JOURNAL OF GORGAN UNIVERSITY OF MEDICAL SCIENCES
Year:2014 | Volume:16 | Issue:3 (51)|Papers Count:25

Background and Objective: Disabilities in upper limb due to stroke are the major problems in hemiplegic patients. Recently, joystick method as new method is applied for the improvment of upper limb disabilities. This study was carried out to compare the effect of joystick in compination verses routine rehabilitation and routine rehabilitation program on hand muscles stiffness in hemiplegic patients.Methods: In this clinical trial study, 12 hemiplegic patients were randomly divided into two control and interventional groups. Subjects in the control group were received rehabilitation program with placebo joystick. Patients in interventional group were received joystick treatment with routine rehabilitation program for 10 sessions, 3 times a week. Pre and post-treatment evaluation was performed based on Wrist Robo Hab method.Results: Flextion and pronation muscle stiffness in control patients showed non significant improvement, but in the interventional group, significant improvement were observed (P<0.05). At the end of study, there was not any significant difference between control and interventional group.Conclusion: According to this finding, there was not any significant difference between the combination of joystick and rehabilitation treatment and routine rehabilitation program on the hand muscle function in hemiplegic patients.

Background and Objective: Paraoxonase-1 is an important factor in preventing lipid oxidation and formation of oxidized low-density lipoprotein. There are conflicting reports on the impact of physical activity on serum level of Paraoxonase-1. This study was done to determine the effect of four weeks of endurance training on serum level of Paraoxonase-1 and lipid profile in non-athlete obese men.Method: In this clinical trial study, sixteen obese healthy non-athletic men randomly divided into intervention and control groups. Subjects in interventional group were practiced endurance running periodic for four weeks, three sessions a week with 65-80% of maximum heart rate. Blood samples collected 48 hours perior the first and 48 hours following the final training. Serum level of Paraoxonase-1 and lipid profile including cholesterol, triglycerides, low-density lipoprotein and high-density lipoprotein were measured by ELISA method.Results: At the end of the training, the serum level of of paraoxonase -1 increased 15.57% (P<0.05) in interventional group and non-significantly reduced in control group (19.25%). The serum level of serum Paraoxonase-1 in interventional group significantly increased compared to controls (P<0.05). The serum level of low-density lipoprotein in interventional group significantly reduced in comparision with controls (P<0.05).Conclusion: 4 weeks of endurance training increased serum level of paraoxonase -1 and decreased lowdensity lipoprotein in non-athlete obese men.

Background and Objective: Aloe vera (Aloe barbadensis M.) as a medicinal herb is practiced in wound healing. This study was carried out to assess the effect of Aloe vera gel (mucilage) on TGF-b gene expression in incisional skin wound in BALB/c mice.Method: In this experimental study, 36 BALB/c male mice with weight range 22±2 gr were allocated equally into negative control (no wound), sham-operated (wound treated with physiological serum) and teratment (wound treated with Aloe vera gel). Two equal full-thickness skin wounds of 10±2mm were made on either side of the vertebral column in the sacral region. The animals in the teratment group were received daily, 2 gram of Aloe vera gel (without any bandage) as a thin layer for a period of 16 days. On 8th and 16th post wounding day, TGF-b gene expression in incisional wounds and Malonyldialdehyde (as end-product of lipid peroxidation) in serum samples was measured using RT-PCR and spectrophotometry methods, respectively.Results: TGF-b gene expression in incisional skin wound increased in Aloe vera gel treated group in compared to negative control and sham-operated groups (P<0.05). Malonyldialdehyde concentration was significantly reduced in Aloe vera treated group in comparision with negative control and sham-operated groups.Conclusion: Aloe vera gel can induce growth factor TGF-b gene expression and reducing the lipid peroxidation content can play an important role in incisional skin wound healing process.

Background and Objective: Physical activities affect on antioxidative pathway. Varity, period and intensity of activities are important in health improvement. This study was carried out to determine the effect of short and medium periods of high intensities aerobic training on serum level of superoxide dismutase (SOD) and Catalase (CAT) enzymes in female rats.Methods: In this experimental study, 45 Sprague Dawley female rats were randomly allocated into control, short (4 weeks) and medium (8 weeks) of high intensities aerobic training groups. The exercise program was performed on 5 session in each week with speed of 10-17 meters per minute in slope range (5<slope<15) for 15-60 minutes. Serum level of CAT and SOD enzymes were determined by ELISA method.Results: Serum level of superoxide dismutase was 98.8±12.8, 126.4±10.2 and 115.1±14.2 U/ml in control, short and medium periods of high intensities aerobic training groups, respectively. Serum level of Catalase was 51.2±7.2, 43.7±5.3 and 52.1±6.3 U/ml in control, short and medium periods of high intensities aerobic training groups, respectively. These differences were not significant.Conclusion: Short and medium periods of high intensities aerobic training do not have any influence on serum level of SOD and CAT antioxidant enzymes in female rats.

Background and Objective: Para-nonylphen as an environmental pollutant has weak estrogenic activity and causes oxidative stress in different organs including testis. This study was done to determine the protective effect of vitamin E on the para-nonylphenol induced-testicular toxicity in adult rats.Methods: In this experimental study, 24 Wistar rats were randomly allocated into four groups including control, vitamin E (100 mg/kg/day, orally), para-nonylphenol (250 mg/kg/day, orally) and finally paranonylphenol (250 mg/kg/day, orally) plus vitamin E (100 mg/kg/day, orally). After 56 days of treatment, removal of the right testis, tissue processing and staining with Heidenhain’s Azan, the morphometric parameters of testicular tissue was evaluated using stereological method.Results: The mean volume of seminiferous tubules, height of the germinal epithelium, seminiferous tubules diameter, thickness of the basement membrane, number of spermatocyte, spermatid and sertoli cells significantly reduced in para-nonylphenol group compared to the controls (P<0.05). These parameters were significantly increased in the para-nonylphenol plus vitamin E group compared to para-nonylphenol group (P<0.05). In the histopathological examination, atrophy of seminiferous tubules, germinal epithelium vacuolation and epithelial disarrangement were observed in para-nonylphenol group. Histopathological alterations reduced in para-nonylphenol plus vitamin E group compared to para-nonylphenol group.Conclusion: Co-administration of vitamin E with para-nonylphenol can prevent the adverse effects of para-nonylphenol on the testicular tissue in adult rats.

Background and Objective: There are controversial reports about the effect of training on serum level of visfatin and TNF-a Cytokine .This study was done to evaluate the effect of 8 weeks of aerobic training on serum level of visfatin and TNF-a in non-athletic young women.Methods: In this quasi-experimental study, thirty non-athletic healthy women were non-randomly based on the weight, height, BMI index and body fat percentage divided into two control and training groups. In the training group 8 weeks of aerobic exercise on a stationary bicycle 3 times a week was performed. Serum level of visfatin and TNF-a was measured using ELISA method, prior and at the end of 8th week of training while the subjects were fasted for 12-14 hours.Results: At the end of 8 weeks of aerobic exercise, serum level of visfatin and TNF-a significantly reduced in the training group in comparison with controls (P<0.05).Conclusion: Eight weeks of aerobic training reduces visfatin and TNF-a serum level in non-athletic healthy women.

Background and Objective: Methadone is a synthetic opioid which is used in opium addiction therapy and relief of acute and chronic pain. Side effects of Methadone were reported on heart and induction of Torsade De Pointes disease and increase QTc interval in electrocardiogram. This study was conducted to determine the effect of Methadone therapy on QTc interval in electrocardiogram and its relationship with dosage and duration of Methadone therapy.Method: This cohort study was conducted on 60 opium addicted patients (57 males, 3 females) whom referred to “Methadone Therapy Clinic” in 5 Azar teaching hospital in Gorgan, northern Iran during 2009-10. Patients were divided to three groups based on the dosage of methadone: 0-35 mg (27 cases), 35-55 mg (27 cases) and 55-120 mg (26 cases) per day. QTc interval in electrocardiogram was measured at the beginning of study, one month and 5 months afterward.Results: The mean±SD of QTc interval in patients at the beginning, one month and 5 months afterward of study was 0.42±0.027, 0.43±0.029 and 0.43±0.041 seconds, respectively. There was a significant increase in QTc interval after one month of methadone therapy, compared to the beginning of study. There was no significant difference in QTc interval between 1 month and 5 months following methadone therapy. There was no significant difference between QTc interval and different dosage of methadone.Conclusion: Methadone therapy increase QTc interval but there is not any relationship between dosage and duration of methadone therapy and QTc interval.

Background and Objective: Valproic acid is used in the epilepsy, bipolar and migraine therapy. As a histone deacetylase inhibitor, Valproic acid has been recently under investigation in cancer treatment, either alone or in combination with either chemotherapy or radiotherapy. This study was done to determine the effect of Valproic acid and radiotherapy on viability of MCF-7 breast cancer cell line.Methods: In this descriptive - analytic study, MCF-7 cell line was obtained from the Iranian Pasteur Institute. The cells were treated and incubated by different concentrations of Valproic acid (1, 2, 4, 8, 16, 32, 64 and 128 mM) either alone or in combination with various dosages (0 .5, 2, 4, 6 and 8 Gray) of radiotherapy. After cell viability assay, using the Neutral red staining, the most nearest results to LD50 were selected. Cell viability was evaluated with trypan blue staining.Results: The most nearest concentrations of LD50 was doses of 2, 8 and 16 mM of valproic acid and dosage of Gray 4 of radiation. There was a significant dose-dependent correlation between reduction of cell viability with valproic acid concentration (P<0.05).Conclusion: Valproic acid, either alone or combination with radiotherapy caused a significant decline in the cell viability of MCF-7 breast cancer cell line.

Background and Objective: Cardiovascular autonomic neuropathy (CAN) is the most common and important type of diabetic autonomic neuropathy. Silent myocardial infarction, respiratory failure and increased mortality are the outcomes of CAN. This study was carried out to screen the cardiovascular autonomic neuropathy in non- insulin dependent diabetics patients.Method: This descriptive - analytic study was carried on 70 (22 males, 48 females) non- insulin dependent diabetics’ patients. Resting heart rate, heart rate variability, orthostatic changes in heart rate, blood pressure and corrected QT interval were recorded for each subject. The final findings were categorized as follow: 0=normal, 1=borderline and 2=CAN positive.Results: 10 (14.3%) of patients were normal, 35 (50%) of patients were borderline and 25 (35.7%) of patients were considered cardiovascular autonomic neuropathy positive. There was significant differences between duration of diabetes and three CAN scores (P<0.05). The systolic blood pressure alterations showed the maximum correlation with CAN scores (r=0.509).Conclusion: In our study, the rate of cardiovascular autonomic neuropathy was higher than other reports. The most important risk factor for cardiovascular autonomic neuropathy was more than 10 years history of diabetes mellitus.

Background and Objective: Chronic subdural hematoma is a common disease among patients whom admitted in neurosurgical departments. Although therapeutic strategy of this disease is simple but prognosis of patients is not easily predictable. This study was done to determine the Prognostic factors in patients with chronic subdural hematoma underwent Burr hole trephination surgery method.Method: This descriptive - analytic study was done on 90 patients with chronic subdural hematoma whom treated with Burr hole trephination surgery technique in Urmia, Iran during 2009-13. Age, sex and size of hematoma, mid-line shift, density and location of hematoma, level of consciousness before surgery, history of disease, physical examination, post-operative brain expansion and post-operative pneumocephalus were recorded for each patient as possible effective variables in outcome. Patients prognosis were evaluated by modified Rankin scale was considered as follow: 0-1=good, 2-5=bad.Results: 63 (70%) and 27 (30%) of patients were in good and bad prognosis, respectively. Age older than 70 years, level of consciousness less than 12 and history of diabetes were the most significant variables being correlated with bad prognosis after surgery (P<0.05).Conclusion: Elderly age, level of consciousness prior to surgery and diabetes were correlated with bad prognosis in patients with chronic subdural hematoma underwent Burr hole trephination surgery method.

Background and Objective: Overweight, obesity and ethnicity are effective factors on pregnancy complications. This study was conducted to determine the relationship between third tri-mester body mass index (BMI) with maternal and neonatal complications.Methods: This descriptive analytic study was conducted on 551 pregnant women in third tri-mester with Fars, Sistani and Turkman ethnicities in Sayad Shirazi teaching hospital in Gorgan, north of Iran during 2012. BMI calculated at the time of labor admission and the subjects categorized into three groups of normal / underweight, overweight and obese.Results: The mean of maternal age among Fars, Sistani and Turkman ethnic groups were 26.5±5.5, 24.6±5.3 and 26.2±5.2 years, respectively. The mean of gestational age among Fars, Sistani and Turkman ethnic groups were 38.4±2.3, 38.6±2.3 and 37.4±3.2 weeks, respectively. A significant relationship was found between BMI and cesarean section and labor dystocia in Fars and Sistani ethnic groups, respectively (P<0.05), while no relationship was found between BMI and neonatal complications.Conclusion: Overweight and obesity in Fars ethnicity are at risk of cesarean section and those with Sistani ethnicity are at risk of labor dystocia.

Background and Objective: Repeated blood transfusion is the major treatment for patients with major thalassemia. However due to antigen encounters, it may initiate body reactions, including alloantibodies against red blood cell antigens. This study was done to determine the Prevalence of alloimmunization in major beta thalassemia patients in northern Iran.Method: This descriptive - analytic study was carried out on 218 thalassemic patients (100 males and 118 females) with average age of 22.5±7 years in northern Iran during 2010. Each sample was tested for the presence of Alloantibodies including C, Cw, Lea, E, Lua, Leb, K, Jkb, N, P1, D, Jka, M, S, Xga, e, Fya, s, c, Fyb, k, Kpa, Jsb, Lub and Coa.Results: Eighty eight cases (40.4%; 95% CI: 33.9-46.9) were positive for the presence of alloantibodies. Alloantibodies against C, Cw, Lea red blood cell surface antigens were the most prevalent (40%). No significant correlation was found between emergence of alloantibody with the age of initial, frequency and duration of blood transfusion.Conclusion: Alloimmunization is a common observation in thalassemic patients and should be prevented by transfusing compatible blood.

Background and Objective: The human anthropometric characteristics are surveyed in anthropology. Anthropology is used in archeology, physiotherapy, rehabilitation and legal medicine. This study was carried out to evaluate the anthropometric characteristics of upper limb in Iranian and Pakistani subjects.Method: This descriptive - analytic study was performed on 300 resident’s adult subjects (180 males and 120 females) in Qazvin, Iran and 356 residents (181 males and 175 females) in Dera Ghazi Khan, Pakistan. Anthropometric characteristics of upper limb were measured in an anatomical position.Results: The mean±SD of arm length was 36.8±2.37 CM and 28.1±2.44 CM, in Pakistani and Iranian males, respectively, this difference was significant (P<0.05). The Mean of forearm length, hand length and hand width in Iranian men and women were non-significantly more than Pakistani subjects.Conclusion: Anthropometric characteristics of upper limb of Iranian are higher than Pakistani subjects, but this difference only in arm length of men was significant.

Background and Objective: Human erythropoietin (EPO) is a glycosylated hormone with molecular weight of about 40 KDa which is synthesized in kidneys and plays an important role in proliferation and differentiation of erythrocytes.This study was done to assess and analyze the expression of recombinant EPO in Leishmania tarentolae host.Method: In this descriptive study, the EPO gene was codoned , optimized with bioinformatics database prior to be synthesized. It was cleaved by KpnIandXbaI enzymes and cloned into pLEXSY expression vector. The constructed expression cassette was transfected into Leishmania tarentolae through electroporaton method. Identification and confirmation of transfected colonies was performed using PCR expression diagnostic primers and EPO specific primers. Induction of the cloned gene was done with tetracycline. The expression in induced strains was analyzed by SDS-PAGE and western blotting techniques. The amount of recombinant protein was quantified by ELISA method. Confirmation of cloning and EPO expression cassette was carried out through genetic engineering procedures.Results: Expression analysis of transfected parasitic strain with SDS-PAGE and western blotting confirmed gene integration into chromosomal of host as well as expression. The optimal conditions for expression were found to be 10mg of tetracycline and 72h induction time. Molecular weight of expressed protein estimated to be 40 KDa and expression level was determined to be 12.4 mg/l which was equal to 1% of total protein mass.Conclusion: EPO expression cassette for cloning and expression in Leishmania tarentolae was designed and protein of interest was successfully induced and identified Leishmania tarentolae can be used as a suitable host for production of recombinant EPO and this technology has a potential for localization.

Background and Objective: Chronic osteomyelitis with huge bone defect is one of the most catastrophic problems in long bone fractures. This study was done to evaluate the distraction osteogenesis with AO tubular external fixator in chronic osteomyelitis with huge bone defect.Methods: In this descriptive study, 12 patients (11 males, 1 woman) with chronic osteomyelitis with huge bone defect underwent distraction osteogenesis with AO tubular external fixator in 5th Azar teaching hospital in Gorgan, Iran. Patients were followed up for 16 months and the onset of re-infection, bone graft, pin loosening, refracture and neurovascular injury were evaluated.Results: All of fractures were open, due to vehicle accident. The fractures include four legs, seven femurs and one tibial plateu fracture. Primary fixation was done with plate (5 cases), Intramedullary Nail (5 cases) and skeletal traction (2 cases). Mean time onset of fracture to treatment with AO tubular external fixator was 75.5 days. Mean sequestrum length was 8.8 cm which it was in femur 10.71 cm and in leg was 6 cm. Mean overall treatment was 16.08 months or 1.91 month/cm. Re-infection and neurovascular injury were not seen. Eight superficial infections treated with antibiotic and four cases of pin loosening were assembled with pin fixation. Seven cases required bone grafting. Premature consolidation in five cases and deviation of bone transport segment were found in four patients which treated with modification in external fixation.Conclusion: Distraction osteogenesis using AO tubular external fixator in chronic osteomyelitis with huge bone defect is suitable treatment method, saving the organ and prevents the amputation.

Background and Objective: Leptospirosis is an infectious and zoonosis disease, which is caused by leptospira and is transmitted from animal to human. The rapid diagnosis can control the disease, therefore this study was carried out to determine the prevalent serovars of leptospira using micro agglutination test (MAT) in human and cattles.Method: In this descriptive study, 175 cattles and 67 suspected human serum samples were tested in five provinces in Iran during 2011-12. Serum samples tested by micro agglutination test using 20 live leptospira serogroup.Results: Ninty nine out of 175 (56.5%) cattle serum samples and 31 out of 67 (46.2%) human samples were positive against leptospira antigen. The most prevalent leptospira serovar in cattles and human were Serjoe hardjo (61.9%) and Serjoe serjoe (23%), respectively. The most frequent titer in positive samples was equal to be 1.400. Fifty percent of human positive samples belong to farmers between 20-40 years old. The common contaminations belong to polluted water (61.1%) and infected blood (28.3%), respectively.Conclusion: Using micro agglutination test, the most prevalent leptospira serovar in cattles was Serjoe hardjo and in human was Serjoe serjoe.

Background and Objective: Fusarium solani is the common etiological agent of fungemia and disseminated fusariosis, which is associated with high incidence of mortality in immune-compromised host. Due to high level of resistance of antifungals in Fusarium solani, rapid and specific identification of organism is essential. This study was done to evaluate the PCR method for rapid and specific diagnosis of Fusarium solani in serum samples of HIV positive patients.Methods: In this descriptive study, the PCR test based on mitochondrial cytochrome b gene as the target gene with 330 bp product was optimized. PCR was applied on 45 serum samples of HIV positive patients after evaluation of sensitivity and specificity of the test.Results: In the optimized PCR test, the 330 bp product was amplified. The sensitivity of the test was a copy of Fusarium solani genome, and its specificity was 100%. Among 45 serum samples, 9 cases (20%) were positive for Fusarium solani.Conclusion: The PCR method has functional capabilities for direct, rapid and specific clinical diagnosis of Fusarium solani in HIV positive patients.

Background and Objective: Imperforate anus is a common anorectal malformation, which is associated with other anomalies. This study was done to determine the associated malformations in newborns with imperforate anus in northern Iran.Methods: This descriptive study was carried out on 40 hospitalized newborns (24 boys and 16 girls) with imperforate anus in Taleghani teaching hospital in Gorgan, northern Iran during 2006-10. Results: From 40 newborns with imperforate anus, 23 newborns (57.5%) had associated anomalies. The commonest associated anomalies was genitourinary (65.2%) followed by heart (47.8%), gastrointestinal (13%) and musculoskeletal anomalies (8.7%).Conclusion: Associated anomalies in newborns with imperforate anus in northern Iran have a high prevalence in comparison with other reports.

Background and Objective: Pterygium is a fibrovascular lesion of the ocular surface with unknown origin, decrease in the vision. This study was done to evaluate the possible role of Epstein-Barr virus (EBV) in the formation of pterygia.Methods: This case-control study was done on 50 tissue specimens of pterygium from the patients who underwent pterygium surgery as the case group and 10 conjunctival biopsy specimens of individuals without pterygium including the patients whom underwent cataract surgery, as controls. The evidence of EBV infection was tested by polymerase chain reaction (PCR).Results: EBV was detected in three (6%) patients with pterygia. EBV was not detected in controls. There was not any significant correlation between pterygium and the presence of EBV.Conclusion: According to this study, EBV virus is not associated with pterygium formation.

Background and Objective: Fungal ear infection is common diseases in tropical areas with manifestation of acute and chronic clinical symptoms in external ear canal. This study was done to compare the fungal flora in external ear canal in chronic otitis media and subjects without otitis media.Method: This case-control study was done on 63 patients with chronic otitis media and 63 subjects without otitis media. Samples were taken from external ear canal with a sterile swab and were placed in the sterile tubes containing normal saline. The direct smear was prepared and samples were cultured in S, SCC and CMA (corn meal agar) media. Identification of genus and species were established using slide culture method and Germ-tube assay.Results: Positive fungi culture in external ear canal was seen in 77.78% and 17.46% of case and control groups, respectively (P<0.05). The most common type of fungi was Saprophyts (57.33%) followed by yeast (20.59%) and dermatophytes (17.32%). The most prevalent fungi in the subgroup of Saprophyts and dermatophytes was Aspergillusnigra (41.66%) and Trichophytonmentagrophytes (36.37%), respectively. The most common subgroup in yeast was Candida SPP with 53.85%.Conclusion: This study showed that the positive fungi culture in external ear canal is more prevalent in patients with chronic otitis media.

Background and Objective: Due to high prevalence of pre-menstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) and its effect on the educational, professional activities and familial behaviors, this study was conducted to determine the prevalence of clinical manifestations of premenstrual syndrome and pre-menstrual dysphoric disorder in medical students.Methods: This descriptive-analytic study was done on 162 female medical students of Golestan University of Medical Sciences in Gorgan, Iran during 2010. Demographic characteristics and PMS and PMDD clinical manifestations questionnaire based on DSM-IV-TR and ACOG criteria was filled for each subject.Results: Mean age and menarche age of subjects was 22.2±2.5 and 13.3±1.2 years, respectively. 145 students (89.5%) were single. 57.4% and 22.8% of participants fulfilled the criteria of PMS and PMDD, respectively. The most frequent affective and somatic symptom was lethargy and fatigability (57.4%) followed by sensation of bloating and weight gain (45.7%). The lowest frequent somatic and affective symptoms were dyspnea (8%) and insomnia (1.2%), respectively. There was significant correlation between the prevalence of PMDD and chronical and menarche age (P<0.05).Conclusion: Pre-menstrual syndrome is a prevalent disorder in medical students of Golestan University of medical sciences in Iran.

Background and Objective: Ruta graveolens is a plant used in traditional medicine with variety of therapeutic effects. This study was done to evaluate the antimicrobial effect of hydro and alcoholic extracts of Ruta graveolens on 8 species of pathogenic bacteria.Methods: In this descriptive study, standard strains of Enterococcus faecalis, Staphilococcus aureus, Staphilococcus epidermis, Strptococcus pneumonia, Escherichia Coli, Klebsiella pneumonia, Salmonella typhi and Enterobacter Cloace were obtained from Iranian institute of scientific and industerial research center. The effect of hydro and hydroalcholic extracts of Ruta graveolens on the growth of bacteria was determined by disc diffusion and serial macro dilution methods. Minimum inhibitory concentration (MIC) for each extract was determined and the findings were compared with 8 common antibiotics including Co-trimoxazole, Oxycycline, Vancomycin, Erythromycin, Furazolidon, Tetracycline, amoxicillin / clavulanic acid and Ampicillin / sulbactam.Results: Hydro and hydro alcoholic extracts of Ruta graveolens did not show any inhibitory effect on growth of the pathogenic bacteria even in the presence of high concentration (3mg/ml).Conclusion: The extracts of arial organs of Ruta graveolens had no inhibitory effect on growth of the common human pathogenic bacteria.