Acta Medica Iranica
Volume:56 Issue: 9, Sep 2018

ystemic Lupus Erythematosus (SLE) is a multi-organ autoimmunity, which could be seen in young adults; while pediatric SLE (pSLE) refers to children below the age of 10 years is less frequent. Few pSLE cases experience very early-onset form of the disease in the first year(s) of life (1). Early onset presence of the disease raises the probability of genetic etiology, especially if patients show the phenotype in the first year of life. Monogenic form of SLE has already been reported. Among them, complement deficiencies, including C1q, C2, and C4 deficiencies are one of the most frequent monogenic cause of pSLE (2,3). Complement proteins such as C1q have important role in the clearance of apoptotic debris, while cell debris maintains in the absence of these proteins, which can initiate an autoimmune response (4).

Matrix metalloproteinases (MMPs) are a group of zinc-dependent proteolytic enzymes that play a role in extracellular matrix (mainly collagen) degradation and remodeling. MMPs are not only causes of the increase rewarding effects of drugs, but also act as pro-addictive agents. In this research, 22 morphine and 20 methamphetamine-dependent patients included and their serum levels and activity of MMP2 and 9 were assessed by ELISA and gelatin zymography and compared with those of 23 healthy individuals as a control group. Our findings showed a significant increase in serum levels and activity of MMP-2 in opium and methamphetamine groups in comparison with the control group. Moreover, unlike MMP-2, serum levels and activity of MMP-9 in both case groups found to be decreased. This study showed that long-term abuse of opium and methamphetamine changes the activity and serum levels of MMP9 and MMP2. The effects of methamphetamines and opium are associated with an increase in extracellular dopamine levels in the brain, achieved by facilitating the release of dopamine from pre-synaptic nerves. Our findings showed that serum levels and activities of MMP-9 and MMP-2 could be considered as alternative valuable biomarkers from those investigated of pro-addictive or anti-addictive factors in dependent patients.

Traumatic Brain Injury (TBI) is generally recognized as a major risk factor for memory impairments and Alzheimer’s disease (AD). In this experimental study, our aim was to investigate the ameliorating effects of luteolin (LUT) on the memory impairments, oxidative stress, and histopathological changes induced by TBI in rats. The adult male Wistar rats were randomly divided into six groups including: Control (Co), sham, TBI, TBI+LUT (10 mg/kg), TBI +LUT (25 mg/kg), TBI +LUT (50 mg/kg). To evaluate the protective effects of LUT on the memory of the rats, passive avoidance test using shuttle box was performed. Finally, the animals were anesthetized, and the brain tissues were removed and analyzed for oxidative stress parameters. Using histological methods, dark neuron production was also evaluated. There was a significant decrease in the latency time to enter the dark compartment in passive avoidance test in TBI animals. This latency time was significantly increased in TBI+LUT (25 mg/kg) and TBI+LUT (50 mg/kg) groups along with significant increases in superoxide dismutase and catalase activity in the hippocampal zone and a decrease in malondialdehyde (MDA). The number of dark neurons in the hippocampus decreased with all three doses of LUT. In the present study, LUT showed neuroprotective effects, improvement in learning and reduction in memory impairment induced by TBI in rats. Protection against oxidative stress might be a possible mechanism behind these effects. Further works are necessary to work out if LUT is potentially a suitable therapeutic candidate for neural disorders.

Measurement of hematological parameters and their reference ranges play an important role in the diagnosis and treatment of many infectious diseases and cancers. However, there are marked differences in the reference ranges between developing and developed countries. The aim of this study was to establish reference ranges of hematological parameters. This cross-sectional study was conducted in patients visiting Noor Eye Hospital who had no systemic diseases. In the lying position, blood samples were collected in two test tubes (Becton Dickinson Ltd, UK) using the Venoject method. EDTA-containing blood samples were used for complete blood count and differential leukocyte count using a cell counter (Nihdon Kohden Celltac E, Japan). Descriptive statistics, t-test, and ANOVA were used for data analysis. The data of 46,595 individuals were analyzed of whom 47.3% (n=22,042) were men. The mean (95% confidence interval) of white blood cells (WBC), red blood cells (RBC), platelet, and Hemoglobin (Hb) was 6.68 (6.66-6.69), 4.83 (4.83-4.84), 238.40 (237.87-238.93), and 14.29 (14.27-14.30), respectively. There was no difference in hematological parameters between male and female subjects. Except for the platelet count that was higher in individuals below 18 years than those 18-64 years and ≥65 years, other parameters had no relationship with age. Normal values of hematological parameters in the Iranian population are similar to the Middle East and African countries but below standard reference values. Except for the platelet count that decreased with age, there was no significant difference in hematologic and immunologic parameters between age and sex groups. Considering the difference between our results and standard reference values, we suggest that normal values be determined locally for each country.

Cranial parameters and cephalic indices are used to evaluate the racial and gender differences. The aim of this study was to assess the cephalic indices, to classify the type of cranium and to determine the relationship between the horizontal cephalic index and cranial parameters among Iranian medical students. This study was done on 200 medical students (100 males and 100 females) with an age range of 18-30-year-old. Head length, head breadth, and auricular height were measured by using a standard spreading caliper. Then cephalic indices were calculated for the classification of cranial type. The linear regression was used for examining the relationship between the horizontal cephalic index and head length, head breadth and auricular height. The results of this study showed that the mean of the horizontal, vertical, and transverse cephalic index in total students were 83.51±6.85, 85.58±5.85 and 102.77±6.35 cm, respectively. According to this result, the predominant head shapes in total students were brachycephalic, hypsicephalic and acrocephalic types. In this study, there was a strongly negative correlation between horizontal cephalic index with head length (r=-0.744, P=0.000), moderate positive correlation between horizontal cephalic index with head breadth (r=0.512, P=0.000) and weakly negative correlation between horizontal cephalic index with auricular height (r=-0.205, P=0.004). The data of the present study can be beneficial in craniofacial reconstruction, clinical diagnosis, and forensic applications.

Cancer is one of the leading causes of death worldwide and among Iranian population; cancer is the third important causes of death. It is a critical issue to identify sex and age group difference of cancer pattern for planning and management of cancer patients, therefore the aim of present study was to examine sex and age difference in cancer incidence during 2003-2008 in Iran. The National Cancer Registry (NCR) reports from 2003 to 2008 have been applied to test trend of cancer incidence and illustrating sex-age disparity of most common cancers in Iran. Direct adjustment method was used for computing the age-specific rates (ASRs) and Cochran-Armitage tests for trends were used to test statistical significance of cancer incidence rate in both genders during 2003-2008. Our findings indicated that male and female incidence rate is increased from 64.2 to 117.5 and from 50.1 to 105.8, respectively during 2003-2008 (P for trend <0.001). Highest Age-Specific Rate of cancer in male was for stomach cancer (ASR=12.8), beside of skin cancer and in female was for breast cancer (ASR=33.2). Highest incidence rate of cancers was found in people aged 80-84 years in both genders. In elderly people, incidence rate of cancer was higher in male than female. The observed sex-age disparity of common cancers in this study indicated that male cancer of stomach and bladder and female cancer of breast and colorectal can be targeted in cancer control and prevention programs are required to reach remarkable reduction of cancer burden in Iran.

The main challenge for training in cosmetic dermatology is the difference in the attitudes of residency programs and residents about the necessity and amount of education during the residency period. A national online survey conducted between September 6th and November 21st, 2017. Residents, members of the Iranian Board of Dermatology, faculty members and program directors (PDs) were asked to participate in the survey.174 participants from 12 residency programs participated in this study and the response rate of residents, professors, and Dermatology Board Directory Members (Boardmans) and PDs was 89.8%, 61.7%, and 81.8%, respectively. Residents declared greater tendency towards practicing medical dermatology (mean score, 5.165±0.8335) over the five years after graduation than that of was perceived by professors (4.043±1.2988), and Boardmans and PDs (4.059±1.0290) (P˂0.001). The first residents’ priority was practicing in medical dermatology (5.165±0.8335) during 5-years after graduation. However, professors (5.261±0.8282) and Boardmans and PDs (5.176±0.7276) predicted residents' first priority would be practicing cosmetic dermatology (P˂0.001). Forty one (60.3%) of the professors, Boardmans, and PDs agreed or strongly agreed that residents’ desire to learn more about cosmetic procedures resulted in their decreased interest in learning medical procedures (P=0.18). Medical dermatology is still clearly the basis for training in residency programs,and even for residents who have a high tendency to practice cosmetic dermatology, there is a strong tendency to work in the field of medical dermatology as well.

Defects in medical records is a common problem in many hospitals of Iran, especially emergency departments. This study was conducted to evaluate and establish a continuous quality improvement (CQI) system for improving the quality of patient data recording in the emergency department. This clinical audit was performed on the medical records of the patients discharged from the emergency department of Jiroft, Imam Hospital in 2017. Evaluations were conducted before and one month after an intervention entitled “data recording quality improvement.” Data registration rate by the medical staff was 73% before and 84% after the intervention. There was no marked difference in the quality of data recording in in-patients before and after the intervention. Regarding the establishment of a CQI system, the data registration rate by the medical staff of the emergency department improved significantly after the intervention.

The nursing profession generates a large number of documents, and despite a number of terminology standards in existence, lack of interoperability in process and data structure still persists. The purpose of carrying out this study was to develop an integrated, comprehensive structure of nursing process as a domain information model which could be suitable for message development which potentially can be used when implementing clinical information software. We present phases of nursing process modeling, followed by mapping the resultant model to the HL7 Reference Information Model, generating a nursing domain message information model. Also, reviewing the Clinical Document Architecture in relation to the nursing process, we present our proposal for changes required to its object model for better support of nursing documents.

A 25-year-old female known case of end-stage renal disease was admitted with chief complaints of headache, dizziness, and vomiting after undergoing her last dialysis seven days prior to her admission and gradual vision loss from 2 days after the onset of her headache. Ocular examination on admission revealed white conjunctiva in the left eye without a pupillary response to light. The ophthalmologic evaluation showed severe retinitis with no fundus change in the left eye. The high intraocular pressure was documented on multiple occasions reaching a peak of 45 mm/Hg. Based on the imaging of the left eye and the clinical presentation of retinitis, the patient was diagnosed with Cytomegalovirus (CMV) retinitis.

Oropharyngeal lymphomas are uncommon but most frequently arise in the Waldeyer’s ring, which is the second most common site for extranodal lymphomas after the gastrointestinal tract. Non-Hodgkin’s lymphoma of the Waldeyer’s ring is a relatively rare entity, and the palatine tonsil is the most frequently involved site. A 72-year-old woman presented with a sore throat who had not responded to routine treatment. On physical examination, a smooth non-tender mass was observed in the left palatine tonsil. Routine laboratory tests were normal. Computed tomography (CT) scan revealed tonsillar hypertrophy and CT images in other areas were also normal. Tonsillectomy was done with a tentative diagnosis of lymphoma. Histological examination confirmed a diagnosis of non-Hodgkin’s lymphoma diffuse large cell type of B phenotype. A combined treatment consisting of chemotherapy and radiotherapy leads to a satisfactory outcome in patients with this uncommon neoplasm, which tends to present at an early stage and to have a favorable prognosis.