نشریه پژوهش در پزشکی
سال سی و پنجم شماره 2 (پیاپی 138، تابستان 1390)

Lateral sphincterotomy is the standard treatment for chronic anal fissure. In recent years, chemical sphincterotomy by several pharmacological agents, i.e. botulinum toxin, nifedipin, glyceryl trinitrate, has been used as alternative treatment. The objective of this study was to compare the results of botulinum toxin injection with lateral sphincterotomy in patients with this condition. In this trial 40 patients were randomized into two groups; 19 patients underwent surgical sphincterotomy and 21 cases were treated with injections of 30 units of botulinum toxin into the internal sphincter at 3 different sites (anterior and lateral). Patients were followed for up to 6 months to appraise the results. There was no significant difference in sex, age, duration of symptoms and anatomical variability of the disease between two groups. The frequency of healing on follow-up visits in the Botox group at 2 weeks, 2 months, 4 months and 6 months was respectively 33.3%, 76.2%, 85.7% and 85.7% and in the sphincterotomy group it was 47.4%, 89.5%, 100% and 94.7%, respectively (p>0.4). None of patients in either groups developed fecal incontinence. The frequency of incontinence to flatus in follow-up visits in Botox group was respectively 38.1%, 19%, 4.8% and 0% and in sphincterotomy group it was respectively 63.2%, 31.6%, 26.3% and 21.1%. The difference in the frequency of flatus incontinence was only statistically significant at the 6th month visit (p=0.04). Chemical sphincterotomy with injection of 30 units of Botox into the internal sphincter at 3 sites is an effective treatment for chronic anal fissure and accompanied by fewer complications. It is suggested as the primary step in treatment of chronic fissure with surgical sphincterotomy reserved for refractory cases.

The Date palm (Phoenix dactylifera L.) is considered an important source of food for both humans and animals in arid and semi-arid regions. The fruits contain a high percentage of carbohydrate, fat, salts and minerals, protein, vitamins and a high percentage of dietary fiber and poly phenol compounds. This study was carried out to evaluate the antioxidant capacity of methanol and aqueous water extracts from date palm fruit cultivar Dayri, cultivated in Iran.

Date fruits (Phoenix dactilyfera var dayri) were collected from Abadan in Khozestan. Methanol and aqueous extracts were prepared from fruits by maceration method. DPPH, TEAC and FRAP method were used to evaluate radical scavenging capacity of extracts. Total phenolic content was determined by the Folin–Ciocalteu method.

In DPPH assay IC50 of methanol and aqueous extracts were 4.65 mg/ml and 76.61 µg/ml. TEAC values of methanol and aqueous extracts in 6 min were 9.39 and 9.06. The EC1 of FRAP assay were 5.36 and 2.01 mg/ml. Total phenolic contents of methanol extracts was 3.77 mg of equivalent Tannic acid ⁄g dried extract and 17.42 mg for aqueous extract.

Methanol and aqueous extracts of Date palm fruit have Antioxidant activity. In all tests, aqueous extracts extract had higher antioxidant activity. The higher activity of the aqueous fraction may be attributed to the presence of higher phenolic content.

Walnut (Juglans regia L.) is widely distributed all over the world. Dry seeds, (nuts), as well as green walnuts, shells, bark, green husks (epicarps) and leaves, have all been used in the cosmetic and pharmaceutical industries. In the present study, hepatoprotective potential of ethanolic extract of walnut leaves was investigated against carbon tetrachloride (CCl4) induced liver damage in rats.

This experimental study was done on 36 rats divided into six groups. Adult male rats were orally administered different doses of walnut extract (50, 100, 200 and 400 mg/kg bw/daily) along with CCl4 (50% CCl4, in olive oil, 1 ml/kg, intrapertioneally) twice a week for 28 consecutive days. Biochemical parameters like alanine amino transferase, aspartate amino transferase, alkaline phosphatase and total protein levels in the serum were determined. Statistical analysis was carried out using ANOVA test.

Administration of CCl4 increased the serum levels of alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase (p<0.01). Treatment with the ethanolic extract of walnut leaves significantly decreased the above parameters (p<0.01).

Ethanolic extract of walnut leaves could protect liver against the CCl4-induced oxidative damage in rats, and this hepatoprotective effect might be due to modulation of toxic and oxidant enzymes and also to the scavenger effect on free radicals.

In molecular approach, serum of camel contains a unique type of antibodies devoid of light chains since the light chain is missing, the heavy-chain antibodies should bind their antigen by one single domain, the variable domain of the heavy immunoglobulin chain. Vascular endothelial growth factor receptor-2 (VEGFR-2) is one of the important proteins in angiogenesis which over-expressed in many types of tumors.

Two male dromedaries (Camelus dromedarius) were immunized against VEGFR-2. ELISA was used to evaluate the immunization process. Camel immune sera were fractionated with protein A and G affinity chromatography. Heavy chain antibodies tested for its specific reactivity in cell-based ELISA in recognition of VEGFR-2 on the cell surface of three cell lines; 293/KDR, HUVECs and A431.

In ELISA test, the camel sera in 1/12800 dilution had the acceptable results. Furthermore, cell-based ELISA demonstrated that the polyclonal heavy chain antibodies bind to VEGFR-2 in 293/KDR and HUVECs cell lines.

Single chain polyclonal antibodies against VEGFR-2 can be used for detection of soluble form of this protein by ELISA, and also flowcytometry, western blotting and immunohistochemistry.

Pulmonary vascular resistance (PVR) index is an important hemodynamic variable in determining the severity of cardiopulmonary diseases. This study was done to define the relationship of echocardiographic parameters of ventricular function with PVR. Mean PVR of 40 patients with cardiac disease was compared with the left ventricle diastolic function indices (LVEF) and the Systolic Pulmonary Arterial Pressure, (SPAP). Results were analyzed by Linear Regression Test; also right ventricle TAPSE index was compared with mean PVR by Mann- Whitney Test, using SPSS Ver. 15. The comparison between PVR and TAPSE showed that the mean PVR reduces significantly with increase of TAPSE (cut off point 1.8; p= (0.0 26). The study of the relation between SPAP and PVR made it clear that an increase in SPAP (mean PAP>25 mmHg) will cause the PVR to increase significantly (P<0.0001). The study of LVEF and PVR showed that PVR decreases significantly parallel with an increase in EF (P= 0.004). The study of mean PVR in LV Diastolic dysfunction groupings showed that the mean PVR difference in Restrictive Pattern was significantly higher than the Normal grouping (P<0.0001) Measurement of right and left ventricles function indices by echocardiography is a reliable and accessible instrument for PVR estimation and monitoring. Noting the significance of PVR measurement in the process of treating cardiovascular diseases, we recommend use of echocardiography as a simple, accessible and noninvasive method for determining PVR, and an also as an index for estimating prognosis.

Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. Anxiety is considered to be a normal reaction to stress, however excessive anxiety results in anxiety disorder. In this study, we investigated the possible interaction between nicotine and nitric oxide system of the dorsal hippocampus on anxiety-like behavior in mice.

This experimental study was performed on 230 male NMRI mice. Mice were anesthetized with intra-peritoneal injection of ketamine hydrochloride, plus xylazine and then placed in a stereotaxic apparatus. Two stainless-steel cannulae were placed in the CA1 region of hippocampus. Nicotine (0.5 mg/kg) was injected intraperitoneally; L-arginine (1 µg/mouse) and L-NAME 50 ng/mouse was instilled in the cannulae; The elevated plus-maze test was used to test for anxiety-like behaviors. One-way analyses of variance (ANOVAs) followed by LSD test, were used for analysis of the data.

Intraperitoneal injection of nicotine or bilateral intra-dorsal hippocampal injections of L-arginine and L-NAME induced anxiogenic effects, p<0.05, p<0.05, p<0.01, respectively. Intraperitoneal injection of lower dose of nicotine (0.1 mg/kg) before different doses of L-arginine or L-NAME inhibited anxiogenic effects of L-arginine or L-NAME.

It seems that both nitric oxide and nicotinic cholinergic systems play a part in the modulation of anxiety in the dorsal hippocampus of mouse; however the interaction between these two systems is complex.

Hepatitis B is one of the most prevalent chronic and persistent hepatitis infections which may lead to chronic hepatitis and hepato-cellular carcinoma. Since hospital personnel are more susceptible to hepatitis B this study was done to determine the relation between number of hepatitis B vaccinations and the presence of anti HBS antibody in personnel working in a large hospital in Tehran.

This was a cross-Sectional study conducted in 2010 on 530 personnel working in Khatam-ol-Anbiya Hospital. Blood samples were collected from the subjects selected through convenience sampling and the level of anti-HBS antibody checked: antibody levels >10 mIU/ml were considered to be protective.

Antibody levels were less than the stated cut-off in 78 individuals, (14.7%). Mean antibody levels were 9.5 mIU/ml in the 27 unvaccinated persons; 86.6 mIU/ml in 7 individuals who had received the vaccine only once; 160 mIU/ml in the 32 who had been vaccinated twice; 192 mIU/ml after 3 doses of the vaccine in 276 persons and in the 58 subjects who had received >3doses, the mean level of the antibody was 321 mIU/ml, (p=0.001).

Anti-HBS antibody levels show a significant rise after repeated vaccinations.

Community acquired pneumonia (CAP) is the main cause of mortality and morbidity world wide. Legionella pneumophila is identified as the fourth agent that causes CAP. The aim of this study was to define the prevalence of L. pneumophila among hospitalized children by culture, direct immune-fluorescence, (DFA) and PCR.

In this study 210 sputum samples were collected from hospitalized children diagnosed with CAP. Samples were cultured on selective buffered charcoal-yeast extract agar (BCYE). Existence of L. pneumophila among sputum samples was confirmed by culture, direct immune-fluorescence and PCR.

Our results for 210 hospitalized children showed that the sputum of 12 children, (5.7%) with acute respiratory infections was positive for L. pneumophila. Of the 12 positive samples 3, (25%) were detected by culture; 5 by DFA, (41.6%); and 9 by PCR, (75%).

PCR is more sensitive than culture and DFA for detection of Legionella pneumonia in sputum samples.