مجله دانشکده پزشکی اصفهان
پیاپی 194 (هفته چهارم امرداد 1391)

Osteoarthritis is the most common form of joint disease and a leading cause of disability in the elderly. The symptoms of osteoarthritis are pain, morning stiffness, and limited motion of the joint. Different treatments have been proposed for management of osteoarthritis but the results are not clear. We compared the effects of acupuncture and physical modalities on symptoms of knee osteoarthritis. In this study, 40 patients with knee osteoarthritis according to American College of Rheumatology (ACR) criteria were recruited using strict inclusion and exclusion criteria. The patients were randomly divided into two groups (A and B). The acupuncture group (A) only received acupuncture at selected acupoints for knee pain. On the other hand, the physical modality group (B) received transcutaneous electrical nerve stimulation (TENS), ultrasound (US), and hot pack at pain areas for 4 weeks. Treatment was performed 3 times weekly for 4 weeks (12 sessions) in both groups. Pain intensity was measured based on a visual analogue scale (VAS) while function was evaluated using knee injury and osteoarthritis outcome score with (KOOS). T-test was used to analyze the data in SPSS11. After treatment, acupuncture and physical modality groups reported significant improvements in symptoms. Compared to group A, group B reported a significantly higher level of improvement in subscale of everyday activity (P < 0.05). Based on VAS, pain intensity scores decreased in both groups but significantly more in group A (P < 0.05). According to the results of the present study, both acupuncture and physical modalities could efficiently reduce pain intensity and enhance daily activities and quality of life in patients with knee osteoarthritis. While acupuncture was more effective on pain reduction, physical modalities could better improve daily activity.

Inhibition of endothelial dysfunction and denudation contributes to the attenuation of atherosclerosis. Numerous studies have suggested that nutritional antioxidants can contribute to the reduction of atherosclerotic lesions. The goals of the present study were to investigate the beneficial effects of pomegranate peel extract in rabbits fed on a high cholesterol diet and to analyze the anti-atherosclerotic activity of the extract. Endothelial progenitor cell (EPC) numbers and atherosclerotic lesion size were determined in rabbits fed on normal diet (control group), high cholesterol diet (HC group), and high cholesterol diet with pomegranate peel antioxidant extract (0.1% in drinking water) (POM or pomegranate group). Pomegranate peel antioxidant-extract supplementation significantly increased EPC numbers (9.95 ± 1.60 in POM group vs. 3.60 ± 2.20 in HC group and 2.01 ± 0.60 in control group; P < 0.05) and inhibited the progression of atherosclerotic lesion formation in aorta of rabbits (P < 0.05). Our results suggested that the beneficial effects of pomegranate peel antioxidant extract in prevention of atherosclerosis may be due to the modulation of EPC numbers and potentiation of the endothelial regeneration.

Chronic hepatitis C virus infection is the most common infectious disease among intravenous drug abusers. We tried to determine the effects of combination therapy using conventional interferon and ribavirin during 12 weeks. In this descriptive analytical study in 2011, 25 patients with chronic hepatitis C who referred to Infectious Diseases Research Center (Isfahan, Iran) were treated with conventional interferon plus ribavirin. After 12 weeks, early virologic response (EVR) was determined using polymerase chain reaction (PCR). The collected data was analyzed in SPSS. The mean virologic load in PCR was 3549878 ± 6139188. After 12 weeks, the virologic load decreased more than 2log in 5 patients (20%) and less than 2log in 1 patient (4%). The reductions were undetectable in 19 patients (76%). Treatment with conventional interferon plus ribavirin was effective in this short-term study.

Colorectal cancer is one of the most prevalent gastrointestinal malignancies. Expression of some proteins including P53, P21, E-cadherin and β-catenin is assumed to have a prognostic role for this malignancy. In the present study we evaluated the association of retinoblastoma (RB) protein expression and pathogenesis of colorectal cancer. The presence of RB in cancerous and non-cancerous colorectal tissue samples were compared using immunohistochemistry method. Tissue sections were taken from tumoral and non-tumoral defined areas of 50 colorectal cancer patients. After coloration according to immunohistochemistry method, all samples were studied for RB expression. We found RB expression in colorectal tumoral cells to be significantly higher than that of non-tumoral cells (P < 0.0001). RB overexpression in cancerous cells may lead to insensibility to apoptosis and consequent long life of affected cells as well as resistance to treatment.

Inguinoscrotal hernia of the bladder is a rare clinical entity. Bladder herniation is commonly small, clinically silent, and incidentally detected during elective hernioplasty. Bladder resection is indicated if tumor or necrosis is detected. Few cases of bladder herniation containing neoplasia have been reported and usually discovered intraoperatively. Case Report: We herein reported our experience with 3 inguinoscrotal bladder hernias treated with partial cystectomy and routine herniorrhaphy. One patient had high grade superficial transitional cell carcinoma and one had bladder stone. Despite the 3 layers of the bladder being normal, it seems reasonable to manage cases of massive inguinoscrotal bladder hernia accompanied by stone or tumor like acquired diverticular disease by diverticular excision (partial cystectomy).