mohammadjavad fatemi
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مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران، سال هشتاد و یکم شماره 1 (پیاپی 264، فروردین 1402)، صص 21 -28زمینه و هدف
استیوآرتریت یک بیماری دژنراتیو مفصلی و شایعترین نوع آرتریت است که سبب درد، ناتوانی و اختلال در عملکرد بیماران می شود. قند خون بالا به واسطه استرس اکسیداتیو و افزایش میزان گونه های فعال اکسیژن و ایجاد واسطه های التهابی برغضروف تاثیر می گذارد. از آنجایی که درمان های دارویی برای استیوآرتریت کوتاه مدت و غیرموثر هستند، نیاز به درمان های جدید جهت درمان استیوآرتریت وجود دارد. استفاده از محلول رویی سلول های بنیادی مزانشیمی یا سیکریتا که حاوی محصولات ترشحی ازقبیل فاکتورهای رشد و سیتوکین ها است به عنوان یک جایگزین مناسب جهت درمان استیوآرتریت درنظر گرفته شود. هدف از این مطالعه اثرات سیکریتا براسترس اکسیداتیو القا شده توسط غلظت بالای گلوکز در کندروسیت های انسانی C28I2 می باشد.
روش بررسیتحقیق حاضر به صورت تجربی از اردیبهشت 1397 تا شهریور 1399 در گروه فارماکولوژی دانشگاه علوم پزشکی ایران انجام شد. اثر سیکریتا و غلظت بالای گلوکز بر میزان بقای سلول های غضروفی C28I2 توسط آزمون WST1 بررسی گردید. سپس تاثیر سیکریتا بر بیان mRNA، کاتالاز (CAT)، سوپراکسید دیسموتاز I (SOD1) و گلوتاتیون اس ترانسفرازها I (GSTP1) در گروه های درمانی و غیردرمانی مقایسه شدند.
یافته هاپیش درمانی کندروسیت های انسانی C28I2 با سیکریتا سبب افزایش بیان ژن های CAT، SOD1 و GSTP1 در سلول های مجاورت داده شده با غلظت گلوکز بالا نسبت به گروه درمان نشده می شود.
نتیجه گیریسیکریتا می تواند در سلول های غضروفی تحریک شده توسط غلظت بالای گلوکز، استرس اکسیداتیو را ازطریق افزایش ظرفیت آنتی اکسیدانی کاهش دهد و چون استرس اکسیداتیو از مکانیسم های اصلی آسیب غضروف می باشند، سیکریتا می تواند در جلوگیری از پیشرفت استیوآرتریت مفید باشد.
کلید واژگان: سیکریتا، سلول بنیادی مزانشیمی، استئوآرتریت، استرس اکسیداتیوBackgroundOsteoarthritis (OA) is the most common form of arthritis characterized by progressive loss of articular cartilage, causing pain and loss of articular function. High glucose is a crucial inflammatory factor playing a pivotal role in the pathogenesis of OA that induces ROS production. Since most of the current therapies for OA are short-term benefits, hence, there is high demand for finding novel therapeutic agents for OA treatment. Recent studies have demonstrated that mesenchymal stem cells secrete important therapeutic factors that protect chondrocytes. In the current study, we investigated the protective potential of Adipose-derived stem cell conditioned medium (CM-ADSC) as an alternative to cell therapy in high glucose-mediated oxidative stress in C28I2 human chondrocytes.
MethodsThis experimental study was performed in the Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran from May 2018 to August 2020. Adipose-derived stem cells were cultured until they reached 90% confluence then washed with PBS and cultured in a FBS-free medium for 48 hours. The conditioned medium was collected and centrifuged. The protective effect of the concentration of conditioned medium on high glucose (75mM)-induced oxidative stress in C28I2 cell viability was evaluated by WST-1 assay. Total RNA was isolated from the treated and untreated cells with TRIzol reagent. The mRNA expression of antioxidant enzymes including, glutathione S-transferase-P1 (GSTP1), catalase (CAT), and superoxide dismutase1 (SOD1) was evaluated by reverse transcription-polymerase chain reaction in treatment and non-treatment groups.
ResultsAdipose-derived stem cell conditioned medium pretreatment remarkably protected C28I2 cells against high glucose. The expression of mRNA of CAT, GSTP1, and SOD1 significantly increased following treatment with the conditioned medium (50%) for 24 hours in high glucose-exposed cells as compared to the control.
ConclusionPresent study indicates that the Adipose-derived stem cell conditioned medium can reduce oxidative stress. It seems that the conditioned medium may protect cartilage in the progression of osteoarthritis.
Keywords: conditioned medium, mesenchymal stem cell, osteoarthritis, oxidative stress -
Background
Hand traumas are common in young men and their complications can have negative effects on their occupation and economic activities. On the other hand, most of the hand injuries are related to occupation accidents and thus necessitates preventive measures. The goal of a clinical registry is assisting epidemiologic surveys, quality improvement preventions.
MethodsThis article explains the first phase of implementing a registry for upper extremity trauma. This phase includes recording of demographic data of patients. A questionnaire was designed. Contents include patients’ characteristics, pattern of injury and past medical history in a minimal data set checklist. This questionnaire was filled in the emergency room by general practitioners. For 2 months the data were collected in paper based manner, then problems and obstacles were evaluated and corrected. During this period a web based software was designed. The registry was then ran for another 4 months using web based software.
ResultsFrom 6.11.2019 to 5.3.2020, 1675 patients were recorded in the registry. Random check of recorded data suggests that accuracy of records was about 95.5%. Most of the missing data was related to associated injuries and job experience. Some mechanisms of injury seems to be related to Iran community and thus warrants special attention for preventive activities.
ConclusionWith a special registry personnel and supervision of plastic surgery faculties, an accurate record of data of upper extremity trauma is possible. The patterns of injury were remarkable and can be used for investigations and policy making for prevention.
Keywords: Registries, Hand Trauma, Occupational accidents, Amputation -
Contribution of platelets in tissue regeneration and their possible application in regenerative medicine, which is primarily mediated via secretion of granular components following platelet activation, has been well established in the recent decades. Therefore, platelet rich plasma (PRP), as a portion of plasma with higher concentrations of platelets than the baseline level, is now an attractive therapeutic option in various medical fields mainly for tissue repair and regeneration following injuries. Burn injuries are devastating trauma with high rate of morbidities affecting several aspects of the patient’s life. They require a long-time medical care and high costs. However, even following the best treatment procedures, post-burn scars are inevitable consequence of burn healing process. Therefore, development of new treatment modalities for both burn healing and prevention of post-burn scar establishment seems to be necessary. Regarding the well-known role of PRP in wound healing, here we aimed to provide a comprehensive insight in the possible application of PRP as an adjuvant therapy for the management of burn injuries and subsequent scars. In terms of the following keywords (individually or in combination), original/review articles were searched in PubMed, Scopus, and Google Scholar databases from 2009 to 2021: platelet rich plasma, PRP therapy, platelet biology, platelet function, burn healing, burn scar, scar formation, burn management, wound healing, regenerative medicine. All type of articles or book chapters in English language and relevant data were included in this review. This review initially focused on PRP, its mechanisms of action, preparation methods, and available sources. Then, pathophysiology of burns and subsequent scars were discussed. Finally, their current conventional therapeutic modalities and implication of PRP in their healing process were highlighted.
Keywords: Burns, Platelet Rich Plasma, Wound Healing -
Background
Burns are among the major health challenges of all societies and more than any other trauma incur physical, mental, social, and economic burdens on the patient and society. This study was conducted to assess whether Recove® burn ointment is capable of alleviating the pain, preventing the formation of new blisters and controlling the microbial contamination of the wound.
MethodsWe, therefore, compared its efficacy to nitrofurazone 0.2% cream. This randomized clinical trial was conducted on individuals who had two burn injuries in their body at the same time in the Motahari Burn Hospital, Tehran Province, from June to October 2016. Sampling was carried out with a non-random method using available samples. The intervention in experimental and control groups was Recove® and nitrofurazone, respectively. The effect of interventions on pain relief, the formation of new blisters and prevention of infection at the burn wound were evaluated. In our double-blind study, blindness was applied to the patients and the person evaluating the outcomes.
ResultsBoth Recove® and nitrofurazone interventions significantly alleviated pain (P < 0.01), but Recove ®showed more effectiveness (P=0.01). Similarly, in terms of new blister formation, the experimental group receiving Recove® showed less new blister formation over 24 hours after treatment compared to nitrofurazone group (P=0.03) and with respect to antimicrobial activity, there was no significant difference between Recove® and nitrofurazone (P=0.12).
ConclusionRecove® was effective on pain reduction, prevention of new blisters formation as well as infection. Therefore, it seems that Recove® could be considered as a new and efficient treatment for burn.
Keywords: Burn, Recove® burn ointment, Nitrofurazone cream, Pain, Blister -
Purpose
The aim of this study was to evaluate the protective effect of conditioned mediumderived from human adipose mesenchymal stem cells (CM-hADSCs) on C28I2 chondrocytesagainst oxidative stress and mitochondrial apoptosis induced by high glucose (HG).
MethodsC28I2 cells were pre-treated with CM-hADSCs for 24 hours followed by HG exposure(75 mM) for 48 hours. MTT assay was used to assess the cell viability. Reactive oxygen species(ROS) and lipid peroxidation were determined by 2,7-dichlorofluorescein diacetate (DCFHDA)and thiobarbituric acid reactive substances (TBARS) assays, respectively. Expressionsof glutathione peroxidase 3 (GPX 3), heme oxygenase-1 (HO-1), and NAD(P)H quinonedehydrogenase 1 (NQO1) were analyzed by RT-PCR. Finally, western blot analysis was used tomeasure Bax, Bcl-2, cleaved caspase-3, and Nrf-2 expression at protein levels.
ResultsCM-hADSCs pretreatment mitigated the cytotoxic effect of HG on C28I2 viability.Treatment also markedly reduced the levels of ROS, lipid peroxidation, and augmented theexpression of HO-1, NQO1, and GPx3 genes in HG-exposed group. CM-ADSCs enhancedNrf-2 protein expression and reduced mitochondrial apoptosis through reducing Bax/Bcl-2 ratioand Caspase-3 activation.
ConclusionMSCs, probably through its paracrine effects, declined the deleterious effect ofHG on chondrocytes. Hence, therapies based on MSCs secretomes appear to be a promisingtherapeutic approaches to prevent joint complications in diabetic patients.
Keywords: Adipose derived mesenchymal stem cells, Conditioned medium, High glucose, Oxidative stress -
BACKGROUND
In many countries, there is no registry system to record data for Epidermolysis Bullosa patients. However, the first steps for establishing a registry system have been taken in Iran. Therefore, we decided to publish it for the first time.
METHODSThis was a prospective cross-sectional study. Data was obtained from 538 patients consecutively enrolled in the Iranian Epidermolysis Bullosa Registry, using a detailed instrument created by burn research center of Iran University of Medical Sciences, Tehran, Iran from Jan 2017 to Sep 2017. Patients’ information such as age, gender, address, educational status, parents’ family relationship and pathology result were recorded. Then a physician examined patients focusing on gastrointestinal system, teeth, ophthalmologic disorders, psychological problems and contracture of the upper and lower limbs and any other complaint. Data entered SPSS ver.19 and analyzed using ANOVA and LSD tests.
RESULTSOverall, 538 EB patients were registered in Iran (6.72 patient in 100.000 person) with an approximately equal ratio between males and females. Among 103 patients whose disease type was determined by a pathologist, 78 patients (75.7%) had dystrophic type, 13 (12.6%) junctional, 9 (8.7%) simplex and 3 (2.9%) kindler type. The most common complaint of patients was dysphagia followed by tooth damage.
CONCLUSIONWe stablished a data registry for EB patients for the first time in Iran. The frequency of EB in Iran is less than many other countries. However, data completion is to be done to include all patients as possible.
Keywords: Epidermolysis bullosa, Epidemiology, Iran -
BACKGROUND
This study was designed for the evaluation of Acellular Dermal Matrix (ADM) as a scaffold for adipose-derived stem cell transferring in the rat model.
METHODSThis experimental study was done in the Burn Research Center of Iran University of Medical Sciences and Bonyakhteh Research Center, Tehran, Iran according to the standards of laboratory animals. Overall, 26 healthy Sprague-Dawley rats were used. Two of them were used to prepare ADM. In group one, the first wound on each, rat was spread with the mixture of fibrin gel and autologous stem cell. Only the stem cells combined with fibrinogen were spread on the other wound. In group two, the first wound on each rat was covered only with ADM, and the second wound was covered with gauze Vaseline. To perform sampling we used observation and photography at 7-30 days. Overall, 48 samples were taken of all the rats using skin punch biopsy on the 30th day for histopathology evaluation.
RESULTSThere were significant differences in each group; however, the difference between different groups on days was not significant. In pathology, epithelialization, vascularization, the amount of collagen, collagen arrangement, the number of fibroblasts, and inflammation indices were investigated. The total score in each group was used for analysis. In statistical analysis, there was no pathology score difference among groups.
CONCLUSIONUsing stem cells with or without ADM could not enhance the process of wound healing or improve pathology indices.
Keywords: Stem cell, Tissue engineering, Acellular Dermis -
BACKGROUND
Randomized skin flaps have been used as a basic treatment modality for covering skin defects for a long time but they have always been in the risk of an inherent ischemia. Fibroblast growth factor 1 is a known angiogenic factor in in vitro studies which has shown conflicting results in in vivo investigation. We aimed to determine the effect of recombinant fibroblast growth factor on the angiogenesis rate of random cutaneous flap in animal model of rats.
METHODSThis experimental study was conducted on 24 adult male rats randomized to 2 groups. In the first group FGF1 was injected subdermally in equally divided doses and distances of random flap surface in days 1, 3 and 5. In second group, normal saline was injected as control. Flap surgery was done on day 21 after first injection. The extent of necrosis and angiogenesis (mean vessel density) were assessed in day 14 after surgery.
ResultsThe mean percentage of clinically apparent necrosis was 35.2% (±10.5) in intervention (FGF1) group and 38.1% (±8.7) in control (normal saline), re-spectively. Mean vessel density was 86.20±5.6/mm2 in control group and 90.17±5.5/mm2 in intervention group, which showed no statistically signifi-cant difference.
CONCLUSIONMean vessel density and mean percentage of clinically apparent necrosis area were similar in 2 groups of rats with random cutaneous flaps receiving FGF1 or normal saline.
Keywords: Fibroblast growth factor 1, Angiogenesis, Random skin flap -
امروزه یکی از بیشترین مراجعه های بیمارستانی و بالینی مشکلات دستگاه عصبی،مربوط به آسیب های واردشده پس از حوادث است که زندگی آسیب دیدگان را دچار اختلال می کند. طبق آمار ارایه شده، در آمریکا سالانه نیم میلیون جراحی به دلیل آسیب دیدن بافت عصب محیطی ثبت شده که هزینه آن ها حدود 5/1 میلیارد دلار برآوردشده است. همچنین، در اروپا بیش از300 هزار مورد و در سراسر جهان به طور تخمینی بیش از 5 میلیون مورد آسیب واردشده به عصب محیطی سالانه گزارش شده است. تروما شایع ترین علت آسیب دیدگی اعصاب محیطی است و آسیب های عصبی به طور مکرر باعث تحلیل عضله با کاهش سینگال های عصبی می شود. آسیب های متنوع عصبی می توانند ناشی ازصدمه های فشاری،کششی و مکانیکی وشکستگی ها باشند. در این مقاله، روش های نوین و زیست پلیمرهای به کاررفته در درمان آسیب بافت عصب محیطی بررسی می شوند. به طور کلی، روش های درمان بافت عصبی به دو دسته متداول پیوند ی (خودپیوند، دگرپیوند و غیرخودی) و نوین مهندسی بافت با استفاده از لوله های عصبی (لوله های عصبی زیستی یاخته زدایی شده و لوله های عصبی سنتزی یا مصنوعی) تقسیم بندی می شوند. لوله های عصبی نیز به سه دسته کلی لوله های زیستی (پروتئین ها و پلی ساکارید ها)،لوله های عصبی سنتزی (پلی استر ها، پلی یورتان ها و پلی ال ها)، لوله های عصبی ترکیبی و عصبی رسانا تقسیم بندی می شوند که هر یک از این روش ها به طور مفصل مرور می شوند.
کلید واژگان: عصب محیطی، پیوند، پلیمر طبیعی، پلیمر سنتزی، لوله های عصبیToday, one of the most common hospital and clinical visits of nervous system problems is related to the injuries after accidents that disrupt the lives of injured.According to statistics, half a million surgeries are registered annually in the United States due to the peripheral nerve tissue damage, and the cost of these surgeries is estimated at about 1.5 billiondollars.Also,more than300,000 peripheral nerve injuriesare reported annuallyin Europe and over 5 million worldwide.Trauma is the most common cause of peripheral nervous damage, and neurological injuries often cause muscle-traumatic neuronal damage.In this article, new methods of treatment of peripheral nerve tissue are reviewed.In this paper, new methods and biopolymers used in the treatment of peripheral nerve tissue injuries are reviewed.Generally,peripheral nerve tissue treatment classified into grafts (autograft, allograft, and xenograft) and nerve conduits (decellularized nerve conduits and manufactured nerve conduits). Synthetic neurotransmitters are also divided into three general categories of biodegradation (polyesters, proteins and polysaccharides), synthetic (polyesters, polyurethanes and polyols) and hybrid neurotransmitters, whicheach of these methods is discussed in detail.
Keywords: peripheral nerve, graft, natural polymer, synthetic polymer, nerve conduits -
BACKGROUND
Phalloplasty is the most amazing reconstructive surgery, and has a vital role in the quality of life of transsexual patients. There are several techniques for glans sculpting, but none of them had long-lasting results. In the present study, a new technique was introduced and compared with Norfolk technique for coronaplasty following phalloplasty.
METHODSIn the present randomized controlled study, 40 transgender patients were enrolled from February 2016 to December 2018, at St. Fatima Plastic and Reconstructive Surgery Center. The patients were randomly assigned in two groups including 20 patients with anterolateral thigh flap (ALT)/radial forearm free flap (RFFF) phalloplasty followed with our new coronaplasty technique (group 1) and 20 patients with ALT flap/RFFF phalloplasty followed with Norfolk technique (group 2).
RESULTSAlmost 85% of the patients underwent the surgery with the new technique were satisfied with the outcome of surgery and considered it acceptable within 6-month follow-up, however, only 70% of the patients in Norfolk technique group reported acceptable results, which was significantly lower than the new technique. Similarly, within 12-month follow-up, 80 and 40% of the patients, respectively in new and Norfolk groups reported acceptable results, which was also significantly higher in the new technique.
CONCLUSIONThis new technique showed remarkably better results relative to the usual technique for glans sculpting in transsexual patients. Moreover, it had the ability to be easily applied along with ALT/RFFF flaps in both immediate and delayed situations.
Keywords: Transsexual, Phalloplasty, Coronaplasty, Norfolk -
زمینه و هدفشکاف کام (Cleft Palate) شایعترین ناهنجاری مادرزادی کرانیوفاشیال بوده و تقریبا یک مورد در هر 2000 تولد زنده اتفاق می افتد. در اغلب این بیماران از بافت های موضعی و منطقه ای داخل دهان برای ترمیم آن استفاده می شود. با این همه در موارد شکاف وسیع یا فیستول های بزرگ و یا عود کرده، این روش ها کافی نبوده و نیاز به انتقال فلپ های آزاد است.مواد و روش هادر این مطالعه گذشته نگر در بیمارستان حضرت فاطمه(س) پرونده هفده بیمار با شکاف یا فیستول کام که با فلپ آزاد درمان شده بودند، بررسی شد. اطلاعات شامل سن، جنس، علت عمل جراحی، نوع فلپ منتقل شده، شریان و ورید گیرنده آناستوموز، وسعت فلپ منتقل شده، نوع انتقال از نظر پری لامینیت یا با گرافت، نتیجه اولیه، عوارض دراز مدت، تاثیر روی ورود مواد غذایی به بینی و مشکلات تکلم جمع آوری شدند. داده ها با نرم افزار SPSS ویرایش 19 مورد تجزیه و تحلیل قرار گرفتند و با استفاده از آمار توصیفی آنالیز شدند.یافته هامیانگین سنی بیماران 540/13± 705/15 (54-3 سال) بود. 10 نفر (60%) از بیماران مرد و 7 نفر (40%) زن بودند.
8 بیمار (47%) به علت شکاف کام وسیع [Wide Cleft Palate (WCP)]، 7 نفر (41%) از بیماران به علت فیستول کام عود کرده [Palatal Fistula (PF)] و یک نفر (6%) از بیماران به علت نقص وسیع کام ناشی از رزکسیون تومور و یک نفر (6%) به علت نقص وسیع کام به دنبال عفونت قارچی موکورمایکوسیس با بیماری زمینه ای دیابت کاندید انتقال فلپ آزاد شدند. همه فلپ ها زنده ماندند و نکروز کامل یا پارشیل فلپ دیده نشد. ورود غذا به بینی Nasal Regurgitation در همه بیماران به جز سه نفر درمان شد و کیفیت تکلم [Velopharyngeal Insufficiency (VFI)] بهبودی نشان داد.نتیجه گیریفلپ رادیال ساعد یکی از بهترین انتخاب ها برای پوشش نقایص کام در بیماران با شکاف کام وسیع یا فیستول مقاوم به درمان می باشد. در مطالعه ما موفقیت فلپ صد در صد هر چند در حدود 18 درصد بیماران عارضه عدم ترمیم کامل مشاهده شد. مهمترین عیب این فلپ اثرات نازیبا شدن و اسکار ساعد است که باید در مقابل مزایای زیاد آن قرار داده شده و تصمیم گیری شود.کلید واژگان: فلپ آزاد، شکاف کام، فیستول کامIntroduction & ObjectiveCleft Palate is the most common congenital craniofacial disorder with prevalence about one in every 2000 births. In most of these patients, local and regional tissues in the mouth are used to repair it. However, in cases of wide cleft palate or large and recurrent fistula, these methods are not efficient and require the transfer of free flaps.Materials & MethodsIn this retrospective study, records of 17 patients with cleft palate or palatal fistula that treated with free flaps were studied. The information includes age, sex, cause of surgery, type of transferred flap, recipient artery and vein, size of skin paddle, pre-laminate or graft coverage of nasal side, early flap survival, long-term results, effects on nasal regurgitation and velopharyngeal insufficiency were collected. Data were analyzed by SPSS software version 19 and using descriptive statistics.ResultsThe mean age of patients was 13.540 ± 15.705 (3-54 years). 10 (60%) were male and 7 (40%) were female. 8 (47%) patients were operated due to wide cleft palate (WCP), 7 (41%) patients due to recurrent palatal fistula (PF), one (6%) patient due to extensive tumor resection and one (6%) patient due to extensive defect followed by Mucormycosis fungal infection in a diabetic patient. All the flaps survived, and complete or partial necrosis were not observed. Nasal Regurgitation was cured in all but three patients and Velopharyngeal insufficiency (VFI) was improved in all patients.ConclusionsRadial Forearm Free Flap is one of the best choices to cover the defect in patients with a wide cleft palate or a recurrent or large palatal fistula. In our study, the success rate was 100%, however, in about 18% of patients, there was complications that needed another operation. The most important disadvantage of this flap is the unaesthetic scar of forearm, which should be placed against its great benefits.Keywords: Free Flap, Radial Forearm Free Flap, Cleft Palate, Palatal Fistula -
Background and ObjectivesThis study was conducted to compare the effect of acticoat and agcoat dressing (2 types of silver nano-crystalline dressings) in the treatment of burn wounds. Infection is one of the most important causes of death in patients with major burn. Despite using different prevention methods, including prophylaxis antibiotics with broad-spectrum antibiotics, no method has been found to prevent this dangerous complication for burn patients. Topical silver sulfadiazine is one of the best topical antibiotics in infection control of burn wounds, and other forms of AG dressings are also useful. Their advantages are slow releasing, further-half-life, less frequent dressing change, and less pain during replacement.Materials and MethodsIn this study, 30 patients with infected full thickness burn wound were selected. The patients’ age range was 18-85 years, with the mean age of 39.7-17.27. Every patient's wound was divided into 2 parts randomly, one part was dressed with agcoat and the other with acticoat. Sampling of the 2 parts was done before dressing and after the third and seventh day of dressing.ResultsThe positive outcome of the first day culturing before silver dressing was 80% and 76.7% for agcoat and acticoat, respectively. However, on the third day, it decreased to 30% and 33.3%, respectively. On the seventh day, it further decreased to 20% in both groups, and the percentage of bacterial growth reduction was not significant.ConclusionBased on the results of this study, silver agcoat dressing was as effective as acticoat dressing in preventing burn wound infection.Keywords: Burns, Infection, Silver nano-crystalline dressing
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کلاژن دارای کاربردهای فراوانی در زمینه داروسازی و پزشکی، تهیه محصولات بهداشتی و آرایشی و صنایع غذایی می باشد. در سال های اخیر توجه زیادی به جداسازی کلاژن از موجودات دریایی شده است که علت آن عدم محدودیت استفاده از آن در رژیم غذایی و عدم ایجاد خطر ابتلا به بیماری های مسری می باشد. در این مطالعه به استخراج کلاژن ازپوست ماهی سفید از ماهیان اقتصادی دریای خزر و ماهی قباد یکی از گونه های تن ماهیان خلیج فارس پرداخته شده است. کلاژن پوست ماهی سفید و ماهی قباد به روش اسید و باز استخراج گردید و سپس به وسیله Pico.Tag ، SDS-PAGE، FTIR و اسپکتوفوتوگرافی UV مورد ارزیابی قرار گرفتند. نتایج براساسSDS-PAGE و ترکیبات اسیدهای آمینه نشان دادند که کلاژن پوست هر دو ماهی کلاژن نوع I و از دو زنجیره α (1α و2α) با وزن مولکولی kDa 130 و مقدار جرئی β تشکیل شده است. هم چنین تجزیه و تحلیل FTIR، ترتیبات مارپیچی از هر دو کلاژن را نشان داد و اسپکتروفتومتری UV در هر دو نمونه کلاژن پوست ماهی سفید و ماهی قباد حداکثر جذب را در 240 نانومتر نشان داد. میزان کلاژن استخراج شده از پوست ماهی سفید 15/6% و ماهی قباد 14/5% بود. تجزیه و تحلیل اسیدآمینه در کلاژن های استخراج شده، مقدار بالایی از گلایسین را در هر دو نمونه کلاژن، ماهی سفید 182/5 residues بر 706/1 residues و ماهی قباد 188/6 residues بر 706/1 residues را نشان داد که آن یک سوم از کل اسیدهای آمینه محاسبه گردید و هم چنین مقدار پرولین به عنوان یک اسیدآمینه منحصر به فرد در کلاژن ماهی سفید 89/6 residues بر 706/1 residues و در ماهی قباد residues 86/8 بر 706/1 residues بود.کلید واژگان: ماهی سفید، ماهی قباد، کلاژن پوست ماهی، ترکیب اسیدآمینه، دریای خزر، خلیج فارسCollagen has a wide range of applications in biomedical, pharmaceutical, cosmetic, and food industries. Collagen from cow has a risk for contamination from bovine spongiform encephalopathy (BSE), transmissible spongiform encephalopathy (TSE). This study proceeds to extract collagen from the skin of Rutilus Kutum main and economical species of the Caspian Sea and Scomberomorus guttatus. Scomberomorus guttatus one of the tuna species of Persian Golf. Acid-soluble collagens (ASC) from the fish skin of Scomberomorus guttatus and Rutilus Kutum were extracted and characterized by Pico.Tag, SDS-PAGE, FTIR and UV spectrophotometry. Based on the data from the SDS-PAGE and the composition of amino acid, both collagens were probable that the obtained collagen classified as type I collagen. Collagens consisted of two different types of α chains, including α1 and α2,and β component. Also, FTIR analysis revealed the presence of helical arrangements of collagens. Moreover, UV spectrophotometry exhibited this collagen have an absorbance at 220 nm. According to the basis of dry weight, the yield of Rutilus Kutum and Scomberomorus guttatus ASC were calculated 15.6 % and 14.5 %. Amino acid analysis revealed a much higher glaycin content in the both collagens extracted which accounted to one third of the total amino acids. Besides, proline as an unique amino acid in Rutilus Kutum and Scomberomorus guttatus ASC had the specific amount of89.6 and 86.8 residues per 706.1 residues.Keywords: Rutilus kutum, Scomberomorus guttatus, Fish skin Collagen, Characterization, Amino acid composition, Caspian Sea, Persian Gulf
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بررسی تطبیقی مجازات جرم اسید پاشی در ایران و کشورهای جنوب آسیا و راه های پیشنهادی برای پیشگیری از آناسیدپاشی نوعی خشونت فجیع است و در کشورهای هند، بنگلادش، کامبوج و پاکستان بیشتر رایج است. بین جرم اسیدپاشی و جایگاه اجتماعی زنان ارتباط نزدیک وجود دارد. این جرم با توجه به صدمات جبران ناپذیری که ایجاد می کند و مهمتر از همه به دلیل این که زیبایی چهره قربانی را از بین می برد، از نظر عده ای حتی به مراتب از جرم قتل عمد نیز سنگین تر است. از آنجا که در سال های اخیر ارتکاب جرم اسیدپاشی در ایران گسترش یافته است، مطالعه این جرم و بررسی مجازات آن در کشورهای مختلف و نیز پیشنهاد روش های پیشگیری مفید به نظر می رسد. قوانین ایران برای بازدارندگی از جرم اسیدپاشی کافی نیست. تولید، توزیع و فروش اسید آزاد بوده و لازم است محدودیت هایی برای آن در نظر گرفته شود. همچنین مجازات قصاص که برای این جرم در نظر گرفته شده است، به دلایل مختلف اجرا نمی شود و کارآیی لازم را ندارد. از آنجایی که سوختگی خصوصا در صورت و دست ها که این بیماران به آن دچار می شوند یک بیماری دائمی است و قابل درمان نبوده و عوارض فیزیکی، روانی، اقتصادی و اجتماعی زیادی داشته و زندگی فرد را به نابودی می کشد، باید علاوه بر دیه، هزینه متعارف درمان بیماری به طور مادام العمر به عهده مجرم باشد. همچنین جریمه های هنگفت مالی و زندان نقش بازدارندگی بهتری خواهند داشت. بالا بردن هزینه اجتماعی جرم اسید پاشی و مطرود شدن عاملین این جنایت از اقدامات لازم می باشد.کلید واژگان: سوختگی، اسیدپاشی، اسید، جرم، مجازاتAcid throwing as a formidable violence is more common in countries such as India, Bangladesh, Cambodia and Pakistan. There is a close connection between acid throwing crime and the social status of women. Regarding the irreparable damage of this crime and, more importantly, destroying the beauty of the victim's face, for some people, it is even heavier than the offense of intentional murder. Since acid throwing has been spread in Iran in recent years, a comparative study of punishment of this crime in Iran with these four countries, according to their legal system, appears to be useful. Therefore, type, quality and quantity of punishment and penalizing the criminal can be helpful in better understanding of criminal law, using strengths and covering weaknesses in legislation. According to the results of this study, there is no enough standard law in this country to deter acid throwing. Accordingly, its production, distribution and sale should be limited and preventable, and its illegal distribution must be punished. Since acid throwing is rarely fatal but causes serious damage to one's appearance and beauty, death penalty is rarely imposed. It is important to note that acid burn is a lifelong disease therefore criminal must incur all of conventional expenses of victim for a lifetime in addition to the wergild.Keywords: Crime, Acid Throwing, Punishment
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ObjectiveTo compare the healing effects of dried and acellular human amniotic membrane and Mepitel for coverage of split-thickness graft donor site (STGDS).MethodsTwenty patients who underwent STGDS regeneration surgery in identical anatomic regions were enrolled in this randomized controlled clinical trial conducted in Hazrate Fatemeh hospital (Iran). Patients were randomly assigned in 3 groups of wound dressing; group A by Mepitel, group B AmiCare (Dried amniotic membrane) and group C OcuReg-A (Acellular amniotic membrane). Re-epithelization rate (healing time), pain sensation, scar formation and infection rate were assessed till complete healing was achieved.ResultsOur results showed no significant difference between Amicare, OcuReg-A and Mepitel in the features analyzed by us including: Re-epithelization rate (healing time) P value; 0.573, Pain sensation P value: day 4 th: 0.131, day8 th: 0.93 and day 12 th: 0.365, Scar formation P value>0.05 and Infection rate.ConclusionOur findings confirmed the safety and efficacy of AmiCare (dried amniotic membrane) and OcuReg-A (Acellular amniotic membrane) in treatment of split-thickness donor site in comparison with Mepitel as a standard wound dressing.Keywords: Split-thickness donor site, Dried amniotic membrane, Acellular amniotic membrane, Mepitel, Re-epithelization
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مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران، سال هفتاد و پنجم شماره 11 (پیاپی 203، بهمن 1396)، صص 790 -796زمینه و هدفبرخی از گیاهان دارویی ارزان و در دسترس مانند گیاه ابوخلسا یا هواچوبه با نام علمی Arnebia euchroma می توانند در درمان زخم سوختگی و کاهش زمان بهبودی موثر باشند. هدف از این مطالعه بررسی اثر پماد ابوخلسا بر ترمیم زخم سوختگی درجه دو عمقی در رت بود.روش بررسیاین مطالعه تجربی در مهر 1394 در آزمایشگاه حیوانات بیمارستان حضرت فاطمه (س) در تهران انجام شد. در قسمت پشت 24 رت نر بالغ نژاد Sprague-Dawley به وزن تقریبی g 250-300 سوختگی درجه دو عمقی به ابعاد cm 4×2 ایجاد گردید و سپس محل سوختگی در گروه اول با پماد ابوخلسا و در گروه دوم با وازلین پانسمان روزانه تا بهبود کامل انجام شد و روند بهبودی زخم با عکس برداری به صورت هر پنج روز یک بار پایش شد. در روز 20 نیز جهت بررسی میزان کلاژن و سلول های التهابی نمونه از زخم سوختگی برای پاتولوژی فرستاده شد.یافته هانتایج نشان داد که در طول روزهای پنج تا 15 وسعت زخم در هر دو گروه کمتر شد (0/001P<) و این کاهش وسعت زخم در گروه وازلین نسبت به پماد ابوخلسا به طور معناداری بیشتر بود (0/040P=). یافته های حاصل از پاتولوژی نیز نشان دادند که هیچ گونه اختلاف معناداری از نظر میزان کلاژن و سلول های التهابی در دو گروه وجود نداشت.نتیجه گیریپماد دارویی گیاه ابوخلسا وسعت زخم را تا حدودی کاهش می دهد اما به نظر می رسد در زخم های سوختگی سطحی در مقایسه با مواد پانسمان دیگر تاثیر بیشتری داشته باشد.کلید واژگان: سوختگی، رت، ترمیم زخمBackgroundBurns is a major health problem due to severe side effects and limited financial resources. Some herbs are cheap and available, such as Arnebia euchroma can be effective treatment of burn wounds and reduce recovery time. The aim of this study was to evaluate the effect of Arnebia euchroma ointment on healing of deep second-degree burn wound in rats.MethodsThis experimental study was conducted in animal laboratory of Hazrat Fatemeh Hospital in 2015, Tehran. In this study 24 male Sprague-Dawley rats weighing approximately 300 to 350 g were selected. After general anesthesia, back of each rat was shaved with clipping device. Then second-degree burn with the area of 2×4 cm was induced on them. Rats were randomly divided into 2 groups, 12 in each. The surface of the wound in the first group was covered with Arnebia euchroma ointment and in the second group with Vaseline. Dressing was done daily until complete recovery and the wound healing process was monitored by photographing every five days. On day 20, the samples were sent for pathological evaluation of the amount of collagen and inflammatory cells.ResultsResults showed that, during days from 5 to 15 the extent of the wounds reduced in both groups (P= 0.000). The reduction of wound size was significantly higher in Vaseline group compared to Arnebia euchroma ointment group (P= 0.040). The results of the pathological examination showed no significant difference in the amount of collagen and inflammatory cells in the two groups.ConclusionIt seems Arnebia euchroma ointment to some extent reduced the extent of the wound especially in superficial burns compared to other dressings. However, it is better to conduct more similar studies with a larger sample size and different method and change in timing of dressing.Keywords: burns, rats, wound healing
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مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران، سال هفتاد و پنجم شماره 9 (پیاپی 201، آذر 1396)، صص 645 -652زمینه و هدفامروزه از ترکیباتی با منشا طبیعی در درمان زخم ها به ویژه زخم سوختگی، به علت هزینه های بالای درمان و بازتوانی آن ها، استفاده می شود. پژوهش کنونی با هدف بررسی تاثیر روغن حیوانی بر ترمیم زخم سوختگی در مدل حیوانی رت انجام گردید.روش بررسیدر این پژوهش تجربی که در آزمایشگاه حیوانات مرکز آموزشی درمانی حضرت فاطمه (س) در اردیبهشت و خرداد 1394 انجام شد، در قسمت خلف 36 رت نر بالغ نژاد Sprague-Dawley به وزن تقریبی g 250-300، سوختگی درجه دو عمقی به ابعاد cm 4×2 ایجاد گردید و سپس رت ها به طور تصادفی به سه گروه 12 تایی تقسیم و به ترتیب با کرم سیلور سولفادیازین، روغن حیوانی و وازلین پانسمان شدند. روند بهبودی زخم با نرم افزارImage J، ver. 1.4.5 (NIH، Maryland، USA) پایش شد. در روز 17 و 30 نیز نمونه ها جهت بررسی پاتولوژی فرستاده شد.یافته هانتایج نشان داد در روزهای 5، 15 و 25 وسعت زخم در گروه های روغن حیوانی و وازلین در مقایسه با سیلور سولفادیازین به طور معناداری کاهش یافته بود (0/001P=)، اما این تفاوت میان گروه روغن حیوانی و وازلین معنادار نبود. در بازه زمانی 17 روز، نتایج از نظر آرایش کلاژنی (0/001P<) و در روز 30، نتایج اپیتلیزاسیون (0/04P=)، سلول های التهابی حاد (0/001P=) و فیبروپلازی (0/001P<) در گروه روغن حیوانی و وازلین به طور معنادار بهتر بود.نتیجه گیریاین پژوهش نشان داد روغن حیوانی نمی تواند ترمیم زخم سوختگی را تسریع و ایندکس های هیستوپاتولوژی را افزایش دهد.کلید واژگان: سوختگی ها، روغن حیوانی، سیلور سولفادیازینBackgroundHigh costs of treatment and rehabilitation lead to increased tendency of researchers in complementary therapies and using the compounds which have natural origin and are cheaper. Sheep ghee, known as yellow oil, is one of the compounds used in many parts of Iran for wound healing. Considering that few studies have been performed on the effect and rate of these materials on burn wound healing, the present work is aimed to investigate the effect of ghee on burn wound healing in rats.MethodsIn this experimental study which was performed in the animal lab of the Hazrat Fatemeh Hospital in Tehran, 36 adult male Sprague-Dawley rats with the relative weight of 250-300 g were selected and second-degree burn with the area of 2×4 cm was induced in them. Then, they were randomly divided into 3 groups, 12 in each. To dress the burn point in 1 to 3 groups, silver sulfadiazine cream, ghee, and Vaseline were used, respectively. The evaluation process was monitored by photography with 5 days intervals using an accurate ruler and ImageJ software, version 1.45 (National Institutes of Health, Bethesda, Maryland, USA). On the 17th and 30th days, Tissue biopsies was performed for the epithelialization rate, degree and arrangement of collagen, and chronic and acute inflammatory cells, the sample of burn wound was sent for pathological investigation.ResultsResults showed that, wound area was significantly reduced in ghee, and Vaseline groups compared with silver sulfadiazine cream on days 5th, 15th, and 25th (P= 0.001). however, the difference between ghee and Vaseline group was not significant. In the 17-day time period, results of collagen arrangement (P= 0.000) and epithelialization results (P= 0.04), acute inflammatory cells (P= 0.001), and fibroplasias (P= 0.000) in 30th day were significantly better in ghee, and Vaseline groups.ConclusionThis study showed that, in contrast to the public belief in some regions in Iran, ghee could not accelerate healing of burn wound and promote histopathological indices. Therefore, they are not recommended.Keywords: burns, ghee, silver sulfadiazine
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BackgroundBurden of injuries is an important public health problem, especially in developing countries. However, a national standard tool for data collection of trauma registry has not been developed in Iran yet.ObjectivesThe present study aimed to describe the steps undertaken in the development of the minimum dataset (MDS) and define the inclusion and exclusion criteria for a case of trauma registry by the national trauma registry of Iran (NTRI).MethodsThe working group consists of sixteen elected expert representatives from seven established countrywide active trauma research centers. Following a structured extensive review of the literature, the working party identified the data variables that included key registry goals for pre-hospital and hospital, outcome and quality assurance information. We used data variables from three trauma registry centers: National trauma data standard questionnaire, European trauma care (UT stein version), and Sina trauma and surgery research center. Then, we performed two email surveys and three focus group discussions and adapted, modified and finally developed the optimized MDS in order to prepare the quality care registry for injured patients.ResultsThe finalized MDS consisted of 109 data variables including demographic information (n = 24), injury information (n = 19), prehospital information (n = 26), emergency department information (n = 25), hospital procedures (n = 2), diagnosis (n = 2), injury severity (n = 3), outcomes (n = 5), financial (n = 2), and quality assurance (n = 1). For a patient sustained one or more traumatic injury in a defined diagnostic ICD-10 codes, the inclusion criteria considered as one of the followings: If the patient stayed > 24 hours in the hospital, any death after hospital arrival, any transfer from another hospital during the first 24 hours from injury.ConclusionsThis study presents how we developed the MDS in order to uniform data reporting in the NTRI and define our inclusion and exclusion criteria for trauma registry. Applying the MDS and the case definition in pilot studies are needed in next steps.Keywords: Focus Group Discussion, Iran, Patient Selection, Registries, System, Wound, Injuries
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Background
Upper extremity is exposed to injuries with physical, mental, social and economic consequences.
ObjectivesThe aim of this research is to study the prevalence and types of personality disorders in patients with upper extremity trauma.
MethodsWe included all patients with upper extremity trauma in a three-month period. The Millon Test was filled by all candidates with a clinical psychologist and psychometric supervision. Results were analyzed statistically.
Results202 male patients participated with age range of 14 to 70 years-old, amongst whom 41.4% had personality disorders. The prevalence of personality disorder in violence and self-injury groups was 72.7% and 39.3% respectively in the group of industrial accidents, which showed a significant difference (P = 0.003). Avoidant personality disorders (P = 001), narcissistic (P = 0.003), antisocial (P = 0.002), borderline (P = 0.001) passive aggressive (P = 0.002) were significantly more common in violence and self-injury groups.
ConclusionsThe present study revealed that the prevalence of personality disorder in patients with upper extremity injuries is more than that in the society. Due to the high rate of personality disorder in hand trauma victims, routine psychological evaluation of these patients is warranted.
Keywords: Prevalence, Personality disorder, Hand Trauma -
Objectives
The objective of the present study was to compare the use of Hirudoid immediately after surgery with its use 6 hours post-operatively when probable thrombosis was formed but tissue damage was still reversible.
MethodsAfter preparing 3 × 11 cm dorsal flap in all rats, one group of 8 rats received Hirudoid topically immediately after surgery during 9 post-operative days. Another group received it 6 h after surgery during 9 post-operative days. The control group received Vaseline immediately after surgery on a daily basis during 9 post-operative days.
ResultsThe mean area of flap survival in the control group was 8.75 ± 3.32 cm2 (mean ± SD) and it was 12.38±1.93 cm2 and 14.36 ± 3.51 cm2 in Hirudoid immediately after surgery and 6 hours after surgery groups, respectively.
ConclusionsIt was found that Hirudoid can be effective in improving flap viability; although its effect was not statistically significant when used immediately after surgery (P > 0.05), it significantly increased flap survival when used 6 h after surgery (P = 0.003).
Keywords: Skin Random Flap, Ischemia, Flap Necrosis, Hirudoid -
مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران، سال هفتاد و پنجم شماره 5 (پیاپی 197، امرداد 1396)، صص 387 -392زمینه و هدفکاهش سطح آلبومین سرم (هایپوآلبومینمی) یک یافته شایع در بیماران سوخته است اما رابطه آن با میزان مرگ و میر بیماران سوخته به طور دقیق مشخص نشده است. هدف مطالعه حاضر اندازه گیری سطح آلبومین سرم در بیماران سوخته و تعیین رابطه آن با سطح سوختگی و طول مدت بستری در بیمارستان بود.روش بررسیاین مطالعه مقطعی بر روی بیماران بالای 16 سال که در شش ماهه دوم سال 1393 و در 24 ساعت اول سوختگی به بیمارستان شهید مطهری تهران مراجعه کردند انجام شد. برای همه ی بیمارانی که وارد مطالعه شدند، CBC، آلبومین، کراتینین توتال، پروتئین، BUN و کلسیم در روزهای بستری، یک هفته پس از بستری و در بیمارانی که بد حال می شدند، به صورت روزانه و در سایر بیماران یک روز پیش از ترخیص مورد بررسی قرار گرفت.یافته هاپژوهش حاضر نشان داد که میانگین مقدار آلبومین در گروه ترخیص شده در روز پذیرش، یک هفته پس از پذیرش و به هنگام ترخیص به طور معناداری بالاتر از گروه فوت شده بود (0/001P<). همچنین میان سطح سوختگی و میزان آلبومین ارتباط معناداری وجود داشت (0/001P<)، به طوری که هر چه سطح سوختگی بالاتر بود میزان آلبومین پایین تر بود ولی بین میزان آلبومین با سن و طول مدت بستری در بیمارستان رابطه معناداری مشاهده نشد.نتیجه گیریپژوهش حاضر نشان داد که سطح آلبومین سرم می تواند به عنوان یک شاخص قابل اتکا برای تعیین وضعیت بیماران سوخته کاربرد داشته باشد، ولی پیدا کردن راهکاری برای رساندن سطح آلبومین به حد مناسب نیازمند پژوهش های بیشتر می باشد.کلید واژگان: آلبومین سرم، سطح سوختگی، طول مدت بستری، هایپوآلبومینمیBackgroundAlbumin is one of the most important proteins in the body by several important functions, it is essential in the maintenance of normal plasma colloid oncotic pressure and is the primary serum binding protein responsible for the transport of various substances in the circulation including fatty acids, hormones, and drugs. Decrease in the amount of serum Albumin (Hypoalbuminemia) is a common finding in the burn patients, but its relationship with mortality is not accurately clear. Our purpose of this study was to measure the amount of Albumin serum in burn patients and find out its relationship between the burned area and length of hospital stay.MethodsThis cross-sectional study was conducted on patients aged over 16 years who referred to the Motahari Hospital of September 2014 to February 2015 in the first 24 hours of their referral. The amount of Albumin was measured in two groups of discharged patients and patients who died while hospitalized, one week after hospital stay and in the time of discharge and death; and its relationship in terms of each other was determined by statistical analysis. We also assessed the relationship between burn and duration of hospital stay with the amount of Albumin on the day of patients admission.ResultsThis study showed that the average amount of albumin in the group of discharged patients in the time of admission, one week after and during admission was significantly higher than the group of expired patients (PConclusionMeasuring the level of Albumin is one of the yardsticks that can be used for prognosis of recovery or death of burn patients, and its assessment at regular intervals in burn patients is essential.Keywords: burns, cross-sectional studies, hypoalbuminemia, length of stay, serum albumin
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Background
Burns are a major cause of stress, and afterwards, many patients suffer from anxiety, depression, and insomnia. Also, the levels of serum antioxidants increase after burns, which causes problems in patients. It has been observed that Melissa officinalis L. can increase serum antioxidant levels and improve mood and sleep quality.
MethodsThirty-six patients who were admitted to Shahid Motahari Burn Hospital were selected. Patients in the control group consumed black tea, and those in the experimental group received Melissa tea. The serum levels of antioxidants were measured using spectrophotometry once before the intervention and at 20 days after the intervention. Depression, anxiety, and insomnia levels were each measured by the Beck, Kettles, and Petersburg questionnaires, respectively.
ResultsIn the study group, the percentages of those experiencing anxiety (P value: 0.023) and depression (P value: 0.002) were significantly less than those of the control group. Also, sleep quality in the experimental group taking Melissa tea increased significantly (P value: 0.031). However, the mean serum antioxidant levels were not significantly different between the control and experimental groups (P value: 0.96).
ConclusionsMelissa officinalis L. can significantly reduce anxiety and depression and improve sleep quality. Therefore, its consumption may be useful for burn patients as a daily drink. However, the effects of Melissa on increasing serum antioxidants needs further investigation.
Keywords: anxiety disorders, depression, insomnia, Burn patients, Melissa officinalis L -
BACKGROUNDAesthetic surgery procedures have been performed at dramatically increased rates in recent years in Iran. Few researches exist documenting the usage of body image coping strategies and its relationship in seeking surgery.
METHODSThe present research examined data from 90 aesthetic surgery participants (30 Subjects each in invasive, minimally-invasive, and control groups). Assessed subjects on body image coping strategies inventory (avoidance, appearance fixing and positive rational acceptance) provided dysfunctional usage of its variables among Iranian clients.
RESULTSBetween the three groups, on variables of body image coping strategies, there was a significant difference. There was a significant difference on avoidance variable in three groups. On positive rational acceptance variable, there was a significant difference for invasive group with minimally-invasive and control groups. No significant difference was found on appearance fixing variable.
CONCLUSIONThe study emphasizes on the role of psychological problems of aesthetic surgery clients that surgeons should be aware of them, which could inhibit the positive effects of aesthetic surgery. These results have implications for pre-surgical assessment along with psychological interventions at first step rather than invasive medical interventions.Keywords: Body Image coping strategies, Avoidance, Appearance fixing, Positive rational acceptance, Aesthetic surgery, Cosmetic surgery -
مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران، سال هفتاد و پنجم شماره 1 (پیاپی 193، فروردین 1396)، صص 17 -23زمینه و هدفگرافت های غضروفی به عنوان یک جزء تفکیک ناپذیر در زمینه های مختلف جراحی پلاستیک به ویژه رینوپلاستی می باشد. عوارضی مانند ایجاد دفرمیتی و باز جذب آن در استفاده از غضروف وجود دارد که محل برداشتن غضروف می تواند از بروز این عوارض پیشگیری کند. پژوهش کنونی با هدف مقایسه میزان جذب غضروف در گرافت غضروفی حاصل از دنده با گرافت حاصل از کونکای گوش در خرگوش انجام شد.روش بررسیدر این مطالعه تجربی که در آزمایشگاه حیوانات مرکز آموزشی درمانی حضرت فاطمه (س) تهران در آبان 1393 انجام شد، در 15 سر خرگوش نر سفید نیوزلندی (با وزن تقریبی 2000 تا g 2500) پس از بیهوشی، بخشی از گوش و غضروف دنده ای آن برداشته و سپس در قسمت خلفی تنه خرگوش در یک سمت ستون فقرات، کونکای گوش و در سمت دیگر غضروف دنده ای پیوند شد. پس از هشت هفته نمونه ها پس از تعیین وزن، از نظر میزان کندروسیت های زنده و فیبروز توسط پاتولوژیست مورد بررسی قرار گرفت.یافته هامیانگین وزن گرافت حاصل از گوش طی دو ماه افزایش داشت ولی این افزایش از نظر آماری معنادار نبود. در گرافت حاصل از دنده میانگین وزن طی دو ماه کاهش معناداری داشته است (0/009P=). از نظر میزان فیبروز و کندروسیت زنده در دو گروه تفاوت معنادار وجود نداشت ولی میزان فیبروز در گروه غضروف گوش بیشتر بوده است.نتیجه گیریبر اساس یافته های پژوهش کنونی می توان نتیجه گرفت که میزان جذب غضروف دنده تا حدودی نسبت به غضروف گوش نتایج بهتری داشته است.کلید واژگان: اتوگرافت، غضروف دنده ای، پیوندBackgroundCartilage grafts is one integral component in the various fields of plastic surgery particular rhinoplasty. Surgeons usually use from various sources, including the septum of the nose, ears and rib. Complications such deformity and reabsorbtion may be created with use of the cartilage. Area of the removal of cartilage can prevent these complications. The aim of this study was to compare the absorption rate and viability of cartilage autograft between two common donor site, the rib and the concha.MethodsThis experimental study was performed on October 2014 in animal laboratory of Hazrat Fatima Hospital, Tehran, Iran. In this study, 15 New Zealand white male rabbits, weighing 2000-2500 g, approximately 12 to 16 weeks of age were used. In each rabbit, a piece of one ear and one cartilage was excised. After careful weighting of grafts, we implanted the rib cartilage graft into the left pocket and the conchal cartilage graft into the right one. After 8 weeks, the grafts were removed and weighed precisely and photography was carried out. The specimens were fixed in 10% formalin solution for histologic examination was. An example of hematoxylin and eosin staining and cut (H&E) were performed and samples of live chondrocytes and fibrosis were examined by a pathologist.ResultsWe lost 3 rabbits during our study. The results showed that the average weight of a graft from the ear within 2 months, but this increase was not statistically significant (P= 0.152). In the rib graft weight loss over 2 months, and this reduction was statistically significant (P= 0.009). The resorption between two group was not significant but the amount of fibrosis was more in conchal cartilage graft.ConclusionAccording to the study it can be concluded that absorption rib cartilage is somewhat better results than the cartilage of the ear. More studies, in addition to cartilage implants longer human studies can contribute to more accurate conclusions.Keywords: autograft, costal cartilage, transplants
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BackgroundBurn is among the problems, which leads to numerous health and financial side effects for the patients and their families. The high costs of new dressings and burn rehabilitation have resulted in the increased tendency of researchers toward using complementary therapies and cost-effective ingredients such as honey with natural origin. Regarding this, the aim of this study was to compare the effect of topical use of honey and Nitrofurazone ointment on superficial second-degree burn healing.MethodsThis clinical trial was conducted on 50 patients with superficial second-degree burns referring to Yaftabad Hospital, Tehran, Iran, during 2013-2015. The participants were selected using the convenience sampling method, and then randomly assigned into two groups. The wounds were dressed daily until complete wound healing, with organic honey in one group and Nitrofurazone ointment and sterile gauze in the other group. For the purpose of the study, the two groups were compared in terms of such factors as pain intensity (for the first week), antibacterial activity (for the first week), histopathological parameters (14 days later), wound healing, and wound scar (6-12 months later). The comparisons were made through the visual analogue scale, laboratory culture results, pathologists ratings, daily photographs, and Vancouver Scar Scale, respectively. The data were analyzed using the SPSS software version 21 by the t-test and Chi-square test.ResultsAccording to the results, the patients pain intensity gradually decreased in both groups of honey (P0.05). Furthermore, the two groups showed no significant differences in terms of the epithelialization rate (P=0.52), inflammatory cells (P=0.71), vascularization (P=0.79), repair duration (P=0.43), and scar score (P=0.28).ConclusionAs the findings of the present study indicated, honey and Nitrofurazoneon had comparable effects on the healing of second-degree burns (i.e., partial thickness) with less extended area. However, further studies are needed for the replacement of Nitrofurazone with honey.Keywords: Honey, Nitrofurazone, Second-degree burn
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