حسین یارمحمدی

Transient cortical blindness (TCB) is an unusual postoperative complication following cardiac surgery. In this report, we present the case of a 54-year-old female who developed TCB after undergoing coronary artery bypass grafting (CABG) surgery. Her vision gradually improved over the course of two months post-operation. No causative ocular damage was found upon ophthalmologic examination, and assessments of related arteries (carotid, vertebral, and ophthalmic) were entirely normal. Following the onset of blindness, a non-contrast computed tomography scan showed bilateral subarachnoid hyperdensities in the occipital and parietal lobes. Magnetic resonance imaging was performed to confirm the presence of cerebral hemorrhage, but no pathology was detected. While the exact mechanism of TCB remains unclear, recognizing this potential complication after CABG is crucial.

Despite significant publications in cancer survivorship, a scoping review was needed to picture the current interests and achievements of lymphedema research, as well as gaps and opportunities in Iran. Databases such as PubMed, Scopus, Google Scholar, and Persian databases (SID and MagIran) were searched to collect data. The main topics were divided into four major categories: treatment, prevention, diagnosis, and complications. Moreover, the level of evidence (LoE) was determined based on the Oxford Criteria 2009. After screening, of the 105 articles included in this study, 68 (64.7%) were English. The number of published articles increased to 14 (13.3%) and 56 (53.3%) during the first (2000-2009) and second (2010-2019) decades, respectively. In addition, 32 (30.4%) articles were published during 2020-2023. The majority of articles were related to breast cancer-related lymphedema (64.7%) and interventional trials (46.6%, 18.1% were RCTs), with the LoE of 1 and 2 (44.7%). The topic of treatment was the most investigated topic among the included articles (51.6%), and valuable studies were recently published about the prediction of lymphedema using machine learning and artificial intelligence. This scoping review showed an increasing trend of lymphedema research in Iran during the past years. Most of the research output is focused on the treatment of breast cancer-related lymphedema (BCRL) and studies on animal models and epidemiology of lymphedema are the main gaps in this field.

Prostatic adenocarcinoma (PAC) is one of the most common tumors worldwide. Immunohistochemical expression of cytokeratins has been evaluated in the diagnosis and prognosis of tumors. The aim of the present study is the evaluation of Cytokeratin-7 (Ck-7) and Cytokeratin-19 (Ck-19) expression and its relationship with Gleason score in patients with PAC.

In this cross-sectional study, 78 samples from 78 patients with PAC referred to Mostafa Khomeini Hospital were gathered. Samples were immunohistochemically stained by Ck-7 and Ck-19 markers. The percentage of each marker in tumor cells was determined, and its relationship with Gleason scores and Gleason grade groups was analysed by SPSS version 24.

The expression of Ck-7 and Ck-19 were seen in 37.2% and 82.1% of samples, respectively. The mean of Ck-7 expression in tumor cells was 4.98%±7.19 (ranged 0 to 26%), while the mean of Ck-19 expression was 41.02%±23.36 (ranged 0 to 78%). There was no relationship between Ck-7 expression with Gleason scores and Gleason grade groups. However, Ck-19 expression was increased in higher Gleason scores and Gleason grade groups (P<0.001). No relationship was found between age and Ck-7 (P=0.309) and Ck-19 (P=0.375).

The Ck-7 expression in PAC samples is weak and focal and had no relationship with the Gleason scores and Gleason grade groups. However, Ck-19 expression in PAC was high and was associated with tumor dedifferentiation of samples. There was no relationship between the expression of both markers with the patient's age.

The important role of physical activity in the prevention and management of diabetes necessitates a review of current research to shed light on gaps in national diabetes guidelines.

This scoping review was part of the Iran Diabetes Research Roadmap (IDRR) study. A systematic search was used based on the Arksey and O’Malley method consisting of six steps. The descriptive analysis was done with SPSS software. Additionally, VOS veiwer software was used to draw the knowledge map of the included studies.

There were 169 articles included from the beginning of 2015 to the end of 2019 in Iran. Aerobic and resistance exercises were types of physical activity with more number of articles. Most of the included clinical studies were randomized clinical trials in design and had a level of evidence two. Also, there was more interest in outcomes such as glycemic control and insulin sensitivity, metabolic syndrome, metabolism, and cardiovascular health. The network of co-authorship was drawn, and "controlled study", "male", and "rat" were the most frequent keywords.

The number of Iranian diabetes researchers on physical activity has been increasing, and the majority of clinical studies had a high level of evidence. With maintaining previous interests and investigations, there should be more emphasis on research in elderly and children age groups as evidence gap in Iran. Also, longitudinal cohort studies should be highlighted, and Iranian researchers should be encouraged to participate in new topics of research worldwide.

 The 2019 coronavirus disease (COVID-19) is threatening public health in many ways. The psychological situation of individuals is important and limited data is available from Iran. In this study, we aimed to illustrate the psychological distress of the general population and evaluate factors affecting it. 

 An online cross-sectional survey was done from 29th to 31st March 2020 in South Khorasan province, affected later than other parts of the country. We included sociodemographic questions, Hospital Anxiety, and Depression Scale (HADS) questionnaire and questions addressing various symptoms and diseases. Most questions had multiple choices to be chosen from and some were open questions. Univariate and multivariate analysis in SPSS software were used to find significant relationships.

 A total of 844 responses were collected, from which 788 records were included in the analysis. The mean age of responders was 36.61 ± 10.97 (age range: 18-88) and 484 (61.4%) of them were female. The mean scores in the anxiety and depression subscale of the HADS questionnaire were 7.01±3.68 and 6.72±3.71 respectively. Experiencing cardiovascular and COVID-19 related symptoms was significantly associated with a higher number of individuals having abnormal anxiety and depression results (p value<0.001). Widowed individuals, females and those experiencing above-stated symptoms showed a significant association with increased anxiety and depression in multivariate analysis.

 Although many existing elements influence the psychological well-being of society during a pandemic, experiencing symptoms related to other diseases or having multiple chronic diseases may cause an extra burden on the psychological state of the society.

 Lymphedema is one of the most disturbing complications of breast cancer treatment and some routine medical procedures such as blood pressure (BP) monitoring or injections have been reported to be the major risk factors for lymphedema. This systematic review aimed to shed light on the safety of some medical procedures among breast cancer survivors with and without lymphedema.

 An electronic systematic search in Pubmed and Scopus was undertaken from 1 January 1992 to 12 May 2020 and all relevant studies were summarized in a table based on the PRISMA guideline.

 Twenty-three articles were included from which 11 and 8 articles were prospective and retrospective original studies, respectively. The remaining 4 articles were case reports. BP measurement, injections, blood draw, and hand surgeries were the medical procedures of interest. Most of the included studies have reported that these medical procedures did not result in lymphedema initiation or worsening in breast cancer survivors; however, case reports of the harmful effects of these procedures were also included in this systematic search.

 Although recent well-designed prospective studies did not show any significant side effects from medical procedures in breast cancer survivors, concerns exist for both healthcare staff and patients. Additionally, it seems that there are specific aspects that have not been investigated properly in previous studies and should be considered in future studies.

Some tests and markers have proved to improve the diagnosis of prostate cancer (PCa). This meta-analysis aimed to review the diagnostic accuracy of three commercial tests, prostate health index (PHI), prostate cancer antigen 3 (PCA3), and prostate imaging reporting & data system V2 (PI-RADS) for detecting of PCa.

We did a comprehensive literature search of international databases including Scopus, Web of Science, and PubMed from January 2000 to Feb 2018. We included three groups of diagnostic accuracy studies that used PCA3, PHI, and PI-RADS to assess PCa. The l quality of the study was measured by the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) criteria.

Twenty-six studies on PHI, 24 articles on PI-RADS, and 26 papers on PCA3 were included for the meta-analysis. For the diagnosis of PCa, the sensitivity and specificity were 0.76 and 0.84 for PI-RADS, 0.48 and 0.85 for PHI, 0.49 and 0.79 for PCA3. Also, the derived area under curves (AUC) from the hierarchic summary ROCs (HSROCs) were 0.86 (95% CI, 0.83-0.89) for PI-RADS, 0.72 (0.68-0.76) for PCA3, and 0.70 (0.66-0.74) for PHI. Fagan’s nomograms showed that the post-test probability of cancer subjects with a positive test was 53%, 63%, and 45%, for PHI, PI-RADS, and PCA3 respectively.

Currently, available evidence suggests that the PI-RADS is superior in the diagnosis of PCa with high sensitivity, specificity, and AUC compared to PHI and PCA3.