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The relationship between Aldosterone level and various LV conditions in patients with End-stage renal disease
Get PDFBackground: Aldosterone has been assumed to be implicated in left ventricular hypertrophy (LVH). Preventing the progression of LVH in the early period of end-stage renal disease (ESRD) can increase patient survival. In this study, therefore, we analyzed the relationship between aldosterone level and LVH in ESRD patients who underwent hemodialysis at Fatemeh Zahra Hospital and Imam Khomeini Hospital in Sari, Iran from 2016 to 2017. Methods: This research is a case-control study involving 69 patients, divided into the case group (n=52, exhibiting LVH) and the control group (n=17, no ventricular hypertrophy observed in the echocardiography). The relationship between the patients’ serum aldosterone levels and LVH was evaluated on the basis of relative wall thickness (RWT). Results: Among the patients, 20.3 had normal cardiac conditions, 53.6 eccentric hypertrophy (EH), 4.3 exhibited concentric remodeling (CR), and 21.7 had concentric hypertrophy (CH). In other words, 24.6 of the patients belonged to the control group, and 75.4 belonged to the case group. The results indicated a significant difference (P=0.006) in average aldosterone levels between the case (165.11±80.8) and control (115.76±72.47) groups and a significant difference in aldosterone levels among the four subgroups (P=0.03), with the levels of the CH group being higher than those of the EH group. Conclusion: Based on the results of the study, a significant relationship exists between plasma aldosterone level and LVH in ESRD patients. Serum aldosterone level is therefore a predictor of LVH
Awareness and perception of multidrug-resistant organisms and antimicrobial therapy among internists vs. surgeons of different specialties: Results from the German MR2 Survey
Get PDFBackground: Recently, antibiotic resistance rates have risen substantially and care for patients infected with multidrug-resistant organisms (MDRO) has become a common problem in most in – and outpatient settings. The objectives of the study were to compare the awareness, perception, and knowledge of MDRO and rational antibiotic use between physicians from different medical specialties in German hospitals. Methods: A 35-item questionnaire was sent to specialists in internal medicine (internists), gynecologists, urologists, and general surgeons (non-internists) in 18 German hospitals. Likert-scales were used to evaluate awareness and perception of personal performance regarding care for patients infected with MDRO and rational use of antibiotics. Additionally, two items assessing specific knowledge in antibiotic therapy were included. The impact of medical specialty on four predetermined endpoints was assessed by multivariate logistic regression. Results: 43.0 (456/1061) of recipients responded. Both internists and non-internists had low rates of training in antibiotic stewardship. 50.8 of internists and 58.6 of non-internists had attended special training in rational antibiotic use or care for patients infected with MDRO in the 12 months prior to the study. Internists deemed themselves more confidently to choose the indications for screening patients for colonization with methicillin-resistant Staphylococcus aureus (P=0.004) and to initiate adequate infection control measures (P=0.002) than other specialties. However, there was no significant difference between internists and other specialists regarding the two items assessing specific knowledge in antibiotic therapy and infection control. Conclusion: Among the study participants, a considerable need for advanced training in the study subjects was seen, regardless of the medical specialty
Pituitary macroadenoma resulting from primary hypothyroidism: A16-year-old girl
Get PDFBackground: Primary hypothyroidism is a common medical condition. It can lead to pituitary adenoma which is usually asymptomatic, but it can also lead to symptomatic macroadenomas which are hard to diagnose due to different clinical presentations. Case presentation: A 16-year-old girl presented for endocrinology consultation prior to neurosurgical operation. She had galactorrhea which was accompanied by vertigo & low grade blurred vision without a headache and was diagnosed with pituitary macroadenoma and was planned for a surgery. She had TSH level of more than 100 mU/L, free thyroxine of 1.9 pmol/L. Her thyroid peroxidase (TPO) antibody level was 13.3 IU/mL, insulin growth factor-1 392 µ/l and serum prolactin level 42 ng/ml. During physical exam and with the laboratory findings, we suspected for a primary hypothyroidism as the leading cause of pituitary macroadenoma. As the result, we cancel the surgery and start levothyroxine therapy 100µg daily for her. In the follow-up it revealed that our diagnosis was correct and she went into remission with pituitary gland shrinking and decreasing TSH and prolactin levels. Conclusion: It is important to understand the different presentation of primary hypothyroidism to decrease the unnecessary risk of maltreatment in patients
Vaginal Leech Infestation: a Rare Cause of Prepubertal Vaginal Bleeding and Anemia
Get PDFBACKGROUND AND OBJECTIVE: Abnormal vaginal bleeding under the age of 10 is rare among girls. In such cases, local lesions, trauma, intra–vaginal foreign body, malignant genital tumors, and precocious puberty should be taken into account. Leech infestation is one of the rare causes of severe prepubertal vaginal bleeding. One case of prepubertal vaginal bleeding due to leech infestation is presented here.
CASE REPORT: An eight–year–old girl referred to the emergency department after three days of painless vaginal bleeding. The bleeding was moderate during the first two days and the patient experienced intensified bleeding and large menstrual clots on the third day. The patient had no history of trauma, coagulation disorder, systemic illness, and drug use, but noted the history of swimming in the muddy creek within a few days before referral to the emergency department. After examining the genital system, a black mass with wavelike movements was observed in the lower one-third of the vagina, and a piece of it was slightly out of the hymen. The leech was removed by forceps without damaging hymen. After a short time, the bleeding stopped. On the next visit, the patient had no vaginal bleeding and was discharged without any problem.
CONCLUSION: In cases of prepubertal vaginal bleeding, accurate examination of the genital system and evaluating the history of swimming or bathing in contaminated creeks, springs, qanats and pools are essential
Report a Case of Beauty Regeneration in a Child with Premature Tooth Decay
Get PDFBACKGROUND AND OBJECTIVE: One of the biggest challenges in pediatric dentistry is the oral rehabilitation of children who have lost their teeth due to early childhood decay severe trauma. In this report, a fixed anterior plaque is reported in a child with early decay.
CASE REPORT: In this study, a 4-year-old boy referred to a dental clinic in Isfahan with a major complaint of ugly appearance and inability to chew on anterior teeth due to decay. After clinical and radiographic examinations of the posterior teeth, pulp treatment and stainless steel coating were applied and the anterior teeth were pulled. After 6 weeks of complete recovery of the wound site, the cords with appropriate size fitted to the second molar maxillary teeth and matched to the upper jaw. After making the appliance and before the cementation, the plaque was examined for oral occlusion and beauty, with the help of Fuji I.GC corporation cement fixed in the mouth. The child was called 24 hours later, then one month later, and was followed up regularly by the age of seven.
CONCLUSION: According to the results of this reported case, the creation of a fixed anterior plaque in the child not only does not cause wounds and discomfort in the child's mouth, but also improves the ability of speech and beauty
The Prevalence of the Genetic Polymorphism of GSTM1, GSTT1 and GSTP1 and Its Relationship with Clinical Criteria of Multiple Sclerosis (MS) Patients in Tehran
Get PDFBACKGROUND AND OBJECTIVE: Multiple Sclerosis is the chronic inflammation of central nervous system with demyelinated lesions in the brain and spinal cord. The genetic polymorphisms associated with glutathione S-transferase enzymes involved in antioxidant defense in Iranian patients have not been investigated. Therefore, in the present study, the prevalence of the genetic polymorphism of glutathione S-transferase M1, P1 and T1 and its relationship with clinical criteria of MS patients with has been examined.
METHODS: In this case-control study, 69 patients who referred to Sina Hospital in Tehran and had no panic attack within the last three months and 74 healthy subjects were interviewed. After examination by neurologist and blood sampling, DNA extraction was performed using Roche kit. Then, the genotypic variations of the samples were evaluated using RFLP-PCR and its prevalence was analyzed in relation with age, birth weight, malignancy (EDSS) and gender using GraphPad Prism software.
FINDINGS: Most malignancies were observed in men (3.1±5.9) and the highest incidence rate was observed in those born in May (30%). Although the results of genotyping between the studied groups and their gender did not show any significant difference (OR: 2-4, p>0.05), patients with GSTM1 deficiency developed the disease at a lower age (32.8±2.6 years) compared with other patients (29.5±8.9 years) (CI-95%: 20.3–26.4, p=0.009). In addition, people with a rare GSTM1 allele who smoked cigarette had higher EDSS (CI-95%: 2.1–3.7, p=0.03).
CONCLUSION: Based on the results of this study, the effect of GSTM1 on malignancy is indicative of its role in detoxification of tobacco products and can be used as an agent for early diagnosis of disease in people who are susceptible to this disease
Evaluation of Hydroalcoholic Extract of Cinnamon Effect on Testicular Tissue and Fertility of Busulfan-Induced Oligo-Spermic Model Rats
Get PDFBACKGROUND AND OBJECTIVE: Busulfan is one of the cancer treatment drugs that cause infertility of the patient. In traditional medicine, one of the important properties of cinnamon is enhancement of fertility. The aim of this study was to investigate the effect of cinnamon on the physiological structure of testes and fertility rate of busulfan-treated rats. METHODS: In this experimental study, 24 adult male rats were divided into 3 groups of 8 subjects, Sham: healthy rats without intervention. Control group: Busulfan-sterilized rats (15 mg/kg) intraperitoneal injection, Cinnamon group: Busulfan-treated rats + cinnamon extract (200 mg/kg) for fourteen days. The testicles length, width and weight parameters as well as the formation of germinal cells were analyzed by H & E staining and optical microscopy. FINDINGS: The number of spermatogonia cells, primary spermatocytes and spermatid in the cinnamon group was 72.25±12.63, 61.71±11.47, and 79.1±10.02, and in the control group was 51.83±23.37, 31.67±5.27 and 38.67±15.7 respectively, and the increase in cinnamon group was significant (p<0.005). The testicles length, width and weight parameters in the cinnamon group were increased compared to the control group (busulfan). The thickness of germinal epithelium in the cinnamon and control group was 53.46 ± 16.44 and 30.4±10.21 respectively, which was significantly higher in the cinnamon group (p<0.001). CONCLUSION: According to the findings of this study, cinnamon extract has positive therapeutic and protective effects on testicular tissue and increases sperm production in busulfan-treated rats
Studying the research scope of mathematics education specialists using keywords
Get PDFBackground and aim: Due to the importance of keywords in the field of research and scientometrics, the keywords used in scientific outputs of mathematics education specialists were investigated in this study to determine the scope of their research.
Material and methods: This cross-sectional study was conducted on the Persian scientific papers published by mathematics education specialists who were the first author and published at least three papers for a 25-year period from 1993 to 2017. Under these conditions, 48 papers presented by eight mathematics education specialists were identified. Descriptive and inferential statistics were used to process the number and repetition of keywords.
Findings: Out of 204 keywords, 10 keywords were applied 44 times repeatedly
(or synonymously). The ratio of total articles to duplicate keywords was 66% and the ratio of duplicate keywords to total keywords was 22%. Linear regression test indicated a direct relationship between the number of articles and ratio of duplicate keywords.
Conclusion: The high proportion of duplicate keywords suggests the subject similarity and focus of articles of mathematics education specialists in Iran
Evaluating Antibacterial Effect of Green Synthesis Oxide Iron Nanoparticles Using Cytoplasmic Extract of Lactobacillus casei
Get PDFBACKGROUND AND OBJECTIVE: With regard to the drug resistance, special attention has been placed on researches for discovering new antimicrobial substances such as nanoparticles. In green synthesis biological resources such as bacteria and yeast are used for producing metal nanoparticles. In this research, we used the Lactobacillus casei extract as a biological source for producing iron oxide nanoparticles and antibacterial effects of these nanoparticles against the standard strains of Escherichia coli and Staphylococcus aureus were investigated.
METHODS: for synthesis of green iron oxide nanoparticles, cytoplasmic extract of Lactobacillus casei and iron sulfate solution 10-3M were mixed and incubated for 3 weeks at 37 ° C in the presence of 5% carbon dioxide. Synthesis of iron oxide nanoparticles were evaluated using X-ray diffraction pattern and Transmission electron microscopy. Antibacterial effects of nanoparticles with dilution of 10, 100 and 1000 micro-grams per milliliter on two standard strains of Escherichia coli and Staphylococcus aureus were evaluated.
FINDINGS: Synthesis of iron oxide crystals was confirmed by XRD analysis. Based on transmission electron microscopy the average of nanoparticles was about 15 nm with a spherical shape. Antimicrobial effect of nanoparticles showed that at concentration of 100 and 1000 µg/ml has an inhibitory effect on the growth on Staphylococcus aureus equal to 12.03±0.32 and 16±0.5, respectively. The only concentration that showed significant effect was 1000µg/ml (p≤0.001). While are ineffective against Escherichia coli.
CONCLUSION: The results of this study indicated that producing iron oxide nanoparticles using cytoplasmic extract of Lactobacillus casei is a biologically safe method and very noteworthy in medicine and pharmacology and may be considered as a good candidate for the treatment of bacterial infections
Comparison of Triage Effectiveness Based on ESI and HEART Scale in Diagnosis of Outcome in Patients with Chest Pain
Get PDFBACKGROUND AND OBJECTIVE: Chest pain is one of the common causes of emergency department visit, but only 25-15% of them are diagnosed with acute coronary syndrome (ACS). However, unexplained cases of ACS have led to high mortality rates. The aim of this study was to compare the effectiveness of ESI triage (Emergency Severity Index) and HEART scale (Chest Pain Diagnostic Scale) in detecting the outcome of patients with complaints of chest pain.
METHODS: This descriptive study was performed on 200 patients with chest pain in emergency department of selected hospitals of Shahid Beheshti University of Medical Sciences in 2017. The ESI triage form, HEART and demographic information were completed for all patients. Six weeks later patients were re-evaluated in terms of heart problems.
FINDINGS: The compliance of the ESI triage and HEART scale in the high-risk group was 27.9% (24 people), the middle-risk group was 79% (62 people) and the low-risk group (30.6%) (11 people). In general, comparing the total scores, these two scales were consistent with 48%. Also, after considering the cut-off point 4.5, the sensitivity 85% and the specificity 89% with a 95% confidence interval for the HEART scale and sensitivity 95%, and the specificity 25% with a 95% confidence interval was found for the ESI triage.
CONCLUSION: According to the results of this study, despite its wide range, the ESI triage has shown a poor performance over the HEART scale. Therefore, the use of the combined HEART triage ESI scale can be very helpful