JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2005 | Volume:15 | Issue:46|Papers Count:19

Background and purpose: Ascorbic acid, an antioxidant vitamine, is found throughout the mammalian central nervous system (CNS).There is evidence that it may modulate neuronal activity, release of neurotransmitters and dopamine receptors activities. There are behavioral evidences supporting the antidopaminergic effect of ascorbic acid. This effect of ascorbic acid may, in part, modulate the stereotyped behaviors induced by dopaminergic system. The purpose of the present study was to determine the interaction between ascorbic acid and the stereotyped licking behavior in rat.Materials and methods: The effects of ascorbic acid and different dopamine receptor antagonists on apomorphine-induced licking behavior were examined. For the induction of licking, the dose of 0.5 mg/k.g, S.c. of apomorphine was used and the number of licking was recorded over a 75 min period.Results: Ascorbic acid (200-350 mg/kg, s.c.) dose-dependently reduced the licking behavior. Subcutaneous injection of ascorbic acid (250 mg/kg, ED61) potentiated the inhibitory effect of dopamine D1 receptor antagonist, SCH 23390 (0.5 and 1 mg/kg, i.p.) but it did not alter the inhibitory effect of dopamine D2 receptor antagonist, sulpiride (25 and 50 mg/kg, s.c.).Conclusion: These results suggest that the inhibitory effect of ascorbic acid on apomorphine-induced licking behavior in rat is mediated by dopamine D2 receptor mechanisms.

Background and purpose: The levels of serum acute phase reactant proteins change in different malignant diseases that along with other proteins could be assessed by electrophoresis.Materials and methods: The electrophoretic pattern of serum proteins of 85 patients bearing different types of neoplasia and 85 matched normal adults were comparatively studied by agarose gel electrophoresis to find out if there is specific protein pattern in cancer. Each protein fraction was analyzed quantitatively by densitometry. The significant differences between variables were evaluated by student's t-test. Multivariate logistic regression and ROC analysis were performed using SPSS software.Results: When total protein and albumin were measured by colorimetric methods, cancer patients showed less total protein concentration (6.3±1.4 g/dL vs. 7.6±0.7; P≤0.000) and albumin (3.9±0.8 g/dL vs. 4.6±0.4, P≤0.000). compared with controls Electrophoretic data of serum proteins showed that, the ratio of albumin to globulin (0.92±0.30 vs. 1.21±0.16, P≤0.000), percent of the fractions albumin (%46.7±8.5 vs. %54.4±3.5, P≤0.000) and β globulin (%11.6±4.4 vs. %13.0±1.9, P≤0.001) decreased and α1 (%5.3±2.5 vs. %2.9±0.8, P≤0.000), α2 (%13.5±4.8 vs. %11.3±2.1, P≤0.000) and γ-globulins (%23.0±7.7 vs. %18.6±3.1, p≤0.000) increased significantly in cancer patients compared with controls. The cancer patients also had higher leukocytes counts (7977±3111 vs. 6505±1566, P≤0.000) and erythrocyte sedimentation rate (35.9±23.5 vs. 14.1±9.5, P≤0.000).Analyses of the data using multiple logistic regression also indicated that, total protein, the ratio of albumin to globulin, the fraction of alpha-1 globulin and ESR were the best parameters to discriminate malignant and normal states. The proteins profile out of the normal ranges occurred in about 83% of the cancer patients and 17% of the controls. The prevalence of cancer was strongly associated with the components of serum proteins profile. The area under the ROC curves was the same for most components of serum proteins profile as about 0.80 + 0.05. The area was 0.59+0.07, P≤0.1 for WBC counts and 0.87±0.06, P≤0.000 for ESR.Conclusion: The profile of serum proteins indicated high diagnostic values for discriminating between cancer patients and healthy individuals. The determination of proteins profile may be useful as an adjunct diagnosis for early detection and screening of malignancy.

Background and purpose: The role of glycoconjugate terminal sugars on development of fetal tissues as inducing factors has been distinguished. Lectinhistochemistry tracing of α-L- fucose terminal sugar, defining its effective time and elucidating its specific role in development of the mouse kidney were among the main objectives of this study.Materials and methods: Fetuses of Balb/c pregnant mice on 9th - 20th gestational days were fixed by formalin. Specimens were histologically parffinized after dehydration. Serial sections were done for preparation of 10 micrometer sections. Lotus tetragonolobus (LTA) lectin as specific tracer of α-L-fucose terminal sugar was diluted as standard solution (10 micrograms lectin in 1 m1 PBS as defined by Sigma Company). Usable sections which had been matched by alcian blue were posed to lectin. Then alcian blue was used as counterstain. Prepared sections were observed using light microscope and the range of reactions determined.Results: The first reaction with LT A was observed on 15th fetal days. Range and intensity of reaction to LTA increased in higher gestational day. This phenomenon reached to maximum on 19-20th fetal days. Outstanding point was selective reaction of urinary tubes to lectin and other tissues were stained merely by alcian blue.Conclusion: Previous researches have confirmed that terminal sugars reveal in some stages of organogenesis and do their key roles on development. In this study we observed that α-L-fucose reveals in 15th fetal day on urinary tubes and increases in higher days. It reaches to maximum in terminal fetal days. So we suggest that this terminal sugar has key role in development of urinary tubes.

Background and purpose: Apoptosis or programmed cell death is a process of cell suicide. Ionizing radiation is one of the stimuli for apoptosis, acting through DNA damage. In the present study, effects of X-rays induced apoptosis in HL60 cells, as well as the protective effects of Stem Cell Factor (SCF) in inhibiting X-ray induced apoptosis have been evaluated.Materials and methods: HL60 cells were exposed to 5 Gy of x-ray and the effect of time on the percentage of apoptotic cells was studied. One group of cells was incubated in medium containing SCF at 37°C for 1 h before X-ray exposure. Other groups of cells were incubated in media containing SCF, MAPK, PI3K and PKC inhibitors as the cellular pathway proteins, and the X-ray induced apoptosis was studied.Results: The X-ray induced apoptosis show a graduall increase from 12h to 60h after X-ray. The SCF attenuated the percentage of apoptotic cells when cells were treated with SCF 1 h before X-ray. X-rays induced apoptosis partially attenuated by a combination treatment of SCF and PKC and PI3K inhibitors, but it was not inhibited by the SCF and ERK inhibitors.Conclusion: SCF protected cells against X-rays through activation of MAPK pathway.

Background and purpose: Zinc has important effects on human health, specially on structural and functional activities of immune system. This study was carried out to examine the in vitro cytotoxic effects of Zinc on Raji and Molt-4cell line.Materials and methods: In this study (by cell culture) the cell line was exposed to different concentration of Zinc followed by incubation (37 c, 5% Co2) at various time points (12 to 72 hrs), Viability and proliferation of Raji and Molt-4 cells were then evaluated with florecent (Ethidium-Bromide and Acridine-Orange) staining. Data were analysed using SPSS (Dunet and analysis of varians test).Results: The results showed different responces to different amount of Zinc by The Raji & Molt-4 cells. Concentrations up to 100µM at different incubation time points had no effects on cell line when compared with the controls. With higher concentrations of Zinc (200-500 µM) viability diminished significantly at 12, 24, ... hrs of incubation times when compared with the controls (p<0.05).Conclusion: We conclude that Zn has dose-dependent cytotoxic effect on Raji and Molt-4 cells.

Background and purpose: There has been some controversies about the etiological relationship between celiac and psychosis. It is even considered that the difference in prevalence of schizophrenia in different countries is due to differences in cereal and wheat consumption. There are reports that psychotic symptoms of schizophrenic patients have been reduced after consumption of gluten tree diet. Some reports indicated that history of celiac disease is a risk factor for schizophrenia. The aim of this study was to investigate the association between psychotic symptoms and celiac disease.Materials and methods: In a retrospective cohort study, 13 celiac patients and 26 controls were recruited and matched for age, sex, perceived stress and thyroid function. A semi structured psychiatric interview based on DSM-IV, family history of psychosis, neurological examination for neurological soft signs and determination of serological levels of IL-2 receptors were done for each groups.Results: None of the individuals in the case and control groups had psychotic symptoms. Neurological soft sign scores and serological levels of IL-2 receptors in each group were not significantly different. Two of the celiac patients had a positive family history of psychotic disease, but no one in control group had such a history. Serological levels of IL-2 receptors in celiac patients who had gluten free diet were higher than non-gluten free diet celiac patients (P=0.05). Conclusion: In this study psychosis was not higher in celiac group than control, and non-significant difference between IL-2 receptor levels in celiac and control group was unexpected.More investigation with larger sample size or boots trap re-sampling after several years is recommended.

Background and purpose: Hepatitis A virus (HAV) vaccination has been advised for patients with chronic liver diseases as HAV super infection in these patients can result in severe or even fatal disease. In Iran the indication for HAV vaccination are not clear due to lack of data on HAV seroprevalence in patients with chronic liver diseases.The aim of this study was to determine the prevalence of antibodies directed against HAV in thalasemic patients with chronic liver disease, and develop a cost-effective vaccination strategy.Materials and methods: We reviewed medical records of 780 thalasemic patients at the Bouali-Cina Hospital Sari-Iran. Demographic and information regarding risk factors were obtained by history and questionnaire administered to all patients. Sera were collected from patients with chronic liver disease and were tested for anti-HAV antibodies. Susceptible individuals were vaccinated with HAV vaccine. The cost of vaccination and antibody testing were determined based on standard laboratory and clinic charges in Iran.Results: A total of 240 patients (42 patients with chronic hepatitis C, 198 with secondary hemochromatosis) were tested for anti-HAV antibodies. Of them 90.5% (217/240) were positive for anti-HAV antibody. Cost analysis revealed that prescreening for hepatitis A before vaccination at a prevalence of less than 10% was cost saving.Conclusion: The sero-prevalence of hepatitis A in those with chronic liver diseases was 90.5% , and was found to be similar to that of the general population in Iran. Cost analysis revealed that screening for hepatitis A before immunization is cost saving.

Background and purpose: In this study, the prevalence of some of the most important and prevalente disorders, affecting the health status of children, has been assessed in primary schools children of Shiraz; and the age- and sex-specific prevalence rate of these disorders has been calculated. In addition, the prevalence rates were calculated in different regions of the city.Materials and methods: This was a descriptive, cross-sectional study and the sampling method was Multistage Random Sampling. The instrument was quastionnaire and the cases were examined by general practitioners .The research was done in 2001-2002 study year, The results were analyzed using Z test and Chi Square test, at significance level of 0.05.Results: The prevalence rates of studied disorders were: Underweight: 14.46%, Overweight: 2.96%, Visual acuity impairment: 7%, Hearing impairments: 0.92%, Dental carries 63.68%, Depression: 0.31 %, Enuresis: 1%, and Speech impediment: 0.77%. The most prevalent of which was dental carries, and the least prevalent disorder was depression (P<0.0001); implying the present need to dental and nutritional health promotion in the primary schools.Among the age- and sex-specifil prevalence rates, there were some significant differences, including: Overweight in girls was more prevalent than in boys (P<0.004), and underwight in the 7-8 year age group was more prevalente than in the 9-11 year age group (P<0.000001). This shows the importance of nutrition and physical activities in the girls and in lower age groups.Conclusion: We concluded, the total prevalences of mental disorders, showed significant differences among different regions of city (P<0.044); implying the need for more specific studies regarding mental disorders, specially in regions of the city with lower socioeconomic levels.

Background and purpose: Serological studies revealed that toxoplasmosis has world wide distribution. It is a zoonosis and humans are infected through contact with infected animal, consuming infected food and congenital infection. Due to the different ways of transmission, prevalence of infection may vary between different groups of people. This study was carried out to determine the prevalence of toxoplasmosis in Mazandaran rehabilation centers.Materials and methods: 336 individuals (50% of population) were randomly selected from a total of 647 mental patients resided in 10 rehabilitation centers. Five milliliter (ml) blood was taken from each individual and sera were separated. Sera were diluted 1:50 and antitoxoplasma antibody detected using indirect immunofluorescense technique. Positive sera were diluted further to 1/100, 1/200, 1/400, 1/800, 1/1600 and the titer of antibody determined prevalence and its confidence interval (Cl) were calculated.Results: 161 of the subjects were male and 175 female. 77.4% of them were positive for toxoplasma antibody (95% CI was 72.9-81.9). Prevalence in male was 73.3% (95% CI was 68.2-78.4) while in female it was 81.1% (a 5% CI was 72-88.2). The difference of prevalence between male and female was not statistically significant (P<0.01). Prevalence of the disease in 10 different rehabilation centers was not significant either.Conclusion: Prevalence of toxoplasmosis was 77.4 in Mazandaran rehabilation centers which is the same as in normal population of Mazandaran, therefore toxoplasmosis is not a considerable problem in Mazandaran rehabilation centers.

Background and purpose: The objective of this study was to evaluate the role of several risk factors in upper gastrointestinal bleeding (UGIB) from peptic ulcers.Materials and methods: Patients with acute UGIB due to peptic ulcers and control patients with peptic ulcer disease without bleeding were enrolled. Upper GI endoscopy and rapid urease test for evaluation of Helicobacter pylori infection were performed in both groups. The relation of the following variables with the risk of UGIB were assessed: sex, age, smoking, previous history of bleeding, non-steroidal anti-inflammatory drugs (NSAID) use, ulcer size, ulcer location, duration of acid-peptic disease and Helicobacter pylori status. Multivariate logistic regression analysis was performed to identify independent risk factors.Results: A total of 161 cases of UGIB and 287 patients with non-bleeding peptic ulcer were enrolled in the study. Univariate analysis showed that smoking and duration of acid-peptic disease were not different in the case and control groups. The odds for the following factors were resulted in the logistic regression analysis: gastric ulcer I duodenal ulcer 11.90 (95% CI:4.04-35.03), previous GI bleeding 7.72 (95% CI: 4.39-13.58), ulcer size 2.63 (95% CI: 1.205.77), NSAID-use 2.21 (95% CI: 1.17-4.20), male sex 1.71 (95% CI:1. 01-2.89) and age by increasing the risk as 1.03 for every year increase in age (95% CI: 1.01-1.04). H. pylori were not an independent factor in the multivariate analysis (OR=O.49, 95% CI: 0.23-1.04).Conclusion: The risk of UGIB is strongly related to gastric ulcer, previous history of bleeding, ulcer size, and NSAID use. In an area with high prevalence of H. pylori infection, this infection may not be a risk factor for bleeding from peptic ulcers.

Background and purpose: Children with urinary stone disease for longer period of time are at risk of stone recurrence. In two-thirds of the cases medical intervention is mandatory and minimally invasive therapy is advised. The purpose of this research was the evaluate the efficacy and complications of ESWL in these children.Materials and methods: In this study 30 patients with renal stones were recruited. Patients with ureteral and bladder stones were excluded. Imaging study for diagnosis of renal stones were sonography (23 patients) kidney-ureter-bladder (3 patients) and intravenous pyelography (IVP) (4 patients). All patients were evaluated for PT, PTT and medical history of coagulophaty.25 patients had renal stones lesser than 20 mm and 5 patients had stones greater than 20mm. Patients treated with 1200- 2200 shocks (mean 1500) and 16-18 KV.All patients were evaluated with sonography 2 weeks, 4 weeks and 12 weeks after treatment. In patients with renal stones greater than 2cm a double J stent inserted before ESWL.Results: Stones were from 9 to 26 mm in size. (mean 13 mm). 25 patients became stone free (83.3%) after on course of ESWL. In one patient (3.3%) three courses and in 4 patients (13.3%) 2 courses of ESWL necessitated for removing of stones. Two cases (6.6%) complicated with steinstrasse one of whom was managed with conservative therapy and in the other TUL was done.Conclusion: Extracorporeal shock wave lithotripsy is effective in the treatment of renal stones in children. In patients with stones greater than 2 cm additional course of ESWL may be necessary. We recommend that in patients with stones greater than 2 cm insertion of a double J stent can reduce occurrence of steinstrasse. Complication of ESWL in children is very low and no significant morbidity occurs with ESWL.

Background and purpose: Congenital anomalies are common causes of mortality & morbidity in children. Its treatment and rehabilitation imposes high economic burden on the society. The occurrence of the defects in newborns with congenital, environmental or both factors is 3-5%.The purpose of this study was to evaluate the incidence of Gross congenital neural tube defect in newborns at obstetric center of the Vally-e-Asr Hospital in Zanjan. Detection of correlation between N.T. D & the parameters such as the place of Mother's residence, duration of pregnancy and past history of N.T.D in family were among the secondary objective.Materials and methods: This was a cross-sectional prospective study done on all newborns that were visited at least once by physician and data were recorded in special form.Results: From a total of 2250 newborns, 14 had N.T.D. (6.2 birth). The most common 1000 (N.T.D) was spina bifida-cystica (Meningomylo cele & then Meningocele) and mothers in this group were resident in villages (78 %) and 71 % of newborns in this groups were term anomaly group, 98% of mothers had history of NTD and also 42% with history of abortion.Conclusion: Contrary to prevalence of NTD in the U.S.A (0.5-0.8/1000 birth) in our study the Gross anomaly of NTD was higher (6.2/1000 birth).There are significant statistical differences between the prevalence of NTD and low socio- economic and residence status of mothers.

Background and purpose: After decades of discussion and debate, there is little agreement about appropriate time to clamp the umbilical cord after birth. With late cordclamping, neonate receives more placental transfusion that may affect blood hematocrit level. The purpose of this study was to evaluate the effect of early and late cordclamping on neonatal polycythemia at 2h and 18h after birth.Materials and methods: In this double blind, randomized, controlled, clinical trial, 64 healthy term vaginaly born neonates were randomly allocated before delivery to having the umbilical cord clamped either at 30s or 3min after birth. During this period of time, neonates were kept at the level of introitus. Measurments of venous hematocrit level of neonates were performed with microhematocrit method, 2h and 18h after birth. Data were obtained by interview, observation and biophysiologic methods and were analyzed using T student, paired T and Covariance analysis tests with SPSS software.Results: There was no significant difference in mean blood hematocrit level of neonates either at 2h (61±4.9% vs 61.6±4.5%) and 18h after birth (56.9±4.1% vs 56.2±3.9%) between early and late cordclamping groups. This was also the case for neonatal polycythemia (20% vs 23.5%). Residual placental blood volume in late cordclamping group was 39.5% lower than the other group (P<0.001). Estimated blood volume of neon ate in late cordclamping group was 7.1% higher than the other group (P<0.001). Conclusion: Late cordclamping does not lead to a significant difference in blood hematocrit level of neonate and neonatal polycythemia. However it leads to a significant decrease in residual placental blood volume and a significant increase in estimated blood volume of neonate. Further trials with delay in cordc1amping until cessation of cord pulse or alter the level that newborn is kept is recommended.

Background and purpose: Malignant and infectious diseases are the most frequent causes of pleural effusion. Malignant diseases produce pleural effusion through different mechanisms: lymphatic and capillary obstruction, pneumonia or atelectasia. Therefore absence of tumor cells in aspirated effusion, highly declines the sensivity of the cytologic study. For this reason, the use of tumor markers to improve the capability of differentiating malignant effusion from benign types is widespread.Materials and methods: 100 patients with pleural effusion were allocated in four groups: I: malignant (positive pleural biology or catology. N=21). II: paramalignant (lnown case of a cancer, but negative cytology or biopsy. N=9). III: Empyema/paraneumonics (clinicalparacillinically proved.) IV: Benign process (CHF, CRF, Liver disease ... n=58). CA 15-3, CA 19-9 and CA 125 quantified using an Ag and ELISA technology.Results: Calculated cut off values were: 500 U/ml for CA 125,35 U/ml for CA 19-9 and 35 U/ml for CA 15-3. Sensivity, specifity, efficiency, PPV and NPV were as follows: CA 15-3 (80%, 90%, 89%, 82%, 91%)CA 19-9 (67%, 89%, 83%, 74%, 86%), CA 125 (60%, 83%, 78%, 60%, 82%)Conclusion: We suggest that using tumor markers in pleural fluid, especially CA 15-3 would greatly increase the diagnostic effectiveness of malignant effusions.

Background and purpose: Social phobia is the third current disorder in psychiatry, that causes functional deficiency in patients and leads to high economic losses in families and society. Social phobia can be managed by different durg and non-durg treatment, one of them probably is cognitive therapy. The purpose of this study is to determine the effect of congnitive therapy on the social phobia of the students in the high school boys of Kashan province in 1999.Materials and methods: This is a clinical trial in which the effects of cognitive therapy were assessed by determining and comparing the social phobia between the cases of cognitive therapy and control groups at their entering the study and after six weeks.The sample of this study consists of 44 boys suffering from society-escaping or avoidant disorder. From 11 state high schools in kashan. They scored higher than other students measured by social phobia scale of mattick and Clarke.Results: The finding of the study showed that social phobia in the cognitive therapy group was significantly different when entering the study and after six weeks. (p=0.0000), while in the control group there was no difference in the social phobia in either points. Furthermore, a significant difference in the social phobia between the cognitive therapy group and control group was noted (P=0.0000).Conclusion: Considering the positive effect of cognitive therapy on social phobia, cognitive therapy is recommended in treatment of the social phobia. We also suggest a study determining the effect of cognitive therapy on the social phobia at short and long term follow up.

Background and purpose: Exclusive breastfeeding for under six months infants is one of the most important elements in ensuing their health. Breasfeeding has many advantages for infant, mother, family and society. Therefore it is equally important to understand the reasons for formula milk consumption in the society.Materials and methods: A descriptive study was conducted on 462 cases under 6 months in 13 cities of Mazandaran province in 2003. Data were collected from all cases that have used formula milk (complete or partial). Questionnaires were filled in. mothers were interviewed, family folders were checked and finally the data were analyzed using t-test and chi square.Results: The data showed that 59.5% percent of infants exclusively used formula milk and 40.5% partially used it.Form 25 reasons for formula consumption, the most significant reasons were 23.8% twin birth (23.8%) lack of breast milk and failure to thrive (13.4%).Conclusion: This study showed that twin birth, lack of breast milk and failure to thrive were the most prevalent reasons (50.8%) for formula consumption. 27.4% of the cases of formula consumption were absolute indication and the rest of the reasons need more elucidation.

Background and purpose: Pain control during orthodontic treatments is important for patients and dentists. The purpose of this study was to compare the effects of acetaminophen codeine and acetaminophen codeine plus caffeine in orthodontic pain and tooth movement.Materials and methods: This clinical trial was performed on 18 orthodontic patients who voluntarily participated in the study of pain and tooth movement. Patients were divided into two groups: acetaminophen codeine (300 mg+20 mg) and acetaminophen codeine + caffeine (40mg). Patients received two doses of drug, the first dose was administered 30 min before and another dose 8 hours after chain placement. The horizontal Visual Analogue Scale (VAS) was recruited to evaluate the degree of pain after placement of the chain. The space of the teeth was measured to evaluate the rate of tooth movement before chain placement and also on the days 7 and 14. Results: There was a significant difference between the two groups in pain scores (p=0.048) and acetaminophen codeine plus caffeine caused more analgesic effect than acetaminophen codeine alone. The highest difference of pain levels between the two groups was found 6 hours after chain the placement and there was a decrease of pain during the 2nd to 7th days after treatment. Maximum pain scores recorded in acetaminophen codeine and acetaminophen codeine plus caffeine groups were 4.67±0.96 and 2.44±0.67, respectively which happened in both groups at 17th hours after the treatment. There was no significant difference between the two groups in the rate of tooth movement. Conclusion: According to the results, a combination of caffeine and acetaminophen codeine could be suggested in orthodontic pain relief. It is also suggested that concurrent use of caffeine can decrease the dose of analgesic drugs and their side effects.