JOURNAL OF BABOL UNIVERSITY OF MEDICAL SCIENCES (JBUMS)
Year:2009 | Volume:10 | Issue:6 (47)|Papers Count:17

BACKGROUND AND OBJECTIVE: Breast cancer is the most common malignancy among women and so leading cause of female death in middle age. So knowledge of the genes include in this disease such as collagenase-IV (MMP9) play important roles in cells segregation from the basic membrane and their metastasis. The aim of this study was to investigate the association between a functional polymorphism (C/T) at this gene promoter and its role in decrease of the age and so on location of metastasis in breast cancer patients.METHODS: This case-control study was accomplished in 90 subjects of breast cancer patients with metastasis and 100 health subjects. The follow-up and clinical tests were performed every two months. After genotyping subjects of this study were categorized into three types including CC, CT and TT and then relation between the genotype of every group was investigated with the type. Age and location of metastasis. For this aim first the related primers was prepared and this location was reproduced by PCR technique then the genotype of each person was investigated by PCR products restriction enzyme digestion.FINDINGS: The results showed that from 90 subjects with metastasis, 37 subjects were under 47 years. Forty one subjects were with metastasis in lymphatic nodes and 21 subjects were with metastasis in wide bone. TI1erewas a significant association between the T allele exist and decrease of metastasis age under 47 years (OR=7.31, 95% CI=2.4-21.8, p<0.001) and so the subject carrying this allele are two folds more susceptible for metastasis in wide bones instead of lymphatic nodes.CONCLUSION: According to the results of this study, the T allele in collagenase-IV promoter is a risk factor for decrease the age of metastasis and also a risk for metastasis to wide bones is more than lymphatic nodes in breast cancer.

BACKGROUND AND OBJECTIVE: Formaldehyde is one of agents with absorbable potential which can use in industry and also in many productions such as technical, pharmaceutical and sanitary compounds. Previous study shown that formaldehyde can affect on testicular tissue and reduce spennatogenesis phenomena. This study was carried out to determine the effects of formaldehyde on leydig cells and testicular vasculogenesis.METHODS: Twenty mature male Balb/c mice were randomly divided into experimental and control groups (n=10). Experimental group were administered 0.25mg/kg body weight dissolved formaldehyde intraperitoneally for 10 days. The control groups were received the same volume of normal saline during the same period of times. At the end of exposure time, animals were scarified and their testes were removed for processing, serially sectioned and immunohistochemistry by using PCNA method, were carried out.FINDINGS: The finding revealed that the numerical density of leydig cells decreased significantly in experimental group in contrast controls (42 versus 66 per/m3 respectively). In addition, a number of shrinkage and picnotic leydig cells indicated occurrence of chromatolysis phenomena in experimental group.CONCLUSION: These data reveal that administration of formaldehyde may result in significant structural changes in male reproductive system such as interstitial tissue of seminiferous tubules and cell death among leydig cells population.

BACKGROUND AND OBJECTIVE: Pain, nausea and vomiting are the most common problems in patients in recovery room and after leaving the recovery room. The aim of this study was to determine the duration of analgesia and its complications after using bupivacaine and lidocaine with buprenorphine and bupivacaine alone.METHODS: This clinical trial study was performed on 187 patients aged 16-60 years old who referred for hemiorrhaphy or lower limb orthopedic surgery to the hospitals of Babol city. Patients were divided into three groups including first group received lidocaine 2cc (5%) with buprenorphine 50mg, second group received bupivacaine 2cc (5%) with buprenorphine 50mg and third group received bupivacaine 2cc (5%) alone. Data including age, sex, duration of analgesia according to visual-analogue score, nausea and vomiting, and itching and urinary retention complications were recorded.FINDINGS: The results showed that the mean time that pain began was significantly more in patients receiving bupivacaine with buprenorphine (8 hours) than those receiving lidocaine and buprenorphine (5.8 hours) and bupivacaine alone (4 hours) (p<0.001). Also the time for analgesia treatment of severe pain was significantly higher in bupivacaine with buprenorphine group (10.8 hours) than other groups (7.9 and 6.3 hours) (p<0.001).The rate of nausea and vomiting was not significantly different between groups but itching and urinary retention was more common in group received bupivacaine with buprenorphine than other groups (p<0.05).CONCLUSION: Results showed using bupivacaine with buprenorphine causes longer duration of analgesia. Therefore it is recommended to use it for spinal anesthesia.

BACKGROUND AND OBJECTIVE: One of the most important purposes in emergency anesthesia in patients undergoing ophthalmic surgery is prevention of gastric content aspiration and increase in intraocular pressure (lOP) during endotracheal intubation. Priority in prevention of gastric content aspiration necessitates use of rapid intubation technique by succinylcholine. The aim of this study was to evaluate the effect of nifedipine on intraocular pressure following endothracheal intubation after administration of succinylcholine.METHODS: In a clinical trial study, 64 patients aged 15-60 years old (ASA class I) were candidated for non ophthalmic surgery. They were randomly divided into two equal groups. Anesthetic technique was similar in both groups. In case group, 10mg sublingual nifedipine was administered 20 minutes before induction and in control group 10 drops of placebo were administered. lOP was measured by schiotz tonometer just before nifedipine and placebo administration and at I, 3 and 5 minutes after induction.FINDINGS: In this study, mean lOP before induction was 12.5±2.8 and 13.9±3.2 mmHg in niledipine and control group, respectively that this difference was not statistically significant. Mean lOP at 1, 3 and 5 minutes was 13.3±2.9, 14.3±3.2 and 11.6±2.9mmHg in nifedipine group and also 17.9±3.5, 21.5±3.5 and 16.9±3.2mmHg in control group, respectively (p<0.001). Also, ranges of IOP changes in two groups were meaningful (p<0.001). But no difference was seen in systolic blood pressure and heart rate alteration between two groups.CONCLUSION: According to the results of this study, increase in lOP caused by endothracheal Intubation with succinylcholine after administration of sublingual nifedipine was very low. Therefore this method with rapid sequence induction and endothracheal intubation can be used in cases that significant changes in lOP are dangerous for ophthalmic procedures (e.g., penetrating eye injury).

BACKGROUND AND OBJECTIVE: Nowadays because of the complications, allergic reactions and drug resistance of chemical drugs, the researchers have been interested in using traditional medicine. Considering rising incidence of cesarean section and frequency of digestive discomforts after this operation, the aim of this study was to compare Cuminum Cyminum with Milk of magnesia (Mg) in prevention of digestive discomfort after emergent cesarean section.METHODS: This clinical trial study was performed on 150 patients after urgent cesarean section. They were randomly divided into two groups (75 in each group). After beginning of food regimen for prevention of digestive discomforts, syrup of Milk of Mg/TDS in control group and Cuminum Cyminum/TDS in case group were prescribed. Data were recorded by observation and examination.FINDINGS: In control group versus case group: moderate abdominal distention in 35 cases (46.6%) versus 15 cases (20%), abdominal colic pain in 24 cases (32%) versus 4 cases (5.3%), heartburn in 40 cases (53.3%) versus 10 cases (13.3%), late gas passing in 30 cases (40%) versus 5 cases (6.6%), late defecation in 10 cases (13.3%) versus I case (1.3%) and mean duration of hospitalization (50±3.5 hours versus 36±3 hours) showed statistically significant difference (p<0.05). The differentiation of two group because of severe abdominal distention in 10 cases (13.3%) versus 3 cases (4%), nausea in 6 cases (8%) versus 2 cases (2.6%) and vomiting in 4 cases (5.3%) versus 10 cases (13.3%) was not significant. Two groups from point of eHective variables on digestive discomforts were the same.CONCLUSION: Results of this research showed that Cuminum Cyminum in prevention of digestive discomforts after emergent cesarean sections is the same or even more effective than Milk of Mg.

BACKGROUND AND OBJECTIVE: Hyperglycemia causes renal morphometric and histological alterations; This study was done to detennine the protective role of urtica dioica on renal morphometric and histological alterations in streptozotocin diabetic rats.METHODS: Thirty adult Wistar rats divided into three groups, Group I normal control group, group II: diabetic group; animal received 80mgkg STZ (streptozotocin) by intraperitoneally and group III: protective group, rats received 100mg/kg daily hydroalcoholic extract of U. dioica for 5 days then diabetes induced in animals by STZ. In the end of five weeks the animals had been scarified, the kidneys fixed by buffer formaldehyde, processed, sectioned and stained with H&E.FINDINGS: Mean of blood glucose concentrations in end of fifth weeks were 99.4, 454.7 and 303.6 in control, diabetic and protective groups, respectively (p<0.05), that was lower in protective group than diabetic group. Ration of kidney/body weight in control, diabetes and protective group were 0.42, 0.51 and 0.48, respectively (p<0.05). Glomerular area in control, diabetes and protective group were 1335.3, 1441.8 and 1326.4mm2, respectively (p<0.05). Glomerular diameter in diabetic group (162.2mm) was higher than control (156.1) and protective group (153.2). Pathology finding as glomerular sclerosis was seen in diabetic group but this finding did not observe in control and protective groups.CONCLUSION: This study demonstrated that administration of urtica dioica before streptozotocin-induced diabetes has protective effects on blood glucose, renal morphometric and histological alteratios in streptozotocin diabetic rats.

BACKGROUND AND OBJECTIVE: Shivering after spinal anesthesia is a common and uncomfortable complication that may interfere with monitoring during operation, excess oxygen consumption and lactic acidosis. Meperidine is first line treatment in patients with postoperative shivering. Since meperidine cannot be used in all patients, so this study was performed to compare the effect of tramadol with meperidine for treatment of shivering in patients with spinal anesthesia.METHODS: This clinical trial study was performed on 40 patients aged between 22 and 51 years (ASA Class I) with shivering after spinal anesthesia. They were randomly divided into two equal groups. Group one received 0.5mg/kg meperidine IV (N=20) and group two received 0.5mg/kg tramadol IV (N=20). The time to cessation of shivering, respiratory depression, vomiting and nausea during operation and recovery was monitored and recorded and then obtained results were compared.FINDINGS: Response to drugs was similar in two groups and shivering stopped in all the patients. Average recovery time was 80.3 seconds and 114 seconds in meperidine and tramadol groups, respectively (p<0.001). Other findings such as respiratory depression, consciousness, nausea and vomiting did not show any statistically significant difference.CONCLUSION: The results of this study showed that tramadol can be an acceptable alternative to meperidine for treatment of shivering after spinal anesthesia.

BACKGROUND AND OBJECTIVE: Noise is one of risk factors threatening health, which can affect on blood pressure. Dwellers surrounding airport and pilots are more susceptible to hypertension, because they are exposed to noise chronically. The objective of this study was to determine the relation between ranges of aircraft noise exposure and incidence of hypertension in airport staff.METHODS: This case-control study was done on 145 personnel of airport who exposed to aircraft noise as case, and 132 personnel as a control that was no exposed to noise. All of subjects were men and controls were similar in regard to demographic factors with cases. The blood pressure of subjects was measured by an experienced nurse in two sequences when the subjects were in relaxation and sitting situation. The period time between each measurement was ten minutes. The blood pressure of subjects were divided into normal, high normal, stage I hypertension, stage II hypertension, stage III hypertension and abnonnal hypertension. Noise exposure assessment carried out with cel-440 sound meter and then Leg was calculated. After completing questionnaire, data was analyzed.FINDINGS: The results showed that the mean of systolic hypertension in case group was 12.3±1.3 while in controls was 11.6±0.9 that there was a significant relationship between them. The mean of diastolic in case and controls were 7.9±0.8 and 8±0.7 respectively and there was not a significant difference. The prevalence odds ratio for high abnonnal hypertension was 16.4 (95% CI: 2.3 to 21.5) among airport staff versus controls.CONCLUSION: The findings of this study showed that exposure to noise higher than permissible value in different parts of airport causes an increase in systolic blood pressure. Therefore, in order to prevent cardiovascular disorders, worker's blood pressure must be investigated continually.

BACKGROUND AND OBJECTIVE: Insulin resistance is a risk for many cardiovascular diseases that the effect of it on prognosis and etiology is not clear. The aim of this study was to determine the association of admission insulin resistance index (AIRI) with prognosis in non diabetic patients with acute coronary syndrome (ACS).METHODS: This analytical study was done on 90 non diabetic patients with ACS in three groups; including UA (unstable angina), STEMI (ST-elevation myocardial infarction) and NSTEMI (Non-ST-elevation myocardial infarction) in CCU ward of Shahid Beheshti hospital, Babol, Iran. The diagnosis of acute myocardial infarction was based on clinical criteria, elevation of cardiac enzyme and ECG (Electrocardiogram) changes. All of patients followed tor complications and ejection fraction within 15 days after admission. 5 cc bloods were obtained from all patients and insulin level and fasting blood sugar were measured after admission. Other data including history of diabetes, hypertension, smoking, family history, sex and age were recorded for all patients.FINDINGS: The mean age, sex distribution and distribution of cardiac risk factor (smoking, hypertension, hyperlipidemia, coronary artery disease, and family history) did not show significant difference between three groups. The mean of AIRI for NSTEMl, STEMI and UA was 6.9±6.6, 10.5±10.8 and 8.6±8.8, respectively. There was no significant difference between the mean AIRl in patients with complication (7.9±9.1) and without complication (8.7±8.8).CONCLUSION: The results of this study showed that AIRI does not seem suitable for detection of non diabetic ACS patients with left ventricular dysfunction.

BACKGROUND AND OBJECTIVE: Historically, patients were fasted following abdominal surgery until return of bowel sounds or passage of flatus.The aim of this study was to evaluate the effect of early feeding after caesarean section on the possible adverse gastrointestinal effects and women's satisfaction.METHODS: In a clinical trial at Shahid Sedughi hospital, Yazd, 220 women delivered by cesarean were randomly divided into two groups. A clear liquid drink was given to 110 women in the early feeding group 2 hours after surgery, and to 110 women in the control group 12 hours after surgery. If the drink was tolerated, solid foods were then given. Two groups were compared in terms of bowel sounds, flatus, nausea and vomiting, women's satisfaction and hospital stay.FINDINGS: Early feeding group was earlier in first bowel sound, first post operation flatusand defecation. Regular diet is tolerated earlier in early feeding group than delayed feeding group (8.6±2.1 versus 20.9±5.9 hour, p=0.00). There were no significant differences in postoperative gastrointestinal complications. Mean duration of hospitalization was 26.6±4.3 h in early feeding group and 54.1±3.8 h in delayed feeding group (p=0.00). The women's satisfaction in the early feeding group was higher than delayed feeding group (79.2±12.1 vs 50.1±13.9, p=0.01).CONCLUSION: Early oral feeding after cesarean delivery was associated with early tolerated regular diet, low duration of hospitalization, high women's satisfaction and no significant adverse gastrointestinal effects compared with delayed feeding.

BACKGROUND AND OBJECTIVE: Emergency care unit in the hospital should be able to save people's lives when they are in danger and offer the emergency medical services. Factors such as personnel, space, and equipment can indicate the rate of preparedness and efficiency of emergency department and these criteria can be applied to compare the hospitals. The objective of this research was to study the structure of personnel, space and equipment in emergency care units of Babol University of medical sciences, Babol, Iran based on national standards in 2007.METHODS: This cross sectional study was performed on technical directors of emergency department, hospital administer, chief nurses, head nurses and supervisors of the hospitals of Babol medical University. The data gathered by questionnaireFINDINGS: Average number of servants and nursing, assistants was I person and less than I person in each work shift. The average of space for each bed in emergency ward was 50 m2. There was a severe lack of space for emergency ward in Amirkola hospital. According to investing medical equipment, some items were less than standard limited and some were higher. In accordance with consuming medical equipment, there was not a difference between them and national standards.CONCLUSION: The results showed that the number of low level personnel needs to be increased and the courses related to management of emergency and triage for higher level personnel is required. In investing equipment part, it seems that some equipment should be repaired and replaced.

BACKGROUND AND OBJECTIVE: Evaluation of health system services is necessary first step for offering services and clients' satisfaction is one of the important factors considered in evaluation. The objective of this study was to evaluate clients' satisfaction with health and therapeutic services offered by urban health care centers of Shahid Beheshti University of medical sciences.METHODS: This cross sectional study was performed on 496 patients who referred to 25 urban health care centers. Data was gathered based on Likert scale, interview and questionnaire.FINDINGS: Mean±SD age of clients was 30±12.5 years and 69.7% of them were female. The percentage of satisfaction with therapeutic services was 60.5% and with health services was 64.6%. Satisfaction level with medical services (68.6%) and family planning (69.4%) was high and with dentistry (51.5%), pharmacy (45.3%) and vaccination services (57.8%) was low. Regarding health education, maternal-child health and injection and dressing services, percentage of satisfaction was middle. Clients who lived at the distance of less than 3kms to health care centers and those with low education level showed significantly higher satisfaction.CONCLUSION: According to the result of this study, offering services to clients in some cases was not suitable. So it is recommended to set up suitable referral system in order to promote clients satisfaction.