Time-Dependent Bearing Capacity Increase of Uniformly Driven Tapered Piles- Field Load Test

This paper describes the results of field load tests on concrete tapered and straight-sided piles driven into a cohesive saturated ground. The piles were driven into a depth of 12 m at a close distance using diesel hammer machine. The soil profile consisted mainly of soft CL and ML in the Unified Soil Classification System. Two piles were tested initially after 35 days from the installation date using maintained load test procedure according to ASTM D1143-81. Then similar tests were performed on two piles after 289 days following the installation date. The results showed the capacities of both piles were roughly identical after 35 days from the installation time. The load-settlement behaviour of tapered showed stiffer than that of the straight-sided pile. After 289 days from the installation date, both piles offered greater bearing capacity values. The long term bearing capacity of a tapered pile was about 80% greater than that of a uniform pile of the same volume and length. In long term, for a given load level applied to the pile heads, the tapered pile offered greater stiffness than the straight-sided pile. This indicates the advantageous use of tapered piles instead of straight sided piles of the same volume and length

Omega 3 in Childhood Migraines: a Double Blind Randomized Clinical Trial

How to Cite This Article: Fayyazi A, Khajeh A, Ghazavi A, Sangestani M. Omega 3 in Childhood Migraines; A Double Blind Randomized Clinical Trial. Iran J Child Neurol. Winter 2016; 10(1):9-13.AbstractObjectiveThe effect of using omega-3 to prevent migraine attacks has been raised in recent studies. The majority of these studies have been conducted in adults.Conversely, other studies have yet to confirm the effect of omega-3. The main purpose of this study was to assess the effects of omega-3 in the prevention of migraine attacks in children.Materials & MethodsIn this study, children aged 5–15 years with a diagnosis of migraine were randomly assigned to case and control groups. The case group was treated with sodium valproate and 1 g of omega-3; the control group was treated with sodium valproate and a placebo for 2 months. The severity of attacks was evaluated before and after the treatment using PedMIDAS and parental satisfaction (CGI) using a 7-point Likert scale.ResultsIn this study, 12 cases and 13 controls were enrolled. The average number of headache attacks per month decreased significantly in both groups after starting the treatment but there was no significant difference between the two groups. The severity of attacks decreased significantly in both groups afterstarting the treatment but it was not significant between them. Examination of the CGI average showed the average was 6.08 (SD = 0.52) in the case group and 6.07 (SD = 0.65) in the control group.ConclusionThe present study indicated that omega-3 with a dose of 1 mg per day has no effect in reducing the severity and frequency of migraine attacks in children.Sodium valproate was effective in reducing the frequency and severity of attacks

The Ketogenic and Atkins Diets Effect on Intractable Epilepsy: A Comparison

How to Cite This Article: Ghazavi A, Tonekaboni SH, Karimzadeh P, Nikibakhsh AA, Khajeh A, Fayyazi A. The Ketogenic and Atkins Diets Effect on Intractable Epilepsy: A Comparison. Iran J Child Neurol. 2014 Summer;8(3): 12-17.AbstractObjectiveIntractable epilepsy is a major difficulty in child neurology, because the numbers of drugs that are available for treatment are limited and new treatments such as diets must be tried. Now there are some diets available for treating patients with intractable epilepsy. The oldest diet is the classic ketogenic diet and one of thenewest diets is the modified Atkins diet. Patients have a harder time accepting the classic ketogenic diet than the Atkins diet, which is easier to accept because the food tastes better. This study compares the efficacy of the ketogenic diet and the Atkins diet for intractable epilepsy in children.Materials & MethodsThis study is a clinical trial survey with sample size of 40 children with refractory epilepsy who were patients at Mofid hospital in Tehran, Iran. Initially, from Jan 2005–Oct 2007, 20 children were treated with the Atkins diet, and then from Oct 2007–March 2010, the other group was treated with the classic ketogenic diet and the results were compared. ResultsIn this study, response to treatment was greater than a 50% reduction in seizures and at the end of first, second, and third months for the ketogenic diet were 55%, 30%, and 70% and for the Atkins diet were 50%, 65%, and 70%, respectively.ConclusionThe results of this study show that there is no significant difference between the classic Ketogenic diet and the Atkins diet at the end of first, second, and third months and both had similar responses to the treatments.References Camfield CS, Canfield PR, Gordon K, Wirrell E, Dooley JM. Incidence of epilepsy in childhood and adolescents in Nova Scotia. Epilepsia, 1996 Jan;37(1):19-23.Gessner U, Sagmeister M, Horisberger B. The cost of Epilepsy in Switzerland. Int J Health Sci 1993;4:121-8.Aicardi J. Epilepsy in children. Philadelphia: Lippincott Williams & Wilkins; 2004. p. 38.4. Kossof EH. More fat and fewer seizures: dietary therapy ofepilepsy. Lancet Neurol 2004 Jul;3()7):415-20.Hassan AM, Keene DL, Whiting SE, Jacob PJ, Champagne JR, Humphreys P. Ketogenic diet in the treatment of refractory epilepsy in childhood. Pediatr. Neurol. 1999; 21: 548-552.Vining EP, Freeman JM, Ballaban-Gil K, Camfield CS, Camfield PR, Holmes GL et al. A multicenter study of the efficacy of the ketogenic diet. Arch Neurol 1998 Nov;55(11):1433-7.Nordli DR, Kuroda MM. Experience with the ketogen diet in infants. Pediatrics 2001 Jun; 108(1):129-33.Tonekaboni SH, Mostaghimi P, Mirmiran P, Abbaskhanian A, Abdollah GF, Ghofrani M, et al. Efficacy of Atkins diet as therapy for intractable epilepsy in children. Arch Iran Med 2010 Nov;13(6):492-7.Kossoff EH, Dorward JL. The modified Atkins diet. Epilepsia 2008 Nov;49 Suppl 8:37-41.Mirjavadi SAR, Tonekaboni SH, Ghazavi MR, Azarghashb E, Abdollah GF, Ghofrani M. Efficacy of ketogenic diet as a therapy for intractable epilepsy in children. Iran J Child Neurol 2010 Sep;4(2):27-36.Karimzadeh P, Tabarestani S, Mahvelati F, Tonekaboni SH, Ghofrani M. Intractable seizure disorfes; efficacy of the classic ketogenic diet. Iran J Child Neurol 2009 Jan; 3(1):15-20.Barzegar M, Ostad Rahimi AR, Eslampour Sh, Shabazi Sh. The Ketogenic diet for refractory epilepsy. Med J Tabriz Uni Med Sci Health Serv 2009;31:15-20.Lefevre F, Aronson N. Ketogenic diet for the treatment of refractory epilepsy in children: A systematic review of efficacy. Pediatrics 2000 Apr;105(4):105-9.Keene DL. A systematic review of the use of the ketogenic diet in childhood epilepsy. Pediatr Neurol 2006 Jul;35(1):1-5.Porta N, Vallee L, Boutry E, Fontaine M, Dessein AF, Joriot S, et al. Comparsion of seizure reduction and serum fatty acid levels after receiving the ketogenic and modified Atkins diet. Seizure 2009 Jun 18(5):359-64

Increase in TGF-β and CD4+ CD25+ regulatory T cells in Iranian patients with type 2 diabetes

Background and Aims Since in patients with type 2 diabetes (T2DM), there is an imbalance of inflammatory cells, the presence of inflammatory cytokines and defects in homeostasis are possible. The present study aimed to evaluate the percentage of Treg cells, lymphocytes, T cells, and T helper cells and gene expression of TGF-β cytokine in the T2DM patients.Methods Fifty patients with T2DM and 50 healthy controls were included in this study, according to the inclusion criteria. The percentage of Treg cells, T cells, and T helper cells was determined by flow cytometry. Also, the expression of CD4, CD25, and FOXP3 markers of Treg cells was examined. The gene expression of TGF-β cytokine was evaluated by real-time polymerase chain reaction (PCR).Results The percentage of Treg cells was significantly lower in patients with T2DM than in healthy controls. The number of T helper cells and lymphocytes decreased in T2DM patients as compared to the healthy controls. Based on the results, the percentage of T cells was higher in T2DM patients than in healthy controls. The expression of CD25 and FOXP3 markers in Treg cells significantly reduced in T2DM patients compared to the healthy controls; however, this decrease was not significant for the CD4 marker. Conversely, the expression of TGF-β cytokine increased in patients with T2DM compared to the healthy controls.Conclusion The expression of TGF-β and the percentage of CD4 + CD25 + regulatory T cells are impaired in patients with type 2 diabetes

Use of Complementary and Alternative Medicine for Epileptic Children in Tehran: A Cross-Sectional Study (2009-2011)

How to Cite This Article: Tonekaboni Sh, Jafari Naeini S, Khajeh A, Yaghini O, Ghazavi A, Abdollah Gorji F. Use of Complementary and Alternative Medicine for Epileptic Children in Tehran: A Cross-Sectional Study (2009-2011). Iran J Child Neurol. 2014 Winter; 8(1):26-31.ObjectiveAlthough the use of Complementary and Alternative Medicine (CAM) has been evaluated globally, there are few studies in our country on this subject. The purpose of this study was to determine the prevalence, pattern of use, parental sources of information, and benefits of CAM in epileptic children in Tehran.Materials & MethodsOne hundred thirty-three parents or relatives of epileptic children who were referred to outpatient clinics or admitted in neurologic ward of four major hospitals in Tehran, were interviewed by our researcher based on a structured questionnaire; from 2009 to 2010. The information obtained comprised the demographic data of patients and their parents, frequency and morphology of convulsions, the type and sources of CAM and finally, the benefits and adverseeffects of this practice.ResultsForty-four percent of the respondents had used CAM methods either alone or in combination with other methods. The most frequently used CAM was written prayers followed by oral herbs and special diets. CAM was mainly introduced to them by relatives. Only 16.7% of these parents had discussed this matter with their children’s physicians. No efficacy to control seizure was observed for most of these methods.ConclusionThis study showed that use of CAM in our study group is relatively common and may have a potentially hazardous role in the treatment process. So, it is necessary for physicians to have enough information about CAM practice in their patients. References:National Institutes of health. More than one third of US adults use complementary and alternative medicine, according to new government survey. [Serial online] 2004 (cited 2004 May 27). Available from: http://nccam. nih.gov/news/2004/052704.htm.Traditional Medicine: The Fifty-Sixth World Health Assembly WHO, 2003. World Health Organization, 2011. Available from: http://apps.who.int/gb/archive/ pdf_files/WHA56/ea56r31.pdfMichi CA. The use of herbal remedies in Jamaica. Ann Trop Paediatr 1992;12(1):31-6.Ricotti V, Delanty N. Use of complementary and alternative medicine in epilepsy. Curr Neurol Neurosci Rep 2006;6(4):347-53.Aburahma SK, Khader YS, Alzoubi k, Sawalha N. Complemetary and alternative medicine use in a pediatric neurology clinic. Complement Ther Chin Pract 2010;16(3):117-20.Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, et al. Trends in alternative medicine use in United States, 1990-1997: results of a follow-up national survey. JAMA 1998;280(18):1569-75.Khonsari A, Gorji K, Abdollahpur F, Dehestani S, Mousavi A, Delfan B et al. Study of international approaches on treatment of common diseases using different methods of complementary medicine. J Ilam Uni Med Sci 2009;4:37-45. (Full text in Persian)Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med 20003;342(5):314-9.Oshikoya KA, Senbanjo IO, Njokanma OF, Soipe A. Use of complementary and alternative medicine for children with chronic health conditions in Lagos, Nigeria. BMC Complement Altern Med 2008;8:66.Liow K, Ablah E, Nguyen JC, Sadler T, Wolfe D, Tran KD et al. Pattern and frequency of use of complementary and alternative medicine among patients with epilepsy in the mid western United States. Epilepsy Behav 2007;10(4):576-82.Tehrani Banihashemi SA, Asgharifard H, Haghdoost AA, Barghamdi M, Mohammadhosseini N. The use of complementary/ Alternative medicine among the general population in Tehran /Iran. Payesh 2008;7(4):355-62.(Full text in Persian)Ekici B, That B, Abah S, Aydinli N, Ozmen M. Application of complementary and alternative medicine in epileptic children at a tertiary pediatric neurology center in Turkey. Eur J Integr Med 2011;4:e71-5.Soo I, Mah JK, Barlow K, Hamiwka L, Wirrell E. Use of complementary and alternative medical therapies in pediatric neurology clinic. Can J Neurol Sci 2005;32(4):524-28.Cuzzolin L, Zaffani S, Murgia V, Gangemi M, Meneghelli G, Chiamenti G, et al. Patterns and perceptions of complementary/alternative medicine among paediatricians and patients’ mothers: a review of the literature. Eur J Pediatr 2003;162(12):820-7

Prophylaxis of Childhood Migraine: Topiramate Versus Propranolol

How to Cite this Article: Tonekaboni SH, Ghazavi A, Fayyazi A, Khajeh A, Taghdiri MM, Abdollah Gorji F, Azargashb E. Prophylaxis of Childhood Migraine: Topiramate Versus Propranolol. Iran J Child Neurol. 2013 Winter; 7 (1):9-14. ObjectiveHeadache is a common disabling neurological disorder and migraine comprises more than half the causes of recurrent headaches in children. Despite extended prevalence of this type of headache there is lack of evidence about best drug treatment for migraine. So we aimed to compare the therapeutic effects of these drugs on childhood migraine.Materials & MethodsIn the current study, a randomized clinical trial consisting of 78 patients according to 2004 International Headache Association criteria were randomly assigned to two groups that matched by age and sex. One of these two groups was treated with Topiramate, while the other was given Propranolol. After one and four months, the efficiency of these treatments was measured in terms of frequency, severity and duration of migraine attacks.ResultsResults obtained from the data collected showed that of these 78 studied patients, 38 patients received Topiramate treatment (group A) and the rest (40 patients; group B) was treated with Propranolol. The average age of group A was 8.5± 2.9 years and that of group B was 8.3 ± 2.8 years. No significant difference was observed between these two groups in terms of reduction in frequency, severity and duration of migraine attacks.ConclusionResults showed that both treatments had the same efficiency in healing migraine headaches and there was no significant difference between their treating results. However, further studies are needed to examine medical effects of these two medicines. ReferencesAbu-Arefeh  I,  Russell  G.  Prevalence  of  headache  and migraine in schoolchildren. BMJ 1994 Sep 24; 309 (6957): 765-9.Lipton RB, Silberstein SD, Stewart WF. An update on the epidemiology of migraine. Headache 1994 Jun; 34 (6):319-28.Stewart WF, Linet MS, Celentano DD, Van Natta M, Ziegler D. Age- and sex-specific incidence rates of migraine with and without aura. Am J Epidemiol 1991 Nov; 134 (10): 1111-20.Marcos J. Cruz, Ignacio Valencia, Agustı´n Legido, et al, Efficacy and Tolerability of Topiramate in Pediatric Migraine. Pediatr Neurol 2009; 41: 167-170.Ashrafi  MR,  Shabanian  R,  Zamani  GR,  Mahfelati  F. Sodium valproat versus Propranolol in pediatric migraine prophylaxis. Eur J Pediatr Neurol 2005; 9 (5): 333-8.Hershey AD, Winner PK. Pediatric migraine: recognition and treatment. J Am Osteopath Assoc 2005 Apr; 105:4 ( Supple 2):2S–8S.Lewis DW, Scott D, Rendin V. Treatment of pediatric headache. Expert Opin Pharmacother 2002 Oct;3(10):1433-42.Stewart WF, Lipton RB, Kolodner K, Liberman J, Sawyer J. Reliability of the migraine disability assessment scores in a population-based sample of headache sufferers. Cephalalgia 1999 Mar; 19 (2): 107-14.Hershey AD,  Powers  SW,  Vockell ALB,  LeCates  SL, Kabbouche MA, Maynard MK. PedMIDAS: development of a questionnaire to assess disability of migraines in children. Neurology 2001 Dec; 57(11): 2034-9.Hershey AD, Powers SW, Vockell ALB, LeCates SL, Segers A, Kabbouche MA. Development of a patient- based grading scale for PedMIDAS. Cephalalgia 2004 Oct; 24 (10): 844-9.Ferraro D, Di Trapani G. Topiramate in the prevention of pediatric migraine: literature review. J Headache Pain 2008 Jun; 9 (3): 147-50.J W. Lance and P J. Goadsby. Mechanism and Management of Headache. Butterworth-Heinemann; 7th edition, 2004.Lipton RB, Silberstein SD. Stewart WF. An update on the epidemiology of migraine. Headache 1994 Jun; 34(6):319-28.

Thyroid Function in Epileptic Children who Receive Carbamazepine, Primidone, Phenobarbital and Valproic Acid

ObjectiveIn this study, we investigated the changes of the serum levels of thyroidhormones including Thyroxine (T4), Triiodothyronine (T3), T3 resin uptake andThyroid stimulating hormone (TSH) in epileptic children during treatment withanti-epileptic drugs (AEDs) including carbamazepine (CBZ), primidone (PRM),phenobarbital and valproic acid (VPA).Materials and MethodsThis study consisted of four case-series comparisons, was conducted on 115epileptic children (37 girls and 78 boys with an age range between 2 monthsand 15 years, mean: 62.06 ± 44.97 months). These children were divided into4 groups who took either phenobarbital (n=29), PRM (n=28), CBZ (n=29), orVPA (n=29) for 3 months. Thyroid hormone levels (T3, T3 resin uptake, T4 andTSH) were measured at the beginning and three months after starting the study.ResultsAt first, all patients were euthyroid and there were no clinical or laboratoryfindings suggestive of hypothyroidism. Regarding thyroid hormones before andafter the administration of phenobarbital, carbamazepine, valproic acid andprimidone, there were no significant changes in serum T3, T4, T3 resin uptakeand TSH levels.ConclusionOur findings showed that short term therapy with phenobarbital, carbamazepine,valproic acid and primidone had no effect on thyroid function etsts.Key words: Anti-epileptic drugs; Thyroid hormones; Epileptic children.  

Integration of phytotherapy and chemotherapy: Recent advances in anticancer molecular pathways

Cancer is a disease characterized by abnormal and uncontrolled growth of cells, leading to invasion and metastasis to other tissues. Chemotherapy drugs are some of the primary treatments for cancer, which could detrimentally affect the cancer cells by various molecular mechanisms like apoptosis and cell cycle arrest. These treatment lines have always aligned with side effects and drug resistance. Due to their anticancer effects, medicinal herbs and their active derivative compounds are being profoundly used as complementary treatments for cancer. Many studies have shown that herbal ingredients exert antitumor activities and immune-modulation effects and have fewer side effects. On the other hand, combining phytotherapy and chemotherapy, with their synergistic effects, has gained much attention across the medical community. This review article discussed the therapeutic effects of essential herbal active ingredients combined with chemotherapeutic drugs in cancer therapy. To write this article, PubMed and Scopus database were searched with the keywords “Cancer,” “Combination,” “Herbal,” “Traditional,” and “Natural.” After applying inclusion/exclusion criteria, 110 articles were considered. The study shows the anticancer effects of the active herbal ingredients by inducing apoptosis and cell cycle arrest in cancer cells, especially with a chemotherapeutic agent. This study also indicates that herbal compounds can reduce side effects and dosage, potentiate anticancer responses, and sensitize cancer cells to chemotherapy drugs

The Anti-inflammatory Effect of Ginger Extract on the Animal Model of Multiple Sclerosis

Background: Experimental autoimmune encephalomyelitis (EAE), as an autoimmune disease in the central nervous system (CNS), is an animal model for multiple sclerosis (MS) mediated by T lymphocytes.Objective: To investigate ginger extract’s effect on reducing inflammation and improving the symptoms in the EAE model.Methods: The EAE was induced by injecting MOG35-55 and pertussis toxin into eight-week-old female C57BL6 mice. The mice were treated with an intraperitoneal injection of 300 mg/kg/day of hydroalcoholic extract of ginger for 21 days. The disease severity and weight changes were measured daily. Then, the mice spleens were removed; the gene expressions of interleukin (IL)-17, transforming growth factor beta (TGF-β), interferon-γ (IFN-γ), and tumor necrosis factor α (TNF-α) were analyzed by Real-time PCR and the percentage of regulatory T lymphocytes (Treg cells) was determined by flow cytometry. Serum nitric oxide and antioxidant capacity were measured, and brain tissue sections were prepared to investigate the leukocyte infiltration and plaque formation.Results: The severity of symptoms in the intervention group was lower than in the control. The gene expression levels of inflammatory cytokines, including IL-17 (P=0.04) and IFN-γ (P=0.01), were reduced. The Treg cells increased significantly, and the serum nitric oxide level was lower in the ginger-treated group. There was no significant difference in lymphocyte infiltration in the brain between the two groups.Conclusion: The present study indicated that ginger extract could effectively reduce inflammatory mediators and modulate immune responses in EAE

Existential Philosophy of the Immune System: Defense or Homeostasis?

Background and Aim: There are two philosophies about the origin of the immune system, defense and homeostasis. In this article, the existential philosophy of the immune system was reviewed, in which the defense role is only part of its homeostasis functions. Materials and Methods: The Medline was searched for terms such as “Homeostasis”، “Immunculus”، “Natural autoantibody” “Evaluation” and “Immune system”. Findings: Hemostasis is the most important part of immune regulation and the existential philosophy of this system, so that its defensive role is only part of homeostasis functions. Natural antibodies play this role as immune reflection by showing qualitative and quantitative changes in the antigenic composition of the body. Therefore, the level of natural antibodies can also serve as a prognostic marker. Conclusion: Although many improvements have been made in explaining the hemostatic role of the immune system, many studies have to be conducted to identify its particular aspects