JOURNAL OF ISFAHAN MEDICAL SCHOOL (I.U.M.S)
Year:2010 | Volume:27 | Issue:101|Papers Count:10

Background: There are some evidences in Iranian traditional medicine that solenanthus circinnatus has been used for pain and inflammation relief. In this study, we investigated the root's hydroalcholic extract of this plant in experimental models of acute and chronic pain compare to analgesic effect of sodium salicylate. Methods: Root extract were prepared using percolation method. Different doses of root extract (100, 200, 300 mg/kg i.p) and sodium salicylate (300 mg/kg i.p) were given. The analgesic activity was assessed in experimental models of acute pain (Tail flick test) and chronic pain (used formalin test).Findings: All doses of extract and sodium salicylate had more analgesic effect than control group in Tail flick test (P<0.05). Among mentioned extract, the dose of 300 mg/kg and sodium salicylate had a significant antinocieptive effect to control group in both of phase formalin test (P<0.05). By comparison of the analgesic effect of sodium salicylate and extract (at the dose of 300 mg/kg in formalin test and 200 mg/kg in Tail flick test) no significant difference was found.Conclusion: It seems that solenanthus circinnatus induces its inhibitory effect on acute and chronic pain.

Background: Tibial diaphyseal fracture is the most common fracture of long bones. Reamed intramedullary nailing is the method of choice for internal fixation of closed fractures. In Iran, plating and unreamed tibial nailing (UTN) are the most commonly used methods; because of paucity of equipments such as c-arm and reaming sets the reamed method is rarely used. This study compared the results of these two methods in the treatment of uncomminuted closed tibial shaft fractures.Methods: A randomized clinical trial study including 100 patients (78 males, 22 females; mean age 24 years; range 16 to 50 years) was performed. Fifty patients were in unreamed locked intramedullary nailing and plate-screw groups. The patients were evaluated with regard to the union time and complications after a mean follow up of 16 months (12-20 months).Findings: The mean time to union was 16 weeks in the UTN group and 14.3 weeks in the plate-screw fixation group (P>0.05). There were 4 (8%) and 3 (6%) non-union after UTN and plating respectively (P>0.05). Plain radiographs showed angulation in 3 patients in each group, all of them were in distal third fractures and in varus (6%). There was no infection after UTN but one superficial infection after osteosynthesis with plate and screw (2%). 4 patients after UTN and 3 patients after fixation with platescrew required reoperation (8% versus 6%).Conclusion: Plate-screw osteosynthesis yields satisfactory results in uncomminuted closed fractures of the tibial shaft and has comparable results with UTN.

Background: The aim of this study was to investigate the effect of 8 weeks regular corrective exercise on spinal columns deformities, such as kyphosis, scoliosis and lumbar lordosis, in girl students.Methods: 150 girl students in Jiroft city, aged 12-14 year, participated in this study. The subjects were examined twice in beginning and after 8 weeks of corrective exercise. Spinal column deformities were measured by grid plane, plumb line and other relevant testes. Co-variation test was used to analysis the data.Findings: In 12 year-old subjets the degree of kyphosis and scoliosis in post-test were lower than pre-test and differences were significant (F=28.5, P<0.001 and F=100, P<0.001, respectively), but in lordosis deformity differences were not significant (F=3.32, P≥0.05). The differences between pre and post measurents of kyphosis and scoliosis in 13 year-old subjects were significant (F=39.7, P<0.001, F=47.8 and P<0.001, respectively) but in lordosis deformity differences were not significant (P≥0.05, F=3.34). Finally in 14 year-old subjects for kyphosis, scoliosis and lumbar lordosis, differences between pre and post measurents were significant (F=7.9, P<0.001, F=112.4, P<0.001, and F=16.6, P=0.009, respectively). Conclusion: It seems that corrective exercise is the safe and valuable method to correct spinal deformities such as kyphosis, scoliosis, and lumbar lordosis and it can decrease the old age problems and disabilities.

Background: Soluble FAS (sFAS) is an apoptosis "programmed cell death" marker and results from shedding of FAS molecules during activation of FAS mediated apoptosis. There are several important reasons that Apoptosis is deregulated in active systemic lupus erythematosus and FAS is over expressed by T-cells; although the role of its soluble form (sFas) is unclear. We have investigated the correlation between serum levels of sFAS and active organ damages in lupus patients.Methods: Our study was performed on 114 systemic lupus erythematosus patients, compared with 50 randomly selected sex-, age- and race-matched healthy controls. The patients were randomly selected in different phases of disease activity. All the physical examinations and laboratory parameters were collected for determination of the SLEDAI index. sFAS, Antids DNA, C3, and C4 levels were determined using a commercially available ELISA kit.Findings: There was a significant difference between serum levels of sFAS in the case and control groups (P=0.001). We found a significant correlation coefficient between the sFAS and SLEDAI2K variables (P=0.001, r=0.494). It was a significant statistical difference between serum levels of sFAS in patients with rising in amount of proteinuria more than 0.5 g/l in 24h urine sample collection and without it (P=0.04), and central nervous system (CNS) damage versus normal CNS patients (P=0.006). It was not difference between sFAS and cardiac damage (P=0.05) but it was near significant difference.Conclusion: We found a correlation between sFAS serum levels and central nervous system involvement and rising in amounts of proteinuria in systemic lupus erythematosus patients.

Background: According to self-regulation model of Leventhal, medical patients construct schematic representations of illness which may impact on various dimensions of their adjustment with the medical condition. The purpose of this study was to exam the relationship of the history of hypertension and illness representations among post-myocardial infarction patients.Methods: One hundred and seventy six consecutive patients following myocardial infarction admitted to the CCU wards were selected based on the inclusive and exclusive criteria. Data obtained by using demographic questionnaire, Brief Illness Perception questionnaire (B-IPQ) and Beck Depression Inventory-II. Their medical data were obtained from medical records and history of hypertension was confirmed by cardiologist based on information recorded, history of patient and taking medications for hypertension. Therefore, the patients were divided into two groups with and without previous hypertension. c2 test, student’s t-test, MANCOVA and Covariance were used to analyze the data.Findings: 30.7% had history of hypertension. A significant difference was seen between two groups in B-IPQ scores (F=2.501, P=0.033). Also, it showed significant differences in two dimensions of controllability/ treatability (F=5.45 P=0.026) and consequences (F=5.054, P=0.026). However, there were no significant differences in identity (F=1.262, P=0.228) and timeline (F=0.261, P=0.549) between two groups. Conclusion: Generally, the findings confirmed that the post-myocardial infarction patients with history of hypertension explain their cardiac attack as a more adverse event than those without history of hypertension. Also having previous hypertension may be associated with patient`s perception of consequences and controllability/treatability of myocardial infarction. However, these findings did not support such link with perception of identity and timeline of the disease. Thus, the post MI patients with history of hypertension likely develop negative schema about some dimensions of cardiac attack.

Background: Cardiac troponin I was found to be a sensitive and high specific marker of myocardial injury even in the pediatric population. This study aimed to elucidate the value of serum cardiac troponin I level after cardio-pulmonary bypass and effect of the time of aortic clamp duration on troponin I level.Methods: In this descriptive cross-sectional study, serum troponin I level measured before, 0.5 and 24 hours after open heart surgery in one hundred pediatric patients (58 female and 42 male) with mean age of 4.5 years old (15 month to 19 years) undergoing elective open heart surgery for congenital heart disease in Tehran Shahid Rajaei cardiovascular hospital. Patients’ demographic data, surgical procedure, length of intensive care unit stay, inotropic support requirement and their duration of endotracheal intubations and aortic cross clamping time on the troponin level were recorded.Findings: Baseline serum troponin level's were less than 0.1 mg/mm, stay of intensive care unit was significantly higher in patients with high troponin I level at 0.5 and 24 hour after surgery (P=0.005, r=0.275 and P=0.001, r=0.543, respectively). Troponin I level 0.5 and 24 hour after surgery was strongly related to intubation time (P=0.004, r=0.258 and P=0.001, r=0.473, respectively). Only Troponin I level's in 24 hour after surgery remained significantly predicative of need to Inotropic Agents (P=0.001, r=0.637). There was strongly relation between time of cardio pulmonary by-pass and troponin levels 0.5 and 24 hour after surgery (P=0.001, r=0.320 and P=0.019, r=0.235, respectively). However, aortic cross clamping time affect to troponin I level only 0.5 hour after surgery (P=0.001, r=0.402). Conclusion: Evaluation of the cardiac troponin I level in patient undergone open heart surgery represent acute myocardial damage, allows further stratification of risk when combined with standard measures. Post operative troponin I level predicts length of intensive care unit stay, need for inotropic agents, and length of need for inotropic agents and intubation time.

Background: Visual impairments affect child development and limit their social activity, education and future life. In this study, the prevalence of visual impairments was determined among school-aged children in a screening program.Methods: All first and third grade students in primary schools, first grade students in secondary and high schools related to Iranian universities of medical science were selected. The data were gathered by universities in 2007. Findings: The prevalence of visual impairments was 4.7% and 3.8% in first grade and third grade students in primary schools. It was 5.8% and 4.1% in first grade students in secondary and high schools respectively. The highest prevalence (10.59%) was reported from Kermanshah University of Medical Sciences.Conclusion: It is considered more detailed interventions are necessary, especially in high prevalence regions, to determine the different types of visual impairments and their risk factors.

Background: Wegener is a granulomatous necrotizing vasculitis characterized by a predilection to affect the upper and lower respiratory tracts and, in most cases, the kidneys.Case Report: Our case was a 20-year-old female with a history of common-cold like signs and symptoms in October 2007. At first, she was referred to a clinic of otolaryngology. By the clinical suspicion to sinusitis, she treated with co-amoxiclav; after 7 days, ear discharge was seen and with suspicion to acute otitis media the patient treated more. Despite of these problems, grippe and common-cold like symptoms was continued and then with suspicion to allergic rhinitis beclometason nasal spray and apo-citrizine tablet was started. In April 2008, she was complaining from knee, tarsal and hip arthralgia accompanied with maculopapular eruptions in distal of legs. In July 2008 sweating, weight loss and anemia was added to other problems and she referred to an oncology clinic and treated with blood infusion, vitamin B12, and folic acid. In October 2008, gastrointestinal symptoms including epigastric pain, hematemesis and vomiting added to other problems and she referred to a gastroenterologist and treated with pantoprazole and plasil. At last in December 2008, since the patient had arthritis of proximal interfalanges, hemoptesia, high ESR levels, and positive CRP, she referred to a rheumatologist and the patient sent to the Al-zahra hospital; after physical and laboratory examination, because of skin lesions, paranchymal lung disease, kidneys involvement, and presence of C-ANCA the diagnosis of Wegener was made and the patient treated with medical treatment.