JOURNAL OF ISFAHAN MEDICAL SCHOOL (I.U.M.S)
Year:2016 | Volume:34 | Issue:387|Papers Count:8

Background: Crescentic glomerulonephritis results from proliferating cells in Bowman's capsule and formation of crescents. It is classified in three major groups: Anti-Glomerular basement membrane (anti GBM) antibody mediated, Immune-complex mediated, and antineutrophil cytoplasmic antibody (ANCA) -associated glomerulonephritis.Methods: This is a cross-sectional study of 87 biopsy-proven cases of crescentic glomerulonephritis during 2011-2015 in a single center. They were classified into six groups: Lupus nephritis, Immunoglobulin A (IgA) nephropathy, ANCA-associated glomerulonephritis (containing of cANCA and pANCA vasculitis), Goodpasture syndrome, Cryoglobulinemia, and Poststreptococcal glomerulonephritis (PSGN).Findings: Of 87 renal biopsy, 62% were males. The mean age in all patients groups was 36±17 years.Frequency distribution of the groups in our study were as follow: IgA nephropathy (41.3%), Lupus nephritis (36.7%), ANCA-associated glomerulonephritis (16%), Goodpasture syndrome (2.2%), Cryoglobulinemia (2.2%), and PSGN (1.1%). Mean and median of serum creatinine and proteinuria were 2±1 mg/dl (Median=1mg/dl) and 1930 ± 830 mg/day (Median=2000mg/day). In this study, we found a significant positive correlation between the number of crescents and age (P<0.001), additionally we found a positive association between the proportion of crescents and serum creatinine (P=0.007), however, there were no significant correlation between the proportion of crescents and proteinuria (P>0.050).Conclusion: This study reveals the importance of relationship between the proportion of crescents and serum creatinine. Therefore the proportion of crescents may influence the prognosis of the disease. This research approved most prevalence reason for crescentic glomerulonephritis was IgA nephropathy. This study shows the role of renal biopsy in early diagnosis of crescentic glomerulonephritis while this study showed the positive correlation between crescents and serum creatinine.

Background: Regulatory CD4+Foxp3+T cells (Tregs) play an important role in the prevention of autoimmune disease. It is also suggested that in multiple sclerosis (MS), a central nervous system disease, an aberrant Treg function may play a role. Lymphocyte activation gene3 (LAG-3) as a surface marker of Treg cells with negative regulation of the immune system can effectively encounter with effector lymphocytes. In this study, we evaluated frequency of CD4+Foxp3+LAG-3+T cells before and after treatment with Fingolimod.Methods: Blood samples was obtained from 20 patients with multiple sclerosis before and after 1 months of Fingolimod treatment, and from 12 age-matched healthy control subjects. Then pripheral blood mononuclear cell (PBMCs) were isolated and the frequency of Treg cells expressing LAG-3 were determined by flowcytometry.Findings: The frequency of CD4+Foxp3+LAG3+T cells in the peripheral blood of MS patients was increased when compared to baseline (P=0.005).Conclusion: Our findings suggested that Fingolimod not only increases CD4+Foxp3+Treg cells, but also is able to enhance expression of LAG-3 on their surface. This is a new finding for the Fingolimod on the immune system.

Background: Valproic acid is a wide spectrum drug in treatment of different types of epilepsy and migrainedis orders. However, few studies have been conducted concerning drug-related side effects and their importance, particularly among Iranian children.Methods: This prospective study was performed on 217 children aged 2 to 15 years old during 2014-15. Simple sampling was used to select children referred to pediatric neurologist in special clinic of medical university of Isfahan, Iran. Required data including demographic data, cause and dose and duration of using sodium valproate and drug-related side effects were collected. One case developed acute pancreatitis and 2 patients passed away.Findings: Out of 217 subjects, most common complication was weight gain in 112 patients (51.6%). Increasing appetite (31.8%), abdominal pain (16.1%), headache (6.0%) and educational decrease (4.1%) significantly related to increasing age and improving mood state (5.1%) related to decreasing age (P=0.036). Vomiting (3.2%) and thrombocytopenia (1.8%) related to increasing dose of valproate (respectively, P=0.0001, P=0.020). Other complications were not associated with age and drug's dose.Conclusion: Serious adverse reactions of sodium valproate as an antiepileptic drug is rare but physician shouldbe careful about alarming signs in children to prevent severe complications.

Background: Milk is an important component of the food pyramid and can provide a lot of human daily nutritional needs. Dairy products can be contaminated to various bacteria and fungi. This study aimed to investigate the contamination of traditional and industrial milk and dairy products in Isfahan, Iran, and also identification of molds by using phenotypic methods.Methods: 155 samples were randomly collected in Isfahan. Specimens were identified by phenotypic tests and data was analyzed using the SPSS software.Findings: There was no relationship between traditional and commercial contamination of dairy products with coliform and Escherichia coli (P=0.79). Penicillium spp. and Candida orthopsilosis had the most (33.5%) and the least (1.2%) prevalence among isolates, respectively. Majority of molds were isolated from cheese and yogurt. The average contamination of mold in traditional products is significantly higher than commercial products (P<0.001).Conclusion: Sanitation and apply appropriate standards for dairy products in order to prevent secondary contamination and health standards in traditional units need to be ensuring the safety of dairy products.

Background: Many factors are involved in the failure rate of dacryocystorhinostomy (DCR) surgery as the standard treatment of nasolacrimal duct obstruction. There is however, a lot of evidence that bevacizumab (Avastin) with less side effects, has the same anti-fibrosis effects. In this study we evaluated the effect of this drug on the failure rate of DCR.Methods: 60 candidates for DCR were divided to two groups each one containing 30 patients. These 2 groups were matched by age and sex. We used Avastin eye-drops (5 mg/ml) every 6 hours in one group for 2 weeks in addition to other post-op routine treatments. The patients were evaluated for failure of DCR 2 weeks and 3 months after surgery.Findings: In the Avasin group no patient showed surgery failure. In the other group, 1 patient in 2 week and 2 patients in 3 months follow-up showed failure. However this difference between 2 groups was not statistically significant and maybe due to small sample size. (P=0.327, Fisher exact test).Conclusion: Avastin eye drop may lower the failure rate of DCR. This subject needs to be more evaluated in further studies.