مجله دانشکده پزشکی اصفهان
پیاپی 389 (هفته اول شهریور 1395)

The most common method of pain control after coronary artery bypass graft surgery is utilization of opioids and non-steroidal anti-inflammatory drugs (NSAIDs). In this study, the authors investigated the analgesic effects of intravenous paracetamol, while aiming to minimalize systemic side effects.
In this prospective, randomized and triple-blinded clinical trial, patients were studied in two groups: a control group (n = 42) and a group treated with paracetamol (n = 51). The paracetamol group received an intravenous injection of the drug 15 minutes before induction of anesthesia and then every 6 hours for 3 days, 1 g paracetamol in 50 ml normal saline was infused in 15 minute. In the control group, normal saline was used instead of paracetamol in all stages of study in the same volume.
Findings: Reported pain severities during resting [after 24 (P = 0.002) hour] and deep breathing [after 12 (P = 0.001), 24 (P Preemptive and then continuous prescription and use of paracetamol after cardiac surgery improves the quality of postoperative pain control of opioids. However, the potency of paracetamol alone is not enough to reduce the required dose and the side effects of opioid and sedative drugs.

Biological effects of ultrasound waves and their applications in the presence of nanoparticles are a rapidly growing research area. In recent years, ultrasonic therapy of cancer cells has been developed successfully. In this study, effects of ultrasound waves in the presence of Ag nanoparticles on the MCF-7 cells were evaluated.
The MCF-7 cells were cultured. The cells were divided into 4 groups including: (1) control, (2) incubated with Ag nanoparticle, (3) treated using ultrasound alone and (4) treated using ultrasound at the presence of Ag nanoparticle. For groups of 2 and 4, nanoparticles were injected into the cells in 50, 100 and 200 µg/ml concentrations. Ultrasound irradiation at 2 W/cm2 intensity was performed on the cells for 3 min.
Findings: Statistical comparison of the results showed that, there was a significant difference in the percent of cell viability between the US treated group at the presence of Ag and the control group (P Results of this study revealed that ultrasound in the presence of Ag nanoparticles can be efficiently used for MCF-7 cells treatment.

Toll like receptor-2 (TLR2) plays an important role in the process of detection and launching the immune response against Candida albicans. Cyclophosphamide is one of the most widely used chemotherapy drugs, which causes severe neutropenia and suppression of the immune system. In this study Balb/c mice were infected to disseminated candidiasis and neutropenia and expression of TLR2 gene was measured in whole blood samples of each mice.
Twenty-eight mice were divided into 4 groups and injected with Cyclophosphamide and C. albicans. Blood samples were used for RNA extraction and cDNA synthesis, and expression of TLR2 gene was measured by real-time polymerase chain reaction (Real-time PCR). Statistical analysis was performed using Kruskal-Wallis and 2-∆∆CT method.
Findings: Gene expression was increased in the group receiving Candida albicans and also in group receiving both Cyclophosphamide and Candida albicans but decreased in the group just receiving Cyclophosphamide.
There was no significant difference between the control group and experimental groups for TLR2 gene expression (P = 0.478). However, the results of this study can be regarding in selecting TLR2 or its receptor as a therapeutic target with monoclonal antibodies or gene therapy techniques.

This study aimed to compare tear film in myopic patients with moderate and normal dry eye before and after photorefractive keratectomy (PRK) surgery.
This was a prospective cohort study which used non-probability convenience sampling method. After running Schirmer's test I (without anesthesia), the patients undergoing PRK surgery were divided into two groups of normal and moderate dry eye. Inclusion criteria for mild to moderate myopic patients was between 2 to 5.5 diopters, without astigmatism or with astigmatism less than 2D which had refractive surgery criteria. Exclusion criteria included refractive surgery contraindications, taking ocular drugs, having dry eye and intensifying factors like smoking, working on computer more than 3 hours a day and repeated refractive surgery. A complete examination of patients was performed before the surgery and 3 months after the surgery, re-examination was performed and the results were evaluated.
Findings: A total of 78 eyes (of 78 male and female subjects) with a mean age of 20-35 were evaluated. The patients were divided into two groups of 42 normal eyes and 36 moderate dry eyes. The two groups had no significant difference in terms of age, gender, spherical mean and corneal thickness. Schirmer 1 test average before the surgery was 28.64 ± 6.14 in the normal group and 8.36 ± 1.87 in the dry eye group. Three months after the surgery, the result was 24.64 ± 9.12 in the normal group and 6.17 ± 2.44 in the dry eye group.
In corneal refractive surgery on both control group and moderate dry eye group, tears were reduced by 3 months after the surgery, but the risk of developing dry eye was higher in the moderate dry eye group.

Streptococcus agalactia (GBS, Group B streptococcus) is a bacterium usually found in the vagina, urinary and digestive tract. Colonization of GBS in mother's vagina may threat the newborn to acquire different infections such as pneumonia, meningitis and bacteremia.
The present analytical-descriptive study was performed using 100 vaginal specimen for detection and phenotyping resistance of GBS to penicillin, erythromycin, clindamycin and tetracycline by Kerby-Bauer method. Resistance genes to erythromycin erm A, erm B, mef A using molecular analysis was also evaluated.
Findings: Tetracycline was found to be the most resistance and penicillin the least. Resistance to erythromycin was 8, clindamycin 10, tetracycline 95 and penicillin 1 percent. That genotypic of erm B 23% and erm A 38% was the most resistance, but, the least resistance gene was mef A with 1%.
This study revealed that the sensitivity of penicillin to GBS is satisfactory, but it seems that resistance of this bacterium to clindamycin, erythromycin is increasing. In addition, it was found that the gene erm A was the most prevalence gene concerning erythromycin resistance.