Internal Medicine Today
Year:2005 | Volume:11 | Issue:2|Papers Count:11

Background and Aim: According to the  results of some experimental and clinical investigations magnetic fields at some densities can affect in many biological and physiological processes such as brain activities. This study  was performed to investigate the effects of an alternative current (AC) magnetic field (MF) on the susceptibility, severity, and durations of Pentylenetetrazol (PTZ)-induced epileptiform convulsions in wistar rats.Materials and Methods: The magnetic field was generated using a solenoid and calibrated with a teslameter. Male wistar rats (3 month, 250-300g), were exposed to a 50 HZ magnetic field at densities of 5 and 10 millitesla (mt) in three periods of life: 1) In embryonic period for 30 min./day. Then these rats received intraperitoneal injections of PTZ.2) After birth for 4 weeks (30 min per day, 7 days per week). These rats also received PTZ injections at the end of the 4th week. 3) Adults, in two groups, chronic and acute: a) In chronic group, rats were exposed for 5 weeks (30 min per day, 4 days per week) to MF (5 mt), and at the end of this period PTZ injections were performed.  b) In acute group, rats were received PTZ injections simultaneously under magnetic field exposure (5 and 10 mt). All above groups and controls received intraperitoneal (IP) injections of PTZ (in three stages, 25mg/kg in each stage, with 15 min. intervals), if rats showed generalized (tonic-clonic) convulsions, injections were stopped. For seizures evaluation, latent periods and durations of each form of convulsion were calculated. Results: No significant differences in severity and susceptibility of seizures and epileptiform convulsions were observed between control and experimental groups. Only some groups showed a significant decrease in latent periods of convulsions. Conclusion: These findings indicate that under the conditions examined, severity and susceptibility to PTZ induced epileptiform seizures are not affected by exposure to the above mentioned magnetic fields. Taken together with previous data, this suggests that if magnetic fields do alter neuronal activity, the effect is likely to be extremely subtle.

Background and Aim: The pituitary gland constitutes Anterior, intermediate (collectively, adenohypophysis), and posterior lobes. It is believed that pituitary arises from two different anlagen, the first one arises from Osteomodeum as an up growth to form Rathke’s pouch, and the second one, develops as a down growth from the floor of the diencephalon to form posterior pituitary gland. The aim of this study was to survey the pituitary developmental stages practically as a pilot study and comparison of Normalin, Carnoy’s, Bouin and B4G fixatives effects. Materials and Methods: In this experimental study, we used 5µm thickness Normalin, Carnoy’s, Bouin and B4G fixed, paraffin embedded serial sections. Rat embryonic sections from day 10 (E10) to 20 (E20) of gestation (n=30) were stained with Haematoxyline and Eosin (H&E).Results: The result of this study demonstrated that the formation of Rathke’s pouch started from E10, and changed during its morphogenesis to E20 to form pituitary gland. At the first developmental stage (E10) to 17 (E17) gestational day all the adenohypophyseal cells reacted with Hematoxiline and reaction of some adenohypophyseal cells with Eosin started from gestational day18 (E18) and increased with proceeding differentiation during the following days and Carnoy’s fixed specimen yielded the best results effectively.Conclusion: Our findings indicate that practical review of Rathke’s pouch show changes during pituitary development and its cell differentiation using H&E staining and Carnoy’s fixative can be used in more advanced techniques to determine developmental stages.

Background and Aim: Assessing feasibility of videofluorography (video recording of fluoroscopic images) in angiography of renal transplant donors and evaluation of results in terms of quality of images and radiation dose.Materials and Methods: In this prospective study, 25 potential live donors underwent both conventional angiography and video fluorography. The images were reviewed by kidney transplantation surgeon and arterial, venous and aorthogram phases were graded 0 to 5 in terms of quality. In cases that underwent surgery, the results of angiography were compared with results of surgery. Radiation doses were compared.Results: Video fluorography resulted in 2.4% improvement in image quality of aortogram and 1.05% and 7.27% improvements in right and left arterial phases. In the venous phases, 21% and 28% reduction of quality was observed. Video fluorography caused 93% reduction in radiation dose.Conclusion: Video fluorography causes significant reduction of radiation dose. The quality of images improves slightly in the arterial and aortogram phases and is reduced slightly in the venous phase. As the arterial anatomy is of most significance in renal transplantation, reduction of quality in the venous phase can be ignored.

Background and Aim: The perfect preanesthetic medication and its ideal route of administration are still debated, but for pediatric surgical patients undergoing brief procedures, preanesthetic medication is frequently omitted because of the concern that it will prolong the children recovery from anesthesia. In this study, the effects of nasally administered midazilam on anesthetic recovery and hospital discharge time were determined in children undergoing probing of the nasolacrimal duct.Materials and Methods: Using a randomized, double- blind, placebo- controlled design, 60 ambulatory surgical patients between 12-22 months of age undergoing probing on nasolacrimal duct were entered into the study. One group received 0.3 mg/kg intranasal midazolam, a second group received intranasal saline drop (0.06 ml/kg). All patients were anesthetized with N2O, oxygen and halothane (1.5-2%). The duration of anesthesia lasted between 6-12 minutes. After preanesthetic medication, the children were evaluated for ease of separation and induction of anesthesia. In addition, the time from when the anesthetic was discontinued until the child recovered from anesthesia and the time the child was discharged home were recorded by a nurse observer blinded to the patient grouping.Results: Children receiving midazolam had smoother, calmer parent- child separation and anesthesia induction scores, and their anesthesia recovery times and hospital discharge times were the same as those receiving placebo. Conclusion: For children undergoing brief surgical procedure nasal midazolam provides satisfactory anxiolysis without delaying anesthesia recovery and hospital discharge.

Background and Aim: Utility of Trans-Thoracic Echocardiography (TTE) in stroke patients is considerable and its cost-effectiveness should be evaluated. Consecutive stroke patients admitted in Valie Asr hospital, Khorasan in 2003-2004 enrolled in this prospective study. Materials and Methods: All of the patients underwent a standard battery of diagnostic investigations including TTE for detection of high-risk cardioembolic sources. The cost-effectiveness of TTE was estimated with using indicational strategies of Braunwald, Warlow and the authors. Results: By performing 302 TTE in all of the stroke patients, 40 cases (13.2%) with high-risk cardioembolic sources were detected. Braunwald, Warlow and authors strategies could reveal 95%, 95% and 87.5% of these high risk cardioembolic sources respectively. The author’s strategy had little expenses comparing with other methods. Conclusion: Indicational strategies with best cost-effectiveness are recommended in developing countries.

Background and Aim: One of the most useful therapeutic methods as a rehabilitation supportive technique is the use of backward running in patients with motional restrictions (especially in patients with anterior cruciate damage).As cardio-pulmonary Function is affected during physical activities. This project was conducted to evaluate the effects of backward running in comparison forward and backward running in a comparison Forward method by indirect measurements.Materials and Methods: The method used was known Bruce protocol which able to evaluate the variables  indirectly,  the cases included 20 healthy young males that were selected randomly; They had to do forward and backward running in weekly intervals assess variable (cardio pulmonary responses) Forward and backward running and results comparisoned.Results: All the variable rates were increased associated with both running methods that were higher in forward running in comparisons with backward running method (P=0.0001). Conclusion: As backward running method transmitted force pattelo-femoral joint (knee) is lower then forward running could be applicable in-patient with knee surgery or anterior knee pain for maintaining of cardio-pulmonary health.

Background and Aim: Helicobacter pylori (HP) infection is strongly associated with chronic gastritis, peptic and duodenal ulcer and gastric malignancy. The incidence of its infection varies between different populations. Since that this organism is related with dangerous illnesses thus, in present study 195 biopsy specimens from 17 Shahrivar hospital in Mashhad were prepared in order to determine the rate of infection between specimen.Materials and Methods: Biopsy specimens were carried to the laboratory in Stuart transport medium. After homogenization of biopsy specimens, diagnosis was performed by direct Gram staining, rapid urease test and culturing in Brucella agar (Merck) with supplements. Results: H. pylori infection was detected in 122 (62.56%) of all 195. Sensitivity and specificity of the culture was 88.24% and 100% and for rapid urease test, 87.80%, 76.60% and for direct Gram staining were 87.80%, 90.9% respectively. There was no significant difference in H. Pylori infection rates between men and women statistically (64.89% men vs. 60.4% women).Conclusion: Since H. pylori infection has relatively high prevalence, diagnosis and treatment of this infection has critical importance. This study confirms a good sensitivity and specificity for culture method. By performance of culturing, there is also a possibility for antibiotic examination of separating bacteria. We recommended the use of three methods together (microscopic examination, urease test and culture), for improving the chance of diagnosis of H. pylori infection.

Background and Aim: Many studies have reported a circadian variation with a peak in the rate of acute myocardial infarction in mornings. The purpose of this study is further analysis of circadian patterns with which symptoms of AMI occur in a different population with different characteristics that influence their physiologic status.Materials and Methods: A descriptive study was done on 246 patients with the diagnosis of AMI. Patients were questioned about their activity during 30 minutes prior to onset of pain, exposure to stress in the past 24 hours, history of diseases and cardiac medications. The frequency of symptom related to attacks within four periods of 6 hours (6 Am to 12 MD, 12 MD to 6 PM, 6PM to 12 MN, and 12 MN to 6 Am) in all samples and sub groups were gathered.The data were analyzed using Chi-Square test and analysis of variance test.Results: The data revealed no significant circadian variation, regarding to attacks of acute myocardial infarction. However, statistically significant relation between the onset time and physical activity (P<0.0001), and stress exposure before pain (P<0.05) was observed, also no significant relationship between onset time and other variables was noticed.Conclusion: The findings were in contrast to previous reports, and no circadian rhythm was observed in occurrence of AMI; so further studies are required to clarify the presence of circadian rhythm in onset of AMI and interaction between endogenous and exogenous rhythms and ischemic events in different population with different conditions.

Background and Aim: Schizophrenia has a prevalence of 1% and accounts for 2.5% of heath-care in USA. FDA has approved the drug Clozapine for treatment of drug resistant forms of schizophrenia. The aim of this study was the comparative therapeutic’s effect of clozapine and risperidone in the drug resistant schizophrenia .Materials and Methods: In this cross-sectional study therapeutic effect of two different drugs clozapine and rispridone have been compared on 40 drug resistant male and female schizophrenia cases admitted in Rehabilitation Center of Chronic Mental Diseases of Zahedan Welfare Organization in Iran. Patients were divided in two groups for treatment with either clozapine or rispridone. The patient’s improvement was evaluated with clinical interviews and BPRS tests. The data was analyzed by Chi-Square and t-test variance analysis.Results: Initial BPRS results was determined as an average of 52.80±7.70 for clozapine group and average of 49.80±5.98 for rispridone group. Three month after start of treatment average of BPRS and SD was 22.95, 1.57, 24.53  for clozapine group, and 2.49 for rispridone group respectively . The average decrease in BPRS was calculated as 29.58±7.08 for clozapine and 25.49±5.94 for rispridone. The statistical markers were determined as P=0.48 and t-test=-2.13.Conclusion: The results confirm that clozapine acted more effectively than rispridone and has been tolerated by the patients.

Bardet-Biedl syndrome (BBS) is a congenital malformation characterized by obesity, retinitis pigmentosa, polydactyly, mental retardation, hypogonadism and kidney involvement, mainly diabetes insipidus. We reported a case of BBS with diabetes insipidus that showed dramatic response to indomethacin. Response to Indomethacin suggested a role by prostaglandins as a pathogenetic factor.