مجله دانشکده پزشکی اصفهان
پیاپی 452 (هفته چهارم آذر 1396)

For replacement of the lost tissue due to trauma and burns, several methods were used; tissue expander in one of them, but few studies has been done about it. This study aimed to compare vascular density in the expanded tissue versus normal tissue in patients with missing tissue.
In a clinical trial study in 2015-2016, 25 candidates for tissue expander were enrolled. Subcutaneous tissue expander was placed and after completion of treatment, at the time getting expanders out of the body, 5 samples were given from expanded capsule, subcutaneous of expanded tissue, subcutaneous of not-expanded tissue, expanded skin, and not-expanded skin. Vascular density of the samples were determined by a pathologist and were compared with healthy tissue of adjacent area.
Findings: The mean vascular density in expanded capsule, subcutaneous of expanded tissue, and subcutaneous of not-expanded tissue were 8.96 ± 4.73, 7.36 ± 3.29, and 5.08 ± 2.40 per mm2, respectively; vascular density of subcutaneous of expanded and not-expanded tissue was statistically different (P Using expanded tissue for destroyed tissue replacement is an efficient method in patients who need it; developing tissue with this method leads to development of vascularity in expanded tissue.

Considering high prevalence of psychiatric disorders in patients with type 2 diabetes, this study aimed to investigate the predicting role of psychological flexibility and self-compassion against depression, anxiety, and stress in patients with type 2 diabetes in Khorramabad City, Iran.
In this periodical quantitative study, participants consisted of 102 men and women with type 2 diabetes selected from clinics using convenient sampling method. To collect the data, Neff Self-Compassion Scale-Short Form, Acceptance and Action Questionnaire-II, and Depression, Anxiety and Stress Scale-21 (DASS-21) were used. Data were analyzed using Pearson correlation coefficient and stepwise regression tests via SPSS software.
Findings: There was a significant negative correlation between psychological flexibility and self-compassion with variables such as depression, anxiety, and stress (P In general, individuals with high self-compassion and psychological flexibility have less stress, anxiety, and depression. So, it is recommended to exercise suitable practices to increase self-compassion and flexibility in patients with type 2 diabetes.

Previous studies showed that dexamethasone and ondansetron had effect on preventing shivering in surgeries under spinal anesthesia but comparison of the two drugs was not studied. This study aimed to compare preemptive effect of intratechal fentanyl with intravenous ondansetron, dexamethasone, and dexamethasone plus ondansetron on shivering during surgeries under spinal anesthesia with bupivacaine.
In a clinical trial study, 185 patients under surgeries with spinal anesthesia were randomly divided in 5 groups of receiving 25 µg intratechal fentanyl, 4 mg intravenous ondansetron, 0.1 mg/kg intravenous dexamethasone, 0.1 mg/kg intravenous dexamethasone plus 4 mg intravenous ondansetron, and 4 ml intravenous normal saline in a bolus dose. The incidence of shivering during surgery was compared between the 5 groups.
Findings: Mean shivering scale during surgery and recovery time in control, dexamethasone plus ondansetron, ondansetron alone, dexamethasone alone, and fentanyl groups were 1.30 ± 0.33, 1.01 ± 0.04, 1.15 ± 0.20, 1.04 ± 0.07 and 1.12 ± 0.15, respectively. Shivering intensity in control group was higher and in dexamethasone plus ondansetron was lower than others significantly (P Using dexamethasone plus ondansetron have more effect on decreasing shivering during and after the surgery. In addition, this compound has not adverse effect on hemodynamic parameters.

Panic disorder is among the prevalent mental disorders. By unexpected and spontaneous occurrence of panic attacks, it can be found that this disorder is accompanied by cognitive and physical symptoms, which can cause cardiovascular, respiratory, neural, and intestinal disorders, perspiration, shivering, fever, and psychological problems. Since aquatic exercises are effective in reducing cardiovascular symptoms, this study aimed to determine the effect of aquatic exercises on QT interval in patients with panic disorder.
36 women with panic disorder, mean age of 38.60 ± 6.45 years, and mean weight of 70.64 ± 11.04 kg were selected purposively after medical screening and placed randomly in two groups experimental and control (n = 18). QT intervals were measured by electrocardiography (ECG), before the intervention and 12 weeks after it. Experimental group participated in a 12-week program for aquatic exercises (three weekly sessions in 1.5-hour basis for each session, with the intensity of 50-80% of maximum heart rate). Patients in control group continued their normal life. All the variables were remeasured after 12 weeks. Paired t-test was used to compare within the groups and ANOVA test was used for the intergroup comparison.
Findings: Comparison of the means between the two groups showed that after 12 weeks of aquatic exercises, significant reductions were observed for QT interval, corrected QT interval (QTc), QRS interval, and heart rate (HR) in patients with panic disorder in experimental group compared to the controls (P Hence, aquatic exercises can be used as a method for improving cardiovascular factors in patients with panic disorder.

Management of cleft palate problems have been improved during last 2 decades. The purpose of palatoplasty is decrease in complications such as palatal fistula. The incidence of cleft palate fistula after palatoplasty reported widely between 0 to more than 76%. This study aimed to evaluate the efficacy of closure of hard palatal fistula using acellular dermal matrix (AlloDerm) graft.
This cross-sectional study was done during 2015 to 2016 in referral Alzahra hospital in Isfahan, Iran. Patients who had a secondary fistula in any ages referred to cleft palate clinic and signed a consent form to be operated with this method were included. Postoperative recurrence in closed fistula was checked with follow-up appointments at 6 months for all cases.
Findings: Of 30 patients (12 men and 18 women) participated in this study, recurrence of hard palatal fistula was seen in 4 patients.
Closure of cleft palate fistula using acellular dermal matrix is a useful method with high success rate.

Prenatal exposure to bisphenol A (BPA) has been associated with adverse birth outcomes. Bromelain belongs to a group of protein digesting enzymes obtained commercially from the fruit or stem of pineapple. It is known to possess antioxidant and immunomodulatory effects and to protect against oxidative stress in experimental models. The aim of the present study was to evaluate the effectiveness of bromelain and vitamin E (a well-known antioxidant) on apparent abnormalities of bisphenol A in rat model.
In this experimental study, 34 pregnant rats were divided into 6 groups. Control group received olive oil gavage and test groups received bisphenol A (300 mg/kg, gavage), bromelain (40 mg/kg, intraperitoneal), bisphenol A plus bromelain (10 mg/kg, intraperitoneal), bisphenol A plus bromelain (40 mg/kg, intraperitoneal), and bisphenol A (300 mg/kg, intraperitoneal) plus vitamin E (100 mg/kg, intraperitoneal) at 6th-15th days of gestation. Fetuses were collected at 20th day of gestation and after determination of weight and length, they were evaluated for apparent abnormalities.
Findings: The mean weight and length of fetuses received bisphenol A were 1.20 ± 0.49 g and 21.76± 3.33 mm, respectively, that significantly were less than other groups; but bromelain improved them, as same as vitamin E. In apparent evaluation of fetuses, only exencephaly was seen in 21.42 percent of fetuses in bisphenol A group and 5.4 percent of fetuses in bisphenol A plus bromelain (10 mg/kg) group, while it was not seen in the other groups.
Regardless of protective mechanism of bromelain, results of this study showed that bromelain can decrease apparent abnormalities of bisphenol A.

microRNAs are non-coding RNAs with about 22 nucleotides in length which modulate gene expression by binding to the gene target mRNA; they have eminent role as oncomiRs or microRNAs tumor suppressors. Changes in microRNAs expression have a radical role in pathobiology of different cancers. In this research, miR-143 and miR-145 expression in the tumor cells and tumor margins of patients with colorectal cancer were evaluated.
Tumor cells and tumor margins were examined after being biopsied from 30 patients with colorectal cancer. Total RNA content was extracted from both tissue types with TRIzol reagent and then, complementary DNA (cDNA) of miRNAs were synthesized. microRNAs expression level was assessed through reverse transcription-polymerase chain reaction (RT-PCR) method using the SYBR Green. For statistical analysis, GraphPad Prism software was applied to compare the expression level of the microRNAs between tumor cells and tumor margins.
Findings: The expression level of miR-143 and miR-145 were significantly lower in tumors compared to the margins (P Expression level of miR-143 and miR-145 were down-regulated in tumors compared to the margins. Lower expression level revealed that miR-143 and miR-145 can be utilized as diagnostic biomarkers in colorectal cancer. This may also introduce these microRNAs as colorectal cancer therapeutic targets.