[ effects of nicotine injection in rat nucleus accumbens on anxiety]

Previous reports showed that nucleus accumbens involved in the etiology and pathophysiology of major depression, anxiety and addiction. It is not clear that how these mechanisms occur in the brain. In the present study, the influence of direct nicotine injection in the nucleus accumbens in rats' anxiety-related behavior was investigated. Wistar rats were used in this study. Male Wistar rats bred in an animal house, in a temperature-controlled [22 +/- 2[degree]C] room with a 12 hour light/darkcycle. Rats were anesthetized using intraperitoneal injection of ketamine hydrochloride and xylazine, then placed in an stereotactic instrument for microinjection cannula implantation The stainless steel guide cannula was implanted bilaterally in the right and left dorsal the nucleus accumbens shell according to Paxinos and Watson atlas. After recovery, anxiety behavior and locomotor activity were tested. We used the elevated plus maze to test anxiety. This apparatus has widely been employed to test parameters of anxietyrelated behaviors including the open armtime percentage [%OAT], open arm entries percentage [%OAE], locomotor activity and we record effect of drugs after injection directly in the nucleus accumbens on anxiety-related behavior. Experiments showed that bilateral injections into the nucleus accumbens Nicotine, acetylcholine receptor agonist, dose 0.1 of the dose [0.05 and 0.1, 0.25, 0.5] microgram per rat caused a significant increase in the percentage of time spent in the open arms [%OAT], compared to the control group. We did not record any significant change locomotor activity and open arm entries percentage [%OAE] in rats. Nicotinic receptors in the nucleus accumbens shell involved to anxietylike behavior in male rats.

[Ovarian response during IVF cycle following laparascopic cystectomy of ovarian endometrioma]

Endometrioma of ovary is one of the common diseases during reproductive age and the effect of laparoscopic cystectomy of endometrioma on infertility is still matter of debate. We designed this case control study to evaluate the ovarian response to controlled ovarian hyperstimulation during IVF [In vitro fertilization] cycle following laparoscopic unilateral cystectomy of endometrioma. In a case control study, we enrolled 30 women with history of unilateral laparoscopic cystectomy of ovarian endometrioma in stripping method who underwent IVF cycle in women Hospital, 2009-2012. The numbers of follicles in response to controlled ovarian hyperstimulation during IVF cycle in the ovary with history of unilateral laparoscopic cystectomy of endometrioma were compared with those from the contralateral ovary. The mean age [ +/- SD] of patients was 32.3 [ +/- 3.4]. The mean [ +/- SD] diameter of excised ovarian endometrioma was42.4 [ +/- 10.4] mm. Interval since ovarian surgery to induction ovulation was2.7 [ +/- 2.6] years. Mean number of follicles in the ovary with history of unilateral laparoscopic cystectomy of endometrioma was2.5 [ +/- 1.2] with the range of1 to 5 and in the control ovary 3.9 [ +/- 1.4] with the range of 1 to 6. There was significant difference in the number of follicles in the ovary with laparascopic cystectomy of endometrioma compared with opposite one [P<0.001]. Laparoscopic cystectomy for unilateral endometrioma is associated with a reduced ovarian response to controlled ovarian hyperstimulation during IVF cycle. We did not find any statistically significant difference in reduced ovarian response with regard to patients age, body mass index, size and location of the cyst, and time duration since ovarian cystectomy.

[Comparison of ultrasonography with radiography for the detection of cervical esophageal foreign body]

Detection of retained foreign bodies remains a significant problem in the emergency department. Foreign bodies can go undetected causing infectious complications ultrasonography is too inaccessible and expensive. The purpose of this study is comparison of ultrasonography with radiography for the detection of cervical esophageal foreign bodies This cross-sectional study evaluated 58 patients referred with suspected upper esophageal foreign body in the Emergency Department, Amir Alam. Patients were evaluated with ultrasonography and x-ray. After surgical exploration, different type of foreign bodies were recorded. The SPSS statistical software was used for analysis. For applicable efficacy outcome measures, a Spearman correlation was used. Differences were significant when P<0.05. All values were expressed as the frequency and present. Fifty eight patients were studied.25 patients [43.4%] were male and 31 patients [56.9%] were female, in 28 [48.2%] patients foreign bodies were detected in radiography. 30patients [51.8%] were not recorded in techniqe. It was found in patients 22 [78.6%] organic body, and six cases[21.4%] non-organic body. radiographic outcomes in patients with foreign bodies were positive in26 patients [92.9%] and in two patients [7.1%]were negative. Ultrasound results were positive in 27 patients [96.4%] and in one patient [3.6%] were negative. Association of ultrasound and radiography results were significant in patients with foreign body [Spearman correlation=0.896, P=0.001 Kappa=0.890]. These reports suggest that result of ultrasound with radiography for the detection foreign bodies in cervical esophagus have good agreement. The use of ultrasonography in the emergency department to detect and eventually remove foreign bodies by emergency physicians is an important issue because there is not always an ultrasound technologist or radiologist available.

[ relationship between CRL and PAPP-A measurements in first trimester fetuses with low birth weight]

Recent studies have suggested that impaired fetal growth are indicators that may be present in the first trimester. The aim of this study was to investigate the relationship between crown-rump length [CRL] and pregnancy associated plasma protein-A [PAPP-A] measurements in first trimester for low birth weight [LBW]. This prospective cohort study were on 120 pregnant women in first pregnancy trimester, in Women's Hospital Mirza Kochak Khan in 2011-2012. Gestational age according to crown-rump length and gestational age according to last menstrual period [LMP], neonatal weight, small for gestational age, pregnancy associated plasma protein-A and low birth weight were recorded. Main outcome measures was weight and gestational age at birth. Statistical tests used included descriptive statistics, t-test, X[2] and all tests were two-tailed and differences with P<0.05 were considered to be statistically significant. Our findings showed that a total of 120 cases were included CRL Z-score and log 10 [MOM PAPP-A] were positively correlated with fetal birth weight. The mean Crown-rump length Z-score was significantly can be reduced in LBW in first trimester pregnancy. [P<0.001] Mean PAPP-A in low birth weight was [0.4 +/- 0.11 MOM], but in normal weight infants was [1.04 +/- 0.7 MOM]. [P=0.011] also mean PAPP-A in pregnant women with SGA infants is significantly less than other pregnant women [0.5 +/- 0.2 versus 1.1 +/- 0.7] [P<0.001]. Our data suggest that crown-rump length and maternal levels of PAPP-A measured during the first trimester are independent factors that influence fetal birth weight. But their predictive powers are not sufficiently good for them to be used alone for low birth weight screening.

[Comparing two ovulation induction methods by brachial artery ultrasonography in infertile women with polycystic ovary syndrome]

Endothelial dysfunction can influence fertility rate in women with polycystic ovary syndrome [PCOS] as flow mediated dilatation [FMD] is impaired in patients with the disease. The aim of this study was to compare two methods of ovulation induction by letrozole or letrozole plus human menopausal gonadotropins [HMGs] in infertile women with PCOS who were resistant to clomiphene citrate based on brachial artery ultrasound findings. In this double -blind randomized clinical trial, 59 infertile women who had the inclusion criteria for PCOS were evaluated in the Infertility Clinic of Shariati Hospital in Tehran, Iran in 2010-2011. The patients were assigned to two letrozole and letrozole plus HMG groups and were evaluated for FMD in the brachial artery by transvaginal ultrasonography. Later, the values were recorded and analyzed statistically. In the letrozole group, infertility treatment was successful in 15 [57.7%] but it failed in 11 [42.3%] patients. In letrozole plus HMG group, the treatment was successful in 18 [54.5%] while it failed in 15 [45.5%] patients. The mean FMD values in the groups with successful and unsuccessful treatment results were 19.42 +/- 10% and 18.57 +/- 7.2%, respectively, but the difference was not statistically significant [P=0.712]. Moreover, the average endometrial thickness in groups with successful and unsuccessful treatment results were 8.4 +/- 1.3 mm and 9.8 +/- 3.9 mm, respectively but the difference was not significant either [P=0.06]. In infertile women with polycystic ovary syndrome that are resistant to clomiphene, letrozole or letrozole combined with gonadotropin can be equally effective for ovulation induction

[Factors related to extubation failure and post pulmonary complications in intracranial surgery in 254 patients: a brief report]

The purpose of this study was to determine the prevalence and associated factors for postoperative pulmonary complications [PPCs] and extubation failure in patients having undergone intracranial surgery. In this retrospective study done in Firozgar Hospital during 2008-2010, we followed up 254 patients through a clinical questionnaire and observation of the clinical course of participants in pre- and post-operative periods. Overall, 40 [15.74%] patients had postoperative pulmonary complications. The most common PPC was pneumonia, which was seen in 24 patients [60% of complications]. The average duration of ventilation in patients with PPC was significantly higher [16.8. +/- 10 vs. 5.09 +/- 4.5 days; P=0.001] than patients without the complication. The mean Glasgow coma scale [GCS] after surgery in patients with PPC was significantly lower [11. +/- 4 vs. 13.2 +/- 3; P=0.001] than the rest of the patients. Moreover, the mean age of patients with PPC was significantly higher [64.02 +/- 14 vs. 41.6. +/- 17 years; P=0.001]. Average duration of stay in ICU in patients with PPC was also higher [24. +/- 27 vs. 8.7 +/- 0.5; P=0.001]. GCS before surgery and failed extubation independently of other variables were significantly associated with pulmonary complications independent of other variables

[ correlation of diastolic dysfunction with TIMI frame count in patients with chronic stable angina pectoris]

Evaluation of diastolic dysfunction and its relationship with TIMI frame count in patients with stable coronary artery disease referred to Ayatollah Taleghani Hospital in Tehran in the years 2010-2011 is the purpose of this study. Patients were divided into two groups: case and control. Both groups had chronic angina. Patient information on check list has been studies based on data provided by angiography and echocardiography methods. Cases had significantly higher values of corrected TIMI frame count [TFC] for the left anterior desending artery [LAD], TFC for Circumflex artery [Cx] and Right coronary artery [RCA], [mean TFC P<0.001]. Conventional echocardiography showed significantly lower maximal peak systolic velocity [sm] [cm/s], Correlation of early diastolic velocity at myocardial segments [Em] and peak systolic velocity at myocardial segments [Sm] with mean TFC in all 3 vessels were significant [P=0/0001]. Ratio of maximal early to late diastolic filling [E/A], in patient with TFC >/= 21 was 0/7 and in patients with TFC/= 21. Correlation between mean of angiography and diastolic disfunction was significant. According to this study diastolic dysfunction which estimated by echocardiography showed significant correlation with TIMI frame count in chronic stable angina patients. Due to simplicity, low cost, quality and reproducibility of this method, this will be helpful.

Reduction of left ventricular hypertrophy by sirolimus in kidney transplant recipients: a nonrandomized clinical trial

Persistence of left ventricular hypertrophy [LVH] in renal transplant recipients is associated with unfavorable outcomes. Calcineurin-inhibitor [CNI] nephrotoxicity is a major cause of morbidity and mortality after kidney transplantation. In this study we compared sirolimus [SRL] with calcineurin-inhibitor as primary immunosuppressants for the attenuation of left ventricular hypertrophy in renal transplantation recipients. In this prospective cohort study done in Shariati Hospital in 2010, we evaluated the effects of sirolimus and CNI on LVH of 55 renal transplant recipients. The cases [19] received sirolimus while the controls [36] received CNI while being matched for age and duration of transplantation. Data regarding blood pressure [BP], hemoglobin, serum creatinine, uric acid and lipid concentrations were assessed and changes in left ventricular [LV] mass were evaluated by echocardiography over a one-year follow-up. Left ventricular mass significantly decreased [P=0.0001] in the SRL group but blood pressure did not differ between the two groups. LV mass and LV mass index both decreased significantly [P<0.05] but the difference was not associated with changes in BP. The difference in interventricular septal thickness at end diastole [IVSD] and posterior wall diameter [PWD] were significant [P<0.05] in the SRL group but the difference in end diastolic diameter [EDD] was not significant. Conversion from CNI to SRL-based immunosuppressive therapy in RTRs is safe and SRL may decrease LVH. SRL seems to be safe and improve renal function without cardiac compromise in kidney transplant recipients

[ effects of metabolic syndrome on left main coronary artery stenosis in coronary angiograms of patients: a two year study]

Left main coronary artery [LMCA] stenosis is a leading cause of mortality and morbidity in many countries. Metabolic syndrome [MS] is a risk factor for coronary artery disease [CAD]. The effects of MS on left main coronary artery stenosis are not well-defined. The aim of this study was to examine the effects of MS on left main coronary artery stenosis. A total number of 495 patients who underwent elective coronary angiography in the Catheter Laboratory of Cardiovascular in Shariati Hospital 2008-2010 were included in the study. MS definition was based on the National Cholesterol Education Program [NCEP]-Adult Treatment Panel III [ATP III] criteria. The stenosis in left main coronary arteries was determined by examining the coronary angiograms of the patients. The study population consisted of 249 [50.3%] men, and 246 [49.7%] women. The mean age of the participants was 58.01 +/- 10 years. MS was present in 86 [17.4%] of the patients based on NCEP-ATP III criteria. LMCA stenosis was seen in 25 [5%] patients. A positive correlation was found between MS and LMCA stenosis [r=0.305, P=0.012]. Moreover, a positive correlation was found between age [r=0.192, P=0.05], sex [r=0.334, P=0.007], smoking [r=0.336, P=0.01] and diabetes [r=0.253, P=0.03] and LMCA stenosis. The metabolic syndrome correlates with LMCA stenosis. LMCA stenosis and its correlation with MS is precipitated by high FBG, age, male sex, and smoking which may synergistically increase the risk for the disease