Imam Reza Hospital

Mashhad, Iran

Imam Reza Hospital

Mashhad, Iran

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Zamani F.,Firouzgar Hospital | Razmjou S.,Firouzgar Hospital | Akhlaghpoor S.,Noor Medical Imaging Center | Eslami S.-M.,Imam Reza Hospital | Amiri A.,Firouzgar Hospital
World Journal of Gastroenterology | Year: 2011

AIM: To investigate the accuracy of T2*-weighted magnetic resonance imaging (MRI T2*) in the evaluation of iron overload in beta-thalassemia major patients. METHODS: In this cross-sectional study, 210 patients with beta-thalassemia major having regular blood transfusions were consecutively enrolled. Serum ferritin levels were measured, and all patients underwent MRI T2* of the liver. Liver biopsy was performed in 53 patients at an interval of no longer than 3 mo after the MRIT2* in each patient. The amount of iron was assessed in both MRI T2* and liver biopsy specimens of each patient. RESULTS: Patients' ages ranged from 8 to 54 years with a mean of 24.59 ± 8.5 years. Mean serum ferritin level was 1906 ± 1644 ng/mL. Liver biopsy showed a moderate negative correlation with liver MRI T2* (r = -0.573, P = 0.000) and a low positive correlation with ferritin level (r = 0.350, P = 0.001). Serum ferritin levels showed a moderate negative correlation with liver MRI T2* values (r = -0.586, P = 0.000). CONCLUSION: Our study suggests that MRI T2* is a non-invasive, safe and reliable method for detecting iron load in patients with iron overload. © 2011 Baishideng. All rights reserved.

Mehdizadeh R.,Mashhad University of Medical Sciences | Parizadeh M.-R.,University of Sfax | Khooei A.-R.,Imam Reza Hospital | Mehri S.,Mashhad University of Medical Sciences | Hosseinzadeh H.,Mashhad University of Medical Sciences
Iranian Journal of Basic Medical Sciences | Year: 2013

Objective(s): This study was designed to evaluate the cardioprotective effect of Crocus sativus L. (saffron) aqueous extract and safranal, the major constituent of the essential oil of saffron, on lipid peroxidation, biochemical parameters and histopathological findings in isoproterenol (ISO)-induced myocardial infarction in Wistar rats. Materials and Methods: The saffron extract (20, 40, 80 and 160 mg/kg/day IP) or control were administered for 9 days along with ISO (85 mg/kg, SC, at 24 hr interval) on 8th and 9th day in rats. Activities of creatine kinase-muscle, brain (CK-MB) and lactate dehydrogenase (LDH) were measured using standard commercial kits. The level of malondialdehyde in heart tissue was estimated with thiobarbituric acid reactive species test. For histopathological examination, hematoxylin and eosin (H&E) staining was used. Results: ISO administration induced a statistically significant increase (P< 0.001) in serum LDH and CK-MB and a significant increase (P< 0.001) in the levels of thiobarbituric acid reactive substances (TBARs) in the heart as compared to vehicle control rats. Saffron pretreatment (20, 40, 80 and 160 mg/kg IP) or safranal pretreatment (0.025, 0.050, 0.075 ml/kg IP) for 8 days, significantly decreased (P< 0.001) the serum LDH and CK-MB and myocardial lipid peroxidation as compared to ISO- induced rats. Histological findings of the heart sections confirmed myocardial injury with ISO administration and preserved nearly normal tissue architecture with saffron or safranal pretreatment. Conclusion: Saffron and safranal may have cardioprotective effect in ISO-induced myocardial infarction through modulation of oxidative stress in such a way that they maintain the redox status of the cell.

Fakhim S.A.,Children Hospital | Naderpoor M.,Imam Reza Hospital | Mousaviagdas M.,Children Hospital
Iranian Journal of Otorhinolaryngology | Year: 2014

Introduction: First branchial cleft anomalies manifest with duplication of the external auditory canal. Case Report: This report features a rare case of microtia and congenital middle ear and canal cholesteatoma with first branchial fistula. External auditory canal stenosis was complicated by middle ear and external canal cholesteatoma, but branchial fistula, opening in the zygomatic root and a sinus in the helical root, may explain this feature. A canal wall down mastoidectomy with canaloplasty and wide meatoplasty was performed. The branchial cleft was excised through parotidectomy and facial nerve dissection. Conclusion: It should be considered that canal stenosis in such cases can induce cholesteatoma formation in the auditory canal and middle ear.

Mahluji S.,Tabriz University of Medical Sciences | Attari V.E.,Tabriz University of Medical Sciences | Mobasseri M.,Imam Reza Hospital | Payahoo L.,Tabriz University of Medical Sciences | And 2 more authors.
International Journal of Food Sciences and Nutrition | Year: 2013

The present study was aimed to evaluate the effects of Zingiber officinale on some biochemical parameters in type 2 diabetic (DM2) patients. In a randomized double-blind placebo controlled trial, 64 patients with DM2 were assigned to ginger or placebo groups (receiving 2 g/d of each). A 3 d diet record, anthropometric measurements and concentrations of fasting blood glucose (FPG), HbA1c, lipid profile (including total cholesterol, triglyceride, low density lipoprotein and high density lipoprotein) and also the homeostasis model assessment (HOMA) and quantitative insulin-sensitivity check index (QUICKI) were determined before and after 2 months of intervention. Ginger supplementation significantly lowered the levels of insulin (11.0 ± 2.3 versus 12.1 ± 3.3; p = 0.001), LDL-C (67.8 ± 27.2 versus 89.2 ± 24.9; p = 0.04), TG (127.7 ± 43.7 versus 128.2 ± 37.7; p = 0.03) and the HOMA index (3.9 ± 1.09 versus 4.5 ± 1.8; p = 0.002) and increased the QUICKI index (0.313 ± 0.012 versus 0.308 ± 0.012; p = 0.005) in comparison to the control group; while, there were no significant changes in FPG, TC, HDL-C and HbA1c (p > 0.05). In summary, ginger supplementation improved insulin sensitivity and some fractions of lipid profile in DM2 patients. Therefore it may be considered as a useful remedy to reduce the secondary complications of DM2. © 2013 Informa UK Ltd.

Feiz H.H.,Tabriz University of Medical Sciences | Afrasiabi A.,Tabriz University of Medical Sciences | Parvizi R.,Tabriz University of Medical Sciences | Safarpour A.,Tabriz University of Medical Sciences | Fouladi R.F.,Imam Reza Hospital
Indian Journal of Orthopaedics | Year: 2012

Context: Congenital heart disease (CHD) patients bear a higher risk of scoliosis during their lifetime compared to their normal counterparts. On the other hand, operation on chest wall has been shown to increase the risk of scoliosis. However, the data are inconclusive. The present retrospective analysis is undertaken to determine the frequency of post-thoracotomy/sternotomy scoliosis in children with CHD. Materials and Methods: One hundred and eighty children with CHD who underwent thoracotomy/sternotomy and had a minimum followup of 3 years in a teaching center from 1997 to 2010 were recruited. After operation, all the patients were regularly examined for the development of scoliosis. 102 patients underwent thoracotomy and 78 sternotomy. Student's t test, Chi-square test, Fisher's exact test were used for statistical analyses. Results: Eighty-eight males and 92 females with a mean age of 9.95 ± 2.31 (range: 5-15) years were enrolled. The mean age at operation was 2.59 ± 1.66 (range: 0-9) years and the mean follow-up period was 7.36 ± 2.12 (range: 5-13) years. Scoliosis was confirmed in two patients (1.1%): 1 (1%) in the thoracotomy group (a 12-year-old female operated 2 years earlier with a spinal 22° convexity to the right and 78° kyphosis) and another (1.1%) in the sternotomy group (an 8-year-old female operated during her neonatal period with a spinal 23° convexity to the left). Conclusion: Scoliosis is not a common finding among the operated children with CHD in our center.

Jalili M.,Tehran University of Medical Sciences | Gharebaghi H.,Tehran University of Medical Sciences | Gharebaghi H.,Imam Reza Hospital
Emergency Medicine Journal | Year: 2010

Background: This study was designed to determine the accuracy of the Ottawa Knee Rule (OKR) when applied to patients with acute knee injury in the Iranian population of the Imam Hospital Emergency Department (ED) at. Methods: This prospective cohort validation study included a convenience sample of all patients with a blunt knee injury sustained in the preceding 7 days presenting to the ED of a tertiary care teaching hospital during the study period. Patients were assessed for the five variables comprising the OKR, and a standardised data form was completed for each patient. Standard knee radiographs were ordered on all patients irrespective of the determination of the rule. The rules were interpreted by the primary investigator on the basis of the data sheet and the final orthopaedist radiograph reading. Outcome measures of this study were: sensitivity, specificity, positive predictive value and negative predictive value of the OKR. Results: A total of 283 patients were enrolled in the study. 22 fractures (7.77%) were detected. The decision rule had a sensitivity of 0.95 (95% CI 0.77 to 0.99), and a specificity of 0.44 (95% CI 0.37 to 0.50). The potential reduction in use of radiography was estimated to be 41%. The OKR missed only one fracture. Conclusion: Prospective validation has shown that the OKR is a highly sensitive tool for detecting knee fractures and has the potential to reduce the number of radiographs in patients with acute knee injuries.

Sasan M.-S.,Mashhad University of Medical Sciences | Nateghi M.,Imam Reza Hospital | Bonyadi B.,Shiraz University of Medical Sciences | Aelami M.-H.,Mashhad University of Medical Sciences
Iranian Journal of Pediatrics | Year: 2012

Objective: Brucellosis is a prevalent disorder in children of developing countries. The aim of this study is to describe the epidemiology and long term prognosis of Brucellosis in Khorasan, Iran. Methods: This is a descriptive cross sectional study (from November 2003 up to February 2006), the subjects of which are composed of 82 patients (from Imam Reza hospital, Mashhad, and Health Center of Kashmar). In this study the diagnosis of Brucellosis is based on serology accompanied with clinical signs and symptoms. Our strategy for duration of treatment was to treat all patients for at least 6 weeks. We followed the patients by phone and if necessary by visiting. Findings: During 38 months we had 82 children with Brucellosis. The mean age was 8.02 y, and 40% of them were girls (M/F=1.21). Summer with 45.9% of the cases was the peak season. History of consuming raw dairy products, close contact with farm animals, living in village and Brucellosis in family was found in 91.6%, 76%, 70.24% and 41.1% of the cases respectively. The presenting symptom in 79.7% of the cases was joint pain, 72.9% had history of fever during the course of the disease. Arthritis, splenomegaly and lymphadenopathy were found in 60.97%, 16.9%, 7.5%, of patients respectively. The therapeutic regimen of 48.7% of our patients was Co-trimoxazole and rifampin. We followed 74% of the patients for at least 3 years which showed the relapse rate of 6.5%. There was a case of reinfection, a patient with residual sequel and one death related to Brucellosis in our case series. Conclusion: Brucellosis is still a common disease in our children and at least a risk factor for it can be found in the history of almost all cases of pediatric Brucellosis. With at least six weeks treatment with two antibiotics and with close follow up, we can decrease the relapse rate in pediatric Brucellosis to zero, even without repeating the serology during or after treatment. © 2012 by Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, All rights reserved.

Babaeinejad S.,Sina | Khodaeiani E.,Sina | Fouladi R.F.,Imam Reza Hospital
Journal of Dermatological Treatment | Year: 2011

Background: Acne vulgaris is the most common dermatological disorder in adolescence and young adults. In past decades, systemic antibiotics have had the main role in the treatment of acne patients with inflammatory papules and cysts. They are sometimes associated with side effects, contributing to reduced compliance. Objective: This study aimed at comparing the efficacy and safety of oral azithromycin and doxycycline in the treatment of moderate acne vulgaris, considering the age of patients as an influencing parameter. Methods: In a randomized, double-blind, clinical trial, 100 patients with moderate acne vulgaris who attended the outpatient dermatology clinic were evaluated during a 15-month period. They were randomized into two equal groups: A and D. Patients in group A received oral azithromycin (500 mg daily, 4 consecutive days per month for 3 consecutive months) and patients in group D took doxycycline (100 mg daily for 3 consecutive months). The number and types of lesions (all over the body) were determined at baseline and at the end of each month for 90 days afterwards. Michaelson's acne severity score was also determined at baseline and at the end of the third month after initiating treatment. Patients were followed up for another 3 months after discontinuation of treatment to determine the recurrence rate. Results: Both antibiotics were comparably effective in the treatment of moderate acne vulgaris. There was no significant side effect in the A group and the complications were minor in the D group. Doxycycline was significantly more effective in patients older than 18 years. Conclusion: Azithromycin is at least as effective as doxycycline in the treatment of moderate acne vulgaris; however, in patients older than 18 years doxycycline is better. © 2011 Informa Healthcare USA on behalf of Informa UK Ltd.

Pishbin E.,Mashhad University of Medical Sciences | Bolvardi E.,Mashhad University of Medical Sciences | Ahmadi K.,Mashhad University of Medical Sciences | Ahmadi K.,Imam Reza Hospital
EMA - Emergency Medicine Australasia | Year: 2011

Objectives: To the best of knowledge, this was the first study of scapular manipulation technique (SMT) in Asia. We conducted this prospective study to report our experiences of reducing anterior shoulder dislocation by SMT without analgesia in a large study group in Iran. Methods: Scapular manipulation technique was applied to 111 patients presenting with anterior shoulder dislocation to the ED of the largest teaching hospital in north-east of Iran between January 2009 and January 2010. Reduction was performed without medication and if unsuccessful, the second attempt was carried out with i.v. injection of midazolam. We also evaluated the pain experienced by the patients immediately after reduction attempt. Results: The study consisted of 112 dislocations (one patient had bilateral dislocation). We achieved a success rate of 87.5% without medication at the first attempt and 97.3% overall. In total, 98.2% of dislocations were reduced in less than 1min. The success rate was significantly lower in the presence of greater tuberosity fractures and also in late presentations (>6h after trauma). We showed a success rate of 100% in recurrent dislocations. Some 81.1% of the patients reported no pain or mild pain. No complications were observed. Conclusion: The results of our study showed that SMT even without medication is a safe, rapid and relatively painless technique in reducing anterior shoulder dislocation in the ED that might reduce medical resource utilization and can be cost-effective. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Gilani M.,Imam Reza Hospital | Zirak N.,Imam Reza Hospital | Razavi M.,Imam Reza Hospital
Saudi Journal of Anaesthesia | Year: 2014

Magnesium sulfate is used frequently in the operation room and risks of wrong injection should be considered. A woman with history of pseudocholinesterase enzyme deficiency in the previous surgery was referred for cesarean operation. Magnesium sulfate of 700 mg (3.5 ml of 20% solution) was accidentally administered in the subarachnoid space. First, the patient had warm sensation and cutaneous anesthesia, but due to deep tissue pain, general anesthesia was induced by thiopental and atracurium. After the surgery, muscle relaxation and lethargy remained. At 8-10 h later, muscle strength improved and train of four (TOF) reached over 0.85, and then the endotracheal tube was removed. The patient was evaluated during the hospital stay and on the anesthesia clinic. No neurological symptoms, headache or backache were reported. Due to availability of magnesium sulfate, we should be careful for inadvertent intravenous, spinal and epidural injection; therefore before injection must be double checked.

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