Avicenna Journal of Clinical Medicine
Year:2006 | Volume:13 | Issue:1 (SN 39)|Papers Count:12

Introduction & Objective: Extra-cellular matrix and basement membrane play important roles in many developmental phenomenons during development and after birth. Among the components of the basement membrane, collagen fibers specially type IV, are the most important part of this area. As kidney is one of the target organs in diabetes mellitus and diabetic nephropathy is a major cause of end stage-renal disease and result an increase in morbidity and mortality of effected individuals, therefore early diagnosis leads to better treatment. The aim of this investigation was to study the primary diagnostic parameters by special regards to collagen IV fibers.Materials & Methods: In this study, 24 male balb/c mice were divided into experimental and control groups. In experimental group, the beta cells of Langerhance were chemically destroyed by an injection of 160 mg/kg alloxan and subdivided in experimental groups 1 and 2. Controls were kept untreated. Experimental group 1and 2 were sacrified 8 and 16 weeks after treatment with alloxan respectively. The same procedure was performed' for control group. Immunohistochmical studies were carried out using monoclonal atntibody. Against collagen type IV in Glomeruli. In addition, using morphometrical and steredlogical methods the volume of the glumerles was compared in all groups. Results: Our finding showed that in experimental groups with special regards in 16 weeks diabetic mice, the rate of collagen type IV in basement membrane around the parietal layer of Bowman capsule, mesangial cells and endothelium of capillary in glomerules increased significantly compared to controls and experimented group 1 (p<0.05), while there was not a significant difference among experimental group 4 and controls. Our data also revealed that the number of mesangial cells as well as glomerular volume increased significantly in experimental 2 (4.635±0.289×106μm3) compared to experimental 1 (3.504±0.189×106μm3) and controls (3.422±0.140×106 μm3).Conclusion: This study indicated that any increase in the amount. of collagen type IV in glomerules as well as mesangial cells and glomeruli volume which may happen; early in diabetes mellitus, could be able to affect the physiology of the kidneys and it is a helpful tool for early diagnosis of affected kidney.  

Introduction & Objective: The objective of this study was to determine the sensitivity and specificity of CA 19-9 test in diagnosis of gastric cancer patients.Materials & Methods: This prospective and cross-sectional study was carried out on 35 patients with gastric cancer and 35 patients without adenocarcinoma of gaster as a control group. Theses patients were referred to alimentary and pathology wards in Ekbatan Hospital of Hamadan city. After selection of the patients who had the inclusion criteria, CA19-9 level was; determined, and information collected in a checklist. Then statistical analysis was performed using χ2 test.Results: Cut off point of 35 was determined as a suitable point with high sensitivity and specificity for diagnosis of gastric carcinoma. In cut off point of 35 the sensitivity and specificity was 77.1% and 97.1% respectively. CA 19-9 was a fairly good test for diagnosis of gastric cancer before performing any invasive methods.Conclusion: CA 19-9 is a sensitive and specific test for gastric cancer.

Introduction & Objective: Among all of the neurologic diseases in adult life, the cerebrovascular disease (CVD) is the most common and important ones. Intracerebral hemorrhage (ICH) in basal ganglia (BG) is one of the common and major types of CVD. The relations between clot size and mortality rate, in different parts of the brain, has been addressed by several researchers. It is unclear whether such a relationship is in BG. Therefore this study was designed to find a formula that predicts outcome of hemorrhage based on clot size in BG. Materials & Methods: This descriptive-comparative study that was carried out prospectively, conducted on all 63 patients who admitted to the hospital during one year, with definite diagnosis of ICH in BG. After urgent CT scanning, the size of hematoma was determined by scan images. Routine treatment was uniform for all patients. Focal signs and consciousness state were assessed in the first and last days of admission. The data were analyzed using descriptive statistics, frequency tables and chi-square and T- test.Results: 33% of patients died. Hematoma size in 70% of them was larger than 5cm and in other 30% smaller. None of the hematoma with less than 4cm size was fatal. In patients with clots of 5cm or larger, the mortality was 100%.Conclusion: The results indicated that, there was meaningful relationship between hematoma size and mortality, in BG hemorrhages. So the clot size can be used as a factor in predicting hemorrhage outcome in BG.

Introduction & Objective: Premenstrual dysphoric disorder is considered as a mood disorders that 30 to 80 percent of women have at least mild symptoms and that 2 to 10 percent have severe symptoms of this disorder. The exact cause of this disorder is not clear, but according to one of the most common theories, it seems to be the higher level of estrogen to progesterone in affected women. The symptoms of this disorder include: hopelessness, agitation, emotional disturbance, anger and physical complaints (headache, breast tenderness and edema). The symptoms cause clinically significant impairment in social, occupational or interpersonal functioning. The purpose of this study was evaluation of the prevalence of premenstrual dysphoric disorder in Hamadan high school girls, in 2003.Materials & Methods: This was a descriptive-analytic cross-sectional study. Maximum sampling error was considered to be as 5% and confidence interval was 95%. 384 educating high school girls from Hamadan were selected randomly and were asked by questionnaires that were designed on the basis of premenstrual dysphoric disorder criteria, according to psychiatric references. Data were statistically analyzed by SPSS 10 using χ2 test.Results: From 384 studied girls. 172 subjects (44.5%) were diagnosed with premenstrual dysphoric disorder which 18 cases of them were suspicious to have other disorder such as depression. 102 patients among affected girls (59.3%) were diagnosed during the first year of beginning menstruation. Duration of symptoms of premenstrual dysphoric disorder was more than three days in 20% of cases. Mood, Behavioral and physical symptoms were coexisted in 71.5%. 61% and 73.2% of the girls with premenstrual dysphoric disorder respectively, and these associations were statistically significant (p<0.01).Conclusion: Prevalence of premenstrual dysphoric disorder in Hamadan high school girls was near to its prevalence in general population (40%). More than two thirds (2/3) of the patients 3 had also three groups mood,Behavioral and physical symptoms together.  

Introduction & Objective: The coronary artery disease (CAD) is the second cause of mortality in women over 40. The risk factors of CAD in females include: age over 55, BP>140/90, smoking and hyperlipidemia. As plasma lipoprotein level changes significantly during pregnancy, low density lipoprotein reaches its peak approximately in the week 36 of pregnancy. Hypercholesterolemia induced by pregnancy may be atherogen. The purpose of this study was to evaluate the relationship between multi-parity and CAD.Material & Methods: In this case-control study 230 women over 50 y were studied in the Ekbatan Hospital, Hamadan in 2005. 115 subjects out of them were considered as case group, who were selected among admitted patients with CAD in the heart ward. Other 115 cases without CAD who were admitted in internal and surgery wards, with normal cardiovascular consultation were selected as control group. Patients with known risk factors such as hypertension, hyperlipidemia, diabetic, obesity, active and passive smoker. Type A personality and any record of hormone replacement therapy were excluded. The data were analyzed using the commercially available software package SPSS version 11. Student's t-test and X2 were used for analysis and results were expressed as mean±SD, and p<0.05 was considered as significant level.Results: Mean ages of the first parity in case and control groups were 16.09±2 and 16.3±2 y respectively that the difference was not statistically significant. Mean of parity in case and control groups was 7.5±3.1 and 5.9±1.9 respectively (P<0.001). The average of cholesterol, HDL and LDL in control group were 164.2, 102.6 and 34.5 mg/dl respectively. And in control they were 164.1, 105.4 and 40.5 mg/dl respectively. Conclusion: Exposure with repeated hyperlipidemia induced pregnancy may increase the risk of CAD particularly in women with more than 4 parity. Age of the first pregnancy was not observed as a risk factor of CAD.

Introduction & Objective: Toxoplasmosis is one of the most widespread parasitic infections in the human beings and other warm-blooded animals that can cause chronic infection in adults, fatal illness in immunodeficient patients and abortion in pregnant women or congenital abnormalities in fetus. The aim of this study was determination of the prevalence of toxoplasmosis in primigrvida women in Hamadan.Materials & Methods: In this cross sectional study a total of 576 primigravida women, who admitted to the health centers were selected by cluster random sampling method. Data for epidemiological factors was collected by a questionnaire and serum samples were collected for detection of total antibodies against Toxoplasma gondii. The titer of ≥1:20 regarded as positive. The relationship between variables analyzed by chi2 test.Results: In this study seroprevalence was 33.5%. Higher seropositivity observed in illiterate subgroup and lower infection rate was found in high school educated subgroup. Our study showed statistically significant relationship between seropositivity and age, fresh and undercooked meat and rate of vegetables consumption (P<0.05). On the other hand, there was not significant relationship between seropositivity and education, having contact with cats and meat, culture and washing vegetables, consuming raw milk and egg (P>0.05).Conclusion: This study indicated that seropositivity for toxoplasmosis in this area is lower than northern parts and higher than central and eastern parts of Iran. Our study showed that about one-third of individuals were seropositive and because of the importance of toxoplasmosis in primigravida women and immonucompromized patients, health education is necessary for prevention of toxoplasmosis.  

Introduction& Objective: The peer assessment rating index (PAR) has been developed to provide a single summary score for all the occlusal anomalies, which may be found in a malocclusion. The score provides an estimate of how it may deviates from normal alignment and occlusion. Reduction of score after treatment reflects the degree of improvement and, therefore, the success of treatment. The aim of this study was assessment of outcome of removable orthodontic treatment performed by under graduated dental students in orthodontic department of Hamadan dental school.Materials & Methods: In this descriptive- analytical study pre- and post-treatment dental-casts of 70 patients were studied. According to PAR Index following variables were evaluated: upper right segment, upper left segment, upper and lower anterior, segments, lower right segment, lower left segment, over jet, overbite, midline and right and left buccal occlusion. Weighed PAR score was given to the rough score of every component and final score were compared using Willcoxon test before and after the treatment.Results: Results showed the differences between the pre- and post-treatment score of upper anterior segment, midline and left buccal occlusion were not significant (P>0.05). However, the pre- and post-treatment score of lower anterior (P =0.039), overjet (P =0.001), overbite (P=0.004) and right buccal segment (P =0.037) had significant differences. The mean of PAR score showed significant difference between pre-treatment (18.2±0.94) and post-treatment (10.8±0.68) in dental casts (P=0.001).Conclusion: According to the results of this study, 38.6% of patients had "worse or non different" degree, 57.1% had "improvement" degree and 4.3% had "greatly improvement" degree.

Introduction & Objective: Nasolacrimal duct obstruction (NLDO) is the most common cause of epiphora in adults. Our purpose was the evaluation of efficacy and complications of NLD probing with adjunctive MMC in the treatment of partial NLDO in adults.Materials & methods: This clinical trial study without control group (quazi experimental) was carried out in adult patients with symptom of epiphora. 40 patients (46 eyes) with partial obstruction of Nasolacrimal duct participated in this study. 6 patients had bilateral and 34 patients had unilateral epiphora. Each patient was followed for at least 6 months and visited 2 weeks, 1 month, 3 months and 6 months after the probing.Results: After 6 months follow up in 20 eyes (43.6%) Nasolacrimal duct was patent (confirmed with irrigation) and 21 patients (52.5%) were symptomatically satisfied. After 6 months follow up no complication was observed.Conclusion: This study showed that probing and irrigation with mitomycin C (0.2 mg/ml) was a method with relatively high success rate and could be an appropriate alternative option for relieving partial obstruction of the Nasolacrimal duct obstruction. Its advantages include simplicity, low morbidity, operable without general anesthesia and with simple instruments.

Introduction & Objective: Locomotor activity is an important physiologic phenomenon that is influenced by several factors. In previous study we showed that the matricaria chamomilla (chamomile) hydroalcholic extract acts differently in male and female mice. Therefore in this study, the role of sex hormones and chamomile hydroalcholic: extract were investigated on motor activity behavior in absence of sex glands in adult male and female NMRI mice.Materials and Methods: Gonadectomized male and female mice were divided into groups (seven mice in each group) including: receiving testosterone (2 mg/kg S.c.), estradiol benzoate (0.1 mg/kg S.c.), and progesterone (0.5 mg/kg S.C.) with and without hydroalcholic extra & Lof chamomile (50 mg/kg i.p). Motor activity monitor system was used to evaluate locomotor activity parameters (fast and slow activity, fast and slow stereotype activity, fast and slow rearing) in all groups.Results: 1) Testosterone had no any effect on motor activity parameters, but extract of chamomile with and without testosterone decreased motor activity parameters in male mice. 2) Estradiol benzoate and chamomile hydroalcholic extract in presence and absence of each other increased locomotor activity parameters in female mice. 3) Progesterone also did not change motor activity parameters in presence and absence of chamomile hydroalcholic extract in female mice. 4) Administration of Estradiol benzoate with progestrone in presence and absence of chamomile hydroalcholic extract did not alter motor activity parameters in female mice.Conclusion: It seems both of the chamomile hydroalcholic extract and estuarial enhance motor activity and probably act through same system and potentiate the effect of each other. Also it seems there are interaction between estradiol and progesterone and also between chamomile extract and progesterone. Testosterone. probably did not have any interaction with chamomile extract in locomotor activity.

Introduction & Objective: According to significance of pervasive developmental disorders (PDD) in children and the increasing rate of its prevalence in referred patients to clinic in recent years and due to absence of any report about the rate of PPD in our country, this study was carried out. The aim of this study was to determine the prevalence of PPD in a sample of Iranian children who referred to medical and rehabilitation centers.Materials & Methods: 248 children who referred to three medical-rehabilitation centers were participated in the research. Accessible sampling with diagnosis of PDD based on DSM-IV criteria was chosen. The obtained data were analyzed using descriptive statistics methods such as percent and frequency distribution.Results: Autistics disorder was most prevalent among pervasive developmental disorders. In this research Autistic disorder (proportion 4/1 to 1), Asperger disorder (proportion 3 to 1) and childhood disintegrative disease were more prevalent in boys than girls. Ret disorders was observed only in girls and pervasive developmental disease (NOS) was seen in both sexes.Conclusion: The results showed that pervasive developmental disorders are 4 times more prevalent in boys than girls and the findings of this research were consistent with those of previous studies.

Introduction & Objective: Ischemic injury of endothelium is associated with prostaglandin synthesis and platelet adhesion and aggregation, which may be associated with the release of aldehydes such as malondialdehyde (MDA). C-reactive protein and cardiac troponin I have been proposed as diagnostic markers of acute coronary syndromes. In this study, we compared the usefulness of plasma MDA as a marker of acute coronary syndromes with that of C-reactive protein and troponin I.Material & Methods: The study population contained 50 patients with unstable angina and 50 patients with acute myocardial infarction admitted to the hearth department of the Ekbatan Hospital of Hamadan. The subjects were matched according to age and sex. Total cholesterol, LDL and HDL cholesterol, triglycerides, plasma MDA; troponin I and C-reactive protein levels were determined in all patients.Results: Results showed that the plasma MDA levels were significantly higher in patients with acute myocardial infarction than in individuals with unstable angina (P<0.001) and were associated-with increased levels of troponin I and C-reactive protein (P<0.001).Conclusion: The combination of the plasma MDA levels, which reflect endothelial injury, and troponin I and C-reactive protein levels may allow better discrimination in acute coronary syndromes patients.

Introduction: Acute appendicitis is the most common emergency abdominal operation. One of its different pathogenesis is infection with microbial agents such as Yersinia. Yersinia is the most common cause of mesenteric adenitis and may represent with right lower quadrant abdominal pain and tenderness and sometimes with systemic manifestation. Frequently in patient with Yersinia infection appendix is normal but may be involved as acute appendicitis.Case Report: This case report represent a 12 years old girl with acute appendicitis and mesenteric adenitis secondary to underline infections process (high probably Yersinia according to clinical syndrome) with multiple organ involvement.Conclusion: We conclude that in patients with clinical findings of acute appendicitis and without improvement after surgery, it should be considered an underline other disease process such as appendicitis and mesenteric adenitis with Yersinia infection.