JOURNAL OF BABOL UNIVERSITY OF MEDICAL SCIENCES (JBUMS)
Year:2008 | Volume:10 | Issue:3 (44)|Papers Count:15

BACKGROUND AND OBJECTIVE: Stroke is one of the leading causes of death and disability in the world. Previous studies have demonstrated that a-tocotrienol (a-TCl) and rosiglitazone (RGZ) reduce ischemic damage by middle cerebral artery (MCA) occlusion when administered before ischemic stroke in mice and rats. The aim of this study was to investigate the neuroprotective effects of a-TCT and RGZ at 3 hours after cerebral ischemia.METHODS: In this experimental study, stroke as induced by embolizing a preformed clot into the MCA. Male Wistar rats (300-350 gr) were assigned to a-TCT (lor 10 mg/kg), rosiglitazone (RGZ) and sham-operation. The drugs were injected i.p. Stained brain sections were scanned and infarct area were determined using a picture analyzer software.FINDINGS: Forty eight hours after embolic ischemia, infarct volume in the control, RGZ, low and high doses of a-TCT were 29.4±2.6%, 15.9±3.1%, 24.9±2.1%and 29±4.8%, respectively.There was a significant difference between control and RGZ groups (p<0.05). Compared to the control group, the low and high doses of a-TCT didn't show any significant difference.Furthermore, only RGZ decreased neurological deficits (p<0.05) and sensory impairments (p<0.01).CONCLUSION: Administration of a-TCT at 3 hr after induction of cerebral ischemia is not neuroprotective but RGZ may have beneficial effects on treatment and management of stroke. So further studies are needed to Survey the neuroprotective effects of a-TCT after stroke.

BACKGROUND AND OBJECTIVE: Different ideas have proposed for translation and rotation values of lumbar vertebrae in sagittal plane that is a challenge for physicians. Calculating method can be one of the difference sources. Of the proposed methods, two common methods are Dupuis and Panjabi methods that have very similarity. Therefore the objective of this study was to compare these two methods.Methods: There were 66 males aged between 20-45 years participated in this study. Radiographic variables contain vertebral translation and rotation in sagittal plane which were calculated with Dupuis and Panjabi methods. The Put to method was used for flexion- extension radiography. Three radiographies were taken in neutral, full flexion and full extension positions. The variables were calculated using CARA software after scanning.FINDINGS: Results demonstrated that the mean differences between two methods for translation of L1 (p=0.19), L2 (p=0.15), L3 (p=0.12), 14 (p=0.89) segments were not significant. The mean differences between two methods for rotation of L1 (p=0.13), L2 (p=0.32), L3 (p=0.08), L4 (p=0.11) segments were not significant. In addition, the correlation of variables between two methods in lumbar segments was high.CONCLUSION: There was not a significant difference between Dupuis and Panjabi methods in calculation of lumbar vertebral translation and rotation. However, calculating translation and rotation of L5 vertebra is not possible using Dupuis method, utilization of Panjabi method would have a better result in clinical point of view.

BACKGROUND AND OBJECTIVE: The main purpose of radiotherapy is exposing enough doses to tumoral volume and protecting the normal tissues around it. Tumor dose for each fraction in radiotherapy prescribes with tumoral tissue consideration. Since viral diseases can affect cell radiosensitivity, this study was done to evaluate the radiosensitivity of tumoral cell that infected with virus.METHODS: In this study the radio sensitivity of HeLa cell with and without the viral agent of polio disease was obtained and compared after gamma radiation of cobalt 60. Different polio vaccine was used to infect cell with polio virus. Finally calculated the percentage of plating efficiency and relative survival at radiated and control cells with colonies countering.FINDINGS: Results implicate that cell death increases up to 20-30% for contaminating with low concentrations of polio virus, 30-40% for moderate concentrations and 70-90% for high concentrations after 2Gy irradiation by cobalt 60.CONCLUSION: Results of this study showed that existing of viral disease in tumoral region can increase radiosensitivity of tumoral cells. Therefore non cancer disease in region under irradiation should be noticed to prescribing dose fraction in radiotherapy of cancers.

BACKGROUND AND OBJECTIVE: Human brucellosis is a worldwide zoonotic infectious disease that can be transmitted between animals and humans. Cattle owners who have occupational contact with animals are at the risk of this disease. Evaluation of production of cytokines especially IL-10 and IL-12 are important factor in investigation of immune response against a variety of intracellular pathogen, vaccination and other immune reactions. In the present study, the cytokines induced during this infection determined the level of IL-10 and IL-12 in serum of cattle owners with brucellosis and without brucellosis compared with health controls.METHODS: This cross-sectional and descriptive study was performed on 30 cattle owners with brucellosis and 30 cattle owners without brucellosis and 20 person of health control. Then 5ee blood sample have been taken from donors and cytokines IL-10 and IL-12 of ELISA were determined by Disclose Company.FINDINGS: The mean serum IL-10 level of cattle owners with positive brucellosis (133.6±20.4) and negative brucellosis (55.5±29.2) compared with the health control (16.1±3.2). This difference was statistically significant (p<0.05). Considering the results of this investigation the mean IL-12 level in positive brucellosis cattle owners (16.6±14.7) and negative bn1cellosis (15.2±8.6) compared with the health control (3.7±0.8). However production of IL-12 response to brucella antigenic in positive brucellosis cattle owners and negative brucellosis was increased in comparison to the health control, differences between the values was not significant. CONCLUSION: Increase of IL-10 indicated relationship between brucellosis and Th2 cell response. Control of immune response can be effective in the treatment of disease.

BACKGROUND AND OBJECTIVE: Clomiphene citrate is the first-line treatment in patients with ovulatory dysftmction, but it may be associated with side effects for example multiple follicles, multiple pregnancy and adverse effects on endometrial growth. Nowadays, it is considered to use letrozole for induction ovulation. The aim of this study was to compare letrozole with clomiphene citrate for ovulation induction, in patients with polycystic ovarian syndrome (PCOs).METHODS: This clinical trial study was performed on 107 PCOs patients. They divided into two groups. Group one received 100mg clomiphene citrate (n=57) and group two received 5mg letrozole (n=50) daily on days 3-7 of their menstrual cycle. Human chorionic gonadotrplin (bCG) at a dose of 10000ID was administered when at least one mature follicle was observed. A single IUI was performed 34 hours later. Then size and number of mature follicles, ovulation rate, endometrial thickness and pregnancy rate was measured.FINDINGS: The number and the size of mature follicles were similar between two groups. The pregnancy rate in letrozole was 6% higher than clomiphene group (20% vs. 14%) that did not show significant difference. Endometrial thickness in letrozole and clomiphene citrate group was 64% and 64.9%, respectively. 86% of patients developed mature follicle in letrozole group who all of them showed ovulation. But in 72% of patients in clomiphene citrate group was developed mature follicles.CONCLUSION: Letrozole may be an acceptable alternative to clomiphene citrate for ovulation induction and pregnancy rate in PCOs patients.

BACKGROUND AND OBJECTIVE: Nowadays, for pain relief in labor, there are pharmacological and nonpharmacological methods which are used in obstetric field. One of these methods is irritation of painful area by painful stimulus which is seemed that release local endorphin and act base on gate theory. So, this study was carried out to evaluate the effect of normal saline and distilled water injection in painful sacrum on back pain in first stage of labor. METHODS: This randomized clinical trial study was done on 140 volunteers who were selected by simple sampling method and then randomly allocated to two groups, 70 participants in case and 70 participants in control. Four areas selected on sacrum for injection of distilled water (0.1 cc) and saline normal (0.1 cc). Then, in the 10th. 30th, 45th, 90th minutes of post injections, pain was estimated in both groups by VAS method which is a standard scale. Data was analyzed by paired t- test, X2 and t-student.FINDINGS: Mean pain was not significant in 2 groups in the 10th. 30th minutes. Mean of preinjection of saline normal was 54.5±34.1 which showed a significant difference with post injection in the 45th minute (61.1±29.5, p=0.02) and, in the 90th minute (65.3±32.1, p=0.01). Mean of reinjection of distilled water was 54.5±33.2 which was significant with post injection in the 45th minute (58.2±29.5, p=0.02) and in the 90th minute (64.1±30.9, p=0.006).CONCLUSION: Data showed that subcutaneous injection of distilled water and normal saline in sacral area did not increase and decrease pain significantly up to 30 minutes, but after 30 minutes, the pain in both two groups increased that the injection frequency may cause a better results.

BACKGROUND AND OBJECTIVE: Pain is a common phenomenon and an inevitable part of process of childbirth. Effective control of labor pain like other acute pains is very important for health and society. The aim of this study was to determine the effect of heat therapy on pain severity and duration of labor in primigravida women.METHODS: In this clinical trial study, 64 low risk mulliparous women were randomly divided into two groups (heat therapy and routine care groups). The control group got routine cares in obstetrics ward and heat therapy group in addition to these cares used warm bag for the low back from cervix dilatation of 3-4 cm to the end of first stage, of labor and for perinea at the second stage. The intensity of labor pain was determined by Mc Gill pain questionnaire and duration of labor was determined by digital clock. Data was analyzed with t-test and chi square and Mann Whitney test (p=0.05).FINDINGS: Mean of pain intensity in first stage of labor in heat therapy group was 8.1±1 and in control group was 8.9%1and mean of pain intensity in second stage of labor in heat therapy group was 8.3±1.9 and in control group was 9.9±1.9 (p=0.01). Also, in heat therapy group duration of the first and third stages of labor decreased. Mean of duration of the first stage of labor in heat therapy group was 16.6±74 minutes and in routine care group was 219.8±5.6 minutes meanwhile mean of duration of the third stage of labor in heat therapy group was 7.3±2.4 minutes and in routine care group was 10.8±3.4 minutes (p<0.001) but duration of second stage of labor showed no significant difference between two groups.CONCLUSION: According to the results of this study, it seems that heat effects on the pain severity of first and second stages of labor and duration of the first and third stages of labor.

BACKGROUNDAND OBJECTIVE: Several studies have shown that hospitals with trained and designated emergency personnel have improved survival performance and hospital discharge. The aim of this study was to determine the effect of trained team on improving the outcomes of cardiopulmonary resuscitation (CPR) in Imam Khomeini hospital, Tehran, Iran.METHODS: This clinical trial study was performed on 87 patients as control group and 53 as intervention group. In control group, after announcing CPR code, routine team (a nurse, Intern and medical resident) performed CPR. In intervention group CPR team included two trained nurses and an emergency medicine resident that were present in emergency department A checklist was used to evaluate the performance and quality of CPR team that was prepared based on American heart association. Physiologic variables and patient condition was obtained from the file. Data was analyzed by parametric and non-parametric statistical methods and p<0.05 was considered significant.FINDINGS: The results showed that the mean age of resuscitated patients in control group was 58.1±19.6 that in comparison to second group (59.4±19.2), there was no significant difference. Also there was no significant difference in physiologic variables of patients before occurrence of cardiac arrest in two groups. However survival in males was more successful but this difference was not statistically significant There was a significant difference in survival after CPR, between control and intervention group (18.4% versus 30%, p<0.01 and also the mean of hours' survival 28 versus 88.44 hours, p<0.001).CONCLUSION: According to the results of this study, trained and designated emergency personnel have improved event and survival. So CPR team training and continuing education for all nurses and residents should be considered. CPR team should be aware of up to date knowledge of CPR in order to decrease the mortality rate.

BACKGROUND AND OBJECTIVE: Although bone channel reaming before fixation of long bone fractures with intramedullary nailing is associated with obvious benefits, there has been concern about the pulmonary complications. The goal of this study was to assess the effect of bone marrow reaming on paraclinical symptoms of fat embolism like heart rate, blood pressure and arterial blood gases variations.METHODS: In this study, 16 male patients (20 to 35 years old) with lower limb long bone fractures, prepared for closed intramedullary nailing were enrolled in the study and the changes in arterial blood gases, pulse rates and the blood pressures of the patients were controlled. The patients were observed closely for development of fat embolism signs and symptoms until discharge (48 hours after operation).FINDINGS: Mean of systolic blood pressure before and after reaming was 123.2±7.7 and 122.9±8.5, respectively. Also mean of arterial oxygen pressure before and after reaming was 185.3±37.5 and 170.9±52, respectively. No statistically significant difference was found between the blood gases, pulse rates and blood pressure of the patients before and after reaming of the canal.CONCLUSION: Although occurrence of fat embolism during reaming of long bone canals is proved, it doesn't seem to be accompanied with blood gas changes and this is in favor of safety of this method.

BACKGROUND AND OBJECTIVE: Postpartum depression endangers mother's health and has negative effect on her social communication and infant development. Depression symptoms in %50 of women who experience postpartum depression are seen during pregnancy time. The aim of this study was to detect depression symptoms and its effective factors during pregnancy and prevention of familial and individual problems caused by postpartum depression.METHODS: This cross-sectional study was performed on 263 pregnant women referred to health centers of Babol, Iran. All women completed a questionnaire consists of demographic information, obstetrics and standard Beck-test in the last three months of pregnancy and 4-8 weeks after delivery. Rate of depression based on scale divided into three groups: non depression, mild depression and moderate depression. Data was analyzed by Wilcoxon statistical test and Linear Regression.FINDINGS: Mean score of depression symptoms before delivery was 18.7±6.4 and after delivery was 20.4±7.5 that showed no significant difference. There was a significant relationship between age, husband’s job and education, gravidity, family income, worry about delivery expense, history of abortion, reaction to pregnancy, present pregnancy complications, last pregnancy outcome, and education regarding delivery in prenatal care with pre and postpartum depression (p=0.001). There was a significant difference between type of delivery, postpartum complication and inconsistency between infant and mother’s benefit with postpartum depression (p=0.001). But there was no significant relationship between woman’s job and living place with pre and postpartum depression.CONCLUSION: According to the results of this study, pregnancy is a proper time for screening mothers for postpartum depression. Considering negative effect of this disorder on family, more attention should be given to its related factors.

BACKGROUND AND OBJECTIVE: Cardiovascular diseases are the leading cause of mortality in Iran (46% of all deaths). 10-30% of patients referred to emergency ward had acute coronary syndrome (ACS), and 1-4% cases with acute coronary syndrome and 2-3% of patients with myocardial infarction discharged mistakenly. The aim of this study was to delineate final diagnosis and characteristics of patients admitted with primary diagnosis of acute coronary syndrome (ACS).METHODS: This cross sectional study was performed on patients with primary diagnosis of acute coronary syndrome admitted in cardiac ward of Loghman hospital from 2003 to 2004. History and physical examination were done before hospitalization. After hospitalization, the result of echocardiography, angiography and electrocardiography was recorded for final diagnosis and then with considering clinical and paraclinical findings, diagnosis was confirmed. Also their family history, current smoking and history of myocardial infarction were surveyed. Test of X 2 and t-test were used for analyzing qualitative and quantitative variables respectively and p<0.05 was considered significant.FINDINGS: From 1015 patients, 116 had primary diagnosis of acute coronary syndrome that 51.6% of patients were female and their mean age was 58.9±12.9 years. Their final diagnoses were acute myocardial infarction in 196 cases (32%), possible unstable angina in 159 cases (26%), definite/probable unstable angina in 135 cases (22%) and non cardiac chest pain in 121 (19.8%). Mean age of acute coronary syndrome group (490 cases) in comparison with non cardiac chest pain group (121 cases) was more. History of diabetes mellitus, hypertension and myocardial infarction were significantly lower in non cardiac chest pain group. Sex, family history and current smoking were not significantly different.CONCLUSION: Considering about 20% of patients with non cardiac chest pain mistakenly hospitalized in cardiology ward, so it is recommended to provide suitable facilities for primary diagnosis in emergency ward to prevent improper hospitalization and discharge.

BACKGROUND AND OBJECTIVE: Childhood obesity has become a major public health problem in both developed and developing countries because of changing the lifestyles among school children. On the other hand, malnutrition affects the health status of millions of children especially in developing countries. The aim of this study was to determine the prevalence of obesity, overweight and underweight among primary school children in Babol, Iran.METHODS: This cross sectional study was performed on 1000 primary school children aged 7- 12 years in Babol. The data of weight and height were measured by standard method and the data of sport activities and leisure time physical activities were collected by a standard Baecke questionnaire. The diagnosis of overweight, obesity and underweight were assessed by comparing BMI (Body Mass Index) values to the BMI index for age and sex percentiles set by the Centers for Disease Control and Prevention.FINDINGS: The overall rates of underweight, overweight and obesity were 13.5%, 12.3% and 5.8%, respectively. The risk of obesity (3.8% vs. 8.8%) and overweight (12.2% vs. 12.5%) was decreased significantly among females compared with males (age adjusted OR=0.69, 95% CI: 0.50-0.96) and the risk tended to increase after 8 years. Among children with parents at the higher levels of education, the risk tended to increase. The odds ratio was significantly higher among private school children compared with public school (age adjusted OR=2.17, 95% CI: 1.47-3.18) but the prevalence of underweight was more common among public school children. For each additional score of leisure time physical activity, the age adjusted OR significantly decreased (OR=0.73; 95% CI: 0.56, 0.96) (p<0.05).CONCLUSION: The findings indicated that the prevalence of obesity and overweight was higher than underweight. Thus, urgent preventive strategies are required to control the future risk of related comorbidities.