مجله دانشگاه علوم پزشکی مازندران
پیاپی 68 (بهمن و اسفند 1387)

Background and Preliminary studies have been established to examine the cardiotonic effect of Citrus bigaradia extract, by implenenting various mechanisms. The functional protective role of this plant against supraventricular tachyarrhythmia remains to be determined.The present study is designed to assess the role of hydroalcoholic extract of Citrus bigaradia by modifing the electrophysiological properties of atrioventricular node, during simulated experimental atrial fibrillation in rabbits and also, to determine the role of adrenoceptores regarding effects of Citrus bigaradia on the AV node. In this present study, Newsland male rabbits(1.5-2 kg) was used. Programmed stimulation protocols (Recovery, Wenckbach, Atrial fibrilation and Zone of concealment) were applied in two groups (N=23) to assess electrophysiological properties of isolated rabbit AV node. In the first group (N=10), different concentrations of hydroalcoholic extract of Citrus bigaradia were added to thyrods to detect nodal concealed conduction. In the second group (N=13), the effects of extracts (54-108 mg/L) were analysied in the presence of β-adereceptor blocker(Nadolol 2 µm). AF protocol was simulated by high-rate atrial pacing with random coupling intervals (range 75-125 ms). All data have been shown as Mean±SE. Citrus bigaradia, had biphasic concentration-effect pattern, such as in low and intermediate concentrations (0.8-3.2 mg/L), shortened nodal functional refractory period and Wenckebach. We observed a non-significant decrease in the average H-H intervals and numbers of concealed beats in all concentrations of Citrus bigaradia. Zone of concealment was shortened by this plant. Nadolol (2 µm) prevented the whole effects of Citrus bigaradia on the nodal conduction time, refractoriness and concealed conduction. The above results indicate the potential pro-arrhythmic effects of Citrus bigaradia in worsing supraventricular tachyarrhythmia. The effects of plant to decrease the AV-nodal refractory period and concealment zone may be considered the major mechanism of this plant.At least some parts of effects of Citrus is mediated through β-adrenoceptores.

Background and In Iran, Organ phosphorus pesticides such as chloropyrifos and diazinon are widely used in agriculture. These compounds inhibit activity of cholinesterase in nearly irreversible manner resulting in malfunction of nerve impulse transmission. This result in humans can produce illness or even death. Therefore, the present study aims to isolate various bacterial strains in specified contaminated regions. We selected one of the isolates that contain the highest OP-hydrolyzing capability for using such strain, in decontaminating environmentally harmful OP residues. In this study, vast waters from chemical factories and contaminated agricultural soil samples were used for isolation of several bacterial strains that contain OPAA enzyme are capable of utilizing chloropyrifos and diazinon as a source of carbon and phosphorus by selective enrichment on mineral salt medium (MSM), which contains chloropyrifos or diazinon. One strain was selected for analysis of degradation ability with growth studies and HPLC technique and characterization by Bergey, s manual. From vast water and soil, ten bacterial strains were isolated using chloropyrifos and diazinon as source of carbon and phosphorus. One of them named IHU strain4; grows most rapidly and luxuriously and displays the highest organophosphate-hydrolyzing capability. On the basis of morphological and biochemical characteristics, the bacterial isolate was identified as a member of the genus pseudomonas. From these findings, it can be concluded that the isolated bacterial strain is able to utilize Organ phosphorus pesticides as a source of carbon and phosphorus. Utilization of these compounds by soil microorganisms is a crucial phenomenon by which these compounds are removed from the environment, thus, preventing environmental pollution. Results from the present study suggest that the isolated bacterial strain may be used for remediation of pesticide-contamination.

Background and Many studies have determined desirable outcomes of elective episiotomy. However, the clinical practice is not based on results in many hospitals. For this reason, the present study assessed the view of practitioners regarding routine episiotomy. This qualitative study was done by content analysis. A through semi-structured interview was done with obstetricians, midwives and midwifery trainers. After gathering information, common points of interviews were coded and stratified. Continuous comparison was done to obtain confidence of internal constancy in coding. For validity and reliability, three members of group coded the interviews independently, followed by defining the final theme. Themes were then returned to participants for confidence of their accuracy. Twenty-four participants were assessed. Factors that influence the usage of routine episiotomy included 5 total concepts. Also, some partial concepts appeared as subcategory of total concepts. They were: 1. delivery agent (personal experience, skill, deficit of agents, fatigue and impatience, low knowledge, ability of communication with mother, and agent's role); 2. Mother (prevention and decline of injuries, anatomical differences, culture, not cooperating and, diseases); 3. Fetus (prevention and decline of trauma, conditions); 4. Legal problems (mother's complaints, remonstrance by seniors). 5. Method of management (non availibity of advanced technology, non usage of new methods for delivery, Mothers not being prepared). In a prolonged clinical practice, such as routine episiotomy, change is difficult. As studies recommend the limited use of episiotomy, intervention is necessary for changing practitioner's attitude and practice. Training of delivery agents, students and pregnant women are basic.

Background and The rate of carbohydrate absorption after a meal, as quantified by glycemic index, has an effect on postprandial hormonal and metabolic response. The aim of the present study is to determine the effects of low-glycemic index diet, versus low-fat diet on the body weight, BMI, WHR (waist/hip ratio) and plasma lipid profile of obese patients. A randomized controlled trial compared the effect of two dietary treatments (low glycemic index & low fat) in 46 adults, ages 18 to 55 years old, BMI >27, who proceeded to Motahary Clinic in Shiraz, Iran. Body weight, BMI, WHR (waist/hip ratio), fast and post-prandial Plasma lipid profile (Triacylglycerol, total Cholesterol, LDL-C, HDL-C concentration) level of obese women were measured at the beginning and end of 6 weeks. Changes in Body weight, BMI, WHR (waist/hip ratio) and Plasma lipid profile (Triacylglycerol, total Cholesterol, LDL-C, HDL-C concentration) were significant in both dietary groups. But no significant differences were observed in any parameter measured between two groups, except for the post-prandial HDL-C in which significant difference were observed. From these findings, it can be concluded that the isolated bacterial strain can utilize Organ phosphorus pesticides as a source of carbon and phosphorus. Utilization of these compounds by soil microorganisms is a crucial phenomenon by which these compounds are removed from the environment, thus, preventing environmental pollution. Both diets can equally be effective in decreasing the body weight and Plasma lipid profile.

Background and Literature review indicates that antibiotic resistance of bacteria may be associated with the resistance to host natural immunity. In the previous study we found that: all meningococcal isolates of meningitis cases are less sensitive to typical anti-meningococcal antibiotics. In present study, the association of the above characters was analyzed in an ex-vivo “case-control” study. A randomized controlled trial compared effect two dietary treatments (low glycemic index & low fat) in 46 adults, ages 18-55 years old, BMI >27,who proceed to motahary clinic in shiraz, Iran. Body weight, BMI, WHR (waist/hip ratio), fast and post-prandial Plasma lipid profile (Triacylglycerol, total Cholesterol, LDL-C, HDL-C concentration) level of obese women measured at the beginning and at the end 6 weeks. The resistance of both groups against selected sera were similar in the ratio 1:2- by SIC and SBC methods. The growth of “test” and “control” groups in the pooled sera were stopped at the ratios 1:512 and 1:1024 respectively. In SBA the population of “test” and “control” groups decreased in parallel to each other. However, the invasive (test) meningococcal strains established slower reduction in WBA. Studies on the correlation between antibiotic resistance of bacteria and the resistance to the natural immunity have ended with different results. According to our experience, it seems that for ex- vivo investigation of natural immunity against meningococci the WBA is more reliable.

Background and Prevalence of over weight and obesity is increasing in the world. Those over weight are more susceptible to cardiovascular diseases than other individuals. Studies indicate that body fat distribution has a determining role in the identification of risk factors. Also, the relation between BMI, cardiac ischemic pains and exercise test condition in such patients, is in need further investigation. The aim of this study was to determine the relation between BMI with exercise tolerance test in patients with cardiac ischemic pains, who were referred to the Cardiac Center of Mazandaran Province, in Sari Township. In this case control study considering the BMI in ischemic patients, 65 were selected as case and 65 persons as control using Tread mill and according to Bruce Protocol, results and tolerance test time was recorded. Independent T test was used for comparison of quantitative indexes mean, while x2 test using SPSS soft ware was used for comparison of the ratio of persons with the qualitative features. Data indicated mean weight of 57.1 kg and height of 1.64m in the case group. Also, 58.5% had history of hyperlipidemia (Cholesterol higher than 200mg/dl) and 78.8% with history of blood sugar (higher than 120mg/dl (P<0.001). Even 63.6% had hypertension of 140/9o mm Hg. Our findings showed that BMI in the case and control groups were (26.95±3.94) and (25.95±3.49) respectively. Moreover, a significant relationship between high BMI with cardiac ischemic pains and exercise tolerance test (P<0.001) were demonstrated. Cardiac ischemic pains in individuals with high BMI is common. Exercise tolerance test as one of the non invasive and less expensive procedures, can be an indicator of cardiac ischemic disease.

Background and Brucellosis is a zoonotic disease with worldwide distribution that is endemic in Iran. Worldwide, brucellosis remains a major cause of morbidity in humans and domesticated animals. The disease has a wide spectrum of clinical manifestation and can affect a variety of organs and systems. This study focused on blood culture of serologic diagnosed brucellosis and antimicrobial susceptibility test. In this cross sectional study, microbiologic survey was done on a total of 30 serum samples with STA titer of 1:160 or greater and 2ME titer of 1:40 or greater, which were presumptive for brucellosis. Blood cultures were done by lysis centrifugation and antimicrobial susceptibility test, against 9 antimicrobial agents by disk method. The data was analyzed by stata V8.0 software. At the end this study, the blood culture isolation rate was 23.3 %(7 cases out of 30 patients) and all of the isolates were brucella melitensis. Antimicrobial susceptibility tests showed high in vitro activity of ofloxacin, ciprofloxacin and doxycycline and also, low in vitro activity of streptomycin and cotrimoxazole. Brucellosis is endemic in Iran. Brucella melitensis was the most common strain of brucella in our patients. Except cotrimoxazole and streptomycin, high in vitro activity was found with other antibrucella agents, especially with ofloxacin, ciprofloxacin and doxycycline.

Stent thrombosis as a complication of percutaneous coronary intervention frequently is associated with deadly events such as myocardial infarction and sudden death. Definitions of stent thrombosis have not been in a uniform manner in different clinical studies. Two episodes of acute ST elevation myocardial infarction nearly two years after implanting a drug – eluting stent in a 58-year-old male patient is reported here. The presence of stent thrombosis was confirmed by coronary angiography.

Kimura is a rare disease that its etiology is not defined exactly. Immunologic and allergic responses are the probable cause of disease. Kimura is most often reported mostly in Asian men. Kimura is presented by subcutaneous nodule or multiple nodules in head and neck region. This Disease is benign. The kimura disease is rare and until 1994 about 120 were reported. In our literature research one documented case was reported in Iran. Treatment of disease include surgery, corticosteroid and cyclosporine. The presented case was a 36 years old man with right parotid gland and submentum lymph nodes enlargement. Excision of mass was done and kimura was documented by pathological examination. Recurrence of disease was happened and treatment was done by cyclosporine, prednisolon and cetirizine. kimura is a very rare disease that may be mistaken with malignancy. Therapy includes surgical excision and medical treatment. Correct diagnosis of disease can prevent radical surgery.