Journal of Guilan University of Medical Sciences
Year:2003 | Volume:12 | Issue:46|Papers Count:17

Introduction: The immune system s reaction to stress, especially exercise is one of the most important subjects in medical sciences. It has been already shown that the effect of physical activity depends on several factors such as: intensity of activity, duration and also distance and frequency of training. In this study maximal exhausting training was chosen as a kind of training, which is usually used by athletes. Objective: The experiment was designed regarding the effect of a maximal aerobic training with a %90 heart rate on serum immunoglobulin G and A. Materials and Methods: Twenty-one students were randomly selected and divided into two groups; experimental group (n=11) and control group (n=10). The mean age, weight and height for these groups were respectively (21.9), (22.7) years, (70), (68) kg, (174.5) and (170.2) cm. The Vena blood sample of subjects was taken both before and immediately after training. Then the levels of IgG and IgA more measured by the method of SRID. Results: Statistical analysis using T-student showed that the means of serum IgG and IgA were significantly decreased (p<0.01). Conclusion: The results indicated that a single maximal aerobic training (%90 HR) had significant effect on serum IgG and IgA in male collegiate students. The obtained data can be related to elevation in cortisol or other hormones and also glutamin activity after training.

Introduction: GABA is a inhibitory neurotransmitter in CNS that plays an important role in the regulation of blood glucose. There have been reports that GABA-A receptors might cause a reduction in the concentration of blood glucose by increasing the insulin plasma and decreasing the glucagon and somatostatine. Objective: This study was carried out to compare the effects of interaperitoneal and intracerebellar ventricle injection of Picrotoxin and Biccuculine on regulation of blood glucose concentration in mice. Materials and methods: In this experimental study, male albino mice weighing 20-30 grams were used. Serial blood collection from each animal was done by retro-orbital sinus puncture, and glucose concentration was measured using O-toluidin. In this experiment, the effect of different doses (IP and ICV) injection of Picrotoxin and Biccuculine on blood glucose was studied. One-way variance analysis and t-test were adopted in statistical analysis of the collected data. Results: The results indicated that IP and ICV injection of Picrotoxin and Biccuculine induce significant increase of blood glucose concentration in two groups (P<0.05). Another point is that increased blood glucose concentration is observed until 45-th minute in all doses but after this time, blood glucose almost according to similar pattern is reduced and in 90 minutes, it will reach its minimal level. Conclusion: Therefore, it seems that GABA-A receptors have an inhibiting role in regulation of blood glucose. Further research seems inevitable since the effects of GABA-A receptors on blood glucose (concentration is a complex phenomenon.

Introduction: Many studies suggest that the consumption of hydrogenated fat may increase the risk of coronary heart disease, while monounsaturated fats may be associated with a lower coronary risk profile. Objective: The present study compares the effects of a diet containing 8%o olive oil or hydrogenated fat in four groups of rabbits for 12 weeks (experimental period). Materials and Methods: Twenty Dutch male rabbits were categorized to four groups (One as control, and the other as experimental group). They received one of standard, standard + olive oil, standard + hydrogenated fat, standard + olive oil+ hydrogenated fat for twelve weeks. Fasting blood samples from heart were collected at the beginning, and at the end of experimental period. Their aortic tissue was prepared for microscopic observation and determining the degree of aortic injuries. Results: Means of total cholesterol, HDL- C, Triglyceride, MDA and antioxidant capacity were not significantly different at the beginning of experimental period. After experimental period, HDL-C, Triglycerides, total cholesterol and MDA were significantly higher in hydrogenated group. The comparison of hydrogenated fat with combined group (Hydrogenated + Olive oil), showed that triglyceride and total cholesterol are significantly lower in combined group. Histological results showed no difference in the occurance of the athermanous lesion in the aorta between these groups. According to the undesirable effects of Hydrogenated fat on lipid profile and lipid peroxidation, these effects could be modulated by substituting olive oil in the diet. Conclusion: In spite of hypercholesterolemic effect of hydrogenated fat, no aortic lesions have been observed.

Introduction: Jaundice is one of the most common problems of neonatal period. It is important because of toxic effect of unconjugate bilirubin on brain and its many severe complications so that invention of a new approach to achieve earlier recovery has always been an issue.Objective: The purpose of this study was to determine the effect of intravenous fluid therapy in addition to phototherapy in reduction of serum bilirubin of affected neonates admitted in hospitals.Materials and Methods: The present study was carried out on 60 neonates with indirect hyperbilirubinemia, weighting over 2500 grams, age over 72 hours, total serum bilirubin 17-25 mg/dl, direct bilirubin < 2mg/dl and without systemic and hemolytic diseases (except for glucose-6-phosphotase deficiency) in Imam Sajjad Hospital of Yasuj from May to September 2001.Patients were randomly divided into the study group and control group. In control group, only conventional phototherapy was used and in the study group, intravenous fluidtherapy dextrose water 10%,1.5 times as much as maintenance requirement with NaCl 3 meq/100 cc fluid for a 24 - hour duration, in addition to conventional phototherapy. The patients were discharged when their serum bilirubin reached 12 mg/dl.Results: Statistically, no significant difference was found between the two groups in terms of age, weight and level of serum bilirubin in admission time. The mean duration of admission in study group was 3.23 days and in control group 4.53 days (P=0.00005). Also the mean of total serum bilirubin in control and study groups after 24 and 48 hours following treatment were reduced to 16.27 mg/dl and 15. 18 mg/dl (P=0.039) and 14.29 mg/dl and 12.65 mg/dl (P=0.0006), respectively.Conclusion: Maintaining adequate hydration with fluids containing 10% dextrose for infants receiving phototherapy results in faster decline in serum bilirubin level and, therefore, earlier discharge from hospital.

Introduction: Health is a turning point of nursing care and nursing education. Nursing instruction program provides a context for the students to examine their life styles and create the appropriate changes in their health and assume the professional responsibility in order to be a good model with regard to health behavior. Objective: In this descriptive-comparative research, we studied the first and last-year nursing students of Guilan Nursing Faculties and their health styles. Materials and Methods: 130 students were selected by stratified random sampling from nursing schools of Rasht, Anzaly, Somesara, Langrood and Lahijan. Data were collected by a questionnaire. Results: Results indicated that the majority of students (58.5%) had risky condition in eating habits. Most of the first-year (58.5%) and last-year (47.7%) students had risky condition in exercise and other activities. 44.6% of them had risky condition in stress control. 78.5% of first-year and 69.2% of last year students had good condition concerning the way of safety maintenance. There was a significant difference between these two groups (P<0.00001). The condition was excellent concerning smoking habits and alcohol consumption. Conclusion: It can be concluded that both first and last-year students did not have appropriate condition regarding the health styles and as the behaviors of health and treatment staff are considered a pattern for others, this problem requires further study and investigation.

Introduction: Tracheal intubation is a safe and popular method for airway control during general anesthesia for sugary, but it has some complictions such as airway mucosal barrier damage that results post-extubation sore throat (21%-65%). This complication is uncomfortable for patients and it is one of causes of delayed discharge in outpatients. Therefore, reducing this complication is useful for both patients and medical health centers. Objective: In this study, we wanted to evaluate the effect of topical Clobetazol cream on sore throat after tracheal extubation.Materials and Methods: In a double- blind randomized clinical trial, 88 patients in ASA class I or II and age over 18 years were selected as candidates for elective surgery other than head and neck surgery.They were randomly divided into two groups. Each group had 44 patients. In one group, Clobetazol cream was applied on tracheal tubes before intubation. In another group, Vitamin A cream was used for this purpose.2, 12 and 24 hours after extubation according to questionnaires, the patients were asked about sore throat. Data were processed by SPSS software and then analyzed with X2 test. (p<0.05 was considered significant).Results: Incidence of sore throat after tracheal extubation in clobetazol group was 24.5% and in Vitamin A group 63.6% (P<0.005)Conclusion: According to results of this study, we concluded that applying Clobetazol cream on tracheal tube before tracheal intubation is highly effective in reducing sore throat after extubation .

Introduction: Decompensated cirrhosis resulting from chronic hepatitis B causes a significant decrease in survival of these patients. Prescription of Alpha interferon for these patients is forbidden. Several studies have shown the effectiveness of Lamivudine in decreasing the Symptoms arising from this decompensation. Objective: The aim of this study is to determine the effect of Lamivudine on liver function and clinical status of the patients with decompensated cirrhosis arising from HBV presenting to the Supporting Center of patients with liver diseases or those being hospitalized at Gastrology Department of Imam Khomeini Hospital.Materials and methods: In a clinical trial on the basis of liver consideration in 55 patients with cirrhosis that had positive HbsAg, positive HBV DNA, child-pugh score more than 8, but not with positive HCV Ab or positive HIV Ab and creatinin of serum, more than 2 mg/dl, they were treated with 100 mg of Lamivudine tablets daily.In these patients, serum level of bilirubin, albumin, ALT, AST and also the PT coagulation time (on the basis of INR) were controlled at the beginning of study and then at intervals of 2 to 6 months and finally 12 months after the start of treatment and in terms of presence and intensity of ascites and encephalopathy, the patients were examined by a physician. Also at the beginning of the study and 6 and 12 months later, HBs, Ag, HBV DNA, Hbe Ag and Hbe Ab were checked. On the basis of the table related to child-pugh, its amount was calculated at the beginning of the study and at intervals of 2 to 6 months and then 12 months.Results: 5 patients died in the first 6 months of treatments. The following results are related to 50 patients being under treatment with Lamivudine at least for a period of 6 months. In these patients mean child-pugh score was decreased from 11±2 (mean ± criterion deviation) to 7±1 (p<.0001), mean level of bilirubin from 4.5±2 to 1.3±1.6 mg/dl (p<.0001) and mean level of albumin from 2.6±2 to 3.8±1.3 g/dl (p<.0001) and mean PT (INR) from 1.7±2 to 1.2±2 (p<.0001) and mean ALT from 98±10 to 32±10 units per liter (p<.0001). Out of 19 patients not being precormutant, 4 patients (22%) had Hbe Ag seroconversion after 6 months of treatments and 5 (26%) after a 12-month treatment with Lamivudine. All of the patients tolerated this drug very well.Conclusion: Lamivudine can be effective in improvement of liver function in patients with decompensated liver cirrhosis resulting from HBV, but for determination of proper period of treatment, further studies are necessary.

Introduction: Prognosis of patients with brain stroke is dependent on multiple factors. A study points out that mild decrease of serum potassium level without clinical signs is associated with bad outcome. Objective: This study was carried out to assess the mild hypokalemia and outcome of patients admitted in Neurology Department of Shafa Medical Center, affiliated to Kerman University of Medical Sciences. Materials and Methods: In this prospective study, 100 patients with brain stroke were selected. Serum levels of potassium ion were determined at the first hours of stroke. Evaluation of patient's situation was carried out 2 months after discharge by phone contacts with patients or their families for investigation about the ability or disability of patients for activity. Results: 100 patients with brain stroke were evaluated. The males were slightly more than females (60%). More than 30% of patients were not active (EDSS>7) and mild hypokalemia (K<3.5 meg/I) without clinical signs was found out in 30% of patients. Mild hypokalemia was seen more in cases that neurological symptoms were more severe (P<0.01). Cases with mild hypokalemia were associated with more disability after 2 months (P<0.01). Conclusion: Mild hypokalemia at the first hours after stroke was more in those patients with more neurological defects and it was associated with higher disabilities after 2 months since the discharge.

Introduction: The preinvasive cervical lesions are increased appreciately in recent years. Early diagnosis and management of abnormal pap test has an effective role in prevention of invasive cervical carcinoma and its related mortality. The aim of this study was to assess the prevalence of intraepithelial dysplasia and to compare colposcopic- histologic results in patients with minimally abnormal papanicolaou smears (ASCUS, nuclear enlargement, low-grade SIL and atypical metaplasia). Objective: The aim of this study was to assess the prevalence of intraepithelial dysplasia and compare colposcopic-histologic results in patients with minimally abnormal papanicolaou smears (ASCUS, nuclear enlargement, low-grade SIL and atypical metaplasia). Materials and Methods: This research was a cross-sectional study that evaluated patients presenting with minimally abnormal pap test to Gynecology Clinic in Alzahra Hospital (Rasht) from June 1998 to December 1999. All patients underwent colposcopy and biopsy due to suspicious lesions immediately. The results were analyzed with X2 test to calculate differences between the two reports of colposcopy and pap test. Results: Out of a research sample consisting of 70 people, 49 patients (70%) had histologic SIL (LSIL and HSIL. Histologic intraepithelial lesions were found in 14 patients out of 21 cases (66.6%) of ASCUS group. Among them, one patient was with HSIL and 13 patients were with LSIL. In a total of 18 patients with a positive result of nuclear enlargement pap test, 12 cases (66.6%) were with intraepithelial lesions (2 patients with HSIL and 10 patients with LSIL. In a total of 19 patients with a positive result of intramenopausal and atypical metaplasia in pap smear test, 12 cases (63.2%) had LSIL. Out of 12 patients with positive pap smear result of LSIL, 10 cases (83.3%) were with intraepithelial lesions (3 with HSIL, 7 with LSIL). Conclusion: Considering the observation of histologic intraepithelial lesions with a high grade in patients with pap smear result of LSIL and nuclear enlargement profile at the age of 30 and above and with regard to ASCUS at the ages below 30, colposcopy and biopsy are suggested when there is a well-equipped center.

Introduction: In spite of the increasing rate of cesarean section and its public acceptance, many are not aware of its complications. Objective: To provide information on pregnant women's knowledge and attitude about vaginal versus abdominal delivery, we carried out the present study. Materials and Methods: 602 pregnant women attending at eight maternity centers and four private offices in Rasht in 2000 were selected randomly. A questionnaire was provided by counseling with gynecologist. Its reliability was confirmed by test and retest. It was completed through interview. The survey showed that 4.2% of women had high knowledge (>80% correct answers), 62.7% of women have moderate knowledge (50-75% correct answers) and 33.7% had limited knowledge (<50% correct answers). 75.4% of women had positive attitude and 24.6% had negative attitude toward vaginal delivery, most of them were aware about pain after cesarean section (8.7%) and also high expenses (77.2%) and longer hospitalization (66.3%).Results: There was significant statistical relation between knowledge and marital age (P<0.006), literacylevel (P<0.001), job (P<0.03) and family income (P<0.001). Conclusion: Considering the low level of knowledge in the women it can be concluded that young people in the society need more training and education about this subject during the first various periods of reproductive life and education.

Introduction: Chronic Renal Failure (CRF) is characterized by impaired renal function, which is progressive & irreversible. Most of these patients will need hemodialysis (HD) in future. Treatment of CRF with HD has many economical & psychiatric problems for patients & society. Objective: The present study was carried out to investigate the reasons of chronic renal failure in hemodialysis patients in Guilan Province. Materials and Methods: In this cross-sectional study, 414 patients under HD were evaluated in 10 centers in Guilan. Required data were obtained from doctors note, sonography, ECG, renal biopsy & history taking include: age, sex, how long form 1st dialysis & causes of CRF. Results: In these study 414 cases including 213 (51.4%) male & 201 (48.6%) female were studied. Mean age of patients was 48.9±15.9 in initiation of HD. Results showed that the most common causes of ESRD in this region were hypertension (26.1%), glomerulonephritis (10.9%), diabetes mellitus (10.1%) renal stone (8.7%) and polycystic kidney (6.8%). Other cases such as congenital disease, lupus, Alport syndrome, trauma, bleeding during labor hemorrhagia and drugs were 10.1% and 23.4% were unknown. Conclusion: The most common causes of End Stage Renal Disease (ESRD) in this region was hypertension (26.1%) and also in this study, glomerulonephritis and diabetes mellitus were second and third causes of ESRD. Also nephrolithiasis, as a cause of CRF was more common in this region. This can be related to probable high-risk prevalence of nephrolithiasis in this region. Causes of CRF between two sexes or age >40 and <40 were different significantly (P<0.05).

Introduction: Cancer is the second cause of mortality after cardiovascular disease in human communities. Frequency of cancers follows ethnic, geographical, and environmental conditions in each area so registration and collection of cancers in each area for centralizing of diagnostic and therapeutic programs should be done. Objective: In this Survey, we determined frequency of cancerous organs in Guilan from 1999 till 2000. Materials and Methods: This research is a descriptive case series study that was carried out performed as census in hematology and pathology centers of Guilan. All malignancy cases were diagnosed from 11/1999-11/2000 was gathered. The prevalence rate per 100,000 populations determined with regard to census of Guilan population in 1996. Data were analyzed by EPI info 2000 program. Result: Among 1409 malignant cases, 750 cases (53.8%) were males and 644 cases (46.2%) were females. Sex ratio (M/F) was 1:16. The mean age of patients was 57.1±17.2. There was the most frequency of cancers in 60-69 age groups (36%). The prevalence rate of cancer was 62.8 per 100,000 people. In this research, stomach cancer was identified as the most common cancer in both sexes (17.8%) and after it follows breast (11%), urinary bladder (9.3%), colorectal (8%), esophagus (7.3%), blood (4.3%), prostate (3.3%), uterus (3%), lymph node (3%) and abdominal cavity (2.1%) respectively. Conclusion: Frequency of cancers in Guilan Province has had a considerable increase in comparison with previous studies. Of course, it may be due to difference in research method and data collection. In recent years, Guilan has been in the first place for stomach cancer in Iran. Perhaps it is because of exposure to nutritional risk factors. It is possible that nutritional factors like salted fish, pickle vegetable, smoked herring, cooked potato and cereals which are important parts of Guilanians diet play a major role in developing gastric cancer.

Introduction: Toxoplasmosis is a zoonosis affecting both human beings and some animal species, and it is caused by coccidia, toxoplasma gondii. Human infection by toxoplasma has worldwide spread and its prevalence varies from zero to ninety percent from a region to the other depending on the geographical situation, people behavioral and nutritional habits. Objective: The purpose of this study was to determine the prevalence of toxoplasma infection in patients admitted to outpatient department in Markaze Tebbi Koudakan, Tehran. Materials and Methods: This was a descriptive, analytical and cross-sectional case study, carried out on 446 blood samples which were collected from individuals admitted to outpatient department in Markaze Tebbi Koudakan (Children Medical Center in Tehran). For each individual a questionnaire was filled in, then two finger prick samples were taken and serologically tested by indirect fluorescent antibody technique using 1:20, 1:100 and 1:200 serum dilutions. Any positive serum in 1:200 dilutions was rechecked for final dilution. Serum dilution of 1:20 and more was considered as a cut-point for the infection. Results: A total of 25 persons (5.6 percent) showed positive titers from 1:20 to 1:800 and 421 persons (94.4 percent) showed no antibody titer and were sero-negative. Although the prevalence rate of infection in males was more than females (6 and 5.1 percent respectively), there was no statistical significance between them. The seropositive rate in children below two years was zero and it seems there is a trend toward increasing seropositivity by aging. The highest prevalence rate (10. 8 percent) was observed in 10-13 year age group. No statistical significance was found between the seropositivity rate and contact with cats, consumption of improperly cooked meat and raw vegetables. We believe that the quality of washing and disinfecting vegetables are efficient and important factors, the findings proved that in 17 positive cases (77.3%) the vegetables were washed by pure water and only 5 cases (22.7%) consumed disinfected vegetables. Conclusion: Although no statistical significance was found between the seropositivity rate and clinical signs (Strabism, microcephally ...), but by using Chi-Square and Fischer tests, there was statistically significant between lymphoadenopathy and toxoplasmosis. Considering the calculation of odds ratio with a confidence interval of 90% it was found that the possibility of being infected by Toxoplasma gondii in people who are involved with lymphoadenopathy was six times more than those who were not.