فهرست مطالب

Research in Medical Sciences - Volume:21 Issue:12, 2017
  • Volume:21 Issue:12, 2017
  • تاریخ انتشار: 1395/10/30
  • تعداد عناوین: 14
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  • Ozge Basaran, Nermin Uncu, Banu Acar Celikel, Fatma Ayd?N, Nilgun Cakar Page 1
    Background
    Blood neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) both have been used as a simple marker of inflammation in many disorders. Here, we aimed to investigate the relationship between NLR, MPV, and familial Mediterranean fever (FMF).
    Materials And Methods
    In this retrospective study, the fi les of FMF patients in pediatric rheumatology outpatient clinic were reviewed. There were 160 participants (68.4%) in the FMF patient group and 74 participants (31.6%) in the control group. Ninety of patients were in attack-free period, and 70 were in attack period.
    Results
    The highest values of NLR were found in the patients at attack period. Patients in attack-free period and the participants in control group had similar levels of NLR (1.71 ± 0.83 and 1.91 ± 1.86 respectively) (P = 0.457), and they had lower ratios than the patients did at attack period (4.10 ± 3.11) (P
    Conclusion
    NLR ratio may indicate FMF attack period. Since there was no significant difference between attack-free patients and control groups, NLR ratio cannot be used as a subclinical inflammation marker. However, NLR could be a useful predictor of inflammation in FMF patients. On the other hand, since our attack and attack-free patients have similar MPV values and both had greater MPV values than control group, we suggest that MPV may be used to show subclinical inflammation.
    Keywords: Familial Mediterranean fever, mean platelet volume, neutrophil to lymphocyte ratio, pediatric
  • Abbasali Palizban, Mahnaz Rezaei, Hossein Khanahmad Page 2
    Background
    The transcription factor 7-like 2 gene (TCF7L2) is an element of the Wnt signaling pathway. There is lack of evidence if TCF7L2 has a functional role in lipid metabolism and regulation of the components constitutes the metabolic syndrome (MetSyn).The aims of this study were to evaluate whether the risk allele of TCF7L2 gene polymorphism is associated with dyslipidemia and MetSyn.
    Materials And Methods
    The MetSyn subjects were participated only based on the National Cholesterol Education Program – Third Adult Treatment Panel criteria. In this case–control study, the DNA from MetSyn patients without (n = 90) and with type 2 diabetes (T2D) (n = 94) were genotyped.
    Results
    The results show that the genotype-phenotype for CC, CT/TT of TCF7L2 gene polymorphism correlated with body mass index and waist circumference in MetSyn and MetSyn T2D subjects (r = ?0.949 and r = ?0.963, respectively). The subjects that only possess MetSyn but are not diabetics show the 2 h postprandial glucose and fasting blood glucose, glycated hemoglobin significantly lower (P
    Conclusion
    The results revealed the important insights essential for the role of TCF7L2 that the T allele of TCF7L2 plays a significant role in the susceptibility to dyslipidemia, MetSyn, and T2D.
    Keywords: Metabolic syndrome, polymorphism, transcription factor 7-like 2 rs7903146, type 2 diabetes
  • Khalil Mahmoodi, Mohammad Soleiman Soltanpour, Koorosh Kamali Page 3
    Background
    Reduced bioavailability of nitric oxide (NO) and the T?786C polymorphism of endothelial nitric oxide synthase (eNOS) gene have been reported as risk factors for the development of coronary artery disease (CAD) with conflicting results. We investigated the association of plasma NO levels, T?786C genetic polymorphism, and gene expression levels of eNOS with CAD risk in an Iranian subpopulation.
    Materials And Methods
    Studied population included 100 patients with angiographically verified CAD and 100 ethnically matched controls. Analysis of T?786C genetic polymorphism and gene expression levels of eNOS was conducted by polymerase chain reaction (PCR) restriction fragment length polymorphism and real?time reverse transcription?PCR methods, respectively. Plasma levels of NO were measured using Griess method.
    Results
    The CC genotype distribution (15% vs. 6%, P = 0.011) and minor C allele frequency (36.5% vs. 21.5%, P = 0.001) of eNOS T?786C polymorphism differed significantly between CAD patients and control. Furthermore, eNOS T?786C polymorphism was more common among smoker than nonsmoker CAD patients (27.7% vs. 7.8%, P = 0.044). The association of the eNOS T?786C polymorphism with the severity of CAD (number of diseased vessel) was significant (P
    Conclusion
    Our study indicated that reduced NO levels and eNOS T?786C genetic polymorphism are significant risk factors for the development and severity of CAD in the Iranian population.
    Keywords: Coronary artery disease, endothelial nitric oxide synthase, eNOST?786C polymorphism, polymerase chain reaction?restriction fragment length polymorphism
  • Mohammad Hossein Izadpanahi, Hojatollah Salimi, Amir Javid, Salman Eslami Page 4
    Background
    The normal prostate-specific antigen (PSA) level in patients with urethral catheterization is a controversy. We designed this study to investigate the effect of nontraumatic urethral catheterization without urinary retention on serum PSA.
    Materials And Methods
    Seventy patients scheduled for urethral catheterization before elective surgeries were randomly selected and included in the study. They were categorized into two age groups: 40–60 years (Group A) and over 60 years (Group B). Total PSA, PSA density, and free/total PSA were assessed before and after catheterization.
    Results
    The PSA levels showed no statistically significant rise after urethral catheterization. The average of PSA level was 1.01 and 1.6 in A and B Groups, respectively, and changed to 1.38 and 1.80 in A and B Groups 1 day after catheterization (P > 0.05). Free/total PSA was 28.75 and 26 in A and B Groups before catheterization and changed to 28.35 and 27.5 in A and B Groups after catheterization (P > 0.05).
    Conclusion
    Nontraumatic urethral catheterization has very little effect on PSA level and in patients with urethral catheter routine evaluation of PSA rising should be considered.
    Keywords: Biopsy, prostate, specific antigen, urethral catheterization
  • Ali Asadollahpoor, Mohammad Abdollahi, Roja Rahimi Page 5
    Background
    Nonalcoholic fatty liver disease (NAFLD) includes a group of chronic liver disorders caused by irregular accumulation of fat in liver tissue. The current study aimed to evaluate chemical composition and the effect of fruit extract and essential oil of Pimpinella anisum in experimental model of NAFLD.
    Materials And Methods
    Sixty rats were randomly divided into ten groups, six in each group. NAFLD was induced in rats using choline?deficient diet for 90 days, followed by 30 days of treatment with 25, 50, 100, and 200 mg/kg/day of hydroethanolic extract (AE) as well as 0.125, 0.25, and 0.5 mg/kg/day of essential oil (AO). Blood samples were collected in the final day, and lipid profile, aspartate aminotransferase (AST), alanine aminotransferase (ALT) as well as biomarkers of oxidative damage including myeloperoxidase, lipid peroxidation, total thiol molecules, and ferric?reducing ability of plasma were measured. Liver tissue sections of the sacrificed rats were also assessed histologically.
    Results
    AE and AO significantly reversed increase in the plasma levels of total cholesterol, low?density lipoprotein, and triacylglycerol and decrease in high?density lipoprotein level in a dose?dependent manner (P
    Conclusion
    It could be concluded that P. anisum fruit extract and essential oil have beneficial effects in the treatment of NAFLD. Further studies are necessary to confirm safety and efficacy of this medicinal plant in clinical setting.
    Keywords: Alanine aminotransferase, anise, aspartate aminotransferase, cholesterol, fatty liver, oxidative stress, Pimpinella anisum, steatohepatitis
  • Behrooz Heydari, Hossein Khalili, Mohammad?Taghi Beigmohammadi, Alireza Abdollahi, Iman Karimzadeh Page 6
    Background
    The most common clinical indication of aminoglycosides (AG) is the treatment of serious Gram?negative infections.The aim of this study was to evaluate plausible effects of atorvastatin on the biomarkers of acute kidney injury (AKI) in patients receiving amikacin.
    Materials And Methods
    In this double?blinded randomized clinical trial, fifty patients (25 in each group) receiving amikacin (15 mg/kg/day) were randomly assigned to either atorvastatin (40 mg/day) or placebo (40 mg/day) groups for 7 days. Blood urea nitrogen (BUN), serum creatinine (SCr), and urinary neutrophil gelatinase?associated lipocalin (NGAL) levels were measured at days 0, 1, and 7 of amikacin treatment.
    Results
    During the study period, 4 (8%) patients including two patients in each atorvastatin and placebo group experienced AKI. Urine NGAL/urine Cr did not change significantly between and within placebo and atorvastatin groups during the study period. Similarly, the mean changes in SCr, BUN, and urine NGAL/urine Cr values did not differ significantly between and within patients with and without AKI.
    Conclusion
    Our data suggested that the changing pattern of urine NGAL/urine Cr ratio did not differ significantly between the atorvastatin and placebo groups during the early phase of amikacin treatment.
    Keywords: Acute kidney injury, amikacin, atorvastatin, biomarkers
  • Hossein Abdali, Ali Akbar Ataee Kachuee, Rastin Mohammadi Mofrad, Mohammad Ali Hoghoughi, Nazgol Esmalian Afyouni Page 7
    Background
    This study aimed to assess dermis fat graft (DFG) as a choice to correct the tissue deficit in the free border of the upper lip in cleft lip repair surgery.
    Materials And Methods
    Thirty?five individuals who referred to Alzahra Hospital at 2013–2014,with lip deformity following the primary repair surgery of cleft lip underwent surgery by DFG technique. Outcomes were assessed 4 months after the surgery based on comparison of preoperative and postoperative photographs.
    Results
    the results in 18 (51.42%) patients were excellent, 10 (28.57%) good, and 7 (20%) intermediate according to the satisfaction of patients and investigators in terms of filling of lip deficit and motion of the upper lip. Moreover, complications and pain were minimal after 4?month follow?up.
    Conclusion
    This method introduces an admissible method with 80% good to excellent results based on satisfactory of patients and surgeon.
    Keywords: Dermis fat graft, repair surgery, secondary cleft lip deformity
  • Fereshte Ashtari, Ali Safaei, Vahid Shaygannejad, Mohammad Amin Najafi, Sahar Vesal Page 8
    Background
    Neuromyelitis optica spectrum disease (NMOSD) is a severe autoimmune demyelinating disorder of the central nervous system that throughout epidemiological data, it has not been completely determined. The aim of this study was to assess characteristics of NMOSD patients in Isfahan as one of the most prevalent cities for multiple sclerosis in Iran.
    Materials And Methods
    Forty-five patients diagnosed as neuromyelitis optica (NMO) disease through 5 years enrolled in this study. Demographics and characteristics of disease such as Expanded Disability Status Scale (EDSS) score, disease duration, clinical symptoms, laboratory data, and magnetic resonance imaging findings (including T1, T2, and flair protocols) were recorded. NMO-immunoglobulin G serology assay was done in all of the patients by ELISA test.
    Results
    Female to male ratio was 5.4:1. The mean age of disease onset was 29.8 ± 11.2 years. NMO antibody was positive in 24.4% of patients. The presenting symptoms were optic neuritis (55.5%), transverse myelitis (40%),and brainstem symptoms (4.5%). The interval between the first and second attack was 19.28 ± 31.27 months (range: 1 month to 17 years). The mean EDSS score of the patients was 2.8 ± 2.25. Frequency of long-extending cervical plaque was higher among men than women (85.7% vs. 57.9%).
    Conclusion
    Based on this study, the mean age of NMOSD onset among Isfahan population was considerably lower than other studies, and there was higher frequency of long-extending cervical lesion among male patients which needs more consideration in further studies.
    Keywords: Demographics, Devic's syndrome, Iran, neuromyelitis optic
  • Samaneh Markazi, Majid Kheirollahi, Abbas Doosti, Mehrdad Mohammadi Page 9
    Background
    Considering a few studies on the genetic basis of the cystinuria in the Middle East and the population-specific distribution of mutations in the SLC3A1, we tried to find genetic variants in three exons (1, 3, and 8) of SLC3A1.
    Materials And Methods
    In this study, exons 1, 3, and 8 of SLC3A1 gene of 25 unrelated cystinuria patients searched for genetic variations by polymerase chain reaction and sequencing.
    Results
    There were five different variations in our studied population. We found one mutation in the SLC3A1 gene including missense variant M467K and identified three polymorphisms: nonsynonymous variant G38G, c. 610 169C>T and c. 610 147C>G within the SLC3A1 gene, and one new variant.
    Conclusion
    Our results confirm that cystinuria is a heterogeneous disorder at the molecular level and more studies are needed to identify the distribution and frequency of mutations causing cystinuria in the Iranian population.
    Keywords: Aminoaciduria, cystinuria, rBAT, SLC3A1, transport
  • Mahdi Bijanzadeh Page 10
    Complex inherited diseases affected by an interaction between collective effects of the genotype at one or multiple loci either to increase or to lower susceptibility to disease, combined with a variety of environmental exposures that may trigger, accelerate, exacerbate, or protect against the disease process. The new aspects of genetic techniques have been opened for diagnosis and analysis of inherited disorders. While appropriate Mendelian laws is applied to estimate the recurrence risk of single gene diseases, using empirical recurrence risks are the most important and available method to evaluate pedigree of complex (multifactorial), chromosomal, and unknown etiology disorders. Although, generally, empirical recurrent risks are not accurate, either because of the difference of gene frequencies and environmental factors among populations or heterogeneity of disease; using results of plenty family population studies, computerized estimating programs, genotyping technologies, and Genome?wide association studies (GWASs) of single nucleotide polymorphisms (SNPs), can make it possible nowadays to estimate these risks. The specific family situation and importance recurrence risks of some common complex genetic diseases will be presented in this review and some important multifactorial disorders’ recurrence risks will be summarized to help genetic counselors for supporting families and representing better view of genetic disorders.
    Keywords: Genetics counseling, pedigree, recurrence
  • Shahin Shooshtari, Shahram Tofighi, Shirin Abbasi Page 11
    Background
    Hospital Incident Command System (HICS) has been established with the mission of prevention, response, and recovery in hazards. Regarding the key role of hospitals in medical management of events, the present study is aimed at investigating benefits, barriers, and limitations of applying HICS in hospital.
    Materials And Methods
    Employing a review study, articles related to the aforementioned subject published from 1995 to 2016 were extracted from accredited websites and databases such as PubMed, Google Scholar, Elsevier, and SID by searching keywords such as HICS, benefits, barriers, and limitations. Then, those articles were summarized and reported.
    Results
    Using of HICS can cause creating preparedness in facing disasters, constructive management in strategies of controlling events, and disasters. Therefore, experiences indicate that there are some limitations in the system such as failure to assess the strength and severity of vulnerabilities of hospital, no observation of standards for disaster management in the design, constructing and equipping hospitals, and the absence of a model for evaluating the system. Accordingly, the conducted studies were investigated for probing the performance HICS.
    Conclusion
    With regard to the role of health in disaster management, it requires advanced international methods in facing disasters. Using accurate models for assessing, the investigation of preparedness of hospitals in precrisis conditions based on components such as command, communications, security, safety, development of action plans, changes in staff’s attitudes through effective operational training and exercises and creation of required maneuvers seems necessary.
    Keywords: Barriers, benefits, Hospital Incident Command System, hospital management, limitations
  • Mehrnoosh Sedighi, Mahmoud Bahmani, Sedigheh Asgary, Fatemeh Beyranvand, Mahmoud Rafieian?Kopaei Page 12
    Background
    Atherosclerosis is one of the most important cardiovascular diseases that involve vessels through the development of fatty streaks and plaques. Plant?based compounds can help treat or prevent atherosclerosis through affecting the involved factors. The main purpose of this review article is to investigate and introduce medicinal plants and their potential activities regarding antioxidant properties, effective on lipids level and development of plaque, atherosclerosis, and progression of atherosclerosis as well as the development of cardiovascular disease and ischemia.
    Materials And Methods
    To search for the relevant articles indexed in Information Sciences Institute, PubMed, Scientific Information Database, IranMedex, and Scopus between 1980 and 2013, with further emphasis on those indexed from 2004 to 2015, we used these search terms: atherosclerosis, antioxidant, cholesterol, inflammation, and the medicinal plants below. Then, the articles with inclusion criteria were used in the final analysis of the findings.
    Results
    Plant?based active compounds, including phenols, flavonoids, and antioxidants, can be effective on atherosclerosis predisposing factors and hence in preventing this disease and associated harmful complications, especially through reducing cholesterol, preventing increase in free radicals, and ultimately decreasing vascular plaque and vascular resistance.
    Conclusion
    Medicinal plants can contribute to treating atherosclerosis and preventing its progression through reducing cholesterolemia, free radicals, inflammation, vascular resistance, and certain enzymes. They, alone or in combination with hypocholesterolemic drugs, can therefore be useful for patients with hyperlipidemia and its complications.
    Keywords: Antioxidant, atherosclerosis, hypercholesterolemia
  • Anahita Alizadeh, Maryam Naseri, Yalda Ravanshad, Shahabaddin Sorouri, Malihe Banihassan, Anoush Azarfar Page 13
    Imaging of the kidneys and urinary tract has a significant and critical role for diagnosis of genitourinary system diseases. Although technological progress goes toward less invasive approaches, some of the current methods are still invasive and annoying. Voiding cystourethrography (VCUG) is the best and most accurate method for diagnosis and grading of vesicoureteral refl ux. VCUG is a distressful procedure that gives serious anxiety and pain in a large proportion of children and fear for parents; therefore, using effective sedative drugs with the least side effects is necessary and should be considered. In this review article, importance and efficacy of different drugs before catheterization VCUG be compared in the base of literature survey on EMBASE, PubMed, and Cochrane source. We found that the treatment should be based on nonpharmacological and pharmacological methods; nonpharmacological treatment includes the psychological preparation before procedures as a safety precaution with little or no risk modality, as well as reassuring support. The presence of parents during painful procedures cannot alleviate children distress. Pharmacological methods include oral midazolam (0.5 mg/kg) and intranasal use (0.2 mg/kg) that had been used 10 min before the procedure can effect on anterograde amnesia and sedation without considerable effect on accuracy and grade of reflux. Nitric oxide has a shorter recovery time versus midazolam but has a potential risk for deep sedation and may interfere with the child’s voiding phase. In summary, oral midazolam of 0.5–0.6 mg/kg or 0.2 mg/kg intranasal is acceptable drug that can be used before VCUG.
    Keywords: Children, cystourethrography, midazolam, sedative
  • Masoud Etemadifar, Mehri Salari, Hossein Badiee, Omid Mirmosayyeb Page 14