مجله دانشکده پزشکی اصفهان
پیاپی 106 (خرداد ماه 1389)

Rate of injuries among female athletes is higher than male. Cyclic sex hormones fluctuation dur-ing the menstrual cycle might play an important role in this respect. The aim of this study was to investigate the rate of female athletes’ injuries in different phases of menstrual cycle. Athletes from twenty clubs participated in Iran league competition (2006-2007) were studied. Infor-mation of menstrual cycle and athlete's injuries was collected using injury report form completed by athletes and team physicians. The rate of injuries, ligament injury and also anterior cruciate ligament injuries were significantly higher in luteal phase, compare to ovulation and follicular phases (P < 0.01). When data were analysed based on the duration of each phase, more injuries were observed in the ovulation phase. There is circamenstrual variation in female athlete's sport injuries. So, for minimising rate of injury, female athletes should avoid from dangerous situations in training and competition during ovulation phase.

The incidence of mortality due to mycoses, particularly those caused by opportunistic fungi, has shown a marked increase in recent years. This happens especially in patients whose immune defense mechan-isms is compromised by antibiotics, immunosuppressive, therapy, or severe underlying disease. In this study‚ the effects of cytoplasmic proteins of candida albicans on lymphocytes were examined.

Candida Albicans (Atcc 1023) was cultured in GYEP medium. Cells harvested by centerifugations were disrupted with glass beads. Disrupted yeast cells were centrifuged at 100’000 × g for 1 hour and superna-tant was taken as cytoplasmic extract. SDS –PAGE was done to determine molecular weight. In order to further purify the cytoplasmic extract‚ gel filtration (G200) was used. Mice were divided in five groups: two groups were sensitized with active and inactive cells (both groups with adjuvant) and the other three groups were sensitized with complete adjuvant, incomplete adjuvant and physiologic serum. After seven days of the last injection‚ spleens were removed and lymphocytes were isolated. MTT assay was used in order to measure lymphocytes proliferation. IL4 and IFN-γ cytokines were thereafter measured by ELISA.

Among five groups of mice‚ antigens in groups 1 and 2 had the highest stimulation index and group 2 showed more stimulation. Studiy of cytokine profile showed that Th1 pattern in cell-mediated immune responses to the cytoplasmic proteins of candida albicans.

According to the results‚ cytoplasmic proteins modulate immune responses as inducers of lympho-cyte proliferation and cytokine produce in vitro. So it can be suggested as a model for vaccine. Immunotheapy with interacellular candida constituents as cytoplasmic proteins will help to inhibit the emergence of resistant candida strains and to treat fungul infections caused by chemotherapeutics after infection.

Renal artery stenosis (RAS) is one of the main causes of secondary hypertension and the most preventable cause of RAS is atherosclerosis. Recently, percutaneous transluminal renal artery angioplasty (PTRA) has become the treatment of choice for RAS. We assessed the outcome of PTRA in a sample of patients referred to heart clinics in Isfahan University of Medical Sciences. Thirty two patients with RAS and persistent hypertension were selected and underwent of percutane-ous transluminal renal artery angioplasty. Then, they were followed for 4 weeks by a cardiologist. The main out-comes were blood pressure, serum creatinine, cardiac functional state and chest pain. The Repeated Measure of ANOVA and Freidman test were used for statistical comparisons via SPSS14 software. The mean of systolic blood pressure decreased from 199.4 to 142.2 mmHg during 4 weeks follow-up (P < 0.0001); the diastolic blood pressure decreased from 114 to 89.2 mmHg too (P < 0.0001). The cardiac func-tional state increased and chest pain decreased significantly during 4 weeks; but the serum creatinine level showed no significant decrease. PTRA is a useful method for treatment of hypertension in patients with RAS. It decreases the Renin-Angiotensin-Aldostron pathway and declines neurohormonl activities. Thus these changes decrease blood pressure level and cardiovascular morbidity and mortality. It improves renal function, too. By this procedure, the need for antihypertensive drugs will decrease and it has economic benefits for patients too.

Menopause is one of the steps in women’s life which accompany with a lot of problems Which the most common of is osteoporosis. This study was designed to assess the comparative effects on osteoporosis of tibolone in postmenopausal healthy women. Tibolone is a synthetic steroid with estrogenic, progestogenic and androgenic properties. Eighty seven women aged 45-64 years were randomly assigned to two groups: 49 women received 2/5 mg tibolone plus Calcium-D daily and 38 other received only Calcium-D daily. At baseline and 6 months of treatment we measured bone turn-over marker (serum ALP and urinary Ca/Cr ratio). Bone mineral density was measured in the spine and neck of femur by dual energy X-ray absorptiometry (DEXA) at baseline and 9 months of treatment. Serum ALP decreased and urinary Ca/Cr ratio also increased significantly in those taking tibolone. Also, T-score, Z-score and BMD increased significantly in the spine and femur in those taking tibolone. No sig-nificant change in the T-score, Z-score and BMD of the either spine or the femur was observed in the control group. Also, there was no significant change in serum ALP and urinary Ca/Cr ratio in them. A significant differ-ence in the increase of T-score, Z-score and BMD of the spine and femur between the different treatment groups was observed in favor of those taking tibolone compared to women who received only Calcium-D. Also, there was a significant difference in the increase of urinary Ca/Cr ratio and decrease in serum ALP in tibolone group to Calcium-D one. Tibolone has beneficial effects on bone mineral density and bone turnover markers.

Sometimes despite an unripe cervix, induction of labor may be needed. In these cases, safe and suitable method should be considered for cervical ripening and pregnancy termination. The aim of this study was to assess the comparison of vaginal misoprostol with foley catheter for cervical ripening and induction of labor. This randomized clinical trial was performed on 110 pregnant women referred to the teaching hospit-als of Mashhad University of Medical Sciences during a time period of September 2007 to March 2008. The women were randomly divided into two groups: misoprostol (49 cases) and foley catheter (59 cases). For first group, 25 microgram vaginal misoprostol every 4 hour up to maximum 6 doses was administered. For second group, foley catheter 18F inflated with 50 cc of sterile water was placed through the internal os of the cervix. Data was analyzed by SPSS software. P < 0.05 was considered statistically significant. Two groups were similar in the view of demographic characteristics, cesarean indications, maternal-fetal outcomes and neonatal outcomes. Vaginal delivery was significantly higher in misoprostol group (89.9 vs. 62.7, P = 0.001). The mean of delivery time was significantly shorter in misoprostol group (11.08 ± 5.6 vs. 13.6 ± 16.0 h, P < 0.05). In the case of need to pregnancy termination and unripe cervix, two methods of misoprostol and foley catheter are suitable, but it seems that misoprostol decreases time of delivery and need to cesarean more than the other.

Bacterial zoonoses have the first priority in laboratory rat colonies to be considered, monitored and eradicated. These bacteria count as health risk factors for personnel and researchers and may interfere with experimental results. In this study, conventional laboratory rats from three breeding colonies including Salmo-nella typhimurium, Salmonella enteritidis, Streptobacillus moniliformis, Pasteurella pneumotropica and Strepto-coccus pneumonia, were screened for detection of five bacterial zoonoses. Study population were carried out for 60 rats of same numbers of male and female of the three breeds including, Sprague Dawley, Wistar and NMRI of 3-4, 6-8 and 25 weeks ages. Animals were allocated in a random fashion as 20 animals for each breed. Two hundred and forty specimens of nasopharynx (n = 120), cecum (n = 60) and liver (n = 60) were taken from all animals and cultured for bacteriological tests. Mentioned zoonotic bacteria were absent in all of specimens; however in 82.1% of the specimens, commonly nonpathogenic bacteria, mainly Escherichia coli, Bacillus spp, Streptococcus other than Streptobacil-lus moniliformis, and Entrobacter aerogenes were observed. There was significant difference in value of infec-tion to nonzoonotic bacteria only between first two age groups of animals with 25 weeks age group in three breed rats (P < 0.001). Results of our study recommend that use of these animals have no human risk or research interfe-rences for mentioned zoonotic bacteria.

Intensivists consider sepsis (the systematic response of the body to severe infection) as the 3rd cause of death due to infection (after pulmonary infections and AIDS). The increasing trend of sepsis incidence and its complications may make it as the most prevalent cause of death in Intensive Care Units. In the late 80 decade, sepsis used to be the 13th cause of death in US and more than about ten billion dollars was spent annually for the cost of its therapy. Estimates reveal that more than 400,000 new cases of sepsis and 200,000 new cases of consequent septic shock were occurred annually in US in which 100,000 of them are unfortunately resulted to death. Many factors are considered for the increasing rate of sepsis and septic shock incidence in which immune system suppressive therapy, raising use of different vascular catheters, increase of life expectance and also increasing rate of resistant infections are more remarkable amongst them. Despite the proposing of new theories on pathogenesis and pathophysiology of sepsis and the introduction of new and potent antimicrobial and antifungal drugs, it seems that there is not sign of clinically significant decrease in the mortality of this syndrome. This mortality rate is still considered unpredictable and for example for gram negative sepsis within the range of 20 to 80%. Though this special clinical situation deserves to be considered and further investigated by scientist from a 360° general point of view. General practitioners whom are the main target population for this review article are not supposed to confront routinely the cases of septic shock and this misleading statement may keep them happily far from the facts mentioned above. The aim of this article is to review the current information on the definitions, etiology, pathogenesis, pathophysiology and pharmacotherapy of sepsis in a teaching and educational basis.