Armaghane Danesh
Year:2007 | Volume:12 | Issue:1 (45)|Papers Count:15

Introduction & Objective: in vitro studies shown the effect of zinc sulfate on healing of ulcers but limited in vivo studies have been done to demonstrate this effect in human. This study was conducted to investigate the effect of zinc sulfate on peptic ulcer disease.Materials & Methods: This is a double blind randomized clinical trial study. We studied people who referred to endoscopy clinic in Sanandaj Besat hospital during 2002-2003. The patients were divided into two groups, case group (n=45) and control group (n=58). Only patients who had duodenal and stomach ulcer were included. All patients received standard treatment for ulcer consisting of amoxicillin, metronidazole, omeprazole and bismuth.Interventional group received one zinc sulfate capsule (220 mg) every other day. After four weeks endoscopy was performed for each patient. Data analysis was done by SPSS software using descriptive statistics, x², Fisher exact and T test.Results: There was no difference between the case and control group in factors such as place of residency, smoking, alcohol and NSAID drug consumption and ulcer size. The mean size of ulcers in case group before and after treatment were 24.65±17.72 mm and 3.8±7.3 mm while in control group were 22.51±21.22 mm and 5.7±10.8 mm, respectively. The differences were not statistically significant.Conclusion: Zinc compound could be effective in healing peptic ulcer; however, more studies with higher doses of zinc are required to determine its effective dose.

Introduction & Objective: Postoperative pain management and narcotic usage after inguinal hernia repair is an important concern for anesthesiologists and surgeons. The purpose of this study was to find out whether the use of local anesthetic nerve block in ilioinguinal and iliohypogastric region by bupivacaine could reduce postoperative pain and hospital admission periods after inguinal hernia repair.Materials & Methods: In a randomized clinical trail, 100 patients with diagnosis of unilateral inguinal hernia undergoing inguinal hernia repair were randomly allocated to two groups. The patients in the intervention group (n= 50) received bupivacaine for ilioinguinal and iliohypogastric nerve blocking, while those in the control group (n =50) received nothing. Then opioids (methadone) usage and hospital admission duration were evaluated in the two groups. The collected data were then analyzed by SPSS software using descriptive and analytic methods (Chi square and student t test).Results: The mean admission times were 1±0.4 and 2±0.91 in the intervention and control groups respectively and the difference was statistically significant (p<0.01). Also the number of the patients who intermittently received methadone was less in the intervention group in comparison with that of the control (p<0.05). Furthermore, intervention group received less amount of methadone during their admission (p<0.05).Conclusion: Local anesthetic nerve block in ilioinguinal and iliohypogastric region by bupivacaine could reduce opioids usage and the duration of hospital stay after inguinal hernia repair.

Introduction & Objective: Ferula gummosa Boiss (Apiaceae) is a perennial plant native to Iran and Afghanistan. Like many plants, this species contains active biological compounds including monoterpenes, alfa pinene and alkaloids which have been demonstrated in phytochemical analysis of different extract of this species. In Iranian traditional medicine Ferula gummosa has been used in intestinal disorders, asthma and convulsion. Previous studies showed that Galbanum is effective in relieving pain in hot plate test model. In this study analgesic effect of intra peritoneal injection of Galbanum (Ferula exudates) was evaluated by formalin test and was compared with the analgesic effect of morphine and non-steroidal anti-inflammatory drugs.Material & Methods: This experimental study was done from July 2003 through 2004 in Shiraz University of Medical Sciences. 120 male Syrian mice weighing 25-32g, in ten groups were used in this study. Mice were pretreated intra peritoneally (i.p.) 15 minutes before formalin injection, with Galbanum (100 mg/kg), morphine (4&6 mg/kg) and sodium salicylate (100&200 mg/kg). In vehicle groups, equal volume of solvent (normal saline and/or DMSO) was injected 15 minutes before formalin test. In diclofenac- sodium (5&10 mg/kg, i.p.) and piroxicam (50 mg/kg, i.p.) groups, animals were pretreated with these drugs 30 minutes before formalin injection. Control group was not pretreated with any drug before formalin test. Data obtained from formalin test were expressed as Mean±SEM and were analyzed by ANOVA and Tukey test.Results: Results of the present study showed that intra peritoneal injection of Galbanum (100 mg/kg) reduced the pain score in acute phase of formalin test (2.28±0.05) and also in chronic phase (1.09±0.03). These differences were significant, in comparison with control values, in both phases (p<0.05).Conclusion: According to our findings, intra peritoneal injection of galbanum (100 mg/kg), like NSAIDs and morphine, reduces acute and chronic pain in formalin test. Moreover, Galbanum along with diclofenac has additive effect at chronic phase of formalin test, which means that it may have an anti-inflammatory effect as well.

Introduction & Objective: Helicobacter pylori are among the important pathogens responsible for chronic gastritis, peptic ulcer and gastric cancer. The present study aimed to comparatively evaluate PCR and RUT methods for detection of H. Pylori and determination of the prevalence of the cagApositive Helicobacter pylori strains in Shahrekord.Materials & Methods: This is a molecular epidemiology study conducted in 1385 on biopsy samples collected from 120 patients with dyspeptic symptoms who were referred to endoscopy department of Hajar hospital of Shahrekord. In order to detect H. pylori, RUT method was used at first and then DNA was directly extracted from biopsy specimens. PCR-amplification was preformed for the ureC and then for cagA gene.Results: The H. pylori infection was found in 74 (61.66%) of the patient by RUT method. In parallel, ureC PCR detected H. pylori in 103 (85.83%) of patients. All RUT-positive patients were found to be ureC-PCR positive, too. The cagA-positive H. pylori strains were found in 83.5 percent of isolated strains.Conclusion: These findings indicate that ureC PCR is more sensitive than RUT for diagnosis of H. pylori infection. In addition, the high prevalence of the CagA-positive H. pylori strains is present in Shahrekord.

Introduction & Objective: The hippocampal formation is a part of limbic system that plays an important role in memory and learning.The hippocampus is divided into three subfields: CA1, CA2 and CA3. In addition to pyramidal neurons and interneurons, the astrocytes play important roles in hippocampus, probably in memory and learning. In fact, learning needs some instruments for information storage and information maintenance mechanisms like memory. On the other hand, memory is always accompanied with learning. This study was conducted to evaluate the changes in number of astrocytes in CA2 subfield of hippocampus in rats due to spatial learning.Materials & Methods: In this experimental study, with the use of Morris Water Maze and two other techniques (Reference and Working memory methods) in the behavioral laboratory of physiology department of Pasteur institute, 15 male Wistar rats were used. Five rats were included in control group and 10 rats in the other two groups (each 5 rat). After performing the educational experiments, animal brain was removed and after histological processing, the slides were stained with PTAH to show the astrocytes. The obtained data were analyzed by SPSS, using T test and variance analysis.Results: The results showed a significant difference in astrocytes number of CA2 area between control and reference memory group. Also the difference between control and working memory groups was significant. Comparing the two educated groups, a significant difference was found in the number of astrocytes in those groups.Conclusion: The number of astrocytes in CA2 area of hippocampus of rats increased due to spatial learning.

Introduction & Objective: Acne vulgaris is one of the most prevalent skin diseases which is common in adolescent of both sexes. Tretinoin has been used therapeutically for its comedolitic effects and inhibition of comedone rupture in acne. It is available in 0.01% to 0.1% as cream, gel or lotion. There have been a few clinical reports of the positive effects of iontophoresis with tretinoin on acne scars. The aim of this study was to investigate the effect of iontophoresis field on transport of tretinoin across synthetic membrane and excised rat skin.Materials & Methods: Topical formulations of tretinoin marketed in Iran ( Retin-A cream, Retin-A gel, Tretinoin cream 0.025% and Tretinoin gel 0.025%) were assessed in terms of drug assay and content uniformity. The in vitro release and penetration characteristics of tretinoin from dermatological preparation was studied through a hydrophilic Dora pore diffusion barriers and membrane excised rat skin using Franz diffusion cell over a period of 2h. These two tests were also accomplished either with or without the presence of an iontophoresis field. The current density of iontophoresis applied field was constant, 0.5 mA/cm2.The amount of drug released from preparations was determined spectrophotometrically at lmax =352nm.Results: The in vitro release of tretinoin through synthetic barrier with an iontophoresis field showed that the cumulative percent of released drug at the end of each experiment was 17.5%, 26.5%, 19% and 54% for Tretinoin gel, Retin-A gel, Tretinoin cream and Retin-A cream, respectively. This was significantly higher than the observed one for release of tretinoin without application of a DC electric field. In addition, the results showed a significantly higher iontophoretic transport of tretinoin compared to passive flux for excised rat skin.Conclusion: The application of an electric current for a limited period of time produced higher post-iontophoresis fluxes of tretinoin than passive diffusion. With application of iontophoresis field, the in vitro release and transport of drug for different formulations of tretinoin follow the zero order kinetics.

Introduction & Objective: Teaching human anatomy, at any level, relies not only on the expertise of a tutor but also on the availability and use of good teaching aids. Plastination specimens have a unique position as a teaching aid to exhibit accurate anatomical structures and are easy to be stored and handled by students. The aim of this study was to assess the comparative use of polyester resin instead of silicon in S10 technique of plastination.Materials & Methods: This is an applied experimental study which was performed on a human body after fixation of the cadaver .The polymer was prepared by mixing glycerin and polyester resin and the cobalt (accelerator) and peroxide (hardening material) were added to it. Dissection, dehydration, defatization and impregnation of the body were carried out. Finally, the palatinate of specimen was compared with the palatinate of Heidelberg University (standard group). The collected data were analyzed by SPSS software using paired T-test.Results: The prepared palatinate specimen was dry, nontoxic and without noxious fumes and showed a normal anatomical position of structure. Flexibility, elasticity and traction were compared with those of standard specimen and no significant differences were observed. Injected colored polymers in vessels were detected easily.Conclusion: According to this study, the palatinate specimen prepared by polyester resin polymer provided an excellent opportunity to demonstrate and study the dissected areas of the difficult structures which can be of great benefit in teaching gross anatomy. In addition, because of the durability, safety, reduction in toxic and noxious fumes of formalin, the palatinate specimens can be unique materials as a teaching aid along with the Wet specimens.

Introduction & Objective: There are different methods for improving hypercholesterolemia, insulin resistance and hypertriglyceridemia, the major risk factors of cardio-vascular disease. Calcium, a nutrient essential for many vital functions of the body is now receiving much attention for its possible hypolipidemic effects. The large bodies of studies on the effects of calcium on the serum lipids have shown conflicting results and also there is little evidence for its effects on serum insulin and glucose.Materials & Methods: In this study, the researchers evaluated the effects of three levels of dietary calcium (0.2, 0.5 and 1.2 gram% diet) on serum cholesterol, HDL-cholesterol, LDL-Cholesterol and serum insulin and glucose in male Sprague-Dawley rats. The amount of fecal fat excretion was measured to determine the possible mechanism of lipid lowering effects of calcium.Results: Findings showed that increasing dietary calcium lowerd the serum cholesterol (p=0.04), LDL-cholesterol (p=0.02) but had no significant effects on HDL-cholesterol, serum insulin and glucose. There was a dose dependent increase in fecal fat excretion but was not statistically different on a percent basis.Conclusion: It can be concluded that calcium is an effective hypocholesterolemic nutrient but its effects on serum triglycerids, glucose and insulin need to be evaluated.

Introduction & Objective: Awareness of invasion of the walls of the cervical vessels by tumor is of great clinical importance before surgery. This study was designed to assess the diagnostic worth of Computed Tomography (CT) in distinguishing jugular vein (JV) invasion by oral –maxillofacial and neck malignant tumors.Material & Methods: CT with contrast was performed on 46 patients who had oral –maxillofacial and neck malignant tumors before surgical intervention. The CT appearance of all tumors was prospectively compared with surgical findings.Results: The abnormal CT manifestation of the patients with JV involvement consisted of 5 types: type I, tumor encasement of greater than 270 degrees of circumference of the jugular vein in 8 tumors; type II, tumor encasement of greater than 180 degrees of circumference of the jugular vein in 13 tumors; type III, compression of JV in 10 and displacement of JV in 3 tumors; type IV, the segmental deletion of fat planes between tumor and JV in 20 tumors; type V, obliteration of JV on segmental axial CT views in 7 tumors. The sensitivity, specificity and positive predicative value were 34.4%, 86.7% and 80% for type I, 59.1%, 66.7% and 72.2% for type II, 57%, 62.5% and 54.4% for type III, 91%, 45.8% and 60.5% for type IV and 38%, 88% and 70% for type V. In addition, correlation coefficient of JV for types I and IV was statistically significant.Conclusion: Although a variety of CT findings was helpful in assessing the JV but types I and IV had more accuracy. Our study demonstrated that although CT images were not an accurate and definite way of jugular vein assessment in head and neck tumors, they could be a useful approach in primary staging, tumoral extension and therapeutic management.

Introduction & Objective: Cytomegalovirus (CMV) infection is most often asymptomatic in immunocompetent individuals with lifelong latency. However, infection with CMV is a major cause of morbidity and mortality in immuno-compromised patients.Transfusion Transmitted HCMV (TT-CMV) can cause serious morbidity and mortality in certain at-risk patients. In this crosssectional study, for evaluating the risk of TT-CMV infection, a seroprevalence survey by ELISA along with a comparison of the results of ELISA with those of a nested-PCR test was carried out.Materials & Methods: In this comparative study during a period of eight months, blood samples were collected from 364 healthy blood donors referring to the blood bank organization of Fars, Shiraz, Iran. IgG and IgM antibodies to HCMV were measured by the enzyme linked immunosorbent assay (ELISA) test. Also, DNA was extracted from 104 buffy coat and 20 serum samples. A nested-PCR was performed to detect HCMV- DNA, and the results were compared with those of ELISA test. The collected data were analyzed by X2 test via SPSS software.Results: Of 364 samples, IgG was detected in 360 sera (98.9%) samples and only 16 samples (4.4%) were both IgG and IgM positive. 64 (64%) of buffy coat samples and 8 (40%) of seropositive samples were positive for HCMV- DNA by the nested PCR. None of 4 seronegative samples was detected positive by PCR method.Conclusion: Although PCR assays have diagnostic value in the detection of HCMV infection, ELISA is still more useful for screening blood donors.

Introduction & Objective: In patients with chronic renal failure who need chronic hemodialysis, AV fistula is one of the most proper ways of vascular access. The aim of this study was to assess the patency and complications of AV fistulas in patients with chronic hemodialysis.Materials & Methods: In this descriptive study 82 patients with chronic renal failure, who underwent AV fistulas in a 5 year- period of time in Imam Khomeini Hospital Center, were enrolled. Age, gender, fistulas patency, complication rate and their relation with diabetes, hypertension and history of Shaldone were assessed.The collected data were analyzed by T and Chi- square test using SPSS soft ware.Results: the age mean of patients was 46.9±18.8 years. 46 patients (%56.1) were male. The mean of age was significantly higher in patients with complication compared to patients without complication. History of shaldone and hypertension were significantly higher in patients with bad fistula blood flow compared to patients with good fistula blood flow. History of shaldone, diabetes and hypertension were significantly higher in patients with complication compared to patients without complication. Female patients were significantly prone to aneurysm than males. History of transplants rejection was significantly higher in patients with aneurysm than in those without aneurysm. History of hypertension was significantly higher in patients with aneurysm and thrombosis compared to those without aneurysm and thrombosis. History of shaldone and Diabetes was significantly higher in patients with thrombosis compared to those without thrombosis.Conclusion: History of shaldone, Diabetes and Hypertension were significantly higher in patients with complication and bad fistula blood flow.

Introduction & Objective: Discectomy for nucleous pulposus herniation is one of he most surgeries in spinal column. In this surgical treatment, postoperative pain is a problem which results in more hospital stay and less daily activity. Postoperative pain control is difficult because opoids don't relieve moderate and severe pain alone. It is believed that corticosteroid and local anesthetic agents or narcotics improve sciatic pain.In this study we compare the effect of different doses of morphine and dexamethasone by placebo on post discectomy operative pain.Materials & Methods: This is a randomized double blind clinical trial in which 90 selected patients, ASA 1-2, with acute-onset herniated nucleus pulposus that were refractory to conservative treatment were enrolled.Subjects were randomly divided into 6 groups and underwent discectomy under equal general anesthesia. Before the closure operational incision, the first group received 5 cc lidocaine %2, second group 5cc normal saline third group 0.5 mg morphine and 8 mg dexamethasone, forth group 1mg morphine and 8 mg dexamethasone, fifth group 1.5 mg morphine and 8 mg dexamethasone, and the last group 2 mg morphine for every level of discectomy and 8mg dexamethasone . Drugs were flushed on dura matter and operation field. Volume of all drugs was increased to 6 cc by adding sterile distilled water. Postoperative back and radicular pain was scaled 6, 12, 18 and 24 hour after operation using visual analogue scale (VAS) and recoded analgesic requirement. Collected data was analyzed by SPSS software using Mann Whitney U and Kruskal-Wallis tests.Results: patients of group 1 to 3 did not showed significant changes in postoperative pain and consumption of analgesic, but when dose of morphine increased, these changes became significant especially in dose of 2 mg for every level of discectomy.Conclusion: It seems that Instillation of morphine and dexamethasone in epidural space after discectomy decreases patient’s postoperative pain which result in reduction in narcotic use.

Introduction & Objective: Fever of Unknown Origin (FUO) has different etiologies due to new diagnostic procedures and geographic areas. This study aimed to evaluate the patients with FUO in hospitals of Shahid Beheshti Universty of Medical Sciences.Materials & Methods: In this survey case series admitted patients with impression of FUO in infectious diseases wards of Shahid Beheshti University of Medical Sciences of Iran in 2003 were studied. 52 patients had fever over 38.3 oC for 3 weeks and their disease was not diagnosed after 3 visits or 3 days of admission.Results: 54% of the patients were male and 46% were female. 85% of the cases were under the age of 60 years. The most common etiology of FUO was Infectious diseases (36.5%), and neoplasm (21%), miscellaneous (17.5%), undiagnosed (13.5%), and connective tissue diseases (11.5%) respectively. Tuberculosis (7.7%), Intra-abdominal abscess (7.7%), lymphoma (11.5%), drug fever (5.8%) and autoimmune hepatitis (3.8%) were the most common infectious diseases.Conclusion: Results of this study are comparable with those in other developing countries and infectious disease is the most common causative agent of FUO.