Journal of Guilan University of Medical Sciences
Year:2005 | Volume:13 | Issue:52|Papers Count:15

Introduction: One of the most important subjects in modern biology is to explain the molecular mechanisms by which an organism adapts in response to environmental signals. In this area, the protooncogene c- fos is widely used as a useful marker for tracing stimuli in the nervous system. It is considered as a general transcription factor, which can regulate expression of related target genes. Objective: The purpose of this research was to study the brain structures involved in seizure using c-fos expression mapping.Materials and Methods: In this study, we used pentylentetrazole 65 mg/kg, i.p, as a kindling inducing drug and approximately two hours after the drug usage, immunohistochemical analysis was performed using immunoperoxidase staining with c-fos antibody, ABC kit and DAB. Results: Results showed a dramatic and specific induction of c-fos in the nuclei of neurons in dentate gyrus, hippocampus, somatosensory cortex and limbic system. Conclusion: It is possible that FOS, a nuclear protein binding to the regulatory part of some target genes such as proenkephaline which is widely released after seizure can contributes to neural plasticity. Therefore, finding the relationship of FOS with target genes in forming appropriate response in nervous systems plasticity is of great importance.

Introduction: Phenobarbital is a anti epileptic drug (AED). FDA has classified this drug as a D group and pregnant women who take this drug under appropriate conditions may have neonates with congenital malformations e.g. hypoplasia of finger or toe nails and digital phalanges, facial and skull deformities and cardiac malformations. Some of the case reports showed severe malformations for this drug such as fetal hydantoin and down syndromes. Objective: This study was carried out to reveal the malformations spectrum of Phenobarbital malformations. Materials and Methods: 30 Balb/c mature female rats, aged 2.5 months and weighted 28 to 30 gr were housed in environmentally controlled room. A group of 3-4 females were caged with a single male of proven fertility overnight. Finding of vaginal plug on the following morning was regarded as a gestational day (GD) 0. Rats were divided into experimental groups; ex. I=received 1.3 mg/kg and ex. II=received 2.6 mg/kg doses of Phenobarbital vial and one control group which received normal saline via intraperitoneally during the first consecutive 10 days of pregnancy. Rats were dissected in GD18 and embryos were collected and then washed with normal saline. Macroscopic observation was done by OLYMPUS SZX JAPAN stereomicroscope. Data were analysed by ANOVA and X2 tests by means of SPSS software.Results: Most of the malformations were in the group II (dose 2.6 mg/kg). Embryos had extensive malformations in the skeletal and nervous system such as short limb, distortion and dislocation of the limbs, scoliosis, encephalocele. The group I (Dose 1.3 mg/kg) also showed these malformations but with a lower severity and some cases of exencephaly and spina bifida.Conclusion: This study revealed that Phenobarbital can induce new severe malformations if this drug is used continuously in the early stage of pregnancy.

Introduction: Head lice infestation is one of the most common diseases of children. The first major symptom of a louse infestation can be intense itching caused by the louse feeding. Breaks in the skin caused by the louse and resultant scratching can cause secondary bacterial skin infection. Objective: This descriptive study was conducted to evaluate the prevalence of pediculosis among primary school students of Guilan province in the school year of 2002-3.Materials and Methods: 2906 students of the first-fifth grades in the primary schools selected by cluster sampling were examined by experienced educators and instruments like lens, forceps and the qusetionnaire were used. The data were compared with chi square analysis.Results: Out of 2906 students selected in this study, 129(4.5%) persons were infected with pediculosis. The rate of infection in girls' school was 5.7% and in boys school was 3.3%. The rate of infection was 3.2% in urban and 5.7% in villages. Also, there was a statistically significant difference between infection and variables such as fathers occupation, health educator, rate of parents, education, rate of knowledge, educational level and there was no statistically significant difference between infection and mothers occupation.Conclusion: Results indicated that 129 (4.5%) students were infected with pediculus humanus capitis. The rates of prevalence in villages were more than those in cities. The prevalence among girls was more than boys. Also, results showed that the prevalence of pediculosis among Guilan primary school students was less than average percentages observed in other students inside and outside Iran. Regarding to the results obtained from the variables test showed that education of parents, fathers occupation, presence of health educator, rate of knowledge and perceptions, educational level play an important role in acquiring infection in students.

Introduction: Esophageal cancer is the 8th prevalent cancer (4% of all) around the world and the sixth leading cause of death from cancers .The Northeastern parts of Iran (Caspian littoral areas) are one of the most prevalent areas of esophageal cancers in the world. Objective: In this study, we examined relationship between esophageal cancer tumor histology and variables like age and sex, in pathologically confirmed cases in the Northeastern of Iran (Caspian littoral margins).Materials and Methods: This descriptive cross-sectional study was conducted in the health care services and pathologic centers in Golestan Province. All pathologically confirmed esophageal cases were enrolled in the study and demographic data were listed. Data were analysed with SPSS-10 software. Variables were compared with one-way ANOVA and Mann-Whitney tests for continuous variables and chi-square for nominal/categorical variables. Level of significance was set at p-value less than 0.05.Results: Four hundred and ninety one pathologically confirmed esophageal cancer cases from 1996 through 2000 were included in this study. Squamous cell carcinoma was the dominant tumor histology in this study and it was more common in females. We found that tumor histology is highly related to gender and this association is independent of age factor. Our finding revealed that this association is only applicable to older age groups (older than 50). Conclusion: Results from this study suggested that demographic factors might be different in esophageal cancer cases in different geographic areas. Our finding can be a reflection of distinctive etiology for esophageal cancer in the Caspian littoral areas.

Introduction: Head injury is an important problem in the community. Side effects of injury relates to nursing care quality. The first and important factor for study in these patients is the situation of airway. Often due to the airway obstruction and reduction of ventilation, hypoxia in brain tissue occurs. With increased number of patients with head injuries and the vital importance of this organ, the observance of the care and nursing points is necessary. For several consecutive years, Aden Brock anesthesiology institute has examined the condition of airway but in Iran, only in 1995, a study in Tehran has considered the nursing, condition of airwaysObjective: The purpose of this study was to investigate the quality of care in the airways of head injury patients in emergency department of Bahonar Hospital in Kerman City. Materials and Methods: This research is a descriptive cross- sectional research carried out on 384 patients with head injury hospitalized in emergency department of Shahid Bahonar Hospital in winter 2003. Instrument for data collection was an observational checklist consisting of 15 care criteria that their validity and reliability were confirmed. It was for gathering demographic data.Results: Results showed that 86.5% of male patients presenting to the emergency department were the morning working shift. The patients were in the age group of 20-24 years. Their arrivals were due to the closed injuries and strokes that were consistent with study of Aden Brock Institute in 1997. The greatest rate of optimal care (98.5%) is related to the mode of oxygen therapy and the lowest correct application of sterile principles in pharynx and tracheal suction. Conclusion: It can be concluded that because of multiple traumas in men, quality of care for female patients was more favorable but among female patients, quality of care for natural airways, the conditions of head and neck, oxygen consumption, observation of safety issues, control of breathing counts and attention to the potency of tracheal tube were unfavorable and, thus, improvement for quality of care is suggested.

Introduction: Surgical removal of adenoid and tonsils is the most common operation in ENT H&N surgery that principally is operated on patients under 15 years. These tissues are arranged as mucosal defense system that is first defense against different organisms and their Ig(s) productions are quite known. Then, this surgery may have an effect on serum Ig(s) levels. Objective: The purpose of the study was to determine whether adenotonsillectomy actually affected on serum Ig(s) levels.Materials and Methods: This study was an experimental-like type that investigated 300 patients under 15 years at Amiral Momenin Hospital in Rasht that needed these operations. Serum Ig(s) levls were measured immediately before and one month after operation. Ig(s) of serum were measured with SRID (Single Radiation Immune Diffusion). Adenoid and tonsils were removed with curette and adenotome and incision blunt dissection snare respectively.Results: Serum IgG levels of all patients were the same pre and post-operations. Preoperative serum IgM levels of 289 cases were normal, but 278 ones had normally postoperative levels. In 11 patients, serum IgM levels decreased post operation in 11 patients. IgM levels that were low preoperations in 4 patients were changed to normal levels postoperatively. In 296 pationts, serum IgA levels were normal pre and post-operation. In 2 of 4 patients, IgA levels reached normal range postoperatively.Conclusion: Adenotonsillectomy has no significant effect on serum Ig(s) levels.

Introduction: Laryngoscopy and endotracheal intubation result in severe homodynamic changes in patients, which in CAD patients are more severe and they need more prompt controls. Objective: Considering the effects of magnesium in coronary vessels, myocardium, cardiac conduction system and whole body vasculature, our purpose in this research was to make a comparison of mg Sulfate, fentanyl and lidocaine in attenuating homodynamic responses to laryngoscopy in patients with coronary artery disease.Materials and Methods: We evaluated mg-sulfate ability in attenuating homodynamic responses to laryngoscopy and intubation, in a double blind, prospective study with fentanyl and lidocaine which are used commonly in this regard.We randomly selected 60 patients and arranged them in 3 groups. All patients had EF more than 45%. In group A, 1.5mg/kg lidocaine, group B, 2 µg/kg fenanyl, and in group C, 30mg/kg mg sulfate were administered intravenously 3 minutes before laryngoscopy and mean arterial pressure (MAP) and heart rate (HR) were measured on arrival (base values), immediately before and after laryngoscopy and 1 min & 3 min after laryngoscopy. Induction of anesthesia in 3 groups was the same.Results: After laryngoscopy, increases in MAP and HR in group B and C (fentanyl and magnesium) were less than those in group A (p<0.05) with no significant difference between group B and C (p>0.05). Conclusion: Magnesium sulfate is completely preferable and superior to lidocaine in attenuating homodynamic responses to laryngoscopy and has equal efficacy and value with fentanyl.

Introduction: Many clinical studies have evaluated different dentin bonding agents in treatment of dentin hypersensitivity (DH). But the use of acid is controversial and the effect of self-etch bonding agents isn't clearly defined. Objective: The aim of this study was to compare two dentin bonding systems, prompt (self-etch bonding system) and excite(with and without acid) in treatment of DH.Materials and Methods: This clinical study had a double-blind, randomized, subject design and was performed on 41 sensitive teeth with DH. We had 3 groups e1 (we used excite without acid), e2 (excite with acid) and p (prompt). Two stimuli (cold water 20‎ْc and compressed air) and two methods for evaluation ((VAS (Visual Analogue Scale) and response time)) in 3 times (before treatment, immediately after treatment and two weeks after it) were used.Results: All treatments showed significant reductions in DH. In the VAS scores, no significant difference was found. But in the response time, the groups e1, P significantly showed better results than group e2.(P<0.05)Conclusion: Treatment effects were improved in all groups with time. Use of acid before the bonding agent had a negative effect but there was no significant difference between prompt and excite (without acid etching). It's worth nothing that the measurement of response time to stimulus compared to the VAS method is more accurate in evaluation studies of pain rate.

Introduction: Tuberculosis is one of the oldest diseases of human. Before application of the molecular methods, because of the long duration of diagnostic- microbiologic procedures (culture and biochemical tests), the diagnosis and beginning of the therapy required experience and clinical intelligence. The diagnostic microscopic assessment methods of the smear and culture of the specimens have their own limitations, one of which is the slow growth of mycobacteria (4-8 weeks) in the culture media.Nevertheless, achievement to the more rapid diagnostic procedures is the main aim in this regard. From the beginning of the last decade, PCR and other more rapid diagnostic assays for the diagnosis of the infections due to Mycobacterium tuberculosis have been used. Objective: Since no laboratory diagnostic procedure has been known as the alternative to the culture, this study has been done for determination of sensitivity, specificity, positive and negative predictive values of the PCR test in comparison to the culture in this center.Materials and Methods: In this study, 169 specimens from the patients with positive smears were cultured on the Lowenstein- Jensen media and after subculturing and related biochemical tests, the results obtained were compared with PCR test results (with IS 6110 target and Dra, Drb primers).Results: Obtained data showed that from 169 smear positive cases, there were 150 positive cultures and after doing biochemical tests, 86 cases were detected as Mycobacterium tuberculosis. According to these results, sensitivity, specificity, positive and negative predictive values of the PCR test in this center were 91.86%, 96.87%, 97.53% and 89.85% respectively. Conclusion: Concomitant use of PCR with culture and biochemical tests is recommended.

Introduction: Nausea is one of the most important problems after outpatient surgeries. This problem, is not only unpleasant, but could also cause patients to stay longer in the recovery room and hospital. If this is accompanied by vomiting, it will cause aspiration and mortality. Objective: This study was carried out to compare metoclopramide, droperidol and promethazine for prophylaxis of nausea after outpatient surgeries.Materials and Methods: Samples were selected from 150 patients (that were divided into three groups of 50), presenting to Family Planning Specialization and Research Center. Inclusion criteria for the study were as follows: (1) Age 20-30 years (2) Physical status (ps I, II) (3) No co- existing disease that increased nausea and vomiting (4) No administration of drugs that increased nausea and vomiting (5) Weight 60-90 kg (6) Height 9 160-170cm).For these patients, prophylactic doses of Metoclopramide (0.1- 0.25 mg/kg), Droperidol (0.625-2.5 mg), Promethazine (0.25-0.5 mg/kg) were administered and then induction and maintenance of anesthesia were conducted in a similar, way. Results: Incidence of nausea with Metoclopramide was 66%, with Droperidol 20%, and with Promethazine 62% (P<0.05).Conclusion: Our present study as well as the previous studies has similar results. It seems that administration of antiemetic drugs not only reduce the incidence of nausea but also the severity of this complication therefore, in case of unavailability of drugs that are more effective to control nausea (Ondansetron and Propofol), administration of prophylactic doses of Droperidol in outpatient's surgeries is preferred.

Introduction: Patients with hepatitis C infection who are candidates for renal transplantation, can undergo renal transplantation if hepatitis C is inactive and without any liver cirrhosis. After renal transplantation due to induced immunosupression, hepatitis C virus can be reactivated and cause progression of liver disease as well as kidney transplant involvement (glomerulonephritis, rejection).Objective: The purpose of this study was to evaluate the results of renal transplantations in patients with a past history of hepatitis C involvement.Materials and Methods: This research is a cross-sectional study on 14 patients with a past history of hepatitis C from a total of 60 patients who had passed one year after kidney transplantation, and between 1998- 2001, of 14 patients, 10 people had liver biopsy before transplantation. HCV-RNA was negative in the patients at the time of transplantation and after that, immunosuppressive drugs used were prednisolone, ciclospori, azathioprine, and mycophenolatemophetile. Then, data were analyzed by SPSS.10 Results: One year after transplantation, no detrimental effects were seen in those patients with a past history of hepatitis C on liver and transplanted kidney, life time of patient and graft survival. HCV-RNA was negative. Rejection cases were seen.in 4 casesout of 14 patients with hepatitis C, that was not due to hepatitis C. No glomerulonephritis cases were seen posttransplantation. The mean plasma creatinine was 1.18 mg/dl. No side effects of immunosupressive drugs were seen on liver of these 14 patients. Only two persons among 14 patients died because of cardiovascular problems and cytomegalovirus infection.Conclusion: This study showed that short- term consequences in our patients with a past history of hepatitis C infection in comparison with those who were not infected with hepatitis C one year post-transplantation were generally good.

Introduction: In a fast growing organization which has activities in several geographical locations, efficient utilization of expert knowledge is a challenge. Many researches have begun to distinguish between conceptual use of knowledge and instrumental use or changes in behavior and practice. So, one central question is whether the approaches do support the motivation of people to use the knowledge and the next point of interest is about knowledge utilization. Objective: This study was conducted to review knowledge utilization process to recognize and compare current models of knowledge utilization in medical sciences. Materials and Methods: Systematic review of articles was applied on basis of Internet resources covering knowledge utilization disseminated between 1997-2003.Results: Utilization may be conceptual, instrumental or even strategic. There are different models of knowledge utilization in medical sciences: Estabrooks, Behavioral, COHRED, Ace star, CURN Stetler CCI and Iowa. Comparing these models based on five factors implied that COHRED model and CCI model are more complete than the other models.Conclusion: Knowledge utilization means knowledge reception, perception and influence on receivers' action. The produced knowledge of medical sciences is useful provided it could be applied in the process of health development.