Avicenna Journal of Clinical Medicine
Year:2011 | Volume:18 | Issue:3 (SN 61)|Papers Count:16

Introduction & Objective: Thalassemia is the most common genetic disorders in the world. These disorders are common in the Middle Eastern countries containing Iran. It seems that factors like splenectomy, iron overload, frequent contacts with antigens during blood transfusion & using chelating agents cause severe disturbances to immune system. This study is done to evaluate the immune status in thalamic patients’ referred to Ahvaz Shafa Hospital.Materials & Methods: This case- control study was done on 40 major thalassemic patients who had not the history of frequent bacterial and viral infections, splenectomy, using immunosuppressive drugs & patients with hepatitis, diabetes or other chronic diseases. Control group contained 31 healthy persons. Peripheral blood samples were collected from all participants. The last CBC and serum ferritin was taken from patient files. NBT test, evaluation of CD4, CD8, CD5, CD20 markers with flowcytometry, and assessment of IgG, IgM, and IgA levels with nephlometry method carried out on peripheral blood samples of patient and control groups. Results: The percent of CD4, CD8 and CD5 markers and CD4/CD8 ratio had no significant difference between case & control groups. The percent of CD20 marker, and IgG, IgM & IgA levels were significantly higher in case group in comparison with control group. NBT test in all case and control groups were normal. There was no significant difference in serum ferritin, WBC count and percentage of lymphocytes and neutrophils among two groups.Conclusion: In major thalassemia patients, cellular immunity and phagocytosis are similar to normal individuals. CD4, CD8 and CD5 positive lymphocytes and CD4/CD8 ratio showed no difference between patients and normal groups. CD20 positive lymphocytes and IgM, IgG & IgA levels in patient group were significantly higher than normal control group. This can’t be due to viral or recurrent infections, because these patients were excluded from our study. This may related to increase in allo antibodies & auto antibodies due to frequent blood transfusion and antigen contact with in these patients which is not related to additional iron.

Introduction & Objective: The present study evaluated staining as a result of the chlorhexidine use and the role of sodium perborate in removing stains; in addition, the amount of decreases in plaque and gingival inflammation and the role of sodium perborate in chlorhexidine efficacy in removing plaque and decreasing gingival inflammation were evaluated.Materials & Methods: In the present randomized clinical trial 40 patients (20-30 years old) referring to the Department of Periodontics, who had mild-to-moderate gingivitis were randomly divided into two groups with a parallel study design and were evaluated in a double-blind scheme. At baseline the patients underwent scaling, root planning and polishing procedures and brushed their teeth daily for two weeks. After two weeks, plaque indexes (PI), gingival indexes (GI) and bleeding indexes (BI) were determined and recorded. In the control group 0.2% chlorhexidine gluconate mouthwash and in the experimental group 0.2% chlorhexidine gluconate mouthwash containing 0.2% sodium perborate were used for 30 seconds. The subjects refrained from tooth brushing during this period. After 14 days the above-mentioned indexes were again determined and recorded, along with staining indexes. Also staining potential of mouthwash and chlorhexidine mouthwash containing sodium perborate was analysed with spectrophotometric devices. Data was analyzed by t-test.Results: There were no statistically significant differences in PI, BI and GI between the control and experimental groups, although there were more decreases in PI, GI and BI in the experimental group compared to the control group. Regarding the intensity of staining, there was a significant decrease in the intensity and extent of staining on tooth surfaces and gingivitis in the experimental group compared to the control group (P=0.001).Conclusion: The use of chlorhexidine mouthwash containing sodium perborate significantly decreases the amount and extent of stains but has no inhibitory effect on chlorhexidine potential to reduce plaque and gingivitis.

Introduction & Objective: Acute otitis media (AOM) is the most common causes of acquired hearing loss in children with increasing incidence. In young children the diagnosis is restricted to otoscopy and tympanometry whereas evaluation of the auditory function is impossible due to noncompliance during pure tone audiometry. For this purpose, measurement of otoacoustic emissions, especially transient evoked ones (TEOAEs), can be applied. The aim of this study was to evaluate the effect of AOM on TEOAEs in young children before and after treatment course.Material & Methods: In an analytic, cross-sectional design, 42 young children with AOM, both sexes, aged 2 to 4.5 years were evaluated through tympanometry and transient otoacoustic emissions (TEOAEs). TEOAEs signal to noise ratio (SNR) and reproducibility of AOM patients were compared before, two weeks and six weeks after the treatment course. Then AOM responses were compared with an age-matched control group. The results were analyzed using SPSS 16.Results: Our findings revealed that TEOAE parameters in AOM subjects were the most affected on highest frequencies. Significant changes of TEOAE parameters were found 2 weeks after the treatment with further improvement 6 weeks after the treatment course (P<0.01). The mean differences in TEOAE responses in AOM children 6 weeks after the treatment and the control group were not meaningful (P>0.05).Conclusion: The results of this study suggest that there was an improvement in TEOAE SNR and band reproducibility in serial TEOAEs measurements. Thus, application of TEOAEs is a beneficial method to follow up medical treatment in young children with AOM.

Introduction & Objective: There are several close links between substance dependency and mental disorders. Many people who regularly abuse drugs are also diagnosed with psychiatric disorders and vice versa. The high prevalence of this comorbidity has been documented in several studies, although most of the research has been carried out in only a few countries and the cultural validity of the data is unknown. Thus the aim of this study was the comparative investigation of mental disorders in drug dependent and non-drug dependent persons in city of Hamadan.Materials & Methods: This study was a descriptive comparative research. 106 men aged 18 to 51 who sought treatment at addiction rehabilitation department of Hamadan were recruited in this study. Also 106 men in the same age range were matched with the first group. Data were collected through structured clinical interview for DSM-IV-TR and SCL 90-R questionnaire. Data were analyzed using t-test and correlation coefficient test.Results: The rate and severity of mental disorders in 9 studied Categories of disorders-phobia, anxiety, somatization, psychotism, depression, paranoid thoughts, aggression, interpersonal sensitivity and obsession-compulsion-were significantly higher among the addicts than the normal group.The level of severity was higher in depression, paranoid thoughts and interpersonal sensitivity than the other disorders. 63.5% of addicts suffered from some psychological disorders while the figures for no addicts were 28.8%. The prevalence of co-morbid psychiatric disorders varied with the pattern of addicts.Conclusion: This study showed that persons with substance dependence display more signs of psycho pathology and mental disorders in comparison with non- substance dependent people.

Introduction & Objective: Venous thromboembolic disease is a significant cause of morbidity and mortality in the United States. Deep venous thrombosis (DVT) and pulmonary embolism (PE) are a spectrum of a single disease entity. In most clinical situations, anticoagulation is the preferred form of therapy.IVC filter placement when using anticoagulation therapy is contraindicated or proves ineffective. The placement of an IVC filter is considered standard preventive treatment for PE. The aim of this study was follow up of patients with permanent vena cava filters in the prevention of pulmonary embolism after six months.Materials & Methods: In this cross sectional study 6 patients with IVC filter were followed up after 6 months. They were examined about having emboli, reccurent DVT, edema, varicosis, bleeding, misplacement, and fracture of filter. Data were analyzed with SPSSV17.Results: 6 patients having a mean age of 58.6 years were evaluated. There was no difference in sex. The reason of admission in all cases was DVT. Doppler sonography was done for all the patients. In 66.66% anticoagulation therapy was done before surgery. The filter was placed percutaneously in all cases. After 6 months in 5 cases there were no signs of DVT, PE, edema, and varicosis. In addition one patient died because of respiratory arrest due to encephalopathy. No complications were seen during admission period.Conclusion: Although IVC filter increases the risk of recurrent DVT in the long term, it remarkably decreases the risk of PE.IVC filter is a useful and effective treatment in patients with contraindication of using anticoagulation therapy especially in patients with cancer.

Introduction & Objective: Industrial wastewaters including heavy metals are one of the important sources of environmental pollution. Heavy metals such as chromium are found in plating wastewater and are harmful for human health and environment. The purpose of the present study was to investigate adsorption of hexavalent chromium Cr (VI) from aqueous solution onto commerical Iron powder as an effective, faster, and cheaper adsorbent. Materials & Methods: This research was an experimental- lablatory study done in batch system. This study investigated the removal of hexavalent chromium by using commerical Iron powder with variation pH, contact time, Iron powder dose and initial hexavalent chromium concentration in batch system, and the result was analyzed by Excel software.Results: The results showed that the removal efficiency decreased with increasing pH and initial chromium concentration. Also the results showed that the removal efficiency increased with increasing Iron powder dose and contact time. With increasing adsorbent dose from 0.1 g/100 cc to 1.5 g/100 cc, the removal efficiency increased from 47.5% to 92.5 % in constant conditions (pH=7, initial hexavalent chromium concentration=20 mg/L). Also removal efficiency increased from 41.1% to 48.5% with increasing contact time from 2 min to 120 min in constant conditions (pH=7, Iron powder=0.1 g/100 cc, initial hexavalent chromium concentration=20 mg/L). Experimental isotherms and kinetics models were assessed by Langmuir and Freundlich isotherms and pseudo-first-order, pseudo-second-order kinetics and modifed pseudo-first-order models. The results showed that the data were acceptably explained by Langmuir isotherms and pseudo-second-order kinetics models, respectively.Conclusion: The results showed that the removal of hexavalent chromium from aqueous solution using sawdust can be done faster and cheaper.

Introduction & Objective: The prevalence of substance abuse among college students is increasing drastically and requires immediate skill-based substance abuse intervention such as assertive skills. The purpose of this study was to develop the healthy behavior to change the subjective norms of students in order to decrease their tendency towards substance abuse.Materials & Methods: A pre and post nonequivalent control group design study carried out on college students. A total number of 140 students were selected through randomized cluster sampling and randomly assigned to the intervention (n=70) and the control (n=70) groups. The data-gathering tool consisted of a self-report questionnaire assessing the variables of moral, descriptive, and injunctive norms. After the diagnostic evaluation, assertive skills promoting program was applied to persuade the participants against substances abuse. Respondents in the control and experimental groups completed questionnaires at baseline and 2 months after the intervention.Results: The result showed that educational manipulation had significant effect on intervention group’s average response for moral norms (t=-3.36, P<0.001), descriptive norms (t=-3.07, P<0.003), and injunctive norms for persuading substance abuse (t=-3.79, P<0.000).Conclusion: These findings suggest that assertive skills training would be an efficient tool in drug abuse prevention programs among adolescents that should also be included in the comprehensive school health programs.

Introduction & Objective: The aim of the study was to identify larval habitats and new species and determine the exact distribution of Culicidae in Hamadan Province.Materials & Methods: This descriptive,cross -sectional study was conducted in six regions of Hamadan Province during 2010. Sampling method was carried out by standard Dipping method. Specimens were mounted by lactophenol solution and were sent to Medical Entomology Laboratory, Tehran University of Medical Sciences with related codes. The accurate diagnosis of Culex pipiens was made with male genitalia morphology. The data were analyzed using standard statistical software (SPSS version 11.5).Results: In total, 4751 larvae of the three genera including Anopheles, Culex, Culiseta, and nine species including An.superpictus, An.maculipennis sl and An.claviger, Cx.pipiens, Cx.theileri, Cx.hortensis and Cx.prexiguuus, Cu.longiareolata, and Cu.subochrea in 36 larval habitat sites in the province were collected and identified. Among Culicidae larvae collected, Culex. Pipiens and Culiseta.subochrea with 58%, and 0.4% of samples were the most and the least species collected.Conclusion: Culex pipiens was reported as the dominant species. Based on morphology of male genitalia, only Culex pipiens was identified among the complex species. The species of Anopheles claviger and Culex prexiguus were found for the first time in this area. The molecular analysis and the egg ridge counts of anopheles maculipennis sl must be extensively studied in the future.

Introduction & Objective: Glomus tumor is a rare benign lesion of the skin and subcutaneous tissue arising from glomus apparatus and accounts for 1.6% of soft tissue tumors that is mainly located in upper extremities and especially in finger and thumb tips. The tumor is clinically characterized by a triad of pain, point tenderness and cold sensitivity. The aim of this study was the evaluation of glomus tumor in upper extremity and reporting 20 cases of them.Materials & Methods: In a case series study we retrospectively reviewed the medical records of 20 patients with glomus tumor who had been treated with surgical excision at our hospital between the years of 1988 and 2009.Results: Twenty patients with mean age of 41 years and a 6- year follow-up were entered in the study. Five of the patients were male and the remaining 15 were female. The main complaints were pain, tenderness and cold intolerance. “Love’s test” was positive in all of the patients. The location of tumor was at the tip of the digits in 19 patients and the right side was involved in 15 patients. The average size of tumor was 2.85 mm but there was an unusual case of tumor with the dimensions of 10 mm by 10mm on the forearm.Conclusion: The glomus tumor should be considered in differential diagnosis of any painful lesion at the tip of fingers even though it is a rare tumor. Since the glomus tumor can occur in greater dimensions and unusual locations, it should also be considered in differential diagnosis of a large painful mass at forearm.

Introduction & Objective: Periodontitis is a multifactorial disease in which host immune system and genetic factors have an important role in its pathogenesis. Genetic polymorphisms in cytokines and their receptors have been proposed as potential markers for periodontal diseases. The aim of the present study was to evaluate whether IL-4R gene polymorphism is associated with chronic periodontitis (CP) or not?Materials & Methods: In this cross sectional study ninety nonsmoker patients (61 women and 29 men) with chronic periodontitis were selected according to established criteria. They were categorized into three groups according to their clinical attachment level (CAL). Mutation at position 375 (alanine/glutamine), 411 (leucine/serine), 478 (serine/proline), 406 (arginine/cysteine) in the IL-4R gene was detected by a polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP) method.Results: The distribution of mutations for IL-4 polymorphism at amino acids 375 (P=0.41), 411 (P=0.22), 478 (P=0.17), 406 (P=0.77) were not significantly different among mild, moderate and sever chronic periodontitis patients. Conclusion: This study suggests that there is no correlation between IL-4R polymorphism of chronic periodontitis.

Introduction & Objective: One of the important problems in modern society is people's sedentary life style. The aim of this study was to determine factors associated with regular physical activity among college students based on BASNEF model.Materials & Methods: This study was a cross-sectional study carried out on 400 students in Hamadan University of Medical Sciences. Based on the assignment among different schools, classified sampling method was chosen for data gathering using a questionnaire in three parts including: demographic information, constructs of BASNEF model, and standard international physical activity questionnaire (IPAQ). Data were analyzed by SPSS-13, and using appropriate statistical tests (Chi-square, T-test and regression).Results: Based on the results, 271 students (67.8%) had low, 124 (31%) moderat, and 5 (1.2%) vigorous physical activities. There was a significant relationship (c2=6.739, df=1, P=0.034) between their residence and physical activity and students living in dormitory were reported to have higher level of physical activity. Behavioral intention and enabling factors from the constructs of BASNEF model were the best predictors for having physical activity in students (OR=1.215, P=0.000) and (OR=1.119, P=0.000) respectively.Conclusion: With regard to the fact that majority of the students did not engage in enough physical activity and enabling factors were the most effective predictors for having regular physical activity in them, it seems that providing sports facilities can promote physical activity among the students.

Introduction: Verruciform xanthoma [VX] is an uncommon benign mucocutaneous lesion of unknown etiology. This rare, harmless lesion usually presents as sessile or pedunculated, pale yellowish-to-red, papillary, granular or verrucous mucosal growth.Case Report: A 25-year-old non-smoking female presented with a lesion on the left latral surface of the tongue with no pain, that she first noticed 2 years prior to seeking medical care.Conclusion: Blood studies revealed normal ranges. Further clinical assessment of the patient did not reveal any associated disease. The complete excision of the lesion was performed and no problem has occurred after surgery.