مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران
سال هفتاد و نهم شماره 6 (پیاپی 246، شهریور 1400)

The recording of electrophysiological activities of brain neurons in the last half-century has been considered as one of the effective tools for the development of neuroscience. One of the techniques for recording the activity of nerve cells is the multi-electrode arrays (MEAs). Microelectrode arrays (MEAs) are usually employed to record electrical signals from electrogenic cells like neurons or cardiomyocytes. MEAs consist of an array of planar or three-dimensional electrodes that act as electrical interfaces and record cellular signals or stimulate cells. These platforms can be used in different applications including neuroscience studies, prostheses and rehabilitation, deep brain stimulation (DBS), cardiac pacemakers, retinal and cochlear implants, or for brain-computer interfaces (BCI) in general. Multi-electrode arrays are known as long-term recording and non-invasive devices. The MEA structure includes arrays of electrodes with micrometer and nanometer dimensions which are designed to stimulate and record the electrical activity of cells, and are fabricated using micromachining technologies. MEAs should be biocompatible to serve as a substrate for cell growth. On the other hand, they must have low impedance to be able to provide a high signal-to-noise ratio, and small size to offer a suitable spatial resolution for recording. MEAs are usually fabricated on glass substrates patterned with high-conductivity metals such as gold, iridium or platinum, which are insulated with a biocompatible layer. Despite fast progress, current multi-electrode arrays for neural applications still face limitations such as low signal-to-noise ratio and spatial resolution. To achieve better spatial resolution and lower noise levels and therefore more accurate signal, it is necessary to develop arrays with smaller sizes and lower impedance. Meanwhile, many nanostructures such as graphene, carbon nanotubes, gold nanoparticles, and also conductive polymers have become attractive candidates for this application due to their interesting properties. In this paper, the technology of multi-electrode arrays, how it works and its various parts are introduced, and finally, the challenges and developments in this field are investigated. Multi-electrode array technology is used for neuroscience research, neural network analysis, drug effects screening, and neural prosthesis studies.

Prostate cancer is the most common malignancy in men and the second leading cause of death in all countries of the world. The exact mechanism of prostate cancer is not known. On the other hand, early detection of prostate cancer can lead to a complete cure. Several clinical experiments including Digital Rectum Examination (DRE), biochemistry such as Prostate Specific Antigen (PSA), and pathology such as Trans Rectal Ultra Sonography (TRUS) are used to assess the size and spread of prostate cancer. In this study, the relationship between mean serum PSA and Gleason score as a standard method in patients with prostate cancer was compared using the parameters extracted from DCE MRI.

This applied-fundamental study was performed on 90 patients with prostate cancer, according to McDonaldchr('39')s criteria who were referred to Shafa Imaging Center in Isfahan, from March 2020 to October 2020. Quantitative analysis is based on modeling the change of concentration of the contrast agent using pharmacokinetic modeling techniques. The pathologist then determined the Gleason score using anatomical landmarks (such as prostate urethra) in the same areas suspected of being cancerous. Existing commercial software captures DCE-MRI data and creates parametric maps such as Ktrans and Kep maps that can be used for diagnostic purposes.

Kep and Ktrans maps showed a significant difference between healthy and cancerous tissue. Kep and Ktrans in prostate cancer were significantly higher than in healthy tissue (P<0.05). Pearson correlation coefficient was used to investigate the relationship between DCE-MRI parameters and histopathological findings. No significant relationship was observed between Gleason score and DCE MRI parameters.

DCE MRI parameters significantly improve the accurate diagnosis of prostate cancer and are useful and effective for diagnosis, management, and evaluation of men with prostate cancer, but should not be considered as a substitute for tissue biopsy.

The risk of anesthesia increases with age, so it is necessary to choose a safe and effective method. In this study, we compared the effectiveness of intranasal fentanyl with intravenous fentanyl in patients undergoing cataract surgery.

This study was a triple-blind prospective randomized clinical trial (The patient, physician, and data analyzer were unaware of the patient grouping). The study was performed from April 2017 to March 2019 in Feyz Hospital, Isfahan, Iran. 90 patients over 18 years of age who were candidates for cataract surgery were included in the study and were divided in two groups receiving intravenous fentanyl (IVF) or intranasal fentanyl (INF). The dose of fentanyl in both groups was 1.5 μg/kg with a maximum of 100 μg. In the IVF group, 1 ml of normal saline was dripped into each nasal passage 10 minutes before surgery and intravenously fentanyl was injected 2 minutes before surgery. In the INF group, 1 ml of fentanyl was administered into each nostril 10 minutes before surgery and 2 ml of saline was administered intravenously two minutes before surgery.

In this study, there was no significant difference between the two groups in terms of mean heart rate (P=0.762), mean arterial blood oxygen saturation (P=0.262), mean systolic blood pressure (P=0.264), mean arterial blood pressure (0.462), satisfaction rate Patient (P=0.231), duration of surgery (P=0.612) and pain intensity (P=0.87). But in the intravenous fentanyl group (IVF), the level of sedation (P=0.002) and the level of surgeon satisfaction (P<0.001) were higher than intranasal fentanyl group (INF). There was no significant difference between the two groups in terms of side effects (P=0.171) and surgery time (P=0.612). The mean VAS was not significantly different between the two groups.

The study showed that intranasal administration of fentanyl compared with intravenous administration of fentanyl provided similar sedation and cardiovascular response. Intranasal administration of fentanyl is a non-invasive, safe and effective method, that is easy to use and can be a viable alternative to intravenous administration.

Acute compartment syndrome is considered a debilitating complication of limb trauma. Early detection of this compartment syndrome helps us in the early initiation of treatment which will result in preventing its subsequent complications reported in these cases.

This research was an analytical cross-sectional study. Patients with direct trauma to extremities, who were referred to the emergency department of Valiasr and Amir Al-Momenin hospitals were studied from October 2018 to April 2019 in Arak, Iran. Patients were selected if they met all of the inclusion criteria and none of the exclusion criteria. Vital signs were measured and recorded for each patient. Also, the results of physical examination, intra-compartmental pressure measurement by a wick catheter and the level of the creatine phosphokinase were recorded. All data analyses were performed with the use of SPSS v21 software.

A total number of 70 subjects were included in this study, comprising 65 males (93.1%) and 5 females (6.9%). The results showed that there is a significant relationship between intra-compartment pressure and the level of creatine phosphokinase enzyme. The higher the intracompartmental pressure, the higher the creatine phosphokinase level. Statistically significant associations were observed between intracompartmental pressure and pallor, edema, lack of limb pulse, and diastolic blood pressure. No significant relationship was found between intracompartmental pressure and limb pain, numbness, inability to move the injured limbs, and systolic blood pressure. In addition, our findings indicated that creatine phosphokinase is significantly associated with edema and lack of limb pulse. No significant relationship was found between creatine phosphokinase with pain, pallor, numbness, inability to move limbs, and systolic and diastolic blood pressure.

The study findings suggest that measurement of intracompartmental pressure could be considered as an effective alternative approach to creatine phosphokinase levels to diagnose compartment syndrome. So, this will prevent irreparable damage to the extremities and is of great importance.

Asthma is the most prevalent chronic disease in childhood and has been growing globally over the last three decades. Studies in this regard indicate different and irrelevant results in Iran. Different prevalence of asthma has been reported in industrialized countries, prevalence of 25.9% in the United Kingdom, 12.8% in Spain and 31% in Australia. This study aimed to evaluate asthma in Iranian children through systematic review and meta-analysis.

This study was performed as a systematic review and meta-analysis from January 2001 to December 2018. Related articles to the reviewed subject were obtained through searches of Scopus, ScienceDirect, Magiran, SID, Medline (PubMed), and Google Scholar databases. Cross-sectional studies were selected for inclusion in the study and observational studies as well as review studies were excluded from the study. Searches on Google search engine and the inspection of sites related to the topic were also incorporated to examine the grays literature. Duplicate articles and articles that were similar and obtained from the same source were removed through the EndNote software. The total number of articles was 896. Subsequently, the number of articles and studies that met the requirements of the first stage was 274. Ultimately after the elimination of 236 irrelevant articles and the elimination of 5 articles in the secondary examination, eventually 33 articles were added to the final stage. By the I2 index, the heterogeneity of the studies was investigated and reported.

In a survey of 33 studies and 97205 participants in the age range of (3-18) years, the general prevalence of asthma in this study based on meta-analysis was 5.1% (CI95%: 4-6.5%). The highest prevalence of asthma was among children from Babol which was 19% (CI95%: 17.8% -20.3%) in 2014 and the lowest prevalence of asthma was among children from Isfahan with 0.7% of prevalence (CI95%: 0.5-1.1) in 2001. Also, with the increase of research years and overall sample size in each study, asthma in children shows increasing and decreasing levels, respectively; and the differences were statistically significant.

Based on what was reported in this study, the prevalence of asthma among Iranian children is lower compared to children of developed countries.

Transradial access is one of the main access techniques in angiography. This method is technically more difficult as it is associated with radial artery occlusion. Radial artery cannulation from the dorsal surface of the hand in the snuffbox area has been introduced as a suitable solution to overcome some of the disadvantages of the standard radial artery method. This study was conducted to compare the incidence of radial artery occlusion and other complications in the two methods.

This study was conducted on 100 patients Who were referred to the Imam Hospital in Ahvaz from 22 September 2020 to 19 Mach 2021. 50 patients underwent angiography with normal radial artery access and 50 patients underwent snuffbox angiography. Basic characteristics including age, sex, underlying disease (diabetes mellitus, hypertension, and dyslipidemia), family history of coronary artery disease, medical history including chronic coronary artery disease, stable ischemic heart disease, smoking, and LVEF, and also the length of hospital stay was also collected and recorded. All subjects in the two groups underwent radial artery ultrasound in the forearm and snuffbox 24 hours after angiography. Also, angiographic complications including radial artery occlusion (thrombosis), pain, hematoma and anesthesia were recorded.

In the present study, the mean age in the two groups was similar (about 50-60 years). The distribution of sex, diabetes, weight, height and blood pressure was homogeneous in both groups. There was a statistically significant difference in the incidence of thrombosis and pain between the two groups. The results of this study showed that in the snuffbox angiography group, the number of uncomplicated cases was significantly more than the radial angiography group and in the snuffbox angiography group, the number of postoperative pain and thrombosis cases was significantly lower. The length of hospital stay in the Snuffbox group was shorter than the radial group, but there was no statistically significant difference.

Snuffbox angiography has fewer complications compared to the usual transradial method, so it can be used as a safe method for angiography.

Millions of deaths occur around the world each year due to lack of access to appropriate treatment for chronic kidney disease patients. Given the importance and mortality rate of this disease, early and low-cost prediction is very important. The researchers intend to identify chronic kidney disease through the optimal combination of techniques used in different stages of data mining.

This cross-sectional research was conducted from February 1999 to May 2014. The used data set included 4145 samples and 32 attributes, where Each sample corresponded to a patient and each attribute corresponded to the demographic and clinical traits. There were several eligibility criteria for the patients for clinical testing. These criteria for the clinical testing included having 18 years of age and older, living in Isfahan city, willing to participate in the study, lack of fever and cold during laboratory tests, no strenuous exercise 48 hours before laboratory tests, and fasting. Individuals who had an incomplete questionnaire or were unwilling to perform accurate tests were excluded from the study. The target variable is kidney disease, the values of which include sick and healthy. Four data mining techniques have been used in the dataset. These techniques are support vector machine (SVM), random forest (RF), artificial neural network (ANN) and Chi-square automatic interaction detection (CHAID).

Accuracy is the evaluation criteria for comparing available data mining methods. Based on the accuracy criterion, the support vector machine performed better than other techniques (random forest, neural network and CHAID). The best rule is that if the patients consume salt in their diet, their age is between 50 and 69, and they have diabetes. they are 82% more likely to develop chronic kidney disease.

The derived rules also showed that if we use salt and we have diabetes, we are at the risk of developing chronic kidney disease. Moreover, having diabetes can increase the risk of mortality in chronic kidney patients. Aged people should also be more careful about getting chronic kidney disease. Because, they are more prone to develop chronic kidney disease.

one of the growing diseases in the world that affects patient life quality is Inflammatory bowel disease (IBD), including ulcerative colitis (UC). Many environmental factors, including nutritional deficiencies, may influence the development of the disease. This study aims to evaluate the role of the level of vitamin D in UC recurrence.

We performed this cross-sectional study at Qom University of Medical Sciences from September 2017 to September 2018 on 50 patients with inactive UC, at least six months after diagnosis, in Shahid Beheshti Hospital in Qom. Patients entered the study sequentially from the target population after describing how to perform the plan and obtaining informed consent. Demographic information, including gender, age, medical history, diseases, and body mass index (BMI), were collected using a checklist. Patients were followed for six months for symptoms and the frequency of disease relapse. During the visits, in terms of adherence to treatment and case of recurrence, the number and severity of recurrence were examined, and the results were recorded in the checklist of each patient. At the end of this period, serum vitamin D level was measured. Data were collected by a checklist and analyzed by independent samples t-test, Chi-square, and variance analysis in SPSS version 18.

Examining the correlation between vitamin D levels and demographic variables shows that low vitamin D levels are significantly associated with an increase in the frequency of recurrences. However, there was no significant relationship between disease duration, age, and body mass index. Among 50 patients, 23 (%46) were male, and 27 (%54) were female, with a mean age of 35.24±10.07 and a mean duration of disease for 15.14±6.67 months. The mean frequency of relapse was 1.34±1.89. The mean level of serum vitamin D was 22.30±13.45 ng/dl. It was significantly associated with the frequency of relapse with a P<0.001.

Vitamin D insufficiency is associated with an increased risk of recurrence in patients with ulcerative colitis.

Neck mass is one of the most common clinical findings in all age groups. Differential diagnosis of masses includes a range of pathologies from congenital to infectious or neoplasm. Understanding the risk factors of neck masses can help us to assess them properly. The purpose of this study is to obtain the epidemiological and clinical features of different neck masses in Kerman, Iran.

This research was a descriptive, retrospective and cross-sectional study. 120 Patients that have been biopsied from neck masses during March 2014 to March 2018  in the otorhinolaryngology department of Shafa hospital of Kerman (referral center of otorhinolaryngology disease of southeastern Iran), were the participants of the study. Data regarding age, sex, history of addiction, smoking and definite pathologic diagnosis were collected and analyzed with SPSS 20th version.

Of 120 cases, 57.5 % were male and 42.5% were female. In the malignant masses group, the male to female ratio was 4.1 to 1. The average age of patients was 39.44 years old. From them, 20.83 percent had a history of smoking but 79.17 percent had never experienced smoking. In addition, 77.5% of the patients have not experienced opium consumption and 22.5% were addicted to opium regularly. There was a significant relationship between smoking and opium consumption and the incidence of malignant cervical masses (P<0.05). In the pathological study, inflammatory and infectious masses with 48.33 percent were in the head of pathology; malignant neoplasm with 25 percent, benign neoplasms with a prevalence of 12.5 percent and congenital masses with a prevalence of 9.7 percent were in the next ranks.

In this study, we investigated the epidemiological and clinical features of neck masses in Kerman. It is obvious that smoking is an important risk factor for neck mass malignancies. Also, the present study revealed that the incidence of malignant tumors increased with age.

Emphysematous cholecystitis is a rare variant of acute cholecystitis with high mortality and morbidity rate. Emphysematous cholecystitis most often occurs in older men and Emphysematous cholecystitis often occurs in patients with chronic diseases such as diabetes and vascular disease. The combination of emphysematous cholecystitis and pneumoperitoneum is even rarer. In this study, we reported a rare case of pneumoperitoneum on plain abdominal X-ray with emphysematous cholecystitis in an 83-year-old woman.

The patient was 83 years old, lady who had been referred to the emergency department of Ghaem Hospital, Mashhad University of Medical Sciences in April 2019, due to diffuse abdominal pain that had started suddenly 3 days earlier. Pneumoperitoneum, the air in the gallbladder wall and the air encircling the gallbladder were reported in standing and supine abdominal x-rays and standing chest X-rays. At first, the patient was resuscitated and treated with broad-spectrum antibiotics. After initial treatment, the patient underwent open cholecystectomy with a subcostal incision on the right and a diagnosis of emphysematous cholecystitis. After surgery, the patientchr('39')s general condition improved and she was discharged without mortality and morbidity with oral third-generation Cephalosporin antibiotics. The general condition of the patient after discharge was good in the examinations performed in the clinic of Ghaem Hospital, 1 and 3 months after discharge.

Emphysematous cholecystitis is a rare and severe form of acute cholecystitis that occurs due to the process of arterial ischemia caused by contamination with anaerobic bacteria and the formation of gas in the wall and lumen of the gallbladder. Emphysematous cholecystitis is more severe than other types of acute cholecystitis and has higher mortality and morbidity and is life-threatening. Due to the acute and progressive course of emphysematous cholecystitis, correct and timely diagnosis and treatment are important.