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Omidi F, Khoshmirsafa M, Kianmehr N, Faraji F, Delbandi A, Seif F, Shekarabi M. Comparison of circulating miR-148a and miR-126 with autoantibodies as biomarkers of lupus nephritis in patients with SLE. J Immunoassay Immunochem 2022; 43:634-647. [PMID: 35938736 DOI: 10.1080/15321819.2022.2099225] [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: 01/11/2023]
Abstract
Lupus nephritis (LN) is the main manifestation of systemic Lupus Erythematosus (SLE). MicroRNAs (miRNAs) and autoantibodies could be suitable candidate biomarkers of LN. This study evaluates the expression of circulating miR-148a and miR-126 along with anti-dsDNA, anti-C1q, and anti-C3b autoantibodies in SLE patients with LN (SLE + LN). 30 women with SLE, 30 women with SLE + LN, and 25 women as healthy controls (HCs) were enrolled in this study. The plasma expression of selected miRNAs was evaluated by real-time PCR. The serum level of anti-dsDNA, C1q, and C3b antibodies was measured by the ELISA. The expression of miR-148a was significantly increased in SLE and SLE+LN groups compared with the control group. No significant difference was found in the expression of miR-126 among the groups. The frequency of autoantibodies was significantly higher in the SLE + LN group than SLE. The Higher levels of circulating miR-148a in the SLE samples compared with the HCs suggest that this miRNA could be a reliable biomarker for SLE patients (with or without LN). Also, autoantibodies against dsDNA, C1q, and, C3 could be used for the prediction of SLE nephritis, independently. However, further studies are needed to confirm these findings.
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Affiliation(s)
- Frouzan Omidi
- Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.,Immunology Department, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Khoshmirsafa
- Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.,Immunology Department, Iran University of Medical Sciences, Tehran, Iran
| | - Nahid Kianmehr
- Rheumatology, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Faraji
- Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Delbandi
- Immunology Department, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Seif
- Immunology, Academic Center for Education Culture and Research, Tehran, Iran
| | - Mehdi Shekarabi
- Immunology Department, Iran University of Medical Sciences, Tehran, Iran
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2
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Kianmehr N, Khoshmirsafa M, Shekarabi M, Falak R, Haghighi A, Masoodian M, Seif F, Omidi F, Shirani F, Dadfar N. High frequency of concurrent anti-C1q and anti-dsDNA but not anti-C3b antibodies in patients with Lupus Nephritis. J Immunoassay Immunochem 2021; 42:406-423. [PMID: 33788670 DOI: 10.1080/15321819.2021.1895215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Lupus Nephritis (LN) in patients with Systemic Lupus Erythematosus (SLE) is one of the most serious and prevalent manifestations. The procedure of renal biopsy is harmful and accompanied by potential hazards. Therefore, introducing reliable biomarkers to predict LN is exceedingly worthwhile. In the present study, we compared the diagnostic values of circulating autoantibodies against dsDNA, C1q, C3b, SSA, SSB, and Sm alone or in combination to predict LN. This study evaluated the abovementioned autoantibodies in 40 healthy controls (HCs) and 95 SLE patients with different kidney involvements, including absent (n = 40), inactive (n = 20), and active (n = 35) LN using EIA method. The frequency and odds ratio of anti-dsDNA (71.4%, OR = 4.2), anti-C1q (62.9%, OR = 5.1), and the simultaneous existence of anti-C1q and anti-dsDNA (51.4%, OR = 6) antibodies were significantly higher in the active LN group compared with both inactive and absent LN groups. Moreover, the levels of anti-C1q and anti-dsDNA antibodies positively correlated with disease activity in patients with SLE. The prevalence of these autoantibodies was associated with the severity of LN biopsies. These data suggest that anti-C1q and anti-dsDNA antibodies and also their simultaneous presence may be valuable diagnostic biomarkers for LN prediction in patients with SLE.
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Affiliation(s)
- Nahid Kianmehr
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Khoshmirsafa
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Immunology Research Center, Institute of Immunology and Infectious Diseases Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Shekarabi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Immunology Research Center, Institute of Immunology and Infectious Diseases Iran University of Medical Sciences, Tehran, Iran
| | - Reza Falak
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Immunology Research Center, Institute of Immunology and Infectious Diseases Iran University of Medical Sciences, Tehran, Iran
| | - Anousheh Haghighi
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Masoodian
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Seif
- Academic Center for Education, Culture and Research, Tehran, Iran
| | - Forouzan Omidi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Shirani
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran
| | - Nima Dadfar
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran
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Masoumi G, Noyani A, Dehghani A, Afrasiabi A, Kianmehr N. Investigation of the relationship between end-tidal carbon dioxide and partial arterial carbon dioxide pressure in patients with respiratory distress. Med J Islam Repub Iran 2020. [DOI: 10.47176/mjiri.34.67] [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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4
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Masoumi G, Noyani A, Dehghani A, Afrasiabi A, Kianmehr N. Investigation of the relationship between end-tidal carbon dioxide and partial arterial carbon dioxide pressure in patients with respiratory distress. Med J Islam Repub Iran 2020; 34:67. [PMID: 32974233 PMCID: PMC7500426 DOI: 10.34171/mjiri.34.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Indexed: 12/01/2022] Open
Affiliation(s)
- Gholamreza Masoumi
- Department of Emergency Medicine, Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Noyani
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Arezoo Dehghani
- School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Afrasiabi
- Hazrat Rasool-e-Akram Hospital, Iran University of Medical Sciences and Health Services, Tehran, Iran
| | - Nahid Kianmehr
- Department of Internal Medicine, Hazrat Rasool-e-Akram Hospital, Iran University of Medical Sciences and Health Services, Tehran, Iran
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Hajsadeghi S, Mirshafiee S, Pazoki M, Moradians V, Mansouri P, Kianmehr N, Iranpour A. The relationship between global longitudinal strain and pulmonary function tests in patients with scleroderma and normal ejection fraction and pulmonary artery pressure: a case-control study. Int J Cardiovasc Imaging 2020; 36:883-888. [PMID: 32060775 DOI: 10.1007/s10554-020-01788-7] [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: 10/05/2019] [Accepted: 01/31/2020] [Indexed: 11/25/2022]
Abstract
This study examined the relationship between global longitudinal strain (GLS) and pulmonary function tests (PFT) in patients with systemic sclerosis (SS) and normal ejection fraction (EF) and pulmonary artery pressure (PAP) and healthy controls. Sixty patients in two groups underwent extensive screening, including echocardiography, physical examination, the modified Rodnan Skin Score, and pulmonary function tests. Pulmonary interstitial disease was diagnosed by the pulmonary function test and by CT scan in case of indication. GLS score was computed as the mean peak systolic strain for 17 segments. The mean GLS score was - 18.36 ± 2.1 in the case group and - 20.66 ± 1.6 in the control group (P value < 0.001). GLS scores had a significant inverse relationship with the forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) ratio (P value = 0.049) and both FEV and FVC in patients younger than 35 years old (P = 0.046 and 0.049, respectively). GLS scores had no significant relationship with time elapsed since the onset of skin manifestations, and Raynaud phenomenon, Rodnan score, EF, systolic PAP, or the six-minute walk test results. The patients' six-minute walk test had a significant positive relationship with FVC and right ventricular end diastolic diameter (P value = 0.018 and 0.047, respectively). According to our findings, GLS is significantly lower in patients with SS (with normal EF & PAP) than in healthy individuals. It is also related with certain pulmonary function indices including FEV1/FVC. The reduction in GLS is associated with reduced pulmonary function strength.
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MESH Headings
- Adult
- Arterial Pressure
- Case-Control Studies
- Exercise Tolerance
- Female
- Forced Expiratory Volume
- Humans
- Lung/blood supply
- Lung/physiopathology
- Lung Diseases, Interstitial/diagnosis
- Lung Diseases, Interstitial/etiology
- Lung Diseases, Interstitial/physiopathology
- Male
- Middle Aged
- Myocardial Contraction
- Prognosis
- Pulmonary Arterial Hypertension/diagnosis
- Pulmonary Arterial Hypertension/etiology
- Pulmonary Arterial Hypertension/physiopathology
- Pulmonary Artery/physiopathology
- Risk Factors
- Scleroderma, Systemic/complications
- Scleroderma, Systemic/diagnosis
- Scleroderma, Systemic/physiopathology
- Ventricular Dysfunction, Left/diagnostic imaging
- Ventricular Dysfunction, Left/etiology
- Ventricular Dysfunction, Left/physiopathology
- Ventricular Function, Left
- Ventricular Function, Right
- Vital Capacity
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Affiliation(s)
- Shokoufeh Hajsadeghi
- Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology & Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mahboubeh Pazoki
- Department of Cardiovascular Disease, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Vahan Moradians
- Pulmonology Department, Hazrat-e-Rasoul Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Pejman Mansouri
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nahid Kianmehr
- Internal Medicine Department, Iran University of Medical Sciences, Tehran, Iran
| | - Aida Iranpour
- Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology & Metabolism, Iran University of Medical Sciences, Tehran, Iran
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Mofidi M, Kianmehr N, Qomi YF, Zaim SN, Moghadam PH, Rezai M, Farsi D, Abbasi S, Mahshidfar B. Daylight saving time and incidence ratio of acute myocardial infarction among Iranian people. J Med Life 2019; 12:123-127. [PMID: 31406512 PMCID: PMC6685301 DOI: 10.25122/jml-2017-0058] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Iran is among the countries which change official time, every year according to their constitutions. Studies have shown an increase of incidence ratio (IR) of acute myocardial infarction by these time transitions. Despite annual time changes in Iran, there is no published data to prove this among the Iranian. This retrospective study examined the IR of patients with AMI, who were admitted to the Emergency Department (ED) of 5 teaching hospitals during the week just after the time transitions (observed period), with two weeks before and after the time transitions (expected period), both in spring and fall. In total, 11051 patients were admitted during the ten weeks (observed and expected), in both spring and fall time transitions. The IR of AMI during both observed and expected period did not show any significant difference (p > 0.05); however, the incidence of AMI was increased during the first week after the transition in spring (p > 0.05). Although the results of the present study did not prove the relation between time transitions and incidence of AMI, a slight increase existed for IR of AMI during three days after spring shift. This increase in IR of AMI can be due to Nowrooz, the national holidays which lasts four days after turning clocks forward in Iran.
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Affiliation(s)
- Mani Mofidi
- Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nahid Kianmehr
- Iran University of Medical Sciences, Department of Rheumatology, Hazrat Rasoul Akram Complex, Tehran, Iran
| | | | - Sonia N Zaim
- Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Peyman Hafezi Moghadam
- Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdi Rezai
- Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Davood Farsi
- Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Abbasi
- Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Babak Mahshidfar
- Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran
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Khajoei S, Hassaninevisi M, Kianmehr N, Seif F, Khoshmirsafa M, Shekarabi M, Samei A, Haghighi A. Serum levels of adiponectin and vitamin D correlate with activity of Rheumatoid Arthritis. Mol Biol Rep 2019; 46:2505-2512. [PMID: 30919210 DOI: 10.1007/s11033-019-04682-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 11/18/2018] [Accepted: 02/07/2019] [Indexed: 01/07/2023]
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease in which numerous cells and mediators affect inflammatory conditions and disease severity. To compare the serum levels of adiponectin, vitamin D, copper, and zinc in patients with RA and to investigate the relationship between these parameters and RA severity. Ninety patients with RA and 30 healthy controls participated in this cross-sectional case-control study between November 2016 and April 2017; according to the ACR/EULAR criteria for RA. Serum levels of adiponectin were determined by ELISA; copper and zinc by colorimetric spectrophotometry; and vitamin D by HPLC. Kruskal-Wallis and Spearman tests were performed using SPSS software and data were depicted by GraphPad Prism software. Compared with healthy controls, the serum level of adiponectin was significantly increased, whereas vitamin D was significantly decreased in patients with RA. Adiponectin and vitamin D levels were inversely correlated in RA subgroups (P < 0.001, r = - 0.410). Adiponectin and vitamin D correlated with RA severity. Furthermore, no significant difference was found in copper and zinc levels between RA groups and controls. The definitive roles of adiponectin, vitamin D, copper, and zinc are not completely determined in RA development. Based on disease activity, these parameters can modulate inflammatory conditions, thus they have the potential to be used as promising therapeutic biomarkers to follow up the severity of disease, as well as the progression and treatment success in patients with RA.
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Affiliation(s)
- Sholeh Khajoei
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran
| | | | - Nahid Kianmehr
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Seif
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Neuroscience Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Khoshmirsafa
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Shekarabi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Azam Samei
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Neuroscience Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Anousheh Haghighi
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran.
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8
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Khoshmirsafa M, Kianmehr N, Falak R, Mowla SJ, Seif F, Mirzaei B, Valizadeh M, Shekarabi M. Elevated expression of miR-21 and miR-155 in peripheral blood mononuclear cells as potential biomarkers for lupus nephritis. Int J Rheum Dis 2018; 22:458-467. [PMID: 30398001 DOI: 10.1111/1756-185x.13410] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [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: 01/03/2018] [Revised: 08/06/2018] [Accepted: 09/15/2018] [Indexed: 12/20/2022]
Abstract
AIM Lupus nephritis (LN) is a severe complication of systemic lupus erythematosus (SLE). There is a great interest in using microRNAs (miRNAs) as diagnostic and prognostic biomarkers in autoimmune diseases. MATERIALS AND METHODS This study evaluated miR-16, miR-21, miR-141, miR-146a, and miR-155 expression levels in peripheral blood mononuclear cells (PBMCs) of 55 female SLE patients with absent, inactive, or active nephritis, and 30 healthy controls (HCs) using quantitative polymerase chain reaction. RESULTS MiR-21 and miR-155 levels were significantly greater in the active nephritis group than in the absent, inactive or HC groups. Moreover, receiver operating characteristic and logistic regression analyses revealed miR-21 and miR-155 were significant risk factors for LN. CONCLUSION Overexpression of miR-21 and miR-155 in PBMCs may participate in LN pathophysiology and these miRNAs could be used as biomarkers for the condition.
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Affiliation(s)
- Majid Khoshmirsafa
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Nahid Kianmehr
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Falak
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Javad Mowla
- Department of Molecular Genetics, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
| | - Farhad Seif
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Behnaz Mirzaei
- Department of Genetics, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mohadeseh Valizadeh
- Department of Genetics, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mehdi Shekarabi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
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Nazari Soltan Aahmad S, Nourollahi S, Kazerouni F, Kianmehr N, Hajipour H, Sanajou D, Hosseini V. Investigation of the relation between bone mass density and serum preptin levels in pre- and postmenopausal women. J Bone Miner Metab 2018; 36:710-715. [PMID: 29134283 DOI: 10.1007/s00774-017-0882-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 06/09/2017] [Accepted: 10/11/2017] [Indexed: 12/27/2022]
Abstract
Preptin is a peptide hormone co-secreted with insulin and amylin from pancreatic β cells. It has been demonstrated to have osteogenic effects both in vitro and in vivo. In the present study, serum preptin levels were measured in pre- and postmenopausal women with similar body mass indexes (BMIs) to elucidate its link with bone mineral density (BMD). Sixty women (30 premenopausal and 30 postmenopausal) with low bone mineral density were studied. The BMD scores, serum preptin levels and serum estradiol levels were measured. The correlation between serum preptin and estradiol levels with BMD was assessed. Serum preptin and estradiol levels were significantly lower in the postmenopausal women than the premenopausal subjects [2102.27 ± 918.66 vs. 2667.30 ± 940.41 ng/L (P < 0.05) and 39.32 ± 31.74 vs. 99.24 ± 49.24 pg/ml (P < 0.001), respectively]. The serum preptin levels had weak positive (albeit statistically significant) correlations with estradiol (r = 0.271, P = 0.036), femur neck BMD (r = 0.233, P = 0.035) and total hip BMD (r = 0.287, P = 0.031), but no correlation was observed between serum preptin levels and L1-4 lumbar spine BMD (r = 0.136, P = 0.474). The findings of the present study suggest that serum preptin levels in women decrease after menopause and have a positive correlation with estradiol, femoral and total hip BMDs.
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Affiliation(s)
- Saeed Nazari Soltan Aahmad
- Department of Medical Laboratory Sciences, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Sajjad Nourollahi
- Department of Medical Laboratory Sciences, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Faranak Kazerouni
- Department of Medical Laboratory Sciences, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran.
| | - Nahid Kianmehr
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran
| | - Hamed Hajipour
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Davoud Sanajou
- Department of Biochemistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Hosseini
- Department of Biochemistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Kianmehr N, Hasanzadeh A, Naderi F, Khajoei S, Haghighi A. A randomized blinded comparative study of clinical response to surface anatomy guided injection versus sonography guided injection of hyaloronic acid in patients with primary knee osteoarthritis. Int J Rheum Dis 2017; 21:134-139. [DOI: 10.1111/1756-185x.13123] [Citation(s) in RCA: 11] [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: 11/30/2022]
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11
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Kianmehr N, Haghighi A, Moghaddasi M, Mofidi M. Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) as a first presentation of systemic lupus erythematosus. ACTA ACUST UNITED AC 2017. [DOI: 10.22631/rr.2017.69997.1021] [Citation(s) in RCA: 2] [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: 11/06/2022]
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12
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Mosaddegh R, Kianmehr N, Mahshidfar B, Rahmani Z, Aghdam H, Mofidi M. Serum cortisol level and adrenal reserve as a predictor of patients' outcome after successful cardiopulmonary resuscitation. J Cardiovasc Thorac Res 2016; 8:61-4. [PMID: 27489598 PMCID: PMC4970572 DOI: 10.15171/jcvtr.2016.12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 06/03/2016] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION It is thought that pituitary-adrenal axis has a fundamental role in outcome of cardiopulmonary arrest (CPA). This study designed to evaluate the correlation between adrenal reserve and post-resuscitation outcome. METHODS In this clinical trial study, 52 consecutive patients with CPA were enrolled in two emergency departments (EDs) over a 3-month period. Plasma cortisol level was measured at the beginning of CPR. Intravenous adrenocorticotropic hormone (ACTH) stimulation test was carried out after successful CPR, and blood samples were taken at 30 and 60 minutes, and 24 hours thereafter. Patients were divided into two groups: in-hospital death or hospital discharge. RESULTS In patients who died, baseline and post-ACTH serum cortisol after 30 and 60 minutes and 24 hours were higher than patients who discharged from the hospital, but it was not statistically significant except to that of minute 60 (P=0.49). A model of multivariate logistic regression analysis showed that age and need for vasopressor infusion correlated with mortality. CONCLUSION Current study could not show the statistically significant difference in initial and post-ACTH serum cortisol levels between survivor and non-survivor patients with cardiac arrest who had initial successful CPR, except to that of minute 60.
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Affiliation(s)
- Reza Mosaddegh
- Firoozgar Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Nahid Kianmehr
- Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Babak Mahshidfar
- Emergency Management Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Rahmani
- Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Hamed Aghdam
- Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mani Mofidi
- Emergency Management Research Center, Iran University of Medical Sciences, Tehran, Iran
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13
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Kianmehr N, Bidari A, Mofidi M, Bahar N. Silent osteonecrosis of the femoral head following high-dose corticosteroids in patients with systemic rheumatic diseases. Med J Islam Repub Iran 2015; 29:259. [PMID: 26793650 PMCID: PMC4715417] [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: 01/10/2015] [Accepted: 05/17/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Osteonecrosis (ON) is known to be one of the most disabling complications following corticosteroid (CS) medications. However, evidence regarding risk of asymptomatic prevalence of ON among different diseases and the impact of variable steroid regimens are conflicting. We aimed to determine the prevalence of ON of femoral head in asymptomatic patients with systemic rheumatic diseases who received high-dose CS and also clarify its relationship with different dosages and regimens. METHODS In this cross-sectional study, 50 consecutive patients receiving high-dose CS for rheumatic diseases who have no pelvic pain were recruited. MRI of both hips was performed on all patients using a 1.5 Tesla to diagnose ON. RESULTS Of 50 subjects, 18 (36%) developed ON of the femoral head. Groups with and without ON were comparable in terms of sex, age and mean starting CS dose. There was no statistical difference in the type of CS regimen including daily dose, peak dose and cumulative dose between the two groups. However, silent ON was associated with both the cumulative CS dose and the duration of CS therapy. CONCLUSION According to high prevalence of ON in our selected patients with no other identifiable risk factor for ON, monitoring of high risk patients with periodic hip MRI would help diagnose necrosis in early stage.
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Affiliation(s)
- Nahid Kianmehr
- 1 Associate Professor of Rheumatology, Internal Medicine Department, Rheumatology Division, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Ali Bidari
- 2 Associate Professor of Rheumatology, Emergency Medicine Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Mani Mofidi
- 3 Associate Professor of Emergency Medicine, Emergency Medicine Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Nasim Bahar
- 4 MD, Internal Medicine Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. ,(Corresponding author) MD, Internal Medicine Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
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Abstract
AIM Fibromyalgia syndrome (FMS) is a common rheumatologic disorder characterized by easy fatigability, widespread musculoskeletal pain and sleep disorder. In spite of its high prevalence, general practitioners, as primary care providers, seem to have inadequate knowledge about FMS. This study aimed to assess Iranian general practitioners' knowledge about FMS and its treatment. METHOD A detailed questionnaire (including items on signs and symptoms, diagnostic criteria and treatment) was completed by 190 general practitioners (54.7% male; mean age: 41 years). Data analysis was performed with SPSS for Windows 15.0 and awareness about all aspects of FMS was reported as percentages. RESULTS About one-third (30%) of the participants had seen at least one case of FMS during their practice. Most subjects (62.7%) claimed to know 1-6 tender points. Only 3.2% knew 16-18 points. The common proposed symptoms of FMS were widespread pain (72.6%), excessive fatigue (72.6%), weakness (60.5%), sleep disorder (36.3%), anxiety (34.7%) and depression (34.2%). Wrong symptoms including elevated erythrocyte sedimentation rate and C-reactive protein, arthritis, joint swelling, weight loss and abnormal radiologic findings were selected by 27.9%, 18.9%, 14.7%, 12.6% and 2.1% of the physicians, respectively. Moreover, selective serotonin reuptake inhibitors, tricyclic antidepressant and pregabalin were identified as treatment options for FMS by, respectively, 45.8%, 22.1% and 15.3% of the participants. Finally, 52.1% and 23.7% of the subjects incorrectly considered nonsteroidal anti-inflammatory drugs and corticosteroids as treatment modalities for FMS. CONCLUSION Iranian general practitioners are not well informed about FMS. Therefore, FMS should be specifically integrated in continuing medical education programs and undergraduate medical training curriculum.
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Affiliation(s)
- Nahid Kianmehr
- Department of Rheumathology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Anousheh Haghighi
- Department of Rheumathology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Bidari
- Department of Rheumathology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Yaser Sharafian Ardekani
- Department of Rheumathology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Karimi
- Department of Rheumathology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Farsi D, Fadaki AAK, Kianmehr N, Abbasi S, Rezai M, Marashi M, Mofidi M. Role of plasma ammonia level in detecting intra-abdominal hemorrhage following blunt abdominal trauma. J Res Med Sci 2014; 19:1080-5. [PMID: 25657755 PMCID: PMC4310083] [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: 11/27/2013] [Revised: 06/15/2014] [Accepted: 09/23/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Blunt abdominal injury is a leading cause of death in trauma patients. A reliable test predicting intra-abdominal hemorrhage would be a novel method. The study objective was to assess the diagnostic accuracy of plasma ammonia in detection of intra-abdominal bleeding in patients with blunt abdominal trauma (BAT). MATERIALS AND METHODS In this observational study, all patients suffering from BAT, referred to our university teaching hospital included. The levels of ammonia were measured at the time of emergency department admission and 1 h after initial treatment. Demographic data, vital signs, and venous blood gas reports were recorded. Findings of contrast-enhanced abdominopelvic computed tomography scan and laparotomy were assumed as a gold standard for abdominal injuries. RESULTS A total of 104 patients was enrolled in the study. 15 patients (14.4%) had intra-abdominal hemorrhage and the mean plasma ammonia level in this group was significantly higher than the other patients on admission time (101.73 ± 5.41 μg/dL vs. 47.36 ± 26.31 μg/dL, P < 0.001). On receiver-operator characteristic curve analysis, in cutoff point of 89 μg/dL, the sensitivity, specificity, positive and negative likelihood ratios were 100% (95% confidence interval [CI], 79.6-100), 93.26% (95% CI, 86-96.8), 14.83 (95% CI, 6.84-32.12), and 0, respectively. CONCLUSION The study findings suggest the measurement of ammonia level at the time of admission in the patients with BAT would be a useful test predicting intra-abdominal hemorrhage. Furthermore, decrease in the ammonia level could be a useful marker for monitoring response to treatment in these patients.
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Affiliation(s)
- Davood Farsi
- Department of Emergency Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Nahid Kianmehr
- Department of Internal Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Abbasi
- Department of Emergency Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdi Rezai
- Department of Emergency Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Marashi
- Department of Emergency Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mani Mofidi
- Department of Emergency Medicine, Iran University of Medical Sciences, Tehran, Iran,Address for correspondence: Dr. Mani Mofidi, Department of Emergency, Iran University of Medical Sciences, Sattarkhan Ave., Nyaiesh St., Rasoul Akram Complex, Tehran, Iran. E-mail:
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Samimagham H, Haghighi A, Tayebi M, Jenabi A, Arabi M, Kianmehr N. Prevalence of fibromyalgia in hemodialysis patients. Iran J Kidney Dis 2014; 8:236-239. [PMID: 24878948] [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] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 11/18/2013] [Indexed: 06/03/2023]
Abstract
This study sought to determine the prevalence of fibromyalgia syndrome and to identify whether fibromyalgia was associated with various clinical symptoms and laboratory parameters in hemodialysis patients. One hundred and forty-eight hemodialysis patients were examined for fibromyalgia symptoms according to the American College of Rheumatology criteria. Demographic characteristics, as well as causes of kidney failure, dialysis duration, and symptoms related to fibromyalgia were investigated. Of 148 patients, 18 (12.2%) were diagnosed with fibromyalgia. Patients with fibromyalgia had significantly poorer sleeping satisfaction than the control group (P = .02).The Beck Depression Inventory score was higher in 77.8% of the fibromyalgia patients than that in the control group (P = .006), but there was no significant difference in the anxiety score between the two groups (P = .86).In conclusion, there was a higher prevalence of fibromyalgia in hemodialysis patients than previously reported. Sleep disturbances and depression levels correlated with fibromyalgia.
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Bidari A, Hassanzadeh M, Ghavidel Parsa B, Kianmehr N, Kabir A, Pirhadi S, Sayfi M, Toutounchi M, Fattahi F, Zandi Karimi F. Validation of the 2010 American College of Rheumatology preliminary diagnostic criteria for fibromyalgia in an Iranian population. Rheumatol Int 2013; 33:2999-3007. [DOI: 10.1007/s00296-013-2829-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 07/10/2013] [Indexed: 11/28/2022]
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18
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Kianmehr N, Bidari A, Mofidi M, Bahar N. SAT0380 Silent Osteonecrosis of the Femoral Head Following High-Dose Corticosteroids in Patients. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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19
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Mofidi M, Mohammadi M, Saidi H, Kianmehr N, Ghasemi A, Hafezimoghadam P, Rezai M. Ultrasound guided lumbar puncture in emergency department: Time saving and less complications. J Res Med Sci 2013; 18:303-7. [PMID: 24124427 PMCID: PMC3793375] [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: 12/31/2011] [Revised: 08/08/2012] [Accepted: 01/06/2013] [Indexed: 10/29/2022]
Abstract
BACKGROUND Lumbar puncture (LP) is an essential procedure in the diagnosis and treatment of several critical situations. This procedure is routinely performed by palpating external landmarks to find the most appropriate inter-spinous space. In the current study, we compared surface landmark and ultrasound (US) guided LP in different aspects. MATERIALS AND METHODS This clinical trial study was conducted at the emergency department (ED) of a teaching hospital from March 2009 to March 2010. Eighty patients were allocated randomly in two equal groups. In first group, LP was performed by US-guided method and in the control group by palpation of external landmarks of spinal column. Pain score, number of attempts for successful dural penetration, numbers of traumatic LP, and procedure time were compared between two groups. The performance of US-guided LP was assessed with regard to body mass index (BMI) of patients too. RESULTS The mean of procedure time and pain scores were markedly higher in land mark group in comparison to US group (6.4 ± 1.2 and 7.4 ± 1.1 vs. 3.3 ± 1.2 and 4.4 ± 1.4 respectively). Number of attempts and number of traumatic LPs were significantly lower in US group too. In patients with different subgroups of BMI, US-guided LP showed better results and less complication when compared with surface landmark guided technique. All of these results were statistically significant. CONCLUSION This study showed that US was able to find pertinent landmarks to facilitate the LP in patients admitted to ED and resulted in less pain and less time wasting. Moreover, patients who have high BMI may benefit more than others.
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Affiliation(s)
- Mani Mofidi
- Department of Emergency Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Mohammadi
- Department of Emergency Medicine, Artesh University of Medical Sciences, Tehran, Iran
| | - Hossein Saidi
- Department of Emergency Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Nahid Kianmehr
- Department of Internal Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ghasemi
- Department of Radiology, Mazandaran University of Medical Sciences, Tehran, Iran
| | | | - Mahdi Rezai
- Department of Emergency Medicine, Iran University of Medical Sciences, Tehran, Iran
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Kianmehr N, Mofidi M, Saidi H, Hajibeigi M, Rezai M. What are Patients' Concerns about Medical Errors in an Emergency Department? Sultan Qaboos Univ Med J 2012; 12:86-92. [PMID: 22375263 DOI: 10.12816/0003092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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: 05/08/2011] [Revised: 08/23/2011] [Accepted: 11/30/2011] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES Concerns about medical errors have recently increased. An understanding of how patients conceptualise medical error would help health care providers to allay safety concerns and increase patient satisfaction. The aim of this study was to evaluate patients' worries about medical errors and their relationship with patient characteristics and satisfaction. METHODS This descriptive cross-sectional study was done in the Emergency Department (ED) of a university hospital over a one week period in October 2008. A questionnaire was used to assess patients' worries about medical errors and their satisfaction levels both at an initial interview and by telephone 7 days after discharge. Data were gathered and analysed by χ2, t-tests and logistic regression. RESULTS Of 638 patients interviewed, 61.6% declared their satisfaction rate as good to excellent; (93 [14.6%] as poor; 152 [23.8%] as fair; 296 [46.4%] as good; 97 [15.2%] as excellent). A total of 48.3% of patients (44.5-52%, with confidence interval 95%) were concerned about the occurrence of at least one medical error. There was a clear relationship between the general satisfaction rate and having at least one concern about a medical error (Chi-square, P <0.001). CONCLUSION This study showed that many patients were concerned about medical errors during their emergency care. Due to the stressful situation in EDs, patients' safety and satisfaction could be improved by a better understanding of patient concerns, education of ED staff and an improvement in the patient-doctor relationship.
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Affiliation(s)
- Nahid Kianmehr
- Department of Internal Medicine, Tehran University of Medical Sciences, Iran, and Department of Internal Medicine, Hazrat e Rasool Akram Hospital, Tehran, Iran
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Kianmehr N, Mofidi M, Rahmani H, Shahin Y. The attitudes of team members towards family presence during hospital-based CPR: a study based in the Muslim setting of four Iranian teaching hospitals. J R Coll Physicians Edinb 2011; 40:4-8. [PMID: 21125031 DOI: 10.4997/jrcpe.2010.102] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Contrary to international guidelines recommending family presence during cardiopulmonary resuscitation (CPR), allowing family members to be present remains a matter of debate in many countries. The purpose of this study was to determine the opinions of healthcare providers from a Muslim setting concerning family-witnessed resuscitation (FWR). METHODS The sample population consisted of CPR responders in four teaching hospitals in Tehran. These centres have no policy regarding the presence of family members during resuscitation. We developed and circulated a questionnaire gathering opinions, and collated their comments. RESULTS From 200 respondents, 77% opposed FWR. We found that gender, age, experience, previous exposure to FWR or specialty (except for emergency physicians) did not predict opinion towards family presence during CPR. The most common reasons given for opposition to family presence were fear of psychological trauma to family members, possible interference with patient care/decision-making, and a perceived increase in staff stress. CONCLUSION In a largely Muslim community, and contrary to general guidelines, our survey suggested that the majority of CPR responders do not favour the presence of relatives during cardiopulmonary resuscitation. Any counter to this opinion would need to be based on educating team members about the possible benefits of relatives being present during resuscitation. Public education surrounding CPR would also be a fundamental element for implementing any formal programme encouraging family-witnessed CPR in hospitals such as ours.
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Affiliation(s)
- N Kianmehr
- Iran University of Medical Sciences, Department of Internal Medicine, Rasool Akram Hospital, Tehran, Iran
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Mofidi M, Kianmehr N, Farsi D, Yazdanpanah R, Majidinezhad S, Asadi P. An unusual case of bilateral anterior shoulder and mandible dislocations. Am J Emerg Med 2010; 28:745.e1-2. [PMID: 20637395 DOI: 10.1016/j.ajem.2009.09.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Accepted: 09/22/2009] [Indexed: 11/18/2022] Open
Abstract
Unilateral anterior shoulder dislocation is the most common major joint dislocation seen by emergency physicians. Bilateral glenohumeral dislocations are rarely seen and almost always posterior after seizure or electrical shock. We present an unusual case of bilateral anterior dislocation of shoulder that had anterior dislocation of temporomandibular joint simultaneously. These problems occurred after a course of generalized tonic-clonic seizure. The coincidence of these dislocations is the first case published in the literature.
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Affiliation(s)
- Mani Mofidi
- Department of Emergency Medicine, Hazrat Rasool-e-Akram Hospital, Iran University of Medical Sciences and Health Services, Tehran, Iran.
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Kianmehr N, Mofidi M, Yazdanpanah R, Ahmadi MA. Medical student and patient perspectives on bedside teaching. Saudi Med J 2010; 31:565-568. [PMID: 20464049] [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: 05/29/2023] Open
Abstract
OBJECTIVE To evaluate the perspectives of medical students and patients on bedside teaching (BST). METHODS A cross-sectional study was undertaken to elicit patients and learners opinions on BST in Hazrat Rasool Hospital, a university teaching hospital in Tehran, Iran. From June 2008 to September 2008, 100 fourth-year medical students and 100 adult patients admitted to the general medical service of a teaching hospital were chosen randomly. Patients who stayed for a minimum of 48 hours and had at least 2 case presentations in 2 consecutive mornings were included in the study. Patients under 18 years of age, non-Persian speakers, and cognitively impaired were excluded from the study. Their perspectives on BST were assessed with 2 separate questionnaires. RESULTS The mean age of medical students was 25.2 +/- 2.2 (22-36) years and 35% were male. The mean age of patients was 46.3 +/- 18.7 (17-85) years and 50% were male. Most of medical students believed that BST is an effective way for learning principle of history taking, physical examination, practical skills, data registry, communicating skills, evidence based medicine, and interpretation of para-clinical findings. Fifty-three percent of them believed that the time of BST is not enough, while 40% thought BST is the most effective way of learning clinical skills. Sixty percent of patients were comfortable with BST and 80% of them preferred that case presentation be performed in front of them. CONCLUSION Our study suggests that teaching in the presence of patients provides unique and valuable opportunities to integrate the knowledge and skills of medicine for the direct benefit of the patient.
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Affiliation(s)
- Nahid Kianmehr
- Department of Internal Medicine, Iran University of Medical Sciences, Tehran, Iran
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Mofidi M, Hasani A, Kianmehr N. Determining the accuracy of base deficit in diagnosis of intra-abdominal injury in patients with blunt abdominal trauma. Am J Emerg Med 2010; 28:933-6. [PMID: 20825927 DOI: 10.1016/j.ajem.2009.06.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2009] [Revised: 06/24/2009] [Accepted: 06/25/2009] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Blunt abdominal trauma is a leading cause of morbidity and mortality among all age groups. A multiplicity of diagnostic modalities exists to evaluate the abdomen. We sought to assess the diagnostic performance of base deficit (BD) in identifying intra-abdominal injury in patients with blunt abdominal trauma. METHODS A prospective, nonrandomized series of patients with blunt abdominal trauma admitted into the 2 emergency departments was investigated from September 2007 to September 2008. Arterial blood samples were analyzed. According to BD, the patients were divided into 2 groups: group 1 who had a BD of -6 or lower and group 2 who had a BD more than -6. Ultrasonography, computed tomographic scan, or laparotomy was performed to find intra-abdominal injury. Follow-up at 7 days by telephone interview was obtained on patients who were discharged. RESULTS A total of 400 patients were enrolled, with a mean (SD) age of 34.8 ± 17.1 years. Two hundred sixty-eight (67%) of them were male. Seventy-six (19%) of patients had a BD of -6 or lower. Sixty-eight (17%) of them showed to have intra-abdominal injury with a BD of approximately -8.7 ± 3.2, compared with patients without intra-abdominal injury, -0.4 ± 0.1. Patients with a BD of -6 or lower achieved more laparotomy and blood transfusion compared with patients with a BD more than -6. On receiver operating characteristic curve analysis, the cutoff point of -6 was obtained with sensitivity and specificity of 88.2% and 95.2% and with positive and negative predictive values of 79% and 97.5%, respectively. None of outpatients had abdominal problem in telephone follow-up. CONCLUSIONS These data show that the BD is an early available important indicator to identify intra-abdominal injury in patients with blunt abdominal trauma, as well as a high transfusion requirement.
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Affiliation(s)
- Mani Mofidi
- Department of Emergency Medicine, Hazrat Rasool-e-Akram Hospital, Iran University of Medical Sciences and Health Services, Tehran, Iran.
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Kianmehr N, Mofidi M, Rahmani H, Forouzan A. CPR team members' attitudes towards family presence during cardiopulmonary resuscitation. Crit Care 2010. [PMCID: PMC2934217 DOI: 10.1186/cc8549] [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: 11/17/2022] Open
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Kianmehr N, Rafati A, Mofidi M, Moradi M, Zamanpoor M. Correlation between pain relief and patient satisfaction. Saudi Med J 2009; 30:1355-1356. [PMID: 19838449] [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: 05/28/2023] Open
Affiliation(s)
- Nahid Kianmehr
- Department of Internal Medicine, Hazrat Rasool Akram Hospital, Iran University of Medical Sciences and Health Services, Tehran, Iran.
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Zare M, Kianmehr N, Hosseinnejad A, Farsi D, Arhamidolatabadi A, Bozorgi F. Crit Care 2005; 9:P317. [DOI: 10.1186/cc3380] [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: 11/10/2022] Open
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