Epidemiology of attempted suicide in Kashan during 2003-8

Background: Suicide is a major public health problem in developing countries which depending on geographical area, several factors have been associated with its prevalence and incidence. This study was conducted to evaluate the prevalence of attempted suicide and its related factors in Kashan during 2003-8

Materials and Methods: This cross-sectional study was performed on all suicide attempters referred to Kashan health centers during 2003-8. Patient's demographic information, manner, outcome and a previous history of suicide attempts were recorded on a questionnaire by interviewing patients or their families

Results: There were 2867 suicide cases during the study period. Most of them were in age range of 25-35 years. Fifty-nine percent of patients were female and 56% married. Drug abuse was the most common method of suicide [79%]. So, an overall attempted suicide rate was 119 per 100000 people in Kashan during 2003-8 and there were only 29 cases [1.1%] of successful suicide

Conclusion: Although the rate of attempted suicide are high in this city, the rate for successful suicide is very low. Therefore, this problem and its related factors need to be considered by health managers

[Dietary intake in people with spinal cord injury based on sex, obesity and injury related variable in brain and spinal injury repair research center]

Despite an increased risk of obesity and CHD in people with spinal cord injury [SCI], there is little known about the dietary intake in this group, therefore the aim of this study was to examine nutrient intake and body mass index [BMI] in the spinal cord injury [SCI] population according to level of injury and related variables. In this cross-sectional study, 162 patients with spinal cord injury participated from Brain and Spinal Injury Repair research Center, Tehran, Iran. Dietary intakes were assessed by means of a semi quantitative food frequency questionnaire. The mean age of study population was 34.1 +/- 0.6 years. Total energy and carbohydrate intake were higher in men than women [P<0.001]. Incomplete injured consumed more MUFA [P=0.03]. The elderly were consumed less total calorie, saturated fat, MUFA, cholesterol [P<0.01] and PUFA [P<0.05]. Injured patients with longer times had lower total calorie, carbohydrate [P<0.01], total fat and MUFA intake [P<0.05]. Based on new classification 60.5% were at the risk of obesity or obese. Central obesity was seen in 33.1%of man and 48.4% of women. BMI of the paraplegia group was greater than that of the tetraplegia group [P=0.009]. Macronutrients balance is moved towards higher saturated fat intake and less complex carbohydrates and protein intake in SCI patient's. The elderly and patients who had lived with SCI longer time tended to maintain healthier diets

[Protective effects of lycopene on the gamma-radiation induced chromosomal damage and cell killing in cultured human fibroblast cells]

Lycopene is one of the most potent antioxidants. It is a red, fat soluble pigment found in certain plants and microorganisms. Several studies have demonstrated the ability of lycopene to protect the cells from ionizing radiation induced damage, however, the mechanisms involved are remained to be clear. In the present study, we investigated the radioprotective effect of lycopene on gamma-radiation induced cytotoxicity and genotoxicity in human cultured fibroblasts. In irradiated groups fibroblast cells were irradiated with 1, 2 and 4Gy. In lycopene groups fibroblast cells were pretreated with different concentrations of lycopene [2, 10 and 20 micro M] then exposed to different doses of gamma radiation. The extent of cytotoxicity was determined by colony formation assay. The level of genotoxicity was detected by analysis of chromosmome breaks. Using colony formation assay, we observed the increase in cell killing with the increase in gamma-radiation dose [1, 2 and 4Gy]. Pre-treatment with lycopene [2, 10 and 20 micro M] restored the cell survival, suggesting that lycopene can protect the cells from killing by ionizing radiation. Similarly, lycopene significantly diminished the level of chromosome and chromatid breaks induced by gamma radiations. The maximum protection of fibroblast cells was observed at 10 micro M of lycopene pretreatment. Data showed that pretreatment with lycopene reduced the level of cell killing and chromosomal breaks and this protecive activity was dependent on the concentration of lycopene. Our finding indicate that lycopene protects human cells from radiation-induced genomic instability, and can reduce the cancerogenic effect of ionizing radiation

Etiological characteristics of people with intellectual disability in Iran

To describe the etiological characteristics of intellectual disability in one Iranian center. In a cross-sectional study, 64 cases with mental retardation [MR] were examined in the Intellectual Rehabilitation and Welfare Care Center of Vardavard, Iran between April and September 2008. Cases were diagnosed with MR or showed delay/regression of developmental milestones. We studied the records of patients and interviewed their families. A total of 64 cases were screened [most were children]. The number of male patients was 19 [29.7%] and the females was 45 [70.3%]. First degree relatives with mental retardation were found in the families of studied patients, among these relatives 48% were female and 52% were male. Up to 77% of the marriages were between relatives, approximately half between first cousins. The illiteracy rate reached 34% in the families of MR children. Hard labor, hypoxia during labor, mother's preexisting systemic disease, and maternal and neonatal infection were the most important factors for MR. Furthermore, most of the families were found to have low socioeconomic class. Cognitive disabilities in children are multifactorial. Consanguinity was the main risk factor for MR and considering its high rate in our country due to traditional marriages, it should be modified

[Prevalence of degenerative disc disorders in patients with lumbar stenosis[2003 - 2004]]

Determining the prevalence of degenerative changes by MRI in patients with low back pain [LBP] and lumbar canal stenosis is valuable for better understanding of important LSS issue. This study was designed to determine the prevalence of disc degeneration changes through MRI images obtained from patients with low back pain and lumbar spinal stenosis. This was a cross sectional study in which 53 patients [selected through examining 200 MRI images from patients seeking medical care because of low back pain [LBP] and referred to our MRI imaging center] with MRI findings compatible with lumbar canal stenosis [LSS], were investigated between June 2003 to September 2004. Intervertebral disc conditions such as normal status, bulging, and herniation were evaluated in patient's MRI images. Findings: In 53 patients with lumbar canal stenosis, 34% were women and 66% men [P<0.005]. Degenerative disc disorders [especially herniation] were found in 51% of our patients and 49% shown to have isolated bony canal stenosis occasionally with bulging discs. The isolated or combined anteroposterior [AP] diameter narrowing between patients with LBP was 94.35% in the current study compared to the previous estimation in our imaging center [80%] found in 1998. There was 5.65% isolated LR narrowing and 7.5% AP and LR narrowing in our study. Based on our results, 51% of patients had degenerative disc disorder in the form of disc herniation associated with spinal canal stenosis; 24.5% with no disc pathology, and 24.5% with bulging discs. Disc degeneration was more prevalent in stenotic group compared to non-stenotic group [51% versus 34%; p>0.03]

Evaluation of effect of silymarin on granulosa cell apoptosis and follicular development in patients undergoing in vitro fertilization

To investigate the effects of silymarin on follicular development, we enrolled 40 healthy women undergoing in vitro fertilization [IVF] due to male factor infertility in this trial. They underwent ovulation induction and on a random and blind basis, patients were assigned to receive silymarin [70 mg X 3/day] or placebo from the beginning of the induction cycle. The number and quality of oocytes retrieved were evaluated and apoptosis of granolusa cells was studied. There was no significant difference between the groups for mean number of follicles >/= 18 mm [P = 0.131], mean number of oocytes retrieved [P = 0.209] or endometrial thickness [P = 0.673]. However, the proportion of total apoptosis in the study group was significantly lower than in the placebo group [P = 0.032]. These data suggest that administration of silymarin in IVF patients concomitantly with gonadotropin results in reduction of granolusa cell apoptosis but does not have any effect in promotion of follicular development, oocyte retrieval or endometrial thickness

[Assessment of Schwann cell purity cultured in autologous human serum for spinal cord injury repair]

Background: Purity of cultured Schwann cell is very important in patients' outcome. The purpose of this study was evaluation of cell purity in a culture without nerve growth factors and fetal bovine serum

Materials and Methods: In this experimental study, for culture of human Schwann cells, nerve growth factors and fetal bovine serum were replaced by human autologous serum. Obtaining a consent from the close relative, nerve grafts were harvested and transported to processing unit where they were cultured in DMEM upon aseptic condition. Then the cultured cells were evaluated with S100 antibody staining for both morphology and purity

Results: Cell purity range was from 97% to 99% [mean=98.11+/-0.782%]. Cell count was 14055.56+/-2480.479 per microliter. There was not significant correlation between cell purity with either the culture period or the age of donors [P>0.05]. The Spearman correlation coefficient for the cell purity with the culture period and the age of donors was -0.21 and -0.09, respectively

Conclusion: We found that the replacement of nerve growth factors and fetal bovine serum with human autologous serum improves the cultured Schwann cells for clinical use with more safety and minimum reagents

[Liver mass: an overview on diagnosis]

Liver lesion is a common condition, which often detect incidentally. A large proportion of liver masses can be diagnosed by progression in imaging modalities. Although, definite diagnosis of liver mass's nature can be made by biopsy of lesion and histopathologic examination, but with imaging findings, we can approach to the diagnosis. In this study, we review many valuable articles and scientific references to define main aspects of diagnosis of liver masses

[ comparative study of patients with pulmonary tuberculosis and extrapulmonary tuberculosis in Kashan during 2002-7]

Background: many studies have shown that the extra-pulmonary tuberculosis is growing compared to the pulmonary one. This study was carried out on under-treatment TB patients in order to evaluate the comparison of pulmonary and extra pulmonary TBs in kashan

Materials and Methods: the study was carried out on available data and the medical documents of TB patients treated in "Kashan TB Center" during a five year-period [2002-7]. All relevant data regarding the treatment were collected based on the definition presented by "Iranian Defense Guidelines against TB"

Results: one-hundred and three [52.6%] female and 93 [47.4%] male TB patients were studied 89 [45.4%] of who were Iranian and 107 [54.6%] was Afghani. The prevalence of pulmonary and extra-pulmonary cases were 130 [66.3%] and 66 [33.7%], respectively. The highest number of pulmonary TB was 72[55.38%] cases in female and extra-pulmonary TB was 35[53.04%] cases in males. Forty-six [69.6%] of extra-pulmonary patients completed their treatment period and 71[54.6%] of pulmonary patients were recovered completely. The most common clinical signs in pulmonary TB and in extra pulmonary TB were coughing [90%], sputum [87.6%] and weight loss [59.1%], night sweating [40.9%], respectively. The highest prevalent foci for extra-pulmonary TB were lymph nodes [19 [28.7%] cases] and bone [12[18.18%] cases]

Conclusions: the study showed that the prevalence of extra-pulmonary TB is one third of all TB cases. Therefore in the evaluation of non-specific findings of patients, TB must be considered

Functional imaging of Broca's area in native Persian speakers: an fMRI study

The problem of localization of speech associated cortices using noninvasive methods has been of utmost importance in many neuroimaging studies, but the results are difficult to resolve for specific neurosurgical applications. In this study, we used fMRI to delineate language-related brain activation patterns with emphasis on the Broca's area during the execution of two Persian language tasks. The subjects comprised of nine healthy right-handed men who participated voluntarily in this study. They performed two consequent fMRI paradigms namely; "Word Production" and "Reverse Word Reading". The fMRI data were collected and analyzed. Then, functional images were registered to anatomical images using FSL software. The laterality indices were also calculated in regions of interest with different threshold levels. The results indicate that Broca's area, as the classical language-production center, was robustly activated while performing these two tasks. In eight out of nine subjects, the left hemisphere dominancy and Broca's area activation were observed and in one case activation was prominent in the homologous area in the right hemisphere. Similar pattern of cortical activation during Persian word production and Anglophone languages such as English was revealed. fMRI is a valuable means for brain mapping in language studies

[Extraction of optimum parameters of inducing reactive hyperaemia for increasing distensibility of brachial artery]

Nowadays, noninvasive evaluation of dilatation changes of endothelium region under hyperaemia has attracted researchers' notice. But optimum conditions for inducing hyperaemia and proper mechanical parameters based on obstruction stress, obstruction time and time of ultrasonic survey after obstruction release were not reported. This study was designed to extract optimum biomechanical parameters for inducing hyperaemia in brachial artery. First, brachial artety of healthy men were forced under 0, 50, 100, 150, 200, 250 mm Hg for five minutes, and 60 seconds after obstruction release ultrasonic assessment was performed and according to maximum distensibility of brachial artery, optimum obstruction was extracted. Then brachial artery of healthy men were forced under optimum obstraction for 1, 2, 3, 4, 5 minutes and optimum obstruction time was extracted. For extracting the optimum time of ultrasonic assessment, brachial artery of healthy men were forced under optimum obstruction pressure and time and then ultrasonic assessment was done in 30, 45, 60, 75, 90 seconds after obstruction release. For extracting diameter changes of artery, maximum systolic velocity, minimum diastolic velocity, and also radial strain and distensibility, multi frames of B-mode and Doppler images were recorded on personal computer. According to ANOVA test, optimum parameters of inducing reactive hyperaemia for increasing distensibility of brachial artery were extracted. Hyperaemia under 150 mm Hg obstruction, for a duration of 4 minutes and 45 and 65 seconds after releasing are the best conditions for ultrasonic assessments. The application of optimum reactive hyperaemia protocol can provide a more accurate noninvasive evaluation of artries' biomechanical parameters

FMRI study of human visual cortex in response to spatiotemporal properties of visual stimuli

The brain response to temporal frequencies [TF] has been already reported, but with no study reported for different TF with respect to various spatial frequencies [SF]. fMRI was performed by 1.5T GE-system in 14 volunteers during checkerboard, with TFs of 4, 6, 8 and 10Hz in low and high SFs of 0.5 and 8cpd. Average percentage BOLD signal change demonstrated the amplitude of the fMRI response to different TFs was maximal in 6Hz for high SF of 8cpd, while, it was maximal at TF of 8Hz for low SF of 0.5cpd. The results are useful for vision therapy [such as the treatment of Amblyopia] and visual task selecting in fMRI studies

Spatial frequency dependence of the human visual cortex response on temporal frequency modulation studied by fMRI

The brain response to temporal frequencies [TF] has been already reported. However, there is no study on different TF with respect to various spatial frequencies [SF]. Functional magnetic resonance imaging [fMRI] was done by a 1.5 T General Electric system for 14 volunteers [9 males and 5 females, aged 19'26 years] during square-wave reversal checkerboard visual stimulation with different temporal frequencies of 4, 6, 8 and 10 Hz in 2 states of low SF of 0.4 and high SF of 8 cycles/degree [cpd]. All subjects had normal visual acuity of 20/20 based on Snellen's fraction in each eye with good binocular vision and normal visual field based on confrontation test. The mean luminance of the entire checkerboard was 161.4 cd/m2 and the black and white check contrast was 96%. The activation map was created using the data obtained from the block designed fMRI study. Pixels with a Z score above a threshold of 2.3, at a statistical significance level of 0.05, were considered activated. The average percentage blood oxygenation level dependent [BOLD] signal change for all activated pixels within the occipital lobe, multiplied by the total number of activated pixels within the occipital lobe, was used as an index for the magnitude of the fMRI signal at each state of TF and SF. The magnitude of the fMRI signal in response to different TF's was maximum at 6 Hz for a high SF value of 8 cpd; it was however, maximum at a TF of 8 Hz for a low SF of 0.4 cpd. The results of this study agree with those of animal invasive neurophysiologic studies showing SF and TF selectivity of neurons in visual cortex. These results can be useful for vision therapy and selecting visual tasks in fMRI studies

Spiral CT scan for detecting coronary artery stenosis

Coronary vessel calcification is an obvious sign of atherosclerotic disease of coronary arteries. Electron beam CT scan is currently the imaging modality of choice for assessing coronary artery calcifications. However, its high cost makes it unavailable to a large number of medical centers. We carried out this study to compare the diagnostic yield of spiral CT scans as an alternative, to coronary angiography. A hundred patients suspicious of having coronary artery disease [CAD] underwent angiography as well as spiral CT scan of the heart. On CT scan, calcification of >90 Hounsfield on a surface area of >0.5 mm2, anatomically superimposed on coronary arteries were highlighted as calcified areas using the volumetric feature of the scanner. The findings were compared to angiographic results. Of 100 patients enrolled [62 males], 69 had coronary artery obstruction [>50% stenosis on angiography]. Angiography was normal in the rest. Spiral CT scan had a sensitivity of 94% and a specificity of 61% for the diagnosis of coronary artery disease. The PPV and NPV were 84% and 79%, respectively. Among the coronary arteries, LAD findings had the highest sensitivity [92%] and the lowest specificity [65%] in the diagnosis of CAD. With age, spiral CT scan had more sensitivity and less specificity for CAD. Detecting calcification by spiral CT scanning could be a useful non-invasive method for diagnosis and evaluation of coronary artery stenosis

Heroin associated priapism

Priapism is a pathologically prolonged and painful penile erection, usually unassociated with sexual desire or intercourse. Causes include certain oral medication, although the mechanism for drug-induced priapism is unknown. We describe one case of priapism attributed to penile heroin injection

dilemma of hemodynamic instablitiy during induction of anethesia: can midazolam serve as a suitable substitute for thiopentone?

Both midazolam and thiopental sodium are being used as induction agents and for maintenance of anesthesia. In contrast to other benzodiazepines such as diazepam, metazoan has a rapid onset of action and fast distribution and causes few cardiovascular or respiratory effects. Being water soluble, midazolam is also associated with a low incidence of venous irritation. The purpose of this study was to see whether midazolam is a suitable substitute for thiopental sodium as an induction agent. To compare the hemodynamic changes associated with midazolam and thiopental sodium as induction agents, this study was conducted in two groups each comprising of 30 patients. No significant hemodynamic changes regarding heart rate and blood pressure could be noticed in the two groups [p<0.05]. All patients in the midazolam group exhibited anterograde amnesia but in the thiopental group, 20% of the patients had recall for operative events one hour after completion of surgery. To arrive at more conclusive results, preferably multi-center studies involving large numbers of cases are recommended

Isolated cervical osteochondroma manifesting as spasmodic torricollis: a case report

We present a 30-year-old man with cervical spine osteochondroma who manifested as spasmodic torticollis. The patient was treated medically for three years without any improvement. Eventually patient's medical records was reviewed and a structural disparity was detected in plain radiography. Further study confirmed a bone tumor in the left pedicle of third cervical vertebra. Upon surgical excision of the mass, the C3 spinal root was released and main bulk of the tumor was resected. Pathologic findings was in favor of osteochondroma and clinical symptoms was fully abated after surgery. Cervical spine tumors such as osteochondroma is an uncommon cause of spasmodic torticollis, however, always should be kept in mind as one of the etiologies

Neurogenic hypertension: report of five cases to highlight the controversy

The entity of "neurogenic hypertension" is defined as arterial hypertension caused explicitly by derangement of the intricate network of the central nervous system. Among 193 cases of cranial rhizopathies operated on between 1984 and 1995 at this center, 5 cases of established arterial hypertension with concomitant rhizopathies also underwent ventrolateral medullary decompression. The elevated blood pressure showed an incredible decline, reaching normal values after vascular decompression. The systolic blood pressure however showed a much greater fall than the diastolic component. An endeavour is made to throw light on the cases operated on with special emphasis on the central nervous system as an etiological factor to explain the cause of essential hypertension