Studies in Medical Sciences
Year:2014 | Volume:25 | Issue:4|Papers Count:11

Background & Aims: Patent ductus arteriosus (PDA) is common in premature neonates and can cause adverse complications such as intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), and bronchopulmonary dysplasia in neonates. The purpose of this study was to evaluate the validity of clinical criteria in diagnosing of PDA in premature neonate.Methods |& Materials: This study was conducted on 61 premature neonates born between 24 to 34 weeks of gestation and with birth weight from 500 to 2100 grams including clinical signs such as tachycardia, heart murmur, hyperdynamic chest, presence of dorsalis pedis pulse, hypotension and worsening of respiratory status at 48-72 hours after birth. Echocardiographic evaluations were done by a pediatric cardiologist blinded to clinical findings. Neonates with sepsis, IVH, congenital anomalies, congenital heart diseases and NEC were excluded from the study.Results: From all 61 premature neonates who entered this study 14 neonates had hemodynamically significant PDA with left to right shunt (PDA+). In five neonates PDA was small and in 42 neonates ductus arteriosus was not patent (collectively PDA-). From clinical criteria who evaluated, heart murmur, heart rate, presence of dorsalis pedis pulse, systolic and diastolic blood pressures between two groups had not differences in statistical analysis. But the number of neonates who had hyperdynamic precordium and worsening of respiratory status in 48- 72 h of life was more in PDA+group. And this difference in statistical analysis was meaningful.(P=0.01) Conclusions: Clinical signs are not reliable and sufficient for early diagnosing of PDA in premature neonates; routine echocardiography must be done for this purpose. From clinical signs hyperdynamic precordium and worsening respiratory status at 48-72 h of life have high sensitivity.In addition, in conjunction with echocardiography are helpful for early diagnosing of PDA in premature neonates.

Background & Aims: Cardiac and vascular diseases are among the main reasons of mortality. Diagnosis of these diseases in the first stages can be very helpful for their treatments. One of the effects of atherosclerosis is the reduction of vessel wall vibrations. Echocardiography images cannot show these vibrations because of their lack of resolution.Materials & Methods: This study was conducted on 24 persons and their radio frequencies (RF) were acquired from the carotid vessel. The test persons were divided into 3 groups (young under 35 years old, middle aged between 35 to 55 years old, and old more than 55 years old); and the laboratory conditions were similar for all cases. To extract the high frequency vibrations, at the first stage large motion of vessel wall due to the heart beat was removed from RF signals using Phase Tracking Method and Hilbert transform. In Hilbert method the large motion of vessel wall can be removed by maximizing the cross-correlation between absolute value of Hilbert transforms of signals of two corresponding windows in depth direction in consecutive frames.Results: Quantitative measures were obtained for every individual and compared. It was revealed that vibrations of the layers of the vessel wall decreased with increasing age. We find 2 new features which can be used to categorize people according to their vessels’ age, which mean the ability of their vessels’ wall vibration to help the blood flow in vessels.Conclusion: Although it seems evident that aging leads to a decrease in vessel wall vibrations, we attempted to find properties of distinction that could be used in further studies. Since this study was conducted for the first time in Iran specifically to evaluate the carotid artery, it is expected that the results would pave the way for future researches.

Background & Aims: Urinary tract infections (UTI) are one of the most common infections in children. Vesico ureteral reflux (VUR) is a major risk factor for recurrent UTIs which can result in renal scarring. The diagnostic tests that are being used to detect VUR include voiding cystourethrography (VCUG) and direct radionuclide cystography (DRC). The sensitivity of each modality is controversial. In this study we attempt to identify the role of DRC in detecting possible VUR in patients without VUR in VCUG and Vice Versa.Materials & Methods: In this analytical study, we included 60 patients (120 kidney units) with recurrent urinary tract infection referred to nephrology clinic at Shahid Motahary Children Hospital. In the first step, 34 children (68 kidney units) without VUR in VCUG underwent DRC and 26 patients (52 kidney units) who had negative results for VUR in DRC underwent VCUG image. Eventually, all patients underwent DMSA imaging to detect renal scars and the results were analyzed using statistical tools.Results: Study unit consists of 60 children with boys equaling to 13 (21.7%) and girls 47 (84.3%) with average age of 4.7 years. DRC study applied for those with negative result of VCUG imaging in 68 kidney units detected 37 (54.5%) new unidentified VUR cases meanwhile; VCUG study just detected 7 (13.5%) neglected VUR with DRC study. According to the significant statistical difference between two modalities one can deduce that DRC has higher diagnostic value in detecting missed VUR.70 unites out of the total of 120 kidney units had scars in kidney which equals to 58.5%, of which 43 unites (61.5%) were positive for VUR. The result implies a very significant relationship between having scar in DMSA studies and having VUR.Conclusion: It can be deduced that having repeated tests of DRC or VCUG can detect missed VUR in patients with recurrent urinary tract infections. Furthermore, DRC study is more valuable than VCUG and in the case of having significant scars on DMSA having repeated tests of cystography can boost detecting missed VUR.

Background & Aims: Psychiatric disorders especially anxiety and depressions often occur in cardiac patients as complication or associated disorders. This study was done to compare the effects of two methods of relaxation and interpersonal cognitive problem solving (ICPS) on decreasing anxiety and depression in cardiac rehabilitation patients.Materials & Methods: This experimental study was conducted on 35 cardiac rehabilitation patients who referred to rehabilitation in the Imam Ali Hospital in the Kermanshah city in the Spring of 2010.Except for the two patients who did not qualify for the study, another 33 patients were randomly assigned into two experimental groups and one control group (n=11 per group). Then, 8 sessions of relaxation or interpersonal cognitive problem solving (ICPS) training was administered to the experimental groups. Cattell Anxiety Scale and Beck Depression Inventory were used as measurement instruments. The data were analyzed using covariance (MANCOVA), test box, and Wilks Lambda post hoc test, and SPPS16.Results: The results show there is a significant effectiveness of intervention methods on decreasing anxiety and depression in cardiac patients. The methods of intervention were not significantly different in reducing anxiety and depression.Conclusion: Applying of psychotherapy can decrease anxiety and depression in cardiac rehabilitation patients and causes more curing corporation between them and members of curing staffs and promotion of their morals and their health promotion.

Background & Aims: Spreading depression is a pathophysiological phenomenon that is initiated by a selfpropagating depolarization wave with a short-term excitability and is followed immediately by an inhibitory phase and then continues with a long-term secondary excitability. Spreading depression has a critical role in many disorders such as migraine and seizures. The purpose of this study was to investigate the role of glutamate receptors and burst activity induced by spreading depression on synaptic plasticity in hippocampus CA1 region.Materials & Methods: This study was performed on brain slices of 18 male Wistar rats, weighing between 250- 350 g. The slices were studied at one group as control and two groups as glutamate receptor antagonists (AP5 and CNQX). After deep anesthesia, the animals were decapitated and the brain was removed from the skull. Horizontal slices (500 mm thick) containing the hippocampus region were prepared and perfused with GABAA antagonist (bicuculline 1.25). SD was created with KCl and then LTP was indused and excitatory field potentials were recorded.Results: Followed by inhibition of glutamate receptors (NMDA, AMPA) after induction of spreading depression a significant reduction in the amplitude of excitatory field potentials was observed in test groups, CNQX (103.26±3.2), AP5 (102.88±1.1), compared to bicuculine (134±6.7) with Mann Whitney U test. (P<0.001).Conclusion: The results of this study emphasize on the role of glutamate receptors in induction of cortical spreading depression, so the antagonists that inhibit these receptors lead to suppression of cortical spreading depression. The study of the phase secondary excitability of SD may help us to understand the mechanism of SD action in associated neurological disorders. This finding can improve the therapeutic strategies for treatment of epilepsy.

Background & Aims: Post Craniotomy surgery headache is classified as moderate to severe pain.Objective of this study was comparison of Bupivacaine scalp infiltration and intravenous morphine on postoperative headache in patients undergoing craniotomy.Materials & Methods: This study was a double blind clinical trial set up at Mashhad University of Medical Science. Sample size was 70 patients (block randomization) who underwent elective supra tentorial craniotomy and patients were divided into two groups of control and case (sub-dermal local infiltration of Bupivacaine %0.25 in incision area versus parenteral administration of morphine). Then we measured Visual Analog Scale (VAS) at 0, 2, 4, 6, 8, 12 and 24 hours after intervention.Results: According to VAS, at beginning of the study, moderate pain was observed more while severe pain was observed less in the case group (p=0.003); at 2 and 4 hours after intervention most patients in case group had mild pain versus moderate pain in control group (p=0.00). At 6 and 12 hour after intervention, mild and moderate pain were significantly more present in Bupivacaine group (p=0.009 and 0.003, respectively).Conclusion: Sub-dermal local infiltration of Bupivacaine decrease post craniotomy severe headache in the first 12 hours after surgery.

Background & Aims: There are various methods for treatment of depression. This study was aimed to examine and compare the efficacy of two therapeutic techniques namely group cognitive behavior therapy and dialectical behavior therapy on decreasing depression level of multiple sclerosis patients.Materials & Methods: This study was a quasi-experimental design from pretest - posttest with control group. Population included patients with multiple sclerosis referring to the Shiraz Multiple Sclerosis (M.S.) Association in spring 2013. A total of 30 patients from participants who had high scores on the Beck Depression test were selected by sampling method and were placed equally and randomly into three groups of cognitive behavioral therapy, dialectical behavior therapy and control groups. The measurement tool was Beck Depression Inventory (BDI-II). The experimental groups participated in 8 sessions of educational group. The mean scores of the two groups were compared through analysis of covariance.Results: The results of the study showed the significant differences between the mean scores of the pre-test and post-test of the experimental groups and control group i.e. cognitive behavior group therapy and dialectical behavior group therapy had reduced the depression mean score in the experimental groups.Conclusion: Since behavioral therapy with significant difference than dialectical behavior therapy could reduce depressive symptoms in patients; therefore, it can be placed as a new approach in prioritizing treatment and reducing depression in M.S. patients.

Background & Aims: The Borderline Personality Feature Scale for Children (BPFS-C) developed to assess borderline personality features in children aged 9 years and older. This scale was adopted from the borderline scale of PAI and assessed affective instability, identity problems, negative relationships, and self-harm dimensions. The aim of this study was to investigate the validity of this scale on nonclinical sample of students.Materials & Methods: This study was conducted on 400 students (200 females, 200 males) with the mean age of 15.78 who were selected via multi-stage random sampling. All participants were asked to complete BPFS-C and Borderline Personality Scale (STB). The validity of BPFS-C was determined using confirmatory factor analysis, concurrent validity, and criterion validity, and its reliability was assessed by correlation coefficients, Kronbach’s alpha and split half method.Results: The correlation between borderline BPFS-C and STB was significant at p>0.001 (r|=0.51).Kronbach’s alpha for whole scale was 0.84 and for the subscales including affective instability, identity problems, negative relationships and self-harm was 0.78, 0.77, 0.77, and 0.76 respectively.Furthermore, the results obtained from confirmatory factor analysis (RMSEA=0.05) illustrate the fair fitness of four factor structure of BPFS-C.The findings of the present study show that BPFS-C is reliable and valid in Iran.

Background & Aims: Doxorubicin (DOX) is an anthracycline antibiotic that is widely used as an anticancer agent. However, the clinical use of DOX is limited due to its toxic side effects upon nontarget tissues. The aim of this study was to investigate the impact of 6 weeks of aerobic training on dox-induced toxicity in rat tissues (heart and liver).Materials & Methods: This study was conducted on thirty-two Wistar male rats randomly assigned to 1.control+salin, 2. control+DOX, 3. training+salin, 4) training+DOX groups. Groups 3 and 4 were trained on treadmill between 25 to 54 min/day and 15 to 20 m/min, 5 days/week for 6 weeks. The groups 2, 4 and groups 1, 3 received DOX (20 mg.kg-1 i.p) and saline (0.9% NaCl i.p), respectively.Animals were sacrificed 24 h after DOX and saline injections. Also, heart and liver tissue homogenization and assay parameters were performed.Results: Doxorubicin administration cause a significant increase in malondialdehyde (MDA), nitric oxide (NO) and a significant decrease in the superoxide dismutase (SOD) activity in heart and liver tissues; however, the difference was not significant between the two tissues. Although the 6-week aerobic training+DOX caused a down-regulation of oxidant markers and up-regulation of the SOD activity in heart and liver tissues, but only changes of the SOD activity was significant between the heart and liver tissues.Conclusion: Our study suggests that cardiac/liver protection induced by chronically exercise in DOX treated rats is associated with inhibition of oxidative stress and increase in the antioxidant defense levels.

Background & Aims: Nowadays, by advent of hybridoma technology in monoclonal antibodies production various cell markers could be evaluated in malignant and non-malignant cells. CD20, nonglycosylated phosphoprotein is as an ideal marker in leukemia and B-cell lymphoma diagnosis which is expressed on more than 95% of normal and neoplastic B-cells except for early B-cells and mature plasma. The prime aim of this study was to produce monoclonal antibody against CD20 and evaluation of specific binding to CD20 expressing cells.Materials & Methods: First, Balb/c mice were immunized 4 times with 100μg peptide from extracellular domain of CD20. Spleen cells of the most immune mouse were fused with SP2/0 by Poly Ethylene Glycol (PEG). The desired clones were selected for limiting dilution (L.D). Large scale of monoclonal antibodies was produced by ascetic fluid method. Monoclonal antibody was purified by Protein-A-Sepharose column affinity chromatography then confirmed by SDS-PAGE. Afterward, evaluation of specific binding of these antibodies was determined by immunological assay such as ELISA and Immunofluorescence and flowcytometry.Results: After cell fusion and screening, one desired monoclone achieved with absorbance about 2. Protein-A-Sepharose column affinity chromatography yielded about 5 mg of purified monoclonal antibody. The SDS-PAGE results confirmed purification of antibody. The result of ELISA, direct immunofluorescence staining and flow cytometry confirmed specific attachment to CD20.Conclusions: These results indicate that such monoclonal antibodies against CD20 can be used in diagnosis of CD20 in the cells surface by immunological assay such as ELISA and Immunofluorescence and flowcytometry.