bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term Outcome of Kasai Operation on Children with Biliary Atresia between 2001-2010 in Namazi Hospital, Shiraz, Iran
Authors: Ghorban nejad Fatemeh , Dehghani Seyed Mohsen , Haghighat Mahmoud , Forootan Hamid Reza , Bahador Ali
Published: January 2022

Background: Biliary atresia is a 100% fatal disorder without any treatment in infants as a leading cause of cirrhosis and Kasai operation, as the only operative choice, which plays a crucial role in increasing their rate of survival. Nonetheless, many patients end up with liver transplantation in the future owing to various inevitable hepatic and biliary problems which do remain after the Kasai operation. In this study, we aimed to assess the prognosis and influential factors on the outcome of this procedure on children attending Shiraz Namazi Hospital.

Patients and Methods: A database of medical records of 61 patients (F=41, M=20) with biliary atresia, aged between 30 to 100 days (65.27Â±18 days) at the time of operation, who had undergone the Kasai operation in Shiraz Namazi Hospital from 2001 to 2010 was examined in a retrospective review. Risk factors of failure (death and liver transplantation) were analyzed by Kaplan-Meier test.

Results: Age at the operation time, type of atresia, and dilatation of the bile ducts were identified as the risk factors; 29 patients had signs of hepatomegaly, 6 patients had liver transplantation. Among them, 3 survived.

Conclusion: Of the patients, 61% with biliary atresia survived for more than 5 years with their native liver while the overall survival rate among 52 patients was 85.30Â±5.96 months. Postoperative care and regular checkups should be considered for all survivors as a lifelong procedure to prevent any possibilities of future hepatic deterioration.
Cardiac Rehabilitation Program with High Intensity Aerobic Exercise Can Reverse Diastolic Impairment in Patients Undergoing Coronary Artery Bypass Surgery
Authors: Rai Alireza , Bahremand Mostafa , Salehi Nahid , Rezaee Mansour , Raeisei Ahmad Ali
Published: January 2022

Background: Cardiac rehabilitation is known as a powerful non-pharmacological approach for improving functional capacity, and left ventricular systolic function; however, some limited data have suggested an attenuation of the decline in diastolic function with this program. This study investigated the effect of high intensity aerobic exercise following coronary artery bypass surgery (CABG) on diastolic dysfunction.

Materials and Methods: Forty four patients with different levels of diastolic dysfunction who underwent CABG surgery were included. The participants attended the complete cardiac rehabilitation program three times per week for two months (totally 24 sessions). The patients underwent complete transthoracic echocardiographic studies including two-dimensional and spectral Doppler echocardiography immediately before attending rehabilitation program and also after the completion of rehabilitation sessions.

Results: There was a significant decrease of isovolumic relaxation time (IVRT) after participating complete cardiac rehabilitation (94.0 to 89.0; P=0.001). The diastolic function parameters of early diastolic mitral inflow peak velocity to late diastolic mitral inflow peak velocity (E/A) ratio (0.94 to 1.04; P=0.001), deceleration time (DT) of the mitral E wave (192.7 to 219.0; P=0.011), and velocity of early diastolic mitral annular motion (Ea) (5.9 to 6.7; P=0.026) were improved after the rehabilitation, whereas mitral A duration to pulmonary A duration (MAD/PAD) ratio was slightly improved (1.07 to 1.12; P=0.056) and pulmonary veins systolic flow to pulmonary vein diastolic flow (PVS/PVD) ratio (0.89 to 1.04; P=0.345) remained unchanged.

Conclusion: A complete cardiac rehabilitation program with high intensity aerobic exercise approach can reverse diastolic impairment in patients undergoing CABG.
Assessment of Musculoskeletal Disorders Between lorry Drivers in Qom, Iran
Authors: Mozafari Abolfazl , Najafi Mohsen , Vahedian Mostafa , Mohebi Siamak
Published: January 2022

Background: Musculoskeletal disorders represent a substantial cause of morbidity worldwide. The contribution of work to these disorders has been well established by various epidemiological and laboratory-based researches. The aim of this study is to investigate the prevalence and associated factors of musculoskeletal disorders in truck drivers.

Materials and methods: This cross sectional study included truck drivers referred to Transportation Company in Qom province. We evaluated musculoskeletal disorders by Nordic questionnaire and demographic data. The questionnaire was filled by direct interview. Data analysis was done in SPSS and P value below Â 0.05 was significant.

Results: Age of 173 male participated in this study was 38.82 years with body mass index (BMI) of 26.02 (Kg/m2) and mean work duration of 8.85 years. In the period of past week and past year, prevalences of musculoskeletal disorders at all of the nine body regions of drivers were 56.6% and 78.6%, respectively. The most common musculoskeletal involvement was lumbar, back and neck regions. There were significant relationship among musculoskeletal problems with age, work duration, and BMI (P<0.05).

Conclusion: This investigation showed the importance of frequent musculoskeletal disorders among Â drivers in different body regions particularly in lumbar area and its Â correlation with work duration, high weight, and age.
A Rare Case of Mullerian Adenosarcoma of Uterus in a 14-year-old Girl
Authors: Sarmadi Soheila , Mohit Mitra , Saatian Minoo
Published: January 2022

Background: Mullerian Adenosarcoma, a rare tumor, is composed of mixed mesenchymal and epithelial elements. The epithelial component is typically benign and admixed with malignant Sarcomatous Stroma. This tumor can be distinguished in approximately 8% of all uterus sarcomas and commonly originates in the endometrium as a growing polypoid mass in the uterine cavity. All age groups are affected but the average age of uterine Adenosarcoma is about 58. Case report: We aim to introduce a 14-year-old case of uterine Adenosarcoma as a rare occurrence, presenting with menometrorrhagia and formation of uterine fragile polypoid mass which extends into vagina. Total Abdominal Hysterectomy (TAH) and staging were performed. She had been clinically disease-free in a 40-month post operation follow-up. Distant metastasis is a very rare phenomenon, albeit the necessity of long-term follow-up seems necessary.Conclusion: Data accumulation of individual cases with such unusual neoplasm is essential for further experience provision.[GMJ.2014;3(4):256-9]
Effects of Carnitine with and without Glutamine Supplementation on Markers of Muscle Damage and Muscle Soreness among Football Players: A Randomized Controlled Clinical Trial
Authors: Mohtadinia Javad , Hozoori Mohammad , Babaei Hossein , Arefhosseini Seyedrafie , Kooshavar Hossein , Sabour Siamak
Published: January 2022

Background: Exercise-induced muscle damage can affect exercise performance. The purpose of this study is to examine the effects of Carnitine and Glutamine supplementation on markers of muscle damage and muscle soreness after physical exertion on football players.Materials and Methods: Twenty eight healthy male football players aged 21.1Â±0.7 were recruited in a double blind, randomized, placebo-controlled clinical trial on 3 weeks of supplementation. Before supplementation protocol, each participant had to run on a treadmill for 30 minutes at 75% VO2max. Participants were randomly divided into 4 groups: L-Carnitine, L- Glutamine, L-Carnitine plus L- Glutamine and placebo. Blood samples were obtained pre-exercise and immediately after exercise. Muscle soreness was assessed on both occasions and two days after each exercise.Results: L-Carnitine and L-Glutamine supplementation for 21 days significantly decreased Creatine Kinase activity as a marker of muscleâ€™s damage before (P=0.014) and after exercise (P=0.047), and muscle soreness two days after physical exertion (P=0.057). However, Lactate Dehydrogenase activity was affected by Carnitine supplementation after exercise.Conclusion: Chronic oral supplementation of Carnitine and Glutamine before exercise can reduce chemical markers of muscle tissue damage after exercise. In addition, these supplements may reduce muscle pain after exercise and optimize the processes of muscle tissue repair.[GMJ. 2014;3(4):207-15]
Patterns of Constitutive and Inducible Clindamycin Resistance in Staphylococcus aureus Isolated from Clinical Samples by D-test Method, Shiraz, Southwest of Iran
Authors: Seddigh Ebrahim Sarai Hadi , Motamedifar Mohammad , Mansury Davood
Published: January 2022

Background: Macrolides, Lincosamides and type B Streptogramins (MLSB) are commonly used for the treatment of Staphylococcal infections. Inducible MLSB resistance (iMLSB) cannot be identified by standard methods of antibiotic susceptibility testing. D-test appears to be a reliable indicator of iMLSB strains. The aim of this study was to determine the prevalence of Clindamycin resistance phenotypes in Staphylococcus aureus (S.aureus) isolated from clinical samples in Shiraz, southwest of Iran.Materials and Methods: This cross-sectional study was performed on a total of 302 S. aureus isolates which were collected from two teaching hospitals in Shiraz during 2012. Methicillin resistant Staphylococcus aureus (MRSA) were screened based on their resistance to 30Î¼g Cefoxitin disk. 168 Methicillin-sensitive Staphylococcus aureus (MSSA) and 134 MRSA isolates were tested in this study. The isolates were tested for susceptibility to Clindamycin (2 Âµg) and Erythromycin (15 Âµg) by Clinical and Laboratory Standards Institute (CLSI) recommended disk diffusion test.Results: Of 302 collected S. aureus isolates, 134 (44.4%) were MRSA and 168 (55.6%) were MSSA. Inducible MLSB resistance was observed in 10.4% of all recovered MRSA and 3% of all MSSA isolates. The majority of MRSA isolates (77.6%) constituted MLSB phenotype (cMLSB); this phenotype was seen in 4.1% of our tested MSSA isolates. Finally, 12.0% of MRSA isolates and 89.9% of MSSA showed sensitivity to both Erythromycin and Clindamycin.Conclusion: Different resistance patterns in hospitals indicated that performing routine D-test for S. aureus infections is highly recommended for each medical center. [GMJ. 2014;3(4):216-21]
Burnout and Socio-demographic Characteristics of Nurses in Iran
Authors: Rashedi Vahid , Rezaei Mohammad , Gharib Masoud
Published: January 2022

Background: Nursing is considered as a profession at risk for high levels of stress and burnout, and these levels may be increasing as the care they deliver becomes complex. The purpose of this study was to investigate the relationship between burnout and socio-demographic characteristics of nurses.Materials and Methods: A cross-sectional descriptive-analytical design was used. The sample consisted of 194 nurses working in five hospitals of Hamadan University of Medical Sciences in Iran, who completed the Maslach Burnout Inventory (MBI) as well as a socio-demographic questionnaire. The data were analyzed using descriptive statistics, Pearson correlations, independent t-test and ANOVA.Results: Results indicated moderate levels of emotional exhaustion, depersonalization and low levels of personal accomplishment. There was significant relationship between burnout and age, length of employment, and educational level.Conclusion: Identifying an integrative process of burnout among nurses is an essential step in developing effective managerial strategies in order to address the problem. To prevent burnout, further research is necessary to determine the factors associated with it so that recommendations can be made for future wellness interventions. [GMJ. 2014;3(4):232-7]
The Effect of Isometric Exercises on Primary Dysmenorrhea: A Randomized Controlled Clinical Trial
Authors: Azima Sara , Rajaei Bakhshayesh Hajar , Abbasnia Keramatollah , Kaviani Maasumeh , Sayadi Mehrab
Published: January 2022

Background: Primary dysmenorrhea is the most common cyclic pelvic pain and is also the most common gynecological problem worldwide and affects quality of life. The present study aimed to investigate the effect of isometric exercises on intensity and duration of pain and level of anxiety in the students with primary dysmenorrhea.
Materials and Methods: In this randomized controlled clinical trial, 68 students living in dormitories of Shiraz University with primary dysmenorrhea Â were randomly assigned to isometric exercises and control groups. The intervention group performed isometric exercises since the third day of the menstrual cycle for 8 weeks. Pain intensity was measured using Visual Analog Scale (VAS). In addition, the anxiety level was assessed using Spielberger questionnaire. The data were analyzed using independent t-test, repeated measures ANOVA, and Bonferroni Post hoc test at the end of the second and third months of the study. Besides, P<0.05 was considered as statistically significant.
Results: Pain intensity and duration of pain was significantly reduced in exercises group (p<0.001). However, no significant difference was found between the two groups concerning the mean anxiety levels.
Conclusion: Primary dysmenorrhea is a common complaint among young women. Isometric exercises seem to be an easy, non-pharmacological method for reducing primary dysmenorrheal.
Post publication peer review in Iranian biomedical journals
Authors: Derakhshan Rad Seyed-Alireza , Ghanbari Ali
Published: January 2022

Background: letters to the editor provide an opportunity for readers to state their views about published articles. Research on this issue has been mainly on western journals and there is no study on the Iranian journals. The present study aimed to investigate this subject in Iranian biomedical journals.

Materials and Method: This was a bibliometric study. The databases of Iran Medex, Medlib, and SID were searched to find the letters published in Iranian biomedical journals. The letters in formats such as commentaries, concise articles, and the preliminary results of studies or brief reports were excluded from the study.

Results: 184 letters were found in Iranian journals; 49 of them were responses of authors to the criticism made by readers. As a result, the number of letters that commented on or criticized the original articles reduced to 135. For every 1198 articles published in Iranian journals, there is only one letter written in correspondence to published articles. 76% of letters published in 2010 to 2012.

Conclusions: the Iranian readers are much less productive in writing letters to Iranian biomedical journals compared to their peers in other places. The low number of letters could be attributed to several issues including a broad unawareness of the importance of the letters and little incentive for writing letter.The sharp rise in the number of letters after 2009 indicates a boosted motivation of Iranians for writing more letters to the editor.
The Prevalence and the Resistance Profile of Methicillin-Resistant Staphylococcus aureus Colonized in the Nostrils of Cancer Patients in Namazi Teaching Hospital, Shiraz, Iran, 2011-12
Authors: Motamedifar Mohammad , Hassanzadeh Razyeh , Kandehkar Ghahraman Mohammad Reza , Ashrafzadeh Abdolsamad , Hashemizadeh Zahra
Published: January 2022

Background: Methicillin-resistant (MRSA) Staphylococcus aureus (S. aureus) are responsible for a vast number of nosocomial infections especially in immunocompromised subjects such as cancer patients. The presence of comorbidities including malignancies has been associated, with S. aureus bacteremia mortality. Thus, the detection of MRSA in this patients and the antibiotic susceptibility pattern of the isolates eases the selection of first-line medications and the prevention from further complications in cancer patients. The aim of this study was to determine the prevalence of MRSA infection and antibiotic susceptibility patterns of the isolates in pre and post-chemotherapy course in cancer patients.

Materials and Methods: From May 2011 to July 2012, 200 nostril samples of cancerous patients were obtained and cultured on blood agar plates. After isolation and confirmation of S. aureus, antibiotic resistance pattern of the isolates was determined pre-chemotherapy and after the chemotherapy against vancomycin, tigecycline, linezolid, chloramphenicol, and oxacillin using disk diffusion test following CLSI guidelines. Chi-square test was used for data analysis.

Results: Among a total number of 200 various cancer patients (64.5% females), 42 (21%) cases were positive for S. aureus and 7 (3.5 %) were MRSA carriers. Mean ages of MSSA and MRSA infected patients were 50.97Â±15.94 and 53.57Â±18.28 years old, respectively. In vitro susceptibility pattern of the MRSA and MSSA isolates to the 4 tested agents did not differed significantly after the chemotherapy in contrast with pre-chemotherapy state.

Conclusions: This study showed that chemotherapy does not change the susceptibility pattern of MRSA species to antibiotics of choice in cancer patients. However, the importance of controlling methicillin resistant staphylococcal infections in critical cases, specifically cancer cases, necessitates the early detection, further investigations on more effective medications.
Lady Kahhal, First Female Ophthalmologist and Medical Journalist in Iran
Authors: Daneshfard Babak , Golshani Alireza , Foruzani Abolghasem , Ghafouri Ziba , Dalfardi Behnam
Published: January 2022

With the advent of constitutional revolution in Iran and the increase in peopleâ€™s knowledge, womenâ€™s status changed and ultimately improved. Publishing newspaper was one of the womenâ€™s attempts to keep their rights. Lady Somayyeh Kahhal was the first woman in this field, as well as ophthalmology in Iran. She published the first specialized newspaper for women in Iran under the title of Danesh (Knowledge). Lady Kahhal tried to disseminate information on womenâ€™s rights, moral issues and also health and hygiene in her weekly-published newspaper. In this paper, we will review the remaining biographical information about Kahhal and will introduce her newspaper, Danesh. [GMJ.2015;4(2):129-32]
Satisfaction of Family Physician Plan: Viewpoint of Physicians and Health Service Consumers in Kerman, Southeast of Iran
Authors: Ahmadi Batoul , Pourebrahimi Mohammad Hossein , Ram Bejandi Malihe , Ram Bejandi Malihe , Sadeghi Ahmad , Khammarnia Mohammad , Siavashi Elham
Published: January 2022

Background: Family Physician plan is known as one of the most appropriate strategies to implement rural health insurance program in the form of referral system in Iran. This study aims to determine the satisfaction of family physicians and service consumers and its causes of dissatisfaction in the South of Iran. Materials and Methods: This cross-sectional study was performed in Kerman Health Network. Nineteen family physicians and 370 service consumers were selected using stratified random sampling. Data was gathered using two standardized questionnaires. Frequency tables, frequency percentage, mean graphs, Z and Freedman statistical tests were used to analyze the data. Results: Mean scores of physiciansâ€™ satisfaction were 9.10 and 4.12 in staff performance and payment system, respectively. Service consumers were satisfaction of physician delivery care (7.25), and para-medical (3.61). Moreover, most physicians were interested in per capita (31/6%). Conclusion: Family physician and health service consumers are highly satisfied. Satisfaction is an important factor for ensuring service quality and any ignorance in this regard can reduce the quantity and quality of delivered care. Physicians are recommended to respect their consumers and consider their waiting time. Meanwhile, health system managers should promote physiciansâ€™ payment. [GMJ.2015;4(2):96-102]
Evaluation of Serum Catalase Activity and Malondialdehyde Level as Stress Oxidative Biomarkers among Iranian Welders
Authors: Sattarahmady Naghmeh , Heli Hossein , Mehdizadeh Ali Reza , Yarmohammadi Hossein , Mortazavi Seyed Mohammad Javad
Published: January 2022

Background: Oxidant/antioxidant imbalance results in oxidative stress which plays a major Â role in many diseases. Inhalation of metal-enriched fumes and exposure to electromagnetic Â fields of welding device could induce oxidative stress in welders. Therefore, it is necessary to determine the level of oxidative stress among welders. Our study is aimed at estimating serum catalase and Malondialdehyde (MDA) levels in Iranian welders. Materials and Methods: Serum catalase activity and MDA levels were measured in 30 Iranian welders and 30 healthy non-welder subjects via catalase and MDA kit (Abcam). Results: The catalase activity (mU/L) and MDA levels (nmol/mL) were found to be 7.19Â±2.30 and 0.97Â±0.55, respectively in welder subjects, 10.73Â±1.08, and 0.58Â±0.38 in the control subjects. Catalase activity among welders was significantly lower than the control subjects (P<0.0001). In addition, plasma MDA level was significantly higher in welders, compared to the control subjects (P=0.0028). There was no significant difference between welder subgroups when the catalase activity and plasma MDA levels were compared. Conclusion: This study indicates that oxidant/antioxidant balances alter in Iranian welders. In other words, these results imply that the threshold limit of the resistance of the welder body against oxidative stress and damage has decreased. [GMJ. 2015;4(3):62-66]
A Comparative Study of the Ability of Facial Emotional Expression Recognition and its Relationship with Communication Skills in Iranian Patients with Mood Disorders
Authors: Seyednezhad Golkhatmi Seyed Hamid , Homayoni Samaneh , Bakhshani Nour Mohammad , Sadjadi SeyedAlireza , Saidian Asl Mohsen
Published: January 2022

Background: Facial emotion recognition impairment in psychiatric patients such as those with mood disorders and impaired communication skills in these patients is one of the most important issues. The present study aims to evaluate and compare facial emotion recognition among patients with depression, bipolar disorder who experience manic phase and the subjects of the normal group without a diagnosis of a disorder. Moreover, the present study aims to evaluate and compare the relationship between facial emotion recognition ability and communication skills among these patients. Materials and Methods: Participants of this study included 30 patients with depression, 30 patients with bipolar disorder and 30 subjects from a normal group; a total of 90 subjects who were selected using convenience sampling method. PC version of Ekmanâ€™s facial emotion test (1976) and Queendomâ€™s interpersonal communication skills test (2004) were used to collect data. Data were analyzed using statistical tests of correlation, one way analysis of variance and Tukeyâ€™s post hoc test. Results: The findings showed that there was a significant difference between facial emotion recognition in patients with mood disorder and the normal group. Moreover, there was a correlation between facial emotion recognition and communication skills among these patients. Conclusions: Based on the results of this study on facial emotion recognition impairment and its significant relationship with communication skills in patients with mood disorder, it can be said that paying attention to them is very important in treating these disorders and reducing the relapse of the disease.[GMJ. 2015;4(3):90-99]
Dietary Nutrients and Male Infertility: Review of Current Evidence
Authors: Hosseini Banafshe , Djafarian Kurosh
Published: January 2022

Lifestyle factors and nutritional status are regarded as critical determinants of normal reproductive function. Hence, the role of dietary nutrients has attracted the attention of researchers to the extent that some studies have addressed the effects of diet on the risk of male infertility. This study aimed to summarize the literature regarding the association between various dietary factors and male infertility. Literature searching for studies on male infertility and nutrition, published between January 1982 and May 2015, was performed using PubMed and Scopus databases. The bibliographies of included studies were also searched for additional references. About 65 articles were identified and after the elimination of irrelevant studies, 35 related studies available for review were examined. Studies have indicated that in men with idiopathic infertility, omega-3 intervention resulted in significant improvement in total sperm count as well as sperm cell density. Moreover, several studies have shown that higher intake of poultry, cereals, fruit and vegetables may play a beneficial role in male infertility; although, some studies have not attained such results. Taken as a whole, studies demonstrated that food consumption may play a major role in preventing or facilitating male infertility. Further studies are needed to clarify this association. [GMJ.2015;4(4):123-29]
â€œRescue-eggâ€ Antioxidants, what they really do?
Authors: Jafarian Kerman Scott Reza
Published: January 2022

No Abstract
Combined Factor V and Factor VIII Deficiency: A Case Report
Authors: Shahverdi Ehsan , Abolghasemi Hassan , Dolatimehr Fardin , Beheshtian Sara , Chaeichi Shima Melatshahi , Masoumi Avishan
Published: January 2022

Background: Combined factor V and factor VIII deficiency (F5F8D, OMIM 227300) is a rare autosomal recessive bleeding disorder. It seems more common among Jews and Iranians, particularly in regions with frequent consanguineous marriages. Case Report: We describe a 5-yearoldÂ  girlÂ  bornÂ  outÂ  ofÂ  consanguineousÂ  marriageÂ  withÂ  aÂ  complaintÂ  ofÂ  prolongedÂ  bleedingÂ  after dental extraction. There were no history of spontaneous bleeding and other coagulation defect symptoms. Conclusion: In frequent consanguineous marriage regions, inherited deficiency of factor V and VIII should be considered in patients with coagulation defect symptoms.[GMJ. 2016;5(1):42-44]
Evaluating the Feasibility of Financial Variables of Health: A Hospital Administratorâ€™s Viewpoint
Authors: Mirzaei Abasat , Tabibi Seyed Jamaledin , Nasiripour Amir Ashkan , Riahi Leila
Published: January 2022

Background: Analysis of costs and incomes and analyzing the relationship between current and capital expenditures, attention to cost recovery and changes in investment patterns are of utmost importance in the economy of hospitals. The effective use of financial variables and subsequently performance evaluation of hospitals would help to facilitate the continuation of activities which provides the ground for the economic administration of hospital industry. The purpose of this study was to evaluate the viewpoints of executive administrators of hospitals in Iran to evaluate the feasibility of using financial variables of health in hospitals. Material and Methods: The present study was an applied research which is conducted using AHP (Analytical Hierarchy Process) technique. After extracting the evaluation variables, the financial performance of hospitals was evaluated using the questionnaire which was confirmed by Cronbachâ€™s Alpha equal to 0.85. Moreover, the group of experts in this study included 62 Iranian hospital administrators. Results: Global indices for the economic evaluation of hospitals were identified which were categorized into 9 domains/factors using AHP (Analytical Hierarchy Process); furthermore, they were prioritized regarding the importance and feasibility in hospitals. Conclusion: Utilizing financial variables in evaluating the economic performance of hospitals can determine their economic growth. Moreover, analysis of the current status of hospitals can be used to make strategic decisions and provides a basis for comparisons between hospitals and their rankings. [GMJ. 2016;5(1):25-30]
Dual Ectopic Multinodular Goiter: A Case Report
Authors: Khosravi Mohammad Hossein , Saeedi Masoumeh
Published: January 2022

Background: As the first endocrine gland to form during embryogenesis, Thyroid develops in the 7th embryonic week through migration from foramen cecum to its adult position, anterolatÂ­eral of 2nd and 4th tracheal cartilages. Ectopic Thyroid can be found anywhere along the migraÂ­tion path with or without co-existence of a normally located Thyroid. Ectopic thyroid glands at two different locations are so rare that only about 24 cases of dual ectopia have been reported. We present the first case of dual ectopic submandibular multinudolar goiter. Case Report: We describe a 35-year-old housewife who consulted us complaining two huge and gradually-growÂ­ing swellings in right and left upper neck regions. In physical examination, two great well-deÂ­fined masses, one in right and one in left submandibular regions, were seen which had firm forÂ­midability with no mobility, tenderness or evidence of inflammation. Imaging and fine-needle aspiration confirmed the diagnosis of dual ectopic submandibular multinodular goiter in our patient as the first case of occurrence. Conclusion: Finally, we recommend ectopic thyroid to be considered in the diagnosis of laterally located and submandibular neck masses especially in the absence of normally located thyroid. Additionally, we confirmed the idea that not all the laterally-located ectopic thyroids are malignant.[GMJ.2016;5(2):98-102]
Correlation Between Body Image and Sleep Quality in Patients with Congestive Heart Failure in the Sari City, North of Iran
Authors: Goudarzian Amir Hossein , Beik Sima , Zamani Fatemeh , Heidari Gorji Alimorad , Ranjbar Mansour
Published: January 2022

Background: The present study was conducted aimed to determine the relationship between body shape and sleep quality in patients with congestive heart failure.

Materials and Methods: In this descriptive-correlation study which was conducted in 2015, 290 patients with congestive heart failure were recruited using the simple random sampling method. Data were collected through the demographic information form (including age, sex, marital status, economic level and education), medical (age, sex, adequacy of economic level, education, history of hypertension and drug use, family history of heart disease and depression in the family, activity and history of special disease), Body Shape Questionnaire (BSQ-34) and Pittsburgh Sleep Quality Index (PSQI). SPSS 20.0 (SPSS Inc., Chicago, IL, USA) were utilized for data analysis with descriptive and inferential statistics tests (Generalized Linear models with bonferroni correction).

Results: Based on results only 48 patients with 4.31 (SD: 0.94; 95%CI: 4.03-4.58) mean score of Pittsburgh Sleep Quality Index Â had a good levels of sleep quality. The mean score of the Body Shape Questionnaire of patients were 122.47 (SD: 19.157; 95%CI: 12.25-124.68).

Conclusion: According to the present study, the sleep quality and body shape of the patients with CHF from their body were weak. It is therefore necessary to do something in order to remove the backgrounds of sleep disorders in these patients as well as the need to more detailed investigation to determine the exact relationship of these two variables.
Thioredoxin Reductase Activity and Its Tissue Distribution in the Pathologic Specimens of Patients with Laryngeal Squamous Cell Carcinoma
Authors: Zare Marzouni Hadi , Barati Bagherabad Matineh , Sharaf Simin , Aryan Hoda , Zarrinkamar Mohammad , Shaban Shahabeddin , Saburi Ehsan
Published: January 2022

Background: Squamous Cell Carcinoma (SCC) is the second most common malignancy of the respiratory tract. Recently, researchers believe that thioredoxin system is effective in the cancerization of some tissues. Thus, this study has been conducted with the aim of measuring of thioredoxin reductase (TrxR) enzyme activity and tissue distribution in the pathologic specimens of patients with laryngeal SCC.Materials and Methods: This study was performed on 40 pathologic blocks (20 healthy and 20 tumoral) from 20 patients with laryngeal SCC who were candidates for laryngectomy surgery. The TrxR enzyme activity was measured by the commercial kit. Also, the tissue distribution of TrxR was determined by immunohistochemical staining and the percentage of staining cells (SC%) and staining intensity were calculated. Data were analyzed by using SPSS13 and significant level was set at Pâ‰¤0.05.Results: The average the TrxR enzyme activity in the healthy and tumoral tissues was 0.004Â±0.003ÂµM/min/ml and 0.006Â±0.003ÂµM/min/ml, respectively (ranged 0.0009 to 0.0104 vs. 0.001 to 0.011 ). However, there was no relationship between the TrxR enzyme activity in the tumoral and healthy tissues (P=0.084). The total score of IHC staining in the healthy tissue was 4.45Â±1.09 whereas the total of these scores in the tumoral tissue 6.25Â±0.63. The both scores of SC% and staining intensity in the tumoral tissue was significantly higher than the healthy tissue (P<0.001).Conclusion: Based on the results, although the TrxR enzyme activity has not the significant differences in tumoral tissue compare to healthy tissue, but the tissue distribution in tumoral tissue was higher than healthy tissue.[GMJ.2016;5(3):153-159]
Study of Quality of Life Among Liver Transplant Candidates in Shiraz, Southwestern Iran
Authors: Parvizi Zahra , Kalateh Sadati Ahmad , Azarpira Negar , Tabrizi Reza , Heydari Seyed Taghi , Lankarani Kamran Bagheri , Parvizi Mohammad Mahdi
Published: January 2022

Background: Liver transplant candidates are under stressconditions which affect their Quality of life (QOL), a subject which is not well-understood and is worthy of evaluation. The aim of this study is to determine the socio-demographic variables about QOL of liver transplant candidates.Materials and Methods: This cross-sectional study was evaluated QOL among 210 liver transplant candidates in Shiraz, Iran. The questionnaire includes demographic and socioeconomic conditions of the patients, in addition to another questionnaire on QOL which comprised 6 dimensions. The statistical analyses used included independent sample t-test and one-way analysis of variance (ANOVA). A two-tailed P-value of less than 0.05 was considered statistically significant. Results: The results obtained showed that the score off emotion was significantly less than males (P=0.05). Patients aged lower than 30 years and patients with lower BMI had a higher score of QOL (P=0.05). Single patients had lower worries than married (P=0.05). Patients with Governmental Health Insurance were less distressed and had more emotions than patients with other insurances who had a more emotional function(P<0.01). Patients living in geographic location 3 in Iran had less QOL than others (P=0.04. Regarding the etiology of disease, patients with cirrhosis had less QOL than those with Wilson and hepatitis B(P<0.05). Conclusion: The QOL of liver transplant candidates is dependent on gender, age, habitat, marital status, BMI, health insurance, and cirrhosis diagnosis. Because QOL is related to the psychological problem, it is suggested to provide psychological consultations on these variables. [GMJ. 2016;5(4):180-87]
Effects of Electro-Acupuncture and Acupotomy Dissolution on mRNA Expression of Center Pro-Opiomelanocortin Detected by In Situ Hybridization in Rats with Non-Specific Low Back Pain
Authors: Badiee Aval Shapour , Khorsand Ali , Mojtabavi Seyed Javad , Rezaei Deloei Shima , Qin Guo Chang
Published: January 2022

Background: Pro-opiomelanocortin (POMC) mainly exists in the pituitary gland, hypothalamus, and peripheral tissues and can relieve pain through its degradation product Î²-endorphin. Its mRNA expression quantity represents the level of gene expression of endorphin system. We aimed to determine the effects of electro-acupuncture and acupotomy dissolution on the mRNA expression of center POMC in rats with non-specific low back pain.Materials and Methods: This study was performed on 42 Sprague-Dawley rats in four groups of normal, model, electro-acupuncture, and acupotomy. The normal group did not receive any intervention, while non-specific low back pain was established in other groups. Then, the model group did not receive any treatment, electro-acupuncture and acupotomy groups were treated with electro-acupuncture therapy and acupotomy, respectively. Microscopic images of the slices, prepared from spinal dorsal horn and hypothalamus, were analyzed to evaluate the mRNA expression of center POMC. Results: Under light microscopy examination, the positive POMC mRNA cells of electro-acupuncture and acupotomy groups increased more than the model group, while its expression in the hypothalamus and spinal dorsal horn was less than the model group, but the difference was not significant (P<0.01). Conclusion: Electro-acupuncture and acupotomy could reduce POMC mRNA expression in spinal cord and increase it in the hypothalamus of rats with non-specific low back pain.[GMJ.2016;5(4):194-99]
A Cohort Study Protocol of Low Back Pain In Rural Area Inhabitants: Fasa Low Back Pain Cohort Study (FABPACS)
Authors: Farjam Mojtaba , Askari Alireza , Hoseinipour Ali , Homayounfar Reza , Jamshidi Javad , Khodabakhshi Fatemeh , Zakeri Habib
Published: January 2022

Background: Low back pain (LBP) is one of the main causes of disability in most societies that imposes much cost to the economic and health systems. In Iranian population, a prevalence as high as 27% has been reported for chronic LBP. So this study was designed to investigate the factors associated with low back pain in Iranian population. Methods/ Design: In Fasa Cohort Study, a branch of Persian cohort study, LBP patients were registered among the participants. A total of 10000 peoples, 1700 patients enrolled in cohort study were registered as LBP patients. In addition to detailed demographic, socioeconomic, anthropometric, nutrition, and medical history, limited physical examinations, determination of physical activity and body composition that was obtained in the cohort study, history of LBP, assessment of the pain severity, McGill pain inventory, and Oswestry questionnaire was filled for the LBP patients. All data are stored online using a dedicated software. Discussion: The cohort study is the best way to collect the necessary information required for policy making in the field of LBP. This study will help in providing some information about LBP in our area to establish a better management of the disease. Moreover, this study will provide many opportunities for clinical trials in this field, and we are going to do interventional studies in the cohort in future.[GMJ.2016;5(4):225-29]
Epidemiology of Stroke in Iran
Authors: Ghandehari Kavian
Published: January 2022

Numerous hospital-based stroke registries have been developed in Iran during last decade. Khorasan Stroke Registry, Khorasan Posterior Circulation Stroke Registry, Khorasan Pediatric Stroke Registry and Khorasan Stroke in Young Adults Registry are among these published registries. Meanwhile, There is only one epidemiologic deigned study of stroke in Iran and Middle East. Based on this standard epidemiologic study; The crude annual incidence rate of First Ever Stroke (FES) is 139 (95% CI, 128 to 149) per 100 000; for men, 144 (95% CI, 128 to 159), and for women, 133 (95% CI, 118 to 148). The incidence rates increases significantly with each decade of life and is similar in men and women. Subtypes of FES in 81.9%  of patients is ischemic stroke,12.7% is intracerebral hemorrhage, and 2.4% have subarachnoid hemorrhage. The crude annual incidence rate per 100 000 inhabitants is 113 (95% CI, 104 to 123) for ischemic stroke, 18 (95% CI, 14 to 21) for intracerebral hemorrhage and 3 (95% CI, 2 to 5) for subarachnoid hemorrhage. Ischemic strokes are occurring approximately 1 decade earlier in Iran than in other countries.
Abducens Nerve Paralysis Caused due to Increased Intracranial Pressure: A Case Report and Review of Literatures
Authors: Haji Naghi Tehrani Khadijeh , Morshedian Zahra
Published: January 2022

Background: Double vision due to abducens nerve palsy in patients with Pseudotumor cerebri is a very rare finding and usually occurs by increasing in intracranial pressure (ICP) and therefore by the effect of pressure on abducens nerve. Case Report: A 21-year-old woman has referred to our clinic with symptoms of the headaches, double vision along with nausea and vomiting lasting for three months, with no history of the disease, drug consumption, and the only clinical findings was weighing about 20 Kg for a recent year. In examination VI nerve palsy of the left eye, papilledema of both eyes was reported. The computed tomography (CT) and magnetic resonance imaging (MRI) as a diagnostic test for a patientâ€™s brain lesions shown normal report. Also, other hormone testing and complete blood count were normal. For the next step patient underwent for lumbar puncture (LP), the patientâ€™s cerebrospinal fluid (CSF) pressure was measured more than 120 CmH2O. According to the findings of the examination, patient diagnosed with pseudotumor cerebri and underwent for frequent LP, which during that the headaches and double vision symptoms of patient decreased, which indicates that all signs and symptoms of patients caused by pseudotumor cerebri were due to sudden increase in body weight over the past year. Patient prescribed for Acetazolamide and recommended to lose weight with proper diet. For three months of follow-up, symptoms of increased ICP and papilledema have been cleared. Conclusion: The pseudotumor cerebri is manageable by proper diet, and there is no need for bariatric surgery. [GMJ.2017;6(1):66-69]
Strategic Analysis of Shiraz Medical Tourism Industry: A Mixed Method Study
Authors: Rahimi Zarchi Mohammad Kazem , Jabbari Alireza , Hatam Nahid , Bastani Peivand , Shafaghat Tahereh , Fazelzadeh Omid
Published: January 2022

Background: The connection between healthcare and tourism industries in many countries has created one of the largest service industries, i.e. "medical tourism industry". Medical tourism services bring significant benefits to the countries.  This study aimed to examine internal and external factors affecting Shiraz medical tourism industry as well as the potential capabilities of the industry.Materials and Methods: This applied research is a mixed method study using both qualitative and quantitative methods in 2017. The study population consisted of all organizations involved in the medical tourism industry. In this study, the deductive qualitative content analysis was employed to determine the internal and external factors affecting Shiraz medical tourism industry. Furthermore, the SWOT technique was used to analyze the data obtained from individual interviews and meetings with expert panels. Results: Internal and external factors were classified into 4 main themes (namely strengths, weaknesses, opportunities and threats) and 10 sub-themes, of which five cases (FORMM) were related to internal factors (i.e. finance, production and products (operations), research and development, marketing and management) and five cases (STEPC) were associated with external factors including socio-cultural, technology, economy, political and competitive ones. Also, the matrix of the internal and external factors indicated an offensive zone for this industry. Conclusions: This industry can make use of the strengths and opportunities to confront the threats and negative points through identifying internal and external factors in order to enjoy benefits such as job creation and revenue gains. [GMJ.2018;7:e1021]
Quantitation of Colonic Cells as Severity Markers in Patients with Irritable Bowel Syndrome
Authors: Miri Mohammad Bagher , Sadeghi Amir , Moradi Afshin , Rostami-Nejad Mohammad , Ehsani-Ardekani Mohammad-Javad , Asadzadeh-Aghdaei Hamid , Safari Mohammad-Taghi , Zali Mohammad Reza
Published: January 2022

Background: Irritable bowel syndrome (IBS) is the most common gastrointestinal syndrome. Routine histopathology and immunohistochemistry (IHC) evaluations have shown an increase in the number of different inflammatory cells in the colon of IBS patients. In this study, we have compared the number of intraepithelial lymphocytes (IELs), eosinophils, mast cells and CD3+ T cells, in IBS patients and normal subjects. Materials and Methods: In 2016, seventy-nine patients with IBS and seventy-nine healthy subjects who underwent colonoscopy for other non-specific causes and with no pathologic findings, were enrolled in this cross-sectional study. Biopsy specimens obtained from the colon were stained, using IHC methods to determine the number of IELs, eosinophils, mast cells and CD3+ T cells. Quantitative and qualitative variables were compared between the two groups, using a Chi-square test and Student’s t-test. Results: Seventy-nine patients with IBS, 79.7% females with a mean age of 42.5±14.6 years, were recruited, as the case group, and seventy-nine individuals, 51.9% females with a mean age of 39.7±18.9 years, were enrolled as controls. The average number of IELs per high power fields (hpf) was found to be higher in the IBS group, and this difference was statistically significant (32.8±11.8 vs. 28.6±12.9; P=0.034). Also, the mean count/hpf of CD3+ T lymphocytes (23.1±7.9 vs. 20.2±8.1; P=0.024) and mast cells (7.6±3.1 vs. 6.6±3.0; P=0.041) were significantly higher in the IBS group, compared to the control group. The number of eosinophils was higher in the IBS group, but the differences were not statistically significant (P=0.066). Conclusion: According to the results, we suggest that analysis of immune cells and IELs in intestinal biopsies might be an appropriate method for diagnosis of IBS. [GMJ.2018;7:e1063]
Bronchospasm During Induction of Anesthesia: A Case Report and Literature Review
Authors: Vojdani Salman
Published: January 2022

Background: Bronchospasm (spasm of bronchial muscles) in general anesthesia caused by many reasons. Untreated bronchospasm can cause hypoxia, hypotension and increased morbidity and mortality. Case Report: A 28 years old female scheduled for tonsillectomy surgery. Immediately after induction of anesthesia patient developed with drop in oxygen saturation and difficulty in mechanical ventilation. Conclusion: Bronchospasm should be considered in differential diagnosis of oxygen saturation drop during general anesthesia. This situation is more common in patients without specific respiratory disorder. Tracheal irritants like sputum and blood can cause bronchospasm. Other causes include histamine or serotonin release. [GMJ.2018;7:e846]
Curcumin and Curcumin-Loaded Nanogel Induce Apoptosis Activity in K562 Chronic Myelogenous Leukemia Cells
Authors: Khatamsaz Sepideh , Hashemi Mehrdad
Published: January 2022

Background: Chronic myeloid leukemia (CML), a hematological cancer of stem cells, is caused by the activation of oncogenic factors alone or/with inactivation of tumor suppressor genes. Curcumin is a hydrophobic polyphenol and the main compound of turmeric, which has been used in daily diets for many years. It is also a safe drug. Nanogels and nanobiotechnology have important roles in the diagnosis and treatment of diseases and drug delivery. Materials and Methods: To prepare the nanodrug, chitosan nanogels were prepared in 1% acetic acid and cross-linked with stearate by 1- ethyl- 3 (3-dimethylaminopropyl) carbodiimide (EDC) and N-hydroxysuccinimide (NHS). Subsequently, curcumin was loaded in the chitosan-stearate nanogel. Physical and morphological characteristics of the nanodrug were determined by transmission electron microscopy (TEM), dynamic light scattering (DLS), and Fourier transform infrared spectroscopy. Different nanodrug concentrations were prepared and evaluated on the K562 CML cell line. The apoptotic activities of curcumin and nanodrug on the cells were detected by flow cytometry, MTT assay, and trypan blue staining. Results: DLS revealed that the size of the nanodrug was 150 nm, which was confirmed by TEM. The half maximal inhibitory concentration (IC50) values of curcumin and nanodrug were 50 and 25 μg/ml, respectively P < 0.05). Apoptosis of the K562 cell line occurred at 48 h post-treatment with 25 μg/ml curcumin and 12.5 μg/ml nanodrug. Conclusion: The increase in the cytotoxicity of curcumin and nanodrug was directly related to the drug concentration and time. The nanodrug exhibited more cytotoxic effects on the vital capacity of the cells and stimulated more apoptosis compared with curcumin alone. [GMJ.2018;7:e921]