Avicenna Journal of Clinical Medicine
Year:2007 | Volume:14 | Issue:3 (SN 45)|Papers Count:15

Introduction & Objective: Several studies have been performed to evaluate correlation of serum high sensitivity CRP (hs-CRP) level with the prognosis of the patients with diagnosis of unstable angina, and by now different results were reported. The aim of this study was to assess correlation between serum hs-CRP level and inhospital prognosis and cardiac events in the patients with unstable angina.Materials & Methods: This descriptive analytic study was performed from Sep 2004 till Feb 2006 in Shahid Beheshti hospital. Kermanshah, Iran. Sera were collected from 250 patients for hs-CRP measurement. Exclusion criteria were: acute ST elevation MI, non ST elevation MI, patients with history of recent infection, patients with recent trauma and patients with serum high sensitive CRP level more than 10 mg/lit. Patients were divided into two groups, first group whose serum hs-CRP level was less than 3 mg/lit and second group whose serum hs-CRP level was between 3 and 10 mg/lit. They were followed for recurrent chest pain, arrhythmias, pulmonary edema, acute myocardial infarction and in hospital death. Results were analyzed using x² and t-test.Results: Mean age were 57±7.8 and 58±11.5 years in first group and second group respectively. There was statistically significant difference in some cardiac complications such as dyspnea, duration of hospitalization, recurrent chest pain, CCU admission (p<0.001) and in hospital myocardial infarction (p=0.03), between two groups. Some complications did not have significant difference such as pulmonary edema, cardiogenic shock, arrhythmia, S3, S4 and pulmonary rates .There was no mortality in both groups.Conclusion: According to the results, we can use serum hs-CRP level for risk stratification in the patients with diagnosis of unstable angina. Obviously the patients with high serum hs- CRP level need more attention whether early invasive management help these patients, may be the matter of later studies.

Introduction & Objective: Breast cancer is the most common disease in women. In the expansion and progression of breast tumors combination of tumor markers including prostate specific antigen (PSA) and telomerase are engaged. The aim of this study was to evaluate relationship between telomerase activity and prostate specific antigen gene expression with steroid hormone receptors in breast cancer patients.Materials & Methods: This study was a case-control and consisted of 50 women diagnosed with breast benign tumors as control and 50 women having malignant tumors as cases. Telomerase activity was measured in tumor cytosol of samples by telomeric repeat amplification protocol (TRAP) assay. PSA protein was measured using ultra sensitive immunoflourometric assay and PSA mRNA expression was carried out using RT-PCR technique in all tumor tissues.Estrogen and progesterone receptors were stained using immunohistochemistry technique in tumor tissues. Data analysis was carried out by using SPSS software version 11.6 and paired t-student test.Results: Using TRAP assay, presence of the telomerase activity was positive in all of the breast cancer patients. The difference of relative telomerase activity (RTA) values between stages and also all grades were more statistically significant (p<0.05). The mRNA of PSA was detected only in benign tumors and stage I and grade I malignant tumor cytosols. Difference of tumor cytosol PSA levels between the cases and control groups and also between all grades and stages of diseases were significant (p<0.05). In all, there was an inverse significant correlation between the RTA and PSA protein levels in the case groups. (r=-0.42, p<0.05).There was a statistically difference between steroid hormone receptors (ER and PR) positive and negative on PSA and telomerase gene expression in breast tumor tissues (p<0.05).Conclusion: It is speculated that differential expression of PSA and telomerase genes in breast tumors are under control of steroid hormone receptors and could be used as a target for treatment.

Introduction and objective: before using multi hook segmental fixation in schuerman kyphosisi (SK) surgery, instrumentation by harington rod (H.R) was common.Materials & Methods: In this study we evaluated the complication and pre and post surgical kyphosis in 26 SK patients who had anterior release and anterior fusion and then halofemoral traction and finally posterior fusion and instrumentation by Harington compression rod, in Shafa Yahyaian Hospital from 1976 till 2001. All of their documents were available in hospital archive and had minimum acceptable follow up.Results: No major complication was noted. One infection and one Harington rod fracture was noted, which they cured by appropriate treatment. Mean degree of thoracic kyphosis was 94 and after surgery it was 43.Conclusion: It seems that most prominent failure was overcorrection after surgery, so sometimes it reached to below 35 degree.

Introduction & Objective: Pregnancy and childbirth are significant developmental excitable for most women. Physical, intrapersonal and relational adaptations are needed to adjust successfully to pregnancy and delivery. Postpartum depression is a serious psychiatric disorder and the adverse impact on infants has been noted. The purpose of this study was to detect postpartum depression in referents to medical and health centers in Hamadan city.Materials & Methods: A descriptive and cross-sectional study involving 400 women completed the Beck Depression Inventory (BDI) within 2-8 weeks of delivery was conducted in urban health centers in Hamadan city, Iran. Data were collected through interviews with women in the clinics in the health centers. Data processing and statistical analysis were performed using SPSS 10.0.Results: The results revealed that majority of women (68.0%) were considered normal. Depression was detected in 32.0% of women. Out of these 19.0, 4.0 and 9.0% were mild, moderate and severe depression, respectively. There were statistically significant differences between postpartum depression and age, number of delivery, education, job and husband's job (P=0.000).Conclusion: Nearly 32.0% of selected women had depression. Therefore, it is important for medical personnel to be well versed in the course and treatment of postpartum depression. Post partum depression should be screened and treated as early as possible for several reasons. It can cause significant suffering for the woman who experiences it, and it can have deleterious consequences for the newborn.

Background & Objective: Diabetes is a metabolic disorder caused by low secretion or resistant to the insulin action. Oxidative stress, an imbalance between the free radical production and antioxidant defense systems of the body, is strongly related to diabetes and its symptoms. The aim of the present study is to evaluate effect of regular swimming on antioxidant system in diabetes.Materials & Methods: Diabetes was induced by a single dose injection of streptozotocin (i.p, 50mg/Kg). Duration of exercise was 8 weeks. 40 male rats (200±20 g) were divided into four groups (control, control with exercise, diabetic, diabetic with exercise). At the end of experiments, rats were anesthetized by sodium pentobarbital (50mg/Kg) and blood samples were collected from the heart. Plasma and red blood cells were used to determine the super oxide dismutase (SOD), gluthathione peroxidase (GPX) and catalase (CAT) activities, and malonedialdehyde (MDA) levels.Results: Diabetes significantly reduced SOD, GPX, and catalase activities in diabetic rats compared with control rats. MDA level, as a lipid peroxidation index, was increased significantly in diabetic-nonexercised rats compared to control. In response to exercise, MDA level decreased significantly in diabetic rats whereas SOD, GPX and catalase activities showed significant increases.Conclusion: Swimming is beneficial in prevention of the hyperlipidemic symptoms and tissue injuries caused by oxidation stress in diabetes mellitus through increasing of the blood antioxidant enzyme activities, decreasing of the MDA level and reducing of the atherogenic index.

Introduction & Objective: Basal cell carcinomas (BCCs), the most common human malignancy, frequently occur on areas exposed to sunlight, but are uncommon on unexposed skin regions. Therefore, location can not be relied as the first factor in diagnosis of BCCs. We report our experience about BCCs located on the covered and uncommon sites of body Materials & Methods: A total of 1135 histologically confirmed primary BCCs, from 1992-2005, were studied. Age, sex and site of presentation and different histological subtypes of BCC were considered.Results: 48 cases (27 men, 21 women) of uncommonly located BCCs were recorded. The average age was 52.7±14.1 years, and the male/female ratio was 1.2. Of 48 BCCs, 27 (56.3%) were on the trunk, 8 (16.7%) on the upper limbs, 11 (22.9%) on the lower limbs, and 2 (4.2%) on the genitalia. Solid BCC (66.6%) was the dominant histologic type for all sites.Conclusion: Although from total of 1135 primary BCCs were studied, only 48 cases (4.2%) located on covered and uncommon sites of body, but in our opinion, BCC should be considered in these areas and biopsy of all suspected lesions is advisable.

Introduction & Objectives: Methotrexate (MTX) is a chemotherapeutic agent that used for the treatment of a variety of tumors and inflammatory diseases. The aim of this study was planed to see the role of human growth hormone (hGH) on testis recovery after treatment with MTX in rat.Materials & Methods: In this experimental study the fifty male wistar rat were selected and randomly divided into five groups; control (n=10) and test (n=40). Hormone grope was received 0.3mg/kg hGH (IP) for 28 consequence day, drug group was received 1mg/kg MTX (IP) per week for four consequence week, protective group was received 0.3mg/kg hGH (IP) for 28 consequence day plus1mg/kg MTX (IP) per week for four consequence week and treatment group was received 1mg/kg MTX (IP) per week for two consequence week with 0.3mg/kg hGH (IP) for14 consequence day, however the control group just received vehicle (IP). In 14 and 28 day the testis tissue of rat in whole groups were removed and sperm was collected from epididymis then prepared for analysis. The statically analysis was ANOVA test.Results: This study was confirmed MTX had destructive effects in testis germinal cells and rate of spermatogenesis was decreased (P<0.05) as compared with control group, and HGh had treatment effects in degenerative seminiferous epithelium and improve spermatogenesis (P<0.05) as compared in other groups.Conclusion: Since in our study hGH had recovery effect on spermatogenesis cycle after treatment with MTX, and it can not have useful effect if only prescript in chemotherapy period than consequently hGH inducement is suitable for sperm health ability parameters after chemotherapy in patient.

Introduction & Objective: The breast cancer is the most common malignancy in women even according to the new studies this is concluded that the breast cancer in women is the most essential and important oncology’s disease .This malignancy is a suitable example of the use of biologic markers to learn more about prediction, incidence, diagnosis, treatment and outcome .One of this markers is cathepsin D. It is an aspartatic lysosomal protease that playes main role in multiple tumor progression stages. The purpose of this study was to determine the frequency of expression of cathepsin D in primary breast cancer and it’s correlation with axillary lymph nodes involvement, grade and stage of tumor.Materials & Methods: The study was a cross-sectional one that was performed on 75 samples from patients with breast cancer who admitted in Mostafa Khomeiny Hospital (2000-2004). After preparing the samples, a tissue section from each sample was obtained. One of the tumoral and lymph nodes sections was stained by H&E. We determined the type of tumor, the number of lymph nodes, the stage and the grade of the tumor. Cathepsin D assessed by a immunohistochemical technique using a monoclonal antibody.Results: Our study showed 68% of samples were positive for cathepsin D.70.7% of patients had lymph nodes involvement. The most of patients were in stage II (57.3%) and 42.7% were in grade II. In this study, we did not find any correlation between cathepsin D expression and the studied factors.Conclusion: According to the results of previous studies and our study, it seems we require to more complete studies with more specimens and long-term follow up to understand exact role of cathepsin D in breast cancer prognosis.

Background & Objective: Methicillin–Resistant Staphylococcus aureus (MRSA) is one of the most important causes of hospital infections worldwide. Treatment of these infections has become more difficult because of resistance to methicillin/oxacillin and other antibiotics. The aim of this study was to determine the incidence of MRSA infections in hospitals affiliated to Hamadan University of Medical Sciences.Materials & Methods: Seventy S. aureus clinical strains were isolated from patients from June, 2005 to June, 2006 and examined by conventional microbiological tests and PCR, respectively. Then, the antibiotic susceptibility to methicillin/oxacillin and other antibiotic were performed by Disk Diffusion Agar (DDA).Results: The results of this study showed that Methicillin resistance gene was detected in 35 (50%) and 22 (31.4%) cases by PCR and DDA, respectively. The results of antibiotic sensitivity assays also showed there was high resistance in MRSA strains to Penicillin (100%), Cloxacillin (91.4%), Tetracycline (74.2%), Cotrimoxazole (68.6%) Erythromycin (68.5%) and Ceftazidim (51.4%). The strains of Methicillin-Sensitive Staphylococcus aureus (MSSA) showed high sensitivity results to antibiotic used, except penicillin, which all of the isolates were penicillin resistance.Conclusion: As a conclusion, the resistant to methicillin/oxacillin in Hamadan hospitals has reached to 50% and they show multi-drug resistant.

Introduction & Objective: Varicocele is often mentioned as a common cause of testicular atrophy. The aim of this study was to evaluate varicocele-related testicular atrophy with Duplex sonography.Materials & Methods: Seventeen patients with testicular atrophy due to varicocele were included into the study.Results: Echogenisity of the atrophic testis was homogeneous. Mean peak systolic velocities (PSV) in intratesticular arteries for atrophic and normal testes were 5.57±2.03 cm/s and 6.49±1.37 cm/s, respectively. The difference was not significant (P > 0.05).Conclusion: Varicocele-related testicular atrophy is not associated with testicular parenchymal heterogeneity, and does not affect the intra-testicular and testicular arterial PSV.

Introduction & Objective: Burn patients are at risk of acquiring infection because of destroy skin barrier, suppression of immunity, prolonged hospitalization, and invasive therapeutic and diagnostic procedure, risk of acquiring infection is high among burned patients. The aim of this study was to assess the incidence rate of bacterial etiology and infections among burn patients in the burn center of Isfahan.Materials & Methods: The study was conducted descriptive – cross sectional during a period of one year, (from august 2004 until September 2005). A total of 106 patients presenting with no signs and symptoms of infection within the first 48 hours of admission were included. CDC definition for nosocomial infections was applied. Each patient’s clinical examinations and records investigated daily. Swab culture, blood culture (during fever time), tissue culture from biopsy specimen of burn wound and urine culture obtained. The data were analyzed and interpreted using SPSS 10 Software, using Chi – square and Kappa Coefficient. P.value < 0.05 was significant.Results: One-hundred and six patients met the inclusion criteria, 91 (85/8%) acquired at least one type of infection, including, urinary tract 28 (26/4%), blood stream 30 (28/3%), and burn wound 91(85/8%). Pseudomonas aeroginosa was the most common causative agent isolated from blood culture and swab culture, 27/42% and 54/4% respectively. Also, E.coli was the major casautive agent of urinary tract infections (6.4%) isolated from urine culture of these burn patients.Conclusion: The results indicated that, biopsy from burn wounds and study of histopathologic specimen day by other day depends on blood and urine culture conditions overall can be effective for early detection of burn wounds infections.

Introduction & Objective: Determination of free silica to calculate threshold limit value is necessary. The purpose of this research was study of free silica in particulate emission in ambient air of stone crushing workshops in Azandarian area.Materials & Methods: 40 samples of respirable dust from workplace air were obtained in breathing zone of workers in different job stations. Samples were taken with personal samples pumps attach to cyclones and analyzed by a gravitmetric method and X –Ray Diffraction.Results: The results were showed that mean concentration of respirable dust and quartz in workshops (type 2) was equal to 1.17-1.24 mg/m3 and 0.94-1.03 mg/m3 respectively, and also in workshops (type 1) was equal to 0.81-1.07mg/m3 and 0.79-1.05 mg/m3 respectively. Free silica rate in ambient air of workshops type1 and type2 was 97.5% and 81.3% respectively. Difference of free silica rate in two types of workshops was statistically significant (p=0.0001).Conclusion: The comparison of time weighted average of respirable dust concentration with threshold limit value showed concentration of respirable particles was less than threshold limit value.

Introduction: Chronic granulomatous disease (CGD) is an inherited disorder of phagocyte function. The defect of intracellular killing in phagocytes is the cause of recurrent pyogenic infection of patients. Clinical presentations and infections mostly occur during the first 2 year of life and early diagnosis of disease can prevent or decrease the rates of recurrence of infections and mortality. Case Report: This case report represents a 21 years old man who was admitted and underwent repeated surgery due to pyogenic infections for CGD. The second case was his 20 years old sister who was underwent surgery due to cervical abscess. Conclusion: This case report implies that CGD mayrarely go undiagnosed until adulthood, so in adults who develop recurrent pyogenic infection, we should be suspicious to CGD, and Nitroblue tetrazolium test is the convenient method for diagnosis.