Zahedan Journal of Research in Medical Sciences
Year:2011 | Volume:13 | Issue:6|Papers Count:17

Background: Connective tissue diseases (CTD) can involve nervous system.Diagnosis and differentiation from multiple sclerosis (MS) can be difficult especially when the disease presented by symptoms and signs related to demyelinating process. The aim of this article is to review the variant forms of central nervous system involvement in CTD especially useful points for differentiation from demyelinating disorders.Materials and Method: We used the relevant articles in PUBMED, Scopus and other databases especially published in recent ten years.Results: Systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS), Behcet’s disease (BD), Sjogren's syndrome (SS), and some vasculitides can involve nervous system. Patients may be present by demyelination areas in the white matter of the brain and spinal cord, which are difficult to differentiate from MS and other demyelinating processes, such as transverse myelitis and optic neuritis. On the other hand, autoantibodies such as antinuclear antibodies (ANA) and antiphospholipid antibodies (aPL) can also occur in MS. Treatment and prognosis of these diseases are quite different. In demyelinating diseases the diagnosis is established on the basis of clinical presentation, magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) examination, visual evoked potentials (VEP) and autoantibody investigation.Conclusion: In many patients, distinction between different etiologies of demyelination can be made by considering clinical and paraclinical data, but in some cases, accurate diagnosis can only be made after long-term follow-up.

Background: Intranasal route administration of opioid drugs has been shown to be an alternative treatment method without major side effects. In this study we evaluated the intranasal (IN) versus intravenous (IV) pethidine for postoperative pain relief after cesarean section.Materials and Method: In this clinical trial, 126 women undergoing elective cesarean section with general anesthesia using thiopental sodium 5 mg/kg, succynylcholine 1.5 mg /kg, then O2/N2O with 50/50 ratio, halothane 0.5 MAC, atracurium 0.2 mg /kg and fentanyl were entered into the study. Parturients were randomized in to two groups receiving IN pethidine (1mg/kg, n=63) or IV pethidine (1mg/kg, n=63) in recovery room. Pain intensity, incidence of nausea and vomiting and systolic blood pressure were recorded after pethidine administration and then every half an hour for 4 hours.Data analyzed with independent student t-test using SPSS software.Results: The mean visual analogue scale score in IV group was less than IN group at first two hours after pethidine administration.No significant difference in the incidence of nausea and vomiting was found between two groups. There was a significant decrease in mean systolic blood pressure in IV group compared with IN group at all the times (P<0.05).Conclusion: Although, IN pethidine was less effective on post cesarean pain relief, it seems to be an interesting alternative route for those who had no intravenous access, or had an allergy to morphine and unabale oral intake.

Background: Diabetes mellitus is a metabolic disorder and one of its most important consequences is renal insufficiency.A multitude of herbs has been described for the treatment of diabetes mellitus.The aim of present study was to assess the protective effect of turnip root ethanolic extract (TREE) on early nephropathy in alloxan-induced diabetic rats.Materials and Method: Eighty male Wistar rats were randomly allocated into 4 equal groups including: healthy rats, normal healthy rats receiving TREE, diabetic rats and diabetic rats receiving TREE.Diabetes was induced by a single injection of alloxan (120 mg/kg; i.p). The extract (200 mg/kg) was gavaged to TREE treatment groups daily for 8 weeks.At the end of experiment; serum levels of urea, uric acid and creatinine were assessed. The lipid peroxidation product, thiobarbituric acid-reacting substances (TBARS), and activities of superoxide dismutase, catalase and glutathione peroxidase were measured in the renal tissue. Finally, the biochemical findings were matched with histopathological verification. Statistically, the quantitative data obtained, compared among the groups by one-way analysis of variance followed by Tukey post-test. Statistical significance was considered at p<0.05.Results: In the diabetic rats, TREE significantly decreased the levels of serum biomarkers of renal injury.Furthermore, TREE significantly decreased the lipid peroxidation and elevated the decreased levels of antioxidant enzymes in diabetic rats. Histopathological findings were in agreement with the biochemical findings.Conclusion: TREE has protective effect on early diabetic nephropathy in the rats with experimentally induced diabetes.

Background: Alternative or complementary medicine includes models for treatment or prevention of disease, which are different in method or efficacy from current biologic medicine. Interest in alternative and complementary medical practices have increased in recent years. This study has been conducted to determine the knowledge and attitude of the general physicians about complementary and alternative medicine.Materials and method: This descriptive study was done on all general physicians of Rafsanjan city (n=80) in a census method.Data were collected by means of questionnaires, which included three parts; demographic, knowledge and attitude questions about complementary and alternative medicine. After collecting, the questionnaires, data were collected and entered in SPSS-16 software and were analyzed statistically by means of descriptive statistics (charts and tables) and analytical statistics (Chi-squared and Fisher statistical tests).Results: The findings of this study (n=80) showed 53.8% (n=43) had a good knowledge and 5% (n=4) had a positive attitude about complementary and alternative medicine.Conclusion: According to the findings of this study, knowledge and positive attitude of general physicians of Rafsanjan about complementary and alternative medicine is low. For promotion of their knowledge, continuous education is needed for proper attitude to be developed.

Background: The barriers to participation in cardiac rehabilitation programs are individual and economic problems and limited availability and access of rehabilitation services. Because of the important role of rehabilitation, home based exercise rehabilitation is a new approach to participate in such programs. The purpose of this study was to evaluate the effects of home-based rehabilitation on quality of life (QoL) in patients with coronary artery disease after coronary artery bypass graft (CABG) and PCI.Materials and Method: Participants included 18 CABG (3 women, 15 men) and 40 PCI (12 women, 28 men) low to moderate risk patients. Finally 17 patients in the exercise group and 16 patients in the control group remained. The SF- 36 was used to evaluate changes in QoL before and after the program.Result: forty-three percent was dropped out from the program. Before and after program, the exercise group was better in all domains of QoL (p<0.05). After 8 weeks of cardiac rehabilitation, significant improvements were observed in quality of life in both groups (p<0.05) but the exercise group showed more improvements in three domains.Conclusion: Home-based exercise rehabilitation after CABG and PCI may improve QoL and provide an efficient lowcost approach to cardiac rehabilitation. It may be helpful due to limited availability and resources in Iran. Nevertheless, for increasing participation and decreasing drop out it needs more training.

Background: The latest version of Diagnostic and Statistical Manual for Mental Disorder (DSM-IV-TR), classified internet addiction disorder under "impulse control disorder not elsewhere classified". This study evaluates diagnostic criteria of DSM-IV-TR for diagnosis of IAD correspondence with Iranian society and culture.Materials and Method: This is a descriptive-analytical and cross-sectional research. For these purpose 400 students of Isfahan universities were entered into the study. Sampling method was quota sampling.At first we performed clinical interview (based on DSM-IV-TR) for all cases, then the interviews reevaluated by another specialist. Data analysis has been done by content validity, inter-scorer reliability (Kappa coefficient) and test-retest with SPSS1-14 software.Results: Content validity of diagnostic interviews match with DSM-IV-TR criteria and their content is appropriate, two items including "chatroom pathological use" and "monthly fees for internet" were added to promote its validity.Internal reliability (Kappa) was 0.80 and test –retest reliability was r=0.74 (p<0.01).Conclusion: Results suggest that diagnostic criteria of DSM-IV-TR are valid and reliable for internet addiction diagnosis and with this clinical interview. We have a more effective way to diagnose internet addiction in the future studies.

Background: Attention to the satisfaction of recipients of medical services is an important issue. This cross-sectional study was carried out to determine the relationship between satisfaction and awareness of villagers about family-doctor program.Materials and Method : In this study, 1100 persons who were covered with the family-doctor program in rural area in Shahr-e-Kord.We used a self-made questionnaire and multi-stage sampling method. Data analyzed using chi-squared and Spearman correlation coefficient tests and p -value less than 0.05 was considered significant.Results: Awareness to family-doctor program was weak in 37.6% of peoples and 48.1 percent of them were fairly satisfied.There was a significant correlation between the knowledge of people and their satisfaction (p =0.04).Conclusion: Informing people about the main goals of family-doctor program will help to promote the quality of program and increase people satisfaction.

Background: Different forms of physical activities can play a very important role in improving health and physical fitness.The purpose of this study was to examine the effect of the programmed exercise on students’ body compositions and heart rate at rest.Materials and Method: Two groups each consisting of 15students, aged averagely 12.6 years were the subjects of this experimental study. The experimental group in each session took part in an exercise program consisting of 20 minutes of aerobic activity (running), 10 minutes of aerobic exercise, 30 minutes of local training and 5 minutes of free exercise.The experiment last for 24 sessions. Control group didn’t do any special practice.In both groups, weight, fat mass, fat percentage, lean body mass and heart rate were measured during rest period before and after the experiment.Results: Results showed that the fat percentage, weight, fat mass and heart rate had decreased after 8 weeks of programmed exercise in the experimental group unlike the control group. However, no significant difference was observed in lean body mass.Conclusion: The exercise program used in this study may help loosing weight and make the heart stronger.

Focal epithelial hyperplasia (Heck) is a rare lesion caused by human papilloma virus subtype 13 or 32 and presents as multiple small white or pink papules on the mucosal surface of lips, buccal mucosa and tongue usually seen in children and adolescent of American Indian and Eskimo background.This disease has a genetic basis. The site of new lesions and recurrence are unpredictable. Continued follow up of the patient is often necessary. In this report, a 50-year-old woman is described with benign papillomatous lesions on dorsal surface of tongue for 15 years.