Tehran University Medical Journal

Study Of The Correlation Between Plama Total Antioxidant Power And Two Immune System Functions (Lymphocyte Proliferation Response And Neutrophils Directed)

Body is exposed to oxidants and free radicals since birth. These compounds are highly reactive and react with different biomolecules. However living organisms possess an antioxidant system to face these compounds. Reactive oxygen species (ROS) in immune system cells, like other cells, are produced both as a part of the normal cell metabolism and during specific activities such as phagocytosis. By prevention of oxidative damages to different parts of immune cells, antioxidants provide the conditions for optimal immune system function.
Methods and Materials: This study had been carried out in Immunology section, Central laboratory of Iran blood transfusion organization and Immunology department of Medical sciences university of Tehran during March 1999 - October 1999. Correlation method was used in this study in which the correlation between plasma total antioxidant power and two main immune cells functions including lymphocytes proliferation response (LTT test by ELISA method) and neutrophils directed movement (chemotaxis test) were investigated. Sample population in this study were 60 healthy males and females aged 21-60. On each blood sample, plasma total antioxidant power (FRAP method), LTT, and chemotaxis tests were carried out. Then statistical spearman correlation between these variables were obtained.
Results: Our results reveal that there are significant correlations (P< 0.0001) between plasma total antioxidant power and the cited variables.
Conclusion: It seems what is important in the functions of the immune system, is the fair balance between oxidants and antioxidants level in the body thus we should be able to use this parameter to evaluate the functions of immune system in health and/ or disease situation.

Study Of Onychomycosis In Submitted Patients To The Pasteur Institute Of Iran 1993 -1999

Fungal infection of the nail, also known as onychomycosis, is a worldwide problem. It is estimated that onychomycosis constitutes 15-22 percent of all nail disorders. It is also known that 2-5 percent of the adult population in Europe have onychomycosis. This problem is quite common in the dermatology clinic of the countries in the Midle East, India and the Far East. The infection rates and types of fungi involved in onychomycosis vary with conditions such as age, sex, occupation, hygiene, foot wear and several environmental and climatic factors.
Methods and Materials: A retrospective study of nail infection was carried out in the section of Medical Mycology, Pasteur Institute of Iran from April 1993 to March 1999. Nineteen hundreds eighty five cases examined for toe and finger nail infections.
Results: Ranging in age were from 3 months to 84 years old. This study reports the causative agents of onychomycosis in the presented patients in the section of Medical Mycology, Pasteur Institute of Iran. The 1985 patients were examined for onychomycosis. Diagnosis was confirmed by demonstration of fungi in direct (K.OH 20 percent) and cultural examination. Onychomycosis were proven in 601 patients. Three hundreds fifty patients were females (59 percent). The fingernails were more commonly positive in females (73.5 percent) than males, while the toenail positivity rate in males was 69 percent. Among 601 isolated species, dermatophytes were 308 cases (51 percent) mainly from toenail were predominant. Candida SPP. Were isolated in 46 percent of the cases, especially from fingernails. Nondermatophytic molds were isolated only in 3 percent of the patients (18 cases). Most common isolated dermatophytes were Trichophyton rubrum (66.5 percent) and T. Mentagrophytes (24.6 percent). Other isolated dermatophytes were: violaceum, T. schoenleinii and Microsporum gypseum. Candida albicans were isolated in 40.9 percent of the yeast onychomycosis. Non- dermatophytyic molds were Aspergillos, Acromonium. Fusarium and Chrysosporium.
Conclusion: Onychomycosis represent 30 percent of all mycotic infections of the skin. Their promoting factors, clinical aspects and differential diagnosis have been reviewed. It is necessary to confirm the clinical diagnosis of onychomycosis by laboratory tests (direct microscopy and cultures).

The Application Of Human Amniotic Membrane In Repairmen Of Dura Mater In Dogs

This study was conducted to show the comparison of efficacy and survival of amniotic membrane grafts and homologous dura grafts.
Methods and Materials: In this study, ten dogs (age 6-9 months & weight 15 lo 20 kg) have been chosen. The study was a single blind clinical trial. The dogs have been assigned into two groups by random allocation method. The amniotic membrane (A.M) was taken from a placenta belonging to a 38 weeks fetus delivered in a cesarean section surgery. In one group the graft was a peace of dura mater and in the other one the graft was a homologous dura graft. Maintenance of all cases was the same. Forty-five days later, another surgeon who was not aware of the assignment, conducted the second exploratory surgery for evaluation of the results.
Results: None of cases in two groups had any infection, abscess formation, fistula, CSF leakage or any toxic status. The healing process was normal in both groups.
Conclusion: There seems to be no difference between the (A.M) grafts and homologous dura in the repairmen of dura mater. This is expected to occur only if the pregnant woman is carefully tested for the presence of certain clinical conditions and the preparation of A.M is contemplated in an ideal environment.

Clonidine Reduce Bleeding Of Endoscopic Sinus Surgery Amir Alam Hospital (1398-2000)

This study was conducted to evaluate effect of clonidine as a premedication on endoscopic sinus surgery bleeding.
Methods and Materials: during a randomized double blind clinical trial we compared two groups of patients who scheduled for endoscopic sinus surgery for polypectomy and etmoidectomy. 216 patients randomly assigned in two groups.In first group 2 hours befor surgery a 0.2mg tablet of clonidine orally adminestered to patients and in second group a 100 mg tablet of vit Bj(with same size and color- as
placebo)was adminestered to patients. The amount of bleeding measured in two groups.
Results: mean bleeding volume in clonidine group was 113+76 ml and in control group was 211 + 113 ml. There was a significant statistical difference between two groups (pO.0001).
Conclusion: Clonidine as premedication can reduce bleeding of endoscopic sinus surgery significantly.

Coma Etiologies And Its One-Month Outcome Sina Hospital (Year 2000)

Defining the patient outcome and decision making about allocation of our limited fund and technology for comatose patients depends on our knowledge about frequency and outcome of various coma etiologies. We determined the various coma causes frequency and one-month outcome of non traumatic coma. . In addition the co existence of the primary neurologic signs with the one-month outcome of non traumatic coma was defined.
Methods and Materials: Our study is based on 130 comatose patients in a one-year study in Sina Hospital that consisted of 80 non traumatic and 50 traumatic patients.
Results: 74% of the cases were men and 26% were women. The most common etiology of coma was trauma (38.5%). The other common etiologies were cerebro vascular diseases (25.4%), cancer (10%) and hypoxia-ischemia (8.5%). The most common cause of coma in men was trauma (46.9%) while the vascular diseases were the most common etiology of coma in women (41.2%).In under 40 year patients trauma was the cause of coma in 57.5% of cases in respect to 28% in above 40 cases. On the other hand, vascular diseases and malignancies were the etiology of coma in 15% of under 40 year patients and 46.5% of above 40 year patients. Among traumatic etiologies of coma, subdural hematoma was the most frequent (40%). In our research none of patients who did not have one of pupillary, oculocephalic or motor reflexes in the 3rd and 7th day of the onset of coma had acceptable outcome after one month. With consideration of pupillary, corneal, oculocephalic and motor reflexes in combination, loss of at least two of them in the 3rd and 7th day accompanied with no acceptable outcome. On the other hand the presence of three or more reflexes in the 3rd and 7th day of coma was a good prognostic factor, with 80% and 88.9% chance of acceptable recovery respectively.
Conclusion: According of the study, the best time for prediction of outcome in a comatose patient, is the third or seventh the day after the onset of coma. Also relay on combination of brain stem reflexes, gives us more acceptable result.

Prevalence Of Depressive Disordrs In Tehran Resident Population (year 2000)

Depression is a debilitating disease that every one is likely to experience over a short or long term period of his or her life.

Methods and Materials: This study aimed to examine the one - month prevalence of anxiety and depression in Tehranian resident population. 1070 men and women (age 20-65) were screened by Beck Depression Inventory (BDI). Then, those who scored above the cut - off point were psychiatrically interviewed. The interviewers were blind to the respondents' scores on BDI 5% of the total sample were also added to the list of those to be interviewed. Interviewers were the third year psychiatric residents at Roozbeh hospital. Tehran, especially trained for this research's purpose.

Results: The results showed women (BDI- 12.16) are more depressed than men (BDI- 8.47). Furthermore, men (%16.7) were less likely to have depession disorders than women (% 30.50).

Conclusion: We will discuss discrepancies between (the present results and the results from previous research by others).

Predisposing Factors In Patients With Silent Myocardial Infarction Farabi Hospital (2000)

Myocardial infarction sequel of coronary artery diseases, can be sometimes asymptomatic, called silent myocardial infarction. Some risk factors predispose the patients to this condition. In this study, we intend to determine the predisposing factors in such patients.
Methods and Materials: We included those patients with electrocardiogram changes, consistent with myocardial infarction, who had not any symptoms of ischemia or a previous history of coronary artery disease, consulted for preoperative work up of eye surgery during the year 2000.
Results: We analyzed 100 patients with the diagnosis of silent myocardial infarction. (59 males and 41 females). Among our patients. 99 percent were above age 50 years of age. Their mean age at the time of study was 69.7 years. 78 percent of patients were illiterate. In 41 of them body mass index was above the normal limits (overweight and obese). Their past medical history revealed that 46 patients had hypertension, 38 patients had hyper-lipidemia. and 26 patients had diabetes mellitus. Also, a positive family history of coronary artery disease was seen in 52 percent of the patients. The rate of cigarette smokers and opium addicts, among our patients, was 33 and 13 percents. respectively. Analysis of electrocardiogram changes, showed that 43 patients had inferior myocardial infarction, 24 had antero-septal. and 17 of them suffered from anterior myocardial infarction.
Conclusion: Almost all of our patients with silent myocardial infarction were in old age group. Diabetes mellitus, hypertension, overweight, hyper-lipidemia, and a positive family history of coronary artery disease were the most important predisposing factors, found in such patients, thus taking into account these predisposing factors and control of them would dramatically reduce the prevalence of morbidity and mortality of silent myocardial infarction.

Comparison Of Oral Premedication With Combination Of Midazolam With Ketamine Vs Midazolam Ketamine Alone In Children Children Medical Center (year 2000)

Anxiolysis and sedation with oral midazolam are common practice in pediatric anesthesia. Good or excellent results are seen in only 50% to 80% of cases, so we decided to investigate if addition of a low dose of oral ketamine to midazolam (ketamine2.5 mg /kg ^midazolam 0.25 mg/kg )resulted in better premedication compared with oral midazolam 0.5 mg/kg or ketamine 6 mg/kg alone.
Methods and Materials: in a prospective, randomized ,double -blind study we study 105 children (mean age 6 ,range 2-10 yr. ) undergoing non thoracic and non cardiac surgery of more than 30 min duration. The patients were in ASA 1, 2. After oral premedication the child's condition was evaluated by assigning 1-4 point to the quality of anxiolysis, sedation, and separation from parents in the induction room .The groups were similar in sex, age, weight, intervention and duration of anaesthesia.
Results: The score of sedation before transfer to the operation room was significantly better in the ketamine, midazolam combination group than in the ketamine or midazolam group. Success rates for anxiolysis and behavior at separation were grater than 90%with the combination, approximately 80% with midazolam and 70% with ketamine alone .The incidence of salivation, excitation, nausea and vomiting was grater in the ketamine group but were very low in other groups. During recovery there were no difference in sedation or time of possible discharge.
Conclusion: In summery, significantly better anxiolysis and separation were observed with a combination of ketamine and midazolam, even in awake children than with midazolam or ketamine alone. Duration of action and side effects of the combination was similar to those of midazolam.