JOURNAL OF MEDICAL SCIENCE OF ISLAMIC AZAD UNIVERSITY OF MASHHAD
Year:2009 | Volume:5 | Issue:1 (17)|Papers Count:14

Introduction: Gonadptropins are the main regulators of women menstrual cycles during which the process of ovulation occurs. Also, infertile women with high level of FSH are poor responders to ovulation during ART cycles and often do not get good results. This Study tends to evaluate the effects of day three FSH and LH level on the number and quality of fertilized oocytes in infertile women who were candidates for ART cycle. The findings of this study may help the physicians to have better prediction about their patients’ responses to the treatment.materials and methods: This is an experimental meta-analysis on 59 women who referred to the Infertility Center for ART treatment. On the third day of menstrual cycles, FSH and LH levels were measured using radioimmunoassay technique and their effects on the quality and quantity of oocytes as well as the pregnancy rate were evaluated. Then, having categorized the rate of FSH and LH into four groups, the data were examined, using SPSS, Version 16.results: After the treatment, the average levels of FSH and LH were measured as 9.01±7.8 and 7.56±7.27, respectively. The number of oocytes was found to be 10.29±7.88. It was also found that FSH level had meaningful relationship with pregnancy rate, oocytes number, oocytes number during Metaphase II, oocytes of quality A and fertilized oocytes. However, LH level had no meaningful effect on the results.Conclusion: In this study, it was found that as the FSH level increases, the number and quality of oocytes, fertilized ooctyes and pregnancy rate increase. The best result can be seen in FSH=10-15 miu/ml. An increase in the level of LH also improved the effects where the best result can be seen in LH³8. In other words, the maximum number of fertilized ooctyes with the quality of grade A and grade B and the least number of grade C quality were observed. Therefore, it can be concluded that day three FSH and LH level can predict the results of ART cycles.

Introduction: Multiple Sclerosis (MS) is a disease of central nerve system which involves brain and spinal cord. The cause of this disease is still unknown. It causes disorders in conducting nerve and electrical current by destroying myelin. The purpose of this study is to investigate the effect of aquatic exercises for 8 weeks on the improvement of balance among female MS patients.materials and methods: This is an applied research study using semi-experimental method. From 100 MS patients, 25 people were randomly selected on the basis of illness degree and age. The criteria applied for the random selection were: Patients’ responses to an Expanded Disability Status Scale (EDSS, 1-4), an average illness time of 4±1 and the age range of 20-50 years. They were divided into two groups: The experimental group consisting of 15 patients and the controlled group which consisted consists of 10 patients. The experimental group participated in the exercises with an intensity rate of 40-50 percent of the maximum heartbeat rate for 8 weeks, three sessions per week. Krutzke EDSS questionnaire was used to measure the EDSS in experimental and controlled groups both before and after the exercises. The gathered data were analyzed by using descriptive statistic and dependent sample t- test.results: The research has shown that after 8 weeks of treatment, the balance in the experimental group was significantly improved (P=0.000). A significant difference in their mean scores on EDSS was observed (P=0.000). Also, there was a significant difference in the experimental group’s EDSS scores in the pretest and post-test (P=0.000). However, there was no significant difference between the pre-test and post-test scores of the controlled group (P=0.279, a=0.05). As the findings suggest, exercises of this type could decrease up to 0.5 degree in EDSS scores among MS patients. Such amount of decrease is very valuable for MS patients.Conclusion: Considering the results of this research suggesting an improvement in the balance of MS patients with low EDSS, it seems necessary to apply aquatic exercises for such patients.Therefore, it is recommended that MS patients practice such exercises, under the supervision of specialists, as a supplementary remedy along with the medical treatments.

Introduction: Terbinafine, a member of the allylamines group, is a new class of antimycotic agents. The aim of this study was to compare the antifungal efficacy of Terbinafine 1% with that of Clotrimazole 1% in the patients with Pityriasis Versicolor.Materials and methods: This controlled-clinical trial study was performed on 53 patients (28 males and 25 females) with a mean age of 25 years old. The patients were divided into two groups. The first group was treated with Terbinafine 1% and the second group with Clotrimazole 1% twice a day. The patients were evaluated both clinically and mycologically at the beginning of the study as well as the end of the second and the fourth weeks. The findings were analyzed using Fisher Exact and Chi Square tests.results: In the 2nd week of the treatment, clinical cure was observed in 44.4% of the patients in the first group (Terbinafine recipients) and in 48% of those in the second group (Clotrimazole recipients) (P=0.90). At the end of the fourth week, the lesions disappeared in 89% and 81% of the first and second groups, respectively (P=0.467). Mycological cures were observed in the 2nd week in 48% of the first group and 38% of the second group (P=0.477) which respectively increased to 92.5% and 88.5% by the fourth week (P=0.66).conclusion: Although the fungicidal activity of both drugs were found to be almost similar, Clotrimazole is recommended because it is more available and less expensive.

Introduction: Cardiovascular diseases are the most common causes of mortality in the world. Increased blood pressure is one of the most important risk factors for cardiovascular diseases. Decreasing blood pressure due to exercise can reduce the risk of cardiovascular incidents. Thus, the objective of this study is to evaluate the effects of exercise on blood pressure, heart rate and rate pressure product.materials and methods: To evaluate the effects of intensity and volume of resistance exercises on the post-exercise cardiovascular responses, 10 young untrained non-athletic men (age: 22±0.8 years; height: 173.05±2.4 cms and weight: 67.2±3.4 kgs) participated in this study as the subjects. The subjects performed four exercise bouts in a randomized order. Each bout consisted of five exercises: arm curl, hamstring curl, squat, seated lat pull-down and bench press. The exercises were determined to be performed at three sets: SHORT volume of LOW 40% 1RM (SL) and HIGH intensity 80%1RM (SH) and at six sets: LONG volume of LOW 40% 1RM (LL) and HIGH intensity 80% 1RM (LH). Blood pressure (BP), heart rate (HR) and rate pressure product (RPP) (product of HR and systolic BP) were measured before the exercise (baseline) and at the ten-minute intervals within 90 minutes after each exercise. Then, the data were analyzed using two way ANOVA repeated measures and LSD post-hoc tests.results: Systolic BP was found to be Affected by the volume and intensity of exercise and became lower during 10 to 60 minutes after the exercises (P<0.05). However, Diastolic BP was not altered after the exercise bouts. HR was increased in 30 minutes after LL and SL, and within 60 minutes after SH and LH exercises (P<0.05). In contrast, after SH and LH, RPP was increased over a period of 50 minutes.Conclusion: The intensity and volume of resistance exercises do not influence the magnitude and duration of post-exercise hypotension. Also, HR and RPP post-exercise are not affected by the resistance exercise volume.

Introduction: Urinary stones are among the most prevalent urological diseases (1-15%). While passing from kidneys to bladder, these stones stay in the lower urethra, causing painful spasms. Watchful waiting method (between 1-6 weeks) is one of the most common remedies in the treatment of lower urethral stones on the other hand, a-receptors, which help with controlling the spasm, exist in the distal urethras, especially in the trigone of the bladder. So, we decided to study the effects of Tamsulosin (a-blockers), as compared to Indomethacin, on patients suffering from distal urethral stones. The objective of this study is to evaluate the effect ofα-blocker (Tamsulosin) on the expulsion of lower urethral stones in the patients who referred to Bahman 22nd and Aria hospitals in one year.materials and methods: 85 patients who were diagnosed as suffering from urethral stones were randomly divided into 2 groups.46 patients who were placed in the first group received Tamsulosin (0.4 mg/daily) with suppository of Indomethacin for 10 days. The other 39 patients in the second group received only Indomethacin. After taking the prescribed medicines, the patients were again examined and controlled by KUB and Ultrasound. Then, the results were compared using statistical analysis.results: 32 of the patients in the first group (the case) who had received Tamsulosin had stone expulsion while the other 14 patients did not. Among the patients in the control group (a total of 39), 22 patients had stone expulsion while 17 patients did not. The result of chi-square test revealed that the 2 groups were not significantly different from each other in terms of stone expulsion and prognosis (P=0.209).There were no statistical differences between the groups of study according to age, gender and the stone size, either.conclusion: According to these findings, we do not suggest the prescription of Tamsulosin as an adjuvant therapy for stone expulsion in patients who have lower ureteral stone without considering their stone size and gender. Instead, just prescribing pain relief (if necessary) and physical activity with large amount of oral liquid intake during the watchful waiting period are enough.

Introduction: Accurate differentiation between upper and lower urinary tract infection (UTI) requires invasive procedures. The objective of this study was to determine the morphology of RBC that originates from kidney or bladder for differentiating between upper and lower urinary tract infection.materials and methods: UTI was induced by the injection of 0.5ml of normal saline containing human E coli (104/cc) into the bladder of rats (n=50). After 48 hours, the rat urine was drained from the bladder and analyzed for the morphology of RBC, culture and cell counter. For diagnosing pyelonephritis, both bilateral kidneys and bladder were biopsied for histopathology and culture.results: Dysmorphic RBC was detected in 33% (10/30) of the subjects with upper UTI and 13% (4/30) with lower UTI, which showed no significant difference (x2=0.04, P=0.63 Fisher Exact Test). The mean and SD of percentage of dysmorphic RBC in the subjects with upper and lower UTI were 35±34% and 44±43%, respectively, which revealed no significant difference (t=0.55, P=0.25). In this sudy, dysmorphic RBC showed rates of 45% sensitivity and 50% specificity for upper UTI diagnosis.conclusion: Urine osmolality may influence the results of RBC morphology for differentiating between upper and lower UTI.

Introduction: Antiemetics currently in use are not totally effective. Serotonin Receptor Antagonists are a new class of antiemetics that have shown promise for the treatment of nausea and vomiting in many situations. This study aims at evaluating the efficacy of Serotonin Receptor Antagonist, Ondansetron, for the prevention of postoperative nausea and vomiting.materials and methods: This randomized, double-blind study compared the efficacy of an intravenous dose of Ondansetron 4 mg. with Metoclopramide 10 mg. for the prevention of postoperative nausea and vomiting (PONV) in patients undergoing general anesthesia for open abdominal surgery. A total of 126 patients (63 Ondansetron group, 63 Metoclopramide group), ASA status I–II, aged 18–65 years, were included and received the study medication after the induction of anaesthesia. A standardized anesthetic technique and intraoperative analgesia were used for all the patients. Within a period of 24 hours after the surgery, the following data were gathered and recorded: the proportion of the patients experiencing no emesis or no nausea as well as those who were provided with rescue antiemetic medication, the duration of nausea and the number of emetic episodes.results: During the overall observation period (i.e.0-24 hours), more patients who had received Ondansetron had significantly no emetic episodes (87.3%) than those who had received Metoclopramide (73%, P=0.044). A higher proportion of patients receiving Ondansetron (71.4%) did not experience nausea (Metoclopramide 63.5%, P=0.342). Fewer patients in the Ondansetron group required rescue medication (P<0.05).conclusion: Ondansetron was superior to Metoclopramide for the prevention of vomiting in the first 24 hours after surgery and the total number of emetic episodes was significantly reduced, as compared with Metoclopramide, but no significant differences were observed between Ondansetron and Metoclopramide for either the prevention of nausea or the treatment failure.

introduction: As the population grows older and more obese, hypertension eventually develops in more people during their life span. The prevalence of kidney stone disease is estimated at 1% to 15%, varying in degree according to age, gender, race, and geographic location. The objective of this study was to determine the frequency of nephrolithiasis in hypertensive patients.materials and methods: Using simple non probability sampling, a total of 200 patients who referred to Aria and Bahman 22nd Hospitals entered this study. The exclusion criteria were determined as: those subjects that had used carbonic anhydrase or thiazide; those who had a history of surgery on their urinary system; those who had been diagnosed with HTN before affected by nephrolithiasis. The main group was divided into 2 groups: Group 1 who had normal blood pressure (control group) and group 2, hypertensive patients (case group). All the patients were examined using both ultrasound and supine abdominal X ray (KUB) for stone scanning. Then, statistical analyses were conducted using t-test, chi-square test and Fisher’s Exact Test. All the subjects signed a testimonial before the test.results: The comparison of sex and age distribution between the case and the control groups showed no significant differences. Also, the results of Ultra sonograms showed echogenic density of the urinary system prevailing in 4.2% of the patients in the control group and in 25% of those in the hypertensive (case) group (P<0.05). Moreover, KUB revealed significantly lower frequency of stone density in kidneys in the control group (4.2%), as compared to the hypertensive group (21%). As a whole, nephrolithiasis was observed in 4% of the patients in the control group and 21% in those subjects in the hypertensive group. Such a difference between the two groups was statistically significant (P<0.001).conclusion: We believe that urinary stone is significantly more frequent in hypertensive subjects than normal subjects.

It is believed that vaginal delivery is associated with less maternal mortality than cesarean section. On the other hand, repeated cesarean sections are said to be associated with more risks threatening both the mother and the infant. Besides, it is believed that during the next pregnancies, there are many risks involved, such as Placenta Previa, Placenta acreta and even hysterectomy. This article is about a woman who experienced successful vaginal deliveries giving birth to healthy newborns in spite of her numerous cesarean sections she had already experienced.