مجله دانشکده پزشکی اصفهان
پیاپی 523 (هفته سوم خرداد 1398)

Increased rate of accidents among students on a hand, and progression of technology on the other hand, demonstrate the necessity of individual health assessment among them. The current study aimed to assess the frequency of accident (traffic and non-traffic) occurrence and its associated risk factors among 11-14-year-old students in Isfahan Province, Iran, in year 2015. The current study was part of a grant plan (coded 188169) done as a cross-sectional descriptive study on 3242 students who were selected using multi-stage cluster sampling method. The data were recruited using a questionnaire conducted by the Deputy of Health, Isfahan University of Medical Sciences, which was filled by a trained interviewer. The incidence of traffic and non-traffic accidents was 29.8% over a year. Accident occurrence was in association with male gender (P = 0.01). The limbs were the most injured organs (80.6%), and accidents mostly took place at school yard (19.2%) following falling (52.0%). Throwing object toward each other [odds ratio (OR): 5.29; P = 0.02) or lame taking in the way to school (OR: 4.30; P = 0.04) were the most prevalent causes of accidents.  Our findings showed that the incidence of accidents (traffic and non-traffic) was about twice as much as the incidence in one year in China, and of course less than the national level in Iran. The incidence was significantly higher in boys. Therefore, it is recommended to pay special attention to students, especially boys, to reduce accidents, and to give them appropriate behavioral education for healthy and low-risk activities.

Concerning the importance and the high frequency of renal involvement in patients with systemic lupus erythematosus (SLE), and the ability to measure the value of hematuria on predicting the incidence of lupus nephritis, this study aimed to determine the frequency of lupus nephritis in SLE patients with hematuria. This cross-sectional study investigated 500 patients with SLE in Isfahan City, Iran, between the years 2001 and 2015. Medical history, as well as demographic and clinical data of patients including the levels of C3, C4, and anti-dsDNA antibody, presence of lupus nephritis, proteinuria, cellular cast, pyuria, urinary tract infection, urinary tract stones, congenital renal defects, and history of any kidney disease were obtained from the patients' files at the end of the study period, and analyzed using SPSS software. The frequency of hematuria in patients with lupus nephritis was 36.1%, and there was no significant relationship between the presence of hematuria and the existence of lupus nephritis in patients with SLE [odds ratio (OR) = 0.727, confidence interval of 95% = 0.376-1.648, P = 0.520]. The individuals with lupus nephritis had a lower age distribution compared to the cases without it (P = 0.005). Most of the cases in the lupus nephritis group had low C3 and C4, but most patients in non-lupus nephritis group had normal levels of C3 and C4 (P < 0.05).  The relative frequency of lupus nephritis in SLE patients with hematuria was approximately 36%. Therefore, the presence of hematuria in patients with SLE may account for incidence of lupus nephritis one-third of the cases.

Nowadays, coronary artery diseases (CADs) are among the most common diseases in societies. The aim of this study was to study the interplay between cholesterol absorption and synthesis in two groups of Iranian patients with CAD by measuring the markers of cholesterol synthesis and absorption pathways in plasma.

The study population included 128 patients undergoing clinically indicated coronary angiography. Patients were divided into two groups after scoring the severity of their coronary stenosis; the S-stenosis group (patients with CAD, n = 75) had a significant stenosis indicated by coronary angiography, and the second group, N-stenosis (n = 55), had no significant coronary stenosis. Fasting plasma samples were used to measure cholesterol absorption and synthesis markers by gas chromatography-mass spectrometry (GC-MS).

The level of cholesterol absorption markers in patients with coronary artery stenosis was slightly increased compared to patients without coronary artery stenosis, but this change was statistically significant only for cholestanol (P < 0.050). In terms of cholesterol synthesis markers, the results did not show any significant differences between the two groups (P > 0.050 for all).

Study of cholesterol synthesis and absorption markers has not been reported in Iranian patients before. This article reports the results of such study for the first time. Considering the high prevalence of CADs and the importance of cholesterol metabolism in pathology of these diseases, the results may be used to understand some underlying mechanisms of development and progression of these diseases, and to manage the patient better.

Opioid abuse is a major and challenging public health problem with a broad range of physical, mental, and psychiatric consequences worldwide. This study was designed to evaluate the effect of low doses of memantine on serum levels of inflammatory mediators in methadone-dependent rats. This study was performed on 40 male wistar rats weighing 300-350 grams in four groups (n = 10). The rats were weighed at the beginning and the end of the study, and fasting blood glucose was measured by glucometer. Within 10 days, one group received intraperitoneal methadone 5 mg/kg, two groups received memantine 30 minutes before methadone injection subcutaneously 1 and 2 mg/kg, respectively, and the last group received normal saline. At the end, rats were sacrificed, and serum levels of high-sensitivity C-reactive protein (hsCRP), nuclear factor kappa B (NF-kB), tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), and lipid profiles were measured. Thera was a significant difference between the four groups in the mean level of NFκβ (P = 0.040) and hsCPR (P = 0.020). There was a significant difference between lipid profiles in mean levels of low-density lipoprotein (LDL) (P < 0.001), high-density lipoprotein (HDL) (P = 0.040), and triglyceride (P = 0.030). Our results showed that dependence on methadone affects the level of inflammatory mediators, and memantine could reduce these levels. Therefore, memantine can be considered as a new anti-addiction approach in the treatment of opioid-dependent patients who are on methadone maintenance treatment (MMT).

Inflammatory pseudotumor is a benign pulmonary tumor of unknown origin which is more common in young adults and children. In this study, successful treatment of total lung collapse using rigid bronchoscopy is reported. The patient was a 22-year-old woman with respiratory signs and symptoms and obstructive spirometry pattern. Computed tomography (CT) scan findings represented a total lung collapse after one month of beginning the symptoms. Fiberoptic bronchoscopy showed an endobronchial mass with total left lung collapse, and there was no evidence of malignancy in the biopsy. The patient underwent rigid bronchoscopy, and the endobronchial mass was completely removed. After total removal of the mass using rigid bronchoscopy, total left lung collapse was completely improved, and patient’s signs and symptoms resolved. There was no evidence of recurrence in the follow-up using chest X-ray and fiberoptic bronchoscopy.  Inflammatory pseudotumor may have acute presentations, and present with total lung collapse. Rigid bronchoscopy can be considered as a less invasive approach than thoracotomy in patients with pulmonary inflammatory pseudotumor.