مجله پزشکی بالینی ابن سینا
سال بیستم شماره 4 (پیاپی 70، زمستان 1392)

Introduction & After periodontal surgery the surgical site is usually covered with periodontal pack. It is suggested that dressings can reduce the rate of infection، bleeding and granulation tissue formation after surgery. In addition، they may promote tissue healing. The aim of this study is to evaluate periodontal dressing’s effect on wound healing، pain and bleeding after periodontal surgery. In this clinical trial study 33 patients attending the Hamadan dental school were evaluated. The patients need flap surgery on both sides of a jaw. Periodontal pack was used in one side of a jaw only. Inclusion criteria were: nearly similar disease distri-bution and planning modified Widman flap for both sides. Data were analyzed using SPSS16 software and chi-square and t-test. Average rate of pain in test and control groups was 1. 73 and 2. 79، respectively and the difference was statistically significant (P<0. 05) but the differences were not statistically significant regarding swelling، bleeding، gingival consistency، granulation tissue formation، gingival color and ease of eating، in the test and control group (P<0. 05). According the results of this study، periodontal pack may be beneficial in reduc-ing pain after surgery. (Sci J Hamadan Univ Med Sci 2014; 20 (4): 267-272)

Introduction & -cells، especially CD8+ T lymphocytes are the most important cells in anti-tumor response. Previously R10 fraction of garlic extract was reported as an immuno-modulator which induced an effective cellular immunity and Th1 responses. In this study the in vitro immunomodulatory effect of R10 on CD8+ T cells viability and production of TNF-? were evaluated. In this experimental study، using monoclonal antibodies attached to magnetic beads with isolating columns by magnetic bead method، CD8+ T cells from spleen cells of Balb/C mice were isolated. R10 fraction based on molecular weight was prepared using Ultra filtration. MTT assay was used to evaluate cell viability. TNF-? level was meas-ured in the supernatant of culture of CD8+ T cells by ELISA. Obtained data was compared and analyzed using Nonparametric Test and Keraskel & Wanny''s Test tests.. The findings indicate that all dilutions of R10 fraction increased cell viability of CD8+ T cells in comparison with the negative control group and in the presence of ConA with dilution of 1:50 of R10 fraction significantly increased cell viability of CD8+ T Cells com-pared to ConA alone. Secretion of TNF-? significantly increased by all dilutions of R10 frac-tion. These findings suggest that R10 fraction of garlic can be used as an Immuno-modulator drug candidate for induction of cellular Immunity in tumor therapy. Sci J Hamadan Univ Med Sci 2014; 20 (4): 273-279)

Introduction & Women during their lifetime experience a variety of physiological changes that can affect their physiological capacity to perform exercise and induce reduction in achieving the benefits of training. So، finding the best time to perform maximum physical performance is essential. Sports drink consumption can also help to enhance athletic performance. The purpose of this study is to determine the best time to perform the maximum physical performance and the effect of sports drink on exercise capacity in active young women. 22 female students with at least 2 years experience in regular aerobic exercise، voluntarily participated in this clinical trial study and were randomly divided into control group (no supplement) and intervention group (drinking sports drink). The physical performance was evaluated in two periods of early and late follicular phases. The data was analyzed by statistical tests and spss16 software. In the early follicular phase compared with the late follicular phase، Vo2max significantly decreased in the control group (P=0. 02)، There was a significant difference between the two groups in the Vo2max during the early follicular phase (P=0. 03). Resting systolic and diastolic blood pressure and heart rate were not significantly different between the groups and different phases (P>0. 05). Contrary to the intervention group، the first and third minute recovery heart rates in the control group significantly increased in the early follicular phase compared with the late follicular phase (Respectively، P= 0. 016،P=0. 043)، and compared with the intervention group، the first and third minute recovery heart rates significantly increased during the early follicular phase (Respectively، P= 0. 021، P=0. 025). Recovery systolic and diastolic blood pressure were not statistically significant between the two groups، and each group in different phases (P>0. 05). Late follicular phase compared to the early follicular phase is the most appropriate time to perform exercise. Sports drink consumption containing 6% carbohydrate during early follicular phase can also improve the physical performance. (Sci J Hamadan Univ Med Sci 2014; 20 (4): 280-287)

Introduction & Preparation of access cavity to root canal is a critical phase in endo-dontic treatment. The purpose of this study was to evaluate the effect of access cavity loca-tion (labial or palatal) on fracture resistance of endodontically treated maxillary central teeth. In this experimental laboratorial study، 84 intact human maxillary central incisors with similar dimensions were selected. The teeth were divided into 4 test groups as follows: Group 1: teeth without access cavity (control group); Group 2: teeth with labial ac-cess; Group 3: teeth with palatal access; and Group 4: teeth with labial & palatal accesses. Root canals were cleaned and lateral condensation technique was used to obdurate the canals and root canal therapy was completed. The access cavities were restored with a light cured microhybrid resin composite. Continuous compressive force at a crosshead speed of 2 mm/min was applied by a testing machine. Load at fracture was recorded in MPa. Modes of fracture were assessed using stereomicroscope at X20 magnification. Data was analyzed us-ing One - Way analysis of Variance and Tukey HSD tests. Means and standard deviations of fracture resistance for the 4 tested groups were: G1:1172. 2±224. 05N، G2:990. 4±199. 324 N، G3:861. 95±237. 089N and G4:784. 27± 221. 586 N. There was significant difference in fracture resistance values between G1 (control) and each tested group (P < 0. 05). Mean fracture resistance for the test group with labial access was higher than the test group with palatal access but no significant difference was observed. Group 2 showed statistical difference compared with group 4 (P=0. 017) but there is no sig-nificance between group 3 and group 4 (P=0. 666). Fracture modes in all groups were an oblique pattern and maximum and minimum of unfavorable fractures were seen in the control group with 48% and group 3 with 5%. Preparation of access cavity reduces tooth fracture resistance. Palatal and labial& palatal accesses decrease considerably tooth fracture of resistance. (Sci J Hamadan Univ Med Sci 2014; 20 (4): 288-294)

Introduction &

One of the mechanisms of antibiotic resistance in gram negative bac-teria، particularly Klebsiella pneumonia strains، is the production of Extended-Spectrum? lactamase enzymes (ESBLs). Encoding genes of ESBLs are usually located on the plasmid and they are able to transfer to other gram-negative bacteria. Thus، due to the importance of resistance pattern recognition and its sensitivity to the? - lactam antibiotics، the above men-tioned issue was examined in this study.

In this study different clinical samples of Boroujerd and Hamadan Hos-pitals during 6 months were collected and identified by biochemical tests and Enterosystem kit. To confirm the strains، the Ure D gene was used as the internal gene of Klebsiella pneumoniae by PCR method. Antibiotic resistance by Disk diffusion method was performed. Phenotypic confirmatory test was used to determine the presence of ESBLs. MIC antibiotics of Ceftazidime and imipenem by E test method were determined.

The results showed that the highest rate of Klebsiella pneumoniae strains resistance was related to Cefexime antibiotics 46. 7%، Ceftriaxone 43. 3%، Azthrunam 43. 3%، Cefo-taxime 41. 7%، Cotrimaksazol 40. 8%، Ceftazidim 36. 7% and the least resistance was related to antibiotics Imipenem 0% Sprofluksasin 16. 7%، Cefepime 25% and Gentamicin 26. 7%. 56 strains (46. 7%) were identified as ESBL –positive strains. Using E-test strip for Ceftazidim antibiotic، 66 strains were resistant، 10 strains intermediate، and 44 strains were sensitive to Ceftazidim and by E test method for Imipenem antibiotic، 120 strains were sensitive.

The high prevalence of antibiotic resistance and ESBLs production in the cities which were studied indicates the need for screening of ESBLs in clinical samples by labora-tory and prescribing appropriate antibiotics with? -lactamase inhibitory power and antibiotics together with clavulanic by physicians. (Sci J Hamadan Univ Med Sci 2014; 20 (4): 295-302)

Introduction & Benzene is one of the most common volatile organic compounds in the indoor and outdoor environments that has always been considered as one of the causes of air pollution. Thus before being discharged to the environment، it must be treated from pol-luted air stream. The aim of this study was to determine the efficiency of catalytic ozonation process with carbosieve in the removal of benzene from polluted air stream. The study was experimental in which catalytic ozonation process with carbosieve was used in the removal of benzene from polluted air stream. The experiments were carried out in a reactor with continuous system and the results of catalytic ozonation were compared with the results of single ozonation and carbosieve adsorbent. The sampling، benzene analyzing and determining of ozone concentration in samples were done with 1501 NMAM method by GC equipped with FID detector and iodometry، respectively. The results of this study showed that the removal effectiveness of single ozonation process is averagely less than 19%. Also the efficiency of absorbent decreased with the con-centration increase of benzene. The increase ratio of efficiency in catalytic ozonation process to efficiency of carbosieve adsorbent was averagely 45%. With regard to high efficiency of catalytic ozonation process and increasing the benzene removal، the catalytic ozonation process is suggested as a promising and alternative technology for elimination of VOCs from the polluted air stream. (Sci J Hamadan Univ Med Sci 2014; 20 (4): 303-311)

Introduction & Medical research of memory deficits and age-related memory loss has resulted in new methods and treatment techniques to improve memory، includ-ing uses of medical herbs and natural medicines. To this purpose، in the present study the ef-fect of hydro-alcoholic extract of Ficus Carica (FC) on passive avoidance (PA) learning and memory was examined in male rats. This experimental study was performed on 40 male wistar rats. Animals were divided in 4 groups randomly: control (normal saline) group and groups treated with three doses (150، 250 and 350 mg/kg) of FC extract. Administrations of saline or extract were done by (daily) gavage for two weeks. Then rats were entered to shuttle box to record animal behavior in PA task. Retrieval test was done 24 hours after training. The results show that there is a significant difference on the PA learning and memory between the groups. Extract of FC dose has dependently improved the acquisition and re-trieval of PA task. It seems that this result is due to sugar and numerous useful compounds in FC and antioxidant effect of these substances on neural structures related to learning and memory processing. (Sci J Hamadan Univ Med Sci 2014; 20 (4): 312-319)

Introduction & Diabetic peripheral neuropathy is a common side effect of diabetes mellitus. In addition to known factors such as hyperglycemia، other factors may also be in-volved in the development of this complication. The aim of this study was to evaluate the role of testosterone in diabetic peripheral neuropathy by comparing its level in two groups of diabetic men with and without diabetic peripheral neuropathy. This study was a case - control study and patients were selected from diabetic men attending the Hamadan Diabetes Center. The patients were divided in two groups of diabetic men with and without diabetic peripheral neuropathy، (35 patients in each case and control groups). NSS and NDS criteria and nerve conduction study were used for the diagnosis of diabetic peripheral neuropathy. The two groups had not significant difference in age، BMI، duration of diabetes and glycemic control. Testosterone level had not significant difference in the case and control groups (5±2. 3 vs 4. 5±2. 2 ng/ml) (P=0. 42). While the effect of testosterone was demonstrated on the nervous system، neuro-genesis، cognitive function and alzheimer disease، this study could not prove any difference between serum level of testosterone in diabetic men with and without peripheral neuropathy. (Sci J Hamadan Univ Med Sci 2014; 20 (4): 320-324)

Introduction & The side effects of drug consumption and also HSV resistance to drugs have been the factors attracting the researchers to herbal drugs. The major aim of the present research was in vitro assessment of possible anti-herpetic activity of glycyrrhiza gla-bra (liquorices root) methanolic extract in more details by performing Tissue Culture Infec-tive Dose fifty percent (TCID50) method. In this experimental study Vero cells were incubated with different con-centrations of methanolic extracts of glycyrrhiza glabra. Neutral red assay was performed in order to consider the appropriate concentration of the extract. Pre-treatment of Vero cells with glycyrrhiza glabra extract before viral infection، incubation of HSV-1 with glycyrrhiza glabra extract and treatment of vero cells with extract 1، 4، 8، 12 and 24 hours after viral in-fection، were exerted. TCID50 was performed in order to assess the antiviral activity of the extract. The results were analyzed after performing the experiments at least three times. Pre-treatment of Vero cells with methanolic extract for two hours and incubation of virus with extract for one and two hours prior to viral infection resulted in remarkable drop in TCID50 amount by significant difference (P <0. 001). Treatment of Vero cells with extract 1، 8 and 12 hours post-infection demonstrated significant changes in TCID50. We observed significant fluctuations and different efficacy of the extract between different incubation time at 1h & 4h، 1h & 24h، 4h & 8h، 4h & 12h، 8h & 24h، 12h & 24h. The current study resulted in more novel findings of anti herpetic activity of gly-cyrrhiza glabra extract. Time course of extract treatment with virus- infected cells was an ef-ficient factor. In addition، the pretreatment of virus and also Vero cells with glycyrrhiza gla-bra extract in our experiment had important effects on the anti-viral activity of the extract. (Sci J Hamadan Univ Med Sci 2014; 20 (4): 325-332)

Prevalence of infective endocarditic induced renal failure is 1-3% and is one of the causes of deterioration of patient or cessation of antibiotic therapy and also delay in treatment duration and medical response. Case Report: Our patient is a 48 year old man with infective endocarditis who had been under treatment by antibiotics (cefteriaxone، gentamycin and vencomycin) and experienced renal failure after 7days of treatment initiation. After ruling out some causes of renal failure in endocarditis such as glumerolonephritis، septic emboli and acute tubular necrosis، acute drug induced interstitial nephritis was documented. In this case، acute drug induced interstitial nephritis was the final diagnosis and after cessation of related drugs (in these case antibiotics) and starting corticosteroids and en-doxane plus، improvement of medical condition and lab data was observed. (Sci J Hamadan Univ Med Sci 2013; 20 (4): 333-336)

Gorlin syndrome is a rare disorder with different diagnostic criteria such as mul-tiple odontogenic keratocysts، basal cell carcinomas، palmar &plantar pits، frontal bossing and hypertelorism and calcification of falx cerebri. Case Report: The case which is reported in the present study was a 27-years old woman re-ferred by a general dentist to oral medicine department of Hamadan dental faculty. On clini-cal and radiographic examination، multiple odontogenic keratocysts of jaws، multiple basal cell carcinomas، palmar pits and hypertelorism were obvious. The jaw cysts were treated with marsupialization and enucleation. The patient was referred to the dermatologist for pho-todynamic therapy.

Most disorders of Gorlin syndrome are slight، which usually do not threat the pa-tient’s life. The prognosis of this syndrome usually depends on the dermal tumor behavior. (Sci J Hamadan Univ Med Sci 2013; 20 (4): 337-341)

Various inherited or acquired disorders are characterized by palmoplantar kera-toderma hyperkeratosis of hands and feet، and when accompanied with deafness indicates mutations in the gene encoding connexin -26 or a particular mutation (A7445G) of the mito-chondrial t-RNA coded for serine (MT-TS1) is created. Case Report: On skin examination of a 7 year old boy، we observed hyperkeratosis of palm and sole، elbows and knees (Keratoderma of palms &soles with extensor surface of limbs involvement)، and found out the history and evidence of sensory-neural deafness since birth-day and he had undergone cochlear implant at the age of two. Thus this patient is placed in a rare group of keratoderma associated with sensory-neural deafness. Since there is no his-tory of similar disease in his pedigree، we suspected the boy had a rare type of keratoderma associated with sensory- neural deafness that has mitochondrial inheritance. In reported cases of this disorder in the world there is no involvement of limb''s extensor. So we probably report a new subtype of the rare disorder or a rare separate disorder. The patient is a case with diffuse palmoplantar keratoderma with the involvement of extensor surfaces and sensory-neural deafness that have mitochondrial inheritance that is unlikely to be reported yet. The disease should be controlled with maintenance treatments. (Sci J Hamadan Univ Med Sci 2013; 20 (4): 342-345)