@article{ author = {Ebrahimi, H and Nikravesh, M and Oskouie, F and Ahmadi, F}, title = {Stress: Major Reaction of Nurses to the Context of Ethical Decision Making}, abstract ={    Background & Aim: Factors such as improved medical technology, resource allocation, increasing costs, individual rights, and the changing role of a nurse can result in ethical conflicts that require the nurse’s abilities to recognize moral dilemmas and conflicts and make appropriate ethical decisions. The goal of this article is describing stress as the major reaction of nurses to the context of ethical decision making in taking care of patients. Patients & Method: The present study was conducted by using grounded theory method. The participants were 17 Iranian nurses working in medical and educational hospitals. Semi-structured, unstructured and in-depth interviews were used for data gathering. All interviews were transcribed verbatim and simultaneously and coded according to Strauss and Corbin method (open, axial and selective coding). Results: Job stress and moral distress were identified as the major reaction of nurses to the context of ethical decision making. The participants believed that decision making context consisting of individual and job characteristics, patient and patient's family features, physician’s traits, and structural and management conditions plays an important role in nurses' stress and their inability to respond morally to patient and patient's family needs and optimal caring for patients. Conclusion: Because of the negative effects of stress on physical and mental health of nurses, it is necessary that they consider the context in their own decisions. Also, the agents who are involved in structural conditions and nursing management should attempt to reform and improve the circumstances so that nurses can make better decisions without stress or moral distress.}, Keywords = { 1) Ethical Decision Making 2) Stress 3) Moral Distress 4) Grounded Theory 5) Nursing}, volume = {14}, Number = {54}, pages = {7-15}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-693-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-693-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Ehsanipour, F}, title = {Cornelia De Lange Syndrome: A Case Report}, abstract ={    Introduction: Cornelia de lange syndrome(CDLS) is a rare syndrome which is characterized by multiple congenital anomalies, mental retardation, characteristic facial appearance, developmental delay, skeletal malformation, hirsutism, and various ophthalmologic problems. The diagnosis of this syndrome is clinical. Case Report: The patient of the present case report was an infant with cornelia de lange syndrome. Conclusion: An increased awareness of this syndrome may result in an early diagnosis and a decrease in morbidity.}, Keywords = { 1) Cornelia De Lange Syndrome 2) Developmental Delay 3) Congenital Anomaly}, volume = {14}, Number = {54}, pages = {17-20}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-694-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-694-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Ansarin, H and Sadeghipour, A.R and SoltaniArabshahi, R}, title = {Expression of Gli1 Protein in Keloids and Hypertrophic Scars}, abstract ={    Background & Aim: Keloids and hypertrophic scars (HS) are proliferative dermal lesions with an overproduction of collagen and extracellular matrix which usually follow trauma to the skin. Keloid is a raised, erythematous, frequently pruritic or burning lesion which grows over normal tissues with no tendency to spontaneous regression while hypertrophic scar remains limited to the boundaries of the initial trauma and tends to regress gradually. Keloid is more frequent in African and Asian descent. No definite cure has been found for this lesion and existing treatments have high rates of relapse. Understanding the pathophysiology of keloid is necessary for development of newer, more effective therapies. Recently it has been shown that Gli1 oncogene (expressed in several of the human tumors) is involved in the pathogenesis of keloid. The aim of the present study is to determine the expression of Gli1 protein in keloids and hypertrophic scars and to define the probable role of this oncogene in the pathogenesis of keloid. Patients & Method: In a cross-sectional study carried out between 2003 and 2005, paraffin-embedded formalin-fixed specimens with the diagnosis of keloid or HS were retrieved from the pathology archives of Rasoul-e Akram, Razi and Hazrat-e-Fatemeh hospitals and Iranian Dermatology Clinic. Clinical data were collected from patients’ records. Immunohistochemical staining with anti-Gli1 antibody(1:20) was performed on pretreated slides. The expression of Gli1 and the degree and intensity of positivity were compared between keloids and HS using Chi-square test. Results: A total of 28 specimens (12 HS, 16 keloids) were studied. The patients’ mean age was 37.8 years, including 13 females and 15 males. The most frequent site of keloid was auricle (31.25%) and the most common cause was surgery (25%). Immunohistochemical staining for Gli1 was positive for all of the keloids but only 25% of HS (p<0.01). The degree and intensity of positivity was significantly higher in keloids compared to HS (p<0.01). Conclusion: Gli1 oncogene is highly expressed in all of the keloids and might be involved in the pathogenesis of this lesion. With regard to these results, drugs that block the Gli1 pathway might be effective in the treatment of keloids. We recommend in vitro and in vivo studies to evaluate the efficacy of anti-Gli1 therapies on keloids.}, Keywords = {1) Keloid 2) Hypertrophic Scar 3) Gli-1 4) Pathogenesis}, volume = {14}, Number = {54}, pages = {21-28}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-695-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-695-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Izadi, F and Pousti, B and Nikbakht, B and Beheshtian, A and Nikoobakht, N}, title = {Assessment of the Effects of Posterior Cordectomy by Co2 Laser on Respiratory Complications due to Vocal Cord Paralysis}, abstract ={    Background & Aim: Laryngeal obstruction due to vocal cord paralysis has been treated in many ways. The purpose of the present study is to evaluate the outcomes of posterior cordectomy by co2 laser and its effects on respiratory complications due to vocal cord paralysis. Patients & Method: In this pre and post-operative clinical trial, we made use of a 2-4 watt co2 laser which was connected to a laryngeal microscope with an x400 lens. The applied method was slightly different from Dennis and Kashima’s usual technique in terms of the application of mithomycin C on the surgical site. Ten cases including 3 females and 7 males underwent posterior cordectomy by co2 laser. The mean age of the subjects was 34.1 years, ranging from 11 to 60. The duration of follow-up ranged from 5 to 24 months with a mean of 17 months. All the patients were suffering from severe dyspnea before the surgery and 8 of them had tracheotomy for their dyspnea before the surgery. The day after the surgery all the patients got decanulated. The changes of breathing, voice and swallowing conditions were analyzed pre and post-operatively using paired t-test. Results: The mean FEV1/FVC ratio that was 67% preoperatively increased to 80% postoperatively(P<0.8). None of the cases encountered aspiration after the surgery. Four of the cases needed a second surgery due to granulation or fibrosis on the site of the previous operation. Ultimately, the surgery resulted in regular breathing in all the patients. Conclusion: This surgery can decrease respiratory complications caused by vocal cord paralysis.}, Keywords = { 1) Vocal Cord Paralysis 2) Posterior Cordectomy 3) Co2 Laser}, volume = {14}, Number = {54}, pages = {29-36}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-696-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-696-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Imani, F and Hassani, V and Entezari, S.R}, title = {Evaluation of Maternal and Neonatal Effects of Adding Tramadol to 2% Lidocaine in Epidural Anesthesia for Cesarean Section}, abstract ={    Background & Aim: Epidural anesthesia is one of the anesthethic techniques for cesarean section. However, epidural anesthesia with lidocaine has some disadvantages such as delayed onset of action and short duration of analgesia. The goal of this study is to evaluate maternal sensory and motor blockade, neonatal Apgar score, and side effects of adding 50 and 100 mg tramadol to 2% lidocaine in epidural anesthesia for elective cesarean section. Patients & Method: Ninety 20 to 40-year-old pregnant patients with ASA physical status I or II who were candidates for elective cesarean section under epidural anesthesia were included in this prospective and randomized study. Epidural anesthesia was performed in lateral position by means of a 18-gauge epidural needle, through L3-4 space. Epidural catheter for additional injections was indwelt. The patients were randomly divided into three groups including 30 each. Anesthetic solution in the control group(lidocaine group: L) contained 20ml 2% lidocaine with epinephrine(1:200,000), in the LT50 group 50mg tramadol, and in the LT100 group 100mg tramadol was added to the above-mentioned epidural solution. For additional intraoperative analgesia, at first 5ml 2% lidocaine through epidural catheter and then 5µg intravenous sufentanil were administered. Postoperative analgesia was provided by 100mg intramuscular meperidine. The onset of sensory block at T6, the highest level of sensory block, the onset of regression in two dermatomes, the onset and duration of complete motor block, sedation score, total intraoperative drug consumption(lidocaine and sufentanil), neonatal Apgar score, the duration of postoperative analgesia, the time of the first request for postoperative analgesics, total 12-hour consumption of postoperative analgesics, complications, and demographic data were recorded. Results: There were no significant differences among the three groups in demographic data and the duration of anesthesia and surgery. Although in the LT100 group the onset of complete motor and sensory block at T6 was more rapid than two other groups, the highest level of sensory block(above T6), the onset of regression in two segments, and the duration of complete motor block were not different between LT50 and LT100 groups but were higher and more prolonged than L group. Also, the average intraoperative lidocaine and sufentanil consumption in LT50 and LT100 groups showed no difference but was lower than L group. The three groups showed no statistically significant difference in the incidence of maternal complications and neonatal Apgar score. In LT50 and LT100 groups, the time of the first postoperative requirement of analgesics was statistically prolonged and the average meperidine consumption was lower than L group. Conclusion: The present study indicates that adding tramadol to 2% lidocaine in pregnant patients undergoing epidural anesthesia for cesarean section offers advantages over using lidocaine alone in terms of intraoperative anesthesia and postoperative analgesia. Moreover, this addition does not increase maternal and neonatal complications.}, Keywords = { 1) Tramadol 2) Lidocaine 3) Cesarean Section 4) Epidural Anesthesia}, volume = {14}, Number = {54}, pages = {37-44}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-697-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-697-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Poormoghim, H and MazaheriTehrani, M}, title = {A Case Report of Sarcoidosis with Sjogren-Like Symptoms}, abstract ={    Introduction: Sarcoidosis is a chronic granulomatous disease of unknown origin characterized by the presence of non-caseating epitheloid cell granulomas in multiple organs such as lymph nodes, lungs, spleen, liver, skin, and salivary and lacrimal glands. The diagnosis is established when clinical and radiologic findings are supported by histologic evidence of non-caseating granulomas. Sarcoidosis shares several of the extragrandular features of sjogren syndrome as well as the involvement of the salivary and lacrimal glands, which makes it difficult to differentiate between the two diseases based on clinical grounds alone. Case Report: This article represents a 19-year-old lady who presented with parotid enlargement, dry mouth and dry eyes since 3 years ago. Chest x-ray was normal but HRCT(High Resolution CT-scan) revealed a bilateral ground glass lesion. Bronchial biopsy reported chronic granulomatous pneumonia with non-caseating granulomas. Angiotensin converting enzymes(ACE) level was elevated. The PPD skin test and acid fast smear were negative. The test results for anti-Ro, anti-La, and anti-nuclear antibodies(ANA) were negative too. Conclusion: Finally, the patient was diagnosed as a case of sarcoidosis and went under treatment. During the follow-up visits, the signs and symptoms disappeared and a normal ACE level was reported after 6 months. Since sarcoidosis with sjogren-like manifestations is unusual, we decided to present this case.}, Keywords = {1) Sarcoidosis 2) Non-Caseating Granuloma 3) Sjogren-Like Syndrome }, volume = {14}, Number = {54}, pages = {45-51}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-698-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-698-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Taghaddosi, M and Afazel, M.R and Seyedi, M}, title = {A Survey on the Relation of Dietary Habits to Ischemic Heart Diseases}, abstract ={    Background & Aim: Today cardiovascular diseases are the most common causes of death. They constitute an important part of care costs every year. Considering the role of life style such as dietary habits in causing cardiovascular diseases, this survey was carried out to determine the relationship between eating habits and ischemic heart diseases in the patients of Shahid Beheshti Hospital in Kashan. Patients & Method: This case-control study was performed on two groups of 200 ischemic heart patients and 200 non-ischemic patients in Kashan. Data were collected by a questionnaire including variables such as age, sex, job, education, place of living, marital status, the kind of fat and meat they used, overeating, using sugary and starchy foods, and the intake of salt, fat, fruit, vegetables, tea, coffee, alcohol and dairy products. The collected data was analyzed by EP15 program and X2 test. Results: The study covered 400 cases including 200 ischemic and 200 non-ischemic patients. 70 cases (35%) were over the age of 66, 121 cases(60.7%) were male, 174 cases(87%) were married, 124 cases(62%) were illiterate, and 136 cases(68%) were living in Kashan city. The findings showed a meaningful relation between using salty food and ischemic heart involvement(P<0.0001). Also, the usage of fatty food and the above-mentioned disease were related meaningfully(P<0.0003). The relation between the intake of fruit, vegetables, dairy products, and starch and ischemic heart disease was meaningful too(P<0.001). In addition, we noticed a meaningful relation between meat and nuts intake and heart failure(P<0.00001). Ischemic patients used alcohol more than non-ischemic ones, a fact which indicates a meaningful relation between alcohol intake and heart involvement(P<0.02). Smoking and the prevalence of ischemic heart disease seemed to be meaningfully related(P<0.04). However, the findings did not reveal a meaningful relationship between the kind of fat and butter, overeating, tea, and coffee and ischemic heart disease. Conclusion: Considering the role of diet in causing ischemic heart diseases, it is advisable that people be encouraged to use more fruit, vegetables, low-fat dairy products, and white meat and avoid consuming extra salt, fat, red meat, and also alcohol.}, Keywords = {1) Ischemic Heart Disease 2) Life Style 3) Food Habits}, volume = {14}, Number = {54}, pages = {53-62}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-699-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-699-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {TaghipourZahir, SHe and Salehinia, H}, title = {Evaluation of the Diagnostic Value of Measuring Adenosine Deaminase in Pleural Effusion to Differentiate between Tuberculosis and Malignancy by Comparison with Pleural Biopsy}, abstract ={    Background & Aim: Pleural effusion is seen in the background of many diseases, two major groups of which are tuberculosis and malignancies. At present pleural biopsy helps us differentiate these two causes from each other, but it is not only an invasive method but also an expensive one. For this reason, investigators are in search of simple and less invasive methods to diagnose the cause of pleural effusion. One of the new methods is measuring adenosine deaminase activity in pleural fluid. This method has been practiced worldwide and has come up with various results. The main objective of this study is to measure adenosine deaminase levels in pleural fluids of patients and compare them with the histopathological results, and if the outcomes are meaningful, this method can be recommended for clinically confusing cases. Patients & Method: This descriptive analytical cross-sectional study was performed on sixty patients who were hospitalized in the infectious and internal wards on suspicion of tuberculosis or malignancy. First, pleural fluid was aspirated to measure the ADA level(cutoff point 35u/lit). Then biopsy was done and the results were compared with each other. Results: The data was analyzed using SPSS 10 software and Chi-square test. Compared to biopsy, the sensitivity and specificity of ADA for the diagnosis of tuberculosis were 68.4% and 92.6% and for malignancies were 91.3% and 37.8% respectively. In comparison to biopsy, the positive predictive value of ADA to diagnose tuberculosis and malignancies was 81.2% and 47.8% respectively, and the negative predictive value of ADA for the diagnosis of TB and malignancies was 86.36% and 87.5% respectively. Conclusion: Based on the obtained data, raised levels of ADA in pleural effusion(over 35u/l) suggest tuberculosis with a more than 90% probability. Although low levels of ADA(below 35u/l) have great sensitivity for the diagnosis of malignancies, as the specificity of ADA level is 37.8%, it does not necessarily propound malignancy.}, Keywords = { 1) Pleural Effusion 2) Tuberculosis 3) Malignancy 4) Adenosine Deaminase(ADA)}, volume = {14}, Number = {54}, pages = {63-70}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-700-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-700-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Taklif, M and Hosseini, A}, title = {A Case Report of Atypical Manifestation of Cutaneous Tuberculosis}, abstract ={    Introduction: Because of the resurgence of tuberculosis in the world, cutaneous tuberculosis remains a clinical and diagnostic problem. Lupus vulgaris is the most common type of cutaneous tuberculosis. Case Report: Herein we present a 35-year-old male with multiple skin lesions in the face and neck since several years ago. Unfortunately due to unscientific manipulation, clinical appearance of the lesions had changed. Thus, the patient underwent laser therapy with the clinical diagnosis of psoriasis or hemangioma. However, because of unsatisfactory response to treatment, the lesions underwent biopsy. Histologic sections, revealed well-formed granuloma accompanied by langhans’ type giant cells and significant lymphocytic infiltration at periphery. Considering the site of lesions, histologic appearance and positive tuberculin test, the diagnosis of lupus vulgaris was confirmed. Conclusion: The above-mentioned patient’s history reemphasizes that clinical appearance of a skin disease by itself does not suffice for diagnosis and therapy. Therefore, biopsy and histopathologic investigation are recommended for atypical lesions.}, Keywords = {1) Cutaneous Tuberculosis 2) Lupus Vulgaris 3) Granulomatous Lesion}, volume = {14}, Number = {54}, pages = {71-75}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-701-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-701-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Hassani, V and Movassaghi, G.R and SedighMaroufi, SH and MoradiMoghaddam, O}, title = {Assessment of Nitrous Oxide Contamination in Pediatric Operating Rooms in Iran, Tehran and Shahid Beheshti University Hospitals}, abstract ={    Background & Aim: The hazards of contact with low concentrations of anesthetics are undeniable. Nowadays N2O is one of the most common drugs used in anesthesia. The aim of this study is to assess the nitrous oxide contamination in pediatric operating rooms in Iran, Tehran and Shahid Beheshti University hospitals. Material & Method: This descriptive study was conducted in 15 pediatric operating rooms in 4 main pediatric educational hospitals. The rooms with continuous usage of N2O with 2-3 lit/min of flow for general anesthesia in pediatric operations were studied. For sampling and detection of N2O concentration in parts per million, a portable IR spectrophotometer(3010 model of Bacharach Inc.) was utilized. The sampling was done in 6 different points of the operating rooms and 3 different hours of work time(8:30-9AM, 10:30-11AM and 12:30-1:00PM). Independent t-test and one-way ANOVA were used to compare the means. Results: There was no significant difference between the means of N2O concentration in different points of the operating rooms(2248±2202, 1325±1237, 1346±1234, 1792±1706, 2615±2590 and 2414±2593, P>0.05). The mean of N2O concentration in different points of operating rooms with standard ventilation system was significantly lower than that of operating rooms without standard ventilation. The kind of anesthesia, anesthesia system(with mask or endotracheal cuffed or without cuff tube), work time, the position of operating room door(opened or closed), and also the cooler(on/off) exert no significant difference on the mean of N2O concentration. Conclusion: The mean of N2O concentration in different points of pediatric operating rooms of educational hospitals is much higher than standards.}, Keywords = { 1) Contamination 2) Operating Room 3) Pediatric 4) General Anesthesia 5) Nitrous Oxide }, volume = {14}, Number = {54}, pages = {77-85}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-702-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-702-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Daneshjoo, KH and Zamani, A}, title = {Evaluation of Serum Ferritin Levels in 6 to 12-year-old School Age Children of Tehran}, abstract ={    Background & Aim: Iron deficiency and iron deficiency anemia which have been associated with multiple complications are among the most important public health problems in the world. Also, iron deficiency is the most important cause of nutritional anemia. The aim of this study is to investigate the prevalence of iron deficiency among school age children in the schools of Tehran. Patients & Method: In a cross-sectional study, 1779 elementary students from 19 districts of Tehran Province were randomly selected and their blood samples were taken for ferritin measurement. After excluding 124 children, ferritin levels were compared among different age and sex groups in various areas of Tehran. Chi-square and Students’ t-test were used for data analysis. Results: Iron deficiency, i.e. ferritin<12µg/l, was diagnosed in 4.6% of the students of whom 46.8% were girls and 53.2% were boys. The mean age of children with low ferritin was 9.10±1.54 years. Iron deficiency was more prevalent among boys than girls(5.7% vs 3.8%) but this difference was not significant(P=0.07). The prevalence of iron deficiency in the north, south, east and west areas of Tehran was 6.2%, 3.7%, 3.1% and 4.8% respectively. The most and least frequent sites of iron deficiency in Tehran were the north and west areas but the difference was not significant, however(P=0.1). Conclusion: According to the results, the prevalence of iron deficiency has decreased in our country in comparison to previous studies. This may be due to an increase in the knowledge of the community and to the nutritional and cultural developments.}, Keywords = {1) Serum Ferritin 2) School Age Children 3) Iron Deficiency}, volume = {14}, Number = {54}, pages = {87-94}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-703-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-703-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Rohani, Z and Naroienejad, M}, title = {A Case Report of Hydatid Cyst of Diaphragm}, abstract ={    Introduction: Hydatid cyst is caused by Echinococcus Granulosus. On occasion human is an intermediate host in whom the disease is manifested by the presence of one or more hydatid cysts. Liver and lungs are usual sites for involvement whereas other organs are rarely involved. Case Report: The patient of the present case report was a 23-year-old woman who had been referred with RUQ (Right Upper Quadrant) pain. The hydatid cyst of diaphragm presented with a right cardiopherenic mass in PA chest x-ray. Also, a cystic lesion in the left lobe of liver was seen in her lung CT-scan. After making imaging studies, she was operated on and hydatid cyst of right hemidiaphragm with no relation to the liver or lung was reported. Conclusion: Hydatid cyst of diaphragm is a rare phenomenon which may present with a right cardiopherenic mass in PA chest x-ray.}, Keywords = {1) Echinococcus Granulosus 2) Diaphragm 3) Hydatid Cyst}, volume = {14}, Number = {54}, pages = {95-99}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-704-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-704-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Safaeian, R and AleNabi, M.A.A}, title = {A Comparison between the Effects of Total Intravenous Anesthesia and Inhalational Anesthesia on Postoperative Pulmonary Function Test}, abstract ={    Background & Aim: Every surgery is followed by some changes in postoperative pulmonary function tests which can dramatically influence this period. Although the type of the surgery and its vicinity to diaphragm are the main determinants of these changes, anesthetic techniques are also responsible. Among different probable factors through which anesthesia could influence postoperative pulmonary function tests, we planned to evaluate the effects of drugs used during the maintenance stage of anesthesia on postoperative pulmonary function tests. Patients & Method: This is a single blind randomized clinical trial in which the patients ranged in age from 15 to 35 and presented with ASA I(American Society of Anesthesiology). All the operations were elective extremity or lower abdominal surgeries and their length was between one and two hours. All the patients had normal preoperative pulmonary function tests. The total number of the subjects was sixty and they were randomly divided into two equal groups(n=30). For the maintenance stage of anesthesia, inhalational agents(N2O 50%, Halothane 0.5-1%) were used in one group and intravenous drugs in the other one (Midazolam 0.1mg/kg/h, Alfentanil 0.5µg/kg/min). 24 hours postoperatively, pulmonary function tests(PFT) were performed and the deviations of three indices(FEV1=Forced Expiratory Volume in 1 sec, FVC=Forced Vital Capacity, VC=Vital Capacity) from their preoperative values were measured and compared. Students’ t-test was used for statistical analysis. Results: FEV1, FVC and VC decreased by 16.3%, 13.5% and 12.5% in the inhalational group and by 12%, 12.9% and 12% in the intravenous group respectively. Comparing the results showed no significant difference between the two groups. Conclusion: Among the factors which are related to anesthesia and can affect postoperative pulmonary indices, the above-mentioned drugs that we used for the maintenance stage, whether inhalational or intravenous, exert no significant influence on postoperative pulmonary function tests.}, Keywords = { 1) Postoperative Pulmonary Function test 2) Total Intravenous Anesthesia(TIVA) 3) Inhalational Anesthesia}, volume = {14}, Number = {54}, pages = {101-107}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-706-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-706-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {TalebiTaher, M and GolBabaii, S}, title = {Clinical and Paraclinical Reports of 100 Cases of Infectious Arthritis in Firoozgar and Rasoul-e-Akram Hospitals, 1998-2003}, abstract ={    Background & Aim: Septic arthritis is an inflammatory and septic process in the joints. The purpose of the present study is to assess the clinical features and determine the pathogens responsible for the treatment and outcome of infectious arthritis in patients admitted to two educational hospitals, i.e. Firoozgar and Rasoul-e-Akram in Tehran, between 1998 and 2003. Patients & Method: Based on existing data, this study was conducted on all 100 patients who suffered from septic arthritis during 5 years, 1998-2003. The obtained data was analyzed by SPSS 11.5 software. Results: Women constituted 48% of the subjects and men 52%. The mean age of the patients was 48.6 years. 67% of the cases had monoarticular involvement and the most common involved joint was knee(57%). The most common predisposing factor was rheumatoid arthritis. Elevated levels of CRP(C-Reactive Protein) were found in all patients. Synovial fluid culture was positive in 45% of the subjects(mostly S.aureus). Other microorganisms were gram negative bacilli, candida, M. tuberculosis, salmonella, and brucella. There were positive radiographic findings in 20% of the patients. 68% of the cases received empiric antibiotic therapy, mostly PRPs(Penicillinase Resistant Penicillin) and third generation of cephalosporins. The average duration of hospitalization was 15 days. Conclusion: The present study highlights the importance of characterizing the kind of microorganism causing septic arthritis. The proper management of this disease is mandatory to all physicians who work in emergency wards.}, Keywords = { 1) Arthritis 2) Septic Arthritis 3) Epidemiology}, volume = {14}, Number = {54}, pages = {109-117}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-707-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-707-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Firoozrai, M and Ghahramanpour, F and Karani, M and Heidari, I}, title = {A Comparative Study of Saturated, Trans and Cis Fatty Acids Measured in Serum and Adipose Tissue between Patients with Type 2 Diabetes and Normal Subjects}, abstract ={    Background & Aim: Diabetes is a heterogenous disease which results from complex reactions among heredity, nutrition and lifestyle. Some studies have shown that a high intake of saturated fatty acids(SFA) increases the risk of type 2 diabetes, while polyunsaturated fatty acids(PUFA) decrease diabetes incidence by increasing insulin affinity to the receptors. In this study, serum fatty acids and adipose tissue composition as a long-term biomarker for fatty acids intake are determined, and their correlation with type 2 diabetes is investigated. Patients & Method: This was a cross-sectional study in which the healthy and the patient groups were compared. The fatty acid composition of fasting serum and adipose tissue was studied in 98 patients with type 2 diabetes and 76 healthy control subjects using gas-liquid chromatography. The serum lipids were measured by autoanalyzer. The means of variables were compared by using Students’ t-test. Results: The percentages of palmitic acid and positional isomer of oleic acid(11c-18:1) in adipose tissue of the patients were higher than the control group(P=0.01, P=0.02 respectively). The percentages of palmitic acid, total saturated and monounsaturated fatty acids in the serum of the patients were higher than the control group too(P=0.001, P=0.006, P=0.02 respectively). Linoleic acid and polyunsaturated fatty acids were lower than the control group, however(P=0.02, P=0.02 respectively). Mean concentration of triglyceride in the patients was higher than the control group(t=-6.7, P=0.001). There was a negative correlation between serum PUFAs and cholesterol to HDL ratio in serum and a positive correlation between serum PUFAs and TG in serum. Also, PUFAs in serum had a negative correlation with TG in serum. Conclusion: Large amounts of palmitic acid and 11c-18:1 in adipose tissue may increase the risk of type 2 diabetes and it seems that patients with type 2 diabetes can have proper control over lipid parameters by having a higher intake of polyunsaturated fatty acids than saturated fatty acids.}, Keywords = { 1) Type 2 Diabetes 2) Fatty Acids 3) Adipose Tissue 4) Gas Chromatography}, volume = {14}, Number = {54}, pages = {119-128}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-708-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-708-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Kadivar, M and Bozorgmehr, N}, title = {Study of Cytologic Grading of Samples Obtained from Breast Carcinoma Cases Referred to Milad and Rasoul-e-Akram Hospitals between 2004 and 2005}, abstract ={    Background & Aim: Breast carcinoma is the most common malignant tumor and the leading cause of death from carcinoma in women. Tumor grading is important as a prognostic factor in the treatment of patients and is routinely done on histologic specimens. Although breast cytology is a proven diagnostic technique in clinical practice, its use is frequently limited to establishing the benign or malignant character of a given lesion. However, a number of authors have shown that this method can provide additional information about tumor grading and its prognosis. The main objective of this study is to evaluate the importance of cytologic grading of breast carcinoma and its association with histologic grading. Material & Method: In the present study, 73 samples of open biopsy for frozen section examination which were sent to the pathology department of Rasoul-e-Akram and Milad hospitals between 2004 and 2005 were selected. Touch-imprint or scraping was used to prepare smears which were then stained by pap and rapid H;E methods. The smears were evaluated based on the grading system described by khan et al which takes 6 parameters into account: pleomorphism, nuclear size, nuclear margin, naked nuclear size, nucleoli and mitotic counts. Histologic samples were evaluated based on the Nottingham modification of the Bloom-Richardson system. Results: The 73 cases included 67 ductal carcinoma NOS(Non-Otherwise Specified), 2 papillary, 1 tubular, 1 lobular, 1 medullary, and 1 cribriform. The concordance rate between cytologic and histologic grading was 76.7%, which is nearly identical to the past study results. The concordance rate for grade-I tumors was 69.2%, grade-II 85.7% and grade-III 61.1%. 5 out of 6 parameters including pleomorphism, nuclear size, naked nuclear size, nuclear margin, and mitotic counts were statistically significant(P-value<0.05). Necrosis had a significant relation with histologic grading but was not used for scoring. Nucleoli, cell dispersion, cellularity, and tubule formation were not statistically significant. Also, there was no statistically significant correlation between cytologic grading and lymph node metastasis. Conclusion: In summary, expertise and sophistication in breast cancer cytopathology and cytologic grading have developed significantly in recent years. This information should be assimilated into the pre-operative plan so that the biologic behavior of the tumor can be determined in order to avoid a blind therapeutic approach. Prospective follow-up studies are needed to evaluate these cytodiagnostic criteria for cytologic grading of breast carcinoma.}, Keywords = { 1) Breast Carcinoma 2) Cytological Grading 3) Histological Grading}, volume = {14}, Number = {54}, pages = {129-138}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-709-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-709-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {GolMohammadi, M and Mehdizadeh, H}, title = {Cardiac Tamponade: The First Manifestation of Myxedema}, abstract ={    Introduction: Cardiac tamponade is rarely found in patients diagnosed with hypothyroidism, but pericardial effusion secondary to hypothyroidism is relatively common. Case Report: The patient was a 70-year-old female with cardiac tamponade who was later diagnosed as a case of myxedema. After the diagnosis of myxedema, pericardiocentesis was performed immediately and followed by thyroxine hormone replacement therapy. The symptoms subsided within a short duration and her clinical status improved. Conclusion: Impending cardiac tamponade is a rare manifestation of hypothyroidism. A strong suspicion must be maintained for timely diagnosis of pericardial tamponade which should be followed by prompt intervention.}, Keywords = { 1) Pericardial Effusion 2) Myxedema 3) Cardiac Tamponade 4) Pericardiocentesis}, volume = {14}, Number = {54}, pages = {139-142}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-710-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-710-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Gouya, M.M and Nabai, S}, title = {Prevalence of Some Sexually Transmitted Infections in a Family Planning Service}, abstract ={    Background & Aim: In all societies, sexually transmitted infections(STIs) are among the most common infections. Approximately 90% of them occur in developing countries. Devastating consequences of these infections can threaten the society in different aspects such as health, economy and social. The above-mentioned infections are not always accompanied by the disease and most cases are asymptomatic or showing mild symptoms. Therefore, they can easily transmit to the others. The goal of this research is to assess the prevalence of STIs in women attending a family planning service. The specific goal is prevalence assessment on the basis of factors including age, parity, contraception, job, husband’s job, drug abuse and education. Patients & Method: This case study was done on 150 women referred to Vali-Asr Family Planning Center through continuous sampling. Background variables were collected by questionnaires. The subjects were tested for three organisms named N. gonorrhea, C.trachomatis and T.vaginalis. The lab tests included culture for N.gonorrhea, direct fluorescent antibody(DFA) for C.trachomatis, and both direct smear and culture for T.vaginalis. Results: The prevalence of STIs was found to be 11.3%(17 persons), which included N.gonorrhea 2%, C.trachomatis 5.3%, and T.vaginalis 4%. The highest rate of infection belonged to the following groups: women aged between 25 and 29, those with one or two deliveries, those whose husbands worked as drivers, and those who used other methods of contraception except condom. Conclusion: With regard to the high prevalence of these infections in the studied group and considering the large young population of Iran, more studies in this field seem quite necessary.}, Keywords = {1) STIs 2) Chlamydia 3) Trichomonas}, volume = {14}, Number = {54}, pages = {143-150}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-711-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-711-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Mohebbi, A.R and Erfan, A}, title = {Primary Hydatid Disease of the Parotid Gland: Report of a Rare Case}, abstract ={    Introduction: Cystic hydatid disease(cystic echinococcosis) is a zoonotic infection of humans caused by the larval stage of the tapeworm Echinococcus Granulosus. Most of the human infections are caused by eating the materials infected with dog’s feces. The oval form would penetrate into the bowels and reach the liver, lung and other organs through the portal vein. Then, there, it would turn into the cystic form. 50% of these cysts are seen in the liver, 30% in the lungs and 20% in other organs. Head and neck involvement is very rare. Case Report: The present article reports a case of isolated parotid gland hydatid cyst. The patient was a young woman who suffered from facial nerve palsy(temporal branch) due to the compressive effect of the cyst. A superficial parotidectomy was performed and the diagnosis was confirmed by the pathologist. The patient was then treated with albendazole(2 courses of a 2-week treatment). No other organ involvement was detected. Conclusion: The incidence of hydatid disease in head and neck is very rare. In endemic regions, the presence of head and neck masses with progressive enlargement should arouse suspicion as to hydatid disease. Iran is also endemic for hydatid disease and this should be considered as one of the differential diagnoses of head and neck masses.}, Keywords = {1) Hydatid Cyst 2) Echinococcus Granulosus 3) Parotid}, volume = {14}, Number = {54}, pages = {151-155}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-712-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-712-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Maleki, F and SadeghHassani, S}, title = {Preparation and Purification of Mature Fasciola Hepatica Worm’s Antigens for the Diagnosis of Fascioliasis}, abstract ={    Background & Aim: Fascioliasis as a zoonosis is one of the important parasitic diseases which is caused when fasciola species enter the host’s body. Approximately 2.4 million people throughout the world are infected with this parasite and 180 million people are vulnerable to it. On time diagnosis and rapid treatment of the disease can substantially prevent the harmful effects of the infection on patients. In the present study, we have tried to separate, purify and assess a useful antigen and apply it as a sensitive and specific serologic method. Material & Method: In this experiment, first healthy worms were collected and then cuticles and the other organs of them were detached, homogenized and sonicated separately. Their levels of protein were measured by Bradford method. Then, all the samples were thickened and put on chromatography gel column(G200 sephadex). Four antigenic reactions for each part were observed. By using ultrafiltration method, the protein level of the samples was adjusted to a suitable level so that the obtained antigen could be used to immunize 36 rabbits. The antibodies taken from the rabbits as well as 30 samples of human sera with fascioliasis were tested with CIEP method. In the present study, fraction 2 antigen of fasciola hepatica’s cuticles showed 90.9% sensitivity and 94.4% specificity in CIEP test. The above-mentioned antigen which was identified by SDS-PAGE method had one distinct band of 60 KD, and no other band was recognized along the gel. This antigen, then, went under experiment by ELISA method which revealed that the antibody in 26 out of 30 samples of human sera and all 36 rabbits was detectable and measurable. Results: Altogether, 60 samples out of 66 including 30 human sera and 36 rabbit sera showed positive sedimentary reaction in CIEP method whereas 62 samples did so in ELISA method. Conclusion: Therefore, it is suggested that 60 KD antigen of fasciola worm’s cuticles be used as a pure antigen in serologic tests such as ELISA and CIEP. However, the results indicate high sensitivity of ELISA method to CIEP method.}, Keywords = { 1) Purification 2) Antigen 3) Fasciola Hepatica 4) Fascioliasis}, volume = {14}, Number = {54}, pages = {157-166}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-713-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-713-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Mousavi, A.S and Mostafaei, P}, title = {Assessment of the Frequency of Pelvic Organ Prolapse and its Risk Factors in Menopausal Women Referred to the Hospitals of Iran University of Medical Sciences in 2004}, abstract ={    Background & Aim: Pelvic organ prolapse which is defined as displacement of bladder, uterus or rectum from their normal position downward is very common in elder women and causes significant morbidity. It is necessary to have a standard staging to investigate this problem, factors influencing it, and the effect of different therapeutic procedures on the course of disease. The aim of this study is to estimate the prevalence of pelvic organ prolapse in menopausal women using the Pelvic Organ Prolapse Quantification examination and to identify factors associated with prolapse. Patients & Method: 240 menopausal women with intact uteruses who were referred to gynecology clinics with any complaint were included in this cross-sectional study. The subjects underwent a POPQ examination during a maximal valsalva maneuver. In addition, they were asked to complete a questionnaire containing some risk factors associated with pelvic organ prolapse. Results: Evaluation of the obtained data revealed the following: age= 58.6±6.1 years, BMI= 27.1±1.04kg/m2, median vaginal parity= 3(range 0-12), and mean years of age after menopause= 8.6 years. Using POPQ system, the subjects were divided into five stages: stage 0 4.2%(n=10), stage I 28.3%(n=68), stage II 61.7%(n=148), stage III 4.2%(n=10), and stage IV 1.7%(n=4). Age(P<0.001), BMI(P<0.001), education(P=0.001), the number of deliveries(P=0.001), age of the first delivery(P=0.001), age of the last delivery(P=0.001), asthma(P=0.001), and waist to hip ratio(P=0.001) correlated with the stage of prolapse. Conclusion: Some degrees of pelvic organ prolapse are quite common in elder women, a fact which should be considered in clinical approaches to these patients. The risk factors vary depending on the nature of supportive defects which involve anterior, posterior or apical walls.}, Keywords = { 1) Pelvic Organ Prolapse 2) Menopause 3) POPQ system }, volume = {14}, Number = {54}, pages = {167-177}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-714-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-714-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Nikpour, S and AtarodiKashani, Z and Mokhtarshahi, SH and Parsay, S and Nooritajer, M and Haghani, H}, title = {Study of the Correlation of the Consumption of Vitamin C-Rich Foods with Preeclampsia and Eclampsia in Women Referred to Shahid Akbar Abadi Hospital in Tehran, 2004}, abstract ={    Background & Aim: Preeclampsia and eclampsia are threatening complications of pregnancy that influence the health of mothers and their fetuses therefore,the prevention of these complications is very important. The need for vitamin C increases during pregnancy and breast-feeding, so providing mothers with vitamin C through natural diet is very prominent. The aim of the present study is to evaluate the correlation between the consumption of diet rich in vitamin C and preeclampsia and eclampsia. Patients & Method: In this case-control study, data collection was done through interviews and filling out questionnaires consisting of two parts. The first section included questions related to background variables and the second part contained some questions relevant to the frequency of the consumption of vitamin C-rich foods. Then, the reported amounts of ascorbic acid in urine and plasma were recorded. 154 women who participated in this study had been selected through a continuous sampling method. The subjects were divided into two groups of case and control. The case group included 75 women with preeclampsia and eclampsia, and 79 women not attacked by preeclampsia or eclampsia formed the control group. The age range of the subjects was between 18 and 35 years. Both groups were matched according to their gravida and multivitamin supplement consumption. Results: The findings indicated that there was a meaningful relationship between preeclampsia, eclampsia and the consumption of vitamin C-rich foods. This relation was significantly meaningful according to the number of servings and also the amount of vitamin C received: for the number of servings for both fruit and vegetables (P=0.00), and for the amount of vitamin C received from diet(≥85mg/day)(P=0.00). Also, the concentrations of ascorbic acid in plasma and urine were(P=0.03) and(P=0.05) respectively, which was significantly related to the presence of preeclampsia and eclampsia. Conclusion: As the results showed, there were direct relations between preeclampsia, eclampsia and insufficient consumption of vitamin C. Proper educational programs about nutrition during pregnancy, especially during the first trimester of the first pregnancy, are recommended and prospective studies are also suggested in order to confirm the existing findings.}, Keywords = {1) Preeclampsia 2) Eclampsia 3) Vitamin C- Rich Foods}, volume = {14}, Number = {54}, pages = {179-192}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-715-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-715-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Nikmanesh, B and Oormazdi, H and Akhlaghi, L and HaghiAshtiani, M.T and Ghalevand, Z and Babaii, Z}, title = {A Survey of the Prevalence of Some Agents Particularly Cryptosporidium to Produce Diarrhea among Children Referred to Tehran Children’s Medical Center}, abstract ={    Background & Aim: Nowadays one of the problems in developing countries is pediatric diseases and their mortalities. In this respect diarrhea plays a significant role. Cryptosporidium is recognized as an important widespread cause of severe and prolonged diarrhea mainly in immunocompromised or malnourished children, but there is no attention to identifying the parasite. The present study was designed and undertaken to assess the prevalence rate of agents causing diarrhea and determine the role of cryptosporidium and its relationship to some potential risk factors. Material & Method: In this cross-sectional study carried out during twelve months(from June 2002 to June 2003), stool samples from 420 children under 10 years of age with diarrhea who were admitted to Tehran Children Medical Center were screened. To identify parasites, direct smear, formalin-ether and modified acid fast staining techniques were applied. In addition, in order to distinguish pathogenic bacteria, differential media and polyvalent standard antisera were used. The obtained data was analyzed using descriptive and analytical statistics, i.e. Chi-square, t-test and Fisher exact test. Results: This study showed that after bacteria, parasites were important causes of diarrhea, and cryptosporidium(2.4%) following giardia(2.9%) was the second parasite isolated in children with diarrhea. Statistical analysis of our results indicated that existence of cryptosporidium was significantly related to the presence of mucus in stool(P<0.003), immune deficiency(P<0.01), and age(P<0.017). Conclusion: This study emphasized that laboratories include appropriate diagnostic techniques for cryptosporidium in the routine examination of watery or mucoid diarrheal stool specimens, particularly for immunosuppressed patients.}, Keywords = { 1) Cryptosporidium 2) Diarrhea 3) Children 4) Bacterium}, volume = {14}, Number = {54}, pages = {193-202}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-716-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-716-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Hashemi, S.M and HaghAzali, M and Mirzaii, M and Sohrabpour, A.A and Mohammadnejad, M}, title = {The Efficacy of Two-Week Metronidazole, Amoxicillin-Based Quadruple Therapy for Eradication of Helicobacter Pylori Infection in Iranian Patients}, abstract ={    Background & Aim: Metronidazole-based quadruple therapy is widely used by physicians as the first line regimen for eradication of helicobacter pylori(H.pylori) in Iran. However, high rate of metronidazole resistance in Iran casts doubt on the efficacy of such regimens in this country. In this respect, this study tries to determine the efficacy of a quadruple therapy based on metronidazole as the first line treatment of H.pylori. Patients & Method: Two hundred fifty-eight patients with peptic ulcer and proven H.pylori infection were included to take a two-week quadruple therapy consisting of metronidazole, bismuth subcitrate, amoxicillin and omeprazole followed by an additional two-week course of omeprazole. Eradication was described as negative 13C-urea breath test(UBT) one month after the completion of the treatment. Results: The patients’ mean age was 45 years and 64.1% of the subjects were female. Seven patients could not complete the treatment course because of intolerable treatment side effects. Eradication rate was 34.9% based on intention-to treat analysis and 35.9% based on protocol analysis. Conclusion: Quadruple therapy based on metronidazole and amoxicillin has limited efficacy in Iran and should not be used for eradication of H.pylori in this country.}, Keywords = { 1) Helicobacter Pylori 2) Antibiotic 3) Metronidazole 4) Omeprazole}, volume = {14}, Number = {54}, pages = {203-208}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-717-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-717-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Hooman, N and Otoukesh, H and Irandoost, SH}, title = {Correlation of the Severity of Initial Clinical and Laboratory Findings with Prognosis in Children with Post Streptococcal Glomerulonephritis in Ali Asgar Children’s Hospital}, abstract ={    Background & Aim: Epidemic acute post streptococcal glomerulonephritis(APSGN) usually shows a good prognosis in children, but some degrees of renal damage have been reported in sporadic forms. The aim of the present study is to evaluate the correlation between the severity of initial manifestations of APSGN and its prognosis in children. Patients & Method: The medical records of 66 children with APSGN who were admitted between 1989 and 2003 were reviewed. This retrospective descriptive study included criteria such as hematuria, recent streptococcal infection, transient decrease in C3, and short-term follow-up for at least six months. The severity of the disease on admission and the severity of renal damage on the last visit were scored. We used Students’ t-test, Wilcoxon rank test and Spearman to compare the means, scores and correlation respectively. P<0.05 was considered significant. Results: 66 children including 51 males and 15 females with the mean age of 8.94 years(±2.4) entered the study. The frequency of moderate to severe hypertension(P=0.03), hyperkalemia(P=0.01), azotemia(P=0.034) and proteinuria(P=0.01) was higher in children under ten. However, clinical, laboratory, and total scores on admission were not significantly different in the two groups. After 1.72 years of follow-up on average, 63% recovered, 6.34% showed some degrees of renal insufficiency, 7.57% had proteinuria, 28.78% presented abnormal urinalysis, and 4.54% remained hypertensive. There was a statistically significant correlation between the initial total laboratory scores and the final scores on the last follow-up(P=0.0001). Conclusion: Despite favorable course of APSGN, the persistence of some degrees of renal damage is not beyond expectations. Therefore, a longer period of follow-up, especially for patients with more severe initial clinical manifestations, is recommended.}, Keywords = { 1) Acute Glomerulonephritis 2) Streptococcal Infection 3) Prognosis 4) Renal Damage}, volume = {14}, Number = {54}, pages = {209-215}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-718-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-718-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Ehsanipour, F}, title = {Henoch-Schonlein Purpura Associated with Pseudomonas Septicemia}, abstract ={    Introduction: Henoch-schonlein purpura(HSP) is the most common form of acute vasculitis with unknown causes, primarily affecting children. Clinical features include skin rashes, arthritis, abdominal pain and nephritis. It is frequently triggered by a streptococcal upper respiratory tract infection. Other bacterias have been implicated as triggering agents. Case Report: We report a case of HSP in a patient with pseudomonas septicemia. Conclusion: Pseudomonas infection should be added to the list of bacteria that can trigger HSP.}, Keywords = {1) Henoch-Schonlein Purpura 2) Leukocytoclastic Vasculitis 3) Pseudomonas}, volume = {14}, Number = {55}, pages = {7-11}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-727-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-727-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {ArjmandiRafsanjani, B and FarzinMoghaddam, S}, title = {Assessment of the Level of the Pregnant Womens Knowledge Towards the Advantages and Disadvantages of Normal Vaginal Delivery and Cesarean Section, Tehran(2005)}, abstract ={    Background & Aim: Normal vaginal delivery(NVD) is defined as the best method of delivery of most times but unfortunately its rate is decreasing because of increasing rate of cesarean section(C/S). Fear of NVD on one hand and preferring C/S on the other causes some difficulties in labor. In one study in Babol city(1998) only 5% of women had appropriate knowledge about kinds of delivery, showing their low level of knowledge. The object of this study is to define the knowledge level of pregnant women about advantages and disadvantages of normal vaginal delivery and cesarean section. Patients and Methods: In this cross sectional study, 1100 pregnant women in Tehran attending one of the governmental hospitals or private centers and that were not physicians or midwives were assessed. Considering the importance of topic questions they were divided in two groups(having 1 or 2 scores). According to their knowledge score, personal knowledge level was classified in to three levels: low level of knowledge(score range 0-16), good level of knowledge(score range 17-32) and satisfactory or high level of knowledge(score range 33-48). Results: The mean age of cases was 29.46 years with SD=7.2. Total mean score of knowledge level was 27.6(SD=8.98). Meanwhile 119 cases(10.8%) had a low knowledge(score range 0-16), 612 cases(55.6%) had a good knowledge(score range 17-32) and 369 cases(33.5%) had a satisfactory or high level of knowledge(score range 33-48) about types of delivery. Conclusion: According to our findings total knowledge of women in Tehran was in an appropriate level but their knowledge is limited and showed bias. We suggest setting up of workshops for general population inorder to increase their knowledge about types of delivery, advantages and disadvantages.}, Keywords = {1) Level of Knowledge 2) Pregnant Women 3) Advantages and Disadvantages}, volume = {14}, Number = {55}, pages = {13-22}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-728-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-728-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Amirmozafari, N and Forohesh, H and Ganji, L}, title = {Comparison of Microimmunofluorescence, ELISA, Rapid Detection Kit(DIMA) and Gimenez Staining for Detection of Chlamydial Induced Cervicitis}, abstract ={    Background & Aim: Chlamydia trachomatis is one of the most prevalent causative agents of sexually transmitted diseases. It causes a variety of genital tract complications such as urethritis, cervicitis, endometritis, epididymitis and lymphogranuloma venereum. The prevalence rate of chlamydia induced cervicitis varies in different societies. In a recent study, the prevalnce of chlamydia cervicitis in sexually active American women was in the range of 5-15% and in pregnant women was 1.2%. The purpose of this study was to evaluate the prevalence of different detection techniques, such as ELISA, MIF, DIMA rapid test and direct microscopy after Gimenez staining. Patients and Methods: A total 137 women with cervicitis(diagnosed according to stablished gynecological protocols) who referred to Rasool Akram hospital and Nilo private clincial laboratory were admitted for this study. Two endocervical swabs were obtained. One of them was used for the rapid Dima test and the other swab was subjected to Gimenez staining. Blood samples were also obtained for serological tests. Results: ELISA tests indicated that 18 patients had positive IgG antibody levels in their blood and 4 of them had IgM antibodies against Chlamydia trachomatis. Ten patients had significant IgG levels and 3 of them had anti-Chlamydia IgM according to the MIF test results. Dima rapid detection test was able to show positive results for only 5 patients. We were not able to detect any Chlamydia inclusion bodies with direct microscopy after Gimenez staining. Conclusion: According to the results obtained with MIF technique which is generally considered to be the "Gold standard" serological detection method, the prevalence of chlamydia induced cervicitis was shown to be 7.2%. There was no statistically significant difference in IgM titers detected by ELISA and MIF methods. But there was statistically different IgG titer rates between ELISA and MIF techniques. Therefore, it is suggested that any ELISA positive IgG titer samples to be rechecked and reconfirmed by MIF method. Due to the lack of chlamydia inclusion body detection by direct microscopy, Gimenez staining is not recommended as a diagnostic tool.}, Keywords = { 1) Chlamydia Trachomatis 2) Microimmunofluorescence 3) ELISA 4) Cervicitis}, volume = {14}, Number = {55}, pages = {23-33}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-729-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-729-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Babaei, S and ChangizyAshtiani, S}, title = {Comparative Assessment of the Healing process of Two Kinds of Endochondral Bone Allografts with each other and with Intramembranous Allografts Assisted by Double Deantigenization}, abstract ={    Background & Aim: When comparing bone autograft and allograft, conditions like performing two surgeries at the same time in an individual, size limitations of autografts, bleeding etc. forced specialists to think about the possible substitution of autografts with the allograft. In this study considering the importance of the kind of the chosen bone for graft, its embryologic origin, its histological structure and also the effective factors that increase the success rate of allografts including the deantigenization method, the healing process of all kinds of Corticocancellous and cortical allografts originating from endochondral bones are compared with each other and with Corticocancellous allografts originating from intramembranous bone. Also the efficiency of deantigenization method is assessed. Materials and Methods: In this experimental study performed on New Zealand white rabbit 42 grafts including 30 grafts in experimental group (including 10 Corticicancellous intramembranous allografts from skull bone(COI), 10 Corticocancellous endochondral allografts from Hip bone(COE) and 10 cortical endochondral allografts from Tibia bone(CE)) were implanted 2cm below the rabbit knee joint. Six autografts, after deantigenization were implanted in Sham group to assess the effects of deantigenization over repair and healing process. Six autografts were implanted in Control group without deantigenization to assess the effects of surgery method and operation room conditions over repair and healing process. They were compared with presence or absence of bone callous and histological decalcified microscopic sections were used to assess the healing process. The results were evaluated by SPSS, Version 11.5 and by Odds ratio Analysis and Fischer's Exact test. Results: The success rate for(COI) grafts was 80%, for(COE) grafts was 60% and for(CE) group was 70%. In sham group healing process was extremely fast(in eight weeks). In control group healing process was obviously slower(till 12 weeks), but after 12 weeks it was compensated. The vacant holes weren't repaired even after three months. Conclusion: The success rate for(COI) grafts was more than(COE) and(CE) but according to statistical analysis this difference is meaningless(Pv>0.05). According to microscopical survey intramembranous allografts have higher rate and speed in :::union::: and healing process.}, Keywords = { 1) Bone Allograft 2) Deantigenization 3) Bone Autograft 4) New Zealand Rabbit}, volume = {14}, Number = {55}, pages = {35-45}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-730-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-730-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Bayanzadeh, S.K and Bolhari, J and AtefVahid, M.K and Nori-GhasemAbadi, R and Lavasani, F and KarimiKisami, I}, title = {Medical and Psychological Interventions in Reducing the Risks of Drug Abuse and Improving the Psychological Status of Drug Addicts in Iranian Prisons}, abstract ={    Background & Aim: Drug abuse in prisons is a serious problem and the high risk methods of drug abuse are even more dangerous, causing greater threats such as the outbreak and spread of HIV/AIDS in the prisons. This indicates the need for treatment of drug abuse and harm reduction in prisons. The aim of this study was to examine the role of medical and psychological interventions in reducing the risks of drug abuse and improving the psychological status of prisoners. Patients and Methods: The effects of methadone maintenance therapy(MMT) and other traditional methods of treatment were compared in a case-control and qualitative study to examine their role in reducing drug use, drug dependence, needle sharing, injections using un-sterilized objects, high-risk sexual behaviors, as well as the psychological well being of the prisoners and their statisfaction with the treatment process. The instruments used in the study were SCL-90-R(farsi version), Highrisk questionnaire,Drug dependence scale, Anger scale and client statisfaction questionnaire. The experimental group(n=38) was provided with MMT and psychological and psychiatric treatment while the control group(N=31) received only the usual psychiatric treatment. Results: Data were analyzed using independent T and Chi-square tests. Six months into the project, the results showed significant changes in the amount of drug use and the extent of needle sharing in the experimental group. However, high-risk sexual conduct remained as prevalent as before. Methadone maintenance therapy also greatly improved the psychological health indicators. In addition, the subjects in the MMT group were considerably more satisfied with the services they received. Conclusion: The findings of this study revealed the advantages of MMT over the traditional psychological and psychiatric approaches in the imprisoned, in helping drug addicts in prisons to overcome their addiction. Based on the results of this study, it can be concluded that not only providing methadone to addicted inmates is safe and harmless, but also can lead to harm reduction and solve many dangerous problems which they face.}, Keywords = {1) Intravenous Addiction 2) Methadone 3) Psychologic Intervention }, volume = {14}, Number = {55}, pages = {47-58}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-731-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-731-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {PourJaffar, M and Karimi, I and Sharifi, S and Salami, S and ShakhsNiyaee, M}, title = {Experimental study of Various Methods of Heparin Administration in Prevention of Adhesion in Infectious and Noninfectious Peritonitis in Guinea Pigs}, abstract ={    Background & Aim: Abdominal surgery may lead to intra-abdominal adhesion. Therefore scientists suggest different methods to prevent this problem. Use of heparin, by its mechanism of coagulation pathway inhibition, is one of these methods. The aim of this study was the comparison of various methods of heparin administration in prevention of post-surgical abdominal adhesion. Materials and Methods: In our experimental guinea pig model, Fourty guinea pigs were divided into eight groups in randomized manner: A(1-4) and B(1-4). A1 and B1 were negative control groups and did not receive any medications. All guinea pigs were anesthetized, laparotomy was performed on each one and 1.5cm midline incision was given. Then peritoneal inflammation was induced in the exposed bowl and peritoneum. After that, experimental infection was induced with inoculation of 100 cfu of Escherichia coli in peritoneal cavity of B(1-4) group. Each guinea pig from A2 and B2 groups received 80mg/kg/day heparin subcutaneously for three days, A3 and B3 groups received one dose of 100IU heparin intraperitoneally and A4 and B4 received 80mg/kg/day heparin three days subcutaneously and one dose of 100 IU heparin intraperitoneally concomitantly. Then the incision was sutured. On the 21 th postoperative day, guinea pigs were euthanized and peritoneal adhesions and specific inflammatory and regeneration reactions were evaluated. Results: The results were analyzed with Fischer's exact test in SAS(version 6, 12) software. Peritoneal adhesions and inflammation reactions in experimental groups had reduced significantly(P0.05). Conclusion: Results revealed that subcutaneous, intraperitoneal and concomitant administrations of heparin are effective in reduction of adhesion formation in infectious and non-infectious experimental peritonitis without significant differences. Therefore since the method of intraperitoneal administration is much easier and more convenient than other methods it is recommended.}, Keywords = { 1) Guinea Pigs 2) Heparin 3) Peritoneal Adhesion 4) Peritonitis }, volume = {14}, Number = {55}, pages = {59-65}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-732-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-732-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Poormoghim, H and Shekarabi, M and Derakhshani, H and Karimi, P}, title = {Clinical Significance of IgA Rheumatoid Factor, Anti-Myeloperoxidase, and Anti-Proteinase 3 Antibodies in Patients with Rheumatoid Arthritis}, abstract ={    Background & Aim: According to the variable progression of rheumatoid arthritis(RA) determination of factors related with poor prognosis is necessary for appropriate treatment of these patients. In this cross section analytical study the aim was to determine the correlation between IgA RF, anti-MPO, anti-PR3 antibodies and clinical, radiological severity in patients with RA. Patients and Methods: Serum samples from 48 patients with RA, who were seen regularly in this clinic were tested. IgA RF, anti-MPO, anti-PR3 titers were estimated by enzyme linked immunoabsorbent assay(ELISA). Hand radiographs were read using the Larsen method as modified by Rau and Herborn also carpometacarpal ratio was calculated. For statistical analysis frequency, percent of frequency indices, mean, median, mode, standard deviation, standard error and for analytic analysis, pearson's correlation coefficient have been used. Results: IgA RF was detected in 33.3% of patients[24.4% of RF(agglutination test) negative patients] and was significantly correlated with low blood hemoglobin(r=-0.311, p=0.02), but not with radiologic damage(r=-0.078). Anti-MPO, and anti-PR3 antibodies were detected in 4.16%, and 2.08% of patients respectively. According to small number of positive sera no correlation was assessed. Conclusion: IgA RF is significantly associated with disease activity and more sensitive in detecting serpositive patients.}, Keywords = { 1) Rheumatoid Arthritis 2) Antimyeloperoxidase 3) Antiproteinase 3}, volume = {14}, Number = {55}, pages = {67-74}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-733-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-733-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Jafari, D and Yeganeh, A and Shariatzadeh, H}, title = {Assessment of Results of Opponensplasty in Patients in Shafa Rehabilitation Center Between 1974-2005}, abstract ={    Background & Aim: In a variety of diseases thumb opposition is absent. Opponensplasty is the transfer of tendon to thumb in order to regain opposition in hands. This operation is perfomed with different tendons and operation techniques results of surgeries are different with various surgical techniques. In this study result of these operations in different patients was assessed in Shafa Rehabilitation Center, between 1984-2005. The aim was to evaluate the results of this type of surgery in different diseases and also to determine the procedure that has the best results. Patients and Method: Ninty five patients with opponensplasty were assessed for results of surgery in Shafa Yahyaeeyan hospital between 1984-2005. Because of varity of diseases such as polio, CP etc. these patient were unable to perform thumb opposition and underwent surgery with different techniques. In this study long term results of these surgeries were assessed with evaluation of patient satisfaction and thumb opposition. Results: Among CP patients, 8(75%) demonestrated good or excellent results. Among Polio patients(35 cases), response was weaker and 62% showed good or excellent results. Meanwhile Burkhalter technique was excellent or good in 80.6% when compared with other methods it was better. Conclusion: Result of opponensplasty was good or excellent in more than 70% of cases Burkhalter technique was better. Results of surgery was better in traumatic disorders as compared to other diseases.}, Keywords = { 1) Tendon Transfer 2) Opposition 3) Opponensplasty }, volume = {14}, Number = {55}, pages = {75-80}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-734-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-734-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Javadi, M and Mohebi, S}, title = {Pathologic Findings in 100 Patients with Chronic Otitis Media in Hazrat-e- Rasool Akram Hospital, Tehran}, abstract ={    Background & Aim: Chronic otitis media(COH) refers to change of middle ear mucosa, usually associted with perforated tympanic membrane. However it may be accompained by some etiology without tympanic membrane perforation. It presents with persistant or intermittent otorrhea, hearing loss and acute and serious complications may occur in its course. Chronic infection, due to it's nature, is irreversible and usually surgery is indicated, and various pathologies are noted. The aim of this study is to evaluate various pathologies in cases of COH that have undergone surgery, so a better clinical diagnosis prior to surgery is reached. Patients and Methods: In this prospective cohort study, one hundred patients with chronic otitis media were evaluated 73 males and 27 females in various age ranges, by most frequency 20-30 year olds were evaluated. Preoperative audiometry and radiology were done and then patients were operated. Results: After data collection and analysis, this result was obtained: 86% granulation tissue, 18% cholesteatoma, 32% tympanosclerosis, 4% cholesterol granuloma and 71% ossicular change. Conclusion: Chronic otitis media presents with hearing loss or otorrhea and may be due various etiologies, most commonly by sequense granulation tissue, cholesteatoma, tympanosclerosis, and cholesterol granuloma. Clinical evaluation of the pathology is useful for clearing matters such as treatment strategy, type of surgery, prognosis, and surgical outcome.}, Keywords = {1) Chronic Otitis Media 2) Cholesteatoma 3) Tympanosclerosis}, volume = {14}, Number = {55}, pages = {81-87}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-735-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-735-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Hassani, V and Javanbakht, S}, title = {Comparison of effects of Halothane, Isoflurane and Sevoflurane on depth of Anesthesia Using BIS Monitoring in Cochlear Implantation of Children Aged 2-6 Years Old, in Hazrat-e Rasool Akram Hospital}, abstract ={    Background & Aim: One of the most important points in the pharmacology of Anesthetic drugs is the their effect on the depth anesthesia and for its assessment recently an important marker BIS is used. In this study we evaluated the effect of three drugs namely Halothane, Isoflurane and Sevoflurane on depth of anesthesia using BIS monitoring. Patients and Methods: This study was performed on 114 patients in ASA-2, who were candidates for cochlear implantation surgery in Hazrat-e Rasool Akram Hospital. The patients were divided in three groups randomly. In the first group who were 36 patients, Halothan was administered for induction. In second group there were 24 patients, Isoflurane was administered and in third group with 54 patients Sevoflurane was administered. For close monitoring of depth of anesthesia BIS technique was used. Time needed for inducing general anesthesia during laryngoscopy, intubation, blood pressure and heart rate were recorded by BIS in collecting data sheet. The study was a randomized clinical trial and tests used for data analysis were One way Anova and Tukey tests. Results: BIS values for patients anesthetized with halothane were 42±1.6 and 42.7±1.5(laryngoscopy and intubation, respectively), with isoflurane were 43±0.3 and 42.1±3.7(laryngoscopy and intubation, respectively) and for sevoflurane group the BIS valves were 42.1±1.3 and 42.4±1.3(laryngoscopy and intubation respectively)(Pv<0.0001). Conclusion: Analysis of data using one way ANOVA and Tukey test showed that there is no difference in regard to the effect on depth of anesthesia and vital signs between three groups but with sevoflurane time was decreased for achieving general anesthesia.}, Keywords = { 1) Cochlear Implantation 2) Halothane 3) Sevoflurane 4) Isoflurane }, volume = {14}, Number = {55}, pages = {89-94}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-736-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-736-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Khalesi, N and Salehi, F and Keshavarz, K}, title = {The First Case Report on Neonatal Familial Oculocutaneous Albinism Associated With VACTERL Syndrome}, abstract ={    Introduction: Albinism refers to a group of inherited conditions. People with albinism have little or no pigment in their eyes, skin and hair. Albinism doesn't occur together with other anomalies with the exception of a case associated with microcephaly and digital hypoplasia. VACTERL is a syndrome consisting of multiple anomalies such as vertebral anomalies, anal atresia, cardiac anomaly, tracheoesophageal fistula, renal and limb abnormalities. Incidence of VACTERL is 1.6 in 10000 live borns and occurs sporadically. Occurrence of albinism and VACTERL together has not been reported yet. Case Report: A 3 day-old term neonate with oculocutaneous albinism phenotype associated with VACTERL syndrome underwent surgery for correction of his anomalies, but because of post operative sepsis and its complications died after few days. Conclusion: Albinism includes a group of clinical conditions that occurs sporadically without associated anomalies. This is the first report of association between albinism and VACTERL syndrome.}, Keywords = { 1) Albinism 2) Sporadic 3) Anomaly }, volume = {14}, Number = {55}, pages = {95-100}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-737-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-737-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Davachi, F and Roghani, K}, title = {Comparsion between the effect of Heparin and Fragmin on Serum Lipid Levels of Hemodialysis Patients in the 15th Khordad Hospital During 9 Months}, abstract ={    Background & Aim: Blood clot during hemodielysis is a reason for blood loss and interference in hemodialysis solution clearance. Therefore during hemodialysis heparin is used for anticoagulation. The aim of this study is to compare the effect of heparin versus fragmin(a type of low molecular weight heparin) on serum lipid levels. Patients and Methods: This is an experimental research performed on two groups of patients on hemodialysis. In group I, there were 11 patients(5 men and 6 women) with average age of 62.5 years old and average of 76.8 months duration of hemodialysis therapy in 15 th Khordad Hospital Hemodialysis Center all received the same dose of heparin. In group II, there were 11 patients(5 men and 6 women) with average age 55.6 years old and average duration of hemodialysis was 80.8 months performed in the same center. They all received the same dose of fragmin, for 9 months continously. None of the patients in either group received lipid lowering drugs. At times 0,3, 6 and 9 months, serum levels of cholesterol, triglyceride, HLD and LDL of all patients were checked. With the hypothesis that fragmin does not have the hyperlipidemic effect of heparin, the heparin used group was selected as "control group" and the fragmin used group was selected as "experimental group". T-test was used for data analysis. Results: The results of study show that there was no significant difference between serum cholesterol levels of these two groups(p=0.59). There was no significant difference between serum triglyceride levels of two groups(p=0.18). Similar results were seen with LDL(p=0.74) and HDL(p=0.09). Conclusion: This study showed that fragmin and heparin have similar effects on serum levels of lipids.}, Keywords = { 1) Hyperlipidemia 2) Heparin 3) Fragmin 4) Cholesterol }, volume = {14}, Number = {55}, pages = {101-106}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-738-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-738-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Zare'Mehrjardi, A and Sami'eeRad, F}, title = {A Morphologic and Immunohistochemical Study of Gastrointestinal Stromal Tumors(GIST) and Value of C-kit Expression in their Histomorphologic Diagnosis}, abstract ={    Background & Aim: Gastrointestinal stromal tumors(GISTs) are the most common mesenchymal tumors of gastrointestinal tract. They are known to express c-kit, which is important in their diagnosis and treatment. The aim of our study was to assess the morphologic and immunohistochemical features of gastrointestinal stromal tumors and the significance of c-kit expression in them. Materials and Methods: The study was descriptive and simple method for sampling was used. Files from pathology laboratory of National Iranian Blood Transfusion Organization were searched for cases referred as GIST between April 2002 and April 2005. Clinical data were recorded and their H;E and IHC slides studied. The results were analyzed by SPSS 10 software. Results: C-kit expression is a key confirmatory marker for GIST diagnosis. Therefore out of 31 referred cases only 22 cases of GISTs(12 males, 10 females) were included in this study. The patient's median age was 51 years. GISTs most frequently occurred in the stomach(12 cases) followed by small intestine(9 cases) and colon(1 case). The size of tumors ranged from 2.5 to 15 cm. Also 72.7% of tumors were hypercellular. Benign spindle cell tumors were 31%, malignant spindle cell tumors 23%, benign epithelioid tumors 23% and malignant epithelioid tumors constituted 23%. Mucosal invasion and tumoral necrosis were present in 22.7% and 27% of cases, respectively: 72.8% of tumors had mitotic activity exceeding 5 per 50 hpf. The expression of other IHC markers were: Vimentin 63.1%, Desmin 13.1%, Smooth muscle actin 22.7%, S-100 protein 22.7% and CD34 63.6%. Conclusion: With regard to the crucial role of c-kit in the pathogenesis of GISTs, c-kit expression is essential for their diagnosis and therapy therefore, tumors which are negative for c-kit, especially those with spindle fascicles, most probably are other mesenchymal neoplasms such as leiomyomas, schwannomas, etc., and should be classified according to their IHC markers. Long-term follow up of all GISTs patients is recommended.}, Keywords = { 1) Gastrointestinal Stromal Tumor(GIST) 2) c-kit 3) Gastrointestinal tract}, volume = {14}, Number = {55}, pages = {107-114}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-739-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-739-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Saied, A.R and Jalilzadeh, A.R}, title = {Evaluation of Radiographic Indices of Wrist in Instabilities of this Joint}, abstract ={    Background & Aim: In radiographic evaluation of carpal instability, the standard method has been the measurement of a series of angles and the new triangulation ratio on lateral wrist radiograms. This study was undertaken to compare these indices in normal and unstable joints. Patients and Methods: Nineteen normal wrist radiograms along with 21 with plamar and 19 with dorsal instability patterns, taken in true lateral position, were enrolled in the study. In each radiogram six variants were measured: capitolunate, radiolunate, radiocapitate, scapholunate and radioscaphoid angles and the triangulation ratio. Results: Between the palmar and normal groups the difference between radiolunate and capitolunate angles and the triangulation ratio, and also between the dorsal and normal groups the difference between the radiolunate and scapholunate angles and the triangulation ratio was statistically significant. In addition, there was no discrete border between normal and abnormal angles. Conclusion: According to these results, it seems that the measure of these angles in itself is not adequate proof for instability of the wrist however among the indices, radiolunate angle and triangulation ratio are more precise than the others.}, Keywords = { 1) Radiogram 2) Instability 3) Wrist}, volume = {14}, Number = {55}, pages = {115-121}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-740-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-740-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {TalebiTaher, M and Mirzaei, A}, title = {A Survey of 50 Cases of Spondylodiscitis: Clinical, Microbiological, Radiological Features and Treatment}, abstract ={    Background & Aim: Septic discitis is an inflammatory process of the intervertebral disc which usually involves the discovertebral junction and may extend in to the epidural space and para spinal soft tissues. The aim of this study was to evaluate spondylodiscitis cases(clinical, microbiological, radiological, treatment and complication features) in Firoozgar and Rasool-e-Akram hospitals during 1998-2003. Patients and Methods: The present research was an observational study done in periodic cross-sectional way on 50 patients with spondylodiscitis. Data collection including age, gender, predisposing factors, radiography, CT.Scan, MRI, CBC, ESR, CRP was done. The results of aspiration or biopsy, prescription of drug and etc. was recorded through a checklist. Statistical analysis was done with spss 11.5 software. Results: Fifty cases of spondylodiscitis were identified, 25 patients were women(50%). The mean age of our patients was 48.20±20.70 years 75 percent of patients were aged ≤65 years. The most common presenting symptom was back pain(86%). ESR was increased in 91.1% of patients. Diagnosis was originally made by MRI. TB spondylodiscitis was the commonest form of disease. The major predisposing factors were invasive procedure and frequent UTI(22% each of them). Conclusion: Spondylodiscitis should be considered in any patient who has severe localized pain at any spinal level, especially if accompanied by fever and elevated ESR. In developing countries such as Iran one of the important causes of this disease is Tuberculosis.}, Keywords = {1) Spondylodiscitis 2) Clinical Features 3) Imaging 4) Microbiology }, volume = {14}, Number = {55}, pages = {123-131}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-741-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-741-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Abdi, E and Rasooli, H}, title = {Glioblastoma in an 18 Year Old Living Related Kidney Recipient}, abstract ={    Introduction: From 1986 to 2005, for 20 years about 2010 renal transplantations(TX) have been performed in our center mainly from unrelated kidney donor. Various bacterial, viral, fungal infections and malignancy after transplantation have been reported due to use of suppressive medications. After 20 years of experience with kidney transplantation in Iran, there are many reports of various malignancies. Case Report: The patient was an 18 year old girl who had been under maintenance hemodialysis(HD) for 6 months. She underwent renal Tx from her father in March 2004. Pathological diagnosis of her native kidney was reflux nephropathy. She had an episode of rejection during the first month and was treated with anti lymphocyte globulin(ALG). Two months after renal Tx we planned to discharge the patient on triple immunosuppressive therapy with excellent allograft function. (Cyclosporine 150mg per day, Mycophenolate Mophtyl 1mg per day, Prednisolone 7.5 mg). Patient was readmitted in our center with fever, severe hirsutism and lower extremity weakness cyclosporine toxicity and CMV infection was suggested. Treatment with gancyclovir was started and cyclosporine dosage reduced. CMV serologic test was positive significantly. IV gancyclovir and 2 months oral anti CMV therapy was initiated for the patient and dosage of cyclosporine reduced to 100 mg/daily. Five months after renal TX, patients was readmitted for progressive lower extremity weakness without focal neurological symptoms 2 episodes of convulsion was noted clinically with normal renal function. On the first day of admission, CT of brain was done. Three space occupaying lesions with different sizes were noted. Brain abscess, toxoplasmosis and CNS malignancy were 3 differential diagnoses in neurologic and neurosurgical consultation. Unfortunately under severe investigation and therapeutic strategies, patient died 2 weeks after admission with functional graft. Brain biopsy showed glioblastoma of brain. Conclusion: With the very interesting CT finding we conclude that in patients with lower extremity weakness other diagnoses besides drug toxicity must be considered. Also it is possible that occult glioblastoma, which is a rare and uncommon malignancy, was provocated with immunosuppression.}, Keywords = {1) Kidney Transplantation(Tx) 2) Hemodialysis(HD) }, volume = {14}, Number = {55}, pages = {133-139}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-742-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-742-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Asgari, M and HafeziAhmadi, M.R}, title = {Value of Immunohistochemistry in Comparison to Immofluorescence for Detecting Immune Deposits in renal Biopsy}, abstract ={    Background & Aim: Evaluation and classification of many renal lesions particularly glomerular diseases are only on the basis of renal biopsy. The clinician's request from the histopathologist is a timely and accurate diagnosis of renal damage which in addition to light microscopy is dependent on the assessment of immune deposits in renal biopsy and verification of immune deposits in Electron microscopy. IF(Immunofluorescence) method which is simple and rapid is gold standard. Due to limitation of this method, received paraffin blocks can be used for detection of immune deposits in IHC(Immunohistochemistry). Other advantages of IHC method include: permanence of stained slides, possibility of morphologic assessment of the lesion and correlation of deposit location and glomerular anatomy. Undoubtedly IHC method has disadvantages including complexity of the technique in comparison to IF, background staining, few number of available antibodies as well as being time consuming. Materials and Methods: In this comparative study renal biopsy specimens from Hasheminejad hospital, which were reported according to IF and light microscopy, were separated and then IHC with IgG, IgM, IgA, C3 and C1q, was performed on these blocks. IHC was based on Immunoperoxidase(IP) method. Presence, kind and location of deposits were recorded by light microscopy. At the same time, H;E, silver, trichrome and PAS stained slides were evaluated. Results: Immune deposits similar to IF were detected by IHC method in 20 out of 26 samples. IHC method couldnot detect visible immune deposits in 4 cases including amyloidosis, MGN(1 case) and IgA nephropathy(1 case). Therefore, sensitivity, specificity, accuracy, positive and negative predictive values of IHC method in diagnosis of renal biopsy specimens is 91%, 100%, 92%, 100% and 65%, respectively. Conclusion: It seems that due to high rate of sensitivity, specificity and accuracy, IHC method which is used by experienced technical staff, can be used as an alternative method for IF when there are no glomeruli in IF specimen or there is difficulty in taking a renal biopsy. Thus according to these finding, the renal pathological lab, should be equipped with both methods, and accountable pathologist, should recognize which method to be used on the basis of clinical state of the patient and adequacy of received specimen.}, Keywords = { 1) Renal Biopsy 2) Immunofluorescence 3) Immunohistochemistry}, volume = {14}, Number = {55}, pages = {141-148}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-743-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-743-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Ashayeri, H and Jafari, Z and AsadMalayeri, S}, title = {The Study of Ages of Suspicion, Diagnosis, Amplification and Intervention In Deaf Children(2005)}, abstract ={    Background & Aim: With early detection of hearing loss at younger ages, there is a better chance for normal language and speech development. Delay in diagnosing hearing loss severly affects language/speech development, social abilities, academic progress, psychological status, job opportunities etc. The present study sought to determine the average ages of suspicion, diagnosis, and amplification of profound hearing loss and intervention in deaf children and to compare at-risk and not-at-risk children based on the studied ages. Patients and Methods: This descriptive-analytic study was conducted on 86 children under 6 years of age with profound bilateral hearing loss in Newsha Aural Rehabilitation Center in Tehran from July to December 2005. Data were gathered through the completion of a questionnaire by the childrens parents. Also childrens medical and rehabilitative records were utilized in order to determine the kind and degree of hearing loss. Results: The mean ages of suspicion, diagnosis, amplification, and intervention were 12.61±8.96, 15.24±9.32, 20.59±11.10, and 22.33±11.64 months, respectively there being statistically significant differences between them. Also 47.70% of the children were in the high-risk group, and statistically there were no significant differences between the at-risk and not-at-risk children in the studied ages. Of all the neonatal diseases investigated, hyperbilirubinemia was the most frequent(40.70%), and there were also 4 cases of meningitis and 6 cases of measles. In terms of consanguinity, mating of first cousins was 41.90% and mating of second cousins and farther familial relationships 14%. After suspecting hearing loss in their children, the parents had visited physicians(57%), audiologists(37.20%), speech therapists(2.3%), or other specialists(3.50%) for the first time. The economic circumstances of the families had a significant bearing on the average ages of suspicion, diagnosis, amplification, and intervention. Conclusion: Despite the remarkable improvement in the average ages of suspicion, diagnosis, amplification and intervention in comparison with those reported in a previous study carried out in Iran(2002), there is still noticeable difference between these ages and those suggested by the Joint Committee on Infant Hearing.}, Keywords = { 1) Suspicion 2) Diagnosis 3) Amplification 4) Intervention}, volume = {14}, Number = {55}, pages = {149-157}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-744-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-744-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Ghazi, F and Gorzin, A.A and Shahrabadi, M and Dabirmanesh, B}, title = {Molecular Analysis of Proteolytic Activity of 3C Protein in Human Parechovirus Type 1}, abstract ={    Background & Aim: Human parechovirus is a genus of picornaviruses which includes a number of important viruses of clinical significance. Recent sequence analysis suggests that human parechovirus type 1(HPEV-1) is distinct from other picornaviruses and lacks the motives believed to be involved in the protease function of 2A. The aim of this study was to analyse proteolytic activity of 3C protein in human parechovirus type 1. Materials and Method: The region of HPEV-1 cDNA that was coded for 3C protein was inserted into plasmid pUBS by Ligase enzyme and pFG3 recombinant plasmid was prepared. After transformation and replication of this plasmid in E.coli MC 10.22, DNA was isolated by phenol extraction and then expressed in prokaryotic(E.coli BL-21) and in vitro systems under T7 promoter. The results were detected by SDS-PAGE and analyzed. Results: The products of expression of recombinant plasmid(not included 3C gene) in both prokaryotic and in vitro systems were analyzed. Just one large band(90 KD) was observed, but with plasmid including 3C gene, several small bands were detected. These results indicated proteolytic activity of 3C protein. After addition of anti protease to the products of plasmid with 3C gene the result was the same as the plasmid without 3C gene. Conclusion: The results showed that HPEV-1 has a processing strategy different from other members of picornaviruses, and 3C protein seems to be the only virus encoded protease that can catalyze cleavages of all sites in the parechoviruses primery polyprotein.}, Keywords = { 1) Picornaviruses 2) Human Parechoviruses 3) 3C Protease 4) Gene Expression}, volume = {14}, Number = {55}, pages = {159-166}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-745-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-745-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Mohammadzadeh, A and ShahFarhat, A and Vahedian, M and Amiry, M}, title = {Comparison of Effect of Breast Feeding and Tube Feeding on O2 Saturation in Very low Birth Weight Infants}, abstract ={    Background & Aim: Preterm infants born at less than 34 weeks postconceptional age are not as neurologically mature as their term counterparts and thus have difficulty coordinating sucking, swallowing and breathing. As a result, they are traditionally gavage fed until they are able to oral feed successfully. The aim of study was to evaluate comparative effect of orogastric and breast feeding on oxygen saturation in very low birth weight infant(<1500gm). Patients and Methods: In this clinical trial all babies admitted in the Neonatal Research Center of Imamreza Hospital, Mashhad during a 4 months period were elected. Criteria for entrance to study included birth weight ≤ 1500 grams, exclusive breastfeeding, having no special problem after 48 hours, receivinge only routine care and intake of milk was 100cc/kg/day. Each neonate received two rounds of orogastric and breast feeding in the morning and in the afternoon, during which mean oxygen saturation was measured by pulse-oxymetry. During the study the heart rate and temperature of the neonates were monitored, and in case of hypothermia, bradycardia(less than 100 per minute) or apnea the feeding was discontinued and the study was repeated the following day. Data analysis was carried out using SPSS and EPI. For comparison & averages of qualitative and quantitative data one-way variance test and for studying the relation between qualitative data Chi Square test was used. Results: Fifty neonates were studied. The average birth weight was 1267.20±165.42 grams and average gestational age was 31.81±1.92 and female/male ratio was 1.2. There was no significant statistical difference in arterial oxygen saturation in orogastric and breast feeding in the morning and in the afternoon.(p=0.16 in the morning and p=0.6 in the afternoon). There was no complication of apnea, hypothermia or bradycardia. Conclusion: There was no significant statistical difference between the two methods in arterial oxygen saturation. It seems that oral feeding(which is a natural route) and skin contact between the mother and neonate causes a strong emotional bonding between the two and brings about better social adaptation for the neonate. Also shorter period of stay in hospital is more preferred, and breast feeding should be started at the earliest possible time after birth.}, Keywords = { 1) Very low birth weight(V.L.B.W) 2) O2 Saturation 3) Breast Feeding }, volume = {14}, Number = {55}, pages = {167-172}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-746-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-746-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {MousaviBahar, S.H and AmirZargar, M.A and Babolhavaeji, H and ManiKashani, KH}, title = {The Study of Success Rate of PCNL in Treatment of Renal Calculi in Patients with Congenital Renal Anomaly}, abstract ={    Background & Aim: Patients with congenital renal abnormality are more prone to calculus formation and have less chance of spontaneous stone passage. Percutaneous treatment of patients with calculi in an abnormal kidney can be challenging due to the altered anatomical relationship in the retroperitoneum. Therefore, we performed a review to assess the safety and efficacy of this minimally invasive technique in patients with congenital renal abnormality. Patients and Methods: We performed percutaneous nephrolithotomy(PCNL) in 15 patients with calculi in anomalous kidneys. Mean age was 34.8 years and 53.3% of the patients were males. The type of anomaly, size of stone, tract site, number of tracts, stone-free rate, transfusion and complication rate and need for secondary intervention were evaluated. Results: Majority of patients had horseshoe kidney(46.7%), 2 cases had ectopic pelvic kidney and 6 others had malrotated and miniaturized kidney. Renal access was obtained through upper pole calyx in 53.3% of the cases, a lower calyx in 33.3% and a middle calyx in 13.3%. Only two cases needed 2 tracts and re-PCNL was performed in 3 cases. Pleural injury occurred in 2 patients and was managed conservatively. There was no need for transfusion. Meanwhile 13(87%) were completely and 2(13%) were relatively stone-free after first or second look procedures. Conclusion: Percutaneous treatment of patients with renal calculi in an anomalous kidney is technically challenging, usually requiring upper pole access. The high stone-free rate and a relatively low incidence of major complications suggest that this minimally invasive method is an effective means of stone management in this complex patient population.}, Keywords = { 1) Kidney 2) Abnormalities 3) Morbidity 4) Surgical Procedures }, volume = {14}, Number = {55}, pages = {173-179}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-747-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-747-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Nasirinezhad, F and RamezanianNick, E and Sadeghi, M and PazokiTorodi, H.R}, title = {Antinociceptive effect of 1,25 Dihydroxy Vitamin D3 in a Neuropathic Pain Model}, abstract ={    Background & Aim: In spite of the fact that many human beings suffer from chronic pain such as neuropathic pain the present clinical methods for treatment of neuropathic pain are not completely successful. 1,25 dihydroxy vitamin D3(1,25 Vit D3) the biologically active metabolite of vitamin D, can increase neurotrophin levels and inhibit the synthesis of nitric oxide synthase which both have potential roles in nociceptive processing. The presence of nuclear receptors of vitamin D in central nervous system indicates the role of this hormone in brain and spinal cord. Vitamin D deficiency in young people is one of the reasons of chronic pain such as musculoskeletal pain. The present experiment was conducted to identify the effects of 1,25 Vit D3 on pain behavior in neuropathic rat model. Materials and Methods: For this reason 40 male Wistar rats weighing 200-250 g were allocated to four groups each including 10 rats. A mononeuropathy was produced by chronic constrictive injury(CCI) of the sciatic nerve. 1,25 Vit D3 was administered by an i.p. injection every 2 days during a month after CCI. In order to evaluate mechanical and cold allodynia, Von frey and acetone tests were used respectively. Rats were tested before CCI, the day after CCI, and every week following CCI. For statistical comparison, ANOVA and Newman kules were used and P<0.05 was considered as significant. Results: Injection of Vitamin D in normal rats did not change pain threshold. Findings revealed the exaggerated responses in the group which received CCI. The group which was treated by 1,25 Vit D3 showed a significant reduction in responses in comparison with the other groups. Injection of Vitamin D increased cold allodynia from the first day of experiment and there was a signifficant difference between Vitamin D with vehicle group which lasted until the end of experiment. In regard to mechanical allodynia, there was a significant difference between vitamin D and the Vehicle group in the fourth week of experiment. Conclusion: Our results suggest that 1,25 dihydroxy vitamin D3 does not affect the pain threshold in normal animals but reduces abnormal pain in the rat model of neuropathy. The effect of Vitamin D on mechanical and cold allodynia came up with different initiation times and abolishes cold allodynia more effectively than mechanical allodynia. So administration of Vitamin D in clinic may provide new approach for treatment of chronic pain.}, Keywords = { 1) Vitamin D3 2) Cold Allodynia 3) Neuropathic Pain 4)Mechanical Allodynia}, volume = {14}, Number = {55}, pages = {181-190}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-748-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-748-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Hashemi, S.M.H and Mohammadi, M and Hashemi, F.S}, title = {Pancreatic Tuberclosis: A Case Report}, abstract ={    Introduction: Tuberculosis is a common disease in developing countries. Extra pulmonary tuberculosis with involvement of pancreas is rare. Abdominal pain especially in epigastrium, fever, night sweat, jaundice and weight loss with pancreatic mass especially in young people is suggestive of pancreatic tuberculosis. Case Report: We report a 51 year old lady with fever, epigastric pain and weight loss from 2 months prior to admission. On sonography and abdominal CT scan a mass lesion was seen in head and body of pancreas with lymph node involvement. Workup with CT guided BX of pancreatic tissue and laparatomy was done. Pathologic report showed granolumatous lesion with caseous necrosis in pancreatic lesion and lymph nodes compatible with tuberculosis. Conclusion: Patient was put on 4 anti tuberculosis therapy response was good. Patient improved.}, Keywords = {1) Pancreatic tuberculosis 2) E.U.S(Endosonography) }, volume = {14}, Number = {55}, pages = {191-195}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-749-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-749-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Hooman, N and Arjmandi, KH and Vossough, P}, title = {Evaluation of Renal Proximal Tubular Function in Children Undergoing Chemotherapy in Ali Asghar Childrens Hospital}, abstract ={    Background & Aim: Chemotherapy may induce mild to moderate glomerular or tubular disorders. We evaluated tubular and glomerular function in children who underwent chemotherapy. Patients and Methods: Between 2003 and 2005 all pediatric cancer patients were entered in a cross sectional prospective study. Demographic data, cumulative doses of anticancer drugs, history of antibiotics, nephrectomy, radiotherapy, and acute renal failure were recorded. Fractional excretion of magnesium, calcium, phosphate, amylase, creatinine clearance(KL/Pcr), and urine protein to creatinine were calculated. The nephrotoxicity was graded from 0 to 9. Pvalue less than 0.05 was considered significant. Results: A total of 233 children(140 males, 93 females) aged 10.5 years(±5.5 SD) on average were enrolled in the study 154 out of 233 patients had lymphoproliferative malignancies and 79 cases has solid tumors. The mean duration of treatment was 28.65 months and the mean duration of therapy discontinuation was 25 months. According to stage of treatment three groups were identified including initial(n=22), during(n=63) and discontinuation(n=148) 28 children had hypertension. The observed renal disorders were as follows glucosuria(n=3), magnesuria(n=9), diluted urine(n=96), metabolic acidosis(n=125), creatinine clearance less than 80ml/min(n=51), phosphaturia(n=55), hypercalciuria(n=96), Amylasuria(n=36) and proteinuria(n=62). Also 207 had mild to severe renal nephrotoxicity. The grade of nephrotoxicity was higher in children<5 years, with history of nephrectomy, radiotherapy, or use of nephrotoxic antibiotics(Kendall-tau, P<0.05). Renal dysfunction was higher during chemotherapy especially with platinium, epipodophylotoxin or ifosphamide (P<0,05). Conclusion: Frequent evaluation of renal function is highly recommended in children during and after termination of chemotherapy.}, Keywords = { 1) Nephrotoxicity 2) Chemotherapy 3) Cancer }, volume = {14}, Number = {55}, pages = {197-205}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-750-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-750-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Yazdanjo, M.A and Sadri, B and MirDehghan, M.H and EbrahimiGhaei, M}, title = {Postoperative Analgesia in Inguinal Herniorrhaphy: Infiltration of 0.25% Bupivacaine before Incision VS before Repair of Incision}, abstract ={    Background & Aim: Postoperative pain is a bad experience which can cause many complications for patients. Nowadays many methods are used to eradicate or decrease pain and the most common methods are use of analgesics and other drugs. One of these methods is infiltrating local anesthetics in the surgical field. The aim of this study was to evaluate the effect of time of administration of analgesics(i.e before incision or before repair of incision) on post operative analgesia. Patients and Methods: Sixty patients undergoing herniorrhaphy were randomized to one of the three treatment groups. The patients were assigned randomly to three groups: Group A(preincisional): "pre" contained 10ml of 0.25% bupivacaine and "post" contained 10ml of 0.9% saline. Group B(postincisional): "pre" contained 10ml of 0.9% saline and "post" contained 10ml of 0.25% bupivacaine. Group C(control): both syringes contained 10ml of 0.9% saline. All patients underwent a general anesthesia induction and maintenance. After positioning and draping 10ml of the "pre" was infiltrated into the incision site after surgery and prior to closure of incision the "post" was infiltrated in the incision. Results: The rate of pain and its scoring were significantly lower in the first group(preincisional) then two other groups(P<0.05). Hemodynamic variables had no significant difference in the three groups. In the first group, patients rate of pain at the first and second analgesic requests was significantly lower than the second group both being lower than control group. Also the mean dose of analgesia in the first 24 hours after the operation was lower in the first group then in the other two groups(P<0.05). Conclusion: The results show that postoperative analgesia gained by infiltration of local anesthetics in the surgical field before herniorrhaphy can reduce the rate of pain and the need for administering analgesics significantly.}, Keywords = { 1) Pain 2) Postoperative pain 3) Herniorrhaphy 4) Bupivacaine }, volume = {14}, Number = {55}, pages = {207-213}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-751-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-751-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {EhsaniPour, F and Abdi, A.A and FaisalNajiAlanaghare, M}, title = {The relation Between Respiratory Rate and Arterial O2 Saturation by Pulse Oximetry in Newborns}, abstract ={    Background & Aim: Rapid breathing is an important clinical manifestation of many illnesses in young infants. Often it is the only sign of illness in this age group. The aim of this study is the evaluation of the respiratory rate as an indicator of hypoxia in infants <1 months. Patients and Methods: This observational study was conducted on 222 ill neonates who were hospitalized in Rasool-Akram NICU. Age, sex and gestational age were recorded and Respiratory Rate(RR) was counted at complete one minute when the neonate was quiet. Then oxygen saturation(SaO2) was measured at finger or toe with a pulse oximeter by another person. Hypoxia was defined as an SaO2<=90%. RR and SaO2 were recorded by 2 fix observers who were unaware of the research. The t2-test was done to find the usefulness of the respiratory rate as indicator of hypoxia. Results: Hypoxia(SaO260/min is a good predictor of hypoxia in neonates brought to emergency service of hospital for any symptoms of acute illness.}, Keywords = {1) Respiratory Rate 2) Pulse Oximeter 3) Arterial Oxygen Saturation 4) Neonate }, volume = {14}, Number = {56}, pages = {7-12}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-767-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-767-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Ahmadi, A. and NasiriNejad,, F. and Parivar, K.}, title = {Effect of Aqueous Extract of the Aerial Part of the Ruta Graveolens on the Spermatogenesis of Immature Balb/C Mice}, abstract ={    Background & Aim: Ruta graveolens(R.G) has been used for sexual impotence in men and abortion in women. In this study the effect of aqueous extract of this plant has been investigated on testis tissue and spermatogenesis. Material and Methods: For this reason as an experimental research, animals were allocated to three groups as control which did not receive anything, vehicle which received only normal saline, and experimental which received ruta extract. Lethal dose 50(LD 50) of extract was considered as 560mg/kg. Based on this, sub LD 50 dose of aqeous extract i.e 280mg/kg was injected intraperitoneally once every other day for one week. A month after the last injection the animals were deeply anesthetized and dissected. Blood was collected intracardically for hormonal assay. The testis were extruded, weighed and then fixed for histological studies. For statistical analysis ANOVA and Tukey as a post hoc test were used. Results: Intraperitoneal injection of 280mg/kg R.G showed nonsignificant changes in body weight and testicular weight and induced a significant decrease in the number of type A spermatogonia(P<0.01) and primary spermatocyte(p<0.05) in experimental group as compared to control and vehicle. There were no significant differences in number of type B and spermatozoid between the groups. There was increase in thickness of tunica albugina and decrease in number of sertoli cells in experimental group as compared to control(P<0.01) and vehicle(P<0.05) which was significant. Also there was a decrease in number of Leydig cells, testosterone and LH levels in experimental group which was not significant. Conclusion: The aqueous extract of R.G diminishes the reproductive system activity and might be useful a substances for birth control process.}, Keywords = {1) Aqueous Extract 2) Ruta Graveolens 3) Spermatogenesis 4) Immature Balb/C Mice}, volume = {14}, Number = {56}, pages = {13-20}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-768-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-768-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {AsadiNoughabi, A.A. and Zandi, M. and Mehran, A. and Alavian,, S.M. and HasanpourDehkordi,, A.}, title = {The Assessment of Education\'s effect on Quality of Life in Patients under P-D Feron Treatment}, abstract ={    Background & Aim: Viral hepatitis is a significant and worldwide health problem. The main purose of treating and caring of patients with chronic disease is to promote life satisfaction and well being feeling. In most of the patients with chronic hepatitis, especially those treated with interferon, quality of life is less than normal. The aim of this study was to evaluate the effect of education on quality of life of patients with chronic hepatitis treated with P-D Feron who had referred to Hepatitis Center-Tehran. Patients and Methods: The present study was done as a semi experimental research with two separate groups: case and control. The intervention included educating the method of self injection of alpha-2B interferon(P-D feron) and following the continuous treatment with interferon. Sampling method was a non-randomized method and carried out according to the subject characteristics. Sample size was 60 patients, grouped randomly in two 30 patient groups(case and control). Data gathering tool was a demographic characteristics questionnaire and the questionnaire of Quality of Life in Patients with Chronic Liver Disease(CLDQ). Educational program was done in four "45 minute sessions" for case group and their relatives. The follow up period was 12 weeks. Quality of life in patients with chronic hepatitis was measured in two stages, before initiating interferon therapy, and after performing educational program. Finally, the quality of life in two groups was compared by Wilcoxon Signed Rank Test. Results: There wasn't significant difference in demographic characteristics of two groups(P>0.005). The total score of quality of life in two groups, before therapy did not show significant difference(P=0.351) while 12 weeks after performing educational program there was a significant difference between two groups(P<0.001). Wilcoxon statistical test showed that total score of quality of life in case group had a significant difference before and after performing educational program(P<0.001), and had improved after performing educational program. The total score of quality of life in control group didn't have significant difference after 12 weeks(P=0.143). Conclusion: Planning short and simple educational programs has a significant effect on the patient's control on his/her disease and its' side effects and can improve quality of life, life satisfaction feeling, and coping with treatment in patients with viral hepatitis.}, Keywords = { 1) Education 2) Viral Hepatitis 3) Quality of Life 4) Interferon Therapy }, volume = {14}, Number = {56}, pages = {21-28}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-769-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-769-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Eshraghi, P. and Hedayati, M. and Daneshpour, M. and Mirmiran,, P. and Azizi, F.}, title = {Association of Trp64Arg Polymorphism of the β3-Adrenoreceptor Gene, Body Mass Index and Serum Leptin Level in Tehran Lipid and}, abstract ={    Background & Aim: There are many articles on the association between β3-adrenoreceptor gene polymorphisms and obesity. The aim of this study was to investigate the association between β3-adrenoreceptor gene polymorphism and serum concentration of Leptin with body mass index(BMI). Materials and Methods: The study was cross-sectional. Participants of Tehran Lipid and Glucose Study were divided on the basis of BMI in four groups: BMI<20, 20≤BMI<25, 25≤BMI<30, BMI≥30. Totally 401 subjects(mean age 44±14 years)[197 men(46±14 years), 204 women(42±13 years)] were selected randomly each group including 97, 98, 104 and 102 subjects, respectively. Leptin level was determined by Enzyme immuno assay(EIA) method and FBS, HDL-C, Triglyceride and Total Cholesterol levels were determined by Enzyme colorimetric method. Factors including Body mass index and blood pressure were measured too. A 210 bp fragment of mentioned gene was amplified using PCR and subject's genotyping in Tehran Lipid and Glucose Study population was determined by RFLP(MvaI, restriction enzyme) method. Data were analyzed using the T-test. We used one-way ANOVA test followed by post hoc multiple comparison(Tukey) between four BMI groups and also between two groups, of AA/TA(arg Carrier) and TT(Arg non Carrier). All data were analyzed using SPSS 11.5. Results: The A(Arg) allele frequency was 0.08 among the population and satisfied Hardy-Weinberg equilibrium. Presence of A(Arg) allele was significantly associated with increase of the BMI(AA/TA, 27±6kg/m2 TT, 25±5 kg/m2 P=0.043) and increase serum Leptin level(AA/TA, 30±25mg/dl TT, 23±21 mg/dl P=0.009). Conclusion: These data showed the association between Trp64Arg polymorphism of β3-adrenoreceptor gene with increasing BMI and Leptin level.}, Keywords = { 1) Obesity 2) Body Mass Index 3) Leptin 4) Polymorphism 5) β3-adrenoreceptor }, volume = {14}, Number = {56}, pages = {29-36}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-770-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-770-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Akbarian,, A. and Haghgo,, A. and Hamkar, R. and HajAbdulbaghi, M. and Esteghamati,, A.R. and Nategh, R. and Zahraee, S.M. and Jalilvand, S. and MokhtariAzad,, T. and NooriJalyani,, K.}, title = {Prevalence of Congenital Rubella Syndrome after Inadvertent MR Vaccination of Pregnant Women in 2003}, abstract ={    Background & Aim: Rubella vaccine contains live attenuated virus that can be transmitted to fetus causing severe abnormalities in the fetus during pregnancy. However there isn't enough studies to show any congenital rubella syndrome(CRS) in these cases, yet. During mass campaign for Measles-Rubella vaccination in December 2003 in Iran, many pregnant women were vaccinated accidently. In this study we evaluated the prevalence of CRS in pregnant women that had referred to Imam Khomeini & Rasool Akram hospitals in 2003. Patients and Methods: In this cohort study, 810 pregnant women 14-25 years of age who received Measles-Rubella vaccine accidently were studied. The cases were grouped in to "susceptible" and "immune against rubella" before vaccination by the status of IgG avidity to rubella vaccine. Then susceptible women were followed up to delivery and their children were followed up to 2yrs of age. Results: Two neonates that were born from susceptible women, showed Rubella-specific IgG in cord blood sera but did not show signs compatible to congental rubella syndrome. Conclusion: According to our findings, the risk of being infected with rubella vaccine virus for fetus of mothers that were accidently vaccinated with rubella vaccine is minimal.}, Keywords = { 1) Measles-Rubella Vaccine 2) Pregnant Women 3) IgG Avidity 4) Congenital Rubella Syndrome }, volume = {14}, Number = {56}, pages = {37-42}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-771-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-771-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {AmirMozafari,, N. and ForouheshTehrani,, H. and Niakani, M.}, title = {Nalidixic Acid Resistance Rate in Typhoidal and Non-Typhoidal Salmonella Isolated from Hospitalized Patients During One Year Period (2005-2006)}, abstract ={    Background & Aim: Nalidixic acid is a quinolone antibiotic with excellent in vitro and in vivo activity against salmonella. It is often the first choice for treating drug resistance salmonella infections. Nalidixic acid resistance can often lead to resistance to fluoroquinolones such as ciprofloxacin. In this survey the extent of salmonella infections, the salmonella strains involved, antibiotic susceptibility patterns, and the MIC values towards nalidixic acid were investigated. Patients and Methods: During one year period(2005-2006), a total of 1333 diarrheal stool samples were collected from hospitalized patients. Stool cultures were performed on differential and selective media for salmonella isolation. A total of 45 salmonella spp.(species) were isolated(3.4%). Species identification were achieved by agglutination with species-specific antisera. Antibiotic susceptibilities were determined by disk-diffusion method(Kirby-Baure). The minimal inhibitory concentration(MIC) of drug-resistance salmonella isolates was performed by E.test. The study was a descriptive work. Data was analyzed by SPSS sftware. Based on difference ratio hypothesis there were no significant differences between the two methods. Results: A total of 45 salmonella spp.(3.4%) were isolated from 1333 stool samples. Agglutination tests with specific antisera indicated that 9 of them belonged to S. enteritids(20.0%), 6 S. typhimurium(13.3%), 4 S. montevideo(8.9%), 3 S. paratyphi C(6.7%), 2 S. paratyphi B(4.4%), 1 S. muenchen(2.2%), 1 S. derby(2.2%), 1 S. schwarzengrund(2.2%), 1 S. arizonea(2.2%) and 13(28.9%) untypable strains. All of the isolates were agglutinated with only anti O-antisera and non showed any reactions with anti-H antisera. Of the 13 untypable strains, 10(22.2%) belonged to the salmonella serogroup C and the remaining 3(6.7%) were serogroup B. Antibiogram tests indicated that 11(24.4%) of the salmonella isolates were resistant to Nalidixic acid in the disk diffusion agar method. However, determination of MIC values with E.test indicated that only 9(20.0%) of these strains showed MIC values within resistant range. Conclusion: The highest rate of nalidixic acid resistance was seen within the non-typhoidal salmonella strains. These strains are widely distributed within our environment and are the major etiological agents of human salmonellosis. Eleven strains were nalidixic acid resistant in the disk-diffusion method whereas, only 9 showed resistant trait with E.test. The MIC of the resistant isolates to nalidixic acid was ≥ 32µg//ml. Despite its high cost, it is therefore concluded that E.test gives a better and more accurate identification of drug-resistance trait as compared to disk diffusion agar method.}, Keywords = { 1) Salmonella 2) Antibiotic Resistance 3) Nalidixic Acid }, volume = {14}, Number = {56}, pages = {43-51}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-772-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-772-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Imani, F. and Hassani, V. and Razi, M. and Entezari, S.R.}, title = {A Comparison of Intra-Articular Pethidine and 0.5% Bupivacaine at the end of Knee Arthroscopy on Postoperative Analgesia}, abstract ={    Background & Aim: One of the methods of controlling pain after knee arthroscopy is intra articular injection of morphine with or without local anesthesia. Pethidine is an opioid that also has week local anesthetic effect. The aim of this study was to compare the analgesic effect of intra-articular pethidine, bupivacaine and their combination at the end of knee arthroscopy on postoperative pain. Patients and Methods: After ethical approval, sixty patients(ASA I or II) undergoing arthroscopic knee surgery during general anesthesia were allocated to this double blinded clinical trial study. Premedication(midazolam and alfentanil) induction(propofol and atracurium) and maintenance(infusion of propofol and alfentanil by infusion pump, O2 and No2 50%, and bolus doses of atracurium) were similar in all groups. At the end of surgery, patients were randomly assigned to one of the three groups(20 patients in each group) to receive intra-articular 0.5% bupivacaine 100mg(Group B), pethidine 100 mg(Group M), or a combination of 0.5% bupivacaine 100 mg and pethidine 100 mg(Group BM) to a total volume of 20 ml. Methylprednisolone 40 mg was added to the solution of all the groups. After transfer to ward, Patient-Controlled Iv Analgesia(PCA) was given for pain control. Duration of postoperative analgesia, pain score(VAS) at 2, 6 and 12 hrs, first analgesic request, total fentanyl consumption during the first 24 hours and side effects were recorded. For statistical analyses, One way Anova, Tukey, Kruskal wallis, Mann-whitney(for quantitative variables) and Chi square or Fischer's Tests(for qualitative variables) were used. Results: Duration of postoperative analgesia was more prolonged in BM group than the other two groups, but M group did not show significant difference as compared to B group(211±51, 72±40, and 51±34 min, respectively). Time for first analgesic request was more prolonged in BM group than other two groups, and also longer in M group than B group(300±38, 132±60, and 82±45 min, respectively, P<0.05). Furthermore, total fentanyl consumption was significantly lower in BM group than other two groups, and also lower in M group than B group(307±52, 352±98, and 382±105mcg, respectively, P<0.05). Although, mean VAS was low in all groups and did not significantly differ between groups at 6 and 12 hrs, but at 2 hrs after surgery it was lower in BM group than others(P<0.05). Patient's satisfaction in BM group showed significant difference than the other two groups(P<0.05). No specific side-effects were observed. Conclusion: Intra-articular pethidine is a potential alternative to bupivacaine in knee arthroscopy. Furthermore, combination of pethidine and bupivacaine provided more therapeutic effects as compared to each used singly.}, Keywords = { 1) Intra-Articular Injection 2) Pethidine 3) Bupivacaine 4) Arthroscopy 5) Analgesia }, volume = {14}, Number = {56}, pages = {53-61}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-773-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-773-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Palizvan, M.R. and Khazaee,, M.R. and Nakhaee,, M.R. and GhaznaviRad,, E.}, title = {Effect of Dietary administration of Cis and Trans Fatty acids on Learning Impairment Induced by Pentylenetetrazol Kindling in Male Rats}, abstract ={    Background & Aim: Impressive research demonstrates the importance of essential fatty acids for many physiological and behavioral mechanisms in both humans and animals. Experimental research showed that deficit in learning and memory is induced after kindling. The objective of this study was to investigate whether dietary cis and trans fatty acids, pre and during pentylenetetraxol(PTZ) kindling would effect learning deficits in male rats. Materials and Methods: This is an experimental research. Eighteen Wistar rats were assigned in three groups. The control group received standard diet. The cis and trans groups received cis and trans fatty acids respectively. The kindling process was initiated one month after the start of the experiment, and the shuttle box learning ability was assessd one week after kindling. Data were analyzed using one way ANOVA and Tukey test. Results: Results showed control and trans groups had impairment in shuttle box learning and no considerable differences were found between these two groups. However on the other hand administration of dietary cis fatty acid reduced impairment in shuttle box learning in pentylenetetrazol kindled rats. Conclusion: The results of this experiment suggest that dietary treatment of kindled rats with cis fatty acids reduced learning deficits induced by PTZ kindling in rats.}, Keywords = { 1) Pentylenetetrazol 2) Kindling 3) Two Way Active Avoidance Learning 4) Cis Fatty Acid 5) Trans Fatty Acid}, volume = {14}, Number = {56}, pages = {63-69}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-774-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-774-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {PourJaffar,, M. and Karimi,, I. and Saraeian,, E. and ShakhsNiyaee,, M. and Badiei,, Kh.}, title = {The effect of Concurrent use of Fresh Garlic or Garlic Tablet with Lead Acetate on Lead(Pb) Burden in Serum and Some Body Tissues of Dog}, abstract ={    Background & Aim: Garlic is a medicinal plant that has been considered and used as "medicine" in various cultures since along time. Considering injuries of lead toxicity especially in vital tissues like liver, kidney and brain and since most drugs used in the treatment of lead toxicity have many side effects it seems necessary to accomplish new studies to identify low risk drugs for prophylaxis and treatment of this important poisoning. The aim of this study was to investigate the effect of fresh garlic and garlic tablet on prevention of lead(Pb) accumulation in some vital tissues. Materials and Methods: Thirty male crossbred-dogs(wt:-9-12 kg, 6-9 months old) were divided into six equal groups(4 experimental groups, 1 control positive and 1 control negative). Experimental groups(A, B) and control positive group(C) received 5 mg/kg lead acetate daily up to one month and A1, A2, B1 and B2 groups received 1/8 and 1/4 of garlic tab, 250 and 500 mg of fresh garlic per kg of body weight respectively. Group D was negative control and received no substance. Results were analyzed using the Dunnet test of Kruskal-Wallis One way analysis of variance on Ranks. Results: Decreased serum lead burden in groups B1 and B2 in comparison with group C was significant(P}, Keywords = { 1) Lead 2) Garlic 3) Tablet 4) Dog }, volume = {14}, Number = {56}, pages = {71-77}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-776-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-776-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Jenabi,, A. and ModirAmani,, O. and Mouraki,, A. and Jabbari,, M. and Osareh,, Sh. and FereshtehNejad, S.M.}, title = {Correlation between Serum C-Reactive Protein(CRP) Level and Sleep Disorders in Chronic Hemodialysis Patients}, abstract ={    Background & Aim: One the most common problems of patients on maintenance hemodialysis is sleep disorders that depends on comorbidities, age, morning dialysis shift, blood pressure and female gender. In addition, nocturnal and daytime sleep abnormalities are accompanied with cardiovascular and infectious diseases. On the other hand, inflammatory processes play an important role in individuals with end-stage renal diseae(ESRD) undergoing hemodialysis, and may affect the levels of additional inflammatory molecules, such as serum C-reactive protein(CRP) which is accompanied with the aggravation of atherosclerosis, protein-dependent malnutrition and cardiovascular diseases. Therefore, the aim of this study was to evaluate the relationship between serum CRP level and the severity of sleep disorders in patients undergoing maintenance hemodialysis no such study has been conducted in Iran or elsewhere. Patients and Methods: This analytical cross-sectional study was performed on 158 chronic hemodialysis patients(with hemodialysis duration of ≥6 months) in Autumn 2005. The patients underwent hemodialysis trice a week(each time 3.5-4 hours). They completed Modified Post Sleep Inventory(PSI) questionnaire to assess sleep related disturbances in 3 forms of sleep: bedtime(PSI1), nocturnal sleep(PSI2) and awakening(PSI3). Simultaneously, a peripheral blood sample was taken for quantitive CRP level before initiating hemodialysis course. The data were collected, described and analyzed using SPSS V.13 software. Results: Statistically significant correlation was found between serum CRP level and PSImean(rs=0.191 and P=0.016). This correlation was more notable in females(rs=0.345 and P=0.002), patients with hemodialysis duration of ≥48 months(rs=0.364 and P=0.001) and during nocturnal sleep(PSI2)(rs=0.249 and P=0.002). Whereas, no significant relationship was found between serum CRP level either with age categories or other forms of sleep disorder. Conclusion: The results of our study show that recommending anti-inflammatory treatment in patients on chronic hemodialysis for sleep disturbances is reasonable and rationale.}, Keywords = { 1) Hemodialysis 2) Sleep Disorders 3) C-Reactive Protein }, volume = {14}, Number = {56}, pages = {79-89}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-777-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-777-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Hassani,, V. and Samarkhah,, M. and KhosraviZanjani,, A.}, title = {The Efficacy of Tramadol 50 and 100mg in Combination with 2% Lidocaine in Epidural Anesthesia for Lower Limb Orthopedic Surgery}, abstract ={    Background & Aim: Tramadol is an analgesic with combined opioid agonist and monoamine reuptake blocker properties, which may be useful as a perioperative analegesic and antinociceptive adjuvant. The aim of this study was to evaluate the efficacy of Tramadol 50 and 100 mg in combination with 2% Lidocaine in epidural anaesthesia for lower limb orthopedic surgery. Patients and Methods: In this randomized, double-blind study, 50 patients undergoing lower extremity orthopedic surgery were enrolled. Patients were randomly assigned to receive either epidural 50 mg Tramadol + 2% Lidocaine(n=25) or 100 mg Tramadol + 2% Lidocaine(n=25). Level and duration of block, change of haemodynamic status and side-effects in each group were compared. Results: There were no differences between the groups in regard to level and duration of analgesia, demographic charecteristics and side effects(P>0.05). Although, systolic blood pressure was decreased significantly in both groups(P<0.05), it was not statistically significant. Conclusion: We suggest that a combination of Tramadol with 2% lidocaine can provide effective and safe preoperative analgesia. Increasing the dose of Tramadol to l00mg, as compared to 50mg dose, does not significantly affect the efficacy and/or side effeds .}, Keywords = { 1) Epidural Analgesia 2) Level of Block 3) Side-Effect 4)Tramadol 5) Duration of Analgesia}, volume = {14}, Number = {56}, pages = {91-99}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-778-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-778-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Khodapanahandeh, F. and Ramzi,, D.}, title = {Evaluation of Status Epilepticus in Patients Admitted to the Pediatric Intensive Care Unit of Rasool Akram Hospital}, abstract ={    Background & Aim: Status epilepticus(SE) is the most common neurological emergency in childhood. Cases referred to pediatric intensive care units(PICU) are the most severely affected. Thus, data from admissions to PICU for SE may provide some insight for devlopment of stategies to reduce the severity and complications of the situation. We conducted this study to determine etiology, factors influencing the occurrence of SE and mortality of patients. Patients and Methods: In a descriptive, cross sectional retrospective study files of 134 children(aged 1 month to 12 years) were reviewed Age, etiology of SE, factors predesposing to occurrence of SE(e.g. previous neurological abnormality), course of the disease and mortality of patients were determined. Descriptive(mean±SD) and comprehensive statistics(χ2 analysis) were used. P<0.05 was considered significant. Results: The mean age of patients was 4.8±4.5yr. Status epilepticus was most common in younger children with 45% of cases occurring in those younger than 2 years. 115(85%) out of 134 patients were admitted with their first episode of SE, while 19(15%) presented with recurrence. The most common etiology group was acute symptomatic(27.7%) whereas, progressive encephalopathy with only 10 patients(7.7%) formed the least common group. 42(31.3%) of the children suffered from Refractory status epilepticus. Also 40.3%(54 out of 134) of patients were neurologically abnormal before the episode of SE(P<0.01) and the older the child the more susceptile to have SE in an abnormal neurological background(P<0.001). Twenty five children(18.6%) died 12 of them(50%) belonged to acute symptomatic group, 10(38.4%) remote symptomatic, 2(7.6%) idiopathic and only 1 patient(3.8%) died of febrile status epilepticus. Conclusion: Children under 2 years included more patients than the other age groups. The most common etiology was symptomatic group(acute & remote). Previous neurological abnormality was a significant factor in occurrence of SE. Acute symptomatic group was the most common etiology in the expired patients.}, Keywords = { 1) Seizure 2) Status Epilepticus 3) Epilepsy}, volume = {14}, Number = {56}, pages = {101-108}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-779-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-779-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Sharifi,, Z. and Yari,, F. and Samiee,, Sh. and MahmoodianShoshtari,, M.}, title = {Cloning of Hepatitis B Virus Surface Antigen(HbsAg) Encoded Gene in E.Coli}, abstract ={    Background & Aim: Hepatitis B virus(HBV) infection is endemic worldwide. It is estimated every year more than 350 million people become infected with HBV(new cases) worldwide. Unfortunately, there are no satisfactory drugs to cure HBV and related diseases and the only way to control it is through vaccination. Measurements of HBV DNA levels are routinely used to identify infectious chronic carriers and to predict and monitor the efficacies of antiviral treatment regimens. The quantification of HBV DNA in clinical specimens has significantly improved with the introduction of real-time PCR into routine diagnostic laboratories. The aim of this research is to study cloning and identify hepatitis B virus surface antigen(HbsAg) encoded gene as external standard. Material and Methods: A descriptive study was done on hepatitis B virus sufrace antigen encoded gene. Genomic DNA was extracted from HbsAg positive serum sample and amplified by PCR. The amplified segments were cloned in pTZ57R plasmid vector. After purification the PCR product was cloned in plasmid vector and transformed into susceptible E.coli(TG1 strain) cell. The bacteria containing the new combination plasmid was than evaluated for antibiotic resistance, PCR, enzyme cleavage and sequencing. The mean of colony numbers that grew in plates with and without ampicilin and also statistical analysis, T-student test was used. Results: After extraction of viral DNA, Sgene was amplified by PCR 175 bp fragment was generated. S gene was than cloned by PT2 57R plasmid. The new plasmid was extracted and was confirmed by enzyme cleavage and PCR. For final confirmation it underwent sequencing. Conclusion: According to the results the 175 bP fragment of s gene was cloned into PT257R Plasmid. It can be used as external standard for real time PCR or as a positive control in laboratory.}, Keywords = {1) Cloning 2) External Standard 3) E.Coli 4) Hepatitis B Surface Antigen}, volume = {14}, Number = {56}, pages = {109-116}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-780-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-780-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Alizadeh,, A.M. and Mohagheghi,, M.A. and Khaniki,, M. and Saeedpour,, Kh. and Khalilvand,, D. and Ghiasi,, S. and Doostdar,, A.R. and Karimi,, M.}, title = {A Study of the effect of Aluminium Hydroxide on the Wound Healing Process in Rat}, abstract ={    Background & Aim: Wound healing is the restoration of physical integrity to internal and external structures and involves intricate interactions between the cells and numerous other factors. Appropriate treatment and care is essential to accelerate healing process, prevent infection and chronicity of the wound and different means and approaches have thus far been used to this end. The aim of this study was to evaluate the effect of aluminium hydroxide, that was used for prevention of bed sore primitively, on the wound healing process in rat. Material and Methods: The effect of aluminium hydroxide on the healing process in two model skin wounds long wounds of 15 mm-long full-thickness and round wounds of 15mm diameter full thickness incision given in the paravertebral area, 1.5mm from midline on the back of rats which was evaluated through measuring the length and area of the healed region with pathological evaluation on different days. Also conducting tensiometry experiments were conducted after complete wound healing. Results: 1. The percentage of wound healing on days 3, 6, 9, 12 and 15 in control group of long wounds changed in the group treated with aluminium hydroxide from 10.13%, 31.88%, 52.46%, 78.75% and 100% to 10.25%, 33.38%, 55.38%, 81.36% and 100% respectively also the percentage of wound healing on days 3, 6, 9, 12, 15 and 18 in control group of round wounds changed in the group treated with aluminium hydroxide from 9.88%, 21.25%, 52.13%, 69.63%, 88.21% and 100% to 10.28%, 29.50%, 52.38%, 75%, 91.73% and 100% respectively. 2. Stress(maximum tensile force causing skin rupture) changed from 13.19 Neuton(N) in the control group of long wound to 15.11 N, also from 11.78 N in the control group of round wound to 11.94 N in group treated with aluminium hydroxide. 3. Strain(tissue length under maximum strain) changed from 9.98 mm in the control group of long wound to 10.59 mm, also from 10.53 mm in the control group of round wound to 11.57 mm in group treated with aluminium hydroxide. 4. The result of patological samples in control and aluminium groups in long and round wounds were nearly similar in regard to healing process, cellular aggregates and clearing of wound area considering the time sequence of samples stained with Hemotoylin and Eosin(HE) Conclusion: Our findings suggest that probably aluminium hydroxide has no effect on skin wound healing process and collagen synthesis in rat, however more immunohistochemical studies are needed.}, Keywords = { 1) Wound Healing 2) Stress 3) Strain 4) Aluminium Hydroxide}, volume = {14}, Number = {56}, pages = {117-124}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-781-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-781-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Firoozrai,, M. and Sarasgani,, M. and Hesabi,, B. and Bandegi,, A.}, title = {Effect of Sports on the Reduction of Cell Membtane Susceptibility, Antioxidant Defense and Oxidative Stress}, abstract ={    Background & Aim: The biological effects of potent oxidative agents in human body are under anti-oxidative control. Functional defects of organs may result from reactions of free radicals with the cell membrane. It is known that major targets of oxygen radicals are cell membrane lipids. Some reports indicate the role of peroxides in development of atherosclerosis. Human body tissues(eg.erythrocytes) contain major antioxidants including glutathione peroxidase and glutathione, hence normal erythrocytes are resistant to oxidative damage. Several controversial studies have demonstrated the effect of sport on improvement of antioxidants and prevention of oxidative damage. Our major objectives were to study the susceptibility of erythrocytes and to evaluate antioxidants such as glutathione peroxidase and glutathione in sports men and compare these variables with that of non-sports men. Patients and Methods: In this cross-sectional study 121 male subjects(80 sportsmen and 41 non sportsmen) have been studied. To evaluate the susceptibility of the erythrocytes, Malondialdehyde(MDA) was measured after they were exposed to H2O2. Glutathione was measured by use of SS Dithio-bis(2-Nitrobenzoic acid)(DTNB). The activity of glutathione peroxidase and Creatine phospho-kinase(CPK) were assessed by enzymatic methods and plasma total anti-oxidants were estimated by Ferric reducing ability of plasma(FRAP) method. For statistical analysis of quantitative and qualitative variables Chi-Square and student T test were used. Results: Creatinine phosphokinase activities in sportsmen were significantly higher. Erythrocytes obtained from non-sportsmen were more susceptible. Since, malondialdehyde resulting from incubation of erythrocytes with hydrogen peroxide in sportsmen(with catalase inhibition: 625.23±132.71nmol/gHb and without catalase inhibition: 521.74±125.05nmol/gHb) was significantly lesser than malondialedehyde of non-sportsmen.(P<0.02 and P<0.01 respectively). Plasma total antioxidant levels, glutathione peroxidase activity and glutathione in the cells were not significantly different. Conclusion: Although anti-oxidative power in sportsmen is not different but it seems lipids of erythrocyte membranes are less susceptible to oxidative stress as compared to nonsportmen.}, Keywords = { 1) Erythrocytes Susceptibility 2) Glutathione 3) Glutathione Peroxidase 4) Malondialdehyde 5) Sportsmen }, volume = {14}, Number = {56}, pages = {125-136}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-782-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-782-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Ghasemi,, M. and SadeghiPourRoudsari,, H. and Dehpour,, A.R. and SadeghiPourRoudsari,, H.R.}, title = {Effect of Endocannabinoid System on the Neurogenic Function of Rat Corpus Cavernosum}, abstract ={    Background & Aim: Although studies have shown the central effects of Endocannabinoid on erection, its' peripheral effect is unknown. The purpose of this study was to investigate the effect of the endogenous cannabinoid anandamide on the nonadrenergic noncholinergic(NANC) relaxant responses to electrical field stimulation in isolated rat corpus cavernosum, a crucial tissue in erectile function. Material and Methods: The rat corporeal strips were mounted under tension in a standard oxygenated organ bath with guanethidine sulfate(5 µM) and atropine(1 µM)(to produce adrenergic and cholinergic blockade). The strips were precontracted with phenylephrine hydrochloride(7.5 µM) and electrical field stimulation was applied at different frequencies(2, 5, 10, 15 Hz) to obtain NANC-mediated relaxation. Anandamide(0.3, 1 and 3 µM in separate groups) was added 20-min before electrical stimulation. In another group, the selective cannabinoid CB1 receptor antagonist AM251(1 µM), the selective cannabinoid CB2 receptor antagonist AM630(1 µM) and a vanilloid receptor antagonist capsazepine(3 µM) were separately added to the bathing medium 45-min before anandamide(1 µM) administration. Using western blotting, the existence of cannabinoid and vanilloid receptors were assessed in this tissue. Each group consisted of six rats. This study was an experimental study. Statistical analysis of the data was performed by one-way analysis of variance(ANOVA) followed by Newman-keuls post hoc test. Statistical significance was considered when P<0.05. Results: The results showed that the NANC relaxant responses were significantly enhanced in the presence of anandamide at 1 and 3 µM. The potentiating effect of anandamide(1 µM) on relaxation responses was significantly lessened by either AM251(1 µM) or capsazepine(3 µM), but not by AM630(1 µM)(P<0.01). Neither of these antagonists had influence on relaxation responses. Preincubation with the nitric oxide synthase inhibitor L-NAME(1 µM) significantly inhibited the relaxation responses in the presence or absence of 1 µM anandamide(P<0.001). Although at 30 nM, L-NAME did not influence NANC responses, it significantly reduced(P<0.01) the attentuating effect of anandamide on NANC responses. Anandamide(1 µM)) had no influence on concentration-dependent relaxant responses to sodium nitroprusside(10nM-1mM), an NO donor. Western blotting revealed the existence of cannabinoid CB1(but not CB2) and vanilloid VR1 receptors in rat corpus cavernosum. Conclusion: For the first time, our results indicated the potentiating activity of anandamide on NANC-mediated relaxation of rat corpus cavernosum through both CB1 and vanilloid receptors. The NO-mediated component of the NANC relaxant responses to electrical stimulation is involved in this enhancement. Also it was shown that CB1 and VR1 receptors are present in this tissue.}, Keywords = { 1) Cannabinoids 2) NANC(nonadrenergic noncholinergic) Nerves 3) Nitric Oxide(NO) 4) Corpus Cavernosum 5) Rat }, volume = {14}, Number = {56}, pages = {137-147}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-783-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-783-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Madani,, A. and Reyhani,, M.J.}, title = {The Relationship between Patellofemoral Pain and Radiographic Changes in Patients Aged 15 to 40 Years Old}, abstract ={    Background & Aim: More attention has been paid to the maltracking of patella in the sulcus as the etiology of the anterior knee pain. Those patients with patellofemoral pain and with no known cause could be called as patellofemoral syndrome. In this study we investigated the relationship between pain and radiographic changes in patellofemoral joint. Patients and Methods: In a cohort study, we studied 64 knees (18 males, 28 females) of 46 patients with patellofemoral syndrome. Duration, severity & quality of pain as well as axial patellofemoral Xray in 20 & 45 degrees of knee flexion was studied before & after a 6 weeks course of physiotherapy and analysed with Mode & Chi square test. Results: Before the treatment mean of pain duration was 6.5 months(SD: 4.8), mean of pain severity 5.5(SD, 1.7), mean of sulcus angle was 129(SD: 8) and mean of congruence angle was 14.8(SD: 11). Six patients had patellofemoral index of more than 1.6. After treatment 22 patients had no pain, 28 had mild pain and no pain relief in 4 patients. Mean of pain severity was 1.4 months(SD, 1.5). There was no relation between sex and age with pain severity before treatment and pain response. However correlation between pain duration and pain relif was significant(P<0.0005). In other works, the lesser the pain duration, the more the therapeutic response. Mean of congruence angle improved to -16.6(SD, 8), which means reduction of the angle as much as 1.8 degree(P=0.041). Patello femoral index was greater than 1.6 in 6 cases after treatment it reduced to 4 cases. Four patient had patellofemoral index of more than 1.6. There was no relation between pain severity and relief of pain with xray changes. However correlation between relief of pain & congruence changes was found in patients who improved with treatment. Congruence angle reduced to 2.3(P=0.028), but this reduction was in only 0.375 of the patients not happy with the treatment, which statistically is not significant(P=0.83). Conclusion: Axial radiography is not correlated with severity of pain and response to treatment. There was significant relation btween response to treatment and change in mean of congruence angle after treatment. After the onset of the symptoms early initiation of treatment, is associated with better therapeutic response.}, Keywords = { 1) Patellofemoral 2) Knee radiography 3) Physiotherapy }, volume = {14}, Number = {56}, pages = {149-156}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-784-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-784-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Motamed,, M.R. and FereshteNejad, S.M. and KhaleghiPanah,, M.}, title = {The Comparison of Sex Hormones and Interferon\'s Impacts on the Number of Relapses and the Progression of Disability in Relapsing-Remitting Multiple Sclerosis(RRMS)}, abstract ={    Background & Aim: Multiple sclerosis(MS) is the most common demyelinative disease of central nervous system among young adults. The differences which are seen in clinical types, drug responses and geographical distribution of MS indicate the role of various factors in the etiology, pathogenesis and epidemiology of this disease. In addition, sexual prevalence and alteration of clinical manifestation during pregnancy may strongly suggest an important role for sex hormones. The aim of this study was to compare the impacts of interferon(IFN) and sex hormone as disease modifying agents in relapsing remitting MS(RRMS). Patients and Methods: This cohort study was conducted on 39 women which were supposed to have RRMS according to McDonald criteria. They were evaluated during a 32-month study period from January 2002 to August 2004 in four groups: 11 patients under both sex hormone and IFN(group A), 12 patients under IFN(group B), 6 patients under sex hormone(group C) and 10 patients who received neither sex hormone nor IFN(group D). The progression of disability which was determined using Kurtzke Expanded Disability Status Scale(EDSS) at the beginning and the end of study period, the number of relapses and demographic data were recorded and analyzed using SPSS v.11.5. For statistical analyses k.s, Paired T-Test, Kruskal-wallis, Mann whitney and correlation tests were used. Results: The mean age of patients was 28.36yr. (SD=8.36). The maximum and minimum number of relapses were seen in groups D(2.5 attacks, SD=1.17) and A(1.36 attacks, SD=0.50), respectively. Analysis showed significant statistical relation between number of attacks and sex hormone therapy(P=0.013). Also results demonstrated significant statistical difference in EDSS before and after treatment(P=0.000) and between EDSS changes and sex hormone therapy(P=0.019). IFN therapy influenced only the number of relapses(P=0.033) and did not show any relation with EDSS changes(P=0.32). Conclusion: The therapeutic role of sex hormones is still controversial. However, the results of our study indicate the role of sex hormone in women with RRMS and suggest that high concentration of sex hormones, especially estrogen(e.g during pregnancy), can decrease the number of relapses. Meanwhile, combination therapy with IFN and sex hormone may have a beneficial influence on decreasing the number of relapses and progression of disability.}, Keywords = { 1) Multiple Sclerosis 2) Sex Hormone 3) Interferon 4) EDSS}, volume = {14}, Number = {56}, pages = {157-164}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-785-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-785-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {ManouchehriPour,, M. and JabbariMoghadam,, M.}, title = {The Study of Effect of Duration of Anesthesia on Appearance of Post Anesthesia Shivering after Limb Surgeries}, abstract ={    Background & Aim: Postanethesia shivering is a common complication of modern anesthesia. With due attention to this point that duration of administration of anesthetic drugs is related to the occurrence of post anesthetic shivering, we studied the effect of duration of anesthesia on the appearance of post anesthesia shivering. Patients and Methods: This double-blind study was performed on 60 patients aged between 20-50 years and ASA class I. Based on duration of anesthesia patients were divided in three groups: In group(1) duration of anesthesia was less than one hour group(2) between 1-3 hours and group(3) between 3-5 hours the amount of post anesthesia shivering was detected at the end of surgery. The anesthesia protocol was similar in the three groups. The results were analysed with chi-square test and Cramer Vi index. Results: Based on our results there was a clear relationship between duration of anesthesia and appearance of post anesthesia shivering. This association becomes more apparent when duration of anesthesia is more than three hours. Conclusion: Increase in duration of anesthesia to more than three hours is a cause for increase in post anesthesia shivering.}, Keywords = {1) General Anesthesia 2) Inhaled Anesthetic Drugs 3) Post Anesthesia Shivering }, volume = {14}, Number = {56}, pages = {165-171}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-786-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-786-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Mehrvar, A. and Vosoogh, P. and Mehrvar, N. and Azarkeyvan, A. and Arjmandi,, Kh. and Ansari,, Sh. and Nickfarjam,, H.}, title = {Study of Immune Response to Hepatitis B Vaccination in Acute Lymphoblastic Leukemia(ALL) Patients in the Maintenance Phase of Chemotherapy in Ali Asghar Hospital}, abstract ={    Background & Aim: HBV is hepatotrophic virus that usually causes infection without any symptoms and it is a very important infective factor in patients with acute lymphoblastic leukemia because they need blood products during their treatment. Because of the importance of this subject the aim of this study was to use hepatitis B virus vaccination in patients who did not have immunity for this disease. Patients and Methods: We used double dose hepatitis B virus vaccination for prevention of hepatitis B in 159 patients with acute lymphoblastic leukemia that were in maintenance phase of chemotherapy. Patients immunity system(humoral and cellular) and hepatic function was checked and didn't have any problem. This was a case – control study for which Chi-Square Test was used to analyse data. Results: The results(Hepatitis B Surface antibody) were checked in both groups 3-5 months after vaccination. 25% of patients showed affirmative response to vaccination and it was a hopeful sign for increasing researches and control in these patients. Conclusion: Studies in other countries, show about 30% positive response to HbsAg vaccination and we can conclude that, it is better to use hepatitis B virus vaccination for those who don't have any protective antibody for hepatitis B disease.}, Keywords = { 1) Acute Lymphoblastic Leukemia 2) Vaccination 3) Hepatitis B }, volume = {14}, Number = {56}, pages = {173-180}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-787-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-787-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Mehrvar, N. and AkhavanSepehi,, A. and Mehrvar,, A. and AzimiRad,, M. and Edalat,, R. and Jaffari, F. and Sanaee,, M. and Mirsaeedi,, K. and Zali,, M.R.}, title = {Discrimination of Salmonella Serotypes Isolated from Children Aged Less than 15yr. with Diarrhea by PCR-Ribotyping}, abstract ={    Background & Aim: Salmonella is the most important pathogenic microorganism causing food borne disease and diarrhea in humans. It could present as diarrhea, fever, vomiting and sometimes bloody diarrhea. Because of its' importance as one of the pathogens, it is essential to identify and characterize its serotypes by molecular methods. The aim of this study was to characterize PCR-Ribotyping technique for identification of salmonella serotypes in stool samples. Material and Methods: In this study our samples were salmonella strains isolated from 115 stools of children with diarrhea. After serotyping, their DNA was extracted with phenol/chloroform method. We performed the PCR-Ribotyping method with P1, P2 primers for 16S-23SrRNA gene. Finally PCR-products were electrophoresed on 1.8% agarose gel. After Ethidium Bromide staining we analysed it. Data were analyzed by SPSS 11.5, Chi-Square test and NTSYS2. Results: One hundred and fifteen strains contained paratyphi A, B, C, D and serotype typhi. All of the serotypes had similar 5 bands ranging 700 to 2500bp. Conclusion: According to the results we conclude that PCR-Ribotyping method has the highest sensitivity for identification of genus salmonella but it does not have enough power to discriminate between various salmonella serotypes.}, Keywords = { 1) Molecular Methods 2) Discrimination Power 3) Salmonella 4) Serotype}, volume = {14}, Number = {56}, pages = {181-187}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-788-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-788-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Nojomi,, M. and ModaresGilani,, M. and Erfani,, A. and Mozafari,, N. and Mottaghi,, A.}, title = {The Study of Frequency of Risk Factors of Cervical Cancer Among Women Attending General Hospitals in Tehran, 2005-2006}, abstract ={    Background & Aim: Cervical cancer is the third most common genital malignancy in women. In majority of developing countries the prevalence of this malignancy is high. The aim of this study was to determine the frequency distribution of risk factors of cervical cancer. Patients and Methods: A cross-sectional study involving 300 women with histologically confirned cervical cancer was conducted in Tehran, Iran. The method of sampling was non-probability(convenience). The setting was 7 general hospitals including obstetric and gynecology departments in Tehran. Demographic variables(age, literacy, marital status, job), contraceptive use, history of abortion, family history of cervical cancer, marriage age, age of first delivery, smoking habits, etc. were evaluated. The method of collecting data was interview, records review and structured questionnaire. We used SPSS software(version 12.0) in order to describe data. Results: The mean of age for studied women was 55.4±11.6yr. Around half of the women were illiterate. Also 17% of them reported more than once marriage 10% reported a positive history of cervical cancer in first degree relative 45% of them had history of using oral contraceptives and 12% were former smokers. Mean age of marriage and mean number of pregnancies were 16.4±4 and 6±2.7 respectively. Average duration of OC use was 9±5 year. 48% of women had history of stillbirth or abortion. Mean age of women at first pregnancy was 18.6±3.7yr. Conclusion: Mean age of studied women was 55.4 years old. The frequency of important risk factors were: positive family history(10%), low mean age of marriage(16.4 years old), high mean number of pregnancy(6), low mean age of birth(18.6years old), and long duration of OC use(9 years).}, Keywords = { 1) Cervical Cancer 2) Risk Factors 3) Frequency}, volume = {14}, Number = {56}, pages = {189-195}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-789-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-789-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Neshasteriz,, A. and Parach,, A.A. and Khoei,, S.}, title = {Evaluation of Iudr Radiosensitization in Multicellular Glioma Spheroids by Comet Assay}, abstract ={    Background & Aim: In vitro experiments and in vivo studies have revealed that radiosensitizers in radiation therapy may serve as powerful tools in the treatment of glioma cancers. Many cell lines, under some specific conditions will aggregate and grow to form multicellular structures called spheroid. Thses spheroids resemble in vivo tumor models in several aspects. Therefore studying growth characteristics and behavior of spheroids is beneficial in understanding the behavior of tumors under various experimental conditions. The aim of the current study was to determine the role of Iudr(Iododeoxyuridine) in sensitizing glioma cell line spheroids to radiation. Material and Methods: This study is an experimental research and T-test was used to compare the results. In this study we compared the DNA induced damages in U87MG cell line using alkaline comet assay method. Experiments were performed with two different sizes of spheroids(100µm and 300 µm). Results: Our results showed the effect of radiation on both diameters of spheres in the presence and absence of Iudr. Accordiology radiation in the presence of Iudr increased the tail moment and thus increased cellular damage. Iudr, in saturation concentration increases the cells radiosensitivity. Specifically in 300µm spheroids, in the presence of Iudr, cell damage was increased to 50%. Conclusion: Comparison of tail moments in spheroids with 100 and 300µm diameter showed that cell damages in larger spheroids(300µm) are lesser than smaller ones(100µm). It may be because of existence of G0 cells and cells with longer cycles, in which Iudr is incorporated to a lesser extent into them. Also, our results showed that minimum presence of Iudr increased the cells radiosensitivity. Therefore inorder to increase the efficacy of this modality of treatmnt we can increase the incubation time of Iudr, increasing the cell population in the cell cycle. In addition cells with longer cycles have more time to incorporate Iudr, or we can use agents that inhibit repairing.}, Keywords = { 1) Radiosensitization 2) Glioma 3) Spheroid 4) Iudr 5) Comet }, volume = {14}, Number = {56}, pages = {197-207}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-790-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-790-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {MirzakoochakKhoshnevis,, F. and NasiriNejad,, F. and Parivar,, K.}, title = {Effect of Alcoholic Extract of Ruta Graveolens on the Function of Reproductive System of Immature Female Balb/C Mice}, abstract ={    Background & Aim: Ruta graveolens(R.G) is currently used by Middle East countries for its antispasmodic, diuretic and sedative effects. Based on recent experiments R.G has antifertility activity in mice when administrated orally. This work was undertaken to examine the possible effect of alcoholic extract of R.G on reproductive system in female immature mice. Material and Methods: In this experimental study the female immature mice(4-5wks old) were divided into three groups namely experimental, control and vehicle. For this reason animals were given 325 mg/kg[Leathal dose(LD)50, 650mg/kg] alcoholic extract of R.G intraperitonally(i.p) once every other day for one week. Animals of vehicle group received similar amount of normal olive oil and animals in control group were intact. One month after the last injection animals were deeply anesthetized with mixture of Ketamin and Xylasin and blood was collected from the heart. Sera were separated and kept in -20˚C. At the same time ovaries were removed, weighed and kept in Bowan for histological analysis. Results: The results showed a significant decrease(P<0.01) in weight of ovaries in experimental group as compared with control. Such decrease in the weight was accompanied with decrease in the number of primordial follicules(P<0.01) and corpus luteum(p<0.01). Also the diameter of remaining corpus luteum decreased significantly(P<0.01). Radioimmuno assay results showed a significant decrease in estrogen levels in animals which received i.p injection of R.G. Conclusion: According to the results alcoholic extract of R.G can interfere with reproductive system functioning in immature female mice and might be useful as an antifertility substance.}, Keywords = { 1) Ruta Graveolens 2) Alcoholic Extracts 3) Female Reproductive System4) Balb/C Mice }, volume = {14}, Number = {56}, pages = {209-217}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-791-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-791-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Hooman,, N. and Otoukesh, H. and Fargah,, F.}, title = {Does Antibiotic Reduce the Severity of Post Streptococcal Glomerulonephritis?}, abstract ={    Background & Aim: Antibiotic treatment prevents new episode of Acute Post Streptococcal GlomeruloNephritis (APSGN). In this study we evaluated the correlation of antibiotic therapy and the severity of APSGN in children. Patients and Methods: Between 1989 and 2001, files of all patients with diagnosis of glomerulonephritis were reviewed retrospectively. Inclusion criteria were: 1- hematuria, 2- evidence of recent streptococcal infection(Rising ASO titer or positive culture) and 3-transient decrease of C3. According to the history of antibiotic usage for infection, the patients were divided in two groups. The severity of clinical and laboratory findings on admission were scored 0 to 4. T-student and Chi square were used for comparing means and frequency, respectively. P value less than 0.05 was considered significant. Results: Eighty six children with average age(SD) of 8.76(2.85) years were included in our study. The most frequent clinical presentations were as follows: hematuria(100%), edema and azotemia(70%), hypertension(68%), and proteinuria(53%). Meanwhile 53 cases had no history of antibiotic usage. The severity of edema(defined by more than 3 plus)(37.3% vs 18.2%), duration of hospitalization(11 vs 8.9 days) and maximum serum creatinine(2 vs 1.3 mg/dl) were significantly higher in that group which did not receive antibiotics(P<0.05). The mean of clinical, laboratory and total scores were statistically significant and higher in those without history of antibiotic(P<0.0001). Conclusion: Antibiotic prescription in prodromal phase may decrease the severity of acute post streptococcal presentation.}, Keywords = { 1) Glomerulonephritis 2) Streptococcus 3) Antibiotic 4) Renal Failure }, volume = {14}, Number = {56}, pages = {219-224}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-792-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-792-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2007} } @article{ author = {Agah,, Sh. and Fereshtehnejad, S.M. and RahmatiNeshat,, T.}, title = {Assessment of the Prevalence of Gallstone in Ultrasonography of Gallbladder and Biliary Duct Among Hospitalized Patients in}, abstract ={    Background & Aim: Gallstone disease or cholelithiasis is the most prevalent disorder of the biliary system and a major costly health problem throughout the world. Over the past two decades, a great deal has been learned about the epidemiology of and risk factors for gallstones and ultrasonography has played a major role in this process. However, the prevalence and epidemiologic features of gallstone disease has changed due to revolutionized life styles. Therefore, this study was performed to determine the prevalence and epidemiologic features of gallstone disease among hospitalized patients in Rasool-Akram hospital. Patients and Methods: This cross-sectional study was performed on 1312 hospitalized patients in Rasool-Akram hospital from 2000 to 2004 who had undergone gallbladder and biliary duct ultrasonography. 420 patients had gallstone which were evaluated for demographic variables, symptoms and laboratory findings. The data were collected, described and analyzed using SPSS v.13 software. Chi Square was performed during analysis. Results: The prevalence of gallstone in this study was 32%(420 of 1312). Among these 420 patients, 316(75.2%) were females and 104(24.8%) were males with the mean age of 58.21yr.(SD=14.3). The most common symptoms were abdominal pain in right upper quadrant (RUQ) in 67.9%, nausea and vomiting in 59.8%. There was a significant association between age group of the patients and both site of gallstone and pain in RUQ (P=0.001 and P=0.000, respectively). Conclusion: The results of our study showed the higher prevalence of gallstone disease in women and ages between 55-74 years. Also there was relation between site of stone with RUQ abdominal pain and patients age. In addition, the site of gallstone was mostly in gallbladder among younger patients whereas, it changed to biliary duct in older individuals.}, Keywords = {Key Words: 1) Gallstone 2) Clinical Symptom 3) Prevalence 4) Epidemiology}, volume = {14}, Number = {57}, pages = {7-13}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-818-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-818-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {EhsaniPour, F. and Shabani,, M.}, title = {Determination of Lactic Dehydrogenase Level in Cerebrospinal Fluid in Neonates}, abstract ={    Background & Aim: Levels of lactic dehydrogenase(LDH) in the cerebrospinal Fluid(CSF) have been used to evaluate a variety of neurologic disorders. However, few studies have been performed on neonates. The aim of this study was to detect levels of this enzyme in normal neonates. Patients and Methods: In this descriptive study, CSF samples were collected from 94 febrile infants 46 aged 0-4 weeks and 48 aged 5-8 weeks. These LDH levels were compared to those of 45 febrile infants with mean age of 10±6/2 months who were suspected of nervous system infection and normal CSF findings. Results: Mean total LDH activity in the CSF was significantly higher in the first month of life than in the second month of life as compared with the control group(p<0.001). Conclusion: We propose evaluation of total LDH activity in CSF of normal neonates according to age.}, Keywords = {Key Words: 1) Cerebrospinal Fluid 2) Lactic Dehydrogenase 3) Neonate}, volume = {14}, Number = {57}, pages = {15-20}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-819-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-819-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {ArjmandiRafsanjani,, Kh. and Vosough,, P. and Bashardoost,, A. and Bahoosh,, Gh. and Faranoosh,, M. and HedayatiAsl,, A.A.}, title = {Evaluation of Survival of Rhabdomyosarcoma and Related Factors in Children who Referred to the Hazrat-Ali Asghar Hospital Between 1993-2003}, abstract ={    Background & Aim: Rhabdomyosarcoma is the most frequent soft tissue tumor in children with prevalence of 5-8% among childhood cancers. The survival of patients are related to some factors such as primary site of tumor, histology, stage of disease, early diagnosis and treatment. The survival rate of these patients has significantly increased since the 1970s. Considering the variety of reports and studies in this regard, we evaluated the 5-10yr. survival rate in this group of patients. Patients and Methods: This is a retrospective cross sectional survival analysis study that has been carried out on 77 children up to 15 years of age with Rhabdomyosarcoma who were admitted in the hematology and oncology wards of AliAsghar children Hospital from 1993-2003 and were evaluated in regard to age at time of admission, pathology, stage of disease, primary site, type of treatment received and its' relation to survival rate. For analysis SPSS version 11.5 software was used. For determination of survival rate Kaplan Meire method and for evaluation of factors affecting it cox regression was used. P value<0.05 was considered statistically significant. Results: The mean age of cases was 6.58 years with SD=4.02, males 60%, females 40% and mean survival time of cases was 8 years(95% CI: 8-9). The 5 year survival in stage I was 85.82%, stage II 86.88%, stage III 64.68% and stage IV 20%. The survival rate in tumor histology was embryonal 86.7%, and alveolar 48%. In regard to primary site of tumor orbit 94%, genitourinary tract 85.71%, parameningeal 57% and in extremity was 58%. Overall 5 and 10 year survival rates were 79.54% and 77.92% respectively. Conclusion: Like other studies, children with lower stages of rhabdomyosarcoma, embryonal histology, orbital and genitourinary as primary sites had better survival. Poor prognosis was associated with metastatic disease at the time of presentation, alveolar histology and tumors of extremity. Children who survived the first 5 years after diagnosis had relatively longer survival and better prognosis 5 and 10yr. survival rates were 79.54% and 77.92% respectively.}, Keywords = {1) Rhabdomyosarcoma 2) Survival Rate 3) Age 4) Primary Site of Tumor }, volume = {14}, Number = {57}, pages = {21-27}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-820-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-820-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Akbari,, M. and Bayat,, M.}, title = {Effects of Mechanical Traction on Patients with Mild and Moderate Cervical Osteoarthritis}, abstract ={    Background & Aim: Osteoarthritis is the most common joint disease among all the joints. It is one of the major agents of physical disabilities. Degenerative changes of the joints begin from second decade of life. Ninety percent of people have degenerative changes at 40 years of age in weight bearing joints. Osteoarthritis is common in spinal joints especially cervical spine, because of its high mobility. The aim of this study was to determine the effects of sustained mechanical traction in patients with mild and moderate cervical osteoarthritis and compare the results with a control group. Patients and Methods: A clinical trial study was conducted in the physiotherapy clinic of faculty of rehabilitation sciences. Patients with mild and moderate cervical osteoathritis were randomly assigned in control and experimental groups. Patients in control group received a routine physical therapy protocol for cervical osteoarthritis, that included superficial heat (hot pack), conventional TENS, exercise for neck and shoulder girdle muscles. Patients in experimental group received a routine physical therapy protocol plus sustained traction. Each participant was evaluated four times: immediately before the 1 st treatment session, at the 5 th treatment session, the last treatment session and 2 weeks after treatment. Intensity of the neck pain, range of the neck motions, sleep disorders and rate of medicine taking were main variables of this study. Results: Cervical pain and mobility improved in both groups(P<0.0001). There was a significant statistical difference in improvement of cervical pain and mobility between control and experimental groups patients in experimental group showed greater improvement. There was a significant statistical difference in pain reduction between two groups in fourth evaluation(P<0.004). Conclusion: Based on the results it can be concluded that application of the mechanical traction in patients with mild and moderate cervical osteoarthritis is useful. It helps in the improvement of cervical pain and mobility and decreases the need of patients to take medicine(NSAID).}, Keywords = {Key Words: 1) Osteoarthritis 2) Physical Therapy 3) Mechanical Traction}, volume = {14}, Number = {57}, pages = {29-40}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-821-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-821-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Bozorgmehr,, M. and Moazzeni,, S.M. and Nikoo,, S. and Zarnani,PhD,, A.H.}, title = {Dendritic Cells and Antigen Specific T Cell Responses: Effect of Pregnant Mouse Serum}, abstract ={    Background & Aim: Tolerance to the semi-allogenic fetal graft by the maternal immune system is a medical enigma that has stimulated investigations for a half of century. Several hypotheses have been proposed to explain the tolerance of mother to the fetus. The successful pregnancy is proposed and proved by many scientists to be a Th2 dominant phenomenon. This hypothesis is proved in most aspects of feto-maternal interface, but systemic effects of pregnancy on immune system, are controversial. Dendritic cells (DCs) are the most potent activators of naïve T lymphocytes capable of tolerance induction as well as immunity. These cells can influence Th cell differentiation, by inducing Th1 or Th2 responses as well. Therefore DCs are one of the probable candidates which mediate immune regulation during pregnancy. The aim of this study was to determine if pregnant mouse serum has any effect on DCs’ functional capacity to stimulate antigen specific proliferation of T lymphocytes and their cytokine profile. Material and Methods: In this experimental study, mid-gestational sera were obtained from allogenic pregnant Balb/c mice (Balb/c  C57BL/6) on days 9-11 of gestation. DCs were purified from Balb/c mice spleens through a three steps method including collagenase digestion of spleen tissues, selection of low-density cells by Nycodenz density gradient medium and plastic adherence. The purity of DCs was determined by flowcytometry, using anti CD11c antibody. DCs were pulsed with Conalbumin as a foreign antigen during overnight culture. In some cultures pregnant mouse sera were added at 2.5% final concentration. Two other groups of DCs were treated with normal mice sera and FBS, respectively. Antigen pulsed DCs were injected in to mice palms. Draining lymph node cells of immunized mice were cultured in presence of Conalbumin after 5 days and their proliferation was measured by 3H-thymidin incorporation method. IFN- and IL-10 production by stimulated T cells was also measured in their culture supernatant using sandwich ELISA. The results were analyzed using non-parametric Mann-Whitney test. Results: Our results showed that normal serum-treated, antigen-pulsed DCs induced a strong proliferative response of T cells and high levels of IFN- and IL-10 production. However, treatment of DCs with pregnant mouse serum markedly blocked their ability to induce antigen-specific lymphocyte proliferation. IFN- and IL-10 productions were also decreased by lymph node cells of mice injected with pregnant serum treated DCs. Conclusion: Our results demonstrate that pregnant mouse serum has suppressive effect on DCs capacity to induce antigen specific proliferation and cytokine secretion by T cells. The suppressive effects of pregnant serum can be induced through HLA-G, IL-10, PGE2, progesterone and several other factors, existing mostly at the feto-maternal interface but because of their overflow can be found in the serum as well. However, determination of the exact mechanism underlying this phenomenon needs more investigation.}, Keywords = {Key Words: 1) Dendritic Cells 2) Pregnant Serum 3) Cell Proliferation 4) Cytokine}, volume = {14}, Number = {57}, pages = {41-52}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-822-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-822-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Hassani, V. and FadaeZadeh,, L. and MoradiMoghadam,, O. and Nojomi,, M. and Charchi,, P}, title = {The Effect of Propofol Infusion on Lipid Profile of Patients Compared to Isoflurane Administration During Surgeries}, abstract ={    Background & Aim: Propofol is one of the sedative hypnotic drugs used for anesthetizing patients undergoing surgery. This drug is lipid based and therefore long-term infusion of it during prolonged surgeries and in intensive care units has the risk of hyperlipidemia. The aim of the study was to investigate the concentrations of triglyceride, cholesterol, high density lipoprotein, low density lipoprotein, and very low density lipoprotein during administration of propofol and comparing it with that of isoflurane in patients undergoing surgeries in operation rooms of Rasool Akram Hospital. Patients and Methods: The study was an interventional clinical trial all patients undergoing surgeries in Rasool Akram hospital during the years 2004-5 were enrolled into our study. The patients were randomly allocated to two groups first group taking propofol and second taking isoflurane as anesthetic agent. Lipid profile(triglyceride, cholesterol, high density lipoprotein, low density lipoprotein, and very low density lipoprotein) and CRP were checked before, immediately after, and the day after drug administration. For statistical analysis, repeated measurement of ANOVA, Chi square, Paired T-test and Square T-test were used. Results: A total of 97 patients were enrolled into our study, 49 of which took propofol and 48 took isoflurane. The mean operation time was 2.24±0.89 and the mean age of the patients was 38.14±18.99yr. Triglyceride and very low density lipoprotein(VLDL) were the two factors with statistically significant rise after infusion of propofol(P<0.000). Such a change was not detected in isoflurane group this increase was associated with a compensatory decrease the day after operation. Conclusion: Propofol infusion can induce dramatic rises in Triglyceride and VLDL even after short term infusions and therefore special attention must be paid to patients prone to hyper-triglyceridemia and pancreatitis.}, Keywords = {Key Words: 1) Propofol 2) Isoflurane 3) Lipid Profile 4) Triglyceride 5) Cholesterol }, volume = {14}, Number = {57}, pages = {53-61}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-823-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-823-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Hemasi,, Gh. and YasinZadeh,, *M.R. and Mofidi,, M. and Abbasi,, S. and Farsi,, D. and AminZare,, M. and Kianmehr,, N.}, title = {Evaluation of Morphine Effect on Diagnosis of Acute Appendicitis}, abstract ={    Background & Aim: Acute appendicitis is one of the most common etiologies of attending of patients with abdominal pain to Emergency Department. In order to diagnose, it, it is necessary to obtain patient's history, and perform physical examination and paraclinical tests that would waste time. Therefore because of the severe abdominal pain in these patients and the fear of some surgeons in giving narcotics (because of missed diagnosis in examination), this research was done to prove the fact that early administration of morphine reduces pain and discomfort of the patients without any disturbance in time and accuracy of diagnosis. Patients and Methods: This randomized controlled clinical trial was done on patients who came to emergency department of Hazrat Rasool Akram hospital because of abdominal pain and whose alvarado scores were above 6 and were operated with diagnosis of acute appendicitis. They were divided to 2 groups: double blind group that received 4 mg morphine and placebo group. The time of intervention and diagnosis was noted. Biopsy samples were sent to pathologist for reports. Results were analyzed by parametric tests(t-test and Chi Square) via SPSS software. Results: Overall 200 patients were enrolled in research and divided into two groups who received placebo & morphine. There is no difference inregard to mean of age and distribution of gender between two groups(p>0.05). There is no difference between two groups inregard to percentage of pathology findings(p>0.05). Also the mean duration from our intervention to time of diagnosis of surgery team was not significantly different between two groups(P>0.05). Conclusion: Our research shows that use of morphine does not affect the accuracy and time of surgical diagnosis. Thus it seems that we can use opiate analgesics in patients with abdominal pain, suspected of appendicitis.}, Keywords = {Key Words: 1) Acute Appendicitis 2) Morphine 3) Alvarado Score}, volume = {14}, Number = {57}, pages = {63-68}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-824-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-824-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Roghani,, M. and BaluchNejadMojarad,, T. and Taheri, S.}, title = {The Effect of Oral Feeding of Aerial Part of Vaccinium Myrtillus on Learning and Memory in Diabetic Rats}, abstract ={    Background & Aim: Diabetes mellitus accompanies disturbances in learning, memory, and cognitive skills in the human society and experimental animals. There is some evidence for anti-diabetic activity of Vaccinium myrtillus(VM) and the beneficial effect of its fruit on learning and memory in normal animals. Therefore, this research study was conducted to evaluate the effect of chronic oral administration of VM on learning and memory in diabetic rats. Material and Methods: In this experimental study, female Wistar rats(n=36) were divided randomly into four: control, VM-treated control, diabetic, and VM-treated diabetic groups. Treatment groups received rat chow containing 6.25% VM with no restriction for 4 weeks. For induction of diabetes, streptozotocin was injected i.p. at a single dose of 60 mg/kg. For evaluation of learning and memory, initial(IL) and step-through latencies(STL) were determined at the end of study using passive avoidance test and alternation behavior percentage was obtained using Y maze. For statistical analysis, one-way ANOVA and repeated measure ANOVA were used for weight and glucose data and Kruskal-Wallis test was used for behavioral parameters. Results: There was a significant increase in IL in diabetic and VM-treated diabetic groups after 4 weeks as compared to control group(P<0.05). Meanwhile, STL significantly decreased(P<0.05) in diabetic group and significantly increased(P<0.05) in VM-treated diabetic group. In addition, STL did significantly change in VM-treated control group in comparison with control group(P<0.05). Alternation percentage was significantly lower in diabetic group relative to control(P<0.05), treated diabetic group did not show a significant difference in comparison with diabetic group, and VM treatment in control group also did not produce a significant difference as compared to control. Conclusion: VM treatment could enhance the capability of consolidation and recall in diabetic animals.}, Keywords = {Key Words: 1) Vaccinium Myrtillus 2) Learning 3) Memory 4) Diabetes Mellitus }, volume = {14}, Number = {57}, pages = {69-76}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-825-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-825-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Saedi,, D. and Salehi,, M. and NejadGashti,, H.}, title = {A Case Report of Angioplasty and Successful Stent Placement in Treatment of Transplanted Renal Artery Stenosis}, abstract ={    Introduction: Renal transplantation has established itself as the treatment of choice for the majority of patients with End stage renal failure(ESRF). Arterial stenosis is the most common vascular complication after kidney transplantation, occurring in approximately 4%-25% of transplant recipients. Case Report: The patient is a 68 year old man with ESRF due to Poly cystic kidney disease(PCKD) that was treated by renal transplantation from a living donor. Vascular anastomosis was end to end from renal artery to right internal iliac artery. After 1.5 month from transplantation, serum creatinine(Cr) raised to 3.1. In color duplex ultrasound Resistance index(RI) in intra renal arteries and spectral wave form in intratenal, renal and internal iliac arteries indicated severe stenosis in internal iliac artery proximal to anastomosis. Magnetic resonance angiography(MRA) shows stenosis of about 80%-90% in internal iliac artery proximal to anastomosis. Radionuclide scan with TC-DTPA suggests mild hydronephrosis & renal dysfunction, so for this patient PTA was performed. 24 hours after stent placement, serum Cr decreased to 2.1. In color Doppler ultrasound, 48 hours after stent placement, wavefrom, time and resistance indices are in normal range. Radionuclide scan 3 days after angioplasty demonstrated normal renal function. Important notes about this case were, short time(1.5 month) from transplant to presentation of symptoms of arterial stenosis, arterial stenosis proximal to anastomosis in internal iliac artery, and stenosis following transplantation from a living donor. Conclusion: Because of successful PTA in this case, stent placement is suggested as an effective and useful treatment for arterial stenosis after renal transplantation.}, Keywords = {Key Words: 1) Transplant Kidney 2) Arterial Stenosis 3) Angioplasty}, volume = {14}, Number = {57}, pages = {77-82}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-826-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-826-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Sahmeddini,, M.A. and Khademi,, S. and Majidi,, F.}, title = {Comparison of effect of Meperidine and Tramadol Treatment on Postoperative Shivering in Elective Cesarean Section}, abstract ={    Background & Aim: Postop shivering is a common complication that needs attention and treatment. Mepridine is an effective drug in treatment of shivering but it has important side effects such as respiratory depression. It is also contraindicated in some patients. The aim of this survey was to compare effects of mepredine and tramadol in treatment of postop shivering in order to find a good substitution for mepridine. Patients and Methods: Ninety women undergoing elective cesarean section under general anesthesia, in ASA class I and II, were enrolled in this double-blind clinical trial. They were randomly divided in three equal groups(n=30 in each group) 1st group received mepredine 0.5 mg/kg, 2nd group received tramadol 0.5mg/kg and 3rd group received tramadol 1mg/kg for treatment of shivering. Data of patients during shivering, time interval between injection of drug and cessation of shivering, incidence of respiratory depression, nausea and vomiting were registered and statistical analysis was done by chi-square test. Results: Shivering ceased in 1st group after 3.9±1.6min, in 2nd group after 4.8±2.6 min and in 3rd group after 2.6±1.1 min(p<0.05). Incidence of respiratory depression in 1st group was %6.66, in 2nd and 3rd groups it was zero(p<0.05). Incidence of nausea and vomiting in 1st group was %13.3, in 2nd group %10 and in 3rd group it was %16.6(P<0.05). Conclusion: According to these findings, tramadol can be substituted with mepredine in treatment of postop shivering and dose of 1mg/kg of tramadol is suggested.}, Keywords = {Key Words: 1) Shivering 2) Tramadol 3) Meperidine 4) Elective cesarean section}, volume = {14}, Number = {57}, pages = {83-90}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-827-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-827-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {SoheiliAzad,, A.A. and Golestan,, B. and JahanBakhsh,, S.}, title = {Determination of the Relation between Osteoporotic and Osteopenic Risk Factors among Women Referring to BMD Center,}, abstract ={    Background & Aim: Osteoporosis is one of the most common diseases among elderly adults and old people, being associated with some risk factors. Osteoporosis is expensive, costly and infirmer disease that is accompanied by mortality and morbidity. Osteoporotic fractures are one of the most common causes of disability and a major contributor to medical care costs in many regions of the world. The aim of this study is to determine the osteoporosis risk factors among women. Patients and Methods: This case-control study was carried out on 100 women with normal bone mineral density settled in control group and 100 persons with low bone mineral density of the same center settled in case group. Data inregard to risk factors including age, BMI, underlying disorders(diabetes mellitus, hyper/hypothyroidism, renal stone, arthritic pain, hernial disk pain, joint pain), family history, history of fracture, tobacco consumption, physical activity, ocp use, estrogen and progestrone consumption, menopause, history of surgery(oopherectomy or hysterectomy), use of dairy products and drug consumption(calcium and corticosteroids) were collected by referring to medical files and recorded in data forms. For data analysis spss software, chi-square and fisher's tests were used. Odds Ratio(OR) and CI 95% were also colculated. Results: Results showed that age>50(P<0.001, OR=5.86), arthritic pain(P<0.001, OR=4.22), menopause(P<0.001, OR= 29.6), use of dairy products(P<0.001, OR=34.02), underlying disorders(P=0.019, OR=2.85), history of fracture(P=0.03, OR=2.37), family history(P=0.021, OR=4.88) and physical activity(P50(P=0.038, OR=2.47), joint pain(P<0.001, OR= 5.43), family history(P=0.002, OR= 7.07), physical activity(P<0.001, OR= 0.14), menopause(P= 0.038, OR= 2.47) and use of dairy products(P< 0.001, OR= 27.44) with osteopenia there were no other significant relation with other factors. Conclusion: This study has been conducted for prevention of osteoprosis. Based on the results, public education in regard to physical activity and dietary intake of calcium is mandatory for prevention of osteoporosis.}, Keywords = {Key Words: 1) Osteoporosis 2) Osteopenia 3) Risk Factors 4) Women 5) Bone density }, volume = {14}, Number = {57}, pages = {91-99}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-828-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-828-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Shahpourian,, F. and Kiani, K. and Sedighian, H. and Hosseini,, F.}, title = {Effect of Water Birth on Labor pain During Active Phase of Labor}, abstract ={    Background & Aim: Water birth is a non-medical intervention, which has been used throughout the world for many years. It can be considered as a new approach for enjoyable birth in Iran. The aim of this study was to determine the impact of water birth on labor pain during active phase of labor. Patients and Methods: The study was a controlled clinical trial in which 114 full term pregnant women gravida 1 st to 3 rd participated. We performed voluntary sampling for experimental group(n=52) and conventional sampling for control group(n=62). Women of both groups, entered the study after having 4-5cm of dilatation(begining of active phase of labor) and all contributors received special individual care whereas the experimental group was put in a warm water pool of temperature between 36.8˚c to 39˚c at least for one hour at the beginning of trial, and during the second stage of labor. A 10 point ruler was used to measure labor pain in different stages of labor. We used paired sample t-test in order to compare pain change scores within each group. Chi-square test, Mann-Whitney test and independent sample t-test were used to compare the pain mean scores between two groups. P value<0.05 was considered as statistically significant level. Results: Our finding showed that, in the first 15 minutes the intensity of pain was stabilized in the experimental group, but was increased in control group(P=0.009). In the second stage of labor, the pain was significantly more severe in control than experimental group(P<0.0001). Overall, patients in the experimental group suffered less pain than the controls. With the exception of the above mentioned points, the differences were not statistically significant. Conclusion: Warm water pool can be an effective way to decrease labor pain and alleviating her suffering especially during first and second stages of labor. Although there were not much significant statistical differences between the two groups, experimental group suffered less pain which could be of clinical importance. Even though the pain of labor is lessened to a small extent, it could be a pleasant experience for the mothers and probably an effective step in decreasing the number of selective cesearen sections, which are performed mainly because of fear of labor pain.}, Keywords = {Key Words: 1) Severity of Pain 2) Active Phase of Labor 3) Water Birth}, volume = {14}, Number = {57}, pages = {101-111}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-829-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-829-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {ShekarAbi, M. and Bahar,, B. and Behbin,, M. and Atri,, M. and Falak,, R. and Imani,, M. and Danesh,, P.}, title = {The Evaluation of Serum Levels of IFN-, IL-12 and Percentage of CD4+, CD8+ and NK Cells in Peripheral Blood of Metastatic, Nonmetastatic Breast Cancer Patients and Normal Individuals}, abstract ={    Background & Aim: The immune system is quite capable to combat tumors and many immunological parameters including cytokines such as IL-12 & IFN-γ play major roles in this regard. IL-12 is also the major cytokine responsible for the differentiation of TH1 cells, which are potent producers of IFN-γ, IFN-γ in turn has a powerful enhancing effect on the ability of phagocytes to produce IL-12 as well as having an important role in cellular immune response. In this study the serum concentration of IL-12 & IFN-γ and percentage of IFN-γ producing cells(CD4+, CD8+, NK cells) in metastatic & nonmetastatic breast cancer patients and healthy adults was evaluated, with the aim of finding out the possible correlation between cytokine levels with disease stage and progression. Since cytokines are produced by all of these cells, cell enumeration may help to find out whether changes in cytokine levels is due to change in the cell number or their function has been altered during disease progression. Patients and Methods: Whole blood samples were taken from 50 breast cancer patients prior to therapeutic manipulation who were admitted to Dr. Shariaty & Day general hospitals. Also 26 healthy people were selected as control and blood was taken similarly. According to disease stage patients were classified into non-metastatic(stage I, II) and metastatic(stage III, IV) groups. 30 patients were non metastatic and 20 patients were in metastatic stages respectively. Serum cytokines level(IFN-γ, IL-12) was measured by ELISA. Lymphocyte subpopulation percentage was measured by flow-cytometry using bichromatic specific antibodies(anti-CD4+/CD8+, anti-CD3/CD16+CD56). The research protocol is designed as a descriptive, comparative cross sectional study. The parametric findings were analysed by one way Anova test and the nonparametric data were analysed using Mann whitney and Kruskal Wallis statistical tests. Results: IL-12 level was increased significantly in metastatic group compared to controls(P=0.017), while IFN-γ levels were in the same range as controls. CD4+ lymphocyte percentage in nonmetastatic(P=0.022) and metastatic groups(P=0.037) was decreased significantly compared to control, but there was no significant difference in CD8+ and NK cell numbers. Conclusion: Despite the decrease in percentage of CD4+ lymphocytes in patients(due to activation of compensative hemostatic system and increase in IL-12), there was no change in IFN- level. It seems that increase in serum IL-12 levels correlates with disease progression. However serum IFN-γ level has no effect on disease progression and as a whole no prominent failure was recorded in the cellular immune response of brease cancer patients as compared to normal individuals.}, Keywords = { 1) Cytokine 2) TH1 Cells 3) Metastatic Breast Cancer }, volume = {14}, Number = {57}, pages = {113-120}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-830-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-830-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Shidfar,, F. and Montazer, M. and Azizi,, H.R. and Darvishian,, M. and Jahangiri,, N.}, title = {The Relation between Age of Introduction of Complementary Feeding and Physical Growth of Infants Under 2 Years of Age in West of Tehran}, abstract ={    Background & Aim: Early or late introduction of complementary feeding is one of the important reasons of infants’ growth faltering and malnutrition which can lead to irreversible economical complications. The aim of this study was to determine the relation between onset time of complementary feeding and introduction of each complementary food with the growth of children aged less than 2 yrs, in the Health centers in West of Tehran. Patients and Methods: In a historical – cohort study and using health files , 359 infants under 2 years of age( 183 boys and 176 girls) were included in study by clustering sampling. All infants were term, with normal birth weight, complete vaccination, healthy mother and were exclusively fed by mother's milk. Growth indices were expressed as standard deviation scores(SDS) of height and weight according to National Health Center Statistics(NCHS) references. Data were analyzed in SPSS version 11 software by ANOVA. Results: A total of 183 boys and 176 girls were studied. There was "increase growth trend" in first month and then "growth faltering" till 1 years of age"growth acceleration" occurred after 1st year. Early onset of complementary feeding(before 6 months) as compared to late onset(after 6 months) leads to lower growth indices although not much significant. Introducing fruit juice at 4-6 months of age(sooner than normal time) leads to significant growth faltering. On time introducion of egg yolk i.e, 6-8 months , leads to better height (but not weight) as compared to late onset group. Introducing meat at 4-6 months of age(sooner than normal time) as compared to late onset group led to faltering in growth indices, although not much significant. Conclusion: Onset time of complementary feeding and also beginning time of introducing each type of complementary food / can influence infants’ growth .Cohort studies are strongly suggested.}, Keywords = {Key Words: 1) Complementary Feeding 2) Under 2 Years Old Infants 3) Physical Growth }, volume = {14}, Number = {57}, pages = {121-131}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-831-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-831-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Sadeghipour,, A. and Abolhasani, M. and Naseripour,, M.}, title = {Association of Vessel Density and Vascular Endothelial Growth Factor with Local Invasive Growth in Ocular Retinoblastoma, Hazrat Rasool Akram Hospital, 2000-2006}, abstract ={    Background & Aim: Retinoblastoma is the most frequent intra-ocular tumor in childhood. The tumor has both endophytic and exophytic patterns of growth. After enucleation, the pathologist is called on to evaluate risk of further growth for prophylactic therapy. Invasion of the choroid or optic nerve are risk factors for developing metastases, but occasionally, metastatic or locally invasive tumors occur in the absence of these risk factors. In this study, correlation of vascular density using CD31 with vascular endothelial growth factor(VEGF) and also both of these markers with local invasive growth of retinoblastoma were assessed. Patients and Methods: The study was analytical cross-sectional and performed on sections of paraffin-embedded blocks of 37 enucleated eyes due to retinoblastoma, at Ophthalmology Department of Hazrat Rasool Akram Hospital in years 2000-2006. Hematoxylin and Eosin stained slides were reviwed for evaluation of local invasive growth of tumor. Vascular density by CD31 and VEGF was assessed by immunohistochemical staining(IHC), using an Strept avidin-Biotin Immunoperoxidase technique. For data analysis, T test, Chi 2 test, Phi test and ROC curve were used. Results: A CD31 number equal or greater than 62/10 HPF with 78.9% sensitivity and 66.7% specificity was considered as the most efficient cutt-off point and with VEGF as a qualitative test, were assumed as predictors for local invasion. Significant correlation was noted between VEGF and CD31. There was no correlation between CD31 and VEGF with uni or bilaterality, age, size and growth type. Conclusion: Assessment of vascular density with the use of CD31 and vascular endothelial growth factor(VEGF) can be useful method for prevention of local invasive growth of tumor and determining the need for prophylactic therapy in patients with advanced ocular retinoblastoma.}, Keywords = {Key Words: 1) Retinoblastoma 2) Vascular Growth Factor 3) Vascular Density}, volume = {14}, Number = {57}, pages = {133-141}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-832-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-832-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Qaravi,, M.J. and Ourmazdi,, H. and Gharegoozlo,, B. and RoeeinTan,, E.S.}, title = {A Comparative Study of the Sensitivity and Specificity of IgM and IgG Assay Techniques in the Diagnosis of Toxoplasmosis}, abstract ={    Background & Aim: Toxoplasmosis is a common disease between human and animal with an extensive distribution. It is caused by the parasitical protozoan Toxoplasma gondii. Most clinical laboratories have problems with the diagnosis of toxoplasmosis. The aim of this study is the comparison of sensitivity and specificity of conventional and unconventional methods in the diagnosis of Toxoplasmosis based on the measurement of IgM and IgG and introduction of the best method. Patients and Methods: In this comparative analytical study, from 100 people that physicians suspected of having the Toxoplasmosis symptoms and had been introduced to two laboratories in Tehran and Karaj for toxoplasmosis testing. Serum specimens were prepared and tested with Enzyme-linked immunoadsorbent assay(ELISA), Indirect fluorescent assay(IFA), Chemiluminescence(CLIA) and Enzyme linked fluorescent assay(ELFA). Data was analyzed via Chi-Square. Results: In comparison with the IgG ELFA method, the IgG CLIA has the most sensitivity, specificity, positive and negative predictive values(100%). In comparision with IgM ELFA, IgM CLIA and IgM ELISA had the same sensitivity(92%), but IgM ELISA had more specificity(100%) than IgM CLIA(97.3%). In IgM ELISA positive and negative predictive values were 100% and 97.4% respectively and in IgM CLIA they were 96% and 98% respectively. Conclusion: Although results of the comparative methods are near to each other, the automatic methods(CLIA, ELFA) are preferred because of a high reproducibility, reduced personnel expenses, time saving, etc. Therefore we suggest using these methods for diagnosing Toxoplasmosis. Also it is suggrsted that for measuring IgM, the mentioned methods are the most suitable of diagnostic methods.}, Keywords = {Key Words: 1) Toxoplasmosis 2) Sensitivity 3) Specificity 4) Diagnostic Methods }, volume = {14}, Number = {57}, pages = {143-149}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-833-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-833-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Firoozrai,, M. and Sharifi,, A.M. and Najafi,, M. and HosseiniGohari,, L.}, title = {Angiotensin Converting Enzyme(ACE) Activity, Levels of Lipids and Apolipoproteins in Patients with Coronary Artery Disease}, abstract ={    Background & Aim: The most important cause of mortality in developing countries is coronary artery diseases(CAD). From ethiological point of view, CAD is multifactorial. In this study, some involved important factors were evaluated. Patients and Methods: In this cross-sectional study, 94 normal controls and 106 cases with 50% angiographically proved coronary stenosis who had referred to Tehran Shahid Rajaii Heart Hospital were selected and investigated inregard to levels of TG, HDL-C, VLDL-C, Apo A1, Apo B100, ACE activity and BMI in the both groups. Results: The results showed significant changes in the serum ACE activity, HDL-C, TG, VLDL-C, APO A1 and BMI compared with control group. Furthermore, multiple linear regression analysis showed odds ratios for ACE activity, cholesterol, HDL-C and VLDL-C as 1.08, 1.24, 1.05 and 0.68 respectively. However, the ACE activity had no correlation with the other studied factors. Conclusion: Increase of serum ACE may be an independent factor in the incidence of CAD and its inhibition may delay the atherosclerosis process.}, Keywords = {Key Words: 1) Angiotensin Converting Enzyme(ACE) 2) Coronary Artery Disease(CAD)}, volume = {14}, Number = {57}, pages = {151-156}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-834-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-834-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Golmohammadi, M. and Aghakhanloo, M.A.}, title = {Comparison of Atracurium and Lidocaine both Alone and With each other for Prevention of Succinylcholine-Induced Postoperative Myalgia}, abstract ={    Background & Aim: Succinylcholine has obvious advantages for facilitating endotracheal intubation in the ambulatory setting patients(eg: low cost, fast onset and no need for reversal of neuromuscular relaxant). Unfortunately postoperative myalgia(POM) may frequently occur after the use of succinylcholine and this myalgia may be particularly troublesome in outpatients. This study was conducted to evaluate the efficacy of Atracurium or Lidocaine alone or together for prevention of succinylcholine – induced fasciculation and postoperative myalgia in patients undergoing small or ambulatory surgery. Patients and Methods: This study was prospective and clinical trial and conducted on 80 ASA physical status I, II patients aged between 30-50 years that were scheduled for elective and ambulatory or small surgeries under general anesthesia in Uromieh Imam Khomeini hospital. Patients were randomly assigned to one of the four groups(n= 20 for each group) group 1: without pretreatment, group 2: 3mg atracurium, group 3: 1mg/kg lidocaine, group 4: 3mg atracurium and 1mg/kg lidocaine together, before 1.5mg/kg succinylcholine was administered. During induction of anesthesia incidence of fasciculation was assessed and four point rating scale was used for its severity assessment. In addition, severity of myalgia was assessed by a four point rating scale at 4, 12, and 24 hours postoperatively. For each of patients data collected included demographic variables(eg: age, sex, duration of operation), presence or absence of fasciculation, myalgia, severity of myalgia, severity of fasciculation and time of onset of myalgia. Correlations between fasciculation and myalgia, limitation in ambulation, and need for excessive analgesics in postoperative phase were assessed and then differences analyzed via Fisher's-Exact test and Chi-Square test. P value<0.05 was considered significant. Results: Non of the patients complained of any side effects after administration of the study drugs. Severity and rate of fasciculation was observed less frequently in groups 1, 3 (30%,50%) as compared with groups 2,4(10%,10%). This difference was significant between groups 1 and 2(pv=0.014) and between groups 1 and 4(pv=0.014). Meanwhile this comparison was not significant between other groups. Inother words decrease in incidence of fasiculation is more pronounced with use of atracurium alone or atracurium with lidocaine than use of succinylcholine without any pretreatment. Seventy percent of fasciculated patients had myalgia in the remaining 30% postop myalgia did not occur. Incidence of myalgia was more frequent in groups 1,3(40%, 25%) as compared with group 2(5%) and this difference was significant between groups 1,2(pv=0.021). However it was not statistically significant between groups 1 and 3(Pv=0.5). However none of the patients in group 4 reported myalgia. Severity of myalgia in groups 1 and 3 was mild and moderate but this severity in group 2 was only mild. Severe myalgia was not reported in any of the cases. Conclusion: This study suggests that use of succinylcholine in conjuction with atracurium(3mg) or lidocaine(1mg/kg) as pretreatment resulted in reduction of fasciculation and postoperative myalgia, (although atracurium was more effective than lidocaine).This study demonstrated that pretreatment with atracurium combined with lidocaine was more effective in reducing Succinylcholine-induced fasciculation and postoperative myalgia, in comparison to using each alone.}, Keywords = {Key Words: 1) Fasciculation 2) Postoperative myalgia (POM) 3) Atracurium}, volume = {14}, Number = {57}, pages = {157-164}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-835-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-835-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Mohebi,, A.R. and Erfan,, A. and Nojomi,, M.}, title = {Assessment of Nasal Volume and Cross-sectional Area in Normal Adult Iranian Population by Acoustic Rhinometry}, abstract ={    Background & Aim: Objective assessment of nasal airway is helpful in understanding nasal breathing function. Acoustic rhinometry is one of the most commonly used objective measurements of nasal airway. This test has the ability to measure cross-sectional areas of the nose in different distances and volume and also determines the site of minimal cross-sectional area. These variables are different in various areas. Defining these normal values in adult Iranian population, as a criteria for diagnosis and treatment of nasal diseases, can be very helpful. Patients and Methods: A number(180) of adult Iranian population(age:18-60 years) without nasal breathing complaints underwent acoustic rhinometry. The mean volume and minimal cross-sectional area of nose and also correlation of these variables with age, sex, height, smoking habitus, and topical nasal decongestant were assessed. This study is cross sectional and the statistical tests were descriptive statistics, T test and correlation test in SPSS software. Results: In this population total nasal volume is 8.12±0.94cm3 and total minimal cross-sectional area is 0.9±0.17 cm2 before decongestion. There was no correlation between those values and age, sex, height, weight and smoking habitus. There was a significant increase in volume and minimal cross-sectional area after decongestion. Conclusion: Due to volume and minimal cross-sectional area differences in various races, measurement of these values in Iranian population is a proper way for diagnosis of rhinological diseases and treatment(medical or surgical) planning and also helpful for comparison of pre and post operative results after nasal surgeries.}, Keywords = {Key Words: 1) Acoustic Rhinometry 2) Nasal Minimal Cross-Sectional Area 3) Nasal Volume}, volume = {14}, Number = {57}, pages = {165-171}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-836-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-836-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Madani,, A. and CheshmKhavari,, A. and Alizadeh,, Y. and Sharifi,, D.}, title = {The Influence of Tendon Length and Time of Implantation on the Strength of a Tendon-Bone Tunnel Complex: A Biomechanical study in Rabbit}, abstract ={    Background & Aim: Many factors influence the tensile strength of the tendon in a tendon-bone tunnel complex. The purpose of this study is to determine the influence of tendon length & time of implantation of the tendon in the bone tunnel on the tensile strength of the tendon in a rabbit model. Material and Methods: In this prospective study fourteen adult(age 6 months) White New Zealand rabbits(weight: 2.5-3 kg) underwent bilateral hindlimb(n=24) surgery in which the Extensor digitorum longus tendon was implanted into the tibial metaphyseal extra-articular bone tunnel. Based on the length of bone tunnel(1 or 2 cm) and duration of implantation(6 or 12 wks), the rabbits were divided into 4 groups. Seven rabbits were sacrificed after 6 weeks(groups 1 and 2) and 7 others were sacrificed after 12 weeks(groups 3 and 4) for tendon tensile loading test to determine ulitimate pull-out strenght. Results: In group one(1 cm, 6wks) one tendon was ruptured and four were pulled out, in group two(2 cm, 6 wks) one tendon ruptured and six pulled-out, in group three(1cm, 12wks) one tendon was pulled out and five ruptured and in group four(2 cm, 12 wks) five tendons ruptured and one was pulled-out. The mean failure force after 6 wks. was 4.98N for group one and 9.37N for group two. After 12 wks. it was 6.36N for group three and 10.81N for group four. Failure force difference was significant between 1 and 2 cm tendon lengths after 12 wks. Tendon rupture site was significantly different after 6 & 12 wks. Conclusion: This study demonstrated that the tendon length within a bone tunnel influences tendon tensile strength after 12 weeks. In other words, increase in tendon length within the bone tunnel, increases its' resistance against tensile strenght with the passage of time. Time of implantation has an additive effect to tendon length on the tendon tensile strength of the tendon-bone tunnel complex.}, Keywords = {Key Words: 1) Tendon Bone Complex 2) Hamstring Tendon Graft 3) Rabbit Extensor Tendon}, volume = {14}, Number = {57}, pages = {173-180}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-837-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-837-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Motamed,, M.R. and Akbari,, M. and Habibi,, A.H. and Fereshtehnejad, S.M. and SetarehShenas,, R.}, title = {Transcranial Doppler Determination of Blood Flow Velocity of Middle Cerebral Artery in Diabetic Patients}, abstract ={    Background & Aim: Diabetes mellitus is one the most prevalent chronic diseases in Iran which has a considerable burden on health system. In addition, hyperglycemia is a well-established independent risk factor for ischemic stroke and the development of microvascular and macrovascular diseases in patients with diabetes. On the other hand, middle cerebral artery is one the most important cerebral arteries which may role in up to 85% of cerebral blood flow. Therefore, this study was performed to determine blood flow velocity of middle cerebral artery (MCA) by means of transcranial doppler (TCD) in diabetic patients. Patients and Methods: This cross-sectional study was conducted on 81 diabetic patients who had referred to Firoozgar hospital in Tehran, Iran in years 2004-2005. All the patients were supposed to be free of previous myocardial infarction (MI) or cerebrovascular accident (CVA) and also had the appropriate criteria for undergoing Transcranial Doppler ultrasonography (TCD). For each patient, demographic data (age and sex), level of hemoglobin A1c, CRP, HDL, LDL, clinical features and TCD findings were recorded. Data were analyzed using SPSS v.13. Results: The mean age of the patients was 55.91(SD=11.05) years. The mean blood flow velocities of right and left MCA were 50.74(SD=15.65) cm/sec and 48.87(SD=15.96) cm/sec, respectively. In addition, the mean end-diastolic blood flow velocities of right and left MCA were 34.82(SD=12.80) cm/sec and 33.60(SD=13.58) cm/sec, respectively. Significant statistical correlations were found between duration of diabetes and end-diastolic blood flow velocity of right MCA (P=0.025, r Pearson = -0.218). Conclusion: As cerebrovascular diseases are preventable, it seems that TCD study may play an important role in decreasing such complications in diabetic patients. Our results showed the inverse relation between duration of diabetes mellitus and blood flow velocity of middle cerbral artery. It also demonstrates the effects of vascular changes in diabetic patients on causing stroke. In addition the improtance of anticoagulants in prevention of cerebrovascular accident has been highlighted.}, Keywords = {Key Words: 1) Diabetes Mellitus 2) Cerebral Stroke 3) Middle Cerebral Artery(MCA)}, volume = {14}, Number = {57}, pages = {181-190}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-838-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-838-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Mehrazma, M. and Hooman,, N. and Yousefi,, Sh. and Otoukesh,, H.}, title = {Histopathologic Characteristics of Hemolytic Uremic Syndrome in Children and their Correlation with early Outcome}, abstract ={    Background & Aim: Hemolytic uremic syndrome(HUS) is the most common cause of renal failure in children. Hemolytic microangiopathic anemia, thrombocytopenia and renal failure are diagnostic triads of the disease. The aim of the preset study is determining histopathological findings of renal biopsy and their correlation with early outcome of the patients. Patients and Methods: In this cross-sectional retrospective study a total number of 28(20 males & 8 females) cases of HUS with mean age of 6 years(± 4.6) who were admitted in Ali-Asghar children hospital from 1994 to 2004 were evaluated. Light microscopic findings of glomeruli(sclerosis, necrosis, capillary loop thickening, crescent, …), arterioles (hyperplastic thickening, thrombi, necrosis, …), arterial(thrombi, necrosis, intimal lipid, …) interstitial(inflammation, fibrosis, edema), medullary vessels and tubules were scored without knowledge of clinical history. Short outcome was defined as appearing of initial improvement signs in less than 3 weeks. The data were analyzed via SPSS V.11.5 software statistical tests such as Pearson correlation and Linear regression. Results: The most common lesions in glomeruli were capillary wall thickening and reduction in luminal size. In arterioles mild luminal stenosis, in arteries intimal thickening, in interstitium mild chronic inflammatory cell infiltration and interstitial edema, in vasa recta congestion and in tubules presence of casts were the most common findings. Arteriolar lesion(arteriolothrombosis) had significant correlation with the serum creatinin level at time of discharge. Conclusion: Vascular lesions(especially arteriolar) are the most important predictors of short outcome of children with HUS.}, Keywords = {Key Words: 1) Hemolytis Uremic Syndrome 2) Histopathology 3) Short Outcome}, volume = {14}, Number = {57}, pages = {191-197}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-839-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-839-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Nourbakhsh, S. and Farhadi,, M. and Tabatabaee,, A. and MohammadPourMir,, A.}, title = {Determination of the Frequency of Chlamydia Pneumoniae Infection in Adenoid Tissue of Adenoidectomized Children in Rasool Akram Hospital, Tehran 2004-2005}, abstract ={    Background & Aim: Recurrent or chronic adenotonsillar infections mainly affect children. The prevalence of potential respiratory pathogens on the adenoid and tonsillar surfaces of children with moderate symptoms of recurrent tonsillopharyngitis and/or adeno tonsillar hypertrophy differs only slightly from that in children without symptoms of adenotonsillar disease. Chlamydia pneumoniae is a common respiratory pathogen which is often found in children. Little is known about the true colonization rate and the localization of the bacteria in the respiratory tract. The findings suggest that Chlamydia pneumoniae is a common pathogen in the adenoids of children undergoing adenoidectomy. The aim was to determine Chlamydia pneumoniae infection in adenoid tissue of adenoidectomized children by PCR and specific antibody in serum. Patients and Methods: In a descriptive cross sectional study during 2005-2006 in ENT department of Rasool Akram hospital, detection of Chlamydia DNA by PCR was performed on 44 adenoid tissue of adenoidectomized children. 168 ELISA tests (IgG;IgM for each sample) were performed. Samples were collected from 53 patients(63.1%) and 31 normal(36.9%) children. The data gathered were analyzed by SPSS 10.5 software. Results: Age of children was between 3-14 years, range 11yr mean 7.95(SD=1.98years). Also there were 54.8% males and 45.2% females. Season of adenoidectomy was: 24% spring 18% summer 36% autumn and 22% in winter. Chlamydia-DNA by PCR was positive in 7(15.9%) of adenoid tissues. Positivity of PCR did not differ with age or sex. Acute chlamydial infection was seen in 3.7% previous immunity was seen in 12.3% of all children. By serology method in 51 patients, acute chlamydia infection was detected in 1(2%) and previous immunity in 6(11.8%). Acute and previous infections did not differ significantly between case and control group. Conclusion: The results suggest that Chlamydia pneumoniae(C. Pneumoniae)is a common finding in the adenoids of children undergoing adenoidectomy. The adenoid tissue, may act as a reservoir for bacteria causing sinusitis, lung and chronic ear infection. Whether or not C. pneumoniae plays a pathogenic role in this group of patients, could not be determined from the data obtained in this investigation. In cases of resistant adenoiditis to usual drugs, we recommend the use of specific antibiotics for Chlamydia(appropriate for age) including erythromycin, tetracycline or other new macrolids (e.g azithromycin, clarythromycin) before surgery.}, Keywords = {Key Words: 1) Chlamydia Pneumoniae 2) Adenoid 3) Chlamydia PCR }, volume = {14}, Number = {57}, pages = {199-207}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-840-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-840-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Nikmaram,, M.R.}, title = {The Effect of Inhibition of the Ryanodine Receptor(RYR) on Pacemaker Activity of intact Sinoatrial and Atrioventricular Nodes in the Heart of Mouse}, abstract ={    Background & Aim: The role of ryanodine receptor(RYR) on pacemaker activity of heart cells is controversial. Some investigators have suggested that it is obligatory, while others believe it is partial and not obligatory. The principle aim of this study was once more to characterize the role of ryanodine receptor(RyR) on the pacemaker activity of the sinoatrial node(SAN) and the atrioventricular node(AVN) in the mouse. Material and Methods: In an experimental study the effect of ryanodine on the cycle length(CL) of action potential of the intact SAN and the AVN of the heart mouse was assessed. The recording of action potential was extra cellular and was done by 2 separated metal microelectrodes. Paired and independent t tests were carried on accordingly. If the P values were less than 0.05, the differences were considered significantly. Results: Ryanodine with 0.2 and 2µM concentrations prolonged CL of action potential by 46.50±15.75% and 70±21% in SAN preparations while 163±72.25% and 241±91.25% in AVN preparations. During ryanodine use, the pacemaker activity was not stopped for all preparations. The effect of ryanodine on two nodes was significant with respect to control. Conclusion: On the basis of obtained result, it may be said that the ryanodine receptor current exists in SAN & VAN. AVN the pacemaker activity was functioning continuously in cardiac nodes when ryanodine was used, therefore, the role of RyR for pacemaker activity is not obligatory. The effect of ryanodine on AVN is significantly greater than SAN that is, the role of RyR in two nodes is not similar.}, Keywords = {Key Words: 1) Sinoatrial Node 2) Atrioventricular Node 3) Pacemaker Activity}, volume = {14}, Number = {57}, pages = {209-216}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-841-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-841-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} } @article{ author = {Hooman,, N. and Nasiri,, S.J. and Alipour,, P. and Mehrazma,, M. and Talachian,, E. and Mahlooji,, Kh. and Otoukesh,, H. and HoseiniShamsabadi,, R. and FeisalNajiAlanaghereh,, M.}, title = {Pancreatic Abscess in a child on Continuous Ambulatory Peritoneal Dialysis}, abstract ={    Introduction: Pancreatitis is uncommon in children. The incidence is higher in chronic renal failure, hemodialysis, and chronic ambulatory peritoneal dialysis(CAPD) patients and accompanied with late complications including pancreatic necrosis, pseudocyst and abscess. Case Report: We report a 5 year old girl with end stage renal disease due to focal segmental glomerulosclerosis, being on CAPD for two years. She was admitted for intermittent severe epigastric pain of four months duration, hypotension, severe cachexia and cloudy drained dialysate with negative culture and mild increment serum amylase. On abdominal imaging a pancreatic cyst was reported which was an infected cyst on laparotomy. Despite drainage of suppurative fluid and antibiotic therapy, the patient expired with severe sepsis and multiorgan dysfunction two weeks after operation. Conclusion: The presence of poor weight gain, unexplained abdominal pain and cloudy drained dialysate in children on CAPD may suggest pancreatitis. Frequent evaluation of pancreatic function and sonography is recommended.}, Keywords = {Key Words: 1) Pancreatic Abscess 2) Pancreatic Pseudocyst}, volume = {14}, Number = {57}, pages = {217-222}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-842-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-842-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2008} }