Histopathology Review of Idiopathic Steroid Resistant Nephrotic Syndrome and Outcome in Children in North-West of Iran

Introduction: There is currently little information in the literature on the spectrum of histopathologic patterns in children presenting with idiopathic steroid-resistant nephrotic syndrome (iSRNS) in Iran. We conducted to compare the histopathologic distribution of different subtypes’ glomerular morphologic patterns in iSRNS and the clinical and biochemical parameters at the time of diagnosis and outcome of patients after immunosuppressive therapy. Material and Methods: This cross sectional study was done in two hundred children, aged 1 - 15 years, who were diagnosed for iSRNS and no response to 4 weeks of standard prednisone therapy (60 mg/m2/day) referred to nephropathology Department of Emam Reza hospital between 2005 and 2013. Demographic, clinical, laboratory, and histopathological data were retrieved from files and original renal biopsy reports. We discussed histopathologic diagnosis and outcome of iSRNS after initial therapy in patients separately. This study investigated prognostic effects of histopathologic pattern on outcome of iSRNS. Results: The study included 200 children with iSRNS: 141 (70.5%) were males and 59 (29.5%) females, with male-to-female ratio of 2.4:1. The mean age was 7.23 ± 4.37 years (range: 1 - 15 years). Upon pathologic investigation of iSRNS cases, focal segmental glomerulosclerosis (NOS subtype) was the first, with a highest prevalence at a rate of 102/200 (51%) and MGN was the last, at a rate of 7/200 (3.5%). Children with iSRNS secondary to MCD are more likely to achieve remission and have better long term prognostic value (P 0.00). Focal segmental glomerulosclerosis (FSGS) (Tip and Collapse subtypes) is more likely to have worse outcome in response to immunosuppressive therapy (P 0.04). Conclusions: This study defines the true spectrum of clinicohistopathology patterns underlying iSRNS in children in Northwest of Iran. Also this study shows that the response to cyclosporine can be correlated with the underlying histopathology patterns which have been earned by adequate renal biopsy.

Functional Outcomes of Traumatic Complex Acetabulum Fractures with Open Reduction and Internal Fixation: 200 Cases

Objective: Acetabular fractures are common injuries in Iran. We assess the functional outcome of open reduction and internal fixation management of displaced Complex acetabular fractures. Materials and Methods: We analyzed a case series of patients with open reduction and internal fixation (ORIF) for complex acetabular fractures. Two hundred patients (132 men, 68 women) in four age groups including with a mean age of 43.39 ± 6.18 years (range 20 - 59 years) and a mean follow-up of 82.34 ± 12.48 months (range 18 - 109 months) met the inclusion criteria. Functional outcome at final follow-up was graded assessed according to Harris score. Factors affecting were defined. Results: Anatomic reduction was achieved in 192 hips, imperfect in 8 and poor in none. Radiological outcome revealed excellent results in 128 (64%) hips, good in eight, fair in five and none in poor. Harris score were excellent in 139 (69.5%) hips, good in 43 (21.5%) and fair in 18 (9%) and poor in none. The anatomical reduction results had a favorable final functional outcome. (0.003) However, BMI (P Conclusion: Optimal functional and radiological outcomes have been achieved with anatomic postoperative reduction. Also experience of specialist, on time surgery and good recovery lead to receiving excellent functional outcome with at least complications.

Herbal medicine in treatment of dysmenorrhea:a systematic review

Objective:Herbal medicine has been a standard treatment for primary dysmenorrhea in different cultures and countries,and multiple studies have shown its possible positive effect on pain relief.This systematic review of the literature was conducted to assess different types of herbal medicine used to treat primary dysmenorrhea and evaluate the effectiveness of these medicines.Methods:This study systematically reviewed published articles on herbal medicine treating primary dysmenorrhea for 10 years(2011-2021),using Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines.In February 2022,international credible scholarly databases were searched.Also,the references of selected articles were hand searched to find relevant studies.Based on the search syntax,the search guideline was first defined for the PubMed database and was later revised according to each database’s specific framework of search method.The studies were included if they were either clinical trials or Quasi-Experimental,published in English or Persian between 2011 to 2021.Grey literature,unfinished studies,and studies without well-defined primary dysmenorrheal participants were excluded.Results:Seventy-three studies investigated the effectiveness of a total of 44 plants and plant combinations(35 single plants and 9 combinations of plants)on primary dysmenorrhea of which only one study did not report a significant positive effect.Ginger was the most investigated plant.Eight studies assessed the effects of ginger alone,and four studied the combination of ginger with other plants,all of them showed significant effects but one study.Nine studies investigated the effects of either fennel or its combination,five studies were on chamomile and three studies were related to lavender.Overall,all of them,except one,reported the positive effect of herbal medicine on primary dysmenorrhea.Conclusions:Different herbal medicine has been used to treat primary dysmenorrhea,significantly reducing pain intensity or duration or bleeding severity or duration.