Armaghane Danesh
Year:2006 | Volume:11 | Issue:2 (42)|Papers Count:14

Introduction & Objective: Skin cancers are the most common malignancies of the mankind. Basal call carcinoma (BCC) constitutes the most prevalent skin cancer in human beings. This study aimed to evaluate the therapeutic and cosmetic results of three methods of treatment of BCC i.e. curettage, surgical excision and combined curettage and cauterization.Materials & Methods: This is an interventional study, through which 79 lesions of BCC on the faces and scalps of 64 patients in 3esat hospital of Sanandaj city in 2001-2003 were treated by curettage, surgical excision and combined curettage and cauterization. Collected data were recorded in frequency tables.Results: 69 (87.3%) of tumors were papulonodular type, 61 of hem had an ulcer on their surface. 26 tumors were treated by surgery which had a cure rate of 91.7%. 45 (57%) tumors were of solid type. During the follow-up period, an overall recurrence rate of 11.4% (9 tumors) was noticed. Two of the tumors that were reacted by surgery, 5 of the tumors treated by curettage, and 2 of those which were treated by combined curettage and cauterization recurred. The cosmetic result in the patients who had been treated by curettage was quite promising, only a small scar or a slight hyper pigmentation was left at the site of the lesions.Conclusion: Curettage is more suitable for the treatment of small lesions of B.C, but it is not recommended for the treatment of the tumors having aggressive behavior or rapid growth. The cosmetic result in the patients treated by combined curettage and cauterization of the lesions was also excellent and in most cases car was minimal or absent. Combined curettage and cauterization a cheap and suitable method for the treatment of BCC and it can easily be accomplished.

Introduction & Objective: Theoretically, it seems that calcitonin can accelerate the healing process, mainly by decreasing bone resorption, but in the literature, there are lots of controversies. The aim of this study is to evaluate the efficacy of calcitonin on bone healing.Materials & Methods: This experimental double blind study was performed on laboratory animals in 1383 at Shiraz University of medical sciences, Department of orthopaedic surgery. Thirty guinea pigs were divided into three groups of ten. Then, they were operated and drilled in proximal part of both tibias. In group A, after operation, calcitonin (30 IU/kg) was injected intraperitonealy (IP) for 7 days. In group 8, the injections were subcutaneous for the same time and dose. Group C was selected as control group. Half of the guinea pigs in each group were sacrificed after 2 weeks (A2, 82, C2) and the others after 4 weeks (M, 84, C4). Multiple sagittal sections were performed on the tibia. In all groups, the formation of periosteum, cortical and trabecular bones were measured. Collected data were analyzed using Kruskall- Wallis test. Results: In A2 and 82 group, the difference of periosteal formation was significant as compared with the control group (p= 0.009). The difference of periosteal formation was even more significant in A2 (IP injection) than in 82 (subcutaneous injection) group. The difference of cortical and trabecular bone formation in groups A2 82 were not significant in comparison with the control group during the second and fourth weeks.Conclusion: High dose of systemic calcitonin is effective for the rapid formation of periosteumin the early stage of bone healing.

Introduction & Objective: Induction of anesthesia in children can be a challenge for anesthetist. A stormy induction may increase the personality & behavioral changes. Therefore, it is desirable that they enter the operating room sedated. Many drugs are used for preanesthetic medication and there are many routes for administration. One route of administration is nasal mucous. In this study we compared the effect and side effect of three drugs (midazolam, ketamin and fentanyle) after intra nasal administration.Materials & Methods: This is a double blind clinical trial. In this study we selected 60 patients (20 patients for every group A, B or C.) We used 3 mg/kg ketamin or 3µg/kg fentanyle or 0.3 mg/kg midazolam by intranasal spray. After administration and in 5, 10 and 15 minutes, we observed the SPO2, PR and RA. After 15 min's we separated children from parents and brought them to the operating room and controlled the acceptance of separation, depth of sedation with Ramsay score, acceptance of mask and tolerance of IV canulation. The data were then analyzed using K2 and kruskal-wallis test.Results: In our study we found that in SPO2 fentanyle had the highest rate of reduction even though none of the children had SPO2 lower than 90%.There were no differences between drugs in RA. In fentanyle group, we had the lowest rate and in ketamin group the highest rate. Midazolamhad the medium rate. The rate of sedation for acceptance of separation from parents had no difference between the groups and all drugs with this dosage were effective for this aim. However, in Ramsay score, acceptance of mask and tolerance of IV canulation, the midazolam was more effective than the others.Conclusion: Intranasal administration of midazolam is a safe route for sedation in children in the pre-anesthetic time.

Introduction & Objective: Previous studies have shown increased ET concentrations in plasma and renal tissues in ischemic or toxic acute renal failure (ARF). These increments were parallel to a reduction of renal blood flow and progression of renal dysfunction. The present study was undertaken to investigate the potential beneficial effect of the novel selective ETA antagonist (UK-350,926), on tissue damages occurring during the early phase of ischemia-reperfusion induced ARF.Materials & Methods: In pentobarbital (60 mg/kg, I.P) anaesthetized male Charles River rats' (290-340 g) abdomens were opened via a mid abdominal incision. The urinary bladder was cannulated and renal arteries and veins of both kidneys were carefully cleared. After 2h rest, a 0.5 h clearance period was taken for basal levels, followed by two 30 min periods, and then a 4h experimental clearance period was considered. Finally, both kidneys were removed and fixed in paraffin for histological studies. The rats were divided into three groups (n=6): 1) Sham Group, 2) Ischemia/reperfusion Group (I/R), in which 30 min after the end of control clearance period, renal ischemia was induced by bilateral renal artery clamp for 30min, and 3) drug treated Group (I/R+D) in which UK-350,926 (50 µg/kg.min) was infused I.V. for 30 min before and 2h after renal clamping.Results: Histological examinations of the kidneys showed mild degree of tissue damage in cortex of I/R group. There was marked apoptosis and disappearance of brush border in proximal tubular cells in this group that was not observed in I/R+D and sham group.Conclusion: These findings show that administration of the ETA antagonist, UK-350,926, improved the renal tissue damages that were parallel to improved reabsorptive function of the kidney.

Introduction & Objective: Oral route is a common route of vadministration for anti-inflammatory drugs including diclofenac. Due to some disadvantages of this route, the alternative routes of administrations are considered. The skin has been increasingly important in this regard, and many drugs have been formulated intradermal delivery systems. The purpose of this study was to prepare a topical diclofenac formulation emulgel with appropriate skin penetration and compare it with standard formulation.Materials & Methods: To prepare the formulation, we used the emulsion form. Several formulations containing different kinds and amounts of diclofenac salts, different emulsifying agents, and different HPMC concentrations were prepared. The skin penetration was evaluated by using Franz cell apparatus and the concentrations of diclofenac were determined in the receptor phase of Franz cell using spectrophotometer. The in vivo absorption of diclofenac was evaluated by determination of drug in urine. The concentration of drug was determined by HPLC. Results: In selected formulation, 85% of drug was released after 4 hours from formulation which was similar to drug released from standard formulation. The values of coefficient variation for HPLC method were utmost 15%. The range of variation in measurement was between 10 and 1000 ng/ml. Conclusion: The selected formulation had appropriate physicochemical properties. We were unable to measure drug concentrations in urine by the constructed HPLC, therefore it can be suggested that one should determine drug concentration in synovial fluid as the drug is concentrated in it.

Introduction & Objective: The previous investigations show that cardiovascular diseases, which are spreading all over our country, account for most health and social problems. The objective of this study was to determine the relation between demographic factors, medical history as well as para clinical factors and Coronary Artery Disease (CAD) within a period of 30 days for patients with chest pain.Materials & Methods: This was a prospective cohort study. Patients referred to the emergency department of Tehran heart centre with a chief complaint of chest pain without ST – segment elevation were followed for 30 days. The outcome variable was coronary artery disease. The Poisson Regression Model was applied in order to identify significant predictors of outcome.Applying this model, we could calculate Adjusted Risk Ratio and 95% confidence interval. The data were analyzed by standard statistical tests using SAS and Stata software.Results: 609 eligible patients were enrolled. Of these 51% were male and 49% female. Based on the final model of Poisson Regression, variables like sex, blood pressure history, heart disease history, changes in electrocardiogram, WBC and CRP had meaningful relationship with CAD.Conclusion: We concluded that prognosis in patients with chest pain needed considering clinical factors (acquired through interview), electrocardiogram and lab findings. Also we were conducted not to rely on traditional risk factors such as history of diabetes, hypercholesterolemia, smoking and family history of heart disease for prediction of the disease.

Introduction & Objective: Adverse side effects of chemical drugs for treatment of diabetes persuaded the using of medical plants.Citrullus colocyn this is a plant which has been used traditionally for treatment of diabetes. The purpose of this study was to evaluate the effect of hydroalcholic extract of Citrullus colocynthis fruit on normoglycemic and streptozocine induced diabetic rats.Materials & Methods: 45 male Wistar rats weighing, 250-350 gr, have been selected and randomly divided in seven groups. Group 1 without any drugs usage, group 2 that received normal saline (IV) and distilled water (oral), group 3 received only streptozocine (IV), group 4 received only the extract of Citrullus colocynth is (1000 mg/kg) , groups 5, 6 and 7 received 500, 1000 and 1500 mg/kg of Citrullus colocynthis extract after injection of STZ and induction of diabetes. Diabetes was induced by intravenous injection (45 mg/kg) of STZ. Blood sampling was provided directly from animal heart and blood sugar was measured. The collected data were analyzed by SPSS software using students t-test and ANOVA.Results: Mean of normal blood sugar in control group was 156.5±15.7 mg/dl which defined as normal blood sugar.Streptozocine significantly increased blood sugar (p<0.05). The Citrullus colocynth is extract with 500 mg/kg dosage has not significantly reduced the blood sugar but is dosage of 1000 and 1500 mg/kg significantly decreased the blood sugar in a dosedependent mode (p<0.05). Results also showed that the extract in dosage of 1000 mg/kg did not have a significant effect on normoglycemic animals.Conclusion: Results of this study indicate that the extract of Citrullus colocynthis fruit dose-dependently reduced the blood glucose level in streptozocine-induceddiabetic rats but did not have significant effect on normal blood sugar.

Introduction & Objective: Zinc is an important nutrient which is critical for normal immune function and physical growth. Zinc deficiency seems to be common in developing countries and this makes children in those countries prone to infectious diseases. The aim of this study was to find out the effect of zinc supplementation on growth of school children in Yasuj, in Southwest of Iran. Materials & Methods: The study was done as a double – blinded clinical trial. Eight hundreds and four school children aged 8-11 were the subjects of this study. Children were randomly assigned to zinc or placebo group to receive daily supplementation of zinc or placebo, in an identical form (syrup) and identical pre-coded containers, 6 days per week, for 7 months. Anthropometric assessment was first performed at the time of enrolment and then monthly. The data were analyzed by standard statistical tests using SPSS software. Results: Results showed significant weight gain in zinc supplemented group compared with placebo group (1.71±1.48 VS 0.65±1.98; p<0.0001). Also the mean height gain was significantly higher in zinc supplemented group than placebo group 3.26±1.55 VS 1.65±0.94; p<0.0001).Conclusion: Zinc supplementation improves children's growth and measures should be taken to supply this nutrient to the children, particularly where zinc deficiency is common.

Introduction & Objective: Calcium is a micronutrient and now receiving much attention for its doubtful effects on weight and body fatness. A few mechanisms has been suggested for calcium effects on body fatness and the most emphasized one is the reducing of lipolysis and increasing lipogenesis via reducing parathyroid hormone levels. The present study is designed to evaluate the effects of nondairy dietary calcium on adipogenes is and adipocyte size in male Sprague dawley rats.Materials & Methods: This experimental study was done from November to September of 2005 at Tehran school of health; nutritiondepartment.48 male Spragu-Dawley rats from Damgostar Company were used in three randomly selected groups. The rats were fed low (0.2% W/W), usual (0.5% W/W) and high (1.2% W/W) dietary calcium based on AIN-93M purified diet. Rats were housed in 12 hours light-dark cycle, 22-25ºC room temperature with free access to their respective diets. At the end of the experiment, rats were decapitated and carcass fat content, carcass ash content and mean adipocyte size in testis, peritoneal and subcutaneous fat pads were compared in three groups. The SPSS 11.5 was used as statistical software, running analysis of variance for comparing the effects.Results: weight gain, carcass fat content and adipocyte size, in groups were not significantly different, while serum parathyroid hormone concentrations in high calcium group was  significantly lower than low calcium group (p<0.05) and insignificantly lower than usual calcium group (12.36, 23.57 and 42.2 pg/dl respectively). Serum concentrations of 25-hydroxy cholecalciferol were also insignificantly lower in high calcium group. E Conclusion: Our findings suggested that physiological concentration of dietary calcium is not effective on weight gain, body fatness and adipocyte size. Relatively equal fat content; beside significant difference in serum parathyroid hormone levels is against the parathyroid theory of calcium effects on body !fatness. Finally we do not suggest any effect for calcium on body fatness and adipocyte size.

Introduction & Objective: Electroconvulsive therapy (ECT) is used widely in psychiatric practice. The goal of anesthesia for ECT is the prevention of complications such as discomfort, fractures, aspiration of gastric contents and hypoxia. However, general anesthesia can cause some adverse effects as hypoxia. Prevention and treatment of hypoxia is important due to its undesirable effects on seizure duration and cardiovascular system. This study was designed to detect the incidence and probable times of desaturation in patients receiving ECT.Materials & Methods: This prospective randomized clinical trial was carried out on 100 patients (18-50 y/o) with ASA I or II who were scheduled for ECT. After pre-oxygenation and similar anesthesia induction the patients received ECT. The patients were ventilated by oxygen and face masked until the return of their spontaneous respiration with adequate tidal volume and respiratory rate. Then they were transferred to recovery room where there was no oxygen supplementation. Oxygen saturation was measured by a Nell core pulse oximeter and was recorded at six stages: before and after anesthesia induction, during ECT, after ECT, 5 minutes after entering recovery room and before leaving there. The data were analyzed by standard statistical tests using SPSS software.Results: Data analysis revealed that desaturation was not noticed at any stage except for the 5th stage (5 minutes after entering recovery room), when 13% of patients developed Sao2% less than 90%. Also there was a significant difference between Sao2% of patients between this stage (5th) and other stages (p<0.001).Conclusion: According to our findings, appropriate oxygen supplementation and pulse oximetry monitoring during recovery period after ECT can be recommend.

Introduction & Objective: Visceral leishmaniosis (VL) is endemic in some parts of Iran. Mediterranean type of disease is present in Iran where its causative agent is Leishmania infantum and dogs are the main. reservoirs. Since many cases of the disease were reported from Noor-abad, in Fars province, we aimed to carry out an epidemiological survey on VL in human and animal reservoirs; (dogs) in Mahoor-Milaty district of Noor-Abad city at West North of Fars province.Materials & Methods: In this cross-sectional descriptive survey, E blood samples were randomly collected from all children≤10 years old, 10%of the adult population and 20% of the dogs kept by ; owners in Mahoor-Milaty villages drawn by systematic sampling.  The specimens were subjected to direct agglutination test (DAT) on serum and PCR on whole blood. The data were analyzed by standard statistical tests using SPSS software.Results: Of the 321 human samples, 234 samples belonged to E children≤10 years old and 87 samples were from adults. 182 (56.7%) out of 321 samples were prepared from males and 139 (43.3%) from females. Totally, 6 cases (1.86%) of human samples showed specific Leishmania antibodies with titers 1:3200 or higher by DAT Of the 19 dog samples, 5 cases (26.3%) showed specific Leishmania antibodies with titers 1:160 or higher. Likewise, kinetoplast DNA (kDNA) of Leishmania infantum was identified in 6 cases (31.5%) of all dogs by PCR with specific primers on whole blood. None of these cases had seropositive titer. E Conclusion: Results of this study show that dogs are the main sources of infection for human visceral leishmaniasis in this region and VL is endemic in Mahoor-Milaty district where the incidence rate of human VL cases has recently been increased. Besides it seems that PCR method is a good tool for primary screening of dogs' blood samples with overt or cryptic VL infection.

Introduction &Objective: Hypomania is a mood disorder with symptoms of constantly high expansive or irritable mood. After a 4-day period, the patient feels to be in need of less sleep, being talkative, or feeling pressure if not treated kindly, having flight of ideas, distractibility, and increase in goal oriented activities (including social, occupational, educational or sexual activities) and being extravagant. Hypomania could be a mood episode of bipolar I and II mood disorder or cyclothymia and could be resulted from consumption of drugs, materials, Electro Convulsive Therapy (ECT) or photo therapy.Case: The present report is the case of a 57-year old married woman, who has had a record of bipolar I mood disorder since 30 years ago. The patient was hospitalized once in psychiatry hospital and referred to psychiatry office 2 years ago. She has been under medication therapy by lithium 600 mg, nortriptyline 75 mg, and colonazpam 1mg. She has taken risperidone 2mg, the symptoms of hypomania have revealed. After stopping the consumption of risperidone, the treatment continued by lithium tablet 900 mg, eskazina tablet 4 mg, nortriptyline 75 mg for one day. She was under care for 15 months and then due to muscle complications of lithium, pessimism, auditory and visual hallucination, she was recommended to take olanzapine tablet 5mg once every night. Two days after taking olanzapine the symptoms of hypomania revealed. Consumption of olanzapine was then stopped and the symptomsdisappeared and she was brought under control after taking sodiumvalproate tablet.Conclusion: Rarely could Hypomania be a mood episode induced by consuming atypical antipsychotics such as risperidone and olanzapine.

Introduction & Objective: It is estimated that in abdominal and pelvic surgery, foreign bodies remain in one in 1500 operations.Here we report a rare kind of retained surgical sponge in the bladder of a patient that underwentopen prostatectomy.Case: The patient is a 60 years old rural man from Yasuj, which came with malodor urine with obstructive and irritative urinary symptoms. He had a history of open prostatectomy 19 months ago.Evaluation revealed, cloudy urine, negative urine culture, normal PSA and normal findings in genitourinary tract sonography. The patient underwent surgery and the bladder was opened through the previous incision. The retained sponge was removed and the patient became symptom free in post operation period.Conclusion: Retained bladder sponge may be tolerated by the patient even for a long period of time. In spite of being a foreign body the patient may only complaint for obstructive and irritative voiding symptoms, which may be common in postprostatectomic patients (bladder instability).