Initial Presentation of HIV Infection With Two Successive Acute Arterial Thromboses: A Case Report.

IntroductionOne of the complications of HIV infection is greater risk of thromboembolic events. A variety of mechanisms has been found to be responsible for prothrombotic tendency in patients with HIV infection.Case presentationA 27-year-old heterosexual smoker man was referred to our center due to a sudden-onset severe left lower extremity pain and claudication since three days prior to admission. In physical examination, end extremity coldness and discoloration as well as left lower extremity pulselessness were found. Color-Doppler sonography revealed a large thrombus in the left common iliac artery and two thrombi in the distal halves of both anterior and posterior tibialis arteries, so the patient was transferred to the operating room for proximal thrombectomy where the blood flow was reestablished and all pulses were then detectable. Two days later, the patient developed another similar episode from knee down and underwent the second thrombectomy. In evaluation, HIV Ab had positive result by ELISA.ConclusionsThis case inspires consideration of HIV infection as a leading cause of thromboembolic event in individuals affected by the first episode of unprovoked one in whom diagnosis of HIV infection has not been established yet

Accessibility and Types of Online Sources Cited in Scholarly Biomedical Journal in Iran

One type of frequently used references in scientific papers is online references. The aim of this study is to study the prevalence, accessibility and types of online sources in biomedical journals in Iran from 2010 to 2012. We analyzed online references cited in 401 articles from 21 scientific journals indexed in PubMed, Web of Science, and Scopus. Findings revealed that only 73 papers (18.2%) had cited online sources in their references. of 186 online citations, 72 (38.7%) citations were accessible, and the URLs to 114 citations did not work (61.3%). The majority of unreachable citations were unstable citations (32.3%). Most online sources (62%) were cited in “Iranian Journal of Public Health”. An increase in the number of online citations was observed over the studied years. The study indicated that the rate of online citations is low in the studied journals, and most online citations were unreachable. The lack of clear guidelines in citing online sources seemed to be a major reason for the inaccessibility of online citations

Assessing Knowledge Translation in Iranian Medical Research Centres

Research centres have been always trying to promote their knowledge translation activities. Thus, understanding the status of knowledge translation in research centres is of high importance. The aim of this study was to investigate the status of knowledge translation in Iranian medical research centres to identify their weaknesses and strengths. This was a cross-sectional and descriptive study. To collect the data, we used a self-assessment tool which consisted of four domains: “research question”, “knowledge production”, “knowledge transfer”, and “the use of evidence”. Data was analyzed using SPSS and descriptive statistics. The mean score of “knowledge translation” in the studied research centres was 3.21 (SD= 0.69, Median= 3.29). “Knowledge production” obtained the highest score (M= of 3.6, SD= 0.72), followed by “knowledge transfer” (M=3.16, SD =0.76), “research question” (M=3.09, SD= 0.73), and “the use of evidence” (M= 2.95, SD= 0.98). Medical research centres had a proper situation in all aspects of knowledge translation. However, they should try to identify and prioritize the research questions of stakeholders and target groups by making more efficient relationship with them. They should also prepare appropriate reports of research results and should consider enough budgets for disseminating the reports among target groups and healthcare decision makers in order to allow them understand the actionable message of research results

Accessibility and Types of Online Sources Cited in Scholarly Biomedical Journal in Iran

One type of frequently used references in scientific papers is online references. The aim of this study is to study the prevalence, accessibility and types of online sources in biomedical journals in Iran from 2010 to 2012. We analyzed online references cited in 401 articles from 21 scientific journals indexed in PubMed, Web of Science, and Scopus. Findings revealed that only 73 papers (18.2%) had cited online sources in their references. of 186 online citations, 72 (38.7%) citations were accessible, and the URLs to 114 citations did not work (61.3%). The majority of unreachable citations were unstable citations (32.3%). Most online sources (62%) were cited in “Iranian Journal of Public Health”. An increase in the number of online citations was observed over the studied years. The study indicated that the rate of online citations is low in the studied journals, and most online citations were unreachable. The lack of clear guidelines in citing online sources seemed to be a major reason for the inaccessibility of online citations

Subclinical left ventricular systolic dysfunction in patients with metabolic syndrome: A case–control study using two-dimensional speckle tracking echocardiography

BACKGROUND: The dramatic increase in the prevalence of metabolic syndrome is associated with more increased cardiovascular morbidity and mortality in this group. Some recent studies suggested that metabolic syndrome is associated with increased risk of subclinical left ventricular (LV) systolic dysfunction. In the present cross-sectional case&ndash;control study, the utility of two-dimensional speckle tracking echocardiography (STE) was examined to detect early LV systolic dysfunction in this population. METHODS: A total of 75 clinically asymptomatic subjects with LV ejection fraction (LVEF) &ge; 55%, 39 without metabolic syndrome and 36 with metabolic syndrome, matched for gender and age, were enrolled in this case&ndash;control study. Metabolic syndrome was diagnosed using the National Cholesterol Education Program/Adult Treatment Panel III criteria. LV systolic function was assessed by STE-derived global and segmental longitudinal strain (&epsilon;LL). RESULTS: Global &epsilon;LL was significantly lower in patients with metabolic syndrome compared with normal population (&minus;18.41 &plusmn; 2.20% vs. &minus;21.2 &plusmn; 2.1%, P &lt; 0.001). Segmental &epsilon;LL was significantly lower in patients with metabolic syndrome in comparison to control group except for basal anteroseptal (&minus;19.95 &plusmn; 2.90% vs. &minus;21.15 &plusmn; 3.30%, P = 0.106), basal anterolateral (&minus;17.5 &plusmn; 5.0% vs. &minus;18.3 &plusmn; 4.1%, P = 0.437), and basal inferolateral segments (&minus;18.1 &plusmn; 6.3% vs. &minus;18.9 &plusmn; 4.1%, P = 0.526). CONCLUSION: STE-derived longitudinal LV strain (&epsilon;LL), a marker of subclinical cardiovascular disease, is impaired in asymptomatic individuals with metabolic syndrome and normal LVEF. &nbsp;&nbsp;</div

Initial Presentation of HIV Infection With Two Successive Acute Arterial Thromboses: A Case Report.

IntroductionOne of the complications of HIV infection is greater risk of thromboembolic events. A variety of mechanisms has been found to be responsible for prothrombotic tendency in patients with HIV infection.Case presentationA 27-year-old heterosexual smoker man was referred to our center due to a sudden-onset severe left lower extremity pain and claudication since three days prior to admission. In physical examination, end extremity coldness and discoloration as well as left lower extremity pulselessness were found. Color-Doppler sonography revealed a large thrombus in the left common iliac artery and two thrombi in the distal halves of both anterior and posterior tibialis arteries, so the patient was transferred to the operating room for proximal thrombectomy where the blood flow was reestablished and all pulses were then detectable. Two days later, the patient developed another similar episode from knee down and underwent the second thrombectomy. In evaluation, HIV Ab had positive result by ELISA.ConclusionsThis case inspires consideration of HIV infection as a leading cause of thromboembolic event in individuals affected by the first episode of unprovoked one in whom diagnosis of HIV infection has not been established yet

Co-Incidence of Acute Appendicitis and Appendiceal Transection after Blunt Abdominal Trauma: A Case Report

A 13-year-old boy with a history of bicycle handlebar injury to the left side of his abdomen was brought to the Emergency Department of our center. On admission, his vital signs were stable and abdominal examination revealed ecchymosis and tenderness of the injured areas. Mild to moderate free fluid and two small foci of free air in the anterior aspect of the abdomen, in favor of pneumoperitoneum, were detected in abdominopelvic sonography and CT-scan, respectively. In less than 6 hours, the patient developed generalized peritonitis. Therefore, exploratory laparotomy was promptly performed, which revealed appendiceal transection and rupture of the small bowel mesentery. Appendectomy and small bowel mesoplasty were done, with pathological diagnosis of acute appendicitis and periappendicitis. After surgery, the patient had a non-complicated hospital course. This rare case highlights the significance of the early management of appendiceal traumatic injuries in order to prevent further complicated events, especially in patients who are much more exposed to this risk due to their traumatic background

Evaluation of mast cell counts and microvessel density in reactive lesions of the oral cavity

Background. Reliable immunohistochemical assays to assess the definitive role of mast cells (MCs) and angiogenesis in the pathogenesis of oral reactive lesions are generally not available. The aim of the present study was to evaluate mast cell counts (MCC) and microvessel density (MVD) in oral reactive lesions and determine the correlation between MCC and MVD. Methods. Seventy-five cases of reactive lesions of the oral cavity, including pyogenic granuloma, fibroma, peripheral giant cell granuloma, inflammatory fibrous hyperplasia, peripheral ossifying fibroma (15 for each category) were immunohisto-chemically stained with MC tryptase and CD31. Fifteen cases of normal gingival tissue were considered as the control group. The mean MCC and MVD in superficial and deep connective tissues were assessed and total MCC and MVD was computed for each lesion. Results. Statistically significant differences were observed in MCC and MVD between the study groups (P < 0.001). MC tryptase and CD31 expression increased in the superficial connective tissue of each lesion in comparison to the deep con-nective tissue. A significant negative correlation was not found between MCC and MVD in oral reactive lesions (P < 0.001, r = -0.458). Conclusion. Although MCs were present in the reactive lesions of the oral cavity, a direct correlation between MCC and MVD was not found in these lesions. Therefore, a significant interaction between MCs and endothelial cells and an active role for MCs in the growth of oral reactive lesions was not found in this study

Botulinum toxin injection for treatment of acute traumatic superior oblique muscle palsy

Purpose: To evaluate the outcomes of botulinum toxin injection into the inferior oblique (IO) muscle for management of unilateral acute traumatic superior oblique (SO) palsy. Methods: In this prospective case series, 10-20 units of botulinum toxin A (Dysport, Ipsen, Biopharm Ltd., Wrexham, UK) was injected into the ipsilateral IO muscle of 13 consecutive patients with unilateral acute traumatic SO palsy. All patients received injections within four weeks of the incident. Results: Mean age was 29 ± 15 years and 12 (92%) subjects were male. Mean amount of hypertropia (in primary position) was decreased from 10.0 ± 3.9Δ at baseline to 4.6 ± 8.9Δ, one month after the injection, and to 1.5 ± 2.7Δ at final follow-up (P = 0.001). IO overaction improved from 2.7 ± 0.6 to 1.0 ± 1.2 and 0.6 ± 0.9 (P ≤ 0.001), and subjective torsion from 5.3 ± 3.9 to 3.2 ± 3.4 and 1.6 ± 2.5 degrees (P ≤ 0.001), at the same time intervals respectively. One month after the injection as well as at final follow-up, 10 (77%) patients were diplopia-free in primary and reading positions. Subgroup analysis showed that patients who recovered had less baseline hypertropia as compared to those who failed (8.3Δ vs. 15.7Δ, respectively; P = 0.01). All patients with a favorable outcome had baseline hypertropia of 10Δ or less. Conclusion: A single injection of BTA into the IO muscle can rapidly and safely resolve symptomatic diplopia in patients with acute traumatic SO palsy, while waiting for spontaneous recovery

A New Brace for Maintaining the Neck in a Suitable Position Following Tracheal Reconstruction

Segmental resection and end-to-end anastomosis is the treatment of choice for patients suffering from tracheal stenosis for whom conservative management is not planned. A complication of this procedure is tension-induced anastomotic failure. To prevent this complication, maintaining the neck in full flexion by means of a suture between the chin and upper chest is a traditional approach. We have designed a new brace (Shiraz brace) that securely supports the neck in this position and decreases the bothersome use of the suture alone