Journal of Kerman University of Medical Sciences
Year:2008 | Volume:15 | Issue:3|Papers Count:13

Introduction: Cytokines production as one of the inflammatory pathways in CNS is responsible for most brain damages following ischemia. On the other hand, during inflammation and brain ischemia, most of the renin- angiotensin components (RAS) increase locally. While it is established that blockade of RAS especially AT1 receptors has a protective effect on ischemia, the interaction of cytokines and angiotensin II is not well understood. This study was designed to investigate the effect of angiotensin II inhibitor oncytokine production as well-as brain edema. Method: Fifty-four male mice were randomly divided into 5 groups of normal, Sham operated, ischemia, Pretreatment with enalapril' (high dose), and Pretreatment with enalapril (low dose) for the measurement of IL-1b and TNF-a in the brain and blood serum by ELIZA method.Results: Ischemia caused a significant increase in water content and neutological deficit scores as well as cytokine levels. Treatment with enalapril had paradoxical effect on ischemia. In high dose, 85% of the animals showed convulsion after reperfusion. The IL-1b in serum and neurological deficit scores of this group were high, in accordance with clinical signs. In contrast, the low dose of enalapril, had protective effect on ischemia. It caused a significant reduction in brain concentration of both IL-Ib and TNF-a (P<0.05) and improved significantly the neurological deficit scores and brain water content as well. (P<0.05).Conclusion: Enalapril as an ACE inhibitor, has a dual effect on stroke. At low dose, it has a protective role at least in part by suppressing the local production of pro-inflammatory cytokines while, at high dose, it increases the inflammation by an unknown mechanism.

Introduction: Motor skills and learning after stroke are of a great importance. This study aimed at studying implicit learning in unilateral stroke patients using affected hand and comparison with normal subjects.Methods: A serial reaction time task by using software was applied for studying implicit motor learning in 15 stroke patients and 15 matched normal subjects. In this task 4 squares with different colors appeared on the monitor and subjects were asked to press its defined key immediately after observing it. In the first day subjects practiced 8 motor blocks (4 patterned blocks, then 2 random blocks and finally 2 patterned blocks).The next day subjects practiced a retention test consisted of 2 patterned blocks. Subjects were not provided with any explanation about the sequence of squares. All subjects were right handed and impaired hand in patients was right side and they practiced with their impaired hand.Results: Task performance of patients was slower than normal subjects. Age, sex and educational level had no significant effects on task performance. Block time differences of second block with fourth, eight and tenth blocks (next day) were significant in both groups.Conclusion: Similar motor learning (defined as stable decrease of block times) in stroke patients and nonnal subjects shows the capability of stroke patients in implicit motor learning during using the affected hand and this is not affected by age, sex and educational level.

Introduction: Acute myocardial infarction is one of the major causes of mortality in developing countries such as Iran. One, of the most important progresses in acute myocardial infarction is early administration of therombolytic agents such as streptokinase. This study was performed to determine the time interval from patients’ referral to the emergency wards to the introduction of thrombolytic therapy and the factors associated with delay in drug administration.Methods: In a period of 8 months, 130 patients with presumed acute myocardial infarction were investigated. In order to determine the causes of delay in streptokinase administration, duration of symptoms onset to drug administration was divided into 4 specified periods and measured in minutes. Results were analyzed using ANOVA and t-test. Results: Findings showed a mean elapsed time of 298 minutes between pain onset and referring to the emergency ward, 73 minutes between patient's arrival and streptokinase administration. Mean time from symptom onset to drug infusion was 370 minutes. There was a delay of 2 hours in drug administration in 18% of patients. The most important causes of delay were long distance and delay of physicians and staff. Conclusion: Considering the findings, increasing people's knowledge about the symptoms of heart problem, providing medical facilities and instruction of medical staff pray important role in decreasing delay time in drug administration and increasing streptokinase output.

Introduction: During coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB), the role of cardioplegic solution which results in cardiac arrest, is critical. This study was planned to evaluate the clinical impacts of N acetylcysteine (NAC) enriched cold-blood cardioplegia on early reperfusion injury in patients with ischaemic heart disease undergoing CABG.Methods: In a randomized double blind clinical trial, seventy patients undergoing elective CABG surgery with CPB were studied. They all underwent similar methods of preoperative medication, anaesthesia and cardiac surgery. Patients were randomly divided into the case group (cardioplegia plus 50 mg/kg NAC) and the control group (cardioplegia with the equal volume of normal saline). The incidence of arrhythmias, usage of DC-shock, pacemaker and inotropic agents during and twenty four hours after surgery, EF five days after surgery and ICU staying and hospitalization periods in the two groups were compared.Results: There were no statistically significant differences between the two groups according to demographic features, EF before surgery, CPB or aorta clamping times, intraoperative DC shock and pacemaker requirements and postoperative inotropic necessity (p >0.05). Two groups showed significant differences in regard to the incidence of arrhythmias (5.7% vs. 22.9%), the inotropic requirement (14.3% vs. 34.3%) during surgery, EF five days after surgery (51.4% vs. 45%) and the mean EF changes postoperatively in comparison with the preoperative period (0.88 vs. -2.28) (p <0.05).Conclusion: Addition of N-acety1cysteine to cardioplegic solution can reduce some of the clinical complications during and after surgery and has positive effects on the postoperative ejection fraction.

Introduction: It has been proved that sufficient amount of fluoride in drinking water can decrease the rate of dental caries. The aim of this study was to determine fluoride content of drinking waters in the 8 cities of Kerman province as well as 11 types of mineral water sold in supermarkets of Kerman.Method: Fluoride contents of 42 drinking water samples belonged to 8 cities of Kerman province and 11 brands of mineral water sold in Kerman city was determined by ponentiometry method and using specific electrode of fluoride ion. Results: Mean Fluoride content of drinking water was 0.17 ppm in Kerman, 0.47ppm in Zarand, 0.39ppm in Rafsanjan, 0.49ppm in Jiroft, 0.43 ppm in Barn, 0.39ppm in Sirjan, 0.44ppm in Kahnooj and 0.41ppm in Baft. Fluoride content of studied mineral waters was in the range of 0.04 - 0.27ppm.Conclusion: Considering the temperature of these cities, it seems that the fluoride content of drinking waters is lower than the recommended range for preventing dental caries.

Introduction: Congenital hypothyroidism (C.H) is one of the most common infants' endocrine diseases and the cause of mental retardation in newborns. This study was performed to determine the prevalence of C.H and it's relation with neonatal's sex, birth weight and height and mothers' age, gestational age, parents' educational level, past medical history of thyroid disease in mother and family and consumption of Iodine salt by mother.Methods: A Total of 3000 neonates aged 2-5 days were screened from November 2005 to July 2006. Specimen collection and transportation to lab were performed according to NCCLS and Wisconsin newborn screening program guidelines. Thyroid stimulating Hormone (TSH) concentration in dried blood spot was determined quantitatively using ELISA technique.Results: From 3000 neonates, 23 cases (0.8%) had TSH³20 mIU/L that were recalled for verification of C.H. Of them, 13 cases (56%) were male and 10 cases (44%) were female. All of 23 infants were detected during 1-2 months after birth and 3 of them had serum TSH³10 mIU/L. According to the protocol of kit they were considered as hypothyroidism cases and were referred for treatment.Conclusion: Considering the importance of congenital hypothyroidism in mental retardation, neonatal screening programs are of high importance. In this study, the prevalence of the disease was 1 in 1000 that is more than that in developed countries. Therefore, it should be considered as One of the hygienic priorities in our country.

Introduction: This research was planned to determine some verbal-auditory skills (verbal-auditory short memory and phonological awareness) that have the closest relationship with speech and language development in 5-year-old children.Method: In this descriptive cross-sectional study, 400 children of pre-school classes affiliated to Education and Welfare organizations in Semnan city were selected randomly. Required data were gathered by using a questionnaire and performing verbal- auditory skills tests.Results: The obtained means were as follows: monosyllable non word repetition: 3.28, 4 syllabic non word repetition: 1.17, syllable recognition: 10.27, syllable segmentation: 3.04, syllable blending: 3.20, alliteration (word with same starter phoneme) recognition: 0.92 and production of word with same starter phoneme: 0.54.Conclusion: Test material has a great influence on the results of the auditory memory test. Due to lack of enough Iranian research and any agreement between them, we cannot detel1Tline the sequence of phonological skills exactly and it requires further researches. Moreover, more surveys are required to find the effect of age.

Introduction: Three basic strategies against substance abuse are control of distribution, treatment of dependents and prevention. Recent years experiences have shown the significant importance of prevention. Considering the decrease in age of substance abuse onset, parents' knowledge about this phenomenon and consequently its early prevention and control in the family is very important.Method: In this cross-sectional study performed in 2005, knowledge of 600 parents of Kerman highs schools' and secondary schools' students in relation to the symptoms of substance abuse was determined by using a researcher-made questionnaire.Results: In whole, 20.1% of the participants had high school or higher educational level and 11.7% of them had history of substance abuse in their family members. The highest knowledge scores in physical symptoms belonged respectively to alcohol (23%), opium (17%) and cigarette (15%). In relation to psychological symptoms, the highest scores were obtained for tranquilizers and analgesics (29%) and then cigarette, alcohol and opium (24%, 19% and 17% respectively).Conclusion: Insufficient Knowledge scores, especially in regard to substances with increasing rate of use is a serious warning requiring serious attempts for increasing knowledge of all classes of society especially parents. This should be done continuously and by using the most efficient educational programs and cooperation of all related organizations.

Disappearing Bone Disease is a rare vascular tumor. The presented case is a 15-year old boy with deformity of the 1st metatarsus in right foot who had a history of mild trauma. In x-Ray examination the proximal phalanxe was absent. In the surgery, proximal phalanx was replaced by fibula bone and biopsy was done. After 15 months in follow up radiography osteolystic lesions in the 1st and 2nd metatarsus of right foot were observed. Due to severe pain and with the diagnosis of disappearing bone disease, the patient underwent radiotherapy. After radiotherapy, in control x-Ray of the right foot, osteolystic lesions of the 2nd metatarsus had been completely absorbed.