60 results on '"Fadakar, A."'
Search Results
2. Insights into subspecies classification and conservation priorities of Central Asian lynx populations revealed by morphometric and genetic analyses
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Nazerke Bizhanova, Olga Nanova, Davoud Fadakar, Alexey Grachev, Zijia Hong, Shahrul Anuar Mohd Sah, Zhansaya Bizhanova, Mikhail Sablin, and Yuriy Grachev
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Medicine ,Science - Abstract
Abstract The Eurasian lynx (Lynx lynx) exhibits geographic variability and phylogenetic intraspecific relationships. Previous morphological studies have suggested the existence of multiple lynx subspecies, but recent genetic research has questioned this classification, particularly in Central Asia. In this study, we aimed to analyse the geographic and genetic variation in Central Asian lynx populations, particularly the Turkestan lynx and Altai lynx populations, using morphometric data and mtDNA sequences to contribute to their taxonomic classification. The comparative analysis of morphometric data revealed limited clinal variability between lynx samples from the Altai and Tien Shan regions. By examining mtDNA fragments (control region and cytochrome b) obtained from Kazakhstani lynx populations, two subspecies were identified: L. l. isabellinus (represented by a unique haplotype of the South clade, H46) and L. l. wrangeli (represented by haplotypes H36, H45, and H47 of the East clade). L. l. isabellinus was recognized only in Tien Shan Mountain, while Altai lynx was likely identical to L. l. wrangeli and found in northern Kazakhstan, Altai Mountain, Saur and Tarbagatai Mountains, and Tien Shan Mountain. The morphological and mtDNA evidence presented in this study, although limited in sample size and number of genetic markers, renders the differentiation of the two subspecies challenging. Further sampling and compilation of whole-genome sequencing data are necessary to confirm whether the proposed subspecies warrant taxonomic standing.
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- 2024
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3. Henle fiber layer hemorrhage associated with combined central retinal vein occlusion and cilioretinal artery occlusion: a case report
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Hamid Riazi-Esfahani, Nazanin Ebrahimiadib, Nikoo Hamzeh, Kaveh Fadakar, and Elias Khalili Pour
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Henle fibre layer hemorrhage ,Central retinal vein occlusion ,Cilioretinal artery occlusion ,Medicine - Abstract
Abstract Background The purpose of this study is to describe a patient who experienced simultaneous central retinal vein and cilioretinal artery occlusions, as well as perifoveal hemorrhage in the Henle fiber. Case presentation A 67-year-old Iranian woman presented with a 3-day history of reduced vision in her left eye. Venous tortuosity and retinal hemorrhage were observed in the retina, together with whitened regions around the fovea, consistent with the diagnosis of central retinal vein occlusion in conjunction with cilioretinal artery occlusion. In structural and en face optical coherence tomography, star-shaped hemorrhages were observed around the fovea, which looked hyperreflective in the Henle fiber layer. Conclusions We present a case of central retinal vein occlusion exacerbated by cilioretinal occlusion and hemorrhage in the Henle fiber layer. The hemorrhage is most likely the result of increased intraluminal pressure in the deep capillary plexus.
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- 2023
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4. Comparison of the fluorescein angiography-guided and indocyanine green angiography-guided photodynamic therapy in the treatment of non-resolving central serous chorioretinopathy
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Nazanin Ebrahimiadib, Arash Mirzaei, Shaghayegh Esfandiarifard, Sonal Tuli, Ehsan Najibzadeh, Marjan Imani Fooladi, and Kaveh Fadakar
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Medicine ,Science - Abstract
Abstract To compare the functional and anatomical outcome of fluorescein angiography (FA) versus indocyanine green angiography (ICGA) guided photodynamic therapy (PDT) in the treatment of non-resolving central serous chorioretinopathy (CSCR). In this prospective interventional case series, all patients with non-resolving CSCR, defined as persistent SRF involving subfoveal area for at least three months, were nonrandomly assigned to receive either FA or ICGA-guided half dose PDT. Baseline and 4 months post-treatment data including best corrected visual acuity (BCVA), the status of foveal subretinal fluid, subfoveal choroidal thickness, choroidal vascularity index, pigment epithelial detachment area, treatment and PDT spot numbers were collected. Thirty-six eyes were included; 24 received ICGA-guided and 12 received FA-guided PDT. Overall, improvement in BCVA and choroidal parameters were observed in all patients. There was no significant difference in baseline parameters as well as follow-up measurements between groups. However, the mean total energy dose and spot number in the IGCA-guided PDT were significantly higher than the FA-guided PDT group (P = 0.001). Both FA-guided and ICGA-guided half-dose PDT were effective in the treatment of non-resolving CSCR, with favorable functional and anatomical outcome. In FA group, PDT with smaller spot sizes and fewer numbers of spots were applied.
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- 2023
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5. Flat irregular pigment epithelial detachment over time and outcome of different treatment regimens
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Nazanin Ebrahimiadib, Mohammadreza Mehrabi Bahar, Hamid Riazi-esfahani, Elias Khalili Pour, Fariba Ghassemi, Hooshang Faghihi, Ahmad Mirshahi, Ramak Roohipourmoallai, Alireza Lashay, Alireza Mahmoudi, and Kaveh Fadakar
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Medicine ,Science - Abstract
Abstract To present long-term visual and structural outcome of treatment in two forms of flat irregular pigment epithelial detachment (FIPED): avascular (aFIPED) and vascularized (vFIPED) in eyes within pachychoroid spectrum. Prospective interventional case series. FIPED were classified into two subgroups; aFIPED and vFIPED based on OCTA. aFIPED underwent PDT, and vFIPED underwent either PDT, IVB, or combination of PDT&IVB. Vision, subretinal or intraretinal fluid, and choroidal biomarkers such as choroidal thickness, area, choroidal vascular index (CVI), and PED area were measured at baseline and last follow-up. Fifteen eyes with aFIPED were followed for a mean of 14.7 ± 10.8 months. Their vision improved, (0.44 ± 0.37–0.33 ± 0.40 LogMAR, p = 0.009) with significant reduction of fluid, choroidal area, thickness, PED area and increase in CVI. Twenty eyes with vFIPED were followed for a mean of 16.5 ± 8.2 months. The same pattern of choroidal alterations without visual improvement was observed in eyes underwent PDT alone. Combination therapy resulted in improvement of vision (0.38 ± 0.10–0.23 ± 0.17 LogMAR, p = 0.006) with reduction of choroidal area and thickness, with an increase in CVI. IVB alone could not change vision or choroidal structure. Single session PDT may lead to sustained visual improvement and structural change in eyes with aFIPED. Combination of PDT and IVB may be a better choice in eyes with vFIPED.
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- 2022
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6. Phylogenetic analyses of Eurasian lynx (Lynx lynx Linnaeus, 1758) including new mitochondrial DNA sequences from Iran
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Farshad Behzadi, Mansoureh Malekian, Davoud Fadakar, Mohammad Ali Adibi, and Eva V. Bärmann
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Medicine ,Science - Abstract
Abstract The Eurasian lynx (Lynx lynx) is one of the widespread felids in Eurasia; however, relatively little is known about the Asian subspecies, and especially the Iranian populations, which comprise the most southwestern part of its range. The current study aimed to assess the phylogenetic status of Iranian populations relative to other populations of Eurasia, by sequencing a 613 bp fragment of the mitochondrial control region. In total, 44 haplotypes were recorded from 83 sequences throughout Eurasia, two of which were found in Iran. The haplotype (H1) is dominant in all Iranian lynx populations and identical to specimens from SW Russia and central China. The second haplotype (H2) is unique and was recorded only from Ghazvin Province in the central Alborz Mountains. Both haplotypes occur in Ghazvin Province. The phylogenetic tree and a median-joining network identified four clades (i.e., East, West 1, West 2, and South). These results are congruent with previous studies and suggest that Eurasian lynx was restricted to the southern part of its range during the glacial maxima and expanded from there to East Asia and to Europe during several independent re-colonization events. The Caucasus region most like plays an important role as a refugium during glacial cycles.
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- 2022
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7. Differentiating features of OCT angiography in diabetic macular edema
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Reza Mirshahi, Hamid Riazi-Esfahani, Elias Khalili Pour, Kaveh Fadakar, Parsa Yarmohamadi, Sayyed Amirpooya Alemzadeh, Samira Chaibakhsh, and Khalil Ghasemi Falavarjani
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Medicine ,Science - Abstract
Abstract The purpose of current study was to evaluate different optical coherence tomography angiography (OCTA) metrics in eyes with diabetic retinopathy with and without diabetic macular edema (DME). In this retrospective study, macular OCTA images of eyes with non-proliferative or proliferative diabetic retinopathy were evaluated. Vascular density, vascular complexity and non-perfusion densities were compared between eyes with and without DME. One-hundred-thirty-eight eyes of 92 diabetic patients including 49 eyes with DME were included. In multivariate analysis, the presence of DME was positively associated with geometric perfusion deficit (GPD) in superficial capillary plexus (SCP), capillary non-perfusion (CNP) of SCP, and GPD in deep capillary plexus (DCP) (all P
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- 2021
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8. Choroidal features in flat irregular pigment epithelial detachment associated with Chronic central serous chorioretinopathy: Avascular versus vascularized.
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Hooshang Faghihi, Alireza Mahmoudi, Elias Khalili Pour, Nazanin Ebrahimiadib, Kaveh Fadakar, Fariba Ghassemi, Ahmad Mirshahi, Alireza Khodabande, Hassan Khojasteh, Fatemeh Bazvand, Mohammadreza Mehrabi Bahar, and Hamid Riazi-Esfahani
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Medicine ,Science - Abstract
PurposeTo investigate the differences in the choroidal biomarkers between two forms of flat irregular pigment epithelial detachment (FIPED): avascular (aFIPED) and vascularized (vFIPED) in eyes with chronic central serous chorioretinopathy (CSC).Materials and methodsEnhanced depth imaging optical coherence tomography (EDI-OCT) was done in eyes with FIPED correlated to chronic CSC, fellow eyes, and also in healthy eyes from gender- and age-matched subjects. Eyes with FIPED were classified into two subgroups based on optical coherence tomography angiography (OCTA) findings: vFIPED and aFIPED. Different choroidal biomarkers such as subfoveal choroidal thickness (SFCT), total choroidal area (TCA), and choroidal vascular index (CVI) were compared between the groups.ResultsForty-four eyes from 42 patients with chronic CSC and FIPED along with 40 eyes from 20 healthy subjects were included. OCTA identified vascularization in 14 eyes in the FIPED group (31.8%). Mean SFCT was higher in the FIPED group compared to two other groups (p = 0.005). In comparison to patients with aFIPED, patients with vFIPED had lower SFCT (p = 0.003) and higher CVI (p = 0.020) based on multivariate analysis.ConclusionsIt seems that measurement of CVI along with SFCT may help to differentiate aFIPED from vFIPED in patients with CSC. Further longitudinal studies would be required to confirm the clinical significance of these findings.
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- 2021
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9. The Association Between Inflammatory Biomarkers and Vitamin D Level With the Evolution and Severity of Stroke
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Afshin Borhani-Haghighi, Anahid Safari, and Nima Fadakar
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Oncology ,Cellular and Molecular Neuroscience ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Vitamin D and neurology ,cardiovascular diseases ,Neurology (clinical) ,medicine.disease ,business ,Stroke ,Inflammatory biomarkers - Abstract
Introduction: Vitamin D deficiency has been linked to the evolution of ischemic stroke, but the data regarding the association between stroke severity and vitamin D level is scarce. Methods: Patients with first-ever ischemic stroke in the middle cerebral artery territory, within seven days after the stroke, were recruited. The control group included age- and gender-matched individuals. We compared 25-OH vitamin D (vitamin D), high sensitive C-reactive protein (hsCRP), serum amyloid A (SAA), and osteopontin levels between stroke patients and the control group. The association between stroke severity according to the National Institutes of Health Stroke Scale (NIHSS) and the Alberta stroke program early CT score (ASPECTS) and levels of vitamin D and inflammatory biomarkers were also studied. Results: There was an association between hypertension (P=0.035), diabetes mellitus (P=0.043), smoking (P=0.016), history of ischemic heart disease (P=0.002), higher SAA (P
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- 2022
10. The Impact of Pictograph-Based Education on Knowledge, Attitude, Self-Care, Fasting Blood Glucose and HbA1c Levels in Type 2 Diabetic Patients in Kerman
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Fatemeh Nazari Robati, Narges Khanjani, Mohammad Reza Mahmoodi, and Mohammad Mehdi Fadakar
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knowledge ,attitude ,self-care ,pictographs ,educational intervention ,type 2 diabetes ,kerman. ,Medicine ,Public aspects of medicine ,RA1-1270 - Abstract
Background and objective: Education can play an important role in the management of chronic diseases such as diabetes. This study was conducted to determine the impact of pictograph-based education on knowledge, attitude, self-care, fasting blood glucose and HbA1c among patients with type 2 diabetes. Materials and methods: This study was a randomized controlled trial (RCT) on 100 patients with type 2 diabetes referred to diabetes clinics in Kerman city. The participants were randomly divided into intervention and control groups with 50 patients in each group. In the intervention group, pictograph-based training was presented in the form of slides and posters along with lectures, but in the control group lectures without pictographs was presented. The data were collected and analyzed using chi-square tests, independent t-test, paired t-test Wilcoxon and Mann-Whitney U through SPSS16. Results: The mean score of total self-care significantly increased in the intervention group (p < 0.0001). The self-care components of foot care and blood glucose monitoring significantly improved in the intervention group, too. Fasting glucose and HbA1c decreased in both groups and knowledge in both groups improved after the intervention, but attitude only increased in the intervention group. Conclusion: Considering the significant role of pictographs in learning health instructions, it seems that education using pictographs can promote self-care behaviors among diabetic patients who are mainly old and/or with low literacy. Paper Type: Research Article.
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- 2016
11. Differentiating features of OCT angiography in diabetic macular edema
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Kaveh Fadakar, Elias Khalili Pour, Sayyed Amirpooya Alemzadeh, Khalil Ghasemi Falavarjani, Parsa Yarmohamadi, Samira Chaibakhsh, Reza Mirshahi, and Hamid Riazi-Esfahani
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Male ,medicine.medical_specialty ,Capillary plexus ,genetic structures ,Science ,Diabetic macular edema ,Foveal thickness ,Comorbidity ,Article ,Macular Edema ,Oct angiography ,Diabetes complications ,Ophthalmology ,medicine ,Humans ,Fluorescein Angiography ,Macular edema ,Aged ,Retrospective Studies ,Diabetic Retinopathy ,Multidisciplinary ,business.industry ,Diabetic retinopathy ,Optical coherence tomography angiography ,Middle Aged ,medicine.disease ,Retinal diseases ,eye diseases ,Multivariate Analysis ,Medicine ,Female ,sense organs ,business ,Microvascular Density ,Perfusion ,Tomography, Optical Coherence - Abstract
The purpose of current study was to evaluate different optical coherence tomography angiography (OCTA) metrics in eyes with diabetic retinopathy with and without diabetic macular edema (DME). In this retrospective study, macular OCTA images of eyes with non-proliferative or proliferative diabetic retinopathy were evaluated. Vascular density, vascular complexity and non-perfusion densities were compared between eyes with and without DME. One-hundred-thirty-eight eyes of 92 diabetic patients including 49 eyes with DME were included. In multivariate analysis, the presence of DME was positively associated with geometric perfusion deficit (GPD) in superficial capillary plexus (SCP), capillary non-perfusion (CNP) of SCP, and GPD in deep capillary plexus (DCP) (all P
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- 2021
12. Alterations in choroidal vascular parameters following panretinal photocoagulation using enhanced-depth imaging optical coherence tomography in diabetic retinopathy
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Reza Mirshahi, Elias Khalili Pour, Sepideh Ghods, Hassan Khojasteh, Fatemeh Bazvand, Fariba Ghassemi, Hooshang Faghihi, Ahmad Mirshahi, Hamid Riazi-Esfahani, Nazanin Ebrahimiadib, and Kaveh Fadakar
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Severe NPDR ,medicine.medical_specialty ,Panretinal photocoagulation ,Retina ,Cellular and Molecular Neuroscience ,Optical coherence tomography ,Ophthalmology ,Diabetes Mellitus ,Humans ,Medicine ,In patient ,Early proliferative diabetic retinopathy ,Diabetic Retinopathy ,Laser Coagulation ,medicine.diagnostic_test ,Choroid ,business.industry ,Diabetic retinopathy ,medicine.disease ,eye diseases ,Sensory Systems ,medicine.anatomical_structure ,sense organs ,Enhanced depth imaging ,business ,Tomography, Optical Coherence - Abstract
To investigate the alteration of choroid in patients with very severe non-proliferative diabetic retinopathy (NPDR) or early proliferative diabetic retinopathy (PDR) following panretinal photocoagulation (PRP). Thirty-nine eyes of 21 patients with very severe non-proliferative diabetic retinopathy (NPDR) (19 eyes) and early proliferative diabetic retinopathy (PDR) (20 eyes) were recruited. Enhanced-depth imaging optical coherence tomography at baseline, 1, and 6 months after PRP was employed to measure choroidal parameters including total choroidal area (TCA) and choroidal vascular index (CVI). In eyes with very severe NPDR, subfoveal TCA decreased non-significantly at month 1, which increased significantly at month 6 (539 ± 131µm2, 502 ± 134µm2, and 598 ± 168µm2 at baseline and months 1 and 6, respectively; P = 0.003). Subfoveal CVI increased at month 1 and then decreased at month 6 (68.25 ± 3.05, 69.74 ± 3.62, and 67.84 ± 1.77 at baseline and months 1 and 6, respectively; P
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- 2021
13. COVID-19 in pediatric kidney transplantation: The Improving Renal Outcomes Collaborative
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Nancy Rodig, Lara Danziger-Isakov, David B. Kershaw, Patricia L. Weng, Judith Sebestyen VanSickle, Samhar I. Al-Akash, Laurie Smith, Debora Matossian, Rouba Garro, Corina Nailescu, Hiren P. Patel, Shiran Chen, Jens Goebel, Charles D. Varnell, David K. Hooper, Cozumel S. Pruette, Saritha Ranabothu, Paul Fadakar, Craig W. Belsha, Michael E. Seifert, Abanti Chaudhuri, Caroline Gluck, Gina Marie Barletta, Chunyan Liu, Paul Brakeman, Lyndsay A. Harshman, and Jodi M. Smith
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infection and infectious agents ,medicine.medical_specialty ,pediatrics ,infectious disease ,kidney transplantation/nephrology ,Disease ,clinical research/practice ,Asymptomatic ,Internal medicine ,Epidemiology ,Humans ,Immunology and Allergy ,Medicine ,Pharmacology (medical) ,Prospective Studies ,Child ,Prospective cohort study ,Kidney transplantation ,Transplantation ,Inpatient care ,SARS-CoV-2 ,business.industry ,Incidence ,Incidence (epidemiology) ,COVID-19 ,Original Articles ,health services and outcomes research ,medicine.disease ,Kidney Transplantation ,Respiratory failure ,Original Article ,epidemiology ,medicine.symptom ,business - Abstract
There are limited data on the impact of COVID-19 in children with a kidney transplant (KT). We conducted a prospective cohort study through the Improving Renal Outcomes Collaborative (IROC) to collect clinical outcome data about COVID-19 in pediatric KT patients. Twenty-two IROC centers that care for 2732 patients submitted testing and outcomes data for 281 patients tested for SARS-CoV-2 by PCR. Testing indications included symptoms and/or potential exposures to COVID-19 (N = 134, 47.7%) and/or testing per hospital policy (N = 154, 54.8%). Overall, 24 (8.5%) patients tested positive, of which 15 (63%) were symptomatic. Of the COVID-19-positive patients, 16 were managed as outpatients, six received non-ICU inpatient care and two were admitted to the ICU. There were no episodes of respiratory failure, allograft loss, or death associated with COVID-19. To estimate incidence, subanalysis was performed for 13 centers that care for 1686 patients that submitted all negative and positive COVID-19 results. Of the 229 tested patients at these 13 centers, 10 (5 asymptomatic) patients tested positive, yielding an overall incidence of 0.6% and an incidence among tested patients of 4.4%. Pediatric KT patients in the United States had a low estimated incidence of COVID-19 disease and excellent short-term outcomes.
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- 2021
14. Expanded Spectrum of Optical Coherence Tomography Findings in Patients with Ocular Toxoplasmosis
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Masoud Soheilian, Alireza Hedayatfar, Seyedeh Maryam Hosseini, Mohammad Zarei, Nazanin Ebrahimiadib, and Kaveh Fadakar
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medicine.medical_specialty ,Choroidal granuloma ,genetic structures ,Visual Acuity ,Serous Retinal Detachment ,Lesion ,chemistry.chemical_compound ,Optical coherence tomography ,Ophthalmology ,medicine ,Humans ,Immunology and Allergy ,In patient ,Toxoplasmosis, Ocular ,medicine.diagnostic_test ,Choroid ,business.industry ,Retinal Detachment ,Retinal ,medicine.disease ,eye diseases ,Toxoplasmosis ,chemistry ,sense organs ,Epiretinal membrane ,medicine.symptom ,business ,Tomography, Optical Coherence - Abstract
Purpose: To describe the optical coherence tomography (OCT) findings of toxoplasmic retinochoroiditis at different stages of activity.Methods: Observational case series.Results: A total of 32 eyes of 31 patients were included; 43 sets of OCT were reviewed. A total of 14 lesions were classified as active, 13 as partially active, and 16 as inactive. All active lesions demonstrated increased retinal thickness and reflectivity with blurring of details of retinal layers. Choroidal granuloma was detected in eight (61.5%) and serous retinal detachment in nine (64%). In partially active lesions, sustained thickening and/or attachment of posterior hyaloid face with fine epiretinal membrane was the hallmark. Scarified lesions showed decreased retinal and choroidal thickness starting from the periphery. Characteristic signs for decreased activity of a lesion seen in majority of both partially active and inactive lesions were RPE changes and retina-RPE approximation. We called this unique feature 'hourglass configuration'.Conclusion: Features in OCT are helpful to specify and monitor the activity of toxoplasmic retinochoroiditis.
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- 2021
15. Assessment of ocular neuropathic pain following vitreoretinal surgery using 23-gauge sclerotomy
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Farid Kalantaritarari, Marjan Imani Fooladi, Golshan Latifi, Mehrdad Goudarzi, Nazanin Ebrahimiadib, Kaveh Fadakar, hanie niktinat, and Fardin Yousefshahi
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medicine.medical_specialty ,business.industry ,Gauge (instrument) ,Neuropathic pain ,Medicine ,Vitreoretinal surgery ,business ,Surgery - Abstract
Purpose: To investigate the presence of persistent ocular pain after 23-gauge pars plana vitreoretinal surgeryMethod: This is a prospective study including patients who underwent 23-gauge vitrectomy or silicone removal with local or general anesthesia. We evaluated the symptoms of ocular neuropathic pain before and two months after surgery using the Brief Pain Inventory (BPI) questionnaire, and the impact of reported ocular symptoms on quality of life. Correlation between ocular pain and factors such as patient demographics and underlying conditions were also assessed.Result: Seventy-five patients with a mean age of 58.93 ± 12.05 years were evaluated. Forty-four (58.7%) were males. Sixty-seven (89.3%) patients underwent vitrectomy and eight had silicone removal surgery, all using 23-gauge instruments. there was an increasing trend in eye pain scores at two months after surgery which did not reach a statistical significance. However, the analgesic consumption increased from 4% before surgery to 17.3% two months after surgery. Patients who reported increased analgesic usage two months after surgery, scored worse in items of the quality-of-life questionnaire. In addition, patients who reported ocular and facial pain and photophobia before surgery had higher chances of analgesic consumption after surgery (p-value: 0.03, 0.003, and 0.001, respectively). Those who reported migraine headaches had higher chances of reporting eye symptoms, postoperatively (p-value: 0.041). Conclusion: Surgeries involving 23-gauge incisions may not induce ocular neuropathic pain. However, increased use of analgesics after surgery was observed.
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- 2022
16. COVID-19 and Immunosuppressive Therapy in Ocular Inflammatory Disease, a Telemedicine Survey
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Arash Maleki, Mohammad Zarei, Leila Bojabadi, C. Stephen Foster, Kaveh Fadakar, Amin Ahmadi, Hamid Riazi-Esfahani, Sydney Look-Why, and Nazanin Ebrahimiadib
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Adult ,Male ,medicine.medical_specialty ,Telemedicine ,Coronavirus disease 2019 (COVID-19) ,Referral ,Comorbidity ,Disease ,Immunomodulation ,Uveitis ,Risk Factors ,Surveys and Questionnaires ,Internal medicine ,Pandemic ,medicine ,Humans ,Immunology and Allergy ,Pandemics ,Close contact ,Immunosuppression Therapy ,SARS-CoV-2 ,business.industry ,COVID-19 ,medicine.disease ,Icu admission ,Ophthalmology ,Female ,business ,Immunosuppressive Agents - Abstract
Purpose: Determine the risk of immunomodulatory therapy (IMT) for COVID-19 infection morbidity.Method: A telemedicine survey on patients of a referral uveitis clinic was performed. Signs of infection, habits, and hospitalizations during the 7 months of the COVID-19 pandemic prior to the study date were recorded. Suggestive findings in chest CT scan and/or positive RT-PCR were considered as confirmed COVID-19 infection while those with only suggestive symptoms were considered as suspected cases. Risk factors including sanitary measures and IMT were compared between patients with confirmed cases and patients without infection.Result: 694 patients were included. Eight patients were identified as confirmed cases and 22 patients as suspected cases of COVID-19 infection. Close contact with infected persons was the only significant risk factor for contracting COVID-19.Conclusion: Using IMT did not affect hospitalization and/or ICU admission and can thus be continued during the pandemic, provided that instructions for preventive measures are followed.
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- 2021
17. Cerebral venous sinus thrombosis associated with COVID-19: a case series and literature review
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Farzad Mardi, Ashkan Mowla, Shima Shahjouei, Mohammad Saied Salehi, Nima Fadakar, Mostafa Almasi-Dooghaee, Mahmoud Reza Azarpazhooh, Afshin Borhani-Haghighi, Maryam Poursadeghfard, Abbas Rahimi-Jaberi, Razieh Foroughi, Ramin Zand, Seyedeh Shaghayegh Zafarmand, Vahid Reza Ostovan, Anahid Safari, Manouchehr Esmaili, Etrat Hooshmandi, Ali Akbar Bidaki, Maryam Owjfard, Mahtab Rostami, Hoda Marbooti, Farzane Farzadfard, Mahnaz Bayat, and Zahra Behzadi
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Neurology ,Coronavirus disease 2019 (COVID-19) ,viruses ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Sinus Thrombosis, Intracranial ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,Cerebral venous sinus thrombosis ,skin and connective tissue diseases ,Pandemics ,Stroke ,Sinus thrombosis ,Neuroradiology ,Original Communication ,SARS-CoV-2 ,business.industry ,Research ,Mortality rate ,fungi ,COVID-19 ,Infection diagnosis ,Middle Aged ,medicine.disease ,Intracranial ,respiratory tract diseases ,Coronavirus ,body regions ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background: Since the COVID-19 pandemic, several cases of cerebral venous sinus thrombosis (CVST) have been reported in SARS-CoV-2 infected individuals. This study provides a series of patients with CVST and SARS-CoV-2 infection.Methods: Consecutive patients with documented SARS-CoV-2 infection, as well as clinical and radiological characteristics of CVST, were reported from three teaching hospitals in the South West, North West, and the center of Iran from June to July 2020. We also searched the abstract archives until the end of August 2020 and gathered 28 reported cases. The diagnostic criteria for SARS-CoV-2 infection were determined according to SARS-CoV-2 detection in oropharyngeal or nasopharyngeal samples in clinically suspected patients. Demographics, main COVID-19 symptoms, confirmatory tests for SARS-CoV-2 infection diagnosis, the interval between the diagnosis of SARS-CoV-2 infection and CVST, clinical and radiological features of CVST, therapeutic strategies, CVST outcomes, rate of hemorrhagic transformation, and mortality rate were investigated.Results: Six patients (aged 31 to 62 years old) with confirmed CVST and SARS-CoV-2 infection were admitted to our centers. Four patients had no respiratory symptoms of SARS-CoV-2 infection. Five out of six patients developed the clinical manifestations of CVST and SARS-CoV-2 infection simultaneously. Three patients had known predisposing factors for CVST. Despite receiving CVST and SARS-CoV-2 infection treatments, four out of six patients passed away.Conclusions: The role of SARS-CoV-2 as a “cause” versus an “additive contributor” remains to be elucidated. Practitioners should be aware of the possibility of CVST in SARS-CoV-2 infection.
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- 2021
18. Contact Zone of Asian and European Wild Boar at North West of Iran.
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Parinaz Khalilzadeh, Hamid Reza Rezaei, Davoud Fadakar, Malihe Serati, Mansour Aliabadian, James Haile, and Hamid Goshtasb
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Medicine ,Science - Abstract
Wild boar (Sus scrofa) are widely distributed throughout the Old World. Most studies have focused on Europe and East Asia with the genetic diversity of West Asia being less well studied. In particular, the genetic variability and genetic structure of the Iranian populations are not yet known; gaps which prevent scientists from resolving the genetic relationships of the Eurasian wild boar. This paper is the first attempt to provide information about genetic relationships among modern Iranian populations of the Eurasian wild boar (S. scrofa) by sequencing 572 bp of the mitochondrial (mt) DNA control region. As a result of this investigation, it was discovered that Iran contains not only Middle Eastern haplotypes, but also shares haplotypes with Europe and East Asia. The Italian clade, which is endemic in Italy, is not identified in Iran, while all other clades, including Asiatic, European, Near East 1, and Near East 2 are found based on the phylogenetic tree and median-joining network. The results of this study illustrate that north west of Iran (specifically Southwest Caspian Sea) is the contact zone between the Asian (Near Eastern and Far Eastern), and the European clades. In light of the fact that the domestication of pigs occurs in Anatolia, this finding is important.
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- 2016
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19. Seizure in patients with COVID-19
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Mohsen Farazdaghi, Fatemeh Javanmardi, Mehrzad Lotfi, Ali A. Asadi-Pooya, Amir Emami, Nima Fadakar, Ali Akbari, and Tahereh Rezaei
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Adult ,Male ,medicine.medical_specialty ,Pediatrics ,Pneumonia, Viral ,Population ,Clinical Neurology ,Lymphocytic pleocytosis ,Dermatology ,Status epilepticus ,Betacoronavirus ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Seizures ,Case fatality rate ,medicine ,Humans ,030212 general & internal medicine ,education ,Pandemics ,COVID ,education.field_of_study ,SARS-CoV-2 ,business.industry ,Infant, Newborn ,COVID-19 ,Symptomatic seizures ,General Medicine ,Middle Aged ,medicine.disease ,Seizure ,Coronavirus ,Psychiatry and Mental health ,Child, Preschool ,Etiology ,Female ,Neurology (clinical) ,Neurosurgery ,medicine.symptom ,Coronavirus Infections ,business ,030217 neurology & neurosurgery - Abstract
Objective The purpose of the current study was to collect the data on the occurrence of seizures in patients with COVID-19 and to clarify the circumstances of the occurrence of seizures in these patients. Methods All consecutive patients who referred to healthcare facilities anywhere in Fars province (located in South Iran with a population of 4.851 million people) from February 19 until June 2, 2020, and had confirmed COVID-19 by positive result on polymerase chain reaction testing and seizure were included. Results During the study period, 6,147 people had confirmed COVID-19 in Fars province, Iran; 110 people died from the illness (case fatality rate 1.79%). During this time period, five people had seizures (seizure rate 0.08%). In four patients, seizure was one of the presenting manifestations, and in one person, it happened during the course of hospital admission. Two patients had status epilepticus. All patients experienced hypoxemia and four of them needed respirator. Two patients had related metabolic derangements and one had cerebrospinal fluid (CSF) lymphocytic pleocytosis. Brain imaging was abnormal in three patients. Four patients died. Conclusion New-onset seizures in critically ill patients with COVID-19 should be considered as acute symptomatic seizures and the treating physician should try to determine the etiology of the seizure and manage the cause immediately and appropriately. Detailed clinical, neurological, imaging, and electrophysiological investigations and attempts to isolate SARS-CoV-2 from CSF may clarify the role played by this virus in causing seizures in these patients. Electronic supplementary material The online version of this article (10.1007/s10072-020-04731-9) contains supplementary material, which is available to authorized users.
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- 2020
20. Outcomes of Descemet-Stripping Automated Endothelial Keratoplasty in Congenital Hereditary Endothelial Dystrophy
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Amin Nabavi, Kaveh Fadakar, Hassan Hashemi, and Masoomeh Mohebbi
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Male ,medicine.medical_specialty ,Intraocular pressure ,Visual acuity ,Adolescent ,genetic structures ,Endothelium ,Treatment outcome ,Visual Acuity ,Slit Lamp Microscopy ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Corneal surgery ,Ophthalmology ,medicine ,Humans ,Child ,Dioptre ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Endothelium, Corneal ,Fuchs' Endothelial Dystrophy ,Corneal Topography ,Retrospective cohort study ,medicine.disease ,Descemet stripping automated endothelial keratoplasty ,Corneal topography ,eye diseases ,Treatment Outcome ,medicine.anatomical_structure ,Child, Preschool ,030221 ophthalmology & optometry ,Female ,sense organs ,Congenital hereditary endothelial dystrophy ,medicine.symptom ,business ,Descemet Stripping Endothelial Keratoplasty ,030217 neurology & neurosurgery - Abstract
Objectives To evaluate the outcomes and complications of Descemet-stripping automated endothelial keratoplasty (DSAEK) in children with congenital hereditary endothelial dystrophy (CHED). Methods Eighteen eyes from 10 children with CHED who underwent standard phakic DSAEK were enrolled in this retrospective interventional case series. Medical records including slit-lamp biomicroscopy, cycloplegic refraction, visual acuity, and measurements of central corneal thickness, corneal topography, and endothelial cell density were evaluated. All complications were recorded. Results The mean age of cases was 8.1±4.2 (range: 3-16) years at the time of surgery. Descemet-stripping automated endothelial keratoplasty was performed successfully in all eyes, which survived in 16/18 (88.9%) of cases during a median follow-up period of 38 (range 19-64) months. In patients with clear graft, best-corrected visual acuity was improved to a range of 20/100 to 20/40 and improved to fix and follow in one younger child. Endothelial cell density decreased by an average of 42.1%, comparing baseline and 6-month follow-up and was relatively stable thereafter. A marked flattening of the anterior corneal curvature (mean change of anterior K reading: +2.56±3.14 diopters) was observed after DSAEK. The only major complication in patients with clear graft was intraocular pressure elevation in 61.1% of the eyes, which was easily controlled with one antiglaucoma medication. None of the eyes developed cataract. Conclusion Descemet-stripping automated endothelial keratoplasty is a safe and successful procedure in children with an acceptable graft survival in a mid-term follow-up period. A marked hyperopic shift could occur after DSAEK in children with CHED.
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- 2020
21. Gold Nanoparticles–Fe3O4 Beads/multiwalled Carbon Nanotubes Modified Glassy Carbon Electrode as a Sensing Platform for the Electrocatalytic Determination of Loratadine in Biological Fluids
- Author
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Reza Fadakar Bajeh Baj, Jafar Abolhasani, and Akbar Hassanpour
- Subjects
Detection limit ,Chemical engineering ,Scanning electron microscope ,Chemistry ,Colloidal gold ,Electrode ,medicine ,Overpotential ,Loratadine ,Electrochemistry ,Amperometry ,Analytical Chemistry ,medicine.drug - Abstract
The glassy carbon electrode was modified by gold nanoparticles (AuNps)–Fe3O4 beads/multiwalled carbon nanotubes (MWCNTs). Surface morphology characterization of the bare and modified electrodes was characterized by scanning electron microscopy technique. This modified glassy carbon electrode was applied for electro-catalytic determination of loratadine. The modified electrode lowered the reduction overpotential of loratadine with the enhancement of its peak current; this behavior was attributed to the electro-catalytic activity of the modified electrode toward loratadine electro-reduction. Various parameters, such as pH of the working solution, amounts of MWCNTs, Fe3O4 beads and AuNps affecting the electrochemical performance of the modified electrode toward loratadine determination were optimized. The linear response of the modified electrode toward loratadine concentration using hydrodynamic amperometry method was between 0.05–5 μM with a detection limit of 0.04 μM (S/N = 3). The modified electrode figures of merit were high repeatability, reproducibility, long-term life time and low response time (
- Published
- 2019
22. Evaluation of radiation maculopathy after treatment of choroidal melanoma with ruthenium-106 using optical coherence tomography angiography
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Babak Masoomian, Hooshang Faghihi, Mohammad Zarei, Fariba Ghassemi, Hamid Abrishami Moghaddam, Ali Mohammadi Torkashvand, Reihaneh Daneshmand, Elias Khalili Pour, Kaveh Fadakar, Fereshteh Tayebi, Tahereh Mahmoudi, Mojtaba Arjmand, Leila Ekradi, and Hamid Riazi-Esfahani
- Subjects
medicine.medical_specialty ,Retina burnout ,genetic structures ,Radiation retinopathy ,medicine.medical_treatment ,Brachytherapy ,Ruthenium-106 ,Radiation maculopathy ,Macular Degeneration ,chemistry.chemical_compound ,Foveal ,Ophthalmology ,medicine ,Humans ,Fluorescein Angiography ,Melanoma ,Retrospective Studies ,Subclinical infection ,Superficial capillary plexus ,Plaque radiotherapy ,business.industry ,Research ,Retinal Vessels ,Retinal ,General Medicine ,RE1-994 ,Middle Aged ,medicine.disease ,Deep capillary plexus ,eye diseases ,medicine.anatomical_structure ,chemistry ,Maculopathy ,Foveal avascular zone (FAZ) ,sense organs ,Ruthenium Radioisotopes ,business ,Tomography, Optical Coherence ,Optic disc - Abstract
Background To assess the impact of brachytherapy on macular microvasculature utilizing optical coherence tomography angiography (OCTA) in treated choroidal melanoma. Methods In this retrospective observational case series, we reviewed the recorded data of the patients with unilateral extramacular choroidal melanoma treated with ruthenium − 106 (106Ru) plaque radiotherapy with a follow-up period of more than 6 months. Automatically measured OCTA retinal parameters were analysed after image processing. Results Thirty-one eyes of 31 patients with the mean age of 51.1 years were recruited. Six eyes had no radiation maculopathy (RM). From 25 eyes with RM, nine eyes (36%) revealed a burnout macular microvasculature with imperceptible vascular details. Twenty-one non-irradiated fellow eyes from the enrolled patients were considered as the control group. Foveal and optic disc radiation dose had the highest value to predict the burnout pattern (ROC, AUC: 0.763, 0.727). Superficial and deep foveal avascular zone (FAZ) were larger in irradiated eyes in comparison to non-irradiated fellow eyes (1629 μm2 vs. 428 μm2, P = 0.005; 1837 μm2 vs 268 μm2, P = 0.021; respectively). Foveal and parafoveal vascular area density (VAD) and vascular skeleton density (VSD) in both superficial and deep capillary plexus (SCP and DCP) were decreased in all irradiated eyes in comparison with non-irradiated fellow eyes (P P Conclusion The OCTA is a valuable tool for evaluating RM. Initial subclinical microvascular insult after 106Ru brachytherapy is more likely to occur in DCP. The deep FAZ area was identified as a more critical biomarker of BCVA than superficial FAZ in these patients.
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- 2021
23. Association of Urban Liveability with Cancer Incidence in Iran: A Nationwide Ecological Study
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Moghadameh Mirzai, Zahra Khorrami, Mohammad Mehdi Fadakar Davarani, and Narges Khanjani
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Cancer Research ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Population ,Ecological study ,Cancer ,medicine.disease ,Cancer registry ,symbols.namesake ,Breast cancer ,Oncology ,Urbanization ,parasitic diseases ,symbols ,medicine ,population characteristics ,Pharmacology (medical) ,Radiology, Nuclear Medicine and imaging ,Surgery ,Poisson regression ,business ,education ,Demography - Abstract
Background: Urban liveability is a multidimensional concept associated with many domains of human health. Objectives: This study aimed at investigating the association between urban liveability and cancer incidence in Iran. Methods: The data of provincial-level urban liveability were obtained from reliable sources. The data of cancer incidence were inquired from the population-based cancer registry of the Iranian Ministry of Health and Medical Education in 2016. Urban liveability scores were determined in all provinces of Iran by utilizing the global liveable city index (GLCI) method. Negative binomial Poisson regression was used to examine the relationship between urban liveability and cancer incidence. Results: Provinces with a higher urban liveability had a higher likelihood of cancer incidence. Higher economic score was significantly associated with higher incidence in colorectal (IRR = 1.49, P = 0.005), liver (IRR = 1.48, P = 0.002), leukemia (IRR = 1.39, P = 0.005), lung (IRR = 1.39, P = 0.039), breast (IRR = 1.38, P = 0.011), and prostate cancers (IRR = 2.11, P < 0.001). Also, provinces with higher environmental friendliness and sustainability had significantly more stomach (IRR = 1.53, P = 0.004), colorectal (1.79, P < 0.001), lung (IRR = 1.43, P = 0.014), and prostate (IRR = 1.50, P = 0.032) cancer incidence. Provinces with higher political governance had significantly more breast cancer (IRR = 1.34, P = 0.002) and leukemia (IRR = 1.30, P = 0.016) incidence rates. Conclusions: Along with the development of urban liveability, the incidence of cancers is increasing in Iran. Cancer control strategies should be implemented especially in settings with higher urbanization.
- Published
- 2021
24. Transient Hyperphosphatasemia Following Pediatric Kidney Transplant
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Elisabeth B. Cole, Melissa J Anslow, Armando Ganoza, Paul Fadakar, Yosuke Miyashita, and Michael L. Moritz
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pre-pubertal post-kidney transplant patients ,Transplantation ,medicine.medical_specialty ,Kidney ,elevated alkaline phosphatase (alp) ,business.industry ,Incidence (epidemiology) ,General Engineering ,Renal function ,Avascular necrosis ,medicine.disease ,Pediatrics ,transient hyperphosphatasemia (th) ,Metabolic bone disease ,Surgery ,Natural history ,medicine.anatomical_structure ,Nephrology ,pediatric kidney transplant ,medicine ,medicine.symptom ,business ,Bone pain ,alkaline phosphatase ,Kidney transplantation - Abstract
Introduction Transient hyperphosphatasemia (TH) is a rare benign condition of elevated serum alkaline phosphatase (AP) levels seen in healthy children. TH has been reported to occur in pediatric solid organ transplants, including kidney transplant patients. Little is known about TH in pediatric kidney transplant patients. Objective To evaluate the incidence and natural history of TH in pediatric kidney transplant patients. Methods A retrospective chart review of patients < 18 years of age who underwent kidney transplantation at the University of Pittsburgh Medical Center (UPMC) Children's Hospital of Pittsburgh between 2008 and 2019 was performed to identify patients with TH, defined as an AP level greater than 1,000 IU/L. Exclusion criteria included repeat kidney transplants or kidney transplant as part of a multiorgan transplant. Results One hundred seventy-six patients underwent a solitary kidney transplant, of which 87 were less than 12 years of age. Eleven patients (6.5%) were found to have TH, all of whom were < 12 years of age (12.8%) (median age: 5 years; range: 1 - 11 years). The median AP level prior to transplant was 183 IU/L (range: 104 - 309 IU/L) and the median peak AP was > 2,300 IU/L (range: 1,227 - 4,912 IU/L). The median time from a kidney transplant to the diagnosis of TH was 0.6 years (range: 0.3 to 7.7 years). The median length of time that TH persisted was 0.5 years (range: 0.2 to 0.9 years). The median estimated glomerular filtration rate (GFR) at the time of diagnosis of TH was 84 mL/min/1.73m2 per the bedside Schwartz equation (range: 45 to 152 mL/min/1.73m2). One patient had variable AP levels over nine months prior to resolution; the other 10 patients had a solitary peak of AP prior to resolution. No patient required treatment of elevated AP levels and the TH resolved spontaneously without intervention. No patients had significant abnormalities of markers of metabolic bone disease or were on active vitamin D, calcium, or phosphorus supplements. Two patients reported bone pain, and one patient was found to have avascular necrosis of the hip. Conclusions TH is a relatively common finding following a pediatric kidney transplant in pre-pubertal children less than 12 years of age. It primarily occurs in the first year following a kidney transplant and usually resolves without recurrence within one year of onset.
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- 2021
25. Intravitreal bevacizumab to treat retinopathy of prematurity in 865 eyes: a study to determine predictors of primary treatment failure and recurrence
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Mohammadreza Mehrabi Bahar, Fatemeh Bazvand, Kaveh Fadakar, Afsaneh Azarkish, Mostafa Heidari, Afsar Dastjani Farahani, and Hamid Riazi-Esfahani
- Subjects
Vascular Endothelial Growth Factor A ,medicine.medical_specialty ,genetic structures ,business.industry ,Infant, Newborn ,Infant ,Retinopathy of prematurity ,Angiogenesis Inhibitors ,Gestational Age ,medicine.disease ,eye diseases ,Bevacizumab ,Ophthalmology ,Intravitreal Injections ,medicine ,Birth Weight ,Humans ,Primary treatment ,Retinopathy of Prematurity ,Treatment Failure ,Intravitreal bevacizumab ,business ,Retrospective Studies - Abstract
Purpose: This study aimed To evaluate the rate and risk factors for primary failure and recurrence after intravitreal anti-VEGF injection in retinopathy of prematurity (ROP).Methods: This retrospective study was performed on 865 eyes from 441 patients with retinopathy of prematurity receiving intravitreal Bevacizumab from 2012 to 2019. Medical records of patients were evaluated.Results: Mean gestational age (GA) and birth weight of patients were 28±2 weeks and 1121±312 g, respectively. Thirty-five eyes (4.04%) had a primary failure, including 18 eyes from 187 eyes in zone 1 (9.6%) and 17 eyes from 678 eyes in zone 2 (2.5%). The mean time of retreatment was 16.64±13.68 days in eyes without regression ROP. The remaining 830 eyes (95.95%) were included in recurrence analysis. The recurrence occurred in 33 eyes (3.97 %) of them in 20 patients, with the meantime of 77.52 days after the first treatment (IVB). Presence of plus disease, history of oxygen therapy or phototherapy, and GA less than 32 were associated with significantly increased prevalence of treatment failure. The risk factor predicting recurrence are lower birth weight, zone 1 pretreatment, history of intubation, anemia, and sepsis.Conclusion: Intravitreal anti-VEGF is a successful treatment for ROP with a low rate of primary failure and recurrence. Attention to risk factors accompanied by special care to patterns of treatment failure and recurrence helps to achieve early detection of treatment failure and vigilant follow up for recurrence.
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- 2021
26. True Mycotic Aneurysms: A Report of Three Patients with Internal Carotid Artery Aneurysm and Mucormycosis, and Literature Review
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Masoumeh Nazeri, Kamiar Zomorodian, Neil J. Spratt, Mehrdad Estakhr, Peyman Petramfar, Nahid Ashjazadeh, Maryam Poursadeghfard, Vahid Reza Ostovan, Mohsen Moghaddami, Bijan Khademi, Owrang Eilami, Carlos Garcia Esperson, Zahra Bahrami, Amir Rudgari, Afshin Borhani-Haghighi, Hanieh Bazrafshan, Mahtab Rostamihosseinkhani, Fatemeh KianiAra, Zahra Ghotbi, Christopher R Levi, Sadegh Izadi, Etrat Hooshmandi, Anahid Safari, Mahsa Kohandel-Shirazi, Abbas Rahimi-Jaberi, Mohammad Saied Salehi, Razieh Shafaei, Masoud Janipour, Mohammad Javad Ashraf, Pariya Kouhi, Behzad Khademi, Nima Fadakar, and Marzieh Basir
- Subjects
medicine.medical_specialty ,business.industry ,Mucormycosis ,cardiovascular system ,medicine ,cardiovascular diseases ,Radiology ,Internal carotid artery aneurysm ,medicine.disease ,business - Abstract
Background Aneurysm formation of internal carotid arteries (ICA) in patients with mucormycosis is a scarce phenomenon. However, the prevalence of rhino-cerebral mucormycosis has been reported to increase after the coronavirus disease 2019 (COVID-19) pandemic. Methods Three patients with stroke and subarachnoid hemorrhage due to ICA aneurysm after the involvement of adjacent paranasal sinuses with mucormycosis were presented. All patients were recruited from Namazi and Khalili hospitals affiliated with Shiraz University of Medical Sciences in Iran from April 2021 to May 2021. Results They had a history of diabetes and corticosteroid use. Also, one of them was treated with imatinib. Two out of three patients were infected with SARS-CoV-2 infection before developing mucormycosis. Two patients had diagnostic angiography before endovascular intervention. One patient did not undergo any therapeutic intervention due to total artery occlusion, whereas the other patient experienced a successful parent artery occlusion by coiling, and only this patient survived. Although all patients received antifungal treatment and surgical debridement, two of them died. Conclusions In the patients with rhino-cerebral mucormycosis evolving of aneurysm should be promptly and meticulously investigated by magnetic resonance angiography (MRA) and computed tomography angiography (CTA). As this type of aneurysms was very fast-growing, as soon as the involvement of sphenoid sinus was detected, the possibility of ICA aneurysm formation should always be kept in mind. If the patient developed an aneurysm, prompt intensive antifungal therapy and therapeutic endovascular interventions such as stenting, coiling, or sacrificing should be considered as soon as possible to optimize outcomes.
- Published
- 2021
27. Choroidal features in flat irregular pigment epithelial detachment associated with Chronic central serous chorioretinopathy: Avascular versus vascularized
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Ahmad Mirshahi, Hassan Khojasteh, Kaveh Fadakar, Hamid Riazi-Esfahani, Hooshang Faghihi, Nazanin Ebrahimiadib, Alireza Mahmoudi, Elias Khalili Pour, Alireza Khodabande, Mohammadreza Mehrabi Bahar, Fatemeh Bazvand, and Fariba Ghassemi
- Subjects
Pigments ,genetic structures ,Cardiovascular Medicine ,Chronic central serous chorioretinopathy ,Biochemistry ,Diagnostic Radiology ,Medicine and Health Sciences ,Medicine ,Cardiovascular Imaging ,Materials ,Tomography ,Multidisciplinary ,medicine.diagnostic_test ,Optical Materials ,Radiology and Imaging ,Angiography ,Retinal detachment ,Middle Aged ,medicine.anatomical_structure ,Central Serous Chorioretinopathy ,Physical Sciences ,Anatomy ,Tomography, Optical Coherence ,Research Article ,Adult ,medicine.medical_specialty ,Imaging Techniques ,Science ,Ocular Anatomy ,Materials Science ,Cardiology ,Research and Analysis Methods ,Retina ,Optical coherence tomography ,Ocular System ,Diagnostic Medicine ,Ophthalmology ,Humans ,Clinical significance ,Aged ,Retrospective Studies ,business.industry ,Choroid ,Retinal Detachment ,Biology and Life Sciences ,medicine.disease ,eye diseases ,Pigment epithelial detachment ,Case-Control Studies ,Eyes ,sense organs ,business ,Head ,Biomarkers - Abstract
Purpose To investigate the differences in the choroidal biomarkers between two forms of flat irregular pigment epithelial detachment (FIPED): avascular (aFIPED) and vascularized (vFIPED) in eyes with chronic central serous chorioretinopathy (CSC). Materials and methods Enhanced depth imaging optical coherence tomography (EDI-OCT) was done in eyes with FIPED correlated to chronic CSC, fellow eyes, and also in healthy eyes from gender- and age-matched subjects. Eyes with FIPED were classified into two subgroups based on optical coherence tomography angiography (OCTA) findings: vFIPED and aFIPED. Different choroidal biomarkers such as subfoveal choroidal thickness (SFCT), total choroidal area (TCA), and choroidal vascular index (CVI) were compared between the groups. Results Forty-four eyes from 42 patients with chronic CSC and FIPED along with 40 eyes from 20 healthy subjects were included. OCTA identified vascularization in 14 eyes in the FIPED group (31.8%). Mean SFCT was higher in the FIPED group compared to two other groups (p = 0.005). In comparison to patients with aFIPED, patients with vFIPED had lower SFCT (p = 0.003) and higher CVI (p = 0.020) based on multivariate analysis. Conclusions It seems that measurement of CVI along with SFCT may help to differentiate aFIPED from vFIPED in patients with CSC. Further longitudinal studies would be required to confirm the clinical significance of these findings.
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- 2021
28. Effect of night work on image quality of optical coherence tomography angiography
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Mojtaba Abrishami, Ahmad Masoumi, Masoud Mirghorbani, Samira Hassanzadeh, and Pouran Fadakar
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medicine.medical_specialty ,genetic structures ,Image quality ,Visual analogue scale ,business.industry ,Optical coherence tomography angiography ,Audiology ,Saccadic masking ,Perceived pain ,Article ,03 medical and health sciences ,Ophthalmology ,0302 clinical medicine ,Signal strength ,030221 ophthalmology & optometry ,medicine ,business ,Artifacts ,Night work ,030217 neurology & neurosurgery ,Fatigue ,Morning - Abstract
Purpose To assess the effect of night shift work on image quality and artifacts when performing optical coherence tomography angiography (OCT-A). Methods In a prospective case series study, twenty nurses underwent OCT-A in two separate sessions: early in the morning before duty shift and at the end of a night shift. Quantitative measurements of horizontal and vertical saccadic, blink, and stretch artifacts and also signal strength of the images were recorded. Moreover, using visual analogue scale of pain (VAS), the perceived pain and discomfort by blue focus light and red scanning laser were recorded. Results Vertical and horizontal saccades, blink, and stretch artifacts were significantly higher after the night shift (P = 0.004, P = 0.015, P
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- 2019
29. Practice patterns and influence of allograft nephrectomy in pediatric kidney re‐transplantation: A pediatric nephrology research consortium study
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John Barcia, Sharon M. Bartosh, Jayanthi Chandar, Jen Jar Lin, Paul Fadakar, Rachel Engen, Matthew M. Grinsell, Amrish Jain, Daniel Ranch, Katherine Twombley, Priya S. Verghese, Rima S. Zahr, Asha Moudgil, Kera E. Luckritz, and Samhar I. Al-Akash
- Subjects
Graft Rejection ,Male ,Reoperation ,medicine.medical_specialty ,Adolescent ,Re transplantation ,medicine.medical_treatment ,030232 urology & nephrology ,030230 surgery ,Nephrectomy ,Transplant nephrectomy ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Child ,Transplantation ,Kidney ,Practice patterns ,business.industry ,Incidence (epidemiology) ,Immunosuppression ,Allografts ,Kidney Transplantation ,United States ,Surgery ,Allograft nephrectomy ,surgical procedures, operative ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,Female ,business - Abstract
INTRODUCTION There are no guidelines regarding management of failed pediatric renal transplants. MATERIALS & METHODS We performed a first of its kind multicenter study assessing prevalence of transplant nephrectomy, patient characteristics, and outcomes in pediatric renal transplant recipients with graft failure from January 1, 2006, to December 31, 2016. RESULTS Fourteen centers contributed data on 186 pediatric recipients with failed transplants. The 76 recipients that underwent transplant nephrectomy were not significantly different from the 110 without nephrectomy in donor or recipient demographics. Fifty-three percent of graft nephrectomies were within a year of transplant. Graft tenderness prompted transplant nephrectomy in 91% (P
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- 2021
30. Quantitative Evaluation of Vascular Density in Diabetic Retinopathy Subtypes using Optical Coherence Tomography Angiography
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Alireza Gholizadeh, Sahar Berijani, Kaveh Fadakar, Fariba Ghassemi, Ameneh Babeli, and Siamak Sabour
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medicine.medical_specialty ,genetic structures ,business.industry ,Ophthalmology ,medicine ,sense organs ,Diabetic retinopathy ,Optical coherence tomography angiography ,medicine.disease ,business ,eye diseases - Abstract
Background: To determine the discrepancy between quantitative measurement of retinal and choriocapillaris (CC) vascular density (VD) in diabetic retinopathy (DR) stages using spectral domain optical coherence tomography angiography (SD OCTA) and compare it with normal subjects.Methods: 188 eyes of 97 participants were recruited in this cross-sectional study. Macular OCTA (3x3mm) scan was performed and VD at the level of superficial capillary plexus (SCP), deep capillary plexus (DCP) and CC were measured with the device software.Results: In normal subjects, VD in SCP, DCP, and CC were higher in all subsegments. In retinal VD, all calculated parameters were reduced in the more extreme stages of DR, except for foveal VD of SCP. There was a constant pattern of decrease in VD of CC from normal cases to cases of NDR and NPDR and then a slight increase happened in the PDR stage but never touching the normal quantities. Age, fasting blood sugar, and years of diabetes mellitus were correlated with reduced VD in different segments. Multivariate linear regression analysis showed that best-corrected visual acuity (BCVA) was positively correlated with parafoveal VD at SCP and VD of foveal area at CC. VD of all subfields of macular area except foveal DCP VD showed reduced levels in diabetic macular edema (DME) patients compared to those without DME.Conclusions: The findings of the study endorse retina VD changes as a potential biomarker for DR development before retinopathy becomes clinically evident. It seems that parafoveal VD of SCP and foveal VD of CC are good biomarkers to predict VA in the diabetic patients.
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- 2020
31. Quantitative assessment of vascular density in diabetic retinopathy subtypes with optical coherence tomography angiography
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Siamak Sabour, Fariba Ghassemi, Kaveh Fadakar, Sahar Berijani, Alireza Gholizadeh, and Ameneh Babeli
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Male ,medicine.medical_specialty ,Visual acuity ,genetic structures ,Vascular density ,Macular Edema ,chemistry.chemical_compound ,lcsh:Ophthalmology ,Foveal ,Ophthalmology ,Diabetes mellitus ,medicine ,Diabetes Mellitus ,Humans ,Capillary plexus ,Fluorescein Angiography ,Retina ,Diabetic Retinopathy ,business.industry ,Diabetes ,Retinal Vessels ,Choriocapillaris ,Retinal ,General Medicine ,Diabetic retinopathy ,Optical coherence tomography angiography ,medicine.disease ,eye diseases ,medicine.anatomical_structure ,Cross-Sectional Studies ,chemistry ,lcsh:RE1-994 ,sense organs ,medicine.symptom ,business ,Microvascular Density ,Tomography, Optical Coherence ,Retinopathy ,Research Article - Abstract
Background Quantitative assessment of vascular density (VD) of retinal and choriocapillaris (CC) in various stages of diabetic retinopathy (DR) using spectral domain optical coherence tomography angiography (SD OCTA). Methods 188 eyes of 97 participants were recruited in this cross-sectional study. The macular OCTA (3x3mm) scan was performed and the computer algorithm assessed VD at the level of superficial capillary plexus (SCP), deep capillary plexus (DCP) and CC. Results All measured parameters were decreased in retinal VD at the more extreme stages of DR, with the exception of SCP foveal VD. There was a constant pattern of decrease in VD of CC from normal cases to cases of NDR and NPDR and then a slight increase occurred in the PDR stage but never touching the normal quantities. Age, fasting blood sugar, and years of diabetes mellitus were correlated with reduced VD in different segments. Multivariate linear regression analysis showed that best-corrected visual acuity (BCVA) was positively correlated with parafoveal VD at SCP and VD of foveal area at CC. VD of all subfields of macular area except foveal DCP VD showed reduced levels in diabetic macular edema (DME) patients compared to those without DME. Conclusions The findings of the study endorse retina VD changes as a potential biomarker for DR development before retinopathy becomes clinically evident. It seems that parafoveal VD of SCP and foveal VD of CC are good biomarkers to predict VA in the diabetic patients.
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- 2020
32. Multimodal imaging for paracentral acute maculopathy; the diagnostic role of en face OCT
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Ramin Nourinia, Hassan Khojasteh, Elias Khalili Pour, Hooshang Faghihi, Kaveh Fadakar, Hamid Riazi-Esfahani, Hamid Ahmadieh, Nazanin Ebrahimiadib, Fariba Ghassemi, and Behnoosh Attarian
- Subjects
medicine.medical_specialty ,Visual acuity ,genetic structures ,Retinal Artery ,Ischemia ,Paracentral acute middle maculopathy ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,lcsh:Ophthalmology ,Central retinal vein occlusion ,Ophthalmology ,Multimodal imaging ,medicine ,030304 developmental biology ,0303 health sciences ,business.industry ,Vascular disease ,Retinal ,medicine.disease ,En face OCT ,chemistry ,lcsh:RE1-994 ,030221 ophthalmology & optometry ,Maculopathy ,Original Article ,medicine.symptom ,business - Abstract
Background To describe the features of multimodal imaging and the diagnostic role of en face OCT in the paracentral acute middle maculopathy (PAMM) spectrum. Methods In this observational case series, 5 eyes of 5 patients with acute PAMM were identified. Demographic characteristics as well as data regarding the underlying disease, presenting visual acuity (VA) and ophthalmic examination results were recorded. All patients underwent multimodal imaging within 3 days after symptom onset. Results The mean age of patients was 52.2 (range, 33–67) years. Systemic comorbidities including diabetes mellitus and hypertension were identified in two patients. Except for one patient diagnosed with isolated PAMM, other patients had signs of retinal vascular disease such as a cilioretinal artery or branch retinal artery obstruction, non-ischemic central retinal vein occlusion, or a combination of these vascular disorders. The central vision was preserved in two cases; however, the remaining cases presented with profound VA reduction. Different patterns of PAMM including arterial, globular, and fern-like were observed in en face OCT at deep capillary plexus (DCP) level. En face OCT images could precisely delineate the margin of the PAMM area. Optical coherence tomography angiography (OCTA) showed decreased vascular density in DCP. Unresolved projection artifact by conventional OCTA software was observed in DCP and choriocapillaris slabs in all cases. Conclusion En face structural OCT in PAMM can delineate the area of ischemia and the degree of foveal involvement. Unresolved projection artifact by conventional OCTA software in the PAMM area can be seen in DCP and choriocapillaris layers.
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- 2020
33. A First Case of Acute Cerebellitis Associated with Coronavirus Disease (COVID-19): a Case Report and Literature Review
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Babak Shirazi Yeganeh, Sedighe Hooshmandi, Sara Ghaemmaghami, Seyed Masoom Masoompour, Vahid Reza Ostovan, Ali Akbari, and Nima Fadakar
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Male ,medicine.medical_specialty ,Neurology ,Ataxia ,Pneumonia, Viral ,Lymphocytic pleocytosis ,Clinical Neurology ,Neurological examination ,medicine.disease_cause ,Gastroenterology ,050105 experimental psychology ,Betacoronavirus ,03 medical and health sciences ,Magnetic resonance imaging ,0302 clinical medicine ,Cerebrospinal fluid ,Short Reports ,Cerebellar Diseases ,Internal medicine ,Edema ,Humans ,Medicine ,0501 psychology and cognitive sciences ,Pandemics ,Coronavirus ,Cerebellitis ,medicine.diagnostic_test ,SARS-CoV-2 ,business.industry ,05 social sciences ,COVID-19 ,virus diseases ,Lopinavir ,Middle Aged ,medicine.disease ,Acute Disease ,Vertigo ,Neurology (clinical) ,medicine.symptom ,Coronavirus Infections ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Novel coronavirus (severe acute respiratory syndrome-coronavirus-2: SARS-CoV-2), which originated from Wuhan, China, has spread to the other countries in a short period of time. We report a 47-year-old male who was admitted to our hospital due to suffering from progressive vertigo and ataxia for 7 days prior to the admission. Neurological examination revealed cerebellar dysfunction, and brain magnetic resonance imaging (MRI) depicted edema of the cerebellar hemisphere associated with leptomeningeal enhancement. Cerebrospinal fluid (CSF) analysis showed mild lymphocytic pleocytosis, elevated protein, and lactate dehydrogenase. SARS-CoV-2 RNA was detected in the oropharyngeal/nasopharyngeal and CSF specimens. As a result, treatment with lopinavir/ritonavir was initiated, and patient symptoms and signs improved significantly during the course of hospitalization. To the best of our knowledge, this is the first case of acute cerebellitis associated with COVID-19 disease which is reported in the literature so far.
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- 2020
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34. Coordinated Circulating T Follicular Helper and Activated B Cell Responses Underlie the Onset of Antibody-Mediated Rejection in Kidney Transplantation
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Marilyn Marrari, Carmen Lefaucheur, Uma R. Chandran, Louis H. S. Lau, Diana Metes, Parmjeet Randhawa, Bala Ramaswami, Adriana Zeevi, Alexander Chang, Camila Macedo, Kevin Louis, Elodie Bailly, Paul Fadakar, Douglas Landsittel, Harinder Singh, Masaki Yamada, and Geetha Chalasani
- Subjects
0301 basic medicine ,Graft Rejection ,Male ,T Follicular Helper Cells ,Cell ,C-C chemokine receptor type 7 ,Flow cytometry ,03 medical and health sciences ,0302 clinical medicine ,Antigen ,Clinical Research ,Isoantibodies ,medicine ,Humans ,Interleukin-7 receptor ,B cell ,B-Lymphocytes ,medicine.diagnostic_test ,biology ,business.industry ,Graft Survival ,General Medicine ,Kidney Transplantation ,030104 developmental biology ,medicine.anatomical_structure ,Nephrology ,Case-Control Studies ,Immunology ,Antibody Formation ,biology.protein ,Cytokines ,Kidney Failure, Chronic ,Female ,Antibody ,business ,030215 immunology ,IRF4 - Abstract
BACKGROUND: Although antibody-mediated rejection (ABMR) has been long recognized as a leading cause of allograft failure after kidney transplantation, the cellular and molecular processes underlying the induction of deleterious donor-specific antibody (DSA) responses remain poorly understood. METHODS: Using high-dimensional flow cytometry, in vitro assays, and RNA sequencing, we concomitantly investigated the role of T follicular helper (T(FH)) cells and B cells during ABMR in 105 kidney transplant recipients. RESULTS: There were 54 patients without DSAs; of those with DSAs, ABMR emerged in 20 patients, but not in 31 patients. We identified proliferating populations of circulating T(FH) cells and activated B cells emerging in blood of patients undergoing ABMR. Although these circulating T(FH) cells comprised heterogeneous phenotypes, they were dominated by activated (ICOS(+)PD-1(+)) and early memory precursor (CCR7(+)CD127(+)) subsets, and were enriched for the transcription factors IRF4 and c-Maf. These circulating T(FH) cells produced large amounts of IL-21 upon stimulation with donor antigen and induced B cells to differentiate into antibody-secreting cells that produced DSAs. Combined analysis of the matched circulating T(FH) cell and activated B cell RNA-sequencing profiles identified highly coordinated transcriptional programs in circulating T(FH) cells and B cells among patients with ABMR, which markedly differed from those of patients who did not develop DSAs or ABMR. The timing of expansion of the distinctive circulating T(FH) cells and activated B cells paralleled emergence of DSAs in blood, and their magnitude was predictive of IgG3 DSA generation, more severe allograft injury, and higher rate of allograft loss. CONCLUSIONS: Patients undergoing ABMR may benefit from monitoring and therapeutic targeting of T(FH) cell–B cell interactions.
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- 2020
35. Vascular abnormalities in uveitis
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Kaveh Fadakar, Ambika Manhapra, Fariba Ghassemi, Arash Maleki, Nazanin Ebrahimiadib, and C. Stephen Foster
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medicine.medical_specialty ,genetic structures ,Retinal Neovascularization ,Vascular occlusion ,Neovascularization ,Uveitis ,Ophthalmology ,medicine ,Humans ,Fluorescein Angiography ,medicine.diagnostic_test ,Retinal vasculitis ,business.industry ,Choroid ,fungi ,food and beverages ,Retinal Vessels ,Uvea ,medicine.disease ,Fluorescein angiography ,eye diseases ,Sclera ,Posterior segment of eyeball ,medicine.anatomical_structure ,sense organs ,medicine.symptom ,business ,Tomography, Optical Coherence - Abstract
Inflammation can involve several ocular structures, including the sclera, retina, and uvea, and cause vascular changes in these tissues. Although retinal vasculitis is the most common finding associated with uveitis involving the posterior segment, other vascular abnormalities may be seen in the retina. These include capillary nonperfusion and ischemia, vascular occlusions, preretinal neovascularization, microaneurysms and macroaneurysms, and telangiectasia. Moreover, vasoproliferative tumors and subsequent coat-like response can develop secondary to uveitis. Fluorescein angiography is ideal for the investigation of retinal vascular leakage and neovascularization, while optical coherence tomography angiography can provide depth resolved images from the superficial and deep capillary plexus and can demonstrate vascular remodeling. Choroidal vascular abnormalities primarily develop in the choriocapillaris or in the choroidal stroma and can appear as flow void in optical coherence tomography angiography and filling defect and vascular leakage in indocyanine green angiography. Extensive choriocapillaris nonperfusion in the presence of choroidal inflammation can increase the risk of choroidal neovascular membrane development. Iris vascular changes may manifest as dilation of vessels in stroma due to inflammation or rubeosis that is usually from ischemia in retinal periphery secondary to chronic inflammation. More severe forms of scleral inflammation, such as necrotizing scleritis, are associated with vascular occlusion in the deep episcleral plexus, which can lead to necrosis of sclera layer and uveal exposure.
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- 2020
36. Early Epidemiological analysis of CoVID-19: First report from South of Iran
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Ali Akbari, Amir Emami, Neda Pirbonyeh, Nima Fadakar, and Fatemeh Javanmardi
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medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Environmental health ,Epidemiology ,medicine ,business - Abstract
Background: Despite the whole world’s effort for controlling, an ongoing global outbreak of lower respiratory tract disease, caused by new corona virus; led to a major public health issue. Current study aims to evaluate the characteristics of infected case in Fars, IranMethods: According to the referral of suspicious patients during one month, 2538 samples were evaluated and extracted for Viral RNA nucleic acids by using the Invitrogen ChargeSwitch® Total RNA Cell Kit (Invitrogen Co.). Data were recorded based on the standardized data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium. Results: By 19 March 2020, 440 admitted patients had been identified with CoVID-19 confirmation. More than 50% of cases were men. Mean age were estimated 48.15 ±18.07. Of all the patients, 30 (6.81%) had a history of travel to Qom city, which was the first infected zone in Iran, also 92(20.90%) had close contact with contaminated or suspected individuals. The mortality rate was estimated 2. 95% (13 cases). Cardiovascular disease (25, 5.68%), diabetes (33, 7.5%), and hypertension (35, 7.95%) were the most common co-existing disorders. Patients with underlying disease are more in danger of death [OR: 11.64, (95%CI 3.14 – 43.18), p= 0.0002]. Conclusion: Human to human transmission of SARS-CoV-II causes Fars province in southwest of Iran become infected and 440 cases identified during one month. The SARS-Cov-2 is more likely to affect male sex and individuals with old age and underlying disorders.
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- 2020
37. Ocular Surface Findings in Patients With Lichen Planopilaris
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Reza Mirshahi, Reza M. Robati, Kaveh Fadakar, Mehdi Gheisari, Mohammad Soleimani, Hamideh Moravvej, and Sahar Dadkhahfar
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Adult ,Male ,medicine.medical_specialty ,Intraocular pressure ,Conjunctiva ,Dry Eye Syndromes ,Meibomian gland ,Corneal Diseases ,Young Adult ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Ophthalmology ,medicine ,Humans ,Young adult ,Aged ,Eyelashes ,business.industry ,Lichen Planus ,Case-control study ,Meibomian Glands ,Middle Aged ,medicine.disease ,eye diseases ,body regions ,Cross-Sectional Studies ,medicine.anatomical_structure ,Hair disease ,Case-Control Studies ,Tears ,Eyelid Diseases ,030221 ophthalmology & optometry ,Female ,Eyebrows ,Hair Diseases ,business - Abstract
Purpose Lichen planopilaris (LPP) is a chronic lymphocytic- mediated disorder that selectively involves hair follicles, leading to cicatricial alopecia. The eyelash follicle and meibomian gland (MG) might also be involved in the disease process leading to ocular surface problems. Methods In this Cross-sectional case -control study, twenty-three patients with histologically confirmed LPP and 23 healthy controls were recruited in this controlled study. To quantify the signs and symptoms of LPP, we used the Lichen Planopilaris Activity Index. The ophthalmologic examination was performed by the same ophthalmologist at Farabi Eye Hospital. Results Patients with LPP had a statistically significant lower tear breakup time (worse test outcome) compared with the control (7.1 6 4.1 vs. 9.6 6 4.4; respectively, P = 0.011). Both MG quality score and expressibility were higher in patients with LPP than in control subjects (14.1 6 4.3 vs. 9.3 6 4.4; P = 0.001; 1.5 6 1.0 vs. 0.4 6 0.8; P = 0.001; respectively). The Schirmer test score was not different between groups. A significant but weak correlation was found between the Lichen Planopilaris Activity Index and tear breakup time. Other ophthalmologic examinations including conjunctiva, lid margin shape, intraocular pressure, and funduscopy were normal in patients with LPP. Conclusions Patients with LPP, scored worse in ocular surface tests. This finding warrants special scrutiny for dry eye and MG dysfunction in these patients.
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- 2018
38. Optical coherence tomography angiography in choroidal melanoma and nevus
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Fariba Ghassemi, Reza Mirshahi, Kaveh Fadakar, and Siamak Sabour
- Subjects
0301 basic medicine ,Choroidal melanoma ,medicine.medical_specialty ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Ophthalmology ,melanoma ,Medicine ,Nevus ,Original Research ,Retinal pigment epithelium ,business.industry ,Melanoma ,Retinal ,Clinical Ophthalmology ,Optical coherence tomography angiography ,medicine.disease ,Dilated fundus examination ,Choroidal nevus ,eye diseases ,030104 developmental biology ,medicine.anatomical_structure ,chemistry ,OCT ,030221 ophthalmology & optometry ,sense organs ,uveal melanoma ,business ,OCTA ,choroidal nevus - Abstract
Fariba Ghassemi,1,2 Reza Mirshahi,1,2 Kaveh Fadakar,1,2 Siamak Sabour3 1Retina & Vitreous Service, 2Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, 3Safety Promotion and Injury Prevention Research Centre, Department of Clinical Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran Synopsis: In optical coherence tomography angiography, the choroidal vascular flow rate in choroidal melanoma is significantly lower than that in choroidal nevus.Objective: The objective of this study was to describe the choriocapillaris and retinal features imaged by optical coherence tomography angiography (OCTA) in eyes with choroidal nevus from small malignant choroidal melanoma.Methods: In this retrospective, noninvasive, observational study, 11 patients diagnosed with small choroidal mass (five with choroidal nevus and six with malignant melanoma) who underwent dilated fundus examination, ocular ultrasonography and OCTA images were compared.Results: In choroidal nevus of all patients, OCTA demonstrated a hyporeflective mass with no significant deformity of choroidal vasculature and an intact retinal pigment epithelium (RPE)–Bruch’s membrane complex. The flow void mass was surrounded by an intense vascular rim named as surface microvasculature (SMV) that had an approximately similar flow rate median of 63.68 mm2 (60.42–67.62 mm2), comparable with the median of the contralateral normal eye of 61.77 mm2 (60.42–64.53 mm2; P>0.09) for nevi. OCTA showed an obscured Bruch’s membrane–RPE–Bruch’s membrane complex and outer retinal layer in choroidal melanomas. Choriocapillaris flow rate over the melanomas was 55.73% (41.93%–60.82%), and the corresponding normal areas had a flow area of 62.75% (61.99%–63.10%; P=0.01). A flow rate difference between choroidal melanoma and nevus was significant (P=0.006). Axial and peripheral feeding vessels were more dilated and tortuous compared with benign nevi.Conclusion: Decreased flow rate of SMV of choroidal melanoma cases compared with nevi was a significant finding. Detection of characteristic vascular features of choroidal melanoma by OCTA could make OCTA an assuring diagnostic modality to differentiate malignant lesions. Keywords: melanoma, choroidal nevus, OCT, OCTA, uveal melanoma
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- 2018
39. BILATERAL CHOROIDAL NEOVASCULARIZATION IN A PATIENT WITH BETA-THALASSEMIA MAJOR AND ITS MANAGEMENT
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Mohammad Yaser Kiarudi, Kaveh Fadakar, and Ebrahim Mousavi
- Subjects
Male ,medicine.medical_specialty ,Visual acuity ,genetic structures ,Angiogenesis Inhibitors ,BETA THALASSEMIA MAJOR ,03 medical and health sciences ,0302 clinical medicine ,Ophthalmology ,Humans ,Medicine ,Intravitreal bevacizumab ,Child ,Macular edema ,medicine.diagnostic_test ,business.industry ,beta-Thalassemia ,Treatment options ,General Medicine ,medicine.disease ,Fluorescein angiography ,Choroidal Neovascularization ,eye diseases ,Bevacizumab ,Angioid streaks ,Choroidal neovascularization ,030221 ophthalmology & optometry ,sense organs ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Purpose To describe a case of bilateral choroidal neovascularization in a patient with beta-thalassemia major and an interventional therapeutic attempt. Method Retrospective case report. Result A known case of beta-thalassemia major presented with gradual vision loss. Fundoscopy revealed bilateral macular edema accompanied by intraretinal hemorrhages. Optical coherence tomography and fluorescein angiography were compatible with the diagnosis of choroidal neovascularization. No signs of angioid streaks or other related abnormalities were noticed in examination and imaging. The patient was treated with intravitreal bevacizumab, and visual acuity improved within 6 months of follow-up. Conclusion Bilateral choroidal neovascularization can be a presenting pathology in patients with beta-thalassemia major. Anti-vascular endothelial growth factor is a promising treatment option.
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- 2018
40. Oxygenated‐bacterial‐cellulose nanofibers with hydrogel, antimicrobial, and controlled oxygen release properties for rapid wound healing
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Aida Fadakar Sarkandi, Majid Montazer, and Mahnaz Mahmoudi Rad
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Polymers and Plastics ,chemistry.chemical_element ,General Chemistry ,Antimicrobial ,Oxygen ,Surfaces, Coatings and Films ,chemistry.chemical_compound ,chemistry ,Chemical engineering ,Bacterial cellulose ,Nanofiber ,Materials Chemistry ,medicine ,Swelling ,medicine.symptom ,Wound healing - Published
- 2021
41. The quantitative measurements of foveal avascular zone using optical coherence tomography angiography in normal volunteers
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Kaveh Fadakar, Houshang Faghihi, Reza Mirshahi, Siamak Sabour, Fatemeh Bazvand, and Fariba Ghassemi
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0301 basic medicine ,medicine.medical_specialty ,genetic structures ,Capillary network ,Foveal thickness ,Foveal avascular zone ,Article ,03 medical and health sciences ,0302 clinical medicine ,Optics ,lcsh:Ophthalmology ,Foveal ,Ophthalmology ,medicine ,Fovea ,business.industry ,Mean age ,Optical coherence tomography angiography ,eye diseases ,Normal volunteers ,030104 developmental biology ,FAZ ,lcsh:RE1-994 ,030221 ophthalmology & optometry ,sense organs ,business ,Normal eye - Abstract
Purpose: To provide normative data of foveal avascular zone (FAZ) and thickness. Methods: In this cross-sectional study both eyes of each normal subject were scanned with optical coherence tomography angiography (OCTA) for foveal superficial and deep avascular zone (FAZ) and central foveal thickness (CFT) and parafoveal thickness (PFT). Results: Out of a total of 224 eyes of 112 volunteers with a mean age of 37.03 (12â67) years, the mean superficial FAZ area was 0.27Â mm2, and deep FAZ area was 0.35Â mm2 (PÂ
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- 2017
42. Refractive lens exchange and piggyback intraocular lens implantation in nanophthalmos: Visual and structural outcomes
- Author
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Mohammad-Reza Fallah-Tafti, Seyed-Farzad Mohammadi, Kaveh Fadakar, Zahra Fallah-Tafti, Azita Khorami, Masoomeh Mohebbi, and Ramon Katoozpour
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medicine.medical_specialty ,Visual acuity ,genetic structures ,medicine.medical_treatment ,Scheimpflug principle ,Visual Acuity ,Ultrasound biomicroscopy ,Glaucoma ,Intraocular lens ,Refractive lens exchange ,03 medical and health sciences ,0302 clinical medicine ,Lens Implantation, Intraocular ,Ophthalmology ,Refractive surgery ,medicine ,Humans ,Microphthalmos ,Prospective Studies ,Dioptre ,Lenses, Intraocular ,business.industry ,medicine.disease ,eye diseases ,Sensory Systems ,030221 ophthalmology & optometry ,Optometry ,Surgery ,sense organs ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Purpose To evaluate the best piggyback intraocular lens (IOL) implantation method and the outcomes in nanophthalmos eyes and to define the postoperative structural changes. Setting Farabi Eye Hospital, Tehran, Iran. Design Prospective case series. Methods Candidates for refractive surgery who were nanophthalmic were recruited. Patients had refractive lens exchange followed by implantation of both IOLs in the bag or 1 IOL in the bag and 1 IOL in the sulcus. The baseline and follow-up visual acuity, refractive status, and structural Scheimpflug imaging were evaluated. Ultrasound biomicroscopy (UBM) was performed 6 months postoperatively. Results The study comprised 9 nanophthalmic patients (18 eyes) with a mean preoperative uncorrected distance visual acuity (UDVA) of 1.53 logarithm of the minimum angle of resolution (logMAR) ± 0.3 (SD), mean corrected distance visual acuity (CDVA) of 0.34 ± 0.2 logMAR, and mean spherical equivalent (SE) of +13.55 ± 4.0 diopters (D). The mean postoperative UDVA improved from baseline. There was no significant difference in the mean UDVA and CDVA between the 2 IOL groups. Postoperatively, both groups had a significant improvement in SE, a significant rise in anterior chamber depth and angle, and similar UBM measurements. Conclusions Piggyback IOL implantation was an effective refractive procedure in nanophthalmic eyes. Both implantation methods resulted in similar outcomes; however, the small number of patients in each group made it less likely that possible differences would be found. The increase in angle values might help prevent the development of closed-angle glaucoma.
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- 2017
43. The Quantitative Measurements of Vascular Density and Flow Area of Optic Nerve Head Using Optical Coherence Tomography Angiography
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Kaveh Fadakar, Fariba Ghassemi, Houshangh Faghihi, Reza Mirshahi, Siamak Sabour, and Fatemeh Bazvand
- Subjects
Adult ,Male ,Aging ,medicine.medical_specialty ,Adolescent ,genetic structures ,Computed Tomography Angiography ,Optic Disk ,Glaucoma ,Age and sex ,01 natural sciences ,010309 optics ,03 medical and health sciences ,0302 clinical medicine ,0103 physical sciences ,Humans ,Medicine ,Child ,Intraocular Pressure ,Aged ,Computed tomography angiography ,medicine.diagnostic_test ,business.industry ,Flow area ,Retinal Vessels ,Optical coherence tomography angiography ,Middle Aged ,medicine.disease ,eye diseases ,Surgery ,Ophthalmology ,Regional Blood Flow ,030221 ophthalmology & optometry ,Optic nerve ,Head (vessel) ,Female ,sense organs ,Tomography ,business ,Nuclear medicine ,Algorithms ,Blood Flow Velocity ,Tomography, Optical Coherence - Abstract
The purpose of this study was to evaluate the vascular density (VD) and the flow area on optic nerve head (ONH) and peripapillary area, and the impact of age and sex using optical coherence tomography angiography (OCTA) in healthy human subjects.Both eyes of each volunteer were scanned by an RTVue XR Avanti; Optovue with OCTA using the split-spectrum amplitude-decorrelation angiography algorithm technique. Masked graders evaluated enface angiodisc OCTA data. The flow area of ONH and the VD were automatically calculated.A total of 79 eyes of patients with a mean age of 37.03±11.27 were examined. The total ONH (papillary and peripapillary) area VD was 56.03%±4.55%. The flow area of the ONH was 1.74±0.10 mm/1.34 mm. The temporal and inferotemporal peripapillary VD was different between male and female patients. Increasing age causes some changes in the flow area of the ONH and the papillary VD from the third to the fourth decade (analysis of variance test; P0.05).A normal quantitative database of the flow area and VD of the papillary and peripapillary area, obtained by RTVue XR with OCT angiography technique, is presented here.
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- 2017
44. Normative values and contralateral comparison of anterior chamber parameters measured by Pentacam and its correlation with corneal biomechanical factors
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Mojtaba Abrishami, Mohammad Reza Sedaghat, Kaveh Fadakar, Sakineh Kadivar, and Vahid Mohammad Zadeh
- Subjects
0301 basic medicine ,medicine.medical_specialty ,genetic structures ,Corneal resistance factor ,Anterior chamber angle ,Corneal hysteresis ,Correlation ,03 medical and health sciences ,0302 clinical medicine ,lcsh:Ophthalmology ,Ophthalmology ,medicine ,Pentacam ,Dioptre ,business.industry ,Mean age ,eye diseases ,Ocular response analyzer ,030104 developmental biology ,lcsh:RE1-994 ,Significant positive correlation ,030221 ophthalmology & optometry ,Optometry ,Original Article ,sense organs ,business ,Corneal disease - Abstract
Purpose: To evaluate the normative values of anterior chamber parameters measured by Pentacam and corneal hysteresis (CH) and corneal resistance factor (CRF) measured by Ocular Response Analyzer (ORA) and their relationship. Methods: In an observational cross-sectional study, patients aged 18–35 years were included. Exclusion criteria were history of any intraocular or corneal disease, anomaly or surgery; hyperopic spherical refraction more than +3, and myopic spherical refraction less than −5.00 diopters (D) or cylindrical refraction more than 2.00 D. ORA was used to measure CH and CRF. Corneal volume (CV), anterior and posterior Q value (QA and QP), anterior and posterior elevation (AE and PE), central corneal thickness (CCT), corneal thinnest thickness (CTT), anterior chamber depth (ACD), anterior chamber volume (ACV) and anterior chamber angle (ACA) were measured with Pentacam. Results: This study evaluated 506 eyes of 253 cases (182 females) with a mean age of 28.43 ± 6.36 years. The average CH and CRF were 10.07 ± 1.61 and 10.33 ± 1.68 mmHg. CH and CRF were not correlated with PQ, AQ, AE and PE. CH and CRF were significantly correlated with CCT (r = 0.499, p
- Published
- 2017
45. The Effect of Educational Intervention based on the theory of planned behavior on Nutritional Behavior with Regard to Cardiovascular Diseases among Health Volunteers
- Author
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Narges Khanjani, Mohammad Mehdi Fadakar, Esmat Rezabeigi Davarani, and Mohammad Reza Mahmoodi
- Subjects
Gerontology ,Nutrition and Dietetics ,business.industry ,Intervention (counseling) ,Public Health, Environmental and Occupational Health ,Theory of planned behavior ,Nutritional behavior ,Medicine (miscellaneous) ,Medicine ,business ,Food Science - Abstract
Background: We sought to evaluate the effect of educational intervention based on the theory of planned behavior (TPB) on nutritional behaviors in relation to the cardiovascular disease (CVD) among health volunteers. Methods: In this quasi-experimental study, the participants included 128 active health volunteers. To conduct the study, 65 and 63 participants were randomly assigned into the intervention and control groups, respectively. Data were collected before and six weeks after the intervention using a validated researcher-made questionnaire. The questionnaire consisted of demographic variables, knowledge questions, and TPB constructs. Data were analyzed by Chi-square, t-test, Mann-Whitney U, and Wilcoxon test. Results: No significant difference was observed between the intervention and control groups with regard to the demographic characteristics, knowledge mean scores, and TPB constructs at the beginning of the study. However, the mean scores of knowledge, attitude, subjective norms, perceived behavioral control (PBC), and nutritional behavior increased significantly (P < 0.001, P < 0.001, P = 0.018, P = 0.007, and P < 0.001, respectively) in the intervention group six weeks after the beginning of study. Significant differences were observed in nutritional performance of the intervention group, in other words the nutritional behavior of the intervention group members changed during the intervention. Conclusion: The PBC was the strongest construct in attitude. To optimize nutritional interventions in preventing the CVD, TPB should be implemented in educational interventions.
- Published
- 2019
46. Effects of panretinal photocoagulation on retinal vasculature and foveal avascular zone in diabetic retinopathy using optical coherence tomography angiography: A pilot study
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Reza Mirshahi, Kaveh Fadakar, Fariba Ghassemi, Hamid Riazi-Esfahani, Ahmad Mirshahi, and Fatemeh Bazvand
- Subjects
medicine.medical_specialty ,genetic structures ,Foveal avascular zone ,Panretinal photocoagulation ,Article ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,lcsh:Ophthalmology ,Foveal ,Diabetic retinopathy ,Ophthalmology ,medicine ,Early proliferative diabetic retinopathy ,business.industry ,Retinal ,Optical coherence tomography angiography ,medicine.disease ,eye diseases ,FAZ ,chemistry ,lcsh:RE1-994 ,030221 ophthalmology & optometry ,sense organs ,business ,OCTA ,030217 neurology & neurosurgery ,After treatment - Abstract
Purpose: To evaluate the optical coherence tomography angiography (OCTA) parameters in patients with diabetic retinopathy following panretinal photocoagulation (PRP). Methods: Eleven eyes of 6 patients with very severe nonproliferative diabetic retinopathy (NPDR) or early proliferative diabetic retinopathy (PDR) were recruited in this prospective interventional pilot study. All patients underwent OCTA imaging at baseline, and choroidal flow, foveal avascular zone (FAZ), retinal thickness, and vascular density were measured at baseline. Three months after treatment, OCTA was repeated, and the alteration in variables was analyzed. Results: The FAZ area remained unchanged following treatment, (P = 0.75). Retinal thickness increased along (P = 0.02) with an increase in vascular density in the superficial and deep foveal area and the macular temporal sector (P = 0.007, 0.03 and 0.049, respectively). Choroidal flow surface area was unchanged (P = 0.10). Conclusion: In this study, foveal vascular density increased and FAZ remained unchanged after PRP for diabetic retinopathy. Keywords: Diabetic retinopathy, Foveal avascular zone, FAZ, Optical coherence tomography angiography, OCTA, Panretinal photocoagulation
- Published
- 2019
47. Genotyping of Echinococcus granulosus from goats and sheep indicating G7 genotype in goats in the Northeast of Iran
- Author
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Bahman Fadakar, Nasim Tabatabaei, Abolghasem Naghibi, and Hassan Borji
- Subjects
Veterinary medicine ,Genotype ,Sheep Diseases ,Iran ,Echinococcosis ,parasitic diseases ,medicine ,Animals ,Internal transcribed spacer ,Echinococcus granulosus ,Ribosomal DNA ,Genotyping ,Goat Diseases ,Sheep ,General Veterinary ,biology ,business.industry ,Goats ,General Medicine ,biology.organism_classification ,medicine.disease ,Parasitology ,Livestock ,business - Abstract
Although cystic echinococcosis (CE) has been a human public health problem in the Northeast of Iran, molecular data regarding the genotypes of Echinococcus granulosus in goats and sheep in these regions are still scarce. In the present study, we determined the genotypes of E. granulosus infecting sheep and goats in northeast of Iran. During April 2013-June 2014, 50 and 30 hydatid cysts were recovered from liver tissue of sheep and goats, respectively,. Protoscoleces or germinal layers were collected from individual cysts, DNA was extracted, and the ribosomal DNA internal transcribed spacer 1 (ITS1) gene was amplified by PCR. The results of PCR-RFLP and the sequence analysis showed that all the samples isolated from sheep (n=50) and most of samples in goats (n=24) were G1 strain, the most prevalent strain in livestock ruminants of Iran. Furthermore, six parasites isolated from goats were found to correspond to E. intermedius (G7 genotype), here reported for the first time from Iran.
- Published
- 2015
48. Efficacy and safety of long pulse Nd:YAG laser versus fractional erbium:YAG laser in the treatment of facial skin wrinkles
- Author
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Reza M. Robati, Sahar Dadkhahfar, and Kaveh Fadakar
- Subjects
Long pulse ,Time Factors ,genetic structures ,Facial rejuvenation ,Dentistry ,chemistry.chemical_element ,Dermatology ,Lasers, Solid-State ,law.invention ,Erbium ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,law ,Dyschromia ,medicine ,Humans ,Wrinkle ,business.industry ,030206 dentistry ,Erbium-YAG laser ,Middle Aged ,Laser ,medicine.disease ,eye diseases ,Skin Aging ,surgical procedures, operative ,Treatment Outcome ,chemistry ,Patient Satisfaction ,Nd:YAG laser ,Face ,Surgery ,Female ,sense organs ,medicine.symptom ,business - Abstract
Fractional lasers such erbium:YAG (Er:YAG) are among popular options for facial rejuvenation. Lasers with infrared wavelength ranges such as long pulse Nd:YAG have been used in nonablative rejuvenation of skin with variable outcomes. In this study, we plan to compare safety and efficacy of fractional Er:YAG and long pulse Nd:YAG for facial rejuvenation applying objective and subjective measurements. Twenty-five patients with Glogau photo aging scale of II to IV were recruited in this randomized face-split double-blind controlled trial. Individuals received three monthly treatments on two sides of the face; one side was treated by fractional Er:YAG laser and the other side by long pulse Nd:YAG laser. Outcomes were evaluated by two blinded dermatologists, patient satisfaction reports and objective measurements of cutaneous resonance running time (CRRT). Both modalities significantly improved periorbital wrinkling, nasolabial folds, dyschromia and skin laxity, and sagging of jowls (p value
- Published
- 2018
49. The Quantitative Measurements of Vascular Density and Flow Areas of Macula Using Optical Coherence Tomography Angiography in Normal Volunteers
- Author
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Masoumeh Mohebbi, Kaveh Fadakar, Siamak Sabour, Fariba Ghassemi, Fatemeh Bazvand, and Reza Mirshahi
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,genetic structures ,Adolescent ,Fundus Oculi ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Foveal ,Ophthalmology ,medicine ,Humans ,Macula Lutea ,Prospective Studies ,Fluorescein Angiography ,Prospective cohort study ,Child ,Aged ,Retina ,business.industry ,Vascular disease ,Retinal Vessels ,Optical coherence tomography angiography ,Blood flow ,Middle Aged ,medicine.disease ,eye diseases ,Healthy Volunteers ,Surgery ,Normal volunteers ,030104 developmental biology ,medicine.anatomical_structure ,Cross-Sectional Studies ,Regional Blood Flow ,030221 ophthalmology & optometry ,Female ,sense organs ,Tomography ,business ,Tomography, Optical Coherence ,Follow-Up Studies - Abstract
BACKGROUND AND OBJECTIVE: The quantification of the density of macular vascular networks and blood flow areas in the foveal and parafoveal area in healthy subjects using optical coherence tomography angiography (OCTA). PATIENTS AND METHODS: Cross-sectional, prospective study in an institutional setting at the Retina Services of Farabi Eye Hospital. One hundred twelve normal volunteers with no known ocular or systemic disease were included, including patient numbers (one or both eyes), selection procedures, inclusion/exclusion criteria, randomization procedure, and masking. En face angiogram OCTA was performed on a 3 mm × 3 mm region centered on the macula. Automated thresholding and measuring algorithm method for foveal and parafoveal blood flow and vascular density (VD) were used. The density of macular vascular networks and blood flow area in the foveal and parafoveal area were measured. RESULTS: A total of 224 healthy eyes from 112 subjects with a mean age of 36.4 years ± 11.3 years were included. In the foveal region, the VD of the superficial capillary network (sCN) was significantly higher than that of the deep capillary network (dCN) (31.1% ± 5.5% vs. 28.3% ± 7.2%; P < .001), whereas in the parafoveal area, VD was higher in the dCN (62.24% ± 2.8% vs. 56.5% ± 2.5%; P < .001). Flow area in the 1-mm radius circle in the sCN was less than in the dCN. Superficial foveal avascular zone (sFAZ) size was negatively correlated with the VD of the foveal sCN, but in the deep FAZ (dFAZ) was not correlated with VD or blood flow area of the fovea. There was no difference between measured VD and blood flow surface area in both eyes of the subjects. CONCLUSIONS: OCTA could be used as a noninvasive, repeatable, layer-free method in quantitative evaluation of VD and blood flow of macular area. The normal quantities of the vascular plexus density and flow will help in better understanding the pathophysiological basis of the vascular disease of retina. [ Ophthalmic Surg Lasers Imaging Retina . 2017;48:478–486.]
- Published
- 2016
50. Risk Factors Associated with Lipomyelomeningocele: A Case-Control Study
- Author
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Zohreh Habibi, Farideh Nejat, Sara Hanaei, Mostafa El Khashab, Arash Esmaeili, Sahar Dadkhah, Mahdi Arjipour, and Kaveh Fadakar
- Subjects
Adult ,Male ,medicine.medical_specialty ,Meningomyelocele ,Multivariate analysis ,Protective factor ,Folic Acid ,Pregnancy ,Risk Factors ,medicine ,Humans ,Obesity ,Family history ,Risk factor ,Child ,Univariate analysis ,Neural tube defect ,Obstetrics ,business.industry ,Case-control study ,Infant ,General Medicine ,Protective Factors ,medicine.disease ,Pregnancy Trimester, First ,Case-Control Studies ,Child, Preschool ,Vitamin B Complex ,Pediatrics, Perinatology and Child Health ,Female ,Surgery ,Neurology (clinical) ,business - Abstract
Background: In general, it seems that both genetic and environmental factors play important roles in the induction of neural tube defects. Lipomyelomeningocele (LipoMMC) is a rather common type of closed neural tube defect, but only limited studies have investigated the potential risk factors of this anomaly. Therefore, the purpose of this case-control study was to investigate the risk factors involved in LipoMMC formation. Material and Method: Various risk factors were evaluated in 35 children between 1 month and 10 years of age with LipoMMC in a hospital-based case-control study. The 2 control arms consisted of 35 children with myelomeningocele (MMC group) and 35 children with congenital anomalies other than central nervous system problems (control group). All groups were matched for age and visited the same hospital. A structured questionnaire was used for the collection of all data, including the mothers' weight and height during pregnancy, education, reproductive history, previous abortions, and socioeconomic status, as well as the parents' consanguinity and family history of the same anomalies. Results: Univariate analysis of the children with LipoMMC compared to the control group showed that the use of periconceptional folic acid supplementation was significantly lower in the MMC and LipoMMC groups compared to the control group. In addition, comparison of the MMC and control groups revealed statistically significant differences regarding the use of folic acid and maternal obesity. In multivariate analysis, use of folic acid in the periconceptional period and during the first trimester was an independent risk factor for LipoMMC and MMC. Furthermore, maternal obesity was a significantly positive risk factor for MMC. Conclusion: The probable risk factors for LipoMMC were investigated in this case-control study. Consumption of folic acid in the periconceptional period and during the first trimester is an independent protective factor against LipoMMC. It seems that larger studies are needed to examine other possible risk factors.
- Published
- 2013
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