Studies in Medical Sciences
Year:2005 | Volume:16 | Issue:2|Papers Count:12

Background and Aims: It has been proposed that iron overload in patients with β-thalassimia is associated with enhanced free-radical formation and/or defects in antioxidant defense. Iron facilitates the generation of free radical species (i.e. hydroxyl radical) via the Fenton reaction. Hydroxyl radicals are the main cause of tissue damage in biological systems. The aim of the present study was to examine the impact of iron overload in patients with β -thalassimia on plasma markers of oxidative stress including vitamin E and malonedialdehyde. Materials and Methods: Patients with major β -thalassimia and control subjects (age: 7.67±4.4.2 years and 10.20 Patient with major β -thalassimia 5.50; n=20 each) were recruited from Imam Hospital, Urmia. Plasma malonedialdehyde levels were analysed spectrophotometrically. Vitamin E concentrations were measured by HPLC coupled to spectrometric detector. Results: Plasma vitamin E levels were lower in patients with β -thalassimia than in control subjects (l4.07±4.25 µM vs 20.04±5.02 µM; p<0.005). Patients with β -thalassimia, on the other hand, had higher malonedialdehyde concentrations than in control subjects (0.34±0.03µM vs 0.19±0.04 µM; p<0.005). Both Iron and Ferritin levels were significantly elevated in patients with major β -thalassimia than in control subjects (160.97±45.54 µg/L vs 61.16±23.42 µg/L and 387.77±334.90 µg/L vs 50.29±34.15 µg/L, respectively). Discussion: This study has shown that oxidative stress resulting from iron overload in patients with β - thalassmia is linked with decreased antioxidant capacity and increased lipid peroxidation than in Control subjects.      

Background &Aims: Photochemtherapy is an effective method for treatment of several diseases especially vitiligo and psoriasis. Some complications have been reported by this method .In this study we tried to record and evaluate the complications of this method and compare them with previous report. Materials and Methods: In a two years period, we studied 110 patients who were under photochemotherapy in Taleghani hospital, Urmia, and recorded the complications and analysed data. Results: We observed three main groups of dermal, ocular, and gastrointestinal complications. Erythema was the most common dermal complication (59.09%) and pruritus was the second (51.81%). Cojunctivitis was the most common ocular complication (22.72%) and nausea was the most common gastrointestinal complications (45.45%). There was not any case of malignancy in our study. The rate of erythema in patients who applied topical methoxalene was higher than who were under systemic PUVA. The complications correlated directly to dose of methoxalene and duration of therapy. Some complications like erythema, blister formation, pruritus and lentigo were higher in our patients than other studies: Instead, some other complications like hyper trichosis, xerophthalmia and actinic keratosis were higher in other reports. Discussion: Complications in this method is more different in Iran, Its cause maybe referred to skin types and cultural and economic differences about using of preventive methods and tools.    

Background and Aims: Splenomegaly is a common finding in numerous diseases such as hepatic diseases like cirrhosis and chronic active hepatitis (CAH). The purpose of this study was evaluation of the grading of splenomegaly in cirrhosis and CAH and comparison between them, according to splenic index. Materials and Methods: Sonography was used to evaluate splenic index (SI) in 72 cirrhotic patients and 34 CAH and 100 healthy control subjects prospectively and blindly in Imam Khomeni Hospital between years of 1379 to 1381. To express spleen size, splenic index was used which is known method. SI was obtained by the following formula: SI (cm2) =a (cm) × b (cm) where (a) is the transverse and (b) is the vertical diameter of the maximum coronal sectional image of spleen. Results: Splenomegaly was present in a high percentage of the patients even though a majority of these spleens were not large enough to palpate. By grading splenomegaly, characteristic distribution of SI was optioned for all subjects. Discussion: In cirrhosis 83.5 % of patients had grade II or higher and 55.5 % had grade III or higher splenomegaly whereas in CAH 83% had grade II or lower to normal splenic index and only 6% had grade III splenomegaly. These characteristic distributions could help us to differentiate two diseases according to splenomegaly grading. (p<0.001)      

Background and Aims: Vitamin D deficiency is determined by serum level 25-OH-VIT D. Several studies revealed high prevalence of vitamin D deficiency in females of the Asian sunny countries. Materials and Methods: The present study investigated serum 25-OH-D of 162 females aged from 15 to 40 yrs referred to Urmia Orthopedic clinics with bone and muscle pain. They were not pregnant or lactating and had no systemic or neurologic diseases. Results: Severe vitamin D deficiency (25-OH-D<10 ng/ml), mild vitamin D deficiency (25-OH-D=10-20 ng/ml), and normal values (25-OH-D>20 ng/ml) for vitamin D were found in 57.4%, 24.7% and 17.9% of cases respectively. A significant relationship was only found between vitamin D deficiency and decreasing age (p=0.003). Discussion: Inadequate exposure to sunlight is the main factor in vitamin D deficiency. Enrichment of foods is recommended.      

Background & Aims: Previous researches reveal that the characteristics and social status of a child's family are important determinants of its chances of surviving beyond childhood. This study investigates the effects of consanguinity in a society in which marriage among close relatives is common. Materiasl and Methods: Our research based on determing the socio-demographic perspective of people and their marriage status. Both questionnaires and face-to-face interview technique were employed. Results: The average rate of consanguineous marriage in this region is 23.20%. Among β-thalassemia cases 59.1 % in the region are the direct result of the mothers married to a first cousin. Of the mothers married to a first cousin, 25.8% endured the abortion of at least one child. 38.1% of the hemophilia patients are the results of consanguineous marriage. These data among the blind and deafness and mental retards children are respectively 60%, 63%, and 15.45%. Older mothers, mothers with high levels of education, and mothers residing in the urban area are less than half as likely to experience these problems. Conclusions: Finding of this study revealed that consanguineous marriages, have major effects in causing of mentioned diseases and therefore in order to prevent them, we have to improve people's cultural practice, values and norms, that lead them to this sort of marriage.      

Background & aims: Pain specialists estimate that at least 90 percent of patients with pain should experience satisfactory relief. Yet at least 50 percent of patients needlessly suffer moderate to severe pain despite two decades of efforts to educate health professionals. The purposes of this study are : 1) Clarifying how & how many of patients' rights about appropriate pain assessment & management are considered by nurses 2) What are the causes of disconsidering patients' rights about appropriate pain assessment & management. 3) Offering practical solutions for pain controlling problem in hospitals. Material & Methods: We chose two available unprivatal hospital with 30 cancer post surgical patients & their clinical nurses in order to basic study & clarifying pain control's present situations in our hospitals. The tools used in this study were two questionnaires: one for patients (For clarifying how & how many of patients' rights about appropriate pain assessment & management are considered ) & another for nurses in order to assessment their knowledge ,attitude ,practice about pain & asking them for offering practical solutions for pain controlling problem in hospitals. Results: Data analysis showed that only 30.9 % of patients' rights about appropriate pain assessment & management are considered nurses said that causes of disconsidering patients' rights about appropriate pain assessment & management are: 1) disappropriate attitudes of nurses about pain cause they consider pain as a patient's compliant, not as a fifth vital sign.2) lack of knowledge & pay low attention to nondrug pain relief methods besides using of drugs. 3) Lack of appropriate pain assessment tools. Discussion: Considering this findings, we offer 3 practical ways for a suitable pain controlling in hospitals:1) Planning pain controlling protocols according to new standards of JCAHO in hospitals .2) Conducting education courses about necessity of considering patients rights in pain controlling. 3) Nurses should be used nondrug pain relief methods besides using of drugs. We also offer correctively applying of these protocols for solving pain controlling problem.    

Background & Aims: Investigation of the type of cellular immune response in stomach of Helicobacter felis infected mice ,and its immunopathogenic role in gastritis, and also invitro comparison of soluble Ag with heat-inactivated and urease Ag, by lymphocyte proliferation test and level of IFN-γ production. Were studied. Materials and Methods: 15 healthy mice, C57BL/6 Strain, 6 to 8 week-old, dividing in 5 groups, each consisting of 3 mice. Four groups of mice were infected by oral administration of three dose of 3×10.7H. felis, and one groups of infected mice were killed and lymphocyte were cultured along with 3 ml of soluble Ag/well for 3 days. Then stimulation index were determined by cellular count. The assay of IFN-γ in culture supernatants were done by a sandwich ELISA. The intensity of gastritis was studied by examination of H&E-Stained histologic section and were graded to mild, moderate and severe, according to percentage of inflammatory infiltrate cells. The level of anti-Helicobacter Abs was measured by a sandwich ELISA. One group of infected mice were injected with anti- IFN- γ, and after 3 weeks were examined for level of IFN- γ, anti Helicobacter Ab, and severity of gastritis. Results: Data showed that soluble Ag induced a proliferative response only in lymphocyte of infected mice, as stimulation index was obtained 50. In constant, heat-inactivated H.felis and urease Ag stimulated an identical response in both infected and non-infected mice. At eight weeks after infection, the cellular infiltration in gastric section were as, mononuclear 40%, plasmacell 35% and neutrophil 20%. The infected mice which received anti- IFN- γ showed a significant decrease in level of IFN-y, anti-Helicobater Ab and gastric inflammation. One and eight weeks after infection, the IFN- γ levels produced from infected mice lymphocyte were respectively 525 picogram and 755 pg/ml. In contast, noninfected mice lymphocyte had no detectable level of IFN-γ in response to Ag stimulation. Discussion: These data demonstrate that cellular response was concomitant with Ag-specific cellular proliferation, high level of IFN-γ production and gastric inflammation. It suggests that the Helicobacter-specific Th1 response may be contributing in pathogensis of disease.  

Background and Aims: Congenital hypothyroidism (CH) is more prevalent in some Asian populations and consanguineous marriage is considered as one of its probable causes. The aim of this study is to investigate and compare the rate of consanguinity among parents of neonates with and without congenital hypothyroidism. Materials and Methods: Since May 2002 to August 2003, the serum T4 and TSH concentrations of 40000 newboms were measured on their 3rd- 7th day of birth, by RIA and IRMA methods, respectively. Newboms with T4<6.5 µg/dl and TSH>20 mIU/L were recalled. Congenital hypothyroidism was diagnosed in newboms with T4<6.5 µg/dl and TSH>10 mIU/L, according to the results of their second-time measurements. The rate of consanguineous marriage in parents was compared in neonates with and without congenital hypothyroidism. Results: From 700 recalled neonates (recall rate=1.75%), hypothyroidism was confirmed in 117 neonates (1:342). There were no relationship between consanguineous marriage (both first and second cousin) and CH (P=0.06, X2=3.3). The odds ratio of CH occurrence in first-degree to non first-degree consanguineous marriage was 1.93. (p=0.009, X2=10.9). Conclusion: Considering the high prevalence of CH and also consanguineous marriages in our community and the relationship observed in this study between CH and first-cousin consanguineous marriages of parents, improvement of community knowledge in this field is necessary.      

Actinomycosis is an indolent progressive anaerobic bacterial infection. About twenty percent of infections are in abdomen. In this study, we describe an unusual case that is confined to liver and spleen. A 39 years old man who presented with abdominal pain for 8 months. Lab investigations showed elevated alkaline phosphates. Abdominal C.T. Scan revealed mixed space occupying lesions posterior to spleen. Laparotomy was done. Splenectomy and liver biopsy performed. Histopathologic investigations revealed spleen and liver actinomycotic abscesses. His postoperative course was uneventful and discharged with oral penicillin.    

Background & Aims: Aggressive angiomyxoma is a rare benign soft tissue tumor characterized by slow growing, locally aggressive but non-metastasizing occurring preferentially in the pelvic and perineum of adult women and is rare in males. Despite its bland histologic features, it has a propensity for local recurence. Case report: The patient was a 54 - year- old man. He had a painless mass measuring about 11× 8. 5 × 6 cm localized in the left upper scrotal area for 5 years Discussion: We report a case of spermatic cord aggressive angiomyxoma in a middle age man and discuss the morphological features; more helpful for distinguishing this tumor from other soft tissue tumors. Aggressive angiomyxoma must be differentiated from benign and malignant myxoid tumors. A wide surgical excision based on correct histopathological diagnosis is the basis of curative treatment.