مجله دانشگاه علوم پزشکی اراک
سال پانزدهم شماره 8 (پیاپی 67، دی 1391)

The presence of oxidant agents yields higher levels of free radical reaction products in erythrocyte membrane proteins and serum proteins. The aim of this study is to investigate the oxidative modifications of recombinant human coagulation factor VIII (rHFVIII) by spectrophotometric analysis. In this experimental study, rHFVIII was incubated aerobically with vitamin C and ferro ions in metal catalyzed oxidation (MCO) system for 4 to 28 hr. Carbonyl assay was used as an index of protein oxidation. For this purpose, 2,4dinitrophenyl hydrazine (DNPH) was used. Reaction of this reagent with carbonyl groups produces dinitrophenylhydrazone derivatives that their concentration was estimated by spectrophotometry. Carbonyl groups in rHFVIII changed in the presence of vitamin C and ferro ions. Dose-dependent effects of vitamin C showed a decrease in carbonyl groups of rHFVIII whileferro ions increased oxidation and carbonyl group formation in this protein. These findings indicate that changes in carbonyl groups in rHFVIII are related to the generation of reactive oxygen species. Also, antioxidant mechanisms are activated in a dose- and time-dependent manner.

Immune thrombocytopenic purpurais an acquired disorder. Conventional treatment of immune thrombocytopenic purpuraincludes prednisolone (1mg/kg/day). Customarily, steroidsareadministered for about 3-6 weeks; however,steroids have several side effects. The aim of this study was to compare theefficacy of two and three-week prednisolone therapy in patients with immune thrombocytopenic purpura In this randomized clinical trial, 66 patients with confirmed immune thrombocytopenic purpurawho had referred to KhansariHospital, Arak, were randomly selected and administered prednisolone (1mg/kg/day) for two and three weeks alternatively. Patients’ platelet count and complications associated with the treatment (diabetes and hypertension) were compared. At the end of the treatment course, there was not a significant difference in mean platelet count between the two groups (p=0.748). Side effects in two and three-week protocols were 15.2% and 18.2%, respectively; however, distribution of the complications (side effect) in the two groups was equal (p=0.9). Considering the absence of significant differencesin mean platelet count between the two groups at the end of the two treatment protocols and the higherpercentageof side effects in the patients that had received the three-week prednisolone therapy protocol, it seems that the two-week course of immune thrombocytopenic purpuratreatment is as effective as the three-week protocol.

Genetic variability of influenza viruses causes new epidemics worldwide annually. Development of a new vaccine for prophylaxis of influenza virus has been amajor objective in recent years. The aim of this study was to construct a recombinant baculoviruscapable of expressing the two surficial antigenic glycoproteins, hemagglutininand neuraminidase, as well as matrix proteinsof swine influenza (H1N1) simultaneously and independently. In this experimental study, first, a triplet cassette providing simultaneous and independent expression of target proteins was designed and subjected to synthesis. It was then cloned into pFastBac1 donor plasmid. Competent E.ColiDH10Bac cells were transformed by donor clone and the recombinant bacmids were produced following homologous transposition. This construction was verified by PCR and then transfected into Sf9 insect cells to package new recombinant baculoviruses. Restriction map of pFastBacI HNM1 donor plasmid confirmed the fidelity of the clone. The results of PCR done on the recombinant bacmidas template indicated that a proper homologous recombination has occurred between pFastBacI HNM1 donor plasmid and the bacmid in E.ColiDH10Bac host cells. Protein analysis of the infected Sf9 cells showed that all target proteins were efficiently expressed at the same time. The recombinant baculovirus constructed in this studypossesses proper characteristics to produce swine influenza virus-like particles in Sf9 cells.

Inmedical practice, learning the correct method of CPR and its practice and continuous training are of great importance. The aim of this study was to determine the effects of mental practice on learning basic CPR operations in undergraduate anesthesiology students studying at Arak University of Medical Sciences. This educational trial was carried out on 46 anesthesiology students at Arak University of Medical Sciences that were divided into intervention (mental and practical training) and control (practice alone)groups. Then they were assessed through accuracy and speed checklist designed by two instructors blind to the presence of training. Data were analyzed by t-test and Chi-square using SPSS software. The mean scores of speed in intervention and control groups were 2.50.26 and 3.160.33, respectively, which showed a significant difference (p=0.001). The mean scores of the accuracy of students’ performance in case and control groups were 4.330.7 and 3.40.62, respectively, which indicated asignificant difference between them (p=0.001). Theopinions of the students in the mental practice group (90%) suggested the positive effects of mental practice on their performance. This study showed that mental practice increases students’ performance. Hence, for achieving better results in clinical practice, the application of both physical and mental exercisesby the teachers is suggested.

Poly chlorinated biphenyls (PBCs) are the group of organic chemical materials that have a great chemical stability. These compounds are hazardous pollutants which pose various occupational and environmental problems. This study was conducted to determine the effect of microwave rays, hydrogen peroxide, Tio2 catalyst, and ethanol on the decomposition of PBCs. In this experimental study, a vessel reactor (250ml volume)that was connected with a tube connector to thecondensor system was used. A microwave oven with a fixed frequency of 2450 MHZ was used to provide microwave irradiation and ray powers used at 540, 720 and 900w. pH and temperature of the samples were continuously monitored and the experiments were repeated three times. Askarel oils were analyzed by GC-ECD. The mean of total PCBS degradation at 540, 720, and 900w was 83.88±1.63, 89.27±2.44, and 95.98±0.81%, respectively. The mean of total PCBS degradation in terms of ratio to solvent with oil transformer in 1:1, 2:1, and 3:1 was 53.8±3.26, 79.04±1.24, and 95.08±1.69%, respectively. The mean of total PCBS degradation in terms of not using H2o2/Tio2 and using H2O2 (20%) and 0.05, 0.1, 0.15, and 0.2 g of Tio2 concurrently was 71.47±0.81, 87.9±2.16, 89.48±1.69, 91.7±1.24, and 93.07±3.09 %, respectively. Using microwave irradiation in the presence of H2O2 oxidant and Tio2 catalyst leads to the reduction of PCBS.

Cataract is the leading cause of blindness and visual impairment. This study was performed to compare effects of two different incision types in cataract surgery on dry eye symptoms and diagnostic test values. In this clinical trial, 300 patients with cataract requiring phacoemulsification were studied. The patients were randomly divided into two operative method groups: limbal and clear corneal (anterior to the vascular arcade) incision. A complete set of ophthalmic examinations and tear related tests were done for all of the patients before surgery and one week and one month after surgery. The collected data were analyzed using SPSS and EPI-Info softwares. Overall, 149 men and 151 women were enrolled in this study. On the first postoperative week, the means of symptoms, and TBUT and TMH values in both groups significantly decreased compared with the preoperative values. These values returned to the preoperative levels one month postoperatively which werein contrast to the changes of debri, PEE, corneal and conjnnctival staining. There were statistically significant differences between the results of pre- and post-operative symptoms, PEE, debri, TBUT, conjunctival and corneal staining. Except for TBUT, the results of these tests were not statistically different according to incision location. Phacoemulsification cataract surgery affects dry eye symptoms and diagnostic test values. In addition, except for TBUT, the location of incision had no effect on other test results and symptoms.

Diabetes mellitus is one of the most important health problems in the world. B-cells are susceptible to damage by free radicals. Noticing the mechanism of cupping, this study was carried out to evaluate the effect of cupping together with drug therapy on biochemical factors and oxidative stress. In this clinical trial, 5ml of intravenous blood was obtained from diabetic patients in beginning and late stages of this disease who referred to a diabetes center. In addition to receiving metformin and glibenclamide, the patients underwent cupping after one month and were analyzed one month later. Blood samples obtained one month before and after the treatment were compared in terms of diabetes and oxidative stress indicators. To evaluate lipid peroxidation, TBA method was used and FRAPS method was employed to measure total serum antioxidants and blood factors by Pars Azmon kit. Hemoglobin A1C, fasting blood sugar, blood sugar 2 hours after fasting, triglycerides, cholesterol, and low-density lipoprotein as well as high-density lipoprotein showed significant increases. Aspartate transferase in diabetic patients significantly decreased after phlebotomy (p<0.05). Cupping improves blood factors in diabetic patients and it is recommended to be used as a complementary treatment in patients with diabetes type II.

Psoriasis is a common chronic skin disease which usually appears as white and silvery spots on the skin. The purpose of this study is to investigate the effect of berberine on patients with psoriasis. This double-blind clinical trial was conducted on 60 psoriasis patients who referred to Imam Khomeini Hospital, Ahvoaz, between July and December 2011. The patients were randomly divided into two equal groups that applied berberine and placebo to the treatment of their lesions twice a day. Lesions severity rate in the patients was assessed 7 times using a Psoriasis Area Severity Index (PASI). Data were analyzed by ANOVA with repeated measurements and Chi-square using SPSS software. After 6 months, severity of lesions showed a significant decrease in the group receiving the berberine cream compared with the placebo group so that the mean PASI score of the group receiving berberine decreased from 3.99 to 2.11 while in the placebo group this decreased from 3.98 to 3.71. Mean difference in PASI score was not significant before receiving the treatment till the third month in berberine and placebo groups, but in the fourth to sixth months it was statistically significant (p=0.013). Berberine cream was more effective than the placebo in reduction of skin lesions of psoriasis patients. Therefore, it is recommended that plant-based drugs, like berberine, be used more besides the main medications of patients.

Avicennia marina (Forssk.) Vireh. or gray mangrove tree, belonging to the family Avicenniaceae, has long been used as a remedy to treat ulcers and skin diseases. In the present study, the antimutagenic activities of young and mature leaf extracts of Avicennia marina against the mutated bacterium Salmonella typhimurium TA100 were investigated. In this experimental study, the bacterial strain was checked for the intended genotypes. Leaves were isolated, dried, and chopped finely using a blender and they were extracted with 80% ethanol or water using a Soxhlet extractor. Metabolic activation was prepared from male rat homogenized liver. Antimutagenic effect of the extracts was tested using Ames test in the presence of a mutagen. The number of mutant colonies decreased in the presence of both ethanol and water extracts with (+S9) and without (-S9) metabolic activation. The ethanolic extract exhibited a higher antimutagenic activity than the water extract. There were no inter-assay differences in the presence and absence of the S9 mixture. The highest (71%) and the lowest (24%) inhibition rates of Salmonella typhimurium TA100 bacterial growth were observed with the ethanolic extract of mature leaves from Bordekhon region and the aqueous extract of young leaves from Assaluyeh region, respectively. The findings of the present study suggest that Avicennia marina (Forssk) Vireh. leaf extracts may contain bioactive compounds that can inhibit mutation, and that biotic and/or abiotic stress might have an effect on the antimutagenic potential of these leaf extracts in the two regions.

Influenza type A virus is one of the most important viral agents in human respiratory diseases. The genetic variability of the influenza viruses leads to the incidence of new epidemics worldwide. Hence, there is a growing need for rapid and effective new methods capable of detection and differentiation of influenza virus circulating strains. This study was done to develop a method for rapid differentiation of the subtypes of influenza type A virus. In this experimental study, reverse-transcription and polymerase chain reaction (RT-PCR) were performed using a primer set based on M gene of H1N1, H3N2, H5N1, and H9N2 influenza subtypes. Then the amplified fragments were subjected to digestion using subtype specific restriction endonuclease enzymes. The results of PCR reaction showed that the primer pair of the M gene was specific and capable of amplifying all influenza subtypes understudy. Also, different restriction fragment length polymorphism patterns (RFLP) were generated using enzyme digestion reaction on the amplified segment of M gene. RT-PCR and RFLP analysis of the M gene can be employed as a useful method for differentiating influenza virus subtypes.

There are various factors effective in the appearance of metastasis that have been surveyed and recognized in different studies. However, the appearance of metastasis by determination of these factors cannot be predicted. One of the models used for the analysis of recurrent data and consideration of heterogeneity between patients is frailty model.

In this survival study, 133 women with breast cancer were treated in Fayazbakhsh Hospital, Tehran, during 2005-2007. All patients were followed until April 2011. Frailty model was employed for the analysis of data and gamma frailty distribution was assumed with the average one and Ө variance. All statistical methods were run in R software.

Disease-free survival rates for 3 and 5 years were 0.78 and 0.72, respectively. During the follow-up period, the risk of metastasis was estimated to be 43%. Two factors were identified as the prognostic factors in the appearance of metastasis: tumor malignancy grade and the number of positive lymph nodes. Frailty variance was 4.27 (P=0.001).

The significant variance of frailty component in the model indicates that patients who have identical explanatory variables face different levels of risk experiencing metastasis. Also, specific characteristics of the patients are important in the incidence of metastasis.

Gastric perforation is a rare occurrence in newborns with unknown etiology and risk factors. This study reports a case of acute gastric perforation in a preterm neonate and its risk factors. Case: The patient was a preterm neonate (26 weeks) with NG tube feeding with GI bleeding. The patient underwent abdominal surgery and gastric perforation in the anterior wall was reported. The risk factors for gastric perforation in this neonate were probably prematurity, low birth-weight, N-CPAP, and frequent insertion of NG tube. It can be concluded from this study that identification of risk factors and reducing or eliminating them are vital to the prevention of this complication.