Journal of Kermanshah University of Medical Sciences
Year:2019 | Volume:23 | Issue:4|Papers Count:7

Introduction: Multiple sclerosis (MS) is an autoimmune of CNS that could be present with other autoimmune disorders. On the other hand, biologic drugs make this association even more complicated because these drugs, themselves, can cause autoimmune disease. Like other diseases, there are reports of other autoimmune diseases developed by these drugs in patients with MS. Case Presentation: The patient was a 55-year-old woman with right-sided hemiparesthesia appearing about 4 years ago that resolved spontaneously. Two years later, she developed paresis of the right hand. With a diagnosis of MS, the patient received steroid pulse therapy with methylprednisolone 1 gr for 5 days followed by weekly intramuscular interferon β 1-α . About 1. 5 years after interferon therapy, the patient developed pain in the limbs, especially in hands. On examination, the wrist and metacarpophalangeal joints were tender and swollen. preclinical evaluation revealed elevated erythrocyte sedimentation rate (ESR), a very high level of anti-cyclic citrullinated peptide (anti-CCP), and a high level of RF. Rheumatoid arthritis (RA) was diagnosed for the patient. Conclusions: MS, like any other autoimmune disease, can be associated with other autoimmune diseases. On the other hand, biologic drugs used to control MS can potentially cause autoimmune diseases.

Objectives: Resistance exercise is an effective method for weight control programs, and it might be useful to understand its influence on acute body energy hemostasis changes. Therefore, the present study aimed to examine the response of nesfatin-1 and insulin resistance (IR) to acute circuit resistance exercise and their changes during recovery periods. Methods: Twelve participants (age: 22. 1 ± 2. 1 y, height: 176. 2 ± 6. 5 cm and weight: 69. 0 ± 8. 2 kg) attended voluntary in this research. After performing one maximal repetition (1-RM) test in a separate session for each participant, they completed circuit resistance exercise trial at 50% of 1-RM intensity. Exercise session consisted of 3 circuit of 7 exercises with 2 minutes and 30 seconds rest between circuits and exercises, respectively. All participants attended a control session with 1 week interval. After 8-10 hours fasting blood samples were obtained from antecubital vein before exercise, after exercise, 1-hour and 24-hour after recovery from the last exercise session, and at the same times of the rest session. Nesfatin-1, insulin and glucose were measured from plasma samples. All data series were analyzed with repeated measure ANOVA (2 × 4). Results: Data analysis revealed significant increases in nesfatin-1 and IR in response to acute circuit resistance exercise (P < 0. 05), but no significant changes were observed in nesfatin-1 and IR at 1-hour recovery period and 24-hour after recovery (P > 0. 05). Conclusions: The present study revealed that nesfatin-1 significantly increased in response to circuit resistance exercise, which suggests that plasma nesfatin-1 may have an influential role in short-term anorexia and insulin secretion immediately after exercise.

Background: Umbilical vein cutdown in neonates as an important method of accessing vascular is very important in cases in which peripheral vein is not available and it is not possible to cut down another vein. The umbilical vein is believed to become thrombotic and lumen is closed and unusable one week postpartum. Methods: In this cross-sectional study, all neonates who were admitted to the surgical ward of Mohammad Kermanshahi Hospital in Kermanshah, who needed emergency vein access and who were unable to have vein cutdown elsewhere during 2012-2014 were enrolled. The participants were divided to four age groups (one week to four weeks) and the possibility of umbilical vein cutdown was assessed in each group. Results: Of all participants, 25 infants were girls and 20 were boys. The umbilical vein cutdown was successful in 39 patients (86. 7%), and failed in 6 patients (13. 3%). The procedure was successful in all infants younger than 3 weeks old except for one case, while the success rate rapidly decreased after 3 weeks old. Conclusions: Umbilical vein cutdown was successful in infants under three weeks old and it was not possible afterward due to umbilical vein thrombosis. One-week age restriction for umbilical vein cutdown is questionable and requires further randomized trials with a control group to reach definitive conclusions.

Restless Legs Syndrome (RLS) is a type of sensory-motor disorder characterized by pain, discomfort, numbness and tingling. This study was conducted to compare the prevalence of RLS in Multiple Sclerosis (MS) patients and healthy controls. Eighty-four patients with MS were selected as the case group and 84 healthy volunteers with no underlying diseases as the controls. The data collection tools included a demographic questionnaire, a scale about the disease details and a diagnostic questionnaire for RLS. A total of 45. 8% of the MS patients and 22. 9% of the healthy subjects had restless legs syndrome and a significant difference was observed between the two groups in this regard. In the study of RLS among MS patients, age correlated significantly with the incidence of this syndrome, and although the difference in the duration of disease was not significant, the mean duration of MS was higher in the patients with RLS. Among the MS patients with RLS, 26. 31% had a family history of RLS. Also, the MS patients suffered from RLS approximately three times more than the healthy group.

Background: Vitamin D has an essential role in bone growth and metabolism. Currently, its role has been investigated in different diseases. It is high prevalence of vitamin D deficiency in the world, particularly in developing countries. Objectives: The aim of this study is to investigate the prevalence of vitamin D deficiency in children of 1-6 years old and its relation with their age, sex and body mass index. Methods: This study was conducted in pediatric clinic of Javaheri Hospital in Tehran, from 2016 to 2017. The study population was children of 1-6 years old presenting to the pediatric clinic for routine examination or treatment. The collected data included age, gender, height, weight, and serum 25-hydroxy vitamin D level. Results: Of the total population of 288 children, 47. 2% were female and 52. 8% were male. The prevalence of vitamin D deficiency was 51%, while 4. 51% had severe deficiency (level of vitamin D < 10 ng/mL). The relation between the level of vitamin D and variables of gender, height, weight, and body mass index was not statistically significant. Nonetheless, the level of vitamin D had a statistically significant relation with age such that, serum level of 25(OH) vitamin D reduced by 3. 47 ng/mL for every one year of age (P < 0. 001). Conclusions: The prevalence of vitamin D deficiency is increasing with increasing age. Therefore, adoption of preventive and therapeutic measures is necessary to reduce its prevalence and side effects.

Background: Preoperative anxiety can reduce the quality of anesthesia and increase the need for anesthetic medications, which can inadvertently increase the length of anesthesia and delay awakening, which results in more complications of anesthesia and surgery. Objectives: The purpose of this study is to investigate the eff ect of binaural beat music (BBM) on anxiety, pain and satisfaction of patients with eye surgery. Methods: This clinical trial enrolled sixty patients presenting to the surgical unit of Imam Khomeini Hospital in Kermanshah who were randomly assigned to two groups of binaural beat music group (n = 30) and control group (n = 30). Midazolam and propofol (if needed) were used in the conventional opioid group, while binaural beat music was played from 5 minutes before to the end of the surgery in addition to fentanyl (1 cc). Scores of state and trait anxiety (measured by STAI), pain score (measured by VAS), hemodynamic changes before and after surgery, patient satisfaction and surgeon satisfaction were recorded and compared between the two groups. Results: State anxiety after surgery was signifi cantly lower in the BBM group than that in the control group (P < 0. 05). There was no signifi cant diff erence between the two groups regarding trait anxiety symptoms and postoperative pain (P > 0. 05). The level of state anxiety, trait anxiety and pain decreased signifi cantly in the BBM group after surgery (P < 0. 05). Furthermore, state anxiety and trait anxiety decreased signifi cantly in the control group after surgery (P < 0. 05). However, no signifi cant diff erence was observed between the amount of pain before and after surgery in the control group (P > 0. 05). Diastolic blood pressure was signifi cantly lower in the BBM group after surgery than that in the control group (P < 0. 05). There was no signifi cant diff erence between systolic blood pressure, heart rate, SPO2 after surgery in the two groups (P > 0. 05). There was no signifi cant diff erence between patient satisfaction and surgeon satisfaction in the two groups (P > 0. 05). Conclusions: Binaural beat music is eff ective in reducing anxiety and pain, controlling hemodynamic changes, and increasing the satisfaction of patients undergoing eye surgery, and can be a suitable alternative for opioid and sedative medications in anesthetized patients undergoing eye surgery.

Background: Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) are major global public health problems. Infection with such viruses is commonly associated with liver cirrhosis and hepatocellular carcinoma. Objectives: The aim of this study was to determine the prevalence rate of HBV and HCV in women in Zakho City, Kurdistan Region of Iraq. Methods: A cross sectional study was performed in Zakho City, Iraq between January 2019 and October 2019. A total of 2223 females aged between 18 to 52 years old were included in this study. ELISA test was used to determine HBsAg, HBc IgG, and HCV antibodies positivity. HCV positive samples were then confi rmed by Xpert HCV quantifi cation assay. Results: Among the studied subjects, 12/2223 (0. 54%) samples were positive for HBs Ag. All these 12 patients showed also positivity for HBc IgG. Only 1/2223 (0. 045%) sample was positive for HCV antibodies. The result of HCV-RT-PCR confi rmed the positivity for this patient. Conclusions: The low prevalence rate of HBV and HCV infection among women in Zakho City was less than that reported in other studies. Population-based study is needed to estimate the prevalence of infection.