فهرست مطالب

Kerman University of Medical Sciences - Volume:26 Issue: 1, 2019
  • Volume:26 Issue: 1, 2019
  • تاریخ انتشار: 1397/10/11
  • تعداد عناوین: 10
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  • Hadi Mirahmadi, Ahmad Mehravaran, Nasrin Rezaee, Saber Gholizadeh, Saber Raeghi *, Elham, Sadat Roointan Pages 1-11
    Background
    Cutaneous Leishmaniasis, is endemically observed in different parts of Iran in two forms of anthroponotic and zoonotic. The identification of both species and the type of disease are beneficial for treatment and prevention. Microscopic identification of Leishmania species has not provided promising efficacy. The aim of this study was to determine the Leishmania species that are responsible for cutaneous leishmaniasis in Zahedan/ Iran by using PCR and PCR-RFLP techniques.
    Method
    Direct smears were obtained from cutaneous leishmaniasis suspected individuals with low parasitemia in cutaneous lesions referred to Zahedan health centers. Eventually, the DNA was extracted from smears using DNA extraction kit. PCR was used to amplify both Leishmania kinetoplastic DNA (kDNA) and ITS1 locus of ribosomal DNA. Additionally, PCR-RFLP on ITS1 products was conducted to determine parasite species.
    Results
    PCR-RFLP test (detecting ITS1 locus) on all positive samples in microscopic analysis led to the identification of Leishmania major in 52 samples (54.7%), and 43 cases were detected to have Leishmania tropica (45.3%). On the other hand, kDNA-PCR results indicated a frequency of 68 (55.7%) for L. major and 54 (44.3%) for L. tropica.
    Conclusion
    Due to the high frequency of kDNA in parasitic genome, PCR-kDNA compared to PCR-RFLP shows a higher efficiency and accuracy not only in identifying infection, but also in determining parasite species, especially among the patients with fewer lesions. This study also indicates that both L. tropica and L. major could be found in Zahedan, with a greater tropical leishmaniasis endemicity.
    Keywords: Leishmania tropica, Leishmania Major, Zahedan, PCR-RFLP, ITS1, kDNA
  • Zahra Kamiab, Mohammad Reza Mohammadi Hassan, Gholamhossein Hassanshahi, Gholamreza Bazmandegan, Shokoofeh Darakhshan * Pages 12-21
    Background
    Sepsis is regarded as a critical clinical status in neonates. Since blood culture is a time-consuming method, the present study was conducted to investigate the serum level of Ferritin, Procalcitonin, and CRP in the peripheral blood of term neonates suspected with sepsis to have a quicker diagnosis for the disease.
    Methods
    In the present cross-sectional study, a total of 60 neonates suspected with sepsis who had been hospitalized in Ali ibn Abi Talib Hospital of Rafsanjan/ Iran in 2015-2016 were randomly selected. Before conducting the treatment processes, blood samples were taken from all neonates and sent for blood culture. The intended markers were measured both before and after the treatments and the results were recorded in special forms for each neonate. Data were analyzed through SPSS20 and using chi-squared test, Paired t-test, and drawing a ROC curve for determining the best cut-off point and measuring the sensitivity and specificity.
    Results
    In this study, 70% of the neonates suspected with sepsis were male, 56.7% were younger than 7 days old and 96.7% had natural weight. The most common symptoms were poor feeding and reduced sucking reflexes. Data analysis of the markers indicate that they reduced significantly after the treatment (p<0.001). The sensitivity, specificity, and the best cut-off point were respectively 64.3%, 43.5%, and 257.8 for Ferritin, 78.6%, 50%, and 23 for Procalcitonin and 85.7%, 65.2%, and 21.5 for CRP.
    Conclusion
    According to the obtained findings, applying these markers can be of a great use in diagnosing neonatal sepsis. However, given the low sensitivity and specificity of Ferritin, Procalcitonin and CRP in the present study, further studies need to be conducted to obtain more definite results.
    Keywords: Sepsis, neonate, Ferritin, procalcitonin, CRP, Rafsanjan
  • Mojgan Sanjari, Ahmad Gholamhoseinian Najar, Gholamreza Asadikaram, Mahboubeh Mashayekhi *, Amirfarhad Ghaseminejad Tafreshi Pages 22-35
    Background
    Diabetes is a global health problem that its prevalence is increasing rapidly. Rosa damascena extract has shown to have an intensive non-competitive inhibitory effect on α-glucosidase in an animal study. The aim of this study was to assess the safety and efficacy of Rosa damascena (RD) Mill in diabetic patients and healthy subjects.
    Methods
    In a triple-blind, placebo and Acarbose-controlled randomized trial in Kerman in the south-east of Iran, we randomly allocated diabetic patients (n=32) and healthy volunteers (n=28) to 100mg Acarbose, 200 mg RD-methanolic extract, 400mg RD-methanolic extract and placebo groups. Over 15 days, the participants were followed up to monitor the changes in blood biochemical parameters and apparent symptoms. Analyses were carried out by intention to treat.
    Results
    RD extract decreased postprandial blood glucose levels comparable to the effects of Acarbose, demonstrating its α-glucosidase inhibitory activity. Besides, fasting plasma glucose levels significantly decreased in patients treated with 400 mg/day RD-methanolic extract compared to the 200 mg RD-methanolic extract (127.6±26.8vs. 165.5±27.1, p=0.041), suggesting that Rosa damascena Mill is effective in a dose dependent manner. No major or minor hypoglycemic event was observed. NO adverse event was observed in the RD treatment groups in comparison with Acarbose or placebo groups. Serum levels of biochemical parameters did not fluctuate significantly in RD treatment groups compared to Acarbose and placebo controls.
    Conclusion
    Rosa damascena not only decreases blood glucose levels, but also is safe to be used for the purpose of controlling blood glucose levels in drug naïve patients with type II diabetes.
    Keywords: Rosa damascene, Acarbose, safety, Efficacy
  • Leila Jafaripour, Reza Naserzadeh, Hassan Ahmadvand *, Forouzan Hadipour Moradi, Koshan Ghobadi, Ehsan Alizamani, Negar Nouryazdan Pages 36-42
    Introduction
    Liver is a vital organ and one of its functions is to release the harmful materials from the body. Gentamicin is an aminoglycoside used to treat gram-negative bacteria infections, though it causes renal and liver injuries. Antioxidants play effective roles in decreasing gentamicin-induced liver injuries. L-glutamine has antioxidant properties and is used to decrease gentamicin-induced liver injuries.
    Methods
    In this study, thirty two wistar rats were randomly divided into four groups of eight as follows: 1) control group, 2) gentamicin, 100 mg/kg for 12 days, 3) L-glutamine, 25 mg/kg by gavage for 12 days, 4) group received both gentamicin and L-glutamine after 12 days. The blood sample of the heart of rats was taken through anesthesia and its serum was used to evaluate alanine transaminase (ALT) and aspartate transaminase (AST). The livers of rats were also isolated to evaluate malondialdehyde (MDA), glutathione peroxidase GPX, catalase (CAT) and glutathione (GSH).
    Results
    Treatment with gentamicin caused some changes in the liver function. We observed an increase not only in AST and ALT, but also in MDA. In addition a decrease was seen in antioxidant enzymes such as CAT, GPX and GSH. In group treated with glutamine, the amount of AST and MDA has significantly decreased compared to group treated with gentamicin. Glutamine significantly increased GPX activity and the level of GSH compared to gentamicin group.
    Conclusion
    The findings of this study showed that the oral use of L-glutamine can moderately decrease gentamicin-induced liver injuries.
    Keywords: L-glutamine, Gentamicin, oxidative stress, hepatotoxicity
  • Mohammad Reza Mahmoodi *, Yadollah Mehrabi, Masoud Kimiagar, Asadollah Rajab Pages 43-54
    Background
    The aim of this study was to find the influence of supplementation with omega-3 plus vitamin E and vitamin C plus zinc on metabolic syndrome components.
    Methods
    In a double-blind controlled clinical trial, 75 diabetic postmenopausal women were randomly assigned to one of the three therapeutic groups of daily supplementation of 1.8g omega-3 plus 400mg vitamin E (group A), 5mg zinc plus 300mg vitamin C (group B), or placebo (group C) for 12 weeks and the results were evaluated.
    Results
    One-way repeated measures ANOVA showed that systolic and diastolic blood pressure and waist circumference showed significant difference before and after the intervention (P= 0.0001, 0.001, and 0.045, respectively). Results of Univariate ANOVA showed that the level of plasma fasting blood sugar (FBS) and HDL-cholesterol significantly increased (P=0.01 and P=0.03, respectively) in patients who had been diagnosed as diabetic ≤7 years in group B. The plasma TG concentration significantly decreased (P=0.007) in patients who had been diagnosed as diabetic ≤7 years in group A. Systolic and diastolic BP significantly decreased (P=0.005 and P=0.04, respectively) in patients who had been diagnosed as diabetic ≤7 years in group A. The most effectiveness of nutraceutical supplementation was on patients that had been diagnosed as diabetic ≤7 years. Plasma TG and systolic BP decreased with omega-3 plus vitamin E; however, plasma FBS and HDL- cholesterol increased with zinc plus vitamin C supplementation.
    Conclusion
    Several factors, such as duration of diabetes, age, gender, pathophysiology status, genetic, and other anthropometric characteristics may influence the effectiveness of supplementation.
    Keywords: Metabolic syndrome components, Postmenopausal women, Supplementation, Type 2 diabetes
  • Amirali Jafarnezhadgero *, Hamed Sheikhalizade Pages 55-66
    Background
    Forward head posture is one of the most prevalent abnormal postures in patients with neck disorders. The aim of this study was to evaluate the effects of forward head posture on gait ground reaction force characteristics in children.
    Methods
    Twelve children with forward head posture (age: 11.8±1.3 years) and sixteen healthy control children (age: 11.7±1.4 years) volunteered to participate in this study. Each participant was asked to walk 10 m in six trials with self-selected speed. The ground reaction force was measured by two Kistler Force Platforms at a frequency of 1000 Hz. MANOVA test ((version 16, SPSS Inc, Chicago, Il)) was used for between group comparisons.
    Results
    In the non-dominant limb, the medio-lateral ground reaction force during push off phasein the forward head group was greater than that in the healthy group by 22.1% (P=0.049). In the dominant limb, time to peak for vertical ground reaction force during heel contact(by 13.7%; P=0.015) and push off(by 14.2%; P=0.004), mediolateral ground reaction force during heel contact (by 46.0%; P=0.006) and push off (by 15.1%; P=0.039) in the forward head group were significantly lower than those in the healthy group. Vertical loading, peak positive and negative free moment, and impulses in all axes were similar in the healthy and the forward head groups (P>0.05).
    Conclusion
    Overall, the results reveal that gait ground reaction force components (especially time to peak for ground reaction forces) in forward head children may have clinical importance for the improvement of walking mechanics of these individuals. Rehabilitation protocols should be designed to increase time to reach peak ground reaction forces and decrease medio-lateral ground reaction force in forward head children during walking.
    Keywords: Walking, loading rate, Impulse, Free moment, Forward head
  • Mehrnaz Karimi, Masoumeh Mirzaie, Mohammad Khaksari, Mahboobeh Akbari, Mahdieh Nazari * Pages 67-76
    Background
    Chondroitin sulfate proteoglycans (CSPGs) are the major cause of axonal regeneration failure at the site of lesion in spinal cord injury (SCI). Inflammation is believed to stimulate the upregulation of CSPGs expression. Recent evidence showed that trehalose reduces the development of inflammation in SCI. The aim of this study was to investigate the effect of trehalose on neurocan and Neural-Glial Antigen 2 (NG2) mRNA levels in SCI in rats.
    Methods
    In this experimental study, male rats were divided into six groups (n=15). Sham (laminectomy), SCI (laminectomy and SCI), vehicle (laminectomy and SCI, treated with phosphate buffer saline), and T10, T100 and T1000 (laminectomy and SCI, treated with 10, 100 and 1000 mM trehalose). Five rats in each group were sacrificed at 1, 3 and 7 days post-injury to measure neurocan and NG2 mRNA levels in lesion. Statistical analysis was performed using Kruskal-Wallis methods followed by the Mann-Whitney test.
    Results
    Findings indicated that SCI upregulated neurocan and NG2 mRNA levels at all times. No significant difference was observed in neurocan and NG2 gene transcripts between SCI and vehicle groups (p>0.05). However, 10 mM trehalose downregulated the mRNA level of both neurocan (0.76 and 0.65 fold) and NG2 (0.75 and 0.70 fold) at 3 and 7 days post-SCI compared to vehicle group (p p<0.01, respectively).
    Conclusion
    Collectively, treatment with low dose trehalose showed a decrease in neurocan and NG2 mRNA levels in spinal cord injured rats.
    Keywords: Spinal cord injury, Trehalose, Chondroitin sulfate proteoglycans
  • Mina Moridi, Gholamreza Asadikaram, Mohammad Masoomi *, Nazanin Ebrahimi Pages 77-85
    Background
    The aim of this study was to assess the relationship between hypertension and aldosterone-renin ratio (ARR) with the severity of coronary artery disease (CAD).
    Methods
    This cross-sectional study was performed on non-diabetic patients who were candidate for coronary angiography in Shafa hospital in Kerman in 2017. The levels of active renin and aldosterone were measured by the radioimmunoassay (RIA) method before angiography. All patients underwent coronary angiography to determine the severity of CAD. The CAD severity was described by the Gensini score.
    Results
    Of the 306 patients, 174 (55.1%) were hypertensive. The overall prevalence of CAD in hypertensive and normotensive groups was not statistically different (39.7% versus 38.9%, p = 0.898). In groups with and without hypertension, normal coronary arteries were found in 60.3% and 60.8%, single-vessel disease in 15.5% and 17.7%, two-vessel disease in 14.4% and 11.5%, and three-vessel disease in 9.8% and 10.0%, respectively. The differences were not significant (p = 0.880). The average Gensini scores in hypertensive and normotensive groups were 29.27 ± 28.42 and 33.74 ± 33.05, respectively with no significant differences (p = 0.370). The mean ARR in those with normal coronaries, one, two, and three-vessel diseases was 3.17 ± 7.63, 2.51 ± 4.21, 1.93 ±1.57, and 1.20 ± 0.68, respectively with no significant difference (p = 0.696). We did not observe any association between the Gensini score and ARR (r = -0.126, p = 0.263). In multivariable linear regression model (Table 3), ARR could not predict the severity of CAD assessed by determining the Gensini score (Beta = -0.463, p = 0.636).
    Conclusion
    There was no significant relation between hypertension and ARR to the severity of CAD.
    Keywords: Coronary Artery Disease, Coronary Angiography, Non-diabetic
  • Elahe Norouzi *, Zahra Daei Parizi, Pedram Niknafs, Bahare Bahman Bijari, Hamid Mousavi, Zahra Jamali, Fateme Sabzevari Pages 86-89
    A term newborn was admitted to the neonatal intensive care unit immediately after the birth, with respiratory distress due to congenital pneumonia. With progression of respiratory symptoms, empyema thoracis was diagnosed due to the right massive purulent pleural effusion in chest X ray. Treatment was fulfilled by ventilator support and pus drainage by means of two chest tubes and appropriate antibiotics. Although, empyema thoracis is seen commonly in children following pneumonia, it is a very rare condition in neonatal period and there are limited reported cases of neonatal empyema which have been treated completely without any complication.
    Keywords: Newborn, Empyema thoracis, Pneumonia
  • Mohammad Khalili, Mohammad Reza Aflatoonian *, Majid Hemati, Ehsan Mostafavi, Behnaz Aflatoonian Pages 90-94
    Background
    Dengue is a mosquito-borne viral disease that has rapidly spread in all regions in recent years. There is little information on dengue fever epidemiology in Iran. High prevalence of dengue fever in Pakistan bordering southeast Iran emphasizes the need for paying more attention to monitoring of the disease in this region. The aim of this study was to study the dengue fever seropositivity among adult febrile patients in southeast Iran.
    Methods
    Dengue fever virus specific IgG antibodies were measured by a commercial enzyme-linked immunosorbent assay (ELISA) in sera of 184 patients.
    Results
    All examined sera were negative.
    Conclusions
    The existence of dengue fever in eastern borders of Iran and tracking the virus vectors in the southeast Iran can be a treat for the circulation of the virus in Iran; however, we did not find any track of the seropositivity in this study and despite the high prevalence of dengue fever in Pakistan bordering southeast Iran, no dengue positive cases were found in this study. This epidemiological research is significant for local health authorities.
    Keywords: Dengue fever, Arbovirus, Serology, Iran