Journal of Kerman University of Medical Sciences
Year:2013 | Volume:20 | Issue:2|Papers Count:12

Background & Aims: The aim of this study was to determine the yield of screening for celiac disease in children with failure to thrive and with or without chronic diarrhea.Methods: In this prospective study, 144 children aged 1-14 years and weighed below the fifth percentile with or without chronic diarrhea were studied during six months in 2010. Sample collection was done in the private office of one of the researchers, health care clinics, schools, and subspecialty clinic of Afzalipour Hospital, Kerman/ Iran. Screening was done by measuring anti-tissue transglutaminase IgG antibody test (tTG test). All positive cases underwent upper endoscopy with pediatric Pentax video endoscope. Definitive diagnosis was made by doing small intestine biopsy and histological study.Results: Mean weight and age of children were respectively 14±4.2kg and 6±3.3 years. One third of subjects had diarrhea. Positive tTG test was observed in 11.1% of children. Celiac was confirmed in all seropositive subjects by intestinal biopsy. Therefore, the predictive value of tTG test was 100%. There was no significant relationship between the prevalence of celiac and variables of age (p=0.445), sex (p=0.859) and chronic diarrhea (p=0.137). Conclusion: Regarding the relatively high prevalence of celiac disease in growth retarded children (11.1%), and high sensitivity (100%) of tTG test found in the present study, screening of growth retarded children with or without chronic diarrhea for celiac disease seems logical.

Background & Aims: The aim of this study was to estimate the prevalence and risk factors for diabetes, pre-diabetes and metabolic syndrome in first-degree relatives (FDRs) of patients with type 2 diabetes.Methods: In a cross-sectional study between 2003 and 2005, 3228 of first-degree relativesof patients with type 2 diabetes (841 men and 2387 women) from Isfahan Endocrine and Metabolism Research Center outpatient clinics, Iran, were examined. All subjects underwent a standard 75 g 2-h oral glucose tolerance test (OGTT). Impaired glucose tolerance (IGT), impaired fasting glucose (IFG) and type 2 diabetes were diagnosed according to the criteria of the American Diabetes Association and metabolic syndrome, according to the Third Report of the National Cholesterol Education Program adult treatment panel (NCEPATP III).Results: The Prevalence of metabolic syndrome, type 2 diabetes, IGT and IFG were 35.8, 10.3, 19.5, and 17.3 percent, respectively. IGT (OR: 0.66; 95% CI: 0.51-0.87)and metabolic syndrome (OR: 0.72; 95% CI: 0.61-0.85)were more common among women, whereas IFG (OR: 1.41; 95% CI: 1.10-1.80) was higher in men. Multivariate analysis revealed that age and obesity or abdominal obesity was significantly associated with diabetes, IGT and IFG. IGT, IFG and lower HDL were associated with metabolic syndrome.Conclusions: First-degree relatives of patients with type 2 diabetes are at higher risk of IGT, type 2 diabetes and metabolic syndrome. This risk increases with age and obesity. These findings may provide evidence for necessity of screening program in identifying a special subset of the population at particular risk of developing type 2 diabetes.

Background & Aims: Clostridium difficult has been identified as a pathogen in antibiotic associated diarrhea (AAD), pseudomembranous colitis and also nosocomial diarrhea. The present study was performed to find the prevalence of toxigenic strains of C.difficile isolated from diarrhea patients hospitalized in Tehran hospitals.Method: A total of 98 fecal samples obtained during July to December 2010 were studied. Samples were rapidly cultured on the CCFA medium and incubated at the anaerobic conditions. Then ELISA was done to detect toxin A and B in the stool. Molecular identification of C.difficile was done by cdd3 universal primer and toxin a gene (tcdA), toxin B gene (tcdB) and binary toxin profiles were determined by PCR method.Results: from a total of 98 fecal samples, 15 samples (15.3%) were positive of which, 12 strains (21.2%) were A+B+, 2 strains (2%) were A+B-, and 1 strain (1%) was A-B+.Conclusion: This study showed that Clostridium difficult is an important pathogen in the development of nosocomial diarrhea. Therefore, routine detection of C.difficile in suspected cases is recommended.

Background & Aims: Post operative pain is cause of suffering in most patients and can cause a lot of problems. Analgesic effects of many narcotics have been widely studied. In this study, the effects of methadone and morphine on postoperative pain scale following thoracic surgery in opium addict patients were assessed.Methods: In this clinical trial and double blind study, sixty opium addict patients (ASA I, II), aged 20-65 yr, were randomly allocated into two groups. Thirty minutes before induction of general anesthesia the first group received 0.1 mg/kg methadone and the second group received 0.1 mg/kg morphine. The two groups were assessed and compared in regard to the intensity of pain and meperidine requirement in the first post operative 24 hr.Results: Intensity of post operative pain and meperidine requirement in the methadone group were significantly lower than those in the morphine group (P<0.01).Conclusion: Administration of 0.1mg/kg methadone as premedication for opium addict patients reduces the post operative pain more than morphine. Therefore, premedication with methadone for opium addict patients undergoing thoracic surgery is recommended.

Background & Aims: Emergence of biofilm producing Proteus strains created a serious problem in the treatment of catheter-associated urinary tract infections. The aim of this research was to study biofilm production and plasmid pattern of proteus strains associated with Urinary tract infection.Methods: A total of 88 strains of Proteus were isolated from samples collected in hospitals of Kerman/ Iran during 2011-2012. The isolates were identified by routin microbiological tests and antibiotic sensitivity tests were carried out by disk diffusion and minimum inhibitory concentration (MIC) by E-test methods. Biofilm production was studied by microtiter plate method and confirmed by Scanning electron microscope. Plasmids from biofilm producing isolates were detected by alkaline lysis technique.Results: From 88 patients infected by proteus, 58% were female and 42% were male. The most and the least frequent age ranges were respectively 20-29 years old (77.39 %) and 60-69 years old. From all isolates, 40.69% (n=59) showed the highest MIC range (16-32±0.05 mg/mL) to ceftriaxone whereas, 59% [n=41] exhibited the least MIC range to chloramphenicol (1-4±0.08 mg/mL). Biofilm production was positive for 17% (n=15) of the isolates and 6% (n=6) did not show any biofilm (P£0.05). Plasmid isolation from biofilm producing isolates revealed that stains number 87, 24 and 19 that produced strong biofilm all carried similar high molecular weight (M. Wt) plasmid. While strain 29 that showed strong biofilm did not have any plasmid.Conclusion: It can be concluded that the majority of isolates of Proteus were resistant to routine antibiotics and limited number of them could produce biofilm. Majority of the biofilm producing isolates contained a similar high M. Wt. plasmid.

Background and Aims: A transient increase of blood concentration of lipids after meal is able to increase the risk of atherogenesis. This study aimed to determine the effects ofAnethum graveolens L. (dill) consumption on atherosclerosis and hepatic risk factors.Methods: In an experimental study, 32 male New Zealand rabbits were randomly allocated to four groups to receive normal diet, a diet containing 1% cholesterol, a diet containing 1% cholesterol plus 200 mg/kg dill powder, and a diet containing 10 mg/kg lovastatin. Risk factors of atherosclerosis including glucose, total cholesterol (TC), triglyceride (TG), apolipoprotein B (ApoB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), low density lipoprotein cholesterol (LDL-C), nitrite, nitrate, fibrinogen, and factor VII were measured and compared between different groups.Results: Consumption of dill caused a significant reduction in glucose compared to the hypercholesterolemic diet group. Dill powder significantly decreased LDL-C, TC, AST, ALT, and fibrinogen. No significant differences were found between dill group and hypercholesterolemic diet group in ApoB, factor VII, nitrite, and nitrate.Conclusion: According to our findings, postprandial consumption of dill may have beneficial effects on atherosclerosis and hepatic risk factors.

Background and Aims: An accurate impression of teeth and supporting structure is necessary to restore a lost tooth structure or to replace a tooth with crown and bridge. Although there are various methods for making impression, putty-wash technique is currently preferred since it is simple and does not require a special tray. Silicone elastomeric impression materials have suitable consistency for putty-wash technique and are thus widely used. Considering the existing controversies over the effects of impression technique on the accuracy of restoration, we evaluated the effects of rewash on the accuracy of stone dies produced by a putty-wash technique.Methods: In this laboratory study, a model with two metallic dies was used. One die had a horizontal notch as an undercut. Ten impressions were made with spacer and ten impressions with rewash technique. A profile meter with accuracy of one micron was used to measure the dimensions of the produced stone models. The original and produced models were compared by t-test.Results: The mean height of dies without undercut decreased significantly in both groups (11.69 with spacer, P<0.001 and 11.44 with rewash P<0.001). The mean diameter of dies without undercut decreased in both groups (10.39 with spacer and 10.27 with rewash) but the difference was only significant using rewash technique (P=0.018). The mean distance between two dies increased in both techniques (30.25 with spacer and 30.43 with rewash). Again, the difference was only significant using rewash technique (P< 0.001). The mean diameter of dies below the undercut increased with spacer technique (10.33; P>0.05) and decreased with rewash technique (10.21; P<0.001). The mean height of dies above the undercut decreased significantly in both groups (9.99 with spacer P<0.001 and 10.21 with rewash P<0.001).Conclusion: The impression technique with spacer was more accurate in all dimensions as compared to rewash technique.

Background and Aims: Production of acoustic cavitation by sonication has been recently recommended as a targeted treatment. The experimental results from studies indicate that the activity of cavitation generated by bi- or multi-frequency ultrasound irradiation is higher than that caused by single frequency irradiation. In this study, effects dual (1 MHz and 40 kHz) and single frequency sonication on acoustic cavitation were investigated by chemical dosimeter using iodide.Methods: In this study, we investigated the exposure parameters in low level dual-frequency ultrasound in near fields of 40 kHz and 1 MHz in the progressive wave mode by chemical dosimeter using iodide. Finally, the effective protocol for enhancement of the inertial cavitation activity was determined.Results: It has been shown that the dosimeter absorbance in the continuous mode sonication is more than the pulse mode. Moreover, significant correlations were found between the time and intensity of single and dual frequency sonication and the iodide dosimeter absorbance. In constant energy, inertial cavitation activity in the pulse mode remained approximately constant. Among different combinations, the combined ultrasound sonication in continuous mode could produce a more remarkable enhancement of the inertial cavitation activity (1.78 times) than the algebraic sum.Conclusion: Simultaneous combined dual frequency sonication is more effective than single frequency sonication in producing the inertial cavitation activity.

Background & Aims: Date syrup is a natural sweetener rich in antioxidants. In addition, fructose is the predominant sugar in date syrup, which elevates blood glucose at a slower pace than the other types of sugar.The objective of this study was to evaluate the glycemic response of healthy persons to dietetic sour cherry jam prepared with date syrup.Methods: In this clinical trial, the glycemic response of 9 healthy persons was evaluated after the consumption of two kinds of jams, one prepared with date syrup and one as a control. Both jams had been produced using a specific formulation. White bread was chosen as the reference food. Having determined the glycemic index (GI) of the two jams, glycemic load (GL) was calculated and compared for the two jams by independent t-test.Results: GL was 15.4 and 18 for the dietetic and control jams respectively, both of which were within the permitted range for diabetic's consumption. No significant difference was observed between the GIs of the two jams. The results showed that, the GL of the dietetic jam was significantly lower than that of the control (p<0.05).Conclusion: The GL of the dietetic jam prepared with date syrup was less than that of the control sample. In light of the other health benefits of date syrup, once confirmed by further studies, this jam may be suitable to be introduced to the public as a dietetic product.

Urethral polyps are a rare finding in children. Urethral fibro epithelial polyps are usually discovered in the first decade of life. They present with voiding dysfunction, obstructive and irritative urinary symptoms, and hematuria. They may be associated with other congenital urinary tract anomalies. Histopathologically, they are usually benign lesions with no tendency to recurrence and are treated by surgical ablation, fulguration or laser therapy. Diagnosis is made by sonography, voiding cystourethogram and cystoscopy. In this report, a rare case of posterior urethral polyp in an eight –year old male child is presented.

Background and Aims: Chemotherapy is utilized as a part of combined-modality programs to achieve organ preservation and improve survival in patients with locally advanced head and neck cancer. Combined modality protocols can be used in three forms: a) neoadjuvant induction chemotherapy before definitive surgery or radiotherapy; b) concomitant chemo radiotherapy; and c) sequential therapy consisting of induction chemotherapy and chemo radiation. The aim of this article was to study the role of these methods in treatment of loco regionally advanced head and neck cancers.Methods: An extensive search was performed on PubMed using five key phrases of head and neck, carcinoma, neoadjuvant chemotherapy, induction chemotherapy, and adjuvant chemotherapy. The search results were limited to randomized trials and meta-analysis.Results: Despite an improvement in organ preservation, induction treatment has no impact on survival. Chemo radiation provides higher survival and increased rate of organ preservation compared to radiation alone. Ongoing phase III comparisons of sequential therapy with chemo radiotherapy may help identify the superior approach.Conclusion: Although further studies in this field are required, taxane-based sequential therapy can be currently used as a reasonable alternative to chemo radiotherapy in patients with locally advanced head and neck cancers.