Feyz Medical Sciences Journal
Year:2005 | Volume:9 | Issue:1 (Serial 33)|Papers Count:18

Background: With respect to need for finding suitable ways for maintenance and survival of neurons after nerve injury, also inadequacy of information for effects of peripheral nerve repair on ultrastructure of sensory neurons, this study was carried out in Iran Medical Sciences University in 2004. Materials and Methods: In this experimental study, 24 male adult Wistar. rat weighing 200-250 grams were randomly assigned in three groups of axotomy, repair, and sham. In axotomy group, left sciatic nerve transected in middle thigh and did not repaired. In repair group, sciatic nerve transected in middle thigh and repaired by epineurial suture. After 8 weeks the fifth left and right (intact) dorsal root ganglion removed. For neuronal counting, after crysel violet staining, neurons were counted with scaled lens. For ultrasrtuctural study, after primary and secondary fixati on, dehydration, and impregnation, ganglions embedded with araldehyde resin. After semi thin and thin sections, and dyeing, they were observed through light and transmission electron microscopes. Results: Average of neurons in axotomy group was 27.42±7.7and in repair group was 33.42±11.4 (P<0.03). Semi thin sections in intact and sham groups had normal appearance. In axotomy group they showed translocation of nucleus and neucleolus, shrinkage, and pyknosis. In repair group these problems decreased completely. Thin sections in intact and sham groups were normal. In axotomy group chromatin condensation, margination and pyknosis as well as abnormal and dilated mitochondria and endoplasmic reticulum were seen. Similar changes were observed in a few of neurons in repair group. Conclusion: Sciatic nerve repair by epineurial suture may cause sensory neuronal loss to decrease after nerve transection, but cannot stop it. Evaluation of effects of other nerve repair techniques on neurons morphology also investigation by histochemistry and immunohistochemistry methods is recommended.      

Background: Evaluating the protein quality of food is of high importance for biological and economical reasons. To determine quality of proteins different biological, microbiological, chemical and combined methods have been presented and used. Among them NPR, RNPR, and PER are considered the most appropriate methods. Using these methods, this study was conducted on Soya products to evaluate the protein quality of Soya in 2003. Materials and Methods: In an experimental study, 32 male Wistar rats, aged 21-23 days, were assigned to 4 groups (8 in each). Each group underwent a diet: Soya, wheat flour+Soya (10% protein), Casein+Methionine (10% protein), and no protein diet (as control). Period of study for NPR was 14 days. Protein intake and weight increased were determined for calculating NPR. Period of study for PER was 28 days. Protein intake and weight gains of animals were determined. NPR, RNPR, and PER were evaluated by t test. Results: NPR for Soya and Casein+methionine groups were 3.65±0.35 and 4.37 ±0.48 respectively (p< 0.01). RNPR was 83. In wheat flour+soya group NPR was 2.7 ±0.3 (P<0.001)and RNPR was 62.7. PER were 2.28±0.35 and 3.04±0.24 for soya and Casein+Methionine respectively (P<0.001) and Soya PER/Casein PER was 75. PER was  1.1±0.1 for Wheat flour+soya (P<0.001). Conclusion: Protein quality of Soya is lower than Casein+Methionine.    

Background: With respect to important role of nutrient and calcium intake in the health of fetus, newborn and mother, the current study carried out to determine nutrient intake and biochemical serum factors related to calcium metabolism during normal pregnancy in Tehranian women. Materials & Methods: In a cross sectional study, 101 normal pregnant women from 5 prenatal care centers and 94 non-pregnant women randomly selected from the Tehran Lipid and Glucose Study population were enrolled. A questionnaire was used to obtain demographic data, 2-day dietary recall and food habits during face-to-face interviews. Venous blood samples were taken to measure serum calcium, magnesium, phosphorus and 25-OH vitamin D. Data were adjusted for age, BMI and weight in both case and control groups. Nutrition intakes were analyzed using Nutritionist /II software and compared to DRI recommendations. T-test was used for statistical analysis. Results: Mean daily magnesium, calcium; phosphorus and vitamin D intakes were 183±79.859±388 and 1009±398 mg and 0.39±0.34 µcg, respectively. Mean magnesium, calcium, phosphorus and vitamin D intakes were significantly decreased during pregnancy as compared to recommended daily intakes: 86, 47.7, 7.5 and 100% of DRJ, respectively, (magnesium, phosphorus and vitamin D, P<0/001 and calcium, P<0/0l1). Pregnant women had higher nutrient intakes than non-pregnant ones of magnesium, calcium, and phosphorus (P<0.001). There were no differences in vitamin D intakes between the two groups. Mean serum levels of calcium, phosphorus and vitamin D were 9.1±0.6, 4.0±0.6 mg/dl and 24.3±14.1ng/m respectively, not significantly different from the controls. Significant differences were found in the mean serum levels of magnesium in pregnant women with their controls (P<0/01). Conclusion: Daily intakes of vitamin D, magnesium, calcium and phosphorus and serum vitamin D levels are low in pregnant women of Tehran. Findings emphasize the need for nutritional counseling programs for these women.  

Background: One of the most painful situations that a woman may experience is labor. On the other hand, except for some indicated cases, cesarean has been proved to be dangerous for mother. The pain of uterus contractions can be diminished by epidural analgesia. Maternal Catecholamine increases during labor and epidural anesthesia reduces Epinephrine level and increases uterine blood flow. The purpose of the present study was to evaluate the effect of epidural analgesia on Epinephrine concentration and duration of first stage of labor. Materials and Methods: Using clinical trial method, we considered 100 healthy parturient primigravid with single fetus and ≥4 cm cervix dilatation without major medical complication for epidural anesthesia with 10 ml Lidocaine 5% (50 patients) or 50 mg IV Mepridin (50 patients). Then venous blood samples (5 cc) were obtainedfram all patients at the end of first stage of labor. All samples were analyzed by a Radio enzymatic assay for Epinephrine level. T test, colmograph and smirnof tests were usedfor data analysis. Results: Plasma epinephrine levels in Mepridin and epidural groups were 95.9±22.2 and 41.4±15.4 pg/ml respectively (P<0.0001) showing decreased in epidural group. Duration of first stage of labor (active phase) in Mepridin and epidural groups were 166.6±25.1min and 153.8±26 min respectively. Duration of first stage (active phase) was shorter in Epidural group (P<0.02). Conclusion: Lumbar epidural anesthesia during labor Reduces maternal Epinephrine level and duration of first stage of labor (active phase.) Epidural anesthesia is an effective method of analgesia in labor.    

Background: In this study effects of stress resulted from using independent and co- administration morphine and carbohydrate on serum cortisol levels in rat were investigated to determine the possible causal link between morphine, carbohydrate and serum cortisol level. Materials and Methods: This experimental study was performed on 24 male Wistar rats (200-250 gr) divided to 3 groups (n=8). Morphine dependency was induced by increasing doses of morphine through intraperitioneal (IP) injection. Animals were injected 10, 20, 30, 40, 50, 60 mg/kg morphine sulfate on days 1, 2, 3, 4, 5, 6 respectively and dose of 60 mg/kg was repeated for 20 extra days (Mo group). Another group of animals received the same dose of morphine plus l gr/kg glucose per day through intraperitoneal (IP) injection (Mo+Glu group). Duration of experiment was 26 days. Results: Significant increase in serum cortisol level was observed after long-term use of both morphine and co-administration of morphine and carbohydrate. However, this increase was higher in Mo+Glu group than morphine group. (16.57% vs. 11.55%, P<0.05) Conclusion: long-term use of morphine, with or without carbohydrate, may increase serum Cortisol level.    

Background: Several investigations on safe anesthesia in preeclamptic parturient show that general anesthesia has greater risk than spinal anesthesia. This study was conducted on preeclamptic parturient to show spinal anesthesia with slow acting drugs not only accompanying stable maternal hemodynamic but also can bypass difficult intubations and consecutive hypoxia. Materials and Methods: It was a randomized clinical trial study (RCT). After we received institutional ethics committee approval and informed patient consent, all preeclamptic parturient aged 18-40 yr and scheduled to undergo elective cesarean section, were randomly divided in two groups: general anesthesia with sodium thiopental S mg/kg and succinylcholine 1.5 mg/kg IV, and spinal anesthesia with marcaine 2mgplus epinephrine 0.2 mg CSF. Blood pressure was measured at 1st, 5th, 10th & 15thminutes and Apgar scores of 1st and 5th minutes were recorded. Data analysis was achieved using chi-square test and SPSS soft ware. Results: There was no significant difference regarding the age and body weight prior to study. IV fluid intake was greater in spinal than general anesthesia (P=0.026). There was no significant difference between desirable and undesirable apgar score of 15th minute (P>0.05). Undesirable apgar score of first minute was greater in general than spinal anesthesia (P=0.004). At the first minute of anesthesia all blood pressures in the spinal anesthesia were desirable but 68.8% of them were desirable in general anesthesia. (P=0.0002). At 15th minute in the spinal anesthesia only 85.4% of blood pressures were desirable but in general anesthesia all blood pressures were desirable. (P=0.0123) Conclusion: In preeclamptic parturient undergoing cesarean section spinal anesthesia with marcaine is safer than general anesthesia.    

Background: Despite wide use of Atropine by midwives and physicians as an adjunct to labor, obstetric literature contains few references to this effect of the drug. This study was a double blind, randomized controlled trial of primigravidas in Iran to determine the safety and efficacy of Atropine on the labor progress. Materials and Methods: One hundred primigravidas in uncomplicated spontaneous labor, cervical dilation less than 4 cm and cervical effacement less than 50% were randomly assigned into two groups: the experiment group (N=50) receiving 0.5mg Atropine and the control group (N=50) receiving placebo, with predetermined codes, single dose injected at the beginning of the active phase of labor. The groups were compared for Bishop score of cervix after 1 h of injection, duration of active phase of labor, duration of second stage of labor, Fetal tachycardia and bradycardia 0.5 and 1 hours after injection, Apgar score and birth weight. The accepted level of significance was P<0.05. Results: The two groups of women did not differ in maternal age, gestational age, initial cervical effacement and dilation and mean birth weight. The mean change in the Bishop score of cervix after 1 h of injection was significantly higher in those receiving hyoscine (3.7 vs. 2.4, P<0.0001), Mean duration of the active phase was significantly shorter in case group (181 Min vs 229.7 Min, p<0.0001).There was a significant difference between two groups in the duration of the second stage of labor (26.5 Min vs 44.2 Min, P<0.0001). The fetal tachycardia and bradycardia occurred more frequently in patients in the Atropine group compared to the control group, after 0.5 hours of injection (14% vs 8%, P<0.6). The mean first and fifth-minutes Apgar score were not significantly different. Conclusions: This small series suggests benefit in a single dose of Atropine for labor progress and represents the first attempt to evaluate the medication. However, more randomized clinical studies are needed to establish efficacy, safety, and optimal dose of Atropine for labor progress at term.    

Background: Coronary stents have been the major advance in percutaneous coronary intervention in the last decade and are used inpatients. The aim of this study was to evaluate the incidence of clinical instent restenosis on the basis of exercise test in patients with coronary disease. Materials and Methods: The cross-sectional strategy of this study was carried out on 345 patients who underwent percutaneous coronary intervention. In this study six months after stent implantation, clinical evaluation was performed by noninvasive study in patients. Results: Of 345 patients, 26 patients were excluded for various causes. There was instent restenonis in 20.7% of patients. In those who had abnormal exercise test, stent had been implanted in left anterior descending artery more than other coronary arteries and they had also shown unstable angina pectoris and myocardial infarction before stent implantation. Conclusion: The incidence of restenosis in patients with acute coronary syndrome was more than choronic stable angina pectoris.    

Background: Hepatitis C virus (HCV) is the predominant cause of nonA-nonB and post transfusion hepatitis. This study was conducted to evaluate the efficacy of third generation Recombinant lmmunoblot Assay (RIBA-3) especially structural and non-structural bands compared with Reverse Transcripatase Polymerase Chain Reactions (RT-PCR) for the diagnosis of hepatitis C infection. Materials and Methods: Sera of 80patients with ELIAS-3positive were analyzed by RIBA-3 and RT-PCR. Results: Forty-eight out of 80 patients were positive in RIBA-3. Of them 92% was RT-PCR positive and only 4 patients were RN negative. Among 20 samples with 4 bands, 18 (90%) were RNA positive. Among the 18, 3-bands positive, 16(88%) were RNA positive, whereas all of 11(J00%) of RIBA-3 positive with anti-capsid and anti-NS3 reactivity are RNA positive. Among the RIBA-3 indeterminate cases (J3 patients), HCV-RNA was positive only in 31 % (4 patients). Sera of these four patients were reactive with the core (C22) region in RIBA-3. All samples reacted to NS-4 regions were RT-PCR negative. So samples with indeterminate results in RIBA-3 should be evaluated by RT-PCR for HCV RNA. All samples without any reaction in RIBA-3 were RT-PCR negative. Conclusion: There were not absolute correlations between the results of RIBA-3 and PCR but all of RIBA-3 positive with anti-capsid and anti-NS3 reactivity were PCR positive, but other profiles were associated with HCV viremia in about 88%-90% of cases.    

Background: "Reject analysis" is considered as the critical evaluation of radiographs. Repeated films represent additional no billable costs as well as additional radiation exposure that affects patients and personnel and also is time consuming. This research was carried out to determine the rate of reject films in hospitals affiliated to Kashan University of medical sciences in 2003. Materials and Methods: This research was a descriptive study in which total radiographies were assessed and repeated films that were not accepted by radiographer and radiologist were determined. The common reasons of repeated films were incorrect exposure factors, incorrect patients position, x-ray equipment faults, processing equipment faults, little cooperation of patients, and miscellaneous reasons. Incidence rate was determined for total cases, body area, hospitals and finally for population. Results: During the study 6438 radiographies were done. Repeated radiographies were 317 cases that constituted %4.9 of total radiographies. Shabihkhani Hospital and Naghavi Hospital had the highest (%6.9) and lowest (%3.8) rate, respectively. Among the most common reasons of repeated radiographies, incorrect exposure factors (%2) and incorrect patient position (%1) were reported. Skull and pelvis had the most repetition (%7). Conclusion: The repeated rate of radiographies in this study was similar to previous studies. The repeated rates in some hospitals and in some organs are not acceptable so we recommend continuous education programs to reduce the repeated radiographies.    

Background: With respect to prevalence of unwanted pregnancy and lack of information on its risk factors in rural population at risk, the current study was carried out on rural women of Najafabad to determine prevalence of unwanted pregnancy and its risk factors in 1997. Materials and Methods: In this cross-sectional study, 788pregnant women of studied area enrolled. Samples were randomly selected. Unwanted pregnancy, age, method of contraception, tendency to abortion, history of unwanted pregnancy and other relevant factors were asked. Data were analyzed using descriptive statistics. Results: Of 788 studied women, 42% had unwanted pregnancy. Place of receiving family planning services, method of contraception and taking QCP played main role in unwanted pregnancy. Conclusion: Prevalence of unwanted pregnancy is dangerously high. More studies on the causes, as well as interventional studies in order to control them, are  recommended.    

Background: Diabetes mellitus has a high prevalence in our country. It is usually complicated with diabetic retinopathy. The aim of the present study was to determine the prevalence and risk factors of diabetic retinopathy in patients referring to Kashan Diabetic Center in 2002-2003. Materials and Methods: In this descriptive study, a thorough ocular examination was performed on 200 randomly selected patients from Kashan Diabetic Center. Stage of retinopathy was determined inpatients. The risk factors such as age, sex, duration of disease and type of diabetes were considered. Results: Diabetic retinopathy was found in 72patients (36%). Sixty-two patients (31% of examined patients) were in non-proliferative phase. There was a significant association between diabetic retinopathy and duration of disease (P=0.00006), creatinin level (P=0.002), blood urea (P=0.002), fasting glucose (P=0.05) and sex (P=0.044). Other risk factors such as blood cholesterol and triglyceride level, hypertension, type of diabetes, and ischemic heart disease did not show a significant association with diabetic retinopathy. Conclusion: With respect to the high prevalence of diabetic retinopathy, controlling the blood sugar, urea, creatinin, blood pressure, and fat level can influence the occurrence of diabetic retinopathy.    

Background: Identifying various scorpion species and manifestation of their bites are of high importance in medicine. Considering the variety of scorpion species and insufficiency of current methods for prevention, control and treatment of their bites, this study was carried out to evaluate the situation of scorpion bite in Iran. Materials and Method: In a review method, after searching key words on the relevant Internet sites and in domestic journals, 47 related articles were selected and reviewed. Conclusion: Approach to scorpion bite as one of the main health problems in Iran is changing. Having clear information and exact programming are needed to decrease number of bites and control their complications. In this regard, information provided by this study can help authorities as well as other researchers of this field.    

 Background: Cutaneous Leishmaniasis is a relatively common disease and cannot be completely controlled. Some reports have suggested drug resistance to the disease and adverse effects of the drug are controversial. The aim of this study was to review different methods of medical treatment, evaluate effects and adverse effects of the drug, and present a protocol for treatment of patients with Cutaneous Leishmaniasis. Materials and Method: In a review method, searching keywords on the Internet, a large number of related articles were extracted. Among them, 66 qualified articles were selected and reviewed. Conclusion: Glucantime is considered to have the most effectiveness and the less adverse effect in patients with Cutaneous Leishmaniasis.    

Background: Perforation of gall bladder is one of the complications of acute cholecystitis, which is of relatively high prevalence. It has been rarely reported as Cholecystocutaneous fistula. This paper presents a case of Cholecystocutaneous fistula referring to Taleqani Hospital in 2002. Case Report: The patient was a 48-year-old diabetic man, complaining of white discharge and swelling in right upper quadrant of abdomen, not responding to antibiotic therapy. The patient underwent cholecystectomy and fistula curettage. Conclusion: With respect to rare reports, in every patient with fistula in right upper quadrant and history of cholecystitis signs and symptoms, involvement of gall bladder should be considered.