مجله دانشکده پزشکی اصفهان
پیاپی 115 (هفته سوم دی ماه 1389)

Lactose intolerance is common in Asian population. Enzyme replacement therapy facilitates consumption of milk and dairy products for patients with lactose intolerance. Clinical evidence in our clinics indicates a nonhomogeneity in improvement of symptoms after ingestion of solid form of exogenous lactase enzyme in patients. Therefore, we designed this study to evaluate the effectiveness of oral solid lactase enzyme in the clinical symptoms of patients with lactose intolerance in Arak city. This randomized double blind placebo controlled trial was performed on 50 adult symptomatic patients with lactose intolerance. Average age of the patients was 37.4 years and 44% were men. Every patient took lactase and placebo for one week respectively. Effects of these treatments on gastrointestinal symptom of patients were gathered by symptom evaluation questionnaire. Results were analyzed by SPSS software. The mean improvement of abdominal pain score after lactase was 1.56 ± 2.51 (P < 0.001) and after placebo was 0.54 ± 0 (P < 0.001). The mean improvement of flatulence score after lactase was 1.6 ± 1.91 (P < 0.001) and after placebo was 0.42 ± 0.94 (P = 0.03). The mean improvement of bloating score after lactase was 1.62 ± 1.79 (P < 0.001) and after placebo was 0.56 (P < 0.001) ± 0.88. The mean improvement of diarrhea score after lactase was 2.70 ± 3.06 (P < 0.001) and after placebo was 0.54 ± 0.99 (P < 0.001). The mean improvement of nausea and vomiting score after lactase was 0.24 ± 0.89 (P = 0.63) and after placebo was 0.04 ± 0.19 (P = 0.15). After ingestion of lactase, 19 patients had no improvement in abdominal pain score, 12 patients in flatulence score, 3 patients in nausea and vomiting score, 17 patients in bloating score, and 7 patients had no improvement in diarrhea score. Lactase tablets significantly reduced clinical symptoms associated with lactose intolerance compared with placebo; but improvement of symptoms were variable between patients.

Some chronic diseases like cancer, and its side effects such as depression, are considered as stressful life events. But, these reactions are not the real results of the mentioned disease and depend on the pressure compensatory factors, like social support, and the performance of confront methods with stress, such as religious coping. The purpose of this research was to investigate the relation of depression, religious coping, and social support in the women with breast cancer. In our research, 240 patients with breast cancer were selected randomly (without considering of the disease stage) and were assisted with self report questionnaires (Beck depression test, religious coping, and social support). The correlation between religious coping and depression was significant and negative (-0.61; P < 0.01). Also, the correlation between depression and social support was significant and negative (-0.84; P < 0.01). But the correlation between social support and religious coping was significant and positive (0.62; P < 0.001). The results showed that as the score of religious coping and social support decrease, an increase in the depression score is observed and vice versa. Corresponding to the Beck depression test, 34.2% of the patients had moderate and severe depression. This research showed the effective role of social support and religious coping in decreasing depression score in the women with breast cancer which should be considered in therapeutic counseling services. Incidentally, the high rate of depression prevalence in these patients should be highlighted for the people in charged.

This study aimed to evaluate the difference between the effect of standard photorefractive keratectomy (PRK) and Q-value adjusted ablation PRK with Allegretto Eye-Q on the ocular refraction. In this clinical trial study performed in Parsian clinic of Isfahan, 75 candidates for photorefractive surgery were included. All of these patients underwent standard PRK in one eye and Q-value adjusted ablation PRK in the other eye. The efficacy of therapy was measured by visual acuity, contrast sensitivity, subjective refraction and patients’ satisfaction, 3 months after the surgery. The mean score of postoperative visual acuity in standard PRK group and Q-value adjusted group was 10.48 ± 1.38 and 10.51 ± 1.22 respectively without correction. The mean postoperative refraction of standard PRK and Q-value adjusted PRK was 0 ± 0.37 and 0.05 ± 0.3 respectively. There was no significant statistical difference in visual acuity, refraction, contrast sensitivity and postoperative satisfaction between the two groups. There is no significant difference between efficacy of standard PRK and Q-value adjusted PRK in optimizing visual acuity, subjective refraction, contrast sensitivity and patient satisfaction.

The expression profile, signal transduction, molecular function and cell growth modulation of adenosine receptor subtypes in the human breast cancer cell lines are described; we decided to investigate the possible roles of adenosine receptors in the human breast tissues. In this study, we used Real-Time (RT) PCR to assess A2A and A2B gene expression in normal and tumoral breast tissues. Breast tumors and non-neoplastic mammary tissues (n = 15) were collected immediately after mastectomy and stored at -80°C until use. All tumors were histologically confirmed to be breast cancer. Total RNA was extracted and reverse transcribed to cDNA. PCR primers were synthesized from human adenosine receptor cDNA sequences. PCR was performed under optimized condition for each receptor subtype. Amplification of beta-actin mRNA served as control for RT-PCR. The PCR products were separated on 1.5% agarose gels. To elucidate the expression of A2A and A2B mRNA in breast carcinoma and normal tissues, we compared the level of A2A and A2B mRNA expression by RT-PCR analysis. All breast tumor and normal tissue specimens expressed A2A and A2B adenosine receptor transcripts. We observed that expression of A2B in tumor tissues is 1.36 fold of normal tissues but there was no difference between the expressions of A2A in tumor and normal tissues of the breast, when normalized against that of beta-actin. These results indicated for the first time, to our knowledge, the expression profile of A2A and A2B adenosine receptors in the human breast carcinoma. The present study showed that a high A2B gene expression level was found in breast tumor tissues in comparison with the normal tissues. However, further studies based on the Real-time quantitative RT-PCR are needed to confirm gene expression levels.

Many studies showed that heart rate recovery (1 min) and exercise capacity at exercise test are both strong predictors of cardiovascular events in various populations. This study compared heart rate recovery (1min) and exercise capacity in individuals with and without metabolic syndrome in Iranian community.

This cross-sectional study was performed on 470 individuals aged ≥ 35 years who followed in Isfahan Cohort Study. A questionnaire including questions on demographic and lifestyle information as well as weight, height, blood pressure, and waist circumference was completed. Triglyceride, fasting blood glucose (FBS), total cholesterol, HDL, and LDL levels were measured as well. All subjects performed a symptom limited exercise test under the standard Bruce protocol. Heart rate recovery (1 min) and exercise capacity were calculated. Data were analyzed by generalized linear model SPSS15 software.

The prevalence of diabetes mellitus, hypertension, and dyslipidemia were higher in individuals with metabolic syndrome (P = 0.001). Heart rate recovery (1 min) was in normal range in individuals with and without metabolic syndrome (> 18 bpm) but in subjects without metabolic syndrome it was higher (41.48 versus 37.07; P = 0.007). There was no difference between men and women in individuals with and without metabolic syndrome (P = 0.645 and 0.39 respectively). Exercise capacity was lower in individuals without metabolic syndrome (P = 0.022).

Our findings suggested that among exercise capacity and heart rate recovery, this is exercise capacity which has a stronger relationship with metabolic syndrome in our community. Also, it seems that there is a need for reconsideration on heart rate recovery threshold.