207 results on '"Shafi, H."'
Search Results
102. Low incidence of venous thrombosis but high incidence of arterial thrombotic complications among critically ill COVID-19 patients in Singapore.
- Author
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Tan CW, Fan BE, Teo WZY, Tung ML, Shafi H, Christopher D, Zheng S, Peh WM, Chan SSW, Chong VCL, Gallardo CA, Chang CCR, Ling LM, Tan JY, Lee KCH, Phua GC, Cherng BPZ, Low JGH, Ho VK, Prasad V, Wong LJL, Lim CXQ, Chee YL, Ong KH, Lee LH, Ng HJ, and Yap ES
- Abstract
Background: Arterial and venous thrombosis are reported to be common in critically ill COVID-19 patients., Method and Results: This is a national multicenter retrospective observational study involving all consecutive adult COVID-19 patients who required intensive care units (ICU) admission between 23 January 2020 and 30 April 2020 in Singapore. One hundred eleven patients were included and the venous and arterial thrombotic rates in ICU were 1.8% (n = 2) and 9.9% (n = 11), respectively. Major bleeding rate was 14.8% (n = 16)., Conclusions: Critically ill COVID-19 patients in Singapore have lower venous thromboembolism but higher arterial thrombosis rates and bleeding manifestations than other reported cohorts.
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- 2021
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103. Case Report: Utilizing AI and NLP to Assist with Healthcare and Rehabilitation During the COVID-19 Pandemic.
- Author
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Carriere J, Shafi H, Brehon K, Pohar Manhas K, Churchill K, Ho C, and Tavakoli M
- Abstract
The COVID-19 pandemic has profoundly affected healthcare systems and healthcare delivery worldwide. Policy makers are utilizing social distancing and isolation policies to reduce the risk of transmission and spread of COVID-19, while the research, development, and testing of antiviral treatments and vaccines are ongoing. As part of these isolation policies, in-person healthcare delivery has been reduced, or eliminated, to avoid the risk of COVID-19 infection in high-risk and vulnerable populations, particularly those with comorbidities. Clinicians, occupational therapists, and physiotherapists have traditionally relied on in-person diagnosis and treatment of acute and chronic musculoskeletal (MSK) and neurological conditions and illnesses. The assessment and rehabilitation of persons with acute and chronic conditions has, therefore, been particularly impacted during the pandemic. This article presents a perspective on how Artificial Intelligence and Machine Learning (AI/ML) technologies, such as Natural Language Processing (NLP), can be used to assist with assessment and rehabilitation for acute and chronic conditions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Carriere, Shafi, Brehon, Pohar Manhas, Churchill, Ho and Tavakoli.)
- Published
- 2021
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104. Cerebral venous thrombosis in a patient with mild COVID-19 infection.
- Author
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Pang YZ, Shafi H, Lee ZC, Ting SKS, and De Silva DA
- Subjects
- Adult, COVID-19 complications, Humans, Intracranial Thrombosis diagnosis, Male, Severity of Illness Index, Venous Thrombosis diagnosis, COVID-19 diagnosis, Intracranial Thrombosis virology, Venous Thrombosis virology
- Published
- 2021
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105. Congenital adrenal hyperplasia presented with bilateral testicular tumor: A case report.
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Akbarzadeh Pasha A, Shafi H, Teimorian M, Rostami G, Nasirimehr K, and Moudi E
- Abstract
Background: Congenital adrenal hyperplasia (CAH) refers to group of congenital diseases resulting from impaired adrenal steroidogenesis, and its most common cause is 21-hydroxylase deficiency. Testicular adrenal residual tumor (TART) is one of the major complications of CAH, possibly resulting from ectopic remnants of intra-testicular adrenal tissue which is stimulated by excessive secretion of adrenocorticotropic hormone (ACTH). This tumor can be misdiagnosed as Leydig cell tumor (LCT) in these people., Case Presentation: The patient we are presenting is a 20-year-old man with a history of precocious puberty and a height below 3% of the population who underwent radical left testicular orchiectomy with a complaint of bilateral testicular mass, which is reported LCT in the pathology report. In preoperative imaging examinations, bilateral adrenal hyperplasia is observed. In hormonal examinations, the patient is diagnosed with CAH and has been treated with corticosteroids for one year., Conclusion: In patients who present with bilateral testicular mass, it is the best image by abdominopelvic CT scan before surgery to detect CAH.
- Published
- 2021
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106. A rare case of papillary cystadenoma of epididymis presented with painless scrotal mass.
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Ghasemi Shektaie SH, Shafi H, Falahi A, Mahmoudlou F, and Moudi E
- Abstract
Background: It is a rare cardiac malignant primary tumor that seems to derive from the same cellular line as myxomas, but the prognosis is very different. It is a rare cardiac malignant primary tumor that seems to derive from the same cellular line as myxomas, but the prognosis is very different. It is a rare cardiac malignant primary tumor that seems to derive from the same cellular line as myxomas, but the prognosis is very different. Cardiac myxosarcoma is a rare neoplasm that appears to rise from the same cellular source like myxoma. It is difficult to differentiate a myxoma tumor from a myxosarcoma tumor because of its appearance and pathology examination. Myxosercoma tumor requires surgery and chemoradiotherapy, but myxoma is treated only by surgery., Case Presentation: We describe a case of a 58-year-old patient with a left atrium myxosarcoma, presenting with congestive heart failure. Transthoracic echocardiogram (TTE) showed a large polypoid and mobile mass in the left atrium, the patient underwent cardiac surgery and the tumor was successfully extracted, and histopathological result revealed typical features of myxoma. 15 days after surgery, he underwent explorative laparatomy because of progressive GI bleeding. Laparatomy revealed extensive metastatic masses in abdomen and the pathology diagnoses was myxosaroma. Unfortunately, in spite of supportive care, the patient expired on postoperative day one., Conclusion: It is difficult to differentiate a myxoma tumor from a myxosarcoma tumor because of its appearance and pathology examination. Maybe magnetic resonance imaging can help us to achieve more data suggesting malignancy., Competing Interests: There is no Conflict of interest.
- Published
- 2021
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107. Transient Transfection of the Respiratory Epithelium with Gamma Interferon for Host-Directed Therapy in Pulmonary Tuberculosis.
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Bharti R, Srivastava A, Roy T, Verma K, Reddy DVS, Shafi H, Verma S, Raman SK, Singh AK, Singh J, Ray L, and Misra A
- Abstract
Nebulized gamma interferon (IFN-γ) protein has been studied for clinical safety and efficacy against pulmonary tuberculosis (TB). The protein is expensive, requires a cold chain, and is difficult to deploy in limited-resource, high-incidence settings. We generated a preclinical proof of concept (PoC) for a dry powder inhalation (DPI) containing DNA constructs to transiently transfect the lung and airway epithelium of mice with murine IFN-γ. Bacterial colony-forming units (CFU) in the lungs of mice infected with Mycobacterium tuberculosis (Mtb) reduced from about 10
6 /g of tissue to ~104 after four doses given once a week. Nodular inflammatory lesions in the lungs reduced significantly in number. Immunohistochemistry of infected lung sections for LC3-1 and LAMP-1 indicated autophagy induction between 18 and 48 h after inhalation. ELISA on bronchoalveolar lavage (BAL) fluid showed differences in kinetics of IFN-γ concentrations in the epithelial lining fluid of healthy versus infected mice. Uninfected mice receiving DNA constructs expressing a fluorescent protein were live-imaged. The fluorescence signals from the intracellular protein peaked at about 36 h after inhalation and declined by 48 h. These results establish preclinical PoC of the efficacy of a DPI and dosing regimen as a host-directed and transient gene therapy of experimental pulmonary TB in mice, justifying preclinical development., (© 2020 The Authors.)- Published
- 2020
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108. Cerebral Venous Thrombosis in Patients with COVID-19 Infection: a Case Series and Systematic Review.
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Tu TM, Goh C, Tan YK, Leow AS, Pang YZ, Chien J, Shafi H, Chan BP, Hui A, Koh J, Tan BY, Umapathi NT, and Yeo LL
- Subjects
- Adult, Antibodies, Antiphospholipid blood, Anticoagulants therapeutic use, Biomarkers blood, C-Reactive Protein analysis, COVID-19 diagnosis, Female, Fibrin Fibrinogen Degradation Products analysis, Humans, Male, Middle Aged, Risk Factors, Sinus Thrombosis, Intracranial blood, Sinus Thrombosis, Intracranial diagnostic imaging, Sinus Thrombosis, Intracranial drug therapy, Treatment Outcome, Venous Thrombosis blood, Venous Thrombosis diagnostic imaging, Venous Thrombosis drug therapy, COVID-19 complications, Sinus Thrombosis, Intracranial etiology, Venous Thrombosis etiology
- Abstract
Background: There has been increasing reports associating the coronavirus disease 2019 (COVID-19) with thromboembolic phenomenon including ischemic strokes and venous thromboembolism. Cerebral venous thrombosis (CVT) is a rare neurovascular emergency that has been observed in some COVID-19 patients, yet much remains to be learnt of its underlying pathophysiology., Objective: We present a case series of local patients with concomitant COVID-19 infection and CVT; and aim to perform a systematic review of known cases in the current literature., Methods: We describe two patients with concomitant COVID-19 infection and CVT from a nationwide registry in Singapore. We then conducted a literature search in PubMed and Embase using a suitable keyword search strategy from 1st December 2019 to 11th June 2020. All studies reporting CVT in COVID-19 patients were included., Results: Nine studies and 14 COVID-19 patients with CVT were studied. The median age was 43 years (IQR=36-58) and majority had no significant past medical conditions (60.0%). The time taken from onset of COVID-19 symptoms to CVT diagnosis was a median of 7 days (IQR=6-14). CVT was commonly seen in the transverse (75.0%) and sigmoid sinus (50.0%); 33.3% had involvement of the deep venous sinus system. A significant proportion of patients had raised D-dimer (75.0%) and CRP levels (50.0%). Two patients reported presence of antiphospholipid antibodies. Most patients received anticoagulation (91.7%) while overall mortality rate was 45.5%., Conclusions: The high mortality rate of CVT in COVID-19 infection warrants a high index of suspicion from physicians, and early treatment with anticoagulation should be initiated., Competing Interests: Declaration of Competing Interest There are no conflict of interests., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2020
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109. Disentangling etiologies of CNS infections in Singapore using multiple correspondence analysis and random forest.
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Zellweger RM, Yacoub S, Chan YFZ, Soon D, Shafi H, Ooi ST, Chan M, Jacobson L, Sessions OM, Vincent A, Low JGH, Ooi EE, Wang L, Wijaya L, and Tan K
- Subjects
- Aged, Central Nervous System Infections microbiology, Communicable Diseases classification, Communicable Diseases epidemiology, Communicable Diseases etiology, Data Interpretation, Statistical, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Singapore epidemiology, Antigens, Bacterial analysis, Antigens, Fungal analysis, Antigens, Viral analysis, Central Nervous System Infections complications, Communicable Diseases diagnosis
- Abstract
Central nervous system (CNS) infections cause substantial morbidity and mortality worldwide, with mounting concern about new and emerging neurologic infections. Stratifying etiologies based on initial clinical and laboratory data would facilitate etiology-based treatment rather than relying on empirical treatment. Here, we report the epidemiology and clinical outcomes of patients with CNS infections from a prospective surveillance study that took place between 2013 and 2016 in Singapore. Using multiple correspondence analysis and random forest, we analyzed the link between clinical presentation, laboratory results, outcome and etiology. Of 199 patients, etiology was identified as infectious in 110 (55.3%, 95%-CI 48.3-62.0), immune-mediated in 10 (5.0%, 95%-CI 2.8-9.0), and unknown in 79 patients (39.7%, 95%-CI 33.2-46.6). The initial presenting clinical features were associated with the prognosis at 2 weeks, while laboratory-related parameters were related to the etiology of CNS disease. The parameters measured were helpful to stratify etiologies in broad categories, but were not able to discriminate completely between all the etiologies. Our results suggest that while prognosis of CNS is clearly related to the initial clinical presentation, pinpointing etiology remains challenging. Bio-computational methods which identify patterns in complex datasets may help to supplement CNS infection diagnostic and prognostic decisions.
- Published
- 2020
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110. Concurrent bilateral testicular tumors with different histopathology: A case report.
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Rostami G, Shafi H, Ranaee M, Saeedfar S, and Mahmoudlou F
- Abstract
Background: Bilateral synchronous testis germ cell tumors with different histopathology are not common., Case Presentation: Here, a case of 27-year-old male who is reported presented with bilateral testicular swellings. There was a high α-fetoprotein level with bilateral lesions on scrotal Ultrasonography. Bilateral orchiectomy was performed. According to pathology report, there was a right testicular seminoma and left testicular mixed germ cell tumor composed of seminoma, yolk sac tumor and embryonal carcinoma., Conclusion: He received one cycle of chemotherapy with BEP regimens., (Copyright © 2020, Babol University of Medical Sciences.)
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- 2020
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111. Disseminated Cryptococcosis in a Non-HIV Patient in Singapore.
- Author
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See J, Fong KCR, and Shafi H
- Abstract
We present a case of disseminated cryptococcosis (DC) in a 71-year-old gentleman with systemic lupus erythematosus (SLE) on long-term corticosteroids. He initially presented with right arm cellulitis in a tertiary hospital in Singapore and was subsequently diagnosed with DC involving skin, meninges, blood, and possibly pulmonary involvement. He eventually succumbed to the disease despite prolonged antifungal therapy. Through this case, we wish to highlight an atypical clinical presentation of an uncommon infection and hope to share the importance of considering DC in the differential diagnosis of nonresolving cellulitis among immunocompromised individuals. Mortality and morbidity rates for this condition remain high despite appropriate treatment. Early diagnosis and treatment are crucial for improved outcomes. More research is needed to improve the therapeutic modalities for treatment of DC and to improve the clinical outcomes for this life-threatening condition., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2019 Jonathan See et al.)
- Published
- 2019
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112. A rare case of primary malignant fibrous histiocytoma: a sarcoma of the kidney.
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Ebrahimtabar F, Shafi H, Ranaee M, and Darzi MM
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- Humans, Male, Middle Aged, Histiocytoma, Malignant Fibrous pathology, Histiocytoma, Malignant Fibrous surgery, Kidney Neoplasms pathology, Kidney Neoplasms surgery
- Abstract
Background: Primary malignant fibrous histiocytoma of the kidney (MFH) is an extremely rare tumor which is indistinguishable from its' mimics in particular renal cell carcinoma (RCC) by clinical features and preoperative imaging evaluation. Due to its high predilection to local recurrence and distant metastases, early diagnosis has great value., Case Presentation: Herein, we describe a 62 year-old man with a 3-month history of abdominal discomfort and a palpable right loin mass whom computerized tomography (CT) showed a large heterogeneous solid mass in the right kidney. With the suspicious to RCC; the patient underwent radical nephrectomy. However, histopathological report revealed pleomorphic-storiform malignant fibrous histiocytoma. Immunohistochemistry study was also confirmed the diagnosis of MFH. Six month follow up showed no evidence of any recurrence., Conclusions: The therapeutic options for MFH differ from other renal tumors, hence histopathology and immunohistochemistry studies are required to establish a definite diagnosis of the disease. Despite of progress made in clinical studies and advances in diagnostic modalities, early diagnosis of MFH has not achieved yet. Further studies and accumulated experience with renal MFH are required to determine the approach to prolong survival in selected cases along with management and prognostic factors of such tumors.
- Published
- 2019
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113. Murine typhus presenting with status epilepticus.
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Shafi H and Hipolito LG
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- Adult, Female, Humans, Male, Status Epilepticus microbiology, Typhus, Endemic Flea-Borne complications, Rickettsia typhi, Status Epilepticus diagnosis, Typhus, Endemic Flea-Borne diagnosis
- Abstract
Patients with rickettsial infection usually present with a febrile illness, headache, arthromyalgia and various biochemical abnormalities. Neurologic involvement is rare in murine typhus. Here, we report a case of a patient who presented with status epilepticus secondary to Rickettsia typhi infection., (Copyright © 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2019
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114. Quadruple valve infective endocarditis presenting with suspected Austrian syndrome: a case report and a case series of quadruple valve infective endocarditis.
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Zheng S, Soh JXJ, and Shafi H
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- Echocardiography, Endocarditis complications, Heart Valves pathology, Humans, Male, Meningitis, Pneumococcal complications, Middle Aged, Pneumonia, Pneumococcal complications, Endocarditis diagnosis, Endocarditis pathology, Meningitis, Pneumococcal diagnosis, Meningitis, Pneumococcal pathology, Pneumonia, Pneumococcal diagnosis, Pneumonia, Pneumococcal pathology, Streptococcus pneumoniae isolation & purification
- Abstract
Objectives: Austrian syndrome comprises the triad of pneumonia, meningitis, and endocarditis secondary to Streptococcus pneumonia. We present what we believe to be the first reported case of Austrian syndrome with quadruple heart valve involvement and review the literature detailing cases of quadruple valve infective endocarditis., Case Presentation and Results: A case is presented of a patient with radiographic evidence of a left lower lobe pneumonia. Sequential transthoracic followed by transesophageal echocardiogram done to evaluate the presence of a cardiac murmur revealed the presence of quadruple valve vegetations. Multiple blood cultures were persistently negative. The patient went on to develop seizures secondary to proven meningitis. Microbiological diagnosis was eventually established through positive Streptococcus pneumoniae antigen (Alere BinaxNOW®) from cerebrospinal fluid, establishing a presumptive clinical diagnosis of Austrian syndrome. A computerized PubMed search for reports of quadruple valve infective endocarditis and their references was collated. A total of 22 patients were found, including our patient. The median age of presentation was 47.5 years. Five patients had a history of intravenous drug abuse, another 5 had underlying congenital heart disease, and 1 had both. Two patients (9.1%) had 2 microorganisms isolated. Staphylococcus aureus and Streptococcus viridans (3 cases, 13.6% each) were the most commonly implicated microorganism. Heart failure was the commonest complication, afflicting 11 patients (50.0%). Ten patients (45.5%) underwent surgery. Overall case fatality rate was 50.0%. Cardiac surgery was of statistical significance in predicting survival (P = 0.009)., Conclusion: Quadruple valve endocarditis is associated with a high mortality rate, and cardiac surgery may be protective., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2019
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115. Effect of Alpinia officinarum Hance rhizome extract on spermatogram factors in men with idiopathic infertility: A prospective double-blinded randomised clinical trial.
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Kolangi F, Shafi H, Memariani Z, Kamalinejad M, Bioos S, Jorsaraei SGA, Bijani A, Shirafkan H, and Mozaffarpur SA
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- Adult, Cell Shape drug effects, Double-Blind Method, Humans, Infertility, Male physiopathology, Male, Plant Extracts pharmacology, Semen Analysis, Sperm Count, Sperm Motility drug effects, Spermatozoa cytology, Treatment Outcome, Alpinia, Infertility, Male drug therapy, Plant Extracts therapeutic use, Spermatozoa drug effects
- Abstract
Despite scientific advances, many of the treatments in male infertility remained indeterminate. In recent years, the attention to herbal remedies as an effective treatment for male infertility is considerable. We designed this study to determine the effects of Alpinia officinarum on the results of semen analysis in men with idiopathic infertility. In this clinical trial, seventy-six participants with idiopathic infertility were included in the intervention (plant treatment: n = 31; placebo: n = 29). Participants were randomised to take capsules containing dried extract of A. officinarum rhizome or placebo on a daily (total daily dosage of 300 mg) basis for 3 months. After 12 weeks of intervention, the sperm count and total number of spermatozoa with normal morphology were increased in participants treated with A. officinarum extract compared with the placebo group. The mean sperm count was initially 52 × 10
6 ± 24 × 106 /ml which changed to 71 × 106 ± 23 × 106 /ml, after intervention (p = 0.043). Also, the mean percentage of spermatozoa with normal morphology was 14.34% ± 9.16% before the treatment which significantly increased to 19% ± 14.89% (p < 0.001). Alpinia officinarum, a traditional medicine remedy, can be effective in the improvement of sperm morphology and sperm count in idiopathic infertility without causing adverse effects., (© 2018 Blackwell Verlag GmbH.)- Published
- 2019
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116. Electroconvulsive Therapy in Depression: Current Practice and Future Direction.
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Hermida AP, Glass OM, Shafi H, and McDonald WM
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- Humans, Depressive Disorder, Major therapy, Depressive Disorder, Treatment-Resistant therapy, Electroconvulsive Therapy adverse effects, Electroconvulsive Therapy methods, Electroconvulsive Therapy standards, Electroconvulsive Therapy trends
- Abstract
The current practice of electroconvulsive therapy (ECT) has evolved over several decades with the implementation of safer equipment and advancement of techniques. In addition, modifications in the delivery of ECT, such as the utilization of brief and ultrabrief pulse widths and individualization of treatment parameters, have improved the safety of ECT without sacrificing efficacy. This article aims to provide psychiatrists with a balanced, in-depth look into the recent advances in ECT technique as well as the evidence of ECT for managing depression in special populations and patients with comorbid medical problems., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2018
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117. Antibiotic prophylaxis in the prevention of urinary tract infection in patients with sterile urine before extracorporeal shock wave lithotripsy.
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Shafi H, Ilkhani M, Darabi Ahangar Z, and Bayani M
- Abstract
Background: One of the lithotripsy complications is urinary tract infection (UTI) and sepsis after extracorporeal shock wave lithotripsy (ESWL). The aim was to study the prophylactic effect of antibiotics on UTI after ESWL., Methods: This randomized double-blind clinical trial was carried out on 600 patients admitted to Babol Clinic hospital in 2014-2015. Patients were randomly divided into treatment group (receiving 200 mg ofloxacin and control group (receiving placebo. The effect of prophylactic antibiotics on the incidence of bacteriuria after ESWL and the impact of variables such as gender, age, urolithiasis size and location and underlying diseases in the incidence of UTI after ESWL were evaluated., Results: Totally, 67 of the population had positive urine cultures. Twenty-nine (10.13%) of them were in the treatment group (n=286) and 38 (13.01%) of them were in the control group (n=292). All 67 patients had asymptomatic bacteriuria. Escherichia coli and proteus were the grown microorganisms in most samples. The mean age of sample population was 44.8±23, and 67.16% of patients with positive urine culture were older than 45 years., Conclusions: The results indicated that prophylactic antibiotics prior to ESWL in patients with urinary calculi and negative urine culture had no significant decrease in urinary tract infection after lithotripsy. It is better that the use of prophylactic antibiotics is limited to patients with risk factors., Competing Interests: None declared.
- Published
- 2018
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118. Non-responsive breast cellulitis after hyaluronic acid filler injection.
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Koh PW and Shafi H
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- 2018
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119. Pneumoperitoneum during treatment of abdominal tuberculosis in a Non-HIV patient: Natural progression or paradoxical worsening?
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Zheng S and Shafi H
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- Aged, Fatal Outcome, Female, Humans, Peritonitis, Tuberculous complications, Peritonitis, Tuberculous pathology, Pneumoperitoneum complications
- Abstract
Paradoxical reactions during tuberculosis (TB) treatment are well-described in the HIV seropositive population but less so in the HIV seronegative group. Abdominal TB rarely presents as spontaneous perforation; cases occurring during anti-TB therapy are even rarer. We describe the clinical progress of a case of an HIV-negative patient who developed acute peritonitis while on anti-TB treatment for peritoneal TB through a series of clinical, radiological and histological images. Visceral perforation can occur as a complication of TB treatment. A high index of suspicion with early surgical intervention is crucial in the management of such cases., Competing Interests: There are no conflicts of interest.
- Published
- 2018
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120. Efficacy of potassium polycitrate on renal stone and microlithiasis predisposed by metabolic disorders.
- Author
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Sorkhi H, Saeedizand N, Poornasrollah M, Bijani A, and Shafi H
- Abstract
Background: According to high prevalence of renal stone in children, we evaluated the efficacy of treatment with potassium citrate and its correlation with metabolic disorders in children less than two years of age with renal stone and microlithiasis., Methods: In this cross- sectionaly study, 100 patients (less than 2 years old) with renal stone or microlitiasis were evaluated for metabolic disorders. They were treated with potassium citrate and followed-up by ultrasonography every 3 months. Then response to treatment was evaluated according to the fresence metabolic disorders (A p-alue<0.05 was significant)., Results: According to this study, hyperuricosuria and hypercalciuria were the two major metabolic disorders (40-33%). Seventy three patients had complete response, and also there as not a significant difference (p<0.05) in the efficacy of treatment due to types of metabolic disorders. There was significant difference between relative response to treatment in children who had metabolic disorders and patient without any metabolic disorders., Conclusion: Based on our results the use of potassium citrate in all children less than 2 years with renal stone or microlithiasis especially those with metabolic disorders, are recommended., Competing Interests: There was no conflict of interest.
- Published
- 2017
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121. The Association of Household Food Insecurity and the Risk of Calcium Oxalate Stones.
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Shafi H, Dorosty Motlagh AR, Bagherniya M, Daeezadeh A, and Safarian M
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- Adolescent, Adult, Aged, Calcium Oxalate analysis, Case-Control Studies, Female, Humans, Iran epidemiology, Kidney Calculi chemistry, Male, Middle Aged, Risk Factors, Surveys and Questionnaires, Young Adult, Body Mass Index, Food Supply, Kidney Calculi epidemiology, Kidney Calculi genetics
- Abstract
Purpose: Food insecurity has been defined as 'limited or uncertain availability of nutritionally adequate and safe foods', which associated with adverse health consequences in human. Another alarming condition, which is related to several comorbidities is kidney stone. This study aimed to determine the association of household food insecurity and developing kidney stones (calcium oxalate) in adults referred to medical centers of Babol., Materials and Methods: This case-control study included 200 participants 18-65 years of ages (100 cases, 100 controls). An 18-items food insecurity questionnaire (USDA), a valid and reliable 147-item food frequency questionnaire (FFQ) and demographic characteristics were obtained via interviewing., Results: Sixty eight percent of cases and 40% of controls were food insecure, respectively. Food insecurity was significantly associated with the risk of kidney stone (P < .05). Furthermore, body mass index (BMI) and family history of kidney stone were significantly associated with the risk of kidney stones (P < .05)., Conclusion: Food insecurity and BMI were significantly associated with the kidney stone, which shows the importance of availability of nutritionally adequate and safe foods in prevention of the kidney stone.
- Published
- 2017
122. The effects of gait training with body weight support (BWS) with no body weight support (no-BWS) in stroke patients.
- Author
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Ullah MA, Shafi H, Khan GA, Malik AN, and Amjad I
- Subjects
- Adult, Female, Gait Analysis, Gait Disorders, Neurologic etiology, Gait Disorders, Neurologic physiopathology, Humans, Male, Middle Aged, Stroke complications, Treatment Outcome, Walk Test, Gait Disorders, Neurologic rehabilitation, Physical Therapy Modalities, Stroke physiopathology, Stroke Rehabilitation methods, Weight-Bearing
- Abstract
The purpose of this study was to measure the clinical outcomes for patients with stroke after gait training with body weight support (BWS) and with no body weight support (no-BWS).Experimental group was trained to walk by a BWS system with overhead harness (BWS group), and Control group was trained with full weight bearing walk on their lower extremities. Treatment session comprised of six weeks training. Treatment outcomes were assessed on the basis of Timed 10 Meter Walk Test, Timed Get Up and Go Test and Dynamic Gait Index. There was a significant (P<0.05) difference in BWS and NBWS for Dynamic Gait Index, Timed Get Up and Go Test, Timed 10 Meter Walk Test (Self-Selected Velocity), and Timed 10 Meter Walk Test (Fast-Velocity). Training of gait in stroke patients while a percentage of their body weight supported by a harness, resulted in better walking abilities than the Training of gait while full weight was placed on patient's lower extremities.
- Published
- 2017
123. Dehydroascorbate-derivatized chitosan particles for targeting antimalarial agents to infected erythrocytes.
- Author
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Shafi H, Reddy DVS, Khan T, Ranjan R, Srivastava A, Vaishya S, Sharma T, Siddiqui MI, Habib S, and Misra A
- Subjects
- Animals, Erythrocytes parasitology, HEK293 Cells, Humans, Plasmodium falciparum drug effects, Antimalarials administration & dosage, Chitosan chemistry, Dehydroascorbic Acid chemistry, Erythrocytes drug effects, Malaria, Falciparum drug therapy
- Abstract
The mammalian glucose transporter GLUT-1 and Plasmodium falciparum hexose transporter PfHT1 are overexpressed on human RBC infected with the parasite (iRBC), presumably for enhanced glucose uptake. Dehydroascorbic acid (DHA) competes out glucose in GLUT-1 binding. We prepared particles containing chloroquine phosphate using novel derivatives of chitosan (CSN). CSN was either pre-derivatized with DHA (PRE) or particles made of CSN were derivatized by surface-grafting DHA (POST). The optimized formulations were analyzed for size (170-200nm) drug content (about 40%) entrapment efficiency (50-57%), in vitro drug release (80% in 72h, Higuchi's model), hemolysis on exposure to whole blood or RBC at 5% hematocrit, cytotoxicity towards cultured HEK 293T (kidney) and HepG2 (hepatic) cells, targeting iRBC and in vitro efficacy against P. falciparum. PRE particles were superior to POST CSN particles in terms of uptake and extent of preferential targeting to iRBCs than RBCs. Unlike starch particles reported earlier, dextrose did not competitively inhibit uptake of DHA-derivatized CSN particles. Both formulations significantly induced parasite inhibition at 1nM while free drug showed comparable activity at 100nM. Both PRE and POST particles were superior to free drug in efficacy. Targeting with high efficiency promises dose reduction and possibility of overcoming efflux-based drug resistance., (Copyright © 2017 Elsevier B.V. All rights reserved.)
- Published
- 2017
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124. Non-healing chest wall ulcer caused by cutaneous melioidosis.
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Shafi H and Meyyur Aravamudan V
- Published
- 2017
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125. Testicular Biopsy in Males With Infertility: A Longitudinal Study.
- Author
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Siadati S, Shafi H, and Ghorbani H
- Abstract
Background & Objective: Regarding the importance of histologic examination of testicular biopsy for clinical planning of infertility, the current study was conducted to compare 2 separate histologic examination of testicular biopsy. Also, some cases with known fertility outcome were followed and their histological patterns were also compared with those of the outcome., Methods: The current study was conducted on testicular biopsies of 924 males evaluated for infertility from 1990 to 2013, retrieved from the archive of pathology department of Shahid Beheshti Hospital, Babol, Northern Iran. All slides were reviewed by a pathologist unaware of the original results. Data including age, histological pattern of spermatogenesis (pure and mixed), smoking, and the history of ejaculatory duct obstruction were retrieved from the pathology archive. In some cases, the outcome was also compared with that of the histological pattern. All analyses were executed using SPSS version 22 statistical software. To analyze the data, t test, Chi-square test, one-way ANOVA, and the least significant difference (LSD) test were used., Results and Conclusion: Out of the 924 testicular biopsies, 34 (3.7%) cases had different reports from original reading. LSD analysis indicated Sertoli cell only syndrome (SCO) as the most common histological pattern. There was a significant difference between the mean age of cases with SCO and that of the ones with hypospermatogenesis (HYPO) (P =0.03). Obstruction was higher in pure pattern (P=0.04). The pregnancy rate was higher in the wives of males with obstructive infertility than the ones with non-obstructive infertility. SCO was the most common histological pattern of testicular biopsy during 23 years. Pure patterns were more than mixed patterns, and the mean age was lower in mixed patterns. Also, pure patterns were the most common findings in the cases with obstructive infertility., Competing Interests: Authors declared no conflict of interest.
- Published
- 2017
126. A probable case of West Nile virus transfusion transmission.
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Groves JA, Shafi H, Nomura JH, Herron RM, Baez D, Dodd RY, and Stramer SL
- Subjects
- Aged, Antibodies, Viral blood, Antibodies, Viral cerebrospinal fluid, Humans, Immunoglobulin G blood, Immunoglobulin G cerebrospinal fluid, Immunoglobulin M blood, Immunoglobulin M cerebrospinal fluid, Male, Aortic Valve, Blood Transfusion, Coronary Artery Bypass, Heart Diseases therapy, Heart Valve Prosthesis Implantation, West Nile Fever blood, West Nile Fever cerebrospinal fluid, West Nile Fever transmission, West Nile virus
- Abstract
Background: Transfusion-transmitted West Nile virus (WNV) infection is infrequent as a result of minipool (MP) and individual-donation (ID) nucleic acid testing (NAT) of blood donations. ID-NAT is triggered on the basis of local WNV activity identified by MP-NAT., Study Design and Methods: A 78-year-old male patient who was treated for cardiac disease received 14 blood components from 30 donors in August 2016. He was discharged 7 days after aortic valve replacement and coronary bypass surgery, but was re-admitted on Day 12 with symptoms of viral infection, and eventually was diagnosed with aseptic meningitis. The patent died on Day 51., Results: The patient was positive for WNV-immunoglobulin M (IgM) antibodies in his cerebrospinal fluid on Day 14 and was positive for WNV-IgM (on Days 14 and 16) and WNV-IgG antibodies (on Day 16) in his serum. All associated donations were nonreactive by MP-NAT or ID-NAT. However, one MP-NAT was noted to have an elevated (but negative) signal-to-cutoff ratio, and one donor from that MP was subsequently found positive for WNV-IgM and IgG antibodies; the donor was diagnosed with a WNV-like viral syndrome that had an onset 3 to 5 days postdonation. The donor's plasma was transfused 12 days before the patient's onset of WNV-meningoencephalitis. Conversion to ID-NAT was triggered for the region 7 days after the implicated donation, which was associated with the region's first human WNV case., Conclusion: Despite the possibility of mosquito-borne transmission, this was considered to be a case of transfusion-transmitted WNV infection from an MP-NAT-nonreactive donation collected just before triggering conversion to ID-NAT; a rare event recognized once in 84 million donations., (© 2017 AABB.)
- Published
- 2017
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127. Development of Rapid and Economical Colorimetric Screening Method for p-Phenylenediamine in Variety of Biological Matrices and its Application to Eleven Fatal Cases of p-Phenylenediamine Poisoning.
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Imran M, Usman HF, Shafi H, Sarwar M, and Tahir MA
- Subjects
- Ammonium Hydroxide, Coloring Agents poisoning, Cresols, Forensic Toxicology methods, Gastrointestinal Contents chemistry, Humans, Hydrogen Peroxide, Indicators and Reagents, Limit of Detection, Liver chemistry, Phenylenediamines poisoning, Trichloroacetic Acid, Colorimetry methods, Coloring Agents analysis, Phenylenediamines analysis
- Abstract
A rapid colorimetric method for detection of p-phenylenediamine (PPD) in various biological samples is developed. The o-cresol test for acetaminophen detection has been modified to detect PPD in blood, urine, gastric contents, and liver. After precipitating protein with trichloroacetic acid solution (2 mL, 10% w/v), biological specimens were required to convert PPD metabolites to PPD by acid hydrolysis. Finally, o-cresol solution (1 mL, 1% w/v), hydrogen peroxide (200 μL, 3%v/v), and concentrated ammonium hydroxide (0.5 mL) were added in the biological samples. The presence of PPD was indicated by formation of violet color which was turned to bluish green color within 10-15 min. The limit of detection was found to be 2 mg/L in blood, urine, and gastric contents and 2 mg/Kg in liver. This method is also free from any potential interference by p-aminophenol, acetaminophen, and other amine drugs under test conditions. This method was successfully employed to thirteen fatal cases of PPD poisoning., (© 2016 American Academy of Forensic Sciences.)
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- 2017
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128. Diffusion-weighted MRI abnormalities in an outbreak of Streptococcus agalactiae Serotype III, multilocus sequence type 283 meningitis.
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Tan K, Wijaya L, Chiew HJ, Sitoh YY, Shafi H, Chen RC, Goh CK, and Lim CC
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- Disease Outbreaks statistics & numerical data, Female, Humans, Infectious Encephalitis epidemiology, Male, Prevalence, Reproducibility of Results, Risk Factors, Sensitivity and Specificity, Singapore epidemiology, Diffusion Magnetic Resonance Imaging methods, Infectious Encephalitis diagnostic imaging, Meningitis, Bacterial diagnostic imaging, Meningitis, Bacterial epidemiology, Streptococcal Infections diagnostic imaging, Streptococcal Infections epidemiology, Streptococcus agalactiae
- Abstract
Purpose: In 2015, an outbreak of group B streptococcal (GBS) infection caused by Streptococcus agalactiae Serotype III, multilocus sequence type 283, related to consuming infected raw freshwater fish, affected more than 200 patients in Singapore. We describe the clinical, laboratory, and neuroimaging features of a subgroup of adults with central nervous system (CNS) infections caused by GBS., Materials and Methods: The database of the Singapore Neurologic Infections Program (SNIP), a national multicenter study for surveillance of infectious neurologic disease, was reviewed to select patients with GBS CNS infection during the outbreak. Cases were diagnosed on the basis of clinical features, cerebrospinal fluid (CSF) findings and identification or isolation of Streptococcus agalactiae in the blood or CSF. Demographic, clinical and neuroradiological information was obtained prospectively and retrospectively abstracted., Results: Fourteen patients (6 male, 8 female; median age, 58 years) presented with fever, meningism, headache, encephalopathy, focal neurological deficits, and/or seizures. All except two were previously healthy. Diffusion-weighted imaging (DWI) on admission was abnormal in 13 patients, showing tiny hyperintensities in the subarachnoid space (7 patients), ventricles (6 patients) and brain parenchyma (8 patients); 5 patients had cerebellar abnormalities., Conclusion: Among healthy non-pregnant adults infected with Serotype III, multilocus sequence type 283 GBS meningitis linked to eating infected raw freshwater fish, DWI detected small pus collections and unusual cerebellar involvement. A collaborative national surveillance system that includes MRI can be helpful during unusual food-borne zoonotic infectious disease outbreaks., Level of Evidence: 4 J. Magn. Reson. Imaging 2017;45:507-514., (© 2016 International Society for Magnetic Resonance in Medicine.)
- Published
- 2017
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129. An overview of treatment options for urinary stones.
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Shafi H, Moazzami B, Pourghasem M, and Kasaeian A
- Abstract
Urolithiasis has become a worldwide problem with the prevalence of the disease increasing over the past few decades. While various treatment modalities have evolved over the years, discrepancies exist regarding the clinical indications and the efficacy of each of these treatment options. In the present review, we aim to review the current treatment modalities for urinary tract stones to provide a better understanding on the therapeutic approaches as well as their clinical indications.
- Published
- 2016
130. Intranasal Eutectic Powder of Zolmitriptan with Enhanced Bioavailability in the Rat Brain.
- Author
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Khan T, Ranjan R, Dogra Y, Pandya SM, Shafi H, Singh SK, Yadav PN, and Misra A
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- Animals, Calorimetry, Differential Scanning, Chromatography, High Pressure Liquid, Particle Size, Rats, Spectroscopy, Fourier Transform Infrared, Tandem Mass Spectrometry, X-Ray Diffraction, Administration, Intranasal methods, Brain metabolism, Drug Delivery Systems methods, Nasal Mucosa metabolism, Oxazolidinones administration & dosage, Oxazolidinones pharmacokinetics, Tryptamines administration & dosage, Tryptamines pharmacokinetics
- Abstract
Intranasal administration can potentially deliver drugs to the brain because of the proximity of the delivery site to the olfactory lobe. We prepared triturates of micronized or crystalline zolmitriptan with a GRAS substance, nicotinamide, to form a eutectic. We characterized the formulation using differential scanning calorimetry, powder X-ray diffraction, and FTIR spectroscopy to confirm its eutectic nature and generated a phase diagram. The eutectic formulation was aerosolized using an in-house insufflator into the nares of rats. Groups of rats received zolmitriptan intravenously or intranasally, or intranasal eutectic formulation. Zolmitriptan was estimated in the olfactory lobe, cerebral cortex, cerebellum, and blood plasma at different time-points by LC-MS. Pharmacokinetics in these tissues indicated the superiority of the intranasal eutectic formulation for brain targeting when compared with results of IV solution and intranasal pure zolmitriptan powder. Enhancement of nose-to-brain transport is likely to have resulted from more rapid dissolution of the eutectic as compared to pure drug.
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- 2016
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131. Fatal Intoxications Due to Administration of Isosorbide Tablets Contaminated with Pyrimethamine.
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Imran M, Shafi H, Mahmood Z, Sarwar M, Usman HF, Tahir MA, and Ashiq MZ
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- Aged, Chromatography, Liquid, Humans, Male, Middle Aged, Tablets, Antiprotozoal Agents poisoning, Drug Contamination, Isosorbide therapeutic use, Pyrimethamine poisoning
- Abstract
In January 2012, 664 cases of pyrimethamine toxicity and 151 deaths were reported among cardiac patients that had recently received free medicines from pharmacy of Punjab Institute of Cardiology, Lahore, Pakistan. These patients, ages ranged from 58 to 75 years, were prescribed simvastatin, clopidogrel, aspirin soluble, isosorbide mononitrate, and amlodipine. On examination of medications being given to them, it was found that a particular batch of isosorbide mononitrate tablets was contaminated with 50 mg pyrimethamine. Cardiac patients were taking isosorbide contaminated with pyrimethamine twice daily (100 mg pyrimethamine/day), whereas therapeutic dose of pyrimethamine for malaria is 25 mg/week. Postmortem urine, cardiac blood, and femoral blood specimens of three deceased males were submitted to author's laboratory for analysis. Postmortem toxicological analysis revealed that pyrimethamine concentration fell within the range of 1-10 μg/mL by liquid chromatography. Clinical, autopsy, histopathological, and toxicological findings strongly suggested toxicity due to pyrimethamine accumulation that resulted in deaths of these cardiac patients., (© 2016 American Academy of Forensic Sciences.)
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- 2016
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132. Successful reduction of plasma free-hemoglobin using therapeutic plasma exchange: A case report.
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Hayes C, Shafi H, Mason H, and Klapper E
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- Acute Kidney Injury blood, Adult, Hemoglobinuria blood, Humans, Male, Acute Kidney Injury therapy, Hemoglobins, Hemoglobinuria therapy, Hemolysis, Plasma Exchange
- Abstract
Massive intravascular hemolysis may overwhelm hemoglobin (Hgb) clearance mechanisms leading to accumulation of excess plasma free-Hgb and subsequent acute kidney injury. We present the case of a 44-year-old male with cardiac failure necessitating placement of a subcutaneous left ventricular assist device. Following insertion, the patient developed mechanical hemolysis and an acute decline in renal function. Three therapeutic plasma exchange procedures were performed resulting in a dramatic decrease in plasma free-Hgb levels and stabilization of renal function. This demonstrates that therapeutic plasma exchange can be used to decrease plasma free-Hgb in cases of intravascular hemolysis, possibly protecting the patient from hemoglobinuric acute kidney injury., (Copyright © 2015 Elsevier Ltd. All rights reserved.)
- Published
- 2016
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133. Hair analysis of an unusual case of Chloroquine intoxication.
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Imran M, Ashiq MZ, Shafi H, Usman HF, Wattoo SA, Sarwar M, and Tahir MA
- Subjects
- Exhumation, Forensic Toxicology, Gas Chromatography-Mass Spectrometry, Homicide, Humans, Kidney drug effects, Male, Chloroquine poisoning, Hair chemistry, Substance Abuse Detection methods
- Abstract
A dead body of middle aged man was exhumed from 6.5 month earth-grave. Autopsy findings were non-specific as the body was completely putrefied. Deceased's scalp hair and kidney was sent for toxicological analysis. Hair sample (50mg) was incubated with 1M NaOH (2 ml). Chloroquine was detected in hair and kidney during basic drug screen performed on GC/MS. For confirmation and quantitation, chloroquine was extracted using Hypersep verify CX SPE cartridges while mass detector was operated in SIM mode using the ions of m/z 245.0, 290.1, 319.0 for chloroquine while ions of m/z 260 and 455 were monitored for nalorphine (internal standard). Chloroquine was present in high concentration in hair (211 ng/mg) as well as in kidney (37.3mg/kg). Moreover, chloroquine was not detected in the wash solvents, suggesting ingestion of the drug rather than an external contamination of hair. These findings strongly suggested the acute exposure of higher doses of chloroquine to the deceased before death., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2016
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134. Azoospermia and testicular biopsy before intra-cytoplasmic sperm injection: Does the type of anesthesia make a difference?
- Author
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Ali Jorsaraei SG, Shafi H, Alereza H, Esmailzadeh S, Delavar MA, Saee A, Fasihiyan M, and Golsorkhtabaramiri M
- Abstract
Aim: Azoospermia is the most common form of male factor infertility, due to which sperms are retrieved for intra-cytoplasmic sperm injection (ICSI) under general or local anesthesia. The aim of the present study was to compare the efficacy of general and local anesthesia in an attempt to extract a sufficient quality of sperm for men with azoospermia, who intend to undergo ICSI., Materials and Methods: A total number of 50 patients with azoospermia, who were within the age range of 20-40, were randomly scheduled for testicular sperm extraction with either general or local anesthesia before ICSI. The hormonal abnormalities and severe varicocele were evaluated and treated before the testicular sperm extraction. The inclusion criteria obliged the researchers to focus on men with azoospermic, those who were diagnosed by two semen analyses after a 3-day abstinence from coitus according to the modified WHO criteria, and 19< body mass index ≤28. The concentration, motility, and morphology of the spermatozoa of the two groups were also compared., Results: A total number of 76 men, with a mean age of 35.1 ± 6.0, were selected, 26 were excluded from the study, and the remaining participants were randomly divided into two groups such as general anesthesia and lidocaine group. According to the results, the differences between the values of sperm parameters within various hours after the testicle biopsy were not statistically significant. Also, there was no significant difference between the two groups in terms of sperm motility and sperm morphology during various timing after the processing., Conclusion: The present study demonstrated that there was no evidence found for values of sperm parameters between the two groups, undergoing local and general anesthesia, within various hours after the testicular biopsy. Further investigations with more focus on concentration-dependent lidocaine on human sperm parameters need to be carried out.
- Published
- 2016
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135. Association of staphylococcus cohnii subspecies urealyticum infection with recurrence of renal staghorn stone.
- Author
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Shahandeh Z, Shafi H, and Sadighian F
- Abstract
Background: Stphylococcus cohnii is an organism of coagulase negative species which is considered as normal flora. However, it has been isolated from urinary tract infections and surgical prostheses but its relation with staghorn stones has not been reported, yet., Case Presentation: A 50-years-old woman presented with left renal staghorn stone in June 2014. She had bilateral staghorn stones 7 years ago. Staphylococcus cohnii subspecies urealyticum were detected from a removed stone. After 7 years, recurrence staghorn stone in her left kidney was diagnosed and patient underwent another surgery. The patient had several attacks of cystitis during these 7 years. The results of stone and urine cultures revealed staphylococcus cohnii subspecies urealyticum., Conclusion: This case report emphasizes a possible association between staphylococcus cohnii subspecies urealyticum infection and recurrence renal staghhorn stone.
- Published
- 2015
136. Analytical methods for determination of anticoagulant rodenticides in biological samples.
- Author
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Imran M, Shafi H, Wattoo SA, Chaudhary MT, and Usman HF
- Subjects
- Animals, Anticoagulants chemistry, Chromatography methods, Forensic Toxicology methods, Humans, Liquid-Liquid Extraction, Mass Spectrometry methods, Molecular Structure, Rodenticides chemistry, Solid Phase Extraction, Anticoagulants analysis, Rodenticides analysis
- Abstract
Anticoagulant rodenticides belong to a heterogeneous group of compounds which are used to kill rodents. They bind to enzyme complexes responsible for recycling of vitamin K, thus producing impairment in coagulation process. Rodenticides are among the most common house hold toxicants and exhibit wide variety of toxicities in non-target species especially in human, dogs and cats. This article reviews published analytical methods reported in literature for qualitative and quantitative determination of anticoagulant rodenticides in biological specimens. These techniques include high performance liquid chromatography coupled with ultraviolet and florescence detectors, liquid chromatography electrospray ionization tandem mass spectrometry, liquid chromatography with high resolution tandem mass spectrometry, ultra performance liquid chromatography mass spectrometry, gas chromatography mass spectrometry, ion chromatography with fluorescence detection, ion chromatography electrospray ionization ion trap mass spectrometry and ion chromatography electrospray ionization tandem mass spectrometry., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2015
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137. Differences in body mass index and height factors between men with and without varicocele.
- Author
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Shafi H and Agajani Delavar M
- Subjects
- Adolescent, Adult, Case-Control Studies, Humans, Male, Body Height, Body Mass Index, Varicocele epidemiology
- Abstract
Aim: Despite many studies published in recent years concerning the relationship between demographic factors and varicocele, this issue remains controversial. The aim of this study was to identify a possible influence of body mass index (BMI) and height on occurrence varicocele in men., Methods: In a case-control study 153 patients aged 18-40 years from 2004 to 20014, with moderate and sever varicocele were studied. The BMI and height of the 153 patients with varicocele were compared with 250 men who had no varicocele as a control group., Results: After the adjustment for socio-demographic factors, the risk of varicocele for obese men was lower than for overweight and normal men (OR= 0.38, 95% CI= 0.17, 0.85). The adjusted OR for varicocele in taller men was higher than in those with low height (OR= 3.42, 95% CI= 1.34, 8.72), and moderate height (OR=2.68, 95% CI= 1.12, 6.46)., Conclusion: The results of this study indicated that tall men and non-obese men may be at higher risk of varicocele, therefore counseling and evaluation of the men at high risk of varicocele may be of benefit for reduced infertility., (Copyright© by the Medical Assotiation of Zenica-Doboj Canton.)
- Published
- 2015
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138. Histological changes of kidney in diabetic nephropathy.
- Author
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Pourghasem M, Shafi H, and Babazadeh Z
- Abstract
Diabetes mellitus is the most common cause of chronic renal disorders and end-stage kidney disease in developed countries. It is the major cause of dialysis and transplantation. Failure in renal function causes wide disorders in the body. Diabetes results in wide range of alterations in the renal tissue. It is believed that early histological changes in diabetic nephropathy are detectable 2 years after diabetes is diagnosed. The glomerular alterations are the most important lesions in the diabetic nephropathy (DN). The Renal Pathology Society provides a new pathological classification for the detection of histopathology of DN. It divides diabetic nephropathy into four hierarchical glomerular lesions. Alloxan or streptozotocin induced diabetic rat is the one most widely used specie to study DN. Histological changes in the rat DN closely resemble the human disease and the most information of this review was obtained through the study of rat DN. All cell types of the kidney such as mesangial cells, podocytes and tubulointerstitial cells are liable to be affected in the event of DN. Severity of renal lesions is associated to the clinical aspect of renal outcome, but the aim of this article was only to review the histological changes of kidney in diabetes mellitus.
- Published
- 2015
139. Extracorporeal photopheresis in heart transplant rejection.
- Author
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Patel J, Klapper E, Shafi H, and Kobashigawa JA
- Subjects
- Allografts, Cytokines metabolism, Heart Transplantation adverse effects, Hemodynamics, Humans, Immune System, Immunity, Cellular, Immunity, Humoral, Immunologic Factors therapeutic use, Immunomodulation, Graft Rejection immunology, Graft Rejection therapy, Heart Transplantation methods, Photopheresis methods
- Abstract
Up to 25% of heart transplant recipients develop rejection requiring intervention. While the majority respond to augmentation of immunomodulatory drug therapy, a subset of patients will remain refractory. Extracorporeal photopheresis (ECP) appears particularly useful in the management of select heart transplant recipients at risk of rejection, with recurrent rejection, or rejection associated with hemodynamic compromise. This chapter summarizes the current clinical experience of ECP in heart transplantation. ECP appears to favorably affect both the cellular and humoral arms of the immune response to the allograft and promote a tolerogenic profile. These immunomodulatory effects also appear to decrease development of cardiac allograft vasculopathy. ECP is generally well tolerated with few adverse effects and low infection risk., (Copyright © 2015 Elsevier Ltd. All rights reserved.)
- Published
- 2015
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140. Impact of parity on obesity: a cross-sectional study in Iranian women.
- Author
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Hajiahmadi M, Shafi H, and Delavar MA
- Subjects
- Body Mass Index, Cluster Analysis, Confounding Factors, Epidemiologic, Cross-Sectional Studies, Female, Humans, Iran epidemiology, Logistic Models, Middle Aged, Postmenopause, Pregnancy, Premenopause, Prevalence, Surveys and Questionnaires, Urban Population, Obesity epidemiology, Obesity etiology, Parity
- Abstract
Objective: The aim of the present study was to analyze whether or not parity influenced the prevalence of obesity in both pre- and postmenopausal women., Subjects and Methods: A cross-sectional study was conducted on characteristics of urban women regarding parity. A total of 1,620 women aged 45-63 years were selected using cluster sampling. A face-to-face household interview was conducted by trained, skillful personnel. A risk factor questionnaire was used to obtain information on reproductive history and sociodemographic factors. Statistical associations between parity and obesity using logistic regression were then investigated., Results: The mean BMI was 29.1 ± 5.1, and 96.8% of the sample population were parous, with a median of 4 births. Of the total women enrolled, 216 (13.3%) had <3 parities, while 1,404 (86.7%) had ≥3 parities. The prevalence of obesity (BMI ≥30) was 38.3%, diagnosed at a mean age of 51.4 ± 5.2 years. After adjustment for a range of potential confounders (age, marital status, employment, education, smoking status, abortion history, savings situation and menopausal status), women with ≥3 parities were at higher risk of being obese (OR 1.74, 95% CI 1.24-2.45; p = 0.001)., Conclusion: A positive association was observed between the number of parities and obesity. The findings of this study suggest that the BMI is associated with high parity in Babolian women. Health policymakers should work with health providers to develop appropriate postpartum weight loss interventions., (© 2014 S. Karger AG, Basel.)
- Published
- 2015
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141. Early renal histological changes in alloxan-induced diabetic rats.
- Author
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Pourghasem M, Nasiri E, and Shafi H
- Abstract
Diabetes mellitus is a progressive disease. Most investigators have focused on glomerular changes in diabetic kidney and non-glomerular alterations have been less attended. The present study has been conducted to find early non-glomerular histological changes in diabetic renal tissue. Twenty male Wistar rats weighting 200-250 g were used for the diabetic group. Diabetes mellitus was induced by single injection of Alloxan. After 8 weeks, paraffin embedded blocks of kidneys were prepared for evaluating the histological changes due to diabetes. Histological study showed the deposit of eosinophilic materials in the intermediate substantial of medulla and thickening of renal arterial wall in the kidney of 70% of diabetic rats. The average weight of kidneys increased when compared to non diabetic animals. Furthermore, the amount of blood flow in arteries of all diabetic kidneys has been enhanced. The present study demonstrates some early renal histological changes in diabetes mellitus which were earlier compared to those reported previously. Diabetic nephropathy is a progressive disease and renal care design can help better prognosis achievement.
- Published
- 2014
142. Kikuchi-Fujimoto disease presenting after consumption of 'Miracle Mineral Solution' (sodium chlorite).
- Author
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Loh JM and Shafi H
- Subjects
- Adult, Diagnosis, Differential, Female, Gastric Mucosa pathology, Humans, Inflammation chemically induced, Intestinal Mucosa pathology, Oropharynx pathology, Solutions, Chlorides adverse effects, Complementary Therapies adverse effects, Histiocytic Necrotizing Lymphadenitis chemically induced, Histiocytic Necrotizing Lymphadenitis diagnosis
- Abstract
We present a case report of a 41-year-old woman of Malay ethnicity who presented with an 11-day history of fever and left-sided lymphadenopathy after consuming 'Miracle Mineral Solution' (sodium chlorite solution) for the first time. A diagnosis of Kikuchi-Fujimoto disease was established via lymph node biopsy after other differentials were excluded. The aetiology of Kikuchi-Fujimoto disease remains controversial, but viral, autoimmune and physicochemical causes have been suggested as possibilities. In this case, we hypothesise that oxidative injury from sodium chlorite initiated an inflammatory response, which triggered the onset of Kikuchi-Fujimoto disease., (2014 BMJ Publishing Group Ltd.)
- Published
- 2014
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143. Prevalence of Varicocele among Primary and Secondary Infertile Men: Association with Occupation, Smoking and Drinking Alcohol.
- Author
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Shafi H, Esmaeilzadeh S, Delavar MA, Haydari FH, Mahdinejad N, and Abedi S
- Abstract
Background: Existing data suggests that varicocele plays a central role in progressive infertility., Aims: This study was designed to assess the occupational and lifestyle factors of development of varicocele among male infertile, for a better prevention and management of the varicocele., Materials and Methods: All males with infertility, who presented at Fatemezahra Infertility and Reproductive Health Research Center between April 2010 and February 2011, were examined. Their occupations, smoking, and drinking alcohol, presence or absence of varicocele were evaluated. The lifestyle factors associated with varicocele were analyzed., Results: The data of 816 men, aged 21-71 years, were included in the study. Two hundred and sixty-one men (32%) with varicocele and 555 (68%) without varicocele were found. Percentage of varicocele was significantly higher in smokers compared with non-smokers (P = 0.035). The adjusted OR for varicocele in smokerswas significantly higher than that in non-smoker (OR = 2.420; 95% CI = 1.04, 5.61). No significant differences were seen between varicocele and occupation or alcohol drinking for the prevalence of varicocele., Conclusions: The findings of the present study indicated that a high frequency of varicocele was indentified among male infertile. Therefore, it is necessary for those male cigarette-smokers to evaluate their possibilities of infertility and varicocele.
- Published
- 2014
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144. Defining early trauma-induced coagulopathy using thromboelastography.
- Author
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Liou DZ, Shafi H, Bloom MB, Chung R, Ley EJ, Salim A, Tcherniantchouk O, and Margulies DR
- Subjects
- Adult, Aged, Blood Coagulation Disorders etiology, Female, Humans, Male, Middle Aged, Prospective Studies, Blood Coagulation Disorders diagnosis, Thrombelastography, Wounds and Injuries complications
- Abstract
Early trauma-induced coagulopathy (ETIC) is abnormal coagulation detected on presentation, but a clear description is lacking. We used thromboelastography (TEG) to characterize ETIC. Data were prospectively collected on high-acuity trauma activations at an urban Level I trauma center between July 2012 and May 2013. Patients with admission TEG before any blood transfusion were stratified by Injury Severity Score (ISS): mild (less than 16), moderate (16 to 24), severe (25 or greater). TEG parameters were compared between groups. ETIC was defined as any abnormality detected on TEG. Fifty-two patients were included; mean age was 49 years and mean time to the emergency department was 26 minutes. Mean ISS for the cohort was 17 with 28 patients in mild, eight in moderate, and 16 in severe. Glasgow Coma Score was lower and head Abbreviated Injury Scale was higher in severe (P < 0.001). Forty-three (83%) patients had an abnormal TEG. Shortened reaction (R) time was noted in 42 patients. There were no differences in any TEG parameters between the injury severity groups. Hyperfibrinolysis was detected in four (8%) patients. ETIC was present in over 80 per cent of high-acuity trauma activations irrespective of injury severity and characterized primarily by shortened R time, indicating ETIC is initially described by a hypercoagulable state as a result of thrombin generation.
- Published
- 2014
145. How we incorporate molecular typing of donors and patients into our hospital transfusion service.
- Author
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Shafi H, Abumuhor I, and Klapper E
- Subjects
- Erythrocytes immunology, Humans, Anemia, Sickle Cell therapy, Blood Donors, Blood Grouping and Crossmatching, Blood Transfusion, Molecular Typing
- Published
- 2014
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146. Transfusion medicine illustrated. Thromboelastography: a more accurate assessment of global hemostasis.
- Author
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Shafi H, Tcherniantchouk O, Chaffin DJ, Mason H, and Klapper E
- Subjects
- Humans, Leukemia, Myeloid, Acute blood, Male, Middle Aged, Hemostasis, Thrombelastography methods, Transfusion Medicine
- Published
- 2013
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147. Clinicopathological significance of HER2/neu genetic heterogeneity in HER2/neu non-amplified invasive breast carcinomas and its concurrent axillary metastasis.
- Author
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Shafi H, Astvatsaturyan K, Chung F, Mirocha J, Schmidt M, and Bose S
- Subjects
- Adult, Aged, Aged, 80 and over, Breast Neoplasms metabolism, Carcinoma, Ductal, Breast metabolism, Carcinoma, Lobular metabolism, Female, Genetic Heterogeneity, Humans, Lymphatic Metastasis, Middle Aged, Mixed Tumor, Malignant metabolism, Mixed Tumor, Malignant pathology, Neoplasm Invasiveness, Receptor, ErbB-2 metabolism, Breast Neoplasms pathology, Carcinoma, Ductal, Breast pathology, Carcinoma, Lobular pathology, Receptor, ErbB-2 genetics
- Abstract
Background: HER2/neu (HER2) is a significant prognostic marker for breast carcinomas. Recently, new guidelines defining HER2 genetic heterogeneity (GH) were published by the College of American Pathologists., Aims: To determine the prevalence of HER2 GH as defined in primary invasive breast carcinoma, to determine its relationship with prognostic variables and to investigate its impact on concurrent axillary metastasis., Methods: 235 consecutive infiltrating breast carcinomas were evaluated for GH (defined as presence of 5-50% of neoplastic cells with HER2/CEP17 ratio >2.2) using fluorescence in situ hybridisation. Pathological features of carcinomas with GH were compared with those lacking GH. GH was also evaluated in a subset of 37 paired primary carcinomas and its concurrent axillary nodal metastases using dual in situ hybridisation., Results: HER2 GH was noted in 27% of HER2 negative breast carcinomas. These carcinomas demonstrated aggressive characteristics (larger size, higher grade and greater incidence of lymph node metastasis) in comparison with HER2 negative cases without GH. Higher levels of GH were associated with the equivocal HER2 status. GH was maintained in the concurrent lymph node metastases with some variations; however, two cases with clusters of HER2 amplified cells in the primary carcinoma showed HER2 amplification in the nodal metastasis., Conclusions: HER2 GH is present in 27% of breast carcinomas, portends an aggressive phenotype and contributes to the equivocal HER2 status. Evaluation of the HER2 status in nodal metastasis of select primary carcinomas with GH may be beneficial before treatment selection.
- Published
- 2013
- Full Text
- View/download PDF
148. Oxindole derivatives: synthesis and antiglycation activity.
- Author
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Khan KM, Khan M, Ambreen N, Taha M, Rahim F, Rasheed S, Saied S, Shafi H, Perveen S, and Choudhary MI
- Subjects
- Dose-Response Relationship, Drug, Glycosylation drug effects, Indoles chemistry, Molecular Structure, Oxindoles, Indoles chemical synthesis, Indoles pharmacology
- Abstract
Oxindole derivatives 3-25 have been synthesized from commercially available oxindole by refluxing with different aromatic aldehydes in good yields. Their in vitro antiglycation potential has been evaluated. They showed a varying degree of antiglycation activity with IC50 values ranging between 150.4 - 856.7 µM. 3-[(3-Chlorophenyl)methylidene]- 1,3-dihydro-2H-indol-2-one (IC50 = 150.4 ± 2.5 µM) is the most active compound among the series, better than the standard rutin with an IC50 value 294.5 ± 1.50 µM. The structures of the compounds were elucidated by 1H-NMR and mass spectroscopy and elemental analysis. A limited structure-activity relationship has been developed.
- Published
- 2013
- Full Text
- View/download PDF
149. Physical activity and body mass index among women who have experienced infertility.
- Author
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Esmaeilzadeh S, Delavar MA, Basirat Z, and Shafi H
- Abstract
Introduction: The experience of infertility is a common medical condition in the developing countries. The aim of this retrospective epidemiologic study was to determine fertility status and parity in Babol, Iran and then identify physical activity and body mass index (BMI) among women who have experienced infertility., Material and Methods: A total of 1,081 women aged 20-45 years were selected using cluster sampling. The current physical activity was measured using the original International Physical Activity Questionnaire short form. Lifestyle factors were compared between those who had experienced infertility (n = 168) and the rest of the women. A face-to-face household interview was conducted using a specially designed interview questionnaire., Results: After adjusting for suspected confounding factors, women with infertility experience had a 4.8-fold increased risk of obesity (OR = 2.02, CI = 0.70, 5.84) and almost a 3.8-fold increased risk of being overweight (OR = 2.11, CI = 0.72, 6.17) compared to women without infertility. No significant differences were found in Met-minutes of sedentary activity, intensity of walking, moderate, vigorous, and total physical activity, self-reported dietary intake, exercise, and level of physical activity between women with and without experience of infertility., Conclusions: Since both obesity and infertility are increasing public health issues in Iranian women, more attention should be paid to lifestyle behaviors, especially gaining weight in women who have experienced infertility.
- Published
- 2013
- Full Text
- View/download PDF
150. Bacteriological study and structural composition of staghorn stones removed by the anatrophic nephrolithotomic procedure.
- Author
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Shafi H, Shahandeh Z, Heidari B, Sedigiani F, Ramaji AA, Pasha YR, Kassaeian AA, Pasha AA, and Mir MM
- Subjects
- Adult, Aged, Anti-Bacterial Agents therapeutic use, Calcium Oxalate analysis, Calcium Phosphates analysis, Female, Humans, Iran, Kidney Calculi chemistry, Kidney Calculi diagnosis, Kidney Calculi epidemiology, Kidney Calculi microbiology, Kidney Calculi urine, Magnesium Compounds analysis, Male, Middle Aged, Odds Ratio, Phosphates analysis, Prevalence, Risk Factors, Struvite, Treatment Outcome, Uric Acid analysis, Urinary Catheterization, Urinary Tract Infections diagnosis, Urinary Tract Infections drug therapy, Urinary Tract Infections epidemiology, Urinary Tract Infections urine, Urine microbiology, Kidney Calculi surgery, Nephrostomy, Percutaneous, Urinary Tract Infections microbiology
- Abstract
This study was conducted to determine the composition of staghorn stones and to assess the proportion of infected stones as well as the correlation between infection in the stones and bacteria grown in urine. Samples of 45 consecutive stones removed through anatrophic nephrolithotomic procedures were taken from the operation site and samples of urine were obtained by simultaneous bladder catheterization. The frequency of infection in the stones and correlation between infection of stone and urine samples were determined with respect to the composition of the stones. Twenty-two males and 23 females, with respective mean ages of 48.3 ± 15.6 years and 51 ± 7.4 years, were studied. The stone and urine cultures yielded positive results in ten and 16 patients, respectively, of a total of 45 patients (22.2% and 35.5%, respectively). Calcium oxalate was the main constituent of staghorn stones, seen in 31 patients (68.8%), uric acid in 12 patients (26.6%) and struvite and/or calcium phosphate in 11 patients (24.4%). In seven of ten stones with bacterial growth, bacteria were isolated from urine cultures as well, which accounted for a concordance rate of 70%. The bacteria grown in the stone were the cause of urinary tract infection (UTI) in 43.5% of the cases. Stone infection was significantly associated with UTI (OR = 6.47; 95% CI 1.43-31.7, P = 0.021) and presence of phosphate in the stones (OR = 18, 95% CI 3.28-99.6, P = 0.0006). E. coli was the most common bacteria grown from the stones, and was isolated in 50% of the cases; Ureaplasma urealyticum was the most common organism causing UTI, grown in 62.5% of the urine samples. There was a high concordance rate between bacteria in the stones and urine. These findings indicate that the urine culture can provide information for selection of an appropriate anti-microbial agent for stone sterilization. In addition, preventing re-growth or recurrence of stones and treatment of post-surgical infections would be facilitated based on the results of the urine culture.
- Published
- 2013
- Full Text
- View/download PDF
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