Original Article

Investigating the predictive ability of FLI for non-alcoholic fatty liver disease involvement

Bahare Rafieian, behzad hatami, Saeed Abdi

School of Medicine Students' Journal, Vol. 4 No. 1 (2022),

Background and aim: non-alcoholic fatty liver disease (NAFLD) is one of the common concerns in the world. This disease has a correlation with obesity, type 2 diabetes, metabolic syndrome, and other diseases. So, prediction and diagnosis of NAFLD is important. Fatty liver index can be used as a good method for prediction of NAFLD involvement but there are few evidences about it. The aim of this study was to investigate the prediction and diagnostic power of FLI to predict and diagnosis of NAFLD.

Materials and Methods: in this diagnostic study, patients who were referred to our hospital from 2020 to 2021 were assessed. Patients with NAFLD (N=108) were compared with normal people (N=220) based on age, sex, anthropometric parameters, laboratory data, and FLI.

Result: the mean age among all participants was 45.62 ± 10.93 years. There were significant differences between NAFLD group and normal group about age, sex, height, weight, BMI, waist circumference, diabetes and hypertension history, TG, LDL, AST, ALT, ALK,GGT. The sensitivity, specificity, and accuracy of FLI in diagnosis of NAFLD were 73.15%, 81.36%, and 78.66%, respectively. The best cut-off point based on ROC analysis and Youden index for differentiation of grade 1 from grade 2 was 69.5 and the best cut-off point for differentiation of grade 2 from grade 3 was 72.5 when the high FLI level considered as 60.

Conclusion: FLI is good method for prediction and diagnosis of NAFLD.

Evaluation of the FNA accuracy in differentiating malignant from non-malignant thyroid nodules in comparison with postoperative histopathological findings

Azam Erfanifar, Tayebe yousefzad, Homeira Rashidi, Atieh Amouzegar, Mohammad Hossein Sarmast Shushtari, Seyad Ahmad fanaei, Neptune Emadmootofi, Fereidoun Azizi, Saeed Kalbasi

School of Medicine Students' Journal, Vol. 4 No. 1 (2022),

Background and aim:: Thyroid nodules are one of the most common thyroid disorders and due to these nodules have a chance for malignancy, all thyroid nodules should be evaluated cytologically. The choice method for this assessment is fine needle aspiration (FNA). Different studies have reported different values for the diagnostic power of FNA compared to the pathological evaluation of the surgical specimen. In this study, we aimed to evaluate the power of FNA in comparison with postoperative histopathological findings in differentiating malignant thyroid nodules from non-malignant nodules.

Materials and Methods: In this diagnostic study, the records of patients with thyroid nodules who required diagnostic FNA based on the findings of clinical examination and diagnosis (ultrasound and TSH) were evaluated. The data of 359 patients with FNA and cytopathology results were assessed based on a surgical specimen.

Results: Of these 359 patients, 279 (77.7%) were women and 80 (22.3%) were men. The mean age of the patients was 43.28 ± 13.37 years. The mean age of patients in the group with benign thyroid nodules was significantly higher than patients with malignant thyroid nodules (P-value = 0.001). For FNA, sensitivity was 74%, specificity was 86%, positive predictive value was 76% and finally negative predictive value was 85%. The accuracy of FNA was 82%.

Conclusion: FNA can be used in most nodules. Of course, accompanying with clinical findings should be considered.

Modified explant culture is the effective technique for isolating mesenchymal stem cells from glioblastoma

Farshid Zamani, Saeed Oraee Yazdani, Neda Heidari, Farshid Yeganeh, Saeed Karima, Seyed Mahmoud Hashemi

School of Medicine Students' Journal, Vol. 4 No. 1 (2022),

Background and purpose: Until now, mesenchymal stem cells (MSCs) have been obtained from a variety of sources, including several tumor types. In order to acquire cells with the best quality and function while also taking economic factors into account, selecting an appropriate isolation procedure is a crucial step. The goal of this study was to use a modified explant culture approach to isolation of pure mesenchymal stem cells from human glioblastoma.

Materials and methods: Six samples of glioblastoma tumors were cut into cube-like fragments of 1-3 mm in diameter (explants). The explants were put into the wells of a 24-well plate, cultured in Dulbecco's Modified Eagle's medium (DMEM), and kept at 37°C with 5% co2 in an incubator.  Inverted microscopy was used to analyze the morphological phenotypes of the cells. Wells with uniform fibroblast-like cell morphology were considered positive and chosen for further expansion and identification.

Results: Totally, 38.46% of the wells were chosen for development after testing positive for all grown explants. According to flow cytometry analyses, the isolated cells were positive for CD73, CD105, and CD90 but negative for CD45 and CD34. The cells also successfully underwent multipotential differentiation into adipocytes and osteoblasts.

The Evaluation of short-term and long-term effects of fibrinolytic drug Alteplase on catheters dysfunction in dialysis patients

Yeganeh Moradi, Sima Golmohammadi, Mohammadreza Sobhieh, Saeed Kalbasi, Farzaneh Futuhi

School of Medicine Students' Journal, Vol. 4 No. 1 (2022),

Introduction: Despite the tendency to important infectious and mechanical complications, central venous catheters have become a common means of vascular access worldwide for patients requiring hemodialysis. In some studies, the use of fibrinolytic drugs is effective in the treatment of catheter function problems. In this study, the effects of Alteplase (a fibrinolytic drug) on catheter function was investigated.

Methods: This study was performed on 100 dialysis patients in the dialysis ward of Imam Reza Hospital in Kermanshah (Iran) who had a catheter dysfunction. After confirmation by the nephrologist, in case of catheter dysfunction and failure to resolve it with the usual methods, one milligram of Alteplase with normal saline was added to each lumen of the catheter and left in place for one hour. After aspirating the lacquered solution, the rate of blood outflow was assessed by aspiration, and catheter function was evaluated.

Results: The mean age was 60.31 +- 11.67 years. 52 patients were male and 48 patients were female. In terms of catheter implantation time, 20 patients were less than 3 months, 12 patients were between 3 to 6 months and 68 patients were more than 6 months. The duration of proper catheter function after injection was less than 3 months in 11 patients, between 3 to 6 months in 31 patients, and more than 6 months in 58 patients. Only 6 out of 100 cases received 2 mg and others received 1 mg of the drug. 25 patients had the insufficient effect of the drug on catheter function in terms of blood flow velocity, and in 75 patients this effect was good. Only 8 patients had inoperable lock catheters. Out of 100 patients studied, 7 had temporary catheters and 93 had permanent catheters.

Conclusion: Alteplase is safe and effective on catheter function in hemodialysis patients.

Effectiveness of cervical cerclage on pregnancy outcomes in pregnant women with the history of preterm labor

hengameh Mohamadkhani shahri, Fakhrolmolouk Yassaee, Leila Mohamadkhani Shahri, Vahideh hafezi

School of Medicine Students' Journal, Vol. 4 No. 1 (2022),

Aim: We aimed to investigate the effectiveness of Cerclage in the pregnancy outcome based on the obstetric history and find out how the timing of the cerclage insertion could improve the pregnancy outcomes.

Method: We conducted a retrospective descriptive study that enrolled 210 women who underwent history-indicated Cerclage. In all the women, McDonald's method was performed. Demographic data and delivery history were retired from the informative hospital system (HIS). The pregnancies were divided into two groups, low-risk group defined as pregnant women with a history of preterm labor (PTL) or second-trimester loss (STL) ≤ 2, and a high-risk group referred to patients with a history of preterm labor or second-trimester loss (STL) ≥3, to compare the efficacy and timing of the Cerclage in both groups. The Pearson Chi-squared test, student t-test, and ANOVA test were performed by SPSS 26.0. p-value<0.05 was statistically significant

Result: of 210 women enrolled in the study, 158 were low-risk. Our results show that the obstetric history and cerclage-related factors shortened the gestational age at cerclage insertion and delivery (p-value<0.05). Earlier cerclage insertion prevented preterm labor and improved neonatal outcomes. However, the time of cerclage insertion was later in the low-risk group, and the gestational age of the low-risk group was statistically significantly longer than the high-risk group (36.61±2 weeks in the low-risk group versus 35±2.14 weeks' gestation in the high-risk group) (p-value<0.001). Women in the high-risk group were significantly more likely to deliver a newborn with low birth weight or be admitted to the NICU ward. 

Conclusion: Cerclage improved pregnancy and neonatal outcomes. The elective Cerclage was more effective in the low-risk group than the high-risk group.

Evaluation of the effects of Occlusal Stabilization Appliance on the cervical dystonia symptoms

Nasim Borhani, mehri salari, Farzad Ashrafi, Soodabeh Kolivand

School of Medicine Students' Journal, Vol. 4 No. 1 (2022),

Background and aims: Cervical dystonia is a contraction of the neck muscles that causes movement problems, pain, and dysfunction in daily functioning. This problem can occur for a variety of reasons, and today it is more common due to computer work or working with mobile phones (any factor that causes prolonged pressure on the neck). Occlusal Stabilization Appliance (OSA) is a dental splint that is said that it is a good method to relax neck and face muscles, reduce symptoms, and even relieve cervical dystonia. In this study, we aimed to investigate the effects of OSA in reducing patient's symptoms.

Methods: In this experimental study performed on patients with cervical dystonia referred to Shohada-e-Tajrish Hospital from start to the end of 2019, 7 patients were studied. OSA was created for patients and the patients were followed up 24 hours, 3 months after using OSA. Follow-ups were performed using the Dystonia Assessment Questionnaire (TWSTRS) and dystonia scaling and examination for improvement.

Results: Three patients were male and four were female. The mean age was 42 ± 11.66 years. Patients had a mean history of dystonia of 10±8 years. There was no statistically significant difference between total relaxation, pain reduction, increased sleep quality, and tremor disappearance between 24 hours and 3 months after prosthesis, but there was a statistically significant difference in increased comfort 24 hours and 3 months after prosthesis (P-value = 0.053). Using OSA improves Rotation, Duration, and Maintain head max time.

Conclusion: The use of OSA in the short term improves pain, increases the quality of sleep, relaxation, and elimination of tremor, but in the long term, has no effect on reducing these parameters.

Mini Review

Therapeutic Effects of Apelin on Spinal Cord Injury: A Novel Promising ‎Treatment Target

Saeed Vafaei-Nezhad, Hojjat Allah Abbaszadeh, Masood Vafaei-Nezhad

School of Medicine Students' Journal, Vol. 4 No. 1 (2022),


Spinal cord injuries can cause a variety of complications such as chronic pain, and complete and incomplete sensory, motor, and autonomic function loss below the site of the lesion. Despite advances in medicine, the treatment of spinal cord injuries remains a complex issue. Recent studies have shown that controlling and regulating the secondary phase of spinal cord injury can reduce the spread of nerve tissue damage, create a suitable environment for nerve fiber regeneration, and ultimately reduce neurological complications in patients with spinal cord injury. Although treatments such as drug therapy, gene therapy, cell therapy hypothermia, and tissue-engineering scaffolds have been studied to induce repair, none of them have completely eliminated the side effects of SCI so far. It is well established that apelin has neuroprotective potential in various nervous system damage and numerous studies carry out on this subject. Recently, researchers proposed that apelin is considered a promising therapeutic ‎goal.‎

Short Communication

Opium-Induced Bowel Dysfunction: A hospital survey in two academic centers of Iran

Dorsa Daneshbakhsh , Shayan Sheikhmiri , Mostafa Hamdieh , Mitra Rahimi

School of Medicine Students' Journal, Vol. 4 No. 1 (2022),

Background and aim: Opioids abuse is associated with several gastrointestinal side effects. We evaluated the prevalence of gastrointestinal symptoms in OIBD in hospitalized patients in different wards of Shahid Beheshti University of Medical Sciences (SBMU) hospitals. This study aimed to investigate patients' frequency symptoms treated with opioids and opium addicts and their derivatives.

Materials and Methods: The present study is a descriptive study conducted from April 2018 to October 2018. Direct interviews with the study population were performed for data collection. Their information, symptoms, and complaints were checked.

Results: Among the gastrointestinal symptoms, constipation was the most common symptom (59.3%). This pattern is followed by bloating (28.6%), heartburn (27.1%), abdominal pain (25.7%), dysphagia (22.9%), gastroesophageal reflux disease (22.1%), nausea (12.1%), and vomiting (7.9 %) and diarrhea (5 %) were the next prevalent symptoms, respectively.

Conclusion: Finally, our study showed that OBID symptoms are present in most opioid users and most of these people suffer from constipation. Also, the type of substance consumed by the person, the duration of continuous use and cigarette smoking play a role in the incidence of these symptoms.