Researcher Bulletin of Medical Sciences
Year:2009 | Volume:13 | Issue:5 (65)|Papers Count:15

Background: There is a considerable number of cancerous patients undergoing the treatment of chemotherapy with Cisplatin and it is of undeniable importance to truly estimate their renal function. Besides, there are several reports owing to the more effectiveness of serum level of Cystatin C (Cys C) than creatinine (Cr) in diagnosis of early stages of impaired renal function. Therefore, this study was carried out to compare the diagnostic power of Cys C with Cr in predicting the reduced renal function, on patients referred to Imam Hossein Hospital between 2006-2008.Materials and Methods: This diagnostic clinical trial was conducted on cancerous patients whom undergone the chemotherapy courses with Cisplatin. Serum creatinine (with RI 1000 combasmira) and serum Cystatin C (with turbidimetery (PETIA)) were measured, before and after the chemotherapy courses. Renal function tests were performed along with creatinine clearance of 24hr urine. Positive and negative predictive values (PPV, NPV) and the accuracy of both serum Cr and Cys C were analyzed by Chi-square test.Results: We studied 80 subjects (mean age 52±11 years old, 32 men and 48 women). Out of them, 40 patients had experienced reduced renal function. Positive predictive value and negative predictive value of Cystatin C were 88.3% and 94.6%, respectively. On the other hand, PPV and NPV of serum creatinine were 85.7% and 69.2%, respectively. There were 7 samples (8.7%) of false positive and negative results through the serum Cys C method, although in serum Cr, there were 20 samples (25%) with false positive and negative results (P<0.01). Moreover, the serum levels of Cr and Cys C did not change after chemotherapy.Conclusion: This study revealed that in contrast to creatinine, serum Cystatin C can preliminarily diagnose the early stages of impaired renal function.

Background: Depression is a common psychiatric disorder. The effect of cognitive therapy is well-known since last three decades. Cognitive group therapy has also been used in last decades. In this study we assessed the effect of "Cognitive Spiritual Group Therapy (CSGT)" on depression of female students studying in Shaheed Beheshti Medical University.Materials and Methods: The samples have been chosen among 80 subjects whom have registered for study. They underwent Beck inventory test and their depression has approved through the psychiatric interview. None of them has used medication. The experimental group participated in 10 sessions of CSGT, but control group administered no psychotherapeutic intervention. Both group re-assessed by Beck inventory test after accomplishment of the sessions. Data were analyzed by Wilcoxon and Mann-Whitney test.Results: The study has been carried out on 16 subjests divided into 2 groups, each contained 8 subjects. Their age, sex, marital status and rate of depression were similar between 2 groups. After CSGT sessions, depression rate became 5.5±5.1 in experimental group, whereas in control group it was 23±6.8 (P<0/01).Conclusion: The cognitive spiritual group therapy (CSFT) was indisputably effective on depressoion of female students. It is necessary to conduct further investigations on other groups of the society.

Background: Unstable intertrochanteric fractures are common problems with unfortunate complicated consequences. There is no reliable record in this regard in Iranian medical literature. This study assessed the outcomes of unstable intertrochanteric fractures treated with DHS with and without cement augmentation in a three-year period (2005-2008).Materials and Methods: 39 patients with unstable intertrochanteric fracture were randomly divided between the experimental (DHS + Calcium phosphate cement) and control groups (DHS alone) after matching. After a six-month follow-up, the incidence of cut-out of femoral head, fracture impaction (sliding) and Iowa hip score were measured in two groups and were evaluated statistically.Results: 20 patients in control group and 19 patients in experimental group were evaluated. Their age was 72±5.4 year old in control group and 74.6±6.2 in experimental group. Cut-out incidence was 15% in control group, whereas there was no complication in experimental group (P<0.12). Fracture impaction in control group was 15.4±4.7mm and in experimental group it was 8.9±2.5mm (P<0.001). Iowa hip score was 58.1±6.6 in control group and in experimental group it was 70.1±2.7 by the end of 6th week (P<0.05). However, at 3rd and 6th months of follow up it became equal amongst both groups. Conclusion: Applying this material can obviously improve the clinical outcome of this sort of fractures. We recommend further studies on greater number of cases.Conclusion: Applying this material can obviously improve the clinical outcome of this sort of fractures. We recommend further studies on greater number of cases.

Background: Pregnancy is known as a life crisis for women, which represents major life transitions. Moreover, it usually has substantial impacts on the sexual adjustment. Also some sexual behavior occurring during pregnancy, are accompanied with some complications for both mother and her fetus. Even though, yet, there are remarkably little empirical data about sexuality during pregnancy. This study helps to define which changes occur in sexual function and what kind of sexual behaviors are experienced by women during pregnancy.Materials and Methods: The study was a cross-sectional one which evaluated 102 pregnant women referring to state health-care centers of Ahvaz city, from February to March 2007. The inclusion criteria were confirmation of pregnancy with either pregnancy tests or sonography and having a stable partnership. Exclusion criterion was having any kind of medical-obstetric restrictions about sexual activities. Assessment was performed using a three-part questionnaire, consisting; 1- Sociodemographic and obstetrics data, 2- Sexual function translated copy of Female Sexual Function Index (FSFI) and 3- Sexual behavior. The validity of materials was confirmed with content validity and the reliability was proved by test-retest method. We completed questionnaires through execute interviews in a private condition after describing the aim of our study to the participants. After correlating data, they analyzed by SPSS 13.Results: 102 pregnant women enrolled in the study. Mean age of women was 24.4 years old, most of them (38.2%) had high school education and most of them (56.9%) were primerigravids. Women’s mean marrital age was 20.23 years and the ethnicity of most of them (52%) was arabic. There was no difference between three group from the demographic variables point of view. When we compared sexual function's domain score between three trimester, consist of desire, excitement, lubrication, orgasm, satisfaction and dysparonia, we observed significant decrease just in dysparonia domain with progressing of the trimesters (P<0.05). Total sexual function score decreased as the pregnancy progressed (P<0.05). 17/6% of pregnant women had been continuing anal sex, however, 38.2% had had oral sex and 29.2% had experienced sexual abuse by their partners, during pregnancy. Conclusion:Sexual function decreased with pregnancy progression. This can have negative effects on marital relationship, although in this study sexual function was less affected by gestational age and trimesters. Assessing the high-risk sexual behaviors during perinatal care, can help to decrease the consequent maternal and neonatal complications and can promote the family health.

Background: The hydrogen sulfide is a toxic, flammable and colorless gas. Traditionally, the control of H2S emissions includes direct air stripping, precipitation and chemical oxidation. Considering the advantages of biological methods, this study aimed at treating H2S using biofiltration. Three types of media; a pearl medium, a compost medium and an activated carbon medium, were evaluated for sulfur inhibition and capacity for removal of hydrogen sulfide (H2S).Materials and Methods: In this study, the biofilter columns were constructed using transparent plexyglass pipes with a diameter of 15 cm and a height of 40 cm, with a bed depth of 27.5 cm. Have been measured, produced H2S gas was passed through the three different biofilter media and effluent readings for H2S at the outlet points of three different columns were measured.Results: The three biofilters with different media blends were operated in parallel for ten weeks continuously treating hydrogen sulfide, at various flow rates and concentrations. After being stabilized, the overall removal efficiencies of three different columns were measured at the outlet points and observed that the efficiency of the column packed with activated carbon remained 100% at different flow rates, concentrations and empty bed retention times (EBRT). The overall removal efficiency of compost and seashell media columns was similar in about 88-90% and 80-90%, respectively.Conclusion: Biological treatment of air emissions is a cost-effective, environmentally friendly and sustainable control technology for industrial and municipal facilities. Having lesser pollution potential in end products as well as lower operational and maintenance costs are the other advantages of these systems.

Background: Systemic Lupus Erythematosus (SLE) is a chronic inflammatory disease that involves many people for long time. SLE affects several organs such as skin, kidney and joints. A substantial number of SLE patients, also suffer from hypertension and are susceptible for insulin resistance and metabolic syndrome. The aim of present study is to compare SLE activity in SLE patients with and without metabolic syndrome.Materials and Methods: One hundred patients enrolled the study. 51 had metabolic syndrome while 49 did not. According to British Isles Lupus Assessment Group (BILAG) Index, Lupus activity was calculated for these two groups and means of Lupus activity score were compared.Results: Mean of lupus activity score was significantly more in metabolic syndrome group (2.14±1.73 vs. 5.90±3.37 P<0.001). Patients were also compared for serum creatinin, history of corticosteroid therapy or Cyclophosphamide administration and elevated ESR levels. All of these parameters were significantly higher in patients with metabolic syndrome.Conclusion: We concluded that Lupus activity in patients afflicted by metabolic syndrome is more than patients without this syndrome. There are many probable reasons for this statement such as various types of SLE treatments, similar inflammatory nature of metabolic syndrome and SLE, further susceptibility of insulin resistance in lupus patients or complications of Lupus flare up.

Background: Induction of in vitro maturation and development of immature oocyte is one of the methods that has been frequently used recently in artificial reproduction techniques and has drawn attention of many investigators. This method is useful especially in women who are affected by cancer and polycystic ovary syndrome. Despite using many types of in vitro media, an appropriate environment has not been reported yet. Present study has been designed to assess the effect of heated human follicular fluid (hHFF), which is similar to in vivo environment for oocyte, on the maturation and fertilization potential of mouse immature oocytes.Materials and Methods: This study was performed by experimental method. Healthy female mice, aged 4-6 weeks, were sacrificed via cervical dislocation and their ovaries were extracted under sterile conditions. After washing, the separated immature oocytes were divided into three groups: In the first group, 209 immature oocytes were placed in culture medium contained MEM-a, HCG, FSC 20%, and rFSH. In the second group, 203 immature oocytes were put in culture medium contained 100%hHFF. In the third group, 205 immature oocytes were placed in culture medium contained MEM-a, HCG, rFSH, and 20% hHFF. Immature oocytes were placed in an incubator for 24 hours. Then, the stages of oocyte maturation were assessed by invert microscope and mature oocytes in each group were transferred to sperm-contained drops. After 24 hr, rate of two-cell embryos was recorded using invert microscope. Data was analyzed by Chi square test.Results: Maturation rate of oocytes in the second group (83.7%) was significantly higher than first (59.8%) and third (67.3%) groups (P<0.0005). The difference between first and third groups was not statistically significant (P<0.2). The formation rate of two-cell embryo in the second group (83.1%) was higher than first (47.2%) and third (54/3%) groups (P<0.002 and P<0.01, respectively). The difference between first and third groups was not statistically significant (P<0.07).Conclusion: it seems hHFF could improve in vitro maturation and fertility potential of immature oocytes and consequently the formation rate of two-cell embryos in mice, in comparison with MEM-α even supplemented with 20%hHFF.

Background: S1 radiculopathy is a high prevalence illness and its early diagnosis is of crucial importance. Several reports have revealed the efficacy of magnetic stimulation in diagnosis of this condition. We conducted this study to compare MMEP latency and MMEP amplitude in patients with S1 radiculopathy and healthy controls in Shohadaye Tajreash Hospital in 2007.Materials and Methods: This historical cohort study investigated 31 patients with S1 radiculopathy (according to clinical history and physical examination) and 33 healthy controls. H-reflex, MMEP latency and MMEP amplitude were evaluated in both groups. Patients and controls were not informed about the type of study and performers were unaware of the participants condition. Results were analyzed using statistical tests.Results: There was not significant difference between cases and controls regarding age and sex. Mean MMEP latency was 15.23±2.47ms and 13.42±1.6ms in patients and controls, respectively (P<0.05) and mean MMEP amplitude was 0.55±0.53µv and 1.29±1.22µv in patients and controls, respectively (P<0.06). We found abnormal MMEP latency in 12.2% of controls and 48.4% of patients (P<0.005) and abnormal MMEP amplitude in 87.9% of controls and 100% of patients (P<0.06).Conclusion: MMEP latency seems to be efficient in diagnosis of S1 radiculopathy. A study with a precise diagnostic design is recommended.

Background: The benefits of breastfeeding for both the infant and the mother are indisputable and the necessity of contraception during breast feeding is one of the most important issues in this regard. This study was conducted to evaluate the usage of minipill (progesterone only pills), its related problems, reasons for give it up and other factors.Materials and Methods: In this cross-sectional study, the contraception method, duration of minipill consumption, side effects and reasons for discontinuation were evaluated.Results: The mean age of participants was 24.8±5.3 years old and mean number of their children was 2.2±0.8. 47% used the minipill and 41.8% gave it up during an 18-month follow up. Side effects of minipill were as follow: 71.4% bleeding disturbances, 52.3% menstrual retard, 38% vaginal discharge, 28.5% spotting, 23.8% headache and palpitation, 4.76% dwindling flow of excreted milk and mastalgia.Conclusion: The usage of minipill is lower than what we expect which is of great concern. Moreover, the side effects and other related problems, are important issues that should be rigorously investigated.

Background: Hypoxemia is one of the most important complications of hemodialysis among patients with renal failure which is related with several factors such as type of dialysis membranes. The aime of this study is to investigate the hypoxemic conditions of hemodialysis patients in terms of different dialysis membranes.Materials and Methods: In this cross-over clinical trial, 29 hemodialysis patients were studied in Fatemieh Hospital in Semnan city in 2004. The arterial O2 Saturations of patients undergoing hemodialysis with polysulfone (a synthetic filter) and hemofane (a cellulose filter) were measured before and stepwisely durinng the process of dialysis and their decreasing trend were compared together.Results: The deacreases in means of arterial O2 Saturations in respectively 5, 30, 60 and 120 minutes after initiation of dialysis was more in hemofane membrane group than polyfone membrane one (P<0.001). In both groups the maximun reduction rate was in 30th and 60th minutes of dialysis period.Conclusion: Applying polysulfone membranes would result in lesser decreases in O2 Saturation percent of hemodialysis patients. Therefore, to reduce the risk of hypoxemia particularely among high-risk patients, it is recommended to use this type of membrane for dialysis.

Background: Regarding the indication of pedicle screw insertion and different reports on prevalence of malposition and related factors, in order to determine the malpositions and its effects on prognosis of patients, this survey was performed on patients admitted in Imam Hossein Hospital betweem 2005-2007.Materials and Methods: This study was a case-series one. All the patients whom had the indication of pedicle screw insertion were evaluated and the cases with skeptisism about non-fusion or difficulty in follow up were excluded from the study. Grading of pedicel screw insertion determined by post-operation CT-Scan. Then efficacy of level, type of surgery and direction of screws surveyed statistically. Effect of malposition of screw at correction of spinal deformity also determined.Results: 35 patients with 206 pedicle screw surveyed. 26 screws (12.0%) had malposition. This had a relationship with thoracic level and spine fracture (P<0.02). In 15% of correct screws and 20% of malpositioned screws there was no correction of deformity after operation. However, these rates changed into 30% and 20%, respectively, during the follow up.Conclusion: It seems that prevalence of pedicle screw malformation is acceptable and perhaps, re-operation for correction of malposition screws is not necessary. However, further experimental studies are on demand.

Background: Owing to the variety of micro-flora population residing on human's skin and an ever-increasing expansion of antibiotic resistance in bacteria, studying the antibiotic resistance in normal microbial flora of human body (especially normal flora of the skin) is like to be necessary.Materials and Methods: In this study, 96 samples from certain area of hand or foot of selected persons was cultured using sterile swab and streak plate method in 37oC and bacteria were identified by microbiologic standard methods. Then production of β-lactamase enzyme was studied by acidometery method and antibiotic resistance profile in b-lactamase positive bacteria was determined by Kirby-Bauer method. Finally, the MIC and MBC of penicillin G were determined on bacteria with multiple antibiotic resistances.Results: 180 microorganisms isolated from 96 samples of skin flora and 26 bacteria produced b-lactamase enzyme. All of strains with b-lactamase enzyme were detected as gram positive bacilli or staphylococci that were resistant to the most of related antibiotics.Conclusion: It is indicated that emerged production of b-lactamase enzyme amongst micro-flora of skin in healthy persons of the community is a result of uncontrolled entrance and consumption of penicillins and cephalosporins in medicine markets. Therefore, skin of healthy persons is considered to be one of the most important reservoirs for microorganisms causing hospital-acquired infections.