فهرست مطالب

Thrita - Volume:3 Issue: 7, 2014
  • Volume:3 Issue: 7, 2014
  • تاریخ انتشار: 1392/12/13
  • تعداد عناوین: 16
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  • Hosnie Hosseini, Akbar Dorgalaleh, Shadi Tabibian, Meysam Kashiri, Esmaeil Sanei Moghaddam, Shaban Alizadeh, Taregh Bamedi, Samira Esmaeili Reykande, Saeed Dorgalaleh Page 5516
    Background
    The presence of interfering substances is the most common preanalytic factor that can affect the precision and accuracy of Blood Cell Count results. These clinical laboratory interferences are difficult to determine and are largely underestimated..
    Objectives
    This study evaluated the effects of biochemical Interfering factors include hyperglycemia, hyperlipemia, and uremia on blood cells indices including different RBC indices, Plt and WBC count. Therefore, this study was conducted to investigate the potential impact of the increased levels of blood lipids, glucose, and urea on different RBC indices, Plt, and WBC count by automated impedance cell counters..
    Materials And Methods
    This Analytical study performed on 366 individuals with hyperglycemia, hyperlipemia, or uremia and 120 randomly selected healthy participants referring to Imam Hospital of Minoodasht city from February to June 2012. Initially, glucose, triglyceride, and urea levels were measured by Biochemical autoanalyzer and then complete blood cell count was done for each participant. Eventually statistical analysis and comparison between case and control groups were done by SPSS v.16 software..
    Results
    Comparison between case and control groups revealed that uremia caused significant increase in MCV and RDW levels (P < 0.05) and had no effect on MCH level (P > 0.05). Both hyperglycemia and hyperlipemia caused increased in MCV level (P < 0.05). In addition, hyperlipemia increased Hb, Hct, and MCH levels (P < 0.05)..
    Conclusions
    According to the results of this study, effect of biochemical interfering factors on test results of impedance cell counter must be considered in clinical laboratories..
    Keywords: Uremia, Hyperglycemia, Hyperlipidemias, Blood Cell Count
  • Shahnaz Tofangchiha, Faezeh Dehghan, Hamid Reza Saberi Page 7065
    Background
    Diabetes complications such as retinopathy and diabetic foot are more important in drivers compared to general population..
    Objectives
    This study was designed to determine the prevalence of diagnosed and undiagnosed patients with diabetes mellitus and glucose intolerant, as well as the effects of follow up in the commercial drivers in Yazd province, Iran..
    Materials And Methods
    During three consecutive years, levels of blood sugars were checked in 1137 registered drivers working on heavy motor vehicles such as trucks and buses. After 3 years, data was collected and analyzed by SPSS version 16. One sample K-S, Mauchly’s test, and if appropriate, variance analysis test were performed to compare FBS levels differences between the three occasions..
    Results
    The mean age of participants was 47.7 ± 28.7 (19 - 56) years old, and they were working on heavy vehicles for 15.3 ± 9.3 (26 - 47) years. The prevalence of diagnosed diabetes was 3.3% (n = 38), but the prevalence of FBS > 127 was 6.3%, and that of impaired glucose test was 4.9%. There was a significant reduction in the blood glucose levels from the first to the third occasions in drivers with type 2 diabetes..
    Conclusions
    The prevalence of diabetes is considerable in drivers and is poorly controlled. Educations during the annual check-ups are helpful in reducing glucose levels and further complications..
    Keywords: Diabetes Mellitus, Blood Glucose, Prevalence
  • Nasrin Shoar, Saeed Shoar *, Sayed Shahabuddin Hoseini, Zahra Abdi Layaei Page 7864
    Introduction

    Systemic lupus erythematous (SLE) is among rheumatic diseases of unknown etiology. Fever of unknown origin (FUO) has been rarely reported to be the presenting sign of SLE. Presence of four or more SLE criteria is diagnostic for the disease. However, presentations may occur serially which make it much more difficult to diagnose an already questioned FUO..

    Case Presentation

    Our case of SLE, presenting with a long history of unidentified FUO, was a 73-year-old man treated due to various diagnoses in different medical services before referring to the department of infectious diseases at Imam Khomeini Hospital. None of the previous treatments were effective to resolve his fever. In infectious ward, we performed multiple diagnostic tests to approach the FUO, and the patient serially presented some criteria of SLE. Therefore, we referred the patient to the rheumatology ward with late-onset systemic lupus erythematous (LO-SLE) for more work ups and management..

    Discussion

    FUO in elderly has a wide range of differential diagnoses and Infection with tuberculosis, immunologic and pulmonary diseases, other multisystem diseases, tumors, and medications are presented on the top. SLE has rarely been mentioned after the age of 50 as a cause of FUO; but due to more severe damages to the body organs, its potential should be considered. Although our case presented only three criteria of SLE, this diagnosis was confirmed and treated by the rheumatologist; thus the symptoms and signs gradually improved..

    Keywords: Lupus Erythematosus, Discoid, Fever of Unknown Origin, Autoimmune Diseases
  • Amir Hashemi Meshkini, Abbas Kebriaeezadeh, Mohammad Reza Janghorban, Khosro Keshavarz, Shekoufeh Nikfar Page 9648
    Background
    Accessibility to pharmacy, including geographic accessibility, is an important goal every government tries to meet..
    Objectives
    In this study, we analyzed the geographic distribution and accessibility of pharmacies in the municipal territory of Qom (a province in Iran) for both pedestrians and drivers..
    Materials And Methods
    The analysis was based on straight-line distance measurements. We considered 150, 300, 450, 600, and 750 m for pedestrians, and 1, 2, and 3 km for driving accessibility as the acceptable distances. We calculated the number and percentage of households located at the acceptable pedestrian and driving distances from each pharmacy. In the second part of study, the day-opened pharmacies were omitted to calculate the pedestrian and driving geographic accessibility of pharmacies during holidays, on weekends and at night..
    Results
    Our analysis indicated that in normal days about 88% of the households located in Qom have acceptable pedestrian accessibility, and almost all of them have acceptable driving accessibility to a pharmacy. In terms of geographic accessibility to the 24/7 pharmacies, the results showed that less than 30% and 95% of households have acceptable pedestrian and driver accessibility, respectively..
    Conclusions
    Geographic accessibility of pharmacies at night and on holidays has to be addressed by provincial health policymakers..
    Keywords: Health Services Accessibility, Geographic Information Systems, Community Pharmacy Services
  • Mohammad Mozafar, Mohammad Reza Radpey, Niki Tadayon, Khashyar Atqiaee, Saran Lotfollahzadeh, Mohammad Reza Sobhiyeh *, Razie Amraei, Maryam Baikpour Page 11359
    Background
    Carotid body is a highly-specialized organ located at the bifurcation of the common carotid artery and responsible for acute adaptation to hypoxia. The most common disease state of carotid body is its enlargement. Carotid body tumors (CBTs) are infrequent and slow growing tumors that must be considered in lateral neck mass evaluations..
    Objectives
    In this study we aimed to review the clinical characteristics and management of CBTs in Shohadaye Tajrish Center during the last ten years (2002 - 2012)..
    Materials And Methods
    This was a retrospective study in which the medical records of patients diagnosed with CBT during the past ten years (from April 1st 2002 to April 1st 2012) were reviewed. The hospital ethics committee approved the extraction of data. For data collection we used a structured questionnaire, designed in six categories: demographic data, life style and predisposing factors, symptoms upon presentation, imaging results, treatment, complications, and follow up. Selected junior residents were responsible for extracting the data from the medical records and fulfilling the forms..
    Results
    Overall, 48 patients with 51 CBTs were included in the study. The CBTs were bilateral in 3 (6.25%) cases. The cardinal presentations of these cervical masses were unanimous in all patients; 6 (12.5%) had symptoms of cranial nerve palsy. All cases had surgeries, while 3 patients with UN resectable tumors regarding massive invasion to CCA, ICA, and ECA, were treated with radiation simultaneously. The follow-up period in surgically resected CBTs did not elucidate any cause for the recurrencies..
    Conclusions
    This study provided clinico-epidemiological data on patients with CBT, which could be useful for prompt diagnosis and appropriate work-up for patients and families with CBTs..
    Keywords: Carotid Body Tumor, Paraganglioma, Iran, Extra, Adrenal
  • Seyed Hassan Eftekhar Vaghefi, Leila Elyasi, Saeed Reza Amirian, Shahrzad Eftekhar Vaghefi Page 11669
    Background
    To assess a dimensional fit between human and his equipment or environment, creating an anthropometric data bank is essential. Anthropometry has an important role in industrial management and ergonomic design. This information must be collected regularly in every population..
    Objectives
    The main objective of this study was to collect the results of anthropometrical measurements of a statistically-valid population of males and females, in Bandar Abbas city, Hormozgan province, Iran..
    Materials And Methods
    In this descriptive and analytical study, we used a static and direct method. Cluster sampling method was used to select the subjects. Participants were 1600 randomly-selected Iranian male (n = 568) and female (n = 1031) workers of five hospitals in Bandar Abbas. Thirty seven static dimensions were measured in the individuals aged 20 - 60. For anthropometric measurement, tape, goniometer, caliper, segmometer, headboard, and weighing scales were used..
    Results
    For females, the average height was 158 cm, sitting height 82 cm, and knee height 48 cm; for males the average height was173 cm, sitting height 92 cm and knee height 52 cm. The average weight was 77 kg for males and 59 kg for females. There were significant differences between males and females regarding sitting and standing height, weight, and other dimensions (P < 0.000)..
    Conclusions
    The gathered data from 1600 Iranian workers in this study will hopefully be applied in the ergonomic design of workstations, tools, equipment, layout designs and interventions, uniquely well-suited for Iranian workers. The use of anthropometric data in designing a product can reduce human errors and improve public health and quality of products and efficient use of workplaces..
    Keywords: Anthropometry, Environment Design, Healthy Worker Effect
  • Mohammad Mahdi Zamani, Malihe Fallahpour, Golnaz Yousefi Harvani, Samaneh Khodi Aghmiuni, Mahsa Zamani, Dariush Minai Tehrani, Gholamreza Savaghebi Firrozabadi Page 12113
    Background
    Crude oil contamination is one of the major concerns for the human health and environment..
    Objectives
    The aim of this study was to find the optimal biological methods to remove crude oil contaminants, especially polycyclic aromatic hydrocarbons (PAHs), from the soil of the lands around the Tehran Refinery site..
    Materials And Methods
    In this study, soil sampling was conducted from five points of the west side of the refinery area through a zigzag sampling method. The soil characteristics were identified in the soil laboratory where PAH contamination was also examined. Advantages and disadvantages of biological, physical, and thermochemical methods of soil treatment were retrieved from the literature. The biological methods were confirmed as the optimum treatment methods which had been more extensively evaluated according to the soil texture, remediated compounds, cost, and timing..
    Results
    The soil was largely composed of silt and clay (silt:41 - 42%, clay: 40 - 43%, sand: 15 - 18%). The average moisture content of the saturated soil was 12.96%,; average electricity conductivity was 18.64 DSm-1; average pH of the paste was 8.36; and average percentage of organic carbon was 0.19%. Result of the laboratory analysis reported the average content of total nitrogen as 0.026%, phosphorus as 14.3 mg/kg-1 and potassium content as 3.4 mg/kg-1. Content of the crude oil derivatives was less than 0.5 %..
    Conclusions
    An efficient method for treating the current low level soil contamination around the Tehran Refinery site is phytoremediation, a cost effective method that helps to create beautiful landscapes around the refinery site. Soil vapor extraction (SVE) should be used in large PAH levels (higher than the current rate). Soil washing is the most time-effective method, which is suitable for cases of emergency soil contamination with petroleum..
    Keywords: Biodegradation, Environmental, Petroleum Pollution, Polycyclic Hydrocarbons, Aromatic, Soil Pollutants, Polycyclic Hydrocarbons
  • Sarah Milanizadeh, Mohammad Reza Bigdeli, Bahram Rasoulian, Davar Amani Page 12914
    Background
    Recently, it is suggested that the use of olive leaf polyphenols like oleuropein (OLP), hydroxytyrosol (HT), and others could decrease breast cancer cells viability significantly. Also it has been shown that it inhibits cell proliferation, induces cell apoptosis, reduces cell viability, and significantly stops cell cycle in growth 1 phase (G1) demonstrated via increasing the Michigan Cancer Foundation-7 (MCF-7) cells in the G0/G1 phase..
    Objectives
    We aimed to study whether the use of olive leaf extract affects breast tumor size and the activity of antioxidant enzymes..
    Materials And Methods
    Four groups of female BALB/c, each containing five mice were studied. Three days after tumor transplantation, the first group received distilled water. The second, third, and fourth groups were treated with 75, 150, and 225 mg/kg/day of olive leaf extract (OLE) for 3 weeks, respectively. To assess anti-cancer and antioxidant effect of OLE, volume and weight of tumor, and also antioxidant enzyme activity were measured..
    Results
    Treatment with 150 and 225 mg/kg/day of OLE reduced the tumor volume and weight (P < 0.05) compared to the first group significantly. It also increased the CAT activity (P < 0.05) in the third group and increased the activity of superoxide dismutase in the third (P < 0.05) and fourth groups (P < 0.005) resulted in excitotoxic tolerance in the treatment groups..
    Conclusions
    Consumption of OLE after tumor transplantation reduced the tumor growth. On the other hand, owing to its highly-packed polyphenols, catalase and superoxide dismutase activities in tumor tissue were increased..
    Keywords: Polyphenols, Antioxidants, Superoxide Dismutase, Catalase, Breast Cancer
  • Siamak Mirab Samiee, Samira Mohammadi Yeganeh, Mahdi Paryan, Houri Rezvan, Ehsan Mostafavi, Parvin Pasalar Page 14033
    Background
    Managing individual-based anti-coagulant therapy with warfarin is an important goal for bleeding prevention in personalized medicine..
    Objectives
    The purpose of the present study was to evaluate the allelic frequency of VKORC1 (C1173T, G1639A) and CYP2C9 (CYP2C9*2 and CYP2C9*3) polymorphic genes with SimpleProbe® real-time PCR as a fast, accurate and easy-to-handle method..Patients and
    Methods
    One hundred unrelated patients under warfarin therapy were recruited as the study population. Real-time PCR was performed with SimpleProbe® for single-nucleotide polymorphisms (SNP) detection of CYP2C9 and VKORC1 genes..
    Results
    The allelic frequencies for VKORC1 C1173T (CC, CT, TT) were 25%, 51% and 24%, respectively and for VKORC1 G1639A (-GG, GA, AA) were 27%, 51% and 22%, respectively. Despite a significant association between allelic polymorphisms in VKORC1 and warfarin dose (P < 0.001), it was not statistically significant for CYP2C9*2 and CYP2C9*3, most probably due to the low rate of CYP2C9*2 and CYP2C9*3 SNPs observed..
    Conclusions
    SimpleProbe® real-time PCR is a fast and accurate technique qualified to detect VKORC1 and CYP2C9 SNPs. These results encourage taking further steps towards using VKORC1 and CYP2C9 allelic screening to prevent clinical complications due to resistance or sensitivity to warfarin as well as anti-coagulant dose adjustment..
    Keywords: VKORC1, CYP2C9, SNP, Real, Time Polymerase Chain Reaction, Warfarin
  • Cyrus Motamed, Jean Louis Bourgain Page 14744
    Background
    Inadvertent perioperative mild hypothermia is a common side effect of anesthesia and surgery. This complication has multiple origins. Hypothermia can negatively affect postoperative outcome. However, it might be prevented by specific measures..
    Objectives
    As part of a quality assurance program, we assessed the incidence of severe intraoperative hypothermia in association with specific surgery and procedures. The next step consisted of a series of measures to decrease its incidence..Patients and
    Methods
    After approval of our institutional review board, we used our computerized recording of anesthesia and postoperative care chart database (DEIO Archive Browser®) to extract the anesthetic files of patients who have experienced severe and mild hypothermia (< 34.5°C) and (≥ 34.5°C and < 35.5°C) between 2005 and 2006..
    Results
    A total of 12780 patients were screened between 2005 and 2006, 36 patients in 2005 and 38 in 2006 had severe hypothermia. A high percentage (33%) of peripheral surgery (breast surgery) was found in this group of patients. The percentage of mild hypothermia was around 0.5%. After analysis and discussion in the Quality Control Management meeting, several basic suggestions were made. Consequently, the number of patients experiencing severe hypothermia decreased by 50% in 2007, but the percentage of mild hypothermia did not change..
    Conclusions
    This study revealed the incidence of severe intraoperative hypothermia in our cancer hospital and we managed to decrease this incidence by simple measures. In addition, it suggests that severe hypothermia does not occur only in prolonged surgery and measures to prevent this complication should be undertaken for all patients. Automated anesthesia recording file is a useful tool to monitor the quality assurance program pertaining intraoperative hypothermia..
    Keywords: Surgery, Anesthesia, Hypothermia
  • Raika Jamali Page 15376
    Context: Viral hepatitis is still considered as a major health concern. Defining the extent of the burden of this condition is the mainstay in choosing better strategies for its prevention and management. The aim of this study was to review the current knowledge on the worldwide prevalence of viral hepatitis, including Iran..Evidence Acquisition: A MEDLINE search spanning January 2000 to January 2012 was performed to identify the published literature addressing viral hepatitis. Viral hepatitis, prevalence, hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis E virus (HEV) were the keywords used for this search. Original research, review articles, and some selected references of those articles were reviewed..
    Results
    Prevalence of viral hepatitis is widely different throughout the world. Overall prevalence of viral hepatitis is declining due to the improvements in preventive measures and immunization strategies..
    Conclusions
    There are few studies on the prevalence of viral hepatitis in the general population of Iran. Most of the reports are from specific groups of patients. Further epidemiologic studies on the general population of Iran are recommended to discover the real burden of viral hepatitis..
    Keywords: Viral Hepatitis, Prevalence, Population, Iran
  • Kaveh Hosseini, Ali Bozorgi, Shahrokh Karbalayi Page 15607
    Background
    Defining the infarct related artery in acute myocardial infarction helps in better and faster management of patients. Therapeutic choices may differ according to the culprit lesion..
    Objectives
    This study aimed to evaluate multiple electrocardiography (ECG) criteria and one algorithm in defining the culprit artery in single vessel inferior ST elevation myocardial infarction (I-STEMI). A new criterion based on posterior leads was also proposed..
    Materials And Methods
    In this retrospective study from June 2007 to July 2012, ECG and angiography films of patients with acute inferior STEMI were reviewed. From a total of 138 studied patients, 25 had 3-vessel disease and 37 had two occluded arteries. Remaining 76 patients were diagnosed with single vessel acute I-STEMI, 56 had right coronary artery (RCA) occlusion [22 (29.3%) proximal RCA, 24 (32%) middle RCA, and 10 (13.3%) distal occlusion of RCA], 19 had left circumflex artery (LCx) lesion and one had middle left anterior descending (LAD) artery occlusion..
    Results
    Prediction of the RCA as culprit lesion using Tierala''s algorithm was 86% sensitive and 50% specific. Prediction of LCx occlusion based on ST-elevation ≥ 1 mm in V6 was 87% specific (P = 0.005). Sum of ST elevation in leads V5 and V6 more than 2.5 mm, was a good marker of LCx prediction (P = 0.044). ST-elevation in V4R was 48% sensitive and 89% specific for RCA prediction (P = 0.004). Wellens'' criterion was 82% sensitive and 47% specific for proximal RCA prediction (P = 0.002). Our new criterion ''Sum of ST elevation in posterior leads (V7 - V8 - V9) < 3 mm'' was 82% sensitive and 50% specific for RCA prediction (P = 0.017). We also revised Tierala’s algorithm by adding the presence of ST-elevation in V3 and V4 to the first step (when STe II ≥ III), which increased the specificity and PPV of LCx prediction (86% vs. 84% and 53% vs. 50%)..
    Conclusions
    Although several criteria and algorithms were previously suggested, they could not reliably determine the site of occlusion. Right and posterior leads may be needed in order to increase the accuracy of prediction..
    Keywords: Coronary Angiography, Electrocardiography, Myocardial Infarction
  • Sahra Emamzadeh Fard, Haleh Naser Hojati, Koosha Paydary, Afshin Tajali, Abdol, Mohammad Kajbafzadeh Page 15853
    Introduction
    Foreign body insertion is a common and important cause of pre-pubertal vaginal bleeding..
    Case Presentation
    We present a three-year-old girl who referred to our clinic with abnormal vaginal bleeding without any other symptoms. The primary assessment revealed a radio-opaque round solid mass in the pelvic cavity. Following vaginoscopy, the button battery was finally removed under general anesthesia. The vagina was washed by normal saline irrigation and some necrotic tissue was evacuated. Digital rectal exam confirmed intact rectal wall. The patient was asymptomatic in the follow up and there was no sign of recto-vaginal fistula..
    Discussion
    Vaginal bleeding in children may have various etiologies such as foreign bodies. Foreign bodies in the vagina lead to severe inflammation and result in vaginal bleeding or blood-stained and foul-smelling discharge. Other sequel may include infections, fibrosis and recto-vaginal fistula..
    Keywords: Child, Female, Foreign Bodies, Vagina, Vaginal Discharge
  • Shirin Farivar, Masoud Dehghan Tezerjani, Neda Parvini, Reza Shiari Page 16020
    Background
    Cytotoxic T-lymphocyte antigen-4 (CTLA-4) is a molecule engaged in regulation of T cells. Polymorphisms in the CTLA-4 gene (CTLA4) are known to be associated with several autoimmune diseases, including Systemic lupus erythematosus..
    Objectives
    To evaluate the potential influences of common SNP in CTLA-4 promoter region (-1661 A/G), a case-control study was performed on Iranian children..Patients and
    Methods
    Genotypes of 31 patients and 50 healthy controls were investigated using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method..
    Results
    Our study showed that there were no statistically significant differences in the allele and genotype frequencies of -1661 A/G SNP between patients with SLE and healthy controls (P > 0.05)..
    Conclusions
    In conclusion, we found no association between SNP-1661 A/G of the CTLA-4 promoter region and susceptibility to SLE in our population..
    Keywords: CTLA, 4 Antigen, Lupus Erythematosus, Systemic, Polymerase Chain Reaction
  • Mariangela Peruzzi, Giuseppe Biondi, Zoccai, Giacomo Frati Page 16158
  • Atousa Janzade, Seyed Behnamedin Jameie, Shahla Choobchian, Farinaz Nasirinezhad Page 16607
    Background
    Oxidative stress contributes to neuropathic pain. Coenzyme Q10 (CoQ10) is used for the treatment of neurodegenerative diseases. However, there is no report regarding the therapeutic effect of CoQ10 on neuropathic pain..
    Objectives
    The present study investigated the effects of CoQ10 on pain alleviation in animals with chronic constriction injury (CCI) of the sciatic nerve..
    Materials And Methods
    Wistar male rats were randomly allocated to four groups. Nerve injury was induced by four loose ligatures around the sciatic nerve. CoQ10 (200 mg/kg) or vehicle were daily injected intraperitoneally for 10 days. Behavioral tests were performed before nerve injury and on fifth and tenth days after injury. Radiant heat, Randall Selitto test, and Von Frey filaments were used to assess the pain threshold. At the end of the experiment, the animals were perfused transcardially. Lumbar spinal cord was removed and prepared for Nissl staining. Analysis of variance (ANOVA) and Mann-Whitney were used for statistical analysis. P-value below 0.05 was considered statistically significant..
    Results
    Reduction in pain threshold and the number of neurons in dorsal horn of the spinal cord after nerve injury (P ≤ 0.001) were resulted. Injection of CoQ10 and vehicles increased the pain threshold (P ≤ 0.001 and P ≤ 0.01) and prevented cell loss in neuropathic rats compared with injured animals with no treatment (P < 0.05). Significant differences observed between animals that had received coQ10 compared with vehicle treated ones (P < 0.05)..
    Conclusions
    CoQ10 abolished neuropathic pain in CCI rats. Prevention of cell loss might be attributed to the analgesic effect of CoQ10. Hence, it might be used as a therapeutic intervention for neuropathic pain..
    Keywords: Chronic Constriction Injury, Sciatic Nerve, Pain, Coenzyme Q10