نشریه ارمغان دانش
سال بیست و یکم شماره 1 (پیاپی 108، فروردین 1395)

Cerebral palsy is a common cause of disability in childhood that effects on posture and motor development and leads in activity limitation.In this children, the function of hand and arm become problematic and this can lead to disability in doing of activities of daily living. Orthosis and splints are used to improve position, range of motion, hand function and finally can improve doing of activities in children. The aim of this study was to investigate the effects of static anti-pronation splint on activity,spasticity, range of motion, and function of affected hand of spastic hemiplegic children of 8-12 years old.
This study is a single blind randomised control trial that was approved by ethical committee of Tehran University of Medical Scienses(Irct ID: IRCT2014042717450N1 ). 20 spastic hemiplegic cerebral palsy children with 8 to 12 years old were selected through students who studied in physical disabled schools in Tehran city and had the inclusion criteria.Patients randomly divided into intervention and control group.Patients in intervention group used a static anti-pronation splint for two months, 6 hours daily.Duration of using the splint was 3 sets of 2 hours a day. In this study the Activity Scale for Kids was used to evaluate activitiy implementation of children, the Modified Ashworth Scale was used to assess spasticity of wrist, forearm and elbow, ROM of wrist, forearm and elbow were tested with goniometer and Box & Block test was used to evaluate hand function.
The results in intervention and control group were interpreted and compared together. Results in intervention group showed a significant improvement in activities of children(p0.05) . In comparing the results of intervention and control group, before the study there was not a significant diference between two groups but after study, the diference was significant.
Information from present research shows that using static anti-pronation splint for 2 months ,6 hours a day, can be an effective method to improve activity implementation, wrist and forearm spasticity and range of motion and hand function in hemiplegic CP children.

exposure to Bisphenol A (BPA) produced a significant increase in levels of the dopamine D1 receptor mRNA in the whole brain. So the aim of present study was to investigate: The effect of BPA on dopamine D1 receptor distribution in accumbens (aca) and caudate putamen (cpu) nuclei in with and without learning of male rats.
Material and In this experimental study, thirty male rats weighting 220- 300 g were used. Animals were divided into 6 groups that each of them have 5 male rats. BPA in doses 5 and 5o mg/kg/day were used by oral intake for 15 days. Learning and memory were performed by a passive avoidance shuttle-box. Distribution of dopamine D1 receptor was investigated by immunohistochemical procedure. For determination of color difference the software of Image Analyzer were used. For data analyzing, Onaway ANOVA test and Tukey as post-hoc were used. Significant level was considered P Data in the present study showed that BPA in two dose significantly (P According to present results BPA impair dopamine D1 receptor distribution in aca and cpu nuclei of male rats, while the BPA in learned animal has not significant effects on dopamine D1 receptor distribution.

.Thyroid gland has an important role in growh and metabolism in the body. Hypothyroidism is a disorder that act on body organs. The medicinal plants in treatment of disease are widely used. Elettaria Cardamomum L. is known as a medicinal plant with widely use in traditional medicine. In this study the Elettaria Cardamomum hydroethanolic extract (ECE) on hypothyroid male mice has been investigated .
Material and In this experimental study 42 male mice were divided to 6 groups randomly: control groups, witness (taking propylthiouracil ,PTU 0.1% in tap water), treated groups 1,2 and 3: (taking PTU, 0.1% in tap water 100, 200 and 400 mg/kg ECE , i.p) and levothyroxine group (taking PTU, 0.1% in tap water 15 µg/kg. gavaged). The PTU 0.1% administered for 15 days, then the groups received ECE and levothyroxine for 10 days. The control group were received daily 0.25ml normal saline intraperituneally. At the end of experiment, animals were anesthetized by ether and blood samples collected from heart directly for analyzing TSH,T3 & T4 hormones. The data were expressed as mean±SEM and analyzed by ANOVA statistical software. The significant differences were expressed with P The results of this study showed that the T3 and T4 level decreased and TSH level increased compared with control group significantly in taking PTU group(P The ECE may be has antioxidant and flavonoid compounds which are able to act on thyroid hormones synthesis considerably and increase its serum levels in male mice.

There are various treatment methods include land-based training, hydrotherapy, locomotor training with bodyweight support and functional electrical stimulation after spinal cord injury. So, the aim of this study was the comparison of effect of conventional exercise and locomotor training on quality of life, body composition and speed walk in incomplete paraplegic persons.
This is a quasi-experimental study. 17 voluntary paraplegic spinal cord injured persons, selected availability and voluntarily. The subjects were randomly assigned to locomotor group (N=10) and conventional exercises group (N=7). The subjects trained for 12 weeks, four sessions per week and 60 min per session. Locomotor session include 15 min warm-up on fixed gear bike, 45 min locomotor with 50% body weight and 10 min cold-down finally. 10% load was added each week. Traditional exercises session included 15 min warm-up plus 45 min stretch exercise and resistance training. The first samples were taken 24 h before the first session and the second samples were taken 48 h after the last session (after 12 weeks).
The data showed that there were significant differences physical functioning (P = 0.039), role-physical (P = 0.001), bodily pain (P = 0.001), general health (P = 0.001), vitality (P = 0.001), social functioning(P = 0.001), role-emotional (P = 0.001), mental health (P = 0.001), between locomotor and conventional exercise groups. On the other hand, there were no significant differences in terms of physical (P = 0.313) and mental (P = 0.257) quality of life between two groups. In addition, the results showed that no significant difference in (P = 0.0031), BMI (P = 0.001), body fat percentage (P = 0.001) and speed walk(P = 0.001) between locomotor training and conventional training groups.
The results showed that in some aspects of quality of life were observed significant differences between the two types of rehabilitation intervention, but overall both practice and effective achievements in improving the quality of life for people with paraplegia with the same.

Apelin is a newly discovered adipokine which plays an important role in regulation of energy homoeostasis and improvement of insulin resistance. The aim of this study was to determine the effect of continuce aerobic training on plasma concentration of apelin and insulin resistance in type 2 diabetic men.
Material and This study was quasi-experimental and applied. In this experimental study, twenty four diabetic men of ahwas were chosen method and randomly divided into training (n=12) and control (n=12) group. Anthropometric measures, body composition and maximal oxygen uptake (VO2max) of the subjects were measured by using a modified Bruce continuce aerobic exercise training was performed during 8 week (3 session per week, 20-45 min per sission, 40%- 70% HRmax). Before, and 48 hours after the last training session, plasma concentration of glucose, insulin and apelin were measured and HOMA-IR was calculated. Data analyse was used by T-tests, ANOVA and Pearson correlation coefficient and the significant level of p˂0/05 was considered.
There was a statisticaly significant decrease in plasma concentration of glucose and insulin and HOMA-IR, and a significant increase in plasma concentration of apelin was observed in training group compared with pretest and control group. Furthermore, a significant negative relationship between plasma concentration of apelin and HOMA-IR after 8 weeks aerobic training was found.
It seems that low to moderate intensity continuce areobic exercise training has significant effect on the amount of plasma apelin in type 2 diabetic men. IT may be a continuce aerobic training is effective to improve insulin resistance and glycemic control in type 2 diabetic men.

Resistance to Extended Spectrum Beta-Lactamase (ESBL) is one of the most widespread enzymatic beta-lactamase in those bacteria which cause infections in hospitals. One major reason for this type of resistance seems to be the arbitrary and/or excessive use of antibiotics. At present, there is no resistance pattern for bacterial strains which cause infections in hospitals with ESBL mechanism in different regions of Iran, they spread differently in different seasons, and more and more cases of the resistance are being reported. Hence, the present study aimed to determine the antibiotic resistance patterns and bacterial strains and to investigate the presence of Beta-lactamase SHV, TEM , CTX-M genes in those Klebsiella strains which produce ESBL. The clinical samples of the study were collected from Yahyanejad Hospital in Babol.
This study, which is a descriptive-analytical one, was carried out in six-months and 2075 clinical samples( of blood, urine, respiratory discharge, throat culture, wound culture, pleural fluid culture, CSF, Ascitic fluid culture, Synovial culture, and bone marrow smear) were gathered during this period in 1393. 39 Klebsiella strains were identified among the hospitalized and out-patients of Yahyanejad Hospital using disk diffusion method and CLSI instructions. Antibiotic allergy tests were given for all the strains, and all the strains were separated using synergic double discs to check the presence of ESBL. In the next phase of the study, the extracted DNA were examined in terms of the presence of SHV, TEM , CTX-M by using specific primers and employing PCR method. The collected data were analyzed using, SPSS and K2 tests.
The frequencies of the identified strains were: isolated Klebsiella Pneumonia: 31(79.49%), isolated Klebsiella Oxytoca: 5(12.82%), and isolated Klebsiella Ozaenae: 3(7.69%). Among the isolated Klebsiella stains 19(48.72%) were resistant to cefotaxime , 14(35.90%) to ceftazidime, 18(46.16%) to Amikacin, 13(33.34%) to Meropenem, 18(46.15%) to Ciprofloxacin, 26(66.67%) to Ceftriaxone, 12(30.77%) to Piperacillin Tazobactam, and 16(41.03%) to Ampicilin sulbactam. Also, among the 39 isolated Klebsiella Pneumonia, there were 10(25.64%) isolated positive ESBL, all the 10(100%) isolated strains having Beta-Lactamase SHV gene, there were 6(60%) isolated positive TEM gene and there were 4(40%) isolated positive CTX-M gene.
Considering the high rate of resistance to third generation cephalosporin, it is imperative to perform accurate antibiogram and avoid irrational prescription of antibiotics in treating infections due to organisms which produce ESBL. In addition, it is of vital importance to screen the clinical samples in terms of resistance to ESBL, and to prepare guidelines for physicians to help realize the disease and to treat the patients properly. Also , the extracted DNA were examined samples purified in identifying genes SHV ,TEM ,CTX-M in Klebsiella Pneumonia is possible PCR method.

Thalassemia is an inherited autosomal recessive anemia caused by structural variations or abnormalities in globin chain synthesis. The screening of thalassemia in marriage candidates is a suitable opportunity for prevention and control of this disease. Regarding hematologic indices variations in above-mentioned patients, this study was conducted to compare the hematological indices variations in types of Thalassemia in marriage candidate patients in Kohgiluye & Boyerahmad province in 1392.
In this cross-sectional study, the results of the genetic analysis by GAP-PCR method and hematological indices including MCV, MCH, HGA2 and RBC of 111 thalassemic marriage candidates who referred to health centers, along with their demographic data was analysed with descriptive statistics and inferential statistics Anova and pirson"s correlation, by SPSS 17 software.
Alpha thalassemia (78/4 percent), non-alpha-beta thalassemia (9 percent) and beta thalassemia (8.1 percent) were the most frequent types, respectively. The average of hematological indices were 2/77 ± 0/75, 75/62 ± 5/58, 23/87 ± 2/40 5/61 ± 0/62 for HbA2, MCV, MCH and RBC, respectively. Alpha thalassemia patients showed higher MCV average in comparison to beta thalassemia cases. The difference of average of MCV between patients with alpha-thalassemia and patients with non-alpha/beta was not statistically significant. MCV average in Beta thalassemia was not different with both Alpha thalassemia and non-alpha/beta thalassemia. MCH and HgA2 difference between different thalassemia types was matched with MCV but RBC average difference was not significant for any types of thalassemia. There was a direct significant correlation between MCV and MCH for all types of thalassemia. MCV and MCH indices averages have inversely correlated with RBC In patients with alpha thalassemia (p =0/01).
Ddifference of average of blood parameters including MCV, MCH and HgA2 between beta thalassemia cases with alpha, non-alpha-beta thalassemia patients with beta thalassemia cases, and beta thalassemia with both alpha and non-alpha-beta thalassemia can be used as a predictive marker for clinical diagnosis types of thalassemia among Kohgiluye and Boyerahmad province patients.

Intrudaction: Medical services pricing is one of the most important tools of each country's health system policy makers. Tariff is effective on equity, efficiency, quality and accountability in the provision of services and it can affect the availability and use of services. Switch medical services tariffs affected providers of hospital and medical services income on the one hand, and on the other hand the cost of medical and hospital care providers of financial resources. This study aims to predict the consequences of the reform of pricing medical services (making medical services tariffs) were performed.
This study is a qualitative study. Sampling was Purposeful and continued until data saturation. Research Society was 12 people of, Health Managers of cities include Tehran, Isfahan and Tabriz, that in the purpose of the study, these people were investigated with deep interview. Analysis of the data in this study is based on a thematic analysis. Criteria such as "reliable information", "trustworthy", "reliability" and "ability to consolidation" of data were considered.
According to findings, the results of the study were divided into two categories: positive and negative consequences as a result of medical services tariff reforms and likely increase, although logically and scientifically. The positive consequences include behavioral outcomes, economic and stakeholder satisfaction. And negative consequences include economic consequences and limited group dissatisfaction.
The consequences have been anticipated at the time of modification of medical tariffs in addition to encouraging health tariff and policy makers Because of the benefits that will be earned in terms of positive consequences, they noticed negative consequences, particularly in economic consequences and the need to provide for an increase in tariffs and the need to think for provides financing compensatory.

our purpose is to report the experience of uterine rupture in a primigravida patient with uterine anomaly for whom misoprostol is used for induced abortion in the second trimester. Misoprostol is a synthetic analogue of E1 prostaglandin which is used to prevent the ulcer peptic causing NSAID. Misoprostol is prescribed for oral, sublingual, vaginal and rectal consumptions to force induced labor and termination in mid-pregnancy and it is also used for dilation and suction in the first trimester. Food and Drug Administration presents the side effects of Misoprostol usage as follow: Uterine hyper stimulation, uterine tetany, uterine ruptures, shocks maternal death, fetus bradycardia and death as well as Meconium amnion fluid.
Uterine rupture in women with uterine anomalies is one of the rare yet serious complications in the second trimester of induced labor and the anomaly rate is between 0.5 to 1.8. Pregnancy in rudimentary horn is rare but it is followed with lethal side effects such as uterine rupture, abortion, ectopic pregnancy and etc. The review of this study indicates that not enough data is available in order to support the usage of Misoprostol for women with uterine anomaly.
although uterine rupture is rarely followed by the usage of Misoprostol, it is of great importance to take in to consideration the irrecoverable complications which compel us undertaking vital cautions and also make sure of the normality of uterine before prescribing Misoprostol.