Studies in Medical Sciences
Year:2006 | Volume:17 | Issue:2|Papers Count:17

Background & Aims: Nitric oxide, as a drug, is a radical molecule which has an important role in many physiological and pathophysiological processes. It can be formed in a wide range of cells by the conversion of L-Arginine to L-Citrolline by nitric oxide synthase (NOS). In this study Nitroglycerine and L-Arginine are used as Nitric Oxide donors, L-NAME and blue Methylene are used as (NOS) inhibitors. This study was designed to investigate whether Nitric Oxide could cause changes in the Pct, Hct and white blood cells. Materials & Methods: 25 male guinea pigs (316 gr±2) were randomly divided into five experimental groups, all groups reared in the same condition, after three days, they were anesthetised by intra peritoneal injection of thiopental sodium (50mg/kg b-w) then after collecting the blood of their hearts, the Pct, Hct and WBC of the bloods were tested with a cell counter (Melet; MS).Results: This study showed that nitroglycerine significantly decreased Pct in group E methylenblue and L-NAME increaded Pct. In group B & C Nitric Oxide had no significant effect on hematocrite and: LA-rginine increased monocytes, nitroglycrine decreased granulo-cytes, L-NAME and nitroglycrine increased Lymphocytes.Discussions: We conclude that, Nitric Oxide has important effects on many factors of guinen pigs' blood and can be a regulator for many factors of blood.

Background & Aims: Acute Aortic Dissection (AAD) is a true emergency situation in cardiac surgery. About 40% of patients expire before diagnosis and 1% or patients die per hour without any surgical plans. The aim of this study is evaluating results and outcomes of aortic dissection surgery in Shahid Madani Heart Hospital in Tabriz, Iran.Materials & Methods: This research is a retrospective and prospective study on 46 patients from 1994- 2003 who were admitted for acute aortic dissection operation. For collecting data a questionnaire was used. The statistical analysis was performed with SPSS software and was done through descriptive statistical methods.Results: The study was performed on 46 patients, 65% males and 35% females. 15.2% (7 cases) of the patients expired in operating room before surgery. 39 (59% male and 41% female) were operated on. Mean age of patients was 48.9±2.3 years old. Pre-operative diagnosis was made by TEE (Transeasophageal echocardiography) and angiography. In 42% of the patients aortic valve was replaced with ascending aorta. In 24% only ascending aorta and in 14 % of patients just distal aortic dissection was replaced. For 10% aortic valve was repaired with AAD and in 10% ascending aorta with aortic arch was replaced. Major complications were hemorrhage (31%) and sever respiratory failure (13.79%), and about 20.07% of patients died in hospital. Only 21 patients (45.5%) have been followed up for 7 years.Discussion: AAD is a very fatal disease. With early diagnosis and surgical intervention we can save about 75% of patients.

Background & Aims: Attempt to commit suicide is an act of intentionally ending one's own life and is done by different methods. At the session of World Health Organization, violence and suicide have been viewed as important problems in field of public health in 1996. At present, it is considered as one of ten important causes of death in the world. The aim of this study was to determine rate of committing suicide and its distribution with regard to individual characteristics, time, and place and also it was designed and preformed to determine effective factors and suicide methods.Materials & Methods: A cross- sectional study with descriptive and analytic aims was conducted for all suicide cases during one year. In these study physicians, nurses, experts, health workers of health centers, and also forensic medicine centers were involved to access data. Questioner teams along with psychologists performed to collect data. A questionnaire including 71 questions was provided. Then data was entered to SPSS software, considering objects of study, absolute and relative frequencies then mean and standard deviation were calculated and chi squared test was used to evaluate the relationship between effective factors and suicide occurrences. Significance level was 0.05.Results: The rate of committing suicide was 146 per 100000 in West Azerbaijan; of these 35.7% were males and 63.35 females. The highest rate of suicide was observed among 15-24 year-old ones and the lowest rate was found in the age group of <64. About 50.4% of the subjects were single, 15% illiterate, 19.4% preliminary education, 25.9% with junior, 35.5% secondary and 4.2% had higher education. 75.5% of them were resided in urban area and 24.5% in rural area. There was significant association between committing suicide regarding gender, age group, place of residence, occupation, marital status and suicide methods.Discussion: The result of this study revealed that attempt to commit suicide is considered as a public health problem and its distribution differs with different characteristics such as age, gender, marital status, occupation, place of residence and suicide causes. It is suggested to pay more attention to this public health problem in order to analyze its factors then plan and perform preventive programs.

Background & Aims: Malaria is one of the most important parasitic diseases in the world. More than forty percent of the world population lives in malarious regions. With the emergence of chloroquine resistant strains of plasmodium falciparum in recent decades, the malarious countries faced some difficulties in treating acute cases of the diseases. Because of this, the need for finding some new drugs with minimal side effects is essential. A few plants have been used for several thousand years as the traditional antimalarial remedies in different parts of the world such as Iran.Materials & Methods: Peganum harmala extract was evaluated in four serial dilutions including 12.5, 25,50 and 100 mg/ml and chloroquine with 8 picomol/well using in vitro method on 23 blood samples from patients infected by plasmodium fa1ciparum.Result: All four serial dilutions of Peganum harmala extract could inhibit parasite growth (P<0.05). In comparison with chloroquine at doses of 12.5 mg/ml and 25 mg/ml, it was less effective than chloroquine while 50 mg/ml and 100 mg/ml had almost similar results to chloroquine. Peganum harmala in doses of 50 and 100 mg/ml could significantly decrease schizont formation of those two strains of plasmodium fa1ciparumparasites which were resistant to chloroquine.

Background & Aims: Glaucoma is the first irreversible factor in the world whose major risk factor is elevated by intraocular pressure (lOP). It causes visual impairment, low vision, and eventual blindness. This prevalent disease is qualified to screen glaucoma due to being chronic and having no specific clinical signs. This research was performed to determine glaucoma prevalence in Urmia pop lab. Materials & Methods: This research was a descriptive-analytic study and was designed in cross-sectional method. In the fIrst stage, the population of pop lab was clustered and then 440 cases aged>/=40 years old were selected by cluster sampling. After coordinating and taking a letter of satisfaction the subjects were asked to refer to the ophthalmology clinic of Imam Hospital. A questionnaire consisting of two parts was used to collect data. Standard methods including tonometry, ophthalmoscopy, and perimetry were used for diagnosis of glaucoma. The collected data was analyzed through proportional frequencies, mean, standard deviation, T and X2 tests.Results: The mean age of cases was 55.2±11.39 and 44.8% of samples were male and 55.2% were female, 43.4% were illiterate, 50% were housewives and only 38.9% of the subjects had background of the disease. A record of familial glaucoma was observed in 8.2% of cases. Clinical examinations showed that 96.1% of them had lOP£21 mmhg and 3.9% IOP2³21mmhg. 98.6% of the cases had Cup/Disk£0/5 and 1.4% with Cup/Disk > 0.5. At the end glaucoma prevalence was estimated about 2.5% in population study.Discussion: In this study ocular hypertension was more prevalent than glucoma with the same results of other studies. Prevalence of OHT and glaucoma rate was higher in women than men. The results of this study was matched with similar studies in the region and indicated that glaucoma prevalence was high in the aged ones. It is suggested to carry out preventive and therapy programs regarding the undesirable prognosis of the disease.

Background &Aims: Dopaminergic neurons in the Ventral Tegmental Area (VTA) are involved in dependence, tolerance, and withdrawal syndrome to opiates. The aim of this study was to investigate the effect of temporary inactivation of VTA on heroin dependency and withdrawal syndrome sign (WSS).Materials & Methods: Male Wistar rats (250-300g) were anaesthetized and implanted with catheters into the right jugular vein. A stainless steel canulae was bilaterally implanted to VTA in related groups. After recovery, the animals were fitted and the external end of the catheter was connected with a pump, then were placed in the self-administration (SA) apparatus daily, for 10 days. Active lever switched on the infusion pump injecting 0.1ml of heroin hydrochloride solution (1 mg/ml) or saline. The experimental groups were as follows (n=6): saline, intact and inhibited VTA (which received 20ml of lidocaine 2% before SA daily). In the end of the 10th day, naloxone 2mg/kg. IP was injected and animals were studied for heroin WSS.Results: Comparison of active and passive lever pressing inside each group and active lever between all groups showed a significant difference (p<0.05 and p<0.001 respectively). After naloxone injection, the animals in the group intact VTA merely showed WSS (P<0.001).Discussion: Temporary inactivation of VTA can prevent the reinforcing effect of heroin and the development of dependence on it. Probably with further studies, handling of VTA can be a useful management for heroin addiction.

Background & Aims: The aim of this study was evaluation of diagnostic and therapeutic procedures for patients with empyema and para preumonic effusion in this center and defemination of effective factors on thoracostomy outcome in thorasic empyema.Materials & Methods: All patients with empyema who underwent thoracostomy entered this study and were required for data like age, gender, background diseases, outcome, location, size, quantity of chest tube, empyema loculation, time to procedures and etc. We used multivariate logistic regressions to analyze the outcome of thoracostomy.Results: 46 patients were involved in this study and the mean age was 23±43 years with 20 to 26 male to female ratio and the most common background diseases were respectively diabetes mellitus and malignancies. 26.1% of cases had successful drainage. Mean time sponts was 13.2±5.92 days from diagnosis to thoracostomy. In 34 cases second procedure was used. There wasn't any significant relationship between girder and drainage outcome. (p= 0.57) The volume of empyema is an effective factor.(p= 0.008). The relation between chest tube location and outcome was significant (p= 0.2) but there wasn't any logical relationship between time duration precedence and the outcome. (p= 0.3).Discussion: Good outcome was less than previous articles, and it seems time gap in using a chest tube is an important cause. The volume of empyema and age are effective factors on outcome. But gender, loculation and background disease are not considered as effective factors. Time gap between diagnosis and treatment is an important cause of success. At last, appropriate coordination among different wards and surgery departments are essential principles for promoting the quality of patients' management.

Background & Aims: The most important causes of mortality and morbidity in hemodialysis patients are Atherosclerotic cardiovascular events. Lipoprotein (a), as an independent risk factor, accompanied with other lipid profiles is effective in this process. Nandrolone Decanoate with changes in some of these factors specially with decreasing LP(a) that increased in hemodilysis patients may prevent this complication.Materials & Methods: This is a randomized clinical trial during 9 months with a control group (n=36) and a treated group (n=36) of hemodialysis patients. In this study 100 mg Nandrolone Decanoate was intramuscularly injected weakly for 6 months in treated group and in both groups laboratory tests of Albumin, Triglyceride, Cholesterol, HDL, LDL, APO-A, APO-B, and LP(a) was measured during the zero months ( before treatment) and 2,4,6,9 (3 months after discontinuation of drug) with immunoturbidimetric assay. The results were analyzed with Repeated Measure ANOVA Test (p=0.05).Results: The changes of some parameters like HDL, TO, APO-A, and APO-B was significant, but despite the decreased level of LP(a) in the second month oftreatment changes of other factors such as Cholesterol, LDL, Alb, and LP(a) was not significant between the treated and the control group. A significant increase during the 4th to 6th month appeared.Discussion: Nandrolone Decanoate influences some lipid parameters that are effective in atherosclerosis.Significant changes with Nandrolone Decanoate seen in HDL, TO, APO-A and APO-B. LP(a) is an independent risk factor for clinical events attributed to atherosclerotic cardiovascular diseases in patients receiving chronic hemodialysis treatment. Decreasing LP(a) level in our study was seen only in 2 months after treatment. Increase in the dose of drug may produce a significant effect on lipid profile. The relatively low sample size and nonhomogenic distribution of them and the different etiologic factors in pathogenesis of end stage renal disease (ESRD) could confound the final results. Our findings can be clinically relevant if confirmed by further studies.

Background &Aims: HBV infection has occurred in greater than 2 billion people of the world and there is 350 million HBsAg carriers in the world. The rate of chronic carrier state varies among different geographic regions. It is estimated that 3-5% of Iranians are chronic carriers of HBV. Our aim is to survey the prevalence of HBsAg carriers in West Azerbaijan province and compare that with previous statistics.Materials & Methods: In this cross sectional study, all volunteer blood donors in the transfusion organization of the West Azerbaijan province were examined by ELISA method in order to survey HBsAg.Collected data was compared with statistics of previous studies in the province and was reported. Results: From all 10200 blood donors, 136(1.33%) people were HBsAg carriers, including 119(87.5%) men and 17(12.5%) women and also 107 people were married and the rest were single. Results showed that the rate of HBsAg positive samples increases with aging.Discussion: In comparison to previous studies in 1365 and 1376 in the province, the prevalence rate of HBsAg carrier state has apparently decreased. It seems that warning and educating people about nature of the disease, routs of transmission, and its prevention have essential roles in decreasing the above mentioned rate.

Background & Aims: Juvenile Xanthogranuloma (JXG) is a fibrohistiocytic lesion that usually occurs during childhood principally involving head, neck, and trunk. However, extracutaneous cases have been reported.Case Report: In this article, we report a 3 year old girl with left axillary, mobile, non-tender, and firm deep soft tissue mass since one year post BCG vaccination on left arm.Discussion: Incidence of this tumor, following post BCG vaccination is a rare condition. The treatment of this lesion is a complete surgical excision. Radiotherapy has been employed for lesions in locations such as eyes and systemic lesions that can not be excised.

Background & Aims: Tolerance of pregnancy in a women with severe left ventriclular systolic dysfunction (due to DCM) is incredible and difficult because hemodynamic changes in pregnancy gives rise to significant enhancement of preload. Report of the present case and its similar cases are helpful for discovery of unknown aspects of medical science.Case Report: This patient is a 45 year-old woman with history of severe DCM (LVEF was about 25% before pregnancy). She had been treated with chest radiation and combination chemotherapy including doxorubicin, for breast cancer about 6 years before pregnancy. She declined termination of pregnancy and was managed medically with good maternal and neonatal outcome. Pregnancy was a complete term and delivery was done vaginally. Four years has elapsed without any problem neither for the mother nor for the infant.Discussion: Pregnancy in patients with severe DCM can be extermly hazardous and contraindicated for both mother and her infant. Similar case reports are very rare. In a multidisciplinary approach termination of pregnancy may be required in management of such patients. High mentality, belief of mother and careful treatment can be a reasonable explanation for successful pregnancy in such patients.

Kawasaki disease is one of the most common vaculity syndromes in children and the most important complication of this disease is cardiac Aneurism. Aneurismal involvement of extremities is one of the rarest vascular manifestations of this disease which reveals as Gangrenous fingers. Because of being rare, most physicians report this type of disease when they see and diagnose it especially in children under I year old.Materials & Methods: This case is a 70 day-old infant that was referred with convolution, fever, and pyuria. We admitted this patient in Pediatric Nephrology Service of Imam Hospital and treated him with possible diagnosis of Pylonephritis. During admission period, Necrosis was seen in his toes. In attention to clinical manifestations, laboratory tests, imaging and response to treatment (IVIG and aspirin) Kawasaki disease was diagnosed and the patient was treated with this regimen (IVIG, NSAIDS) and responded well.Conclusion: Kawasaki disease is usually seen in 1-5 year old infants and its prognosis is fairly good (mortality less than 2 percent). The complication and mortality of the disease increases if it is seen in the ages of 1-5, especially those who are under one year old. For example Necrosis of Extremities is one of the rarest complications that is reported only in infants under 7 months old.It seems that in patients with Gangrenous organs especially in extremities without other Necrotizing diseases such as Nephritic Syndrome, Arterial Emboli, DIC, and etc Kawasaki disease should be considered.