In Honor of Dr. Mehdi Assmar, a Distinguished Researcher at the Pasteur Institute of Iran

Dr. Mehdi Assmar is a prominent researcher in Iran, with a specialization in parasitology and medical entomology, who has done a large amount of research related to the public health in Pasteur Institute of Iran and other institutions or universities for four decades. Most of his research has been on plague, recurrent fever, malaria, toxoplasmosis and leishmaniasis. Discovering the cause of resistance to plague infection among the rodents of the Kurdistan region is one of his important achievements. During his research, he found the extent of plague in the studied areas, the frequency of wild rodents and their external and internal parasites, the susceptibility of different strains of plague strains to antibiotics, and the effectiveness of systemic toxins in controlling the rodent fleas.This paper provides an overview of his scientific activities

Evaluation of the Degenerative Changes of the Distal Intervertebral Discs after Internal Fixation Surgery in Adolescent Idiopathic Scoliosis

Study Design Retrospective study. Purpose Lumbar intervertebral disc degeneration is an important cause of low back pain. Overview of Literature Spinal fusion is often reported to have a good course for adolescent idiopathic scoliosis (AIS). However, many studies have reported that adjacent segment degeneration is accelerated after lumbar spinal fusion. Radiography is a simple method used to evaluate the orientation of the vertebral column. magnetic resonance imaging (MRI) is the method most often used to specifically evaluate intervertebral disc degeneration. The Pfirrmann classification is a well-known method used to evaluate degenerative lumbar disease. After spinal fusion, an increase in stress, excess mobility, increased intra-disc pressure, and posterior displacement of the axis of motion have been observed in the adjacent segments. Methods we retrospectively secured and analyzed the data of 15 patients (four boys and 11 girls) with AIS who underwent a spinal fusion surgery. We studied the full-length view of the spine (anterior-posterior and lateral) from the X-ray and MRI obtained from all patients before surgery. Postoperatively, another full-length spine X-ray and lumbosacral MRI were obtained from all participants. Then, pelvic tilt, sacral slope, curve correction, and fused and free segments before and after surgery were calculated based on X-ray studies. MRI images were used to estimate the degree to which intervertebral discs were degenerated using Pfirrmann grading system. Pfirrmann grade before and after surgery were compared with Wilcoxon signed rank test. While analyzing the contribution of potential risk factors for the post-spinal fusion Pfirrmann grade of disc degeneration, we used generalized linear models with robust standard error estimates to account for intraclass correlation that may have been present between discs of the same patient. Results The mean age of the participant was 14 years, and the mean curvature before and after surgery were 67.8 and 23.8, respectively (p<0.05). During the median follow-up of 5 years, the mean degree of the disc degeneration significantly increased in all patients after surgery (p<0.05) with a Pfirrmann grade of 1 and 2.8 in the L2–L3 before and after surgery, respectively. The corresponding figures at L3–L4, L4–L5, and L5–S1 levels were 1.28 and 2.43, 1.07 and 2.35, and 1 and 2.33, respectively. The lower was the number of free discs below the fusion level, the higher was the Pfirrmann grade of degeneration (p<0.001). Conversely, the higher was the number of the discs fused together, the higher was the Pfirrmann grade. Conclusions we observed that the disc degeneration aggravated after spinal fusion for scoliosis. While the degree of degeneration as measured by Pfirrmann grade was directly correlated by the number of fused segments, it was negatively correlated with the number of discs that remained free below the lowermost level of the fusion

A New Modified Method for Inserting Iliosacral Screw versus the Conventional Method

Study DesignMethodological study.PurposeTo our knowledge, this is the first study to introduce a new modified method for inserting iliosacral screws and to compare its results with those of a conventional method.Overview of LiteraturePrevious techniques, such as open reduction and internal fixation, are associated with perioperative hemorrhage, postoperative infection, and neurological deficits. Although percutaneous iliosacral screw insertion confers the advantage of being minimally invasive, leading to less blood loss and a low postoperative infection rate, it harbors the risk of screw malpositioning due to narrow sacral proportions and a high interindividual variability.MethodsNine cadaveric pelvises were included in this study, with one hemipelvis of each being assigned to the new modified method and the other to the conventional iliosacral screw insertion method. In the new modified method, the guidewire entry point was determined using a lateral sacral X-ray. To do so, we first identified the anterosuperior quadrant of the S1 body on one hemipelvis. The anterosuperior quadrant was further divided into four imaginary quadrants, and the guidewire was inserted into the posteroinferior quadrant. The guidewire trajectory was perpendicular to the sagittal plane so that the guidewire resembled a single point in the lateral sacral view. Guidewires were inserted into corresponding hemipelves using the conventional method as described in the literature. Subsequently, an axial computed tomography scan with 1-mm fine cuts was obtained, and sagittal and coronal views were reconstructed. The distance of the guidewire from the sacral canal, anterior sacral cortex, and first sacral foramen was measured in axial, sagittal, and coronal views. The minimum measurement among different views was defined as the safety index of the insertion methods. The conventional and new modified methods were then compared in terms of safety and duration of the procedure.ResultsThe minimum distance of the guidewire from the S1 foramen and anterior sacral cortex was not significantly different between the two methods. However, the minimum distance between the guidewire and sacral canal was significantly greater in the new modified method than in the conventional method. The duration of guidewire insertion was significantly shorter in the new modified method than in the conventional method.ConclusionsThis new modified method of iliosacral screw insertion could be safely and simply implemented while taking less surgical time than the conventional methods

Updating the Curriculum of Ph.D by Research Training Courses in Medical Sciences in Iran

Background & Objective: Ph.D by research is one of the highest post-graduate education degrees in Iran. There are educational and research-based courses in this program. There was a need for revision in these courses because of some controversies in running the program. This study aimed to determine the required courses, their credit and objective of each course in the program. Methods: The study was done by the Delphi approach in two rounds. In the first round, the current program was evaluated by an internet survey and an expert panel. The expert panel consisted of professors and PhD by research students of medical sciences universities in Iran. At the end of the first round, the curriculum of the program was prepared. The curriculum consisted of course titles, credits, objective and core or non-core curriculums. In the second round, the curriculum was sent to PhD by research supervisors and students and their feedbacks were collected via e-mail. Results: At the end of the study, the list of current courses (per credit) was confirmed. Advanced statistics (3), advanced research (2), ethics in research (1) and documentation (2) were considered as core courses. This was suggested to change project management (2) and research projects (4) to non-core courses. The electronic data management (2), knowledge transfer (2), laboratory techniques (2) and course thesis were suggested to consider as non-core courses. Conclusion: The essential courses that students need for their research were considered as core and the courses which require the educational center point of view were considered as non-core courses. Keywords Delphi approach PhD by research Revision Curriculu

A reversal of age-dependent proliferative capacity of endothelial progenitor cells from different species origin in in vitro condition

Introduction: A large number of cardiovascular disorders and abnormalities, notably accelerated vascular deficiencies could be related to aging changes and increased length of life. During the past decades, the discovery of different stem cells facilitates ongoing attempts for attenuating many disorders, especially in vascular beds. Endothelial progenitor cells (EPCs) are a subtype of stem cells that have potent capacity to differentiate into mature endothelial cells (ECs). However, some documented studies reported an age-related decline in proliferation and function of many stem cells. There is no data on aging effect upon proliferation and morphological feature of EPCs. Methods: To show aging effect on EPCs proliferation and multipotentiality, bone marrow samples were provided from old and young cases in three different species; human, mouse and dog. After 7 days of culture, the cell morphology and clonogenic capacity were evaluated. We also calculated the mean number of colonies both in bone marrow samples from old and young subjects. To confirm the cell phenotype, isolated cells were immune-phenotyped by a panel of antibodies against Tie-2, CD133 and CD309 markers. Results: Our results showed that EPCs exhibited prominent spindle form in all bone marrow samples from young cases while the cell shape became more round by aging. Notably, the number of colonies was reduced in aged samples as compared to parallel young subject samples (P < 0.05). We also detected that the expression of endothelial related markers diminished by aging. Conclusion: The results of this study suggest that the age-related vascular abnormalities could be presumably related to the decline in stemness capacity of EPCs