiani , Mehdi Amirinia and Mohamad Goldust
  Cicatricle alopecia represents a diverse group of diseases characterized by a lack of follicular ostia and irreversible alopecia. This study aimed at evaluating cicatricial alopecia in Iranian patients. One hundred patients with cicatricial alopecia were studied. Patients disease was pathologically proven. All epidemiologic and clinicopathologic data were obtained through questionnaires. The results were analyzed by means of descriptive statistical methods. One hundred patients were consisted of 52 (52%) males and 48 (48%) females. 30 patients (24 males and 6 females) suffered from folliculate decalvans, 25 cases (10 males and 15 females) from DLE, 18 patients (6 males and 11 females) from brocq pseudopelade, 14 patients (4 males and 10 females) from lichen planopilaris, 8 patients (4 males and 4 females) from morphea and 5 cases (4 males and 1 female) from folliculate colloidalis. Early stage diagnosis by biopsy and proper treatment will reduce further progression and especially alleviate psychosocial disturbances.
  Shamsi Abbasalizadeh , Zahra Neghadan Pharabar , Fatmeh Abbasalizadeh , Morteza Ghojazadeh and Mohamad Goldust
  The term of preterm birth is used to define the premature neonates considering pregnancy age. In less than 34 week pregnancies, corticosteroids are prescribed to promote embryos’ lung maturity. The presents study aimed at evaluating effects of betamethasone injection on feeling embryo motion by mother and index and biophysical profile in preterm pregnancies. In a descriptive-analytical study, 40 pregnant women with the pregnancy age of 30-34 weeks were evaluated. Embryo motion and index and biophysical profile of the amniotic fluid were checked before prescription of double dosage of muscular betamethasone (12 mg) at a 24 h time interval. The injection was repeated for 24 and 48 h after the first injection. The resulted outcomes were compared with those results related to before betamethasone injection. In this study, there was statistically meaningful relationship between embryo motions before injection of betamethasone and 12 h after its injection (p = 0.03). Also, there was a significant relationship between embryo motions 24 and 48 h after injection of betamethasone (p = 0.001). In other words, the embryo motions decreased 12 h after injection of betamethasone. They were improved 48 h after betamethasone injection. But, index and biophysical profile results of amniotic fluid were left unchanged. Application of betamethasone leads to evident but transient decrease in embryo motions. Although motion element of index and biophysical profile of amniotic fluid which is one of the tests used in evaluating the embryo health is fixed and normal, it can be concluded that injection of betamethasone may not affect embryo health.
  Parvin Mostafa Gharabagy , Poone Zamany , Abbas Delazar , Morteza Ghojazadeh and Mohamad Goldust
  Pain is the most common complaint in all kinds of diseases. Considering side effects of chemical medicines as well as unnecessary continuation of pain after surgery, the present study aimed at evaluating anti-pain effect of Chelledaghi herbal extract on mitigation of pain after hysterectomy surgery. This study was conducted on 90 randomly selected patients. The subjects were divided into three groups each of them consisting of 30 cases. One group was regarded as control and two other groups as case groups. The group A (control group) received the placebo from 24 h before surgery to 24 h after surgery. The group B (case I) received placebo 24 h before surgery and medicine containing Chelledaghi herbal extract for 24 h after surgery. The group C (case II) received medicine containing Chelledaghi herbal extract which was prepared as a suppository from 24 before to 24 h after surgery for every 12 h. Then, pain severity based on VAS within different time intervals after surgery. Mitigation rate of pain after surgery, need to use sedatives, low dosage of the consumed anti-pain medicine and pain severity after surgery were all better in the groups B and C in comparison with the placebo group. Rate of complications after surgery was the same for all three groups and there was not any statistically meaningful difference in this regard. Chelledaghi herbal extract can be effectively used to mitigate pain after surgery in the selected patients without any significant side effects.
  Farshad Seyyednejad , Amirreza Rezaee , Sarvar Haghi and Mohamad Goldust
  Mucositis is a toxic side effect of anti-cancer treatments and is a major focus in cancer research. Pro-inflammatory cytokines have previously been implicated in the pathophysiology of chemotherapy-induced mucositis. The aim of this study was to detect a correlation between serum cytokine levels in head and neck (H and N) cancer patients receiving combined chemo-radiation therapy. Thirty patients with H and N epithelial cancer were recruited to this study. All patients received radiotherapy to the H and N region with doses ranging from 50-70 Gray (Gy). Chemotherapy with cisplatin, carboplatin, 5-fluorouracil and taxanes was given to high-risk patients, using standard chemotherapy protocols. Patients were evaluated for mucositis according to WHO common toxicity criteria and blood samples were drawn for inflammatory (IL-1 and TNF-a) and before and during treatment. The mucositis evaluation demonstrated mucositis grade IV in 33.3% of the patients after the 3rd treatment week. At the end of treatment, the number of patients with grade IV mucositis was less. IL-1 and TNF-α did not show any correlation with PEG tube installation. The level of cytokines measured before and during therapy showed decreased TNF-α especially after the third week of therapy. No relationship between IL-1 and TNF-α, level and mucositis grade was shown.
  Ahad Razi , Farideh Golforoushan , Amir Bahrami Shahla Babaee Nejad and Mohamad Goldust
  Many symptoms arise in thyroid diseases. The aim of this study was to evaluate the dermal symptoms in hypothyroidism and hyperthyroidism. In this cross sectional study, 120 patients with hyperthyroidism and 50 patients suffering from hypothyroidism were studied. Cutaneous, hair and nail clinical symptoms were studied and registered in a special questionnaire. Mean age of patients suffering from hypothyroidism and hyperthyroidism were 38.24±14.45 and 25.86±14.69 years old. Dry and Coarse/rough skin were the most prevalent manifestations in the skin involvement in hypothyroidism since softness was the most prevalent ones in hyperthyroidism. Fragileness was the most prevalent symptom in patients with nail involvement in hypothyroidism since soft skin was the most prevalent ones in hyperthyroidism. Coarse/rough skin was observed more in patients with hair involvement in hypothyroidism since the most prevalent ones was separation of nail from its bed in hyperthyroidism. High prevalence of skin, hair and nail symptoms in thyroid patients, early diagnosis of the signs may be helpful in premature diagnosis and treatment of thyroid diseases.
  Mohsen Sokouti , Vahid Montazeri , Ashraf Fakhrjou , Shabnam Samankan and Mohamad Goldust
  Thyroid cancer comprises a broad spectrum of diseases with variable prognoses. The aim of this study was to assess thyroid cancer in young population using the surveillance, epidemiology and end results database and whether radioactive fallout from the Chernobyl accident in 1986 influenced thyroid cancer incidence among children and adolescents in Tabriz, Iran. Patients aged 5-25 in Tabriz from April 2000 to April 2012 were studied. Using the surveillance and end results database, the study examined the overall incidence of thyroid cancer with variations based on tumor pathology, size and stage, as well as the current surgical therapy of thyroid carcinoma. This study demonstrated a positive correlation between thyroid carcinoma tumor size and stage of disease. Mortality rates were higher among men than women. Recurrence rates are also higher in men. Compared with women, men have greater likelihood of loco regional lymph node involvement and more than twice the rate of distant metastases. Operative treatment for thyroid cancer also has shifted with Radical dissection+Total thyroidectomy replacing partial thyroidectomy as the most common surgical procedure. Our data indicate that the increasing incidence of thyroid cancer cannot be accounted for fully by an increased detection of small neoplasms. This study show the increasing in thyroid cancer incidence related to exposure to radiation from the Chernobyl accident.
  Rezvanie Salehi , Jahanbakhsh Samadikhah , Rasul Azarfarin and Mohamad Goldust
  Evaluating left atrium volume is a good way to estimate prognosis in acute myocardial infarction patients because it indicates to time and severity of diastolic dysfunction and longer-term results of acute myocardial infarction. The present study aims at evaluating the effect of left atrium volume on patients’ prognosis following acute myocardial infarction. This is a cohort study conducted on 100 patients who were admitted with acute myocardial infarction. They were studied for 9 months and their one-month mortality rate was evaluated. The patients were studied considering demographic factors, risk factors, mechanical and arrhythmic complications and echocardiography indexes such as systolic and diastolic functions and left atrium volume. It was seen that mortality (27.3%, 6.22) in patients with atrium index>32 mL m-2 is more than cases with lower atrium index (1.3%, 1.78) (p = 0.001). There was not any meaningful difference in mortality rate of the patients considering age and gender (p>0.05). This study indicated to lack of any meaningful difference in patients’ mortality rate in terms of hypertension, diabetes, smoking and dyslipidemia. But, mortality rate was significantly higher in MI as a result of elevated-ST, diastolic dysfunction, restrictive pattern, ejection fraction of left atrium<40%, left atrium volume index>32 mL m-2. High volume left atrium independently refers to bad prognosis in patients with acute myocardial infarction which is confirmed with outcome clinical predictors and common echocardiography indexes even following modification.
  Masoud Nemati , Hoseingholi Nosratinia , Mohamad Goldust and Ramin Raghifar
  At present, trauma is a common problem and regarded as the third cause of mortality in different societies. Significant part of injuries resulting from trauma is due to vascular damages. Tissue ischemia associated with vascular injuries is regarded as medical emergencies which can result in irretrievable ischemia if it continues for 6 h. Therefore, early diagnosis and quick treatment of vascular injuries are of high importance. In this cross sectional study, all trauma patients referred with possible vascular injury to angiography department of Tabriz Imam Khomeini Hospital from Apr. 2011 to Apr., 2012 underwent angiography. The results were compared with the similar studies conducted in other countries. Out of all patients, angiography detected vascular injury in 75 cases consisting of 93.7% of men and 5.3% of women. Motor vehicle (93.3%) especially motorcycles accidents were the most common cause of the damages. Leg was the most common site of trauma (62.2%) and associated fracture was seen in 86.7% of cases. Also, double fracture of leg was the most common associated fracture. Anterior tibial artery (36%) and complete arterial occlusion (62.7%) were the most common injured vessel and vascular injury, respectively. Vascular injuries are more common in young men (20-30 years old) mainly resulted from blunt trauma associated with motor vehicle especially motorcycle accidents. Leg and anterior tibial artery were introduced as the most common site and injured artery, respectively.
  Rezvanie Salehi , Maryam Motemavele and Mohamad Goldust
  The present study aimed at evaluating coronary risk factors in women with definite coronary artery disease. This prospective study was conducted on 250 women with primary diagnosis of acute myocardial infarction or unstable angina. The patients were selected randomly using interview and registering the related risk factors. The primary diagnosis included 11.5% of myocardial infarction and 88.5% of unstable angina. All patients had risk factors. Diabetes was seen in 38.5%, hypertension in 78%, smoking in 27%, cholesterol >150 mg in 98%, consumption of oral contraceptive in 57%, family history in 28% and limited physical activity in 2.6% of the patients. Body mass index of 59.6% of the patients was equal to or more than 27 kg m-2. Also, 66.7% of the patients were post menopausal and history of premature hysterectomy was seen in 9.6% of the patients. There were 3 or more risk factors of coronary artery disease in most patients. Considering the known risk factors in women, dyslipidemia, premature menopause, hypertension, oral contraceptives, diabetes and smoking were regarded as the most common ones.
  Zahra Fardiazar , Iraj Derakhshan , Reza Torab , Amir Vahedi and Mohamad Goldust
  In this study maternal and neonatal outcome evaluated in each trimester of pregnancies with non obstetric laparotomies. In this descriptive-analytic study, 100 pregnant women operated during pregnancy were evaluated. Based on available data a questionnaire comprising general information, kind of surgery as well as the maternal-neonatal outcome was fulfilled. These outcomes were compared in the different gestational ages. In this study, 28 (28%), 48 (48%) and 24 (24%) patients had been operated in the first, second and third trimester, respectively. The patients of these three groups were matched for general characters. Sixty one patients had appendectomy, 30 adnexal mass or torsion, 6% cholecystectomy, 3% abdominal mass. Maternal complications were recorded in 6, 3 and 9% patient in 3rd, 2nd and 1st trimester of pregnancy, respectively. Abortion in first trimester was 8.2%. Low apgar in fifth minute and asphyxia were higher in third trimester. Appendectomy was the most common surgery in the pregnancy. Maternal and fetal complications were higher in third and first trimester. Besides obstetric and pediatric consultation before surgery are necessary for optimal safety of the woman and the fetus.
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