KOWSAR MEDICAL JOURNAL
Year:2010 | Volume:15 | Issue:3|Papers Count:11

Aims: Sulfur mustard, has been employed as a chemical weapon in imposed war against Iranian troops. At the present time there are more than 40000 people suffering from pulmonary lesions especially chronic obstructive pulmonary disease due to mustard gas in Iran. Sulfur mustard increases the endogenous production of reactive oxygen species. The toxicity of oxidative stress reduces by antioxidants and there is adequate evidence that antioxidants play a role in cellular protection against oxidative stress. This study was undertaken to investigate the expression of Glutathione S-transferase, an important free radical detoxification molecule which is found in human airways.Materials & Methods: In this experimental study in year 1388, 4 normal and 8 sulfur mustard induced chronic obstructive pulmonary disease patients’ bronchial biopsy were taken. The samples were fixed in praformaldehyde and cut in 20 micrometer slices by cryostat and then GSTp1 expression was compared using immunohistochemistry methods.Results: All Sulfur mustard exposed samples were immune-negative for Glutathione S-transferase antibodies compared to control samples which expressed high amounts of it.Conclusion: Results revealed that antioxidant expression is dramatically down-regulated in these patients. This antioxidant may play an important role in cellular protection against oxidative stress and its down-regulation due to mustard gas toxicity may be the cause of exacerbation and persistence of airway disease in these patients.

Aims: Measuring superoxide dismutase activity is of importance in common diseases like cardiovascular disease, cancer and autoimmune disorders. Nowadays measuring enzyme activity is performed with expensive imported kits in different fields of science. The aim of this study was to design a quantitative method for chemiluminometeric measurement of superoxide dismutase activity with improved sensitivity, accuracy and speed.Materials & Methods: In this method luminol substrate and iodophenol were used as reaction accelerators in luminometry measuring reaction in order to determine the superoxide dismutase activity in serum samples and to increase measurement sensitivity. Sensitivity, precision tests, intra and inter-assay test, accuracy tests, recovery and parallelism tests, method comparison and methods’ correlation and coherence investigation were also performed. In order to increase reading speed and precision, measurement was performed in microplate and reading was done in luminometry plate.Results: Standard operating range was 3 to 300 U/ml. Sensitivity of the method was 0.1U/ml. Intra and interassay coefficient of variation was less than 6.6 and 7.3% respectively. In recovery and Parallelism tests, the recovery percent range was 92 to 110. Comparison of common colorimetric method and the designed method indicated a Pearson's correlation coefficient of 0.917.Conclusion: This method can measure superoxide dismutase activity in serum samples with acceptable precision and accuracy and probably can be a good alternative for conventional colorimetric methods.

Aims: The pain caused by peripheral nerve neuropathy is one of the most frequent complaints of diabetic patients. Nowadays, researchers are looking for new extracts of therapeutic herbs as a cure for diabetic hyperalgesia due to lack of proper and safe medications. Cyanidin is a potent antioxidant and anti-inflammatory agent, which reduces oxidative stress and also plays an anti-diabetic role in type II of diabetes mellitus. This study was designed to investigate the antinociceptive effect of cyanidin in diabetic rats. Materials & Methods: 48 rats were used in this case-control study. Rats were divided into control, cyaniding treated control, diabetic, sodium salicylate treated diabetic, and cyanidin treated diabetic groups. Intra peritoneal cyanidin injection was performed one week after diabetes induction for two months. Pain threshold and nociception were evaluated using hot water tail immersion and formalin tests respectively. Data was analyzed by SigmaStat 3.5.Results: Cyanidin treated diabetic rats had lower nociceptive scores at chronic phase of formalin test. Cyanidin treatment didn’t cause a significant change in tail immersion latency in diabetic rats.Conclusion: Although chronic treatment with cyanidin does not affect pain threshold but significantly reduces nociception in an experimental model of diabetes mellitus and this may be considered as an auxiliary treatment for diabetic hyperalgesia.

Aims: It has been estimated that gastroenteritis is caused by bacteria in 30-70% of cases. Enterotoxigenic Escherichia coli or ETEC is one of the most common agents causing diarrhea. Protective immunity may be induced against this disease. Designing and producing a vaccine against this disease is one of the purposes of World Health Organization. Vaccine candidate molecules have to induce protective immunity against a broad spectrum of ETEC bacteria. Most ETEC strains can produce labile toxin; therefore labile toxin may be a proper candidate for being used as a vaccine molecule. The aim of this study was to optimize Heat-labile Toxin B Subunit expression in order to investigate its immunological properties.Materials & Methods: Optimizing of 3 parameters (IPTG concentration, time and temperature of promoter induction) was performed. Recombinant protein was purified with Ni-NTA column. Purified Heat-labile Toxin B Subunit was injected to mice subcutaneously in 4 sessions. Blood samples were taken during the interval between the injections and after last injection. Then, ELISA was performed.Results: The optimum expression occurred at 1mM IPTG concentration, after 3 hours and at 37oC. Recombinant protein was highly purified (>95%) with Ni-NTA column. Also, ELISA showed high titer of antibody production in mice.Conclusion: Expressed Heat-labile Toxin B Subunit is an immunogenic protein and can be one of the important components in vaccine development against ETEC.

Aims: Pseudomonas aeruginosa Exotoxin A is an important virulence factor of this bacterium. Exotoxin A is made of three domains: binding domain, translocation domain and catalytic domain. Exotoxin A inhibits protein synthesis by ADP-ribosylating EF-2 factor in eukaryote cells. Translocation domain has an important function in translocation of toxin into the cell. Purpose of this study was to product recombinant domain of translocation for antibody production against it.Materials & Methods: Pseudomonas aeruginosa samples were isolated from burnt inpatients of Moosavi Hospital in Zanjan and were identified by biochemistry tests. Bacteria genomic DNA was extracted and Exotoxin A presence was approved by PCR. Translocation domain of Exotoxin A was reproduced by PCR and PCR products were cloned in a pET28a plasmid. Clones were sequenced, screened and enzyme-digested by PCR. Recombinant protein was approved by SDS-PAGE and western blotting with its specific antibody.Results: PCR and enzyme digestion results approved the cloning of translocation domain of Exotoxin A and results of Exotoxin A translocation domain sequencing was the same as the Gene Bank database. Expression of recombinant translocation domain protein was determined in IPTG 1mM concentration incubated at 37oC for 12 hours.Conclusion: Expression of recombinant protein is higher than Pseudomonas aeruginosa. The whole toxin is not necessary for vaccine production and this recombinant protein can be used instead.

Aims: This study was designed to determine the effect of implementation of Orem self care program on headache indices of migraine headache.Materials & Methods: In this randomized controlled clinical trial, 83 patients with migraine who were referred to the neurology clinic of one of Tehran’s hospitals in year 2009 Patients were divided into two groups by random allocation: 43 of patients in experimental group and 40 patients in control group. Data collection tools were demographic questionnaire, indices of migraine headache questionnaire and Orem cognition form, self care checklist and form of headache diary. Self care programs were held as four 30-45 minutes training sessions based on their self care needs for experimental group. Headache indices including migraine attack frequency, intensity and duration of attacks were evaluated by indices of migraine headache questionnaire before and after three months of self care program. Finally, headache indices were compared in two groups. Data were analyzed by SPSS 15.Results: Average frequency, intensity and duration of headache attacks of experimental group showed a significant decrease after intervention, compared to the control group (p<0.05).Conclusion: Performing Orem self care program reduces migraine headache indices in patients suffering from migraine.

Aims: Focused Assessment with Sonography for Trauma (FAST) is used as a screening tool to detect hemoperitoneum in patients with blunt abdominal injuries in many trauma centers all over the world. However, Iranian trauma centers are unaccustomed to performing it as a routine. The aim of this study was to evaluate the sensitivity and specificity of FAST performed by surgeons and to announce its advantages to Iranian surgeons Materials & Methods: Data were collected prospectively in one hundred blunt abdominal trauma patients admitted to Baqyiatallah Hospital from April 2008- April 2009. FAST was used by surgeons or senior surgical residents to detect intra peritoneal fluid and considered positive if such fluid was identified. Data were analyzed using SPSS14.Results: 5 of the 100 patients had proven intra abdominal injuries and 95 had no injuries. FAST result was positive in 7 patients and negative in 93 patients. There were 2 false positive results. The sensitivity and specificity of FAST were 100% and 97.8%, respectively. The positive predictive value was 71.4%, the negative predictive value was 100% and the accuracy was 98%.Conclusion: Focused Assessment with Sonography for Trauma which is performed by general surgeons, can detect the presence or absence of intra peritoneal fluid rapidly and accurately. FAST is a potentially valuable tool for better management of trauma patients.

Aims: Annually, one million people worldwide undergo coronary revascularization with use of cardio-pulmonary bypass. The metabolically active medullary thick ascending loop of Henley is particularly vulnerable to hypoxia. Change in renal bio-markers is delayed and therefore checking them is not a proper way for early assessment of acute kidney injury. In this study, measurement of Urine Oxygen Pressure (PUO2) is examined for assessment of early renal function in patients undergoing open heart surgery.Materials & Methods: This cohort study was performed on 101 patients referred to one of Tehran’s hospitals for open heart surgery. Fresh urine sample from Foley catheter (for measuring PUO2) and Arterial blood sample (for measuring Pao2) was taken before cardio-pulmonary bypass and every 30 minutes after cardio-pulmonary bypass. 24 hour creatinine clearance, 24 hour urine volume, Cr and BUN levels were documented after operation. Data was recorded in separate charts and was analyzed by SPSS 11.Results: Relationship between PUO2 and decrement of creatinine clearance demonstrates significant statistic difference. Relationship between Urine Flow rate and decrement of creatinine clearance demonstrates no meaningful statistic difference.Conclusion: PUO2 measurement can be applied for real time assessment of early renal function in patients undergoing open heart surgery.

Aims: Inappropriate use of antibiotics causes serious problems such as microorganism resistance and may lead to several side effects and even death. Drug Utilization Review studies are suitable means of drug use evaluation and revealing immethodical drug utilization trends and proposing proper solutions. This study was designed to evaluate the utilization trend of Ceftriaxone in Iran.Materials & Methods: This descriptive cross-sectional study was performed on 300 inpatients of internal and surgical wards in an educational hospital in Tehran for two six month periods in years 2008 and 2009. A protocol containing prescribing and consumption rules for ceftriaxone was prepared based on ministry of health protocol and reference books. Essential data were collected through a questionnaire designed by authors. Data was analyzed by SPSS 16.Results: Of 300 patients who entered the study, 266 cases had received the drug as surgical antibiotic prophylaxis that 32% were according to protocol and 68% were not completely according to the protocol. In 34% cases who received ceftriaxone for infection treatment, 17.4% were according to the protocol and 85.3% were not.Conclusion: There is a remarkable incoherence between current ceftriaxone use trend and the designed protocol in this study; therefore more attention should be paid to available guidelines. Establishing better surveillance methods and medical staff training programs is suggested.

Aims: Over exercise is the most frequent cause of chronic shoulder pain and rotator cuff muscles chronic tendonitis is the most frequent problem among professional athletes. The purpose of this study was to review the effect of a period of compound treatment (physiotherapy, massage therapy, PNF stretching exercises) on rotator cuff muscles chronic tendonitis in Professional athletes.Materials & Methods: 30 sportsmen who visited physiotherapy and sport centers of Arak city in year 2008 were selected during 11 months. They were divided into two groups of physiotherapy (Control group) and compound treatment (Experimental group). MRI was used for diagnosis. Universal goniometry and Athletic Shoulder outcome Rating Scale questionnaire were used for plan investigation. Data was analyzed with SPSS 11.5. Results: Compound treatment had a significant effect on pain reduction and increase of range of motion in professional athletes (p<0.023). In tests which were performed after program, there was a significant difference in rate of external rotation in experimental group and control group (p<0.05). Pain reduction was significant after compound treatment (p<0.043).Conclusion: Compound treatment (physiotherapy, massage therapy and PNF exercises) has more influence on rotator cuff muscles chronic tendonitis compared to single physiotherapy method. Increase in range of external rotation of shoulder demonstrates the significant effect of compound treatment on rotator cuff muscles chronic tendonitis.