JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2004 | Volume:14 | Issue:42|Papers Count:18

Background and purpose: Embryonic stem cells (ESC) can be produced by culturing blastocytes inner cell mass in a proper condition. ESC is used as research tool in producing transgenic animals and in the study of embryo development. Produced blastocytes can be vitrified and used in appropriate time. Aim of this study was to determine the mean number and survival rate of vitrified ICM, in order to use vitrified embryos in production of stem cells.Materials and methods: After in vitro maturation and fertilization of immature bovine oocytes, embryos were co-cultured in HamsF10 medium over Vero cells for 7 or 8 days at 30oc and 5% CO2. 500 blastocytes were selected and divided into two groups; case and control. The blastocytes of the case group were vitrified (Ethylene glycol 40%, Ficoll 18% and 0.3M sucrose). After thawing, embryos were cultured for 24hr and the expanded embryos, along with the blastocytes in the control group were isolated by immunosurgery method. Cell survivals were assessed by trypan blue staining.Results: The survival rate of ICM cells at the day 7 blastocytes in the control and vitrified groups were 96% and 83% respectively, and the average number of ICM cells were 17.4 ± 3 and 14±2 respectively. The survival rate of ICM cells from day 8th blastocytes in control and vitrified groups were 95% and 82% respectively. Mean number of ICM cells were 18.6±3.Conclusion: Survival rate and number of blastocyte inner cell mass in the control and vitrified groups on the day 7 and 8 were significantly different. In vitrified condition the survival rate and number of the cells declines significantly. Therefore it is not recommended to use vitrified blastocytes for production of the embryonic stern cells.

Background and purpose: Brucellosis is a disease with zoonotic and transmissible world wide distribution which, often becomes chronic with high rate of recurrence. Since the immune responses during brucellosis have not been studied profoundly, therefore in this study cytokine production in the patients suffering from brucellosis and in healthy individuals has been evaluated.Materials and methods: 14 with acute and 13 with chronic brucellosis (mean age of 38.03+18.2 years) and 22 healthy individuals matched for age ( mean age of 35.33+21) were recruted for the study. Diluted boiled samples were cultured in presence of either mitigen, heat inactivated brucella melitensis Rev-1 strain or medium alone. IL-12. Il-10, Il-13 and IFN- γ were measured by specific sandwich ELISA and blastogenic responses of lymphocytes were also counted by liquid scintillation counter (LTT).Results: Interferon-y production and specific proliferative responses were significantly diminished in chronic brucellosis compared to the acute patients (P<0.05). In contrast. IL-12 production in whole blood culture of chronic patients was higher than that of acute patients (P<0.05). IL-10 production was also augmented in chronic patients, which had no relation with IFN- γ production.Conclusion: Findings indicate that brucella- spectific cytokine patterns observed in patients with brucellosis differ between acute and chronic plases of the disease. Also the results suggest that diminished production of Th1 cytokines and T cell blastogenic responses may be due to lack of T cell responses to brucella antigens, in patents suffering from chronic brucellosis.

Background and purpose: Coffees is a popular traditional drink in many countries, it has duretic and vasodilator properties and reduces free radicals of oygen. Evidences show that coffee reduces urea and serum keratinin, but over drinking leads to glomerulosch lerosis. In this study the effects of high concentrations of coffee extract on kidney is studied by sterologic methods.Materials and methods: In this study 60 sprague-dawley rats weighing 230-250 grams were randomly selected and divided into 5 groups. To the control group water and to the experimental groups aqueous extract of coffee with concentrations of 0.025, 0.5, 1, 1.5 gr/kg were administered oraly twice a day. After 48 hours, the animals went under deep anaesthesia with ether, disected and after fiation with 10% formalin for solution by vascular perfured. Following routine tissue processing, 1 mm kidney tissue section was prepared and from each section, pairs of 5 μm diametor were prepared and stained with M H & E. prepared sections were studied by physical dissector method.Results: There was no significant differece between the number of kidney glomeruli between the control and experimental groups.Conclusion: It seems that, high concentrations of coffee have no effect on the number of glomeruli. Howere, further studies with unea and serum keratinin measurements are required to confirm the resuto reportes here.

Background and purpose : Kidney colitis is a common urologic emergenc. In this double blind clinical trial, the effect of intra cutaneous injection of slerile distilled water (D/W) in the treatment of kidney colitis is studied, is studied.Materials and methods: Total number of 100 patients suffering from kidney colitis were randomly and egualy devided into control and cause groups. Those patients whose kidney stone could not be proved by imaging were excluded from the study. 0.5 ml of D/W and 0.5 ml of normal saline were injected intracutaneusly to case and control groups respectively. Severity of pain was recorded by VAS system prior to and 30 and 90 min after injection.Results: Mean severity of pain prior to the treatment in the case and control groups was 9.86+0.40 and 6.42+ 0.19 respectively. This deference was not statistically significant (P<0.12) means for severity of pain 30 and 90 minutes after treatment in case group were 203+ 0.76 and 1.02+2.63 and in control group 5.94+4 and 6.7+4.19 respectively. The differences in means were statistically significant in both groups (P<0.001). There was no pain after injection of D/W wheras oney 34% of the patients in control group had no pain. No certain complications were observed in two groups, except for severe but transienc pain at the time of injection.Conclusion: Results of this study reveal that intra cutaneus injection of D/W is effective in treatment of acute pain like kidney colitis. Advantages of these methods are being cheap. availabity effectiveness and ease of use.

Background and purpose: Hysterectomy is one of the most common surgeries in women and is followed by post-operative infections of respiratory and urinary tracts, wound, volva and boils. Prophylaxis with antibiotics is a preventive measure against post-hysterectomy infections. This comparitive study was conducted to compare the abdominal post-hysterectomy infections managed with 24 h-versus 7 days-antibiotic medication regimen.Materials and methods: The study design was a randomized controlled clinical trial. 506 patients matching the criteria of the study were selected and randomly allocated into two groups. 6 patients were excluded from the study because of the need for intervension of bladder pelvis and intestine. 300 patients were divided randomly in two groups of 24 h-and 7 days-antibiotic therapy, both groups were followed up for febrile complications while admitted and for up to two weeks later.Results: Two groups were matched for age, level of education, BMI, hemoglobin prior to operation number of the admitted days and duration of surgery. There was no significant difference in occurrence of febrile complications in two groups.Conclusion: Due to lack of difference in post operation febrile complications for 24 h-and 7 days-oral antibiotic prophylaxis, it is recommended to confice antibiotic only to 24 hours and avoid unnecessary prescription of antibiotic at home, which is common in Iran.

Background and purpose: Adminstration Fluid balance in critically ill patients is a common problem in ICU and is often associated with a poor outcome. In addition, important clinical changes in hemodynamic variables occur after diuretic therapy. This study was conducted to evaluate the safety and relative effectiveness of two diurectic protocols in ICU.Materials and methods: Twenty- two ICU patients with pulmonary edema and fluid overload and Pa O 2/ FiO2< 300 were enrolled and divided into two groups, continuos infusion or intermittent bolus, and hemodynamic and biochemical measurements were recorded.Results: Heart rate and mean arterial pressure increased in two groups in the first hour followed by a decrease to baseline in the second hour. During this study, bolus administration led to higher increase in heart rate, blood urea nitrogen and more potassium depletion. Patients in continuous infusion group had non-significantly more cumulative urine output and less cumulative input compared with bolas group.Pa O2 FiO2, pH and APACHE II (Acute physiology and chronic health evaluation II scoring system) significantly improved in both groups.Conclusion: Protocol guided diuretic management can be readily implemented in ICU. Although both continuos and bolus diueretic regiments appear to be eqally effective in achieving negative fluid balance. Therefor, docters may consider a continuous infusion of furosemide in the hemodynamically and electrolytically unstable patients to ensure more controlled diuresis with less hemodynamic and electrolyte flactutions.

Background and purpose: Chronic low back pain (CLBP) is a major clinical problem and is one of the most prevalent diseases. Lack of adequate knowledge about the recurrent onset after the first period of treatment in some of the patients necessitates further related studies. Objective of this study was to assess the effect of exercise therapy, particulary on reduction of back pain, disability and increase in performance of proprioceptive system of CLBP.Materials and methods: Participants of this study included 16 females with CLBP under exercise therapy and 30 healthy females. Pain severity and disability were measured by Quebec and Oswestery questionnaire using dynamic stability platform. Performance of propriocoptive system in case and control groups were evaluated during two different upright standing and standing with flexed trunk up to 45 angle positions. After three months of exercize therapy. In patients, all variables were measured again.Results: Findings of this study indicate that back pain and degree of disability reduce by 58% and 53% respectively. The postural away of the patients was 3.3 times greater than that of the normal group before treatment. However, after treatment, the postutal away decreased by 70% showing a significant improvement on the function of the proprioceptives systems.Conclusion: Proprioceptive system performance in CLBP patients is weak. Exercise therapy results in the reduction of back pain and disability and increase in performance of proprioceptive system in the patients suffering from CLBP. At both of diagnostic and rehabilitation stages evaluation of proprioceptive system performance has clinical significance.

Background and purpose: Menopause is one of the four critical stages in women which make them vulnerable to effective, strong, persistant and permanent hormonal changes. Therefore, assessment of menopauseal age and its enfluencing factors are very important.Materials and methods: This is a descriptive study on rural and urban women living in mazandaran province whose menopausal period started 12 months before the study. Sampling was done through clastering method by calling in the houses of 3036 menopasual women.Data on demographic, anthropometric, obstetric menstruation, menopause, reproduction, breast feeding and stress were recorded in questionnaire. Weight, blood pressure and hight were measured and analyzed using statistical analysis of varionce, X2, regresion and t test.Results: Mean menopausal age of the women under study was 47.93 ± 4.37 and 3.7% of the women prior to 40 years of age were menopause. Statistical analysis did not show any statistical relationship between menopausal age and education, economic condition, BMI, being left handed, using contraceptive, history of menopause and stresses between the women with early and late menopause. Howere, there was significant relationship between age of menopause with profession, number of pregnancies, age of the latest pregnancies, menopausal age of mother and sister(P<0.05).Also this study showed that there is a significant relationship between the age of menopause in deferent cities of Mazandaran.Conclusion: Considering the low mean menopausal in this study and also in other studies done in Iran compared to developed countries and the complications due to low age of menopause, it is recommended that special clinics to be established for menopause women and more information and services be available to them.

Background and purpose: The risk of developing breast cancer during the lifetime of females is 12.5% (about 1 in 8). In addition hormone replacement therapy is part of the preventive measure in women at their menopausal period. Studies have revealed that screening mammography changes with age, mammographyic density and family history of breast cancer. This study was designed to evaluate the breast parenchimal changes, sensitivity and mamographic charactenstics in diagnosis of breast cancer.Materials and methods: Total of 516 persons referred to the clinics for breast complaint during 1991-1998 was selected. On the basis of using hormone replecement therapy, women were divided into two groups of HRT positive and HRT negative and 4 subgroups of true negative, fals positive, true positive and fals negative. This was a double blind study and sensitivity and specificity of the study were estimated using statistical formulas. All of the cases had a base-line mammography as well as a follow up screening mammography to compare the changes in density.Results: Sensitivity and specificity of screening mammography for HRT were lower (67% Vs 79%, P<0.008) and (32% VS 84%, P<0.002) respectively. Density of breast mammography in HRT positive women compared to HRT negative ones.Conclusion: Hormone replacement therapy in menopausal women increases the breast density and at the same time decreases the sensitivity and specificity of screening mammography. This reduction of sensitivity of mamography in menopausal women under HRT, reduces the potential of screening mamography in reducing the death rate caused by breast cancer.

Background and purpose: Staphylococcus aureaus (staph. Aureaus) is a common cause of nosocomial infections, and in many cases, the sources of infections are hospital Staff who one nasal carriers of the germ Determination of antibiotic resistance patterns of isolated strains are essential for treatment of nosicomial infections. As antibiotic resistance pattern can be used as a guideline in selection of proper antibiotic, resistance pattern of 87 species of Staph. aures isolated from nose of the two teaching hospitals staff was determined against 14 different antibiotics.Materials and methods: Disc diffusion method was used for defection of Staph aureus resistance pattern to antibiotic. Also agar dilution method was performed for determination of minimal inhibitory concentration (MIC) for oxacillin.Results: Most of the samples (90.8%) were resistant to penicillin. No resistance to vancomycin and rifampin was observed. The rate of resistance to the other antibiotics was as follows: Amoxyclare 33.3%, tetracycline 19.8, Erythromycin cephalexin and ciprefeloxazine 3.5% clindamycin 2.8% gentamycin 2.3% cephalethin 1.2%. MTC for different straing of the bacteria was different (<0.12.5 to >256 migrogram/Liter). In total 11.8% of the staph. aureas were resistant to methicillin.Conclusion: This study showed that, some of the hospital staff is carriers of sometimes antibiotic pesistout staph. aureau,. Continnuous study on the transmission patern of antibiotic resistant in hospital staff carriores is necessary in order to control the nosocmial infection. In addition, using the resistance pattern, proper antibiotics can be selected for carriors treatment.

Background and purpose: Peripheral leukocytosis is a marker of inflammatory response in the early phase of acoute myocardial infarction(AMI). Role of peripheral leukocytosis and relative neutrophilia as a risk factor for early development of left ventricular systolic dysfunction (LVSD) is not established. Objective of this study was to examine the relation between peripheral leukocyte differential count and relative neutrophilia with the early development of mild to severe LVSD following AMI LVSD. The study was designed as a prospective cohort study and included 140 patients with AMI.Materials and methods: This was a prospective cohort study done on 140 AMI patients. Presence and absence of neutrophilia in the patients was determined and LVSD during 7 days of hospital stay in both groups was studied. Moderate to severe LVSD was defined as ejection fraction (EF) of less than 40% in the first week following AMI and was detected by echocardiography.Results: Fourty- seven percent of the cohort had a leukocyte count > 11.0×109/L on admission and 64% had relative neutrophilia (neutrophiu perecentage >65%). LVSD was detected in 46% of the cohort. Of these patients, 65% had leukocytosis and 65% had neutrophilia. Whereas in non LVSD patients leakocytosis and neutrophilia were 32% and 45% respectively. Statistical analysis revealed significant assocition between leukocytosis and the subsequent development of LVSD (odds ratio 3.8, confidence interval of 95% was 2.9-14.7).Conclusion: In patients with AMI, peripheral leukocytosis and relative neutrophilia are independently associated with the early development of moderate to severe LVSD. Hene, knowing this condition may help to reduce morbidity and mortality in patients with AMJ by treatment interventions.

Background and purpose: Today sexually transmitted diseases (STD) are the most common infectious disease in the United States infecting 13 million new cases annually. Considering their wide distribution and complications, knowledge about STD transmission, common symptoms and treatment methods are important in their prevention. Hence this study was undertaken to investigate the knowledge and health behaviour of married women about transmission of STD. Materials and methods: This cross sectional study was conducted by simple sampling and standard questionnaire on 200 married women being referred to the health service clinics of babol town ship. Questionnaire comprised of demographic, knowledge and performance questions about the reasons of not using condom and regular STD check up. Knowledge and performance were scored using likert scale. X2 and analysis of variation were used for determination of correlation between variables.Results: The mean age of participants was 28.8 years. 72.5% of the individuals in case group did not have good knowledge. The most familiar STD disease was HIV (88.5%), and the least were genital wart (40%) and chlamdia (28.5%). The most improper answers were about the ways of transmission, complications and methods of prevention. 60.5% of the cases did not have good practice about the prevention of STD. In other words only 18.5% of women used them as part of pregnancy prevention. 23% of women had regular referring to STD clinics for check up. Level of knowledge showed significant correlation with age, level of education, profession of couples, number of family members, method of prevention and level of performance.Conclusion: Despite high prevalence rate of STD in the society, knowledge and practice of women about STD and their prevention methods are weak. Establishment of STD clinics to meet the need of screening, treatment, health education and concepts related to STD is recommended. At the same time education should include public and also health workers.

Background and purpose: On time diagnosis and treatment of lower limb diseases are of crucial importance to the patients. Conventional angiography is the standard procedure of diagnosis, which is followed by different problems such as, X-ray hazards, sensitivity to contrast drugs and complications of opening vessel. Doppler ultrasonography has low differentiation power. MR angiography is a suitable procedure for diagnosing vessel diseases. During different studies on 1.5 Tasla equipments it was possible to obtain proper images with different values for different parts of limb. To date no research of such kind has been done in Iran and angiography of lower limbs is not done at present. In this study, it was tried to proper images of lower limbs considering the capabilities of designed protocol system.Materials and methods: 1.5 Tasla MRI equipments with optimized parameters for different positions calculated on the volunteers, patients and phantom was used. SNR and CNR images were compared, and categorized by radiologist based on diagnostic values. Results: 2D-ROF4 method using GRE-spoiled pulse sequences were selected and TR/TE/FA/Th parameters for pelvis area 20/6/90/5, thigh area 30/6/90/4, knee and leg 33/8/60/2/5 were obtained. First stage of recovery current, a lower, mobile pre saturated pulses, NSA=1, matrix size 128 to 180 at direct phase and 256 direct frequency were selected. The qualitative value of the images 3 at pelvis area; 3 at femoral and knee areas; and 4 for knee was obtained. Total time required for imaging of lower limb was 45 minutes.Conclusion: Althoagh spoiled GRE 20-TOF method does not produce acceptable images compared to the femora conventional angiography, the value of obtained images taken particularly for knee were significant and can be a good reference of required information for surgeons and specialists. This technique is useful particularly for the patients who can not go under conventional angiography. The value of the MR images using contrast drug is higher than the images obtained by this method, however this method is cheaper.

Background and purpose: Kawasaki disease is the causing agent of acute vasculitis in children with unknown etiology, and at present it is the leading cause of acquired heart diseases in the japenes and North American children. This study is designed to know about the epidemiological, clinical and treatmental features of this disease and its outcome in children living in sari.Materials and methods: This is a descriptive-review done on the files of the kawasaki patients admitted in the East region of Mazandaran hospitals. The criteria for selection of the patients were based on the American heart association diagnostic criteria. Data on individual features, clinical pictures, laboratory findings,treatment and outcome were recorded and analyzed statistically.Results: Of 29 admitted Kawasaki patients, 25 met the criteria for selection. Mean rate of annual incidence of the disease was 7.3 per hundred thousand in children under 5 years. Mean age for occurance was 38±22.3 months and age range was 3.5 to 80 months, in 40% of the cases it occurred in full season, ratio of boys to girls was 1.27/1, mean time between the onset of illness and diagnosis and treatment was 8.2±3.1 days and the least required clinical finding for diagnosis was lymphadenopathy of 73%. Five out of 25 patients had cardiovascular abnormalities (CVA) prior to the beginning of treatment (one with myocarditis and pericarditis, 4 with coronary artery abnormalities). Out of 25 patients, 22 gave response simultaneously to one dose of intravenous injection of immunoglubolin (IVIG) and high dose of aspirin (ASA). Recovery was observed in 2 patients with two doses and one with the third dose of IVIG in a 3 to 12 months period of follow up. All of the patients excluding one completely recovered from cardiovascular complications.Conclusion: In Mazandaran province, Kawasaki disease in one of the most common vasculitis conditions. The prevalence corresponds with the reports given in north America but more that the european countries and less then japan. Although 1/5 of the patients prior to the treatment suffered from cardiovascular abnormalities, most of them responded to the treatment with IVIG and ASA and recovered compaletely within 3 to 12 months follow up.

The incidence of anomalous left circumflex coronary artery (LCX) originating from the right cusp of aorta is a rare finding. It has prevalence rate of 0.30% to 0.37% which may be overlooked by Cardiologists, and may lead to the improper treatment of the patients. Here, a 50 years old woman with non specific complaint referred to the clinic is introduced.