Isfahan University of Medical SciencesJournal of Isfahan Medical School1027-75952915220110923Clinical Evaluation of Oral Curcumin in Prevention of AcuteClinical Evaluation of Oral Curcumin in Prevention of Acute1216122313505FASiminHematiAssistant Professor, Department of Radiation Oncology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranArminSaeediResident, Department of Radiation Oncology, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran0000-0001-7517-8987Journal Article20110620Background: Acute radiation induced dermatitis, has a history as long as breast radiotherapy. Although new techniques have reduced the onset of dermatitis in breast radiotherapy patients, no standard protocol exists for its prophylaxis. This study has evaluated “Curcumin” for prophylaxis of radiation induced dermatitis.Methods: 40 breast radiotherapy candidates randomly put in two equal groups, received oral capsules (four 500 mg capsules, 3 times a day) filled with Curcumin or Placebo from 2 days before to the last day of radiotherapy 6 weeks course. Dermatitis degree recorded in weekly visits.Findings: A faster increasing in mean degree of dermatitis was seen in placebo group. The difference was statistically significant in last two weeks of radiotherapy. No considerable side effect was reported. Patients’ age, type of surgery, hormone receptor and HER2/neu status, did not affect curcumin group superiority in degree of radiation induced dermatitis.Conclusion: Oral curcumin is effective in prophylaxis of radiation induced dermatitis in breast cancer radiation.Background: Acute radiation induced dermatitis, has a history as long as breast radiotherapy. Although new techniques have reduced the onset of dermatitis in breast radiotherapy patients, no standard protocol exists for its prophylaxis. This study has evaluated “Curcumin” for prophylaxis of radiation induced dermatitis.Methods: 40 breast radiotherapy candidates randomly put in two equal groups, received oral capsules (four 500 mg capsules, 3 times a day) filled with Curcumin or Placebo from 2 days before to the last day of radiotherapy 6 weeks course. Dermatitis degree recorded in weekly visits.Findings: A faster increasing in mean degree of dermatitis was seen in placebo group. The difference was statistically significant in last two weeks of radiotherapy. No considerable side effect was reported. Patients’ age, type of surgery, hormone receptor and HER2/neu status, did not affect curcumin group superiority in degree of radiation induced dermatitis.Conclusion: Oral curcumin is effective in prophylaxis of radiation induced dermatitis in breast cancer radiation.https://jims.mui.ac.ir/article_13505_6d4cc77f57f9dddf6862cb7168a08d2f.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75952915220110923Effect of Angiotensin Receptor Inhibitors on Endothelial DysfunctionEffect of Angiotensin Receptor Inhibitors on Endothelial Dysfunction1224122813506FAAlalehGheisariAssociate Professor, Department of Pediatrics, Nephrology Research Center, School of Medicine, Isfahan University of Medical sciences, Isfahan, IranShaghayeghHaghjooy JavanmardAssociate Professor, Department of Physilology, Physiology Research Center, School of Medicine, Isfahan University of Medical sciences, Isfahan, IranRouhollahShirzadiResident, Department of Pediatrics, Child Health Promotion Research Center And Student Research Committee, School of Medicine, Isfahan University of Medical sciences, Isfahan, IranMasoudAminiProfessor, Department of Endocrinology, Endocrine and Metabolism Research Center, School of Medicine, Isfahan University of Medical sciences, Isfahan, IranJournal Article20110611Background: Children and teenager with diabetes type I (IDDM or Insulin dependent diabetes mellitus) are strongly at risk for diabetic nephropathy in adolescents and adulthood. Treatment of endothelial dysfunction can increase the longevity of these patients. The aim of this study was to evaluate the effect of angiotensin receptor blockers (ARBs or Angiotensin receptor blockers) in endothelial dysfunction indices in patients with diabetic nephropathy.Methods: This prospective clinical trial study was conducted between 2010 and 2011 in Isfahan, Iran. 32 patients with diabetic nephropathy that their microalbuminuria has been proved in two urine samples were enrolled in the study. All of the studied patients were treated with valsartan (an ARBs medication) for one month. The level of nitric oxide (NO), vascular cell adhesion molecule (VCAM) and Fetuin-A was measured before and after the treatment period.Findings: The mean age of patients was 24.66 ± 2.16 years. 34.4% of petients were men. Before the intervention, the level of Fetuin-A was o.36 ± 0.03 mg/dl and after intervention it declined to 0.25 ± 0.02 mg/dl. The mean level of NO before and after the intervention was respectively 0.23 ± 0.01 and 0.29 ± 0.01 mg/dl. The level of VCAM was 0.251 ± 18.5 ng/ml before the intervention and 211.5 ± 11.2 ng/ml after it. Conclusion: The evidence of this showed that the Valsartan medication or other angiotensin receptor inhibitors can be effective can improve endothelial function. Therefore, it is recommended to improve endothelial function of drugs used angiotensin.Background: Children and teenager with diabetes type I (IDDM or Insulin dependent diabetes mellitus) are strongly at risk for diabetic nephropathy in adolescents and adulthood. Treatment of endothelial dysfunction can increase the longevity of these patients. The aim of this study was to evaluate the effect of angiotensin receptor blockers (ARBs or Angiotensin receptor blockers) in endothelial dysfunction indices in patients with diabetic nephropathy.Methods: This prospective clinical trial study was conducted between 2010 and 2011 in Isfahan, Iran. 32 patients with diabetic nephropathy that their microalbuminuria has been proved in two urine samples were enrolled in the study. All of the studied patients were treated with valsartan (an ARBs medication) for one month. The level of nitric oxide (NO), vascular cell adhesion molecule (VCAM) and Fetuin-A was measured before and after the treatment period.Findings: The mean age of patients was 24.66 ± 2.16 years. 34.4% of petients were men. Before the intervention, the level of Fetuin-A was o.36 ± 0.03 mg/dl and after intervention it declined to 0.25 ± 0.02 mg/dl. The mean level of NO before and after the intervention was respectively 0.23 ± 0.01 and 0.29 ± 0.01 mg/dl. The level of VCAM was 0.251 ± 18.5 ng/ml before the intervention and 211.5 ± 11.2 ng/ml after it. Conclusion: The evidence of this showed that the Valsartan medication or other angiotensin receptor inhibitors can be effective can improve endothelial function. Therefore, it is recommended to improve endothelial function of drugs used angiotensin.https://jims.mui.ac.ir/article_13506_ed7ebf1d0e87774f12b2102e2cba4476.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75952915220110923Evaluatiin the Effectiveness of Magnesium Sulfate Nebulizer inEvaluatiin the Effectiveness of Magnesium Sulfate Nebulizer in1229123413507FAMohammad RezaModaresiAssistant Professor, Department of Pediatrics, Child Health Promotion Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan. IranJamalFaghihiniaAssociate Professor, Department of Pediatrics, Child Health Promotion Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan.IranSayed HosseinMirlohiResident, Department of Pediatrics, Child Health Promotion Research Center, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, IranFarhadPajhangPediatrician, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20110618Background: Acute Bronchiolitis is a common seasonal lower respiratory disease in infants. Syncytial respiratory virus is responsible for more than 50 percent of bronchiolitis events. The treatment is usually supportive. This study was done to examine the efficacy of nebulizer magnesium sulfate in the treatment of acute bronchiolitis.Methods: This study was a double blind clinical trial in which 60 patients admitted with acute bronchiolitis in Alzahra, Amin and Shariati hospitals in Isfahan, Iran during 2010 and 2011 were studied. Patients were randomly divided into two groups, A and B. Group A were treated by magnesium sulfate, epinephrine and normal saline and group B were treated only by epinephrine and normal saline. Severity of symptoms was investigated by measuring the temperature, SPO2, pulse rate (PR), respiratory rate (RR) and respiratory distress assessment instrument (RDAI) index, at the beginning of stuy to 3 days after treatment by follow-up questionnaires. Data were analyzed by Student t-test and repeated measure ANOVA.Findings: The mean of temperature, SPO2, PR, RR and RDAI at admission and during hospital stay was not significantly different between two groups. After removing the confounding effect of different arrival, RDAI in second and third days in group A was significantly less than group B (P < 0.01). Conclusion: According to this study, treatment with magnesium sulfate has no effect on symptoms of acute bronchiolitis. Magnesium sulfate can reduce RDAI only in the second and third days of hospitalization.Background: Acute Bronchiolitis is a common seasonal lower respiratory disease in infants. Syncytial respiratory virus is responsible for more than 50 percent of bronchiolitis events. The treatment is usually supportive. This study was done to examine the efficacy of nebulizer magnesium sulfate in the treatment of acute bronchiolitis.Methods: This study was a double blind clinical trial in which 60 patients admitted with acute bronchiolitis in Alzahra, Amin and Shariati hospitals in Isfahan, Iran during 2010 and 2011 were studied. Patients were randomly divided into two groups, A and B. Group A were treated by magnesium sulfate, epinephrine and normal saline and group B were treated only by epinephrine and normal saline. Severity of symptoms was investigated by measuring the temperature, SPO2, pulse rate (PR), respiratory rate (RR) and respiratory distress assessment instrument (RDAI) index, at the beginning of stuy to 3 days after treatment by follow-up questionnaires. Data were analyzed by Student t-test and repeated measure ANOVA.Findings: The mean of temperature, SPO2, PR, RR and RDAI at admission and during hospital stay was not significantly different between two groups. After removing the confounding effect of different arrival, RDAI in second and third days in group A was significantly less than group B (P < 0.01). Conclusion: According to this study, treatment with magnesium sulfate has no effect on symptoms of acute bronchiolitis. Magnesium sulfate can reduce RDAI only in the second and third days of hospitalization.https://jims.mui.ac.ir/article_13507_af50a8df9bf6c87ef204851a6a1d1918.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75952915220110923Influence of the Anesthetic Depth on the Inhibition of the Oculocardiac Reflex during Propofol Anesthesia for Pediatrics Strabismus SurgeryInfluence of the Anesthetic Depth on the Inhibition of the Oculocardiac Reflex during Propofol Anesthesia for Pediatrics Strabismus Surgery1235124113508FAHassan AliSoltaniProfessor, Department of Anesthesia, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranAlirezaJafariResident, Department of Anesthesia, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20110618Background: The effect of the anesthetic depth as assessed by bispectral index (BIS) on oculo-cardiac reflex (OCR) during strabismus surgery was controversial. This study was done for determination of Influence of the anesthetic depth on the inhibition of the OCR during propofol anesthesia for pediatrics strabismus surgery.Methods: 75 patients (aged 2-18 years) undergoing strabismus surgery were randomly allocated to one of three groups (25 for each) according to target BIS value of 40, 50 and 60. The propofol concentration was adjusted towards target BIS. The incidence of OCR and the lowest heart rate were recorded in relation to the propofol concentration. The data collected in a check list and then analyzed by χ2 test and one-way ANOVA test by SPSS18.Findings: There is no significant difference between three groups for age and sex (P > 0.05). The incidence of OCR was higher in group with BIS-60 (60%) than in group with BIS-40 (20%) and BIS-50 (28%) (P < 0.001). The propofol concentration was not significantly different between three groups (P > 0.05). Conclusion: We confirme that OCR is relevant to the depth of anaesthesia. It seems that between 40–50 BIS value is adequate for the inhibition of OCR. The results suggest that BIS may be a valuable tool during propofol anaesthesia for strabismus surgery in children.Background: The effect of the anesthetic depth as assessed by bispectral index (BIS) on oculo-cardiac reflex (OCR) during strabismus surgery was controversial. This study was done for determination of Influence of the anesthetic depth on the inhibition of the OCR during propofol anesthesia for pediatrics strabismus surgery.Methods: 75 patients (aged 2-18 years) undergoing strabismus surgery were randomly allocated to one of three groups (25 for each) according to target BIS value of 40, 50 and 60. The propofol concentration was adjusted towards target BIS. The incidence of OCR and the lowest heart rate were recorded in relation to the propofol concentration. The data collected in a check list and then analyzed by χ2 test and one-way ANOVA test by SPSS18.Findings: There is no significant difference between three groups for age and sex (P > 0.05). The incidence of OCR was higher in group with BIS-60 (60%) than in group with BIS-40 (20%) and BIS-50 (28%) (P < 0.001). The propofol concentration was not significantly different between three groups (P > 0.05). Conclusion: We confirme that OCR is relevant to the depth of anaesthesia. It seems that between 40–50 BIS value is adequate for the inhibition of OCR. The results suggest that BIS may be a valuable tool during propofol anaesthesia for strabismus surgery in children.https://jims.mui.ac.ir/article_13508_282b2d93c42db32b12a17752c36ee10d.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75952915220110923The Causes of Delay to Diagnosis the Cancer of Bladder in Patients with SymptomsThe Causes of Delay to Diagnosis the Cancer of Bladder in Patients with Symptoms1242124713509FASeyed Mohammad ArashTaghaviStudent of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranMohammad HatefKhoramiAssociate Professor, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-1136-8073Journal Article20110719Background: Secondary prevention, as defined by early diagnosis, has very important role in response to treatment and reduction of complication of bladder cancer. In this study we sought to investigate the interval between onset of symptoms and definite diagnosis and their related factors.Methods: This study was done on 82 patients extracted from cancer registry.Findings: Mean interval between onset of symptoms and definite diagnosis was 3.8 months. Mean delay from onset of symptoms to first medical visit was 2.76 months and mean GPs delay in making a patient refer to urologist was 0.98 months. Conclusion: The present study revealed patients' late referral to physicians and general physicians' delay in referring the patients as two major factors in delayed diagnosis. This finding emphasizes the importance of public information provision about early referral after the onset of symptoms, as well as promoted education for general physicians.Background: Secondary prevention, as defined by early diagnosis, has very important role in response to treatment and reduction of complication of bladder cancer. In this study we sought to investigate the interval between onset of symptoms and definite diagnosis and their related factors.Methods: This study was done on 82 patients extracted from cancer registry.Findings: Mean interval between onset of symptoms and definite diagnosis was 3.8 months. Mean delay from onset of symptoms to first medical visit was 2.76 months and mean GPs delay in making a patient refer to urologist was 0.98 months. Conclusion: The present study revealed patients' late referral to physicians and general physicians' delay in referring the patients as two major factors in delayed diagnosis. This finding emphasizes the importance of public information provision about early referral after the onset of symptoms, as well as promoted education for general physicians.https://jims.mui.ac.ir/article_13509_d0999cebc8f4ed4eb54d5317367e9b2f.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75952915220110923Retroperitoneal abscesses: 12 years of evaluation in Isfahan, IranRetroperitoneal abscesses: 12 years of evaluation in Isfahan, Iran1248125413510FAMahtabZarghamAssistant Professor, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranAsgharGhalamkariAssistant Professor, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranMohamad HatefKhoramiAssociate Professor, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-1136-8073AsgharDadkhahResident, Department of Urology, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, IranHamidMazdakAssociate Professor, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranMohamadYazdaniProfessor, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-7336-3318Journal Article20120505Background: Retroperitoneal abscesses (RPAs) are serious long-term infections leading to considerable mortality and morbidity. We evaluated these uncommon clinical problems and focused on diagnostic techniques, pathologic causes, and therapeutic difficulties useful to the practicing surgeon.Methods: Between October 1995 and November 2007, the medical records of 23 patients seen at Alzahra Hospital (Isfahan, Iran) with the diagnosis of RPA were reviewed retrospectively. Attention was directed to pathogenesis, predisposing factors, clinical presentation, diagnostic imaging, and outcome. The clinical data was then analyzed.Findings: RPAs were more likely to occur among middle-aged men (mean age = 35 years). The disease was likely to present insidiously. On the average it took 10.8 days to diagnose after hospitalization. Among etiologic factors, postsurgical complication of urology played an important role. Tuberculosis still seemed to be an important medical risk factor for RPA. Sonography strongly enhanced the diagnosis of RPA (45%). However, the diagnostic imaging modality of choice was computerized tomography (CT). Finally, RPA led to prolonged hospitalization (12.8 days) and a high mortality rate (21.7%). Conclusion: A correct clinical suspicion is an important factor in diagnosing this chronic illness. Distinction of predisposing factors would lead to successful treatment and decreased morbidity. Sonography is the simplest and the most available diagnostic modality for RPA. The most common causes of RPA include urological causes and the most successful therapeutic decision is surgical drainage.Background: Retroperitoneal abscesses (RPAs) are serious long-term infections leading to considerable mortality and morbidity. We evaluated these uncommon clinical problems and focused on diagnostic techniques, pathologic causes, and therapeutic difficulties useful to the practicing surgeon.Methods: Between October 1995 and November 2007, the medical records of 23 patients seen at Alzahra Hospital (Isfahan, Iran) with the diagnosis of RPA were reviewed retrospectively. Attention was directed to pathogenesis, predisposing factors, clinical presentation, diagnostic imaging, and outcome. The clinical data was then analyzed.Findings: RPAs were more likely to occur among middle-aged men (mean age = 35 years). The disease was likely to present insidiously. On the average it took 10.8 days to diagnose after hospitalization. Among etiologic factors, postsurgical complication of urology played an important role. Tuberculosis still seemed to be an important medical risk factor for RPA. Sonography strongly enhanced the diagnosis of RPA (45%). However, the diagnostic imaging modality of choice was computerized tomography (CT). Finally, RPA led to prolonged hospitalization (12.8 days) and a high mortality rate (21.7%). Conclusion: A correct clinical suspicion is an important factor in diagnosing this chronic illness. Distinction of predisposing factors would lead to successful treatment and decreased morbidity. Sonography is the simplest and the most available diagnostic modality for RPA. The most common causes of RPA include urological causes and the most successful therapeutic decision is surgical drainage.https://jims.mui.ac.ir/article_13510_2cc18398df2e6692fffc29a610cb72e3.pdf