Avicenna Journal of Clinical Medicine
Year:2008 | Volume:14 | Issue:4 (SN 46)|Papers Count:15

Introduction & Objective: During recent decades so many researches have been engaged to assess the relation of electromagnetic fields with different powers on prevalence of fetal - developmental disorders, sterility, advent of nervous and sleeping disorders, gastrointestinal and cardiovascular mortality, variety of neoplasm's and among the rest hematopoietic and lymphatic tissue neoplasm's and even hematopoiesis disorders. The results provided by these studies are different and very miscellaneous and the research horizon in this field still is spreading. I n this study the effects of low electromagnetic field (LEMF) and the field intensity of 5 militesla (50 HZ) on the numbers of megakaryocytic and the volume, of liver in NMRI mice fetus was assessed.Materials & Methods: This experimental- analytical study has assessed the effect of LEMF (50 Hz) on the number of liver's megakaryocytic and the weight of 66 three months NMRI mice embryos that they were divided into 6 groups. Experimental groups were exposed to LEMF and then randomly an embryo was selected from each mother and its liver was extracted and fixed in formalin. After providing microscopic sections according to stereological methods, cell counting was performed and data were analyzed and verified by common stereological methods and formulas. SPSS (versionl1.5) software and Kuruskal-Wallis and Chi-square tests were used for statistical analysis.Results: The number of liver megakaryocytes in all experimental groups comparing to sham and control groups was reduced but the difference was not significant (P>0.05), the most reduction was in 17-21 days of exposure and the least reduction was in group10-14 days of exposure. The embryos weight in all experimental groups comparing to sham and control groups was reduced, however this difference was not significant (P>0.05) and the most difference was related to group 10-14 days of exposure.Conclusion: The results of this study revealed that in pregnant mice exposed to LEMF irrespective of the length of pregnancy there are not significant changes in the liver volume and the numbers of liver's megakaryocytes in NMRI mice fetus.

Introduction & Objective: Gentamicin is an amino glycoside antibiotic widely used during the neonatal period. It is associated with nephrotoxic effects in neonates, including glomerular impairment and renal tubular dysfunction. Electrolyte balance is very important, especially in the sick premature neonate receiving aminoglycosides. The purpose of this study was early diagnosis of gentamicin nephrotoxicity.Materials & Methods: This quasi-experimental study was performed on 23 neonates (11 full - term and 12 preterm) with suspected sepsis who were admitted and treated with gentamicin. Blood and urine samples were collected before infusion and on the 3rd day of treatment. Serum and urine concentration of Na, K, creatinine (Cr) and urine concentration of Ca were measured. Then fractional excretion ofNa and K were estimated. Ca excretion was estimated as the UCa/UCr ratio. Then the collected data were analyzed using SPSS package.Results: In all neonates, increase in fractional excretion of Na and UCa/UCr, in the 3rdday of treatment were observed as compared to those of before infusion (P=0.01 and P=0.02 respectively). Serum creatinine levels decreased in all patients. Serum level of electrolytes during therapy was normal.Conclusion: The results of this study clearly demonstrate an effect of gentamicin infusion on renal sodium and calcium excretion. These results may be of clinical importance especially for sick preterm neonates receiving treatment with gentamicin. These babies are usually saltlosers and are also more susceptible to early onset hypocalcemia. Gentamicin can aggravate these complications.

Introduction & Objective: TEM-1 beta lactamase gene is one of the important plasmidic genes in Enterobacteriaceae which is the cause of over 90% of Escherichia coli isolates resistance to beta lactam antibiotics. In this study, the frequency of TEM-1 gene in nosocomial strains of Escherichia coli, Klebsiella pneumoniae and Enterobacter was investigated using PCR.Materials & Methods: In this descriptive -analytical study, 83 ESBLs producing enteric bacteria (Escherichia coli, Klebsiella pneumoniae and Enterobacter strains) isolated from hospital clinical samples were studied for the presence of TEM-1 gene using TEM-1 beta lactamase specific primers (Gene-Fanavaran, Iran) using PCR. The detection of 1079 bp bands in poly acrylamide gel electrophoresis was considered 'as presence of TEM-1 gepe in bacterial isolates. Data were analyzed using Chi-Square test. Results: TEM-1 gene was detected in 54.2% (45) of isolated bacteria. The frequency of TEM- 1 gene in different isolates was not significant. TEM-1 gene was detected in 62.5 % Of Enterobacter, 58.3% of K.pneumoniae and 48.7% of E.coli isolates.Conclusion: This study showed that, TEM-1 gene encodes over 50% of ESBLs in. enteric bacteria. Therefore, we recommend detection of this gene as a routine bacteriologic procedure in management of the nosocomial infections caused by enteric bacteria.

Introduction & Objective: Closed intramedullary nailing has become the standard treatment for femoral shaft fractures, but because the existing closed reduction methods are difficult and demanding, in the most trauma centers these fractures usually are treated by open reduction method. Our objective was close reduction of these difficult fractures by a simple but effective method using Schanz screws for manipulating fracture fragments on a radiolucent table.Materials & Methods: In this prospective study, 30 patients whose femoral shaft fractures required reduction were operated on a radiolucent table in the lateral position and their fractures reduced closed by SchaZ pins and fixed with IM Rod. The patients were followed up 1 year.Results: We obtained reduction in 93% of patients. Average time of reduction in the first 48 hours was 9.23minutes and after 48 hours it was 19.7minutes (p<0.05). Also time to reduction was dependent on amount of preoperative traction. When the amount of preoperative traction was 5kg, that time was 19.16minutesbut in maximal amount of traction it was 10.29minutes. Time to reduction also was shorter in Winquist-Hansen type In and IV fractures than in type I and n fractures. There was 13% valgus deformity (5-10 °), 33% external malrotation (5-15°) and 37% shortening (up to 1-3 cm). But we had no infection and no need for blood transfusion or bone grafting.Conclusion: Schanz screws provide a very effective method for close reduction of femoral shaft fractures. Complications of this method are the same or even in some parts are less than other close reduction methods. The method is more successful if performed in the first 48 hours, or if the weight of preoperative skeletal traction is near to the maximum (15% of body weight).

Background & Objective: Diabetic hyperglycemia is associated with increased production of Reactive Oxygen Species (ROS). ROS reacts with DNA results in products such as 8- hydroxydeoxyguanosine that excrete in urine due to DNA repair processes. This study aims to evaluate correlation between oxidative damage of DNA and protein glycation in patients with Type 1 diabetes. We measured urinary 8-0HdG level in diabetic and control group and evaluated its correlation to glycated hemoglobin (HbA1c) and glycated serum protein (GSP) levels. Furthermore plasma malondialdehyde (MDA) level was measured as an important indicator of lipid peroxidation in diabetes.Materials & Methods: We studied 32 patients with diabetes mellitus Type 1 and compared them with 48 sex and age-matched non-diabetic controls. GSP and MDA measurement were made by colorimetric assay. Hemoglobin Ale measured by ion-exchange chromatography method and urinary 8-0HdG measurement was made by competitive in vitro enzyme-linked immunosorbent assay (ELISA). Results: In the present study urinary 8-0HdG, blood HbA1c, plasma MDA and GSP levels were significantly higher in diabetics comparing to the control subjects (P<0.05). Furthermore, we found significant correlation between urinary 8-OHdG and HbA1c (P<0.05) in diabetic group. In addition, fasting blood sugar showed significant correlation with GSP and MDA (P<0.05). However the correlation of MDA with HbA1c was not significant in diabetic patients.Conclusion: This case-control study in young diabetic patients showed that increased blood glucose and related metabolic disorders result in oxidative stress and oxidative damage to DNA and lipids. Furthermore oxidative damage to DNA correlated to glycemic control, while there was no significant correlation between lipid peroxidation and the level of HbA1c.

Introduction & Objective: Polycystic ovary syndrome (PCOS) is a heterogeneous disorder that affects 5-10% of women of reproductive age patients with this syndrome one of the high risk groups for type 2 diabetes mellitus in future. This study was carried out to determine the prevalence of PCOS in patients with type 2 diabetes mellitus. Materials & Methods: One hundred women under 45 years with, type 2 diabetes treating with diet Qrhypoglycemic drugs, referred to Kerman diabetic center in 2005 were identified. Women with galactorrhea or history of thyroid dysfunction were excluded from the study. Data were collected through interview and then data of 92 women were analyzed using t-test and X2.Results: Ninety two women enrolled in the study and 18 cases (19.5%) had clinical symptoms of PCOS. The mean of age was 38 years (38.76±5.92 years). The mean age of women with PCOS was 34.89±3.96 and that of normal women was 39.7±5.96 years (P<0.05). The mean of body mass index in women with PCOS was 28.19±4.4kg/m2 and in normal "women was 26.06±3.83kg/m2 (P<0.05). 38.9% of women with PCOS and 14.8% of normal women had abdominal obesity (P<0.05). There was no sign cant relation between familial type 2 diabetes, gestational diabetes with PCOS (P>0.05).Conclusion: This study indicated women with type 2 diabetes mellitus had a higher prevalence of polycystic syndrome. Android obesity is associated with the increased risk of type 2 diabetes in women with PCOS.

Introduction & Objective: Endothelill-1 is involved in induction and progression of atherosclerosis. Since several changes with abnormality in transferring of calcium ions have been seen in - atherosclerotic vessels, it is supposed that calcium channel blockers can slowdown the process of atherosclerosis.Materials& Methods: This study was an interventional experiment. 36 News land white male rabbits were divided into four groups: control group receiving normal diet, a group receiving normal diet and amlodipine, a group with high-cholesterol diet and finally high-cholesterol diet with amlodipine group.Results: The levels of cholesterol and triglyceride in groups with high-cholesterol diet significantly increased compared to controls (p<0.01). Amlodipine consumption ip eight weeks reduced significantly (p<0.01) plasma endothelin-1 levels in both of (high-cholesterol diet plus amlodipine and amlodipine groups compared to control and high-cholesterol diet groups respectively. Amlodipine consumption also caused significant reduction in the level of endothelin-1 in carotid tissue of subjects received high-cholesterol diet (p<0.01).Conclusion: High-cholesterol diet increased plasma and carotid tissue endothelin-1, whereas amlodipine reduced plasma and tissue endothelin-1 levels in high-cholesterol diet group. In conclusion amlodipine treatment may have positive effects in pathology of atherosclerotic carotid arteries.

Introduction & Objective: In recent years mental health attracts attention of many researchers, and severe emotional stress that can interfere in creation of different organic diseases is one of the most prominent of this aspects. Sudden hearing loss (S.H.L.) is one of these disorders that could followed after stress and eventually may heal completely, relatively or lead to permanent deafness. S.H.L. could influence on interpersonal relationships and in this way could change quality of life negatively, so enough and appropriate attention is necessary. In this research by determination of level of stress we intended to study relationship between mental health and incidence of S.H.L.Materials & Methods: In this case - control study65 patients that referred to otolaryngology services of Hamadan during 2005-2006 with S.H.L. (case group) compared to 89 healthy subjects (control group). Control group were free from any systemic diseases and were matched from sex and age aspects to the case group. In case group after complete audiometric evaluation and confirmation of S.H.L, stress level was assessed using GHQ-28 questionnaire.This questionnaire contained 28 questions in 4 different fields: somatic symptoms, anxiety and insomnia, social problems and depression. Linkert scoring method was used for scoring of questionnaires and all data were analyzed using T-Test and chi-square test.Results: During 4 months incidence of S.H.L. in referred patients were 5.1%, significant statistical relationships between S.H.L. and level of stress (P<0.001) and severity of hearing loss and level of stress (P<0.05, r =0.34) were found. The most common audiometric pattern was downward slopping pattern (56.92%). Evaluation of level of stress between two sex groups did not show any significant difference (P<0.05). Conclusion: Stress can be known as one of the predisposing factors of S.H.L. and may be possible to control by paying more attention to the role of self-awareness and education of life skills. In this way reduction of level of stress may be effective in prevention of S.H.L. in some cases.

Background & Objective: Periodontal problem is a common infectious disease in human. Certain systemic diseases that may influence on development and progress of periodontal disease, recent evidence have approved effects of the periodontal disease on a few systemic diseases including acute myocardial infarction and vise versa. This study evaluated clinical periodontal indices and determined the prevalence of periodontal disease in patients with myocardial infarction.Materials & Methods: The study was carried out in 125 patients (25 females and 100 males) aged 39-70 years that admitted due to MI in Ekbatan Hospital, Hamadan in 2005. The subjects were examined periodontally and their clinical indices (bleeding on probing index, probing depth, clinical attachment level) were measured. Sex, age and the number of remaining teeth of each patient was recorded in a chart. The conditions with positive bleedingno probing index or attachment loss³1 mm were recognized as periodontal disease.Results: In the study, the patients aged 56.32±6.77 years (mean±SD) and 20% of them were female. The findings showed that the mean probing depth and the mean attachment level was 3.38±0.35 mm and 3.55±0.4 mm, respectively. The bleeding on probing index was 72.8%±20.46% on average. It was achieved a mean number of 18.33±5.55 for the remaining teeth. The prevalence of periodontal disease was 89.6% in the patients with MI.Conclusion: Results of the present study showed a high proportion of periodontal disease with in MI patients. Further more, the aged teeth missing was very early.

Background & Objective: one of the important indicators of scientific study and science production in the universities is original research and its scientific article. The aim of this study was to determine the academic members' attitude about main factors of not approaching to scientific writing in Hamadan Dni. Med. Sci.Material & Methods: The current survey was a descriptive cross-sectional study. Statistical population was all of the academic members of this university in 2006 (N=260). The data collected through a questionnaire consists of 2 parts: I.the demographic characteristics, II. the questions related to their attitude. After distribution of the questionnaires we received 228 completed ones. The data was statistically analyzed by SPSS software.Results: Outcomes showed that the main factors of not approaching to write the scientific articles were: education, teaching and treatment engagement mean with 3.89±1.16 of 5, the barriers of doing original -research and writing the articles (3.88±0.93), long duration of sending and accep1ationof articles in Persian scientific journals (3.84±1.07) and weakness of English language skill (3.83±1.05).Conclusion: The barriers of scientific writing were in 3 parts: organizational, personal and personal-organizational problems. The academic members' activities and university managers' supports are needed to remove these barriers.

Introduction: Crimean-Congo hemorrhagic fever (CCHF) is a viral hemorrhagic fever of the Nairovirus group. Although primarily a zoonosis, sporadic cases and outbreaks of CCHF affecting human do occur. The disease is endemic in many countries in Africa, Europe and Asia. Onset of symptoms is sudden, with fever, myalgia, dizziness, neck pain and stiffness, backache, headache, sore eyes and photophobia. There may be nausea, vomiting and sore throat early on, which may be accompanied by diarrhea and generalized abdominal pain. IgG and IgM antibodies may be detected in serum by ELISA.Case Report: A pregnant woman was admitted in a hospital with severe vaginal bleeding. Fever, myalgia, headache, nausea, abdominal pain, gingival bleeding, jaundice, petechia, and ecchymoses were present. ELISA IgM for CCHf was negative in the first day of admission but in the sixth day of illness, this test became positive.Conclusion: Treatment with oral Ribavirin in was started and continued for ten days. After ten days, the patient was discharged from hospital. No problems were detected in follow up visits.

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 years 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 under Went surgery due to cervical abscess.Conclusion: This case-report implies that CGD may rarely 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 its diagnosis.