Production of 177Lu and formulation of Ethylene diamine tetramethylene phosphonate [EDTMP] kits as a bone-seeking radiopharmaceutical

Owing to its favourable decay characteristics 177Lu [T1/2= 6.71 d, Ebeta[max]= 497 keV] is an attractive radionuclide for various therapeutic applications. Ethylene diamine tatramethylene phosphonate [EDTMP] is one of the most widely used ligands which form stable complexes with various radionuclides and all the complexes. Enriched 176Lu2O3 was dissolved in 0.1 N HCl and evaporated several times and 176LuCl3 target was irradiated at 2.6x1013 n.Cm- 2.S-1 thermal neutron flux for 14 days.177LuCl3 was dissolved in 1N HCl. EDTMP was dissolved in double distilled water at pH=7.5-8.5 and freeze-dried kits was radiolabeled with 177LuCl3. Distribution studies were done in healthy mice. The yield of 177Lu was [220 TBq/g; 6000 Ci/g], the radionuclidic purity was 99%.The radiolabeling yield of EDTMP kits at 37°C after 30 min and 4 hours was 98 +/- 0.5% and after 72 hours was 90 +/- 2.1%, the in vitro stability in human serum at 37°C up to 72 hours post radiolabeling was 85 +/- 1.8%.The biodistribution studies of 177Lu-EDTMP and 177LuCl3 in normal mice showed skeleton uptake and low soft-tissue concentration. In this study, we produce 220 TBq/g [6000 Ci/g] of 177Lu by neutron activation of 176Lu in the Tehran Research Reactor. Our results showed 177Lu-EDTMP as a bone-seeking radiopharmaceutical. Due to its suitable nuclear characteristics 177Lu appears to be worthwhile for palliative therapy of bone metastasis

[Fire work-related injuries in Tehran's Charshanbe Soori]

Fireworks are the leading cause of injuries in the ceremony of Chaharshanbeh Soori in Iran. The present study was designed to assess the prevalence and the severity of such injuries, the high-risk population, the causes and the accompanying morbidities in such ceremonies. This cross-sectional study was performed on individuals referred to different medical centers by Tehran Emergency Service due to fireworks- and Chaharshanbe soori-related injuries in 2007. The patients' demographic data, the cause of the accident, the type of the firework, the severity and the site of the injury, the performed prehospital and hospital care, and the patients condition at the time of discharge were extracted from the patients medical records. The information on the severity of the remaining morbidities in 8 months after the accident was also gathered. About 197 patients were enrolled in this study. The mean age of the patients was about 20.94 +/- 11.31 years. The majority of them were males. Crackers and home-made grenade were the most frequent cause of injury. The most frequently reported injuries consisted of bums, laceration and contusion, soft tissue injury and bone injuries, respectively. Fireworks should be produced and distributed based on standard regulations. Educating the families and students, and holding public ceremonies under the direct control of the families are considered as important strategies in reducing such injuries

[Study of lysozyme, immunoglobulin, blood cell and hematocrit changes following experimental infection with a pathogenic aeromonas hydrophila in rainbow trout]

In order to determine the changes in serum and blood factors of rainbow trout following experimental infection with a pathogenic Aeromonas hydrophila, the cause of haemorrhagic septicemia in fish, three groups of rainbow trout [10 fish in each group] were injected intraperitoneally with 10[5], 10[6] and 10[7] of this bacteria respectively. The same number of fish in a control group were injected similarly with physiologic saline. After the appearance of clinical symptoms of haemorrhagic septicemia in fish, samples from skin mucus and blood of the fish were collected in order to determine lysozyme, anti- Aeromonas hydrophila immunoglobulins [measured by plate method and ELISA respectively], total white and red blood cells[WBC/RBC]. Results showed that the lysozyme level in skin mucus and sera was significantly higher than the control group [p<0.05] while the immunoglobulin level of skin mucus of experimentally challenged fish was not significantly higher than that of control group except that of the group 2 and 3 of the experimental fish. WBC/RBC and hematocrit of the experimentally challenged rainbow trout were significantly higher than the control. Thus infection of rainbow trout with Aeromonas hydrophila increases the level of mucus and serum lysozyme, serum immunoglobulins, decreases RBC count and heamatocrit percentage

influence of age at the time of cochlear implantation on hearing threshold in prelingually deaf children

There always has been a question about the best age for cochlear implantation [CI] in prelingual deaf children. The age factor in the outcome of cochlear implantation in prelingual deaf children has been the subject of many studies. The aim of the present study was to find the effect of age at the time of implantation on hearing threshold of these children. One hundred and nine prelingual deaf children who had undergone CI were enrolled. The mean hearing threshold [HT] at octave intervals from 125 to 8000 Hz at different periods from the operation time were compared between those patients whose age at the time of implantation were less than 24 months and those whose age were equal or greater than 24 months. The mean age of patients at the time of implantation was 38.9 months and a half of them had less than 28 months. There was no difference in mean HT between the two age groups across different measurement periods. A multiple regression model showed that device type was the sole significant predictor of mean HT at the first and third months after implantation, where age replaced it at the sixth month. These results suggest that what had been found in other studies as a favorable effect of younger age at the time of implantation on speech perception cannot be explained by a better hearing, and there are other important factors including rehabilitation programs beginning at a younger age that may explain those findings

ways of research promotion in Sina educational-medical hospital

The objective of this study is to clarify the opinions of scientific board members of Sina university hospital about medical research and the ways of promoting these researches. This is a grounded theory study in which we used in-depth interviews and focus group discussions. Scientific board members and different authorities of the hospital such as the chief of hospital and the deputy of education were participated in the study. We used three different FGDs. Each group included about 5 people. We also interviewed the chief, the deputy of education and the head of clinical research center of the hospital. Most of the participants in our FGDs believed that the most important factor for research promotion in the hospital was preparation of a data base of patients. They also mentioned that, different research workshops are important for empowering scientific board members in research. According to our study the most important strategies for research promotion in Sina hospital are data bank preparation, providing repeated research workshops, revising the bureaucratic process of proposal approvals, revising the manner of evaluation of scientific board members and more participation of the department of epidemiology in clinical researches

[Effect of gamma irradiation sterilization on the osteoinductive capacity of demineralized bone matrix]

Gamma irradiation has been widely used for secondary sterilization of bone allograft before clinical use to reduce the risk of infection and associated complications. The current study evaluated the effect of gamma irradiation sterilization on the osteoinductive capability of human demineralized bone matrix using a rat model. Eighteen euthymic rats received two separate implants consisting of 30 mg sterile-harvest demineralized bone matrix and 30 mg gamma irradiation-sterilized demineralized bone matrix. The demineralized bone matrix from each group was placed into two separate muscle pouches created in the paravertebral muscles of each rat. All 18 rats were euthanized after 4 weeks and each implantation site was removed with 0, 5 cm normal tissue around the implant. Histological examination was performed to determine the presence or absence of new bone, cartilage and bone marrow elements, All except one of 18 [94.4%] sterile-harvest demineralized bone matrix sites histologically contained new bone elements and five of 18 [27.7%] ethylene oxide sterilized demineralized bone matrix sites showed evidence of new bone elements, which was statistically significant [p<0.05]. The results of this study indicate that demineralized bone matrix sterilized with gamma irradiation loses its osteoinductive capacity in a manner similar to that of steamsterilized demineralized bone matrix, making it unsuitable as a method of secondary sterilization of demineralized bone matrix

[HCV in intravenous drug users]

Hepatitis C [HCV] is increasing worldwide including Iran. HCV is more prevalent among intravenous drug abusers [IDU], especially if imprisoned, mostly due to needle sharing. We determined the rate of HCV seropositivity among IDU prisoners and compared it with those of non prisoners. A cross-sectional survey was done on consenting IDU inhabiting two prisons and attending three rehabilitation centers in Tehran, Iran. A questionnaire was completed for each subject and 5mL blood drawn. The samples were kept at 2-8°C until the sera were separated and stored at -70°C. HCV Ab [ELISA 1, third generation, DIA. PRO, Italy] with a sensitivity and specificity of 98% was checked by a single technician. Chi-square, Fisher's exact test and multivariable analysis were used where appropriate. Four-hundred and sixty seven subjects [346 [74.1%] prisoners; 425 [91%] male] were enrolled. Overall 66% tested positive for HCV Ab [287 male [67.5%], 21 female [50%], p<0.02]. HCV seropositivity was higher among prisoners [78.3% vs. 30.6%, p<0.001] and older IDU [76.9% vs. 62.9%, p=0.002]. Multivariable analysis showed association between HCV seropositivity and imprisonment [OR= 9.32, 95%CI: 5.60- 15.51], sharing syringes [OR=2.00, 95%CI: 1.27-3.17], duration of intravenous drug use annually [OR=1.16, 95%CI: 1.08-1.24] and male sex [OR=4.18, 95%CI: 2.02- 8.67]. HCV is rather common among IDU prisoners. Imprisonment is an independent risk factor. The infected IDU going back to the community may be an important source of HCV. Taking effective strategies [high risk group education, provision of sterile syringes, identification and treatment of infected IDU] to reduce the risk of this public health problem is needed urgently

[HCV in intravenous drug users]

Hepatitis C [HCV] is increasing worldwide including Iran. HCV is more prevalent among intravenous drug abusers [IDU], especially if imprisoned, mostly due to needle sharing. We determined the rate of HCV seropositivity among IDU prisoners and compared it with those of non prisoners. A cross-sectional survey was done on consenting IDU inhabiting two prisons and attending three rehabilitation centers in Tehran, Iran. A questionnaire was completed for each subject and 5mL blood drawn. The samples were kept at 2-8°C until the sera were separated and stored at -70°C. HCV Ab [ELISA 1, third generation, DIA. PRO, Italy] with a sensitivity and specificity of 98% was checked by a single technician. Chi-square, Fisher's exact test and multivariable analysis were used where appropriate. Four-hundred and sixty seven subjects [346 [74.1%] prisoners; 425 [91%] male] were enrolled. Overall 66% tested positive for HCV Ab [287 male [67.5%], 21 female [50%], p<0.02]. HCV seropositivity was higher among prisoners [78.3% vs. 30.6%, p<0.001] and older IDU [76.9% vs. 62.9%, p=0.002]. Multivariable analysis showed association between HCV seropositivity and imprisonment [OR= 9.32, 95%CI: 5.60- 15.51], sharing syringes [OR=2.00, 95%CI: 1.27-3.17], duration of intravenous drug use annually [OR=1.16, 95%CI: 1.08-1.24] and male sex [OR=4.18, 95%CI: 2.02- 8.67]. HCV is rather common among IDU prisoners. Imprisonment is an independent risk factor. The infected IDU going back to the community may be an important source of HCV. Taking effective strategies [high risk group education, provision of sterile syringes, identification and treatment of infected IDU] to reduce the risk of this public health problem is needed urgently

Emotional changes in children undergoing cochlear implantation through evaluation of their drawings

Background: the emotional changes of patients undergoing cochlear implantation [CI] has been addressed in a few studies. To date, no special test has been developed to measure these Changes

Objective: to measure the emotional status of children undergoing CI by interpreting their drawings

Methods: a prospective longitudinal study on prelingually deafened children from 4-14 years of age undergoing CI and sex and age-matched non-CI candidate deaf children comprised the study population. Drawings were produced before implantation and after 1, 3, 6, and 12-month intervals. These were scored with regard to a questionnaire developed in Amir Aalam Hospital Hearing Research Center, Tehran, Iran

Results: the prevalence of drawings with cues of rage/anxiety decreased from 35% to 21.9%. Similarly, sadness prevalence dropped from 36.8% to 20% and the prevalence of immaturity was reduced from 20% to 7.1%

Conclusion: we recommend drawing to be included in the rehabilitation program of children undergoing CI and used as a practical measure of their emotional progress

Role of magnesium loading test in detecting hypomagnsemia in critically ill Patients

Magnessium [Mg] deficiency has not usually been considered in clinical practice due to lack of relevant blood tests and because the symptoms are often vague and non-specific. Serum concentrations may not adequately reflect Mg status. Mg Loading Test [MLT] can provide information on total body Mg stores. We prosectively studied 21 critically ill patients [10 males, 11 females] admitted to the ICU, to investigate the prevalence of Mg deficiency. Their mean age was 50 +/- 21 years. To determine serum Mg, venous blood specmens were obtained just before the MLT. Mg sulfate [30 mmol] was infused during an 8-hr period and 24-hr urine samples were collected from the starting of Mg infusion. Although low serum Mg [<1.8 mmol/L] was present only in 2 patients, MLT showed Mg deficiency in 18 patients. MLT detected Mg deficiency in 13 out of 14 patients with normal serum Mg, in 2 out of 2 subjects with hypomagnesemia, and in 3 out of 5 cases with hypermagnesemia. Of 7 fetal cases, 6 occurred in individuals with hypomagnesemia [6/18] and 1 death occurred in the normomagnesemic group [1/3]. There was no relationship between Mg retention, age [r=0.33, p=0.63] and serum Mg concentrations [r=0.15, p=0.925]. There was a significant correlation between Mg uptake and APACHE II score [r=0.46, p=0.035]. In conclusion, Mg depletion is highly prevalent in ICU patients according to MLT. MLT is superior to serum Mg in determining actual Mg status in this group. Therefore, we suggest that MLT, and not serum Mg, should be carried out in patients when Mg deficiency is suspected