Journal of Mazandaran University of Medical Sciences
Year:2009 | Volume:19 | Issue:70|Papers Count:17

Background and purpose: b-carboline alkaloids, also known as harmala's alkaloids have a wide spectrum of pharmacological actions including a stimulatory action on release of dopamine and other catecholamines in several brain regions and an inhibitory action on monoamine oxidase (MAO). These findings suggest that b-carbolines should alleviate at least some of the dopaminergic stereotyped behaviors. The purpose of present study is to determine the effects of b-carbolines harmane, norharmane and harmine on apomorphine-induced pecking behavior in chick.Materials and methods: All experiments were carried out on male/female chicks (40-60 g). The modulatory effects of b-Carbolines on stereotyped behavior were assessed using the pecking behavior induced by apomorphine. Subcutaneous (s.c.) injection of apomorphaine (0.025 mg/kg, mixed agonist of dopamine D1/D2 receptors) induced pecking. The pecking response was counted by direct observation and recorded for a 40-minute period.Results: S.C. injection of harmane (2.5-10 mg/kg) and harmine (1.25-5 mg/kg) significantly decreased the pecking behavior induced by apomorphine (0.25 mg/kg). The norharmane (2.5-15 mg/kg, i.p.) response was biphasic. The inhibitory effects of harmane, norharmane and harmine were blocked by flumazenil (5 mg/kg, i.e., 30 minutes before the test) or reserpine (5 mg/kg, i.e., 18 hours before the test).Conclusion: Results suggest that the modulatory effect of harmane, norharmane and harmine on the pecking behavior may be mediated through an inverse agonistic/monoaminergic mechanism.

Background and purpose: Although adjunct chemotherapy may increase life in non-menopausal breast cancer patients, however, it may cause short-term complications such as nausea, vomiting, alopecia, as well as long-term complications in ovarian failure and premature menopausal. The objective of this study was to investigate chemotherapy-induced secondary amenorrhea in non-menopausal women with breast cancer.Materials and methods: A descriptive design (case series) was preformed on fifty breast cancer patients, non-menopausal (normal mense) and chemotherapy in Ramsar Emam Sajad Hospital Oncology unit from 2007 to 2008. Sampling was consecutive. Data gathering method was questionnaire & blood sampling (FSH & Progesterone) for prior and 12 months after the end of chemotherapy. Data was analyzed by paired-t, independent-t and one-way ANOVA tests.Results: Results showed that 62% of patients were amenorrhea 12 months after the end of chemotherapy. Results showed that there was no meaningful relationship between age, hormone therapy, disease stage, node-positive and ER & PR status to amenorrhea; however, there was a meaningful relationship between duration of treatment, type and dose of chemotherapy to amenorrhea.Conclusion: In pre-menopausal patients with breast cancer, receiving cytotoxic chemotherapy against tumor cells, amenorrhea may occur do to ovarian failure.

Background and purpose: Osteoporotic fractures are much more common in older post-menopausal women and account for significant morbidity and mortality. Although age is an independent risk factor for fractures, bone micro-architecture is the predictor of subsequent fractures. Adequate calcium and Weight-bearing exercise are known to affect skeletal development, however, the effects of calcium supplement and treadmill endurance running on bone micro-architecture are not well known. The objective of this study was to determine the effects of treadmill endurance running training and calcium supplement, on micro-architectures of cortical and trabecular bone in the proximal tibia metaphyseal in ovariectomized Sprague Dawley rats.Materials and methods: Forty-three rats were randomly divided into endurance running training, calcium supplement, control, pre-test and base groups. The rats in the treadmill running group performed the progressive running exercise in 12 to 20 m/minutes for a total of 10 to 60 minutes, 5 times a week. Calcium group received ca supplement using Gavage (35 mg/kg/day) for 8 weeks. After 8 weeks, micro-architecture parameters in the proximal tibia metaphyseal were measured by using a semi-automated image analysis system.Results: The ovariectomay was associated with a significant decrease in the trabecular volume and thickness, while separation insignificantly decreased in the cortical volume and thickness in the proximal tibia metaphyseal. The treadmill running exercise and calcium supplement significantly increased cortical or trabecular volume and also thickness and the trabecular separation compared with age-matched controls. Furthermore, the micro-architectures of cortical and trabecular bone in the proximal tibia metaphyseal was insignificant between the treadmill endurance running and calcium supplement groups.Conclusion: Skeletal benefits can be obtained by changes in life style including: weight-bearing exercise or calcium supplement. Furthermore, weight-bearing exercise or calcium supplement, followed by ovariectomay had an inhibitory effect or reversal on micro-architecture parameters in weight-bearing bones.

Background and purpose: Helicobacter pylori, which infect approximately one half of the world’s population, are an important risk factor in chronic gastritis, peptic ulcer disease, and gastric cancer. H. pylori eradication is now widely recommended as the most effective treatment of peptic ulcer disease. One of the most important reasons for treatment failure is H. pylori resistance to the antimicrobials usage in therapy. The aim of this study was to determine susceptibility patterns of H. pylori isolates in 6 routine anti-microbial agents in Northern Iran.Materials and methods: 125 patients from Tooba Medical Center in Sari with endoscopic evidence of dyspepsia complaints were used for obtaining gastric biopsies specimens. Biopsies were sent to the laboratory in thioglycolate broth (transport medium). Bacteria were primarily cultured on Columbia agar supplemented with 7% horse blood, 7% fetal calf serum. Urease, Catalase and Oxidase activities were used for H. pylori identification. Bacterial suspensions equivalent to 3 Mc. Farlands were spread on plates, along with antibiotic disks and placed in the diameter zone. Inhibition was measured after 3 days of incubation in micro-aerophilic condition.Results: H. pylori were isolated from 116 (92.8%) subjects, a total of 125 biopsy specimens. Resistance to metronidazole, amoxicillin, clarithromycin, tetracycline, furazolidone and ciprofloxacin were 71%, 35%, 25%, 9%, 24% and 25%, respectively. Multiple resistance (amoxicillin-clarithromycin-metronidazole) were found in (6) 5% of the isolates.Conclusion: Comparison of our data with previous results showed that prevalence of H. pylori resistance to clarithromycin, furazolidone and metronidazole has increased in Iran considerably. Resistance to amoxicillin in our study was too high in comparison with foreign studies. The present study demonstrates the need for continuous monitoring of the antimicrobial susceptibility in H. pylori in order to determine the optimal drug regimens.

Background and purpose: There are some debates with decision making for withdrawal/ withholding of life sustaining treatment in infants with adverse prognoses and incurable conditions.  This study is conducted to review attitudes and practice of pediatrics and gynecology physicians in this field.Materials and methods: This survey was conducted during 2009 in Sari and Babol. A total of 140 pediatricians, gynecologists and residents/fellows in these fields were recruited by census; 106 doctors completed an anonymous questionnaire (response rate 75.7%).Results: More than 70 percent of respondents disagreed and less than a quarter of them agreed with euthanasia. Thus far, none of the doctors prescribed drugs to expedite neonatal death. Withdrawal of life sustaining treatment in infants with adverse prognoses and incurable conditions was uncommon, and reported by one fifth of physicians in their diagnosis of infants with multiple congenital anomalies.Influential factors in their decision to withdraw life sustaining treatment in these infants were: the number of children, the insistence of hospital staff, the request from parents, the infant's sex, lack of hospital facilities, parental history of infertility and family income, respectively. Religious beliefs were effective for withdrawal/withholding of life sustaining treatment in the decision making process and was led to an agreement more with the approval of the law in the majority of cases.Conclusion: This study revealed that attitude and sanctity of life, overcomes the attitude regarding to quality of life from most of the physicians. Law approval in this field is necessary.

Background and purpose: Visceral leishmaniasis (Kala-azar) is one of the parasitic zoonotic diseases which is caused by Leishmania donovani complex parasites. Thus, the aim of this study is the application of different enzymatic systems for discrimination species and strains visceral leishmaniasis agent.Materials and methods: In this experimental study, reference strains of Leishmania infatum, Leishmania major, Leishmania tropica in addition, the leishmania parasites isolated from bone marrow of subjects and internal organs of dogs infected to visceral leishmaiasis (VL) were inoculated on RPMI+FBS 10 % medium for mass cultivation. Then, using electrophoresis on polyacrilamid gel, six enzymatic systems including GPI, PGM, MDH, G6PD, 6PGD and NH2 were examined in order that identification of species and strains of the isolates and thus finding the appropriate enzymatic systems for discrimination of these compared with reference strains.Results: Isoenzymatic profile of six enzymatic systems mentioned above for these isolates were compared with reference strains and also relative migration were calculated. Finally, the results were showed that only five enzymatic systems, except 6PGD, had discriminated ability of different species.Conclusion: In the present study, GPI and G6PD enzymes had the most heterogeneity while NH2 enzyme had the most homogeneity. Moreover, PGM, GPI and MDH were highly active enzymes.

Background and purpose: Chemokines and their receptors are expressed in different types of malignancies. CC chemokines MIP-1a (CCL3), MIP-1b (CCL4) and RANTES (CCL5) is believed to be anti-tumor and also aid to the metastasis in tumor microenvironment. CCR2 and CCR5 are special G-protein receptors for these chemokines. Due to the important role of CCR5 chemokine receptor in tumor biology, this project is designed to examine d 32 mutation in CCR5 gene regards breast cancer.Materials and methods: This experimental study was performed during 2007-8 on 100 healthy adults and 36 breast cancer patients by Gap-PCR. The demographic information also was collected by questionner and t-test Chi-square was used for statistical analysis of data.Results: Our results showed that none of breast cancer patients had CCR5-d 32 mutation while 3 (3%) cases of controls had heterozygotic form of this mutation.Conclusion: Our results showed that there is not any CCR5-d 32 mutation in patients. Therefore, it appears that this mutation don’t play any role in breast cancer.

Background and purpose: Longterm breastfeeding is an important factor for women. Reverse effects of breastfeeding regarding sexual activities have been reported. However, the impact of breastfeeding, along with sexual activity of women during postpartum, is a debatable matter. This effect remains unknown in many societies such as Iran. Sexual activity during breastfeeding from women has not been studied. This study was carried out to compare the association of sexual activity of breastfeeding and non-breastfeeding women within 2-6 months after birth.Materials and methods: In this historical cohort study, which was carried out in 2007, the sexual activity of breastfeeding women was compared with 198 bottle-feeds women, who were referred to a public maternity health care center in Tehran. Women were recruited within the age of 20-35, being their first or second child and in 2-6 months after birth. A self-structured questionnaire was used for data collection. Women were interviewed face-to-face by the first author.Results: Of 456 respondents, 258 were currently breastfeeding and 198 were bottle feed. Mean age of the mothers was 27±4.7 years. 28.3% of breastfeeding women and 22.9% of non breastfeeding women had sexual intercourse within the one month of postpartum period. There was no significant difference between the time of resumption of sexual activity and being breastfeed or not (p<0.07). Also, no significant difference was found between breastfeeding and bottle-feed women on sexual desire and satisfaction prior to pregnancy and in postpartum period (p<0.1, p<0.5). In 49/8% of breastfeed and 43.3% of non breastfeed women, sexual desire was decreased and also in 32.6% and 33%, sexual satisfaction was decreased respectively. The orgasm experience did not have a significant difference between the two groups during postpartum (p=0.4) so that 65.7% of breastfeed women and 64% of non breastfeed women reached orgasm in postpartum period.Conclusion: We did not find a significant difference between breastfeeding and non breastfeed women. Sexual history taking and counseling in antenatal class as well as postpartum period are suggested for clients.

Background and purpose: Clinical and radiological manifestations of Pulumonary tuberculosis are well known. However, it appears there is an increasing rate of unusual radiological patterns in immuno-competent adults, with smear positive pulmonary tuberculosis (based on our experience). The aim of this study was to analyze chest X-ray (CXR) findings and clinical patterns among immuno-competent men and women with smear positive pulmonary tuberculosis (TB) in Sari, Qaemshahr and Neka, during March 2006 to March of 2007.Materials and methods: All new cases of pulmonary TB diagnosed during 12 months in 3 districts in Northern Iran, (Mazandaran Province) were included in a cross-sectional study. Inclusion criteria's were: positive smear of sputum and absence of any immuno-suppressive state. 65 cases fulfilled the inclusion criteria. Descriptive methods were used for data analysis.Results: The common presenting symptoms were: coughing at 83%, hemoptysis at 24.6%, night sweating at 55%, anorexia at 60%, weight loss at 73.8 %, and fever at 60%. Usual radiological patterns was found in 70.8% of patients (upper lobe lesion with or without the remaining part) and incidence of an unusual radiographic pattern was 29.2%(middle and lower lob infiltration without upper lob lesion, milliary pattern, hilar lymphadenopathy and normal CXR).Conclusion: This study showed that TB with atypical radiographic manifestations is more common than reported previously.These varieties of radiologic manifestations can mimic other disease entities. Therefore, recognition and understanding of radiologic manifestations and complication of tuberculosis are important to facilitate a diagnosis.

Background and purpose: To establish a simple method for preparation of pure epidermal cell in serum-free medium, without co culturing with lethally irradiated 3T3 cells.Materials and methods: A piece of skin biopsy was taken from a rat. After trypsinazation to separate epidermal layer, the epidermis was cut into explants 1×1 mm and were laid at 50 mL on tissue cultured flasks. Then, the explants were covered with serum-free keratinocyte growth medium, while the culture medium was changed every two days. The keratinocyte colonies were expanded in flasks and proliferated to 70% confluency on day 21. After two subcultures, the cells were frozen.Results: Pure epidermal cells are established by this technique in a serum-free keratinocyte growth medium, under feeder cell-free condition.Conclusion: Culturing of keratinocytes in serum-free medium is proved to be a useful and simple method for keratinocyte isolation. The successful culturing of keratinocytes from a small skin biopsy can be useful in the treatment of major burn wounds.

Background and purpose: Right ventricular dysfunction is common in major pulmonary embolisms. The purpose of this study was to evaluate the prevalence and diagnostic utility of cardiac troponin I and also to identify patients with RV dysfunction in pulmonary embolism.Materials and methods: This study was conducted on 42 patients with pulmonary embolism in Ekbatan Hospital, in Hamedan city. Data from history, echocardiogram, and lung perfusion scan was obtained from medical records. Blood samples were obtained immediately after pulmonary embolism was diagnosed. Cardiac troponin was measured using chromatographic assay.Results: Two patients (4.8%) had positive troponin I ( ³0.5mg/l), and 40 patients (95.2%) had negative troponin I (<0.5mg/l). RV dysfunction was detected in 16 patients (38%). RV dysfunction was detected in 1 of positive troponin I patients and 15 with negative troponin I (37.5%). No significant relationship was found between RV dysfunction and troponin I level (p>0.05). Conclusion: Our data demonstrates that troponin I measurement is not able to distinguish specifically between coronary and non- coronary causes of chest pain.

Background and purpose: Primary immune-deficiencies (PID) are associated with a wide range of clinical disorders along with variable symptoms. The aim of this study was to evaluate and improve our knowledge regarding PID from patients that were referred to Booali Sina Hospital.Materials and methods: We evaluated all of PID`s that were referred to Booali Sina Hospital from their data records. Demography, clinical and laboratory data were recorded and then analyzed.Results: In the duration of 3 years, we had 10 patients with PID (7 males and 3 females). Of these cases, 5 had hum oral (50%), 1case had phagocytic (10%), 3 cases had cellular (30%) and 1 case had hyper IgE syndrome (10%). Many of them had respiratory and otitis media infections, while a few patients had adenitis, gastroenteritis, liver abscesses, bleedings and malignancy.Conclusion: PID is a diverse disorder that involves different immune systems. Knowledge from patient’s clinical symptoms and consideration in their differential diagnosis can be helpful in early diagnosis and an effective treatment.

Tracheo-innominate artery fistula (TIF) is a rare, life threatening and catastrophic complication, which may occur 7 to 14 days after surgery. The Incidence Rate of TIF is 0.1-1% and survival rate of patient is 14.3%. Herein, we describe TIF in a patient 50 days post tracheotomy, based on our research, it appears that our case is the first finding with the latest onset of TIF after tracheotomy, which now has been improved by early diagnosis and surgical treatment.

Wiscott-Aldrich syndrome (WAS) is an x-linked immune-deficiency disorder associated with eczema, recurrent infections, and increased frequency of autoimmune diseases, malignancy and thrombocytopenia with small size platelet. Our case is an 11 year old from a non- related parent, who was admitted with abdominal pain (hematoma), lower extremities bleeding (ecchymosed) and vomiting. Also, he had many admit ion cause bleeding in different areas. Lastly, he had retinal bleeding associated with blindness from 1 year ago.

The aim of this study was to determine the effect of a school- based educational program regarding HIV/AIDS and the knowledge held by the high school students. This quasi-experimental study was conducted with 230 high school students (grade 10-12; female, male). Teaching aids used for this intervention was a combination of three methods including lectures, showing an educational movie and pamphlets that encompassed a total of 90 minutes.There was a significant difference between the student's knowledge regarding HIV/AIDS before and after this type of intervention.