Shiraz Emedical Journal
Volume:9 Issue: 2, Apr 2008

Glucose or N-Acetylglucosamine induce similar filamentous growth and a specific calcium and magnesium-dependent intracellular glycoprotein pattern in C. albicans at 37 °C in vitro. Both filament growth and its associated glycoprotein pattern are inhibited by calcium ions. The above inhibition can be reversed by magnesium ions, though only in N-Acetylglucosamine- but not in glucose-treated cells. Our data show that in contrast to glucose, N-Acetylglucosamine more than being only a carbon source, it is a key factor for filamentous growth and intracellular protein glycosylation to occur, and thus, it may effect the interaction of C. albicans with its host in a calcium- and magnesium-dependent manner

Mississippi has one of the highest stroke mortality rates in the nation. This paper present results of 2005 and 2006 surveys undertaken in an intervention and control county in rural Mississippi. A random-digit-dial (RDD) telephone surveys were conducted on adults 18 and older sampled from the civilian, non-institutionalized populations of Warren (control) and Washington (intervention) counties before and after implementing a 6-month long stroke awareness educational campaign in Washington County. The analyzed results indicate that response rates to several of the questions increased after the intervention in Washington County, the results of this small sample survey do not show sufficient evidence to support any effect of the intervention. A significant lesson learned from this effort is that a more specific target population must be selected for intervention, and much tailored messages and appropriate media must also be identified and implemented.

Recently polymerase chain reaction technique is being used for detection of leishmania DNA in clinical samples of patients suspected with visceral leishmaniasis. Since many of the patients are children and also suffering from anemia and leucopenia, there is a need for the development of a DNA extraction method using small amount of clinical samples. In the present study, a simple and rapid method was introduced for performing the DNA extraction procedure which was capable of removing inhibitors from the whole blood samples and of providing the appropriate DNA for Leishmania PCR amplification. EDTA-peripheral blood specimens were collected from healthy volunteers and frozen at –20°C. The thawed specimens were spiked with a definite number of L. infantum promastigotes. Using in house made lysis buffer and boiling, a DNA extraction method was developed for the purification of Leishmania genome from 500 µl of blood samples. The developed method was then compared with the classical standard method to obtain the highest sensitivity for the diagnosis of visceral leishmaniasis. The sensitivity of the PCR for the developed method was 10 copies of L. infantum DNA per reaction tube. When clinical samples collected from patients with a definite diagnosis of visceral leishmaniasis were used, no false negative was demonstrated with newly developed method. Since hazardous materials such as phenol-chloroform are not used during extraction procedure, it seems to be much safer than the standard phenol-chloroform method. However, the use of small amount of sample (i.e. 0.5 ml) and removal of PCR-inhibitors from the whole blood are the major advantages of our developed DNA extraction method.

Although rare,the spleen is the third most common location of hydatid disease after liver and lung. The aim of this study was to analyze the long-term outcome of surgical treatment of patients with splenic echinococcosis comparing spleen-preserving surgery with splenectomy. During a period of 10 years (1996-2006), 20 patients with splenic echinococcosis entered our study as test and control groups. In our series the spleen was the only organ involved. Splenectomy was performed in the control group and spleen preserving drainage of cyst in test group. There was no significant difference between the splenectomy and spleen-preserving groups concerning median hospital stay, postoperative complication rate and recurrence. (p<0.5) The median follow-up in 15 patients was 52 (range 6-300) months. In the present series it was possible to preserve the spleen affected by hydatid cyst without significant increase of recurrent echinococcosis.

The reported incidence of post mastectomy pain syndrome following surgery for breast cancer varies considerably with reports from as low as 4-6% to as high as 100%. This pain can be severe enough to interfere with sleep and performance of daily activities. Post mastectomy pain syndrome is a neuropathic pain condition that can follow surgical treatment for breast cancer. The purpose of this study is to evaluate the effect of stellate ganglion block with gabapentin on post mastectomy pain. Sixty patients referred from department of oncology and surgery to pain clinic were allocated to two groups. In group A stellate ganglion block was performed with 8ml bupivacaine 0.25%. In group B, patients were treated with gabapentin 900mg per day in three divided doses. Drug dose was increased if necessary until eight weeks. Pain score and quality of life were determined. Data were collected before treatment, 48 hours and every 15 days after treatment until three months. Pain scores at 48 hours after treating were higher in group B than group A and lower at one week, one month and three months after treatment which were statically significant. (P<0.001, 0.024, 0.047 and <0.001 respectively) In our study gabapentin was used as an ideal treatment technique for chronic pain following breast surgery.

Citations are an important measure of the quality and content of scientific communications. Since no study regarding the most cited surgical articles from Iran exists, this article aims to identify these top cited articles. The 50 most frequently cited articles in all fields of surgery originated from Iran were identified in database of Scopus in January 2007. The mean number of citations per article was 10. The most cited article received 54 citations, and the least cited article received 4. More than two-thirds of articles were published after 2000. Ophthalmology and urology led the list of the surgical fields, each with 11 articles. A few articles in the field of general surgery were noted. There was not even an Iranian journal appeared on the list. It can be concluded that although the number of citations of Iranian articles is far behind top-cited international articles, the current trend is promising.

Necrotizing fasciitis is uncommon and can be difficult to diagnose. It causes progressive morbidity until the infectious process is diagnosed and properly treated. A delay in diagnosis is associated with a grave prognosis and increased mortality. The main goal of the clinician must be to establish the diagnosis and initially treat the patient within the standard of care. We would like to present a case of 70-year-old gentleman with poorly controlled diabetes, who was diagnosed with type 1 primary necrotizing fasciitis of the neck and present the imaging findings which led to the diagnosis.

A 38 yr-old man was scheduled for laparoscopic cholecystectomy. General anesthesia was selected and induced. About 40 minutes after initiation of laparoscopic surgery a progressive tachycardia and hypertension was noticed. We checked anesthetic machine, O2, inhalational anesthetics and appropriate position of tracheal tube. Then narcotic and muscle relaxant repeated but our efforts were ineffective. The operation ceased and when laparoscope was withdrawing it accidentally touched the anesthesiologist''s hand. It was unexpectedly hot and heat injury supposed. The abdomen was opened immediately. Intraabdominal temperature was abnormally high and visceral organs were reddish and inflamed. After rapid irrigation of abdomen with cold normal saline, tachycardia and hypertension regressed to normal situation and open cholecystectomy was down.