Studies in Medical Sciences
Year:2004 | Volume:15 | Issue:2|Papers Count:11

Background & Aim: Helicobacter pylori (HP) infection is one of the most common infections in the worldwide. It has been accepted as a major cause of peptic ulcer disease. Eradication of Helicobacter pylori infection leads to cure of ulcers, reduction of its complications, and prevents relapse. In various regimens in the world, triple therapeutic regimens with metronidazol or claritromycin bases as 7, 10 and 14 days courses, has been suggested. These regimens usually contain a proton pump inhibitor and another antibiotic. Clarothromycin, was shown to be a good alternative to metronidazole in therapy for helicobacter pylori eradication especially in areas where metronidazole resistant bacteria are common. A randomized controlled clinical trial to determine the efficacy of triple therapy with clarithromycin, amoxicillin and omeperazole for eradication of HP. was done and comparison of 7 days versus 14 days treatment with such regimens. Materials &Methods: This study carried out on patients who had peptic ulcer or dyspepsia that was established by endoscopy and endoscopic biopsy samples of them were positive for rapid urease test and histopathological studies. The patients were divided randomly in two groups. Group A was treated with clarithromycin 500 mg b.i.d., amoxicilin 1 gr b.Ld. and omeprazole 20 mg b.Ld. for 7 days and group B was treated with such drugs and regimens for 14 days. Clinical evaluation and reendoscopy were carried out 4 weeks after finishing treatment and if both of rapid urease test and histopatological studies on biopsy samples were negative, HP. eradication was accepted. Results: 65 of 81 patients enrolled into this study completed the study and returned for repeated endoscopy. The per protocol HP. eradication rates in group A (35 patients) and group B ( 30 patients) were 85.6% and 86.6%, respectively ( p=0.6). Although the intent - to – treat eradication rates decreased, that for group A (N =41) and group B (N =40) were 73.1% and 65% respectively (p =0.42 ) There is not any significant relationship between the H.P. eradication rates and age, sex, severity of inflammation on pathological samples and presence of peptic ulcer or dyspepsia. 19.5% of patients had minor side effects but there was not shown any major side effect and significant relationship between side effects and the duration of therapy. Discussion: Triple therapy containing clarithromycin results in an acceptable eradication rates of HP. infection and there isn't any significant difference between the two above protocols.

Introduction: According to the prevalence of cardiovascular diseases and myocardial infarction in our community, especially among youths and the main role of cardiac rehabilitation in increasing of mental and physical abilities of CVD patients and help to return them to their previous life and also in decreasing social and economical problems due to these diseases; this study was done to assess the effect of shortening the length of cardiac rehabilitation period.Materials & Methods: In this study, 30 low risk patients with MI were randomly selected were discharged about one month ago and referred to cardiac rehabilitation unit of Isfahan Cardiovascular Research Center to follow up their treatment. They underwent 12-week rehabilitation period.Their exercise capacity, depression, anxiety and hostility scores were measured at their first reference and also at the end of third, sixth and twelfth weeks by a SCL 90 questionnaire. Mean studied factors were compared by paired t-test in SPSS software.Results: Results showed that all of the studied variables during intervals of cardiac rehabilitation were significantly different from of first reference (P<0.05). Hostility and anxiety scores at the end of sixth week were not significantly different from those of twelfth week. But practical capacity and depression scores were improved till the end of the rehabilitation period.Discussion: Generally, it can be concluded that practical capacity, depression, anxiety and hostility of low risk patients can be cured by performing rehabilitation programs.Practical capacity and depression in each interval were significantly different from those of the previous interval. But hostility and anxiety were improved until the end of sixth week. The study showed helpful changes at the end of sixth week. Then in cases that the facilities are limited, a 6- week period of rehabilitation can be replaced instead of 12-week period.

Introduction: Leishmaniasis is a spectrum of disease caused by at least 20 Leishmania sp. in clinical forms of cutaneous, diffused cutaneous, mucocutaneous and visceral. Leishmania major and Leishmania tropica are major causative agents of the cutaneous disease in Iran. At least 80 countries over the world have endemic foci of the disease. For this reason, WHO has emphasized on its prophylaxis and control. The suggested programs that WHO considered, are treatment of patients with the goal of decreasing psycho-social disorders and prevention and control of disease in regions which human is considered as a reservoir.Materials and Methods: In this study, female BALB/c and NMRI mice in 4-6 week age were distributed in twenty per group in 2 control and case groups. Each mice were challenged in the base of tail by 2 x106 of promastigotes of L.major (MRHO/IR/75/ER) from stationary phase of culture. Various protocols of induction of determined voltages of direct current electricity were used to treat the appeared lesions 2 times per week for 3 weeks. The two control groups received no treatment procedure. This method repeated 3 times because of reproducibility.Results: Variance analyses were used for comparing the results of pro tocols between the two groups of test and control in both BALB/c and NMRI mice. The results were showed this method can cure all of mice after 3 weeks of induction of electricity. Follow up (of the mice resulted in recurrence of the disease in BALB/c mice, not NMRI, next to 3 weeks after finishing treatment.Discussion: Direct Current electricity was evaluated as an effective method of treatment equal to chemical drugs. Electrotherapy in this way, in effectiveness, might eliminate costs and side effects of poisonous antimoniate.

Background & Aim: Vitamin E has an antioxidant effect and recommended for patients with coronary artery disease (CAD), with dosage of 100mg/day. The antilipidemic effect of vitamin E is contraversial. This study planned for evaluation of antilipidemic effect of vitamin E on serum lipoproteins.Material & Methods: In this double blind, Placebo controlled clinical trial, we selected 108 consecutive patients (mean age 57:1:.7.2) with CAD and basal low density lipoprotein cholestol (LDL-c) level of 100-130mg/dl, and randomised in two groups, 58 patients in case group and 50 in control group. Case group received protocol of non pharmacological treatment plus 1 tablet of 100mg vitamin E per day, and control group received protocol of nonpharmacological treatment plus 1 tablet of placebo. After I month period lipid profile was measured two time for 1 week apart after 10 hours fasting periods, and mean level was detected. Data analysed statisticalty and P<0.05 considered significant.Results: No significant reduction were observed between mean of changes in total cholestrol, HDL-C, triglycerid and LDL-C in female group (p<0.05). In this period after adjusting for non pharmacological treatment, only in male group (46 case) with CAD decrease in LDL-C was observed (11.2% vs 2.8%), but in female group, it was 4.8% in vitamin E group vs 2.4% in controls. Discussion: It can be concluded that 100mg vitamin E per day has no beneficil effect on plasma lipid levels. Decrease in LDL-C level of male group can be due to male hormonel effect of vitamin E that needs further investigation.

Background & aim: While the role of iron in induction of oxidative stress has been confirmed, the Nitric Oxide one's (NO) remained vague. Also there have been some controversies on the interaction of iron and NO. In this study we have examined this interaction in plasma and we measured Vit E (Vitamin E) level as a marker of oxidative stress.Material & method: Sixty-four male rats were allocated into 8 groups as the following: 1- SHAM (Nonnal Saline), 2- Fe (Iron Dextran), 3- ARG (L-Arginine - precursor of NO), 4- L-NAME (blocker of NO synthase, 5- Fe+ARG, 6- Fe+L-NAME, 7- DFO (Defferoxamine- Iron Shelator), and 8- ARG+DFO. After 20 hours of injections, Vit E in plasma was measured by using high peifonnance liquid chromatography.Results: Iron caused Vit E reduction in Fe group compared to SHAM group (p< 0.01). ARG did not have any effects on Vit E by itself. In Fe+ARG group there was no significant difference with sham group. The most reduction in Vit E occurred in group Fe+L-NAME so that its significant difference with SHAM and Fe+ARG was p<0.001 and 0.01 respectively.Discussion: We conclude that ARG by increasing NO concentration prevents and L-NAME by decreasing NO concentration exacerbates iron induced oxidative stress.

Introduction & Aims: Dientomoeba fragilis as a Pathogenic parasite needs to be diagnosed by laboratory. This protozoa has' not cystic form and usually transmitted by E. Vermicularis ova. Some reports show that D.f creat clinical symptom in infected persons and has been estimated that prevalence rate of symptomatic persons is 15 to 27%.View of this parasite is by staining of feaces smear that unfortunately don't carry out in most of clinical Laboratories. Because We can't diagnosis this organism in direct and formalin ether method some time M.D cannot diagnosis and treat Patient with diarrhea, Vomiting, lose Wight,... .Material & Methods: This study carries out on 790 cases in 6 months. Samples survived with iron hematoxylin cainion stainig method Result In 790 survaid samples 102 cases was positive that unfortunately has not been reported even 1 case. Prevalenc was 13 percent.Conclusion: Because of high prevalence of this organism and role of parasite in unknown diarrhea we are recommend use of staining method (iron hematoxylin cainion) for diagnosis of D. F.

Introduction: Despite the improvements in assisted reproductive technologies, ART Process is with a low successing rate. There are two major determinants of implantation: embryos and the endometrium. Although progesterone secretion is considered the major hormonal event during the luteal phase, E2 appears to play a crucial role as well.Methods: Patients who were undergoing ICSI with controlled ovarian hyperstimulation using a GnRH analog participated in the study. Patients were prospectively randomized into two groups for luteal phase supplementation. Patient's in-group I did not receive exgenouse E2 supplementation during the luteal phase. Patient's in-group 2 received 2mg of E2 polbid that starting on day 3 after E.T.serum concentrations of E2 and progesterone were measured in all patients on day HCG injection and on day 12 after E. T. pregnancy and implantation rate were documented. Student's ttest and Fisher's exact were used for the statistical analysis of the date.Results: Higher E2 and progesterone levels found during the luteal phase and higher pregnancy rate were recorded in the patients who receive E2 supplementation and were treated with the long GnRH analog protocol.Conclusion (s): The results of this study indicate the patients who are treated with the long GnRH analong protocol for controlled ovarian hyperstimulation, the addition of E2 to the progestin support regime may have a beneficial effect on pregnancy rate.

Introduction: Blunt abdominal trauma is one of the most common mechanisms of trauma especially in motor vehicle accidents. Diagnostic problems are the matter of concern in these patients. There are many reports about the accuracy of diagnostic tools considering the decrease in the rate of negative laparotomies at the same time.Materials and methods: In this study all emergency laparotomies of a referral hospital are evaluated in a 5 years period retrospectively (1996-2000).Results: There were 61 positive and 14 negative (18.7%) laparotomies in 75 patients. 4 patients underwent nontherapeutic laparotomy because of retroperitoneal hematoma. Sonography was done in 34 cases with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) as 84.3%, 50%, 96.4% and 16.6%, respectively. Diagnostic peritoneal lavage (DPL) which was done for 16 patients had 100% sensitivity, 66.7% 5pecificity, 92.8% PPVand 100% NPV. There were 9 negative laparotomies (32.2%) in 28 patients whom were operated on the basis of clinical findings merely.Discussions: We concluded that sonography is a valuable tool for initial assessment of blunt abdominal trauma. Of course, more accurate tests should be in mind whenever clinical findings are incompatible with sonographic data, considering its low specificity and NPV. DPL still, is a safe and accurate method for evaluating blunt abdominal trauma victims. Laparotomy without any diagnostic procedure yields more negative results.

Background: current researches have demonstrated the relationship between psychological factors and asthma as a psychosomatoic disorder. The purpose of this study was to evaluation the relation between usual life stresses and asthmatic attacks and is to help psychiatrists and other physicians engaged in the management of asthmatic patients.Method & material: This study was done on 100 patients (56 female, 44 male) hospitalized at internal ward of Sina hospital and pulmonary section of Imam Khomaini hospital in Tabriz from 21th of may 2001 to 21th of April 2002. Internists and pulmonary specialist established the diagnosis. For 100th patients and /00 individuals of general population who had similar economics and cultural conditions the mean stress was studied tow groups during the previous year by filing Holms & Rahe questionnaire.Results: In the male patients, the mean stress was 173.5 for each man during one year before asthmatic attack. It was 241.35 for women and 211.48 for all patients. In control group the mean stress was 88.54 for men, 50.5 for women and 67.24 for all individuals during one-year before asthmatic attack.Discussion: It is concluded that stress is an underlying factor for asthma that affects the process of treatment. It is worthy to say that a few patients visit a psychiatrist and psychiatric consultation is not requested in the hospitals that they are under treatment in them. It is expected that our dear colleagues who are specialized in pulmonary or internal diseases pay attention to the mental aspects of the illness that leads to the immediate improvement of diseases.

Introduction: Addiction to opium and morphine can be studied from different angles including personal, social, psychic, and etc. In addiction studies the important part is the accuracy and precision of morphine identification in urine tests. Reporting any incorrect results will Cause major problems to the patients as well their family members. The aim of the present study was to evaluate the morphine identification methods in urine used in the laboratories country-wide.Materials and Methods: In the .first trial (Feb 2002) of morphine identification External Quality Assessment Scheme (EQAS), more than 900 urine lyophilized unknown samples were prepared and distributed among 300 morphine identification laboratories across the country. Three samples including; negative, positive, and false positive were sent to the each laboratory. The testing procedure for reporting the correct result, arranged in a way that a technologist analyzed the sample in two steps, first by using screening methods identified the negative sample and then by using chromatography methods confirmed the positive and false positive samples.Results: Obtained results indicated that 36% of engaged laboratories in the study, reported test results without any further confirmation. About 29% of the laboratories that used confirmatory tests and about 80% of them that used screening methods reported false results.Discussion: With respect to the initial results, it was obvious that urine morphine identification laboratories need more supervision. In addition, Method's accuracy, precision, and sensitivity should be checked and assures. Sine reporting any incorrect result may cause problems for the individual and even his family, subsequent control regarding routine method's accuracy for morphine identification is necessary. Moreover, introducing standard methods in this matter can be of help.EQAS: External Quality Assessment Scheme.