مجله دانشکده پزشکی اصفهان
پیاپی 407 (هفته سوم دی 1395)

The highly increase of Alzheimer's disease among human lead to increasing the demand of finding a reliable way to diagnose its symptoms at the early stages. Recent researches in this area demonstrate that the signal complexity analysis of the electroencephalogram can be useful in prognosis the development of this illness form mild cognitive impairment to Alzheimer's disease. The focus of this study was on approximate entropy and proposing an effective approach for using this criterion to diagnose the mild cognitive impairment.
In this research, the electroencephalograms of 16 normal subjects and 11 patients were used. The signals were captured based on 10-20 international system for 30 minutes. In the preprocessing phase, the artefacts were eliminated both by visually inspection by a specialist physician and using band pass filter. In the processing phase, different scenarios were considered and applied to define the different parameters of approximate entropy. Finally, the results were analyzed using t-test to optimize the define protocol of the entropy and find the appropriate channels for diagnosing the disease.
Findings: A protocol for extracting the complexity based on approximate entropy was determined, in which the difference of the entropy of normal subjects and patients were more remarkable. By using this protocol, the number of appropriate channels for diagnosing the disease increased (P Using the entropy measurements for different channels of patients with mild cognitive impairment, demonstrate that the amount of complexity of signals decreased.

The cause of epilepsy in most of cases is unknown but inherited causes can play a role in its incidence. Recently, many researches have been conducted in the field of epilepsy. The aim of this study was to identify gene(s) responsible in an Iranian family with autosomal recessive non-syndromic epilepsy using whole exome sequencing (WES) method.
In this experimental study, genomic DNA was extracted from whole blood belonging to three affected persons and a healthy individual and whole exome sequencing was performed using Illumina Hiseq2000 platform. At first, variants classification were carried out based on mutation types, position of the mutation and their allele frequencies and then, prioritization was performed via two approaches. Sanger sequencing was carried out for RNF216 confirming the variant [NM_207111.3 (RNF216): (g.5780794G > A), (c.854C > T)].
Findings: From 130855 variants, 85% were single nucleotide variants and 15% were indels. One third of them located in intergenic and intronic regions, one third located in 3’and 5’ UTRs and one third located in exonic and splice site regions. 3.8% and 3.4% of variants had allele frequencies below 0.01 in ExAC and 1000 genome project databases, respectively. By using the two prioritization approaches, a variant in RNF216 gene [NM_207111.3 (RNF216): (g.5780794G > A), (c.854C > T)] was selected as a prior candidate. However, this variant did not co-segregate with the disease in all of the members of this family.
Exome sequencing has been considered as a tool for studying genetic causes of Mendelian disorders; but it has some limitations. Mutation in the non-coding regions of the genome, clinical heterogeneity of disease, wrong clinical diagnosis, phenocopy, and technical and analytical limitations can be considered as a reason that we could not find gene(s) responsible for the disease in this family.

Migraine is one of the most common causes of headache characterize by pulsatile headache. Most patients with migraine experience chronic fatigue syndrome. This syndrome includes chronic fatigue for at least 6 months with neurological symptoms and muscular pain. One of the first line agents in migraine treatment is sodium valproate. In addition, usage of fluoxetine as a prophylactic treatment of migraine has been effective in recent researches. In this research, a comparison between sodium valproate and fluoxetine in treatment of patients with migraine and chronic fatigue syndrome was done.
In this clinical trial study, 64 patients with migraine and chronic fatigue syndrome were enrolled. They were divided into two equal groups of 32 participants. Each group took one of the fluoxetine (20 mg daily) or sodium valproate (400 mg daily) for 8 weeks. The groups were compared in aspect of intensity score and frequency of headaches. Student's t and ANOVA statistical tests were used to analysis the results.
Findings: The mean headache intensity score decreased in both sodium valproate and fluoxetine groups by 34.83% and 22.82%, respectively. In addition, the mean headache frequency decreased in both fluoxetine and sodium valproate groups by 23.68% and 40.54%, respectively.
It could be understood that both sodium valproate and fluoxetine are effective in treatment of migraine with history of chronic fatigue syndrome, yet sodium valproate was more effective. The effectiveness of fluoxetine was obvious in patients with depression history.

Androgenic alopecia (AGA) is one of the most common problems among men; in some societies, 50 percent of 50-years-old men are involved. In the past, opium versions of therapeutic compounds for the treatment of hair loss were used. Therefore, this study aimed to examine the relationship of opium consumption and androgenic alopecia in men.
In this case-control study, 604 men referred to the Isfahan Amin Hospital, Iran, were enrolled. The sampling method was a simple classification (convenient) and men were divided to 2 equal groups of control (non-consumer of opium) and addict (consumer of opium). The intensity of androgenic alopecia was compared on the basis of a Hamilton Norwood scale. Data were collected using physical examination and a researcher-made questionnaire. Statistical analysis was carried using chi-square, Student's t, Spearman and One-way ANOVA tests.
Findings: Percentage frequency of androgenic alopecia in addict men was significantly less than control group (P Our finding indicates that the prevalence of androgenic alopecia in opium-addict men is lower than non-consumer men.

Acinetobacter baumanniii is a highly antibiotic-resistant nosocomial opportunistic pathogen possess. This study aimed to assess the antibiotic-resistance pattern and detect the molecular frequency of aphA6 and aadB genes in Acinetobacter baumannii isolated from patients in intensive care unit (ICU).
In this cross-sectional study, 58 Acinetobacter baumannii isolates collected from ICU patients in Imam Reza hospital, Kermanshah, Iran, were confirmed using standard bacteriological tests. Disc diffusion method was deployed for screening resistant isolates. The prevalence of aphA6 and aadB genes was assessed using polymerase chain reaction (PCR) method with specific primers.
Findings: The highest antibiotic resistance rates were seen in ticarcilin (87.9%) and ceftazidime (86.2%) and the lowest was of polymyxin B (12.1%). Of 58 Acinetobacter isolates, 36 (62.1%) and 9 (15.5%) harbored aphA6 and aadB genes, respectively. In addition, 5 isolates (8.6%) harbored both genes and 18 isolates (31.3%) were negative for any of those genes.
80% of Acinetobacter isolates showed resistance to aminoglycoside antibiotics. Considering the high rates of antibiotic resistance to this category and other investigated antibiotics in this study, it seems necessary to precise on the use of antibiotics such as polymyxin B to treat the infections caused by this pathogen.