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  1. Article: Clinical outcome of thymectomy in myasthenia gravis patients: A report from Iran.

    Seyfari, Benyamin / Fatehi, Farzad / Shojaiefard, Abolfazl / Jafari, Mehdi / Ghorbani-Abdehgah, Ali / Nasiri, Shirzad / Yaghoobi-Notash, Aidin / Molavi, Behnam / Latif, Amir Hossein / Eslamian, Reza / Mir, Ali / Soroush, Ahmadreza

    Iranian journal of neurology

    2018  Volume 17, Issue 1, Page(s) 1–5

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2018-08-13
    Publishing country Iran
    Document type Journal Article
    ZDB-ID 2685400-4
    ISSN 2252-0058 ; 2008-384X
    ISSN (online) 2252-0058
    ISSN 2008-384X
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  2. Article: Large and deep diabetic heel ulcers need not lead to amputation.

    Shojaiefard, Abolfazl / Khorgami, Zhamak / Mohajeri-Tehrani, Mohammad Reza / Larijani, Bagher

    Foot & ankle international

    2013  Volume 34, Issue 2, Page(s) 215–221

    Abstract: Background: Management of large and deep heel ulcers (LDHUs) is a challenge in patients with diabetic foot lesions. We assessed outcomes of a treatment protocol to save feet with LDHUs from amputation.: Methods: We managed LDHUs (larger than 3 cm(2)) ...

    Abstract Background: Management of large and deep heel ulcers (LDHUs) is a challenge in patients with diabetic foot lesions. We assessed outcomes of a treatment protocol to save feet with LDHUs from amputation.
    Methods: We managed LDHUs (larger than 3 cm(2)) in diabetic feet using a multidisciplinary approach consisting of medical and surgical management, including revascularization and amputation, if necessary. For deep heel infection and/or gangrene, we frequently debrided and drained the deep spaces of the heel, as needed. In patients with non-ischemic feet, we made a flap from the heel pad with a broad pedicle. When satisfactory granulation tissue covered the base of the heel and the inner surface of the flap, we sutured the heel flap to its base.
    Results: We managed 37 feet with LDHUs among 384 patients. Twenty-nine patients (78.4%) had neuropathy, 6 (16.2%) had ischemic diabetic feet, and 2 (5.4%) had both neuropathy and ischemia. Twelve (32.4%) had septic diabetic feet. We performed two femoropopliteal bypasses, 2 infrapopliteal bypasses, and 1 distal bypass (crural) for ischemic heel ulcers. Thirty-three of the 37 feet with heel lesions (89.2%) were salvaged using this multidisciplinary approach. These 33 LDHUs healed after 4 to 7 months (median, 6 months). Transtibial amputation was performed for 4 feet (10.8%; 2 ischemic and 2 neuropathic cases).
    Conclusions: Diabetic patients with LDHUs can be managed with a multidisciplinary approach to prevent amputation. If necessary, deep spaces of the heel can be debrided by elevating the heel pad like a flap and then performing satisfactory reconstruction.
    Level of evidence: Level IV, retrospective case series.
    MeSH term(s) Amputation ; Anti-Bacterial Agents/therapeutic use ; Cross-Sectional Studies ; Debridement ; Diabetic Foot/pathology ; Diabetic Foot/therapy ; Diabetic Neuropathies/complications ; Drainage ; Female ; Heel/blood supply ; Humans ; Ischemia/complications ; Limb Salvage/methods ; Male ; Middle Aged ; Osteomyelitis/therapy ; Patient Care Team ; Prospective Studies ; Surgical Flaps ; Vascular Grafting ; Wound Healing
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2013-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1183283-6
    ISSN 1944-7876 ; 1071-1007
    ISSN (online) 1944-7876
    ISSN 1071-1007
    DOI 10.1177/1071100712460228
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  3. Article ; Online: Assessment and treatment of choledocholithiasis when endoscopic sphincterotomy is not successful.

    Shojaiefard, Abolfazl / Esmaeilzadeh, Majid / Khorgami, Zhamak / Sotoudehmanesh, Rasoul / Ghafouri, Ali

    Archives of Iranian medicine

    2012  Volume 15, Issue 5, Page(s) 275–278

    Abstract: Background: Choledocholithiasis exists in approximately 15% of patients with gallstones and is present in 3%-10% of those undergoing cholecystectomy.: Methods: In this study, we retrospectively analyzed the outcome patients with choledocholithiasis ... ...

    Abstract Background: Choledocholithiasis exists in approximately 15% of patients with gallstones and is present in 3%-10% of those undergoing cholecystectomy.
    Methods: In this study, we retrospectively analyzed the outcome patients with choledocholithiasis that were managed by open common bile duct (CBD) exploration according to our center's protocol. Endoscopic retrograde cholangiopancreatography (ERCP) was performed for CBD stone clearance. If ERCP and sphincterotomy were not successful, open surgical exploration of CBD was performed with T-tube insertion without routine intraoperative cholangiography (IOC).
    Results: We studied 1462 patients with choledocholithiasis. ERCP was successful in in 1276 (87.2%) patients. A total of 186 (12.8%) underwent surgery. Of these, 82 (45.2%) had CBD exploration and T-tube insertion without IOC. Choledochoduodenostomy was performed in 82 (44.1%) patients and choledochojejunostomy was performed in 20 (10.8%). Retained stones were found only in 4 cases which were treated by ERCP.
    Conclusion: ERCP is successful in most cases with choledocholithiasis. If ERCP fails, open exploration of CBD and T-tube insertion, or biliary-enteric anastomosis are acceptable ways for CBD drainage. The rate of retained stone is not more than expected, thus elective IOC is more acceptable than routine IOC. Routine IOC is time-consuming and particularly difficult in elderly patients and emergency conditions.
    MeSH term(s) Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy, Laparoscopic ; Choledocholithiasis ; Humans ; Sphincterotomy, Endoscopic
    Language English
    Publishing date 2012-05
    Publishing country Iran
    Document type Journal Article
    ZDB-ID 2204979-4
    ISSN 1735-3947 ; 1029-2977
    ISSN (online) 1735-3947
    ISSN 1029-2977
    DOI 012155/AIM.006
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  4. Article: Peripheral lymphadenopathy: approach and diagnostic tools.

    Mohseni, Shahrzad / Shojaiefard, Abolfazl / Khorgami, Zhamak / Alinejad, Shahriar / Ghorbani, Ali / Ghafouri, Ali

    Iranian journal of medical sciences

    2014  Volume 39, Issue 2 Suppl, Page(s) 158–170

    Abstract: Peripheral lymph nodes, located deep in the subcutaneous tissue, clean antigens from the extracellular fluid. Generally, a normal sized lymph node is less than one cm in diameter. Peripheral lymphadenopathy (LAP) is frequently due to a local or systemic, ...

    Abstract Peripheral lymph nodes, located deep in the subcutaneous tissue, clean antigens from the extracellular fluid. Generally, a normal sized lymph node is less than one cm in diameter. Peripheral lymphadenopathy (LAP) is frequently due to a local or systemic, benign, self-limited, infectious disease. However, it could be a manifestation of underlying malignancy. Seventy-five percent of all LAPs are localized, with more than 50% being seen in the head and neck area. LAP may be localized or generalized. Cervical lymph nodes are involved more often than the other lymphatic regions. Generally, it is due to infections, but most of the supraclavicular lymphadenopathies are associated with malignancy. Based on different geographical areas, the etiology is various. For example, in tropical areas, tuberculosis (TB) is a main benign cause of LAP in adults and children. Complete history taking and physical examination are mandatory for diagnosis; however, laboratory tests, imaging diagnostic methods, and tissue samplings are the next steps. Tissue diagnosis by fine needle aspiration biopsy or excisional biopsy is the gold standard evaluation for LAP. We concluded that in patients with peripheral LAP, the patient's age and environmental exposures along with a careful history taking and physical examination can help the physician to request step by step further work-up when required, including laboratory tests, imaging modalities, and tissue diagnosis, to reach an appropriate diagnosis.
    Language English
    Publishing date 2014-01-31
    Publishing country Iran
    Document type Journal Article ; Review
    ZDB-ID 603872-4
    ISSN 1735-3688 ; 0253-0716
    ISSN (online) 1735-3688
    ISSN 0253-0716
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  5. Article ; Online: Various techniques for the surgical treatment of common bile duct stones: a meta review.

    Shojaiefard, Abolfazl / Esmaeilzadeh, Majid / Ghafouri, Ali / Mehrabi, Arianeb

    Gastroenterology research and practice

    2009  Volume 2009, Page(s) 840208

    Abstract: Common bile duct stones (CBDSs) may occur in up to 3%-14.7% of all patients for whom cholecystectomy is preformed. Patients presenting with CBDS have symptoms including: biliary colic, jaundice, cholangitis, pancreatitis or may be asymptomatic. It is ... ...

    Abstract Common bile duct stones (CBDSs) may occur in up to 3%-14.7% of all patients for whom cholecystectomy is preformed. Patients presenting with CBDS have symptoms including: biliary colic, jaundice, cholangitis, pancreatitis or may be asymptomatic. It is important to distinguish between primary and secondary stones, because the treatment approach varies. Stones found before, during, and after cholecystectomy had also differing treatments. Different methods have been used for the treatment of CBDS but the suitable therapy depends on conditions such as patient' satisfaction, number and size of stones, and the surgeons experience in laparoscopy. Endoscopic retrograde cholangiopancreatography with or without endoscopic biliary sphincterotomy, laparoscopic CBD exploration (transcystic or transcholedochal), or laparotomy with CBD exploration (by T-tube, C-tube insertion, or primary closure) are the most commonly used methods managing CBDS. We will review the pathophysiology of CBDS, diagnosis, and different techniques of treatment with especial focus on the various surgical modalities.
    Language English
    Publishing date 2009-08-06
    Publishing country Egypt
    Document type Journal Article
    ZDB-ID 2435460-0
    ISSN 1687-630X ; 1687-6121
    ISSN (online) 1687-630X
    ISSN 1687-6121
    DOI 10.1155/2009/840208
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  6. Article: Comparison the effect of stump closure by endoclips versus endoloop on the duration of surgery and complications in patients under laparoscopic appendectomy: A randomized clinical trial.

    Sadat-Safavi, Seyed Abas / Nasiri, Shirzad / Shojaiefard, Abolfazl / Jafari, Mehdi / Abdehgah, Ali Ghorbani / Notash, Aidin Yghoobi / Soroush, Ahmadreza

    Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences

    2016  Volume 21, Page(s) 87

    Abstract: Background: Laparoscopic appendectomy is a well-described surgical technique. However, concerns still exist regarding whether the closure of the appendiceal stump should be done with a clip, an endoloop, or other techniques. In this study, the effect of ...

    Abstract Background: Laparoscopic appendectomy is a well-described surgical technique. However, concerns still exist regarding whether the closure of the appendiceal stump should be done with a clip, an endoloop, or other techniques. In this study, the effect of stump closure on duration of surgery and complications by endoclips was compared with endoloop in patients under laparoscopic appendectomy. The study was carried out as a prospective randomized clinical trial between 2013 and 2015 in Shariati Hospital of Tehran.
    Materials and methods: Seventy-six patients under laparoscopic appendectomy were enrolled and randomly assigned to receive either endoclips or endoloop for stump closure. The results in terms of the operating time, length of hospital stay, and the complications were compared and analyzed between two groups. After collecting the essential data by using a checklist and examination of patients, the data were analyzed with SPSS.
    Results: The mean age was 23.13 ± 5.07 years and 44.7% of the patients were male. Moreover, in this study, it was seen that the mean duration of surgery was 23.2 min versus 21.5 min in endoloop and endoclips groups, respectively (
    Conclusion: The effect of stump closure with endoloop versus endoclips is not different for complications, but the duration of surgery was shorter in endoclips method. Both methods could be used based on the opinion of the surgeon without expecting a statistically significant difference in the results.
    Language English
    Publishing date 2016-10-18
    Publishing country India
    Document type Journal Article
    ZDB-ID 2513029-8
    ISSN 1735-7136 ; 1735-1995
    ISSN (online) 1735-7136
    ISSN 1735-1995
    DOI 10.4103/1735-1995.192503
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  7. Article ; Online: Independent risk factors for amputation in diabetic foot.

    Shojaiefard, Abolfazl / Khorgami, Zhamak / Larijani, Bagher

    International journal of diabetes in developing countries

    2009  Volume 28, Issue 2, Page(s) 32–37

    Abstract: Background: Diabetic foot (DF) is the main cause of nontraumatic lower extremity amputation. Early recognition and management of risk factors for foot complications may prevent amputations and other adverse outcomes.: Materials and methods: At our ... ...

    Abstract Background: Diabetic foot (DF) is the main cause of nontraumatic lower extremity amputation. Early recognition and management of risk factors for foot complications may prevent amputations and other adverse outcomes.
    Materials and methods: At our hospital we have a protocol for the management of patients hospitalized because of DF. We collected clinical and laboratory data, details of diabetes complications, and history of comorbidities in 146 patients who were admitted for management of DF to determine the risk factors of amputation (major or minor) in these patients. We divided these patients into two groups, those whose treatment included amputation and those who were treated conservatively and carried out a comparative analysis of the variables in the two groups.
    Results: Major amputation was performed in 5.5% of the patients and minor amputation in 22.6%. Those who required amputation presented a significantly higher (P < 0.05) incidence of nephropathy, history of previous amputation, ischemic diabetic foot and first fasting blood glucose (FBG) > 200 mg/dl after admission. Multivariable-adjusted odds ratios in stepwise logistic regression model was 2.64 for nephropathy (95%CI: 1.06 to 6.60; P = 0.03); 3.03 for ischemic diabetic foot (95%CI: 1.28 to 7.18; P = 0.01); and 3.01 for first FBG > 200 after admission (95%CI: 1.32 to 6.83; P= 0.01).
    Conclusion: Nephropathy, ischemic diabetic foot, and first FBG > 200 mg/dl are independent predictors of limb amputation in patients hospitalized for DF lesions. In addition to early detection and treatment of foot lesions, early management of risk factors is also important.
    Language English
    Publishing date 2009-10-28
    Publishing country India
    Document type Journal Article
    ZDB-ID 2263351-0
    ISSN 1998-3832 ; 0973-3930
    ISSN (online) 1998-3832
    ISSN 0973-3930
    DOI 10.4103/0973-3930.43096
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  8. Article ; Online: Evaluation of Response to Preoperative Chemotherapy Versus Surgery Alone in Gastroesophageal Cancer: Tumor Resectability, Pathologic Results and Post-Operative Complications.

    Kashefi Marandi, Aref / Shojaiefard, Abolfazl / Soroush, Ahmadreza / Ghorbani Abdegah, Ali / Jafari, Mehdi / Khodadost, Mahmoud / Mahmoudzade, Hossein

    Asian Pacific journal of cancer prevention : APJCP

    2016  Volume 17 Spec No., Page(s) 231–237

    Abstract: Gastroesophageal cancer is one of the most common types of cancer worldwide. Despite significant developments in management, 5-year survival in the developing world is less than 20 percent. Due to restricted research about the impact of preoperative ... ...

    Abstract Gastroesophageal cancer is one of the most common types of cancer worldwide. Despite significant developments in management, 5-year survival in the developing world is less than 20 percent. Due to restricted research about the impact of preoperative chemotherapy (POC) on tumor resection, pathological response and postoperative complications in Iran, we designed and implemented ‎the present retrospective cross- sectional study on 156 patients with gastroesophageal cancer (GEc) between 2013 and 2015 at Shariati Hospital of Tehran. Two groups were included, the first group had previously received preoperative chemotherapy and the second group had only undergone surgery. All patients were followed for at least one year after the operation in terms of tumor recurrence, relapse free survival and one-year survival. The two groups were eventually compared regarding tumor resection, pathological response, postoperative complications, recurrence rate and survival. The mean age was 66.5± 7.3 years and 78 percent were male. The tumor resectability, pathological response and postoperative complications in the group which received POC were 93.5%, 21.8% and 12.8%, respectively, and in the surgery alone group figures for tumor resection and postoperative complications were 76% and 29.5%, respectively. Also based on our study the 5-year survival in the POC group was better (79.5% vs. 66.5%). Using standard neoadjuvant regimens (preoperative chemotherapy/ chemoradiotherapy) beforesurgery could increase tumor resectability, pathological response, and improve the general status of the patients. Therefore using POC may be recommended over surgery alone.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Cross-Sectional Studies ; Esophageal Neoplasms/drug therapy ; Esophageal Neoplasms/pathology ; Esophageal Neoplasms/surgery ; Esophagogastric Junction/pathology ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local/drug therapy ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/surgery ; Neoplasm Staging ; Postoperative Complications ; Preoperative Care ; Prognosis ; Retrospective Studies ; Stomach Neoplasms/drug therapy ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery ; Survival Rate ; Young Adult
    Language English
    Publishing date 2016-05-10
    Publishing country Thailand
    Document type Journal Article
    ZDB-ID 2218955-5
    ISSN 2476-762X ; 1513-7368
    ISSN (online) 2476-762X
    ISSN 1513-7368
    DOI 10.7314/apjcp.2016.17.s3.231
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  9. Article ; Online: Septic diabetic foot is not necessarily an indication for amputation.

    Shojaiefard, Abolfazl / Khorgami, Zhamak / Larijani, Bagher

    The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons

    2008  Volume 47, Issue 5, Page(s) 419–423

    Abstract: Unlabelled: Management of the septic foot is a challenge in diabetic patients, and this condition often progresses to amputation in an effort to alleviate otherwise incurable infection. We designed and followed a protocol for the management of the ... ...

    Abstract Unlabelled: Management of the septic foot is a challenge in diabetic patients, and this condition often progresses to amputation in an effort to alleviate otherwise incurable infection. We designed and followed a protocol for the management of the septic diabetic foot and, after 2 years (May 2004 through June 2006), we analyzed the data related to 31 septic feet of 139 patients. The treatment protocol consisted of blood glucose control, intravenous antibiotic therapy, controlling comorbidities, revascularization, ulcer drainage and irrigation, systematic debridement, dressing changes and wound care, and amputation if necessary. The outcomes of interest were amputation and limb salvage. The analyses showed that frequent drainage and debridement, along with revascularization when indicated and possible, resulted in 4 (12.9%) major (below-the-knee) amputations and 3 transmetatarsal amputations. Of the 7 amputations, 3 were associated with ischemia, 4 with neuropathy, and 1 with neuropathy and ischemia. In follow-up, 1 patient with a prior history of septic diabetic foot required major amputation. Based on these findings, it is concluded that the septic diabetic foot is not necessarily an indication for amputation, and aggressive management by means of metabolic and surgical care can lead to a favorable outcome.
    Level of clinical evidence: 2.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Amputation/statistics & numerical data ; Anti-Bacterial Agents/therapeutic use ; Blood Vessel Prosthesis ; Debridement ; Diabetic Foot/microbiology ; Diabetic Foot/therapy ; Drainage ; Female ; Foot/blood supply ; Foot/surgery ; Humans ; Ischemia/surgery ; Limb Salvage/methods ; Male ; Middle Aged ; Prospective Studies ; Sepsis/therapy
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2008-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1146972-9
    ISSN 1542-2224 ; 1067-2516
    ISSN (online) 1542-2224
    ISSN 1067-2516
    DOI 10.1053/j.jfas.2008.05.005
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  10. Article ; Online: Sciatic nerve compression resulting from posttraumatic pseudoaneurysm of the superior gluteal artery: a case report and literature review.

    Zafarghandi, Mohammad Reza / Akhlaghi, Hamed / Shojaiefard, Abolfazl / Farshidfar, Farshad

    The Journal of trauma

    2009  Volume 66, Issue 6, Page(s) 1731–1734

    MeSH term(s) Adult ; Aneurysm, False/complications ; Aneurysm, False/diagnostic imaging ; Aneurysm, False/surgery ; Angiography ; Buttocks/blood supply ; Humans ; Male ; Nerve Compression Syndromes/etiology ; Nerve Compression Syndromes/surgery ; Sciatic Nerve
    Language English
    Publishing date 2009-06
    Publishing country United States
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 219302-4
    ISSN 1529-8809 ; 0022-5282 ; 1079-6061
    ISSN (online) 1529-8809
    ISSN 0022-5282 ; 1079-6061
    DOI 10.1097/01.ta.0000242215.42642.01
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