مجله دانشگاه علوم پزشکی بابل
سال شانزدهم شماره 11 (پیاپی 86، آبان 1393)

Mechanical ventilation affects heart and hemodynamic function. Nitroglycerine (NG) and Na Nitroprusside (NPS) are used to apply as deliberate hypotension by decreasing the preload and afterload of heart, respectively. This study was evaluated the effects of different tidal volumes on a few hemodynamic components during these kinds of controlled hypotension. In a double-blind clinical trial, 60 anesthesia patients were randomly selected during mechanical ventilation with different tidal volumes (5, 10 & 15 cc/kg) for ten minutes before and after controlled hypotension which induced by NG or NPS. Changes of some hemodynamic components were measured and analyzed. Before hypotension, the cardiac output (CO) decreased from 3.35±0.35 to 3.05±0.65 and from 3.51±0.34 to 3.06±0.56 lit/min in NG and NPS groups, respectively (p<0.000) and stroke volume (SV) decreased from 35.26±3.43 to 17.42±4.36 and 36.28±3.04 to 18.71±5.05 cc respectively (p<0.000) by increasing the tidal volume from 5 to 15 cc/kg. During controlled hypotension by increasing the tidal volume from 5 to 15 cc/kg, the CO decreased from 2.84±0.73 to 2.57±0.64 in NG group and increased from 4.26±0.56 to 4.57±0.81 lit/min in NPS group (p<0.000) and SV decreased from 15.86±4.62 to 13.46±4.29 in NG group and enhanced from 18.75±5.52 to 19.58±5.42 cc in NPS group (p<0.028). The results of this study showed that the cardiac output was decreased by increasing the tidal volume during mechanical ventilation and controlled hypotension by NG while it was increased in NPS group. The decrease of stroke volume in NG group was greater than NPS group by increasing the tidal volume.

Laparoscopic cholecystectomy is now the gold standard for the treatment of symptomatic gallstone disease. Despite the minimally invasive nature of laparoscopy، high incidence of postoperative nausea and vomiting (PONV) remains a major cause of morbidity. The aim of the present study was to investigate the effect of single dose of dexamethasone on PONV in patients undergoing laparoscopic cholecystectomy. This clinical trial study included 92 patients undergoing laparoscopic cholecystectomy. We divided the patients into two groups randomly. One group received Dexamethasone (5mg، IV) and the other group received Saline (5cc، IV) 10 minutes before extubation. The patients were observed for any episode and severity of nausea and vomiting or whether the patient required any anti emetic drug in the 24 hours postoperative period. Two patients in saline group excluded the study. There were no significant differences between groups regarding to age، gender and body mass index. Incidence of nausea in dexamethasone and saline groups were 34. 8% (16) and 47. 7% (21) respectively. The difference was not significant (RR=0. 73، CI 95%: 0. 44-1. 20، p=0. 310). Also incidence of vomiting in dexamethasone and saline groups were 30. 4% (14) and 34. 1% (15) respectively، and the difference was not significant (RR=0. 89، CI 95%: 0. 49-1. 69، p=0. 884). Our study has shown that a single dose dexamethasone (5mg، IV)، 10 minutes before extubation، has no effect on PONV.

Thalassemia is the most common genetic disorder of hemoglobin synthesis by reducing alpha or beta globin chains is determined. The main symptoms of the disease include bone deformities, especially in the skull, maxilla and zygoma and dental decay and periodontal disease. Given the higher prevalence of dental complications in these patients, we can prevent or treat complications of thalassemia patients by early diagnosis and treatment, thus in this study we examined the relationship between gingivitis and periodontitis with β-thalassemia disease. Methods and Materials: This case - control study of 50 patients with thalassemia major and thalassemia center Amirkola 15-35 years and 50 healthy individuals as a control group of healthy people examined. For patients with a questionnaire includes general information (such as gender, age, etc.) and clinical examination information such as gingival index (GI), probing pocket depth (PPD) and attachment loss (AL) and the oral health index-simplified (OHI-S) was completed. The mean age of the patients and healthy subjects, respectively, 23/92 ± 5/591 and 23/98 ± 6/554. Average Indexed Health 2/18 ± 0/77 in the patient group versus 1/2 ± 0/81 control group and no statistical differences were not statistically significant (P= 0/635). Intermediate GI patients, significantly more than the healthy controls (respectively 1/28 ± 0/73, 0/94 ± 0/59 and P =0/014); well as pocket depth in patients 0/4 ± 0/53 and the control group 0/12 ± 0/33 and mean attachment loss in patients 0/4 ± 0/53 and the control group 0/08 ± 0/27, respectively. Differences were statistically significant level (respectively P = 0/003 and P <0/001).Discussion and Among the examined parameters, periodontal indexes in patients with thalassemia were significantly higher than normal group which show more prevalence of periodontal disease and gingival, as a result, we can prevent and early treat complications and problems caused by the thalassemia by continuously track and periodic monitoring the status of patients.

Morphine withdrawal increases the neuronal activity in the brain associated with the changes in the level of neurotransmitters and second messenger system. The aim of this study was to evaluate the effect of felodipine (calcium channel blocker) alone and in combination with CCPA (A1 receptor agonist) or SCH58261 (A2A receptor antagonist) on the morphine withdrawal syndrome. This experimental study was conducted on 80 NMRI male mice divided into 8 groups (n=10) including Saline, Felodipine (2.5, 5, 10 mg/kg), CCPA, SCH58261, Felodipine+CCPA, and Felodipine+SCH groups. Animals received increasing doses of morphine sulphate subcutaneously (S.C). Animals were examined in terms of jumping behavior and diarrhea for 30 minutes after intraperitoneal (i.p.) injection of naloxone (4 mg/kg i.p.). In comparison with the saline group, 5 mg/kg of Felodipine (88.1±7.199 & 44.8± 8.421, p<0.05), CCPA (88.1±7.199 & 20.4± 5.02, p<0.001) and SCH (88.1±7.199 & 37.2± 3.623, p<0.001) significantly reduced the number of jumps. Three doses (2.5, 5 and 10 mg/kg) of felodipine decreased the amount of diarrhea (0.478±0.059, 0.109±0.035, p<0.001), (0.478±0.059, 0.112±0.054, p<0.001), (0.478±0.059, 0.067±0.026, p<0.001), respectively and the CCPA significantly reduced diarrhea (0.478±0.059, 0.057±0.010, p<0.001), too. In the combination therapy, Felodipine (5mg/kg) +CCPA significantly decreased jumping (88.1±7.199 & 28.3±4.758, p<0.001) and diarrhea (0.478±0.59 & 0.011±0.007, p<0.001). Felodipine (5mg/kg) +SCH 58261 significantly reduced jumping (88.1±7.199 & 41.7±5.226, p<0.001) and diarrhea (0.478±0.59 & 0.027±0.023, p<0.001). The results showed that using the felodipine in combination with SCH58261 and CCPA decreased morphine withdrawal symptoms, but synergistic effect was not observed in combination therapy.

Rosa damascena Mill is from Rosacea family which has been used in traditional medicine for the treatment of gastrointestinal diseases. The effects of petal’s hydro-alcoholic extract of Rosa damascena Mill were examined on the trachea, aorta and uterus of Wistar rats in this study. This experimental study was conducted on forty male Wistar rats randomly divided into five groups of eight including control group, the groups receiving 0.5, 0.75 and %1 doses of Rosa damascena Mill extract with the presence and absence of calcium chloride. Isometric contraction was recorded by adding KCl to smooth muscle with stability device. After reaching the pan state, the effects of saline and cumulative concentrations of extracts were recorded and the percentage changes were calculated. Cumulative extract of Rosa damascena Mill (0.5, 0.75 and 1μg/m) dependent on dose caused the rat’s trachea, aorta and uterus contractions (p<0.05). The contractions of cumulative extract of Rosa damascena Mill were 54± 2/37, 96±3/32 and 62±2/17 in aortic smooth muscle, trachea and uterus, respectively with the presence of 60mM calcium chloride. The results of this study showed that Rosa damascena Mill increased the trachea, aorta and uterus contractions. Therefore it should be used with caution in patients suffering from asthma, dysmenorrhea or hypertension.

Chromosomal or mitochondrial DNA abnormalities are the main causes of male infertility. So far, a lot of genes are identified on X and Y chromosomes that control the spermatogenesis process in a special order. Y chromosome genes have an important role in sex determination and male reproduction process, and so any mutation or disruption on the Y chromosome genes effects on male fertility. In this study, several kinds of genetic disorders and new area of gene and mutation damaging on the Y chromosome was investigated. In this review article the genetic abnormalities induced by molecular mutations on Y chromosome was investigated.Papers pertaining to gene polymorphisms, abnormal spermatogenesis, genetic evaluation andandrogen receptor genes were used.Microdeletions, chromosomal abnormalities, molecular genetics, environmental conditions were also studied.Among 2000 genes involved in spermatogenesis, only 30 genes are located on Y chromosome. Environmental condition, hormonal and immune disorders, antioxidants, genetic factors and elements deficiency are effective in male infertility. Y chromosome abnormalities usually associated with the removal of some factors. Genes on Y chromosome usually have an important role in spermatogenesis and testes development.Chromosomal translocation and loss of genetic material cause infertility. Microscopic deletion is usually transmitted to sons and their infertility cannot be solved even using the ICSI technique. Effect of genes polymorphism on male fertility is associated with a decrease in sperm count.Azoospermic factor region on human Y chromosome contains a lot of genes which any mutation or deletion in these genes lead to impaired spermatogenesis and low sperm fertilization.

The nature and concept of death are not inexistence but transfer. Death is a transfer from the living world to the Hereafter and is an undeniable fact that encompasses every existing phenomenon. Quran mentions the death in different terms and emphasizes that the body and sprite of human beings are fully taken and nothing of them is scattered and lost. The man's death is determinate and imminent fate that nobody can escape from it with relying upon any position. However, the appearance of death and facing to it is not the same for all humans and the conditions of different people are various in moribund time. Death moment – death agony in Quran- is hardly described in verses and traditions. The aim of this study was to investigate the moment of soul separation of human, death and its states. Agony of death and different reactions of moribund people were investigated in this study based on religious sources, Quran, Bharalanvar, Nahjolbalaghe and using keywords. Most people always remember the death as uncertain fate, think death equals destruction and the life after death is meaningless, fear the remembrance of death and escape from it because the life amuses them. Certainly, Quran declares the death will come and this is a certain and undeniable fact for every living being but most people are scared of it and it can have multiple causes. The concept of death for everyone is according to his life. It means that the perception of life and death plays an important role and the death time is different for each group of people. (Relatively) losing any person's life is based on his performance and accords with his beliefs and intents. The role of inclinations to the body, family, property and world is undeniable.

Nitrate and Nitrite are entered to environment and ground water resources through using the chemical fertilizers, discharging the effluent of municipal and industrial sewage treatment plants and discharging the human wastewater. Nitrate is the cause of Methemoglobinemia disorder in babies. The aim of this study was to determine the concentration of Nitrate and Nitrite in drinking water of transmission line and of consumption points in rural and urban places of Babol. This cross-sectional descriptive study was performed in Babol in 2013. A total of 376 water samples were randomly collected from water transmission line and consumption points in rural and urban places of Babol in summer and winter. Spectrophotometer of HACH Company, DR5000 model with 520 and 570 nm wavelengths was used for measurement of Nitrate and Nitrite concentration in water. The results were compared with national standards and WHO guideline of Nitrate and Nitrite concentrations in drinking water. The concentrations of Nitrate and Nitrite in drinking water of transmission line and consumption points of rural places were 4.4±2.7 and 0.04±0.02 mg/l and 8.3± 5.3 and 0.035±0.03 mg/l, respectively. In urban localities these amounts were 8±1.5 and 0.045±0.3 mg/l and 8.8±3.7 and 0.038±0.035 mg/l. There was significant difference between the Nitrate of water in transmission line and consumption points (P= 0.03). The concentrations of Nitrate and Nitrite in drinking water in summer and winter were 6.7±1.9 and 0.03±0.001 mg/l and 9.4±3.9 and 0.04±0.001 mg/l respectively. There was significant difference for the concentration of Nitrate in terms of analysis (P=0.014). Result of this study showed that the maximum Nitrate and Nitrite concentrations in all rural and urban water supplies in summer and winter were fewer than the standard of drinking water of Iran and WHO guidelines. However, it is necessary to monitor continuously the contents of the nitrogenous compounds into the drinking water resources due to undesirable effects on the human.

Thoracolumbar junction (T11 to L1) is the most common site of spine fractures. Surgery of these fractures is performed by using long and short segment methods and each of them has its own advantages and disadvantages. In addition to these methods, the modified short segment method that includes the placement of pedicular screw in fractured vertebra and two intact adjacent vertebrae has been presented but its success rate has not been clearly established yet. The aim of this study was to evaluate the efficiency of modified short segment method in the treatment of unstable thoracolumbar junction fractures. This cross-sectional study was conducted on 50 patients with unstable thoracolumbar fractures who underwent the surgery with modified short segment method (insertion the pedicular screw in fractured vertebra and the below and above of it) in the neurosurgical department of Uremia Imam Khomeini Hospital during 3 years. Evaluating the efficiency of surgery in patients was performed by comparing the kyphotic deformity (Cobb method) and the pain intensity (visual analogue scale) before, immediately and 12 months after the surgery. A total of 50 patients, 28(56%) and 22(44%) persons were male and female, respectively. The mean age of patients was 46±17.3 (19-72 years). The mean of kyphosis was 28.3±6.4 degrees preoperatively which became 5.4±3.6 degrees (p<0.001) in immediate postoperation and 7.4±5.8 degrees (p<0.01) at final follow-up. The mean of visual analogue scale was 8±1.4 preoperatively and became 4±2.7 after surgery and at final follow-up was 2±0.7 (p<0.05). The results showed that the surgery with modified short segment fixation technique using pedicular screw in fractured vertebra is an effective method for treatment of unstable thoracolumbar fractures.