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Acta Medica Iranica - Volume:53 Issue: 9, Sep 2015

Acta Medica Iranica
Volume:53 Issue: 9, Sep 2015

  • تاریخ انتشار: 1394/07/23
  • تعداد عناوین: 13
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  • Mohammad Azimi Alamouti, Mehrdad Bakhtiyari, Fatemeh Moradi, Tahmineh Mokhtari, Azim Hedayatpour, Fariba Zafari, Mohammad Barbarestani Page 523
    Multiple Sclerosis (MS) causes loss of the myelin sheath, which leads to loss of neurons. Regeneration of myelin sheath stimulates axon regeneration and neurons’ survival. In this study, olfactory ensheathing cell (OEC) transplantation is investigated to restore myelin sheath in an experimental model of MS in male mice.OECs were isolated from the olfactory mucosa of seven-day-old infant rats and cultured. Then, cells were evaluated and approved by flow cytometry by p75 and GFAP markers. A total of 32 mice (C57BL 6) were studied in four groups; 1) without any treatment (control), 2) Sham (receiving PBS), 3) MS model and 4) MS and OEC transplantation. MS was induced by adding Cuprizon in the diet of animals for six weeks. After the expiration of 20 days, histologic analysis was performed with approval of the presence of cells in the graft area and the removal of myelin and myelin regeneration with two types of luxal fast blue (LFB) staining and immunohistochemistry. The purity of the cells ensheathing the olfactory was 90%. There was a significant difference in Myelin percentage of PBS and OEC recipient groups (P≤0.05). MBP and PLP of the myelin sheath in the group receiving OECs were more than MS group.According to the findings, in MS model MBP and PLP of the myelin sheath is reduced. In the group receiving OECs, it was returned to a normal level significantly compared to the sham group received only PBS significant differences were observed. The OECs transplantation can improve myelin restoration.
    Keywords: Olfactory ensheathing Cell, Remyelination, Demyelination
  • Bagher Larijani, Hamidreza Aghayan, Parisa Goodarzi, Fereshteh Mohamadi, Jahani, Abbas Norouzi, Javidan, Ahmad Reza Dehpour, Khadijeh Fallahzadeh, Forough Azam Sayahpour, Kazem Bidaki, Babak Arjmand Page 530
    In this study, our aim was to produce a generation of GMP-grade adipose tissue-derived mesenchymal stem cells for clinical applications. According to our results, we fulfill to establish consistent and also reproducible current good manufacturing practice (cGMP) compliant adipose tissue-derived mesenchymal stem cells from five female donors. The isolated cells were cultured in DMEM supplemented with 10% fetal bovine serum and characterized by standard methods. Moreover, karyotyping was performed to evaluate chromosomal stability. Mean of donors’ age was 47.6 ± 8.29 year, mean of cell viability was 95.6 ± 1.51%, and cell count was between 9×106 and 14×106 per microliter with the mean of 12.2×106 ± 2863564.21 per microliter. The main aim of this project was demonstrating the feasibility of cGMP-compliant and clinical grade adipose tissue-derived mesenchymal stem cells preparation and banking for clinical cell transplantation trials.
    Keywords: Adipose, derived stem cell, Cell therapy, Good manufacturing practice, Mesenchymal stem cells
  • Reza Heidari, Rafieh Alizadeh, Niloufar Abbasi, Parichehr Pasbakhsh, Azim Hedayatpour, Mostafa Farajpour, Mohammad Reza Khaleghi, Mehdi Abbasi, Ahmad Reza Dehpour Page 537
    Varicocele is one of the most common causes of primary male infertility. Pilea microphylla (PM) is being used as folk medicine. This study was aimed to investigate the effects of PM in a rat model of varicocele. A total of 30 male Wistar rats were divided into control, sham, varicocele, accessory varicocele and PM-treated groups. After 10 weeks of varicocele induction, sperm parameters and chromatin (Aniline blue, acridine orange and toluidine blue) were evaluated, except for the treated and accessory groups that received 50 mg/kg PM orally daily for 10 weeks and then were sacrificed. Sperm parameters significantly decreased in varicocele groups (P < 0.01). Moreover, there was a negative correlation between the DNA fragmentation and sperm parameters in varicocelized rats. Administration of PM led to significantly increased sperm parameters and AO staining (P < 0.05). These findings suggest that PM improves sperm parameters and DNA fragmentation in varicocelized rats. PM can reduce the damage to sperm DNA but not chromatin condensation.
    Keywords: Varicocele, Pilea microphylla, Sperm parameters, Sperm chromatin, Sperm DNA fragmentation, Rat
  • Kaveh Khazaeel, Yazdan Mazaheri, Mahmood Hashemi Tabar, Hossein Najafzadeh, Hassan Morovvati, Alireza Ghadrdan Page 545
    Enrofloxacin is a synthetic chemotherapeutic agent from the class of the fluoroquinolones that is widely used to treat bacterial infections. It is metabolized to ciprofloxacin in the body as active metabolite. Fluoroquinolones change in the articular cartilage, especially with high doses and more than two weeks use. So, due to relatively excessive use of enrofloxacin in mammals and similarity of lambs to human subjects with respect to skeletal activity cycles, this study was done to investigate the effects of enrofloxacin on some cellular and molecular changes in growing lamb articular cartilage to evaluate some possible mechanisms involved these changes. Twelve, 2-month-old male lambs divided into three groups: control group received only normal saline; therapeutic group received mg/kg enrofloxacin subcutaneously, daily, for 15 days and toxic group received 35 mg/kg enrofloxacin in the same manner as therapeutic group. Twenty four hours after the last dose, the animals were sacrificed, and their stifle joints were dissected. Sampling from distal femoral and proximal tibial extremities was done quickly for further histological and molecular studies. Collagen-п content was studied with avidin-biotin immunohistochemistry method in different groups. Expression of Sox9 and caspase-3 was evaluated by Real–time PCR. Immunohistochemical changes were included decreases of matrix proteoglycans, carbohydrates, and Collagen-п in the toxic group. Some of these changes were observed in the therapeutic group with less intensity in comparison to the toxic group. Enrofloxacin were significantly decreased (P≤0.05). Sox9 expression in therapeutic and toxic groups compared to control group. But caspase -3 expressions in the toxic group significantly increased (P≤0.0001) with a comparison to other groups, while, between control and therapeutic groups, there were no significant differences. So, it can be concluded that enrofloxacin increases apoptosis in chondrocytes and decreases their numbers. Enrofloxacin use in growing lambs even at recommended therapeutic dose is not completely safe on articular cartilage. Moreover, higher doses of enrofloxacin induce severe changes in lamb articular cartilage.
    Keywords: Enrofloxacin, Lamb, Articular cartilage, Immunohistochemistry, Sox 9
  • Mansoureh Shayeghi, Jalil Nejati, Leila Shirani, Bidabadi, Mona Koosha, Mehdi Badakhshan, Mulood Mohammadi Bavani, Kourosh Arzamani, Nayyereh Choubdar, Fatemeh Bagheri, Abedin Saghafipour, Arshad Veysi, Fateh Karimian, Amir Ahamd Akhavan, Hassan Vatandoost Page 552
    Insects with over 30,000 aquatic species are known as very successful arthropods in freshwater habitats. Some of them are applied as biological indicators for water quality control, as well as the main food supply for fishes and amphibians. The faunistic studies are the basic step in entomological researches; the current study was carried out emphasizing on the fauna of aquatic insects in Karaj River, northern Iran. A field study was carried out in six various sampling site of Karaj River during spring 2013. The aquatic insects were collected using several methods such as D-frame nets, dipping and direct search on river floor stones. Specimens were collected and preserved in Ethanol and identified by standard identification keys. Totally, 211 samples were collected belonging to three orders; Plecoptera, Trichoptera and Ephemeroptera. Seven genuses (Perla, Isoperla, Hydropsyche, Cheumatopsyche, Baetis, Heptagenia and Maccafferium) from five families (Perlidae, Perlodidae, Hydropsychidae, Batidae, Heptagenidae) were identified. The most predominant order was Plecoptera followed by Trichoptera. Karaj River is a main and important river, which provides almost all of water of Karaj dam. So, identification of aquatic species which exist in this river is vital and further studies about systematic and ecological investigations should be performed. Also, monitoring of aquatic biota by trained health personnel can be a critical step to describe water quality in this river. Understanding the fauna of aquatic insects will provide a clue for possible biological control of medically important aquatic insects such as Anopheles as the malaria vectors.
    Keywords: Aquatic insects, Faunistic, Karaj River, Iran
  • Atabak Najafi, Ali Khodadadian, Mehdi Sanatkar, Reza Shariat Moharari, Farhad Etezadi, Arezoo Ahmadi, Farsad Imani, Mohammad Reza Khajavi Pages 562-567
    The empiric antibiotic therapy can result in antibiotic overuse, development of bacterial resistance and increasing costs in critically ill patients. The aim of the present study was to evaluate the effect of procalcitonin (PCT) guide treatment on antibiotic use and clinical outcomes of patients admitted to intensive care unit (ICU) with systemic inflammatory response syndrome (SIRS). A total of 60 patients were enrolled in this study and randomly divided into two groups, cases that underwent antibiotic treatment based on serum level of PCT as PCT group (n=30) and patients who undergoing antibiotic empiric therapy as control group (n=30). Our primary endpoint was the use of antibiotic treatment. Additional endpoints were changed in clinical status and early mortality. Antibiotics use was lower in PCT group compared to control group (P=0.03). Current data showed that difference in SOFA score from the first day to the second day after admitting patients in ICU did not significantly differ (P=0.88). Patients in PCT group had a significantly shorter median ICU stay, four days versus six days (P=0.01). However, hospital stay was not statistically significant different between two groups, 20 days versus 22 days (P=0.23). Early mortality was similar between two groups. PCT guidance administers antibiotics reduce antibiotics exposure and length of ICU stay, and we found no differences in clinical outcomes and early mortality rates between the two studied groups.
    Keywords: Procalcitonin, Antibiotics, Intensive care unit, Systemic inflammation syndrome
  • Fatemeh Laloha, Negin Mahboob Asiabar, Ameneh Barikani, Farideh Movahed, Ezzatossadat Haj Seyed Javadi Pages 568-572
    The use of corticosteroids is one of the methods put forward for the strengthening and speeding up the process of labor. After identification of glucocorticoid receptors in human amnion, the role of corticosteroids in starting the process of labor has been studied in numerous studies. The purpose of this study was to determine the effect of intravenous Dexamethasone on preparing the cervix and on labor induction. A randomized, clinical, and double – blind trial was conducted on 172 women divided into a control and an experimental group. The inclusion criteria were that they had to be primparous, in or before the 40th week of pregnancy, and with Bishop scores (B.S.s) of or lower. The exclusion criteria were diabetes, preeclampsia, macrosomia, twin pregnancy, rupture of the membrane (ROM), breech, and women suffering from background diseases. The B.S.s of the women was measured in charge of the study, and each woman was intravenously injected with eight milligrams of Dexamethasone or eight milligrams of distilled water. Four hours after the injections, the B.S.s of the participants was measured, and they were put under the conditions of labor induction using oxytocin. Information was collected in checklists A and B. The patients were compared with respect to B.S., the time the induction started, the average interval between the start of induction and the beginning of the active phase of childbirth, and the average length of time between the start of the active phase and the second stage of childbirth.The first and five minutes Apgar scores of the two groups of women were compared. The frequencies, the means, and the standard deviations were calculated using the SPSS – 16 software, and analysis of the results was performed with the Student’s t- test and the chi-square test with P<0.05. There were no statistically significant differences between the two groups in terms of their age, period of pregnancy, and B.S. at the start of the study. The average B.S. of women four hours after the injections with Dexamethasone was 5.9 ± 1.57 and the corresponding figure for women in the control group was 4.6 ± 1.72. These figures were significantly different at P<0.001. The average interval between labor induction and the start of the active phase in the group injected with Dexamethasone was significantly less than that of the control group 2.87±0.93 versus 3.80± 0.93 at P<0.001). The average duration of the active phase of the second stage of childbirth was 3.47±1.10 hours in the experimental group and 3.6 ± 0.99 hours in the control group at P<0.49. These two figures were not significantly different. The Apgar scores of the first and fifth minutes after the birth of the children of the two groups of women were not significantly different. It was found that intravenous Dexamethasone improves the Bishop score of the cervix and thus causes softening of the cervix and reduces the length of time between labor induction and the start of the active phase of childbirth.
    Keywords: Dexamethasone, Labor induction, Duration of labor
  • Ramin Mehrdad, Khosro Sadeghniiat Haghighi, Amir Hossein Naseri Esfahani Pages 573-578
    Professional firefighting is among the most demanding jobs. Prior studies have showed the notable prevalence of poor sleep quality among professional firefighters that may result in catastrophes. The aim of this study was in field confirmation of zolpidem usage 10 mg/PO/bed time) for short term management of poor sleeps quality among professional firefighters. In a double-blind, randomized, placebo-controlled crossover clinical trial among professional firefighters, 27 poor sleepers were assigned randomly to one of the two groups. Two 14 days experimental periods were separated by a 14-day washout phase. Sleep quality was assessed using the Persian version of Pittsburgh Sleep Quality Index (PSQI). Six of the 27 enrolled voluntaries dropped out. Two rare side effects of zolpidem occurred in the study. A significant improvement of the PSQI score was detected in zolpidem period versus placebo in both groups (7.14 ± 3.02 vs 12.38 ± 2.51, P<0.001) although zolpidem had no significant effect on time of waking up (6.76 ± 1.21 vs. 6.64 ± 1.27, P=0.89). Zolpidem significantly improved all components of PSQI (Subjective sleep quality, Sleep latency, Sleep duration, Habitual sleep efficiency, Sleep disturbances and Daytime dysfunction) in the current study except the use of sleep medication. Sleep onset latency was the component of PSQI with the greatest degree of abnormality among firefighters in a previous study. Interestingly, sleep latency was the component of PSQI with the most treatment effect of zolpidem in the current study. Zolpidem can be used as a part of treatment regimens in short time management of poor sleep quality among professional firefighters.
    Keywords: Zolpidem, Professional firefighters, Sleep quality, Occupational Medicine
  • Zarrin Keihani Douste, Mohhamad Taghi Haghi Ashtiani, Mamak Shariat, Fatemeh Tehrani Pages 579-581
    Convulsion is one of the most common problems in children and hypocalcemia is one the most frequent etiological items in children’s convulsion. Corrected QT (QTc) in EKG is prolonged in hypocalcemia, so it can be a useful tool for evaluation of serum ionized calcium. In three groups (first seizure, multiple seizures, without seizure or control) every 25 cases, QTc, serum ionized ca, total ca, ABG, and serum albumin level have been checked in the Department of Pediatrics of Imam Khomeini Hospital and outpatient department of Ahari children’s medical center in 2008. Prolonged QTc was observed in 72% of convulsive children (36 cases) but only 19% of non-convulsive children (5 cases) showed this pattern. Ionized calcium was significantly higher in non-convulsive than convulsive groups. There was no correlation between prolonged QTc and total serum calcium; however, this correlation with low ionized calcium was significant. QTc is an easy and rapid method for serum ionized calcium evaluation.
    Keywords: QTc, Ionized Calcium, Total serum calcium, Convulsion
  • Shahla Afsharpaiman, Ali Bagheri Hagh, Mohammad Kolbadi Nejad, Susan Amirsalari, Mohammad Torkaman Pages 582-584
    Sleep problems are common in childhood, but there are limited studies regarding that in Iranian children and awareness of the sleep problems and their complication in Iranian parents. We arranged this study in which parents of children attending for a sick visit or routine growth control to assess whether sleep problems are under-reported at general pediatric visits. In a cross - a sectional study from April 2010 to April 2011 in 301 children aged 2-14 years old attending to pediatric clinics were enrolled. To investigate the general orientation of parents about their child sleep problem we asked them a global question at first regarding sleep of their child. After that, the Persian version of BEARS questionnaire was completed by them. Only 30 (9.9%) parents reported sleep problems in their children in response to primary global question but by collecting the data from BEARS questionnaire it was revealed 45.18% (136/301) of children had one or more of sleep disorders at all. As mentioned 136 (45.18%) children had slept problems of which the most frequent complaint (15.28%) was related to bedtime problems. The second complaint (11.96%) was awakening during the night children. A significant association between sleep problems and child gender was not found. Co-sleeping with parents was found in 55.48% of all children in this study. Despite the high prevalence and adverse effects of sleep disorders, the present study suggests that parents underreport sleep problems at consultation. We suggest children should be assessed for sleep disorders in monitoring and health screening visits.
    Keywords: Sleep disorders, Children, Parent's awareness: Bedtime problems
  • Feridoun Sabzi, Donya Khosravi Pages 585-589
    Hemolytic anemia is exceedingly rare and an underestimated complication after aortic valve replacement (AVR).The mechanism responsible for hemolysis most commonly involves a regurgitated flow or jet that related to paravalvar leak or turbulence of subvalvar stenosis. It appears to be independent of its severity as assessed by echocardiography. We present a case of a 24-year-old man with a history of AVR in 10 year ago that developed severe hemolytic anemia due to a mild subvalvar stenosis caused by pannus formation and mild hypertrophic septum. After exclusion of other causes of hemolytic anemia and the lack of clinical and laboratory improvement, the patient underwent redo valve surgery with pannus and subvalvar hypertrophic septum resection. Anemia and heart failure symptoms gradually resolved after surgery.
    Keywords: Hemolytic anemia, Mitral valve repair, Regurgitated jet, Heart failure
  • Impending Complete Airway Obstruction from a Reinforced Orotracheal Tube: a Case Report
    Nima Hosseinzadeh, Shahram Samadi, Mihan Jafari Javid, Alireza Takzare Pages 590-592
    Reinforced tubes are commonly used to minimize the opportunity of upper airway obstruction in patients at risk. There are a few reports of the airway obstruction resulted from kinked reinforced tubes. This report describes the obstruction of a reinforced tube in an adult patient who underwent tonsillectomy. Under general anesthesia; an armoured endotracheal tube was inserted into the trachea uneventfully. A few minutes after starting the surgery, the anesthesia machine detected a high airway pressure and an increased ETCO2 (end-tidal CO2) up to 50 mmHg. Further evaluation showed spiral wire damage resulted from Mouth Gag device that led to airway obstruction. Early anticipation of the complications leads to proper management of such critical and life threatening complications and prevention of hypoxia, hypercapnia, pneumothorax, and pulmonary edema. Based on our experience using an armoured endotracheal tube in tonsillectomy does not guarantee a safe airway and intensive monitoring is necessary.
    Keywords: Airway obstruction, Armoured tube, Boyle, Davis Mouth Gag, Tonsillectomy
  • Erratum: Indeterminate Cell Histiocytosis: Report of a Case
    Alireza Ghanadan, Kambiz Kamyab, Mazaher Ramezani, Azadeh Goodarzi, Maryam Daneshpazhooh, Kamran Balighi, Mahsa Ansari, Seyed Farzad Mirfallah Nassiri, Soroush Daklan Page 593