Avicenna Journal of Clinical Medicine
Year:2005 | Volume:11 | Issue:4 (SN 34)|Papers Count:15

Among antiepileptic drugs, valproic acid (VA) is a well known teratogenic agent. Although axial skeletal malformations (vertebral column) and limb defects have been described, its main target organ is neuroepithelium of neural tube. Therefore it seems that administration of VA during early pregnancy may affect on neural tube and adjacent tissues. The goal of present study was to determine whether there is a relationship between maternal valproic acid exposure and developmental changes during neural tube and notochord and their interactions.For this reason, on 9th day of gestation, wistar rats were treated with double dose of 600 mg/kg VA given once in the morning and another in the evening (in experimental group). The controls were received the same volume of normal saline by animal feeding. For teratological studies, fetuses were examined on 20th day of gestation and histological study were carried out.Our findings showed that in addition to some well known congenital malformations (such as axial skeletal defects and spina bifida) there was an abnormal cavitation in cervical and thoracic segments of spinal cord (syringomyelia) which was accompanied with a delay in determination of notochord at these levels. At these area, the syrinx (cyst) is lined by compact glial tissue. In this kind of abnormality there is an atrophy of gray and white matter in the neighboring of syrinx in the spinal cord.These data revealed that, there is a strong association between maternal VA administration and risk for severe spinal cord defect such as syringomyelia and the same pathological changes might occur in human.

Western blotting or immunoblotting commonly use for study of reaction between antigens and antibodies. Denaturation of many proteins in immunoblotting can affect greatly the reactivity of antibodies and outcome of the procedure. In this study proteins of Brucella abortus (S19) was extracted by a mild method and reaction of the extracted proteins with serum of infected human and goat and immunized rabbit compared by affinity chromatography and immunoblotting. Gamma globulin (mostly IgG) fraction of the sera was precipitated by half saturation of ammonium sulfate and linked to activated sepharose 4B. The extracted proteins were loaded on the affinity column. Attached proteins was eluted by low pH and analyzed by SDS-PAGE. Reaction of the total extract and eluted fractions with IgG fraction of sera was evaluated by Western blotting.Upon the results of affinity chromatography and immunoblotting, Brucella proteins can be classified in four groups: 1- The proteins that adsorbed to the affinity column and react with IgG in westernblotting. 2- Proteins that react with IgG in native state but no in denatured state. 3- Proteins that do not react with IgG in native state but react in denatured state. 4- Proteins that do not react with IgG in native and denatured state.

Cholecyctectomy is one of the most painful operations that due to adjacent of incision site with chest cage reducing the pulmonary function and accompanied with its complication. Effective analgesia after operation reduces these alternation, complications and improve patient’s outcome. The aim of this study was the comparison of the survey of effectiveness of interpleural bupivacaine and intramuscular opioid (methadone) in post cholecyctectomy analgesia.This randomized clinical trial study was carried out in surgery wards of Ekbatan and Mobasher Kashani hospitals in Hamadan. 20 ASA I and II patients who were candidate for operation were selected into two groups, for IPB group 20cc of 0.25% bupivacaine was injected into interpleural space and for IMM group 70µg/kg methadone was injected intramuscular. The above drugs were repeated every 8hr with the same dosage for 48hr. 6 hours after the operation ABG was repeated and severity of pain with VAS route was measured.There was no statistical significant difference in sex and age between two assessed groups. Postoperative pulmonary function parameters such as vital capacity reduced in 2 groups and had lower change in IPB group and this difference was statistically significant(P=0.03). VAS in IPB group in 6, 24 and 48 hr post operatively was so lower than IMM group that had statistically difference (P=0.006). Patient satisfaction from analgesia was higher in IPB group in compare to IMM group. This difference was also statistically significant (P=0.004). The results of this study showed that using interpleural analgesia in compare with intramuscular methadone for open cholecyctectomy pain were more satisfied and pulmonary function were protected better too.

The angle of long axis of tooth crown is called tip in mesiodostal and torque in faciolingual direction. Both have special importance for producing an ideal occlusion. The aim of the present study was determination of the average tip and torque of each permanent tooth in well treated patients with edgewise system compare to control group with normal occlusion. In this study, 19 well treated cases through standard edgewise technique with non extraction strategy and 20 students of pre-university schools with normal occlusion according to IOTN were selected. Reference points and lines were marked on facial surface of each tooth on casts. Special device was designed for measuring the faciolingual and mesiodistal inclination of crowns. After 3 times measuring the tip and torque of teeth, student t-test and Kruskal – Wallis analysis were used for statistical analysis.The mean age of control group was 18.8 ± 0.5 year and in treated group was 20.3 ± 0.8. There was significant difference between mean of torque in control group and treated group for upper lateral incisor (4.75±5.21, 8.76±5.82 respectively, p<0.03). Also a significant difference was seen in average torque of lower second premolar between control group and treated one (-23.48±5.99, -26.66±4.64 respectively, p<0.05). There were no significant differences in tip of teeth between two groups. In comparison with Andrews study, in normal occlusion group, upper canine & first molar and lower lateral & first premolar had more buccal root torque. Except the torque of upper lateral incisor and lower 2nd premolar, torque and tip of other teeth had no significant difference.

The objective of this study was the comparison of Bare Sclera and Rotational Flap methods in primary pterygium surgery.This study was retrospective Cohort and studied population were 80 patients (40 patients in each group) with primary pterygium in stage II and III operated in Hamadan Emam Khomeini hospital , during 2001-2003. All of the patients followed up 48 hours, 1 week , 1,3 and 6 months after operative surgery.In this study , complications and recurrences of both methods (Bare Sclera and Rotational Flap) were compared and the results were as follows: Recurrence rate in Bare Sclera method was 22.5% and in rotational flap method 11.1% , that obtained no significant relationship between two groups. Also there was not significant difference in complications.

Studies of headache risk factors are numerous but their results are based on clinics and hospitals. Few data have been reported in children. No data are available regarding migraine and tension-type headache risk factors among Iranian children. Therefore we determined the sociodemographic risk factors of migraine and tension-type headaches and their correlations in schoolchildren. This study was a matched case-control method using the prevalence study data. The subjects were the patients with migraine and tension-type headache diagnosis (38 schoolchildren with migraine and 122 with tension- type headache). Each case was matched by school, sex and age, for migraine cases three controls and for tension-type headache cases two controls who had never been diagnosed as migraine or tension-type headache were chosen. Cases and controls for migraine and tension-type headache were compared separately for family history of headache, atopic diseases, sleep disorders and socioeconomic class. Conditional logistic regression was used for data analysis. Odds ratio for migraine in schoolchildren who had positive family history of headache was 8.4 (95% CI, 2.8 to 25.4) and for tension-type headache was 2.9 (95% CI, 1.7 to 4.9). The odds ratios for migraine and tension-type headache in students who had abnormal sleeping pattern were 5.6 (95% CI, 1.3 to 20.8) and 4.4 (95% CI, 2.2 to 8.4) times higher than those with normal sleeping pattern. OR of migraine and tension-type headache for atopic diseases were estimated as 15.4, 2.05, respectively. Migraine and tension- type headache were not significantly associated with other factors. It is concluded that family history of headache and sleep disorders had most significant effects on occurrence of migraine and tension-type headache in school children.

Lidocain solution 1-2% have used with or without adrenaline for skin local anesthesia. Also normal salin, diphenhydramine and bacteriostatic salin have been used. The purpose of this study was to compare the effectiveness of 1% lidocain with 0.1% lidocain in local skin anesthesia. This study was carried out by triple blind method on 140 patients that submitted to Hamedan Sina Hospital in 2000. These patients divided in two groups randomly, 70 cases received 1% lidocain and other 70 cases received 0.1% lidocain. The pain assessment score was between 0-10 that was asked from each patient and collected data analyzed by statistical methods. This study showed that 51.1% of patients that received 1% lidocain and 48.9% that received 0.1% lidocain did not have any pain during injection (P>0.05). Also 54.3% of patients that received 1% lidocain and 45.7% that received 0.1% lidocain solution did not have any pain throw the procedure (P>0.05).The effect of 0.1% lidocain solution had no much difference from 1% lidocain in skin local anesthesia and thus it is suggested to use it for wide anesthesia in skin surgeries.

Acute myocardial infarction (AMI) is usually due to thrombotic occlusion of coronary arteries. Interacellular magnesium decreases after AMI. One of the drugs in treatment of AMI is parenteral magnesium sulphate that its efficacy is still ambiguous in decreasing ventricular arrhythmia and in-hospital mortality rate. We decided to investigate magnesium efficacy in in-hospital prognosis of AMI. This study was a double blind randomized clinical trial. Sixty patients with AMI were randomized equally in two groups(one magnesium sulphate and other DW 5% as placebo).Magnesium sulphate infused at arrival to the patients (8 mmol in the first 5 minutes and 65 mmol in next 24 hours) and the patients in two groups were compared with respect to frequency of in- hospital mortality rate, ventricular arrhythmia and ejection fraction. Age, sex and AMI-type distribution in two groups were not significantly different. The frequency of ventricular arrhythmia in treatment and placebo group was 7(23.3%) and 19(63.3%) respectively, which was statistically different (P=0.002). In-hospital mortality rate after AMI was one (3.3%) in treatment group and 4(13.3%) in placebo group that was not significantly different (P=0.177). Also mean of EF in treatment and placebo group was 54.3% and 46.5% respectively (P=0.003). Results showed that parenteral magnesium sulphate was efficient in decreasing ventricular arrhythmia after AMI. Ejection fraction was also increased significantly after magnesium sulphate therapy. In spite of decrease in mortality rate, the difference was not statistically significant.

The most common neurologic sign in neonatal period is Convulsion, based on the condition of each neonate with seizure the radiologic survey will carry out. In this study the role of brain- CT scan without contrast was evaluated for neonates with seizures. This was a cross-section descriptive study on 80 neonates with seizure admitted in NICU of Ekbatan hospital Hamadan during 2002-2003. The brain Ct-scan without contrast was done for all of them, the radiologic reports were recorded on special forms, and evaluated with statistically methods. 65% of neonates had abnormal CT: Intracranial hemorrhage in 19 cases (23.7%), Local ischemic lesions in 18 cases (22.5%), Hypoxic- ischemic encephalopathy in 15 cases (18.7%), Brain dysgenesis in 8 cases (10%) and combined forms in 18 cases (22.5%). In this study abnormal CT scan findings were noticeable , most of the seizure occurred at 24-72 hrs after birth and association with difficult labor was statistically meaningful (P<0.05). Because the difficult delivery and hypoxia are participating factors of neonatal seizures, perhaps the proper or inappropriate delivery and perinatal intervention is a factor for interpretation of findings of this study.

This research was a quasi - experimental study that carried out, the purpose was to determine the effectiveness of injection duration on site pain intensity associated with subcutaneous heparin in patients of wards of the Hazrat Fatemeh and the Shahid Beheshtie hospital of Shiraz in 2002. Sample group was estimated 167 patients according to pilot study and sampling was done by continous manner. Data colloction was done by using a researcher-made checklist, consisted of section of demographic carachtristics and a section to record site pain intensity. In order to assess the site pain intensity, visual analogue scale (V.A.S) was used immediately after injection. Data analysis was done by distributional indexes and parametric (paired t-test) and Bi- parametric (Mann witney-U and kruskal wallis tests). Results indicated the 30-seconds duration of injection resulted in significantly less site pain (P<0.001), thus mean of pain intensity at 10 second duration technique (38.12 ± 35.38) was higher than that of 30 second duration injection technique (22.66 ± 30.62). There was a significant difference on site pain intensity between male and female cases, in both injection techniques (10-seconds and 30- seconds), so that mean of site pain intensity of females was more than males. Between age group and site - pain intensity was a significant difference (P<0.05) in 10-seconds injection technique , so there was higher pain intensity in 61-70 year age group and lower pain intensity in 17-50 year age group. But between pain intensity in different age groups there were not significant difference in 30 seconds injection technique, so approximately the mean of pain intensity in all age groups was equal. Therefore results of this research indicated administering a subcutaneous heparin injection over longer duration reduces injection site pain specially in females.

Malignancy is observed in 5-10% of MN in adults , with the risk being highest in patients over the age of 60. A Solid tumor (such as carcinoma of the lung or colon) is most often involved. It is presumed that tumor antigens are deposited in the glomeruli: this is followed by antibody deposition and complement activation, leading to epithelial cell and basement membrane injury and proteinuria due to the associated increase in glomerular permeability. These processes are reversed with removal of the tumor, usually leading to gradual remission of the proteinuria. The malignancy in presumed tumor-induced MN has usually been diagnosed or is clinically apparent at the time at which the proteinuria is noted. The incidence of occult tumor causing MN is less than one to two percent. As a results, a tumor work-up should not be initiated in the absences of some suggestive finding such as unexplained anemia, guaiac positive stools, or weight loss. The presented patient was a 76 years old man and he was suffering from MN. In the followed studies, the existence of metastatic malignancy was proved.