Journal of Shahrekord University of Medical Sciences
Year:2001 | Volume:3 | Issue:3|Papers Count:15

Effective radiotherapy requires high selectivity and cytotoxicity. An alpha emitting radio-immunoconjugate (RIC) was prepared and tested against malignant melanoma. The melanoma monoclonal antibody 9.2.27 was labeled with an alpha emitter, Bismuth-213 and a positron emitter, Terbium-152. Two-chelator agents cDTP Aa (cyclic anhydride of diethylene triamine pentaacetic acid) and a DTPA derivative, CHX-A (2-[p-isothiocyanatobenzyl] cyclohexyl), were used to obtain high labeling yields for both radioisotopes. The labeling efficiency with 213Bi was found to be 96% and 92% for cDTPAa and CHX-A respectively. With 152Tb, it was 93% and 89% respectively. Serum stability studies showed a maximum of 20% and 13% leaching for 213Bi and 152Tb respectively. Cell avidity studies showed no difference in cell-binding of the labeled and unlabeled antibodies. Cell survival data indicated that the therapeutic activity ratio with both radioisotopes for same endpoint (D0) was 120. The high stability and outstanding cytotoxicity of the alpha emitter, offers a new approach to the control of metastatic melanoma.

Oxidative stress is one of the known in vivo effects of phenytoin that could account for some of its side effects; Previous studies have shown a strong correlation between phenytoin free radicals induceds damage and its teratogenicity. In this study, the role of this pro-oxidative property in some other side effects of phenytoin has been investigated. Phenytoin sodium, or its vehicle, distilled water, was chronically administrated to groups of mice and rats by gastric gavage. Two hours before phenytoin administration, the animals also received one of the antioxidants: a-tocopherol acetate, ascorbic acid, sodium selenite or their vehicles, distilled water or olive oil, through the same route. At the end of chronic treatment period, the responsiveness of animals to myorelaxant effect of pancuronium, anesthetic activity of urethane and ketamine, serum sugar as well as transaminase levels and prothrombin time were examined. Chronic phenytoin treatment resulted in a significant resistance to pancuronium and urethane effects, while no difference in other measured parameters was observed between phenytoin received and respective control groups. Supplementation with any of the mentioned antioxidants significantly reversed the phenytoin-induced alterations in animal's responsiveness to pancuronium and urethane. Therefore phenytoin induced oxidative stress is a major contributor to at least some of its side effects and, antioxidants supplementation seems worthy to be investigated as a novel approach for reducing side effects of this drug.

Sufficient vision is essential for driving. However according to the traffic law, changing of driving license and vision test, must be done every ten years, which seems a long time especially for old drivers. The purpose of this survey was to investigate the prevalence of low vision drivers in Chaharmahal and Bakhtiary Province, during 1999 The study was, performed on 400 over 40 years old professional drivers, referred to an ophthalmologist for eye test as required for changing their driving licenses. The results showed that, 112 out of 400 had a binocular visual acuity less than 10.10, from which the vision of 95 persons was corrected using glasses. 17 persons failed to renew their license due to very low vision or incurable eye diseases. Since cars and buses perform most of the transportation in this country, eye test of professional drivers in shorter intervals may help to reduce the related risks.

Ketotifen is a benzocycloheptathiophene with a range of pharmacological activities including inhibitory effect on rat isolated uterus contractions induced by KCI, acetylcholine or oxytocin. As the inhibition of contractile overactivity of the uterus is the base of the treatment of pre-tenn labor, provided that similar effect will be seen in vivo, then ketotifen may have clinical benefits for treatment of this condition. Therefore, the aim of this study was to investigate the inhibitory effect of ketotifen and diazoxide on uterus contractions in conscious rats, in comparison with 132 adrenoceptor agonist, terbutaline and inhibitor of synthesis of prostaglandin (PG), diclofenac. For this purpose non-pregnant female Wistar rats (180-220 g) were anaesthetized with ketamine (75 mg/kg) and bilaterally ovariectomized. A micro-balloon was inserted into one of the uteri and a jugular vein was also cannulated. 24h later when rats were recovered from surgery and were freely feeding, drugs were delivered via jugular vein by an infusion pump and uterus contractions were recorded by connecting the micro-balloon tube to a pressure transducer. Blood pressure and heart rate were also assessed for same drug concentrations. Administration of terbutaline (400 µg/kg) had a quick inhibitory effect on uterus contraction and when infusion was completed (15 min) uterus contraction was reduced to 6±3% of the control value. This inhibitory effect persisted 2h after drug administration (36±15%). Diazoxide (45 mg/kg) also had an inhibitory effect on uterus contraction and at above times, contractions were reduced to 13±5% and 48±16% of the control values respectively. However, ketotifen even in high dose couldn't inhibit spontaneous uterus contraction in conscious rats and there was no significant differences between effect of saline and ketotifen (15 mg/kg). On the other hand, diclofenac (75 mg/kg) had a fine inhibitory effect on uterus contractions and at the end of the experiment, contraction was still 23±7% of the pre-drvg administration value. Ketotifen and diclofenac did not affect the blood pressure significantly, but diazoxide at this concentration reduced blood pressure. The inhibitory effect of diclofenac suggest that synthesis and release of PG has an important role in spontaneous contractions of rat uteru"s in this method and it is possible that ketotifen is unable to inhibit contractions induced by PG. It can be concluded that this method is a suitable way to investigate effects of drugs on uterus contraction due to release of PG in vivo, and since PG have a major role in induction of pre-term labor, ketotifen is not a suitable drug for control of pre-term uterus contractions.

Considering the high prevalence of hepatitis C and its undetermined routes of transmission in 35% of the cases, this survey was performed to find the rate of intrafamilial transmission among the families of thalassemic patients suffering from hepatitis C in Shahrekord, 1999. The tests of AL T and anti HCV antibody were carried out in 136 persons from 25 thalassemic families at two phases of 6 months apart. The average age of the sample was 22.4±14.3 and 51.5% were female. Five persons had contact with the patient's needle (needle stick). No rise in ALT was seen and all of the cases were anti HCV negative. Also, no case of hepatitis C was found among the families of thalassemic patients. In conclusion, intrafamilial transmission was not detected but due. to its possibility and since a great number of patients has no other risk factor, this transmission route could not be ignored.

Background: Pruritic skin disorders are one of the most common disorders in elderly. Objective: To find out the prevalence of pruritic skin disorders in the elderly residing in Kahrizak Institute in Tehran. Patients & Methods: In this descriptive, cross sectional survey, all the elderly over 60 years of age without dementia residing in Kahrizak Institute in Tehran in the first 6 months the year 1379 were studied for the presence of 9 pruritic skin disorders including xerosis, eczema, lichen simplex chronicus, infections, urticaria, insect bite and scabies, psonasls vulgaris, eruption and drug anogenital pruritus. Questionnaires were completed for persons who complained from pruritus, based on general examinations. Statistical analysis was done by using SPSS/PC software. Results: Out of 734 elderly included in the study, 161 (22%) had pruritus including 89 women (54%) and 72 men (46%). The most common cause of pruritus in both sexes were xerosis or senile pruritus. Eczemas were more common in males and the most common type was seborrheic dermatitis. Diabetes mellitus was the most common systemic disorder associated with pruritus. Conclusion: Pruritic skin disorders are very common in elderly. The responsible organizations must pay attention to this fact and plan better institution and medical facility for this precious group of our society.

This survey was performed on 19530 women admitted to public health centers of Chaharmahal and Bakhtiari province for annual papsmear test during 1995 to 1996. Smears were tested cytologicaly for possible infection with trichomonas vaginalis. The result revealed that the average infection rate of the whole sample was about 1.37%. The highest level of infection (3.4%) was among women living in Lordegan district. In contrast, the lowest level of infection (0.46%) was observed in women living in Shahrekord. Also the infection rates of various cities of the province were significantly different.

Background: Cutaneous leishmaniasis is a common parasitic disease in Isfahan province. A common complication of cutaneous leishmaniasis is bacterial superinfection which may intensify the disease and produce scarnng. Objective: The aim of this study was to determine the bacterial species isolated from infected lesions of cutaneous leishmaniasis. Patients & Methods: Two hundred out of 874 patients with cutaneous leishmaniasis referred to Dermatology and Leishmaniasis Research Center in Amin Hospital in Isfahan during four months (September to December 1999) who had of bacterial signs superinfection were studied by taking microbial cultures from their lesions. Results: Bacterial cultures were positive in 177 cases (20.7% of all patients and 88.5% of sampled patients). The isolated bacterias included S. aureus in 61.5%, S. epidermidis in 20.5%, E. coli in 3.5%, Proteus vulgaris in 1.5% and Klebsiella in 1.5%. Eighty seven percent of infected patients had ulcerative nodules. Bacterial superinfection was significantly more common in ulcerated lesions than non-ulcerated ones (P-value= 0.00001).

Candidiasis is an opportunistic fungal disease with several predisposing factors such as leukemia and lymphoma. Since immune system can play a major role in prevention of this disease, part of the relation between cellular immunity and candidiasis in leukemic and Iymphomatic patients was investigated in this study. The case group .consisted of 38 candidiasis patients which divided to 3 subgroups based on their suffering from one of the following diseases, myeloblastic or lymphonblastic leukemia and lymphoma. The control group consisted of 20 patients, suffering from one of the leukemic diseases or lymphoma, but not from candidiasis. Blood samples were taken from both groups and number as well as type of Iymphocytes was examined using the flow cytometric method. Statistical comparison was performed using Z and t-test. The results showed that, the averages of T cells and CD4 lymphocytes were significantly (P<0.05) lower in myeloblastic patients compared to those of control group. It seems that the lower counts of T and CD4 lymphocytes in case group, are the predisposing factors for candidiasis, since these lymphocytes play a major role in prevention of candidiasis.

Lateral labial melanocytic nevus or mole has cosmetic value among young or middle aged Iranian ladies particularly those with fair complexion. I describe autotransplantation of a melanocytic nevus from a remote area of the body to lateral labial skin. After selection of a 3-mm nevus, both donor and recipient sites were anesthesized. A punch with a diameter comparable to the diameter of the nevus was chosen. First the recipient site was punched out and discarded. Then the nevus was punched out and transplanted in the recipient site and dressed by dry gauze and fixed by adhesive tape. The transplanted nevus was attached to surrounding skin after 10 days. A superficial crust was developed and seen after removing the dressing 10 days later. Mild shrinkage in size and reduction in pigmentation was seen a month later which gradually improved thereafter.

Actinic prurigo is a rare disease occuring mainly in individuals of American Indian Origin and those living in high altitudes. Skin lesions consist of pruritic papular or nodular excoriated lesions mainly affecting exposed skin but covered skin is also involved in up to 50% of patients. This is the first case report of an Iranian patient. This 19-year-old female had pruritic papular and nodular lesions on face, trunk, buttocks and extremities since age of 9 years. The lesions were photosensitive. Histopathological findings were compatible with the diagnosis of actinic prurigo.

Lung tumors are one of the most common malignancies in males and females. Because definite treatment of many of the tumors (such as small cell carcinoma or lymphoma) is chemotherapy or radiotherapy but not operation, a histological diagnosis of the tumor is very important before definite operation. Percutaneous needle biopsy is a safe, easy, sensitive and inexpensive procedure for diagnosis of thoracic tumors. This prospective and pilot study was performed to estimate the sensitivity, specificity, accuracy, positive and negative predictive values of percutaneous needle biopsy and compare the results with those obtained from open biopsy. The sample consisted of 61 patients suspicious to thoracic tumor admitted to Alzahra hospital, Isfahan, during 1997 to 1999. Based on the open biopsy 51 out of .61 patients had lung cancer and 10 patients had benign disorders such as anthracosis, tuberculosis, pulmonary infarction, etc. The results of Fine Needle Aspiration (FNA) were as followings: sensitivity: 72%, specificity: 100%, accuracy: 57%, positive predictive value: 100% and negative predictive value: 28%. Therefore FNA is a safe, easy, relatively sensitive and exactly specific procedure for diagnosis of thoracic tumors. By this procedure we can avoid many unnecessary thorachotomies or invasive and expensive procedures and save money and hospital beds.

The third important reason for admission of neurologic patients into hospital is brain tumor. Due to latency of diagnosis and severity of signs & symptoms, clinical and Para clinical analysis of brain tumors is necessary. In this study 55 brain tumors were analyzed with respect to clinical examination, CT scan findings, signs & symptoms, and postoperation pathology, using data extracted from the patients' files. Age of most of the patients was in the range of 20-60 years. The most prevalent signs & symptoms were headache (76%), nausea & vomiting (47%), limb paresis (43%) and seizure (28%) respectively. About 82% of tumors were supra and 18% were infratentorial. The most common tumor was meningioma 32% (glioma 30%), and the rate of others located between 2% to 9%. The high percentage of menigioma especially in women may be due to the latency of diagnosis resulted from the special socioeconomic conditions of Chaharmahal and Bakhtiari.

Hydatid cyst is the larval stage of a cathode worm, echinoccus granulosus, which in human and some other mammalians causes echinoccusis disease. Iran is located in endemic zone of this disease and due to existence of sheep husbandry jobs, Chahannahal and Bakhtiari province has the potential of high prevalence of the disease. Therefore this descriptive study was performed to find the seroepidemiology of hydatic cyst in human in this area. Serum samples of 1000 blood donors and about 1500 patients who had laboratory diagnostic tests were subjected to immunoeletrophoresis test in order to find possible infection with hydatid cyst. The prevalence of hydatid cyst (seroepidemiology) was 4.8%. The prevalence of the disease among male and female patient was 4.4% and 5.1% respectively. The city of Lordegan had the highest (17.6%) and the city of Ardal had the lowest (1.9%) prevalence of the disease. The prevalence of hydatid cyst in Chaharmahal and Bakhtiari province is comparable to other investigated areas of Iran. However the prevalence of the disease in this province is higher than that of the other parts of the world.