مجله دانشکده پزشکی اصفهان
پیاپی 495 (هفته سوم آبان ماه 1397)

The aim of this study was to determine the effect of intravenous amiodarone on the central venous pressure in patients undergoing coronary artery bypass graft surgery. In a clinical trial study, 76 patients underwent coronary bypass surgery were randomly divided in two groups of 38; in the first group, after exiting from cardiopulmonary bypass, 150 mg amiodarone was dissolved in 100 cc dextrose 5% serum and infused in 10 minutes. In the second group, with the same volume, dextrose 5% serum was injected to the patient over the same period. Patients in the two groups underwent anesthesia induction. Systolic, diastolic, mean arterial, and central venous pressures were measured in both groups at the time of induction, 15 minutes after separation from pump, and at the time of admission to the intensive care unit (ICU); the results of the two groups were compared. Findings: Systolic, diastolic, mean arterial and central venous pressures did not show any significant difference between the two groups (P > 0.05). During the study, 8 patients had electrocardiographic changes, of which 7 were from the control group and 1 from the amiodarone group (18.9% vs. 2.2%), and the difference between the two groups was significant (P = 0.02). It seems that administering amiodarone in the operative phase does not have a significant effect on central venous pressure and hemodynamic parameters; but administration of this drug significantly reduces the incidence of arrhythmia in patients undergoing coronary artery bypass graft.

Multiple sclerosis (MS) is a demyelinating inflammatory disease of central nervous system. Avascular necrosis (AVN) of femoral head is reported as an unusual complaint of multiple sclerosis. In this study, occurrence of AVN due to use of interferon-beta remedies was assessed. This was a descriptive cross-sectional study on 6420 cases with relapsing-remitting multiple sclerosis from 2007 to 2017. Recorded information were based on the assessment by expert neurologist, and included demographics, time of disease onset, time of the diagnosis of avascular necrosis (AVN), unilateral or bilateral necrosis, duration and dosage and type of beta-interferon, dosage of oral corticosteroid, and pulse of corticosteroid therapy. The data were analyzed, and descriptive information was expressed as mean, standard deviation, and percentage.   Findings: In this study, 6420 patients with history of relapsing-remitting multiple sclerosis were evaluated. Of them, 4900 cases were treated with interferon-beta which included in the study. Eight patients presented avascular necrosis of femoral head. Mean age of patients was 30.25 ± 10.09 years. 75% of 4900 cases were treated with interferon-beta were women. Mean duration between multiple sclerosis onset and presentation of avascular necrosis was 42.12 ± 28.47 months. 62.5% of patients had unilateral avascular necrosis. 87.5% of cases were under treatment with interferon-beta-1a and the rest 12.5% treated with interferon-beta-1b. Based on the findings of our study, it is possible to hypothesize that use of interferon-beta may have an effect on occurrence of avascular necrosis among patients with multiple sclerosis. The probable mechanisms could be angiogenesis inhibition, vasoconstriction, and small thrombosis formation in arterioles, as well as leukocytoclastic vasculitis. Further studies are recommended

Recently, renal transplantation has increased worldwide. The incidence of metabolic syndrome is common after renal transplantation that might reduce renal function and increase cardiovascular complications. In this study, we compared renal function after renal transplantation in patients with or without metabolic syndrome. This cohort prospective study was conducted in 2017 among patients with renal transplantation aged more than 20 years in Isfahan City, Iran. Metabolic syndrome criteria including blood pressure, fasting blood sugar, high- and low-density lipoprotein, triglyceride, and waist circumference, as well as serum creatinine were measured in 30 patients with metabolic syndrome and 30 without metabolic syndrome in one-year follow-up period.   Findings: 17 patients were women and 43 were men. The mean serum creatinine changes were not significantly different among the patients with or without metabolic syndrome (P = 0.227) in 1-year follow up. There was no significant association between serum creatinine level with metabolic syndrome criteria such as waist circumference (P = 0.214), diastolic blood pressure (P = 0.061), triglyceride (P = 0.409), high-density lipoprotein (P = 0.315), and fasting blood sugar (P = 0.284) in patients with metabolic syndrome, and only the association between serum creatinine level and systolic blood pressure was significant (P = 0.008). Serum creatinine did not increase significantly in patients with metabolic syndrome. We recommend to consider longer follow-up periods in future studies.

Hydatid cyst is one of the most common diseases of humans and animals, which its most common involved site is liver. Despite various treatments, hydatid cyst recurrence is still a serious problem in areas with high prevalence. Therefore, in this study, we aimed to investigate the recurrence rate of hydatid cyst, and also the association of recurrence with the characteristics and manifestations of sonography according to the classification of hydatid cyst by World Health Organization (WHO). In this cross-sectional study, all patients with hydatid cyst, who underwent surgery during 2011-2014 were evaluated for demographic characteristics, cyst features, and types of surgical methods. After surgery, all the patients were followed up for 3 years, and increase of size in repeated sonographies was considered as recurrence. Findings: Based on WHO classification, the most common types of cysts included 23 cases (35.4%) of cystic echinococcosis type 1 (CE1), 12 cases (18.5%) of CE3b, 11 cases (16.9%) of CE3a, 7 cases (10.8%) of CE2, 3 cases (4.6%) of CE4, and 2 cases (3.1%) of CE5. Three cases (4.6%) of the patients had hydatid cyst recurrence. There was no significant association between demographic characteristics, cyst features, cyst classification according to WHO, and surgical methods with recurrence rate (P > 0.05). Hydatid cysts types of CE1, CE3b and CE3a are the most common types based on the WHO classification, and there is no association between their frequencies and the recurrence rate of hydatid cyst. Therefore, the use of this method of hydatid cyst classification is not recommended in order to determine the probability of recurrence of patients. However, more extensive studies in this field are recommended to determine the efficacy of this classification method to determine the risk of recurrence of hydatid cyst

Herpes simplex virus type 1 (HSV-1) infections are of the most common diseases in human population. HSV-1 can cause subclinical to severe diseases, especially in immunocompromised patients. There are few anti-herpes drugs for treatment of HSV-1 infection. Acyclovir is one of the most important drugs. The extensive use of this drug has led to the development of resistant strains. Therefore, development of new anti- herpes drugs with different mechanisms is noticeable. This study aimed to use microRNAs as a novel method for inhibiting HSV-1 infection. Synthesized miRNA mimics hsa-miR-7704 (miR-SX1) were transfected into Hela cells, and then infected with HSV-1. Cellular morphological changes were observed 24 hours post-infection by inverted microscope, and photographed. Viral titers were measured using 50% tissue culture infective dose (TCID50) method. Findings: miR-SX-1-transfected cells produced low-titer HSV-1, without affecting cell viability. The data suggest that miR-SX1 inhibits HSV-1 replication, and may provide an alternative mechanism to prevent HSV-1 infection