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Zangouri V, Ranjbar A, Homapour F, Seyyedy MS, Gooya S, Karami MY, Halimi E. Breast Cancer Survivors and COVID-19: Prevalence and Risk of Severe Disease in a Screening Study. Med J Islam Repub Iran 2023; 37:114. [PMID: 38145185 PMCID: PMC10744123 DOI: 10.47176/mjiri.37.114] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Indexed: 12/26/2023] Open
Abstract
Background Determining the risk of severe course coronavirus disease 2019 (COVID-19) and its related factors in survivors of common cancers such as breast cancer is important. This study has been designed to evaluate the prevalence of COVID-19 infection in breast cancer survivors and also estimate the risk of severe disease in this population. Methods Out of 6134 patients in the Shiraz Breast Cancer Registry (SBCR), A total of 292 patients who elapsed less than a year from their breast cancer diagnosis were excluded. We called 5842 patients. Finally, 4135 breast cancer survivors who agreed to cooperate were screened for COVID-19 symptoms by a symptom-based questionnaire in November 2020. COVID-19 in symptomatic participants was confirmed by a polymerase chain reaction (PCR) test. The clinical and paraclinical data of the COVID-19 course were collected for patients with a positive PCR test. Results A total of 247 (5.9%) participants had at least reported one of the COVID-19 symptoms. Also, 17% of symptomatic participants had a positive PCR test; 83.7% had mild disease, 9.5% moderate, and 16.7% had severe conditions. Chronic cardiovascular disease, hypertension, and diabetes were related to an increased risk of severe illness ( P = 0.018, P = 0.018, P = 0.002). Conclusion This study suggests that breast cancer intermediate and longtime survivors without other underlying diseases are considered at low risk for developing severe/critical COVID-19.
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Affiliation(s)
- Vahid Zangouri
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz,
Iran
- Surgical Oncology Division, General Surgery Department, Shiraz University of
Medical Sciences, Shiraz, Iran
| | - Aliyeh Ranjbar
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz,
Iran
| | - Farhad Homapour
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz,
Iran
- Surgical Oncology Division, General Surgery Department, Shiraz University of
Medical Sciences, Shiraz, Iran
| | | | - Shakila Gooya
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz,
Iran
| | - Mohammad Yasin Karami
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz,
Iran
- Surgical Oncology Division, General Surgery Department, Shiraz University of
Medical Sciences, Shiraz, Iran
| | - Elham Halimi
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz,
Iran
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2
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Karami MY, Dehghanpisheh L, Karami A, Sabzloun Z, Niazkar HR, Mojarad N, Panah A, Talei A, Tahmasebi S. Comparison of volatile/inhalational and IV anesthesia in long-term survival of patients with breast cancer: a retrospective study. Eur J Med Res 2022; 27:271. [PMID: 36463276 PMCID: PMC9719258 DOI: 10.1186/s40001-022-00911-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE Breast cancer is a worldwide health concern, and surgical removal has remained the preferred therapeutic option in most patients. Furthermore, the current study was designed to investigate the disease-free survival and overall survival in breast cancer patients, who receive either propofol or isoflurane during operation. METHOD This retrospective study was conducted on 994 patients (IV group, n = 530; volatile/inhalational group, n = 464) who underwent breast cancer operation from January 2006 to December 2016 at Faghihi Hospital, Shiraz, Iran. All studied patients were followed up till 2020. Patients are classified into two groups, IV and volatile/inhalational, according to the received anesthesia. For statistical analysis, The Cox regression test was conducted to investigate the association between factors affecting the recurrence of the disease and the Log Rank test was utilized to assess the patients' survival. Finally, to reduce the effect of confounding factors, all patients were matched according to age, tumor size and tumor grade. RESULTS Based on results from the log-rank test, the volatile/inhalational group had a better recurrence-free survival (P = 0.039) compared to the total IV group. However, the overall survival was not considerably different (P = 0.520). CONCLUSION The current study showed that although 2-year disease-free survival is higher in the volatile/inhalational group, there is no meaningful association between the 5-year overall survival and anesthesia technique.
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Affiliation(s)
- Mohammad Yasin Karami
- grid.412571.40000 0000 8819 4698Breast Diseases Research Center, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Laleh Dehghanpisheh
- grid.412571.40000 0000 8819 4698Department of Anesthesiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Karami
- grid.412571.40000 0000 8819 4698Department of Anesthesiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Sabzloun
- grid.412571.40000 0000 8819 4698Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Reza Niazkar
- grid.412571.40000 0000 8819 4698Breast Diseases Research Center, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Najmeh Mojarad
- grid.412571.40000 0000 8819 4698Breast Diseases Research Center, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ashkan Panah
- grid.412571.40000 0000 8819 4698Department of Anesthesiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdolrasoul Talei
- grid.412571.40000 0000 8819 4698Breast Diseases Research Center, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedigheh Tahmasebi
- grid.412571.40000 0000 8819 4698Breast Diseases Research Center, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
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3
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Rezaei S, Masoudi N, Karami MY, Sobhanian E, Amestejani M. Prognostic value of increased postoperative carcinoembryonic antigen in patients with early intestinal anastomosis leakage who underwent right hemicolectomy surgery. Pol Przegl Chir 2022; 95:20-24. [PMID: 36806164 DOI: 10.5604/01.3001.0015.8481] [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] [Indexed: 11/13/2022]
Abstract
<b> Introduction:</b> Anastomotic leak after colorectal surgery is a serious complication that causes significant postoperative morbidity and mortality. </br></br> <b>Aim:</b> This study aimed to investigate the predictive value of increased postoperative carcinoembryonic antigen (CEA) in early intestinal anastomosis leakage in patients who underwent right hemicolectomy surgery.</br></br> <b>Material and methods:</b> In this prospective study, 535 patients who underwent right colon cancer surgery with stapled anastomosis were enrolled. A subset of 315 patients was included in the study after meeting the inclusion criteria. Preoperatively, their serum CEA levels were measured, and on postoperative days 3 and 6, the levels were measured again.</br></br> <b>Results:</b> Early AL occurred in 18 patients (5.71%). The mean SD age of patients was 65.06 11.69 years. Increased CEA level was associated with increased odds of intestinal AL among the patients after three and six days of surgery (OR after three days = 1.3; 95%CI = 1.11.5, OR after six days = 1.7 95%CI = 1.142.5). The mean CEA level significantly increased among patients with anastomose leakage (P-value < 0.001). </br></br> <b>Conclusion:</b> The results showed that increasing CEA levels can be used as one of the non-invasive markers in detecting early AL in patients with right colon cancer surgery.
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Affiliation(s)
- Seifollah Rezaei
- Department of Surgery, Imam Khomeini hospital, Urmia University of Medical Sciences, Urmia, Iran
| | - Naser Masoudi
- Department of Surgery, Imam Khomeini hospital, Urmia University of Medical Sciences, Urmia, Iran
| | - Mohammad Yasin Karami
- MD (Cancer Surgeon), Department of Surgical Oncology,Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ehsan Sobhanian
- Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Amestejani
- Department of Surgery, Imam Khomeini hospital, Urmia University of Medical Sciences, Urmia, Iran
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4
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Zangouri V, Nasrollahi H, Taheri A, Akrami M, Arasteh P, Hamedi SH, Johari MG, Karimaghaee N, Ranjbar A, Karami MY, Tahmasebi S, Mosalaei A, Talei A. Intraoperative radiation therapy for early stage breast cancer. BMC Surg 2022; 22:26. [PMID: 35081942 PMCID: PMC8793207 DOI: 10.1186/s12893-021-01427-5] [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: 03/04/2021] [Accepted: 12/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background and objective We report our experiences with Intraoperative radiation therapy (IORT) among breast cancer (BC) patients in our region. Methods All patients who received radical IORT from April 2014 on to March 2020 were included in the study. Patient selection criteria included: Age equal or older than 45 years old; All cases of invasive carcinomas (in cases of lobular carcinomas only with MRI and confirmation); Patients who were 45–50 years old with a tumor size of 0–2 cm, 50–55 years old with a tumor size of < 2.5 cm, and those who were ≥ 55 years old with a tumor size of < 3 cm; Invasive tumors only with a negative margin; Negative nodal status (exception in patients with micrometastasis); A positive estrogen receptor status. Primary endpoints included death and recurrence which were assessed using the Kaplan–Meier method. Results Overall, 252 patients entered the study. Mean (SD) age of patients was 56.43 ± 7.79 years. In total, 32.9% of patients had a family history of BC. Mean (SD) tumor size was 1.56 ± 0.55 cm. Mean (IQR) follow-up of patients was 36.3 ± 18.7 months. Overall, 8 patients (3.1%) experienced recurrence in follow-up visits (disease-free-survival of 96.1%), among which four (1.5%) were local recurrence, two (0.8%) were regional recurrence and two patients (0.8%) had metastasis. Median (IQR) time to recurrence was 46 (22, 53.7) months among the eight patient who had recurrence. Overall, one patient died due to metastasis in our series. Eleven patients (4.3%) with DCIS in our study received IORT. All these patients had free margins in histopathology examination and none experienced recurrence. Conclusion Inhere we reported our experience with the use of IORT in a region where facilities for IORT are limited using our modified criteria for patient selection. Supplementary Information The online version contains supplementary material available at 10.1186/s12893-021-01427-5.
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Affiliation(s)
- Vahid Zangouri
- Surgical Oncology Division, General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran.,Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Nasrollahi
- Radiation Oncology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Taheri
- Trauma Research Center, Rajaei Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majid Akrami
- Surgical Oncology Division, General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Arasteh
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Hassan Hamedi
- Radiation Oncology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Nazanin Karimaghaee
- Core Medical Trainee, Northumbria Healthcare NHS Foundation /Trust, Newcastle Upon Tyne, UK
| | - Aliye Ranjbar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Yasin Karami
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedigheh Tahmasebi
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Ahmad Mosalaei
- Shiraz Institute for Cancer Research, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdolrasoul Talei
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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5
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Alvandipour M, Karami MY, Azadfar M, Yazdani Charati J. Inter sphincter rectal resection with and without Malone ante grade continence enema in cases with low rectal cancer: A randomized, prospective, single-blind, clinical trial. Caspian J Intern Med 2022; 13:546-554. [PMID: 35974933 PMCID: PMC9348201 DOI: 10.22088/cjim.13.3.546] [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: 05/04/2020] [Revised: 05/09/2021] [Accepted: 12/04/2021] [Indexed: 11/21/2022]
Abstract
Background Fecal incontinence is the main morbidity of inter-sphincteric resection (ISR) in ultra-low rectal cancer. Malone Ante grade Continence Enema (MACE) has been proposed for these patients. We aimed to compare the quality of life outcomes in cases with ultra-low rectal cancer who had undergone ISR±MACE. Methods The current randomized clinical study was accomplished for two years from December 2016 to February 2018 in Imam Khomeini Hospital (Sari City, I.R.Iran) on 30 patients (15 in each group) with rectal cancer. The inclusion criteria of the study were stage 1 and 2a of low rectal cancer with type 2 and 3 of Rullier's classification, those who received neoadjuvant chemo radiotherapy. The exclusion criteria were comorbidity diseases, immune deficiency, poor follow-up. The follow-up period was one year. The Quality of Life (Qol) was reported as primary endpoint. The EORTC QLQ-C30 score and Wexner questionnaires were used. SPSS Version 22 was used. A p-value less than 0.05 was considered statistically significant. Results The mean age of patients was 56.23± 8.72 years. The overall Qol score was better in the ISR-MACE (P=0.023). The overall Qol was lower in women than in men in both groups. Low anterior resection syndrome score was lower in the ISR plus MACE group than the ISR group (P=0.030). The Wexner score revealed better scores in the ISR with MACE group than the ISR without MACE group (p<0.0001). Conclusion Patients who underwent ISR plus MACE surgery had better defecation control and better quality of life than patients without MACE.
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Affiliation(s)
- Mina Alvandipour
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Science, Sari, Iran
| | - Mohammad Yasin Karami
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Correspondence: Mohammad Yasin Karami, Department of Surgery, Shiraz University of Medical Sciences, Zand Ave, Shiraz, Iran. E-mail: , Tel: 0098 7132236001, Fax: 0098 7132236001
| | - Mahmood Azadfar
- Department of Suregry, Mazandaran University of Medical Science, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
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6
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Nikoupour H, Arasteh P, Shamsaeefar A, Shafiekhani M, Moradi AM, Karami MY, Eghlimi H, Gondolesi GE, Nikeghbalian S. Surgical Management of Intestinal Failure; Initial Experiences from an Intestinal Failure, Rehabilitation and Transplant Unit in Iran. Arch Iran Med 2021; 24:289-295. [PMID: 34196188 DOI: 10.34172/aim.2021.40] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 09/20/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Intestinal failure (IF) is a life-threatening medical condition. The management of IF in low- and middle-income countries without home parenteral nutrition (HPN) remains unclear. We recently established an intestinal rehabilitation unit (IRU) and aimed to provide our experience on the current management and outcomes of IF in Iran. METHODS In this cross-sectional case series, data were collected from an established database on IF in the Shiraz Transplant Center in Abu Ali Sina hospital, affiliated to Shiraz University of Medical Sciences, Iran from January 2018 to October 2018. RESULTS Overall, 30 patients with a mean age of 44.13 ± 10.32 years, which included 25 males, were recruited. Short bowel syndrome (SBS) (60%) and enterocutaneous fistulae (27%), as complication of previous surgeries, were the main causes of IF. The most common type of IF was type 3 (67 %). Mesenteric ischemia was the leading mechanism of IF (47%). Fifteen patients (50%) received autologous gastrointestinal reconstruction surgery (AGIRS), and two (7%) patients had serial transverse enteroplasty (STEP). At the end of follow-up, 15 patients recovered from IF (50%). The overall survival rate was 83.3%. CONCLUSION This series introduced the results of a multidisciplinary program for the treatment of IF in a middle-income country that lacks facilities for HPN. Our protocol of care, understanding the need for development of HPN, showed promising clinical outcomes.
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Affiliation(s)
- Hamed Nikoupour
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Arasteh
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Shamsaeefar
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Shafiekhani
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Mohammad Moradi
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Yasin Karami
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hesameddin Eghlimi
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gabriel E Gondolesi
- Unidad de Insuficiencia, Rehabilitacion y Trasplante Intestinal, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - Saman Nikeghbalian
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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7
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Hassanpour SE, Farnoush N, Karami MY, Makarem A. The effect of silicone gel versus contractubex gel on the upper-extremity postsurgical scars: A randomized, double-blinded, controlled trial. Med J Islam Repub Iran 2020. [DOI: 10.47176/mjiri.34.146] [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: 11/09/2022] Open
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8
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Akrami M, Nasrollahi H, Vahabi M, Hamedi SH, Tahmasebi S, Karbasi S, Pashnesaz M, Zangouri V, Karami MY, Mosalaei A, Talei A. Intraoperative radiation therapy in non-breast cancer patients: A report of 26 cases from Shiraz, south of Iran. Med J Islam Repub Iran 2020. [DOI: 10.47176/mjiri.34.50] [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: 11/09/2022] Open
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9
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Hassanpour SE, Farnoush N, Karami MY, Makarem A. The effect of silicone gel versus contractubex gel on the upper-extremity postsurgical scars: A randomized, double-blinded, controlled trial. Med J Islam Repub Iran 2020; 34:146. [PMID: 33437742 PMCID: PMC7787045 DOI: 10.34171/mjiri.34.146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/29/2019] [Indexed: 11/24/2022] Open
Abstract
Background: Wound healing is a process that has three overlapping inflammatory, proliferative, and reconstruction phases. Silicone gel and Contractubex (onion extract gel) are two main topical agents used for the prevention and treatment of hypertrophic scars. This clinical trial study aimed to evaluate the efficacy and safety of onion extract and silicone gel on hypertrophic scars of the upper extremity and compare it to non-treated patients.
Methods: This randomized, double-blind, parallel, clinical trial was done on 120 male patients who had undergone upper extremity sharp injury repair. Patients were assigned to three groups, i.e., Silicone gel (Kelo-cortTM; WA, USA) (group 1; 40 patients), Onion extract (ContractubexTM, Merz Pharma, Frankfurt, Germany) gel (group 2; 40 patients), and No Intervention (group 3; 40 patients), using drawing sealed envelopes and a computer-based table of randomization. Data were recorded using the Vancouver scale in each visit by two surgeons who were blinded to the study groups. IBM SPSS Statistics for Windows, Version 22.0. (Armonk, NY: IBM Corp). Data were compared using the ANOVA test. A P-value of less than 0.05 was considered statistically significant.
Results: Vascularity (p=0.200), pliability (p=0.058), pigmentation (p=0.701), and height (p=0.438) as subjective scar parameters were approximately similar in post-upper extremity sharp injury wound hypertrophic scar among the three groups.
Conclusion: Vascularity, pliability, pigmentation and height, as subjective scar parameters, were not statistically different in post-upper extremity sharp injury wound hypertrophic scar among the groups. Even though onion extract gel and Silicone gel show preventive effects in the literature, especially in burns wounds, further studies are recommended to be conducted to prove the topical effects of above-mentioned gels in patients.
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Affiliation(s)
- Seyed Esmail Hassanpour
- Department of Plastic Surgery,15 Khordad Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazila Farnoush
- Department of Plastic Surgery,15 Khordad Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Yasin Karami
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Makarem
- Department of Urology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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10
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Paydar S, Karami MY, Nezhad GSM, Rezaei R, Makarem A, Noorafshan A, Mohseni S. Local Tranexamic Acid for Local Hemostasis in an Animal Liver Injury Model. J Emerg Trauma Shock 2020; 13:196-200. [PMID: 33304069 PMCID: PMC7717464 DOI: 10.4103/jets.jets_17_19] [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: 01/29/2019] [Accepted: 05/29/2019] [Indexed: 11/19/2022] Open
Abstract
Background: Hyperfibrinolysis is a state of increased clot resolution often seen in trauma patients with ongoing hemorrhage. Tranexamic acid (TXA) inhibits fibrinolysis preventing clot resolution affecting hemorrhage continuation and is used by intravenous administration. Aims: The purpose of this study was to evaluate the local tranexamic acid application for hemostatic control in an experimental animal liver injury model. Settings and Design: This study was an experimental prospective treatment study to check the local TXA effects on liver injury. This study was approved by the Ethics Committee. Materials and Methods: Twenty adult male Sprague-Dawley white rats were equally randomized to two groups after a standardized liver injury was conducted under anesthesia. One group were “liver-packed” with gauze (TXA [−]) and the other group with gauze soaked in TXA (TXA [+]). Bleeding from the injured middle liver lobe was measured at 2 and 15 min, and at 48h second-look surgery, with euthanasia conducted at 14 days. The liver was sent for histopathological and stereological analysis. Statistical Analysis and Results: There was no difference in bleeding at 2 or 15 min after packing; however, larger amount of free blood at 48 h in the TXA (−) group was noticed. Five animals in the TXA (−) were alive at 14 days compared to eight animals in the TXA (+) group. Significantly larger volume density of fibrosis, granulation tissue, and amorphous tissue were seen in the TXA (+) group compared to the TXA (−) group at the stereological analysis. Conclusion: Local TXA application on the injured liver surface might offer better hemostatic control than packing alone. Further studies are mandated before the clinical application of our findings.
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Affiliation(s)
- Shahram Paydar
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Yasin Karami
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Rouhollah Rezaei
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Makarem
- Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Noorafshan
- Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahin Mohseni
- Department of Surgery, Division of Trauma and Emergency Surgery, Orebro University Hospital and Orebro University, Orebro, Sweden
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11
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Akrami M, Nasrollahi H, Vahabi M, Hamedi SH, Tahmasebi S, Karbasi S, Pashnesaz M, Zangouri V, Karami MY, Mosallaei A, Talei A. Intraoperative radiation therapy in non-breast cancer patients: A report of 26 cases from Shiraz, south of Iran. Med J Islam Repub Iran 2020; 34:50. [PMID: 32884925 PMCID: PMC7456436 DOI: 10.34171/mjiri.34.50] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Indexed: 11/05/2022] Open
Abstract
Background: Intraoperative radiation therapy (IORT) is the delivery of radiation at the time of surgery. Whereas the dose delivered by external beam radiation therapy (EBRT) is limited by the tolerance of the surrounding normal tissues, IORT allows exclusion of a part or all of the dose-limiting sensitive structures by operative mobilization and/or direct shielding of these structures. The aim of the present study was to report the non-breast cancer patients' outcomes after receiving IORT in Shiraz, Iran. Methods: In this retrospective study, all cases who had received IORT and had non-breast malignancies were selected. Diagnosis was confirmed by biopsy. Additional imaging was done by sonography, magnetic resonance imaging (MRI) and computed tomography (CT). IORT was applied by self-shielded, LIAC 6-12 MeV Sordina mobile linear accelerator. Typically, a single dose of 10-21 Gy was given for maximally resected tumors. The statistical analyses were carried out using SPSS (version 21). Results: Twenty-six patients were treated with IORT alone or combined with EBRT. Different tumors were treated, including colorectal adenocarcinoma (10 cases, 38.4 %), Soft Tissue Sarcomas (STS, 11 cases, 42.3 %), head and neck cancers (3 cases, 11.5 %), one cervix malignancy case and one paravertebral fibromatosis case. Mean ± SD overall survival was 15±14.89 (0-38) and 34.3±15.72 (14-53) months for colorectal cancer and STS, respectively. Conclusion: IORT is mostly useful for pelvic and abdominal malignancies where normal bowel limits the dose that can be delivered with EBRT. However, the dose delivered in a single fraction with IORT is rarely sufficient for tumor control; therefore, IORT is usually preceded or followed by additional EBRT which should be further evaluated preferably in prospective randomized trials.
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Affiliation(s)
- Majid Akrami
- Breast Diseases Research Center, Department of Surgical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Nasrollahi
- Radiation Oncology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mostafa Vahabi
- Breast Diseases Research Center, Department of Surgical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Hassan Hamedi
- Radiation Oncology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedigheh Tahmasebi
- Breast Diseases Research Center, Department of Surgical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sareh Karbasi
- Radiation Oncology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehran Pashnesaz
- Breast Diseases Research Center, Department of Surgical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Zangouri
- Breast Diseases Research Center, Department of Surgical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Yasin Karami
- Breast Diseases Research Center, Department of Surgical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Mosallaei
- Radiation Oncology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdolrasoul Talei
- Breast Diseases Research Center, Department of Surgical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
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12
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Nikoupoor H, Moradi AM, Arasteh P, Shamsaeefar A, Karami MY, Eghlimi H, Shafiekhani M, Nikeghbalian S. Guideline for Management of Mesenteric Ischemia: Shiraz Intestinal Failure Unit Protocol. Arch Iran Med 2020; 23:422-425. [DOI: 10.34172/aim.2020.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 02/04/2020] [Indexed: 12/11/2022]
Abstract
We have recently established an intestinal rehabilitation unit (IRU) in Abu Ali Sina transplantation center affiliated to Shiraz University of Medical Sciences, Iran. Our intestinal failure rehabilitation and transplant program aims to provide state-of-the-art care for adult patients with different degrees of intestinal insufficiency and failure. In the IRU, we aimed to design an algorithmic approach to patients with small bowel ischemia and short bowel syndrome (SBS) based on our institutional experience in our country and based on other pioneering studies from other regions of the world.
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Affiliation(s)
- Hamed Nikoupoor
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Mohammad Moradi
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Arasteh
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Shamsaeefar
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Yasin Karami
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Surgical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hesameddin Eghlimi
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Shafiekhani
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saman Nikeghbalian
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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13
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Karami MY, Mansournia N, Bagherian N, Makarem A, MoeinVaziri N, Borna S, Pourdavood AH, Shamohammadi I. Effects of Azelnidipine-Carboxymethylcellulose Gel on Healing of Full-Thickness Skin Wounds in Streptozotocin Induced Diabetic Rats. Vet Med (Auckl) 2020; 10:215-222. [PMID: 31908995 PMCID: PMC6925554 DOI: 10.2147/vmrr.s224514] [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] [Received: 07/29/2019] [Accepted: 12/05/2019] [Indexed: 11/23/2022]
Abstract
Objective To evaluate the effects of azelnidipine-carboxyl methyl cellulose (AZL-CMC) gel and carboxyl methyl cellulose 2% gel (CMC) on the healing of full-thickness skin wounds of diabetic rats. Methods Fifteen Sprague Dawley male rats were studied. The rats were divided into three groups: AZL-CMC gel-treated, CMC 2% gel-treated, and control group. Wounds were assessed by wound area measurement every 3 days and histopathology samples were collected at 4, 7 and 12 days post wounding to evaluate the healing process using stereological study. Mann–Whitney U-test repeated measurement and non-parametric one-way analysis of variance (ANOVA) were used to analyze the data using SPSS, version 18. Results Numerical density of the fibroblasts of the AZL-CMC gel treated group was 59.17±2.69 (×104/mm3) and higher than the control 22.64±1.34 (×104/mm3) and CMC 2%-treated groups 40.80±5.27 (×104/mm3), respectively, P<0.001. The volume density of the collagen bundles and LV of the vessels were 83.1±4.46 and 42.16±5.78, respectively, in the AZL-CMC treated group, and higher compared to the control (53.96±5.07, 9.9±2.49) and the CMC 2%-treated (65.88±2.13, 18.1±2.20) groups (P <0.001). Conclusion The healing of AZL-CMC gel-treated wound was better than the control wounds, grossly. Wound healing processes and wound closure in the intervention group began sooner and was completed more quickly. The quantitative and qualitative parameters showed the significant wound healing effect of the AZL-CMC gel-treated group.
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Affiliation(s)
- Mohammad Yasin Karami
- Metabolic Disease Research Center, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran.,Breast Disease Research Center, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasrin Mansournia
- Metabolic Disease Research Center, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Neda Bagherian
- Department of Pediatrics, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Makarem
- Department of Urology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader MoeinVaziri
- Department of Surgery, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sahar Borna
- Student Research Committee, Faculty of Medicine, Sari University of Medical Sciences, Sari, Iran
| | - Amir Hossein Pourdavood
- Department of Surgery, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Iman Shamohammadi
- Department of Urology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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14
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Sharifkazemi MB, Mehdinejad E, Karami MY. P800 Effect of Valsalva Maneuver on echocardiographic systolic and diastolic parameters in patients with acute coronary syndrome, a comparison between normal and high ventricular filling pressures. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.456] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Nil
OnBehalf
Nil
Introduction
Echocardiography is used as a useful and common method for the assessments of left and right ventricular (LV & RV) systolic and diastolic functions. Valsalva Maneuver (VM) with the increase in the intra-thoracic and intra-abdominal pressure is often used as a simple, inexpensive and non-invasive method to diagnose some clinical conditions such as heart murmurs. However, in terms of echocardiography, the use of VM is limited to a few parameters for many years. On the other hand, blood level of N-Terminal Pro–B-Type Natriuretic Peptide (NT Pro–BNP) indirectly discriminates normal or high ventricular filling pressure (FP).
Purpose
The purposes of this research is to provide a comprehensive review of the technique and to compare the effect of VM in ACS patients, with and without elevated FP on either RV and LV diastolic and systolic echocardiographic parameters.
Methods
Thirty-eight patient, who were diagnosed with possible ACS; Unstable Angina Pectoris, NSTEMI and STEMI, underwent coronary angiography enrolled in this double–blinded clinical trial study. The mild Coronary Artery Disease (CAD) with normal levels of NT Pro–BNP were included in study group one and patients with significant CAD and high level of NT Pro–BNP who underwent PCI were included in study group two. All the systolic and diastolic indicators of both ventricles, totally twenty-four parameters those had mentioned in the academic literature previously, have been evaluated; once before Valsalva and once during stage 2 of the maneuver. Echocardiography is performed by an advanced echo machine and by an expert cardiologist- echocardiographer, which the recorded images were reviewed by the second echocardiographer separately.
Results
Between the two groups, LV parameter analysis showed significant difference in LV EF pre and post VM. However, there was statistically insignificant difference regarding other systolic as well as diastolic parameters. Between the two groups, RV parameters analysis showed no significant difference in systolic and diastolic parameters pre and post VM.
Conclusion
To the best of our knowledge, this is the first report assessing post VM changes in four chambers as well as mitral and tricuspid valves parameters in ACS patients with normal versus high level of FP. Previously, LV diastolic dysfunction and Doppler mitral inflow pattern correlation with VM were approved. In the present study, in addition to those known findings from before, except the LV ejection fraction (LVEF) that showed there was statistically significant difference in pre– and post-VM, other systolic parameters, as well as diastolic indicators in either RV and LV, were identical.
Therefore, we do not recommend conducting Valsalva maneuver on the rest of the other parameters to diagnose systolic and diastolic dysfunction in ACS patients with mild versus significant CAD who were assumed to have normal or elevated filling pressures.
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Affiliation(s)
- M B Sharifkazemi
- Shiraz University of Medical Sciences, Shiraz, Iran (Islamic Republic of)
| | - E Mehdinejad
- Shiraz University of Medical Sciences, Shiraz, Iran (Islamic Republic of)
| | - M Y Karami
- Shiraz University of Medical Sciences, Shiraz, Iran (Islamic Republic of)
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15
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Khoshmohabat H, Paydar S, Makarem A, Karami MY, Dastgheib N, Zahraei SAH, Rezaei R, Mahmoudi Nezhad GS. A review of the application of cellulose hemostatic agent on trauma injuries. Open Access Emerg Med 2019; 11:171-177. [PMID: 31534375 PMCID: PMC6682168 DOI: 10.2147/oaem.s205006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 02/12/2019] [Accepted: 07/24/2019] [Indexed: 11/22/2022] Open
Abstract
Introduction Planning for management of bleeding in trauma injuries is very important. The initial purpose in emergency situations should be immediate establishment of an efficient hemostasis, principally in its topical application. In this study, we aimed to review the major relevant articles in the case of application of cellulose hemostatic agent on trauma injuries. Methods We searched the online databases such as PubMed, MEDLINE, Wiley, EMBASE, ISI Web of Knowledge, and Scopus. Two reviewers independently searched and assessed the titles and abstracts of all articles. Results Upon screening the titles and abstracts, 24 studies were identified for full-text review. The oxidized cellulose had the best clotting times, while it demonstrated low absorption ability. Surgical and thermosensitive chitosan hemostatic could be valuable for managing hemorrhage from liver injuries in trauma patients. Conclusion Recently, the application of cellulose hemostatic agents has been one of the main improvements obtained for controlling bleeding in trauma injuries. However, generally according to the literature review, the decision about using each agent should be made on a case-by-case basis. However, it can be mentioned that the perfect hemostatic agent has not been still identified.
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Affiliation(s)
- Hadi Khoshmohabat
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Shahram Paydar
- Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Makarem
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Yasin Karami
- Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Niloofar Dastgheib
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Rohallah Rezaei
- Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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16
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Alvandipour M, Zamani MS, Ghorbani M, Charati JY, Karami MY. Comparison of Limberg Flap and Karydakis Flap Surgery for the Treatment of Patients With Pilonidal Sinus Disease: A Single-Blinded Parallel Randomized Study. Ann Coloproctol 2019:313-318. [PMID: 31113167 PMCID: PMC6968717 DOI: 10.3393/ac.2018.09.27] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 09/27/2018] [Indexed: 12/20/2022] Open
Abstract
Purpose Pilonidal sinus disease is a common condition, which mostly affects young men. While various surgical techniques have been introduced for treating intergluteal pilonidal disease (IPD), controversies still exist regarding the best surgical approach. The purpose of this study was to compare the efficiency and the short-term outcomes of Limberg flap and Karydakis flap surgeries for the treatments of patients with IPD. Methods A total of 80 patients with IPD who had underwent either Karydakis flap (KF group: n = 37) or Limberg flap (LF group: n = 27) surgery between January 2015 and January 2016 at Imam Khomeini Hospital of Sari in the North of Iran were recruited for inclusion in this randomized, single-blind study. Results Compared to the KF group, the LF group showed faster complete wound healing, longer duration of surgery and hospital stay, larger wound size, and shorter period of incapacity for work. The overall patient satisfaction in the LF group was significantly higher than that in the KF group. The visual analogue scale score of pain was lower in the LF group than in the KF group. Also, the overall frequency of postoperative complications was higher in the KF group than in the LF group. Recurrence was reported in one patient from the KF group. Conclusion Given the lower rate of postoperative complications and greater cosmetic satisfaction of patients, the Limberg flap procedure should be selected, instead of the Karydakis flap procedure, as the standard technique for treating patients with IPD.
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Affiliation(s)
- Mina Alvandipour
- Department of Colorectal Surgery, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Mojtaba Ghorbani
- Department of Colorectal Surgery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
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17
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Ayaz M, Karami MY, Deilami I, Moradzadeh Z. Effects of Early Versus Delayed Excision and Grafting on Restoring the Functionality of Deep Burn-Injured Hands: A Double-Blind, Randomized Parallel Clinical Trial. J Burn Care Res 2019; 40:451-456. [DOI: 10.1093/jbcr/irz033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Mehdi Ayaz
- Division of Burn and Reconstructive Surgery, Department of Surgery, Shiraz, Iran
| | | | - Iman Deilami
- Division of Burn and Reconstructive Surgery, Department of Surgery, Shiraz, Iran
| | - Zahra Moradzadeh
- Physiotherapy and Rehabilitation Department, Shiraz University of Medical Sciences, Shiraz, Iran
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18
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Paydar S, Mahmoudi Nezhad GS, Karami MY, Abdolrahimzadeh H, Samadi M, Makarem A, Noorafshan A. Stereological Comparison of Imbibed Fibrinogen Gauze versus Simple Gauze in External Packing of Grade IV Liver Injury in Rats. Bull Emerg Trauma 2019; 7:41-48. [PMID: 30719465 PMCID: PMC6360012 DOI: 10.29252/beat-070106] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Objective To evaluate the effect of imbibed fibrinogen gauze on survival, bleeding and healing in liver trauma. Methods This animal experimental study was conducted on 20 adult male Sprague-Dawley rats; with a mean weight of 300±50 gram; divided into two groups. Grade IV injury was induced to the subjects' liver. Then, the bleeding site was packed with simple gauze in the control group, and imbibed fibrinogen gauze in the experimental group. All animals were re-evaluated for liver hemostasis 48 hours after the initial injury. Bleeding in the intra peritoneal cavity was measured using Tuberculosis Syringe in the first and second operations. Subjects were followed-up for 14 days. Eventually, the rats were sacrificed and their livers were sent to a lab for stereological assessment. Statistical comparisons were performed via Mann-Whitney U-test using SPSS. P-Values less than 0.05 were considered to be statistically significant. Results Half of the rats in the control group died, while all the rats in the imbibed fibrinogen gauze group survived after two weeks (p= 0.032). Bleeding in the imbibed fibrinogen gauze was significantly less than control group, 48 hours' post-surgery (p<0.001). According to the stereological results, granulation tissue in the imbibed fibrinogen gauze group were more than the control group (P= 0.032). Also, fibrosis in the imbibed fibrinogen gauze group were more than the control group (P= 0.014). Conclusion Our study indicated that imbibed fibrinogen gauze can potentially control liver bleeding and improve survival through increasing granulation tissue and fibrosis in injured liver.
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Affiliation(s)
- Shahram Paydar
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohammad Yasin Karami
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Abdolrahimzadeh
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Samadi
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Makarem
- Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Noorafshan
- Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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19
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Ziaeian B, Karami MY, Sahafi SM. Photoclinic. Arch Iran Med 2018; 21:310-311. [PMID: 30041529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 04/15/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Bijan Ziaeian
- Department of Thoracic Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
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20
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Nikeghbalian S, Nikoupour H, Dehghani M, Karami MY, Hemati R. Cytoreductive Surgery and Hyperthermic Intraoperative Chemotherapy for Management of Peritoneal Carcinomatosis. Arch Iran Med 2018; 21:158-163. [PMID: 29693406] [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] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 12/11/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND Treatment of peritoneal metastases has gained interest among oncologic communities around the world. Cytoreductive surgery (CRS) and hyperthermic intraoperative chemotherapy (HIPEC) have come to be the treatment of choice for selected patients with peritoneal carcinomatosis (PC) in recent years. Prior to HIPEC, patients were treated with palliative support and only guaranteed a few months to live. We reviewed our first 30 patients who underwent CRS and HIPEC. The aim of the study was assessment of the patients' survival, morbidity, and mortality rate and identifying prognostic factors of patients treated with CRS and HIPEC. METHODS In this cross-sectional study, data were retrospectively collected from 45 patients (15 men and 30 women) who underwent CRS and HIPEC between December 2008 and October 2016, at Nemaazi educational hospital and Shiraz central hospital of Shiraz University of Medical Sciences. Peri-operative and regular follow-up data on survival and complications were gathered and analyzed to identify their prognostic value for survival. RESULTS The mean age of the patients was 49.7±16.46 years. The participants in this study consisted of 19 females (63.3%) and 11 males (36.7%). The most common primary tumor was ovarian cancer (30.1%). A completeness of cytoreduction score of CC0/CC1 was obtained in 80% of patients operated on with curative intent. The overall mortality rate was 20%. The 1- and 4-year overall survival (OS) were 89% and 54%, respectively. CONCLUSION CRS and HIPEC are most successful in treatment of selected patients. Development of complete resection with CRS in these 8 years and good OS in our patients encourage us to continue the procedure with all its difficulties and cost.
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Affiliation(s)
- Saman Nikeghbalian
- Shiraz Organ Transplantation Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamed Nikoupour
- Shiraz Organ Transplantation Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoud Dehghani
- Shiraz Organ Transplantation Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Yasin Karami
- Student Research Committee, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rahim Hemati
- Department of Cardiac Surgery, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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21
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Karami MY, Niakan H, Zadebagheri N, Mardani P, Shayan Z, Deilami I. Which One is Better? Comparison of the Acute Inflammatory Response, Raja Isteri Pengiran Anak Saleha Appendicitis and Alvarado Scoring Systems. Ann Coloproctol 2017; 33:227-231. [PMID: 29354605 PMCID: PMC5768477 DOI: 10.3393/ac.2017.33.6.227] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 07/12/2017] [Indexed: 12/13/2022] Open
Abstract
Purpose Acute appendicitis (AA) is one of the most common causes of an acute abdomen. The accuracies of the Alvarado and the acute inflammatory response (AIR) scores in the diagnosis of appendicitis is very low in Asian populations, so a new scoring system, the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) system, was designed recently. We applied and compared the Alvarado, AIR, and RIPASA scores in the diagnoses of appendicitis in the Iranian population. Methods We prospectively compared the RIPASA, Alvarado, and AIR systems by applying them to 100 patients. All the scores were calculated for patients who presented with right quadrant pain. Appendectomies were performed; then, the postoperative pathology reports were correlated with the scores. Scores of 8, 7, and 5 or more are optimal cutoffs for the RIPASA, Alvarado, and AIR scoring systems, respectively. The sensitivities, specificities, positive predictive values, negative predictive values (NPVs), positive and negative likelihood ratios (LRs) for the 3 systems were determined. Results The sensitivity and the specificity of the RIPASA score were 93.18% and 91.67%, respectively. The sensitivities of the Alvarado and the AIR scores were both 78.41%. The specificities of the Alvarado and the AIR scores were 100% and 91.67%, respectively. The RIPASA score correctly classified 93% of all patients confirmed with histological AA compared with 78.41% for the Alvarado and the AIR scores. Conclusion The RIPASA scoring system had more sensitivity, better NPV, a positive LR, and a less negative LR for the Iranian population whereas the Alvarado scoring system was more specific.
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Affiliation(s)
- Mohammad Yasin Karami
- Student Research Committee, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Niakan
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Fars Province, Shiraz, Iran
| | - Navid Zadebagheri
- Student Research Committee, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parviz Mardani
- Department of Surgery, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Shayan
- Trauma Research Center, Department of Community Medicine, The Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iman Deilami
- Student Research Committee, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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22
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Paydar S, Karami MY, Khalili H, Dehghankhalili M, Sabetian G, Ghaffarpasand F. Heart Rate Beat to Beat Variability of Trauma Patient in Neurogenic Shock State: Time to Introduce New Symptoms. Bull Emerg Trauma 2017; 5:141-142. [PMID: 28795056 PMCID: PMC5547199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 06/10/2017] [Accepted: 06/18/2017] [Indexed: 06/07/2023] Open
Affiliation(s)
- Shahram Paydar
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Yasin Karami
- Student Research Committee, Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hosseinali Khalili
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Dehghankhalili
- Student Research Committee, Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Golnar Sabetian
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fariborz Ghaffarpasand
- Student Research Committee, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
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Hodjati H, Sohrabi Nazari S, Dehghani Nazhvani S, Karami MY, Geramizadeh B. Inferior Vena Cava Reconstruction by Gallbladder Patch: An Experimental Design. Bull Emerg Trauma 2017; 5:160-164. [PMID: 28795059 PMCID: PMC5547202] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 04/22/2017] [Accepted: 04/22/2017] [Indexed: 06/07/2023] Open
Abstract
OBJECTIVE To evaluate the efficacy of the gallbladder for reconstruction of the inferior vena cava in a canine model. METHODS The experimental study was conducted on 5 dogs; an oval window with a diameter of (4×1 cm) was made in the inferior vena cava and then repaired using the autologous gallbladder patch with preservation of gallbladder function. The patency and functionality of the graft were assessed macroscopically and microscopically at 2 months postoperatively. RESULTS All the dogs were euthanized at 2 months, showing excellent patency of the vena cava macroscopically. In the microscopic examination, all the patches were completely endothelialized. No evidence of infection and inflammation and thrombosis was noted. CONCLUSION The gallbladder patch is an available and safe alternate for reconstruction of the inferior vena cava at least in animal model. However, further well designed prospective studies are needed to confirm this hypothesis.
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Affiliation(s)
- Hossein Hodjati
- Professor of vascular Surgery, General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sahar Sohrabi Nazari
- Trauma Research Center, General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohammad Yasin Karami
- Student Research Committee, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bita Geramizadeh
- Professor of pathology, Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
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Mardani P, Karami MY, Jamshidi K, Zadebagheri N, Niakan H. A Primary Pleural Hydatid Cyst in an Unusual Location. Tanaffos 2017; 16:166-169. [PMID: 29308082 PMCID: PMC5749330] [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: 11/05/2022]
Abstract
Hydatid cyst has a predilection to involve the liver and lungs. Most of the reported cases of intra-pleural hydatid cyst are secondary; primary involvement has rarely been reported in the English-language literature. Here, we report on a 33-year-old woman who presented with complaints of dyspnea, cough, low-grade fever, and chills over the previous 3 months. Primary pleural hydatidosis was suspected on abdominopelvic CT; hence, right thoracotomy and cystectomy were performed. Albendazole was administered postoperatively for 6 months. During this period, liver function tests and abdominal sonography results were normal. Despite its rarity, our case emphasizes that general surgeons should suspect primary hydatidosis of the plural cavity when they detect large cystic masses in patients with mediastinal shifting and radiography findings such as white lung, especially in patients with fever and dyspnea.
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Affiliation(s)
- Parviz Mardani
- Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Yasin Karami
- Student Research Committee, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Correspondence to: Karami MY, Address: Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran, Email address:
| | - Kamran Jamshidi
- Student Research Committee, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Navid Zadebagheri
- Student Research Committee, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Niakan
- Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
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Affiliation(s)
- Sedighe Tahmasebi
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Yasin Karami
- Department of Surgery, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mehrnoosh Maalhagh
- Department of Surgery, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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Alvandipour M, Gharedaghi B, Khodabakhsh H, Karami MY. Purse-String Versus Linear Conventional Skin Wound Closure of an Ileostomy: A Randomized Clinical Trial. Ann Coloproctol 2016; 32:144-9. [PMID: 27626025 PMCID: PMC5019967 DOI: 10.3393/ac.2016.32.4.144] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 07/14/2016] [Indexed: 01/07/2023] Open
Abstract
Purpose Infection is one of the most frequent complications that can occur after ileostomy closure. The incidence of wound infection depends on the skin closure technique, but there is no agreement on the perfect closure method for an ileostomy wound. The aim of this study was to evaluate the incidence of infection, the patient's approval, and the patient's pain between purse-string closure (PSC) and the usual linear closure (LC) of a stoma wound. Methods This randomized clinical trial enrolled 66 patients who underwent a stoma closure from February 2015 to May 2015 in Sari Emam Khomeini Hospital. Patients were divided into 2 groups according to the stoma closing method: the PSC group (n = 34) and the LC group (n = 32). The incidences of infection for the 2 groups were compared, and the patients' satisfaction and pain with the stoma were determined by using a questionnaire. Results Infection occurred in 1 of 34 PSC patients (2.9%) and in 7 of 32 LC patients (21.8%), and this difference was statistically significant (P = 0.021). Patients in the PSC group were more satisfied with the resulting wound scar and its cosmetic appearance at one month and three months after surgery (P = 0.043). Conclusion After stoma closure, PSC was associated with a significantly lower incidence of wound infection and greater patient satisfaction compared to LC. However, the healing period for patients who underwent PSC was longer than it was for those who underwent LC.
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Affiliation(s)
- Mina Alvandipour
- Department of Colorectal Surgery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Babak Gharedaghi
- Department of General Surgery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamed Khodabakhsh
- Department of Emergency Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Yasin Karami
- Student Research Committee, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Alvandipour M, Karami MY, Khalvati M, Khodabakhsh H. Incidentally Solitary, Synchronous, Metastatic Left Adrenal Mass From Colon Cancer. Ann Coloproctol 2016; 32:79-82. [PMID: 27218099 PMCID: PMC4865469 DOI: 10.3393/ac.2016.32.2.79] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 02/06/2016] [Indexed: 11/04/2022] Open
Abstract
The authors report the case of a 63-year-old man who underwent an open adrenalectomy for a synchronous, malignant, metastatic left adrenal tumor and a total colectomy for T3N0M1 (stage 4) primary, malignant colon cancer. Two polypoid lesions, one measuring 40 mm × 30 mm × 30 mm and the other measuring 20 mm × 10 mm × 10 mm, were found in the ascending colon and rectosigmoid (RS) junction, respectively, and a synchronous, malignant, left adrenal gland lesion measuring 70 mm × 50 mm × 30 mm was incidentally found on abdominal computed tomography scan. Histological examination revealed a metastatic, necrotic adenocarcinoma of the left adrenal mass, an adenocarcinoma of the cecal mass, and an adenomatous polyp (tubulovillous type) of the smallest polypoid lesion in RS junction that had invaded deeply into the submucosal layer. The patient recovered uneventfully, and his condition is now stable, with no evidence of local recurrence or metastatic disease, 2 years after the surgery. To the best of our knowledge, only 25 cases of an adrenalectomy for treating metastatic adrenal gland tumors have been reported to date; physicians should be aware of the possibility of this event.
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Affiliation(s)
- Mina Alvandipour
- Department of Surgery, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Mehdi Khalvati
- Department of Surgery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamed Khodabakhsh
- Department of Surgery, Mazandaran University of Medical Sciences, Sari, Iran
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Maalhagh M, Jahromi AS, Yusefi A, Razeghi A, Zabetiyan H, Karami MY, Madani AH. Effects of Prepubertal Acute Immobilization Stress on Serum Kisspeptin Level and Testis Histology in Rats. Pak J Biol Sci 2016; 19:43-48. [PMID: 26930799 DOI: 10.3923/pjbs.2016.43.48] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Stress has inhibitory effect on HPG axis through increasing cortisol serum level. In this study, the effect of acute prepubertal stress on kisspeptin, which plays essential role in puberty achievement is assessed. To do this experimental study thirty immature healthy male wistar rats of 4 weeks old and without any symptoms of puberty were selected randomly. These rats were divided into three groups, randomly. Two groups were chosen as control and pretest and one as stress (test) group. Immobilization stress was applied for 10 days and serum level of cortisol, testosterone and kisspeptin were measured. Primary and secondary spermatocyte and sertoli cell evaluated and compared among groups. Mean serum level of kisspeptin in pretest group, control group and stress (test) group were 0.0381 ± 0.0079, 91.0500 ± 4.87430 and 15.2156 ± 3.88135 pg mL(-1) respectively. Serum level of kisspeptin had significant differences between three groups (p < 0.001). Acute prepubertal immobilization stress led to decrease in serum level of kisspeptin and testosterone in stress (test) group compared to control groups. Also stress caused a significant decrease in the numbers of secondary spermatocytes of the test group.
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Mirzaei R, Mahjubi B, Alvandipoor M, Karami MY. Late presentation of anal canal duplication in adults: a series of four rare cases. Ann Coloproctol 2015; 31:34-6. [PMID: 25745625 PMCID: PMC4349915 DOI: 10.3393/ac.2015.31.1.34] [Citation(s) in RCA: 7] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 09/19/2014] [Indexed: 12/04/2022] Open
Abstract
Anal canal duplication (ACD) is a very rare condition, especially in adults. Four cases in adults are reported. In three cases, the orifice of duplication was located behind the native anus, and in one case, it was located anteriorly. In all cases, no communication between the anal canal and the tract of duplication was noted. Complete removals of the duplications were done through a perineal approach. Histology showed fibro-muscular tissue lined with a squamous epithelium. The postoperative courses were uneventful.
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Affiliation(s)
- Rezvan Mirzaei
- Department of Surgery, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Teheran, Iran
| | - Bahar Mahjubi
- Department of Surgery, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Teheran, Iran
| | - Mina Alvandipoor
- Department of Surgery, Mazandaran University of Medical Sciences, Sari, Iran
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Ghobadifar MA, Zabetian H, Karami MY, Mosallanezhad Z, Kalani N. [Importance of maternal body temperature recording after injection of meperidine during spinal anesthesia in patients undergoing cesarean section: an offering for conducting clinical studies]. Braz J Anesthesiol 2014; 64:449. [PMID: 25437707 DOI: 10.1016/j.bjan.2014.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 02/05/2014] [Indexed: 11/28/2022] Open
Affiliation(s)
- Mohamed Amin Ghobadifar
- Departamento do Comitê de Ética em Pesquisa, Jahrom University of Medical Sciences, Jahrom, Irã.
| | - Hassan Zabetian
- Departamento de Anestesiologia, Jahrom University of Medical Sciences, Jahrom, Irã
| | - Mohammad Yasin Karami
- Departamento de Cirurgia Geral, Mazandaran University of Medical Sciences, Mazandaran, Irã
| | - Zahra Mosallanezhad
- Departamento de Ginecologia e Obstetrícia, Shiraz University of Medical Sciences, Shiraz, Irã
| | - Navid Kalani
- Departamento de Anestesiologia, Jahrom University of Medical Sciences, Jahrom, Irã
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Zekavat OR, Makarem AR, Shayan Z, Shojaee M, Karami MY. Obesity and overweight among primary school children in Iran. Minerva Pediatr 2014; 66:579-584. [PMID: 25336101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM The aim of this paper was to describe the prevalence of overweight (preobesity and obesity) among 7- to 13-year-old children in different parts of Jahrom City, Southern Iran, during 2008-2009. METHODS A total of 1158 students (587 males and 571 females) aged 7-13 years were assessed over a period of 12 months. Schools were randomly selected in each district of the city, and the participating children were selected using stratified randomization for age, with the aid of a table of random numbers. Body Mass Index (BMI) was measured for each subject. We adopted the 5th, 85th and 95th percentiles of the CDC as cut-off points for thin, overweight and obese children, respectively, as generally accepted. RESULTS Age of the children ranged from 7 to 13 years with a mean of 9.9 ± 1.6 years. A total of 58 boys (9.9%) and 57 girls (10%) were overweight, and the difference between them was not statistically significant. However, obesity was less prevalent among girls (4.9%) compared to boys (5.1%). CONCLUSION In this survey, prevalence of obesity among girls and boys was 4.9% and 5.1%, respectively. The scope of prevalence of obesity is remarkable enough for a mid-size semi-industrialized society in comparison with heavy industrialized parts of Iran, thus there is an urgent need to target younger ages for prevention and implementation of public educational programs to curtail this rising trend of obesity in young men and women.
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Affiliation(s)
- O R Zekavat
- Department of Pediatrics Jahrom University of Medical Sciences Jahrom, Iran -
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Ghobadifar MA, Zabetian H, Karami MY. Spinal pethidine and shivering for elective caesarean section. Anaesth Intensive Care 2013; 41:805. [PMID: 24180725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- M A Ghobadifar
- Jahrom University of Medical Sciences, Medicine School, Ghasrodasht Avenue,Shiraz, Iran
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Zabetian H, Jahromi AS, Karami MY, Ghobadifar MA. Antishivering Effect of Low Dose Meperidine in Caesarean Section under Spinal Anesthesia: A Randomized Double-blind Placebo-controlled Trial. INT J PHARMACOL 2013. [DOI: 10.3923/ijp.2013.305.311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Paydar S, Karami MY, Bolandparvaz S, Abbasi HR, Akrami M, Amanat A. Side-curtain air bag is a protective item: an effective necessity. Am J Surg 2012; 204:558. [DOI: 10.1016/j.amjsurg.2011.02.016] [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] [Received: 02/08/2011] [Accepted: 02/18/2011] [Indexed: 10/14/2022]
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