Tehran University Medical Journal

Investigating the effects of 217 Hz frequency of cell phone on learning and spatial memory in rats

Bolouri B

Background: Extremely low frequency (0-300 Hz) fields from power lines, electronic equipment and medical devices, have been reported to produce various biological effects. Global system for mobile (GSM) is most largely used in everybody's life. This system utilizes a low frequency band as well as a high frequency range of electromagnetic field. This study investigated the effects of 217 Hz electromagnetic field (the modulating signal in GSM) on spatial learning and memory in rat.
Methods: Twenty four male Wistar rat (200- 250 g) were randomly divided in to three groups as: test, sham and control. Using a Helmholtz coil system, the test group was exposed to a uniform pulsed EMF of 200 µT (micro Tesla) intensity for 4 h/day for 21 days (2 time in a day). This procedure was repeated for the sham group but with no field. All groups were trained prior to the day 21 on the 15th day for five days four trial per day in Morris Water-Maze system. Then the probe test was carried out for 60 seconds with no platform.
Results: The ANOVA test revealed that no significant differences were found between control and exposed rats in all day of learning acquisition. Also, in probe test for investigating the memory, no significant differences observed. (P≤0.05 is accepted for significant level.
Conclusion: This finding is in consistent with previous studies and indicates low frequency band of electromagnetic fields (EMF) (200 µT intensity) in cell phone may not have any effect on the learning acquisition and spatial memory in rat.

The effect of cytosolic extract of Alternaria aternata fungus on Monocyte-derived dendritic cell maturation and T-lymphocyte polarization in the presence of myelin basic protein

Loghmanni A

Background: Multiple Sclerosis (MS) is an autoimmune disease with impairment in function of central nervous system. Macrophages and dendritic cells play important roles in alleviating or progression of the disease. These cells can cause inflammation and damage to the myelin of nerve cells by realizing of harmful substances when these cells get matured. We studied the effect of Alternaria alternata extract on maturation of monocyte- derived dendritic cell (modc) and T-cell responses in the presence of Myelin Basic Protein (MBP) as a laboratory model of multiple sclerosis (MS). The purpose of this study is suitable dendritic cells production for usage in MS immunotherapy.
Methods: For this study plastic adherent monocytes were cultured with granulocyte/ macrophage- colony stimulating factor (GM-CSF) and interleukin -4 for converting these cells to modc and pulsed with MBP and matured in the presence of monocyte-conditioned medium (MCM) in control group and MCM + Alternaria alternata extract in treatment groups. Anti-CD14, anti-CD83, anti-human leukocyte antigen-DR (anti HLA-DR) monoclonal antibody were carried out for phenotyping. Autologos T cell responses and cytokine production were evaluated.
Results: The results showed that the expression of CD14 decreased and CD83, HLA-DR increased in treatment groups in comparison with control groups. The production amount of IL-10 overcame IL-12 and in T cell the production of cytokines, IL-17 and Interferon-γ (IFN-γ) decreased and IL-4 was increased (P<0.05). These effects escalated with increasing of dosage from 50 to 100 (mg/ml) (P<0.001).
Conclusion: Alternaria alternata extract can cause maturation of MBP-pulsed modc and skewing of T- lymphocyte toward Th2 and thereby can evolve into a new strategy in immunotherapy of MS.

Isolation of melittin from bee venom and evaluation of its effect on proliferation of gastric cancer cells

Morady A

Background: Gastric cancer (GC) is one of the most common cancers worldwide and in Iran. Conventional therapies are surgery and chemotherapy. Current studies are evaluating natural compounds in inhibiting growth of cancer cell. In this study isolated peptide melittin with 26 amino acids from bee venom and its impact on the viability and proliferation of gastric cancer cells was investigated.
Methods: At first melittin was purified from honeybee venom using a reversed-phase high performance liquid chromatography (RP- HPLC) and C18 column. In order to investigate whether melittin, a 26 amino acids peptide which is the main components of honeybee venom, inhibits proliferation of human gastric adenocarcinoma cell line (AGS cells), MTT ((3-(4, 5-dimethylthiazol-2-yl)-2, 5- diphenyltetrazolium bromide) assay was performed. Hemolytic assay carried out in order to confirm the biologic activity of the isolated melittin. AGS cells were plated in a 96-well plate and treated with serially diluted concentrations of melittin for 6 and 12 hours. The mortality of the cells was measured via MTT assay at 540 nm.
Results: The obtained chromatogram from RP-HPLC showed that melittin comprises 50% of the studied bee venom. SDS-PAGE analysis of melittin fraction confirmed purity of isolated melittin. Hemolytic activity assay indicates that isolated melittin shows a strong hemolytic activity (HD50=0.5). MTT assay showed that melittin strongly inhibits proliferation of gastric cancer cells at concentrations more than 2µg/ml. This inhibitory effect is dependent to melittin concentration and incubation time.
Conclusion: This study provides evidence that melittin inhibits proliferation of the gastric cancer cells. Results showed that isolated melittin from honey bee venom have cytotoxic effect on AGS cell line with a trend of increasing cytotoxicity with increasing concentration and incubation time.

Maternal factors in newborns breast feeding jaundice: a case control study

Sepahran M

Background: Neonatal jaundice, especially breast feeding jaundice is one of the most common causes of neonatal readmission during the first month of life. Breast feeding jaundice may be due to decreased milk intake with dehydration and/or reduced caloric intake. The aim of this Study was to determine maternal risk factors of breast feeding jaundice in order to prevent it than before.
Methods: This case- control study was performed at Bahrami University Hospital, Tehran, Iran and involved 75 term exclusively breast fed newborns admitted for hyperbilirubinemia, with a weight loss greater than 7%, with one positive lab data as: serum Na&ge 150meq/lit, urine specific gravity> 1012, serum urea&ge 40mgr/dl, without assigned cause for hyperbilirubinemia. They were compared with 75 matched controls with weight loss less than 7%, without dehydration and a known cause of hyperbilirubinemia.
Results: In comparison with control group, in neonates with breast feeding jaundice, inappropriate feeding practice (P<0.033), delayed onset of lactation (P<0.0001), inverted nipple (P<0.001) were significantly higher. In our study, there was no significant difference between two groups in education level of mother, learning breast feeding practice before and after delivery, method of delivery (cesarean or vaginal delivery), primiparity or multiparity and use of supplements (water or glucose water).
Conclusion: This study shows need for special attention and follows up of mothers and neonates at risk for breast feeding jaundice, especially those with inverted nipples or undergraduate for successful breast feeding. On the other hand this study shows encouraging mothers for early lactation especially in the first hour of life decreases the risk for this kind of jaundice.

Intralipid efficacy in decreasing Amphotericin B associated nephrotoxicity

Dehghan Manshadi SA

Background: Amphotericin B Deoxycholate (ABD) has been the best therapeutic agent for treatment of most systemic fungal infections. However, untoward adverse effects like nephrotoxicity may limit its appropriate therapeutic use. We studied administration of fat emulsion early after infusion of ABD to evaluate its effects on ABD-associated nephrotoxicity.
Methods: This study was a randomized clinical trial. Patients with fungal infections admitted in Amir-Alam and Imam-Khomeini University Hospitals, Tehran, Iran, entered the study during 1390- 1391. The patients were randomized to intervention and control groups. In both groups, patients received 1mg/kg/day ABD in dextrose 5%. In intervention arm, the patients additionally received intralipid 10% daily that was started as soon as possible within one hour after infusion of ABD. ABD-associated nephrotoxicity (a minimum 50% increase in baseline serum creatinine to a minimum of 2mg/dl), daily serum creatinine changes during first two weeks of treatment and some other relevant indices of renal function were compared between groups. ABD-related hypokalemia was also compared as an additional target.
Results: Thirty one patients entered the study. ABD-associated nephrotoxicity and values of other relevant indices of renal function were not different between intervention and control groups (P>0.05). Daily changes in serum creatinine level within first two weeks of treatment in both groups were not also statistically different (P=0.62). Furthermore, ABD-related hypokalemia was not significantly different between groups (P=0.47).
Conclusion: Administration of intralipid 10% early after infusion of ABD in dextrose 5% does not have any effect in decreasing ABD-associated nephrotoxicity. Moreover, it does not have any significant effect on ABD-related hypokalemia.

Percutaneous endoscopic gastrostomy technique: the outcome and complications

Ramim T

Background: Percutaneous endoscopic gastrostomy (PEG) is one of the ways to non-oral feeding in patients with dysphagia caused by conditions such as stroke, oropharyngeal malignancy and motor neuron disease. The aim of study was assessment of early outcome of PEG in hospitalized patients according to clinical situation and underlying disease.
Methods: This study was cross- sectional and prospective. Sixty five patients were included with PEG from April 2011 to July 2012, at Sina University Hospital, Tehran, Iran. Tube function, feeding, and patients' symptoms were assessed and patients were followed six month at least to one year after procedure .The follow up of patients were stopped if the patient died or removal of tube.
Results: Sixty five patients (33 men, 32 women) enrolled in this study. The mean age of patients was 57.45±16.83 years (19-94 years). Head trauma and postoperative thoracic surgery were in 15 (23.1%) and 4 (6.2%) cases. 36 of patients (55.39%) had no symptoms. The complications include lickage (11 cases), stenosis (9 cases), cellulitis (7 cases), and PEG separation (2 cases). A total of 29 patients were complicated and 21 patients (72%) of them complicated 2 -5 months after PEG. No statistical significant differences between two sexes in PEG complication. 27 patients (41%) died that have no relation to complications of PEG.
Conclusion: Finally, the study showed the PEG is a safe method to enteral nutrition. The advantages of this method include its simplicity, no need to general anesthesia and low rate of complications especially in inpatient under the supervision of medical staff. Therefore it can be used as a favorable method.

The relation of increasing serum bilirubin during 24-48 hours of birth and birth season

Sajjadian N

Background: The relationship between season of birth and human diseases is well known and such a relationship could be mediated by seasonal and environmental effects on early events of extrauterine life Empirical neonatological experience suggests that prevalence and degree of neonatal jaundice might be dependent on seasonal variation, mainly due to the sunshine duration. However, evidence based data on this issue are scarce. Thus, we have analyzed the seasonal effect on the rise of serum bilirubin level during the neonatal period.
Methods: A prospective cohort study was done on a sample of 629 term and healthy infants born consecutively in Shariati Hospital, Tehran, Iran, during the years 2008-2009. The cord bilirubin level and then the serum bilirubin level near to 48 hour of age were measured. Seasonal differences in rise of serum bilirubin were studied.
Results: Rise of serum bilirubin in spring was 3.951.4 mg/dl, in summer 3.761.69 mg/dl, in fall 3.511.60 mg/dl and in winter 4.791.99 mg/dl. Serum bilirubin level in cord blood did not appear to be correlated with season of birth. After correction for the possible effect of these variables the relation between season of birth and rise of serum bilirubin remained significant. The rise of serum bilirubin in winter was significantly higher than other season (P<0.0001).
Conclusion: Season acts as an independent etiological factor of neonatal hyperbilirubinemia. Mean rise of serum bilirubin in winter is higher than other season. This provided information to improve education for nurses in identifying risk factors and the prevention of hyperbilirubinemia readmissions.

Staphylococcal superantigens toxic shock syndrome toxin-1 and enterotoxins in pediatric otitis media effusion: a brief report

Noorbakhsh S

Background: Staphylococcal superantigens (SAg&aposs) may have some role in otitis media with effusion (OME). The aim of this study was the search of staphylococcal SAg&aposs in middle ear effusion of children with OME.
Methods: This cross sectional-analytic study was done in ENT & pediatric wards upon 64 children with otitis media with effusion (OME) between 1-15 years, (mean age=7.42+4 years) of Rasoul Akram University Hospital, Tehran, Iran in 2009-2011. Fifty six percent (36) of cases were male, 43.8% (28) were female. Staphylococcal SAg&aposs Toxic Shock Syndrome Toxin-1 (TSST-1), Staphylococcal enterotoxin A, B, C, D (Enzyme immune assay, AB Cam, USA) were detected in middle ear effusion samples after conventional culture.
Results: None type of SAg&aposs found in 39% of OME cases, enterotoxin B found in: 22% enterotoxin A: 17%, enterotoxin C: 15.6%, enterotoxin D: 12.5%, Toxic Shock Syndrome Toxin-1 (TSST-1): 7.8% Mean age of cases with positive TSST-1, enterotoxin A, B, C, and D was: 1, 5, 8.6, 9.6 and 9.6 years respectively. Positive TSST had no agreement with positive enterotoxin A and C but had weak agreement with type B and D. Mean age of cases with positive TSST was one years which had significant difference with (7.9 years) in cases with negative TSST test (P<0.0001).
Conclusion: At least one or more type of staphylococcal toxins had found in middle ear effusion of 70% of OME cases with negative culture for Staphylococcus aureus. Even in culture negative cases, staphylococcal toxins might have some immunologic role in middle ear effusion forming. Finding the SAg&aposs (at least one type) are important for treatment of immunosuppressive or corticosteroid in cases with resistant OME.

Uterine rupture following incomplete molar pregnancy: a case report

Ayati S

Background: In molar pregnancy, when hydatidiform changes are local and some embryonic components are observed, the term of partial mole is used. The risk of persistent trophoblastic tumor after partial mole is much lower than complete mole. In this persistent cases almost all are non metastatic. The aim of this study is to report a case of uterine rupture following incomplete molar pregnancy.
Case presentation: The patient was a 26 year old woman with obstetric history of an abortion and one molar pregnancy and no child. She was referred to emergency unit in Ghaem University Hospital, Mashhad, Iran in May 2011. She had an evacuation curettage following molar pregnancy three months before and without any follow up visit. The patient was referred to emergency unit with hemorrhagic shock. She immediately underwent laparotomy. The uterine fundal rupture was repaired and evacuation curettage performed. In post operative evaluation, she had a nine millimeter metastatic nodule in base of right Lung. As a patient in low risk stage III, she received weekly intramuscular methotrexate (40mg/m2) for six courses. In follow up visit -hCG titer was negative (<10miu/ml) at 5th week.
Conclusion: In cases of in complete molar pregnancy risk of metastasis is very low. Serial beta-hCG titer is the most accurate method for detection of persistent gestational trophoblastic disease (GTN). In neglected cases like this case preservation of ruptured uterus in GTN is possible.

Proximal onychomycosis due to Malassezia furfur: a case report

Hashemi SJ

Background: The etiologic role of Malassezia furfur in onychomycosis, because of its controversial keratinolytic ability, has not been proven. The most reported cases are distal subungual onychomycosis (DSO). In our knowledge no cases of proximal onychomycosis (PO) has been reported. For the first time we report proximal onychomycosis. This case report describes the isolation of Malassezia furfur from fingernails.
Case presentation: An Iranian 56- year- old women had been referred to mycology lab with hyperkeratosis in proximal regions of right hand nails and clinical diagnosis of onychomycosis without paronychia in May 2012. She used several medicines for her cardiac disease, mental illness, severe stress and blood glucose fluctuation diseases. Scraping and sampling from nail lesions were done, budding yeast cells with broadband connections were observed in 15% KOH wet mounts. Also, other differentiation tests, consist of staining with methylen blue, cultures and biochemical tests were done. In order to rejecting the probable etiologic role of any dermatophytic or non-dermatophytic fungi in this case, samples were collected from other parts of the body by scotch tape and scraping with scalpel blade too, but the results of direct microscopy and culture were negative. Finally, Malassezia furfur was identified as the causative agent of onychomycosis.
Conclusion: Despite failure to prove Malassezia furfur keratinolytic ability, it can be the etiologic agent of proximal onychomycosis that shows the aggressive properties of this species. Its clinical importance is the easier transmission to hospitalized patients and other people.