@article{ author = {Jabbari, Ali and Alijanpour, Ebrahim and AmriMaleh, Parvize and Heidari, Behz}, title = {Lung protection strategy as an effective treatment in acute respiratory distress syndrome}, abstract ={Lung protection strategy as an effective treatment in acute respiratory distress syndrome}, Keywords = {}, volume = {4}, Number = {1}, pages = {560-563}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-184-en.html}, eprint = {http://caspjim.com/article-1-184-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Fallahi, Sasan and Rostamian, Abdolrahman and Khalvat, Ali and Khazaeipour, Zahra and Shahbazi, Fatemeh}, title = {Depicting and comparing the time to normalize "erythrocyte sedimentation rate" following two combination therapies in rheumatoid arthritis patients: a randomized clinical trial}, abstract ={Background: Erythrocyte sedimentation rate (ESR) is one of the predictors of improvement in handling rheumatoid arthritis. This study was designed to define and compare the time of achieving normal ESR and also the percentage for the normalization of this marker at several points of time in two different combination therapies.Methods: Fifty-two rheumatoid arthritis patients randomly received methotrexate, chloroquine, prednisolone (MCP) or azathioprine, chloroquine, prednisolone (ACP) and all were followed up for 34 weeks. Chloroquine and azathioprine were given, 150 mg/d and 2 mg/kg/d, respectively. Methotrexate was given, 0.2 mg/kg/week and simultaneously increased 2.5 mg monthly if no clinical response was seen. Prednisolone was started, 0.3 mg/kg/d and tapered after one week. ESR at baseline and during follow-up were checked. The data were collected and analyzed. This clinical trial was registered in the Iranian Registry of Clinical Trials (www.irct.ir) with registration number ID: 2012110611383N1.Results: The percentages of obtaining normal ESR after 2nd, 4th, 6th, 8th, 18th, 34th weeks of follow up were 42.4%, 53.9%, 57.7%, 65.4%, 88.5%, 96.2% in the MCP group and 47.9%, 65.3%, 74%, 78.3%, 82.7%, 87% in the ACP group. The mean time of obtaining normal ESR was 9.15 (95%CI, 5.58 to 12.73) weeks in MCP group and 9.04 (4.04 to 14.05) weeks in the ACP group (p>0.05). Conclusion: The results show that the time to achieve normal ESR and percentage of its normalization were almost the same in both treated groups.}, Keywords = {Rheumatoid arthritis, Inflammation, Methotrexate, Azathioprine, Prednisolone}, volume = {4}, Number = {1}, pages = {564-568}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-185-en.html}, eprint = {http://caspjim.com/article-1-185-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Alaoddolehei, Haydeh and Samiei, Haydeh and Sadighian, Farahnaz and Kalantari, Narges}, title = {Efficacy of daily versus intermittent administration of iron supplementation in anemia or blood indices during pregnancy}, abstract ={Background: Pregnant women take iron supplements in order to prevent iron deficiency anemia which may have undesirable effects for both the mother and fetus. This study aimed to compare the daily and intermittent dose of iron supplementation in blood and iron indices in healthy pregnant women.Methods: In this clinical trial study, 145 healthy pregnant women were selected with Hb;#880511g%. The participants were randomly divided into two groups. Group 1 received daily iron supplement at 50 mg/day and group 2 received an intermittent dose of 3 times per week. Blood samples were assessed for complete blood count (Hb, Hct, RBC), iron, ferritin and zinc at baseline in the first trimester in all participants and the two groups were compared in regard to mean changes from baseline to the end of the study period in the third trimester. This clinical trial was registered in the Iranian Registry of Clinical Trials (www.irct.ir) with registration number ID: 2012082810682N1. Results: The incidence of iron deficiency anemia was 2.7% in both groups. The mean levels of Hb, Hct and RBC in the first trimester were 13.3 g/dl, 39.4% and 4.5 mil/ml3, respectively. At the end of the study, Hb, Hct, and RBC reduced significantly in both groups compared with baseline values (p<0.05). The difference from baseline in Hb and other blood indices did not differ significantly across the two groups.Conclusion: These findings indicate that daily or intermittent administration of iron supplement to pregnant women has the same outcome. Regarding the side effects of iron in pregnancy, intermittent method seems preferable to daily intake.}, Keywords = {Iron deficiency, Ferritin, Zinc, Pregnancy, Iron supplement}, volume = {4}, Number = {1}, pages = {569-573}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-186-en.html}, eprint = {http://caspjim.com/article-1-186-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Akinbami, Akinsegun and Popoola, Abiodun and Adediran, Adewumi and Dosunmu, Adedoyin and Oshinaike, Olajumoke and Adebola, Philip and Ajibola, Sarah}, title = {Full blood count pattern of pre-chemotherapy breast cancer patients in Lagos, Nigeria}, abstract ={Background: Full blood count has been shown to predict disease severity and mortality risk in cancer patients. This study aimed to highlight the degree of derangements of full blood count parameters and provide mean values in pre-chemotherapy breast cancer patients compared with apparently normal control subjects.Methods: This was an unmatched case-control study among breast cancer patients attending Oncology clinic of Lagos State University Teaching Hospital, Ikeja and the nurses of the institution as control. A total of 4.5 mls of blood was collected from each participant into EDTA bottle for full blood count analysis, done on the same day of collection. Results: A total of 100 histologically diagnosed, consenting, pre-chemotherapy patients of the clinic (cases) and 50 nurses of the institution as controls were studied. Anemia was found in 58%, 43% and 20% of cases compared with 38%, 36% and 2% of controls using PCV< 36%, 30-36% and 30%, respectively. The mean MCV, MCH, MCHC (82.62±7.48 fl, 26.01±2.78 pg, 30.73±4.06 g/l respectively) of cases were lower than the controls (85.36±5.74 fl, 27.24±1.90 pg, 31.81±0.8 g/l, respectively and RDW of cases (15.61±3.53) was higher than the control (14.24±0.75). The mean WBC counts, neutrophil and lymphocyte percentages of cases (6.96±7.22, 54.75±13.1% and 38.19±12.70%, respectively) were higher than the controls (5.47±1.57, 44.39±8.78% and 8.82±15.97%, respectively). The mean platelet count of cases 291.51±103.38 was also higher than the controls (222.82±57.62).Conclusion: Breast cancer patients presented with deranged full blood count pattern, consequent to the disease compared with the controls.}, Keywords = {Full blood count, Pre-chemotherapy, Breast cancer}, volume = {4}, Number = {1}, pages = {574-576}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-187-en.html}, eprint = {http://caspjim.com/article-1-187-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Veghari, Gholamreza and Sedaghat, Mehdi and Maghsodlo, Siavash and Banihashem, Samieh and Moharloei, Pooneh and Angizeh, Abdolhamid and Tazik, Ebrahim and Moghaddami, Abbas}, title = {Impact of literacy on the prevalence, awareness, treatment and control of hypertension in adults in Golestan Province (northern Iran)}, abstract ={Background Hypertension is considered as a major health problem in our society. The association between educational level with hypertension and its control in the Golestan Province (northern Iran) were the main objectives of this study.Methods: This was a population-based cross-sectional study that enrolled 3497 subjects aged 15-65 years using stratified and cluster sampling. The interviewers recorded the data using a multidimensional questionnaire, including blood pressure level. Blood pressure was measured three times with 5 minutes interval and defined based on Join National Committee (JNC-7). Results: Totally, 741 (21.2 %) cases suffered from hypertension and illiterate people were significantly more aware of their disease (p=0.011). In the aware group, 435 (89.6%) cases used one method to control their disease and it was not statistically significant as far as educational levels was concerned. The control of hypertension was significantly greater in college educated group than the illiterate one (32.4% vs 68.8%) (p=0.001). Logistic regression analysis revealed that illiteracy is a risk factor for hypertension (p<0.001). Conclusion: In spite of awareness in the illiterate people was high, the rate of hypertension control was low in this group. Prevention, detection, treatment, and control of hypertension especially the illiterate people should be given high priority.}, Keywords = {Literacy, Awareness, Control, Treatment, Hypertension, Iran}, volume = {4}, Number = {1}, pages = {580-584}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-188-en.html}, eprint = {http://caspjim.com/article-1-188-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {KhosoosiNiaki, Mohammad Reza and Mahdizadeh, Hamid and Farshidi, Fatemeh and Mohammadpour, Mehdi and TaghiSalehiOmran, Mohamm}, title = {Evaluation of the role of opium addiction in acute myocardial infarction as a risk factor}, abstract ={Background: More than half of myocardial infracted (MI) patients have no conventional risk factors. Regarding the belief that opium addiction has a protective effect on heart diseases, addiction prevalence has unfortunately increased in recent years. This study was conducted to investigate the effect of opium addiction on patients with acute myocardial infarction. Methods: This case-control study was performed on 118 patients with acute myocardial infarction admitted to CCU ward (case group), and 118 patients with no history of MI to other wards (control group) of Shahid Beheshti Hospital in Babol, Iran. Opium addiction conventional risk factors were evaluated for both groups, and the data were analyzed using chi-square test and logistic regression model was used to adjust the conventional risk factor effects. Moreover, demographic variables as well as the extent of MI (extensive or non-extensive), and infarction type (ST-elevated or non-ST elevated) also were evaluated.Results: Sixty-seven patients in MI and 6 subjects in control group had a history of opium consumption (p<0.0001, OR=24.5). Blood pressure, hyperlipidemia, and smoking showed a significant difference between the two groups (p<0.05), whereas, no significant difference was observed for diabetes and family history. The results of adjusted model report a significant effect of opium consumption with the development of MI (OR=26.3). No significant difference was found in terms of infarction type and the extent between the addicts and non addicts in MI group.Conclusion: The results show that opium addiction is a strong risk factor for myocardial infarction.}, Keywords = {Ischemic heart diseases, Myocardial infarction, Opium addiction, Conventional risk factor}, volume = {4}, Number = {1}, pages = {585-589}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-189-en.html}, eprint = {http://caspjim.com/article-1-189-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {KhosoosiNiaki, Mohammad Reza and Saravi, Mehrdad and Oliaee, Farshid and Akbari, Roghayeh and Noorkhomami, Sepideh and BozorgiRad, Seyed Hassan and Fallahpoor, Kobra and Ramezani, Mir Saee}, title = {Changes in QT interval before and after hemodialysis}, abstract ={Background: Cardiovascular mortality and morbidity are high in chronic renal failure (CRF) patients. Increased dispersion of QT intervals is known to predispose to ventricular arrhythmias and sudden cardiac death. This study was conducted to assess the effect of hemodialysis (HD) on corrected QT (QTc) intervals and their dispersions (QTd) in chronic hemodialyzed patients. Methods: Fifty-eight patients ( mean age 54.2±15.8 years) with chronic renal disease on chronic hemodialysis (HD) were assessed by standard examination including blood pressure, body weight, heart rate, 12–lead electrocardiography and laboratory tests like electrolytes (Na +, K +, Ca ++, phosphate), urea, and creatinine 30 minutes before and after HD. The QT intervals and QTc QTc= QT R-R/ (in milli seconds [ms]) for each lead were measured manually by one observer using calipers. The difference between the maximum and the minimum of QT interval was noted as QT dispersion (QT d).Results: The mean of pre and post dialysis R-R intervals was 859.22±96.85 ms and 870.43±91.45 ms, respectively (p>0.05). The mean of corrected QT cmax intervals increased significantly from 423.45±24.10 to 454.41±30.25 ms (p<0.05). The mean of QT dispersions and the corrected QT interval dispersions changed from 51.56±12.45 to 63.21±14.43 ms (p<0.05) from 59.40±13.58 to 68.33±14.55 ms (p<0.05), respectively. The changes in serum potassium and calcium levels were related with QT interval prolongation.Conclusion: QT and QTc interval and dispersion increase in HD patients. Prolonged QT interval indices had relation with K+ and Ca++ ions before but not after HD.}, Keywords = {Chronic renal disease, Hemodialysis, QT interval, Arrhythmia}, volume = {4}, Number = {1}, pages = {590-594}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-190-en.html}, eprint = {http://caspjim.com/article-1-190-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Jabbari, Ali and Alijanpour, Ebrahim and Mir, Mehrafza and Banihashem, Nadia and Rabiea, Seyed Mozaffar and Rupani, Mohammad Ali}, title = {Post spinal puncture headache, an old problem and new concepts: review of articles about predisposing factors}, abstract ={Post spinal puncture headache (PSPH) is a well known complication of spinal anesthesia. It occurs after spinal anesthesia induction due to dural and arachnoid puncture and has a significant effect on the patient’s postoperative well being. This manuscript is based on an observational study that runs on Babol University of Medical Sciences and review of literatures about current concepts about the incidence, risk factors and predisposing factors of post spinal puncture headache.The overall incidence of post-dural puncture headache after intentional dural puncture varies form 0.1-36%, while it is about 3.1% by atraumatic spinal needle 25G Whitacre. 25G Quincke needle with a medium bevel cutting is popular with widespread use and the incidence of PSPH is about 25%, but its incidence obtained 17.3% by spinal needle 25G Quincke in our observation. The association of predisposing factors like female, young age, pregnancy, low body mass index, multiple dural puncture, inexpert operators and past medical history of chronic headache, expose the patient to PSPH. The identification of factors that predict the likelihood of PSPH is important so that measures can be taken to minimize this painful complication resulting from spinal anesthesia.}, Keywords = {Post spinal puncture headache (PSPH), Spinal anesthesia, Headache, Risk factors, Treatment}, volume = {4}, Number = {1}, pages = {595-602}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-191-en.html}, eprint = {http://caspjim.com/article-1-191-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Janbakhsh, Alireza and Mansouri, Feizollah and Vaziri, Siavash and Sayad, Babak and Afsharian, Mandana and Rahimi, Mehrali and Shahebrahimi, Karoon and Salari, Farham}, title = {Effect of selenium on immune response against hepatitis B vaccine with accelerated method in insulin-dependent diabetes mellitus patients}, abstract ={Background: Poor response to various vaccines especially hepatitis B is common. The purpose of this study was to evaluate the effect of selenium on immune response against hepatitis B vaccine with accelerated method in insulin-dependent diabetes mellitus patients.Methods: In this randomized clinical trial study, 62 insulin dependent diabetic patients were divided into case and control groups (each of 31 cases). In the control group, hepatitis B vaccine 20 µg was done by intra-deltoid injection on a 0, 10, 21 day schedule with placebo, and in case group, 200 µg of selenium as a supplement was added once daily to same vaccine schedule from the first day to the 30th day of the month. After one month, serum sample was obtained and evaluated for anti-HBs using ELISA method. Data were collected and analyzed.Results: In the case group, 23 cases (74.2%) and in control group, 15 cases (48.4%) achieved protective level of anti-HBs irrespective to sex and age (p=0.037). The mean antibody levels were 233.75±163.45U/L and 144±69.29U/L in selenium and control groups, respectively.Conclusion: Our study showed that selenium could help to increase protective rate and level of anti-HBs by accelerated vaccination method. Adding selenium by routine HBV vaccination in diabetic patients is recommended for increasing the rate and level of anti-HBs in such group.}, Keywords = {Selenium, IDDM, Vaccination, Hepatitis B}, volume = {4}, Number = {1}, pages = {603-606}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-192-en.html}, eprint = {http://caspjim.com/article-1-192-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Davarpanah, Mohammad Ali and RasekhiKazerouni, Akbar and Rahmati, Hashem and Neirami, Roxana and Bakhtiary, Hamid and Sadeghi, Mohamm}, title = {The prevalence of pediculus capitis among the middle schoolchildren in Fars Province, southern Iran}, abstract ={Background: Pediculosis capitis is a common parasitic infection of children. In this study we assessed the prevalence of head pediculosis among the middle schoolchildren in the urban and rural areas of Fars province, southern Iran.Methods: All middle schoolchildren ages 11-14, in all the urban and rural areas of the province were screened for head lice infestation by examining their hair and scalp. The parents of the infested children were also examined. The study was repeated in the different seasons in the same areas. Moreover, the infested children were treated with permethrin shampoo and re-examined one week later for any relapse.Results: The general prevalence of head lice infestation in middle school students was 0.23% in autumn, 0.27% in winter and 0.11% in spring. In all three seasons, pediculosis capitis prevalence was higher among females and in the rural areas. Treatment with permethrin shampoo was markedly more successful in males from both regions in all months except the urban areas in spring.Conclusion: The results show that pediculus capitis is generally uncommon among Fars Province middle schoolchildren. It is needed that health providers promote heath education programs especially in the rural areas.}, Keywords = {Pediculosis, Head Louse, Students, Permethrin}, volume = {4}, Number = {1}, pages = {607-610}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-179-en.html}, eprint = {http://caspjim.com/article-1-179-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Heidari, Behz}, title = {C-reactive protein and other markers of inflammation in hemodialysis patients}, abstract ={Background: Hemodialysis patients are at greater risk of cardiovascular disease. Higher than expected cardiovascular morbidity and mortality in this population has been attributed to dislipidemia as well as inflammation. The causes of inflammation in hemodialysis patients are multifactorial. Several markers were used for the detection of inflammatory reaction in patients with chronic renal disease. These markers can be used for the prediction of future cardiovascular events. Among the several parameters of inflammatory markers, serum, CRP is well known and its advantages for the detection of inflammation and its predictor ability has been evaluated in several studies. This review addressed the associated factors and markers of inflammation in hemodialysis patients. In addition, their ability in predicting future atherosclerosis and effect of treatment has been reviewed. However, this context particularly in using CRP as a prediction marker of inflammation and morbidity requires further studies.}, Keywords = {Hemodialysis, Inflammation, C-reactive protein, Statin}, volume = {4}, Number = {1}, pages = {611-616}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-180-en.html}, eprint = {http://caspjim.com/article-1-180-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Sadeghi, Mahmood and Jabbari, Ali and Bayani, Masomeh and Alijanpour, Ebrahim and Javaniyan, Mostafa and Asgharzadeh, Seyed Ahm}, title = {Crimean congo hemorrhagic fever appearance in the north of Iran}, abstract ={Background: Crimean-congo hemorrhagic fever (CCHF) is an acute tick-borne viral, zoonotic disease with hemorrhagic manifestations and considerable mortality in humans. The purpose of this study was to introduce CCHF as a case report from Babol, north of Iran. It is known as an endemic pathogen in some regions of Iran.Case presentation: We present a case of CCHF suffering from sudden onset of fever, headache, nausea, vomiting, melena and hemorrhagic manifestations like petechiae and epistaxis accompanied with evidence of ticks bite in a non-endemic area in the north of Iran. The laboratory dignosis was CCHF. He was treated with ribavirin and recovered completely.Conclusion: CCHF may be seen in non- endemic regions and clinicians must be awarded about its diagnosis and treatment.}, Keywords = {Crimean-congo hemorrhagic fever, Ribavirin, Epidemiology, North of Iran}, volume = {4}, Number = {1}, pages = {617-620}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-181-en.html}, eprint = {http://caspjim.com/article-1-181-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Mehrain, Raheleh and Nabahati, Mehr}, title = {A case of rhabdomyosarcoma of kidney mimicking nephroblastoma}, abstract ={Background: Rhabdomyosarcoma (RMS) is one of the common malignant tumors in infants and children, but it is extremely rare in the kidney. In this paper, we present a case of RMS the kidney of a child. Case presentation: A 6-month old girl presented with agitation, low fever and abdominal distention which started 5 days ago. On physical examination, the infant had a large and firm soft tissue mass in the palpation of her abdomen.Plain abdominal x-ray, sonography and CT scan showed soft tissue mass and Doppler ultrasound demonstrated regions of vascular flow in mass. The abdominal mass was replaced and on pathological examination and immunohistochemistry the diagnosis was embryonal RMS.Conclusion: Rhabdomyosarcoma of the kidney should be considered in the differential diagnosis of children with huge abdominal mass.}, Keywords = {Abdominal mass, Children, Rhabdomyosarcoma}, volume = {4}, Number = {1}, pages = {621-623}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-182-en.html}, eprint = {http://caspjim.com/article-1-182-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Jabbari, Ali and Tabasi, Shabnam and Masrour, Jil}, title = {Vitamin D serum level and chronic obstructive lung disease}, abstract ={Vitamin D serum level and chronic obstructive lung disease}, Keywords = {}, volume = {4}, Number = {1}, pages = {624-626}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-183-en.html}, eprint = {http://caspjim.com/article-1-183-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Hajian-Tilaki, Karimollah}, title = {Receiver Operating Characteristic (ROC) Curve Analysis for Medical Diagnostic Test Evaluation}, abstract ={This review provides the basic principle and rational for ROC analysis of rating and continuous diagnostic test results versus a gold standard. Derived indexes of accuracy, in particular area under the curve (AUC) has a meaningful interpretation for disease classification from healthy subjects. The methods of estimate of AUC and its testing in single diagnostic test and also comparative studies, the advantage of ROC curve to determine the optimal cut off values and the issues of bias and confounding have been discussed.}, Keywords = {Sensitivity, Specificity, ROC curve, Area under the curve (AUC), Parametric, Nonparametric, Bias.}, volume = {4}, Number = {2}, pages = {627-635}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-193-en.html}, eprint = {http://caspjim.com/article-1-193-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Alavi, Seyed Mohammad and Alavi, Leil}, title = {Treatment of brucellosis: a systematic review of studies in recent twenty years}, abstract ={Background: The treatment of human brucelosis is controversial. The purpose of this study was to search published clinical trial papers to provide a simple and effective treatment in brucellosis. Methods: Many studies on brucellosis treatment in a twenty- year span from 1993 to 2012 were searched in PubMed, Web of Science (ISI), Scopus, Google Scholar, Magiran, Iranmedex and SID. The studies that were searched and classified in groups according to combination therapy and monotherapy and their results in treatment outcome were compared. Regimens with lower treatment failure or relapse were considered as more suitable for brucellosis treatment. Results: The comparison of combined doxycycline and rifampicin (DR) with a doxycycline plus streptomycin (DS) favors the latter regimen. The combined doxycycline/co-trimoxazole (DCTM) showed similar effect with DR. The treatment with the combined regimen including quinolones was similar to DR but with higher relapse rates. Higher relapse rate was searched in monotherapy (13% vs. 4.8%) and in short-term (less than 4 weeks) treatment regimen (22% vs. 4.8%), respectively. Although in children, clinical trials were limited but showed cotrimoxazole plus rifampin for six weeks was the best treatment regimen. Conclusion: In uncomplicated brucellosis in adult patients, doxycycline-aminoglycoside combination is the first choice with doxycycline- rifampin and doxycycline-cotrimoxazole should be the alternative regimens. The other oral regimens including quinolones may be considered as alternatives. Cotrimoxazole plus rifampin for six weeks may be the regimen of choice for the treatment of patients younger than 8 years old. Gentamicin for 5 days plus cotrimoxazole for six weeks may be a suitable alternative regimen.}, Keywords = {Brucellosis, Treatment, Streptomycin, Doxycycline, Relapse}, volume = {4}, Number = {2}, pages = {636-641}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-194-en.html}, eprint = {http://caspjim.com/article-1-194-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Solooki, Mehrdad and Miri, Mirmoham}, title = {Approach to undiagnosed exudative pleural effusion: the diagnostic yield of blind pleural biopsy}, abstract ={Background: Blind percutaneous pleural biopsy has traditionally been performed to investigate the etiology of exudative pleural effusion in which the initial thoracocentesis has been non- diagnostic. In view of the increasing use of image-guided and thoracoscopic pleural biopsies, this study examined the role of blind Abrams pleural biopsy in the investigation of the exudative pleural effusion in the largest tertiary pulmonary center in Tehran, Iran. Methods: All patients with pleural effusion admitted from September 2007 to April 2009 entered in this study. The patients with exudative pleural effusion underwent blind Abrams pleural biopsy when the initial thoracocentesis was non-diagnostic. The patients with non-diagnostic blind biopsy underwent surgical biopsy or other investigations based on the physician’s decision. The data were collected and analyzed.Results: Blind percutaneous pleural biopsy was performed in 171 patients. Malignancy was diagnosed in 56 and tuberculosis in 52 cases with blind biopsy. For all the diagnoses, blind biopsy had a sensitivity of 70.1% and negative predictive value of 14.8%. For malignant diagnosis, the sensitivity value was 58.9%, specificity 100% and negative predictive value 63.2%. For TB diagnosis, sensitivity value was 88.1%, specificity 100% and negative predictive value 93.6%. The overall malignancy was diagnosed in 95 (58.6%) and TB in 59 (36.4%) patients. Conclusion: Blind Abrams needle biopsy was diagnostic in approximately three out four patients presented with undiagnosed exudative pleural effusion. The data support the use of the Abrams needle in the investigation of pleural effusion especially in the less developed countries.}, Keywords = {Abrams needle, Pleural biopsy, Pleural effusion, Malignancy, Tuberculosis}, volume = {4}, Number = {2}, pages = {642-647}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-195-en.html}, eprint = {http://caspjim.com/article-1-195-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Ziaee, Amir and AbbasVaezi, Amir and Oveisi, Sonia and Javadi, Amir and Hashemipour, Sima and MohammadKazemifar, Amir}, title = {Effects of additive therapy with spironolactone on albuminuria in diabetes mellitus: A pilot randomized clinical trial}, abstract ={Background: Early diagnosis of albuminuria and the prevention of its progression to macroalbuminuria and diabetic nephropathy are crucial. Angiotensin converting enzyme inhibitors (ACEIs) and antagonists of angiotensin II receptors type I (ARBs) are currently used as first-line treatment for albuminuria in these patients. The present study was conducted to assess the efficacy of addition of spironolactone to ACEIs or ARB in the prevention of diabetic nephropathy. Methods: Sixty patients were selected from the patients who referred to a Diabetes Clinic in this randomized clinical trial study. The control group received enalapril and the case group took additive therapy with spironolactone for 12 weeks. Blood pressure, concentrations of creatinine and albumin in the serum and urine, urinary albumin/creatinine ratio, serum potassium were determined for each patient in the beginning of and every 4-6 weeks until the end of the study. This clinical trial was registered in the Iranian Registry of Clinical Trials (www.irct.ir) with registration number ID: IRCT201105084849N2.Results: There was statistically significant difference in albumin/creatinine ratio between the two groups (p<0.001). Albuminuria reduced more significantly in case group compared to control group. It was measured 66.6±26.8 mg/mmol and 45.7±19 mg/mmol in control and case groups, respectively. The patients did not develop any significant adverse effect including reduction in GFR, hyperkalemia, and hypotension. Conclusion: Low to moderate doses of spironolactone can augment the effect of ACEIs in the prevention of diabetic nephropathy.}, Keywords = {Diabetic nephropathy, Albuminuria, Spironolactone, Angiotensin Converting, Enzyme Inhibitors (ACEIs)}, volume = {4}, Number = {2}, pages = {648-653}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-196-en.html}, eprint = {http://caspjim.com/article-1-196-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Najafi, Narges and Alikhani, Ahmad and Babamahmoudi, Farhang and Davoudi, AliReza and Ghasemiyan, Roya and Aliyan, Shahriar and Shoujaiifar, Arm}, title = {Increased cefepime MIC for enterobacteriacae clinical isolates}, abstract ={Background: Cefepime was used as empirical treatment in ventilator-associated pneumonia (VAP) induced by gram-negative and gram-positive bacteria. This study aimed to determine the antimicrobial susceptibility pattern of cefepime against microorganism causing VAP in Mazandaran, North of Iran. Methods: This study was performed on VAP patients diagnosed with clinical pulmonary infection score (CPIS) scores in ICU of two hospitals. For each patient suspected of having VAP, quantitative culture of endotracheal aspiration (QEA) was performed and MIC was determined by micro dilution test. Data were collected and analyzed.Results: Thirty- five cases of enterobacteriaceae were isolated orderly including E coli 13, P. aeruginosa 11, Enterobacter 7 and K. pneumonia 4 cases. All the isolated E. coli, Enterobacter and Klebsiella, 54.5% of P. aeruginosa isolated were fully resistant to cefepime. Conclusion: The results of this study show that cefepime is not a reasonable choice for empirical treatment of nosocomial pneumonia and VAP.}, Keywords = {Cefepime, Enterobacteriacae, MIC, VAP, ICU.}, volume = {4}, Number = {2}, pages = {654-657}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-197-en.html}, eprint = {http://caspjim.com/article-1-197-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Jenabian, Niloofar and MohammadGhaziMirsaeed, Ali and Ehsani, Hodis and Kiakojori, Amir}, title = {Periodontal status of patient’s underwent hemodialysis therapy}, abstract ={Background: Chronic renal failure patients undergoing hemodialysis are susceptible to periodontal diseases due to systemic complications of the disease and using different drugs. The present study investigated the periodontal status of patient’s who underwent hemodialysis, in Babol, northern Iran. Methods: One-hundred-fifteen hemodialysis patients (63 males, 52 females) with the mean age of 47.9±15.3 years were studied at Shahid Beheshti Hospital in Babol, Iran. Periodontal parameters including plaque index (PI), gingival index (GI), clinical attachment level (CAL) and probing pocket depth (PPD) were measured in these patients. The data were collected and analyzed. Results: The PI, GI, CAL and PPD were 2.37±0.55, 2.36±0.63, 3.98±1.61 and 4.41±1.4, respectively. Significant positive correlations were found between the participants’ age and PI (p<0.024) and p<0.001, respectively. Also, CAL was significantly higher in males than females (4.39±1.57 vs. 3.53±1.56, p<0.02). Conclusion: The results show that longer duration of hemodialysis is associated with severe periodontal diseases, especially in males.}, Keywords = {Haemodialysis, Periodontal disease, Oral hygiene}, volume = {4}, Number = {2}, pages = {658-661}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-198-en.html}, eprint = {http://caspjim.com/article-1-198-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Jabbari, Ali and Banihashem, Nadia and Alijanpour, Ebrahim and Vafaey, Hamid Reza and Alereza, Hakimeh and Rabiee, Seyed Mozafar}, title = {Serum lactate as a prognostic factor in coronary artery bypass graft operation by on pump method}, abstract ={Background: Lactic acidosis in cardiac surgical patients is a manifestation of systemic inflammation and excess pro-inflammatory cytokine production. This investigation was designed to integrate basic concepts about lactate acidosis with a clinically used of serum lactate in patients under coronary artery bypass surgery (CABG) by on pump method. Methods: From August to September 2012, 15 patients scheduled for routine cardiac surgery entered to our sample and followed up two weeks. Lactate concentration in arterial blood sample was studied. Method of surgery duration of cardiopulmonary bypass, aorta cross clamp timing, hemodynamic parameters, inotrope dosage and patient outcome were documented. The data were collected and analyzed. Results: The mean age of the patients was 62±14 years. The patients with a poor outcome had significantly higher lactate levels in ABG samples (p0.05). The PH of ABG samples did not generally correlate with the ABG lactate concentration (r=0.116, p=0.68). Increased lactate concentration was reliably associated with patient hemodynamic parameters, inotrope dosage, duration of on pump time and aorta cross clamp time. Conclusion: This study demonstrates a correlation between serum lactate levels and patient prognosis after CABG surgery by on pump method.}, Keywords = {Serum lactate, Prognosis, Coronary artery bypass graft}, volume = {4}, Number = {2}, pages = {662-666}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-199-en.html}, eprint = {http://caspjim.com/article-1-199-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {KhosraviSamani, Mahmoud and Jalali, Farzad and SeyyedAhadi, Seyyed Masud and Hoseini, Seyyed Reza and DabbaghSattari, Farh}, title = {The relationship between acute myocardial infarction and periodontitis}, abstract ={Background: Periodontitis is common in adults and cardiovascular diseases (CVD) are the most common cause of adult death in the world. This study aimed to investigate the relationship between CVD and periodontitis. Methods: Sixty patients with myocardial infarction (MI) as case and 63 subjects with periodontitis without MI as control were studied. Periodontitis was assessed according to Ramfjord periodontal diseases index and the number of missing teeth besides classic risk factors of MI were recorded. Results: The patients who lost more than 10 teeth were at more risk of myocardial infarction (OR=2.73). There was a significant relationship between mean attachment loss and MI (p=0.0001). There was also a relation between attachment loss more than 3 mm and MI with OR of 4. Significant difference between mean PDI (periodontal disease index) was seen in case and control groups (p=0.0001). Subjects with PDI>4 were at more risk of periodontal diseases (OR=7.87). Conclusion: The results show the presence of significant relation between periodontitis and MI which could serve as an alarm to treat periodontitis carefully.}, Keywords = {Periodontitis, Myocardial infarction, Attachment loss, Periodontal disease index (PDI)}, volume = {4}, Number = {2}, pages = {667-671}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-200-en.html}, eprint = {http://caspjim.com/article-1-200-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Maddah, Ghodratollah and Abdollahi, Abbas and Katebi, Mehr}, title = {Gastrointestinal anthrax: clinical experience in 5 cases}, abstract ={Background: Bacillus anthracis may usually cause three forms of anthrax: inhalation, gastrointestinal and cutaneous. The gastrointestinal (GI) anthrax develops after eating contaminated meat. Thus, in this paper were report 5 cases of intestinal anthrax. Case Presentation: We report a case series of intestinal anthrax, with history of consumption of raw or poorly cooked liver of sheep. One patient was female and 4 were males with the age range between 17 and 26 years. All patients were admitted with abdominal pain, nausea, and vomiting. Examination revealed abdominal distention on the right lower quadrant or diffuse tenderness. Laboratory examination in all patients showed leukocytosis with polymorphonuclear of >80%. Because of the unclear and questionable diagnosis, exploratory laparotomy was performed on several patients, invariably showing an abundant yellowish and thick ascitic fluid, soft hypertrophied mesenteric lymph nodes (3-5 cm) mostly in the ileocecal region, and substantial edema involving one segment of small bowel, cecum or ascending colon. Anthrax was diagnosed on the epidemiologic basis (ingestion history of half cooked liver of sheep) or microbiologic (microscopy with bacterial culture) and pathologic testing (post surgery in four patients or autopsy in one patient). With appropriate treatment, 4 survived and one patient died. Conclusion: Gastrointestinal anthrax is characterized by rapid onset, fever, ascitis and septicemia. The symptoms can mimic those seen in an acute surgical abdomen. Rapid diagnosis and prompt initiation of antibiotic therapy and then exploratory laparotomy (right hemicolectomy) are keys to survival.}, Keywords = {Anthrax, Gastrointestinal, Bacillus anthracis}, volume = {4}, Number = {2}, pages = {672-676}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-201-en.html}, eprint = {http://caspjim.com/article-1-201-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Yousefghahari, Behnaz and Ahmadi, Abbasali and Guran, Ardeshir}, title = {Three cases of alkaptonuria in one family in Mazandaran Province, Iran}, abstract ={Background: Alkaptonuria is a rare genetic disease leading to the accumulation of homogentesic acid in joint and ear cartilage, sclera and some other tissues causing significant morbidity in these patients. In this paper, we report three cases of Alkaptonuria among the family or household members. Case Presentation: A 51-year-old man with mechanical low back and knee pain was referred to Rheumatology Clinic of Babol University of Medical Sciences. The physical examination showed thoracic kyphosis and limitation of motion in thoraco-lumbar spine, severe knee osteoarthritis and blue-black discoloration of ear cartilages. There was intervertebral disc calcification in plain radiography, and mitral valve calcification in echocardiography. His urine sample was tested positive in Benedict’s test. The diagnosis was confirmed by qualitative assessment of homogentesic acid (HGA) that was highly positive. In addition, we found two more cases of Alkaptonuria in his family. Conclusion: Although alkaptonuria is a rare disease, but it may be found in cluster among the family members.}, Keywords = {Alkaptonuria, Cluster, Iran}, volume = {4}, Number = {2}, pages = {677-680}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-202-en.html}, eprint = {http://caspjim.com/article-1-202-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Shafaei, Shahriar and SoleimaniAmiri, Shima and Hajiahmadi, Mahmoud and Sadeghi-Haddad-Zavareh, Mahmoud and Bayani, Masomeh}, title = {Histological grading and staging of liver and its relation to viral loads in chronic anti-HBe positive hepatitis}, abstract ={Background: Hepatitis activity index (HAI) and fibrosing stage are two important findings during the evaluation of liver samples in patients with chronic hepatitis B. The aim of this study was to determine the HAI and fibrosing stage in patients with anti-HBe positive chronic hepatitis B. Methods: Liver biopsy slides of 72 patients were evaluated at the Department of Pathology in two teaching hospitals of Babol University of Medical Sciences, Iran, from April 2006 to August 2011. Total HAI or grading as well as its components including piecemeal necrosis, confluent necrosis, spoty necrosis, portal inflammation and fibrosis scores or staging in considering with viral loads more or less than 105 copies/ml were enumerated according to Ishak scoring system.Results: The mean age of these patients was 34.4±12 years. Fifty-six patients had viral load> 105 copies/ml. Piecemeal necrosis and grading scores with viral load (103,103-105 and >105 copies/ml) were 0.8±0.7, 0.9±0.4, 1.8±1 and 3.8±1.9, 4.4±2, 5.9±2.6, respectively (p=0.005 and p=0.04, respectively). There was not any significant difference with fibrosis stage regarding different viral loads. In total, 18 cases had fibrosis scores > 1 and 24 cases had confluent necrosis. HAI?4 was seen in 29 (60.4%) of the 48 cases without confluent necrosis and in 23 out of 24 cases with confluent necrosis (p=0.007).Conclusion: The results show that piecemeal necrosis and higher grading scores are associated with higher viral loads. The presence of confluent necrosis is associated with more severe diseases.}, Keywords = {Grade, Stage, Confluent necrosis, Viral load}, volume = {4}, Number = {3}, pages = {0-0}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-204-en.html}, eprint = {http://caspjim.com/article-1-204-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Bayani, Masomeh and Hasanjani-Roushan, Mohammad Reza and Siadati, Sepideh and Javanian, Mostafa and Sadeghi-Haddad-Zavareh, Mahmoud and Shokri, Mehran and Mohammadpour, Mehdi and Zarghami, Amin and Asghari, Samaneh}, title = {Seroepidemiology of varicella zoster virus in healthcare workers in Babol, Northern Iran}, abstract ={Background: Varicella zoster virus (VZV) infection is one of the nosocomial infections and healthcare workers (HCWs) are at high risk group who work in the hospital with likelihood of varicella acquisition or transmission. This study evaluated the VZV seroprevalence in this high risk population in Babol, Iran. Methods: Serological testing for VZV using enzyme linked immunosorbent assay (ELISA) was performed on 459 HCWs in Ayatollah Rouhani Hospital, Babol, Northern Iran from 2011 to 2012. The questionnaire consisted of age, gender, place of residence, marital status, history of chickenpox, educational level, working experience and risk of exposure. The data were collected and analyzed.Results: The mean age of these subjects was 32.2±1.1 years. Four hundred-sixteen (90.6%) cases were females and 43 (9.4%) were males. The overall positive seroprevalence of VZV was 94.6%. No statistically significant differences were observed between age, gender, place of residence, risk of exposure, marital status, educational level, working experience and seropositivity. The seropositivity of varicella was seen in 278 (95.5%) of 297 cases with positive history and in 30 (81.1%) of 37 cases who did not (p=0.005). Conclusion: The results show that a positive history of VZV is associated with positive seroprevalence but can not be a reliable indicator of the immunity, therefore, serological screening should be considered for all the HCWs. Also, vaccination of susceptible subjects was recommended.}, Keywords = {Seroprevalence, VZV, Healthcare workers, Iran}, volume = {4}, Number = {3}, pages = {686-691}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-205-en.html}, eprint = {http://caspjim.com/article-1-205-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Saravi, Mehrdad and Tamadoni, Ahmad and Jalalian, Rozita and MahmoodiNesheli, Hasan and Hojati, Mosatafa and Ramezani, Saee}, title = {Evaluation of tissue doppler echocardiography and T2* magnetic resonance imaging in iron load of patients with thalassemia major}, abstract ={Background: Iron-mediated cardiomyopathy is the main complication of thalassemia major (TM) patients. Therefore, there is an important clinical need in the early diagnosis and risk stratification of patients. The aim of this study was to evaluate the efficacy of tissue doppler imaging (TDI) to study cardiac iron overload in patients with TM using T2* magnetic resonance (MR) as the gold-standard non-invasive diagnostic test. Methods: A total of 100 TM patients with the mean age of 19±7 years and 100 healthy controls 18.8±7 years were evaluated. Conventional echocardiography, TDI, and cardiac MRI T2* were performed in all subjects. TDI measures included myocardial systolic (Sm), early (Em) and late (Am) diastolic velocities at basal and middle segments of septal and lateral LV wall. The TM patients were also subgrouped according to those with iron load (T2* ? 20 ms) and those without (T2* > 20 ms), and also severe (T2* ? 10 ms) versus the non-severe (T2* ? 10 ms).Results: Using T2* cardiovascular MR, abnormal myocardial iron load (T2* ? 20 ms) was detected in 84% of the patients and among these, 50% (42/84) had severe (T2* ? 10 ms) iron load. The mean T2* was 11.6±8.6 ms (5–36.7). A negative linear correlation existed between transfusion period of patients and T2* levels (r = -0.53, p=0.02). The following TDI measures were lower in patients than in controls: basal septal Am (p<0.05), mid-septal Em and Am (p<0.05), basal lateral Am (p<0.05), mid-lateral LV wall Sm (p<0.05) and Am (p<0.05).Conclusion: Tissue doppler imaging is helpful in predicting the presence of myocardial iron load in Thalassemia patients. Therefore, it can be used for screening of thalassemia major patients.}, Keywords = {Thalassemia major, MRI, Tissue doppler imaging, Iron overload, T2* MRI}, volume = {4}, Number = {3}, pages = {692-697}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-206-en.html}, eprint = {http://caspjim.com/article-1-206-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Yadegarynia, Davood and Fatemi, Alireza and Mahdizadeh, Masih and KabiriMovahhed, Reihaneh and AfshinAlizadeh, Mohamm}, title = {Current spectrum of bacterial infections in patients with nosocomial fever and neutropenia}, abstract ={Background: Neutropenic patients are vulnerable to a wide spectrum of infectious agents. The aim of this study was to determine the current frequency of bacterial infections in patients with nosocomial fever and neutropenia. Methods: In a retrospective study, the neutropenic patients’ specimens with nosocomial fever were cultured on blood and MacConkey agar plates and evaluated at microbiology laboratory. Ninety-five significant isolates as species level were recognized by bacteriological techniques.Results: The most observed microorganism was Escherichia coli, followed by Pseudomonas aeruginosa, Acinetobacter baumanii, Klebsiella pneumoniae, Coagulase positive staphylococci and Coagulase negative staphylococci. One fungal infection was also observed. Overall, 67% of the organisms were gram negative, 29.8% gram positive, and 3.2% polymicrobial. Conclusion: The changing pattern of infectious agents in neutropenic patients overtime postulates the necessity of other studies to give the most up-to-date insight of the organisms to physicians.}, Keywords = {Bacterial Infections, Spectrum, Nosocomial, Fever, Neutropenia}, volume = {4}, Number = {3}, pages = {698-701}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-207-en.html}, eprint = {http://caspjim.com/article-1-207-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Yousefghahari, Behnaz and Alhooei, Saman and Soleimani-amiri, Mohammad Jafar and Guran, Ardeshir}, title = {Comparison of sensitivity and specificity of anti-CCP and anti-MCV antibodies in an Iranian cohort of patients with rheumatoid arthritis}, abstract ={Background: Anti-CCP is a test commonly used for the diagnosis of rheumatoid arthritis. The aim of this study was to determine the diagnostic values of ACCP compared to anti-MCV in rheumatoid arthritis patients in north of Iran. Methods: The serum samples of 150 RA patients and 75 controls, with the mean age of 49.6+11.8 and 48.8+12 years respectively, were tested using the commercially available ELISA kits for ACCP and anti-MCV. Sensitivity, Specificity were determined and Roc curve were used for comparison between these two groups.Results: The sensitivity of ACCP versus anti-MCV was 85% and 81%, respectively. Specificity was 96% and 95%, respectively. In the RA patients, ACCP was positive in 127 (84.7%) and anti MCV in 121 (80.7%) cases. In the control group, these parameters were positive in 3 (4%) and 4 (5.3%) (p<0.0001 and p<0.0001, respectively). The correlation coefficient for ACCP and anti-MCV was calculated at 0.63 (p<0.001). The area under the curve for ACCP was 0.941±0.015 (p<0.001), anti-MCV was 0.902±0.02 (p<0.001). The measure of agreement (Kappa) for these variables was 0.81. In these patients, there was no correlation between DAS28 and the positivity of these tests. Conclusion: It was concluded, compared to ACCP, anti-MCV has approximately the same accuracy for the diagnosis of rheumatoid arthritis and it does not have additional value.}, Keywords = {Rheumatoid arthritis, ACCP, Anti-MCV}, volume = {4}, Number = {3}, pages = {702-706}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-208-en.html}, eprint = {http://caspjim.com/article-1-208-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Adewumi, Adediran and Alani, Akanmu and Akinsegun, Akinbami and Titilope, Adeyemo and Vincent, Osunkalu}, title = {Urine methyl malonic acid levels in HIV-infected adults with peripheral neuropathy}, abstract ={Background: Cobalamin deficiency and peripheral neuropathy (PN) are commonly seen in HIV-infected adults. The level of urine methylmalonic acid (UMMA), a reliable indicator of tissue cobalamin status, was determined in HIV infected subjects with and without PN to establish this association. Methods: One hundred and ninety-eight (198) consenting HIV infected subjects with and without PN were recruited for the study. UMMA level was determined by Cation Exchange High Performance Liquid Chromatography (HPLC) with Ultraviolet detector in 165 subjects. Simple proportions of patients with raised UMMA (defined as value> 3.4 mg in 24hr) were determined for each arm.Results: Among the 198 subjects studied, 146 had PN and 52 had no PN. From the 165 subjects whose UMMA was studied, raised UMMA was found in 76.6% (36 of 47) of subjects with no PN as compared with 53.4% (63 of 118) of those with PN (p=0.018).Conclusion: Cobalamin deficiency (measured by UMMA level) even though common in HIV infected subjects, may not be the cause of peripheral neuropathy in these subjects.}, Keywords = {Peripheral Neuropathy, Cobalamin deficiency, Urine methylmalonic acid (UMMA), HIV infection}, volume = {4}, Number = {3}, pages = {707-711}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-209-en.html}, eprint = {http://caspjim.com/article-1-209-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Ala, Shahran and Zanad, Fatemeh and Shiran, Mohammad Rez}, title = {Population pharmacokinetics of omeprazole in a random Iranian population}, abstract ={Background: Omeprazole is metabolized predominantly by CYP2C19, a polymorphically expressed enzymes that show marked interindividual and interethnic variation. These variations cause a substantial differences that have been reported in the pharmacokinetics of omeprazole. The aim of the present study was to evaluate the pharmacokinetic parameters of omeprazole in a random Iranian population. Methods: From the 20 subjects, only 17 healthy unrelated individuals of either sex (9 females age range 22-24 years) participated in the study. After an overnight fasting, a sample of blood was collected. The subjects received a single oral dose of 40 mg capsule of omeprazole (losec) and blood samples were taken up to 8 hours. Omeprazole was analyzed by the HPLC method and population pharmacokinetic analysis was performed using population pharmacokinetic modelling software P-Pharm.Results: The mean value for apparent plasma clearance (CL/F) was 20.8±6.9 (L.h-1). The corresponding value for apparent volume of distribution (V/F), and t1/2 beta were 21.6±7.5 (L) and 0.8±0.3 (h), respectively. A comparison of the weight normalized V/F and CL/F of omeprazole between males and females revealed that both parameters were significantly higher in females than males (p?0.03).Conclusion: These results show a substantial interindividual variability in omeprazole pharmacokinetics and this might affect the therapeutic effects of omeprazole as reported previously.}, Keywords = {Population pharmacokinetics, Omeprazole, Iranian}, volume = {4}, Number = {3}, pages = {712-716}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-210-en.html}, eprint = {http://caspjim.com/article-1-210-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Alavi, Seyed-Mohammad and Nadimi, Mohammad and Zamani, Gholam Abbas}, title = {Changing pattern of infectious etiology of fever of unknown origin (FUO) in adult patients in Ahvaz, Iran}, abstract ={Background: Although infectious diseases are the most common sources for the fever of unknown origin (FUO), but the spectrum of infectious diseases is changing overtime. The purpose of the study was to define the clinical spectrum and changing the pattern of FUO.Methods: This existing data based study was undertaken from 2007 to 2011. One hundred-six patients fulfilling the modified criteria for FUO referred in a teaching hospital in Ahvaz were enrolled for analysis. The data extracted from the patient's medical files and etiologic agents caused FUO to be assessed.Results: Infections were the most common cause of FUO in 48.4% of the patients. Among the infections, the most important causes of FUO were represented by extra-pulmonary tuberculosis 15 (31.9%), osteomyelitis 10 (21.3%) and abdominal abscesses 6 (12.8%).Conclusion: The pattern of FUO in the region is thought to be changed to extra pulmonary TB and osteomyelitis. Tuberculosis is still the leading cause of FUO in our region.}, Keywords = {Fever of unknown origin (FUO), Infectious diseases, Tuberculosis, Ahvaz}, volume = {4}, Number = {3}, pages = {722-726}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-211-en.html}, eprint = {http://caspjim.com/article-1-211-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {MahmoodiNesheli, Hassan and Hadizadeh, Amereh and Bijani, Ali}, title = {Evaluation of inhibitor antibodies in haemophilia A population}, abstract ={Background: Inhibitory antibody to exogenous Factor VIII (FVIII) is a major complication of hemophilia treatment. This study was conducted to determine the prevalence of inhibitor antibody directed against FVIII.Methods: From May 2010 to May 2011, 52 patients with severe hemophilia A admitted in Amirkola Children’s Hospital were evaluated. Those who had abnormal mixing study, antibody against FVIII were measured. Data were collected and analyzed. Results: The age range of the patients was 4-60 years. The inhibitor antibody was seen in 9 (17.3%) patients. The mean age of patients with inhibitor at the time of diagnosis was 10.22 years (ranged 4-31 years). Old patients had more hemarthrosis than young patients. The mean level of inhibitor antibody was 8.47 Bethesda (ranged 2.3-29). Six patients had inhibitor antibody level ?5 Bethesda unit and three patients had inhibitor antibody level<5 Bethesda unit.Conclusion: This study showed that the prevalence of inhibitor antibody in young patients is more than the old patients.}, Keywords = {Inhibitory antibodies, concentrated FVIII, hemophilia A, Hemarthrosis}, volume = {4}, Number = {3}, pages = {727-730}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-212-en.html}, eprint = {http://caspjim.com/article-1-212-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Ahmadi, Elham and Fallahi, Sasan and Alaeddini, Mojgan and HasaniTabatabaei, Masoomeh}, title = {Severe dental caries as the first presenting clinical feature in primary sj?gren’s syndrome}, abstract ={Background: Sj?gren’s syndrome is an autoimmune syndrome involving the exocrine glands specially the salivary and lacrimal glands leading to xerostomia and xerophtalmia. This paper presents a case with primary Sj?gren’s syndrome that severe dental caries were the first clinical manifestation. Case Presentation: A 42-year-old man was referred to the School of Dentistry, Tehran University of Medical Sciences due to unexplained severe dental decays. After systematic evaluation and consultation with the rheumatologist and the ophthalmologist, the diagnosis of primary sj?gren’s syndrome was suggested and confirmed by serologic and histopathologic study.Conclusion: Primary sj?gren’s syndrome should be considered in the differential diagnosis of patients with early severe dental caries}, Keywords = {Sj?gren’s syndrome, dental caries, Autoimmune}, volume = {4}, Number = {3}, pages = {731-734}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-213-en.html}, eprint = {http://caspjim.com/article-1-213-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Ghaffari, Javad and Abedian-Kenari, Saeed and Ghasemi, Maryam and Gohardehi, Farz}, title = {Psoriasis in hyper IgE syndrome – a case report}, abstract ={Background: Hyper IgE syndrome (HIES) is a rare primary immune deficiency, described as Job`s syndrome characterized by increased serum levels of IgE, eczema, recurrent cutaneous and pulmonary infections. In this paper, we presented a case of Hyper IgE syndrome.Case Presentation: A 16-year-old Iranian boy presented with a one year history of skin lesions in knees and elbows was diagnosed of psoriasis disease. He had a history of recurrent infections including otitis media, pneumonia, diarrea and skin infection. Laboratory results showed increased level of total IgE and normal in other immunoglobulin. Histologic finding showed hyperkeratosis, parakeratosis of acanthotic epidermis with regular elongation of rete ridges diagnose psoriasis disorder.Conclusion: In conclusion, this is the first case of hyper IgE patient with psoriasis disorder. We addressed the important laboratory findings and actual theories explaining possible association between hyper IgE immunoglobulinemia and psoriasis disorder.}, Keywords = {Hyper IgE syndrome, Psoriasis, Immune deficiency}, volume = {4}, Number = {3}, pages = {735-738}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-214-en.html}, eprint = {http://caspjim.com/article-1-214-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Vakili-Sadeghi, Mohsen and Omranpour, Mohammadhas}, title = {Chronic myeloid leukemia following colon cancer treatment: A case report and literature review}, abstract ={Background: Solid tumors may occur in 3% of the patients with chronic myeloid leukemia (CML). In this paper, we presented a case of CML following treatment of colon cancer. Case Presentation: A 25 year old man was diagnosed of adenocarcinoma of rectosigmoid treated with fluorouracil-based chemotherapy. Following relapse, he received florouracil, oxaliplatin and irinotecan during the next year. Then he developed BCR-ABL positive CML. With Imatinib 400 mg/day, he achieved hematologic response but died because of progressive colon cancer.Conclusion: This article emphasizes that there is a possibility for etiologic correlation between CML and chemotherapeutic agents in solid cancers.}, Keywords = {Chemotherapy, Chronic myelogenous leukemia, Colon cancer}, volume = {4}, Number = {3}, pages = {739-742}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-215-en.html}, eprint = {http://caspjim.com/article-1-215-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Sharifi-Mood, Batool and Metanat, Maliheh and Alavi-Naini, Roya and Shakeri, Asad and Bameri, Zakaria and Imani, Maryam}, title = {Nasal carriage of methicillin-resistant staphylococcus aureus among ICU personnel working at Zahedan University, southeastern Iran}, abstract ={Nasal carriage of methicillin-resistant staphylococcus aureus among ICU personnel working at Zahedan University, southeastern Iran}, Keywords = {}, volume = {4}, Number = {3}, pages = {743-744}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-216-en.html}, eprint = {http://caspjim.com/article-1-216-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Khedmat, Hossein and Karbasi-Afshar, Reza and Agah, Shahram and Taheri, Saee}, title = {Helicobacter pylori Infection in the general population: A Middle Eastern perspective}, abstract ={Helicobacter pylori (H.pylori) infection is probably the most important factor that has been associated with the development of gastric cancers in human populations. However, there are no reliable data on the prevalence of this infection in the Middle East. In this article, based on a comprehensive literature review, we aimed to evaluate the situation in this region. The literature has been searched for the incidence and prevalence of H.pylori infection by Pubmed and Google Scholar. Search was repeated for each of the Middle Eastern countries, and to empower the method, citations of each found article were searched for the related studies. Seventy seven reports from the countries of the Middle East region had been reviewed and they all indicated a high rate of infection either in the general population or in the dyspeptic patients, the rate seemed to be higher in patients with dyspepsia, in patients with histologically confirmed gastritis and in patients of older age groups.}, Keywords = {Hpylori, Gastric cancer, Middle eastern}, volume = {4}, Number = {4}, pages = {745-753}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-217-en.html}, eprint = {http://caspjim.com/article-1-217-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {O.Dosunmu, Adedoyin and A.Akinola, Rachael and A.Onakoya, Josephine and M.Balogunt, Taiwo and O.Adeyeye, Olufunke and A.Akinbami, Akinsegun and M.Arogundade, Olanrewaju and TBrodie-Mends, Ayodeji}, title = {Pattern of chronic lung lesions in adults with sickle cell disease in Lagos, Nigeria}, abstract ={Background: The vascular response to recurrent tissue hypoxia and reperfusion following red blood cell sickling causes acute chest syndrome and chronic lung disease. The purpose of this study was to determine the pattern of chronic lung lesions and possible risk factors in sickle cell patients in lagos, Nigeria.Methods: From July 2012 to April 2013, Pulmonary function test (PFT) and chest-x-ray were determined in 56 eligible patients with sickle cell disease. Full blood count, red cell indices, hemoglobin F level, oxygen saturation, liver function tests, lactate dehydrogenase and tricuspid regurgitant jet velocity were measured.Results: The mean age of the patients was 22±6 years. The mean forced vital capacity was low (76.49%±16). Abnormal PFTs were restrictive lung lesion (53%), obstructive lesions (3.7%) and mixed lesions (11%). The vital capacity had negative correlation with the white cell count and platelet count while it had positive correlation with age. There were no significant differences when normal and abnormal PFTs were compared based on the following laboratory data: lactate dehydrogenase (244 vs. 301), hematocrit (22.7 vs. 23.6), fetal hemoglobin (6.2% vs. 4.2%), mean corpuscular hemoglobin concentration (33.7 vs 33.3), aspartate transferase (34.2 vs. 35.1), tricuspid regurgitant jet velocity (1.3 vs. 0.92) and oxygen saturation (95.8 vs. 95.5). Abnormal x-ray findings were present in 84% of participants. Chest x ray showed ischemic (17%), congestive (69%), fibrotic and inflammatory (14%) changes.Conclusion: Chronic lung lesion is common in sickle cell disease associated with rising white cell count, platelet count. All adult patients should have regular spirometry done to ensure early detection.}, Keywords = {Sickle cell disease, Tricuspid regurgitant jet velocity, Spirometry}, volume = {4}, Number = {4}, pages = {754-758}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-218-en.html}, eprint = {http://caspjim.com/article-1-218-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Bahar, Adele and Kashi, Zahra and AhmadzadehAmiri, Ahmad and Nabipour, Maji}, title = {Association between diabetic retinopathy and hemoglobin level}, abstract ={Background: Anemia may be considered to be an independent risk factor for the development of diabetic retinopathy (DR) in patients with renal failure. The purpose of this study was to investigate the association between blood hemoglobin level and retinopathy in diabetic patients with normal renal function tests.Methods: From 2009 to 2011, 1100 diabetic patients underwent retinal examination. Among them, 159 subjects were diagnosed to have DR and were compared with 318 diabetic subjects with normal retinal examination as the control group. The level of hemoglobin (Hb), Hb A1C, serum iron, ferritin, and total iron binding capacity were compared between these two groups.Results: Among the 159 patients with DR, 112 (70.4%) had mild to moderate no proliferative retinopathy (NPDR) and 47 (29.6%) had advanced retinopathy (severe NPDR or proliferative). The mean hemoglobin level in case and control group was 12.15±1.50 and 12.73±1.38 g/dl, respectively (p<0.001). Anemia was seen in 45.9% and 26.1% in the case and the control groups, respectively (p<0.001). Ferritin <15ng/ml was seen in 7.4% and 6.1% of patients with and without DR, respectively (p=0.8).Conclusion: The results show that diabetic patients with retinopathy have lower level of hemoglobin and higher frequency of anemia. It is suggested that the level of hemoglobin should be evaluated periodically in diabetic patients}, Keywords = {Anemia, Diabetic retinopathy, Hemoglobin, Retinopathy}, volume = {4}, Number = {4}, pages = {759-762}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-219-en.html}, eprint = {http://caspjim.com/article-1-219-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Yousefi, Fatemeh and Mahjoub, Soleiman and Pouramir, Mahdi and Khadir, Fatemeh}, title = {Hypoglycemic activity of Pyrus biossieriana Buhse leaf extract and arbutin: Inhibitory effects on alpha amylase and alpha glucosidase}, abstract ={Background: The mechanism of hypoglycemic and hypolipidemic activities of Pyrus biossieriana Buhse leaf extract (PbBLE) and its phytochemical component arbutin, have not been well determined. The present study was performed to understand the hypoglycemic activity mechanisms of pbBLE and arbutin more clearly.Methods: In vitro enzymatic carbohydrate digestion with PbBLE and arbutin was assessed using ?-amylase and ?-glucosidase powders. The enzyme solutions were premixed with PbBLE and arbutin at different concentrations (0.1, 1, 10 and 100 mg/ml). Substrate solutions and colorimetric reagents were added to the reaction. The release of glucose was determined by spectrophotometric method. Acarbose was used as the positive control.Results: The extract (10, 100 mg/ ml) completely inhibit ?- amylase and ?- glucosidase activities. The extract produced higher reduction of ?-amylase and ?-glucosidase activity than arbutin. Inhibition at various concentrations (0.1, 1, 10, 100 mg/ml) were significantly different (p<0.05).Conclusion: Our results exhibited that both the extract and arbutin were able to suppress the enzymes strongly.}, Keywords = {Hypoglycemic; Pyrus biossieriana Buhse extract; Arbutin; ?-Amylase/ ?-glucosidase inhibitors}, volume = {4}, Number = {4}, pages = {763-767}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-220-en.html}, eprint = {http://caspjim.com/article-1-220-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Shafaei, Shahriar and Sharbatdaran, Majid and Kamrani, Ghodsieh and Khafri, Soray}, title = {The association between CD166 detection rate and clinicopathologic parameters of Patients with colorectal cancer}, abstract ={Background: Metastasis and recurrence of colorectal cancer after treatment is attributed to stem cells. The aim of this study was to determine the relationship between the expression of stem cell marker CD166 in colorectal cancer by immunohistochemistry and clinicopathologic parameters.Methods: From 2006 to 2012, 121 colectomy specimens of patients with colon cancer that were operated in Babol Medical University in Iran were evaluated. The paraffin blocks were extracted from the archive and the slides were prepared and stained for H;E and Immunohistochemical (IHC) methods. The samples with cytoplasmic and/or membranous staining more than 50% of tumor cells were considered as positive. Pathological parameter including type of tumor, stage and grade, vascular invasion and location of the tumors were recoerded.Results: The mean age of the patients was 58.7±15.1 years. Sixty-four (54.9%) patients were males. Eighty-six (71.1%) subjects were positive for cytoplasmic and 42 (34.7%) for membranous and 42 (34.7%) for both cytoplasmic and membranous staining. The cytoplasmic expression of marker CD166 marker in mucinous type was 10 (50%) and was lower than non-mucinous type 76 (75.2%) (p=0.031). There was significant relationship between membranous expression of CD166 marker and tumor location (right colon in 23(54.8%), left colon in 18 (24.3%)] (p=0.001). There was no significant difference in the expression of marker with other demographic and clinicopathologic variables.Conclusion: The results show that CD166 expression was seen in more than two-thirds of the patients. The cytoplasmic expression of CD166 marker was higher in non-mucinous type. The distributions of membranous expression of marker CD166 was related more in right colon with colorectal cancer.}, Keywords = {Colorectal cancer, Cancer stem cells, CD166, Immunohistochemistry}, volume = {4}, Number = {4}, pages = {768-772}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-221-en.html}, eprint = {http://caspjim.com/article-1-221-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Siadati, Sepideh and Seyedmajidi, Maryam and Sharbatdaran, Maji}, title = {Frequency of different oral lesions in children and adolescents in Babol, Northern Iran}, abstract ={Background: Few studies regarding oral lesions of children and adolescents were reported in the medical literature. The aim of this study was to determine the frequency of these lesions in patients from birth to 20 years old in Babol, Northern Iran.Methods: The slides of all cases of oral lesions in children and adolescents, between 1990 and 2012 were obtained from the pathology archives of Shahid Beheshti Hospital and School of Dentistry, Babol University of Medical Sciences in Iran. The lesions were categorized as follows: cystic lesions, tumor/tumor-like lesions and inflammatory/reactive lesions. The data were collected and analyzed.Results: The 244 retrieved cases accounted for 27% of total oral biopsies (8956) were performed during this period. Male to female ratio was 0.8. Inflammatory / reactive category (61.9%), tumor/ tumor-like category (23%) and cystic category (15.2%) were in order of frequency. Mucocele was seen in 55 (35.8%) of 151 cases of inflammatory/ reactive, centeral giant cell granoloma (CGCG) in 15 (26.8%) of 56 tumor/ tumor like and radicular cyst in 14 (37.9%) of 37 cystic lesions. Conclusion: Our findings indicate that mucocele, CGCG and radicular cyst were frequent lesions in inflammatory / reactive, tumor / tumor like and cystic categories, respectively in our region.}, Keywords = {Anemia, Diabetic retinopathy, Hemoglobin, Retinopathy}, volume = {4}, Number = {4}, pages = {773-776}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-222-en.html}, eprint = {http://caspjim.com/article-1-222-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Eini, Peyman and OwayseeOsquee, Hamid and Nasab, Masoud and NasiroghliKhiyabani, Farzaneh and Rahighi, Amir Hosei}, title = {Chest radiological features among patients with smear positive pulmonary tuberculosis}, abstract ={Background: Chest x-ray has an important role in the diagnosis of tuberculosis (TB). The aim of this study was to determine the radiological changes in patients with smear positive pulmonary tuberculosis.Methods: In this study, 325 patients with smear positive pulmonary TB was enrolled. The affected lobe or lobes of the left or right lung were recorded. The types of involvement were categorized based on patchy consolidation, cavitation, collapse consolidation and bronchopneumonia. The data were collected and analyzed.Results: From the 325 patients, 116 (35.7%) were males and 209 (64.3%) were females. The most frequent involved site was the left upper lobe in 175 (53.8%) followed by the right upper lobe in 134 (41.2%) cases. The most frequent radiographic finding was bronchopneumonia in 242 (74.4%) cases. Patchy consolidation was detected in 99 (30.4%) patients. Cavitary lesion and pleural effusion were observed in 68 (20.9%) and 35 (10.7%) patients, respectively.Conclusion: The results show that pulmonary upper lobes were the most frequent involved sites.}, Keywords = {Pulmonary tuberculosis, Smear positive TB, Chest X-ray}, volume = {4}, Number = {4}, pages = {777-780}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-223-en.html}, eprint = {http://caspjim.com/article-1-223-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Alavi, Seyed Mohammad and Jamshidian, Ramin and Salmanzadeh, Shokrolah}, title = {Comparative study on toxoplasma serology among HIV positive and HIV negative illicit drug users in Ahvaz, Iran}, abstract ={Comparative study on toxoplasma serology among HIV positive and HIV negative illicit drug users in Ahvaz, Iran}, Keywords = {Keywords: HIV, Toxoplasma antibody, Illicit drug user.}, volume = {4}, Number = {4}, pages = {781-784}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-224-en.html}, eprint = {http://caspjim.com/article-1-224-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Farazi, Aliasghar and Sofian, Masoomeh and Zarrinfar, Nader and Katebi, Fatemeh and Hoseini, Seyed Davood and Keshavarz, Roohollah}, title = {Drug resistance pattern and associated risk factors of tuberculosis patients in Iran\'s Central Province}, abstract ={Background: One of the fundamental issues of infectious disease treatment is drug resistance. The aim of the present study was to investigate the first-line anti-tuberculosis drug resistance rates and determine the risk factors related to multidrug resistant mycobacterium tuberculosis.Methods: From March 2011 to September 2012, mycobacterial strains were collected from one hundred fifteen diagnosed smear positive patients in the central province of Iran and tested for drug susceptible against ethambutol, rifampicin, isoniazid and streptomycin and the risk factors influencing the development of drug resistance were determined.Results: The mean age of patients was 52.23±19.75 years. The rate of multi-drug resistant tuberculosis (MDR-TB) was 7.8%. Our study revealed that there were significant associations between prior treatment, age < 45 years, positive smear result at the end of the second month and positive smear result at the end of the third month. However, there was no association found between gender, inhabitant, nationality, close contact with TB patient, HIV infection and size of mantoux test.Conclusion: The results show that about 8% of TB cases in Arak are MDR TB. The age under 45 years, previous TB treatment and positive smear at the end of the second and third months of treatment were the main factors in the development of MDR-TB.}, Keywords = {Drug resistance, Mycobacterium tuberculosis, Risk factor}, volume = {4}, Number = {4}, pages = {785-789}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-225-en.html}, eprint = {http://caspjim.com/article-1-225-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Changal, Khalid Hamid and Raina, Hameed and Parray, Manzoor Ahmed and AhmadSofi, Fayaz}, title = {Carcinoma of the Breast Presenting As Deep Vein Thrombosis of the Axillary Vein}, abstract ={Background: Breast cancer is the most common type of malignancy in the female population, rarely is reported by thromboembolic events during the course of the disease. In this case, we present a rare case of breast cancer presenting as deep vein thrombosis of the axillary vein.Case Presentation: A 40-year- old female was admitted due to pain and swelling of her right arm and forearm of two months’ duration. The right arm was grossly edematous with pitting edema. Breast examination showed non-tender fixed nodules in the right outer quadrant of the right breast. Doppler ultrasonography showed right axillary vein thrombosis. The pathologic examination of the nodules confirmed infiltrating ductal adenocarcinoma.Conclusion: This case highlights the procoagulant state of malignancies and it is important to remember that though rare, breast malignancies can present as deep venous thrombosis. This case also highlights the early and aggressive evaluation of any breast discharge to rule out carcinoma of the breast}, Keywords = {Breast carcinoma, Deep Vein Thrombosis, Axillary vein}, volume = {4}, Number = {4}, pages = {790-792}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-226-en.html}, eprint = {http://caspjim.com/article-1-226-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Motallebnejad, Mina and Shirzad, Atena and Molania, Tahere and Seyedmajidi, Maryam}, title = {Multiple recurrent vesicles in oral mucosa suggestive of superficial mucocele, (an unusual presentation of allergic stomatitis)}, abstract ={Background: Superficial mucocele presents as small, clear vesicle on noninflamed mucosa. In this study, we report several vesicles on the bucal mucosa of a woman diagnosed as superficial mucocele.Case Presentation: A 48-year old woman presented with multiple vesicles on her labial mucosa, ventral surface of the tongue, floor of the mouth and palate. A mucosal biopsy was taken from the vesicle. Histopathologically, intraepithelial mucocele was diagnosed. The lesion was successfully treated with mouthwash betamethasone. There has been no recurrence for 18 months.Conclusion: In the present study, several mucoceles were seen in the oral mucosa. No similar case was reported previously.}, Keywords = {Superficial mucocele, Vesicle, Mucosa, Salivary gland}, volume = {4}, Number = {4}, pages = {793-796}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-227-en.html}, eprint = {http://caspjim.com/article-1-227-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} } @article{ author = {Mansour-Ghanaei, Fariborz and Vahhabi-Moghaddam, Masrour and Joukar, Farahnaz and Asgharnezhad, Mehrnaz and Kiyani, Noufar}, title = {Non invasive evaluation of nonalcoholic steatohepatitis (NASH)}, abstract ={No abstract}, Keywords = {nonalcoholic steatohepatitis, NASH, Non-alcoholic fatty liver disease}, volume = {4}, Number = {4}, pages = {797-798}, publisher = {Babol University of Medical Sciences}, url = {http://caspjim.com/article-1-228-en.html}, eprint = {http://caspjim.com/article-1-228-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2013} }