Journal of Advances in Medical and Biomedical Research
Year:2016 | Volume:24 | Issue:103|Papers Count:14

Background and Objective: Macular edema is an important cause of visual loss in diabetic patients which can lead to permanent vision loss in untreated cases. This study compares the efficacy of intravitreal injection and the sub-tenon capsule of triamcinolone on the visual acuity in patients with diabetic retinopathy.Materials and methods: In this randomized clinical trial study, 82 diabetic retinopathy eyes were randomly assigned to intravitreal triamcinolone injection group and 74 eyes to sub tenon capsule injection. In terms of visual acuity and intraocular pressure, patients were followed up after first week, first month, and 3rd month. The collected data were analyzed using ANOVA with repeated data (Repeated ANOVA) and Stata software (version 13).Results: Crude comparison between groups did not exhibit significant differences. However, by controlling the confounding baseline effect, level of visual acuity, log Mar of the visual acuity in the intravitreal injection group (-0.78) was significantly less than the sub-tenon capsule group (-0.67). Also, after controlling for other confounding variables (age and sex), the mean IOP was significantly higher in the intravitreal injection group.Conclusion: Visual acuity in intravitreal injection group was significantly less than the sub-tenon capsule group and also the mean IOP was higher in the intravitreal injection group. Therefore, sub-tenon capsule of triamcinolone stands out as a superior approach.

Background and Objective: Stroke results in increased sensory disorder, motor impairment and functional deficit. Sensory stimulation is the basis for beginning of the process of brain plasticity and recovery of sensory motor function in the affected limbs. The objective of this study was to investigate the effect of sensory retraining on functional recovery of upper limbs in patients with ischemic stroke.Materials and Methods: This pre-post intervention experimental study was undertaken with 30 patients (both male and female) aged 40-65 years old suffering from ischemic stroke who were assigned to the experimental and control groups (n =15). A number of instruments were used to collect the necessary data: questionnaires for background information, Fugl-Meyer for clinical tests (limb function), Box and Block to assess manual skills of the patients, and Motoricity index for assessment of the motor impairment. The experimental group received defined treatments for 24 sessions (every other day).The collected data prior to and following the treatment were analyzed.Results: The main pre-treatment baseline values were similar and there was no significant difference between the groups. Pre and post treatment values were statistically significant for all tests in the experimental and control groups (with a clear superiority of the experimental group) which denoted an improving trend. The variations in test percentages was statistically significant in the experimental group compared to the control group.Conclusion: Sensory retraining accompanied by routine physiotherapy lead to significant improvement in functional tests, manual skills, and upper limb motor deficits. Therefore, sensory retraing is recommended due to its positive effect on patients rehabilitation.

Background and Objective: Diabetic foot ulcer as one of the most common complications of diabetes mellitus is known to be resistant to conventional treatment of wound healing. The objective of this study was to evaluate the efficacy of low level laser therapy with Ga-As laser, 904 nm, in foot ulcer healing of type 2diabetic patients.Materials and Methods: 27 patients with Type 2 diabetes mellitus suffering from Wagner Grade II ischemic foot ulcers were randomly divided into two groups: Ga-As laser (n=15) and placebo (n=12). In the laser therapy group, Ga-As, (2 j/cm2, 90mW) was applied while in the placebo group laser probe was set similar to the laser group, but the power was off. Conventional treatment after laser therapy was done for both groups in a similar vein, i.e., three times a week for twelve sessions. Wound surface area and temperature around the wound (before and after therapy) in the 1st, 6th and 12th sessions and Ankle Brachial Index (ABI) in the1st and 12th sessions were recorded.Results: Throughout the 6th and 12th sessions, reduction in wound surface percentatage in comparison with baseline was significantly (P<0.05) higher in the laser group (43.98±6.36, 72.08±7.22 respectively) than the placebo group (6.48±7.98, 12.69±9.05 respectively), but the skin temperature and ABI values did not show any significant difference.Conclusion: Ga-As laser using photochemical and non-thermal mechanisms may be effective on the acceleration of diabetic chronic foot ulcer closure.

Background and Objective: Acute myeloid leukemia (AML) is a clonal proliferation of immature myeloid progenitors in the bone marrow. Multiple genetic and environmental factors have been reported to be involved in the pathogenesis of AML. Cytochromes, such as cytochrome P450 are among detoxifying enzymes whose aberrant expression can make individuals susceptible to a variety of cancers and leukemias including AML. The aim of this study was to evaluate the G15631T, CYP2B6 subfamily of cytochrome P450 gene with susceptibility to AML in some AML patients and normal individuals.Materials and Method: We enrolled 76 AML patients and 80 normal individuals as the control group for the study of G15631 T polymorphism of CYP2B6 gene. This polymorphism was amplified by PCR using specific primers. The PCR products were digested by Bsr I enzyme and Electrophoresed on Agarose gel.Results: The frequency of G15631T polymorphism was significantly higher in patients (55%) than the control group (31%). The risk of AML (with CI = 95%) in patients with GT genotype was 1.95 fold more than individuals with the same genotype in the control group The TT genotype was found in 4 patients with AML, but in none of the individuals in control group.Conclusion: The results show that there is a direct relationship between G15631T, CYP2B6 gene polymorphism and susceptibility to acute myeloid leukemia in some patients in our study population. However, further studies on larger populations are recommended.

Background and Objective: Current and common treatment of toxoplasmosis consist of oral administration of pyrimethamine and sulfadiazine. However, this drug combination has substantial toxicity and side effects on patients, especially in immunocompromised individuals. Echinacea purpurea is a medicinal plant with antimicrobial properties which boosts the immune system. This study was carried out to evaluate the ant itoxoplasma effect of E. purpurea extract in vitro and acute toxoplasmosis in a mouse model.Materials and Methods: Parasite suspension containing 42000 live toxoplasma tachyzoites (RH strain) was added to serial concentrations of 50, 100, 200, 500 and 1000 mg/ml alcoholic extrac of E. purpurea and incubated at 37oC for 5 hours. Then, IC50 was calculated using linear regression. Subsequently, 48 BALB/c mice were asssigned to 5 treatment groups and a control group and were intraperitoneally infected with 104 tachyzoites. 24 hours post infection, the E. purpurea extract was injected intraperitoneally by the aforementioned concentrations on a daily basis until the death of the mice. The control group received sterile saline. Survival time of the groups was analyzed by One way ANOVA and Duncan tests and between-group differences at the level of P<0.05 were considered statistically significant.Results: Using linear regression, IC50 values of E. purpurea extract was 784 mg/ml, after 5 hours. The mean survival time of the mice in the treated groups was significantly higher than the control group, respectively 6.5±0.9 and 5±0.0 days (P<0.05). The maximum survival time (7.3±1.0) without any significant difference with other test groups, was obtained in the fifth group (1000 mg/ml).Conclusion: The tested concentrations of alcoholic extract of E. purpurea did not pose any inhibitory effect on tachyzoites in vitro, but significantly increased the survival time of the infected mice in vivo.

Background and Objective: Because of the critical role of cell death in the pathology of neurodegenerative diseases, its prevention is regarded as one of the most salient ends in neuroprotective strategies. Concerning the bulk of reports about the putative neuroprotective effects of erythropoietin (Epo), in the present study following axotomy, the effects of different doses of Epo on spinal moto neurons in neonates was investigated.Materials and Methods: Following transection of the right sciatic nerve of 20 two-day-old neonate rats and induction of apoptotic cell death in related moto neurons, the animals were subdivided into three experimental and one control groups. The experimental groups received different doses of 2500, 5000, 10000U/kg recombinant human Erythropoietin (rhEpo), and the control group was treated with equal volume of normal saline, intraperitoneally for 5 successive days. 24 hours following the last injection, histologic sections from the neonate spinal cords were prepared for counting of spinal moto neurons. In all samples, the intact side was regarded as the internal control.Results: The difference between moto neuron means of intact and axotomy sides was significant in all groups, which advocates the efficacy of axotomy in cell death induction. Comparison of axotomized side of different groups indicated significant differences between both 5000 and 10000U/kg groups with control, and also between 10000 and 2500 groups, but no significant differences could be seen between other groups. Thus, 5000U/kg of rhEpo can be considered as the neuroprotective dose which can prevent cell death of axotomized moto neurons.Conclusion: rhEpo has dose-dependent neuroprotective effects on axotomized spinal moto neurons.

Background and Objective: Alzheimer is a neurodegenerative disease in which a reduced memory capacity and numerous changes occur in the patients brain. This study was embarked to shed light on the effects of eight weeks of endurance training and chloride administration on brain-derived neurotrophic factor serum levels in female rats with Alzheimer’s disease.Materials and Methods: 70 female Sperag Dawley rats were randomly divided into seven groups including: 1.control, 2. Sham, 3. lithium chloride 20, 4. lithium chloride 40, 5. Endurance training, 6. Endurance training lithium chloride 20, 7. Endurance training and lithium chloride 40. Alziemer was induced in rats by methyl chloride. Groups of endurance training, endurance training plus lithium coloride 20 and endurance training plus lithium chloride 40 ran on a treadmill with no incline at the speed of 15 to 20 meters per minute for 15 to 30 minutes each session and five times for eight weeks. The groups of lithium coloride 20, endurance training and lithium coloride 20 received lithium coloride 20 mg/kg according to their body weight per day. The lithium coloride 40, endurance training and lithium coloride 40 received lithium coloride 40 mg/kg of their body weight per day for 14 days. During this period, the control group did not have any activity and did not recieve any treatment. ANOVA and tukey post hoc tests were used for statistical analysis.Results: The results showed that chloride as well as endurance training along with their interactive effects increased levels of brain-derived neurotrophic factor poisoning by neurotoxins. But the greatest impact was observed in endurance training and chloride 20. Also, serum levels of brain-derived neurotrophic factor significantly decresed owing to Methyltin poisoning in female rats (p<0.05).Conclusion: Based on these findings, we conclude that chloride, endurance training and their interactive effects in female rats with Alzheimer’s disease raised brain-derived neurotrophic factor serum levels which implies that Alzheimer’s disease can be improved.

Background and Objective: Wheras renal ischemic-reperfusion injury increases lipid peroxidation level in the liver tissues, it decreases the antioxidant activity and antioxidant enzymes. Olive leaves are considered as significant sources of bioactive phenolic compounds with superior antioxidant capacity, anti-inflammatory and radical scavenging.Materials and Methods: In this study 50 male rats were allocated randomly to 5 groups: 1) control, 2) 1h I/R, 3) 1h I/R-OLE (Olive Leaf Extract), 4) 24h I/R and 5) 24hI/R-OLE. The animals received 100 mg/kg olive leaf extract in 0.5 ml drinking water using gavage for 28 days in 3and 5 groups before induction of ischemia (1hour). Other animals received 0.5 ml normal saline by gavages. At the end of the reperfusion period (1and 24 hours respectively), the serum level of urea, creatinine and liver enzymes as well as antioxidant enzymes including MDA, SOD and GPX were determined in liver tissue.Results: MDA level in OLE- treated groups decreased significantly compared to ischemic-reperfusion groups (p<0.05). In the meantime, it was detected that activity level of SOD and GPX in liver tissue of ischemic groups was significantly lower in comparison to OLE treated groups (p<0.05).Conclusion: This study enlightened that OLE is a protective agent against renal ischemic-reperfusion injury in liver tissue.

Background and Objective: Micro leakage is the most important reason for secondary caries and treatment failure. The aim of this study was to evaluate the effect of liner (flowable composite) and bonding agents on micro leakage of resin composite (z250) in class II cavities.Materials and Methods: Standardized Class II cavities were prepared on mesial and distal of 80 human premolars. The teeth were divided into eight groups based on the position of gingival marginal, bonding agent and liner. Thus, the classification of groups were as follows: group I: margin (1mm sub CEJ), bonding (single bond,3M), and resin composite(z 250,3M), group II: flowable composite (filtek flow, 3M) as a liner, the rest similar to group I. group III: margin (1mm supra CEJ), the rest similar to group I, group IV: margin (1mm supra CEJ), the rest similar to group II, group V: bonding (Adper easy bond,self-etch,3M), the rest similar to group I, group VI: bonding (self-etch), the rest similar to group II, group VII: self-etching bonding, the rest similar to group III, and group VIII: self-etching bonding, the rest similar to group IV. All the samples were thermo cycled (3000 times) and placed in 10% metylen blue dye, then sectioned with diamond disk. They were evaluated using a stereomicroscope (40 x). The data were analyzed by one way variance and tuky test (p<0.05).Results: Concerning sub-CEJ margin, the greatest micro leakage was in group I and the least was in group VI (P>0.05). Concerning supra-CEJ margin, group III had the greatest micro leakage while group VIII had the least. (p>0.05). The comparison between groups showed significant differences between groups I and VIII (p<0.05).Conclusion: Combination of self-etch adhesive with flow able resin composite (liner) as a packable resin composite z250 decreases micro leakage.

Background and Objective: Ischemic heart disease implies reduction of oxygen and blood supply in the myocardium. The most common cause of ischemia is atherosclerotic coronary artery disease. While numerous risk factors lead to coronary diseases, the mechanism of infectious agents in CAD remains unidentified.Materials and Methods: In this study, 360 patients with and without coronary disease underwent evaluation in terms of cytomegalovirus (CMV) and herpes simplex virus (HSV) seroprevalences. Serology was performed by means of ELISA assays.Results: Of 360 patients, positive serology was reported for CMV and HSV in 91.7 % and 93.3% with CAD as well as 66.1 % and 57.5 % without CAD (P<0.001). The risk of coronary disease by cytomegalovirus and herpes simplex in people who had positive serology were 1.5% and 6.81% times, respectively. The risk in regard to the control of other significant variables was statistically significant (P<0.001). The risk of coronary disease pointed out an increase by 3% per age which was statistically significant. In men at risk of coronary artery disease, positive HSV serology was 4.8 times more than women and in patients with a history of myocardial infraction, this risk was reported 6.47 % times more than the patients without this history (P<0.001).Conclusion: Owing to possible association of viruses and bacteria in the process of atherosclerosis, further research is recommended to find out the relationship of other infectious agents with CAD and the presence of microorganisms in the coronary atherosclerotic specimens.

Background and Objective: Cancer-related fatigue is one of the most common side effects of breast cancer treatments. Humor therapy has a special role in alternative and complementary medicine. The aim of this study was to determine the effect of humor therapy on fatigue severity and quality of life in breast cancer patients undergoing external radiation therapy Materials and Methods: This study was a clinical trial which was carried out on 58 patients with breast cancer receiving radiation therapy (5 weeks) in two groups of experimental and control. Patients in the experimental group attended humor therapy sessions twice a week for one month. Fatigue questionnaires were completed at the end of the first week as the pretest and at the end of following weeks as the posttest. Results were analyzed through statistical methods of repeated measures ANOVA and independent t test in SPSS 17 software.Results: Comparison of four items of fatigue severity in both groups after humor therapy showed statistically significant differences between treatment and control groups (P=0.001). There was a mild fatigue interfering with normal activities in the humor group and a severe fatigue interfering with making relationship with others and enjoyment of life in the control group this difference was statistically significant between two groups (P=0.001).Conclusion: The results of this study suggest that humor can be effective in reducing cancer-related fatigue in breast cancer patients undergoing radiation therapy. Nursing managers are recommended to supplement facilitities for implementation of humor in order to improve the quality of life of cancer patients.

Background and Objective: Stroke accompanied by psychiatric disorder and mental performance is one of the most disabling neurological diseases in adults and depression is the most common psychical complication among them. The aim of this study was to determine the prevalence and risk factors of early depression after stroke.Materials and Methods: Using a convenient sampling method throughout this descriptive study, data gathering was done via check lists and DSM-IV-TR criteria. Interviews along with observations were also applied to collect the data. The study population consisted of 80 stroke patients referred to Imam Sajjad and Tonekabon Shaheed Rajaei Hospitals over the years of 2010-2012. Anatomic location of the lesion was determined by MRI and CT-scan after examining and diagnosis. Descriptive and inferential statistics (t-test, ANOVA, and chi-square) were used to analyse the collected data.Results: The overall incidence of early post stroke depression was 45%. There was no significant correlation between early post stroke depression and age, sex, involved vascular line, hypertension, hyperlipidemia, heart disease, multiplicity of stroke attacks and anatomical place of stroke. There was a significant correlation of early post stroke depression with type of stroke (p=0.023) and diabetes (p=0.027).Conclusion: The results showed high prevalence depression in patients after stroke attack. Therefore, it is necessary to pay attention to depression symptoms and its risk factors for accelerating recovery and decreasing the risk of subsequent stroke and mortality.