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Tehrān, Iran

Mahmoudian S.,University of Veterinary Medicine Hannover | Mahmoudian S.,Tehran University of Medical Sciences | Mahmoudian S.,National Science Foundation | Farhadi M.,Tehran University of Medical Sciences | And 8 more authors.
Journal of Research in Medical Sciences | Year: 2012

Background and Purpose: Tinnitus is associated with an increased activity in central auditory system as demonstrated by neuroimaging studies. Brain perfusion scanning using single photon emission computed tomography (SPECT) was done to understand the pattern of brain blood perfusion of tinnitus subjects and find the areas which are mostly abnormal in these patients. Materials and Methods: A number of 122 patients with tinnitus were enrolled to this cross-sectional study. They underwent SPECT and magnetic resonance imaging (MRI) of brain, and the images were fused to find the regions with abnormal perfusion. Results: SPECT scan results were abnormal in 101 patients (83%). Most patients had bilateral abnormal perfusion (N = 65, 53.3%), and most subjects had abnormality in middle-temporal gyrus (N = 83, 68%) and temporoparietal cortex (N = 46, 37.7%). Patients with multifocal involvement had the least mean age than other 2 groups (patients with no abnormality and unifocal abnormality) (P value = 0.045). Conclusions: Brain blood perfusion pattern differs in patient with tinnitus than others. These patients have brain perfusion abnormality, mostly in auditory gyrus (middle temporal) and associative cortex (temporoparietal cortex). Multifocal abnormalities might be due to more cognitive and emotional brain centers involvement due to tinnitus or more stress and anxiety of tinnitus in the young patients.

Hassani V.,Tehran University of Medical Sciences | Mohsen Homaei M.,Tehran University of Medical Sciences | Shahbazi A.,Tehran University of Medical Sciences | Mahdi Zamani M.,Tehran University of Medical Sciences | And 5 more authors.
Anesthesiology and Pain Medicine | Year: 2014

Introduction: Postoperative visual loss (POVL) has become the focus of attention for anesthesiologists as a hallmark of perioperative management in spine surgery. A number of Intraoperative and postoperative factors has been documented but the exact etiology is still unclear. Nowadays, perioperative management and also complete curing of POLV is a big question of ophthalmologists and anesthesiologists. The purpose of this case report is to present a unique experience of complete curing the POLV. Case Presentation: Our patient was a 61-year-old man, with 75 kg weight and 180 cm height. The patient had no history of visual impairment except mild cataract in his right eye. The patient had a history of diffuse idiopathic skeletal hyperostosis (DISH). The patient had undergone lumbar surgery in prone position. The operation time was about 6 hours. About 30 minutes after transferring to postanesthesia care unit (PACU), patient was awake and complained of losing his eyesight. There was no vision and light perception in his right eye on primary examination. Urgent ophthalmologist consultation was requested. In ophthalmology examinations, the pupil reflex to light was absent in the right eye. After obtaining patients and his family informed consent, four hours after the operation, 40000 I.U. of recombinant human erythropoietin (rhEPO) was administered for patient in PACU (IV infusion, in 30 min). An ophthalmologist visited him every 6 hours after administration of rhEPO. The patient was transferred to intensive care unit (ICU) one hour later with total visual loss in the right eye. Ophthalmologic examination after the second dose of rhEPO, 30 hours after the operation, reported pupil reflex enhancement and light perception in his right eye. Finally the third dose of rhEPO (40000 I.U., IV infusion) was administered on the third day. Ophthalmologic examination after the third dose of rhEPO, 60 hours after the operation, reported normal pupillary light reflex of the right eye and visual acuity improvement to 20/20. The patient was discharged from hospital after six days, with normal visual acuity and without any new complications except surgical site pain. Conclusions: Our case report showed the therapeutic effect of rhEPO in complete curing of POVL. Regarding the side effects of EPO such as thrombogenic effects or mild hemodynamic changes like transient sinus tachycardia during infusion, it seems that beneficial effects of EPO is more than its disadvantages and expenses, for patients with POVL. © 2014, Iranian Society of Regional Anesthesia and Pain Medicine (ISRAPM).

Yousefzadeh A.,Pars General Hospital | Yousefzadeh A.,Shahid Beheshti University of Medical Sciences | Mostafavizadeh S.M.,Pars General Hospital | Jarollahi A.,Pars General Hospital | And 6 more authors.
Clinical Laboratory | Year: 2014

Background: Persistent infection by HPV is now recognized as the main cause of cervical cancer. HPV prevalence data is not yet available in Iran. This study is organized to evaluate type-specific HPV prevalence and to compare it with Pap smear results among Iranian women attending regular gynecological visits. Methods: A total of 851 women aged 18-65 years, attending regular gynecological visits, were retrospectively evaluated. HPV detection and genotyping was performed by use of Polymerase Chain Reaction (PCR) and Restriction Fragment Length Polymorphism (RFLP). Cytological evaluation was done by Papanicolaou method and the association between cytological results and HPV status was analyzed. Results: 19 different HPV types were detected in 265 of the 851 specimens (31.1%). Overall HPV infection as well as infection with High Risk (HR) HPV types was highest in women aged 18-25 years and decreased with age. Type-specific prevalence of HPV-16 and 18 was 7.3% and 2.8%, respectively, and a large number of women (20.2%) were infected by HR HPV types other than HPV-16 and/or HPV-18. There was also an upward trend in the prevalence of HR HPV infections as the abnormality in cytology increased. The prevalence of HPV co-infection was 29.1% of HPV positive patients and declined from LSIL (18.2%) to HSIL (3.9%). Conclusions: Our study indicated that the burden of HPV infection among Iranian females was higher in comparison with previous estimates reported from Iran. Furthermore, higher prevalence of premalignant changes in Iranian women infected with HR HPV types, other than vaccine types, should be considered in immunization programs and development of population-specific HPV vaccines. This remarkable difference in prevalence of HPV types among previous studies, confirms our need to further investigations on epidemiology of HPV infection in Iran.

Eshtehardi P.,Pars General Hospital | Ghassemi-Kakroodi P.,Pars General Hospital | Garachemani A.,Pars General Hospital | Eslami M.,Pars General Hospital | Moayed D.A.,Pars General Hospital
Heart and Lung: Journal of Acute and Critical Care | Year: 2011

We report on a 20-year-old man who presented with an extensive acute anteroseptal myocardial infarction (from a thrombotic occlusion of the left anterior coronary artery) as the initial manifestation of hereditary protein C deficiency. This case report, along with previous reports, indicates that a diagnosis of protein C deficiency in young patients with myocardial infarctions is essential for more appropriate management and for the prevention of recurrent events. Furthermore, family screening could lead to a prophylactic approach in carriers of this mutation. © 2011 Elsevier Inc.

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