مجله دانشکده پزشکی اصفهان
پیاپی 424 (هفته چهارم اردیبهشت 1396)

Epilepsy is one of the common diseases affect some cognitive functions such as perception, attitudes and subjective well-being. Therefore, this study aimed to investigate the relationship between cognitive factors with subjective well-being among people with epilepsy, and also develop a structural equation model for this relevance.
This was a descriptive study of the type of structural equation modeling. This study population was people over 14 years old suffered from epilepsy and referred to Isfahan’s epilepsy charity, Iran, in the year of 2016; 120 of them were chosen via available sampling method. Research tools included subjective well-being questionnaire, dysfunctional attitude questionnaire, perception of illness questionnaire, and cognitive errors questionnaire. To analyze the results of this study, SPSS and AMOS software were used.
Findings: There was a good fit with the default model. Analysis of the original model indicated that understanding the emotional response to the disease (β = 0.81), the confidence to treat (β = 0.66), cognitive errors (β = 0.53), and dysfunctional attitude scale (DAS) (β = -0.42) were correlated with subjective well-being. In addition, understanding the emotional response to the disease (0.65), the confidence to treat (0.43), cognitive errors (0.28), and dysfunctional attitude scale (0.1.7) were involved in patient's subjective well-being.
The results show that subjective well-being in patients with epilepsy greatly appreciates the understanding emotional response to the disease and the confidence in the treatment. So, that is necessary for therapists to pay attention to these two factors beside the medical treatments.

There is no a comprehensive study on early-onset multiple sclerosis (EOMS) population on the role of well-known MS risk factors. Moreover, age at puberty and the critical window exposure to environmental risk factors is never investigated in neither adult nor pediatric MS population.
A case-control study, including 97 patients with early-onset MS and 97 matched controls, was conducted in Isfahan Multiple Sclerosis Society. Information on age at puberty, gestational risk factors, environmental exposures, and past medical history was obtained from medical charts and interviews.
Findings: In logistic regression model, every year of decreasing in pubertal onset in females and males was associated with 1.766 and 2.250 folds increase in risk of early-onset MS, respectively. In utero exposure to cigarette smoking was significantly associated with 2.33 (P = 0.010), and having smoker parents or passive smokers before puberty had 2.88 (P =0.006) fold in risk of early-onset MS. One hour less daily sun exposure increased the risk of early-onset MS as 2.007 folds (P In utero and parental exposure to smoking as well as history of measles and appendectomy are risk factors for early-onset MS. Future studies should shed more light on the true interaction between pineal gland, gender, smoking, sunlight and other environmental and genetic risk factors in adult and pediatric MS population.

Previous studies have shown that the amniotic membrane and its cells can be an appropriate choice for cancer treatment due to their anticancer properties. This research was designed to evaluate the impact of cryopreservation method on the anti-angiogenic and apoptosis induction properties of amniotic membrane.
In this study, the cancer cells were treated with fresh and cryopreserved amniotic membrane condition medium during 24 hours and the percentage of cancer cells viability was determined using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. To evaluate the changes of angiogenesis, the rat aorta ring assay was examined for both fresh and cryopreserved amniotic membrane within 7 days, and penetration and lack of penetration of fibroblasts-like and capillary-like cells of the aorta were evaluated in both amniotic epithelial and mesenchymal sides of fresh and cryopreserved amniotic membrane, in the presence and absence of epithelial cells.
Findings: Viability of cultured cancer cells treated with condition medium of fresh and cryopreserved amniotic membrane decreased dose-dependently and no significant difference was observed between the fresh and cryopreserved amniotic membrane. The aorta ring assay in fresh and cryopreserved amniotic membrane revealed that the amniotic epithelial stem cells inhibited the penetration of fibroblast-like cells and angiogenesis. Moreover, the penetration of fibroblast-like cells was observed in both epithelial and mesenchymal sides of fresh and cryopreserved amniotic membrane, after the removing epithelial cells.
According to the results of this study, cryopreserved amniotic membrane condition medium reduced the viability of cancer cells, as well as the fresh amniotic membrane condition medium. Moreover, it seems that the maintenance of epithelial cells layer and basement membrane of the amniotic membrane preserves the angiomodulatory properties of amniotic membrane in the cryopreservation method.

One of the most prevalent problems in patients under surgeries with spinal anesthesia is postoperative headache; despite several studies, no optimal method is recommended for prevention of this problem. This study aimed to compare the effect of dexamethasone, acetaminophen, and normal saline on the prevention of headache in patients under elective cesarean section.
In a clinical trial study, 135 patients under cesarean section were randomly divided in three equal groups. 15 minutes before the termination of surgery, patients received 8 mg dexamethasone, 1 g acetaminophen, or the same volume of normal saline, respectively. The incidence and intensity (visual analog scale or VAS) of headache after spinal anesthesia was compared between the three groups.
Findings: The mean headache intensity was 8.3 ± 7.4, 11.1 ± 2.9, and 19.3 ± 5.7 in dexamethasone, acetaminophen, and normal saline groups, respectively, and the difference between the three groups was statistically significant (P Preemptive dexamethasone and acetaminophen had a considerable effect on the prevention of post-spinal-anesthesia headache but there is not any difference between dexamethasone and acetaminophen. As using dexamethasone in some patients is limited and may lead to some complications such as hyperglycemia, hormone abnormality, and gastrointestinal bleeding, using acetaminophen is proffered.

Postburn leukoderma often is associated with psychosocial disabilities in patients. Several surgical techniques are suggested for the treatment of leukodermic burn scars. Melanocyte-keratinocyte transplant procedure (MKTP) is an important surgical modality for the treatment of this unpleasant complication. This study was designed to assess the efficacy of melanocyte-keratinocyte transplant procedure in postburn leukoderma using dermabrasion or Erbium YAG laser for recipient site preparation.
11 patients with 44 leukoderma lesions were randomized into two groups of dermabrasion-treated or Erbium-YAG-laser- treated recipient site for melanocyte-keratinocyte transplant procedure. Repigmentation rate and color matching were assessed at least 6 months after the treatment.
Findings: The mean percentage of repigmentation in was 64.20 ± 25.80 and 20.00 ± 9.40 in dermabrasion-treated and Erbium-YAG-laser treated groups, respectively (P Transplantation of autologous melanocyte-keratinocyte suspension could be considered as an effective and potentially safe treatment in leukodermic burn scars. Better results were achieved with dermabrasion for de-epithelialization of the recipient sites compared to Erbium YAG laser. Further studies on larger series of patients are needed to confirm the efficacy of melanocyte-keratinocyte transplant procedure in treating postburn leukoderma.

Around 90% of deadly accidents are due to human errors. Human factors like visual errors are the major cause of traffic accidents. We aimed to check the prevalence of different eyesight disorders in professional drivers going to take their driver's health card and also to evaluate used vision assessment tools.
In this cross sectional study, all the drivers (1941 persons) referred to the occupational medicine center of Baharlo hospital, Tehran, Iran, in a 6-months period were evaluated. Eyesight acuity, visual field, and color vision were evaluated using Snellen chart, vision screener apparatus, and plastic color plates and also Ishii Hara's standard test.
Findings: 243 drivers, without correcting their eyesight, were ineligible (in aspect of visual acuity) to receive health card. Among people corrected their vision, except one person, all the rest were able to receive health card. Just 2 persons (0.1%) had problem in distinguishing color plates; visual field was normal in all the participants.
Findings indicate the need for precise evaluation of visual acuity, specialized assessment of visual field, and usage of color vision functional tests. More studies are needed about optometric approaches and vision adequacy criteria in taking health card by drivers.

Pompe is a progressive and rare disease with major form (infantile form) resulted from lack of lysosomal alpha-glucosidase enzyme. This disease inherits in an autosomal recessive form and contains spectrum of different symptoms based on the age of onset. The variety of symptoms has seen in this disease like muscle weakness, cardio pulmonary problems, disability in daily routine works, and so on.
Case Report: In this case study, we studied the characteristics of 7 established patients in Iran recognized from 8 years ago. The age range of these patients was from 6 months to 28 years.
Different diagnosis time in patients, which is important, in this study was between 6 months to 28 years, which could cause many problems in patients whom their diagnosis was delayed.