مجله دانشگاه علوم پزشکی اردبیل
پیاپی 42 (زمستان 1390)

Pain is one of the most common problems for which human have always been looking for efficient treatment. Several different factors may cause pain, but one of the most widespread reason is the application of some treatments and nursing measures such as intramuscular injection. The present study was designed to compare between the intensity of pain due to intramuscular injection by two different Z- track and Air lock method. In this semi-experimental study, 60 volunteer female nursing students were included. The subject was injected with one milliliter of sterilized water two times within 24 hours: the first injection by Z method and the second one by the Air lock method. The intensity of pain was measured two times by a scale graded from zero to ten. The results were compared by using descriptive statistics and independent t-test by SPSS 12 software. Our findings showed that the mean of pain intensity in Z method was 1.80 ± 1.90, and raised to 3.13 ± 2.33 in Air lock method. Moreover, the intensity of pain in these two different methods had significant difference (p <0.01). These results indicated that the pain caused by Z method is less than the pain felt through Air lock method. With respecting to these results the Z method is proposed as preferred method for intramuscular injections.

Ischemic stroke is the third leading cause of death and disability in most of the human societies. There is no effective treatment due to complexity of the pathophysiological mechanisms. Today, more researches are designed to introduce involving factors and new treatment strategies in brain ischemia. The objective of this study is to introduce an experimental model of the focal cerebral ischemia in rat with increased success rate and low mortality rate. In this research 32 male rats (Sprague-Dawley) were studied as in four experimental groups. Animals were anesthetized with chloral hydrate (400mg/kg, ip). Focal cerebral ischemia was induced by intraluminal filament method. A silicon coated nylon filament was used for middle cerebral artery occlusion. Regional cerebral blood flow was monitored by laser Doppler flowmetery to guide the insertion of the filament into the vascular pathway. 24 hours after ischemia (90minutes), animals were assessed for neurological outcome, infarct volume and brain edema formation. A new and reformed neurological test was used for evaluation of neurological deficits. 2 - millimeter coronal sections were collected from 6 levels of the brain and stained, digitized and quantified by using an image analysis system. Ischemic brain edema formation was investigated by brain water content detection. Induction of ischemia in ischemic group, seriously caused impairment of motor functions (neurological deficit score 4±0.5) While sham operated rats had no motor deficit and infarction. Mean total infarct volume of left (ischemic) hemisphere was 402±43 mm3 and 62.7 percent of infarction occurred in cortical regions of the brain. Induction of focal cerebral ischemia in the left (ischemic) hemisphere of the brain significantly increased water content (84±0.23 percent) compared to both hemispheres of sham group and right hemisphere of the same group. Success rate of ischemia induction was 100 percent and there was no mortality due to technical problems. Our findings indicate that continuous recording of regional cerebral blood flow using laser Doppler flowmeter had significant role in increasing success rate and lowering mortality rate in the present model of ischemic rat. This experimental model with high success rate and low limitation can be used for brain ischemia studies and evaluating new therapeutic strategies.

Expansion of microbial drug resistance, have indicated to introduce new source of drugs with antimicrobial properties such as antimicrobial secondary metabolites which produced of Cyanobacteria spp. Antimicrobial activity of Cyanobacteria spp. of Urmia Lake catchment area was not already reported, therefore in this research, antibacterial and antifungal properties of cyanobacteria varieties isolated from this ecosystem and identification of the potent strains were investigated. Different environmental samples screened for isolation of cyanobacterial strains. Cyanobacterial extracts were prepared by using different solvents. The effect of these extracts was evaluated by disc diffusion method and by measuring minimum inhibitory concentrations (MIC) against some gram positive and gram negative bacteria and fungi. Cyanobacteria spp. with the high antimicrobial activity was identified according to Microscopic and macroscopic characters and 16SrRNA sequences. In this research, 54 cyanobacterial strains were isolated that six strains with significant antimicrobial activity identified as Gloeocapsa sp., Anabaena sp., Nodularia sp., Synechococcus sp., Leptolyngbya sp. and Chroococcus disperses. the highest antimicrobial activity achieved by the chloroform extract on gram positive bacteria and fungi. Minimum inhibitory concentration (MIC) levels for the cyanobacterial strains were ranged 20 to 80 µg/ml and Leptolyngbya sp. showed the highest effects on Candida krusei with MIC level 20 µg/ml. According to the results, cyanobacteria can be a source of production new antimicrobial compounds.the results showed that the filamentous cyanobacteria Anabaena sp., Nodularia sp., and Leptolyngbya sp. produce active compounds against gram positive bacteria and yeasts.

Hypocalcaemia is one of the severe complications of total thyroidectomy. This complication occurs due to parathyroid glands damage during operation. The aim of this study was to evaluate the frequency of transitory and permanent hypocalcaemia in patients who were subjected to total thyroidectomy and the role of the parathyroid autotransplantation on permanent hypocalcaemia. In this retrospective study, one hundred patients who suffered from malignant (group I, 46 persons) and benign (group II, 54 persons) thyroid diseases and subjected to total thyroidectomy were included and preventing role of parathyroid autotransplantation on hypocalcaemia (permanent and transitory) was studied. Of 37 individuals of the group I who were treated with total thyroidectomy, 3 patients (subgroup A) were autotranspalnted with parathyroid glands and the rests (9 persons) who their neck lymph nodes were dissected radically and then undergone total thyroidectomy, 4 patients (subgroup B) were accomplished the autotranspalntation. In group II, just 2 patients were autotranspalnted. In overall, only in 9% of cases the autotranspalntations were done into sternocleidomastoid and deltoid muscle fibers. Sixty seven percent of the patients were female with average age of 39.9 ± 10.8 years and 33% were male with average age of 37.2 ± 8.8 years. Seventeen percent of the patients showed transitory hypocalcaemia (13 persons in group I: 8 persons in subgroup A and 5 persons in subgroup B, 4 persons in group II). They were treated with intravenous and oral calcium supplements. None of patients progressed to permanent hypocalcaemia. The recovery rate obtained by the autotransplantation was significant statistically between two groups (p =0.006) and two subgroups (p =0.04). Temporary recurrent laryngeal nerve paresis also occurred in 2% of patients but no paralysis was observed. The autotransplantation of injured or incidentally removed parathyroid glands into sternocleidomastoid or deltoid muscle fibers can prevent the permanent hypocalcaemia.

Amikacin is one of the key second-line drugs for treatment of tuberculosis. Mutations at the codons 1400, 1401and1483 of the 16srRNA gene are associated with resistance to amikacin. The purpose of this study was to detect these mutations using PCR-RFLP method in multi-drug resistant (MDR) strains of Mycobacterium tuberculosis showing resistance to amikacin. Susceptibility of strains (n=100) against first and second–line anti-tuberculosis drugs was performed by proportional method. Based on antimicrobial resistance pattern 97 strains were analyzed by PCR-RFLP method. rrs1096 and rrs1539 primers were used to amplify a 460bp region of the rrs gene. Then, the PCR products were digested using Tai 1 and Dde1 restriction enzymes. The results were analyzed by the SPSS software using Chi-square test. Based on results from proportional method, 63 strains (64.9%) were MDR (Multiple Drug Resistant), 26 (26.8%) and 8 (8.2%) strains were susceptible and non-MDR, respectively. Also, 13.4% and 6.1% of the strains were XDR (Extensively Drug Resistant) and TDR (Totally drug resistant) respectively. Using PCR-RFLP method, 7 (7.2%) strains were resistant and 90 (92.7%) strains were susceptible to amikacin respectively. Moreover, we found that the mutation at the codon 1400 was the most frequent mutations responsible for resistance to amikacin. The PCR-RFLP method can be used as a supplemental method to detect resistance to amikacin; however to increase our knowledge, mutatuions in several number of codons in rrs gene need to be studied.

Stress in developing countries is an important problem in human health. Feelings of stress in humans result from interactions between persons and their environment. Stressor is an external stimulus or an event that provokes a stress response in an organism. Animal models enable preclinical testing of new treatments and therapies for physical symptoms of stress disorder. In the present study the effects of social stress on male mouse reproductive system were investigated. Sixty male mice were divided into 6 groups, including two non-stressed control groups (2 cages, 5 mice per cage), two mild-stressed groups (2 cages, 10 mice per cage), and two high-stressed groups (2 cages, 15 mice per cage). Three cages (one cage from each group) kept for one month and three cages kept for two months. After one and two months the mice were anaesthetized with ketamine and xylazine. Tissue samples of testes, epididymis and vas deferens for light microscopy were removed. Data analysis was performed using one-way ANOVA. P <0.05 was considered significant.The results showed that there was no significant difference between mild and high-stresses groups in the diameter of seminiferous tubules, vas deferens, height of epithelial cells of epididymis and vas deferens. The diameter of epididymis in mild and high-stressed groups was significantly decreased as compared with that in non-stressed control groups (P <0.02, P <0.009). The diameter of vas deferens in mild-stressed groups was significantly decreased as compared with in non-stressed control groups (P <0.02). The height of epithelial cells of vas deferens in mild and high-stressed groups was significantly decreased as compared with that in non-stressed control groups (P <0.001, P <0.001). This study shows that crowding stress can decrease the diameter and height of epithelial cells of epididymis and vas deferens of male mice.

Anatomical reconstruction of articular surface and restoration of walking ability without pain are the main goals of displaced intra-articular calcaneal fracture management, but treatment results are not always satisfied. This paper focused on comparison between open reduction and internal fixation using: A) auto graft B) bone cement, in patients with displaced intra-articular calcaneal fracture. This prospective comparative study of 44 patients with displaced intra-articular calcaneal fractures. Patients had been divided into 2 groups and then, they were operated by the standard protocol, including lateral approach, open reduction and internal fixation with reconstruction plate. Posterior facet was supported by autogenous bone graft in the first group (BG) and it was strengthened by bone cement in the second group (BC). Patients were followed up from the point of view of following surgical complications: 1- superficial infection, 2- wound dehiscence, 3- incisional site skin necrosis, 4- Sural nerve paresthesia, 5- osteomyelitis. Functional outcome were evaluated using calcaneal fracture scoring system and ankle-hind foot scaling system of AOFAS. The gathered data was analyzed in SPSS 16 software. Of 44 included patients, 36 were male (81.8%) and eight were female (18.2%). The mean of age was 44.25± 11.34 (range: 16-69 yrs), and the mean of follow-up duration was 13.27±2.71 months (range: 9-18 months). The mean of operation time in second group (BC) (41.82min) was significantly lower than first group (BG), (p <0.001). Five patients (23%) from first group (BG) and only one patient (5%) from the second group (BC) showed surgical complications (p =0.079). There was no significant difference between the average score evaluated by calcaneal fracture scoring system and the average scale indicated by ankle-hind foot scaling system. Instead of autogenous bone graft, the use of bone cement decreases the duration of operation time and it seems to lead in less complications.

Diarrhea is one the important causes of mortality among children in developing countries. The effect of zinc supplementation in reduction the rate of diarrhea is controversial. The aim of this study was to evaluate the effect of zinc supplementation on the severity and duration of diarrhea in children less than 5 years old hospitalized in Ali-Asghar hospital in Ardabil, 2005. This study was a double-blind, randomized, placebo-controlled trial including 228 children with acute diarrhea. The subjects randomly assigned into two placebo and experimental groups (114 patients in each group). The placebo group received glucose (5%), while the experimental group received 20 mg/day Zn sulfate. The severity and duration of diarrhea were assessed during the study. Data were analyzed using Chi-square, Pearson correlation coefficient tests and Students t-test by SPSS software. Our findings showed that most of the patients in both groups were male (age range; 1-12 months, weight range; 3-11 kg, weight percentile; 3-50). These children had breast feeding and complete vaccination. They were the first baby in their family and the majority of them were from urban area (Ardabil city). The severity of diarrhea in zinc supplemented children (74.6%) was less than placebo group (89.5%) (p =0.037). There was no significant difference between two groups in the duration of diarrhea (p =0.737). There also was no relationship between the severity of diarrhea and weight percentile (p = 0.085). Our data indicate that zinc supplementation reduces the severity of acute diarrhea and could be advised in children with acute diarrhea.

Antibody-based radiopharmaceutical drugs are the great current interest in imaging and radiotherapy of cancers, and provide an important tool for target-specific delivery of radionuclides to specific antigens in the diseased tissues. The monoclonal antibody avastin binds, neutralizes VEGF (Vascular endothelial growth factor) and blocks VEGF-induced angiogenesis in tumor tissues. In this study, the complex of avastin and beta particle was investigated as a first step in the production of a radiopharmaceutical drug.Antibody of avastin was prepared and purified. The antibody was conjugated with freshly prepared DOTA-NHS and then labeled with 153Sm-samarium chloride (185 MBq). The efficiency and in vitro stability of antibody labeling were determined using thin layer chromatography. The integrity of the radiolabeled antibody was checked by SDS-PAGE (Sodium Dodecyl Sulfate PolyAcrylamide Gel Electrophoresis) protocol. Biodistribution study of 153Sm-DOTA –Avastin was performed in BALB/c mice at 2, 24, 48 and 72 hours after injection. The efficiency of antibody labeling was more than 98%. The in vitro stability of the labeled product in human serum after 120h was 83 ±2%. There was no fragmentation in the labeled antibody during SDS-PAGE protocol. The highest (%ID/g) was observed in the liver, lungs and kidneys. The monoclonal antibody avastin against angiogenesis was effectively radiolabeled with 153Sm. The Biodistribution study showed that it has a high specificity to accumulation in tissues with enriched blood vessels.

Hydatid disease infection in humans is caused by larva of Echinococcus granulosus. Definitive hosts are carnivores such as dogs, while intermediate hosts are herbivores. Humans can also be intermediate hosts. Hydatid disease is clinically related to the presence of cysts, most frequently in the liver and the lungs and less frequently in the other organs such as kidney, spleen, brain, heart and bone. In this article, a case of splenic hydatid cyst is reported. A 50-years-old man was admitted to the clinic with a abdominal pain lasting for two weeks. Sonography and computed tomography (CT) scan revealed a splenic cyst. Cyst was removed by a surgery. The diagnosis of a hydatid cyst was confirmed by histopathology.