IRANIAN SOUTH MEDICAL JOURNAL (ISMJ)
Year:2011 | Volume:14 | Issue:3|Papers Count:13

Background: It is stabilized that one of Atherosclerosis cause is an inflammatory phenomenon. E selectin and interleukin 6 (IL-6) are the sensitive markers of systemic inflammation. The aim of this study was to compare the serum level of this cytokines between acute coronary syndrome (ACS) and stable angina (SA) patients, and define relation between serum level of these cytokines and plaque complication.Methods: The patients were selected consequently and all of them were male. The mean age of patients was 56/3±9/4 years and there was no significant difference in mean age between two groups. The patients with ACS were recruited in first group. In contrast SA patients were put in the second group. Coronary angiography was done for all patients. The serum E-selectin and interleukin-6 were assessed by ELIZA methods. At the end data were analyzed by T test and ANCOVA model.Results: The mean of total cholesterol and LDL cholesterol were higher in SA patients significantly. The average of serum E-selectin in ACS was 53/4±25/7 mg/dl and in SA group was 49/4±23/7 mg/dl. The mean of IL-6 were 101/6±190/7 vs 226/9±366 in two groups consequently. There was statistically significant difference in mean of IL-6 between two group (t=2/869, p=0.005), but no in E-selectin serum level.Conclusion: Our data showed no significant difference between ACS and SA patients in E-selectin serum level, but mean of serum IL-6 was higher in SA patients. It is considered that inflammatory process has essential role in chronic atherosclerosis.

Background: In stent restenosis (ISR) following endovascular interventions is the main limitation of their long-term success. Despite advances have been made during recent years to decrease restenosis, it remains a challenging clinical problem. The aim of this study was to evaluate the relationship between angiographic coronary in stent restenosis, inflammation after successful stent implantation.Methods: This study included 78 patients, 35year old and higher who underwent coronary angiography more than 1 year after drug-eluting stent (DES) implantation because of symptoms suggestive ischemia. Patients were divided into ISR group (case) and patent stent group (control) according to angiography results. For all patients blood lipids and high sensitivity C-Reactive Protein (hsCRP) were measured simultaneously.Results: Age, sex, hypertension, current smoking, and lipid profile other than High Density Lipoprotein (HDL-C) of patients in the case and control groups were similar. However, HDL-C<40 mg/L was more prevalent with ISR (66.7% vs. 30.8%, p=0.002). The hsCRP level was 2.98±2.06 mg/L in the case group and 2.50±1.80 mg/L in the control group. There were no significant differences in mean hsCRP concentration between the two groups (p=0.14), however mean hsCRP level was significantly higher in men of case group than control group (3.35 mg/L vs. 2.21 mg/L, p<0.05).Conclusion: This study demonstrates that in men but not in women inflammation may be a predictor of in stent restenosis more than 1 year after drug eluting stent implantation. Also, high-density lipoprotein (HDL) probably has protective effect against stent restenosis.

Background: Vancomycin has been widely used in the treatment of infections caused by methicillin-resistant coagulase negative Staphylococci (MRCoNS). The emergence of vancomycin-intermediate and-resistant coagulase negative Staphylococci (VICoNS and VRCoNS, respectively) in various parts of the world, has caused great concern. In this study we investigated the prevalence of MRCoNS and Emergence of VICoNS and VRCoNS in Shahrekord Hospitals.Methods: Eighty eight coagulase negative Staphylococcus isolates were identified out of 284 Staphylococcus isolates collected from Shahrekod’s hospitals, Then, antimicrobial susceptibility pattern was determined for 12 antibiotics with Disk Diffusion method. Methicillin resistant strains were identified by several methods: Disk diffusion, E-test and Real-time PCR. Vancomycin resistant strains were also identified by several methods: Disk diffusion, Agar screening, E-test and Duplex PCR.Results: Using the disk diffusion test, 100% of isolates were resistant to penicillin while the lowest resistance (33%) was found for of loxacin. Fourty six CoNS strains were methicillin resistant and none of these isolates were vancomycin resistant and none had vanA/vanB genes demonstrated by PCR.Conclusion: This study showed a high prevalence of MRCoNS at Shahrekord hospitals, but, vancomycin resistance was not found.

Background: In healthy blood donors, 2%–5% have isolated anti-HBc. Prevalence of hepatitis B, C and co- infection (HBV+HCV) among injection drug user is high. Hepatitis C suppress of HB SAg and may be hepatitis B presented only with isolated anti HBC. This study determined of prevalence of isolated anti HBC among injection drug users and compare with blood donors in Arak city.Methods: A total 684 subjects (531 voluntary blood donors and 153 injection drug users) in Arak, Iran were included in this study. Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), anti-HBc, and hepatitis C antibody (anti-HCV) were tested in all subjects.Results: A total of 531 voluntary blood donors living in the city of Arak, in the Central Province of Iran, with a mean age of 36±10.18 years (range 16-60 years) were enrolled in the study. Ninety-three percent of patients were male and 7% were female. Of the 531 cases, 11 subjects (2.1%) had isolated anti-HBc. A total of 153 injection drug users of Arak, in the Central Province of Iran, with a mean age of 30.66±5.92 years (range 20-50 years) were enrolled in the study. All of them were male. Of the 153 cases, 12 subjects (7.84%) had isolated anti-HBc. All of 12 cases were HCV positive.Conclusion: Prevalence of isolated anti-HBc among injection drug users was 3. 73 fold in comparison with blood donors. For diagnosis of hepatitis B in this group test for anti-HBc will be done. Evaluation of occult hepatitis B in subject with isolated anti-HBc by exact method such as real time PCR is necessary.

Background: Myasthenia gravis is an auto immune disease thymus have important role in this disease which Thymoma is the primary tumor of thymus that is produced by augmentation of epithelial cells inside of Glands. Thymectomy can improved myasthenia gravis disease. The main aim of this study is to assess the remission among the myasthenic patients after thymectomy.Methods: From 1993 to 2004, 68 patients who underwent thymectomy for mysthenia gravis were studied. Myathenia was established by positive electromyography and tensilon tests. These patients were operated by one surgeon at teaching and private hospitals, the specimens were tested by pathologist and patients were under follow up for 12 to 48 months. In following-up time the patient’s answer to remedy was basis to daily use of Mestinone and myasthenia crisis was investigated.Results: The age of the patients was 14 to 60 years. The average age of the patients who was 34/08 years old. In 42 of patients was female and 26 was men. Between the men, 11 had complete remission 14 partial remission and one no answer. Between the female, 21 had complete remission. 19 partial remission and 2 no answer. This study had no inhospital mortality, but in follow up we 4/4% mortality seen. In pathology studies, 21 patients had thymoma, 45 had hyperplasia, and 2 had normal thymus. In 21 patients with thymoma, 11 had complete remission, 10 partial remissions. Between 45 patients with hyperplasia, 20 complete remission, 22 partial remission and 3 no answer. From two normal pathology reports, 1 complete and one partial remission.Conclusion: We conclude that thymectomy is a beneficial procedure for myasthenia gravis patients with a complete clinical remission rate in our series. Therefore we conclude thymectomy for myasthenia gravis patients is indicated as early as possible in the course of disease.

Background: Muscle cramps are common complains during pregnancy muscle cramps occur mostly during nights causing sleep disorder. The causes of muscle cramps are unknown. One probable cause could be the imbalance between intake and excretion of serum electrolyte such as calcium.Methods: The method used for the present study was double blind clinical trial. The study was conducted on 60 pregnant women suffering from leg muscle cramps who sought medical treatment in three selected clinics in Bushehr from April 2006 to November 2007. All subjects being third trimester of pregnancy, single pregnant, only used iron and multivitamins. Irregular use of medication, PLP (Preterm Labor Pain), disability completion forms excluded of study. Simple and accessible sampling was used in this study. Selection of study group and placebo were random. Visual analog forms were used to record the number and intensity of muscle cramps. These forms had provisions for 7 days of pretreatment and 28 days of treatments. At the end of the first week, the subjects were prescribed to take medications every night for four weeks. The subjects were asked to record the intensity of their muscle cramps on the visual analog forms during these four weeks.Results: The number and intensity of muscle cramps were considered in this study. The results of the study showed no significant change in intensity in the two groups. However, there was a significant reduction in the number of cramps in the study group after taking calcium (p=<0.02<0.05).Conclusion: Taking calcium resulted in a significant reduction in the number of cramps in this study compared to placebo group. Therefore, prescribing calcium is effective in reducing the number of cramps, when the numbers of occurrences are excessive. In cases of highly intensive and painful cramps, however, taking calcium is as effective as placebo.

Background: Brown-Vialetto-Van Laere syndrome is a neurological devastating condition classified as one of motor neuron disorders. In spite of rarity, it has a widespread distribution. It mostly presented with progressive pontobulbar palsy and bilateral deafness. Diagnosis is based on clinical and electrophysiological findings.Methods: We reviewed related articles by search in pub med, Ovid, Cochrane library and Scopus database. The used key words included motor neuron disorders, Brown-Vialetto-Van laere Syndrome, progressive pontobulbar palsy and sensorineural deafness.Results: The search culminated in 351 articles which 25 were correlated with the subject of our study. The results are presented in epidemiology, pathogenesis, clinical features, diagnosis and differential diagnosis subtitles.Conclusion: In this study Brown-Vialetto-Van Laere syndrome is explained regarding laboratory and clinical findings in previously reported cases. Similar syndromes based on discriminating features were also described.

Awake endotracheal intubation is indicated when risk of pulmonary aspiration and difficult airway management is present. In this way, patient cooperation and topical anesthesia with experience of anesthesiologist in difficult airway management is necessary. In this case report, we present a 21-year-old man with (Body Mass Index) = 51 and 140 kg of weight candidates for lumbar discectomy in prone position. After conclusion about his condition with difficult anesthesia, awaked endotracheal intubation in supine position was done and self positioned to prone for operation.

Our age is one of very rapid progress in the sciences and technologies, together with Globalization. Thus, interrelationships between science, technology and society are becoming more complex. This makes economic and social trends more difficult to predict and hence, more sophisticated approaches are needed to predict new challenges in science and technology. Technology foresight is the most attractive approach. In fact, technology foresight is a … a systematic means of assessing those scientific and technological developments which could have a strong impact on industrial competitiveness, wealth creation and quality of life. This book presents a brief review or foresighting theory and methods. The book provides a series of key methodologies along with a discussion of how technology foresight relates to sustainability.