The incidence and prevalence of ALS in the Iranian population seems to be lower compared to other populations and the survival of patients was longer than previously reported.

BACKGROUND Aryl-carbon receptor (AhR), a ligand-activated transcription factor, is best known for its ability to mediate the effects of environmental toxins such as 2,3,7,8-tetrachlorodibenzo-p-dioxin. AhR is expressed in several tumor cells and regulates the expression of genes in the signal transduction pathways. In this study, we examined the soluble levels of AhR in patients with pancreatic cancer. METHODS 123 samples, including 59 (48%) samples of pancreatic ductal adenocarcinoma based on histological evidence and 64 (52%) healthy control samples, were evaluated to determine plasma levels of AhR by Enzyme-linked immunoassay. RESULTS The median of AhR among patients was 0.280 ng/mL, which differed considerably from 0.07 ng/mL in the control group (p < 0.001). Significant differences of the AhR were observed between the plasma samples of the patients compared with the healthy group, with respect to male sex (p < 0.001), age groups (p = 0.001), diabetic status (p < 0.001), body mass index (BMI) categories (p = 0.035), and constantly smokers (p < 0.001). We also observed significant differences between the level of AhR expression between men and women (p = 0.01) and ever to never smokers (p = 0.009) in the case group. In addition, the age of 65 and a BMI of 25 or less were significant factors in plasma AhR levels ([1.61 95%CI 1.08-2.38] and [1.84 95%CI 1.22-2.77], respectively). CONCLUSION The results of this study can add diagnostic information to pancreatic cancer involving AhR and the potential efficacy of this receptor in therapeutic strategies.

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Background and Objectives. The null hypothesis of this study was that TA has no effect on postsurgical bleeding in patients undergoing TKA. Methods. This study was a double-blind randomized trial. In the first group (T) patients received 500 mg of intravenous Tranexamic acid (TA) twice (once preoperatively and once 3 hours postoperatively) and in the second group (P) they received slow infusion of normal saline as placebo. The primary outcome of the study was the level of Hb 48 hours after surgery. Results. Hb levels 48 hours after surgery as the primary outcome were 10.92 ± 0.97 and 10.23 ± 0.98 (g/dL) in groups T and P, respectively, and the difference was statistically significant (P = 0.001). Statistically significant differences were also observed in Hb levels 6 and 24 hours after surgery, the drain output 48 hours after surgery, and the number of units of packed cells transfused between study groups (P < 0.05). There was no significant difference in duration of hospitalization between the study groups (P = n.s.). Conclusions. The low dose perioperative intravenous TA significantly reduces blood loss, requirement for blood transfusion, and drain output in patients undergoing TKA. However, duration of hospitalization did not change significantly.

Background:Degenerative changes and inflammation in the rotator cuff (RC) are the most important causes of shoulder pain. The aim of the present study was to determine the effectiveness of platelet-rich plasma (PRP) in patients with chronic RC tendinopathy.Materials and Methods:This study was an open-label study performed at Kashani Hospital between April 2012 and June 2014. Patients with a <1 cm partial tearing of the bursal side of RC with no or little response to conservative management were included. PRP injection was done using ultrasonography guide via posterior subacromial approach. Demographic data were obtained in all patient before the study, and shoulder function was evaluated using Constant shoulder score (CSS) before and 3 months after PRP injection.Results:A total number of 17 patients were enrolled. The mean of CSS before and after intervention was 37.05 ± 11.03 and 61.76 ± 14.75, respectively (P < 0.001). There was no statistically significant correlation between the pain score before the study and the improvement in CSS (P = 0.45, r = 0.03). Significant relation was observed between the individuals’ age and improvement of CSS (P = 0.02, r = −0.49). There was no significant difference in CSS improvement between genders (P = 0.23).Conclusion:Single injection of PRP is effective to reduce pain and improve range of motion in patients with bursal side partial tearing of RC who failed to respond to conservative treatments.

Background:Pelvic and acetabular fractures constitute 2% of all fractures. The aim of the present study was to present acetabular fracture outcome in patients who underwent operative treatment.Materials and Methods:This study was a prospective cohort study, which was performed in Isfahan, Iran. During the period study, all patients who admitted to Alzahra Hospital with acetabular fracture and underwent acetabular surgery were evaluated. Data about age, sex, associated fractures, Intensive Care Unit admission, the time between admission and surgery were gathered. Patients were encouraged to return to the hospital after 1 week, 4 weeks, 6 months, and then yearly for the follow-up.Results:Sixty-five patients with acetabular fractures were referred to our hospital. Of them, 30 patients were indicated for surgical intervention and recruited in the study. The most frequent type of fracture involved posterior wall accounting for 49.9% of all fractures. More than 80% of study patients reached satisfactory results (excellent or good) based on Harris Hip Score (HHS). Female patients had significantly lower HHS in comparison with male patients (P = 0.01). Heterotopic ossification (HO) formation was more common in whom surgery was performed after 2 weeks (P = 0.005), however, there was no significant difference in HHS between these groups (P = 0.28).Conclusions:It is concluded that the female gender had an impact on the surgical outcome of acetabular fracture and indicated the lower functional outcome. Although there is an increase in HO formation in patients who do not undergo surgery during 2 weeks after the trauma, however, it does not influence the surgical outcome.

Background:The aim of this study was to determine the diagnostic value of magnetic resonance imaging (MRI) in the diagnosis of knee injuries.Materials and Methods:Ninety-eight consecutive patients were enrolled in the study. In all patients, MRI and arthroscopy were performed and the results were compared.Results:MRI was most sensitive in the detection of medial meniscus injuries, and the highest specificity and negative predictive value (NPV) were found in the detection of posterior cruciate ligament injuries.Conclusion:MRI is a valuable tool, and according to its high NPV, normal MRI can prevent unnecessary arthroscopic interventions.

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