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 46, No 5 (2008)
Articles
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Renal ischemia-reperfusion (IR) injury is a common problem in kidney transplantation. There is increasing evidence about the role of the reactive oxygen species (ROS) in these injuries and endogenous antioxidants seem to have an important role in decreasing the renal tissue injury. The aim of this study was to investigate the effects of kidney IR on renal antioxidant enzymes activity such as catalase and superoxide dismutase (SOD) and renal glutathione (GSH) levels. The level of malondialdehyde (MDA), an end product of lipid peroxidation, also was quantified. Male Wister rats (200-280 g) were anesthetized and after right nephrectomy, the left renal artery was clamped for 40 min. After 24 h reperfusion, serum and kidney tissue samples were obtained for metabolites assay. Results showed that renal IR increased serum creatinine and urea level [90.59 ± 12.93 vs. 44.06 ± 4.07 µmol/L (P < 0.01), and 40.22 ± 10.27 vs. 20.8 ± 1.8 mmol/L, (P < 0.05), respectively]. The renal catalase activity was decreased (33.13 ± 2.02 vs. 43.78 ± 2.38 units/mg protein, P < 0.01) but SOD activity was increased (57.59 ± 4.64 vs. 42.84 ± 1.85 units/mg protein, P < 0.05). The GSH level also was decreased (24.67 ± 2.31 vs. 37.44 ± 3.09 nmol/mg protein P < 0.01). MDA level after IR was not significantly different from control group (2.05 ± 0.27 vs. 1.84 ± 0.2 nmol/mg protein, P = 0.55). Our data indicated that despite decrease in renal GSH level and catalase activity following IR, SOD activity was increased.
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Iron is a pro-oxidant cofactor that may belinked to atherosclerosis progression. Free iron catalyzes the generation of free radicals and free radicals promote the oxidation of lipids. Reduction of body ironstores secondary to blood donation has been hypothesized toreduce lipid peroxidation. The aim of this study was to evaluate the association between blood donation and antioxidant enzymes and lipid peroxidation product malondialdehyde (MDA). We investigated hemoglobin (Hb), serum ferritin, MDA level, glutathione peroxidase (GPX) and superoxide dismutase (SOD) activities in the whole blood of 150 male volunteer blood donors aged from 30 to 60 years attending Tehran Blood Transfusion Center. Subjects were divided into 5 groups according to the frequency of blood donation per year. With increasing the number of blood donation in a year, the body iron stores, GPX activities and serum MDA were significantly reduced (P < 0.05) but SOD was significantly increased (P < 0.05). High-frequency blood donors had evidenceof decreased body iron stores, decreased lipid peroxidation and enhanced activity of antioxidant enzymes when compared with low-frequencydonors
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Various studies suggest that selective serotonin reuptake inhibitors (SSRIs) may be useful in treating pathological skin picking (PSP). This study sought to assess effectiveness of citalopram in comparison with placebo in treating PSP. Forty five individuals with PSP were recruited in a four-week, randomized clinical trial of citalopram (20 mg/day) in comparison with placebo. Study measures assessing skin picking severity, mental health status, obsessive compulsive disorder and quality of life were given at baseline, weeks 2 and 4. PSP severity, general health status, obsession-compulsion severity and quality of life level were similar between two groups at baseline (P > 0.05). Treatment analyses revealed significant improvements in quality of life, general health status and obsession-compulsion severity in citalopram group compared to placebo group (P < 0.05). Mean PSP severity reduction in citalopram group was more than placebo group but this difference was not significant. Citalopram can improve general health status and quality of life in individuals with PSP but its effect on skin picking behavior doesn't differ significantly with placebo. Other trials with longer time are needed to determine the exact efficacy of citalopram on PSP
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Central retinal vein occlusion (CRVO) is the third most common blinding vascular retinal disorder. As there is no proven treatment for CRVO, we performed this study to evaluate the effectiveness of radial optic neurotomy (RON) on visual acuity in eyes with CRVO. This study was designed as an interventional case series. Pars plana vitrectomy with RON was performed in 18 eyes of 16 patients with ischemic CRVO with visual acuities of 20/400 or less. Postoperative and preoperative visual acuities were compared using t paired test. Mean preoperative visual acuity was 20/1000 (range, 20/1600 to 20/630). Mean follow-up time was 3.6 months (range, 1 to 9 months). Mean postoperative visual acuity was 20/400 (range, 20/1600 to 20/50) at last follow-up and the difference was significant (P < 0.01; t paired test). Six patients (33%) improved to 20/200 postoperatively. There were no major complications intraoperatively. Chorioretinal shunts developed in neurotomy site in 9 cases (50%) 4 to 10 weeks after procedure which were associated with faster resolving of hemorrhage and venous dilation. There were no major complications noted with this procedure but vitreous hemorrhage and iris neovascularization was observed in the early postoperative period in 2 (11%) of 18 cases. RON may improve visual acuity in eyes with CRVO. It is a technically feasible and fairly safe procedure but postoperatively it may result in some complications such as vitreous hemorrhage, iris neovascularization and retinal detachment.
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Patients with end stage renal disease need a good vascular access for hemodialysis. Arteriovenous fistula is the method of choice for vascular access in these patients. However, failure of arteriovenous fistula due to thrombosis is a major problem. The aim of this study was to evaluate the effect of the heparin on the patency of the arteriovenous fistula. This prospective interventional case control study was performed from November 2003 through May 2005 in vascular surgery ward in Imam Reza Hospital. All the patients who underwent a surgery in order to perform an arteriovenous fistula in cubital or snuff box areas for the dialysis means were enrolled. They were randomly divided into two groups. The case group (n = 96) received intraoperative heparin whereas the controls (n = 102) did not. Early observation of arteriovenous fistula (immediately after surgery) showed patency in 89% of heparin group and in 87% of the control group. The patency rate 2 weeks after the surgery was 85% in heparin group versus 74% in the control group, resulting in a statistically significant difference (P value = 0.046). According to higher patency rate of arteriovenous fistula in 2 weeks following surgery in case group, we recommend intraoperative use of heparin in arteriovenous fistula operations.
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Percutaneous nephrolithotomy (PNL) is commonly used to treat patients with complex renal calculi. Placing a nephrostomy tube is the last step after completing PNL. Significant early postoperative discomfort after percutaneous procedure is usually secondary to nephrostomy tubes. The goal of this study is to evaluate the safety of tubeless PNL. A total of 45 patients with mean age of 46.6 years entered the study. Tubeless PNL was performed in 28 patients and 17 patients were treated with standard PNL. The results of 2 groups were compared with t test. In both groups, PNL was performed successfully without any significant complication. Postoperative hospitalization in standard group was 3.71 day and in tubeless group was 1.65 day that significant statistical difference was observed (P < 0.05). Analgesic dose using in standard group was 101.56 mg (pethidine) vs 99.07 mg (pethidine) in tubeless group, with no significant statistical difference. There wasn't any organ trauma. Rate of complications, including hematuria, extravasation, fever, UTI and urosepsis, didn't have any significant statistical difference in two groups. It seems that tubeless PNL may be an effective and safe method in renal stone treatment in selected patients. In comparison with standard PNL, tubeless PNL has some benefits including reduction the length of hospitalization. Further studies on more patients are needed to determine the advantages of this technique.
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Coronary artery bypass grafting (CABG) surgery is being performed increasingly in Iran. So far, no large-scale report has described characteristics and risk factor profile and in-hospital mortality of patients undergoing this procedure in Iran. We conducted this study to address these topics in order to help clarify Iran's current state of CABG and to provide assistance in planning combat against coronary artery disease based on frequency of major risk factors. Patients who underwent isolated, first-time, elective, on-pump (conventional) CABG in a cardiac surgery center in Tehran were prospectively studied from September 2004 and March 2005. Demographic data, risk factor profile and discharge status for each patient were recorded. There were 1258 patients, 937 men (74.5%) and 321 women (25.5%). The mean age was 58.7 years (range 28 to 81); 133 patients (10.6%) were 70 years old or older. Mean body mass index (BMI) was 27.01 and 42.2% of the patients were smokers, 39.4% were hypertensive, and 27.6% had diabetes. Family history was positive in 40.3%. Congestive heart failure was found in 26.6%. New York Heart Association functional class III or IV was observed in 52.8% of patients. Single-vessel, two-vessel, and multi-vessel disease was found in 4.2%, 21.1%, and 74.7% of patients, respectively. Left main was involved in 9.8% and 14.4% had ejection fraction < 35%. The in-hospital mortality was 1.5%, mainly due to cardiac causes. This study indicates significant prevalence of major cardiovascular risk factors in Iranian CABG patients. In-hospital mortality of primary isolated CABG in Iran is similar to reported rates.
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Large preterm infants are generally not considered good candidates for surfactant treatment until they have been intubated for progressing respiratory distress. This study has been done to detect the effect of electively providing early single-dose surfactant to large preterm babies with mild to moderate respiratory distress syndrome (RDS). A randomized clinical trial was performed on 45 infants with birth weight > 1250 grams, gestational age < 36 weeks, postnatal age 0-12 hours, FiO2 > 40% and no immediate need for intubation. They were randomly divided into two interventional (n = 22) and control (n = 23) groups. Interventional group infants were intubated and received surfactant in the first 12 hours of life with signs of mild to moderate RDS and were extubated as soon as possible. The control group infants were only intubated and received surfactant when clinically or radiographically indicated. The primary outcome was duration of assisted ventilation. Interventional group infants had a median duration of assisted ventilation of 4.45 hours compared to 1.02 hours in the control group in the first 24 hours of life, since only 8 of 23 infants in the control group (34%) needed intubation and mechanical ventilation. There were no differences in the two groups for need of subsequent retreatment with surfactant and requirement for supplemental oxygen or mechanical ventilation, hospital stay and adverse outcomes. Results of this study indicate that elective intubation for administration of early single-dose surfactant to large preterm infants is not necessary.
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Mother's mental health status during pregnancy has important effects on fetal growth and development. However, there are few studies concerning association of maternal depression and biophysical profile (BPP) of the fetus. We performed this research to know if maternal depression has any association with fetal BPP score. For measuring depression, Farsi version of Patient Health Questionnaire-9 (PHQ-9) was completed. A total of 100 pregnant women in their third trimester (>24 weeks) who had not hyperthyroidism, hypothyroidism, eclampsia and preeclampsia, fever, infection, diabetes or a fetus with intrauterine growth retardation (IUGR) and were not using any medication entered the study. Spearman correlation coefficient between the score of PHQ-9 questionnaire and BPP score was -0.08 (P = 0.43). Based on Kruskal Wallis test, there was no difference in BPP score of depressed and nondepressed women (P = 0.65). We found no relationship between maternal depression and BPP score in third trimester of pregnancy. Further studies for elucidating neuro-hormonal mechanisms related to the result of our study are suggested
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Urinary tract infection (UTI) may lead to irreversible changes in renal parenchyma. Early diagnosis using scintigraphy with technetium-99m-labeled dimercaptosuccinic acid (DMSA) scan and early treatment may decrease or prevent development of renal parenchymal lesions. The aim of this study was to assess the occurrence of renal parenchymal lesion in children admitted with a first-time symptomatic UTI and to evaluate the relation between renal parenchymal damage and severity of vesicoureteral reflux (VUR). A total of 102 children with first time acute pyelonephritis (APN) were enrolled in the study. All children studied with DMSA scan and ultrasonography (US). Voiding cystourethrography (VCUG) was performed in 98 children when urine culture became negative. Changes on the DMSA scan and US were found in 178 (88%) and 5 (2.4%) out of 203 renal units during the acute phase, respectively. All abnormal renal units on US showed severe parenchymal involvement on DMSA. We also found significant correlation between severity of VUR and abnormal US results on kidneys. Of 40 kidneys with reflux, 38 (95%) were found to have abnormal renal scan. Among 155 kidneys with non-refluxing ureters 132 (85.2%) revealed parenchymal changes on renal cortical scintigraphy. Kidneys with moderate to severe reflux were more likely to have severe renal involvement. We found a high incidence of renal parenchymal changes in children with APN. Additionally, renal involvement was significantly higher in children with moderate to severe reflux. When there are high-grade VUR and female gender, the risk of renal parenchymal involvement is higher.
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There is a lack of large, prospective epidemiologic studiesconcerning acute lung injury (ALI) and acute respiratory distresssyndrome (ARDS) in pediatric population. To determine the different causes of respiratory distress in children, we prepared a retrospective study and included the whole 567 children with respiratory distress referred to 17-Shahrivar Hospital, Rasht, Guilan. Using their medical files, data including age, sex, and causes of respiratory distress were collected. SPSS 13.0 (statistical software) applied for statistical analysis. Pneumonia, asthma, and croup were the major causes of ARDS in children with a rate of 38.4, 19.04, and 16.5 percent, respectively. It seems that infectious factors are at the top of the list of ARDS causing factors which can be helpful to approach and manage such patients. We suggest vaccinating these at risk groups against common infectious factors such as H. Influenza and RSV which can cause either pneumonia or inducing asthma.
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Pregnant women are at increased risk for urinary tract infection (UTI) but in many cases infection is asymptomatic. This study was performed to determine the incidence of asymptomatic bacteriuria and pyuria in pregnant women. A total of 86 pregnant women during first trimester and 56 nonpregnant women were evaluated. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine samples were collected for both groups. Urine samples were examined microscopically and were cultured. Bacteriological examination revealed asymptomatic bacteriuria in 25 (29.1%) and 3 (5.4%) of the study group and controls, respectively (P < 0.05). Microscopic analysis of urine revealed pyuria in 18 (20.9%) and 3 (5.4%) of the study group and controls, respectively (P < 0.05). In study group, Escherichia coli were found in 20%, Staphylococcus epidermidis in 36%, Staphylococcus haemolyticus in 12%, streptococcus group D in 12%, Staphylococcus saprophyticus in 12% and Proteus mirabilis in 8%. In control group, E. coli were found in 33.3% and S. epidermidis in 66.7%. Our results show that the incidence of asymptomatic bacteriuria is significantly higher in pregnant women than nonpregnant women. The main finding in the present study was that 29.1% of the pregnant women who were in first trimester had asymptomatic bacteriuria which is much higher than figures reported from other countries. The use of microscopic urinanalysis was not an effective method of detecting asymptomatic bacteriuria and urine culture is necessary for screening these pregnant women.
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One of the great challenges in the treatment of infectious diseases is the resistance of pathogenic bacteria against antibiotics, and antibiotic resistance to Shigella is broadly observed in different parts of the world. The object of this study was to determine Shigella antibiotic resistance pattern against the antibiotics such as ampicillin, amoxicillin, trimethoprim-sulfamethoxazole, chloramphenicol, nalidixic acid, ciprofloxacin and ceftriaxone. In this cross-sectional study, a total of 147 Shigella strains were collected from the diarrheic patients referring to different medical centers of Zahedan. Specific antisera were used for serotyping of isolated Shigella and their antibiotic resistance patterns were determined by standard Kirby-Bauer method. Of the 147 studied Shigella strains, 102 (69.3%) belonged to S. flexneri, 32 (21.7 %) to S. dysenteriae, 11 (7.4%) to S. boydii, and 2 (1.36%) to S. sonnei species. The isolated strains showed resistance to ampicillin (99.3%), trimethoprim-sulfamethoxazole (52%) and nalidixic acid (1.3%), but there was no resistance against ciprofloxacin and ceftriaxone. According to the findings, it is suggested that antibiotics should not be used without laboratory testing (antibiogram).
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There is no report on the etiology of acute viral hepatitis in Sistan and Baluchestan province, southeast of Iran. We performed this study to compare the clinical, biochemical and demographic properties of acute viral hepatitis (AVH) in this province. Demographic and clinical data were collected from 263 patients with AVH. They were tested for HBsAg, IgM anti-HAV, IgM anti-HBc, IgM anti-HDV, or IgM anti-HCV. Numbers of patients with hepatitis A, B, C, D and non A-D were: 188 (75.5%), 47 (17.9%), 6 (2.3%), 5(1.9%) and 17(6.6%), while mean ages were 6.1, 20.6, 20.2, 26.2 and 18.7 years, respectively. Hepatitis A patients presented with lower initial serum levels of bilirubin, ALT and AST, but higher alkaline phosphatase, and they were more likely to have anorexia, vomiting, fever, chills, abdominal pain and prodromal symptoms. Nearly all cases of AVH in children were due to Hepatitis A, whereas hepatitis B, C and D generally occurred in adults. There were some differences in clinical and laboratory findings regarding to the etiology.
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Classification of occlusion is the first step in diagnosing the relationship between the upper and lower jaw's teeth. Based on Angle's classification, occlusion is divided into three categories: class I, class II, and class III. The aim of this study was to determine the prevalence of occlusion categories, based on Angle's classification, in adolescents with permanent dentition in Tehran. This is an epidemiological cross sectional, randomized and descriptive study. Based on minimum rate of prevalence belonging to class III, number of cases was calculated and 1524 students, equal boys and girls, were studied. The prevalence of each classification in boys, girls and in total was determined. Among all cases, 79% were in class I occlusion; about 14.5% were in class II and 6.5% in class III. From Angle's 1899 study of prevalence of occlusion type until now, many studies have been done with different results. It seems that prevalence of occlusion type strongly depends on genetic factors and area of the study.
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Giant cell granuloma is a relatively common, benign, non odontogenic lesion of oral cavity. It is a reactive response to local irritations and trauma that may be of central or peripheral type. It predominantly affects women and occurs most frequently in first 4 decades of life when hormonal changes are prominent. Therefore, hormonal effects are considered as a main factor in the etiology of this lesion. Purpose of this descriptive study was evaluating the relationship between circulating levels of sex hormones (testosterone, estrogen and progesterone) and presence of giant cell granuloma. We measured circulating levels of these hormones in 20 patients with giant cell granuloma utilizing radio immunoassay (RIA). Our sample included 12 females and 8 males from 10 to 65 years of age. Results were compared with normal range by means of t test. There were no significant differences between testosterone, progesterone and estrogen levels in patients with normal ranges. Our findings suggest that giant cell granuloma does not depend on sex hormones directly and role of sex hormones in development of this lesion is secondary to local factors such as trauma and poor oral hygiene.
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Bacterial meningitis after spinal and epidural anesthesia is a very rare but serious complication. We report a case of meningitis developing a number of hours after a spinal block for Caesarean section. No organism was grown but the CSF pattern was suggestive of bacterial meningitis. Severe neurological sequelae were present after three months of hospitalization. Meningitis is a serious complication and its early diagnosis and effective treatment is essential. Meningitis should always be considered as a possible differential diagnosis in patients suspected of having post spinal headache, convulsion and changes in mental statues. A thorough knowledge and practice of aseptic techniques is crucial in performing spinal and epidural anesthesia.
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Reports which describe sick sinus syndrome due to malignant lymphoma have been rare and only eight cases have been reported until now. This is a case of sick sinus syndrome and superior vena cava syndrome secondary to invasion of occult malignant lymphoma of the lung in a 60 years old male. There were no symptoms or signs of malignancy before the first presentation with sick sinus syndrome. Patient was treated with implantation of a permanent pacemaker. SA node involvement by lymphoma should be considered as an etiological factor when sick sinus syndrome of unknown cause is encountered.
