Journal of Isfahan Medical School
Year:2014 | Volume:31 | Issue:267|Papers Count:7

Background: Carpal tunnel syndrome is a common condition in which the median nerve passes through the carpal tunnel is compressed. Then, gradual paralysis occurs. This study aimed to compare patient outcomes after surgery for carpal tunnel syndrome in both groups with and without splint.Methods: This study was conducted in Isfahan University of Medical Sciences, Iran, in Kashani hospital during 2011.64 patients underwent surgery for carpal tunnel syndrome were selected and randomly divided into two groups of 32. For the first group, splints were considered after the surgery and for the second group, as the control group, splint was not given. Patients within 3, 6 and 12 weeks after surgery were followed and healing in the sense of motion and pain based on the visual analogue scale (VAS) measures were examined.Findings: Sensory conflict scores at the 3rd and 6th weeks in the group with splint were higher than the group without it; but, 12 weeks after the treatment, the results were identical. In any cases, motor involvement was not seen. At the 3rd week after the treatment, the mean pain score in the group without splint was higher than with splint group. The results of the 6th week after the treatment in both groups were almost identical; but, at the 12th week after the treatment, changes in pain intensity was not significantly different between the two groups (P=0.97).Conclusion: Splinting after the surgical release of the median nerve probably causes a delay in the recovery of sensory, motor and pain; but due to the effect of material of used splint, the result is still uncertain and further broader interventions needs to be done in this regard.

Background: Lipoxygenase enzymes play an important role in various mechanisms of organisms. So far, many studies on human and other organisms lipoxygenase activity have been conducted. In eukaryotes, this enzyme converts arachidonic acid to a variety of inflammatory mediators. For example, leukotrienes are products of this enzyme reaction. This inflammatory mediator plays an important role in the healing process. Recent studies have shown that the lipoxygenase enzyme extracted from an amphibious (Ambystoma mexicanum) is more effective in the healing process in comparison with human lipoxygenase. Like in the case of other enzymes, the first step for enzyme identification and characterization is to produce a large amount of purified enzyme, but the recombinant production of these proteins in bacterial expression system has not yet been reported. Therefore, in the present study we have cloned and expressed lipoxygenase axolotls (LOXe) in Escherichia coli (E. coli) BL21.Methods: The sequence encoding LOXe was designed based on the amino acid sequence of the protein and then, codon optimized in order to ensure the maximum expression in E. coli. At the next step, the synthetic DNA encoding LOXe inserted into the pUC57 vector using appropriate restriction sites and then, subcloned in the pET21-a, an expression vector in order to high production of the protein in bacteria. Recombinant vector transformed to E. coli BL21 as an expression host and expression of 71kDa protein LOXe (623 amino acids) was induced in the presence of IPTG (Isopropyl-beta-D-thiogalactopyranoside).Findings: The cloning of LOXe was performed successfully and possibility of expression of this enzyme in E. coli was confirmed.Conclusion: Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) analysis indicated that LOXe protein over-expressed successfully in E. coli cytoplasm.

Background: Cardiac rehabilitation improves functional capacity in cardiac patients after coronary artery bypass. The aim of this study was to compare the eight weeks of interval training with continuous training on stress test physiological variables in patient with cardiac diseases after coronary artery bypass graft (CABG) surgery.Methods: In this clinical trial study, 30 patient with cardiac diseases in Tehran Heart Center (Iran) having had CABG surgery were randomly divided into two groups, high-intensity interval and continuous moderate-intensity training (program common). The program of interval group was included 4 repeats × 4 minutes at 90-95% peak of heart rate (HR) and continuous group, 60-80 minute at 70-85% peak HR, three sessions per week for 8 weeks. Functional capacity (VO2 peak), distance traveled, time to exhaustion and maximum heart rate (HRmax) were assessed during the Bruce exercise stress test before and after the training program. The collected data were analyzed using the one-way analysis of variances (ANOVA) and post hoc Fisher's least significant difference (LSD) tests.Findings: Functional capacity was increased significantly following the both of training programs with no significant difference between the two groups (P<0.05). The increases in traveled distance, time to exhaustion, and HRmax after interval program were more in interval program group (P<0.05).Conclusion: It seems that both high-intensity interval and moderate-intensity continuous training improve functional capacity in cardiac patient with cardiac diseases after coronary artery bypass sugery. However, interval training was more beneficial than continuous training in some parameters such as traveled distance, time to exhaustion, and HRmax during exercise stress test.

Background: Laryngoscopy and endotracheal intubation are critical procedures and if the anthropometric indices of the patient leading to difficult intubation are not considered before the procedure, it can be accompanied by serious complications. One of the most practical concepts suggested about difficult intubation, is Cormack and Lehane criteria used in most medical centers.However, there is not any valuable study demonstrate the effect of anthropometric indices in difficult intubation and the immediate prediction of its complications. This study aimed to evaluate the correlation of anthropometric indices and hemodynamic changes after laryngoscopy and endotracheal intubation.Methods: This descriptive-analytic study was carried out in 2012 in Kashani hospital, Isfahan, Iran. 130 patients with fulfilling inclusion criteria were entered the study. The recorded data included age, weight, height, neck circumference, waist-to-hip ratio and body mass index. The difficulty of intubation was assessed when the patient was completely unconscious. The predictive role of obesity indices in difficult intubation and the cardiovascular changes after intubation was assessed using receiver operating characteristic (ROC) curve.Findings: The best cut-off point for body mass index (BMI) was 26.56; according to this cut-off point, the sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of BMI were 100, 38.84, 10.8 and 91.1 percent, respectively. The best cut-off point for neck circumference was 38; according to this cut-off point, the sensitivity, specificity, PPV and NPV of neck circumference were 7.85, 2.28, 2.45, 1.91 percent, respectively.Conclusion: BMI, neck circumference and waist-to-hip ratio are valuable in assessing difficult intubation and their value is mostly due to NPV. Therefore, we can achieve a significant NPV and sensitivity in assessment of difficult intubation by considering all these indices.

Telomere is a special structure protects the ends of human chromosomes to degrade. Telomere becomes shorter after each cycle of cell division. However, telomerase is an enzyme activated in cancer cells and germ lines rebuild telomere. However, apparently there is no correlation between telomere length and telomerase activity. The enzymatic activity of telomerase correlates with tumor malignancy. In general, telomerase activity and histological grade are too closely correlated and the results of studies indicate that telomerase activity may be an important malignancy marker in brain tumors. As a conclusion, we can say that activity of telomerase should be considered as a prognostic biological marker of response to treatment.