Isfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953333620150622IndexIndex14642FAJournal Article20151006Click to download the index of this issue.Click to download the index of this issue.https://jims.mui.ac.ir/article_14642_1be9573be51135cd5be1e191f44e09f8.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953333620150622Epidemiologic and Demographic Features, Disease Process and Treatment Procedures in the Patients with Guillain-Barre SyndromeEpidemiologic and Demographic Features, Disease Process and Treatment Procedures in the Patients with Guillain-Barre Syndrome77077914643FAParvizKashefiProfessor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-7254-204XAbdollahMoravejiStudent of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20150202Background: Considering the characteristics of Guillain-Barre syndrome is important for providing hospital instruments for surveillance and treatment of the disease. The aim of this study was to evaluate the epidemiologic and demographic features the disease process and treatment procedures of Guillain-Barre syndrome.Methods: In a cross-sectional study, 100 patients with Guillain-Barre syndrome hospitalized in Al-Zahra Medical Center, Isfahan, Iran, during 2007-2011 were studied. The demographic and epidemiologic data, disease process and treatment activities were achieved from hospital records and analyzed.Findings: The mean duration of hospitalization was 18.5 ± 8.6 days. The mean duration of the disease was 26.1 ± 14.6 days. The severity of the disease in 26, 25 and 49 patients were mild, moderate and severe, respectively. Among all, 14 cases had problem in cranial nervous system, 14 in autonomic nervous system and 6 in both cranial and autonomic nervous systems.Conclusion: According to our results, patients with Guillain-Barre syndrome may be encountered to several problems, and hospital managers must try to prepare adequate facilities based on the condition of patients, complications and symptoms, and treatment protocols.Background: Considering the characteristics of Guillain-Barre syndrome is important for providing hospital instruments for surveillance and treatment of the disease. The aim of this study was to evaluate the epidemiologic and demographic features the disease process and treatment procedures of Guillain-Barre syndrome.Methods: In a cross-sectional study, 100 patients with Guillain-Barre syndrome hospitalized in Al-Zahra Medical Center, Isfahan, Iran, during 2007-2011 were studied. The demographic and epidemiologic data, disease process and treatment activities were achieved from hospital records and analyzed.Findings: The mean duration of hospitalization was 18.5 ± 8.6 days. The mean duration of the disease was 26.1 ± 14.6 days. The severity of the disease in 26, 25 and 49 patients were mild, moderate and severe, respectively. Among all, 14 cases had problem in cranial nervous system, 14 in autonomic nervous system and 6 in both cranial and autonomic nervous systems.Conclusion: According to our results, patients with Guillain-Barre syndrome may be encountered to several problems, and hospital managers must try to prepare adequate facilities based on the condition of patients, complications and symptoms, and treatment protocols.https://jims.mui.ac.ir/article_14643_62ad044325613ca7658d8feded658584.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953333620150622Effects of Crocin on Rotational Behavior, Lipid Peroxidation and Nitrite Levels in Rat’s Brain Striatum in an Experimental Model of Parkinson's DiseaseEffects of Crocin on Rotational Behavior, Lipid Peroxidation and Nitrite Levels in Rat’s Brain Striatum in an Experimental Model of Parkinson's Disease78079114644FAMaryamHosseiniMSc Student, Department of Physiology, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, IranZibaRajaeiAssociate Professor, Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranHojjatallahAlaeiProfessor, Neurosciences Research Center AND Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20150110Background: Degeneration of the nigrostriatal dopaminergic system is the pathologic hallmark of Parkinson's disease (PD), which leads to movement disorders. Compelling evidence implicates that oxidative stress plays an important role in degeneration of dopaminergic neurons in the disease. The aim of this study was to investigate the neuroprotective effect of crocin, a potent antioxidant in saffron, in an experimental model of Parkinson's disease in rat.Methods: 32 adult male Wistar rats were randomly divided into 4 groups of 8 including sham, parkinsonian and parkinsonian treated with crocin at doses of 30 and 60 mg/kg. 6-hydroxydopamine (6-OHDA) (16 µg in 0.2% ascorbate-saline) was infused into the left medial forebrain bundle. Crocin was injected intraperitoneally from 3 days before the surgery until 6 weeks. Rats were tested for rotational behavior by injection of apomorphine hydrochloride (2 mg/kg, intraperitoneally) at the weeks 2, 4 and 6. Malondialdehyde and nitrite levels were measured in the striatum at the end of the week 6.Findings: The apomorphine-induced contralateral body rotations were highly significant in parkinsonian group at the end of the weeks 2, 4 and 6 compared to the sham group (P < 0.001). Treatment of parkinsonian rats with crocin at the doses of 30 and 60 mg/kg did not change the rotations compared to the parkinsonian group. Malondialdehyde and nitrite levels in the striatum were significantly increased in parkinsonian group compared to the sham group (P < 0.050). Treatment of parkinsonian rats with crocin at a dose of 60 mg/kg significantly decreased the nitrite levels in the striatum compared to the parkinsonian rats (P < 0.05). However, treatment with crocin had no effect on malondialdehyde levels in the striatum.Conclusion: According to the present study, it seems that crocin at a dose of 60 mg/kg is effective on preventing the nitrosative stress in an experimental model of Parkinson's disease. However, crocin has no effect on improvement of rotational behavior and oxidative damage.Background: Degeneration of the nigrostriatal dopaminergic system is the pathologic hallmark of Parkinson's disease (PD), which leads to movement disorders. Compelling evidence implicates that oxidative stress plays an important role in degeneration of dopaminergic neurons in the disease. The aim of this study was to investigate the neuroprotective effect of crocin, a potent antioxidant in saffron, in an experimental model of Parkinson's disease in rat.Methods: 32 adult male Wistar rats were randomly divided into 4 groups of 8 including sham, parkinsonian and parkinsonian treated with crocin at doses of 30 and 60 mg/kg. 6-hydroxydopamine (6-OHDA) (16 µg in 0.2% ascorbate-saline) was infused into the left medial forebrain bundle. Crocin was injected intraperitoneally from 3 days before the surgery until 6 weeks. Rats were tested for rotational behavior by injection of apomorphine hydrochloride (2 mg/kg, intraperitoneally) at the weeks 2, 4 and 6. Malondialdehyde and nitrite levels were measured in the striatum at the end of the week 6.Findings: The apomorphine-induced contralateral body rotations were highly significant in parkinsonian group at the end of the weeks 2, 4 and 6 compared to the sham group (P < 0.001). Treatment of parkinsonian rats with crocin at the doses of 30 and 60 mg/kg did not change the rotations compared to the parkinsonian group. Malondialdehyde and nitrite levels in the striatum were significantly increased in parkinsonian group compared to the sham group (P < 0.050). Treatment of parkinsonian rats with crocin at a dose of 60 mg/kg significantly decreased the nitrite levels in the striatum compared to the parkinsonian rats (P < 0.05). However, treatment with crocin had no effect on malondialdehyde levels in the striatum.Conclusion: According to the present study, it seems that crocin at a dose of 60 mg/kg is effective on preventing the nitrosative stress in an experimental model of Parkinson's disease. However, crocin has no effect on improvement of rotational behavior and oxidative damage.https://jims.mui.ac.ir/article_14644_58c1dbad4977b4c106bca8015477757e.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953333620150622Infectious Mononucleosis Syndrome in Alzahra Referral Educational Medical Center, Isfahan, IranInfectious Mononucleosis Syndrome in Alzahra Referral Educational Medical Center, Isfahan, Iran79279914645FAAlirezaEmami-NaeiniAssociate Professor, Department of Infectious and Tropical Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranMohsenMeidaniAssistant Professor, Department of Infectious and Tropical Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranShohrehJafariStudent of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, IranAliMehrabi-KoushkiEpidemiologist, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0001-5864-4683Journal Article20150308Background: Infectious mononucleosis (IM) syndrome is an acute disease that often occurs after primary infection with Epstein-Bar virus. Because of high prevalence of this syndrome in our country and few researches about that, this study was done in Alzahra referral educational medical center in Isfahan, Iran.Methods: In this descriptive study, during 2001-2012, 49 patients with Infectious mononucleosis syndrome hospitalized in Alzahra medical center were studied for demographic features, signs, symptoms and laboratory findings. The data were achieved from hospital records, entered to special questionnaire and finally analyzed.Findings: There were 25 (51%) men and 24 (49%) women. The mean age of patients was 21.2 ± 9.6 with the range of 3-44 years. The most prevalent signs were fever, sore throat, painful swallowing (odynophagia) and chill and the most prevalent symptoms were exudative pharyngitis, lymphadenopathy and splenomegaly.Conclusion: According to the results, prevalence of signs, symptoms and laboratory findings in patients with Infectious mononucleosis syndrome in Alzahra medical center in Isfahan were similar to global statistics. But, this study was done in one medical center and there is not any study like this in our country; therefore, more studies should be done in other centers in our country.Background: Infectious mononucleosis (IM) syndrome is an acute disease that often occurs after primary infection with Epstein-Bar virus. Because of high prevalence of this syndrome in our country and few researches about that, this study was done in Alzahra referral educational medical center in Isfahan, Iran.Methods: In this descriptive study, during 2001-2012, 49 patients with Infectious mononucleosis syndrome hospitalized in Alzahra medical center were studied for demographic features, signs, symptoms and laboratory findings. The data were achieved from hospital records, entered to special questionnaire and finally analyzed.Findings: There were 25 (51%) men and 24 (49%) women. The mean age of patients was 21.2 ± 9.6 with the range of 3-44 years. The most prevalent signs were fever, sore throat, painful swallowing (odynophagia) and chill and the most prevalent symptoms were exudative pharyngitis, lymphadenopathy and splenomegaly.Conclusion: According to the results, prevalence of signs, symptoms and laboratory findings in patients with Infectious mononucleosis syndrome in Alzahra medical center in Isfahan were similar to global statistics. But, this study was done in one medical center and there is not any study like this in our country; therefore, more studies should be done in other centers in our country.https://jims.mui.ac.ir/article_14645_93e4d7106625e1b0f2eb8af065c83452.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953333620150622The Effect of Zolpidem or Promethazine Premedication on Agitation, Sedation and Cognitive Disorders before and after Coronary Artery Bypass Graft SurgeryThe Effect of Zolpidem or Promethazine Premedication on Agitation, Sedation and Cognitive Disorders before and after Coronary Artery Bypass Graft Surgery80081214646FAMojtabaMansooriAssociate Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranAmir BahadorBoroumandStudent of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20150606Background: Lack of control of agitation and patient’s pain before and after coronary artery bypass graft surgery (CABG) can cause severe and irrecoverable complications. Till the time of our study, there was no study to compare the effects of two drugs premedication, zolpidem and promethazine, in agitation, sedation and cognitive problems before and after coronary artery bypass graft surgery; we decided to do this.Methods: The study was a double-blind clinical trial on 85 patients undergoing coronary artery bypass graft in the age-range of 40 to 70 years. The subjects were divided in two groups receiving zolpidem or promethazine. The hemodynamic status, analysis of arterial blood gas, scale of sedation and agitation (SAS) and Clock Drawing Test (CDT) were checked before coronary artery bypass graft surgery, in Intensive Care Unit (ICU) and at the time of discharge.Findings: Sedation was higher and agitation was lower in zolpidem group before coronary artery bypass graft surgery and the differences were significant (P = 0.019). The score of zolpidem group was significantly more in clock drawing test before the surgery (P = 0.043).Conclusion: According to this study, patients who received zolpidem, had more sedation and less agitation than the promethazine group and cognitive disorder was less in them.Background: Lack of control of agitation and patient’s pain before and after coronary artery bypass graft surgery (CABG) can cause severe and irrecoverable complications. Till the time of our study, there was no study to compare the effects of two drugs premedication, zolpidem and promethazine, in agitation, sedation and cognitive problems before and after coronary artery bypass graft surgery; we decided to do this.Methods: The study was a double-blind clinical trial on 85 patients undergoing coronary artery bypass graft in the age-range of 40 to 70 years. The subjects were divided in two groups receiving zolpidem or promethazine. The hemodynamic status, analysis of arterial blood gas, scale of sedation and agitation (SAS) and Clock Drawing Test (CDT) were checked before coronary artery bypass graft surgery, in Intensive Care Unit (ICU) and at the time of discharge.Findings: Sedation was higher and agitation was lower in zolpidem group before coronary artery bypass graft surgery and the differences were significant (P = 0.019). The score of zolpidem group was significantly more in clock drawing test before the surgery (P = 0.043).Conclusion: According to this study, patients who received zolpidem, had more sedation and less agitation than the promethazine group and cognitive disorder was less in them.https://jims.mui.ac.ir/article_14646_dfc0a2d63b0d7a1ce1cd07ffe3a3aea7.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953333620150622Safety and Efficacy of Transcranial Magnetic Stimulation (TMS) and Repetitive Transcranial Magnetic Stimulation (rTMS) in Treatment of Major Depressive Disorder: Systematic Reviews and Meta-AnalysisSafety and Efficacy of Transcranial Magnetic Stimulation (TMS) and Repetitive Transcranial Magnetic Stimulation (rTMS) in Treatment of Major Depressive Disorder: Systematic Reviews and Meta-Analysis81382514647FAMohammadMoradi-JooCancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranHesamGhiasvandResearch Center for Health Services Management, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, IranSeyed MansoorRayganiPhysical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranSaharMohabbat-BaharSchool of Psychology and Educational Sciences, Allame Tabatabai University, Tehran, IranBita SadatZegordiFasa Universit of Medical Sciences, Fasa, IranHamidRavaghiAssociate Professor, Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IranJournal Article20141112Background: Prevalence of major depressive disorder allocated significant contribution of disease burden in developed and developing countries because of involving active and productive age groups and communities in recent decades. Different methods are used to manage and treat this disorder that one of them is Transcranial Magnetic Stimulation (TMS). The purpose of this study was assessment of safety, effectiveness and cost-effectiveness of Transcranial Magnetic Stimulation and Repetitive Transcranial Magnetic Stimulation (rTMS) technology in treatment of major depressive disorder.Methods: In order to gather evidence, main databases [Cochrane Library, Centre for Reviews and Dissemination (CRD), PubMed, Scopus, Trip, Embase, Inahta, PsycINFO, Google Scholar] were searched with appropriate keywords and strategies. After quality assessment of studies, consequences of safety and efficacy of the technology were extracted and Stata 12 software was used, if needed, for meta-analysis.Findings: From a total of 273 studies, 43 studies were entered firstly and 8 studies were selected after final review. The amount of standardised mean difference (SMD) was equal to -0.3 with a %95 confidence interval of -0.82 to 0.23 for rTMS-treated group versus sham group with a substantial rate and significant heterogeneity (P < 0.001, I-Squared = 81.9%).Conclusion: Repetitive Transcranial Magnetic Stimulation is a method with significant and high safety. On other side, its efficacy, compared to sham group, is not very significant.Background: Prevalence of major depressive disorder allocated significant contribution of disease burden in developed and developing countries because of involving active and productive age groups and communities in recent decades. Different methods are used to manage and treat this disorder that one of them is Transcranial Magnetic Stimulation (TMS). The purpose of this study was assessment of safety, effectiveness and cost-effectiveness of Transcranial Magnetic Stimulation and Repetitive Transcranial Magnetic Stimulation (rTMS) technology in treatment of major depressive disorder.Methods: In order to gather evidence, main databases [Cochrane Library, Centre for Reviews and Dissemination (CRD), PubMed, Scopus, Trip, Embase, Inahta, PsycINFO, Google Scholar] were searched with appropriate keywords and strategies. After quality assessment of studies, consequences of safety and efficacy of the technology were extracted and Stata 12 software was used, if needed, for meta-analysis.Findings: From a total of 273 studies, 43 studies were entered firstly and 8 studies were selected after final review. The amount of standardised mean difference (SMD) was equal to -0.3 with a %95 confidence interval of -0.82 to 0.23 for rTMS-treated group versus sham group with a substantial rate and significant heterogeneity (P < 0.001, I-Squared = 81.9%).Conclusion: Repetitive Transcranial Magnetic Stimulation is a method with significant and high safety. On other side, its efficacy, compared to sham group, is not very significant.https://jims.mui.ac.ir/article_14647_e35284b6966864480f02bc12997b8b49.pdf