Dr Shahram Agah:

• Gastroenterology and liver specialist from Tehran University of Medical Sciences
• Fellowship in endosonography and endoscopy therapeutics from the German Elliptical University

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New discovery of scientists about lung cancer

Together, the McGill University Health Centre (MUHC), the Centre hospitalier de l’Université de Montréal (CHUM) and St. Mary’s Hospital Center (SMHC) have contributed to an international clinical trial that will change the way we treat non-small cell lung cancer (NSCLC)—the most common form of lung cancer. In this trial, an immunotherapy drug called pembrolizumab (KEYTRUDA®), used in conjunction with neoadjuvant chemotherapy (i.e., given before surgery) and then again after surgery, has been shown to slow cancer progression and recurrence and to reduce the presence of residual tumours in patients with early-stage operable NSCLC. In the experimental group, three out of five patients remained stable for two years (without cancer progression or recurrence), compared with two out of five in the control group, an improvement of around 50 per cent.

The interim analysis of this randomized, double-blind, Phase III clinical trial was recently presented at the American Society of Clinical Oncology (ASCO) 2023 Annual Meeting in Chicago and published in The New England Journal of Medicine.

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According to the official announcement of the World Health Organization, one to two out of every 1,000 newborns have hearing loss in one or both ears.
According to experts, the maximum time to diagnose hearing problems in babies is up to the age of one month, and finally, the baby should be ready to start hearing rehabilitation training by the age of three months, which shows the importance of timely follow-up and parents’ attention to their child’s hearing problems.

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The use of Implantable Corneas from Pig Skin to Restore Vision

Scientists in Sweden from Linköping University have successfully developed implantable corneas from pig skin for 14 previously blind patients. From sites in Iran and India, a study was performed on 20 patients who got an implant for restoring their corneal thickness and curvature to a normal level. The visual outcome was perfect as a human-donated cornea was used.

An implant rejection was prevented due to an eight-week course of immunosuppressive eye drops used instead of the normal regimen typically used following a human corneal transplant. An eight-week course of immunosuppressive eye drops was enough to prevent implant rejection, much shorter than the regimens typically used following a human corneal transplant.

According to the analytics firm Vision Research Reports, the corneal implants market is around $420 million this year but it is expected to increase to $700 million by 2030. This growth is due to the rising prevalence of corneal diseases and the interest of industries in bioengineered, 3D-printed, and stem cell-derived corneas.

Source: Pharmiweb

 corneal / pig / Sweden / Linköping University  / Iran / Transplant

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THE INCIDENCE of chronic renal failure (CRF) in children is unknown, but current data suggest that 1.5
to 3 children per million develop end-stage renal disease (ESRD) each year.

The prevalence of CRF in the pediatric population worldwide is approximately 18 per million.

It has been reported that approximately 8% of adults on dialysis and 20% to 30% of children on dialysis have
abnormal urinary tracts.1 The registry of the North America Pediatric Renal Transplantation society confirms that different forms of obstructive uropathy (including reflux and dysplasia)

were not significantly different with regard to mean donor and recipient ages, and sex distribution. We also divided our patients
into two groups (before versus after 1996,) seeking to match patients by immunosuppressive drugs and year of transplantation.

Rejection was clinically diagnosed when a patient exhibitedtenderness over the graft site, swelling of the graft on ultrasonography, persistent fever, oliguria, hypertension, and progressive elevation of serum creati nine.

Biopsy was performed in cases of suspected rejection; the diagnosis was confirmed by increased
mesengial matrix, increased lobularity, decreased glomerular size and hyalinization, and vascular and tubular lesions. Children
returned to chronic dialysis, those who required retransplantation, and those who died of renal complications were all considered to have lost their grafts.

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n

Abstract: NGAL is a member of the lipocalin protein family that has diverse function but similar structure. The functions of NGAL are not clear, but it appears to be expressed in stress conditions and in tissues undergoing involution.

Varied studies have shown increased levels of plasma or urinary NGAL in diverse renal damages. The aim of this study was the serial measurement of serum and urinary NGAL within the first week after renal transplantation in children to predict imme- diate and short-term graft function. A total of 27 patients were assessed.

These patients were classified into those with rapid reduction in serum creatinine (more than 50% reduction in serum creatinine in the first day after transplantation) and patients with slow reduction in serum cre- atinine (<50% reduction in serum creatinine). We also assessed the absolute reduction in serum creatinine before and after transplantation. Serum and urinary NGAL on the first day post-transplantation were higher in recipients with slow reduction in serum creatinine (urinary NGAL at the first day: 197 ± 153 [s.e.m.] vs. 22.54 ± 8.5 [s.e.m.],

p = 0.04; serum NGAL at the first day: 199 vs. 69.8, p = 0.003). The cutoff point of serum NGAL at the first day after transplantation for prediction of slow creatinine reduction was 174 ng/mL with a sensitivity of 100% and specificity of 95.5%. However, we did not find association between the absolute reduction in serum creatinine before and after transplantation with the amount of serum and urinary NGAL post- transplant. Additionally, we did not find any effect of high serum and urine NGAL concentration on the graft function at the first year post- transplant. Although it is supposed that high serum and urine NGAL may predict ischemia of graft in early phases; however, it appears that this mild ischemic injury to graft without DGF or SGF cannot affect the graft function in short-term period. Further studies are needed using larger transplant recipients in pediatric age group. It is also needed to determine the effects of mild ischemic injuries on the graft function in long-term period in future studies.

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The choledochal cyst is one of the congenital diseases of the bile ducts in children, which is treated surgically.

During this surgery, the cyst is removed and the ducts are reconstructed using the intestine or duodenum.

Until now, this surgery was only performed in an open manner with a relatively large incision on the right side of the abdomen.

Dr. Seyed Mojtabi Mousavi Khoshdel, a specialist in pediatric surgery, for the first time in the country, succeeded in performing this complex surgery using the mini-laparoscopy method at Hazrat Ali Asghar (AS) educational and therapeutic center.

In this advanced method, instead of making a big incision and cutting the abdominal muscles, several 5 mm incisions are used in the depth of the abdominal wall.

As a result, the complications and pain after the operation will be reduced and the scar of the abdominal wound will not appear after the operation

– operation – abdomen – abdominal Hazrat Ali Asghar – surgery mini – laparoscopy – laparoscopy – pain – cyst – congenital – diseases –

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“Dr.Sam Zeraatiannejd Davani”

I wonder if you have heard about the Cardiac Resynchronization Therapy. There exist a lot of patients with low output Cardiac failure and low LVEF or ejection fraction, as a result of Coronary Artery Disease, Dilated Cardiomyopathy, or Valvular Heart Disease.

There exist some cases who are not good candidate for transplantation or as a result of paucity or lack of adequate donor or suitable donor for these patients, these patients unfortunately pass away during their waiting list so we have to do alternative technics.

Here you are in Iran, in Ay Health  center in Rasool Akram Hospital, we have performed more than one hundred cases of Cardiac Resynchronization Therapy (via) Anterolateral Thoracotomy which can increase the Cardiac LVEF more than fiftteen to twenty percenst in these patients and alleviate all of their symptoms especially their Dyspnia and Exertion and especially their chest pain and especially their complications as result of Cardiac Failure, just like Pleural Effusion or right side heart failure and another issue to take into consideration while speaking about Cardiac Resynchronization Therapy or battery pacemaker insertion for the patients it can impede the further alteration in the rythm of the patients just like impeding the further venticular, Tachyarrhythmia or Venticular Fibrillation and etc.

So, in order to do so, you can call and contact with mrs. Haghi in Ay Health in order to do that operation in Rasool Akram Hospital, Syou can share your information , send your diagrams, your Echocardiography, your Angiogram and your documentations in order to assess them and then give you your all feedbacks.

Really appreciate you.

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