Zahedan Journal of Research in Medical Sciences
Year:2009 | Volume:11 | Issue:3|Papers Count:12

Background: The incidence of post-operative nausea and vomitting (PONV) is increased after middle ear surgery and it may complicate and interact with reconstruction after surgery, so prevention and treatment of these complications are necessary.The aim of this study was to evaluate the efficacy of anti-emetic combinations in decreasing the PONV after middle ear surgery.Materials and methods: This double blind clinical trial was carried out during 2007-2008 on 111 patients of 15-45 years old with ASA I-II who were candidates for elective middle ear surgery under general anesthesia. The patients were divided into three groups. Patients in the ON group received Ondansetrone 0.1mg/kg + Nacl 0.9% 2cc, OD group received Ondansetrone 0.1mg/kg + Dexamethasone 0.15mg/kg and MD group received Dexamethasone 0.15mg/kg+ Metoclopramide 0.15mg/kg intravenously just before the end of surgery. The patients were evaluated for nausea, vomiting, need of anti-emetic drugs and drug dosage in recovery, 1-6, 6-12 and 12-24 hours after operation and then all data were statistically analyzed by SPSS software, Chi-square, ANOVA and t- Test. P<0.05 was significant.Results: There were no significant differences among three groups in age and sex. The incidence of PONV among 3 groups was not significantly different during 24 hours after operation.(P=0.271) but the incidence of PONV in the first six hours was different among 3 groups (P=0.007) (ON: 8.1%, OD: 0%, MD: 21.6%). Also Metoclopramide consumption was significant between three groups.Conclusion: This study showed that the need to anti-emetic drugs in first 6 hours was the least in OD group, but the difference in the incidence of PONV was not significant otherwise.

Background: Resistance to drugs with different structure and function is a great obstacle to the successful treatment of breast cancer. A well-known mechanism responsible for drug resistance is over-expression of ABC-transporter genes such as MDR1. MDR1 gene polymorphisms may result in drug resistance. In this study we investigated the possible correlation between MDR1 gene C3435T polymorphism and clinic pathologic findings and response to treatment in Iranian breast cancer patients.Materials and Methods: In this descriptive study we investigated C3435T polymorphism of MDR1 gene in 54 breast cancer patients admitted to Imam Khomeini Hospital of Tehran and 40 individuals without history of breast cancer by PCR-RFLP technique during 2006-2008.Association of this polymorphism with response to treatment and clinicopathologic characteristics were also investigated. Data were analyzed using Chi-Square test and SPSS software. P values<0.05 were considered to be statistically significant.Results: In patient group frequencies of genotypes were 18% for CC, 56%for CT and %26 for TT whereas in control group frequencies of genotypes were %23 for CC, %50 for CT and %27 for TT. There was no significant difference in frequency of C3435T polymorphism between breast cancer patients and healthy controls. Frequency of C3435T polymorphism between responders and nonresponders was not significant.Conclusions: It seems that there is no correlation between C3435T polymorphism of MDR1 gene and response to treatment, clinical findings and pathologic characteristics of breast cancer. So the role of C3435T polymorphism in response to treatment is still controversial.

Background: Luting agents are used to attach indirect restoration into or on the tooth. Poor mechanical properties of cement may be a cause of fracture of this layer and lead to caries and restoration removal. The purpose of this study was to compare the elastic modulus and compressive strength of Ariadent (A Poly) and Harvard polycarboxylate (H Poly) cements and Vitremer resin modified glass ionomer (RGl).Materials & Methods: In this experimental study 15 specimens were prepared form each experimental cement in Laboratory of Tehran Oil Refining Company. The cylindrical specimens were compressed in Instron machine after 24 hours. Elastic modulus and compressive strength were calculated from stress/strain curve of each specimen. One way ANOVA and Tukey tests were used for statistical analysis and P values<0.05 were considered to be statistically significant. Results: The mean elastic modulus and mean compressive strength were 2.2 GPa and 87.8MPa in H poly, 2.4 GPa and 56.5 MPa in A Poly, and 0.8GPa and 105.6 MPa in RGI, respectively. Statistical analysis showed that compressive strength and elastic modulus of both polycarboxylate cements were significantly different from hybrid ionomer (P<0.05), but the difference between elastic modulus of two types of polycarboxilate cements was not statistically significant.Compressive strength of two polycarboxilate cements were significantly different (P<0.05). Conclusion: An ideal lutting agent must have the best mechanical properties. Between the tested luttins RGl cement had the lowest elastic modulus and the highest compressive strength, but the A poly cement had the highest elastic modulus and the lowest compressive strength. Therefore none of them was the best.

Background: Head trauma is a common and potentially fatal injury. Various models such as APACHE II, simplified APACHE (SAPA II), MPM II, and TRISS have been proposed to predict mortality in these patients. In this study, we compared the efficacy of APACHE II, adjusted APACHE II and TRISS models in predicting the mortality rate and quality of provided services in head trauma patients.Materials and Methods: In this retrospective cross sectional study, we calculated the APACHE II and TRISS scores, and predicted mortality rate by each model as well as predicted rate of adjusted APACHE II in head trauma patients admitted to a general ICU at Khatam-al-Anbia hospital of Zahedan from June 2006 to June 2007. The discriminating power of the models to predict the mortality rates were then measured and compared using area under ROC curve and z statistics, respectively. P value less than 0.05 was considered statistically significant.Results: Fifty six patients were included in this cross-sectional study. Of these, there were 49 men and 7 women with the mean age of 24.4 years. The mean duration of ICU admission was 10.07±6.40 days and 11 patients (19.6%) passed away. The mean APACHE II and TRISS scores were 44.78±5.13 and 18.75±8.79, respectively. The comparison between the APACHE II and adjusted APACHE II (P value = 0.8), APACHE II and TRISS (P value=0.2), and adjusted APACHE II and TRISS (P value=0.25) showed no significant difference.Discussion: Our study revealed that APACHE II predicted the mortality rates better than adjusted APACHE II and TRISS models in head trauma patients admitted to ICU but this priority was not statistically significant.

Background: GLucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common known enzymopathy in human. G6PD deficiency is usually asymptomatic, however, deficient individuals are at increased risk of developing acute hemolytic anemia and hyperbilirubinemia following intake of oxidative agents and fava. The objective of present study was to detect prevalence of G6PD deficiency in admitted males for premarriage tests in Zahedan Reference Laboratory. Also, we compared blood indices of normal and G6PD deficient individuals.Materials and Methods: This descriptive study was carried out on 1340 admitted males in Zahedan Reference Laboratory from February 2008 to March 2009. G6PD activity was determined in EDTA containing blood samples by qualitative fluorescence spot test, then G6PD deficiency was confirmed by quantitative spectrophotometric method. Total leukocyte count and RBC indices of G6PD deficient samples and the same number of normal samples were compared. The differences between two groups were compared using Sigmaplot software and t-Student test. A P-value less than 0.05 was considered statistically significant.Results: G6PD deficiency was found in 84 individuals of total 1340 by fluorescence spot test and confirmed in 79 by quantitative method. Therefore, prevalence of G6PD deficiency in Zahedan was estimated to be 5.9%. Comparison of deficient and normal individuals did not show significant difference in WBC count, RBC count, hemoglobin concentration, hematocrit, mean corpuscular hemoglobin (MCH) and RDW-SD. However, mean corpuscular volume (MCV) was significantly high and mean corpuscular hemoglobin concentration (MCHC) and RDW-CV were significantly low in G6PD deficient individuals compared to those with normal enzyme level.Discussion: Present study revealed that the prevalence of G6PD deficiency in Zahedan is 5.9%. Severity of G6PD deficiency in quantitative assay indicated that class I and II are probably dominant variants in Zahedan.

Background: Many clinical studies have shown the efficacy of pit and fissure sealants in reduction of caries. However saliva contamination during the treatment is the cause of fissure sealant failure. The purpose of this study was to evaluate the microleakage of fissure sealant applied under isolated and non-isolated conditions.Materials and methods: In this experimental seventy six sound human premolar teeth collected from Dentistry centers of Zahedan during 2007 were investigated in two groups: isolated group and contaminated with saliva. A fissure was prepared on buccal surface of the teeth by a ¼ round bur. Fissure sealant was applied to all teeth, then test group teeth were contaminated by saliva for 5 seconds after deposing fissure sealant on the fissure. The sealed tooth was thermocycled (5-55 degrees, 2000 cycles) and then immersed in 0.5% basic fuchsin solution for 24h. The teeth were sectioned in buccal lingual dimention and the amount of microleakage was assigned by a sterio microscope and the results were evaluated by Chi-square and Mann – Whitny analysis and P<0.05 was considered significant.Results: Significant difference was noticed in microleakage of fissure sealant in isolated and non isolated state (P=0.001). The difference in microleakage of dye in the space between enamel and sealant was significant between two groups (P=0.001). Even in some cases (31.59 %) sealant was separated from the tooth in non- isolated teeth.Discussion: According to the results of this study it is recommended to do the teeth sealant therapy in a completely isolated situation and repeat sealant therapy if any contamination occurred after deposing the sealant.

Background: Entamoeba histolytica, resident in large bowel, is the causative agent of an estimated 40 to 50 million cases of amebic colitis and liver abscess, and is responsible for up to 100000 deaths world wide each year. Based on the results of various studies, it is accepted that Entamoeba histolytica and Entamoeba dispar which are morphologicaly identical, differ in biology and pathogenicity. This study was performed to estimate the prevalence of contamination of stool samples with these species in medical centers of Zahedan city.Materials and Methods: In this descriptive study we used microscopy, Formalin-ether concentration, culture and PCR techniques to differentiate of Entamoeba histolytica from Entamoeba dispar in 1562 stool samples in medical center of Zahedan during July 2004 to January 2006. Data were analyzed with Chi-square, Mann-Whitney and Fisher tests. P value<0.05 considered to be statistically significant.Results: Eight cases (0.51%) of all samples were positive for Entamoeba histolytica/ Entamoeba dispar by direct microscopy and Formalin-ether concentration Methods. All isolates were cultured in HSr+s and Robinson Media. Seven samples were examined by 2 set of oligonucleotid primers HSP1,2 and DSP1,2 by PCR technique and six isolates were identified to be Entamoeba dispar. Conclusion: This study by using PCR technique showed that most of the patients referred to medical centers of Zahedan were infected with Entamoeba dispar.

Background: Lichen planus is a chronic mucocutaneous disease that often affects the oral mucosa.However, the exact etiology and pathogenesis remain unclear, there are reports about theassociation between Oral Lichen Plans (OLP) and immunological disorders and psychological factors. The role of psychosocial factors especially depression and anxiety in oral lichen planus is debated. This study was done to determine the association of these factors in oral lichen planus. Materials and Methods: This descriptive study was done in department of oral medicine of Zahedan University of Dentistry from May 2007 to May 2008. One hundred and sixty patients were evaluated in three groups of OLP, negative control and positive control using Beck Anxiety (BAI), Beck Depression (BDI) and Stress Life Event Questionnaires. Data were analyzed using Kruskal Wallis and Mann-Whitney tests. P value<0.05 was considered statistically significant. Results: Mann-Whitney showed that oral lichen planus patients and positive controls had significantly higher stress, anxiety and depression levels than the negative controls (P < 0.05).However, no statistically significant difference was found in stress, anxiety and depression level between the oral lichen planus and positive control population (P >0.05).Conclusions: It seems that psychosocial factors may have role in the causation of oral lichen planus. These factors may form a starting point for initiation of various autoimmune reactions, which have been shown to be contributory to the pathogenesis of oral lichen planus.

Wandering spleen is a rare condition characterized by increased splenic mobility due to the absence or laxity of its suspensory ligaments that may present as acute abdomen when it is twisted on its pedicle. Herein we report a case of torsion of a wandering spleen in a 24- year-old female patient without any history of trauma .The patient was admitted to emergency ward at February 2008 with clinical findings of acute abdomen. Laparotomy was performed and the infarcted spleen was removed. Although wandering spleen is a rare clinical entity, the possibility of torsion should be kept in mind in the differential diagnosis of acute abdomen to avoid serious complications.