Mandana Ashrafi - Academia.edu (original) (raw)

Papers by Mandana Ashrafi

Research paper thumbnail of Surveillance for hepatocellular carcinoma after autologous stem cell transplantation in cirrhosis

Middle East journal of digestive diseases, 2012

During the resent years there has been interest in using bone marrow stem cells to treat liver ci... more During the resent years there has been interest in using bone marrow stem cells to treat liver cirrhosis. However, there is a potential concern for malignant transformation after stem cell therapy. The aim of this study was to evaluate the development of hepatocellular carcinoma (HCC) after autologous bone marrow stem cell transplantation for liver cirrhosis. All the patients who underwent autologous stem cell transplantation for liver cirrhosis between 2005 and 2011 at our center were enrolled. Cellular infusion was made through peripheral vein, portal vein, or hepatic artery.The patients were invited to undergo screening for hepatocellular carcinoma. The screening was made with ultrasonography and alpha-feto protein (AFP) measurement. Thirty two patients (18 males) were included in the study. Mean age of patients was 45.7 years. Fifteen patients (47%) received mesenchymal stem cell (MSC), 9 (28%) received bone marrow mononuclear cells, 5 (16%) were given CD 133-positive bone marro...

Research paper thumbnail of Does pioglitazone improve depression through insulin-sensitization? Results of a randomized double-blind metformin-controlled trial in patients with polycystic ovarian syndrome and comorbid depression

Psychoneuroendocrinology, 2012

Thiazolidinediones have shown beneficial effects in short-term treatment of depression. However, ... more Thiazolidinediones have shown beneficial effects in short-term treatment of depression. However, it is unclear whether the antidepressant efficacy of these agents is related to their insulin-sensitizing action. We conducted the present study to compare the antidepressant efficacy of pioglitazone with another insulin-sensitizer, metformin, in obese patients with concomitant polycystic ovarian syndrome (PCOS) and major depressive disorder (MDD). In a six-week double-blind study, 50 patients with PCOS and MDD (DSM-IV-TR criteria) with Hamilton depression rating scale (HDRS) score of <20, randomly received pioglitazone (15mg twice daily; PO) or metformin (750mg twice daily; PO). Assessment was done using HDRS (weeks 0, 3, 6) together with fasting Insulin, glucose, and lipid profile, liver enzymes, homeostatic model assessment of insulin resistance (HOMA-IR), anthropometric measures, and serum androgens (weeks 0 and 6). Pioglitazone was superior to metformin in reducing HDRS scores at...

Research paper thumbnail of Minocycline add-on to risperidone for treatment of negative symptoms in patients with stable schizophrenia: Randomized double-blind placebo-controlled study

Psychiatry Research, 2014

The objective of this study was to assess the efficacy and tolerability of minocycline add-on to ... more The objective of this study was to assess the efficacy and tolerability of minocycline add-on to risperidone in treatment of negative symptoms of patients with chronic schizophrenia. In a randomized double-blind placebo-controlled study, 40 patients with chronic schizophrenia who were stabilized on risperidone for a minimum duration of eight weeks were recruited. The patients were randomly assigned to minocycline (titrated up to 200 mg/day) or placebo in addition to risperidone (maximum dose of 6 mg/day) for eight weeks. Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale, and Extrapyramidal Syndrome Rating Scale were used. Thirty-eight patients completed the study. Significant time  treatment interaction for negative [F(2.254,85.638) ¼59.046, P o0.001] general psychopathology [F(1.703,64.700) ¼6.819, P¼ 0.001], and positive subscales [F(1.655,62.878) ¼ 5.193, P¼ 0.012] as well as total PANSS scores [F(1.677,63.720)¼ 28.420, Po 0.001] were observed.

Research paper thumbnail of Predictors of mental and physical health in non-cirrhotic patients with viral hepatitis: A case control study

Journal of Psychosomatic Research, 2012

Objective: To identify independent predictors of mental and physical health in patients with vira... more Objective: To identify independent predictors of mental and physical health in patients with viral hepatitis. Methods: Hepatitis C (HCV) and hepatitis B (HBV) infected patients, and community control subjects with equal age and sex distribution were recruited. All subjects filled in personal characteristics questionnaire, Hospital Anxiety and Depression Scale (HADS), Iowa Fatigue Scale (IFS), and Medical Outcomes Survey Short Form-12 (SF-12). All patients had measurement of routine laboratory values, and some had recent liver biopsy. Regression analyses were used to identify predictors of physical and mental health. Results: One hundred eighty nine subjects (162 males, 27 females, for each group N = 63) with mean (± SD) age of 39 ± 11 years were included. Anxiety and depression were important predictors of SF-12 (and its subscales MCS and PCS) and IFS scores, whereas IFS scores independently predicted HADS, PCS, MCS, and SF-12 scores. After controlling for confounders, HCV infection was independently associated with impairment of physical health. Moreover, creatinine showed an inverse strong relation with fatigue. Genotype 3a of HCV was independently associated with depressed and anxious states, whereas higher inflammation grade was significantly related to depression. Marital status, non-psychiatric comorbidities, and history of alcohol abuse also predicted health scores in the patients. Adjusted R 2 s for linear models were 0.571 to 0.709, whereas areas under the receiver operating characteristic (ROC) curve for logistic models were 0.90 to 0.93. Conclusion: In viral hepatitis patients, besides mental and medical comorbidities, marital status, and alcohol abuse, HCV infection itself is associated with impaired physical and possibly mental health.

Research paper thumbnail of Melatonin for prevention of metabolic side-effects of olanzapine in patients with first-episode schizophrenia: Randomized double-blind placebo-controlled study

Journal of Psychiatric Research, 2014

Please cite this article as: Modabbernia A, Heidari P, Soleimani R, Sobhani A, Roshan ZA, Taslimi... more Please cite this article as: Modabbernia A, Heidari P, Soleimani R, Sobhani A, Roshan ZA, Taslimi S, Ashrafi M, Modabbernia MJ, Melatonin for prevention of metabolic side-effects of olanzapine in patients with first-episode schizophrenia: randomized double-blind placebo-controlled study, We aimed to determine the efficacy of melatonin 3 mg/day in prevention of olanzapine-induced metabolic side-effects. In a randomized double-blind placebo-controlled study, 48 patients with first-episode schizophrenia who were eligible for olanzapine treatment, were randomly assigned into olanzapine plus either melatonin 3 mg/day or matched placebo for eight weeks.

Research paper thumbnail of Memantine add-on in moderate to severe obsessive-compulsive disorder: Randomized double-blind placebo-controlled study

Journal of Psychiatric Research, 2013

There is a growing body of evidence for the efficacy of memantine augmentation in patients with o... more There is a growing body of evidence for the efficacy of memantine augmentation in patients with obsessive-compulsive disorder (OCD). However, to date, no double-blind study has addressed this issue. The objective of the present randomized double-blind placebo-controlled study was to evaluate efficacy and tolerability of memantine add-on treatment in patients with moderate to severe OCD. Forty-two patients with the diagnosis of OCD based on DSM-IV-TR who had a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score of ≥21 were randomly assigned to memantine (10 mg/day for the first week, and 20 mg/day for the rest of the trial) or placebo in addition to fluvoxamine for eight weeks. Patients were assessed using Y-BOCS every two weeks. Thirty-eight patients completed the study. Repeated measure ANOVA showed significant effect for time × treatment interaction in total scale [F (2.096, 75.470) = 5.280, P = 0.006] and obsession [F (2.340, 94.547) = 5.716, P = 0.002] and near significant effect for compulsion subscales [F (2.005, 79.179) = 2.841, P = 0.065]. By week eight, all patients in the memantine group and six (32%) patients in the placebo group [P value of Fisher&amp;amp;amp;amp;amp;amp;amp;#39;s exact test &amp;amp;amp;amp;amp;amp;amp;lt;0.001] met the criteria for partial and complete response. At the end of the trial, 17 (89%) patients in the memantine group compared with six (32%) patients in the placebo group achieved remission (χ(2)(1) = 13.328, P &amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Frequency of side-effects was not significantly different between the two groups. In summary, we showed that memantine add-on to fluvoxamine significantly improved short-term outcomes in patients with moderate to severe OCD.

Research paper thumbnail of Memantine Add-On to Risperidone for Treatment of Negative Symptoms in Patients With Stable Schizophrenia

Journal of Clinical Psychopharmacology, 2013

We aimed to evaluate the efficacy of memantine add-on in the treatment of primary negative sympto... more We aimed to evaluate the efficacy of memantine add-on in the treatment of primary negative symptoms of patients with stable schizophrenia. In a double-blind placebo-controlled clinical trial, 40 patients with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) who were stabilized on risperidone for a minimum of 8 weeks were randomized to either memantine (20 mg) or placebo in addition to risperidone, 6 mg/d, for eight weeks. Assessment was done using the Positive and Negative Syndrome Scale at baseline, week 4, and week 8. The Hamilton Depression Rating Scale and the Extrapyramidal Symptom Rating Scale at baseline and week 8 were used to assess depression and extrapyramidal symptoms, respectively. All 40 patients had at least one postbaseline measurement, and 38 patients completed the trial. Patients in the memantine group showed a significantly greater improvement on negative subscale than the placebo group at end point (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The same effect was observed for the total score (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and the general psychopathology subscale score (P = 0.002). There was no significant difference in reduction of positive symptoms score between the 2 groups (P = 0.757). Changes in the Hamilton Depression Rating Scale and the Extrapyramidal Symptom Rating Scale scores and frequency of adverse effects did not differ between the 2 groups. Our study showed that memantine is a tolerable and efficacious add-on treatment for primary negative symptoms of schizophrenia.

Research paper thumbnail of Aspirin for treatment of lithium-associated sexual dysfunction in men: randomized double-blind placebo-controlled study

Bipolar Disorders, 2013

Aspirin for treatment of lithium-associated sexual dysfunction in men: randomized double-blind pl... more Aspirin for treatment of lithium-associated sexual dysfunction in men: randomized double-blind placebo-controlled study Saroukhani S, Emami-Parsa M, Modabbernia A, Ashrafi M, Farokhnia M, Hajiaghaee R, Akhondzadeh S. Aspirin for treatment of lithium-associated sexual dysfunction in men: randomized double-blind placebo-controlled study. Bipolar Disord 2013: 15: 650-656.

Research paper thumbnail of Brain-Derived Neurotrophic Factor Predicts Physical Health in Untreated Patients with Hepatitis C

Biological Psychiatry, 2011

Research paper thumbnail of Eosinophilic gastroenteritis: a case series from iran

Middle East journal of digestive diseases, 2011

BACKGROUND Eosinophilic gastroenteritis (EG) is a rare inflammatory disorder of the gastrointesti... more BACKGROUND Eosinophilic gastroenteritis (EG) is a rare inflammatory disorder of the gastrointestinal (GI) tract. There have been several case series of patients with EG from the western world and East Asia. However, there has not been a report of patients with EG from the Middle East region. The aim of this study is to describe clinical characteristics and treatment response in a series of EG patients from Iran. METHODS We retrospectively reviewed charts with a diagnosis of EG from 1997 to 2010 at Shariati Hospital and the private clinics of the authors. Clinical characteristics of the patients were evaluated, and the treatment response and relapse rate were assessed. RESULTS Twenty-two patients (9 male) with EG were identified. Mean age of the patients was 45.1±15.5 (range: 27-75) years. Median duration between symptom onset and diagnosis was 12 (range 1- 48) months. Twenty (90%) patients had mucosal involvement, one (5%) had muscular involvement and one (5%) had subserosal involve...

Research paper thumbnail of Surveillance for hepatocellular carcinoma after autologous stem cell transplantation in cirrhosis

Middle East journal of digestive diseases, 2012

During the resent years there has been interest in using bone marrow stem cells to treat liver ci... more During the resent years there has been interest in using bone marrow stem cells to treat liver cirrhosis. However, there is a potential concern for malignant transformation after stem cell therapy. The aim of this study was to evaluate the development of hepatocellular carcinoma (HCC) after autologous bone marrow stem cell transplantation for liver cirrhosis. All the patients who underwent autologous stem cell transplantation for liver cirrhosis between 2005 and 2011 at our center were enrolled. Cellular infusion was made through peripheral vein, portal vein, or hepatic artery.The patients were invited to undergo screening for hepatocellular carcinoma. The screening was made with ultrasonography and alpha-feto protein (AFP) measurement. Thirty two patients (18 males) were included in the study. Mean age of patients was 45.7 years. Fifteen patients (47%) received mesenchymal stem cell (MSC), 9 (28%) received bone marrow mononuclear cells, 5 (16%) were given CD 133-positive bone marro...

Research paper thumbnail of Does pioglitazone improve depression through insulin-sensitization? Results of a randomized double-blind metformin-controlled trial in patients with polycystic ovarian syndrome and comorbid depression

Psychoneuroendocrinology, 2012

Thiazolidinediones have shown beneficial effects in short-term treatment of depression. However, ... more Thiazolidinediones have shown beneficial effects in short-term treatment of depression. However, it is unclear whether the antidepressant efficacy of these agents is related to their insulin-sensitizing action. We conducted the present study to compare the antidepressant efficacy of pioglitazone with another insulin-sensitizer, metformin, in obese patients with concomitant polycystic ovarian syndrome (PCOS) and major depressive disorder (MDD). In a six-week double-blind study, 50 patients with PCOS and MDD (DSM-IV-TR criteria) with Hamilton depression rating scale (HDRS) score of <20, randomly received pioglitazone (15mg twice daily; PO) or metformin (750mg twice daily; PO). Assessment was done using HDRS (weeks 0, 3, 6) together with fasting Insulin, glucose, and lipid profile, liver enzymes, homeostatic model assessment of insulin resistance (HOMA-IR), anthropometric measures, and serum androgens (weeks 0 and 6). Pioglitazone was superior to metformin in reducing HDRS scores at...

Research paper thumbnail of Minocycline add-on to risperidone for treatment of negative symptoms in patients with stable schizophrenia: Randomized double-blind placebo-controlled study

Psychiatry Research, 2014

The objective of this study was to assess the efficacy and tolerability of minocycline add-on to ... more The objective of this study was to assess the efficacy and tolerability of minocycline add-on to risperidone in treatment of negative symptoms of patients with chronic schizophrenia. In a randomized double-blind placebo-controlled study, 40 patients with chronic schizophrenia who were stabilized on risperidone for a minimum duration of eight weeks were recruited. The patients were randomly assigned to minocycline (titrated up to 200 mg/day) or placebo in addition to risperidone (maximum dose of 6 mg/day) for eight weeks. Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale, and Extrapyramidal Syndrome Rating Scale were used. Thirty-eight patients completed the study. Significant time  treatment interaction for negative [F(2.254,85.638) ¼59.046, P o0.001] general psychopathology [F(1.703,64.700) ¼6.819, P¼ 0.001], and positive subscales [F(1.655,62.878) ¼ 5.193, P¼ 0.012] as well as total PANSS scores [F(1.677,63.720)¼ 28.420, Po 0.001] were observed.

Research paper thumbnail of Predictors of mental and physical health in non-cirrhotic patients with viral hepatitis: A case control study

Journal of Psychosomatic Research, 2012

Objective: To identify independent predictors of mental and physical health in patients with vira... more Objective: To identify independent predictors of mental and physical health in patients with viral hepatitis. Methods: Hepatitis C (HCV) and hepatitis B (HBV) infected patients, and community control subjects with equal age and sex distribution were recruited. All subjects filled in personal characteristics questionnaire, Hospital Anxiety and Depression Scale (HADS), Iowa Fatigue Scale (IFS), and Medical Outcomes Survey Short Form-12 (SF-12). All patients had measurement of routine laboratory values, and some had recent liver biopsy. Regression analyses were used to identify predictors of physical and mental health. Results: One hundred eighty nine subjects (162 males, 27 females, for each group N = 63) with mean (± SD) age of 39 ± 11 years were included. Anxiety and depression were important predictors of SF-12 (and its subscales MCS and PCS) and IFS scores, whereas IFS scores independently predicted HADS, PCS, MCS, and SF-12 scores. After controlling for confounders, HCV infection was independently associated with impairment of physical health. Moreover, creatinine showed an inverse strong relation with fatigue. Genotype 3a of HCV was independently associated with depressed and anxious states, whereas higher inflammation grade was significantly related to depression. Marital status, non-psychiatric comorbidities, and history of alcohol abuse also predicted health scores in the patients. Adjusted R 2 s for linear models were 0.571 to 0.709, whereas areas under the receiver operating characteristic (ROC) curve for logistic models were 0.90 to 0.93. Conclusion: In viral hepatitis patients, besides mental and medical comorbidities, marital status, and alcohol abuse, HCV infection itself is associated with impaired physical and possibly mental health.

Research paper thumbnail of Melatonin for prevention of metabolic side-effects of olanzapine in patients with first-episode schizophrenia: Randomized double-blind placebo-controlled study

Journal of Psychiatric Research, 2014

Please cite this article as: Modabbernia A, Heidari P, Soleimani R, Sobhani A, Roshan ZA, Taslimi... more Please cite this article as: Modabbernia A, Heidari P, Soleimani R, Sobhani A, Roshan ZA, Taslimi S, Ashrafi M, Modabbernia MJ, Melatonin for prevention of metabolic side-effects of olanzapine in patients with first-episode schizophrenia: randomized double-blind placebo-controlled study, We aimed to determine the efficacy of melatonin 3 mg/day in prevention of olanzapine-induced metabolic side-effects. In a randomized double-blind placebo-controlled study, 48 patients with first-episode schizophrenia who were eligible for olanzapine treatment, were randomly assigned into olanzapine plus either melatonin 3 mg/day or matched placebo for eight weeks.

Research paper thumbnail of Memantine add-on in moderate to severe obsessive-compulsive disorder: Randomized double-blind placebo-controlled study

Journal of Psychiatric Research, 2013

There is a growing body of evidence for the efficacy of memantine augmentation in patients with o... more There is a growing body of evidence for the efficacy of memantine augmentation in patients with obsessive-compulsive disorder (OCD). However, to date, no double-blind study has addressed this issue. The objective of the present randomized double-blind placebo-controlled study was to evaluate efficacy and tolerability of memantine add-on treatment in patients with moderate to severe OCD. Forty-two patients with the diagnosis of OCD based on DSM-IV-TR who had a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score of ≥21 were randomly assigned to memantine (10 mg/day for the first week, and 20 mg/day for the rest of the trial) or placebo in addition to fluvoxamine for eight weeks. Patients were assessed using Y-BOCS every two weeks. Thirty-eight patients completed the study. Repeated measure ANOVA showed significant effect for time × treatment interaction in total scale [F (2.096, 75.470) = 5.280, P = 0.006] and obsession [F (2.340, 94.547) = 5.716, P = 0.002] and near significant effect for compulsion subscales [F (2.005, 79.179) = 2.841, P = 0.065]. By week eight, all patients in the memantine group and six (32%) patients in the placebo group [P value of Fisher&amp;amp;amp;amp;amp;amp;amp;#39;s exact test &amp;amp;amp;amp;amp;amp;amp;lt;0.001] met the criteria for partial and complete response. At the end of the trial, 17 (89%) patients in the memantine group compared with six (32%) patients in the placebo group achieved remission (χ(2)(1) = 13.328, P &amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Frequency of side-effects was not significantly different between the two groups. In summary, we showed that memantine add-on to fluvoxamine significantly improved short-term outcomes in patients with moderate to severe OCD.

Research paper thumbnail of Memantine Add-On to Risperidone for Treatment of Negative Symptoms in Patients With Stable Schizophrenia

Journal of Clinical Psychopharmacology, 2013

We aimed to evaluate the efficacy of memantine add-on in the treatment of primary negative sympto... more We aimed to evaluate the efficacy of memantine add-on in the treatment of primary negative symptoms of patients with stable schizophrenia. In a double-blind placebo-controlled clinical trial, 40 patients with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) who were stabilized on risperidone for a minimum of 8 weeks were randomized to either memantine (20 mg) or placebo in addition to risperidone, 6 mg/d, for eight weeks. Assessment was done using the Positive and Negative Syndrome Scale at baseline, week 4, and week 8. The Hamilton Depression Rating Scale and the Extrapyramidal Symptom Rating Scale at baseline and week 8 were used to assess depression and extrapyramidal symptoms, respectively. All 40 patients had at least one postbaseline measurement, and 38 patients completed the trial. Patients in the memantine group showed a significantly greater improvement on negative subscale than the placebo group at end point (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The same effect was observed for the total score (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and the general psychopathology subscale score (P = 0.002). There was no significant difference in reduction of positive symptoms score between the 2 groups (P = 0.757). Changes in the Hamilton Depression Rating Scale and the Extrapyramidal Symptom Rating Scale scores and frequency of adverse effects did not differ between the 2 groups. Our study showed that memantine is a tolerable and efficacious add-on treatment for primary negative symptoms of schizophrenia.

Research paper thumbnail of Aspirin for treatment of lithium-associated sexual dysfunction in men: randomized double-blind placebo-controlled study

Bipolar Disorders, 2013

Aspirin for treatment of lithium-associated sexual dysfunction in men: randomized double-blind pl... more Aspirin for treatment of lithium-associated sexual dysfunction in men: randomized double-blind placebo-controlled study Saroukhani S, Emami-Parsa M, Modabbernia A, Ashrafi M, Farokhnia M, Hajiaghaee R, Akhondzadeh S. Aspirin for treatment of lithium-associated sexual dysfunction in men: randomized double-blind placebo-controlled study. Bipolar Disord 2013: 15: 650-656.

Research paper thumbnail of Brain-Derived Neurotrophic Factor Predicts Physical Health in Untreated Patients with Hepatitis C

Biological Psychiatry, 2011

Research paper thumbnail of Eosinophilic gastroenteritis: a case series from iran

Middle East journal of digestive diseases, 2011

BACKGROUND Eosinophilic gastroenteritis (EG) is a rare inflammatory disorder of the gastrointesti... more BACKGROUND Eosinophilic gastroenteritis (EG) is a rare inflammatory disorder of the gastrointestinal (GI) tract. There have been several case series of patients with EG from the western world and East Asia. However, there has not been a report of patients with EG from the Middle East region. The aim of this study is to describe clinical characteristics and treatment response in a series of EG patients from Iran. METHODS We retrospectively reviewed charts with a diagnosis of EG from 1997 to 2010 at Shariati Hospital and the private clinics of the authors. Clinical characteristics of the patients were evaluated, and the treatment response and relapse rate were assessed. RESULTS Twenty-two patients (9 male) with EG were identified. Mean age of the patients was 45.1±15.5 (range: 27-75) years. Median duration between symptom onset and diagnosis was 12 (range 1- 48) months. Twenty (90%) patients had mucosal involvement, one (5%) had muscular involvement and one (5%) had subserosal involve...