نشریه پژوهش در پزشکی
سال سی و هفتم شماره 2 (پیاپی 146، تابستان 1392)

Reduced Nitric oxide (NO) synthesis has been reported in hypothyroidism. NO has many physiological and pathological roles. The purpose of this study was to determine NO metabolites، nitrate and nitrite (NOx)، levels in serum and tissues of heart، brain، cerebellum and aorta of rats with fetal hypothyroidism.. Hypothyroidism was induced in female rats using 6-n-propylthiouracil in drinking water from beginning to the end of gestation. Male offsprings of the control and experimental groups (with induced hypothyroidism) were kept under observation until adulthood and divided into four groups (n=9 in each group): control and experimental groups who were administered L-arginine (2%) and control and experimental groups without L-arginine. NOx concentrations in serum and tissue samples were analyzed using Griess method. NOx concentrations in the heart، brain، cerebellum and aortic tissue of the experimental group were significantly lower than the control group. After 1 week of L-arginine administration، NOx concentrations in the heart، brain، cerebellum and serum decreased in the control group while in aortic and liver tissue it was immeasurable. In the rats with fetal hypothyroidism NOx concentrations decreased in serum and aorta but showed a significant increase in the cerebellar tissue. NOx metabolism in hypothyroidism is different from controls and thyroid hormones have an effect on NOx metabolism. Increasing extracellular L-arginine concentration alters NOx concentration in serum and tissues.

Heat shock proteins، (Hsps) are used as adjuvants in vaccines; these proteins induce the inflammatory cytokines and the maturation of monocyte MQ to dendritic cells. This study was done to determine the effect of Hsp90 on the immunogenicity of HbSAg in BalbC mice. In this experimental study we injected Hsp90 β subunit together with HbsAg to 30 balbC mice. After one and two weeks the humoral and cellular systems of these animals and their controls were studied by ELISA. There were significant rise in serum total IgG and IgG2a in the experimental group as compared to controls. Hsp90 also caused an initial increase and subsequently a significant fall in the level of IL-4. Hsp90 β subunit can be considered as a proper adjuvant in the formulation of hepatitis B vaccine. In future we should test its protective effect on BalbC mice.

Resistance of Helicobacter pylori to different antibiotics leads to recurrent infection which is an important risk factor for peptic ulcer disease and gastric cancer. This study was done to determine the effect of cinnamon on eradication of Helicobacter pylori. After taking biopsies from patients with dyspepsia، 60 patients infected with the Helicobacter pylori were selected. Samples were transported to the laboratory، cultured on Brucella agar containing 10% horse serum، vancomycin، polymyxin، trimethoprim and amphoteripcin and incubated at 37 ° C for 5-7 days under microaerophilic conditions. Grown colonies were identified by using standard microbiological and biochemical tests. To extract cinnamon oil، we obtained the concentrate from bark of Cinnamon trees by Clevenger distillation apparatus. Antibiotic susceptibility of Helicobacter pylori to metronidazole، amoxicillin، clarithromycin، tetracycline and disks impregnated with extracts of Cinnamon was determined by disk diffusion method according to the CLSI guidelines. Sensitivity of Helicobacter pylori to different agents was as follows: clarithromycin 76%، tetracycline 62%، amoxicillin and metronidazole 100% and Cinnamon oil 100%. Cinnamon plant can be effective in eradicating Helicobacter pylori.

Parkinson''s disease is a disorder of the central nervous system in adults. It is characterized by slowly progressive muscle stiffness، tremor and loss of motor skills. When certain areas of the brain lose their ability to produce dopamine، this disorder occurs. Selenium is a trace element that has antioxidant properties and regulates dopamine levels in the body; it is an essential element for many physiological functions. The aim of this study was to compare the serum selenium concentration in Parkinson’s disease and healthy cohorts. In this case-control study، the serum level of selenium in patients with Parkinson’s disease and healthy cohorts was determined by atomic absorption spectrometry. Data were analyzed using MATLAB software version 6. 5. The result of this study demonstrated that there is significant difference between the serum level of selenium in patients with Parkinson''s disease and healthy individuals. Serum levels of selenium were 57 ± 13 μg/l in patients versus 93 ± 18 μg/l in healthy individuals; serum selenium levels in patients was 63% less than controls (P<0. 000). Selenium supplementation may help to eliminate the symptoms of Parkinson’s disease.

Using dietary supplements depends on age، gender، marital status and other factors. The present community-based study was aimed to investigate the factors affecting dietary supplement consumption amongst people residing in south of Tehran. Through a cross-sectional study using convenient sampling، 708 records of individuals referred to nutritional centers in south of Tehran between 2006 and 2010 were examined. A predesigned checklist with items relevant to dietary supplement consumption was used to document the necessary information. Data was analyzed using Chi-square test and logistic regression. There was a significant relationship between dietary supplement consumption and age، gender and marital status (p<0. 05)، but not with body mass index (p<0. 05). The frequency of dietary supplement consumption for 19 to 35 years age group، women and married people was significantly higher. Eventually، after adjusting confounding factors، marital status still remained as the most significant factor affecting dietary supplement consumption. Focusing on dietary supplement consumption in target groups including youngsters، men and singles living in southern Tehran is recommended.

Addiction affects all aspects of life including the spiritual status of addicts. Some studies have reported improvement in the quality of life in addicts treated with Methadone. The purpose of this study was to survey the role of methadone on spiritual health of addicts.

This historical cohort study was done on two groups of addicts. Case group consisted of patients on methadone and addicted patients who had not received methadone were placed in the control group; effort was made to match the individuals in the control group as much as possible with the case group. Two components of spiritual health (beliefs about existence and religion) were tested by means of a standard test consisting of 20 indicators with Likert scale and 7 choices. Analysis was done by Mann Whitney test.

Test was carried on 250 cases and 250 controls. Score in case group was 6.01±0.49 with P Value 0.003 and in control group it was 2.72±0.46 with P Value 0.002.

It seems that methadone can cause improvement in spiritual health of addicts.

Meningioma is the most common CNS tumor; association of this tumor with specific markers P53، Ki67 has been reported in some studies. This study was done with the aim of determining the frequency of these markers in patients presenting with meningioma in a teaching hospital in Tehran. This cross-sectional study was done on samples obtained from all patients operated for meningioma in Shohadae Tajrish Hospital from 1996 to 2011. Meningiomas were graded in accordance with the WHO grading system. This method was performed by tissue microarray on paraffin embedded blocks of the samples; several pin-size samples were placed on a single glass slide and immune-histo-chemistry study was done for Ki67 and P53 markers. Study done on 89 paraffin embedded blocks of meningiomas revealed that 43. 82% were grade 1، 44. 94% grade 2، 3. 37% grade 3، and 4. 49% of meningiomas had atypical features while 3. 37% had invaded the brain. Expression of P53 was seen in 31. 28% of meningiomas in grade 1، 57. 77% in grade 2، 60% in grade 3، 47. 5% in tumors with atypical features and in 65% of tumors invading the brain (P= 0. 087(. Expression of Ki67 was observed in 7. 46% of grade 1، 33. 5% of grade 2، 22. 5% of grade 3، 10. 78% of meningiomas with atypical features and 20% of tumors invading the brain (P= 0. 032). It seems that there is a relationship between the grade of meningiomas and expression of Ki67 in tumor cells.

Efflux systems are components of the bacterial membrane that play a role in homeostasis of the cell and extrusion of toxic compounds. Efflux pumps of the resistance nodulation cell division (RND) superfamily، confer multidrug resistance to their host when over-expressed. One of the RND efflux systems، is AdeABC which have been characterized for A. baumannii. Another pump belonging to the MATE family، AbeM، has been characterized. The aim of this study was to analysis the expression and function of multidrug efflux pumps of Acinetobacter baumannii strains. The descriptive study was done during a period of 18 month. A total of 194 isolates of A. baumannii were studied using Rep-PCR، disk diffusion test، and E-test. Gene expression and function of efflux pumps were evaluated in 50 non-clonal multidrug resistant clinical isolates of A. baumannii via real-time PCR and ethidium bromide accumulation. The resistance rates against the tested antibiotics ranged from 69 to 99% with all isolates harboring adeB (100%) and abeM (100%) genes. No mutation was detected in adeS or adeR gene. An expression of adeB mRNA is correlated with reduced susceptibility to Cefepime but not other antibiotics. The expression of abeM was not associated with changes in MICs. It seems that several mechanisms are involved in multidrug resistance of A. baumannii. The increased expression of adeABC is not the main contributor for antibiotic resistance.

Nosocomial infections constitute an important health problem in hospitalized patients especially in developing countries. The aim of the present study was to evaluate the blood stream and surgical wound nosocomial infections in the Intensive Care Units (ICUs) of six hospitals in Tehran and also to detect the responsible bacteria and their resistance profiles. In this descriptive study، 37 blood and 30 wound samples were collected from patients with nosocomial infections admitted in ICUs of 6 different hospitals. Diagnosis of nosocomial infections was made in accordance with the CDC criteria and bacterial isolates from the samples were identified according to standard biochemical identification schema. Resistance profiles of the identified bacteria were assessed against conventional antimicrobials according to NNIS system. Acinetobacter spp. and Pseudomonas spp. was reported as the most common organisms and showed high resistance to imipenem. All the S. aureus isolates were resistant to oxacillin and cefoxitin (methicillin-resistant S. aureus، MRSA) and 33% of the Enterococcus spp. isolates were resistance to vancomycin (VRE). Among the isolated bacteria 84. 6% showed MDR phenotype. Linozolide and vancomycin were proposed as the most effective drugs among 15 tested antibiotics against these bacteria. Among the studied ICUs MRSA، VRE، 3rd generation cephalosporin-resistant Enterobacteriaceae، and imipenem or ciprofloxacin-resistant P. aeruginosa and A. baumannii were predominantly present. For these reasons، a program to control the emergence of new resistant organisms and eradication of hyper resistant isolates seems necessary.

Measurement of serum level of procalcitonin in patients with H1N1 influenza could decrease the consumption of unnecessary antibiotics. This study aimed to determine the serum levels of procalcitonin in patients with swine flu (H1N1) in the Hajar Hospital of Shahrekord in 2011. In this cross-sectional study patients presenting with clinical manifestations of influenza (chest pain، low blood pressure، cough، myalgia)، were enrolled. Blood and pharyngeal specimens were collected and swine flu confirmed by PCR (Institute Pasteur Tehran); serum level of procalcitonin was measured by chromatography (Brahms، Germany) and recorded in ng/ml. Levels of 2ng/ml were considered as a marker for severe disease with bacterial infection. From 140 patients with suspected swine flu، 61 (43. 6%) were infected with swine flu، of which (54. 1%) were female. Level of serum procalcitonin was <0. 5ng/ml، 0. 5-2ng/ml and 2-10ng/ml in (72. 1%)، (18%) and (9. 8%)، respectively، revealing that nearly 10% of patients had accompanying bacterial infections. Procalcitonin serum level measurement could be valuable in differentiating bacterial from viral infections.

Socioeconomic status (SES) or social class is a determinant factor for having a healthy society، particularly in the elderly. The present study aimed to investigate the socioeconomic status of the elderly population in Ilam province in 2012. Through a cross-sectional study using cluster sampling، 1012 persons with the age of 60 years and over، residing in Ilam province were recruited. A questionnaire consisting of social class parameters was administered. Data was gathered by using face to face interviews and then analyzed using χ2، Mann-Whitney and Kruskal-Wallis tests in SPSS software. Mean age was 70. 1±8. 02 years and 60. 5% were male. Majority were illiterate (61. 4%) and unemployed (81%). Almost one in three (29. 8%) received financial support from their children. Nearly half (47. 6%) were regularly visited by their relatives. Majority، (64. 1%) mentioned the provision of sufficient health facilities as their main concern. Health and housing needs in females were two (OR=2. 23) and four (OR=4. 43) folds more than elderly males، (p<0. 0001). There were significant relationships between visiting by relatives with age، gender، job and education levels of the studied group. It seems that the economic status of the elderly depends largely on the financial status of their children. Health and housing needs in females were more than males. Social status، housing and health needs of old people call for more attention from Social and Health authorities in Ilam province.

Alopecia areata is a common autoimmune disease that mostly affects adolescents and young people. Prevalence in the population is about 0. 1-0. 2%، seen in both sexes and in all races. This study was done to determine the pattern of disease in patients referred to a teaching hospital in Tehran. A descriptive research was performed. All patients seen in Loghman hospital during the study period from1999 to 2004 were evaluated. Diagnosis of AA was made according to the AA standard and patient characteristics were determined. During the study period 30 patients were enrolled، 53% were between the ages of 13 to 25 years; 73. 3% were males and 26. 7% had family history of AA in first-degree relatives. Epidemiological results of our AA patients are different from other countries which may be due to racial differences، regional or behavioral habits.