Journal of Isfahan Medical School
Year:2013 | Volume:31 | Issue:229|Papers Count:6

Background: N-Acetylcystein (NAC) is a thiol compound with antioxidant effect that can be effective in cancer, cardiovascular disease, HIV infection, and organ toxicity. Cisplatin is widely used in clinics, and the common side effect of this drug is nephrotoxicity that can be also gender related. In order to prevent cisplatin induced nephrotoxicity, antioxidants supplementation is suggested; therefore, the main objective of this study was to determine the preventive role of NAC on cisplatin-induced nephrotoxicity in male and female rats.Methods: 40 Wistar rats of both sexes were studied in six groups. Male rats received a single dose of cisplatin (7 mg/kg) at first day and 600 (group 1) and 300 (group 2) mg/kg/day NAC and saline (group 3) for a period of one week, intraperitoneally. Female rats in the groups 4 to 6 were received similar regimen as the groups 1 to 3, respectively. Before-and after-study serum levels of blood urea nitrogen (BUN), creatinine (Cr), nitric oxide metabolite (nitrite), and magnesium (Mg), and after-study serum levels of superoxide dismutase (SOD) and malondialdehyde (MDA) was measured. The kidney was subjected to pathological investigation to determine the intensity of kidney tissue damage.Findings: No significant difference in the serum levels of MDA, Cr, BUN, nitrite and Mg were observed between the groups not only in male groups but also in female rats. However, the serum level of SOD was significantly different between the groups (P<0.05). Lack of kidney tissue damage difference between the groups in two different sexes confirmed the ineffectiveness of intraperitoneal administration of NAC to prevent cisplatin-induced nephrotoxicity.Conclusion: The intraperitoneal administration of NAC, as a potent antioxidant, did not protect the kidney against cisplatin-induced nephrotoxicty in male and female rats.

Background: One of the most important environmental risk factors for kidney cancer is occupational exposure to chemical carcinogens. Since the Isfahan province is one of the major industrial centers in Iran and various chemical industries operating in the province, this study was conducted to determine the association of kidney cancer and occupation.Methods: This case-control study was conducted in 2012 in Isfahan, Iran. Patients with cancer diagnosed between 2002 and 2010 were considered as the case group (n=180); one group of age and sex matched healthy persons were considered as controls (n=452). Demographic and employment data were gathered from the hospital records of patients; in the absence of sufficient information, the patient's family was contacted.Findings: In the patient and control groups there were 24 and 44 labors, 24 and 101 employees, 46 and 114 self-employed, 58 and 123 households, 26 and 47 farmer and rancher, and 4 and 23 other jobs, respectively (P=0.017). Of the case group, 34.4% and of the controls, 25.7% were in contact with chemical agents for more than 5 years in place of working (P=0.027). In the patient group, 32.1% were in contact with fertilizer, 46.6% with color, and 14.3% with chemical warfare agents, while in the control group 21.1% were in contact with fertilizer, 12.8% with color, 14.7% with oil, and 14.7% with synthetic chemicals (P<0.001).Conclusion: Exposure to various chemicals in patients with kidney cancer in Isfahan is one of the risk factors for kidney cancer. Given the known carcinogenic effects of various chemicals, it is necessary to assign specific rules and improve occupational health in industry regarding exposure of workers to chemical agents and to conduct periodical tests.

Background: At this study, we aimed to compare the urinary value of N-acetyl-b-D-glucosaminidase (NAG) with b2-microglobulinuria (b2M) to find the best marker for early diagnosis of acute kidney damage in children. These markers were used instead of routine evaluations of renal function tests such as creatinine (Cr).Methods: This study was conducted on 80 pediatric patients with the age range of 3 to 16 years old. They were categorized into patients with glomerular disease, tubular disease, and finally patients who had urological problems. Urinary NAG, b2M and Cr were measured. The ratio of NAG/Cr and b2M/Cr was compared between the groups. For analysis, one way ANOVA, chi-square, post-hoc least significant difference (LSD) and receiver operating characteristic (ROC) curve were used.Findings: The mean of NAG/Cr in glomerular disease group was significantly more than the other groups (P<0.05). There was no significant difference of NAG/Cr between two groups of tubular disease and urological disease patients’ group (P>0.05). The mean of NAG/Cr in two groups of patients with tubular and urological disease was more than control group (P>0.05). In patients with glomerular disease group, the mean of b2M/Cr ration was more than other groups. Besides, the mean of b2M/Cr in two groups of patients with tubular and urological disease was more than control group (P>0.05). In all groups, the diagnostic value of NAG/Cr was more than b2M/Cr.Conclusion: Urinary measurement of NAG/Cr is a simple, cost benefit and non-invasive method which can be used to detect early stages of renal injury such as glomerular, tubular or urological problems.

Background: The children with nephrotic syndrome suffer from various complications such as nutritional deprivations, frequent hospitalization and drug side-effects. In this study, we aimed to evaluate the quality of life in children with nephrotic syndrome who have not been progressing to end-stage renal disease (ESRD) yet.Methods: In this cross-sectional study, after receiving written consent from both child and his/her parents, children who have nephrotic syndrome, with age of less than 18 years and glomerular filtration rate (GFR) of more than 90 ml/min, were entered. PedsQL Tm 4.0 generic core scale was used for data recording. Demographic and laboratory data, as well as drugs history and period of disease and being responsive or irresponsive to steroids, were recorded and analyzed either.Findings: 25.3% were between 2 to 4 years, 42.7% between 5 to 7 years, 21.3% between 8 to 12 years, and 10.6% were between 13 to 18 years. There was significant statistical difference among groups regarding physical, emotional, social and school performance. The differences between groups were analyzed and the most significant difference was among the children of 5 to 7 years old when considering quality of life in social and school performance. But, we did not find any co-relation between the measured quality of life and paraclinical data.Conclusion: In this study, we concluded that children with nephrotic syndrome need more attention regarding social activities to help them in improving their quality of life.

Background: Dizziness is one of the most commonly occurring chief complaints in neurology. The aim of this study was to differentiate patients with dizziness according to organic and somatoform vertigo and evaluate the relationship of dizziness/vertigo symptoms with psychological symptoms in patients with chronic vertigo and dizziness.Methods: This multicenter, cross-sectional study was conducted on 18- to 65-year-old referred to two neurology outpatient clinics in the city of Isfahan, Iran, during 2012-2013. Patients completed the symptom check-list (SCL-90-R), and vertigo symptom scale-short form (VSS-SF).Findings: During the study period, 179 patients (mean age: 30.9±0.1 years, 81.7% women) were included. In 74.3% of the patients (n=133) dizziness was of organic and in 25.7% (n=46) of nonorganic origin. Compared with the organic group, the patients with nonorganic dizziness had much more scores on SCL-90-R.Conclusion: The results indicates that psychological symptoms are associated with dizziness symptoms in patients with psychiatric disorders and it should be included in the differential diagnosis in patients with chronic dizziness. Hence, in cases of dizziness disorders, early interdisciplinary cooperation is both helpful and essential during diagnostic work-up to include signs of somatic and psychosomatic origin and perevent chronification and reduce the severe handicap, and incurring high medical costs.