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Eghbal K, Rakhsha A, Saffarrian A, Rahmanian A, Abdollahpour HR, Ghaffarpasand F. Surgical Management of Adult Traumatic Atlantoaxial Rotatory Subluxation with Unilateral Locked Facet; Case Report and Literature Review. Bull Emerg Trauma 2018; 6:367-371. [PMID: 30402528 PMCID: PMC6215068 DOI: 10.29252/beat-060416] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Atlantoaxial rotatory subluxation (AARS) is rarely occurred in adults with trauma as the most common cause. In type A and B it is usually managed with close reduction and external brace; however, in nonresponsive cases, surgical interventions might be needed. Our patient is a 21-year-old man with neck pain and torticollis after a car turn- over. There was C1-C2 rotatory subluxation with left side locked facet and C1 rotation about 40 degrees relative to C2 on computed tomography without evident of ligamentous injury in magnetic resonance imaging (MRI). However, during the first 48 hours, two tries of close reduction using Gardner cervical traction under fluoroscopy were failed. Thus, the patient underwent open reduction of the subluxation and atlantoaxial fixation (Harm’s technique) with subsequent relief of pain and torticollis. This a rare case of traumatic AARS type A with unilateral locked facet joint in an adult patient which needed surgical manipulation for reduction. The management of the AARS in adults should be individualized in each patient.
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Taghipour M, Ghaffarpasand F. Corpus Callosotomy for Drug-Resistant Schizophrenia; Novel Treatment Based on Pathophysiology. World Neurosurg 2018; 116:483-484. [PMID: 30049036 DOI: 10.1016/j.wneu.2018.04.113] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 04/17/2018] [Indexed: 10/28/2022]
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Farrokhi MR, Ghaffarpasand F, Taghipour M, Derakhshan N. Transventricular Transvelar Approach to Trochlear Nerve Schwannoma: Novel Technique to Lesions of Inferior Pineal Region. World Neurosurg 2018; 114:274-280. [DOI: 10.1016/j.wneu.2018.03.132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 03/18/2018] [Accepted: 03/19/2018] [Indexed: 11/26/2022]
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Taghipour M, Ghaffarpasand F. Antinocioceptive Effects of Spinal Cord Stimulation by Activation of Periaqueductal Gray Matter and Rostral Ventromedial Medulla: A Mechanism Beyond the Gate Control Theory. Neuromodulation 2018; 21:520-521. [DOI: 10.1111/ner.12788] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Taghipour M, Ghaffarpasand F. Selective Amygdalohippocampectomy for Mesial Temporal Sclerosis: Special Considerations in Geniuses. World Neurosurg 2018; 111:429-430. [DOI: 10.1016/j.wneu.2017.11.135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 11/22/2017] [Indexed: 10/17/2022]
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Taghipour M, Ghaffarpasand F, Saffarrian A. Circumventricular Organ Origin of Hemangioblastoama; Hypothesis for Pathogenesis of Disease. World Neurosurg 2017; 108:980. [PMID: 29179425 DOI: 10.1016/j.wneu.2017.08.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 08/26/2017] [Indexed: 11/17/2022]
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Rahmanian A, Ghaffarpasand F, Alibai E, Choque-Velasquez J, Jahromi BR, Hernesniemi J. Surgical Outcome of Very Small Intracranial Aneurysms Utilizing the Double Clip Technique. World Neurosurg 2017; 110:e605-e611. [PMID: 29162525 DOI: 10.1016/j.wneu.2017.11.060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 11/10/2017] [Accepted: 11/11/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To report the outcome of patients with very small intracranial aneurysm (VSIA) undergoing surgical clipping using a double-clip technique. METHODS This cross-sectional study was conducted in Namazi Hospital, the main referral neurovascular center in Southern Iran during a 6-year period from September 2010 to March 2016. All patients with VSIAs (≤3 mm) undergoing surgery with double-clip technique were included. This technique reduces the clip slippage. The short- and long-term outcomes determined by Glasgow outcome score (GOS), modified Rankin Scale (MRS), and complications. RESULTS Operations were performed on 32 VSIAs in 26 patients with a mean ± SD age of 55.7 ± 10.1 years. Middle cerebral artery was the most common location for VSIA (50.0%). There was no neck remnant, and the complete occlusion rate was 100%. The rate of intraoperative aneurysm rupture was 30.8%, and none of the patients experienced rebleeding. The 6-month mortality rate was 0% in ruptured VSIAs and 6.25% in unruptured VSIAs. Most of the patients had favorable outcomes (88.5%), and the overall mortality rate was 11.5%. The rate of permanent neurologic deficit was 10.0% in ruptured and 12.5% in unruptured VSIAs. Multivariate logistic regression analysis revealed no association between baseline and clinical characteristics and outcome in this series. CONCLUSION VSIAs are difficult to treat because of their small sizes; therefore, with a double-clip technique, one can reduce complications related to the treatment of small aneurysms.
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Farzanegan GR, Derakhshan N, Khalili H, Ghaffarpasand F, Paydar S. Effects of atorvastatin on brain contusion volume and functional outcome of patients with moderate and severe traumatic brain injury; a randomized double-blind placebo-controlled clinical trial. J Clin Neurosci 2017; 44:143-147. [DOI: 10.1016/j.jocn.2017.06.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 04/22/2017] [Accepted: 06/08/2017] [Indexed: 01/20/2023]
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Khalili H, Derakhshan N, Ghaffarpasand F, Heydari ST. In Reply to the Letter to the Editor Regarding "Effects of Oral Glibenclamide on Brain Contusion Volume and Functional Outcome of Patients with Moderate and Severe Traumatic Brain Injuries: A Randomized Double-Blind Placebo-Controlled Clinical Trial". World Neurosurg 2017; 105:1021. [PMID: 28847125 DOI: 10.1016/j.wneu.2017.06.188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 06/28/2017] [Indexed: 11/25/2022]
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Taghipour M, Ghaffarpasand F. Letter to the Editor Regarding “Six Walls of the Cavernous Sinus Identified by Sectioned Images and Three-Dimensional Models: Anatomic Report”. World Neurosurg 2017; 104:1014-1015. [DOI: 10.1016/j.wneu.2017.03.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 03/16/2017] [Indexed: 10/19/2022]
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Taghipour M, Saffarrian A, Ghaffarpasand F, Azarpira N. Dumbbell-Shape Hydatid Cyst of Meckel Cave Extending to Cerebellopontine Angle and Middle Fossa; Surgical Technique and Outcome of Rare Case. World Neurosurg 2017; 104:1049.e7-1049.e10. [DOI: 10.1016/j.wneu.2017.05.091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/13/2017] [Accepted: 05/16/2017] [Indexed: 10/19/2022]
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Masoudi MS, Rasafian M, Naghmehsanj Z, Ghaffarpasand F. Intraperitoneal cerebrospinal fluid pseudocyst with ventriculoperitoneal shunt. Afr J Paediatr Surg 2017; 14:56-58. [PMID: 29557353 PMCID: PMC5881288 DOI: 10.4103/ajps.ajps_94_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Ventriculoperitoneal (VP) shunting is mostly used in the treatment of hydrocephalus and many complications have been reported with this method. Abdominal Pseudocyst (APC) are relatively uncommon but important complications in patients with VP shunts. We herein report the case of a 9-year-old boy with VP shunt who presented with abdominal distension, abdominal pain, malaise, and decrease of appetite. Abdominal pelvic computed tomography confirmed a diagnosis of APC. Laparotomy was done and VP shunt was placed into the other side of peritoneal cavity again. Also here, etiology, presentation, diagnosis, and treatment of APC were reviewed.
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Khalili H, Niakan A, Ghaffarpasand F, Kiani A, Behjat R. Outcome Determinants of Decompressive Craniectomy in Patients with Traumatic Brain Injury; A Single Center Experience from Southern Iran. Bull Emerg Trauma 2017; 5:190-196. [PMID: 28795064 PMCID: PMC5547207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 06/06/2017] [Accepted: 06/29/2016] [Indexed: 06/07/2023] Open
Abstract
OBJECTIVE To investigate the determinants of outcome in patients with traumatic brain injury (TBI) undergoing decompressive craniectomy (DC) in a large level I trauma center in southern Iran. METHODS This retrospective cross-sectional study was conducted during an 18-month period from 2013 to 2014 in Shahid Rajaei hospital, a Level I trauma center in Southern Iran. Patients with TBI who had undergone DC were included and the medical charts were reviewed regarding demographics, clinical, radiological and outcome characteristics. The outcome was determined by extended Glasgow outcome scale (GOS-E) after one year of surgery. The variables were compared between those with favorable and unfavorable outcome to investigate the outcome determinants. RESULTS Overall 142 patients with mean age of 34.8 ± 15.5 (ranging from 15 to 85) years were included. There were 127 (89.4%) men and 15 (10.6%) women among the patients. After 1-year, the mortality rate was 58 (40.8%) and 8 (5.6%) patients were persistent vegetative state. The final outcome was found to be unfavorable in 77 (54.2%) patients. Unfavorable outcome was associated with lower GCS on admission (p<0.001) as well as occurrence of postoperative hydrocephalus (p=0.011). Formation of the postoperative subdural hygroma after the operation was found to be associated with favorable outcome (p=0.019). CONCLUSION DC in patients with TBI is associated with favorable outcome in most of them. On admission GCS, postoperative hydrocephalus and presence of postoperative subdural hygroma are among the important predictors of outcome in TBI patients undergoing DC.
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Paydar S, Karami MY, Khalili H, Dehghankhalili M, Sabetian G, Ghaffarpasand F. Heart Rate Beat to Beat Variability of Trauma Patient in Neurogenic Shock State: Time to Introduce New Symptoms. Bull Emerg Trauma 2017; 5:141-142. [PMID: 28795056 PMCID: PMC5547199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 06/10/2017] [Accepted: 06/18/2017] [Indexed: 06/07/2023] Open
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Rahmanian A, Masoudi MS, Ghaffarpasand F, Ashraf MH, Alibai E. Outcome of Microsurgical Revascularization in Patients with Moyamoya Disease: First Report from the Iranian Population. Turk Neurosurg 2017; 28:394-399. [PMID: 28593628 DOI: 10.5137/1019-5149.jtn.20480-17.0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM To report the outcome of microsurgical revascularization in patients with Moyamoya Disease (MMD) in Southern Iran. MATERIAL AND METHODS This cross-sectional study was conducted in Southern Iran during a 7-year period from 2009 to 2016. All the patients with Moyamoya Disease (confirmed with digital substraction angiography) who underwent microsurgical revascularization (extracranial-intracranial bypass or synangiosis) were included. All the patients were followed for at least 1 year and the outcome was measured using the Glasgow outcome scale (GOS) and modified Rankin scale (MRS). RESULTS Overall we included 13 patients with 14 involved hemispheres undergoing direct and indirect revascularization. The mean age of the patients was 20.6±17.5 (ranging from 0.5 to 55) years and there were 5 (38.4%) males and 8 (61.6%) females. We did not have any unfavorable outcome defined as mortality and persistent vegetative state. We performed 12 (85.7%) superficial temporal artery (STA)-middle cerebral artery (MCA) bypass and 2 (14.3%) encephalo-myo-synangiosis (EMS) procedures. The symptoms improved in 7 (53.8%) patients and remained as the preoperative course in 5 (38.5%) patients. Only 1 (7.7%) patient developed immediate postoperative vasospasm and brain swelling, and was managed successfully with decompressive craniectomy and subsequent cranioplasty (GOS=5, MRS=0). CONCLUSION This is the first study to report the safety, efficacy and outcome of the direct (STA-MCA bypass) and indirect (EMS) revascularization in patients with MMD in the Iranian population. As the prevalence of MMD is low in Iranian population, the experience and technique remains in its infancy and further advancements in the field is required.
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Khalili H, Sadraei N, Niakan A, Ghaffarpasand F, Sadraei A. In Reply to "Intracranial Pressure Monitoring in Traumatic Brain Injury". World Neurosurg 2017; 100:704-705. [PMID: 28437883 DOI: 10.1016/j.wneu.2017.01.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 01/20/2017] [Indexed: 10/19/2022]
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Ghaffarpasand F, Dehghankhalili M. Current Concepts and Advancements in Management of Traumatic Brain Injury; A Glimpse at the Recently Published Evidence. Bull Emerg Trauma 2017; 5:67-69. [PMID: 28507992 PMCID: PMC5406175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 02/28/2017] [Accepted: 02/28/2017] [Indexed: 06/07/2023] Open
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Khalili H, Niakan A, Ghaffarpasand F. Effects of cerebrolysin on functional recovery in patients with severe disability after traumatic brain injury: A historical cohort study. Clin Neurol Neurosurg 2017; 152:34-38. [DOI: 10.1016/j.clineuro.2016.11.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 11/11/2016] [Accepted: 11/12/2016] [Indexed: 11/29/2022]
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Masoudi MS, Derakhshan N, Ghaffarpasand F, Geramizadeh B, Heydari M. Multifocal atypical teratoid/rhabdoid tumor: a rare entity. Childs Nerv Syst 2016; 32:2287-2288. [PMID: 27757569 DOI: 10.1007/s00381-016-3272-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 10/07/2016] [Indexed: 10/20/2022]
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Khalili H, Niakan A, Ghaffarpasand F. Massive Pneumocephalus and Pneumorrhachis after Severe Skull Base Fracture. Bull Emerg Trauma 2016; 4:248-249. [PMID: 27878133 PMCID: PMC5118580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/05/2016] [Accepted: 08/18/2016] [Indexed: 06/06/2023] Open
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Khalili H, Sadraei N, Niakan A, Ghaffarpasand F, Sadraei A. Role of Intracranial Pressure Monitoring in Management of Patients with Severe Traumatic Brain Injury: Results of a Large Level I Trauma Center in Southern Iran. World Neurosurg 2016; 94:120-125. [DOI: 10.1016/j.wneu.2016.06.122] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 06/27/2016] [Accepted: 06/28/2016] [Indexed: 02/01/2023]
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Eghbal K, Ghaffarpasand F. An Acute Cervical Subdural Hematoma as the Complication of Acupuncture: Case Report and Literature Review. World Neurosurg 2016; 95:616.e11-616.e13. [PMID: 27591101 DOI: 10.1016/j.wneu.2016.08.090] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 08/18/2016] [Accepted: 08/20/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Several injuries in the cervical region as complications of acupuncture have been previously reported in the literature, including cord and medulla oblongata injuries, subdural empyema, and cervical hematoma. Spinal cord subdural hematoma is a rare condition mainly associated with coagulopathy, trauma, and iatrogenic procedures. We herein report an acute cervical subdural hematoma after cervical acupuncture for neck and shoulder pain. CASE DESCRIPTION A 74-year-old woman presented with progressive quadriparesis and sensory deficit after receiving acupuncture in the neck and shoulder. Magnetic resonance imaging of the cervical spine showed a subdural lesion that was a hyperintense mass in the T1-weighted and hypointense in T2-weighted images at the C4-C6 level, which proved to be an early subacute subdural hematoma. After surgical evacuation of the hematoma, the patient had significant neurologic improvement. CONCLUSIONS Although rare, cervical spinal cord hematomas are disastrous complications of cervical acupuncture. These procedures should be performed under direct observation of trained physicians with appropriate knowledge of cervical anatomy to avoid these complications.
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MESH Headings
- Acupuncture Therapy/adverse effects
- Aged
- Cervical Vertebrae/diagnostic imaging
- Cervical Vertebrae/surgery
- Female
- Hematoma, Subdural, Acute/diagnostic imaging
- Hematoma, Subdural, Acute/etiology
- Hematoma, Subdural, Acute/surgery
- Hematoma, Subdural, Spinal/diagnostic imaging
- Hematoma, Subdural, Spinal/etiology
- Hematoma, Subdural, Spinal/surgery
- Humans
- Magnetic Resonance Imaging
- Quadriplegia/etiology
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Ghaffarpasand F, Shahrezaei M, Dehghankhalili M. Effects of Platelet Rich Plasma on Healing Rate of Long Bone Non-union Fractures: A Randomized Double-Blind Placebo Controlled Clinical Trial. Bull Emerg Trauma 2016; 4:134-140. [PMID: 27540547 PMCID: PMC4989039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/06/2016] [Accepted: 06/14/2016] [Indexed: 06/06/2023] Open
Abstract
OBJECTIVE To determine the effects of platelet rich plasma PRP on healing rates of long bone non-union fracture. METHOD This was a randomized double-blind placebo controlled clinical trial being performed in a 12-month period. We included 75 adult (>18 years) patients suffering from long bone (Femur, Tibia, Humerus and Ulna) non-union fracture who were randomly assigned to receive 5mL PRP (n=37) or 5mL normal saline as placebo (n=38) in the site of fracture after intramedullary nailing or open reduction and internal fixation (ORIF) along with autologous bone graft. Patients were followed each 45 days till 9 months and were evaluated both clinically and radiologically in each visit. The healing rate, failure rate, incidence of infection, mal-union and limb shortening were recorded and compared between groups after 9 months of follow-up. RESULTS The healing rate was significantly higher in PRP group compared to placebo (81.1% vs. 55.3%; p=0.025). The limb shortening was significantly higher in those who received placebo (2.61±1.5 vs. 1.88±1.2mm; p=0.030). Injection of PRP was also associated with lower pain scores ( p=0.003) and shorter healing duration ( p=0.046). The surgical site infection ( p=0.262) and mal-union rate ( p=0.736) were comparable between groups. CONCLUSION Application of PRP along with autologous bone graft in the site of non-union of long bone after intramedullary nailing or ORIF results in higher cure rate, shorter healing duration, lower limb shortening and less postoperative pain. Higher infection rate might be a complication of PRP application. CLINICAL TRIAL REGISTRY This trial is registered with the Iranian Clinical Trials Registry (IRCT201208262445N1; www.irct.ir).
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Ghaffarpasand F, Akbarzadeh A, Heiran HR, Karimi AA, Akbarzadeh A, Ghobadifar MA. Effect of Topical Morphine on Cutaneous Leishmaniasis in an Animal Model: A Preliminary Report. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e24402. [PMID: 27437123 PMCID: PMC4939412 DOI: 10.5812/ircmj.24402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 02/13/2016] [Accepted: 04/02/2016] [Indexed: 12/01/2022]
Abstract
Background Pentavalent antimonials remain the choice of treatment for leishmaniasis, despite their toxicity, high cost, and difficult administration. As an alternative, morphine may induce the healing process of cutaneous leishmaniasis by its immunoregulatory characteristics. Objectives To study the effect of morphine on the wound-healing process of cutaneous leishmaniasis (CL) in a mouse model. Materials and Methods This was an experimental study in which 40 BALB/c mice (female, 6 - 8 weeks) were divided into four groups (each n = 10) who received either placebo alone (group 1), morphine ointment after parasite inoculation (group 2), morphine ointment after wound occurrence (group 3), or placebo after wound occurrence (group 4). Wound size was measured weekly for eight weeks. Results On the first day of treatment, the lesions measured ~1.5 mm in diameter. After eight weeks of treatment, the wound size was significantly smaller in the mice who received morphine ointment (4.81 ± 3.22 mm) compared to those who received placebo after parasite inoculation (8.95 ± 5.71 mm; P = 0.0001) or placebo after wound occurrence (P = 0.028). Conclusions The above data suggest that topical application of morphine accelerates the healing process of CL wounds. We are cautiously optimistic that the results of this study can be used clinically for potentiating CL wound-healing.
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Aminmansour B, Asnaashari A, Rezvani M, Ghaffarpasand F, Amin Noorian SM, Saboori M, Abdollahzadeh P. Effects of progesterone and vitamin D on outcome of patients with acute traumatic spinal cord injury; a randomized, double-blind, placebo controlled study. J Spinal Cord Med 2016; 39:272-80. [PMID: 26832888 PMCID: PMC5073761 DOI: 10.1080/10790268.2015.1114224] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Steroid hormones offer promising therapeutic perspectives during the acute phase of spinal cord injury (SCI) while the role of progesterone and vitamin D remain controversial. The aim of the current study was to investigate the effects of progesterone and vitamin D on functional outcome of patients with acute traumatic SCI. METHODS This was a randomized clinical trial including 64 adult patients with acute traumatic SCI admitted within 8 hours of injury. All the patients received methylprednisolone on admission according to standard protocol (30 mg/kg as bolus dose and 15 mg/kg each 3 hours up to 24 hours). Patients were randomly assigned to receive intramuscular injection of 0.5 mg/kg progesterone twice daily and 5µg/kg oral vitamin D3 twice daily up to 5 days (n = 32) or placebo (n = 32). Patients were visited 6 days, 3 and 6 months after injury and motor and sensory function was assessed according to American Spinal Injury Association (ASIA) score. RESULTS There was no significant difference between two study groups regarding age (P = 0.341), sex (P = 0.802) and therapy lag (P = 0.609). The motor powers and sensory function increased significantly after 6 months in both study groups. Those who received progesterone and vitamin D had significantly higher motor powers and sensory function after 6 months of therapy. Those who received the therapy within 4 hours of injury, had significantly higher motor powers and sensory function 6 months after treatment in progesterone and vitamin D group. Therapy lag was negatively associated with 6-month motor powers and sensory function in progesterone and vitamin D group. CONCLUSIONS Administration of progesterone and vitamin D in acute phase of traumatic SCI is associated with better functional recovery and outcome.
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