Researcher Bulletin of Medical Sciences
Year:2007 | Volume:11 | Issue:5 (53)|Papers Count:14

Background: Lithium and ECT combination therapy is a challenge in psychiatric disorder management. Some experts believe that it causes cognitive impairment. The literature on this topic is controversial.Materials and Methods: Psychiatric in-patients who were candidates for ECT by their physicians enrolled in the study based on lithium (case) or no lithium (control) co-therapy. MMSE was compared after 1st, 3rd and 6th ECT sessions in two groups.Results: 154 patients, 75 patients in case and 79 patients in control groups, who were matched on sex, age, anesthetic medications and psychiatric disorders, were compared. Cases group patients had significantly better cognitive status (p<0.02) especially in earlier sessions.Conclusions: This study showed that litium-ECT combination therapy has not got cognitive side effects more than ECT monotherapy but it is necessary to replicate the study to generalize the results to other patients.

Background: Meningioma accounts for the second most common intracranial tumor. Middle aged women constitute most of the patients. According to the high prevalence of the tumor and numerous sites of intracranial involvement, the results of surgical treatment of 185 patients were studied from 1979 till 2005.Materials and Methods: Surgical results of 185 patients among 405 serial cases with intracranial meningioma are presented. Signs and symptoms, imaging characteristics, predisposing factors, extent of resection, surgical approaches and complications are reviewed as well as clinical outcome and recurrence rates. The extent of resection is evaluated with postoperative contrast enhanced CT or MRI.Results: This study was based on the clinical data of 185 surgically treated patients among 405 serial cases visited in the senior author's clinic. 59.5 percent of the patients were female and 40.5 percent were male. The median age of the patients was 49.9 (range between 20 and 81). In 85.4 percent of the patients, total tumor resection was performed. The patients were followed between 1-180 mo (mean=32.1 mo). In 69.2 percent of the patients no surgical complications occurred. The recurrence rate was 14.6 percent and mortality occurred in 3.8 percent of the patients.Conclusions: With the use of modern micro-neurosurgical techniques, the surgical results of our patients are comparable with the reported results in developed countries. It seems that radiotherapy plays a significant role in the treatment of cases with recurrence or partial resection.

Background: Rotaviruses are major causes of acute gastroenteritis in infants under 5 years old. In this study, the prevalence of electrophoretypes and subgroups I and II among rotaviruses isolated from children less than 5 years old with acute diarrhea were investigated.Materials and Methods: The study was carried out with 372 fecal samples of children with acute diarrhea, admitted in the biggest pediatric hospital of Tehran, Iran, during February 2003 and January 2004.Resnlts: Sixty seven out of 372 samples (18.01%) were positive by Polyacrylamide gel electrophoresis (PAGE) with 89.5 percent (60/67) long RNA pattern with 6 different patterns and 10.5 percent (7/67) short RNA pattern with 3 different patterns. Of 67 rotavirus-positive samples tested for VP6 subgroup in epitope, subgroup II was predominant (95.5%) with only a few subgroup I strains (7.5%).Conclusions: The prevalence of long pattern and subgroup II are predominant rotaviruses among Iranian children in Tehran that is similar to those reported from other countries.

Background: Chronic treatment with neuroleptics leads to the development of abnormal orofacial movements described as vacuous chewing movements (VCMs) in rats. Vacous chewing movements in rodents are widely accepted as one of the animal models of tardive dyskinesia. Oxidative stress and the products of lipid peroxidation are implicated in the pathophysiology of various neurological disorders including tardive dyskinesia. On the other hand, numerous studies have shown that Ginkgo Biloba has antioxidant and neuroprotective properties. The purpose of this study was to evaluate the preventive role of Ginkgo Biloba extract on haloperidol induced orofacial dyskinesia in a rat model of tardive dyskinesia.Materials and Methods: In the present study, sixty four adult male sprauge-dawley rats (250-300 g), in eight groups, were used. Chronic haloperidol (1.5 mg/kg i.p for 21 days) treatment was done for induction of vacuous chewing movements in rats. Ginkgo Biloba with 25, 50 and 100 mg/kg were administered orally. Behavioral assessments were done by observation and counting of VCMs.Results: Chronic haloperidol treatment significantly induced vacuous chewing movements in rats (mean difference=-8.67 S.E=2.45 P=0.012). One-way ANOWA of data revealed a significant difference between treatment groups (F=5.80 df=4 p=0.002). Co-administration of Ginkgo Biloba 25mg/kg reduced these haloperidol induced movements significantly (mean difference=-8.02 S.E=2.36 P=0.016), but higher doses of Ginkgo Biloba failed to diminish VCMs.Conclusions: The findings of the study revealed that effect of Ginkgo Biloba co-administration on attenuation of haloperidol induced orofacial movements eliminates with higher doses. Further study on the doses lower than 25mg/kg is suggested for determining a biphasic doseresponse relationship. Ginkgo Biloba could prove to be a useful agent in neuroleptic-induced orofacial dyskinesia.

Background: Among adults, 1 in 3 experiences neck pain throughout life. This study was designed and executed to assess the compatibility of MRI and electrodiagnosis with each other and both, with physical exam in cervical radiculopathies to assess the most involved muscle in each radiculopathy.Materials and Methods: In a descriptive analytical study, 40 patients were selected among the patients referring to the rehabilitation clinic at Shohadaye Tajrish Hospital. The patients were evaluated first by specialized physical examinations, and then MRI and electrodiagnostic studies were performed. Cramer coefficient and chi square tests were used for more assessments. SPSS version 11 was used for data analysis and p value less than 0.05 was considered significant.Results: Correlation of electrodiagnosis and physical exam as well as MRI and physical exam were 75 and 52 percents, respectively. In C5 radiculopathy, deltoid, biceps and brachioradialis muscles were the most common sites. In C6 radiculopathy, pronator teres, brachioradicalis and extensor carpi radialis were the most common sites. In C7 radiculopathy, triceps, extensor digitorum communis and flexor carpi radialis were the most common sites. The results suggested significant correlations between clinical findings, MRI and electrodiagnostic studies.Conclusions: This study suggests that electrodiagnostic studies are much compatible regarding determination of the involved root. Both modalities have acceptable correlation with each other and with clinical findings and pronator key is a golden key muscle in assessing C6 root lesion.

Background: The relationship between nutrition and coronary heart disease (CHD) has been established and healthy diet reduces mortality after myocardial infarction. Due to the effect of family on the nutrition status in members, family participation seems to be a necessity to improve diet habits. This study aimed to determine the effect of family-centered intervention on dietary patterns in post myocardial infarction.Materials and Methods: In a clinical trial 60 patients with myocardial infarction ranged from 31 to 65 ages, selected by a convenient sampling method and 30 patients assigned to each group randomly. Pre-and post-test dietary patterns obtained by questioner through interview. In the case group, intervention program started in hospital with participation patient and one of family members and continued post discharge at home. Follow-up of subjects in this group accomplished each two weeks over long 6 weeks. Intervention program included diet recommendations and family-patient interactions.Results: Results indicated that mean score improvement of dietary patterns in the case group regarding "to be abstain of fatty foods" (p<0.002) "eating white meat" (p<0.003),"eating food in small quantity" (p<0.032), "eating of fruit and vegetable" (p<0.007) based on an independent t test was significantly was higher compared with the controls. However, mean score improvement in "consuming of edible liquid oil" in the case group was not higher significantly.Conclusions: This study showed that family-centered approach is considerably effective in preventive dietary patterns in cardiovascular patients. Therefore, regarding to some cultural views about family interactions in Iran, we suggest that interventions related to dietary changes interventions need to be established with the participation of patients family.

Background: Simultaneous knee ligament injury with ipsilateral diaphyseal leg fracture happens not infrequently. Such injury could be missed on original evaluation of the broken limb. We report the prevalence of such occurrence in isolated ipsilateral diaphyseal leg fractures.Material and Methods: Eighty-two cases of diaphyseal leg fractures were enrolled in this study during a 18-month period. All these cases had a thorough examination of knee ligaments in the operating room following internal fixation of their fractures.Results: Of 82 cases 87.8 percent were male. Their average age was 27.2 years and 65.8 percent were involved in motorcycle accident. Sixteen cases (19.5%) with ligamentous injury were observed which included 8 patients (9.7%) with medial collateral injury (MCL), 6 (7.3%) anterior cruciate ligament (ACL) tear, 2 (2.4%) lateral collateral ligament (LCL) injury and 2 (2.4%) posterior cruciate ligament (PCL) tear and in two cases simultaneous injury of MCL and ACL occurred.Conclusions: Ipsilateral diaphyseal leg fractures, even in isolation, are associated with high risk of ipsilateral knee ligament injuries. This is an important fact to remember when dealing with such fractures.

Background: Hip fracture including intertrochanteric and femoral neck fractures are common in elderly people and have great effects on health care system and society in general. Mortality rate following these fractures is significant and has reported to be as high as 37 percent within one year. Factors such as age, cardiopulmonary disease malignancy, dementia and malnutrition can aggravate it. The aim of this study was survival analysis in elderly (³60 year) patients with hip fracture admitted to Taleghani hospital during years 2003-2005.Materials and Methods: The study was based on an observation-analytical with non-prorable sampling. Survival state of the patients along with other related information was gathered from patient records or by phone calls. Then survival times and survival curves were achieved and analyzed by Kaplan Meier survival analysis.Results: Of 96 patients, 23 (24%) deaths occurred within 1 month and 48 (50%) cases within one year. In correlation analysis there was statistically significant relationship (p<0.05) between survival time and age. In Kaplan-Meier analysis, mean survival time was 558 days with SE of 55 and confidence interval of 450 to 667 days. Survivalrate was decreased with non-operative treatment, Concomitant systemic disease, age over 80 years and spinal anesthesia.Conclusion: Mortality rate after hip fracture is high and is increased by age, non- operative treatment and systemic disease. Further researches in multiple centers are necessary to confirm the results.

Background: Regarding to different prevalence and incidence of glial tumors in different societies, histopathologic and clinical varieties and role of appropriate diagnostic and therapeutic measures in outcome we performed this investigation for determination of glial cell origin brain tumors at Loghman hospital during years 1982-2004.Materials and Methods: This study was based on the existing data within patients' files. All patients that underwent craniotomy due to brain mass and with definite glioma pathologic diagnosis included in this study. Demographic characteristics, family history, clinical manifestation, diagnostic evaluations, tumor site, pathologic grading and follow-up data were extracted from patients' files, then classified and reported.Results: In this study 910 cases with definite brain glioma who underwent brain CT or MRI were assessed. There were 97 males (64.6%) and 53 females (35.4%) with glioma grade I: Grade II cases were consisted of 172 males (57.3%) and 128 females (42.7%) as well as 115 males (64%) and 121 females (36%) for grade III and 98 males (79%) and 26 females (21%) for grade IV (GBM) There were 120 cases of cerebellar astrocytomas (73 males and 47 females) Average age of patients with glioma grades II&III were 33.7±17.7; cerebellar astrocytoma 10.2±6.2 and GBM 47±15.6 the most common site of glioma grade I was cerebellum (62.6%) and then cerebral hemispheres (37.4%); grade II cerebral hemispheres (78.6%), brain stem (12.6%) and cerebellum (8.8%) and low grade glioma (grades I,II)in frontal lobe. The most common site of GBM was parietal lobe. Twelve percent of patients were hospitalized due to recurrence of tumor that in half of them cerebellar astrocytoma was the primary tumor. Symptoms of patients with cerebellar astrocytoma were headache (80.8%), nausea & vomiting (79%); with low grade glioma headache (73.8%) and seizure (59%) and with GBM extremities paresis (81.4%) and headache (79%).Conclusion: Demographic characteristics and hemispheric involvement of brain gliomas in this study are not concordant with the results published in the reference texts.

Background: Cervical cancer is one of the most ideal cancers for screening. Screening has caused dramatic reduction in cervical cancer mortality. In this study we compared liquid-based (LB) cytology with conventional Pap smear (CS) regarding to identification power and conflicting factors in the diagnosis of cervical displasis.Materials and Methods: In this cross-sectional study we evaluated 1500women referred to the gynecology clinic at Ghaem hospital or some private offices in Mashhad. Two smear samples, one in LB method and the other in CS method were taken from each woman. The woman with class 3 or more in each smear report underwent cervical biopsy. Biopsy pathologic reports were considered as gold standard and other smear reports were compared to them. The amount of inflammation and endocervical cells in samples compared in two methods.Results: Although because of insufficient number of samples, the results were not meaningful, the result showed that LB has more sensitivity and its false negative value is lower than CS. In addition, we can say definitely that the amount of inflammation and endocervical cells in the samples is lower in LB than CS.Conclusion: Diagnosing cervical cancer by LB method is practical in lran and the results are Concordant with other countries. It is more sensitive than CS and the inflammation and number of endocervical cells are less than CS.

Background: Improper prescription of vancomycin is one of the -reasons for emerging resistance of enterococci to this antibiotic. Therefore, such resistance can be reduced if other effective antibiotics such as gentamicin in combination with ampicillin are used against the susceptible strains. The purpose of this study was to evaluate the possible synergistic effect of these antibiotics against isolates of Enterococcus Faecalis that show low level of resistance to gentamicin (MIC<16 mg/ml).Material and Methods: 97 isolates of E. Faecalis (MIC<500) were selected. The synergy test was performed between ampicillin at 1/4 % and 1/2 MIC for each strain and gentamicin at 2 and 4 mg/ml.Results: Synergyreslilts showed that gentamicin 4mg/ml was more effective than 2 mg/ml. The most effective concentration of apicillin in synergy experiment was 1/2, of MIC for every strain. The strongest synergy activity was detected among the antibiotic treated cells after a6- hour treatment. Conclusions: The growths of more than 70% of low level gentaniicin resistant (MIC<16 mg/ml) isolates E. Faecalis were inhibited in combined antibiotics consisting of 4 mg/ml, of gentamicin with 1/2 MIC of -ampicillin of each strain. Based on the results it appears that low level gentamicin resistant isolates -are susceptible to, combination therapy with gentamiein and ampicillin, thus they may be a good altemative regimen for vancomyc in and gentamicin.