Journal of Sabzevar University of Medical Sciences
Year:2012 | Volume:19 | Issue:3 (65)|Papers Count:11

Background: Given the high prevalence and high mortality of cardiovascular disease, special attention should be paid to its treatment. Currently, the main treatment for ST-elevation myocardial infarction is restoring blood flow by dissolving the clot. In addition to this basic treatment, several pharmacologic agents have been studied during the past years. In this paper, clinical trials about glucose-insulin-potassium are discussed in addition to adjuvant treatment which has been suggested in recent years.Materials and Methods: All studies published in journals or presented at scientific conferences were searched in Elsevier, PubMed, Cochrane, and SID databases using relevant keywords. After quality control, eligible articles were included in the study.Results: The results of this review article showed that studies on the effects of glucose-insulin-potassium treatment on mortality, cardiac enzyme levels, left ventricular ejection fraction, ST resolution, and inflammatory and oxidative biomarkers have been conflicting. But, generally, evidence from newer studies conducted on larger numbers of patients has shown ineffectiveness of glucose-insulin-potassium therapy.Conclusion: Currently, glucose-insulin-potassium therapy should not be recommended as an adjunct to thrombolytic therapy.

Background: Low-frequency stimulation (LFS) (<5 Hz) is a suitable approach for treating seizures caused by epilepsy.Different patterns of LFS have different effects on epileptic seizures. Since no LFS pattern has so far been determined to have the best efficacy in seizure quenching, this study investigated the effect of 60-min application of LFS on amygdalakindled seizures in rat.Materials and Methods: In this experimental study, two groups of animals (14 rats) received twice-daily kindling stimulations after stereotactic surgery and a 1-week recovery period. In group 1 (n=6), fully kindled animals received daily kindling stimulations for four days, while in group 2 (n=8), kindled animals received LFS (1 Hz, 0.1 ms pulse duration, ½ afterdischarge threshold intensity) four times (in 24-hour intervals) exactly before kindling stimulations. Afterdischarge duration (ADD), stage 2 latency (S2L), stage 4 latency (S4L), and stage 5 duration (S5D) were recorded and compared with related control groups (the same animals that had received only kindling stimulation). Data was analyzed using repeated-measures ANOVA and post-hoc Tukey’s test for within-group comparisons and Student’s t-test for between-group comparisons.Results: The first LFS application resulted in a significant increase of S2L and S4L by 91.5% (p<0.05) and 79.5% (p<0.01) compared with control group, respectively. Four-day consecutive LFS applications decreased S5D significantly, so that the first LFS application decreased S5D by 100% (p<0.001). In the first 2 days of LFS application, ADD decreased significantly by 46.9% and 40.4% (p<0.05), respectively, relative to control.Conclusion: The results suggest that LFS application immediately before seizure initiation has anticonvulsant effects.

Background: ADHD is one of the most common neuropsychiatric disorders in children. Methylphenidate is the most frequent medication prescribed for this disorder, while bupropion is suggested as an alternative for treatment. This research aims to compare the efficacy and safety of bupropion and methylphenidate (Ritalin) in children with ADHD.Methods: Forty children with ADHD, aged 6 to 12 years, from consecutive referrals to child psychiatric clinic of Ibn-e-Sina hospital were selected and randomly divided into two categories (treatment with methylphenidate or bupropion). Evaluations were carried out based on ADHD Rating Scale (by teacher and parent) and Global Clinical Scale (by clinician) at the beginning of the study and again after 4 and 8 weeks of the study. Adverse effects were also checked at 4 and 8 weeks. Data was analyzed using SPSS software, version 11.5.Results: Data was normally distributed in the two categories in terms of demographic and quantitative variables. Therapeutic response, in parents’ views, was better in Ritalin group and was significantly different at the end of the 8th week (p=0.014). Ritalin was also more efficacious in teachers’ views, but had no significant advantage (p=0.092). Global clinical scale showed a significant advantage in both categories regarding response to therapy (p=0.014). Therapy was seen efficacious by parents, teachers, and clinician (p<0.001).Conclusion: Results showed that bupropion was an effective agent in ADHD treatment, but its effect was less than methylphenidate based on the parents’ report.

Background: In brain tumors, the main source of energy is from glycolysis, which is initiated by hexokinase type I (HK-I), an enzyme bound to the outer mitochondrial membrane, involving two sets of binding sites. In addition to the glucose-6-phosphate (G6P) -sensitive site (Type A), the enzyme is bound on a second set of sites (Type B) which are insensitive to G6P, but totally releasable by high concentrations of chaotropic salts such as KSCN. In the present study, we investigate possible changes in HK-I binding to the outer mitochondrial membrane during malignancy.Methods: In this experimental study, 2 mM G6P was used for releasing enzyme from site A, while site B was depleted using a mixture of KSCN and KCl with a total concentration of 45 mM.For blocking binding sites in site A, dicyclohexylcarbodiimide (DCCD) was used.Results: DCCD, which normally has the capacity to block HK-I binding at site A, was found ineffective for mitochondria obtained from astrocytoma and glioma specimens, presumably due to changes in the microenvironment of Glu 72 of porin with which it interacts. It also appears that increased incorporation of cholesterol, reported to occur in the mitochondria of cancer cells, may influence HK binding due to changes in mitochondrial membrane fluidity.Conclusion: Taken together, these results support earlier conclusions on possible changes in the microenvironment of bound HK-I and also fluidity of membrane upon malignancy.

Background: All hemodialysis patients experience some degree of anxiety during hemodialysis. Anxiety increases morbidity and mortality. The aim of this research is to compare the effect of orange essential oil aromatherapy on anxiety of hemodialysis patients.Materials and Methods: In this clinical trial, sixty-two hemodialysis patients were randomly assigned to two groups: an orange oil group (n=31), and a usual care group (n=31). In orange oil group, subjects inhaled orange oil using handkerchiefs smeared with orange oil for 15-20 minutes. This method was used three times a week for four weeks. In the usual care group, subjects received the routine care of the hemodialysis ward. The level of anxiety in the two groups was measured and compared before intervention, as well as after the first, second, third, and fourth weeks of intervention, using Spielberg State-Trait Anxiety Inventory questionnaire.Results: Before intervention, the mean state anxiety scores were 46.9±9.7 and 48.3±11.6 and the mean trait anxiety scores were 46.5±9.2 and 47.9±11.6 in orange oil and usual care groups, respectively. After intervention, the mean state anxiety scores were 35.9±8.7 and 45.1±1.7 and the mean trait anxiety scores were 36.0±10.0 and 45.6±11.8 in orange oil and usual care groups, respectively. In orange oil group, the level of state and trait anxiety decreased significantly compared with usual care group (p<0.001). Also, in orange oil group, the level of state and trait anxiety decreased significantly between the first, second, third, and fourth weeks of intervention (p<0.05).Conclusion: Orange oil aromatherapy can reduce state and trait anxiety in hemodialysis patients without important complications. (Quarterly Journal of Sabzevar University of Medical Sciences, Volume 19, Number 3, pp.249-257).

Background: Hyoscyamus niger has many different therapeutic effects, such as anti-convulsive and sedative effects. In this study, we tried to evaluate the eventual effect of hydro-alcoholic extract of Hyoscyamus niger on spatial learning and memory in mice using Morris water maze task.Materials and methods: In this study, 23 mice were randomly divided into one control group and two experimental groups. The control group received normal saline and the experimental groups received hydro-alcoholic extracts of Hyoscyamus niger (1 or 2 mg/kg, i.p.). At first, saline or extracts were injected daily (7 days) and then spatial learning was evaluated for 5 consecutive days. For evaluating short-term memory, two probe-trial experiments were performed. Finally, data were analyzed using one-way ANOVA, followed by Tukey’s test.Results: Results obtained from day 3 and day 4 of the learning period showed a significant reduction in learning the water maze task in the experimental group (2 mg/kg) compared with the control group (p<0.05). In addition, probe-trial experiments demonstrated that Hyoscyamus niger (1 and 2 mg/kg) prevented formation of short-term memory, while control animals succeeded to make short-term memory.Conclusion: Hydro-alcoholic extract of Hyoscyamus niger decreases the learning of the water maze task and also disturbs short-term memory.

Background: Crocin is a major constituent of saffron, the dried stigmas of Crocus sativus L., which is used mainly as a herbal medicine or a food coloring agent around the world. Novel publications reporting a cancer preventive effect for crocin motivated us to evaluate telomerase activity, the main cause of immortality in cancer cells, under treatment with crocin.Materials and Methods: IC50 concentration of crocin was estimated in MCF-7 cell line, a breast adenocarcinoma cancer model, by MTT (3- (4, 5-dimethylthiazol-2-yl) -2, 5- diphenyltetrazolium bromide) test after 48 hours of treatment. A conventional telomere repeat amplification protocol (TRAP) assay and a real-time quantitative telomere repeat amplification protocol (qTRAP) assay were used to estimate relative telomerase activity in crocin-treated cells in comparison with untreated control cells.Results: Telomerase activity in the treated cells with different concentrations of crocin up to IC50 showed an increment after administration of very low doses of crocin, whereas higher concentrations of crocin remarkably inhibited the enzyme in a dose-dependent manner. IC50 values of crocin reduced by 85% in comparison with untreated control cells.Conclusion: qTRAP estimations show a good correlation with the conventional assay results. Antiproliferative effect of crocin in cancer cells is probably due to strong inhibition of telomerase activity.

Background: Leaching of nutrients and heavy metals from municipal solid waste compost leads to accumulation of certain elements in soil layers, causing underground water pollution. The objective of this study was to investigate the effect of compost on leaching and adsorption of heavy metals and nutrients (sodium, potassium, and sulfate) from silt-loamy soils.Materials and Methods: In this empirical, applied study, three polyethylene columns (height 50 cm, inner diameter 10 cm), filled with sandy clay loam soil, were randomly selected. Then, 10 kg of compost per square meter were sprayed onto the columns, and leachates exiting the columns were routinely analyzed for pH, electrical conductivity, sulfate, sodium, potassium, lead, chromium, and cadmium. Data analysis was performed with Excel and SPSS software using Kruskall-Wallis test.Results: The data showed that the use of enriched and unenriched compost leachate decreased pH (from 7.43±17.0 to 6.7±0.25 and 7.07±0.11, respectively) and increased the electrical conductivity (EC) (from 1.8±0.3 mSiemens/m to 3.7±0.12 and 12.87±0.41 mSiemens/m respectively). Leakage of metals in the unenriched treatments was not significantly different from the control (p>0.78), but leakage with three metal-enriched compost applications was significant compared with control (p<0.001).Conclusion: Application of composts containing heavy metals onto loamy soils increases leaching of heavy metals from the compost into groundwater. Therefore, frequent use of compost endangers groundwater quality.

Background: Recent studies have shown that normobaric hyperoxia is effective in the treatment of acute ischemia, a phenomenon called preconditioning. However, the exact mechanism of this kind of preconditioning in vivo is not known. In this study, the effect of intermittent normobaric hyperoxia on expression of HIF1a in a stroke model was investigated.Materials and Methods: In this experimental study, rats were divided into 4 groups. Hyperoxia groups were exposed to 95% inspired oxygen for 4 h/day and 6 consecutive days. Oxygen concentration in the control groups was 21% (normoxia). After 24 h, rats in stroke groups were subjected to 60 min of right middle cerebral artery occlusion. After 24 h, reperfusion neurological deficit scores were assessed. The brain HIF1α levels were analyzed by Western blot. Statistical analysis was performed using two-way ANOVA, Bonferroni post-test, Fisher exact test, and GraphPad Prism 5 software.Results: The results of this study showed that HIF1α levels increased in stroke groups compared with normoxia groups, while the amount of protein in hyperoxia groups was not significantly different from normoxia groups. Significantly increased HIF1a levels were observed in hyperoxia stroke group.Also, hyperoxia improved neurological deficit scores from 8.83% down to 3.46%.Conclusion: Hydroxylation, instability, and degradation of HIF1α occurred following hyperoxia. In the stroke groups, lack of oxygen delivery to cells prevents hydroxylation and degradation of HIF1a. In hyperoxia stroke group, inflammatory cytokines with increased ROS can induce increased expression of HIF1a.

Background: Patients, regardless of their age, sex, race, and other differences, have a right to knowledge, choice, respect, confidentiality, territoriality, and efficient care and treatment in health care settings. Rehabilitation experts, like other health care providers, should be knowledgeable and observant of these rights. This study was designed to determine the relationship between experts’ knowledge of patients’ rights and their level of observance of these rights.Materials and Methods: In this cross-sectional, descriptive and analytical study, all experts working in rehabilitation and welfare centers in the city of Tehran with at least 6 months work experience were included by census method. Sixty-two experts were examined by a questionnaire with confirmed validity and reliability, consisting of 2 subscales measuring knowledge and observance of the participants on patients’ rights.Results: Of all the participants, 79% were female and 77.4% had bachelor’s degrees. The mean age was 35.9 (SD=8) years.Knowledge on patients’ rights was at the very good level in 59.7%, at the good level in 35.55%, and at the moderate level in 5.3%. Observance of patients’ rights was at the weak level in 13.6%, at the moderate level in 79%, and at the good level in 8.5%. Mean level of observance had significant relationships with sex (p<0.02) and educational level (p<0.03). The relationship between knowledge and observance was significant at the 0.001 level.Conclusion: Data showed significant relationships between the experts’ knowledge and observance in the domain of patients’ rights. It is recommended to hold training courses on patients’ rights for rehabilitation staff.

Background: The association of an ovarian tumor with Ollier’s disease (multiple encondromatosis) is a known entity but chondrosarcoma and ovarian tumors is rare. Only one case with Ollier’s disease was reported. In this clinical presentation we report a patient with granulosa cell tumor and chondrosarcomaCase Report: Our patient was a 20 year old woman with acute abdominal symptoms and adnexal mass. She had emergency surgery. Ovarian mass was removed and sent for pathologic study. Ovarian granulosa cell tumor was reported. In the next follow-up CTscan reported osteolitic mass of iliac bone. Biopsy was done and was compatible with chondrosarcoma of iliac. Then radical surgery and resection of iliac bon was performed. Due to the demand for fertility preservation, she was undergoing chemotherapy.Conclusion: There is a risk of malignant change to chondrosarcoma or other bone tumours in Ollier's Disease. The attractive point of this patient is the association of ovarian tumor with primary iliac chondrosarcoma that has not been reported. Concurrent findings may help future research in finding the cause, early diagnosis and appropriate treatment of tumors.