مجله دانشکده پزشکی اصفهان
پیاپی 514 (هفته دوم فروردین 1398)

Diarrhea is one of the most common causes of death in children, and there is also a direct relationship between low level of zinc and diarrhea. The purpose of this study was to evaluate the effect of zinc sulfate on acute diarrhea in children, in terms of the socioeconomic status of parents in Isfahan City, Iran. In this clinical trial study, 82 children with acute diarrhea, referred to clinics affiliated to educational centers in Isfahan, entered the study according to the criteria for entering socioeconomic level (low or high). The intervention group (38 cases) received zinc sulfate according to the age group, and the placebo group was under treatment with placebo same as the other group. The data of this study were compared between the two groups. The mean recovery time in the intervention group was significantly lower than placebo group (P < 0.050). Moreover, in the follow up of 5 and 14 days, the incidence of diarrhea, outpatient visits, and hospitalization in the intervention group was significantly lower than placebo group (P < 0.050). In follow up of 1 and 3 months, the incidence of diarrhea and hospitalization was significantly lower in the intervention group compared to placebo group, too (P < 0.050). The use of zinc sulfate in patients with different socioeconomic levels is a highly effective, safe, and non-adverse drug supplement to reduce the incidence, severity, recovery period, outpatient visits, and hospitalization due to diarrhea.

Laparoscopic cystectomy for ovarian endometrioma, despite its high usefulness, reduces ovarian reserve; so, several methods are proposed to reduce this problem. This study was designed to evaluate the effect of vasopressin injection in laparoscopic cystectomy on ovarian reserve in patients with unilateral endometrioma. In this clinical trial study, 66 women with unilateral endometrioma undergoing laparoscopic cystectomy were divided into two groups of 33. The first group received vasopressin via injection, and the second group did not received any drug via injection. Anti-Muller hormone (AMH) level before and 6 months after surgery as well as hemoglobin level before and 6 hours after surgery were measured and compared. The mean AMH level before and after the intervention was 3.43 ± 2.46 and 2.67 ± 1.5 ng/ml (P = 0.070), and 3.49 ± 2.48 and 1.61 ± 1.79 ng/ml (P = 0.040) in intervention and control groups, respectively. The level of AMH reduction in vasopressin injection group was lower than control group. The mean hemoglobin level before and after treatment was 11.97 ± 1.12 and 11.29 ± 0.97 (P = 0.69) and 11.5 ± 1.79 and 10.23±1.99 g/dl (P < 0.001) in intervention and control groups, respectively, and blood loss in vasopressin injection group was lower than control group. It seems that vasopressin injection reduce blood-loss, ovarian damage, and the damage to ovarian reserve during laparoscopic cystectomy for ovarian endometrioma.

Thyroid carcinoma is the most common endocrine cancer. There are several methods for determining the mutation of genes, one of them is random amplified polymorphic DNA polymerase chain reaction (RAPD-PCR). This study aimed to compare DNA changes in the genome of thyroid hyperplasia, thyroid papillary carcinoma, and healthy tissues using RAPD-PCR. In this case-control study, 49 patients with papillary carcinoma and thyroid hyperplasia which had normal, hyperplasia, and papillary carcinoma tissues of the thyroid gland were randomly selected. Then, the primer pattern of the sequence 5'-AAGAGCCCGT-3' containing 10 pairs base was evaluated and compared between the tissues. The prevalence of 370-bp pair base band observed in normal, hyperplasia, and pylori thyroid carcinoma tissues was 6.1, 53.1, and 89.8 percent, respectively, and there was a significant difference between the three tissue types (P < 0.001). There was also a significant difference between normal tissue with hyperplasia and papillary carcinoma of the thyroid and between hyperplasia with thyroid carcinoma in this regard (P < 0.050). It seems that using RAPD-PCR is a suitable method for the detection and differentiation of normal, hyperplasia, and papillary thyroid carcinoma cells. Bat notice to the limitation of the study, more investigation in this field is recommended.

The development of pulmonary complications after breast radiotherapy is still controversial. These complications might result in temporary or permanent damage to the lung. The aim of this study was to evaluate changes in the lung volume parameters (LVP) and to assess their relation with mean dose and the percentage of the lung receiving 20 Gy (V20) in the upper and lower lobes of the lung. Twenty three patients with breast cancer who underwent locoregional radiotherapy were selected. Six thermoluminescence dosimeters (TLDs) were distributed uniformly throughout the chest phantom to assess the accuracy of lung dose was calculated using treatment planning system (TPS). Body plethysmography was performed before, and 3 and 6 months after radiotherapy. Changes in LVP showed a decrease 3 months, and a slight improvement 6 months after radiotherapy. The mean percentage decrease in LVP was 0.64% and 0.34%for each Gy increase in mean lung dose (MLD) and for each percentage increase of V20, respectively. There was no significant correlation between changes in LVP with respect to age and concurrent hormonal therapy. The minimum and maximum calculation errors of the TPS were 1.8% and 4.2%, respectively. This study showed that changes in LVP, 3 and 6 months after radiotherapy did not cause pulmonary disease, and the TPS dose distribution was reasonably accurate.

Nowadays, various methods are used to determine the difficulty of laryngoscopy. In this study, we aimed to compare the performance of the acromioaxillosuprasternal notch index (AASI) with the old anatomical criteria of the head and neck in predicting difficult laryngoscopy in pediatrics surgical procedures requiring tracheal intubation under general anesthesia. In this cross-sectional study, 379 children undergoing general anesthesia and intubation were divided into two groups based on easy (grades 1 and 2) and difficult (grades 3 and 4) laryngoscopy based on the score of Cormack-Lehane. The systems of thyromental distance, the ratio of height-to-thyromental distance (RHTMD), Upper lip bite test (ULBT), the circumference of the neck, and AASI were assessed and compared in predicting the difficulty of laryngoscopy. The laryngoscopic view was difficult in 48 patients (38 with grade 3 and 10 with grade 4). There was no significant difference between the two types of difficult and easy laryngoscopy based on thyromental distance, neck circumference, RHTMD, and AASI methods (P > 0.050); but there was a significant difference between two easy and difficult laryngoscopies based on ULBT and MMT methods (P < 0.050). The sensitivity of RHTMD, AASI, and neck circumference was 31.2, 47.9, and 51.1 percent, respectively, and specificity of them was 52.7, 45.6, and 48.9 percent, respectively. The neck circumference and then ASSI method is better than the RHTMD method, and the MMT method is better than the ULBT method in order to determine difficult laryngoscopy in children.