Journal of Kerman University of Medical Sciences
Year:2009 | Volume:16 | Issue:3|Papers Count:17

Background & Aims: Hypertension, hyperuricaemia and nephrotoxicity are some common side-effects of Cyclosporine A (CsA) treatment in renal transplant recipients. Previous studies suggest that Calcium Channel Blockers (CCB) can increase serum level of CsA and may improve graft function in patients receiving CsA. The aim of this study was to evaluate the effects of Diltiazem and Amlodipine on cyclosporine dose adjustment with respect to trough and 2-hour concentrations in renal transplant recipients treated with CsA.Methods: This observer-blind randomized clinical trial was performed on 120 renal transplant recipients treated with CsA. Patients received either Amlodipine (5-10mg/day) or Diltiazem (90-180mg/day) for 3 months and were compared with control group receiving no CCB. Data were analyzed using ANOVA, Post Hoc and Correlation tests.Results: Diltiazem significantly decreased CsA dosage (20%) from 162.03±40.6 mg/dl to 128.5± 25.5 mg/dl (P=0.000) and Amlodipine, too, decreased it to 140.5±22.3 mg/dl (13%) which was significant (P=0.008). Trough concentration in patients who had received Amlodipine were significantly higher than control group (P=0.019). Diltiazem significantly decreased Cholesterol Level (P=0.027) but other parameters were not significantly different between Amlodipine / Diltiazem and control groups. Discussion: Diltiazem and Amlodipine were well tolerated in co-administration with CsA with no adverse effect on graft function and did not affect blood pressure or heart rate. Our findings support that these two CCBs can be used in clinical settings to reduce the administered dose of cyclosporine.

Background & Aims: This study aimed to determine if serial measurement of serum CA-125 level could be used as a useful test in the differential diagnosis of intact and ruptured tubal pregnancies.Methods: In a single-blind prospective controlled clinical study, 59 women with tubal pregnancy of 6– 12 weeks (26 women with ruptured tubal pregnancy, 33 women with intact tubal pregnancy and 59women with normal intrauterine pregnancy of the same gestational age as control group) were studied prospectively. Serum CA-125 levels were measured in all women and compared among three groups.Results: Demographic features (age, gestational age, parity and educational level) were not significantly different in three groups. CA-125 level in ruptured tubal pregnancy group was significantly higher than that in control group (P = 0.04). Both these two groups had higher levels of CA-125 comparing to the intact tubal pregnancy group (P = 0.001, P = 0.006, respectively).Conclusion: In intact tubal pregnancies managed with medical treatment, serial measurements of CA-125 could be a supplementary test for an early diagnosis of tubal rupture.

Background & Aims: Type 1 fimbriae is the most common adhesion factor in urine tract infection. In this Study, presence of virulence genes in isolated strains of uropathogenic E.Coli, O serotyping and molecular detection of phase variation of type 1 fimbriae were assessed during solid surfaces exposure.Methods: Isolated E.coli from urine samples of patients were serotyped by using serologic methods. Phenotypic estimation of phase variation was applied by mannose – resistant hemagglutination (MRHA). Fim opron phase variation was studied by HinFI digestion and PCR reaction.Results: For all 158 E.coli strains, the most occurrences belonged to O44. Forty nine percent of the isolates were mannose-sensitive and expressed fim operon in agar medium. While, 51% of strains were resistant to mannose in the same position. In Broth medium 68% of isolates were mannose-sensitive and 32% were mannose-resistant. PCR products with 359bp and 200bp long fragment demonstrated ON position and those with 489bp and 70bp long fragment indicated ON and OFF positions.Conclusion:  Uropathologic E.coli strains posses few number of O serotypes. Environmental factors play an important role in regulation of fimberiae operon expression. Strains recovered from these urine samples, however, were shown capable to switch the fim operon to the ON position after culture in broth medium. Type 1 fimbrial expression and flagella motility are probably representative of an essential dynamic interplay between bacterial adhesion and motility. The strains present in urine samples but nonattached to the epithelium are inactive for type 1 fimbriae expression.

Background & Aims: Gastric cancer is the second common cancer in Iran and it has unfortunately no diagnostic signs in early stages. Considering the role of genetic and environmental factors in the development of gastric cancer, this study aimed at evaluating DNA-content of stomach cells in patients with gastric cancer in order to find a reliable index for prediction of disease prognosis and providing more exact therapeutic procedure.Methods: A total of 22 samples taken from patients with gastric cancer were evaluated. Peritoneal lavage cells were centrifuged and stained with DNA-staining kit. Then DNA-content was analyzed and compared with that in normal cells by employing flow cytometry and using modfit software.Results: In whole, 12 out of 22 samples were positive and DNA aneuploidy was present in 33.3%. SPF increase was observed in 22.2% of positive cases.Conclusion: SPF can be used as a reliable indicator in pathological staging of cancer and consequently in decision making for treatment.

Background & Aims: Diabetes mellitus influences the reproductive system. Since investigations have showed that cinnamon may have an improving effect on diabetes, this study was designed to investigate the effect of cinnamon extract on the ovary structure in diabetic rats.Methods: A total of 24 female wistar rats (186±15gr) were randomly divided into 4 equal groups of control, control + cinnamon extract, diabetic and diabetic + cinnamon extract. Streptozotocin (60 mg/kg) was injected to induce diabetes and cinnamon extract (80 mg/kg/day) was administered orally through gavage. After 14 weeks, blood sugar and body weight were determined then rats were anesthetized and the right ovaries were taken out weighed and underwent the process of slice preparation and staining by H&E method. The total volume of ovary, cortex and medulla, diameter of Graafian follicle and oocyte and thickness of zona pellucida were estimated by stereological methods. Data were analyzed using one way ANOVA and Tukey test.Results: Blood sugar was reduced significantly in diabetic +extract group compared with diabetic rats. Mean total volume of ovary, cortex and medulla were increased significantly in diabetic group compared with other groups. Mean total volume of ovary, cortex and medulla were the same in diabetic + extract, control and control + extract groups. Body weight in both diabetic groups was reduced significantly compared with control groups. Ovary weight in diabetic group showed a significant increase in comparison to that in the diabetic + extract group.Conclusion: Based on the results, water-alcohol extract of cinnamon causes reduction in blood glucose level and prevents increase in ovary weight and volume of ovary, cortex and medulla in diabetic rats.

Background & Aims: Labor conditions cause stress and anxiety specifically in nulliparous women and hence the chance of a normal vaginal delivery is reduced. According to some studies lavender scent improves mood and reduces stress and anxiety. The purpose of this study was to investigate the effect of lavender scent on anxiety status in nulliparous women and also to determine changes in plasma cortisol, serotonin and 5- hydroxyl indol acetic acid (5-HIAA) concentrations.Methods: In this study 121 nulliparous women with gestational age >37 weeks and cervical dilatation of 3-4 cm, referring to labor room of Zeinabieh and Hafez hospitals in Shiraz were devided into case group (N=63) and control group (N=58). The case group smelled lavender essential oil for 1 hour. In both groups anxiety changes were determined before and after aromatherapy by Spielberger questionnaire, and at the same times pulse rate, blood pressure and plasma cortisol, serotonin, and 5-HIAA concentrations were determined by ELISA.Results: Anxiety status and hormone levels were the same in both groups at the beginning of the experiment. Lavender decreased significantly anxiety and cortisol concentration while increased plasma serotonin and 5-HIAA concentrations. The difference between cortisol concentration before and after the aromatherapy in the test group was significantly lower than that of the control group. Lavender scent did not affect blood pressure and pulse.Conclusion: Aromatherapy with lavender improves anxiety status during labor in nulliparous women and decreases cortisol secretion from adrenal gland and increases serotonin secretion from GI tract.

Background & Aims: Studying about background radiation is important because human beings are continuously exposed to these radiations which leave energy in tissues and the transferred energy leads to undesirable biologic effects. The level of background radiation differs in indoor and outdoor places. Since, people spend more time indoors; in this research environmental gamma dose rate for indoor and outdoor places of Kurdistan towns was determined and compared.Methods: To estimate dose rate at outdoors, four stations in the length of main directions and one in the center of each city were selected. To estimate dose rate at indoors, two stations in each town according to the type of buildings were selected. In each station gamma dose rate was measured for one hour by RDS-110 servimeter at one meter height from the earth.Results: The average of outdoor and indoor environmental gamma dose rate for Kurdistan towns obtained as follows: Baneh 134 (SD=5), 166 (SD=25) nSv/h, Bijar 113 (SD=17), 141 (SD=8) nSv/h, Divandareh 110 (SD=8), 134 (SD=12) nSv/h, Saqez 105 (SD=12), 134 (SD=11) nSv/h, Sanandaj 110 (SD=12), 133 (SD=4) nSv/h, Qorve 114 (SD=20), 160 (SD=4) nSv/h, Kamyaran 92 (SD=4), 115 (SD=14) nSv/h, Marivan 110 (SD=9), 122 (SD=18) nSv/h. Conclusion: Data shows that indoor dose rates in Baneh (%24), Bijar (%24), Divandareh (%22), Saqez (%28), Sanandaj (%21), Qorveh (%40), Kamyaran (%25) and Marivan (%11) exceed outdoor dose rate in these towns.

Background & Aims: considering the risks and complications resulting from tobacco use this study was performed to find the prevalence of paan use and its correlates among high school boys in Zahedan during the academic year 2007.Methods: In this cross-sectional study, 292 high school boys of Zahedan were selected randomly. A structured questionnaire was used to collect data on demographic information and paan use and to determine the rate of current users (at least once during the last 30 days) and life time users (at least once or twice in their life). Data were analyzed by using chi square test and SPSS 14 software.Results: In whole, 58 students (19.9%) were current users and 29.9% had used paan during their life time. Paan consumption showed significant relationship with parents’ educational level, educational statue of students, family size, the number of cigarette smokers in the family and ethnicity (P<0.05), while it has no significant relationship with age.Conclusion: paan use among Zahedan high school boys is prevalent and indicates the necessity of preventive programs in schools.

Background & Aims: Aflatoxin M1 (AFM1) is a major metabolite of aflatoxin B1 detected in the milk of mammals that their foods have been contaminated with aflatoxins. Aflatoxins are a group of highly toxic metabolites produced by the common fungi Aspergillus flavus, A. parasiticus. They are among the most potent carcinogens found in foods. Considering its risk to the human health and high consumption of milk and diary products, this study was undertaken to determine the level of AFM1 in pasteurized milk in Kerman province for the first time.Method: From 19 Dec. 2007 to 19 March 2008, a total of 76 pasteurized milk samples produced by eight factories were collected and checked for the level of AFM1 using immunoaffinity column and high performance liquid chromatography coupled to fluorimetric detector.Results: The minimum detected level was 0.002 ppb and the amount of AFM1 in milk samples ranged from 0.002 to 0.14 ppb. No sample had greater AFM1 levels than the maximum allowed levels in milk accepted by FDA (o.5ppb), however, in 34 (44.7%) samples AFM1 level was over the maximum allowed limit in milk accepted by the European Union (0.05ppb). Mean AFM1 level in milk samples obtained from Jiroft factory was the least (0.019±0.01ppb) compared to that for other factories.Conclusion: Although the amount of AFM1 in samples selected from commonly consumed milks in Kerman province, does not appear to create a serious public health problem at present, because of high consumption of milk and dairy products especially in children it is necessary to consider it as a serious health problem.

Background & Aims: Esophageal and gastric cancers are among prevalent cancers in the world and it is believed that nitrate and nitrite contaminations of drinking water are important factors in increasing the risk of these cancers. This study was designed to determine the correlations between these factors and upper gastrointestinal cancers.Methods: In this ecologic study, mean concentrations of nitrite and nitrate of drinking waters in Golestan urban areas were obtained during 2004-2005. All patients with esophageal and gastric cancers during this period who resided in urban areas were recruited to estimate the incidence rate and Age Standardized Rate (ASR) of these cancers. The province was divided into three regions of low, intermediate and high incidence based on 33% and 66% quartiles of both cancers. Spearman Correlation Coefficient and regression line were used to analyze data.Results: Based on the results, nitrite and nitrate concentration of drinking waters in all three regions were in the standard range. There was a significant positive correlation between nitrate increase and esophageal cancer incidence (R=0.624 , P=0.013). There was no correlation between levels of nitrite in drinking water and the risk of esophageal and stomach cancer.Conclusions: It seems that there is an increased risk of esophageal cancer correlated with higher nitrate levels in drinking water. But nitrite level of drinking water has no impact on the esophageal and gastric cancer, from the ecological point of view. Further studies on food resources and drinking water of urban and rural areas are recommended to determine the effects of these factors on the upper gastrointestinal cancers.

Psychotic disorders have been observed in association with some autoimmune disorders. Moreover, autoimmune mechanisms have been recently considered in evaluation of schizophrenia spectrum disease managements. Vitiligo is one of the autoimmune diseases, but there is no report of vitiligo association with psychosis. We report three patients with vitiligo and schizophrenia spectrum disease that are indicative of the role of autoimmunity in psychosis. Moreover, unusual manifestation and poor response to treatment in the reported cases show that autoimmunity can complicate the prognosis of psychosis.