OTHERS_CITABLE Comparison of PCR and culture methods for detecting of Listeria monocytogenes in vaginal samples Listeria monocytogenes is an opportunistic intracellular pathogen that has become an important cause of human food borne infections worldwide. The aim of this study is the determinate sensitivity of diagnostic methods of this organism and achieving a test that can detect Listeria monocytogenes in all circumstances in clinical samples. Materials and Methods: In this study 88 vaginal swabs were collected from women with age of (15-45) referred to gynecologic clinics in the hospital (Sari, Iran). Vaginal swabs were examined by culture on specific PALKAM agar medium and PCR technique by specific primers. Results: Out of 88 studied vaginal swabs, 8 cases with culture method and 27 cases were positive with PCR technique. The sensitivity of PCR and culture is reported %100, %29 respectively. Conclusion: The results show that PCR is a more sensitive, easier, and faster method in comparison to in clinical samples. http://intjmi.com/article-1-275-en.pdf 2017-07-16 71 74 Listeria monocytogenes PCR culture methods Mohtaram Nasrollahi 1 Professor in Microbiology, Department of Microbiology, Mazandaran University of Medical Science, Mazandaran, Sari, Iran. AUTHOR Zeynab Marzhoseyni 2 MSc in Microbiology, Department of Microbiology, Mazandaran University of Medical Science, Mazandaran, Sari, Iran AUTHOR Tahoora Mousavi 3 Ph.D. Student in Molecular and Cell Biology, Student Research Committee, Molecular and Cell Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. AUTHOR Mohammad Ahanjan 4 Associate Professor, Department of Microbiology, Mazandaran University of Medical Science, Mazandaran, Sari, Iran. AUTHOR
CASE_STUDY Meningitis retention syndrome: a case report Urinary retention is a urologic emergency that is defined by an inability to voluntarily void urine, which can be acute or chronic. Benign inflammatory nervous diseases also cause acute urinary retention, in which patients lack apparent urethral outlet obstruction, but exhibit minor neurological and cerebrospinal fluid (CSF) abnormalities. The development of urinary retention in the context of meningitis and CSF pleocytosis without any lumbosacral radiculomyelitis is known as Meningitis Retention Syndrome (MRS). We report a 24-year-old male with complaints of urine dribbling, fever and also complete urinary retention a few hours later and nausea/vomiting, headache and flank pain. The general and genitalia examinations, routine laboratory tests, diagnostic ultrasound, and brain MRI were normal. But HSV Ab (IgG) and PCR HSV were positive in CSF analysis. Finally, Urologist performed the Urodynamic study and flaccid neurologic bladder was reported due the patient was treated with intravenous acyclovir 500 mg, every eight hours, with the diagnosis of MRS. MRS is a rarely described clinical entity with features of meningitis and acute urinary retention. The most common cause of urinary retention is benign prostatic hyperplasia. Other common causes include prostatitis, cystitis, urethritis, stones, and vulvovaginitis receiving medications in the anticholinergic and alpha-adrenergic agonist classes and cortical, spinal, or peripheral nerve lesions. Since MRS has a benign and self-remitting course, the effectiveness of immune treatments (steroid pulse therapy) remains unclear, although such treatments may shorten the duration of the disease. Management of the acute urinary retention is necessary to avoid renal injury due to hydronephrosis. http://intjmi.com/article-1-276-en.pdf 2017-07-16 75 80 urinary retention Meningitis Retention Syndrome MRS Farhang Babamahmoodi 1 Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran. AUTHOR Roya Sheikholeslami 2 Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran. AUTHOR Tahoora Mousavi 3 Ph.D. Candidate in Molecular and Cell Biology, Student Research Committee, Molecular and Cell Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. AUTHOR Lotfollah Davoodi 4 Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran. AUTHOR
OTHERS_CITABLE A Case Series of Portal Vein Thrombosis Following Laparoscopic Sleeve Gastrectomy Background: laparoscopic sleeve gastrectomy is presently the most common bariatric surgery at our center (King Hussein Medical Center). Portal vein thrombosis is a rare surgical complication with an insidious presentation and a high risk of bowel compromise. The aim of this study is to present a series of patients who developed portal vein thrombosis post sleeve gastrectomy, and to describe the overall incidence, associated risk factors, clinical presentation and management. Case Reports: Four patients developed portal vein thrombosis post laparoscopic sleeve gastrectomy at King Hussein Medical Center during the period (Jan 2006 to Feb 2017). All patients presented with abdominal pain, nausea, and vomiting and decrease oral intake. The abdominal Computed tomography (CT) scan confirmed the diagnosis of portal vein thrombosis in all of them. One patient required medical treatment along with operative intervention and bowel resection. The other three patients were treated conservatively with anticoagulation and fluid resuscitation. Conclusion: Portal vein thrombosis is a rare but severe complication after laparoscopic bariatric surgery. Familiarity with this high-risk entity is critical. Early diagnosis and management, initiated by a high index of suspicion, is crucial. http://intjmi.com/article-1-278-en.pdf 2017-08-06 81 92 Acute Porto-mesenteric Venous Thrombosis Laparoscopic Sleeve Gastrectomy Omar Al-Shawabkeh 1 Laparoscopic and Bariatric Surgery Specialist, Department of Surgery, Division of upper GI, laparoscopy and bariatric surgery , Royal Medical Services, Amman, Jordan AUTHOR Ramadan Al-Hasanat 2 Laparoscopic and Bariatric Surgery Specialist, Department of Surgery, Division of upper GI, laparoscopy and bariatric surgery, Royal Medical Services, Amman, Jordan. AUTHOR Adnan Zayadeen 3 Senior Specialist in Diagnostic Radiology, Radiology Department, Royal Medical Services, Amman, Jordan AUTHOR Mohammed Al-Hroot 4 FACS, Laparoscopic and Bariatric Surgery Consultant, Department of Surgery, Division of upper GI, laparoscopy and bariatric surgery, Royal Medical Services, Amman, Jordan AUTHOR Wael Ali Al-Na’ssan 5 FACS, Laparoscopic and Bariatric Surgery Consultant, Department of Surgery, Division of upper GI, laparoscopy and bariatric surgery , Royal Medical Services, Amman, Jordan. AUTHOR
CASE_STUDY A case report of primary hyperparathyroidism in pregnant female: clinical diagnostic and therapeutic procedures challenges Primary hyperparathyroidism (PHPT) is a disease caused by excessive secretion of parathyroid hormone (PTH), and occurs because of individual parathyroid adenomas.in this report we discussed prgnant 25 female who suffered from as weakness, lethargy, nausea and vomiting . Primary experimental results suggested severe hypercalcemia. Ultrasonography of patient’s neck revealed a cystic thyroid nodule (12.8mm) in mid of right lube. The observation suggested normal parotid and submandibular glands.Based on ultrasound and MRI results, the patient received protective treatment. Early diagnosis can helpful to best managament of primary hyperparathyroidism especially during the pregnancy. http://intjmi.com/article-1-279-en.pdf 2017-08-08 93 98 Primary hyperparathyroidism pregnancy hypercalcemia Tahereh Babaei 1 Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran AUTHOR Arash Rezaei Shahmirzadi 2 Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran AUTHOR Hossein Ghanadanhili 3 Department of neurology, Clinical Research Development Unit (CRDU), Sayad Shirazi hospital, Golestan University of Medical Sciences, Gorgan, Iran AUTHOR Seyed Arad Mosalammi Aghili 4 School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran. AUTHOR Seyed Fateme Zahra Hashemi Tervejeni 5 Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran. AUTHOR Hamide Akbari 6 Department of endocrinology, Clinical Research Development Unit (CRDU), Sayad Shirazi hospital, Golestan University of Medical Sciences, Gorgan, Iran. AUTHOR
CASE_STUDY Morgagni hernia in a 73-year-old woman: A case report. The majority of adult diaphragmatic hernias is due to a chronic hiatal hernia or caused by a diaphragmatic hernia. Compared to other different forms of congenital hernias, Morgagni hernias are relatively rare. Here we introduce a case of a 73-year-old woman diagnosed with Morgagni Hernia and the choice of treatment used for the patient. The patient, a 73-year-old woman, presented with abdominal pain with the onset of 10 days prior to her visit. In the chest x-ray silhouette sign on the right side border of the heart was seen that suggested a Morgagni hernia as our primary differential diagnosis. The patient was discharged 3 days after the operation. Studies show that a Morgagni hernia should be a differential diagnosis for any patient that presents with unspecific abdominal pain or respiratory symptoms. http://intjmi.com/article-1-280-en.pdf 2017-08-08 99 102 Morgagni Hernia Diaphragmatic Reza Afghani 1 Professor of thoracic, Faculty of Medicine, Golestan University of Medical Sciences, Golestan, Iran. AUTHOR Saeid Amirkhanlou 2 Department of Nephrology, Clinical Research Development Unit (CRDU), Sayad Shirazi hospital, Golestan University of Medical Sciences, Gorgan, Iran AUTHOR Hamed Jafarpour 3 Medical Student, Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran AUTHOR Arash Rezaei Shahmirzadi 4 Medical Student, Student Research Committee, Faculty of Medicine, Golestan University of Medical Sciences, Golestan, Iran AUTHOR Tahere Bakhshi 5 Student Research Committee, Faculty of ParaMedicine, Golestan University of Medical Sciences, Golestan, Iran AUTHOR
CASE_STUDY Inferior Vena Cava injury in an elderly man with penetrating abdominal trauma Inferior vena cava injury in abdominal trauma is rare but it puts a big problem in front of trauma surgeon. Despite improvements in preoperative care, skills and surgical facilities, inferior vena cava injury mortality rate remains high. The most important factors that play a prominent role in mortality are presence of shock on admission, anatomic level of vena caval injury or other major vascular and visceral injuries. In this article we have reported successfully treated a case of the inferior vena cava injury after penetrating abdominal trauma in old age man with hemorrhagic shock, survived due to immediate laparotomy, successful surgical management with team approach and critical postoperative surgical management without any residual complication. http://intjmi.com/article-1-281-en.pdf 2017-08-08 103 108 Inferior Vena Cava Massive haemoperitoneum abdominal trauma hemorrhagic shock Reza Motalebi 1 Golestan University of Medical Sciences, Trauma Centre, 5 Azar Hospitals, Gorgan, Iran. AUTHOR Mohammad Hadi Molseghi 2 Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran AUTHOR Arash Rezai Shahmirzadi 3 Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran AUTHOR Mahdi Babaei Hatkehlouei 4 Dentistry student, student research committee, Mazandaran University of medical science, sari, Iran AUTHOR Sohrab Malekmahmoudi 5 Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran. AUTHOR Saeid Amirkhanlou 6 Department of Nephrology, Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran. AUTHOR
CASE_STUDY Treatment of acute antibody-mediated rejection using Rituximab Introduction: One of the optimal therapies for most of the end-stage renal disease (ESRD) patients is transplantation. Acute Antibody Mediated Rejection is one type of acute rejection in which antibodies are directed against donor specific human leukocyte antigen (HLA). Rituximab is one kind of the drugs used for AMR treatment based on elimination of circulating Ab. It is a chimeric monoclonal Ab which is specific for human B lymphocyte– restricted differentiation antigen (CD20). Concerning the incidence of AMR in transplantation, existence of resistance to usual AMR therapy and their poor outcomes, we decided to use Rituximab (RTX) in treatment of AMR and to study its outcomes. Material/Patients: All patients who underwent renal transplantation from 2009 to 2014 in Chamran and Labbafinejad centers enrolled. these patients further receiving conventional therapy AMR (tacrolimus + Cellcept + corticosteroids ± PP), were treated with one or two dosage of RTX 500mg and the graft`s response and the patient's response to RTX were studied. Results: After 5-11 months follow-up, patients’ survival was 100% and grafts survival was 77%. In 17 patients renal function improved which the average creatinine (Cr) in the first month after treatment was 1.6+/-0.5 (P<0.001) and the average Cr in 6 month was 1.5+/- 0.8 (P<0.001).Conclusion: In comparison with outcomes reported before in treatment of AMR, our study obtained excellent outcomes in patient and graft survival (100% and 77% respectively). Our findings suggest that the usage of RTX in the treatment of AMR at least in short and medium term may be effective. http://intjmi.com/article-1-282-en.pdf 2017-08-08 109 115 Rituximab Renal Transplantation Acute Antibody-Mediated Rejection Saeid Amirkhanlou 1 Department of Nephrology, Clinical Research Development Unit (CRDU), Sayad Shirazi hospital, Golestan University of Medical Sciences, Gorgan, Iran AUTHOR Anna Rashedi 2 Department of Radiology, Clinical Research Development Unit (CRDU), Sayad Shirazi hospital, Golestan University of Medical Sciences, Gorgan, Iran AUTHOR Mohammad Hadi Molseghi 3 Medical Student, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran AUTHOR Mahdi Babaei Hatkehlouei 4 Dentistry student, student research committee, Mazandaran University of medical science, sari, Iran. AUTHOR Mohsen Nafar 5 Chronic Kidney Disease Research Center and Department of Nephrology, Shahid Labbafinejad Medical Center and Shahid Beheshti University of Medical Sciences, Tehran, Iran AUTHOR Fatemeh Rezaghoulipoor 6 Chronic Kidney Disease Research Center and Department of Nephrology, Shahid Labbafinejad Medical Center and Shahid Beheshti University of Medical Sciences, Tehran, Iran AUTHOR Arash Rezai Shahmirzadi 7 Student Research Committee, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran. AUTHOR
CASE_STUDY Aggressive Ulcerating Squamous Cell Carcinoma Arising In Old Burn Scar: A Case Report Carcinoma arising in posttraumatic ulcers and chronic wounds was first described by Jean- Nicholas Marjolin in 1828. Marjolin’s ulcers are malignant neoplasms that originate from chronic irritation such as burn wounds, venous stasis ulcers, traumatic wounds, osteomyelitis, fistulas, and lacerations, Burn wounds are the most frequent underlying etiology of Marjolin’s ulcers. We reported Marjolin’s ulcer that arising from very old burn scar in foot. http://intjmi.com/article-1-283-en.pdf 2017-08-15 116 120 Carcinoma Marjolin’s ulcer scar Masoud Shayesteh Azar 1 Associated Professor of orthopedic surgery, Orthopedic Research center, Mazandaran university of medical science, Sari, Iran AUTHOR Fatemeh Montazer 2 Assistant Professor, Dermatopathologist. Department of Pathology, Orthopedic Research center, Mazandaran University of Medical Science , Sari, Iran AUTHOR Mohammad Hossein Karimi Nasab 3 Associated professor of orthopedic surgery, Orthopedic Research center, Mazandaran university of medical science, Sari, Iran AUTHOR Abolfazl Kazemi 4 Orthopedic resident, Orthopedic Research center, Mazandaran university of medical science, Sari, Iran AUTHOR Soroush Felezi 5 Pathology Resident, department of pathology, Mazandaran university of medical science, sari, Iran AUTHOR Hamed JafarPour 6 Medical student, Student research committee, Mazandaran university of medical science ,sari, Iran AUTHOR