2024-03-29T10:02:48+03:30 http://caspjim.com/browse.php?mag_id=29&slc_lang=en&sid=1
29-730 2024-03-29 10.1002
Caspian Journal of Internal Medicine Caspian J Intern Med 2008-6164 2008-6172 10.22088/cjim 2017 8 1 Prevalence of diabetes, impaired fasting glucose and impaired glucose tolerance in patients with thalassemia major in Iran: A meta-analysis Milad Azami milad98azami@gmail.com Ali Sharifi Siros Norozi Akram Mansouri Kourosh Sayemiri Background: This study aimed to investigate the prevalence of diabetes, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) in Iranian patients with thalassemia major. Methods: The current study has been conducted based on PRISMA guideline. To obtain the documents, Persian and English scientific databases such as Magiran, Iranmedex, SID, Medlib, IranDoc, Scopus, PubMed, ScienceDirect, Cochrane, Web of Science, Springer, Wiley Online Library as well as Google Scholar were searched until December 2015. All steps of the study were conducted by two authors independently. To the high heterogeneity of the studies, the random effect model was used to combine studies. Data were analyzed using STATA Version 11.1 software. Results: Thirty-two studies involving 3959 major thalassemia patients with mean age of 16.83 years were included in the meta-analysis. The prevalence of diabetes in Iranian patients with thalassemia major was estimated as 9% (95% CI: 6.8-10.5) and estimated rate was 12.6% (95% CI: 6.1-19.1) for males and 10.8% (95% CI: 8.2-14.5) for females. The prevalence of IFG and IGT were 12.9% (95% CI: 7-18.8) and 9.6% (95% CI: 6.6-12.5) respectively. No relationship between serum ferritin and development of diabetes was noted. Conclusion: The prevalence of diabetes, IFG, and IGT in patients with thalassemia major in Iran is high and accordingly requires new management strategies and policies to minimize endocrine disorders in Iranian patients with thalassemia major. Screening of patients for the early diagnosis of endocrine disorders particularly diabetes, IFG, and IGT is recommended. Diabetes Impaired Fasting Glucose Impaired Glucose Tolerance Ferritin Thalassemia Major Iran Meta-analysis 2017 1 01 1 15 http://caspjim.com/article-1-730-en.pdf
29-710 2024-03-29 10.1002
Caspian Journal of Internal Medicine Caspian J Intern Med 2008-6164 2008-6172 10.22088/cjim 2017 8 1 Conjugate and 23-valent pneumococcal polysaccharide booster vaccination in asplenic patients with thalassemia major: A randomized clinical trial study Mohammad Sadegh Rezai drmsrezaii@yahoo.com Javad Ghaffari javadneg@yahoo.com Mohammadreza Mahdavi mrmahdavi@yahoo.com Amir Bahari abahari@yahoo.com Shahram Ala shala@yahoo.com Background: Pneumococcal vaccine provides protection against invasive pneumococcal disease in population at risk. This study was conducted to compare the antibody response to 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine in patients with thalassemia major. Methods: A randomized cross-over clinical trial was performed on 50 asplenic patients with thalassemia major who referred to thalassemia center at Bouali Sina Hospital, Sari, Iran from 2013 to 2014. Patients were divided into two equal groups. The first group received 13-valent pneumococcal conjugate vaccine (PCV) injected into the deltoid muscle at first and received 23-valent polysaccharide vaccine (PPV) by the same way two months later. The second group received PPV vaccine at first and PCV13 two months later. Levels of serum antibody were checked and measured by enzyme-linked immunosorbent assay (ELISA) before vaccination, and then 8 weeks after the first injection and 2 months after the second injection in all patients. Each time 0.5-ml dose of the vaccine was injected. Results: Of the 50 patients, three cases were excluded due to lack of cooperation and avoidance of vaccination.  From 47 patient participants, 28 (59.6%) were males and 19 (40.4%) were females with age ranged between 20 to 44 years (average age of 29.6±1.4 years). Pneumococcal IgG levels in a group that used PCV before PPV (Group A) increased from 114.5±87.7 to 1049±720 U/ml (p=0.0001) and in another group that used PPV before PCV (Group B) increased from 115±182.2 to 1497.3±920.3 U/ml (P=0.0001). Conclusion: It can be concluded that PCV vaccine before PPV can be more effective in asplenic thalassemia major patients as a booster dose. PPV-23 PCV-13 Thalassemia Major Asplenia 2017 1 01 16 22 http://caspjim.com/article-1-710-en.pdf
29-795 2024-03-29 10.1002
Caspian Journal of Internal Medicine Caspian J Intern Med 2008-6164 2008-6172 10.22088/cjim 2017 8 1 Incidence and risk factors for cytomegalovirus in kidney transplant patients in Babol, northern Iran Mostafa Javanian mjavanian@gmail.com Arefeh Babazadeh fazeli2233@gmail.com Farshid Oliaei ol_1964@yahoo.com Roghayeh Akbari roghayeh.akbari@yahoo.com Abazar Akbarzadepasha aapasha812@yahoo.com Ali Bijani alibijani@gmail.com Mahmoud Sadeghi drm_sadeghihz@yahoo.com Background: Cytomegalovirus (CMV) disease is an important cause of death and possibly transplant rejection in kidney transplant (KT) patients. This study was conducted to investigate the incidence and risk factors of CMV disease in kidney transplant patients. Methods: All end-stage renal disease (ESRD) patients who underwent kidney transplantation during 1998-2014 and their donors were assessed. All samples were followed-up for approximately 70 months. CMV was identified by polymerase chain reaction (PCR) and/or PP65 antigen in peripheral blood leukocytes along with clinical manifestations. Results: A total of 1450 cases participated in the current study. CMV was diagnosed in 178 out of 725 (24.6%) kidney recipients.  The annual incidence of CMV disease was 4.2%. Patients older than 40 years had a higher incidence of CMV disease. The level of CMV disease incidence in the 41-60 age group was 4 fold compared to those under 20 of age group (P=0.001). Conclusion: This study demonstrated that the incidence of CMV disease in our region is relatively low and also age more than 40 years and EBV infection are the important risk factors in kidney transplant patients. So care and monitoring of these patients are crucial in the first 5 months. Cytomegalovirus Incidence Renal transplantation 2017 1 01 23 29 http://caspjim.com/article-1-795-en.pdf
29-812 2024-03-29 10.1002
Caspian Journal of Internal Medicine Caspian J Intern Med 2008-6164 2008-6172 10.22088/cjim 2017 8 1 Etiology evaluation of chylothorax in Babol, Northern Iran Novin Nikbakhsh novinsu@hotmail.com Mohammad Zamani mzamani20@gmail.com Askari Noorbaran anoorbaran20@gmail.com Ali Naghshineh anaghshineh11@gmail.com Danial Rastergar-Nejad yavash_9@yahoo.com Background: Chylothorax results from leakage of lymph in the pleural cavity because of thoracic duct injury which is associated with severe metabolic disorders. The aim of this study was to evaluate the rate of chylothorax and its causes among hospitalized patients in Shahid Beheshti Hospital of Babol city, North of Iran. Methods: In this cross-sectional study, all patients with chylothorax admitted to the surgery department of Shahid Beheshti Hospital during 2002-2015 were included. Information including gender, age, duration of symptoms, laboratory findings, causes of disease and the type of treatment were extracted from the patients' records. Results: Of the 42 patients, 27 (64.3%) were men and 15 (35.7%) were women. The mean age of the study population was 51.03±16.95. The most common clinical symptoms were dyspnea (66.7%) and dyspnea with cough (21.4%), respectively. In all patients, the pleural fluid triglyceride level was greater than 110 mg/dl, whereas the presence of lymphatic in pleural fluid was eventful in 18 (42.8%) patients. The causes of the disease were traumatic (54.8%), non-traumatic (38.1%) and unknown (7.1%), which were not significantly correlated with gender. Nineteen (45.2%) patients were operated, 16 (38.1%) patients received supportive therapy, and 7 (16.7%) patients had the treatment of the underlying conditions and then supportive therapy. Conclusion: According to the results, trauma was the most common cause of chylothorax. Therefore, identification and control of the traumatic factors seem to be the steps to prevent and reduce the chylothorax incidence and its complications. Chylothorax Lymph Thoracic duct Trauma Surgery 2017 1 01 30 34 http://caspjim.com/article-1-812-en.pdf
29-755 2024-03-29 10.1002
Caspian Journal of Internal Medicine Caspian J Intern Med 2008-6164 2008-6172 10.22088/cjim 2017 8 1 Effect of SeptimebTM as a new natural extract on severe sepsis: A randomized clinical trial Alieh Pourdast dr_apourdast@yahoo.com Maryam Sanaie sanaeimaryam@gmail.com Sirous Jafari jafari@gmail.com Mostafa Mohammadi Mohammadi@gmail.com Hossein Khalili Khalili@gmail.com Gita Shafiee gshafiee.endocrine@gmail.com Zeinab Ahadi zeinab_ad@yahoo.com Mahsa Rostami mahsa_rstm@yahoo.com Saba Alizad Alizad@gmail.com Ramin Heshmat ahadi.ze@gmail.com Minoo Mohraz minoomohraz@ams.ac.ir Background: Septimeb as a herbal medicine has regulatory effects on inflammation. This study set to evaluate the effects of Septimeb among patients with sepsis on inflammatory biomarkers and survival rate. Methods: In this randomized clinical trial, 51 patients with sepsis from the ICU and medical ward of Imam Khomeini Hospital were divided into two groups: Septimeb (n=25) and control group (n=26). In the control group, the patients received a standard treatment only for 7 days, while Septimeb group received Septimeb (6cc vial with 500cc serum glucose infusion 5% daily for one to two hours) plus standard treatment of sepsis for 7 days. Then, blood samples were analyzed. APACHE (Acute Physiologic and Chronic Health Evaluation), SOFA (Sequential Organ Failure Assessment), and GCS (Glasgow Coma Score) values were calculated daily. Results: Treatment with Septimeb showed a significant decrease in SOFA value (1.54±0.83) compared to the control group (2.39±0.88) (P<0.001) and a significant increase in GCS value (14.46±0.88) compared to the control group (12.86±1.78) (P<0.001).  Improvements of these values can confirm the potential of Septimeb in the reduction of severity of sepsis (P<0.05). There were significant decreases in lactate and blood sugar and WBC levels. In addition, inflammatory factors such as ESR (Septimeb group: 52.07±34.80, control group: 51.75±42.10, P=0.98) and CRP (Septimeb group: 48.86±23.21, control group: 49.93±36.22, P=0.92) decreased, but did not show a significant reduction. Conclusion: Septimeb has positive effects on reduction of the severity of sepsis which leads to reduction of patients’ mortality rates. Sepsis Septimeb Infection Inflammatory 2017 1 01 35 43 http://caspjim.com/article-1-755-en.pdf
29-783 2024-03-29 10.1002
Caspian Journal of Internal Medicine Caspian J Intern Med 2008-6164 2008-6172 10.22088/cjim 2017 8 1 Skeletal complications of brucellosis: A study of 464 cases in Babol, Iran. Soheil Ebrahimpour drsoheil1503@yahoo.com Masomeh Bayani m_biany@yahoo.com Mohammad Reza Hasanjani Roushan hagar2q@yahoo.ca Background: Skeletal complication of brucellosis is common in endemic region of brucellosis, but its frequency has not been clearly determined. The aim of this study was to determine the frequency of skeletal complication in brucellosis patients in Babol, north of Iran. Methods: From 2005-2015, 1252 cases of brucellosis were diagnosed at the Department of Infectious Diseases, Ayatollah Rouhani Teaching Hospital, in Babol, North of Iran. The diagnosis of brucellosis was established using serum agglutination test (SAT≥1/160), and 2-mercaptoethanol (2ME≥ 1/80) with clinical and epidemiological findings compatible with brucellosis. Among them, 464 (37.1%) cases demonstrated skeletal complication. The diagnosis of skeletal involvement was established with appropriate diagnostic facilities. The data were collected and analyzed. Results: The mean age of these patients (299 males, 165 females) was 33.2±17.6 years. Three hundred-thirty four (72%) cases were from rural areas. In 350 (75.4%) patients with peripheral arthritis, 242 (52.1%) cases were monoarthritis. Furthermore the knee arthritis was seen in 148 (31.9%) patients and hip in 54 (11.6) cases. Sacroiliitis was seen in 59 (12.7%) patients and spondylitis in 55 (11.9%) cases. There were no significant differences regarding the occurrence of these focal lesions in both sexes. Conclusion: The results show that about one-third of brucellosis in human is associated with skeletal complication. Peripheral arthritis, sacroiliitis and spondylitis are the frequent skeletal complications of human brucellosis. Brucellosis Skeletal complication Sacroiliitis Spondylitis Arthritis 2017 1 01 44 48 http://caspjim.com/article-1-783-en.pdf
29-469 2024-03-29 10.1002
Caspian Journal of Internal Medicine Caspian J Intern Med 2008-6164 2008-6172 10.22088/cjim 2017 8 1 Cryptogenic hepatitis simulating cyst rupture and hydatid jaundice in a patient with preexisting asymptomatic hydatid cyst Ulas Aday ulasaday@gmail.com Cuneyt Kayaalp cuneytkayaalp@hotmail.com Murat Kapan drmuratkapan@gmail.com Background: Rupture into the biliary ducts is the most frequent complication of hydatid liver disease. In endemic areas of Echinococcus granulosus, development of jaundice in a patient with liver cyst is initially suspected to have hydatid cyst. Case Presentation: A 48 year-old woman with history of asymptomatic hydatid liver cysts was admitted to the emergency department with right upper quadrant abdominal pain,  increased levels of liver enzymes, bilirubin and alkaline phosphatase and the initial clinical diagnosis was the hydatid cyst rupture into the bile ducts. Surgery was planned but radiological evaluation (MRI) revealed non-dilated intra-extra biliary ducts. High suspicion of hydatid rupture required diagnostic ERCP that was normal and surgery was cancelled then. A possible diagnosis of coexistent hepatitis was suspected. Liver function tests normalized gradually and no cyst rupture was determined during surgery. Conclusion: These findings suggest considering the possible development of cryptogenic hepatitis in patients with preexisting hydatid cyst. hydatid liver disease surgery jaundice cryptognic hepatitis 2017 1 01 49 51 http://caspjim.com/article-1-469-en.pdf
29-572 2024-03-29 10.1002
Caspian Journal of Internal Medicine Caspian J Intern Med 2008-6164 2008-6172 10.22088/cjim 2017 8 1 Arteriovenous malformations of the colon: A report of two cases and review of the literature Ghodratollah Maddah maddahgh@mums.ac.ir Abbas Abdollahi abdollahia@mums.ac.ir Omid Rouhbakhshfar rouhbakhsho881@mums.ac.ir Shirin Taraz Jamshidi tjamshidish@mums.ac.ir Masoumeh Hassanpour hassanpourm1@mums.ac.ir Background: Arteriovenous malformations are one of the most common vascular disorders of the colon. Vascular disorders present as painless, high-volume rectal bleeding. Case Presentation: This study elucidates two rare cases of vascular disorders that are diagnosed as angiodysplasia of the left colon and cavernous hemangioma of the colon and rectum.  The chief complaint in two patients was rectorrhagia. The patients who were diagnosed of ulcerative colitis were treated with sulfadiazine and prednisone. Due to continuous bleeding, the patients were referred to the surgery department for operation. The patients underwent total proctocolectomy. Conclusion: We discuss the faults in the diagnosis and management of vascular disorders of the intestine. Gastrointestinal Hemorrhage Rectorrhagia Arteriovenous malformation Angiodisplasia 2017 1 01 52 55 http://caspjim.com/article-1-572-en.pdf
29-573 2024-03-29 10.1002
Caspian Journal of Internal Medicine Caspian J Intern Med 2008-6164 2008-6172 10.22088/cjim 2017 8 1 Oral contraceptive-related transverse sinus thrombosis as an initial manifestation of antiphospholipid syndrome in the absence of systemic lupus erythematosus Payam Saadat sepanta1968@yahoo.com Reza Mohseni-Ahangar Oral Contraceptive Agents Cerebral venous sinus thrombosis Antiphospholipid syndrome Anticardiolipin antibody Antiphospholipid antibody 2017 1 01 56 58 http://caspjim.com/article-1-573-en.pdf
29-711 2024-03-29 10.1002
Caspian Journal of Internal Medicine Caspian J Intern Med 2008-6164 2008-6172 10.22088/cjim 2017 8 1 Fulminant hepatic failure due to metastatic choroidal melanoma Emmanuel Escobar-Valdivia dreescobar@hotmail.com Roberto Monreal-Robles roberto_monreal@hotmail.com Guillermo Delgado-García guillermo.delgadogr@uanl.edu.mx Badir Hernández-Velazquez badir84@hotmail.com Fulminant liver failure Acute liver failure Melanoma Metastatic melanoma Choroidal melanoma 2017 1 01 59 62 http://caspjim.com/article-1-711-en.pdf
29-457 2024-03-29 10.1002
Caspian Journal of Internal Medicine Caspian J Intern Med 2008-6164 2008-6172 10.22088/cjim 2017 8 1 Time to appreciate Avicenna’s knowledge of rabies Nader Aghakhani mgn1370@yahoo.com Mehdi Azami mehdi.azami@gmail.com Mohsen Ghomashlooyan ghomashlooyan@med.mui.ac.ir Alireza Nikoonejad : nikoonejad.anikoo@gmail.com Rabies Avicenna Traditional medicine Treatment 2017 1 01 63 64 http://caspjim.com/article-1-457-en.pdf
29-734 2024-03-29 10.1002
Caspian Journal of Internal Medicine Caspian J Intern Med 2008-6164 2008-6172 10.22088/cjim 2017 8 1 Geographical mortality distribution of cardiovascular diseases: First report from South Khorasan, Iran Toba Kazemi drtooba.kazemi@gmail.com Gholam-reza Sharifzadeh rezamood@yahoo.com Nahid Borna borna.nahid@gmail.com Mortality Cardiovascular diseases Geographical distribution Iran Indirect matching 2017 1 01 65 66 http://caspjim.com/article-1-734-en.pdf