مجله پزشکی بالینی ابن سینا
سال بیست و سوم شماره 3 (پیاپی 81، پاییز 1395)

Introduction & Trichomoniasis is one of the most common non viral sexually transmitted diseases caused by Trichomonas vaginalis. The aims of this study were to determine the prevalence of the infection and to consider the metronidazole susceptibility of the T. vaginalis isolates.
This cross sectional study was conducted on 670 women attending to gynecology clinics in Qorveh, Kurdistan province, in 2015. Diagnosis of trichomoniasis was performed by using Dorset culture medium and wet mount methods. In vitro drug susceptibility testing was done aerobically after establishment of the isolates in axenic culture medium, Diamond.
From 670 vaginal samples, eight (1.2%) and four (0.6%) of them were positive for T. vaginalis by wet mount and cultured methods, respectively. Fifty percent of the infected individuals aged from 35 to 44 years old and who were illiterate (P Although, the prevalence of trichomoniasis is relatively low in the studied population but due to the importance of sexually transmitted diseases in public health, strategic measurements are necessary to prevent and control of the infections.

Due to the increasing trend of antibiotic resistance in the Enterobacteriaceae family, treatment of infections caused by these bacteria has been difficult. The aim of this study was to identify of class I and II integrons and associated gene cassettes in clinical isolates of Escherichia coli and Klebsiella pneumonia.
In this cross-sectional study, of 500 strains isolated from clinical samples of hospitals in Hamadan, Iran, in 2015, 129 K. pneumoniae and 118 E. coli isolates were isolated and examined. Then, the isolates were verified by standard biochemical methods and PCR was performed on class I and II integron genes using specific primers.
The results of this study showed that the prevalence of class I integrons was more than class II integrons. The most frequent class I integron gene cassettes were aadA1 and dfrA7 respectively, which are resistance encoding genes for kanamycin and trimethoprim.
The result of this study indicated a high prevalence of class I integrons in E. coli and K. pneumonia isolates. Thus, the identification of these resistance genes for infection control programs and to prevent the spread of resistant strains is very important

Post Dural Puncture Headache (PDPH) is a relatively common complication after spinal or epidural anesthesia, myelography and lumbar puncture. Despite numerous studies that have identified many therapies, debate and survey continues on the best technique to prevent this complication. Therefore, the purpose of this study was to evaluate the ''Reverse Flow" technique in prevention of headache after dural puncture in cesarean section under spinal anesthesia.
In this single blind, simple randomized clinical trial, patients were divided to two groups: intervention and control. Each group constituted of 120 patients. In the intervention group we mixed 3 mL Marcaine 0.5% with 1 cc fentanyl and injected 3 mL of this mixture into subarachnoid space by 24-gauge quincke spinal needle then simultaneously with injection of 1mL of this mixture, the needle was withdrawn. In the control group only 3 mL of this was mixture was injected into subarachnoid space and we had no injection while needle withdrawing. Then we evaluated headache at 6, 12, 18, 24, 48 and 72 hours after the operation and if patients had headache we determined severity of pain with the Numerical Rating Scale.
Incidence of headache in the intervention group was 2.5% and 9.2% in the control group (P = 0.028). The average severity of headache was 5.66 ± 3.21 in the intervention group and 5.18 ± 2.89 in the control group (P = 1). The mean age was 29.26 ± 5.95 in the control group and 27.89 ± 5.58 in the intervention group (P = 0.066). The mean age in patients, who suffered from headache, was 24.66 ± 3.05 in the intervention group and 29.72 ± 6.54 in the control group (P = 0.23). Patients who complained of headaches were younger than others.
This study indicated that use of "Reverse Flow" technique in cesarean section under spinal anesthesia reduces PDPH. The incidence of PDPH in patients, who have not received this technique, was 3/7 times more than patients, who have received this technique. Also the onset of headache in the control group happened earlier than in the case group.

The characteristics of a suitable restoration material is having acceptable mechanical properties, protecting teeth against decay and ease of use in clinics. Diet can affect properties of restorative materials in the mouth. Since amongst important properties of composite restorations are mechanical properties such as hardness, the aim of this study was evaluation of the effect of Coca-Cola Beverages on surface hardness of a silorane based (p90) and methyl methacrylate (p60) composites.
In this experimental study, thirty disc-shaped specimens (5 × 2 mm) of each of methyl methacrylate based (Filtek p60, 3M Dental Products, USA) and a silorane based (Filtek p90, 3M Dental Products, USA) composite resins were prepared, according to manufacturer's instructions. Specimens were randomly divided to four groups as follows (N = 15): G1: Filtek p90 without exposure to Coca-Cola, G2: Filtek p90 with exposure to Coca-Cola, G3: Filtek p60 without expure to Coca-Cola, G4: Filtek p60 with expure to Coca-Cola. The specimens were exposed to regular soft drinks Coca-Cola, (Khoshgovar, Tehran, Iran) at room temperature for seven days with a frequency of three times daily for 20 minutes at a time. In the remaining times of the day, they were kept in distilled water. Then, micro hardness measurements were made for each specimen with a Vickers hardness testing machine (Buehler, Lake Bluff, IL, USA) under 500 g of force for 15 seconds. Data were analyzed using SPSS 18 and independent t-test at a significance level of 0.05
Micro hardness values of four groups were G1: 68.28 ± 2.65; G2:59.56 ± 6.61; G3: 93.5 ± 2.38; and G4:86.76 ± 5.47, respectively. The results of this study showed that Coca-Cola reduces the surface hardness of the two composite materials (P The results showed the hardness of both Filtek p90 and Filtek p60 composite significantly decreases with Coca-Cola yet the reduction was equal.

Intestinal helminthesof dogs are a serious threat to human health and may cause dangerous diseases such as: hydatidosis and visceral larva migrans,thatwhich cause severe complications in human. The aim of this study was to determine the prevalenceof intestinal helminthes of stray dogs in Hamadan city, Iran..
A total of 103 stray dogswere shot in the inner and around of the city in year 2015. Following necropsy, the intestine's contents of dogs were examined for helminthes macroscopically. Then, the collected worms, after washing with saline,were counted and identified according to being Nematode, Cestodeor Acantcephala. Then, collected Nematodes were put in glass containers containing 70% ethanol-glycerine and Cestodes after processing on slides were put in the 10% formalin. To identify the species of helminthes, the Cestodes were stained using carmine acid and Nematodes were cleared in lacto-phenol.
Result indicated that, 74(71.8%)stray dogs were infected at least by one species of intestinal helminthes. The species of parasites were as follows: Echinococcus granulosus 37.9%, Dipylidium caninum 51.5%, Toxocara canis 19.4%, Taenia hydatigena 24.3%, T. multiceps 2.9%, T. ovis 1.9%, Mesocest oideslineatus 4.9%, and Acantho cephala 5.8%.There was no association between insex, season and region with prevalence of intestinal helminthes (P > 0.05). On the other side, there was a significant deference (P This study indicatesd that,infection rate of helminthes in stray dogs is washigh in Hamadan city. These parasites are important in terms of human health and economic aspects. Therefore, it is more essential that public health authoritiesto develop control strategies for stray dog's population.

Dry eye is a common problem amongst post-menopausal women. Cataract surgery may worsen symptoms of dry eye and this can influence the quality of life in patients. This study was performed to evaluate the incidence and severity of dry eye symptoms after phacoemulsification surgery.
This case-series study was performed on 43 women aged over 50 years during 2013-2014. Patients underwent phacoemulsification surgery on one eye. Symptoms of the operated and contra lateral eye were analyzed by c2 statistical test and SPSS software, preoperative and one month after the surgery.
One month after the surgery, the mean value of incidence and severity of dry eye in operated and non-operated eyes were 90.06 ± 3.5, 80.96 ± 3.55, 71.11 ± 3.52, and 63.51 ± 3.04, respectively. The difference between the two groups was significant (P Cataract surgery may lead to worsening of dry eye symptoms. Treatment of dry eye before cataract surgery is an important issue to prevent ocular surface damage.

The present study aimed to examine changes in depression and anxiety symptoms and their correspondence to fluctuations in sexual dysfunction with daily diary approach.
The present study was of the correlation type, conducted in 2015. To investigate this study, at first, 120 young married women from the University of Tehran were selected in a manner available nationwide. First, using female sexual distress inventory, Beck depression inventory and Beck anxiety inventory, the baseline was conducted. Then, for 14 days, mood and anxiety symptoms and sexual function by the mood and anxiety symptoms questionnaire and female sexual function index were evaluated and finally, data were obtained and analyzed by HLM7.
In the study of simultaneous relation, there was more general distress, with less orgasm (P = 0.001), vaginal lubrication (P = 0.001), and anhedonia, with less desire (P = 0.001). Also, anxious arousal was associated with less sexual arousal (P = 0.001) and desire (P = 0.001).
In general, simultaneous changes in symptoms of depression and anxiety with changes in sexual function were associated

In studies of the adsorption of pollutants onto different adsorbents, determining the adsorbent dose of the most important characteristics must be considered. The aim of the study was the determination and modeling of dose-response bone char fluoride removal from aqueous solutions and comparison of the adsorption isotherm models with dose-response models from the perspective of adsorption.
In this experimental study, bone char was prepared by using an electric furnace at 450˚C in two hours. Sorting the adsorbent was conducted by standard sieve ASTM in the range of 18-35 meshes and its characteristics were determined with conventional methods. The concentration of fluoride was measured according to the recommendation of manufacturer (HACH) with Dr-5000 of regent fluoride. Dose-response models were fit to the data and parameters were estimated. Based on the quality of fitness indicators, the adsorption isotherm models were compared with dose-response models. Analysis of the data in this study was performed using the R software version 3.1.2 and stats package.
Fit indexes (AIC and R2) showed that the most appropriate model for the data in pH= 10, concentration = 10 and pH = 7, concentration = 20 was the Emax model and in pH = 7, concentration = 10 and pH = 7, concentration = 15 the quadratic model. According to these models, the median of effective dose on bone char at removal of fluoride was determined 0.11 g in concentration of 10 mg/L and pH = 10. The maximum effective dose was determined 1.25 g in concentration of 20 mg/L and pH = 7. The index (AIC) showed that quadratic dose-response models better fit to adsorption data than adsorption isotherm models.
The median and maximum effective doses of bone char at removal of fluoride were estimated by statistical models more accurately. In addition, determining the goal dose was performed using modeling method, which was more economic than repeated testing, and the performance time was also more cost-effective. Quadratic dose-response model can be a good alternative for adsorption isotherm models in the adsorption behavior.

Obesity and high fat diet (HFD) has side effects on male fertility. The aim of this study was to evaluate the effect of apple vinegar on spermatogenesis and serum total antioxidant status (TAS) in rats under HFD.
Twenty-four Wistar male rats were divided to three groups, including (n = 8): control, HFD, HFD apple vinegar. The control group received 16.6 kcal/day and the other two groups received HFD containing 51.6 kcal/day. After 16 weeks, group 3 received 5% apple vinegar in drinking water orally for six weeks. At the end of the experiment, epididymis sperm parameters including: count, morphology and motility, were measured. Serum level of TAS, testosterone and estradiol was assayed with enzyme linked immunosorbent assay (ELISA). Testicular apoptosis was assayed with terminal deoxynucleotidyl transferase (TdT) dUTP nick-end labeling (TUNEL) and spermatogenesis was studied with quantitative histologic method. Statistical analysis was performed using analysis of variance (ANOVA) and Tukey’s test.
Apple vinegar increased count and forward motility of sperms, when compared with HFD (P This study indicated that daily use of apple vinegar in rats under HFD for six weeks improved spermatogenesis through reduction of testis apoptosis, increasing serum TAS and testosterone.

Seborrhea is a condition of sebaceous glands hyperactivity and increase in the secretion of sebum on head and face surface. Sebaceous glands hyperfunction causes oily and glassy appearance with large pores on the skin. The effect of androgens on providing seborrhea is controversial. Since sufficient and definite information about testosterone and dihydrotestosterone in seborrhic cases is not available, this study was carried out to evaluate effect of serum testosterone and dihydrotestosterone levels in the seborrheic patients.
In this case-control study, 36 patients with seborrhea and 36 control individuals, under 40 years of age were selected. Serum testosterone and dihydrotestosterone levels were measured in ng/mL. Data were analyzed using SPSS v.16, Chi-square and t-tests (α = 0.05).
Twenty-three males and 49 females, who referred to the dermatology department of Farshchian Hospital of Hamadan, participated in this study. The age distribution of the participants was between 19 and 39 years old with mean age of 28.66 ± 5.71. The mean level and SD of serum testosterone in control and case groups was 2.83 ± 2.75 and 1.21 ± 1.09, respectively, while dihydrotestosterone level was 500.38 ± 373 and 350.99 ± 228.2 ng/mL. Means and SDs values of serum testosterone were 2.83 ± 2.75 and 1.21 ± 1.09 and dihydrotestosterone was 500.38 ± 373 and 350.99 ± 228.2 ng/mL in case and control groups, respectively. The findings showed that there were differences in serum testosterone and dihydrotestosterone values between case and control groups (P According to the results of this study there is a positive relationship between serum testosterone and dihydrotestosterone values with seborrhea

Chronic use of opiates is associated with a wide range of neuropsychological deficits. Therefore, this study aimed to evaluate one of the neuropsychological functions, updating function of working memory, in three groups, including substance abusers (heroin and opium), those under treatment with methadone, and normal controls.
The method of this study was causal-comparative. Ninty individuals in three groups, including substance abusers (n = 30), those under treatment with methadone (n = 30), and normal controls (n = 30) were selected from people referred to the addiction treatment Clinics in Shiraz (2015) with the purposeful sampling method. All subjects were evaluated regarding working memory updating and self-reported mental effort scale and the results were analyzed by Multiple Analysis of Variance (MANOVA) test and Tukey post hoc test with SPSS software (version 23).
The results showed a significant difference between the three groups in the updating function of working memory; so that effectiveness and efficiency of processing in the normal group was better than the other two groups and the performance effectiveness and efficiency of processing in the group under methadone treatment was better than substance abusers group.
substance abuse has a negative effect on neurological function. Given that the group of methadone treatment had better performance in the updating function of working memory than the group of substance abusers, these results provide hope that the effects of examined drugs on working memory is not permanent and we can look for psychological interventions to treat these patients and prevent problems recurrence

Papillary Glioneuronal Tumor (PGNT) is a rare tumor with approximately 70 cases reported in the last decade. This tumor is more common in young adults and is the most common clinical manifestation of headaches and seizures. This tumor has an indolent clinical behavior. Regarding gender prevalence there is no detailed epidemiological information available, because of the rarity and newness of this tumor.
A 32-year-old female patient with a sudden headache and blurred vision referred to our hospital. The magnetic resonance imaging (MRI) revealed a heterogeneous mass with dimensions of 35 × 33 × 20 mm in the right frontal lobe. Histologically, a biphasic tumor composed of a glial component arranged in papillary architecture overlaying hyalinized vessels, associated with interpapillary areas, containing monotonous oligodendrocyte-like and ganglion-cells were seen. The immunohistochemical staining indicated glial fibrillary acidic protein (GFAP)-positive glial cells and positive synaptophysin and neuron-specific enolase (NSE) in interpapillary neurocytes.
Papillary Glioneuronal tumor is a rare tumor with slow growth and low grade. The possibility of transformation to high-grade tumor, is low. Due to having the structure of pseudopapillary, along with clinical and radiographic characteristics, it must be distinguished from other variants of glioneuronal tumor mix.