Iranian Red Crescent Medical Journal
Year:2005 | Volume:8 | Issue:1|Papers Count:14

Background: Some labiatae family plants show antinociceptive activities. Melisa officinalis belongs to this family, thus antinociceptive activity of the aqueous decoction and ethanolic maceration extracts of the aerial parts of this plant studied in mice. Results: Antinociceptive activities were done using hot-plate and writhing tests. In hot-plate and writhing tests, the intraperitoneal injection of both extracts showed significant antinociceptive activity in mice. Naloxone, an opioid antagonist, pre-treatment, inhibited the antinociceptive activity of the extracts in hot-plate test. The extracts exhibited antinoceceptive activity against acetic acid induced writhing which was partially blocked by naloxone. Conclusion: It is concluded that the aqueous decoction and ethanolic maceration of the aerial parts of M. officinalis has antinociceptive effects and this may be mediated partially by opioid receptors.

Objectives: The polygenic mode for inheritance of Vesicoureteral Reflux (VUR) is a debutable issue. Our study is aimed to investigate the correlation between HLA system and VUR. Materials: The study included thirty patients with VUR and sixty patients from kidney donors as control group. Initially the HLA formulas of each patient were detected according to racialgeographical distribution as well as common and specific antigens. Then, the Relative Risk (RR) for the class I antigens of the HLA system was calculated and the X2 statistical test was performed for the antigens with RR>1 to establish a significant association between HLA system and VUR.Results: Increased frequency of the genes HLA-A9, HLA-B44 were characterized by statistical analysis (RR>1, X2>3.84). Therefore, the significant correlation was found between VUR and HLA system (P<0.05).Conclusion: There are significant correlation between VUR and HLA-A9 and HLA-B44. However, more study is necessary that these genes may become markers for VUR.

Background: Recombinant human erythropoietin (EPO) is known to accelerale erythropoesis in preterm infants. This study was designed to access of EPO in treatment of anemia of prematurity.Materials and Methods: Preterm infants with hematocrit less than 30% when they were between 2 to 3 weeks of life, were divided randomly in two groups, each group include ten babies. The mean gestational age in control group was 31±1.65 weeks and birth weight was 1450±200 grams and in case group was 31±2.12 weeks and birth weight was 1370±211 grams. Infants in case group received EPO 400 u/kg twice weekly for 4 weeks. All infants in control and case group were fed human milk and supplemented with entral iron. Vitamin E and folic acid prophylaxy. Levels of hematocrit and reticulocvtes were determined for each infant at the beginning of the study, 3 days after treatment and one week after the end of treatment.Results: The groups had significant differences in hematocrit and reticolocyte count at the end of study (P<0.001) and P=0.024 respectively). In control group the prophylactic iron, vitamin E an folic acid supplementation was not sufficient to prevent anemia and we found a significant decrease in hematocrit  level at the end of study (P<0.0001).Conclusion: We concluded the early treatment of anemia of prematurity with recombinant human EPO plus iron, vitamin E and folic acid increase hematocrit and retyculocyte in preterm infants. If we can minimize blood sampling for laboratory analysis in preterm infants, treatment with EPO will reduce the need for blood transfusion in these infants.

Objective: The aim of this study was to determine the rate of blood culture contamination, to describe and compare the epidemiologic, clinical and microbiological characteristics of hospital-and community-acquired stream infections.Methods: In this survey during one year (2002-2003) all patients over 18 years of age admitted in different hospitals for whom blood culture were drawn, were included. In the cases that positive blood cultures were drawn more than 72houra after the patients had been admitted to the hospital or if the patients had been recently discharged from the hospital the infection was classified as hospital-acquired. If the cultures were drawn within 72 hours after admission to the hospital, the infection was classified as community-acquired. Severity of illness was categorized as non-fatal, ultimately-fatal, and rapidly-fatal according to McCabe and Jackson groups. For determining the susceptibility of isolated bacteria to the used antibiotics in the hospitals, Kirby-Bauer disk diffusion test was used and the results were reported.Results: The rates of positive blood cultures associated with significant bacteremia and contamination were 43.4%, and 21.7% respectively. Of the 168 episodes of bacteremia, 70.8% were hospital-acquired, and 29.2% were community-acquired. The most commonly isolated microorganisms were Staphylococci (49.6%), Escherichia coli (19.3%) and Klebsiella (16%) in hospital-acquired infection, and Pneumococci (24.5%), Brucella spp (20.4%) and Escherichia coli (16.3%) in community-acquired episodes. Mortality rate was 26.5% in hospital acquired and 17.2% in community-acquired infections. Fetal underlying diseases, severity of illness, severe sepsis, bladder and intravenous catheters, severity of illness, severe sepsis, bladder and intravenous catheters, previous usage of antibiotics, previous surgery and tracheal intubation were found to be associated with death in hospital-acquired infections.Conclusion: Nosocomial infections are more severe than others and antibiotic resistant bacteria will continue to challenge all who care for patients with blood stream infections.

Background: Hip fracture, the most serious complication of osteoporosis, burdens lots of costs on any health providing system. Previous reports on rates of hip fractures in Asian countries used to differ a lot. The aim of this study was to estimate incidence rate of hip fractures in the city of Shiraz, Iran.Methods: All operating room logs with the diagnosis of hip fracture were reviewed for hip fractures proceeded by a simple falling down in patients over 50 years, between 21st of March 2000 to 21st of March 2003. According to patients medical records, age, sex, type of fracture (intertrochanteric, neck, subtrochantheric) and patients residency regions regarding to Shiraz municipality division were obtained.Results: The age adjusted incidence rates of hip fracture comparing to the United States population records in 1985, (325.74/100000 for men and 519.05/10000 for women) and to the United States population records in 1989 (384.61/100000 for men and 548.17/100000 for women) was the highest in Asia. The intertrochanteric fracture was significantly higher among females (P=0.003). The incidence of intertrochanteric and neck fractures were increased with age. In all the age groups, females had more incidence rates of fractures except of the ages of over 80, in which males had more incidence rates than females.Conclusion: High incidence rate of hip fractures in our population especially in our males of over 80 shows that preventive strategies for hip fractures and osteoporosis should be considered in males as well as females. Further studies are needed to fine this incidence rate in other cities especially city of Tehran.

Background: Postoperative pain is a common problem suffering the patients after knee surgery. Treatment with intra-articular corticosteroid proparation has been advocated but the value of this approach had not been established. We compared the efficacy of intra-articular dexamethasone plus bupivacaine with the efficacy of intra-articular bupivacaine alone to prevent post-operative pain after meniscectomy.Methods: Sixty ASAI patients undergoing meniscectomy with general anesthesia were randomly assigned to receive intra-operative intra-articular bupivacaine, bupivacaine plus dexamethoasone, or placebo under double blinded condition. The goup 1 (n=20) received 10 ml of buplivacaine 0.5% with epinephrine 1:2000000, group 2 (n=20) received 8ml bupivacaine 0.5% with epinephrine 1:200000 plus 2ml (8mg) dexamethosone and group 3 (n=20) received 10ml of normal saline. The patients were evaluated until 12 hours after the operation and pain levels at rest measured by a Visual Analogue Scale (VAS).Results: During the first six hours after the operation, both combination of bupivacaine and dexamethasone and bupivacaine alone significantly reduced patient’s pain (P=0.000) and during six to twelve hours after operation the patients in dexamethasone group had significantly lower pain scores comparing to other group (P=0.037). The low pain scores were associated with lower requirement of supplementary analgesics (P=0.000).Conclusion: Combination of intra-articular dexamethoasone and bupivacaine significantly reduces post-poertive pain and consumption of analgesics following meniscectomy than intra-articular bupivacaine alone.

Background: Surgeries on hypophyseal tumors and other sellar lesions are among the most common practice of otolaryngologists and neurosurgeons. The present article reviewes historical evolution in endoscopic approach to sellar lesions and introduces a new lechnique to get easy access to sella turcica through a much safer and even less invasive approach.Materials and Methods: For this article, we have searched in medical literature by means of various keywords such as pituitary adenoma, surgery, endoscopy, endoscopic hypophsectomy, complication, pituitary surgery, etc. Finally, We introduce our new technique to approach sella turcica.Conclusion: We believe that the new approach could significantly reduce complications and associate with further patient’s convenience.

Objectives: To identify the factors that are associated with the development of scoliosis and its manifestations.Summary of the background data: Painful scoliosis is a well-recognized presentation of osteoblastoma but as a result of small number of previous reports the outcome and habits of tumor in spine is not well-known.Methods: Ten factors were assessed including: age, sex, duration of symptoms, site of the lesion in individual, Cobs angle at presentation, chief complaint at presentation, neurological involvement, type of treatment, recurrence of tumor.Results: Fifty Percent of patients had scoliosis. All of the lesions typically were present on the concave side of the curve. In the thoracic and lumber spine 80% had scoliosis, but no scoliosis was seen on cervical and sacral regions.All the patients were under 30 years. The mean time to diagnose at our center was 18.4 months. All of the patients with cervical involvement (2 patients) had deformity (Cock Robin) and restriction in range of motion. The lesion was in posterior elements in all of the cases and localized in only one side of the spine. Chief complaint was pain in 67%, deformity in 16% and both (pain and deformity) in 17%. Radiological exam was diagnostic in 58% of the cases.Conclusions: Findings support the concept that scoliosis is secondary to asymmetric muscle spasm. The most common complaint is pain and then deformity. In the cervical spins deformity and restriction of motion are chief complaints.In children, spastic pain was more obvious than deformity. Treatment is curettage as wide as possible. There was no recurrence.

Surgical site infections are the second most common nosocomial infections. As surgical site infection is the cause of significant mortality and morbidity in patients, recognition of risk factors and routs of decreasing their incidence is of considerable value. In this study, 1383 orthopaedic operations, which were conducted from 1999 to 2000 in Shariati Hospital, were reviewed. There were two groups of patients: In the first group, the patients were shaved on the day before operation and in operating room, after application of betadine 7.5%, the patients were painted with betadine 10% before the operation. In the second group, shaving and painting (without scrub) was done in the operating room just before surgery. The prevalence of surgical site infection in these two groups was recorded. Statistical analysis with T-test and Chi-square methods revealed that although overall surgical site infection prevalence in two groups was the same, but the prevalence of deep infection in group twp was significantly lower than that of group 1 (P<0.01). This difference leads to a decrease in therapeutic cost of approximately 560000000 Riyals each year in this country.

Background: To evaluate the correlation of lipoprotein (a) as a risk factor for accelerated atherosclerosis with intimae-media thickness of carotid artery as a sign of atherosclerosis in chronic renal failure patients, not yet on dialysis, hemodialysed and kidney transplanted patients.Methods: One hundred-thirty subjects consist of (group 1) 29 normal healthy person, (group 2) 33 chronic renal failure not yet on dialysis, (group 3) 43 hemodialysed patient and (group 4) 25 kidney transplanted patients were evaluated for carotid-intimae-media (IMT) sonography and some laboratory analysis. IMT mort than 0.8 mm and Lp(a) more then 39 mg/dl were considered abnormal.Results: There was significant difference of Lp(a) between control group and group 1 and 3. Scheffe test showed a significant difference of IMT between normal subjects and CRF group, HD group and kidney transplanted group. Moreover the study showed significant difference between IMT of CRF patients with HD group. There was a significant correlation between IMT and age in group 1, group 2 and group 3, no significant correlation between IMT and age in group 4 was found, no significant correlation between constant variables (LDL-c, HDL-c, LP(a), Tg, chol, sex) with IMT (dependent variable) in group 1 and 3 were found. No association between IMT with other lipids (chol, Tg, LDL-c, HDL-c), sex and duration of disease in group 2 and 3 were found. In group 4 only the positive correlation, was between IMT and LDL-c.Conclusion: This study showed positive correlation of lipoprotein (a) with IMT only in hemodialysed patients, which showed effects of dialysis on acceleration of atherosclerosis, and the most important factor in association with thickening of intimae-media complex in normal, FRF as well as hemodialysed and kidney transplanted groups.

Background: Zinc and Copper are those trace elements which are necessary for human growth and biological functions. Concentration changes of these elements in the body are clinically important. This research has been set up to study the possibility of zinc and copper variations after haemodialysis, and to determine the serum zinc and copper concentrations before and after heamodialysis.Methods: This project is a comparative, non-experimental study. The sample population was 50 of haemodialized patients chosen randomly from the patients referred to Azar hospital in Gorgan in the year of 2003 (33 male and 17 female). The concentration of serum urea, creatinine, and copper of these patients were determined before and after dialysis, and were analyzed by SPSS software suing the Wilkacson tests. Results: The results of this research indicates that the average concentration of zinc and copper in haemodialized patients after dialysis were 135.32 59.32 and 136.40 51.25 microgram/deci litre respectively which is markedly increased in comparison to the serum concentrations of these trace elements before dialysis which were 78.38 37.46 and 89.92 32.54 microgram/deci litre respectively.Conclusion: In this study the average increase in concentration of zinc and copper after the process of dialysis among the haemodialized patients had a meaningful statistical variation (P<0.001). Uremia, quality of dialysis membrane and quality of water used for the process of dialysis could be a reason for increase in concentration of zinc and copper.

Background: Astrocytic tumors are the most common primary CNS tumors. The grading of the astrocytomas has been traditionally relied on histologic assessment, but sometimes its still a subject of debate. This study used MIB-1 monoclonal antibody, a proliferative marker that can be used in formalin fixed paraffin embedded tissue to evaluate its capability for differentiating between different grades of astrocytomas.Patients and Methods: Ninety cases of low grade astrocytoma, anaplastic astrocyloma and gliboblatoma (30 cases of each) were selected from total 236 cases of astorcytomas during a period of 1994 to 2003. Histologic grading of the tumors was performed based on WHO classification. The proliferative potential of the tumors was estimated by counting mitosis and using the MIB-1 Ll performed on paraffin sections. Variety of analysis methods were used to evaluated difference in MIB-1 Ll between the tree groups.Results: The mean MIB-1 Ll was 10.13 (range: 1 to 63) in low grade astrocytomas 48.75 (range: 2 to 366) in anaplastic astrocytoma and 238 (range: 6 to 532) in glioblastoma. The mean of mitotic count was 0.133 (range: 0-3), 2.93 (range: 0-23) and 11.66 (range: 1 to 34) in 1000 counted unclei in low grade astrocytomas, anaplastic astrocytoma, and glioblastoma respectively. Multivariate analysis showed that after omission of effect of age which was significantly higher in glioblastoma, there is a meaningful difference between mean of MIB-1 Ll of the three groups (P<0.000).Conclusion: This study suggests that MIB-1 Ll can be used as an adjuvant to histopathogic grading for proper diagnosis and grading of astorcytomas especially in borderline cases and small biopsies. Due to high heterogencity of this value, determination of cut off point is impractical.

An eleven-year-old girl was seen in December 2001 because of a lender swelling on the medial aspect of her left great toe. She related the swelling to a trivial trauma happened six month ago. The personal medical history revealed no relevant information and the family history was negative for important congenital or hereditary diseases.Physical examination of the left great toe showed a localized swelling over the dorsal aspect of the toe, which was tender, reddish and warm. Range of motion of the toe was normal and neurovascular examination did not reveal any abnormality.Plain radiograph of the toe showed no fracture or bony abnormalities. Laboratory investigations consisting of full blood count, blood sugar, serum electrolytes and urinalysis showed a leucocylosis of 11,200/ml and the other features were within the normal range.The provisional diagnosis of this swelling was a soft tissue abscess, for which she was taken to the theatre for incision and drainage. Under general anesthesia and without using tourniquet the lesion was incised directly. There was no pus collection and two lobulated, bluish soft tissue masses appeared over the proximal phalanx of the great toe, having no attachment to tendons, bone or other adjacent structures. The specimens were sent for histopathology examination to two different laboratories. The wound healed within 10 days postoperatively.The histopathology reports were received six days later with the following details…..

Primary appendiceal lymphoma is rare and seldom reported in the literature in this age. It is mostly of B-cell nonHodgkin’s type. Most of the cases in the prior reports were in men and the elderlies. Our case is a unique, according to the age which is 15, Our patient was presented with abdominal pain and signs and symptoms of acute appendicitis. After operation pathology specimen showed an appendicular mass of four centimeter in diameter. Histological and immunohistochemical study showed a diffuse large B-cell lymphoma. He received chemotherapy and now he is in good condition after two years....