[Role of viruses in the destruction of the central nervous system and its impact on the multiple sclerosis]

Multiple sclerosis [MS] is a chronic inflammatory immune-mediated disease of the central nervous system. Despite extensive investigations, many aspects of etiology and pathophysiology remain unclear. In multiple sclerosis patients, immune system reacts against autologous proteins in the myelin membrane. Most evidences support the hypothesis that both genetic and environmental factors contribute to disease development. But after the failure of genetic findings to explain the reason for the unequal incidence of MS in identical twins, investigators focused further on environmental factors such as vitamin D deficiency, smoking, living in different latitudes and perhaps the most importantly the role of viruses in people whom are genetically susceptible to MS. There is increasing evidence that viruses may play important role in MS pathogenesis following environmental triggers. Recently, studies focused on the role of herpes virus family, especially Epstein- Barr virus, human herpes virus 6 [HHV-6] and Varicella Zoster virus, as the virus is prevalent in society. This review mainly focused on the identification of important viruses with key role in MS the mechanism behind pathogenesis and describes the animal models of MS. The results of researches are shown strong evidence of the virus or antibodies to viral components in active plaques in MS affected patients, but still cannot be stated with certainty that one or more specific viruses are simultaneously trigger the disease. Further studies are required to prove the pathogenesis of viruses in MS

[Emergency caesarean section in patient with thyroid storm and severe preeclampsia: a case report]

Hyperthyroidism can occur with pregnancy. Thyroid storm is a life-threatening exacerbation of hyperthyroidism. The mortality rate for thyroid storm remains surprisingly high at approximately 20%. A 21-year-old primigravida woman presented at 25 weeks, with severe pre-eclampsia and uncontrolled hyperthyroidism was scheduled for emergency cesarean section. Treatment includes rapid alleviation of thyrotoxicosis and general supportive care. Thyroid function tests may not help in differentiating thyroid storm from symptomatic hyperthyroidism. The major risk of anesthesia in the poorly controlled thyrotoxic patient is thyroid storm, which must be aggressively treated with beta-blockers, iodide, and antithyroid drugs

[Does traumatic uncontrolled blood loss require intensive hydration therapy?]

Hemorrhage in trauma is important and replacement of the blood loss is one of the ways which may reduce the number of mortalities. We decided to study the use of hypersaline serum in comparison with normal saline serum and not prescribing blowing serum in caring animal simulation model of uncontrolled hemorrhagic shock following trauma. The assessment of 3% hyper saline serum application compared with saline normal serum and not prescribing blowing serum in caring animal simulation model of hemorrhagic shock in trauma. The animal lab investigation and the grant of this animal trial was provided by AJA University of medical science. The goats were sedated with Ketamine and Diazepam. The tracheostomy was done on the goat and was ventilated with protable ventilator. Continuous blood pressure and electrocardiogram monitoring was positioned. Animals were cut and blood volume was measured. The bleeding was not being controlled and after 300-350 ml of bleeding, the goats were randomized into 3 groups; those treated with normal saline 20ml/kg [n=10], hypersaline 3% 6ml/kg [n=10] and no fluid resuscitation [n=10]. Data related to the duration of survival, volume of lost blood, blood pressure and metabolic acidosis were gathered and analyzed. Blood volume loss in normal saline group, hypersaline group and no volume resuscitation group was 1139ml, 1551ml, 600ml respectively. The mortality rate significantly increased using hypersaline. Also, blood acidosis increased and hemoglobin decreased significantly while using normal and hypersaline serum vs. no fluid resuscitation. Resuscitation with normal saline or hypersaline can increase blood loss during a hemorrhagic shock and do not improve survival

Evaluation of Glu 298 Asp polymorphism of the endothelial nitric oxide synthase gene and its relationship with coronary artery disease and type II diabetes mellitus with/without CAD in Kermanshah

There are some reports indicating that the Glu298Asp polymorphism of the endothelial nitric oxide synthase [eNOS] gene is associated with coronary artery disease [CAD]. The aims of the present study were to evaluate possible association between the endothelial nitric oxide synthase [eNOS] gene polymorphism of Glu298Asp [G894T] and occurrence of CAD and diabetes in type II diabetic patients with and without CAD. In this case-control study, the polymorphism of eNOS Glu298Asp was detected using PCR-RFLP method in 203 diabetic patients with/without CAD, 105 CAD patients and 92 healthy subjects according to angiographic evidence. All studied individuals were from Kermanshah, a city in western Iran. The frequencies of three eNOS genotypes of GG, GT and TT were not significantly different in diabetic patients with CAD [53.9%, 40.2% and 5.9%, respectively] compared to those without CAD [59.4%, 35.6% and 5%, respectively, P= 0.730]. But the frequencies of these genotypes in diabetic patients with CAD were significantly different compared to those of control subjects [72.8%, 26.1% and 1.1%, respectively, P=0.013]. Although the frequencies of these genotypes in diabetic patients without CAD were not significantly different compared with those of control subjects [P=0.08], the mutant allele in diabetic patients was seen more. .The eNOS 298Asp mutation is common in diabetic patients with CAD and also in CAD patients from Kermanshah. This might be associated with occurrence of CAD in patients with or without diabetes

Metabolic syndrome and hypertension in diabetic patients

Athough a controversial issue, the Metabolic Syndrome [MS] is known to by be related to certain genetic and lifestyle factors such as hypertension. The object of this study is to evaluate the prevalence of MS and its association to hypertension among diabetic patients with and without hypertension, in the Fatemeh Zahra hospital in Najafabad, Iran. This cross-sectional descriptive study was performed on diabetic patients referring to the Fatemeh Zahra Hospital, of whom 66 subjects were randomly selected and data was obtained from their hospital files, including systolic and diastolic blood pressure, Body Mass Index [BMI], Fasting Blood Sugar [FBS], lipid profiles, waist circumference, age, sex, family history and history of diabetes. Patients with blood pressure 140/90 were considered hypertensive. MS was confirmed according to the Adult Treatment Panel [ATP] III criteria. Data was analyzed with SPSS software using the independent Student t- test, regression and chi-square, P < 0.05. MS was more prevalent in hypertensive than in normotensive patients [93.3% vs 62.7%, p < 0.02]. Mean systolic and diastolic blood pressures were higher in MS patients than in patients without the syndrome, [136.85 +/- 25.20 vs 121.25 +/- 28.00 and 81.63 +/- 17.00 vs 72.00 +/- 11.96 respectively]. The findings of this study indicate the need for MS screening among diabetic hypertensive patients and importance of primary and secondary prevention of hypertension in order to curtail the impending epidemic of non-communicable diseases in our society

Removal of hydrogen sulfide by zinc oxide nanoparticles in drilling fluid

Hydrogen sulfide is a very dangerous, toxic and corrosive gas. It can diffuse into drilling fluid from formations during drilling of gas and oil wells. Hydrogen sulfide should be removed from this fluid to reduce the environmental pollution, protect the health of drilling workers and prevent corrosion of pipelines and equipments. In this research nano zinc oxide with 14-25 nm particle size and 44-56 m2/g specific surface area was synthesized by spray pyrolysis method. The synthesized nanoparticles were used to remove hydrogen sulfide from water based drilling fluid. The efficiency of these nanoparticles in the removal of hydrogen sulfide from drilling mud were evaluated and compared with that of bulk zinc oxide. The obtained results show that synthesized zinc oxide nanoparticles are completely able to remove hydrogen sulfide from water based drilling mud in just 15 min., whereas bulk zinc oxide is able to remove 2.5% of hydrogen sulfide in as long as 90 min. under the same operating conditions

Relationship between serum lactate levels and morbidity outcomes in cardiovascular patients after CABG

To evaluate the relationship between postoperative serum lactate levels and outcome in patients undergoing open heart surgery and verify the clinical impact of hyperlactatemia[HL] and low lactemia[LL] during CABG in terms of postoperative morbidity and mortality rate. Descriptive study. Sina Heart Centre [non-university hospital in Isphan, Iran] from fall 2005 to fall 2006. Hundred consecutive patients undergoing cardiac surgery with cardiopulmonary bypass were admitted in the study. Post operative lactate concentration and other metabolic parameters were determined. Evaluation of lactate concentrations, pH values and base excess during the first 24 post operative hours were assessed. Hyperlactatemia was defined as a peak arterial blood lactate concentration exceeding 3 mmol/l. Pre- and intraoperative factors were tested for independent association with the peak arterial lactate concentration and HL. The postoperative outcome of patients with or without hyperlactatemia was compared. We found positive effect of time on lactate and pH levels. On day 1, HL and LL patients had comparable lactate concentrations, which remained significantly higher than those of HL patients. HL is frequent after cardiac surgery. Based on our analyses, postoperative measurement of lactate level appears to be clinically useful. A threshold of 3 mmol/L at ICU admission was able to identify a subpopulation of patients at higher postoperative risk. Sequential determinations identified patients at higher risk for major complication and thus the need for closer surveillance of their therapeutic responses and their metabolic consequences

Efficacy and safety of ginger to reduce nausea and vomiting of pregnancy: a systematic review and meta-analysis

To assess the efficacy and safety of ginger [rhizome of Zingiber officinale] to reduce severity of nausea and numbers of vomiting in early pregnancy. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL and SID databaseswere searched for relevant sources. Randomized trials of oral ginger in comparison with placebo for nausea and/or vomiting in early pregnancy were selected. Two reviewers assessed the trial quality and extracted the data independently. Five trials met the inclusion criteria to assess the efficacy. Based on these trials, there was a significant reduction in severity of nausea after taking ginger compared with placebo [Pooled SMD= 0.882, 90% confidence interval 0.267 to 1.496]. Also there was similar effect in reducing number of vomiting [Pooled SMD= 0.631, 90% confidence interval 0.433 to 0.829]. In addition, there were 5 trials or observational studies which had assessed the potential fetomaternal side effects of ginger. There was no supporting evidence for increasing pregnancy complications after using Ginger. Based on the current evidences, Ginger reduces the severity of nausea and frequency of vomiting in early pregnancy. There are considerations about adverse effects, but they are not supported by the clinical evidence. It seems that ginger could be used during pregnancy in therapeutic doses [almost 1 gr per day] for limited durations

Efficacy of intravenous dexamethasone in treatment of acute migraine headache: a randomized clinical trial running title

Migraine is characterized by unilateral and pulsatile headache with or without aura. There are various treatments of migraine attack. One of them is intravenous [IV] Corticosteroids which is used in status migrainous. The aim of this study is comparison of the efficacy of I.V Dexamethasone with intramuscular [I.M] Methadone in improvement of migraine attacks. This study was a controlled double- blind randomized clinical trial on all patients whom referred to emergency room with diagnosis of migraine attack. The patients were randomized in four groups. Groups I and II received intravenous 8 mg Dexamethasone, while groups III and IV received intramuscular 10 mg Methadone. Thereafter all of them were evaluated after 2, 4 and 6 hours. One-hundred and eighty one patients were evaluated; 107 patients were treated with IV Dexamethasone and 74 patients with IM Methadone. One-hundred and three of 107 patients [96.2%] had complete or significant improvement whereas 63 of 74 patients [85%] whom received IM Methadone had similar improvement [P= 0.01]. Our study showed that treatment of acute migraine headache by using intravenous Dexamethasone is more effective than Methadone

Assessment of physical activity pattern IV nurses of Esfahan social security organization hospitals

According to high prevalence of non-communicable diseases, inactivity is the most important risk factor for them and health care providers advise people to take more physical activity in their lives. Nurses are at high risk of illnesses such as cardiovascular, musculoskeletal and psychologic disorders due to characteristic features of their job. The objective of the current study was to assess physical activity pattern among nurses who work at Esfahan social security hospitals. In this descriptive-analytical and cross-sectional study we nurse from 3 hospitals of Esfahan social security organization. Data were collected by standard 7-days International Physical Activity Questionnaire [IPAQ] which include 5 sections for work, transportation, home, leisure-time and sitting physical activities during one week that was detailed in minutes /week for each section. [Activities that last at least for 10 minutes] The results of this study medicated that women performed more physical activity of home while men perfumed more at their leisure time. There was not a significant difference in time of work and Tran's portion physical activity between men and women. According to the results of the current study, It is strongly recommended to nurses to modify their lifestyle and have more active life particularly in transportation and their free time

Outcomes of cardiac rehabilitation after angioplasty [PTCA], bypass surgery [CABG] and myocardial infarction [MI]

Cardiac rehabilitation [CR] reduces cardiovascular mortality and improves cardiovascular and mental status of cardiac patients. Evaluation of the effects of CR in different groups according to sex, age and cause of disease would help the CR program to be special and individual and reduces the cost of treatment. The aim of this study was to evaluate the outcomes of CR in patients referring to CR program with different reasons. We studied 310 cardiac patients including 150 CABG, 44 PTCA and 110 persons with any other cause like Ml, angina, etc. without revascularization. All patients were subjected to a 24 sessions of CR including aerobic exercise, education and diet therapy. Exercise capacity, ejection fraction [EF], lipid profile and body mass index [BMl] were measured before and after the CR program. The data were analyzed using Chi-square, independent pair t-test and ANOVA. Results of this study showed that lipid profile, exercise capacity, EF and BMl were improved after CR in all groups. Changes of the variables were the same in all groups and the differences were not statistically significant. all the male and female patients attending CR program equally benefited from cr. we concluded that patients under medical treatment could improve their cardiovascular status before revascularization and sometimes postpone the intensive procedures

Cytotoxicologic studies of the extracts of Iranian juniperus Sabina and platycladus orientalis on cancer cells

Background: isolation and identification of some potent anti-tumor compounds from medicinal plants, has motivated researchers to screen different parts of plant species for anti-tumor effects. It has been reported that several conifers posses cytotoxic activities on some human tumor cell lines

Methods: in this study male and female branchlets or fruits of two different species of Iranian conifers were collected from the northern parts of Iran and identified. Hydroalcoholic extracts of them were prepared by perculation. The cytotoxic effects of the extracts on three human tumor cell lines [Hela, KB, and MDA-MB-468] were determined. Different concentrations of extracts were added to cultured cells and incubated for 72 h. Cell survival was evaluated using MTT-based cytotoxicity assay. Cytotoxicity was considered when mor than 50% decrese was seen in cell survival

Results: although the extracts from Platycladus orientalis significantly decreased Hela and MDA-MB-468 cell curvival, their effects were not considerable. Extracts from fruit and branchlets of male and female Juniperus sabina showed cytotoxic activities against Hela and MDA-MB-468 cells

Conclusion: it is concluded that extracts of J. sabin have cytotoxic effects on cancer cells