Journal of Arak University Medical Sciences
Year:2008 | Volume:11 | Issue:2 (43)|Papers Count:20

Introduction: Pollen grains are male gametophytes of flowering plants that with self interference in fertilization have an important role in plant fertilization, increasing fertilization and improving quality of products. Pollen grains are of important allergenic plants and 80-90% of allergens have plant origin. Achillea plant has medical usage and grows in different regions of the country. This research is done in order to acquire scientific information pertaining to pollen grains allergenicity in their development stages and comparing mature and immature pollen grains allergenicity.Materials and Methods: In this experimental study Achillea plant pollen grains in different developmental stages were collected around Isfahan city and samples were studied using light and electronic microscopy (SEM). Pollen extracts were prepared by incubating pollen grains in phosphate buffered saline, PH: 7.4. The allergenicity experiment was done on male Guinea pigs (Hartley strain, 350-500g weight, 4-6 week-old, Pausteur institute of Iran) and electrophoresis of proteins was done on 12% SDS- polyacrylamide gel. Data were analyzed using one way ANOVA and Duncan test.Results: Images of light and electronic microscopy showed pollens from ellipsespherical type, with two colpate and echinate exine. The skin tests in Guinea pigs treated with pollen extracts indicated wheal with diameter larger than control group. In clinical tests, the numbers of eosinophils, neutrophils and IgE were increased in animals treated with pollen extract comparing control group. In SDS- PAGE protein profiles, 6 richly colored protein bands were seen in mature pollens in 14.4 to 66 KD and 5 slightly colored protein bands in immature pollens in 14.4 to 45 KD.Conclusion: This research shows changes of immature pollens` ellipse morphology to spherical form in mature pollens, partial increasing in accumulation and height of exine surface echins, changes in quality and quantity of immature and mature pollen grains and difference in their allergenic severity.

Introduction: Urinary tract infection is one of the most common nosocomial infections that mainly occurs after urinary tract instrumentation, particularly after urinary catheterization. This study was conducted to assess the effects of disinfecting meatus and urinary catheter with 10% Povidone Iodine ointment on incidence of bacteriuria in hospitalized patients of neurological unit of Shohadaye Tajrish hospital.Materials and Methods: This study is a randomized clinical trail. It is done on seventy stroke patients that were catheterized by urologic specialist. Patients were selected on a convenience sampling and randomly divided to two groups (Experimental group: 35 patients, Control group: 35 patients). The two groups were matched based on some characteristics. In the experimental group, meatus and catheter drainage tube junction were disinfected daily and spigot was disinfected two times a day by PVP10% ointment. In the control group the cares were done by normal saline. In days: 2, 5, 8, 11, and 14; a urine sample was sent to the lab for culture. The maximum period of study was 14 days. Data were gathered by a data collecting form, NIHS scale. Data were analyzed using fisher’s exact test, relative risk, Mann-Whitney and Chi2 tests.Results: Incidence of bacteriuria in experimental and control groups were 20% and 42.9%, respectively. Relative risk was 2.14, thus disinfection by PVP can decrease the incidence of CAUTI. The most prevalent microorganism weas E.coli (experimental group: 40%, control group: 57.1%). In patients with positive urine cultures: puria was 85.7% in experimental group and 86.6% in control group. Clinical symptoms of UTI were 28.6% in experimental group and 33.3% in control group. In this study relationship between bacteriuria and severity of disease was significant in both groups (experimental group: p=0.028, control group: p=0.048). Relationship between UTI and length of catheterization was also significant (experimental group: P=0.022, Control group: P=0.047).Conclusion: This study showed that application of povidone-iodine 10% ointment for disinfection of meatus and catheter drainage tube junction is effective in preventing catheter-associated urinary tract infection in male patients.

Introduction: The increasing use of the electromagnetic field producer sets in daily living causes concerns about these waves on human health. The effects of extremely low frequency electromagnetic field (50 Hz) on induction of chromosomal damages on bone marrow erythrocytes of male Balb/C mouse have been investigated in this research.Materials and Methods: This is an experimental study in which the laboratory system of producing electromagnetic with low frequency (50 Hz) was used. Five week old male Balb/C mice were divided into three controls, sham-exposed and experimental groups. The experimental mice exposed were exposed to electromagnetic field (50 gauss) for 4 days (12 hours/day). After treatment, the chromosomal damages were assessed using micronucleus test in polychromatic erythrocytes and resultant quantity data were analyzed using t and Mann-Whitney test.Results: Results showed that frequency of micronucleated polychromatic erythrocytes of experimental group (14/35±1/589) was more than Sham-exposed (8/958±1/049) and control group (7/65±0/768) significantly (p<0/05).Conclusion: Extremely low frequency electromagnetic field (50 Hz) causes chromosomal damages induction in polychromatic erythrocytes of bone marrow male Balb/C mouse.

Introduction: Quality of life (QOL) has become an important concept in medical research. Some research has shown a curvilinear relationship between QOL and glycemic control, but some did not so. The aim of this study is to investigate different aspects of QOL and also assess the hypothesis in diabetic patients.Materials and Methods: In a cross-sectional study, a random sample of adult diabetic outpatients (n=110) were selected and completed the WHO-QOL assessment instruments. In addition HbA1c was measured in these patients by calorimetric method. Patients were divided in to 3 groups: 1-good control (HbA1c<7), 2-fair control (7³HbA1c<9) and 3-poor control (HbA1c³9). QOL was assessed by measuring physical, psychological, social and environmental domains. Data were analyzed with one way ANOVA (Tukey as post hoc), Chi2 and Mann-Whitney, and correlation tests.Results: A significant correlation was seen between BMI and glycemic control, physical and social aspects, physical and environmental aspects, psychological and environmental aspects, and social and psychological aspects. No significant difference was seen between mean score of different dimensions of QOL in relation to HbA1c changes. The mean score of each dimension in relation to glycemic control showed that, better score of psychological, environmental and social dimensions is seen in patients with fair glycemic control. But regarding the overall score of QOL this is completely reverse. The mean score of physical dimension is decreased with increasing HbA1c. There was no correlation between other domains of QOL and glycemic control.Conclusion: In this survey higher quality of life was seen in fair glycemic control in social, environmental and psychological dimensions, but physical dimension in patients was decreased when HbA1c was increased. Regarding the overall score of QOL it can be seen that the lowest score of QOL is in patients with fair glycemic control which is in contrast with curvilinear hypothesis.

Introduction: The vast majority of children with febrile seizure have a normal long term out come, but their parents are always worrying about recurrent febrile seizure. With attention to controversy in treatment a precise knowledge of the short and long term side effect is an important prerequisite for assessing the various treatment strategies. In this study we evaluated the efficacy of intermittent Diazepam and continuous Phenobarbital for the prophylaxis of recurrence of febrile seizure.Materials and Methods: In this clinical trial study 100 children with febrile seizure treated with intermittent Diazepam were compared with 100 children with febrile seizure treated with continuous Phenobarbital. Diazepam (1 mg/kg/d) was administered orally every eight hours during all febrile illness and Phenobarbital (3-5 mg/kg/d) was administered daily. Data were analyzed by chi-square and t-test.Results: During a mean follow up of 19 months, recurrence rates in the two groups were similar (14%). 74% of children receiving Phenobarbital had side effects versus 26% receiving Diazepam. (p=0.00001). Mean of fever in year was 3.2 ± 1.4 in Phenobarbital group and 3.0 ± 1.1 in which had no significant difference.Conclusion: Oral Diazepam, given only when fever is present, is safe and reduces the risk of recurrent febrile seizure.

Introduction: Preeclampsia is one of the three major causes of death in pregnant women. Researcher believed that consuming proper nutrients can be a solution. In the last few years, the effect of type of fruits and vegetables on prevention of preeclampsia has been investigated, but there are still questions about the proper amount (unit) of fruits and vegetables.Materials and Methods: This case-control study was done on pregnant women referring to Thaleghani hospital in Arak. 35 pregnant women with preeclampsia were selected as case, and 70 healthy pregnant women as control group. The two groups were matched. Data were collected with a questionnaire consisting of two parts, first demographic information and second information about the amount of consumed fruits and vegetables. Each woman was questioned about food consumption 3 month before and during second trimester of her pregnancy. Portion of fruits and vegetables was calculated per week and then compared between the two groups. K-S, Leven, Mann-Whitney, and Chi2 tests were used for analyzing data.Results: In preeclampsia group, 3 month before pregnancy mean consumption of fruits and vegetables was 7.69±16 per week, and in healthy group was 12.43±1.87. There was a significant difference between the two groups (p=0/029). In the second trimester of pregnancy the mean was 11.03±1.6 and 13.95±0.98 in case and control group, respectively. Differences were significant (p=0.03). Incidence of preeclampsia was increased in group with less than 25% consumption of fruits and vegetables before pregnancy (less than 5unit per week) (P=0.05, OR: 2.32, 95%CI:1/7, 7/24). This difference was also significant in the second trimester (P<0/03, OR: 2.57, 95% CI: 1/4, 54/29). Also in women who consume less than 8 units per week, the incidence of preeclampsia was increased.Conclusion: It was concluded that it seems there is relationship between consumption of fruits and vegetables with decreasing occurrence of preeclampsia. So researchers suggest that high risk groups of women be identified and educated to consume fruits and vegetables.

Introduction: Cataract is a type of tarnish observable opacity in different layers constituting the lens and will cause light occlusion or scattering. Necessity for treatment of Cataract via surgery and its close relation with corneal astigmatism, when we applied a new method in cutting and type of cataract surgery, led us to measure the post-operation corneal astigmatism changes in frown incision Phacosection.Materials and Methods: This interventional study has been done on 73 eyes (58 patients). These patients were gone under Cataract surgery via no stitch frown incision sclera tunnel phacosection method. In this study we have 7mm external scleral incision with no suture. They were Keratometerized in four separate periods including pre-operation, one week, one month and three months post- operation. Data was analyzed using independent and paired t-tests.Results: Age, sex and left or right eye had no influence on astigmatism. Mean preoperation astigmatism was 0.84±0.87D, mean astigmatism 1 week post- operation was 0.27±0.88 D, 1 month post- operation 0.06±0.82 D, and three months post-operation was -0.03±0.85 D (P= 0.0001). Before operation, 80% of the patients did have an astigmatism rate less than 1D that increased to 94.5% in three months period after operation and in 89% of the cases, the ultimate change in astigmatism has been found lower than 1D. The obtained information revealed that there is a meaningful difference between pre-operation astigmatism and the same after one week, one month and three months post-operation (P= 0.0001). Independent sample t and paired t-test were used to analyse data.Conclusion: Our study indicated that the no stitch frown incision scleral tunnel phacosection surgery can reduce pre-op corneal astigmatism, and because of induction of the slight controlled astigmatism we can apply this technique for all cataractic patients.

Introduction: Oral Ketamine is used as a low side effect analgesic in comparison with opioids, in different pain syndromes. This study is designed to evaluate the effect of oral Ketamine in renal colic treatment.Materials and Methods: In this clinical trial study 104 patients with renal colic, hospitalized in emergency department, were divided in to two groups by Random block design. Group B received Pethidine (1 mg/kg up to 100 mg) and placebo, and group A received Pethidine with the same dose and Ketamine (0.5 mg/kg). All patients were assessed for pain by using VAS chart, for nausea by a 0-3 scale and for the number of vomiting; at baseline and 1, 2 and 3 hours after taking drug. The results were analyzed by t-test.Results: Average pain score and vomiting in all times and nausea score in one and three hours after receiving drugs were reduced significantly in patients who took Pethidine and Ketamine comparing patients who took Pethidine and placcbo (p<0.05).Conclusion: Regarding the significant effect of Ketamine in reduction of pain, nausea and vomiting without side effects, it is possible to use Ketamine as an adjuvant drug in treatment of renal colic and to reduce narcotic dosage.

Introduction: Extracts of leaves from Camellia sinensis L contains polyphenolic components with antimicrobial activity. In this investigation biofilm inhibitory effects of black and green tea extracts were defined for five members of enterobacteriacea family including: Enteropathogenic Escherichia coli, Shigella flexneri, Proteus mirabilis, Klebsiella pneumonia and Salmonella enterica serovar Typhimurium. Because tea is the most widely drunk beverage in Iran, therefore investigation of its effects on enterobacterial biofilm formation and colonization is very important.Materials and Methods: In this experimental study after extraction of samples with Soxhlet extractor in water/ methanol solution, further extraction took place in Ethyl acetate phase. The extracts preserved in 4oC refrigerator after sterilization by 0.44 m filters. Well diffusion (Kirby Bauer) and broth dilution methods were used for evaluation of minimum inhibitory concentration of biofilm formation in black and green tea extracts treated cultures. Evaluation of biofilm formation was assayed by observation of colony forming unit of cultured bacteria per milliliter by sampling from Erlenmeyer flask wall scratching onto Tripticase soy agar medium and comparing the results with controls. Analysis of data was done using analysis of variance.Results: Biofilm inhibitory effects of black tea were greater than green tea. The concentration of 4.5 mg/ml of black tea and 5mg/ml of green tea had bactericidal effects against examined bacteria. On Mueller Hinton agar, Proteus mirabilis was more sensitive to black tea; EPEC was more sensitive to green tea and Klebsiella pneumoniae showed more resistance to both extracts.Conclusion: Due to the fact that gastrointestinal tract is directly affected with consumed beverage, the high concentration of tea entered in lumen can reduce the number of enterobacteriaceae and can reduce their carcinogenic amine products. Thus it plays an important role in inhibition of gastrointestinal lymphoma and colon carcinoma. Also application of tea polyphenols as a food preservative can be useful.

Introduction: Delivery of immediate medical interventions appropriate to the severity of clinical status of patients is a main public expectation of emergency departments. Waiting time and length of stay are the key measures to asses the quality of care in emergency departments. This study is done to investigate the waiting time and length of stay of attendants to emergency department of Vali-e-Asr Hospital, Arak-Iran.Materials and Methods: This analytical cross-sectional research was conducted in a general emergency department of a teaching hospital in Arak to asses the waiting time and length of stay of patients. In the first stage of the study all attendants during a 6 weeks period were classified regarding to the severity of their clinical status by an educated nurse and a general practitioner using a three category scale (guideline) presented by ministry of Health and Medical Education (2001). Also waiting time for a general practitioner visit was measured and documented by the resident general practitioner. In the second stage, a sample of 100 documents of patients in group 1 and 2 admitted for specialist visit were assessed for the waiting time and length of stay in emergency department. Mean of waiting time according to patients clinical status and the specialty of the first physician were analyzed by t-test and ANOVA (p =0.05).Results: During a 6 weeks period, of 1963 patients, 179(9.1%) were categorized as emergent (category 1), 391(19.9%) urgent (category 2) and 1393 (71%) non urgent. The mean waiting time for general practitioner visit was 5 minutes. The median and mean of waiting time for specialist visit in group 1 and 2 of patients were 225 and 262±156, 220 and 227±153 minutes, respectively. The median and mean of length of stay was 1 and 2 days, respectively. No differences were found between waiting time of various specialties visit in patients of categories 1 and 2.Conclusion: Regarding the long waiting time for specialist visit, using triage in emergency departments is necessary. This needs planning and organization for the presence of specialists in the hospital, over the time. Also regarding the large number of nonurgent patients, 24 hours presence of a general practitioner is necessary.

Introduction: Based on statistical and epidemiological studies, cancer is the third most common cause of death after heart diseases and accidents, therefore planning to control cancer are essential for public health. Cancer registration is an important part of cancer control, and the collected data could be useful in etiological studies, and health programming to prevent and treat the disease. In this study cancer incidence and cancer registration in Markazi province investigated.Materials and Methods: In this descriptive study, data related to cancer were collected from the health center of Markazi province, from 2001 to 2006. Then the prevalence and incidence of different kind of cancer were determined.Results: Results showed that the top ten cancers among women were: 1-Breast 2- Skin 3-Stomach 4-Colorectal 5-Lung 6-Uterus 7-Bladder 8-Lymphoma 9-Thyroid 10- Esophagus, and the ten most prevalent cancers among men were: 1-Skin 2-Bladder 3-Stomach 4-Lung 5-Prostate 6-Colon and Colorectal 7-Esophagus 8-Lymphoma 9-Testese 10-Gall bladder.Conclusion: In this investigation we also compared cancer incidence and distribution in Markazi province with national rates and our results showed that in some years, cancer statistics is different from national statistics which it may be due to different environmental and epidemiological factors.

Introduction: Methicillin resistant staphylococcus aureus strains are the most important agents of nosocomial infections. The conventional antibiotic susceptibility methods such as disk diffusion are not suitable for detection of these strains due to their heteroresistancy. Therefore, in this study, agar screen and duplex-PCR were compared in determination of methicillin resistant Staphylococcus aureus (MRSA) strains isolated from nose of personnel in Hajar hospital of Shahre-kord, 2007.Materials and Methods: In this experimental study a total of 204 nasal swabs from personnel of Hajar hospital over a period of 6 months were collected. The specimens were cultured on mannitol salt agar for primary isolation and identification of Staphylococcus aureus strains and their susceptibility pattern to oxacillin was assessed using agar screen method. Finally, using duplex PCR, the isolates were tested for the presence of mecA gene. Results were compared and sensitivity and specificity of the method was determined.Results: In this study, 23 of the 52 (44%) Staphylococcus aureus isolates were resistant to oxacillin using agar screen method. However, mecA gene was detected in 27 of the 52 strains (52%). Our results showed that the sensitivity and specificity of agar screen method in determination of MRSA strains were 81.5% and 96%, respectively comparing with PCR.Conclusion: Oxacillin agar screen, comparing PCR, is an inexpensive, applied and phenotypical method with low false positive and suitable for screening of MRSA. However, due to its relatively high false negative results is not appropriate for screening of MRSA strains isolated from hospital-employed nasal carriers.

Introduction: In this study, antimutagenesis effect of ethanolic extract of propolis by Ames test against two mutagenic substances named azide sodium and potassium permanganate in the presence and the absence of microsomal homogenate of mouse liver (S9) has been investigated.Materials and Methods: In this experimental study at first, different concentrations of ethanolic extract of propolis (0.1-5%) for determining minimum inhibitory concentration (MIC) against tester strains were used. Then by Ames test, antimutagenesis effect was assessed in nontoxic extent. In this test, various strains of Salmonella typhymurium (TA100 and TA97) that contained selective mutation in their operon histidine, were used. Mutant strains (His-) were grown on culture media containing minimum salt and glucose in the presence of mutagen substances above. So only those bacteria that were reversed by mutation (His+) could grow and form colonies on culture media. If antimutagen (EEP) and mutagen substances were gathered, reversed mutation would be reduced and the rate of mutation inhibition could be calculated by means of formula. The differences between the averages of revertants per plate of the sample in relation to the mutagens were analyzed using SPSS software and one-way ANOVA.Results: The resulted MIC values clearly showed that ethanolic extract of propolis at 5% concentration has antibacterial activity against Salmonella typhymurium, but in 0.1-4% concentrations, such effects were not seen. Findings also showed that propolis in such concentrations could neutralize mutagenic effects of those substances in a dose dependent manner.Conclusion: Finally we found that ethanolic extract of propolis that contains different kinds of major and important substances like flavonoids, has good antimutagenic effects and the best concentration for obtaining such effect is in 4% which also was confirmed with microsomal results. The mechanism of antibacterial effect of propolis is complex and it has no analogy to any classic antibiotics, but it should be emphasized that bacterial cell division is inhibited by propolis. Some researchers also argue that propolis could inhibit DNA-dependent RNA polymerase.

Introduction: Typhlitis is a complication in GI tract specially in ileum and cecum due to sever prolonged neutropenia. The syndrome usually occurs in patients with leukaemia who take aggressive chemotherapy or in solid tumor treated with taxane base regimen. The syndrome is accompanied with neutropenia, fever, generalized abdominal pain especially in right lower quadrant and probably a mass in this area.Case: The patient is a 44 year old man which was presented with enlargement of right testes since two months ago. In sonographic evaluation of testes a mass was defined and surgery was done for him, which pathologic result was seminoma. Staging workup was done and in CT scan a lymph node with size of 35 mm was detected in paracaval area. According to this result the patient received chemotherapy with Cisplatin and Etoposide. One day after completion of chemotherapy he developed abdominal pain , fever and bloody diarrhea and referred to hospital and admitted with diagnosis of typhlitis.Conclusion: Typhlitis is not restricted to a complication of leukaemia treatment or taxane base chemotherapy and other cytotoxic drugs can induce this problem. On the other hand, neutropenia and typhlitis can occur immediately after chemotherapy in sensitive patient and so the time of nadir value of white blood cell is too short.

Introduction: A pseudoaneurysm is a pulsetile hematoma secondary to bleeding into soft tissue, which involves peripheral vessels in the most cases. A femoral artery pseudoaneurysm that is a rare complication, mainly occurs following prior arterial catheterization but it may also be formed with trauma. In this article a superficial femoral artery is reported.Case: The patient is a 24 years old woman who was admitted with a wound in the posteroinferior region of right tight 10 days before her recent referral. The skin of the wound had been repaired. After 1 week; pain, progressing swelling in inferior region of tight and knee, fever, shivering and limping were presented. In physical examination, 90 degree flexion of knee, edema, warmth and tenderness in inferior region of tight were observed. Any pulse of dorsalis-pedis and posterior-tibialis was not touched. In the next step; blood laboratory test, simple X-ray, Doppler sonography and magnetic resonance imaging (MRI) of right lower limb were accomplished. Finally, with the diagnosis of femoral artery pseudoaneurysm, excision of the pseudoaneurysm with reverse saphenous vein grafting was performed.Conclusion: Pseudoaneurysm should be noticed in patients with history of penetrating trauma and symptoms due to infection. In these cases sonography is necessary to get the exact diagnosis. The size of aneurysm and patient’s symptoms, determine the method of treatment.