Journal of Research in Medical Sciences
Volume:10 Issue: 5, Sep & Oct 2005

Oxidative agents like ultraviolet are one of the important cause of cataract and vitamin C is an important water soluble antioxidant agent in the aqueous humor. This study aimed to evaluate the concentration of vitamin C in the aqueous and plasma of patients with senile cataract. In a descriptive cross- sectional study on 85 patients (41 men and 44 women) admitted for cataract surgery, aqueous (0.2 ml) and blood (5ml) were sampled just before operation under general anesthesia from anterior chamber and vein, respectively. Spectrophotometer measured the concentration of vitamin C in both samples. The mean age was 64.3±11.1 years. Aqueous and plasma concentration of vitamin C was 4.29± 1.11 mg/dl and 0.77±0.0332 mg/dl, respectively. The differences were statistical significant (P≈0). Vitamin C of aqueous were equal in both sexes, but vitamin C of plasma in women were higher than men (P= 0.043). The concentration of vitamin C showed no relation to the type of cataract. Vitamin C of aqueous and plasma in senile cataract are lower than normal. More study is recommended for evaluating preventive effect of high vitamin C diets or supplements.

We evaluated the efficacy of valproate plus risperidone versus valproate plus lithium combination in the treatment of acute mania. In 2-week, randomized, double-blind, parallel group study, 46 acute manic patients according to DSM-IV criteria were randomly assigned to receive combination of valproate 20 mg/ kg/day plus risperidone 2-4 mg/day (n=23) or lithium600-1200 mg/day (n=23). The assessment of efficacy measures were according to Young Mania Rating Scale (YMRS) and Clinical Global Impressions-Severity (CGI-S) and Improvement (CGI-I) scale. Other effectiveness measures included YMRS response (YMRS reduction >50 %) and YMRS remission (YMRS total scores

Intra-operative pain has adverse effects on hemodynamic parameters. Due to complications of opioids for pain relief, using non-opioids medication is preferred. The purpose of this study was to investigate the effect of oral dextrometorphan premedication on intra-operative Morphine requirement. After approval of the Ethics committee and informed consent, 40 adult patients who stand in American Society of Anesthesiologists Physical Status I and II, under general anesthesia for elective laparatomy were selected and classified in two equal groups randomly. In group A, oral dextromethorphan (60mg) was administered at 10 PM and 6 AM preoperatively. In group B, placebo (dextrose) was administered. After induction of general anesthesia and before skin incision, intravenous morphine (0.01 mg/kg) was administered. During surgery, when systolic blood pressure or heart rate was increased more than 20% of the preoperative baseline, 0.01 mg/kg morphine was administered. At the end of surgery, the totally prescribed morphine (mg/kg) and maximal increase in systolic, diastolic, mean arterial blood pressure and heart rate relative to the baseline values were calculated and statistically compared with student’s t-test. The mean dose of administered morphine during surgery was significantly less in group A than group B (P

Sellick''s maneuver (cricoid pressure) may make laryngoscopic view and tracheal intubation more difficult. This study compared the different techniques of cricoid pressure (CP) regarding to the laryngoscopic view and time to intubation. In142 anesthetized patients, 4 types of CP was randomly applied; A) one-handed CP using thumb, index and middle fingers, B) one-handed CP using index and middle fingers, and the heel on the sternum, C) technique A with another hand below the neck, D) technique C with a pillow below the neck. There was significant difference in the laryngoscopic view changes. The view was better in group A, C, D and B, respectively. Mean intubation time did not show significant difference. One-handed CP using thumb, index and middle fingers can provide the best views at laryngoscopy without significant effect on time to intubation.

There are many various hypotheses about pathophysiology of migraine headaches. One of them is autonomic nervous system disturbance, but the exact location of the disturbance is not well known. Since most of migraine attacks are accompanied with a retro-orbital pain, we assessed the efficacy and safety of topical Timolol on blockage of β adrenergic receptors for preventing migraine headaches. In a clinical trial study, 43 migraine patients (7 male and 36 female) were studied in two neurology clinics in Isfahan. Timolol maleate (5% eye drop) prescribed twice a day. The patients visited weekly for the first 4 weeks; then 8th and 12th week after the beginning of treatment, and the duration and frequency of attacks were evaluated. The severity of headache measured subjectively. The patients were aged 14 to 54 years, with mean age of 34.2 years and mean disease duration of 9.5 years before the study. They had 13.1 headache days per month. After treatment, the frequency of attacks reached to 3.4 attacks per month. The mean duration of each attack were 16.4 hours before treatment and 2.1 hours after treatment by using Timolol eye drop which were significantly different (P

Many patients with suspected acute myocardial infarction (AMI) and eligible for thrombolytic therapy may not be treated because of association between hemorrhagic complications especially intracranial hemorrhage (ICH), and severe hypertension (HTN) at presentation. Unfortunately, this leads to under use or delay in thrombolytic therapy. We assessed effect of decreasing elevated blood pressure before thrombolytic therapy in order to reduce the incidence of ICH without increasing mortality rate. This observational and analytical cohort study enrolled 293 patients (215males and 78 female) with STsegment elevation (AMI) that were hospitalized in emergency department of Noor hospital, Isfahan, Iran. Severe hypertension (blood pressure ≥180/110mmHg) was diagnosed in 132 patients. All of them received 1.5 million units streptokinase within one hour intravenously. In the hypertensive group, elevated blood pressure was lowered to less than180/110mmhg before thrombolysis and they were observed to detect development of symptomatic ICH and they underwent Brain CT scan, if required. The incidence of total stroke, ICH and death were 1.4%, 0.7% and 4.8%, respectively. The incidence of death and ICH in patients with severe hypertension was less than control group (P value=0.13 and 0.59, respectively) Although we did not find any increase in ICH incidence in severe hypertensive patients treated be streptokinase due to AMI, but we recommend a multi-centric study with more cases and varied thrombolytic protocols.

Consanguinity has been a long-standing social habit among some of Iranians. The estimation of consanguinity ratios in different parts of Iran ranged from 30 to 85%. This study aimed to delineating the role of consanguinity on congenital malformations in Khominishahr rural population, Isfahan, Iran. In a case-control study, 518 malformed population (case group) and 518 normal subjects (control group) were randomly selected from khominishahr rural population, from July to November, 2003. The frequency of consanguinity of parent’s was 59.7% in case group and 31.5% in control group. This different was statistically significant (p < 0.001). Family history of congenital malformation may play an important role in the high rates of congenital malformation.

The etiology of multiple sclerosis (MS), a chronic demyelinative disease-is unknown. The damage of blood–brain barrier (BBB) vasculature is a characteristic of MS and Homocystein (Hcy) can damage BBB, then increase in total Hcy may be important in MS pathogenesis. The aim of this study was to compare the serum level of total Hcy in MS patients with control group. In a case control study, serum level of total Hcy measured in 35 MS patient and compared with 30 healthy matched controls. All patients had definitive MS according to Poser criteria, without history of myocardial infarction, stroke, neuropathy, transient ischemic attack, homocystinuria or renal failure. The serum concentration of total homocystein was significantly higher in multiple sclerosis patients than healthy controls. The mean total Hcy level was 17.92± 6.9 mmol/lit in cases and 14.6±2.92 mmol/lit in controls (P=0.013). Serum total Homocystein may have a role in MS pathogenesis and reduction of it should be studied moreover.

Contrast induced nephropathy is a potential cause of mortality and morbidity in patients undergoing angiography–angioplasty. Except for hydrating and probably low – isoosmolar contrast agents in high risk groups, other modalities have not provided benefit. We investigated preventive effects of captopril for contrast induced nephropathy during angiography–angioplasty. In a double blind placebo controlled clinical trial, 88 patients were randomized to two groups: 42 patients received captopril (12.5 mg) every 8 hours from 2 hours before the procedure until 48 hours thereafter, and 46 patients received placebo in the same manner. Serum creatinine was measured before and 48 hours after angioplasty. The data were analyzed by SPSS software, using unpaired student t-test for comparing mean creatinine rise in both groups and paired student t-test for the changes in serum creatinine in each group. The mean creatinine rise in captopril group (0.214 mg/dl) and placebo group (0.226 mg/dl) were not significantly different. The incidence of acute renal failure (creatinine rise more than 0.5 mg/dl) in the captopril (11.9 %) and placebo group (10.8 %) were not significantly different. Captopril does not effectively prevent contrast nephropathy, but it is not harmful for renal function and can be administered safely during angiography – angioplasty in patients with normal renal function. However, the effect of captopril in patients with high- risk characteristics remains to be clarified. Of note, we found a trend for less creatinine rise in diabetics who received captopril during the procedure in comparison to diabetics who received placebo.

Gadolinium-porphyrins have been synthesized and are currently being investigated as magnetic resonance imaging (MRI) contrast agents. This study aimed to synthesize Gd-hematoporphyrin and applicate it for in vitro detection of breast cancer cell line (MCF-7). The naturally occurring porphyrin (hematoporphyrin) was inserted with gadolinium (III) nitrate hexahydrate to yield Gd-H. T1 relaxation times and signal enhancement of the contrast agents were presented, and the results were compared. UV spectrophotometer measured the attachment of Gd to the cell membrane of MCF-7. Most of gadolinium chloride (GdCl3) was found in the washing solution, indicate that it didn`t fixed to the breast cell membranes during incubation. Gd-DTPA showed some uptake into the MCF-7 cell membranes with incubation, however, its uptake was significantly lower than Gd-H. Good cell memberan uptake of Gd-porphyrin is comparable to controls, indicating selective delivery it to the breast cell line and considerable potency in diagnostic MR imaging for detection of breast cancer.

Renal cell carcinoma (RCC) is a tumor with high degree of potentiality for distant metastasis. Intracranial metastasis is a very rare location for this tumor. Here is presented a 47-year-old female with history of RCC and cerebellar metastasis.

Cerebrospinal fluid (CSF) ascites is a rare complication after ventriculopritoneal (VP) shunts. Most patients have gradual abdominal protrusion without any neurological sign or symptom of shunt malfunction. We presented a girl with posterior third ventricle glioblastoma and acute hydrocephalus who developed increasingly abdominal protrusion one month after VP shunt operation. Ascites fluid examination showed characteristic findings similar to CSF with no evidence of infection or malignant cells. Ventriculo-atrial shunt revision cured patient''s ascites. Review articles of patients with CSF ascites after VP shunt were presented in details.

Osteoid osteoma is a benign bone tumor, mainly seen in 10-30 years male. Spine is a relatively common site and almost always, posterior elements are involved. Plain X-Ray-, CT scan and Isotope scan help to identify and localize spine lesions. We described one 18 years old boy with 3 years low neck pain. Isotope scan, MRI and CT scan showed two lesions in C7 and T1. Gross inspection and histopathology examination confirmed osteoid osteoma in two adjacent vertebrae which has not been reported elsewhere in the literature.