Razavi International Journal of Medicine
Volume:5 Issue: 2, Spring 2017

In this study we assessed the relationship between corrected-QT intervals and other ECG characteristics with methadone dose and other parameters in MMT patients and healthy subjects.

This was a case-control study which was carried out on patients underwent MMT and healthy control group who had been referred to Ebne-Sina academic hospital, Mashhad during 2014 - 2015. At the time of the study, 40 patients who received MMT therapy for at least 6 months and 40 voluntary healthy subjects who matched on age and sex enrolled in the study. 12-lead ECG was performed for all the patients. Mean QT interval, PR interval and QRS duration in every 12 leads were documented for each patient in maximum.

To evaluate the patients, we divided 80 patients into two groups: 40 patients under treatment with Methadone and 40 voluntary participants as control group. There were 20 males and 20 females in each group. Duration of addiction was 214.80  126.99 months in MMT group. Significant differences were observed in PRi between the patient and control groups (P = 0.007), and also between methadone dose and PRi (r = 0.468, P = 0.038) in males. QTc prolongation was reported in 4 patients of addicted group (10%). All of the QTc prolongation patients were female (P = 0.037). There was significant relationship between PRi and weight (P = 0.015), addiction period (P = 0.011), methadone treatment period (P = 0.018) as well as methadone dosage (P = 0.14). Methadone cut off point of 65 mg had a significant relationship with systolic blood pressure (P = 0.002), diastolic blood pressure (P = 0.013), QTCi (P = 0.016) and QRS (P = 0.044); however, no significant relationship was reported with PRi (P = 0.451).

We found that there is no exact dosage of methadone in which the side effects such as TdP (Torsade de pointes) or QTc prolongation can be predicted. Female gender and methadone dosage 65 mg were risk factors of our study for QTc prolongation which may result in subsequent deteriorated conditions.

Lens luxation generally happens secondary to trauma and hereditary disorders into the vitreous body. However, spontaneous dislocation especially into the anterior chamber occurs rarely. We report an unusual case with spontaneous anterior dislocation of a posterior chamber intraocular lens (IOL) 4 years after cataract surgery.

A 42-year-old woman was referred to ophthalmology department with complaint of sudden onset blurring of vision in the left eye 4 years after cataract surgery. No history of trauma and systemic disorder was reported and no capsular fibrosis was found during eye examination. The patient underwent corneoscleral incision under general anesthesia and the IOL was extracted using a viscoelastic material.

To our knowledge, this is the first reported case in the literature. This report may imply that IOL related factors could be considered for spontaneous dislocation of intraocular lenses.

Some hypertensive patients experience dyspnea with exercise due to rise in filling pressures. So, exercise is helpful to determine left ventricular filling tension.

This study aims to evaluate the effect of dobutamine stress echocardiography on diastolic function in hypertensive patients with normal ejection fraction.

In this study, 30 hypertensive patients (52.7  3.6 years) and 30 sex and age matched healthy controls (50.8  7.6 years) were examined. Exclusion criteria were patients with coronary artery disease, significant valvular heart disease, hypertrophic cardiomyopathy, left ventricular systolic dysfunction (EF (ejection fraction) < 50%), atrial fibrillation and bad echogenic view. We performed complete echocardiography and dobutamine stress echocardiography with pulsed wave Doppler tissue imaging at rest and during peak stress to measure primary mitral inflow diastolic wave rate (E), late mitral inflow diastolic wave rate (A), E/A ratio, primary diastolic myocardial wave rate (E0) and late diastolic myocardial wave velocity (A’).

At rest, E’ was significantly lower in patients than controls (8.21.6 vs 14.72.6 P value< 0.001) and E/E (early mitral inflow diastolic wave rate/early myocardial diastolic wave rate) was significantly higher in patients (7.61.2 vs 4.81.0 P value

Tractional retinal detachment (TRD), a major vision threatening complication, is one of the most common eye emergencies. The most common cause of TRD is proliferative diabetic retinopathy (PDR). The aim of this study was to evaluate the effect of simultaneous usage of bevacizumab and silicone oil injection after vitrectomy for the treatment of diabetic tractional retinal detachment

Twenty five patients (25 eyes) with severe proliferative diabetic retinopathy were recruited into the study. All eyes underwent a single intravitreal injection of bevacizumab 1.25 mg in 0.05 mL along with silicone oil injection after vitrectomy for the management of tractional retinal detachment or vitreous hemorrhage due to severe proliferative diabetic retinopathy. Patients were then scheduled for postoperative clinical examinations at one, three and six months. The main outcome measures were regression of neovascularization, intraocular pressure, visual acuity and retinal reattachment.

This study evaluated 25 eyes of 25 patients (12 men, 13 women) with a mean age of 55.686.94 years (range 21 to 49 years). In all eyes visual acuity improved and retinal attachment was accomplished. The mean preoperative visual acuity was 2.01  0.03 Log MAR which significantly improved to 1.10  0.50 Log MAR in 6th month after surgery (P < 0.000). Active neovascularization regressed significantly (P < 0.004) and intraocular pressure was controlled in 88% of patients.

The findings of our study may suggest that simultaneous injection of Bevacizumab and silicone oil after vitrectomy improve early results. We have found it to be particularly useful in diabetic eyes with tractional detachments of short duration.

Organophosphate compounds cause poisoning and death more than any other insecticide. These toxins can cause peripheral neuropathy which is delayed for about 3 - 6 weeks and no method has been known for predicting the incidence. It has been claimed that electrophysiological tests (EMG - NCV) can help in predicting the disorder.

The main purpose of this research was to study EMG - NCV tests in patients with moderate to severe organophosphate poisoning.

This was a cross-sectional study conducted on patients with moderate to severe organophosphate poisoning from 2014 to 2016 in Imam Reza hospital of Mashhad. The minimum sample size was calculated as 68 patients and then all data was collected on the basis of inclusion and exclusion criteria using data collection form designed by the researcher, and finally data were analyzed using SPSS V.21 software, descriptive tests (including mean, median, mode) and analytical tests (K square, ANOVA).

Of all 78 patients with the mean age of 27.5010.0, 45 were female and the rest were male. Totally 29.5% of the patients had abnormal EMG - NCV. Although no significant differences were observed between electro diagnostic tests (EMG - NCV) and age, gender, clinical symptoms and levels of acetylcholinesterase serum activity, the relationship between EMG - NCV and RBC levels of acetylcholinesterase activity was significant.

Electrophysiological tests are not associated with clinical symptoms (muscle weakness) and they cannot be considered as a determining factor to discharge the patients; therefore, careful examination of the patients or evaluating the level of AChE activity in red blood cells is needed.

Abstract Osteoid osteoma near the joints is a rare case which is difficult to diagnose. Osteoid osteomas refer to solitary, benign, agonizing lesions of the bone with a nidus of 1.5 to 2 cm, which consists of osteoid, osteoblasts, and varying quantity of fibrovascular stroma. This study reports the case of 37-year-old man with a painful flexion contracture of left elbow for 18 months, then was diagnosed a peri-articular osteoid osteoma. Any attempt for movement, whether passive or active, exacerbated the pain. His conditions was treated as tennis elbow and treated for several months, but his pain persisted continuously. A subcortical osteoid osteoma was observed in fine-cut CT scan within the posterior cortex of the capitulum. Thus, a wide en bloc surgical excision of the nidus was implemented, with total mitigation of pain and quick return to daily activities. It is stressed that history of disease and detailed physical examination can help diagnosis.

The Basal-Like breast cancer, is always known for lack of expression of estrogen receptor (ER), progesterone receptor (PR) and as well, absence of epidermal growth factor receptor 2 (HER2) gene amplification. Improper expression pattern of ER, PR, and Her2, makes Basal-Like breast tumors resistant to the current hormonal and anti HER2 treatments. In recent decades, several studies have been conducted to investigate the regulatory role of chemical modifications of core histones in gene expression. Their results have shown that histone acetylation is involved in regulation of cell survival. Acetylation of core histones is regulated by the epigenetic-modifying enzymes named Histone Deacetylases (HDACs). As a new approach to control the viability of breast tumor cells resistant to the hormonal and anti-HER2 treatments, we have targeted the HDACs. Using Trichostatin A (TSA) as a known HDACs inhibitor, we have tried to hyperacetylate the core histones of MDA-MB-231 cells as an in vitro model of Basal-Like breast tumors. Then we have investigated the effect of histone hyperacetylation on viability of MDA-MB-231 cells.

MDA-MB-231 cells were cultured in RPMI 1640 medium containing 10% fetal bovine serum (FBS) and were incubated at 37°C, in a humidified incubator with 5% CO2 atmosphere. Then cells were treated with different concentrations of TSA including: 50, 100, 200, 400, 800 and 1000 nM or control (1% DMSO). After 24 and 48 hours, viability of cells was evaluated by MTT assay.

After 24 and 48h exposure to different concentrations of TSA, MDA-MB-231 cells showed a maximum tolerable dose. At higher concentrations, TSA decreased the percentage of cell viability through a time-dose dependent manner. IC50 value for 48h treatment was 600 nM.

Our results indicate that HDACs inhibition and subsequently hyperacetylation of histones, leads to cytotoxic effects on breast tumor cells resistant to the current treatments. Following this pilot research we are trying to suggest molecular mechanisms underlying the anti-proliferative effects triggered by HDACs inhibition.