مجله دانشگاه علوم پزشکی گرگان
سال هفدهم شماره 1 (پیاپی 53، بهار 1394)

Repair of peripheral nerve is one of main challenge in surgery and despite improvement in this field less than 50% of cases have functional improvment. This study was done to evaluate the comparison of epineural and peripheral methods in ulnar nerve repair. In this clinical trial study, 28 patients with ulnar nerve injury in distal of forearm were randomly divided equly into epineural and peripheral surgery methods. After 4 months of surgery, the subjects were examined using with EMG, nerve conduction velocity (NCV) and sensorimotor examination on the first dorsal interosos muscle (FDIM) and abductor digiti minim muscle (ADM). The mean of domain nerve activity, latency nerve activity and NCV in affected upper limb and non affected side had significant differences in epineural and peripheral methods (P<0.05). Latency nerve activity and NCV were similar in both methods. The mean of motor unit potential (MUP) was determined in 71% and 64% of patiants in epineural and peripheral methods, respectively. Muscle activity of FDIM was observed in 64% and 57% of patients in epineural and peripheral methods, respectively. Light touch was determined in 35.7% and 28.5% of patients in epineural and peripheral methods, respectively. Pain was reported in 78.5% and 57% of patients in epineural and peripheral methods, respectively. There was no difference between nerve repair by epineurium and prineurium methods using EMG, NCV and motorosensorial examination.

Leptin has a key role in obesity and type 2 of diabetes. This study was done to compare the effects of eight weeks aerobic and combined training on serum levels of leptin and glucose in type 2 diabetic men. This clinical trial study was performed on 24 men with type 2 diabetes whom reffered to Taleghani Hospital in Kermanshah, West of Iran during June to August 2012. The patients were randomly divided into 3 groups including aerobic training, combined training (aerobic and resistance training) and control groups. Training protocols included three 1-hour sessions per week for eight weeks. Subjects in the control group did not participate in any physical activities. Serum levels of leptin and glucose were measured 48 hours before and 48 hours after intervention as fasting values in pre-and post-tests. There was no significant difference between groups at pre-test for serum levels of leptin and glucose. After intervention, serum level of glucose in the aerobic group and serum level of glucose and leptin in the combined group were significantly reduced in compared to the controls (P<0.05). Aerobic and combined training with beneficial effects on the sera glucose level are recommended for patients with type 2 diabetes. However, combined training, regarding reducing leptin level seems to be more useful for these subjects.

Stem cells are a suitable treatment method for improvement of central nervous system diseases. Neuron regeneration is occure in damaged region using stem cell transplantation. This study was done to determine the effect of bone marrow mesenchymal stem cells on memory and neuronal cells graft number in the trimethyltin chloride damaged hippocampus. In this experimental study, 28 wistar male rats were allocated into four groups including control, model, Vehicle and treatment groups. Animals were received 8 mg/kg/bw of neurotoxin trimethyltin chloride by the intraperitoneal injection for causing damaged in hippocampus. One week after intraperitoneal injection of trimethyltin chloride, stem cells was injected by stereotaxy method. Six weeks after stem cells injection, the spatial memory was assessed by Morris water maze and histological studies were done by Nissl staining and normal cells count by Olysia bio report software. After bone marrow mesenchymal stem cells graft, the number of normal cells were more in the treatment group (74±15.190) in compared to the Vehicle (44.67±12.971) and Model (48.56±18.105) groups (P<0.05). Also in Morris water maze test, the treatment group (387.35±189.18), (31.30±13.67) spent shorter distance and escape latency to reach the hidden platform, but this reduced non significantly in compared to Vehicle (438.18±192.56), (40.14±14.89) and model (407.98±225.44), (37.68±17.15) groups. The model and Vehicle groups spent longer distance to reach the hidden platform in comparision with the control (275.45±165.10) group (P<0.05). Also the traveled distance in target quarter had significant increased in the treatment groups (799.80±125.91) in compared to model (588.51±136.94) and Vehicle (546.48±86.47) groups (P<0.05). Using the bone marrow mesenchymal stem cells leads to reduce hippocampal lesions and increase the number of pyramidal neurons and improving memory in damaged hippocampus in animal model.

Nicotine is an addictive substance and Ritalin is a medicine which has been prescribed for treatment of hyperactivity / attention deficit disorder (ADHD). This study was done to evaluate the effect of Ritalin and nicotine and combination of Ritalin and nicotine on daily sperm production and epididymal sperm reserve in mice. In this experimental study, 120 adult male BALB/c mice were randomly allocated into one control group and 11 experimental (treatment) groups. Animals, in the first, second and third treated groups were received nicotine at the doses of 100, 200 and 400 microgr/kg/bw, respectively. Mice in fourth and fifth treated groups were received Ritalin at doses of 2 and 10 mg/kg/bw, respectively. Animals in sixth and seventh treatment groups were received nicotine in 400 microgr/kg/bw and Ritalin in 2 and 10 mg/kg/bw and in eighth and ninth groups, nicotine at dose of 200 microgr/kg/bw and Ritalin at doses of 2 and 10 mg/kg/bw, respectively. Animals in tenth and eleventh treated groups were received nicotine as dose of 100 microgr/kg/bw and Ritalin at doses of 2 and 10 mg/kg/bw, respectively. Ritalin and nicotine were administrated orally for 40 days. At the end of study, daily sperm production and epididymal sperm reserve were measeared. The daily sperm production was significantly reduced in the groups with high consumption doses of nicotine and different doses of Ritalin and the majority of groups which used the combination of Ritalin and nicotine (P<0.05). The epididiymal sperm reserve was significantly increased in experimental groups of 8, 9, 10 and 11 which were received the combination of Ritalin and nicotine in different doses (P<0.05). The combination of Ritalin and nicotine reduces daily sperm production and it incereases epididiymal sperm reserve in adult BALB/c mice.

Ginger as a medicinal herb is used as a food flavoring and thraphy of many diseases including infertility and male sexual disabilities. This study was carried out to evaluate the effect of alcoholic extract of Ginger during fetal life and breastfeeding on serum level of testosterone, LH, FSH and spermatogenic cell lines in male mature offspring rats. In this experimental study, 72 female adult mice were randomly allocated into the 9 groups, including: control group (no treatment), sham groups including neonatal and perinatal groups which were received normal salin (0.5 ml daily) and 6 interventional groups. Animals in interventional groups were received doses of 50, 100 and 200 mg/kg/bw of alcoholic extract of Ginger, during neonatal and perinatal period, orally. After puberty eight male rats from each group were sacrified. Serum level of testosterone, LH, FSH were measeared and then by isolating testes, the cell numbers of leydig, sertoli, spermatogonia, spermatocyte and spermatid were counted. The extract of Ginger dose-dependently significantly increased the level of testosterone (P<0.05) and the number of spermatogenic cells in compared to controls (P<0.05). The dosage of 100 and 200 mg/kg/bw of alcoholic extract of Ginger significantly reduced the FSH and LH in compared to controls (P<0.05). The oral consumption of Ginger during pregnancy and lactation dose-dependently increase the level of testosterone and the number of spermatogenic cells.

Lead exposure induced toxic effects on reproductive system. This study was done to evaluate the effect of Grape seed oil (Vitis vinifera) on serum gonadotropins and testosterone level in toxicited adult male rats by lead acetate. In this experimental study, 56 adult male Wistar rats were randomly allocated equally into 7 groups. Animals in control group did not receive any matter. Animals in the sham, experimental 1 and experimental 2 groups were received orally distilled water, 8ml/kg Grape seed oil (GSO) and 0.1 mmol/lit lead acetate for 21 days, respectively. Animals in the experimental group 3, 4 and 5 were received 0.1 mmol/lit lead acetate for 21 days and then 2 ml/kg/bw, 4 ml/kg/bw and 8ml/kg/bw GSO from day 22 up to day 42, recpectively. Blood samples were taken from control, sham and experimental groups 1 and 2 at the end of day 21. At the end of day 42, blood samples were taken from experimental groups 3, 4 and 5. Serum level of LH, FSH and testosterone were measured by Radioimmunoassay. Serum level of LH, FSH and testosterone were significantly reduced in the experimental group 2 in compared to control group. Serum level of LH, FSH and testosterone were significantly increased in experimental group 4 and 5 in comparision with the experimental group 2. Grape seed oil extract at doses of 4 and 8ml/kg/bw increased serum level of LH, FSH and testosterone in lead acetate exposed male rats.

Hyperactivity / attention deficit disorder (ADHD) with 3-5% is the most common disorder in children. This study was done to compare the efficacy of behavioral, medicinal and combination of behavioral and medicinal therapy on reduction of ADHD symptoms in children. This quasi-experimental study was carried out on 40 male elementary students with ADHD in Gorgan, Northern Iran during 2011-12. Subjects were divided into the four groups including control, behavioral, medicinal (Ritalin 10 mg three times per day) and combination of behavioral and medicinal therapy. Conner's Rating Scale for parents (home) and teachers (school) were used in pretest-posttest spot after 8 weeks therapy. After intervention ADHD symptoms significantly reduced in behavioral, medicinal and combination of behavioral and medicinal therapy in compared to controls (P<0.05), but this reduction was more in medicinal and combination of behavioral and medicinal therapy groups than behavioral group. Medicinal and combination of behavioral and medicinal therapy has the same efficacy in reducing ADHD symptoms in children.

By increasing the number of athletes, sports-related injuries are increased and of those lower extremities injuries are more common. This study was done to evaluate the relation of sole arch index and static balance in female athletes with lower-extremity injury. This case – control study, was done on 18 female athletes without a history of lower extremity injury which were considered as controls and 18 female athletes with a history of lower extremity injury in past two years which were considered as cases. Static balance and sole arch index were evaluated using stork stand and Chippaux-Smirak index tests. Static balance with open eyes was 16.10 seconds and 26.53 seconds in cases and controls (P<0.05), whereas, there was no significant difference in static balance with closed eyes and sole arch index between cases and controls. Poor static balance with neuromuscular control deficit can consider as lower extremity injury in female athletes.

Hypertension in long time can cause cardiovascular disorders and increase chance of stroke. This study was done to determine the association between some dietary factors and risk of hypertension. This cross-sectional study was conducted on the fourth phase (2008-11) of Tehran lipid and glucose study (TLGS). In this study 6089 subjects (2807 males and 3282 females), aged 19-70 years, were participated and dietary, demographic, anthropometric and blood pressure of each subject were collected. Dietary intake was assessed using a validated and reliable food frequency questionnaire with 147-items. Odds ratio for hypertension according to quartiles of dietary factors was determined using logistic regression with adjustment for confounder variables. The rate of hypertension was 29.8%. Mean of weight, body mass index, waist circumference, prevalence of abdominal obesity and alliteration in the hypertensive subjects were significantly higher than normotensive subjects (P<0.05). There was a non significant direct relationship between energy density, total fat and saturated fat. Higher consumption of fiber was associated with lower risk of hypertension (OR: 0.62, 95% CI: 0.37-0.97). The risk of hypertension increased in the highest quartiles of dietary protein (OR: 1.20, 95% CI: 1.02-1.43). Odds ratio for hypertension was higher among subjects whom consumed lower fruits and nuts than those subjects with higher fruits consumption (OR: 1.33, 95% CI: 1.15-1.85) and nuts (OR: 1.21, 95% CI: 1.02-1.42). High consumption of fiber could protect against hypertension while some dietary factors such as high consumption of protein could increase risk of hypertension.

Bacterial resistance to Imipenem is increased in bacterial infections in Iran. In regard to the importance of Imipenem in the treatment of nosocomial infections and the key role of disc diffusion method as a major antibiotic susceptibility testing assay, this study was done to determine the prevalency of imipenem-resistant bacterial strains isolated from hospital and accuracy of Iranian imipenem disc product. In this descriptive-analytic study, 241 bacteria were isolated from patients in different wards of the Baqyatallah hospital in Tehran, Iran during 2013-14. After streaking of the organisms, identification was performed by all conventional biochemical tests. The bacterial resistance to imipenem was determined by disk diffusion method using Iranian and Mast imipenem discs. True imipenem-resistant isolates were examined for susceptibility to six different antibiotic including Ciprofloxacin, Gentamicin, Cephalexin, Azitromysin, Tetracycline and Ceftazidim, using disk diffusion method. The most prevalent isolates organisms were gram-negative bacilli (Klebsiella, Escherichia coli, and Pseudomonas aeruginosa, respectively). The common clinical source was urine and wound samples, respectively. Resistant to Imipenem was 68 (25.7 %) and 19 (7.8 %) based on the results of Iranian and Mast Imipenem discs, respectively. False results for Iranian Imipenem discs was higher than Mast Imipenem discs (P<0.05). Among the 19 true Imipenem resistant isolates, 17 micro organisms were Pseudomonas aeruginosa. 57% of isolated resistant to Imipenem were isolated from ICU ward. The most resistance was seen to Gentamicin (84%) and the lowest was seen to Ciprofloxacin (63%). 84% of isolated samples were multi drug resistance. Although a small percentage of the isolates obtained as important nosocomial pathogens were resistant to Imipenem, but the rate of multiple resistance and high rate of isolates obtained from ICU was noticeable.

Bariatric surgery is the most effective treatment for morbid obesity. The classic procedure, jejunoileal bypass, has many complications. This study was carried out to assess the evaluation of clinical complications in morbid obese patients after modified jejunoileal bypass surgery. This descriptive – analytic study was carried out on 120 morbid obese patients referred for bariatric surgery. A modified jejunoileal bypass was performed in which the defunctionalized organ eliminated by anastomosing its ends to the gall bladder and cecum. Weight loss and clinical complications were recorded after one year follow up. The mean weight and body mass index reduced from 136 kg and 48 kg/m2 before surgery to 83 kg and 29/8 kg/m2 after one year follow up, respectively (P<0.05). Before surgery, articular pain (24.3%), dispana (21.6%), cardiovascular disorders (10.8%), fatty liver (5.4%) and sleep disorder (5.4%) due to obesity were recorded. One year follow up after surgery, articular pain (1.5%) and dispana (1.5%) were seen in patiants. No serious post-operative clinical complication was observed. One year follow up after surgery showed that the modified jejunoileal bypass is very effective in reducing body weight and does not lead to serious complication.

Nasal obstruction is a common complaint leading to septoplasty as one of the most common surgical procedures in otorhinolaryngology. This study was done to determine the relationship between patient's satisfaction following septoplasty with rhinomanometry perior and after surgery. This descriptive – analytic study was done on forty-one patients, candidated for septoplasty, from Oct 2012 to Sep 2013. Rhinomanometry were tested perior and 6 months after surgery. At the time of rhinomanometry after surgery, common clinical symtomps and patient's quality of life and their satisfaction from operation were recorded by using GBI questionnaire. Nasal obstruction and congestion, trouble sleeping, insufficient breath during physical activity and difficulty breathing through the nose were significantly reduced after surgery (P<0.05). In overall, patient's satisfaction after septoplasty was 90.24%. Rhinomanometry was not predictive factor for satisfaction after surgery. Six month follow-up after surgery showed high patients satisfaction (90.24%) following nasal septoplasty, but this was not related to rhinomanometry test results.

Nowadays the food contamination is increased and threating human health. This study was done to determine the concentration of cadmium, lead, zinc and copper in tomatoes and cucumber in Northern Iran. In this descriptive study, 48 cucumber and 48 tomatoes samples were collected randomly from the two sampling stations of Gorgan and Gonbad the two cities in Golestan province of northern Iran during spring and summer of 2012. Cadmium (Cd), lead (Pb), zinc (Zn) and copper (Cu) concentrations were determined by voltammetry method of 797 Polarography models. Mean±SE of Zn, Cd, Pb and Cu concentration in samples of cucumber in Gonbad was 53.4±7.7, 0.09±0.013, 1.47±0.21 and 4.1±0.66 mg/kg wet weight, respectively. Mean±SE of Zn, Cd, Pb and Cu concentration in samples of cucumber in Gorgan was 60.3±8.7, 0.12±0.017, 1.4±0.2 and 3.7±0.53 mg/kg wet weight, respectively. Mean±SE of Zn, Cd, Pb and Cu concentration in samples of tomatoes in Gonbad was 17.9±2.6, 0.03±0.004, 0.5±0.07 and 0.85±0.12 mg/kg wet weight, respectively. Mean±SE of Zn, Cd, Pb and Cu concentration in samples of tomato in Gorgan was 23.8±3.4, 0.08±0.01, 0.66±0.09 and 1.7±0.24 mg/kg wet weight, respectively. Mean concentrations of Cd and Pb in cucumber and tomatoes samples of Gonbad was up to 2, 14, 0.6 and 5 times and mean concentrations of that in cucumber and tomatoes of Gorgan was up to 2.4, 14.4, 1.6 and 7 times exceed the maximum allowable limits of WHO/FAO. Mean concentration of Cd and Pb in cucumber and tomato samples was exceeded the maximum allowable limits of WHO/FAO and mean concentration of heavy metals in cucumber was more than tomato samples.

The size of the human body is studied in anthropometry. In the one field of anthropometry, the relation of skull and brain size with body weight and height in human are studied. This study was done to determine the relation between cranial capacity and brain weight with body weight and height in 18-26 years old Iranian students. This cross-sectional study was done on 286 students (150 females and 136 males) in Arak, Iran. Cranial capacity, brain weight, body weight and height, cerebral index and the ratio of brain to body (cerebral quotient) in 18-26 years old students were measeared. The mean of cranial capacity in males and females were 1393.71 and 1168.71 mm3, respectively (P<0.05). The mean of brain weight in males and females were 1445.19 and 1209.61 gram, respectively (P<0.05). The mean of cerebral index in males and females were 1.99 and 2.2, respectively (P<0.05). Positive statistical correlation was seen between cranial capacity with body weight, height and BMI in both gender. Cranianl capacity and brain weight in males was more than females while cerebral index was more in females.

Pregnancy can not only protect mothers against intimate partner violence but even it may increase the rate and severity of intimate partner violence. This study was done to determine the intimate partner violence during pregnancy in the Northern Iran. This cross-sectional - analytical study was done on 1500 mothers whom attended the primary health centers of Mazandaran province, Northern Iran from Feb to Sep 2010. Mothers screened using modified standard world health organization intimate partner violence questionnaire via interview. The questionnaire included physical, emotional and sexual intimate partner violence. Intimate partner violence was categorized to severe, moderate and mild. A multivariate logistic regression analysis was used to identify predictor of intimate partner violence. The most common intimate partner violence was restriction of mothers in terms of money, food, and clothing (88.8%). The prevalence of physical, psychological and sexual intimate partner violence was 14.1%, 69.9% and 10.8%, respectively. The adjusted odds ratio for physical intimate partner violence in mothers with low education and low socio-economic status were significantly higher in those mothers with high education and fair socio-economic status (P<0.05). Mild psychological intimate partner violence is prevalent in Mazandran province, North of Iran.

MIRU-VNTR typing is currently one of the most frequently-used standardized genotyping systems in molecular epidemiology of tuberculosis in the world. This sudy was done to determine the Mycobacterium tuberculosis genotyping by MIRU-VNTR method. This descriptive study was done on sputum, gastric lavage clinical specimens of 53 tuberculosis suspected patients. Fifty-three isolates were identified by 16S rRNA and Rv-typing followed by RD typing. They were then subjected to a 12-locus (ETRA, ETRB, ETRC, ETRD, ETRE and ETRF, MIRU-10, MIRU-26, MIRU-39, MIRU-30 plus QUB-11b) MIRU-VNTR typing system. In MIRU-VNTR typing, forty-four types were identified with 13 isolates classified in 4 clustered and the remaining 40 isolates representing 40 orphan patterns. In comparative analysis of MIRU-VNTR loci, MIRU-26 with 7 alleles displayed the highest diversity level (Simpson’s diversity index = 0.767. Out of the 53 isolates, only one was identified as Mycobacterium bovis. All the remaining isolates were characterized as Mycobacterium tuberculosis. None of the samples was affected to Mycobacterium complex strain. No evidence of either double or co-infection of the patients with more than one species/strain was detected. While the genomic diversity observed by MIRU-VNTR typing sounds extensive, the population genomic structure on the whole however, seems to be homogenous. Recent transmission between studied patients does not appear to be a frequent event as only 13 isolates representing 4 MIRU-VNTR types, were assumingly epidemic.

Hemoglobin D-Punjab is one of the variant of hemoglobin caused by a mutation on position 121 of beta globin gene which is frequent in India, Pakistan and Iran. Heterozygote form of this variant is mainly asymptomatic while in combination with hemoglobin S, severe form of anemia occure. This study was carried out to determine the beta globin gene haplotypes associated with hemoglobin D-Punjab in Northern Iran. This descriptive study was carried out on families of 18 individuals whom were carriers of hemoglobin D-Punjab in Sari in Northern Iran. Genomic DNA was extracted from peripheral blood samples using Phenol-chloroform standard protocol. In order to identify different haplotypes associated with hemoglobin D-Punjab, PCR-RFLP method and family linkage analysis were used. In 17 subjects hemoglobin D-Punjab was linked to [+ - - - - + +] haplotype and in one case association with [- + + - + + +] haplotype was observed. The hemoglobin D-Punjab alleles have mainly unicentric origin and [- + + - + + +] rare haplotype may have different genetic origin or is created as a result of gene recombination.

Yersinia enterocolitica is a worldwide pathogen belong to genus Yersinia. The association between acute childhood diarrhea and other diseases caused by Yersinia enterocolitica has been established by several researchers. Due to the lack of sufficient information on other pathogenic Yersinia species, this study was done to determine the prevalence and the pattern of antibiotic susceptibility of atypical Yersinia spp isolated from children, less than 14 years old. This descriptive cross - sectional study was carried on 384 children with diarrhea whom referred to the Tehran children medical center, Tehran, Iran during August 2011 to August 2012. 384 fecal specimens of children were transferd to the laboratory and cold enrichment in alkaline buffer with pH of 7.2 for 21 days. The samples were cultured in Cefsulodin-Irgasan-Novobiocin Agar (CIN) differential media in 7, 14, and 21 days. The identification of Yersinia species were carried out by conventional procedure. Antibiotic susceptibility test to Ciprofloxacin, Co-trimoxazole, Tetracycline, Chloramphenicol, Erythromycin, Ampicillin, Gentamicin, Penicillin were determined by standard disk diffusion method. Out of 384 fecal samples, 3 (0.7%) were infected with Yersinia. Three species of Yersinia were Y.enterocolitica, Y.Kristensenii and Y.frederiksenii. All three strains were sensitive to Cotrimoxazole, Tetracycline, Chloramphenicol, Ciprofloxacin and Gentamicin. This study showed that atypical Yersinia play important role in diarrhea. Therefore, more attention should be noticed to atypical Yersinia species in addition to Yersinia enterocolitica.