Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 26 90 2008 09 22 Clinical and paraclinical findings related to the rupture of hydatid cyst into the liver biliary ducts Clinical and paraclinical findings related to the rupture of hydatid cyst into the liver biliary ducts 12986 FA Mohammad Ali Rajabi Associate Professor, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences Journal Article 2010 11 07 Background: The rupture of hydatid cyst into the intra-hepatic bile ducts is considered as one of the problematic and important hydatid side effects. Considering the fact that this parasite is endemic in Iran, detection and treatment of hydatid cyst ruptured into the biliary system is crucial for any surgeon. Failure in detecting and predicting this complication can result in irremediable consequences. Methods: This study was retrospective and included 196 patients with liver hydatid cyst who were surgically operated (1994-2005) in hospitals of Isfahan University of Medical Sciences (Kashani Hospital, Isabne Maryam hospital and Al-Zahra Hospital) by the researcher, and among them, 22 patients were excluded because of incomplete records or lack of the conditions required for entering the study, and finally 174 patients were selected for the study. The quantitative and qualitative data were analyzed by t-test and Fisher's exact test respectively, also with Pearson test when necessary, at the statistical significant level of P< 0.05 in SPSS-10 software. Findings: Laboratory findings in patients with liver hydatid rupture was as follows: total bilirubin more than 1 mg/dl (p < 0.05), direct bilirubin more than 0.4 mg/dl (p < 0.05), alanine aminotransferase more than 31.5 u/l (p < 0.05), aspartate aminotransferase more than 29.5 u/l (p < 0.05), jaundice in last two weeks (p < 0.05), cyst size more than 14.5 cm (p < 0.05) and alkaline phosphatase more than 275.5 u/l (p < 0.05). Age, gender, white cell count, and cyst size smaller than 10 cm were insignificant and non helpful in making the diagnosis. Conclusion: In cases that rupture of liver hydatid cyst cannot be detected by ultra-sonography, surgeon must be careful during the operation in exploration for detection of probable rupture of liver hydatid cyst to provide the necessary treatments during the cyst operation and to prevent further operations and side effects. Key words: Complicated hydatid cyst, liver hydatid cyst, hydatid disease, intrabiliary cyst rupture.   Background: The rupture of hydatid cyst into the intra-hepatic bile ducts is considered as one of the problematic and important hydatid side effects. Considering the fact that this parasite is endemic in Iran, detection and treatment of hydatid cyst ruptured into the biliary system is crucial for any surgeon. Failure in detecting and predicting this complication can result in irremediable consequences. Methods: This study was retrospective and included 196 patients with liver hydatid cyst who were surgically operated (1994-2005) in hospitals of Isfahan University of Medical Sciences (Kashani Hospital, Isabne Maryam hospital and Al-Zahra Hospital) by the researcher, and among them, 22 patients were excluded because of incomplete records or lack of the conditions required for entering the study, and finally 174 patients were selected for the study. The quantitative and qualitative data were analyzed by t-test and Fisher's exact test respectively, also with Pearson test when necessary, at the statistical significant level of P< 0.05 in SPSS-10 software. Findings: Laboratory findings in patients with liver hydatid rupture was as follows: total bilirubin more than 1 mg/dl (p < 0.05), direct bilirubin more than 0.4 mg/dl (p < 0.05), alanine aminotransferase more than 31.5 u/l (p < 0.05), aspartate aminotransferase more than 29.5 u/l (p < 0.05), jaundice in last two weeks (p < 0.05), cyst size more than 14.5 cm (p < 0.05) and alkaline phosphatase more than 275.5 u/l (p < 0.05). Age, gender, white cell count, and cyst size smaller than 10 cm were insignificant and non helpful in making the diagnosis. Conclusion: In cases that rupture of liver hydatid cyst cannot be detected by ultra-sonography, surgeon must be careful during the operation in exploration for detection of probable rupture of liver hydatid cyst to provide the necessary treatments during the cyst operation and to prevent further operations and side effects. Key words: Complicated hydatid cyst, liver hydatid cyst, hydatid disease, intrabiliary cyst rupture.   https://jims.mui.ac.ir/article_12986_97f58cc60361f36cb40942c5c9a9e029.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 26 90 2008 09 22 Random urine protein/creatinine ratio for the predic-tion of significant proteinurea in pre-eclampsia Random urine protein/creatinine ratio for the predic-tion of significant proteinurea in pre-eclampsia 12991 FA Roya Nasiri Assistant Professor, Department of Obstetrics and Gynecology, School of Medicine, Mashhad Islamic Azad University Mohammad Sarafraz Yazdi Assistant Professor, Department of Internal Medicine, School of Medicine, Mashhad Islamic Azad University Istak Rezaei General Practitioner, Researcher, School of Medicine, School of Medicine, Mashhad Islamic Azad University Journal Article 2010 11 07 Background: Proteinuria is the main sign of preeclampsia. The gold standard test for quantitative evaluation of proteinuria in patients with suspected preeclampsia is the 24-hour urine analysis. Howewer, the collection of 24 hour urine specimens is time consuming, cumbersome, costly and unreliable procedure. The purpose of this study was to determine the diagnostic value of the protein/creatinine ratio in predication of 24-hour urine total protein among women with suspected pre-eclampsia. Methods: This study was a cross-section investigation and was performed on 45 hospitalized pregnant women evaluated for suspected pre-eclampsia at > 24 weeks of gestational age and a BP > 140/90 mmHg at 22-Bahman hospital between Dec 2006 and Jan 2008. For each patient, a random morning urine sample was obtained for the calculation of the protein/creatinine ratio then a 24-hour urine collection for determination of urinary protein excretion was collected Findings: From 45 patients, 67 percent of the study population had significant proteinuria. There was a strong correlation between urine protein/creatinine ratio and 24-hour urine protein excretion. Pearson's correlation coefficient was 84% and p = 0.0001. The best cut off point for the random urine protein/creatinine ratio was 0.23 with sensitivity, specifity, positive predictive value and Negative predictive value 81%, 77%, 89%, 63%, respectively. Conclusion: With further studies the random urinary protein/creatinine ratio could replace the 24-hour urine collections as an easier, faster, more useful screening test for ruling out significant proteinuria in suspected patients. Key words: Pre-eclampsia, pregnancy, random urine, protein/creatinine ratio, proteinuria.   Background: Proteinuria is the main sign of preeclampsia. The gold standard test for quantitative evaluation of proteinuria in patients with suspected preeclampsia is the 24-hour urine analysis. Howewer, the collection of 24 hour urine specimens is time consuming, cumbersome, costly and unreliable procedure. The purpose of this study was to determine the diagnostic value of the protein/creatinine ratio in predication of 24-hour urine total protein among women with suspected pre-eclampsia. Methods: This study was a cross-section investigation and was performed on 45 hospitalized pregnant women evaluated for suspected pre-eclampsia at > 24 weeks of gestational age and a BP > 140/90 mmHg at 22-Bahman hospital between Dec 2006 and Jan 2008. For each patient, a random morning urine sample was obtained for the calculation of the protein/creatinine ratio then a 24-hour urine collection for determination of urinary protein excretion was collected Findings: From 45 patients, 67 percent of the study population had significant proteinuria. There was a strong correlation between urine protein/creatinine ratio and 24-hour urine protein excretion. Pearson's correlation coefficient was 84% and p = 0.0001. The best cut off point for the random urine protein/creatinine ratio was 0.23 with sensitivity, specifity, positive predictive value and Negative predictive value 81%, 77%, 89%, 63%, respectively. Conclusion: With further studies the random urinary protein/creatinine ratio could replace the 24-hour urine collections as an easier, faster, more useful screening test for ruling out significant proteinuria in suspected patients. Key words: Pre-eclampsia, pregnancy, random urine, protein/creatinine ratio, proteinuria.   https://jims.mui.ac.ir/article_12991_6a54289b29ceb58cb7609cc50e0dc1c8.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 26 90 2008 09 22 The protein creatinine ratio in spot morning urine samples and 24 hour urinary protein excretion in patients with Systemic Lupus Erythematosus The protein creatinine ratio in spot morning urine samples and 24 hour urinary protein excretion in patients with Systemic Lupus Erythematosus 12994 FA Mansoor Salesi Assistant Professor, Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-7108-6188 Mansoor Karimifar Assistant Professor, Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Ziba Farajzadegan Associate Professor, Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-8811-6678 Kamal Esalatmanesh Assistant Professor, Department of Internal Medicine, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran Shahrzad Khosravi Researcher, Member of Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran Parvin Falahi Clinical Pathologist, Tehran University of Medical Sciences, Tehran, Iran Mahmood Akbarian Professor, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran Journal Article 2010 11 07 Background: 24-h urinary pr is a standard way to diagnose lupus nephritis. Assessment of Pr/Cr ratio in morning spot urine is a valuable method in diabetic patients but it has no use in SLE patients routinely. In this study Pr/Cr ratio in spot urine was compared with 24-h urine Pr. If they have valuable correlation, we can use this test instead of 24-h urinary Pr. The aim of this study was to evaluate the correlation of spot urine protein-creatinine ratio for prediction of significant proteinuria (> or = 300 mg/24 h) in patients with systemic lupus erythematous. Methods: A cross-section study was conducted in 74 hospitalized women with systemic lupus erythematous. The correlation between Prot/Cr in first morning urine specimens and urinary protein excretion were analyzed in 24-h collections. Findings: Correlation between Prot/Cr ratio in spot morning urine specimens and urinary protein excretion in 24-h collections was significant. Conclusion: A high correlation and precision of agreement were demonstrated between the two methods of assessment proteinuria in lupus patients. The difference between the two methods was less than the biological variability in the protein excretion and its measurement, enabling the methods to be used interchangeably creatinine ratio in spot morning urine samples is a precise indicator of proteinuria in patients with lupus nephritis and represents a simple and inexpensive procedure in establishing severity of proteinuria in patients with systemic lupus erythematous. Key words: Systemic Lupus Erythematous, 24-h urine protein measurement, protein / creatinine ratio.   Background: 24-h urinary pr is a standard way to diagnose lupus nephritis. Assessment of Pr/Cr ratio in morning spot urine is a valuable method in diabetic patients but it has no use in SLE patients routinely. In this study Pr/Cr ratio in spot urine was compared with 24-h urine Pr. If they have valuable correlation, we can use this test instead of 24-h urinary Pr. The aim of this study was to evaluate the correlation of spot urine protein-creatinine ratio for prediction of significant proteinuria (> or = 300 mg/24 h) in patients with systemic lupus erythematous. Methods: A cross-section study was conducted in 74 hospitalized women with systemic lupus erythematous. The correlation between Prot/Cr in first morning urine specimens and urinary protein excretion were analyzed in 24-h collections. Findings: Correlation between Prot/Cr ratio in spot morning urine specimens and urinary protein excretion in 24-h collections was significant. Conclusion: A high correlation and precision of agreement were demonstrated between the two methods of assessment proteinuria in lupus patients. The difference between the two methods was less than the biological variability in the protein excretion and its measurement, enabling the methods to be used interchangeably creatinine ratio in spot morning urine samples is a precise indicator of proteinuria in patients with lupus nephritis and represents a simple and inexpensive procedure in establishing severity of proteinuria in patients with systemic lupus erythematous. Key words: Systemic Lupus Erythematous, 24-h urine protein measurement, protein / creatinine ratio.   https://jims.mui.ac.ir/article_12994_5d5c18e4cd078a34b4db2ac85fbc1ed0.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 26 90 2008 09 22 The comparison of oral omeprazole and intravenous pantoprazole effects in high risk upper gastrointestinal bleeding patients The comparison of oral omeprazole and intravenous pantoprazole effects in high risk upper gastrointestinal bleeding patients 12995 FA Ahmad Shavakhi Assistant Professor, Department of Gastroenterology, Isfahan University of Medical Sciences, Isfahan, Iran Saeid Ataei Medical Student, Isfahan University of Medical Sciences, Isfahan, Iran Mahnaz Ataei Medical Student, Isfahan University of Medical Sciences, Isfahan, Iran Mahsa Khodadostan Resident of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-1499-5390 Mohammad Reza Minakari Assistant Professor, Department of Gastroenterology, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2010 11 07 Background: Proton pomp inhibitor drugs are used in the patients presenting gastrointestinal (GI) bleeding as adjuvant to endoscopic treatment. Proton Pomp Inhibitor (PPI) therapy is used via IV or oral route, with significant difference in cost and convenience. The aim of this study was the evaluation of outcomes in PPI therapy via IV or oral rout in high risk patients (i.e. active bleeding, adherent clot and non bleeding visible vessel). Methods: After endoscopic treatment, high risk patients presenting with upper gastrointestinal bleeding were randomly divided into two groups. Group one including 45 patients who received IV pantoprazole (80 mg stat, and 8 mg/h for 48 hours) and group two 48 patients received omeprazole (40 mg bid for 48 hours). Findings: The mean age of pantoprazole group was 45 ± 18 years (45 patients, Male (28)/Female (17) = 1.6) compared to omeprazole group 42 ± 15 years (48 patients Male (30)/Female (18) = 1.7). The two groups were matched for site of ulcer, age, rate of H. pylroi infection and type of bleeding stigmata. There were no differences between two groups in regards to transfusion units, death, surgery and rebleeding. Conclusion: High dose oral omeprazole is as effective as intravenous pantoprazole in high risk GI bleeding patients treated with endoscopic treatment. Key words: Peptic ulcer, omeprazole, proton pomp inhibitor, upper gastrointestinal bleeding.   Background: Proton pomp inhibitor drugs are used in the patients presenting gastrointestinal (GI) bleeding as adjuvant to endoscopic treatment. Proton Pomp Inhibitor (PPI) therapy is used via IV or oral route, with significant difference in cost and convenience. The aim of this study was the evaluation of outcomes in PPI therapy via IV or oral rout in high risk patients (i.e. active bleeding, adherent clot and non bleeding visible vessel). Methods: After endoscopic treatment, high risk patients presenting with upper gastrointestinal bleeding were randomly divided into two groups. Group one including 45 patients who received IV pantoprazole (80 mg stat, and 8 mg/h for 48 hours) and group two 48 patients received omeprazole (40 mg bid for 48 hours). Findings: The mean age of pantoprazole group was 45 ± 18 years (45 patients, Male (28)/Female (17) = 1.6) compared to omeprazole group 42 ± 15 years (48 patients Male (30)/Female (18) = 1.7). The two groups were matched for site of ulcer, age, rate of H. pylroi infection and type of bleeding stigmata. There were no differences between two groups in regards to transfusion units, death, surgery and rebleeding. Conclusion: High dose oral omeprazole is as effective as intravenous pantoprazole in high risk GI bleeding patients treated with endoscopic treatment. Key words: Peptic ulcer, omeprazole, proton pomp inhibitor, upper gastrointestinal bleeding.   https://jims.mui.ac.ir/article_12995_e9f4bcf9d56d5602c41b7ec6ab371bdc.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 26 90 2008 09 22 Intracranial venous anatomy and variation on cerebral Magnetic Resonance Venography in normal population Intracranial venous anatomy and variation on cerebral Magnetic Resonance Venography in normal population 12996 FA Ali Hekmatnia Associate Professor, Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Ehsan Yousefian General Practitioner, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Masih Saboori Associate Professor, Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2010 11 07 Background: The MR venography is used to examine the intracranial venous system. However, little information is available about the age and sex-related variation in intracranial veins and (venous system) sinuses. We evaluated the normal intracranial venous anatomy in different age and sex groups by MRV. Methods: 742 patients with normal brain Magnetic Resonance Imaging (MRI) were studied by MRV. Patients categorized into the three groups (Age < 15, 15-55, Age > 55). All the patients who have a history of brain tumor, vasculitis and anticoagulant therapy were excluded from the study. Findings: The transverse sinus distribution was %51.9 bilaterally, %12.2 only on the left side and %35.8 only on the right side. Only in one patient this sinus was not visible (0.1%).The occipital sinus was seen in 69/1% (224 patients) and the sigmoid sinus was visualized in 67.7% (490 patients). The Galen's vein was visualized in 72.8% and Rosenthal's vein was visualized in 66.6%. The superior sagittal sinus was visualized in all patients. There was a statistically significant difference in intracranial venous anatomy between three age groups but not in different sex groups. Conclusion: The MRV is a valuable non-invasive imaging modality in the assessment of intracranial venous anatomy and its age related variation. Key words: Magnetic Resonance Venography, Variation, vein, intracranial Sinus.   Background: The MR venography is used to examine the intracranial venous system. However, little information is available about the age and sex-related variation in intracranial veins and (venous system) sinuses. We evaluated the normal intracranial venous anatomy in different age and sex groups by MRV. Methods: 742 patients with normal brain Magnetic Resonance Imaging (MRI) were studied by MRV. Patients categorized into the three groups (Age < 15, 15-55, Age > 55). All the patients who have a history of brain tumor, vasculitis and anticoagulant therapy were excluded from the study. Findings: The transverse sinus distribution was %51.9 bilaterally, %12.2 only on the left side and %35.8 only on the right side. Only in one patient this sinus was not visible (0.1%).The occipital sinus was seen in 69/1% (224 patients) and the sigmoid sinus was visualized in 67.7% (490 patients). The Galen's vein was visualized in 72.8% and Rosenthal's vein was visualized in 66.6%. The superior sagittal sinus was visualized in all patients. There was a statistically significant difference in intracranial venous anatomy between three age groups but not in different sex groups. Conclusion: The MRV is a valuable non-invasive imaging modality in the assessment of intracranial venous anatomy and its age related variation. Key words: Magnetic Resonance Venography, Variation, vein, intracranial Sinus.   https://jims.mui.ac.ir/article_12996_167cacf79c851c2fb628a3706bcbc991.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 26 90 2008 09 22 The evaluation of ARG expression in DLBCL staging The evaluation of ARG expression in DLBCL staging 12997 FA Faribourz Mokarian Assistant Professor, Department of Hematology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-9874-298X Shahnaz Amani Nutritionist, Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Zahra Kabiri General Practitioner, Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mansoor Salehi Associate Professor, Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2010 11 07 Background: ARG is a proto-oncogene and a member of a tyrosine kinase proteins family. It has great importance in many cancers, but there is no conclusive evidence on its role in DLBCL staging. The aim of this study was to evaluate importance of ARG, in this cancer's staging. Methods: Sixteen DLBCL and 4 reactive lymph node (as control group) samples, after staging using Ann Arbor staging system, were used in this study. Formaldehyde fixed paraffin embedded blocks were prepared from the samples. After the sectioning, all samples were hybridized with primary antibodies against ARG and GAPDH (as control house keep keeping gene). The slides were then washed and hybridized with fluorescently labeled secondary antibodies (ARG, green labeled and GAPDH, red). After capturing the pictures using CCD camera, the intensity of green and red colures was measured and the ratio between green/red, that demonstrate changes in ARG expression, were calculated. Findings: The mean ratio of green/red (ARG expression) was significantly different between reactive lymph node, stage I, II and III of DLBCL. ARG expression was different between all groups except for between stage III and VI of DLBCL. Conclusion: The observed changes in ARG expression is a potential biomarker for DLBCL staging. In addition specific inhibitors of ARG can be considered as new chemotherapy agents in the DLBCL treatment. Key words: Lymphoma, ARG, DLBCL   Background: ARG is a proto-oncogene and a member of a tyrosine kinase proteins family. It has great importance in many cancers, but there is no conclusive evidence on its role in DLBCL staging. The aim of this study was to evaluate importance of ARG, in this cancer's staging. Methods: Sixteen DLBCL and 4 reactive lymph node (as control group) samples, after staging using Ann Arbor staging system, were used in this study. Formaldehyde fixed paraffin embedded blocks were prepared from the samples. After the sectioning, all samples were hybridized with primary antibodies against ARG and GAPDH (as control house keep keeping gene). The slides were then washed and hybridized with fluorescently labeled secondary antibodies (ARG, green labeled and GAPDH, red). After capturing the pictures using CCD camera, the intensity of green and red colures was measured and the ratio between green/red, that demonstrate changes in ARG expression, were calculated. Findings: The mean ratio of green/red (ARG expression) was significantly different between reactive lymph node, stage I, II and III of DLBCL. ARG expression was different between all groups except for between stage III and VI of DLBCL. Conclusion: The observed changes in ARG expression is a potential biomarker for DLBCL staging. In addition specific inhibitors of ARG can be considered as new chemotherapy agents in the DLBCL treatment. Key words: Lymphoma, ARG, DLBCL   https://jims.mui.ac.ir/article_12997_ac5145d76cd82e2fb875e94ba0c5b4b4.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 26 90 2008 09 22 The study of the serum manganese concentration in the bladder cancer patients in comparison with healthy subjects The study of the serum manganese concentration in the bladder cancer patients in comparison with healthy subjects 12998 FA Hamid Mazdak Assistant Professor, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Nooshin Mirkheshti General Practitioner, Hakiman Shargh Research Company, Isfahan, Iran Ahmad Movahedian Associate Professor, Department of Biochemistry, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran Faranak Yazdekhasti General Practitioner, Member of Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Ebrahim Behzad General Practitioner, Member of Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Shafieian General Practitioner, Member of Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Zahra Shamszadeh General Practitioner, Member of Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2010 11 07 Background: Manganese (Mn) is one the more important trace elements in the humans. Mn plays an important role in antioxidant defences and it is an essential cofactor for a number of enzymes. Some studies have revealed that Mn deficiency is teratogenic. The relationship of Mn deficiency and cancer induction also has been studied in some studies. We evaluated the serum Mn concentration in patients with bladder cancer in comparison with healthy individuals. Methods: During this cross sectional study, 51 patients with bladder cancer and 58 normal subjects were selected regarding the inclusion and exclusion criteria. Blood samples were collected after 8 hours of fasting. The Mn serum concentration was measured in all samples and copamared between two groups. Findings: Mean of serum Mn concentration was 1.3 ± 0.39 µg/l in bladder cancer patients and 1.87 ± 0.84 µg/l in control group. There was a significant difference between two groups (p < 0.001). Conclusion: According to the results of this study Mn serum concentration had significant decrease in bladder cancer patients in comparison with normal subjects. This result is similar to the other researches done in different cancers. Regarding the high Mn level in fresh foods and vegetables, consumption of these nutrients, is recommended in high risk individuals for bladder cancer. Key words: Bladder cancer, trace elements, manganese.   Background: Manganese (Mn) is one the more important trace elements in the humans. Mn plays an important role in antioxidant defences and it is an essential cofactor for a number of enzymes. Some studies have revealed that Mn deficiency is teratogenic. The relationship of Mn deficiency and cancer induction also has been studied in some studies. We evaluated the serum Mn concentration in patients with bladder cancer in comparison with healthy individuals. Methods: During this cross sectional study, 51 patients with bladder cancer and 58 normal subjects were selected regarding the inclusion and exclusion criteria. Blood samples were collected after 8 hours of fasting. The Mn serum concentration was measured in all samples and copamared between two groups. Findings: Mean of serum Mn concentration was 1.3 ± 0.39 µg/l in bladder cancer patients and 1.87 ± 0.84 µg/l in control group. There was a significant difference between two groups (p < 0.001). Conclusion: According to the results of this study Mn serum concentration had significant decrease in bladder cancer patients in comparison with normal subjects. This result is similar to the other researches done in different cancers. Regarding the high Mn level in fresh foods and vegetables, consumption of these nutrients, is recommended in high risk individuals for bladder cancer. Key words: Bladder cancer, trace elements, manganese.   https://jims.mui.ac.ir/article_12998_7d806dddbe08d7bec369ecdfdd6f7cbf.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 26 90 2008 09 22 The prevalence of hepatitis B, hepatitis C and associated risk factors in intravenous drug addicts (IVDA) with HIV in Isfahan The prevalence of hepatitis B, hepatitis C and associated risk factors in intravenous drug addicts (IVDA) with HIV in Isfahan 12999 FA Katayoun Taeri Specialist in Infectious Disease, Behavioral Disease Council Center, Isfahan University of Medical Sciences, Isfahan, Iran Nazila Kasaeian Research Assistant, Infectious Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Reza Fadaei Nobari Specialist in Infectious Disease, Managing Center Prevention of Diseases, Health Deputy, Isfahan University of Medical Sciences, Isfahan, Iran Behrooz Ataei Assistant Professor, Infectious Disease, Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2010 11 07 Background: Viral co-infection is a major cause of human mortality and morbidity and diagnosis of infected patients can lead to prevalence reduction. Methods: In a cross-sectional study, 106 HIV positive patients with a history of IVDA, addmitted among 2000-2007 to Navab-Safavi curing center in Isfahan, were studied. HBs Ag and HCV-Ab were carried on by ELISA method and check-list of related risk factors was completed for each patient. The prevalence of hepatitis B and C and related risk factors were analyzed using Odds Ratio (95% CIs) and logistic Regression tests. Findings: Our result showed that 2 patients (1.8%) had hepatitis B, 80 patients (75.5%) had hepatitis C and 10 patients (9.4%) had both of them. History of imprisonment and unemployment were independent risk factors for IVDA [OR (95% CIs): 18.27 (5.9-56.5) and 8 (2.4-26.1) respectively] but marital status, education and age have not any correlation with neither IVDA nor hepatitis. Conclusion: Our results indicated high prevalence of hepatitis B and C in HIV positive patients with IVDA history. Unemployment and low hygiene in prisons must be mentioned to reduce IVDA in our society. Key words: HIV, HBV, HCV, Risk factors, IVDA.   Background: Viral co-infection is a major cause of human mortality and morbidity and diagnosis of infected patients can lead to prevalence reduction. Methods: In a cross-sectional study, 106 HIV positive patients with a history of IVDA, addmitted among 2000-2007 to Navab-Safavi curing center in Isfahan, were studied. HBs Ag and HCV-Ab were carried on by ELISA method and check-list of related risk factors was completed for each patient. The prevalence of hepatitis B and C and related risk factors were analyzed using Odds Ratio (95% CIs) and logistic Regression tests. Findings: Our result showed that 2 patients (1.8%) had hepatitis B, 80 patients (75.5%) had hepatitis C and 10 patients (9.4%) had both of them. History of imprisonment and unemployment were independent risk factors for IVDA [OR (95% CIs): 18.27 (5.9-56.5) and 8 (2.4-26.1) respectively] but marital status, education and age have not any correlation with neither IVDA nor hepatitis. Conclusion: Our results indicated high prevalence of hepatitis B and C in HIV positive patients with IVDA history. Unemployment and low hygiene in prisons must be mentioned to reduce IVDA in our society. Key words: HIV, HBV, HCV, Risk factors, IVDA.   https://jims.mui.ac.ir/article_12999_2ff7b03aaa6645dd2263c569d0ff7f54.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 26 90 2008 09 22 The effect of sildenafil on the pulmonary artery hypertension caused by Mustard gas The effect of sildenafil on the pulmonary artery hypertension caused by Mustard gas 13000 FA Parya Tavakolipour Resident of Cardiovascular Disease, Isfahan University of Medical Sciences, Isfahan, Iran Masoomeh Sadeghi Assistant Professor, Department of Cardiovascular Disease, Isfahan University of Medical Sciences, Isfahan, Iran Ramin Heidari Assistant Professor, Department of Cardiovascular Disease, Isfahan University of Medical Sciences, Isfahan, Iran Ali Akbar Vosough Internist, Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Katayoun Rabiei Research Assistant, Isfahan, Iran Journal Article 2010 11 07 Background: One of the causes of pulmonary artery hypertension (PAH) is mustard gas poisoning. Mustard gas is a destroying factor in chemical Bumps that contaminated Iranian soldiers in the war between Iran and Iraq. This study was designed for evaluating the effect of sildenafil, (one of the effective drug in PAH) on the PAH caused by Mustard gas. Methods: In a quasi experimental study on 20 patients poisoned with mustard gas and symptomatic PAH, pulmonary artery pressure (PAP) was measured with transthorasic echocardiography (TTE). Patients did 6 minutes walking test (6 MWT); then, they were treated for 12 weeks with 50 mg sildenafil, daily. At the end, echocardiography and 6 MWT were repeated. Findings: All the patients were men with mean age 42.89 ± 3.91 years old. Mean pressure of pulmonary artery at the beginning of the study was 37.75 ± 8.21 mmHg and walked distance at 6 MWT was 263.35 ± 2.28 meter. These values after 12 weeks treatment were 29.10 ± 6.55 mmHg and 291.35 ± 82.39 meter, that wee statistically meaningful improvement. Conclusion: There are studies demonstrate the effect of sildenafil in improving PAH. This study also reveals that sildenafil improves mustard gas PAH. According to the results, even single daily dose of sildenafil can has good effect on these patients. Key words: Pulmonary artery hypertension (PAH), mustard gas poisoning, sildenafil.   Background: One of the causes of pulmonary artery hypertension (PAH) is mustard gas poisoning. Mustard gas is a destroying factor in chemical Bumps that contaminated Iranian soldiers in the war between Iran and Iraq. This study was designed for evaluating the effect of sildenafil, (one of the effective drug in PAH) on the PAH caused by Mustard gas. Methods: In a quasi experimental study on 20 patients poisoned with mustard gas and symptomatic PAH, pulmonary artery pressure (PAP) was measured with transthorasic echocardiography (TTE). Patients did 6 minutes walking test (6 MWT); then, they were treated for 12 weeks with 50 mg sildenafil, daily. At the end, echocardiography and 6 MWT were repeated. Findings: All the patients were men with mean age 42.89 ± 3.91 years old. Mean pressure of pulmonary artery at the beginning of the study was 37.75 ± 8.21 mmHg and walked distance at 6 MWT was 263.35 ± 2.28 meter. These values after 12 weeks treatment were 29.10 ± 6.55 mmHg and 291.35 ± 82.39 meter, that wee statistically meaningful improvement. Conclusion: There are studies demonstrate the effect of sildenafil in improving PAH. This study also reveals that sildenafil improves mustard gas PAH. According to the results, even single daily dose of sildenafil can has good effect on these patients. Key words: Pulmonary artery hypertension (PAH), mustard gas poisoning, sildenafil.   https://jims.mui.ac.ir/article_13000_c7bc77c261dc56714cf777b3e72cca43.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 26 90 2008 09 22 Breast tuberculosis: A case report Breast tuberculosis: A case report 12987 FA Ahmad Alikhani Assistant Professor, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran Majid Pooya Assistant Professor, Department of Thoracic Surgery, Tonekabon Azad University, Tone-kabon, Iran Nazanin Mirzaei Pathologist, Emam Sadjjad Hospital, Ramsar, Iran Journal Article 2010 11 07 Background: Tuberculosis infects one third of the world population and the leading of death worldwide. Lymphadenitis is the most frequent form of extra pulmonary tuberculosis. Breast tuberculosis is an extremely rare form of extra pulmonary tuberculosis. We introduced a case of breast tuberculosis that presented with axillary sinus tract, left supraclavicular lymph node and left breast edema. Case Report: A 15 year-old girl with a history of left breast swelling and left axillary sinus tract discharge from 2 months ago was admitted to our hospital. The physical examination showed left supraclavicular lymphadenopathy (size=1×0.5, fixed, firm with mild tenderness), left breast mass (size=2×2, firm, mild tenderness) with normal overlying skin, left axillary sinus tract with large mass (size=8×8, tender, erythematous and firm). She has also edema of the chest wall especially in the left hemi thorax. Chest X-Ray was normal and ultrasonographic study of breast showed an ovaloid mass (13×29) with cystic structure and multiple septations. Abdominopelvic sonography was normal and PPD was negative. Excisional biopsy of left axillary lesion showed granuloma and caseous necrosis compatible with tuberculosis. Within 2 weeks of anti-TB medication, the patient developed with left breast discharge. After 6 weeks of anti-TB therapy discharge from this site and left axillary sinus tract was stopped. Conclusion: The tuberculosis of breast is a disease of younger age group and the younger patients usually manifests sign of a pyogenic breast abscess. In our case left breast swelling and left axillary sinus tract discharge were the first presentation of disease. Key words: Breast Tuberculosis, Edema, Axillary sinus tract.   Background: Tuberculosis infects one third of the world population and the leading of death worldwide. Lymphadenitis is the most frequent form of extra pulmonary tuberculosis. Breast tuberculosis is an extremely rare form of extra pulmonary tuberculosis. We introduced a case of breast tuberculosis that presented with axillary sinus tract, left supraclavicular lymph node and left breast edema. Case Report: A 15 year-old girl with a history of left breast swelling and left axillary sinus tract discharge from 2 months ago was admitted to our hospital. The physical examination showed left supraclavicular lymphadenopathy (size=1×0.5, fixed, firm with mild tenderness), left breast mass (size=2×2, firm, mild tenderness) with normal overlying skin, left axillary sinus tract with large mass (size=8×8, tender, erythematous and firm). She has also edema of the chest wall especially in the left hemi thorax. Chest X-Ray was normal and ultrasonographic study of breast showed an ovaloid mass (13×29) with cystic structure and multiple septations. Abdominopelvic sonography was normal and PPD was negative. Excisional biopsy of left axillary lesion showed granuloma and caseous necrosis compatible with tuberculosis. Within 2 weeks of anti-TB medication, the patient developed with left breast discharge. After 6 weeks of anti-TB therapy discharge from this site and left axillary sinus tract was stopped. Conclusion: The tuberculosis of breast is a disease of younger age group and the younger patients usually manifests sign of a pyogenic breast abscess. In our case left breast swelling and left axillary sinus tract discharge were the first presentation of disease. Key words: Breast Tuberculosis, Edema, Axillary sinus tract.   https://jims.mui.ac.ir/article_12987_94f79e7c90b87514a07c47bdc5498262.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 26 90 2008 09 22 Srgical release of the suprascapular nerve en-trapment Srgical release of the suprascapular nerve en-trapment 12992 FA Mohammad Dehghani Assistant Professor of Orthopedics, School of Medicine, Isfahan University of Medical Sci-ences, Isfahan, Iran Arsalan Mahmoudian Resident of Orthopedics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2010 11 07 Background: Entrapment of the suprascapular nerve may causes pain in the shoulder which may be attributing wrongly to the other shoulder disorders and the treatment often delayed. Many authors believed that the treatment of this disease is conservative. This study was conducted to assess the effect of surgical release of the suprascapular nerve on the improvement of the patients' functional score. Methods: Operative release for the entrapment of the suprascapular nerve was carried out in 5 patients. All patients were followed for 16 months (between 12-20 months). They finally were assessed by the functional shoulder score devised by constant and murley. The average score before the operative release was 40 ± 17. The diagnosis was confirmed with electrophysiologic studies and MRI. The average time from the onset of symptoms to operation was 7.8 ± 3.2 months.  Results: All patients were followed for an average of 16 months after operative release. Final constant score was 75.8 ± 26.2. There was an excellent result in all patients, except one who obliged to change his job (case 1). All patients were pain free after operation and had full recovery of muscle bulk except for case 1. Conclusion: The symptomatic and functional outcome in our study showed that operative decompression and entrapment of the suprascapular nerve improved the patients' functional score. It seems that, if conservative treatments such as physiotherapy failed, it is better to do operative release as soon as possible, because the delayed operation has negative effect on final outcome. Key words: Suprascapular nerve, entrapment, functional constant score, nerve release, ganglion.   Background: Entrapment of the suprascapular nerve may causes pain in the shoulder which may be attributing wrongly to the other shoulder disorders and the treatment often delayed. Many authors believed that the treatment of this disease is conservative. This study was conducted to assess the effect of surgical release of the suprascapular nerve on the improvement of the patients' functional score. Methods: Operative release for the entrapment of the suprascapular nerve was carried out in 5 patients. All patients were followed for 16 months (between 12-20 months). They finally were assessed by the functional shoulder score devised by constant and murley. The average score before the operative release was 40 ± 17. The diagnosis was confirmed with electrophysiologic studies and MRI. The average time from the onset of symptoms to operation was 7.8 ± 3.2 months.  Results: All patients were followed for an average of 16 months after operative release. Final constant score was 75.8 ± 26.2. There was an excellent result in all patients, except one who obliged to change his job (case 1). All patients were pain free after operation and had full recovery of muscle bulk except for case 1. Conclusion: The symptomatic and functional outcome in our study showed that operative decompression and entrapment of the suprascapular nerve improved the patients' functional score. It seems that, if conservative treatments such as physiotherapy failed, it is better to do operative release as soon as possible, because the delayed operation has negative effect on final outcome. Key words: Suprascapular nerve, entrapment, functional constant score, nerve release, ganglion.   https://jims.mui.ac.ir/article_12992_ec2f08ae409f4a81a531d63db671d55f.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 26 90 2008 09 22 The effect of prenatal restraint stress on the immune function of 60 days male rats The effect of prenatal restraint stress on the immune function of 60 days male rats 12988 FA Hatam Ahmadi PhD Student, Department of Biology, School of Sciences, Tarbiat Moalem University, Tehran, Iran Parvin Rostami Professor, Department of Biology, School of Sciences, Tarbiat Moalem University, Tehran, Iran Journal Article 2010 11 07 Background: The role of prenatal restraint stress on the immune function of male rats has been studied previously. In this study we evaluated the effect of this stress on some of the blood cells. Methods: To study of the prenatal restraint stresses effect on the immune system, pregnant rats were divided into four groups including one control group and three experimental groups. The control group did not receive any stress during the gestation period. In the experimental groups (1, 2 and 3) the pregnant rats were subjected to the restraint stress respectively from 8 to 21, 8 to17, and 17 to 21 days of gestation Offspring were housed in laboratory conditions with their mothers until 40 days of age. At the age of 60 days the blood samples were taken from the male rats. Findings: Prenatal stress markedly decreased the total number of white blood cells (WBC) in groups 1 and 3, and the percent of granulocyte cells in groups 1, 2 and 3 decreased. The percent of lymphocyte cells in the groups 1, 2 and 3 compared with control group increased significantly. The number of red blood cells (RBC) significantly increased in group 1 and 2 compared to control group. The number of platelet cells also increased in group 1. Conclusion: Our data support that prenatal restraint stresses alter the function of immune and hemopoietic system. Further studies needed to evaluate these effects precisely. Key words: Restraint stress, prenatal stress, immune function.   Background: The role of prenatal restraint stress on the immune function of male rats has been studied previously. In this study we evaluated the effect of this stress on some of the blood cells. Methods: To study of the prenatal restraint stresses effect on the immune system, pregnant rats were divided into four groups including one control group and three experimental groups. The control group did not receive any stress during the gestation period. In the experimental groups (1, 2 and 3) the pregnant rats were subjected to the restraint stress respectively from 8 to 21, 8 to17, and 17 to 21 days of gestation Offspring were housed in laboratory conditions with their mothers until 40 days of age. At the age of 60 days the blood samples were taken from the male rats. Findings: Prenatal stress markedly decreased the total number of white blood cells (WBC) in groups 1 and 3, and the percent of granulocyte cells in groups 1, 2 and 3 decreased. The percent of lymphocyte cells in the groups 1, 2 and 3 compared with control group increased significantly. The number of red blood cells (RBC) significantly increased in group 1 and 2 compared to control group. The number of platelet cells also increased in group 1. Conclusion: Our data support that prenatal restraint stresses alter the function of immune and hemopoietic system. Further studies needed to evaluate these effects precisely. Key words: Restraint stress, prenatal stress, immune function.   https://jims.mui.ac.ir/article_12988_d0622bf20c3152d6c0d4335f537707ca.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 26 90 2008 09 22 Sexual dysfunction in menopause Sexual dysfunction in menopause 12993 FA Marjan Beigi Department of Midwifery, School of Nursing, & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Fariba Fahami Instructure, Department of Midwifery, School of Nursing, & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Roshanak Hasanzahraei Instructure, Department of Midwifery, School of Nursing, & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran Sorour Arman Associate Professor, Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2010 11 07 Background:  Regarding adverse effects of sexual dysfunctional in mental health of the menopause women and their families, the evaluation and detecting related factors to sexual dysfunctional in this period seems to be essential. Methods: In this analytic-descriptive cross sectional study, 174 married menopause women referring to health centers to receive health care were concluded. The data were collected through interviews by Beck depression standard test and locally (self) made questionnaires like the questionnaire of demographic characteristic, sexual knowledge, quality of relations with the spouse, and sexual dysfunctional (based on DSM-IV). Descriptive and inferential statistical methods, t-test, χ2 test and Mantel hanszel χ2 test all were used to analyze the data. Results: Our results showed that participant based variables such as: age, educational level, job, depression, sexual knowledge, and spouses' relations quality as well as some other variables like husbands' educational level, residing status, and economic status are associated with sexual dysfunction in menopausal period. The findings also showed that husband's age, spouses' age difference, husbands' job, marriage length, wives' weight, number of pregnancies and marriage status have no association with sexual dysfunctional in menopausal period. Conclusion: Hypoactive sexual disorder and sexual dysfunction can be affected by demographic characteristics, psychiatric disorders and lack of knowledge. Regarding to many psychological and community injuries caused by sexual dysfunctional, the role of health care professional in counseling and education is emphasized. Key words: Menopause, sexual dysfunctional, depression, sexual knowledge.   Background:  Regarding adverse effects of sexual dysfunctional in mental health of the menopause women and their families, the evaluation and detecting related factors to sexual dysfunctional in this period seems to be essential. Methods: In this analytic-descriptive cross sectional study, 174 married menopause women referring to health centers to receive health care were concluded. The data were collected through interviews by Beck depression standard test and locally (self) made questionnaires like the questionnaire of demographic characteristic, sexual knowledge, quality of relations with the spouse, and sexual dysfunctional (based on DSM-IV). Descriptive and inferential statistical methods, t-test, χ2 test and Mantel hanszel χ2 test all were used to analyze the data. Results: Our results showed that participant based variables such as: age, educational level, job, depression, sexual knowledge, and spouses' relations quality as well as some other variables like husbands' educational level, residing status, and economic status are associated with sexual dysfunction in menopausal period. The findings also showed that husband's age, spouses' age difference, husbands' job, marriage length, wives' weight, number of pregnancies and marriage status have no association with sexual dysfunctional in menopausal period. Conclusion: Hypoactive sexual disorder and sexual dysfunction can be affected by demographic characteristics, psychiatric disorders and lack of knowledge. Regarding to many psychological and community injuries caused by sexual dysfunctional, the role of health care professional in counseling and education is emphasized. Key words: Menopause, sexual dysfunctional, depression, sexual knowledge.   https://jims.mui.ac.ir/article_12993_aba36cc3760e0b1c6a655f019a68b878.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 26 90 2008 09 22 هیپرتانسیون و نفروپاتی: دو عارضه‪ی جدی دیابت هیپرتانسیون و نفروپاتی: دو عارضه‪ی جدی دیابت 12989 FA Afsoon Emami Naeini دانشیار گروه نفرولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران Journal Article 2010 11 07 - - https://jims.mui.ac.ir/article_12989_38d6996f11a4b0f404d4219625ca24c2.pdf

Isfahan University of Medical Sciences Journal of Isfahan Medical School 1027-7595 26 90 2008 09 22 Electroconvulsive Therapy Electroconvulsive Therapy 12990 FA Mahmoud Rafieian Kopaei Professor of Pharmacology, Medical Plant Research Center,Shahr-e-Kord Medical University Akbar Rouzbahani MD,Medical Plant Research Center Journal Article 2010 11 07   Electroconvulsive therapy (ECT) is a procedure in which electric currents are passed through the brain, deliberately triggering a brief seizure. This seems to cause changes in brain chemistry that can alleviate symptoms of certain mental illnessesECT is most often used as a treatment for severe major depression which has not responded to other treatment, and is also used in the treatment of mania (often in bipolar disorder), catatonia, schizophrenia and other disorders.   Electroconvulsive therapy (ECT) is a procedure in which electric currents are passed through the brain, deliberately triggering a brief seizure. This seems to cause changes in brain chemistry that can alleviate symptoms of certain mental illnessesECT is most often used as a treatment for severe major depression which has not responded to other treatment, and is also used in the treatment of mania (often in bipolar disorder), catatonia, schizophrenia and other disorders.