نشریه پژوهش در پزشکی
سال سی و ششم شماره 3 (پیاپی 143، پاییز 1391)

Phenytoin is one of the oldest anti epileptic drugs; it may result in fetal abnormalities if taken during pregnancy. This study was designed to determine teratogenic effects of phenytoin on the development of skeleton and neural tube defects in mouse fetuses.. Forty small experimental pregnant mice (NMRI Type) were divided in to three experimental groups (I, II, III) and one control group. The experimental groups received phenytoin in doses of 60, 75 and 90 mg/kg/day and the control group received 0.2 ml normal saline intraperitoneally (ip) from the 6th day to 14th day of pregnancy. The mice were sacrificed on the 18th day of pregnancy and fetuses examined for skeletal abnormality. Alizarin red and Alcian blue stains were used to detect neural tube abnormalities. Data was analyzed with ANOVA and Tukey tests. In all three experimental groups (I-III) abnormalities were observed in the skeletal system, abnormalities primarily consisted of displacement and disruption in the shape of the limbs, rate of these anomalies was significantly different from the control group (p<0.05); also the rate of neural tube defects as spina bifida cystica was significantly higher in experimental group III as compared to the control group, (p<0.05). Findings of this study show that ingestion of phenytoin during pregnancy can induce neural tube defects and skeletal abnormalities in the mouse fetus.. Keywords: phenytoin, teratogen, neural tube defects, skeletal abnormalities.

Taking into account the resistance of cancer cells to chemical drugs and considering the various reports on the effects of plants from the genus Artemisia for the cure of various ailments and diseases, this investigation was undertaken to compare the cytotoxic effects of different plant organs collected from low and high altitudes. In this study the cytotoxicity of methanol extracts from the flower, leaf, stem and root of Artemisia absinthium collected from two different altitudes, on breast cancer cell line MCF7 and Human Embryonic Kidney cell line (HEK293) was evaluated. This research was performed experimentally. The breast cancer cell line MCF7 and normal cell line HEK293 were cultured in RPMI-1640 and DMEM media respectively supplemented with 10% Fetal Calf Serum (FCS). Plant materials were extracted by methanol solvent and the cellular toxicity measured using 3- (4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay at different concentrations (31.25, 62.5, 125, 250, 500 μg/ml). The cytotoxic effect of the methanol extract from different organs of A.absinthium at higher altitude was 20% - 30% higher as compared with lower altitude. Plant extracts obtained from the flowers and roots of this species at the higher altitude showed the highest and the lowest cytotoxicity on MCF7 with IC50 221 and >500 µg/ml respectively. The cytotoxicity of this species on normal HEK293 cells was 20% - 30% lower than the cancer cells. It appears that the A.absinthium plants growing at a higher altitude have a higher cytotoxic effect.

Weight loss and malnutrition are common among cancer patients. These two factors highly affect their survival and quality of life during treatment. Since cancer is becoming increasingly common in the world and in order to provide better treatment measures, it is important to identify and prevent its side effects. The present study has been conducted in 2010 on a sample of cancer patients in the Oncology Center of Shahid Beheshti University of Medical Sciences to determine the prevalence rates and factors associated with malnutrition. The PG-SGA standard questionnaire was administered to 416 cancer patients to evaluate their nutrition status. The frequency of each malnutrition stage was determined. Correlations and ANOVA tests were used to analyze the relationship between factors predisposing to weight loss. The prevalence of malnutrition among the patients was 53.1%; out of which 29.1% had moderate and 24% had severe malnutrition. The most common factors inducing nutritional symptoms were depression and anorexia; 35% of the patients had >5% weight loss in the last 1 mouth. The average PG-SGA score was 10.11 with 49 being the highest score. 46.1 percent of the patients scored over 9 (requiring critical nutrient intervention). Malnutrition has a high correlation with weight loss, limitation of activities, nutritional symptoms, and the cancer stage, but it has a low correlation with treatment and the pathologic type. Malnutrition has a high prevalence in Iranian cancer patients and has a close relationship with mortality, morbidity and treatment-related problems and also quality of life, so periodical assessments by PG-SGA are necessary to detect malnutrition in patients and provide appropriate nutritional intervention.

Coronary artery disease, (CAD) is an important risk for morbidity and mortality. Because of controversial reports about relation between high-sensitivity C-reactive protein (hs-CRP) level and the severity of coronary artery stenosis, this study was done in Taleghani Hospital. In this case-control study 85 patients with CAD undergoing coronary angiography were studied. Angiography findings were based on severity of disease according to the Gensini score: <10 was classified as mild, 10 to 50 as moderate and >50 as severe. Blood samples (1mL) were collected from each patient. After centrifugation in laboratory the level of hs-CRP were measured, and classified in three levels: <1mg/L, 1 to 3 and >3mg/L respectively as mild, moderate and significant elevation of hs-CRP. Correlation of these levels with the severity of CAD was analyzed with chi-square test. Out of 85 subjects, 64.7% were males; mean age 55.7±7.06 years. In 28.2% the hs-CRP level were <1 mg/L, in 27.1% between 1 and 3 mg/L and in 44.7% >3mg/L. Findings revealed significant elevation of hs-CRP level in patients with moderate and severe coronary artery stenosis (p<0.01). Findings of this study demonstrated correlation between serum hs-CRP level and severity of coronary artery stenosis.

The correlation between QT dispersion (QTd) and myocardial ischemia is controversial. The main purpose of current study was to investigate the relationship between QTd and the severity and extent of myocardial ischemia. In this cross sectional study, 100 patients with suspected coronary artery diseases (CAD) were studied. Based on the results of the myocardial scan (SPECT), patients were categorized as normal, or with mild, moderate and severe ischemia; QTd was measured in rest and stress as maximum difference between QT intervals in 12 lead ECG. As a final point, the correlation between rest and stress QTd and the severity and extent of ischemia (number of ischemic segments and summed ischemic score) were investigated, and also rest and stress QTd was compared between groups and normal value of 65 milli seconds (ms). Normal myocardium and mild, moderate and severe ischemia was observed in 58, 16, 20 and 6 percent of patients, respectively. Mean rest QTd of normal subjects and ischemic patients were 48.6±12.3 ms and 43.2±18.7 ms (0-130), respectively (p=0.052). Mean stress QTd of normal subjects (45.6±14 ms) was significantly lower than ischemic patients (65±23.2 ms) (p<0.001). Stress QTd was correlated positively with number of ischemic segments and summed ischemic scores in total patients. In normal subjects, stress and rest QTd were the same, but there was significantly increased stress QTd in ischemic patients. It seems that stress QTd is correlated with severity and extent of myocardial ischemia and is useful in clinical practice to investigate the ischemic lesions of the myocardium.

Several single nucleotide polymorphisms have been found in CYP1A1 gene and it was reported that C allele in T/C gene polymorphism is associated with lung cancer. Current study investigates interaction between cigarette factor and C/T polymorphism in the m1 locus. Present study is a case-control and retrospective study. T/C polymorphism in 112 patients with lung cancer and 120 healthy controls was genotyped using RFLP-PCR technique. Association of the polymorphism and initiation of cancer including cigarette risk factor was analyzed statistically. , Association was seen between patient and control groups in the distribution of gene polymorphism (P<0.0001). No significant difference was seen in distribution of gene polymorphism between the two patient groups (smokers and non-smokers) (P=0.098). Results of present study show individuals with C allele are susceptible to lung cancer independent of cigarette smoking factor in Isfahan population. However determining the role of C allele as a biological risk factor needs more investigation.

Changes in body weight are common in psychiatric patients. This study was done to investigate factors associated with weight changes in patients admitted in the psychiatric ward of Imam Hussein (AS) hospital. This was a cross-sectional study performed on 150 patients admitted to the psychiatric ward of Imam Hussein (AS) Hospital. Body weight of patients was documented on admission and after one month. Information about demographic characteristics, current diagnosis of patient, addiction, drugs, and housing, marital and economic status, history of diabetes, physical activity and sleep levels was collected through a self-administrated questionnaire. Independent t-test and correlation coefficient tests were utilized for data analysis. Mean age of the subjects was 29.36 years; with 35.3% males. Weight change was found to have significant relationship with the marital status, housing status, activity level, medical history and the following medications: clozapine, Alanzpyn, sertraline and tricyclic antidepressants (p < 0.05 in all instances). Anti- psychotic medications are not the sole triggers for changes in body weight; Pre-admission social and economic factors such as marital status, housing and medical history, also contribute to weight change in psychiatric patients.