Journal of Arak University of Medical Sciences

The Effects of Timolol and Latanoprost vs. Timolol and Dorzolamide on Intraocular Pressure in Open Angle Glaucoma Patients

Reza Rezaee

Background: Glaucoma is the second most common cause of blindness and it is one of the main causes of irreversible blindness. Multi-drug regimens usually recommended in reducing intraocular pressure (IOP) in patients with glaucoma. This study was aimed to compare the effect of combination therapy with Timolol and Latanoprost vs. Timolol and Dorzolamide in reducing IOP in patients with open-angle glaucoma.

Materials and Methods: In this blind randomized clinical trial study, 60 eyes with glaucoma were randomly assigned to two treatment groups including Timolol and Latanoprost vs. Timolol and Dorzolamide. Required variables were measured before and 6 weeks after the intervention. The data was analyzed by running the Stata software (version 12) at a significance level of 0.05.

Results: The mean age in groups of Timolol-Latanoprost and Timolol and Dorzolamide was 72.6 and 67.6 years old, respectively. Analysis of the data revealed that there was no significant difference between groups in terms of intraocular pressure (IOP), visual acuity and cup to disc ratio.

Conclusion: According to our findings, there were no statistical significant differences in the IOP lowering effect between both treatments in open angle glaucoma patients.

Predictive Factors of Breakthrough Infection in Patients with Vesicoureteral Reflux Under Antibiotic Prophylaxis

Mehrdad Bakhtiari

Background: Vesicoureteral Reflux (VUR) is the most common urologic anomaly in children. In spite of prescribing prophylactic antibiotics in children with VUR, in some cases breakthrough infection (BTI) occurs while receiving prophylactic antibiotics which may cause pyelonephritis that can ultimately lead in renal scarring.

Materials and Methods: In this discreptive-analytic study, 288 children with primary vesicoureteral reflux under Cotrimoxazole(2mg/kg) treatment have been under supervision for duration of at least one year. Based on the collected data, predictive effect of some factors like gender, mean age of VUR diagnosis, VUR grade, unilateral versus bilateral and presence of abnormal renal scar on the breakthrough infection under prophylactic treatment, were examined.

Results: Breakthrough infection while receiving prophylactic antibiotics was observed among 111(38.54%) patients consisting of 88 girls (79.28%) and 23 boys (20.72%). The moderate to high VUR grades (grade III-V), presence of renal scar and female gender were found to be the important risk factors for BTI. However, no statistically significant relationship between mean age of VUR diagnosis and unilateral versus bilateral VUR with BTI was found.

Conclusion: Results of the current study will help improving parents' and physicians' awareness of the risk factors associated with BTI which may potentially lead to renal damage.

The Relationship Between Nutrition and Physical Activity with Menarche Age of Girls in Ahvaz

Shahnaz Najar

Background: The average age of menarche varies from country to country due to regional variation and different factors, including genetic and environmental factors that affect the onset of menarch. This study performed to survey relationship between nutrition and physical activity with menarche age of girls in Ahvaz city.

Materials and Methods: This survey is a cross-sectional study that was conducted on 1249 female students 8-15 years in 2012- 2013 year. Participants were selected by random cluster sampling from 4areas and 16 elementry and middle and high schoolsin Ahvaz city. The data were collected based on interviews and questionnaire (food frequency and physical activity). After collecting the data, then they were encoded and analyzed by SPSS16 software and descriptive and analytic statistics.

Results: The mean of age at menarche in girls in Ahvaz was 11.86±1.07 and age at menarche was not associated with nutrition and physical activity.

Conclusion: Based on these findings, significant association between nutrition and physical activity and age at menarche (p<0.001)was not observed.

To Assay the Relation between the Vascular Endothelial Growth Factor Expression and Breast Cancer Tumor Formation

Zohreh Hojati

Background: Vascular endothelial growth factor (vegf) is one of the most important regulator of angiogenesis, there are some reports about the relation of VEGF over expression and progression of tumor in several cancers. The aim of this study is assay of four VEGF isoforms expression in breast cancer tumor samples.

Materials and Methods: 25 breast cancer tumor samples and 25 health samples were used in this study, mRNA was extracted from each sample and then cDNA was made. The expression of four isoforms VEGF121, VEGF165, VEGF183 and VEGF189 was measured by real time reverse transcription PCR (RT-PCR) and gel electrophoresis.

Results: Among the four isoforms, VEGF165 and VEGF 121 had maximum and VEGF 183 and VEGF 189 had minimum expression level in all samples. The total expression level of VEGF had a significant increase in tumor samples in comparison with the control samples (4/6, p<0.01).

Conclusion: There is a significant relation between the VEGF over expression and breast cancer tumor formation, which it can be used as a prognosis marker of breast cancer in future.

Effect of Parenteral Calcitonin on Cortex Healing up & Accidents of Distal Radius’ Fracture in Women with More Than 60 Years Old Referring to Arak Valiasr Hospital

Abbas Alimoradian

Background: The distal radius’ fracture is one of the most prevalent fractures in menopause women. Because of no delisery of an exact dosage by inhalation calcitonin, the effect of a systemic form such as parenteral on healing up of this area was investigated.

Materials and Methods: This study was a prospective cohort on 44 women 60 years-old with distal radius’ fracture divided into 2 equal groups of control and treatment (parenteral calcitonin, just after operation, 100 I.U/day during 10 days consecutive of each month for 3 months). The rate of improvement, hand ability and stiffness of joints of hand fingers and wrist according with physical examination, time of cortex healing up, level of alkaline phosphatase, calcium and phosphor serum levels and rate of osteoporosis accord to radiography indexes.

Results: The rate of osteoporosis and pain was less tham that of control group. Prevention of osteoporosiss and the cortex healirg was significaltly more than that of control group. The hard activity (Mayo Wrist index) and ability of ceetching of objects was better in calcitonin group. There were not any significant effects of calcitonin on level of alkalire phosphatose, calcium and phosphor us serum levels.

Conclusion: Calcitonin especially with calcium supplements can accelerate the improvement of distal radius’ fracture. Then patients will tolerate fewer problems at convalescence period.

Effeet of Aquatic Aerobic Training on Serum A and B Apoproteins and Lipoproteins in Obese and Normal Weight Menopause Women

Maryam Koushkie Jahromi

Background: Regarding the importance of prevention of cardiovascular disease during menopause the purpose of present study was evaluating the influence of eight weeks progressive aquatic exercise on serum Apoproteins of A and B and lipoproteins in obese and normal weight menopause women.

Materials and Methods: This was a semi-experimental study in which 29 menopause women from Isfahan (age: 57.4 ±4.68 years) voluntarily participated in it. According to body mass index (BMI), participants were divided to obese (n=15, BMI= 30.21 ±3.90) or normal weight (n=14, BMI=22.44 ±2.25) groups. Subjects of both groups participated in 8 weeks aquatic exercise, three times a week, by progressive intensity of 50 to 70% of maximal heart rate and duration of 45 minutes.

Results: Findings of study indicated a significant influence of exercise on VLDL, Apo A and B and ApoB/ApoA in in obese group. In normal weight group, exercise caused significant changes in LDL, VLDL, Apo A and B and ApoB/ApoA, but there was no significaut difference between groups in none of study variables.

Conclusion: According to our findings, progressive aquatic aerobic exercise induces similar reduction of some cardiovascular risk factors especially ApoB and ApoB/ApoA and increasing ApoA in obese and normal weight menopause women.

Analysis of Glu298Asp eNOS Gene Polymorphism in Patients with Gastric Cancer in the Guilan Population

Zivar Salehi

Background: Nitric oxide is synthesized in endothelial cells by eNOS and acts as a pleiotropic regulator involved in carcinogenesis. Most gastric cancers develop from stomach epithelial cells therefore, NO may play a role in their development. Polymorphisms of eNOS have been shown to be associated with cancer susceptibility. In the present study, we investigated the association of the eNOS genotypes with gastric cancer risk in Guilan Population.

Materials and Methods: In this case-control study, we analyzed the Glu298Asp polymorphism of eNOS in 87 patients with gastric cancer and 90 healthy controls. The genotyping of eNOS polymorphism was performed using polymerase chain reaction–restriction fragment length polymorphism assays. All statistical analyses were conducted by the MedCalc statistical software.

Results: No association between the eNOS genotypes and gastric cancer risk was found. Among the 87 patients, 45 had Glu/Glu, 38 were Glu/Asp, and 4 were Asp/Asp. In the control group, 44 had Glu/Glu, 40 were Glu/Asp, and 6 were Asp/Asp. We found no significant differences in allele and genotype frequencies between control and patient specimens.

Conclusion: We found that there was no association between this polymorphism and gastric cancer risk. Results suggest that eNOS polymorphism may play a role in inhibition of gastric cancer. However, larger population-based studies are needed for clarifying the role of eNOS polymorphism in gastric cancer.

Antinociceptive Effect of Brassica Juncea on Peripheral Neuropathy Induced by Diabetes in Rat

Abdolkarim Hosseini

Background: Diabetes mellitus is a common metabolic disorder that is associated with many complications such as peripheral neuropathies. This study was designed to investigate the effect of Brassica juncea on peripheral neuropathic pain in diabetic rat.

Materials and Methods: In this experimental study, male Wistar rats (250±20 g) were divided randomly to normal and diabetic (control, B. juncea extract at doses 150 and 300 mg/kg) groups. Experimental diabetes was induced by the intraperitoneal injection of streptozotocin (60 mg/kg). After four weeks treatment, animals were subjected to Tail-flick test to evaluate pain threshold and data were analyzed using SPSS software. Statistical significance was considered at p<0.05.

Results: The results of this study showed that diabetes significantly decreased pain threshold in the rats. Also diabetes-induced hyperalgesia was significantly decreased by treatment with extracts of B. juncea at doses 150 and 300 mg/kg (p<0.05 and p<0.01, respectively).

Conclusion: Our observation indicates that B. juncea could be a therapeutic option for control and treatment of hyperalgesia associated with diabetic neuropathy in diabetic patients. However, further studies are required to elucidate the antinociceptive effects of B. juncea.

Determining the Effect of Intravenous Ondansetron in Pereventing Hypotension in Patients Under Elective Cesarean Section

Bita Malekian Zadeh

Background: Spinal anesthesia is an efficient method of providing intra operative analgesia and a safe alternative to general analgesia in many cesarean patients. Despite its advantages, SA is not free from adverse effects, which include unwanted cardiovascular events, in most cases: hypotension and bradycardia. Ondansetron is a 5HT3 receptor antagonist, with known efficacy on preventing nausea and vomiting. Maybe ondansetron given intravenously attenuates the fall of blood pressure and heart rate, by 5HT3 blocking in vagal nerve endings and effect on BJR.(Bezold jarish Reflex).

Materials and Methods: In this clinical trial 102 healthy pregnant women that were candidate for elective cesarean in hamedan fatemieh hospital during 3 months in 1390, studied. They were randomized into 2 groups: the ondansetron group, n= (51) received (4miligram) ondansetron intravenously before performing spinal anesthesia, and placebo group n= (51): received 2cc sterile water before spinal anesthesia. Spinal anesthesia was performed with hyperbaric bupivacaine (0.5%) 10 mg and sufentanil (5 µg) BP and HR were measured and recorded before and after anesthesia immediately. If hypotension happened, ephedrine 5- 10mg injected. Itching and nausea recorded every 10 min during operation by observation and question.

Results: There were no significant differences in SBP, DBP, MAP, HR and itching in both groups. Nausea and vomiting ,and mean consumed ephedrine was siginificantly different in both groups.(p=0.001, p=0.009).

Conclusion: Ondansetron given intravenously with antiemetic dose (4miligram), decreases mean consumed ephedrine and nausea and vomiting after spinal anesthesia, but doesn't have an influence on BP, HP and pruritus

Prevalence of Obsessive-Compulsive Disorder in Pediatric Patients with the Daytime Frequency Syndrome of Childhood or Pollakiuria

Ali Khosrobeigi

Background: Some children have abrupt onset of severe urinary frequency, voiding as often as every 10-15 min during the day, without dysuria, UTI, daytime incontinence, or nocturia. The most common age for these symptoms to occur is 4-6 yr, after the child is toilet trained, and the vast majority are boys. This condition is termed the daytime frequency syndrome of childhood or Pollakiuria. The condition is functional no anatomic problem is detected. The symptoms occur often just before a child starts kindergarten or if the child is having emotional family stress-related problems. OCD is a chronically disabling illness characterized by repetitive, ritualistic behaviors over which the patient has little or no control. OCD has a lifetime prevalence of 1-3% worldwide, and as many as 80% of all cases have their onset in childhood and adolescence. The purpose of this study was to investigate the relationship between OCD and Pollakiuria.

Materials and Methods:In this case-control study, we evaluated (152) children aged 6-18 years old who were visited in the pediatric clinics of Amir-Kabir Hospital, Arak, Iran. The control group considered of (76) healthy children and the case group included (76) age and sex matched children with Pollakiuria. Then, the children’s behavioral status was evaluated using the children’s Yale-Brown Obsessive-Compulsive Scale (C-YBOCS). The C-YBOCS is helpful in identifying children with OCD. The data was analyzed using descriptive and analytical statistics in SPSS-16.

Results: OCD was detected in (5) case (6.6%) with Pollakiuria and (8) controls (10.5%). The difference in OCD was not significant (p-value 0.282) between the two groups.

Conclusion: OCD isn’t more common in Pollakiuria versus non-Pollakiuria children. It is recommended to conduct a study with higher sample volume in order to detect the relationship between OCD and Pollakiuria.