ACTA MEDICA IRANICA
Year:2007 | Volume:45 | Issue:4|Papers Count:16

Research evaluation is a peer review action to evaluate the quality of research in faculties and research centers. Universities are institutions that are reactive to the demands of their societies needs to change and to solve community health problems by promoting high quality research. Research evaluation is a pronouncement concerning the effectiveness of a plan or treatment and is expected to provide data on the “value for money”, to supplement the concern with financial accountability. Evaluation will contribute toward improved planning, better management and greater accountability. To achieve these goals, we need to increase the efficiency of the research programs by different kinds of support plus continuous evaluations of the system. At the university, science of evaluation must be seen as a science of instrumental development and interpretation. A core definition for the evaluation of the university research proposals and reports is to interpret or judge (measuring) the quality, efficiency, relevance, viability and the effectiveness of the university researches. Besides, the evaluation itself must be improved in a way that is responsive to the needs of the universities change.

Professor Nasser Maleknia, who passed away on 15 June 2007, was one of the most distinguished professors of Tehran University. His greatest achievement was training of several generations of Iranian physicians and scientists who will always remember his unique style of teaching and his modest manner in life. Nasser Maleknia was born on 4 August 1931 in Tehran. As a teenager he was fond of mathematics and geometry. He left Iran in 1949 to study chemical engineering and principles of medicine in New York University (NYU). He then moved to France where he studied medicine in “Faculté de Médecine de Paris”.

Day surgery (also called ambulatory or outpatient surgery), the practice of performing surgery without an overnight hospital stay, is not new- indeed it can trace its origins back to the early 1900s (1, 2)- but it only really became popular from about the 1980s. North America, the United Kingdom and Northern Europe were amongst some of the earliest advocates, but the practice has since spread far wider.Experience from North America suggests that 70- 80% of all elective surgeries may be possible on a day case basis and the United Kingdom is rapidly approaching these levels.

Recent advances in DNA based technology have made available a wide range of molecular characteristics for taxonomic and systematic studies of malaria vectors. One region of the anopheline mosquito genome that has received particular attention is the ribosomal DNA. In this study, mosquitoes of the Anopheles superpictus collected from a wide geographical distribution of Iran were investigated for sequence variation within the ribosomal DNA ITS2. Two morphological forms of this species were identified based on adult female palpi and compared to genotypes identified by the rDNA ITS2 sequences. Sequence analysis of the ITS2 within and between populations identified three genotypes designated as X, Y, and Z. Genotype X occurred in north, west, south, and central regions whereas genotypes Y and Z were found sympatric in Baluchistan in southeast corner of the country. Totally 127 mutations occurred in the 518 bp region sequenced. The rate of genetic variation was 24.52% in which respectively 0.2%, 0.77% and 23.55% corresponded to 28S, 5.8S, and ITS2 regions. The length of ITS2 region was varied between populations; one group had 357 and other one 378 bp. These genotypes appeared to be evolving independently suggesting the possibility of cryptic species within taxon. This study is the first comparative study on morphological and genetic characteristics of An. superpictus and for the first time in the world reporting this taxon as a species complex.

Vitex agnus castus (chasteberry) is a popular treatment for the management of female reproductive disorders including corpus luteum insufficiency, premenstrual syndrome (PMS), menopausal symptoms, and insufficient milk production. According to developing situation of complementary medicine, and frequent use of this herb, it is important to examine its effects during pregnancy. In this research we studied its effects on mice development, and we focused on macroscopic parameters, such as CRL (Crown-Rump length) and the weight of embryos, and diameter and the weight of placenta, and microscopic parameters such as the diameters of eye and lens of embryos. We found that Vitex has special effects during different stages of mice development, for example it can improve the growth of embryos in 8th and 9th day of pregnancy (it causes significant increase in CRL and weight of embryos). Also, it may changes some microscopic parameters. These founding suggest that it should be used more cautiously during pregnancy.

The etiopathogenesis of Alzheimer’s disease (AD) is still unclear. However, long-term oxidative stress is believed to be one of the major contributing factors in progression of neuronal degeneration and decline of cognitive function in AD. In order to assess the presence of oxidative stress in AD, we examined the enzymatic activities of the erythrocyte Cu-Zn superoxide dismutase (Cu-Zn SOD), glutathione peroxidase (GSH-Px), catalase (CAT), and plasma level of total antioxidant status (TAS) in AD and control groups (age and sex-matched). The results showed that the Cu-Zn SOD activity was significantly higher and the level of GSH-Px and TAS activities were significantly lower in AD subjects than that in the control group (2111 ± 324 U/grHb, 43.7 ± 11.6 U/grHb, and 1.17 ± 0.23 mmol/l compared with 1371 ± 211 U/grHb; t= -2.17, P = 0.036, 56.3 ± 9.5 U/grHb; t=3.8, P = 0.014, and 1.54±0.2 mmol/l; t=11.18, P < 0.001, respectively). While, the erythrocyte CAT activity was lower in AD subjects compared to the control group, the difference was not statistically significant (t = 1.3, P = 0.15). These findings support the idea that the oxidative stress plays an important role in the pathogenesis underlying AD neurodegeneration. In addition, the enzymatic activity of the erythrocyte Cu-Zn SOD and GSH-Px and the plasma level of TAS can be used as a measure of the oxidative stress and a marker for pathological changes in the brain of patients with AD.

HDL can prevent LDL-c oxidation. The low HDL-c State also may benefit clinically from supplemented antioxidant. This study was designed to evaluate the combination therapy of statin and vitamin E in hypercholesterolemic patients. The patients were randomized in a clinical trial aimed to avaluate the effect of vitamin E and/or statin. The life style of patients didn’t alter during intervention. The subjects were randomized to two treatment groups A and B: (1) lovastatin 20mg daily at bedtime. (group A); (2) vitamin E 400 iu daily plus lovastatin 20mg daily (group B). The lipid values of each patients at baseline and after 8 weeks of treatment were compared by paired t test. The mean baseline lipid levels for 60 subjects were as follows: plasma cholesterol, triglyceride, LDL-c and HDL-c 285±68, 268±121, 158±32, 49±11 mg/dl respectively. Serum lipid levels changes in group A (statin only) and in group B (statin and vitamin E) were statistically significant. In comparison of lipid profiles changes between two groups we observed that HDL-c changes in group B were significantly lower than in group A. Vitamin E supplement blocks the respons of HDL-c to lovastatin therapy in hypercholestrolemic patients.

To determine the importance of Q10H2 as an antioxidant in cancer, we measured the activity of lipoamide dehydrogenase (Q10H2 recycling enzyme) in HL-60 and normal lymphocyte. The cultured cells of HL-60 and human normal lymphocytes were assayed in cell lysate of given number of both HL- 60 and normal lymphocyte. The activity of lipoamide dehydrogenase and the protein concentration were determined by spectrometric methods. The activity of LAD was found to be 0.216.mol/min/.g protein in HL-60 cells and 0.0415.mol/min/.g protein in normal lymphocytes. Although the average protein concentration ratio in HL-60 cells to normal lymphocyte was found to be %124, the average ratio of enzyme activity in HL-60 to normal lymphocyte was %526. These results are indicative of independence of enzyme increase in HL-60 cells of increase of protein synthesis.

Considering the importance of adequate analgesia for the quality of life of the patient with advanced cancer, and considering the consequences of opioids abuse, we decided to evaluate the proper and improper usage of narcotics in our cancer patients. Prescription of narcotics by the responsible physician and procurement through the legal channels was defined as “use”; otherwise it was defined as “abuse”. From a total number of 300 patients who were interviewed, 21 (7%) used narcotics prescribed by the responsible physician (use) and 30 (10%) used narcotics without the prescription or approval of the responsible physician (abuse). The male-to-female ratio, though similar in the “use” and “no narcotics” patients, was very much higher in the “abuse” group. Also income was significantly lower in the “abuse” patients. Disease extent was significantly higher in the “use” but not in the “abuse” group.In addition, the level of pain was very much higher in the “use” and “abuse” groups than the “no narcotics” patients. Both the extent of disease and level of pain were significantly higher in the “use” than the “abuse” group. In multifactorial analysis, pain had a very significant effect for “use” of narcotics and extent of disease was close to statistical significance. For “abuse” of narcotics, sex and pain had significant effects. Pain was the most significant factor leading to both use and abuse of narcotics, and a striking male predominance was seen in narcotic abusers. Nearly half of cancer patients with significant pain were not receiving opioids for adequate analgesia.

Despite the large body literature focused on the modified Ashworth Scale (MAS), validity of the scale for measuring spasticity is still questionable. The purpose of this study was to investigate the validity of the MAS by using both the conventional (Hmax/Mmax ratio) and the new indicators (Hslp/Mslp) of motoneuron excitability. Main outcome measures were the MAS and electrophysiologic assessments. The latter was performed using both conventional and new indicators of alpha motoneuron excitability. Data on 20 hemiplegic patients (17 men and three women) were analyzed. Correlation between the MAS and either soleus Hmax/Mmax or soleus Hslope/Mslope was not significant. In 10 patients whose H-reflex could be evoked bilaterally, only new spinal excitability indicator showed significant difference between the affected and non-affected sides. Based on the results of this study, there is no relationship between the MAS and the indicators of alpha motoneuron excitability. This research suggests that the MAS is not a valid measure for the assessment of spasticity in ankle plantar flexors.

Although many studies provide insight into the possible muscle strength and functional deficits in patients with osteoarthritis (OA), they had not controlled or matched the subjects for various variables The aim of study was to investigate and compare the concentric torque of Quadriceps and Hamstring muscles and Timed-Walking test in two groups. Thus, one group of healthy subjects and one group of patients with low grade of tibiofemoral OA were selected. Concentric torque of Quadriceps and Hamstring were measured in both groups. Besides, pain measurement, Timed-Walking test, range of motion and the muscle bulk of thigh were assessed in both groups. The independent t-test revealed significant differences between the two groups with regard to concentric torques and Timed-Walking test. However, no significant difference in range of motion and the muscle bulk was seen. In conclusion, patients with low grade of osteoarthritis and minimum clinical signs had weaker muscles and functional limitation in comparison with the matched healthy individuals.

Need of mother and fetus to iron gradually increases during pregnancy and reaches its highest level at the end of the pregnancy. This study was preformed to evaluate the knowledge and practice of pregnant women in Fars province about supplements containing iron intake. Data were collected by a questionnaire, including their demographic information and questions about the importance and method of consumption, unused complications and the method of iron table intake, completed by face to face interview using simple nonrandom sampling method in 2997 pregnant women of urban and rural areas. Among studied women, 44.4% of women were in the first pregnancy, 25.9% in the second, 14.2% in the third and 15.5% in fourth and later pregnancies; 75.9% of pregnant women were aware about the reason of iron supplementary use during pregnancy, 86.3% knew the method of administration and 91% used supplements containing iron after fourth month of pregnancy. The lowest rate of use was seen in Abadeh and Eghlid and the highest in Estahban; 43.3% used the tablet correctly. Further studies are needed to judge about the percentage of correct daily iron need, the percentage of correct use and digestive system complications.

Trauma continues to be the most frequent cause of death in the first four decades of life that is a main public health problem in some countries. We perform an epidemiological study of Penetrating Abdominal Trauma (PAT). We describe epidemiological of patients in PAT. In a cross-sectional study we evaluated epidemiological PAT admitted to emergency department in six general hospitals in Tehran. The data was collected through a questionnaire that was completed by trained physician trauma center. Statistical analysis was performed using the SPSS software (version 11.5 for windows).Statistical analysis using the chi-square and P<0.05 was accepted as being statistically significant.During the study period, 0.86 % (69/8000) of our patients sustained PAT. Sixty-six (95.7%) patients were male and 3(4.3%) cases were female. The peak age incidence was 15-29 years, with 43(62.3%) patients. Stab wound was the leading cause of PAT in male and female, with 62(89.9%) cases. Firearm was responsible for 7(10.1%) cases. Young males are the most common victims. This is the most productive age group and this has grave implication for the national economy.

There are several conflicting reports about the EEG of the migraineurs. In this study we report the ictal and interictal EEGs of 100 migraineurs, in comparison with control group. The range age for patient and control groups were 9-48 (mean: 26 ± 1.8) and 10-46 (mean: 23 ±v 2.1) years respectively. 32% of the patients were less than 14 years old and the remaining 68% were more than 14 years. In the patient group, 68% of cases had migraine without aura and 32% suffered from migraine with aura. Hemiplegic and basilar migraines were observed in one and two of our patients respectively.Gender and age had no effect on the type of migraine. Family history for first degree relatives was found in 64% of patients, without being influenced by gender or type of migraine. Male to female ratio was 1/1.6 (38/62). Abnormal EEG was found to be much more frequent in migraineurs than the control group (47% vs. 7%). Children had an overall somewhat more abnormal EEGs, compared with adult group (53% vs. 44% or 17/32 vs. 30/68), though slow discharges were detected more in adult group.The most common abnormality was slow high voltage waves, which was observed in 33/47 (70%) of abnormal recordings. The less common findings, in decreasing order of frequency were: focal (slow, sharps or mixed) discharges in 14/47 (29%), epileptiform (alone or associated with slow waves) in 4/47 (8.5%), diffuse beta and frontal intermittent delta, activity each being in 1/47 (2.1%) of abnormal recordings.

Surgery of ruptured anterior communicating artery aneurysms has a high incidence of complications. Successful treatment depends on understanding the anatomical location of aneurysm, early surgery, selecting the superior method of surgery and providing post-operative care. In this study 30 patients with anterior communicating artery aneurysms underwent surgery in a 3-year period. In all patients early surgery with pterioneal method was performed. We applied the basic tenets of aneurysm surgery, including vascular control, sharp dissection, meticulous preservation of perforating arteries and intraoperative monitoring of lesions oft the anterior communicating artery complex. This focus eliminates unnecessary operative manipulations and makes surgeon prepare for any crises that might arise. The majority of patients (83.3%) were in grade I or II (Hunt and Hess scale). The mortality rate was 10%. The results of this study demonstrated that early surgery and selecting the superior method of surgery improve the surgical outcome of ruptured anterior communicating artery aneurysms.

Some recent studies have revealed the relationship among excess ferritin, coronary heart disease, and insulin resistance. To assess the association between serum ferritin concentration and impaired fasting glucose, this study was designed. A total of 187 people including 91 impaired fasting glucose (IFG) subjects and 96 normal glucose subjects who had been recognized in a large epidemiological study in Zanjan in 2001 were enrolled. The cohorts were well matched for age, sex and BMI. Body mass index and blood pressure of the participants were measured and serum cholesterol, triglyceride and ferritin were evaluated. All the data were analyzed by t-test, x² test and analysis of variance. Serum ferritin was higher in the IFG cohort (85.5 ± 6.6 m/l vs. 49.4 ± 3.7 m/l, P = 0.001). A positive correlation was found between fasting plasma glucose and serum ferritin in this study (r: 0.29, P: 0.001). Using multiple regression analysis, we found an association between serum ferritin and BMI (0.06, p: 0.4), blood pressure (0.15, P = 0.01), FPG (0.29, P = 0.001), triglyceride (0.08, P = 0.01) and cholesterol (0.07, P = 0.03). The odd’s ratio for the association of IFG in male subjects with the high serum ferritin level was 8.3 (CI 95%:1.211.9, P = 0.01) and for females was 3.06 (C.I 95%: 0.58-15, P: 0.1). Our study, implying that hyperferritinemia occurs before elevation of plasma glucose concentration more than 126 mg/dl. If prospective and interventional studies Confirm an etiologic role of iron overload in the pathogenesis of insulin resistance and type 2 diabetes, reduced dietary iron intake, especially in men with additional risk factors for type 2 diabetes, would appear to be a logical consequence.