مجله دانشکده پزشکی اصفهان
پیاپی 184 (هفته دوم خرداد 1391)

Abnormalities in vascular reactivity due to factors like endothelial dysfunction are well recognized in type 2 diabetes. However, the effects of drugs like salsalate in decreasing the disease process especially on endothelial aspects are still controversial. The aim of this study was to evaluate the effects of this drug on some serum and endothelial factors of patients with the diagnosis of impaired glucose tolerance or new diabetic patients. Patients with the diagnosis of impaired glucose tolerance or new diabetic patients who were referred to Isfahan Endocrinology Research Center during February-June 2009 were recruited. After history taking and physical examination, blood samples were obtained to evaluate hemoglobin A1c (HbA1C), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), aspartate transaminase (AST), and serum insulin. Flow mediated dilation (FMD) was also assessed. Patients were randomly divided to receive 1.5 g salsalate (2×750 mg) or placebo twice a day for three months. After three months, blood sampling and FMD measurements were repeated. Before and after the intervention, the data was registered and analyzed. Overall, 40 patients including of 8 males and 32 females were recruited. The mean age of patients was 47.15 ± 6.67 years. Fasting blood sugar (FBS) and white blood cell (WBC) count decreased and C-reactive protein (CRP) level increased significantly after the intervention with salsalate. Moreover, FMD increased significantly in the intervention group (P = 0.004). Salsalate could be a tolerable drug in type 2 diabetes patients and may improve FBS level and endothelial function of these patients. However, its safety among these patients should be evaluated by more studies.

Attention deficit hyperactivity disorder (ADHD) is the most common childhood psychiatric disorder which affects 5-10% of children in school age. It seems that the disorder is more common among children with enuresis. The aim of this study was to investigate ADHD in children with enuresis and compare it with a control group in patients referring to Amir Kabir Hospital (Arak, Iran). This case-control study was performed on 100 children with enuresis and 100 children without enuresis in the age bracket of 5-16 years old. In all patients, Conners questionnaire [based on the diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV)] and a demographic checklist about age, gender, history of maternal disease during pregnancy, birth weight, and head trauma were filled. The subjects were interviewed by a psychiatrist to confirm the diagnoses. The data was analyzed using descriptive and analytical statistics in SPSS15. Attention deficit was observed in 16 cases (16%) with enuresis and 5 controls (5%) (P = 0.01). Moreover, while 25 children with enuresis (25%) were affected by hyperactivity/impulsive behavior, only 16 controls (16%) were affected by this behavior. However, this important difference was not significant between the 2 groups (P = 0.08). ADHD in children with enuresis is significantly more common than non-enuretic children. The observed correlation between ADHD and enuresis makes psychological counseling mandatory in children with enuresis.

The purpose of this study was to investigate the effects of 8 weeks of aerobic, resistance, and concurrent training on secretion of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) in elderly women. A total number of 60 elderly women were randomly allocated to four groups of aerobic training (n = 15), resistance training (n = 15), concurrent training (n = 15), and control (n = 15). Blood samples were taken before and 4 weeks after the initiation of exercise training and also at the end of the 8-week course of training. Maximal oxygen consumption (VO2Peak) was measured after 48 hours using Rockport walk test. Inferential analysis of the collected data was performed by repeated measures analysis of variance (ANOVA). Significant differences were further evaluated by the least significant difference (LSD) test. The relation between VO2Peak and secretion of GH and IGF-1 was assessed by Pearson's correlation coefficient. The significance level was considered as P ≤ 0.05 in all tests. The results showed that 8 weeks of regular exercise significantly increased levels of GH and IGF-1. A significant increase was also observed in VO2Peak values after 8 weeks of regular exercise (P < 0.05). VO2Peak was directly correlated with GH and IGF (P < 0.001, r = 0.72). In conclusion, regular exercise significantly increased levels of anabolic hormones. Moreover, the combined-exercise training better enhanced GH and IGF-1. VO2Peak increased with increases in GH and IGF-1 levels.

This study aimed to compare the impacts of applying diclofenac drops and artificial tear drops before cataract surgery on decreasing pain after the operation. This double-blind randomized clinical trial study was conducted patients who referred to Feiz Hospital (Isfahan, Iran) for cataract surgery during 2011-12. The participants were divided into two groups of 44 people to receive either diclofenac drops or artificial tear drops before the operation. Patient's age, sex, weight, and pain severity, as well as the surgeon's satisfaction, sedative drug dosage during and after the surgery, and the complications after the operation were recorded. Pain intensity was evaluated by a visual analogue scale (VAS). The American Society of Anesthetics (ASA) scores were also recorded. Chi-square, Mann-Whitney U, and students-t tests along with stratified regression were used to analyze the collected data. Among the total number of 88 studied patients, 33% were males. Their mean age was 64.8 years. The ASA score in all patients was 1.6. Diclofenac drops and artificial tear drops were not significantly different in reducing pain during or after the surgery. No significant differences were observed between the two groups in most of the other measured variables. However, the dosage of ketamine during the surgery and the ASA scores were lower in patients who had received diclofenac drops compared to those who had received artificial tear drops. Based on the results of this study, diclofenac drops and artificial tear drops were not significantly different in reducing pain after cataract surgery. Moreover, the surgeon's satisfaction during surgery from the patient's cooperation was at the same level in both groups. It is worth mentioning that diclofenac drops were more effective on reducing the dosage of ketamine during the surgery. Since ketamine is an anesthetic with analgesic properties, the lower need to ketamine in the diclofenac group implies the effects of the drug on reducing pain during surgery. However, the two kinds of drops had no significantly different impacts on the dosage of consumed drugs during the surgery and in the recovery room.

Glioblastoma multiforme (GBM) is the most malignant form of brain tumors. Despite intensive treatment, the mean survival of these patients is about 1 year. Recent studies have shown that a small population of cells, called brain tumor stem cells, are resistant to chemo- and radiotherapy. They thus have the ability to reinitiate the tumor. Therefore, it seems that destroying these cells is very important for curing this disease. This review summarized the methods for isolating and enriching brain tumor stem cells. It also discussed critical signaling pathways and transcription factors that are important targets for new drugs.