Evaluation of the catheter tip position among children with totally implantable port during 2015 in Dr. Sheikh Children’s hospital

Introduction: Totally implantable port insertion is a common procedure in pediatrics surgery and the main concern is the position of catheter tip, which is directly related to its complications, failure and durability. The best position is in superior vena cava (SVC)/ right atrium (RA) junction which is compatible with carina or T5-T6 vertebral level in chest x-ray. In our center we routinely use surface anatomy to estimate the adequate length for the tip to reach SVC/RA junction. In this study we compared the precision and accuracy of this method by post-operative chest x-ray study.Materials and Methods: as a retrospective study we evaluated the accuracy of surface anatomical land marks to estimate the catheter tip position, considering the carina or vertebra in chest x-ray which represents the SVC/RA junction. Fourty eight patients were included and their records were reviewed in Dr. Sheikh Children’s hospital in Mashhad.Results: Considering the carina as the best radiographic land mark, we had accurate tip position only in 29.2%, over insertion in 45.8% and under inserted catheter tip in 10.4%. Considering the vertebral bodies as radiographic land mark, 50% were over inserted, 35.4% accurate and 14.6% under inserted.Conclusion: Regarding our high rate of catheter tip mal-position arising from considering surface anatomy alone, we suggest not only to rely on surface anatomy but use imaging modalities such as portable X-ray, fluoroscopy or ultra-sonography within the operation room while inserting implantable port devices

Studying gap junction beta 2-related deafness in Iranian population

Hearing loss is the most common sensory disorder in humans, from every 1000 births, 1 is affected by severe to profound deafness. Many genes are involved in deafness that GJB2 gene is one of the most important ones and encodes the connexin 26 proteins. A mutation called delG35 composes most of mutated alleles of connexin 26 and is also the most common cause of congenital sporadic and hereditary deafness. Open Access Journals (DOAJ), Google Scholar, PubMed (NLM), LISTA (EBSCO), and Web of Science have been searched for literature. GJB2 gene mutations play the most significant role in non-syndromic deafness in Iran. 35delG mutation has a high frequency in most parts of Iran, especially in the North and North-West and is also the most common mutation in GJB2 deaf population of Iran. GJB2 gene mutations in Iran play less important roles compared with other countries in causing deafness; however, so far, it has been introduced as the gene that plays the most significant role in causing deafness gene in Iran. It seems that many other genes and loci play roles in causing deafness in Iran that requires more studies to be conducted. (Cite this article as: Mehri-Ghahfarrokhi A, Hashemzadeh-Chaleshtori M, Shojaeian A, Mahmoudian-Sani MR. Studying gap junction beta 2-related deafness in Iranian population. Otorinolaringol 2017;67:89-95. DOI: 10.23736/S0392-6621.17.02115-4

Study of common mitochondrial mutations in patients with nonsyndromic hearing loss

Hearing loss is the most common sensorineural disorder involving one out of 1000 people. Around 50% of hearing losses occur due to genetic causes. Three mitochondrial mutations, A1555G in MTRNR1, A3243G in MTTL1, and A7445G in MTTS1, are the most important non-syndromic sensorineural causes of hearing loss in some populations. The aim of this review was to study common mitochondrial mutations in people with hearing loss in Iran. EVIDENCE ACQUISITION: Directory of Open Access Journals (DOAJ), Google Scholar, PubMed (NLM), LISTA (EBSCO) and Web of Science were searched. EVIDENCE SYNTHESIS: Studies have indicated that the mitochondrial mutations A3243G, A1555G, and A7445G play no significant part in the development of hearing loss in Iran. Different variants of A7445C and G3316A have been identified in Iran. CONCLUSIONS: Further studies on other ethnicities and with a larger sample size are necessary to elucidate the role of these genes in hearing loss development in Iran

Comparison of the effects of two anesthesia maintenance methods by remifentanil or halothane on endoscopic sinus surgery condition

Introduction: Endoscopic surgery is a new standard method of treatment for chronic sinusitis. During this operation even small amount of bleeding may reduce the visual field of surgeon significantly and make the procedure troublesome. In this study we have compared the operative condition between patients who receive either remifentanil or halothane for general anesthesia. Materials and Methods: Endoscopic sinus surgery was performed in 60 patents. Pre- medication was done by fentanil and midazolam and induction was done by propofol and atracurium. Halothane or remifentanil was used in two groups of patients respectively for anesthesia maintenance. Monitoring was performed during anesthesia. Bleeding volume was measured and operation field condition was assessed by the surgeon. Results: Personal characteristics such as age and sex were the same in both groups. Intra- operative systolic blood pressures was significantly lower in remifentanil group but diastolic and mean blood pressure and heart rate didn’t change after induction and during maintenance in both groups. Recovery time in remifentanil group was also significantly shorter than halothane group. Finally bleeding volume was lower and operation field condition was better significantly in remifentanil group. Conclusion: Remifentanil is a good choice to maintain an ideal anesthesia for endoscopic sinus surgery.  

Association of serum miR-375, miR-155 and miR-146b levels with distinguish of papillary thyroid cancer from benign thyroid masses among Iranian patients

Background and aim: Certain serum levels of microRNAs (miRNAs) throughout the body can be helpful for cancer diagnosis and prognosis. The miRNAs can be secreted from the papillary thyroid cancer (PTC) into the circulatory system. Accordingly, this study aimed to measure the serum levels of miR-146b, miR-155 and miR-375 to evaluate their diagnostic potentials in distinguish of benign from malignant lesions. Materials and methods: The serum levels of miRNAs were measured by real-time quantitative RT-PCR among100 patients with benign thyroid nodules and 30 patients with PTC. Results: The mean miR-375 and miR-155 expression levels in the PTC group were greater when compared with the benign group. The area under the ROC curve (AUC) was estimated at 0.81 for the miR-375 with 0.76% sensitivity and 0.80% specificity to distinguish between benign and PTC lesions. The AUC was calculated to be 0.75 for the miR-155 with 0.69% sensitivity and 0.90% specificity. Conclusion: According to the results of this study, the serum levels of miR-155 and miR-375 were increased in the patients with PTC, which may be useful as alternative seromarkers for the PTC

Decreased cell proliferation and induced apoptosis in human B-chronic lymphocytic leukemia following miR-221 inhibition through modulation of p27 expression

Background This study aimed to investigate the effects of the miR-221 inhibition on the human B-chronic lymphocytic leukemia (B-CLL) cell viability and the p27 gene expression, to introduce a new treatment approach for this type of cancer. In this context, the cyclin-dependent kinase (Cdk) inhibitor 1B (p27(Kip1)) is considered as an enzyme inhibitor that encodes a protein belonging to the Cip/Kip family of the Cdk inhibitor proteins. Methods The affected miR-221 inhibition in the B-CLL cell viability was initially assessed. The inhibition of miR-221 in the B-CLL cell line (183-E95) was thus performed using locked nucleic acid (LNA) as an antagomir. After the LNA-anti-miR-221 transfection, the miR-221 quantification, cell viability, and apoptosis assays were evaluated at different intervals by the reverse transcription-quantitative polymerase chain reaction (RT-qPCR), the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay, and flow cytometry (FC), respectively. The qRT-PCR was also completed for the p27 gene. The data were subsequently analyzed by independent-samples t-test and one-way analysis of variance (ANOVA). Results A gradual reduction was observed in the B-CLL cell viability, and consequently the transfected LNA-anti-miR cell viability reached below 55% of the untreated cells after 72 h of transfection. A statistically significant difference was found in the cell viability between the LNA-anti-miR-treated and control groups (p-value <= 0.043). The downregulation of miR-221 in the B-CLL (183-E95) cells was further conducted by LNA-anti-miR-221. Conclusion The miR-221 inhibition significantly decreases cell viability through augmenting the p27 gene expression and inducing apoptosis. Moreover, the findings demonstrated that the inhibition of miR-221 might be a new treatment approach for B-CLL, although more confirmation is needed by investigating appropriate animal models

Assessing morphological changes in a human-impacted alluvial system using hydro-sediment modeling and remote sensing

Abstract Construction of managed aquifer recharge structures (MARS) to store floodwater is a common strategy for storing depleted groundwater resources in arid and semi-arid regions, as part of integrated water resources management (IWRM). MARS divert surface water to groundwater, but this can affect downstream fluvial processes. The impact of MARS on fluvial processes was investigated in this study by combining remote sensing techniques with hydro-sediment modeling for the case of the Kaboutar-Ali-Chay aquifer, northwestern Iran. The impact of MARS on groundwater dynamics was assessed, sedimentation across the MARS was modeled using a 2D hydrodynamic model, and morphological changes were quantified in the human-impacted alluvial fan using Landsat time series data and statistical methods. Changes were detected by comparing data for the periods before (1985–1996) and after (1997–2018) MARS construction. The results showed that the rate of groundwater depletion decreased from 2.14 m/yr before to 0.86 m/yr after MARS construction. Hydro-sediment modeling revealed that MARS ponds slowed water outflow, resulting in a severe decrease in sediment load which lead to a change from sediment deposition to sediment erosion in the alluvial fan. Morphometric analyses revealed decreasing alluvial fan area and indicated significant differences (p &lt; 0.01) between pre- and post-impact periods for different morphometric parameters analyzed. The rate of change in area of the Kaboutar-Ali-Chay alluvial fan changed from −0.228 to −0.115 km²/year between pre- and post-impact periods

Ultrasonographic Evaluation of the Sacrococcyx and Spinal Canal in Children with Constipation

Background The occult neurological disorders are an important cause of constipation in children. This study aimed to evaluate the spinal canal and lumbosacral by ultrasound in pediatric constipation to better identifying neurological causes of constipation. Materials and Methods In this case-control study, 100 children with constipation (age range 1 to 14 years) without previously known chronic illness referred to the Radiology Department of the Mashhad Pediatric Dr. Sheikh Hospital were selected. After recording clinical data, the patients were undergone sacral and spinal cord ultrasound examinations and the results were compared with the control group (healthy children with transient illness (otherwise constipation or urinary disorders) who had referred to radiology department for sonographic examination). Results The mean age of patients was 6 ± 3.3 years old. The tethered cord and occult intrasacral meningocele were observed in 2% of patients group. Spina bifida was found in 64% patients, and 31% control subjects with significant difference (P = 0.009). About one third of cases with spina bifida were found in lumbar L5 vertebra, and another two third were in high sacral vertebrae (S1 or S2). Various degrees of caudal regression were observed in 8% patients suffering from constipation and in control group, 2% children had coccyx hypoplasia. No significant correlation was found between case and control groups regarding the location of spina bifida and non-formation of the posterior arch of the sacrum, the mean coccyx length, dural diameter and the ossification age of first vertebra of coccyx. Conclusion In pediatric age, lumbosacral spinal anomalies can easily evaluate with ultrasound. The prevalence of spina bifida and caudal regression in children with constipation was significantly higher compared with normal control group

Progranulin (PGRN) as a regulator of inflammation and a critical factor in the immunopathogenesis of cardiovascular diseases

Abstract Immune dysregulation has been identified as a critical cause of the most common types of cardiovascular diseases (CVDs). Notably, the innate and adaptive immune responses under physiological conditions are typically regulated with high sensitivity to avoid the exacerbation of inflammation, but any dysregulation can probably be associated with CVDs. In this respect, progranulin (PGRN) serves as one of the main components of the regulation of inflammatory processes, which significantly contributes to the immunopathogenesis of such disorders. PGRN has been introduced among the secreted growth factors as one related to wound healing, inflammation, and human embryonic development, as well as a wide variety of autoimmune diseases. The relationship between the serum PGRN and TNF-α ratio with the spontaneous bacterial peritonitis constitute one of the independent predictors of these conditions. The full-length PGRN can thus effectively reduce the calcification of valve interstitial cells, and the granulin precursor (GRN), among the degradation products of PGRN, can be beneficial. Moreover, it was observed that, PGRN protects the heart against ischemia-reperfusion injury. Above all, PGRN also provides protection in the initial phase following myocardial ischemia-reperfusion injury. The protective impact of PGRN on this may be associated with the early activation of the PI3K/Akt signaling pathway. PGRN also acts as a protective factor in hyperhomocysteinemia, probably by down-regulating the wingless-related integration site Wnt/β-catenin signaling pathway. Many studies have further demonstrated that SARS-CoV-2 (COVID-19) has dramatically increased the risks of CVDs due to inflammation, so PGRN has drawn much more attention among scholars. Lysosomes play a pivotal role in the inflammation process, and PGRN is one of the key regulators in their functioning, which contributes to the immunomodulatory mechanism in the pathogenesis of CVDs. Therefore, investigation of PGRN actions can help find new prospects in the treatment of CVDs. This review aims to summarize the role of PGRN in the immunopathogenesis of CVD, with an emphasis on its treatment

Controlled vs Spontaneous Ventilation for Bronchoscopy in Children with Tracheobronchial Foreign Body

Introduction Tracheobronchial foreign body aspiration is a common life-threatening condition in children. There are controversies in the management of this condition, including the type of ventilation during bronchoscopy.  This study aims to compare anesthesia with controlled ventilation versus spontaneous ventilation in rigid bronchoscopy in children with foreign body aspiration.  Materials and Methods: Patients who were candidates for rigid bronchoscopy due to foreign body aspiration were randomly assigned to either anesthesia with spontaneous ventilation or controlled ventilation. End tidal CO2 (ETCO2), electrocardiogram (ECG), heart rate (HR), oxygen saturation (SpO2), non-invasive blood pressure (NIBP) and complications and accidents during the surgery and recovery were recorded for each patient. Surgeon comfort during the procedure was also evaluated for each patient. A 20% change in HR or NIBP was considered significant. SpO2 values under 90% are considered desaturation.  Results: Fifty-one patients (31 male and 20 female) entered the study. The mean age was 26.76 months, ranging from 6 to 100 months. Choking and cough were present in 94% and 96.1% of the patients, respectively. Nuts were the most common foreign body (76.9%). The controlled ventilation group had significantly fewer complications, and surgeon comfort was significantly higher in this group. Oxygen desaturation was significantly more prevalent in the spontaneous ventilation group during laryngoscopy and bronchoscopy (