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Research in Medical Sciences - Volume:23 Issue: 2, Feb 2018

Journal of Research in Medical Sciences
Volume:23 Issue: 2, Feb 2018

  • تاریخ انتشار: 1396/12/28
  • تعداد عناوین: 8
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  • Alireza Milajerdi, Shima Jazayeri, Najmeh Hashemzadeh, Elham Shirzadi, Zhaleh Derakhshan, Abolghassem Djazayeri, Shahin Akhondzadeh * Page 1
    Background
    Metabolic control is a major concern in preventing diabetic complications. Sa?ron as a natural source of antioxidants could play a role in alleviating diabetes insults. Te aim of this study was to investigate e?ect of sa?ron hydroalcoholic extract on metabolic control in type 2 diabetes (T2D) mellitus.
    Materials And Methods
    Tis randomized triple blind study was included 54 T2D patients which randomly received either sa?ron (Group 1) or placebo (Group 2) twice daily other than routine antidiabetic treatments for 8 weeks. Serum concentration of fasting blood sugar (FBS), 2?h plasma glucose, hemoglobin A1c (HbA1c), total cholesterol, triglyceride (TG), low?density lipoprotein, and high?density lipoprotein were measured as the markers of metabolic control. Anthropometric measures and blood pressure were also measured at the baseline, every 2 weeks during the intervention and the end of the study. Data analyzed using repeated measure analysis of variance test.
    Results
    Te baseline metabolic parameters were the same in two group (P > 0.01). FBS serum level signifcantly decreased within 8 weeks in the sa?ron group (128.84 ± 31.86) as compared to the placebo (153.76 ± 41.23), (P 0.01).
    Conclusion
    Sa?ron hydroalcoholic extract may improve blood glucose control by reducing FBS in T2D patients. However, sa?ron extract has no signifcant e?ect on other aspects of diabetic control in diabetic patients.
    Keywords: Diabetes mellitus, fasting blood glucose, lipid, metabolic syndrome, sa?ron extract
  • Omid Ahmadi, Amir Shirvani Dehkordi, Farhad Heydari, Mohammad Nasr Esfahani, Behzad Mahaki Page 2
    Background
    Renal colic is a painful medical emergency, needs urgent intervention to reduce pain. Nonsteroidal anti?in?ammatory drugs, opioids, and entonox are pain?relieving agents. Tis study was aimed to compare fentanyl entonox (nitrous oxide O2) versus fentanyl oxygen.
    Materials And Methods
    One hundred and twenty patients with acute renal colic presenting to the emergency department were enrolled. First, 50 µg fentanyl was infused for all patients. Ten, patients divided into two groups receiving masks of entonox and oxygen, respectively. Quantitative measurement of pain was performed by visual analog scale, before the intervention, after 3, 5, 10, and 30 min of that. If the pain was not relieved after 30 min, 50 µg fentanyl was infused. If the pain was still continued, ketorolac and ketamine were used. Hospitalization duration and severity of pain at specifed times were compared between patients in two groups.
    Results
    Te mean (standard deviation) time of hospitalization was 211 (59) and 236 (61) min in fentanyl entonox and fentanyl O2 groups, respectively (P = 0.024). Te decrease in pain severity after 10 and 30 min in fentanyl entonox group were signifcantly greater than fentanyl O2 group (P = 0.002 and 0.001, respectively). Mean (standard error) of needed time for renal colic pain to get better was 11.27 (1.23) and 20.47 (1.71) min in fentanyl entonox and fentanyl O2 groups, respectively (P
    Conclusion
    Entonox is more e?ective to decrease the duration of hospitalization and reduction of pain than O2 in renal colic patients.
    Keywords: Fentanyl, nitrous oxide, oxygen, renal colic
  • Silva Hovsepian, Shaghayegh Haghjooy Javanmard, Marjan Mansourian, Mahin Hashemipour, Mohamadhasan Tajadini, Roya Kelishadi Page 3
    Background
    Genetically, predisposed children are considered as at?risk individuals for cardiovascular disease. In this study, weaimed to compare the frequency of four?lipid regulatory polymorphism in obese and normal?weight children with and withoutcardiometabolic risk factors.
    Materials And Methods
    In this nested case–control study, 600 samples of four groups of participantsconsisted of those with normal weight with and without cardiometabolic risk factors and obese with and without cardiometabolic risk factors. Allelic and genotypic frequencies of GCKR (rs780094), GCKR (rs1260333), MLXIPL (rs3812316), and FADS (rs174547)polymorphisms were compared in the four studied groups.
    Results
    Data of 528 samples were complete and included in this study.
    Te mean (standard deviation) age of participants was 15.01 (2.21) years. Frequency of tt allele (minor allele) of GCKR (rs1260333)polymorphism was significantly lower in normal weight metabolically healthy participants than metabolically unhealthynormal weight (MUHNW) and obese children with and without cardiometabolic risk factor (P = 0.01). Frequency of ga allele ofGCKR (rs780094) polymorphism was signifcantly higher in normal weight children with cardiometabolic risk factor than in theirobese counterparts with cardiometabolic risk factor (P = 0.04). Frequency of cg and gg alleles (minor type) of MLXIPL (rs3812316)polymorphism in normal weight metabolically healthy participants was signifcantly higher than MUHNW (P = 0.04) and metabolicallyhealthy obese children (P = 0.04).
    Conclusion
    Te fndings of our study indicated that the minor allele of GCKR (rs1260333)single nucleotide polymorphisms (SNPs) could have pathogenic e?ect for obesity and cardiometabolic risk factors. Ga allele of
    GCKR (rs780094) SNPs had a protective e?ect on obesity. Minor alleles of MLXIPL (rs3812316) could have a protective e?ect forobesity and cardiometabolic risk factors.
    Keywords: Children, fatty acid desaturases, glucokinase regulatory protein, metabolic syndrome, MLXIPL protein, obesity, polymorphism
  • Hamid Mazdak, Amir Mohammad Abtahi, Fatemeh Momeni, Mohammad Hossein Izadpanahi Page 4
    Background
    We aim to compare the degree of pain control and complications in three types of anesthesia using periprostatic nerve block (PPNB) plus intrarectal local anesthesia (IRLA), low?dose spinal anesthesia, and intravenous (IV) sedation in patients undergoing transrectal ultrasound (TRUS)?guided prostate biopsy.
    Materials And Methods
    In this clinical trial study, 106 patients were participated from December 2015 to December 2016 at Alzahra Hospital, Isfahan, Iran. Patients were randomly allocated into three groups to receive PPNB plus IRLA (n = 36), low?dose spinal anesthesia (n = 35) and IV sedation (n = 35) before TRUS?guided prostate biopsy. Pain scores were recorded using a 10 point visual analog scale right after the biopsy was done. Early and late complications were assessed using a questionnaire after the procedure and in follow?up of patients.
    Results
    Overall, the pain score in the low?dose spinal anesthesia group was signifcantly lower than PPNB plus IRLA and IV sedation groups (P
    Conclusion
    Tis study demonstrates that low?dose spinal anesthesia is superior to PPNB plus IRLA and IV sedation in terms of pain controlling and was associated with higher tolerance of the examination and patient comfort.
    Keywords: Intravenous sedation, nerve block, pain, prostate biopsy, spinal anesthesia, trans rectal ultrasonography
  • Sara Abolahrari Shirazi, Javad Kojuri, Zahra Bagheri, Zahra Rojhani Shirazi Page 5
    Background
    This study aimed to compare the effects of combined endurance?resistance training (CT) versus endurance training (ET) on some cardiovascular markers in patients with heart failure after percutaneous coronary intervention (PCI).
    Materials And Methods
    Te study applied a randomized, controlled design in which 75 patients with heart failure who had undergone PCI were randomly assigned to one of three groups: ET, CT, and control. Te ET group performed ET for 45 min, three times a week for 7 weeks. Te CT group performed the same ET for 30 min followed by a resistance exercise protocol. Te control group received usual care. Functional capacity, N?terminal pro?brain natriuretic peptide (NT?pro BNP), and high sensitivity C?reactive protein (hs?CRP) levels were measured.
    Results
    After the intervention, functional capacity was improved (P
    Conclusion
    Exercise training is safe and feasible in post?PCI patients, even in those with reduced ejection fraction. CT was as e?ective as ET in reducing NT?pro BNP level and improving functional capacity in heart failure patients after PCI.
    Keywords: Brain natriuretic peptide, C?reactive protein, exercise, heart failure, percutaneous coronary intervention, resistance training
  • Zahra Laleh Eslamian, Elahe Zarean, Maryam Moshfeghi, Zahra Heidari Page 6
    Background
    Early prediction of adverse neonatal outcome would be possible by Doppler impedance indices of middle cerebral artery (MCA), umbilical artery (UmA), and descending aortal artery (AO) that result in decrease neonatal morbidity and mortality rate. Te aim of the present study was a determination of optimal value for the ratio of MCA to descending aorta blood ?ow (MCA/AO) impedance indices and its comparison with the ratio of MCA to UmA (MCA/UmA) impedance indices and their relationship with neonatal outcome.
    Materials And Methods
    Tis was a prospective cohort study on 212 pregnant women with gestational age 36 weeks or more, in three hospitals in Tehran, from April 2012 to April 2013. We investigated AO, MCA, and UmA impedance indices Doppler ultrasound every 2 weeks till delivery. Te mother was monitored for adverse pregnancy outcome (hypertension [HTN], fetal growth tardation, and other maternal complications) then infant birth weight, cord blood of pH, and Neonatal Intensive Care Unit (NICU) admission during the frst 24 h after delivery were assessed. Finally, we investigated relationships between Doppler indices and neonatal outcomes include neonatal body weight (NBW), cord blood of pH, and NICU admission.
    Results
    MCA/AO resistance index (RI) and MCA/AO pulsatile index (PI) showed an area under the receiver operating characteristics curve (area under the curve) of 0.905 (95% confdence interval (CI): 0.850, 0.959) and 0.818 (95% CI: 0.679, 0.956), respectively. Te cuto? values for pH (?7.2 vs.
    Conclusion
    In the end of third?trimester pregnancies with the assessment of MCA and AO artery Doppler ultrasonography, it is possible to prevent many cases of neonatal acidosis caused by prenatal asphyxia as well as inappropriate interventions which are applied on mother. If MCA/AO PI was
    Keywords: Complicated pregnancy, Doppler indices, neonatal outcome uncomplicated pregnancy
  • Mohammad Matinfar, Shahrzad Shahidi *, Awat Feizi Page 7
    Background
    Nonmelanoma skin cancer (NMSC) in renal transplant recipients is common and associated with signifcant morbidity and mortality. Te aim of the present systematic review and meta?analysis was to estimate the incidence of NMSC among renal transplant recipients.
    Materials And Methods
    We systematically searched PubMed, Medline, Scopus, and Web of Science databases for studies that assessed the incidence of NMSC in renal transplant recipients using a combination of relevant keywords. Two independent investigators included studies and extracted necessary information. Random e?ect meta?analysis was used to estimate pooled incidence of NMSC with 95% confdence intervals (CIs).
    Results
    Twenty?nine studies comprising 36,021 patients meet the criteria for the systematic review. Te pooled incidence of NMSC in renal transplant recipients was 12.6% (95% CI: 12%–14%) with a majority of squamous cell carcinoma (SCC) 55% (95% CI: 47%–63%). Te pooled estimate of the incidence rates of SCC and basal cell carcinoma was 2.7% (95% CI: 2%–3.4%) and 2.2% (95% CI: 1.5%–2.8%), respectively. Subgroup analysis per geographic location showed that pooled incidence of NMSC was 39.1% (95% CI: 26.3%–51.8%), 12.4% (95% CI: 8.8%–16%), and 1.2% (95% CI: 0.4%–2%) in Australia and New Zealand, Europe, and Middle East, respectively.
    Conclusion
    Te results of the current meta?analysis demonstrated that the incidence of NMSC in renal transplant recipients varies widely. Regarding the high incidence of NMSC among renal transplant recipients, awareness of associated risk factors and early diagnosis of the malignancy in the population is a major clinical need.
    Keywords: Basal cell carcinoma, incidence, nonmelanoma skin cancer, renal transplantation, squamous cell carcinoma
  • Shahin Soltani * Page 8