@article{ author = {Mahmoudpour, Zeinab and Shirafkan, Hoda and Mojahedi, Morteza and Gorji, Narjes and Mozaffarpur, Seyyed Ali}, title = {Digesters in traditional Persian medicine}, abstract ={Background: Functional gastrointestinal diseases are common in general populations and comprise more than 40% visits to gastroenterologists. Treatment options of gastrointestinal diseases have been limited. There are a few medications for functional gastrointestinal diseases and some of medications are not available in the market or in the place where the patient lives. Traditional Persian medicine (TPM) is a branch of alternative and traditional medicine based on individual viewpoint and humoral theory, focuses on lifestyle modification and uses natural products to manage the patients. Methods: In this study, a set of compound drugs known as digesters (jawarishes) and other applications are described based on main TPM text books. Results: Jawarishes have different formulations containing various medicinal herbs used for better food digestion and improved gastric functions and also used for other disorders including reinforcing the brain, heart, liver and some therapeutic approaches. Conclusions: By reviewing medieval Persian pharmaceutical manuscripts, we can conclude that many herbs are effective in different systems of the body and improve gastric functions. Zingiber officinalis and Piper nigrum are mixed together to get various formulations. The variety of jawarishes formulations and their different clinical applications can indicate continuity of their use.}, Keywords = {Gastrointestinal tract, Herbal medicine, Jawarish}, volume = {9}, Number = {1}, pages = {1-6}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.1}, url = {http://caspjim.com/article-1-957-en.html}, eprint = {http://caspjim.com/article-1-957-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Jangi, Majid and Fernández-de-las-Peñas, Cesar and Tara, Mahmoud and Moghbeli, Fateme and Ghaderi, Fariba and Javanshir, Khodabakhsh}, title = {A systematic review on reminder systems in physical therapy}, abstract ={Background: The main goal of physical therapy is to help the patient gain a better health status. Several studies have investigated the use of reminders to prevent such failures on the patients’ side. This article presents a systematic review of the literature concerning reminders in physical therapy. Methods: Databases were searched until May 2017 and literatures were found from April 1992 until 2017. The literature recruitment strategy was based on applying several keywords and Medical Subject Heading (MeSH) combination running against title and abstract, including concepts such as reminder, physical therapy. The finally selected articles were categorized through reminder aspects such as how, who feedback. Data were extracted according to PRISMA guidelines. Results: In 47% of studies, the reminder was sent to the patients, 29% to the physical therapists and 12% to the caretaker team. In 24% of the studies, paper-based letters were main medium for reminders while the rest were various types of media like emails and SMS mobile text messages. 35% of the articles showed positive effects of the reminders. Conclusions: Many reminder methods consisted of SMS, phone calls, letters, emails and notices on the wall were used in physical therapy. Reminders may be used to improve patients' adherence to exercise programs.}, Keywords = {Reminder, Physical therapy, Systematic review}, volume = {9}, Number = {1}, pages = {7-15}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.7}, url = {http://caspjim.com/article-1-1024-en.html}, eprint = {http://caspjim.com/article-1-1024-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Khazaei, Salman and Karami, Manoochehr and Ayubi, Erfan and Mohammadbeigi, Abolfazl and Hasanbeigi, Azim and Mansori, Kamyar and Mir-Shekar, Mohammad Rez}, title = {Trends in epidemiology of Hepatitis B and C Infections in Ilam Province: National Notifiable Diseases Surveillance System data}, abstract ={Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the main causes of severe liver failure worldwide. This study was conducted to evaluate the incidence rate and trend of these infections over six successive years from 2008 to 2013 in Ilam Province, western Iran. Methods: We studied the registered data of HBV and HCV based on the National Notifiable Diseases Surveillance System in Ilam Province from 2008 to 2013. Incidence rate per 100,000 populations was estimated for HBV and HCV infections through location, years and age groups of patients. Results: The overall incidence rate per 100,000 populations from 2008 to 2013 for HBV infection was 9.57, 5.83, 16.26, 12.44, 21.89 and 13.93, respectively. The corresponding values for HCV infection were 0.55, 0.72, 1.44, 2.69, 1.24 and 1.93, respectively and these trends for both the HBV and HCV infections were increasing. The major distribution of HBV and HCV infections was 25-44 years of age. Both HBV and HCV infections were more common in males, urban areas and married patients. Forty-one percent of cases were carriers and history of surgery was the common risk factor. Conclusions: Our results showed that HBV and HCV are prevalent in the middle-age group. Despite effective vaccination against hepatitis B, optimized blood donor screening and better sterilization procedures for blood products, trend of HBV and HCV in Ilam are increasing. Further studies should address the role other risk factors in the trend of HBV and HCV.}, Keywords = {Hepatitis B, Hepatitis C, Incidence, Trend, Iran}, volume = {9}, Number = {1}, pages = {16-21}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.16}, url = {http://caspjim.com/article-1-893-en.html}, eprint = {http://caspjim.com/article-1-893-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Hussein, Nawfal}, title = {Risk factors of hepatitis B virus infection among blood donors in Duhok city, Kurdistan Region, Iraq}, abstract ={Background: Hepatitis B virus (HBV) infection is a public health problem. The lack of information about the seroprevalence and risk factors is an obstacle for preventive public health plans to reduce the burden of viral hepatitis. Therefore, this study was conducted in Iraq, where no studies had been performed to determine the prevalence and risk factors of HBV infection. Methods: Blood samples were collected form 438 blood donors attending blood bank in Duhok city. Serum samples were tested for HBV core-antibodies (HBcAb) and HBV surface-antigen (HBsAg) by ELISA. Various risk factors were recorded and multivariate analysis was performed. Results: 5/438 (1.14%) of the subjects were HBsAg positive (HBsAg and HBcAb positive) and 36/438 (8.2%) were HBcAb positive. Hence, 41 cases were exposed to HBV and data analysis was based on that. Univariate analysis showed that there were significant associations between history of illegitimate sexual contact, history of alcohol or history of dental surgeries and HBV exposure (p<0.05 for all). Then, multivariate analysis was conducted to find HBV exposure predictive factors. It was found that history of dental surgery was a predictive factor for exposure to the virus (P=0.03, OR: 2.397). Conclusions: This study suggested that the history of dental surgery was predictive for HBV transmission in Duhok city. Further population-based study is needed to determine HBV risk factors in the society and public health plan based on that should be considered}, Keywords = {HBV, Iraq, Duhok, Risk factors}, volume = {9}, Number = {1}, pages = {22-26}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.22}, url = {http://caspjim.com/article-1-809-en.html}, eprint = {http://caspjim.com/article-1-809-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Vafaey, Hamid Reza and SalehiOmran, Mohammad Taghi and Abbaspour, Sadaf and Banihashem, Nadia and FaghanzadehGanji, Ghassem}, title = {Anti-coagulation therapy following coronary endarterectomy in patient with coronary artery bypass graft}, abstract ={Background: Since there is a lack of research on postoperative anticoagulation protocol in patients undergoing coronary artery bypass graft (CABG) / coronary endarterectomy (CE), we recommend a new protocol for anticoagulation in these patients. Methods: In this double-blind randomized clinical trial study, 52 patients undergoing CABG / CE entered the study and were divided into two groups. In group 1, the patients were given  warfarin(international normalized ratio (INR) between 2-3) together with 80 mg aspirin daily for 3 months. In group 2, the patients were given 75 mg plavix daily together with 80 mg aspirin daily for 3 months. We evaluated patients with electrocardiography, echocardiography and checking ceratin phosphokinase MB and troponin I in the several stages. The data were analysed SPSS Version18 software. Results: There was no significant difference between pre and post-operative Ejection fraction in patients with plavix (P=0.21) and warfarin (P=0.316) regimen. However, wall mrotion score was significantly better in clopidogrel – aspirin patients in late (3 months) post operation (p<0.001). Conclusions: Since warfarin has serious hemorrhagic complications and requires closed monitoring of serum drug activity by serial INR checking, it is recommended that clopidogrel – aspirin can be the preferred alternative anticoagulation therapy in CABG / CE patients.}, Keywords = {Coronary artery bypass graft, Coronary endarterectomy, Warfarin, Clopidogrel}, volume = {9}, Number = {1}, pages = {27-31}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.27}, url = {http://caspjim.com/article-1-954-en.html}, eprint = {http://caspjim.com/article-1-954-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Seyfi, Shahram and Banihashem, Nadia and Bijani, Ali and Hajian-Tilaki, Karimollah and Daghmehchi, Mohse}, title = {Analgesic effects of lidocaine-ketorolac compared to lidocaine alone for intravenous regional anesthesia}, abstract ={Background: Intravenous regional anesthesia is a simple and reliable method for upper extremity surgery. In order to increase the quality of blocks and reduce the amount of pain, many drugs are used with lidocaine. In this study, the effect of ketorolac-lidocaine in intravenous regional anesthesia was investigated. Methods: 40 patients undergoing elective upper limb with America Society of Anesthesiologists class I and II were selected and randomly divided into two groups. The first group of 20 patients received 200 mg of lidocaine, and the second group, 200 mg of lidocaine with 20 mg of ketorolac. In both groups, the drug was diluted to 40 ml. In both groups, the onset of sensory block, onset of tourniquet pain, the onset of pain after opening the tourniquet, score of postoperative pain and analgesic prescription in the first 24 hours, during 1, 6, 12 and 24 hours were studied. A measure of the quality of analgesia was evaluated by VAS. Results: The mean onset of tourniquet pain in the two groups was not significantly different (P=0.443). In the ketorolac group, the onset of pain after opening the tourniquet was significantly longer than lidocaine group (p<0.001). The mean postoperative pain score during the first 24 hours after surgery in the ketorolac group was significantly lower than lidocaine group (p<0.001). The average number of analgesia prescription during the 24 hours after operation was significantly lower in ketorolac group than lidocaine group (p<0.001). Conclusions: Adding ketorolac to lidocaine for regional anesthesia can reduce the postoperative pain for up to 24 hours after opening the tourniquet.}, Keywords = {Lidocaine, ketorolac, pain, Intravenous regional anesthesia}, volume = {9}, Number = {1}, pages = {32-37}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.32}, url = {http://caspjim.com/article-1-736-en.html}, eprint = {http://caspjim.com/article-1-736-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Naderinabi, Bahram and Soltanipour, Soheil and Nemati, Shadman and Saberi, Alia and Parastesh, Sepideh}, title = {Acupuncture for chronic nonpulsatile tinnitus: A randomized clinical trial}, abstract ={Background: There is challenge to find an effective treatment for tinnitus. Few studies were done on the effects of acupuncture on tinnitus. This study evaluated the effect of acupuncture on chronic non-pulsatile tinnitus. Methods: This randomized double-blind clinical trial was conducted from December 2014 to September 2015. Patients suffering from chronic non-pulsatile tinnitus were randomly allocated into two groups: acupuncture vs. placebo. They were treated in 15 sessions and at the end of the fifteenth sessions and 3 weeks after completion of the treatment, visual analog scale (VAS) for tinnitus loudness and tinnitus severity index (TSI) questionnaires were completed. Results: The case group included 26 males and 18 females, and in the control group there were 27 males and 17 females: with mean age of 49.11±1.07 and 55.20±8.33 years, respectively (p=0.005). TSI and VAS before treatment were 43.84±2.81 and 9.56±0.43 in cases and 43.52±2.94 and 9.54±0.45 in controls, respectively. Both measures improved after 15 sessions in cases to 24.82±1.04 and 2.88±0.33, and to 33.16±1.24 and 7.86±0.23 in controls. The changes of TSI and VAS were significant in all groups (p<0.001). TSI and VAS in acupuncture group were lower than placebo group in each session (p<0.001), except TSI in the tenth session (p=0.392). Conclusions: Acupuncture is effective in reducing the loudness and severity of tinnitus and can be a useful treatment for nonpulsatile chronic tinnitus}, Keywords = {Tinnitus, Acupuncture, Severity, Loudness}, volume = {9}, Number = {1}, pages = {38-45}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.38}, url = {http://caspjim.com/article-1-930-en.html}, eprint = {http://caspjim.com/article-1-930-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Faramarzi, Fatemeh and Shiran, Mohamadreza and Rafati, Mohamadreza and Farhadi, Roya and Salehifar, Ebrahim and Nakhshab, Maryam}, title = {The efficacy and safety of two different doses of caffeine in respiratory function of preterm infants}, abstract ={Background: Caffeine is widely used for prevention of apnea and helps successful extubation from mechanical ventilation. It facilitates the transition from invasive to noninvasive support and reduces duration of continuous positive airway pressure (CPAP) in preterm infants. The optimum caffeine dose in preterm infants has not been well-studied in terms of benefits and risks. We compared efficacy and safety of once versus twice-daily caffeine dose in premature infants. Methods: This study was a randomized clinical trial conducted in Bu-Ali Sina Teaching Hospital, Sari. Patients with gestational age of <37 weeks were included. Both groups received 20 mg/kg loading dose of caffeine intravenously followed by maintenance dose of 5 mg/kg/day in group 1 or 2.5 mg/kg every 12 hours in group 2. Extubation failure, CPAP failure and possibly adverse reactions were evaluated. Results: The mean of gestational age and birth weight were 32.27±3.23 (weeks) and 1824.5±702.54 (gr), respectively. The rate of extubation and CPAP failure and length of NICU stay were lower in twice-daily-group with no statistically significant difference. The means of O2 saturations on the first three days of caffeine therapy were higher in twice-daily-group. Caffeine was generally safe and well tolerated. Conclusions: This study, which assayed short-term effects of caffeine, showed that twice daily caffeine maintenance dose was related to more benefits in facilitating extubation or prevention of CPAP failure in preterm infants. However, there was not statistically significant difference between two groups.}, Keywords = {Caffeine, Extubation failure, CPAP failure, Preterm infants}, volume = {9}, Number = {1}, pages = {46-53}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.46}, url = {http://caspjim.com/article-1-947-en.html}, eprint = {http://caspjim.com/article-1-947-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Zamani, Mohammad and Vahedi, Amin and Tamaddoni, Ahmad and Bijani, Ali and Bagherzade, Mojgan and Shokri-Shirvani, Jav}, title = {Relationship between β-Thalassemia minor and Helicobacter pylori infection}, abstract ={Background: Until now, no study has been reported investigating the association between β-thalassemia minor and Helicobacter pylori (H. pylori) infection. This study was designed to compare H. pylori infection rate between β-thalassemia minor patients and healthy controls. Methods: A number of 100 β-thalassemia minor patients (50 males, 50 females) and 100 gender-matched healthy controls were prospectively recruited in this study in a period of 3 months. The study population consisted of the people who referred to a health center in Babol, North of Iran, for premarital counseling. H. pylori status was assessed by measuring the anti-H. pylori IgG antibodies using enzyme-linked immunosorbent assay. Demographic information and informed consent were collected from all participants. Results: The overall H. pylori infection rate was 43%. The infection was significantly more prevalent in thalassemia patients (53%) than in the controls (33%) in both univariate (OR=2.29, 95% CI: 1.3-4.06) and multivariable analyses (OR=2.05, 95% CI: 1.12-3.76). Age was the only significant factor which was positively correlated with the infection in β-thalassemia minor cases (OR=1.11, 95% CI: 1.02-1.2). Gender, blood groups, residency, and education level were not related to the infection. Conclusions: According to the results, it can be concluded that β-thalassemia minor patients are possibly more susceptible to H. pylori infection than healthy people. Further studies are needed to discover more about the exact mechanisms of increased susceptibility to H. pylori infection in β-thalassemia minor patients}, Keywords = {Helicobacter pylori, thalassemia minor, prevalence}, volume = {9}, Number = {1}, pages = {54-59}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.54}, url = {http://caspjim.com/article-1-1061-en.html}, eprint = {http://caspjim.com/article-1-1061-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Sharbatdaran, Majid and Halakou, Amin and Kashifard, Mehrdad and Bijani, Ali and Firozjaei, Alireza and Hossaini, Akram and Siadati, Sepideh}, title = {Fecal calprotectin Level in patients with IBD and noninflammatory disease of colon: a study in Babol, Northern, Iran}, abstract ={Background: Inflammatory bowel disease (IBD) is a chronic disease with a relapsing course of inflammation in the digestive system. Endoscopy and histopathology are the golden standard methods for detection and assessment of IBD. A distinct increase of fecal calprotectin level can be a useful marker for the diagnosis of IBD. The aim of this study was to evaluate the fecal calprotectin level in patients with IBD and without inflammatory diseases of the colon. Methods: Calprotectin levels of patients referred to the Ayatollah Rouhani Hospital of Babol, northern Iran with clinical symptoms of colon disease were evaluated. After a week, colonoscopy and biopsy were performed on all patients and they were divided into two groups. The first group included patients with confirmed IBD and the second group included patients with diseases other than IBD, patients with IBS and healthy persons. Then the measured fecal calprotectin level was compared between the two groups before colonoscopy. Results: We observed correlation between calprotection in these two groups (p<0.0001). 38 (86.8%) patients in the case group and 5 (13.2%) patients in the control group had positive fecal calprotectin test and 12 (23.1%) patients in the case group and 40 (76.9%) patients in the control group had negative results. Basad on ROC curve, the cutoff point of calprotectin was 127.65 with 73% sensitivity and 89% specificity. The area under the curve was 0.83 with 95% confidence interval, 0.74-0.91 (p<0.0001). Conclusions: The results pointed to this fact that fecal calprotectin can be a noninvasive marker in differentiating IBD from IBS}, Keywords = { Fecal calprotectin level, Inflammatory bowel disease, Irritable bowel syndrome}, volume = {9}, Number = {1}, pages = {60-64}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.60}, url = {http://caspjim.com/article-1-524-en.html}, eprint = {http://caspjim.com/article-1-524-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Ayatollahi, Hossein and Keramati, Mohammadreza and Shirdel, Abbass and Kooshyar, Mohammadmehdi and Raeiszadeh, Majid and Shakeri, Sepideh and Sadeghian, Mohammadhadi and Shams, Fatemeh}, title = {BCR-ABL fusion genes and laboratory findings in patients with chronic myeloid leukemia in northeast Iran}, abstract ={Background: A specific chromosomal abnormality, the Philadelphia chromosome (BCR-ABL fusion), is present in all patients with chronic myeloid leukemia (CML). The b2a2 and b3a2 fusion mRNAs encode p210 fusion protein p210 and e1a2 encode p190. The aim of this study was to evaluate the frequency of BCR-ABL fusion transcript variants in Northeast of Iranian CML patients and to compare the laboratory results of our patients. Methods: This study was conducted in 85 peripheral blood and bone marrow samples of CML patients. Ribonucleic acid (RNA) was extracted by a commercial kit, RT- PCR for identifying BCR-ABL fusions was carried out by using designed primers and the PCR products were electrophoresed in agarose gels. Finally, statistical analysis was performed for variant frequency identification and their comparison was performed. Results: All patients examined were positive for BCR/ABL rearrangement. Fusion of b3a2 was detected in 53 (62.35%) patients, b2a2 in 25 (29.41), e1a2 in 1 (1.17%) and coexpression of b3a2 and e1a2 in 6 (7.05%) patients. There were significant differences between the mean age in patients with b3a2 positive ( 44.07 years) and in b3a2 negative group (50.35 years) however, no significant differences were seen between sex and b2a2 (P=0.61), b3a2 (P=0.79) and e1a2 (P=0.20). Conclusions: This study showed higher frequency b3a2 than b2a2 and e1a2 transcripts in CML patients in Northeast Iran and there was no association between e1a2 transcripts frequencies and monocytosis in peripheral blood}, Keywords = {BCR-ABL, RT-PCR, chronic myeloid leukemia, Iran}, volume = {9}, Number = {1}, pages = {65-70}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.65}, url = {http://caspjim.com/article-1-825-en.html}, eprint = {http://caspjim.com/article-1-825-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Khosrowbeygi, Ali and Rezvanfar, Mohammad Reza and Ahmadvand, Hass}, title = {Tumor necrosis factor- α, adiponectin and their ratio in gestational diabetes mellitus}, abstract ={Background: It has been suggested that inflammation might be implicated in the gestational diabetes mellitus (GDM) complications, including insulin resistance. The aims of the current study were to explore maternal circulating values of TNF-α, adiponectin and the adiponectin/TNF-α ratio in women with GDM compared with normal pregnancy and their relationships with metabolic syndrome biomarkers. Methods: Forty women with GDM and 40 normal pregnant women were included in the study. Commercially available enzyme-linked immunosorbent assay methods were used to measure serum levels of TNF-α and total adiponectin. Results: Women with GDM had higher values of TNF-α (225.08±27.35 vs 115.68±12.64 pg/ml, p<0.001) and lower values of adiponectin (4.50±0.38 vs 6.37±0.59 µg/ml, P=0.003) and the adiponectin/TNF-α ratio (4.31±0.05 vs 4.80±0.07, P<0.001) than normal pregnant women. The adiponectin/TNF-α ratio showed  negative correlations with insulin resistance (r=-0.68, p<0.001) and triglyceride (r=-0.39, P=0.014) and a positive correlation with insulin sensitivity (r=0.69, p<0.001). Multiple linear regression analysis showed that values of the adiponectin /TNF-α ratio were independently associated with insulin resistance. Binary logistic regression analysis showed that GDM was negatively associated with adiponectin /TNF-α ratio. Conclusions: In summary, the adiponectin/TNF-α ratio decreased significantly in GDM compared with normal pregnancy. The ratio might be an informative biomarker for assessment of pregnant women at high risk of insulin resistance and dyslipidemia and for diagnosis and therapeutic monitoring aims in GDM}, Keywords = {Gestational diabetes mellitus, Adiponectin, Tumor necrosis factor- α, Insulin resistance}, volume = {9}, Number = {1}, pages = {71-77}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.71}, url = {http://caspjim.com/article-1-1009-en.html}, eprint = {http://caspjim.com/article-1-1009-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Bijani, Ali and Esmaili, Haleh and Ghadimi, Reza and Babazadeh, Atekeh and Rezaei, Reyhaneh and Cumming, Robert G and Hosseini, Seyed-Rez}, title = {Development and validation of a Semi-quantitative food frequency questionnaire among older people in north of Iran}, abstract ={Background: The study was conducted to assess reliability of modified semi-quantitative food frequency questionnaire (SQFFQ) as a part of the Amirkola Health and Aging Project (AHAP). Methods: The study was carried out in a sample of 200 men and women aged 60 years and older. A 138-item SQFFQ and two 24-hour dietary recalls were completed. The reliability of SQFFQ was evaluated by comparing eighteen food groups, energy and nutrient intakes derived from both methods using Spearman and Pearson’s correlation coefficients for food groups and nutrients, respectively. Bland-Altman plots and Pitman’s tests were applied to compare the two dietary assessment methods. Results: The mean (SD) age of subjects was 68.16 (6.56) years. The average energy intake from 24-hour dietary recalls and the SQFFQ were 1470.2 and 1535.4 kcal/day, respectively. Spearman correlation coefficients, comparing food groups intake based on two dietary assessment methods ranged from 0.25 (meat) to 0.62 (tea and coffee) in men and from 0.39 (whole grains) to 0.60 (sugars) in women. Pearson correlation coefficients for energy and macronutrients were 0.53 for energy to 0.21 for zinc in male and 0.71 for energy to 0.26 for vitamin C in females. The Pitman’s test reflected the reasonable agreement between the mean energy and macronutrients of the SQFFQ and 24-hour recalls. Conclusions: The modified SQFFQ that was designed for the AHAP was found to be reliable for assessing the intake of several food groups, energy, micro-and macronutrients.}, Keywords = {Reliability, Semi quantitative food frequency questionnaire, Cohort study, Elderly}, volume = {9}, Number = {1}, pages = {78-86}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.78}, url = {http://caspjim.com/article-1-1241-en.html}, eprint = {http://caspjim.com/article-1-1241-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Fallah, Golnaz and Moudi, Sussan and Hamidia, Angela and Bijani, Ali}, title = {Stimulant use in medical students and residents requires more careful attention}, abstract ={Background: Stimulant pharmaceuticals are abused among academic students to elevate mood, improve studying, intellectual capacity, memory and concentration, and increase wakefulness. This study was designed to evaluate the current situation of stimulant use among medical students and residents of Babol University of Medical Sciences. Methods: This cross-sectional study was conducted among 560 medical students and clinical residents of Babol University of Medical Sciences during the academic year 2014-2015. A self-administered questionnaire was used for data collection. Results: Four hundred and forty-four (79.3%) students filled out the questionnaires. 49 (11%) individuals reported amphetamine and methylphenidate (ritalin) use. The mean age of the stimulant drug users was 24.6±4.8 years. The main initiator factor was to improve concentration (29 persons; 59.2%). There were significant statistical correlations between stimulant drugs abuse and male gender, living in dormitor in residence and internship and past medical history of psychiatric disorders (depression, attention deficit hyperactivity disorder and substance abuse) (p<0.05).16 (32%) students started the drug use on their friends’ advice; 15 (30%) due to self-medication and 12 (24%) persons with physician´s prescription. Conclusions: Because of significant prevalence of stimulant use, regulatory governmental policies and also planning to improve essential life skills, awareness about the side effects and complications of these drugs, screening of at-risk college students and early identification of the abusers are suggested}, Keywords = {Stimulants, Medical students, Residents}, volume = {9}, Number = {1}, pages = {87-91}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.87}, url = {http://caspjim.com/article-1-984-en.html}, eprint = {http://caspjim.com/article-1-984-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Hossieni, Kaveh and Jahangiri, Mojtaba and Vasheghani-Farahani, Ali}, title = {Performance of electrophysiologic study in an asymptomatic patient with type 2 intermittent Brugada syndrome: To do or not to do?}, abstract ={Background: Brugada syndrome (BrS) is an inherited channelopathy, which is associated with sudden cardiac death due to rapid polymorphic VT or VF. There is no definite consensus regarding the management of asymptomatic patients. Some experts advocate close follow-up; others propose the programmed stimulation for risk stratification. We aimed to evaluate the benefit of complete atrial and ventricular stimulation in patients with BrS and palpitation. Case Presentation: A 30-year-old man was admitted to our hospital because of a family history of sudden cardiac death (SCD) at age less than 45 years. He complained of self-terminated episodes of palpitation with no history of syncope. Baseline ECG showed incomplete right bundle branch block (RBBB) and saddle-back-like ST deviation in V1. Flecainide challenge test (FCT) revealed Brugada pattern. Complete EPS was done for evaluation of VT/VF inducibility and probable concomitant supraventricular arrhythmias. Programmed atrial stimulation showed inducible typical slow-fast AVNRT with AH jump 75 msec. Successful slow pathway ablation was done. There was no inducible ventricular arrhythmia. Conclusions: Patients with drug-induced BrS, positive family history of SCD and also episodes of palpitation, benefit from complete EPS. However, ICD implementation is not recommended in asymptomatic patients with drug-induced BrS and negative EPS for ventricular stimulation}, Keywords = {Brugada syndrome, Supraventricular Tachycardia, electrophysiology study}, volume = {9}, Number = {1}, pages = {92-95}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.92}, url = {http://caspjim.com/article-1-936-en.html}, eprint = {http://caspjim.com/article-1-936-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Arzani, Mahsa and Rezaei, Hamed and NaserMoghadasi, Abdorrez}, title = {Association of Limb-Girdle muscular dystrophy with multiple sclerosis: A case report}, abstract ={Background: The association of limb-girdle muscular dystrophy (LGMD) with other neurological disorders is uncommon. Case presentation: We report a 25-year-old female with LGMD who suffered from slowly progressive proximal muscular weakness and atrophy since she was 12 years of age. The patient recently presented with acute loss of left side visual acuity. After evaluation, findings were suggestive of multiple sclerosis. Conclusions: This is the first report of LGMD in association with MS. The simultaneous occurrence of MS with myopathies may be incidental but there may be a genetic susceptibility for both diseases. This comorbidity may influence the treatment of MS}, Keywords = {Limb-Girdle Muscular Dystrophy, Multiple Sclerosis, Myopathy}, volume = {9}, Number = {1}, pages = {96-99}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.96}, url = {http://caspjim.com/article-1-897-en.html}, eprint = {http://caspjim.com/article-1-897-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Hamdi, Wafa and Miladi, Saoussen and Kaffel, Dhia and Zouch, Imen and Kchir, Med Montacer}, title = {Sarcoidosis and spondyloarthritis: A coincidence or common etiopathogenesis?}, abstract ={Background: Sarcoidosis is a multisystem granulomatous disease. Co-existence with spondyloarthritis (SA) has been more described as an adverse effect of anti-TNF α therapy than an association. We report herein a case of a typical sarcoidosis confirmed by histological proofs and an advanced SA with a bamboo column. Case Presentation: A 48-years-old woman presented with inflammatory back pain for 5 years and ankle swelling for 1 year. On physical examination, she had an exaggerated dorsal kyphosis and disappearance of lumbar lordosis with limitation in motion of the cervical and lumbar spine. Laboratory tests did not show an inflammatory syndrome or hypercalcemia. Plain radiographies of the spine and pelvic revealed a triple ray appearance with sacroiliitis grade 4. Chest radiography and CT confirmed the presence of bilateral hilar lymph nodes and parenchymal nodes. Bronchoscopy and biopsies were performed showing non-calcified granulomatous reaction without cell necrosis. The diagnosis of SA was performed based on 9 points of Amor criteria associated with pulmonary sarcoidosis. She was treated with 15 mg per week of methotrexate and 1mg/kg/day of prednisone for pulmonary disease with good outcomes. Conclusions: Sarcoidosis may be associated to SA besides paradoxical drug effect. The same physio pathological pathways mediate by TNF α are arguments for association than hazardous coincidence}, Keywords = {Sarcoidosis, Ankylosing Spondylarthritis, Tumor Necrosis Factor Alpha}, volume = {9}, Number = {1}, pages = {100-103}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.100}, url = {http://caspjim.com/article-1-860-en.html}, eprint = {http://caspjim.com/article-1-860-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Komasi, Saeid and Saeidi, Mozhgan and Sariaslani, Payam and Soroush, Ali}, title = {A new delivery model to increase adherence to methadone maintenance treatment}, abstract ={}, Keywords = {Methadone maintenance treatment, Substance abuse, Technology}, volume = {9}, Number = {1}, pages = {104-105}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.1.104}, url = {http://caspjim.com/article-1-1050-en.html}, eprint = {http://caspjim.com/article-1-1050-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Kalantari, Narges and Ghaffari, Salman and Bayani, Masomeh}, title = {Cryptosporidium spp. infection in Iranian children and immunosuppressive patients: A systematic review and meta-analysis}, abstract ={Background: Cryptosporidiosis is an important cause of diarrhea in children and immunosuppressive patients. The current study was intended to evaluate the prevalence rate of Cryptosporidium infection and clarify the epidemiological characteristics of the infection in both children and immunosuppressive patients in Iran. Methods: Five English electronic databases including PubMed, Google Scholar, Science Direct, Scopus and Cochrane, and two Persian language databases Magiran and Scientific Information Database were searched. Additionally, reports from the Iranian congresses of parasitology and graduate student thesis dissertations were assessed manually. Results: Out of 1856 studies from the literature search, our search resulted in a total of 27 articles published from 1991 to 2016. These include 14 reports on cryptosporidiosis in children and 13 papers regarding immunosuppressive patients. 8520 children and 2015 immunosuppressed cases were evaluated. Oocysts of Cryptosporidium were found in 3.8% and 8% children cases and immunosuppressed patients, respectively. There was a relatively high variation in the prevalence estimates among different studies, and the Q statistics was high among articles regarding children (p<0.0001) and also between records regarding immunosuppressed patients (p<0.0001). Findings showed that the prevalence rates of Cryptosporidium infection are significantly higher in children under 5 years (P=0.00). Conclusions: In summary, the present study provides a comprehensive view of the epidemiology of Cryptosporidium in children and immunosuppressive patients in Iran. Furthermore, a multidisciplinary and multicenter study to evaluate the real prevalence of Cryptosporidium infection and to determine its risk factors using an adequate sample size and standardized methods is highly recommended.}, Keywords = {Children, Cryptosporidium spp., Cryptosporidiosis, Immunosuppressive patients, Iran, Prevalence}, volume = {9}, Number = {2}, pages = {106-115}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.106}, url = {http://caspjim.com/article-1-1033-en.html}, eprint = {http://caspjim.com/article-1-1033-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Adhe-Rojekar, Arati and RamchandraMogarekar, Mukund and VijayRojekar, Mohit}, title = {Paraoxonase Activities in Metabolic Syndrome in Children and Adolescents}, abstract ={Background: Metabolic syndrome (MetS) is a collection of various interrelated risk factors that appear to have an impact as development of atherosclerotic cardiovascular disease (CVDs). Epidemic of childhood and adolescent’s obesity has increased interest in the metabolic syndrome (MS) due to the potential projection into adulthood. The prevalence of MS in adolescents has been estimated to be 6.7% in young adults and 4.2% in adolescents. We aimed to study the MetS in children and adolescents with respect to metabolic changes. Methods: The international Diabetes Federation criteria were used for the selection of cases. Serum paraoxonase 1 (PON1) activities were measured using spectrophotometer. Statistical analysis was done using MyStat statistical software. Results: Serum PON1 arylesterase (ARE) and lactonase (LACT) activities were found to be reduced significantly in patients with MetS than in controls. Regression analysis showed a significant correlation between PON1 activities and body mass index. Area under curve (AUC) found to increase from HDL to PON1 ARE to PON1 LACT. Conclusions: From the present study, it is clear that in children and adolescents, reduction in PON1 activities in MetS is mainly due either to abnormalities with synthesis or secretion of HDL cholesterol or oxidative stress as a consequence of excess production of the free radicals. This study also iterates that it is the quality and not the quantity of HDL cholesterol which is important while studying the pathophysiology of MetS.}, Keywords = {Paraoxonase1, Arylesterase, Lactonase, Area under Curve, ROC curve, Regression Analysis}, volume = {9}, Number = {2}, pages = {116-120}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.116}, url = {http://caspjim.com/article-1-590-en.html}, eprint = {http://caspjim.com/article-1-590-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Vafaeimanesh, jamshid and Parham, Mahmoud and Norouzi, Samieh and Hamednasimi, Parinaz and Bagherzadeh, Mohamm}, title = {Insulin resistance and coronary artery disease in non-diabetic patients: Is there any correlation?}, abstract ={Background: Cardiovascular diseases are the most common causes of death in the world and type 2 diabetes is one of them because it is highly prevalent and doubles heart disease risk. Some studies suggest that insulin resistance is associated with coronary artery disease in non-diabetics. The aim of this study was to evaluate the association of insulin resistance (IR) and coronary artery disease (CAD) in non-diabetic patients. Methods: In this cross-sectional study, from September 2014 to July 2015, 120 patients referring to Shahid Beheshti Hospital of Qom were evaluated. Their medical history, baseline laboratory studies, BMI and GFR were recorded. After 8 hours of fasting, blood samples were taken from the patients at 8 am, including fasting glucose and insulin level. We estimated insulin resistance using the homeostatic model assessment index of IR (HOMA-IR). Finally, we evaluated the association between IR and CAD. Results: Totally, 120 patients were assigned to participate in this study, among them, 50 patients without CAD and 70 with coronary artery stenosis. Insulin resistance (HOMA-IR> 2.5) was positive in 59 (49.3%) patients and negative in 61 (50.7%) patients. Hence, the correlation between IR and CAD was not statistically significant (P=0.9). Conclusions: In this study, although the correlation was not found between insulin resistance and coronary heart disease, among men, we found a significant association between coronary heart disease and insulin resistance.}, Keywords = {Insulin resistance, coronary artery disease, nondiabetic patients}, volume = {9}, Number = {2}, pages = {121-126}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.121}, url = {http://caspjim.com/article-1-735-en.html}, eprint = {http://caspjim.com/article-1-735-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Shirzad, Atena and Bijani, Ali and Mehryari, Mahsa and Motallebnejad, Mina and Mohsenitavakoli, Sam}, title = {Validity and reliability of the persian version of the chronic oral mucosal diseases questionnaire}, abstract ={Background: Chronic oral mucosal disease questionnaire (COMDQ) is used to evaluate the quality of life in patients with chronic conditions of the oral mucosa. The aim of the present study was to evaluate the validity and reliability of the Persian version of this questionnaire. Methods: A total of 135 subjects were selected in two groups; group 1 consisted of 95 patients with chronic oral mucosal conditions, including recurrent aphthous stomatitis, oral lichen planus and pemphigus and mucous membrane pemphigoid and group 2 consisted of 40 patients with other oral diseases. The subjects completed the demographic data sheets and COMDQ and then underwent examinations to determine disease severity. After 14 days, the questionnaire was completed again by the group 1subjects only. Results: Cronbach’s α coefficient for COMDQ was estimated at 0.969 and the interclass correlation coefficient was estimated at 0.997. There was a significant relationship between the mean COMDQ scores and disease and pain severity. There was a clear correlation between the patients’ self-report about their general health and mean COMDQ scores and also between their opinions about their oral health and the mean COMDQ scores. Conclusions: The Persian version of COMDQ exhibited proper levels of reliability and validity. It is suggested that this questionnaire be used for the evaluation of the effect of treatment on the oral health-related quality of life (OHQoL).}, Keywords = {Chronic Oral Mucosal Disease, Reliability, Validity, Quality of life, Questionnaire}, volume = {9}, Number = {2}, pages = {127-133}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.127}, url = {http://caspjim.com/article-1-1049-en.html}, eprint = {http://caspjim.com/article-1-1049-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {ahmadi, norjis and Mahjoub, Soleiman and Hajihosseini, Reza and Taherkhani, Mostafa and Moslemi, Dariush}, title = {Alterations in serum levels of trace element in patients with breast cancer before and after chemotherapy}, abstract ={Background: Breast cancer is the most common serious disease around the world. The trace elements have a vital role in the metabolism and chemotherapy may change the level of metal ions. Due to the ambiguity of the existence in this regard, the study examined the trace element serum levels in women with breast cancer before and after chemotherapy . Methods: Sixty patients were studied undergoing specialist. First sampling was taken before chemotherapy (after 4 weeks of surgery) and second sampling was taken after the completion of 3 courses of chemotherapy, approximately 9 weeks after the first chemotherapy. The patients took Adriamycin 60mg/m2 Cytoxan 600mg/m2. Serum zinc and iron levels were measured using standard spectrophotometric method. Measurement of serum copper was done by atomic absorption spectroscopy. Results: Serum zinc and iron levels in women after chemotherapy significantly decreased (p<0.001), however, the serum level of copper increased but was not significant (P=0.676). Conclusions: Our findings demonstrate significant decrease in zinc and iron levels in breast cancer patients after 3 courses of Adriamycin and Cytoxan chemotherapy. Prescribing zinc supplements can be useful after chemotherapy}, Keywords = {Breast cancer, Chemotherapy, Trace elements, Adriamycin, Cytoxan}, volume = {9}, Number = {2}, pages = {134-139}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.134}, url = {http://caspjim.com/article-1-1149-en.html}, eprint = {http://caspjim.com/article-1-1149-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Vakili-sadeghi, Mohsen and Sedaghat, Sadegh}, title = {Is 99m Tc-methylene diphosphonate bone scintigraphy a sensitive method for detecting bone lesions in multiple myeloma?}, abstract ={Background: Bone lesion in multiple myeloma (MM) is most commonly presented as a lytic lesion in this disease. Determination of extent of bone lesions in MM is necessary to follow-up the patients. Whole body bone scan with 99m, Tc-methylene diphosphonate (MDP) has a lower sensitivity than other modalities. Methods: From the patients with MM admitted to Ayatollah Rouhani Hospital of Babol-Iran from 2009 to 2015, who had undergone whole body bone scan during diagnostic process, were entered into the study. Findings of bone scan were compared with MRI. Results: Of the 19 patients, sixteen (84.2%) of them had positive finding in bone scan, fifteen (78.9%) had MRI of the spine. While of the thirteen patients who had positive finding in MRI, seven (53.8%) had more positive finding in thorcolumbosacral MRI than in bone scan. Conclusions: 99m-Tc MDP bone scan is a sensitive but insufficient method for detecting bone lesions in MM.}, Keywords = {Tc-99m methylene diphosphonate, bone lesion, multiple myeloma}, volume = {9}, Number = {2}, pages = {140-143}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.140}, url = {http://caspjim.com/article-1-1014-en.html}, eprint = {http://caspjim.com/article-1-1014-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Wu, Hong and Ouyang, Peng and Sun, Wenju}, title = {High -density lipoprotein cholesterol as a predictor for diabetes mellitus}, abstract ={Background: Diabetes is a prevalent chronic disease around the world. To evaluate risk of diabetes comprehensively, we developed a score model for the risk prediction with HDL-C as a protective factor. Methods: We extracted physical examination data of 2728 individuals. The data contain 18 demographic and clinical variables. To identify the statistical significant feature variables, the backward stepwise logistic regression was used based on the data of the “exploratory population”. To ascertain the cutoff value of the selected variables, we used the Youden index. Then we assigned each variable level a score according to the estimated regression model coefficients and then calculated the individual’s total score. We gained the cutoff value for the total score through the Youden Index and stratified the total score into four levels. We employed the data of “validation population” to test the performance of the score model based on the area under the ROC curve. Results: Age, LDL-C, HDL-C, BMI, family history of diabetes, diastolic blood pressure and TCHO were selected as statistically significant variables. The diabetes risk score range varied from 0 to 17. The risk level categorized by the total score was low, middle, high and extremely high, with a score range of 0-2, 3-7, 8-12 and 13-17, respectively. Conclusions: The score model based on physical examination data is an efficient and valuable tool to evaluate and monitor the potential diabetes risk for both healthy and unhealthy people at an individual level.}, Keywords = {diabetes, risk score, score model}, volume = {9}, Number = {2}, pages = {144-150}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.144}, url = {http://caspjim.com/article-1-946-en.html}, eprint = {http://caspjim.com/article-1-946-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Khezri, Marzieh Beigom and Mosallaei, Maryam Al-sadat and Ebtehaj, Mahdi and Mohammadi, Navi}, title = {Comparison of preemptive effect of intravenous ketorolac versus meperidine on postoperative shivering and pain in patients undergoing cesarean section under spinal anesthesia: A prospective, randomized, double-blind study}, abstract ={Background: Pain and shivering are two unpleasant problems in postoperative period. Various techniques are used to alleviate the postoperative shivering and pain.  We compared the preemptive prescription of a single dose of intravenous meperidine and ketorolac on postoperative pain and shivering in patients undergoing cesarean section with spinal anesthesia. Methods: One hundred and fifty patients who were scheduled for elective cesarean section under spinal anesthesia were randomly allocated to one of three study groups to receive either intravenous ketorolac (group K), meperidine (group M) or normal saline (group P). Time to first analgesic request, analgesic requirement in the first 24 hours after surgery, body tympanic temperature, hemodynamic variables and incidence of shivering were assessed as outcome variables. Results: There was no significant difference between meperidine and ketorolac groups in terms of prevalence of shivering, although both groups were different from the placebo group (p<0.04). The mean time to first analgesic request was longer in group k (3.8±1.4) and groups M (3.3±1.2) than in group P (2.1±0.8) hours (p<0.001). Conclusions: The preemptive prescription of a single dose of intravenous meperidine and ketorolac can provide a satisfying analgesia immediately after surgery and decrease shivering prevalence without any serious side effects.}, Keywords = {shivering, ketorolac, meperidine, spinal anesthesia, cesarean section }, volume = {9}, Number = {2}, pages = {151-157}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.151}, url = {http://caspjim.com/article-1-1029-en.html}, eprint = {http://caspjim.com/article-1-1029-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Barzegari, Ali and Mirdar, Shadmehr}, title = {Effect of a 12-week submaximal swimming training in rats exposed to tobacco- derived nitrosamine ketone}, abstract ={Background: Tobacco contains carcinogens such as NNK (nicotine-derived nitrosamine ketone) that makes induction of lung cancer by changing the stimulation of IL-10 expression. The aim of this study was to investigate changes in resting levels of IL-10 in lung tissues of rats exposed to NNK after a 12-week aerobic submaximal swimming training. Methods: For this purpose, 46 Wistar rats were randomly divided into five groups consisting training, training + NNK, NNK, saline and control. NNK-induced groups received NNK subcutaneously one day per week at a rate of 12/5 mg per kg body weight and the training groups performed submaximal swimming training for 12 weeks. The levels of IL-10 in homogenized lung tissue were measured by ELISA. Results: Findings indicated that a period of swimming training increased the IL-10 levels significantly in lung tissue of training group when compared to control (P=0.00) and NNK groups (P=0.00). Also, a significant increase of IL-10 level was observed in exercise + NNK group when compared to NNK group (p≤0/02). Furthermore, it was observed that IL-10 levels of NNK group had a significant decrease when compared to training group (P=0/00), training + NNK group (p≤0/02), but had insignificant increase when compared to saline group (p≤0/85). Conclusions: Generally, it could be confirmed that regular submaximal aerobic training plays an important role in the inhibition of the effects of lung inflammation induced by NNK via increasing IL-10 activity.}, Keywords = {Interleukin 10, tobacco derived nitrosamine ketone, submaximal aerobic activity, inflammation.}, volume = {9}, Number = {2}, pages = {158-163}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.158}, url = {http://caspjim.com/article-1-1030-en.html}, eprint = {http://caspjim.com/article-1-1030-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Rib, Yelena and Zhussupova, Gulnar and Igimbayeva, Gaukhar and Abdrakhmanov, Ayan and Jalali, Seyedfarz}, title = {Can chronotropic incompetence predict life-threatening ventricular arrhythmias in patients with stable ischemic heart disease?}, abstract ={Background: Chronotropic incompetence has prognostic value of all-cause and cardiovascular mortality in both patients with asymptomatic and symptomatic ischemic heart disease (IHD), regardless of traditional risk factors. The aim of this study was to investigate the relationship between chronotropic response during exercise test and the development of ventricular arrhythmias. Methods: 153 patients with stable ischemic heart disease were screened and observed during the 24 months since October 2014 in a university hospital in Astana Kazakhstan. They underwent bedside electrocardiography, 24h heart rate Holter monitoring, echocardiography, exercise stress test (treadmill) for assessment of chronotropic index calculating at first contact. Holter- electrocardiography was repeated three times (at 3, 6, 12 months of follow-up period) to reveal life-threatening ventricular arrhythmias. Results: The quantity of the ventricular extrasystoles was higher in the group with low chronotropic index. Low chronotropic index increased the risk of high grade ventricular extrasystoles more than two times (P=0.015); episodes of non-sustained VT more than three times (p<0.001); and episodes of sustained VT more than nine times (p<0.001). Conclusions: Chronotropic index less than 35.6 increases the risk for life-threatening ventricular arrhythmias in patients with stable chronicle ischemic heart disease irrespectively of severe left ventricle systolic dysfunction.}, Keywords = {Chronotropic incompetence,stable ischemic heart disease, ventricular arrhythmias, risk factor}, volume = {9}, Number = {2}, pages = {164-170}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.164}, url = {http://caspjim.com/article-1-1103-en.html}, eprint = {http://caspjim.com/article-1-1103-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Heidari, Behzad and Heidari, Parnaz and Hajian-Taliki, Karimollah and Bayani, Mohammadali and Babaei, Mansour}, title = {Effect of long-term low dose prednisolone administration on bone mineral density: Relating to non-compliant women with rheumatoid arthritis}, abstract ={Background: Long-term treatment of rheumatoid arthritis (RA) with prednisolone (PRED) is associated with bone mineral density (BMD) loss. This study aimed to determine the status of BMD in non-compliant women who used PRED alone for RA. Methods: Non-adherent RA taking < 7.5 mg daily PRED without DMARDs for > 6 months, and RA patients taking methotrexate +PRED (RA control) were compared with age-matched non-RA controls. BMD was measured by dual energy x-ray absorptiometry (DXA) method and osteoporosis (OP) was diagnosed by WHO criteria. Influence of PRED on RA bone mass, and the risk of OP in RA  was assessed by comparing PRED users RA and RA control,versus non-RA controls. Results: Sixty-four PRED user RA, 39 RA controls and 111 non RA-controls, with respective mean (±SD) age of 52±11; 8, 51±11; and 52±7.5 years (p=0.91) were studied. Median duration of treatment in PRED users and RA control was 2.5 and 4 years, respectively. BMD g/cm2 at the femoral neck (FN-BMD) and lumber spine (LS-BMD) in PRED users and RA control was significantly lower than non-RA control (P=0.001). The prevalence of OP at either FN or LS in both RA groups was significantly higher than controls (P=0.001). In PRED users, the risk of OP increased by OR=4.9, P=0.001) and in RA controls by OR=1.7 (P=0.20). The risk of OP in PRED user RA was 2.89 times (P=0.014) greater than RA controls. Conclusions: These findings indicate significantly lower BMD, and higher prevalence of osteoporosis in non-compliant women with RA taking low-dose PRED alone for a median period of 2.5 years, as compared with patients taking standard treatment comprising methotrexate +PRED.  }, Keywords = {Rheumatoid arthritis, Compliance Steroid users, Prednisolone, Osteoporosis }, volume = {9}, Number = {2}, pages = {171-177}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.171}, url = {http://caspjim.com/article-1-32-en.html}, eprint = {http://caspjim.com/article-1-32-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Gharib, Sara and Moazezi, Zoleika and Bayani, Mohammadali}, title = {Prevalence and severity of ocular involvement in Graves’ disease according to sex and age: A clinical study from Babol, Iran}, abstract ={Background: Thyroid-associated eye disease (TED), previously known as Graves’ ophthalmopathy is a cosmetically and functionally debilitating disease that is seen worldwide. The aim of this study was to evaluate the prevalence and clinical severity of ocular manifestations of Graves’ disease according to sex, age and duration in northern Iran. Methods: Between April 2011 and March 2012, 105 patients with Graves’ disease, underwent ophthalmic examination, including ocular motility, exophthalmometry, intraocular pressure (IOP), slit lamp and fundoscopy. Patients received scores according to modified Werner’s NO SPECS classification. Results: Ocular involvement was found in 70 patients with established Graves’s disease. The mean age was 35.0 years, (SD 13.0, range 15 to 69). The most common ocular findings were exophthalmometric proptosis of more than 20 mm (63.8%), lid lag (55.7%), lid retraction (52.8%) and tearing (38.6%). Almost 70% of patients had bilateral involvement. Elevated IOP was seen in 15 (25.4%) patients, and was significantly related to proptosis (P=0.007). More than half of the patients (n=36, 52.2%) had a modified Werner’s NO SPECS score of 3.00. Clinical severity as shown by the increasing number of signs and symptoms per patient was correlated to increasing age (r=0.31, P=0.01) but not to gender (P=0.17). Conclusions: Both functional (ocular motility disorders, increased IOP) and cosmetic (proptosis, periorbital edema) sequels are common ocular presentations in patients with Graves' disease. Proptosis was the most common finding in this study and was associated with elevated IOP. Clinical severity was found to correlate to increasing age.}, Keywords = {Graves’ disease, thyroid-associated eye disease, proptosis, no specs}, volume = {9}, Number = {2}, pages = {178-183}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.178}, url = {http://caspjim.com/article-1-888-en.html}, eprint = {http://caspjim.com/article-1-888-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Azarkar, Zohreh and Ebrahimzadeh, Azadeh and Sharifzadeh, Gholamreza and Ziaee, Masood and Fereidouni, Mohammad and Taheri, Fatemeh}, title = {Persistence of immunity to hepatitis B vaccine as infants, 17 years earlier}, abstract ={Background: In Iran scince 1992, hepatitis B vaccination was a part of the national vaccination program. Hepatitis B vaccination is effective in the epidemiology of hepatitis B. The aim ofthis study was to evaluate the long – term persistence of immunity. Methods: This cross-sectional analytical study was conducted on children and adolescents aged between 6-18 years in Birjand, who received a three – dose hepatitis B vaccination in accordance with the national immunization program. No students were infected with hepatitis B. Antibody titer higher than10 IU/L was considered positive. Results: A total of 530 patients (307 boys and 223 girls) were recruited for the study of which 44% had positive antibody titer (≥10 IU / L). The geometric concentration mean (GMCs) of antibody in subjects was 64.9±34.2, HBS antibody titer was positive in 40.4% of the boys and 59.6% of the girls. A significant difference in antibody titers was observed in terms of gender and according to the time elapsed since the last vaccination. Antibody titer in children older  than 13 years had passed since their last vaccination and was significantly less than those children younger than thirteen years old had passed since their vaccination logistic regression analysis showed that the only predictive factor of anti-HBS low titer (<10 IU/L) is elapsed time of vaccination. Conclusions: Based on results of this study hepatitis B vaccine has created a good level of protection in 44% of the adolescents after 17 years}, Keywords = {Hepatitis B, Vaccination, Infant, Anti-HBS antibody, Immunity}, volume = {9}, Number = {2}, pages = {184-188}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.184}, url = {http://caspjim.com/article-1-915-en.html}, eprint = {http://caspjim.com/article-1-915-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Yokus, Osman and Gedik, Habip}, title = {Jak-2 mutation frequency in patients with thrombocytosis}, abstract ={Background: We aimed to investigate the etiologic causes and the existence of Janus kinase 2  mutation (JAK2) in cases with thrombocytosis. Methods: In this retrospective study, patients, who were admitted to hematology clinic with thrombocytosis between 2013 and 2015, were investigated in terms of the etiological causes of thrombocytosis and the existence of JAK2 mutation. Results: We retrospectively evaluated 136 cases that underwent JAK2 mutation analysis due to ET preliminary diagnosis in our hematology clinic. The mean age of the patients was 56.7±15.3 years (range: 22-86 years) and 71 (52%) were males. JAK2 mutation was found to be positive in 58 (42%) of cases. The mean platelet counts of the cases were 860.25×109 / L (range: 455-1,105 109 /L) and the mean spleen vertical length was 135.1±21.6 mm (range: 110-220 mm). Conclusions: JAK2 mutation analysis and bone marrow biopsy are the two main procedures to diagnose primary thrombocytosis in adults with persistent thrombocytosis after excluding the causes of secondary thrombocytosis. Myeloproliferative neoplasms and essential thrombocytosis are the common causes of primary thrombocytosis in adults with persistent thrombocytosis, as myelodysplastic syndrome rarely causes primary thrombocytosis.}, Keywords = {Thrombocytosis, Janus kinase 2, Essential thrombocytosis}, volume = {9}, Number = {2}, pages = {189-193}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.189}, url = {http://caspjim.com/article-1-787-en.html}, eprint = {http://caspjim.com/article-1-787-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Tavassoli, Ali and Sadeghi, Mahmood and Amrimaleh, Parviz}, title = {Botulism and cavernous sinus thrombosis induced by Acute rhinosinusitis: A case report}, abstract ={Background: Botulism is an acute and rapidly progressive descending paralytic disease caused by a neurotoxin of clostridium botulinum. Case presentation: A 28-year-old woman presented with severe generalized ascending symmetrical muscle paralysis. The patient was intubated and transferred to the medical intensive care unit with several symptoms including: severe headache, dysphagia, dyspnea, ptosis, diplopia, and dry mouth. Despite being alert, pupils were bilaterally midriatic and had absent corneal reflux. Pansinusitis was seen in the paranasal sinus scan. At first, the movement of eyelids, head and neck were restored. The movement of the upper limbs (15th day) and chest wall (20th day), abdomen (25th day) and the lower extremities (32nd day) were then gradually restored. On 41st day, the patient was completely disconnected from the ventilator. Conclusions: Botulism should be a diagnosis in any patient with an acute progressive symmetrical descending paralysis. Sinus mucosal injury (acute sinusitis) can be inoculated with spores of botulinum}, Keywords = {Acute sinusitis, Botulism, Paralysis}, volume = {9}, Number = {2}, pages = {194-197}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.194}, url = {http://caspjim.com/article-1-1023-en.html}, eprint = {http://caspjim.com/article-1-1023-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Jafari, Alimohamm}, title = {A rare case of hepatic subcapsular biloma after laparoscopic Cholecystectomy and subsequent endoscopic retrograde cholangiopancreatography}, abstract ={Background: Biloma is a rare abnormal localized accumulation of bile out of biliary tree due to an injury that occurs usually postoperatively from an injured cystic or bile duct. While most bilomas collect in the subhepatic space, we describe a rare case of hepatic subcapsular biloma after laparoscopic cholecystectomy and ERCP which was done one week after surgery successfully treated by percutaneous drainage and placement of plastic stents in CBD. Case presentation: A 30-year-old woman with right upper quadrant pain referred to our center. Four weeks ago, she had a history of laparoscopic cholecystectomy and two weeks ago she had a history of ERCP. Abdominal ultrasonography showed a mass in her right liver lobe. The patient underwent the fluid aspiration under ultrasonography guidelines. Chemical analysis of aspirated fluid proved that the liquid was bile. A drainage catheter was placed in site of bile accumulation to drain the liquid. The next follow up ultrasonography showed that the mass disappeared and no recurrence was detected. Conclusions: Diagnosis of biloma in a patient with the history of laparoscopic cholecystectomy or ERCP should be considered for proper interventional treatment to reduce morbidity and mortality}, Keywords = {Biloma, Fine Needle Aspiration, Laparoscopic cholecystectomy, ERCP}, volume = {9}, Number = {2}, pages = {198-200}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.198}, url = {http://caspjim.com/article-1-1119-en.html}, eprint = {http://caspjim.com/article-1-1119-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Gharaeinejad, Kaveh and Eftekhari, Hojat and rafiei, rana and Darjani, Abbas and Alizadeh, Narges}, title = {Inflammatory myopathies in a patient with Darier\'s disease, a possible association}, abstract ={Background: Darier disease (DD) is an autosomal dominant genetic disorder which develops from a mutation in the ATP2A2 gene. Inflammatory myopathies (IM) are the largest group of potentially treatable myopathies. In this case, we report development of IM in a patient with DD for the second time in the literature. Case presentation: The patient is a 59-year-old female, a known case of  DD, who developed proximal muscle weakness 2 weeks prior to admission. Elevated muscle-enzymes, as well as typical electromyographic and radiologic confirmed the diagnosis of IM. Conclusions: Abnormalities in intracellular calcium homeostasis may explain the association between DM and DD, therefore it is noteworthy to keep this association in mind and conduct more research regarding this issue}, Keywords = {Darier Disease, Inflammatory myopathy, dermatomyositis, poly myositis}, volume = {9}, Number = {2}, pages = {201-203}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.201}, url = {http://caspjim.com/article-1-906-en.html}, eprint = {http://caspjim.com/article-1-906-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Komasi, Saeid and Soroush, Ali and Saeidi, Mozhg}, title = {Cardiac patients perception about psychological risk factors on chest pain intensity and discomfort}, abstract ={}, Keywords = {Cardiovascular disease, risk factor, perception, pain.}, volume = {9}, Number = {2}, pages = {204-205}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.2.204}, url = {http://caspjim.com/article-1-1037-en.html}, eprint = {http://caspjim.com/article-1-1037-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Rostami, Sahar and EmamiAleagha, Mohammad Sajad and Ghasemi-Kasman, Maryam and Allameh, Abdolamir}, title = {Cross-talks between the kidneys and the central nervous system in multiple sclerosis}, abstract ={Multiple sclerosis (MS) is an inflammatory demyelinating disease, which is considered as a common autoimmune disorder in young adults. A growing number of evidences indicated that the impairment in non-neural tissues plays a significant role in pathology of MS disease. There are bidirectional relationship, metabolic activities and functional similarity between central nervous system (CNS) and kidneys which suggest that kidney tissue may exert remarkable effects on some aspects of MS disorder and CNS impairment in these patients compels the kidney to respond to central inflammation. Recently, it has been well documented that hormonal secretion possesses the important role on CNS abnormalities. In this regard, due to the functional similarity and significant hormonal and non-hormonal relationship between CNS and kidneys, we hypothesized that kidneys exert significant effect on initiation, progression or amelioration of MS disease which might be regarded as potential therapeutic approach in the treatment of MS patients in the future.}, Keywords = {Multiple sclerosis, Kidneys, Central nervous system, Hormones}, volume = {9}, Number = {3}, pages = {206-210}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.206}, url = {http://caspjim.com/article-1-1131-en.html}, eprint = {http://caspjim.com/article-1-1131-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Geraili, Zahra and Riahi, Seyed Mohammad and Khani, Soghra and Bayani, Masomeh and Rostami, Ali and Hajian-Tilaki, Karimollah and NourollahpourShiadeh, Malihe}, title = {Cytomegalovirus infection and risk of preeclampsia: A meta-analysis of observational studies}, abstract ={Background: Cytomegalovirus (CMV) infection is one of the most common infectious diseases in pregnant women in terms of global impact and is related with many adverse health consequences during pregnancy. For the first time, we performed a systematic review and meta-analysis study to evaluate the possible association between CMV infection and preeclampsia (PE). Methods: A comprehensive literature search to identify the relevant papers published earlier than February 2018 was performed in PubMed, ISI (Web of Science), Google Scholar and SCOPUS databases. We followed the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines for design, analysis and interpretation of results.  Pooled odds ratio (OR) and 95% confidence intervals (CI) were estimated using a random-effects meta-analysis model. Heterogeneity was assessed with Q-test and I2 statistics. Results: A total of 13 studies including 6158 pregnant women (2734 women with PE and 3424 healthy controls) met the eligibility criteria. The results of meta-analyses based on PCR (OR: 3.09; 95% CI:0.72–13.24; I2=57.3%), IgG-ELISA (OR: 1.24; 95% CI:0.83–1.85; I2=71%) and IgM-ELISA (OR: 1.04; 95% CI:0.66–1.65; I2=0.0%) demonstrated that CMV infection could not be a potential risk factor for PE. Conclusions: In conclusion, results of the present study demonstrated that CMV infection could not be a potential risk for developing PE. More epidemiological and experimental studies are needed to investigate the impact of CMV infection on the development of PE.  }, Keywords = {Cytomegalovirus infection, Pregnant women, Preeclampsia}, volume = {9}, Number = {3}, pages = {211-219}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.211}, url = {http://caspjim.com/article-1-1431-en.html}, eprint = {http://caspjim.com/article-1-1431-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Kheirkhah, Farzan and Tayyebi, Gooya and Rabiee, Seyed Mozaffar and Moghadamnia, Ali-Akbar and Bijani, Ali}, title = {Efficacy of different doses of ketamine as a bolus in major depressive disorder}, abstract ={Background: Major depressive disorder is a severe, heterogeneous, common medical illness and a leading cause of disability throughout the world that poses a significant public health issue. Previous studies have shown rapid antidepressant effects following a single administration of ketamine. This study aimed to assess the impact of route of administration and dose of ketamine for the reduction of depressive symptoms and compare the effects of different doses and methods. Methods: A double-blind clinical controlled trial was done on 100 patients with a primary diagnosis of major depressive disorder who were assigned into two groups of 50 subjects at a dose of 0.5 mg/kg and 0.75 mg/kg ketamine and each group was divided into two groups of 25 subjects following a single dose of intravenous bolus and infusion of ketamine. The patient’s severity of depression was evaluated with Hamillton Depression Rating Scale and Beck Depression Inventory scores after 2 days, 7 days, 30 days and 60 days of ketamine administration, then the results were compared between groups. Results: According to Hamilton and Beck score, the treatment response in investigated patients was 64% and 60%, respectively. Conclusions: These data suggest that ketamine effect is related to drug dose and type of administration. The dose of 0.75 mg/kg of ketamine is more effective than 0.5 mg/kg and a bolus injection of low-dose ketamine (0.5 mg/kg) is more effective than infusion and in high-dose ketamine (0.75 mg/kg), there was no difference between the methods of drug administration.}, Keywords = {Ketamine, Major depressive disorder, Bolus, Infusion}, volume = {9}, Number = {3}, pages = {220-227}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.220}, url = {http://caspjim.com/article-1-1012-en.html}, eprint = {http://caspjim.com/article-1-1012-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Uzer, Fatih and Ozbudak, Omer}, title = {Benefits of omalizumab on anxiety and depression in patients with severe asthma}, abstract ={Background: Asthma is one of the most common chronic diseases and may cause psychiatric disorders affecting the patients’ quality of life. In our study, we evaluated the effect of omalizumab treatment on anxiety disorder and depression using Beck Depression Scale (BDS) and State Trait Anxiety Inventory (STAI). Methods: Anxiety level was determined with STAI, whereas depression level was evaluated by BDS. Patients were asked to mark the questionnaires to reflect their emotional state before treatment, and to reflect their emotions they are feeding in the current moment. All patients receiving omalizumab treatment were included in the study. Patients with known neuropsychiatric disorder were excluded from the study. Results: A total of 20 patients with mean age of 50.25 years were enrolled in the study. Gender distribution was: 5(25%) male patients and 15(75%) female patients.  All patients with severe asthma received omalizumab treatment. The omalizumab treatment period was shown for mean 17.6 months (2-40 months). In anxiety scales, there was statistically significant difference compared with pretreatment and posttreatment periods. Depression (moderate to severe) was present in 12 patients before omalizumab treatment and 3 patients after omalizumab treatment. Conclusions: Uncontrolled asthma as a chronic disorder can cause depressive symptoms and worsen quality of life. We believe by controlling asthma, quality of life will improvein such patients. In appropriate indication, omalizumab can improve depression and anxiety in asthma patients.}, Keywords = {anxiety, asthma, depression, omalizumab }, volume = {9}, Number = {3}, pages = {228-231}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.228}, url = {http://caspjim.com/article-1-1203-en.html}, eprint = {http://caspjim.com/article-1-1203-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Babaei, Mansour and Bijani, Ali and Heidari, Parnaz and Hosseini, Seyyedreza and Heidari, Behz}, title = {Serum ferritin levels and bone mineral density in the elderly}, abstract ={Background: Iron overload influences negatively on bone mineral density (BMD) but the results of studies regarding serum ferritin (SF) and BMD are conflicting.This study aimed to determine the association of SF and BMD in the elderly. Methods: All participants of the Amirkola cohort selected between 2011-2012, aged > 60 years were classified as high or normal (<200ng/ml) SF. BMD at femoral neck and lumbar spine was determined by dual energy x-ray absorptiometry (DXA) and the results were expressed as BMD g/cm2 and BMDT-score. Multiple logistic regression analysis with calculation of odds ratio (OR) and 95% confidence interval was used to estimate the association of low BMD (LBMD) defined as BMD T-score < -1 with SF. Results: 1089 subjects (women, 44.7%) were studied. High SF was observed in 366 (33.6%) and LBMD in 874 (80.2%) subjects. The two groups of SF were similar regarding biochemical parameters and demographic characteristics except MetS, overweight /obesity and diabetes which were more prevalent in high SFgroup. BMD g/cm2 at both measurement sites was significantly higher (P=0.001 for both) and the prevalence of LBMD was significantly lower (74.1% vs 83.1%, P=0.001) in high SF group by OR= 0.60 (0.44-0.81). After adjustment for all biochemical and demographic variables, the association remained significant by adjusted OR= 0. 68 (0.49-0.94). Conclusions: These findings show a negative association between high SF and LBMD indicating a beneficial effect of high SF in the elderly. Regarding detrimental effect of iron overload on bone mass, these findings require further studies.}, Keywords = {Association, Bone mineral density, Elderly people, Serum ferritin}, volume = {9}, Number = {3}, pages = {232-238}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.232}, url = {http://caspjim.com/article-1-1152-en.html}, eprint = {http://caspjim.com/article-1-1152-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Hajiaghamohammadi, Ali Akbar and Daee, Mohammad Mahdi and Zargar, Ali and AhmadiGooraji, Somayeh and Rahban, Alfred and Attaran, Fereshte}, title = {Q-T interval prolongation in cirrhosis: Relationship and severity}, abstract ={Background: Cirrhosis as the final stage of progressive fibrosis of liver can affect other organs such as lungs, kidneys and heart. "Cirrhotic cardiomyopathy" involves the electrophysiological abnormalities such as QT interval prolongation. We assessed correlation between corrected QT interval prolongation and severity of cirrhosis based on Child Classification in each ECG lead. Methods: In this case-control study, the patients attending the outpatient clinic and inpatient department of internal medicine of Velayat Hospital in Qazvin were enrolled from September 2014 to July 2015. Total samples were 74 patients, half of which were used as controls. Cirrhosis severity was determined as per Child Classification. Both groups had Ca2+, Mg2+, K+ tested and 12- lead ECG was obtained. The QT interval was corrected by two different formulas: (1) QTc=QT/√RR (QTc1); (2) QTc=QT+1.75 (heart rate-60) (QTc2). To analyze the data, the software SPSS Version 16 and Mann-Whitney, Pearson’s chisquare test-Kruskal-Wallis, and t-tests were used. Results: The mean of QTc1 and QTc2 was longer in cirrhotics than the control group. There was a significant correlation between Child score and length of QTc1 in leads: III (p=0.032), AVL (p=0.041), V2 (p=0.049), V6 (p=0.015). There were significant differences in length of QTc1 in leads: V3 (p=0.031) and V6 (p=0.021); and QTc2 in lead V3 (p=0.039) between Child Classification. Conclusions: Cirrhosis can induce QTc interval prolongation. Lead V3 has statistically significant correlation with the severity of cirrhosis based on child classification. We propose that QT interval prolongation be added as a criterion for prioritizing liver transplantation.}, Keywords = {Cardiomyopathy, Prolonged QT interval, Severity of cirrhosis, Child score}, volume = {9}, Number = {3}, pages = {239-243}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.239}, url = {http://caspjim.com/article-1-928-en.html}, eprint = {http://caspjim.com/article-1-928-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Shahrbanian, Shahnaz and Duquette, Pierre and Mayo, Nancy}, title = {Impairment, disability and fatigue in multiple sclerosis}, abstract ={Background: Identifying the predictors of pain is important for both health professionals and researchers, because pain has repeatedly been found to be a strong predictor of activity limitations and participation restrictions. The objective of this study was to determine the predictors of pain presence and severity in a large, well-designed sample of community dwelling individuals with multiple sclerosis (MS). Methods: This was a cross-sectional study. A center-stratified random sample including 188 persons with MS were recruited from three major MS clinics in the Greater Montreal, Canada. Main outcomes included pain prevalence and severity. Predictor variables included depression, anxiety, perceived health status, fatigue, sleep problems, and perceived cognitive deficits. Participants completed three questionnaires: the first asked about the socio-demographic and clinical information of the subjects, the second assessed the pain characteristics of the subjects, and the third covered the predictor variables. Results: The prevalence of pain in our sample was 42%. MS- related disability was found to be in the main predictor for both pain presence and intensity. Fatigue also was a main contributor to pain presence. The results of this study also showed that pain was associated with higher levels of depression, anxiety, sleep problems, and perceived cognitive deficits, and diminished perceived health status. Conclusions: The results of this study indicated that pain is a common symptom among people with MS. Pain presence was predicted by MS-related disability and fatigue, while pain intensity was only predicted by MS severity.}, Keywords = {Multiple sclerosis, Pain severity, Pain presence, Fatigue, MS-related disability}, volume = {9}, Number = {3}, pages = {244-251}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.244}, url = {http://caspjim.com/article-1-1116-en.html}, eprint = {http://caspjim.com/article-1-1116-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Bakhtiari, Afsaneh and Hajian-Tilaki, Karimollah and Ghanbarpour, Azit}, title = {Metabolic syndrome and different obesity phenotypes in the elderly women population: Iran’s Health System on aging}, abstract ={Background: Current literature has been focused on types of obesity with normal BMI (body mass index), but metabolically unhealthy.This study evaluates the prevalence of metabolical phenotypes of obesity. We also identified the best obesity index in predicting the components of metabolic syndrome (MetS). Methods: A cross-sectional study has been conducted on 164 women over 60 years. Anthropometric parameters, body fat percentage (%BF), and biologic criteria were measured to assess the types of obesity. Unhealthy metabolic was defined by modified Adult Treatment Panel III, and obesity based on BMI≥25.ANOVA and logistic regression were utilized for the association of MetS components and obesity phenotypes, and linear regression logistic for finding the best MetS related obesity index. Results: The prevalence of metabolically unhealthy was 45.7%, out of which 33.3% was among the individuals with normal BMI.Logistic regression has shown that triglyceride (TG) (OR=3.30, p<0.001) and high density lipoprotein (HDL-C) (OR=2.15,p<0.01) was independently related to metabolically healthy and normal weight(MHNW) phenotype. Moreover, TG (OR=3.92,p<0.001), HDL-C (OR=2.18,p<0.001), fasting blood glucose(FBG) (OR=1.73,p<0.01) and waist circumference(WC) (OR=3.18,p<0.001) are correlated significantly with metabolically unhealthy and overweight/obese (MUO) and also TG (OR=2.88,p<0.001) and WC (OR=2.67,p<0.001) with metabolically unhealthy and overweight/obese(MHO).WC followed by %body fat (BF) showed to be highly correlated with the prognosis of MetS components. Conclusions: There is a high prevalence of unhealthy metabolic among the elderly women,even with normal weight.There were different associations between MetS components and various obesity phenotypes.TG was the most powerful indicator for the prognosis of unhealthy metabolic phenotypes which was independently correlated with the WC, %BF and BMI.  }, Keywords = {Obesity phenotypes, Older Women, Metabolic syndrome, Prevalence}, volume = {9}, Number = {3}, pages = {252-259}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.252}, url = {http://caspjim.com/article-1-1085-en.html}, eprint = {http://caspjim.com/article-1-1085-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Gholinezhad, Maryam and Golsorkhtabaramiri, Masoumeh and Esmaeilzadeh, Sedighe and Ghanbarpour, Azit}, title = {Insulin resistance and adverse metabolic profile in overweight/obese and normal weight of young women with polycystic ovary syndrome}, abstract ={Background: Polycystic ovary syndrome (PCOs) is an endocrine-metabolic disorder. This study intends to determine the comparison of insulin resistance (IR) and metabolic disturbance in overweight/obese and normal-weight of young women with polycystic ovary syndrome. Methods: Using a comparative cross-sectional study design in 2015, 27 normal weight (18<bmi Results: 112 women with PCOS participated in this study. The mean age was 22.4±3.48 years in the normal PCOS group (n=27) and 24.4±5.06 years in the overweight/obese PCOS patients (n=85). BMI had a significant straight correlation with insulin resistance (p<0.001) and a negative correlation with insulin sensitivity (p<0.001). BMI showed a straight stronger correlation with triglyceride (TG) (p<0.001) and LDL cholesterol (<0.05) and a stronger reverse relationship with SHBG (p<0.001). In overweight/obese group, 91.7% (48) of the women showed insulin resistance (HOMA>3.15) vs. 8.3% (5) in the normal group (P<0.001). 82.4% (62) of the overweight/obese group revealed low insulin sensitivity (QUICKI<0.34) while this value was 17.6 % (13) within their lean counterparts (p<0.001). In the study group, 89.7 % (54) showed elevated fasting insulin concentration (>13µU/ml) vs. 10.3% (7) in the control group (p<0.001). Conclusions: Overweight/obese PCOs patients revealed higher insulin resistance and lower insulin sensitivity, and also greater TG and LDL cholesterol. Priority of management of insulin resistance and lipid profile should be considered on identifying these potentially major complications.</bmi  }, Keywords = {Insulin resistance, Obesity, Polycystic ovary syndrome, Overweight}, volume = {9}, Number = {3}, pages = {260-267}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.260}, url = {http://caspjim.com/article-1-1011-en.html}, eprint = {http://caspjim.com/article-1-1011-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Akbarpour, Samaneh and Khalili, Davood and Zeraati, Hojjat and Mansournia, Mohammad Ali and Ramezankhani, Araz and Fotouhi, Akbar}, title = {Lifestyle patterns in the Iranian population: Self- organizing map application}, abstract ={Background: The present study evaluated the lifestyle behavior patterns and its associations with demographic factors in the Iranian population. Methods: A total of 8244 people aged 25-70 years who participated in a national survey in 2011 were included in the study. Factors related to lifestyle (such as diet, physical activity, and tobacco use) have been collected using a questionnaire. A self-organizing map was used for cluster analysis and a multinomial logistic model was used for assessment of associations. Results: Seven clusters were identified as the following: cluster 1 (15.84%): healthiest lifestyle; cluster 2 (12.45%): excessive consumption of sweet tasting soft drinks, salt, and fast food; cluster 3 (33.73%): no recreational physical activity; cluster 4 (6.86%) alcohol consumption, smoking, and consumption of sweet tasting soft drinks; cluster 5 (14.18%): less salt and oil intake and lack of physical activity; cluster 6 (7.85%): no use of dairy products; cluster 7 (9.08%): the most unhealthy lifestyles; excessive work-related physical activity and smoking and unhealthy diet. Male gender was associated with higher odds of being in clusters 4 and 7. Individuals who were in unhealthy lifestyle clusters were mostly less educated and more self-employed or laborers. Conclusions: A very small percentage of individuals was in the healthy lifestyle cluster yet they had poor nutrition. Health policy-makers should pay more attention to low recreational physical activity among elder people and in middle-aged and housekeepers, and also to high work-related physical activities that have a strong tendency to be in a cluster with smoking among workers and less educated men.  }, Keywords = {lifestyle pattern, self-organizing map, cluster analysis, lifestyle, Iran}, volume = {9}, Number = {3}, pages = {268-275}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.268}, url = {http://caspjim.com/article-1-1257-en.html}, eprint = {http://caspjim.com/article-1-1257-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Vasheghani-Farahani, Ali and Kazemnejad, Fatemeh and Sadeghniiat-Haghighi, Khosro and Saadat, Soleil and Tavakolipoor, Parya and Yazdani, Tahereh and Alidoosti, Mohammad and GhasemAmooeian, Vahid and Ashraf, Haleh}, title = {Obstructive sleep apnea and the severity of coronary artery disease}, abstract ={Background: It has been implicated that obstructive sleep apnea (OSA) is associated with increased risk of cardiovascular disease including stroke, myocardial infarction, coronary artery disease (CAD) and hypertension. The aim of this study was to investigate the correlation between OSA and severity of atherosclerosis assessed by angiography. Methods: This study included 337 patients undergoing diagnostic coronary angiography at Tehran Heart Center, Iran. The Gensini score was obtained from each patient for coronary angiogram, and OSA were assessed by using Multivariable apnea prediction (MAP) risk index on the day of cardiac catheterization. The Gensini scores increased in accordance with increases in the MAP value. Results: The prevalence rates of three-vessel disease were 68.0% in OSA group and 32.0% in non-OSA group. The MAP index was the most significant independent determinant for the Gensini score. Conclusions: The independent association between OSA and CAD, even after adjustment for traditional confounders, suggests that, OSA should be taken into account when considering risk factors for CAD.}, Keywords = {Atherosclerosis , coronary angiography ,coronary artery disease, Gensini score, Obstructive sleep apnea}, volume = {9}, Number = {3}, pages = {276-282}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.276}, url = {http://caspjim.com/article-1-1027-en.html}, eprint = {http://caspjim.com/article-1-1027-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Talebi, Ghadam Ali and Saadat, Payam and Javadian, Yahya and Taghipour, Mohamm}, title = {Manual therapy in the treatment of carpal tunnel syndrome in diabetic patients: A randomized clinical trial}, abstract ={Background: Generally, conservative interventions including physiotherapy modalities and manual therapy have been recommended in the management of carpal tunnel syndrome (CTS), but this subject has not been studied in diabetic patients with CTS. Therefore the aim of this study was to investigate the effects of manual therapy on diabetic patients with CTS. Methods: Thirty diabetic patients with CTS were randomly divided into two equal groups: modality group and manual therapy group. Participants in the modality group received transcutaneous electrical nerve stimulation (TENS) and therapeutic ultrasound (US) and patients in the manual therapy group received manual techniques for the median nerve and its surrounding structures. Interventions were applied 3 times weekly for 4 weeks in both groups. Visual analogue scale (VAS), symptom severity scale (SSS), functional status scale (FSS) and median neurodynamic test (MNT) were evaluated before and after the interventions in both groups. Paired t-test and independent t-test were used for statistical analysis. Results: Paired t-test revealed that all of the outcome measures had a significant change in the manual therapy group, whereas only the VAS and SSS changed significantly in the modality group at the end of 4 weeks. Independent t-test showed that the variables of SSS, FSS and MNT in the manual therapy group improved significantly greater than the modality group. Conclusions: Manual therapy techniques applied to mechanical interface of the median nerve and nerve mobilization possess more appropriate and valuable effects on hand difficulties than modalities in diabetic patients with CTS.  }, Keywords = {Diabetic Patient, Carpal tunnel syndrome, Manual Therapy}, volume = {9}, Number = {3}, pages = {283-289}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.283}, url = {http://caspjim.com/article-1-1156-en.html}, eprint = {http://caspjim.com/article-1-1156-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Sorkhi, Hadi and Behzadi, Raheleh and Joghtaei, Neda and Poornasrollah, Mohammad and Bijani, Ali}, title = {Glomerular filtration rate determination by creatinine and cystatin-C in patients with acute pyelonephritis}, abstract ={Background: Measurement of glomerular filtration rate (GFR) and monitoring of it in any patient on nephrotoxic drugs is very important. Recently, cystatin C (cys-C) has been introduced as a better marker for determining and monitoring renal function than creatinine especially in a mild decrease of GFR. This study was done to assess the change of GFR measurement based on serum Cys-C and creatinine and their comparison in children with acute pyelonephritis on amikacin. Methods: All children with acute pyelonephritis who were admitted in Nephrology ward were enrolled in this study. Serum creatinine, serum cys-C and the GFR calculation based on them were measured in patients on the day of admission (day zero) and then on days 3 and 7 after the start of treatment with amikacin and p-value less than 0.05 was considered significant. Results: Among the 70 children, 61 patients were females and the others were males. Mean age was 42.66±41.53 months. Estimated GFR based on creatinine on day 0 (before amikacin administration), 3 and 7 were 72.41±20.89 ml/min/1.73 m2, 78.42±21.15 ml/min/1.73 m2 and 80.5±22.43 ml/min/1.73 m2, respectively. Moreover, GFR based on cys-C during these days were 116.23±58.9 ml/min/1.73 m2, 116.49±53.31 ml/min/1.73 m2 and 108.37±51.02 ml/min/1.73 m2, respectively (p<0.05). Conclusions: According to this study, decrease of GFR calculation based on Cys-C was seen and estimated GFR was not changed according to creatinine. So, we recommend the use of cys-C for the monitoring of renal function in any patient treated with nephrotoxic drugs such as amikacin.}, Keywords = {Nephrotoxicity, Amikacin, Cystatin C, Creatinine, Acute pyelonephritis, Glomerular filtration rate}, volume = {9}, Number = {3}, pages = {290-295}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.290}, url = {http://caspjim.com/article-1-1206-en.html}, eprint = {http://caspjim.com/article-1-1206-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Shafi, Hamid and Ilkhani, Masomeh and DarabiAhangar, Zeinab and Bayani, Masomeh}, title = {Antibiotic prophylaxis in the prevention of urinary tract infection in patients with sterile urine before extracorporeal shock wave lithotripsy}, abstract ={Background: One of the lithotripsy complications is urinary tract infection (UTI) and sepsis after extracorporeal shock wave lithotripsy (ESWL). The aim was to study the prophylactic effect of antibiotics on UTI after ESWL. Methods: This randomized double-blind clinical trial was carried out on 600 patients admitted to Babol Clinic hospital in 2014-2015. Patients were randomly divided into treatment group (receiving 200 mg ofloxacin and control group (receiving placebo. The effect of prophylactic antibiotics on the incidence of bacteriuria after ESWL and the impact of variables such as gender, age, urolithiasis size and location and underlying diseases in the incidence of UTI after ESWL were evaluated. Results: Totally, 67 of the population had positive urine cultures. Twenty-nine (10.13%) of them were in the treatment group (n=286) and 38 (13.01%) of them were in the control group (n=292). All 67 patients had asymptomatic bacteriuria. Escherichia coli and proteus were the grown microorganisms in most samples. The mean age of sample population was 44.8±23, and 67.16% of patients with positive urine culture were older than 45 years. Conclusions: The results indicated that prophylactic antibiotics prior to ESWL in patients with urinary calculi and negative urine culture had no significant decrease in urinary tract infection after lithotripsy. It is better that the use of prophylactic antibiotics is limited to patients with risk factors.  }, Keywords = {ESWL, Prophylactic antibiotic, Urine culture}, volume = {9}, Number = {3}, pages = {296-298}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.296}, url = {http://caspjim.com/article-1-1093-en.html}, eprint = {http://caspjim.com/article-1-1093-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Kalayci, Belma and Karabag, Turgut and Erten, Turgay and Akgun, Tunah}, title = {Pacemaker lead endocarditis with hiccups (Kalayci)}, abstract ={Background: Lead-related infections that might develop after pacemaker implantation associated with high mortality and morbidity rates are challenging to manage and pose high-cost. Patients with lead-related infections usually present with fever, chills and fatigue and the treatment can be challenging unless the implant system is extracted. Case presentation: A 66-year old male patient who underwent dual chamber pacemaker and implantable cardioverter defibrillator was admitted to the emergency service with a six-week history of complaints of hiccups and fever. After a detailed investigation, lead-related infective endocarditis was the diagnosis. The patient was initiated on antibiotic therapy and lead extraction was performed. Conclusions: Patients with signs of infection who underwent pacemaker implantation may present with atypical symptoms such as hiccup. In these cases, imaging, particularly echocardiography, should be performed as soon as possible and the localization of the pacemaker leads and signs of infective endocarditis should be investigated.  }, Keywords = {Hiccup, Pacemaker lead, Infective endocarditis, Echocardiography}, volume = {9}, Number = {3}, pages = {299-302}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.299}, url = {http://caspjim.com/article-1-1132-en.html}, eprint = {http://caspjim.com/article-1-1132-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Maatallah, Kaouther and Mahmoud, Ines and Belghali, Safa and BenAbdelghani, Kawther and Saidane, Olfa and Bouajina, Elyes and Laatar, Ahmed and Tekaya, Rawdha and Abdelmoula, Leil}, title = {Reparative radiological changes of hip joint after TNF inhibitors in ankylosing spondylitis}, abstract ={Background: Hip involvement in ankylosing spondylitis (AS) is a common extraspinal arthritic manifestation, which is associated to a worse functional outcome. Little data are available on the effectiveness of conservative treatment strategies. The TNF inhibitors have been proven effective on AS activity parameters. Their structural effect on hip disease however, little is studied. Case presentation: We describe four new cases of reparative changes of a damaged hip joint after treatment with TNF inhibitors. The average of age was 32.5 (27- 36) years. There were 3 men and 1 woman. Hip involvement was bilateral in all cases. Etanercept was prescribed in 3 cases and infliximab in 1 case. At baseline, all patients had a painful and limited hip with high disease activity and an important functional impairment. After an average of 5.5 years of treatment with TNF inhibitors, the BASRI hip evaluated in antero-posterior x-rays of the pelvis remained unchanged at 2.4. The average of mean hip joint space was 2.9mm (2.3-3.6). A widening in hip joint space was observed in all cases with less subchondral cysts. Conclusion: TNF inhibitors seem to be effective on hip joint disease in patients with AS.}, Keywords = {spondylarthritis, hip, imaging, TNF inhibitors}, volume = {9}, Number = {3}, pages = {303-305}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.303}, url = {http://caspjim.com/article-1-760-en.html}, eprint = {http://caspjim.com/article-1-760-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Torkaman, Ali and YousofGomrokchi, Alireza and Elahifar, Omid and barmayoon, pooyan and Shojaei, Seyedeh Fahimeh}, title = {Simultaneous bilateral rupture of patellar tendons in diabetic hemodialysis patient: A case report}, abstract ={Background: Bilateral rupture of the patellar tendon is a very rare injury, which takes place in relation to chronic systemic diseases. These injuries are known causes. Some of these causes are particular in patellar tendon rupture and another are in quadriceps tendon rupture. Case presentation: 70-year-old diabetic man with simultaneous bilateral patellar tendon disruption of proximal insertion without trauma, receiving long-term hemodialysis. Conclusions: In the present study, we report a case of patellar tendon rupture that has two differences with literature: first, renal failure is a known risk factor for quadriceps tendon rupture, and secondly, the prevalent age of patellar tendon rupture is less than 40 years. Clinical picture, diagnosis, pathogenesis and treatment are discussed. Finally, the literature is reviewed based on previous studies.}, Keywords = {Bilateral, Hemodialysis, Patellar tendon, Rupture}, volume = {9}, Number = {3}, pages = {306-311}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.306}, url = {http://caspjim.com/article-1-1072-en.html}, eprint = {http://caspjim.com/article-1-1072-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Anvari, Kazem and Gharib, Masoumeh and Jafarian, Amir Hossein and Saburi, Amin and Javadinia, Seyed Alirez}, title = {Primary duodenal malignant melanoma: A case report}, abstract ={Background: Melanoma is a neoplasm derived commonly from melanocytic cells of skin. Although coetaneous presentation of malignant melanoma is easily recognizable, the presentation of melanoma in other organs is so confusing. In particular, when it metastasizes to other organs, many bizarre figures and unusual organs may be involved. In this report, we present a case of primary duodenal malignant melanoma. Case Presentation: A 68-year-old man presented with a history of iron deficiency anemia. The upper gastrointestinal endoscopy showed a prominent papilla of duodenum along with an ulcerative lesion adjacent to second part of duodenum. Histopathologic evaluation showed a high-grade malignant neoplasm involving the bowel wall which was labeled for S100 protein and markers of melanocytic differentiation; Melan-A indicating the definitive diagnosis of malignant melanoma of the second portion of duodenal mucosa. Conclusions: In patients with a history of iron deficiency anemia, any GI symptom should be evaluated carefully. However, the diagnosis of primary GI melanomas in patients without any history of melanoma is possible. Full medical investigations are recommended in these patients with primary mucosal lesions.}, Keywords = {Melanoma, Duodenum, Gastrointestinal tract}, volume = {9}, Number = {3}, pages = {312-315}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.3.312}, url = {http://caspjim.com/article-1-1112-en.html}, eprint = {http://caspjim.com/article-1-1112-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Veisani, Yousef and Khazaei, Salman and Delpisheh, Ali}, title = {5-year survival rate based on the types of leukemia in Iran: a Meta-analysis}, abstract ={Background: According to epidemiological studies, leukemia is among the five most common cancers in Iran. Keeping efforts to estimate survival is critical to monitoring and improving patients’ quality of life with leukemia. The purpose of this study was to evaluate the 5-year survival rate of leukemia patients in Iran using meta-analysis method. Methods: This meta-analysis was carried out according to studies that adhere to inclusion and exclusion criteria during enrolment. The valid Iranian databases included: Medex, Magiran, SID, and Medlib, along with international data bases, namely, Scopus, Pubmed, and ISI were searched to find relevant articles. After determining the heterogeneity between studies, the random effects models were used to estimate pooled survival in leukemia patients. Results: In total, 18 studies involving 2517 participants were included in this meta-analysis. The pooled 5-year survival rate was 0.56 % (95% CI, 0.54 to 0.58). According to types AML and ALL, the 5-year survival rates in Iran were 35.0 % (95% CI: 32.0-38.0) and 57.0 % (95% CI: 54.0-60.0), respectively. Conclusion: Based on our findings, slightly less than 50% of leukemia deaths happened in the first 5 years after diagnosis, which is lower than the global average.}, Keywords = {ALL, AML, Leukemia, Survival, Iran}, volume = {9}, Number = {4}, pages = {316-324}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.316}, url = {http://caspjim.com/article-1-1342-en.html}, eprint = {http://caspjim.com/article-1-1342-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Mikaniki, Mojtaba and Babaei, Neda and Mikaniki, Ebrahim and Hasanjaniroshan, Mohammadreza and Bijani, Ali}, title = {Concurrent presence of buccal mucosal and ophthalmologic lesions in Behcet’s syndrome}, abstract ={Background: Behcet’s syndrome is a disease with different aspects in its clinical manifestations. The purpose of this study was to evaluate the simultaneous presence of oral mucosal and ophthalmologic lesions in patients with Behcet’s syndrome. Methods: From April 2012 to December 2014, 50 cases of Behcet’s syndrome who referred to the Departments of Ophtalmology, Oral Diseases and Infectious Diseases of Babol University Medical Sciences were entered into the study. The diagnosis of the disease was performed using the Iranian criteria for the diagnosis of Behcet’s syndrome.  The demographic findings as well as clinical manifestations were recorded. Results:  Thirt-six (72%) were males and 14 (28%) were females. The mean age of the patients was 35.6±9 years. Oral aphthous (94%), ocular lesion (76%) and genital ulcers (70%) were the most clinical findings. The clinical onset of the disease in 43 (86%) was oral lesions and in 5 (10%) was ocular lesions. Among the forty-eight cases with oral lesions, 77% had ocular lesions concurrently. HLA-B5 was positive in 35 (70%) cases. Ocular lesion was seen in 33 of 35 (91.4%) cases versus 6 of 15 (40%) with HLA-B5 positive and negative cases, respectively (p<0.05). Oral lesion was seen in 94.3% cases with positive HLA-B5 and in 100% cases with negative HLA-B5 (p>0.05). Conclusions: The results show that concurrent ophthalmic and oral lesions  in Behcet’s syndrome are relatively high. HLA-B5 positive cases are associated with more ophthalmologic lesions.}, Keywords = {Behcet,s syndrome, Aphtos lesion, Ocular lesion, genital lesion.}, volume = {9}, Number = {4}, pages = {325-327}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.325}, url = {http://caspjim.com/article-1-612-en.html}, eprint = {http://caspjim.com/article-1-612-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Majzoobi, Mohammad-Mahdi and Mamani, Mojgan and Hashemi, Seyyed Hamid and Gazan, Hadis and Ghasemibasir, Hamidreza and Nikbakht, Mina and Esna-Ashari, Farzaneh}, title = {Isolated hepatitis B core antibody in HIV infected patients--can response to hepatitis B vaccine help to elucidate the cause?}, abstract ={Background: Concomitant hepatitis B and HIV infections are common. In some of these patients, HBcAb is the only serologic marker of hepatitis B. This study was conducted to elucidate the cause of isolated HBcAb in HIV-infected patients via hepatitis B vaccination. Methods: In this interventional study during 2014-15 in the HIV Clinic in Hamadan, thirty four patients with HIV infection and isolated HBcAb positive isolate, received hepatitis B vaccine and their responses to vaccination were investigated. Demographic data, stage of disease, and status of CD4 and HCV Ab were extracted from the patients' medical records and were entered in a checklist. Results:  Of the 103 HIV positive patients, the prevalence of HBs Ag, and HBc Ab isolates were 6.79% (n=7) and 46.6% (n=48), respectively. All of the patients with isolated HBcAb were positive for HCV Ab. Among the 48 patients with isolated HBc Ab, 34 (70.8%) were available and examined for HBV DNA in serum samples. The result of PCR was negative in all. After the first round of hepatitis B vaccination, HBs Ab titer exceeded 10 International Units Per Liter (IU/L) in 58.8% of patients with isolated HBc Ab. With the completion of the three-dose of vaccine, this titer was observed in 97% of patients. Significant correlation was observed between titer of antibodies and values of CD4 cells. Conclusions: Due to favorable response to hepatitis B vaccination in HIV positive patients with isolated HBc Ab, false positive HBc Ab and recovery from previous infection were more probable than hidden hepatitis B.}, Keywords = {HIV, Hepatitis B Virus, Isolated Anti Hepatitis B Core, Hepatitis B Vaccine}, volume = {9}, Number = {4}, pages = {328-333}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.328}, url = {http://caspjim.com/article-1-1384-en.html}, eprint = {http://caspjim.com/article-1-1384-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Agrawal, Vijay Kumar and Prusty, Saroj Kumar and Reddy, Ch Santosh and KrishnaMohanReddy, Gangireddy and Agrawal, Rakesh Kumar and Bandaru, VCS Srinivasarao}, title = {Clinical profile and predictors of Severe Dengue disease : A study from South India}, abstract ={Background: Dengue is endemic and prevalent in tropical and sub-tropical countries including India and can cause significant mortality and morbidity. There are limited studies available on factors associated with severe dengue from India, to investigate the predictors of severe dengue in south Indian patients. Methods: We recruited 334 patients with dengue admitted in Yashoda Hospital, Hyderabad. Study period was between March 2015 and February 2017. Based on clinical symptoms, we divided patients into severe dengue and non-severe dengue. Univariate and multivariate analysis was performed for prognostic factors of severe dengue. Results: Out of 334 patients, there were 186(55.6%) males with mean age 30.3±14.3 39 years (age range: 10-73 years), severe dengue was seen in 117(35%) and non-severe dengue in 217(65%). Clinical symptoms of diabetes, low platelet count (<50,000mm3), melena, skin rash, delayed admission (>5days after onset) elevated hematocrit, lymphadenopathy, hepatomegaly, splenomegaly, convulsions and mortality were significantly associated with severe dengue. After multivariate analysis, diabetes (OR: 2.12; 95% CI:1.34-4.65) (<0.0001), elevated hematocrit (OR: 3.14; 95% CI:2.17-6.14) (<0.0001), skin rashes (OR: 1.99; 95% CI: 1.11-3.55) (<0.0001), melena (OR: 2.59; 95% CI:1.40-4.93) (<0.0001),  low platelet count (OR: 6.71; 95% CI:4.12-13.6) (<0.0001), lymphadenopathy (OR: 3.12 95% CI: 1.91-7.85) (<0.0001) and delayed admission (OR: 2.40; 95% CI:1.31-3.41) (<0.0001) were significantly associated with severe dengue disease. Conclusions: In our study, it was established that low platelet count, elevated hematocrit, diabetes, skin rash, melena, lymphadenopathy and delayed in admission (>5days) were independently associated with severe dengue.}, Keywords = { clinical manifestation and laboratory test, and delayed in admission severe dengue disease. ,}, volume = {9}, Number = {4}, pages = {334-340}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.334}, url = {http://caspjim.com/article-1-1219-en.html}, eprint = {http://caspjim.com/article-1-1219-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Mahmoodi-Nesheli, Mohsen and Alizadeh, Shaabanali and Solhi, Hassan and Mohseni, Jila and Mahmoodi-Nesheli, Masomeh}, title = {Adjuvant effect of oral Silymarin on patients’ wound healing process caused by thermal injuries}, abstract ={Background: According to the side effects of the usual treatment of burns, in improving the patients’ prognosis, there is a need to introduce faster and more effective adjuvant therapies to treat wounds, thus to improve the prognosis of patients. The aim of this study was to investigate the effect of adjuvant treatment with oral silymarin on wound healing process caused by second degree-burns among the patients admitted to Valiasr Hospital of Arak. Methods: This randomized, double-blind clinical trial study was carried out on 80 patients with second-degree burns covering 20 to 30 percent of the body with flame. Patients were randomized into 2 groups with an equal number: The intervention group (treated daily with oral 140-mg silymarin) and control (under the administration of placebo). Patients were treated for 8 weeks and at the end of weeks 1, 2, 3 and 4 according to the degree of wound healing (grade 1, 2 and 3) were followed during 2016-2017. Results: Changes in degrees of burn wound healing in both the intervention and placebo groups during the 4 weeks of treatment, significantly improved grade 3 completely. Based on the results, the complete remission in all four follow-up stages was significantly higher in silymarin group than the placebo group: Week 1 (intervention: 9 (22.5%), control: 0 (0%), (p=0.011), week 2 (intervention group: 18 (45%), placebo: 7 (17.5%), (p=0.000), week 3 (intervention: 24 (60%), placebo: 11 ( 27.5%), (p=0.051); week 4 (intervention: 27 (67.5%), control: 19 (47.5%), (p=0.003). Conclusions: According to our results, the 4-week adjuvant treatment with oral silymarin resulted in the full and faster wound recovery in patients with second degree-burn. So, it is recommended to use adjuvant treatments to obtain effective results.  }, Keywords = {Thermal injury, Placebo effect, Silymarin, Wound Healing}, volume = {9}, Number = {4}, pages = {341-346}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.341}, url = {http://caspjim.com/article-1-1028-en.html}, eprint = {http://caspjim.com/article-1-1028-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Peyro-Shabani, Alireza and Nabahati, Mehrdad and Saber-Sadeghdoust, Mohammad-Ali and Soleymani, Mohammad Jafar and Oliaei, Farshi}, title = {Risk factors associated with aortic calcification in hemodialysis patients}, abstract ={Background: There are some uncertainties among the risk factors of vascular calcification in the hemodialysis patients. This study was planned to examine the association between abdominal aortic calcification and concerned biochemical parameters in hemodialysis patients. Methods: In this cross- sectional study, 84 stable hemodialysis patients admitted on hemodialysis section of Shahid Beheshti Hospital in 2013 were enrolled after obtaining informed consent. Pre-dialysis venous blood samples were taken from patients to determine the amount of intact parathyroid hormone (iPTH), alkaline phosphatase (Alk.P), C - reactive protein (CRP), calcium (Ca) and phosphorus (P). Patients underwent abdominal CT scanning and ACI (ACI) was calculated. Statistical analysis was performed using SPSS Version 20. Chi-square, Kruskal Wallis and One Way ANOVA tests were used. P-values < 0.05 were considered significant. Results: The average age of participants was 50.15±17.03 years (18-83 y/o).A statistically significant correlation was observed between ACI and ALK-P serum levels (p=0.01). It was found that ACI had a significant relationship with phosphorus in women (p=0.01). ALK-P serum levels in men also had a significant relationship with ACI (p=0.02). In addition, there was a significant correlation between ACI and history of cerebro-cardiovascular disease and also duration of dialysis (p=0.004 and 0.0001, respectively). Conclusions: In patients with longer duration of dialysis, and patients with a history of cardiovascular and cerebrovascular events, ACI levels were significantly higher. ALK-P and phosphorus were correlated with aortic calcification in males and females respectively. No significant correlation was found between iPTH serum levels and aortic calcification.}, Keywords = {Dialysis, iPTH, Ca, P, Alk.P, vascular calcification, cardiovascular disease }, volume = {9}, Number = {4}, pages = {347-352}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.347}, url = {http://caspjim.com/article-1-1328-en.html}, eprint = {http://caspjim.com/article-1-1328-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Yahyapour, Yousef and Rahmani, Rabeae and Alipour, Majid and Alizadeh, Ahad and Khademian, Aynaz and Sadeghi, Farzi}, title = {Prevalence and association of human papillomavirus, Epstein-Barr virus and Merkel Cell polyomavirus with neoplastic esophageal lesions in northern Iran}, abstract ={Background: Studies concerning on esophageal squamous cell carcinoma (ESCC) etiological factors have been done for several decades, however, results reported from various investigations were not consistent. The present investigation aimed to explore the presence of 3 oncogenic viruses, human papilloma virus (HPV), Epstein-Barr virus (EBV) and Merkel cell polyomavirus (MCPyV) in the neoplastic and non- neoplastic esophageal lesions collected from Mazandaran, a high risk area of Iran. Methods: In total, 168 esophageal specimens (100 with ESCC confirmed diagnosis and 68 without esophageal malignancy) were analyzed for HPV, EBV and MCPyV by Real Time PCR. Results: HPV DNA was detected in 27 out of the 100 neoplastic esophageal lesions (27.0%) and 28 out of the 68 samples from non-neoplastic group (41.2%). EBV DNA was detected in esophageal specimens of 10 out of the 100 neoplastic cases (10%) and 3 out of the 68 samples in non- neoplastic group (4.4%). MCPyV DNA was detected in esophageal specimens of 30 out of the 100 neoplastic cases (30.0%) and 24 out of the 68 samples in non- neoplastic group (35.3%). There was no statistically significant difference in HPV (p=0.066), EBV (p=0.143) and MCPyV (p=0.471) DNA positivity between neoplastic and non-neoplastic groups. Conclusions: This study showed that HPV, EBV and MCPyV can be detected in both neoplastic and non-neoplastic esophageal tissues and weakens the hypothesis of the pathogenic role of these viruses in esophageal malignant transformation.}, Keywords = {Esophageal squamous cell carcinoma, Human papillomavirus, Epstein-Barr virus, Merkel cell polyomavirus.}, volume = {9}, Number = {4}, pages = {353-360}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.353}, url = {http://caspjim.com/article-1-1267-en.html}, eprint = {http://caspjim.com/article-1-1267-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Kazemian, Fahimeh and jalali, seyed farzad and Hajian-Tilaki, Karimolah and Arzani, Afsaneh and Amin, Kamyar}, title = {Underlying risk factors and their relationship with extent of coronary vessel involvement in patients undergoing coronary angiography in North of Iran}, abstract ={Background: Coronary artery disease (CAD) is one of the most progressive and life-threatening diseases and is the first leading cause of death affecting both genders in Iran. The present study aimed to determine the extent of coronary vessel involvement and relevant relationship with several underlying risk factors. Methods: In this cross-sectional study, 1452 patients undergoing angiography who met the inclusion criteria were recruited consecutively in Babol, Iran during 2016. Data collection was performed through a questionnaire including demographic and clinical characteristics and information on underlying diseases via an interview with the patient and looking into the patients’ records. Results: Of these patients, 459 (31.6%) had normal coronary arteries, 220 (15.1%) suffered from non-obstructive CAD and 773 (53.3%) had one, two or three-vessel obstructive involvement. The results of multiple logistic regression showed that the chances of having coronary artery involvement in patients with diabetes (OR=1.55, p=0.012), age> 60 years old (OR=3.52, P=0.001), male gender (OR=2.54, P=0.001), history of heart attack (OR=3.16, P=0.001), and history of hospitalization because of cardiac problem (OR=1.51, P=0.021) significantly increased. Conclusions: Diabetes, male gender, age over 60 years old, history of myocardial infarction and history of hospitalization due to cardiac problem were related to the extent of coronary vessels involvement. Therefore, it is recommended to practice preventive measures more extensively in this regard.  }, Keywords = {Risk factors, Coronary Angiography, Coronary Vessels, Coronary Stenosis}, volume = {9}, Number = {4}, pages = {361-367}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.361}, url = {http://caspjim.com/article-1-1353-en.html}, eprint = {http://caspjim.com/article-1-1353-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Barat, Shahnaz and Batebi, Zohreh and Bouzari, Zinatossadat and Ghanbarpour, Azit}, title = {Triglyceride to HDL cholesterol ratio and risk for gestational diabetes and birth of a large-for-gestational-age newborn}, abstract ={Background: Using oral glucose for glucose challenge test (GCT) and glucose tolerance test (GTT) is problematic, especially in early pregnancy when the pregnant woman is experiencing gastrointestinal complications. This research seeks to investigate the relationship between the ratio of Triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) and the risk of gestational diabetes and large for gestational age (LGA) fetus for suggesting a more appropriate index for diagnosis of gestational diabetes. Methods: The present cross-sectional study investigated pregnant women visiting the Perinatal Clinic of Ayatollah Rouhani Hospital in Babol for prenatal care from September 2015-2016. The GCT was performed on these pregnant women at 24-28 weeks as a screening test and their lipid profile, including HDL-C and TG, was simultaneously assessed after eight to 14 hours of fasting. Results: Significant differences were observed between women with and without gestational diabetes in terms of mean triglyceride, HDL, LDL/HDL ratio, triglyceride/LDL ratio and triglyceride/HDL ratio. The cut-off point of TG/HDL in the GTT was 4.254 with a sensitivity of 79.07% and specificity of 78%. Conclusions: According to the results obtained, lipid profile can help predict the risk of gestational diabetes, especially TG/HDL ratio that has a high sensitivity to diagnose gestational diabetes, while, lipid indices could not predict birth of a LGA neonate. Keywords: Gestational Diabetes, Triglyceride, Cholesterol, Triglyceride/HDL Ratio, Risk }, Keywords = {Gestational Diabetes, Triglyceride, Cholesterol, Triglyceride/HDL Ratio, Risk Factors}, volume = {9}, Number = {4}, pages = {368-375}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.368}, url = {http://caspjim.com/article-1-1169-en.html}, eprint = {http://caspjim.com/article-1-1169-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Mirmiran, Parvin and Hadavi, Hoda and Mottaghi, Azadeh and Azizi, Fereidou}, title = {Effect of dietary patterns on oxidative stress in Patiants with metabolic syndrome: Tehran Lipid and Glucose Study}, abstract ={Background: Metabolic syndrome is a prevalent condition with dramatic rising trend worldwide. Single dietary factors, such as omega-3 fatty acids consumption protect body against oxidative damage by reinforcement of dietary total antioxidant capacity but the combination of all dietary components may be more effective when studied as integrated dietary patterns. This present study was designed to assess the association between different dietary patterns and oxidative stress in a population of Tehranian adults suffering from metabolic syndrome. Methods: Dietary data were collected using a validated 147-item semi-quantitative FFQ with a standard serving size. Factor analysis method was used to derive dietary patterns. Blood analysis and anthropometric measurements were also obtained. Oxidative stress was assesses using serum levels of Malondialdehyde (MDA) and total antioxidant capacity (TAC). Results: The regression coefficient for TAC and MDA with different quintiles of dietary patterns, adjusted for potential confounder in model 3 reveal a significant positive association between healthy pattern and serum TAC levels (β=0.244, p=0.008) and also between serum MDA levels and the unhealthy pattern (β=0.387, p=0.0001). On the other hand, a significant negative association found between serum TAC levels (β=-0.289, p=0.001) and the unhealthy pattern, a relationship also noted between serum MDA levels and the healthy dietary pattern (β=-0.273, p=0.002). Conclusions: Our findings suggest that following a healthy pattern filled with fruits and vegetables ameliorates oxidative stress status and on the contrary, attachment to an unhealthy pattern, characterized by higher intakes of fast foods and processed foods, aggravated the oxidative stress levels in Tehranian individuals suffering from metabolic syndrome.}, Keywords = {dietary patterns, oxidative stress, metabolic syndrome}, volume = {9}, Number = {4}, pages = {376-385}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.376}, url = {http://caspjim.com/article-1-1359-en.html}, eprint = {http://caspjim.com/article-1-1359-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Kheirkhah, Farzan and Roustaei, GholamAbbas and MohebiAbivardi, Elham and Hamidia, Angela and JavadianKutenai, Sakineh}, title = {Improvement in Cognitive Status and Depressive Symptoms Three Months after Cataract Surgery}, abstract ={Background: Cataract induced vision impairment can lead to loss of older people’s independence and self-esteem and limit their daily activities. Moreover it has comorbid cognitive impairment and depression. Cataract surgery may be one way to attenuate these comorbidities. The aim of this study was to compare pre-operative and postoperative depressive symptoms and cognitive impairments of patients who underwent cataract surgery. Methods: This study was a before - after clinical trial. Participants completed the following validated surveys one day before and again three months after surgery. Dependent variables were preoperative to postoperative within-patient difference in Geriatric Depression Scale (GDS) and Mini-Mental State Examination (MMSE) scores. Independent variable was improvement of visual acuity. Results: Mean age was 71.77±8.08, 54% were females. Mean postoperative visual acuity improvement was 0.7720±0.1758, mean GDS score difference was -1.49±1.72 and mean MMSE score difference was 0.28±0.88. Postoperative improvement of visual acuity, GDS and MMSE scores were statistically significant (p=0.001). The mean visual acuity improvement in the participants with age over 80 years was lower than the younger subjects; while improvement in MMSE scores in this age group was significantly higher than them. There were no significant relationship between visual acuity, GDS and MMSE scores before and after surgery based on BMI and educational level. Conclusions: It was concluded that cataract surgery is effective for relieving depressive symptoms in the elderly. Improved visual acuity at older ages has far more effects on reducing cognitive impairment.}, Keywords = {Depressive symptoms, cognitive impairment, cataract surgery, visual acuity, GDS, MMSE}, volume = {9}, Number = {4}, pages = {386-392}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.386}, url = {http://caspjim.com/article-1-1396-en.html}, eprint = {http://caspjim.com/article-1-1396-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Karajibani, Mojhde and Hasanjani-roushan, Mohammadreza and bayani, masumeh and Javanian, Mostafa and Bijani, Ali and Masrour-Roudsari, Jil}, title = {Spontaneous relapse in patients with inactive chronic hepatitis B virus infection}, abstract ={Background: Chronic hepatitis B virus infection (HBV) may reactivate during the course of the disease and is called spontaneous relapse. The purpose of this study was to evaluate the incidence of relapse of hepatitis in subjects with inactive HBV carriers. Methods: This follow-up study was performed on 785 patients with inactive HBV carriers that were followed-up at six month intervals. The presence of serum HBsAg and anti-HBe, without HBeAg, HBV DNA levels <2000 IU/ml with normal alanine aminotransferase (ALT) levels was defined as inactive carriers. Patients who developed ALT ≥80 IU/L with HBV DNA levels ≥2000 IU/ml were considered as spontaneous relapse. Results: Seven hundred- eighty five cases (441 males, 344 females) of chronic HBV infected individuals were followed-up. The mean age at the entrance of the study was 30.5±11.8 years. The mean follow-up duration was 5.9±5 years. Relapse was seen in 35 (4.5%) cases,  in 27 out of 441 (6.1%) males and in 8 out of 344 (2.3%) females and in 4.2% subjects ≥ 30 years versus in 4.7% cases of under 30 years (p>0.05). The development of relapse in males was higher than females (hazard ratio 2.53, 95% CI 1.2-5.6, p=0.021), but age ≥30 or < 30 years did not have effect (hazard ratio1.21, 95% CI 0.62-2.36, p=0.58). Conclusions: The results show that spontaneous relapse of hepatitis may develop during the course of chronic HBV infection. We suggest that all patients with chronic hepatitis B, regardless of their age, be examined for the possibility of relapse.}, Keywords = {hepatitis B virus , relapse, inactive}, volume = {9}, Number = {4}, pages = {393-396}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.393}, url = {http://caspjim.com/article-1-1026-en.html}, eprint = {http://caspjim.com/article-1-1026-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Ghassabi, Farzaneh and Malekzadegan, Yalda and SedighEbrahim-Saraie, Hadi and Heidari, Hamid and Sabet, Mozhgan and Bagheri, Abdollatif and Bagheri, Narges and RaeisiShahraki, Hadi and Hasanabadi, Alireza and Motamedifar, Mohamm}, title = {Gonor‌rhea and syphilis co-infection and related risk factors in HIV patients from Shiraz, South of Iran}, abstract ={Background: Neisseria gonorrhea and Treponema pallidum as an obligate human pathogen are two common causes of sexually transmitted diseases (STDs). The present study aimed to determine the prevalence of N. gonorrhoeae and T. pallidum among human immunodeficiency virus (HIV) patients in the southwest Iran. Methods: This retrospective study was performed from 2004 to 2013, on HIV patients who were tested for detection of gonorrhea and syphilis infection at Shiraz HIV/AIDS Research Center. ELISA technique was used for preliminary detection of HIV and confirmed by a Western Blotting test. Gonorrhea was routinely diagnosed using direct Gram-staining and culturing on selective agar. Syphilis was routinely diagnosed by RPR test. Results: Of the 806 HIV patients, 39 (2.6%) cases had co-infection with gonor­rhea. Compared with mono-HIV infected patients, gonor­rhea was significantly more likely among the males (69.4% vs. 92.3%, P=0.002). History of addiction and prison seems to be a significant risk factor for gonor­rhea infection (P<0.05). Also, the mean of CD4+lymphocyte was higher among gonor­rhea infected patients (368±238 vs. 415±328). Logistic regression analysis showed that sexual contact increased risk of gonococcal infection about 4 fold (OR: 4, CI: 1.7-9.39, P=0.001). None of the HIV patients had syphilis co-infection. Conclusions: As a preliminary survey, our findings provided unique information on the prevalence of gonorrhea and syphilis co-infections among HIV patients. Moreover, we introduced the main risk factors associated with gonorrhea co-infection in HIV patients in our region including gender, history of addiction and prison, CD4+lymphocyte count, and transmission routes for effective management of STDs.  }, Keywords = {Sexually transmitted disease (STD), Human immunodeficiency virus (HIV), Neisseria gonorrhea, Treponema pallidum}, volume = {9}, Number = {4}, pages = {397-402}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.397}, url = {http://caspjim.com/article-1-1311-en.html}, eprint = {http://caspjim.com/article-1-1311-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Karakonstantis, Stamatis and Pitsigavdaki, Sofia and Korela, Dafni and Galani, Despoi}, title = {Lower lobe pneumonia presenting as singultus (hiccups)}, abstract ={Background: Persistent hiccups can be a debilitating symptom and many such patients present to the emergency department seeking relief. A variety of serious conditions have been associated with persistent hiccups. Cases of pneumonia as a cause of hiccups have been rarely described. Case presentation: A 79-year-old male patient presented to the hospital due to persistent hiccups for 4 days. Despite lack of new respiratory symptoms or fever, a chest x-ray demonstrated a left lower lobe consolidation, which was also confirmed with a chest CT. The patient was treated with levofloxacin and at 1-month follow-up hiccups had completely resolved, while a repeat chest CT demonstrated resolution of the consolidation. Conclusions: The presentation of pneumonia in elderly patients may be atypical and may lack the symptoms and signs observed in younger patients. Hiccups may be the main presenting symptom of pneumonia.}, Keywords = {hiccups, singultus, pneumonia, chlorpromazine, hypotension}, volume = {9}, Number = {4}, pages = {403-405}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.403}, url = {http://caspjim.com/article-1-1160-en.html}, eprint = {http://caspjim.com/article-1-1160-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Crkvenac, Maja and Jakopovic, Marko and Hecimovic, Ana and Pavlisa, Gordana and Samarzija, Miroslav and VukicDugac, Andre}, title = {Hemothorax as the first manifestation of idiopathic pulmonary arteriovenous malformation}, abstract ={Background: Pulmonary arteriovenous malformations (PAVM) are rare pulmonary vascular anomalies and hemothorax as a presenting feature of PAVM is a very rare occurrence. Case presentation: A 45-year old woman presented with chest pain and breathlessness. A chest x-ray showed left-sided pleural effusion. An emergency MSCT scan with contrast showed no signs of pulmonary embolism but instead a probable AV malformation was shown. Diagnostic thoracocentesis revealed hemorrhagic exudate with negative cytology and microbiology findings. Thoracic drainage was performed resulting with complete regression of hemothorax. Three months later, patient was treated with transcatheter embolization of PAVM with good clinical outcome. Conclusions: We have shown that management of PAVM related hemothorax initially by thoracic drainage followed by later on performed catheter embolization of the PAVM could lead to a successful outcome.}, Keywords = {idiopathic PAVM, pleural effusion, hemothorax, catheter embolisation}, volume = {9}, Number = {4}, pages = {406-409}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.410}, url = {http://caspjim.com/article-1-1167-en.html}, eprint = {http://caspjim.com/article-1-1167-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {Tarashandefoumani, Azade and Elyasi, Forouz}, title = {Oxymetholone-Induced Acute Renal Failure: A Case Report}, abstract ={Background: The prevalence of using anabolic steroids such as oxymetholone is increasing. This highlights the need for closely monitoring side effects of this drug. Acute renal failure (ARF) has been reported as a complication of rhabdomyolysis in anabolic steroids users. Case presentation: We present one   33-year-old man complaining of decreased urine volume, urine color change, and lower abdominal pain.  He is engaged with a rare side effect of oxymetholone abuse. During assessments of potential medical issues associated with the intake of anabolic steroids, known side effects are known to be transient, but the need for appropriate interventions remains essential. Conclusions: Rhabdomyolysis due to drug use and the consequent acute kidney injury are among the lethal risks associated with anabolic steroid abuse. In most cases, the symptoms are extensive and often misleading. Therefore, detailed history taking, physical scrutiny, paraclinical testing, and early diagnosis are crucial for rhabdomyolysis patients.  }, Keywords = {anabolic steroids , Oxymetholone , Addiction , Rhabdomyolysis , Renal Failure}, volume = {9}, Number = {4}, pages = {410-412}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.406}, url = {http://caspjim.com/article-1-1146-en.html}, eprint = {http://caspjim.com/article-1-1146-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {ShoaibKhan, Muhammad and Zahid, Sohaib and Ishaq, Muhamm}, title = {Fatal Hypermagnesemia: an acute ingestion of Epsom Salt in a patient with normal renal function}, abstract ={Background: Generally, it is very rare for clinically significant hypermagnesemia to develop in an individual with normal renal functions as the renal handling of serum magnesium is a very potent process and it has the capacity, under conditions of hypermagnesemia, to completely block Mg (magnesium) reabsorption from the thick ascending limb of Henle. Therefore, hypermagnesemia usually arises in the setting of renal failure. Case presentation: We present a very rare case of a 40-year-old African American obese female with prior normal renal functions, who presented post-cardiac arrest following accidental overdose of Epsom salt. The patient was initially given supportive therapy and was later considered for the dialysis despite normal renal functions, as serum Mg levels kept on creeping up and clinical status kept on deteriorating continuously. Conclusions: Seemingly harmless magnesium containing (over-the-counter) (OTC) can potentially be lethal, and such consequences must always be taken into account when using such medications for a prolonged period of time.  }, Keywords = {Epsom salt, Magnesium, Hypermagnesemia, Normal Renal Functions}, volume = {9}, Number = {4}, pages = {413-415}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.413}, url = {http://caspjim.com/article-1-1332-en.html}, eprint = {http://caspjim.com/article-1-1332-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} } @article{ author = {javanian, Mostafa and Masrour-Roudsari, Jila and Ebrahimpour, Soheil}, title = {Clinical diagnosis challenges in Zika virus infection}, abstract ={}, Keywords = {Zika virus, diagnosis, flu like illness}, volume = {9}, Number = {4}, pages = {416-417}, publisher = {Babol University of Medical Sciences}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.22088/cjim.9.4.416}, url = {http://caspjim.com/article-1-1433-en.html}, eprint = {http://caspjim.com/article-1-1433-en.pdf}, journal = {Caspian Journal of Internal Medicine}, issn = {2008-6164}, eissn = {2008-6172}, year = {2018} }