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Effect of Low Dose Dopamine on Early Graft Function in Living Unrelated Kidney Donors
Hamzeh Hosseinzadeh,Samad Golzari,Mohammad Abravesh,Ata Mahmoodpoor
Urology Journal , 2012,
Abstract: Purpose: To evaluate the effect of low-dose dopamine administration on the early function of the kidney in unrelated kidney donors after transplantation.Materials and Methods: In this double-blinded clinical trial, 60 adult kidney donors and 60 recipients, younger than 50 years old, were studied. Donors and recipients were randomly divided into two groups; group 1 received dopamine 3 μg/kg/min and group 2 received similar regimen of placebo. During the first 3 days postoperatively, serum levels of urea and creatinine as well as urine output and early kidney function were compared between two groups.Results: Serum levels of creatinine and urea and urine output during the first three days after the operation did not differ statistically significantly between two groups (P = .549, P = .306 and P = .375, respectively). Early kidney function was better significantly in group 1 (5.3 ± 3.2 versus 8.6 ± 8.0 hours; P = .048). Conclusion: Premedication of the kidney transplant donors with low-dose dopamine accelerates early kidney function after transplantation, but has no effect on the hemodynamic status and serum levels of creatinine and urea in the donors.
The Incidence of Breast Cancer in Northwest Iran (2003 -2008)
Shahryar Hashemzadeh,Raheleh Aligholipour Maleki,Samad EJ Golzari
Journal of Cardiovascular and Thoracic Research , 2012,
Abstract: Introduction: Breast Cancer is the most common cancer in Iranian women and Iranian patients are relatively young. Given that Iran has a female population of about 38 million, this corresponds to a total number of 6000 new cases of breast cancer annually. This study aims to demonstrate the characteristics of breast cancers according to athologic records in East Azerbaijan province, Iran. Methods: In this retrospective cross-sectional study, 159314 pathology records of the main hospitals and pathology laboratories were observed for a period of 5 years. For each patient, sex, age, breast specimen pathology, pathological grading of malignant lesions and place of residence of patients were collected and statistically analyzed. Results: There were 12083 cancer cases; 902 of which were primary breast cancer. Breast cancer was the most common cancer in females (22.2%) but it ranks the 22nd in males. The annual incidence of breast cancer in women was 52.3 per 100,000. The mean age of women with breast cancer was 48.3±12.7 years (range, 16-85) and for male 54.0±13.6 years range, 23-76). The highest frequency of malignancies was observed in the 40-49 year old age groups (34.5%). Invasive ductal carcinoma was the most common histological type diagnosed in both sexes. Conclusion:In Iran, breast cancer affects women at least one decade younger than developed countries. In spite of the rare incidence of breast cancer in men, the descriptive epidemiology of this malignancy is urprisingly similar to that of women. A considerable proportion of cancers of our research were in breast which mandates a national cancer detection program encouraging women for breast self-examination and participation in screening tests to improve breast cancer care.
Globus Sensation Due to a Mobile Foreign Body in a 41-year-old Female
Saman Vegari,Mehdi Ghaffarlou,Leila Davarimajd,Samad EJ Golzari
Journal of Cardiovascular and Thoracic Research , 2012,
Abstract: Leech infestation could be associated with wide range of complications including epistax-is, stridor, hemoptysis, globus sensation, hematemesis, and vaginal bleeding. In the present case report. , we introduce a case of leech infestation in a 41-year-old female presenting with chronic globus sensation, stridor, vomiting and dysphagia later diagnosed with leech infestation. Therefore, leech bites might be considered as a differential. Diagnosis of glo-bus sensation in the endemic rural areas where in unhealthy water from natural sources is consumed without taking required hygienic precautions.
Cost-Effectiveness of Intraoperative Transesophageal Echocardiography in Cardiac Valve Surgery
Bahman Naghipour,Rasoul Azarfarin,Samad Golzari,Moussa Mirinazhad
Journal of Cardiovascular and Thoracic Research , 2011,
Abstract: Introduction: Being a unique diagnostic technique, transesophageal echocardiography (TEE) has influenced many different aspects of cardiac surgery including valve repair surgery. The cost-effectiveness of this method however is questioned considering the conditions of every region and country. In this study we aimed at answering the question if utilizing TEE throughout valve repair surgery could be cost-effective. Methods: Twenty four patients were studied within two groups of case "valve repair operation plus intra-operative TEE (IO-TEE)" and control "valve replacement operation". Variables including age, gender, left ventricle ejection fraction (LVEF), re-operation, intensive care unit (ICU) stay, hospital stay and cost were studied and compared. Results: There was no significant difference regarding age, gender and LVEF between two groups (p=0.559, p=0.413, and p=0.408, respectively). ICU stay in repair group was less than replacement group (p=0.009). Hospital stay difference however was not statistically significant (p=0.928). The cost of valve repair under IO-TEE monitoring was significantly less than valve re-placement (p=0.001). Conclusions: IO-TEE not only would assist surgeons by increasing their interest toward valve repair operation instead of replacing impaired cardiac valves but also consequently decrease hospital costs. It is also advised for the cardiac anesthesiologists to use IO-TEE routinely in the valve repair operations provided that there are no contraindications.
The Association Between Epicardial Adipose Tissue and Coronary Artery Disease: an Echocardiographic Cut-off Point
Mehrnoush Toufan,Rasoul Azarfarin,Boshra Sadati,Samad EJ Golzari
Journal of Cardiovascular and Thoracic Research , 2012,
Abstract: Introduction: EAT is an independent factor in coronary artery disease (CAD). The objective of the current study was to define an echocardiographic cut-off point for EAT and to determine its diagnostic value in predicting the increase in CAD risk. Methods: Two hundred patients underwent coronary artery angiography for diagnosis of CAD and transthoracic echocardiography for measurement of EAT on the right ventricle (RV), RV apex and RV outlet tract. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the EAT cut-off points in the three above-mentioned areas for predicting the severity of CAD were measured. The relation between the EAT and CAD risk factors was evaluated as well. Results: EAT was independent from gender, height, hypertension, diabetes, HDL, total cholesterol, ejection fraction, acute coronary syndrome, and the location of the coronary artery stenosis in the coronary artery in all three anatomical areas. EAT on RV and RV apex had a significant relation with CAD (P ≤ 0.05). Overall, RV EAT≥ 10 mm and RV apex EAT ≥ 8 mm had sensitivity and PPV of more than 70% in predicting coronary stenosis ≥ 50% and acute coronary syndrome (ACS) and RVOT EAT ≥ 13 mm is of PPV=83.5% for predicting coronary stenosis ≥ 50%. Conclusion: EAT thickness has an acceptable diagnostic value for predicting severe coronary artery stenosis and ACS. Therefore, non-invasive EAT thickness measurement could be of great assistance to clinicians for detecting the patients at risk and helping them to undergo supplementary evaluations with invasive approaches.
Evaluation of Anthropometric Indices of Patients with Left Ventricle Dysfunction Fallowing First Acute Anterior Myocardial Infarction
Rasoul Azarfarin,Jahanbakhsh Samadikhah,Roya Shahvalizadeh,Samad EJ Golzari
Journal of Cardiovascular and Thoracic Research , 2012,
Abstract: Introduction: In the current study, we evaluated the effect of anthropometric indices on ejection fraction following first acute anterior myocardial infarction. Methods: In an analytic-cross sectional study, 50 patients with acute anterior myocardial infarction and abnormal anthropometric indices (Body Mass Index (BMI) ≥ 30, Waist Hip Ratio (WHR) ≥ 1 and ≥ 0.85 in males and females respectively and Waist Circumference (WC) ≥ 102 cm and ≥ 88 cm in males and females respectively) were recruited as case group and 50 patients with acute anterior myocardial infarction and normal anthropometric indices as control group. Subsequently, the relation between anthropometric indices and left ventricle dysfunction was evaluated and compared between two groups. Results: 77 peopleof the studied patients were male and 23 female with the mean age of 59± 1.2 years and an age range of 32-90 years. To evaluate the left ventricle function, the mean ejection fraction of the patients was measured as 34.3± 7.2 % and 44.8± 6.3% in patients withabnormal anthropometric indices and patients with normal anthropometric indices respectively (P= 0.0001). Calculation of the correlation coefficient between ejection fraction and BMI, WHR and WC in males and females revealed a moderate reverse (r=-0.521 tor=-0.691) and statistically significant (P= 0.0001) relations which was of more strength in females. Conclusion: Anthropometric indices including BMI and waist circumference influence cardiac function following myocardial infarction.
Pleurodesis by erythromycin, tetracycline, Aerosil? 200, and erythromycin plus Aerosil? 200 in a rat model: a preliminary study
Shahryar Hashemzadeh, Khosrow Hashemzadeh, Kamran Mamaghani, Elnaz Ansari, Raheleh Aligholipour, Samad EJ Golzari, Kamyar Ghabili
DARU Journal of Pharmaceutical Sciences , 2012, DOI: 10.1186/2008-2231-20-79
Abstract: Overall, 75 adult male Spraque-Dawley rats were randomized to 5 treatment groups. Each group received an intrapleural injection via 5 Fr Silastic tubes of one of the following sterile agents: 35mg/kg erythromycin in 2 ml of saline, 35mg/kg tetracycline in 2 ml of saline, 35mg/kg Aerosil? 200 in 2ml of saline, erythromycin (35mg/kg in 2 ml of saline) plus Aerosil? 200 (35mg/kg in 2 ml of saline), or 2 ml of saline as a control. The animals were euthanized and necropsied 30 days after injection. The pleurae were assessed for macroscopic and microscopic evidence of surrounding inflammation and fibrosis.The median macroscopic score in the Aerosil? 200 group was significantly higher than that in the erythromycin group (P?<?0.005). The median microscopic score in the erythromycin group was significantly lower than that in the Aerosil? 200 and erythromycin plus Aerosil? 200 groups (P?<?0.005). Furthermore, maximum and minimum pleural fibrosis was observed in the erythromycin plus Aerosil? 200 and erythromycin groups, respectively (P?<?0.05).This study suggests that Aerosil? 200 with or without erythromycin may be more potent pleurodesis agent than erythromycin and tetracycline.Obliteration of the pleural space (pleurodesis) to prevent recurrent pleural effusion (mostly malignant) or pneumothorax is chiefly achieved through the use of chemical pleural sclerosants [1]. The best pleural sclerosant should be safe, inexpensive, widely available, and easily administered. However, none of the pleurodesing agents including talc, the sclerosant of choice in clinical practice, fulfil all these criteria [1-3]. Intrapleural administration of the most preferred pleurodesing agent, the talc, is believed to accompany with severe complications such as adult respiratory distress syndrome. On the other hand, parenteral tetracycline which was once the sclerosant agent of choice in clinical practice is no longer commercially available [4]. In addition, intrapleural application of some antineo
Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department
Hassan Soleimanpour, Kamaleddin Hassanzadeh, Hassan Vaezi, Samad EJ Golzari, Robab Esfanjani, Maryam Soleimanpour
BMC Urology , 2012, DOI: 10.1186/1471-2490-12-13
Abstract: In a prospective randomized double-blind clinical trial performed in the emergency department of Imam Reza educational hospital of Tabriz, Iran, we studied 240 patients, 18–65?years old, who were referred due to renal colic. Patients were divided into two groups. In group I (120 people) single-dose intravenous lidocaine (1.5?mg/kg) was administered and in group II (120 people) single-dose intravenous morphine (0.1?mg/kg) was administered slowly. Visual Analogue Pain Scale (VAS) was recorded while admission, 5, 10, 15 and 30 minutes after injection. Statistical data and results were studied using descriptive statistics as percentage and Mean?±?SD. To compare the response to treatment, Mann–Whitney U-test was used in two groups. Consequently, the data were analyzed using the SPSS16 software.Pain score measured in two groups five minutes after the injection of lidocaine and morphine were 65?% and 53?% respectively (95% CI 0.60 - 0.69, CI 0.48 – 0.57, p?=?0.0002).108 (90?%) patients (95?% CI 0.84 – 0.95) from group I and 84 (70%) patients (95?% CI 0.62 - 0.78) from group II responded appropriately at the end of the complete treatment. The difference was statistically significant (p?=?0.0001).Changing the smooth muscle tone and reducing the transmission of afferent sensory pathways, lidocaine causes a significant reduction in pain.Clinical Trials IRCT138901042496N3Affecting 1-5?% of the population in industrialized countries, renal colic is considered as a major concern in medicine. Renal colic has been reported to be experienced by 20?% of white males and 5-10?% of white females [1]. The classic presentation of acute renal colic includes sudden pain onset radiating from the flank to the lower extremities which is usually accompanied by microscopic hematuria (85?% of cases), nausea and vomiting . Costovertebral angle tenderness is a common finding as well [2].To relieve the pain until being discharged or undergoing the required operation is mostly performed in emergency
Role of anesthesiology curriculum in improving bag-mask ventilation and intubation success rates of emergency medicine residents: a prospective descriptive study
Hassan Soleimanpour, Changiz Gholipouri, Jafar Panahi, Mohammad Afhami, Rouzbeh Ghafouri, Samad EJ Golzari, Maryam Soleimanpour, Robab Esfanjani
BMC Emergency Medicine , 2011, DOI: 10.1186/1471-227x-11-8
Abstract: A prospective descriptive study was conducted at Nikoukari Hospital, a teaching hospital located in Tabriz, Iran. In a skills lab, a total number of 18 emergency medicine residents (post graduate year 1) were given traditional intubation and bag-mask ventilation instructions in a 36 hour course combined with mannequin practice. Later the residents were given the opportunity of receiving training on airway management in an operating room for a period of one month which was considered as an additional training program added to their Anesthesiology Curriculum. Residents were asked to ventilate and intubate 18 patients (Mallampati class I and ASA class I and II) in the operating room; both before and after completing this additional training program. Intubation achieved at first attempt within 20 seconds was considered successful. Successful bag-mask ventilation was defined as increase in ETCo2 to 20 mm Hg and back to baseline with a 3 L/min fresh gas-flow and the adjustable pressure limiting valve at 20 cm H2O. An attending anesthesiologist who was always present in the operating room during the induction of anesthesia confirmed the endotracheal intubation by direct laryngoscopy and capnography. Success rates were recorded and compared using McNemar, marginal homogeneity and paired t-Test tests in SPSS 15 software.Before the additional training program in the operating room, the participants had intubation and bag-mask ventilation success rates of 27.7% (CI 0.07-0.49) and 16.6% (CI 0-0.34) respectively. After the additional training program in the operating room the success rates increased to 83.3% (CI 0.66-1) and 88.8% (CI 0.73-1), respectively. The differences in success rates were statistically significant (P = 0.002 and P = 0.0004, respectively).The success rate of emergency medicine residents in airway management improved significantly after completing anesthesiology rotation. Anesthesiology rotations should be considered as an essential component of emergency med
Surgery for Gynecomastia in the Islamic Golden Age: Al-Tasrif of Al-Zahrawi (936–1013 AD)
Seyed Hadi Chavoushi,Kamyar Ghabili,Abdolhassan Kazemi,Arash Aslanabadi,Sarah Babapour,Rafail Ahmedli,Samad E. J. Golzari
ISRN Surgery , 2012, DOI: 10.5402/2012/934965
Abstract: The rise of European science during the Renaissance is greatly indebted to the flourishing of the sciences during the Islamic Golden Age. However, some believe that medieval Islamic physicians and in particular surgeons had been merely a medium for Greco-Roman ideas. Contrarily, in some medieval Islamic medical books, such as Al-Tasrif of Al-Zahrawi (936–1013), the surgical instructions represent a change in the usual techniques or are accompanied by a case history, implying that the procedure was actually undertaken. Along with the hundreds of chapters on different diseases and related medical and surgical treatments, Al-Tasrif includes a chapter on surgical techniques for gynecomastia. The present paper is a review of the description of the surgical management of gynecomastia by Al-Zahrawi as well as that of the ancient Greek, medieval, and modern medicine. Although Al-Zahrawi seemed to base his descriptions of surgery for gynecomastia upon those of Paulus of Aegina, his modification of the procedure and application of the medicinal substances might be indicative of Al-Zahrawi’s own practice of the procedure. Al-Zahrawi’s surgical procedures remained unchanged for many centuries thenceforward until the technological evolution in the recent centuries. 1. Introduction The rise of European science during the Renaissance is greatly indebted to the flourishing of the sciences during the Islamic Golden Age [1–3]. In the Eastern Caliphate of Baghdad, Muslim scholars translated and assimilated the Greek works, while adding their own commentaries [4]. Thereafter, thanks to their own perceptive observations, trials, and skills, renowned scholars such as Muhammad ibn Zakariya al-Razi or Rhazes (865–925), Ali ibn al-Abbas al-Majusi or Haly Abbas (930–994), and Abu-Ali al-Husain ibn Abdollah ibn Sina or Avicenna (981–1037) remarkably contributed to the scientific treasure of this era [5]. Meanwhile, in the Western Caliphate of Córdoba, Muslim physicians and philosophers almost as brilliant as those of the East strongly promoted this scientific movement [6]. Studied and practiced medicine at Seville and Córdoba, Al-Zahrawi or Albucasis (936–1013), Ibn Zuhr or Avenzoar (1092–1162), and Ibn Rushd or Averro?s (1126–1198) were the most influential physicians of the western lands [7]. Nonetheless, some believe that medieval Islamic physicians had been merely a medium for Greco-Roman ideas. On the other hand, Abbasids' attempts to resurrect the conviction that the Greek medicine is in essence derived from Persian have persuaded some medical historians to repudiate the
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