Researcher Bulletin of Medical Sciences
Year:2002 | Volume:7 | Issue:3 (29)|Papers Count:30

Background: Prior investigators have demonstrated the role of oral tolerance for the treatment of some auto immune disorders. In the present study we determine the effect of oral tolerance and immune responses in immunized rats. Materials and methods: We have examined the effects of oral administration of multiple low and high doses of tyrosinase enzyme on humoral and cellular immune responses of female 6-week age C57BL/6 mice. Results: Results have revealed that multiple low and high doses of tyrosinase antigen increase humoral immune response. This response was statistically significant and was more prominent in mice fed low dose of antigen. However, oral administration of multiple low and high doses of tyrosinase enzyme caused significant reduced DTH responses. Conclusion: Oral administration of antigen is associated with reduced DTH, but increased humoral immune responses.

Background: WHO has introduced DOTS as an effective tool in the treatment of tuberculosis. We have determined this strategy in PHC centers of Varamin, from 1996 till 1998 (for a 30-month period). Materials and methods: It was a quasi-experimental nonequivalent group post-test only study. Those with chronic cough, lasted for at least 3 months, were introduced to the laboratory for direct sputum analysis for acid-fast bacilli. Having the diagnosis established, they were referred to their nearby PHC center for DOTS. Follow up examinations (sputum analysis at months 2, 3, and 5 after diagnosis) were achieved. Results: Of 3236 sputum specimens, 167 (5.2%) were positive. Among all recorded cases, 197 were newly diagnosed cases, including 83 (42%) males and 114 (58%) females. 65 were smear-negative and 84 had extrapulmonary tuberculosis. Conclusion: With respect to the expected conversion rate of 85% and remission rate of 87% in our country, combined activities against tuberculosis in urban and rural areas of Varamin revealed to be successful.

Background: Headache is the most common form of pain. Previous reports have demonstrated that chronic recurrent headache (migraine and tension headache) is more prevalent among those with sleep disorders. We studied patients referred to a private clinic and Shaheed Beheshti University hospital in 1999 to determine the association between sleep disorders and migraine and tension headache. Materials and methods: During this case-control study, we studied the occurrence of headache following sleep disorder and then recovery after sleeping. Those with migraine or tension headache comprised our case group. A relative who was matched according to the sex and age and had no previous history of headache was set as control. Then, sleep disorder, headache following sleep disorder, and recovery after sleeping were all determined. Odd's ratio was measured as the main statistics. Results: The study population included 400 individuals, 200 as the cases and 200 as control subjects. The mean age of case and control group was 28.5±7.5 and 32.9±4.7 years, respectively. Sleep disorder was reported in 17% of control subjects and 80% of the cases (p<0.001). The prevalence of sleep disorder in patients with migraine and tension headache was 18-fold higher than that in control subjects. Sleep disorder was found in 81 % of patients with migraine and 79% of those with tension headache (NS). 43 (87%) have reported post sleep migraine and 87 (78.4%) have had post-sleep tension headache (NS). Of these patients, 35 (81.4%) and 77 (88.5%) have recovered after sleeping, respectively (NS). Conclusion: Sleep disorder is associated with migraine and tension headache. Experimental studies to determine the effects of sleeping pattern on headache are highly recommended.

Background: Cough and airway hyperresponsiveness are diagnostic clues in asthma. Thus, we could employ methacoline test in whom the diagnosis of asthma remains uncertain. The present study was conducted with the aim of surveying the positive results of a methacoline inhalation challenge in patients with chronic cough referred to NRITLD in 1998 and 99. Materials and methods: 101 patients were included in this cross sectional study. Sinusitis, recent pulmonary infection, gastroesophageal reflux, and underlying pulmonary diseases were our exclusion criteria. Results of spirometery were within the normal range in all the candidates. They underwent methacoline test and airway hyperresponsiveness was determined. Then, results were compared with cigarette smoking and clinical signs and symptoms. Results: The study population included 51 males and 50 females with the mean age of 38.8±15.4 years. Methacoline test was positive in 52 (51.5%), negative in 41 (40.6%), and undetermined in 8 (7.9%). Positive test results were shown to be significantly associated with wheezing (p<0.0001). Conclusion: With respect to the poor results of methacoline test, it is not recommended as the test of choice in asthma, however, it could be used as a useful diagnostic test in whom the diagnosis of chronic cough is unknown. Further studies are strongly recommended.

Background: There are some evidences that believe arterialized capillary blood gas (CABG) can be used instead of arterial blood gas (ABG), however, few studies have evaluated ACBG in hypoxic patients. This study was conducted to compare the arterialized capillary blood gas in hypoxic patients admitted to ICD with arterial blood gas. Materials and methods: In this cross sectional study, 30 hypoxic patients were included. Two different methods of arterial (radial artery) and arterialized (forth finger of the opposite hand) blood gas were employed for each patient. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were all calculated. Results: The study population included 17(57%) males and 13 (43%) females, with the mean age of 48.3±10 years. Sensitivity and specificity of PH were 100 and 95%, respectively, however, for bicarbonate were 96% and 50%; and for PC02 were 64% and 63%, respectively. Conclusion: Results have revealed that ACBG could be a reliable test in hypoxic patients. Further studies in different situations are highly recommended.

Background: Lichen planus is a prevalent dermatologic problem made patients visits the physicians. In view of the association between lichen planus and hepatitis C, there are controversial reports in the literature, thus the present study was conducted on patients referred to Loghman Hakim Hospital to evaluate the aforementioned association. Materials and methods: It was a case-control study. 32 patients with lichen planus and 32 control subjects matched according to the sex, age, and occupation were studied. Results: Positive HCY-Ab or abnormalities in liver function tests did not detect in the patients. A control subject was PCR-documented HCY-Ab positive, in whom liver enzymes were increased, however, Fischer's exact test showed no significant statistically difference. Conclusion: Probably geographic differences as well as age and type of lesions are involved hereby. More detailed studies are needed to confirm our results.

Background: Despite international trends towards forbidding chemical weapons, during the imposed war Iraqis have used these lethal weapons several times. Chemical war gases are associated with acute and delayed complications. The present study was conducted on Iranian combatants attacked by chemical gases to determine the delayed cutaneous complications. Materials and methods: 5668 combatants were included in this descriptive study. Those who have been exposed to chemical war gases and had medical record of acute cutaneous involvement were examined. Results: The study population included 5452 males with the mean age of 37 years anq 216 females with the mean age of30.9 years. Itching was the most common symptom reported by 75.1% and 83.3% of males and females, respectively. Hair loss, burning sensation, skin dryness, and sweating were other common findings. Scaring and pigmentation changes were the most prevalent signs found in males and females, respectively (reported by 31.2% and 9.6%). However, excoriation, lichenification, colloid, skin dryness, and atrophy were other observed signs. Conclusion: Fortunately no dangerous complication was found among combatants, however, delayed cutaneous lesions and malignancies should always be considered, thus, further studies in the future are strongly recommended.

Background: Menopause and its effects on women's life are of utmost importance. In the present study we decided to evaluate the effects of estrogen on menopausal women with sleeping disorders. Materials and methods: 60 menopausal women were included in a 3-month clinical trial with concurrent controls. 30 patient cases were received conjugated estrogen 0.625mgld orally for 3 months, however, control subjects were given placebo (one tablet) per day for the same period. Before and after the treatment, both groups were asked to complete the questionnaire. Results: Treatment with estrogen reduces number of awakenings, daily drowsiness, morning tiredness, and improved repeated sleeping (p<0.05). We could not find any correlation between weight, age, time of menopause and cause of menopause with sleep disorders. Conclusion: We concluded that estrogen replacement therapy reduces sleeping problems in postmenopausal women.

Background: Recurrent sunburn, a frequent problem observed in dermatology clinics, could lead to skin aging and malignant or benign neoplasm. This may be sufficiently prohibited by sunscreens, however, these products are available with different SPFs. We have compared two different sunscreens with SPF=30 and SPF=100 in mountain climbers in Tehran in 2001. Materials and methods: 76 candidates (152 samples) were included in this clinical trial. Each side of the candidate's face was randomly selected as "experiment" or "control". Those sides as "experiment" were received 0.3ml of a-DV sunscreen with SPF=30.0n the other hand, sides as "control" were received 0.3ml of Photoderm sunscreen with SPF=100. The procedure was repeated 2.5 hours later. Having at least 5-hour mountain climbing, candidates were examined for signs of erythema, itching and burning sensation. Mc nemar and chisquare were used for data analysis. Results: The study population included 30 males and 36 females with the mean age of 21.8±3.5 years. Both sunscreens effectively protect against sunburn (88.2% for SPF=30 and 82.9% for SPF=100, p<0.0005). Erythema and itching were reported in 11.8% and 6.5% of cases in the "experiment" group, however, for the "control" group these were 17.1 % and 7.8%, respectively. Moreover, 89.4% of the "experiment" and 85.5% of "control" subjects were satisfied. These differences were not statistically significant. Conclusion: Results have showed no significant difference between the two sunscreens. It seems reasonable to use sunscreen with SPF=30 instead of those with SPF=100, to prevent undesirable side effects.

Background: 99mTC-GHA is a radiopharmaceutical agent widely used in brain and renal scintigraphy, however, in spite to glucose properties, it is also used in imaging of metabolically active lesions such as tumors, inflammatory process and infections. Materials and methods: The present study was conducted to evaluate 99mTC-GHA scintigraphy in patients with active pulmonary tuberculosis and compare this with radiologic and microbiologic findings. To meet this demand, 21 patients with active pulmonary tuberculosis proven by sputum smear and culture, were include in this study. AP chest images were obtained 20 and 60 minutes following the injection of 15 mci (555MBq) 99mTC-GHA. Visual and semiquantitative evaluation of the images performed by two observers blindly. For visual evaluation lesion activity was compared by tracer uptake of neck soft tissue and cardiac and mediastinal blood pool. For semi quantitative evaluation, regions of interest (ROIs) were drawn over the lesion(L), nonlesion(NL) and neck soft tissue(NST). The mean count values of ROIs were obtained and L/NL and L/NST were calculated. L/NL is obtained 1.29±0.15 for (+) and L/NST is obtained 1.50±0.20 for (+), therefore below of these values were considered normal uptake. Results: Increased radiotracer uptake was seen in all candidates, of whom 3 were (+), 14 were (++) and 4 were (+++). 73 lesions in CXR and 57 zones of increased uptake are seen in scintigraphy but only 38 lesions were common in both. Conclusion: Lung scintigraphy by 99mTC-GHA may have a complementary role in the diagnosis of active pulmonary tuberculosis.

Background: Odontogenic cysts have the capability of conversion to ameloblastoma, meanwhile, histologic differentiation between conventional and unicystic ameloblastoma and odontogenic cysts is difficult. Nowadays different diagnostic approaches have introduced to differentiate these lesions, of which staining with AgN03 and the number of nuclear organizers region (NOR) have shown better results. The present study was conducted on paraffin-embedded blocks to determine the number of nuclear organizers region (NOR) in selected lesions. Materials and methods: It was a cross sectional study. Of 37 paraffin-embedded blocks, 10 were conventional ameloblastoma, 7 were unicystic ameloblastoma, 10 were odontogenic cysts, and 10 were dentigerous cysts. Separate black spots were considered as a unit spot. Results: There were significant differences between the numbers of nuclear organizers region of four lesions. (p<0.001) Meanwhile, conventional ameloblastoma and odontogenic keratocysts have shown significant differences (2.45±0.32 vs. 1.68±0.47). These differences were also noted between conventional ameloblastoma and dentigerous cysts (1.49±0.51), between unicystic ameloblastoma (2.34±0.35) and odontogenic keratocysts, between unicystic ameloblastoma and dentigerous cysts (p<0.05). However, no significant difference was found between NORs of different blocks of the same tumor type. Conclusion: The number of nuclear organizers region (NOR) is a useful tool to differentiate between conventional and unicystic ameloblastoma and odontogenic keratocysts and dentigerous cysts. Few reports are available in the literature, thus, further studies especially in odontogenic cysts, are strongly recommended.

Background: Prior investigators have demonstrated that determining recirculation in aterovenous fistula is a reliable tool for evaluation of hemodialysis. Dialysis patients were reported to be 22000 cases in our country, for whom aterovenous fistula were prepared with different techniques. To our knowledge, there is not any study clarifying the quality of hemodialysis in the affected subjects. Materials and methods: A descriptive study was conducted on 97 patients in Hasheminejad Dialysis Center in Tehran, all of whom had native aterovenous fistula. Recirculation was determined by low blood flow technique. Type and site of the fistula were compared according to the recirculation rate. Results: Recirculation varied from zero to 16% with the mean of 2.5%. The highest mean of recirculation was found in end to side proximal fistulas and the lowest was reported in side to side proximal fistulas. Conclusion: Recirculation was within the normal range. It does not show correlation with site and type of fistula at flow of 300 ml/min.

Background: Control of hyperlipidemia is vital in CVD patients. Omega 3 fatty acids have desirable effects on serum triglyceride, thrombosis and arrhythmia but lead to increased level of LDL. Vitamin C can induce LDL receptor and catabolize LDL particle. The present study was conducted to determine the effects of administration of omega-3-fatty acid, vit C, and omega-3-fatty acid+vit C on LDL and other lipoproteins' profile and malonaldehyde in hyperlipidemic patients. Materials and methods: In a double-blinded, placebo controlled trial, 68 hyperlipidemic patients (TG and total cholesterol >200 mgldl) were randomly assigned to receive Vit C 500mgld, omega 3 fatty acid 191d, Vit C+omega 3 fatty acid (500mg and Ig per day), or placebo for 10 weeks. Fasting blood samples were collected at the beginning and at the end of the period, then, TG, TC, LDL, and HDL were determined enzymatically, and MDA and Vit C were measured calorimetrically. Results: The pattern of food consumption, socioeconomic and anthropoemetric status were not significantly changed during the study. There was a significant difference in the blood Vit C level at the end of the study, in comparison to the initial value in the Vit C (p<0.001) and Vit C+03Fas group(p<0.02), and also at the end of the study in Vit C+03Fas group in comparison to the control subjects (p<0.001). There was a significant difference in the serum TG at the end of study in the 03FAs group (p<0.002). In the Vit C group, a significant decrease was found in TC (p<0.004) and MDA (p<0.01), however, a well defined increase was noted in serum level of Vit C compare to the control group (p<0.01), meanwhile, significant decrease was showed in MDA compare to 03FAs group(p<0.03). At the end of the study, there was a significant decrease in TG/HDL ratio in 03F As group (p<0.04). Conclusion: Simultaneous administration of 03F As and Vit C had no beneficial effects on lipid profile of hyperlipidemic patients, however, Ig of purified 03F As daily for 10 weeks is a useful supplement for decreasing TG and TG/HDL without any increase in LDL and MDA.

Background: Staphylococcous-related urinary tract infection is a common problem. Antibiotic resistance has been reported hereby, for which incomplete recovery has occurred. The present study was conducted in 3 university hospitals in Shaheed Beheshti University of Medical Sciences to determine the type of staphylococcous ssp and their related sensitivity to antimicrobial agents. Materials and methods: 467 patients referred consecutively for UTI, were included in this descriptive study. Our inclusion criteria were: positive urine culture for staphylococcous ssp and antibiogram results. To determine drug resistance, isolated staphylococcous ssp were exposed to 17 different antibiotics by disc diffusion technique. Results: Of 467 positive urine cultures, coagulase-negative staphylococcous was found in 77% and S. aureus in 23%. Staphylococcous ssp have shown a complete resistance to penicillin and amoxicillin. Cloxacillin and vancomycin have shown the highest and the lowest sensitivity (100% and 20%, respectively). Conclusion: With respect to the varied antimicrobial resistance, antibiogram seems to be of utmost importance. Thus, misprescription would be ceased and better therapeutic outcomes will achieve.

Background: Gestational diabetes is the most common disorder during the pregnancy. It is usually asymptomatic and accompanied by maternal and fatal complications. Complications and prenatal mortality rate could be sufficiently reduced by good prenatal care and prompt diagnosis and treatment. Materials and methods: 52 patients entered this descriptive study, of whom 20 had overt diabetes and 32 had gestational diabetes. Results: Abortion and prenatal mortality were more common among patients with overt diabetes. Deliveries were achieved by cesarean section in patients with overt diabetes much more commonly, this was mainly due to macrosomia. Mean of birth weight and the first minute apgar score was more in patients of gestational diabetes. Conclusion: Cesarean section is more common in overt diabetes. Meanwhile, the mean birth weight and first minute apgar score were a little bit higher in patients of the gestational group. This is chiefly achieved through better prenatal care.

Background: There are reports about incidence of subclinical Vitamin D deficiency in Middle East countries. The aim of this study was to determine the vitamin D status in mothers and their neonates and to evaluate the impact of low maternal and neonataI25-0H-D on the infant"s calcium metabolism. Materials and methods: This descriptive longitudinal study was carried out in two phases: Phase I: Fifty mothers and their neonates were including in this study, which started in April 1988 and went through the infancy of each index case. Venous and cord blood samples were obtained from mothers and neonates, respectively, and levels of 25-0H-D vitamin D, iPTH, calcium and alkaline phophatase were determined. Phase II: Seventeen index infants with no detectable vitamin D at birth were examined and in 13 of them levels of PTH, calcium, pliosphorus, and alkaline phosphatase rechecked. Results: Phase I; mean serum level of 25-0H-D was 6.7±5.1 and 3±3.6 nglml in mothers and neonates, respectively. Sixty seven percent of the mothers had very low levels of 250HD (<6ng.ml). There was positive correlation between maternal and neonate"s serum 25-0H-D level (r=0.88, p<0.001). Phase II; mild to moderate clinical signs, indicative for vitamin D deficiency (hypotonia, convulsion, developmental delay) were noted in 17 infants. Four of the 13 serologically examined infants had biological evidence for moderate vitamin D deficiency. Conclusion: Our results indicate a high incidence of vitamin D deficiency in child bearing women affecting the vitamin D status of their newborns and infants. This implies a more rigorous enforcement of vitamin D supplementation during pregnancy, breast-feeding and infancy. Of further interest is to study the impact of climate and socio-economical conditions on the vitamin D status in respective population.