مجله دانشکده پزشکی اصفهان
پیاپی 422 (هفته دوم اردیبهشت 1396)

This article aimed to study the effect of donepezil prescription on the incidence of post-operative cognitive disorder in patients undergoing coronary artery bypass graft (CABG) surgery.
In this double-blind randomized clinical trial study, the statistical population consisted of all candidates for coronary artery bypass graft surgery visiting Chamran hospital, Isfahan, Iran. Convenience sampling was employed and the patients were enrolled according to the order of visiting and inclusion criteria. Data were collected using a questionnaire and psychiatric tests by filling up check lists and conducting interviews. The data were then analyzed using chi-square, t, and Mann-Whitney tests via SPSS software.
Findings: The frequency of cognitive disorder development was greater in control group than donepezil group on the first and second days of hospitalization and the differences were significant (P 0.050). The average number of cryo blood products had a significant difference between two groups after cardiopulmonary bypass (CPB) (P = 0.004). No significant difference was found between the two groups concerning the average pump time, clamping time, duration of surgery, length of stay in intensive care unit (ICU), and length of stay in hospital (P > 0.050 for all).
Donepezil significantly declines the cognitive disorder after coronary artery bypass graft surgery.

Diabetes mellitus can lead to structural disorders in the brain. Aloe vera has antidiabetic, antioxidant, and neuroprotective effects. This study was designed to evaluate the effects of Aloe vera gel on the morphometric changes in the brain of streptozotocin-induced diabetic rats.
25 male Wistar rats were randomly divided into 5 groups including: control (normal saline), diabetic (normal saline), Aloe vera gel (400 mg/kg/day; gavage), diabetic Aloe vera gel (400 mg/kg/day; gavage) and diabetic Neutral Protamine Hagedorn (NPH) insulin (10 IU/kg/day; subcutaneous). Experimental diabetes was induced by streptozotocin injection (60 mg/kg; intraperitoneal). All groups treated for 8 weeks. At the end of treatment course, the rat's brains were removed intact immediately after sacrifice for morphometric measuring by caliper. Histological brain sections were also prepared to assess morphometry of cerebral cortex and hippocampus via ammonium iron (III) sulfate staining.
Findings: Diabetes induction reduced weight and dimensions of brain, and diameters of the hippocampus, and white and gray matter of cerebral cortex compared to the control group after 8 weeks (P The results showed that oral administration of Aloe vera gel in diabetic rats improves structural disorders of brain and ameliorates diabetes-induced hyperglycemia.

Leishmaniasis is a parasitic disease caused by protozoan called Leishmania that is transmitted by sand flies. The aim of this study was to determine the demographic and clinical characteristics of children with cutaneous leishmaniasis in Isfahan province, Iran.
This was a cross-sectional study on all children patients with age of five years and younger in Isfahan province during 2011 to 2015. Demographic and clinical characters of patients were presented as the number and percentage. The mean age of patients according to sex was compared using t test via SPSS software.
Findings: Of 1529 patients, 51.8% were boys, 56.0% were in rural areas, and 92.9% were Iranian. The mean age of patients (± SD) was 2.71 ± 1.5 years. The smallest patient was 2 months old. Most of the patients were in the age group of one year (20.4%) and the lowest were in the age group of less than one year (5.6%). Leishmania major was the most common (91.8%) cause of disease. Wound size at 63.37% of patients was more than 2 cm. In 11.2% of patients the number of wounds was equal or more than 4 wound. In children, face was the most common (33.7%) region of wound.
Leishmaniasis is endemic in Isfahan province, and children are in high risk for incidence of disease. However, the process for combating the animal reservoirs and mosquito vector should be considered as a priority to control the disease. Furthermore, the facilities should be provided for accurate and timely diagnosis and treatment of patients.

Hoarseness is a common complication after tracheal intubation. The aim of this study was to investigate the correlation between hoarseness after tracheal intubation with some demographic and clinical characteristics of patients undergoing elective surgery in Alzahra hospital, Isfahan, Iran.
This descriptive-prospective analytic study conducted on 98 patients (mean age: 38.7 ± 13.4 years, gender: 53.2% were women) undergoing elective surgery and had eligible criteria for the study. The correlations between intubation complication (hoarseness) and some demographic data [sex, age, weight, height, and body mass index (BMI)] and clinical characteristics (duration intubation, type of surgery, and tube size) were studied. Data were collected 72 hours after the surgery and analyzed using SPSS software.
Findings: In this study, 98 patients with a mean intubation time of 165.5 minutes were studied. Straining during extubation (55.1%), hoarseness (25.5 %), cough (7.1%), and sore throat (7.1%) were prevalent intubation complications, respectively. The correlations between duration of intubation (P = 0.027), and type of surgery (P = 0.040) with hoarseness were statistically significant. But there was not significant correlation between age, height, weight, tracheal tube size, and body mass index with hoarseness (P ≥ 0.050).
The results indicate significant correlation between hoarseness and duration of intubation and type of surgery.

Cardiovascular disease is the most common disease of the century and is considered as a major cause of mortality and heart failure in industrial and semi-industrial societies. Using electrical signals produced by the heart muscle have an important role in the recognition and diagnosis of heart diseases.
In this study, the signal recorded via vectorcardiography using an electrode arrangement called Frank, and electrocardiography were performed; a limited number of signals available in the database of the National Metrology Institute of Germany (Physikalisch-Technische Bundesanstalt or PTB) were also used. At the end, the data in each field vectorcardiography and electrocardiographic were assessed and compared. In order to make better use of time and optimize signal analysis, feature extraction operation was performed in the wavelet domain; and then, reducing the characteristics and classification were performed using support vector machine technique.
Findings: There were the accuracy of 83.18% and the validity of 99.06% in vectorcardiography leads and the accuracy of 75.44% and the validity of 97.16% in electrocardiographic leads.
Based on support vector machine classification system, the properties of the Frank system leads tended to better results than conventional 12-leads electrocardiogram (ECG).

Health Sector Reform (HSR) has been implemented in Islamic Republic of Iran since 2005 in rural, nomadic, and urban areas with population of less than 20 thousands, called Family Physician Program. One of the main objectives of this program is improvement of the accessibility and utilization rate of primary health cares. This study carried out to evaluate the case-finding rate of mental disorders after implementing this program.
In a cross-sectional study in Isfahan province, Iran, the data of the patients received mental health services during the period 2008-2015 were collected. After summarizing and providing mental health indicators in accordance with the objectives of the program, the results of these indicators were compared with expected country indicators provided by the Iranian Ministry of Health and Medical Education.
Findings: In that interval, the mean case finding rates of severe mental disorders, mild mental disorders, epilepsy, mental retardation, and behavioral disorders were 1.59, 6.37, 2.89, 2.87, and 0.6 per one-thousand population per year, respectively.
The case finding rate of severe mental and behavioral disorders were declined after implementing Health Sector Reform in rural areas of Isfahan province compared to the expected country indicators and also before Health Sector Reform.

Multiple Sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS). There is a correlation between up-regulation of a variety of cytokines with inflammatory reactions in multiple sclerosis lesions. This study aimed to investigate the effects of high-intensity resistance exercise program on prevention of experimental autoimmune encephalomyelitis (EAE) (a model for studying multiple sclerosis).
Resistance exercises were performed for 6 weeks, 5 days a week. Training program started with 50% of rat's body weight. In the first session, animals performed 8 to 10 repetitions (up the ladder) with 2-minute rest intervals. Rats were immunized with spinal cord and complete adjuvant of guinea pigs. Disease process and changes in rat's weights were measured every day. Experimental autoimmune encephalomyelitis model was induced at the end of the sixth week of training.
Findings: Resistance training in Lewis female rats with experimental autoimmune encephalomyelitis resulted in a significant reduction in tumor necrosis factor-alpha (TNF-α) (P = 0.001) and a significant increase in interleukin-10 (IL-10) (P = 0.001). However, it did not cause significant changes in Brain-Derived Neurotrophic Factor (BDNF) (P = 0.055). In addition, clinical symptoms in exercised rats were postponed.
Regarding the results, it appears that resistance exercises with necessary duration and intensity delay the onset, reduce the severity of clinical symptoms, and decrease TNF-α, increase IL-10, with no change in BDNF, in Lewis rats with experimental autoimmune encephalomyelitis.