Scientific Journal of Kurdistan University of Medical Sciences
Year:2010 | Volume:14 | Issue:4 (SERIAL NUMBER 54)|Papers Count:14

Background and Aim: Isoniazid is one of the essential first line drugs in TB treatment. Resistance rate to this drug is increasing in many parts of the world. Mutations in KatG and inhA genes are frequently the cause of resistance of mycobacterium TB to INH. The aim of this study was to find a precise method for early detection of mutations associated with resistance of mycobacterium TB to INH.Materials and Methods: After performing sensitivity tests, presence of mutations in special loci of katG and inhA genes in 90 specimens obtained from positive cultures of TB patients was investigated. PCR-RLFP method was used to detect mutations in katG 315 codon. The PCR product resulting from the reproduction of this genetic segment (620 bp) was digested by restriction enzyme MspI. To identify mutations in inhA gene, MAS-PCR technique was used.Results: 34.5% of the INH resistant strains had Thr315 phenotype and 65.5% had Ser 315 phenotype. Thr 315 is 100% specific for determination of INH resistant isolates. Among 52 resistant isolates, 34.6% had Arg and 65.4% had Leu in codon 463. The frequencies of mutations in the (-15C ® T) locus of inhA gene were 20% and 16.7% in MDR and Non MDR isolates respectively.Conclusions: By using PCR-RFLP with restrictive enzyme and MAS PCR mutations in codon 315 of KatG gene and promoter location of inhA gene can be identified. These methods are simpler and cheaper than other methods and provide early accurate and reliable results.

Background and Aim: Transdermal fentanyl can be used for treatment of chronic pain and postoperative pain. The aim of this study was to compare the effect of transdermal fentanyl with that of IV morphine on post thoracotomy pain and their complications.Material and Methods: 40 patients ASA I, II who had been selected randomly for thoracotomy, was divided into two similar groups. After operation, morphine 0.1 mg/kg was administered IV Q6h for morphine group in ICU and in fentanyl group fentanyl patch 50 mg/h was administered 2 hours before operation. Also in both groups morphine 0.1 mg/kg was infused PRN. SPSS13 was used for data analysis & P<0.05 was considered significant.Results: Demographic parameters such as age, sex, weight and smoking were similar in two groups. Decrease of blood pressure was more in morphine group but it was not significant & increase of heart rate was more common in fentanyl group (p<0.01). Pain relief was more in fentanyl group (3.2 vs 4.6 score based on VAS). Morphine consumption in M group was three times more than that of fentanyl group (71±3.16 vs 22.5±9.79).Conclusion: Transdermal fentanyl was more effective than IV morphine for controlling post thoracotomy pain and respiratory changes were similar in both groups. Hypotension in morphine group was more common than that of fentanyl group but tachycardia was more prevalent in fentanyl group.

Background and Aim: Today one of the most important causes of death in the world and our country is cardiovascular diseases. One of the risk factors of these problems is the pathologic changes in the level of serum lipid and lipoproteins. Scientific evidence shows that over weight and obesity are related to high serum lipid and lipoprotein levels. The purpose of the present study was to investigate the effects of strength exercise program of anterior muscles on the body composition and serum lipids of the students of Azad University.Material and Methods: This was a semi experimental study. The volunteer male students of Sanandaj Islamic Azad University were entered into the study selectively after measuring the total subcutaneous fat of subscapular and triceps areas. Finally 27 subjects with a mean age of 20.63±1.09 years and subcutaneous fat of more than 30 mm were selected. They performed Strength exercise on Anterior muscles 3 sessions per week for a total of 8 weeks (24 sessions). The following measurements, were recorded before and after the exercise program blood sampling from anticubital vein in order to determine the level of total cholestrol, and triglycerides (TG), subcutaneous fat of subscapular, biceps, abdomen, triceps and pectoral sites of the subjects by using caliper. Waist, buttocks and abdomen circumfrences of the subjects were also measured by a tape. And finally body fat percentage was estimated by using the method recommended by Boileau, Lohman & Slaughter. The collected data were analyzed by use of paired t test.Results: The result of the study indicated that the Strength exercise program of the anterior muscles had significant relationship with reduction of cholesterol, TG and subcutaneous fat of sub-scapular, abdomen, triceps and pectoralis areas, and also decrease in waist, hips and buttock circumfrences, total body weight, body fat, and body fat percentage of the subjects. However these types of exercises did not have any significant effect on subcutaneous fat of biceps and lean body weight.Conclusion: We concluded this specific strength exercise program of the anterior muscles not only decreases TG and cholestrol but also reduces the fat of the abdomen and other sites of the body, which had not been exercised. On the other hand such execise can produce a reduction in the size of waist and butocks in addition to abdomen.

Background and Aim: Nowadays, MDR strains of mycobacterium tuberculosis are a serious problem in many countries which poses difficulties for TB control program. Since 1990s, spread of MDR TB cases in different parts of the world have been reported which is mainly because of incorrect use of TB drugs. One of the main causes of drug resistance occurring as a complication of human mistakes can be wrong classification and lack of monitoring of the patients during treatment and lack of supervision on the consumption of anti TB drugs. The purpose of this study was to investigate genetic diversity of M.tuberculosis strains isolated from patients by means of MIRU-VNTR technique.Material and Method: In this study 96 mycobacterium tuberculosis strains were isolated from the patients with pulmonary tuberculosis and drug sensitivity tests was performed by MIRU-VNTR technique. Genetic diversity of the strains based on MIRU-VNTR loci was estimated. Allelic difference of each loci was determined by means of statistical HGDI formula.Results: Genetic pattern of sensitive strains showed that these strains belong to families of Dehli/CAS, Haarlem, LAM, H37RV and Caprae. Most drug resistant strains had genetic pattern of Haarlem and LAM families. Loci allelic differences between sensitive and resistant strains were not significant. Based on differentiation index of all strains, 10, 16, 26, 31 and 40 loci had the most allelic differences (HGI ³0.6) and 2, 4, 20, 24 and 27 loci had the least differences (HGI £0.3).Conclusion: The results showed that most genetic diversity of sensitive and resistant strains belonged to Haarlem and Dhli/CAS families and MIRU-VNTR technique used in this study for determination of genetic diversity of mycobacterium strains is a rapid, accurate and cheap method which can be used easily in the populations with high frequency of TB.

Background and aim: One of the important aspects of human life is marriage and marital satisfaction. Marital satisfaction is a situation in which, couples have satisfaction and happy feeling of marriage and living together. The aim of this study was to evaluate the factors influencing marital satisfaction in the students of Islamic Azad University in Sanandaj.Material and Method: This was a descriptive analytic study. The study population included 240 couples in this university who were selected by means of random sampling. The results of this study were collected by means of marital satisfaction inventory (M.S.I) and a researcher made questionnaire. Data analysis was performed by statistical regression test and variance analysis.Results: The results of this study indicated that prediction of marital satisfaction by demographic variables (age, sex, education, occupation and number of off springs) is possible. Other results of this research indicated that with increasing age marital satisfaction decreases and there is a significant relation between marital years and factors such as attractiveness, rapport, attitude and spiritual matters with marital satisfaction.Conclusion: Demographic variables can be used to predict marital satisfaction in university students.

Background and Aim: Unwanted pregnancy is one of the important problems in the world and developing countries in particular Iran. The rate of unwanted pregnancy in Iran is about 25%. Among family planning methods emergency contraception (EC) is the only method that can be used after intercourse and can prevent unwanted pregnancy in 75% of cases. Considering the importance of women's knowledge and practice about this method, the present study was designed in order to determine the level of knowledge and the rate of using EC among married women referring to health-care centers of sanandaj in 2008.Materials and Methods: In this descriptive-analytical study, 400 married women between 15-49 years old referring to health care centers in sanandaj were selected through cluster sampling. The data were collected and recorded in a questionnaire with two parts for demographic characteristics and determination of the level of knowledge with rate of practice of EC. The data were introduced into SPSS software and analyzed by means of variance analysis and chi-square tests.Results: The results showed low level of knowledge in 62.7% of subjects about indications, in 83.5% about method of using and 62.7% about side effects of EC. 61.7% of women had low general knowledge about EC. The level of general knowledge about EC had a significant relation with educational level, employment and history of using EC (P<0.05).8.75% of the women had history of appropriate practice of EC.Conclusion: Considering the interest of most women to use this method, the rate of unwanted pregnancies and their complications can be reduced hopefully by increasing the quality of family planning consultations and proper education about using EC method.

Background and aim: Breast cancer is the most important malignancy in women, leading to mortality and morbidity in most developed and many developing countries. Considering increasing rate of incidence of breast cancer in Iran molecular investigation seems necessary. In several studies BRCA1 gene mutations had been investigated but in contrast to familial cases, the incidence of non genetic breast cancer is very high. The aim of the present study was to evaluate the role of BRCA1 gene mutations in sporadic cases of breast cancer.Material and Methods: In this study we used PCR-SSCP technique to detect BRCA1 mutations. Thirty paraffin-embedded human breast specimens were reviewed by a pathologist. The specimens had been obtained from the patients with sporadic breast cancer who had been operated in Imam Reza and Taleghani Hospitals in Kermanshah. Tumor samples were studied by use of PCR-SSCP technique to detect mutations in exon 5, exon 11A (300bp) and exon 11B (296bp) of BRCA1 gene. X2 test was used for data analysis.Results: Mutations were detected in 6 cases (20%) 4 cases (13.3%) in exon 5, and 2 cases (6.7%) in exon 11B. No mutation was detected in exon 11A.Conclusion: Our results suggested exon 5 and exon 11B gene mutations contribute to the development of breast cancer in sporadic cases.

Background and Aim: Current therapeutic regimens used for eradication of H.pylori consist of two antibiotics with proton pump inhibitors and bismuth compounds. Clarithromycin is the most important antibiotic used for treatment of H.pylori infection in Iran. The aim of this study was to identify clarithromycin resistance in H.pylori strains and evaluate role of A2143G, A2142G and A2142C of 23SrRNA point mutations in producing resistance to this drug.Material and Methods: This was a cross-sectional study which included 263 patients who had referred to endoscopy department of Hajar hospital, in Shahrekord city, in 2007. Biopsy samples were cultured on brucella agar medium and incubated. For identification of H.pylori gram stain, urease, catalase, oxidase tests were used and PCR method was used to identify Urec gene. Standard method of NCLSI (National Clinical and Laboratory Standards Institute) was used for assessment of clarithromycin resistance. Specific primers and restriction enzymes BsaI and MboII were used to detect A2143G and A2142G mutations by PCR-RFLP method. Also for determination of A2142C mutation, specific primers and PCR method were used.Results: Isolation of 84 strains of H.pylori (31.94%) was confirmed by means of PCR method. Among 19 (22.62%) of clarithromycin resistant strains, 13 (68.40%), 3 (15.78%) and 2 (10.52%) had A2143G, A2142G, A2142C mutations respectively and one unknown mutation was detected in 23SrRNA gene.Conclusion: Because of considerable resistance to clarithromycin, precise diagnosis of this mutation by molecular approach in other parts of the country seems necessary.

Background and Aim: Considering the importance of environmental impact assessment of projects, an environmental impact assessment (EIA) of establishment of compost plant in Sanandaj was planed. The aim of this study was to assess positive and negative impacts resulted from establishment of the compost plants and provide managerial solutions to minimize environmental harmful impacts by use of modified Leopold Matrix and Scaling checklist methods which was an innovation in our study.Material and Methods: In this study, the present environmental situation was investigated. Considering the properties and kind of pollutions of this plant, after determination of assessment criteria, direct and indirect impacts of construction and exploitation of the plant on environmental elements were evaluated at short, medium and long term intervals. By expansion of Leopold Matrix into four parted matrix, in addition to the amount (importance) and extent of the impacts, the remaining duration of impacts on the environment was assessed as a separate factor.Results: The results of this study were presented in the form of two alternatives: No (performance of the project with no concern for environmental issue) and yes (performance of the project with application of the methods to reduce environmental harmful impacts).Conclusion: The resultant of the first alternative (No) was (-253). Therefore the project was rejected.After reducing the harmful impacts, the resultant was (+351) ant the project was accepted.

Background and Aim: Although marriage is one of the most important issues in life, yet many couples do not devote time and energy to enter in this relationship. A significant proportion of married couples experience serious marital conflicts early in their common life. Since marital distress has been related to many negative long-term health and emotional consequences, prevention of these detrimental outcomes is the main priority for psychologists and the health care field specialists. One of the famous applied approaches for this problem is marriage enrichment. Marriage enrichment is an educational approach to help couples to improve their relationships and become aware of themselves and their partners, encourage empathy and intimacy, and develop effective communication and problem-solving skills. In This study the effectiveness of one of the marriage enrichment programs in Iranian couples was estimated.Material and Methods: This was a quasi experimental research with pretest and post test and included fifteen couples in two non matched groups. We used two marital satisfaction scales -ENRICH and Dyadic Adjustment Scale - for assessment of their marital satisfaction in three steps: pre test, post test, and follow up. Eight couples (experimental group) received time program (training in marriage Enrichment) educations for ten weeks, and seven other couples (control group) didn’t receive any education. Data were analyzed by means of descriptive and inferential statistics.Results: The results showed that control group didn’t have any change in marital satisfaction scales but experimental group showed a significant improvement in the post test that persisted into the follow up step (p<0.00008 for Enrich Scale and p<0.0002 for DAS Scale).Conclusion: The results of this study supported the beneficial effects of marriage enrichment program on marital satisfaction in our study couples.

Background and Aim: In the present epoch with scientific competitions, test anxiety is increasing day by day and this anxiety can lead to distraction of mind. Occupation of the mind can result in inadequate information processing and causes the students to be deprived of their major potentialities. The aim of this study was to assess the level of test anxiety and its related factors in the students of Kurdistan University of Medical Sciences.Material and Methods: This was a descriptive-analytic study. The study population included 374 students. Data were collected and recorded in valid and reliable spielberger's test anxiety questionnaire and demographic characteristics of the subjects were recorded in another questionnaire. SPSS statistical software was used for data analysis.Results: 55.9% of the subjects were female, 58.8% were between 18-20 years of age, 92.5% were single, 19.8% were medical students, 50.8% had associate degree and 38.5% were from medical school. Evaluation of test anxiety showed: 48 (12.8%) subjects had healthy anxiety level, 272 (72.7%) had relative healthy anxiety level & 54 (14.4%) had morbid anxiety level. There was a significant relationship between educational degree & morbid anxiety level and this anxiety was higher in those with associate degree (p<0.05). No significant relationship was detected between morbid anxiety level and variables such as age, gender and different faculties (p>0.05). There were significant relationships between anxiety level and educational fields in different fields of study, so that laboratory sciences students had a high level of test anxiety (p<0.05).Conclusions: In this study there were students with high anxiety levels. Considering the negative effects of this kind of anxiety on educational performance of the students, psychological counseling and identification of the causes of anxiety and designing plans for elimination of these causes are recommended.