نشریه پژوهش در پزشکی
سال سی و نهم شماره 3 (پیاپی 155، پاییز 1394)

The study emphasizes the reasons use of beta-lactamase inhibitors in combination with beta-lactam antibiotics. ß-lactam-ß-lactamase inhibitors are currently the most successful strategy for infections caused by extended-spectrum β-lactamase and carbapenemases bacteria.

Introduction and Nicotine is a nitrogenous organic compound which constitutes the major material of cigarettes. This toxic alkaloid is extracted from tobacco plant. Ritalin or Methylphenidate is a medicine from amphetamines group and structurally similar to cocaine with a widely usage. The objective of this study is surveying the vitality of sperm and fertility of the females received the gametes of the males used Nicotine and Ritalin. This study conducted in Islamic azad university Tehran medical science branch.(1392).
In this experimental study a total number of 120 male mice and 54 female mice were selected and the male mice were randomly divided into 11 experimental groups and one control group. In two experimental groups Ritalin was used 2 and 10 mg/kg of body weight, in three experimental groups nicotine was used 100, 200 and 400 mg/kg of body weight and in other experimental groups nicotine and Ritalin were used together as gavage for 40 days. At the end of the treatment period, three male mice from each group were selected and each was kept with a female in a separate cage. After 10 days the female mice were euthanized and by counting the fetuses and the corpora lutea, the percentage of fertility in females which is an indicator of the male mice were estimated. Also the remaining males were euthanized and after removing the testes for determining the percentage of aliv sperm using eosin nigrosin, the numbers of stainmed sperms were specified. The data were calculated statistically by ANOVA and Tukey Test and the criterion of statistical derivation was considered pFindings: The results of this study showed that percentage of fertility in the experimental group reciving nicotine [400 µg/kg/day] with nicotine comparing control group (95.42±4.68) with the experimental group [400 µg/kg/day] (63.10±38.37) the groups reciving Ritalin [2mg/kg/day] (64.96±18.51) and [10mg/kg/day] (18.53±16.72) compared with the control group (95.42±4.68) showed a significant reduction. These results confirm more reduction of fertility percentage in Ritalin consumption than nicotine. Morever in the other 6 groups consuming the combined form of nicotin with the doses of 100,200 and 400 µgr/kg/day and Ritalin with the doses of 2 and 10 mg/kg/day, fertility percentage should a significant reduction compard to the control group. Although this reduction in the group consuming nicotine at the dose of 400 µgr/kg/day and Ritalin at the dose of 10 mgr/kg/day (10.00±20.03) was more intense than the control group.

In recent years, Magnesium sulfate was used for acute pain relief following several types of surgeries. In current study for the first time, we compared the effects of this drug on acute pain following open repair of inguinal hernia with that of bupivacaine.
In current randomized clinical trial, there were 80 patients with unilateral inguinal hernia assigned to two equal groups: bupivacaine (B) and magnesium sulfate (M). Open repair was performed. Group B received tramadol 0.5% (5 cc) in 5 mL 0.9% normal saline and group M received 10 cc of magnesium sulfate 20, both as a local wound infiltration before the wound closure. At first postoperative day, pain intensity, analgesic consumption, and incidence of side effects were measured and compared.
The pain intensity was the same at hours 1 and 3; however, was significantly lower in group B in hours 6, 12 and 24 (p The local infiltration of bupivacaine provides better pain relief and is associated with lower analgesic consumption following open repair of unilateral inguinal hernia compared to magnesium sulfate.

It has been suggested that local endometrial injury (LEI) can increase the success rate of assistive reproductive technologies. Previous studies have been resulted in controversial diseases. In current study, we investigated the effect of LEI on the rate of clinical pregnancy and live birth in women undergoing frozen embryo transfer (FET).
There were 120 infertile women assigned to two equal groups, randomly: LEI group and control group. Patients underwent FET procedure. The rate of clinical pregnancy and live birth were compared between two groups.
Findings: The rate of clinical pregnancy was the same (35% in LEI group versus 33.3% in control group; p Based on our findings, LEI does not improve the rate of clinical pregnancy and live birth in women undergoing FET.

Upper respiratory tract infection (URTI), the most common infectious disease among trained endurance athletes, declines the athletic performance. The aim of this study was to investigate the influence of IL-8 gene polymorphisms on upper respiratory tract infection (URTI) incidence.
This is a historic cohort study and one hundred healthy elite male athletes were classified as either healthy or prone to frequent URTI. Taking blood samples, DNA isolation, multiplex PCR, and PCR-RFLP were carried out. Using the QIAmp DNA Blood Mini Kit (Qiagen, Hilden, Germany), genomic DNA was extracted. For comparison of the distribution of genotypes between two groups and for estimating odds ratios (OR) for URTI susceptibility in relation to the IL-8-251 polymorphism, Pearson’s chi-square and Logistic regression method were used respectively.
The IL-8-251 genotype distribution significantly differed between athletes with URTI and healthy athletes (P=0.01). The IL-8 low genotypes (AA) were observed at a greater frequency in the illness-prone group compared with the healthy group (46.81% vs. 7.55%).
Findings from this study have identified a potential role of genetic variation in influencing the risk for URTI in athletic populations and SNPs in the IL-8-251 genes were associated with an altered risk profile. These measures may have a predictive value in the identification of individuals who are more likely to experience recurrent infections when exposed to high physical stress in the areas of athletic endeavor

Accurate medical diagnosis is an important issue for an appropriate treatment.the aim of this study was to compare clinical diagnosis and autopsy findings in patinents who died in university hospital in thehran.
In this study, the data were collected in two part.medical records and autopsy findings od 4641 dead case,who were referd for postmortem examination to determine the cause of death,were extracted from 4671 yearle dead one files ina hospital.first part of information included demographic data (age,sex),clinical records of hospitalized patients and the first clinical diagnosis and cause of death by the physician .the second part was releted to autopsy findings(both pathology and serology)and definit cause of death.
Findings :Postmortem examination revealed acceptabele clinicali diagnosed cause of death in 47.40 %is incorrect in internal medicin and in 1.85%of cases ,the cause of death was incorrect in nurosurjery medicine.
considering the low rate of correct clinical diagnosis of cause of death in study,post-mortem examination remains a valuable source of patinent information.it is recommended to design a process to inform hospital physicians about the final cause of death.it may improve the management of hospitalized patients based on better diagnosis in similar situations.

Pulmonary hypertension is an independent risk factor in COPD. Echocardiographic evaluation is important for determination of prognosis in these patients. Cardiovascular manifestations in COPD include increased arterial stiffness, ischemic heart disease, chronic heart failure and cor-pulmonale. Some studies suggest that right ventricular (RV) dysfunction occurs in early stages of COPD as compared with healthy people. The aim of this study is evaluation of RV function by echocardiography in early stages of COPD in comparison with normal subjects.
Material and In this case-control study, 39 COPD patients and 39 healthy controls subjects matched for age and sex and were compared with 39 healthy controls. After obtaining demographic and clinical data from the participants, they underwent detailed Doppler echocardiography to evaluate the right and left ventricular function.
Findings: In this study, right ventricular diameter was significantly more in COPD patients versus control group (p This study revealed that patients with COPD and no serious cardiac disorders; with or without PHTN in primary phases have RV dysfunction in compare with healthy people.
Therefore, better control of respiratory qualifications may have an affective benefit in prevention and postponement of RV dysfunction in COPD patients.

Given the high prevalence of thyroid disorders during pregnancy and the importance of these disorders in pregnant women and studies on the relationship between thyroid dysfunction during pregnancy and adverse pregnancy outcomes, still there is no consensus on effectiveness of screening all women in early pregnancy regarding thyroid dysfunction and among the international scientific communities recommend the targeted high-risk case finding approach to identify these disorders in pregnancy. The purpose of this study is to compare universal screening with targeted high-risk case finding for diagnosis of thyroid disorders in Iranian pregnant women.
The present study is a cross-sectional study that was carried out on 1600 pregnant women in their first trimester. After data collection using questionnaires, their risk status in terms of thyroid disorders was estimated by the check lists of risk factors. Then, their incidence to thyroid disorders was characterized based on clinical examinations and measuring serum levels of T4, TSH, TPOab and T-uptake. The prevalence of thyroid disorders were identified and the predictive risk factors of thyroid disorders were determined by regression analysis.
The study was conducted on 1,600 pregnant women, the prevalence of thyroid disorders was 36.5% (n=584). According to the results of hormonal tests in the high-risk group 42.9% (n = 386) and in the low-risk group 28.3% (198 patients) were diagnosed with a type of thyroid disorders. Among the risk factors, history of thyroid drug use, family history of thyroid disorders and Previous history of a thyroid disorder, were significant prognostic factors (p It seems that with lack of universal screening about one-third (33.9%) of women with thyroid disorders are not diagnosed during pregnancy. Further studies are recommended.

Airway obstructioy system could be varyies from a little change to a life-threatening disorder. Clot in endotracheal can mimic clinical signs and radiographic changes in focal obstructive airway tract.
Clinical findings:n due to post intubation blood clot is seen in different situations. Its effects on respirator We report the patient with severe hemoptysis due to tuberculosis. When the patient was under rigid bronchoscopy suddenly, tracheal ruptured and tracheal tube filled of bright red blood and clot. Obstruction was recorded. Ddiagnosis by clinical and para clinical and endoscopic evaluation. Initial treatments includes: lavage, suction and pull out of clot by forceps was done. The second treatments in this situation are rigid bronchoscopy, fogarty catheter and regional thrombolytic agents. If clot in endotracheal tube is established, treatment is changingchanges the tube as soon as possible. Delay can cause death or severe morbidities.
Airway obstruction due to blood clot is rare but is a serious dangerous complication. Early diagnosis can be effective in prevention of life treatment disorders