39 2228-7043 Iran University of Medical Sciences 1641 ENT Surgery Effect of the extract of dried hedera helix leaves on respiratory tract mucociliary system Elahi Homayoun b Jahandideh Hesam c Salimi Mohammadreza d Abdolmohammadi Mahmoud b Tehran University of Medical Sciences (TUMS) c Tehran University of Medical Sciences (TUMS) d Tehran University of Medical Sciences (TUMS) 1 7 2011 18 85 1 6 28 08 2011   Background: Respiratory tract is continuously exposed to environmental pollutants, respiratory pathogens and dispersed toxins in the air. Respiratory tract clearance through mucociliary system is the main defensive mechanism in the upper and lower airways. Various studies demonstrated the effectiveness of herbal drugs, however little studies conducted about mechanism of action of these drugs.   Methods: In this prospective case-series, saccharin test as a measure of mucociliary clearance time, was conducted on 40 subsequently healthy volunteers presenting to otolaryngology clinic of Firoozgar Hospital. Time between placing saccharin over nasal mucosa to sensation of sweet flavor in the pharynx was recorded. Saccharin test was re-performed after administration of 3 doses of 7.5 cc of Prospan syrup. Data were analyzed by Wilcoxon signed ranked test and SPSS V.16.   Results: In this study 32 patients (80%) were male and 8 were female (20%) with mean age of 38.4±12.07 years. Mean of time between “placing saccharin on nasal mucosa” to “sensation of sweet flavor in the pharynx” was 15.55±3.67 minutes before Prospan administration and 10.31±4.94 minutes after 3 doses of Prospan. Average reduction in the time of sweet sensation in the pharynx was 5.23±3.7 minutes.   Conclusion: This study in conjunction with preliminary studies regarding the effectiveness of the extract of dried Hedera helix leaves on respiratory symptoms shows that “improvement in the function of mucociliary system” is one of the main mechanisms of actions of this drug.
1642 Microbiology Frequency of ESBLs in Escherichia coli and Klebsiella pneumoniae strains isolated from hospitalized and out-patients with urinary tract infection in selective centers in Esfahan (2009-2010) Jalalpoor Shila f Mobasherizadeh Sina g f Islamic Azad University Shahreza Branch g Isfahan University of Medical Sciences 1 7 2011 18 85 7 16 28 08 2011   Background: Urinary Tract Infection (UTI) is the second most common infection in human. Most of UTIs are due to Escherichia coli ( E.coli) and Klebsiella pneumoniae ( K.pneumoniae) . These bacteria are relevant opportunistic pathogens that account for nosocomial infections. Prevalence of Extended-Spectrum Beta-lactamase (ESBLs) in pathogenic bacteria leads to antibiotic resistance and mortality and morbidity in patients. The best method for controlling strains that produce ESBLs is use of standard method for recognizing ESBLs producer strains. The objective of this study was to evaluate and compare the frequency of ESBLs in Escherichia coli and Klebsiella pneumoniae strains isolated from hospitalized and out-patient with urinary tract infection in selective centers from Esfahan.   Methods: The research was of descriptive type and performed in Al-zahra, Shariaty, and Kashany hospitals and Reference and Mahdieh laboratories during 2009-2010 in Isfahan. According to statistical formula 378 UTI samples were randomly selected . Bacterial identification was performed with microbiological methods and ESBLs production was performed with screening and confirmatory test. For data analysis, Chi square test and Whonet 5.4 software was used.   Results: From 378 samples, 167 bacteria were from hospitalized cases and 211 bacteria were from out-patient samples. Frequency of E.coli in hospitalized and out-patients was respectively 52% and 64% and frequency of K.pneumoniae in hospitalized and out-patient was respectively 64% and 22%. Frequency of ESBLs in E.coli strains in hospitalized and out-patient was respectively 58% and 17% and frequency of ESBLs in K.pneumoniae strains in hospitalized and out-patient was respectively 64% and 22%.   Conclusion : The results showed high rate of nosocomial UTI and high frequency of ESBLs in isolated bacteria from hospitalized cases as compared to out-patients that represent high incidence of antibiotic resistant strains in hospitals. 1643 Physiotherapy Latency and recruitment order of the shoulder muscles in dynamic complex movement in patients with shoulder impingement syndrome Khanmohammadi Roya h Talebian Saeed i Shadmehr Azadeh j Entezari Ebrahim k h Tehran University of Medical Sciences (TUMS) i Tehran University of Medical Sciences (TUMS) j Tehran University of Medical Sciences (TUMS) k Tehran University of Medical Sciences (TUMS) 1 7 2011 18 85 17 26 28 08 2011 Background: Shoulder muscle timing is very important, however, study on the shoulder muscle timing and recruitment patterns is limited. Thus, the aim of the study was to determine and compare the timing and recruitment order of the shoulder muscles in subjects with and without Shoulder Impingement Syndrome (SIS). Methods: In this case-control study, 9 female subjects with shoulder impingement syndrome and 13 matched healthy female volunteer subjects selected by simple-non random sampling participated. Surface electromyography of serratus anterior, pectoralis major, upper trapezium, lower trapezium, posterior deltoid, and anterior deltoid muscles of dominant side were recorded during D1flex movement. Muscle latency time, relative muscle latency time and recruitment order were processed and compared in subjects with and without SIS. Non parametric test [2 independent samples (Mann-Whitney U)] was used for data analysis Results: In patient group some muscles showed a greater latency time than healthy group but this increase wasn't statistically significant. Also, in patient group recruitment order of shoulder muscles was changed. Conclusion: Altered recruitment patterns of one or more muscles in the patient group as compared to healthy group indicate neuromuscular control has changed. Thus rehabilitation programs should be designed to restore and optimize the activation sequences and motor control of these muscles. 1644 Physiology Anti-convulsant effect of alcoholic Hyoscyamus niger L seed extract on PTZ model of kindling in male mice Kiasalari Zahra l Khalili Mohsen m Heidari Hamid n Azizi Yaser o l Shahed University m Shahed University n Shahed University o Shahed University 1 7 2011 18 85 27 33 28 08 2011   Background: Regarding the prevalence of epilepsy in human society and with respect to inefficiency of the usual treatments, finding new strategies and methods for the medical treatment of epileptic patients are essential. Henbane seed has been used in Iranian traditional medicine as an anti-convulsion herb. With this regard the present study was carried out to consider the anti-convulsive effect of Henbane seed extract on the chemical kindling-induced convulsion.   Methods: The present experimental study has been conducted at Medical Faculty of Shahed University in 2009. Sixty male mice have been chosen randomly and divided into 5 experimental groups including 12 mice in each group as follows: 1-control group receiving only Pentylene tetrazole (PTZ), 2nd,3rd and 4th experimental groups received alcoholic extract of henbane seed in doses of 50, 100 and 200 mg/kg intraperitoneally 30 minutes before PTZ injection and 5th group was positive control that received valproic acid 100 mg/kg 30 minutes before PTZ injection. Chemical kindling was performed in all of them by a total of 11 treatments with intraperitoneal injection of PTZ 35 mg/kg at every 48 hours. In the 12th injection all groups were tested for PTZ challenge dose (75 mg/kg). Mice were observed 30 minutes after the last injection to detect convulsion. Data analysis was carried out by One way ANOVA and Tukey post-hoc tests.   Results: Data analysis shows that administration of henbane seed extract had an inhibitory effect on the steps, progression and duration of seizure, especially in the last steps of convulsion. However, therapy with henbane seed extract resulted in an efficient anticonvulsive effect from the 8th injection reaching the highest level of efficiency at the 12th step (p<0.001) .   Conclusion: The results obtained from the present study showed that alcoholic Hyoscyamus niger seed extract could have markedly alleviated PTZ-induced seizure phases in male mice. Also, the extract at 100 mg/kg significantly increased and reduced the threshold and duration of 5th seizure phase. 1645 General Surgery Treatment of upper limb deformities using soft tissue distraction: an introduction to pentagonal frame Nazerani Shahram p Kalantar Motamedi Mohammad Hossein Keramati Mohammad Reza Paydar Mohammad Ali Nazerani Tara Koohnavard Marjan p Tehran University of Medical Sciences Tehran University of Medical Sciences Tehran University of Medical Sciences Tehran University of Medical Sciences Tehran University of Medical Sciences Tehran University of Medical Sciences 1 7 2011 18 85 34 41 28 08 2011   Background : Soft tissue distraction is an increasingly accepted treatment method in hand surgery which can be applied as a method of contracture release from elbow to proximal phalangeal joints. Common methods have been shown that contracture release alone is not enough and leads to recurrence after a while. Currently, joint and soft tissue distraction and holding them in a proper position in which physiotherapy can be done is the most accepted method. Herein we present a technique named “pentagonal frame” for soft tissue distraction which can help us in reaching the desired outcome. As a result of novelty of this technique and lack of enough data regarding its outcome, we would like to report its treatment results in this article.   Methods: In this case series study, we report 33 patients that presented with soft tissue contracture in their hands. In this method, a thin 1-1.5 mm Kirschner wire was passed horizontally at the proximal head of the distal phalanx and bent like a frame around the finger, forming a pentagonal shape for anchorage and allowing limb traction without damage to pulp and soft tissues. Two forms of traction were performed: static (with a wire exerting pressure) or dynamic (using a rubber band to adjust the tension). The wire or rubber band may be temporarily freed to commence active and passive physiotherapy. We maintained the frame for 3-6 weeks which played the role of night splint within final weeks. SPSS V.16 was used for data analysis.   Results : In this study, 33 patients (23 male, 10 female) with a mean age of 20.91 years (SD=13.05) were evaluated. The patients underwent surgery for a mean of 3 times. After the surgery and removing the frame, patients were followed up every 6 months for a maximum of 5 years. The difference between flexion contracture in PIP, before and after the surgery was statistically significant (65.15 ± 37.44 vs. 7 ± 4.74, p<0.001). Except for one case of pin infection that was treated using antibiotic administration and its removal, no other major complications were encountered during the follow-up period (3-5 years).   Conclusion : The pentagonal frame with its effective traction on soft tissues and ligaments and additional physiotherapy may be used as an effective treatment for soft tissue adhesions. Moreover, it provides traction to the fingers and even the hand without complications on distal phalanx and joints and allows concurrent physiotherapy. 1646 Pulmonary Disease Anthropometric indices, fat-free mass index and their relationship with pulmonary function in COPD patients Yazdanpanah Leila Shidfar Farzad Javad Mousavi Seyed Ali Heidarnejad Hassan Haghani Hamid Tehran University of Medical Sciences Tehran University of Medical Sciences Tehran University of Medical Sciences Shaheed Beheshti University of Medical Sciences Tehran University of Medical Sciences 1 7 2011 18 85 42 51 28 08 2011   Background: Loss of body weight and depletion of muscle mass are common nutritional problems in Chronic Obstructive Pulmonary Disease (COPD) patients . They are associated with increase disability, reduction of respiratory and skeletal muscle mass and strength, and these exert destructive effects on pulmonary function and quality of life in COPD patients. The aim of the current study was to assess the anthropometric indices and Fat-Free Mass Index and their relationship with pulmonary function in COPD patients in Hazrat Rasool Akram hospital in Tehran.   Methods: This cross sectional study comprised 63 stable COPD patients, with a mean age (SD) of 67.6 (9.4) years in disease stages 2 to 4. In this study, assessment of anthropometric indices included BMI (Body Mass Index), TSF (Triceps Skinfold Thickness), MAMC (Mid Arm Muscle Circumference) and FFMI (Fat-Free Mass Index) analyzed by bioelectric impedance categorized by percentiles according to the severity of disease. Also spirometry for measuring FEV1, FVC, FEV1/ FVC, VC was performed on all participating COPD patients. Fisher`s Exact Test was used for assessing relation between anthropometric indices and FFMI with stages of disease. Assessment of relationship between anthropometric indices, FFMI and respiratory factors was performed using Pearson`s Correlation Coefficient test. SPSS V.12 was used for data analysis.   Results: Reduction of weight, depletion of fat mass and fat-free mass was observed in different disease stages. Reduction of body mass index, and depletion of muscle mass showed a significant increase as the disease progressed, MAMC (P=0/02) and BMI (P=0/04). After assessing relationship between anthropometric indices and FFMI with respiratory factors, results showed significant relationship between BMI (P=0.02, r = 0.2) and MAMC (P=0.03, r = 0.2) with FEV1.   Conclusion: Reduction of weight, depletion of muscle and fat mass were observed in many patients along with an increase in the severity of the disease. In regard to these results, measurement of anthropometric indices in addition to BMI in routine evaluation of COPD patients, provide more information about nutritional abnormalities and alterations in body composition usually occurs in COPD patients.