مجله طب جنوب
سال سیزدهم شماره 3 (پاییز 1389)

This study was designed to investigate the effect of ascorbic acid on expression of Bax and Bcl-2 and maturation of mouse prenatal follicles isolated from vitrified and non-vitrified ovaries. In this study one ovary from each forty female mouse was vitrified. Preantral follicles were mechanically isolated from vitrified and non- vitrified ovaries and cultured in α-MEM in vitro for 10 days in four groups; non-vitrified and non-ascorbic acid (NVNA), non-vitrified and ascorbic acid (NVA), vitrified and non-ascorbic acid (VNA), vitrified and ascorbic acid (VA). Expression of Bax and Bcl-2, survival rate, diameter of follicle and number of antral follicles were compared in four groups. In all groups, the diameter of preantral follicles was increased during in vitro culture. The mean diameter of follicles on day 2 of culture in NVNA, NVA, VNA, and VA groups were 158.5±7.2, 161.9±9.6, 151.7±6.4, and 156.9±7.6 respectively and at day 4 of culture were 213.1±11.8, 218±8.5, 202.9±6.2, and 215.9±9.2 respectively. There were significant differences between the mean diameter of follicles in non-vitrified groups and VNA group at day 2 and 4 of culture (p=0.011 and p=0.001 respectively). The addition of ascorbic acid increased follicular diameter on day 4 of culture in vitrified group (p=0.001). The level of Bax mRNA in NVA group was significantly lower than that other groups (p=o.oo1). Although the addition of ascorbic acid to the media had no effect on growth, survival rate and antrum formation of follicles in vitro, but this reduced the level of the Bax proapoptotic gene in non-vitrified group and improved the growth of preantral follicles after ovarian vitrification.

Hearing impairment (HI) is the most prevalent Neurosensory disorder which is heterogenous and can also occur due to environmental causes. The majority of hearing deficiencies are of genetic origin affecting about 60% of the HI cases. A novel gene DFNB59 encodes pejvakin has been recently shown to cause deafness. This study aims to determine the frequency of DFNB59 gene mutations in coding region the gene in Bushehr province. In this descriptive experimental study, we investigated the presence of DFNB59 gene mutations in Exons (2-7) of the gene in 80 deaf subjects. DNA was extracted using standard phenol –chloroform method. The screening of gene mutations was performed by PCR-SSCP/HA procedure. Finally, the possible mutations were confirmed by direct sequencing. In all, 9 polymorphisms 793C>G were found in 80 non-syndromic, genetic hearing loss subjects studied. However no DFNB59 gene mutation was identified. We conclude that the association of DFNB59 gene mutations with hearing loss is very low in samples studies

Primary percutaneous angioplasty is a modality of choice to restore reperfusion in infarct related artery now. No-reflow phenomenon is a complication of this modality that increase mortality and morbidity of patients. Assessment of its associated and predictor factors may be useful to its prevention. All patients with ST elevation myocardial infarction (STEMI) who treated with primary percutaneous angioplasty during 30 months were enrolled to the study. Then patients with and without no-reflow phenomenon assigned to two groups and statistical analysis was performed. Twenty one cases of no-reflow were found in total 263 cases of primary PCI (7.9%). Mean age and prevalence of risk factors such as diabetes mellitus, smoking, hypertension and hyperlipidemia wasnt different in two groups. No- reflow was observed more frequently in females (P<0.01). Mean symptom to balloon time was longer in No-reflow group (P <0.01). Patients with no- reflow phenomenon have more cardiogenic shock, less predischarge ejection fraction, more inhaspital mortality, longer stent length, more LAD as infarct related artery and more use of thrombectomy(p value <0.05). There wasnt statistical significant in presence of collateral vessels, visible calcification, GP IIb/IIIa inhibitors usage, predilation, post dilation, and stent diameter (p value >0.05). The study demonstrated that female gender, LAD as infarct related artery, use of long stents and primary PCI in prolonged symptom to balloon time could be predictors of no- reflow phenomenon.

Non-alcoholic fatty liver disease (NAFLD) is a common hepatic disease, and attention is being paid to its association with obesity and metabolic syndrome. The goal of this study was to clarify the role of visceral fat accumulation in Nonalcoholic fatty liver disease. 105 patients with probable NAFLD based on clinical and paraclinical evaluations, in the absence of known etiologies of liver diseases were enrolled in the study. Ultrasound was performed for grading of fat accumulationin the liver and measurment of visceral fat thickness. Anthropometric indices and biochemical parameters measured too. Based on liver ultrasound, 13.3% had no evidence of fatty liver, the remaining had: 55.2% mild, 23.8% moderate and 7.6% severe fatty liver. Weight (P=0.001), body mass index (P=0.001), triglyceride (P=0.004), alanine aminotransferase (P=0.011), aspartate aminotransferase (P=0.009), waist circumference (P=0.001) and mesenteric fat thickness (P<0.001) were correlated significantly with high grade of fatty liver. On the other hand fasting blood glucose, total Cholestrol, LDL, HDL, total and direct bilirubin did not show significant correlation with grading of fatty liver. Mesenteric fat thickness was indipendent factor for hepatic steatosis (R=0.61). Visceral fat is strongly associated with hepatic steatosis. Sonographic measurment of mesenteric fat thickness is an easy, non-invasive and repetitive method for assessment of central obesity.

The objective of this study was to evaluate graft survival among the recipients of second renal transplant in Imam Khomeini centre hospital in Urmia. The study population consisted of 50 patients receiving renal grafts for the second time between 1988 and 2008 in Imam Khomeini centre hospital in Urmia. Two survival outcomes, first and second graft survival, were analyzed. Graft survival was defined from date of transplant until its rejection. For the purpose of graft survival analysis, graft failure was defined as return to dialysis, and death due to the functioning graft. Data were collected through individual patient questionnaires. Demographic and clinical factors, transfusion history, type of immunosuppressive drugs, levels of serum creatinine, triglyceride, cholesterol, and LDL at 3 and 6 months after transplantation were collected. Cox-proportional hazard model and Kaplan-Meier were used to data analysis. First graft survival at 1, 2, 3, and 5 years was 74%, 66%, 53%, and 41%, respectively. Second graft survival at 1, 2, 3, and 5 years was 81%, 74%, 70%, and 61%, respectively. Causes of graft loss in first renal transplantation were 6% sever acute graft rejection, 12% acute graft rejection and 82% chronic graft rejection. In the multivariate analysis, only serum creatinine, blood pressure, and immunosuppressive drugs predicted first graft loss and serum creatinine, immunosuppressive drugs, and related donor family predicted second graft rejection. The serum creatinine and immunosuppressive drugs including cyclosporine, cellcept, and prednisolone are the most influential factors on graft survival.

Medication errors refer to inappropriate use of drugs, can lead to harmful and serious consequent. Many factors contribute to incidence of these errors. To investigate this factors a descriptive analytic study was done that assess clinical staff medication errors in Bushehr medical centers. The participants were 400 clinical staff, including nurses, midwives and nurse assistances to complete designed medication errors questionnaire. This questionnaire include 2 parts, part one was demographic data and part two, assess influencing factors of medication errors in six domain. Results showed that the half of participants (49.9%) had medication errors in acquaintance and the most error in dosage (37.7%) and then type of drugs(27.7%). 73.3% of participants reported their errors and in unreported cases the most cause was fear of managers. According to participants attitude factors that interfering to medication errors were physicians factor, including illegible order in patient file (24.94%), nurses factors including, incorrect documentation (24.38%), interpersonal relationship (19.45%), inappropriate environment (15.3%), knowledge deficit and lack of experience (11.23%) and stressful events (4.66%). No statistical significant correlation between situation of job and shift work. Results show that medication errors are common and human factors are the most factors in these errors.

Research in marine pharmacology will promise new bioactive agents. The marine bioenvironment is the unique resource for bioactive agents that could not be found in terrestrial organisms. A total of known 611 seashells species in the Persian Gulf were investigated for synonymy in OBIS database. Then, all the species, including their synonymy were searched in PubMed database to find their isolated bioactive agents. From 611 known seashells in the Persian Gulf, 172 genera/species had bioactive compounds. Bioactive agents were isolated and purified for 16 genera/ species. The crude or purified extracts from these seashells had immunomodulatory effects (6 seashells), anti-toxicologic effects (4 seashells), analgesic (1 seashell), cardiotonic and vasoactive agents (2 seashells), hypolipidemic agents (4 seashells), anti-osteoporotic and osteoblastic agents (2 seashells) and anti-dermatitis effect (1 seashell). The known seashells from the Persian Gulf have bioactive and immunomodulatory compounds and increase in the efforts to isolate these agents will promise a treasure for novel anti-infective agents.

Fish bone is the most common foreign body that is ingested accidentally and can be caused gastrointestinal complications such as perforation, abstraction, and abscess. We describe a 75-year-old man who suffered from constipation, diarrhea, and fever and chills for 3 months. He had mild tenderness in hypogasteric region and also mild tenderness and swelling on anterior rectal wall and prostate upon clinical examination. The abdominal and pelvic sonography and CT scan findings suggested existence of abscess in the space of between bladder and rectum. The patient underwent laparotomy to drainage the pelvic abscess. The surgeon found a 6-cm fish bone which was embedded in the abscess. The presented case indicated the importance of accidental fish bone ingestion and its possible complications. In addition, the patients with abdominal pain, GI bleeding, and fever of unknown origin living in the seaside regions, the wandering fish bone as a differential diagnosis should be kept in mind.