JOURNAL OF BABOL UNIVERSITY OF MEDICAL SCIENCES (JBUMS)
Year:2009 | Volume:11 | Issue:2 (49)|Papers Count:15

BACKGROUND AND OBJECTIVE: Co-administration of cyclosporine and erythromycin can cause nephrotoxicity which could be a result of interaction in absorption and/or metabolism level. The purpose of this work was to investigate the interaction of erythromycin and cyclosporine in absorption level to evaluate the effect of erythromycin on cyclosporine absorption quantitatively. The stability of drug at 37oC and its adsorption to plastic syringe and tubes were also investigated.METHODS: 32 Wistar rats weighting between 200-300 g were used in the present study. They were divided into 4 test groups and 4 control groups. A jejunal segment of anaesthetized rat was cannulated and perfused by concentrations of 20, 15, 10 and 5 micromolar of drug in the presence and absence of 150 micromolar erythromycin by flow rate of 0.2 ml/min. Samples were obtained up to 90 min. Drug concentrations were assayed in different time points. The drug effective permeability values were calculated for its different concentrations in different experiments. A reverse-phase HPLC method was used for analysis of all samples.FINDINGS: The cyclosporine effective permeability values were increased from 22.1-33.4 (´10-6) cm/sec in control group to 37.2-53.4 (´10-6) cm/sec in test group that this difference was significant (p<0.05). Moreover cyclosporine was stable and only 4-5% loss of drug was observed at the end of experiment. However there was a significant adsorption of drug to syringe and tubing.CONCLUSION: Based on obtained results cyclosporine is a low solubility and high permeability drug. At least some part of clinical interaction between cyclosporine and erythromycin is due to interaction in absorption level.

BACKGROUND AND OBJECTIVE: Neuropathic pain is a consequence of disease or trauma to peripheral nerves or the central nervous system. In spite of so many people suffering from neuropathic pain it is still extremely difficult to treat. The aim of this study was to examine the cumulative effect of adrenal transplantation and intrathecal injection of histogranin (HN) on pain behavior in neuropathic rats.METHODS: In this experimental research 20 rats were allocated to 2 groups, 10 rats in each. One week after unilateral sciatic nerve ligation using chronic constriction injury (CCI) model, animals received either adrenal medullary or control striated muscle tissue transplantation in lumbar part of spinal cord. One week after animals received different doses of HN (0.5, 1, 3, 6 mg/10ml) or saline interathecally. Behavioral tests were preformed before induction of CCI, before transplantation, before injection and 10 min after injection of HN.FINDINGS: CCI caused heat and mechanical hyperalgesia. In adrenal transplanted animals heat and mechanical thresholds in animals which received low dose of histogranin (0.5 mg/kg) was 9.3±0.6 and 9.5±1.1, respectively which increased comparing to before injection time (p<0.05). Injection of 6 mg HN was not effective. In muscle transplanted animal’s only higher dose of histogranin increase thermal threshold. Thermal threshold in this groups increased from 6.4±0.35 before injection time to 9±0.9 after injection of 3 mg of HN (p<0.05). However alleviation of pain was significant with the lower doses of histogranin in adrenal medullary transplanted animals (p<0.05).CONCLUSION: The results showed that the pain alleviation effect of histogranin when accompained with adrenal medullary graft is dose dependant and low doses of histogranin can augment the effects of adrenal medullary transplants and may be an effective adjunct in the treatment of chronic pain.

BACKGROUND AND OBJECTIVE: Atypical antipsychotic drugs are first line treatment for psychotic disorders and well tolerated by the patients because of less extra pyramidal side effects and better efficacies. But there are different reports about metabolic dysfunctions that are associated with use of these drugs. So the aim of this study was to compare these side effects among atypical antipsychotic drugs (clozapine, olanzapine, risperidone) and haloperidol.METHODS In this cohort study psychotic patients (according to DSM IV criteria) due to their response to previous treatment regiment or new onset of disorder were received clozapine, olanzapine, risperidone (atypical group) and haloperidol (typical group). Patients who were resistant to other drugs treated with clozapine and bipolar patients received olanzapine. Fasting blood level of glucose, cholesterol and triglyceride of all patients were measured before initiating and six weeks after drug administration.FINDINGS: 75 inpatients or out patients with variety of psychotic disorders enrolled the study, as 45 patients were in atypical and 30 in typical drug groups. Two groups were matched by age and sex. The mean level of fasting blood glucose, triglyceride and cholesterol of patients in atypical drug group before treatment was 90.7%±16.2, 144±35.5 and 163±25.1 mg/dl, respectively and in typical group it was 88.6±27, 162.3±38.5 and 164.2±25 mg/dl, respectively. The mean level of fasting blood glucose, triglyceride and cholesterol of patients in atypical drug group after treatment was 94.4±13.1, 168±50.8 and 168.6±33.5 mg/dl, respectively and in typical group was 92.9±27, 175.3±45.9 and 164±26.5 mg/dl, respectively that showed no significant difference.CONCLUSION: Antipsychotic drugs (either typical or atypical) didn’t increase fasting blood level of glucose, cholesterol and triglyceride in psychotic patients.

BACKGROUND AND OBJECTIVE: Helicobacter pylori (HP) are one of the most important causes of chronic stomach infection, chronic gastritis, peptic ulcers and stomach cancer in men. Designing rapid, simple and less expensive techniques for its diagnosis lead to early treatment and preventing several complications due to H. Pylori infection. The aim of this research was to compare invasive (histology) and non invasive (serology) methods in HP detection in patients with dyspepsia.METHODS: This analytical study was performed on 150 patients with dyspepsia who referred to Yahyanejad hospital in Babol medical University. All of the patients underwent endoscopy and biopsy was taken from gastric antrum. For detecting helicobacter pylori histological examination by Giemsa staining was done in biopsy specimens and for serologic study serum levels of IgG and IgA were measured by ELISA. Data were statistically analyzed.FINDINGS: From all 150 patients with dyspepsia, serology was positive in 80.7% (n=121) and histology of antrum specimen was positive in 90% (n=135). Positive histology was seen in 76 males (56.3%) and 59 females (43.7%). In our study, accuracy, sensitivity, specificity, negative predictive value and positive predictive value of serology technique were 78.6%, 82.9%, 40%, 20.6% and 92.5%, respectively. The sensitivity and specificity were 77% and 40% for IgG and were 51.8% and 86.6% for IgA. Accuracy of serology in males was more than females (81.2% vs. 75.7%). CONCLUSION: According to the high sensitivity, low specificity, simplicity, rapidity and lower cost of serologic examination in comparison with histological evaluation for Helicobacter pylori detection in our population, serology can be applied as the best major technique in screening and epidemiological evaluation of H. pylori detection. This report suggests that serological examination must be employed with other standard assessments in diagnosis of H. pylori infection.

BACKGROUND AND OBJECTIVE: Asthma is one of the most frequent chronic respiratory diseases and relation between caesarean and asthma is controversy. Regarding high number of caesarean in this area, the aim of this study was to determine the relation between asthma and mode of delivery in the asthmatic children compared with the control group.METHODS: This case-control study performed on 512 children in case and control groups that were between 3 to 14 years. Case group included children with asthma and control group included children without asthma that referred to Amirkola hospital. Case and control were matched by age. The collected information for both group contained: mode of delivery, demographic variables and effective factor for asthma.FINDINGS: There was cesarean in 159 subjects (62.1%) of case group and 147 subjects (57.4%) (OR=1.2, CI95%: 0.8-1.7) that showed no significant difference. Distribution of sex, passive smoking, gestational age, hospitalization due to severe respiratory infection in first year that there was no significant difference between case and control groups but contact to pets in control and family history of asthma in case group were significantly higher (p<0.05).CONCLUSION: The results of present study show that there was no relation between mode of delivery and asthma in children.

BACKGROUND AND OBJECTIVE: Perineal pain due to episiotomy is a stressful problem for women and in the first day of postpartum has more severity. The aim of this study was to investigate the efficacy of lidocaine gel 2% in relieving pain after a vaginal delivery with an episiotomy.METHODS: In a randomized, double-blind, placebo-controlled trial, 150 women who had episiotomy received lidocaine gel 2% (n=75) or a placebo (n=75). Two groups were matched for age, pregnancy age, parity, education, nationality, infant sex and weight, kind of episiotomy, consumption of pethidine in labor, person's repair, consumption of analgesic in postpartum. After episiotomy we administered lidocaine gel and lubricant gel for women in experimental and control groups, respectively. Then pain ratings were recorded before the administration of the drugs and at 6 and 12 hr after the first dose, according to a numerical and verbal rating scale. Data were analyzed.FINDINGS: Average pain scores before using lidocaine gel in control group was 2.9±2 and in case group was 3.3±1.8. Twelve hours after using gel mean of pain score was 2.6±2 in case group and 3.6±2.4 in control group (p=0.009). Analgesia used in 6 subjects (8%) in case group and in 15 subjects (20%) in control group (p=0.034). There weren't any adverse effect with lidocaine gel uses.CONCLUSION: This study suggested that lidocaine gel is a safe and effective method for episiotomy pain relief in first day of postpartum.

BACKGROUND AND OBJECTIVE: Pregnancy, neonatal and fetal complications are higher in twin than singleton pregnancy. Considering use of assisted reproductive technology (ART) and twin births is increased, the aim of this study was to compare the complications in spontaneous vs. assisted conception twin pregnancies for recognition of high risk mothers and prevention and treatment of them as soon as possible.METHODS: This analytical study was performed on 40 assisted conception twin pregnancies and 80 pregnant women with spontaneous twin pregnancies. Two groups were matched for age. Maternal morbidity (preeclampsia, preterm delivery) and neonatal complications (Intra uterine growth restriction and low birth weight) were recorded and compared.FINDINGS: Mean gestational age in spontaneous pregnancy was 34.4±3.2 weeks and in ART pregnancy was 33.7±2.1 weeks that showed no significant difference. Gestational diabetes was in 13 versus 8 cases (p=0.004), intrauterine growth restriction in 3 cases versus 0 (p=0.035) and transfer to neonatal intensive care unit 30 cases versus 26 (p=0.000) in ART pregnancy and spontaneous, respectively. Birth weight in ART pregnancy was significantly lower than spontaneous group (p=0.002, 0.004). Premature rupture of membrane, preeclampsia, placental events, intrauterine fetal death and gestational age had not significant difference between two groups.CONCLUSION: Because some of maternal and fetal morbidity in twin pregnancies was higher in assisted conceptions than spontaneous conception, these patients need closer prenatal care.

BACKGROUND AND OBJECTIVE: Brucellosis is a zoonotic disease in the world. It has been shown that host resistance to brucella bacteria depends on Th1 response, whereas Th2 response is involved in the severity of the disease. It is suggested that CD26 and CD30 are surface molecules expressed on activated Th1 and Th2 cells, respectively. The aim of the present study was to determine the levels of soluble (s) CD26 and CD30 molecules in sera of brucellosis and healthy controls.METHODS: The study included 90 brucellosis patients and 70 healthy controls. Brucellosis was diagnosed base on clinical findings, microbiologic or/and serologic findings. The levels of sCD26 and sCD30 were determined by a sandwich enzyme-linked immunosorbent assay in sera of study population.FINDINGS: Serum levels of sCD26 were 847.07±249.7 and 504.97±165.6 ng/ml in brucellosis and controls, respectively, which shown a significant difference (p<0.0001). Meanwhile, there was no significant difference in sCD30 levels between brucellosis and controls (51.33±35.9 and 42.75±20.87 IU/ml).CONCLUSION: These findings indicate that assessment of sCD26 and sCD30 levels are a valuable and quick method for evaluating immune response to brucellosis.

BACKGROUND AND OBJECTIVE: Due to aspect of biomechanical and neuromuscular, intermuscular coordination have a major role in function of knee joint and prevention of knee joint injuries. The purpose of this study was to characterize the effect of velocity and fatigue on the intermuscular coordination of hamstrings and quadriceps muscles.METHODS: This study is quasi-experimental that was done on 31 healthy and non-athletic subjects (24 women, 7 men) aged between 20-30 years. They were selected by convenience non-probable sampling method. Subjects performed sixty knee flexion and extension with maximum voluntary effort at the velocity of 45o/s. Surface EMG of quadriceps and hamstring muscles was recorded for the study of EMG onset time during extension of the knee joint in the velocities 45o/s, 150o/s and 300o/s by isokinetic dynamometer before and after fatigue. Then data were compared.FINDINGS: The findings showed in various velocities of fatigue and non fatigue conditions, EMG onset of hamstring muscles related to quadriceps muscles are delayed. The average of these delayed time decreased with increasing velocity in non-fatigue condition: 45o/s=74.3±13.2 ms, 150o/s=50±7.5 ms, 300o/s=53.8±7.2 ms (p<0.05) and in fatigue condition: 45o/s=68±8.8 ms, 150o/s=50.8±11.6 ms, 300o/s=48.3±4.4 ms) did not change with increasing velocity.CONCLUSION: The results of this research showed that higher velocity have more effect on delay onset time of hamstrings and quadriceps muscles activations. In fact, we can say that significant changes are related to effect of velocity not fatigue.

BACKGROUND AND OBJECTIVE: The deep cervical flexor muscles have a major role to play in neck stabilization and evidence suggests that these muscles especially longus colli muscle (LCM) becomes dysfunctional in the presence of neck pain. Therefore, measurement of these muscles in healthy subjects and patients may be of great value to understand the stabilization function of the muscles. The purpose of this study was to assess within and between days reliability of LCM size measurement using ultrasonography (US) in a group of healthy subjects and a group of patients with chronic neck pain.METHODS: This methodological research was performed on 10 patients with chronic neck pain (27-44 years old) and 15 healthy subjects (19-41 years old). Neck LCM size was measured at the level of thyroid cartilage using a real time US device. Two images were taken on the same day with an hour interval to assess the within- day reliability and the third image was taken one week later to determine between- days reliability. Cross sectional area (CSA), anterior posterior dimension (APD), and lateral dimension (LD) were measured at each time. The shape ratio was calculated as LD/APD. Then data were compared using statistical tests.FINDINGS: The ICC measurements for within day and between days reliability in healthy subjects were varied ranging from 0.8 to 0.9 for CSA, 0.9 to 1 for APD, and 0.6 to 0.9 for LD. In patients group it was also ranged between 0.8 to 0.9, 0.8 to 0.9, and 0.7 to 0.9, respectively. The highest reliability score were found for CSA measurement in healthy subjects (ICC= 0.90-0.93).CONCLUSION: The results indicated that US could be a reliable tool to measure the LCM dimensions in healthy subjects and patients with chronic neck pain. Therefore, the non invasive method can be used to follow up the effect of exercise therapy interventions.

BACKGROUND AND OBJECTIVE: The presence of physical complaints of unknown etiology is a fairly common occurrence in pediatric populations and often interferes with school, home life, and peer relationships. There are potential relationships among parental illness, parental stress and particularly, negative parent-child relationships and dysfunctional parenting style and children's somatic complaints. The purpose of this study was to investigate the effect of the triple p-positive parenting program on children with somatic complaints.METHODS: This research is a semi-experimental design with pre-post test and control group. Eighteen mothers whose children had received scores above of cut-point (T=64) on somatic symptoms subtest of child behavioral checklist (CBCL) and their problems were also confirmed by the teacher report form (TRF) were selected and randomly allocated to the experimental (n=9) and control (n=9) groups. Experimental group received triple-p for 8 weeks, single a week sessions lasted two hours. Both groups of mothers were evaluated again by CBCL.FINDINGS: Mean age of subjects in experimental group was 32.2±4.4 and in control group was 31.8±4.3 years. In control group, mean pre-test score was 3.8±0.8 and mean post-test score was 3.6±0.9. In experimental group, mean pre-test score and mean post-test score was 3.7±0.7 and 2.8±1.1, respectively. Also difference in score in control group was 0.2±0.4 that showed a significant difference (p<0.05).CONCLUSION: This research showed that the triple p-positive parenting program should be implemented for parents without considering their children's age and sex.

BACKGROUND AND OBJECTIVE: Bilateral femoral neck fracture is a rare injury, mostly seen in adults often with bony and metabolic disorders. This injury occurs very rarely in children and only few of them have been reported, our case being one of them. In this article the aim is emphasis on early diagnosis and prompt treatment.CASE: A 4 years old boy was referred after a heavy object fell on his pelvis. The child did not allow for careful physical examination but both hips movements were tender. Pelvis radiogram was obtained which revealed bilateral femoral neck fractures with fractures of iliac wings and pubi. Early surgical treatment with close reduction and pin fixation of the fracture via surgical incision after evacuation of hematoma was performed. The patient was followed up for two years and fortunately developed no problem.CONCLUSION: Bilateral femoral neck fracture is extremely rare in children, but in patients with pelvis trauma it should be suspected and the radiograms should be carefully reviewed.