Zahedan Journal of Research in Medical Sciences
Volume:15 Issue: 4, Apr 2013

Chemokines are small protein molecules involved in cell signaling processes. They play a crucial role in many physiological and pathological processes. Chemokines are functionally classified into two categories; inflammatory/inducible and constitutive. Their biologic functional differences are the result of their receptors structural differences. Recently some studies were performed about the chemokines changes in diabetes. Inflammatory mechanisms have an important role in diabetes. In this review article we searched the keywords chemokines, diabetes, diabetes pathogenesis, and type 1 and 2 diabetes in Persian resources, PubMed and famous English-language websites through advanced search engines and found the newest studies about the role of chemokines in the pathogenesis of diabetes. The results of the studies showed that diabetes and its disorders enhance the activation of immune cells and the expression of cytokines such as IL-1, IL-6, IL-8, IL-10, SDF-1, INF-γ, TGF-β, MCP-1, IP-10, TNF-α, and RANTES; most of them have impact on the pathogenesis of diabetes. Comparison and analysis of the results obtained from our research and the results of performed studies in the world and Iran shows that chemokines, like other protein molecules involved in the pathogenesis and etiology of diabetes, play a role in this process.

Pseudomonas aeruginosa may be colonized in different human tissues and result in some infections potentially. Thus, considering that these bacteria are resistance to most of the current antibiotics, an examination on pathogenesis mechanisms of such bacteria can be effective in controlling the infections developed by it. In this project, among 40 blood samples (20 healthy persons, 20 infants), an amount of 5 ml (2 ml in the infants) heparinized blood was collected form each and then neutrophils were isolated by a standard method and were counted by neubauer lam. After culturing Pseudomonas bacteria in broth medium, some tubes with densities of 1, 2, 3 and 4 McFarland were prepared and the bacteria were isolated by centrifuge method with 3000rpm for 10 minutes and then its exotoxin were exposed to neutrophils of the groups under study. The effect of time and the bacteria count on the amount of the secreted toxin and in adjacency to neutrophils was measured. There were 11 men and 9 women in the health group and the infants group consisted of 12 boys and 8 girls. Death cell percentage of neutrophils was 100% in the health group and 8.90% in the infants group. Percentage of bacterial growth in the medium 1 and 2 McFarland was zero; in the medium 3 McFarland, it was 12.5% in the healthy group and 1% in the infants group (p<0.10). The average rate of cell death in the minute 15th was different in two groups (68.5% in health group vs. 92.5% in the infants) (p<0.0005). This study showed the effect of Pseudomonas bacteria on the development of early cell death in the infants very well. As it was shown, this effect is time-dependent and this cell death (apoptosis) is occurred in the infants earlier than health people.

Treatment of Helicobacter pylori as a major cause of gastric diseases is of utmost concern. We aimed to assess efficacy of triple therapy (amoxicillin, clarithromycin and pantoprazole) plus probiotic yogurt (PY) on eradication of H. pylori. Total 102 H. pylori positive patients were divided to 3 groups equally and randomly. For treatment of each group amoxicillin, clarithromycin and pantoprazole were used. Group A had additional PY and Group B ordinary low fat yogurt in their regimen as well. These groups were compared regarding treatment success. Total number of 88 patients finished the treatment course. The most common experienced side effects were dysgeusia in groups A and B (25.8% and 32.3%, respectively), and dysgeusia with diarrhea and abdominal pain (30.8%) in group C. Eradication rate was, respectively, 61.3%, 64.5% and 71.3% in group A, B and C of which difference was not statistically significant. However, the difference between 3 groups in regard to education level was statistically significant (p=0.005). PY enriched triple therapy has decreased side effects of antibiotics consumption; however, this has no impact on eradication of H. pylori. PY and triple therapy can be used concomitantly to increase the patient tolerance.

So many methods have been developed and tested to control post-surgical pain. In this study, the effect of bupivacaine-H medicine (along with epinephrine) on the post-surgical pain reduction in cesarean mothers was examined. Materials and Method s: In a double blind randomized clinical trial study conducted in Kerman, 70 pregnant women who were eligible for elective cesarean section participated in the study as randomized into two case and control groups. In all the patients, cesarean section incision lengths were equal and bupivacaine was injected after infant delivery. In the control group, physiological serum was used as placebo instead of medicine. Pain severity was compared between two groups using Visual Analogue Scale (VAS) on 6, 12, 24 and 48 hours after operation. The results were analyzed applying SPSS-11 software and using Mann-Whitney U and Wilcoxon tests. Mean age of the patients was 25.36 years with standard aviation of 2.48 years and the age range of 18-28 years. A previous cesarean with relative frequency of 38.5 percent was the main cause of cesarean section in such patients. In the case group, pain severity before 24 hours was less than that in the control group. After 24 hours of the operation, the pain severity in both case and control groups were similar. In general, bupivacaine injection into the cesarean incision area will cause to reduce the pain after cesarean section in the mothers and considering its minor complications, such medicine may be used as an effective pain control method in women.

The Apgar score (Appearance, Pulse, Grimace, Activity, and Respiration) of newborn babies immediately after birth is a determining factor involved with mortality of newborns after birth. Regarding the disagreement on advantages and possible disadvantages of propofol rather thiopental in the available references, the study was triggered with the aim of analyzing effects of two mentioned drugs on babies’ apgar score, mothers’ nausea, vomit and time necessary for mothers’ recovery. In this double-blind clinical trial, a total of 230 healthy women who were volunteered to undertake cesarean operation were selected and then divided randomly into two equal groups using statistical blocking. One group was treated by propofol while other one was treated by thiopental. The prescribed drugs for both groups were identical except the anesthesia induction drug. Babies’ Apgar score 1 and 5 minutes after birth and recovery period, mothers’ nausea and vomiting after operation were recorded. Apgar score I minute 1 (p=0.041) and apgar score in minute 5 (p=0.034) for propofol group were meaningfully higher than those for thiopental group. Recovery time from anesthesia was not different meaningfully in two groups (p=0.67). Statistical analysis of nausea and vomit in both groups showed that they are lower in propofol group rather thiopental group (p=0.028). It seems that in cesarean operations, after sufficient fluid therapy, propofol can be a proper drug to achieve anesthesia. Moreover it exerts less impact on cesarean babies’ apgar and stimulates lower levels of nausea and vomiting in mothers.

Migraine is considered as a chronic disease. Ocular symptoms and sensitivity to light stimuli are common in the patients with such disease. There are some evident that visual system function in the patients with migraine is impaired even between the attacks as compared with health people. In this study, we examine Visual Evoked Potential in 30 patients suffered from migraine before, during and after aura. 30 patients suffered from classic migraine and with visual aura were evaluated in terms of visual stimulatory potentials before, during and after aura. P-100 latency and amplitude were evaluation criteria in our study. The results of this investigation were evaluated by χ2 test. Abnormal amplitude frequency was occurred in 17 cases before aura, in 27 cases during aura and in 20 cases, it occurred after aura. Reduction of the amplitude wave p-100 during and after aura was significantly more in both eyes (p<0.05). Ten cases had abnormal P-100 latency during aura and the other two cases had it after aura. There is a significant difference in the P-100 latency during aura (p<0.05). There is no difference between the changes in visual stimulatory potentials with gender. Some changes were found in the parameters in the visual stimulatory potentials in the patients with classic migraine before, during and after aura.

The most common reason for seizure in elderly duration is the stroke. This study was conducted aiming to assess the frequency of seizure attack occurrence in those patients. This investigation was carried out through a cross-sectional method for one year on 330 patients admitted to the neurology ward as diagnosed with stroke. The required data was collected through the researcher-made questionnaire from the patients suffering from stoke which was diagnosed based on clinical findings, CT-Scan and MRI as required. Among 330 patient suffering from stroke (162 men and 168 women), 48 cases (14.5%) were suffering from seizure. Six percent of the patients had early seizure and another 8.5% had late seizure. Among 162 men suffering from the stroke, 32 ones were without seizures and 30 men were suffering the seizure. A number of 150 women out of total 168 ones suffering from the stroke, had no seizure and 18 others had seizures; frequency of seizure occurrence was more in male samples (p=0.044). In the people under 60 year, there were mostly early types of seizure (45%) and in the age range above 60 year, it was mostly late type (89.3%). A 68.5% of the patients suffering from the seizure had experienced ischemic stroke. However, the frequency of seizure occurrence in the patients with hemorrhagic stroke was statistically greater (p=0.003). This examination showed that occurrence of seizure attacks in the people with stroke is 14.5% and it is seen more in the hemorrhagic strokes than ischemic ones. The frontoparietal area is the most common location involved and tonic clonic was the most common seizure in the patients suffering from it who have experienced the stroke.

Coronary Artery Bypass Graft surgery)CABG) is one of the most common surgery procedures performed annually in worldwide. The objective of this study is to determine the prevalence and risk factors of the early neurologic complications emerged after CABG surgery. In a cross-sectional study we have investigated 160 consecutive patients undergoing CABG between July 2008 and April 2011 in cardiac surgery ward. Risk factors that evaluated in our analysis consist of hypertension (HTN), diabetes, age, sex, perioperative Myocardial Infarction (MI), postoperative atrial fibrillation, duration of aortic clamp, severity of carotid artery stenosis and addiction. Our dependent variables were delirium, CVA and seizure. The data were analyzed by SPSS-16 with Chi-square test and p<0.05. In our analysis, of total 160 patients, 58 (36.2%) were female. Mean age of patients was 62.7±9.6 years. Of total patients, 71 (44.4%) were found to have HTN, 35.6% had diabetes, 18.8% had atrial fibrillation, 30.6% had a history of preoperative MI and 10.6% had addiction. Mean time of aorta clamp time was 78.5±8.9 min. The incidence rate of delirium after CABG was 12 out of 160 patients (7.5%) and for CVA were 2 (1.2%). There was not any seizure among our population. Of total patients, 7% of diabetic patients, 8.5% of patients with HTN, 16.7% with atrial fibrillation and 8.2% of patients with a history of preoperative MI affected with delirium after the CABG surgery. In our analysis, no significant correlation observed between delirium and these risk factors. In present study, duration of aortic clamp had a significant relation with CVA after CABG (p=0.0001). According to this analysis, duration of aorta clamp time is one of the most important risk factors of CVA after CABG.

Multiple sclerosis (MS) is one of the most frequent and debilitating disease of the nervous system. Some recent studies show the possible role for iron and ferritin in the course of MS. The aim of this study was to evaluate the level of serum iron and ferritin in patients with MS and comparision of them with control group. In this descriptive study, serum iron and ferritin were determined in 30 patients with MS and compared with 30 healthy persons, which were matched in terms of age and gender. Data were analyzed with statistical descriptive methods and and t-test. In this study, 30 patients were evaluated. The mean age of both groups was 35.2. Mean serum iron in patients group was 85.16±38.38, and in control group was 91.73±27.89. Mean serum ferritin in patients group was 132.20±80.71 and in control group was 147.40±75.02. There was no significant relationship between serum iron and ferritin in both groups, and also there was no relationship between serum iron and ferritin with age and sex and the type of disease. This study did not show any difference between serum iron and ferritin in patients with multiple sclerosis and control group.

The elicited parameters from the center of pressure (COP) of patients after surgery of the anterior cruciate ligament are proper indications for estimating balance after surgery and rehabilitation. Thus, making sure about repeatability of COP parameters which can determine the knee joint after the knee reconstruction surgery is very important. This study measures repeatability rate of some COP parameters after reconstructing anterior cruciate ligament in various positions. In this study, 15 athlete men (mean age: 27±5) after 4-6 months since repair of their anterior cruciate ligament were included; they have been selected through simple non-probability sampling method. The study was conducted in biomechanics lab of Tarbiat Modares University in 2010. Assessment of balance was done with open/closed eyes, with/without foam using force platform in two sessions with 48 hours interval. The external-internal amplitude (0.86), external-internal standard deviation (0.86), phase plane (0.82) and area oscillation (0.81) were among parameters which showed the most repeatability. The average oscillation of anterior - posterior frequency (0.6) showed the lowest repeatability. A number of parameters caused by oscillation of COP show high rate of repeatability after reconstructing anterior cruciate ligament which can be used as an assessment of patients condition after reconstruction of the anterior cruciate ligament.

The milks expressed from the mothers’ breast might be infected during squeeze, storage and/or transmission. The infection level has been reported as different in various studies up to 97 percent. The main purpose of this study is to determine the infection level and its relevant organisms as well as to specify drug allergy of the expressed milks from the mothers with their infant admitted to NICU ward. In this study, among the expressed milks from 80 mothers, were cultured each in an amount of 0.5-1cc and antibiotic discs selected for every strain was placed. The results indicate that 85 percent of samples were infected and dominant microorganisms were firstly Klebsiella (13.7%) and then S. epidermidis (12.5%). In addition, 95% of Gram negative bacteria strains were susceptible to imipenem. The most effective antibiotic on isolated staphylococci was ceftizoxime (46.6% resistance). The colony count in 32.4% gram negative bacteria and in 66.7% gram positive bacteria was between 104 to 105 CFU/ml and the remaining was above 105 CFU/ml (p=0.02). Furthermore, there was no significant relationship between bacterial infection of the expressed milks with the site of milk expressing (house or hospital), mode of expressing (by pump or hand), storage duration and the mother’s demographic characteristics including age and/or literacy. The studies show that infection prevalence in the milk samples was 85%; the most common infection factor was Klebsiella and then S. epidermidis that is indicative of high prevalence of hospital infection (nosocomial infection) in the infants ward.

Drug abuse is associated with numerous complications including hormonal disorders of hypothalamic-pituitary-gonadal axis and spermatogenic disorders. We have compared the hormone concentration of pituitary-gonadal axis and the semen analysis in opioid-dependent and non-opioid-dependent men. In this case-control study, serum concentration of pituitary- gonadal axis hormones and semen analysis in 48 opioid-dependent men as eligible to participate in the study were compared with those in 12 non-dependent men. Free testosterone concentration in all test groups was significantly less than that in control group. Furthermore, the concentration of Dihydrotestosterone (DHT) and Dehydroepiandrosterone Sulfate (DHEAS) in all test groups except those addicted to heroin was less than in those in control group. Concentrations of LH, FSH, prolactin, SHBG, progesterone and estradiol, normal and abnormal sperm count in test groups were significantly different from control group. However, in all test groups, sperm motility rate was less than control group. No significant relationship was found between the concentration of sex hormones and the status of sperms motility. Chronic use of opioids will affect testosterone hormone and sperm, and it will cause hypogonadism and impairment of sperm motility.

Diabetes is one of the most common chronic diseases of the present era. This disease with its many complications has so many effects on quality of life that affects people. Since awareness increase is effective on self-control, some strategies can improve quality of life and technology has changed the way of education and life1. So, this study was performed to survey SMS effect on general health and quality of life in people with diabetes type 2 referring to clinic of 22-Bahman hospital of Gonabad city in 2011. This is a quasi-experimental study. The samples were chosen with a simple random sampling from those referring to clinic of 22-Bahman hospital of Gonabad city in 2011. The data were collected by SF-36 quality of life questionnaire. In both of the intervention (X = 40) and the control groups (X = 40) SF-36, quality of life questionnaire was completed before intervention and again one month after sending educational short messages through mobile phone, and then the data were analyzed by independent Mann-whitney, Wilcoxon, Chi square and T-test and using SPSS-14 software. This study reviewed the mean quality of life before and after sending educational short messages in two intervention and control groups. The findings showed that the average quality of life score before intervention was 56.9 in the control group and 58.3 in the intervention group (p=0). But the comparison of the quality of life scores showed a significant difference in the intervention group according to t-test before and after sending educational mobile messages to them (p= 0). SMS based on educational text is effective on quality of life increasing and then modern technology can be effective positively if it used approprately.

To assess the results of patellar fracture treatment by tension band wiring. This retrospective study was performed to evaluate clinical and radiological results of patellar fracture during past 6 years. Twenty four patients were participated in follow-up. Union was occurred in the mean time of 2.67±0.61 months. Falling down and direct trauma were the most common cause of fracture. Most common complications were thigh muscle atrophy and pin irritation. Excellent and good results in 87.5% and fair results in 12.5% of the patients were seen. Fixation of patellar fractures with tension band wiring was associated with a high rate of union.

The purpose of this investigation is to determine auditory neuropathy in the students with severe to profound hearing losses in Ahwaz. In this cross-sectional study, 212 children of 7-11 year old with severe to profound hearing loss performed ordinary audiometric evaluations as well as ABR and OAE. The patients with normal DPOAE who had no record of acoustic reflex having normal ABR, were considered as the patients with auditory neuropathy. The neuropathic complication found in 14 children was appeared in 8 ones as one-sided (57.14%) and in 6 ones (42.86%) as two-sided. 68% of the patients as diagnosed had a very low Speech Discrimination Score (SDS). we must be very vigilant in auditory neuropathy diagnosis for the purpose to be successful in appropriate treatment of severe to profound hearing losses.

Urticaria is a common dermatologic disease. About 20 per cent of the population experiences it in a life-time period. The aim of this study was to compare the various laboratory examinations of chronic urticaria patients and healthy individuals and to determine the necessity of laboratory tests in such patients. In this study 78 patients suffering from chronic urticaria and 67 healthy individuals (2-50 year-old) with analogous demographic features underwent ALT, AST, S/E, ESR, CBC, TSH, T4, C4, C3, CH50, ANA, anti-thyroglobulin, anti-peroxidase, and anti H. pylori antibodies testing. Forty-one per cent of patients had increased IgE in comparison to 14.92% in normal subjects. Anti-thyroid antibodies were positive in 17.94% of cases while only 9% of normal individuals were positive (p<0.05). Anti H. pylori antibodies were positive in 69.23 % of patients (all above 18-year-old) and 61.19 per cent of normal population (p>0.05). No significant difference found in other variables. Urticaria is often diagnosed based on clinical grounds and no routine laboratory examination is required.

This study is carried out aiming to determine the prevalence of various causes of hirsutism in patients referred to the endocrine clinic of Golestan Hospital in Ahwaz. In a cross-sectional study, 520 patients suffered from hirsutism whiting the age range of 10-50 year old participated based on Ferriman-Gallwey hirsutism classification system. Out of 520 patients under study, 274 ones (52.7%) had PCO, 176 ones (33.8%) suffered from idiopathic hirsutism, 24 persons (4.6%) had hyperprolactinemia, 22 persons (4.2%) had hirsutism caused by drugs consumption, 11 ones (2.1%) had hypothyroidism, 9 patients (1.7%) had cushing as well as 3 persons (0.57%) having Late Onset Congenital Adrenal Hyperplasia (LOCAH) and 1 person (0.19%) had ovarian tumor. Results of this study show that PCO and idiopathic hirsutism constitute totally 86% of hirsutism causes.

The present study is carried out to make a comparison between two pharmacological (heparin) and physical (compression stockings) in the prevention of deep vein thrombosis in lower limb of the patients suffered from acute stroke. In this investigation as a clinical trial, the effectiveness of the above methods on 100 patients with the stroke was compared in two groups of 50 persons. Three patients in physical group and two patients in pharmacological group got deep vein thrombosis that showed no significant difference between two groups. In spite of no significant relationship and due to less incurrence of thrombosis in heparin group, it is more reasonable to use pharmacological methods.

Because of being exposed to a wide range of ultraviolet radiations, welders are prone to eye and skin diseases. This study aims at determining the ultraviolet exposure level in welding workers of Sar-Cheshmeh Copper Complex. This cross-sectional study was conducted in 2010 on all welding workers of the complex using Hagner UV digital radiometer. The mean value for the received ultraviolet radiation level was 0.09±0.045 j2/cm2. The level of UV exposure was significantly different (p=0.001) for the welders working in different units of the complex. The mineworkers received the highest level of radiation (0.14 j2/cm2). In this study, the ultraviolet exposure of welding workers is below the allowable threshold limit for UV radiation.

Post extubation pulmonary edema and hemorrhage is an uncommon condition. In order to have good insight to the condition it will review the clinical course of 3 cases. Cases presentation: Undergoing surgery on one healthy middle age woman with lumbar disc herniation، and two young men (one with renal stone and one with varicocele) complicated by postextubation pulmonary edema and hemorrhage. Dyspnea and agitation were the main symptoms. Thacypnea، cyanosis، and hemoptesis were the main signs. Onset was rapid and all patients were managed conservatively by rest، supplemental O2، and hydrocortisone. Initial chest X-ray showed patchy، acinar infiltration in all three cases. All patients were improved rapidly within 24 to 48 hours and CXRs were fully cleared without any consequences. Considering the pulmonary edema and hemorrhage as a consequence of postextubation laryngospasm، so anesthesiologist have to place in the good insight to preventing the condition and watch all patients in post operative period at least for 2 to 6 hours.

Familial hypercholesterolemia (FH) is an autosomal disorder that causes severe elevations in total cholesterol and low- density lipoprotein. FH is one of the primary risk factors for premature coronary artery disease in children and adults which requires early diagnosis and appropriate medical intervention. In this article, we report two cases of homozygous familial hypercholesterolemia.

Hemoptysis in the patients suffered from pulmonary tuberculosis (TB) may be resulted by active TB or the complications of such disease which appears as bronchiectasis, fungal lesions deployed in tuberculosis cavities or Rasmussen aneurysm, Bronchiolitis or relapse and sometimes, it may be considered as caused by reasons irrelevant to TB. In this report, the patient is a 69-year-old man as complained of hemoptysis with a treated TB experience that was found as normal in the preliminary review of X-ray and CT. During bronchoscopy, a live leech (bloodsucker) was found in hypopharynx area that was swallowed after repeated attempts to remove it through the gastrointestinal tract and its suction signs were appeared as a mucosal mass in the hypopharynx area. The patient had no symptoms during his stay in the hospital.

Acute Necrotizing Encephalopathy of Childhood (ANEC) is a rare disease with a higher prevalence in the East Asia which is characterized with symmetrical and multifocal involvement of areas including thalamus, brainstem, cerebellum and white matter and it is associated with death as well as long-term neurological disabilities (sequel) in the individuals who survive. In this report, we introduce a child with acute neurological symptoms resulted by a possible infection process and explain his CT-scan and brain MRI as well as paraclinical symptoms.