Internal Medicine Today
Year:2004 | Volume:10 | Issue:3|Papers Count:13

Background and Aim: Immunoglobulins or antibodies are a group of glycoproteins found in the serum and lymphatic fluids of all mammals. They are produced in large amounts by plasmocytes which originate from B lymphocytes. Of the five classes, of human immunoglobulins, three classes including IgG, IgA and IgM are of greater importance against foreign bodies. They play an important role in controlling infectious factors. The aim of the present study was to evaluate the rate of immunoglobulins in iron deficiency anemia. Materials and Methods: In this case-control study, 5cc of venous blood were obtained and poured into the single test tubes from both case subjects with the clinical signs of anemia without any other disease and control healthy subjects of the same age and sex referred to Yazd central laboratory. After 4 hours the serum was separated and kept in freezer at 80°C. The immunoglobulins IgG, IgM and IgA were measured using the SIRD method. The amount of ferritin was measured using ELISA. Statistical data were analyzed using chisquare and t tests. Results: Out of 90 subjects with ferritin deficiency, 17 subjects (18.88%) were in the age group of 1-19 years old, 43 subject (47.77%) were in the age group of 20-29 years old and 30 subjects (33.33%) belonged to the age group of 30-59. The average of IgG in the subjects with ferritin deficiency was 877.33 mg/dl, while for the subjects with normal ferritin level was 1048.7 mg/dl showing a statistically significant difference (P=0.001).The average IgM in subjects having ferritin deficiency was 134.2 mg/dl while in the subjects with normal feretin level it was 138.92 showing no statistically significant difference (P= 0.487).The average IgA in subjects with ferritin deficiency was 149. 82 mg/dl while it was 179.33 for the subjects with normal ferritin level showing a statistically significant difference (P= 0.002). The correlation coefficient of ferritin with immunoglobulins was not statistically significant in the subjects with ferritin deficiency and the subjects with normal ferritin levels. Conclusion: The average of IgA and IgG in the subjects with ferritin deficiency was significantly less than that of subjects with normal ferritin.

Background and Aim: Eye color is of a genetic origin and is basically characterized by the accumulation and distribution of melanin and lipochrome pigments in the iris. Pigments in the iris cause its blue color turning to green, hazel and brown with the increase in the iris pigmentation. Although normally Cup/Disc (C/D) ratio can range from 0 to 0.8, normally the ratio is less than 0.3. This study is mainly intended to examine the relationship of iris and pupil margin pigmentation.with optic Disc CUP in subjects with no primary or secondary ocular disease. Materials and Methods: The target population of this descriptive analytical study included women referring to Sabzevar Eye Clinic. They were examined by slit lamp for the color of their iris in three groups: dark brown, medium brown (green) and light brown (blue). Their pupil margin pigmentations were qualitatively divided into five groups: those with one, two, three or many rows of pigmentation and those with no pigmentation. C/D ratio was qualitatively estimated upon funduscopy by direct ophthalmoscope. The obtained data were statistically analyzed using Chi-Square and Fishers exact test. Results: Total sample was 227; mean OD and OS CUP were 0.1617 ± 0.1178 and 0.1648 ± 0.1197 respectively. CUP ranged from 0 to 0.5 but the most frequent OD and OS CUP were 0.2 and 0.1 respectively; the least frequent in both eyes was 0.5. The most common iris color was dark brown (55.9%); the most common pigmentation of the pupil margin was 47% in two rows. 4.5% of the subjects were observed to be asymmetric as for the CUP of their eyes; it was 0.9% for CUP of 0, 0.1 and 0.2; it was 0.5% for CUP of 0.3; also 1.3% for CUP of 0.4; no asymmetry was observed for CUP of 0.5. No significant relationship was observed to exist between OD and OS CUP with iris color and pupil margin pigmentation. But OD CUP 0 indicated a correlation at P=0.041; while no such relationship was found in the left eye. Significant relationships were also observed for OD CUP of 0.1, 0.4 and 0.5 with eye color at p-values of 0.004 for blue, 0.038 and 0.035 for medium brown (green). Relationships of CUP and OD pupil margin pigmentation were also obtained for CUP of 0.1 and three rows (P=0.048), CUP of 0.2 and two rows (P=0.020) and no pigmentation (P=0.036). In the left eye, relationships were obtained for CUP of 0.1 and pupil margin pigmentation for two rows (P=0.024), and three rows (P=0.03); for CUP of 0.2 and two rows (P=0.018), three rows (P=0.024) and with no pigmentation (P=0.031). Conclusion: As no significant relationships were observed in the relationships of CUP, eye color and pupil margin pigmentation, except for some particular CUP, iris color and pupil margin pigmentation which indicated significant relationships, the issue demands more research to help make scientific predictions of these relations on the basis of certain landmarks.

Background and Aim: Biologic dressing with amniotic membrane is one of the therapeutic methods of managing damaged tissues in burns. There are various methods for topical treatment of burns including antimicrobial dressing that uses topical antibiotics and biologic dressing using live tissues. In this study two methods were compared regarding to complications, treatment cost, and hospital stay. Materials and Methods: In a clinical trial survey accomplished in 2000 at ward of burns, Khatam-al-Anbia hospital, Zahedan, Iran, 80 patients with burns received biologic dressing with amniotic membrane were compared with 80 patients undergoing antimicrobial dressing. Data were analyzed by Chi-Square and t tests with P<0.05 as a limit of significance. Results: Local infections in the biologic and antimicrobial dressing were 35% and 78.8%, respectively. Pulmonary complications were 22.5% in the antimicrobial dressing and 1.2% in the biologic dressing. The mean temperature in toe biologic dressing and the antimicrobial dressing were 39.04± 0.94 C and 39.7± 0.98 C. Thrombophlebitis was found in 16.2% of the biologic dressing and 18.8% of the antimicrobial dressing. There was statistically significant difference in local infection, pulmonary complications, and fever between the two groups that revealed less complication in the biologic dressing group. The two groups did not show significant difference concerning thrombophlebitis. The mean hospital stays were 5±3 and 9± 5 in the biologic and antimicrobial group, respectively. There was a statistically significant difference between the groups concerning hospital stay and treatment costs. They were less in the bIologic group. Conclusion: Biologic dressing is a simple and cost effective and practical method in the burned patients and is preferred to antimicrobial dressings regarding treatment cost, hospital stay, and complications.

Background and Aim: Primates have long been used as the most resembling animal model to human. Primates are natural hosts of HTLV/STLV retroviruses. From this family, HTLV-I is a health problem in Khorasan. Recently a new HTLV-I resembling virus has been detected in olive baboon, which suggests this animal as an ideal animal model for therapeutic studies of this disease, for such studies inventing methods and tools to quantify cytokines of this animal, especially IFN-γ, has high priority. Materials and Methods: Here in, we report methods for isolating cDNA of IFN-γ from peripheral blood, comparison of its sequence with other primates, construction of competitive plasmids and primers for quantifying this cytokine. In order to standardize the results of quantification, we needed to measure the expression level of a house keeping gene too, so we designed a competitor plasmid and set of primers toquantify the expression of Glycer Aldehyde 3 Phosphate DeHydrogenase (G3PDH) too. Results: Two new cDNA sequences of baboon IFN-γ and G3PDH were registered in NCBI GENBANK. The competitive PCRs of a sample of this animal measured 7 pg and 0.455 pgof IFN-γ and G3PDH transcripts respectively. Conclusion: Phylogenetic analysis of lFN-γ well classified this baboon among old world monkeys, while the structure of this cytokine seems to be same as human. According to the methodology presented here, it is possible to use the ratio of IFN-γ/G3PDH expression as a tool to compare levels of IFN-γ production in different samples.

Background and Aim: Metformin, a biguanide antihyperglycemic drug, has been shown to improve ovarian function and glucose metabolism in women with polycystic ovary syndrome (PCOS), but results concerning its effects on insulin sensitivity are controversial. Oral contraceptive pills are commonly used in the treatment of PCOS, but like metformin, their influence on insulin sensitivity is not well known. The aim of this study was to investigate endocrine and metabolic effects of metformin versus Diane in women with polycystic ovary syndrome. Materials and Methods: This research was a prospective randomized clinical Trial study, we randomized 60 women (20-49 years old) with PCOS either to metformin (500mg x3 daily for 6 months) or to oral contraceptive pills (Dian) 35 µg ethinyl estradiol 2mg cyproterone acetate for 6 moths. Data were analyzed by Chi-Square ,t Mann-Whitney and Wilcoxon Signed Ranks tests with P<0.05 as a limit of significance. Results: Results showed that metformin significantly decreased serum glucose, insulin concentrations, serum cholesterol, serum testosterone, serum DHEAS (Dehydro epiandrosterone sulfate) and improved menstrual cycIicity and insulin sensitivity. Diane significantly decreased serum testosterone and serum DHEAS but slight effect in carbohydrate metabolism and increase serum glucose. Conclusion: Metformin, probably by way of its effects on adipose tissue, leads to reduction of hyperinsulinemia and concomitant improvement, and therefore, it offers a useful alternative treatment for anovulatory women with PCOS. Despite slight increase in fasting glucose, Diane is an effective for women with hyperandrogenism and hirsutism.

Background and Aim: Acute myocardial infarction is one of the main causes of mortality and morbidity in developed and under developed countries. The aim of the present study was to evaluate the changes in mortality and risk factors in patients with acute myocardial infarction in Birjand from 1994-2003. Materials and Methods: This descriptive analytical study was based on patients that admitted due to acute myocardial infarction in Birjand hospital from 1994 -2003. The source of data collection were questionnaires that completed by two educated nurses with supervision by cardiologist. Then data entered to SPSS and analyzed by t-test and Chi-Square at α=0.05. Results: From 918 patients that hospitalized for acute myocardial infarction during 1994-2003, 84 patients was died (9.1%). Changes in mortality during this ten years was showed reduction of mortality (14.7% in 1994- 6% in 2003). In this study, 319 patients (34.7%) had no risk factor and others had at least one risk factors. Prevalence of risk factors was increased for all risk factors, but prevalence of hypefIipidemia (18.2%, 30.1% P<0.001) and smoking (18.2%,23.5% P=0.03) increased statistically significantly during ten years. Conclusion: Because of increasing in prevalence of cardiovascular risk factor in these 10 years, is needed to design interventional program for reducing this risk factors.

Background and Aim: Major depressive disorder is a common psychiatric disorder. It causes major dysfunction for the patient. Traditional pharmacological agents for treatment of this disorder are SSRls, TCAs , MAOls, NSRls etc. some researching have shown the effectiveness of herbal medicine in the treatment of depression. Citrus Fragrance ( the essence of orange) is one of herbal drugs, which has had some reports of stimulant and anti depressant effects. Materials and Methods: In this clinical trial study, the sample was 150 adult patients with the diagnosis of major depressive disorder based on DSM-IV. They were divided in three groups randomly. The first group received Fluoxetine 20 mg daily. The second group received Citrus Fragrance 10 drops tid from 2% concentrated solution and the third group received 20 drops tid from it. The patients were evaluated by clinical interview, Hamiltons depressive rating scale and Adverse effects inventory before treatments and 3 and 6 weeks after treatment. Data were analyzed by t-test and ANOVA through SPSS software. Results: 74 patients remained in the treatment till the end of research (19 men and 55 women). The male/female ratio was equal in the three groups. Their average age was 2804 Y. The recovery rate based on Hamiltons scale after 6 weeks was 8.15 in the first group and 15.8 and 12 in the second and third group. The most effective regimen was 10 drops of Citrus Fragrance (P<0.05). The rate of adverse effects was similar in the groups (P>0.05). Conclusion: Citrus Fragrance has an effective antidepressant effect especially in the does of 10 drops tid. The severity of its adverse effect is similar with Fluoxetine.

Background and Aim: Acute myocardial infarction (AMI) is one of the most common diseases today. One of the important issues which are under attention of searchers is to diagnose AMI accurately using paraclinic methods. The aim of this study was to determine the level of two important biochemical markers of AMI cardiac troponin I and T. Materials and Methods: This study was a descriptive-analytic study, which was performed on 100 patients in whom-according to criteria of WHO and references-diagnosing of AMI is definite, in second day of admission in CCU, cardiac markers including troponin I using qualitative immunochromatography assay and cardiac troponin T using third generation cTnT detection assay (CARDIAC) and also total creatine kinase (CK) was measured and record for patients. This information was recorded in a special data sheet and than analyzed by using SPSS, Chi-Square and Hest. Results: Mean age of patients was 59.73 ± 12.57.38 patients were women and 62 of them were men. 83 of patients ( 83%) had positive troponin I, 97 (97%) had values of troponin T more than 0.1 mg/ml (indicating AMI) and also 93 patients (93%) had total CK value more than normal. Conclusion: Troponin T is a more sensitive marker for diagnosis of AMI comparing with other cardiac markers of AMI in 24 h after AMI.

Background and Aim: Using saffron is one of the common habits in Eastern parts of Iran which has been used either with tea. Therefore, saffron used for ending unwanted pregnancy but, it can impress site effect on embryo. The aim of this study was to evaluate of saffron on abortion and its side effect on mice balb/c Materials and Methods: In this experimental study, fifty female mice balb/c with vaginal plagues, divided into two groups. The first group (case) was fed with saffron. The second group (control) was fed with water. Data were analyzed by odds- ratio with P<0.05 as the limit of significance. Results: The results indicated that the percent of absorbed and abnormal embryos were increased significantly in the group that tread with saffron (OR: 1.1, 4.46) but fibrous and teratum sacrum wasnt significantly different. Conclusion: The study indicated that saffrons usage in pregnancy can have some complication on the embryo.

Juxtaglomerular cell tumor or reninoma is an extremely rare tumor of the kidney, specially occurring in the young adults. This tumor by producing rennin and activating the Renin-Angiotansin- Aldostrone pathway causes an increase in blood pressure associated with hypokalemic metabolic alkalosis. We report a young female patient, aged 18 years .presented with hypertension, as the chief complain, and associated hypokalemia. CT-Scan and sonography showed a renal mass diagnosed as renal cell carcinoma or pheochromocytoma. In the nephrectomy specimen there was a tumor measuring 4.5*3.5 cm, creamy to browni-sh color limited to. the renal capsule. Microscopic examination revealed an encapsulated tumor composed of sheets of round to polyhedral cells in a vascular stroma with slight atypia and without mitoses or necrosis, finally diagnosed as juxtaglomerular cell tumor. Microscopic features and clinical course are discussed with reviewing the literatures. Because of the rarity of this neoplasm we highly emphasize reninoma should always be considered as a probable cause in a young adult with hypertension.