Journal of Shahrekord University of Medical Sciences
Year:2010 | Volume:12 | Issue:1|Papers Count:16

Background and aim: Salivary immunoglobulin A is the main component of immune system in upper respiratory tract. Thus this study examined the effects of continuous and intermittent trainings on resting level and acute response of mucosal immunity in male basketball players.Methods: In this study 20 male basketball players performed 8 weeks continuous and intermittent trainings. Every fortnight the intensity and the volume of trainings were increased. At the beginning, (week 1) and the end of the study (week 8), five ml un-stimulated saliva were collected from each subject before (rest condition), immediately and one hour after one bout exercise to exhaustion on treadmill to determine exercise induced changes in basal mucosal immunity. In addition, saliva samples were collected every two weeks before training. The amount of S-IgA and total protein were measured and then data were statistically analyzed using t-test and ANOVA.Results: One bout exercise training in week 1 caused significantly decrease in s-IgA (P<0.001), but it was not changed in week 8. Total protein was not significantly change in week 1 after exercise, but it was significantly increased in week 8 after exercise (P<0.01). The comparison of S-IgA, total protein and this ratio showed significant decrease after eight weeks training. Conclusion: The results of this study showed that decreasing resting salivary s-IgA after performing incremental physical activity caused mucosal immunity suppression, which is dependent on intensity of physical activity. On the other hand, these results confirmed the cumulative hypothesis of effects of single exercise training on mucosal immunity.

Background and aim: Resistance to clindamycin (CL) in Staphylococcus aureus is both constitutive and inducible. In the present study, the prevalence of the constitutive and inducible resistance to CL was investigated by disk diffusion and double-disk diffusion (D-test) methods.Methods: This descriptive-analytical study was performed on 230 Staphylococcus isolates. D-test was carried out for all the isolates with resistant phenotype for erythromycin and susceptible phenotype for CL. 15mg erythromycin and 2 mg CL disks were placed on plate at a distance of 15 mm. The appearance of D-shaped zones around the strains was checked after proper incubation. Results: Of the 230 staphylococcus isolates, 55.6% were susceptible to CL, 37.5% had constitutive and 5.2% had inducible resistance to CL. The frequencies of constitutive and inducible resistance for CL in methicillin-resistant Staphylococcus aureus (MRSA) isolates were 66% and 9%, respectively and the frequencies of constitutive and inducible resistance for CL in methicillin-susceptible isolates (MSSA) were 15.4% and 2.3%, respectively. Statistical tests revealed the inducible resistance in MRS isolates to be 4.2 times more frequent than that in MSS isolates. The inducible resistance frequency was 10.8- fold in MRSA compared to MSSA isolates.Conclusion: The study results showed that the inducible resistance should be determined by D- test in all methicillin-resistant staphylococcus isolates and also staphylococcus strains resistant to erythromycin and susceptible to CL.

Background and aim: Surgical procedures including open and close lateral sphincterotomy were the main treatment of chronic anal fissure in past years. Nowadays, medical treatments are the standard therapy for this disease, but there are some limitations for this method of treatment. This study aimed to compare the efficacy and complication of surgical and medical treatments by lidocaine ointment for patients with chronic anal fissure.Methods: A clinical trial study was conducted on 180 patients with chronic anal fissure who had symptoms for more than 6 weeks. The main symptoms of patients were pain during defecation, anal bleeding and skin tag. After history taking and physical examination, method of treatment was explained for patients to choose one group: Group 1 (surgery) or group 2 (medical treatment with lidocaine H). Surgery was performed by closed method. Medical treatment was consisted of high fiber regimen, sits baths, C-lax tablet nightly, Naproxen tablet 250 mg twice daily and 5% lidocaine anal application before defecation and anal washing during defecation. Patients were followed for 8 weeks. Data were analyzed using chi-square, Fisher and Mann-Whitney tests.Results: one hundred of patients in group 1 and 80 patients in group 2 completed the study. Duration of symptoms was 8.1±2.5 weeks in group 1and 7.9±3.1 weeks in group 2. Post operative complications in group 1 were skin ecchymosis (10%), large hematoma (2%) and 10 cases (10%) complained from mild incontinency to flatus. There was no complication in group 2. Healing rate was 93% in group 1 and 75% in group 2 (P<0.05).Conclusion: Medical treatment with lidocaine is a safe and effective treatment for chronic anal fissure.

Background and aim: Osteoporosis is a major health problem for postmenopausal women in all over the world. Use of dual x-ray absorptiometry (DXA) as standard diagnostic procedure, due to the cost is not economical for screening of all postmenopausal women. Based on clinical risk factors, several screening tools have been invented and one of the most popular screening tools is Simple Calculated Osteoporosis Risk Estimation (SCORE). The objective of this study was to evaluate performance of this tool in screening of Iranian women for osteoporosis.Methods: This descriptive–analytical study was performed on 341 postmenopausal women who were referred to Isfahan bone densitometry centre. We made use of the osteoporosis screening tools (SCORE) for postmenopausal women aged 45 years or more, without secondary cause for osteoporosis, and the results were compared with their bone mineral density. Results: Among 341 postmenopausal women, who were studied in this study, 20.8% were osteoporotic (71 persons), 39.6% had low bone mineral density in one or both studied areas by DXA and the rest of women (39.6%) were found normal. SCORE tool was shown to have sensitivity about 87.2% (95% CI 97.2%–76.4%) and specificity of 37.9% for screening of low bone mass in postmenopausal women. Conclusion: SCORE tool has acceptable sensitivity and accuracy to be used as a tool to identify low bone mineral density in vast majority of Iranian postmenopausal women.

Background and aim: Sarcosystosis is a cosmopolitan protozoan zoonotic infection and is caused by different species of sarcosystis. This parasite can cause contamination in many animals and cause a lot of hygienic and economic effects in society. This study was aimed to determine sarcosystis infection in slaughtered animals of Shahrekord, using histhopathological method.Methods: In this descriptive study, 70 samples were obtained from healthy goats and 70 samples were obtained from healthy sheep during summer 2008 Esophagus, thigh, diaphragm and heart of each animal were macroscopically evaluated for having sarcosystis cysts. To prepare a pathology section for microscopic examinations, hearts were kept in formalin and after providing tissue sections, samples were studied using a microscope. Data were analyzed by SPSS software.Results: In macroscopic evaluations of diaphragm of the sheep and goats, sarcosystis cysts were detected 15.7% and 2.8%, respectively. In addition, 7.1% and 1.4% of esophagus from sheep and goats were also infected by sarcosystis, respectively. We also performed microscopic investigations on healthy hearts and found that 80% of sheep's hearts and 70% of goats' hearts were infected by sarcocystis cysts.Conclusion: Considering the high prevalence of sarcocystis contamination in the world and Iran (up to 100%), more studies are needed to detect sensitivity and specificity of histhopathology method to confirm our findings. Finally looking at the our results it is likely that in healthy hearts some comments should be considered, such as appropriate meat keeping, sufficient cooking, and moving from traditional animal husbandry into industrial husbandry in future.

Background and aim: Iron-deficiency anemia is one of the main nutritional problems especially in young women. There are many strategies to combat iron deficiency anemia, including change in food habits and nutritional education. Aim of this study was to determine the effect of nutritional education on iron deficiency anemia among high schools girls.Methods: In this semi-experimental study, 68 high schools girls with iron deficiency anemia were educated for 4 months. Education materials were included brochures, pamphlets, and lectures. During nutritional education sessions the girls were presented with a pamphlet in which nutritional topics such as food groups, iron absorption enhancers and inhibitors, good sources of iron and ways to improve absorption of iron from foods were explained in simple words. Hemoglobin, serum ferritin, and serum zinc were measured in the beginning and end of the intervention. The girl's knowledge and their attitude about nutrition were also obtained before and after the study. Paired-t test, Wilcoxon, and Spearman tests were used for data analysis. Results: The amount of hemoglobin at the beginning and the end of the study were 109.5±10 g/l and 123.3±13 g/l, respectively (P<0.001). Serum ferritin level was 4.5±3.2 and 25.4±36.9 mg/l, respectively (P<0.001). Serum zinc level was 1.4±0.5 mg/dl at the beginning of the study and it was increased to 3.7±1 mg/dl at the end of the study (P<0.001). Knowledge scores at the first and final intervention were 5.7±2.7 vs. 6.8±1.9 (P<0.01), and attitudes scores were 25.1±3.4 vs. 25.4±3.7 (P>0.05), respectively.Conclusion: Nutritional education can be used for improving the serum iron and zinc among anemic girls.

Background and aim: Safflower (Carthamus tinctorius L.) flowers, mostly used for coloring and flavoring food, are attributed with anti-rheumatic and anti-diabetic effects in traditional medicine. The purpose of this research was to experimentally assess the effect of hydroalcoholic extract of Carthamus tinctorius on the level of AST and ALT in alloxan-induced diabetic rats.  Methods: In the present study, 18 male Wistar rats, of body wt. 180–220 g were randomly allocated into three groups with six rats per group: first group, non-diabetic rats; second group, diabetic rats; third group, diabetic rats treated with hydroalcoholic extract of Carthamus tinctorius (200 mgkg-1 BW, i.p.). Rats were fasted for 16h and then fasting blood samples were collected in heparinated tubes. Sampling was performed from the orbital sinus. ANOVA was used for data analysis.Results: Our results indicated a significant difference in AST and ALT levels in the diabetic group compared with the other groups (P<0.05). Histomorphological studies of the liver of these animals, demonstrated the same results.  Conclusion: Hydroalcoholic extract of Carthamus tinctorius can inhibit liver failure-induced by diabetes and is suggested as an antidiabetic drug.  Further biochemical and pharmacological investigations should be performed to elucidate its mechanism of action in detail.

Background and aim: The aim of this investigation was to evaluate effects of maternal diabetes on lumbosacral region of spinal cord in offspring of diabetic mothers (ODM) in comparison with normal mothers. Methods: In this study sixteen adult female rats were divided in two groups. Diabetes was induced in one group by Alloxan (145mg/kg). Both groups became pregnant by natural matting. After delivery lumbosacral samples were prepared from 7 day, 14 day, 21 day and 28 day old offspring of both groups. After applying histological techniques, various histological parameters were determined. Weight of infants was measured at the same time and compared with the other group. Data were analyzed by student t-test.Results: Our results showed that the weight of ODM were significantly (21.2%) more than the control group (P<0.05). There is a significant decrease in transverse and vertical diameters of spinal cord and decrease in number of neurons in grays matter of spinal cord of ODM compared to the control group (P<0.05). Conclusion: Hyperglycaemia caused by maternal diabetes can disturb natural formation of spinal cord, especially in the lumbosacral region. This defect leads to different malformations, such as change in the shape of spinal cord and also decrease in the number of neurons in grays mater. These problems are formed in fetal period and remain in the body after birth and lead to offspring disability in several actions.

Background and aim: Hospitals are known as one of the main health care providing organizations. Increasing expenditures is claimed to be one of the most serious problems in hospitals. In this context, economic analyzing is very essential for health system evidence based decision making. We aimed to collect and analyze the hospital resources and this article specially is going to clarify the human resources arrangement in hospitals affiliated with ministry of health. Methods: This is an Applied Cross Sectional study, which was performed on 139 hospitals in 2009. We were going to collect the date from all Iranian hospitals affiliated with MOHME. In this regard, an expert’s panel defined some inclusion criteria and finally 139 out of 530 hospitals were selected. Nine online questionnaires were used to collect data. We categorized the hospitals on the basis of bed numbers, being educational or non educational and locating in poor or rich areas (A: below 50 beds, B: 51-150 beds, C: 151- 300 beds and D: above 300 beds). We analyzed the data using SPSS software.Results: In 139 hospitals, there were 23674 active beds and 48238 personnel (2.04 personnel per each bed). Our data showed that 48.4 percent of personnel had an under-associate degree, 40% had bachelor degree and the rest had higher degrees. Nurses and midwives were 48.1 percents of all personnel.  Average bed occupancy rate was 57.8 % and the lowest bed occupancy rate was belonged to the under 50 bed hospitals (31.4%). The ratio of clinical personnel in teaching hospitals (71.1%) was higher than the non-teachings (70.4%). This ratio was higher in rich areas (71.2%) compared to the poor areas (68.7%). The proportion of number of personnel per bed in teaching hospitals (2.09) was higher than non-teaching hospitals (1.9). This proportion was lower in rich areas (2.02) than the poor areas (2.17). The density of logistic personnel was higher (29.1) than the other personnel.Conclusion: The high density of logistic personnel is a sign of low efficiency in selected hospitals. Despite of increasing ratio of clinical personnel to total number of personnel, the ratio of medical personnel per beds was decreasing and this can be a sign of low quality and effectiveness. Big hospitals have a better bed occupancy rate compared to small ones.

Background and aim: Hydatid cyst disease is one of the most common zoonotic diseases which is mostly due to the inhabitance of Echinococus granulosus larva stage. Iran is one of the hyper- endemic areas for this disease and operation is still the best way for its treatment. It is very important to know the epidemiological aspects of this disease for control and prevention programs. The aim of this study was to evaluate hydatid cyst disease in hospitalized patients with operation in Chaharmahal va Bakhtiary province from 1988 to 2007.Methods: in this retrospective- descriptive study patients who were hospitalized due to hydatid cyst operation in Shahrekord Ayatollah Kashani, Brougen Hazrat Vali-Asr and Farsan Seyed-Alshohadah hospitals during 1988-2007 were recruited. Data were collected using questionnaire and were analyzed by chi-square test.Results: Our data showed that from the total of 144 patients, 98 persons were female and 46 cases were male. While the youngest case was an 11 year old boy, the oldest patient was 92 years old. In addition, 93 cases of the patients were tribes or lived in rural areas and 51 cases lived in urban areas. The highest frequency of the disease (44 cases) was seen in 27-41 year old group. The lowest frequency was seen in patients over 72 years old. The highest frequency (87 cases) belonged to housewives and the lowest frequency belonged to government employees. Most of the cysts (97 cysts) were in the right lobe of liver. Left lobe of the liver, right and left sides of the lung were the other locations respectively. Eight cysts were elsewhere.Conclusion: As many people in Charmahal va Bahktiari province live in tribes' style and also human, sheep and dogs are in a very close contact, more education programs are needed for people who are living in rural areas, especially housewives.  In addition, infected dogs should be controlled and be treated in case of infection with Echinococus granulosus.

Background and aim: B-cell chronic lymphocytic leukemia (B-CLL) is a B-cell malignancy which has been associated with a variety of abnormalities in non-malignant T cells. Viral antigens are able to produce profound alterations in T-cells and cytomegalovirus (CMV) has been involved in T-cell abnormalities in healthy elderly individuals. Therefore, the relationship between these changes and CMV was studied in CLL patients. Methods: This was a cross sectional study and included 79 B-CLL patients (41 CMV seropositive and 38 CMV seronegative). The cell counting was done by Coulter cell counter. The T-cell subgroups and cell phenotype were studied by monoclonal antibodies and flow cytometry. The secretion of cytokine was detected by intracellular cytokine staining post stimulation and short time culture. Results: CD8+ and CD4+CD8dim T cell subgroups were significantly more in CMV+ patients than CMV negatives (P<0.01). IFN-g producing T cells were significantly more in CMV+ patients, whereas IL-2 producing T cells were more in CMV- patients (P<0.05 and P<0.01, respectively). A prominent decrease was seen in the expression of CD27, CD28, CD45RA and CCR7 in CMV+ patients, whereas CD45RO and CD57 showed significant rise (P<0.05 and P<0.001, respectively).Conclusion: CMV seropositivity causes broad alterations in T-cells and expression of terminally differentiated phenotype in B-CLL patients. Therefore, such profile in B-CLL is highly related to CMV seropositivity.

Background and aim: Gestational trophoblastic tumor associated with ectopic pregnancy is a very rare event. This paper reports a case of an invasive mole arising from a tubal pregnancy.Case report: Patient is a 26-year-old G2L1Ep1 who was referred to Isfahan Beheshti Hospital due to rise in BHCG level after surgery of ectopic pregnancy (EP). The patient had initially been treated with salpingectomy. The pathologic study of specimen was invasive mole. The patient underwent two period of MTX treatment. Because of sonographic report of adnexal mass, the patient underwent laparotomy. The result of laparotomy was invasive mole. The patient underwent EMACO regimen and was released when the BHCG was 1.Conclusion: Appropriate monitoring of BHCG titers following surgery of EP is important not only to diagnose persistent EP, but also for rejecting the presence of GTT. In addition, follow up of the pathologic report is also important, although the clinical diagnose seems to be correct.