مجله دانشکده پزشکی اصفهان
پیاپی 212 (هفته دوم دی ماه 1391)

Preeclampsia is a pregnancy related hypertensive disorder with 7-10% prevalence which occurs after 20 weeks’ gestation. Regarding the fact that preeclampsia is the second leading cause of maternal mortality after embolism، its prevention and treatment during prenatal care is of a high priority. According to the suggested association between infection and preeclampsia، periodontal infection، which is one of the most common chronic infectious disorders in humans، might be linked to preeclampsia. Thereby، the necessity of this study to confirm this relationship to reduce the preeclampsia prevalence is felt. In this case-control study، the placental samples of 46 selected patients were collected immediately after cesarean section with a sterilized technique. Form each individual، 4 placental samples were taken from the periphery and the center of both maternal and fetal sides. To make the study blind، a code was assigned to each sample. Afterwards، the samples were sent to the laboratory to be evaluated by qualitative polymerase chain reaction for the presence of five periopathogenic bacteria (actinomycetem comitans، prevotella intermedia، porphyromunas gingivalis، treponema denticula، and tannerella forsythenesis). There was no significant difference in mean age، parity، and gravidity between two groups. There was no significant difference in five microorganisms between the two groups. This study did not show any significant difference between preeclamptic and non-preeclamptic women with normal pregnancy regarding the periopathogenic bacterial profile of the placenta.

We evaluated the correlation between intracranial pressure (ICP) measured by Schiotz tonometer and computed tomography (CT) scan findings in craniotomy patients. This cross-sectional study was performed in Alzahra Hospital in Isfahan from 2010 to 2011. We included the elective craniotomy patients aged 18-64 years with the American Society of Anesthesiologists (ASA) physical status I or II. After being evaluated by CT scan، ICP was studied with Schiotz tonometer in Burr hole before dura opening. 58 patients (mean age: 44. 37 ± 11. 53 years) scheduled for elective craniotomy were included in the study. There were 36 males (62. 1%) and 22 females (37. 9%). The results showed significant correlation between ICP measured by Schiotz tonometer and by CT scan (r = 0. 913، P < 0. 001). This study showed that Schiotz tonometer could consider as a safe and reliable alternative to CT scan in ICP evaluation.

300 million people are suffering from asthma worldwide. Since some patients have difficulty swallowing tablets and capsules، oral films stepped into the market. This drug form is easily consumed without the need for drinking water. Additionally، fast-dissolving oral films release their drugs more rapidly. Ondansetron، folic acid، zolmitriptan، dextrometorphan and loratadin are some examples of this kind of formulation. In this study، the salbutamol oral films were made by sodium carboxymethylcellulose، hydroxypropyl methylcellulose and polyvinyl alcohol as the base polymer and glycerin as the plasticizer by casting method. The prepared films were evaluated for pharmaceutical properties such as thickness، disintegration time، assay، and drug release. The Design-Expert 7. 1. 5 software (Stat-Ease، Inc.، USA) was used for designing and evaluating the formulations. Design was validated by extra design checkpoint formulations. The survey of the films shows that the formulation containing polyvinyl alcohol and sodium carboxymethylcellulose had desirable pharmaceutical properties and was selected as the optimum formulation with desirability factor of 0. 884. This formulation began to disintegrate within 60 seconds and 93 percent of drug was released within 150 seconds. The release kinetic of this formulation best fitted the Non-Fickian profile. According to the desirable specifications of fast-dissolving salbutamol oral film comprising immediate drug release and being comfortable to use، the compliance of patients in asthma treatment would greatly improve.

Acute gastroenteritis in pediatric patients entails high rates of morbidity and mortality. One of its complications is dehydration، which should be managed carefully. We evaluated the efficacy of metoclopramide in the control of vomiting in children with acute viral gastroenteritis and moderate dehydration. In this single-blind randomized clinical trial، we randomly assigned children aged 1-7 years with vomiting due to acute viral gastroenteritis to two groups of serum therapy (control) and metoclopramide (intervention). The control group received 5% dextrose water solution along with electrolyte management while the intervention group، in addition to the standard treatment، received 0. 1 mg/kg metoclopramide intravenously. Patients were followed for 4 days for the number of vomiting episodes. 240 children were studied in intervention and control groups (120 in each group). The mean number of vomiting episodes was significantly lower in metoclopramide-assigned patients in all 4 days of the follow up period (P = 0. 021، P = 0. 007، P = 0. 002، and P = 0. 001، respectively for day 1 to 4). Although metoclopramide have shown effectiveness in the treatment of vomiting due to acute gastroenteritis، it is suggested performing multicenter studies comparing this drug with other common anti-emetics to allow for a better judgment.

Helicobacter pylori infection is common in children. It results in a series of diseases such as peptic ulcer، iron deficiency anemia، reduced growth، and gastrointestinal malignancies. Every test to detect H. pylori has particular limitations. Moreover، various noninvasive methods have different sensitivity and specificity. We investigated the sensitivity of available diagnostic methods to identify the best noninvasive method for detection of H. pylori. During a one-year period، 99 children who presented at Alzahra Hospital (Isfahan، Iran) with epigastric tenderness، abdominal pain at night، and early satiety were examined. They all underwent endoscopy and rapid urease and serologic tests. Stool samples were also obtained to detect H. pylori antigen. Culture was considered as the gold standard in diagnosis of H. pylori infection. The last step was the statistical analysis of the collected data. According to culture results، 33% of the patients were positive for H. pylori infection. The sensitivity and specificity of urease test were 61. 3% and 86. 6%، respectively. The corresponding values were 74. 1% and 98. 3% for serological tests and 74. 1% and 96. 7% for H. pylori antigen detection in stool. We found endoscopy to be the best method of H. pylori detection. Examining stool samples for the presence of H. pylori antigen and rapid urease test were the second and third methods in our ranking.

People are forced to exercise in areas with inappropriate conditions such as polluted air. Harmful effects of air pollution are intensified during physical activity and training due to increased metabolic needs. This study compared the effects of intermittent exercise in polluted and clean air on hemolysis of red blood cells in endurance runners. Using purposive convenience sampling، 10 female endurance runners with at least three years of experience of regular exercise were selected. Their mean age، height، weight، and body mass index were 18. 80 ± 2. 74 years، 164 ± 2. 84 cm، 51. 58 ± 3. 37 kg، and 19. 67 ± 1. 28، respectively. Immediately after an interval training protocol with 85% of maximum heart rate، blood samples from left brachial vein were collected in a sitting position. The first samples were obtained on a polluted day (air quality index: 118). Second sampling was conducted 18 days later، after a rainy night (air quality index: 77). Both procedures were performed at a particular time of day. Hemolysis of red blood cells was determined by measuring bilirubin and serum haptoglobin levels through spectrophotometry and immunoturbidometric tests، respectively. Paired t-tests were used to compare the two measurements. Bilirubin levels increased significantly (22%) after exercise in polluted air compared to clean air (P = 0. 001). Although haptoglobin levels decreased (23. 86%) after exercise in high concentrations of pollutants، this reduction was not statistically significant compared to the levels obtained in clean air (P = 0. 09). It seems that an interval training session in high concentrations of air pollutants will be associated with more hemolysis of red blood cells.

Neurotransmitters، such as dopamine and serotonin، play an undeniable role in the incidence of mental illnesses. Sports have positive effects on the level of neurotransmitters in nerve cells and the balance in neurological function. They can thus reduce a person''s mental abnormality. In this study، 35 female patients who had been admitted to the psychiatric ward of Khorshid Hospital (Isfahan، Iran) were evaluated. The patients were randomly allocated to experimental and control groups. Although the experimental group initially included 24 subjects، four women were excluded since they were not interested in group sports. They were encouraged to perform individual activities such as stretching. Finally، the experimental and control groups comprised 20 and 15 participants، respectively. After warm up and stretching exercises، the experimental group played volleyball، badminton، or dodgeball in teams of 4-5 every day for two months. However، the control group were only encouraged to perform warm up and stretching. At the end of the 60-day period، Beck Depression Inventory was filled out by physicians based on the statements of patients. According to the patients، both individual and group exercises had positive effects on their mental state. In fact، some patients were discharged after the period of study. Nevertheless، mental health of the control group improved considerably more than the control group. This finding suggests the benefits of group exercise. Regular exercise will promote individuals’ physical and mental health. It reduces the risk of chronic diseases، increases life expectancy and eliminates depression. Proper exercise helps the body to control its nervous system and results in greater confidence and better decision-making under stress. On the other hand، depression and stress are influenced not only by a person’s mental conditions and confidence but also their physical state. Exercise will regulate blood temperature and enhance physical functions under special circumstances. We obviously observed the positive effects of sports، especially team sports، on women''s depressive symptoms.