Journal of Mazandaran University of Medical Sciences
Year:2007 | Volume:17 | Issue:60|Papers Count:20

Background and purpose: Knee arthroscopy is an approved technique for the diagnosis and treatment of intra-articular lesions. Moderate to severe pain is experienced after surgery; thus, relieving pain post arthroscopy, will help patients in performing their daily activities as soon as possible. Many studies have been performed for reducing pain after arthroscopy. The aim of this study is to compare the efficacy of intra-articular injection of morphine with marcaine in patients for pain relief after arthroscopy. Materials and Methods: 30 patients were considered for arthroscopic surgery, due to the tearing of the menisci. In this simple non-probability trial, patients were divided in two groups. The first group received 7cc intra-articular marcaine at 0.5% and the second group received 10mg of intra-articular morphine after the arthroscopy. The response was measured by VAS in hours 6, 12, 18, 24 postoperatively and by flexion, extension and walking. Results: The results showed that there was no significant statistical difference between the two groups, except in hour 6 after surgery, indicating marcaine is more effective than morphine. There were no side effects experienced within the two groups. Age, gender, height and weight also had no effect in reducing the pain in patients. Conclusion: Intra-articular Injection of marcaine is more effective than morphine six hours after surgery; however, there are no differences between them after that time frame. More research is needed in order to reduce pain after arthroscopy.

Background and purpose: Binding a monoclonal antibody to tumor associated antigens is an effective method for cancer therapy because these agents can specifically target malignant cells. In fact, monoclonal antibodies are effective agents for diagnosis, grading and treatment of different kinds of cancers. In this research, a new monoclonal antibody against colon cancer cells was prepared and radiolabeling with technetium-99m evaluated.Materials and Methods: This research was done in three parts: preparation of hybridoma cell against colon cancer cell line (HT29), production of monoclonal antibody, determination of its characterizations and radiolabeling with technetium-99m.Results: mAb-D2 is an IgG1 with affinity constant of 7.2 × 109M-1  which can recognize CEA in tumor cells. Radiolabeling showed that 99mTc-HYNIC-mAb-D2 complex is stable, immunoradioactive, and has a desirable biodistribution.Conclusion: In this study, we gained a new radiopharmaceutical that may be a good candidate for radioimmunoscintigraphy.

ackground and purpose: Candida albicans (C. albicans) as a micro flora of the human could be responsible for a continuous release of allergen and may be responsible for chronic atopic dermatitis (AD) in sensitive patients. Thus, in this study, we analyzed AD patients for total IgE and specific IgE, against C. albicans.Materials and Methods: A total of 120 AD patients (male 52 and female 68) were introduced in this study. The age range varied from 4 months to 60 years (mean about 12.9 years). Serum total IgE was assayed by ELISA kit (RADIM). Solid phase was captured by sandwich ELISA assay, using a micro well format for the determination of serum specific IgE to C. Albicans was used according to the manufacturer’s instructions, (ALerCHEK Allergen specific human IgE). Results: Of the 120 AD patients, 37 subjects (30.8%) had total IgE higher than 100 IU/mL, 44 subjects (63.7 %) 20-100IU/mL and 39 subjects (32.5%) less than 20 IU/mL. 9 (7.5%) of the patients had specific IgE against C. albicans. Among the patients who were positive for specific IgE to C. albicans, 6 (66.7%) were women.Conclusion: The result of our study on serum total IgE in AD patients is concordant with other studies from different countries. In comparison to other studies, our AD patients showed less frequency of specific IgE against Candida albicans. The explanations for the variation in the results obtained in various studies could be due to the age of patients, severity of disease, difference in the antigen preparation, different methods for IgE analysis and total IgE level.

Background and purpose: Anal fissure is a chronic condition characterized by painful defecation and rectal bleeding. The aim of this study was to compare the injection of botulinum toxin (BT), versus with surgical lateral internal sphincterotomy (LIS).Materials and Methods: In this clinical trial, 40 patients enrolled with chronic idiopathic anal fissure (CIAF) and were divided into 2 groups (20 BT group and 20 LIS group). Both groups were compared according to complications and healing process during one week, following, 2 and 4 months after interventions.Results: There were no statistical significant differences between 2 groups as a viewpoint of duration of disease, pain and other symptoms at the beginning of the study. The rate of healing in the LIS group was greater than the BT group within the first month (16/0), and second month (16/7) (p<0.05), however, there were no significant differences between the two groups in the 4th month (17/11) of the study (p>0.05). In comparison with the BT group, the severity of pain in the LIS group decreased significantly. There were no significant differences between the two groups regarding complications.Conclusion: Healing in the BT group was approximately similar to the LIS; yet it appears to occur slower than LIS. Therefore, according to the results of the study, injection of the BT is recommended within the first step of CIAF treatment. To obtain the maximum healing effects of BT, a minimum period of 4 months is needed.

Background and purpose: Propofol causes pain and hypotension when it was injected. Magnesium (Mg) and ketamine are antagonists of the N-methyl-d-aspartate (NMDA) receptor ion channel and cause analgesia. In view of the analgesic activity of Mg and ketamine, we tested the effect of intravenous administration of magnesium sulfate in reducing pain induced by propofol.Materials and Methods: Two hundred ASA I-II adults patients undergoing elective ophthalmic surgery were randomly assigned into four groups of 50 subjects in each groups. Group M received magnesium sulfate 2.48 mmol, Group K received ketamine 10 mg, Group L received lidocaine 1% (30 mg) and Group C received normal saline, all in a volume of 5 mL followed by 5 mL of 1% propofol 30 s later. Pain was assessed on a four-point scale: 0 = no pain, 1 = mild pain, 2 = moderate pain, and 3 = severe pain at the time of pretreatment and propofol injection.Results: Eighty-eight percent of patients in the control group had pain during iv propofol as compared to 34%, 28%, and 18% in the magnesium, ketamine, and lidocaine groups respectively (P<0.01). Incidence of mild, moderate, and sever pain were significantly lower in groups K, L, and M compared to group C (P<0.05). Ketamine, lidocaine, and magnesium pretreatments were same effect in attenuating pain during the propofol injection (P>0.05).Conclusion: Intravenous pretreatment of magnesium, ketamine, and lidocaine are same effect in attenuating propofol-induced pain.

Background and purpose: High concentrations of respirable particles may cause high incidence of respiratory diseases and mortality in public populations and in particular in public transportation workers. Epidemiological exposure studies showed that respirable particles that emitted from traffic sources have more potential effects on more incidence of hospitalization or mortality caused by cardiovascular diseases. In this study personal exposures of bus drivers to respirable particles (PM10) and factors that caused high personal exposure were studied in Sari city.Materials and Methods: In this study, a calibrated real time monitor (Micro Dust Pro) with a personal sampling pump with 2 lit/min flow rate were used to measure Sari’s bus drivers personal exposure to PM10 concentrations on 3 main routs. This study was carried out during a one calendar year and all possible effective factors on personal exposure were recorded in a questionnaire.Results: The mean personal exposures to PM10 concentrations among bus drivers were varied in different months. Exposure to PM10 concentrations were higher in autumn and winter and increased to 300µgm-3 in some days. Personal exposures to these particles were increased in the evening and on high traffic flow routs. Other factors such as rainy weather and temperature, number of passengers, bus' model year, picking up and dropping off the passengers were the most effective factors on driver's personal exposures.Conclusion: Bus drivers' exposure to respirable particles PM10 in Sari was varied in different time. It was due to entrance of outdoor particulate air pollutants into the bus during the picking up and getting off the passengers and resuspension of settled fine particles.

Background and purpose: A gastric conduit is usually used to reconstruct the foregut after esophagectomy for cancer. The gastric emptying may be impaired after this operation, so some esophageal surgeons routinely add a pyloric drainage procedure. The aim of this study was to determine the emptying of the intrathoracic stomach after esophagectomy and cervical esophagogastrostomy with or without pyloromyotomy.Materials and Methods: Between January 2003 and April 2006, in a randomized controlled trial, 30 patients with esophageal carcinoma were randomized to have with or without pyloromyotomy as a gastric emptying procedure for the gastric conduit used for esophageal replacement. Patterns of gastric emptying in the vagotomized intrathoracic stomach were studied using radioisotope techniques. Gastric emptying (GE) was evaluated 8 weeks after the operation. Patients were available for 6 months follow-up.Results: A total of 30 patients were enrolled in this study. Sixty percent (18) were male, and 40% (12) were female. Twenty three patients (76.7%) had squamous cell carcinoma and 7 (23.3%) had adenocarcinoma. Delayed GE was reported in 11 (73.3%) and normal GE in 4 (26.7%) of patients with Pyloromyotomy. Delayed GE was reported in 9 (60%) and normal GE in 6 (40%) of patients without Pyloromyotomy. There were not any significant differences between complications of post surgery in both groups.Conclusion: These findings were showed that esophageal surgery can be don’t add a pyloric drainage procedure in esophagectomy and cervical esophagogastrostomy and that very few patients actually need it.

Background and purpose: The aim of this study was to determine the incidence and presence of a relationship between predictors of body mass index (BMI) or C-reactive protein (CRP) and duration of mechanical ventilation, in trauma patients who were admitted to the intensive care unite (ICU). Furthermore, we compared their prognostic significance, with known indicators such as, the Sequential Organ Failure Assessment (SOFA) score.Materials and Methods: This prospective observational study was preformed on 72 admitted critically ill trauma patients in a general ICU setting, in Alzahra Medical Center of Isfahan University. Patients were categorized by duration of mechanical ventilation to the group A (≤ 7 days) and group B (> 7 days). The severity of illness was assessed by the Revised Trauma Score (RTS) calculated on the first admission to the ICU unit. The biological status of the patients was assessed by the serial measurement of CRP on admission to ICU (T1), at 48, 72 hours subsequently, and on the beginning day (T2) or discontinuation (T3) from mechanical ventilation. Data on BMI, serum albumin, and the SOFA score, were also collected on T2 and T3.Results: There was no significant difference between two groups in demographic characteristic or RTS. On T3, the SOFA score, BMI, albumin, and CRP were significantly higher within group B patients, as compared with group A (P < 0.01). The incidence of low BMI (≤ 20 kg/m²) or high CRP (> 10 mg/L) on T2 was 72.2% (52/72) and 81.9% (59/72) respectively. The incidences of low BMI or high CRP in group B patients were significantly higher on T2 or T3, as compared with group A (P < 0.05). CRP or BMI on T3 had high specificity for predicting more than seven days of MV. On T3, the SOFA score, serum albumin, CRP, and BMI provided significantly good discrimination (area under curve > 0.5) in descending order. Mean serum CRP level within 72 hours after admission to the ICU or on T3 was significantly more in group B patients, as compared with group A (P < 0.01). The most significant predictor more than seven days of mechanical ventilation was CRP followed by BMI on T3. Conclusion: Both the BMI and CRP comparables with the SOFA score can be used in estimating the risk of prolonged mechanical ventilation. It is also concluded that maintaining the level of BMI or CRP in normal range, could shorten the duration of mechanical ventilation.

Background and purpose: High constitutive levels of SDF-1 a have been observed in the non-inflamed biliary epithelium of the liver. SDF-1a is also produced by ductal plate cells (biliary epithelial cells progenitors) and it is involved in maturation and homing of B cells in fetal liver.Giving the above brief introductory remarks, this chemokine was chosen to analysis in isolated and cultured hepatocytes.Materials and Methods: We employed gene cloning methods to clone and northern analysis to show the expression of the gene in hepatocytes. In the first stage of this work, we have sequenced cloned fragment of SDF-1 in cultured rat hepatocytes and compared with database to prove that the studied and cloned gene is SDF-1.Results: we showed that the fragment, which we have used as probe for our northern blotting analysis is SDF-1 by sequencing methods. Following using specific produced probe for SDF-1, in this study we showed that SDF-1 is expressed by hepatocytes after isolation and early culture of hepatocytes.Conclusion: Isolation of hepatocytes by enzymatic methods causes liver injury and therefore hepatocytes may stimulate to response to the injury. The expression of this chemokine may involve in stress response of hepatocytes to isolation.

Background and purpose: The Beijing genotype is one of the most important strains of Mycobacterium tuberculosis involving outbreaks of tuberculosis in various parts of the world. Unsought regarding Beijing genotype in Iran, is the reason this study is undertaken in order to evaluate the frequency of this genotype in Mashhad.Materials and Methods: This descriptive study was carried out on 113 M.tuberculosis Specimens isolated from patient with pulmonary tuberculosis in hygienic centers, located at Ghaem and Imam Reza hospitals in the City of Mashhad. In this study, Beijing genotypes were detected with PCR based method, and spoligotyping. Results were processed with descriptive statistics and Cl was evaluated.Results: Beijing genotype was detected in 8 specimens of all the 113 isolated M.tuberculosis strains (7.1%, Cl 95%, 2.36-11.84). Out of 8 isolated specimens, 5 isolates belonged to Afghan patients and 3 specimens were isolated from Iranian patients. Out of 8 patients that were infected with Beijing genotype, 2 patients were male and 6 patients were female.Conclusion: Although the rate of Beijing family is low in Iran, in comparison to other Asian countries, however, one needs to adopt a suitable policy in order to prevent its spread.

Background and purpose: The objectives of this study were to evaluate the effect of super-ovulation with gonadotrophins, on implantation and fetal growth after blastocysts transfer into the mice uterine. We compared the rate of endometrial acceptance after various number of blastocyst transfer into each of the uterine`s horn in mice.Materials and Methods: NMRI female mice 2-3 months’ olds, were haphazardly divided into two control and experimental groups; and each was subsequently was divided into two groups,’ donor and recipient. All of donors and experimental recipients were super-ovulated with PMSG and hCG. 5 and 10 obtained blastocysts were then respectively transferred into left and right uterine horns of pseudo- pregnant recipients. All recipients were killed on the 14th. day of pregnancy and were evaluated from the rate of implantation and fetal weights.Results: No significant statistical differences were found in the grown fetal rate in super-ovulated recipients (6.1%), as compared with control recipients (7.3%). The grown fetal rate in the left horn of uterine were (13% in control recipients and 11.4% in super-ovulated recipients) was significantly higher than in the right horn (4.5% in control recipients and 3.5% in super- ovulated recipients). Furthermore, no significant statistical differences were found in the rate of not grown fetuses in super-ovulated recipients (10.4%), as compared with control recipients (12.3%). Moreover, no significant statistical differences were found in the mean weight of fetuses obtained from super ovulated- recipients as compared with that of fetuses obtained from the control recipients.Conclusion: No significant effect was observed with ovarian stimulation on the implantation rate and fetal growth. The capacity of uterine acceptance was decreased with added embryos.

Background and purpose: Obsessive-Compulsive Disorder (OCD) is a disease that appears to be under-diagnosed and under-treated despite the evidence for effective treatments. There are variable estimates of OCD prevalence (many studies reported that its prevalence is betwent 2% and 3% in general population). It is dependented to age, sex, marital status, socio-economic & educational state, in population.Materials and Methods: This method was a cross sectional descriptive study on high school girl students in Sari city. 3104 girls were selected and interviewed through randomized systematic & cluster sampling method from all high school girl students. The assessment was done by Muadsley obsession compulsive inventory & demographic inventory. After the data were analized by descriptive and qualitative methods.Results: 108 students were excluded then 2996 girls were entered in this study, 31.2% (936 individuals) had OCD and mean of their age was 16.22 ± 3.4. 30.7% of girls was first child, 35.1% of mothers & 34.7% of fathers had low educational class and low socio economic state.Conclusion: Prevalence of OCD in high school girl students was significant in sari city, and it was related to number of birth, family size, and low socio-economic and educational level.

Background and purpose: N-Acetylcysteine (NAC) has been found to reduce the risk of Contrast Induced Nephropathy (CIN) in chronic renal insufficiency after CT imaging with contrast enhancement. The purpose of the current study was to evaluate the efficacy of NAC, for the prevention of CIN in normal renal functioning patients undergoing coronary angiography.Materials and Methods: We prospectively studied 100 patients, who were undergoing coronary angiography with meglumin compound 76% (Urografin®), Patients were randomized one to two groups. Group one, IV hydration and NAC 600 mg PO were administered twice daily for 2 days (on the day prior to and on the day of coronary angiography). Group two, was administered IV hydration alone (Control Group).Results: One hundred patients completed the study. There was no significant difference between the group in baseline characteristics, duration of angiography, mean volume of contrast agent infused or in mean IV hydration. Contrast nephropathy developed in 30% of subjects. 11/50 (22%) in NAC group and 19/50 (38%) in control group (P= 0.12). In control group, the mean of Createnin Serum Level significantly increased 48 hours after administration of the contrast agent (P=0.001).Conclusion: Our findings do not support routine prophylactic administration of oral NAC as an adjunct to saline hydration for prevention of contrast induced nephropathy, in patients with normal kidney, undergoing coronary angiography.

Background and purpose: This study was undertaken to examine the reversibility of renal injury in the male New Zealand white rabbits, subsequent to a 90-days exposure to uranyl nitrate (UN) in the drinking water. Animals were exposed for 90 days to uranyl nitrate in their drinking water (24 or 500mg/l).  The control group was given municipal tap water.Materials and Methods: The biomarkers of kidney function measured in this study includedb-2 micro globulin (marker of tubular), micro albumin (marker of glomerular) and the marker for cell toxicity was catalase.Results: Excretion of b-2 micro globulin was to be significantly different and was correlated with uranium intake for rabbits in early weeks. Microalbuminuria was found to be significantly different but this different was within normal range. Catalasuria was not significantly different in this study.Conclusion: These results suggest that chronic ingestion of uranium in the drinking water affects kidney function and is related to the proximal tubule, rather than glomerul.

Background and purpose: Dairy products often associated with problems such as short shelf life and poor hygiene control. A novel approach is to utilize bacteriocin or bacteriocin producer strains, to control undesirable micro flora as Listeria monocytogenes and Bacillus cereus in foods. Hence, we studied the effect of nisin like producing Lactococcus lactis against Listeria monocytogenes and Bacillus cereus, in order to compare the isolated strain within different countries.Materials and Methods: In this research we studied the effect of nisin like producing Lactococcus lactis, with producer spot test method. We also used supernatant from 24 h culture of Lactoccus lactis. Moreover, we studied the effect of bacteriocin on Listeria monocytogenes and Bacillus cereus growth curves. Results: The growth of both strains was inhibited by the bacteriocin. Conclusion: According to our results, the bacteriocin could be used in liquid food with bacteriocin added directly or as a starter culture in fermentation. This would inhibit the growth of Listeria monocytogenes; furthermore, Bacillus cereus is used to reduce food poisoning for fermented food products.

Cornelia De Lange is a rare congenital syndrome with multiple anomalies including; Facial dysmorphism, hirsutism, height, weight and head circumflex retardations, cardiac defects, gastrointestinal and renal defects and extremity anomaly. Prevalence of this syndrome is 1 to 30000 or 1 to 50000. The diagnosis of this syndrome is based on clinical evidence. Genetic foundation is known to have two forms including dominant autosomal and is X linked. Often mutations are NIPBL and SMC1L1. The aim of this paper is to show a case of Cornelia De Lange syndrome.