Internal Medicine Today
Year:2016 | Volume:22 | Issue:3 |Papers Count:13

Aims: Propofol is the most widely used intravenous anesthetic medication. It is necessary to assess the doses of the medication to determine proper anesthetic depth and to prevent its side-effects. The aim of this study was to compare 1 and 2.5mg/Kg doses of propofol in hemodynamic changes, myoclonus degree, and bi-spectral index (BIS) monitoring level in patients under anesthetic induction.Materials & Methods: In the two-blind random clinical trial study, 92 patients being candidate for surgery wit general anesthesia induction were studied in Shahr-e Kord Kashani Center in 2013. The subjects, selected via simple sampling method, were randomly divided into two groups. The first and the second groups were received 1 and 2.5mg/kg doses of propofol, respectively. Hemodynamic, myoclonus, and BIS indices were measured at four different times in the groups. Data was analyzed by SPSS 17 using independent T and Chi-square tests, as well as repeated ANOVA and Fisher’s test.Findings: There was no significant difference between the groups in the hemodynamic variables such as systolic and diastolic blood pressure, mean arterial blood pressure, pulse rate, and BIS (p>0.05). In addition, the change rates of the variables were the same. Nevertheless, there was a significant difference between the groups in the pulse change rate (p=0.032). There was no significant difference between the groups in myoclonus (p>0.05).Conclusion: The hemodynamic changes and the changes in myoclonus degree and BIS are the same in 1 and 2.5mg/kg doses of propofol in the patients undergoing anesthetic induction.

Aims: Playing an important role in regulating glucose hemostasis, apelin might empower the correlation between any increase in the adipose tissue mass and obesity and the correlated metabolic diseases. The aim of this study was to investigate the effects of 6-week intensive periodic massive exercises with cinnamon supplementation on the apelin serum concentration and insulin resistance in the overweight boys.Materials & Methods: In the semi-experimental study, 40 male overweight students were studied in Zahedan in 2014. The samples, randomly selected, were divided into four groups including exercise, exercise and supplementation, supplementation, and control.6-week intensive periodic massive exercises were done in the exercise groups. In addition, three 380mgcinnamon capsules were administrated in the supplementation groups. Blood sampling was done from the subjects 48 hours before and after the exercise program. Apelin, glucose, and insulin levels were measured. Data was analyzed by SPSS 19 software using one-way and two-way ANOVA tests and covariance analysis.Findings: There were significant differences between “exercise” and “exercise and supplementation” groups and “control” group in apelin and insulin resistance levels after the exercise program (p=0.0001). In addition, there was a significant difference between “cinnamon supplementation” and “control” groups in insulin resistance (p=0.001).There were significant differences between the exercise groups and supplementation group in apelin (p=0.0001) and insulin resistance (p=0.003) levels.Conclusion: The serum apelin level and the insulin resistance index in the overweight boys are reduced by 6-week intense periodic massive exercises. In addition, the cinnamon supplementation only reduces the insulin resistance index.

Aims: The medical herbs play important roles in the treatment of liver diseases.In the traditional medicine, Salvia officinal is is highly used to heal a wide range of diseases. The aim of this study was to investigate the treatment effects of Saliva officinali son hepatotoxicity due to acetaminophen.Materials & Methods: In the experimental study, 60 albino mice were studied.The rats were divided into 6 groups. The first, second, and third groups were physiological serum, crude extract of Saliva officinal is, and 500mg acetaminophen per 1Kg consumed as single dose, respectively. The fourth, fifth, and sixth groups received 5-day 125, 250, and 500mg per 1Kg extract of Saliva officinal is, respectively. Then, they received 500mg acetaminophen one hour after the last administration of extract. Blood sampling was done from the carotids of the rats 24hour later, and the levels of bilirubin and liver enzymes were measured. In addition, their liver tissues were studied. Data was analyzed by SPSS 16 software using one-way ANOVA.Findings: There were significant increases in the direct and complete bilirubin concentration and liver enzymes due to acetaminophen compared to control group (p<0.05). There were significant reductions in the direct and complete bilirubin and liver enzymes due to 125, 250, and 500mg per 1Kg of the extract of Saliva officinal is compared to control group (p<0.05). The results were confirmed by the histology studies.Conclusion: 250 and 500mg per 1Kg of Saliva officinal is potentially protect the damages caused by acetaminophen. In addition, they considerably improve the tissue damage and the biochemical indices in the liver damages.

Aims: Being prevalent in the more than 40 years old persons, the knee osteoarthritis is one of the main factors in the function system failure mainly affecting their life. There is a type of instability in the persons with knee osteoarthritis, which is an increase in the domain and frequency of body pressure center. The aim of the present study was to compare the standing stability parameters in persons with knee osteoarthritis and healthy persons.Instrument & Methods: In this case-control, 15 patients with knee osteoarthritis referred to the physiotherapy clinic of the rehabilitation center and Al-Zahra hospital were studied in the muscle-skeletal research center of Isfahan University of Medical Sciences in 2015. The subjects were selected via stratified sampling method. As control group, 15 healthy persons were also studied in Isfahan. Total path length and the domain and frequency of pressure center in different directions were measured to assess the stability. Data was analyzed by SPSS 19 software using descriptive statistics and paired T test.Findings: There were increases in the mean movement domain and the frequency of pressure center in the anterior-posterior and the internal-external directions, as well as in the total path proceeded by the pressure center in the internal-external direction, in the persons with knee osteoarthritis than the healthy persons (p<0.05). Nevertheless, there was no significant difference in the mean total path proceeded by the pressure center in the anterior-posterior direction (p>0.05).Conclusion: Standing stability and balance in persons with knee osteoarthritis decreases compared to healthy persons.

Aims: It is very important to detect the coagulase-negative Staphylococci, which produce the hospital infections. Being one of the most expensive and time-consuming stages before the polymerase chain reaction (PCR), DNA extraction is one of the primary stages of PCR. Then, it should be noticed that the elimination of the stage might save time and costs. The aim of this study was to compare two PCR methods including the method with the utilization of the extracted DNA with the extraction kit and the direct PCR method in the detection of the methicillin-resistant genes in the coagulase-negative Staphylococci.Materials & Methods: In the descriptive cross-sectional study, 135 Staphylococcus epidermidis and 88 Staphylococcus saprophytic us samples were studied, separated from blood, wounds, urinary catheter, and urine samples of patients hospitalized in the treatment centers of Zahedan. The direct PCR was done on the Staphylococcus saprophytic us and Staphylococcus epidermidis colonies. PCR with the extracted DNA was done for mecA and 16srDNA genes using the extraction kit, and the results were compared.Findings: In both methods, mecA and 16srDNA genes were successfully amplified in 310bp and 420bp related to Staphylococcus bacteria identifying gene and methicillin resistant gene, respectively. In addition, there were approximately the same band qualities.Conclusion: In order to save time and costs, the direct PCR method can be used to detect methicillin-resistant coagulase-negative Staphylococci.

Aims: One of the major factors in sudden cardiac arrest is the initiation and continuation of deadly arrhythmias during ischemia. It is known that betahydroxy-beta-methyl butyrate (HMB) has useful effects such as anti-inflammatory and anti-apoptosis effects in the skeletal muscles. The aim of this study was to investigate the preventive effects of HMB on the ventricular arrhythmias due to the ischemia.Materials & Methods: In the experimental study, 30 Wistar male rats were randomly divided into three groups including control, HMB320, and HMB700.As control group received normal saline, HMB320 and HMB700 groups orally received 320 and 700 mg/Kg HMB as gavage for 2 weeks, respectively. The rats, having been anesthetized, underwent 30-minute ischemia. Then, the numbers of premature ventricular contractions (PVC), the appearance duration of ventricular tachycardia (VT), and the ventricular fibrillation (VF) were assessed. Data was analyzed by SPSS 16 software using Kruskal-Walis, one-way ANOVA, Tukey’s post-hoc, and Chi-square tests.Findings: There was a significant reduction in the mean PVC number in HMB320 and HMB700 groups than control group (p=0.001). In addition, there was such a significant difference between the groups received the doses (p=0.008). There was a reduction in the mean appearance duration of VT in HMB320 and HMB700 groups than control group (p=0.001). There was a significant reduction in the mean appearance duration of VF in HMB700 group compared to control group, only (p=0.003).Conclusion: Through arrhythmias reduction, 2-week preventive consumption of HMB might considerably reduce the severe side effects of ischemia.

Aims: As factors that affect the pulmonary functioning, different climatic conditions and physical activities can produce respiratory diseases. The aim of this study was to compare the effects of physical activities on the pulmonary functioning in 12-14 years old females in two different Kerman and Gorgan climatic conditions.Materials & Methods: In the semi-experimental study, 128 female students of the elementary schools, aged between 12 and 14 years, were studied in Kerman and Gorgan (n=64 per city) in 2013. The subjects were selected through random cluster method. The pulmonary functioning test was done before, immediately after, 7min after, and 20min after the physical activities. The peak expiratory flow (PEF), the expiratory volume in 1 second (FEV1), the forced vital capacity (FVC), the maximum expiratory flow at 50% of forced vital capacity (MEF50%) were measured. More than 15% reductions in FEV1 and PEF after the activities were explained as Exercise Induced Asthma. Data was analyzed by SPSS 19 software using repeated measurement of variences and Chi-square tests.Findings: There was no significant difference in either FEV1 or PEF between Kerman and Gorgan cities (p>0.05). Nevertheless, there was a significant difference in the mean FVC between the cities (p=0.001). In total, there was more pulmonary-functioning drop after the activities in Kerman than Gorgan.Conclusion: More than average severe physical activities reduces the pulmonary capacity in 12-14 years old female, which cool and dry climate leads to more drop in the pulmonary functioning after the activities, as well as the continuance of the drop, than the wet climate.

Aims: The exposure to chemical materials and colors affects thyroid gland functions. The aim of this study was to investigate the effects of fume inhalation of oil-based paints on the serum level of thyroid hormones in female and male rats.Materials & Methods: In the experimental study, 15 male and 15 female Wistar rats were studied. The rats were divided into six 5-rat groups including a control group and groups with either 1- or 8-hour a day exposure to the paint fumes by gender division. The serum levels of T3, T4, and TSH thyroid hormones were measured after 10 weeks. Data was analyzed by SPSS 20 software using two-way ANOVA and Tukey’s post-hoc.Findings: Mean values of T3 and T4 hormones were significantly reduced in both 1- and 8-hour male and female groups than control group (p<0.001). In addition, the more the inhalation time, the more the reduction was. Any reduction in T3 in females in 1-hour (p<0.001) and 8–hour (p<0.05) groups was significantly more than the males. Nevertheless, a significant reduction in T4 was only in 1-hour group (p<0.001). Mean TSH hormone was significantly increased due to the inhalation of paint fume than control group (p<0.001). In addition, such an increase was significant in the female rats in 8-hour group than the male group (p<0.01).Conclusion: The inhalation of oil-based paint fume leads to a reduction in the serum levels of T3 and T4 thyroid hormones, while increases TSH serum level.Such an effect is stronger in the females.

Aims: New medications with less side-effect are increasingly noticed now a day. L-Carnitine and Acetyl L-Carnitine reduce the secondary side-effects of Type I diabetes. The aim of this study was to investigate the effects of oral administration of the materials on the blood glucose and the lipid per-oxidation of the liver and brain tissues in the diabetic rats.Materials & Methods: In the experimental study, 50 male Wistar rats were studied. The rats were randomly divided into five groups including control (the healthy rats), negative control (the diabetic rats), and three treatment diabetic groups. The diabetic groups received 110mg/Kg alloxan via injection to become diabetic. The treatment groups received L-Carnitine, Acetyl L-Carnetine, and LCarnetine with Acetyl L-Carnetine (300mg/Kg) as gavage for 30 days. The lipid per-oxidation, the serum glucose, the lipid profile, and the liver enzymes were measured at the end of the experiment. Data was analyzed using one-way ANOVA followed by Tukey complementary test.Findings: The fasting blood concentration, triglyceride, cholesterol, creatinine, the serum liver enzymes, and the level of the liver tissue malondialdehyde significantly decreased in treatment diabetic group than diabetic group without any treatment, while HDL level increased as well (p<0.05). The brain tissue malondialdehyde and the serum HDL decreased and increased due to the administration of Acetyl L-Carnitine, respectively. Nevertheless, it affected no other parameter significantly. The positive effects of L-Carnitine were reduced by the administration of Acetyl L-Carnitin with L-Carnitine.Conclusion: The administration of L-Carnitine further reduces the secondary side-effects of diabetes than Acetyl L-Carnitine. In addition, simultaneous administration of the materials is not recommended.

Aims: Probabely through improvements in the levels of apo lipoproteins (ApoA and ApoB) and visfatin, the sport activities helps to reduce the risks of cardiovascular diseases in the diabetic persons. The aim of this study was to compare the effects of intensive interval and combined trainings on the levels of ApoA and ApoB, visfatin, and insulin resistance in the middle-aged women with Type II diabetes.Materials & Methods: In the semi-experimental study, 52 middle-aged female patients with Type II diabetes were studied in Shahr-e-Kord in 2015. The subjects, selected by convenience sampling method, were randomly divided into three groups, incluing simultaneous strength-endurance training, interval intensive training, and control groups.12-week trainings, composed of three endurance training sessions per week with 60% of maximum heart rate and two resistance training sessions per week with 70% of one maximum repetition, were done in strength-endurance group. Three training sessions per week with 4-10 repetition of 30-second Wingate test on the ergometer were conducted in interval intensive training group with maximum effort. Data was analyzed by SPSS 21 software using dependent T test, covariance analysis, and LSD test.Findings: At the post-test stage and following interval intensive trainings, ApoA reduction (p=0.03) and ApoB/ApoA (p=0.01) were significant. However, no significant difference was observed in combined group. The levels of visfatin and serum insulin and insulin resistance index significantly decreased in both training groups (p<0.01).Conclusion: The interval intensive trainings further affect the levels of blood apo lipoprotein, visfatin, and insulin resistance in the middle-aged women with Type II diabetes, than the combined endurance-resistance trainings.

Aims: Pains caused by the invasive actions such as intramuscular injection lead to the physical and mental tensions in the children. Therefore, such pains should be given relief. One of the main priorities in the nursing is to notice methods that reduce pains due to the invasive actions in the children. The aim of this study was to investigate the effects of injection displayed on a doll on the pain intensity due to the intramuscular injection in the preschool children.Materials & Methods: In the randomized controlled clinical trial, 62 kids aged between 4 and 6 years with pharyngitis were studied in the clinic of the health network of Khalil-abad Township in 2015. The intramuscular injection of penicillin 6.3.3 was administrated for the kids. The subjects, selected by simple lottery, were divided into two groups including experimental and control groups (n=31 per group). Data was collected using a demographic characteristic collecting form and Oucher standard pain assessment tool. In experimental group, the kid watching, one intramuscular injection was displayed on a doll by a nurse; then, the kid underwent an intramuscular injection. In control group, the routine injection method was done. Data was analyzed by SPSS 19 software using Mann-Whitney, independent T, and Chisquare tests.Findings: Mean pain intensity after injection in experimental group (3.22±0.90) was significantly lower than control group (4.19±0.83; p<0.001).Conclusion: The injection displayed on a doll before the intramuscular injection might lead to pain reduction in the preschool kids.

Aims: Endometrial cancer is the most common malignancy of the female reproductive tract. As the prognosis factors, the determination of exact cancer stage and the differentiation of the lymph nodes plays a role in the selection of treatment plan and the rate of patient’s survival. The aim of this study was to investigate the diagnosis accuracy of dynamic and diffusion imaging techniques in the endometrial cancer staging as well as the differentiation of metastatic and non-metastatic lymph nodes.Materials & Methods: In this prospective study, 30 patients with endometrial cancer were studied in MRI ward of the imaging center of Imam Khomeini Hospital in Tehran in 2013-14. The subjects, selected by purposeful sampling method, underwent the pelvis imaging before the surgery. T1W and T2W scenes, the dynamic technique in phases including 25, 60, 120, and 240 seconds after the injection, and the diffusion technique (b=zero and 1000 s/mm2) were used in the imaging. Data was analyzed by SPSS 22 software using kappa statistic, two-independent T test, and one-way ANOVA.Findings: The agreement rate between the results of radiology and pathology in the determination of the different cancer stages was approximately 0.8, showing a good and considerable result (p<0.001). The diagnostic authenticity rate of the dynamic and diffusion techniques was 0.83. The results of radiology and pathology were completely consistent regarding the differentiation between the metastatic and non-metastatic lymph nodes. In different cancer stages, as well as in the metastatic and non-metastatic lymph nodes, the mean age and number of fertility were not significantly different (p>0.05).Conclusion: In the differentiation between the metastatic and non-metastatic lymph nodes in patients with endometrial cancer, the diagnostic accuracy is increased by the diffusion techniques utilizing the routine scenes and the injection.