Behzad Einollahi - Academia.edu (original) (raw)

Papers by Behzad Einollahi

Nephro-Urology Monthly, 2019

Background: The effectiveness of dialysis or dialysis adequacy is an important standard for evalu... more Background: The effectiveness of dialysis or dialysis adequacy is an important standard for evaluating hemodialysis patients. Also, measuring this standard is a crucial goal to all healthcare teams. Inadequate protein intake and catabolism can impact dialysis efficacy. Objectives: This study aimed to investigate the effect of intradialytic isometric resistance exercise and supplementation with BCAAs on dialysis adequacy in patients undergoing dialysis. Methods: A total of 51 patients were randomly divided into three control, exercise and BCAA (EXBCAA), and exercise only (EX) groups and the number of the subjects in each group was 17 patients. The training program consisted of an exercise for arm muscles and another exercise for thigh and core muscles. Exercise sessions were conducted twice a week for two months (24 sessions). Dialysis adequacy variables were kt/v and URR and were measured before the intervention, four weeks after the start of the intervention, and again at eight weeks, which was the end point of the intervention. Results: After the intervention, the kt/V and URR variables presented a significant difference between the two experimental groups vs the control group (P < 0.001). The group that received BCAA and performed isometric resistance exercise indicated the most effective improvements in kt/v (+20%) and URR (+12.5%). Conclusions: Results of this study showed that exercise during hemodialysis can increase dialysis adequacy of hemodialysis patients. Receiving BCAA's can improve the adequacy even more.

Iranian journal of allergy, asthma, and immunology, Jan 13, 2013

There are limited clinical investigations identifying the percentage of T helper 1 (Th1) and T re... more There are limited clinical investigations identifying the percentage of T helper 1 (Th1) and T regulatory (Treg) cells in stable as well as rejected kidney allografts, a concept which needs to be more studied. The aim of our study was to compare the percentage of CD4+ IFN-γ+ cells, the number of IFN-γ secreting cells and the amount of FoxP3 expression in patients with or without stable graft function, to determine the roles of these immunological factors in stable and rejected renal allografts. In this prospective study, 3 months after transplantation 30 patients who received renal transplants from unrelated living donors were enrolled and divided into two groups, 20 patients with stable graft function and 10 patients with biopsy proven acute rejection. The percentage of Th1 CD4+ IFN-γ+ cells was determined on PBMC by flow cytometry and the number of IFN-γ secreting cells by ELISPOT method. Furthermore, FoxP3 expression of PBMCs was measured by Real Time PCR method. The results of t...

Infectious Diseases

BACKGROUND The newly emerged pandemic of coronavirus disease-2019 (COVID-19) is the world's m... more BACKGROUND The newly emerged pandemic of coronavirus disease-2019 (COVID-19) is the world's main health challenge because infected patients become vulnerable to a variety of opportunistic diseases. OBJECTIVE This study aimed to assess clinical outcomes, diagnosis, utilized drug therapies, and ongoing COVID-19 practices in Iranian cases co-infected with COVID-19 and mucormycosis. PARTICIPANTS AND METHODS A case-series analysis was conducted in the presence of 10 patients with COVID-19 and mucormycosis co-infection (two men and eight women; mean age of 48.8 years) from March to October 2020. Demographic variables, signs/symptoms, and comorbidities of all patients were recorded. COVID-19 was confirmed with reverse transcription polymerase chain reaction (RT-PCR) nasopharyngeal swab tests and high-resolution computed tomography (HR-CT)_ scans. RESULTS All patients had a positive RT-PCR for SARS-CoV-2. Eight patients had a history of diabetes, while three of them exhibited a hypertension history. Remarkable laboratory findings were elevated fasting blood sugar in 6 cases and anaemia in four patients. A rhino-orbital-cerebral of mucormycosis in all patients was detected based on HR-CT scans and otorhinolaryngological or ophthalmological examinations. Neurological disorders including facial, trigeminal, optic, and oculomotor nerve involvement resulted in paraesthesia, pain, ptosis, no light perception, blurred vision, and papilledema in five cases. Maxillary and ethmoid sinuses were the most common sites of involvement. CONCLUSION Vulnerable COVID-19 patients with comorbidities, any facial involvements, or treated by excessive doses of glucocorticoids and antibiotics should undergo precise examinations during the appearance of early signs and hospitalization to diagnose and treat mucormycosis using the standard care and antifungal treatments.

Iranian Journal of Pharmaceutical Research : IJPR, 2017

N-acetylcysteine (NAC) is a potent antioxidant that acts through regenerating glutathione stores ... more N-acetylcysteine (NAC) is a potent antioxidant that acts through regenerating glutathione stores and scavenging oxygen-free radicals. This study assesses the short-term effects of NAC in cadaveric kidney transplant (KT) recipients. A double blind, randomized, placebo controlled trial was designed and patients were randomly assigned to receive either NAC or placebo. Glutathione peroxidase (GPX) activity in erythrocytes and serum malondialdehyde (MDA) levels were measured and serum creatinine levels and estimated glomerular filtration rate (eGFR) determined in the early phase after transplantation, were also compared between two study groups. Thirty-seven males and 20 females, with mean ± SD age of 44.6 ± 12.4 years completed the study. Significant difference (P = 0.02) was seen between GPX activity reduction in the placebo group, and that of the NAC group and on the levels of MDA there was no significant difference between two study groups (P = 0.53). Significant improvement in immed...

The aim of this study is to introduce a parametric mixture model to analysis the competing-risks ... more The aim of this study is to introduce a parametric mixture model to analysis the competing-risks data with two types of failure. In mixture context, i t h type of failure is i th component. The baseline failure time for the first and second types of failure are modeled as proportional hazard models according to Weibull and Gompertz distributions, respectively. The covariates affect on both the probability of occurrence and the hazards of the failure types. The probability of occurrence is modeled to depend on covariates through the logistic model. The parameters can be estimated by application of the expectation-conditional maximization and Newton-Raphson algorithms. The simulation studies are performed to compare the proposed model with parametric cause-specific and Fine and Gray models. The results show that the proposed parametric mixture method compared with other models provides consistently less biased estimates for low, mildly, moderately, and heavily censored samples. The an...

Biomedical Research-tokyo, 2017

Background: In recent decades, multiple treatment strategies have been developed for the treatmen... more Background: In recent decades, multiple treatment strategies have been developed for the treatment of renal calculi. However, these are less convincing and cause side effects of the kidney. Objectives: The main objective of this research is to study the use of a novel drug subtracted from chicken gizzard for treatment of renal calculi. Methods: Twenty-three patients diagnosed with kidney stones by ultrasonography and radiography. All patients had the stone size of more than 5.0 mm and age>18 y old and these patients were randomly assigned by nephrology and urology specialists to one month treatment program with capsules (500 mg) filled by a substance of chicken gizzard (four capsules, 3 times daily within 24 h during one month). Results: In general, 49 stones belonging to the 23 patients were used by chicken gizzard substance for treatment of nephrolithiasis. The mean of the stone size after treatment for 15 and 30 d groups were 6.2 ± 3.2 mm (P=0.001) and 5.6 ± 2.9 mm (P=0.006), ...

Kidney International Reports, 2020

BMC Infectious Diseases, 2020

Background Pulmonary endarteritis is a rare clinical phenomenon with congenital heart that can po... more Background Pulmonary endarteritis is a rare clinical phenomenon with congenital heart that can potentially lead to major complications. Case presentation We report a 47-year-old man with pulmonary endarteritis. This patient presented with hypertension, chest pain and a previous history of pulmonary valve disease during childhood. Also, eight-months prior, he was hospitalized with dyspnea (Functional Class III), cough, phlegm, and night sweats without fever. Echocardiographic diagnosis in the first transtransthoracic echocardiography (TTE) was intense pulmonary valve stenosis (PVS) an, thus, the pulmonary valve vegetation and PVS, established by transesophageal echocardiography (TEE). He was referred for surgery after 1 weeks of intravenous antibiotic therapy for removal of the vegetation. Conclusions Finally he was asymptomatic at 3-months of follow-up and was clinically in good condition. Therefore, the detection of infective endocarditis of the lung valve must not lengthy be prolo...

Archivio Italiano di Urologia e Andrologia, 2020

A 22-year-old female, was referred with a history of a headache and elevated blood pressure witho... more A 22-year-old female, was referred with a history of a headache and elevated blood pressure without family history of hypertension or familial dyslipidemia. Initially, a spiral computed tomographic angiography of the renal arteries was conducted, demonstrating completely abnormal left renal artery at the medial portion of the vessel with suspicious stenosis, which was supposed to be due to fibromuscular dysplasia (FMD). Subsequently, the patient underwent selective renal angiography and balloon angioplasty. Severe stenosis was observed on the left side and moderate stenosis on the right side in the medial and proximal part of the vessels, respectively. After the diagnosis of FMD, the left side was treated by balloon and finally, the patient was discharged with good control of blood pressure by losartan/amlodipine treatment.

Medical - Surgical Nursing Journal, 2018

Background: Compliance with dietary and fluid restrictions is an integral part of treatment in he... more Background: Compliance with dietary and fluid restrictions is an integral part of treatment in hemodialysis patients. In fact, nonadherence to these restrictions could entail serious consequences. Objectives: The present study was conducted to explore the impact of continuous care model on compliance with dietary and fluid restrictions in these patients. Methods: The current study was a clinical trial with a control group, which was carried out on 98 hemodialysis patients at two hospitals in Tehran. The subjects were chosen via purposive sampling and randomly assigned to the treatment and control groups. The treatment adherence questionnaire was completed by both groups in the pretest. Afterwards, in the treatment group, once the subjects were presented with the educational manual, a continuous care model was implemented for them. The model consisted of four stages, including awareness-raising, sensitization, control, and evaluation. At the end of three consecutive months, the questionnaire was completed. In the control group, the questionnaire was similarly completed except the subjects had not been exposed to any intervention. Data were collected using descriptive tests, chi-square, t-test, and a repeated measures design. The results were analyzed with the SPSS 21 software. Results: The findings showed that the pattern of adherence to dietary and fluid restrictions in the two groups was statistically significant over time (P < 0.001) such that changes in the intervention group were indicative of the positive effects of continuous care on compliance with dietary and fluid restrictions among hemodialysis patients. Conclusions: By implementation of the continuous care model, the patients, through counseling and training, developed a greater adherence to their dietary and fluid restrictions. Hence, it is suggested for ICU nurses to make use of this model to prevent complications and improve quality of life of hemodialysis patients.

Nephro-Urology Monthly, 2017

Background: Depression, anxiety, and stress are very common among hemodialysis patients. The aim ... more Background: Depression, anxiety, and stress are very common among hemodialysis patients. The aim of this study was to investigate effects of aromatherapy using the damask rose oil on depression, anxiety, and stress in these patients. Methods: In a clinical trial that was performed in 2015, 60 patients under hemodialysis treatment were randomly allocated to two groups of control and intervention each consisting of 30 subjects. The DASS21 scale was used to measure the rates of depression, anxiety, and stress before and four weeks after intervention. In the intervention group, the patients were asked to inhale the damask rose oil with a constant density of 2% from a piece of cloth smeared with three drops for an hour. In the control group, only the usual, standard care was applied. Results: The comparison of the mean scores before and after the intervention in the two groups showed that after intervention, the depression, anxiety, and stress scores significantly decreased in the damask rose group (P ≤ 0.05). Conclusions: Inhalation aromatherapy using the damask rose oil can decrease depression, anxiety, and stress in hemodialysis patients.

Transplantation Proceedings, 2007

Background. Considering the organ shortage crisis for renal transplantation worldwide, assessing ... more Background. Considering the organ shortage crisis for renal transplantation worldwide, assessing the risk factors to establish better allocation strategies to improve graft survival seems to be crucial. Objectives. We aimed to evaluate the risk factors influencing graft and patient survival after renal transplantation to construct a model of prognostic factors for living renal transplantation (LRT), namely living unrelated renal transplantation (LURT). Methods. We designed a retrospective multicenter survey including medical record review of 3028 patients who received renal transplants at 2 hospitals between July 1984 and December 2005. We assessed the impact on graft survival of recipient/donor relationship, recipient age and gender, donor age and gender, and viral hepatitis B and C infections. Results. Among 3028 recipients, including 94.8% primary grafts, 63.4% were men, mean Ϯ SE of age 36.4 Ϯ 0.3 years, with mostly end-stage renal disease due to diabetes mellitus, hypertension, or glomerulonephritis. One-, 5-, 10-and 15-year graft survival rates were 85.4%, 68.3%, 46.4%, and 23.8%, respectively. Patient survival rates were 93.4%, 87.5%, 79.4%, and 66.4% at the above intervals, respectively. Donor age (relative hazard [RH], 1.024; P Ͻ .001), unrelated donors (RH, 1.7; P Ͻ .001), and hepatitis C virus (HCV) infection (RH, 2.65; P Ͻ .001) were the only significant factors affecting graft survival. Conclusion. Increased donor age, unrelated donor, and HCV infection were significant factors negatively impacting graft survival; thus, proper management of these factors may lead to better graft and patient survival.

Background. Kidney transplantation has gained widespread popularity by improving the outcome of e... more Background. Kidney transplantation has gained widespread popularity by improving the outcome of end-stage renal disease (ESRD) patients. However, this is a highly complicated and expensive procedure that puts much pressure on the health system in developing countries. We report the costs in Iran model of kidney transplantation. Materials and Methods. We reviewed the regulations for kidney transplantation using Dialysis and Transplant Patients Association (DATPA) information, 2005. All data regarding the cost of transplantation procedure, immunosuppression, and the money given to donors were included. The cost of transplantation procedure was categorized into personnel, drugs, paraclinics, hospital bed, and other expenses. To achieve more comprehensive results, all costs were converted into US dollars (1 USD ϭ 9000 Rials). Results. The total cost of kidney transplantation procedure was $9224. Of this, 65.8%

Transplantation Proceedings, 2007

Transplantation Proceedings, 2007

Background. We assessed the abstracts of the IXth Congress of the Middle East Society for Organ T... more Background. We assessed the abstracts of the IXth Congress of the Middle East Society for Organ Transplantation (MESOT) held December 6 to 10, 2004, in Ankara, Turkey. Methods. Assessment was done with a 19-item quality assessment checklist, which was developed by Timmer et al (2003) with a good interrater agreement (intraclass coefficient 0.61 to 0.81). From the total 396 Congress abstracts, cluster random sampling was applied to select abstracts from oral and poster presentations. We assessed 109 abstracts, by recording presentation type, study type, country of study, number of authors, and transplantation type. We also evaluated study design and obtained a final quality score for each sample. Evaluation of the abstracts was performed by a single investigator. Results. The mean (SD) quality score of all abstracts was 0.60 Ϯ 0.11 (range: 0.33 to 0.81). More than 80% had a score above 0.50. Human observational studies showed higher scores compared with human and basic interventional studies (P ϭ .001). Other variables showed no association with quality scores. The strongest parts of the abstracts were the appropriateness of the subjects and a sufficient description of them. The weakest parts of abstracts for common items were characteristic of subjects, method of selection, and sufficient detail of results. Conclusion. Overall, the quality of the abstracts presented at the IXth MESOT congress was acceptable. However, according to our study, better description of the subjects, their method of selection, and detailed report of the results would improve their quality.

Transplantation Proceedings, 2005

Background. Tuberculosis (TB) is an important infection encountered posttransplantation, especial... more Background. Tuberculosis (TB) is an important infection encountered posttransplantation, especially among patients in developing countries, where there are high incidences of morbidity and mortality. Materials and Methods. One hundred and twenty subjects (1%) from 15 major kidney transplantation centers in Iran from 1984 to 2003 were compared with 440 controls who were matched for operative time, treatment center, and surgical team. Results. Mean ages of research subjects and controls were 38.6 and 36.6 years (P ϭ .04), respectively. The mean duration of pretransplantation hemodialysis was 29 months (range, 2 to 192 months) in research subjects and 20 months (range, 1 to 180 months) in controls (P ϭ .003). Positive past history of tuberculosis was detected in 4 (3.3%) research subjects and in 7 (1.5%) controls (P ϭ .2). Fifty-two research subjects (43.3%) and 241 controls (54.8%) had pretransplantation purified protein derivative of tuberculin less than 5 mm (P ϭ .02). Mean dosages of initial and maintenance immunosuppressive drugs in research subjects and in controls were not significantly different. Sixty research subjects (50%) and 152 controls (34.5%) had rejection prior to diagnosis of TB (P ϭ .03). Conclusion. To our knowledge, this is the first study that demonstrates an increased risk of posttransplant TB by prolonged duration of pretransplant hemodialysis and number of posttransplant rejection episodes. Further study is needed to clarify these findings specifically with respect to various immunosuppressive regimens.

Transplantation Proceedings, 2005

Fasting during the holy month of Ramadan is a religious duty for all healthy adult Muslims. They ... more Fasting during the holy month of Ramadan is a religious duty for all healthy adult Muslims. They are only allowed to eat and drink between sunset and dawn. This study was designed to find the effect of Ramadan fasting on allograft function. We prospectively studied 19 kidney transplant recipients who voluntarily chose to fast during Ramadan versus 20 matched recipients, who had not fasted for 3 consecutive years. Data were recorded before, during, and after the fasting month. The mean posttransplant periods in the fasting and control groups were 52.6 Ϯ 30.3 and 56.6 Ϯ 30.0 months, respectively. A statistical analysis showed no significant changes in serum creatinine concentrations before and after Ramadan 1.07 Ϯ 0.24 versus 1.08 Ϯ 0.22 mg/dL (P Ͼ .05) and 1.00 Ϯ 0.24 versus 1.03 Ϯ 0.28 mg/dL (P Ͼ .05) in fasting and control groups, respectively. The results did not show any adverse effects of fasting in recipients with stable renal function. In conclusion, our study suggests that fasting during the month of Ramadan is safe and has no significant harmful effects on kidney transplant recipients with normal renal function.

Transplantation Proceedings, 2005

Episodes of acute rejection may represent an important risk factor for the development of chronic... more Episodes of acute rejection may represent an important risk factor for the development of chronic allograft nephropathy. Various studies have shown that pretransplant cytokine profiles in recipient blood are associated with transplant outcome. Serum samples were collected 24 hours before transplantation from 57 patients (38 men and 19 women of age 36 Ϯ 5 years) receiving kidneys from unrelated living donors. Additional samples were collected at 1 and 2 weeks after transplantation, as well as during every rejection episode. The immunosuppression consisted of a cyclosporine, prednisolone, and mycophenolate mofetil. Among the transplanted patients, 19 (33.3%) individuals experienced an acute rejection episode based on an increased level of serum creatinine and blood urea nitrogen during the first 14 days after transplantation. TGF-␤, IL-2 and IFN-␥ serum levels were determined by an ELISA method using Bindermed system kits.

Transplantation Proceedings, 2005

A perplexing issue in diagnosing the cause of renal allograft dysfunction is differentiation betw... more A perplexing issue in diagnosing the cause of renal allograft dysfunction is differentiation between rejection-t he most common cause-and many other possibilities that have detrimental effects on graft function. This study was designed to determine whether technetium-99m sulfur colloid (TSC) accumulation could predict graft rejection. We prospectively studied 54 episodes of allograft dysfunction in 53 kidney transplant recipients who had undergone TSC scintiscanning and graft biopsy, within one week of evidence of allograft dysfunction. Visual analysis of TSC uptake was done by comparing allograft uptake with that of the fifth lumbar vertebra (L5) marrow. A 3+ result meant that allograft uptake was greater than L5 marrow uptake; 2+, allograft uptake was the same as L5 marrow uptake; 1+, less than and 0, no allograft uptake. Transplant accumulation of �2+ was considered consistent with rejection (p=O.O 1). Allotransplant biopsies were interpreted based on the Banff Working Classification and rejection was noted in 45 of 54 renal biopsies. 42 of 45 biopsy-proven rejection episodes had �2+ graft uptake. This nuclear medicine technique has a sensitivity of 93.3%, specificity of 44.4%, a positive predictive value of 89.3%, a negative value of 57.1 % and an efficiency of 83.3% in the diagnosis of renal allograft rejection.

Nephro-Urology Monthly, 2019

Background: The effectiveness of dialysis or dialysis adequacy is an important standard for evalu... more Background: The effectiveness of dialysis or dialysis adequacy is an important standard for evaluating hemodialysis patients. Also, measuring this standard is a crucial goal to all healthcare teams. Inadequate protein intake and catabolism can impact dialysis efficacy. Objectives: This study aimed to investigate the effect of intradialytic isometric resistance exercise and supplementation with BCAAs on dialysis adequacy in patients undergoing dialysis. Methods: A total of 51 patients were randomly divided into three control, exercise and BCAA (EXBCAA), and exercise only (EX) groups and the number of the subjects in each group was 17 patients. The training program consisted of an exercise for arm muscles and another exercise for thigh and core muscles. Exercise sessions were conducted twice a week for two months (24 sessions). Dialysis adequacy variables were kt/v and URR and were measured before the intervention, four weeks after the start of the intervention, and again at eight weeks, which was the end point of the intervention. Results: After the intervention, the kt/V and URR variables presented a significant difference between the two experimental groups vs the control group (P < 0.001). The group that received BCAA and performed isometric resistance exercise indicated the most effective improvements in kt/v (+20%) and URR (+12.5%). Conclusions: Results of this study showed that exercise during hemodialysis can increase dialysis adequacy of hemodialysis patients. Receiving BCAA's can improve the adequacy even more.

Iranian journal of allergy, asthma, and immunology, Jan 13, 2013

There are limited clinical investigations identifying the percentage of T helper 1 (Th1) and T re... more There are limited clinical investigations identifying the percentage of T helper 1 (Th1) and T regulatory (Treg) cells in stable as well as rejected kidney allografts, a concept which needs to be more studied. The aim of our study was to compare the percentage of CD4+ IFN-γ+ cells, the number of IFN-γ secreting cells and the amount of FoxP3 expression in patients with or without stable graft function, to determine the roles of these immunological factors in stable and rejected renal allografts. In this prospective study, 3 months after transplantation 30 patients who received renal transplants from unrelated living donors were enrolled and divided into two groups, 20 patients with stable graft function and 10 patients with biopsy proven acute rejection. The percentage of Th1 CD4+ IFN-γ+ cells was determined on PBMC by flow cytometry and the number of IFN-γ secreting cells by ELISPOT method. Furthermore, FoxP3 expression of PBMCs was measured by Real Time PCR method. The results of t...

Infectious Diseases

BACKGROUND The newly emerged pandemic of coronavirus disease-2019 (COVID-19) is the world's m... more BACKGROUND The newly emerged pandemic of coronavirus disease-2019 (COVID-19) is the world's main health challenge because infected patients become vulnerable to a variety of opportunistic diseases. OBJECTIVE This study aimed to assess clinical outcomes, diagnosis, utilized drug therapies, and ongoing COVID-19 practices in Iranian cases co-infected with COVID-19 and mucormycosis. PARTICIPANTS AND METHODS A case-series analysis was conducted in the presence of 10 patients with COVID-19 and mucormycosis co-infection (two men and eight women; mean age of 48.8 years) from March to October 2020. Demographic variables, signs/symptoms, and comorbidities of all patients were recorded. COVID-19 was confirmed with reverse transcription polymerase chain reaction (RT-PCR) nasopharyngeal swab tests and high-resolution computed tomography (HR-CT)_ scans. RESULTS All patients had a positive RT-PCR for SARS-CoV-2. Eight patients had a history of diabetes, while three of them exhibited a hypertension history. Remarkable laboratory findings were elevated fasting blood sugar in 6 cases and anaemia in four patients. A rhino-orbital-cerebral of mucormycosis in all patients was detected based on HR-CT scans and otorhinolaryngological or ophthalmological examinations. Neurological disorders including facial, trigeminal, optic, and oculomotor nerve involvement resulted in paraesthesia, pain, ptosis, no light perception, blurred vision, and papilledema in five cases. Maxillary and ethmoid sinuses were the most common sites of involvement. CONCLUSION Vulnerable COVID-19 patients with comorbidities, any facial involvements, or treated by excessive doses of glucocorticoids and antibiotics should undergo precise examinations during the appearance of early signs and hospitalization to diagnose and treat mucormycosis using the standard care and antifungal treatments.

Iranian Journal of Pharmaceutical Research : IJPR, 2017

N-acetylcysteine (NAC) is a potent antioxidant that acts through regenerating glutathione stores ... more N-acetylcysteine (NAC) is a potent antioxidant that acts through regenerating glutathione stores and scavenging oxygen-free radicals. This study assesses the short-term effects of NAC in cadaveric kidney transplant (KT) recipients. A double blind, randomized, placebo controlled trial was designed and patients were randomly assigned to receive either NAC or placebo. Glutathione peroxidase (GPX) activity in erythrocytes and serum malondialdehyde (MDA) levels were measured and serum creatinine levels and estimated glomerular filtration rate (eGFR) determined in the early phase after transplantation, were also compared between two study groups. Thirty-seven males and 20 females, with mean ± SD age of 44.6 ± 12.4 years completed the study. Significant difference (P = 0.02) was seen between GPX activity reduction in the placebo group, and that of the NAC group and on the levels of MDA there was no significant difference between two study groups (P = 0.53). Significant improvement in immed...

The aim of this study is to introduce a parametric mixture model to analysis the competing-risks ... more The aim of this study is to introduce a parametric mixture model to analysis the competing-risks data with two types of failure. In mixture context, i t h type of failure is i th component. The baseline failure time for the first and second types of failure are modeled as proportional hazard models according to Weibull and Gompertz distributions, respectively. The covariates affect on both the probability of occurrence and the hazards of the failure types. The probability of occurrence is modeled to depend on covariates through the logistic model. The parameters can be estimated by application of the expectation-conditional maximization and Newton-Raphson algorithms. The simulation studies are performed to compare the proposed model with parametric cause-specific and Fine and Gray models. The results show that the proposed parametric mixture method compared with other models provides consistently less biased estimates for low, mildly, moderately, and heavily censored samples. The an...

Biomedical Research-tokyo, 2017

Background: In recent decades, multiple treatment strategies have been developed for the treatmen... more Background: In recent decades, multiple treatment strategies have been developed for the treatment of renal calculi. However, these are less convincing and cause side effects of the kidney. Objectives: The main objective of this research is to study the use of a novel drug subtracted from chicken gizzard for treatment of renal calculi. Methods: Twenty-three patients diagnosed with kidney stones by ultrasonography and radiography. All patients had the stone size of more than 5.0 mm and age>18 y old and these patients were randomly assigned by nephrology and urology specialists to one month treatment program with capsules (500 mg) filled by a substance of chicken gizzard (four capsules, 3 times daily within 24 h during one month). Results: In general, 49 stones belonging to the 23 patients were used by chicken gizzard substance for treatment of nephrolithiasis. The mean of the stone size after treatment for 15 and 30 d groups were 6.2 ± 3.2 mm (P=0.001) and 5.6 ± 2.9 mm (P=0.006), ...

Kidney International Reports, 2020

BMC Infectious Diseases, 2020

Background Pulmonary endarteritis is a rare clinical phenomenon with congenital heart that can po... more Background Pulmonary endarteritis is a rare clinical phenomenon with congenital heart that can potentially lead to major complications. Case presentation We report a 47-year-old man with pulmonary endarteritis. This patient presented with hypertension, chest pain and a previous history of pulmonary valve disease during childhood. Also, eight-months prior, he was hospitalized with dyspnea (Functional Class III), cough, phlegm, and night sweats without fever. Echocardiographic diagnosis in the first transtransthoracic echocardiography (TTE) was intense pulmonary valve stenosis (PVS) an, thus, the pulmonary valve vegetation and PVS, established by transesophageal echocardiography (TEE). He was referred for surgery after 1 weeks of intravenous antibiotic therapy for removal of the vegetation. Conclusions Finally he was asymptomatic at 3-months of follow-up and was clinically in good condition. Therefore, the detection of infective endocarditis of the lung valve must not lengthy be prolo...

Archivio Italiano di Urologia e Andrologia, 2020

A 22-year-old female, was referred with a history of a headache and elevated blood pressure witho... more A 22-year-old female, was referred with a history of a headache and elevated blood pressure without family history of hypertension or familial dyslipidemia. Initially, a spiral computed tomographic angiography of the renal arteries was conducted, demonstrating completely abnormal left renal artery at the medial portion of the vessel with suspicious stenosis, which was supposed to be due to fibromuscular dysplasia (FMD). Subsequently, the patient underwent selective renal angiography and balloon angioplasty. Severe stenosis was observed on the left side and moderate stenosis on the right side in the medial and proximal part of the vessels, respectively. After the diagnosis of FMD, the left side was treated by balloon and finally, the patient was discharged with good control of blood pressure by losartan/amlodipine treatment.

Medical - Surgical Nursing Journal, 2018

Background: Compliance with dietary and fluid restrictions is an integral part of treatment in he... more Background: Compliance with dietary and fluid restrictions is an integral part of treatment in hemodialysis patients. In fact, nonadherence to these restrictions could entail serious consequences. Objectives: The present study was conducted to explore the impact of continuous care model on compliance with dietary and fluid restrictions in these patients. Methods: The current study was a clinical trial with a control group, which was carried out on 98 hemodialysis patients at two hospitals in Tehran. The subjects were chosen via purposive sampling and randomly assigned to the treatment and control groups. The treatment adherence questionnaire was completed by both groups in the pretest. Afterwards, in the treatment group, once the subjects were presented with the educational manual, a continuous care model was implemented for them. The model consisted of four stages, including awareness-raising, sensitization, control, and evaluation. At the end of three consecutive months, the questionnaire was completed. In the control group, the questionnaire was similarly completed except the subjects had not been exposed to any intervention. Data were collected using descriptive tests, chi-square, t-test, and a repeated measures design. The results were analyzed with the SPSS 21 software. Results: The findings showed that the pattern of adherence to dietary and fluid restrictions in the two groups was statistically significant over time (P < 0.001) such that changes in the intervention group were indicative of the positive effects of continuous care on compliance with dietary and fluid restrictions among hemodialysis patients. Conclusions: By implementation of the continuous care model, the patients, through counseling and training, developed a greater adherence to their dietary and fluid restrictions. Hence, it is suggested for ICU nurses to make use of this model to prevent complications and improve quality of life of hemodialysis patients.

Nephro-Urology Monthly, 2017

Background: Depression, anxiety, and stress are very common among hemodialysis patients. The aim ... more Background: Depression, anxiety, and stress are very common among hemodialysis patients. The aim of this study was to investigate effects of aromatherapy using the damask rose oil on depression, anxiety, and stress in these patients. Methods: In a clinical trial that was performed in 2015, 60 patients under hemodialysis treatment were randomly allocated to two groups of control and intervention each consisting of 30 subjects. The DASS21 scale was used to measure the rates of depression, anxiety, and stress before and four weeks after intervention. In the intervention group, the patients were asked to inhale the damask rose oil with a constant density of 2% from a piece of cloth smeared with three drops for an hour. In the control group, only the usual, standard care was applied. Results: The comparison of the mean scores before and after the intervention in the two groups showed that after intervention, the depression, anxiety, and stress scores significantly decreased in the damask rose group (P ≤ 0.05). Conclusions: Inhalation aromatherapy using the damask rose oil can decrease depression, anxiety, and stress in hemodialysis patients.

Transplantation Proceedings, 2007

Background. Considering the organ shortage crisis for renal transplantation worldwide, assessing ... more Background. Considering the organ shortage crisis for renal transplantation worldwide, assessing the risk factors to establish better allocation strategies to improve graft survival seems to be crucial. Objectives. We aimed to evaluate the risk factors influencing graft and patient survival after renal transplantation to construct a model of prognostic factors for living renal transplantation (LRT), namely living unrelated renal transplantation (LURT). Methods. We designed a retrospective multicenter survey including medical record review of 3028 patients who received renal transplants at 2 hospitals between July 1984 and December 2005. We assessed the impact on graft survival of recipient/donor relationship, recipient age and gender, donor age and gender, and viral hepatitis B and C infections. Results. Among 3028 recipients, including 94.8% primary grafts, 63.4% were men, mean Ϯ SE of age 36.4 Ϯ 0.3 years, with mostly end-stage renal disease due to diabetes mellitus, hypertension, or glomerulonephritis. One-, 5-, 10-and 15-year graft survival rates were 85.4%, 68.3%, 46.4%, and 23.8%, respectively. Patient survival rates were 93.4%, 87.5%, 79.4%, and 66.4% at the above intervals, respectively. Donor age (relative hazard [RH], 1.024; P Ͻ .001), unrelated donors (RH, 1.7; P Ͻ .001), and hepatitis C virus (HCV) infection (RH, 2.65; P Ͻ .001) were the only significant factors affecting graft survival. Conclusion. Increased donor age, unrelated donor, and HCV infection were significant factors negatively impacting graft survival; thus, proper management of these factors may lead to better graft and patient survival.

Background. Kidney transplantation has gained widespread popularity by improving the outcome of e... more Background. Kidney transplantation has gained widespread popularity by improving the outcome of end-stage renal disease (ESRD) patients. However, this is a highly complicated and expensive procedure that puts much pressure on the health system in developing countries. We report the costs in Iran model of kidney transplantation. Materials and Methods. We reviewed the regulations for kidney transplantation using Dialysis and Transplant Patients Association (DATPA) information, 2005. All data regarding the cost of transplantation procedure, immunosuppression, and the money given to donors were included. The cost of transplantation procedure was categorized into personnel, drugs, paraclinics, hospital bed, and other expenses. To achieve more comprehensive results, all costs were converted into US dollars (1 USD ϭ 9000 Rials). Results. The total cost of kidney transplantation procedure was $9224. Of this, 65.8%

Transplantation Proceedings, 2007

Transplantation Proceedings, 2007

Background. We assessed the abstracts of the IXth Congress of the Middle East Society for Organ T... more Background. We assessed the abstracts of the IXth Congress of the Middle East Society for Organ Transplantation (MESOT) held December 6 to 10, 2004, in Ankara, Turkey. Methods. Assessment was done with a 19-item quality assessment checklist, which was developed by Timmer et al (2003) with a good interrater agreement (intraclass coefficient 0.61 to 0.81). From the total 396 Congress abstracts, cluster random sampling was applied to select abstracts from oral and poster presentations. We assessed 109 abstracts, by recording presentation type, study type, country of study, number of authors, and transplantation type. We also evaluated study design and obtained a final quality score for each sample. Evaluation of the abstracts was performed by a single investigator. Results. The mean (SD) quality score of all abstracts was 0.60 Ϯ 0.11 (range: 0.33 to 0.81). More than 80% had a score above 0.50. Human observational studies showed higher scores compared with human and basic interventional studies (P ϭ .001). Other variables showed no association with quality scores. The strongest parts of the abstracts were the appropriateness of the subjects and a sufficient description of them. The weakest parts of abstracts for common items were characteristic of subjects, method of selection, and sufficient detail of results. Conclusion. Overall, the quality of the abstracts presented at the IXth MESOT congress was acceptable. However, according to our study, better description of the subjects, their method of selection, and detailed report of the results would improve their quality.

Transplantation Proceedings, 2005

Background. Tuberculosis (TB) is an important infection encountered posttransplantation, especial... more Background. Tuberculosis (TB) is an important infection encountered posttransplantation, especially among patients in developing countries, where there are high incidences of morbidity and mortality. Materials and Methods. One hundred and twenty subjects (1%) from 15 major kidney transplantation centers in Iran from 1984 to 2003 were compared with 440 controls who were matched for operative time, treatment center, and surgical team. Results. Mean ages of research subjects and controls were 38.6 and 36.6 years (P ϭ .04), respectively. The mean duration of pretransplantation hemodialysis was 29 months (range, 2 to 192 months) in research subjects and 20 months (range, 1 to 180 months) in controls (P ϭ .003). Positive past history of tuberculosis was detected in 4 (3.3%) research subjects and in 7 (1.5%) controls (P ϭ .2). Fifty-two research subjects (43.3%) and 241 controls (54.8%) had pretransplantation purified protein derivative of tuberculin less than 5 mm (P ϭ .02). Mean dosages of initial and maintenance immunosuppressive drugs in research subjects and in controls were not significantly different. Sixty research subjects (50%) and 152 controls (34.5%) had rejection prior to diagnosis of TB (P ϭ .03). Conclusion. To our knowledge, this is the first study that demonstrates an increased risk of posttransplant TB by prolonged duration of pretransplant hemodialysis and number of posttransplant rejection episodes. Further study is needed to clarify these findings specifically with respect to various immunosuppressive regimens.

Transplantation Proceedings, 2005

Fasting during the holy month of Ramadan is a religious duty for all healthy adult Muslims. They ... more Fasting during the holy month of Ramadan is a religious duty for all healthy adult Muslims. They are only allowed to eat and drink between sunset and dawn. This study was designed to find the effect of Ramadan fasting on allograft function. We prospectively studied 19 kidney transplant recipients who voluntarily chose to fast during Ramadan versus 20 matched recipients, who had not fasted for 3 consecutive years. Data were recorded before, during, and after the fasting month. The mean posttransplant periods in the fasting and control groups were 52.6 Ϯ 30.3 and 56.6 Ϯ 30.0 months, respectively. A statistical analysis showed no significant changes in serum creatinine concentrations before and after Ramadan 1.07 Ϯ 0.24 versus 1.08 Ϯ 0.22 mg/dL (P Ͼ .05) and 1.00 Ϯ 0.24 versus 1.03 Ϯ 0.28 mg/dL (P Ͼ .05) in fasting and control groups, respectively. The results did not show any adverse effects of fasting in recipients with stable renal function. In conclusion, our study suggests that fasting during the month of Ramadan is safe and has no significant harmful effects on kidney transplant recipients with normal renal function.

Transplantation Proceedings, 2005

Episodes of acute rejection may represent an important risk factor for the development of chronic... more Episodes of acute rejection may represent an important risk factor for the development of chronic allograft nephropathy. Various studies have shown that pretransplant cytokine profiles in recipient blood are associated with transplant outcome. Serum samples were collected 24 hours before transplantation from 57 patients (38 men and 19 women of age 36 Ϯ 5 years) receiving kidneys from unrelated living donors. Additional samples were collected at 1 and 2 weeks after transplantation, as well as during every rejection episode. The immunosuppression consisted of a cyclosporine, prednisolone, and mycophenolate mofetil. Among the transplanted patients, 19 (33.3%) individuals experienced an acute rejection episode based on an increased level of serum creatinine and blood urea nitrogen during the first 14 days after transplantation. TGF-␤, IL-2 and IFN-␥ serum levels were determined by an ELISA method using Bindermed system kits.

Transplantation Proceedings, 2005

A perplexing issue in diagnosing the cause of renal allograft dysfunction is differentiation betw... more A perplexing issue in diagnosing the cause of renal allograft dysfunction is differentiation between rejection-t he most common cause-and many other possibilities that have detrimental effects on graft function. This study was designed to determine whether technetium-99m sulfur colloid (TSC) accumulation could predict graft rejection. We prospectively studied 54 episodes of allograft dysfunction in 53 kidney transplant recipients who had undergone TSC scintiscanning and graft biopsy, within one week of evidence of allograft dysfunction. Visual analysis of TSC uptake was done by comparing allograft uptake with that of the fifth lumbar vertebra (L5) marrow. A 3+ result meant that allograft uptake was greater than L5 marrow uptake; 2+, allograft uptake was the same as L5 marrow uptake; 1+, less than and 0, no allograft uptake. Transplant accumulation of �2+ was considered consistent with rejection (p=O.O 1). Allotransplant biopsies were interpreted based on the Banff Working Classification and rejection was noted in 45 of 54 renal biopsies. 42 of 45 biopsy-proven rejection episodes had �2+ graft uptake. This nuclear medicine technique has a sensitivity of 93.3%, specificity of 44.4%, a positive predictive value of 89.3%, a negative value of 57.1 % and an efficiency of 83.3% in the diagnosis of renal allograft rejection.