مجله دانشکده پزشکی اصفهان
پیاپی 270 (هفته سوم اسفند 1392)

When Parkinson's disease progresses, complications such as impaired balance, can affect patient's quality of life. Results have indicated that complementary program processes such as physiotherapy can reduce these complications while the brain and its waves are ignored. This study aimed to verify the effect of neurofeedback training on postural stability and fall risk in patients with Parkinson's disease. This was an experimental research with pre-, post-test method and control group. 16 patients were selected through purposive sampling and were randomly divided to two experimental and control groups. The experimental group participated in 8 sessions of actual neurofeedback training as well as control group participated in 8 sessions of sham neurofeedback training. Before and after the training, the pre- and post-test of postural stability and fall risk were administered using biodex system. The mean scores of fall risk and the postural stability improved significantly after the intervention in experimental group (P < 0.001), while there were no significant changes among control group in fall risk (P = 0.450) and the postural stability (P = 0.750) scores. Our results showed that the neurofeedback training can be used to control the symptoms of Parkinson's disease, especially postural stability and fall risk.

In human immunodeficiency virus HIV-infected patients, oropharyngeal candidiasis is a common infection. The aim of present study was molecular typing of Candida albicans isolates recovered from HIV-infected patients with oropharyngeal candidiasis and comparing the molecular patterns of fluconazole-resistant and susceptible isolates. The molecular typing of genomic DNA of 48 Candida albicans isolated from HIV-infected patients were assessed by the random amplified polymorphic DNA-polymerase chain reaction (RAPD-PCR) fingerprinting. Sensitivity of strains to fluconazole was determined by the broth microdilution method. We detected two main clusters and seven sub-clusters, comprising 24 genotypes of Candida albicans strains. No associations between the patterns of strains isolated from hospitalized patients and outpatients and clinical forms of oropharyngeal candidiasis were detected. There was also a relative correlation between fluconazole susceptibility and strain clustering. The presence of several genotypes of Candida albicans in HIV-infected patients would lead to problems in the treatment and prevention of oral candidiasis. The lack of correlation between genotypes and clinical forms of oropharyngeal candidiasis shows the importance pf host condition in the pathogenesis of candida infections. The lack of phylogenetic relationships among strains from hospitalized patients approves endogenous origin of candida infection. The results indicate that HIV-infected patients have favorable conditions for the growth and proliferation of different genotypes of Candida albicans. In conclusion, molecular typing using RAPD-PCR revealed a genomic heterogeneity in the Candida albicans clinical isolates studied in HIV-infected patients.

Hyperbilirubinemia is one of the most common causes of neonatal re-hospitalization; using transcutaneous bilirubin (TCB) measurement nomogram, the aim of this study was to determine the risk of severe hyperbilirobinemia in term and near-term Iranian neonates at discharge time. 450 healthy newborn infants, with the gestational age of ≥ 35 weeks, weight of ≥ 2 kg, and the age of 12 to 140 hours were enrolled in this randomized-descriptive practical study. Before being discharged, the infant’s bilirubin was measured using Bilichek that was placed on their chest and between two nipples. After being discharged, the newborn infants were followed up. According to the discharge time transcutaneous bilirubin level, the infant's age (in terms of hour), and based on bilirubin nomogram, the newborns were divided into four groups of low-risk, low-medium-risk, high-medium-risk, and high-risk. In following up the infants, if they were suffering hyperbilirobinemia, the bilirubin was measured again. According to discharge time transcutaneous bilirubin level and the infant's based-on-hour age, 20% of the subjects were included in the low-risk group, 33.1% in low-medium-risk group, 32.2% in high-medium-risk group, and 14.7% in high-risk group. The risk of severe hyperbilirobinemia in followed-up newborns was 1.4%, 6.9%, 13.6%, and 32.8%, in groups 1 to 4, respectively. During this time, 11.9% of the newborns were found to have sever hyperbilirubinemia (more than 95th percentile. By providing bilirubin nomogram, based on transcutaneous bilirubin level and the infant's age (in terms of hour), the severity of future hyperbilirobinemia can be estimated in Iranian healthy newborns. The transcutaneous bilirubin method with bilichek, that is a non-invasive method, can be recommended for all newborns at discharge time.

Clopidogrel is an adenosine-5' diphosphate (ADP) receptor antagonist that eventually inhibits platelet aggregation. It is used concomitantly with percutaneous coronary interventions and in patients with acute coronary diseases. This study was conducted to determine the effects of preoperative clopidogrel administration on perioperative blood loss and transfusion requirements in patients undergoing coronary artery bypass graft (CABG) surgery. For 100 patients who underwent nonurgent first-time coronary artery bypass grafting surgery participated in this study. clopidogrel was discontinued in 2, 3, 5-6 or 7-8 days before surgery. A cell salvage device was used during surgery and salvaged blood was recorded. After surgery, chest tube output and need for blood transfusion were measured and recorded. Patient's mean age was 61.7 ± 8.0 years (range: 50 to 77). There was a reverse relation between the time clopidogrel had been discontinued and blood loss and need for transfusion of packed cell and blood products during and after surgery (P < 0.05 for all). Preoperative clopidogrel administration increases perioperative blood loss and need for blood transfusion in patients undergoing coronary artery bypass grafting surgery.

For decades, nucleic acid analogues have been emerged in molecular biology. Some of these analogues are powerful bimolecular tools in biotechnology. Among the four major classes of these synthetic molecules (XNA: xenonucleic acid, LNA: locked nucleic acid, PNA: peptide nucleic acid and morpholino), PNA is the most important. In PNA, N-aminoethyle glycine units (to which purine/pyrimidine bases have been attached), are joined together to form an achiral and peptide-like structure that mimics the behavior of DNA and can hybridize to nucleic acid and to other PNA in sequence specific manner. Because of its unique physicochemical properties, PNA in many cases prefers over natural oligonucleotide and therefore, have been exploited in some strategies and methods in the field of diagnostics and therapy. In this review, we describe the structure, biochemical properties, and biomedical applications of PNA.