مجله علوم پزشکی رازی
سال شانزدهم شماره 11 (پیاپی 68، بهمن 1388)

Gabapentin is a novel antiepileptic drug that is used for the treatment of partial and secondary generalized seizures. There are few and sometimes contradictory reports concerning the teratogenic effects of this drug. This study was done to compare teratogenic effects of gabapentin on skeletal system when it is used intraperitoneally and via gavages. In an experimental research, 60 mature female Balb/c mice were chosen and randomly divided into six groups: two experimental groups which received 25mg/kg (I), and 50 mg/kg (II) of gabapentin intraperitoneally from the initiation of pregnancy for the first 15 days of pregnancy. The other two experimental groups,i.e. III and IV, received the same doses at the same periods but via gavages. Two control groups,i.e. V and VI, received normal saline at the same time intraperitoneally and via gavages. Dams were dissected under deep anesthesia by eter inhalation on the 18th gestational day and embryos were harvested. The macroscopic observation was performed by a stereomicroscope. Then the embryo's weights, resorption and the number of dead and alive fetuses were determined and registered. Finally, malformed fetuses were double strained for bone and cartilage and their skeletons were examined. Data were analyzed by ANOVA and Chi-square tests using SPSS software. Differences less than 0.05 (P < 0.05) were considered significant. Both experimental groups I and II revealed similar malformations which can be categorized as three sets: 1- Decreased fetal body weight and increased fetal resorption 2-Macroscopic external malformations 3- Skeletal malformations.The mean fetal body weight in group I (0.98 0.063 g) and group II (0.91 0/06 g) was lower in comparison to the control group (1.17 0.033 g). Also, an increase in resorbed fetuses was observed in both experimental groups as compared to the fetuses in the control group. Macroscopic malformations in both experimental groups included exencephaly, limbs defects, brachygnathia, vertebral column deformity and generally malformed fetuses. Skeletal malformations included delayed ossification, scoliosis, calvaria deformity and mandibular hypoplasia. In the experimental groups III and IV only delayed ossification was observed.No malformation was found in the control groups. This study revealed that the route of gabapentin administration may induce different teratogenic effects on mice fetuses.

Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) are the members of the Toll-like receptor family and play important roles in recognition and subsequent immune response against mycobacteria. Two functional polymorphisms for TLR2 (Arg677Trp, C à T Arg753Gln, G à A) and TLR4 (Asp299Gly, A à G Thr399Ile, C à T) genes have been associated with a negative influence on their function, which may affect the innate host response to mycobacteria. The aim of this study was to investigate TLR2 and TLR4 genetic variants in a sample of Iranian patients with pulmonary tuberculosis compared to healthy controls. Patients and A case-control study was carried out on 96 patients and 122 ethnically matched healthy controls. Genotyping protocol was based on a novel polymerase chain reaction sequence-specific primers (PCR-SSP) method. Allelic and genotypic distribution of mentioned polymorphisms were compared by using Fischer’s exact test between patient and control groups. The prevalence of TLR4 variant alleles (Gly299 and Ile399) was significantly higher among patients compared to control individuals (Gly299: 7.2% vs. 2.9%, OR=2.66, P=0.028 and Ile399: 4.2% vs. 0.8%, OR= 5.26, P value = 0.022). Regarding TLR2 Arg753Gln polymorphism, no significant difference was observed between patient and control groups (0% vs.0.8%, P>0.05). The other TLR2 polymorphism (Arg677Trp) was not found in any of the studied subjects. Our data demonstrates that TLR4 genetic polymorphisms may influence the risk of developing tuberculosis after exposure to mycobacterium. In addition, very low frequency of TLR2 genetic variants is revealed in Iranian population.

High frequency waves are widely used in telecommunication and cooking. The biological effects of these waves are in great attention. Increased hematological problems proposed their possible relation to the use of microwaves. Bone marrow and blood cells are the body tissues which can be affected by these waves. Ladies are more in touch with microwave oven.The age of exposure may also be an important factor. This study was carried out to evaluate hematological parameters in female mice exposed to microwave radiation at pre and post pubertal stages. For this study 20 adult (2 months old, 25-28 g) and 20 immature (7 days old, 3-4 g) female mice were selected and each group was randomly divided into two groups: control and test group. Test groups were exposed to 2450 MHZ microwaves produced by microwave oven three times a day, 30 minutes each time. After 60 days blood was collected by heart puncture and hematological parameters including Hb, MCHC, MCV,total number of platelets, RBC and WBC were evaluated. In immature group, Hb, MCHC,and total number of PLT and WBC decreased significantly compared to controls, while the number of RBC did not change in both test groups. In mature group, only the number of WBC decreased and the number of platelets increased significantly compared to control group (P<0.05). Exposure to radiation leakage of microwave oven significantly affected hematological parameters in both mature and immature female mice. These changes were more severe in immature group. These effects may be attributed to direct effect of waves on bone marrow or peripheral blood cells.

Hyperthyroidism is one of the important and common diseases of endocrine glands.Since nowadays many people in the world suffer from hyperthyroidism, it imposes economic load upon societies. According to epidemiological studies and existing evidence and papers, hyperthyroidism has significant effects on the metabolism of various organs especially renal function.Therefore, the main purpose of this study is that we believe evaluation of renal function which has an important role in filtering metabolic waste can be clinically useful.This research has been done to evaluate renal function in patients with hyperthyroidism and normal individuals referred to Bu Ali laboratory in Zanjan city. Patients and In this case-control study, BUN & creatinine indices in two groups of patients with hyperthyroidism and control subjects were evaluated and compared by calorimetric method. Also, complete urinalysis was performed in both groups. 50 patients with hyperthyroidism (mostly female and aged 26-66 years) who were confirmed by an endocrinologist were compared to an equal number of subjects in the control group (mostly female and aged 12-75 years).The collected data was analyzed by independent sample t-test. Statistical analysis by t-test indicated that BUN concentration of serum in normal persons (14.32±3.48) and that of patients (14.89±2.49) had no significant difference(P=0.670 for men and P=0.089 for women), while creatinine concentration of serum in patients compared to normal persons showed significant differences in all sex and age groups(P=0.004 for men and P=0.0001 for women). According to the obtained results, this study indicates that in hyperthyroidism because of an increase in heart output and consequently an increase in GFR and also muscular atrophy, the serum creatinine concentrations have increased significantly but serum BUN concentrations show no significant difference in both groups. Besides, hyperthyroidism has no influence on urine analysis test.

Low density lipoprotein (LDL) particles are heterogenous with respect to their size,density and lipid composition. Among LDL particles, the smaller and denser LDLs (small dense (sd)LDL) are believed to be atherogenic since these particles are taken up more easily by arterial wall.They are readily oxidized and have reduced affinity for LDL receptor and increased affinity for arterial proteoglicans. Therefore, they are strongly associated with development of coronary artery disease(CAD).The aim of this study was to compare sdLDL levels in CAD patients and healthy individuals. Patients and In this comparative cross-sectional and case-control study, the sdLDL levels were determined in 86 patients with coronary stenosis,35 patients without coronary stenosis confirmed by angiography, and 30 healthy individuals. SdLDL was measured by a direct homogenous LDL-C assay in the supernatant of serum that remained after heparin-magnesium precipitation. The results of ANOVA test showed that the sdLDL levels were higher in patients with coronary stenosis than patients without coronary stenosis and healthy individuals(21.54±7.1 mg/dl,16.88±4.4 mg/dl and 15.45±5 mg/dl respectively, p=0.001). In addition, linear regression analysis and Pearson correlation coefficient revealed that sdLDL levels were positively correlated with serum triglyceride (r=0.494),total cholesterol(r=0.354) and LDL-C(r=0.749) and were inversely correlated with HDL-C(r=-0.586) (p<0.01). The results suggest that patients with increased levels of sdLDL are at high risk for coronary artery stenosis.

Refractive change after strabismus surgery is a known phenomenon which may be attributed to the extraocular muscle traction.Since previous studies were often done by conventional methods,accompanied by a short follow-up, and without considering simultaneous evaluation of both refractive and topographic changes, this study was organized to evaluate refractive and topographic changes after strabismus surgery by hangback method. Patients and In this prospective, interventional,and case series study, 53 eyes of 33 patients undergoing hangback strabismus surgery were studied. Cyclorefraction with autorefractometer and topographic evaluation were done before and 2 weeks, 2 months, and 6 months after the operation. Data were analyzed by SPSS software version 15 using t- test and Chi-square test. The mean age of the subjects was 17.7 ± 10.2 years. We performed medial rectus recession on 18 eyes, lateral rectus recession on other 18 eyes, and simultaneous recession-resection on the remaining cases. In comparison to preoperative astigmatism, mean surgically induced astigmatism evaluated by cyclorefraction 2 weeks, 2 months, and 6 months postoperatively was 0.17± 0.52, 0.35±0.62 and 0.11±0.27 diopters, respectively. The overall axis shift was toward 180 (2, 24, and 15 degrees respectively)(in all cases p<0.05). Mean surgically induced astigmatism evaluated by topographic data was 16±0.97, 0.53±1.2, and 0.29±0.63 diopters (in all cases p<0.05). The overall flat meridional shift was toward 180 (30, 25, and 7 degrees respectively). Comparing astigmatic changes in topography with those in cyclorefraction revealed a statistically significant difference in the second week measurements and not in other measurement times. Hangback surgery can induce refractive changes and astigmatism, which may be due to corneal changes. Surgically induced changes reach a maximum amount in 2 months, and despite shifting toward baseline, will persist for 6 months.

Phototherapy plays a significant role in the treatment and prevention of hyperbilirubinemia. However, this treatment modality may itself result in the development of some complications. A lesser Known complication of phototherapy is hypocalcemia. The aim of the present study was to determine the prevalence of phototherapy-induced hypocalcemia in icteric neonates admitted to the hospital. Patients and In a cross-sectional analytical study, 150 icteric neonates undergoing phototherapy were evaluated. All of them were full term and >2500 gram. These neonates were completely normal on physical examination. Serum bilirubin and calcium were checked on arrival and 48 hours after starting phototherapy. Patient's information was analyzed by Chi-square and Mann-Whitney tests. 123 neonates(82%) developed hypocalcemia 48 hours after starting phototherapy. The difference between pre and post phototherapy plasma calcium was found to be statistically significant (p=0.001). The study showed that hypocalcemia is common in neonates under phototherapy.

Tibial plateau fractures are among the most important fractures which involve knee, as one of the most important weight-bearing articulates, whose injuries may lead to major functional disorders. Patients and This descriptive cross-sectional study was performed on 54 patients with tibial plateau fractures who were referred to Hazrat Rasool-e-Akram Hospital between 2001 and 2006.It was performed to evaluate the outcome of tibial plateau fractures treatment and compare the results obtained by visual analogue scale & Lysholm knee score. Hospital documents of patients were used for data collection. To analyze the data, K.S test, Kruskal-Wallis, and Chi-square tests were used. The mean Lysholm score was 79.7 (± 12.3). The minimum score was 48 in three patients and the maximum score was 94 in nine patients (16.7%). According to scores gained by patients, the result of treatment was excellent in 8 cases(14.8%), good in 19 (35.1%), fair in 17 (31.4%) and poor in 10 (18.6%). The mean VAS score was 2.77 (± 1.14). According to the findings of the recent study and previous studies, it seems that the treatment of tibial plateau fractures is challenging. Proper and accurate pre-operative evaluations with proper anatomic reconstruction of the articular surfaces with stable fixation may lead to better functional outcomes.