مجله مطالعات علوم پزشکی
سال سی و سوم شماره 1 (فروردین 1401)

Febrile Neutropenia (FN) is one of the common complications of chemotherapy in the children with malignancy. In this study, we investigated the effective factors in response to the treatment of patients with febrile neutropenia. By using these factors, it is possible to have a better analysis about the severity of infection of these patients and it will helpful in choosing the right antibiotic.

In this cross-sectional study, children with acute lymphoblastic leukemia (ALL) who underwent chemotherapy during the last 10 years and were hospitalized due to febrile neutropenia were included in the study. The patients had no known source of infection and fever and all were treated with the same antibiotics.

The mean age of the patients was 9.13 ± 3.84 years. The mean hospitalization period of the patients was 10 days, and 9 (7.1%) of the patients were admitted to the ICU. 25 (20.5%) of the hospitalized patients had died. The amount of ESR had a significant effect on the number of days with fever, and with an increase of one ESR unit, the chance of fever continuing for more than 5 days increased by 1.02%. The number of platelets at the time of hospitalization was identified as one of the factors affecting the death of patients, and the odds ratio of death in the patients with a platelet count of ≤50,000 was higher than that of people with a platelet count >50,000.

 Increased CRP and thrombocytopenia at the beginning of hospitalization are among the predictors of bad prognosis in the patients with febrile neutropenia.

Due to the high prevalence and importance of postoperative pain and opioid complications, we aimed to compare the prophylactic effect of intravenous injection of magnesium sulfate and paracetamol and their combination on pain intensity after deep vitrectomy in this study.

In this clinical trial study, 140 candidates of deep vitrectomy randomly distributed in four groups of 35. in the first group, 7.5 mg/kg magnesium sulfate was injected 20 minutes before the operation. In the second group, 15 mg/kg paracetamol, in the third group 10 mg/kg paracetamol plus 5 mg/kg magnesium sulfate within ten minutes, and in the fourth group, normal saline with the same volume was injected. The patients were then examined and compared in terms of hemodynamic parameters, pain intensity, amount of palliatives consumed, frequency of receiving palliatives, and occurrence of postoperative complications.

The mean postoperative pain intensity in the four groups of magnesium sulfate, paracetamol, magnesium sulfate-paracetamol, and control were 1.32 ± 0.9, 1.42 ± 0.34, 1.05 ± 0.38, and 1.72 ± 0.95, respectively, and the difference between the groups was significant (P = 0.003). The number of patients received pethidine were significantly lower in the combination group than the other groups (P = 0.018). The time interval between entering recovery and receiving analgesia in the group was significantly longer in the combination group than the other groups (P <0.001).

The use of magnesium sulfate-paracetamol combination reduces the postoperative pain intensity, prolongs the time of requesting analgesia, and reduces the use of analgesia within 24 hours after surgery, without any significant hemodynamic complication.

Despite the high prevalence and importance of uterine myoma, no specific etiology has been proven for it so far. The aim of this study was to investigate the factors associated with the incidence of uterine myoma in the women of reproductive age in Tehran, Iran, along 2014-2015 years.

In this case-control study, 160 women referred to the Gynecology Clinic of Valiasr Hospital in Tehran along 2014-2015 years were chosen to the study and randomly divided into case and control groups. A demographic information questionnaire and a checklist of factors related to myoma were used to collect data. Finally, the data were analyzed by descriptive statistics, chi-square, t-test, and multivariate logistic regression tests using SPSS16 software.

The mean age of women participating in this study was 34.69±6.57 years. Based on the data of this study, age and number of menstrual days, serum vitamin D level, menarche age, systolic blood pressure, family history, history of taking hormonal contraceptives, curettage, pregnancy history, and hypertension were directly and the duration of the menstrual cycle and Menarche age were inversely related to uterine myoma (P-value <0.05).

Some factors related to the occurrence of myoma such as family history and menstrual characteristics are not intervenable. However, interventions such as weight loss, avoidance of hormonal contraceptives, vitamin D consumption, and control of blood pressure can reduce the possibility of myoma.

The infant mortality rate is a reflection of the health status of the country. Undoubtedly, the first step in improving the level of this indicator is to identify the factors related to infant mortality. Based on this, the present study was conducted to determine the factors related to infant mortality in Abadan, Iran, during 2016 and 2017.

The present study is a descriptive-retrospective study. All died neonates during the year 2016 and 2017 (115 newborns) were evaluated and same number of live newborns were selected by random stratified sampling method from Abadan hospitals. Data gathered from the documents archived in hospitals of Abadan, and registered in the checklist of infants. SPSS version 21 was used to analyze the data.

The frequency of the main causes of neonatal death were: prematurity (49.6%), congenital anomalies (27%), respiratory distress syndrome (20.8%), death without cause (1.7%), and injuries during childbirth and cerebral hemorrhage (9.9%), respectively. None of these cases were observed in the group of live births. The infant mortality rates at different times of the neonatal period include: 43 infants in the first 2-7 days (37.4%), 26 infants in the first 12-24 hours of birth (22.6%), 18 infants in the first hour of birth (15.7%), 17 infants in the first 1-12 hours of birth (14.8%), 6 infants in the second week (5.2%), and 5 infants in the third week (4.3%).

Considering that the main causes of infant mortality in Abadan city are prematurity and congenital anomalies, and that there was a positive and significant relationship between the mode of delivery, age, mother's education and the infant mortality rate, education related to screenings before and during pregnancy, proper mother's nutrition and hygiene should be strengthened in these cases.

Despite the recognition of the parasite responsible for leishmaniasis in the world, unfortunately this disease is still considered as an endemic disease in many countries of the world and is spreading even with the predictions made. This trend is also observed in Iran. Considering this importance, the aim of this study is to investigate the effect of monoclonal antibodies in the diagnosis of Kalaazar disease, which is the visceral type of leishmaniasis.

Leishmania infantum promastigote forms were prepared in a special culture medium and then BALB/c mice were immunized with these forms. The mouse with the best response was selected and its spleen cells were merged with myeloma SP2/o cells. After the formation of hybridoma cells, specific antibody-producing cells were prepared as single clones.

In this study, five clones 3E6 FIII3, 3E6 FIII4, 2C4 FII5, 2C4 FII3, and 2C4 FII2 were obtained. Among them, 3E6 FIII4, 2C4 FII5 and 2C4 FII2 monoclones which had the highest ODs were selected for investigation.

Although these antibodies are not able to distinguish between different species of Leishmania parasite, but it seems that they can be used to further investigate Leishmania parasite antigens and also to diagnose Leishmaniasis.

Helicobacter pylori is a gram-negative bacillus that can be colonized in the mucosal layers of the human stomach. According to the classification of the World Health Organization, this organism is among the class 1 carcinogens. Although numerous studies have been performed on the reaction between H. pylori and immune cells, however, the study of the reaction of individual pathogens with these cells can reveal obscure aspects of the pathogenesis of this bacterium. It is important to study the reaction between some pathogenic factors of H. pylori such as CagA and VacA with immune cells has begun. On the other hand, by examining the type of reaction of a factor that is considered also as a vaccine candidate, we can evaluate the type of immune cell stimulation behavior of the factor in vitro before injection of it into the laboratory animal. FlgE2 recombinant protein from H. pylori can be considered as a suitable candidate that has not been studied yet. The aim of this study was to evaluate the immunological effects of FlgE2 on the amount of TNF-alpha production in macrophage cells in laboratory conditions by ELISA method.

In this experimental study with the bioethical code of SBU/1542/D, FlgE2 recombinant protein was expressed and purified. Peritoneal macrophages of mice were extracted. Different concentrations of 4, 20, 40, and 80 μg/ml were used to evaluate the effects of recombinant protein on macrophage cells. Exposure supernatant was isolated and used to evaluate the effects of cytokines on ELISA.

Based on statistical analysis, the highest secretion was observed at the concentration of 20 µg/ml and then at the concentration of 4 µg/ml (P<0.0001) and 40 µg/ml (P <0.0017). Statistical analysis shows that there was a significant and close difference at 4, 20, and 40 µg/ml, compared to the control group; however, the amount of TNF-α at the concentration of 80 µg/ml was not significantly different from control group (P = 0.4028).

This study showed that the recombinant FlgE2 protein is one of the important factors in the pathogenicity of H. pylori and its structure and function are very important for effective vaccine candidate strategies. This protein factor can stimulate the immune system and activate macrophages. As a result, investigation of the effects of this protein separately can lead to new treatment strategies and prevention of H. pylori infections, which has involved half of the world's population.

VNTR alleles in the phenylalanine hydroxylase (PAH) gene are used for carrier detection and prenatal diagnosis in phenylketonuria families. The aim of this study was to investigate linkage between VNTR alleles and the PAH gene mutations in PKU patients in Guilan province, Iran.

In this descriptive cross-sectional study, 19 unrelated PKU patients from 17 Shahrivar children hospital in Rasht were enrolled. Genomic DNA was extracted from blood samples of PKU patients. Amplification of gene fragments was carried out by PCR method and underwent direct sequencing.

Our analysis showed that PKU patients in Guilan province had VNTR3/VNTR3, VNTR3/VNTR7, ND/VNTR7, VNTR7/VNTR7, and VNTR8/VNTR8 genotypes in PAH gene. The frequencies of VNTR3, VNTR7, and VNTR8 alleles were 21.05%, 28.94%, and 47.4%, respectively. Length of one allele was not determined (ND) by frequency 0.03%. The linkage between was observed in some mutations of PAH gene such as R400K, R261X, R261Q, IVS4+5G>T و and IVS10-11G>A with VNTR allelels PKU patients.

VNTR3, VNTR7, and VNTR8 alleles can be considered as useful marker in determining PKU carriers in Guilan. Furthermore, Genetic heterogeneity and geographic variation may be the cause of correlation of different mutations with VNTR alleles in PAH gene in Guilan province.

Due to the role of platelets in thrombosis formation, platelet activation markers may be able to predict the prognosis in patients with acute pulmonary thromboembolism.

In this prospective cohort study, 40 patients were evaluated for platelet parameters including mean platelet volume (MPV) and platelet distribution width (PDW) as well as for pulmonary embolism severity index (PESI) risk score. The primary goal was to evaluate the relationship of these parameters with all-cause mortality in the studied hospital.

Out of 40 patients, 13 (32.5%) were male and 27 (67.5%) were female. The patients were classified based on the median PESI into two groups of ≥100 (47.5%) and <100 (52.5%) and then were analyzed. 25 patients (62.5%) had known risk factors for PTE. 26 patients (65%) had no bad outcome and 14 patients (35%) had bad outcome. The mean MPV and PDW were about 35 and 18 in the ≥100 group and about 91 and 26 in the <100 group, respectively.

There was no significant relationship between platelet indices with prognosis and severity of PTE. Evaluation of the relationship between platelet indices and pulmonary thromboembolism severity score using Pearson correlation coefficient (Spearman) test showed that MPV was inversely related to embolism severity (r = - 0.16), although this difference was not statistically significant (p<0.05). PDW index was directly related to the severity of embolism (r = 0.08).