Journal of Isfahan Medical School
Year:2011 | Volume:29 | Issue:155|Papers Count:7

Background: Many studies in various populations showed the correlation between the level of CA-125, CA15-3, CA19-9 and a.Fetoprotein with the stage of liver fibrosis in chronic hepatitis and cirrhosis. This study was done to evaluate this correlation in Iranian community.Methods: This cross–sectional study was performed on 30 patients with chronic hepatitis that referred for liver biopsy to the gastroenterology department of Isfahan Alzahra hospital from September 2009 to September 2010. Clinical data and routine laboratory tests at the time of liver biopsy were collected, and serum AST, ALT, CA-125, CA15-3, CA19-9 anda.Fetoprotein levels were assayed. Fibrosis staging was assigned according to the HAI (Histological activity index). Data were analyzed by multivariant logistic regression, Spearman’s Ranke Correlation Coefficient, and generalized linear model tests.Findings: Increased CA15-3, CA19-9 and a.Fetoprotein levels were correlated significantly with liver fibrosis staging (P value was 0.008 and 0.004 and 0.038 respectively). We did not find a significant correlation between serum level of CA125 and liver fibrosis staging (P=0.079).Conclusion: Our findings suggested that elevated CA15-3, CA19-9 and a.Fetoprotein levels were associated with advanced fibrosis. Because of small sample size, we can not recommend these tumor markers as a tool for diagnosis of liver fibrosis staging. But it should be considered that elevation of mentioned markers in patients with advance cirrhosis necessarily does not mean the presence of concomitant malignant tumor.

Background: The purpose of the present study was to determine the effectiveness of nutrition education program based on the BASNEF (Belief, Attitude, Subjective Norm and Enabling Factors) model among elderly subjects above 60 years old with type 2 diabetes.Methods: In this study, 100 diabetic elderly (≥ 60 years) patients were divided into intervention and control groups randomly. Data of control and intervention groups was collected in two stages, before intervention and 12 weeks after intervention. Intervention of nutritional education was performed based on baseline assessment and BASNEF model. Finally, data were analyzed by using c2, Student’s t and paired t-test.Findings: Our findings indicated that mean scores of knowledge and BASNEF model variables were significantly increased in the intervention group compared to the controls after intervention (P<0.001). Also, behavioral nutrition improved significantly. The number of serving’s intake, regarding the fruit and vegetable, has been increased significantly in the intervention group (P<0.001).HbA1c and fasting blood sugar (FBS) levels decreased significantly in the intervention group (-0.36% and 19.5 mg/dl, respectively).Conclusion: BASNEF–based nutrition education intervention led to improve nutritional behaviors in addition to improve knowledge and attitude of diabetic elderly and it led to improve indices of glucose control during 3-month intervention.

Background: Tympanoplasty is done to eradicate ear pathology and to restore the conductive hearing mechanism. The relapse of disease is seen after using Temporalis fascia, as graft, in this surgery. Cartilage is of the materials that can be used to enhance graft. This study was done to evaluate hearing after homograft cartilage tympanoplasty.Methods: This clinical trial study conducted in Alzahra hospital in Isfahan, Iran.40 patients with recurrent perforation, retraction pocket and cholestatoma were operated by homograft cartilage tympanoplasty method. The audiometery was down for all of the patients before and after tympanoplasty.All patients were followed up for at least 6 months. The data was analyzed by SPSS software using Student’s t, paired t and ANOVA tests.Findings: After at least 6 months of surgery, there was not any case of perforation or cholestatoma recurrency. The change in range of 500, 1000, 2000 and 4000 frequency was 5.9 ± 1.9, 5.9 ± 1.6, 4.6 ± 1.6 and 3.8 ± 1.6 respectively and the difference between before and after surgery was statistically significant. In the other word, audiometry revealed improvement at all frequencies.Conclusion: Homograft cartilage tympanoplasty prevents perforation, cholestatoma and retraction paket recurancy after surgery. Hearing results were good.

Background: In conventional methods of surgical debridement for deep burn wounds, application of pre and post-operative antibiotics is a routine prescription in many centers. But, recently some new ideas indicate that decreasing antibiotics prescription has the same or better clinical results. This study evaluates the role of antibiotics in the management of burn wound which require surgical debridement.Methods: In this clinical trial, 214 patients with deep (3rd degree and deep 2nd degree) burn and total body surface area (TBSA) between 35 to 50% were randomly divided in control (105 patients) and intervention (109 patients) groups. In intervention group, only a pre-operative single dose of ceftazidme was prescribed. But in control group, pre and post-operative antibiotics was administered for 7 days. Sign and symptom of infection and tissue culture were compared in 2 groups for detection of wound infection.Findings: The incidence of wound infection was 28% in intervention group and 26.5% in control group (P>0.05). The other benefits of single dose pre-operative antibiotic therapy were decrease in antibiotic resistant germs, the cost, and the time for nursing care.Conclusion: In deep burn wounds with total body surface area of less than 50%, application of single dose pre-operative antibiotic do not increase the risk of infection and can also decrease the final cost, multi-drug resistant bacteria production, and spent time in nursing care. As a result of this investigation, single dose pre-operative ceftazidme is recommended for all burned patients with less than 50% of total body surface area.

Background: Rheumatoid arthritis (RA) is defines as a Th1 dominant disease. Tregs cell are a rather new group of T cells that regulates other immune cells including Th1 and Th2. Foxp3 is a lineagedetermining factor for Treg cells. Several subsets of Foxp3+regulatory T cells are ever identified. In this study we investigated the frequency of CD4+Foxp3+Treg and CD8+Foxp3+Treg cells in patients with rheumatoid arthritis.Methods: Peripheral blood samples were obtained from 31 patients with rheumatoid arthritis and 21 healthy controls. Monoclonal antibodies including anti-CD4 and anti-CD8 and anti-Foxp3 were used and the staining process was performed. Flow cytometry were applied to evaluate the markers.Findings: The percentage of CD4+Foxp3+Treg cells was 1.03% ± 0.28 % in rheumatoid arthritis and 1.25% ± 0.3% in control group (P=0.010). The percentage of CD8+Foxp3+Treg cells was 0.79 ± 0.18, and 0.63 ± 0.16 in rheumatoid arthritis and control groups respectively (P=0.002). The WBC and Lymphocytes population in rheumatoid arthritis group were higher than control group (P=0.001).Conclusion: These data demonstrate that frequency of Treg cells might be involved in the pathogenesis of rheumatoid arthritis. This may be a contributory factor in the susceptibility to rheumatoid arthritis (Th1 dominant), or it may achieved during the progression of the disease.