Journal of Research in Medical Sciences
Volume:9 Issue: 3, May & Jun 2004

During the past 15 years Enzyme Linked ImmunoSorbent Assay (ELISA) has been described as an alternative to radioimmunoassay for steroid detection. In addition to gonads, sperm itself is capable of producing reduced progesterone metabolites. In this study we introduced a method to extend the applicability of previous measures by describing a general preparation procedure for the enzyme label which is applicable to any steroid hormone. A simple and rapid Enzyme Linked Immunosorbant Assay (ELISA) is described and validated for 17,20β- dihydroxy-4-pregnen-3-one (17,20βP). A general procedure for preparation of the acetylcholinesterase labelled steroid is described which is applicable to any steroid. Use of acetylcholinesterase tracer increased the sensitivity of assay so that reliable measurements of each steroid could be achieved with only 10 µl of plasma. ELISA was applied to measure of 17,20βP steroid production by sperm of trout which has sufficient amount of potent and active 20βHSD enzyme to convert 17α-hydroxy-4-pregnen-3-one (17αP) substrate to 17,20βP product. The results showed that a clear shift in 17,20βP production was found with increase in substrate concentration in all in vitro incubations. ELISA method presented in this study has greater sensitivity and accuracy compared to previously described method that uses radiolabelled substances.

Many of the knees affected by rupture of the posterior cruciate ligament (PCL) lack their desirable function. Researchers are currently seeking surgical procedures for treating PCL rupture, which can offer a reliable degree of objective and subjective knee stability after surgery. This study assesses the results of anatomical reconstruction of PCL using graft from the tendon of the quadriceps muscle. This is a descriptive prospective study involving 14 patients with clinical diagnosis of PCL rupture. The patients complained of knee discomfort in spite of conservative treatment and many sessions of physiotherapy. Subjective symptoms of knee instability, i.e. giving way, pain after long walks and pain during climbing, as well as objective knee instability symptoms as assessed by posterior drawer test at 30° and 90° knee flexion, and neutral rotation were recorded and compared prior to and after surgery. The procedure entailed anatomical reconstruction of PCL using grafts taken from the tendon of quadriceps muscle and part of proximal patella. Two patients were excluded from the study due to their failure to refer for follow-up. The patients included 11 men and 1 woman with a mean age of 23 years. The patients displayed statistically significant improvement after surgery as regards subjective symptoms, i.e. giving way, pain after long walks and pain in climbing. Objective knee instability symptoms as evaluated by posterior drawer test at 30° and 90° knee flexion and neutral rotation also showed significant improvement compared to pre-operation findings. Reconstruction of PCL is aimed at achieving normal knee kinematics and stability. The procedure used in this study entailed anatomical reconstruction of PCL. Given the objective and subjective results obtained, the use of this procedure is recommended by authors as the method of choice for reconstructing PCL.

Regarding the unexpected frequency of epilepsy in patients with Duchenne Muscular Dystrophy (DMD), this study was conducted to assess the impression of Duchenne - related epilepsy. After definite diagnosis of DMD in 57 children attended to neurology clinics, a questionnaire including demographic variables and data related to symptom presentations was completed for each one. If history of epilepsy was present, complementary information on the background of epilepsy (based on history taking and Paraclinical data) was obtained. Among 54 patients with DMD, seven cases (12.3%) had the history of epilepsy versus 0.4 - 0.5% in general population (p

Despite the effectiveness of pharmacotherapy in acute phase of bipolar mood disorder, patients often experience relapses or recurrent episodes. Hospitalization of patients need a great deal of financial and humanistic resources which can be saved through understanding more about the rate of relapse and factors affecting this rate. In a descriptive analytical study, 380 patients with bipolar disorder who were hospitalized in psychiatric emergency ward of Noor hospital, Isfahan, Iran, were followed. Each patient was considered for; the frequency of relapse and recurrence, kind of pharmachotherapy, presence of psychotherapeutic treatments, frequency of visits by psychiatrist and the rank of present episode. The overall prevalence of recurrence was 42.2%. Recurrence was lower in patients using lithium carbonate or sodium valproate or combined therapy (about 40%), compared to those using carbamazepine (80%). Recurrence was higher in patients treated with only pharmacotherapy (44.5%) compared to those treated with both pharmacotherapy and psychotherapy (22.2%). Patients who were visited monthy by psychiatrist had lower rate of recurrence compared to those who had irregular visits. The higher rate of recurrence observed in carbamazepine therapy may be due to its adverse reactions and consequently poor compliance to this drug. Lower rates of recurrence with psychotherapy and regular visits may be related to the preventive effects of these procedures and especially to the effective management of stress.

While determining the cause of abnormal uterine bleeding, sampling from the endometrium is necessary. Considering that pipelle suction curettage can be performed on an out patient basis and does not require hospitalization, using anesthesia and cervical dilatation, we performed this study. The aim of this study was to compare the diagnostic value of dilatation and curettage (D&C) with pipelle suction curettage. This study was quasiexperimental on 200 pre and postmenopausal patients with abnormal uterine bleeding who refered to Shabihkhani hospital in Kashan, Iran. Endometrial sampling was performed in all patients with two methods namely pipelle and D&C. A pathologist examined the samples each having a predetermined code. The mean age of subjects was 46.2 ±6.2 years, minimum age was 35 years and the maximum was 70 years. The various pathological lab findings were proliferative endometrium, secretory endometrium, athrophic, decidua, cystic and adenomatous hyperplasia. The reports were the same in two methods except for 2 cases where they were different: secretory endometrium with D&C but cystic hyperplasia in pipelle method. The result of our study shows the comparability of obtaining endometrial sample by pipelle with D&C. Due to comfort and convenience of patients in pipelle methode especially in the office setting which does not need anesthesia, pipelle method can easily be employed instead of D&C.

Many etiological factors have been proposed for Premenstrual Dysphoric Disorder (PDD) and different drugs and techniques have been suggested for its treatment. This study was designed to assess the efficacy of vitamin B6 in the treatment of PDD. In a randomized double-blind placebo controlled study, 121 Women, aged 20-45 years, who according to DSM-4 criteria, had PDD were randomly divided into two groups to receive orally either vitamin B6 (group A) 40 mg twice daily during luteal phase of their menstrual cycle or starch as placebo. Vitamin B6 and starch both were prepared in gelatin capsules with the same shape and color. Emotional and somatic scores for the severity of PDD symptoms were determined and compared between the two groups. Emotional score decreased significantly in group A compared to group B and basal value. No changes in somatic scores were observed. It seems that vitamin B6 is an effective drug for relief of emotional symptoms in PDD.

The purpose of this study was to evaluate the effect of smear layer on apical seal of endodontically treated teeth. Sixty extracted single–rooted human teeth were randomly divided into two experimental groups (n=25) and two control groups (n=5). The teeth were instrumented with K–type files to size 40 and then flared. Apical patency was ensured in all teeth. 5% sodium hypochlorite and 17% Ethylenediamine tetraacetic acid was used as irrigants to remove the smear layer in the second experimental group. The experimental groups were obturated by laterally condensed gutta – percha with Roth 801 sealer. The positive control group was obturated with gutta – percha without sealer. The root surfaces were then coated with nail polish and sticky wax except for the apex in the experimental groups and positive control group. The roots were completely covered in the negative control group. The samples were then immersed in India ink for 1 week at 37°C. The statistical analysis of the results showed that the apical leakage was significantly increased in obturated canals with smear layer. The removal of smear layer might improve the long term apical seal and success of endodontically treated teeth.

Osteoarthritis (OA) is one of the most common forms of articular disease and one of the major causes of pain and disability especially among the elderly. The purpose of this study was to assess the effect of lavage and interaarticular (IA) injection of corticosteroid in the knee joint for the treatment of OA compared to interaarticular injection of corticosteroid alone. This prospective clinical trial was done on 39 patients. In the first group (lavage plus interaarticular injection), 19 patients were enrolled and in the second group (interaarticular injection alone), 20 patients included. Initially the patients were classified with respect to their intensity of joint pain using a 100 mm visual analog scale (VAS), their global status (0-100) and Lequesne’s functional Index (0-25). These data were obtained at baseline, 4th week, 8th week and 12th week. In the first group, the intensity of pain in 4th, 8th and 12th weeks became significantly attenuated in comparison with baseline value (P

Haemophilus influenza (HI) is the most commonly found pathogenic bacteria in pediatric otitis media and lower respiratory tract infections. Bacterial attachment to pharyngeal cells and proliferation may be necessary for infection. In the presence of human milk, attachment of HI to pharyngeal cells and colonization may be inhibited. To evaluate the protecting role of breast milk, we investigated the incidence of HI isolated from the throat of healthy infants with different feeding methods. Between August 2002 and March 2003, 210 healthy infants (70 purely breast-fed, 70 purely formula-fed, 70 mixed-fed), aged 1-6 months were enrolled into the study and a throat culture was taken in all of them. The incidence of HI was evaluated using Haemophilus Test Agar Bose (HTAB) plates. The incidence of HI in purely breast-fed, mixed-fed and purely formula-fed infants was 2.9%, 42.9% and 75.7% respectively (P = 0.000). The mean age and weight of cases in the three groups were not statistically different. These data suggest that human milk protects the throat of healthy infants from HI colonization especially in purely breast-fed cases.

Ligamentum flavum normally has neural ends so it has sensory role and helps to protect vertebral column against different injuries. The aim of this study was to detect the neural ends in ligamentum flavum in patients with discopathy. Samples were taken from ligamentum flavum of the patients with discopathy during surgery. One hundred samples were considered. Five hundred sections were obtained and stained with H & E method and were studied under light microscope. Nerve corpuscles were found in none of the sections of the patients. It seems that ligamentum flavum in patients has a loss in the nerve ends that leads to a decrease in proprioceptive information to control nervous system and may injure tissues like cartilage, osseous and fascia.

AbstractWe present a case of unilateral tibia vara associated with an area of focal fibrocartilaginous dysplasia in the medial aspect of the right proximal tibia. Such a case has not been described previously. The affected child was 8 months old. Deformity resolved without aggressive treatment. The pathogenesis of the focal lesion remains controversial. The most likely explanation is that the mesenchymal anlage of the tibial metaphysis has for unknown reasons, developed abnormality at the insertion of the pes anserinus.

A healthy 34 year old man was referred to the operating room for the repair of his totally avulsed lower jaw. He did not tolerate the supine position and always maintained a sitting position to keep his airway open. The patient was successfully managed with a special anesthetic technique to overcome his airway problem and to intubate him