مجله دانشکده پزشکی اصفهان
پیاپی 197 (هفته سوم شهریور 1391)

Vitamin D and its analogues are a part of preventing rapid bone loss after kidney transplantation. According to difference in cost of active and inactive forms of vitamin D3، we decided to compare the effects of these drugs on bone mineral density (BMD) of kidney transplant patients. In a randomized، controlled، clinical trial، 37 kidney transplant patients were treated with either vitamin D-calcium or calcitriol plus calcium carbonate for one year. Drug dose in both groups was changing according to serum calcium and 24 h urine calcium. BMD was measured before and one year after transplantation. Serum calcium and phosphorus were checked monthly. Serum parathyroid hormone (PTH) and alkaline phosphatase (ALKP) levels were checked before transplantation and every six months. Glomerular filtration rate (GFR) and 24 h urine calcium were measured every three months. In the vitamin D group، T and Z scores in lumbar spine and hip were increased. However، in the calcitriol group، the scores decreased in lumbar spine and increased hip. The increment in Z scores of lumbar spine in vitamin D group and the difference between Z scores of the two groups were significant (P = 0. 03). In both groups، PTH and ALKP decreased significantly. In the calcitriol group، 24 h urine calcium increased significantly (P = 0. 01). Compared to calcitriol، vitamin D-calcium is cheaper and more effective on BMD. Therefore، we recommend the use of vitamin D-calcium in kidney transplant patients.

One way to achieve a healthy society is population control and providing effective contraceptive methods. Hormonal contraceptives are the most effective method of birth control. However، their satisfaction rate is affected by many factors. We aimed to study the effective factors on satisfaction from contraceptives including Depot Medroxyprogesterone Acetate (DMPA)، Cyclofem، and low dose (LD) in women who referred to health centers in Isfahan، Iran. This descriptive comparative study was conducted on 150 women who were selected using non-probability sampling during April-October 2010. The subjects were using receive DMPA، Cyclofem، or LD pills for the first time or had used them for less than three months. Data was collected through face to face interviews using a standard questionnaire called ORTHO Birth Control Satisfaction Assessment Tool (BC-SAT) three months after consumption. The data was analyzed using descriptive and inferential statistics. Cyclofem gained the highest mean satisfaction score. There were no significant differences in mean total satisfaction scores assigned by three groups. Although the three groups had significant differences in mean satisfaction scores in ease of use، menstrual impact، and compliance/adherence، no statistically significant differences were observed in lifestyle impact، assurance/confidence، side effects، future fertility concerns، and overall satisfaction. Satisfaction from hormonal contraceptives is influenced by many factors such as knowledge، information، lifestyle، religion، side effects، understanding of individual and others، anxiety، and concerns. On the other hand، satisfaction will in turn influence on the attitudes of individuals.

The most common drug poisoning in Iran، especially in Tehran، is poisoning with tramadol which is a synthetic analgesic. Like poisoning with other opioids، poisoning with tramadol is commonly treated using naloxone. As documented in poisoning references، seizure is a serious and dangerous side effect of this poisoning. The aim of this study was to compare the prevalence of seizure between patients with tramadol overdose who received or did not receive naloxone in Imam Khomeini Hospital، Ardabil، Iran. In this cross-sectional، descriptive study during 2007-10 data about 122 patients with tramadol overdose in Imam Khomeini Hospital was collected using a questionnaire. The collected data was analyzed in SPSS. Males constituted 89. 3% of the participants (n = 109). The mean age of subjects was27. 0 ± 7. 2 years. Seizure was observed in 21 persons (17. 2%). No significant relationship existed between seizure and sex، age، and history of addiction to tramadol and other opioids (P > 0. 05). Among the 60 subjects who received naloxone، 28. 3% had seizure. The prevalence of seizure in persons who did not receive naloxone was 11. 2%. The highest prevalence of seizure caused by naloxone was seen during the first 1. 5 hours after injection. The lowest dose of naloxone that caused seizure was 1000 mg. Seizure caused by tramadol had no relationship with sex، age، and history of addiction to tramadol or other opioids. Moreover، seizure occurrence is rare in therapeutic dosage. Using naloxone in treatment of tramadol overdose increases the risk of seizure.

Helicobacter pylori is the main cause of various gastroduodenal diseases. The consequences of H. pylori infection may be related to differences in genotype or expression of virulence factors of bacteria as well as host and environmental factors. The aim of this study was to assess cagA/vacA genotypes of H. pylori strains isolated from patients with gastric disorder.

In this cross-sectional study، gastric biopsy specimens were taken from 200 patients with gastroduodenal diseases. The specimens were processed for DNA extraction. The presence of ureC، vacA subtypes، and cagA genes were tested by polymerase chain reaction (PCR). Statistical analyses were performed to investigate the relationships between genotypes and gastric disorders.

Overall، 164 H. pylori strains were isolated from 200 specimens. The frequency of the vacA alleles، sa1/m1a، s1a/m1b، s1a/m2، s1b/m1a، s1b/m1b، s1b/m2، s1c/m1a، s1c/m1b، s1c/m2، s2/m1a، s2/m1b، and s2/m2 were 16. 60%، 4. 30%، 28. 04%، 3. 70%، 2. 50%، 6. 10%، 7. 40%، 2. 50%، 11. 00%، 3. 70%، 0%، and 13. 50%، respectively. The prevalence of cagA gene was 92%. Different alleles of s1/m1 had the strongest relationship with gastric disorders.

Based on our findings، it seems that the presence of cagA gene with vacA s1 genotypes is associated with severe gastric disorders. However، none of studied variables can be considered as an independent marker for the onset of disease.

The existence of cancer stem cells (CSCs) has been already established in several hematopoietic and non-hematopoietic cancers. Chemoresistance has also been demonstrated as a major cause of cancer treatment failure. Although chemotherapy kills most cells in a tumor، it is believed to leave CSCs behind which might be an important mechanism of resistance and thereby cancer treatment failure. The quiescent nature and existence of adenosine triphosphate (ATP) -binding cassette (ABC) drug transporters in CSCs have been suggested to protect them from chemotherapeutic agents. Gaining a better insight into the mechanisms of CSCs chemoresistance might therefore lead to new therapeutic targets and development of better anticancer strategies.