Ahmad Reza Shamshiri

Publications of Ahmad Reza Shamshiri

• The use of polymerase chain reaction assay versus cell culture in detecting neonatal chlamydial conjunctivitis.

  Authors: Sedigheh Rafiei Tabatabaei, Seyed Abolfazl Afjeiee, Fatemeh Fallah, Nafiseh Tahami Zanjani, Farideh Shiva, Arezou Tavakkoly Fard, Ahmad Reza Shamshiri, Abdollah Karimi

  Archives of Iranian medicine. 03/2012; 15(3):171-5.

  One of the most common bacterial infections that causes ophthalmia neonatorum is Chlamydia trachomatis, (C. trachomatis). Very few studies have been performed in Iran using both cell culture andOne of the most common bacterial infections that causes ophthalmia neonatorum is Chlamydia trachomatis, (C. trachomatis). Very few studies have been performed in Iran using both cell culture and polymerase chain reaction (PCR) methods to determine the prevalence of C. trachomatis as an etiological agent of ophthalmia neonatorum. This study aimed to evaluate the prevalence of neonatal chlamydial conjunctivitis (NCC) as diagnosed by both methods in two hospitals in Tehran, Iran. From March 2008 to May 2009, out of 2253 neonates, 241 (10.7%) with clinical findings of conjunctivitis were included in this study. A total of 241 conjunctival swabs were tested by cell culture (as the gold standard test), PCR, and Giemsa staining. Cell cultures were positive for C. trachomatis in 31 (12.9%) neonates, C. trachomatis was positive in 40 (16.6%) neonates by PCR and 18 (7.5%) by Giemsa staining. The sensitivity of PCR was 100%, whereas Giemsa staining sensitivity was 558.1%. High sensitivity (100%) and specificity (95.7%) of PCR as compared to culture makes it a proper diagnostic method for the detection of C. trachomatis.

• Oral and dental health status in patients with primary antibody deficiencies.

  Authors: Ghasem Meighani, Asghar Aghamohammadi, Honarmand Javanbakht, Hassan Abolhassani, Sina Nikayin, Seyed Mehryar Jafari, Mehdi Ghandehari Motlagh, Ahmad Reza Shamshiri, Nima Rezaei

  Iranian journal of allergy, asthma, and immunology. 12/2011; 10(4):289-93.

  Primary antibody deficiencies (PAD) are a group of immune system disorders, associated with decreased levels of secretory and protective immunoglobulins. Because of the important role ofPrimary antibody deficiencies (PAD) are a group of immune system disorders, associated with decreased levels of secretory and protective immunoglobulins. Because of the important role of immunoglobulins in the protection of oral cavity, patients with PADs are more susceptible to dental caries or oral manifestations. This study was performed to investigate the oral and dental manifestations of PADs patients. In this study, 33 patients with PADs (21 common variable immunodeficiency, 8 X-linked agammaglobulinemia and 4 hyper IgM syndrome) and 66 controls were examined; the number of decayed, missed and filled teeth (DMFT) were investigated. Aphthous was the most frequent manifestation in PADs patients (38.7%), which was significantly16.7% higher than the controls (p=0.03). The patients with PADs showed significantly higher presentation of other oral and dental manifestations, including herpes sores, candidiasis tonsillitis, gingivitis, calculus, enamel hypoplasia and other ulcerations. The mean DMFT scores were 6.15±3.6 and 1.93±0.4 in PADs patients and controls, respectively (p<0.001). Although the patients with common variable immunodeficiency had higher means of DMFT in comparison with other groups of PADs, this difference was not statistically significant. This study showed significantly higher frequency of oral and dental manifestations in the patients with PADs compared to controls. Therefore, regular examination of oral cavity could be suggested in this group of immunodeficient patients.

• Immunohistochemical detection of p53 protein expression as a prognostic factor in Wilms tumor.

  Authors: Farzaneh Jadali, Delaram Sayadpour, Mohammad Rakhshan, Abdollah Karimi, Mohsen Rouzrokh, Bibi Shahin Shamsian, Ahmad Reza Shamshiri

  Iranian journal of kidney diseases. 07/2011; 5(3):149-53.

  Histological typing, especially the evidence of anaplasia and stage of the tumor are two major prognostic indicators in Wilms tumor, but some genetic factors have recently been noted. Mutations inHistological typing, especially the evidence of anaplasia and stage of the tumor are two major prognostic indicators in Wilms tumor, but some genetic factors have recently been noted. Mutations in TP53, which is a tumor suppressor gene, have been demonstrated to be associated with poor prognosis in some malignancies. There are also few studies which have confirmed the correlation between p53 protein overexpression and advanced course in Wilms tumor. This study was conducted to determine the correlation p53 immunoexpression and prognosis and outcome of Wilms tumor. The overexpression of p53 in 44 specimens of children (26 boys and 18 girls) with Wilms tumor (median age, 36 months; range, 4 to 96 months) was assessed in Mofid Children's Hospital, Tehran, Iran. The overexpression of p53 was determined by immunohistochemistry with antihuman p53 antibody. A positive immunostaining for p53 was detected in 24 of the 44 cases (54.7%). The grade of the tumor and anaplasia were associated with p53 positivity, but there was no association of p53 with the tumor stage. In comparison to p53 negatives, week-moderate and high p53-expressing tumors had significantly decreased the overall survival (hazard ratio, 3.75 and 8.61; P = .05 and P = .01, respectively). Overexpression of p53 protein in Wilms tumor is an indicator of poor pro gnosis, because it is correlated with unfavorable histology tumors and a shorter survival period.

• The effect of zinc sulfate in the prevention of high-dose chemotherapy-induced mucositis: a double-blind, randomized, placebo-controlled study.

  Authors: Ava Mansouri, Molouk Hadjibabaie, Masoud Iravani, Ahmad Reza Shamshiri, Alireza Hayatshahi, Mohammad Reza Javadi, Seid Hamid Khoee, Kamran Alimoghaddam, Ardeshir Ghavamzadeh

  Hematological oncology. 06/2011;

  The purpose of this study was to evaluate the effect of oral zinc sulfate in the prevention of chemotherapy-induced mucositis in patients undergoing hematopoietic stem-cell transplantation (HSCT).The purpose of this study was to evaluate the effect of oral zinc sulfate in the prevention of chemotherapy-induced mucositis in patients undergoing hematopoietic stem-cell transplantation (HSCT). This study was a double-blind, randomized, placebo-controlled design, with 60 patients undergoing HSCT, divided proportionally in experimental group who received zinc sulfate, and in placebo group. They all had received high-dose chemotherapy conditioning regimen for allogenic transplantation. Oral mucositis assessed was based on World Health Organization (WHO) oral mucositis scale. There were no significant differences in the development of mucositis between the two groups. Severity of mucositis was not significantly different between the two groups either. The same result was obtained regarding the duration of mucositis. Zinc sulfate did not show any significant adverse effects in experimental group. In conclusion, Zinc sulfate did not have any clinical benefits in prevention or reduction of severity, and duration of high-dose chemotherapy-induced mucositis in patients undergoing HSCT. Copyright © 2011 John Wiley & Sons, Ltd.

• Association analysis of intractable epilepsy with C3435T and G2677T/A ABCB1 gene polymorphisms in Iranian patients.

  Authors: Mohammad Sayyah, Fateme Kamgarpour, Mehri Maleki, Morteza Karimipoor, Kourosh Gharagozli, Ahmad Reza Shamshiri

  Epileptic disorders : international epilepsy journal with videotape. 06/2011; 13(2):155-65.

  The results from studies investigating a possible association between ABCB1 polymorphism and drug-resistant epilepsy are so far inconsistent. Moreover, recent meta-analyses studies do not confirm anyThe results from studies investigating a possible association between ABCB1 polymorphism and drug-resistant epilepsy are so far inconsistent. Moreover, recent meta-analyses studies do not confirm any link between ABCB1 C3435T polymorphism and drug resistance. Yet, if patients with comparable clinical status (same type of epilepsy, antiepileptic drugs, epilepsy onset and gender) are evaluated, the link between ABCB1 polymorphisms and drug resistance may be unmasked. We studied the association between C3435T and G2677T/A ABCB1 gene polymorphisms and drug resistance in Iranian epilepsy patients. Two hundred healthy subjects and 332 epilepsy patients (200 drug-responsive and 132 drug-resistant) were selected. Genotypes were determined by polymerase chain reaction followed by restriction fragment length polymorphism or the amplification refractory mutation system. The risk of drug resistance was higher in patients with a C/T genotype than in those with C/C or T/T genotypes at position 3435 in patients with cryptogenic epilepsy (p=0.01). A higher risk of drug resistance was observed in adult patients with a C/C genotype than in those with a T/T genotype at position 3435 (25.8% vs 15.8%, p=0.01). The risk of drug resistance was also higher in female patients with a C/C genotype than in those with a T/T genotype at position 3435 (26.8% vs 16.3%, p=0.04). No significant association was found between G2677T/A polymorphism and epilepsy drug resistance in the different subgroups of patients. Iranian adult female patients with a C/C genotype at position 3435 of the ABCB1 gene have a higher risk of resistance to antiepileptic drugs. Replication studies with large sample sizes are needed to confirm the results.

• Survey of needle-stick injuries in paediatric health personnel of 5 university hospitals in Tehran.

  Authors: Farideh Shiva, Anahita Sanaei, Ahmad Reza Shamshiri, Fatemeh Ghotbi

  JPMA. The Journal of the Pakistan Medical Association. 02/2011; 61(2):127-31.

  To study the prevalence and correlates of needle-stick injury in the health personnel of the Paediatric Department of five university-affiliated hospitals in Tehran, from April till JuneTo study the prevalence and correlates of needle-stick injury in the health personnel of the Paediatric Department of five university-affiliated hospitals in Tehran, from April till June 2009. Cross-sectional questionnaire survey. Physicians undergoing paediatric training and nurses working in the paediatric departments filled up a pre-designed questionnaire. Relevant variables were compared between doctors and nurses. Three-hundred fifty-five health personnel were enrolled. Of these 49.3% had incurred needle stick injury at least once, 36.7% doctors and 54.9% nurses (p=0.002). Nurses fared better than the doctors as regards knowledge about hazards of improper needle disposal. Correct answers from doctors and nurses respectively were: 45.6% vs. 59.3% about needle separation and 41.9% vs. 81.2% about recapping, (p=0.02 and <0.001). Doctors 11.1% and Nurses 37.7% believed injections to be better than oral medication for children, (p<0.001), however, 68.9% of doctors and 46.6% of nurses believed that parents preferred injections to oral medicines for their children, (p<0.001). Only 26.6% knew about auto-disable syringes. Vaccinated against Hepatitis B was present in 92.7%. Doctors 58.7% and 55.3% nurses knew HBV to be the most common needle transmitted infection, (p=0.56). Needle-stick injuries are common among Paediatric health care personnel and their knowledge about prevention strategies is suboptimal. Most, health personnel are immunized against Hepatitis B.

• Technetium Tc 99m dimercaptosuccinic acid renal scintigraphy in children with acute pyelonephritis: correlation with other imaging tests.

  Authors: Masoumeh Mohkam, Saiid Maham, Afrand Rahmani, Ilana Naghi, Babak Otokesh, Hamid Raiiati, Nima Mohseni, Ahmad Reza Shamshiri, Mostafa Sharifian, Reza Dalirani, Ruhollah Ghazi, Majid Ahoopai

  Iranian journal of kidney diseases. 10/2010; 4(4):297-301.

  INTRODUCTION. Urinary tract infection is the most common serious bacterial infection in children. The aim of this study was to compare the value of different laboratory and imaging techniques inINTRODUCTION. Urinary tract infection is the most common serious bacterial infection in children. The aim of this study was to compare the value of different laboratory and imaging techniques in detecting renal involvement in acute pyelonephritis. MATERIALS AND METHODS. In a cross-sectional study of patients 1 month to 14 years of age diagnosed with urinary tract infection were examined with systemic inflammatory markers, renal ultrasonography, voiding cystourethrography (VCUG), and technetium Tc 99m dimercaptosuccinic acid ((99m)Tc-DMSA) renal scintigraphy. A total of 1467 pediatric patients were eligible for treatment of pyelonephritis. Evaluations included a complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), urinalysis, urine culture, and measurement of serum blood urea nitrogen and creatinine levels. RESULTS. The results of (99m)Tc-DMSA scans were normal in 20.2%, mild decreased cortical uptake in 45.0%, moderate decreased cortical uptake in 12.3%, severe decreased cortical uptake in 12.0%, and decreased cortical function plus irregularity or scar formation in 10.5%. Voiding cystourethrography showed vesicoureteral reflux in 25.9%. The sensitivity of (99m)Tc-DMSA for prediction of vesicoureteral reflux was 84.1% with a negative predictive value of 80.6%. Significant differences were found in the level of blood leukocyte count (P = .03), urine leukocyte count (P = .003), ESR (P = .008), and age (P = .04) between patients with normal and abnormal (99m)Tc-DMSA scan results. CONCLUSIONS. We found that in patient with clinical signs of pyelonephritis, (99m)Tc-DMSA renal scintigraphy can detect pyelonephritis more accurately than the other inflammatory and imaging tests.

• Association between ABCB1-T1236C polymorphism and drug-resistant epilepsy in Iranian female patients.

  Authors: Mehri Maleki, Mohammad Sayyah, Fatemeh Kamgarpour, Morteza Karimipoor, Aida Arab, Anahita Rajabi, Kourosh Gharagozli, Ahmad Reza Shamshiri, Esmaeil Shahsavand Ananloo

  Iranian biomedical journal. 07/2010; 14(3):89-96.

  One third of epileptic patients are resistant to several anti-epileptic drugs (AED). P-glycoprotein (P-gp) is an efflux transporter encoded by ATP-binding cassette subfamily B member 1 (ABCB1) geneOne third of epileptic patients are resistant to several anti-epileptic drugs (AED). P-glycoprotein (P-gp) is an efflux transporter encoded by ATP-binding cassette subfamily B member 1 (ABCB1) gene that excludes drugs from the cells and plays a significant role in AEDs resistance. Over-expression of P-gp could be a result of polymorphisms in ABCB1 gene. We studied the association of T129C and T1236C single-nucleotide polymorphisms (SNP) of ABCB1 gene with drug-resistant epilepsy in Iranian epileptics. DNA samples were obtained from 200 healthy controls and 332 epileptic patients, of whom 200 were drug responsive and 132 drug resistant. The frequencies of the genotypes of the two SNP were determined by polymerase chain reaction followed by restriction fragment length polymorphism. No significant association was found between T129C and T1236C genotypes and drug-resistant epilepsy neither in adults nor in children. However, the risk of drug resistance was higher in female patients with 1236CC (P = 0.02) or CT (P = 0.008) genotype than in those with TT genotype. The risk of drug resistance was also higher in patients with symptomatic epilepsies with 1236CC (P = 0.02) or CT (P = 0.004) genotype than in those with TT genotype. The risk of drug resistance was lower in patients with idiopathic epilepsies with 129TT genotype (P = 0.001) than in those with CT genotype. Our results indicate that T1236C polymorphism is associated with drug resistance in Iranian female epileptic patients. Replication studies with large sample sizes are needed to confirm our results.

• Push-out bond strength of Resilon/Epiphany self-etch to intraradicular dentin after retreatment: a preliminary study.

  Authors: Noushin Shokouhinejad, Mohammad A Sabeti, Mahboubeh Hasheminasab, Farhad Shafiei, Ahmad Reza Shamshiri

  Journal of endodontics. 03/2010; 36(3):493-6.

  Retreatment procedures might affect the adhesion capability of refilling materials to dentinal walls. The purpose of this study was to compare the effect of different retreatment techniques on bondRetreatment procedures might affect the adhesion capability of refilling materials to dentinal walls. The purpose of this study was to compare the effect of different retreatment techniques on bond strength of Resilon (Resilon Research LLC, Madison, CT)/Epiphany (Pentron Clinical Technologies, LLC, Wallingford, CT) self-etch (SE) with radicular dentin after canal reobturation. Sixty extracted single-rooted human teeth were prepared using Mtwo rotary files (VDW, Munich, Germany) and obturated with Resilon/Epiphany SE. The roots were randomly divided into four groups; in group 1, no retreatment procedure was done; group 2 was retreated using Mtwo R/Mtwo files; group 3 was retreated using Mtwo R/Mtwo combined with chloroform; and group 4 was retreated using Mtwo R/Mtwo combined with Endosolv R (Septodont, Paris, France). The root canals were then reobturated with Resilon/Epiphany SE. One-millimeter slices of midroot dentin were prepared for the push-out test (n=30 slices per group). Failure modes after the push-out test were examined under microscopy. The data were analyzed by using a one-way analysis of variance and the Dunnett post hoc test. Group 3 showed significantly the lowest mean bond strength (p<0.02). No significant difference was found between the values of groups 1, 2, and 4 (p>0.26). The mode of bond failure was predominantly adhesive for all groups. This study showed that the bond strength of Resilon/Epiphany SE after root canal retreatment using Mtwo files, either alone or combined with Endosolv R, was not significantly different from that of nonretreated specimens. Chloroform used for retreatment had an adverse effect on the bond strength of Resilon/Epiphany SE after root canal reobturation.

• Technetium Tc 99m Dimercaptosuccinic Acid Renal Scintigraphy in Children With Acute Pyelonephritis: Correlation With Other Imaging Tests

  Authors: Mohkam Masoumeh, Maham Saiid, Rahmani Afrand, Naghi Ilana, Otukesh Babak, Raiiati Hamid, Mohseni Nima, Ahmad Reza Shamshiri, Sharifian Mostafa, Dalirani Reza, Ghazi Ruhollah, Ahoopai Majid

  Iranian Journal of Kidney Diseases. 01/2010;

  Introduction. Urinary tract infection is the most common serious bacterial infection in children. The aim of this study was to compare the value of different laboratory and imaging techniques inIntroduction. Urinary tract infection is the most common serious bacterial infection in children. The aim of this study was to compare the value of different laboratory and imaging techniques in detecting renal involvement in acute pyelonephritis.Materials and Methods. In a cross-sectional study of patients 1 month to 14 years of age diagnosed with urinary tract infection were examined with systemic inflammatory markers, renal ultrasonography, voiding cystourethrography (VCUG), and technetium Tc 99m dimercaptosuccinic acid (99mTc-DMSA) renal scintigraphy. A total of 1467 pediatric patients were eligible for treatment of pyelonephritis. Evaluations included a complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), urinalysis, urine culture, and measurement of serum blood urea nitrogen and creatinine levels.Results. The results of 99mTc-DMSA scans were normal in 20.2%, mild decreased cortical uptake in 45.0%, moderate decreased cortical uptake in 12.3%, severe decreased cortical uptake in 12.0%, and decreased cortical function plus irregularity or scar formation in 10.5%. Voiding cystourethrography showed vesicoureteral reflux in 25.9%. The sensitivity of 99mTc-DMSA for prediction of vesicoureteral reflux was 84.1% with a negative predictive value of 80.6%. Significant differences were found in the level of blood leukocyte count (P = .03), urine leukocyte count (P = .003), ESR (P = .008), and age (P = .04) between patients with normal and abnormal 99mTc-DMSA scan results.Conclusions. We found that in patient with clinical signs of pyelonephritis, 99mTc-DMSA renal scintigraphy can detect pyelonephritis more accurately than the other inflammatory and imaging tests.

• Varicella Zoster antibodies among health care workers in a university hospital, Teheran, Iran.

  Authors: Mahshid Talebi-Taher, Maria Noori, Ahmad-Reza Shamshiri, Mitra Barati

  International journal of occupational medicine and environmental health. 01/2010; 23(1):27-32.

  This study was designed to evaluate the immune status of health care workers against varicella zoster in a university hospital in Teheran, Iran, and to compare the history of chickenpox infectionThis study was designed to evaluate the immune status of health care workers against varicella zoster in a university hospital in Teheran, Iran, and to compare the history of chickenpox infection with the presence of varicella antibodies in this population. Serologic testing for varicella was performed for 405 health care workers with different job categories and at different age. The enzyme immunoassay was used for determining IgG antibodies against varicella zoster virus. A total of 405 health care workers, aged 19-50 years (median: 29 years), were examined. Of these, 289 (71.4%) were found to be seropositive. No statistically significant differences were observed between gender, age, or occupation, and seropositivity (p = 0.09, 0.75, 0.54. respectively). Statistical analysis revealed that the correlation between chickenpox history and seropositivity showed a 62.3% sensitivity, 72.4% specificity, 84.9% positive predictive value, and 43.5% negative predictive value. Serologic screening of health care workers is essential to determine their immunity to varicella, regardless of the age, occupation and history of infection. This population is recommended to be considered a target group for future immunization programs in Iran.

• Substance P and calcitonin gene-related neuropeptides as novel growth factors for ex vivo expansion of cord blood CD34(+) hematopoietic stem cells.

  Authors: Somayeh Shahrokhi, Massoumeh Ebtekar, Kamran Alimoghaddam, Ali Akbar Pourfathollah, Maryam Kheirandish, Alireza Ardjmand, Ahmad Reza Shamshiri, Ardeshir Ghavamzadeh

  Growth factors (Chur, Switzerland). 11/2009;

  There is little evidence on roles of growth factors other than cytokines in expansion of cord blood (CB) stem cells. We aimed to explore a novel approach for expansion, using Substance P (SP) andThere is little evidence on roles of growth factors other than cytokines in expansion of cord blood (CB) stem cells. We aimed to explore a novel approach for expansion, using Substance P (SP) and calcitonin gene-related peptide (CGRP) neuropeptides. CB CD34(+) cells were cultured in different concentrations of SP and/or CGRP in combination with a cytokine cocktail. Phenotypic and functional analysis was performed by flowcytometry and colonogenic assay. Our results show a significant improvement of total expansion of neuropeptide treated cells. There was a selective effect of CGRP on CD34(+) CD133(+) cells, SP on CD34(+) CD45(dim) cells, and 10(- 9) M SP and/or CGRP on expansion of CD34(+) CD38(- ) cells. There was also a tendency for erythroid and granulocyte-myeloid colony formation in SP and CGRP treated cultures, respectively. Supplementation of cytokines with other growth factors, such as neuropeptides, might enable us to overcome the difficulties of ex vivo expansion of CB cells.

• Exposure to Secondhand Smoke in Infants: Declining Trends From 2001 to 2008?

  Authors: Farideh Shiva, Ahmad Reza Shamshiri, Fatemeh Ghotbi, Shadnaz Fakhteh Yavari

  Asia-Pacific journal of public health / Asia-Pacific Academic Consortium for Public Health. 08/2009;

  OBJECTIVE: To define the trend in young children's exposure to parental secondhand smoke. METHODS: Secondary analysis of data was done on families of infants between the ages of 6 and 24 months thatOBJECTIVE: To define the trend in young children's exposure to parental secondhand smoke. METHODS: Secondary analysis of data was done on families of infants between the ages of 6 and 24 months that had been enrolled for 2 cross-sectional studies in 2001 and 2008. RESULTS: Data from 648 families were analyzed. Overall, 29.8% of children had been exposed to parental secondhand smoke; 32% in 2001 and 27.4% in 2008, (P value >.05). In all cases, the source of exposure was the father; in 2008, 4 families reported both parents as being habitual smokers. Ratio of indoor to outdoor smokers was 2.92 in 2001 and 0.93 in 2008. CONCLUSION: The decline in the percentage of infants exposed to parental smoking is nonsignificant; parental indoor smoking has decreased significantly but remains at unacceptably high levels. Authorities responsible for the health of young children need to revise interventional policies.

• Comparison of WBC, ESR, CRP and PCT serum levels in septic and non-septic burn cases.

  Authors: Mitra Barati, Faranak Alinejad, Mohammad Ali Bahar, Mahbobe Satarzadeh Tabrisi, Ahmad Reza Shamshiri, Nosrat-Ol-Lahe Bodouhi, Hamid Karimi

  Burns : journal of the International Society for Burn Injuries. 06/2008;

  Diagnosis of sepsis is difficult, particularly in cases of burn where signs of sepsis may be present in the absence of a real infection. This study compared serum levels of procalcitonin (PCT),Diagnosis of sepsis is difficult, particularly in cases of burn where signs of sepsis may be present in the absence of a real infection. This study compared serum levels of procalcitonin (PCT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) among 60 burned people with and without infection, in order to assess the value of the information for diagnosis of sepsis. A significantly higher PCT level was observed in the septic group compared to those without sepsis (8.45+/-7.8 vs. 0.5+/-1.0, respectively, p<0.001); no significant differences were found in CRP or WBC levels, neutrophil count or ESR. The area under the receiver operating characteristics curve in the diagnosis of sepsis was 0.97 for PCT (p<0.001) with sensitivity of 100% and specificity of 89.3%. Non-survivors had a mean PCT level significantly higher than that of survivors. Thus the serum PCT level was a highly efficient laboratory parameter for the diagnosis of severe infectious complications after burn, but WBC, neutrophil, ESR and CRP levels were of little value.

• The prevalence of low selenium levels in adult patients undergoing bone marrow transplantation: a brief communication.

  Authors: Molouk Hadjibabaie, Masoud Iravani, Ahmad Reza Shamshiri, Zahra Zaker, Asadollah Mousavi, Kamran Alimoghaddam, Babak Bahar, Ebrahim Kalantar, Ardeshir Ghavamzadeh

  Nutrition and cancer. 02/2008; 60(6):837-9.

  Selenium (Se) is an essential trace element, and its deficiency is considered to be important in various types of cancer. There are just a few data regarding this issue among adult patients withSelenium (Se) is an essential trace element, and its deficiency is considered to be important in various types of cancer. There are just a few data regarding this issue among adult patients with hematological malignancy. Serum Se levels were determined in 22 adult patients candidates for bone marrow transplantation (BMT) in Iran. The mean serum Se levels before BMT was 19.91 microg/l (from 12.00 to 62.00 microg/l), and almost all the patients had low Se serum levels (normal serum Se level: 46-143 microg/l). The level of Se 20 days after BMT was 22.53 microg/l, which did not show any significant changes. Most of the patients did not suffer from malnutrition, as they had mostly normal albumin levels. Even though the results of this study showed that Se deficiency is common among our hematological malignant patients, it can not be concluded that these low Se levels are causally related to cancers for which BMT is undertaken. Further studies are needed to evaluate the Se levels at diagnosis before treatment effects.

• Frequency of Red Cell Alloimmunization in Patients with β-Major Thalassemia in an Iranian Referral Hospital

  Authors: Bibi Shahin Shamsian, Mohammad Taghi Arzanian, Ahmad Reza Shamshiri, Alavi Samin, Khojasteh Omid

  Iranian Journal of Pediatrics. 01/2008;

  Objective: Frequency of red cell alloimmunization in patients with β-major-thalassemia in Mofid children's hospital. Tehran. IranMaterial & Methods: This is a cross-sectional descriptive studyObjective: Frequency of red cell alloimmunization in patients with β-major-thalassemia in Mofid children's hospital. Tehran. IranMaterial & Methods: This is a cross-sectional descriptive study conducted in Mofid children's hospital, March 2007. A total of 121 major thalassemia patients on regular blood transfusion were included in this study. Clinical and laboratory data were collected and analyzed to find out the frequency, pattern and factors influencing red cell immunization secondary to multiple blood transfusions in these patients.Findings: Mean age of patients was 13 (6.19) from 2-26 years. They had received regular blood transfusions during periods ranging from 1 to 25.5 years. Red cell alloimmunization was found in 9 patients (7.4%). In female group, 5 out of 66 (7.6%) patients and in male group 4 out of 55 (7.3%) patients had evidence of alloimmunization.The mean age of patients with alloimmunization was 9.6 (6.5) years (range 3.7-20). Four patients (44.4%) with alloimmunization were more than 3 years old at the time of first blood transfusion. The mean age at first blood transfusion in patients with alloimmunization and without alloimmunization was 2.8 (2.4) and 1.7 (2.0) years (P=0.1). The differential rate of splenectomy as a risk factor between patients with and without alloimmunization (11.1% and 8% respectively) was not statistically significant (P=0.5). Direct or indirect antiglobulin tests were positive in 5 (62.5%) patients. The blood alloantibodies by a panel of antibodies using standardized blood bank methods were detected in 4 patients, which were of anti-K and anti-D types. Conclusion: The rate of red blood cell alloimmunization is relatively low in our patients. The age at first blood transfusion and splenectomy were not statistically significant as risk factors for alloimmunization in this study.

• Serum electrolyte changes at engraftment time in patients undergoing allogeneichematopoietic stem cell transplantation.

  Authors: Toktam Faghihi, Masoud Iravani, Ahmad Reza Shamshiri, Molouk Hadjibabaie, Seyyed Asadolah Mousavi, Kamran Alimoghaddam, Ardeshir Ghavamzadeh

  Annals of transplantation : quarterly of the Polish Transplantation Society. 14(3):51-7.

  Background: Metabolic abnormalities have been reported in patients undergoing hematopoietic stem cell transplantation (HSCT). Potential causes, risk factors and outcomes of electrolyte imbalancesBackground: Metabolic abnormalities have been reported in patients undergoing hematopoietic stem cell transplantation (HSCT). Potential causes, risk factors and outcomes of electrolyte imbalances have thoroughly been investigated. On HSCT recipients, multiple pathophysiologic contributers are inflicting electrolyte abnormalities, with special attention being paid to engraftment per se as an important contributer. Engraftment contribution to electrolyte imbalances has been reported for hypophosphatemia and for other electrolyte abnormalities in autologous setting. However in the allogeneic setting serum electrolyte level changes and the timing of any probable abnormalitiy are unknown. Material and methods: We performed a retrospective study in order to evaluate the pattern of phosphorous, magnesium, potassium and uric acid serum changes, timing of any probable abnormality and their possible association with WBC and platelet engraftment in 65 allogeneic HCT recipients from day -9 to +32 after transplantation. Besides we assessed frequency and severity of the abnormalities. Results: We observed a declining pattern of electrolyte concentrations with nadirs antedating WBC and platelet engraftments. Phosphorous and potassium serum changes were correlated with natural logarithm of WBC and platelet level changes. Observed overall incidence of hypophosphatemia (9.2%) and hypomagnesemia (3%) was lower than those previously reported. Conclusion: Abnormalities found reflect a combination of pathophysiologic mechanisms. Occurrence of electrolyte nadirs antedating engraftment confirms increased consumption by rapidly replicating cells as a contributor in allogeneic setting and specifies a susceptible period requiring intensive monitoring. Considering high risk patients and managing various organ system complications lower incidence of some electrolyte abnormalities may be observed.

• Continuous bladder irrigation prevents hemorrhagic cystitis after allogeneic hematopoietic cell transplantation.

  Authors: Molouk Hadjibabaie, Kamran Alimoghaddam, Ahmad Reza Shamshiri, Masoud Iravani, Babak Bahar, Asadollah Mousavi, Mohammad Jahani, Ali Khodabandeh, Yasha Anvari, Kheirollah Gholami, Ardeshir Ghavamzadeh

  Urologic oncology. 26(1):43-6.

  Hemorrhagic cystitis is 1 of the most troublesome complications of hematopoietic cell transplantation conditioning regimens. We conducted a nonrandomized controlled clinical study to investigate theHemorrhagic cystitis is 1 of the most troublesome complications of hematopoietic cell transplantation conditioning regimens. We conducted a nonrandomized controlled clinical study to investigate the role of continuous bladder irrigation in addition to mesna, hydration, and alkalization in the prevention of hemorrhagic cystitis after allogeneic hematopoietic cell transplantation. A total of 80 eligible patients entered the study. From May 2006, 40 patients who underwent allogeneic hematopoietic cell transplantation received continuous bladder irrigation in addition to the common protocol. A historical control group of 40 consecutive patients with same inclusion criteria who did not receive bladder irrigation was enrolled from before May 2006. Hemorrhagic cystitis occurred in 50% of patients in the no bladder irrigation group versus 32% in bladder irrigation group (P = 0.11). The mean duration of hemorrhagic cystitis was significantly reduced in the bladder irrigation group (10 vs. 18 days; P = 0.02). Duration of hospitalization was significantly shorter in the bladder irrigation group (30.2 vs. 39.6; P < 0.001). Late-onset hemorrhagic cystitis that occurred beyond 4 weeks after allo-hemorrhagic cystitis happened more significantly in the no bladder irrigation group (P = 0.001). High-grade hemorrhagic cystitis was more frequently associated with high-grade graft-versus-host disease within 30 days after transplant (P = 0.06). In general, continuous bladder irrigation added to mesna, hydration, and alkalization regimens was well tolerated, decreased the complications of hemorrhagic cystitis, and may be useful in hematopoietic cell transplantation patients. However, more investigations with randomized controlled clinical trials with more patients are needed.

• A 10-year single center survey of pediatric patients with histiocytic disorders in Iran.

  Authors: Bibi Shahin Shamsian, Maryam Nikoufar, Shadi Abdar Esfahani, Ahmad Reza Shamshiri, Mohammad Taghi Arzanian, Samin Alavi, Farzaneh Jadali, Atoosa Gharib, Nima Rezaei

  The Turkish journal of pediatrics. 53(1):34-42.

  Childhood histiocytosis is a rare and diverse group of proliferative disorders, characterized by accumulation and infiltration of antigen-presenting cells or antigen-processing cells, which canChildhood histiocytosis is a rare and diverse group of proliferative disorders, characterized by accumulation and infiltration of antigen-presenting cells or antigen-processing cells, which can affect any tissue or organ. This study was performed in order to investigate the clinical characteristics of Iranian children with different types of histiocytic disorders. Thirty-five patients, with a median age of 3.5 years, who were referred and diagnosed with histiocytic disorders in a referral Children's Hospital in Iran from 1997-2006, were investigated in this study. According to the World Health Organization classification, 27 patients were in class 1, followed by 6 patients in class 2, and 1 patient in class 3. Moreover, 1 patient was diagnosed with sinus histiocytosis with massive lymphadenopathy. Bone lesions were the most common manifestation, which were detected in 15 cases, followed by skin lesions (11 cases) and fever (10 cases). Nonspecific findings like hepatomegaly and splenomegaly were found in 15 cases. Different types of treatment protocols were used according to the diverse groups of histiocytic disorders and different stages of disease, including surgical excision, radiotherapy, chemotherapy, and stem cell transplantation. Twelve patients did not respond well to the treatment and subsequently died due to complications of their disease. Although histiocytosis is considered a rare condition, it can be problematic for pediatric hematologists because of the unknown etiologies and pathogenesis, variable classifications and subtypes, diagnostic difficulties, poor therapeutic responses with high mortality, and some complications after different therapeutic protocols.