Lack of antibacterial activity of Ruta graveolens extracts against Enterococcus fecalis.

Enterococcus fecalis is responsible for majority of enterococci infections and can cause clinical disorders in adult and pediatrics. In order to adverse effects of synthetic drugs, it has made a positive attitude toward alternative and complementary medicine. Ruta graveolens has a wide therapeutic application for various diseases. Aim of this study was to see the effect of this herb on Enterococcus fecalis growth. In this investigation we used standard Enterococcus fecalis. Effect of hydro-alcoholic, aqueous and methanolic extracts of Ruta graveolens on growth of bacteria has been evaluated by disc diffusion and serial dilution method and compared with eight prevalent antibiotics. None of disks with different extracts in the range of 50 to 400µ/ µl show any non-growth hallo. Disks with 500µg of all type extracts in comparison with antibiotic disks did not avoid from growth of bacteria. Third test showed the growth of bacteria and ineffectiveness of various amount of extracts. It seems that this ineffectiveness is because of low antibacterial substance against the bacteria in extracts of the herb and high resistant nature of Enterococcus fecalis to antibiotics and it needs more studies.

Effects of monosodium glutamate on testicular structural and functional alterations induced by quinine therapy in rat: An experimental study.

BACKGROUND: Quinine (QU) as an anti-malarial drug induces alterations in testicular tissue. Toxic effects of monosodium glutamate (MSG) on the male reproductive system have been recognized. OBJECTIVE: To investigate the impact of MSG administration on the intensity of gonadotoxicity of QU. MATERIALS AND METHODS: Sixty eight-wk old Wistar rats weighing 180-200 gr were divided into six groups (n = 10/each): the first group as a control; the second and third groups received low and high doses of MSG (2 & 4 gr/kg i.p.), respectively, for 28 days; the fourth group received QU for seven days (25 mg/kg); and in the fifth and sixth groups, QU was gavaged following the MSG administration (MSG + QU) from day 22 to day 28. Serum testosterone and malondialdehyde (MDA) levels were measured. Testes samples were prepared for tissue MDA levels, histomorphometry, and immunohistochemistry of p53. Sperm analysis was performed on cauda epididymis. RESULTS: Serum and tissue MDA levels were increased in treated groups compared to the control group. This increment was higher in the MSG + QU groups. The testosterone levels were reduced significantly (p < 0.0001) in all treated groups. In addition, histomorphometric indices and tubular epithelium population were reduced significantly (p < 0.0001) in QU, MSG + QU, and consequently in high-dose MSG, QU, MSG + QU groups. All spermatogenic indices were reduced in the treated groups, particularly in the MSG + QU groups. Sperm motility and viability indices were reduced significantly (p = 0.003) in the MSG + QU groups. Finally, the overexpression of p53 was observed in the MSG + QU groups. CONCLUSION: The administration of MSG before and during QU therapy may intensify testicular tissue alterations.

Is active surveillance an appropriate approach to manage prostate cancer patients with Gleason Score 3+3 who met the criteria for active surveillance?

OBJECTIVE: Prostate cancer is one of the common malignant tumors in men worldwide. Nowadays it seems that Gleason Score 3+3 may not need definite treatment and some of the experts even ignore it as a cancer but we should be aware that in some patients with Gleason Score 3+3 there is a higher risk for harboring higher-grade cancer. We had done this study to evaluate patients with prostate cancer with Gleason Score 3+3 to determine the value of tumor volume in these cases. MATERIAL AND METHODS: From September 2010 to October 2017, radical prostatectomy was done for 123 sequential patients with localized prostate cancer in two referral centers of Shahid Beheshti Medical University, Tehran, Iran, and 42 cases with Gleason Scores 3+3 which who were candidates for active surveillance were included in the study. RESULTS: Thirty of 42 (71.4%) patients had significant tumor volumes (≥0/5 cm3). When tumor volume was less than 0.5 cm3, none of the patients had extra prostatic tumor extension. In patients with tumor volume greater than 0.5 cm3, two cases (6.6%) had extra prostatic extension, 4 cases (13.3%) had positive margins, four cases (13.3%) reactive lymph nodes and 16 cases (53.3%) perineural invasion. CONCLUSION: We suggest that some patients with Gleason Score 3+3 have tumor volume >0.5 cm3 who are considered having significant cancer pathology and active surveillance may not be appropriate approach to manage all cases with Gleason Score 3+3.

Sarcoidosis, a report from Guilan (an Iranian northen province) (2001-09).

BACKGROUND: Sarcoidosis is a chronic multiorgan autoimmune disorder that affects all racial and ethnic groups and occurs at all ages. OBJECTIVE: The aim of this study was to assess the clinical and epidemiological features of sarcoidosis patients in a referral clinic of pulmonary disease in city of Rasht (Guilan-Iran). METHOD: This retrospective study was done by reviewing sarcoidosis patient's records containing demographic, sign and symptom and clinical data in a pulmonary clinic in Rasht from 2001-09. All statistical analyses were achieved using SPSS. RESULTS: most common signs and symptoms were respiratory, systemic and musculoskeletal complaints. According to Chest X-Ray, 61.3% had bilateral hilar lymphadenopathy (BHL) alone (stage 1), and 24.2% had BHL plus parenchymal involvment (stage 2). The most common abnormal finding in spirometry was small airway disease (20.3%).The follow-up data showed that 178 patients (45.2%) had significant improvement clinically, radiologically or both. CONCLUSION: It seems many clinical and radiological aspects of sarcoidosis in our patients are similar to other series. However, presentation with Lofgren's syndrome is a common feature and skin (n=48, 12.3%) and eye (n=19, 4.8%) involvement are less frequent. There is significant difference between west and east of Guilan in relation to referred patients (12.9 % vs 78.5% respectively).Of course this may be due to referral issues of patients and medical teamwork connections

A randomized controlled trial of foley catheter, extra-amniotic saline infusion and prostaglandin e2 suppository for labor induction.

OBJECTIVE: The aim of this study is to further compare the efficacy of PGE2 suppository, the intracervical foley catheter and extra-amniotic saline infusion in nulliparous women referred for labor induction. MATERIALS AND METHODS: Totally 368 nulliparous women with a Bishop score ≤ 4 with singleton gestation, vertex presentation and intact membrane referred for labor induction were randomly assigned to 3 groups; Foley catheter alone, Extra-amniotic saline infusion (EASI) and PGE2 suppository. All women received concurrent dilute oxytocine infusion. The change in the Bishop Score, labor progress, various labor endpoints and outcomes of labor were assessed. RESULTS: From 363 women studied after exclusion of 5, 119 were assigned to EASI, 121 to Foley and 118 to PGE2. Patients' demographics did not differ significantly between three groups nor did indication for induction (P = 0.0001). The EASI group had a significant improvement in Bishop Score 6 hours after induction. The mean time to active phase was 357±135min for EASI,457±178 for Foley and 609±238 min for PGE2 group respectively (P < 0.05).rate of spontaneous rupture of membranes was higher in the EASI group (P = 0.0001) and the mean time from the start of induction up to spontaneous rupture of membranes in the EASI group was shorter than other group(P < 0.05). The mean time to vaginal delivery was 14.8±6.1 in EASI group,11.4±4.8 in Foley and 18.9±6.4 in PGE2 group(P < 0.05).there were no differences in Apgar scores, mean neonatal birth weight and neonatal morbidity. CONCLUSION: Our study showed that pre-induction cervical ripening by EASI with concurrent oxytocin is better than Foley and PGE2 in Bishop score and various labor end point and outcomes.

Neonatal exchange transfusion for hyperbilirubinemia in Guilan (the north province of Iran): a 3-year experience.

Exchange transfusion is the standard method for treatment of severe hyperbilirubinemia. Our goal was to determine the indications for exchange transfusion (ECT) and the rates of ECT-related adverse events. A retrospective descriptive investigation was performed in newborns that underwent ECT at 17 Shahrivar Pediatric Hospital, Rasht, Guilan province during the period April 2008 to April 2011. Of the 69 patients, 2 (2.9%) required more than one ECT. The mean total serum bilirubin before ECT was 21.55 ± 5.12 mg/dl. The most common cause of ECT was ABO incompatibility (26.1%). ECT complications occurred in 9 neonates (13.0%), the most common being sepsis (7.4%). No case of ECT related mortality was observed. All the adverse events resolved completely before discharge. ABO isoimmunization was the most common cause of ECT in this study. The majority of adverse events associated with ECT are asymptomatic and reversible.