Acta Medica Iranica
Volume:57 Issue: 9, Sep 2019

- The bleeding during dacryocystorhinostomy (DCR) surgery is one of the main complications that led to the surgeon’s dissatisfaction and increased the duration of the operation. The current study aimed at comparing the effects of labetalol and nitroglycerine (TNG) on blood loss and the surgeon’s satisfaction during DCR. The current prospective and randomized study enrolled 60 patients candidate for DCR under local anesthesia and sedation and divided into two groups. When the surgeon dissatisfied with bleeding during the operation, patients in the labetalol group received labetalol infusion at a rate of 0.5-2 mg/kg and compared with the subjects in the TNG group that received TNG infusion at a rate of 0.1 µg/kg/min. Additionally, the surgical condition was assessed by the surgeon using the average category scale (ACS) and surgeon’s satisfaction by a scoring system. The average bleeding in the labetalol group was 140.5±24.5 ml versus 170.4±24.6 ml in the TNG group, respectively (P=0.001). The average category scale for the labetalol group was better than the TNG group during all the time of operation. The surgeon satisfaction score during the operation was more in the labetalol group (3.4 in the labetalol group versus 2.8 in the TNG group, respectively). Labetalol was better than TNG for controlling bleeding during DCR procedure because of decreasing surgical blood loss and optimum operative condition.

Given the necessity of executive functioning to perform day-to-day activities, the capacity of widely-used cognitive screening tools to detect potential executive dysfunctions could have important meanings for health care practices. Current research on this topic, however, is still scarce and controversial. The current study is the first of its kind to assess the association between a commonly used cognitive screening tool with multiple executive measures from two wildly used batteries of executive functioning tests. The Mini Mental State Examination (MMSE) along with the Delis Kaplan Executive Function System (DKEFS) and the Behavioural Assessment of the Dysexecutive Syndrome (BADS) were administered to 73 healthy adults aged 16-40 years (M=24.34, SD=6.53). Most of the relations between the MMSE total score and the executive measures were significant and in the moderate-to-strong range. The highest correlation of MMSE was with the BADS total profile score (r= .62, P< .01). In a secondary analysis, among the MMSE domains, the Attention and Calculation domain had the highest relations with the executive measures. As a measure of general cognitive ability, the MMSE taps on various basic- and higher-level cognitive processes interconnected with the multi-dimensional and multi-level executive processing. Thus, empirical separation of executive measures and general cognitive indices is difficult. Using multiple measures of the executive functioning could be an effective strategy to better understanding the interconnections.

Intimate partner violence is a serious public health problem in all societies that affects all aspects of victim’s health especially mental health. The present study aimed to determines the relationship between intimate partner violence and mental health among Iranian women who referred to the Forensic Medicine center in Tehran. This cross-sectional study was done on 196 married women who referred to the south center of Forensic Medicine in Tehran. Data were collected in 2013 by using three questionnaires: demographic questionnaire, CTS-2, and GHQ-28. Data analyzed by using SPSS-14 software. The age of participants was 29.9±6.3 years (range 18-57 years). The most of women were housekeeper (73%) with moderate economic status (48.5%). Physical violence had the highest mean score (37.29±16.80); and after that, highest mean scores are related to Psychological violence 29.37±7.01, verbal violence 14.83±8.15, Physical violence leading to injury 14.47±6.85, and sexual violence 8.38±7.36, respectively. Verbal violence didn’t show any relation with all subscales of mental health. The somatic and anxiety symptoms was significantly correlated to total and all violence subscales score (p<0.001). Also social function was correlated to total violence score (p=0.032), Sexual (p=0.002), and psychological violence (p=0.025). Depression symptoms was correlated to total violence score (p<0.001), physical leading to damage violence (p<0.001), Sexual violence (p<0.001), Psychological violence (p=0.002), and physical violence (p<0.001). Our results showed IPV is related to mental health of battered women but verbal violence didn’t show any statistical relationship with somatic, anxiety, and depression symptoms and social function.

Brucellosis is a common infectious disease around the globe. The aim of the present investigation was to evaluate the effect of brucellosis on the serum levels of chromium (Cr), lead (Pb), soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) as well as high-sensitivity C-reactive protein (hsCRP) and homocysteine in patients suffering from brucellosis. The present case-control study was executed on 40 treated brucellosis patients (case) and 40 healthy individuals (control). Blood samples were obtained from all the participants for the measurement of the desired indices. The serum levels of chromium in the case group (0.109±0.025 μg/L) was significantly lower compared with that in the control group (0.121±0.027 μg/L, P=0.047). The levels of lead in serum were almost unchanged between the two groups (12.58±1.94 vs. 12.28±2.42 μg/dL, P=0.533). The sTWEAK levels were significantly lower in the case group as compared to the control subjects (235.20±48.45 pg/mL vs. 262.00±67.25 pg/mL, P=0.044). The levels of hs-CRP were significantly higher in the case group (2.23±0.34 mg/L) than that in the control group (2.05±0.32 mg/L, P=0.016); similarly, homocysteine levels were higher in the serum of patients in case group as compared to the control ones (16.18±4.47 µmol/L vs. 14.36±3.06 µmol/L, P=0.038). The current investigation underlined that brucellosis causes alterations in serum chromium and sTWEAK levels, the markers that are considered as the predictors of cardiovascular disease.

Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of mortality worldwide. Evidence shows that COPD increases the risk of type 2 diabetes possibly due to insulin resistance induced by inflammatory cytokines. The aim of the current study was to evaluate the association between forced expiratory volume in one second (FEV1) and plasma glycated hemoglobin (HbA1c) level in patients with COPD. In this study, 50 non-hospitalized patients with COPD were studied. For all patients, a spirometry test was performed and FEV1 was determined. The quality of spirometry was assessed based on Guidelines from the American Thoracic Society/European Respiratory Society Task Force and the severity of COPD was determined based on GOLD criteria. HbA1c was measured by commercial kits. Anthropometric indices were measured and a questionnaire was applied to collect general characteristics of patients. The mean age of patients was 60.18±7.63 years. Seventy-eight percent and 22% of patients were male and female, respectively. Twenty-seven subjects were current smokers and 23 subjects were non-smokers. A significant inverses association was found between HbA1c level and FEV1% in (r= -0.722, P<0.001). There was a statistically significant correlation between weight and HbA1c level (r=0.349, P<0.05), and BMI and HbA1c (r=0.242, P<0.05). We could not find any significant correlation between age and smoking and the level of HbA1c and FEV1 (P>0.05). Our study showed there is a negative correlation between the level of HgA1c and respiratory function in COPD patients.

Consequence of Streptococcus agalactiae, Group B Streptococcus (GBS) relating infant’s diseases are well documented. Although many women carry this bacterium in their vagina, they may transfer to their infant during delivery and may result in different neonatal invasive diseases. The aim of this study was to determine the prevalence of GBS and serotyping the isolated species among un-selective non-pregnant women who attended two gynecology clinics in Tehran. In this cross-sectional study, a total of 560 vaginal samples collected from non-pregnant women. Following inoculation of the specimen on Blood Agar, the standard technology was applied for the final identification of GBS. Detected GBS species were further confirmed using specific PCR directed on dlts gene. Capsular serotyping was done by using the multiplex polymerase chain reaction (PCR) method. The chi-square method was used for statistical analysis. Fifty (8.9%) out of 560 non-pregnant women were carriers of GBS. The most common types were III (36%), followed by type II (32%), Ia (26%), and Ib (6%), respectively. Results represent that the prevalence rate of GBS in non-pregnant women was reliable and similar to what obtained from pregnant women. In addition, the serotype III was found the most dominant types, as well as other investigations in the Tehran area. Therefore, vaccine designation based on type III is recommended.

Cardiopulmonary complications have been observed after the evacuation of benign hydatiform mole which can lead to substantial morbidity and mortality. We report a 30 years old woman who came to our outpatient department of obstetrics and gynecology at 9 weeks gestational age with a sonography which represented molar pregnancy. Evacuation of the mole was done under spinal anesthesia as an elective procedure. 6hours after evacuation, the patient had a complaint of dyspnea. CXR showed some reticular opacity at the field of both lungs with increased Broncho vascular marking. CT angiography showed pulmonary edema with sub segmental atelectasis in the base of both lungs without any pattern of pulmonary thromboembolism. Pulmonary edema was regress by administering frusemide and conservative management after 8 days of ICU admission. She was discharged on 10th post-operative day in satisfactory and stable condition.

Pilomyxoid astrocytoma( PMA ) is a recently described histological type of pilocytic astrocytoma ( PA ), but the tumors show histological differences. PMA has more aggressive malignant behaviour than PA. Magnetic resonance imaging ( MRI ) may play a cruical role in the preoperative setting and also help to establish an appropriate therapeutic regimen. In this case report, we illustrated MRI findings of a hypothalamic-chiasmatic PMA in a 15 year-old female patient  presenting with extensive leptomeningeal  seeding. The patient was operated for total tumor resection, but could not survive the second post-operative day. We have comprehensively discussed the clinical, imaging and histopathological features of these relatively rare tumors and also reviewed the recent literature.

Although the most common site in Non-Hodgkin's Lymphoma (NHL) is the Waldeyer’s ring, the involvement of tongue is extremely rare. The present study revealed a 70-year-old female with primary non‑Hodgkin’s lymphoma (NHL) of the base of tongue with chief complaint of sore throat and dysphasia as a rare case report. The patient was expired 3 months after diagnosis because of advanced stage of disease and poor physical statue. The diagnosis was confirmed as primary NHL diffuse large B cell type by histopathological and immunohistochemistry results.