JOURNAL OF ISFAHAN MEDICAL SCHOOL (I.U.M.S)
Year:2012 | Volume:29 | Issue:171|Papers Count:13

Background: EAE (experimental autoimmune encephalitis) is an animal model of MS (multiple sclerosis). Today in Iran for induction of EAE on rats we need to buy specific encephalitogen such as MBP, MOG, PLP from developed countries. It is very essential for us to find a way for induction of EAE which is cheaper and more rapid that make us independent. It is a fundamental technique. Because if we want to study MS (multiple sclerosis), we will need animal model. If we get proper result, we can overcome many obstacles and difficulties in future for further investigations on MS and its etiology and its pathophysiological mechanism.Methods: In this study after one of rats exsanguinations the brain tissue was put in a saline solution and then was homogenized with a homogenizer of Silent Crusher S model. It brought a suspension. A constant amount of CFA with different amounts of quantity of this prepared suspension then was combined and was injected subcutaneously to a series of similar rats n=10. In this investigation all were rats and 590±10 g and 3 months old. The administration was repeated with a week interval for some of the rats and the results were compared. Also a different combination was administered and the results were compared. Finally neurological deficit was looked for which was our aim.Findings: This study illustrated that supernatant solution was more encephalitogen than Suspension solution, and this was usable in an applicable technique for induction of Neurological paralysis in rats (P<0.05) but does not show any optimum combination of supernatant and CFA for that aim.Conclusion: With modifying old method for induction of EAE we could find preferable one rather than high costly methods which are used today. Also this method should be assessed with further investigations on different mice and rats strains and compared with each other and also with further investigations this method should be compared with other methods in literature.

Background: Postoperative nausea and vomiting (PONV) is the most common complication after surgery that might prolong discharge time and cause some morbidity.Methods: This double-blind placebo-controlled randomized clinical trial study was conducted on 150 patients of both sexes aged 18-65 years. Patients were all ASA (American Society of Anesthesiologists) class I or II candidate for general anesthesia. They were randomly divided into three groups of ketamine, tramadol, and normal saline. We injected 2 cc of normal saline and 0.5 mg/kg of ketamine and 0.3 mg/kg of tramadol, respectively to the saline, ketamine, and tramadol groups. All injections were performed 30 minutes before the surgery ended. All patients were monitored for nausea and vomiting in the recovery room and during the first 24 hours after surgery.Data was analyzed by SPSS16.Findings: The three groups did not differ significantly regarding patient characteristics. Average severity of PONV was 0.31±1.2, 0.78±1.89, and 1.25±2.2 in the ketamine, tramadol, and saline groups, respectively (P=0.24).Conclusion: Our study showed ketamine to reduce PONV. In addition, tramadol did not increase PONV.

Background: One of the most remarkable factors in blast cells diagnosis is the increment of nucleus cytoplasm ratio. Some other parameters like size of the nucleus and the whole, and how round the nucleus is also affect the diagnosis.Methods: In this study, the explicit characters of nucleus were used to identify it from the other parts of blood smear. The nuclei were thus extracted by k-means clustering. The cytoplasm was then extracted based on gray level histogram.Findings: This study was conducted on 100 microscopic images. The method had a specificity of 82.5% and a sensitivity of 84% in the extraction of nuclei. The corresponding values for cytoplasm detection were 75.02% and 79%.Conclusion: In this Study present an automatic method to determine the nucleus and cytoplasm.Although the ratio of the cell nucleus to the cytoplasm is an important factor in determining the blast, but other signs such as detecting nucleolus are also effective in the final diagnosis.

Background: Colloids play an important role in fluid resuscitation. However, their unfavorable effects on the coagulation system have led to the limited usage of these solutions. Newer types of colloids are currently being claimed to have minimal effects on homeostasis. This study tried to evaluate such a claim.Methods: In a double blind clinical trial, 58 ASA (American Society of Anesthesiologists) I and II patients candidate for elective lower limbs or lower abdomen surgeries under spinal anesthesia were studied. Using thromboelastography, the coagulation system was evaluated before and 1 hour after an infusion of 15 cc/kg of hydroxyethyl starch (HES) 130 in the study group and HES 200 in the control group. Hemodynamics were monitored and recorded during the study and data was analyzed by chisquare test, analysis of variance (ANOVA) and Mann-Whitney test at a significance level of 0.05.Findings: Mean age in the study and control groups were 37.83±16.1 and 44.07±15.6 years, respectively. There were 23 males and 6 females in each group. Mean weight in the study and control groups were respectively 69.48±8.7 and 69.72±7.5 kg. The results of statistical analyses did not show any differences in these three variables. Repeated measures ANOVA only revealed P values less than 0.05 for heart rate and body temperature. However, the patients were not significantly different in blood pressure. Mean values of thromboelastography parameters, including R(reaction time), K(coagulation time), a (angle), MA (maximal amplitude), and LY30 (percentage lysis 30 minutes post-MA) did not have significant differences between the two groups after infusion of starches.Conclusion: The patients had similar hemodynamic indexes during the study. They did not show any significant differences in thromboelastography parameters (R, K, a , MA, and Ly30). Therefore, 15 cc/kg of HES 130 does not have any priority over HES 200 for effects on coagulation.

Background: Massage therapy is one of the methods used to improve and prevent sports injuries. The purpose of this study was to examine the effects of an athletic massage after acute eccentric exercise on physical performance and perceived recovery in male body building athletes.Methods: Thirty male body building athletes were selected and randomly divided into two groups of experimental (n=15) and control (n=15). They performed 5 sets of ten maximal eccentric contractions at a level of 80 ± 5% of a one-repetition maximal contraction of the knee flexors and extensors at maximal angular velocity. The experimental group received athletic massage using massage techniques for 30 minutes immediately after exercise, whereas the control group was instructed to maintain their current lifestyle. Physical performance and perceived recovery were assessed using the Sargent jump test and perceived recovery questionnaire before and immediately after exercise, and at 2, 24, 48 and 72 hours after exercise. The obtained data was analyzed using repeated measures analysis of variance (ANOVA).Findings: Significant reductions in physical performance as well as significant increments in muscle soreness were observed in both groups after acute exercise. However, the results showed significant improvements in physical performance and perceived recovery in the experimental group compared with the control group 24 hours after massage therapy (P<0.05).Conclusion: These results suggest that a massage therapy session may improve the physical performance and perceived recovery following acute eccentric exercise in male body building athletes.However, it may not be beneficial in the treatment of strength and functional declines.

Background: One of the major causes of mortality in patients with kidney failure requiring dialysis is cardiovascular diseases. Metabolic syndrome refers to a collection of metabolic disorders that causes systemic inflammation and therefore plays an important role in increasing the incidence of cardiovascular disorders and the associated mortality and morbidity. Given the increasing prevalence of metabolic syndrome in the general population, this study was designed to investigate the prevalence of metabolic syndrome in patients on peritoneal dialysis and hemodialysis.Methods: A cross-sectional study on 170 patients on dialysis was performed in Alzahra Hospital, Isfahan, Iran. Blood samples were obtained to examine glucose, lipid profile, hemoglobin, albumin, parathyroid hormone (PTH), calcium, phosphorus, and white blood cell count (WBC). Blood pressure, weight, height, and waist circumference were also measured by standard methods. The information of patients was recorded in a questionnaire.Findings: Metabolic syndrome was observed in 67% of the studied population. The prevalence of metabolic syndrome was higher in females than males (77% vs.57%). The syndrome was also more prevalent among peritoneal dialysis patients than individuals on hemodialysis (73% vs.47%). The highest prevalence in hemodialysis patients was seen in patients who were dialyzed through a temporary catheter. The average weight, body mass index, albumin levels, and WBC were significantly higher in patients with metabolic syndrome. However, the differences in hemoglobin, PTH, calcium, and phosphorus values were not statistically significant between patients with and without metabolic syndrome.Conclusion: The prevalence of metabolic syndrome is high in dialysis, especially in peritoneal dialysis, patients. In addition, women are more at risk than men. Therefore, in order to prevent cardiovascular mortality and morbidity, these patients need to be regularly examined to diagnose and treat the risk factors of metabolic syndrome as soon as possible.

Background: Cystic fibrosis (CF) is an autosomal recessive disorder due to genetic defect resultin g cilliary function impairment. So that these patients are inclined to recurrent infection with opportunistic microorganism such as Pseudomonas aerugin osa. This organism is most important pathogen in cystic fibrosis (CF) which intends to colonize and form biofilm to confront immunsystem and therapeutic dosage of antimicrobial drug. These bacteria can mutate to survive and adapted to new to new condition. Colony morph typing and antimicrobial drug resistant detecting in Pseudomonas aeruginosacan help treat of CF patient and prevent patient form being resource of resistant strain bacteria. The aim of this assay is detection of colony morphotype, antimicrobial resistant in Pseudomonas aeruginosa isolated form CF and urinary tract infection (UTI) patient, hospital personnel and environment.Methods: It is a cross sectional study. Samples wet were taken with swab in 59 CF patients (between 82-87 years), 27 UTI patient, 113 sample from hospital environment, 123 sample from 91 personnel (throat, hand, lab uniform) in Alzahra Hospital, Isfahan, Iran. Isolated Pseudomonas aerugin osa form these samples were identified bacteriologic standard method. The isolates were investigated for morph typing and antimicrobial drug resistance.Findings: 21 cases form 59 patients (35.5%), 25 cases 27 UTI patient (92.5%) were infected with Pseudomonas aeruginosa. Pseudomonas aerugin osa were isolated from 11 of 113 sample taken from hospital environment and 4 of the (123 sample) were taken 91 hospital personnel. From 21 Pseudomonas aeruginosa isolated from CF patient (35 male, 24 female and the ages between 2 month to 24 years), 9 isolates had mucoid form (42%) and the rate antibiotic resistance to Gentamicin, Amikacin, ciprofloxacin, piperacillin and ceftazidime were 9.5%, 9.5%, 14.2%, 19% and 86% respectively.Conclusion: The mucoid form of Pseudomonas aerugin osa was seen most frequently in CF patients comparing with other samples. In all groups, antimicrobial resistance to Ceftazidime and antimicrobial sensitivity to Amikacin were most frequent.

Background: Breast cancer is one of the most common malignancies in women and its metastasis plays an important role in mortality, treatment failures and complications. The objective of this study was to evaluate the risk factors of metastatic breast cancer.Methods: In a retrospective cohort study, breast cancer patients in Isfahan, Iran were followed up for ten years. The existence of metastasis was considered as the dependent variable while independent variables included age at diagnosis, hormone receptor status, family history, number of lymph nodes dissected in surgery and involved ones, number of pregnancies, age at first pregnancy and menarche, menstrual status, histopathology and tumor size. All data was collected from patients' profiles and analyzed using logistic regression in SPSS16.Findings: A total of 685 patients with breast cancer were studied during 1999-2009. While 91.4% of cases had no metastasis, distant metastasis was found in 8.6% of subjects. Sites of metastasis according to prevalence were lung (4.7%), bone (2.6%), other organs (1.1%), and liver (0.3%).Number of involved lymph nodes (P=0.043) and number of pregnancies (P=0.022) had significant relationships with metastasis.Conclusion: We concluded that less pregnancies and more involved lymph nodes indicate a high probability of metastasis occurrence. Therefore, survival improvement might be possible with early diagnosis of breast cancer, using prophylactic treatments, and identifying metastatic cases by diagnostic tests.

Background: Pap smear is an easy and cost-effective screening method for cervical carcinoma and its precursors. The Bethesda system 2001 for reporting cervicovaginal cytology provides valuable information about specimen adequacy. In the present study, we investigated the status of specimen adequacy in Pap smears taken from women who had referred to Beheshti Hospital in Isfahan, Iran.Methods: In this cross-sectional study, all women with Pap smears in Beheshti Hospital in a 6-month period were evaluated. Exclusion criteria were the history of previous cervical cone biopsy or total hysterectomy. The specimens were studied by the investigators using a two-headed microscope and their adequacy was classified according to the Bethesda system 2001.Findings: Overall, 99.1% of the 1420 investigated specimens were satisfactory. Moreover, 66.1% of partially obscured and 46.2% of unsatisfactory specimens had been obscured by excessive thickness.Conclusion: The results of this study showed that a considerable percentage of Pap tests are satisfactory for evaluation. Excessive thickness was found to be the most frequent obscuring factor in this study. Since this obscuring factor happens during smear preparation, training is helpful in reducing its frequency.

Background: The growing epidemics of obesity and metabolic syndrome (MetS) have been accompanied with dietary fat restriction and carbohydrate elevation. We evaluated the efficacy of moderately-restricted carbohydrate diet on features of the MetS in women.Methods: In a randomized cross-over clinical trial, 30 overweight or obese (Body mass index>25 kg/m2) women with the MetS were enrolled. Subjects were randomly allocated to receive either a high-carbohydrate (HC) (60-65% carbohydrates, 20-25% fats) or a moderately-restricted carbohydrate (MRC) (43-47% carbohydrate, 36-40% fats) diet. Diets were continued for 6 weeks followed by a 2-week washout period. Anthropometrics, blood pressure and biochemical variables were measured before and after each intervention period.Findings: Despite similar weight loss in both diets, the efficacy of MRC diet in reducing waist (-3.9 vs. -2.6 cm; P=0.07) and hip circumferences (-2.7 vs. -1.5 cm; P=0.07) was marginally greater compared with HC diet. In contrast to HC diet, MRC diet resulted in favorable changes in serum triglyceride (TG) concentrations (0.13 vs. -31.3 mg/dL; P=0.07). This was also the case for TG to high density lipoprotein (HDL) -cholesterol ratio (-0.9 vs. -0.1; P=0.06). The reductions in systolic blood pressure (-8.93 vs. -2.97 mmHg; P=0.06) and diastolic blood pressure (-12.7 vs. -1.77 mmHg; P=0.001) by MRC diet were higher than those by HC diet. The prevalence of MetS was significantly decreased only by MRC diet (P=0.03).Conclusion: Partial replacement of dietary carbohydrates by unsaturated fats might be recommended as an effective strategy for treatment of MetS.