Papers by Seyed Ali Alamdaran
Polish Journal of Thoracic and Cardiovascular Surgery, 2021
DOAJ (DOAJ: Directory of Open Access Journals), Jul 1, 2022
Journal of Clinical Medicine, Jan 4, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Research Square (Research Square), Jun 13, 2023
Background: Septic arthritis is an important differential diagnosis of hip joint pain. Joint aspi... more Background: Septic arthritis is an important differential diagnosis of hip joint pain. Joint aspiration analysis is a necessary diagnostic measure for septic arthritis. In order to reduce the need for joint aspiration, we compared the combination of ultrasound findings and laboratory findings to separate septic arthritis from reactive arthritis. Methods: Children aged <14 years who were referred to Akbar pediatric hospital in 2020-2022 with hip pain or limping were included in this longitudinal study. Participants underwent ultrasound examinations of the hip and blood samples were obtained from them. After confirming an effusion, dependent on patient status and clinical diagnosis, one of the following approaches was recommended; the close follow-up, or the ultrasound-guided aspiration of the hip joint effusion, and or arthrotomy. The various ultrasound and laboratory were documented. Data were analyzed and P<0.001 being considered statistically significant. Results: Overall, 115 patients with a mean age of 3.43 ± 5.76 years, 46 of whom were girls, were studied. The final diagnosis in 23 cases (20.0%) was septic arthritis and 92 (80.0%) had reactive arthritis. Serum CRP and ESR unlike aspirate volume, effusion volume measured on ultrasound, capsule thickness, total thickness, and recorded capsule-to-effusion ratio were significantly higher in patients with septic arthritis (P<0.001). There was a significant agreement between the volume of measured fluid in the anterior recess and the volume of aspirated fluid (2.5 times, P<0.001). Septic arthritis was not observed in any of the patients with effusion volume in anterior recess less than 0.5cc and ESR less than 40 or CRP less than 15. Conclusion: Since septic arthritis was not observed in any of the patients with effusion volume <0.5cc and normal inflammatory factors (ESR or CRP), conservative management and close follow-up can be recommended in these patients instead of joint fluid aspiration.
Journal of pediatric nephrology, Dec 22, 2016
To determine whether the timing of voiding cystoureterogram (VCUG) in the first or the third week... more To determine whether the timing of voiding cystoureterogram (VCUG) in the first or the third week after a diagnosis of urinary tract infection (UTI) is important in the diagnosis and severity of VUR. Materials and Methods: In this case-control study, 72 children between 1 month and 15 years old diagnosed with their first episode of UTI were investigated over one year. The study population was divided into 2 groups of 36, early (VCUG in the first week after UTI) and late (VCUG 3 weeks after UTI), and compared the severity and incidence of reflux in both groups. Results: The prevalence of VUR was 66.6%. Twentytwo cases in the first group (61%) and 26 cases in the second group (72.2%) presented with VUR. The peak age of the disease in both groups was 1-3 years with a female predominance. The most common germ detected was E-Coli and the most common presentations were fever (87.5%) and dysuria (26.3%). Conclusions: As VUR following UTI is very common in children and is one of the most important risk factors of early hypertension and chronic renal failure, early diagnosis by VCUG seems to be useful in all UTI patients before discharge.
Breast Journal, May 5, 2017
To the Editor: Breast cancer is one of the most prevalent cancers in the world and surgical treat... more To the Editor: Breast cancer is one of the most prevalent cancers in the world and surgical treatment of breast cancer has experienced marked changes in recent years. The preferred method of treatment for many women with early breast cancer is breast conserving surgery. These surgical techniques are associated with core needle biopsy in the diagnostic process, and surgical excisional biopsy is less likely used to avoid scarring incisions and eliminate second curative surgery. This image-guided procedure should be performed with suitable local anesthesia. There are different anesthetics for a local procedure that the type of anesthesia and needle size for injection can affect the level of anesthesia and the risk of complications. We studied the effect of routine local dental anesthetics in breast biopsy to investigate whether it can decrease probable complications associated with biopsy. The subjects were 89 referred female patients with suspicious breast mass, 4a until 5, based on the 2012 fourth edition BIRADS. Patients were randomly divided into two groups (48 patients for the case group and 41 patients for the control group). In the case group, 48 females with the age ranged from 15 to 60 years were enrolled in the study. The anesthesia was administered using routine local dental anesthetics Persocaine-E (1.8 cc of lidocaine 2% with 1:80 000 epinephrine; Darou Pakhsh pharmaceutical Mfg, Tehran, Iran). A disposable dental needle (27 gauge, 38 mm) mounted on a professional dental aspirating syringe was inserted. In the control group, 41 patients with the same characteristics were enrolled in the study. The routine local dermal anesthesia was administered using local anesthetics 5 cc of lidocaine 2% Caspian Tamin Pharmaceutical, Tehran, Iran) with insulin (for skin) and a 23gauge needle (for biopsy pathway) and their syringe. The data regarding pain feeling during procedure was assessed based on a visual scale 1-5, sonographic observed hematoma, blood oozing during procedure, change in hemodynamic index during procedure, and observed bruise and ecchymosis 48 hour after procedure and its diameters were recorded in the two local anesthesia methods. The pain feeling was not statistically different between two groups (P=.959). However, the comparison of pain score (VAS) during and after the procedure indicated a significant difference between the two groups (P=.580). Bleeding during the procedure and sonographic observed hematoma was not significantly different. During the next visit, after 48 hours, in physical examination, bruise and ecchymosis were significantly different (P<.001). The mean bruise diameter was significantly different (P=.000). No statistically significant difference was found in the change rate of hemodynamic index during the procedure between the two groups (P=.080). Routinely, local anesthesia is induced with 5 cc lidocaine 2% using an insulin syringe (for skin) and a 23-gauge needle (for biopsy pathway). Lidocaine toxicity and anaphylaxis is rare but unfortunately lethal insult is sometimes reported in outpatient clinics. Vasoconstrictor effect of epinephrine when associated with lidocaine causes a longer term effect and lower rate of toxicity of lidocaine and hemorrhage. Although the administration risk of local anesthesia in combination with epinephrine is not lower than lidocaine alone, but lower dose of dental cartilage (1.8 cc) versus lidocaine alone (5 cc) may be associated with less complication. In addition, epinephrine itself is an antianaphylaxis agent. In this study, we used Persocaine-E (1.8 cc lidocaine 2% epinephrine 1:80 000), which may be associated with lower anaphylaxis reaction. Epinephrine in combination with lidocaine also causes a longer term effect and lower rate of pain feeling. Needle size is another factor that can affect the side effects, such as pain, during the procedure and outcome of biopsy. Small gauged diameter needles can cause lower pain, hemorrhage, etc. The disposable dental needles (27 gauge 38 mm) used in this study are the smallest size of needles. In addition, their higher length (38 mm) compared to usual needles (22 or 23 gauge 32 mm) is associated with anesthesia covering a large area through the needle biopsy trajectory tract until mass surface. Although use of epinephrine especially in cardiovascular patients can suddenly raises the blood pressure and heart rate, but some studies have shown that the amount of epinephrine that is usually added to lidocaine as a local anesthesia is safe and has no considerable effect on the cardiac parameters. However, epinephrine dosage should be minimized, for patients with significant cardiovascular disease, in particular ischemic heart disease. The usage of local dental anesthetics (lidocaine-epinephrine) by professional dental needles and syringe in breast biopsy is associated with fewer side effects and can be considered as an option for local anesthesia in breast biopsies. Considering limitations of our…
PubMed, Mar 1, 2011
Objective: Cystic fibrosis (CF) is characterized by chronic pulmonary disease, insufficient pancr... more Objective: Cystic fibrosis (CF) is characterized by chronic pulmonary disease, insufficient pancreatic and digestive function, and abnormal sweat concentration. There is controversy about predisposing factors of nephrolithiasis and nephrocalcinosis in patients with cystic fibrosis. We assessed the results of metabolic evaluation in patients with cystic fibrosis and its correlation with nephrocalcinosis. Methods: Forty five CF patients, mean age 47.1 months, were enrolled in the study. No one had past history of nephrolithiasis and/or nephrocalcinosis. The records were reviewed for clinical characteristics and all patients underwent metabolic evaluation including serum electrolyte measurements and spot urine analysis. Ultrasonography was performed in all patients to detect nephrocalcinosis and urolithiasis. Findings: Nephrocalcinosis was found in 5 (11%) patients. No patient had clinical symptoms of nephrolithiasis and/or micro/macroscopic hematuria. Metabolic evaluation of the CF patients versus normal reference values showed decreased serum uric acid in 48.8%, elevated serum phosphate in 24.4%, and urine oxalate excretion in 51%. Metabolic evaluation of the nephrocalcinosis positive patients versus nephrocalcinosis negative group showed no statistical difference in serum electrolytes. The mean value of urine calcium excretion was lower in patients with nephrocalcinosis (P=0.001). Despite lack of any significant correlation, higher numerical hyperoxaluria was observed in patients with severe steatorrhea. There was no statistical correlation between steatorrhea and urine calcium as well as oxalate excretion. Conclusion: Hypocalciuria in the nephrocalcinotic CF patients may be seen. It can be hypothesized that hypocalciuria may be due to a primary defect in renal calcium metabolism in CF patients.
International Journal of Pediatrics, Jul 1, 2021
Background Studies on colonic motor function in pediatric patients with constipation have reveale... more Background Studies on colonic motor function in pediatric patients with constipation have revealed some dysfunctional patterns of colonic transit. The aim of this study was to evaluate the times and patterns of colon transit time to diagnose and categorize of colon abnormalities.
International Journal of Pediatrics, Dec 1, 2017
Background The occult neurological disorders are an important cause of constipation in children. ... more Background The occult neurological disorders are an important cause of constipation in children. This study aimed to evaluate the spinal canal and lumbosacral by ultrasound in pediatric constipation to better identifying neurological causes of constipation. Materials and Methods In this case-control study, 100 children with constipation (age range 1 to 14 years) without previously known chronic illness referred to the Radiology Department of the Mashhad Pediatric Dr. Sheikh Hospital were selected. After recording clinical data, the patients were undergone sacral and spinal cord ultrasound examinations and the results were compared with the control group (healthy children with transient illness (otherwise constipation or urinary disorders) who had referred to radiology department for sonographic examination). Results The mean age of patients was 6 ± 3.3 years old. The tethered cord and occult intrasacral meningocele were observed in 2% of patients group. Spina bifida was found in 64% patients, and 31% control subjects with significant difference (P = 0.009). About one third of cases with spina bifida were found in lumbar L5 vertebra, and another two third were in high sacral vertebrae (S1 or S2). Various degrees of caudal regression were observed in 8% patients suffering from constipation and in control group, 2% children had coccyx hypoplasia. No significant correlation was found between case and control groups regarding the location of spina bifida and non-formation of the posterior arch of the sacrum, the mean coccyx length, dural diameter and the ossification age of first vertebra of coccyx. Conclusion In pediatric age, lumbosacral spinal anomalies can easily evaluate with ultrasound. The prevalence of spina bifida and caudal regression in children with constipation was significantly higher compared with normal control group.
Daneshvar, Mar 15, 2009
2 : DANESHVAR MEDICINE FEBRUARY-MARCH 2009; 16(79):7-10. COMPARISON OF MAMMOGRAPHIC CHANGES IN TW... more 2 : DANESHVAR MEDICINE FEBRUARY-MARCH 2009; 16(79):7-10. COMPARISON OF MAMMOGRAPHIC CHANGES IN TWO COMMON REGIMENS OF POST MENOPAUSAL HORMONE REPLACEMENT THERAPY AFZALI ...
Iranian Journal of Radiology, Jun 30, 2005
... pain A. Alamdaran MD1. M. Hiradfar MD2. B. Zandi MD3. M. Orei MD4. R. Taheri5 1. Assistant pr... more ... pain A. Alamdaran MD1. M. Hiradfar MD2. B. Zandi MD3. M. Orei MD4. R. Taheri5 1. Assistant professor, Department of Radiology, Dr. Sheikh Children Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. 2. Assistant ...
PubMed, Mar 1, 2021
Background: Intrathoracic kidney is the rarest form of an ectopic kidney that is usually accompan... more Background: Intrathoracic kidney is the rarest form of an ectopic kidney that is usually accompanied by left congenital diaphragmatic hernia (CDH) (Bochdalek hernia), the association of which with other anomalies is rare. Case presentation: Herein, we describe a case with a diagnosis of an intrathoracic kidney associated with the ectopic spleen and diaphragmatic hernia diagnosed during imaging studies for urinary tract infections (UTIs). This study reports an 11-month-old male case with a history of CDH and several episodes of UTIs. A kidney ultrasound revealed that the left kidney and spleen were located in the thoracic cavity. Despite intrathoracic lying of the left kidney, there was no vesicoureteral reflux. Technetium-99m dimercaptosuccinic acid scan reported a highly positioned left kidney . Conclusion: With the consideration of a pediatric literature review among patients with intrathoracic ectopic kidney, our case was special and notable since it was the first neonate who had an association of intrathoracic spleen and kidney in the same side with a delayed diagnosis. The main point of this case was that radiologists should consider thoracic kidney a differential diagnosis of unilateral renal agenesis when there is a history of diaphragmatic hernia.
Ultrasound, Nov 23, 2022
Background: Ultrasound evaluation of normal, ectopic, asymmetric, and hyperplastic thymus and als... more Background: Ultrasound evaluation of normal, ectopic, asymmetric, and hyperplastic thymus and also its differentiation from abnormalities are challenging in children, and few studies have addressed this issue. This study aimed to investigate the thymus sonographic changes with age. Methods: In this cross-sectional study, 118 healthy children were categorised into six age groups. Sonographic features of the thymus, including volume, anatomical position, symmetry, and echo-texture, were recorded. Results: The thymus was visible at all ages from the suprasternal view. In 77.5% of participants, the thymus gland volume in lobes was symmetrical; however, left (21.2%) and right (1.3%) predominance were also found. The most common position of the thymus was in front of the great vessels (100%) with suprasternal extension (97.5%). The mean volume of thymus was 21.3 ± 10.5 (mm). There was no significant difference in the volumes of the thymus between different age groups. The predominant echo-texture of the thymus in different age groups was hypoechoic with thin echogenic septa (liver-like) in below 2–3 years of age, the appearance of echogenic foci and hyperechoic echo-texture (liver-like with starry sky) in 2–14 years, and uniform hyperechoic echo-texture (fatty liver-like) or geographic echo-texture with coarse reticular pattern in above 14 years. Conclusion: In children, the thymus gland is visible in ultrasound examination in all age groups from the suprasternal view; however, the echo-texture of the normal thymus changes with age. There was no significant correlation between age and sex with total thymic volume. The specificity of these appearances has made ultrasound a problem-solving modality in children.
Anesthesiology and Pain Medicine, Mar 13, 2022
Background: Airway management is an important skill for emergency physicians, and confirmation of... more Background: Airway management is an important skill for emergency physicians, and confirmation of correct endotracheal tube (ETT) placement is a crucial component of airway management. Objectives: Due to the occurrence of incorrect ETT positioning in emergency departments, the present study aimed to compare the diagnostic sensitivity of ultrasound using suprasternal and subxiphoid methods for confirming the correct placement of ETT compared to capnography. Methods: This cross-sectional study was conducted by examining patients requiring intubation. Ultrasound was performed by two independent emergency medical assistants using two suprasternal and subxiphoid methods to confirm correct ETT placement; the results were then interpreted. To observe the tube passage through the vocal cords, capnography and lung auscultation were applied as the gold standards, and the results of two ultrasound methods were compared. Results: A total of 66 patients, who were intubated in the emergency department, participated in this study. The positive and negative predictive values, sensitivity, and specificity of supernatural ultrasound were 96.72%, 80%, 98.33%, and 66.67%, respectively. Also, positive and negative predictive values, sensitivity, and specificity of subxiphoid ultrasound were 97.95%, 29.41%, 80%, and 83.33%, respectively. The diagnostic odds ratios of suprasternal and subxiphoid ultrasounds were 1.026 and 1.024 compared to capnography, respectively. Conclusions: Ultrasonography using the suprasternal method was feasible. Considering the high sensitivity and specificity of this method in confirming correct ETT placement, it produced reliable results. Overall, this modality can be used as one of the main methods to verify correct ETT placement in emergency departments.
International Journal of Pediatrics, Aug 1, 2021
International journal of cancer management, Dec 31, 2017
Background: Sentinel lymph node biopsy is the standard method of evaluating and staging the axill... more Background: Sentinel lymph node biopsy is the standard method of evaluating and staging the axilla in the patients with early stage of the breast cancer. The aim of this study is to evaluate the axillary recurrence rate in patients with negative sentinel node biopsy. Methods: From 2006 to 2010, all the patients with a negative sentinel lymph node in their pathologic results were introduced in the study. All patients were invited to the breast cancer clinic for the follow up examination. The axillary ultrasonography was performed to determine the recurrence. Results: Among 150 female patients with negative sentinel lymph node, 52 were entered into the study and were followed up. The mean age was 45.7 ± 8.58 years, and the mean primary tumor size was 2.36 × 2.40 cm. The primary tumor was located in the upper outer quadrant (90.4%) and the mean number of lymph nodes removed was 1.65. All patients underwent physical examination and axillary ultrasonography, which showed axillary lymph node in 3 patients of 31, 48 and, 62 years. Tumors in all 3 patients were located in the upper lateral part of the axilla and 3 lymph nodes were excised. Only 1 patient had histologically confirmed tumor extension into the axillary lymph node. Conclusions: Axillary recurrence after a long-term follow up of patients with negative sentinel lymph node is very rare and our study suggest that the SLN procedure is a gold standard method for the staging of breast cancer.
Journal of child science, 2022
Postoperative fibrotic band formation is a common complication that causes bowel obstruction, chr... more Postoperative fibrotic band formation is a common complication that causes bowel obstruction, chronic pain, and especially reoperation problems. We tried to evaluate the ultrasound signs of different adhesions over time in children. This descriptive study was performed in children hospital of Mashhad University of Medical Sciences. Sixtyfive children aged 4 months to 15 years (mean age of 7.2 AE 6.5 years) were enrolled in the study. Complete abdominal sonography using 5 to 12 MHz multifrequency probes was performed by a pediatric radiologist. The sonographic findings and data analysis were performed. In first week after surgery, the fibrinous exudates are seen as hypoechoic shadows. It has uneven thickness and usually encases the bowel loops in a circular shape. In second week, they gradually become straighter with uniform thickness. In this period, in 68% of cases, a hyperechoic line is formed in the center of hypoechoic fibrinous exudates, which is usually placed between the bowel loops (interloop fibrosis). The omentum or mesentery entrapment in the fibrinous exudates was occurred in $50% and 25% of these cases, respectively. In this state, echogenic omentum or mesentery was seen simultaneously with the hypoechoic fibrinous exudates. After 1 month from surgical procedure, One of the following four sonographic patterns are seen: attachment hyperechoic omentum to retroperitoneum (50%), attachment hyperechoic mesentery to anterior abdominal wall (26%), interloop fibrosis (39%), and severe hypoechoic fibrotic band (30%). Absence of visceral sliding was seen in 65 to 80% of patients. Overall, there are five morphologic patterns of adhesion on ultrasound: fibrinous exudates, interloop fibrosis, fibrotic band, fixed omentum to retroperitoneum, and fixed mesentery to abdominal wall.
Reports of radiotherapy & oncology, Aug 21, 2018
Objectives: Neoadjuvant chemotherapy in locally advanced breast cancer is associated with a volum... more Objectives: Neoadjuvant chemotherapy in locally advanced breast cancer is associated with a volume decrease of the tumor and needs tumor bed localization. We evaluated the accuracy of the radio-opaque surgical clip marker/wire localization in 35 patients. Methods: Patients who were candidates for breast-conserving surgery after neoadjuvant chemotherapy were enrolled at Omid Hospital, Mashhad University of Medical Sciences, Iran in 2015-2017. The lesion localization was performed before the start of chemotherapy. A radio-opaque manually straightened surgical clip was inserted into the mass center by a coaxial needle. After the completion of the neoadjuvant chemotherapy, a localization wire was introduced adjacent to the clip and the surgeon removed the tumor bed. The resected mass was assessed for marginal involvement and location of the clip by the pathologist. Data analysis was performed by SPSS and P values of less than 0.05 were considered significant. Results: The mean maximum diameter of the mass before neoadjuvant chemotherapy was 3.8 ± 1.1 cm. The marker was seen at the center of the lesion in 32 (91.4%) patients and at the para-central part in three patients. All patients had a response to chemotherapy as a decrease in size in 22 patients (63%), and complete effacement of the mass in 13 patients (37%). After chemotherapy, the marker was localized in the peripheral part of the residual mass in six patients. Intra-tumoral clip displacement was detected in 3 patients (8.6%). The clip migration out of the lesion was not seen in any patient. In all of the patients, the tumor bed was resected in the pathology examination and marginal involvement was not seen in any of the cases. Conclusions: In the absence of seed localization, the combination of a surgical clip and wire localization is an easy, safe, available, and accurate choice for localizing the tumor bed in advanced breast cancer patients that are candidates for neoadjuvant chemotherapy.
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Papers by Seyed Ali Alamdaran