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Functional endoscopic sinus surgery in pediatric population
Farhadi M,Sharafi M
Tehran University Medical Journal , 1997,
Abstract: This is a report of 30 cases of pediatric functional endoscopic sinus surgery (FESS). 28 of these children had chronic sinusitis and 2 had acute sinusitis the most common chief complaints were: 1) Chronic Rhinorea 2) Nasal obstruction 3) Chronic cough. Systemic predisposing conditions were allergy in 7 pts and immotile cilliasyndrome in 2 pts, all of the procedures were performed under general anesthesia. The most common procedures were: 1) Resection of lateral part of the middle turbinate. 2) Antrostomy of the maxillary sinus. 3) Turbinoplasty of the inf turbinate. 4) Anterior erhnoidectomy, (Messerklinger, Approach). There were no kajor complication and only 3 cases of minor complication (2=regeneration of polipoid tissues, 1 synechia) occurred. The duration of follow up was from 6-18 mths recovery occurred in 26 pts. Two of the pts didn't respond because of severe allergy and were referred to immunologist for further therapy 2 others didn't respond appropriately because of immotile cilliasyndrome
Determination of the MIC of Antibiotics for Gram Negative Microorganisms Isolated from the Sterile Sites of Children Hospitalized in Rasool Akram Hospital
S Noorbakhsh,M Farhadi,A Tabatabaei
Iranian Journal of Pediatrics , 2006,
Abstract: Background: The increased prevalence of resistant gram negative organisms in our hospital is documented in our previous retrospective study during 1996-1998. The present study was conducted to determine the resistance frequency of gram negative organisms responsible for infection in children. Methods: In a descriptive prospective study within 2 years (2002-2003). We surveyed 101 children aged 1 month-14 years hospitalized in pediatric and ENT wards of Rasool Akram hospital selected by simple sampling. All gram negative organisms isolated from blood, CSF and other sterile sites (middle ear; mastoid; sinus; trachea) were evaluated first by disc diffusion and then E-testing for MIC to find appropriate antibiotics for the isolated organisms. Findings: The isolated germs consisted of Pseudomonas aeroginusa (47.5%), Klebsiella pneumoniae (22.8%); E. coli (17.8%), entrobacter and Acinetobacter (4.9%), Fusobacter and Salmonella paratyphi (1%). Resistance of pseudomonas was high (80%) for gentamycin; cotrimoxazole and rifampin; moderate (50%) for ceftazidim and amikacin, but low (<15%) for imipenem. Resistance of Klebsiella to ampicillin, gentamycin, amikacin, cotrimoxazole and ciprofloxacin was high (70%), but showed lower resistance for ceftriaxone and imipenem (30%). More than 90% of E. coli was resistant to ampicillin, cotrimoxazle, with moderate resistance (20%) to gentamycine and cephalexin. Resistance of Entrobacter to ceftriaxon was less than 40%. More than 80% of Acinetobacter was sensitive to amikacin and cotrimoxazole. Conclusion: Ceftazidime, despite increasing resistance of pseudomonas to it, combined with amikacin is still adequate for empiric treatment in admission. For other resistant types, cefepime or imipenem is useful. For Klebsiella pneumoniae, ceftriaxone and imipenem; for E. coli, amikacin or ceftriaxon; and if it does not respond imipenem or azteronam. Cefriaxon is the best choice for early treatment of Enterobacter infections.
Introduction to Secure PRNGs  [PDF]
Majid Babaei, Mohsen Farhadi
Int'l J. of Communications, Network and System Sciences (IJCNS) , 2011, DOI: 10.4236/ijcns.2011.410074
Abstract: Pseudo-Random Number Generators (PRNGs) are required for generating secret keys in cryptographic algorithms, generating sequences of packet in Network simulations (workload generators) and other applications in various fields. In this paper we will discuss a list of some requirements for generating a reliable random sequence and then will present some PRNG methods which are based on combinational chaotic logistic map. In the final section after a brief introduction to two statistical test packets, TestU01 and NIST suite tests, the PRNG methods which are presented in the fourth section will be appraised under these test packets and the results will be reported.
Superantigens in Polyp Tissue of Patients with Chronic Rhino-Sinusitis, A Comparative Study: A Brief Report
M Farhadi,A Tabatabaee,M Shekarabi,S Noorbakhsh
Tehran University Medical Journal , 2012,
Abstract: Background: Staphylococcus aureus secretes numerous superantigenes which trigger the inflammatory mechanisms of sinus mucosa and cause chronic rhino-sinusitis. This study was designed to evaluate the role of staphylococcus aureus superantigens in polyp tissues of patients with chronic rhino-sinusitis in comparison with a control group.Methods: Polyp tissue samples of 28 patients and mucosal specimens of 19 healthy individuals were evaluated for staphylococcus aureus bacterium superantigens, exotoxins A, B, C and D and TSST-1 with RT-PCR and ELISA methods Rasoul Akram Hospital during 2 years.Results: Polymerase chain reaction (PCR) results revealed that 88.2% of the patients and 45.5% of the controls had at least one type of superantigen (P=0.03). Evaluation of superantigens using ELISA method showed presence of at least one type of superantigen in the nasal samples of all patients and in 35.3% of the controls (P<0.001).Conclusion: A relationship between staphylococcal superantigens and nasal polyps is concluded from this study which indicates the probable role of these superantigens in the pathogenesis of nasal polyposis.
The Comparison of TH1 and TH2 Cytokines Gene Expression in Allergic and Non-Allergic Patients With Nasal Polyps By PCR
Farhadi M,Tabatabaee A,Shekarabi M,Noorbaksh S
Tehran University Medical Journal , 2011,
Abstract: Background: Too many studies are in the process of determining the probable role of immune system in the etiopathogenesis of nasal polyposis. This study was designed to identify the probable participation of Th1, Th2 lymphocytes in the induction and progression of nasal polyposis.Methods: Seventy-five patients, 42 male and 33 female, with nasal polyposis were examined for total serum IgE, specific serum IgE and reaction to skin test for differentiating allergic from non-allergic participants in Rasoul Akram Hospital during 2010. To determine the possible correlation of allergic reactions in the upper respiratory tract and nasal polyposis, cytokine gene expression was evaluated on the extracted RNA by RT-PCR. The data were analyzed by using c2, independent t-test, correlation and Receiver operating characteristic (ROC) curve.Results: The mean age of participants was 38 years (18-81 years). IFN-γ and IL-4 gene expressions were more prevalent in allergic than non-allergic individuals (IFN-γ: 39.5% vs. 14.2%, P=0.3 and IL-4: 44.7% vs. 18.9%, P=0.02, respectively). IL-10 and IL-12 (P35 and P40 fractions) genes were not significantly different between the two groups. IL-10 and IL-12 (P35, P40) genes did not differ significantly either.Conclusion: This research suggests that overproduction of cytokines and an imbalance of Th1 and Th2 cell production may play an important role in the pathophysiology of allergic or non-allergic nasal polyp formation. Thus, although nasal polyposis is a multifactorial disease with several different etiological factors, chronic persistent inflammation is undoubtedly a major factor irrespective of the etiology.
Correlation between Total Lymphocyte Count, Hemoglobin, Hematocrit and CD4 Count in HIV/AIDS Patients
Alavi S.M,Ahmadi F.,Farhadi M.
Acta Medica Iranica , 2009,
Abstract: Lymphocyte CD4+count, a standard laboratory test for staging of HIV infection, is expensive and unavailable in resource-restricted countries. Total lymphocyte count (TLC) and hemoglobin (Hb) are recommended as simple & inexpensive surrogates. The aim of this study was to assess the correlation, sensitivity and predictive power of these parameters as substitutes for CD4 count. One hundred HIV patients enrolled in this analytic descriptive study in Ahvaz, a city in the South of Iran, from 2005 to 2006. They were tested for CD4 count, TLC, Hb, and hematocrit (Hct). The cutoffs were determined as: 200 cells/μL, 1200 cells/μL, 12 g/dl and 30%, respectively. We used Sys Max SE 9500 for CBC and Flow cytometry for CD4 count. The correlation coefficient established correlation between values. Sensitivity, specificity and positive predictive values were calculated. 2 females (%2) and 98 males (%98) of the mean age of 32±5 years were studied. 87 cases (%87) were IV drug users, the majority having a history of imprisonment. The mean CD4 count, TLC, Hb and Hct were 279±225, 2102±1250, 10.7±2.4 and 30.4±9.0, respectively. A strong correlation was observed between CD4 count and TLC (R = 0.645, P = 0.001), but no correlation was seen between CD4 count and Hb or Hct (R= 0.451, P=0.056 and R= 0.375, P=0.816 respectively). This study shows that TLC is a suitable surrogate marker for CD4 count. Hb and Hct are of limited value in predicting CD4 counts and should not be substituted for CD4counts.
The Level of Serum immunoglobulins in Children suffering from Sinusitis
Noorbakhsh, S,Farhadi,M,Tabatabaei,A,Ghafari, M
Medical Laboratory Journal , 2009, DOI: http://www.goums.ac.ir/mljgoums/index.php?&slct_pg_id=10&sid=1&slc_lang=en
Abstract: Background and objectives: Paranasal sinuses are the common place for infectionin children and adults. Early and effective antibiotic treatment is necessary toreduce the infection period and mucosal injuries, and to prevent from theInvolvements of orbit or CNS. This article aims to clarify the Serumimmunoglobulins accompanying by Sinusitis in Children.Material and Methods: the Subjects of this Cross-Sectional study were 400patients with paranasal sinusitis confirmed by imaging techniques. The study wasconducted in infectious and ENT Clinics of Rasoul Akram hospital in 2003-2004.We measured the Levels of serum immoglobulins including IgG, IgM, IgA and IgEby standard radio-immunodiffusion test, and Compared with normal range of eachage group. The data was analyzed by SPSS software (11.5)Results: The Subjects aged 4.42±2.62 are both male (70.7%) and female (29.3%).Maxilla is the most Common Sinus involved. Thirty-eight of them (95%) haveincreased IgG Level. Forty-four percent of children suffered from rhinosinusitishave been diagnosed with Immune-humoral disorders: the increase of IgE (N=9),Lack of IgA (N=3), decrease of Isolated IgG (N=2), decrease of both IgG and IgA(N=1) and Hyper IgM syndrome (N=3). There is Significant Correlation betweendifferent Immunoglobulins and duration of Sinusitis (P<0.05).Conclusion: The results of this study show that an increase of IgE is one of themost Common disorders in children suffering from Sinusitis and the incidence ofimmunity disorders is higher than the expected rate. Thus, we recommend theImmunologic assessment for Children Contracting with Sinusitis, esp. forprotracted one.Key words: Rhinosinusitis, Hypogamma Globulinemia, Resistant Rhinosinusitis,Serum Immunoglobulins
Variation of the Carabelli Cusps in Maxillary First Molars by Casts within 8-15 Year Old Referred to Dental School of Guilan University of Medical Sciences
M Eskandari,M Rabiei,F Salamat,ME Farhadi
Journal of Shahid Sadoughi University of Medical Sciences , 2012,
Abstract: Introduction: Teeth are valuable sources of information for anthropological and paleontological studies due to the variation in their shape and size. Dental morphological characteristics are useful to provide information for phylogenic and genetic studies as well as understanding variation within and among species. The goal of this study was to determine variation of the Carabelli cusps within the 8-15 years old who referred to Dental School of Guilan University of medical sciences. Methods: In this research the stone models of 231 children (103boy and 128girl) aged 8-15 were evaluated to determine the frequency of Carabelli cusps. This research was based on Dahlberg scale that involves 8 scores. In order to analyze data, SPSS.v.11.5, and to report results, frequency tables and Chi Square test were used. Results: Prevalence of Carabelli cusps was totally 85.7%. Most of them, according to grade 1 of Dahlberg scale, were assigned to the small vertical ridges. Distribution of this feature among boys and girls was equal and no significant differences were found between the sexes (p=0.658). Conclusions: This feature has significant presence in Iranian society. This variation in the population of our study was more likely to grade 1, with 27.7% in general of which 22.3% was devoted to men and 32% to women. Therefore, the probability that Gene or genes which cause traits, are located on sex chromosomes is faded, and we can conclude it may be inherited by autosomal chromosomes.
Serum pneumolysin antibody and urinary pneumococcal antigens (Binax) level in children with upper respiratory tract infection versus normal controls
Noorbakhsh S,Farhadi M,Ebrahimi Taj F,Hojaji Z
Tehran University Medical Journal , 2010,
Abstract: "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Streptococcus pneumoniae is a common cause of respiratory infection. Pneumococcal upper respiratory tract infection (URTI) in children is seldom bacteremic. Determination the prevalence of S.pneumoniae infections in children with URTI using rapid urinary antigen test (BINAX now) and titration of serum pneumolysin antibody (added to conventional culture) was the object of this study."n"n Methods: A cross sectional, case-control study done in ENT & pediatric departments of Rasoul Hospital in Tehran, Iran, (2008 -2010) upon 133 cases with upper respiratory tract infection (otitis media, sinusitis and tracheitis). The nosocomial infection omitted in first step. 60 remaining cases followed for S.pneumoniae infection by culture and rapid urinary antigen test (Binax Now). Serum pneumolysin antibody titers compared between 45 cases and 66 controls. "n"n Results: Positive culture (S.pneumoniae, H.influenza) obtained in 4/60 URTI cases. Positive urinary S.pneumoniae antigen detected in 50% (30/60) of cases and 6% (4/66) of controls (p=0.01). The pneumolysin antibody level with cut-off level 525pg/ml was higher in URTI cases than controls (982±441 Vs. 525±42, p<0.0001). Area under the ROC curve for pneumolysin antibody was 0.923 (95%CI 0.86-0.97, p<0.0001) and had 87% sensitivity and 82% specificity for differentiation between cases and controls. "n"n Conclusions: The high pneumolysin antibody level in cases with URTI strongly indicates the pneumococcal infection. Pneumolysin antibody level even in little amounts (525pg/ml) with 87% sensitivity and 82% specificity is a suitable test for diagnosis of pneumococcal infection in children with URTI, but this test should be added to conventional culture (gold standard) and rapid urinary antigen test.
Immunoasssay Chromatographic Antigen Test for Rapid Diagnosis of Group A Beta Hemolytic Streptococcus Pharyngitis in Children: A Cross/ Sectional Study
S Noorbakhsh,A Tabatabaei,M Farhadi,F Ebrahimi Taj
Iranian Journal of Microbiology , 2011,
Abstract: Background and Objective: Group A beta-hemolytic streptococcus (GABHS) is an important pharyngotonsillitis etiologic agent in children. The objective of this study was diagnosis of streptococcal pharyngitis based on rapid antigen detection test and conventional pharyngeal culture.Materials and Methods: The rapid GABHS antigen detection test was compared to culture on blood agar, the gold standard for the diagnosis of this etiologic agent.Results: Streptococcal antigen was detected in pharyngeal specimens of 34.5% of cases by rapid strip test. We detected group A Streptococcus in 17.2% of pharyngeal culture. There was no agreement between two methods ( PV < 0.1). The negative pharyngeal culture results are probably due to antibiotic usage in 43.2 % of patients. Positive rapid test results in pharyngeal swab was age dependent ( P < 0.05). There was good correlation between observing the "petechia in pharynx of patients" and positive rapid test in pharyngeal swab (P < 0.004). Throat culture results were relatated to previous antibiotic usage ( P < 0.03).Conclusion: The rapid test in pharyngeal swab is helpful for rapid diagnosis and treatment of GABHS pharyngitis. Diagnosis of GABHS pharyngitis based on soley clinical findings is misleading in the majority of cases. Petechia observed in pharynx of the cases was highly predictive of streptococcal pharyngitis.
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