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Fatal Hypermagnesemia: an acute ingestion of Epsom Salt in a patient with normal renal function
Get PDFBackground: Generally, it is very rare for clinically significant hypermagnesemia to develop in an individual with normal renal functions as the renal handling of serum magnesium is a very potent process and it has the capacity, under conditions of hypermagnesemia, to completely block Mg (magnesium) reabsorption from the thick ascending limb of Henle. Therefore, hypermagnesemia usually arises in the setting of renal failure.
Case presentation: We present a very rare case of a 40-year-old African American obese female with prior normal renal functions, who presented post-cardiac arrest following accidental overdose of Epsom salt. The patient was initially given supportive therapy and was later considered for the dialysis despite normal renal functions, as serum Mg levels kept on creeping up and clinical status kept on deteriorating continuously.
Conclusions: Seemingly harmless magnesium containing (over-the-counter) (OTC) can potentially be lethal, and such consequences must always be taken into account when using such medications for a prolonged period of tim
The Preventive/Protective Effect of Testosterone on Haloperidol-Induced Extrapyramidal Disorders in Male Rats
Get PDFBACKGROUND AND OBJECTIVE: Many non-motor symptoms of Parkinson's disease such as depression are associated with testosterone deficiency. On the other hand, the effect of testosterone therapy on the motor symptoms of Parkinson's disease is unknown. Therefore, the present study was conducted to evaluate the effect of testosterone on haloperidol-induced extrapyramidal disorders.
METHODS: In this experimental study, 60 male Wistar rats weighing 180–220 g were randomly divided into 10 groups of 6. Rats were intraperitoneally pretreated with saline, polyethylene glycol, flutamide (10 mg/kg) or testosterone (1 mg/kg) for 1 or 7 consecutive days and before administration of haloperidol. The effects of testosterone and flutamide on catalepsy and motor disorder caused by haloperidol were measured by bar test and rotarod test, respectively.
FINDINGS: Haloperidol (1 mg/kg) significantly (p<0.004) resulted in catalepsy (170±17.25) and balance impairment (52±8). Pretreatment with testosterone for 7 days had a preventive effect on haloperidol-induced extrapyramidal disorders and improved catalepsy (55±8) (p<0.001) and balance impairment (178±8) (p<0.05) in mice, whereas co-administration of flutamide prevented the ameliorative effects of testosterone on extrapyramidal disorders.
CONCLUSION: The results of the study showed that pretreatment with testosterone has a significant effect on the improvement of catalepsy
Evaluating the Performance of Flow Cytometric Method in Identification of Platelet Resistance in Patients with Acute Myeloid Leukemia (AML)
Get PDFBACKGROUND AND OBJECTIVE: Immune platelet resistance is a condition in which antibodies are produced against platelet antigens and cause damage to injected platelets by phagocytes and macrophages. The aim of this study is to evaluate the efficacy of flow cytometry in predicting the results of platelet injections and platelet resistance and selecting compatible platelet for patients.
METHODS: This case-control study was performed on 15 patients with acute myeloid leukemia (AML) with two or multiple injections of platelets and 15 healthy subjects without a history of platelet injection. After marking the platelets with 5-Chloromethylfluorescein diacetate (CMFDA) and their adjacency to the serum of patients, the amount of phagocytosis of platelets by monocytes was assessed in the two groups.
FINDINGS: The mean phagocytic power of platelets by monocyte was 18.27 ± 2.86% in the control group, 68.47 ± 10.40% in the group of patients with immune platelet resistance, and 36.73 ± 15.21 in the group of patients without immune platelet resistance (p = 0.001). In addition, there was a significant negative correlation between phagocytic power of platelets by monocyte and Corrected Count Increment (CCI) at 1 and 24 hours (p = - 0.001).
CONCLUSION: Based on the results of this study and considering the high sensitivity of the flow cytometric method, the use of CMFDA is highly appropriate for evaluating platelet studies, and it can also be used for platelet crossmatch by flow cytometry
Assessment of AFT and Cox Models in Analysis of Factors Influencing the survival of Women with Breast Cancer in Yazd city
Get PDFBACKGROUND AND OBJECTIVE: Breast cancer is one of the most common cancers in women. The statistical methods in the survival analysis of these patients are accelerated time models and Cox model. The purpose of this study is to evaluate two models in determining the effective factors in the survival of breast cancer.
METHODS: The study was an analytical and cohort study of survival analysis. The 538 of the patients referred to Ramezanzade Radiotherapy Center who had breast cancer and recorded survival status as a census from the April 2005 until March 2012 in Yazd. and survived by phone call. The Kaplan-Meier estimate was used to describe the survival of the patients. The research variables included clinical and demographic factors. The choice of final variables in the model was done by the methods of diminishing the dimension and all possible Cox regressions by the acaian criterion. Then, the best accelerated time model was considered Getting different distributions was also determined by the Akayake criteria.
FINDINGS: The most effective Cox model among all Cox models was variables including Age, Her2 and Ki67 variables (AIC = 30270). The generalized gamma model was the most optimal accelerated time model (AIC 463.966). Her2 was significant in both accelerated and cox models(p0.05).
CONCLUSION: In both accelerated time- Generalized Gamma- models and Cox Models, the Her2 variable was identified as a risk factor for breast cancer and There is a positive impact on the risk of death and reduced survival
The Effect of Aromatherapy with Peppermint Essential Oil on Nausea and Vomiting in the Acute Phase of Chemotherapy in Patients with Breast Cancer
Get PDFBACKGROUND AND OBJECTIVE: Chemotherapy is one of the main treatment options for cancer patients. Nausea and vomiting are also the most common side effects of chemotherapy drugs. The aim of this study was to determine the effect of aromatherapy with peppermint essential oil on nausea and vomiting in the acute phase of chemotherapy (the first 24 hours) in patients with breast cancer.
METHODS: This randomized clinical trial was conducted on 100 women with breast cancer who were referred to the chemotherapy centers of Imam Khomeini Hospital on an outpatient basis for the first course. Patients were randomly divided into intervention and control groups. Peppermint essential oil was used in the intervention group, while normal saline was used in the control group. Frequency and severity of acute nausea and vomiting in the first night after chemotherapy were recorded and compared using Rhodes standard questionnaire with a mean score of 0 – 32.
FINDINGS: The two groups were not statistically different in terms of age, duration of cancer, history of alcohol abuse and history of nausea and vomiting. The mean score of nausea in the aromatherapy group was 1.1±1.02 and in the in the control group was 1.82±1.39 (p<0.014). The mean score of vomiting in the intervention group was 0.34±0.66 and in the control group was 0.66±0.97 (p<0.032).
CONCLUSION: The results of this study showed that the use of aromatherapy with peppermint essential oil, along with the use of routine anti-nausea / vomiting drugs, can reduce nausea and vomiting in the acute phase of chemotherap
Development and validation of a Semi-quantitative food frequency questionnaire among older people in north of Iran
Get PDFBackground: The study was conducted to assess reliability of modified semi-quantitative food frequency questionnaire (SQFFQ) as a part of the Amirkola Health and Aging Project (AHAP).
Methods: The study was carried out in a sample of 200 men and women aged 60 years and older. A 138-item SQFFQ and two 24-hour dietary recalls were completed. The reliability of SQFFQ was evaluated by comparing eighteen food groups, energy and nutrient intakes derived from both methods using Spearman and Pearson’s correlation coefficients for food groups and nutrients, respectively. Bland-Altman plots and Pitman’s tests were applied to compare the two dietary assessment methods.
Results: The mean (SD) age of subjects was 68.16 (6.56) years. The average energy intake from 24-hour dietary recalls and the SQFFQ were 1470.2 and 1535.4 kcal/day, respectively. Spearman correlation coefficients, comparing food groups intake based on two dietary assessment methods ranged from 0.25 (meat) to 0.62 (tea and coffee) in men and from 0.39 (whole grains) to 0.60 (sugars) in women. Pearson correlation coefficients for energy and macronutrients were 0.53 for energy to 0.21 for zinc in male and 0.71 for energy to 0.26 for vitamin C in females. The Pitman’s test reflected the reasonable agreement between the mean energy and macronutrients of the SQFFQ and 24-hour recalls.
Conclusions: The modified SQFFQ that was designed for the AHAP was found to be reliable for assessing the intake of several food groups, energy, micro-and macronutrients
Stimulant use in medical students and residents requires more careful attention
Get PDFBackground: Stimulant pharmaceuticals are abused among academic students to elevate mood, improve studying, intellectual capacity, memory and concentration, and increase wakefulness. This study was designed to evaluate the current situation of stimulant use among medical students and residents of Babol University of Medical Sciences.
Methods: This cross-sectional study was conducted among 560 medical students and clinical residents of Babol University of Medical Sciences during the academic year 2014-2015. A self-administered questionnaire was used for data collection.
Results: Four hundred and forty-four (79.3%) students filled out the questionnaires. 49 (11%) individuals reported amphetamine and methylphenidate (ritalin) use. The mean age of the stimulant drug users was 24.6±4.8 years. The main initiator factor was to improve concentration (29 persons; 59.2%). There were significant statistical correlations between stimulant drugs abuse and male gender, living in dormitor in residence and internship and past medical history of psychiatric disorders (depression, attention deficit hyperactivity disorder and substance abuse) (p<0.05).16 (32%) students started the drug use on their friends’ advice; 15 (30%) due to self-medication and 12 (24%) persons with physician´s prescription.
Conclusions: Because of significant prevalence of stimulant use, regulatory governmental policies and also planning to improve essential life skills, awareness about the side effects and complications of these drugs, screening of at-risk college students and early identification of the abusers are suggested
Performance of electrophysiologic study in an asymptomatic patient with type 2 intermittent Brugada syndrome: To do or not to do
Get PDFBackground: Brugada syndrome (BrS) is an inherited channelopathy, which is associated with sudden cardiac death due to rapid polymorphic VT or VF. There is no definite consensus regarding the management of asymptomatic patients. Some experts advocate close follow-up; others propose the programmed stimulation for risk stratification. We aimed to evaluate the benefit of complete atrial and ventricular stimulation in patients with BrS and palpitation.
Case Presentation: A 30-year-old man was admitted to our hospital because of a family history of sudden cardiac death (SCD) at age less than 45 years. He complained of self-terminated episodes of palpitation with no history of syncope. Baseline ECG showed incomplete right bundle branch block (RBBB) and saddle-back-like ST deviation in V1. Flecainide challenge test (FCT) revealed Brugada pattern. Complete EPS was done for evaluation of VT/VF inducibility and probable concomitant supraventricular arrhythmias.
Programmed atrial stimulation showed inducible typical slow-fast AVNRT with AH jump 75 msec. Successful slow pathway ablation was done. There was no inducible ventricular arrhythmia.
Conclusions: Patients with drug-induced BrS, positive family history of SCD and also episodes of palpitation, benefit from complete EPS. However, ICD implementation is not recommended in asymptomatic patients with drug-induced BrS and negative EPS for ventricular stimulation
Plexiform schwannoma of the floor of the mouth: a case report
Get PDFPlexiform schwannoma is a type of schwannoma that can be occured at any age and any site of the oral cavity. In the gross and histopathological features, it shows plexiform or multinodular growth pattern. This variant of schwannoma is sometimes associated with neurofibromatosis type II or schwannomatosis. Histopathologically, plexiform schwannoma is composed of schwann cells that show Anthony A growth pattern. Mitosis are rare or absent. This study reports a case of a healthy 34 year old female with swelling in floor of her mouth; according to the clinical and histopathological findings, the diagnosis was Plexiform schwannoma