مجله دانشکده پزشکی اصفهان
پیاپی 538 (هفته دوم مهر 1398)

Morphine is an analgesic drug from the opium family that directly affects central nervous system (CNS) to reduce pain. Naloxone is a pure opioid antagonist that eliminates their respiratory suppressive effects in CNS. The aim of present study was to compare the effect of morphine on testes, and serum level of cholesterol and testosterone in male rats.

In this experimental study, 18 mature male Wistar rats were selected, and randomly divided in 3 equal groups. The groups received normal saline, morphine alone (5 mg/kg), or combination of morphine (5 mg/kg) and naloxone (0.4 mg/kg) subcutaneously 4 days in week for 7 weeks. After one week, the histological structure of testes was studied microscopically, and serum levels of cholesterol and testosterone were determined and compared between the groups.

In histology, degeneration of some seminipherous tubules and increase of distance between them was seen in morphine group; these changes were not seen in morphine-naloxone and control groups. There was not any significant difference between the groups in terms of serum level of cholesterol and testosterone.

Our study suggests that morphine can result in changes in the structure of the testes but the effect of morphine-naloxone on rats was only changes in body weight.

Magnetic resonance imaging with contrast enhancement (CE) is an essential method in the detection of active multiple sclerosis (MS) plaques. Nevertheless, in patients who are contraindicated with gadolinium, this method is not possible, and needs to be replaced. Susceptibility-weighted imaging (SWI) has been reported to be effective in detecting MS plaques, but its ability to detect active plaques is unclear.

This cross-sectional study was performed on 147 patients with MS in Shafa Imaging Center, Isfahan, Iran, using 1.5 Tesla magnetic resonance imaging (MRI) System. In addition to conventional MRI sequences including T1</sub>, T2</sub>, FLAIR and CE-T1</sub>W, SWI sequences were also obtained. Then, the images of contrast enhancement, final SWI, and magnitude were examined and signal intensity was measured by drawing return on investment (ROI) in three areas of active plaque, passive plaque, and background.

From 147 patients, 32 had active plaque. There was a direct and significant relationship between final SWI with CE as well as between magnitude and CE (P < 0.001). The final SWI had a sensitivity of 71.87 and a specificity of 91.30; and a magnitude of SWI had a sensitivity of 75 and a specificity of 87.83 in detecting active plaques. Moreover, the accuracy of determination of active plaques was 87.07% for final SWI and 85.03% for large-size ones.

The results of our study show that SWI method is capable of detecting MS plaques with high sensitivity, specificity, and accuracy, and distinguishes active plaques from passive plaques as well.

Diabetes mellitus is one of the common chronic diseases in societies that has been associated with many psychological disorders. In this study, we aimed to investigate the frequency of psychological disorders in middle-aged women with and without diabetes mellitus in Isfahan City, Iran, during the years 2015-2016.

In this cross-sectional study, 246 women with diabetes mellitus and 246 healthy women were randomly selected from patients referring to comprehensive urban and rural health centers. Psychological evaluation, mental illness, epilepsy, and suicidal thoughts were assessed based on Iranian Woman Health Form.

The frequency of psychological disorders such as anxiety, restlessness, frustration, sadness, and being motiveless for doing daily tasks, as well as overall frequency of psychological disorders, and the frequency of suicidal ideation, epilepsy, and history of mental illnesses was significantly higher in those with diabetes mellitus compared with healthy subjects (P < 0.001). Based on the multiple logistic regression model, patients with psychiatric disorders were 5.32 times more likely to develop diabetes than healthy controls [odds ratio (OR) = 5.32; 95% confidence interval (Cl) = 3.30-8.62).

There is a positive correlation between psychiatric disorders and diabetes mellitus; so people with psychological illnesses should be screened for diabetes.

Non-alcoholic fatty liver disease (NAFLD) is the most common type of liver disease across the world. Due to the high prevalence of NAFLD, some patients tend to use herbal medicines for its treatment. The aim of the present study was to evaluate the effects of curcumin pill on NAFLD.

In this clinical trial study, 100 patients with NAFLD were enrolled. Then, their height, weight, and body mass index were measured, and liver function tests and liver ultrasound were performed, too. The patients were then divided into two groups of case and control, and received curcumin and placebo for eight weeks, respectively. Before and after intervention, fasting blood sugar (FBS), lipid profile levels [including total cholesterol, triglyceride, low-density lipoprotein (LDL), high-density lipoprotein (HDL)], human C-reactive protein (hCRP) level, and liver markers such as aspartate aminotransferase (AST), alkaline phosphatase (ALP), and alanine transaminase (ALT) were measured and recorded again. Data were analyzed and compared between two groups using SPSS software.

There was no significant difference between the two groups in terms of gender, age, clinical features, total cholesterol, triglyceride, LDL, HDL, FBS, liver function markers such as ALP, ALT, and AST, and hCRP, and fatty liver grade at the onset of the study (P > 0.050). However, the level of ALT, AST, and hCRP significantly reduced in the case group after the intervention (P < 0.001).

According to the results of the present study, it seems that curcumin can be recommended for appropriate treatment of NAFLD.

Vertigo is one of the common causes of the admission of patients to the emergency department. The aim of this study was to compare the effects of promethazine, ondansetron, and diazepam in the treatment and management of vertigo.

This was a randomized clinical trial study conducted in Alzahra and Kashani hospitals, Isfahan, Iran, in 2019. 105 patients with peripheral vertigo were randomly divided into three groups of 35, which received 25 mg of promethazine (intramuscularly), 4 mg of ondansetron (intravenously), and 5 mg of diazepam (intravenously), respectively. The intensity of vertigo was measured before and after injection, and was compared between the three groups.

The mean severity of vertigo before and after treatment was 6.98 ± 1.26 and 3.43 ± 2.29 in promethazine group, 6.97 ± 1.01 and 2.14 ± 1.15 in ondansetron group, and 6.4 ± 1.26 and 2.97 ± 2.09 in diazepam group, respectively (P < 0.001). The percentage of reduction in dizziness severity was 49.4 ± 33.5, 67.57 ± 24.4, and 54.0 ± 32.0 percent in promethazine, ondansetron, and diazepam groups, respectively, and the reduction in the severity of dizziness was significantly different between the three groups (P = 0.035).

All promethazine, ondansetron, and diazepam drugs are effective in improving vertigo symptoms, but ondansetron is more effective than the two other drugs.