Iranian Red Crescent Medical Journal
Year:2012 | Volume:14 | Issue:2|Papers Count:12

Background: Acute kidney injury (AKI) is a common major complication after coronary artery bypass grafting (CABG) especially when the cardiopulmonary bypass is performed. This study was conducted to evaluate the impact of the off-pump technique on the incidence of AKI, also to determine the major risk factors for AKI.Methods: In this prospective cohort study, 535 consecutive adult patients who underwent CABG between January 2007 and May 2010 in a tertiary Hospital. Some 64 of 535 patients were operated through the off-pump coronary artery bypass (OPCAB) technique and another 471 patients by the on-pump coronary artery bypass graft (CABG) technique. Stratified sampling was used to assign patients to be operated either by the OPCAB or ONCAB technique. The AKI incidence and severity were compared between the two groups.Results: In OPCAB group 9.4% (6 patients) and in ONCAB group 4.1% (19 patients) developed AKI with no significant difference. Furthermore, the AKI severity was alike in the two groups and 10.5% (2 patients) in ONCAB and 33.3% (2 patients) in OPCAB group had mild AKI, 78.9% (15 patients) in ONCAB and 50% (3 patients) in OPCAB group had moderate AKI, and 10.5% (2 patients) in ONCAB and 16.7% (1 patients) in OPCAB group had severe AKI.Conclusion: As the differences of incidence and severity of postoperative AKI between OPCAB and ONCAB groups were not significant, further studies to find other useful protective methods such as free-radical scavengers, anti-inflammatory agents, and other modalities are recommended to prevent AKI.

Background: Finding more efficient agents with fewer side effects for treatment of burns has always been a concern for researchers. Silver sulfadiazine (SSD), apparently due to its antimicrobial effect, is still one of the most common prescribed agents. Previous studies suggested that Arnebia euchroma (AE) has shown antimicrobial and anti-inflammatory activities. This study investigates the healing effect of AE extract in comparison with SSD in second degree burn wounds.Methods: Fort eight female Wistar rats (220±20 g) were divided into four groups. Standard second degree burn wounds were induced on the back of their necks. One group was treated with SSD, two groups were treated with AE cream at concentrations of 10% (AE10) and 20% (AE20) and the control group which received no treatment. The duration of treatment was 28 days.Results: This study revealed that AE and SSD noticeably improved re-epithelization, fibroblasts proliferation, and collagen bundle synthesis and had a noticeable anti-inflammatory effect compared with the control group.Conclusion: Results of the present study revealed that Arnebia euchroma herbal extract was an effective treatment for second degree burn wounds when compared with SSD.

Background: Recurrent aphthous stomatitis (RAS) appears to be the most common type of oral ulcers. The lesion is usually self limited but its painful presentation results in some difficulties. Therefore, an efficient therapeutic strategy is required and currently existing therapies seem to be inadequate because of its unclear etiology.Here the therapeutic effect of triamcinolone acetonide ointment as a relatively expensive medication has been compared with phenytoin syrup on aphthous ulcers in patients with Behcet’s syndrome.Methods: Thirty out of 60 our patients with Behcet’s syndrome were randomly treated by phenytoin syrup and the remaining were advised to use 0.1% triamcinolone acetonide ointment. After a week, they were visited again to determine the status of aphthous ulcers.Result: Positive response in the triamcinolone acetonide group and phenytoin group was 86.7% and 53.3%, respectively.Conclusion: The effectiveness of triamcinolone acetonide ointment was more than phenytoin on aphthous ulcers in patients with Behcet’s syndrome.

Background: Intellectual disability (ID) has a worldwide prevalence of 1-3% and results from extraordinary heterogeneous. To shed more light on the causes of ID in Kerman Province, in Southeast Iran, we set out in 2008 to perform systematic clinical studies and homozygosity mapping in large Iranian families with ID.Methods: Fifty seven families with a minimum of two mentally retarded children from Kerman Province were initially tested for metabolic disorders, by Tandem mass spectrometry. Fragile X testing and standard karyotyping were performed for all probands of families. Cases with autosomal recessive (AR) pattern of inheritance and microcephaly were subjected to homozygosity mapping by using several microsatellite markers for known MCPH loci.Results: Three out of seven families with X-linked pattern of inheritance were positive for fragile X syndrome. Chromosome abnormality was not observed in any of dysmorphic patients and all families were negative for metabolic tests. Among the remaining 50 families of AR ID, six were found to be microcephalic, of which 2 linked to two MCPH loci (33.3%). The rest 4 families were not linked to any of the known loci.Conclusion: The results of this study showed that ID with microcephaly comprised 12% of ID cases in Kerman Province. In two families with apparent linkage to the MCPH5 and MCPH6 locus, mutation screening was not successful, which might indicate that either the mutation is located in the regulatory sequences of the gene or that there might be another genes present in these regions, which is mutated in such cases.

Background: Continuous performing of diabetes self-care behaviors was shown to be an effective strategy to control diabetes and to prevent or reduce its- related complications. This study aimed to investigate predictors of self-care behavior based on the extended theory of reasoned action by self-efficacy (ETRA) among women with type 2 diabetes in Iran.Methods: A sample of 352 women with type 2 diabetes, referring to a Diabetes Clinic in Khoy, Iran using the nonprobability sampling was enrolled. Appropriate instruments were designed to measure the variables of interest (diabetes knowledge, personal beliefs, subjective norm, self-efficacy and behavioral intention along with self-care behaviors). Reliability and validity of the instruments using Cronbach’s alpha coefficients (the values of them were more than 0.70) and a panel of experts were tested.Results: A statistical significant correlation existed between independent constructs of proposed model and modelrelated dependent constructs, as ETRA model along with its related external factors explained 41.5% of variance of intentions and 25.3% of variance of actual behavior. Among constructs of model, self-efficacy was the strongest predictor of intentions among women with type 2 diabetes, as it lonely explained 31.3% of variance of intentions and 11.4% of variance of self-care behavior.Conclusion: The high ability of the extended theory of reasoned action with self-efficacy in forecasting and explaining diabetes mellitus self-management can be a base for educational intervention. So to improve diabetes self-management behavior and to control the disease, use of educational interventions based on proposed model is suggested.

Background: Bone healing and its reconstruction in fractures, especially in long bones are of particular importance in regenerative medicine. This study compares the bone healing rate after a human xenograft of mineralized bone and together with an allograft of bone marrow mesenchymal stem cells (MSCs) in an experimental tibial bone fracture rabbit model.Methods: In fall 2009, twenty New Zealand white rabbits were randomly divided into 2 equal groups. In both groups, a 5 mm segmental defect was created in the right tibia. In group A, a scaffold pin was seeded with allogenic rabbit MSCs and was placed in the defect area and in group B, the defect was filled with an unseeded pin human mineralized bone xenograft. An untreated defect was induced in the left tibia of all animals serving as the control. After 4-8 weeks, the segmental defects were histologically evaluated and also by a compressive test.Results: In groups A and B, healing and formation of new bony tissue were significantly more than the control group and with a significant less inflammation.Conclusion: Tissue engineering of mineralized bone xenograft and MSCs allograft may be significant steps in bone healing and regenerative medicine.

Background: The ability to respond quickly and effectively to a cardiac arrest situation rests on nurses being competent, prepared and up-to-date in the emergency life-saving procedure of cardiopulmonary resuscitation (CPR). This study aimed to determine the extent to which nurses acquire and retain CPR cognitive knowledge and psychomotor skills following CPR training courses.Methods: A quasi-experiment was used. CPR knowledge of 112 nurses was assessed via a questionnaire using valid multiple-choice questions. An observatory standard checklist was used and CPR performance on manikins was evaluated to assess psychomotor skills (before the course baseline, after the course, after 10 weeks and then 2 years after the 4 hours CPR training course). Scores were based on a scale of 1 to 20.Results: A mean baseline score of 10.67 (SD=3.06), a mean score of 17.81 (SD=1.41) after the course, 15.26 (SD=3.17) 10 weeks after and 12.86 (SD=2.25), 2 years after the 4 hours CPR training course was noticed. Acquisition of knowledge and psychomotor skills of the nurses following a four-hour training program was significant. However, significant deterioration in both CPR knowledge and psychomotor skills was observed 2 years after the training program among 42 nurses.Conclusion: The study findings present strong evidence to support the critical role of repetitive periodic CPR training courses to ensure that nurses were competent, up to date and confident responders in the event of a cardiac arrest.

be traced back to several centuries ago. A careful study of Rhazes’Treatments on Gout reveals a lot about the nature and therapy of gout.Methods: We managed to study the perceptions about pathogenesis, symptomatology, diagnosis, and treatment of gout that have changed over time. We also discussed some of the past and present fallacies regarding this disease.Results: Rhazes provided a detailed description on the vital role of genetics and the relationship between the development of gout, an indulgent way of living, and tophi at a period of time between 1st and 6th centuries AD.Conclusion: This study showed that the findings of Rhazes about treatments of gout were consonant with modern medical theories.

A case of follicular ameloblastoma of the left maxilla in a 74-year-old man is reported. The tumor was presented as a radiographically solid mass filling the left sinonasal cavity and invaded maxillary alveola. After radical surgery, the patient has pursued a non-aggressive clinical course after 4 years of follow-up. The radio-pathological features of this tumor were reviewed and the possibility of its sinonasal epithelium origin was discussed.

Dear Editor, Despite major advances in dentistry and dental prostheses, complete removable dentures are still widely used for oral rehabilitation of edentulous people. Denture surfaces prepare a favorable environment for adherence and proliferation of oral endogenous microorganisms, which is a crucial first step in the initiation of biofilm formation, caused denture stomatitis. Candida species are known as the predominant oral etiologic agent of denture stomatitis, a common mucosal inflammation usually seen on the denturebearing mucosa of denture wearers.

High quality health services need not only be universally accessible but also utilized by those for whom they are meant. Client satisfaction is an important determinant of health service utilization. According to Keegan, satisfaction comprises both cognitive and emotional facets and is related to previous experiences, expectations and social networks. Fulfilling clients’ satisfaction in rehabilitation services is important from different aspects. It is a pre-requisite for patient compliance and adherence to instructions.

Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world that is frequently diagnosed by obtaining core needle biopsies. However, distinguishing a well-differentiated HCC from benign hepatic lesions, such as fatty liver, hepatitis, cirrhosis, and adenomas, particularly in these small specimens, can be quite challenging. In this study, we used the microvessel density (MVD) index to help this differentiation.