Journal of Research in Medical Sciences
Volume:17 Issue: 4, Apr 2012

In a manuscript in this issue of the journal, entitled «Determination of the Causes of Tendency toward Red Meat and Meat Products in the West of Iran», Falahi et al. [1] concluded that the amount of red meat (beef or lamb) and red meat products (such as sausages and hamburgers) intake was approximately high among the population of western Iran (594. 6 ± 956. 2 g/week for red meat and 132. 5 ± 251. 1 g/week for red meat products). Although correct for western Iran, such a finding cannot be generalized to the whole Iranian population. They suggested the most important factors of tendency towards red meat consumption to be delectability, palatability, accessibility, cultural and traditional beliefs, lack of food diversity, animal husbandry, nomadic life, and hospitality in this part of Iran. Cautious recommendations regarding red meat consumption should be provided as some reports showed that red meat consumption was associated with the prevalence of metabolic syndrome among Iranians. [2] In fact, increased red meat intake was cross-sectionally related to higher level of inflammation among Iranian population. [2] Inflammation is in turn related with increased risk of chronic diseases. [2] The same results have also been mentioned in other studies on different populations. [3, 4] Previous studies have also reported the relationship between red meat intake and other chronic diseases such as type 2 diabetes and cardiovascular diseases. [5, 6]

This study aimed to determine the association of particulate matters with endothelial function, measured by flow mediated dilation (FMD) of brachial artery, in children with or without exposure to secondhand smoke. This cross-sectional study was conducted from January to March 2011 in Isfahan, which is the second large and air-polluted city in Iran. The areas of the city with lowest and highest air pollution were determined, and in each area, 25 prepubescent boys with or without exposure to daily tobacco smoke in home were selected, i.e. 100 children were studied in total. FMD was significantly smaller in those living in high-polluted area and those exposed to secondhand smoke. Multiple linear regression analysis, adjusted for age and body mass index, showed that both passive smoking status and living area in terms of particulate air pollution were effective determinants of the brachial artery diameter. The standardized coefficient of passive smoking status was -0.36 (SD = 0.09, P < 0.0001) showing negative association with percent increase in FMD. Likewise, the percent increase in brachial artery diameter was lower in passive smoker children. Similar relationship was documented for PM10 concentration with a regression coefficient of -0.32 (SD = 0.04, P < 0.0001). Without considering passive smoking variable, PM10 concentration has significant independent effect on FMD level. Our findings provide evidence on the association of environmental factors on endothelial dysfunction from early life. Studying such associations among healthy children may help identify the underlying mechanisms. The clinical implications of environmental factors on early stages of atherosclerosis should be confirmed in longitudinal studies.

Clinical studies have reported that osteoporosis after spinal cord injury (SCI) can be the inflammation-induced base condition and n-3 polyunsaturated fatty acids (PUFAs) suppress the production of pro-inflammatory cytokines. This study documents the effects of n-3 PUFAs on cytokines in a group of patients after chronic SCI. This double-blind, placebo- controlled trial was designed in 82 (69 males and 13 females) osteoporotic patients with SCI for 4 months. All participants received 1 000 mg calcium and 400 IU vitamin D daily. The patients received two MorDHA capsules (435 g of DHA and 65 mg of EPA per day) or two placebo capsules (one with lunch, and the other with dinner) in the treatment and control groups, respectively. Serum interleukins and Dietary intakes were assessed in the beginning and end of the study. Mean difference for each group was compared by using Student''s t test. A total of 75 (13 females, 62 males) participants completed the study over 4 months. The supplemented and control groups did not show any difference in their baseline characteristics. There were significant difference neither between two groups at the end of the study nor in each group between beginning and end of the study. Conclusins: MorDHA supplementation for 4 months had no significant effect on inflammatory markers. Although mean difference in all pro-inflammatory cytokines were not significant in both treatment and control groups during the study (P>0.05), the decrease in treatment group was weakly higher that it may be important in point of clinical view.

quercetin is a bioflavonoid occurs in many food items. Some previous studies on quercetin showed the inconsistent results on exercise performance and muscle damage in athletes. The aim of this study was to determine the effects of 8 weeks of quercetin supplementation on exercise performance and muscle damage indices in student athletes. this placebo-controlled, double-blind clinical trial was conducted on 60 male students for 8 weeks. The subjects were randomly assigned to one of the four groups: a) quercetin (500 mg/day quercetin + 200 mg/day placebo), b) quercetin+ vitamin C (500 mg/day quercetin + 200 mg/day vitamin C), vitamin C (500 mg/day placebo + 200 mg/day vitamin C), and placebo (500 mg/day placebo + 200 mg/day placebo). Time to exhaustion (TTE) for measuring performance, aspartate transaminase (AST), and creatine kinase (CK) for measuring muscle damage and body fat percent (BFP) were measured before and after intervention. CK levels reduced in group 1 significantly (P=0.045) and BFP reduced in group 1, 3, and 4, significantly, too (P=0.018, P=0.013, and P=0.043, respectively). Whereas statistically significant changes between groups were not observed for TTE, AST, CK, and BFP after 8 weeks of intervention. supplementation with quercetin and vitamin C for 8 weeks did not improve exercise performance but reduced muscle damage and body fat percent in healthy subjects.

Pseudomonas aeruginosa is a common cause of nosocomial infections. It exhibits innate resistance to a wide range of antibiotics. This study was performed to determine clonal characteristic of P. aeruginosa isolated from clinical specimens, hospital means, and hospital personnel by PCR- ribotyping patterns. a total of 104 P. aeruginosa were isolated from clinical and environmental samples (59 clinical, 45 hospital means and hospital personnel). P. aeruginosa was identified by standard bacteriological methods, mucoid colony morphotypes, and antibiotic resistance rate. The genomes of isolates were extracted and all considered species were confirmed by 16S rDNA- based PCR assay. Then all isolates were genotyped by the 16S - 23SrDNA and Hinf1 restriction enzyme technique. antibacterial sensitivity pattern of isolates showed clinical and environmental specimens were approximately identical (high antibiotic resistance to Ceftazidime and low antibiotic resistance to Amikacin). Colony morphotypes of specimens revealed that mucoid type of clinical isolates were more than that of environmental isolates. Among clinical and environmental strains P1; (570 bp) was the most prevalence pattern. antibiotic resistance, phenotypic characterization, and PCR- ribotyping pattern showed there is clonal relatedness between clinical and environmental isolates and environment could be a main reservoir for P. aeruginosa infections in hospital.

The most common complications after tracheal intubation during general anesthesia are sore throat, hoarseness, and laryngospasm which can cause severe discomfort to patients. Several methods have been suggested to prevent these complications. In this study, the effects of intracuff dexamethasone, lidocaine, and normal saline in reducing post-extubation reactions were compared. This double-blind clinical trial was performed on 180 men of ASA (American Society of Anesthesiologists) class I or II who underwent general anesthesia for elective inguinal herniation surgery in Imam Reza Hospital, Tehran, Iran during 2008-2010. Depending on the kind of drug used to fill the endotracheal tube (ETT) cuff, patients were randomly allocated into normal saline, lidocaine, and dexamethasone groups. Post-extubation reactions were then evaluated in all groups. The groups were demographically comparable. There were no significant differences between the three groups regarding post-extubation sore throat, hoarseness, or laryngospasm (p > 0.05). However, a significant difference in cough existed between the three groups (p = 0.02). Moreover, the groups were not significantly different in terms of patient satisfaction after 24 hours (p = 0.062). Prolongation of spontaneous ventilation time and time to extubation were observed in the three groups. No significant differences were detected between the three groups regarding hemodynamic variables. The three drugs were not significantly different in attenuating post-extubation reactions such as hoarseness, sore throat, and laryngospasm. However, lidocaine was more effective on cough incidence while dexamethasone had better efficacy in reducing cough severity. In addition, all three drugs could satisfy patients after 24 hours. ETT tolerance was more in the lidocaine group than the other two groups.

Consumption of oral contraceptive pills (OCP) is a known risk factor for cerebral venous and sinus thrombosis (CVST) among women. We determined whether misuse of OCP could increase the risk of CVST in women. A case-control study was conducted from 2003 to 2007 on 64 female patients with CVST admitted to Al- Zahra medical center and 232 healthy age-matched female OCP users as controls. Patients and controls were interviewed and misuse of OCP was categorized to taking OCP for self-treatment of dysfunctional uterine bleeding, for family planning without physician consult, or for delaying menstruation in purpose of religious customs or traveling, and taking OCP in high dose during the preceding year. Among 64 cases and 232 controls, 30 (46.9 %) and 63 (27.2 %), respectively, had a history of OCP misuse (Odds Ratio = 2.36, 95% Confidence Intervals = 1.33 to 4.18, P = 0.002). Also, using cyproterone compound (Diane) was more frequent in the CVST group (P<0.001). Multivariate analysis controlling for age, OCP misuse, type of OCP, and history of coagulopathy showed that OCP misuse (P<0.001) and using Diane as the OCP (P = 0.006) were both independently associated with CVST. OCP misuse can be considered as an additional predisposing factor for CVST among women and partly responsible for larger proportion of female patients with CVST. These findings should alarm the healthcare system to create strategies controlling the inappropriate use of OCP among Iranian women.

Malignancies are primarily environmental diseases mostly attributed to environmental factors. By plotting the prevalence and spatial distribution maps, important differences can be observed in detail. This study aimed to determine the association between map distribution of malignancies and the geological phenomena of lead (Pb) accumulation in soil in the province of Isfahan, Iran. Spatial distribution maps of malignant diseases were plotted by using data recorded during 2007 to 2009 in the Isfahan Cancer Registry Program. Data on Pb accumulation in soil was obtained from the National Geological Survey and Mineral Exploration. Pb concentrations were documented in three parts of agricultural, non-agricultural, urban, and industrial land. The geographical mapping of cancers and soil Pb were then incorporated into a geographic information system (GIS) to create a spatial distribution model. The spatial distributions of ten common malignant diseases in the province, i.e. skin cancers, hematological malignancies, and breast cancers, followed by other malignancies were scattered based on Pb distribution. In fact, common cancers were more prevalent in the parts of the province where soil Pb was more abundant. The findings of this study underscore the importance of preventing Pb exposure and controlling industrial production of Pb. The data is also important to establish further effects modeling for cancers. Moreover, physicians and health professionals should consider the impact of environmental factors on their patients'' health.

Type 2 diabetic patients are faced with a higher risk of dyslipidemia and cardiovascular disorders. This study was undertaken to assess the effect of consumption of 1 cup cranberry juice by type 2 diabetic patients on serum paraoxonase-1 (PON-1) activity, apoA-1, apoB, glucose, and Lp(a). In a double-blind randomized clinical trial, 58 type 2 diabetic male patients were randomly divided to receive 1 cup cranberry juice (CJ) or placebo drink daily for 12 weeks. Fasting blood were obtained at beginning and at the end of study (12th week). Serum glucose and PON-1 activity were measured by enzymatic and colorimetric methods, respectively. ApoB, apoA-I, and Lp(a) were determined immunoturbidimetrically. The data were analyzed by SPSS version 16. There were significant decrease in serum glucose and apoB (P>0.05 and P>0.01, respectively) and significant increase in serum apoA-1 and PON-1 activity (P>0.05 and P<0.01, respectively) at the end of study in CJ group compared with control group. In CJ group at the end of study, there were significant decrease in serum glucose and apoB (P<0.01 and P<0.01, respectively) and significant increase in serum apo A-1 and PON-1 activity (P<0.01 and P<0.01, respectively) compared with initial values. In CJ group, there was no significant change in Lp(a) at the end of study compared with initial values and also compared with control group. 1 cup CJ for 12 weeks is effective in reducing serum glucose and apoB and increasing apoA-1 and PON-1 activity, so may have favorite effects on reducing CVD risk factors in type 2 diabetic male patients.

More than one third of energy intake in Iran is provided from bread. Therefore, improving bread mineral bioavailability through dephytinization can play an important role in decreasing the prevalence of many mineral deficiencies. In this study, effect of phytase supplementation on zinc, iron and calcium status in growing rats fed with a diet containing high phytate Iranian bread (Sangak) was assessed. Thirty weanling Wistar male rats were assigned to phytase (Aspergillus niger) or control group for 6 weeks. The diet was designed based on Iranian’s food pattern and 34.2% of the energy was supplied from Sangak bread. Food intake, body and organ weight and body height were measured. Zinc was measured in blood, liver and femur. Iron was assessed in blood and liver and calcium was titrated from femur bone. Statistical analyses were performed using SPSS software. Paired sample t-test, Wilcoxon signed-rank test and repeated measurement ANOVA were used for proper analysis of data. Although weekly weight gain was not different between groups, final weight was in favor of control group. Food intakes, liver and femur bone weight did not differ between the two groups. However, the blood zinc was higher in the phytase group (26.2 ± 7.4 vs. 19.2 ± 5.2, P = 0.03). Thus positive effects of phytase supplementation on zinc, independent of growth was found. Other variables did not show any differences between groups. Addition of phytase to diet containing high phytate Iranian bread can improve blood zinc status in growing rats.

There is a gap in the literature regarding the extent of possible co-occurrence of attention deficit hyperactivity disorder (ADHD) and pervasive developmental disorders (PDD). This study aimed to investigate co-occurring of ADHD in children with PDD. A clinical sample of 68 children with PDD was assessed according to DSM-IV criteria to make ADHD and/ or PDD diagnoses. All the different types of PDD were included. DSM-IV derived criteria for ADHD and PDD were analyzed. An exploratory factor analysis was conducted. the rate of autism, Asperger syndrome, Rett’s disorder, childhood disintegrative disorder and PDD-NOS (not otherwise specified) was 55.4%, 16.9%, 3.1%, 3.1%, 21.5%, respectively. 53.8% of the sample was with ADHD co-morbidity. The rate of ADHD subtypes was 37.1%, 22.9%, and 40.0% for inattentive type, hyperactivity/impulsivity type and combined type, respectively. ADHD and its symptoms highly co-occur with PDD. Meanwhile, the result of factor analysis supports the independence of ADHD and PDD diagnostic criteria.

Although meat constitutes an important part of many consumers’ diet, its consumption has become a quiet controversial issue. Several factors are effective on tendency to red meat consumption. The 2007’s report of the world Cancer Research Fund makes the recommendation to limit the consumption of red meat to less than 500 g per week. The aim of this study is to determine meat and meat products consumption and causes of tendency to red meat among people of Khorramabad city, Iran. This cross- sectional study was carried out on 300 adults (178 women and 122 men; aged 19-70 years) of Khorramabad city, Iran. Red meat and processed meat intake (from a FFQ), demographic and causes of tendencies to red meat consumption (from a self-reported questionnaire) were evaluated. Statistical methods included independent t- test and one-way ANOVA. Consumption of red meat and meat products was 531.8 ± 543.5 g/w and 132.5 ± 251.1 g/w, respectively. The most important factors of tendencies toward red meat consumption were delectability, palatability, accessibility, cultural and traditional beliefs, and lack of food diversity in Lorestan province, animal husbandry, nomadic life, and hospitality. Red meat consumption was more common among men and lower in the income levels of $300. The results demonstrated that red meat consumption in adult people of the west of Iran was high. Since consumption of meat and meat products may create health concerns for people, it is necessary for policymakers to adopt effective strategies to advocate the use of fish and poultry.

Ectopic pregnancy (EP) still remains a main cause of maternal mortalities. This study is designed to evaluate the accuracy of serum Activin A in detection of ectopic pregnancy. This prospective observational study was conducted from 2009 to 2010 at two main referral university hospitals, Isfahan University of Medical Sciences, Isfahan, Iran. Two hundred subjects who were under 10 week’s pregnancy with clinical presentations of abdominal pain and vaginal bleeding were enrolled. After sampling serum Activin A, patients underwent ultrasonography, titer of B-HCG and surgery (if indicated) and were divided into two groups: EP (n = 100) and intrauterine pregnancy (IUP) (n = 100). The mean of Activin A was compared between groups and by ROC curve, the optimal cut off with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were determined. The mean age of women with IUP was 25.4 ± 4.3 years (15-40 years) compared with 25.9 ± 4.1 years in women in EP group (P = 0.448). Statistical difference was not found between EP versus IUP groups in gestational age (6.32 ± 1.03 vs. 6.85 ± 1.82 weeks, P = 0.124). The mean of serum Activin A in EP group was 0.264 ± 0.0703 ng/ml versus 0.949 ± 0.5283 ng/ml in IUP group (P < 0.05). According to ROC curve (area under the curve = 0.981, P < 0.05, confidence interval: 0.961-1.000), the optimal cut off was estimated as 0.504 ng/ml with sensitivity of 97% and specificity of 93.5%. This study indicated that the mean of serum Activin A is lower in EP compared with IUP. The serum Activin A has a fair accuracy in detecting EP.

The aim of the study was to determine the relative frequency of abnormal urodynamic findings in new multiple sclerosis (MS) cases without micturition complaints and to find its correlation with the number of MS plaques on magnetic resonance imaging (MRI), urinary tract involvement and the number of disease episodes. In this prospective study, 50 new female case of multiple sclerosis were enrolled. Age, urodynamic findings, micturition complaints and number of plaques on MRI were recorded on admission. Occurrence of urinary symptoms and number of episodes of the disease were recorded every three months during one-year follow-up. The mean patients’ age was 32.4 ± 7.2 years and all patients were female. Of the 50 patients, 19 (38%) had a normal urodynamic test and 31 (62%) had abnormal urodynamic findings at the beginning of the study. The occurrence of micturition complaints during follow-up in patients with abnormal urodynamic findings (94%) was significantly higher (p < 0.0001) than patients with normal urodynamic findings (37%). In addition, the number of plaques on MRI at the beginning of the study in patients with abnormal urodynamic finding was significantly higher (p < 0.004) compared to patients with a normal urodynamic study. The number of episodes during follow-up was not statistically different between patients with normal and abnormal urodynamic findings (p = 0.46). According to this study, 62% of all new MS patients had an abnormal urodynamic test. This is a considerable proportion of patients and it seems urodynamic studies can be used when MS is first diagnosed.

Carthamus tinctorius L. (Compositae) has been used in Iranian traditional medicine for treatment of diabetes. In this study, anti-diabetic effect of its hydroalcoholic extract was compared with that of glibenclamide. Male white Wistar rats were randomly allocated into four groups of six each: nondiabetic control; diabetic control; diabetic treated with hydroalcoholic extract of Carthamus tinctorius (200 mg kg-1 BW); diabetic rats treated with glibenclamide (0.6 mg kg-1 BW). Alloxan was administered (120 mg kg-1 BW), intraperitoneally to induce diabetes. Fasting blood samples were collected three times, before injection of alloxan, two weeks and six weeks after injection of alloxan and fasting blood sugar (FBS), Hb A1C, insulin, cholesterol, LDL-C, HDL-C, VLDL-C, triglyceride, alkaline phosphatase (ALP), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured each time. FBS, triglyceride, cholesterol, LDL-C and VLDL-C had a meaningful decrease in diabetic rats treated with Carthamus tinctorius and diabetic rats treated with glibenclamide as compared with diabetic rats with no treatment. Insulin level increased significantly in diabetic groups received treatment (glibenclamide or Carthamus tinctorius L) in comparison with diabetic group with no treatment. The histological study revealed size of islets of Langerhans enlarged significantly consequentially as compared with diabetic rats with no treatment. The extract appeared non toxic as evidenced by normal levels of AST, ALP and ALT. Effects of administrating glibenclamide or extract of Carthamus tinctorius L on all biochemical parameters discussed above showed no difference and both tend to bring the values to near normal. These results suggested that the hydroalcoholic extract of Carthamus tinctorius possesses beneficial effect on treatment of diabetes.

Continuous evaluation of research performance is an effective tool for financial and human resource allocation to promote knowledge production by academic institutions. The aim of this study was to evaluate the scientific performance of Isfahan University of Medical Sciences (IUMS) from April 2010 to April 2011 in the national medical research ranking. This cross sectional study was carried out through running advanced searches in the national, local and international information databases and other websites. Then the data were analyzed in order to demonstrate IUMS scientific production and research status at a national level. From April 2010 to April 2011, about 9% of total Iranian medical articles, 6% of total Iranian ISI indexed articles in medical science and 12% of Iranian PubMed indexed articles affiliated to Isfahan University of Medical Sciences. Although Isfahan University of Medical Sciences stood at the third place in the annual national research ranking, but it was first in the scientific growth among Iranian medical universities. The study indicated that Isfahan University of Medical Sciences witnessed striking improvement in scientific productivity, research performance and national research grade during 2010-2011

For many years, anticoagulants have been used in the emergent treatment of patients with acute ischemic stroke. Anticoagulants are prescribed in an effort to prevent first or recurrent stroke, especially among patients with cardioembolism due to arterial fibrillation and large-artery atherosclerotic disease. Despite the widespread use, efficacy and safety of anticoagulants are controversial. Experts have given a broad spectrum of opinions. Surveys of practitioners have also demonstrated a lack of consensus on the use of anticoagulants for ischemic stroke. The uncertainty is due, in large part, to the lack of definitive clinical data. A review by the panel of the Stroke Council of the American Heart Association found no strong evidence for effectiveness of anticoagulants in treating acute ischemic stroke. Several clinical trials have suggested that utility of emergent anticoagulation has no significant effect in improving clinical outcomes for patients with acute ischemic stroke. In the present review, we have attempted to provide a framework for the emergent use of anticoagulants in acute ischemic stroke patients.

This study was undertaken to determine the prevalence of psychological stress among Isfahan medical sciences students. Cross-sectional, questionnaire-based survey was carried out among the 387 medical sciences students (medicine, pharmacy, and dentistry) of Isfahan, Iran through census. In academic year 2010–2011, Kessler-10 questionnaire was given to the students a month before semester examinations. Scores ≥20 were considered as indicative of positive stress symptoms. The overall prevalence of stress among medical sciences students was found to be about 76.1%. The prevalence of stress among medicine students was 22.7% mild, 23% moderate and 21.4% severe while 32.8% showed no stress. The prevalence of stress among pharmacy students was 22.22%, 22.22%, 26.19%, and 29.36% mild, moderate, and severe and no stress, respectively. The prevalence of stress among dentistry students was 25% mild, 27% moderate, and 10% severe while 37.5% showed no stress. The prevalence of stress was higher (70.6%) in pharmacy students when compared with medicine (66.1%) and dentistry (62.5%) students. The odds of student having stress is higher in dentistry students (OR: 1.44, P= 0.33), where as the odds are decreasing in pharmacy student (OR: 1.16, P= 0.66). There is no statistically significant association between gender, ages, and term and having stress symptoms. The high level of stress necessitates interventions like social and psychological support to improve the student’s well-being. A prospective study is needed to study the association of psychological morbidity with sources of stress and coping strategies.

Ectodermal dysplasia (ED) is a hereditary syndrome which affects the ectodermal layer and thus appendages originating from this layer like hair, teeth, and sweet glands. The hairs of the scalp and eyebrows are sparse and broken and sometimes absent in ED patients. We reported a case of ED who underwent successful hair transplantation for her eyebrows.Case Report: A 17-year-old female with previously known Ed referred to our clinic because of absent lateral eyebrow hairs. She also had hypodontia (she lacked incisor teeth) and hypohydrosis. We designed a hair transplantation procedure for the lateral third of her eyebrows with follicular unit transplantation (FUT) method. We selected the occipital part of the scalp as the donor. After 6 months and 2 years follow-up, the patient was quite satisfied with her appearance. The facial appearance of ED patients could be corrected well enough by hair transplantation methods.

Gallstone ileus is an uncommon complication of gall stones associated with potentially serious morbidity and mortality.We reported a 60-year-old male case who presented with renal failure and pain in right hypochondriac region. He also had a history of brain infarcts along with diabetes which is an additional factor for mortality.On Computed Tomography of the abdomen, he was diagnosed to have an obstruction in the distal part of the ileum and air in the gall bladder. Its diagnosis is difficult and especially treatment is challengeable in septicemia and surgery remains the mainstay in management. In follow up of 1 month patient is doing well.