Journal of Mazandaran University of Medical Sciences
Year:2012 | Volume:22 | Issue:95|Papers Count:13

Background and purpose: Hepatitis B virus (HBV) is a major global health problem. The prevalence of HBV infection varies throughout regions of the world. More than 350 million people live with chronic HBV infection and many different clinical symptoms are associated with it. Long-term complications of HBV infection lead to cirrhosis of the liver and hepatocellular carcinoma. Consequently, 0.5-1.2 million death occurs every year. However, early diagnosis and appropriate treatment could reduce such complications. This study intended to investigate the correlation of serum concentrations of HBVDNA and HBeAg with liver enzymes.Materials and methods: In this cross-sectional study, serum samples of 146 chronic hepatitis B patients were studied. They referred to RaziTeaching Hospital, Qaemshahr, from 2007 to 2009. The subjects were assessed regarding HBV-DNA, HBeAg and ALT enzymes. The patients' serum was extracted and Real Time PCR test was performed using HBV RG Kit (Nov in Gene). Afterwards, the patients' medical records were studied and the data was analyzed using Pearson correlation coefficient and t-test in SPSS.Results: From the total of 146 patients, 94 were found negative HBeAg and 52 were HBeAg positive. No correlation was seen between HBV-DNA level and AST enzyme, while there was a significant relationship between HBV-DNA level and ALT enzyme.Conclusion: ALT enzyme is a reliable indicator for severity of liver involvement even in negative HBeAg stages and hidden period of the disease. Hence, the serum levels of HBV-DNA and ALT should be measured in such individuals before developing liver cirrhosis and thereby starting immediate antiviral therapy.

Background and purpose: Nano silver particles are associated with oxidative stress due to free radical production. Long-term use of antioxidant agents could result in harmful production of free radicals. This study assessed the protective and antioxidant effects of Peganumharmala L.onmalemicetreated with nano silver particles.Materials and methods: In this study 32 male Albino mice (25-30gr) were divided into four groups, one control group and three intervention groups. The intervention groups included a group receiving 500 ppm nano silver particles, a group fed 20 mg/kg/day by ethanolic extract of P.harmala for 30 days, and a group which was given ethanolic extract of P.harmala orally and the same dose of nanosilver particles. Onthreeconsecutive day sat the beginning of the experiment intraperitoneal injections of nano silver were performed. Post-treatment blood samples were collected from the hearts and the activity of serum catalase (CAT) and glutathione peroxidase (GPx) I nredblood cell and concentration of serummalondialdehyde (MDA) were determined.Results: In the mice treated with nano silver particles the MDA concentration significantly increased, while significant decreases were seen in GPx and CAT activities (P<0.001). However, P.harmalaextract reversed these effects i.e. it increased GPx and CAT activities and decreased the MDA level significantly (P<0.001).Conclusion: The ethanolic extract of P. harmala with antioxidant properties is believed to decrease thefreeradicals produced by silvernanoparticles.

Background and purpose: Host genetic and environmental factors and factors associated with hepatitis C virus (HCV) play critical roles in development of the hepatitis. This study was performed to investigate the association between Interleukin- 28B (IL-28B) genetic variants and chronic hepatitis C.Materials and methods: This case-control study was conducted in 133 HCV-RNA positive patients attending two methadone treatment clinics, a hemophilia center, a thalassemia center and three dialysis center in Mazandaran province, Iran, 2010-2011. In addition, 173 HCV negative subjects were recruited as the controls. The two groups were matched for age, sex and geographic region. The IL-28B genotype at polymorphic site rs12979860 was determined by Tetra-ARMS-PCR method. Quantitative and qualitative data were analyzed using Student t and Chi square tests, respectively.Results: The mean age of patients with HCV (96 male, 27 female) was 36.38±12.49 years. The control group comprised 107 male and 66 female with the mean age of 38.27±11.27 years. The distribution of IL-28B genotypes did not differ between the two groups (P=0.008). On the other hand, the frequency of C/C, C/T and T/T genotypes were 41.4, 41.6 and 17.3% in experimental group and 42.5, 40.6, and 16.9% in the control group, respectively. The frequency of C and T alleles was not significantly different between the two groups (P=0.84).Conclusion: No significant difference was observed in the frequency of the rs12979860 polymorphism in upstream of IL-28B among HCV patients and control groups. According to the proven role of C allele in association with HCV treatment response it is assumed that genetic differences in IL-28B or IFN-l could predict treatment outcome.

Background and purpose: Catheter radiofrequency ablation is the first step in therapeutic approach to Atrioventricular nodal reentrant tachycardia (AVNRT). Different protocols for slow pathway ablation are found to have various ranges of efficacy and side effects. This study compared the effects of partial and complete ablation of the slow pathway on recurrence, symptom relief and complications in patients with AVNRT.Materials and methods: In a cohort study100 patients with accurate diagnosis of AVNRT were recruited from Baqiyatallah Hospital during 2009-2011. Atropine (0.04 mg/kg) and Propranolol (0.2 mg/kg) were used for autonomic blockage. Electrophysiology study was used to evaluate the remaining slow pathway function following ablation.Results: The research population included 40 male and 60 female. The mean age of the patients was 43±13. Forty eight cases were found with incomplete slow pathway ablation while complete ablation was seen in 52 cases. No considerable adverse reaction to the study medication was observed among the patients. Moreover, we did not find any significant recurrence symptoms (palpitations, chest pain and fainting) after ablation between the two groups (P<0.05). However, complications such as AV block, DVT, and pericardial effusion were significantly different among the two groups (P<0.05).Conclusion: The symptoms improved in both groups but complications were seen less in partial ablation. Excessive effort for ablating the reentry pathway in patients with AVNRT leads to more complications, however, the rate of success remains similar.

Background and purpose: Salmonella is a group of Enterobacterias that cause infectious diseases in human and animals. Typhoid, bacteremia, enterocolitis and salmonellosis which are caused by this bacterium are considered major health concerns in developing countries, such as Iran. Quick, accurate, reliable and early diagnosis is vital to prevent Salmonella outbreak.Materials and methods: There are various diagnosis methods such as immunoassay and culture, PCR, and Real time PCR for detection of salmonella in contaminated samples. These methods require long time for diagnosis, numerous bacterial colonies, expensive laboratory equipments and expert lab personnel. Therefore, this study used a new method to avoid the disadvantages of previous methods.We used Loop-Mediated isothermal amplification of DNA (LAMP) with two fluorescent probes. Then it was compared with PCR.Results: In this study four Salmonella isolations were used for PCR, LAMP, and LAMP using fluorescent probes. The time to identify Salmonella in PCR method was three hours compared to two hours in LAMP method, while this time reduced to 70 min using LAMP with fluorescent Prob.Conclusion: LAMP with two fluorescent probes is a fast, accurate, economic and practical method with more level of coverage in medical diagnosis laboratories, legal medicine, and agricultural researches. Other advantages of this method are temperature independency and no thermo cycling by replacement of PCR machine with simple and very cheap thermo block instrument. Moreover, detection is more accurate than turbidity detection in simple LAMP.

Background and purpose: Many studies have investigated the cardio protective effects of olive leaf extract (OLE). None, however, has reported its antiarrhythmic role for in vivo model arrhythmia.This study aimed at investigating the antiarrhythmic effect of OLE and assessing the duration of its use in anesthetized rats.Materials and methods: Forty eight male Wistar rats were divided into six groups of eight. All groups-except group one (the control group)-received OLE (200 mg/kg/day, orally) for 1, 3, 7, 14 and 28 days, respectively. Then, their left anterior descending coronary artery (LAD) was occluded for 30 min under general anesthesia and artificial respiratory support. Direct blood pressure and electrocardiogram (ECG) were continuously monitored before and during the ischemia.Results: The data showed that severity of arrhythmia including ventricular ectopic beats, incidence of ventricular tachycardia (VT), and ventricular fibrillation (VF) reduced significantly in groups that received OLE for at least 14 days. Also, the number and duration of VT and VF episodes decreased significantly in groups five and six, especially the group that received OLE for 28 days.Conclusion: These results show that oral administration of OLE could induce antiarrhythmic effect, if used for more than seven days. Further studies are required to determine the effects of different doses and durations and cellular mechanisms of OLE.

Background and purpose: Many emergency referrals are due to renal colic which is more frequently caused by nephrolithiasis. Imaging techniques have a key role in diagnosis and treatment of this disease. There are some limitations associated with these techniques, so this study aimed at comparing the diagnostic value of CTU and MRU for the diagnosis of the obstructions of urinary tract.Materials and methods: This study was conducted in 30 patients with renal colic and heamaturia attending Imam khomaeini Hospital, Sari. The selected subjects were patients with suspicions of obstruction of the urinary tract whom diagnosis were not confirmed through ultrasonography.Results: The sample consisted of 30 patients (24 male and 6 female) with a mean age of 46.8. The sensitivity of MRU and CTU without contrast agent were 50% and 90%, respectively and the specificity of both methods was 100%. The findings also showed that MRU and CT scan without contrast agent had relatively good agreement (66.7%, Kappa=0.33) for the accurate diagnosis of renal colic and 100% agreement rate (Kappa=1) for the diagnosis of urinary tract obstruction and renal hydronephrosis.Conclusion: Our results showed that the MRU is a suitable alternative and efficient method for CTU in the renal colic cases. Because in this method the exposure to X-Ray is less which could be more appropriate during pregnancy and in uremic patients.

Background and purpose: Giving birth to a child is a critical stage in a woman's life. Second stage of labor is extraordinary painful that requires a lot of energy and the mother is highly involved with stress, anxiety, and fatigue. There is a controversy over suitable position during this stage, so this study was performed to compare the effects of different positions during the second stage of labor on mother’s experiences regarding birth, pain, anxiety, and fatigue.Materials and methods: This quasi-experimental study was conducted in 148 women referring to Taleghani Hospital in Arak during 2009 to 2010. The recruited cases were 37-42 weeks primiparous women with singletone pregnancy. They were randomly allocated for one of three groups including lithotomy position (n=49), squatting position (n=49), and kneeling position (n=50). All participants were located in defined positions after completing dilatation and effacement. Then, mother’s experiences regarding pain, anxiety, and fatigue were assessed. Social and demographic status questionnaire and obstetric profile form were completed for all participants.Results: The results showed no significant differences in the severity of pain, anxiety, and fatigue in admission time and the face of maximum slope (P>0.05). Also, mothers' feeling towards birth, satisfaction with position, their interest in a particular position for next birth, and severity of pain at delivery were not significantly different among all groups (P>0.05).Conclusion: Building a positive birth experience and satisfaction with delivery are amongst the puroises of any obstetrics team. The results of present study did not prove the efficacy of upright positions in women's experiences of birth. However, the freedom to adopt positions could positively influence mother's experiences during labor.

Background and purpose: Breast cancer is one of the most common malignancies in women and early diagnosis of this cancer is a key element for successful treatment. Breast cancer is a multistep disease in which a virus can play a role. Epstein-Barr Virus (EBV) is identified as an important factor in human cancer. This study investigated the relationship between EBV and breast cancer.Materials and methods: Sixty seven paraffin-embedded tissue blocks of breast cancer were used and 53 paraffin blocks of non-cancerous breast tissue (26 fibro adenoma and 27 fibrocystic) were collected as the controls. DNA was extracted using the Roche kit, then all samples were analyzed for the presence of beta-globin gene and suitable samples were evaluated for the existence of DNA-EBV through Polymerase Chain Reaction (PCR). X2 test of homogeneity and SPSS ver.15 were used to analyze the data.Results: Two cases negative for beta-globin gene in paraffin-embedded tissue blocks of breast cancer were excluded from the study. EBV was detected by PCR in 23 (35.38%) cases of breast cancer specimens and in 11 (20.75%) cases among the control samples (7 fibro adenoma and 4 fibrocystic). From the total of 118 samples 34 cases (81.28%) were found positive.Conclusion: This study found significant correlation between EBV infection and breast cancer.Further epidemiological, biological and molecular assessments are needed to confirm the possible association between this virus and the process of carcinogenesis.

Acute aortic dissection is a common disease caused by primary tear in the aortic intima or rupture of vasa vasorum. Every year 5-30 per million are affected by that.Untreated aortic dissection (dissecting aortic aneurysm) carries a high mortality rate. More than 90% of acute dissections present with acute pain in chest or back or both. Aortic dissection may mimic other more common conditions and high index of suspicion is required for prompt diagnosis and emergency treatment. In this paper, six patients with acute aortic dissection are presented who had atypical symptoms. Syncope, abdominal pain and diarrhea, dyspnea of exertion, severe weakness, faint and epigastric pain were chief presenting symptoms in these patients. Absence of severe chest pain has made the authors to present this study as case report. These cases signify the high clinical suspicion in diagnosis and treatment of aortic dissection. Furthermore, treatment of chronic hypertension is a strong modality in reducing the risks of aortic dissection.

Background and purpose: Too much salt cardiovascular and renal complications related to heart disease are a disease. Given the importance of knowledge and attitude of conserving salt Therefore this study was done to survey of knowledge, attitude, about salt intake in referring to health centers of Sari.Materials and methods: This study was descriptive and analytic. The sample size of this study 416 person of referring to health centers of Sari. The sample was selected by tow stage randomization method as: first 5 health center was selected by random between all health centers of Sari Township and the second stage the studied person was selected by random. Study tools were questioner and the data was collected by trained raters. At last the data was analyzed by use of 16 version of SPSS software and the appropriate statistical methods were used in these analysis.Results: The results showed that the average score of 53.67 percent attitude and 37.69% and the 47.4 percent. The average household salt was 12.8 grams and in the study, the relationship between the knowledge age and sex were not found to be significantly (P>0.05). The attitude of the marital relationship is statistically significant (P=0.01). But significant relationship was found between attitudes to sex.Conclusion: With respect the results of this study, amount of salt consumption in this population was high. Therefore Health education about salt consumption is necessary.

Hollow fiber membrane contactors have been applied in various industries e.g. chemistry, petroleum, biotechnology and medicine. They are also widely used in artificial organs e.g. artificial lung, kidney and liver as well as some pharmaceutical procedures such as separation and purification of biological materials. Intrinsic properties of hollow fiber membranes, such as high packing density and high mass transfer rate have increased the use of these membranes. In tissue engineering, using such membranes is of great importance for membrane bioreactors and culturing of cells sensitive to stress and those which require high mass transfer rates. This article comprehensively investigates the use of the hollow fiber membrane contactors applied in advanced medical sciences and pharmaceutics. Their composition materials in addition to the important factors affecting their performance characteristics are also discussed.

Meningomas is usually a benign, encapsulated tumor with a predominance in women. Parasagittal Meningomas is a common type of these tumors and with clinical manifestation like Cerebrovascular diseases.This is a report on 80-year-old female patient with a cut presentations of a parasagittal meningiomas with apoplexy of tumor and subcoma and right hemiplegia, that resected totally in the Behshar Imam Khomeini Hospital (August 2011).