Journal of Kerman University of Medical Sciences
Year:2011 | Volume:18 | Issue:2|Papers Count:10

Taking medications during breastfeeding is common and physicians are usually asked about the safety of prescribed medicines, herbal medications, or tobacco and alcohol consumption during lactation. Safety of medications during breastfeeding is related to maternal factors, neonatal factors and the type of medication, In the case of necessity of taking medication for the mother, there are ways to minimize neonate’s exposure to the medication. In this article, drugs have been classified according to the different diseases and their safety or side effects in lactation have been discussed.

Background & Aims: Release of proinflammatory cytokines after traumatic brain injury (TBI) is a major cause of brain edema. Previous studies demonstrated that sex steroids decrease brain edema induced by TBI. In this study changes of brain cytokines after the administration of estrogen and progesterone 24 hours after TBI were evaluated.Materials and Methods: Female rats were divided into 7 groups. Groups 1 and 2 were considered as control and sham respectively and other 5 groups underwent bilateral ovariectomy and considered as vehicle, physiologic does of estrogen (E1), pharmacologic dose of estrogen (E2), physiologic dose of progesterone (P1) and pharmacologic dose of progesterone (P2). Vehicle and sexual steroid hormones were injected intraperitoneally 30 minutes after TBI. Moderate TBI was induced by Marmarou method. Neurologic scores (VCS) were evaluated immediately, 1 h, 4 h and 24 h after TBI. Brain level of IL-1b, IL-6, TNF-a, TGFestrogen and progesterone were measured 24 hours after TBI by ELISA method.Results: E1 and E2 groups showed respectively 27.5% and 27% decrease in brain level of IL-1b compared to vehicle. Brain level of IL-1b increased in vehicle group compared to sham. E1 and P1 groups showed respectively 47% and 20.5% decrease of brain IL-6 level compared to vehicle. Brain Level of TNF-a increased 48.5% in E2 group compared to the vehicle group. Both estrogen and progesterone in physiologic and pharmacologic doses increased TGF-b, but the highest increase of TGF-b level was about 9.5 times and was observed in E1 group. Brain level of b-Estradiol increased 1.8 times in E2 group and progesterone increased 1.84 times in P2 group compared to the vehicle group. Veterinary coma scale (VCS) increased in E1, E2, P1 and P2 group at 1 hour after TBI, whereas, 4 h after TBI only in E1 and P1 and 24 h after TBI, in E1, E2 and P1 groups VCS, showed increase. Conclusion: Neuroprotective effect of sex hormones in reducing cerebral edema is probably performed by decrease of brain level of IL-1b and IL-6 and increase of brain level of TNF-b and TGF-a after TBI.

Background & Aims: Cutaneous leishmaniasis (CL) is a prevalent disease worldwide including Iran. In Iran Leishmania tropica and Leishmania major are two causing factors of cutaneous leishmaniasis and Bam is one of the old and well-known focuses of CL. The objective of the present study was to identify the resistant isolates to meglumine antimoniate (MA) for implementation of future control measures in Bam. Methods: This work has been conducted during 2009-2010 in the city of Bam and Kerman School of Medicine. From a total of 2126 patients with CL, 235 patients (11.1%) were resistant against MA (Glucantime) of whom 51 ones were randomly selected. Skin scrapings were taken for direct smear preparations and culture media and Nested-polymerase chain reaction (PCR) were used for species identification.Findings: In this study, 122 males (51.9%) and 113 females (48.1%), resistant to MA were identified that shows no significant difference between the two sexes. With a significant difference most of the resistant patients were in the age group 11-21 years (29.4%), followed by£ 10 years (21.6%) and the lowest were in the age group³ 55 years (5.9%). Most of the lesions were on face (55.5%), the majority had one lesion (64.5%) and 33.3% received MA intra -lesionally. According to the results of PCR, all 51 isolates were Leishmania tropica. Conclusion: To our knowledge this is the first study that is carried out on the resistant patients to MA in Bam. Since the incidence of this disease and drug resistance have been increased after the earth quake of 2003, further studies to identify genetic variants of resistant isolates in order to use new alternative drugs are required.

Background & Aims Head and neck squamous cell carcinoma (HNSCC) is the fifth most common cancer worldwide. Despite major advancement in cancer diagnosis and treatments, survival rate has not significantly improved over the past few decades. Our ability to make prognosis of advanced cases of HNSCC is especially poor. The aim of this study was to investigate the expression of cyclin D1 protein in HNSCC by immunochemical study. Methods: The standard biotin streptavidine peroxidase immunochemical staining method was used to study the expression of cyclin D1 on formalin fixed paraffin embedded blocks of 42 cases of HNSCC and 25 cases of normal mucosal epithelium. Results: A total of 42 cases of HNSCC were compared with 25 cases of normal mucosal epithelium. Positive expression of cyclin D1 was seen in 66.3% of cases and also more positive immunoreactivity was seen in grade 2 HNSCC. Positive correlation between overexpression of cyclinD1 and more aggressive phenotype of HNSCC also was evident. There was a significant difference between tumor site and grading with more aggressive phenotype of HNSCC. Conclusion: We suggest that immunohistochemistry for cyclin D1 is reliable in identifying the phenotype of more aggressive HNSCC cases with poor outcome.

Background & Aims: Considering increasing incidence of cardiovascular disorders in diabetes mellitus and some evidence on antioxidant and antidiabetic potentials of naringenin, this study was conducted to evaluate the beneficial effects of 6-week administration of naringenin on contractile reactivity of isolated thoracic aorta in diabetic rats.Methods: Male Wistar rats were divided into control, naringenin-treated control, diabetic and glibenclamide-treated, and naringenin-treated diabetic groups. For induction of diabetes, streptozotcin (STZ) was administered (60 mg/Kg). Naringenin (10 mg/kg) was administered i.p. one week after diabetes induction in every other day intervals for 6 weeks. Serum glucose level was measured before naringenin administration and at 6th week. Finally, contractile reactivity of thoracic aortic rings to KCl and phenylephrine (PE) was cumulatively determined.Results: Serum glucose level at week 6 showed a significant decrease in naringenin-treated diabetic group compared to diabetics (P<0.01). In addition, naringenin-treated diabetic group showed a significantly lower contraction to PE (P<0.05) as compared to diabetic group and such significant reduction was also observed for KCl (P<0.05). Meanwhile, there was also a significant difference between control and naringenin-treated control groups regarding their contractile reactivity to PE (P<0.05).Conclusion: Subchronic administration of naringenin for 6 weeks could exert an anti-hyperglycemic effect and lowers contractile responsiveness of thoracic aorta rings to KCl and phenylephrine.

Background & Aims: Cervical spine is prone to various abnormalities and sport injuries. There is still no non-aggressive measurement instrument with high reliability for easy and rapid assessment of cervical spine secondary complications.The aim of this research was to investigate the validity of goniometric method for cervical lordosis measurement through radiography. Method: In this study, 16 female students of Kerman Bahonar University with mean age of 19.81±1.06 years, mean weight of 56.56±2.78kg, and mean height of 1.60±1.96m who had forward head deformity, were participated. The measurements of deformity were made by goniometry and radiography. Radiography images were analyzed with Kapandji, Cobb, Harrison methods and a similar goniometric method. Pearson’s correlation coefficient was used for comparison of goniometric and Radiographic results. Results: There was a significant correlation between the results of goniometry and the similar method on radiographic images in measuring cervical lordosis deformity (r=0.945, P<0.01), but no significant correlation was found between goniometry and other measurement methods.Conclusion: Since goniometry showed low validity in the assessments of cervical lordosis, it is not suitable for the evaluation of cervical lordosis.

Background & Aims: Hydatidosis as a parasitic zoonotic infection is endemic in Iran, but systematic information about the exact rate of hydatidosis prevalence in different regions of the country is very limited. Because of the importance of disease this study was undertaken in East-azarbaijan province to determine the prevalence rate of hydatidosis by ELISA method.Methods: Totally, 1500 serum samples were collected from patients referred to different health centers in 8 cities of East-Azarbaijan province in 2009. Antigen B was obtained from infected sheep’s lung and liver. All sera were checked in 1:400 dilutions by ELISA test. Optimal antigen concentration and serum dilution were determined by cross-titration method. Data were analyzed with t-test and chi-square. Results: Overall, 19 cases (1.28%) were positive for human hydatidosis, of whom 8 cases (0.93%) were from urban population and 11 cases (1.8%) were from rural areas. There was no significant difference between urban and rural population in this regard. Also 1.76% of females and 0.83% of males were positive that shows significant difference between two sexes (P<0.001). Age group of 30-40 years old had significantly (P<0.001) the highest rate of positive cases (1.66%).Conclusion: According to the results of this study, in East Azarbaijan hydatidosis is an important endemic disease with a considerable prevalence. Because of high rate of infection in different age and occupational groups, prevention and control of this disease should be considered as one of the health priorities. Moreover, further studies are needed to investigate the sources and transmission routes of the infection.

Background & Aims: This study was carried out to determine the leading indications for corneal transplantation in Kerman province.Methods: Medical records of 186 patients underwent corneal transplantation during 3 years (2004-2006) in Shafa Medical Center were evaluated retrospectively. The initial diagnosis and causes of corneal grafting were recorded. Infectious keratitis (Bacterial, Fungal, and acanthamoeba keratitis), corneal opacity and scarring, keratoconus, bullous keratopathy, regrafting, corneal dystrophy and degeneration, herpes simplex keratopathy (active keratitis), etc. were considered as indications of corneal transplantation.Results: A total of 186 patients (110 males, 76 females) were included in the study. Mean age of  patients was 47.7± 24.3 years (6-85). The leading indications of grafting was corneal opacity (32.3%) followed by keratoconus (22.6%), bacterial keratitis (15.6%), aphakic bullous keratopathy (6.7%), pseudophakic bullous keratopathy (6.5%), regrafting (4.8%), herpes simplex keratopathy (3.8%), fungal keratitis (1.6%), corneal dystrophy (1.6%) and spheroidal degeneration (1.6%).Conclusion: Corneal opacity and scarring were the most common indications of corneal transplantation that might be due to high prevalence of infectious keratitis in this region.

Aneurysmal bone cysts mostly occur in long bones and spine. It is relatively rare in the maxillofacial region. In this article, we present a 19-year- old woman with the complaint of swelling in the left mandibular premolar tooth. She had got antibiotic therapy after the diagnosis of dental cellulites. On the X-ray study, a well- defined unilocular bony lesion within the preapical premolar tooth was observed. The patient referred after six months with vast swelling in the left mandible associated with parestesia and rapid growth. In 3D CT study a multilocular lesion suggestive of vascular lesion was observed. Surgical resection was done with curettage and immediate reconstruction of the plate.Aneurysmal bone cyst is a non-neoplastic but locally aggressive tumor that due to its occasional rapid growth should be differentiated from other multilocular processes like amiloblastoma, ossifying fibroma, epithelial cyst and also giant cell granuloma and sarcomas.Treatment of choice is conservative surgical excision of the mass with curettage or enucleation.