مجله علوم پزشکی رازی
سال هجدهم شماره 1 (پیاپی 83، فروردین و اردیبهشت 1390)

Hyperkalemia is a common disorder among renal failure patients and is considered as an important internal medicine emergency. On the other hand, considering the non-specific symptoms of hyperkalemia and its similarity to the underlying diseases’ symptoms, the occurrence of dangerous side effects is probable. One of the most important effects is on myocardium. Considering the immature mechanism of potassium conformity in confrontation with hyperkalemia in Acute Renal Failure (ARF) patients, the toxic effects of hyperkalemia occurs in lower potassium levels. The aim of this study is comparing the EKG changes due to hyperkalemia in patients with acute and chronic renal failure undergoing chronic hemodialysis. The recent study was an analytic cross-sectional one performed on patients hospitalized in hemodialysis ward in Hashemi Nejad, Shohadaye-hafte- tir and Rasoul Akram hospitals, during 1382-1383. The serum electrolyte levels and EKG changes of 138 patients with End Stage Renal Disease (ESRD) who were under chronic hemodialysis and 91 patients with ARF, who were hospitalized in different wards, were measured and evaluated, using SPSS V.11 software and t and Chi Square tests Among 229 patients, 138 (60%) were ESRD patients who were under chronic hemodialysis and 91 (40%) had acute renal failure. The mean potassium level in ARF and ESRD patients were 5.66 ± 1.2 and 5.77 ± 0.91 mE/l which did not differ significantly (p=0.4). In EKG evaluations, the mean height of T wave, R wave and T/R ratio in ARF patients were 6.3 ± 2.4 mm, 5.7 ± 2.1 mm and 1.3 ± 0.9 mm respectively. These data in ESRD patients were 6 ± 2.2 mm, 5.6 ± 2.3 mm and 1.2 ± 0.78 mm. No significant difference was seen among two groups (P = 0.3, 0.8 and 0.7). In ARF and ESRD patients, there was a significant relationship between peaked tall T wave frequency and hyperkalemia severity (p<0.001). In the simultaneous presence of hyperkalemia and hypocalcemia, peaked tall T wave frequency, mean of R wave height and T/R ratio in ARF and ESRD groups were not significantly different. On the other hand, in the coincidence of hyperkalemia and hyponatremia peaked tall T wave frequency and T/R ratio in ARF and ESRD groups were significantly different. (P <0.05) Severe hyperkalemia, hyperkalemia in the setting of ARF and the simultaneous presence of hyperkalemia and hyponatremia may increase the probability of cardiac changes. These groups of patients who undergo hemodialysis need vigorous care considering the cardiac complications.

Kefir is a probiotic mixture of bacteria and yeast originating from Qafqaz region.The Kefir grain contain s both Lactic acid bacteria (Lactobacillus,Lactococcus,Leuconostoc,Acetobacte and Streptococcus spp.) and yeast (Kluyveromyces,Torula,Candida and Saccharomyces spp.). Kefir is claimed to have therapeutic effect.This study looked at the antimicrobial activity of Kefir on Pseudomonas aeruginosa. The antimicrobial activity of Kefir extract were determined on Pseudomonas aeruginosa (ATCC 27853) and on those isolated from burned patient. Effect of antibacterial extracts Kefir fermentation time in both 48 and 72 hours at a temperature of 35 degrees Celsius were determined with the disk plate and well test in vitro. The MIC was defined as the lowest antimicrobial concentration able to completely inhibited bacterial growth up to 24 h. MIC values were determined by microdilution method. The lactic acid contents of the Kefir extracts were determined by reverse-phase HPLC (high performance liquid chromatography). The result showed that the highest antimicrobial activity of Kefir extract on Pseudomonas aeruginosa (ATCC 27853) and the burned patient isolation, ranged from 250 mg/mL(MIC) to 250 mg/mL(MBC) on time 96h. The Kefir extract showed significant antimicrobial activity on Pseudomonas aeruginosa (ATCC 27853) and the clinical isolate of Pseudomonas aeruginosa.

Antibiotic misuse is an important cause of antibiotic resistance. The aim of this study was to determine the pattern of empirical antibiotic administration in emergency department of an educational hospital. In this cross-sectional study we evaluated the pattern of antibiotic administration (indication, drug appropriateness, dose, and method of administration) in 190 patients who had been received antibiotic in emergency department of an educational hospital of Tehran Medical University in 2009. Data were collected from medical records and statistical analysis was performed by SPSSv.15 software. 55.8% of patients were male and 44.2% were female. Mean age of them was 56.61 ± 23.66. 26.3% of patients received one antibiotic and 73.7% received two antibiotics or more. The most common prescribed drug was ceftriaxone (72.1%). 63.7% of prescribed antibiotics were appropriate choice and 36.3% were inappropriate. Unnecessary antibiotic was prescribed in 15.8% of patients. Inappropriate dose and method of administration were 6.8% and 2.1%, respectively. Total mistakes in determination of indication of antibiotic, selection of appropriate drug, dose and administration method were 40.5%. Antibiotic misuse was more than what expected in a university hospital. It seems logical to conduct educational courses about antibiotic administration guidelines.

Excessive caloric intake as a result of carbohydrate over feeding is the main cause of obesity. Recently, more attention has been given to the influence of herbal medicines for prevention and treatment of obesity. Teucrium polium (Calpoure) has been hypoglycemic, hypolipidemic, and antioxidant effects. At present study, the effect of T. polium ethylacetate extract that known as hepatoprotective and antioxidant agent has been investigated on obesity parameters sucrose-induced rats. Materials: In this Experimental study, 30 adult male Wistar rats weighting 180 20 g were divided into 5 groups. Four groups obtained sucrose 50% in drinking water for 10 weeks. After 8th week, 3 randomly selected groups were treated with ethylacetate extract of T. polium for 50, 100 and 200 mg/kg. Sham animal group was fed using normal rat chow. After ten weeks, animals were euthanized and physical parameters have also been evaluated. The results have been shown that in control group food intake and energy consumption in comparison with the other groups, increased and decreased respectively. Sham animal group in comparison with the other groups, the weight of heart, body and abdominal fat pad, also leptin particularly were significantly increased. On the other side, it has been shown that the using T. polium ethylacetate extract significantly decreased the weight of heart, body, abdominal fat pad and Blood levels Leptin in a relatively dose-dependent way This study showed that the using of T. polium ethylacetate extract with dose of 100 and 200 mg /kg for 2 weeks cause reduction in obesity parameters

The vitreoretinal interface is involved in a wide range of vitreoretinal disorders and separation of the posterior vitreous face from the retinal surface is an essential part of vitrectomy surgeries. A diverse range of enzymatic and non-enzymatic agents are being studied as an adjunct before or during vitrectomy to facilitate the induction of posterior vitreous detachment. There is a significant body of knowledge in the literature about different vitreolytic agents under investigation for a variety of pathologies involving the vitreoretinal interface which will be summarized in this review. Method s: Articles retrieved by Pubmed search using keywords “Vitreolysis”, pharmacologic Vitreolysis, plasmin and vitrectomy, and microplasmin and vitrectomy, were used in this review. recent reports have raised strong hopes that pharmacologic vitreolysis may eventually find its way to clinical practice. Further investigations will demonstrate whether enzymatic vitreolysis could be used as an adjunct and/or alternative treatment for treatment of vitreoretinal disorders.

Gonadogenesis is a complex developmental process which is regulated by molecular interactions such as cell surface and extracellular matrix (ECM) Glycoconjugates terminal sugars. The aim of this study was to determine Glycoconjugates terminal sugars expressions and changes during Gonadogenesis in Rat using Lectin histochemical technique. To determine of glycoconjugate terminal sugers by Lectin histochemistry method, thirty Wistar Rat embryos at different stages from days 12 to 16 of gestation were fixed in formalin, embedded in paraffin and cut in to 5µm thickness sections serially. The sections were incubated with different HRP- lectins from Lotus tetragonolobus (LTA), Maclura pomifera(MPA) and Arachis hypogaea or Peanut (PNA), that are specific for terminal sugars L-Fuc (α2-4)GlcNAc, Gal(β1-3)GalNAc and D-Gal(β1-3)DGalNAc respectively. On the basis of colorimetery data that was determined by blind’s method, sections were graded and SPSS statistic soft ware and kruscal Wallis tests were used for comparing different embryonic stages. Our finding showed that LTA did not react with developing gonads at gestational day 12(E12). LTA reactivity was found in extracellular matrix (ECM) of developing gonads from E14 through E16 (P<0.05) and PGCS as well as surface epithelium at E16 (P<0.05). Surface epithelium were reacted with MPA from E12 to E14 and increased LTA reactivity at E16 (P<0.05). ECM was reacted with MPA at E14 and diminished at E16 (P<0.05). LTA reactivity was found in PGCS at E16. PNA did not react with developing gonads at gestational day 12(E12) but its reaction was started with PGCS from E14 and increased to E16 (P<0.05). In addition, PNA reactivity was started with ECM and surface epithelium from E14 and increased at E16 significantly (P<0.05). According to our result, it is concluded that the expression and changes of glycoconjugates with terminal sugars L -Fuc (α2-4) GlcNAC, and D-Gal (β1-3) DGalNAC are regulated developmentally during rat gonadogenesis.