مجله پزشکی کوثر
سال ششم شماره 4 (پیاپی 22، زمستان 1380)

The regulation of Th1 and Th2 types of cytokine patterns is important in the final outcome of many diseases. The critical role of Th1 and Th2 cytokine patterns is well characterized in the murine model of leishmaniasis. Balb/c mice are highly succeptible to Leishmania (L) major infection and develope a Th2-type response that is incapable of mediating parasite clearance and healing. We have examined the efficacy of garlic and an immunomodulator fraction isolated from garlic to promote healing and regulation of Th1/Th2 cytokine patterns in highly suscebtible Balb/c mice infected with L. major. Separate groups of infected mice received 20 mg/kg/day garlic, 0.4 mg/kg/day fraction or PBS alone (as control) on day 30 after infection for two weeks. ELISA was performed on spleen cell cultures supernatants for IFN-g, IL-2, IL-4 and IL-10. The results indicate that garlic and immunomodulator fraction treated mice developed Th1-type cytokine responses. However garlic is more effective than its isolated fraction far treatment of infection. These results suggest that garlic extract may provide effective therapy against L.major.

n this study, alveolar macrophages were lavaged from rat lung, exposed to two concentrations of caffeine and incubated for 24 hours at standard condition. The effect of caffeine was assessed by measuring percent of viable cells, DNA fragmentation and superoxide anion production. The results show that the effects of caffeine was dose dependent. The viability of the cells, at low concentrations of caffeine (>5 mM) increased remarkably with a peak at 2.5 mM. Analysis of anion superoxide production and DNA fragmentation showed no significant increase. At moderate concentrations of caffeine (5-20mM), the viabilty was higher than the control, while at higher concentrations (<20 mM) significant reduction in the cell survival and a significant rise in both anion superoxide production and DNA fragmentation were observed. These results suggest that low concentrations of caffeine prevents apoptosis of alveolar macrophages where at moderate concentrations induces apoptosis and at high concentrations necrosis has occurred.

this study the sensitivity level of scorpions, H.lepturus, M.eupeus, A.crassicauda, O.doria, S.maurus and B.sulcyito insecticides (Lindane, Malathion, Propoxur, Diazinon, Cypermethrin and Chlorpyrifos) were studied. For determining sensitivity level in scorpions to pesticides, the same method of sensitivity of cockroaches to insecticides were used. The results showed that Lindance (Vetabl Powder 25%) in ranges of 0.1-0.16 mg/cm2 (25-40 mg/cm2 poison technique), Chlopyrifos (Emulsion 40%) in amount of 0.02-0.033 mli/cm2 (8-13:2 mg/cm2 poison technique), Diazinon (Emulsion 60%) 0.02-0.026 mli/cm2 (12-15.6 mg/cm2 poison technique), Cypermethrin (Emulsion 10%) 0.087-0.113 mli/cm2 (8.7-11.3 mg/cm2 poison technique), propoxur (Emulsion 20%) and Malathion (Emolsion 57%) in amounts 0.075 mli/cm2 (15 mg/cm2 poison technique) and 0.13-0.173 mli/cm2 (74-98.61 mg/cm2 technique poison) after five minutes in touch with poisonous area created 100% mortality rates in above scorpions.except in S.maurus species within 24-48 HS.

Physiological and metabolic abnormality following sulfur mustard (SM)-induced DNA alkylation leading to cellular death is irreversible. But the cellular reaction consequence of DNA alkylation (like, inflammation, protease activity, DNA repairment activity) and other celluar abnormalities like burn injury including cellular and capillary inflammation, infection, necrosis and dermal ischemia that continue 24 to 48 hours, and harm or delay the healing process, may be preventable. In this study the beneficial effect of bee pollen cream (BPC) and silver sulfadiazine cream was tested against skin injury induced by SM. The selection of bee pollen cream was due to its potential anti- inflammatory, antibacterial, wound healing, anti-oxidative and capillary strengthen activity that may affect the process of healing. The 20 ml of 10% sulfur mustard in isopropyl alcohol was dropped on shaved skin of guinea pigs. The bee pollen (20%), silver sulfadiazine (1%) and placebo cream was applied on the affected skin two times a day for 20 days in the different groups of guinea pigs. The area of injury was measured on days 10, 20, 25 and 30. The results indicate that the area of injury at 10, 20 and 25 days in the BPC treated group was significantly (P>0.01) lowered as compared to silver sulfadiazine and placebo treated groups. This positive effect may be due to inhibitory effect of BPC on cellular reaction consequence of DNA alkylation. However further exprimental studies may test BPC of different percentages as well as cream made up of mixtures of alcoholic and extracted bee pollen, for treatment of SM induced skin injury as well as burn injury.

Sulfur mustard has not any excitatory or primary sensory effects one hour after use. For this reason it was used during the imposed war by IRAQ against IR.IRAN. Necrosis of the epithelial cells in stomach and intestines, Severe diarrhea, reduction and inhibition of cell division, weight loss and death are the common clinical problems of this chemical agent. Attention to the importance of jejunal absorption of nutrients and the role of goblet cells has been assessed to study the acute and chronic effects of sulfur mustard on these cells in this study 78 NMRI male mature rats weighting 200 × 40 gram were selected and divided into 13 groups. One group received Thyrod’s baffer as a solvent of SM sham group. (The other group as control group did not receive any injection. In the other 9 groups different doses of SM (2.5, 5, 10 mg/kg) were injected after 24 hours, 2 weeks and 8 weeks. In last 2 groups different doses 20,40 mg/kg were used and followed for 24 hours of SM. Samples were taken from first 1 cm of jejunum and fixed in Bowins solution, dehydrated and then embeded in parafin wax and serially sectioned (UM). Sections were stained by Hematoxyline/ Eosin. Microscopic eye piece)Holland eye piece HWF 1 OX) were used for cell counting. The result indicated that SM has direct effects. on gastrointestinal tract and disturbance of digestion and absorption. It reduces appetite weight loss was significantly more compared to sham and control groups. But this effect was reduced by the time. SM also causes reduction in the number of jejunum goblet cells. which is related to the doses of SM. According to the result, this reduction was signifient (P>0.001) in group 24 hours with 20, 40 mg/kg dose and 2 weeks with 5,10 mg/kg dose,and eight weeks with all three doses (2.5, 5, 10mg/kg).

The association of serum apolipoprotein (apo) A-I and apo B concentrations, and paraoxonase (PON) enzyme activity with angiographically determined coronary artery disease (CAD) was investigated in Iranian nondiabetic patients with premature CAD and normal coronary artery control subjects in a sex and age matched case-control study. The study population consisted of 59 nondiabetics subjects with premature CAD (25 men and 34 women) and 55 CAD- controls (21 men and 34 women) who were referred for their first coronary angiography. Premature CAD was defined as presence of angiographically detected coronary stenosis (< 50% in 1 or more coronary arteries) in men younger than 55 and in women younger than 65 years of age. CAD- was defined as a maximum stenosis of 10 % in any coronary artery. All study participants had fasting blood sugar levels of less than 140 mg/dl and had no history of taking oral hypoglycemic agents. Apo concentrations were measured by immunoturbidometric assay and Pon/arylesterase activities by spectrophotometric assay of p-nitrophenol/phenol production following addition of paraoxon /phenylacetate to serum. No significant difference was observed in mean age of CAD and control groups (52.5 × 6.4 vs 52.5 × 7.4). In CAD patients, increased concentration of total cholesterol (215 × 43 vs 193 × 43, P>0.05) triglycerides (169 × 125 vs 156 × 118, P>0.05) LDL-C (138 × 46 vs 116 × 39, P>0.05) and apo B (102 × 24 vs 84 × 17.5, P>0.001) and decreased ratio of apo A-I/apo B (1.7 × 0.4 vs 2.0 × 0.6, P>0.001) were observed compared to control group. Other study variables were not significantly different between the two groups. On multiple logistic regression analysis in presence of all lipid and nonlipid variables, the only marker for discrimination between CAD + group and CAD- controls was apo B. It is concluded that in Iranian nondiabetic patients with premature CAD, the concentration of apo B is a better marker than traditional lipid parameters in discriminating between CAD+ and CAD- subjects. Lack of significant difference in PON activity berween CAD+ patients and CAD- controls supports the concept of interethnic variability in PON polymorphism observed in other studies

Neonatal jaundice is one of the most common causes of hospitalization and investigation in neonatology. lmportance of diagnosis and appropriate treatment for jaundice is related to its severe neurologic sequel in high levels of bilirubin and also to its causes. Urinary tract infection (UTI) is one of the leading causes of exageration and prolongation of neonatal jaundice. Because of the importance of neonatal jaundice as a sign of urinary tract infection, we decided to determine prevalence of UTI among asymptomatic icteric neonates. 348 neonates 8-28 days of age were studied. Initially direct urine exam and urine bag culture were obtained from all neonates. Then if there was any contamined or positive urine culture or WBC<5, suprapubic aspiration for urine culture was carried out. The prevalence of UTI among these neonates was 0.86% (3 in 348). All of 3 neonates were male, and none of them had low birth weights. Regarding prevalence of UTI in asymptomatic neonates(0.1-1%), we can not easily say that UTI is significiantly more in these icteric neonates.

Many studies have been made on wound infection and its causes. However,wound infection is still the most frequent postoperative complication. Numerous factors besides skin preparation of the operative site play a role in prevent of infection, skin preparation is an integral part of surgical oprations, and many methods have been proposed. Surgeons are always seeking a rapid, simple, cheap and effective method of skin preparation for surgery. The surgical texts recommend two methods of preparation: A 1-minute prep with alcohol and povidine-iodine or a 10-minute prep with Povidine-Iodine solution. No preference has been given to either technique despite the fact that the 1-minute prep is much quicker. This study seeked to evaluate postoperative wound infection following preparation using both methods in 180 patients undergoing abdominal surgery, with similar age, and operating patients were followed for one month. Eleven patients developed infections, five of these were from the 1-min prep group and six were from 10-min prep group. The Chi-square test did not show a significant difference between the groups. Therefore the 1-min prep may suffice for abdominal surgery.

Spontaneous bladder perforation is a rare disease which is either idiopathic or occurs following pathologic changes induced by infections, radiotherapy, cancer outlet obstruction, neobladder construction, cyclophosphamide therapy or bladder stones. It is usually intraperitoneal and often occurs at the dome or posterior wall of the bladder. Patients often present with sudden onset of lower abdominal pain and inability to urinate which may or may not be accompanied by hematuria and /or progressive lower abdominal distention. Some urine may be drained following urethral catheter insertion but this does not rule out the possibility of bladder perforation. Although U/S and CT scan are invaluable in diagnosis but exact diagnosis should be confirmed by cystography. Sometimes the diagnosis remains unclear at the time of diagnostic laparatomy. It should be noted that any delay in diagnosis and treatment of this condition harbours high mortality rate (about 25%). We introduce a patient who has experienced emergent laparatomy to due to acute abdominal pain due to spontaneous bladder perforation.

Kikuchi-Fujimoto or histiocytic necrotizing lymphadenitis is a benign disorder of lymph nodes that was first recognized in Japan. Clinical features consist of localized tender cervical lymphadenopathy often with upper respiratory prodrome and associated with fever. Kikuchi-fujimoto disease may be confused with lymphoma, systemic lupus erythematosis and infections mononucleosis. This case is a 41 year old woman with A two months history of fever of unknown origin

War injuries of the body are caused by high velocity missiles such as bullets and also low velocity shell fragments. If the resulting trauma reaches vital body organs such as the heart, brain, abd viscus, and chest, the person may suffer either immediate or dealyed death, and permanent or temporary disabilities. This discriptive and retrospective study was done on 999 war casualties with injury to different body organs at the Shahid Rahnemoon hospital from 1983 to 1985. The aim was to determine the rate of injuries in the liver, spleen, intestines, nerves, and blood vessels. The Information was as follow: 899 patients (89. 9%) had penetrating trauma and 100 (10.1%) had blunt trauma. The most common cause of injury due to shell fragments of missiles was 724. The bullets injury per sewas 106 (10.06 %) and of bullets and shell fragments both together 30 (3%). Explosion wave of shell fragment was seen in 38 (3.8%) of the patients. The Important point in this study other conflicts. Was more trauma due to shell fragments compare to. The most penetrating were in the limbs, head, neck, spine chest, abdomen, and (10.1%) with blunt trauma. Penetrating trauma was mosty in upper parts of the body and the average age between 17-22 years. The longest duration of stay was for the patients injured by bullet and shell fragments or both. Results of therapy showed 804 (80.4%) patients with recovery 43 (4.3%) permanent disability 1% with temporary disability, (7.6%) left their request and (6.3%) were sent to more equipped medical centers, patients died.