JOURNAL OF MEDICAL RESEARCH (JMR)
Year:2002 | Volume:1 | Issue:1|Papers Count:9

Background: Previous studies have shown that progesterone can alter the immune response and a high level of this hormone in pregnancy has a substantial role in blastocyst implantation and fetus survival. Since a fetus can be regarded as an allograft for the mother, it seems that high levels of progesterone may have the same effect on other types of grafts. In the present study, the effect of high dose progesterone administration on skin allograft survival was investigated in rats. Materials and Methods: Sixty-one female rats and their newborns were divided into four groups. Three groups of mother rats received medroxy progesterone acetate (6.5, 16.5, 25 mg/kg, I.M.) in a single dose. In the control group (n=14), mother rats received the same volume of vehicle. After five days, a full thickness skin graft was obtained from the back (interscapular region) of the The dressing at the grafted sites were changed every day and observed for any rejection signs including graft infiltration, scar formation and graft loss. Biopsies from skin grafts were prepared for histopathological studies. Results: Graft survival time of the groups that received progesterone in high doses were significantly more than Conclusion: High dose progesterone administration can have an ameliorative effect on skin allografts and can prolong survival time.

Background: Quantitative changes of histopathological structures are important in the process of improvement or regression of diseases. The aim of this study was to stereologically assess kidney volume (cortex and medulla) in glycerol-induced acute renal failure (ARF). Materials and Methods: Twenty-four Sprague Dawley rats were selected and randomly divided into two groups. In the case group, ARF was induced by intramuscular injection of 50% glycerol (10 ml/kg). The control group received the same amount of saline solution. After 48 hours, anesthetized rats were sacrificed and the right kidneys were fixed by formalin perfusion. Kidneys were embedded in agar block and 1 mm thick slices were prepared by microtome. Each slice was processed and stained by hematoxylin eosin. Microscopic slides were used to measure the kidney volume using the point counting method and Cavalieri principle. Results: Kidney volume in the experimental group was more than that in the control group and there was a significant relationship between the cortex and whole kidney volumes. Conclusion: It seems that pathological changes coincided with volume changes. Although this procedure is unbiased, the results should be supported by further studies.

Background: Post-operative nausea and vomiting can prolong recovery and its treatment has traditionally been dependent on parenteral medication which is expensive and may cause various side effects. In recent studies, sniffing of isopropyl alcohol (ISO) appears to relieve post-operative nausea and vomiting. We performed this pilot study to examine the efficacy of ISO sniffing in the treatment of postoperative nausea and vomiting. Materials and Methods: Eighty-two consecutive patients (48 females, 34 males) who complained of nausea and vomiting after elective surgery were enrolled in this study. The patients were randomly divided into two groups. 0.5 ml of either normal saline (control group) or ISO (study group), was applied to a instructed to sniff twice. The symptoms were reassessed immediately and 5 minutes later. All the patients who did not respond to the initial treatment after 5 minutes received a second treatment. The patients who did not respond the second time, received an injection of metoclopromide. Results: Thirty-two (78%) patients responded the first time and 9 (22%) did not respond to ISO (P<0.0001). However, in the control group only 3 (7.3%) patients responded and 38 (92.7%) patients failed to respond to normal saline and metoclopramide was administered. Out of 32 patients who responded to isopropyl alcohol, nausea and vomiting redeveloped in 14 (43.8%) and ISO was readministered after 5 minutes. Five patients again developed the symptoms and were treated by metoclopramide. Conclusion: Isopropyl alcohol may serve as a simple, innocuous, and inexpensive treatment for post-operative nausea and vomiting.

Background: Hairy cell leukemia (HCL) is a chronic B cell disorder that follows an indolent but progressive course. The ability of the new purine analogue deoxyadenosine to induce long-term complete remission in patients with hairy cell leukemia has revolutionized the treatment of this disease. In this clinical trial, we report the long term outcome of patients with HCL treated with this drug in Shiraz. Materials and Methods: From October 1993 to April 2002, 58 patients with symptomatic classic hairy cell leukemia were treated with 2-chlorodeoxy adenosine (2-CdA) with a dose of 0.1 mg/kg of body weight per day by a continuous intravenous infusion for 7 days.Results: Fifty patients (86.2%) achieved an initial complete remission and 7 (12.0%) showed a partial response. The patients were followed up for a mean duration of 63 months. Five patients (10%) relapsed after a mean of 43 months, all of whom received a second course of 2-CdA. Four of the patients (80%) achieved a second complete response and one (20%) had a partial response. No case of secondary malignancy was observed after treatment with 2-CdA over a mean follow-up period of 63 months. Conclusion: A single course of 2-CdA induced a long-term remission in the vast majority of patients with HCL. Relapse rate for complete responders was low. Patients who relapsed were successfully retreated with a second course of this drug. It can be concluded that 2-CdA has high efficacy with a low rate of acute and long-term toxicity with no increased risk of development of a secondary malignancy.

Background: Necrotizing enterocolitis (NEC) is one of the major causes of morbidity and mortality among preterm neonates at intensive care units. The aim of this study was to determine the risk factors contributing to NEC at Shiraz University of Medical Sciences. Materials and Methods: Medical records of all neonates with diagnosis of NEC, who were admitted at neonatal intensive care units, during 1990-1997, were reviewed. Results: Thirty-three neonates were treated with the diagnosis of NEC. The male to female ratio was 1,2 Seventy-three percent of the neonates were under 2500 grams and 75% had a gestational age of less than 37 weeks. Perinatal complications including preterm delivery, premature rupture of membrane and toxemia of pregnancy were recorded in 85% of the neonates. Patients were grouped in three stages of Bell's classification; Stage I (76%), Stage II (12%) and Stage III (12%). The overall survival rate was 57%. Conclusion: Recognizing risk factors such as prematurity, low birth weight, perinatal complications and asphyxia would help reduce the morbidity and mortality due to necrotizing enterocolitis.

Background: Psoriasis is a chronic and common papulosquamous disease characterized by proliferation of keratinocytes and infiltration of inflammatory cells in epidermis and dermis. Its prevalence is 1-3 percent of the general population, with a male to female ratio of 1:1. This study was performed in order to determine the demography, different clinical aspects, age, sex, sites at the onset of disease, family history, involvement of scalp and hair loss in psoriatic patients admitted to Faghihi Hospital, between 1990 and 2000. Materials and Methods: Data were collected from the medical files of 191 patients with psoriasis (123 men and 68 women). The information was recorded in appropriate questionnaires and the data were then analyzed. Results: The age at the onset of disease was from birth to 85 years of age, with two peaks at 21-30 and 51-60 years. The mean age of the onset for men and women was 30.68 years (SD= 18.8) and 31.95 years (SD=21), respectively. One hundered and forty-four cases (75.39%) had scalp involvementwith a male to female ratio of two to one. Nine out of 191 cases (4.71%) had hair loss, which was greater in men. The commonest form of psoriasis was vulgaris (59.68%). More than one half of the patients were from Fars province, the majority from the city of Shiraz, followed by Bushehr province. Conclusion: The prevalence of psoriasis was greater in men than women (M/F ratio=1.8). Seventy-five percent of the patients had scalp involvement and male to female ratio was two to one. The commonest form of scalp involvement was the generalized type followed by the occipital type.

Background: Low back pain is one of the most common occupational problems in the society. The aim of this study was to compare the probability and rate of low back pain in different occupations. Materials and Methods: This study was performed on the basis of information collected by questionnaires followed by clinical, radiological, and laboratory evaluations .One thousand men aged 25- 50 years (mean 37.5 years) were randomly selected from five different occupations (farmers, labourers, employees, nurses and tradesmen).Results: The overall lifetime and one year period prevalence of low back pain were 27.8% and 15.4%, respectively. Symptoms were more common in men with manual occupations than in those with non-manual jobs. Thus, the rate of low back pain in different occupations were different (p=0.0001). The lifetime prevalence of low back pain was 41% in labourers, 37% in farmers, 27% in employees , 21% in nurses and 13% in tradesmen. The most prominent physical risk factors associated with low back pain were the stooping position (p=0.01) and sitting position more than four hours a day (p<0.05). Age and duration of working hours were the other risk factors (p<0.05 for age and p=0.001 for working hours).Accentuated lumbar lordosis and positive straight leg raising test were-the most prominent clinical findings. The most important radiological findings were traction spur and disc space narrowing. Conclusion: Stooping position is an important risk factor for low back pain in jobs with heavy manual work. In sedentary workers and employees, sitting more than 4 hours a day is another prominent risk factor for low back pain.

Background: Suicide is a major health problem leading to 9% of deaths. It is also a common cause of hospital admissions. Materials and Methods: From Mehr 1379 to Khordad 1380, one hundred patients, who had attempted suicide were selected by simple random sampling at Faghihi and Nemazee hospitals. Results: The patients were between 15 to 65 years of age. The majority of the cases were in the age group of 20-29 years. Fifty-four per cent were females and 57% were single. Fifty-nine per cent suffered from a previous psychiatric disorder notably depression (53%). 78% used drugs as the suicidal agent. The most commonly used drugs for suicide were benzodiazepines (41%). The most important symptom of poisoning was decrease in the level of consciousness (64%). Fifty-one percent of the patients required hospital admission, 5% of them developed major complications after their suicidal attempt and 1% died. Conclusion: The high rate of suicide in the young age group, warrants a more careful look at their mental health problems. Also the high percentage of suicide in married females in comparison to studies from abroad shows a lower social support for this group.