Journal of Gorgan University of Medical Sciences
Year:2011 | Volume:12 | Issue:4 (36)|Papers Count:22

Background and Objective: Several investigations have indicated the antinociceptive, anti-inflammatory, antipyretic effects and smooth muscle relaxant activity of Cassia species. This study was done to determine the effect of Cassia fistula on sleeping time and the level of anxiety in mice.Materials and Methods: In this experimental study, 80 male albino mice (25-30 g) randomly allocated in 8 groups. For measuring the sleeping time we used the Angle method and animals were divided into three experimental (250, 500 and 1000 mg/kg) and one control group. For evaluating of anxiety levels, animals randomly were divided into three experimental and one control group, and elevated plus maze (EPM) model was used. The evaluation of anxiety indices included number and percent of time spent in open arm. Different doses of the aqueous extract of Cassia fistula (250, 500, 1000 mg/kg IP) were injected intraperitoneally to the treated groups. Controls were received 10 ml/kg/BW normal saline intraperitoneally in both methods.Results: The extract of Cassia fistula (250, 500 and 1000 mg/kg) significantly increased sleeping time [F (3, 39) =23.19, P<0.05]. Also open time [F (3, 39) =15.55, P<0.05] and the number of open arm entries [F (3, 39) =24.21, P<0.05] were significantly in doses (250mg and 500 mg) were significantly more than control group, respectively (P<0.05).Conclusion: This study showed that the aqueous extract of Cassia fistula fruit increase the sleeping time and decreasing level of anxity in mice.

Background and Objective: Tinea versicolor is a common fungal infection of the skin caused by the dimorphic lipophilic yeast Pityrosporum orbicular (Malassezia furfur). Lesions begin as multiple small, circular macules of various colors. The upper trunk is most commonly affected due to the side effects of oral treatment and drug resistance, this study was done to compare the therapeutic efficacy of topical terbinafine versus topical ketoconazole in Tinea versicolor.Materials and Methods: This Randomized double blind clinical trial study was conducted between 2008-09. Sixty nine patients with a clinical diagnosis of pityriasis versicolor confirmed by microscopic potassium hydroxide (KOH) examination were taken for the study. Patients randomly divided into 2 treatment groups: 35 patients in terbinafine group, treated by terbinafine 1% once daily for 2 weeks and 34 patients in ketoconazole group, treated with ketoconazole 2% once daily for 2 weeks. Five patients of terbinafine and 4 patients of ketoconazole groups were excluded due to lack of follow-up. Patients were followed up at monthly intervals for 3 months and recurrence and cure rate for each subject were recorded. Data was analyzed by SPSS-16, t student and Chi-Square test.Results: The mean moderate cure rate obtained one month after treatment was 20% in terbinafine group versus 3.3% in ketoconazole group, and there was no any significant difference between two groups. The mean moderate cure rate two month after treatment was 67.7% in terbinafine group and 60% in ketoconazole group (P<0.05). The mean complete cure rate three month after treatment was 73.3% in terbinafine group and 10% in ketoconazole group (P<0.05). The percent of positive KOH examination, three month after treatment was 10% in terbinafine group and 36.7% in ketoconazole group (P<0.05).Conclusion: This study showed that terbinafin is more effective than ketoconazole in treatment of tinea versicolor.

Background and Objective: Osteoarthritis is the most common joint disease and associated with degeneration of the joint cartilage. Its high prevalence, particularly in the elderly, and the high rate of disability related to disease make it a leading cause of disability. The symptoms of osteoarthritis are pain, morning stiffness and joint limited motion. This study was carried out to compare the effects of physical modalities and home based exercise training on symptoms and function of knee osteoarthritis.Materials and Methods: In this randomized clinical trial study, forty patients with knee osteoarthritis according to the American college of rheumatology (ACR) criteria randomly divided into two treatment groups. The physical modality group (A) received TENS, US and Hot pack at pain areas. The exercise group (B) received isometric exercise of the knee. Each group received 3 treatment sessions per week for 4 weeks. Evaluating measuring tools were pain intensity (based on Visual Analogue Scale: VAS) and function was measured with koos questionnaire.Results: Improvement in pain, quality of life, symptoms, sports and reduction, in pain intensity on VAS in the physical modality group after treatment were seen (P<0.05). Also significant improvement in symptoms and quality of life was observed in the exercise group. Improvement in activity of daily life found in the physical modality group in comparison with exercise group (P<0.05).Conclusion: This study showed that physical modality and exercise training reduce pain and improve quality of life, activity of daily life and sport in patients with the same rate. While activity of daily life improves more in physical modality method.

Background and Objective: Asthma is the most prevalent chronic disease during childhood and it is estimated that 4.8 million children involved in asthma all over the world and its prevalence and incidence is increasing. The aim of this study was to identify the peak-flow meter application on quality of life in asthmatic children.Materials and Methods: This clinical trial study was done on 80 asthmatic children between 7 to 15 years old which referred to Shahid Beheshti hospital clinic in Kashan, Iran during 2009. Susan Sylvia questionnaire included 3 parts, was filled for every child. The questions in any section had three options in which there were 5 items in activity limitation, 13 questions in symptoms and 6 questions in emotional functions. Every question had 1 to 3 points and whole questionnaire taken 23 to 69 points. The children were learnt to measure their PEFR (Peak Expiratory Flow Rate) 3 times a day using Peak flow meter device and upon the results, the management procedure was changed. After 3 months the outcome were evaluated and data analyzed by SPSS-15 and paired t-test.Results: Mean age of patients was 8.82±2.75 years old. Thirty three subjects (41.3%) were girl. The average score in emotional functions was 13.1±3.07 before and 14.35±3.7 after using peak-flow meter (P<0.05). The average score in activity limitation was 7.33±1.57 and 8.47±0.67 before and after using peak-flow meter, respectively (P<0.05). The average score in symptoms before and after pek-flow meter was 28.81±5.13 and 32.02±5.62, respectively (P<0.05). Finally total score of quality of life showed significant increase in children after using peak-flow meter (P<0.05).Conclusion: This study showed that the application of pek-flow meter increase emotional functions, decrease limitation of activity and symptoms in asthmatic children. Therefore, it is suggested pek-flow meter dievice taking into account in asthma management of asthmatic patients particularly in children.

Background and Objective: There has been considerable debate regarding the best treatment of the Achilles tendon rupture. One of the nonoperative treatment method for Achilles tendon rupture is using the functional brace. The aim of this study was to evaluate the effect of the functional brace with/without patellar tendon bearing on treatment of patients with Achilles tendon rupture.Materials and Methods: In this semi experimental study, 17 patients with Achilles tendon rupture were recruited and randomly allocated into 2 groups: functional brace with patellar tendon bearing and functional brace without patellar tendon bearing. Pain, plantar and dorsi flexion strength and the required time for progressively increased dorsi flexion position in orthoses to reach the neutral position were measured. Data analyzed with SPSS-13, independent t-test and Smironov-Kolomogrov.Results: Three patients were excluded during follow up and finally this study was done on 14 patients. The difference of the pain intensity and the plantar and dorsi flexion, in each group, before and after the intervention was significant (P<0.05), but the difference between two groups after intervention in all variables was not significant.Conclusion: This study showed that both brace with/without patellar tendon bearing are effective on improvement of pain and the plantar flexion and dorsi flexion strength and also are effective in required time to reach the neutral position.

Background and Objective: An increased risk of invasive infections with encapsulated bacteria such as Streptococcus pneumoniae has been described among splenectomized patients. Pneumococcal vaccination has been recommended in these patients. In this study, the serum antibody response to pneumococcal polysaccharide antigens in splenectomized patients with idiopathic thrombocytopenic purpura (ITP) or trauma who immunized with Pneumovax 23 was evaluated. Materials and Methods: This case - control study was performed on two groups of patients including fifteen cases of trauma patients (11 male, 4 female) and twenty patients with ITP (10 male, 10 female) along with 40 healthy volunteers as controls who were immunized with Pneumovax 23 to prevent pneumococcal infections. All patients received the pneumococcal vaccine before splenectomy. The serum antibody response (IgG and IgG2) to pneumococcal antigens was determined by enzyme-linked immunosorbent assay (ELISA) technique prior to vaccination and 4 weeks post-vaccination. Analyzing of data was performed using student t-test and linear regression test.Results: The mean of post-vaccination IgG or IgG2 titer to the pneumococcal antigens in ITP patient group was significantly lower than those in controls or in trauma group (P<0.05). No significant differences in IgG or IgG2 antibody titer increase were found between trauma group and healthy control group. Response to immunization was poor in 9 of 20 ITP patients.Conclusion: This study indicated that 45 percent of patients suffered from ITP who have undergone splenectomy responded poorly to pneumococcal antigens.

Background and Objective: Polycystic ovarian syndrome (PCOS) is one of the most prevalent (6-10%) endocrine glands disorders among child - bearing women. In addition to the patients, their first degree relatives are exposed to some risk factors such as abnormal lipoproteins. Due to high prevalence PCOS among women and the role of genetic factors in this abnormality, it is necessary to recognize high risk people particularly among first degree relative. Therefore this study was conducted to determine the level of serum lipoproteins in first degree relatives of patients with PCOS.Materials and Methods: This case control study was done on 107 individuals of the first degree relatives of PCOS patients as cases and 107 normal individuals of the first degree of non-PCOS as controls in Shiraz, Iran during 2009. Participants completed a test assessing demographics and blood sample were taken from all participants in order to assay serum lipoproteins including total cholesterol, LDL, HDL and triglyceride. Data was analyzed by means of independent t-test and Fisher's exact test as well as Chi-Square.Results: The means±SD of total cholesterol, HDLc and triglyceride in cases was 191±31.64, 167±4.06 and 191±31.64 mg/dl, respectively. The means±SD of total cholesterol, LDLc and triglyceride in controls was 158.25±18.25, 123±21.33 and 120.42±17.11 mg/dl, respectively. Serum level differences of LDL and triglyceride in cases and controls were significant (P<0.05). The means±SD of HDLc in cases and controls was 40.06±6.95 and 45.9±6.7 mg/dl, respectively (P<0.05).Conclusion: This study showed that the serum level of lipoproteins in the first degree relatives of PCOS patients is significant higher than non-PCOS.

Background and Objective: Placenta previa (PP) is a common cause of pri-partum bleeding leading to high mortality and morbidity in mothers and neonates. This study was conducted to determine risk factors and outcomes of PP in Golestan province of Iran.Materials and Methods: This case-control study was done on pregnant women admitted for delivery to the Dezyani hospital of Gorgan, Iran during 2002-07. All PP cases were recruited as case group and 251 non-PP ones were entered into the study as control group. Student t-test and Chi-Square test were used to assess the relationship between variables.Results: In this study out of 33473 pregnant cases, 82 women (0.24%) had PP. The mean (±SD) age of mothers with PP was 28.5 (±6.2) years. There was a significant correlation between PP and delivery method (P<0.05). History of cesarean section was significantly higher in cases than controls (P<0.05). The prevalence of hysterectomy due to PP was significantly higher in women with history of cesarean section (24%) than other ones (5%) (P<0.05).Conclusion: We found a significant relationship between history of cesarean section and hysterectomy due to PP. Therefore, PP should be considered in women with a history of cesarean section.

Background and Objective: Millions of women in the world use oral contraceptive pills (OCPs). On the other hand %16 to %19 of women suffer from migraine and many of them have tension headaches. These women may wonder whether the consumption of OCPs is harmful for them. This study carried out to determine the effects of combined low estrogen oral contraceptive pills on migraine and tension headaches.Materials and Methods: This case control study was done on 344 women which reffered to health care centers in Mashhad, Iran during 2009. Case group include 244 women which consumed oral contraceptive for at least three month. 100 women without OCPs consumption were considered as control group. The criteria of International Headache Society for migraine and tension headaches were used to diagnose headache. The severity and the frequency of headaches before and after the consumption of OCP were recorded. Data was analyzed by Chi-Square, Fisher exat, Logestic regression and Wilcoxon tests.Results: The frequency of migraine headache was 5% and 6% in case and control groups respectively. This different was not significant (OR=0.88, 95%CI: 0.3-2.69, P=0.804). The frequency of tension headache in cases and controls was 12% and 10%, respectively. This different was not significant (OR=1.26, 95% CI: 0.56-2.86, P=0.055).Conclusion: This study showed that the consumption of OCPs has no effects on the advent of migraine and tension headaches and do not increase the rate and severity of the attacks.

Background and Objective: Human immunodeficiency virus (HIV) belongs to the retroviridae family and is the agent of acquired immunodeficiency syndrome (AIDS). Treatment of HIV for the global health has made a special importance for the new antiviral drug discoveries in addition to HIV vaccine developments.Materials and Methods: In this experimental study single cycle replicable (SCR) HIV-1 virions with the capability of one cycle of replication were produced by the co-transfection of three plasmids of pmzNL4-3, psPAX2 and pMD2.G to the HEK cells and their replication capacity of the first generation SCR visions in HEK 293T, MT-2, and mouse spleen cells was examined by p24-capture ELISA, syncytium formation assay. The infectivity of the SCR-produced virions was also analyzed on MT-2 cells.Results: Experiments showed the efficient production of SCR virions. Moreover, results indicated the replication potency of SCR virions on the investigated cells and the inactivity of the produced SCR HIV virions. Complete HIV antigens are expressed in their native forms by SCR virions, but this second viral particles lack the replication capacity.Conclusion: SCR HIV virions produced in this study are capable of one cycle of replication and will be inactivated thereafter. These features make SCR virions as a good candidate for HIV vaccine studies. Moreover, considering the one cycle replication, SCR virions do not need the severe biosafety concerns involved in retrovirus studies.

Background and Objective: The Candida albicans is an opportunistic fungi that can be pathogenic in patients suffering from diabetes and AIDS. This organism can cause various infections such as superficial of the skin and mucosa to deep tissue infections. In this study the antifungal effects of ZnO and SDS on Candida albicans in comparison with Fluconazole were investigated.Materials and Methods: This was an experimental study which evaluated the antifungal effects of biocide SDS and ZnO on Candida albicans by microbroth dilution assay in broth and agar medium. Minimum Inhibitory Concentration (MIC) was determinated for each inhibitor during colony count in comparison with control.Results: MIC of ZnO was 1.013-296 mg/ml and for SDS and Fluconazole were 0.001-0.56 and 0.062-128 mg/ml respectively.Conclusion: This study demonstrated antifungal activity of ZnO can be candidates for the elimination of candida in medicine particular in medical instruments.

Background and Objective: Open fractures mostly appear in leg (24%), and often accompany with soft tissue defects that predispose the limb for amputation. One of the best ways for limb salvage is to support both bone and soft tissue by the means of soft tissue reconstructing surgeries. The aim of this study was to evaluate the outcomes of soft tissue reconstruction surgeries in legs open fractures.Materials and Methods: This descriptive study was performed on 59 patients with leg open fractures and soft tissue reconstruction surgery at Shahid Kamyab hospital in Mashhad, North-East of Iran during 2004-05. Individual characteristic, clinical and physical examination, and outcome of the surgery were gathered in a questionnaire and analyzed by descriptive and Chi-Square test.Results: Eight patients excluded and finally the study was done of 51 patients. Out of 51 patients 84.3% were male with mean age of 30 years. Leg open fractures in 76.5% of patients was IIIB type. Surgery was successful in 76.5% of patients. Delayed union occurred in 56.9% and osteomyelitis in 33.13% of patients. There was a correlation between the time of soft tissue reconstruction and union, deep infection and osteomyelitis (P<0.05).Conclusion: This study showed that high frequency of deep infection, osteomyelitis and delayed union due to leg open fractures with lack of soft tissue.

Background and Objective: Intercostal and supracostal access tract are usual access for percoutaneous nephrolithotripsy (PCNL) for upper calices stones. But pleural complication of these tracts is high. This study was done to evalute percutaneous nephrolithotomy (PCNL) of upper calices with subcostal access.Materials and Methods: Seventeen patients (12 males, 5 females) with stones limited to upper calices with diameters of 11-27 mm and 1-5 in numbers, candidate for PCNL. Ultrasonography and intravenous urography were performed for all patients prior to surgery. In all patients PCNL performed in prone position and access is made at prolonged and deep inspiration from subcostal with fluoroscopic guidance. Following access to upper calices, guide wire inserted and dilatation of tract up to 28 or 30 Fr informed. After insertion of 28 or 30 Fr Amplatz sheat nephroscopy performed.Results: Two patients excluded and finally 15 patients were accounted. In 15 patients subcostal access performed successfully (88.2%). In 5 patients’ stones of less than 10 mm extracted with grasps. In 10 patients after pneumatic lithotripsy, particles of tones removed. 11 patients rendered stone free (73.3%). 4 patients had residual stones of greater than 5 mm in minor calices that in 3 patients after single ESWL resolved. 3 patients needed infandibular dilatation for complete stone extraction. No infection, transfusion, pneumothorax, hydrothorax, respiratory discomfort in operation and post operation period was seen. In one patient a perirenal collection of liquid with diameter of 5 cm was detected. Perirenal collection of liquid was removed with preventional treatment and antibiotics regiments.Conclusion: PCNL with subcostal access for upper calices stones is a feasible and safe with low complication and can be performed instead of supracostal access tracts.

Background and Objective: Although directly observed treatment (DOT) strategy had decreased tuberculosis (TB) mortality, but in developing countries, TB is yet one of the leading cause of deaths. Inappropriate treatment regimens and poorly planned and one of the TB control programs have contributed to rise in its incidence. The purpose of this study was to describe knowledge, attitude and compliance with tuberculosis treatment.Materials and Methods: This sescriptive –analytic study was done on 167 tuberculosis patients in Ahvaz-Iran during 2009. A questionnaire, observation, sputum smear, potts –cozart test (for detect of isoniazide metabolites in urine) was used for data collection. Reality of questionnaire was determined by alpha-cronbach correlation method (a=0.81). Data analyzed with Chi-Square test.Results: The findings showed that 52.7%, 35.3% and 12% of the patients demonstrated good, midscores and poor adherence to drug regiment respectively. Also there was a significant relation between control of medication and knowledge and attitude in tuberculosis patients (P<0.05).Conclusion: This study showed that a half of patients used medication according to DOT strategy, knowledge and attitude were effective on quality of adherence to the medication.

Background and Objective: Mortality rate and causes of death is one of the main components in health planning at each society. This study was done to show the pattern of mortality trends in Iran during 1970-2009.Materials and Methods: In this cross-sectional descriptive study related data to 9740656 deaths registered in National Organization Civil Registration were surveyed and analyzed during 1970-2009. SPSS software and statistical descriptive methods were applied to evaluate the data.Results: 60.4% of all registered death was in rural areas. 61.1% were male. Crude death rate according the current statistics decreased from 13 per 1000 in 1970-75 to 5 per 1000 in 2005-09. Life expectancy with 28.6% increased from 55.2 years in 1970-75 to 71 years in 2005-09.Conclusion: This study showed that all mortality indicators in Iran were lower than other part of the world. There was a general decreasing in infant mortality rate in last three decade. Also the death registry system has been improved during study years.

Background and Objective: Substance abuse is a major concern all over the world. Due to some individual, familial and social factors the identification of related factors can help us to design more effective strategies for the prevention of drug abuse. This study was performed to evaluate the relation between individual and familial characteristics with substance abuse tendency in self-introduced addicts.Materials and Methods: This case control study was done on 120 addicted subjects referred to addiction clinic of 5Azar hospital, Gorgan, North of Iran and 120 matched non-addicted subjects were considared as controls. Data collections were performed by questionnaire and interview. Data analyzed with using T-test, Chi-Square and logistic regression.Results: Univariate analysis showed that high school (OR=4.63, 95% CI: 1.78-12.02) and high school graduate subjects (OR=15.5, 95% CI: 4.9-50) showed higher tendency toward addiction compared to university educated people. History of substance abuse in friends (OR=7.33, 95% CI: 4.09-13.13) and previous and present cigarette smoking (OR=12.35, 95% CI: 6.65-22.93) increased abuse tendency. Permanent employment decreased abuse tendency (OR=0.109, 95% CI: 0.05-0.22) compared to temporary job.Conclusion: This study showed that addicted friends, cigarette smoking, low level of education and temporary job increase drug abuse tendency.