Journal of Kerman University of Medical Sciences
Year:2011 | Volume:18 | Issue:1|Papers Count:15

Background & Aims: Liver ischemia-reperfusion (IR) is one of the common consequences of liver surgery, especially during liver transplantation which results in organ dysfunction. Acute hepatic injury causes systematic inflammatory responses which may finally lead to functional disturbances in remote organs such as heart, lungs and kidneys. In this study, the effects of a potent inhibitor of inflammatory cytokines (pentoxyfilline, PTX) and a well-known antioxidant, (N-acetylcysteine, NAC), was evaluated on renal functional damage and oxidative stress following liver IR.Method: Five groups of six male rats were used. Group one was sham operated. In group 2, 90 min liver partial ischemia was conducted by a clamp around hepatic artery and portal vein and followed by 4 hours of reperfusion. In group 3 and 4, PTX or NAC was injected intraperitoneally before the ischemia, while in group 5 both drugs were co-administered. The levels of ALT, AST, ALP, BUN and creatinine in serum as well as MDA and GSH levels in renal tissues were measured.Results: Significant increase in the serum levels of ALT, AST in IR group is indicative of liver functional damages comparing to sham operated rats. Elevated BUN levels and increased renal tissue MDA and decreased GSH levels in IR group demonstrates a significant kidney functional damage and oxidative stress comparing to sham group. Administration of PTX alone and PTX+NAC prevented the IR-induced increase in renal MDA levels. Administration of both drugs and their co-administration prevented the reduction in renal GSH levels.Conclusion: Pretreatment with PTX and NAC before liver IR induction may prevent renal oxidative stress by protection of cellular GSH concentration and a reduction in MDA levels.

Background & Aims: Diabetes is the most common cause of renal insufficiency throughout the world. The main cause of renal failure in diabetic patients is microvascular endothelial injuries that are secondary to atherosclerosis and ischemia. The efficacy of renal Doppler indices such as resistive index (RI) and pulsetile index (PI) for the evaluation of intrarenal arteries has been shown. This study was done to determine the accuracy of RI and PI indices in earlier detection of renal involvement in type II diabetes.Method: Sixty diabetic patients were divided into two groups of with microalbuminuria and without microalbuminuria. After determinig RI and PI, the two groups were compared by using independent t-test, fisher exact test and Pearson correlation and through SPSS 15.Results: A statistically significant correlation was found between RI and positivity of microalbuminuria (P= 0.013). There was no correlation between RI and variables of age, sex and duration of diabetes. Moreover, 60% of cases without microalbuminuria had RI>0.7 that shows the diagnostic value of RI in earlier detection of renal failure in comparison to microalbuminoria test.Conclusion: Further studies for proving the efficacy of RI as the screening test for earlier detection of renal involvement in diabetes are recommended.

Background & Aims: Recent evidences indicate that parts of the immunoregulation system such as CD4+CD25+Tcells (Treg) and Th2 cells and Th1 cells, play very important roles in the maintenance of pregnancy. The deficiency in proper recognition of fetal alloantigen by the maternal immune system is associated with recurrent pregnancy failure. Here, we investigate the proportional changes of CD4+CD25+Tcells in peripheral blood of women with unexplained recurrent spontaneous abortion in comparison to women with normal pregnancy by using flowcytometry.Methods: The case group was comprised of 24 women who had at least three successive miscarriages with unexplained etiology. They had normal karyotypes, anticardiolipin and prolactin and their husbands had normal spermograms. The percentages of TCD4+CD25+cells in peripheral blood of these patients were compared with those of 21 women who had normal pregnancy with no history of pregnancy loss. Anti-CD4, anti-CD25 and anti-CD3 antibodies were added to lymphocytes isolated from peripheral blood. Then samples were incubated, centrifuged and washed. Finally cells were analyzed using FACS Caliber system and data of the two groups were compared.  Results: Mean percentage of CD4+CD25+bright T cells in peripheral blood in case group was significantly lower compared to the control group (P=0.000). Mean percentage of CD4-CD25 bright cells in the CD4+Tcell peripheral blood was significantly higher in case group campared to the control group (P=0.021). Conclusion: Decrease of CD4+CD25 bright T cells plays a major role in tolerating conceptus antigens and cytokine and might contribute to the maintenance of pregnancy. Inadequate CD4+CD25+Tcells or their functional deficiency may link with miscarriage. Therefore, alteration of CD4+CD25+T cells can be used as an immunologic marker for monitoring of patients with unexplained recurrent spontaneous abortion.

Background & Aims: Renal transplantation is the best therapeutic option for End Stage Renal Disease (ESRD). The aim of this study was to determine the graft survival rate of renal transplantation in patients who have been transplanted from live donor in Shiraz Transplant Research Center, Shiraz, Iran.  Methods: In a survival analysis study, organ survival rate after kidney transplantation from live donor was determined in 843 patients being transplanted in Shiraz Transplant Research Center, Iran during a period of 10 years (March 1999 to March 2009). Kaplan-Meier method was used to determine the survival rate, Logrank test was used to compare survival curves and Cox proportional hazard model was used for multivariate analysis.Results: Mean follow-up period (± Standard deviation) was 53.07±34.6 months. Allograft survival rates at 1, 3, 5, 7 and 10 years after kidney transplantation were found to be 98.3%, 96.4%, 92.5%, 90.8% and 89.2%, respectively. Using Cox proportional hazard model, age of donor and creatinine level at discharge showed significant relationships with survival rate of renal allograft.Conclusion: The 10- year graft survival rate of renal transplantation from live donor in this center is 89.2% which in comparison with reports from large centers of transplantation it is satisfactory.

Background Aims: Anthropometric indices are among common tools used in assessing nutritional status in children. This study was done to determine anthropometric indices of Rafsanjan schoolchildren by using Body Mass Index and Waist Circumference and height.Methods: In this cross-sectional study, 1275 primary schoolchildren were selected using two stage random sampling method. Demographic questionnaire was completed. Then weight, height and waist circumference (WC) were measured by standard scale and tape respectively. Overweight and underweight were defined based on BMI scores and were compared using CDC (Center for Disease Control and Prevention) chart. Stunting was detected using percentiles of stature for age. Abdominal obesity was defined based on WC percentile for age and gender presented by IDF (International Diabetes Federation). Data were analyzed by using Chi Square and t-student tests.Results: According to our finding, about 13.3% of children were underweight and 16.1% of them were stunting, 11.5% were at risk of overweight and 9.4% were overweight. Girls were significantly more stunting than boys (17.7%, Vs. 13.6%, P= 0.04). Abdominal obesity was seen among 6.4% of students and it was seen more in boys compared to girls (8.4% Vs. 5%, P=0.016).Conclusion: Our findings showed that underweight, stunting and overweight are common health problems among schoolchildren of Rafsanjan.

Background & Aims: Metaphysical distal radius fractures are common fractures account for almost half of the fractures in Orthopaedic Emergencies. According to different studies, 1-6 weeks cast immobilization after distal radius surgery has been recommended. The aim of this study was to compare outcomes and complications of short-term and long-term immobilization treatment methods.Methods: In a randomized clinical trial, 50 patients with metaphysical distal radius fractures and extra joint or intra joint fractures without comminution referred to the Emergency Unit of Shohada Hospital in Tabriz, Iran who were treated by percutaneous pinning were selected and divided into two groups of immobility for one week (group 1) and immobility for four weeks (group 2).Results: Loosing of pins was not seen in any of the groups. There were no significant differences in intensity of pain, infection at the site of pins and range of motion improvement between the two groups. Most of the patients in group two like group one have gained their ability in three months, but 1.5 month after the treatment return of motions in the early motion group was significantly faster.Conclusion: According to these findings, there is no difference in final therapeutic and functional outcomes between 1- and 4- week post-operative immobility. Earlier initiation of movements after one week is not associated with more complications in comparison to late initiation of movements, but patients return to their daily activities earlier.

Background & Aims: Diabetes mellitus is one of the most common types of chronic disease leading to serious complications such as blindness, end stage renal disease (ESRD), neuropathy and cardiac disorders. Skin tag is a common benign skin tumor that its association with impaired carbohydrate metabolism has been reported in some studies. The aim of this study was to compare the frequency of diabetes and other carbohydrate metabolism disorders in patients with and without skin tag.Methods: In a case- control study on 200 individuals over 30 years old referring to Dermatology Clinic of Afzalipour Hospital, 100 individuals with at least 3 skin tags as case group and 100 individuals without skin tag as control group underwent FBS and standard GTT tests.Results: There was no significant difference between case and control groups in the frequency of diabetes (19% vs. 10%), IGTT (11%vs.13%) and IFG (19% vs. 15%).Mean FBS and GTT were significantly higher in the case group compared to the control group.There was a positive correlation between the total number of skin tags and mean FBS (r= 0.33, P= 0.001) and GTT (r= 0.37, P= 0.000). The frequency of diabetes in patients with at least 20 skin tags was 45.8%. Positive predictive value, negative predictive value, sensitivity and specificity of skin tag for the diagnosis of diabetes were 19%, 90%, 52% and 65% respectively. Conclusion: This study revealed that patients with skin tags are at a higher risk of carbohydrate metabolism disorders. Therefore, screening of patients with skin tag for carbohydrate metabolism disorders is recommended.

Background & Aims: One of the problems hindering people’s success in losing weight is their lack of knowledge about the limitations they face. The aim of this research was to investigate the contributing factors to BMI decrease in women referring to the clinic for weight reduction programs.Method: In this cross-sectional study, the medical files of 100 women (18-65 years old) with BMI>23, being at least 3 months under weight reduction programs, were observed. Data related to their anthropometric statue, demographic features, physical activity and some other features were recorded into four designed questionnaires. Data were analyzed by using paired t-test, One-way ANOVA, Chi-square and logistic regression and considering P<0.05 as the statistically significant level.Results: In women who had the highest rate of BMI decrease, reducing fat consumption (77%) and also consumption of starchy, sweet foods (74%) were the main reasons of weight loss success. Meanwhile, women with weight loss ³10%, stated that the strategy of reducing food volume (43.8%) and substitution of fruits & vegetables in their diets (81.2%) had been main reasons of weight loss success. The most important obstacles in weight reduction program were respectively the difficulty of bearing a low-calorie diet (42%), dissatisfaction of husbands & families (33%) and medical problems (27%). There was an indirect relation between educational level and fatness (P=0.005) and a direct relation between age & fatness (P=0.004). The most efficient motives of weight loss were beauty reasons in women younger than 45 and physicians advice in women over 45 years. There was no significant relationship between physical activity and BMI decrease (r=0.08, P=0.93).Conclusion: Nutritionists advice for avoiding high-fat foods and suggesting appropriate substitutes to people before starting weight loss program is essential. Difficulty of tolerating low-calorie diets necessitates nutritionists attempt to introduce appropriate weight loss diets.

Background & Aims: Based on serological studies the prevalence of Helicobacter Pylori infection in Iranian adults is up to 80%. Gastritis, peptic ulcer and gastric adenocarcinoma are common clinical outcomes of this infection in Iran. Since antibiotic resistance patterns of Helicobacter pylori are different geographically, local studies are highly required.Method: From April to December 2009, 63 isolates of Helicobacter pylori were obtained From 191 patients referred to the endoscopy unit of Afzalipour hospital in Kerman. Demographic features including age, gender, symptoms, … were recorded before the sampling and sensitivity to six common antibiotics used for the treatment of H.pylori infection was determined. Modified disk diffusion test was used to evaluate antibiotic resistance pattern. Data analysis was done through SPSS 16 and using Pearson chi-square test.Results: The patterns of antibiotics resistance were as below: metronidazole 55.5%, clarithromycin 30.1%, tetracycline 3.1%, amoxicillin 26.9%, ciprofloxacin 7.9% and no resistance to furazolidone was detected. While 12.7% of the isolates were susceptible to all the six antibiotics, 55.6% were resistant to one antibiotic, 25.4% to two antibiotics, 6.3% to three antibiotics and there was no resistance to more than three antibiotics at the same time.Conclusion: According to the obtained antibiotic resistance rates in this study, performing antibiogram tests before starting the treatment is necessary.

Background & Aims: Sever early childhood caries (SECC) is a multifactor common disease that unfortunately there have been a lot of unknown points about it. This study was performed to compare the levels of total S-IgA in children with and without SECC.Methods: In this cross-sectional study 44 children aged 6-24 months were divided into two groups of with SECC (n=20) and without SECC (n=24). The two groups were compared for the concentration of S-IgA assessed with Nephlometric method. The obtained data were analyzed by using t-test and through SPSS 15 software.Results: Mean saliva concentration of S-IgA in children with SECC (18.30 mg/dl) was higher than that in children without SECC (9.46 mg/dl) and this difference was statistically Significant (P<0.05).Conclusion: According to this study, the hypothesis of lower levels of S-IgA in children with SECC might be rejected.

Intestinal obstruction may be duo to various mechanical or functional reasons. Worms, especially Ascaris worms are one of the mechanical reasons of intestinal obstruction. Obstruction due to Taenia saginata is a rare henomenon.Here we report a case of intestinal obstruction due to Taenia saginata infection in a 30 year-old male patient undergoing laparatomy with the diagnosis of intestinal obstruction. The cause of intestinal obstruction was unknown initially, but during milking of intestinal contents through naso- gastric tube a Taenia saginata worm was accidentally detected in the tube.

There have already been a few studies on Q fever in Iran and most of them go back to more than 50 years ago. Preliminary serologic studies on ruminants and febrile patients in Southeast Iran show a high seropositivity in this region. Misdiagnosis as well as poor attention of public health authorities to this infection can facilitate the epidemic spread of Q fever. Further studies on the diagnosis of acute and chronic types of Q fever and detection of Coxiella burnetii are in progress by the authors.

Mercury is a metal found in elemental, organic, and inorganic forms in the nature. This substance is present in the composition of earth crust, soil, air, and even in some tissues of plants and sea animals. Each year nearly 3400 tons of mercury compounds are released in the environment, which 95% settle in the soil, 3% in the oceans, and 2% in the atmosphere. Different industrial products like medicines, health products (soaps, creams, skin lightening creams), medical instruments (thermometer, sphygmomanometer), some substances in dentistry (amalgam), mirrors, and even some of toys contein mercury. All of these compounds may enter into the human body via skin, gastrointestinal and respiratory tracts and cause serious harms. They may cause different signs of toxicity, local and general signs and symptoms, and in some cases even they may end up to death. When mercury toxicity is suspected, in addition to primary evaluations, some special laboratory tests may be of a great help.In order to provide a treatment, the basic steps for all toxicities must be performed to prevent further serious damages,and of course the care giver has to pay attention to specific and non specific features of this toxicity.