فهرست مطالب

Research in Medical Sciences - Volume:11 Issue: 5, Sep & Oct 2006

Journal of Research in Medical Sciences
Volume:11 Issue: 5, Sep & Oct 2006

  • 70 صفحه،
  • تاریخ انتشار: 1385/10/10
  • تعداد عناوین: 14
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  • Abkollah Jafarzadeh, Mehdi Salari Pages 285-291
    Background
    Helicobacter pylori (H. pylori) infection is thought to play an etiologic role in several gastroduodenal diseases including gastric ulcer, duodenal ulcer, gastric MALT lymphoma, and distal gastric cancer. Several studies have suggested that H. pylori which express cytotoxin-associated gene A (CagA) may be more virulent than those that do not, but limited populations have been studied to date. The aims of the present study were to evaluate the seroprevalence of anti-H. pylori IgG, IgA and anti-CagA antibodies in peptic ulcer (PU) patients and healthy individuals in the city of Rafsanjan.
    Methods
    A total of 60 PU patients (30 males and 30 females, aged 17 to 60 years) and 138 age-matched healthy individuals (65 males, 73 females) were enrolled in this study. Diagnosis of PU disease was established on the basis of findings by gastrointestinal endoscopy. The control group was recruited from among healthy blood donors referred to Blood Transfusion Center of Rafsanjan. A blood sample was collected from each participant and the sera were tested for the presence of anti- H. pylori IgG and IgA antibodies and antibody to bacterial virulence factor (CagA) by use of enzyme-linked immunosorbent assay. The serum concentrations of anti-H. pylori IgA and anti-CagA antibody were expressed as mean ± SD in each group.
    Results
    In PU patients the overall seroprevalence of anti-H. pylori IgG (95.8%), IgA (96.6%) and anti-CagA (91.6%) were higher than those observed in the control group (73.2%, P
  • Ziba Zahiri Soroori, Seyedeh Hajar Sharami, Abtin Heidarzadeh, Leila Shokri Pages 292-296
    Background
    Narcotic drugs are usually used for postoperative pain control which could cause several complications such as respiratory depression and apnea. Therefore, replacement of these drugs with safer analgesics is recommended. The aim of this study was to compare the analgesic effects of suppository diclofenac and pethidine in post-cesarean section (C/S) patients.
    Methods
    In this clinical trial, pregnant women who were admitted to Alzahrah Hospital, Isfahan, Iran, between August and February 2004 and met the inclusion criteria were recruited. After obtaining informed consent, the patients were randomly assigned (block randomization) to two groups. In group A, 100 mg rectal suppository diclofenac was used after operation at four time points: at the end of operation and 8, 16 and 24 hours after the operation. Group B received pethidine 1 mg/kg intramuscularly at similar time points. The pain scores were assessed at 2, 10, 18 and 26 hours after C/S using the Visual Analogue Scale (VAS). Age, gestational age, parity, history of previous abortion, C/S and abdominal surgery, level of education, pain score, side effects and satisfaction level were assessed. Analysis was carried out with ANCOVA model and χ2 Mantel Haenszel tests by SPSS.10 software. P0.05). There was no significant difference between side effects in the two groups except for dizziness in 11 cases in group B. There were significant statistical difference between pain intensity in 10, 18 and 26 hours after C/S in group A and group B (2.05 ± 2.07, 1.4 ± 1.6 and 0.5 ± 1.1 vs. 2.6 ± 2.2, 2.3 ± 2.2 and 1.3 ± 1.9) respectively.
    Conclusions
    The results of the present study showed that the use of suppository diclofenac is an appropriate replacement therapy for pain relief after C/S.
  • Manoochehr Mahram, Farshid Ahmadi Pages 297-301
    Background
    H. pylori infection is one of the most common infections worldwide. The prevalence of this infection among children varies due to socioeconomic development and differs among different countries. Regarding the absence of previous studies for the Iranian children, this research was performed to detect the prevalence of H. pylori infection among children of city of Zanjan.
    Methods
    In this study 278 children of 7-9 years old in Zanjan (summer 2004) were selected by multistage random sampling and then, anti H. pylori antibody (IgG) was assayed on their serum samples. The specimens were examined by ELISA–IgG (DSL Kits made in USA) in the laboratory of Vali-Asr hospital of Zanjan. Titer greater than 15 IU/dL was considered as positive regarding to the false negative or positive states. Finally, the data were analyzed.
    Results
    Out of all obtained samples, 147 were positive and 131 negative, which indicated the prevalence of 52.8% of H. pylori infection in 7-9 year-old children of Zanjan. Also, based on the results there was no significant difference between males and females (P = 0.5).
    Conclusions
    Different studies have shown the prevalence of H. pylori infection in children from 5% to 90%, Moreover, the prevalence in developing countries is higher. The reports varied in different parts of Iran for the adults (e.g. 30.6% in Yazd and 47.5% in Ardebil) but no previous study was done for the children. Our findings in children not only indicate a high prevalence rate but also show the importance of paying more attention to this infection.
  • Naser Yeganeh, Bahman Roshani Pages 302-308
    Background
    Target-controlled infusion is a new delivery system for intravenous anesthetic agents with which the anesthetist targets a plasma or effect-site drug concentration to achieve a predetermined effect. With this system, the tedious task of calculating the amount of administered drug required to achieve the target concentration is left in charge of a microprocessor which commands the infusion device. In this prospective study we compared alterations in blood pressure and heart rate from initiation of induction of anesthesia until 3 minutes after tracheal intubation in two methods of drug infusion, target-controlled infusion (TCI) and manually controlled infusion (MCI). Total anesthetic drug used until 3 minutes after intubation and level of produced hypnosis also were compared between two methods.
    Methods
    40 patients were enrolled in this clinical trial study and were allocated randomly in two groups, each group consisting of 20 patients. In TCI group, patients received propofol and remifentanil with TCI pump to achieve 7 µg/ml and 4 ng/ml as plasmatic target drug levels, respectively. In MCI group, patients received propofol 2 mg/kg and remifentanil 1 µg/kg of body weight with manually controlled infusion. Both groups received succinylcholine as muscle relaxant to facilitate laryngoscopy and tracheal intubation. Bispectral index (BIS) was passively recorded in two groups to compare the level of hypnosis. Blood pressure (BP) and heart rate (HR) were recorded at 5 different times (T-1, T0, T1, T2 and T3). Independent t-test and paired t-test were used for data analysis.
    Results
    Systolic arterial pressure (SAP) was not different at T-1 between two groups but systolic hypotension was seen in MCI group more than TCI group at T0 (P
  • Alireza Ashtari, Ali Akbar Mortazavi Pages 309-312
    Background
    This study was conducted to evaluate variations in heart rate and to determine the occurrence of oculocardiac reflex (OCR) during laser in situ keratomileusis (LASIK).
    Methods
    This descriptive, prospective study was designed to observe the effect of suction ring and ablation stages during LASIK procedure on the heart rate. The ECG was taken before and during LASIK operation on the first eye in 61 patients. These patients were selected randomly among cases that presented to Al-Zahra Hospital, Isfahan, Iran for LASIK surgery in summer 2001. All patients were healthy without history of cardiovascular disease and no systemic medication. The ECG prior to the procedure was considered as baseline. Decrease in the heart rate of 10% or more of baseline was considered as oculocardiac reflex.
    Results
    In 12 patients (20%) the heart rate decreased more than 10% during the suction ring stage. In 19 patients (31%) the heart rate increased more than 20% of baseline. In 15 patients (25%) the heart rate increased 10%-20% more than baseline during the preparation and ablation stages. In the remaining 15 patients (25%) the heart rate did not change during the procedure.
    Conclusions
    Results of this study confirm that oculocardiac reflex may occur during the LASIK procedure especially in the suction ring stage. Because the oculocardiac reflex may cause heart rate changes during LASIK, the patients should be closely monitored during the procedure.
  • Ata, Allah Ghohiri, Elahe Zarean, Mehdi Rasth, Shahriar Adibi Pages 313-318
    Introduction
    Adhesion formation after pelvic surgery is still a major cause of several morbidities such as infertility, pain, bowel obstruction and subsequent intra-operative complications. Our aim was to investigate the effects of d-penicillamine in preventing adhesion formation in rat uterine horn.
    Methods
    This experimental trial was conducted on 30 rats. The rats were randomly assigned to two groups of 15. Measurable serosal injury was created using a standard technique. The rats in one of the two groups were given 17 mg/kg of d-penicillamine. All of the animals were operated on 4 weeks after surgery and adhesions were assessed and scored by an examiner who was blind to the test.
    Results
    Frequency of severe adhesions in control and case groups were 76 and zero percent, respectively. Total scores of adhesions were found to be significantly reduced in the d-penicillamine treatment group when compared with control group (P = 0).
    Conclusion
    This study showed that penicillamine can decrease the chance of post-operative intra-peritoneal adhesion formation.
  • Mahmoud Ashrafi, Masoud Jamshidi, Mahdi Fareed, Mohmmad Hosein Sanei Pages 319-324
    Background
    When we perform surgery in utero, lungs have an appropriate time to decrease magnitude of hypoplasia, with surgery in uterus.
    Methods
    Six time-dated single-fetus ewes were selected to induce diaphragmatic hernia. Fetal lambs were divided proportionally into 2 groups, namely group 1, diaphragmatic hernia and tracheal ligation (TL group), and group 2, diaphragmatic hernia only (NL group). Morphologic assessments (weight, volume, bronchiolar branching) and histological tests (lung maturation phase) were performed.
    Results
    Lung weight in relation to lamb weight in the tracheal ligation group differed significantly from the control group (P
  • Mohammad Ali Shafa, Alireza Vakilian, Alireza Poorebrahimi, Jafar Ahmady Kahnali Pages 325-328
    Background
    Multiple Sclerosis (MS) is the most common demyelinating disease. An autoimmune basis has been confirmed for pathogenesis of MS. Prolactin (PRL) has roles in these mechanisms. Its serum levels change in MS according to some reports. The purpose of this study was to survey these changes in MS patients.
    Methods
    Sixty MS patients were included in this cross-sectional study. The same number of controls matched for sex and age were studied. Pregnant, lactating women, consumers of specific medications and patients with underlying diseases were excluded from our study. RIA was used for determination of serum levels of PRL.
    Results
    In this study, PRL level in male patients was 14.23 ± 11.47 ng/ml compared to controls with mean level of 7.21 ± 4.12 ng/ml (P value
  • Mohammad Ehsan, Mohammad Reza Ahangaran Pages 329-331
    Gastrointestinal obstruction by a gallstone is an uncommon but important complication of biliary stone disease which mostly affects the elderly. The classic triad of radiological features includes pneumobilia, ectopic gallstone and evidence of intestinal obstruction. Terminal ileum is the most common site of obstruction, followed by jejunum and gastric outlet. We present a case of duodenal gallstone ileus of a large, fluid-density mixed biliary stone with a peripheral rim of hyperdensity (very fine calcification) in CT scan.
  • Hamid Mazdak, Mohammad Reza Gharaati Pages 332-333
    Hemangioma of the spermatic cord is a benign, extremely rare tumor. We report a case of spermatic cord hemangioma presenting with a painless mass in the left hemiscrotum. Physical examination revealed a non-tender non-transilluminating irregular mass in the left hemiscrotum, above and clearly separate from the left testis. After surgical removal of the mass arising from the spermatic cord, histologic examination showed a benign vascular tumor consistent with cavernous hemangioma. To our knowledge, only a few cases of spermatic cord hemangioma have been previously reported in the literature.
  • Mehrdad Katebi, Ghodratollah Maddah, Mahdi Tarhini, Ali Fawzi Pages 334-338
    Papillary microcarcinoma of thyroid (PMC) as a variant of papillary carcinoma less than 1 cm in size is a new clinicopathological entity, with high incidence and good prognosis. There are many differences between PMC and clinically apparent papillary thyroid carcinoma. Also, there are some PMC case reports with unusual metastasis and aggressive courses. Prognostic factors are age, size and morphology of tumor, multifocality, cervical lymphadenopathy, etc. Here we report a case of unifocal PMC less than 0.4 mm in size in one lobe of thyroid in an elderly man which was discovered by thorough cutting of thyroid gland after detecting its large and cystic cervical metastasis.
  • Mohammad Hossein Sanei, Nezameddin Berjis, Alireza Mesbah Pages 339-342
    Cervical thymic cyst is not a common pathology encountered in either an adult or a child. Our case presentation is of an infant girl with a right cervical soft mass. It was totally resected and histological analysis revealed a thymic cyst. The diagnosis of thymic cyst is not possible prior to histological examination. Therefore, in children the disorder should be considered as a differential diagnosis of each cervical soft tissue mass and evaluation of mediastinum should be done for the presence of thymic tissue.
  • Mir Davood Omrani, Soraya Saleh Gargari Pages 343-348
    The androgen insensitivity syndrome is a heterogeneous disorder with a wide spectrum of phenotypic abnormalities, ranging from complete female to ambiguous forms that more closely resemble males. The primary abnormality is a defective androgen receptor protein due to a mutation of the androgen receptor gene. This prevents normal androgen action and thus leads to impaired virilization. A point mutation of the androgen receptor gene affecting two siblings with complete androgen insensitivity syndrome is described. On examination they both had normal external female genitalia.Genomic DNA was extracted from EDTA-preserved blood samples and isolated according to standard procedures. The androgen receptor gene was screened for mutations using an automated sequence analyzer (ABI Prism 310). Both girls possess one substitutions (G>A at position 2086 in exon 4), leading to D695N mutation. Mother was found to be a heterozygous carrier for this mutation. GTG banded karyotype of the girls showed they both have male karyotype (46, XY). In addition, the SRY gene screening showed they both have intact SRY gene. The labioscrotal folds contained palpable gonads measuring 1.5 cm in largest diameter. Ultrasound examination of the pelvis revealed absence of the uterus. Serum follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone values were higher than normal range. To our knowledge this is the first confirmed instance of AIS due to an AR mutation occurring in familial cases in this country. Furthermore, the phenotype has complete association with this mutation.
  • Mitra Jabalameli, Hasanali Soltani, Mahmood Omranifard Page 349