Journal of Sabzevar University of Medical Sciences
Year:2007 | Volume:14 | Issue:1 (43)|Papers Count:13

Background and purpose: Assessment of genetic changes from a molecular viewpoint is essential for diagnosis, follow-up and treatment. For molecular procedures, DNA extraction is the first step. Therefore, applying economical and easy procedures will be helpful. Pathological specimens are normally fixed in formalin and paraffin after surgery and it is important to extract quality DNA from specimens. This study is intended to compare Chelex and Phenol / Chloroform methods of DNA extraction in Paraffin-embedded Colorectal Cancer specimens and their effect on PCR-SPSS.Methods and Materials: This descriptive-analytical study was conducted on 60 colorectal cancer specimens including 10 rectal and 50 various colon specimens. DNA extractions were done by Chelex and Phelex / Chloroform methods and their quality and quantity were measured by spectrophotometer. The P53 gene was amplified using specific primers in a PCR assay and, consequently, electrophoresis was done. The two methods were compared and analyzed by Kappa coefficient.Results: Out of 60 subjects, 15 were female and 45 male. Their age ranged from 44 to 91 with the mean being 62 years. Quality DNA was extracted from 44 formalin-fixed specimens by Chelex method, and the PCR was positive. However, with the same sample, 32 specimens had suitable PCR assay by Phenol / Chloroform method. Therefore, a significant relationship was observed between the two methods (p<0.01).Conclusion: The findings revealed that DNA extraction of paraffin-embedded specimens was better conducted by Chelex method rather than Phenol / Chloroform.

Background and purpose: Attention to labor pain and its sedation are important parts of maternity care. Mother positioning seems to be effective in pain intensity and positions that women choose in order to become more comfortable are often those that tend to promote the baby's progress through the birth canal.Women often describe less pain when the fetus and pelvis are better aligned. This study investigated the effects of mother's selected positions on the intensity of several types of pain in the first stage of labor.Methods and Materials: This is a clinical trial on 68 pregnant women with singleton fetus in vertex presentation, 38-42 weeks gestational age and normal labor progress at Zeinab hospital in Mashad in 2004-5. They were randomly allocated to selective positions group and routine positions group. Mothers in selective positions group changed position as they wished while mothers in routine positions group were cared in bed. Pain intensity of low back and abdomen were measured hourly by visual analog scale. Data were gathered by using forms of interview and observation, and visual analog scale and analyzed in SPSS using Student ttest, Chi-square, Mann-whitney and Fisher's exact test.Results: Scores of total pain (average of low back pain and abdominal pain) and low back pain were significantly lower for the selective positions group than those for the routine positions group (p=0.007 and p<0.001 respectively). Score of abdominal pain was the same in both groups. In accordance with time and location, the mean score of low back pain between contractions was significantly lower for the selective positions group than that for the routine positions group (p<0.001).Conclusion: This study showed that in the active phase of the first stage of labor, mother's selective positions reduce intensity of low back pain between contractions. Therefore using alternative positions are simple and cost effective methods that reduce labor pain.

Background and purpose: Morphine vaccine is a product of morphine-6- succinate synthesis and its conjugation with albumin serum. Each dose contains 0.5 mg Aluminum hydroxide, 8 mg sodium chloride, 1.12 mg di- sodium hydrogen phosphate, 1.1 mg sodium di- hydrogen phosphate and 50 mg morphine-6- succinate albumin serum. Humoral safety is achieved in morphine addicts following three successive doses within 0-30- 60-day intervals. Its immunogenicity brings about withdrawal without the risk of abstinence syndrome. This study was conducted to examine the effect morphine vaccine on morphine addicts. Methods and Materials: Based on the Ethics protocol of Pasteur Institute of Iran, this clinical trial was conducted on 102 male volunteer addicts (mean age 25 years). Variables included vaccine dosage and concentration on of antibodies. Volunteers were divided into groups of 30 (experimental) and 4 (placebo).Adjuant was injected to placebo group addicts; the three experimental groups were given 5, 12, 100 and 600 mg within 0- 30-60 days interval through injection to deltoid; all subjects referred for follow-up on the 90th day. Blood samples and antibody evaluation was obtained from all three groups in months 5, 7, 9, 11 and 12.Results: A positive correlation was observed between antibody production and vaccine dosage as well as frequency of injection.Anti-morphine antibody was detected after the first injection of 100mg/ml, 600mg/ml and second injection of 12.5mg/ml doses. Antibody levels reached the peak by three months and did not decline to the baseline after one year Conclusion: the vaccine was well tolerated and lacked the reverse and unfavorable effects, characteristic of vaccines and drugs. On day 90, humoral immunity was created in all patients.

Background and Purpose: Surviving is one of the eight members of the human inhibitors of apoptosis (IAP), which appears to be differentially expressed in cancer cells. This study was conducted to evaluate the clinical usefulness of survivin immunostaining to distinguish between follicular adenoma and carcinoma of thyroid.Methods and Materials: This study was a cross-sectional descriptive-analytical research. The study population was tissue samples from surgery patients at Shariati Hospital in Tehran, Iran. All samples were studied through immunohistochemical staining for surviving.Results: Surviving expression was significantly (p<0.005) higher in patients with follicular carcinoma diagnosis than those with adenoma. Odds ratio of follicular carcinoma for surviving expression was reported to be 21.375 (95% CI: 3.283-139.177).Conclusion: The study indicated that surviving can play an effective role in distinguishing follicular thyroid adenoma from follicular thyroid carcinoma.

Background and purpose: Cataract is the lens opacity which brings about vision disorders and is generally divided into four types: congenital, traumatic, secondary and age-related. It is commonly a disease of middle-age and geriatric age and the main factor in low vision and blindness throughout the world. This study is intended to survey the prevalence of cataract in the rural population of Sabzevar in Iran.Methods and Materials: This research is a cross-sectional epidemiological descriptive study. 40 villages were selected through cluster sampling and the statistical population included all rural residents in 2002-2004 (1381-1383). 2805 subjects (with the age range of 11 days to 92 years old) participated in the primary screening which consisted of tests of visual acuity, red reflex, retinoscopy and the examination of anterior segment via torch or ophthalmoscope. Subjects with visual disorders or defected red reflex were referred to ophthalmologist for complete examinations.Results: Mean age for 1014 male (40.5%) and 1494 female (59.5%) were 27.84±22.07 and 27.90±19.05 years respectively.The overall prevalence of cataract was 6% (confidence interval 95%). Its prevalence in men and women were 7.8% and 4.8% respectively.Conclusion: Regarding the limited number of similar epidemiological studies in Iran, further studies can be helpful in estimating the magnitude of cataract and visual disorders due to cataract in the rural population since estimating the magnitude of this controllable disease can be of considerable personal, social and economical advantages.

Background and Purpose: At least two different elements can be detected in the structure of mature intervertebral disc. The central portion contains nucleus pulpous. Its few cells being embedded in gel form material. The outer protein, however, is called annulus fibroses, composed of concentric layers of intertwined annulus bands. Although the major anatomical structures of intervertebral disc are well known, there are little information on the development of its components such as cell type and extracellul matrix. Therefore, this study was conducted to study the histological changes in the development of intervertebral disc in mouse.Methods and Materials: In this study, collagen fiber appearance and cellular differentiation were studied using serial section and histological staining methods in the course of intervertebral disc development in mouse embryo. Results: The findings indicated that from the 12th day of gestation, the notochord starts getting separated from the floor plate of neural tube. Gradually on the next days, as mesenchyme cells get condensed around, patterns of intervertebral disc differentiation can be observed, leading to disc development toward the end of gestation. Throughout this process, the notochord degenerates. Theses changes start from the middle portion of notochord and proceeds towards head and tail. Then vertebral bodies are forward in portions with degenerated notochord changes.Conclusion: During the development changes of intervertebral disc, remnants of notochord form nucleus pulpous in the intervertebral disc. However, the mesenchyme surrounding it (forthcoming annulus fibrosus) consist of structurally dissimilar regions. Under these circumstances, the outer portion is made up of highly-densed collagen material but in the inner portion, remnants of embryonic hyaline cartilage and collagen fibers can be detected.

Background and purpose: Rest and sleep have restorative protective roles In the restoration of our mental and physical Iran abilities which are two important dimensions in the quality of life.Non-rapid eye movement sleep is important in protecting the cardiac function in CABG patients, who return to normal life after 8-12 weeks while sleep disorders prevail for one year after surgery. Therefore, this study was conducted to investigate the relationship between sleep patterns and the quality of life in CABG patients.Methods and Materials: This longitudinal, descriptive and correlational study was conducted on 91 patients admitted to Imam Reza Hospital in Mashad, Iran in 2005 (1384). Subjects were selected in three phases: 24 hours before surgery, as well as 6 and 10 weeks after surgery. Interview checklists were used for data collection. Three scales were used to measure sleep patterns: Pittsburgh sleep quality index, Epworth sleepiness scale and sleep log. Quality of life was measured with 36 short forms.The first two interviews were done at the hospital clinic and the last via telephone. Relevant data were analyzed in SPSS using student Hest and Pearson correlation coefficient.Results: Mean score of nocturnal sleep quality and efficiency in all three stages were undesirable. Also, mean score of sleepiness in all three stages were normal and mean score of quality of life was in the mid one-third of 0-100 scale. No significant differences were found between on-pump and off pump groups in their sleep patterns and quality of life. In all three stages, sleep quality positively and significantly correlated with quality of life (p<0.001, p=0.002 and p=0.004 respectively).Moreover, significant positive correlation existed between sleep efficiency and quality of life (p<0.001, p=0.002 and p=0.005 respectively). However, no significant correlation was found to exist between sleepiness and quality of life. Conclusion: The findings of the present study indicated a significant and positive correlation between sleep pattern and quality of life in CABG patients. Therefore, it is necessary to restore their physical and mental health as soon as possible.

Background and Propose: Thalassemia major is the most common hemolytic anemia, in Iran and the world over, which requires regular transfusion. Repeated transfusion leads to iron overload in the body and various complications if chelation therapy is absent or irregular; the most common complications include cardiac diseases, endocrine disorder and infections such as HIV and hepatitis. This study was conducted, therefore, to investigate the complications of Thalassemia major and factors affecting the onset of these complications.Methods and Materials: In this cross-sectional retrospectivestudy, 806 thalassemic patients, admitted to the Cooley's ward at Shahid Dastghaib Hospital in Shiraz, Iran, were studied using a structured questionnaire through enumeration method. The statistical population was all thalassemia major cases from Shiraz province. In addition to the age of occurrence, demographic information, age of onset and type of onset and type of transfusion as well as chelation therapy method were specifically recorded. The diagnosis was made by specialist medical doctors. Obtained data were analyzed through description and analytical statistics (or confidence interval chisquare test, independent t-test and pearson correlation coefficient).Results: The subjects age ranged from 1 to 43 years and their mean age was 15.34±6.82. The prevalence of spleenectomy, cardiac diseases, hypogonadism, hypothyroidism, hypoparathyroidism, diabetes mellitus and HCV were 28.7% (onset age 11.46±5.7), 15.4% (onset age 16.43±5.4), 14.5% (onset age 18.42±3.6), 2.4% (onset age 15.83±3.5), 6.9% (onset age 16.98±4.5), 7.5% (onset age 17.19±4.8) and 14.4% respectively. There were significant relationships between prevalence and onset age of some complications and variables such as sex, mother's education and age of chelation therapy onset (p<0.05).Conclusion: Early onset of blood transfusion with late chelation therapy increases the likelihood of appearance of complications and their early onset. To avoid such complications, timely transfusion according to chelation therapy is recommended. Parental education can be vital. Regular examination and early diagnosis can prevent progression of complications and enhance patient's efficiency.

Background and Purpose: Situs inversus or situs transversus is a rare congenital condition where abdominal organs are positioned in a transverse manner, as in front of a mirror. Its prevalence is less than one in 10/000. This paper is intended to report one such case.Patient's history: A fourteen-year-old boy referred to the clinic with complaints of leftward abdominal pain beneath the navel, nausea and vomiting. Early diagnosis of acute appendicitis was made after clinical examinations, laboratory tests and sonography. Radiography reports revealed the shift of heart to the right of chest, confirming the diagnosis of Dextrocardia.Gastric bubble and spleen were observed on the right and liver and cholecyst on the left with sonography. Pancreas was also positioned on the opposite side. LLQ results indicated acute appendicitis on the left. Clinical findings and paraclinic measures rendered the certain diagnosis of situs inversus totalis. The patient finally underwent left appendectomy.Conclusion: Normally, situs inversus is accompanied with dextrocardia and major vessels dislocation and its prognosis is good. This condition with levocardia is less common and amounts to one in 22/000, with a likelihood of increasing congenital cardiac diseases. In the reported case, no particular problem came up after surgery. Inverted anatomical condition and the atypical history of situs inversus make the early diagnosis difficult in these patients. Accurate history and clinical examinations and reliance on imaging techniques in traumatic cases can reduce and minimize medical errors in treating such rare cases.