Journal of Birjand University of Medical Sciences
Year:2006 | Volume:13 | Issue:2 (27)|Papers Count:22

Almost 10 centuries ago, clinical symptoms of allergy were reported for the first time by the great Iranian sage and scientist, Zakariya Razi. However, his report was neglected because fatal infectious diseases were taken more seriously into account. About 1000 years after this report, infectious diseases were less dramatically propagated due to the improvement of hygienic conditions. Nowadays, prevalence of allergic diseases has increased more than ever before. This prevalence has imposed heavy charges on society. Thus, diagnosis and treatment of such diseases has gained particular importance .In Addition to recording patients' history, having skin prick test by applying natural extracts of allergens is among the oldest diagnostic methods. Using natural extracts, providing and standardizing of which is challenging, is often desirable in diagnosis of the allergic reactions. Developments in molecular biology, biochemistry, molecular biotechnology and genetic engineering techniques of preparing proteins has made it possible to identify and purify natural and recombinant allergens. The present paper, while presenting a brief review of diagnostic techniques of allergic diseases, pinpoints the role of recombinant allergens in promoting the applied techniques.

Background and Aim: Diabetes Mellitus is a prevalent metabolic disease, which is caused by deficiency in insulin secretion or malfunction of a series of agents affecting its function. Diabetic hyperglycemia and hyperlipidemia can induce many structural and functional disturbances in all body systems. The aim of the present study was to identify histochemical liver tissue changes in diabetes mellitus in Rats as an experimental model.Materials and Methods: A total number of 60 male Sprague Dawley Rats with the average weight of 250±20 gr were chosen and divided into two experimental (45) and control (15) groups. Each of these groups was then divided into three subgroups of 2, 8, and 16-weeks. All the rats were put in a standard condition with respect to temperature, humidity, darkness and lighting periods; availability of water and food stuff. The experimental group developed diabetes through receiving I.P. injection of 60mg/kg of streptozotocin. Rats in the control group received the same amount of normal saline. In due course, liver specimens were taken from both groups. Tissue specimens  were processed routinely and paraffin blocks prepared; then, the dissected tissues were stained by Hematoxylin Eosin, PAS, PNA/Alcian blue pH=2.5. Lectin (10 microgram/mL) was diluted with Buffer phosphate (pH=6.6.( Results: The study showed very little presence of disaccharide galactose/ install galactosamine in bile subendothelial ducts and in the center of lobule venule in the diabetic group. PAS staining showed an increase in the quantity of glycogen particles in peripherally located hepatocytes of liver cell lobule especially in the 16 week subgroup. Besides, liver congestion was observed in the diabetic groups.Conclusion: It seems that liver tissue changes in diabetic groups is time dependent and could be seen in blood vessels, bile duct epithelium and hepatocytes. Further studies will probably show the role of these changes in pathogenesis of diabetes mellitus.

Background and Aim: Spinal anesthesia is the preferred method for cesarian section -because of minimal maternal and neonatal complications and low cost. Intrathecal sufentanil is used for augmentation of analgesic effect in spinal anesthesia. The aim of this study was to evaluate the effect of intrathecal sufentanil on homodynamic measurements and other complications.Materials and Methods: This randomized double-blinded clinical trial was done in Rasool-e-Akram hospital in Tehran and Niknafas maternity hospital in Rafsanjan on 100 full term pregnant women who were candidate for cesarean section. Lidocaine 5% was used for spinal anesthesia and participants were indicated to receive intrathecal administration of 5 mg sufentanil or placebo. For 50 patients, in addition to lidocaine, 5 micrograms (1mL) intrathecal sufentanil was administered (case group). In the control group, instead of sufentanil, 1mL of normal saline was injected. The obtained data was analyzed by SPSS using fisher exact tests, and independent t-tests at significant level P≤0.05.Results: Decreased blood pressure of more than 10% in the case and control groups were observed in 32.6% (16 individuals) and 67.4% (31 cases), respectively. Decreased heart rate of lower than 10% were measured in 40.8% (20 cases) and 91.3% (42 cases) of the case and control groups, respectively. Both of the above complications were significantly lower in the case group compared with control group (P<0.0001).Regarding other complications such as nausea, vomiting, respiratory depression, and neonatal apgar, no significant differences were noted between the two groups. However, itching was observed in 11 patients (22%) of the case group but not in the controls.Conclusion: Addition of 5 microgram sufentanil to lidocaine 5% for spinal anesthesia in cesarean section improved homodynamic stability without causing important complication. The only noticeable side effect of sufentanil was mild pruritus.

Background and Aim: Alzheimer's disease is the most common cause of dementia, leading to debilitating the patient and indirectly causing a lot of economical and psychological problems both for the rest of the family and for the society. Because of the high incidence of the disease and no definite treatment for it, a lot of studies are being carried out to find effective therapies. Recent studies suggest that estrogen and hormone replacement therapy (HRT) may slow down or stop the progression of the disease. This study was aimed to determine the effect of HRT on the symptoms of the disorder in women with Alzheimer and their EEG changes. Materials and Methods: This interventional- clinical trial study was carried out on thirty post menopausal women suffering from Alzheimer's disease aged forty-one and over with no contraindications for hormone therapy. For every patient EEG and MMSE were performed and then the patients were randomly divided into case and control groups. For four months, the case group received conjugated-estrogen 0.625 mg with half of a medroxy progesterone acetate tablet daily. The other group received placebo. After two and four month intervals MMSE and EEG were recorded again and finally the data was analyzed by SPSS software, paired and unpaired t tests and at the significant level P £0.05.Results: Mean MMSE score in the case group two months  and four months after intervention was 19.47±2.2 and 19.87±2.53, respectively which were significantly higher than the score before intervention (17.27±2.31) (P=0.001 and P=0.001). Mean MMSE score in the  control group  after two and four months was 19±4.17 and 19±4.61 respectively, which did not show a significant difference with before intervention mean score (17.73±5.13), (P=0.08 and P=0.192, respectively). Frequency distribution of EEG changes two months after intervention in both groups did not statistically show a significant difference but  four months after intervention positive EEG changes compared to other changes in the case group were higher than those in the  control group, which was a significant difference (P=0.003). Conclusion: From the findings of this study support the hypothesis that hormone replacement therapy improves symptoms and EEG changes of most women with Alzheimer's disease. Thus, hormone therapy with estrogen and progesterone, while having the least complications, can be beneficial in the treatment of women with Alzheimer's disease.

Background and Aim: During the past three decades, life-threatening fungal infections have frequently been emerging through opportunistic infections with the advent of cancer chemotherapy, organ transplantation, and or AIDS. Most of systemic fungal infections are mainly caused by opportunistic pathogens such as Candida species. Although many researchers have carried out intensive studies attempting to develop new antifungal drugs some of which are now under clinical trials, amphotericin B and the azole compounds remain the mainstay of fungal systemic infection therapy. However, the adverse effects of polyenes and the emergence of Candida strains resistant to commercial azole compounds make the treatment of patients with deeply invasive mycoses difficult. Therefore, demand for the development of new antifungal agents which have low side effects and broad-spectrum activity against various fungi is greater than ever before. The present study aimed at evaluating the anticandidial effects of Berberis vulgaris Root extracts (ethanolic and aqueous) and comparing their effects with those of clotrimazole.Materials and Methods: In this experimental study, aqueous and ethanolic extracts of Berberis each having 1 mg/mL concentration were prepared. Candida albicans (100000 CFU/mL) was cultured on dextrose agar medium.Then, after incubation period of 48 hours, anticandidal strength of the extracts and clotrimazole was measured through zone of inhibition. Zone of inhibition for 1-10 mm was 1+, for 10-20 mm 2+, for 20 –30 mm 3+ and for 30-40 mm 4+. The obtained data was analysed by using SPSS software package, ANOVA and Tukey B tests. Resutls: Average zone of inhibition for aqueous extract of Berberis was 16.89 mm, for ethanolic extract of Berberis it was 27.69 mm, for pure ethanol 0 mm, and for clotrimazole 33.63 mm. Besides, these differences were statistically significant (P<0.001).Conclusion: According to our findings, Berberis vulgaris root extracts have anticandidal effects, and these effects are more prominent for ethanolic extract. Because ethanol, by itself, doesn't have any anticandidal effects (zone of inhibition=0), we can conclude that all of the anticandidial effects of ethanolic extract of Berberis are due to Berberis vulgaris root extract.

Background and Aim: Menopause is not avoidable and will occur in every woman's life. Understanding its risk factors and their prevention is necessary for every woman. This important measure will be possible through health care education and the first step in every education is knowledge and analysis of subjects' awareness and attitude. The purpose of this research was to find out the effect of education on middle-aged women’s knowledge and attitude towards menopause.Materials and Methods: In this quasi-experimental study, 90 women aged between 40 and 60 years were randomly selected based on purposive sampling. Then, the effect of education on their knowledge and attitude was evaluated. Before implementing the education program, primary information about women’s Knowledge and attitude was collected through questionnaires. After study the obtained data and need- assessment of the subjects, an appropriate education program was planned. Then, in two one-hour sessions individual face to face education was offered to all subjects. Three months later, information was collected through the original questionnaires again. Student-t, one-way variance analysis, and paired t tests were used for data analysis.Results: The results of this research showed that post-education mean knowledge was significantly different from that of pre-education (P=0.000). Before education, 43.3% of the subjects had poor knowledge, 42.3% had moderate and only 14.4% had good knowledge. However, after education none of the women had poor knowledge, 31.1% had moderate and 68.9% had good knowledge. Attitude also significantly varied after education (P=0.000). Before education, 10% of women had negative attitude, 66.7% had neutral attitude, and 23.3% had positive attitude towards menopause; however, none of the women had negative attitude after the education, 53.3% of the subjects had a neutral, and 46.7% had a positive attitude. Conclusions: The study showed that the reasonable way to increase people's knowledge is based on health education. Through such education, it is possible to equip individuals with enough knowledge to take care of their health.

Background and Aim: Study on the effect of carrot and tomato juice on the lipid metabolism in the human and experimental cases is going on. This study was performed aiming the study on the effect of short period carrot and tomato juices consumption regularly on the rat’s serum lipid level.Materials and Methods: In this experimental study, in 30 month old rats with nearly 150-200g weight divided into three groups. Serum triglyceride (TG), total cholesterol (Chol), and HDL-C concentrations were determined by a spectrophometery method using lab. For group 1 1mL tap water and TG and Chol riched mixture, for group 2 1mL carrot juice and 1mL of the same mixture and for grup3 1mL tomato juice and 1mL of mentioned mixture were given orally everyday for the period of two weeks. After two weeks nutritional intervention blood sampling was performed again and the lipids were measured. Statistical analysis was performed using t-test at P≤ 0.05 considered as a significant level.Results: Cholesterol level in group 1 (control) had a significant rising (P<0.05) after the nutritional intervention whereas in group 2 and 3 that received carrot and tomato juice Chol and TG significantly (P<0.05) decreased after the nutritional intervention. TG level in groups of control and carrot did not change significantly (P>0.05). HDL-C level also in three groups of rats did not change significantly after the nutritional intervention.Conclusion: Carrot and tomato juices diminish Chol serum level and these effects can play a role in prevention of cardiovascular diseases.

Background and Aim: According to previous studies, surgical closure of atrial septal defects (ASDs) was considered as the standard treatment. Two surgical methods, the conventional sternotomy (CSA: median sternotomy) and ante lateral thoracotomy were used. This study was carried out to compare early results of the two techniques in ASD's closure.Materials and Methods: In this descriptive-analytical study from March 1998 to March 2004, the records of 73 patients with ASDs referring to Shahid Madany Hospital - affiliated to Tabriz University of Medical Sciences- were studied. The obtained data were analysed through filling out questionnaires; Fisher, and Mann-Whitney accurate tests were used for statistical analyses at the significant level of P £0.05.Results: Out of 73 patients, 38 cases had undergone thoracotomy (group I); and 35 of them had experienced sternotomy (group II). The difference between mean surgery time in group I (4.33 hours) and in group II (3.43 hours) was significant at P<0.001. Duration of hospitalization between the two groups (10.08 and 12.79 days, respectively)- P=0.01, was significant. There was no significant differences on mean cross-aortic clamping time (32.35 and 35.88 minutes, respectively - P=0.41), mean time of extracorporeal circulation (65.68 and 69.48 minutes, respectively, - P=0.27). Besides, there was no significant difference between the two groups regarding the amount of drainage.Conclusion: Right anterolateral thoracotomy for ASD closure can be an appropriate technique, in terms of lower hospitalization days, limited surgical scar and better cosmetic outcome.

Background and Aim: Endometrial hyperplasia is the overgrowth of endometrial glands due to prolonged unopposed estrogenic stimulation. Its major clinical symptom is abnormal uterine bleeding (especially per menopausal). The disease has several risk factors. The aim of this study was to assess the prevalence of endometrial hyperplasia and its risk factors in perimenopausal period in women who referred to Yahyanezhad educational and therapeutic center because of Abnormal Uterine Bleeding (AUB) between 2000 and 2003.Materials and Methods: In this descriptive- analytic (cross- sectional) study, we surveyed the records of per menopausal patients (40-60 years) referring to Yahyanezhad hospital, affiliated to Babol University of Medical Sciences, for having AUB between 2000 and 2003. Information regarding age, diabetes mellitus (DM), hypertension, hormone therapy, endometrial hyerplasiabased on pathology specimen for every patient was gathered .The data were then analyzed by SPSS -10 software using Fisher exact test at the significant level of P £ 0.05.Results: A total of 366 per menopausal AUB records were studied. Of these, 73 cases had endometrial hyperplasia. Relative abundance of hyperplasia was about 19.9% in the studied population. Also, it was found that the studied risk factors including aging, DM, hypertension, and estrogen hormone replacement therapy increase the risk of endometrial hyperplasia. In none of the cases there was a significant relationship between endometrial hyperplasia and the risk factors, but taking oral contraceptive pills (OCP) had significantly decreased hyperplasia (P<0.05).Conclusion: Endometrial hyperplasia in the studied region had a high frequency. DM, hypertension, old age, and history of hormone replacement therapy were not diagnosed as major risk factors of the disorder, but OCP was found to have preventive effect.

Background and Aim: Musculoskeletal disorders may induce by occupational injuries in nurses during work. Assessing work activities by postural analysis in different nursing tasks can identify the hazardous aspects of the job that can be changed by alternative methods to decrease these hazards. The aim of this study was ergonomic evaluation of working postures of nurses and musculoskeletal disorders among them. Materials and Methods: In this cross-sectional study all registered nurses in Medical- Surgical wards of Birjand University of Medical Sciences hospitals-Imam Reza and Valiyye Asr- in 2005 were selected. Data was collected using Nordic questionnaire and Rapid Entire Body Assessment (REBA) checklist of 6 more common working postures in nursing. REBA risk level and necessary action were determined by REBA software.Then, the data was analyzed by descriptive and analytic tests.Results: From 43 nurses assessed 95.3% were females whose mean age was 34.8±5.94 years. 58.1% had B.Sc. Degree and 41% had less than a 5 year work experience. Most musculoskeletal disorders were in the legs (62.8 %) and low back (53.5%). The most probable cause for their disorders was found to be their working condition. In REBA assessing, although all tasks were in moderate risk level, the score was 8 or more, which necessitated taking action when patient handling was done.Conclusion: According to the obtained results, in educational programs, teaching nurses on body mechanics, and changing the physical demands of the job (using an ergonomic approach) through using assistive devices) must be taken into account.

Background and Aim: Malnutrition is one of the important health problems throughout the world, particularly in developing countries, which has undesirable effects on mental and physical health of children. It is an underlying factor for infections and an important cause of child mortality in these countries. The aim of this study was to find out the prevalence of malnutrition in hospitalized children aged 1-36 months old in Birjand Valiyy-e-asr Hospital.Materials and Methods: This cross sectional and descriptive analytical study was done on 360 hospitalized children aged 1-36 months, between June and November 2004. The data were collected through measuring of weight and height; and structural questionnaires, which were completed by interviewing children's parents. The nutritional status was evaluated according to the weight-for-age (Gomez), weight-for height (Waterlow) and height-for-age (Waterlow) methods. Data were analyzed by chi-square test, taking a= 0.05 as the significant level.Results: The prevalence of malnutrition based on three criteria including "weight for age", "height for age" and "weight for height" were 68.6, 58.6 and 32.4, respectively. Malnutrition in children  had a significant association with "birth weight"," mother's job", "parents’ educational level", and "duration of breast feeding" (P<0.05). Malnutrition increased among children in rural areas, low birth weight ones, those whose mothers were housewives, children having illiterate or semi-literate parents, short duration of breast feeding, and late beginning of complementary nutrition.Conclusion: With regard to the increased prevalence of malnutrition among hospitalized children and its connection with the above mentioned variables, measures such as increasing parents' awareness and literacy-especially mothers' knowledge-constancy of breast-feeding until the age of 2 years, starting complementary nutrition in due course; promoting economic, social, and health status of families; and preventing infectious diseases-particularly gastroenteritis- are recommended.