Pattern of Splenectomy Indications in Kashan Shahid-Beheshti Hospital : A 5-Year Study

Background: The spleen is amongst the most vulnerable organs which are easily injured in abdominal trauma. Nowadays, blunt trauma is the most prevalent indication of splenectomy. Objectives: We conducted this study to determine the pattern of indications for open splenectomies carried out during the past five years in Shahid-Beheshti hospital, a central hospital in Kashan, Iran. Patients and Methods: Demographic data of all patients who had undergone an open splenectomy in Kashan Shahid-Beheshti hospital during the past five years (2007-2012), indications for this type of surgery and outcome of patients were collected and entered into the study. Results: During the study period, the data from a total of 99 open splenectomies were entered in our study. Sixty-eight (68.7%) patients were male and 31 (31.1%) female. The mean age was 31.64 years, 75.8% of the cases had indications of trauma and 24.2% were elective. The most prevalent indication for trauma was motor-bike rider accidents and for elective ones portal hypertension. Conclusions: Most cases of splenectomy in our center caused by trauma, and among the different types of trauma, blunt trauma is the dominant cause. Road traffic accidents, in particular motor vehicle accidents, especially motorbike injures, are the most frequent cause of splenectomy. Due to the instability of trauma patients, a mortality rate of 8% seems to be reasonable for splenectomy. \r\nWe recommend that more research be conducted in this area and more cases enrolled with a reasonable follow-up period for splenectomy complications in this study

Peritoneal Potassium and pH Measurement in Early Diagnosis of Acute Mesenteric Ischemia in Rats

Background: In contemporary practice, acute mesenteric ischemia (AMI) remains a serious cause of morbidity and mortality in abdominal emergencies. Objectives: We report the measurement of peritoneal fluid potassium and pH on a small series of rats that developed extensive AMI following the surgical ligation of superior mesenteric vessels and compare the results with control groups. Materials and Methods: A total of 32 rats were used in our study. They were divided into four groups with eight rats in each one and received following treatments: group I (G-I), 60-minute controls; group II (G-II), 120-minute controls; group III (G-III), 60-minute cases; and group IV (G-IV), 120-minute cases. In case groups, the small bowel mesenteric root was double-ligated and an arrow single-lumen central venous catheter was passed through the skin to the peritoneum. In control groups, the catheter was placed without any intervention. Postoperatively, peritoneal lavage was performed at 60 (G-I, G-III) and 120 minutes (G-II, G-IV). Results: The mean peritoneal potassium values were 1.3 ± 0.3, 1.97 ± 1.06, 2.14 ± 0.89, and 3.28 ± 0.66 mmol/L in G-I, G-II, G-III, and G-IV, respectively. There were significant differences between G-III and G-IV (P = 0.002), between G-I and G-III (P = 0.024), and between G-II and G-IV (P = 0.001). The mean values of peritoneal fluid pH were 7.1 ± 0.26, 6.82 ± 0.22, 6.66 ± 0.16, and 6.78 ± 0.04 in G-I, G-II, G-III, and G-IV, respectively, which indicated significant differences between G-I and G-III (P = 0.001) and between G-II and G-IV (P = 0.018). There was a significant correlation between peritoneal fluid potassium and intestine ischemic grade (F = 4.77, P = 0.048) Conclusions: Our findings show that for early detection of bowel ischemia, an evaluation of intraperitoneal potassium and pH was useful and with prolongation of ischemia, potassium changes were more significant

The effect of melatonin on expression of p53 and ovarian preantral follicle development isolated from vitrified ovary

Ovarian vitrification is a strategy for conservation of fertility of young female patients, suffering from infertility, due to iatrogenic loss of ovarian function, resulting from chemotherapy and/or radiation therapy. The purpose of this study was to determine the influence of melatonin on expression of p53 and the developmental rate of preantral follicles isolated from vitrified and non-vitrified ovaries. This experimental study was carried out on 40, 14-day-old female mice (NMRI). One ovary from each mouse was used randomly for the vitrification procedure. Preantral follicles with a diameter of 120�140 μm derived from vitrified-warmed and non-vitrified ovarian tissues were cultured individually in α-MEM medium supplemented with or without melatonin. The expression of p53, diameter of follicle, survival rate, and number of antral follicles were compared using post hoc LSD, t test, and chi-square test, respectively in four groups: non-vitrified and non-melatonin (NVNM), non-vitrified and melatonin (NVM), vitrified and non-melatonin (VNM), vitrified and melatonin (VM). p53 gene was expressed in four groups and was strongly expressed in the antral follicles of VNM (p = 0.011). The addition of melatonin increased survival rate and the mean diameter of follicles in vitrified group (p = 0.001). There were no significant differences in antral formation of follicles between different groups. Adding melatonin to culture medium reduced expression of p53 apoptotic gene in vitrified group and improves in vitro maturation and survival rate in isolated follicles from vitrified ovaries. © 2017, Springer-Verlag London Ltd

Assessment of Relationship Between Expression of Survivin Protein and Histopathology Diagnosis and Malignancy Severity in Colon Specimen

Background: Survivin is a member of the inhibitor of an apoptosis protein family that has been shown to inhibit apoptosis, promote cell proliferation and enhance angiogenesis. In this study, the survivin protein expression in normal, colon polyp, and adenocarcinoma tissues was investigated. Methods: Immunohistochemical staining for nuclear survivin was carried out on 45 normal colon tissue samples, 38 samples of a colonic polyp, and 37 cases of colon adenocarcinoma operated by colonoscopy or colectomy. The percentages of cells that expressed survivin were classified qualitatively into four categories (0, 1+, 2+, and 3+) based on the intensity of staining and the percentage of cells. An area of samples with colon polyp diagnosis or colon adenocarcinoma that had no microscopic pathology was considered as normal tissues. Results: Survivin protein expression was negative in all cases of normal colon tissue samples while it was expressed in 31 out of 38 colon polyp specimens (81.5) and in 35 out of 37 (94.5) colon adenocarcinoma samples. Amount of expression in the colon adenocarcinoma (p < 0.001) was significantly higher than the amount of expression in the colon polyp. There was not a significant correlation between the survivin protein expression and the low and high grade adenocarcinoma (p = 0.874). Conclusions: Survivin protein was not expressed in normal colon tissues and its amount was higher in the colonic adenocarcinoma compared to the colon polyp. Due to the variations in the intensity of expression in colon polyp (changing from negative to + 3), this marker cannot be used for differentiating the polyp from the adenocarcinoma. © 2019, Springer Science+Business Media, LLC, part of Springer Nature

Association of Regulatory T Cells with Diabetes Type-1 and Its Renal and Vascular Complications Based on the Expression of Forkhead Box Protein P3 (FoxP3), Helios and Neurophilin-1

In recent years, it has been recognized that regulatory T cells (Tregs) play a critical role in maintaining immune tolerance. Moreover, the expression of two markers named Helios and neurophilin-1 (NRP-1) has been highlighted in such cells. Helios, an intracellular transcription marker, largely differentiates twomost operative sub group of Tregs, namely naturally occurring (nTreg) and induced (iTreg) Tregs, and NRP-1 is reckoned as a membranous activity marker of Tregs. We aimed to count peripheral mononuclear cells expressing such markers in a group of type 1 diabetes patients to elucidate the possible role of Tregs in the pathogenesis of such disease and its complications. Blood samples from 61 adult patients with type 1 diabetes and 61 sex and age-matched healthy controls were tested to count two types of Tregs, namely naturally occurring and inducible types, according to the expression of cell surface markers of CD4/CD25/CD47�FITC/PE/APC and intracellular markers of FoxP3/Helios�PE-CY5/eFlour450 by flow cytometry, respectively.We also investigated the relation between expression of such markers with HbA1c, urine albumin/creatinine ratio (UACR), and common carotid intima thickness (CIMT). The circulatory frequency of both Helios+ and Helios- T-cells were significantly decreased in patients compared to those in healthy controls (p<0.001). There was also a significant decrease in circulatory frequency of Helios+ NRP-1+ and Helios- NRP-1+ cells in the patients compared to controls (p=0.029). According to expression of Helios and NRP-1 markers, the number and function of both Tregs were decreased in diabetic patients. Moreover, the neurophilin expression was inversely associated with complications of type 1 diabetes. Copyright© April 2018, Iran J Allergy Asthma Immunol. All rights reserved

Survivin polymorphisms and susceptibility to prostate cancer: A genetic association study and an in Silico analysis

Survivin is a member of the apoptosis inhibitor protein family and its polymorphisms may lead to susceptibility to cancer. The aim of this study was to investigate the possible association of c.-31G>C (rs9904341), c.454G>A (rs2071214), c.*148T>C (rs2239680) and c.*571T>C (rs1042489) polymorphisms of survivin gene with prostate cancer risk and provide some justification using in silico analysis. The 157 men with prostate cancer and 145 healthy controls were included in a case-control study. The studied polymorphisms were genotyped using PCRRFLP method. An in silico approach was employed to show the possible effects of the polymorphisms on the survivin gene function. The study revealed that there are significant associations between c.-31CC genotype (OR= 2.29, 95 CI= 1.20-4.37, p= 0.012), c.-31C allele (OR= 1.62, 95 CI= 1.17-2.26, p= 0.004), c.454AG genotype (OR= 2.03, 95 CI= 1.02-4.04, p= 0.043), and c.*148C allele (OR= 1.49, 95 CI= 1.04-2.15, p= 0.031) with prostate cancer. Using stratified analysis, we found also significant effects of age distribution on the association of c.-31G>C with prostate cancer risk (OR= 2.10, 95 CI= 1.08-4.10, p= 0.030). Also as a preliminary study, it was shown that smoking status has significant effects on the association of c.-31G>C (OR= 1.94, 95 CI= 1.08- 3.49, p= 0.027) and c.*148T>C (OR= 2.60, 95 CI= 1.47-4.60, p= 0.001) polymorphisms with prostate cancer risk. Finally, in silico analysis revealed that c.-31G>C, which is located in a CpG island of the promoter may change transcriptional regulation of survivin gene and c.454G>A and *148T>C could affect protein structure and possible miRNA interaction with 3'-UTR of survivin transcript respectively. According to the results, c.-31G>C, c.454G>A, and c.*148T>C polymorphisms could be genetic risk factors for prostate cancer in an Iranian population. However, further studies with larger sample size and different ethnicities are required to obtain more comprehensive results. © 2018, Leibniz Research Centre for Working Environment and Human Factors. All rights reserved

Evaluation effect of silybum marianum, cynara scolymus L. and ziziphus jujube mill. Combination extract on non-alcoholic fatty liver in rats

Introduction: Non-alcoholic fatty liver disease includes a spectrum of clinical syndromes from early steatosis to liver cirrhosis. The aim of this study was to evaluate the effect of combined extract of silymarin, artichoke and jujube on non-alcoholic fatty liver, induced by high-fat diet in rats. Materials and Methods: In this experimental study, 40 male rats were divided randomly into two groups, a sham group (n=8) and a high-fat diet group (n=32). After 4 months of being fed the high-fat diet, rats suffering from fatty liver were divided into 4 groups (n=8 each) including a high-fat diet group and the three groups receiving a dose of the combined extract 100, 200 and 400 mg/kg for 2 months. Finally, lipid profiles, activity of serum liver enzymes and liver histology were investigated. Results: The high-fat diet increased Chol, TG and LDL and decreased HDL levels (P<0.001). This diet also increased serum activity of ALT, AST and ALP to 84, 113 and 228, respectively. Receiving extract at doses of 200 and 400 mg/kg improved lipid profiles and hepatic enzyme activity (P<0.05). Histopathology confirmed changes in liver induced by the high fat diet and the protective effect of the extract. Conclusion: High-fat diet induced nonalcoholic fatty liver in rats and treatment with combined extracts of silymarin, artichoke and jujube improved the complications of the disease. © 2018, Endocrine Research Center. All rights reserved

Sensitivity of FNA test for diagnosis of positive cases of Gynecomasty and ectopic breast

History and Objectives: Gynecomasty and ectopic breast are disorders of breast. Due to difficulties in the biopsy diagnosis and different reports on sensitivity of FNA test for diagnosis of gynecomasty and ectopic breast and in order to identify the sensitivity of FNA test, the present study was carried out on patients referred to surgical clinic of Kashan Shaheed Beheshti hospital for clinical diagnosis of gynecomasty and ectopic breast. Materials and Methods: A descriptive study was conducted on patients with clinical diagnosis of gynecomasty and ectopic breast. FNA test was performed before the surgical operation to remove the mass (Biopsy). The outcome of the 2 tests was compared and the positive cases of FNA in gynecomasty and ectopic breast were identified. Results: From total of 20 patients, 9 with the mean age of 27.1±11 years had axillary mass with ectopic breast and 11 cases (Mean age of 28.9±9.5 years) had gynecomasty. The rate of positive FNA test was 33.3 for ectopic breast and 54.5 for gynecomasty. Conclusion: It seems that FNA test for the positive diagnosis of gynecomasty and ectopic breast is less sensitive therefore further research is need

Prevalence of trait anxiety in patients with cancer

Cancer as a life threatening disease has a huge burden on lives of people with cancer and also on their families. Persons with cancer will find that their feelings of anxiety increase or decrease at different times. In this study we reported the Trait Anxiety based on the last 20 questions of State-Trait anxiety Inventory. This study investigated trait (hidden) anxiety among 250 patients with the diagnosis of cancer in Kashan. Neither sex, age nor cancer duration was related with trait anxiety in the study population. The most common type of anxiety in the patients was moderate type. The cancer type that requires more invasive treatments can be categorized as anxiety-causing cancer types and a great attention should be paid for this fact. © IDOSI Publications, 2013

Clinical, paraclinical and pathologic findings of irritable bowel syndrome

Background: Irritable bowel syndrome(IBS) is a common GI complaint. Since there exist some controversies with reference books regarding the clinical and pathological findings, the present study was conducted to determine the clinical, paraclinical and pathologic findings of irritable bowel syndrome in a group of patients. Materials and methods : For this descriptive study, 80 patients who had been diagnosed as IBS according to the ROME criteria were selected. Other diseases were excluded by complementary studies. Colonoscopy and barium enema was performed and multiple biopsies were obtained. Results : The study population included 42 males and 38 females with the mean age of 26.5±7 years. The most common chief complaints were flatulence, abdominal pain, and diarrhea. Pathologic findings were revealed in 77 cases (96.3). Conclusion : High prevalence of pathologic changes is a unique finding in our patients. Further studies regarding the diagnostic modalities and proper treatment are suggested