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Nailfold Capillaroscopy Findings in Diabetic Patients (A Pilot Cross-Sectional Study)

Open Journal of Pathology 2015年第2期5卷 65-72页

作者： Alireza Rajaei Pooneh Dehghan zahra farahani Rheumatology Loghman Hospital Shahid Beheshti University of Medical Sciences Tehran Iran Radiology Taleghani Hospital Shahid Beheshti University of Medical Sciences Tehran Iran Maternal Fetal and Neonatal Research Center Tehran University of Medical Sciences Tehran Iran

Background: Microcirculation is affected in diabetes mellitus and Microvascular abnormalities cause persistent diabetic complications. The aim of this study was nailfold capillaroscopic assessment to describe the pathological changes (morphological and structural) in capillary of a large series of patients with type 1 and 2 diabetes. Methods: A cross-sectional study was carried out in a Nailfold Capillaroscopy Center (Tehran-Iran) between 2011 and 2014. The study included 235 types 1, 2 diabetic patients. All patients underwent 10 nailfolds capillaroscopy examinations. Microvascular architecture, disturbances capillary distribution, capillary morphology, capillary density, efferent/afferent limb ratio, subpapillary venular plexus, and morphological abnormalities were evaluated. Conclusions were stated as normalor scleroderma pattern. Results of patients’ capillaroscopic images were recorded and analyzed quantitatively and qualitatively. P value < 0.05 was considered as statistical significance. Results: of all participants with mean age 59.91 ± 12.39, 183 cases (77.9%) were female and 52 (22.1%) were male. Tortuosity of capillaries was more often observed in our subjects (235 cases) followed by angiogenesis (171 cases). Normal and early scleroderma patterns were observed in 195 (83.0%) and 40 cases (17.0%). Based on P values, altered micro vascular architecture, capillary distribution and capillary morphology were more frequent in patients with scleroderma pattern in comparison to patients with normal pattern (P value < 0.05). Morphological abnormalities except from neo formation capillary and mega capillary were also significantly more common in patients with scleroderma pattern than patients in counterpart group (P value < 0.05). Conclusion: Nailfold capillaroscopy as a non-invasive, diagnostic and prognostic method may potentially affect on diabetes outcome and control.

关键词： Diabetes Nail Fold Capillaroscopy Normal Pattern Scleroderma PatternDiabetes Scleroderma Pattern

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Obstetrics Risk Management in 5 Iranian Hospitals (Tehran-2012)

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Open Journal of Obstetrics and Gynecology 2015年第5期5卷 259-267页

作者： Nasrin Changizi Farah Babaee Hamid Ravaghi zahra farahani Maternal Fetal and Neonatal Research Center Tehran University of Medical Sciences Tehran Iran Ministry of Health and Medical Education Tehran Iran Iran University of Medical Sciences Tehran Iran

Background: Risk management is improving quality of health care services and creating a safer system of care. We determined the main maternal and fetal risks in five Hospitals (Tehran-Iran) to offer some practical strategies to decline obstetric adverse events and provide better pregnancy outcome. Methods: A descriptive, cross-sectional study was carried out in 5 Iranian hospitals (2011-2012).?Twelve Obstetricians/perinatalogists and midwives from 5 hospitalswho were in charge of Maternity Units, were our assistants in these hospitals. We organized a secretariat including Obstetricians/perinatalogists and midwives. The principles of Obstetrics Risk Management were introduced to them in a 2 days’ workshop. Then the delegates from each hospital were asked to report the most common obstetrical complications of their hospitals. The main results were 24 complications. Then for sorting these risks we asked them to do scoring of the 24 complication with 1 - 10 grading in 4 aspects of probability of occurrence, possibility of prevention, priority of interventions and short term response to interventions. Post partum haemorrhage, labor management problems, and neonatal hypothermia got the highest scores in these regards, and then these 24 items were categorized in 2 groups of risk assessment and hospital management. Finally based on Risk Management Rules in Clinical Governance, the complications analysis was done with use of failure mode, effects analysis and practical strategies to decline obstetrical adverse events were suggested. Results: We understood all reported complications had common infrastructural problems: defects in Risk Assessment and Hospital Management Policies. We focused on basic infrastructural management in these 2 main subjects and in these two: our main problems were related to staff management and hospital management issues. Conclusion: Since managerial and staff dependent problems were our main problems, these two should be considered as our main prio

关键词： Risk Management Hospital Risk Reporting Obstetrics Labor Delivery Room

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Evaluation of Parents’ Awareness and Knowledge about Problems and Issues Related to Their Premature Infants in an Iranian Hospital

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Open Journal of Nursing 2015年第5期5卷 465-469页

作者： Nasrin Khalesi Fatemeh Shoaae Anjom Golnaz Rezaeiezadeh zahra farahani Neonatal Division Aliasghar Hospital Iran University of Medical Sciences Tehran Iran Maternal Fetal & Neonatal Research Center Tehran University of Medical Sciences Tehran Iran Breastfeeding Research Center Tehran University of Medical Sciences Tehran Iran

Premature infant is an infant who was born before the end of 37th weeks of pregnancy. Approximately 9.6% of infants are premature and they can be at risk for hospitalization. This study has done for evaluation of awareness and knowledge of parents about problems of premature infants in Neonatal Intensive Care Unit (NICU). This was a descriptive study with 160 parents whose premature infants were admitted to NICU (Tehran-Iran, 2009-2011). Data were collected by a questionnaire for evaluation of awareness and knowledge of parents about problems of prematurity, and then analyzed by using descriptive analytic statistical methods and SPSS software. Based on the results, there was a significant relation between age and the total score of questionnaire (P = 0.022, R = 0.18). Mothers had higher awareness and knowledge than fathers (P < 0.05). The most awareness in parents was about doing of hygienic principle when they entered to NICU and about the importance of regularly and continuous attendance in ward. Awareness and knowledge of parents about problems of their premature infant were related to their age and being a mother or father. Parents had little knowledge about some NICU principles and premature infant’s needs and care.

关键词： Awareness Knowledge Infant Neonatal Intensive Care Unit Prematurity

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The Incidence of Respiratory Distress Syndrome among Preterm Infants Admitted to Neonatal Intensive Care Unit: A Retrospective Study

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Open Journal of Pediatrics 2015年第4期5卷 285-289页

作者： Maryam Saboute Mandana Kashaki Arash Bordbar Nasrin Khalessi zahra farahani Department of Pediatrics Akbarabadi Hospital Iran University of Medical Sciences Tehran Iran Department of Pediatrics Ali Asghar Hospital Iran University of Medical Sciences Tehran Iran Maternal Fetal and Neonatal Research Center Tehran University of Medical Sciences Tehran Iran

Background: Respiratory distress syndrome (RDS) or hyaline membrane disease (HMD) is the most common cause of neonatal morbidity and mortality in preterm infants. We aimed to determine the frequency of RDS among 3 groups of preterm infants and the value of some related factors. Methods: A cross-sectional, descriptive analytical investigation was carried out in the NICU ward of Akbarabadi Hospital (Tehran-Iran) during spring 2011. Newborns’ data were collected and assessed by using their hospital medical records. Seventy-three preterm infants with gestational age < 34 weeks were hospitalized in the NICU. All participants were divided into 3 groups: extremely preterm (<28 weeks), very preterm (28 to <32 weeks) and moderate preterm (32 to 34 weeks). Frequency of RDS and some related factors were compared among 3 groups. Results: RDS was observed in 65.6% of all participants;however frequency of RDS was not different between three groups. An inversely correlation was found between gestational age and mortality rate (p = 0.05). In regard to Betamethasone administration prior to birth, this interval was significantly longer in alive neonates in comparison to infants who died (p < 0.05). Conclusion: RDS was frequent in preterm neonates with gestational age < 32 weeks. Time of Betamethasone administration prior to birth can significantly influence on neonatal mortality rate.

关键词： Respiratory Distress Syndrome Neonatal Intensive Care Unit Preterm Infant Mortality Rate

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Introducing a Rapid and Safe Method for Myeloperoxidase Staining

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Open Journal of Pathology 2015年第2期5卷 38-41页

作者： Fatemeh E. Mahjoub Fahimeh Firouzjaie Karder Issa Jahanzad Saghi Vaziri Ramezan Ali Sharifian zahra farahani Pathology Maternal Fetal and Neonatal Research Center Tehran University of Medical Sciences Tehran Iran Imam Khomeini Hospital Complex Central Laboratory and Cancer Institute Pathology Laboratory Tehran University of Medical Sciences Tehran Iran Valiasr Hospital Central Laboratory Tehran University of Medical Sciences Tehran Iran Imam Khomeini Hospital Complex Cancer Institute Tehran University of Medical Sciences Tehran Iran Hematology Oncology Imam Khomeini Hospital Complex Valiasr Hospital Tehran University of Medical Sciences Tehran Iran

Background: Myeloperoxidase staining is used to differentiate leukemias since several decades. Despite implementation of flow cytometric, cytogenetic and molecular techniques for identification of leukemic blasts, histochemical stains such as myeloperoxidase stain are persistently used for better classification of leukemias. The myeloperoxidase staining is a time consuming and hazardous procedure. The present report describes a sensitive, rapid and easy method for assessment of peroxidase activity. Materials and Methods: Bone marrow aspiration slides were stained with Dako product: Code number: K3467 containing DAB chromogen (3,3-diaminobenzidine in chromogen solution) and substrate buffer (Imidasole-HCL buffer, PH 7.5 containing hydrogen peroxide and an anti microbial agent) in a rapid procedure taking only ten minutes time. The staining needs no material preparation steps. Neutrophils in the slide are taken as positive control or another normal smear was costained to be used as control. All cases were followed up with flow cytometry and cytogenetic studies. Result: The reaction product of this stain is brown and granular. Promyelocytes and myelocytes are the most strongly staining cells with positive (primary) granules. Lymphoblasts are negative. The result of classification of leukemias with this technique was in concordance with flow cytometric immunophenotyping. Discussion: Many practical techniques have been described using benzidine as an indicator for myeloperoxidase staining. Benzidine is a carcinogenic material and its usage is severely restricted in laboratory. Formerly we prepared requisite materials for myeloperoxidase staining by hazardous ways (boiling), but we decided to apply ready to use 3,3-diaminobenzidine (DAB), which is used in final step of immunohistochemistry stains. Conclusion: Use of 3,3-diaminobenzidine (DAB) is highly recommended for myeloperoxidase staining, while the result is extraordinary and fully compatible with flow cytometry and

关键词： Myeloperoxidase Staining DAB 3 3-Diaminobenzidine Safe and Rapid Method

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Invasive aspergillosis in liver transplant recipients, an infectious complication with low incidence but significant mortality

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World Journal of Transplantation 2023年第5期13卷 264-275页

作者： Azam farahani Fereshteh Ghiasvand Setareh Davoudi zahra Ahmadinejad Department of Infectious Diseases Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehran ***Iran Liver Transplantation Research Center Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehran ***Iran

BACKGROUND Infections,including invasive fungal infections(IFIs),are among the leading causes of mortality in liver transplant recipients during the first year *** To investigate the epidemiology,clinical manifestations,risk factors,treatment outcomes,and mortality rate of post-liver transplantation invasive aspergillosis(IA).METHODS In this case-control study,22 patients with IA were identified by reviewing the archived and electronic medical records of 850 patients who received liver transplants at the Imam Khomeini Hospital complex in Tehran,Iran,between 2014 and *** control group comprised 38 patients without IA infection matched for age and *** information obtained included the baseline characteristics of liver transplant patients,operative reports,post-transplantation characteristics of both groups and information about the fungal infection of the patient *** The prevalence rate of IA among liver transplant recipients at Imam Khomeini Hospital was 2.7%.The risk factors of IA among studied patients included high serum creatinine levels before and post-transplant,renal replacement therapy,antithymocyte globulin induction therapy,post-transplant bile leakage,posttransplant hepatic artery thrombosis,repeated surgery within 30 d after the transplant,bacterial pneumonia before the aspergillosis diagnosis,receiving systemic antibiotics before the aspergillus infection,cytomegalovirus infection,and duration of post-transplant hospitalization in the intensive care *** most prevalent form of infection was invasive pulmonary aspergillosis,and the most common chest computed tomography scan findings were nodules,pleural effusion,and the halo *** the case group,prophylactic antifungal therapy was administered more frequently than in the control *** antifungal therapy response rate at 12 wk was 63.7%.The 3-and 12-mo mortality rates of the patients with IA were 36.4%and 45.4%,respectively(compared with the mortality rate o

关键词： Aspergillosis Cytomegalovirus infection Immunosuppression therapy Liver transplantation Risk factors Fungal infections Fungal pneumonia

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