Researcher Bulletin of Medical Sciences
Year:2003 | Volume:8 | Issue:3 (33)|Papers Count:23

Background: Lizard leishmania has different specimen with variety of characteristics. Prior investigators have revealed that some lizard leishmania specimen could immunize balb-C rats against major leishmania. The present study was conducted to isolate a protein fraction of lizard leishmania to be used as vaccine against leishmana. Materials and methods: A species of leishmana promastigote was grown up by inoculation of lizard cardiac blood on NNN medium and irrigated thrice by PBS. In order to prepare a prefect and effective vaccine, we isolated a 68 KDa protein fragment of lizard leishmania promastigote by using ammonium sulfate precipitation and gel filtration chromatography techniques.Results: A protein band of almost 68 KDa was observed on ammonium sulfate precipitation. Then, it was passed through chromatography column containing Cephadex gel of G100 .Finally, the protein was dialyzed and the antibody was prepared in rabbit.Conclusion: This protein has great antigenicity and could be used to develop a vaccine.

Background: Lower leg tissue defects are associated with a number of complications. Recently, some reports have explained the satisfactory success rate of Reversed Saphenous Neuro-cutaneous Island Flap in the aforementioned patients. Materials and methods: Five patients with lower leg or foot tissue defects have been enrolled for this clinical trial. The extension of tissue defect, type of lesion, and patients' characteristics has been recorded. We have used Reversed Saphenous Neuro-cutaneous Island Flap. We have followed patients for two years. Then, the flap survival rate, performance, changes and deformities were analyzed. Results: The study population included 4 males and 1 female with the mean age of 39.2±17.1 years. The mean flap area was 37±10.8 cm2. Flap survival and deformity correction as well as better performance was observed in all cases (P<0.05). Conclusion: Reversed Saphenous Neuro-cutaneous Island Flap is associated with a good success rate in reconstructing lower leg tissue defects.

Background: With respect to the prevalence of iron deficiency anemia in parturients receiving iron supplementation and to determine the efficacy of iron supplementation during pregnancy the present study was conducted on parturients referring to Health Care Centers in Isfahan province in 1999. Materials and Methods: For this cross sectional study, 800 parturients with gestational age of ? 17 weeks were randomly selected through females who received perinatal care. Meanwhile, 330 employees who were working in health care centers were also randomly selected. The prevalence of anemia (Hb<11 g/dl), iron deficiency (ferritin<15 µgr/l) and iron deficiency anemia (Hb<11 g/dl), ferritin<15 µgr/l) was determined in all candidates. Then, their knowledge, attitude, and performance towards the iron supplementation were determined, meanwhile, acceptance and iron tables intake was requested and the efficacy of iron supplementation program was defined. Results: Anemia, iron deficiency, and iron deficiency anemia were reported in 14.2, 50.9 and 10.4% of the candidated, respectively. Poor knowledge towards iron micronutrient and iron supplementation was revealed in 48.1 and 24%, respectively. However, 49.3% had excellent attitude and 68.2% had excellent performance towards iron supplementation. Program was accepted by 70.7%. There exist a significant association between anemia, iron deficiency, and iron deficiency anemia with performance and acceptance of the program (P<0.05). Poor knowledge of employees towards iron micronutrient was 3% and towards iron suplementation was zero. 99% of them had excellent or good attitude towards iron supplementation. Conclusion: Despite satisfactory knowledge, attitude, and performance towards iron supplementation, there exist still a large number of females with anemia, iron deficiency, and iron deficiency anemia. Since females have poor knowledge of iron micronutrient, a study dealing with the efficacy of education and nutrition counseling in association with iron supplementation is highly recommended.

Background: Chemotherapy can be associated with stomatitis. Previous therapeutic approaches have been failed to result in satisfactory outcomes. The present study was conducted in three different hospitals in Tehran to determine the efficacy of aqueous extract of Plantago major leaves in preventing chemotherapy-induced stomatitis. Materials and methods: 60 patients have been enrolled for this single blind clinical trial. A checklist was used to determine the mouth inflammation status prior to the therapy, meanwhile, demographic characteristics such as age and sex were also recorded. Patients were distributed in 3 groups of experiment (Aqueous extract of Plantago major), control (normal saline 5%), and placebo (distilled water). They used the aforementioned liquids thrice a day for 21 days following the chemotherapy. The mouth inflammation status was determined in days 7th, 14th, and 21st. Results: On the 21st day the following results have been obtained; in the experiment group 75% were normal, 20% and 5% had ulcer of first and second grade, respectively. In normal saline group 15% were normal, 10, 70, and 5% had ulcer of 1st, 2nd, and 3rd grade, respectively. These figures were 10, 15, 55, and 20% in the placebo group, respectively. There was a significant correlation between the experiment group and the other two groups in the 7th day (P=0.001), 14th day (P=0.003), and 21st day (P=0.0001) regarding the severity of stomatitis. Conclusion: Aqueous extract of plantago major leaves could be helpful in the treatment of chemotherapy-induced stomatitis.

Background: Reconstructing extensive and deep lesions of the palmar of the hand is a problem occasionally occurred for the affected patients. Nowadays, skin graft, pedicled flaps, abdominal flaps, and free flaps are therapeutic approaches usually used for these patients. However, these techniques are associated with a number of complications such as thickened or inflammation of the graft, flap adhesion to the underlying structures, and altered color or structure of the graft. The present study was carried out in Alborz and 15 Khordad hospitals to evaluate the outcomes of reconstruction of the palmar of the hand during a 7-year period, 1994-2001. Materials and Methods: It was an existing data type study. All patients who have undergone reconstruction of the palmar of the hand were followed. Initial data including sex, age, type Of lesion, and the surgical techniques were all recorded. Surgery outcomes, complication on the operated site or the flap site, presence of hair, flap thickness, its adherence to the underlying tissue or graft were all determined. Results: Ot 36 eligible reports, 16 were burned by flame, 10 with hot liquid, 6 electrical burning and the remaining 4 were burned by hot materials. We have observed any noticeable defect or complication in instep site of the flap. Meanwhile, instep flap of the foot was hairless. Its color, structure, thickness, and adherence were compatible with palmar region. Furthermore, its size was suitable. Conclusion: We have found that the free instep flap of the foot is the best to be employed for palmar lesions.

Background: Anxiety disorders are one of the most prevalent psychiatric disorders and if not managed properly, would result in many disabilities. Anxiety disorder is more common among patients afflicted by heart disease than in general population and has a negative effect on its course. This study was conducted in Labbafi-Nezhad and Loghman hospitals to determine characteristic of anxiety disorders in patients who admitted at CCU wards and comparing the effects of diazempam and oxazepam. Materials and methods: First of all, age, sex, history of CCU admission, type of cardiac disease and cardiac drugs were collected sequentially form the files of patients who were admitted at CCU wards, then, anxiety score for each patient was calculated using Hamilton scale, considering patients of score higher than 17 as having anxiety disorder were divided into three groups: two case groups & one control, randomly. Diazepam 6 mg PO daily was given to the first case group, Oxazepam 15 mg PO daily to the 2nd case group and placebo to the control group, then effect of treatment was compared in these three groups. Results: The study population included 130 males and 68 females with the mean age of 57±12.2 years. The overall prevalence of anxiety was (10.9% in patients with a diagnosis of Myocardial Infarction (MI) and 8.2% in patients with diagnosis of Unstable Angina (UA). There was no significant difference in severity of anxiety disorder between these two groups of patients. Sex and history of CCU admissin had no effect on frequency and severity of anxiety. It was understood that taking benzodiazepines in comparison with placebo decrease the anxiety severity significantly. Myocardial Infraction patients had a better response to diazepam, however UA patients responded much better to oxazepam. Conclusion: Considering the high prevalence of anxiety disorder in CCU patients, on time diagnosis and treatment would contribute to a patients rehabilitation.

Background: Lennox-Gastaut Syndrome (LGS) is one of the intractable epilepsies of childhood causing morbidity in patients who suffer this type of epilepsy. In this study the efficacy of lamotrigine (LTG) in LGS has been evaluated in children referring to Mofid hospital between 1997-98.Materials and methods: For this clinical trial, eighteen 4-12 year old children were selected. All of whom were resistant to conventional anti epileptic drugs. They have used at least five different categories of antiepileptic drugs but experienced at least one attack per day. Dose of LTG and its titration was adjusted according to the dosage of other antiepileptic drugs. Efficacy of Lamotrigine was judged upon reduction of seizure frequency after 3 months of drug consumption compared to previous 3 months. Meanwhile, drug safety was evaluated based upon effects reported by parent's, clinical findings and results of periodic laboratory test. Results: Sixty percent of the patients (9 of 15) had more than 50% reduction in seizure frequency. Rash was noted in 17% of the patients (3 of 18) which necessitated discontinuation of LTG. Besides skin eruption, no any abnormal findings were noted in clinical or laboratory parameters. Conclusion: The results of our study indicate that Lamotrigine add-on-drug therapy is both effective and safe in patients who suffered LGS.

Background: Restorative proctocolectomy and reconstruction of ileal puch and anastomosis to anus (IPAA) has become a standard surgery for patients with Ulcerative Colitis (UC) and familial adenomatous polyposis (FAP). The authors report the results of 6-year experience of this surgery at Imam hoseins Hospital with attention to complication of this surgery. Materials and methods: Chart review was performed of 22 patients undergoing IPAA from 1996 though 2001. Initial data were obtained regarding patient demographics, type and duration of diseases, indication for surgery, complication and performance capability. Results: Mean age of patients was 32 years. Histopathologic diagnosis was UC in 68% of FAP in 32%. The most common indication of surgery in UC was resistance to medical treatment an in FAP was multiple polyps. During a mean follow-up time of 2.5 years, the overall morbidity rate was 59% (13 patients). The most common complication was intestinal and then anal stricture, pouch vaginal or cutaneous fistula, and parapouch abscess. Postoperation relative complete continence was 90% and the others have leakage during asleep and in a very few patients during awakeness. However, quality of life was excellent in 82% and almost all were satisfied. Conclusion: IPPA is a safe and useful procedure although total morbidity is appreciable, in hands of experience surgeons, functional results generally are good and patient satisfaction is high.

Background: Cake as a snack has allocated the highest rate of consumption to itself. Thus, with respect to the necessity of diabetics to diabetic foods, the present research was carried out by aims of formulation and production of diabetic cake, comparing chemical and sensory specifics of diabetic cake and control cake, and also determining their glycemic index in type II diabetic patients. Materials and methods: Formulation and sensory evaluation were performed by experimental studies and the cakes' glycemic index was determined by clinical trial. The chemical tests were performed according to the Iranian standard methods and A.O.A.C, sendory evaluation was carried out with two preference test by 30 type II diabetes patients using In-house consumer panel and cakes' glycemic index was determined in seven patients with type II diabetes in comparison with bread as standard meal. The subjects ate the portions of white bread or test cake containing 50 gr carbohydrate after an overnight fast with 3 days interval and blood glucose response was calculated on fasting, 60 and 120 minutes after the start of ingestion of the test cake or white bread by glucose oxidas method. analysis was carried out by t-test and two-side binomial. Results: The result showed that there was significant difference between two kind of cake regarding ash, moisture, calorie and non-reducing sugar. Reduction in calorie intake of diabetic cake was about 22.6%. In addition, no significane difference was found in sensory evaluation between two kind of cake. Glycemic index of the dietetic cake and control cake was 77.96±22.93 and 112.63±35.19, respectively, the difference is significant. Conclusion: There is the possibility to produce dietetic cake without sucrose by suitable sugar substitutes with good sensory specific and low glycemic index.

Background: Hepatitis B is a major problem occurred in patients with thalasemia major due to repeated blood transfusion. Regarding its acute (fulminant hepatitis) and chronic (cirrhosis, hepatic neoplasm) complications, vaccination could be helpful. As time elapsed, the antibody level is diminished. The present study was conducted to define the exact time of booster vaccination to be generalized as a uniform guideline for thalasemic patients. Materials and Methods: For this historical cohort study, 50 patients with thalasemia major and 50 normal subjects who have received hepatitis B vaccine were selected. HBS-Ab was determined using ELISA technique. Then, reduced antibody level was judged with elapsed following vaccination. Results: In the normal subjects, 8 years following the vaccination, there exist a suitable level of antibody (99.5±5 U/l), however, in the case group, those who have received vaccine within the recent 7 years have still suitable level of antibody (90±5 U/l), but others (time elapsed following vaccination was greater than 7 years) lacked sufficient level of antibody (12.5±2.5 U/l) (P<0.01). Conclusion: We recommend determining the antibody level 7 years following the initial vaccination in patients with thalasemia major, so that if sufficient level is absent, booster vaccination should be applied.

Background: Antigen retrieval (AR) incorporate high temperature heating of tissue sections before immunostaining that strongly increases intensity of immunohistochemical staining.Materials and methods: We have tested the hypothesis that PH of the AR solution may influence the quality of immunostaining by using 3 different AR buffer solutions at 3 different PH values (2.7, 6.16 and 9.27). We have evaluated the staining of 9 antibodies on routinely formalin fixed embedded sections under different PH condition with microwave heating for 10 minutes. The intensity of immounostaining was graded by two pathologists.Results: Antigens have revealed different patterns of staining in different PH. Some antigens showed more or less equal intensity of immunohistochemical staining in these PH. Others showed a dramatic decrease in the intensity of AR immunohistochemical staining at PH=6.16. Still others showed their strongest intensity in PH=9.27.Conclusion: According to several studies concerning optimization of AR system and the aforementioned findings, standardization of AR system should therefore include optimization of the temperature and PH. Meanwhile, PH=9.27 seems to be suitable for most antigens to be effectively retrieved.

Background: Diabetes is now the most common cause of new patients requiring renal replacement therapy. Patient survival in diabetics on maintenance dialysis is lower than that seen in nondiabetics with end-stage renal failure due to other disease. The inadequacy of dialysis and decrease in nutritional status are important contributors to the unfavorable outcome in diabetics. This study aims at assessing the adequacy of dialysis and nutritional status in diabetic patients and comparing them with nondiabetics in an Iranian population. Materials and methods: Thirty-nine patients with diabetic nephropathy and end-stage renal disease were compared with seventy-two age and sex matched nondiabetic patient with end-stage renal disease. Patients were selected from teaching hospitals of Shaheed Beheshti University of Medical Sciences, Tehran, Iran. Clinical examinations and anthropometric measurements were done for all patient. A fasting predialyssis and 2-minute postdialysis blood samples were obtained and serum BUN, creatinine, cholesterol, triglycerides, HDL-C were measured at Research Laboratory of Endocrine Research Center. Adequacy of dialysis (KT/V) and urea reduction ratio (URR) were calculated for all patients. Results: Age (60±9 vs 56±14 years), sex, body mass index (BMI) and waist-to-hip ratio were not significantly different between diabetic and non diabetic groups. In nondiabetic patients, increased concentration of serum creatinine (5.1±0.9 vs 4.6±0.9 mg/dl, P<0.05) and decreased FBS (94±20 vs 154±40 mg/dl; P<0.05) was observed compared to diabetic group. Serum albumin, predialysis BUN, total cholesterol, triglycerid, HDL-C, Kt/v and URR did not significantly differ between the two groups. Conclusion: Results have revealed that there was not a significantly difference in Kt/v between two groups. Lower serum creatinine level in diabetic patients as compared with nondiabetics reflects lower lean body weight (LBW) in these patients and is associated with poor prognosis.

Background: Macrophages are a group of mononuclear leukocytes that differed widely in phenotype and duration of life. During phagocytosis a metabolic process is occurred in activated macrophages that could be evaluated by NBT test. We have evaluated the effects of PMA on maturation and development of monocytes and their transformation to macrophages. Materials and methods: During this experimental study, development and adhesion of monocytes and their transformation to macrophages was first assessed, then, metabolic process in activated macrophages was ealuated using NBT test. Results: Having stimulated with PMA, monocytes showed adhesion capability during the second and third hours, however, after that they revealed to be decreased in number due to apoptosis. Meanwhile, cellular viabiligy was higher in nonstimulated group with PMA since PMA showed to have an apoptotic effect. Conclusion: PMA could stimulate monocytic-macrophagic systems. Further studies on human beings are highly recommended.

Background: Reflux nephropathy is leading cause of end stage renal disease (ESRD) around the world. Vesicoureteral reflux (VUR) is present in about one percent of normal children. This comprises 30-70% children with urinary tract infection (UTI) ad up to 40-50% of their siblings. To examine whether urinary β2-microglobulin (β2MG) can be used as a screening test for VUR, it was measured in random urine samples in 47 patients with various grades of reflux and 36 non-refluxing children. Material and Methods: β2 microglobulin and creatinine were measured in 83 random urine samples obtained at the time of Voiding Cysto Ureterography (VCUG). Fifty five patients were females of whom 31 patients had VUR and of 28 males, 16 had reflux. Β2 MG was measured using radio immunoassay method and the creatinine by spectrophotometry and recorded as microgram per mg creatinine. Results: The mean β2MG/Cr was higher in the reflux-group (3.45±7.97) than non-reflux-group (0.23±0.24) (P=0.01). The mean Β2 MG/Cr was higher in patients with VUR grades 4 and 5 (8.93±12.01) than patients with VUR grades 1 to 3 (0.81±3.04) (P=0.02). Maximum β2MG/Cr was detected in patients with grade 4 VUR (33.3) and the minimum was zero in non refluxing patients. No significant difference was present in Β2MG/Cr values in patients with VUR Grade 1,2 and 3 and non refluxing patients (0.21±0.7, 1.21±0.18 and 0.23±0.24, respectively. No patient in the non-reflux-group had Β2MG/Cr higher than 0.85. There was no significant difference in Β2MG/Cr in patients with bilateral (4.94±9.91) and unilateral (1.91±5.9) reflux. Conclusion: This study revealed that the maximum Β2MG/Cr value in non-refluxing children was 0.85 microgram/mg Cr. Higher values can be considered a cut off point in screening children for VUR. The study also revealed that patient with higher graded reflux have very high Β2MG/Cr values and this can be considered and prognostic factor for progression to renal failure. The correlation between urinary β2-microglobulin and renal scars should be considered in future studies.

Background: With respect to the increased number of renal transplantation and reports of false positive increment of tumor markers in the affected patients, the present study was conducted in Namazi hospital to determine the correlation between the tumor markers and hemodialytic patients' characteristics and renal transplantation. Materials and Methods: For this descriptive study, 30 hemodialytic children and 29 patiets who have referred for renal transplantation were enrolled. None of these have a definite malignancy. The following tumor markers were evaluated: CEA, PSA, AFP, CA-125, and CA-19-9 using ELISA technique. Then, in hemodialytic patients, the tumor markers" level were compared with sex, age, etiology of renal disease, duration of renal disease, duration of hemodialysis, and blood pressure. In patients referring for renal transplantation the tumor markers" level were compared with age, type of graft, duration of renal disease, hemodialysis prior to transplantation, number of rejections, grafted kidney performance, blood pressure, and blood group. Their correlation was determined. Results: the mean age was 16.5±6.2 years. In hemodialytic patients there was a significant correlation between PSA and age, CA 19-9 and duration of renal disease, and CA-125 and adequacy of dialysis (P<0.007, P<0.032, and P<0.003, respectively). In patients referring for renal transplantation, there was a significant correlation between PSA and CA 15-3 with duration of hemodialysis prior to the transplantation (P<0.005), CA-125 with systolic blood pressure and number of rejections (P<0.009), and CA 19-9 with diastolic blood pressure (P<0.01). Conclusion: Results have revealed that there exists a correlation between the tumor markers and patients characteristics. Further analytical studies are highly recommended.