Avicenna Journal of Clinical Medicine
Year:2003 | Volume:10 | Issue:1|Papers Count:14

Iran is an essential metal which involved in more cell activities in the form of ‎enzymes and/or other metaloproteins. Indium is one of the toxic elements that may be ‎interfered with iron metabolism. Using this element has increased recently by ‎different industry. Therefore the aim of this investigation was to study interfere of ‎indium on first phase of iron metabolism (absorption intestinal) by averted gut sac ‎‎(E.G.S). Preliminary results showed that the optimum concentration of iron and ‎indium for best intestinal absorption were 102 and 70 mg/I, respectively. Addition of ‎glucose to incubation media caused increase in iron and/or indium absorption and ‎reduction was seen where ouabain was added to the media, suggest a probable active ‎transport of the element across of the intestinal mucosal cell. Iron absorption was ‎reduced almost by 28% when indium was presented in incubation media. Results ‎obtained from this study indicated that indium might be able to interfere with iron ‎metabolism, at intestinal absorption‏.‏

Intravenous regional anesthesia (IVRA) used in procedures below the elbow and below the knee. Lidocaine is the drug most used in this technique but because of it's complications (CNS and cardiovascular) it is used cautiously and some other replacements have been studied and this study is performed with this aim. In this study we used fentanyl and pavlon (pancuronium) as adjuncts for lidocaine to reduce its required dose and compare the effect of this combination with lidocaine alone in IVRA.In this double blind clinical trial study , fifty-four patients candidated for orthopedic procedures in ASA class I, II were selected and divided randomly in two equal groups each of them had twenty-seven patients. Lidocaine (200 mg in volume of 40 cc) was injected in one group and combination of lidocaine (100mg) fentanyl (0.05mg) - pavlon (0.5 mg) in volume of 40Cc was injected in the other group. Then the following parameters were discussed and recorded:The time of onset of block (by pinprick test) , the length of operation , the time of opening the first and second tourniquets , the quality of block , the time of pain returning , the length of postoperative analgesia-patient and surgeon satisfaction. Thereafter the obtained parameters from each group were analyzed with Epi info 6 software.Success rate was the same in both groups. The quality of block, and patient and surgeon satisfaction were same in both groups and statistically were not significant. In lidocaine group the average time of onset of block (5.3min) was less than those of lidocaine- fentanyl - pavlon group (7.7 min) (P=0.0008). However the average time of operation was same in both groups. The average time of postoperative returning of pain in lidocaine fentanyl-pavlon group (15.5 min) was greater than lidocaine group (6.6min) (P=0.0001).In regard of the lack of difference between two , we can conclude that using this combination (with lidocaine dose half of the other group) is preferred to lidocaine alone (with complete dose) and the rate of complication will reduce.

Recent studies in amnion and chorion trophoblasts have shown that glucocorticoids (GC) increase and decrease expression and activity of PGHS and PGDH enzymes respectively. However, the effects of GC on the expression of these enzymes in placental cells (PC) is unknown.Human placenta were obtained from uncomplicated term pregnancies after elective cesarian section delivery. The dispersed cells were filtered and loaded on to a continous percoll gradient (5-70%) and after 72 hrs incubation of primary culture cell medium were washed and changed and then treated for 24 hrs in the presence or absence of arachidonic acid (5 M), plus various combinations of meloxicam (MEL, 1 M), indomethacin (Ind, 1 M) dexamethasone (DEX, 1 M) and sulphasalazine (SFZ , 1 M). After incubation period cell mediums were collected for determination of PGE2 by radioimmunoassay. One-way ANOVA test and student's t-test were used to assess statistical differences and statistical significances were set at P<0.05.Dexamethasone produced a significant, almost doubling of PGE2 output, but this was not altered further by Mel. In the presece of SFZ alone , there was a significant approximate doubling increase in the output of PGE2 (P<0.05) and this increase further in the presence of dexamethasone that increase was reduced by further addition of Mel (P<0.05). Indomethacine treatment significantly reduced stimulation of PGE2 output seen in the presence of SFZ, or the further increase seen in cells treated with SFZ plus dexamethasone.We conclude that basal PGE2 output by term human PC likely depends on the activity of PGHS-1 not PGHS-2 .The effects of SFZ show the importance of endogenous PGDH in regulating PGE2 output , and interactions with SFZ , DEX and MEL suggest that GC stimulated output of PGE2 by PC may be attributable to both up regulation of PGHS and decrease activity of PGDH.

Toxoplasmosis is one of the most common parasitic infection in human and other ‎warm-blooded animals. Serological methods are reliable techniques actually used for ‎diagnosis of toxoplasmosis. Comparison of sensitivity of ELISA and DIG-ELISA for ‎diagnosis of human toxoplasmosis was the main objective of the present work. 68 ‎human serum samples (48 positive sera and 20 negative sera) were tested using ‎ELISA and DIG-ELISA (diffusion in Gel-ELISA). Among three dilutions of sera ‎‎(1:1, 1:10 and 1:100) tested for evaluation, the serum dilution 1:100 was selected as ‎cut off. In this dilution, diameter of reaction zone was 6.08/ mm. In ELISA, 1:200 ‎serum dilution was selected as cut off and at this dilution OD was 0.735. The ‎sensitivity and specificity of DIG-ELISA for serodiagnosis of toxoplasmosis at 1:100 ‎serum dilution were 93.37%, 100%, respectively while the sensitivity and specificity ‎of ELISA (at 1:200 serum dilution) were 91.66%, 85% respectively. The results of ‎present study indicated that, DIG-ELISA in 1:100 serum dilutions, in comparison ‎with ELISA proved higher sensitivity and specificity for diagnosis of toxoplasmosis‏.‏

Pregnancy make demands upon maternal calcium homeostasis and the extent to which ‎the maternal bone mass is effected remains uncertain. Recently changes in the bone ‎mass during human pregnancy have been associated also with the transformation of ‎the cancellous architecture and the bone surface available for exchange. These ‎jistomorphometrical structural changes were examined further in an animal, model. ‎Using uniparous laboratory rats fed libitum, the histomorphometry of cancellous bone ‎was compared in undecalcified of caudal vertebrae. Between 3 and 6 sections (8 pm) ‎were analyzed by an automated trabecular analysis system (TAS) which measures a ‎comprehensive range of structural variables including the trabecular separation, ‎number, connectivity and width. There was an early stimulation of bone formation ‎that was indicated by generation of thicker and interconnected trabecular. However in ‎caudal vertebrae, there were architectural changes in cancellous bone commencing ‎with a significant increase in the trabecular separation. It was concluded that ‎strengthens the cancellous component of the maternal skeleton possibly to counter ‎increased load and to facilitate mineral mobilization in maternal/neonate exchange ‎during the subsequent lactation period‏.‏

The prevalence of urinary tract stone disease is estimated to be 2-3%. There is not any absolute prophylactic and medical therapeutic measure for urinary stone disease. But there is significant improvement in minimally invasive surgical techniques for stone removal. PCNL (Percutaneous Nephro Lithotripsy) is a minimally invasive and safe technique to treat the urinary calculi. All patients that were candidates for open surgery due to renal or upper ureteral stone, undergone operation by PCNL without fluoroscopy technique. 62 patients(5 -71 y/o) were operated by the same technique in 12months period. In 3 cases we could not reach to pyelocaliceal system and procedure stopped. Surgery terminated successfully in all other cases and stones was removed. Multiple tracts and RePCNL in some patients required. We can do PCNL without flouroscopy or with minimal X-ray exposure, especially in hydronephrotic kidneys. Thought X-ray exposure and harmful effect of that to surgeon and patient can be negotiate.

This study was conducted to determine the combined effects of noise and shift work on physiological parameters including body temperature, heart rate and blood pressure. This study was performed in a chemical industry in Tehran in 1993. The workers' physiological parameters were recorded at the beginning and at the end of all work shifts. Groups under study included: day workers (n=115), day workers with continuous noise exposure (n=44), two-shift workers without noise exposure (n=180) , three-shift workers without noise exposure and three-shift workers with continues noise exposure (n=216). In workers with continuous noise exposure, noise dosimetry was performed using B & K noise dose meter type 4428.The results showed that noise and shift work hove more effects on systolic and diastolic blood pressure than body temperature. The statistical analysis showed that in 3-shift workers, combined effects of noise and shift work on systolic and diastolic blood pressure caused considerable differences between exposed and control group. In general, regarding research design of this study to determine probable combined effects of noise and shift work on physiological parameters, our findings confirmed the additive effects of noise and shift work on systolic and diastolic blood pressure in which the effect of noise was more significant. Our findings showed that combined exposure to shift work and noise may be regarded as a risk factor for cardiovascular diseases because it is responsible for increasing blood pressure in exposed workers.

The objective of this study was the evaluation of pathologic fractures in hospitalized patients in Mobasher Hospital, Hamadan, during years 1991 - 1997.Present retrospective cross-sectional study was done by preparation of a checklist from necessary information that were obtained from the patients files and then the results were analyzed and discussed. According to the results the frequencies of the pathologic fractures in women was 52.4% and in men 47.6%. Most frequency concern to 11-20 year and 61-70 year age groups. Hospitalized patients were 54% urban and 46% rural. The most common etiology of fractures was senile osteoporosis (23.8%), fibrous dysphasia. Puget disease and hyper parathyroidism respectively. The most frequency site of fractures was femur (54%) and the least frequency (1.6%) was concern to pelvic and also to methacarps as well. The most common type of treatment was open reduction (60.3%) and conservative therapy had the least frequency (4.8%). Most patients (95.2%) after treatment in a good condition were discharged and a few of them (4.8%) were expired.

Studies during recent decade indicate that low calorie intake has potentiating effect on immune response. So the effect of fasting in holly month of Ramadan on cellular immune was studied. In this study , delayed type hypersensitivity (DTH) to purified protein derivative (PPD) test was selected to evaluate cellular immune response , because this test is not only very simple but also is valuable and reliable.This research studied DTH to PPD in two groups of students before and after the holly fasting month of Ramadan. The range of age in the both groups was 20-30 year. Mantoux method was the selected method to evaluate DTH response to PPD.DTH response to PPD in fasting group increased from 8.8 to 13 mm , which is statistically significant (P<0.05). It is noticeable that the differences between the rates of increasing DTH response to PPD in control group and fasting group was statistically significant (P<0.05).Based on the above finding it can be concluded that fasting has potentiating effect on cellular immune response.

Pain is the most important and current nursing diagnosis at I.C.U of heart surgery. So it must be relived for its acute complication. The purpose of this study was to compare nurses and patients perception of pain and its relation to analgesics in patient's undergone coronary bypass surgery in one of the selected hospital in Iran medical university in 2000 and to give some suggestions according to results of this study.This research was a descriptive study. In this study 30 patients with30 nurses caring of them in cardiac surgery I.C.U in one of the hospital of Iran medical university were participated .The materials in this study included question forms, scale of intensity of pain and analgesic dose check list. The first part included questions related to personal specifications of nurses and patients participating in study. The second part included 25 sentences about patients and nurses understanding of pain. For evaluating the degree of pain and severity of its perception in patients the statistical method was used. According to its"10" scores column the "o" was for no pain perception and "10" was for the most possible sense pain. The result of this study was summarized in 6 figures. The " T " statistical analysis showed that the patients average of pain perception was more than pain perception of nurses (P=0.001). The "pair t-test" detected significant differences between degree of perception of pain in patients before and after injection of analgesics and also perception of patients pain in their nurses (P=0.001). In addition according to "t-test" there was significant differences between the degree of pain in patients and degree of perception of this pain in nurses before and after the injection of analgesics (P=0.001). But, there was no relation between dose of analgesics with the patients' and nurses' perception of pain, and also the degree of patient's pain before and after the injection of analgesics and degree of nurse's perception of patients pain before and after the injection of analgesics.According that nurses' perception of patients' pain is an important factor in decision making strategy of pain relative; so the nurses must pay more attention to patient's pain.

Fragile X Syndrome, the most common cause of inherited mental retardation, results from mutation in fragile X mental retardation gene (FMR1) on long arm of X chromosome, Xq27.3. Clinical features include moderate to severe mental retardation without neurologic deficit, long face, large ears, prominent jaw, macro-orchidism, attention deficit, behavior disorder and occasionally autistic behavior. Hyperextensible joints may also be seen in these patients. There is no other congenital malformation in fragile X syndrome.In this article we presented a 6 years old boy with fragile X syndrome who in addition to his characteristic clinical features had large thumbs and toes, which was disproportionate in size to his thumb nails and toe nails. In a case report from division of medical Genetics, Newyork Hospital in Cornell University, a twin brothers with fragile X syndrome also had cleft palate and ventricular septal defect. The diagnosis of this case was performed by culturing the patient's peripheral blood lymphocytes in media lacking folate which expose the fragile X sites. The chromosomal analysis was performed using G-banding.

This report describes a rare case of omentum and inguinal lymph node's malakoplakia associated with inflammatory bowel disease (ulcerative colitis) in a 23 year - old man.He was admitted for the first time by fever, bloody diarrhea, abdominal pain and mass.During 4 years after first admission, patient had recurrent attack of bloody diarrhea, Weight loss and extra intestinal manifestations. In the last time, patient had perianal abscess, rectal stenosis associated with inguinal lymphadenopathy and omental masses.Pathologic examination of omentum and lymph node's biopsy revealed a diffuse infiltration of macrophages with granular Periodic - Acid - Schiff positive and diagnostic bodies (Michaelis – Guttmann's bodies).