مجله دانشکده پزشکی اصفهان
پیاپی 340 (هفته چهارم امرداد 1394)

The estimation of patient absorbed dose is the first step of radiation protection that depends on quantification of organ activity in nuclear medicine. The aim of this study was estimating the organ activity for the purpose of calculating the dose and predicting radiation risks. The anterior and posterior images of volunteers were taken at 15، 60 and 120 minutes after the injection، either at rest or during exercise. Then، the organ activity was calculated using the conjugate view method، and also uptake of 99mTC-MIBI was determined. The activity in the heart، liver and kidneys ranged 0. 10-0. 45، 0. 26-4. 19 and 0. 68-2. 03 mCi، respectively، in rest and 0. 14-0. 65، 0. 47-2. 70 and 0. 46-2. 63 mCi after the exercise. The uptake was 0. 6-3. 5، 1. 4-23. 1 and 2. 6-14. 1 percent of injected dose (ID) in heart، liver and kidney، respectively. The results of this study were in good agreement with similar studies. So، the conjugated view method with conventional method for background correction is an accurate approach for quantification of organ activity in myocardial perfusion scan.

Tinnitus is one of the most common and distressing otological problems. Oxidative processes are one of the mechanisms involved in tinnitus. Therefore، in the present study، the concentrations of antioxidant micronutrients (Cr and Mn) were determined in the serum of the patients with tinnitus in comparison with healthy subjects. In this case-control study، 55 patients with tinnitus and 47 healthy volunteers were enrolled، after matching age and sex. The concentrations of Cr and Mn were measured via flameless atomic absorption spectroscopy. Comparisons were made using Student’s t test. There was a significant decrease in mean Cr level of serum in patients with tinnitus comparing to the controls (P < 0. 001). Moreover، there were no statistically significant differences between the mean serum levels of Mn in patients with tinnitus and controls (P = 0. 770). In the present study، a relationship was seen between the serum level of trace element، Cr، and the occurrence of tinnitus. Trace elements are related to nutrition; so; investigation trace elements can be cost-effective and must be evaluated and considered in designing the treatment regimen for patients complaining of tinnitus. However، defining such a cause-and-effect relationship needs several prospective studies to be done.

Induction with hypnotic drugs، as well as suspention laryngoscopy، can be coupled with vast changes in hemodynamic indices. This study aimed to analyze the effect of propofol، etomidate and thiopental sodium، as hypnotic drugs، in hemodynamic changes during suspension laryngoscopy. In this double-blinded study، 75 patients undergoing elective suspension laryngoscopy were divided into three groups of etomidate (0. 3 mg/kg)، propofol (2. 2 mg/kg) and thiopental sodium (5. 0 mg/kg). Hemodynamic parameters were measured at 1، 3، 5، 10، and 15 minutes after induction and 3، 5، 15، and 30 minutes after the recovery; surgeon''s satisfaction of surgery and the duration of surgery and recovery time were recorded، too. SPSS software was used for data analysis. There was no statistical differences in term of demographic data، except height (P = 0. 014)، hempdynamic parameters after induction of anesthesia، the duration of recovery time، the duration of the surgery and the duration of hospitalization. Five patients (20%) had an episode of hypotension in etomidate group، one person (4%) in Propofol group and four patients (16%) in thiopental group; statistical analysis did not show differences between the groups (P = 0. 270) Our study showed that there was no difference between administration of propofol، etomidate or thiopental sodium in terms of hemodynamic changes، surgeon''s satisfaction of anesthesia and surgery duration. Further studies with greater population are required.

Medical errors almost have been the most common causes of proceedings against physicians، and a significant amount of complaints is related to inevitable issues. This study aimed to investigate the causes of complaints related to skin and cosmetics to give over preventive solutions. In this descriptive study، the medical malpractice cases related to skin and cosmetics were studied in general offices of legal medicine of Isfahan Province، Iran، during 2002-2013. As the instrument was a checklist، the formal validity was approved by the relevant experts. Mean and standard deviation for quantitative variables and frequency for qualitative variables were calculated using SPSS software. The chi-square test was used to evaluate the correlation of variables. Most of the complaints were from specialists (62. 7%). The issued votes included 41. 9% failure، 55. 8% acquittal and 2. 3% were closed with no vote. The blood money was less than 25% in 55. 6% of cases، 25-50% in 22. 2% of cases and more than 50% in the 22. 2% of cases. The chi-square test showed no significant relationship between the issued judgments and physicians’ educational certifications (P > 0. 05). In general، we can say that the medical malpractices were related to specialists and the complaints mainly were from specialists in other fields. For this reason، making sure that the diagnosis is based on appropriate expertise and avoiding the interference in other fields are recommended.

The p53 tumor suppressor gene plays important roles in genomic stability. A common polymorphism at codon 72 in the p53 gene has been associated with increased risk for lung، oral، prostate، breast and colorectal cancers. Several reports have noted racial differences in the prevalence of p53 genotypes at the codon 72 in certain cancer types. We studied this polymorphism in patients with chronic myeloid leukemia in isfahan، Iran. We undertook a case-control study to examine the possible associations of the TP53 variants Arg4Pro at codon 72 with the risk of chronic myeloid leukemia. 41 whole blood specimens from healthy people as controls and 41 bone marrow specimens from patients with chronic myeloid leukemia from the city of Isfahan were analyzed. p53 codon 72 genotypes were identified using allele-specific polymerase chain reaction. The gathered data were analyzed using chi-squared test. The genotype distribution for p53 polymorphism was 43. 9%، 51. 2% and 4. 9% for the Arg/Arg، Arg/Pro and Pro/Pro genotypes، respectively in control samples; and، 31. 7%، 46. 3% and 22% for mentioned genotypes، respectively in chronic myeloid leukemia specimens. The differences in the distribution of p53 codon 72 polymorphism between the cases and controls were statistically significant (P = 0. 023). The findings of the present study indicate that p53 codon 72 polymorphism may be a genetic factor in chronic leukemia development in Isfahan. However، further studies are needed in order to elucidate the role of p53 codon72 polymorphism in chronic myeloid leukemia.