Armaghane Danesh
Year:2008 | Volume:13 | Issue:2 (50)|Papers Count:15

Introduction & Objective: Atrial fibrillation (AF) is the most common important arrhythmia of cardiac surgery. Magnesium, like several other pharmacologic agents, has been used in the prophylaxis of postoperative AF with varying degrees of success. The purpose of this study was to determine the effect of magnesium administration in reducing postoperative AF after cardiac surgery.Materials & Methods: In a double blind randomized clinical trial, over an 18-month period, 162 patients that electively scheduled for coronary artery bypass graft (CABG) surgery involving cardiopulmonary bypass were studied. The patients were randomly assigned to magnesium receiving (n=81) and placebo (n=81) groups. In magnesium group, the patients were received an intravenous infusion of magnesium sulfate, 2 g, immediately after the termination of cardiopulmonary bypass. Total serum magnesium concentration was measured before induction, immediately after operation (before magnesium infusion), and 24 hr after ICU admission. AF was sought with a 12-lead electrocardiogram (ECG) from the end of surgery up till 72 hr after operation.Results: AF occurrence in magnesium group (7.4%) was lower than placebo group (34.6%) and the differences were statistically significant (p<0.0001). There was no significant difference in serum magnesium level during the follow-up. In patients with AF, the serum magnesium concentration before operation was significantly lower than others (p=0.0001). In all patients, the serum magnesium was decreased immediately after operation (p<0.0001). Conclusion: This study showed that hypomagnesemia is a common finding after postoperative cardiac surgery and it is associated with post operation AF. The use of magnesium in early postoperative periods is highly effective in reducing the incidence of AF after coronary artery bypass grafting.

Introduction & Objective: Transurethral resection of prostate (TURP) is the operation most frequently performed in urology. In view of the morbidity associated with this procedure, research has been conducted to propose an endoscopic alternative to TURP. Using of high energy laser is the most promising method in these cases. In this study, we evaluated the effect of home made KTP laser on re-sected prostate adenoma after open prostatectomy. Materials & Methods: 40 patients complaining of symptomatic BPH were treated by open prostatectomy. These 40 prostates were divided in to two parts. One part was sent for pathology assessment (group A) and the other part was sent to KTP laser room in the same hospital (group B). The prostates in group B were divided into 4 groups (1, 2, 3, 4), each with 10 prostate tissue. In groups 1, 2, 3 and 4, prostate lobes underwent laser ablation in one, two three and four stage. In any stage, KTP laser, 5 watts for 15 seconds, was used. All of prostate ablated with laser were sent to pathology for evaluation of tissue ablation capacity and deep tissue penetration. The study in all of stages was blinded for pathologist.Results: Mean age of participants was 73.25±6.8 years and mean level of PSA was 3.65±2.1 ng/dl. In both groups, with every stage laser, we have 1 to 2 mm tissue ablation associated with prostate type. In pathologic examination, we have 0-2 mm tissue destruction with disappearance of cells' nuclei, basophilia of stroma and damaged tissue (cutter like effect). Findings were compatible with burn effect.Conclusion: Pathologic findings proved, in the ex vivo investigation, that KTP laser offers a good tissue ablation capacity and minimal microscopic tissue damage. The risk of capsule perforation is very low. This procedure is safe and effective in which bladder outlet obstruction symptoms will be quickly relieves and has a low rate of complications. Moreover KTP laser has much cost effectiveness, although we need further studies on live prostatic tissues.

Introduction & Objective: Despite advances in anesthesia nausea and vomiting is still a frequent post operative complication of general anesthesia for laparoscopic surgery. Many treatment modalities have been tried to reduce this unpleasant side effect. In this study we assessed the efficacy of oral clonidine in laparoscopic surgery in gynecological laparoscopic surgery.Materials & Methods: In this prospective double blind study, 86 ASA classes 1 or 2 were selected. Study group (n=43) received clonidine (0.2 mg tablet with 50 cc water) 60–90 minutes before surgery while control group (n=43) received placebo. The patients were monitored for presence of nausea and vomiting for 24 hours. Moreover sedation scores and hemodynamic changes between 2 groups were compared. Collected data were analyzed by SPSS using chi–square and Fisher tests.Results: Nine patients (20.9%) in study group and 19 patients (44.2%) in control group nauseated (p=0.021) while 16.3% of patients in study group and 34.9% in control group vomited (p=0.048).Conclusion: Clonidine had statistically significant effect on reducing the incidence of both nausea and vomiting. It is a simple effective solution and its routine use can be suggested in gynecological laparoscopic surgery.

Introduction and Objective: Recent studies have demonstrated that mammalian preimplantation embryos are exposed to a mixture of many different growth factors and cytokines, expressed by the follicles, oviducts and endometrium. Receptors for many of these growth factors have also been shown to be expressed by preimplantation embryos. In vitro culture of human and animal's embryos in conventional media lacking growth factors can result in suboptimal growth and a variety of short-term and long-term developmental abnormalities. One of these factors is Leukemia Inhibitory Factor (LIF). The aim of this study was to evaluate the effects of LIF on the mouse preimplantation embryo development.Materials & Methods: Six to eight weeks old NMRI mice were superovulated by injection of 10IU PMSG and 10IU HCG 48h later. The mated mice were killed 48 hours after HCG injection, oviducts were flushed and two-cell embryos were collected and divided randomly to two groups (control and treatment). Control medium was HTF and treatment medium was HTF+1000u/ml LIF. In each group the embryos were cultured in an incubator at 37oC with 5% CO2 for 72h.The state of embryo development was evaluated in 12 hours interval using inverted microscope. Results: There was not any significant difference in the rate of morolla and blastocyst formation after 36 hours. In comparing hatching rates, 60 and 72 hours after culture, there were significant difference between control and treatment groups (p<0.008). Conclusion: LIF doesn’t provide obvious stimulation in the early mouse embryo development until morolla stage. However, it has positive effects on preimplantation blastocyst growth, differentiation and hatching.

Introduction & Objective: Trichophyton rubrum and T. mentagrophytes are most common causative agents of dermatophytosis in the world. Differentiation of these species is important from the epidemiological and pathological point of view. Conventional methods including macroscopic and microscopic morphology and biochemical tests are time-consuming (in some cases it takes 3-4 weeks), laborious and still sometimes insufficient to identify these agents. The aim of this study was to use polymerase chain reaction followed by enzymatic digestion for differentiation of these 2 species.Materials & Methods: In this descriptive-experimental study one hundred strains were isolated from patients with dermatophytosis. Preliminary identification was done by morphological methods. DNA was isolated and purified by glass-bead methods and ITS1-5.8SrDNA-ITS2 region was amplified by PCR and the amplicon was digested by the restriction enzyme MvaI. The products were visualized after agarose gel electrophoresis and staining. Differentiation of the species was based on sequence analysis and the electrophoretic patterns.Results: Morphological tests were not able to definitely differentiate the two tested species, especially for isolates with intermediate features. Using molecular methods, it was found that 45 isolates are T. rubrum and 54 are T. mentagrophytes. One isolate was Fusarium spp. Physiological tests were confirmed the results except for 4 isolates. It was also found that hair perforation test is more reliable than urease test for differentiation of these two species.Conclusion: We found that DNA-based method, although expensive, is a fast and reliable method for differentiation of T. rubrum and T. mentagrophytes. The frequency of mentioned species was almost similar in the tested isolates. The method is recommended for differentiation of other dermatophytes.

Introduction & Objective: Magnesium is an essential metal in carbohydrate metabolism that causes activation and release of insulin. Increasing of blood sugar in diabetic patients resulted in decreasing of magnesium in the serum and its low concentration in urine. The aim of this study was to evaluate the effect of oral administration of magnesium on glucose concentration and formalin test in diabetic rats.Materials & Methods: This experimental study was done from April 2007 till July 2008 in medical school of Qazvin University of Medical Sciences. In this study 80 NMRI rats (Razi Co. Iran) categorized in ten groups control, diabetic without treatment of magnesium, diabetic with treatment of magnesium in one (1), two (2), three (3) and four (4) week(s). The other 4 normal groups were treated with magnesium in same timescales. In the diabetic groups, diabetes was induced with i.p. injection of 60mg/kg of streptozotocin. Besides of weight measurements, glucose concentration of animals was measured with enzymaticcolorimetric method. Pain scores were measured in formalin test. Statistical analysis was carried out by ANOVA and Tukey test. Results: The results showed that the difference in animal weight and glucose concentrations between control and diabetic groups was significant (P<0.0001). Glucose concentrations of magnesium treated diabetic groups were significantly different between 1 and 2 (P<0.005); 1 and 3 or 4 groups (P<0.0001); 2 and 3 (P<0.001) and 2 and 4 (P<0.01). Statistical differences between control and magnesium treated diabetic groups were significant between control and 1 (P<0.0001); control and 2 (P<0.05). Considering the weight of rats, there was no significant difference between diabetic in one side and 1 and 2 groups in other side while differences between diabetic and the other 3 and 4 groups were significant (P<0.001 and P<0.0001, respectively). In this study results from flinching and licking responses have been evoked by formalin in biphasic model of formalin test.Conclusion: Magnesium consuming in diabetic rats resulted in time dependent increasing of animals weight and decreasing of glucose concentration. Results from formalin test show hyperalgesic effects in diabetic and diabetic treated with magnesium groups in comparison with control groups.

Introduction & Objective: The decrease of peroxidantion of lipoproteins as a key event in the development of atherosclerosis by increasing plasma antioxidant capacity might be an effective approach in preventing such diseases. It has been shown that some amino acids and polyamines have antioxidant activity. In this study antioxidant and antiatherogenic effects of valine in hypercholesterolemic rabbits have been investigated. Materials & Methods: fifteen male white rabbits were divided into three groups including: normal control, hypercholesterolemic control and hypercholesterolemic treated with L-valine. Animals were fed with special diets for five weeks and then plasma total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), conjugated diens (CDs), malondialdehyde (MDA) and antioxidant capacity (AC) were measured. Coronary arteries were obtained in order to measure fatty streaks formation by histological studies.Results: No significant difference was observed in plasma TC, LDL-C and CDs levels between valine treated and hypercholesterolemic control groups. However the levels of TG, HDL-C and MDA in valine-treated group showed a significant differences in comparison with hypercholesterolemic control group (p<0.05). Comparison of serum antioxidant capacity in valine treated group showed significant increase comparing to hypercholesterolemic control group. The mean size of produced fatty streaks also showed significant reduction in valine-treated group in comparison with hypercholesterolemic control group (p<0.05).Conclusion: The results showed that valine can prevent the formation of fatty streaks in hypercholesterolemic rabbits by increasing of serum antioxidant capacity and decreasing the level of lipid peroxidation.

Introduction & Objective: Pedestrian injuries are a significant source of morbidity, mortality and disability among children. Prevention of these injuries is thus a major priority for public health and requires a comprehensive approach and educational strategies. The purpose of this study was designing and evaluation of an educational program, based on the PRECEED-PROCEED model for improvement of safety behavior in primary school boys.Materials & Methods: This study is a field trial carried out in 6th areas of Tehran in 2007. Participants (n=88) were 10-11 year old who followed by items measuring the PRECEED-PROCEED model before and after two months of intervention. The collected data were analyzed with T test, X2 and pair T test using SPSS software.Results: After participating in educational program, significant improvements were found in knowledge, attitude, behavior, enabling and reinforcing factors of the components of PRECEEDPROCEED model.Conclusion: The findings suggest the beneficial effects of educational intervention based on the PRECEDE-PROCEED model on improving the safety behavior. It can be recommended that health education plan be used on educational models.

Introduction & Objective: previous studies suggest that satisfactory social support leads to physical health and psychological well-being. The aim of the present study was to investigate the gender differences in relation betweens different dimensions of perceived social support and different aspects of well-being in Iranian University Students. Materials & Methods: This analytical study was conducted, using three different groups of students. Students were selected among the students of Tehran University and Allame Tabatabayi university, in 2007. Students were asked to complete perceived social support, positive affect, negative affect, life satisfaction, and psychological and social well-being scales. All the students voluntarily completed and returned the questionnaire. Multiple regression analysis was used to analyze the data using SPSS software.Results: It was found that, social support measures are better predictors for life satisfaction and affect balance in girls compared with boys. Moreover, perceived social support from family plays a more important role in girls when it comes to prediction of psychological and social well-being. In contrast, perceived social support from friends plays the same role in boys. Finally, perceived social support from special person and colleagues’ faculty can not significantly predict aspects of well-being. Conclusion: there were gender differences in addition to similarities in the relation between aspects of perceived social support and aspects of well-being. Some aspects of perceived social support predict well-being better in boys and some others are better for prediction of well-being in girls.

Introduction & Objective: The role of stress in gastronomic diseases has been known since a long time ago. IBS and peptic ulcer have been more investigated and are more suspected to be affected by stress. Recently some (such as Lazarus) believe that stress, itself alone, could not affect person but this is assessment and coping skill of person which determine this effect. This research was designed to investigate the coping skills in peptic ulcer, IBS and normal people.Material & Methods: This is an analytic study in which 41 patient with IBS, 41 with peptic ulcer and 91 normal people were selected from people who referred to internist clinic. Using brief COPE scale, data were collected and analyzed by SPSS. Results: The result showed that the religious and substance use as two coping skill were the highest and lowest skills used by men and women in tree groups respectively. The result also showed that three groups were different in active coping, using emotional support, using instrumental support, positive reframing, planning, self- blame and venting.Conclusion: This study showed that patient groups used more negative coping skills, while normal people mostly used effective positive skills.

Introduction & Objective: Vaccination is an important and precious intervention which can protect individuals and community against vaccine preventable diseases with low cost. Although vaccines in use including DPT are very effective but there is no vaccine without adverse events. The DPT adverse events can be classified as vaccine reaction, injection reaction, coincidental events and program error. The aims of this study were to investigate the adverse events of DPT and providing measures for improvement of existing surveillance and reporting system. Materials & Methods: in this cross sectional study a total number of 2000 children who were vaccinated with DPT were followed for a 4 month periods from the beginning of June to the end of September for adverse events. Sampling was done by clustering methods in 20% of rural and urban health centers which were randomly selected. A structural questionnaire was completed for each subject along with interview and physical exam. Data were analyzed using SPSS software version 11.5.Results: Systemic reactions including; loss of appetite was seen in 4.9%, fatigue in 3%, pallor in 1.8%, crying for more than 3 hours in 1.6% and vomiting in 1.5% of vaccinated children. local reactions was seen in 56% of cases which were including: redness in the injection site (13.5%), swelling without redness (12.2%), swelling with redness (6.2%). Vaccine reaction (fever as the most) was noted in 45% of cases, program error in 7.6% of cases, injection reaction in 3% of children and coincidental in 1.2% of children. Conclusion: the most common adverse event following DPT vaccine was due to vaccine reaction. Injection site had the most quotas in presenting the vaccine reaction. We suggest changing of the DPT injection site from deltoid to upper outer part of thigh. Injection reaction can also be due to first experience of the young children in their first vaccination schedule.

Introduction & Objective:: PCNL is the treatment of choice for renal calculi larger than 20-3o millimeter, staghorn stones and stones that are multiple or resistant to ESWL. The aim of this study was the evaluating of the impact of spinal anesthesia on intraoperative and postoperative outcome in patients undergoing PCNL.Material & Methods: The intraoperative and postoperative anesthetic and surgical variables were evaluated for hundred and twenty consecutive patients underwent PCNL. Anesthetic and surgical variables during and after operation in patient undergoing PCNL under spinal anesthesia were recorded and collected data were analyzed by SPSS software using chi square test.Results: Mean time of operation from the beginning of anesthesia to the end of operation was 98±45 minutes. Mean stone size was 3.1±1.8 cm. Mean time for return of sensory and motor activity were135±22.7 and 112±35.7 minutes respectively. Major intraoperative or postoperative complications such as visceral or vascular injury and unusual bleeding did not occur in any of patients. Five patients needed transfusion of 1 unit pack cell and four patients complain from mild to moderate headache and dizziness and also mild low back pain for 2-4 days after operation that improved with analgesics and bed rest. Conclusion: Spinal anesthesia is safe and effective and also comfortable for performing PCNL and is a good alternative for general anesthesia in adult patients.

Introduction & Objective: The nasolacrimal duct obstruction is a bothersome disorder that appears after acute or chronic inflammation, trauma, tumor, surgery or congenital disorders. The early treatment is irrigation or probing. If these methods were unsuccessful, dacryocystorhinostomy can be done .The purpose of this study was a comparison between the results of external vs endonasal dacryocystorhinostomy, which is done in shiraz university of medical sciences (Khalili hospital).Materials & Methods: In this prospective study 46 patients who suffered from primary nasolacrimal duct obstruction were operated by endonasal dacryocystorhinostomy in Khalili hospital during 2001 to 2005. The results were compared with external dacryocystorhinostomy as control group and analyzed by SPSS using chi-square test.Results: After 10-31 months (average 20 mo) 40 patients (87%) cured completely and 60 patients (92.3%) among 65 patients of control group cured completely. There was no statistically significant difference between these two methods. Conclusion: Endonasal dacryocystorhinostomy has more benefit in compare with external dacryocystorhinostomy because of less trauma, no skin incision and less complications after surgery.