Acta Medica Iranica
Volume:45 Issue: 1, Jan-Feb 2007

Although some vitamins have been shown to prevent glucocorticoids induced osteoporosis in short time, the magnitude of this effect remains to be clarified. The aim of this study was to evaluate protective effect of vitamin D3 on methylprednisolone acetate (MPA) induced osteoporosis in rats. Twenty-four male Sprague Dawley rats were randomly divided into four groups: Group A (n = 6), was a base line control or normal animals. Group B (n = 6), was treated only normal saline, group C (n = 6), was treated MPA (0.2 mg/kg) subcutaneously for 4 weeks (3 times per a week) and finally group D (n = 6) were administered MPA resemble to group C and treated by Vitamin D3 (0.1 µg/kg dissolved in ethanol daily). Level of calcium, osteocalcin and acid phosphatase in serum were measured before and after treatment. Also, bone mineral density (BMD) of lumber vertebrae was measured by dual energy X-ray absorptiometry. The results showed that the serum calcium level unaffected by MPA in all groups before and after treatment, but the serum osteocalcin level and bone mineral density of lumbar vertebrae were significantly (P < 0.05) decreased in group C compared with groups A and B. In group D serum osteocalcin level increased again significantly (P < 0.05) but increasing of BMD and bone mineral content were not significant. The findings indicate that by using of vitamin D3 in MPA treated rats could increase bone formation and decrease bone resorption.

Secreted cytokines of Th1 (T-helper)/Th2 cells play an important role in the pathogenesis of many diseases. Th1 cells secrete predominantly IFN-γ and IL-2 which regulate cell-mediated immunity against intracellular pathogens and tumors. In this study, expression of IFN-γ was studied using semiquantitative RT-PCR. In brief, lymphocytes of a healthy donor were stimulated with PHA (1μg/106 cell/ml) in cell culture at different incubation times (0, 4, 8, 12, 24, 48 and 72 hours) to express IFN-γ. Total RNA was extracted and cDNA synthesized. A sequence (273 bp) between two oligonucleotide primers (chosen from two different exons of the IFN-γ gene sequences) was amplified using a heat-stable DNA polymerase. In semi-quantitative RT-PCR, we used a serial dilution (1/2, 1/4, …) for cDNA in order to determine the titer of cDNA which gives visible band in agarose gel (2%) electrophoresis. Results show the highest level of IFN-γ expression was achieved after 4 hours activation with PHA and it was stable at least for 22 hours. Then it fell to baseline level.

Abstract: Evaluated under laboratory condition. The objective of the present study was to observe the effect of impregnated torn bednets on the number of bites by An. culicifacies A glass made tunnel test was designed to The effect of torn bednets treated with three dosages of cyfluthrin 5% EW, were induce hungry female mosquitoes to pass through holes cut in the pyrethroid treated nets. A guinea pig used as bait to attract mosquitoes through circular holes in the netting. With untreated netting, 72-87% of laboratory-reared females passed through the holes overnight, 64-92% blood-fed successfully and 0.3/9-4/3% died. When the netting was treated with cyfluthrin at doses of 25, 50 and 100 mg a.i./m2, the entry Index (the proportions that passed through the holes overnight) were 43.37%, 42.82% and 24.72%; mortality rates were 66.31%, 81.45% and 95.99%; and the feeding rate were 45%, 27% and 3%. In conclusion it should be stressed that efficacy of pyrethroid impregnated bednets using “Tunnel Tests” showing acceptable protection rate both in lower and higher dosages as well as cause dead in the blood-fed mosquitoes. In addition, the higher dosages of these three dosages pyrethroid provided good levels of protection against An. culicifacies.

Vertebrobasilar insufficiency is the cause of cerebrovascular accidents in 20% of cases. There are few reports regarding spectral Doppler indices (SDIs) of vertebral arteries (VAs) normal blood flow. The objective of this study was to provide basic reference data about SDIs of VAs normal blood flow separately and in comparison with internal carotid arteries (ICAs) and common carotid arteries (CCAs) normal blood flows SDIs. This cross-sectional study performed on 70 normal patients. Color Doppler sonography (CDS) and spectral Doppler sonography (SDS) of right and left VAs (RVA and LVA), right and left CCAs (RCCA and LCCA), right and left ICAs (RICA and LICA), were performed. The mean PSV, EDV, and RI values of RVA blood flow were as 41.60 ± 9.6 cm/s, 14.60 ± 3.7 cm/s and 0.65 ± 0.06, and the mean PSV, EDV and RI values of LVA blood flow were as 42.20 ± 10.2 cm/s, 15.20 ± 4.2 cm/s, and 0.64 ± 0.05, respectively. There was not statistically significant difference between the mean PSV, EDV and RI values of RVA and LVA blood flows. The mean PSV and EDV values of VAs blood flows were significantly lower than the values of CCAs and ICCAs blood flows, respectively. The mean RI value of VAs blood flows was significantly lower than the mean RI Value of CCAs blood flows, but there was not statistically significant difference between the mean RI value of VAs blood flows and the mean RI value of ICAs blood flows.

Patients with valvular heart disease and suffering atrial fibrillation of more than 12 months duration have a low probability of remaining in sinus rhythm after valve surgery alone. We performed intra-operative radiofrequency ablation or cryoablation as an alternative to surgical maze ІІІ procedure to create linear lesion lines for conversion of this arrhythmia to sinus rhythm. A total of 30 patients with valvular heart disease and chronic persistent atrial fibrillation underwent different combinations of valve surgery and concomitant maze procedure with radiofrequency or cryo probes. These patients aged 48.10 ± 9.84 years in radiofrequency ablation group and 51.10 ± 13.93 years in cryoablation group. Both atrial ablation with radiofrequency probes, needed 26.15 ± 3.67 min extra ischemic time and ablation by mean of cryo-probes needed an extra ischemic time of 29.62 ± 4.27 min. There was one in hospital death postoperatively because of respiratory failure but no other complication. 6 months after the operation, among 30 patients with both atrial ablations, 25 patients were in sinus rhythm, no patient had junctional rhythm and 5 patients had persistent atrial fibrillation. At 12 months follow up, freedom from atrial fibrillation was 85% in radiofrequency group and 80% in cryo group. Doppler echocardiography in these patients demonstrated atrial contractility in 70% of the patients. Intraoperative radiofrequency or cryo-ablation of both atriums are effective and less invasive alternatives for the original maze procedure to eliminate the atrial fibrillation, and can be done in patients with valvular heart disease without increasing the risk of operation.

Costochondral and rib grafts have long been used for reconstruction of lost condyle. Donor site morbidity has less been under investigation and researched. Pleural disruption pneumothorax and ugly scars are among the donor site complications. This study aims to determine the rate of pleural disruption following costochondral graft harvesting from the 4th to the 7th ribs of right and Left ribs from recently expired cadavers; so maxillofacial surgeons and thorax surgeons could spare high risk ribs and minimize post- operative complications. This interventional study was performed on 80 ribs from 32 adult male cadavers with the recorded death being within the last 24 hours and all free of pulmonary diseases. We harvested 80 costochondral grafts from 32 cadavers and the incidences of pleural disruption were examined for the 4th to the 7th ribs of right and left side by means of SPSS software (10 harvestings from each rib). The incidences of pleural disruption were 17.5% while the right fifth rib had the highest risk (30%) and the left fifth rib had the lowest risk (0%). For the fourth to seventh ribs there were no significant differences between the ribs for pleural disruption, (P = 0.95) either in the right or the left ribs (P = 0.24). Pleural disruption was more probable to exist under the chondral part of costochondral grafts (CCG) rather than the osseous part. Valsalva maneuver was more useful than the naked eye for diagnosis of pleural disruption (P < 0.0001).

The main goal of early detection of hearing impairment in children is early intervention. There is growing interest in early detection of hearing impairment in developing countries. The main purpose of this study was to investigate the spoken language development in severe to profound hearing impaired children and compared their speech intelligibility with normal hearing children at the same age. Nine severe to profound hearing impaired children below 2 years old out of the primer 42 cases were selected for this survey. They receive aural habilitation and also speech therapy after beginning the speech production. Speech intelligibility test of these children was recorded on audio-tape, when they read five questions which can be answered with one word only, at the age of 4, 5 and 6 in comparison with 27 normal hearing children at the same age. At the age of 4 the mean speech intelligibility score of the studied group was 31.77% (SD 12.17) and the control was %96 (SD 2.23). At the age of 5, this score was %51.22 (SD 14.42), the control one 97.85% (SD 1.93). Finally at age 6 it was 72% (SD 18.97) for hearing–impaired group and 99.22% (SD 1.18) in control one. Severe to profound hearing impaired children acquired spoken language but not at the same level. In general, their speech development showed about 2 to 3 years delay. Their speech intelligibility was acceptable for severe group around the age 6 but almost semi–intelligible for profound group at the same age.

Cephalometry is an important branch of anthropology in which the dimensions of head and face can be determined. These dimensions are used to show indexes for studying brain growth and formation of all types of head and face. Indexes are vary from 65 to 95 for head and 65 to105 for face, which are used to determine 4 international anatomic types of head and 5 international anatomic types of face. The present study was carried out to determine all types of head and face among subjects aged less than 6 years. A total of 267(145 male and 131 female) children were enrolled in this study. Convenience sampling was collected from kindergarten and preschool children. The subjects categorized to 1, 2, 3, 4, 5, 6 months and 11 groups of 12-72 months. Appropriate equipments were used for measuring height and width of the head and face. The results of this study indicated that brachycephalic (38%) was the most common anatomical type of head, euryprosopic (38.6%) and hyperleptoprosopic type (4.5%) for face.

For many years, it was thought that nasal polyps are small tumors of the nasal or sinus mucosa. However, it is now believed that nasal polyps are formed as a result of frequent local swelling of nasal or sinus mucosa, which enlarge by increasing sub-mucosal edema and then expose to the air pipe and cause some symptoms. However, the main cause of polyp formation is not exactly understood. The prevalence of disease is 1-4% of population. With increasing use of antibiotics, many fungi both saprophytes and pathogens are appeared in many diseases. We also cannot rule out the importance of fungal infections in large cities because of air pollution. In this study, attempts were made to investigate prevalence of fungal infections in nasal polyposis, and suggest suitable treatment in addition to the routine one. During 7 months, polyp samples from patients with nasal polyposis were collected. From the total amount of samples (50), both direct test with 10% KOH and culture with Sabouraud''s dextrose agar were performed. In direct test, 42% of samples were positive for fungus. 34% of samples showed fungal colonization in culture, which include 30% aspergillus flavus and 4% aspergillus fumigatus. However, none of invasive fungi were found in pathological lamella. Regarding to our results, it seems the high prevalence of fungal colonization in nasal polyposis may explain etiological factors, reasons of growth, increasing in numbers, and frequent recurrence of nasal polyps to some extent.

Abstract- The adverse effects of periodontal disease on dental pulp has been debated for many years. This case- control study was performed to assess the possible effects of advanced periodontal disease on the structure of dental pulp. Fifty-two permanent teeth extracted because of advanced periodontitis with  5mm attachment loss and grade III mobility were compared to fifty-two control teeth, obtained from systemically healthy adults. Two groups were matched for age and teeth types. Inflammation, fibrosis, calcification and necrosis were observed in the (27.8- 40%), (0-59.4%), (0-26.4%) and (0-20.9%) of the different sections of the study group, and (0%), (9.7-50%), (0-11.6%) and (0%) of the control group (P < 0.05). Abnormal pulp tissue was observed in the (33.3-88.1%) and (12.9-50.5%) of different sections of the study and control groups respectively (P < 0.05). Complete necrosis of dental pulp occurred only when depth of adjacent periodontal pocket reached the apical third of the root. There was an increase in frequency of pathologic changes as the depth of periodontal pocket increased (P = 0.00). We conclude that advanced periodontal disease can affect the dental pulp, although not necessarily leading to complete pulp disintegration. Careful consideration of diagnostic and treatment planning in patients with endodontic-periodontal involvement is recommended. Fibrosis and diffuse calcification of dental pulp in teeth with advanced periodontal involvement may endanger root canal therapy; if needed.

Currently there is little information regarding septic arthritis and osteomyelitis in Iran. This retrospective study has been conducted to assess the clinical features and determine the pathogens responsible for septic arthritis and osteomyelitis in patients admitted to our hospital over a 10 year period between 1995 and 2005. A total of 145 cases of septic arthritis and osteomyelitis were studied. The mean age of patients was 18 month. 56.5% (82/145) were male and 43.5% (63/145) were female. The most frequent presenting symptom was pain reported by 69.6 % of the patients. Fever at presentation defined as an oral temperature above or equal to 38◦ C was present in 67.5 % of the patients. 71 of 145 (48.9%) cases of septic arthritis and osteomyelitis that reviewed in this investigation were culture positive that 71.8 % (51/71) of microorganisms recovered from synovial fluid culture. Moreover 8.4% (6/71) of microorganisms isolated from blood culture alone, while 19.7 % (14/71) of microorganisms recovered from both synovial fluid and blood culture. Staphylococcus aureus was the most common pathogen isolated, making up 60.5% of all positive culture. Coagulase negative staphylococci (CONS) and klebsiella sp. was found in 7 cases (9.8%) and 10 cases (14%) respectively. Group B streptococcus identified in 5 patients (7%). The present study highlights the importance of characterizing the profile of species causing septic arthritis or osteomyelitis in specific regions.

Brucellosis is an endemic disease in our country. Neurobrucellosis occurs in 5 to 10% of cases, and can present at any stage of of the disease. This study was undertaken to evaluate clinical, epidemiological and paraclinical aspects of brucellosis with and without neurological manifestations. Data of 30 patients, 15 cases with nervous system involvement (neurobrucellosis) and 15 cases without neurological complication (brucellosis) were collected and analyzed. Constitutional manifestations of the disease were detected with nearly the same frequencies in both groups. Exceptions were headache which was more common in patients with neurobrucellosis (73% vs. 33%) and arthralgia which was detected more frequently in cases with brucellosis than neurobrucellosis (53% vs. 13%). Signs and symptoms of meningeal irritation and disturbances of consciousness were the most common manifestations in cases with neurobrullosis, which had been detected in 60% and 46.7% of cases, respectively. Less common neurological presentations, in decreasing order of frequency were ophthalmoplegia, papilledema and seizures, spastic weakness of limbs, hearing loss and spinal epidural abscess. In two patients with negative serum and CSF agglutinin test, diagnosis of neurobrucellosis was made by blood and CSF cultures. In patients with neurobrucellosis, MRI of brain and spinal cord showed abnormalities in 5/15(33.3%) of cases, including decreased lateral ventricular volume due to brain swelling (2/15), hydrocephalus with periventricular edema and meningeal enhancement in posterior fossa (1/15), multiple hypodense periventricular lesions, ischemic or demyelinating in nature (1/15) and spinal epidural abscess (1/15). Brucellosis should be kept in mind in patients with neurological presentations.

Quality of life has emerged as an important concept and outcome in health and health care. This study was performed to evaluate the ability of the health education program to improve quality of life of patients with coronary artery bypass graft surgery (CABG). In pre operation period, 70 patients were randomized in two groups, experimental and control group (35 patients in each). The demographic information, SF-36 and Nottingham Health Profile questionnaire were administered before surgery to all patients. Patients in the experimental group received the educational intervention according to Mico’s education planning model. These patients were followed up to 1-month. At result, SF-36, Nottingham Health Profile questionnaires were administered 1-month after education by patients again. Significant improvements in quality of life between two groups, as measured by the Nottingham Health Profile, were seen in energy (P < 0.001), pain (P < 0.006), emotional reaction (P < 0.00001), sleep (P < 0.01), physical mobility (P < 0.00001) and total average quality of life (P < 0.00001). Significant improvements in quality of life between two groups, as measured by the SF-36, were seen in physical function (P < 0.00001), role limitations resulting from emotional status (P < 0.007), role limitations resulting from physical status (P < 0.05), mental health (P < 0.03), vitality (P < 0.02) and total average quality of life (P < 0.02). The findings demonstrate that health education result is improved quality of life for patients with CABG

Hypercalcemia complicating malignancy is a rare complication in pediatric age group. In this article, we present a case with acute lymphoblastic leukemia presenting as severe hypercalcemia. A 10 years old girl presented with an acute onset of fever, nausea, vomiting, loss of weight, costovertebral pain and frequency. She was admitted with a presumptive diagnosis of acute pyelonephritis. Her examination showed mild hepatosplenomegaly. In laboratory studies she had sever hypercalcemia. Despite the absence of circulating blast, bone marrow aspiration was diagnostic of acute lymphoblastic leukemia. The hypercalcemia was initially treated with intravenous hydration and furosemide but the serum calcium levels normalized only after the beginning of specific chemotherapy. Hypercalcemia represents an emergency in children, and acute leukemia must be considered in differential diagnosis even when there are no circulating blasts.

Developmental midline perinasal masses in children are rare lesions specifically in association with choristomas. We encountered a 3-year-old boy with epiphora, a striking mass on the nasal bridge and ipsilateral nasal hypoplasia. CT scan imaging showed multiple calcified areas within the tumor in addition to linear defect in frontal bone, hypoplastic left ethmoidal sinus and left nasal cavity, and absence of left nasal concha. The patient had no history of seizure, no neurologic deficit, and ocular developmental exams were normal. After performing excisional biopsy of the tumor, histopathologic analysis revealed complex choristoma composed of cartilage and bone. The most appropriate name for this malformation, which we have not found described in the literature, seems to be, nasal hypoplasia with complex choristoma and nasolacrimal duct obstruction.

Acute lymphoblastic leukemia (ALL) is the most common form of childhood cancer representing 80-85% of all leukemia. We describe a 3 years old girl with pain, swelling and tenderness in extremities since 8 months prior to her present admission. X-ray of extremities revealed callus formation, osteopenia and site of healed fractures. Bone marrow aspiration revealed ALL-L2 with normal peripheral smear. It is important for physician to recognize the skeletal manifestations of acute leukemia of childhood because a delay in diagnosis has an adverse effect on survival.