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Volume 54, Issue 1 (30 1996)
To evaluate the tolerance and effectiveness of conjugated Estrogen for women with established post-menopausal Osteoporosis and hot flushes, with the use of paired comparison, randomized, we tested during an 10 month period the bone mineral contents and plasma glucose in subjects who afforded by premarin in dosages of 0.625 mg for days 1 to 25 and oral medroxy progesterone acetate for days 15 to 25 of a 29 days cycle. All subjects received supplementation to ensure a minimum of 800 mg calcium per day. 25 subjects completed at least 10 month follow up serum calcium, phosphate, glucose and urinary calcium and phosphatae measurements by colorimetric, method. We compared women with herselves, the median change in biochemical studies showed significant decrease in serum calcium, phosphate an urinary excrition of calcium, but significant increase in urinary excrition of phosphate. Fasting plasma glucose did not change significantly. Decrease serum calcium (9.6 compared with 9.16 P<0.005) decrease, serum phosphate (3.77 compared with 3.39 P<0.005), decrease uri calcium (149.81 compared with 121.46, P<0.005), increase uri phosphate (625.83 compared with 676, P<0.005), FBS (92.03 compared with 91.45, 0.1>P>0.05). Regarding the effects of conjugated Estrogen on plasma and urinary calcium and phosphate levels and amelioration of clinical symptoms, we concluded that conjugated Estrogen treatment in effective in post-menopausal Osteoporosis, but we did not find relation between exogenous Estrogen in post-menopausal women with FBS and hot flush
Volume 64, Issue 1 (30 2006)
Background and Aim: In epileptic patients, behavioral disorders are the most important deficits therefore evaluation of deficits by animal model should be essential. The role of Zinc in behavioral disorder and its relation with hippocampus or serum zinc may help explain why some brain region is commonly facilitated while other did not harm. The main purpose of this study was to evaluate Zinc itself effect on changing behavioral disorder and control of brain seizure.
Materials and Methods: Type of this study is prospective, empirical and blind. The population was adult male Sprauge-Dawley rats and randomly assigned in six groups (n=8). Each group was treated two months before of inducing animal model of seizure by Zinc(248 mg/lit) or tap water and also in group 1 and 4 saline, group 2and 5 bicuculine(1mg/kg) and group 3 and 6 pentobarbital(10mg/kg) .epileptic model was induced by injection of Lithium chloride (127mg/kg)and 24 hr later ,pilocarpin(50 mg/kg) in to peritoneum. During this study, neurological deficits (behavior) was recorded at 1, and 2 hrs after sizuring.
Results: The results showed that Zn had a minus feature on neurological deficits. GABA A antagonists had the same effect as Zn on neurological deficits but GABA A agonists ameliorate it significantly. Serum zinc level didn&apost change significantly among the animals but hippocampus zinc was altered significantly in Zn treated animals compared with the controls.
Conclusion: This study shows that Zn deleterious effects on neurological deficits were carried out via GABAergic system.
Volume 64, Issue 3 (1 2006)
Background: Occlusive disease of lower extremity arteries are so common and cause severe stenosis or complete local obstruction in arteries as it need treatment. The treatment could be surgery or interventional procedures like angioplasty or implant of stent. Sometimes such treatments are impossible because of severity or location of complication and cause amputation.The purpose of this study is an assessment about more common locations of arterial obstruction in lower extremities which is necessary for treatment planning and prediction for efficient supplements.
Methods: In this descriptive study from 2000 until 2005, 100 patients with occlusive disease of lower extremity arteries who underwent angiography in medical imaging center of Imam Khomeini hospital in Tehran had been studied according to location of arterial obstructions. In the point of view of homodynamic conditions, obstructions over 70% consider important, so all of these patients had arterial obstruction over 70% up to 100%.
Results: Our findings show that the most common locations of arterial obstruction in lower extremity are superficial femoral artery (47%), arteries of leg (21%) and iliac arteries (19%).
Conclusion: This study can show appropriate assessment of the most common locations of arterial obstruction in lower extremity to predict supplements that may be needed for treatment of these patients.
Volume 65, Issue 3 (2 2007)
Background: Diabetic neuropathy is an incapacitating disease that afflicts almost 50 percent of patients with diabetes. A late finding in type 1 diabetes, diabetic neuropathy can be an early finding in non insulin-dependent diabetes. Diabetic neuropathies are divided primarily into two groups, sensorimotor and autonomic. Patients may acquire only one type of diabetic neuropathy or may present with combinations of neuropathies, such as autonomic neuropathy or distal symmetric polyneuropathy, the latter of which the most common form. Motor deficits, orthostatic hypotension, silent cardiac ischemia, hyperhidrosis, vasomotor instability, gastroparesis, bladder dysfunction, and sexual dysfunction can also result from diabetic neuropathy. Strict control of blood sugar, combined with proper daily foot care, is essential to avoid the complications of this disorder. With the potential to afflict any part of the nervous system, diabetic neuropathy should be suspected in all patients with type 2 diabetes as well as patients who have had type 1 diabetes for over five years. Although some patients with diabetic neuropathy notice few symptoms, upon physical examination mild to moderately severe sensory loss may be noted by the physician. Idiopathic neuropathy has been known to precede the onset of type 2 diabetes.
Volume 65, Issue 4 (3 2007)
Background: Ultrasound (US) has been used in neuroprotection after cerebral ischemia however, its use is controversial. Application of US in combination with fibrinolytic agents may improve fibrinolytic effects. In this study the effects of US, alone or in combination with tissue plasminogen activator (tPA), on brain ischemic injury were examined and we studied whether US is protective in the brain injured by ischemia under normothermic conditions.
Methods: We performed two studies. In the first study, rectal and brain temperatures were compared. In the second study, we studied whether US alone or in combination with tPA is neuroprotective in thromboembolic stroke. To induce focal cerebral ischemia, a clot was formed in a catheter. Once the clot had formed, the catheter was advanced 17 mm in the internal carotid artery until its tip was 1-2 mm away from the origin of the middle cerebral artery (MCA). The preformed clot in the catheter was then injected, and the catheter was removed. The wound was then closed and the infarction volume, edema and neurological deficits were measured after MCA occlusion.
Results: The temperature in the brain was approximately 0.50 ºC lower than the rectal temperature. In the control, US+low tPA, low tPA, US+high tPA and, high tPA groups, the infarct volume (%) was 34.56±4.16, 17.09±6.72, 21.25±7.8, 13.5±10.72 and 20.61±6.17 (mean ±SD) at 48 h after MCA occlusion, respectively. The results indicate that US alone reduces the infarct volume by 30% compared to that of the control group (P<0.05). US improved neurological deficits and reduced brain edema significantly (p<0.05).
Conclusions: This study indicate that US appears to have a protective effect, alone and in combination with tPA, in an embolic model of stroke.
Volume 65, Issue 9 (3 2007)
Background: Stomatitis, the inflammation of the mucous lining of any of the oral structures, is a frequent side-effect of anticancer drugs due to excess uric acid production. Strict oral hygiene and the application of an appropriate mouthwash has been reported to relieve pain and improve patient quality of life. Allopurinol is a drug used to treat conditions caused by excess uric acid. The aim of this study to evaluate the effectiveness of prophylactic use of allopurinol mouthwash for stomatitis in patients undergoing chemotherapy.
Methods: In this quasi-experimental study, 42 patients were randomly assigned to either a study group or a control group. In the study group (28 patients), patients used 5 mg/ml allopurinol mouthwash in hydroxyl propyl methyl cellulose. The control group (14 patients) used water instead of the mouthwash. Treatment was administered for 16 days.
Results: Data collected during the daily follow-up of the patients' oral mucosa showed that allopurinol mouthwash decreased the severity, pain and duration of stomatitis.
Conclusion: Preventing stomatitis in patients receiving chemotherapy improves the health of the patient and compliance with treatment. Based on our findings, allopurinol mouthwash should be used for all chemotherapy patients for the prevention of stomatitis. This nursing intervention can also improve the patient's nutritional state and level of satisfaction.
Volume 65, Issue 12 (2 2008)
Background: Ultrasound (US) has been used in neuroprotection after cerebral ischemia, however the mechanism of action remains unclearly. We have previously shown the protective effect of ultrasound on infarction volume and brain edema in ischemic brain injured at normothermic condition. Ultrasound may also amplify the effect of fibrinolytic medications in thrombolysis process .We have also shown that hyperthermia can exacerbate cerebral ischemic injury and that the efficacy of tissue plasminogen activator (tPA) is reduced in the presence of hyperthermia. In this study, the effects of US alone or in combination with tPA on brain ischemic injury were evaluated.
Methods: Focal ischemic brain injury was induced by emblazing a pre-formed clot into the middle cerebral artery in rats. Principally, we examined whether US can reduce the perfusion deficits and, the damage of blood- brain barrier (BBB) in the ischemic injured brain. There are two series of experiments at this study .in the first series, animals were randomly assigned to four groups (n=7 per group) as follows: 1-control (saline), 2-US (1W/cm2, 10 duty cycle ), 3- US+high- tPA (1W/cm2, 10 duty cycle +20 mg/kg) and 4- high -tPA (20 mg/kg). We also examined the effects of US and tPA on BBB integrity after ischemic injury. The animals were assigned into four groups (n=7 per group), treatment is the same as above. BBB permeability was assessed by the Evans blue (EB) extravasations method at 8 h after MCA occlusion. BBB permeability was evaluated by fluorescent detection of extravagated Evans blue dye and Perfusion deficits were analyzed using an Evans blue staining procedure. The perfused microvessels in the brain were visualized using fluorescent microscopy. Areas of perfusion deficits in the brain were traced, calculated and expressed in mm2.
Results: The results showed that US improved neurological deficits significantly (p<0.05). The administration of US significantly decreased perfusion deficits and BBB permeability. In the control set, for the US+high tPA, high tPA only and US only groups, the mean perfusion deficits (±SD) were 14.32±3.15, 7.03±4.08, 5.92±1.90 and 9.14±3.37 mm2, respectively, 8 h after MCA occlusion (P<0.05).
Conclusions: These studies suggest that US is protective in a rat embolic model of stroke due to decreased perfusion deficits.
Volume 68, Issue 4 (6 2010)
Background: Some complications of pregnancy such as abortion, gestational diabetes mellitus, preeclampsia, and preterm delivery are more common among women with polycystic ovary syndrome (PCOS). Recently it has been reported that metformin treatment during pregnancy reduces pregnancy complications, so this study was conducted to demonstrate the possible effects of metformin on the uteroplacental circulation and pregnancy complications. Methods: Seventy pregnant women with polycystic ovary syndrome (PCOS) from 1386 to 1388 were enrolled in a randomized, double-blind, placebo-controlled trial of metformin during pregnancy in Shariati hospital. Doppler ultrasound examinations of the uterine arteries and umbilical artery were performed at 12th and 20th weeks of gestation. All patients were followed up to the end of pregnancy, then the effect of metformin on the uteroplacental circulation was evaluated by the comparison of the pulsatility index (PI) of uterine arteries and prevalence of obstetric complications between two groups. Results: The mean reduction of PI in metformin group from 12th to 20th weeks of gestation was 0.38 versus 0.16 in placebo group (p=0.016). Gestational diabetes mellitus,pre-eclampsia and preterm delivery, were more common in pregnant women in placebo group but the difference was not statistically significant. Conclusions: Metformin treatment in pregnancy accompanied with reduced uterine artery impedance between 12 and 20 weeks of gestation but this reduction showed no effect on the pregnancy complications such as preterm delivery, preeclampsia and gestational diabetes
Volume 69, Issue 5 (6 2011)
Background: Entanglement of the umbilical cord around fetal neck has been reported to be associated with birth asphyxia. On the other hand, current evidence suggests that umbilical arterial pH analysis provides the most sensitive reflection of birth asphyxia. In this study we aimed to evaluate and compare the umbilical arterial hydrogen-ion concentration (pH) and to analyze the blood gases of neonates with or without nuchal cord.
Methods: In this cohort study, 92 newborns with and 95 without nuchal cords were enrolled at Shahid Akbar Abadi Hospital in Tehran, Iran between the years 2009 and 2010. From each newborn an umbilical arterial blood sample was collected to measure pH, base excess and blood gases.
Results: There were no statistically significant differences between newborns with or without nuchal cord regarding maternal age, gestational age, and history of pregnancy. The mean pH in the newborns with nuchal cord (7.21±0.1) was significantly less than the value in the newborns without the cord (7.28±0.1), (P<0.001). In contrast, the mean base excess in the newborns with nuchal cord was more than the ones without the cord (P<0.001). Seven newborns (7.9%) in the group with nuchal cord passed meconium during labor while only one (1%) newborn did so in the other group.
Conclusion: Our finding showed that nuchal cord had a significant relationship with acidosis in newborns with nuchal cord. However, this finding needs further investigation to reach a common conclusion.
Volume 71, Issue 9 (December 2013)
Background: Aspirin is the drug of the century, and is a multifunctional drug and one of the most prescribed drugs in the world. Aspirin is a safe drug at low doses but also it has life-threatening side effects when administered at high doses. This study investi-gates the effects of aspirin on renal cortical and medullary tissue in rat embryos.
Methods: In this study, 30 pregnant female rats were randomly divided into 6 groups. Control group with no intervention, sham group received 2 ml distilled water (as a sol-vent of aspirin) received from days 8 to 20 of pregnancy, and four experimental groups received different doses of 75, 100, 200 and 300 mg/kg of aspirin by gavage. Pregnant rats were sacrificed on the twenty days of pregnancy and the fetuses were removed. Weight of the fetuses and placenta and Crown-Rump length were measured. Fetal kid-neys were fixed in formalin processed, sectioned and stained with Hematoxylin- Eosin. Thickness of renal cortical and medullary tissue by using a Motic hardware and soft-ware system were measured and recorded. A significance level of 0.05 was predeter-mined for all statistical analyses.
Results: No apparent fetal anomalies were observed in experimental groups. In addi-tion, no significant differences were shown in the mean of fetal weight, placental weight, mean of Crown-Rump length in experimental groups 75, 200 and 300 mg/kg compared to control and sham groups. Mean fetal and placental weight in experimental group 100 significantly increased compared to control and sham groups. Mean ratio of renal cortex to renal medulla in experimental group 75, 100 and 300 were significantly decreased compared to control and sham groups (respectively P= 0.03, P= 0.013, P= 0.03).
Conclusion: It seems that maternal use of aspirin during pregnancy can not cause fetal abnormalities. However, it can cause some changes in renal cortical and medullary tis-sue of rat embryos.
Volume 76, Issue 10 (January 2019)
Methods: This cross-sectional study was conducted in the Department of Surgery at the Baqiyatallah University Hospital, Tehran, Iran, from April 2017 to September 2017. The study was carried out on 182 postoperative patients. Surgeries were performed in different methods such as; open, closed, semi-closed and limited excision. Diabetics, obese patients and patients with acute pilonidal abscess or prior PD surgery were excluded. All patients were followed for at least three years after surgery. During the follow -up period, patients were assessed for recurrence, satisfaction, complications rate and wound healing time. The outcomes were assessed by case notes analysis and follow-up telephone and postal questionnaires.
Results: In this study forty-four patients were operated via closed Method, 48 patients through open, 48 via semi-closed and 42 one's trough limited excision methods. The highest rate of recurrence was in the open group. There were no cases of recurrence in the closed group. There were also less postoperative hemorrhage and faster wound healing in the closed group. The average satisfaction of all patients was 88.9±8.7. The mean satisfaction rate in the closed group was 95.9±5.3 which was higher than other groups.
Conclusion: The results of this study demonstrated that in the non-recurrent cases of sacral pilonidal sinus, complete Excision and primary repair have fewer complications and shows higher satisfaction rate.
Volume 77, Issue 10 (January 2020)
Methods: The study population in this descriptive cross-sectional research consisted of all doctors who had been sued in Tehran's Legal Medicine Organization (Forensic Committees of Tehran Province) from the first day of July 2018 to the end of December 2018. The study was carried out in and under supervision and support of the Legal Medicine Research Center. Data were collected using a checklist of the files from Tehran's Legal Medicine Organization.
Results: The results showed that most medical errors are of organizational types. Major medical failures occur in university-affiliated hospitals among the male technical staff aged 41-50 years with a work experience less than 6 years. Most complaints were recorded against general practitioners, general surgeons, and anesthesiologists, respectively. The smallest percentage of the complaints related to orthopedics, urologists, and ear, nose, and throat (ENT) specialists.
Conclusion: The results of the study indicated that most of medical failures have of an organizational nature and occur in university hospitals among male technical officials who are in the fifth decade of life with a low work experience. So, paying attention to these issues can help the better selection of technical officials. The technical authorities of the hospitals must be careful about the responsibilities given to them. In order to reduce the failure of the technical authorities of the hospitals, doctors with a high standard of service should be appointed as technical officers. These doctors ought to possess legal knowledge and be familiar with the course of complaints filed in the judiciary.
Volume 77, Issue 11 (February 2020)
Methods: In a case series study, during an outbreak, four members of a family with symptoms including paralysis, ptosis, blurred vision, diplopia, weakness, dysphagia, dry mouth, respiratory problems, vertigo, and lethargy, referred to Loghman Hospital of Tehran. Among the patients was an elderly woman and a pregnant woman. All clinical signs and symptoms of the patients were recorded daily in a researcher-made questionnaire from 27 August to 3 September 2018. At the time of admission, vital signs (pulse rate, respiration rate, and body temperature) of patients were stable and within normal limits. Following clinical suspicion of food-borne botulism in these patients, samples of the first two patients, including serum, stool, gastric secretions, and homemade whey were sent to the Botulism Laboratory of Microbiology Department of Pasteur Institute of Iran for the mouse bioassay.
Results: Type A neurotoxin was detected in homemade whey after the mouse bioassay. Therefore, foodborne botulism was confirmed in patients with laboratory results. Patients included two men and two women with a mean age of 52.7 years old. The length of hospitalized days was between 2 and 6 days. Two of the patients were admitted to the intensive care unit (ICU). Patients under study were fully recovered with timely diagnosis of the disease, treatment with antitoxin, and supportive care.
Conclusion: When conscious patients referred to the hospital with symptoms of paralysis, foodborne botulism is an important differential diagnosis. On-time diagnosis and antitoxin treatment can prevent serious complications.
Volume 78, Issue 10 (January 2021)
Methods: This basic science survey was carried out at the Shiraz University of medical sciences from July to December 2019. Phylogenetic analysis was used to compare the temperature sensitivity of C. auris and the species with which it is genetically related. The sequences of Internal transcribed spacer (ITS) region and the growth temperature ranges for C. auris and yeasts belonging to the Candida haemulonis complex as well as other environmental yeasts isolated from different geographical areas of the world were randomly selected and evaluated. Their phylogenetic relationship was investigated with the mapping of the phylogenetic tree based on ITS sequences.
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Results: Study of temperature ranges which the fungi are capable of growing clearly shows that all species of C. auris can tolerate temperatures higher than the mammalian body temperature. Genetic distances, as well as geographic distances between species of C. auris are visible during phylogenetic studies. These results illustrate the possibility that, despite these distances, the temperature tolerance attribute for each C. auris clade was independently and under a common external pressure such as global warming.
Conclusion: The results of this study have discussed the increased incidence of emerging fungal infections due to climate changes; however the role of other contributing factors in the spread of these infections needs further investigation. |
Volume 79, Issue 5 (August 2021)
Methods: This cross-sectional study was performed on 210 infants, which were newly born on Baharloo Hospital from march2018 to march2019. 2.5 cc cord blood sample was extracted from each infant, and microcytic anemia were diagnosed according to factors such as Hb, MCV and others parameters.
Results: in this study, we demonstrated that there is a significant association between MCH and microcytic anemia. Our results showed that the rates of newborn infants with anemia disease (Hb<13ml/dl) were 14.3% and the rates of microcytic anemia were 9.5%. There were not any significant differences between mother's age, neonatal weight and height, type of parturition, pregnancy age and parental ratio with the incidence of microcytic anemia.
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Conclusion: Anemia has a relatively high prevalence in the center of Baharloo Hospital, Tehran, Iran. So screening and further investigation for anemia and related factors are critical. According to the results of our investigation, studies showed that anemia is a multifactorial disease that depends on different factors. The existence of variable results in different studies requires evaluating more parameters that affect the incidence of microcytic anemia, such as iron deficiency, eating habits, level of parental education, and use of iron supplements in pregnancy. Management of this disease requires screening and early diagnosis for more effective treatment and reduction of its potential complications.
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Volume 80, Issue 5 (August 2022)
Methods: This study was conducted at Bahrami Children's Hospital from May 2018 to May 2019. In this single-blind randomized controlled clinical trial, 52 children with type 1 diabetes (aged 2 to 16 years) were studied. We created two groups of 26 individuals. The inclusion criteria were determined as follows: Proof of T1DM by history and information of children’s medical record. Also, the Exclusion criteria were determined in this way: Patients consuming probiotics in the last 4 weeks, gastrointestinal infections in the last 2 weeks, and presence of chronic underlying intestinal diseases. The probiotic group received, in addition to insulin therapy, a daily probiotic capsule for 90 days. The control group received only routine insulin therapy. Blood samples were taken to measure lipid profiles at the beginning and end of the trial.
Results: A total of 52 patients were included. The mean age of children was 9.3±2.9 (4 to 14 years). The mean age in the probiotic and control groups was 9.6±3.5 and 9.4±3.0 respectively. The results of this study showed that HDL-C was increased in the probiotic group compared to the control group, although it was not statistically significant (P>0.05). Also, changes in total cholesterol, LDL-C, and triglyceride were not statistically significant.
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Conclusion: In this study, the use of oral probiotics for 90 days in children with type 1 diabetes did not have a significant effect on blood lipid profiles compared to the control group.
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