Journal of Guilan University of Medical Sciences
Year:2007 | Volume:16 | Issue:63|Papers Count:17

Introduction: Nitric oxide, directly or indirectly, can modulate electrophysiological parameters of the heart. On the other hand Nitric Oxide Syntase enzymes were founded in the Av-node. Various studies pointed to Anti ischemic and Hypotensive effects of the Crocus Sativus (Saffron). Objective: To determine the effects of Hydroalcholic extract of Saffron on the tonic and functional properties of Atrioventricular Node and the role of Nitic Oxide in the mechanism of Saffron. Materials and Methods: In this experimental study, We used isolated Newlands male rabbits with the method of isolated perfused AV-node in the suitable experimental condition, in three separate groups, in the first group (N=20), we assessed effect of hydroalcoholic extract of Crocus Sativus (19x10-2 mg/l) in order to survey its Electrophysiological effects on AV-node (before and after). In the second group (N=6) Saffron in presence of LName (75mmol) and in the third group (N=6) Verapamil (0/1mmol ) were examined. The primary characteristics are including: Nodal Conduction Time (AVCT), Wenckebach Time (WBCL), Effective & Functional Refractory Period(ERP&FRP). All changes in the variables were detected on line by A/D board and Av node pack software. Results: The results have shown an inhibitory effects of Crocus Sativus on basic (AVCT, WBCL, FRP) and Functional Electrophysiological Parameters of AV -node including an increasing AVCT (32.4±4 to 41.7±4 msec) and FRP (157.6±3 to 163.7±4 msec). Also we had significant increased in the amount of facilitation and magnitude of fatigue (5.9±0.3 to 11.1±1 msec). NOS inhibitor (L-Name) has preventing effect on depressant effect of Crocus Sativus on AVCT and FRP. Conclusion: The hydroalcholic extract of Crocus Sativus can use as Anti -Arrhythmic drug by increasing (AVCT) and (FRP). A part of its effects mediated by Nitrigic pathway.

Introduction: Autoimmune disease is one of the questionable processes in atherosclerosis. Recognition of new risk factors and anticipated agents are caused to on time distinction and take prevention action. Objective: Survey the level of anti phospholipids anti body and evaluation of association between autoimmune disorder (anti phospholipids antibody) and atherosclerotic phenomena (carotid IMT) in young people with AMI. Materials and Methods: In this case-control study 33 patient under 50 years old with AMI were included IgG and IgM anti phospholipids antibody were selected carotid ultrasonography were calculated in all participant. The control group adjusted according to age and sex. Data was analyzed by SPSS-11, statistical analysis were x2, T-Student and Spearman correlation coefficient. Results: From all participant 15.2% was female. There was not any difference between case and control groups. But carotid IMT was significantly higher in case croups as comparison with control group. There was not any correlation between antibody and IMT. BMI, diabetes, cigarette smoking and dyslipidemia were significantly higher in case group. Conclusion: The higher carotid IMT can recommend atherosclerotic process in young AMI. In contrast to other study, anti phospholipids antibody did not have any difference between two groups. It may be due to more male than female subjection in our study.

Introduction: The elbow is frequently involved in trauma and is one of the most frequently radiographed joint in emergency ward. Posterior fat pad displacement has been describing in a variety of disorder such as hemophilia, rheumatoid arthritis and any condition that concomitant with joint effusion such as trauma. So it may be the manifestation of an Occult fracture as a result of trauma. Objective: The purpose of this study was to assessment the implication of posterior fat-pad sign in occult elbow fracture. Materials and Methods: This research is a prospective and descriptive study that carried out on 328 patients with the age under 18 years old and a history of traumatic elbow injury. All of patients with the radiographically positive posterior fat pad sign, without any intraarticular fracture were introduced in study. After 3 weeks the injury, anteroposterior, lateral, and oblique radiographs were made and evaluated for evidence of fracture healing (Periostial reaction). If there was evidence of new bone formation on any of this three radiographs, it was considered to indicate a fracture of elbow. Result: From 328 patients, 73% (242) were boys and 26% (86) were girls. 29(96)% of patients were posterior fat pad positive sign that 85% (82) of above patient after 3 weeks become positive they had evidence of a fracture and in 18% (14) of patient hadn’t any evidence of fracture. 82% (65) of patients had supracondylar fracture, 41% (5) a fracture of lateral condyl humerus, 1.64% (2) a fracture of medial condyl humerus.Conclusion: This study demonstrated that the prevalence of posterior fat-pad sign with the evidence of fracture in elbow is very high and need to evaluate the patients with occult fracture correctly is very important.

Introduction: There is controversy about the effect of fasting on fasting blood sugar of diabetic patients. In this study we are going to determine this issue in the patients with type II diabetics (DM2). Objective: Survey the effect of fasting on blood sugar in NIDDM patients in Ramazan month. Materials and Methods: In a quasi experimental study, 17 NIDDM patients (5 males & 12 females) aged 32-65 years old, with the mean of 48.6±8 years old were selected by easy sampling. All patients were on oral agents or diet and fasted during a Ramazan month. Patients with symptomatic diabetic complications & those under 30 & over 65 years old were of this study. Blood was drawn for FBS before & during fasting month at 2 weeks. interval. The cases were emphasized to observe the same diet constituents & calorie as before the holy month. Results: The mean of FBS before & during the holy month was 152±56 mg/dl and 140±25 mg/dl respectively. The difference between fasting blood sugar was not significant. Conclusion: Fasting did not have any significant effect on FBS in diabetic group of patients.

Introduction: There are some reports about Anti-Diabetic effect of black seed in Islamic and traditional medicine. Therefore, hypoglycemic and hypolipidemic effect of this medicinal plant was investigated. Objective: Survey the hypoglycemic and hypolipidemic effect of chronic oral administration of Nigella Sativa in diabetic rat. Materials and Methods: Male Wistar rats (n=44) were randomly divided into 4 groups, including control, black seed-treated control, diabetic, and black seed-treated diabetic. For induction of diabetes, Streptozotocin (STZ; 60 mg/Kg; i.p.) was used at a single dose intraperitoneal. A serum glucose level higher than 250 mg/dl was considered as diabetic state. The treatment groups received oral administration of black seed-mixed pelleted food (6.25%) for two months.Results: The results showed there were significant increase in serum glucose level in diabetic group 4 and 8 weeks after interventation as compared with the week before periment (P<0.001), Although there were no significant difference between same groups at the same time Nigella Sativum treatment of diabetic rats did not show any significant effect. In addition, Also, triglyceride level in diabetic group increased 8 weeks after interventation in comparison with related data one week before the study (P<0.05) and there was a significant lower level of triglyceride in Nigella Sativum-treated diabetic rats (p<0.05). Furthermore, a similar high significant reduction was obtained for black seed treated-diabetic group as compared to diabetic group regarding serum cholesterol level (p<0.05).Conclusion; The obtained results demonstrated that oral chronic administration of Nigella Sativum could significantly reduce Serum Triglyceride and Cholesterol Level in Diabetic rats and this may reduce some Diabetic complications.

Introduction: Due to certain issues such as; social, economical, physical & medical problems among the disabled children, planning for health, prevention & also recognition of their oral health require a particular attention. It is necessary to identify and assess the health status and oral diseases among these people. Due to high DMFT in these children it is better to assess the relationship between diet and caries. Objective: This study aimed to evaluate the prevalence of dental caries among physically & mentally disabled children in gilan province. Materials and Methods: A total of 82 participants aged 6-12 years, 28 female and 54 male took were assessed. This is a descriptive study done in 2003 in Gilan and SPSS 10 soft ware was used fordata analysis. Results: Findings showed that mean value of DMFT in permaent teeth of all cases was 2.23 and in deciduous teeth was 4.25 & it was 4 among 12 years of age. There were 1/2 in 6 y/o children and 2/36 in educatables and 3.07 in trainable samples Conclusion: According to achieved results it can be emphasized that number of dental caries in disabled children are greater than the children of normal health of the same age and the number of caries increases with the age and severity of disability and decreases with improvement of oral hygiene and socio-economical status of the families.

Introduction: Myringotomy and Grommet insertion is one of the most common operations that occurred in the Otorhinolaryngology. The most frequent complication after this operation is Otorrhea. Several treatments are suggested for preventation of early Otorrhea. One of them is the topical antibiotic therapy. Objective: To determine the effect of topical antibiotic therapy in preventation of early otorrhea. Materials and Methods: This non controlled clinical trial study was done on 98 cases of Refractory Serous Otitis Media (196 ears) that were candidated of Myringotomy and Ventilation tube insertion. We used 3 drops of topical Cyprofloxacin in right ear and considered left ear as control. All patients were examined for Otorrhea two weeks after surgery. Results: Total Otorrhea rate was 2.04%. This rate was 0 and 4.08 percent in right and left (control) ears, respectively. This difference was not statistically significant.Conclusion: Although use of topical antibiotic therapy effect on decreasing of early Otorrhea after Grommet insertion. This difference is not statistically significant.

Introduction: Many researchers believed that in patients with low back pain, secondary prevention because of its possibility is more important than primary prevention. The most cost be used for patients who will have disability, finding disability preventing variables predictor can be very important. Objective: Comparison of patients with first-episode acute low back pain and healthy subjects in order to finding differentiate variables. Materials and Methods: In this experimental case-control study were selected two groups including patients with first episode low back patients (n=32) and normal subjects (n=51). Studied variables were thickness of rectus abdominis muscles, obliques internous muscles, obliques internous muscles, transversus abdominis muscles (measured by ultrasonography), Lumbo-pelvic stability (measured by pressure biofeedback) and muscle endurance Results: Mean flexor endurance was (143 secound), mean extensor endurance was(240.58 secound) and lumbopelvic stability was (7.30) in normal group. These variables were 47.61, 62.71 and 4.81 in patient group. These three variable had significant statistically differences. The mean of Thickness of transverses abdominis in patient group is less than normal group and rectus abdominis thickness in patient group is more than normal group but these differences were not significant.Conclusions: Endurance, lumbo-pelvic stability and muscle thickness may be change not only after chronic low back pain but also after first episode acute low back pain.

Introduction: G6PD Deficiency is the most common enzyme deficiency in all over the world. The prevalence of this defect differs in the different parts of the world (from 0.1 to 50 percent). Clinical complications such as Acute Hemolytic Anemia and Neonatal Jaundice are common in areas that materials which have oxidant factor such as Fava bean is used excessively. Objective: Study of the prevalence of this defect in Rasht. Materials and Methods: In this cross-sectional study, 605 male and 585 female neonates were examined by FST (Fluorescent Spot Test) in 17 Shahrivar Hospital. Results: 59 males (9.8%, CI 95%=7.5-12.5%) and 18 females (3.1%, CI 95%= 1.9-4.9%) were detected as G6PD Deficient. Total prevalence was 6.4 percent (CI 95%: 5-8 percent). It is obvious that G6PD Deficiency in males was more than females (p<0.001, RR=3.3). There was no significant relation between G6PD Deficiency and being term or preterm (p>0.1). Conclusion: Because G6PD is sex related, its three times more prevalence in male compared with female in expected. This deficiency is more common in south compared with north of Iran (probably because of malaria) but the excessive use of Fava bean is the main reason for incidence of its complications in this area, then, the wise policy would be screening neonates and instruction parents.

Introduction: Pyelonephritic scarring is the most common cause of Unilateral Renal Paranchymal Disease that ultimately could be terminated to hypertention, Renal Insufficiency and Chronic Renal Failure. Regarding to the importance of diagnosis and treatment of Urinary Tract Infection and VUR as risk factor for renal scar formation this study was performed in according to probality of renal scar in patients with urinary tract infection. Objective: Survey the Renal Scar in Children with VUR and Urinary Tract Infection in 17 Shahrivar Hospital in Rasht(2004-2006). Materials and Methods: In this descriptive study all children with UTI and VUR who had referred or hospitalized in 17 shahrivar Clinic Hospital were selected. For evaluating Renal Scar, DMSA Scan was performed 4-6 months after the last UTI. The received findings were evaluated by SPSS soft ware and T.test. Results: Of 128 patients, 106 cases were female and 22 patients were male of 33 patients with VUR 24 cases were female and 9 patients were male. Among 66 checked renal units, 42 units had VUR and 24 units had not Reflux. Renal Scar was observed in %64 units with VUR and %12.5 of renal units without VUR. In male patients 11 units and in Female’s children 31 units had reflux. Renal scar was observed in upper pole (%47); middle pole (%22) and lower pole (%31). Renal Scar was observed in 11 units of the right kidney and 16 units of the left kidney.Conclusion: The results of this study showed that male and age lower than 2 years old had higher risk for VUR and scar. There is no relationship between the age of children and Renal Scar (P>0.05). According to these findings, evaluation and early diagnosis of VUR and Renal Scar and proper treatment are very important.

Introduction: Human Fascioliasis is a commonplace infection caused by leaf-shaped Trematode “Fasciola hepatica” incidentally affects a human host. It seems that the incidence of infection is increasing in worldwide. Human Fascioliasis has differentially diagnosed from hepatobiliary diseases such as acute hepatis, neoplasms and other liver infections. Diagnosis of the disease is achieved by locating the ova either in feces or duodenal drainage or by serologic studies. Imaging techniques are the most useful methods for confirming the diagnosis and also follow up of treatment. In this article, we present Ultrasonographic features of human Fascioliasis in the hepatitis phase to differentiate it from lesions such as metastasis and primary malignant liver tumor. Objective: Survey the sonographic findings role in Human Fascioliasis. Materials and Methods: 248 patients were selected from 1998 to 1999. All of patients refered by gastroenterologists and infectious disease specialists Our sonographic apparatus brand was ALOKA 288 with 3.5 MHZ probe in a private clinic. Sonographic study could be helpful to differentiate hepatic facioliasis from tumoral liver disease. Data were collected and analyzed by SPSS.10 software. We used Chi-Square Test for analysis. P value less than 0.05 was considered significant. Results: 78 (31.5%) were males and 170 (68.5%) were females. A majority of involvement patients aged 20-40 years. 45.2% had paranchymal involvement, 7.3%, 13.7%, 4.8% had Biliary Tracts involvement, Gall bladder infection by worms and involvement of both liver and Biliary Tracts, respectively. There was no abnormal finding in 29% of patients. The most frequent site of liver involvement was posterior segment of right lobe. There was no significant difference between site of involvement and sex or age groups.Conclusion: Ultrasonography can play an important role in the diagnosis of Human Fascioliasis.

Introduction: Incompetent cervix is a gradual and painless dilatation of cervix that can cause loss of pregnancy with inducing recurrent abortion or preterm labor, 20-25% of preterm labors are associated with Incompetent cervix. This illness can cause physical and psychological disorder for mother and so long illness or costly care for neonates. Thus early diagnosis of incompetent cervix and assessment of its associated factors is very important. Objective: Determine the frequency of some associated factors with incompetent cervix. Materials and Methods: This descriptive cross-sectional study was done on 90 patients (from September 2004 till August 2005) who showed the Incompetent cervix on the basis of history, clinical examination and vaginal sonography or was done cerclage. Data was collected by questionnaire and was analyzed. Results: The frequency of Nulipar mothers (43.3%) was more than Primipars and Multipars. Mean cervix length was 27.9 mm. The most frequency in associated factors belonged to abortion (70%) and then D&C (48.4%). (45.5%) of patients had abortion and curettage simultaneously. Frequency was in multiple gestation7.5%, cryo 6.7%, rupture of cervix 5.6%, conization 2.2% and nobody had history of cauterization.Conclusion: An analytic comparative study is recommended for more considering associated factors with incompetent cervix. This study showed that we must avoid of unnecessary dilatation and curettage and improve our skills and so use of chemic dilators as prostaglandins for preventing of incompetent cervix.

Introduction: Extra Corporal Shock Wave Lithotripsy (ESWL) is the most common treatment of urinary system stone. One of the ESWL complications is urinary tract infections .There is controversy about preventive effect of prophylactic antibiotic therapy in infectious complications. Objective: Assessing the effect of antibiotic prophylaxis in reducing the chance of positive urine culture in patients who undergo ESWL in Rasht Hospitals (Iran). Materials and Methods: This is a controlled randomized clinical trial that carried out on 88 patients with Urolithiasis who underwent ESWL for Lithotripsy They divided in 2 groups randomly that for one group prophylactic antibiotic and for the other group placebo have been administered. After 10 days urine culture for all patients was performed and results were analyzed with chi-square test. Result: Positive urine culture were 4.5% (2patients) in patients who administered prophylactic antibiotic therapy and 6.8% (3 patients) in control group patients (p>0.05). There was no satisfactory relationship between prophylactic antibiotic therapy and decreased positive urine culture. Conclusions: There is no significant Differences between prophylactic antibiotic therapy and decreased positive urine culture .However, more studies is recommended.

Introduction: Motor neuron disorders are a group of Neurodegenerative disorders which consist of degeneration of lower motor neurons and corticospinal tract. Sometimes there is involvement of medallary motor nuclei. In these group there is no involvement of sensory and autonomic systems. Madras pattern of Motor Neuron Disease (MMND) is mostly seen in southern India. Most of cases is being below 30 years of age. Classic features of disease include bulbar palsy with involvement of seventh to twelfth cranial nerves, sensori-neural deafness, weakness and atrophy of muscles of limbs and rarely optic atrophy and cerebellar signs. Case study: Our patient was a 16 years old girl who has sersori-neural hearing loss since 10 years before admission with a progressive course until 10 years of age. Weakness of limbs has started about 3 years before admission with a progressive course and bulbar palsy has started since 3 months before admission. Clinical and paraclinical studies were compatible with diagnosis of MMND.Results and Conclusion: MMND was reported rarely from other countries except India. Our case has characteristic features of MMND and there was no other report of MMND from Iran yet. Our patient had more progressive course rather than most of other reported cases.