Tehran University Medical Journal
Year:2010 | Volume:68 | Issue:3|Papers Count:10

Background: High-frequency electromagnetic field (EMF) is generated by different sources such as radar installations, radio and television transmitters, medical microwave diathermy device and domestic use of microwave ovens. Radiation leakage of microwave oven may be harmful for users. Kids who are residing near their mothers may expose to electromagnetic field. This study was carried out to evaluate the effect of radiation leakage of microwave oven on body weight, cortisol, thyroid hormones and plasma lipid profile.Methods: Radiation leakage of microwave oven was measured by RF measuring instrument. For this study 20 immature (7±3 days old and 5±1 g weight) mice were selected and randomly divided in two groups, control and test group. Test groups were exposed to 2450 MHZ microwaves produced by microwave oven three times a day, 30 minute each time. After 60 days, body weights of both groups were determined and the blood samples were collected by heart puncture. Serum cortisol and thyroid hormones levels were evaluated using RIA method.Results: Radiation leakage from oven showed variations from 6.5 to 57.5 mW/cm2. Mean body weight in test group was 29.5% lower than control group. Serum cortisol, T3 and T4 level were significantly higher in test group compare to control group, (17.44±1.78 vs.9.94±1.21 ng/ml), (1.39±0.15 vs.0.86±0.09 nmol/L) and (77.80±7.67 vs.54.6±6.2 nmol/L) respectively. Compare to control group serum Triglyceride level increased while HDL decreased significantly in test group (p<0.05).Conclusion: Microwaves leaked from oven have deleterious effect on body weight, T4 and cortisol level by decreasing weight gain and increasing these hormones.

Background: The hypersensitivity to cow’s milk allergens is the most common allergies in children at the first year of life. The specific IgE evaluation is one of the important methods in diagnosis of allergic disease. The aim of this study was development of a sensitive and credible procedure for detection of cow’s milk allergens specific IgE.Methods: The allergen discs were prepared by coating of allergens on nitrocellulose paper. After incubation of allergen discs with patients serum, anti-human IgE conjugated were used. In following optimization of any step of ELISAs test, a complete kit was designed. Efficiency of designed kits were evaluated by determination of specific IgE in normal (n=29) and patient (n=153) children serum samples and compared with commercial kits.Results: The specific IgE against three allergrns involving casein, a-lactalbumin and b- lactoglobulin were measured on normal and patient children serum with designed and commercial ELISA kits. Results were demonstrated specificity of 93%, 89.7% & 82.8% and sensitivity of 86.3%, 81.3% & 89.6% respectively for casein, a-lactalbumin and b- lactoglobulin specific kits and these results were similar and comparable with commercial kits.Conclusion: The Designed kits in comparison with the commercial kits were showed equivalent sensitivity and specificity. The designed kit stability was ultimately one month, probably due to don’t using of stabilizers for prepared allergen discs. We suggest these kits for commercial product in Iran and we hope be helpful for easier accesses for Cow’s milk allergy diagnosis and extend that for other allergens.

Background: Proteolytic enzymes, especially collagenases, are used for digestion of extracellular matrix, cell isolation and primary culture. Because of the problems in purification and low amount of collagenases in bacterial or animal sources, it is important to find new sources of the enzymes. So, in the present study actinidin, a plentiful protein in kiwifruit was purified and a mixture of actinidin and trypsin was applied to isolate rat aortic endothelial cells.Methods: Aortic endothelial cells were isolated using digestion solution containing different concentrations of actinidin (from 2 to 16 mg/ml) and trypsin (0.3, 0.6, 1.2 and 2.4 mg/ml) in different times (from 15 to 90 minute). Isolated cells were cultured in DMEM culture medium. Isolated cells were identified by morphological characteristics and immunocytochemical staining; viability of separated cells was estimated by trypan blue exclusion test.Results: Actinidin in concentration of 10 mg/ml with trypsin in concentration of 1.2 mg/ml for one hour could isolate rat aortic endothelial cells. In this condition the viability of cells was estimated 90%. Morphological and immunocytochemical characteristics confirmed the isolated cells as endothelial cells.Conclusion: The results showed that the mentioned mixture of actinidin and trypsin has not considerable toxic effects on separated cells and is a novel and suitable option for isolation of rat aortic endothelial cells.

Background: Meningiomas are among the most common tumors of the brain. Skull base meningiomas comprise s major part of brain meningiomas. They are difficult to treat because of proximity to major vital neuro-vascular structures which makes their surgical resection hazardous and fraught with a high rate of complications. Radiosurgery is considered as an alternative efficient way to treat them, which targets the tumor and its supplying vasculature. The standard treatment consists of tumor eradication and its supplying vessels through homogeneous dose of 201 rays of cobalt 60 source.Methods: In a case-series study, we report 230 meningiomas referred to Iraninan Gamma Knife Center, treated by radiosurgery with type C Gamma Knife. Radio-surgery was performed at a mean dose of 15 Gy and 50% isodose.Results: Two hundred and thirty of all meningioma cases refered to our institute were skull base lesions. Eighty (35%) were new case and the rest were previously treated microsurgically one or more times. None of the patients died after treatment and the most common post-operative complications were headache (30 patients) and peritumoral edema (12 patients).Conclusion: Tumoral control is defined as reduced tumor volume or as no change in tumor volume. Tumor control was achieved in 218 (95%) patients. In those who were not treated microsurgically, clinical improvement was more pronounced. Thus when suitable (favorable tumor size and absence of progressive mass effect signs) the patients could be primarily treated with Gamma knife. Other patients could be managed complementarily with radiosurgery after they are treated surgically.

Background: The inguinal hernia is a common disorder in general surgery. Different methods have been described for repair of these hernias. In modern methods, synthetic mesh is used to cover the wall defect and the most known method is Lichtenstein surgical repair. The laparoscopic totally extra peritoneal procedure (TEP) is a newer technique of repairing hernia. The aim of this study is to compare the outcomes of totally extraperitoneal laparoscopic inguinal hernia repair versus Lichtenstein open repair in patients with inguinal hernia.Methods: Among 50 patients, 25 cases underwent Lichtenstein procedure and 25 patients underwent TEP technique for repairing primary unilateral inguinal hernia. Findings during the operation have been recorded and the 12-months follow-up of patients in different views was performed through a questionnaire and then the results were compared.Results: The operation duration, the rate of complications and frequency of recurrence were similar in two groups; but the hospital stay, postoperative pain, chronic groin pain and the required time to return to normal activity were significantly lower in patients who underwent the TEP method compared to the patients who underwent the Lichtenstein technique (p<0.001, p<0.001, p=0.012, p<0.001, respectively).Conclusion: The TEP surgical technique can be recognized as a safe method with acceptable results for patients and has significant effects on improvement of patients’ quality of life after hernia repair. Suitable results of this surgical method are achieved when the surgeon goes through the learning curve.

Background: Induction of labor implies stimulation of contractions before the spontaneous onset of labor and is indicated when have benefits to eighter mother or fetus. Uterine contractions and an appropriate cervix are two important factors in labor and are contributed to good outcomes. Nowadays, there are many therapeutic modalities for it such as misoprostol. Both vaginal and oral misoprostol may be used for eighter cervical ripening or labor induction. The tablets are stable at room temperature. Regarding the issue importance and lack of similar studies in Iran, this study was conducted to compare the efficacy of sublingual and vaginal misoprostol for labor induction.Methods: This study was conducted as a randomized double-blind clinical trial. In this survey, 250 women were randomly assigned to receive 25 mg vaginal misoprostol plus sublingual placebo or 25 mg sublingual misoprostol plus vaginal placebo in Arash hospital Tehran, Iran from 2008 to 2010. The maternal and fetal complications, Bishop Score, and time of pain onset and it’s interval with labor were monitored in two groups analyzed.Results: Mean Bishop Score, and time of pain onset and its interval with labor were similar in two groups (p>0.05).43 patients (34.4%) in sublingual and 54 (43.2%) in vaginal group had normal vaginal delivery (p>0.05). The frequencies of maternal and fetal complications were similar between two groups (p>0.05).Conclusion: It may be concluded that there is no difference between efficacy of sublingual and vaginal misoprostol in pregnancy outcomes, maternal and fetal complications and so each one may be used according to pregnant woman’s condition and physician attitude.

Background: Coronary Artery Disease (CAD) is one of the leading causes of mortality and morbidity all over the world. One of the most important predictors of outcome of patients with coronary aterey disease is the site of stenosis i.e. Proximal versus nonproximal stenosis. This study designed to evaluate the relationship between CAD risk factors and site of stenosis.Methods: In this case- control study in the patients undergone coronary angiography (CAG) in Imam Khomeini Hospital, Tehran, Iran a total of 125 CAD patients with proximal lesion in CAG enrolled the study as case group and equal sex and age matched number of patients with non proximal lesion selected as control group. Two groups were compared based on presence or absence of DM, hypertension, hyper cholestrolemia, hypertriglyceridemia and cigarette smoking.Results: Relative frequency of DM was 33.6% and 10.4% in case and control group respectively (p<0.0001). Relative frequency in two groups were 33.6 vs 28.8% For HTN (p=0.41), 30.4% vs 29.6% for hyper cholestrolemia (p=0.89), 19.2% vs 16.8% for hypertriglyceridemia (p=0.062) and 28.8 vs 39.2 for C/S (p=0.08). Multivessle disease was significantly more prevalent in diabetics compared with non diabetic patients 89.1% vs 61% (p<0.0001), no relationship was seen with HTN (p=0.41), Hyper cholestrolemia (p=0.052) hypertriglyceridemia (p=0.38) and cigarette smoking (p=0.375).Conclusion: Proximal involvement of coronary arteries and multivessle disease in CAD patients is related to the history of DM but not to the history of hypertension, hypercholestrolemia, hypertriglyceridemia and cigarette smoking.

Background: Pulmonary hydatic cyst is a common parasitic disease and health care problem in developing countries. In our study we assessed treatment outcomes of pulmonary hydatic cyst in our area.Methods: All patients presenting to Ghaem, Omid and Mehr hospitals of Mashhad- Iran since 1981 to 2008 with pulmonary hydatic cyst were enrolled in this study and demographic data, location and number of cysts, diagnostic methods, type of operations, out comes and rate of recurrence were statistically analyzed.Results: One thousand and twenty for patients enrolled in this study. The mean age was 30.6±16.1 years and male to female ratio was 1.2. The most common symptoms were cough (55.1%) and chest pain (33.8%).53.8% of the patients had right side involvement, 40% had left side involvement and 6.2% had bilateral disease. Inferior lobe was the most common involved lobe. The cyst was intact in 52.6% and the other cases were complicated or perforated. The most common surgical technique was removing the cyst membrane without resection of pericyst and closure of air leaks (67.2%). The cyst was enucleated in 21.2% and parenchymal resection was performed in 10.3%. The mortality rate was 0.2% and morbidity occurred in 8.4% of patients. The most common complications were dead-space in pulmonary parenchyma in 3.4% of cases and wound infection in 1.5%.Conclusion: The best treatment for pulmonary hydatic cyst disease is surgery with low mortality and morbidity. The most common treatment is extraction of cyst membrane and closure of small air ways. Pulmonary resection should be reserved for complicated forms of disease.

Background: Human respiratory syncytial virus (HRSV) is the most important viral agent of acute lower respiratory tract disease in infants and young children worldwide. This virus is responsible for 50% brochiolitis and 25% pneumonia in infants. There are limited data of molecular epidemiology of HRSV from developing countries. This is the report on the molecular epidemiology of human respiratory syncytial virus in Iran.Methods: In this study, RT-PCR for second hypervariable region of the HRSV G glycoprotein was performed on 72 throat swabs collected from children less than 5 years of age with acute respiratory symptoms in 1386.Results: Of the 72 throat swabs collected from children with acute respiratory symptoms, 14 (19.44%) were positive for HRSV. Phylogenetic analysis revealed that all HRSV-positive samples clustered in three genotypes of subgroup A: 12 strains (85/71%) in genotype GA2, 1 strain (7/1%) in genotype GA1, and 1 strain (7/1%) in genotype GA5. In this study we couldn’t identify any genotype of subgroup B.Conclusion: Our results revealed that multiple genotypes of subgroup A were cocirculated during 1386 in children less than 5 years of age in Iran. Also this study revealed that genotype GA2 was predominant genotype in isolates were obtained from several cities (Tehran, Isfahan, Karaj, Qazvin, Bandar Abbas, Shahreza), so we speculate that this genotype may be predominant during 1386 in Iran. This study supported that RT-PCR for second variable region of G protein is an effective method for further studies of HRSV genotype designation in Iran.

Background: Fever in neutropenic patients is a medical emergency which may happen in patients undergoing chemotherapy. The definition of neutropenia varies from institution to institution but is usually defined as an absolute neutrophil count (ANC) <500 cells/ml or<1, 000 cells/ml with a predicted nadir of<500 cells/ml. Bacterial and fungal infections are the most important in neutropenic patients. Viral infections with agents such as herpes simplex virus and cytomegalovirus are common but less than other pathogens.Case presentation: We report a patient with fever & neutropenia following cytomegalovirus infection during chemotherapy course for breast cancer.Conclusion: Although fever and neutropenia after cytomegalovirus infection is not very common but prompt diagnosis and treatment of this disease reduces the mortality and morbidity associated with cytomegalovirus. For this reason, screen testing for CMV infection in high risk patients including patients with cancer and preemptive therapy in patients with viremia, for prevention of CMV disease could be considered as a strategy for prevention of CMV infection.