فصلنامه علوم پزشکی دانشگاه آزاد اسلامی
سال هجدهم شماره 4 (پیاپی 54، زمستان 1387)

Known biological effects of crown ethers influence us to investigate its effect in human body and use in drug production. The aim of this study was to evaluate the effects of Dibenzo-18-crown-6 on colony formation of bone marrow cells of mouse in culture medium and to find the probable mechanisms of the process. In this experimental study, red bone marrow cells of mouse (Balb/C) were used as source of haemapoietic stem cells. Culture of red bone marrow cells was done in the form of semi solid in the presence of different concentrations of crown ether, cAMP, PHO4H2K and PO4H2Na. Different concentrations of crown ether have significant inhibitory effects on colonizing of red bone marrow cells. The maximum inhibitory effect was observed in concentration of 80 mg/ml crown ether and no colony was found. The inhibitory effects of crown ether was diminished in the presence of cAMP with concentration of 10× 10-6 mol, PO4H2Na with concentration of 10× 10-6 mol and PO4H2K with concentration of 5×106 mol, but it couldn’t achieve the level of control group without presence of crown ether. HPLC method demonstrated that remaining level of crown ether reached to zero after sixth hour. The inhibitory effects of crown ether in control of colonizing the red bone marrow cells occur via decreasing of cations value and changing the physiological function of membrane resulting disorder in the cAMP signaling pathway.

Diabetes is a common disorder characterized by abnormal metabolism of carbohydrates, caused by insulin secretion deficiency and or insulin cell membrane receptors dysfunction. In this study, the effects of sodium tungstate on blood sugar and pancreatic islands were investigated in diabetic rats. Forty-eight male Wistar rats, each weighting 250 grams, were studied in eight groups of six. Group one was considered as control 1 and did not receive any drug. Groups 2 and 3 received sodium tungstate at dose of 1.75 and 2.25 g/lit for ad libitum for 60 days. Group 4, as control 2, was diabetized by single dose injection of 60 mg/kg streptozocin (STZ). Groups 5 and 6 received 1.75 and 2.25 g/lit of sodium tungstate ad libitum for 15 days then were diabetized and received sodium tungstate for another 45 days in the same manner. Groups 7 and 8 were diabetized, and then were treated with sodium tungstate for 60 days. Blood levels of glucose and histopathologic findings of pancreas were evaluated at the end of study. Administration of sodium tungstate at dose of 1.75 and 2.25 g/lit, before and after diabetes, led to a significant blood sugar decrease. Sodium tungstate has had a positive, but not significant, effect on the number and diameters of Langerhans islands. This study showed that sodium tungstate decreases blood sugar, increases the number of cells in each island, regenerates Langerhans islands and prevents further development of diabetes.

In most mammalian species, the temperature of the testis is a few degrees lower than abdominal temperature, and this cooler temperature has been shown to be essential to maintain an optimal environment for spermatogenesis and sperm fertility. The aim of this study was to assess apoptosis in epididymal tissue after unilateral experimental cryptorchidism in adult male rat. In this experimental study, adult male wistar rats (200-250 gr) were divided into 15 groups of 8 animals each. Seven groups became unilaterally experimental cryptorchidism by fixation of right testis to abdomen wall. The epididymis (head, body and tail) of seven experimental groups was dissected 1, 3, 6, 10, 15, 30 and 60 days after operation, respectively. In 8th to 14th groups, as a sham after incision, testis were replaced from scrotum to abdominal cavity and then returned to scrotum. 15th group, as a control group, didn’t receive any operation. After sampling and fixation in saline formalin 10%, tissue processing and preparing histological section and staining with tunnel method, apoptosis were studied. Tunnel staining showed apoptosis in epithelial cells of epididyms in groups with experimental cryptorchidism. Peak of apoptotic cells was observed in 3 and 6 days after operation. There were no significant changes between sham and control groups. Our results showed that experimental cryptorchidism induces apoptosis probably via heat and oxidative stress in the epididymal epithelial cells.

Three dimensional deformity in idiopathic scoliosis of the spine is associated with the deficits on the proprioceptive performance. The aim of this study was to evaluate the effects of balance training with reference to the proprioceptive training on the dynamic balance performance and Cobb angle patients with mild adolescent idiopathic scoliosis. In this quasi-experimental study, twenty girls with adolescent idiopathic scoliosis with mean height and weight of 157.1 ± 5.22 cm and 42.8 ± 5.9 kg were studied. Their minimum and maximum Cobb angle was measured using AP radiography. Using a dynamic stability platform in standing position with opened eyes on stable and unstable platform, their balance performance was measured. Patients underwent four months (54 sessions) balance training with special reference to the proprioceptive training. The measurements were repeated after the exercise therapy. Repeated Measure ANOVA was used for statistical analysis. The postural deviation and body sway of the patients were reduced by 0.97 ± 0.3 and 0.96 ± 0.3, respectively. The greatest improvement in balance performance was obtained, when hip strategy was involved. Exercise training was affected in the reduction of the Cobb angle in 60 % of the subjects (1 to 11 degrees). In 25 % of the patients, the Cobb was not changed and in 15 % of the patients, there was only 1 degree increase on their Cobb angle. According to significant effect of balance training based on the proprioceptive training on the treatment of the scoliotic deformity, the inclusion of the proprioceptive training in the treatment of the mild scoliotic deformity is recommended.

High prevalence rates of celiac disease (CD) in patients with type 1 diabetes (T1D) have been reported in several countries. However, the data regarding this association are scarce in Iran. In this study, we reported the prevalence of celiac disease in type 1 diabetic patients in North-West of Iran, using tissue transglutaminase antibodies (tTGA) as a screening test. In this case-control study, one hundred T1D patients (58 female and 42 male) who admitted to endocrinology clinic of Tabriz Sina’s Hospital were studied. One hundred and fifty healthy people (82 female and 68 male) who randomly selected, were used as controls. All subjects were screened for the tTGA. Total IgA was obtained to investigate IgA deficient subjects. tTGA positive and IgA deficient subjects were submitted to upper gastrointestinal endoscopy. Eight T1D patients (8%) and three of the controls (2%) were positive for tTGA (P=0.023). Only 3 (3%) of the tTGA positive T1D patients underwent duodenal biopsy and all of them showed partial or total villous atrophy. The mean age of tTGA positive cases was significantly lower than tTGA negative ones (mean difference: 7.17 95%CI: 0.82-13.52). None of the tTGA positive T1D patients had a history of chronic diarrhea but 1 out of 8 tTGA positives reported history of dermatitis (P= 0.001). Also None of the tTGA positive subjects presented IgA deficiency. There was a significant difference in the history of chronic diarrhea (P= 0.006) and autoimmune diseases (P= 0.001) between T1D patients and controls. This study showed higher prevalence of CD in T1D patients than general population in North-West of Iran and the data lend support to recommend regular screening for CD in all patients with type 1 diabetes.

Labor pain is the most severe pain in the world and its control is the main goal of maternity care. Nowadays, complementary therapies are suggested in order to labor pain elimination and there is controversial idea about applying of these methods. This study assessed the effects of emotional support and non pharmacological pain relief in labor. In this experimental study, 300 nuliparous women (150 women in control and 150 in empirical group) with single pregnancy, cephalic presentation and spontaneous labor who referred to the Fatemiyeh hospital, Shahrood, Iran, were evaluated. 150 women of empirical group received non pharmacological pain relief methods, including massage therapy, breathing techniques, relaxation, effleurage and emotional supports. No one of them received pharmacological pain relief methods. Pain intensity in the first and second stage of labor was determined by verbal numeric analog scale. Data were analyzed by Mann-Whitney U, Chi- square and Fisher exact tests. There was no difference in mean of age, level of education, residency (rural or urban), vaginal exam in admission time and interventions in labor between two groups. In control group, cesarean request (26.6% vs 16.2%, P<0.05), ventous applying (4.5% vs 0%, P<0.01), duration of the first (P<0.001) and second stage of labor (P<0.05 (and mean of pain score in the first (P<0.01) and second stage) P<0.001 (of labor was greater and mean apgar score in 1 min (P<0.01) was less than experimental group. This study showed positive effects of complementary therapies on pain relief and labor outcomes. So, education of pregnant women, progress in willingness for vaginal delivery and presenting the complementary therapies are recommended in labor units.

From the aspirations of verse 15 of blessed Ahghaf and 233 of Baghareh chapters of the holy Quran, the sum of pregnancy and breast feeding period is 30 months and the maximum breast feeding period is 24 months. Therefore, it is concluded that the minimum period of pregnancy in the view of the Holy Quran is 6 months. The main purpose of this study was to determine the age of pregnancy (between 20 and 36 weeks), which could be with sudden increase in the number of survived preterm infants. In this descriptive cross-sectional study, 304 records of preterm infants from 3 hospitals (Milad, Javaheri and Amir almomenin hospitals) during one year were studied. Subjects were divided to four groups based on age of pregnancy at the time of delivery: A (21-24 weeks), B (25-28 weeks), C (29-32 weeks), D (33-36 weeks). Survival and mortality rate of preterm infants in each group were measured. Survival rate of preterm infants was 11.1% in group A, 26.5% in group B, 78.6% in group C and 95.6% in group D. our results indicate sudden increase in the number of survived preterm infants after the 28th week. This finding is compatible with concepts of mentioned verses of holy Quran.

Endogen arteriovenous fistulas (AVFs) are one of important hemodialysis access. According to current use of this technique, especially snuff box AVF, we compared the efficacy and complications of the two main techniques of snuff box AVFs, including with distal vein ligation and without ligation the vein. This double blind clinical trial was performed on 110 (11 to 83 years old) chronic renal failure (CRF) patients without evidence of proximal vein stenosis. Case and control group were matched regarding in age, sex, underlying disease and history of previous AVF. Vein distal to the site of AVF was ligated in case group and left open in control group. Patients were followed up in the days 1, 30, and 180 after the surgery to evaluate the efficacy and complications of two techniques. Short-term efficacy was 90% and 93.6% in case and control groups, respectively. Long-term efficacy was 90% in case group and 84.8% in control group (NS). The most common complication in both groups was thrombosis followed by edema of the limb and venous hypertension. Venous hypertension was seen only in the control group (NS). There are no statistical significant differences between two groups in efficacy and complications. Venous hypertension did not occur in any of the patients in case group. So, we recommend distal ligation of vein in snuff box AVFs.

Ignorance in infection control precautions and great number of women's seeking health services necessitate conducting of effective educational interventions in order to improving performance of outpatient units in prevention of transmission of infectious agents. This study compared two educational methods, including seminar with printed materials and printed materials only. In this interventional study, gynecologists and midwives of both public and private sections were studied. Data were gathered by questionnaire, checklist and microbiologic studies. After primary data gathering, methods of seminar with printed materials and printed materials only were performed in 81 and 67 subjects, respectively. After three months, results were compared with primary data. Regular controlling of dry heat or autoclave by medical engineers, using disposable speculum, proper disinfectant solution and reducing the number of positive microbial samples were highly influenced by printed materials method. While, in meeting standard time and temperate limit of sterilization and using proper disinfectant solution, the first method had better influence. In the most items, printed materials had higher result compared with participate in seminar and receiving printed materials. performance indicator increased from 65% to 78% in first method and 80% in second method (p<0.001). Our findings are compatible with recent studies published in Iran and other countries. It showed the less effect of traditional presentations alone and high effects of audit and feedback on professional practice and health care outcomes. Therefore policy making on effective medical education and audit and feedback for infection prevention is recommended.

Regarding incremental trend in infections transmitted by blood or other body secretions, and evolving infectious diseases such as avian influenza and SARS, and keeping in mind that health care personnel including nurses are at high risk of being infected, Center for Disease Control (CDC) has recommended standard precautions for all infectious diseases and isolation in cases of specific diseases. Aims of this study were to asses and determine knowledge and information of nursing staff on isolation and standard precautions. In a descriptive study, 191 nurses of educational hospitals completed a questionnaire consisting 12 questions about standard precautions and isolation recommended by CDC. Validity and reliability of the questionnaire was good and Kronbach alpha was measured 82%. Questionnaire scored 12 points and the responders were divided in 4 categories, including well, intermediate, weak, and very weak. The data were analyzed by EpiInfo2000 with t-test, chi-square and Fisher exact test. Of 191 nurses, 169 were female, 13 were male and 9 persons didn’t identify their gender. 56% worked in a general hospital, 28.2% in children's hospital, 12.6% in obstetrics and gynecology hospital and 3.2% in psychiatric hospital. Average score was 6.9±1.6 out of 12 points. 4.2% scored well, 57.6% intermediate, 35.1% weak and 3.1% very weak. Correct isolation and standard precautions need sufficient knowledge, and nurses and healthcare workers should have more detailed and comprehensive education in this field.

Violence against women, which is seen in most societies, is a concealed social disorder. This social issue in itself gives rise to other health and social problems among its victims. This study attempted to identify the contributing factors in violence against women in Iran by evaluating the cases referred to Karaj Forensic Medicine Center. In this case– control study, a questionnaire was fulfilled for 100 married women who suffered violence at home and referred by the judiciary in 2005 to Karaj forensic medicine center, and also 100 married women who referred to Karaj forensic medicine kenter by the judiciary for reasons other than wife abuse and report no history of violence at home. With increasing age of women and men, wife abuse decreased. There was no significant association between education level of men or women and wife abuse (NS). Crime history (P<0.001), polygamy (P<0.001), religious conviction (P<0.001) and addiction of husband (P<0.001) had a significant association with wife abuse. Lower age of woman, addiction of man, and low economic welfare of family of man were independent predictors of wife abuse. In addition, our study revealed that incompatibility of partners, guardianship of a person in family of husband, polygamy, religious conviction of man, violence against children, man job, and history of criminal record are the contributing factors in wife abuse.

Sonography is a non-invasive, well stablished and low complication technique, which renders the determination of benign and malignant focal liver masses. In this study, diagnostic value of sonography in discriminating liver space occupying lesions and its related factors was evaluated and compared with clinical and pathological results. In this descriptive and diagnostic study, 102 patients with hepatic tumor admitted in Shaheed Sadoughi hospital in Yazd between March 2001 and April 2004 were studied. Patient's age, sex, clinical diagnosis, and pathologic and sonographic results were entered in a questionnaire. Data were analyzed by SPSS software with chi-square and Fisher exact tests. 102 patients with mean age of 52±18.7 years (range: 4 months- 87 years) were studied. 54 (53%) were male and 48 (47%) female. Of 102 liver mass, Sonography detected 36 benign and 66 malignant tumors, while clinical diagnosis reported 42 benign and 6n malignant tumors. Of 64 malignant tumors diagnosed by pathologic studies, sonography reported 51 malignant and 13 benign tumors. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of sonography in discriminating benign and malignant liver masses were 79.69%, 60.53%, 77.27%, 63.89 and 75.56%, respectively. Regarding the high sensitivity and accuracy of sonography in discriminating benign from malignant liver masses, it can be helpful for evaluation of hepatic tumors. However, sonographic results should confirm by pathologic studies.