Iranian Journal of Medical Sciences
Year:2020 | Volume:45 | Issue:2|Papers Count:11

COVID-19, the name given by the World Health Organization (WHO) to the recent coronavirus associated disease, has become a well-known term around the world recently. The first reports on this infection were made in December 2019 in Wuhan, China as a series of pneumonia with an unknown cause, which was linked to a novel kind of coronavirus on 31 December 2019. 1, 2 SARS-CoV-2, the causing agent of this disease, is an enveloped positive sense RNA virus3 belonging to betacoronavirus genera, Coronaviridae family. 4 Although this group of viruses usually induces mild cold conditions, Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) were identified from the same family several years ago causing deadly serious respiratory diseases. 3 In spite of the lower fatality rate of SARS-CoV-2 than MERS-CoV and SARS-CoV, 4 its risks are regarded serious, mainly because of the high transmissibility of the virus and its ability to survive for long hours on different surfaces. Moreover, the reports show that it may cause only insignificant flu-like symptoms in many contaminated people2 who can easily infect others in the society. On this basis, COVID-19 was declared as a public health emergency of international concern by WHO....

Background: The use of antibiotics is common, but its excessive or improper use leads to antibiotic resistance. Consequently, scientists have been interested in exploring traditional medicine to identify a new source of anti-bacterial agents. The present study aimed to conduct a systematic review to determine the anti-bacterial activity of Satureja khuzestanica Jamzad (SKJ) and Zataria multiflora Boiss (ZM) essential oils against Pseudomonas aeruginosa in vitro. Methods: A comprehensive literature search for studies published on SKJ and ZM was carried out. Various keywords (S. Khuzestanica, Marzeh-e-Khuzestani, Z. Multiflora, Z. Multiflora Boiss; avishane-shirazi, shirazi thyme, thymol, carvacrol; P. aeruginosa, Iran, antibacterial effect; traditional medicine, phytomedicine, herbal medicine) were used to search both international and Iranian databases (Google Scholar, Science Direct, Web of Science, MEDLINE; PubMed, Scopus, Cochrane Library, Academic Search; Journal Storage, Magiran, Irandoc, Scientific Information Database (SID), and IranMedex). The selected articles were published during 2000-2017 and were written in English or Persian. Results: Seventeen articles were included in the review. The main ingredients of SKJ and ZM plants were carvacrol and thymol. The potential anti-bacterial activity of essential oils from these plants was confirmed. The carvacrol content, as the major active ingredient of SKJ was between 38. 33-97. 89%. The major ingredients of ZM were carvacrol (16. 8-82. 7%) followed by thymol (25. 70-64. 87%). The minimum inhibitory concentration (MIC) value of SKJ and ZM essential oils against bacterial strains was in the range of 0. 31-450 and 2-8, 000 μ g/mL, respectively. Conclusion: The present review study confirmed the antibacterial activity of SKJ and ZM, particularly against Pseudomonas in vitro.

Background: Drug abuse is a major issue and one of the main causes of health, psychological, and social problems. Studies have shown the effectiveness of narrative therapy in reducing psychological symptoms of addiction. The present study aimed to assess the effectiveness of group narrative therapy on depression, quality of life (QoL), and anxiety among people with amphetamine addiction in Kermanshah, Iran. Methods: A randomized clinical trial was conducted during 2015-2016 among patients (n=26) with amphetamine addiction in Kermanshah, Iran. The participants were randomly divided into intervention and control groups. The intervention group followed 10 sessions of narrative therapy, whereas the control group received routine psychiatric care. The data collection tools included a demographic data form, Beck depression inventory-II, QoL questionnaire, and Beck anxiety inventory. The data were analyzed using SPSS software (version 22. 0). P<0. 05 was considered statistically significant. Results: There was a statistically significant reduction in depression and anxiety scores between the pre-and postintervention stages (P<0. 001) in the intervention group. However, their QoL was unaffected by the therapy (P=0. 487). These variables did not show a significant change in the control group. Conclusion: Group narrative therapy reduced the level of depression and anxiety in patients with amphetamine addiction. However, their QoL was unaffected by the therapy.

Background: There is a wealth of research done in developed countries on the investigation of the working memory (WM) performance in people with high-functioning Autism Spectrum Disorders (ASD) (IQ>70), with different reported findings. There is a dearth of similar studies in developing countries. In addition, the findings suggest that WM is possibly influenced by culture. The present study investigated WM performance and its relationship with the symptoms of ASD and Attention Deficit Hyperactivity Disorder (ADHD). Methods: The present study is a cross-sectional comparative study between two groups of participants with high-functioning ASD, aged 8-16 years (n=30) and typically developing (n=30). This study was conducted in 2016-2017 in Tehran (Iran). The Multivariate Analyses of Variance (MANOVA) was used to compare the between-group differences on WM tasks. In addition, Pearson’ s correlation coefficient was used to examine the relationship between the ASD and ADHD symptoms with WM performance. The data were statistically analyzed using the Statistical Package for the Social Sciences (SPSS), version 16. Results: It was found that in general, WM was impaired in the people with ASD. Unexpectedly, in the present study, two subscales of Social interaction and Stereotyped Behaviors of the Gilliam Autism Rating Scale-Second Edition showed a significant positive correlation respectively with a score of two WM tasks, i. e. Visual Digit Span and Digit Span Forward. Conclusion: These results showed that WM was impaired in individuals with ASD and that could have implications for intervention, but it is necessary that therapists be careful in choosing the appropriate tasks for intervention.

Background: Although pregnancy and childbirth are physiological processes, fear of childbirth is a common problem that is often associated with requests for cesarean delivery. This study was undertaken to determine the validity and reliability of the Wijma Delivery Expectancy/Experience Questionnaire A (W-DEQ [A]) primiparous women in Mashhad, Iran. Methods: This study was conducted on 220 primiparous women with a gestational age of 28-30 weeks referred to health centers in Mashhad. Using demographic questionnaire, Beck’ s Anxiety Inventory, Beck’ s Depression Inventory, and the W-DEQ (A), for determining the validity and reliability of the W-DEQ (A), first two linguists translated the questionnaire into Persian; then, two other linguists translated the Persian version back into English. The content validity of this version was then assessed by expert faculty members. The final version was sent to the questionnaire’ s original developers (Klass Wijma and Barbro Wijma) and then used after their approval. Factor analysis was used to analyze the data. Results: The result of actor analysis revealed six factors, forming 58. 8% of the total variance. The reliability of this questionnaire was confirmed with a Cronbach’ s alpha coefficient of 0. 84, and the fear of childbirth was found to be correlated with Beck’ s anxiety (r=0. 414) and depression (r=0. 287) scores. Conclusion: The W-DEQ (A) is a valid and reliable tool for measuring the fear of childbirth and is recommended to be used for measuring the fear of childbirth among Iranian women.

Background: Recurrent hydatidiform moles (RHMs) are an unusual pregnancy with at least two molar gestations that are associated with abnormal proliferation of trophoblastic tissue and a failure in the embryonic tissues development. Three maternaleffect genes, including NLRP7, KHDC3L, and PADI6 have been identified as the cause of RHMs. The present study aimed to understand the association of a founder mutation with the incidence and prevalence of a disease in different individuals of a population. Methods: 14 unrelated Iranian patients with recurrent reproductive wastage, including at least two HMs, entered this study. In order to find a possible mutation in KHDC3L, all the 14 samples were Sanger sequenced. For haplotype analysis, three single nucleotide polymorphisms (SNPs) were selected with highest Minor Allele Frequency along KHDC3L. Results: A common KHDC3L mutation with the same haplotype was identified in four out of 14 patients with RHM. Regarding the present study, c. 1A>G is the highest reported mutation in KHDC3L so far and is also the first report of the homozygous state that has led to RHM. Conclusion: c. 1A>G mutation in KHDC3L is the highest reported mutation around the world. Our data also demonstrated the presence of founder effects for this particular mutation in Iranian populations. These data suggest that the high frequency of this mutation is potentially responsible for a higher rate of RHM in Iran.

Background: To date, more than 90 Streptococcus pneumoniae (S. pneumoniae) capsular serotypes are known. The prevalence of these serotypes varies according to the geographical area and the regional vaccination program. Due to the lack of regular vaccination programs for S. pneumoniae in developing countries, serotyping of the prevalent isolates is useful in selecting the correct vaccine. The present study aimed to evaluate common serotypes of pneumococcal meningitis in Bojnurd, Iran. Methods: All cerebrospinal fluid (CFS) samples suspected for bacterial meningitis were analyzed. The samples were collected during 2014-2018 in the Laboratory of Imam Reza Hospital (Bojnurd, Iran). Due to the high rate of false-negative cultures, polymerase chain reaction (PCR) was used for the detection of lytA and psaA genes of S. pneumoniae. In addition, the modified Marimon’ s PCR method was used for serotyping the bacteria. The data were analyzed using Pearson’ s Chi-square test. Results: Out of the 901 CSF samples, 106 cases tested positive for S. pneumoniae using the PCR method, while only 92 cases tested positive using the conventional methods. Based on the Marimon’ s PCR method, serotypes 23F, 19F, 19A, 1, 14, and serogroup 6A/B were the most common types. Serogroups 18C, 15A/F, 15B/C, 9A/V, 7A/F, 11A/D/F, and 22A/F were also detected in isolates. Note that 2. 8% of the samples were non-typable (NT). Conclusion: The results showed that only 13 serotypes were responsible for all meningitis cases. Pneumococcal capsular vaccine-13 (PCV-13) is the preferred choice against common serotypes of S. pneumoniae in northeast Iran. The abstract was presented in Iran’ s 19th International Congress of Microbiology, as a poster and published in the congress abstracts book.

Background: Kidney stone disease can be quite painful, recurrent, and affects many people. Despite advances in drug therapy, there is still a need to find effective drugs with fewer complications for long-term treatment of kidney stones and to prevent its recurrence. The present study aimed to evaluate the effect of Prunus mahaleb L. seed extract on ethylene glycol-and ammonium chloride-induced urolithiasis in BALB/c mice. Methods: The Prunus mahaleb L. seeds were collected in Mashhad (Iran) in June 2017. Urolithiasis was induced in male BALB/c mice by adding ethylene glycol (EG) 0. 75% (v/v) and ammonium chloride (AC) 2% (w/v) to their drinking water for 21 consecutive days. A total of 72 animals were randomly divided into six groups of twelve animals each. Group 1 received purified water as control; group 2 received EG+AC in drinking water; groups 3-5 received the extracts by gavage in dosages of 100, 300, 500 mg/kg body weight, respectively; and group 6 received 888 mg/kg Sankol by gavage. Note that urolithiasis was induced in groups 3-6 in the same manner as in group 2. The data were analyzed using GraphPad Prism Software (version 5. 01). Results: The group receiving Prunus mahaleb L. extract in a 500 mg/kg dose responded better to the treatment and less damage to the kidney tissue was observed. The serum parameters remarkably decreased in the calculi-induced animals. Besides, the acute toxicity test showed that the use of the extract was safe in animals. Conclusion: The results showed that the use of Prunus mahaleb L. extract effectively prevented the formation of kidney stones.

Resistant ovary syndrome (ROS) is a presentation of hypergonadotrophic hypogonadism condition with very low incidence. Infertility is one of the most common complaints of women with this syndrome. We herein present a case of a 27-yearold woman with all features of secondary amenorrhea and secondary sexual characteristics. In 2018, the patient was referred to the Hazret-e-Zeinab Infertility Center affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. She was diagnosed with secondary amenorrhea and increased gonadotropin secretion after menopause. However, the patient had a normal antral follicle count, anti-Mü llerian hormone level, 46, XX karyotype, and thyroid function. After taking oral contraceptives her menstruation started, but she showed no response to high doses of exogenous gonadotropins. She was advised to have an embryo derived from in vitro maturation. By using patients’ own oocyte maturation, this technique could be a better treatment for infertile women with ROS. This case report is particularly interesting due to the rarity of its prevalence and similarity with primary ovarian insufficiency.

Conjoined twins are derived from the division of a single fertilized ovum; a phenomenon accompanied with multiple congenital anomalies. Such twins are identical, of the same sex, and more likely to be female. Most twins die during the embryonic period, and only 18% survive longer than 24 hours. There are complex anomalies in thoraco-omphalopagus twins that makes them unlikely to live long enough to undergo separation. Treatment of this uncommon condition presents both surgical and anesthetic challenges. The management of rare anomalies is difficult even for skilled surgeons. Therefore, it is logical to use the knowledge gained from previous experiences. We herein present the first successful surgical separation of two pairs of thoraco-omphalopagus conjoined twins at the Pediatric Surgery Center of Namazi Hospital (Shiraz, Iran). In both cases, the neonates had separate hearts and common pericardium. Contrast-enhanced computed tomography of two sets of twins showed fusion of sternum, pericardium, diaphragm, and left lobe of liver. Critical steps of the surgical separation were identified and contingency plans were made for possible partial liver donation and cross-circulation between twins. The separation procedure and reconstruction of the abdominal wall were successfully performed. Both pairs of twins, now 6-and 8-year-old, are healthy and have normal growth and are under follow-up.

Dear Editor With great interest, I read a recently published article (IJMS issue: Volume 44, number 6, November 2019) by Mohammadi and colleagues titled “ Effects of tranexamic acid on bleeding and hemoglobin levels in patients with staghorn calculi undergoing percutaneous nephrolithotomy” . 1 In their randomized controlled trial, they evaluated the effect of Tranexamic acid (TXA), as an anti-fibrinolytic agent, in preventing excessive bleeding after percutaneous nephrolithotomy (PCNL). They concluded that “ TXA reduced the risk of bleeding during and after PCNL and attenuated the drop in the hemoglobin level in the postoperative period” . Furthermore, in the methods section, they stated: “ The exclusion criteria comprised of intravascular coagulation, skeletal disorders, acquired color vision, subarachnoid hemorrhage, drug sensitization, and non-consumption of aspirin, warfarin, or vitamin E” . Based on the above, it is not clear whether patients with disseminated intravascular coagulation or those with thrombosis in the renal veins or lower extremity vessels had been excluded from the trial. Moreover, I believe that the non-consumption of aspirin, warfarin, or vitamin E should have been the inclusion rather than exclusion criterion.