[Polyethylene glycol versus lactulose in chronic pediatric constipation]

Introduction: Constipation is one of the most prevalent causes of abdominal pain in pediatrics, with no underlying pathology. It is defined as functional constipation in 95% of cases evaluated. This study was designed to compare the therapeutic effect of polyethylene glycol [PEG] and lactulose in treating chronic functional constipation in children

Materials and Methods: In this randomized, double blind clinical trial, patients were classified into two groups: lactulose [n=65] and PEG [n=63]. During an eight week period, patients were either treated with an average of 3.5 g/day [PEG] or 7 g/day [lactulose]. Successful treatment was defined as defecation [painless and soft, or normal] three times or more per week. Analysis was performed by calculation and comparison of the success rate in both groups, followed by reporting the relative risk and number needed to treat [NNT]

Results: Response to treatment in the second week was significantly higher in the PEG group when compared with the lactulose group [P<0.0001]. There was a significant difference in the response rate between both groups in the 4th and 6th weeks [P<0.0001]. In the 8th week all patients in the PEG group were treated successfully, whereas there were five [7.7%] cases who did not respond in the lactulose group

Conclusion: These results have shown that a four week treatment period with PEG [3 g/day] lead to a response rate of 87% in children, in comparison with lactulose [7 g/day] which needed at least eight weeks of treatment

Recurrent ameloblastoma of the mandible: two cases report

Six cases of ameloblastoma were treated by enucleation and peripheral osteoctomy during 1992-2001. Histologically, desmoplastic reaction, epithelial cells with severe fibrous, and keratin formation in the acanthomatous follicles were seen. The disorder was in the mandible in five cases, and in the maxilla in one case. Two cases were male and four were female, and the age at surgery was between 20 to 28 years. For all cases, a uniform surgical protocol was applied. The lesions were removed primarily by enucleation with peripheral ostectomy. There was recurrence in two cases. An enbloc resection was done for the first case and a radical resection with titanium bone plate reconstruction for the second case. The patients did not have any problem, bone grafting being recommended for the first case as soon as possible. Based on our knowledge, the procedure was successful in approximately 70% of cases, but more radical surgery methods may be recommended in the initial surgery

Comparison of ibuprofen, celecoxib and tramadol in relief of pain after extraction of mandibular third molar teeth

The ultimate goal of oral health care providers is not only to restore function, but also to relieve pain. This study was undertaken to compare the analgesic efficacy of ibuprofen, celecoxib and tramadol in patients after extraction of mandibular third molar teeth. Forty one patients entered our study and were randomly divided into three groups. Group 1 received ibuprofen [600 mg] and groups 2 and 3 received celecoxib [200 mg] and tramadol [100mg] respectively, 8 hours and one hour before extraction of mandibular third molar teeth. The patients reported their pain severity in a questionnaire four and eight hours after the tooth extraction. To evaluate the side effects of the drug, the patients were asked to report if they had any problem using the drug. Fourteen patients received ibuprofen, 15 celecoxib and 12 tramadol for relief of pain. The pain severity in ibuprofen group, 4 and 8 hours after tooth extraction was less than celecoxib, and was less in these two groups when compared to tramadol group but no significant difference was found between the three groups. No undesirable side effects were reported in ibuprofen and celecoxib groups, but side effects such as headache, nausea, vomiting, oral dryness, drowsiness, tremor and vertigo were observed in the tramadol group. All patients who used tramadol were not satisfied from the drug while it had disturbed their daily activities. Regarding the very little side effects of celecoxib and its desirable analgesic effects, it can be administered as one of the analgesic drugs of choice in dentistry

Deletion and testicular expression of DAZ [deleted in azoospermia] gene in patients with non-obstructive azoospermia

Deletions of the DAZ [deleted in azoospermia] genes within the human Y chromosome's AZFc region are the most common cause of spermatogenesis failure. These deletions are usually assessed by analyses of genomic DNA extracted from peripheral leukocytes. DAZ genes are expressed in male germ cells. In this prospective study, we investigated DAZ expression and deletion in 102 consecutive infertile men presenting with non-obstructive azoospermia in Avesina Research Institute, Tehran, Iran during 2005-6. In this prospective study, we extracted genomic DNA from peripheral blood leukocytes for detection of DAZ deletions and testicular biopsies for histopathological assessment and analyses of DAZ expression level by reverse transcription polymerase chain reaction. DAZ levels were normalized to expression of the housekeeping Phosphoglucomutase 1 gene. In four out of 102 patients [3.9%], we found DAZ deletion. DAZ expression was observed in 60 [61.2%] of 98 other patients. Expression was not detected in patient with Sertoli cell-only syndrome, but observed in 37 of 40 [92.5%] patients with maturation arrest and 20 of 26 [76.9%] with hypospermatogenesis. The absence of DAZ expression could result in quantitative reduction of germ cells and might be observed despite of normal genomic DNA constitution. We recommend to check DAZ testicular expression and genomic DNA deletion, in non-obstructive azoospermia. This is more recommended to avoid transmission of genetic abnormalities which might lead to infertility in male offspring, when assisted reproductive techniques [ART] are performed

Expression of synaptonemal complex protein 3 [SYCP3] m RNAin the testis: a molecular marker for spermatogenesis in azoospermic men

Men with unexplained infertility and azoospermia are often observed in the context of genetic defects. The expression of a wide variety of genes is developmentally regulated during human meiosis. Synaptonemal Protein 3 [SYCP3] gene, located on chromosome 12, encodes a DNA-binding protein as the structural component of the synaptonemal complex,which mediates the synopsis or homologous pairing of chromosomes during meiosis. Absence of SYCP3 in mice may lead to male infertility as well as female sub-fertility. SYCP3 expression analysis could be a tool for the prediction of human spermatogenesis progression, especially in infertile men. SYCP3 mRNA expression in testicular samples of 110 patients with non-obstructive azoospermia were studied in Avesina Infertility Clinic in Tehran, Iran during 2005 and early 2006. Semi-quantitative nested reverse transcriptase-PCR was employed in order to find the strength of gene expression. Using histopathological scoring for all samples, the expression level of SYCP3 during spermatogenesis was also evaluated. Testicular SYCP3 mRNA expression was observed in 67 patients [60.9%]. The expression level correlated with the degree of spermatogenic failure [p<0.0001]. While this gene had been expressed in patients with hypo-spermatogenesis and maturation arrest, a lack of expression was seen in those with spermatogonial arrest, Sertoli cell-only syndrome and testicular atrophy. These data indicate that SYCP3 is expressed in the human testis and it is restricted to germ cells. Our findings, in association with those obtained in experimental animals, show that lack of SYCP3 expression may have negative effects on spermatogenesis and male fertility. SYCP3 gene expression may help detect specific spermatogenesis stages in conjunction with histopathological findings

[ efficacy of DOTS strategy in treatment or failure of treatment in respiratory Tuberculosis]

Background and Objective: about 1.3 billions people are infected with Tuberculosis [TB] all over the world. There is a close relationship between the quality of TB treatment and the rate of drug resistance. The recurrence epidemy of TB and increased resistance to some drugs was the basis for the WHO to suggest the directly observed short course treatment strategy or [DOTS] strategy, for the TB patients

Materials and Methods: this research was a cohort study and aimed to evaluate the epidemiological finding, the clinical basis and strategy of DOTS on improving, and prevention from failure of treatment and was compared with non-DOTS procedure. Sample population were total of 260 smear positive patients that had been under study for a period of 2 years [1999-2000]. All of the patients were new cases. SPSS software and Fisher exact test was used to analyzed the data

Results: the rate of treatment failure in DOTS strategy in the beginning of 5th month was 1.7%, but in the control group the failure in the same period was 7.3% [P<0.05]

Conclusion: this study indicated that the DOTS strategy is substantially increasing the success rate of TB treatment