@article{ author = {MODARESGILANI, MITRA and HASANZADEH, MALIHE and BEHTASH, NADEREH}, title = {VULVAR CARCINOMA IN PREGNANCY: A CASE REPORT}, abstract ={  ABSTRACT Carcinoma of the vulva has commonly been recognized as a disease of postmenopausal women, but some cases have been reported in young women during pregnancy. Medical records were reviewed for a patient with vulvar carcinoma diagnosed in pregnancy. Using Medline and cross references, pertinent articles were sought and reviewed. A 28-year-old Afghan woman in her sixth pregnancy presented with a vulvar lesion. Subsequent biopsy revealed squamous cell carcinoma. The patient was treated with local excision. She had a cesarean section in her 36'h week of pregnancy. She undetwent modified radical vulvectomy with bilateral groin dissection four weeks after ce arean. Because of a grossly positive groin lymph node, she also unde1went radiation therapy. She is alive without invasive cancer 7 months after diagnosis. This case demonstrates the need to biopsy all suspicious vulvar lesions, even in young and pregnant women.}, Keywords = {Vulvar carcinoma. pregnancy, squamous cell carcinoma of vulva.}, volume = {19}, Number = {2}, pages = {185-187}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-513-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-513-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2005} } @article{ author = {NAKHJAVANI, F.A. and BONAKDARHASHEMI, F. and KALANi, M.T. and KAZEMI, B. and NOURI, K. and AZADI, N. and HAGHIASHTIANI, M. and ALIGHOLI, M. and ERFANI, U. and ABEDINI, M.}, title = {DETECTION OF HAEMOPHILUS INFLUENZAE TYPE B IN CEREBROSPINAL FLUID OF SUSPECTED CHILDREN WITH MENINGITIS BYPCR}, abstract ={ ABSTRACT Background: A polymerase chain reaction (PCR) assay with primers from "hpd" gene was compared with culture for the detection of Haemophilus influenzae type b (Hib) in CSF samples from children suspected of meningitis. Methods: 300 cerebrospinal fluid (CSF) samples from suspected meningitis cases were studied by culture (Leventhal ; Chocolate Agar) and PCR. Results: The latter method could detect Hib in all 5 culture positive and in 2 of 295 culture negative cases, showing sensitivity, specificity, and an accuracy index of 100%, 99% and 99%, respectively. The PCR result was available within a day. Conclusion: This study has shown that PCR is a rapid, sensitive, and specific diagnostic test for Hib from CSF samples. Futthermore, to maximize management of meningitis cases to reduce the morbidity, mortality, and complications of invasive Hib infection a combination of culture and PCR is necessary for the detection ofHib infection. The incidence ofHib meningitis among children in Children's Medical Center in Tehran based on culture and PCR results were 2.4% and 1.7% respectively. Based on culture results, Hib causes 15.6% of all cases ofbacte1ial meningitis in children. }, Keywords = {Haemophilus influenzae type b; Meningitis: PCR; culture; CSF; Iran; Incidence.}, volume = {19}, Number = {2}, pages = {181-184}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-512-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-512-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2005} } @article{ author = {NAJARPEERAYEH, SHAHIN and MIRDAMADI, ROOHOLLAH}, title = {COMPARISON OF CULTURE WITH POLYMERASE CHAIN REACTION FOR DETECTION OF UREAPLASMA UREALYTICUM IN ENDOCERVICAL SPECIMENS}, abstract ={Background: Ureaplasma urealyticum is known as a sexually transmitted agent, causing mainly urethritis, pelvic int1ammatory disease, spontaneous abortion, pyelonephritis, infertility, stillbirth, low birth weight neonatal meningititis, and neonatal pneumonia. U. urealyticum infections not only jeopardize fertility but also pose a risk for infertility treatment and resulting pregnancies. Diagnosis of U. urealyticul7I infections by bacterial conventional methods is very difficult The aim of this study was to compare culture with polymerase chain reaction (PCR) to determine the prevalence of U. urealyticum in endocervical specimens from infertile women. Methods: 312 endocervical swab samples were taken from infel1ile women, and transpOJ1ed with mycoplasma transpol1 media. The culture was done with liquid-solid methods. DNA was extracted by Cadieux method, and analyzed by PCR protocol with species-specific U4;US primers. Results: U. urealyticum was detected in 26.2% (82/312) of specimens by both culture and PCR methods. 12.5% (39/312) of samples were PCR positive as well as culture positive, 11.2% (351312) were positive only by PCR,and2.S%(8/312) were positive only by culture. Conclusion: A sensitivity of 90% and 57% was found for PCR and culture respectively, PCR is therefore sensitive and more rapid «24 hour) than culture (2-5 days) for the detection of U. urealyticum in endocervical secretions.}, Keywords = { Urealasma, urealyticm, Infertility, PCR. mycoplasma, genitourinary tract diseases}, volume = {19}, Number = {2}, pages = {175-179}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-511-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-511-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2005} } @article{ author = {SAFARI, MOHAMMAD-REZA and REZAEI, MOHSEN and TAHERKHANI, HESHMATOLLAH}, title = {EFFECTS OF UBIQUINOL-1 0 AND f3-CAROTENE ON THE IN VITRO SUSCEPTIBILITY OF LOW-DENSITY LIPOPROTEIN TO COPPER-INDUCED OXIDATION}, abstract ={ ABSTRACT Background: Dietary antioxidant intake has been reported to be inversely associated with coronary miery disease. To clarify the possible role oflipophilic antioxidants in the prevention of atherosclerosis, we investigated the effects ofubiquinol-1 0 and ~-carotene on the susceptibility oflow-density lipoprotein(LD L) to oxidative modification. Methods: In this study, first "ubiquinol-1 0 and ~-carotene" were added to plasma and incubated for 3hr at 37°C. Then, the LDL fraction was separated by ultracentrifugation. The oxidizability ofLDL was estimated by measuring conjugated diene (CD), lipid peroxides and thiobarbituric acid-reactive substances (TBARS) after cupric sulfate solution was added. Results: We showed that ubiquinone-! 0 and ~-carotene significantly (p ~-carotene. Conclusion: LDL exposed to the lipophilic antioxidants in vitro reduced oxidizability. These findings suggest that ubiquinol-1 0 and ~-carotene have a role in ameliorating atherosclerosis. }, Keywords = {LDL, Oxidation, Atherosclerosis, Ubiquinol -1 0,β -Carotene .}, volume = {19}, Number = {2}, pages = {169-174}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-510-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-510-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2005} } @article{ author = {MOOSAVI, AZAM SADAT and TEHRANIAN, AFSANEH and BEHTASH, NADEREH and MODARESGILANI, MITRA and GHAEM-MAGHAMI, FATEMEH}, title = {LONG TERM ORAL ETOPOSIDE AS SECOND-LINE THERAPY IN RECURRENT EPITHELIAL CARCINOMA OF THE OVARY}, abstract ={Background: The activity and toxicity of etoposide in women with recurrent ovarian cancer was evaluated in a case series of women with recurrent ovarian cancer who had measurable disease, Methods: All patients had plior platinum-based chemotherapy and developed progressive disease, Etoposide was given as 50mg/day for 21 days every 4 weeks until progression of disease or prohibitive toxicity, Between December 1999 and January 2004,32 patients were enrolled in this study. Results: 30 patients received a total of 133 cycles of etoposide. Median age was 49 years (range, 19 to 75). The median number of etoposide cycles was 4 (range, 1 to 12). There were 5 partial responses (16.6%). The mean response duration was 4.8 months (range, 3.5 to 6). median progression-free interval CPFI) was 7 months (range, 3 to 13), and median survival time was 12.5 months (range. 1.3 to 36). Conclusion: The major toxicity was leukopenia. One patient required red blood cell transfusions, and the main non-hematologic toxicity was nausea and vomiting. There were no treatment-related mortalities. Although etoposide appears to exhibit modest activity in recurrent ovarian cancer after platinum-based therapy, response and survival durations are short.}, Keywords = {Oral etoposide, recurrent epithelial ovarian cancer, second-line chemotherapy}, volume = {19}, Number = {2}, pages = {159-164}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-1602-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-1602-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2005} } @article{ author = {PARSANEZHAD, MOHAMMAD EBRAHIM and PAKNIAT, MAHNAZ and ALBORZI, SAEED and SCHMIDT, ERNST HEINRICH}, title = {A DOUBLE BLIND, RANDOMIZED, PLACEBO CONTROLLED STUDY TO ASSESS THE EFFICACY OF KETOCONAZOLE FOR REDUCING THE RISK OF OVARIAN HYPERSTIMULATION SYNDROME}, abstract ={ ABSTRACT Background: In order to evaluate the role ofketoconazole in the prevention of ovarian hyperstimulation syndrome (OHSS) in women with polycystic ovary syndrome (PCOS) undergoing ovarian stimulation with gonadotropins, a prospective, randomized, double-blind, placebo controlled study was done on one-hundred and nine PCOS women that had been refeiTed to be treated by gonadotropins. Methods: Alll09 women were assigned for random allocation. Group A (50 patients) received two ampoules ofhMG beginning on day 2 or 3 of the cycle and ketoconazole (50 mg/every 48 hours) starting on the first day ofhMG treatment. Group B (51 patients) received the same protocol ofhMG combined with one tablet of placebo every 48 hours. Main outcome measures were follicular development, E2levels, and pregnancy rate. Results: The total number ofhMG ampoules and duration oftreatment to attain ovarian stimulation was higher in group A (p<O.OOO 1 ). Serum E2level and number of patients with dominant follicles on day 9 of the cycle were higher in group B (p<O.OOO 1 ). There was no significant difference between semm E2level and total number of follicles at the time ofhCG administration in the two groups. The cancellation rate and OHSS rate were similar in the two groups. Conclusion: Ketoconazole has no effect in prevention of OHSS in PCOS patients undergoing ovarian stimulation. It may however reduce the rate of folliculogenesis and steroidogenesis. }, Keywords = {Polycystic ovary syndrome. ovarian hyperstimulation syndrome, ketoconazole.}, volume = {19}, Number = {2}, pages = {153-158}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-509-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-509-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2005} } @article{ author = {ZANDIEH, TAHEREH and COHAN, NADER and SAMIEI, SHAHRAM and AMINI, SEDIEGHEH and ATAEI, ZAHRA and KAVARI, MAHNAZ}, title = {CHARACTERISTICS AND PREVALENCE OF OCCULT HEPATITIS B VIRUS INFECTION IN PATIENTS WITH HEPATITIS C IN IRAN}, abstract ={ ABSTRACT Background: Hepatitis B virus (HBV) infection in patients who lack detectable hepatitis B surface antigen (HBsAg) is called occult hepatitis B infection. Such infections have been frequently identified in patients with chronic hepatitis Cliver disease, but their prevalence is not known. Methods: 207 patients with chronic hepatitis C who were HCV -RNA and antiHCV positive were studied for HBV-DNA by PCR, and for HBsAg and anti-HBc by ELISA. DNA was extracted by high pure nucleic acid kit (Roche-Germany). HBVDNA amplification was done with a set of primer directed to the pre-S region. HBsAg and anti-HBc were evaluated by a commercially available ELISA kit (Dade Behring). Results: 23 of 207 patients with chronic hepatitis Cliver disease ( 11.1%) were positive for HBV-DNA (co-infection). Among this group 17 patients (8.2%) were HBsAg negative (occult infection). 8 of 17 patients with occult infection ( 4 7%) were anti-HBc positive and 9 were anti-HBc negative (53%). No significant difference was found in epidemiological and biochemical parameters in patients with HCV alone in comparison with HCV co-infected with occult hepatitis B (p= 0.453 for ALT and p= 0.498 for AST). Conclusion: Occult hepatitis B virus infections occur frequently in patients with chronic hepatitis Cliver disease and may have clinical significance. }, Keywords = {Occult hepatitis B. Surface antigen, chronic hepatitis C, PCR.}, volume = {19}, Number = {2}, pages = {147-151}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-508-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-508-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2005} } @article{ author = {HOOSHMAND, B. and GOODARZI, M.T. and OURAI, F. and SAFARI, M.R. and AMIRI, S.}, title = {ADVANCED GLYCATION END PRODUCTS AND ThiOBARBITURIC ACID REACTIVE SUBSTANCE IN GINGIVAL TISSUES OF DIABETIC AND NON-DIABETIC PATIENTS WITH CHRONIC PERIODONTITIS}, abstract ={ ABSTRACT Background: Production of advanced glycation end products (AGEs) is directly linked to the level and duration of hyperglycemia in diabetic patients. Oxidative stress plays a major role in the pathogenesis of diabetes mellitus. Free radicals are f01med in diabetes by glucose oxidation, nonenzymatic glycation of proteins and subsequent oxidative degradation of glycated proteins. Thiobarbitwic acid reactive substance (TBARs) is a factor evidence in the presence of oxidative stress as a potential mechanism underlying periodontal disease associated with diabetes. Methods: ll subjects (mean age 38.9 years, 6M, SF) with chronic periodontitis associated with diabetes (5 Type I, 6 Type II) and 16 subjects (mean age 36.7 years, 7M, 6F) with chronic periodontitis as a matched control group participated in this study. Clinical attachment loss and bleeding on probing were determined in all subjects during clinical examination. FBS and HbAlc were measured in all subjects. Sections of gingival ti sue of all patients were removed dUiing periodontal surge1y. AGEs and TBARS were measured in all removed gingival tissues. The statistical analysis was carried out using T-test, Mann-Whitney U-test and Spearman correlation coefficient. Results: FBS in diabeti c and non-di abetic patients was 155.0 ± 82.0 and 87.4± I 0.6 mg/dL respectively and the difference between the two groups was statistica lly significant (p= 0.03 ). There was also a significant eli fferenee in HbA lc between the two studied groups (5±0.04 and9.1± 1.03%) in diabetic and non-diabetic subjects respectively, (p= 0.000). A higher level ofTBARs was observed in diabetic patients compared to non-diabetics ( 1.13±0.3 vs 0.05±0.01 mole/lit p= 0.00 I ). Clinical attachment loss also was higher in diabetic patient (p= 0.008). Conclusion: From the results of this study it can be concluded that oxidative stress plays a major role in the development of pe1iodontitis in diabetic patients.}, Keywords = {Diabetes. Periodontitis. Advanced glyca1ion end produc1s (AGE). Thiobarblluric acid reactive substance (TBARS).}, volume = {19}, Number = {2}, pages = {141-145}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-438-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-438-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2005} } @article{ author = {SAKHA, K. and BEHBAHAN, A.G.G.}, title = {THE ONSET TIME OF LACTATION AFTER DELIVERY}, abstract ={ ABSTRACT Background: As any delay in the onset of milk production and ejection in the first few days after delivery can cause breast-feeding failure, this study has been done to determine factors that may affect the onset time of lactation in vaginal and cesarean section deliveries with and without labor pain (elective). Methods: 300 partUJient mothers selected from two private and university hospitals were divided in three separate groups (each consisted of 100 cases) according to their delivery type [vaginal and cesarean section with and without pain (elective)]. Interfering factors like mothers' ornewboms' illnesses were omitted, the needed infom1ation about filling ofbreasts and milk ejection was given to mothers before partw·ition, then a questionnaire was provided and offered to them, data collected and statistical analysis cruTied out. Results: There was a meaningful difference between average time of milk-ejection in groups with different types of delivery (p= 0.00 I), but no difference was found between elective cesarean section and cesarean section with labor pain (p= 0.741 ). We found that milk-ejection time has a strong COITelation with type of delivery (r= O.SlO) and also the time of taking the neonate back to mother (r = 0.256), and this correlation is statistically meaningful (p= 0.000). Conclusion: Any kind of stress including cesarean section may postpone milk ~jection by hmmonal inhibition for a few days after delivery and this will result in newborn weight loss and fai lure of nursing by the mother. So, to support breast feeding in our country, the rate of cesarean section must be wisely diminished, vaginal delivery encouraged, and after deli very every newborn taken back to his or her mother as soon as possible for nursing.}, Keywords = {Lactation, Vaginal de li very. Cesarean deli very.}, volume = {19}, Number = {2}, pages = {135-139}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-437-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-437-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2005} } @article{ author = {AKHONDIAN, JAVAD and POURAKBAR, ALI}, title = {SIMILARITY BETWEEN FIRST SEIZURE AND RECURRENT SEIZURES IN CHILDREN}, abstract ={ ABSTRACT Background: The efficacy of anticonvulsants after a first seizure is uncertain the more predictable the time and the type of recunent seizure, the more preventable the probable events. This study was conducted to evaluate sirnilmity of type and time of a first seizure and its recutTence in children. Methods: 174 children with at least two separate seizures were taken into account. Results: Overall in 90.5% the sleep-wake state at the second seizure was the same as the first one, while the seizure type was consistent from the first seizure to the second with 95.9% being the same. Conclusion: This infonnation should be helpful in 1) counseling parents after their child has had a first seizure, and 2) in answering the question whether treatment should be started in a child presenting with a first epi Ieptic seizure.}, Keywords = {Seizure, RecmTence, chi ldren.}, volume = {19}, Number = {2}, pages = {131-134}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-436-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-436-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2005} } @article{ author = {DAVARITANHA, FATEMEH and SARDARI, FARIBA and EFTEKHAR, ZAHRA and KAVEH, MAHBOD and IZADYMOOD, NARGESS}, title = {PREDICTING THE RISK OF PRETERM LABOR BY SECOND TRIMESTER MEASUREMENT OF MATERNAL a-FETOPROTEIN LEVELS AND A RISK FACTOR SCORING SYSTEM}, abstract ={ ABSTRACT Background: Preterm labor (delivery after 20 weeks and before 37 weeks of gestation) is the leading cause of prenatal mortality in developed countries. Many women who have pre term labor have abnom1ally high plasma levels of a-fetoprotein in early pregnancy. Methods: This study was designed to evaluate the ability of this biochemical test and a clinical risk factor scoring system to prospectively discriminate pregnancies at high risk for preterm delivery. In nested case control study six~hundred women were studied prospectively from the early second trimester until delivery. There were sixty women in the study group (those with preterm delivery) and sixty women in the control group (those with term delivery). A plasma level sample was collected during the second trimester, between 17 and 30 week's gestation. Then a-fetoprotein was determined in both groups. Results: The mean AFP level was 196.75± 151.48 IU/mL in the study group and 85.98±55.90 IU/mL in the control group, both of which were statistically significant (p<O.OO 1). The mean infants age was 33.11±3.40 weeks in the study group and 38.83±0.86 weeks in the control group (p<O.OOl) and mean of birth weight was 1988±672.33 grin the study group and 3241 .50±405.98 grin the control group (p 10 in 17% of women in the study group and in 8% of women in the control group. The sensitivity, specificity, PPV and NPV of this test was 78%, 65%,69.10 and 75% respectively. The accuracy of the test, LR+ and LR- were 71%,2.24 and 0.333 respectively. Conclusion: The combination of measurement ofmatemal serum AFP in the second trimester associated with a risk factor scoring system provides a more accurate indicator ofthe1iskofpretenndeliveryand therefore may be of use in targeting prevention strategies.}, Keywords = {a-fetoprotein, prematurity, pretenn deli very}, volume = {19}, Number = {2}, pages = {127-130}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-435-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-435-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2005} } @article{ author = {KHASHABI, J. and SALARILAK, S. and KARAMIYAR, M. and MUSSAVI, H.}, title = {COMPARISION OF THE EFFICACY OF NEBULIZED L-EPINEPHRINE, SALBUTAMOLAND NORMAL SALINE IN ACUTE BRONCHIOLITIS: A RANDOMIZED CLINICAL TRIAL}, abstract ={ ABSTRACT Background: Acute bronchiolitis is the most common form of lower respiratory tract infection in infancy. There are numerous contradictory reports regarding the efficacy of nebulized bronchodilators in the management of infants with acute bronchiolitis. This study was designed to compare the efficacy of nebulized epinephrine with salbutamol for treatment of the disease. Methods: In a randomized clinical trial, 72 infants with moderately severe bronchiolitis were enrolled in three equal groups. Three doses of epinephrine, salbutamol, and normal saline as a placebo nebulized with oxygen were given at 20 minute intervals. Oxygen saturation, respiratory rate and distress were recorded before intervention and I0 minutes after each dose of the drugs. Results: At the end of the study, pre- and post-treatment mean oxygen saturation values, clinical scores and respiratory rates showed significant differences between the epinephrine and salbutamol groups in comparison with the placebo group. The results were more significant in the epinephrine group than other groups. After the treatment course 66%, 50%, and 25% of patients in epinephrine, salbutamol, and placebo groups respectively showed significant improvement at a degree that they could be sent home. No serious side effects were observed. Conclusion: Both nebulized epinephrine and salbutamol improved oxygenation and decreased respiratory distress better than normal saline. L-epinephrim was more effective in relieving respiratory distress and improving oxygen saturation as well as the need for hospitalization than nebulized salbutamol.}, Keywords = {Epinephrine, Salbutamol, Bronchiolitis, Clinical trials, Infants.}, volume = {19}, Number = {2}, pages = {119-125}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-434-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-434-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2005} } @article{ author = {REZAIE-YAZDI, Z. and FORGHANIZADEH, J. and REZAIE, J. and SALEHIAN, P. and MANSOURITORGHABEH, H.}, title = {COMBINATION THERAPY WITH PULSE CYCLOPHOSPHAMIDE PLUS CORTICOSTEROIDS IMPROVES RENAL OUTCOME IN PATIENTS WITH LUPUS NEPHRITIS}, abstract ={ ABSTRACT Background: The prognosis of SLE is int1uenced by the onset of glomerulonephtitis. Clinical ttials in lupus nephritis have demonstrated that cyclophosphamide therapy is the superior regimen in the management oflupus nephritis for preserving renal function. Objective: The purpose of this study is to define the outcome of renal function with bolus pu lses of cyclophosphamide and steroid according to our protocol and also to determine an appropriate pattern of treatment of lupus nephritis. Methods: In this open-label clinical triaL to evaluate the results, the short-term prognosis and the rate of complications of an immunosuppressive regimen with corticosteroids and cyclophosphamide, twenty-five patients with biopsy-proven lupus nephritis were studied. Treatment was structured in 4 phases: I) Induction with bolus methylprednisolone and cyclophosphamide. 2) Maintenance with oral prednisolone for 4 weeks and monthly cyclophosphamide pulses for 6 months. 3) Tapeting with reduction of prednisolone by 10% each month and continuing cyclophosphamide every other month till one year and for the second year every 3 months. 4) Discontinuation with oral prednisolone slowly tapered to the least effective daily dose and cyclophosphamide discontinued after 2 yr of therapy. We defined primary outcome measures according to these criteria: renal function return to normal limits or become stable, regression of systemic and local inflammatory symptoms. urine protein excretion h1lling below 0.3 gr/ elL or by at least SOo/c. RBC cast disappearance, C3, C4, Hb, and ESR return to notmallimits. Result: Twenty-three patients wi th lupus nephritis completed our therapeutic protocol. Renal biopsy was perfonned in 22 cases and indicated type IV in 20 patients (95.2%), and type V in 2 patients. After an average of 4+ 1.95 months 22 patients achieved remission (95.65%) and only one case remained non-responsive. She became pregnant in her fourth month of therapy. Significant statistical differences were achieved between creatinine, proteinuria, hematuria, leukocyturia, urinary cast, C3, C4, ESR, and Hb before and after therapy (p<0.05). Plasma creatinine fell from 1 .44+0.95 mg/dL to 0.97+0. 78 (p<0.004). Proteinuria fell from 1879.78+ 1854.46 to 408.34+572.92 mg/24h (p<O.OO1). Thirteen episode of relapses were treated again with repeated cycles of cyclophosphamide and all remitted again. Conclusion: Intensive immunosuppression with steroid and cyclophosphamide provides excellent results with an acceptable rate of complications in the treatment of lupus nephritis.}, Keywords = {Lupus nephriti s-Cyc lophosphamide- Glomerulonephritis.}, volume = {19}, Number = {2}, pages = {109-117}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-433-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-433-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2005} } @article{ author = {BEIGI, ABOUTALEB and ZARRINKOUB, FARIBA}, title = {ELECTIVE VERSUS ULTRASOUND –INDICATED CERVICAL CERCLAGE IN WOMEN AT RISK FOR CERVICAL INCOMPETENCE}, abstract ={ ABSTRACT Background: To compare pregnancy outcomes in women at risk for cervical incompetence after elective versus ultrasound- indicated cerclage. Methods: In a prospective randomized tlial, singleton pregnancies with at least one previous spontaneous midtrimester loss or early preterm delivery (between 15 and 32 weeks' gestation) who met clinical crite1ia for the diagnosis of cervical incompetence were allocated to receive either an elective cerclage (elective cerclage group) or serial transvaginal cervical sonography at rest and after trans fundal pressure every 2 weeks between 14 and 24 weeks'gestation, with cerclage only if indicated by cervical shortening (transvaginal sonography group). The Mann-Whitney U test, Chi- square and Fisher exact test were used for analysis of the data. Results: A total of97 patients were identified. Forty-five received elective cerclage and 52 were followed up with transvaginal sonography, of which 53.8% (28/52) required a cervical cerclage because of cervical changes. There were no significant differences in demographic characteristics and risk factors for cervical incompetence. The median gestational age at delivery [38 (range 17- 40) vs. 38 (range 19-40)weeks p= 0.90], the early losses before 25 weeks' gestation (8.8% vs. 9.6% p= 0.70) and preterm deliveries before 37 weeks'(20% vs. 25%p= 0.50) were similar in the elective cerclage group and transvaginal sonography group respectively. Conclusion: In women at risk for cervical incompetence, serial transvaginal cervical sonography, with cerclage only if indicated by cervical shortening, appears to be a safe a! ternati ve to traditional elective cerclage.}, Keywords = {Cervical incompetence, Cerclage. Transvaginal Sonography, Preterm birth.}, volume = {19}, Number = {2}, pages = {103-107}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-432-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-432-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2005} } @article{ author = {EBRAHIMI, ISMAEIL and SHAHHOSSEINI, GHOLAM REZA and FARAHINI, HOSSEIN and ARAB, AMIR MASSOUD}, title = {CLINICAL TRUNK MUSCLE ENDURANCE TESTS IN SUBJECTS WITH AND WITHOUT LOW BACK PAIN}, abstract ={ ABSTRACT Study design: A cross-sectional non-experimental study. Objectives: To collectively detect the reliability and feasibility of the five types of clinical tests that have been used to measure endurance of the trunk muscles in subjects with and without low back pain (LBP) and identifY the sensitivity of each test to predict the probability of the occurrence ofLBP. Background: Testing spinal muscle endurance seems to be very important in prediction, prevention and rehabilitation ofLBP. Several types of methods of static endurance testing such as: Sorensen test, prone isometric chest raise test, prone double straight-leg raise test, supine isometric chest raise test and supine double straight-leg raise test regarding their utilization have been reported in the literature. However, identification ofthe tests that have more dominant sensitivity on assessment ofLBP has not yet been determined. Information regarding the sensitivity of each test is needed for effective prevention and appropriate treatment strategies. Methods: A total of200 subjects pmiicipated in this study. Subjects were categorized into four groups: asymptomatic males (N= 50, mean age= 38+ 12 years), asymptomatic females (N= 50, mean age= 43+ 11 years), males with LBP (N= 50, mean age= 39+ 12 years), and females with LBP (N= 50, mean age= 43+ 12 years). Five clinical tests were measured in each group and the relative association of each test on LBP was assessed. Results: Among all the performed tests, the prone double straight-leg raise test had the highest association with LBP. Other tests such as the prone isometric chest raise test, Supine isometric chest raise test and Supine double straight-leg raise test had low association with LBP in comparison with the prone double straight-leg raise test. Conclusion: It seems that the prone double straight-leg raise test has more association with LBP than other tests and could be used as a useful method for testing spinal muscle endurance, prediction of the probability of the occurrence of LBP, and prevention and rehabilitation of LBP.}, Keywords = {Muscle endurance. Low back pain, Test.}, volume = {19}, Number = {2}, pages = {95-101}, publisher = {Iran University of Medical Sciences}, url = {http://mjiri.iums.ac.ir/article-1-431-en.html}, eprint = {http://mjiri.iums.ac.ir/article-1-431-en.pdf}, journal = {Medical Journal of The Islamic Republic of Iran (MJIRI)}, issn = {1016-1430}, eissn = {2251-6840}, year = {2005} }