Studies in Medical Sciences
Year:2006 | Volume:17 | Issue:3|Papers Count:14

Background and Aims: Pemphigus disease is defined as a chronic autoimmune bullous skin disease that is characterized as histologic regarding intraepidermal bullae due to acantholysis. Direct causes of this disease are unknown. However, it may be related to inheritance and several other factors that play roles in its acceleration. The aim of this study is surveying human leukocyte antigens- type in patients with pemphigus, who referred to Tabriz Sina Hospital dermatology ward and clinic.Methods &Materials: In this cross - sectional study, venous blood samples of 51 patients with pemphigus who referred to Tabriz Sina Hospital dermatology ward and clinic, Azar 81- Aban 82, were evaluated to determine human leukocyte antigens with microcytotoxicity technique and were compared with the results of HLA- type in control groups.Results: In this study the most common leukocyte antigen was BW6 (49%) followed by BW4 (39%), A3 (35%) and B5 (31%). In patients with positive familial history of disease, B5 leukocyte antigen was positive in 75%.There was a significant relationship between gender and B5, CW7 leukocyte antigens (P= 0.016).The prevalence of A26 among patients with recurrent disease was 20% but HLA B35 was positive in the control groups(26%) more than the patients(6%).In this study the prevalenceofBW6 - BW4 - A3 - B5 leukocyte antigens was high that some of leukocyte antigens were common with previous studies but some of leukocyte antigens were specialized to our region.Discussion: Due to attention to specialization of some leukocyte antigens (such as BW4, BW6) to region of this study, we can use this type of antigens for screening patients with pemphigus. In this study there was a significant relationship between B5 leukocyte antigen and familial history but the prevalence of B35 was high in the control groups.

Background finds Aims: Nowadays, tissue expansion is used for repairing skin defects. Traditionally, duration for operating was about 4 to 6 weeks but according to recent articles it can take less time as 72 to 96 hours. Clinical outcomes and histologic changes of these two methods are compared in recent studies.Methods and Materials: 20 patients were randomly allocated and studied during a year in two separate groups. Because of severe complications, 3 patients were removed from the study. Among 17 patients, 8 persons (47.1%) were male and 9 persons (52.9%) were female. Rapid tissue expansion (72 hours) was used in one group and traditional method (6 weeks) was used in the other one.Results: There is no significant statistical difference of expanded skin adequacy, color of skin, and complication rate between two groups. Further more, there is no significant histologic difference except for the changes of epidermis and vessels.Discussion: According to the results of the study and comparing them with recent articles and studies, it seems that rapid tissue expansion is a secure, efficient, and reliable method especially if it is done individually and in a desired condition.

Background &Aims: This study tries to investigate the effects of renal transplantation on life quality of dialyzed patients in Urmia. As a prospective study needs long time so the study was randomly carried out case- controlly on 80 dialyzed and 80 transplanted patients.Materials and Methods: The material of the study was a questionnaire including personal characteristics, type of disease, and life quality in three different areas of physical, psychological, and social relationships. The questionnaire was validitated by doing a=0.9466 Cronbakh. Questionnaires were filled by doing interviews.Results: From all the 152 patients, 9% reported their quality of life as bad, 44.9% as moderate, and 46.2% as good. In the dialyzed group, the percentage was as follows: 56.8% as bad, 40.5% moderate and 2.7% good. The mean number of transplanted patients was 3.47 by 0.736 standard deviation. It was 2.32 by the standard deviation of 0.489 for the dialyzed group. The difference between the two was significant (p<0.0005).Discussion: It is concluded that by doing transplantation, the life quality of dialyzed patients would improve. So it is strongly suggested that by doing cultural programs, the people should be persuaded to present their kidneys in case of serious brain damages. The spiritual and humanitarian sides of the presenting a kidney must be emphasized too. In that case, it is not necessary for dialyzed patients to wait long for transplantation. Kidney transplantation will increase quality of life in these patients.

Background and Aims: Abnormal uterine bleeding is an important sign of uterus cancer. Therefore, the outmost precautions are required in its diagnosis and an appropriate treatment of these bleedings. The golden standard for diagnosis of abnormal bleedings with uterus source is D&C (Diagnostic Curettage). Nowadays it has been observed that it is not necessary to perform D & C in all women with abnormal uterine bleeding. Therefore, it is important to recognize those who may need these procedures. This will decrease the rate of D&C and all probable complications. Recently, one of the paraclinical methods that has attracted experts' attention is performing sonohysterography to study abnormal bleeding of uterine. This may help to eliminate abnormal uterine bleeding that is the main reason for D&C, so this procedure should be performed to those patients who have abnormal sonohysterographic findings.Materials and Methods: Women with abnormal uterine bleeding who were addressed to Urmia Kosar Hospital were evaluated and patients who were candidates for D&C were enrolled in our study. Sonohysterography was performed by a radiologist in presence of a house resident. D&C was performed by a third year gynecology resident.Results: In eighty-five patients with AuB sonohysterography revealed 15 endometrial polyps or submucous myomas, 16 endometrial with thickness more than 5mm and regular, 4 endometrial with thickness more than 5mmand irregular, 50 endometrial with thickness£5mm. The results of D&C are as follows:1 patient had endometrial cancer, 4 patients had endometrial hyperplasia, 9 had atrophic endometrium, 41 had proliferative endometrium, 18 had secretary endometrium, 10 had pill effect endometrium, and 2 had decidualize endometrium. Our main goal in this study was to predict negative predictive value which was 100%. This value illustrates that 50 cases had normal endometrium on sonohysterography and D&C was normal.Discussion: Due to the fact that one of the reasons for AuB in women is the occurrence of hyperplasia and endometrial cancer, therefore; performing justified diagnosis is necessary. The golden standard for these cases is the performance of D&C. It is preferred to use other paraclinical methods. This may enable us not to use D&C in all other cases of AuB that are candidates for D&C. In cases that sonohysterography does not have positive findings (thickness£5mm and endometrium regular) we could simply eliminate performing D&C because D&C does not have positive finding (endumetrial hyperplasia, cancer, fibroids and polypoied mass) and our study proves this point. In other cases of AuB with local lesions in uterine wall, the intended results may not be found when performing D&C, but in these cases we can localize uterine lesions with doing sonohysterography and then with goaled D&C or even better performing of hysteroscopy; we can pickup focal lesions under direct vision because there was no samples of all uterus with simply performing D&C.

Background and Aims: Laser therapy with low-level laser can cause physiological and biochemical changes in cells. These changes depend on laser therapy effect with wave length and special power without increasing temperature in the cellular reactions. The effects of low-level laser can be summarized in three sections: 1. Biological stimulation 2. Anti-inflammatory 3. Analgesic. In this project we have focused on the biological stimulation effect.Materials and Methods: In this study peripheral lymphocyte cells were divided into two groups of experimental and control. Experimental group was exposed to the Ar, He-Ne, Ga-AI-As laser with 0.5-10 j/cm2 density.Results: In the experimental group metaphase plates due to radiation Ga-Al-As (l= 810 nm), He-Ne (l=632.8 nm) laser was 1.5 times bigger than the control group. Results showed that the highest cellular stimulation was in l= 810nm, l=632.8nm which was significant comparing to A=488nm.Discussion: In this study proliferation of metaphasic plates with 4 J/cm2 energy revealed the highest stimulation in the lymphocyte while the prevented energy of metaphysic plates was 10 J/cm2; therefore, the increasing laser density had a preventing effect on the lymphocytic cells. So it has stimulating effect on 632.8 nm. This finding can be used in healing of ulcers and in diseases where there is a decreased velocity in cellular proliferation.

Background &Aims: This study was designed to determine effects of morphine on frequency of different components of seizure induced by Low Mg2+ ACSF in whole hippocampus preparation of neonate mice.Materials and Methods: C57/BL6 mice 11 to 19 days of age were used. Animals anaesthetized and the brain was removed (n=25) and placed in ice-cold continuously oxygenated ACSF. Then the hippocampi was dissected and incubated in normal ACSF at room temperature for one hour before electrophysiologic recording. Seizure activity was induced by perfusing the hippocampus with Low Mg2+ ACSF. Extracellular recordings were performed mainly in the CA1 pyramidal cell layer. Seizure activity was quantified by measuring the frequency of the ictal events.Results: All applied concentrations of morphine and naloxone 10 mM decreased the frequency of seizure more effectively on tonic part of seizure. Naloxone not only unblocked the the effects of morphine on the frequency of seizure, but also markedly suppressed the frequency of epileptiform activities. In addition, combined application of morphine and naloxone completely blocked the tonic-clonic part of the seizures. Discussion: Our results indicate that morphine may decrease the frequency of hippocampal seizure through different receptors other than opioid receptors because naloxone as an opioid receptors antagonist unblocked these inhibitory effects of morphine.

Background and Aims: Stroke in young adults (15-45 y) is not unusual. More than 40 causes have been recognized for young adults stroke. One less known etiology is arterial thrombosis due to antiphospholipid antibody. This study evaluates the frequency of antiphospholipid antibodies in an unselected young population with cerebral ischemia; moreover, antiphospholipid antibody-positive stroke patients were compared with those showingno stroke characteristics.Materials and Methods: All admitted patients (15-45 years old) to Imam Khomeini Hospital 2003-2004, who suffered cerebral ischemia were tested for antiphospholipid and anticardiolipin antibodies and compared with a matched sex and age group without cerebral ischemia. Twenty five patients with stroke (37+/-5.4y) and 40 controls (37.12+/- 5.8) were studied. In stroke group there were 14 women and 11 men (60% female). The antibodies (both IgG and IgM classes) were measured by standardized enzyme-linked immunosorbent assay (ELIZA).Results: About 7.5% of strokes occurred in subjects under 45 years old. The prevalence of these antibodies in stroke patients was 24% compared to 5% in the controls (p=<0.05). Mean of all antibodies' levels, except the antiphospholipid antibody IgG, were significantly high in the stroke group. There was at least one prior cerebral event in 2 of 6 ischemic patients (33.3%) with high antibodies, and 2 of 19 (10.5%) without them; the change was not that much significant.Discussion: We conclude that the prevalence of antiphospholipid antibodies is rather high in young adults with cerebral ischemia. These patients may have unrecognized systemic lupus erythematosus. The antiphospholipid antibody-positive stroke patients did not differ significantly from antibody-negative stroke patients with regard to stroke characteristics only for mild echocardiographic abnormalities (p= 0.047).

Background and Aims: The limited availabillity of donor sites for nerve grafts stimulates research toward finding suitable alternatives for autograft.Materials and Methods: This research is an experimental study that 48 male rats (200-250 gr) were used. After axotomy, 1cm segment of the sciatic nerve in rats was removed and the gap was then bridged using one of four following methods (Polyvinylidene fluride or PVDF + NGF + IGF-1, Autograft, Sham, and Control). All animals were evaluated 7, 21, 35, 46, 60 and 90 days after operation by sensory test, and Sciatic Functional Index (SFI) and at 90 days by electrophysiologic testing. After 28 and 96 days of implantation sciatic nerve was studied by light and electron microscope.Results: 90 days after operation, there was no difference in sensory testing between groups. After 56 days, the mean SFI autograft group was superior in NGF + IGF-I + PVDF group (p<0.01). Mean motor nerve conduction velocity in different experimental groups was not significant (p=0.05). After 28 days of implantation, the regenerated tissue cables into PVDF tube were round shaped and the mean number of myelinated axons in different experimental groups was not significant (p=0.06) After 96 days of implantation, the mean number of myelinated axons in NGF + IGF-I + PVDF group was lower than the autograft group (p<0.01).Discussion: In this study positive effects of NGF + IGF-I on regeneration of nerves through a PVDF channel shows that it may be useful in treating peripheral nerve injuries.

Background & Aims: Committing suicide by drugs and chemical materials has had considerable dimensions in the world. Using drugs and chemical materials is known as the most common way of committing suicide. Due to importance of chemical poisoning, here we study four hundred self-poisoned patients to determine the relation of stressor factors in committing suicide.Methods & Materials: This cross sectional study performed by clinical interview of four hundred patients hospitalized for intentionally committing suicide. Determining the variables was done in accordance with a questionnaire of Holmes-Rahe social rating scale that consists of forty stressor factors. Chi-Square test was used to determine the relationship between frequency of factors and bachelorhood, being unemployed number of children and type of poisoning.Results: From four hundred subjects, 55.5% were female and 44.5% male. 52.5% of patients were 15-24 years old. 80.8% of suicides had occurred among bachelors and unemployed people. In present study the most common stressor factors were poverty (64.75%), attracting other's attention (42.5%), unemployment (40%), quarrel between wife and husband (32.5%) and family strife (29.5%). The most common stressor factors among young adults were matrimonial quarrels and poverty. There was a significant association between frequency of stressor factors and bachelor hood, unemployment, number of children and type of poisoning material (p<0.001).Discussion: Although development of appropriate medical facilities in poisoning wards is necessary and should be noticed, but decreasing psychological health problems is essential. There might be predisposing factors for committing suicide such as inadequate psychological health, drug abuse, lack of marital satisfaction, boredom on the financial problems in young adults, poor supervision by parents and cultural leadership at risk groups such as teenagers and young adults and etc.

Introduction: Pregnancy and delivery in women of 35 years old are along with more complications. This study was done to compare pregnancies in two age groups of ±35 years.Methods & Materials: An analytic- descriptive - cross sectional study was carried out on 737 pregnant women who referred to Kosar hospital for delivery (2002-2003). Sampling was done non-randomly, then pregnancy and delivery complications were considered.Results: 370 pregnant women who went under study were in age group of +35 years and 367 of them were in age group of 20-34 (with average of 31.7±7.07T).he results indicated that the prevalence of preeclampsia and Cesarian section were high in the age group of +35. The difference between two groups regarding preterm delivery, mal presentation and abnormal upgar score were due to the effect of confounding variable of Parity. No significant difference was observed by eliminating the mentioned effect. Discussion: There was a significant difference between two age groups in preeclampsia and C-Section, so it is suggested to pay more attention to the age group of +35. In the present study as compared with other studies there was no significant difference in other complications.

In the early stages of development the median artery is the main artery of forearm and after birth this artery arises from the common interosseous or the anterior interosseous artery; its size is small and terminated by supplying the median nerve. The aim of this paper is to report the variations in origin, route and anastomoses in the median artery of an Iranian male cadaver.In routine dissection, it was observed that the right side median artery arised from ulnar artery just proximal to the origin of the common interosseous artery and accompanied the median nerve into palm through the carpal tunnel. In the palm, median artery completed the radial side of the superficial arch and ultimately in the first interdigital space, it formed a rhomboid anastomotic ring with the radial artery.A thrombosed median artery was associated with compression of the median nerve in carpal tunnel which might be important to surgeons in carpal tunnel syndrome complications.

Vaginal epithelium is the most important site for initial contact of protozoan parasite Trichomonas vaginalis. Importance of initial adhesion followed by invasion and persistence are well accepted for establishment of infection in human. The effect of Lactobacillus acidophilus and pH in attachment of T vaginalis isolated from 10 symptomatic and 10 asymptomatic patients to vaginal epithelial cells were investigated. Vaginal epithelial cells from normal women were used for measuring cell adherence by parasite in vitro by adding Lactobacillus acidophilus (whole cells), excretory secretary product (ESP) of L. acidophilus and changing the pH of the media either by HCI or L. acidophilus. Wet mount prepared after everyone hr up to 4 hrs. Mean reading of three such experiments was taken to compare the isolates and their controls. In presence of L. acidophilus (whole cells) at one hr time period, there was enhancement followed by gradual fall observed at two and three hrs time period ultimately leading to non-viability of T vaginalis at four hrs of incubation. In the presence of ESP of L. acidophilus from the beginning i.e. even at one hr of time period decreased adhesion was observed and non-viability was seen again at four hrs time period. On the whole the symptomatic patient isolates showed higher adhesive ability in comparison to asymptomatic isolates and this difference was much more appreciable compared to control group.The b-number of VECs attached by T vaginalis isolated from symptomatic patients (62%) and asymptomatic (52%) patients were more at pH 4.5 reduced by HCI as compared to when pH was reduced by L. acidophilus to 4.5 in symptomatic (47%) and in asymptomatic (35%) patients. The presence of L. acidophilus was found to be effective in enhancing the attachment at initial step of infection, but has deleterious effect after that on parasite. Thus, increase of vaginal Lactobacilli and decrease of vaginal pH could be effective in eradication of parasite, it especially could be useful for drug resistance patients.