JOURNAL OF ISFAHAN MEDICAL SCHOOL (I.U.M.S)
Year:2016 | Volume:34 | Issue:390|Papers Count:6

Background: Considering the controversies regarding the association of vitamin D deficiency and disease activity in patients with systemic lupus erythematosus (SLE) and highly recommendations for investigating the effectiveness of this supplement on disease activity through interventional studies، we aimed to study the effectiveness of vitamin D administration on disease activity in patients with systemic lupus erythematosus and vitamin D deficiency.Methods: In this randomized double-blind placebo-controlled clinical trial، 90 patients with systemic lupus erythematosus were selected and randomly allocated in two groups of intervention (50000 unit vitamin D weekly for 12 weeks and then 50000 unit monthly for 6 months) and placebo. The levels of vitamin D and disease activity using Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) were measured and compared before and after intervention in two studied groups.Findings: There was a relationship between the serum level of vitamin D and disease activity before the study (r=0.26; P=0.019). But، after intervention، the correlation between serum level of vitamin D and disease activity was not significant (r=0.19; P=0.07).Conclusion: The findings of current study indicated that vitamin D administration have no significant effect on the disease activity in patients with systemic lupus erythematosus and vitamin D deficiency. According to our study، it is suggested that using vitamin D in patients with systemic lupus erythematosus could not have better outcomes in this regard. But، there are many unknown environmental or biological factors which are associated with the disease activity of systemic lupus erythematosus and are not identified yet.

Background: The aim of this study was to determine the prevalence of Cryptosporidium infection in patients with multiple sclerosis compared to control group in Isfahan city، Iran.Methods: In a case-control study، that was done in Alzahra hospital in Isfahan during 2015-2016، 50 multiple sclerotic and 50 healthy people were selected and the prevalence of Cryptosporidium in the two groups were detected by direct methods and concentration and compared between the two groups.Findings: Only 3 cases out of 100 were positive for Cryptosporidium SPP where one case was from control and 2 cases were from the case group (2 versus 4 percent). But، prevalence of Cryptosporidium in the two groups was not statistically different (P=0.56). Prevalence of this parasite in residence and domestic animal keeping had significant difference. 3 cases of positive were in rural areas and kept domestic animals on their houses (P<0.001).Conclusion: In this study، there was significant difference between this parasite and residence and keeping domestic animal.

Background: This study aimed to determine the prevalence and incidence of early and late complications of lumbar spine fusion surgery in Alzahra and Kashani hospitals، Isfahan city، Iran، during 2011-2015.Methods: In a cross-sectional study، all the patients undergoing lumbar spine fusion surgery from the early 2011 until the end of 2015 were studied for the early and late complications caused by spine fusion.Findings: In this study 326, patients were evaluated where 51 patients (15.6%) had postoperative complications. Type of complications included 4 cases (7.8%) of symptomatic hematoma، 9 cases (17.6%) of techal injury، 6 cases (11.8%) of decrease in muscle strength، 7 cases (13.7%) of fractures or displacement on instrument 15, cases (29.4%) of superficial and deep infection، 2 cases (9.3%) of deep vein thrombosis 2, cases (3.9%) of problem in screw place، 1 case (2%) of root damage and 5 cases of other complications.Conclusion: The incidence of postoperative complications in patients undergoing spine fusion is high and among the complications، infection was the most common early complication and force reduction is the highest late complication. Therefore، care is required after surgery and lifestyle modification and control of the underlying disease such as diabetes is a priority.

Background: This study was aimed to determine the effects of remifentanil، propofol and remifentanyle plus propofol on the sedation score among patients under phacoemulsification cataract surgery with local anesthesia and comparison with a control group.Methods: In a clinical trial study in 2015-2016, 140 candidates for cataract surgery with phacoemulsification method randomly divided in four groups of 35 patients. Propofol، remifentanil، propofol plus remifentanil and normal saline was injected during surgery in the groups and sedation score was measured during surgery and compared between the four groups.Findings: Sedation score in the before operation in Propofol، remifentanil، propofol plus remifentanil and normal saline was 3.31±0.87, 4.91±0.28, 2.97±0.75 and 4.97±0.30, respectively (P<0.001). Also sedation score at 30th min was 2.00±0.01, 3.40±0.55, 2.10±1.00 and 3.00±0.01, respectively (P=0.110). The mean changes of the sedation score in the four groups were different (P<0.001)Conclusion: Using remifentanil plus propofol in patients under phacoemulsification cataract surgery led to better sedation during surgery and lower post-operative pain. So، using both the drugs is recommended.

Background: Considering today's life، sports and physical activities are of special importance in people’s health. Athletes، as a unique part of the society، are very famous and children and teenagers look at them as heroes. But، they are at the risk of sudden death mainly because of unknown origin. Since there is little information about the causes of sudden death among the athletes in Iran، this study aimed to assess the causes of nontraumatic sudden death during sport activities in Isfahan province، Iran، according to the data of Isfahan Legal Medicine Organization.Methods: In this retrograde descriptive study، considering the data of Isfahan Legal Medicine Organization، 32942 file of the Division of Decedents from the years 2003 to 2013 were investigated; in some cases، the pathological samples were studied again to confirm the diagnosis and in some others، their families were asked to complete the data. Finally، the sample consisted of 30 cadavers (27 men and 3 women) who were divided to 2 groups of under and over the age of 35 years. Findings were presented using tables and charts.Findings: Hypertrophic cardiomyopathy (HCM) was the most common cause of death seen in 11 cases (37%)، 9 of them were of the group of under 35 years. Second prevalent cause was ischemic coronary atherosclerosis in 9 cases (30%)، 3 of were of the group of under 35 years. Mitral valve prolapse was seen in 2 cases (7%) both of the group of under 35 years. Coronary and cerebral arteries abnormalities each one were seen in one case (3%) both of the group of under 35 years where as myocardial dysplasia was seen in 1 case (3%) of the group over 35 years. Other causes were identified in 4 cases (13%) of the group of less than 35 years.Conclusion: Based on this study، the most common cause of nontraumatic sudden death during sport activities in Isfahan Province was severe coronary atherosclerosis for the ages of over 35 years hypertrophic cardiomyopathy for the ages of less than 35 years.