مجله دانشکده پزشکی اصفهان
پیاپی 202 (هفته چهارم مهر ماه 1391)

First- and second-degree heart blocks are partly common rhythm disorders in thalassemic patients. However، complete heart block is a very rare complication of iron overload cardiomyopathy. Case Report: A 15-year-old boy with major β-thalassemia was admitted to our emergency unit with dyspnea and cough. The electrocardiogram showed complete heart block with junctional escape rhythm. Interestingly، his previous electrocardiogram that had been taken two months earlier showed some premature ventricular contractions and second degree، Mobitz I (Wenckebach) heart block. After improvement of dyspnea and controlling blood pressure in the normal range، a dual-chamber permanent pacemaker was implanted for the patient. Since his symptoms improved، he was discharged. However، he died 24 days after discharge. We presented a rare case of complete heart block after a second-degree (Mobitz I) heart block that was due to severe iron overload cardiomyopathy.

Prompt treatment of patients with multiple sclerosis would decrease the burden of this chronic disease. In this study، the efficacy of acupuncture in the treatment of chronic pain and fatigue in the patients with multiple sclerosis was evaluated. In this before-after study، 49 patients with multiple sclerosis who referred to traditional medicine clinics were recruited. The patients underwent acupuncture treatment bi-weekly for six months and pain and fatigue scores were calculated according to Oswestry Disability Index (ODI). The initial and final scores were then compared. The mean ODI scores were 41. 16 ± 3. 74 and 33. 59 ± 5. 14 before and after the treatment، respectively (P < 0. 0001). In addition، all ten variables contributing to ODI were decreased significantly after treatment with acupuncture (P < 0. 0001). Fatigue and chronic pain are subjective، multifactorial symptoms in patients with multiple sclerosis. Therefore، further studies with larger sample size and adjustment for Expanded Disability Status Scale (EDSS) scores are required to approve the obtained results. Acupuncture can then be suggested as a complementary method in patients with multiple sclerosis.

The aim of this research was to examine the effects of green tea supplementation on plasma total antioxidant capacity (TAC) and lipid peroxidation in young women after a resistance training session. Forty young women were randomly divided into four equal groups of green tea supplementation، green tea supplementation and resistance training، resistance training، and control. After supplementation period (14 days، 600 ml/day)، subjects performed an intensive resistance training session with 85% of one repetition maximum (1RM). Blood samples were taken at baseline، at the end of supplementation period، and after the exercise protocol. TAC and malondialdehyde (MDA) were measured using Ferric Reducing Antioxidant Power (FRAP) assay and thiobarbituric acid (TBA)، respectively. After 14 days، the TAC significantly increased (P < 0. 001) and MDA significantly decreased (P < 0. 01) in the green tea supplementation and resistance training group. However، intensive resistance training decreased TAC (P < 0. 04) and increased MDA (P < 0. 01) significantly in the resistance training group. Our results suggested that green tea supplementation will be useful for improving TAC and thereby inhibiting exercise-induced lipid peroxidation after intensive resistance training.

In the absence of treatment with conservative therapy for thoracic outlet syndrome (TOS)، surgery is performed to remove the operating pressure. This study evaluated the characteristics، complications، and outcomes two surgical procedures in patients with thoracic outlet syndrome.

This retrospective، descriptive، analytical study was conducted in Alzahra Hospital (Isfahan، Iran) during 2001-10. Of approximately 120 patients with TOS who had surgery during the mentioned period، 47 persons were allocated to two groups. In group 1 (n = 16)، the tension was constant and dynamic and the first rib was completely removed at once. In group 2 (n = 31)، the tension was altering and the rib was chopped and removed. Symptoms، complications، and outcomes of surgery were extracted from patient records. The collected data was then compared between the two groups.

Males and females constituted 23. 4% and 76. 6% of the studied population، respectively. The mean age was 38 years. Before the surgery، signs and symptoms were in the left side in 21 patients (44. 7%)، in the right side in 18 patients (38. 3%)، and in both sides in 8 patients (17%). Postoperative discomfort was reported by 35 persons (74. 5%). On the other hand، 12 patients (25. 5%) did not have discomfort after surgery. While 14 patients (29. 8%) were completely satisfied with the outcome and 19 (40. 4%) were satisfied despite having mild symptoms، 13 patients (27. 7%) were dissatisfied. In addition، the two groups were not significantly different in terms of recovery rate and postoperative complications. In group 1، 75% of patients had postoperative discomfort (mild to severe) but 62. 5% considered the surgery as excellent or good. In group 2، 74. 19% of patients had postoperative discomfort (mild to severe) but 80. 58% of them considered surgery to be excellent or good.

Although recovery rate after surgery was not significantly different between the two groups، transaxillary procedure seems to be safer due to less harm to vascular and nervous elements and gradual removal of the rib.

Kefir is a probiotic organism that produces jellylike grains as during growth. The grains contain both lactic acid bacteria and yeasts. These microorganisms are surrounded by a polysaccharide matrix named kefiran. Kefiran is a water-soluble branched glucogalactan which has been reported to have antibacterial، antimycotic، and antitumor activity. Kefir grains were constantly cultured in pasteurized milk. They were then harvested and washed with 100°C and 50°C distilled water. The mixture was centrifuged and the polysaccharide in the supernatant was precipitated by addition of cold ethanol. The precipitate was finally dissolved in hot distilled water and lyophilized. The samples were tested for estimation of proteins by Bradford method. Antimicrobial activities of kefiran extract were evaluated using the well diffusion method with several indicator strains. The effects of proteolytic enzymes on the antimicrobial activity of the extract were also determined. Both extracts (purified at 100°C and 50°C) had inhibitory effects on the growth of indicator bacteria. Although Bradford test showed the existence of proteins in the extract، the antimicrobial effects of the extract were resistant to proteolytic enzymes. Antimicrobial activity of kefiran extract may depend on its protein component.