Associated Risk Factors Of Acute Myocardial Infarction Among Hunan Population In China

@#The purpose of this study to determine the clinical characteristic of the associated risk factors of acute myocardial infarction patients (AMI) among the Hunan Han population in China. The retrospectively collected the records data of 595 both STEMI and NSTEMI patients from the first Xiangya hospital, Hunan, China over a period of January 2018 and December 2018. These studies revealed clinical characteristics with associated risk factors among acute myocardial infarction patients. A total of 595 diagnosed acute myocardial infarction patients participated in this study among males 70.9% and females 29% with mean age e 52.9+11.3 years. While 90% had STEMI and 9.9 % had NSTEMI. The chest pain 94.4%, 86% and shortness of breath 55%, 100% presented with STEMI and NSTEMI groups respectively. Smoking incidence in male subject 70.3% had higher than in female subject 29.1 % (P<0.05). Hypertension and diabetes mellitus found 59%, 69.5% in male participants as compared to 40.6%, 30.4% in female participants respectively (P<0.05). However, no statistical difference was found among dyslipidemia males 48.6% and females 47.4%. The most common type of AMI was STEMI and usually presented with chest pain and shortness of breath. The AMI patients were more found in male and common associated risk factors were smoking and hypertension followed by diabetes mellitus and dyslipidemia.

Pregnant women risk perception of medications and natural products use during pregnancy in Alahsa, Saudi Arabia

Introduction: The use of medications during pregnancy has increased in the recent years. Some congenital anomalies, birth defects, and miscarriages have been found to be preceded by some medications use during pregnancy. The use of herbal medicines is not yet proved to be safe during pregnancy, since some herbs showed increased risk of certain congenital malformations

Aim: This study assesses the pregnant women perception, beliefs, and attitude toward medication and natural products use and their influencers during pregnancy

Methodology: This is a cross-sectional study targeting women in Alahsa, Saudi Arabia. More than 300 women have responded to a pretested questionnaire collecting their sociodemographic, perception and attitude toward medication and natural product. The data were analyzed using SPSS Statistics under the supervision of a statistician

Results: This study involved 184 participants, 29.2% of pregnant women avoided using prescribed medications, 40.7% non-prescribed, and 33.3% natural products during pregnancy. Paracetamol was on the top of the avoided medications, and herbals were on the top of the avoided natural products. The most common reason for avoidance was fearing of its effect on fetus. More than half of the participants always looked for the product safeness. Pain killers, antibiotics, cinnamon, and pineapple are the most commonly believed products to be harmful during pregnancy. 1st trimester is believed to be the critical period in which medications and herbals should be avoided

Conclusion: Pregnant women should be educated more about unsafe products during pregnancy. Women's beliefs about natural products need further exploration because of lack of evidence

Prevalence of people that using multivitamins supplementation and experiencing a side effect in Saudi Arabia

Introduction: multivitamins are normally used to treat vitamin deficiencies. They may cause constipation and diarrhea. We are concerned to see the prevalence for using multivitamins supplementation and awareness of their side effects among saudi people

Methods: we conducted a cross sectional study and data collected by distributing an electronic questionnaire from 6/3 to 15/8/2017 and approved by the King Faisal University in Alhass, SA. Both gender above 18 years were included and excluded people below them. Statistical analyses were performed using SPSS

Results: this study was applied on 471persons from different areas of Kingdom of Saudi Arabia. Most of them were female 67.5 %.the age of our studied group was above 18 years. Most of them was healthy, pre-university, from western area and used multivitamins for weight gain. 15.5% had harmful effect and 69.6% had vitamins or minerals deficiency [51.7% iron deficiency]. 43.1% used them with no prescription and 85% used as pill. 80.8% considers them are important to their health and 35.8% believe there is no difference between using vitamins with or without medical advice. 24.9% believe they have no side effects and16.3% believe that they are sufficient for the variety and quantity of food.70.7% believe that the amount of vitamins in the food is not sufficient for the daily body and 42.5% read about vitamins from scientific books

Conclusion: the majority of the participants were using vitamins according to medical advice and there is a less percentage of people that experienced a side effect from using that supplementations

Objectives: to determine the prevalence, reasons, source of information of multivitamins supplement uses, and their side effects

Immunohistochemical expression of Napsin A, CD82 and Cyclin D1 in some renal tumors

Background: most of renal neoplasms are of epithelial origin and they are malignant. Renal cell carcinoma [RCC] accounts for approximately 2% of all cancers. The disease resulted in more than 100,000 yearly deaths worldwide. Histologic diagnosis of renal neoplasms is usually straight forward by routine light microscopy. However, immunohistochemistry may be essential in several contexts, including differentiating renal from nonrenal neoplasms, differentiating subtypes of primary renal epithelial neoplasms and diagnosing rare types of renal neoplasms or metastatic RCC in biopsy specimens

Aim of the work: multiple therapeutic options tailored to an individual patient are now being offered. In view of these developments, availability of a robust and dependable panel of immunohistochemical stains becomes even more important because pathologists are frequently asked to render diagnosis on limited material

Material and methods: in this study a total number of 50 cases of some types of renal cell tumors were immunohistochemically stained for Napsin A, CD 82 and Cyclin D1

Results: these cases included 18 cases of ccRCC [36%], 16 cases of PRCC [32%], 8 cases of ChRCC [16%] and 8 cases of oncocytoma [16%]

Conclusion: we concluded that napsin A may be useful in differentiating between ccRCC and PRCC [particularly type 1 which showed more vacuolated or clear cytoplasm]. CD82 may be useful in differentiating between ChRCC, which was CD82 positive and oncocytoma, which was CD82 negative. Cyclin D1 had no significant value in the differentiation of different types of renal epithelial tumors

Recommendation: we recommended the usage of Napsin A in differentiating between ccRCC and PRCC and CD82 in differentiation between ChRCC and oncocytoma. More studies are needed to evaluate napsin A in differentiating between ChRCC and oncocytoma

Awareness and attitude among Saudi females toward breast cancer screening in Al-Ahsa, KSA

Background: breast cancer is a progressive disease, there are three screening tests essential for early detection; clinical breast examination [CBE], X-ray mammography and breast self-examination [BSE]. Lack of knowledge and wrong beliefs about cancer breast prevention among women affect adversely on their perception of cure from early detection of the cancer and of screening tests effectiveness

Aim of the work: this baseline study aimed to assess the awareness of females in Al-Ahsa about breast cancer and their practice of BSE

Materials and Methods: this was a cross-sectional research, a self-administered survey was used a questionnaire was distributed to 400 females aged between 20 and 70 years. The questionnaire was divided into three domains: socio-demographic characteristics, the respondent's knowledge of breast cancer and BSE and their experience of breast cancer screening and breast self-examination [BSE]. Statistical analysis was performed using SPSS version 23

Results: the overall response rate was 93.3%. Approximately half of the respondents were highly educated [Bachelor degree] 109 [59.6 %]. Of 319 female that responded only 98 [39.7%] had good awareness of breast cancer. 281 [88.1%] perceived the cause to be brought about by smoking. This was followed, in descending order, by 272 [85.3%] who felt that the old age caused breast cancer, 264 respondents [82.8%] attributed the cause to hereditary, 211 [66.1%] attributed the cause to oral contraceptive use. Most of the participants were aware about the protective effect of the breast feeding and multiparty against breast cancer, 306 [95.9%], 247 [77.4%] respectively Overall, 114 [35.7%] of the participants aware of breast cancer knew of BSE as a method for the early detection of breast cancer and only 14 [4.4%] had ever performed

Conclusion: the current status of awareness of breast cancer in Al-Ahsa and their use of BSE are insufficient. Women need to be encouraged to self-monitor in order to detect abnormalities in their breasts. Appropriate educational interventions are urgently required to encourage women to engage in regular BSE

Impact of usage of different coping strategies on academic performance of female students in college of medicine, al-ahsa

Background: academic stress can be prescribed as mental distress with respect to some anticipated frustration associated with academic failure or even awareness of the possibility of such failure. Medicine in specific is one of the most stressful fields of education because of its highly demanding professional and academic requirements, highly extensive medical curricula, repeated difficult exams and fear of failure all are causes of persistent stress and anxiety for medical students. Student's ability to handle these increasing demands of medical school can affect their academic success and emotional health. Experiencing stress and anxiety is beneficial to some extent as it can enhance the academic performance. In the other hand, increasing levels of stress that students exposed may have a negative effect on their cognitive functioning and learning abilities in the medical school. Coping is an important key point of dealing with stress and preventing psychological problems

Aim of the work: this study explored the impact of usage of different coping strategies on academic performance of students of College of Medicine in Al-Ahsa, 2018 and which type they use more than the other and which of these different strategies comprise more satisfaction than the others do

Methods: this was a cross sectional study was carried out among female students in college of medicine in king Feisal University in the academic year 2017-2018. Data had been collected by electronic and paper survey, which contained demographics, educational level, family income, GPA, studying hours and the Lazarus's ways of coping framework, which was a widely accepted model containing 66 points that distinguishes between distinct active and emotion based coping methods

Results: 73 students were completed the survey, 58.9% of them reported being upset/sad for significant amount in 2 weeks period, and 49.3% of students report that they feel they need psychiatric consultation. No significant association was noticed between GPA and each of coping strategies addressed in this study. Positive reappraisal was the most used strategy by 76.86%, while confrontive coping was the least to use by 55.83%

Conclusion: medical students were more vulnerable to academic stress due to highly demanding professional and academic requirements. To overcome this, students used different coping strategies. According to our study, there was no significant impact on the GPA or difference between these strategies

Neurofeedback effect on perceptual-motor skills of children with adhd

Objectives: This Study investigates the impact of neurofeedback on perceptual-motor skills of 5 to 12 years old children with Attention Deficit Hyperactive Disorder [ADHD]

Methods: In this clinical Study, 40 children between the ages of 5-12 years, who were patients of the Tavanesh Clinic and diagnosed with ADHD, were randomly chosen and divided into two groups of control and test. 20-neurofeedback intervention sessions were performed The tools utilized in this Study included Bruninks-Oseretsky Tesl of Motor Proficiency and Child behavior checklist [CBCL] survey questionnaire. For evaluation after the intervention, Bruninks-Oseretsky TeSt of Motor Proficiency scale for children, along with CBCL questionnaire surveys were asked to fill up by the participants' mothers

Results: After the intervention, the analysis of the scores in all perceptual-motor skills showed significant differences in both groups, but no significant difference was observed in the subteSt of Strength. The CBCL survey questionnaire revealed that the average scores on attention disorder, aggression, lack of attention and hyperactivity, externalizing and general problems in the test group is significantly less than that of the control group. However, in the confrontational behavior [internalization], there was no Statistically significant difference between the test and control groups

There was a correlation between the change of motor skills and change of behavioral patterns in ADHD children

Discussion: Neurofeedback intervention can have positive effects on improving the perceptual-motor skills of children with ADHD

The diagnostic value of circulating microRNAs for middle-aged (40–60-year-old) coronary artery disease patients

OBJECTIVE: Circulating microRNAs have been recognized as promising biomarkers for various diseases. The present study aimed to explore the potential roles of circulating miR-149, miR-424 and miR-765 as non-invasive biomarkers for the diagnosis of coronary artery disease in middle-aged (40–60-year-old) patients. METHODS: Sixty-five stable coronary artery disease patients (49–57 years old), 30 unstable coronary artery disease patients (49–58 years old), and 32 non-coronary artery disease patients (49–-57 years old) who were matched for age, sex, smoking habits, hypertension and diabetes were enrolled in this study. Total RNA was isolated from plasma with TRIzol reagent. Circulating miRNA levels were measured by quantitative real-time polymerase chain reaction. RESULTS: Circulating miR-149 levels were decreased 4.49-fold in stable coronary artery disease patients (1.18 ± 0.84) and 5.09-fold in unstable coronary artery disease patients (1.04 ± 0.65) compared with non-coronary artery disease patients (5.30 ± 2.57) (p<0.001). Circulating miR-424 levels were reduced 3.6-fold in stable coronary artery disease patients (1.18 ± 0.60) and 5-fold in unstable coronary artery disease patients (0.86 ± 0.54) compared with non-coronary artery disease patients (4.35 ± 2.20) (p<0.001). In contrast, circulating miR-765 levels were elevated 3.98-fold in stable coronary artery disease patients (6.09 ± 2.27) and 5.33-fold in unstable coronary artery disease patients (8.17 ± 2.77) compared with non-coronary artery disease patients (1.53 ± 0.99) (p<0.001). Receiver operating characteristic curve analysis revealed that the respective areas under the curve for circulating miR-149, miR-424 and miR-765 were 0.938, 0.919 and 0.968 in stable CAD patients and 0.951, 0.960 and 0.977 in unstable coronary artery disease patients compared with non-coronary artery disease patients. CONCLUSION: Our results suggest that circulating miR-149, ...

Is LASIK an effective treatment modality for hyperopia or hyperopic astigmatism?

Purpose: To assess the efficacy, safety and stability of LASIK surgery for treatment of low to moderate degree hyperopia and hyperopic astigmatism

Patients and methods: The study included 34 eyes in 17 patients [7 males, and 10 females] with bilateral low to moderate degree hyperopia or hyperopic astigmatism. Their mean age +/- SD was 26.7 +/- 4.1 years. Range of hyperopia was between +1.75 to +5.50 D, astigmatic errors range was 0.00 to -1.50 D while the spherical equivalent refraction ranged from +1.4 to + 4.8 D. Patients included in this study had a stable refraction for at least one year. All patients underwent bilateral LASIK surgery in the same session in Dr Soliman Faqeeh Hospital [DSFH] and the Eye Subspecialty Center [ESC]using the ALLEGRETTO EYE - Q Excimer Laser machine

Results: UCVA after one year was 20/20 or better in 30 eyes [88.2%], 20/30 or better in 32 eyes [94.1%] and 20/40 or better in 34 eyes [100%], while BCVA was 20/20 or better in 33 eyes [97.1%] and 20/40 or better in 34 eyes [100%]. There was no decrease in UCVA after LASIK surgery. One eye [2.9%] showed 2 lines drop in BCVA after LASIK surgery due to broad wrinkles of the flap. The flap was lifted after one day; trial to flatten the wrinkles showed incomplete resolution. One eye [2.9%] showed diffuse lamellar keratitis [DLK] at one week after LASIK surgery. There was regression in the manifest spherical equivalent refraction one year after LASIK surgery as compared with that at one month, but the difference was statistically insignificant [P=O.46]. The mean score of patient satisfaction was 9.4 at one year postoperatively

Conclusion: LASIK surgery is a safe, predictable, stable and effective for treatment of mild to moderate degree hyperopia and hyperopic astigmatism. No significant regression in UCVA, BCVA or manifest refraction was reported up to 12 months follow up

Effect of follicular flushing during oocyte retrievalon clinical outcome of assisted reproductive technology

Is to determine whether follicular aspiration and flushing increase the number of oocytes yield and pregnancy outcome over aspiration alone in women undergoing ICSI. Prospective randomized controlled trial. One hundred eighty five infertile women who underwent ICSI were included in the study. They were randomized into two groups 92 cases in [aspiration and flushing group] and 93 cases in [aspiration only group],during the period from September 2011 to September 2013. Controlled ovarian hyperstimulation using long GnRH agonist was the standard protocol, hCG administrated 10000 iu when three or more follicles were at least 18 mm in largest diameter, Trans-vaginal follicular aspiration performed 34-36 hours after hCG trigger. In the aspiration alone group, a 16 gauge single lumen needle used, with suction continue until a small amount of blood stained fluid appeared in the tubing or flow stop, When flushing accompany aspiration of follicular fluid in the study group, the same needle used with a double-way tap allowing flushing of [2 ml] of embty follicleby Earl's medium till oocyte retrieved or maximum two times. The study observed 60.5 % oocyte recovery rate with aspiration only compared with 80.9 % with follicular aspiration and flushing.Operative time [minutes] was significantly longer among flushing group, the retrieval time was 1.3 fold higher among those undergoing follicular flushing. Pregnancy was non-significantly more frequent among flushing. Implantation rates non-significantly more frequent among flushing group than non-flushing group [31.6% versus 26.3%, P= 0.424] and ongoing clinical pregnancy non-significantly more frequent among flushing group [27.4% versus 21.1%, P= 0.31]. Conclusion, flushing non-significantly increase implantation and clinical pregnancy outcome and associated with a significant increase in the procedure time for oocyte retrieval, so patient groups where a small number of oocytes are available for retrieval may represent patients most likely to benefit from follicle flushing as only one extra oocyte may affect the outcome

Value of cerebrospinal fluid tumor necrosis factor-alpha [TNF-ALPHA] for rapid diagnosis of bacterial meningitis

Meningitis is common in tropical areas and also in Egypt and has a world-wide distribution This study evaluated the potential role of CSF TNF alpha in diagnosis and differential diagnosis of acute meningitis [bacterial versus aseptic meningitis]. This case-control study was conducted between Ain Shams University Tropical Medicine Department and Embaba Fever Hospital. Fifty patients with suspected meningitis were recruited during from January 2014 to June 2014. They were divided according to culture results into 2 groups: GI: 40 patients with acute bacterial meningitis [proved by CSF culture], G2: 10 patients matched according to age and sex with clinical sings of CNS infection but without laboratory evidence of bacterial origin, [Suspected cases, and negative culture]. Both groups were subjected to thorough history taking, full clinical examination, and laboratory investigations including CSF analysis and CSF TNF was measured by ELISA. The results showed a highly significant difference between cases and control regarding CSF TNF [P=0.00]. The criteria's of diagnostic validity test was 100% for all at cutoff >/= 275ng/ml and 0.05]

Identification of Malassezia species isolated from patients with Pityriasis versicolor using PCR-RFLP method in Markazi province, central Iran

The lipophilic yeasts of Malassezia species are members of the normal skin microbial that are cause of pityriasis versicolor. Pityriasis versicolor is a common superficial fungal infection with worldwide distribution. The phenotypic methods for identification of Malassezia species usually are time consuming and unreliable to differentiate newly identified species. But DNA-based techniques rapidly and accurately identified Malassezia species. The purpose of this study was isolation and identification of Malassezia Species from patients with pityriasis versicolor by molecular methods in Markazi Province, Central Iran in 2012. Mycologic examinations including direct microscopy and culture were performed on clinical samples. DNA extraction was performed from colonies. The ITS1 region of rDNA from isolates of Malassezia species were amplified by PCR reaction. The PCR were digested by Cfo I enzyme. From 70 skin samples, were microscopically positive for Malassezia elements, 60 samples were grown on culture medium [85.7%]. Using PCR-RFLP method, that was performed on 60 isolates, 37[61.6%] M. globosa, 14[23.3%] M. furfur, 5[8.4%] M. sympodialis and 4[6.7%] M. restrictawere identified. In one case was isolated M. globosa along with M. restricta. The PCR-RFLP method is a useful and reliable technique for identification of differentiation of Malassezia species

effects of Adiantum capillus-veneris on wound healing: an experimental in vitro evaluation

A lot of remedies, mostly plant based, were mentioned in the Persian old pharmacopoeias for promoting of burn and wound healing and tissue repairing. The efficacy of most of these old remedies is unexplored till now. Adiantum capillus-veneris from Adiantaceae family is one of them that was used to treating of some kinds of chronic wounds. Methanol extract was fractionated to four different partitions that is, hexane, ethyl acetate, n-butanol, and aqueous. The potential of A. capillus-veneris fractions in wound healing or prevention of chronic wounds were evaluated through angiogenesis and fibroblast proliferation, in addition to in vitrotests for protection against damage to fibroblasts by oxygen free radicals. The aqueous part of A. capillus-veneris promoted significant angiogenesis [P < 0.05] through both capillary-like tubular formations and proliferation of endothelial cells in vitro. In addition, in the tests for protection against damage to fibroblasts by oxygen free radicals, aqueous and butanol fractions showed significant protective effects in the concentrations 50, and 500 microg/ml [P < 0.05] in comparison with a control group. In the toxicity testing, it showed weak irritation in the Hen's egg test chorioallantoic membrane [CAM] bioassay at the vascular level on the CAM of the chicken and no significant cytotoxicity in the MTT assays on normal human dermal fibroblasts. Angiogenic effects and protective effects against oxygen free radicals suggested aqueous partition of A. capillus-veneris local application for prevention of late-radiation-induced injuries after radiation therapy and healing of external wounds similar to bedsores and burns

Prediction and control of stroke by data mining

Today there are abounding collected data in cases of various diseases in medical sciences. Physicians can access new findings about diseases and procedures in dealing with them by probing these data. This study was performed to predict stroke incidence. This study was carried out in Esfahan Al-Zahra and Mashhad Ghaem hospitals during 2010-2011. Information on 807 healthy and sick subjects was collected using a standard checklist that contains 50 risk factors for stroke such as history of cardiovascular disease, diabetes, hyperlipidemia, smoking and alcohol consumption. For analyzing data we used data mining techniques, K-nearest neighbor and C4.5 decision tree using WEKA. The accuracy of the C4.5 decision tree algorithm and K-nearest neighbor in predicting stroke was 95.42% and 94.18%, respectively. The two algorithms, C4.5 decision tree algorithm and K-nearest neighbor, can be used in order to predict stroke in high risk groups

Evaluation of intima media thickness of carotid arteries in 40-60 years old persons with type D personality and its comparison with normal ones

In some studies, the involvement of dangerous psychological and behavioral factors in etiology and physiotherapy of vascular disturbances have been shown. In other studies, the relationship between the personality type and increase in cardiovascular disease has been demonstrated. The type D personality is defined as having two characteristics of negative affect and social inhibition. It is thought that individuals with type D personality are at increased risk of carotid artery intima-media thickening which predisposes them to vascular disease that is one of the most important factors for the stroke. In this study, we try to determine whether type D personality is a contributing factor to an increase in the intima-media of the carotid artery. This study was done in 2012 in the teaching hospital of Alzahra in Isfahan Iran. This is a case/control study which is done at Alzahra hospital in Isfahan in 2011-12. The statistical population in this study is composed of individuals who do not have any risk factors for stroke and are randomly selected among the hospital staff or the patient's family members who accompanied the patient at the hospital. They filled out a questioner that would assist in detecting type D personality. A carotid Doppler ultrasound that measures the intima media thickness in the selected individuals was performed. The information obtained from the study was evaluated by Statistical Product and Service Solutions [SPSS] software and the intima-media thicknesses were compared in two groups of patients. The average thickness of intima media in two groups, consist of placebo and patients, was 0.739 +/- 0.12 and 0.759 +/- 0.14 millimeter, respectively. There was no meaningful difference between the two groups based on t-test values [P = 0.19]. It is important to note that based on the results, 22.9% of placebos and 48.6% of individuals with type D personality presented with abnormal thickness. The difference between the two groups were meaningful based on Chi-Squared test [P = 0.001]. We conclude that type D personality increases the risk of cardiovascular diseases specially the stroke and myocardial infarction due to the higher prevalence of hormonal imbalances leading to arterial vasospasm and atherosclerotic disease. As a result, it is necessary to evaluate and treat these patients due to increased risk of atherosclerotic diseases, stoke, and myocardial infarction

Effect of nicotine administration on physical and psychological signs of withdrawal syndrome induced by single or repeated doses of morphine in rat

Background and purpose: Morphine addiction and morphine withdrawal syndrome are of main problems in human societies. In the present study, effect of nicotine on the strength of physical and psychological dependency, produced by single and repeated doses of morphine, was investigated

Material and method: Male wistar rats were dependent to morphine with single and repeated dose protocols. In the single dose protocol, rats received only one dose of morphine and 24h later were given Naloxone. In the repeated dose protocol, rats received incremental doses of morphine for 7 days and 24h after the last dose [8th day] were given Naloxone. In the single dose protocol, rats were given one dose of nicotine 30 min before Naloxone. However in the repeated doses they received nicotine 15 min before morphine for 4 days from 4th day to 7th day. 5 min after Naloxone each rat?s behavior was captured for 30 min. then physical and psychological signs of withdrawal syndrome were recorded

Results: Results showed that injection of repeated and even single dose of morphine can produce dependency. Nicotine consumption attenuated strength of withdrawal syndrome signs, specially increasing weight excrement and total withdrawal score in single dose protocol and weight excrement increasing, weight decreasing, place aversion, and total withdrawal score in repeated dose treatment

Conclusion: Based on our data, even a single dose of morphine can produce dependency in rats. Conversely, Nicotine consumption attenuates strength of withdrawal syndrome signs

effect of nicotine administration on physical and psychological signs of withdrawal syndrome induced by single or frequent doses of morphine in rats

Morphine addiction and morphine withdrawal syndrome are the two main problems of today's human society. The present study has investigated the effects of nicotine on the strength of physical and psychological dependency in single and repeated doses morphine administrated rats. Male Wistar rats were subjected to morphine consumption with single or frequent dose protocols. In the single dose protocol, rats received only one dose of morphine and 24hrs later they also received one dose of nicotine 30 min prior to injection of naloxone. In the repeated dose protocol, rats received incremental doses of morphine for 7 days and 24hr after the last dose [the 8th day] were given naloxone. However, the nicotine regimen of this group was injected 15 min before the morphine injection, for 4 days, from the 4th to the 7th day. Five minutes after naloxone injection, each rat's behavior was captured for 30 min, and then physical and psychological signs of withdrawal syndrome were recorded. Data were analyzed by ANOVA followed by Tukey tests and p<0.05 was considered as significant difference. Results showed that the injection of frequent and single doses of morphine lead to morphine dependency. In single dose protocol, nicotine consumption attenuated the signs of withdrawal syndrome, especially weight of excrement and total withdrawal score. In frequent dose protocol, in addition to these effects, nicotine induced weight loss and place aversion. The inhibitory effects of nicotine on signs of withdrawal syndrome may involve a dopaminergic portion of the central nervous system and is mediated by central nicotinic receptors. There is also a cross-dependence between nicotine and morphine

[ efficacy of botulinum toxin type A injection in the hamstring and calf muscles with and without serial foot casting in gait improvement in children with cerebral palsy]

The goal of this study was to compare the efficacy of botulinum toxin type A [BTX-A] injection in the hamstring and calf muscles with and without ankle serial casting in the improvement of gait in children with cerebral palsy [CP]. This double-blind prospective clinical trial was performed on 25, 2 to 8-year-old children with hemiplegic or diplegic CP in Tehran, Iran in 2010. The participants were chosen by simple randomized sampling and were matched for age, gross motor function classification system [GMFCS] and type of CP and were randomly divided into two groups: children in the first group [13] only received BTX-A injection, but the second group [12] received BTX-A and serial foot casting starting one week after the injection. Comparison of the gross motor function, right and left knee spasticities and passive ROM of both knees between the two groups before and 1, 3, 6 and 12 months after the injections were not statistically significant [P>0.1]. Furthermore, comparison of the right and left ankle spasticities and passive ROM before the injections and in1 and 3-month follow-ups did not show a statistically significant difference [P>0.1], but the differences were significant in 6 and 12-month follow-ups [P<0.05]. BTX-A injection with serial foot casting vs. BTX-A alone was more effective in decreasing spasticity and improving passive ROM in the ankle of children with CP, but such injections in the hamstrings were not useful in these regards

single posterior approach for vertebral column resection in adults with severe rigid kyphosis

Correction of severe kyphosis is a challenging operation in spinal surgery. A two stage operation has been commonly used: anterior release and decompression followed by posterior correction and fusion. We describe the posterior vertebral osteotomy technique for eorrecticfn of severe and rigid kyphosis through posterior-only approach. Twelve patients [six male and six female] with severe and rigid kyphotic deformity of the thoracic spine were treated by posterior vertebral column resection using a single posterior approach. The apex level of kyphosis was at the upper thoracic in five patients, the lower thoracic in four patients and mid thoracic in three patients. There was old fracture in one patient, congenital deformity in six, tumor in three and neurofibromatosis in two patients. After posterior vertebral column resection, segmental posterior instrumentation was used for correction of the kyphotic deformity. Complications and radiographic findings were analyzed to evaluate clinical outcomes and radiologic changes of posterior vertebral column resection in patients with angulated kyphotic deformity. The major curve correction was averaged 31.66 ° [SD=15.69] [45%]. The resection was performed at the involve level in every patient. Posterior segmental fusion was achieved in average 8.9 [SD=1.7] segments. Anterior reconstruction was with titanium mesh cage in two and with cancellous chip packing in other patients. There were no neurologic complications after six month. Bony fusion achieved in all patients, and there was no correction loss. Satisfactory correction is safely performed by posterior vertebral column resection with a direct visualization of the circumferentially decompressed spinal cord. Although the performance is technically laborious, it offers good correction without jeopardizing the integrity of the spinal cord

[Survey the average of cost in out patient and imaging in Alzahra hospital and comparing with service's tariff]

One of the basic problems of hospital management is lack of an effective fiscal system, which causes in loose cost control. Meanwhile, accounting techniques and economic analyses may help the managers to decide better in planning programs and investing fields. Then, it's time to have a better estimate of health care services costs in our competitive situation for the hospitals, in this case "The Isfahan Al-Zahra Hospital". This study based on the data in the first half of 2006. This was a descriptive retrospective study on different clinical and Para clinical departments of the Isfahan Al-Zahra Training and Medical Services. All direct and indirect costs gathered through fiscal system documents and via direct process observations. Health care costs estimated using cost accounting techniques after fragmenting all accumulated costs over relative cost centers. Data analyzed by Excel software. The mean value of expense were 14.2 $, 0.7 $ and 4.6 $ in general clinical, libratory and radiology departments, respectively the mean value of expense were 2.8, 10.5, 24.5, 9, 2.5, and 5.8 in sonogeraphy, CT scan, MRI, EEG, ECG and rehabilitation departments respectively. Mean of different with the governmental price were 8.2, 0.03, 1, 6.7, 8.7, 22.9, 12, 0.1, and 3.7 $ in clinics, laboratory, radiology, sonogeraphy, CT scan, MRI, EEG, ECG and rehabilitation departments respectively. According to the findings, except for some Para clinic services, others showed a noticeable imbalance between their costs [at the end] and their Tariffs. This- in turn- conducted to an economic imbalance in those departments in the survey period