مجله دانشکده پزشکی اصفهان
پیاپی 335 (هفته سوم تیر 1394)

Neonatal jaundice is a common disease، and has been seen in almost 60% of term and 80% of preterm infants. There are three methods of assessing bilirubin level، visual، cutaneous and serum measurement. Method of measuring serum bilirubin، due to blood sampling from the baby، is not ideal. Visual assessment method is not an accurate criterion. So، the researchers looked for a way to measure bilirubin level non-invasively. In 1980، the first review was done and high correlation was found between the skin bilirubin level and the amount of bilirubin in serum. Some of noninvasive bilirubinmeter devices poorly acted in heterogeneous groups in terms of gestational age and races. Some of the newer methods، for each infant، need an initial correction. The latest method of measuring skin bilirubin uses the reflection of the wide spectrum of visible light. We intended the designing and construction of a noninvasive neonatal jaundice meter، using newest methods and designs. In this device، light، with five different wavelengths، transmitted to the skin and after measuring the reflection from baby’s skin، the bilirubin concentration in terms of mg/dl could be obtained. Clinical testing of the device was done on 32 infants; and correlation of 74%، between the transcutaneous (TCB) and the total serum bilirubin (TSB) values was obtained. An acceptable correlation was obtained between the transcutaneous and the total serum bilirubin values. The device can be used to screen newborns for measurement of bilirubin with decreased number of blood samples.

Oral lichenoid reaction is the general nomenclature for explanation of the lesions that have the same clinical and histological appearance. These reactions include lichen planus and oral lichenoid reactions [lichenoid contact reaction، lichenoid drug eruption، and (graft-versus-host disease GVHD)]. This study tried to document the differences between these two groups lesions based on immunological criteria such as immunoglobulins (Ig) G، M، E and A. The method of this research was descriptive and analytic. The statistical samples included two groups of 25 patients who had lichen planus or lichenoid reactions differentiated from each other via clinical and histopathological criteria of World Health Organization (WHO). 5 cc of blood was taken from each patient. Then، all of the achieved data were analyzed using t and chi-square tests. The level of IgE increased in two groups، but there was not significant difference between oral lichen planus (OLP) and oral lichenoid reaction (OLR). The level of IgA was increased in oral lichen planus patients (P < 0. 05). There were not significant differences between IgG and IgM in two groups. Suggestion of criteria for distinguishing oral lichen planus from oral lichenoid reaction is the first line for obtaining favorable treatment planning for all the patients.

Multiple sclerosis (MS) is an organ-specific autoimmune disease in central nervous system، which about 2. 5 million people around the world are suffering from it. Various factors including environmental and genetic factors are involved in the incidence of the disease. T cell immunoglobulin and mucin (TIM) gene is one of the genetic factors which recently demonstrated that has critical role in autoimmune diseases. In this study، the frequency and the association of TIM-3-1541C>T polymorphisms with multiple sclerosis disease in Isfahan، Iran، population were investigated. Blood samples were collected from 140 patients with multiple sclerosis and 138 healthy controls. After DNA extraction، the TIM-3-1541C>T polymorphism was detected via polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) techniques. The results were analyzed with the SPSS16. 0 software package. The frequency of CT genotype in patients with multiple sclerosis was higher than the control group and there was a significant association between multiple sclerosis and TIM-3-1541C>T polymorphism in Isfahan population (P = 0. 009، OR = 4. 08). T cell immunoglobulin and mucin gene family (TIM) is located on human chromosome 5q33. 2 and play a critical role in regulating immune responses including allergy، transplant tolerance and autoimmunity. This study was done based on the results of previous studies about the association of TIM-3-1541C>T with rheumatoid arthritis، since the mechanisms of pathogenesis of this disease and multiple sclerosis are similar. Our results showed that TIM-3-1541C>T polymorphism is associated with multiple sclerosis in Isfahan population.

As a result of studies، kidney transplantation from a donor with high blood pressure to a receiver with normal blood pressure and kidney transplantation from a donor with normal blood pressure to a patient with high blood pressure may lead to tissue hypo- and hyper-perfusion and finally، effect on the survival of the transplanted kidney. The aim of this study was determining the effect of blood pressure difference between the receiver and donor in kidney transplantation on the outcome of kidney function. In a cross-sectional study، 30 kidney transplantations were studied. Blood pressure of donor and receiver was measured before the transplantation and with demographic data entered to special checklist. All the patients were followed after 48 hours after the surgery for outcome of kidney transplantation based on creatinine level and urine output. The effect of the difference in blood pressure between the donor and receiver on the survival of transplanted kidney was evaluated. The mean creatinine level of the receivers with higher and lower blood pressure amounts was 4. 15 ± 1. 20 and 5. 27 ± 1. 69 mg/dl، respectively، and the difference between the two groups was statistically significant (P = 0. 044). Six hours after the surgery، the mean level of creatinine was 3. 84 ± 0. 89 and 4. 65 ± 1. 72 mg/dl in higher and lower blood pressure receivers، respectively with no statistically difference (P = 0. 100). The mean level of creatinine، 24 hours after surgery، was 2. 54 ± 0. 84 and 4. 05±2. 24 mg/dl in higher and lower blood pressure receivers، respectively، and the difference was not statistically significant (P = 0. 180). According to the results of this study، the difference between blood pressure of donor and receiver is one of the important factors on survival of transplanted kidney. Thus، before the transplantation، investigations about the difference between the blood pressure of donor and receiver mast be noticed.

Diabetes in pregnancy is the most common and the most important metabolic condition، since it can result in several fetal malformations. Maternal hyperglycemia may have teratogenic effect for developing of fetal central nervous system (CNS). Several lines of evidence indicate that the children born to diabetic mothers، exhibit disturbances in behavioral and intellectual functioning. The hippocampus subserves important behavioral and physiological functions such as memory consolidation، and is a brain structure particularly vulnerable to changes in glucose concentration. Hippocampal neurogenesis might underlie particular aspects of neuronal plasticity and might play an important role for the memory and cognitive functions. We reviewed the current understanding of the effect of diabetes on developing of central nervous system during the pregnancy.