Researcher Bulletin of Medical Sciences
Year:2009 | Volume:13 | Issue:6 (66)|Papers Count:17

Background: With regard to the increasing prevalence and mortality rate of prostate cancer and several related reports studying the role of promoter Hypermethylation of RARB and p16 in predicting the prognosis, this research is carried out on 3 groups of subjects with; poor prognostic factors (case), good prognostic factors (control-2) and healthy person (control-1), at three general hospitals of Imam Hossein, Modarres and Labbafineyhad, between 2007-2009.Materials and Methods: The research has case-control Design. All three goup of participants (21 subjects in each group) were analyzed for hypermethylation of RARB- p16. All groups were matched for age, tumor stage, grade & PSA. The technique was methylation specific polymerase chain reaction (MSPCR).Results: In control-1, no methylations of RARB were observed. In control-2, RARB was positive in 33%. In case group, the RARB was positive for 71.4%. For control 2 and case groups, the RAR positivity was higher than control-1 (P<0.001). Conclusion: Hypermethylation of promoter RARB and p16 would be a good prognostic factor for early detection and prognosis of prognosis cancer.

Background: Isotretinoin (ISO) revolutionized the treatment of acne since 1980s and therafter, sever forms of acne have been treated more effectively, with less residual cosmetic or psychological damage. The use of Isotretinoin is associated with significant side-effects such as mucocutaneous involvement, dyslipidemia and increased liver enzymes. The aim of study was the evaluation of homocysteine (Hcy) levels and the responsible vitamins for its metabolism in patients with moderate to sever acne vulgaris undergone ISO treatment.Materials and Methods: Forty-seven (n=47) patients with acne, prepared with liver function tests, folate, vitamin B12, homocysteine and serum lipids evaluations. Hcy was evaluated before (Value 1) and on the 2nd month (value 2) of treatment with Isotretinoin (0.5 mg/kg/day), by HPLC methods.Results: Hcy levels (value 1: 11.8 ±5.3mmol/L vs. value 2: 13.6±7.4mmol/L; P<0.001) were statically significantly increased in patients treated with ISO. In addition, lipids and liver enzymes increased in mentioned group. However, there was no significant correlation between Hcy levels, vitamins and liver enzymes.Conclusion: Elevated Hcy levels in patients after 2 months on ISO treatment might be resulted from liver function disturbances. Folate supplementation along with frequent evaluations of Hcy serum levels are strongly reconnnened for the prevention of a premature occlusive disease.

Background: Magnesium is an inorganic ion. There are several products containing magnesium and it has a number of therapeutic properties. Magnesium-sulfate is a very common product and its usefulness has been proven in field of anesthesiology. This study looks at the effect of prescribing intravenous magnesium-sulfate on acute pain following orthopedic surgery of the lower extremities in patients anesthetized with spinal anesthesia method.Materials and Methods: In this double-blind, randomized, placebo-controlled clinical trial, 60 patients were selected and were randomly divided into 2 groups. Efforts were made to place both groups under the same method of anesthesia and other variable were kept constant to the best of our ability. One group received intravenous magnesium sulfate under a given protocol and the second one received the same volume of placebo, intravenously. To present the results Mean (±SD) was used and the P-value of less than 0.05 was considered statistically significant.Results: There was no difference between the 2 groups under basic variables. Pain reported by the first group who received magnesium sulfate was significantly less at the 1st, 3rd, 6th, and 12th hours after the operation in comparison to the group who received placebo. At the 18th and 24th post-operation hours, there was no significant difference between the 2 groups.Conclusion: Receiving intravenous magnesium sulfate following lower extremities orthopedic surgery would significantly reduce the pain in the first few hours after the operation.

Background: Coronary heart disease is an increasing illness and one of the gold standards for their diagnosis is catheterization (CA). Post-CA bed rest may cause back pain. In Iran, there has been no study about the effects of changing the position on their back pain after coronary angiography. This study was designed to explore these effects amongst the patients admitted to Taleghani hospital, 2006-2007.Materials and Methods: This clinical trial was carried out on 130 patients hospitalized for coronary angiography. Each Patient was assigned randomly to either the control group (which remained in supine position for 6 hours after coronary angiography), or experimental group. The position of experimental group were changed hourly, from supine to 3o degree elevation and semi position (elevated to 45 degrees) during the first 6 hours after coronary angiography. Check list and numeric pain intensity scale were used for data collection.Results: None of patients developed bleeding, haematoma and arterial thrombosis. There was no significant difference between two groups. There was a significantly lesser pain intensity in experimental group (P<0/001). The extention of back pain was lesser in experimental group but it was not significantly different (P<0/07).Conclusion: Changing the bed position of patients would reduce the back pain without increasing the risk of vascular complications. It also promotes physical comfort among patients undergone coronary angiography.

Background: Metal working fluids sprayed in air through lathe in form of oil mist, are considered as hazardous chemical pollutant. Metal working fluids are detrimental to skin and respiratory system and they possibly may produce carcinogenic effects. Due to increasing application of lathe machines in Iranian industries and unavailability of a sensitive analytic method, the objective of this study was to develop and validate a molecular spectroscopy for analysis of metal working fluids in the air.Materials and Methods: This study was conducted in two phases of method development and examination its validity. In the first phase, 10 ml of fresh mineral undiluted mineral oil were collected in cleaned glass vial and were used to prepare standard solutions. After pre-cleaning of the mineral oil by centrifuging at 5000g, standard solutions of oil were prepared from a spiked mixed cellulose filter using chilled pentane in concentration range of 1 to 200ppm in series of 10 ml volumetric flax. Air-borne mineral oil were sampled from the breathing zone of workers on the mixed cellulose filter membranes and after extraction by pentane, mineral oil was determined by UV-spectroscopy in the wave length range of 190-380ηm. In the second phase of this study, the new method was validated through examination of coefficient of correlation of concentrations versus their respective absorptions and coefficient of variation and recovery tests.Results: Standard concentrations of all bulk metal working fluids obtained from lathe operations had optimum absorptions in wave length range of 190-202hm. linear concentration ranges of three standard solutions were in range of 5-100ppm and with Pearson correlation of coefficient (r2) of 0.999, 0.997 and 0.998, respectively. Coefficient of variations of the three sets of standards for inter-day and intra-day variations were in the range of 3.4-6.6 and 5.4-8.6. Recoveries of known quantity of mineral oil added to standard solutions were in the range of 100 ±10. Developed method is capable of analyzing of air-borne mineral oil in the range of 0.09-3.66 mg/m3.Conclusion: The developed method is by far more sensitive than other routine methods and regarding the results of its validity, it can be considered as alternative method to previous ones.

Background: acne vulgaris is the most common disorder of pilosebaceous units which can develop serious psychological disabilities. It is clear that nutritional minerals (such as zinc) can intricately be involved in pathogenesis of inflammatory disorders such as acne vulgaris. This study was conducted to measure the serum zinc level in patients with acne vulgaris and compare it with healthy controls.Materials and Methods: We studied 30 patients with acne whom were matched in their age, sex and place of residence with healthy controls. Their serum zinc levels were measured using atomic absorption spectrophotometric method.Results: Mean serum level of zinc in acne patients and controls were 92.42±37.6mg/dl and 101.3±43.41mg/dl, respectively. Although, the mean serum zinc level was lower in acne group, it was not statistically significant (P=0.32).Conclusion: it seems that relative decrease of serum zinc level in acne patients can further highlight the role of this trace element in the pathogenesis of acne vulgaris.

Background: Operative stress and post-operative pain are important issues in medicine. After any types of surgery, the stress hormones release responding to pain In this study we applied Bupivacain infiltration in surgical wounds of inguinal hernia amongst children aged 3-7 years and evaluated its effects on some stress hormones and plasma levels of glucose.Materials and Methods: In this prospective study, 116 children aged 3-7 years (24 females, 92 males) undergone unilateral repair of inguinal hernia under general anesthesia at Mofid children hospital during 2005-2007, were divided into 2 groups. Perincisional wound infiltration of 1-2 mg/kg of Bupivacain was performed in experimental group. In both groups, 10-15 mg/kg of Acetaminophen suppository were recommended at the recovery room. 4 ml of blood samples were obtained at three distinct stages (preincisional stage, at the end of operation and 4 hours after operation) to measure the insulin, prolactin cortisol and glucose plasma levels of subjects. Post operative pain was measured objectively by Hannalla scale.Results: In both groups plasma prolactin levels increased at the end of operation along with insulin, cortisol and glucose. However, these differences became statistically significant just for insulin. There were no significant differences between other variables. In addition, although the plasma concentration of above mentioned variables became lesser in the 4th hour of post-operative period in experimental group, there was no statistically significant difference compared to the those of control group.Conclusion: Wound infiltration of Bupivacain decreases the stress hormones and pain during the post-operative period. We recommend this type of infiltration applying long-acting anesthetic agents with fewer numbers of side-effects.

Background: Acoustic neurinoma is a benign neoplasm of schwann cell source that mainly originate from vestibular branch of 8th cranial nerve. In this study we evaluated the result of suboccipital retrosigmoid surgery in patients operated in Shohada hospital from 1998 to 2006.Materials and Methods: This retrospective study was carried out using the hospital records of patient with suboccipital retrosigmoid operated in Shohada hospital between 1998-2006. The clinical information and outcome of surgery were extracted and then analyzed.Results: A total of 80 patients (42men and 38 women) with mean age 45±7 years evaluated. The most common clinical presentation was hearing loss. In 93% of patients, the tumor size was greater than 3 cm. The location of the tumor was left side in 25 patients and right side in 50 patients, whereas in 5 patients it was bilateral. All of the patients had been operated with retrosigmoid craniectomy approach and tumor was totally resected in 87% of cases. Regardless of the the tumor size, the facial nerve had anatiomically been saved in 76.2% of patients. 6 patients (7%) died and temporary morbidity occured in 34% of patients which has been recovered by medical treatment. 59 patients were had accurately followed up. After 1 year of surgery, the functional condition of facial nerve was: Excellent 73/5%, good 22/5% , fair 6%.Conclusion: We demonstrated that facial nerve was considerably preservated in patients with acoustic neurinoma after operation. In this study, tumors were mainly large. Therefore, it is better to use CT Scan and MRI in patients in order to achieve the earlier diagnosis and appropriate treatment.

Background: The objective of the current research was to determine the relationship between parenting styles and pro-social behaviours (particularly respecting to rules) among pre-school children in Tehran's pre-school centers.Materials and Methods: 394 children whom were enrolled in this study and their mother’s were randomly selected through a multi-stage cluster sampling. Pro-social behaviours of children were assessed by means of teacher's rating checklist of pro-social behaviours and parenting styles was assessed by means of parenting style questionnaire.Results: Findings showed that there is a positive and significant relationship between authorative parenting style and pro-social behaviours.Conclusion: According to the findings of this study, there is a significant relationship between parenting styles and pro-social behaviours of children, especially their respect to rules.

Background: Children are vulnerable to different sort of injuries, including poisoning which may have inevitable effects and even significant mortality among this group. The aim of this study was to determine the pattern of poisoning-related deaths in Loghman hospital in Tehran. Materials and Methods: It was an existing-data type study from March 1995 to March 2004; all intoxication fatalities of under 12 year-old subjects which had been occurred in Loghman hospital were reviewed. Demographic data were reviewed for each case via a questionnaire and reported with descriptive statistics. Results: A total of 11150 childhood severe poisonings were hospitalized during this period, of which 37 (0.33%) died. 32.4% were dead on arrival time. Male to female ratio was 1.2/1. The majority of fatalities occurred in children aged 1-4 years (59.1%). Their mean age was 4.3±3.5 years old. All poisonings happened accidentally. Thirty (81%) of exposures were via ingestion and most of them were in summer (37.8%). Most of deaths had not occurred in Tehran but in rural areas or other cities and 35% referred to hospital with more than 6 hours delay. Hydrocarbons were the most common cause of mortality (27%) followed by carbon monoxide, poisonous mushrooms and opium (10.8% for each of them), organophosphates pesticides and botulism (co-ingested with rice tablet) (8% for each), mercury vapor (5.4%) and scorpion stin and corrosive acid ingestion (2.7% for each) and 13.5% were other drugs. Conclusion: Our study points out the need to proper management of childhood dangerous poisoning like hydrocarbons, opium, organophosphates, etc. We also have to bear in mind that the prevention is an important issue.

Background: Open leg fractures are serious problems with high incidence and several complicated consequences in affected patients. There is no reliable record in this regard in Iranian medical literature. This study assesses the results of open leg fractures treated with external fixator in Imam hossein hospital in a 3 year periods; 2003-2006.Materials and Methods: At an experimental study, all the patients with open leg fracture, referred to Imam hossein hospital and treated with external fixator monolateral (AO) evaluated. All the patients were encouraged to bear weight early and dynamization was performed in relation to amount of comminution. Patients were visited every 4 to 6 weeks during the treatment. Minimal follow up was 8 months and the results of treatment were evaluated using a requirement for both secondary procedures and quality of reduction. In addition, effect of age, gender, grade, fracture type and causes of injury on this two problems were calculated with Fisher's exact and Chi-square tests.Results: 58 patients referred to Imam hossein hospital and 8 ones were excluded from study owing to different intervening causes. 10% of patients needed secondary procedures. Exact reduction was performed at 64%. Fractures with comminution, grade III Gustilo and displacement of more than 2mm had high probability of secondary procedures (P<0.02). Mean time of union was 22 weeks. Fractures with exact reduction had lesser mean time compared to others.Conclusion: External fixator is a safe implant in treatment of open leg fractures and we recommend further clinical trials with control groups.

Background: Hydatidiform mole is the commonest type of gestational trophoblastic diseases. Diagnosis of molar pregnancies is essential since molar pregnancies might be associated with maternal complication and would result in malignant trophoblastic disease. Recently, there has been a significant change in clinical presentation of hydatidiform mole due to use of ultrasound in early pregnancy before onset of systemic manifestations. The aim of this study was to assess the accuracy of systemic ultrasound in early diagnosis of molar pregnancies.Materials and Methods: This was a review of patients with molar pregnancies admitted to Mahdieh hospital from 2001 to 2006. Women with histologically-proven hydatidiform moles were evaluated by their age, gestational age, clinical manifestations and ultrasound findings. All data were analyzed with SPSS. The sensitivity and positive predictive value of ultrasound in diagnosis of hydatidiform mole was calculated.Results: The mean mother's age was 24.84±6.26 years old. The mean gestational age at the time of evacuation was 12.3±3.85 weeks. The most common symptom was vaginal bleeding (76.2%). Basically, there were 49.5% of cases whom were histologically confirmed as complete hydatidiform mole, while 50.5% had partial hydatidiform mole. 81.3% of patients had pre–evacuation sonography compatible with hydatidiform mole. The sensitivity and positive predictive value of ultrasound in detecting the histologically-proved hydatidiform moles were 90% and 100%, respectively.Conclusion: In this study, ultrasound had high accuracy in diagnosis of molar pregnancies. Therefore, sonography is highly recommended in all patients with vaginal bleeding in their first trimester.