مجله دانشکده پزشکی اصفهان
پیاپی 215 (هفته اول بهمن 1391)

Knowing the symptoms of heart failure and the way they are different among men and women can reduce decision making time in providing diagnostic and therapeutic measures. It can also improve the quality of the response. This study aimed to compare the type and severity of symptoms experienced by men and women with acute coronary syndromes. In this cross-sectional study, 175 patients admitted to coronary care and cardiac units of Imam Hossein Hospital (Shahroud, Iran) were evaluated. Data was collected via interviews and a checklist including demographic characteristics, symptoms, risk factors, disease history, and associated symptoms. Severity of subjective symptoms was measured through a visual analogue scale. Data was analyzed using chi-square test and independent t-tests. Out of 175 subjects with a final diagnosis of acute coronary syndrome, 100 subjects (57.1%) were women and 75 (42.9%) were men. Chest pain was significantly more common in men than in females (P = 0.004). Most patients (69.7%) reported pain in the central and upper regions of the chest. However, this symptom was significantly more prevalent among women than among men (P = 0.002). There were gender differences in some atypical symptoms but angina was similar. The mean scores of severity of pain, sweating, and palpitations were significantly higher in women. This study showed that symptoms of men and with acute coronary syndrome were somewhat different. Hence, excessive attention to typical symptoms of acute coronary syndrome can foreclose care in early stages.

Due to advantages of imaging techniques, they are used in most endoscopic procedures. They help magnify the anatomy of structures, detect anomalies easier, and facilitate airway manipulation. Imaging during intubation helps the operator and the assistant to synchronize their movements. Therefore, imaging techniques have become the method of choice in teaching. Fiber optic guided laryngoscope has been introduced as a novel device for performing and teaching intubation. This study aimed to evaluate this new method.

We evaluated 227 patients in two groups. Group A (n = 206) seemed to have normal airways and did not require difficult intubation. However, intubation in group B (n = 21) was predicted to be difficult.

External laryngeal manipulation (ELM) was required in 21 (10%) patients in group A. Only one intubation was not successful at the first try in this group. In group B, direct laryngoscopy was difficult due to the subjects’ anatomical conditions. All 21 cases in this group required ELM but were successfully intubated using the fiber optic guided laryngoscopy.

Improved harmony between the anesthesiologist and his/her assistant and short learning time make fiber optic guided laryngoscopy superior to conventional laryngoscopy.

Adenoviral keratoconjunctivitis is a prevalent form of eye infection which involves the conjunctiva and less commonly the cornea. The signs and symptoms of the disease are more often overlapped with other causes of conjunctivitis. In this study, we applied polymerase chain reaction (PCR) as a sensitive test for diagnosis of adenovirus to determine the prevalence, sensitivity, and specificity of each sign and symptom of adenoviral keratoconjunctivitis. This descriptive, analytic, cross-sectional study was conducted from September 2011 to September 2012 at Feiz Hospital of Ophthalmology and laboratory of virology, affiliated to Isfahan University of Medical Sciences, Iran. After obtaining ocular specimens from 195 patients with general signs and symptoms of conjunctivitis, their signs and symptoms were recorded. The specimens were tested by PCR to evaluate adenoviral etiology. Prevalence, sensitivity, and specificity of each sign or symptom was measured based on the findings of PCR. The ocular specimens were collected from 106 (55%) males and 87(45%) females with the mean age of 27.3 ± 7.1 years old. The prevalence of adenoviral keratoconjunctivitis was 11.4 %. There was no significant difference in signs and symptoms between patients with positive and negative adenoviral PCR test. The most sensitive (100%) sign and symptom were conjunctival hyperemia and sudden onset, respectively. The least sensitive (0%) sign and symptom were blepharospasm and membrane/pseudomembrane formation, respectively. The most specific (98.84%) and the least specific (1.16%) were blepharospasm and conjunctival hyperemia, respectively. Although many signs and symptoms accounted for adenoviral conjunctivitis, there was no hallmark for disease diagnosis. Conjunctival hyperemia is a sensitive criterion to diagnose adenoviral keratoconjunctivitis and there was no prevalent specific criterion for this purpose.

Quercetin is found in a wide range of food sources. Previous research has reported inconsistent findings about the effects of quercetin on inflammation and heart disease. Hence, the present study evaluated the effects of quercetin intake on blood pressure, lipid profile, and inflammatory biomarkers of patients with type 2 diabetes. This double-blind randomized clinical trial assessed 72 women for 10 weeks. Subjects were assigned to quercetin and placebo groups using permuted-block randomization with a block size of two. A 500 mg quercetin capsule was given to the quercetin group every day. Biochemical variables were measured at baseline and the end of the study and changes were compared using appropriate statistical methods. Quercetin intake decreased systolic blood pressure significantly (-8.8 ± 9.3 in the quercetin group vs. -3.5 ± 11.7 in the control group, P = 0.04). However, changes in diastolic blood pressure in two groups were not significantly different (P = 0.19). While high density lipoprotein cholesterol (HDL-c) was significantly decreased in both groups, there were no significant with group or intragroup differences in changes in total cholesterol, low density lipoprotein cholesterol (LDL-c), triglycerides (TG), and ratio of TG/HDL-c and LDL-c/HDL-c. Quercetin supplementation significantly reduced serum concentration of tumor necrosis factor alpha (TNFα) and interleukin-6 (IL-6) (P = 0.01 and P < 0.01, respectively). Nevertheless, the mean changes in serum levels of IL-6, TNFα, and high sensitivity C-reactive protein (hs-CRP) were not significantly different between groups. Although quercetin supplementation significantly reduced systolic blood pressure, it had no effects on other cardiovascular risk factors and inflammatory biomarkers. Considering the biological effects of quercetin in vitro, more studies with stronger design, larger sample size, and different doses of quercetin are warranted.

Patients under hemodialysis are exposed to remarkable volume of water. As dialysis water is in direct contact with patients’ blood, absence of regular disinfection of pipes will facilitate the transfer of the endotoxins produced by bacteria in water to the patient's body. Thus, regular control of dialysis system and water disinfectant equipment is compulsory. This study aimed at comparing relative frequency of positive culture for microorganisms in piped water before and after filtration, culture of water after passing from pipes, and culture of dialysis fluid before entering the dialysis filter in hemodialysis section of Alzahra Medical Center (Isfahan, Iran). During 2010 and 2012, an interventional study was performed in Alzahra Hospital. Samples were taken from piped water before and after filtration and from dialysis fluid before passing from membrane. The obtained samples were cultured in tryptic soy agar (TSA) and the isolated bacteria were then evaluated. Interventions included the disinfection of pipes used for transmission of water and replacement of pipes in hemodialysis section. Purified water was studied before and after passing the pipes. Dialysis fluid was also assessed before and after the intervention. Bacteria had grown in eight out of 14 samples (57%) before the intervention. In fact, five samples developed Escherichia coli, three had pseudomonas, and one had candida. However, after the intervention, only one out of 14 samples was found to have bacteria (alcaligenes) after filtration and before entering dialysis water pipes. According to the results of this study, the probability of bacterial growth is very high in filtration system of dialysis water. Regular disinfection and microbial sampling and culture are hence crucial.

Kelussia odoratissima Mozaffarian is an endemic plant which grows wildly in Iran. The plant is used as food supplement and medical herb in traditional medicine. Extracts and essential oil of the plant have been proved to possess anti-inflammatory, sedative, fibrinolytic, antacid, memory enhancer and antioxidant effects. Damage to deoxyribonucleic acid (DNA) has a very important role in mutagenesis, aging, and cancer. This study aimed to evaluate the protective effects of methanolic and aqueous extracts of K. odoratissima on DNA damage induced by methyl methanesulfonate (MMS). The comet assay method was selected to evaluate the antigenotoxicity as it is a fast, sensitive, inexpensive, and easy method to perform. Therefore, after incubation of different concentrations of extracts with liver hepatocellular cells (HepG2) for one hour, cells were exposed to MMS for an hour. Then, cell suspension was added to precoated normal agarose slides. After lysing the cells with lysis solution, electrophoresis method was used to assess DNA damage. Using comet score, tail length, percent of DNA in tail, and tail moment were measured. Concentrations of 5, 10, 50 µg/ml of aqueous extracts and 0.5, 1, 5 µg/ml of methanolic extracts of K. odoratissima significantly reduced MMS-induced damage to DNA of HepG2 cells. We observed the antigenotoxic or genoprotective effect of aqueous and methanolic extracts of K. odoratissima against DNA damage caused by MMS. Therefore, the use of K. odoratissima can probably prevent the complications of these damages.

Understanding the function of different kinds of neurons in the brain has been a priority in basic and clinical neuroscience for ages. Optogenetics provides the ability to use light to inhibit or activate specific neuron types within neural networks. It enhances the ability of neuroscientists to understand how neurons contribute to brain functions both in health and disease. Optogenetics is a technology that allows fast control of precisely defined events in biological systems from cells of a cell culture to very complex systems in freely moving animals. Optogenetic approaches deliver precise and fast optical control and open new landscapes for the study of biological processes within neural networks in vivo and in vitro. Experiments on conscious animals usually insert an optical fiber connected to a remote laser into the brain or employ an implanted light-emitting diode (LED) connected to a remote power source. Recently, a fully wireless system has been designed to allow long-term experiments on moving animals. The present study reviewed available optogenetic approaches.