[Efficacy of defroxamine- deferiprone on cardiac function of patients with major thalassemia]

Background and Objective: Deferoxamin is the current "gold standard" chelator in comparison with new chelators. Combined therapy of Deferiprone and deferoxamin reduces the cardiac iron overload in patients with major talassemia. This study was done to evaluate the effect of defriprone-deferoxamine on heart function in patients with major thalassemia

Methods: In this historical cohort study, 8 patients with major beta thalassemia treated by subcutaneous deferoxamine were randomly selected and LVEF [the rate of blood that exited from heart in each beat] and serum ferritin were measeared. The patients were treated by deferiprone [50-100 mg/kg/day] compained with dferoxamine [30-50 mg/kg as 3 times in a week]. In the end of each year, LVEF and serum ferritin of patients were measured

Results: The ferritin level changed from 3243.12 in the first year to 2672.75 mg/kg at the end of third year. The mean of LVEF changed from 71.12% to 64.62 %. The correlation of serum ferritin and LVEF only at the end of third year was significant [P<0.05]

Conclusion: Combined therapy of deferiprone-deferoxamine during 3 years reduces ferritin and LVEF in patients with major thalassemia

[ Qualitative Study on Health Experts' Utilization Pattern of Medical Images]

Introduction: In health sector, image functions as a form of document that can convey a considerable amount of information. Employing this type of information can increase the effectiveness of the performance of medical experts. This study aimed to survey how health experts use medical images in their practice

Methods: This applied qualitative study was carried out in 1392 [2013]. The study population constituted 25 medical experts from 17 disciplines in basic sciences and clinical sciences at Hamadan University of Medical Sciences. Data were collected by means of semi-structured interview and were analyzed based on the Grounded Theory approach

Results: Participants described various advantages for using images. They considered image as a kind of document that can convey a maximum amount of information in a minimum amount of time. These experts considered images as an integral part of medical education especially in the way images can objectify various concepts. Among content and structural features, color attraction and three-dimensional structure of images as well as the attractiveness of the texts were found to be effective in practice

Conclusion: As the experts understand the significance of images as part of medical education and for this reason, they emphasize using them in their teaching, research, and treatment activities

[Medical image retrieval in the web from the perspective of experts in medical sciences: a qualitative study]

Introduction: The medical image as a source of non-textual information has an important role in the field of medicine. Since the quality of life is directly related to health, employing this type of information is effective in improving the practice of health professionals. This study was aimed to survey medical image retrieval in the Web from the perspective of experts in medical sciences

Methods: This qualitative research study was conducted by means of a semi-structured interview with 25 medical experts. The data were analyzed on the basis of the grounded theory approach

Results: According to experts' opinion the following reasons were responsible for the retrieval of medical images on the Web: educational, research, and medical applications of images, instrumental and training role of images, benefits, importance and special characteristics of medical images, and motives such as personal, educational and research interests. Participants of this study used non-technical search engines and technical resources such as medical databases to retrieve these images on the Web. Their methods of recovery consist of browsing, accidental retrieval, purposeless and purposeful search, and diverse search. Experts have mentioned individual, organizational, systemic and technical issues as the most important problems in the area of medical image retrieval

Conclusion: The results showed that image retrieval is important for the experts. Despite numerous difficulties in retrieving images, the image is still the best type of information in the medical profession. To improve physicians' access to and retrieval of medical images, it is recommended to hold training courses for search strategies and retrieval of images

[Investigating the structure of central libraries' websites based on meta tags in medical science universities in Iran]

One of the recommended ways in organizing the information in the websites is the application of Meta Tags. The application of a variety of Meta Tags can affect the precision rate of search engines retrieval. They can also promote the rank of a website. The purpose of the study was to investigate the structure of libraries websites based on Meta Tags in medical science universities in Iran. This descriptive survey was carried out on 31 websites that included 342 web pages. Data was collected by a checklist and analyzed by SPSS. Title meta tags [98.53%] and Charset meta tags [89.47%] among 15 meta tag types had the most usage and refresh meta tag had the least usage. Usage of keyword and descriptive meta tags were 55.6% and 55.2%, respectively. Generally, 100% websites under investigation used one type of meta tags. Title, Charest, Robot, Keyword and Descriptive meta tags received more attention from the designers of central libraries. But Googlebot, Refresh, Expire and cache Meta Tags received less attention. Librarians' participation in creating library websites and the application of meta tags will play important role in electronic information retrieval

[Evaluation of lavandula officinalis extract on lymphocyte proliferation and tumor necrosis factor-aplha production]

Studies have demonstrated that plant extracts have various biological effects including immunomodulatory effect. In the present study, the immunomodulatory effects of Lavandula officinalis on lymphocyte proliferation and tumor necrosis factor alpha cytokine production were investigated. [3H] - thymidine incorporation assay on stimulation of the peripheral lymphocytes with PHA and determination of tumor necrosis factor alpha production was assayed, using LISA method. The herbal extract in a concentration of 50 micro g/ml and lesser, in the presence of mitogen increased peripheral blood lymphocytes proliferation. However, there was not significant effect in concentrations more than 50 micro g/ml. Also, the extract in the concentration of higher than 50 micro g/ml suppressed the production of tumor necrosis factor alpha in the exposed cells. The extract showed immunomodulatory effect by increasing of lymphocyte proliferation in a concentration of 50 micro g/ml and lesser. Also, decreasing in tumor necrosis factor alpha in the concentration of more than 50 micro g/ml was observed. Further studies, should focus on identifying the immunomodulatory mediator of this herbal extract

effect of maternal selenium supplementation on pregnancy outcome and the level of oxidative stress in neonates

Pregnancy is regarded as a condition which is usually accompanied by oxidative stress. This study was undertaken to investigate the effect of maternal selenium supplementation during gestation on the level of oxidative stress in neonates and the pregnancy outcome. In this double-blind trial, 179 primigravid pregnant women in the first trimester of pregnancy were randomly assigned to receive 100 micro g of selenium [Se group] or a placebo [control group] per day until delivery. The level of oxidative stress and serum selenium concentration was determined in the maternal and umblical cord sera of the subjects. Oxidative stress was measured by means of a novel assay of prooxidant-antioxidant balance [PAB]. The incidence of any pregnancy complications and outcomes was also evaluated in all neonates, being fully examined and followed up until 45 days. Although maternal selenium concentration was significantly higher in the Se group [p<0.001], there was no statistically significant differences in the umblical cord selenium content between the two groups. Selenium supplementation was not associated with any significant decrease in PAB values in the Se group. The incidence of neonatal complications and outcomes did not differ significantly between the groups. Maternal selenium supplementation during pregnancy was safe but was not associated with a significant change in the extent of oxidative stress in neonates

[Evaluation of urinary tract infections following Neonatal hyper-bilirubinemia]

Urinary tract infection [UTI] is a common and serious clinical problem in newborns. Previous studies have suggested that jaundice may be one of the signs of a UTI in infants. The aim of this study was to evaluate the incidence, age presentation, severity of jaundice, signs and complications of UTI in newborns with asymptomatic, unexplained indirect hyperbilirubinemia in the first month of life. This case-control study was conducted at the Neonatal intensive care unit, Ghaem Hospital, in Mashhad from May 2004 to April 2009. We evaluated asymptomatic, jaundiced infants for the evidence of having UTI. Some laboratory tests such as a serum fractionated bilirubin level, as well as urinanalysis and a urine culture were performed in all patients. Renal ultrasound was performed in almost all the cases with UTI. Detailed questionnaires, which were included demographic information, prenatal, intrapartum, postnatal events and risk factors were filled. The control group was jaundiced-infants with unknown etiology. A total of 1487 patients were enrolled in this study. From these patients 1061 infants were evaluated for UTI. There was a statistically significant difference [P<0.05] between the two groups regarding age presentation, age admitted to hospital, age improved jaundice, serum bilirubin level and hospital stay. UTI was diagnosed in seventy four [6.97%]. Renal ultrasound showed urinary tract abnormalities in thirty two [32%] patients. Six infants had unilateral grade 1-3 reflux in voiding cystourethrogram. In our study UTI was found in 7% of asymptomatic, jaundiced infants. Therefore, we recommend that a UTI test should be included in asymptomatic, jaundiced infants presenting after five day of life as part of their evaluation.These infants should be evaluated for urinary tract abnormalities by renal ultrasound and voiding cystourethrogram

Coronary artery disease and T wave inversions in electrocardiogram at high altitude

To find out the role of coronary artery disease [CAD] as a cause of T wave inversions in electrocardiogram [ECG] in otherwise healthy soldiers who were evacuated from high altitude because of chest pain. A prospective observational study. The study was carried out at CMH Skardu from September 2003 to September 2004 fifty-four consecutive patients evacuated from height > 4000 meters [13123 feet] with symptoms of chest pain and electrocardiographic changes of T-wave inversions in a group of leads were included in the study. Echocardiography and Exercise tolerance test [ETT] was performed on all the patients. All of the patients with indeterminate or inconclusive results on ETT underwent coronary angiography at Armed Forces Institute of Cardiology, Rawalpindi. Out of 54 patients, 36 [66.7%] patients had normal exercise tolerance test. In the rest 18 [33.34%] patients coronary angiogram was done and in 04 patients it was reported abnormal. In 02 [3.70%] patients coronary angiogram confirmed coronary artery disease. In 02 patients coronary angiograms were abnormal but there was no evidence of coronary artery disease. T wave inversions at high altitude suggestive of IHD are not true indicators of underlying coronary artery disease

possible role of gastroesophageal reflux disease in children suffering from chronic otitis media with effusion

The aim of this study was to compare the efficacy of antireflux therapy with both conventional management and those with no treatment in children with chronic otitis media with effusion [COME]. In this prospective randomized clinical trial ninety children with COME which lasted more than 3 months or more, documented by physical examination and Type B tympanogram in at least one ear without clinical signs and symptoms of active infection that were refractory to 3 period of antibacterial treatment, were randomly allocated to receive a 3 month course in three groups of antireflux treatment [AR group, Cisapride 1 mg/kg/day], conventional antibacterial treatment [AB group, Co-amoxiclave 40 mg/kg/day TID] and those with no treatment [Control group, no medication]. All patients were followed every month. The favorable response was considered as complete resolution of effusion clinically and type A or more than -200 peak in tympanometry. Of the 30 patients assigned to AR group, 10 [33.3%] were judged to be clinically cured and in AB group 12 [40%] were cured while only 3 [10%] in control group were cured. The cure rate in AR and AB groups was significantly higher compared with control group but there was no significant difference between cure rates in AR and AB groups [P=0.59]. No subjects experienced complications during or after the study. There may be a possible role for GER medical management in patients with COME. Further investigations are necessary in order to confirm this hypothesis

Catamenial anaphylaxis

It is well documented that the hormonal changes during menstrual cycle influences systemic diseases, among them are allergic disorders. There are some reports of cyclic anaphylactic reactions during menstrual period which is reffered as [Catamenial anaphylaxis]. It must be differentiated from a closely related condition called [APD] or autoimmune progesterone dermatitis which is also a rare condition. It seems that hormonal changes especially rising progesterne levels and other mechanisms like back-diffusion of prostaglandines from contracting uterus into the systemic circulation may have some role in pathogenesis of these conditions. In catamenial anaphylaxis symptoms appear in direct association with the start of the menstrual flow but in APD, sign and symptoms begin earlier in the pre-menstrual phase. A 19 year old girl [not married] was referred because of a 8-months history of recurrent monthly urticarial and anaphlactoid reactions. Her symptoms began at first day of menstruation and lasted 1 to 2 days. The eruptions started as a sense of flushing and intense pruritis all over the body. Soon urticarial lesion as giant hives appeared which in some instances was associated with respiratory distress. The patient denied any changes in her diet and had taken no medications. Complete blood Count and erythrocyte sedimentation rate [ESR] revealed no abnormalities but VDRL positivity led us to consider rheumatological background like systemic lupus erythematosous. Anti cardio Lipin antibody [ACLA] was surprisingly above normal laboratory values. Her serum was taken in an episode of cyclic anaphylactic reactions and stored to be used later in her cycle when no more menstruating. Skin prick test with autologous serum collected during menstruation is performed at the midcycle and also in the late-cycle period in another ovulatory cycle. Both prick tests led to resurgence of severe allergic reactions as flushing, urticaria, pruritis and dry cough which were managed appropriately. The patient's history and physical examination and hormonal assay were consistent with catamenial anaphylaxis. She is currently under control and follow up, using cyclic conjugated estrogens