Acta Medica Iranica
Volume:49 Issue: 5, May 2011

Tamarindus indica is used as a traditional treatment for diabetes. To elucidate whether Tamarindus indica seed aqueous extract (TSE) ameliorates metabolic syndrome in hyperinsulinemic rats, we evaluated serum insulin, dehydroepiandrosterone sulfate (DHEAS), triglyceride (TG), total cholesterol (TC), very low density lipoprotein (VLDL), low density lipoprotein (LDL), high density lipoprotein (HDL), and glucose levels in fructose-fed rats. Animals were divided into three groups; control (C) receiving tap water, fructose-fed (F) and TSE-treated fructose-fed rats (F-T) both receiving tap water supplemented with 10% (w/v) fructose. Water was prepared every day for a period of 8 weeks for all three groups. F-T rats were fed with TSE via gavage feeding at the dose of 20 mg/0.5 ml distilled water/100 g body weight per day. Fasting serum glucose levels of three groups were comparable. TSE treatment prevented the increase in fasting serum insulin, TG, TC, VLDL, and LDL in the F-T group (P<0.01) when comparing with the F group. Fructose feeding led to a decrease in fasting serum DHEAS, and HDL levels in the F group (P<0.01) compared with the control. TSE treatment prevented the decrease in fasting serum DHEAS, and HDL levels in the F-T group (P<0.01) while these results were not seen in control rats. It is indicated that the hyperinsulinemia in fructose-fed insulin resistant rats are associated with low levels of DHEAS, and HDL; and high levels of TC, VLDL, LDL, and TG. TSE supplementation probably ameliorates metabolic syndrome due to the improved insulin action.

The aim of this study was to investigate the effect of acute swimming stress on plasma corticosterone and leptin levels in female and male rats. Thirty- seven adult male (n=20) and female (n=20) Sprague Dawley rats (200-250 g weight) were used. The leptin and corticosterone levels were measured following swimming stress (10 minutes) or no stress. Plasma leptin and corticosterone were measured by ELISA system. The plasma leptin and corticosterone levels were significantly increased in female and male rats by swimming stress. Plasma leptin level was not correlated significantly with plasma corticosterone in all groups. There were no sex differences in leptin level among stressed and non stressed rats. The results suggest that changes in plasma leptin level could not be associated with stimulation of corticosterone secretion from adrenal glands and leptin secretion is not sex dependent.

Atrial fibrillation (AF) is the most common arrhythmia after cardiothoracic surgery. AF following coronary artery bypass graft (CABG) is associated with an increase in morbidity, mortality, hemodynamic instability, thromboembolic events, severity of heart failure and ICU and hospital stay. Corticosteroids have a variety of beneficial effects on recovery after elective surgery. This study was designed to test the hypothesis that low dose of Methylprednisolone (MP) can affect post-CABG AF and early complications in patients with severe left ventricle dysfunction who underwent elective off-pump coronary artery bypass. A total of 120 patients with LV dysfunction undergoing elective off- pump CABG randomly received either MP or placebo. Diabetic patients and those who were receiving corticosteroids were excluded. The MP group received 5mg/kg of MP intravenously after induction of anesthesia and the placebo group received an equal volume of normal saline. We evaluated Post-CABG variables including incidence, duration and frequency of AF recurrence and early morbidity such as bleeding, infection, vomiting, renal and respiratory dysfunctions, ICU or hospital stay and early mortality. The mean age of patients was 62.11 ± 12.34 years with the 2.4 male to female ratio. AF occurred in 23(19.2%) patients. No significant difference in the incidence of new AF was found between the placebo (21.7%) and MP group (16.7%) (P=0.47). MP did not affect postoperative bleeding, infection, vomiting, renal and respiratory dysfunction and mortality; however, MP significantly reduced ICU and hospital length of stay. MP did not affect the incidence, duration and frequency of AF recurrence in patients with severe LV dysfunction undergoing off-pump CABG. However, MP could reduce ICU and hospital stay significantly in these patients.

The present study was conducted to investigate antimicrobial resistant pattern of Escherichia coli (E. coli) strains isolated from clinical specimens of Jordanian pediatric patients during the period from January to December 2008. A total of 444 E. coli strains were isolated from clinical specimens and tested for their susceptibility to different antimicrobial drugs. Overall, high resistance rate was observed for ampicillin (84%), followed by amoxicillin-clavulanic acid (74.3%), cotrimoxazole (71%), nalidixic acid (47.3%), cephalothin (41%). Lower resistance rates were observed for amikacin (0%) followed by Cefotaxime (11%), Ceftriaxone (11.7%), ciprofloxacin (14.5%), Norfloxacin (16.5%), gentamicin (17.3%) cephalexin (20.9%), Ceftazidime (22.5%), cefixime (29.6%), and cefaclor (32.8%). Ampicillin, amoxicillin-clavulanic acid and cotrimoxazole were found to be ineffective at in vitro inhibition of the E. coli of pediatric origin. Amikacin was highly effective for E. coli with susceptibility rate of 100%. The majority of E. coli strains were susceptible to third generation cephalosporins and fluoroquinolones.

Traditional teaching methods used in medical education couldnt meet the need for keeping pace with up to date information. Present study has conducted in order to compare the effect of lecture and e-learning methods on nursing student's learning outcomes in the context of Iran. A cross-over design was applied. Study sample was consisted of 32 students which were in third semester of nursing bachelor program and were passing Maternal Child nursing course. The first part of the course was taught using lecture method during first four weeks; an e-learning method was the technique used to educate the remained part of the course during the second four weeks. Student's learning outcomes in each method, opinion toward and participation with both educational methods was assessed. No significant difference was found between students exam scores in both methods. Considering student's opinion toward educational methods, no significant difference was found between two methods in general but students reported better "capability" and "independency" in e-learning method while lecture was obtained higher scores in "effectiveness on learning" and "motivation" characteristics. E-learning can be used in teaching some nursing courses. It is recommended to use e-learning method with appropriate interactive strategies and attractive virtual environments to motivate students.

According to its superficial anatomical location, the thyroid gland is easily accessible by sonography. Sonography allows an exact documentation of the size and thyroid volume. The relationship between thyroid volume and anthropometric characteristics is a matter of controversy. The aim of this study was to investigate thyroid volume and its determinants in healthy adult. A cross-sectional study was performed from June2003 until April 2005 in 314 healthy adults aged over 18 years old in Yazd, Iran. Data were collected on age, sex, and weight and thyroid size by sonoraphy. Mean of thyroid volume in male and female was 9.08 ± 2.49 and 7.93 ± 3.2 milliliter which the differences was significant (P<0.003).Differences between thyroid volume and weight was significant (P=0.001). Mean of female weight and proportion of thyroid volume to their weight was 61.83 ± 12.09kg and 0.130 ± 0.33. Mean of male weight and proportion of thyroid volume to their weight was 71.41 ± 9.05kg and 0.126 ± 0.028 (P<0.003). Results of study is similar to other studies. Mean of thyroid volume in Yazd citizens is not differ from other Iranian but is different from other countries. This difference could be related to food intake habit, geographical region and daily oral iodine consumption.

We aimed to investigate the correlation of tonsillectomy with palatine tonsil size and to compare the differences of tonsil size and the need for surgery in children and adults. Also we can predict the outcome of tonsillectomy. We measured tonsil sizes in (height and width) in 150 children and 35 adults with hypertrophy of palatine tonsils and we measured the mass of tonsils and then the data analysis. In both groups of children and adults, tonsil sizes were significantly correlated with the rate of tonsillectomy. Tonsil size of grade 3 and 4 were with a high tonsillectomy rate in adults but tonsil size grade 2, 3 and 4 had a high tonsillectomy rate in children. Tonsillectomy correlated with tonsil size in both groups children and adults. The rate of tonsillectomy increased proportionally with tonsil sizes in both groups children and adults.

The duration of ICU (intensive care unit) stay in cardiac surgery patients has an important role in the rate of complications and costs. The aim of this study was to determine the role of perioperative risk factors in clinical outcome based on the time of ICU discharge. In this descriptive study, 219 patients undergoing off-pump coronary artery bypass (OPCAB) surgery in Afshar Hospital in Yazd, an Iranian city, were divided into early (≤24 hrs) and late (>24 hrs) ICU discharge groups according to the duration of ICU stay. The preoperative, intraoperative and postoperative risk factors, the complications and the outcome were evaluated. Age, sex, hyperlipidemia, diabetes mellitus, previous myocardial infarction, renal failure, cerebrovascular accident, and level of hematocrit and creatinine were not significantly different between the two groups. Patients with hemodynamic instability, respiratory dysfunction, ejection fraction <35%, hypertension, inotrope administration, left main coronary artery involvement, use of intraaortic balloon pump (IABP) and arrhythmia had significantly higher mortality and longer ICU stay (>24 hrs) compared to others (P value <0.05). The duration of intubation was significantly lower in the early discharge group (7.8 ± 3.8 hrs compared to 17 ± 9.9 hrs) than in the late discharge group. Time of ICU discharge depends on perioperative risk factors, and risk factor modification may improve clinical outcome.

urns account for a significant proportion of injuries, and of these the face, neck, and anterior torso are commonly affected. Burn scars remain a lasting reminder of the insult both for the patient and the outside world. There is little doubt that the change in appearance and the limitation imposed by a burn scar contribute to negative body image. Treatment of hypertrophic scars in the neck has been quite challenging if there is no intact tissue for local flaps. So application of full-thickness skin grafts could be of great value. We applied full-thickness grafts obtained from lower abdominal skin for treatment of severe neck contractures in four patients when other treatment modalities such as local flaps could not be used. Full-thickness skin graft of the neck is a safe and reliable treatment option with fairly good functional and aesthetic results. It has little donor site morbidity in spite of providing a large surface area of full-thickness skin.

Iron deficiency can cause cognitive and functional learning disorders in children. Some studies have reported a relationship between low serum ferritin levels in patients with anemia and Helicobacter pylori (H. pylori) infection. Therefore, we aimed to determine the relationship between these two common diseases. This descriptive analytical cross-sectional study was performed to assess serum ferritin levels and H. pylori antibody titers (IgG) among 6-12 year old healthy primary school children in Tehran during the academic year 2005-2006. Specimen collection was done by cluster and randomization methods (multistage sampling). Personal information and laboratory results were compiled in questionnaires and data were analyzed by descriptive and analytical statistics via SPSS software. 165 primary school children (43% boys, 57% girls) with mean age 9.2 ± 1.5 years were enrolled in the study. H. pylori IgG antibody titer was positive in 26% of cases with mean values of 0.79 ± 0.42 units in boys and 0.75 ± 0.39 units in girls, which showed a significant statistical difference (P=0.004). H. pylori infection was more common among children of large families or those with low economic status (P=0.002). 29% of children had low serum ferritin levels. Out of the children with low serum ferritin levels, 71% and 28% had negative and positive anti H. pylori antibody titers (IgG levels), respectively. Also, 296 children (25%) with normal ferritin levels had H. pylori infection. We did not find a significant relationship between H. pylori infection and low serum ferritin levels or iron deficiency anemia.

Tissue-engineered gingival graft was used for regenerating facial gingiva around an implant at lower left first premolar area with insufficient attached gingiva. Engineered gingival graft was produced by mixing 250 ml bovine skin collagen with 250 ml nutritional medium containing human gingival fibroblasts (2×105). 3 months post-surgery, there were gains in the attached gingiva compared to pre-surgery. The histological examination revealed a keratinized tissue on the treated site. Based on the result of this investigation, this graft was safe and capable of generating keratinized gingiva.

We report a rare case of brucellosis presenting with pleural and pericardial effusions in a 35 year-old male rancher in Iran with fever and dyspnea. Such findings should prompt inclusion of brucellosis in the differential diagnosis in endemic areas.

Lutembacher syndrome refers to the rare combination of a congenital atrial septal defect and acquired mitral stenosis. Traditionally, Lutembacher syndrome has been corrected by surgical treatment. We describe two patients treated percutaneouly with a combined Inoue balloon valvuloplasty and septal defect closure using the Amplatzer septal occlusion device.