Acta Medica Iranica
Volume:50 Issue: 4, Apr 2012

It has been shown that the immunophilin ligands have the special advantage in spinal cord repair. In this study, the effects of cyclosporine A (CsA) on functional recovery and histological outcome were evaluated following spinal cord injury in rats. After spinal cord hemisection in thirty six adult female Sprague-Dawley rats (200- 250 g), treatment groups received CsA (2.5 mg/kg i.p.) at 15min and 24h after lesion (CsA 15min group and CsA 24h group) daily, for 8 weeks. Control and sham groups received normal saline and in sham operated animals the spinal cord was exposed in the same manner as treatment groups, but was not hemisected. Hindlimb motor function was assessed in 1, 3, 5 and 7 weeks after lesion, using locomotive rating scale developed by Basso, Bresnahan and Beattie (BBB). Motor neurons were counted within the lamina IX of ventral horn and lesion size was measured in 5 mm of spinal lumbar segment with the epicenter of the lesion site. The mean number of motor neurons and the mean BBB scale in 3, 5 and 7 weeks in CsA 15min groups significantly increased compared to the control group. Although, the lesion size reduced in rats with CsA treatment compared to the control group, no significant difference was observed. Thus, it can be concluded that CsA can improve locomotor function and histological outcome in the partial spinal cord injury.

Oxidative stress mediated by reactive oxygen species is known to contribute to the inflammatory process of bronchial asthma. Reactive oxygen species are released into the bronchial tree by activated inflammatory cells. In this study, we aimed to determine the effect of vitamin C administration on leukocyte vitamin C level as well as severity of asthma. In this double blind clinical trial study we evaluated 60 patients with chronic stable asthma. The patients were divided into two groups (A and B) including 30 patients in each group. Patients in these groups were matched according to their age, weight, height, gender, BMI and drug consumption. In addition to standard asthma treatment (according to stepwise therapy in 4th step of bronchial asthma) in which the patients were controlled appropriately, group A received 1000 mg vitamin C daily and group B received placebo. At the baseline and after one month treatment, non-fasting blood samples were drawn for laboratory evaluations. Asthmatic patient's clinical condition was evaluated through standard pulmonary function test (PFT). The mean (±SD) leukocyte vitamin C level in group A at the baseline and after one month treatment with 1000 mg/day vitamin C, were 0.0903 (±0.0787) µg/108 leukocytes and 0.1400 (±0.0953) µg/108 leukocytes respectively (P<0.05). The mean (±SD) leukocyte vitamin C level in group B at the baseline and after one month administration of placebo, were 0.0867 (±0.0629) µg/108 leukocytes and 0.0805(±0.0736) µg/108 leukocytes respectively. The leukocyte vitamin C level in group A was higher than those of group B after one month treatment with vitamin C and placebo and the difference was statistically significant (P<0.05). Comparing PFT (FEV1, FVC and FEV1/FVC) in group B during the study period showed a significant increase in FEV1 (P<0.05), while the other two parameters remained unchanged. In group A, who received 1000 mg/day vitamin C, none of the spirometry parameters changed after one month treatment, indicating no effect of vitamin C treatment in the spirometry parameters.

To assess the effectiveness of ondansetron pretreatment in alleviating propofol injection pain, 135 patients were randomly assigned to one of following three groups. Group 1 who received up to 2 mL pretreatment 50 mg tramadol in the saline, group 2 cases who received up to 2 mL pretreatment 4 mg ondansetron in saline, and group 3 who received up to 2 mL solution saline. A 20 gauge cannula was placed into the largest vein on the dorsum of the hand. Tourniquet was closed to the arm above the cannula and inflates to 70 mmHg, and then drug was injected. After 20 seconds, the tourniquet deflated, and propofol 2mg/kg injected over 10 seconds and pain assessment was made. Tramadol and ondansetron significantly reduced the incidence and severity of propofol injection pain more than placebo (P=0.001). The efficacy of ondansetron in alleviating the pain on injection of propofol was no different from tramadol (P=0.330). Ondansetron pretreatment may be used to reduce the incidence of pain on injection of propofol, an advantage added to the useful prevention of postoperative nausea and vomiting.

Fatigue is one of the most frequent symptoms in patients with multiple sclerosis (MS) and it is difficult to clarify the nature of this symptom and manage it. This study was aimed to evaluate the frequency of fatigue, depression and sleep disturbances in Iranian patients with MS. 100 patients from the outpatient MS clinic of Sina hospital were asked to complete Beck Depression Inventory (BDI), Pittsburg Sleep Quality Index (PSQI), Sleep Disorder Questionnaire (SDQ), Modified Fatigue Impact Scale (MFIS) and Epworth Sleepiness Scale (ESS) questionnaires. Student's t-test, ANOVA, Spearman correlation and Stepwise multiple linear regressions by SPSS version 15.0 were used for data analysis. From participants, 64 had fatigue complaint during day time and 36 did not feel fatigued. BDI, PSQI, MFIS and SDQ scores were significantly higher in fatigued patients than non-fatigued group but there were no statistically significant differences in ESS, EDSS and duration of disease between fatigued and non-fatigued cases. There were significant correlations between MFIS and BDI scores (r=0.49, P=0.01), MFIS and PSQI scores (r=0.399, P=0.01) and MFIS and ESS (r=0.25, P=0.01). This study demonstrates that depression is not the only cause of fatigue in patients with MS and it is also associated with sleep disorders, so this complaint should be carefully evaluated and managed in these patients.

Quality of work Life (QWL) originates from interactions between employee's needs and relative organizational resources. QWL is aimed to improve and retain employee's satisfaction, productivity and effectiveness of all organizations. A cross-sectional descriptive study was conducted among 15 Tehran University of Medical Sciences. A Cross-Sectional, descriptive study was conducted among 15 Tehran University of Medical Science's Hospital's Radiology Department's Employees by QWL questionnaire. Respondents were asked to express their attitudes about a range of key factors as the most important issues impacting their QWL. The data was collected and analyzed by SPSS version 15 software. Most of the respondents indicated that they were unsatisfied and very unsatisfied with key factors of their QWL. Comparison of QWL key factors of TUMS radiology employees with the other countries indicated that most of the employees are unsatisfied with their poor QWL factors. We hope, the implications of these findings deliberate to improve QWL within each of TUMS hospitals radiology departments and also be relevant and value to policymakers of healthcare organizations in Iran.

There has been an increase in the frequency of substance abuse among hospitalized burn injury patients. However, few studies have investigated substance abuse among burn patients. This study was aimed to identify the incidence of substance abuse in burn injury patients using the "Drug Abuse Screening Test" (DAST-20). We determined the validity of DAST-20 in spring 2010. Subsequently, this descriptive study was performed on 203 burn injury patients who fit the study's inclusion criteria. We chose a score of 6 as the cutoff and thus achieved a sensitivity of 89% and a specificity of 85% for the DAST-20. During the study, we gathered demographic data, burn features and DAST-20 results for all patients. Patients with scores of 6 or more were considered to be substances abusers. A statistical analysis was conducted using SPSS v16 software. According to the DAST-20 results, 33% of the patients were in the user group. The mean score of DAST-20 was significantly higher among users than it was among nonusers (P<0.05). The level of substance abuse was severe in 77% of users. No significant differences were found among the substances, with the exception of alcohol. Substance abuse is an important risk factor for burn patients. In addition, this study showed that DAST-20 is a valid screening measure for studies on burn patients.

This study was designed to determine the correlation of hepatitis B virus surface Ag (HBsAg) variations with the clinical/serological pictures among chronic HBsAg positive patients. The surface gene (S-gene) was amplified and directly sequenced in twenty-five patients. Eight samples (group I) contained at least one mutation at the amino acid level. Five showed alanine aminotransferase (ALT) levels above the normal range of which only one sample was anti-HBe positive. Group II (17 samples) did not contain any mutation, 4 were anti-HBe positive and 9 had increased ALT levels. In both groups, from a total of 18 mutations, 5 (27.5%) and 13 (72.5%) occurred in anti-HBe and HBeAg positive groups respectively. The small number of amino acid mutations might belong to either the initial phase of chronicity in our patients; or that even in anti-HBe positive phase in Iranian genotype D-infected patients, a somehow tolerant pattern due to the host genetic factors may be responsible.

In research outputs both quality and quantity are of critical value and evaluation of both aspects is required for best evaluation. Several studies have worked on single or two-dimensional methods that provide the assessment of quality, quantity or both simultaneously in different branches of sciences, but none of them have played a role in a particular area of medicine. This study has been conducted to compare countries worldwide in the field of medical researches. Measuring both quality and quantity of researches is performed separately. In order to evaluate countries from both aspects of quantity and quality of research outputs, a modified form of the citation per publication (CPPm) and publication per population (PPPm) were used to make these indices comparable through different years and nations by normalizing the values according to the world average standards. When countries are ranked by CPPm, Iceland ranks the 1st with the score of 1.98, Faroe Islands and Gambia rank the 2nd and the 3rd with scores of 1.84 and 1.63, respectively. In PPPm Switzerland, Sweden and Denmark ranked the top three with scores of 13.34, 11.67 and 10.32, respectively. Iran ranked 71 in CPPm and 141 in PPPm. Ranking countries makes it possible to identify countries which have performed better in research outcomes by means of quality and quantity; thus, reforming policies can be taken into action to lower the waste of money, higher quality and quantity of outputs while providing helpful tip(s) for institutions to improve.

Long-lasting insecticidal nets (LLINs) have been advocated as an effective tool against malaria transmission. However, success of this community based intervention largely depends on the knowledge and practice regarding malaria and its prevention. According to the national strategy plan on evaluation of LLINs (Olyset nets), this study was conducted to determine the perceptions and practices about malaria and to improve use of LLINs in Bashagard district, one of the important foci of malaria in southeast Iran. The study area comprised 14 villages that were randomized in two clusters and designated as LLINs and untreated nets. Each of households in both clusters received two bed nets by the free distribution and delivery. After one month quantitative data collection method was used to collect information regarding the objectives of the study. On the basis of this information, an educational program was carried out in both areas to increase motivation for use of bed nets. Community knowledge and practice regarding malaria and LLIN use assessed pre- and post-educational program. The data were analyzed using SPSS ver.16 software. At baseline, 77.5% of respondents in intervention and 69.4 % in control area mentioned mosquito bite as the cause of malaria, this awareness increased significantly in intervention (90.3%) and control areas (87.9%), following the educational program. A significant increase also was seen in the proportion of households who used LLINs the previous night (92.5%) compared with untreated nets (87.1%). Educational status was an important predictor of LLINs use. Regular use of LLIN was considerably higher than the targeted coverage (80%) which recommended by World Heaths Organization. About 81.1% and 85.3% of respondents from LLIN and control areas reported that mosquito nuisance and subsequent malaria transmission were the main determinants of bed net use. These findings highlight a need for educational intervention in implementation of long-lasting insecticidal nets; this should be considered in planning and decision-making in the national malaria control program during the next campaigns of LLINs in Iran.

Scleroderma or systemic sclerosis is a multisystem disease due to excessive collagen deposition in different organs and autoimmunity by production of autoantibodies.According to previous reports, brain is rarely affected in scleroderma, howeverrecent studies show central nervous system can be affect not only as a complication of systemic involvement (hypertension, renal failure) but also as a primary manifestation.In scleroderma, thrombus formation in central nervous system and peripheral systems is uncommonmay be due to endothelial cells damage which causes to release antithrombotic factors. We discuss a scleroderma patient with high titter of anticardiolipin antibody who developed to cerebral sinus thrombosis and cerebellum infarction. Then we review literature for both primary brain involvement and thrombotic event in systemic sclerosis.

Post-stroke shoulder pain is associated with either a peripheral or central pathology. However, most of the time, it is challenging to establish a cause-and-effect relationship between the suggested pathology and shoulder pain reported. We report a 66 year-old man who developed a right hemiplegic shoulder pain two months post stroke with initial investigations suggestive of peripheral pathologies. Pharmacological and non-pharmacological treatment did not improve his shoulder pain. Later he developed complex regional pain syndrome (CRPS) of the right hand and the initial shoulder pain subsequently relieved following resolution of the CRPS.