Razavi International Journal of Medicine
Volume:3 Issue: 1, Winter 2015

Context: 

Amniotic Fluid Derived Stem Cells (AFSC) has mesenchymal origin and is multipotent. Having played their role in the detection of genetic abnormalities in the unborn children, they are gaining attention in the regenerative medicine because of their pluripotency.

 Evidence Acquisition:

 AFSCs possess great proliferating ability and have no ethical and religious issues in their use. AFSCs may also be studied for the stem cells differentiation such as production of multiple lineages of different cells like heart, liver, pancreas, etc. The potential of their use in regenerative medicine as well as their differentiation into multiple cells is possible.

AFSCs have the potential to be used in tissue repair and regeneration of bladder and kidney injuries, for the treatment of congenital anomalies like tracheal anomalies and spina bifida therapy etc. However, like every therapeutic potential, AFSCs also have some limitations such as low rate of differentiation of transplanted AFSCs and immune rejection.

AFSCs have great therapeutic potential, but extensive research is warranted to overcome the limitations to use AFSC as therapy.

Diabetes was one of the most important metabolic and public health diseases all over the world. It was the most common endocrine disease caused by metabolic disorders. Type 2 diabetes is rapidly progressing in world. The incidence of diabetes is predicted to double in the following 20 years.

The current study was aims to evaluate the effect of standard nutrition and exercise on glucose and lipid levels in diabetic patients.

It was an intervention study whose target population is consisting of 120 diabetic patients who had referred to PARSIAN Diabetes Research Center. Sampling size has been non-randomly selected. Mean and standard deviation are quantitative data applied in this study. T-test and independent sample T-test have been respectively utilized to compare changes within and between the groups. The amount of p-value has been calculated less than 0.05 which indicates statistical significance.

The achieved findings shows that glucose level has significantly decreased in experiment group using a pretest-posttest design (P < 0.05).

Eight-week standard nutrition and regular exercise have significant effect on decrease of glucose level, insulin resistance and plasma lipoproteins. It is suggested to apply these programs in diabetes centers.

Bone is an uncommon site of involvement in hydatid disease; with the prevalence of 0.5-2% among bone lesions.

In this study, we report the treatment of 5 cases of hydatid disease of tibia by curettage of the lesion; wash with Betadine lotion and hypertonic saline and filling the cavity with poly methyl metacrylate (PMMA) bone cement. After operation, we continued treatment with oral mebendazole for 6 months.

With the average 89 months follow-up, no recurrence of the diseases was found in the patients. It seems that using of cement and oral anti-parasitic, after extensive resection of the lesion is a proper treatment of bone hydatid disease.

The most important diarrheal disease of the year warm seasons is cholera with Vibrio cholera bacteria that some cases are observed in the country every year.

The purpose of this study was to identify the outbreak factors of diarrheal disease and prevention ways of its mortality rate among Gonabad city workers.

This study is a case-control study conducted in 29 June 2013 to 6 August 2013, followed by diarrhea outbreak occurred in Brick kilns of Kosar industrial unit in Gonabad city. The data were collected by a questionnaire from patients and healthy people. Cholera sample and Stool exam were taken from all the patients. To determine the source of disease, water microbial sampling, chlorine metering and chlorine chlorination was conducted.

A total of 120 workers were studied (60 cases and 60 controls) who were the same from age and sex point of view. Clinical signs observed in 60% of cases were abdominal cramping and 11.6% had nausea. Human test results showed 1 sample of Eltor ogawa serotype and 4 Nag strains. No significant differentiation was observed in hand washing between the patients and the healthy ones (P = 0.15). The risk factor of using from water storage was 3 times more in case than the control group.

Health disobedience and neglect of local residents were the causes of water pollution that was controlled with preventional measures, with performing daily chlorination of Brick kilns drinking water and diarrheal disease treatment of the patients.

One of most important operations research problems is Nurse Scheduling Problem (NSP) that tries to find an optimal way to assign nurses to shifts with a set of hard constraints. Most of the researches are dealing with this problem in deterministic environment with constant parameters. While In the real world applications of NSP, the stochastic nature of some parameters like number of arriving patients, stay periods, etc. are some sources of uncertainties that need to be controlled to provide a qualified schedule.

In this article we propose our model in an uncertain environment in Department of Heart Surgery in Razavi Hospital.

The demand and stay period of patients are stochastic whose the distribution is determined from historical data. Finally, the demand of nurses in each shift in planning horizon is calculated regarding the priority (vitality) of patients.

The stochastic optimization is adapted for our problem and the Sample Average Approximation (SAA) method is used to obtain a optimal schedule with respect to minimizing the regular and over time assignment costs. The results have been analyzed and show the validity of our model.

In this model the demand and stay period of patients are stochastic whose the distribution is determined from historical data. We also consider the priority (vitality) of patients in our model.

Risk stratification models allow preoperative assessment of individual patients cardiac surgical risk and enable analysis of postoperative outcome in the intensive care unit (ICU) as well.

The aim of this single-center study was to explore the prediction of extended ICU stay after cardiac surgery using the European System for Cardiac Operative Risk Evaluation (Euro SCORE).

A retrospective cross-sectional study was conducted. We collected clinical data of 1841 consecutive patients undergoing cardiac surgery. The outcome measure was the duration of ICU stay in days. The predictive performance of Euro SCORE was analyzed by the discriminatory power of a receiver operating characteristic (ROC) curve.

Overall observed mortality was 3.5% (57/1841). Patients had a median ICU stay of 3 days and a mean ICU stay of 3.1 days. Mean additive Euro SCORE was 4.36% (range: 0-21) and logistic Euro SCORE was 4.81% (range: 0.88-44.28). The logistic Euro SCORE model yielded an area under the ROC curve of 0.832, 0.768 and 0.643 for each ICU length of stay, respectively (7, 5, 3 days). Values of Euro SCORE and ICU stay were positively correlated (P < 0.001).

In our center, prolonged length of stay in the ICU correlated positively with Euro SCORE. The overall predictive performance of Euro SCORE is acceptable and provides both surgeons and intensivists with a good estimate of patient risk in terms of ICU stay.

Coronary artery bypass grafting (CABG) is a revascularization method for coronary artery disease (CAD), which is done with and without cardiopulmonary bypass (CPB). CABG without CPB (off-pump) has been prevalent due to CPB related complications but a number of studies have not demonstrated superiority between these two methods.

This study designed to evaluate changes in patients’ echocardiography findings during 4 years after CABG with and without CPB.

118 patients who underwent CABG were included in this historical cohort study. Demographic data echocardiographs, serum creatinine and hemoglobin before and after surgery extracted from patients’ medical records. In the next visits, history taking, cardiovascular events, physical examination, and echocardiography considered in all patients. Data compared in Off-Pump and On-Pump CABG groups.

One hundred eighteen patients with the mean age of 59.47 ± 9.68 years were included (81 male and 37 female). On-pump CABG was done on 84 patients and off-pump on 34 patients. The mean age was significantly more and numbers of atherosclerotic vessels were less in off-pump patients. Left ventricle ejection fraction (EF) was significantly decreased in on-pump group and increased in off-pump group. Right ventricle EF was significantly decreased in both groups, with significant decrease in on-pump patients. Mitral and tricuspid valves regurgitation were significantly more in on-pump patients (P < 0.05).

Our study showed superiority of off-pump CABG regarding LVEF, RVEF and valves regurgitations. Future studies with prospective structure, accurate randomization, longer follow up duration, and larger sample size are needed.

Context: 

Chronic myeloid leukemia (CML) is believed to occur following the clonal expansion of haematopoietic stem cells and is maintained by expanding clones which have acquired a BCR-ABL fusion gene. The properties of untreated CML stem/progenitor cells correlate with a subsequent response to chemotherapy.

Evidence Acquisition: 

The fifty two significant articles discussing the stem cell in chronic myeloid leukemia from 1996 to 2012 were selected according to the authors’ experience.

Studies have shown that primitive CML cells are less responsive to Tyrosine Kinase Inhibitors (TKIs) and are a reservoir for the relapse of multi drug resistant (MDR).

Following that, minimal residual disease (MRD) measurement aims to detect very small numbers of leukemic cells, below the detection limit of morphology and cytogenetics with molecular techniques for patients in clinical remission.