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Naser Moghadasi A, Ashtari F, Baghbanian SM, Shaygannejad V, Anjidani N, Ghadiri F, Sedighi B, Saeidi M, Amirifard H, Ayromlou H, Beladi Moghadam N, Ranjbar MB, Nazeri M, Niknam Z, Faraji F, Afsorde A, Sahraian MA. Safety and Effectiveness of Cinnomer ® on Disease Characteristics, Depression, and Quality of Life of Patients with Multiple Sclerosis: A Phase IV, Post-marketing, Prospective, Multicenter Study. Arch Iran Med 2023; 26:647-653. [PMID: 38310425 PMCID: PMC10864943 DOI: 10.34172/aim.2023.95] [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] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 09/19/2023] [Indexed: 02/05/2024]
Abstract
BACKGROUND Every patient diagnosed with definite multiple sclerosis (MS) should begin disease modifying therapies. Cinnomer® contains 40 mg glatiramer acetate (GA) and is available in prefilled syringes and autoinjector devices. METHODS A phase IV multicenter study was conducted to explore the safety and effectiveness of Cinnomer® in the treatment of MS. Study-related data were collected for 14 months. RESULTS Totally, 368 Iranian relapsing-remitting MS patients in nine cities were enrolled. The patients were either treatment naïve (n=191) or switchers (n=177). Cinnomer® treatment was associated with a significant reduction in annual relapse rate (ARR) (RR: 0.65, 95% CI: 0.43, 0.98). Final mean Expanded Disability Status Scale (EDSS) scores showed improvement from baseline (difference: -0.21, 95% confidence interval (CI): -0.34, -0.08). There was a significant decrease in gad-enhancing lesions during treatment (difference: -0.38, 95% CI: -0.64, -0.12). The mean score for the depression measure (21-item BDI-II questionnaire) significantly improved (difference: -2.39, 95% CI: -3.74, -1.03). There was a significant change in the "psychological well-being" dimension (P=0.02) (in line with BDI-II scores) and "rejection" MusiQoL dimensions (P=0.04). The adverse events documented throughout the study were not unexpected for GA and were principally not serious. CONCLUSION Safety measures were in line with the known profiles of GA. The results suggest that Cinnomer® is effective with respect to clinical outcomes and from the patient's perspective and in reducing MRI-measured MS activity.
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Affiliation(s)
- Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Ashtari
- Isfahan University of Medical sciences, Kashani Comprehensive MS Center, Isfahan, Iran
| | - Seyed Mohammad Baghbanian
- Multiple Sclerosis Fellowship, Neurology Department, Boualicina Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Vahid Shaygannejad
- Isfahan University of Medical sciences, Kashani Comprehensive MS Center, Isfahan, Iran
| | | | - Fereshteh Ghadiri
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnaz Sedighi
- Neurology Research Center, Kerman University of Medical Science, Kerman, Iran
| | - Morteza Saeidi
- Department of Neurology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Amirifard
- Department of Neurology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Hormoz Ayromlou
- Neurology Department, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nahid Beladi Moghadam
- Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Masoume Nazeri
- Clinical Neurology Research Center, Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Fardin Faraji
- Department of Neurology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | | | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Asadi-Pooya AA, Masoudi MS, Hashemi B, Mosalamiaghili S, Nazeri M, Fazelian K. Hypothalamic hamartoma surgery in a setting with limited resources. Epilepsy Behav 2023; 147:109439. [PMID: 37716328 DOI: 10.1016/j.yebeh.2023.109439] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/04/2023] [Accepted: 09/03/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Three years ago (in 2020), we at the epilepsy center in Shiraz, Iran, started an endeavor to initiate a surgical program for patients with hypothalamic hamartoma (HH). We discussed that although minimally invasive techniques are desired, they are not available in the nation. We decided to proceed with open disconnection and resection surgery techniques. The current manuscript presents the results of the HH surgery program at our center as a case series. METHODS This study included all patients with a diagnosis of HH who were referred to Shiraz Epilepsy Center with drug-resistant epilepsy and who underwent HH surgery from October 2020 to January 2023 at our epilepsy center, Namazi Hospital, Shiraz, Iran. RESULTS Seven patients were included. All patients had gelastic seizures. Four patients (57%) underwent total resection of HH, and the lesions were disconnected and partially resected in three other patients (43%). Three patients (43%) became seizure-free after surgery, and three patients (43%) had more than 50% reduction in their seizure frequencies. Three patients (43%) had no post-operative complications. Only one patient (14.3%) suffered from a permanent postoperative complication (right hemiparesis). The mortality rate was zero. Five parents (71%) were satisfied with the surgery outcomes. CONCLUSION Hypothalamic hamartoma surgery is feasible even in centers with limited resources if a close collaboration exists between the epileptology and neurosurgery teams. Careful planning based on the expertise of the team members and the available resources is required to foster success.
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Affiliation(s)
- Ali A Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Mohamad S Masoudi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Bita Hashemi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | | | - Masoume Nazeri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Khatereh Fazelian
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Abolhasani Foroughi A, Mokhtari M, Heidari E, Nazeri M, Rastgouyan H, Babaei A. Concordance between TIRADS and Cytology in Thyroid Nodule. Iran J Otorhinolaryngol 2022; 34:295-302. [PMID: 36474488 PMCID: PMC9709392 DOI: 10.22038/ijorl.2022.57663.2984] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 08/30/2022] [Indexed: 12/14/2022]
Abstract
Introduction Palpable thyroid nodules are stated in 4 to 7% of individuals. This study was designed to evaluate the relation of Thyroid Imaging Reporting and Data System (TIRADS) and fine-needle aspiration (FNA) based cytology reports in patients with thyroid nodules. Materials and Methods In this retrospective cross-sectional study, individuals with thyroid nodules who were selected for ultrasonographic-guided FNA enrolled in this study. Demographic data, radiologic assessment, and cytology report were gathered based on hospital medical records. TIRADS grading of the nodules was assessed for each nodule. Cytology was performed on all samples. Sensitivity and specificity were calculated by comparing cytology with ACR-TIRADS and also cytology with TIRADS 4-5 cut-off point as a radiologic malignant lesion. Results 172 patients were studied, 151 of whom were female and 21 were male. The mean age of the patients was 49.46 years. Most of the patients had TIRADS 4 (53.5%) followed by 3 (31.4%), and 5 (11.6%). 151 patients (87.8%) had a benign lesion in cytology. Of them, 118 had colloid nodules. There was a statistically significant relation between TIRADS and cytology (p-value<0.001). Sensitivity, specificity, AUC, and positive and negative predictive value for ACR-TIRADS classification were 76.19%, 47.54%, 0.619, 20.00%, and 92.06%, respectively. These values for cut-off "4-5" classification was 86.36%, 38.00%, 0.622, 16.96%, and 95.00%. Conclusions According to the significant concordance between TIRADS and cytology, as shown in the results of our study, it seems that TIRADS could be used to decrease the amount of unnecessary FNA in individuals with thyroid nodules.
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Affiliation(s)
- Amin Abolhasani Foroughi
- Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Science, Shiraz, Iran.
| | - Maral Mokhtari
- Pathology department, Shiraz University of Medical Science, Shiraz, Iran.
| | - Emad Heidari
- Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Science, Shiraz, Iran.,Corresponding author: Medical Imaging Research Center, Shiraz University of Medical Science, Shiraz, Iran. E-mail:
| | - Masoume Nazeri
- Clinical Neurology Research Center,Shiraz University of Medical Science Shiraz, Iran.
| | - Hemmat Rastgouyan
- Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Science, Shiraz, Iran.
| | - Amirhossein Babaei
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran.
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Asadi-Pooya AA, Nemati H, Shahisavandi M, Akbari A, Emami A, Lotfi M, Rostamihosseinkhani M, Barzegar Z, Kabiri M, Zeraatpisheh Z, Farjoud-Kouhanjani M, Jafari A, Sasannia S, Ashrafi S, Nazeri M, Nasiri S. Correction to: Long COVID in children and adolescents. World J Pediatr 2022:10.1007/s12519-022-00588-4. [PMID: 35781635 DOI: 10.1007/s12519-022-00588-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ali A Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
- Department of Neurology, Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Hamid Nemati
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mina Shahisavandi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Akbari
- Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Emami
- Burn & Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrzad Lotfi
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Zohreh Barzegar
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Kabiri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Zeraatpisheh
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Anahita Jafari
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sarvin Sasannia
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shayan Ashrafi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoume Nazeri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Nasiri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Foroughi AA, Rahmani A, Borazjani R, Nazeri M, Zeinali-Rafsanjani B, Khalili H. Temporal changes in extra-axial brain hematoma's signal intensity in magnetic resonance images of trauma patients: A preliminary, technical study. J Forensic Leg Med 2021; 85:102296. [PMID: 34896891 DOI: 10.1016/j.jflm.2021.102296] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 11/27/2021] [Accepted: 12/06/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Dating the exact or estimated time of trauma is an important issue facing forensic medicine. Several clinical and radiological methods were used to achieve this purpose. In the recent study, we aimed to track the changes in the signal intensity of the extra-axial brain hematoma using magnetic resonance imaging (MRI) conventional sequences as well as diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC). MATERIALS AND METHODS Considering inclusion and exclusion criteria, all patients with blunt head trauma were involved. After proper management., stabilization, and resuscitation, the participants were assessed using conventional sequences of MRI and DWI twenty-four hours, forty-eight hours, and three weeks after the injury. Temporal changes of signal intensity were compared by Wilcoxon ranged test. RESULTS Sixteen patients sustaining blunt head trauma were included in this study. The study showed that during the time, diffusion restriction could be seen in an extraaxial hematoma. At the first 24 hours, the signal of hematoma was void in 87.5% of DWI and 100% of ADC. On the second day, they were hypo-signal in 75% of DWI and 100% 0f ADCs, and after three weeks, 100% of cases were hyper-signal in DWI and hypo-signal ADCs. CONCLUSION This preliminary study has shown that the DWI can be used to detect and track the extra-axial hematoma. The signal intensity was void during the first twentyfour hours, although it became hypo-signal after 48 hours. Of note, the diffusion restriction is noted after three weeks.
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Affiliation(s)
- Amin Abolhasani Foroughi
- Epilepsy Research Center,Shiraz University of Medical Sciences, Shiraz, Iran; Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Ali Rahmani
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Roham Borazjani
- Trauma Research Center, Shahid Rajaee Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Masoume Nazeri
- Epilepsy Research Center,Shiraz University of Medical Sciences, Shiraz, Iran; Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | | | - Hosseinali Khalili
- Trauma Research Center, Shahid Rajaee Trauma Hospital, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.
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Asadi-Pooya AA, Akbari A, Emami A, Lotfi M, Rostamihosseinkhani M, Nemati H, Barzegar Z, Kabiri M, Zeraatpisheh Z, Farjoud-Kouhanjani M, Jafari A, Sasannia F, Ashrafi S, Nazeri M, Nasiri S, Shahisavandi M. Risk Factors Associated with Long COVID Syndrome: A Retrospective Study. Iran J Med Sci 2021; 46:428-436. [PMID: 34840383 PMCID: PMC8611223 DOI: 10.30476/ijms.2021.92080.2326] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/30/2021] [Accepted: 09/29/2021] [Indexed: 12/22/2022]
Abstract
Background Recently, people have recognized the post-acute phase symptoms of the COVID-19. We investigated the long-term symptoms associated with COVID-19, (Long COVID Syndrome), and the risk factors associated with it. Methods This was a retrospective observational study. All the consecutive adult patients referred to the healthcare facilities anywhere in Fars province from 19 February 2020 until 20 November 2020 were included. All the patients had a confirmed COVID-19 diagnosis. In a phone call to the patients, at least three months after their discharge from the hospital, we obtained their current information. The IBM SPSS Statistics (version 25.0) was used. Pearson Chi square, Fisher's exact test, t test, and binary logistic regression analysis model were employed. A P value of less than 0.05 was considered to be significant. Results In total, 4,681 patients were studied, 2915 of whom (62.3%) reported symptoms. The most common symptoms of long COVID syndrome were fatigue, exercise intolerance, walking intolerance, muscle pain, and shortness of breath. Women were more likely to experience long-term COVID syndrome than men (Odds Ratio: 1,268; 95% Confidence Interval: 1,122-1,432; P=0.0001), which was significant. Presentation with respiratory problems at the onset of illness was also significantly associated with long COVID syndrome (Odds Ratio: 1.425; 95% Confidence Interval: 1.177-1.724; P=0.0001). A shorter length of hospital stay was inversely associated with long COVID syndrome (Odds Ratio: 0.953; 95% Confidence Interval: 0.941-0.965; P=0.0001). Conclusion Long COVID syndrome is a frequent and disabling condition and has significant associations with sex (female), respiratory symptoms at the onset, and the severity of the illness.
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Affiliation(s)
- Ali Akbar Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Neurology, Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ali Akbari
- Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Emami
- Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrzad Lotfi
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Hamid Nemati
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohreh Barzegar
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Kabiri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Zeraatpisheh
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Anahita Jafari
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fateme Sasannia
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shayan Ashrafi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoume Nazeri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Nasiri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mina Shahisavandi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Asadi-Pooya AA, Akbari A, Emami A, Lotfi M, Rostamihosseinkhani M, Nemati H, Barzegar Z, Kabiri M, Zeraatpisheh Z, Farjoud-Kouhanjani M, Jafari A, Sasannia F, Ashrafi S, Nazeri M, Nasiri S, Shahisavandi M. Long COVID syndrome-associated brain fog. J Med Virol 2021; 94:979-984. [PMID: 34672377 PMCID: PMC8662118 DOI: 10.1002/jmv.27404] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [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: 07/14/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 01/03/2023]
Abstract
We investigated the frequency of brain fog in a large cohort of patients with documented coronavirus disease-2019 (COVID-19) who have survived the illness. We also scrutinized the potential risk factors associated with the development of brain fog. Adult patients (18-55 years of age), who were referred to the healthcare facilities anywhere in Fars province from February 19, 2020 to November 20, 2020 were included. All patients had a confirmed COVID-19 diagnosis. In a phone call, at least 3 months after their discharge from the hospital, we obtained their current information. A questionnaire was specifically designed for data collection. In total, 2696 patients had the inclusion criteria; 1680 (62.3%) people reported long COVID syndrome (LCS). LCS-associated brain fog was reported by 194 (7.2%) patients. Female sex (odds ratio [OR]: 1.4), respiratory problems at the onset (OR: 1.9), and intensive care unit (ICU) admission (OR: 1.7) were significantly associated with reporting chronic post-COVID "brain fog" by the patients. In this large population-based study, we report that chronic post-COVID "brain fog" has significant associations with sex (female), respiratory symptoms at the onset, and the severity of the illness (ICU admission).
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Affiliation(s)
- Ali A Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Neurology, Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ali Akbari
- Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Emami
- Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrzad Lotfi
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Hamid Nemati
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohreh Barzegar
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Kabiri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Zeraatpisheh
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Anahita Jafari
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fateme Sasannia
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shayan Ashrafi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoume Nazeri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Nasiri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mina Shahisavandi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Nazeri M, Bazrafshan H, Abolhasani Foroughi A. Serum inflammatory markers in patients with multiple sclerosis and their association with clinical manifestations and MRI findings. Acta Neurol Belg 2021; 122:1187-1193. [PMID: 33837496 DOI: 10.1007/s13760-021-01647-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 10/23/2020] [Accepted: 03/08/2021] [Indexed: 01/20/2023]
Abstract
Inflammation in a myelinated portion of the nervous system is the mainstay of multiple sclerosis (MS). Elevation of inflammatory markers such as procalcitonin, ESR and hs-CRP is suspected to occur in MS patients. However, their prognostic role and their relationship with the severity of clinical symptoms of MS and MRI evidences has remained unnoticed in the literature. Hence, we aim to evaluate the serum level of inflammatory markers in the acute attack of MS patients and demonstrate the potential prognostic role of these inflammatory markers. This study was carried on case and control groups of definite MS patients. The cases were patients with active MS and were further allocated into four subgroups, while as control group included patients with non-active MS. Furthermore, all the participants underwent brain and cervical magnetic resonance imaging (MRI) using a contrast agent. A significant difference was detected in hs-CRP level (p = 0.009) across the subgroups of the cases. The highest level of hs-CRP was reported in patients with cerebellar and brain stem symptoms (mean = 6998.13 ± 3501.16), while the lowest in patients with pyramidal and urinary incontinence symptoms (mean = 1958.91 ± 2662.16). Moreover, correlation coefficient between values of MRI contrast-enhanced lesions and ESR level was statistically significant (Rs = 0.503 and p = 0.001). Elevation of ESR serum level positively correlates with disease activity evidenced by values of contrast-enhanced plaques of MRI in relapsing-remitting MS patients which may predict the disease activity. In addition, MS relapse with cerebellar and brain stem symptoms is associated with a high concentration of hs-CRP plasma level.
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Affiliation(s)
- Masoume Nazeri
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Clinical Neurology Research Center, Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hanieh Bazrafshan
- Clinical Neurology Research Center, Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Abolhasani Foroughi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Asadi-Pooya AA, Nemati H, Shahisavandi M, Akbari A, Emami A, Lotfi M, Rostamihosseinkhani M, Barzegar Z, Kabiri M, Zeraatpisheh Z, Farjoud-Kouhanjani M, Jafari A, Sasannia F, Ashrafi S, Nazeri M, Nasiri S. Long COVID in children and adolescents. World J Pediatr 2021; 17:495-499. [PMID: 34478045 PMCID: PMC8414448 DOI: 10.1007/s12519-021-00457-6] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/22/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND To identify the prevalence and also the full spectrum of symptoms/complaints of children and adolescents who are suffering from long COVID. Furthermore, we investigated the risk factors of long COVID in children and adolescents. METHODS All consecutive children and adolescents who were referred to the hospitals anywhere in Fars province, Iran, from 19 February 2020 until 20 November 2020 were included. All patients had a confirmed diagnosis of COVID-19. In a phone call to patients/parents, at least 3 months after their discharge from the hospital, we obtained their current status and information if their parents agreed to participate. RESULTS In total, 58 children and adolescents fulfilled the inclusion criteria. Twenty-six (44·8%) children/adolescents reported symptoms/complaints of long COVID. These symptoms included fatigue in 12 (21%), shortness of breath in 7 (12%), exercise intolerance in 7 (12%), weakness in 6 (10%), and walking intolerance in 5 (9%) individuals. Older age, muscle pain on admission, and intensive care unit admission were significantly associated with long COVID. CONCLUSIONS Long COVID is a frequent condition in children and adolescents. The scientific community should investigate and explore the pathophysiology of long COVID to ensure that these patients receive appropriate treatments for their condition.
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Affiliation(s)
- Ali A. Asadi-Pooya
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ,grid.265008.90000 0001 2166 5843Department of Neurology, Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, PA USA
| | - Hamid Nemati
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mina Shahisavandi
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Akbari
- grid.412571.40000 0000 8819 4698Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Emami
- grid.412571.40000 0000 8819 4698Burn & Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrzad Lotfi
- grid.412571.40000 0000 8819 4698Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahtab Rostamihosseinkhani
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohreh Barzegar
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Kabiri
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Zeraatpisheh
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Farjoud-Kouhanjani
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anahita Jafari
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fateme Sasannia
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shayan Ashrafi
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoume Nazeri
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Nasiri
- grid.412571.40000 0000 8819 4698Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Nazeri M, Dastgheib SA, Asadi-Pooya AA. Job consultation in patients with psychogenic nonepileptic seizures: Systematic review and survey of physicians' opinion. Epilepsy Behav 2020; 103:106863. [PMID: 31899167 DOI: 10.1016/j.yebeh.2019.106863] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/15/2019] [Accepted: 12/15/2019] [Indexed: 02/01/2023]
Abstract
OBJECTIVES The objectives of this study were 1) to review the literature about "job/employment and psychogenic nonepileptic seizures (PNES)" and 2) to gather the views of neurologists and psychiatrists on the issue of job consultation in patients with PNES. METHODS Phase one involved a systematic literature review; phase two involved the collection of the views of neurologists and psychiatrists, practicing in Fars province, Iran, on the issue of job consultation in patients with PNES. A questionnaire was designed for the purpose of this study. RESULTS No studies were identified by the systematic review process on the issue of job consultation in patients with PNES. Of the 87 health-care professionals approached, 63 responded to the survey (response rate: 72%). Respondents included 31 neurologists and 32 psychiatrists. In response to the question "Should all patients with PNES be counseled to pursue any job or profession they would like?", 17 (55%) neurologists and 19 (59%) psychiatrists answered "no" (p = 0.8). CONCLUSION While it is possible that some patients with PNES are more likely than other people in the general public to be involved in job-related difficulties (performing duties related to any job, accidents, etc.), there is currently no evidence supporting or refuting this proposition. However, in this study, the majority of the health-care professionals, who often deal with these patients, believed that not all patients with PNES should be counseled to pursue any job or profession they would like (i.e., there should be some restrictions).
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Affiliation(s)
- Masoume Nazeri
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Ali Dastgheib
- Substance Abuse Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Ali A Asadi-Pooya
- Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA.
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Asadi-Pooya AA, Dastgheib SA, Nazeri M. Disability benefits in patients with psychogenic nonepileptic seizures: a survey of physicians' opinions. Epilepsy Behav 2020; 103:106877. [PMID: 31937514 DOI: 10.1016/j.yebeh.2019.106877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The aim of the current study was to gather the views of healthcare providers practicing in the field of psychogenic nonepileptic seizures (PNES) on the issue of "disability benefits eligibility and PNES". METHODS This was a questionnaire study that was sent to all neurologists and psychiatrists practicing in Fars province, Iran. The survey included seven questions: one question about professional qualifications, one question on the participants' personal experience with the topic of interest (i.e., PNES), and five questions probing their opinions about the matter of interest (i.e., the issue of disability benefits eligibility in PNES). RESULTS The response rate was 72%. Respondents included 32 psychiatrists and 31 neurologists. In response to the question "Do you think that patients with PNES should be counseled to avoid performing all jobs or professions as long as they have active PNES?", 47 (75%) physicians answered "no" (22 neurologists and 25 psychiatrists; P = .5). In response to the question "Do you think that patients with PNES should be qualified for disability benefits?", 47 (75%) physicians answered "Patients with specific jobs or professions should be qualified for disability benefits" (23 neurologists and 24 psychiatrists; P = 1); while, nobody believed that "All of them should be qualified for disability benefits". CONCLUSION While collection of the opinions of physicians is valuable, this is just one piece of the puzzle; future studies should investigate the opinions of other stakeholders. More importantly, investigators should explore whether patients with PNES have any job-related difficulties.
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Affiliation(s)
- Ali A Asadi-Pooya
- Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, PA, USA.
| | - Seyed Ali Dastgheib
- Substance Abuse Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Masoume Nazeri
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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12
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Dehghani R, Borhanihaghighi A, Shariat A, Nami M, Nazeri M, Abolhasani Foroughi A, Mehrabi S, Emamghoreishi M. Validity and Reliability of the Persian Versions of National Institute of Health Stroke Scale and Modified National Institute of Health Stroke Scale in Hospitalized Patients. Galen Med J 2019; 8:e1188. [PMID: 34466470 PMCID: PMC8343978 DOI: 10.31661/gmj.v8i0.1188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 05/14/2018] [Accepted: 06/12/2018] [Indexed: 11/16/2022] Open
Abstract
Background National Institute of Health Stroke Scale (NIHSS) and Modified National Institute of Health Stroke Scale (mNIHSS) are two valid and reliable questionnaires that assess stroke severity. This study aimed to examine and compare the validity and reliability of Persian versions of NIHSS and mNIHSS in hospitalized patients. Materials and Methods The English versions of NIHSS and mNIHSS were translated to Persian (forward and backward), and three neurologists examined the face and content validity of both questionnaires. The Persian versions of NIHSS and mNIHSS were used in 75 hospitalized stroke patients (hemorrhagic and obstructive) admitted to Namazi teaching hospital, Shiraz, Iran. The reliability and validity of the Persian versions were examined by Cronbach's alpha coefficient and convergent validity. Results The values of Cronbach's alpha for Persian versions of NIHSS and mNIHSS were 0.81 and 0.86, respectively. The scaling success of convergent validity in NIHSS and mNIHSS were 80% and 100%, respectively. Conclusion The Persian versions of NIHSS and mNIHSS were reliable and valid. However, mNIHSS was more valid and reliable than NIHSS. Persian version of mNIHSS can be suggested to be used for assessing stroke severity in hospitalized stroke patients by neurologists and researchers.
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Affiliation(s)
- Reza Dehghani
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmacology, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Afshin Borhanihaghighi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Neurology, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdolhamid Shariat
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Neurology, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Nami
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoume Nazeri
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Neurology, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Abolhasani Foroughi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Radiology, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samrad Mehrabi
- Sleep Disorders Laboratory, Division of Pulmonology, Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Emamghoreishi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmacology, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- Correspondence to: Masoumeh Emamghoreishi, Department of Pharmacology, School of medicine, Shiraz University of Medical Sciences, Zand, Fars province, Shiraz, Iran Telephone Number: +987132307591 Email Address:
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Dolatabadi S, Ahmadi B, Rezaei-Matehkolaei A, Zarrinfar H, Skiada A, Mirhendi H, Nashibi R, Niknejad F, Nazeri M, Rafiei A, Gharaghani M, Erami M, Taghipour S, Piri F, Makimura K. Mucormycosis in Iran: A six-year retrospective experience. J Mycol Med 2018; 28:269-273. [PMID: 29545123 DOI: 10.1016/j.mycmed.2018.02.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 10/09/2017] [Revised: 02/24/2018] [Accepted: 02/24/2018] [Indexed: 01/24/2023]
Abstract
Mucormycosis is a devastating infection caused by Mucoralean fungi (Mucormycotina, Mucorales). Data concerning the global epidemiology of mucormycosis are scarce and little is known about the characteristics of mucormycosis in Iran. In this study, we aimed to understand the distribution of this infection in Iran retrospectively and to ascertain whether the patterns of infection are associated with specific host factors or not. A total of 208 cases were included in this study occurring during 2008-2014 and were validated according to (EORTC/MSG) criteria. A rising trend as significant increase from 9.7% in 2008 to 23.7% in 2014 was observed. The majority of patients were female (51.4%) with median age of 50 and the infections were seen mostly in autumn season (39.4%). Diabetes mellitus (75.4%) was the most common underlying condition and sinus involvement (86%) was the mostly affected site of infection. Amphotericin B (AmB) was the drug of choice for the majority of cases. Sixty four isolates did not show any growth in the lab and only 21 cases were evaluated by ITS sequencing, among them; Rhizopus arrhizus var. arrhizus was the dominant species. Considering the high mortality rate of mucormycosis, early and accurate diagnosis, with the aid of molecular methods may provide accurate treatments and improve the survival rate. Therefore, increased monitoring and awareness of this life-threatening disease is critical.
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Affiliation(s)
- S Dolatabadi
- Faculty of Engineering, Sabzevar University of New Technology, Sabzevar, Iran
| | - B Ahmadi
- Department of Medical Laboratory Sciences, School of Para-Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - A Rezaei-Matehkolaei
- Department of Medical Mycology, School of Medicine, Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - H Zarrinfar
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - A Skiada
- Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - H Mirhendi
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - R Nashibi
- Health Research Institute, Infectious and Tropical Diseases Research Center, Infectious Diseases Department, Razi Teaching Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - F Niknejad
- Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - M Nazeri
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - A Rafiei
- Department of Medical Mycology, School of Medicine, Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - M Gharaghani
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - M Erami
- Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran
| | - S Taghipour
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - F Piri
- Department of Medical Mycology, School of Medicine, Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - K Makimura
- Division of Clinical Laboratory Medicine, Graduate School of Medical Care and Technology, Laboratory of Space and Environmental Medicine, Graduate School of Medicine, Teikyo University, Tokyo, Japan
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Nemati R, Nazeri M, Emami S. Association between iron deficiency anemia and cerebral venous thrombosis. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1781] [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: 11/16/2022]
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15
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Abolhasani Foroughi A, Salahi R, Nikseresht A, Heidari H, Nazeri M, Khorsand A. Comparison of diffusion-weighted imaging and enhanced T1-weighted sequencing in patients with multiple sclerosis. Neuroradiol J 2017; 30:347-351. [PMID: 28452571 DOI: 10.1177/1971400916678224] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction The purpose of this study was to assess whether demographic, brain anatomical regions and contrast enhancement show differences in multiple sclerosis (MS) patients with increased diffusion lesions (ID group) compared with diffusion restriction (DR group). Method MRI protocol comprised T1- and T2-weighted sequences with and without gadolinium (Gd), and sagittal three-dimensional FLAIR sequence, DWI and ADC maps were prospectively performed in 126 MS patients from January to December 2015. The investigation was conducted to evaluate differences in demographic, cord and brain regional, technical, and positive or negative Gd contrast imaging parameters in two groups of ID and DR. Statistical analysis was performed by using SPSS. Results A total of 9.6% of patients showed DR. In the DR group, 66.6% of the patients showed contrast enhancement of plaques, whereas 29.2% of the IR group showed enhancement of plaques. The most prevalent group was non-enhanced plaques in the ID group, followed by Gd-enhanced plaques in the ID group. Patients in the ID group (90.4%) were significantly more than in the DR group (9.6%). Out of the 40 patients with Gd-enhanced plaques, 80.5% was from the ID group and 19.5% from the DR group. Conclusion MRI of the brain, unlike of the cord, with Gd demonstrates significant difference in enhancement between the two groups ( p < 0.05). No significant difference was seen in demographic, cord and brain regional, and technical parameters, EDSS, disease duration, and attack rate as well as demographic and regional parameters between the ID and decrease diffusion groups ( p > 0.05).
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Affiliation(s)
- Amin Abolhasani Foroughi
- 1 Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz Iran
| | - Roohollah Salahi
- 1 Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz Iran
| | - Alireza Nikseresht
- 2 Clinical Neurology Research Center, Department of Neurology, Shiraz University of Medical Sciences, Shiraz Iran
| | - Hora Heidari
- 2 Clinical Neurology Research Center, Department of Neurology, Shiraz University of Medical Sciences, Shiraz Iran
| | - Masoume Nazeri
- 2 Clinical Neurology Research Center, Department of Neurology, Shiraz University of Medical Sciences, Shiraz Iran
| | - Ali Khorsand
- 1 Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz Iran
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Vaezi A, Fakhim H, Khodavaisy S, Alizadeh A, Nazeri M, Soleimani A, Boekhout T, Badali H. Epidemiological and mycological characteristics of candidemia in Iran: A systematic review and meta-analysis. J Mycol Med 2017; 27:146-152. [PMID: 28318900 DOI: 10.1016/j.mycmed.2017.02.007] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [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: 01/09/2017] [Revised: 01/30/2017] [Accepted: 02/17/2017] [Indexed: 10/20/2022]
Abstract
To date, there has been no comprehensive review of the epidemiology, risk factors, species distribution, and outcomes of candidemia in Iran. This study aimed to perform a systematic review and meta-analysis of all reported candidemia cases in Iran until December 2015. The review process occurred in three steps, namely a literature search, data extraction and statistical analyses. After a comprehensive literature search, we identified 55 cases. The mean age of patients was 46.80±24.30 years (range 1-81 years). The main risk factors for candidemia were surgery and burns (23.6%), followed by malignancies (20%), use of broad-spectrum antibiotics (18.2%), and diabetes (7.3%). Candida parapsilosis (n=17, 30.8%) was the leading agent, followed by Candida albicans (n=15, 27.3%), Candida glabrata (n=10, 18.2%), and Candida tropicalis (n=8, 14.5%). The frequencies of candidemia cases due to C. glabrata, C. parapsilosis, and C. albicans were significantly higher among patients aged>60, 21-40, and 41-60 years, respectively. Comparison of risk factors for candidemia by multiple logistic regression showed that one of the most important risk factors was surgery (OR: 4.245; 95% CI: 1.141-15.789; P=0.031). The outcome was recorded in only 19 cases and 13 of those patients (68.4%) expired. This study confirms that knowledge of the local epidemiology is important when conducting surveillance studies to prevent and control candidemia and will be of interest for antifungal stewardship.
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Affiliation(s)
- A Vaezi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran; Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - H Fakhim
- Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - S Khodavaisy
- Department of Medical Mycology and Parasitology, Tehran University of Medical Sciences, Tehran, Iran
| | - A Alizadeh
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - M Nazeri
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - A Soleimani
- Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - T Boekhout
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands; Institute of Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, Amsterdam, The Netherlands
| | - H Badali
- Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Invasive Fungi Research Center (IFRC), School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
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Abstract
Background and Purpose: Candida species are considered a common cause of fungal blood stream infections, which are associated with considerable mortality and morbidity rates, especially in the admitted and immunocompromised patients. Despite the increase in new and available antifungal agents, the emergence of resistant strains is growing. Regarding this, the aim of the present study was to assess the fungal epidemiology of candidemia and the antifungal susceptibility patterns against five current antifungal agents among the patients with prolonged fever, who were admitted to Beheshti Educational Hospital, Kashan, Iran. Materials and Methods: This cross-sectional study was conducted on 253 hospitalized patients with prolonged fever despite receiving broad-spectrum antibiotic therapy. Blood samples were collected aseptically, and then cultured using an automated blood culture system and conventional broth culture bottle. Candida isolates were identified at species level using morphological and physiological properties and produced color on the CHROMagar Candida. Furthermore, the antifungal susceptibility testing was performed using (CLSI M27-A3 and CLSI M27-S4) broth microdilution methods. Results: The most positive cultures were detected by the automated blood culture system. C.albicans (%50) was the most prevalent species, followed by C. glabrata (%40), and C. parapsilosis, (%10) respectively .The mortality rate was high (%60) and most patients with candidemia were admitted to the Intensive Care Unit and Neonatal Intensive Care Unit. All isolates were susceptible to amphotericin B, while the highest resistance belonged to caspofungin. Conclusion: In this study, high resistance was reported, especially for caspofungin, which can be regarded as the emergence of caspofungin-resistant strains. Regarding this, the establishment of a surveillance and prevention program for the reduction of the emergence of resistant species is necessary.
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Affiliation(s)
- R Razzaghi
- Department of Infectious Diseases, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - M Momen-Heravi
- Department of Infectious Diseases, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - M Erami
- Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran
| | - M Nazeri
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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Razzaghi R, Rastegar R, Momen-Heravi M, Erami M, Nazeri M. Antimicrobial susceptibility testing of Brucella melitensis isolated from patients with acute brucellosis in a centre of Iran. Indian J Med Microbiol 2016; 34:342-5. [DOI: 10.4103/0255-0857.188336] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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19
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Khodavaisy S, Badali H, Hashemi SJ, Aala F, Nazeri M, Nouripour-Sisakht S, Sorkherizi MS, Amirizad K, Aslani N, Rezaie S. In vitro activities of five antifungal agents against 199 clinical and environmental isolates of Aspergillus flavus, an opportunistic fungal pathogen. J Mycol Med 2016; 26:116-121. [PMID: 26948143 DOI: 10.1016/j.mycmed.2016.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 10/18/2015] [Revised: 12/30/2015] [Accepted: 01/18/2016] [Indexed: 11/29/2022]
Abstract
Aspergillus flavus is the second leading cause of invasive and non-invasive aspergillosis, as well as the most common cause of fungal sinusitis, cutaneous infections, and endophthalmitis in tropical countries. Since resistance to antifungal agents has been observed in patients, susceptibility testing is helpful in defining the activity spectrum of antifungals and determining the appropriate drug for treatment. A collection of 199 clinical and environmental strains of Aspergillus flavus consisted of clinical (n=171) and environmental (n=28) were verified by DNA sequencing of the partial b-tubulin gene. MICs of amphotericin B, itraconazole, voriconazole, posaconazole, and MEC of caspofungin were determined in accordance with the Clinical and Laboratory Standards Institute M38-A2 document. Caspofungin, followed by posaconazole, exhibited the lowest minimum inhibitory concentrations (MIC). All isolates had caspofungin MEC90 (0.063μg/ml) lower than the epidemiologic cutoff values, and 3.5% of the isolates had amphotericin B MIC higher than the epidemiologic cutoff values. However, their clinical effectiveness in the treatment of A. flavus infection remains to be determined.
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Affiliation(s)
- S Khodavaisy
- Department of medical mycology and parasitology, Kurdistan university of medical science, Sanandaj, Iran; Division of molecular biology, department of medical mycology and parasitology, school of public health, Tehran university of medical science, Tehran, Iran
| | - H Badali
- Department of medical mycology and parasitology, antimicrobial resistance research center (ARRC), Mazandaran university of medical science, Sari, Iran
| | - S J Hashemi
- Division of molecular biology, department of medical mycology and parasitology, school of public health, Tehran university of medical science, Tehran, Iran
| | - F Aala
- Department of medical mycology and parasitology, Kurdistan university of medical science, Sanandaj, Iran
| | - M Nazeri
- Department of medical mycology and parasitology, Kashan university of medical science, Kashan, Iran
| | - S Nouripour-Sisakht
- Department of medical microbiology, faculty of medicine, Yasouj university of medical sciences, Yasouj, Iran
| | - M S Sorkherizi
- Department of medical mycology and parasitology, faculty of medicine, Iran university of medical sciences, Tehran, Iran
| | - K Amirizad
- Student research committee, Mazandaran university of medical sciences, Sari, Iran
| | - N Aslani
- Student research committee, Mazandaran university of medical sciences, Sari, Iran
| | - S Rezaie
- Division of molecular biology, department of medical mycology and parasitology, school of public health, Tehran university of medical science, Tehran, Iran.
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Abolhasani Foroughi A, Ghaffari H, Haghpanah S, Nazeri M, Ghaffari R, Bardestani M, Karimi M. Comparative study of radiographic and laboratory findings between Beta thalassemia major and Beta thalassemia intermedia patients with and without treatment by hydroxyurea. Iran Red Crescent Med J 2015; 17:e23607. [PMID: 25838937 PMCID: PMC4376990 DOI: 10.5812/ircmj.23607] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Revised: 12/24/2014] [Accepted: 01/13/2015] [Indexed: 11/24/2022]
Abstract
Background: In patients with thalassemia, chronic anemia causes bone marrow expansion and consequently skeletal manifestation in spine, skull, face and rib bones. Objectives: We aimed to compare chest radiographic findings and facial bone deformity in patients with thalassemia major (TM) and intermedia. Patients and Methods: In this cross sectional study, 86 consecutive thalassemia patients referring to the Thalassemia clinic in Shiraz, Southern Iran were evaluated during 2012. Patients were divided into three groups including TM and thalassemia intermedia (TI) with and without taking hydroxyurea (HU). Findings ofchest radiography (trabeculation, rib widening and paraspinal masses) as well as facial bone deformity were evaluated by an expert radiologist. Besides, laboratory findings were measured regarding hemoglobin, ferritin, NRBC and platelet count. Results: All radiologic findings were significantly higher in patients with TI compared to TM (P< 0.05). In patients with TI, only trabeculation was observed with a higher frequency in patients with HU compared to those without HU (68% vs. 27.3%, P= 0.008). In the regression model, from all variables evaluated, only NRBC showed a significant correlation with trabeculation (Exp B = 1.014, CI: 1.004-1.025, P = 0.008) and age showed a significant correlation with paravertebral mass (Exp B = 1.147, CI: 1.03-1.27, P = 0.013). Conclusions: In patients with TM, bone widening, trabeculation, paraspinal masses and facial bone deformity were lower than patients with TI, whichcan be related to effectiveness of therapy with blood transfusion irrespective of its adverse effects in TM patients.
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Affiliation(s)
- Amin Abolhasani Foroughi
- Medical Imaging Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Hosein Ghaffari
- Medical Imaging Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Masoume Nazeri
- Department of Neurology, Motahhari Clinic, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Roghieh Ghaffari
- Department of Pediatric, Urmia University of Medical Sciences, Urmia, IR Iran
| | - Marzieh Bardestani
- Department of Library and Information Science, College of Humanities, Khouzestan Science and Research Branch, Islamic Azad University, Ahvaz, IR Iran
| | - Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Corresponding Author: Mehran Karimi, Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel/Fax: +98-7136473239, E-mail:
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Karimi M, Haghpanah S, Ashjazadeh N, Shariat A, Nazeri M, Emami S, Forough AA, Petramfar P, Yaghoubi E. Cerebral Artery Velocity Determined by Transcranial Doppler Ultrasonography in Patients With β-Thalassemia Intermedia Compared to β-Thalassemia Major. Clin Appl Thromb Hemost 2013; 19:367-73. [DOI: 10.1177/1076029612461068] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We aimed to compare cerebral artery velocity and relevant clinical factors in patients with β-thalassemia intermedia (β-TI), β-thalassemia major (β-TM), and healthy individuals. For this study, 60 patients with β-TM and 64 with β-TI were randomly selected. Sixty healthy adults comprised the control group. Time average maximum mean velocity (TAMMV) was measured in large cerebral arteries with transcranial Doppler (TCD) ultrasonography. In all arteries, TAMMV was significantly higher in the β-TI group than that of β-TM or controls ( P < .001). Patients with β-TM had significantly higher TAMMV than controls in most arteries evaluated ( P < .001). Overall, the lack of regular blood transfusions, splenectomy, and lower age (to a lesser extent) was found to be independent influencing factors contributing to high cerebral artery velocities. Further detailed longitudinal studies are needed to confirm these results and to determine the risk of silent infarction and stroke in patients with thalassemia and abnormal TCD, with particular focus on patients with β-TI.
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Affiliation(s)
- Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nahid Ashjazadeh
- Department of Neurology, Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdolhamid Shariat
- Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoume Nazeri
- Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sajad Emami
- Department of Neurology, Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Abolhasani Forough
- Medical Imaging research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Petramfar
- Department of Neurology, Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ehsan Yaghoubi
- Department of Neurology, Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Shariat A, Nazeri M, Abolhasani Foroughi A, Karimi M. Transcranial Doppler Ultrasonography in Beta-thalassemia Major Patients Without and With Thrombocytosis. Iran Red Crescent Med J 2013; 15:234-8. [PMID: 23984004 PMCID: PMC3745753 DOI: 10.5812/ircmj.4606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Revised: 06/15/2012] [Accepted: 01/23/2013] [Indexed: 12/03/2022]
Abstract
Background Beta-thalassemia is a type of anemia in which the patients may require splenectomy and this can lead to thrombocytosis with increased risk of stroke. Transcranial Doppler ultrasound is a method for determining cerebral vessel stenosis. Objectives The aim of this study was to investigate whether the risk of a future stroke secondary to cerebral artery stenosis can be predicted with the use of transcranial Doppler ultrasound in beta-thalassemia major patients. Patients and Methods This study included 54 beta-thalassemia major patients divided into 2 groups; group A consisted of 28 patients who have thrombocytosis secondary to a previous splenectomy and group B comprised of 26 patients who did not have a splenectomy with normal platelet count, as well as a control group of 30 healthy individuals. Results Transcranial Doppler ultrasound of the cerebral vessels were performed in all participants, and the results for each group were compared with the controls. In addition, patients were evaluated for evidence of high flow velocity in the cerebral vessels that met the clinically significant criteria of ≥ 50% stenosis. Transcranial Doppler ultrasound velocity criteria for > 50% stenosis, indicating a risk of stroke, were not documented in any patients but increase in cerebral blood velocities in many arteries in group A and in some arteries in group B were revealed. Conclusion Following splenectomy, thrombocytosis can predispose the patients to an increase in cerebral blood velocities more than respected with anemia. But by transcranial doppler ultrasonography no evidence of significant stenosis were found in intracerebral arteries to conclude that the beta-thalassemia major patients were more prone to the development of stroke secondary to this abnormality.
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Affiliation(s)
- Abdolhamid Shariat
- Department of Neurology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Masoume Nazeri
- Department of Neurology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Amin Abolhasani Foroughi
- Medical Imaging Research Center, Department of Radiology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Corresponding author: Mehran Karimi, Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel/Fax: +98-7116473239, E-mail:
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Nazeri M, Abareghi F. LB07 Role of Psychiatric disorders in association of headache and temporomandibular disorders. J Headache Pain 2013. [PMCID: PMC3620310 DOI: 10.1186/1129-2377-1-s14-p223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Zaini F, Kanani A, Falahati M, Fateh R, Salimi-Asl M, Saemi N, Farahyar S, Kheirabad AK, Nazeri M. Identification of Prototheca zopfii from Bovine Mastitis. Iran J Public Health 2012; 41:84-8. [PMID: 23113230 PMCID: PMC3469032] [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: 01/21/2012] [Accepted: 06/10/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of this study was identification of the epidemiology of Prototheca zopfii species from the milk samples of dairy cattle in Isfahan, central Iran. METHODS Milk samples were obtained from 230 dairy cattle, 130 with and 100 without mastitis, in Isfahan. The samples were cultured in Prototheca Isolation Medium (PIM) and Sabouraud's dextrose agar. All P. zopfii isolates were identified by morphological and biochemical methods. Then, as a confirmatory test they were examined by genotype-specific PCR. RESULTS Four P. zopfii strains (3.07%) were isolated from the 130 samples of dairy cattle with clinical mastitis and there was no isolation from totally 100 samples of healthy bovines without mastitis. Specific PCR product (about 946 bp) was detected in four isolates. CONCLUSION It seems that P. zopfii genotype II plays a key role in affecting bovine mastitis that confirmed other previous studies. Our study was the first, which identified the Prototheca species by traditional and molecular methods in Iran and Middle East as well.
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Affiliation(s)
- F Zaini
- Dept. of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - A Kanani
- Dept. of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - M Falahati
- Dept. of Parasitology and Mycology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Authors: Tel: (+9821) 88622653, E-mail address:
| | - R Fateh
- Dept. of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - N Saemi
- Dept. of Nutrition, Allied Medical School, Tehran University of Medical Sciences, Tehran, Iran
| | - Sh Farahyar
- Dept. of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Dept. of Parasitology and Mycology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - A Kargar Kheirabad
- Hormozgan Research Centre for Infectious and Tropical Disease, Hormozgan University of Medical Sciences, Hormozgan, Iran
| | - M Nazeri
- Dept. of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Akhtardanesh B, Ghanbarpour R, Babaei H, Nazeri M. Serological evidences of canine brucellosis as a new emerging disease in Iran. Asian Pacific Journal of Tropical Disease 2011. [DOI: 10.1016/s2222-1808(11)60023-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Naeini A, Nazeri M, Shokri H. Antifungal activity of Zataria multiflora , Pelargonium graveolens and Cuminum cyminum essential oils towards three species of Malassezia isolated from patients with pityriasis versicolor. J Mycol Med 2011. [DOI: 10.1016/j.mycmed.2011.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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