JOURNAL OF BABOL UNIVERSITY OF MEDICAL SCIENCES (JBUMS)
Year:2011 | Volume:13 | Issue:1 (58)|Papers Count:13

BACKGROUND AND OBJECTIVE: Halothane is the most common inhalation anesthetic drug in the world and there is an increasing interest for using intravenous anesthetics like propofol. The purpose of this study was to compare the effect of halothane and propofol on hepatic enzymes after general anesthesia.METHODS: This randomized clinical trial study was performed on 58 patients (14-69 years old) classified in class I of American Society of Anesthetics. These patients who had no preliminary symptomatic hepatic, cardiac or renal disease admitted for elective surgery (ENT, eye, orthopedics, general surgery, and urology). These patients were divided randomly into two groups: 30 patients in the propofol group and 28 patients in the halothane group. In both groups, pre-medication and induction of anesthesia were the same. For the maintenance of anesthesia in the study group there was continuous infusion of propofol and for the control group, 0.5-1% halothane inhalation. From all the patients, three blood samples were taken separately prior to the anesthesia, twenty four hours and seven days after the anesthesia. These samples were tested and compared for aspartate aminotransferase (AST), alanine amino transferase (ALT), alkaline phosphates (ALP) and Billirubin (total and direct)FINDINGS: Mean anesthesia duration in propofol group was 91±14.7 minute and in halothan group was 93.2±17 minute that there was not statistically significant difference in duration of anesthesia between the two groups. Seven days after anesthesia ALP, the total and direct billirubine levels did not show significant differences between the two groups. However, AST (p=0.008) and ALT (p=0.003) increased in halothane group in compared with propofol group.CONCLUSION: The results show that propofol has less effect on liver enzymes as compared to halothane. This can be considered in anesthetic drug usage.

BACKGROUND AND OBJECTIVE: In Iranian traditional medicine, the core of the fruit of Anacardium occidentale (A.O) was used for relief of pain. Significant analgesic effect of A.O methanolic extract was reported previously. By considering the hepato-renal adverse effects of common analgesic drugs, therefore the hepatorenal toxicity of percolated extract of A.O were investigated in this study.METHODS: In this experimental study, 30 male rats between 190-270 g weight (five groups of six male rats in each group) were used. The extract was administered orally to three groups of 6 male rats with doses of 200, 400 and 800mg/kg every 24 hours for 7 days. Normal saline was administered 5ml/kg, in control group. One other control group was used without any treatment (Sham). At the end of 7th day, urine, blood and tissue specimen were collected for analysis. In second phase of the experiment, the blood enzymes including; Alanin transpherase (ALT), Aspartate transpherase (AST), Alkalin phosphatase (ALP), and the serum creatinin (Cr), and the Blood Urea Nitrogen (BUN) and urinary enzymes activity including; gama-glutamil transpherase (GGT), and lactate dehydrogenase (LDH), changes in the left kidney weight were determined. In third phase of the experiment, histopatological study in kidney and liver were evaluated.FINDINGS: Renal function tests showed, there were no significant differences in BUN and creatinin levels of the control and extract treated groups, and histopathological studies showed no changes in tubules of kidneys, but there was little changes at doses of 800mg/kg. There were significant increases in AST levels at doses of 400 and 800mg/kg (p<0.05) but there was a significant decrease in ALT levels only at doses of 400mg/kg (p<0.01). There was a significant decrease in ALP levels in 200mg/kg group in comparison to Sham groups (p<0.01). The histopathologic studies of liver showed evidence of hepatotoxicity with high dose of 800mg/kg.CONCLUSION: The results showed no hepatorenal toxicity after oral administration of 200 and 400mg/kg methanolic extract of (A.O). But there were some evidences for hepatorenal toxicity with higher doses of extract, 800mg/kg (A.O). Since therapeutic analgesic dose (200 mg/kg) of A.O did not induce any hepatorenal toxicity, therefore it seems that the A.O is a suitable plant for further investigation for introducing as analgesic drug for clinical use.

BACKGROUND AND OBJECTIVE: Nano particles because of the marvelous anti-microbe effects and increasing consumption in different industries are part of the most usable of these particles which this has increased the necessity of the study on the safety of using these materials. The aim of this study was to examine the effects of time and consumption dose of these particles on the some biochemical and blood parameters of rats of wistar race.METHODS: Thirty six Wistar race rats after 4 week similarization period divided to 6 groups of 6 rats (one control and five tests). Nanosilver (nanocid L2000) solution was purchased from NanoNasb-e-Pars Co and 95PPm, 65PPm, 35PPm, 20PPm and 5PPm concentrations were prepared. Then above solutions were used as water for 6 months. Three rats of each group were randomly selected after 3 and 6 months and biochemical parameters, Hb and HCT was measured and compared in different groups.FINDINGS: There are no significant changes in the rats' blood cholesterol and sugar in the form of dose/time dependent manner in spite the fact that increasing the blood sugar level in all doses specially 35PPm after six months was considerable. The blood triglyceride level showed significantly decrease both in synchronic (p<0.01 after 3 months and p<0.05 after 6 months) and dose dependent (decreasing with p<0.01) manner. Lowering of triglyceride in 35PPm was considerable again. Counting the white blood cells shows dose dependent decreasing in number of these cells (p<0.001). No tangible change was seen on counting of red blood cells and measuring Hb and HCT parameters.CONCLUSION: The results of this study showed that oral consumption of nanosilver particles especially in high doses and long terms causes not only damage to the liver but also decrease the number of white blood cells (WBCs) and immunity level of the organism.

BACKGROUND AND OBJECTIVE: Inflammation is a side effect of many diseases that could yield immune system disability. The recognized acute and chronic inflammations are the main factors for permanence of infection and long lasting in recovery of disease. Regarding to incomplete treatment of inflammation by using chemical drugs and alkaloid compounds of barberry (berberis vulgaris) root bark such as Berberine that have strong anti-inflammatory property, in the present study, the anti-inflammatory effect of alcoholic extract of berberis vulgaris fruit using experimental methods is examined.METHODS: In this research as an experimental study, 86 male NMRI rats weighting 300-350 gr were chosen at random, and were divided into five groups: 1-control (only Evans blue), 2-sham (inflamed without treatment) 3, 4 and 5- treatment groups which received the alcoholic extract of barberry at doses of 75, 150 and 300 mg/kg intraperitoneally. Each of groups was subjected to three methods in order to measure the acute inflammation (formalin injection to paw, xylane to ear and intraperitoneally received acetic acid), and one group was examined with chronic inflammation (implantation of cotton in groin border of rats). Finally in a complementary assessment, the analgesic effect of the most effective dose of extract was evaluated using formalin test.FINDINGS: Effective doses of 150 and 300 mg/kg of berberis vulgaris fruit extract could change significantly the light absorption of inflamed foot, from 0.1±0.03 in control group to 0.15±0.02 and 0.16±0.01 respectively (p<0.05). In addition, 300 mg/kg dose of extract, increased the light absorption of peritoneal fluid significantly from 1.43±0.1 in control group relative to 0.7±0.09 in experimental group (p<0.05). Chronic inflammation has decreased significantly from 33.4±2.14 in control group relative to experimental groups (20.11±2.27 and 24.15±2.84, respectively) (p<0.01, p<0.05). Finally, the late phase of chronic pain has decreased significantly by dose of 300 mg/kg from 1.79±0.18 (control) to 1.25±0.1 (p<0.01).CONCLUSION: Our result shows that alcoholic extract of barberry in medium and maximum doses is able to decrease the formalin and acetic acid injection-induced inflammation in foot and peritoneum significantly and also can decrease an external body-induced chronic inflammation as well. In addition, the reduction of late phase of chronic pain in parallel with chronic inflammation suppression is considerable.

BACKGROUND AND OBJECTIVE: Cardiovascular diseases that are the most common causes of mortality worldwide can be recognized and prevented through measurement of some anthropometric indices. Relationship of many anthropometric indices with cardiovascular diseases risk factors has been well documented. The aim of this study was to introduce a novel anthropometric index that can be used more easily and accurately.METHODS: This cross sectional study was performed on 179 healthy and inactive men and women selected from individuals referring to cardiovascular department of Imam Reza hospital of Mashhad for normal heart checkup under supervision of a cardiovascular surgeon. Their anthropometric indices (neck circumference, waist circumference, weight, body mass index, waist to hip ratio) and atherosclerosis risk factors (lipids and glucose) was determined. Then the relationship between anthropometric indices and atherosclerosis risk factors was determined.FINDINGS: Results showed positive and significant correlation between neck circumference with TC/HDL, TG, TG/HDL and VLDL, waist circumference with glucose, TG and VLDL, body mass index with TC/HDL and TG/HDL and waist to hip ratio with glucose (p<0.05). In men neck circumference with LDL, VLDL, TG, TC/HDL, TC and TG/HDL and waist circumference with LDL, LDL/HDL, TC, TC/HDL, TG, TG/HDL and VLDL had positive and significant correlation and waist to hip ratio had negative and significant correlation with HDL (p<0.05).CONCLUSION: According to the results of this study, neck and waist circumference had more precision in predicting of atherosclerosis risk than other indices, thus we can use these indices especially neck circumference that is simpler for determination of atherosclerosis risk in middle aged women and men.

BACKGROUND AND OBJECTIVE: The postpartum period is associated with great changes in women's quality of life. These changes can influence mother-baby health. Regarding the importance of quality of life and postpartum, and effective factors on postnatal quality of life including the mode of delivery, this study was conducted to compare quality of life in women after vaginal delivery and cesarean section at 8 weeks postpartum.METHODS: In this prospective analytic study 420 pregnant women aged 16-35 years who referred to health center without history of general medical conditions, psychological and pregnancy problems, drug intake, and without experiencing stress at 9 past months were recruited using nonprobability sampling. Subjects completed Edinburgh Postnatal Depression Scale (EPDS) during the third trimester pregnancy and subjects with EPDS score >12 were excluded from the study. From 290, 148 in normal vaginal delivery group and 142 in cesarean section group were followed up at 8 week postpartum. Quality of life in physical, psychological, social, environmental and overall domains was assessed and compared using WHOQOL BREF questionnaire.FINDINGS: At 8 weeks postpartum in NVD group the mean score of quality of life was 75.01±11.74 for physical domain that was significantly higher than the mean score of QOL for physical domain in C/S group (70.54±10.48) (p=0.000). In NVD group the mean score of quality of life was 73.14±14.71 for psychological domain that was significantly higher than the mean score of QOL for psychological domain in C/S group (69.23±13.71) (p=0.024). There was no statistically significant difference between two groups in social, environmental and Overall domains.CONCLUSION: According to the results of this study, the score of quality of life in NVD group was better than C/S group on physical and psychological domains; health care provider for correct choice of mode of delivery can be effective in reducing elective cesarean and improving quality of life after delivery.

BACKGROUND AND OBJECTIVE: Carpal tunnel syndrome (CTS) or compression neuropathy of median nerve in carpal tunnel is the main cause of pain, numbness and tingling in the upper limb. The most common conservative interventions in mild to moderate CTS are wrist splints. The purpose of this study was to compare the effect of the Manu splint to wrist cock-up splint on the symptoms and functional status in CTS.METHODS: In this clinical trial study, we randomized 20 hands (12 female patients) with CTS into a group wearing the splint that keep 3rd and 4th fingers in extension (Manu splint) and into another one wearing the short cock-up splint with natural wrist angle, at night for 4 weeks. The patients were evaluated and compared after 2nd and 4th weeks by Boston Carpal Tunnel Questionnaire (BCTQ) and Pain Visual Analog Scale. The questionnaire comprised two parts: symptoms severity and functional statues that maximum scores were 55 and 40 for symptom severity and functional statues, respectively. Maximum score was 100 for PVAS.FINDINGS: The average symptom scores of BCTQ and pain scores significantly reduced in both groups after 4 weeks. Functional statues score was diminished significantly only in Manu splint group after 2 weeks (p=0.004). In comparison between 2 groups, after 4 weeks, the mean symptom severity score in Manu splint group was -31.15±15.37 and in cock-up splint group was -51.38±15.21 (p=0.008), the mean pain severity score in Manu splint group was -61.72±34.86 and in cock-up splint group was -98.59±2.96 (p=0.004). After 4 weeks no significant differences exited between 2 groups in term of functional status.CONCLUSION: The results of this study show that a 4 week treatment with either the hand brace or the wrist splint induced symptomatic benefit in patients with CTS. In the orthotic treatment of CTS, wrist posture is more important than finger posture.

BACKGROUND AND OBJECTIVE: Hearing loss is one of the most important morbidities in high risk neonates admitted to NICU and special care nursing. This study was carried out to screen and follow up for hearing impairment in neonates who treated and discharged from NICU and newborn services (level II and III) in Amirkola children hospital, Babol, IranMETHODS: All neonates admitted to the division of neonatology (level II and III), Amirkola children hospital, Babol, Iran included in this study between September 2006 and July 2008. At first stage all neonates before discharge were screened with portable Otoacoustic Emission (OAE) based on this examination. The results were divided in two groups: PASS and REFER. All babies who failed to respond bilateral referred for brain stem responses (ABR) 15 days later, and unilateral failure at 3 months of age. All neonates with severe and profound bilateral hearing loss received hearing aids at three months of age. These neonates were tested by ABR at nine months of age. In the case of no response they referred to cochlear implantation at 12 months of age.FINDINGS: At first stage from 363 neonates, 311 (85.70%) passed the OAE exam. Fifty two (14.33%) referred for ABR (CI: 95%, 10.70-17.95). At the second stage 15 neonates (4.13%) diagnosed having severe to profound hearing loss (CI: %95, 108-6.19). Three neonates suffered from bilateral profound hearing loss and five neonates had bilateral sever hearing loss. Overalls 8 (2.2%) of screened babies needed hearing rehabilitation (CI: 95%, 0.69-3.73).CONCLUSION: The prevalence of hearing loss is high. Up to establishing of universal neonatal hearing screening, we recommend hearing screening of all neonates treated in division of neonatology in our country.

BACKGROUND AND OBJECTIVE: Physical disabilities are the most common side effects of Cerebro Vascular Accident (CVA) in adults. Hemiplegics individuals experience a wide range of functional disabilities including upper limb disabilities. Therefore, rehabilitation treatments are quit important in this regard. The aim of this study was to assess the correlation between pinch and grip strengths with dexterity in adult hemiplegia.METHODS: This cross-sectional study was carried out on 34 adult hemiplegic patients. All procedures were approved by ethical committee of Tehran University of Medical Sciences and written consents were also taken. Patients were familiarized with the procedure, pinch and grip strengths were measured by dynamometer according to the amount of kilograms and dexterity has evaluated by Minnesota manual dexterity test based on the number of seconds. Finally, the relationship of these factors was studied.FINDINGS: Age range of patients in this study was 50-70 years (mean=62.4±7.2 years). The average elapsed time from stroke was 22.3±10.4 months and all of the patients were right dominancy. There was a significant relationship between dexterity with grip strength (p=0.000) and pinch strength (p=0.008) in patients. However, no significant relationship was observed between age of patient and the elapsed time from stroke.CONCLUSION: Pinch and grip strengths have a significant relationship with dexterity in hemiplegic patients. Hence, any disturbance in dexterity could affect on the function and activity of daily living in this group of patients.

BACKGROUND AND OBJECTIVE: Glucose 6-phosphate dehydrogenase (G6PD) deficiency is the most common enzymatic disorder of red blood cells in humans. G6PD deficiency is prevalent in Iran especially in north region. Considering that favism is one of the most reason of hospitalization of these patients, the aim of this study was to evaluate the clinical and laboratory findings of favism in adults, in north of Iran.METHODS: This cross-sectional study was performed on 50 adult patients with favism hospitalized in Babol city, north of Iran (2006-2008). Data on demographic and clinical features and laboratory findings, cause of hemolysis and blood transfusion were evaluated and then data was analyzed.FINDINGS: All of patients had exposure to fava beans. Twenty six (52%) were male and 24 (48%) were female. Thirty (60%) hadn't experience of such attack. Clinical features were dark urine in 45 (90%), headache in 34 (68%), nausea in 28 (56%), stomach pain in 23 (46%), vomiting in 20 (40%) and fever in 8 (16%). Sclera was icteric in all patients. Bilirubinuria and hemoglobinuria were seen in 9 (18%) and 16 (32%), respectively.CONCLUSION: According to the findings of this study based on favism new onset in adults (60%), and no difference in gender distribution, future studies to evaluate causes of hemolysis due to fava bean in adults and relations with G6PD deficiency suggested. Also, the results show that in north of Iran in management of adults with icter or acute hemolytic anemia, favism should be considered (also in women).

BACKGROUND AND OBJECTIVE: Traffic accidents are one of the main causes of death in world and the first cause of year life lost in Iran. Although paths leading to the Amol town are busy and eventful, we have not comprehensive information about effective factors in traffic accident and the factors related to traffic accident severity. This study was done to determine mortality and injury severity in the accident victims referred to the Hefdah Shahrivar hospital of Amol, Iran.METHODS: This cross-sectional study was studied on 1397 road accident victims referred to Hefdah Shahrivar hospital of Amol town in 2007. Information on characteristics of injured persons, how accident occurred, accident location and time were recorded in the checklist. Injury severity scores (ISS) ranged from 1-6 according to physician's opinion.Then data was evaluated.FINDINGS: From 1397 cases, 995 (71.2%) were male and 633 (45.2%) were at the age group of 15-30 years old. Number of deads was 125 (8.9%) that cause of death in 72 (6.57%) of them was head trauma. Number of injured cases was 476 (34.2%) and severity of injury was 7.85±10.21 on the roads outside urban area that was more than other roads (p<0.05). The passenger car occupants injured more (731 cases=52.3%) but the mean of injury severity in cyclists was 9.26±11.05 that was more than pedestrians, passenger car occupants and motorcyclists.CONCLUSION: The results of this study showed that a variety of factors, including the type and location of traffic accidents being involved in causing injuries, mortality and severity of injuries. Therefore, identifying these native factors will be a good guidance for the accurate and effective planning in improving the health of society.

Given the fact that, periodontal disease is a disease with an infective agent, treatment by using antibiotics with scaling and root planing (SRP) has been considered as an adjunctive therapy. According to disadvantages of systemic antibiotic therapy such as: resistance, fluctuations in concentration, need for cooperation and side effects, local drug delivery systems in the form of irrigants or forms of drug releasing agents, seems to be a suitable substitute. Because periodontal diseases are often limited to several teeth. A local delivery device consists of a drug reservoir and a limiting element that controls the rate of medicament release. The goal is to maintain effective concentrations of chemotherapeutic agents at the site of action for long periods, despite drug loss from cervicular fluid clearance. Current data suggest that local delivery of antimicrobials into a periodontal pocket can improve periodontal health. It can be concluded that the adjunctive use of local drug delivery may provide a defined, but limited, beneficial response.