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Serum levels of interleukin-23 and 35 in patients with and without type 2 diabetes mellitus and chronic periodontitis
Get PDFBackground: Type 2 diabetes mellitus (DM) and chronic periodontitis (CP) show common pathophysiological features. We investigated the serum levels of IL-23 and IL-35 in people with type 2 DM and CP. Methods: In a cross-sectional study, 72 patients were divided into four equal groups: group A, participants without type 2 DM and CP; group B, patients with type 2 DM without CP; group C, patients with CP and without type 2 DM; and group D, patients with type 2 DM and CP. Demographic data were obtained and periodontal conditions including clinical attachment loss, bleeding on probing, plaque index, gingival index, and probing depth was evaluated on all existing teeth. Fasting blood sugar (FBS) levels, hemoglobin (Hb) A1c, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were assessed. In addition, serum levels of IL-23 and 35 were measured using enzyme-linked immunosorbent assay. Results: The serum levels of IL-23 and 35 showed no significant differences between all groups (P>0.05). A significant positive correlation between the serum concentration of IL-23 and clinical attachment loss in the control group (r: 0.548, P=0.019) was detected. A significant negative correlation between IL-35 and the plaque index in group B (r: -0.578, P=0.012), plus significant negative correlations between IL-23 with ESR (r: -0.487, P=0.040) and CRP (r: -0.498, P=0.035) in groups C and D were also detected. Conclusion: Despite significant associations of serum concentration of IL-23 and 35 with certain periodontal and inflammatory indices, neither type 2 DM nor CP differentially affects serum levels of these two cytokines
Undiagnosed hypertension and diabetes among the elderly Adults in the Amirkola, North of Iran
Get PDFBackground: As populations of elderly grow, the prevalence of type 2 diabetes and hypertension increases. These diseases can be asymptomatic for a long time and cause irreversible damages to organs. Therefore the aim of this study was to evaluate the prevalence of undiagnosed hypertension and diabetes among the elderly in Amirkola. Methods: This is a descriptive/analytical cross-sectional study and a part of the first phase of a cohort study on the health status of the elderly in Amirkola (a city in the North of Iran) which has been conducted on all people aged 60 and over since 2011. The demographic information was collected using a questionnaire, the hypertension was diagnosed by measuring blood pressure in lying down- position and the diabetes was diagnosed by measuring fasting blood glucose level. Results: This study was conducted on 1568 elderly participants including 703 (44.8) females and 865 (55.2) males. The overall prevalence of diabetes was 30.6 of which, 23.3 was diagnosed and 7.4 was undiagnosed. Nearly one-fourth (24.1) of the participants with diabetes were unaware of their disease. Thirty-one percent of the people with undiagnosed diabetes also had undiagnosed hypertension. The overall prevalence of hypertension in this study was 62.8, including 41.2 diagnosed and 21.5 undiagnosed hypertension. Conclusion: Regarding the results of this study and the high prevalence of undiagnosed diabetes and hypertension in elderly, improving the individual’s general awareness and screening in older adults for timely management are necessary
Resistance integrons. Mini review
Get PDFIntegrons represent genetic mechanisms that allow bacteria to adapt and evolve rapidly through the stockpiling. The genes are embedded in a specific genetic structure called gene cassette (a term that is lately changing to integron cassette) that typically carries one promoterless ORF together with a recombination site (attC). Additionally, an integron will usually contain one or more gene cassettes that have been incorporated into it. The gene cassettes may encode genes for antibiotic resistance. In recent years, they have had a crucial role in the acquisition, expression, and dissemination of antibiotic resistance genes. Therefore, the ongoing threats posed by integrons require an understanding of their origins and evolutionary history. This review examines the functions and activities of integrons. It shows how antibiotic use selected particular integrons from among the environmental pool, so that integrons carrying resistance genes are now present in the majority of Gram-negative pathogens. In closing, it examines the potential consequences of widespread pollution with the novel integrons in Iran and the world
Effectiveness Of Continuous Versus Pulsed Short-Wave Diathermy In The Management Of Knee Osteoarthritis: A Randomised Pilot Study
Get PDFBackground: Short-wave diathermy (SWD) is an electrotherapeutic modality used in the conservative treatment of knee osteoarthritis (KOA).  Electromagnetic radiation delivered in continuous (cSWD) or pulse (pSWD) mode provides a deep heating effect on tissues.  There is no consensus on outcomes of treatment with cSWD versus pSWD in KOA. The aim of this study was to compare the effects of cSWD versus pSWD on pain, functionality and walking distance in KOA. Methods: 34 female patients aged 49-65 with KOA were randomized into two groups.  A total of 27 patients completed the study. One group (n=11) was treated with cSWD, the other (n=16) with pSWD for three weeks. Patients were assessed before, after and at one month post therapy. Outcome measures included visual analogue scale (VAS) for knee pain, Western Ontario and Mcmaster University Osteoarthritis Index (WOMAC) and a six-minute walking test (6MWT). Results: Based on the minimal clinically important improvement (MCII), there was a reduction in VAS and WOMAC scores in both cSWD and pSWD groups post treatment (-37.3mm, 31.2mm respectively for VAS and 26, 23 respectively for WOMAC) and at one month post treatment. There was no difference in pre and post treatment VAS for pain, WOMAC or 6MWT scores between the two groups.  There was a small post treatment effect size on between- group 6MWT scores (Cohen’s d: 0.238). Conclusion: Both treatment options appear to be efficacious in reducing pain and improving functionality in KOA.  There was no between-group difference. A larger study must be conducted to consolidate these findings.    
The Epidemiology of Psychiatric Disorders in Children and Adolescents in Mazandaran Province
Get PDFBACKGROUND AND OBJECTIVE: New information on the epidemiology of psychiatric disorders in children and adolescents is essential for planning and management of health system. Despite the significance of recognizing the health status of children and adolescents, the prevalence of psychiatric disorders in children and adolescents in Iran has not been systematically investigated. This study, which is part of the National Survey of Iranian Children and Adolescents (IRCAP), examines the prevalence of psychiatric disorders in children and adolescents in Mazandaran province, northern Iran.
METHODS: In a cross-sectional survey, 1051 children and adolescents residing in Mazandaran, aged 6 – 18 years, were selected by multistage cluster random sampling. In addition to demographic data, the Persian version of K-SADS-PL (Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime Version) was used to assess psychiatric disorders based on Axis I of the DSM-IV.
FINDINGS: The overall prevalence of psychiatric disorders is 18% (20.42 – 15.78), mood disorders is 2% (3.15 – 1.38), psychotic disorders is 0.1% (0.2 – 55.02), anxiety disorders is 10.4% (12.8 – 36.67), separation anxiety disorder is 4.6% (6.3 – 01.46), post-traumatic stress disorder (PTSD) is 0.3% (0.8 – 0.1), behavioral disorders is 5.1% (6.3 – 65.96), attention deficit hyperactivity disorder (ADHD) is 2.9% (4.16 – 2.09), conduct disorder is 2.0% (0.0 – 8.1), neurodevelopmental disorders is 2.1% (3.1 – 15.38) and mental retardation is 0.8% (1.4 – 49.0). 42.9% of the cases with depressive disorders also have anxiety disorders. 17.4% of anxiety disorders are associated with behavioral disorders.
CONCLUSION: According to the results of this study, psychiatric disorders are considerably common among children and adolescents in Mazandaran. Anxiety disorders are the most common and psychotic disorders are the least common group of psychiatric disorders. Separation anxiety disorder is the most common and post-traumatic stress disorder (PTSD) is the least common anxiety disorder. Attention deficit hyperactivity disorder (ADHD) is the most common and conduct disorder the least common behavioral disorder. Among psychiatric disorders, the highest comorbidity is between depression and anxiety disorders
The Effect of Gender on Dimensions of Lumbar Vertebral Pedicle Using Computed Tomography
Get PDFBACKGROUND AND OBJECTIVE: Having the correct anatomical points and the size of the pedicle dimension is necessary to minimize neurological complications. Currently, the gold standard for spinal fusion is the use of pedicle screws. In this method, the pedicle screw should be placed in its ideal position. Given the importance of this topic, the present study was performed to determine the dimensions of right and left pedicle by computed tomography (CT) scan in three axial, coronal and sagittal planes based on gender in Fars-native ethnic group.
METHODS: This cross-sectional study was performed on 40 patients (20 females and 20 males aged 18 – 45 years) from Fars-native ethnic group. The average height for males was 165 to 180 cm and for females between 165 and 175 cm. Healthy vertebrae were selected in people who referred to a CT scan unit with symptoms of spinal pain or trauma. Determination of height, length and width of right and left pedicle of lumbar vertebrae in axial, coronal and sagittal view in 1.5 mm sections was performed by CT scan.
FINDINGS: Mean and standard deviation of height (1.458±0.141), width (0.788±0.173), and length (1.248±0.195) of pedicle in men (based on millimeter) was significantly higher compared to mean and standard deviation of height (1.268±0.140), width (0.618±0.148), and length (1.08±0.174) in women (p<0.05).
CONCLUSION: The results of this study showed that gender affects the dimensions of lumbar vertebral pedicle
A Case Report of Tuberculosis with Extrapulmonary Manifestations
Get PDFBACKGROUND AND OBJECTIVE: Mycobacterium tuberculosis affects millions of people in the world and Iran is one of the endemic areas. This disease has a wide range of manifestations, which is pulmonary in 80 – 85% of cases and extrapulmonary in 15 – 20% of cases. The most notable extrapulmonary infection sites are lymph nodes, pleura, genitourinary system and digestive system. Considering the prevalence of tuberculosis in Iran, familiarity with the uncommon manifestations of this infection seems to be essential for timely diagnosis and treatment. Therefore, a rare extrapulmonary manifestation of tuberculosis is reported here.
CASE REPORT: The patient was a 64 – year – old woman who was hospitalized due to fever, icterus, decreased consciousness and progressive asymmetrical weakness of the limbs. Symptoms of focal neurologic deficits and heart murmurs were found in examinations. During the tests, including brain and spinal imaging, cerebrospinal fluid analysis, computed tomography of the abdomen and pelvis, and echocardiography, extrapulmonary tuberculosis (cerebral abscess, spondylitis, liver and spleen abscess, psoas muscle abscess, and possible endocarditis) was confirmed. Four-drug regimen including isoniazid, rifampin, ethambutol, and pyrazinamide with vitamin B6 was started for two months, and two-drug regimen continued for 10 months. At the end of the course of treatment, the patient was able to walk with the cane in good general condition.
CONCLUSION: Considering the reported case, paying attention to some of the more uncommon manifestations of the disease can prevent mortality and disability
Comparing the Effects of Propofol Infusion and Inhalation Isoflurane on Hemodynamic Variations and Depth of Anesthesia in Cataract Surgery Patients
Get PDFBACKGROUND AND OBJECTIVE: In cataract surgery, given that most patients are older people, surgery with general anesthesia requires better hemodynamic control along with maintaining the depth of anesthesia. The present study was conducted to compare the effects of propofol and isoflurane on hemodynamic variations and depth of anesthesia in cataract surgery patients.
METHODS: The present clinical trial was conducted among 60 patients who were cataract surgery candidates. The patients were randomly assigned to propofol group (n = 30) and isoflurane group (n = 30). One µg/kg fentanyl and one mg/kg intravenous lidocaine were administered in both groups and anesthesia was induced using 1.5 – 2.5 mg/kg propofol. In order to maintain anesthesia, 50 – 75 µg/kg/min propofol was administered in the first group and 1% isoflurane was administered in the second group. Depth of anesthesia, hemodynamic variations, recovery time, wake-up time, nausea and vomiting were recorded and compared in the two groups.
FINDINGS: Depth of anesthesia was similarly below 60 in both groups at different times. Hemodynamic variations were not significantly different in the two groups. Mean recovery time in propofol and isoflurane groups was 20.56 and 15.4 minutes, respectively (p<0.001), and wake-up time in the two groups was 8.83 and 7.16 minutes, respectively (p= 0.004).
CONCLUSION: The results showed that there was no difference between the effects of these two drugs on hemodynamics and depth of anesthesia, but recovery time and wake-up time in propofol group were significantly higher than isoflurane group
The effect of low- dose tranexamic acid on postoperative blood loss in patients treated with clopidogrel and aspirin
Get PDFBackground: Clopidogrel in combination with aspirin increases bleeding, allogeneic red cell transfusion and reoperation rates after CABG. Tranexamic acid, an antifibrinolytic agent, has been approved for use in cardiac surgery to reduce bleeding. In the present study, we evaluated the impact of tranexamic acid on the transfusion and post-operative blood loss after CABG in patients treated with clopidogrel less than 5 days before surgery. Methods: This study was a prospective, randomized, double-blinded clinical trial. Patients undergoing on-pump CABG with their last dose of clopidogrel and aspirin less than 5 days preoperatively were randomly assigned to receive tranexamic acid (10 mg/kg before surgical incision and 10 mg/kg after protamine neutralization) or a corresponding volume of saline solution. The incidence of allogeneic red cell transfusion and 48h postoperative blood loss were recorded. Results: The average volume of blood loss was 776.92±459.81mL for the TXA group and 1075.00±670.91mL for the control group (P=0.03) in the patients with clopidogrel exposure within 48 h before surgery. The average volume of blood loss was not different between two groups in the patients with clopidogrel exposure within 5 days before surgery and also transfusion rate. Conclusion: The result of this study shows that tranexamic acid reduced blood loss in the patients with clopidogrel exposure within 48 h before surgery. So, it is better that we use tranexamic acid before surgery in all patients
Effect of equisetum arvense extract on bone mineral density in Wistar rats via digital radiography
Get PDFBackground: Osteoporosis is a common disease of old age. The present study used digital radiography to determine the effects of equisetum arvense extract on the bone mineral density (BMD) of experimental rats. Methods: In this experimental study, 25 male and 25 female Wistar rats, aged three weeks old and weighing 100 grams, were randomly divided into five groups: (1) control group, (2) calcium/vitamin D group, (3) 60 mg/kg equisetum arvense extract group, (4) 90 mg/kg equisetum arvense extract group and (5) 120 mg/kg equisetum arvense extract group. Rats received these diets for 30 days. The spongy bone density was measured in the maxilla and mandible using digital radiography and the serum levels of calcium, vitamin D and phosphorus were measured at baseline and after 30 days. The data were analyzed using ANOVA and Tukey test. Results: There was no significant difference between serum calcium and phosphorus levels in the five groups before and after 30 days. The serum vitamin D in the group receiving calcium and vitamin D was significantly higher than in the other groups (with average values of 24.7, 61.7, 23.47, 23.95 and 39.16 in the male groups 1 to 5 and 29.0, 85.07, 31.58, 42.34 and 18.83 in the female groups 1 to 5, respectively (p<0.001). Moreover, the increased mandibular BMD in the 120 mg/kg equisetum arvense group was significantly higher than in the control group (p<0.01). Conclusion: A diet containing 120 mg/kg equisetum arvense extract resulted in increased mandibular bone mineral density