Hajar Khazraei
Shiraz University Of Medical Sciences, Surgery, Faculty Member
PurposeWounds with dead tissue, purulent wounds, and gangrene are good options for larval therapy. We aim to investigate the effect of larval therapy on diabetic wounds and compare it with traditional treatment.MethodsThe sterile larvae... more
PurposeWounds with dead tissue, purulent wounds, and gangrene are good options for larval therapy. We aim to investigate the effect of larval therapy on diabetic wounds and compare it with traditional treatment.MethodsThe sterile larvae were used in wound treatment and the infection rate, Erythrocyte Sedimentation Rate (ESR), and wound size were measured and compared before and after the treatment.ResultsThe scars of 40 patients in the larval therapy group were evaluated every 10 days and the mean size of the scar decreased from 38.5 cm (36.6 cm) before treatment to 5.0 cm (6.6 cm) after 60 days. ESR mean was decreased from 57.3 (18.3) before treatment to 15.8 (4.8) after treatment in the larval therapy group. These parameters were significantly decreased compared to the debridement group (p < 0.001).ConclusionsLarval therapy is effective in diabetic wound healing. The size of the wound after larval treatment is smaller than before. There was no difference between the two groups for infection rate. ESR was significantly decreased in the larval therapy group that indicating the lower inflammation in this group.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40200-022-00973-w.
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The aim of this study was to correlate the connection between self-management behaviors and anthropometric indices after Roux-en-Y gastric bypass (RYGB). A sample of 180 patients suffering from obesity were treated with RYGB in 2019; 6... more
The aim of this study was to correlate the connection between self-management behaviors and anthropometric indices after Roux-en-Y gastric bypass (RYGB). A sample of 180 patients suffering from obesity were treated with RYGB in 2019; 6 and 18 months after surgery, anthropometric indices, including weight, waist circumference, waist- to-height ratio, body mass index (BMI), and waist-to-hip ratio, were gauged, and participants completed the post-bariatric surgery self-management behaviors questionnaire. Correlation matrix results showed that all anthropometric indices had a significant positive relationship with self-management behaviors after RYGB; the results of the 18-month post-surgical follow-up exhibited no significant difference between anthropometric indices and self-management behaviors, 6 and 18 months after surgery. Therefore, the more self-management behaviors increase, the greater decrease in anthropometric indices will happen after RYGB.
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Background: Mortality among Iranian patients with colorectal cancer has not been fully examined and the factors associated with their survival are still controversial. This study aimed to determine the mortality rate and its related... more
Background: Mortality among Iranian patients with colorectal cancer has not been fully examined and the factors associated with their survival are still controversial. This study aimed to determine the mortality rate and its related factors among the patients with colorectal cancer in southwestern regions in Iran. Materials and methods: This prospective cohort study was conducted on 220 patients with colorectal cancer referred to Fahighi Hospital, Shiraz, Iran from 2009 to 2014. Data were collected from the patients' medical records and were analyzed using Cox regression analysis. Results: Over a median follow-up of 29.3 months, 56 out of the 220 patients (25.5%) died, 32 (14.5%) aged below 40 years, and 45.5% were female. Based on the results of multiple Cox regression analysis, family history of gastrointestinal cancer, stage III, former smoking, type of lesion (fungative and polypoid), and opium use were associated with a greater risk of colorectal cancer mortality (all <0.05). Conclusions: This cohort study found that the mortality rate of colorectal cancer in Iran is lower than that in European countries. In addition, behavioral and clinical factors were significantly associated with the survival rate. Addressing the related factors would help healthcare providers and physicians provide the best care and improve the survival rate.
Research Interests: Cancer, Medicine, Colorectal cancer, Iran, Prospective studies, and 15 moreHumans, Internal Medicine, Europe, Female, Pubmed, Male, Regression Analysis, Registries, Middle Aged, Adult, Public health systems and services research, Proportional hazards model, Risk Factors, Mortality rate, and Colorectal Neoplasms
Background: There are several scolicidal agents for inactivation of hydatid cyst protoscolices during surgery, but most of them are associated with adverse side effects such as sclerosing cholangitis (SC) and liver necrosis. The present... more
Background: There are several scolicidal agents for inactivation of hydatid cyst protoscolices during surgery, but most of them are associated with adverse side effects such as sclerosing cholangitis (SC) and liver necrosis. The present study aimed to evaluate the adverse effects of Eucalyptus essential oil to induce SC in animal models. Materials and Methods: Eighteen rabbits weighting 2000–3500 g were included in three groups for this study. About 0.3 ml of Eucalyptus essential oil (1%), or 5% hypertonic saline, or normal saline was injected for 5 min in the gallbladder. After 4 months, the liver, common bile duct, and duodenum were resected and immediately sent for cholangiography and pathologic studies. Results: According to pathological studies, inflammation is more common in Eucalyptus and hypertonic saline groups. Due to cholangiographic studies, stricture was slightly higher in the hypertonic saline group than the Eucalyptus group. Conclusion: Thus, 1% Eucalyptus essential oil is at least as safe as 5% hypertonic saline, but for clinical uses, it must be confirmed with further studies.
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Background: Rectal cancer is a malignant tumor of the digestive tract and as it is a widespread condition it demands comprehensive research. At the time of the writing of the present study, COVID-19 infection rates are rising rapidly in... more
Background: Rectal cancer is a malignant tumor of the digestive tract and as it is a widespread condition it demands comprehensive research. At the time of the writing of the present study, COVID-19 infection rates are rising rapidly in Iran and the study attempts to make an evaluation of the country’s rectal cancer management during the pandemic. Methods: 83 patients were divided into two groups and closely studied. The first group underwent rectal cancer surgery during a 9 month period in 2019, while the second group underwent the same process during the same amount of time in 2020. Demographic data, surgery and outcomes after surgery were assessed and compared between the two groups. The data were analyzed by SPSS (statistical analyzer software, ver. 22). Results: The age, weight, height, BMI, size of tumor, and numbers of involved lymph nodes were not different between the two groups. The radiotherapy techniques were significantly different between two groups (p=0.012). Neoadjuvant long course chemoradiation therapy was changed to short-course radiation therapy during the pandemic and hospital stay for the patients was significantly longer during the pandemic (p=0.010). There is no difference in the recurrence or overall survival between the two groups. Metastasis was seen in six patients in the 2019 group,, whereas this phenomenon was not observed in the 2020 group. . The size of tumors were larger in the 2020 group, but it was not statistically different (p=0.064).Conclusion: Cancer is a highly complicated and problematic decease which stresses the importance of immediate diagnosis and treatment; however during the COVID-19 pandemic, medical centers may need to take additional measures to protect their cancer patients.
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Toxic effects of vegetables have been the subject of numerous investigations in recent years. Eucalyptus globulus of the Myrtaceae family has been traditionally used in the treatment of various infectious disorders. This study aims to... more
Toxic effects of vegetables have been the subject of numerous investigations in recent years. Eucalyptus globulus of the Myrtaceae family has been traditionally used in the treatment of various infectious disorders. This study aims to assay the potential anticancer effect of Eucalyptus globulus essential oil, in vitro, and compare its cytotoxic effects on cancerous and non-cancerous cell lines. The cytotoxicity of the Eucalyptus globulus essential oil was evaluated in colon cancer cell line SW48, liver cancer cell line HepG2, HEK293t, and skin fibroblast using the MTT assay. We used 5-FU as the control treatment for cancer. The essential oil was diluted by phosphate buffer saline in cell culture. Eucalyptus globulus essential oil with the concentration of 0.01% did not reduce the cell viability of SW48 (IC50 = 0.2%) and fibroblast cells (IC50 = 5%) after a 48-h treatment period. Eucalyptus globulus essential oil did not also exhibit any toxic effects on HEK293t and HEPG2 cell lines, except in high dose (0.5%) with IC50 = 0.2% for both of the cell lines. Eucalyptus essential oil showed some side effects and might not be safe to use for treatment at high doses (0.5% and 5%). Moreover, the findings of the present study show that eucalyptus essential oil suppressed the proliferation of human colon cancer cells by inducing apoptosis. Eucalyptus essential oil might be a good candidate for the treatment of colon cancer.
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Background Adaptive cognitive emotion regulation (CER) strategies toward eating play a very important role in obesity and according to schema therapy, patients with obesity learn that don't respond to their emotional stimuli by... more
Background Adaptive cognitive emotion regulation (CER) strategies toward eating play a very important role in obesity and according to schema therapy, patients with obesity learn that don't respond to their emotional stimuli by eating. Thus, this study aimed to evaluate the effectiveness of an online video-based group schema therapy in improvement of the CER strategies and body mass index (BMI) in women who had undergone bariatric surgery. Methods Forty women who had undergone sleeve gastrectomy were selected and randomly divided into two groups of control and experimental. The experimental group received 10 weekly 90-min sessions of group schema therapy, the control group did not receive any intervention at all. Both groups completed the CER strategies questionnaire during pre-test, post-test and follow-up stages, and the data were analyzed using a multivariate analysis of covariance (MANCOVA) through SPSS software (version 20). Results Our results indicated that the experiment...
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BACKGROUND: Parkinson’s disease is a neurodegenerative disorder characterized by degeneration of dopaminergic neurons in the substantia nigari. Previous studies have shown that Helicobacter pylori (H. pylori) infection is associated with... more
BACKGROUND: Parkinson’s disease is a neurodegenerative disorder characterized by degeneration of dopaminergic neurons in the substantia nigari. Previous studies have shown that Helicobacter pylori (H. pylori) infection is associated with treatment and clinical response to Parkinson’s disease. In the present study, we aimed to investigate the effect of H. pylori infection in the pathogenesis of Parkinson’s disease. METHODS: 75 patients who suffered from Parkinson’s disease and H. pylori infection and 91 healthy controls were recruited. All the subjects were evaluated for serum IgM, IgG, and IgA antibodies as well as TNF-α, IL-6, and IL-4 cytokines by Enzyme-Linked ImmunoSorbent Assay (ELISA)methods. RESULTS: The participants included 102 men and 64 women with a mean age of 66±10.2 and 52.6±10.7 years in the patients and control groups, respectively. The level of IgG, TNF-α, IL-6 in the patients with Parkinson’s infected with H. pylori was significantly more than that in the control g...
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The present study explored three-dimensional spatial arrangements of the cardiomyocytes and microvessels within the heart of rats and evaluated the arrangement for differences after diabetes using second-order stereology. Isector method... more
The present study explored three-dimensional spatial arrangements of the cardiomyocytes and microvessels within the heart of rats and evaluated the arrangement for differences after diabetes using second-order stereology. Isector method was applied to obtain isotropic uniform random sections of the heart. The pair correlation g(r) and cross-correlation functions were estimated by counting dipole probes (with length of 3.57 μm) superimposed on histological sections of the heart. The co-variograms indicated that the curve of g(r) for the cardiomyocyte showed a gap between cardiomyocytes at r=21-25 μm in the control rats and a wider gap at r=18-50 μm in diabetic hearts. Estimates of g(r) for the vessels also showed a wider gap (at r=25-39 μm) in diabetic hearts compared to the control rats (r=25-32 μm). These indicate a negative correlation (repulsion) between the cardiomyocytes and microvessels in the diabetic hearts. Evaluation of the cross-correlation function of the cardiomyocytes and microvessels showed that at 32-36 μm, both structures had a negative correlation in the control group, but not in the diabetic rats. Dissociation of the cardiomyocytes at some places can be seen in diabetic heart. This can be seen also in microvessels. Neither cardiomyocytes nor microvessels are arranged normally after diabetes.
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Ranolazine is a new antianginal drug that is postulated to act through blocking of cardiac late sodium channels and improvement in cardiac blood flow. The present study has been carried out to investigate its possible effect on... more
Ranolazine is a new antianginal drug that is postulated to act through blocking of cardiac late sodium channels and improvement in cardiac blood flow. The present study has been carried out to investigate its possible effect on microcirculation of normal and diabetic rats’ cardiac muscle. Normal and diabetic rats were anesthetized.The chest was opened and a surface laser Doppler flowmeter probe was sutured on the left ventricle next to the left anterior descending branch of the coronary artery. After 30 minutes of animal adaptation, baseline flow was recorded.Thereafter, ranolazine was injected intravenously (10 mg/kg) through the jugular vein and the changes in the cardiac blood flow were measured every 5 minutes for 30 minutes. Systolic blood pressure and heart rate were also recorded. Although, injection of ranolazine resulted in some reduction of cardiac blood flow, no significant changes were observed in normal and diabetic animals. Ranolazine had no significant effect on systolic blood pressure of either groups studied. Nevertheless, it caused a mild but statistically significant increase in the heart rate of diabetic and normal rats. In conclusion, in normal and diabetic rats, no evidence of improvement in intramyocardial blood flow by ranolazine was obtained.
Research Interests: Cardiology, Microcirculation, Medicine, Biological Sciences, Blood Pressure, and 12 moreAnimals, Male, Heart rate, Rats, Time Factors, Blood Flow, Coronary Circulation, Experimental Diabetes Mellitus Type 1 and 2, Blood Flow Velocity, Laser Doppler Flowmetry, Ranolazine, and Medical and Health Sciences
Internal mammary artery (IMA) and saphenous vein (SV) are two most common vessels used in coronary artery bypass grafting (CABG). In the present study, the effect of levosimendan (a novel inotropic/vasodilator compound) and papaverine are... more
Internal mammary artery (IMA) and saphenous vein (SV) are two most common vessels used in coronary artery bypass grafting (CABG). In the present study, the effect of levosimendan (a novel inotropic/vasodilator compound) and papaverine are compared, using IMA and SV obtained from CABG patients. Unused segments of IMA and SV of each patient were cut into two rings of 3 mm length. Four rings (two from IMA, two from SV) were suspended in an organ bath, contracted with norepinephrine and then the responses to the cumulative concentrations of levosimendan and papaverine were recorded. Levosimendan relaxed IMA but failed to relax SV completely. In addition, its IC50 value (concentration which reduced 50% of initial contraction) to relax SV was about 300 times higher than the IC50 value for IMA. Its arteriodilating concentration was in the range of its clinically effective inotropic concentration. Papaverine relaxed both vascular preparations completely. Its IC50 value was about 2.4 times higher toward SV in comparison to that of IMA. It is concluded that levosimendan is much more potent to relax norepinephrine-induced contraction of human IMA in comparison to its effect on human SV. It may have the potential to be used as a mixed inotropic/arteriodilator compound in several clinical settings including CABG in which it can increase cardiac contractility and prevent IMA vasospasm.
Research Interests: Cardiology, Comparative Study, Medicine, Humans, Internal Medicine, and 15 moreFemale, Male, Norepinephrine, Aged, Middle Aged, Hydrazones, Muscle Relaxation, Cumulant, Contractility, Coronary artery bypass graft, Levosimendan, inotrope, Nicorandil, Pharmacology and pharmaceutical sciences, and In Vitro Techniques
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Background: Anastomotic leakage is a significant complication after colorectal anastomosis. The aim of this study was to evaluate the risk factors and preventive measures for anastomotic leakage after rectal cancer surgery. Methods: A... more
Background: Anastomotic leakage is a significant complication after colorectal anastomosis. The aim of this study was to evaluate the risk factors and preventive measures for anastomotic leakage after rectal cancer surgery. Methods: A total of 171 patients who had undergone laparoscopic and open rectal cancer resection with a double stapling participated in this study. Twelve independent variables include age, sex, obesity, smoking, ASA grading, medical diseases, preoperative radiotherapy, preoperative chemotherapy, splenic flexure mobilization, diverting ileostomy, and the number of stapler firing were analyzed. Results: The anastomotic leakage rate was 2.33% (4 of 171). The mean age of the patients was 58.33 years old while their mean body mass index (BMI) was calculated as 24.10 kg/m2. In our study, 16.3% of patients were cigarette smokers. Of the 171 rectal surgeries, 69.0% of patients were diverted by loop ileostomy and 1.16% were supported by ghost ileostomy. Of 171 patients i...
Background: Emotions, attitudes, and behaviors toward eating play a very important role in obesity and according to a schema-based approach; patients with obesity learn some coping strategies since childhood to cope with the schemas. So,... more
Background: Emotions, attitudes, and behaviors toward eating play a very important role in obesity and according to a schema-based approach; patients with obesity learn some coping strategies since childhood to cope with the schemas. So, this study aims to evaluate the effectiveness of group schema therapy on the cognitive emotion regulation (CER) strategies in women who underwent bariatric surgery during COVID-19.Methods: Forty women who underwent bariatric surgery were selected and were randomly divided into two groups of control and experimental. The experimental group received ten 90-min sessions of group schema therapy. Both groups completed the CER questionnaire during pre-test, post-test and follow-up stages and data were analyzed using a multivariate analysis of covariance (MANCOVA) in SPSS software (version 20). Results: Our results indicated that the differences between two groups in variables of adaptive CER strategies (P = 0.0001, F = 31.15) and maladaptive CER strategie...
Wounds with dead tissue, purulent wounds, and gangrene are good options for larval therapy. We aim to investigate the effect of larval therapy on diabetic wounds and compare it with traditional treatment. The sterile larvae were used in... more
Wounds with dead tissue, purulent wounds, and gangrene are good options for larval therapy. We aim to investigate the effect of larval therapy on diabetic wounds and compare it with traditional treatment. The sterile larvae were used in wound treatment and the infection rate, Erythrocyte Sedimentation Rate (ESR), and wound size were measured and compared before and after the treatment. The scars of 40 patients in the larval therapy group were evaluated every 10 days and the mean size of the scar decreased from 38.5 cm (36.6 cm) before treatment to 5.0 cm (6.6 cm) after 60 days. ESR mean was decreased from 57.3 (18.3) before treatment to 15.8 (4.8) after treatment in the larval therapy group. These parameters were significantly decreased compared to the debridement group (p < 0.001). Larval therapy is effective in diabetic wound healing. The size of the wound after larval treatment is smaller than before. There was no difference between the two groups for infection rate. ESR was significantly decreased in the larval therapy group that indicating the lower inflammation in this group.
Background: Vegetable oils recently have been evaluated in many tissues. Pistacia lentiscus (mastic) of the Anacardiaceae family and Sesamum indicum (sesame) of the Pedaliaceae family are conventionally used in the management... more
Background: Vegetable oils recently have been evaluated in many tissues. Pistacia lentiscus (mastic) of the Anacardiaceae family and Sesamum indicum (sesame) of the Pedaliaceae family are conventionally used in the management of gastrointestinal, lung, and skin illnesses. This assay attempts to determine if the oral usage of mastic and sesame oils has any short-term toxic effects in vivo on the rat and evaluate the human anticancer effect in vitro. Materials and Methods: Twenty-one male Sprague-Dewley rats were assigned to three groups randomly: (A) control, (B) mastic oil (400 mg/kg), and (C) sesame oil (2cc/kg). The effects of these oils were investigated by determining histopathological and stereological parameters after six days, and the anticancer effects were evaluated on SW48, HepG2 human cell lines. Results: A mild chronic interstitial inflammation was seen in just one kidney of mastic oil group (B) and the other oneswere normal. In the sesame oil group (C), mild chronic in...
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Background: Zataria multiflora Boiss is a well-known medicinal plant and its’ essential oil (EO) is traditionally used for treatment of respiratory and digestive disorders and/or bacterial, viral, fungal, and parasitic infections.... more
Background: Zataria multiflora Boiss is a well-known medicinal plant and its’ essential oil (EO) is traditionally used for treatment of respiratory and digestive disorders and/or bacterial, viral, fungal, and parasitic infections. Objective: This study was undertaken to evaluate the effect of long-term consumption of Z. multiflora EO on hematological and biochemical parameters in patients infected with liver hydatid disease. Materials and Methods: Fifteen patients were administered orally with Z. multiflora EO (60 mg daily) for six months. Hematological and biochemical analysis were performed on the blood samples of patients before the start of treatment and after completion of the treatment course. In hematological analysis, WBC, RBC, Hb, hematocrit, MCV, MCH, MCHC and platelets were measured. In biochemical analysis, FBS, BUN, creatinine, cholesterol, triglycerides, HDL, LDL, Na, K, Cl, AST, ALT, and ALK were assessed. Results: No apparent changes were observed in the values of he...
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Dear Editor: Sacral nerve stimulation (SNS) is a minimally invasive surgical procedure which exerts chronic electrical stimulation of nerves in sacral plexus and influences organs which are innervated by these nerves [1]. The beneficial... more
Dear Editor: Sacral nerve stimulation (SNS) is a minimally invasive surgical procedure which exerts chronic electrical stimulation of nerves in sacral plexus and influences organs which are innervated by these nerves [1]. The beneficial effect of sacral nerve stimulation (SNS) on bowel, bladder, and sexual function has been previously reported in patients with neurological deficit. However, this effect was not yet evaluated in spinal cord injury (SCI). Here, we investigated the outcomes of SNS in three patients who underwent implantation of permanent interStim lead in third sacral foramen. This report is the preliminary report of a phase one clinical trial in evaluating safety and efficacy of SNS implementation in patients with SCI. The selection process of patients included six stages before implanting the device and four episodes of follow-up after surgery. In the first stage, potentially suitable patients were screened and were referred by a colorectal surgeon. In stage two, patients were selected based on inclusion and exclusion criteria, and written consents were obtained after explaining adequate information. Inclusion criteria were (1) age between 18–50 years, (2) incomplete spinal cord lesion, (3) minimum post injury duration of 2 years, (4) existence of urination and defecation incontinence as a consequence of spinal cord injury, (5) intact external sphincter and levator ani muscles (which is confirmed by physical examination accompanied by anal endosonography and/or MRI), (6) defecation frequency less than once a week and/or fecal incontinence, (7) existence of no other treatment options for patients with constipation or incontinence according to neurology and neurosurgery consultation, (8) existence of stable emotional status confirmed by psychiatry consult, (9) intertractable constipation (defecation less than twice a week or having difficulty in defecation with feeling incomplete evacuation in more than 25% of attempts), (10) being completely conscious and well-informed by signing the consent form, and (11) being able to use hands in applying the device and recording defecation habits. Exclusion criteria were (1) complete pudendal nerve damage (confirmed by EMG/NCV), (2) history of inflammatory bowel disease (IBD) or irritable bowel syndrome (IBS) (if necessary, mentioned IBD was ruled out by using colonoscopy), (3) pregnant patients or intention to become pregnant, (4) history of a congenital anorectal disorder, (5) mental retardation (confirmed by psychiatry consultation), (6) history of rectal prolapse or anterior resection, (7) active skin infection, bed sore, or existence of pilonidal cyst, and (8) non-repairable destruction of external sphincter and levator ani muscles. Before the patients were trained to perform biofeedback exercises, some investigations were performed including: anorectal manometry, urodynamic assessment, evaluation of life quality with SF-36 questionnaire, estimation of ‘Cleveland constipation score’ (CCS), estimation of sexual activity, and satisfaction with the International Index of Erectile Function (IIEF) questionnaire and Visual Analog Scale (VAS) (stage 3). In stage 4, biofeedback exercises of anal sphincter were explained and taught to patients and after 6 weeks the same tests and evaluations in stage 3 were performed (stage 5). In stage 6, test lead was A. N. Javidan : S. Latifi :M. M. Maghari (*) :H. Saberi : A. Nikfalah : S. A. M. Daryasari :M. S. Yekaninejad Brain and Spinal Injury Research Center (BASIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, Gharib Street, PO box: 6114185, Tehran, Iran e-mail: mmmaghari@hotmail.com