Journal of Advances in Medical and Biomedical Research
Year:2008 | Volume:16 | Issue:64|Papers Count:13

Background and Objective: Thyroid cancer is the most common endocrine malignancy. Because of the highly heterogeneous nature of tumoral and non-tumoral thyroid nodules and lack of suitable clinico-pathological criteria and absence of appropriate molecular markers, scientists have been trying to find a molecular tumor marker for specific diagnosis of thyroid tumors. Recent attention has been paid to Survivin, a novel member of the Inhibitor of Apoptosis Protein Family (IAP), as a new molecular marker in cancer. Studies have demonstrated that Survivin and its splice variants have different expression in cancerous tissues compared to normal tissues.Materials and Methods: In this study the expression of Survivin and its splice variants; 2B and DEx3 were evaluated as new diagnostic molecular markers in thyroid cancer. Tissue samples were collected from 61 thyroid specimens including 14 tumor margins, 11 non-tumoral and 36 tumoral samples. Expression levels of Surviving and its variants were measured by semi quntitative RT-PCR.Results: Expression level of Survivin in tumor samples was significantly higher compared with surgical margins and non tumural tissues. There was also a significant increase in expression level of Survivin-DEx3 in tumoral tissues compared with surgical margins. The expression of Survivin 2B in tumors was lower than the non-tumoral tissues.Conclusion: Our data indicated the important role of Survivin in production of thyroid tumors and also revealed that high expression of DEx3 variant is correlated with nature of thyroid tumors. Therefore, evaluating Survivin gene expression and its recently introduced splice variants may be used in diagnosis and classification of thyroid tumors from non-tumoral lesions.

Background and Objective: X-linked agammaglobulinemia (XLA) is a primary immunodeficiency disorder characterized by recurrent bacterial infections, profound lack of serum antibodies and reduced circulating B lymphocytes. Mutations in Bruton´s tyrosine kinase gene (BTK) result in XLA. It is shown that absence of Btk protein expression may be accompanied by no mutations in coding regions in some cases, instead alterations in conserved regulatory domains of promoter and the first intron of BTK gene maybe occurred.The aim of this study was evaluation of Btk expression and mutation analysis in coding and regulatory regions of the gene.Materials and Methods: In this study, eleven XLA patients were enrolled. Btk expression was analyzed by western immunoblotting method. Mutation analysis was carried out in eight patients. In three cases, PCR of the regulatory regions was performed with designed primers, followed by sequencing.Results: According to western blot, normal Btk expression in three patients and null expression in eight others was observed. Mutation analysis showed two novel BTK mutations in two patients (1038-1040 delAGG and IVS8-2delA). No coding or regulatory region mutations were found in three cases with null Btk expression.Conclusion: Based on these results, three cases with null expression and had no coding or regulatory reion mutations are interesting. It is possible that some rare regulatory defects may have been occurred, other than conventional sites. This must be taken into account for future investigations.

Background and Objective: There are many studies showing that fetal lung maturation in complicated pregnancies like preeclampsia is accelerated. Lung maturation in this condition is due to glucocorticoid secretion in response to stress. There are also con-tradictory opnions about fetal lung maturation in preeclampsia. In this study the relationship between lung maturation in preterm infants and maternal preeclampsia was investigated.Materials and Methods: This case control study was applied to 96 preterm infants with Respiratory Distress Syndrome (RDS) as the case group and 96 preterm infants without RDS as the control group in Zanjan- Valiasr hospital during the years 2004-2005. Both groups were similarized for age, sex, weight and type of delivery. Patient’s data were obtained from their medical records and were analyzed by T and X2 tests.Results: In 31 preterm infants with RDS (31.6%), and in 23 preterm infants without RDS (23.4%), the mother was preeclamptic. This difference was not statistically significant.Conclusion: According to the results of present study, the risk of RDS in preterm infants of preeclamptic mothers is not lower than the non preeclamptic mothers; therefore fetal lung maturation is not accelerated in maternal preeclampsia.

Background and Objective: Shivering is a common post anesthetic complication. The relative efficacy of pharmacologic interventions used for the treatment of postoperative shivering is not well understood. The aim of this study was to evaluate the effect of administration of a 1mg/kg single dose Tramadol to induction of anesthesia in order to prevent post-anesthetic shivering.Materials and Methods: In this randomized, double-blind and placebo-controlled clinical trial, 60 patients which were classified based on American Association of Anesthesiologists (ASA) to physical status I or II selected for elective abdominal gynecologic surgeries by general anesthesia (GA). Before induction of anesthesia, 30 patients (study group), received a single dose of 1 mg/kg intravenous Tramadol, and the other 30 patients (placebo group) received 0.9% saline.Results: 3 patients (10%) of the study group and 17 patients (56.66%) of the placebo group experienced post anesthesia shivering (P<0.0001). Incidence of pain in the immediate postoperative period was significantly higher in the placebo group (90% vs 23.33% of patients respectively; P<0.0001). No significant difference was observed in the incidence of postoperative adverse effects between the two groups.Conclusion: This study supports administration of single dose of 1 mg/kg Tramadol, prior to induction of general anesthesia in prevention of post anesthetic shivering.

Background and Objective: “Perchloroethylene” is a solvent widely used in dry cleaning industry. Various effects on liver, kidney, nervous and cardiovascular systems have been attributed to exposure to this solvent. In this study we assessed some of the neuropsychological effects of chronic exposure to perchloroethylene on exposed dry cleaning workers.Materials and Methods: 40 exposed and 40 non exposed workers were compared in this historical cohort study. The researchers collected the data using a questionnaire and a check list. Frequency of selected neuropsychological effects were evaluated and compared in each group by means of statistical software. Results: After adjustment for age and educational status, the frequency of depression in exposed group and non-exposed group was calculated to be %42/5 and %22/5 respectively (P=0/056). Frequency of memory loss was higher in exposed group (%27/5) compared to non-exposed group (%17/5) (P>0.05) and the frequency of repetitive checking was surprisingly higher in non-exposed group and this difference was statistically significant (P<0/05).Conclusion: The observed difference in .frequency of depression in exposed and non exposed workers in our study was consistent with findings of previous studies. We were not able to demonstrate any statistically significant relation between perchloroethylene exposure and other neuropsychological effects. Our findings of repetitive checking was unexpectedly in contrast to the findings of previous studies.

Background and Objective: Recognition of various environmental allergens is of great importance. Since contact with them may cause or accelerate sympotoms in allergic patients. Our purpose of this study was to determine sensitivity to common allergens by skin prick test.Materials and Methods: Patients with allergic rhinitis, asthma and atopic dermatitis referred to Allergy Clinic of Valie Asr Hospital of Zanjan City, 2003-2005, were submitted to skin prick test with a series of indoor, outdoor and food allergens.Results: Two hundred patients (111 females and 89 males) 4-60 years of age were recruited. Eighty three percent of subjects showed at least one positive skin prick test. The skin prick tests were positive for grass (Rye grass 41%), weed (pigweed 27%, Herb 21%), Tree (olive 22%, Ash 20%, Butirytis 19.5%), Mites (D.P 16%, D.F 16%), Cockroach 14.5%, feather11%, Mold (Aspergillus 11.5%, Alternaria 7.5%), Food (Wheat 9%, Pepper7.5%, Egg 6.5%).Conclusion: According to the frequency of positive skin tests to pollens in our patients, it seems that avoiding contanct with these agents in related seasons, treatment ineluction, drug dose acceleration and desensitization procedures would be of great help in allergic patients.

Background and Objective: Dysphagia is the most distressing problem in patients with advanced inoperable esophageal cancer. Palliative interventions like balloon dilation and stenting are used to improve quality of life and make patients enable to eat more comfortably. This study was designed to determine the outcome of palliative care in esophageal cancer patients referred to Gorgan and Gonbad gastrointestinal clinics, northeast Iran.Materials and Methods: This cross-sectional study was performed on inoperable esophageal cancer cases during 2005-2006. Demographic data were collected during the procedure and cases were followed every month for six months. Improvement proportion was calculated with 95% confidence interval, to determine the rate of improvement. Survival analysis and Kaplan-Meier methods were used to estimate the duration of palliative care effectiveness.Results: We recruited 39 cases into the study. Male to female ratio was 1.6 to 1 and mean age was 67.5±13.7 years. Twenty two patients had grade 3 dysphagia and other 17 had grade 4 at the beginning of the study. Dilation was the most preferred method (89.7%) and stenting was performed in 4 (10/3%) cases. Decreasing dysphagia score was not related to palliation method used or pathologic type of carcinoma but it was showed to be related to the age of the patients significantly. Mean survival was significantly different between 2 groups (with and without dysphagia improvement in first month of follow-up).Conclusions: Results of this study showed a lower survival rate after palliative care in advanced esophageal cancer cases, although dysphagia scores showed some improvement.

Background and Objective: Staphylococcus aureus is considered to be one of the leading causes of food-borne illnesses. Foodstuff contamination may occur directly from contaminated food-producing animals or may result from poor hygiene during food production processes, or the retail and storage of foods, since humans may carry the microorganism. The number of S.aureus strains that exhibits antimicrobial-resistance properties has increased, together with the potential risk of transmitting the same properties to the human microflora via food or inducing infections hard to be treated. The aim of this study was to evaluate the occurrence of S.aureus in various food samples and determination of antibiotic resistance pattern in this isolates.Materials and Methods: A total of 1047 food samples were analysed from July 2006 to December 2007. To determine the presence of S.aureus, the samples were analysed according to the guidelines of Iran standard instructions (No.1194). S.aureus isolates were tested for susceptibility to a panel of 11 antimicrobics using the agar disc diffusion method on Muller-Hinton agar.Results: Of 1047 samples analysed 100 (9.5%) were contaminated with S.aureus. Among these contaminated samples, 31% showed antimicrobial resistance properties to at least one of the antibiotic tested and 15 antibiotypes were determined.Conclusion: According to the observed prevalence of S.aureus strains in food samples and their antibiotic resistance pattern, more attention shonld be paid in foodstuff industry to prevent contamination and transmission of resistant strains.

Background and Objective: Methicillin-resistant Staphylococcus Aureus (MRSA) is a serious problem in hospitals. The purpose of this study was to determine the prevalence and related risk factors of methicillin resistance S. aureus isolated from clinical specimens in Kashan hospitals.Materials and Methods: This descriptive study was carried out on 100 S.aureus strains isolated from patients admitted to Kashan hospitals in 2006- 2007. Strains were inoculated on blood agar containing 5% sheep blood and 7.5% mannitol salt agar media, and were incubated at 35°C for 24 hours. The isolated S. aureus strains were identified using gram staining, catalase test, coagulase tube test, growth on chrome agar and the DNAse test. The antibiotic sensitivity test was determined by disk diffusion method. Variables including age, sex, previous hospitalization, duration of hospitalization, previous antibiotic therapy, and type of the disease, were recorded in questionarres. Data were analyzed statistically by the Chi-square and Fischer.s exact tests.Results: Penicillin and Ciprofloxacin revealed the highest and lowest resistance rates respectively (99%, vs 11 %). Meticillin resistance was 22% and an intermediate resistance to Vancomycin was detected in 7% of isolates. A significant correlation was established among the presence of resistant staphylococci with age of more than 46 years old (P<0.040), previous hospitalization (P<0.000), hospitalization for more than 1 week (P<0.000), previous antibiotic therapy (P<0.004), and administration of antibiotics for more than 1 week (P<0.002).Conclusion: Awareness about the prevalence of antibiotic resistant S.aureus and identification of risk fac ors for infection with resistant isolates is essential to help clinicians, choosing appropriate antibiotic regimen.

Background and Objective: Trauma-related mortality (due to road accidents and gunshot and disaster.) is unexpectedly high in Iran. Short trauma care training course to rural health system and villager of Mehran, Eylam would improve the care for trauma victims. The objective of the present study is to describe the training and evaluate its effect using changes in physiological function of victims.Materials and Methods: Advanced trauma care course for physicians and nurses, complementary basic trauma care course for emergency technicians and health workers, basic trauma care for highly educated people and first aid short course for ordinary people were developed. After training, the region traumatic patients entered the system through two channels: to the local Mehran Emergency Clinic (some with primary treatment before the local emergency clinic) or directly to Ilam University Hospital. Outcome indicator was the physiological change assessed with the physiologic severity score (PSS).Results: During courses period, 185 physicians & nurses, emergency technicians & health workers, 239 highly educated people and 4410 ordinary people were trained for trauma care.During 3 years leater 366 injured were transported to Mehran Emergency Clinic (226 received primary treatment before the local emergency clinic) and 245 were admitted directly to Ilam University Hospital. Total mortality rate was 10.3 percent (66 out of 641 injured people) and the mine injured mortality rate was 20.7% (37 out of 179 mine injured). In the injured who received trauma care at Mehran Emergency Clinic, PSS mean was 6.4 which improved to 7.5 in the hospital (P<0.001) in comparison with 6.79 in the other group.Conclusions: Rural health worker and general population could be upgraded to care for victims of injuries by using available resources. This system can improve the indicators and reduce trauma mortality rate.