مجله دانشکده پزشکی اصفهان
پیاپی 188 (هفته دوم تیر1391)

Large numbers of overweight students live in the third world countries. They are confronted with physical and psychological incidences due to lack of education. Getting enough education would thus enable such students to control their weight and restart their daily activities. They would consequently be less influenced by complications resulting from the overweight phenomenon. The aim of this study was to determine the effects of a lifestyle adjustment course on overweight female elementary school students in Urmia (Iran) during 2011.

In a quasi-experimental study, 95 students with body mass index (BMI) > 85% were included. Demographic and lifestyle characteristics of the subjects were collected through questionnaires. A lifestyle modification course, including 6 1-hour sessions in 1 month, was then held for the students. The participants were evaluated during the course and 3 months after the last session. Paired t-test and Wilcoxon test were used to analyze the collected data.

Our results showed of the efficacy of the lifestyle modification course to be moderate. The mean lifestyle score changed from 46.2 ± 17.3 before the course to 56.3 ± 13.6 after the educational intervention. According to Wilcoxon test, the difference between the two values was significant (P = 0.001). In addition, BMI decreased from 92.8 ± 4.6% before the course to 90.5 ± 3.4% after it. Paired t-test showed examined significant difference between these two values (P = 0.001).

The performed lifestyle modification course improved the lifestyle of elementary school students and reduced their weight. Similar educational interventions are thus suggested to prevent obesity-related complications.

Neonatal hearing screening test is an early intervention for identification of hearing loss, deafness, and sensorineural impairment. Pediatric diagnosis of audiology needs different tests to collect the required information. Transient evoked otoacoustic emissions (TEOAE) are among the main hearing screening tests. It shows cochlear outer hair cells activity that causes the most important infant hearing loss. This study was conducted to evaluate the effects diagnosing neonatal hearing impairment and referring patients to receive appropriate interventions to prevent language and speech impairments. In a cross-sectional study in Baharestan Hospital (Isfahan, Iran), 1232 neonates, born during 2008-10, were screened with TEOAEs before age of one month. Neonates with failed tests were then referred to an audiologist. The collected data was analyzed by SPSS. In this study, the prevalence of hearing impairment was 4.8 per 1000 live births that is close to previous international studies. Among the neonates with negative test results, 50% had no risk factors while the other 50% had risk factors including positive family history of hearing loss, meningitis, prematurity, and prolonged mechanical ventilation. According to the calculated prevalence of hearing impairment in this study (4.8 in 1000 live births) and considering the importance of hearing in language and speaking development and lack of suspicion to infant hearing loss by parents, more research is required to assess the practice of neonatal universal hearing screening in the related centers in Iran.

Human cytomegalovirus (HCMV) is a member of herpes virus family and its early diagnosis could be very critical in kidney transplant patients. The clinical manifestations of HCMV infection include a wide range from tissue rejection to death. The aim of this study was to compare the accuracy of two common methods of HCMV monitoring, i.e. real-time polymerase chain reaction (PCR) and pp65 antigen assay. We extracted the genomic DNA of 135 kidney transplant patients from their whole blood. HCMV monitoring was performed using TaqMan scanning probes and pp65 surface antigen detection by real-time PCR and pp65 antigen assay, respectively. According to our results, real-time PCR and pp65 antigen assay showed positive results in 36 (27%) and 29 patients (21%), respectively. In addition, the maximum and minimum rates of infection with HCMV were detected in spring (28%) and winter (16%), respectively. However, no significant association was established between HCMV infection and seasonal patterns. Our results indicated that real-time PCR was more accurate than pp65 antigen assay to detect HCMV infection in kidney transplant patients. We could also show that the maximum rate of infections with HCMV belonged to spring. However, the rates in the 4 seasons were not significantly different.

Recent studies have demonstrated an important role for Th-17 and FoxP3+Treg lymphocytes in pathogenesis of autoimmune diseases. Although previous studies have demonstrated the immunomodulatory potential of statins (such as atorvastatin), these effects have been mostly justified by alterations in Th1/Th2 cytokines. The present study was carried out to investigate the therapeutic effects of atorvastatin on experimental autoimmune encephalomyelitis (EAE) and its effects on the response of T-helper cells. EAE was induced by MOG35-55 peptide and complete Freund's adjuvant in female C57BL/6 mice. The mice were placed in two therapeutic groups of 7. Treatment with atorvastatin (10 mg/kg daily) was started in the treatment group at day 12 when they developed a disability score. At the same time, the control group received vehicle alone with the same schedule. Signs of disease were recorded daily until the day 33 when mice were sacrificed. Then, splenocytes were tested to assess proliferation rate, cytokine, and the frequency of FoxP3+Treg cells by the 3-(4,5 dimethylthiozol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay, enzyme-linked immunosorbent assay (ELISA), and flow cytometry, respectively. Atorvastatin significantly decreased the clinical signs of established EAE. Aside from reducing lymphocyte proliferation, atorvastatin significantly inhibited the production of pro-inflammatory interleukin 17 (IL-17) as well as interferon gammas (IFN-γ) through antigen-specific restimulation. In addition, the level of anti-inflammatory IL-10 was significantly increased. However, the frequency of FoxP3+Treg cells did not alter significantly. Parallel with decreasing proliferation of autoreactive lymphocyte and cytokine production in favor of pro-inflammatory cytokines, atorvastatin ameliorated established EAE.

Low back pain is a major economical and social problem nowadays. Intervertebral disc herniation and central degeneration of disc are two major reasons of low back pain that occur because of structural impairment of discs. Intervertebral disc includes the annulus fibrosus, transitional region, and nucleus pulposus (NP). NP forms the central nucleus of the disc. Reduction of cell count and extracellular matrix, especially in NP, causes disc degeneration. Different scaffolds (natural and synthetic) have been used for tissue repairing and regeneration of intervertebral disc in tissue engineering. Most scaffolds have biodegradable and biocompatible characteristics and also prepare a fine condition for proliferation and migration of cells. Although no specific marker or method has been suggested for recognition of NP cells, some studies have used real time and immunocytochemical methods and reported high expression of cytokeratin 19, 18, 8, and others as markers for NP cells. This study aimed to recognize NP cells of human intervertebral disc by flow cytometry of cytokeratin 18 marker. It also compared the proliferation and morphology of these cells in chitosan-gelatin scaffold and alginate scaffold. NP cells were derived by enzymatic hydrolysis of collagenase from NP tissue of patients undergoing open surgery for discectomy in Alzahra Hospital (Isfahan, Iran). Chitosan was blended with gelatin and glutaraldehyde was used for cross linking of the two polymers. Then, alginate scaffold was prepared. After approving the NP cells by flow cytometry of cytokeratin 18 marker, a cellular suspension with 4×105 cells was transferred to each scaffold and cultured for 21 days. Cell viability and proliferation were investigated by trypan blue and methyl thiazolyl tetrazolium (MTT) assay. A scanning electron microscope (SEM) was used to assert the porosity and to survey the structures of the scaffolds. We can use flow cytometry of cytokeratin 18 markers for recognition of NP cells. MTT assay demonstrated that cell viability on the third day had significant difference with the first day in both scaffolds. There was also a significant reduction in cellular viability from day 3 to day 21. Results of cell count showed that mean difference between cell counts in alginate scaffold was significantly more than chitosan-gelatin scaffold (P < 0.001). Flow cytometry of cytokeratin 18 can be used as a method for recognition of NP cells. Compared to chitosan-gelatin scaffold, alginate scaffold prepared a better condition for proliferation of NP cells. The results of this study suggested that alginate scaffold could be useful in in-vivo studies and treatment.