2023 CiteScore: 0.7
pISSN: 0044-6025
eISSN: 1735-9694
Editor-in-Chief:
Ahmadreza Dehpour, PharmD, PhD
This journal is a member of, and subscribes to the principles of, the Committee on Publication Ethics (COPE).
Vol 41, No 4 (2003)
Articles
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Cytotoxicity evaluation of Daphne mucronata (Thymelaeaceae) extract and one of its active purified components, using seven different cancerous cell lines, revealed the strong antiproliferative activity of the plant. Using flow cytometry technique, it was found that treatment of the most responsive cells (K562) with the plant extract or the active component inhibited the progression of cells through G1 phase by almost 15% compared to the untreated cells. Based on the extent of [3H]-thymidine and [3H]-uridine incorporation into DNA and RNA, respectively, the major metabolic effects of D. mucronata were found to be mainly on DNA and to a less extent on RNA synthesis. These data strongly support the flow cytometry observation and provide a mechanism for the antiproliferative activity of D. mucronata.
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In this study the plasma levels of lipid peroxidation (LP) products, protein carbonyls and antioxidant capacity of plasma as judged by ferric reducing ability of plasma (FRAP assay) were compared in adult and weanling rats treated with vitamin K1 phylloquinone).
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Patients with diabetes mellitus (DM), experience significant morbidity and mortality from microvascular retinopathy, nephropathy and neuropathy. Hyperglycemia can induce diabetic complications through multiple pathways. Activation of protein kinase C (PKC) by hyperglycemia is one of the pathways which causes diabetic complications. Effect of nifedipine (a calcium channel blocker), and polymyxine B sulphate (a Protein kinase C inhibitor) was studied in adult male Sprague- dawley rats, who was made diabetic with streptozotocin. PKC activity was determined in tissues and serum enzymes and metabolite level was measured in all controls, diabetic and drug treated animals. The results showed that, levels of the, urea (two –fold), creatinine (60%), triglyceride (two-fold) and liver alanine transaminase (ALT) activity (two-fold), were significantly increased in diabetic group. In nifedipine, treated diabetic group, although urea and creatinine level was increased, but liver enzymes were not significantly different from those of control group. In diabetic group which was treated with polymyxine, all the measured metabolites and enzyme levels were the same as the control group, except glucose level which was increased and liver glycogen was decreased significantly. Protein kinase C activity in the cytoplasm of diabetic liver was increased comparing to its control group (5.73 ± 0.56 Vs, 4.00 ± 0.62). The enzyme activity in the plasma membranes of untreated and nifedipine treated diabetic groups was significantly increased (6.2 ± 0.42 and 3.66 ± 0.31 Vs 2.38 ± 0.36). These results show that polymyxine is more effective than nifedipine against protein kinase C activity in diabetic complications. In conclusion our results show that, liver and kidney damage in DM are related to PKC activation. The fact that polymyxine prevents diabetic related increase in PKC activity more than nifedipine, support the hypothesis that different PKC isozymes may play different roles in the development of diabetic complications.
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In this center, from 1991 to 2002, 89 chronic myelogenous leukemic (CML) patients, age ranging between 8-48 years with a median age of 29, underwent hematopoietic stem cell transplantation. Eighty-eight patients were in the first chronic phase of disease. Twenty-three patients received bone marrow transplantation (BMT) and 66 patients received peripheral blood stem cell transplantations (PBSCT). Transplantation was performed at a median interval of 19 months post-diagnosis. All with five exceptions received busulfan + cyclophosphamide (Bu Cy) conditioning regimens. To maintain graft vs. host disease (GVHD) prophylaxis, all with three exceptions received cyclosporine + metothrexate. Administration of granulocyte colony stimulating factor (G-CSF), per protocol, was included in post-transplantation regimens from the year 1999 on 48 patients. All patients received marrow transplantations from sibling donors. Fifty seven of transplanted patients are alive. Disease free survivals (DFS) from 6.2 to 9.5 and from 2.2 to 6.2 years for BMT group were 38.2% and 47.8%, respectively. DFS for PBSCT group was calculated as 54.3% in a period of 1.9 to 4.6 years.
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Cytogenetics has now been well established as one of the most valuable prognostic factors in acute myeloid leukemia (AML). This is the first study to describe the cytogenetic findings in Iranian AML patients. During 1998 to 2001, 104 patients with adult de novo AML (excluding M3) were diagnosed and treated with the standard protocols in our center. Adequate cytogenetic analysis performed on bone marrow at diagnosis was available in 39 of these patients. Clonal chromosomal abnormalities were detected in 74.4% of the patients. The chromosomal changes seen in this study in order of frequency were: t(9;22), trisomy 11 [n=4, 10.3%], trisomy 8, Abn (3q)[n=3, 7.7%], trisomy 22, monosomy 7/del (7q), monosomy X, complex karyotype [n=2, 5.1%], and t (8;21), t (6;9), trisomy 21, monosomy 5/del (5q), monosomy Y, and Abn (11q) [n=1, 2.6%]. We also categorized the patients into favorable (2.6%), intermediate (74.4%), and unfavorable (23.1%) prognostic groups based on the criteria defined by Grimwade et al in MRC-AML-10. The frequencies of different clinical and paraclinical indices were studied in these groups. Notably, complete remission (CR) rates after one cycle of chemotherapy were 60.0% and 25.0% in intermediate and unfavorable prognostic groups respectively. The overall CR rates were 83.3% and 66.6% in the mentioned groups. These findings are somewhat comparable to the results of the larger studies in other countries, suggesting the importance of cytogenetics in Iranian patients. The differences could be due to methodological variations (notably exclusion of AML-M3 in this study), and the small sample size, although ethnic and geographical differences should not be disregarded. To further clarify these results with statistical significance a larger analytical study with a greater sample size is certainly needed
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Thalassemia major patients require repeated transfusions of packed cell and their lysis lead to iron deposition especially in the cardiac walls such as septum and posterior wall, so make thickening and cause cardiac disorders. In this case-control study, our object was to appoint if QT and QTC and Te dispersions were predictors of cardiac disorders in thalassemia major patients or not. 34 thalassemic patients who had no cardiac sign or symptom and 34 normal subjects between 16-18 years old of age were referred for evaluation of their QT, QTC, and Te dispersions in their ECGs. All standard 12-lead ECGs were obtained from them and were digitized by a single observer blinded to the assigned groups. As references, QT and Te were measured and QTC was calculated by Bazett,s formula.Results showed highly significant differences in QT and QTC dispersions between thalassemic patients and control group (P-value = 0.004 and 0.001 respectively); but it was moderate for Te (P-value = 0.086). About the means of QT, QTC and Te, there were highly significant differences between two groups too (P-value = 0.001, 0.000, and 0.000 respectively). QT and QTC dispersions are significantly higher in thalassemic patients than normal persons and may be predictors of cardiac disorders such as arrhythmias or sudden death in thalassemic patients in future.
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The prevalence of vesicoureteral reflux (VUR) among siblings of children with VUR has been reported to be from 4.7% to 51%. The incidence of VUR in the general population is less than 1% but it is high in risk groups. In a prospective study we started identifying the incidence and severity of VUR and renal parenchymal lesions in the siblings of patients known to have urinary tract infection (UTI) with reflux. Between October 1994 and February 2002, 31 siblings of 26 index patients were screened with direct voiding cystography. Technetium -99m dimercaptosuccinic acid (DMSA) nuclear renal scans were performed in siblings with VUR to detect renal scarring. The cystograms were interpreted as showing the presence or absence of VUR and the DMSA scan as symmetrical or asymmetrical differential function, with or without renal scar. Sixteen of 31 siblings were found to have vesicoureteral reflux representing an incidence of 51.61%. Mean age at presentation of the 8 boys and 23 girls was 2.5 years (range 6 months to 12 years). The majority of them were asymptomatic. Reflux was unilateral in 11 siblings and bilateral in 5. Of 16 siblings with reflux, 6 (37.5%) had a history of symptomatic UTI. The frequency of VUR was equal in siblings over 6 years and those younger. Fifteen of the 16 siblings with VUR had DMSA scintigraphy, of whom 5 were normal and 10 (66.66%) showed abnormalities (nine asymmetrical differential function and one parenchymal defect), which was bilateral in 7 and unilateral in 3. This study confirms a significant overall incidence of VUR in the siblings of patients with known reflux. The prevalence of reflux in older siblings is similar to those in the younger ones. The high rate of reflux in this population, especially girls, over 6 year old might be attributed to bladder dysfunction.
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Primary hypokalemic periodic paralysis is a familial channelopathy inherited as an autosomal dominant trait. The first attack of paralysis may be evolved at any age, but has been reported to be most common in the second decade, so that some authorities believe that an episodic weakness beginning after age 25 is almost never due to primary periodic paralysis. In this retrospective study, we reviewed 50 patients admitted in two hospitals of Tehran University of Medical Sciences during 1992-2001 with acute flaccid weakness and hypokalemia, twenty-three of whom fulfilled our inclusion and exclusion criteria. Two patients showed first attack below age 15, 8 in 15-20, 4 in 20-25, 3 in 25-35, 4 in 35-45, and 2 beyond age 45. In our study, in contrast to previous ones, the first attack was beyond age 20 in 13 patients (56.5%) and beyond 25 in 9 (39 %). Age at first attack is more than other studies, which seems to be due to a difference between our epidemiological characteristics compared to that in the West. In other words, in our epidemiological condition, periodic weakness, although started beyond second decade of age, could be due to primary periodic paralysis if secondary hypokalemia had been ruled out.
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This study has been designed to compare visual inspection of cervix with acetic acid (VIA test) with cytology as an accepted method for screening of cervical carcinoma and its precursors. 1200 eligible women were examined by both Pap-smear and VIA tests in Imam Khomeini Hospital, a referral general hospital in Tehran, Iran. Those who had abnormal results in one or both of the screening tests (n = 308) and those who had clinically suspicious lesions even if the tests were negative in addition to 10% of otherwise normal patients with negative tests (totally 290 patients) were referred for colposcopy and biopsy if mandated. From 598 patients who were introduced to colposcopy services, 355 patients required biopsies or endocervical curettage (ECC). Those with CIN I or worse lesions diagnosed by histology were considered true-positive. VIA results were positive in 191 women (16.1%) and cytology was abnormal (for ASCUS or worse lesions) in 226 women (19%). VIA and cytology detected 130 (74%, 95% CI: 68%-81%) and 126 (72%, 95% CI: 65%-79%) cases respectively, yielding a sensitivity ratio of 1.03. VIA detected 31 lesions which were cytologically negative and cytology detected 27 lesions which were negative by VIA; 18 cancerous and precancerous lesions were missed in both modalities. The approximate specificities of VIA and cytology were 94% (95% CI: 93%-95%) and 90.2% (95% CI: 88%-92%) respectively. Also, the positive predictive values were 68.1% (95% CI: 61%-75%) and 55.7% (95% CI: 49%-62%) respectively. These results indicate that VIA and cytology had very similar performance in detecting CIN I or worse lesions in this study.
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This study has been designed to compare visual inspection of cervix with acetic acid (VIA test) with cytology as an accepted method for screening of cervical carcinoma and its precursors. 1200 eligible women were examined by both Pap-smear and VIA tests in Imam Khomeini Hospital, a referral general hospital in Tehran, Iran. Those who had abnormal results in one or both of the screening tests (n = 308) and those who had clinically suspicious lesions even if the tests were negative in addition to 10% of otherwise normal patients with negative tests (totally 290 patients) were referred for colposcopy and biopsy if mandated. From 598 patients who were introduced to colposcopy services, 355 patients required biopsies or endocervical curettage (ECC). Those with CIN I or worse lesions diagnosed by histology were considered true-positive. VIA results were positive in 191 women (16.1%) and cytology was abnormal (for ASCUS or worse lesions) in 226 women (19%). VIA and cytology detected 130 (74%, 95% CI: 68%-81%) and 126 (72%, 95% CI: 65%-79%) cases respectively, yielding a sensitivity ratio of 1.03. VIA detected 31 lesions which were cytologically negative and cytology detected 27 lesions which were negative by VIA; 18 cancerous and precancerous lesions were missed in both modalities. The approximate specificities of VIA and cytology were 94% (95% CI: 93%-95%) and 90.2% (95% CI: 88%-92%) respectively. Also, the positive predictive values were 68.1% (95% CI: 61%-75%) and 55.7% (95% CI: 49%-62%) respectively. These results indicate that VIA and cytology had very similar performance in detecting CIN I or worse lesions in this study.
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Cancer of the stomach carries poor prognosis. Surgery is the best treatment for gastric cancer. Prediction of survival depends on the stage at the time of presentation. Fluoroscopy, sonography, and computerized tomography are used for advanced gastric cancers staging, but they are not accurate enough to grade advanced gastric cancers. Laparoscopic findings of lesions under direct vision, are magnified 15 times and have been used for gastric cancer staging and more specific prediction. To demonstrate the importance of laparascopy, we carried out this study on 84 confirmed cases of gastric cancer prior to laparatomy. Results of computerized tomography were compared with the findings of laparascopies, and laparotomy was the gold standard in this study. Abdominal CT of gastric lesions had recommended resectability in 84 cases. Resectability was believed possible by laparoscopy only in 65 patients (19 false positives). Sixty-five patients were considered to have true positive diagnosis of resectability and one false negative and two false positive cases had false laparoscopic finding, which were confirmed by laparatomy and all of them were resectable. Eleven patients were diagnosed as stage IV because distant metastases were found during laparoscopy. This study showed that there are 42% differences between CT and laparoscopic findings. In this study the sensitivity and specifity of CT for stage II are respectively 77.7% and 82% but sensitivity and specifity of laparoscopy for stage III are respectively 78% and 55% and sensitivity and specifity of laparoscopy for stage III gastric cancer are respectively 94.5% and 100%. Laparoscopic examination is a valuable tool for diagnosing metastases and should be used for the management of advanced gastric cancers. We observed that 22% of patient had no need to undergo surgical operation, if they had pre-operative laparoscopic examination. This study suggests that terminally ill patients, and in advanced gastric cancer where surgery may be ineffective, laparascopic examination may predict and avoid unnecessary surgical interventions.
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Intussusception is a common pediatric surgical emergency, but rarely seen postoperatively as a cause of obstruction. This complication occurs after abdominal, thoracic, orthopaedic and urologic operations. Ileus and obstruction due to adhesion band are the common causes of postoperative obstruction, however, although intussusception is less frequent but can be serious. We have to consider this diagnosis in pediatric age group. This study was done between 1983-2000 among 10 patients with postoperative intussusception. Primary operation in most cases was diaphragmatic operation (40%), and abdominal esophageal operation (20%), most being performed under the age 3 years. The interval between primary operation and initiation of symptoms and signs was less than 5 days in 60% of cases and the most common type of intussusception was ileoileal in 80% of cases. Since classic signs and symptoms of intussusception are frequently absent and diagnostic tools are less helpful, high degree of suspicious is required for early diagnosis. Timely operation can give excellent results.
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Respiratory syncytial virus (RSV) is the major cause of lower respiratory tract infections in infants,and also an important factor for hospitalization during the winter months. To determine the prevalence and importance of RSV as a cause of acute lower respiratory tract infection, we carried out a prospective study during 5 months period from November to March 1998 in 6 pediatric hospitals. A nasopharyngeal aspirate was obtained for detection of RSV in all cases. Sociodemographic data, clinical signs, diagnosis and hospital admissions were documented. During this study period, 365 young infants (51.5% male, 48.5% female) with respiratory tract infection were visited in 6 hospitals. The median age of patients was 24 months (range: 1 month to 5 years).RSV infection was found in 70 out of 365 patients (19.18%).Among the 70 children with RSV infection, 29 patients (41.42%) were under 12 months of age.The main clinical manifestations of RSV infection were cough (88.57%) and coryza (78.57%). There were no significant differences between patients who were tested positive for RSV and those who were tested negative with regard to demographic variables and clinical diagnoses. This study indicates that RSV is an important cause of respiratory tract infection in infants and young children .Distinguishing RSV from other respiratory infection is difficult because of the similarity in clinical presentation among children.
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Popliteal artery injuries are mainly seen in military experience. This study was undertaken in a civilian vascular surgical unit with a large trauma workload dealing with traffic accidents. A retrospective review of patients treated between 1995 and 2001 was undertaken. 145 cases of popliteal artery injuries were treated. These cases included 46.89% compound and lacerated injuries due to traffic accident, 24.82% blunt trauma and 6.20% of iatrogenic nature. Associated fractures occurred in 14 (9.65%) patients and 19.34% had popliteal vein injuries. Treatment of the arterial injury included vein graft inter-position in 101, primary reanastomosis in 28, prosthetic graft interposition in six, lateral suture in 12, vein patch in five and ligation in one. Eithy four fasciotomies were performed. No perioperative death occurred. There were 9 primary and 11 secondary amputations. Factors associated with amputation were compound and lacerated injuries, delay in revascularization in excess of 7 hours, arterial transection, associated fracture, and compartment syndrome or muscle infarction. Usually the traffic accident trauma leading to popliteal artey injuries is associated with a high amputation rate. Prompt resuscitation and revascularization appear to be the only factors that may improve limb salvage rates.;
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Rectal prolapse is a relatively common disease of children and is defined as a rectal mucosa protrusion or a fullthickness protrusion (all layers) from anus. The purpose of this retrospective study is the review of different surgical techniques used in our centers and recommendations for optimal surgical management of rectal prolapse. This study was based on a 19 years experience in rectal prolapse management at Amir Kabir and Bahrami hospitals. In a total number of 67 cases sclerotherapy by 5% phenol in glycerin was the chosen procedure used. Since rectal prolapse is a self limiting disease and due to the fact of good results obtained from this technique with low morbidity, low cost and easy management, we recommend sclerotherapy for surgical treatment of rectal prolapse in pediatric age group.
