Excerpts from Persian Medical Literature
Excerpts from Persian Medical Literature
Intravitreal Clindamycin and Dexamethasone versus Pyrimethamine, Sulfadiazine, and Prednisolone in Treatment of Ocular Toxoplasmosis
This study compared the efficacy of intravitreal clindamycin plus dexamethasone (IVCD) with classic treatment (CT) for ocular toxoplasmosis.
This was a prospective, randomized single-masked clinical trial of 68 patients with active ocular toxoplasmosis. Patients were randomly assigned to two treatment groups: IVCD (n = 34) and CT (n = 34). The IVCD group received 1–3 injections of 1 mg intravitreal clindamycin and 400 g/ldexamethasone.The CT group received six weeks of treatment with pyrimethamine and sulfadiazine plus prednisolone. Antitoxoplasmosis antibodies (IgM and IgG) were measured by enzyme-linked immunosorbent assay.
The mean number of injections in the IVCD group was 16. Reductions in lesion sizewere statistically significant after treatment in both the IVCD (P < 0.001) and CT groups (P = 0.009). The difference in the mean percentage of reduction at six weeks was not significant in the IVCD group (57 ± 27.6%) versus the CT group (58.4 ± 29.3%). When compared to baseline, VA increased by 0.44 ± 0.24 and 0.29 ± 0.19 logarithm of the minimum angle of resolution units in the IVCD and CT groups, respectively (P < 0.001).However, the difference in VA improvement between groups was not significant. The interaction effect of IgM and treatment group on lesion size reduction was significant (P = 0.002).This indicated that IgM-positive cases responded better to CT and IgM-negative cases responded better to IVCD treatment. Reductions in vitreous inflammation were comparable between the groups. Within two years, four eyes (two in each group) had one episode of recurrence. Adverse drug reactions occurred in two patients in the CT group. No major injection-related complications were encountered in the IVCD group.
Intravitreal injection of clindamycin and dexamethasone may be an acceptable alternative to CT in ocular toxoplasmosis. IVCD may be more convenient, have a safer systemic profile and greater availability, with the need forfewer follow-up visits and hematologic evaluations.
Authors: Azirnzadeh A, Soheilian R, Esfandiari H, Sadoghi MM, Ramezani AR, Dehghan MH,et al.
Source: Bina J Ophthalmol. 20l2; 17(3):192– 196.
Household Food Security Status and Consumption among High School Students in Esfahan, Iran
Food safety (access to safe, nutritious, affordable food) is one of the important determinants of the status of health. Since the monitoring and assessing factors associated with food security are essential for health planning, this study attempts to determine household food security status and food consumption amongst high school students' families in Esfahan, Iran.
This cross-sectional study was conducted in Autumn 2008 on 580 high school students (14 – 17years old)from Esfahan, Iran using a systematic cluster sampling. A food security and food frequency questionnaire was completed by interviewing students and their mothers.
The prevalence of household food insecurity was estimated as 36.6% (95%CI: 33 – 40). Household food insecurity was positively associated with frequency of some food group intakes among students, such as bread, macaroni, potato, legumes, and eggs (P < 0.05). In addition, negative associations were observed between food insecurity and the frequency of other food group intakes, including rice, red meat, sausage, hamburger, poultry, fish, green vegetables, root and bulb(colored) vegetables, melons, bananas, pineapple, coconut, mango, apples, oranges, milk, and yogurt (P < 0.05).
The results of this study indicated that food insecurity is prevalent among students’ households in Esfahan. In addition, students who reside in food-insecure households more frequently consume inexpensive foods that contain a high energy per kg. Therefore, appropriate nutritional programs should be designed to improve the quality of household food consumption.
Authors: Mohammadzadeh A, Dorosty AR, Eshraghjan MR.
Source:Iranian Journal of Epidemiology. 2011; 7(1): 38 – 43.
Anterior Pituitary Function Following Traumatic Brain Injury
Neuroendocrine dysfunction following traumatic brain injury (TBI) is frequently missed due to the absence of major symptoms. Thus, often no appropriate management is prescribed which delays patient recovery. This study aimed to determine the frequency and pattern of anterior pituitary dysfunction following TBI. From June to December 2009, a total of 156 cases were admitted to a trauma center following TBI. Out of 70 patients (61 males and 9 females; mean age: 30 years) included in the study, 39 had moderate TBI (GCS: 9 – 12) and 31 had severe TBI (GCS < 8). Patients were tested six months after injury for possible secretory abnormalities of the anterior pituitary hormone. Anterior pituitary secretary function was assessed by the measurement of serum levels of FT4, TSH, basal GH, IGF-1, 8 am cortisol, FSH, LH, total testosterone, and prolactin. Dynamic tests of ACTH and glucagon stimulation were used to evaluate the pituitary-adrenal axis and GH secretory status. There were 41 patients (58.6%) noted to be suffering from at least one hormonal secretory abnormality, as follows: gonadotropins (LH, FSH, 12.9%), corticotropin (ACTH, 12.9%), somatotropin (GH, 4.3%), and prolactin (PRL,1.4%). There was no case with thyrotropin deficiency. Hyperprolactinemia was found to be present in 23 cases (31.5%). The results of this study showed that anterior pituitary hormone deficiencies occurred frequently, six months following TBI. Most commonly involved were the pituitary-gonadal and the pituitary-adrenal axes. Hypocortisolism may be particularly harmful for patients' health.
Authors: Abbasi Ranjbar I, Bahrami A, Shakeri M, Aliasgarzadeh A, Mobasseri M, Najafipour F, et al.
Source: Iranian Journal of Endocrinology and Metabolism.2012; 3: 524 – 529.
Prevalence of Gastrointestinal Symptoms in Type 2 Diabetic Patients and their Associations with Glycemic Control and Diabetes Duration
Long-standing uncontrolled type 2 diabetes mellitus (DM) may affect motility and function of the gastrointestinal (GI) system, at any point throughout the GI tract from the esophagus to the anorectal region. This study evaluated the prevalence of GI symptoms in type 2 DM patients and its association with age, sex, glycemic control, and duration of diabetes. This was a cross-sectional study conducted on 350 adult type 2 DM patients, selected with sequential sampling from the Ahvaz Diabetes Research Center Clinic in 2010. Data were collected by questionnaires and analyzed using the independent t-test and chi-squaretest with SPSS version18. The mean age of patients was 56 t 11 years. The prevalence of GI symptoms was 67%. The most prevalent GI symptoms were constipation (43%), bloating (35%), and regurgitation (31%). The prevalence of GI symptoms was related to the duration of diabetes (P < 0.001). Higher levels of fasting plasma glucose increased prevalence (P = 0.003), which was significantly higher in females than males (P < 0.001) and also in older patients (P = 0.003). There was no association between prevalence and levels of HbA1C or BMI. There was a significant association between the prevalence of GI symptoms and acute glycemic control (FBS), the duration of type 2 DM, sex, and age.
Authors: Shahbazian H, Hashemi J, Arghideh M, Fardad F, Latifi M.
Source: Iranian Journal of Endocrinology and Metabolism.2012; 3: 459 – 466.
DNA Phenotyping in Criminal Scene Investigation
Recently in forensic research, a form of DNA-typinghas the capability to identify genetic traits such as hair and skin COIOf; gait, geographic ancestry, and predisposition to smoking. This techniqueis forensic DNA phenotyping (FDP). FDP is also called phenotypic profiling, molecular photo fitting, and visual trait prediction. FDP differs from traditional DNA-typing (DNA-fingerprinting), as DNA-fingerprinting does not reveal personal body information. DNA-fingerprinting determines the possibility of a match between two samples, one from the crime scene and the other from the suspect. If they match, the police assume that the suspect is the perpetrator. This technology has little use when the police do not have any suspects and/or forensic DNA-database evidence.
FDP seeks to surpass this limitation by using more DNA information and creating a genetically based description of a suspect’s appearance. Unlike traditional DNA-typing, which confirms the suspect’s identity, FDP predicts the appearance, behavior, and geographical ancestry. Researchers hope that in the future this technology will be used safely in forensic and genetic investigations.
Authors: Bahadori M.
Source: Scientific Journal of Forensic Medicine. 2010; 16: 285 –290.