Researcher Bulletin of Medical Sciences
Year:2004 | Volume:9 | Issue:4 (40)|Papers Count:13

Background: Coronary artery disease is the most common cause of death worldwide and angioplasty is one of the most effective modality of treatment. Ticlopidine and clopidogrel, as antiplatelet drugs, have been used to prevent the development of recurrent stenosis in these patients. The aim of this study was comparison of drugs efficacy and side effects in coronary stent patients. Materials and methods: In this sequential randomized double blind clinical trial, the effectiveness and cardiac & non-cardiac side effects of two antiplatelet drugs (clopidogrel & ticlopidine) were compared. All patients regardless age or number of diseased coronary arteries who underwent sent angioplasty between Feb. 2000 – Feb. 2002 in Shaheed Modarres hospital were randomly divided between two groups. Patients in case group received ticlopidine + ASA and controls received clopiogrel + ASA for a month. During the period of 3 months follow up, all patients were evaluated for GI, skin, cardiovascular and hematological complications by means of direct examination, periodic CBC(every 2 weeks) and exercise test (after 8 months). Results: Follow up of 196 patients was completed. Regarding cardiac events (ie: MI, Unstable angina, Abrupt closure and death) no significant difference was noted between two groups. Although leukopenia, thrombocytopenia, bleeding, GI & skin cruptions were more frequent in ticlopidine group but these differences were not statistiacally significant. Number of restenosis cases (following angiography) was equal between two groups which was comparable with other studies. Conclusion: On the basis of results, there wasn't any superiorty of clopidogrel to ticlopidine. Of course the study should continue to cover adequate sample size for final analysis.

Background: Cisplatin is one of the most widely used drugs in cancer chemotherapy. This drug has shown a great therapeutic advantage on the treatment of advanced ovarian carcinoma, bladder, head and neck, lung and some childhood neoplasms. Cell culture is one of the most suitable methods for the assesment of chemical’s effects on cell proliferation and growth, specially the cancer ones. This study was performed to investigate the effects of cisplatin on cancer cells growth. Materials and methods: Chinese hamster ovarian carcinoma cell line (CHO) has been grown in DMEM/F12 media supplied with 10% FCS and in the humified 5% CO2, 37°C incubator. Growth curve of these cells has been drawn in control and cells exposed to the highest dose-response followed concentration for one hour. Cisplatin cytotoxicity has been calculated using clonogenic assay. Prism© V.4 software has been used for statistical calculation and to draw related graphs on computer.Results: CHO growth curve followed the general pattern of logarithmic and plateaue phases. Doubling time of control cells was calculated equal to be 18.26±2.6 hour. Cisplatin cytotoxicity on this cell line followed the dose-response pattern up to 1 mg/ml. Cisplatin exposed concentration didn’t increase CHO cytotoxicity after then. Cisplatin exposure to CHO cells decreased the plating efficacy of these cells for 37% (p<0.05). Conclusion: Cisplatin affects CHO growth parameters at all different phases of plating efficacy, logarithmic and plateau. The most critical effect is however on the plating efficacy, which is consequently affecting other phases. This is what has been shown for the first time in this study. Such an observation might suggest cisplatin usage as an anti-implating agent for cancer cells, which may result in the inhibition of secondary tumour progression of patients. Other novel discovery of this study shows that although cisplatin cytotoxicity is following a direct dose-response pattern within the clinical concentrations of this drug, but has a limited range for such a direct relationship. Cisplatin does not have a significant cytotoxic effect in doses higher than 1 mg/ml in CHO cells. A similar comparative study in other cell lines and more deep investigation on possible mechanisms for these observations is suggested.

Background: Urinary tract infection (UTI) is a common problem in infants& children. Infection can spread to the kidneys and causes pyelonphritis which is associated with long term consequences. In the absence of specific symptoms and simple laboratory findings, DMSA renal scintigraphy is the reference method to determine renal damage. According to the previous studies, blood procalcitonin (PCT); a new indicator of bacterial infections may be an accurate marker for diagnosis of acute pyelonephritis. The object of this prospective study was to compare the accuracy of PCT with the other routine diagnosistic tests in an attempt to identify upper s UTI. Materials and methods: This clinical trial study was performed on 50 children with UTI , suspected to acute polynephrities admitted in Mofid children hospital, Tehran . Serum PCT levels (BRAHMS PCT), CPR, ESR, WBS and PMN were determined in all children. At days 3-5 DMSA-Scan was performed and the diagnosis was based on the DMSA scan results. Serum PCT levels equal 0.5 ng/ml was considered as normal and higher level as acute pyelonphritis. Results: 50 Children inluded 43 girl (86%) with mean ages 24.9 month and 7 boys (14%) with mean ages 22.4 month were studied. The mean PCT level was 1.63 ng/ml. In 10 children, the PCT level was less than 0.5 ng/ml. Some evidences on acute polynephritis were found in 47 children by DMSA scan. Sensitivity and positive indicative value of PCT were calculated 83% and 97.5%, respectively. Conclusion: There was a significant correlation between plasma levels of PCT and the existance of acute polynephritis. But, more invesigaions with large sample sizes are suggested to clarify this subject.

Background: Intracranial aneurysms are potentially fatal but curable neurologic disorders that usually present with catastrophic clinical picture due to subarachnoid hemorrhage. Successful diagnosis and treatment of this disorder has become possible owing to numerous developments in practice of neurosurgery during the last century including development of microsurgical techniques, progress in neuroanesthesiology and improvement in pre and post operative managements and special cares. Materials and methods: Clinical course and outcome of surgical treatment of intracranial aneurysms have been reviewed in 85 cases between 1991-2001.The survey includes demographic data as well as signs and symptoms, location of the aneurysms, surgical approaches and postoperative complications. Results: Ninety aneurysms in 85 patients have been reviewed with male to female ratio as 3.1.The mean age of the patients was 46.2±15.4 y. Twenty seven of the aneurysms were located in anterior communicating artery territory, 22 in posterior communicating artery, 20 in middle cerebral artery and 18 in other branches. Fifty five percent of our patients were in Hunt & Hess grade 1, 38% in grade 2, 9% in grade 3 and grade 4 &5 1% each. Early surgery was performed on 8 patients and late surgery on 59 cases.18 patients were operated during vasospasm phase. Neurological complications occurred in 52% and medical problems in 28%. Postoperative mortality reached 18% in our cases. Conclusion: Surgical outcome was clearly worse in patients operated during vasospasm period but no significant difference was observed between early and late surgery.

Background: Breast irradiation after MRM is an integral component in patients with high loco regional recurrence of breast cancer. Because an optimal fractionation schedule (radiation dose given in a specified number of fractions or treatment sessions over a defined time) for breast irradiation has not been uniformly accepted, we examined whether a 21-day fractionation schedule was as effective as the more traditional 35-day schedule in reducing recurrence. Materials and methods: 100 women with invasive carcinoma of the breast treated by MRM that referred to Imam Hossein and Madaen hospitals for irradiation were studied. 50 patients (case group) received short course radiotherapy (40 Gy in 15 fractions over 21 days) and the control group received traditional radiotherapy (50 Gy in 25 fractions over 35 days). Patients in both groups were matched by age, stage of cancer, laterality, chemotherapy and hormone therapy items. Results: Mean age (±S.E.) in the case group (49.9±10.99) and the control group (49.12±9.74) were similar approximately. Three patients experienced local breast cancer recurrence as a first event during 5 years: 1 in the short treatment arm and 2 in the long treatment arm. Local recurrence-free survival was approximately similar in both groups. During 5 years, local recurrence-free survival was 98% in short arm and 96% in long arm. In this study, no difference were detected for disease-free survival (P<0.84) or overall survival (P<0.76). Conclusion: Results from this study support the use of a modest increased in daily fraction size for breast irradiation when the total dose and overall treatment time is reduced. This study demonstrates that a shorter fractionation schedule of 40 Gy in 15 fractions over 21 days is as effective as the more traditional schedule of 50 Gy in 25 fractions over 35 days in terms of preventing recurrence of cancer in the breast.

Background: Breast cancer is the most common malignancy and the second cause of cancer –based death due to cancer in women. 99m Tc- Methoxyisobutylisonitrile (99m Tc-MIBI) is a radiopharmaceutical which has been used initially in myocardial perfusion studies, however, since nearly one decade its role in detection of some maligncies such as breast cancer has been proven. This investigation was carried out to assess the diagnostic value of 99m Tc-MIBI scintimammography in detection of breast cancer and advantage of prone lateral view compared to common anterior views in women with breast mass in the nuclear medicine department of Taleghani hospital. Materials and methods: In a descriptive study, 15 women with breast mass Results: Sensitivity, specificity and accuracy values of 99m Tc-MIBI scintimammography for breast carcinoma in supine anteror view were 75%, 100% and 81% respectively. With changing the patient's position to prone and taking the lateral views from breasts, these values arised to 91%, 100% and 93% respectively. Conclusion: It seems 99m Tc-MIBI scintimammography is a valuable diagnostic modality for detection of breast cancer particularly in breasts with architectural distorition due to previous biopsy or surgical manipulation, however, sensitivity and accurcay of the test can be raised to higher values by using the prone lateral view.

Background: Role of serum AFP as a tumor marker and prognostic factors in gastric adenocarcinoma is doubtful. This study was performed to determine the relationship between clinicopathological features of patients with non metastaic gastric cancer and serum AFP in Imam Hossein hospital and Khatam–al–anbia hospital during period of 1381-1383. Materials and methods: In this cross-sectional study, all of the patients with non metastatic gastric adenocarcinoma cancer were studied and their clinicopathological feature of disease (liver metastasis, peritoneal seeding pathologic stage, respectability) and serum AFP were determined. Values more than 20IU/ml were considered as high serum AFP (or abnormal) and clinicpathologic features of disease evaluated statistically. Results: From 96 patients with gastric cancer (non metastatic) only 9 patient had abnormal AFP. There was a significant relationship between respectability and peritoneal seeding with elevation of AFP (p<0.05), but not between AFP elevation with patient’s background. Conclusion: According to this study, AFP is an important factor to diagnosis the non-metastatic gastric adenocarcinoma, Since this test is feasible and low price ,it is suggested to be done in these patients. Because, respectability and peritoneal seeding are unrespectable in patients with abnormal AFP, we recommend to do laparascopy before surgery to prevent unnecessary surgery and propose connection between AFP value, peritoneal seeding and respectability in analytical research.

Background: One of the most important and urgent problems during prenancy is preeclampsie which can lead to eclampsia. In this condition, early diagnosis and treatment of the disease is so critical for prevention of the fatal consequences. The first stage of this study was conducted to determine the prevalence of preeclampsia and eclampsia as well as their related factors with respect to controversial reports regarding the topic. Materials and methods: Subject population randomly selected consisted of 4856 women in their 20th or more week of gestation referring to university hospitals in Tehran in 2001. Diagnostic criteria for preeclampsia included blood pressure (BP) of 140/90 mmHg, 30 mmHg and 15 mmHg rise in systolic and diastolic BPs, respectively as well as generalized edema specially in hands and face and proteinuria above 300 mg/dl or more in 24 hour urine collection or above 100 mg/dl in two urine specimens over 6 hours. The women who had convulsions associated with the above mentioned signs were diagnosed as eclamptic. Accordingly, the prevalence was then calculated (CI, %95). In the second stage, a case – control design was applied to determine the role of related factors in the incidence of preeclampsia and eclampsia. Women with preeclampsia or eclampsia were considered as case group. Control group were unaffected women referring to the same hospitals whose matched by age, educational level, occupation, living place (city or country), and smoking with case group. Economic status, familial relationship with spouse, blood group, history of hypertension as well as preeclampsia or eclampsia in close family members, first pregnancy, history of preeclampia and eclampsia and also BMI factors, quality of prenatal care, severe pica, intervals of gestation, contraceptive technique, and Rh were statistically correlated with the prevalence of the two conditions. Results: 143 women (%3) had preeclampsia and 8 women (%0.16) had eclampsia. The case group (151 affected women) and 378 unaffected women (the control group) were compared. The mean age (±s.e.) of case (151 women) and control (378 women) groups were 26±6.3 and 25.95 ± 5.6, respectively. There was no difference in the educational level, occupation, living place, and smoking between groups. %25.8 of the case group and %3.7 of the control group had the history of preeclampsia (P<0.0001). There was also a significant difference between blood group B in case group (%16.6) and in control group (%2.1) (P<0.0001), low economic status in case (63.6) and control (%51.8) groups (P<0.01), history of hypertension in case (%16.6) and control (%2.1) groups (P<0.0001), familial relationship with spouse in case (%37.1) and control (%27) groups (P<0.02), familial history of preeclampsia and eclampsia in case (%15.4) and control (%6.8) groups (P<0.003), and first pregnancy in case (%36.5) and control (%45) groups (P<0.08). There was no significant difference in other factors. Conclusion: According to the results, it can be concluded that these conditions are not the matter of concern in Tehran city. Further experimental studies concerning monitoring pregnant women with the history of preeclampsia and eclampsia, blood group B, the history of hypertension, low economic status, and familial relationship with spouse in connection with the prevalence of both conditions are warranted.

Background: There is no consensus about the effect of low glycemic index (LGI) foods in a mixed meal on glycemic response in type 2 diabetic patients. In this study therefore, we examined the effect of half replacement of bread in usual breakfast with apple or lentil on glycemic response in patients with type 2 diabetes. Materials and methods: In a randomized cross-over clinical trial 18 diabetic patients who had fasting blood glucose between 126 to 180 mg/dl were studied. Patients received the modificated breakfast on 3 occasions with one-week interval. On the first day of the study, subjects ate their regular breakfast in usual amounts. Type and amount of the ingredients were recorded then. After one-week wash out period they were randomly divided into two groups, one had a breakfast in which half of bread replaced with apple and the other group received a breakfast in which half of bread was replaced with lentil. After one-week wash out period the diet switched between the 2 groups. Venous blood samples were collected before (after 12 hours fasting) and 60, 120, and 180 minutes after the breakfasts. Plasma glucose measured using enzymatic method (glucose oxidase) and incremental area under the 3 hours glycemic response curve were calculated. The data were statistically analyzed by paired t-test. P<0.05 was considered as significant.Results: Sixteen patients (13 female and 3 male) aged 49.8±6.2 years (42 to 63 years) with diabetes duration of 5.6±5.1 years participated in this study. Regular breakfast items included tea, bread, cheese, tomato and cucumber. There were no significant differences between the compositions of regular breakfast with the two modificated breakfasts except for dietary fiber, which was significantly higher in two modificated breakfasts compared to regular breakfast. There was no significant difference in incremental area under the curve or peak plasma level between the breakfasts containing apple and lentil (4814.9±3041.9 mg/dl/min and 4352±2231.9 mg/dl/min respectively). The incremental area under glycemic response curve with regular breakfast (8469.9± 4174.5 mg/dl/min) showed significant reduction compared to the breakfasts containing apple or lentil (apple, p<0.02 and lentil, p<0.005). Peak glucose level was also significantly lower with the breakfasts containing apple or lentil (apple p<0.01 and lentil p<0.002). Conclusion: It seems that half replacement of bread with the same unit of apple and lentil in regular breakfast has similar effects on blood glucose. Thus these replacements can be recommended to improve blood glucose response in type 2 diabetics.

Background: Entering the university is a new stage in everybody’s life and causes new adaptability, accommodation and method of operation in presence of recent conditions.Regarding above-mentioned points, the kind of family function and proficiency is the most important factor for everyone to succeed in the new situation and leads to form the human being self-concept. This study was performed to determine the relationship between self-concept and family assessment in students of faculty of rehabilitation in Shaheed Beheshti University. Materials and methods: 103 students were asked to fill out the family assessment device (FADI), Beck self-concept test and demographic questionnaire in this descriptive study. Cronbach alfa and Pearson’s coefficients were calculated to assign the test validity and analyze the data respectively.Results: There is a significant correlation between self-concept and family function. (r=0.21). On the other hand, the correlation between self-concept and problem solving subscale is also significant. (r=0.1).Conclusion: The findings indicate a significant relationship between family economical conditions and problem Solving and role-playing subscales.