HAKIM RESEARCH JOURNAL
Year:2005 | Volume:8 | Issue:2|Papers Count:12

Introduction: Achalasia, a Neurologic disease, causes incomplete relaxation of lower esophageal sphincter (LES) and aperistalsism of esophagus. There are several methods of treatment including: medical, botolinum injection, Balloon dilatation and surgery. In adults, balloon dilation is well recognized for the first line treatment, whereas in children there are several but limited studies that elucidate its efficacy in this group too and several validate centers use it for the first line treatment, in pediatric achalasia. Yet, we aimed to evaluate the success rate of balloon dilatation for the treatment of pediatric achalasia in Iran and have a base line study in our country. Material and Method: twenty - five pediatric patients (12 boys, 13 girls) from 4.5 months to 14 yrs old with average (9.25 ±4.61 yrs) in two hospitals affiliated to Tehran Medical University, treated with balloon dilation appropriate with age (TTS or achalasia specific balloon rigiflex) under direct vision endoscopy from 1997-2003. These patients undergo follow up after one, two, and then every six month with average 36. 7 months. If any recurrence of symptoms occurred, with greater size balloon treatment were done. Improvement for children over 5 yrs old include: sum of symptom score after treatment to pre- treatment lower than 50% and the recurrence upper than 50%. For achalasia under 5 yrs old improvement include: no vomiting, improvement of relaxation of LES and normal movement of it with breathing and no esophageal inflammation on endoscopy. All patients during treatment and 6 hours later were under direct controlling for any side effects (bleeding, perforation, etc). In this study any child with previous surgery on esophagus were excluded. Results: In this study 39 dilation for 25 patients were done (1.56for every patient). About 48% (12patient) one, 48% (12 patient) two, and one patient undergo three dilation. One patient (4%) after two dilation had symptoms of achalasia and suffered from it, but because of refusal from third one, accepted as treatment failure and referred for surgery. Five pediatric patients were under 5 yrs old, that all of them (100%) improved after treatment and did not have any problem until our follow up. Over all 96% of patients respond to balloon dilation treatment that with respect to vantrappen table: 64% excellent, 8% good and 24% had moderate response. During our study there were no serious side effects. Conclusion: Balloon dilatation for treatment of pediatric achalasia is very effective and safe and can repeat for several times under direct endoscopy.    

Introduction: There are different methods for mid-trimester abortion which have some shortcomings and limitations. Considering our country's facilities in order to find an inexpensive, effective and safe method we compared two methods of using oxytocin and foley catheter with oxytocin in mid-trimester abortion in Shariati Hospital. Methods: An interventional study using historical controls was conducted on patients who were candidate for mid-trimester abortion. After informing patients and taking informed consent foley catheter was inserted in 32 cases through the cervical canal at the top of internal osevs and inflamed with 45-50 ml normal saline under sterile condition. If adequate contraction did not develop within 24 hours, high doses of oxytocin were administered intravenously. The control group included those women who had been terminated with concentrated oxytocin during 3 previous years. Maternal age, gestational age gravidity, parity, oxytocin dosage, induction to delivery interval, indication for abortion and complications were compared in both groups. Data were analyzed by using x2 or Fisher's exact test, Mann – Whitney Utest, z test and t test. Results: The mean maternal age in foley catheter group was significantly less than controls (P = 0.02). The mean gravidity, parity and gestational age were similar in two groups. Induction to delivery interval was significantly shorter in foley catheter than control groups (39hrs vs. 51 hrs, P<0.001).Median dose of oxytocin was significantly less than controls (65 units vs. 400 units, P<0.001). Complications such as fever, need for hysterotomy were not significantly different. Conclusion: We conclude that induction to delivery interval using foley catheter and high doses of oxytocin was shorter than the only oxytocin and less oxytocin was used with foley catheter.      

Introduction: Male external genitourinary anomalies are common and important. Early diagnosis and treatment of the diseases can prevent late organic and psych 0- economic complications. Methods: The simplest way of diagnosis is a thorough physical examination. In this study we examined 4260 young male students (6-12 yrs old) from 16 primary schools in Tehan. Then the parents of the children with anomaly were asked about their history of anomalies. Results: Anomalies were found in 156 (3.6%) students. The common anomalies were inguinal hernia in 80 cases (51.3%), unilateral undescended testis in 35 (22.3%). Hypospadiasis in 13 (8.3%), bilateral undescended testes in 4 (2.56%) and epispadiasis as well as chordoe in 3 (1.9%), respectively. In previous operated cases, 102 (66%) had emergent operation, 24% had been diagnosed by their physicians and 10% with their parents by chance. Conclusion: According to easy availability of this system and complications of delayed management, it is recommended that routine physical examinations must be done.      

Introduction: Male infertility constitutes the primary cause of infertility for up to 30% of couples amongst many other reasons. Genetic disorders are too important because DNA integrity in sperm is necessary for having healthy next generation. The aim of this study was to evaluate the baseline DNA damage in sperm samples obtained from normal and infertile individuals. Methods: Baseline DNA damage in spermatozoa from fertile (n=30) and infertile (n=90) individuals was compared using a modified alkaline single cell gel electrophoresis (comet assay). This technique was used to assess DNA integrity in the cells by measuring damages reflected as strand break under alkaline conditions. The cells were embedded in agarose on glass slides followed by lysis of the cell membranes after which, damaged DNA strands migrate under electrophoresis from nucleus towards the anode and deposited to one side giving the appearance of a tail. DNA damage in each group was calculated following visual observation and grading of comets under a fluorescence microscope. The significance of inter-group differences was statistically evaluated using analysis of variance (ANOVA) and Post hoc tests. Results: Results indicate that the average DNA damage in normal sample is less than any other groups. Samples from oligospermic, oligoasthenospermic and asthenospermic patients showed various degrees of DNA damage significantly different from normal (p<0.05). The highest degree of DNA damage was seen in asthenospermic samples. Conclusion: DNA damage in infertile individuals is found to be higher than normal. The reason for this observation may be due to a deficiency in antioxidants which is essential present during spermatogenesis. The presence of antioxidants prevents DNA damages in sperms due to oxidative agents.      

Introduction: Evaluating patients with allergic disease and many other conditions, may be necessary to quantitate the levels of immunoglobulins like IgE. A number of factors, including age, gender and atopic status have been reported to influence levels of serum IgE. In many instances, normal ranges are supplied by the manufacturer of equipment or the reagents used in quantitation and may not reflect the normal values of the local population. The purpose of this study was to evaluate the total serum IgE in some resident of Tehran Province. Methods: Using a commercial enzyme immunoassay (EIA-gen Biochem IgE kit) the mean serum level of IgE was determined in 267(72 males, 195 females) non allergic, non-smoker, apparently healthy and 1002 residents of Tehran province with rhinitis, contact determatitis, urticaria, eczema, parastic infections, hepatitis, mental retardation, renal disorders or smokers aged 2 to 65 years. Results: Mean serum IgE value in healthy controls and patients was 111.8(SE=14.2) and 127.9 IU/ml (SE=9.1), respectively, and there was significant differences in mean of IgE between healthy females and males (p<0.01). There was not any significances in mean of IgE between healthy and patients group. History of allergic disease and smoking didn't show any significant positive association with serum levels of IgE. No significant effect of sex was found on the IgE values at different ages. Conclusion: The values for some Tehran population were higher than those reported from Canada and Isreal, but lower than those reported from Oman.      

Introduction: Drug dependents' offspring are at a higher risk of substance dependency. The study aims at investigating some factors that protect this population from being substance dependent. Methods: Male clients of drug treatment centers whose fathers were either drug dependent or nondependent, along with their non-dependent brothers participated in the study. Checklists designed to gather information on demographic and resiliency factors were filled out for all four groups. These factors were education, friends networks, parental control, and attachment with a confiding adult. Results: In drug dependent fathers group, staying nights out of home until late without parental permission and staying nights out of home until late for more than one night with parental permission were found in drug dependents significantly more than non- dependents. Crude number of non-dependent intimate friends in workplace, the ratio of this number to the whole number of all close friends in workplace, staying nights out of home until late with and without parental permission, and staying nights out of home until late for more than one night without parental permission, were found in drug dependent persons significantly less, in first three variables and more in the last variable than drug non-dependent persons with non-dependent father, respectively.Conclusion: Parental control in both groups with drug dependent and non-dependent fathers and staying less than a night out of home with parental permission and drug- free close relations in the group who had non-dependent fathers, have a role in protecting them from drug

Recurrent appendicitis is a rare event after appendectomies, but can be occurred when there is incomplete appendectomy. In this report a 14 y/o male patient is presented with abdominal abscess and cecal mass seven and nine months after appendectomy. Review of literature showed that this uncommon clinical situation may be found after laparoscopic appendectomy, but it is very rare after open appendectomy. Awareness of the existing condition helps to make early diagnosis and prompt treatment.    

Introduction: Verotoxins are subunit toxins that involve in pathogenesis of Enterohemorrhagic Escherichia coli. Early studies of cytotoxicity on tumor cells indicate that verotoxin1 is effective in in vitro and laboratory animals. Because of specific receptors on studied tumor cells, verotoxin1 exerts selective cytotoxicity. The purpose of this study was to compare the cytotoxicity of verotoxin1 on vero and MCF-7 cell lines. Methods: Toxin production in five verotoxigenic straines was screened by verotoxin-producing Escherichia coli-reverse passive latex agglutination test (VTEC-RPLA kit, Oxoid, Co, Ltd) and after confirming verotoxin1 production from one of them, toxin purified by affinity chromatography. Then Vero and MCF-7 cells treated with serial dilutions of toxin, and viability and fragmentation of genome were studied. Results: Our results indicated that MCF-7 cells were also susceptibile. The Lethal Dose 50% (LD 50%) for the treated cells was about 50 nanograms of toxin per milliliter. Evidences of apoptosis in the cells were studied by the fragmentation of DNA. Conclusion: Our results are in accordance with previous studies about cytotoxicity of verotoxin1 against human tumor cells and specially breast cancer lines. It indicates that verotoxin1 can be used as a potential selective cytotoxic factor against wide variety of human tumors.      

Introduction: In this study, we investigated in vitro anti-tumoral effects of whole extract from bitter melon on human caucasian larynx carcinoma cell line (Hep2) and normal mouse fibroblast cell line (L929) by MTT assay. Methods: Hep2 and L929 cell lines were maintained in RPMI-1640 culture medium. Bitter melon extract was prepared by 75% ethanol. The number of 5×104 cell/ml were incubated in the presence or absence of the different concentrations (100, 50,25,2.5, 0.25, 0.025 µg/ml) of bitter melon extract into 6 well tissue culture plates. The plant extract cytotoxicity screening was performed by using 3-(4,5-dimethyl thiazol-2y1)-2,5- diphenyl tetrazolium bromide (MTT) colorimetric assay. Inhibitory concentration at 50% (IC50) was determined by plotting of the extract concentration against the optical density (OD) at 570nm from MTT assay. Results: There was a dose dependent cytotoxicity effect on Hep2 cells. At the highest concentration (100µg/ml), the plant extract completely inhibited the growth of cells and these effects gradually decreased as the dose reduced. After 48 hours incubation of the Hep2 cells at concentration of 100 µg/ml with the extract, viability of the cells were only 26% in compare to the L929 control cells. IC50 for Hep2 cell line was 27µg/ml. The plant extract showed no effect on L929 cell viability and characteristics. Conclusion: From this study it can be suggested that whole extract from bitter melon has a dose dependent cytotoxicity effect on Hep2 cell line. Therefore, this compound may be used for inhibition of the growth of cancer cells such as human larynx carcinoma.