مجله دانشکده پزشکی اصفهان
پیاپی 110 (مهر 1389)

In patients with hepatitis B and C, environmental factors such as smoking and alcohol can cause liver fibrosis progression. But opium effects on liver fibrosis progression are not clear. This study was designed to assess the relationship of opium user and liver fibrosis progression. In this case-control study, sixty patients in hepatitis B group and sixty patients in hepatitis C group underwent liver biopsy due to hepatitis treatment and the severity of injury based on HAI (histopathological activity index) was evaluated. In the control group, patients were smoker but in the case group patients were smoker and opium user. In this study, correlation between amount and time of consumption of opium with HAI was determined. There was significant relationship between HAI and opium using in both hepatitis B and C. In Hepatitis B, significant relationship was seen between amount of consumption of opium and grade of liver but no significant relationship was between amount of consumption of opium and stage of liver; also, there was not significant relationship between time of consumption of opium with stage and grade of liver. In hepatitis C, significant relationship was determined between stage with amount and time of consumption of opium and no relationship was noted between grade with amount and time of consumption of opium. Correlation of opium and liver fibrosis progression, particularly in hepatitis C, was determined.

Hyperlipidemia and overweight are more common problems in schizophrenic patients. In several studies showed the mortality in schizophrenic patients more than the general population. One of the most common problems is overweight. Body mass index (BMI) more than 30 is also associated with the use of antipsychotic drugs in patients. This study was assessed to understand the association between BMI and demographic and clinical factors such as sex, age, education, and used drugs in schizophrenia patients. In descriptive study, 160 patients with detected schizophrenia were studied. In this study the frequency distribution of BMI was investigated. The data analyzed with SPSS soft ware and chi- square and ANOVA tests. Twenty percent patients had a BMI under normal value, 41.9% had normal BMI, 46.3% were overweight, and 11.9% were fat. The results showed a significant relation between BMI and sex (P = 0.03). This study showed that BMI in schizophrenic patients, especially in women, is more than normal population. But age, type of drugs, and education does not affect BMI. Because of more BMI than normal population, we must apply an effective activity to control weight in schizophrenia patients.

A glass injury to the wrist and forearm is a common condition in adults and children that may cause significant discomfort and disability. This study was conducted to evaluate the accuracy of preoperative examination of this injury. In this prospective study, among patients referred to Kashani hospital in Isfahan, Iran from August 2006 to March 2008, 150 patients with glass injury to the wrist and forearm were enrolled. In this case, the first, careful clinical examination and routine exploration without expansion of wound was done by an orthopedic specialist and then surgical exploration in the operative room was done for the same patient by the same physician. The evaluated information was obtained and compared before and after treatment. Despite the enough accuracy of preoperative examination in glass injury of dorsal side of wrist and forearm, the preoperative examination significantly underestimated the amount of damage to tendons, nerves and arteries on the volar side of forearm and wrist. The most frequent injury pattern was the flexor digitorum superficialis (60%), median nerve (18%), and Flexor carpi ulnaris (16%). The most injured structure on dorsal side of forearm was Extensor digitorum tendons. It seemed that the preoperative examination, even when specifically evaluating for deficiencies is done, significantly underestimates the extent of glass injury to the volar side of wrist and forearm. If glass is implicated as a causative agent, careful orthopedic evaluation and surgical management should be considered even in sight of a normal preoperative examination.

Various psychological interventions were considered as part of the treatments of irritable bowel syndrome. However, the effectiveness of coping strategies in improving symptoms of this disease remains unclear. The objective of this study was to assess the effects of coping strategies training in treatment of irritable bowel syndrome (IBS). In this randomized, placebo-controlled trial 46 consecutive patients with IBS were selected from referrals to Noor hospital, Isfahan from 2008 to 2009; they were randomly assigned to the intervention group or the placebo group (twenty four in the intervention group and twenty two in the placebo group). The intervention group received usual care plus a 8-weekly 2 hours group sessions of coping strategies training whereas the placebo group received usual care plus psychological placebo in four 90 minutes group sessions (bi-weekly). Severity of symptoms, quality of life, anxiety, and depression were evaluated before and two weeks after the intervention using standard questionnaires. Analysis of covariance was used to analyze the data. Covariance analysis showed significant differences between intervention and placebo groups in severity of IBS symptoms (F = 9.15, P = 0.004). Also the results indicated the significant difference in the percent of the response of patients between the two groups (P = 0.001). Although the findings showed no significant difference between two groups in the levels of depression (P = 0.376, F = 0.8) and anxiety (P = 0.242, F = 1.408) after treatment; quality of life (P = 0.084, F = 3.131) had a trend to be significant. The combination of coping strategies training with standard medical care has considerable effects in the improvement of IBS symptoms. Further studies with larger samples and long-term follow-up are warranted.

SNAP-IV rating scale developed by Swanson, Nolan and Pelham to diagnose Attention Deficit Hyperactivity Disorder (ADHD). The aim of this study was determination of psychometrics specifications of this scale. This was a methodological, applied and validity assessment study. One thousand students at 7 to 12 years of age in primary school in Tehran city were selected by cluster sampling. Then the student's teachers were asked to complete rating scale to consider behavior of their student. Thirty staff members of sample group were retested with SNAP-IV and was interviewed with DSM-IV. Data were analyzed by factor analysis, Pearson correlation coefficient, Kolmogrov-Smirnov and Behrens-Fisher t tests. Criterion validity was 55%. Factor analysis was detected 2 factors that explain 71% of the total variance. Reliability coefficient by test-retest was 88%, internal consistency coefficient was 95%, and Split-half coefficient was 73%. Cut-off point in scale and subscale was 2.08, 2.10, and 2.37 respectively. The SNAP-IV rating scales have fit psychometrics characters. Therefore, it is useable in screen study and therapeutic conditioning.

P19 cells are mouse embryonic carcinoma cells which contain pluripotent ability, like stem cells, to differentiate into different cell lines. There are several properties for this cell line that make it a valuable cell model for study of developmental stages. At the first step, PTS2-EGFP coding sequence which was cloned in pUcD2.hygro vector was used for transfection in to P19 cells. As the plasmid contained hygromycin (Hygror) resistance gene, stable cells were selected using hygromycin as an antibiotic. Stable transformed cells were characterized by RT-PCR and immunostaining analyses. RT-PCR results indicated EGFP was expressed in these cells. Moreover immunocytochemical analysis of the cells confirmed the preserved pluripotency states of transfected cells. As P19 Cells are able to differentiate into several cell lines, using this stable cell line we will able to chase the molecular kinetics of peroxisomes.

Nosocomial infections are one of the most important medical problems in developed and under developing countries which cause the spread of infections diseases in society. Pseudomonas aeroginosa is one of the most important causes of hospital infections, especially in wounds from operated patients. Increase in antibiotic-resistance of pseudomonas aeroginosa cause a lot of problems for patients and in some cases lead to septicemia and death of patients. The aim of this study is to isolate and determine the drug resistance pattern of indigenous pseudomonas leading to cutaneous infections of patients in Alzahra hospital. In this study 770 samples were obtained from cutaneous wounds of patients hospitalized in Azahra hospital. Biochemical tests were used for identification of Pseudomonas aeroginosa. Antibacterial susceptibility test for antibiotics amikacin, cephtazidin, ciprofloxacin, tasocin, imipinim was performed using disk diffusion (Kirby- Buer) methods. Among 770 patients, 56 patients (7.3%) showed cutaneous infection caused by pseudomonas aeroginosa. Antibiotic resistance pattern showed that 82. 14% samples were resistant to ceftriaxone and for amikacin 57.14%, ceftazidime 53.57%, ciprofloxacin 42.85%, tazocin 39.28%, imipenem 14.28% respectively. These results indicate the necessity of culturing and antibiogram tests before treatment of bacterial cutaneous infections. Antibiotic resistance- patterns can be very helpful in choosing the appropriate drug. Also in the first phase, it cold be considered for treatment of the disease.

Although gestational diabetes is a well-known cause of pregnancy complications, its epidemiology in Iran has not been studied systematically. The aim of this review of published data was to describe epidemiology of gestational diabetes in Iran. We searched MEDLINE, www.sid.ir, www.magiran.com, www.iranmedex.com, and www.irandoc.ac.ir sites through March 2009, and examined the reference lists of pertinent articles, limited to studies in humans. The 20 eligible studies (4 English and 16 Farsi) included 20’985 participants and 826 incident cases of gestational diabetes. The prevalence of gestational diabetes was 3.9 percent (95% confidence interval: 3.64-4.19 percent). These findings were more consistent in Tehran studies, and its prevalence was 1.3 to 11.9% in other parts of the country. We found that differences in screening programs and diagnostic criteria or various ethnic groups make it difficult to compare frequencies of gestational diabetes among various populations. Nevertheless, factors that place women at increase risk of gestational diabetes were age, body mass index, and number of pregnancies. The literature is limited by lack of a consistent standard for screening or diagnosis of gestational diabetes. We conclude that the epidemiological data suggest that gestational diabetes is common among Iranian women. Large studies are needed to clarify this issue and to develop appropriate diabetic prevention strategies that address the potentially modifiable risk factors.