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Kadivar M, Sangsari R, Rostamli S, Sotoudeh S, Mirnia K. Amniotic membrane dressings for treatment of aplasia cutis in newborns. Pediatr Dermatol 2024. [PMID: 38409959 DOI: 10.1111/pde.15540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/13/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Aplasia cutis congenita (ACC) is a rare congenital skin defect characterized by a focal or extensive absence of the epidermis, dermis, and occasionally, subcutaneous tissue. When the wound caused by this defect is wide or deep, various treatments are used, including skin grafting. The amniotic membrane (AM) is a biological dressing that facilitates re-epithelialization as it contains mesenchymal cells and numerous growth factors. OBJECTIVE To report the efficacy of AM dressings in treating the skin defects of ACC. METHOD This study was conducted on five neonates diagnosed with ACC born between 2018 and 2022, referred to the Children's Medical Center in Tehran, Iran. AM dressings were applied on wounds larger than 1 cm2 . The wounds were assessed weekly and, if required, an additional AM dressing was applied. RESULTS The skin defects gradually re-epithelialized after application of the AM. The complete healing process took around 3.5 weeks on average. No hypertrophic scarring was observed. CONCLUSION The application of AM dressing resulted in satisfactory cosmetic outcomes, with no hypertrophic scar formation. Complete healing occurred in all cases except one. The length of the hospital stay ranged from 2 to 6 weeks, depending on the size of the wound.
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Affiliation(s)
- Maliheh Kadivar
- Department of Pediatrics, Division of Neonatology, School of Medicine, Tehran University of Medical Sciences, Children's Medical Center, Tehran, Iran
| | - Razieh Sangsari
- Department of Pediatrics, Division of Neonatology, School of Medicine, Tehran University of Medical Sciences, Children's Medical Center, Tehran, Iran
| | - Somayeh Rostamli
- Neonatal Intensive Care Nursing, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheila Sotoudeh
- Department of Dermatology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kayvan Mirnia
- Department of Pediatrics, Division of Neonatology, School of Medicine, Tehran University of Medical Sciences, Children's Medical Center, Tehran, Iran
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Mirnia K, Haji Esmaeil Memar E, Kamran N, Yeganedoost S, Nickhah Klashami Z, Mamishi S, Mahmoudi S. Short-term side effects of COVID-19 vaccines among healthcare workers: a multicenter study in Iran. Sci Rep 2024; 14:4086. [PMID: 38374372 PMCID: PMC10876545 DOI: 10.1038/s41598-024-54450-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 02/13/2024] [Indexed: 02/21/2024] Open
Abstract
Since the initiation of the COVID-19 vaccination effort, there has been widespread concern regarding vaccine efficacy and potential side effects. This study aimed to explore the short-term side effects of four available COVID-19 vaccines (Sputnik V, Sinopharm, Oxford-AstraZeneca, and Covaxin) among healthcare workers (HCWs) in Iran. The multicenter study involved 1575 HCWs, with the majority received Sputnik V (74.1%), followed by Covaxin (15.6%), Sinopharm (6.4%), and Oxford-AstraZeneca (3.8%). The prevalence of at least one side effect after the first and second dose COVID-19 vaccine was 84.6% and 72.9%, respectively. The common side effects (presented in > 50% of the study participants) after the first dose of the vaccine were injection site pain (61.7%), myalgia (51.8%), and muscle pain (50.9%). The most reported side effects after the second dose of the vaccine were injection site pain (26.8%), myalgia (15.8%), fever (10.3%), headache (9.9%), and chills (9.2%). In conclusion, according to the COVID-19 vaccine type, different side effects might occur following the first and second doses of vaccination. These findings assist in addressing the ongoing problems of vaccination hesitancy which has been driven by widespread worries about the vaccine safety profile.
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Affiliation(s)
- Kayvan Mirnia
- Department of Neonatology, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elmira Haji Esmaeil Memar
- Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Niyoosha Kamran
- Department of Pediatrics, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zeynab Nickhah Klashami
- Endocrinology and Metabolism Research Institute (EMRI), Tehran University of Medical Sciences, Tehran, Iran
| | - Setareh Mamishi
- Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
- Pediatric Infectious Disease Research Center, Pediatrics Center of Excellence, Children's Medical Center Hospital, Tehran University of Medical Sciences, Dr. Gharib Street, Keshavarz Boulevard, Tehran, Iran.
| | - Shima Mahmoudi
- Pediatric Infectious Disease Research Center, Pediatrics Center of Excellence, Children's Medical Center Hospital, Tehran University of Medical Sciences, Dr. Gharib Street, Keshavarz Boulevard, Tehran, Iran.
- Biotechnology Centre, Silesian University of Technology, 44-100, Gliwice, Poland.
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Mirnia K, Saeedi M, Sangsari R, Kazemzadeh K. A five-day-old child with lipid hemihypertrophy: A case report. Clin Case Rep 2024; 12:e8476. [PMID: 38333663 PMCID: PMC10849986 DOI: 10.1002/ccr3.8476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 12/18/2023] [Accepted: 01/21/2024] [Indexed: 02/10/2024] Open
Abstract
Key Clinical Message Lipid hemihypertrophy should be considered in the differential diagnosis of neonatal asymmetry. Early recognition and further evaluation for associated disorders are important for appropriate management and surveillance of potential complications. Abstract We present the case of a 5-day-old female neonate who presented with a visibly enlarged right thigh, right labia majora, and below the right mandible. This case report highlights the importance of early identification, comprehensive evaluation, and multidisciplinary management in neonates with lipid hemihypertrophy to optimize their long-term outcomes and quality of life.
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Affiliation(s)
- Kayvan Mirnia
- Division of Neonatology, Department of Pediatrics, Children's Medical Center, Pediatric Center of Excellence, Faculty of MedicineTehran University of Medical SciencesTehranIran
| | - Maryam Saeedi
- Division of Neonatology, Department of Pediatrics, Children's Medical Center, Pediatric Center of Excellence, Faculty of MedicineTehran University of Medical SciencesTehranIran
| | - Razieh Sangsari
- Division of Neonatology, Department of Pediatrics, Children's Medical Center, Pediatric Center of Excellence, Faculty of MedicineTehran University of Medical SciencesTehranIran
| | - Kimia Kazemzadeh
- Students' Scientific Research CenterTehran University of Medical SciencesTehranIran
- Network of Neurosurgery and Artificial Intelligence (NONAI)Universal Scientific Education and Research Network (USERN)TehranIran
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Tanourlouee SB, Nasirzadeh M, Zolbin MM, Azimzadeh A, Babaei JF, Bitaraf M, Kajbafzadeh AM, Masoumi A, Hassani S, Mirnia K. Effects of fresh bone marrow mononuclear cell therapy in rat model of retinopathy of prematurity. Regen Ther 2023; 24:43-53. [PMID: 37334242 PMCID: PMC10276165 DOI: 10.1016/j.reth.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/22/2023] [Accepted: 05/25/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction Retinopathy of prematurity (ROP) is a vasoproliferative disease that alters retinal vascular patterns in preterm neonates with immature retinal vasculature. This study was conducted to investigate the effects of cell therapy by bone marrow mononuclear cells (BMMNC) on neurological and vascular damages in a rat model of ROP. Methods Ten newborn Wistar rats were divided randomly into the control and the oxygen-induced retinopathy (OIR) groups. Animals in the OIR group were incubated in an oxygen chamber to induce retinopathy. One eye of animals in the OIR group received BMMNC suspension (treated eyes), and the contralateral eye received the same volume of saline injection. Then, all animals underwent funduscopy, angiography, electroretinography, histopathology and immunohistochemical assessments. Results Compared to the saline injection group, eyes treated with BMMNC had less vascular tortuosity while veins and arteries had relatively the same caliber, as revealed by fundus examinations. Eyes in the treatment group showed significantly elevated photopic and scotopic B waves amplitude. Neovascularization in the inner retinal layer and apoptosis of neural retina cells in the treatment group was significantly lower compared to untreated eyes. Also, BMMNC transplantation decreased glial cell activation and VEGF expression in ischemic retina. Conclusions Our results indicate that intravitreal injection of BMMNC reduces neural and vascular damages and results in recovered retinal function in rat model of ROP. Ease of extraction without in vitro processing, besides the therapeutic effects of BMMNCs, make this source of cells as a new choice of therapy for ROP or other retinal ischemic diseases.
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Affiliation(s)
- Saman Behboodi Tanourlouee
- Pediatric Urology and Regenerative Medicine Research Center, Gene, Cell & Tissue Research Institute Tehran University of Medical Sciences, Tehran, Iran
- Faculty of Veterinary Medicine, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
| | - Mohammadreza Nasirzadeh
- Department of Basic Sciences, Faculty of Veterinary Medicine, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
| | - Masoumeh Majidi Zolbin
- Pediatric Urology and Regenerative Medicine Research Center, Gene, Cell & Tissue Research Institute Tehran University of Medical Sciences, Tehran, Iran
| | - Ashkan Azimzadeh
- Pediatric Urology and Regenerative Medicine Research Center, Gene, Cell & Tissue Research Institute Tehran University of Medical Sciences, Tehran, Iran
| | - Javad Fahanik Babaei
- Electrophysiology Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Bitaraf
- Pediatric Urology and Regenerative Medicine Research Center, Gene, Cell & Tissue Research Institute Tehran University of Medical Sciences, Tehran, Iran
| | - Abdol-Mohammad Kajbafzadeh
- Pediatric Urology and Regenerative Medicine Research Center, Gene, Cell & Tissue Research Institute Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Masoumi
- Ophthalmology Department and Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shokoufeh Hassani
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
| | - Kayvan Mirnia
- Pediatrics Center of Excellence, Department of Neonatology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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Farshid P, Mirnia K, Rezaei-Hachesu P, Maserat E, Samad-Soltani T. Developing a model to predict neonatal respiratory distress syndrome and affecting factors using data mining: A cross-sectional study. Int J Reprod Biomed 2023; 21:909-920. [PMID: 38292513 PMCID: PMC10823121 DOI: 10.18502/ijrm.v21i11.14654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 08/11/2023] [Accepted: 10/26/2023] [Indexed: 02/01/2024] Open
Abstract
Background: One of the major challenges that hospitals and clinicians face is the early identification of newborns at risk for adverse events. One of them is neonatal respiratory distress syndrome (RDS). RDS is the widest spared respiratory disorder in immature newborns and the main source of death among them. Machine learning has been broadly accepted and used in various scopes to analyze medical information and is very useful in the early detection of RDS. Objective: This study aimed to develop a model to predict neonatal RDS and affecting factors using data mining. Materials and Methods: The original dataset in this cross-sectional study was extracted from the medical records of newborns diagnosed with RDS from July 2017-July 2018 in Alzahra hospital, Tabriz, Iran. This data includes information about 1469 neonates, and their mothers information. The data were preprocessed and applied to expand the classification model using machine learning techniques such as support vector machine, Naïve Bayes, classification tree, random forest, CN2 rule induction, and neural network, for prediction of RDS episodes. The study compares models according to their accuracy. Results: Among the obtained results, an accuracy of 0.815, sensitivity of 0.802, specificity of 0.812, and area under the curve of 0.843 was the best output using random forest. Conclusion: The findings of our study proved that new approaches, such as data mining, may support medical decisions, improving diagnosis in neonatal RDS. The feasibility of using a random forest in neonatal RDS prediction would offer the possibility to decrease postpartum complications of neonatal care.
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Affiliation(s)
- Parisa Farshid
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kayvan Mirnia
- Department of Pediatrics, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Peyman Rezaei-Hachesu
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Maserat
- Department of Medical Informatics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Taha Samad-Soltani
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
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Moftian N, Rezaei-Hachesu P, Arab-Zozani M, Samad-Soltani T, Esfandiari A, Tabib MS, Mirnia K. Prevalence of gram-negative bacteria and their antibiotic resistance in neonatal sepsis in Iran: a systematic review and meta-analysis. BMC Infect Dis 2023; 23:534. [PMID: 37582726 PMCID: PMC10426195 DOI: 10.1186/s12879-023-08508-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/03/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Neonatal sepsis, particularly gram-negative (GN) bacteria-induced, is a significant cause of morbidity and mortality in newborns. Healthcare professionals find this issue challenging because of antibiotic resistance. This study aims to combine findings to identify the prevalence of GN bacteria and their antibiotic resistance in Iranian neonates with sepsis. METHODS This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The literature search was performed through international databases, including (PubMed/MEDLINE, EMBASE, Scopus, and Web of Science), Iranian local databases (Magiran, Iranmedex, Irandoc, Scimed, and SID), and the first 100 records of Google Scholar. Analytical cross-sectional study checklist from the Joanna Briggs Institute (JBI) was used for the quality assessment of included studies. Comprehensive Meta-Analysis Software Version 2 was used to conduct the meta-analysis. The between-study heterogeneity was investigated by I2 statistics. RESULTS The prevalence of GN bacteria was estimated to be 53.6% [95% CI: 45.9- 61.1: P = 0.362] in Iranian neonates with sepsis, based on 31 studies with a sample size of 104,566. klebsiella pneumoniae (K.pneumonia) (23.2% [95% CI: 17.5-30.0, P < 0.001]) followed by Escherichia coli (E.coli) (13.5% [95% CI: 9.4-18.9, P < 0.001]) were more prevalent among GN bacteria. The highest resistance in K.pneumoniae was observed in Cefixime (80.6%, [95% CI: 56.3-93.1, P = 0.018]). E.coli showed greater resistance to Ampicillin (61.8%, [95% CI: 44.2-76.5, P = 0.188]. The prevalence of GN bacteria in Iranian neonates with sepsis has a decreasing trend based on the year, as shown by a meta-regression model (P < 0.0004). CONCLUSION GN pathogens, particularly K.pneumoniae, and E.coli, are the leading cause of neonatal sepsis in Iran. GN bacteria showed the highest resistance to Third-generation cephalosporin and Aminoglycosides.
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Affiliation(s)
- Nazila Moftian
- Department of Health Information Technology, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Peyman Rezaei-Hachesu
- Department of Health Information Technology, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Taha Samad-Soltani
- Department of Health Information Technology, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Atefeh Esfandiari
- Department of Health Policy & Management, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohammad Saleh Tabib
- Department of Pediatrics, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Kayvan Mirnia
- Children Medical Center, Tehran University of Medical Sciences, Tehran Province, Keshavarz Blvd, P94M+85P, Tehran, 14197 33151, Iran.
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Kadivar M, Bitaraf M, Nasrabadi SAH, Mirnia K. Evaluating the Efficacy of Amniotic Membrane in Treating Neonatal Extravasation. Adv Skin Wound Care 2023; 36:1-6. [PMID: 37212569 DOI: 10.1097/01.asw.0000926620.27523.a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Extravasation is leakage of material from a peripheral venous access into adjacent tissue, which results in tissue damage ranging from local irritation to necrosis and scar formation. Neonates are at extravasation risk with IV treatment because of their small, fragile veins and the long treatment period required. In this report, investigators assessed the efficacy of amniotic membrane (AM) as a biological dressing to heal extravasation wounds in neonates. METHODS This case series includes six neonates who presented with extravasation injuries from February 2020 to April 2022. Neonates born at any gestational age diagnosed with a wound secondary to extravasation were recruited. Neonates with skin disorders and those who had stage 1 or 2 wounds were excluded. Providers covered infection- and necrosis-free wounds with AM and assessed the wounds after 48 hours. Five days after placement, providers removed and replaced the AM; they continued to replace the bandages every 5 to 7 days until healed. RESULTS The average gestational age of included neonates was 33.6 weeks. Average healing time was 12.5 days (range, 10-20 days), and no adverse reactions were observed. All neonates healed completely without scar formation. CONCLUSIONS This preliminary report suggests that the application of AM in treating extravasation in neonates is safe and effective. However, controlled trials with larger sample sizes are needed to evaluate this outcome and determine implications for practice.
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Affiliation(s)
- Maliheh Kadivar
- At the Children's Medical Center, Tehran University of Medical Sciences, Iran, Maliheh Kadivar, MD, is Assistant Professor of Neonatology, Pediatrics Center of Excellence, Department of Neonatology; Masoud Bitaraf, MD, is Postdoctoral Research Fellow, Pediatric Urology and Regenerative Medicine Research Center; Seyed Ali Hashemi Nasrabadi, BSN, is Nurse at Neonatal Care Ward, Pediatrics Center of Excellence, Department of Neonatology; and Kayvan Mirnia, MD, is Associate Professor of Neonatology, Pediatrics Center of Excellence, Department of Neonatology
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Moftian N, Samad Soltani T, Mirnia K, Esfandiari A, Tabib MS, Rezaei Hachesu P. Clinical Risk Factors for Early-Onset Sepsis in Neonates: An International Delphi Study. Iran J Med Sci 2023; 48:57-69. [PMID: 36688195 PMCID: PMC9843461 DOI: 10.30476/ijms.2022.92284.2352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/24/2021] [Accepted: 01/30/2022] [Indexed: 01/24/2023]
Abstract
Background Despite growing evidence, there is still uncertainty about potentially modifiable risk factors for neonatal early-onset sepsis (EOS). This study aimed to identify potential clinical risk factors for EOS based on a literature review and expert opinions. Methods A literature search was conducted in PubMed (MEDLINE), Cochrane, Embase, and Scopus databases. Articles in English, published up to May 2021, on clinical risk factors for neonatal EOS were included. Initially, a questionnaire on risk factors for EOS was developed and validated. The fuzzy Delphi method (FDM) was used to formulate the final version of the questionnaire. The validity of the risk factors was assessed using the Chi square test. P<0.05 was considered statistically significant. Results In the review phase, 30 risk factors were approved by two neonatologists and included in the FDM phase. In total, 25 risk factors met the consensus criteria and entered the validation phase. During the observational study, 114 neonates (31 with and 83 without EOS) were evaluated for two months. The results of the Chi square test showed that cesarean section was not a significant risk factor for EOS (P=0.862). The need for mechanical ventilation and feed intolerance was observed in about 70% of neonates with EOS, and therefore considered significant risk factors for EOS (P<0.001). Finally, 26 potential clinical risk factors were determined. Conclusion Neonatal-related risk factors for EOS were birth weight, one-min Apgar score, and prematurity. Maternal-related risk factors were gestational age and urinary tract infection. Delivery-related risk factors were premature rupture of membranes, chorioamnionitis, and intrapartum fever.
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Affiliation(s)
- Nazila Moftian
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Taha Samad Soltani
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kayvan Mirnia
- Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Atefeh Esfandiari
- Department of Health Policy and Management, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohammad Saleh Tabib
- Department of Pediatrics, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Peyman Rezaei Hachesu
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
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Sangsari R, Saeedi M, Maddah M, Mirnia K, Goldsmith JP. Weaning and extubation from neonatal mechanical ventilation: an evidenced-based review. BMC Pulm Med 2022; 22:421. [DOI: 10.1186/s12890-022-02223-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/03/2022] [Indexed: 11/17/2022] Open
Abstract
AbstractMechanical ventilation is a lifesaving treatment used to treat critical neonatal patients. It facilitates gas exchange, oxygenation, and CO2 removal. Despite advances in non-invasive ventilatory support methods in neonates, invasive ventilation (i.e., ventilation via an endotracheal tube) is still a standard treatment in NICUs. This ventilation approach may cause injury despite its advantages, especially in preterm neonates. Therefore, it is recommended that neonatologists consider weaning neonates from invasive mechanical ventilation as soon as possible. This review examines the steps required for the neonate's appropriate weaning and safe extubation from mechanical ventilation.
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Mirnia K, Kadivar M, Sangsari R, Saeedi M, Kaveh M, Maleki M, Makuku R. Respiratory patterns in neonates hospitalized with brief resolved unexplained events. J Clin Neonatol 2022. [DOI: 10.4103/jcn.jcn_69_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kajbafzadeh AM, Sangsari R, Mirnia K, Saeedi M, Asl N. Prognostic value of carbohydrate antigen 19-9 in the urine of mothers with fetal hydronephrosis to the severity and cause of neonatal renal involvement. J Clin Neonatol 2022. [DOI: 10.4103/jcn.jcn_6_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Mirnia K, Dindarian S, Mohammadi S, Rostami P, Mohammadi H. A suggested screening method for hypothyroidism in very preterm and/or very low birth weight neonates. Rev paul pediatr 2022; 40:e2020376. [PMID: 35544902 PMCID: PMC9095062 DOI: 10.1590/1984-0462/2022/40/2020376in] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 04/01/2021] [Indexed: 11/30/2022]
Abstract
Objective: To assess thyroid function in very preterm or very low birth weight (VLBW) neonates by measuring combination levels of thyroid-stimulating hormone TSH and free T4 (FT4) Methods: Inclusion criteria were defined as all very preterm (gestational age <32 weeks) or VLBW (birth weight ≤1500g) neonates with initial Thyroid Function Test (TFT) who were admitted to the Neonatal Intense Care Unit (NICU) of Taleghani Hospital, Tabriz, Iran, from March 2015 to March 2016. Exclusion criteria were the absence of initial TFT with any major congenital anomaly. The primary value of TSH was evaluated at 3–5 days, and mean levels of TSH with FT4 were measured at 2, 4, and 8-weeks. Results: Ninety-five neonates with a mean gestational age of 29.5 weeks were included, and the mean levels of thyrotropin and FT4 at postnatal week two were 4.4mIU/L and 1.4ng/dL, respectively. Two of the patients had serum TSH concentration >25mIU/L that was considered as permanent primary hypothyroidism. Among nine hypothyroxinemia cases, two had elevated TSH levels (10.8±0.4mIU/L at the end of 8 weeks) and normal FT4 concentration, and were considered transient hypothyroidism. Seven cases had normal TSH levels (1.6±1.0mIU/L at 2 weeks, 3.5±2.8mIU/L at 8 weeks) and low FT4 concentrations. Conclusions: Combined venous TSH and FT4 concentration at the end of the first postnatal month can be an efficient approach for detecting neonatal hypothyroidism.
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Sattari M, Ostadi A, Hassani S, Mazloumi Z, Noshad H, Mirnia K, Salek Maghsoudi A. Plasma Concentration of Taurine Changes following Acetaminophen Overdose in Male Patients during Hospitalization. Iran J Pharm Res 2021; 20:297-306. [PMID: 34567163 PMCID: PMC8457743 DOI: 10.22037/ijpr.2020.113698.14435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Changes in plasma concentration of taurine during hospitalization of acetaminophen poisoned patients have not been studied. Hepatotoxicity is a common consequence of acetaminophen overdose that may lead to acute liver failure. Numerous biomarkers for drug-induced liver injury have been explored. All biomarkers are usually obtainable 48 h following acetaminophen overdose. We have already introduced taurine as a non-specific early biomarker of acetaminophen overdose. This study aimed to follow up changes in plasma concentration of taurine during the first three days of acetaminophen overdose. Sixty-four male patients suffering from acetaminophen overdose were selected for the study. Four blood samples were taken from the patients every 12 h. Sixty blood samples were also taken from sixty healthy humans. The plasma concentration of taurine in both groups was analyzed an already developed HPLC method. Analysis of regression showed a significant correlation between means of plasma concentrations of taurine and acetaminophen, aspartate aminotransferase, Alanine aminotransferase, glutathione peroxidase, and prothrombin time during hospitalization. The high plasma concentration of taurine, 6 h or more after acetaminophen overdose, could be a useful early indicator of liver damage.
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Affiliation(s)
- Mohammadreza Sattari
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Ostadi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Internal Medicine, Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shokoufeh Hassani
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeynab Mazloumi
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamid Noshad
- Department of Nephrology, Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kayvan Mirnia
- Department of Neonatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Armin Salek Maghsoudi
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
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14
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Mirnia K, Heidarzadeh M, Afjeh SA, Alizadeh P, Kashan AA, Bordbar A, Maghsoudi A. Signal Processing of Heart Rate for Predicting Sepsis in Premature Neonates. J Med Signals Sens 2021; 11:222-226. [PMID: 34466402 PMCID: PMC8382031 DOI: 10.4103/jmss.jmss_30_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/27/2020] [Accepted: 04/04/2021] [Indexed: 11/20/2022]
Abstract
The heart rate characteristic (HeRO score) is a figure derived from the analysis of premature neonate's electrocardiogram signals, and can be used to detect infection before the onset of clinical symptoms. The United States and Europe accept this diagnostic technique, but we require more tests to prove its efficacy. This method is not accepted in other developed countries so far. The present study aimed to investigate changes in the heart characteristics of two neonates in Akbar Abadi Hospital in Tehran. Experts chose one newborn as a sepsis case, and the other neonate was healthy. The results were analyzed and compared with previous studies. In this research, a group of five neonates was selected randomly from the neonatal intensive care unit, and cardiac leads were attached to them for recording heart rates. We selected two neonates from the five cases, as a case (proven sepsis) and control, to analyze heart rate variability (HRV). Then, we compared the differences in the heart rate of both neonates. Analysis of HRV of these two neonates showed that the pattern of HRV is compatible with reports from US studies. Considering the results of this study, heart rates and their analysis can provide useful indicators for mathematical modeling before the onset of clinical symptoms in newborns.
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Affiliation(s)
- Kayvan Mirnia
- Children's Medical Center, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad Heidarzadeh
- Department of Pediatrics, Pediatric Health Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Seyyed Abolfazl Afjeh
- Department of Pediatrics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parinaz Alizadeh
- Department of Pediatrics, Mofid Children Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Abbas Abaei Kashan
- Department of Mechanical Engineering School, Iran University of Science and Technology, Tehran, Iran
| | - Arash Bordbar
- Department of Neonatology, Akbar Abadi Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Amid Maghsoudi
- Department of Mechanical Engineering, Mechanical Engineering School, Iran University of Science and Technology, Tehran University of Medical Science, Tehran, Iran
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15
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Sepand MR, Maghsoudi AS, Shadboorestan A, Mirnia K, Aghsami M, Raoufi M. Cigarette smoke-induced toxicity consequences of intracellular iron dysregulation and ferroptosis. Life Sci 2021; 281:119799. [PMID: 34229007 DOI: 10.1016/j.lfs.2021.119799] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/27/2021] [Accepted: 06/30/2021] [Indexed: 01/18/2023]
Abstract
Despite numerous studies on the mechanisms of cigarette smoking toxicity over the past three decades, some aspects remain obscure. Recent developments have drawn attention to some hopeful indicators that allow us to advance our awareness of cigarette-induced cell death. Ferroptosis is considered a type of governed death of cells distinguished by the iron-dependent lipid hydroperoxide deposition to fatal concentrations. Ferroptosis has been linked with pathological settings such as neurodegenerative diseases, cancer, heart attack, hemorrhagic stroke, traumatic brain injury, ischemia-reperfusion injury, and renal dysfunction. This review tries to explain the causal role of ferroptosis cascade in cigarette smoke-mediated toxicity and cell death, highlighting associations on potential action mechanisms and proposing suggestions for its detoxifying and therapeutic interventions.
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Affiliation(s)
- Mohammad Reza Sepand
- Nanotechnology Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran 13169-43551, Iran
| | - Armin Salek Maghsoudi
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Shadboorestan
- Department of Toxicology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Kayvan Mirnia
- Department of Neonatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Aghsami
- Department of Pharmacology and Toxicology, School of Pharmacy, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Raoufi
- Nanotechnology Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran 13169-43551, Iran; Physical Chemistry I and Research Center of Micro and Nanochemistry (Cμ), University of Siegen, Siegen, Germany.
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16
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Salek Maghsoudi A, Hassani S, Mirnia K, Abdollahi M. Recent Advances in Nanotechnology-Based Biosensors Development for Detection of Arsenic, Lead, Mercury, and Cadmium. Int J Nanomedicine 2021; 16:803-832. [PMID: 33568907 PMCID: PMC7870343 DOI: 10.2147/ijn.s294417] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 01/14/2021] [Indexed: 12/11/2022] Open
Abstract
Heavy metals cause considerable environmental pollution due to their extent and non-degradability in the environment. Analysis and trace levels of arsenic, lead, mercury, and cadmium as the most toxic heavy metals show that they can cause various hazards in humans' health. To achieve rapid, high-sensitivity methods for analyzing ultra-trace amounts of heavy metals in different environmental and biological samples, novel biosensors have been designed with the participation of strategies applied in nanotechnology. This review attempted to investigate the novel, sensitive, efficient, cost-benefit, point of care, and user-friendly biosensors designed to detect these heavy metals based on functional mechanisms. The study's search strategies included examining the primary databases from 2015 onwards and various keywords focusing on heavy metal biosensors' performance and toxicity mechanisms. The use of aptamers and whole cells as two important bio-functional nanomaterials is remarkable in heavy metal diagnostic biosensors' bioreceptor design. The application of hybridized nanomaterials containing a specific physicochemical function in the presence of a suitable transducer can improve the sensing performance to achieve an integrated detection system. Our study showed that in addition to both labeled and label-free detection strategies, a wide range of nanoparticles and nanocomposites were used to modify the biosensor surface platform in the detection of heavy metals. The detection limit and linear dynamic range as an essential characteristic of superior biosensors for the primary toxic metals are studied. Furthermore, the perspectives and challenges facing the design of heavy metal biosensors are outlined. The development of novel biosensors and the application of nanotechnology, especially in real samples, face challenges such as the capability to simultaneously detect multiple heavy metals, the interference process in complex matrices, the efficiency and stability of nanomaterials implemented in various laboratory conditions.
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Affiliation(s)
- Armin Salek Maghsoudi
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
- Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Shokoufeh Hassani
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
- Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Kayvan Mirnia
- Department of Neonatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
- Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
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17
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Khodabandeh M, Mirnia K, Eshaghi H, Borhani K. Is COVID-19 Infection Transmitted Through Food? JNFS 2021. [DOI: 10.18502/jnfs.v6i1.5294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction: Coronavirus disease (COVID) has had a growing outbreak around the world. China reported COVID-19 infection for the first time in December 2019. Symptoms of this disease often include respiratory symptoms, but gastrointestinal symptoms (nausea, vomiting, and diarrhea) were also reported in COVID-19 infection. Coronavirus transmits through direct droplets, contact, or fomites. However, other modes of transmission include airborne, fecal-oral, blood-borne, and mother-to-child transmission. Furthermore, studies showed that the virus was excreted through the feces. Case presentation: In this study, we introduced two cases of the disease in a mother and her daughter, who were contaminated with the disease through contact with the contaminated food.
Conclusion: Due to the possibility of oral-fecal transmission, food hygiene is recommended.
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18
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Amini Pouya M, Afshani SM, Maghsoudi AS, Hassani S, Mirnia K. Classification of the present pharmaceutical agents based on the possible effective mechanism on the COVID-19 infection. Daru 2020; 28:745-764. [PMID: 32734518 PMCID: PMC7391927 DOI: 10.1007/s40199-020-00359-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 07/14/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES There are several types of research on the COVID-19 disease which have been conducting. It seems that prevailing over the pandemic would be achieved only by mastering over the virus pathophysiology. We tried to categorize the massive amount of available information for useful interpretation. EVIDENCE ACQUISITION We searched databases with different keywords and search strategies that focus on virulence and pathophysiology of COVID-19. The present review has aimed to gather and categorize all implemented drugs based on the susceptible virulence mechanisms, and the pathophysiological events in the host cells, discussing and suggesting treatments. RESULTS As a result, the COVID-19 lifecycle were categorized as following steps: "Host Cell Attachment" which is mainly conducted with ACE2 receptors and TMPRSS2 from the host cell and Spike (S) protein, "Endocytosis Pathway" which is performed mainly by clathrin-mediated endocytosis, and "Viral Replication" which contains translation and replication of RNA viral genome. The virus pathogenicity is continued by "Inflammatory Reactions" which mainly caused moderate to severe COVID-19 disease. Besides, the possible effective therapeutics' mechanism and the pharmaceutical agents that had at least one experience as a preclinical or clinical study on COVID-19 were clearly defined. CONCLUSION The treatment protocol would be occasional based on the stage of the infection and the patient situation. The cocktail of medicines, which could affect almost all mentioned stages of COVID-19 disease, might be vital for patients with severe phenomena. The classification of the possible mechanism of medicines based on COVID-19 pathogenicity.
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Affiliation(s)
- Maryam Amini Pouya
- Department of Pharmaceutics, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyyedeh Maryam Afshani
- Department of Pharmacoeconomics, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Armin Salek Maghsoudi
- Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Shokoufeh Hassani
- Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), the Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.
| | - Kayvan Mirnia
- Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
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19
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Salek Maghsoudi A, Hassani S, Rezaei Akmal M, Ganjali MR, Mirnia K, Norouzi P, Abdollahi M. An Electrochemical Aptasensor Platform Based on Flower-Like Gold Microstructure-Modified Screen-Printed Carbon Electrode for Detection of Serpin A12 as a Type 2 Diabetes Biomarker. Int J Nanomedicine 2020; 15:2219-2230. [PMID: 32280216 PMCID: PMC7127862 DOI: 10.2147/ijn.s244315] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/17/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose In the present study, a highly sensitive and simple electrochemical (EC) aptasensor for the detection of serpin A12 as a novel biomarker of diabetes was developed on a platform where flower-like gold microstructures (FLGMs) are electrodeposited onto a disposable screen-printed carbon electrode. Meanwhile, serpin A12-specific thiolated aptamer was covalently immobilized on the FLGMs. Methods The electrochemical activity of a fabricated aptasensor under various conditions were examined by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). Aptamer concentration, deposition time, self-assembly time, and incubation time were optimized for assay of serpin A12. The differential pulse voltammetry (DPV) was implemented for quantitative detection of serpin A12 in K3 [Fe (CN) 6]/K4 [Fe (CN) 6] solution (redox probe). Results The label-free aptasensor revealed a linear range of serpin A12 concentration (0.039–10 ng/mL), detection limit of 0.020 ng/mL (S/N=3), and 0.031 ng/mL in solution buffer and plasma, respectively. Conclusion The results indicate that this aptasensor has a high sensitivity, selectivity, stability, and acceptable reproducibility for detection of serpin A12 in diabetic patients.
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Affiliation(s)
- Armin Salek Maghsoudi
- Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Shokoufeh Hassani
- Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
| | - Milad Rezaei Akmal
- Center of Excellence in Electrochemistry, Faculty of Chemistry, University of Tehran, Tehran, Iran
| | - Mohammad Reza Ganjali
- Center of Excellence in Electrochemistry, Faculty of Chemistry, University of Tehran, Tehran, Iran.,Biosensor Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kayvan Mirnia
- Department of Neonatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Parviz Norouzi
- Center of Excellence in Electrochemistry, Faculty of Chemistry, University of Tehran, Tehran, Iran.,Biosensor Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
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20
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21
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Safdari R, Ghazi Saeedi M, Masoumi-Asl H, Rezaei-Hachesu P, Mirnia K, Mohammadzadeh N, Samad-Soltani T. National Minimum Data Set for Antimicrobial Resistance Management: Toward Global Surveillance System. Iran J Med Sci 2018; 43:494-505. [PMID: 30214102 PMCID: PMC6123552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Success of infection treatment depends on the availability of accurate, reliable, and comprehensive data, information, and knowledge at the point of therapeutic decision-making. The identification of a national minimum data set will support the development and implementation of an effective surveillance system. The goal of this study was to develop a national antimicrobial resistance surveillance minimum data set. METHODS In this cross-sectional and descriptive study, data were collected from selected pioneering countries and organizations which have national or international antimicrobial resistance surveillance systems. A minimum data set checklist was extracted and validated. The ultimate data elements of the minimum data set were determined by applying the Delphi technique. RESULTS Through the Delphi technique, we obtained 80 data elements in 8 axes. The resistance data categories comprised basic, clinical, electronic reporting, infection control, microbiology, pharmacy, World Health Organization-derived, and expert-recommended data. Relevance coding was extracted based on the Iranian electronic health record coding system. CONCLUSION This study provides a set of data elements and a schematic framework for the implementation of an antimicrobial resistance surveillance system. A uniform minimum data set was created based on key informants' opinions to cover essential needs in the early implementation of a global antimicrobial resistance surveillance system in Iran.
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Affiliation(s)
- Reza Safdari
- Department of Health Information Technology, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Ghazi Saeedi
- Department of Health Information Technology, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Masoumi-Asl
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran;
| | - Peyman Rezaei-Hachesu
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran;
| | - Kayvan Mirnia
- Department of Neonatology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Niloofar Mohammadzadeh
- Department of Health Information Technology, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Taha Samad-Soltani
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran;
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22
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Rezaei-Hachesu P, Samad-Soltani T, Yaghoubi S, GhaziSaeedi M, Mirnia K, Masoumi-Asl H, Safdari R. The design and evaluation of an antimicrobial resistance surveillance system for neonatal intensive care units in Iran. Int J Med Inform 2018; 115:24-34. [PMID: 29779717 DOI: 10.1016/j.ijmedinf.2018.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 01/11/2018] [Accepted: 04/13/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Neonatal intensive care units (NICUs) have complex patients in terms of their diagnoses and required treatments. Antimicrobial treatment is a common therapy for patients in NICUs. To solve problems pertaining to empirical therapy, antimicrobial stewardship programs have recently been introduced. Despite the success of these programs in terms of data collection, there is still inefficiency in terms of analyzing and reporting the data. Thus, to successfully implement these stewardship programs, the design of antimicrobial resistance (AMR) surveillance systems is recommended as a first step. As a result, this study aimed to design an AMR surveillance system for use in the NICUs in northwestern Iranian hospitals to cover these information gaps. METHODS The recommended system is compatible with the World Health Organization (WHO) guidelines. The business intelligence (BI) requirements were extracted in an interview with a product owner (PO) using a valid and reliable checklist. Following this, an AMR surveillance system was designed and evaluated in relation to user experiences via a user experience questionnaire (UEQ). Finally, an association analysis was performed on the database, and the results were reported by identifying the important multidrug resistances in the database. RESULTS A customized software development methodology was proposed. The three major modules of the AMR surveillance are the data registry, dashboard, and decision support modules. The data registry module was implemented based on a three-tier architecture, and the Clinical Decision Support System (CDSS) and dashboard modules were designed based on the BI requirements of the Scrum product owner (PO). The mean values of UEQ measures were in a good range. This measures showed the suitable usability of the AMR surveillance system. CONCLUSION Applying efficient software development methodologies allows for the systems' compatibility with users' opinions and requirements. In addition, the construction of interdisciplinary communication models for research and software engineering allows for research and development concepts to be used in operational environments.
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Affiliation(s)
- Peyman Rezaei-Hachesu
- School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Taha Samad-Soltani
- School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
| | | | - Marjan GhaziSaeedi
- School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Kayvan Mirnia
- Paediatrics Research Centre, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Masoumi-Asl
- Centre for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Reza Safdari
- School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
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23
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Mirnia K, Akrami F, Jodeiry B, Heidarzadeh M, Safavinia S. Clinical Outcomes of High-Risk Infant Follow-Up Program in a Tertiary Care Centre. Iran J Nurs Midwifery Res 2017; 22:476-480. [PMID: 29184588 PMCID: PMC5684797 DOI: 10.4103/ijnmr.ijnmr_62_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND High-risk infant follow-up (HRIF) program is necessary for early detection, timely intervention, and promotion of health outcomes in vulnerable infants, ethically. The present study was carried out to assess the clinical outcomes of the HRIF Program in Alzahra hospital as a tertiary care centre, in Iran. MATERIALS AND METHODS In this cohort study, 5840 neonates were born at Alzahra hospital, from June 1, 2011 to 30th February 2012. Among those who were admitted to neonatal intensive care unit (NICU), 253 infants were recruited by census according to HRIs criteria. After doing necessary measurements and family education, information was recorded in HRI health certificate and then entered in the access database for analysis. RESULTS From 253 eligible HRIs registered, 241 (95%) infants attended the follow-up clinic after discharge. A total of180 cases were recalled for further visits, 110 of which attended the clinic. Anthropometric indices had an increasing trend in the first 6 months of life. There was no significant relation between ages and stages questionnaire (ASQ) results and infant birth weight, height, and head circumference. The ratios of intraventricular hemorrhage (IVH) and retinopathy of prematurity (ROP) were 8.7% and 3.1%, respectively. The incidence of congenital hypothyroidism was 2:341 in HRIs. CONCLUSIONS Although some outcomes, such as ROP, improved in our study compared to similar studies, the findings indicate an impairment of the current follow-up processes and highlight the necessity to modify the current HRIF program. Ethically, we insist on integrating HRIF program in child health services to promote early childhood development.
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Affiliation(s)
- Kayvan Mirnia
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Forouzan Akrami
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behzad Jodeiry
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Heidarzadeh
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sima Safavinia
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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24
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Safdari R, GhaziSaeedi M, Masoumi-Asl H, Rezaei-Hachesu P, Mirnia K, Samad-Soltani T. A national framework for an antimicrobial resistance surveillance system within Iranian healthcare facilities: Towards a global surveillance system. J Glob Antimicrob Resist 2017; 10:59-69. [PMID: 28689924 DOI: 10.1016/j.jgar.2017.03.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 03/20/2017] [Accepted: 03/27/2017] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES The threat of antimicrobial resistance (AMR) is growing rapidly, perhaps more dramatically in developing countries. A demand to monitor, surveil and predict AMR has prompted the design and implementation of AMR surveillance systems (AMRSSs) at all geographic levels, especially in the national context. This study reviewed AMRSSs in leading countries and organisations in order to customise a comprehensive framework for a national system in Iran. METHODS The research was conducted in two phases: a review of the literature and comparative analysis; and a knowledge, attitude and practice study. In the first phase, the AMRSSs of pioneering organisations and countries were reviewed by examining related documents. In the second phase, important components for the Iranian national system were determined on the basis of the World Health Organization's Global Antimicrobial Resistance Surveillance System (WHO GLASS). RESULTS This study determined the surveillance methods, priority specimens and pathogens, testing methods, reporting protocols and scheduling, recommended data sets, and tools and information flow necessary for the Iranian system. On this basis, a national framework was developed using the class and activity diagrams in Unified Modelling Language. A context diagram was also designed on the basis of a generic biosurveillance architecture. CONCLUSIONS The design and implementation of a national AMRSS for Iranian healthcare facilities is critically required because of irrational antimicrobial use in Iran and insufficient data regarding its consequences.
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Affiliation(s)
- Reza Safdari
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Marjan GhaziSaeedi
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Hossein Masoumi-Asl
- Centre for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Islamic Republic of Iran
| | - Peyman Rezaei-Hachesu
- Department of Health Information Technology, School of Health Management and Informatics, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Kayvan Mirnia
- Department of Neonatology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Taha Samad-Soltani
- Department of Health Information Technology, School of Health Management and Informatics, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran.
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Mirnia K, Samad-Soltani T, Rezaei-hachesu P. Implementation and Evaluation of NICU Registry in IRAN. J Clin Diagn Res 2017. [DOI: 10.7860/jcdr/2017/27660.10852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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26
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Jodeiry B, Heidarzadeh M, Mirnia K, Akrami F, Heidarabadi S, Ebadi A. Innovation of High-risk Infants Follow-up Surveillance System in Iran. Int J Prev Med 2015; 6:35. [PMID: 25969705 PMCID: PMC4421883 DOI: 10.4103/2008-7802.156072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 02/23/2015] [Indexed: 11/28/2022] Open
Abstract
Background: Early childhood development is one of the most social determinants of health that must be notified in order to reducing social gap and inequity. In spite of increasingly developing intensive neonatal care wards and decreasing neonatal mortality rate, there is no follow-up surveillance system to identify high-risk infants (HRI) and their health problems for timely intervention after discharge. This study was carried out to design and pilot high-risk infant follow-ups (HRIFs) surveillance system, in Alzahra Hospital, a tertiary level center of Tabriz University of Medical Sciences (TUOMS), in 2012–2013. Methods: In this qualitative research after studying international documents, consensus about criteria of HRIs accomplished by focus group discussion. Then, Delphi agreement technique was used to finalizing assessment timetable. In the second phase, we piloted the designed surveillance system in Alzahra Hospital, a tertiary level center of TUOMS. Pilot study was implemented by follow-up team organized in designed model at the first phase of the study. Then, the findings of the pilot study were being assessed by an expert panel. If the members agreed on made decisions, they were being placed on the agenda of the national committee of development care of newborns for final approval. Results: High-risk infants follow-up surveillance system was designed in following steps: Defining of evidence-based criteria of HRIs, organizing the follow-up team, regulating the organs and neurodevelopment assessment timetable, publishing a health certificate notebook for HRIs, and designing Access database software for data collection, report and evaluation. Conclusions: We designed and piloted HRIFs surveillance system, so this system was institutionalized in Alzahra Hospital, finally. It can be prepared to apply in the whole country, after detecting the quantitative outcomes and developing the program in East Azarbijan.
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Affiliation(s)
- Behzad Jodeiry
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Heidarzadeh
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kayvan Mirnia
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Forouzan Akrami
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Ali Ebadi
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Mirnia K, Samad Soltani T, Rezaei M, Heidarzadeh M, Piri Z. Design and evaluation of electronic briefs of neonatal intensive care unit in Taleghani hospital, Tabriz, Iran. Glob J Health Sci 2014; 6:125-31. [PMID: 25168989 PMCID: PMC4825516 DOI: 10.5539/gjhs.v6n5p125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 04/26/2014] [Accepted: 03/31/2014] [Indexed: 11/12/2022] Open
Abstract
More than 9 million neonatal deaths are reported through out the world each year happening in the early weeks of life most of which relate to developing countries. Thus it is very important to present a better way to keep the infants healthy which could be possible by accessing accurate information at any time required during hospitalization of infants. Therefore the required data should be collected, stored and analyzed before which is best possible by using computer. The main objective of this research is enabling researchers and clinicians quick access to the data of the babies admitted in NICU. This study involves the stage of developing a system design and its implementation following the evaluation of the electronic records which is done in a query form. By defining the neccessary terminology and designing a data model, the database and user interface are developed by using a programing language and data base tools. Finally, the system has been evaluated by user satisfaction showing to be about 85% As a result we suggest the hospitals take serious in buying the suitable technology for the NICU ward along with teaching the staffs how to work with it.
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Affiliation(s)
| | | | | | - Mohammad Heidarzadeh
- Assistant professor of neonatology , pediatric health research center, Tabriz university of medical sciences, Tabriz , Iran.
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Abstract
Ring chromosome 13, is an uncommon genetic syndrome. We report a girl infant with ring chromosome 13. She is 2nd offspring of family. She had no family history of genetic disorder. Karyotype showed 46xx,r(13). She had hypertelorism, wide nasal bridge, and long philtrum. She is the first report of ring chromosome 13 in Iranian children. DOI: http://dx.doi.org/10.3126/jnps.v34i1.7961 J Nepal Paediatr Soc 2014;34(1):74-76
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Mirnia K, Heidarzadeh M, Hosseini MB. Comparison Outcome of Surfactant Administration Via Tracheal Catheterization During Spontaneous Breathing with Insure. ACTA ACUST UNITED AC 2013. [DOI: 10.12816/0002647] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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