مجله دانشگاه علوم پزشکی گرگان
سال بیست و دوم شماره 1 (پیاپی 73، بهار 1399)

Appropriate analgesia after surgery helps patients feel more comfortable and increase the mobility of them. The purpose of this study was to compare the effect of subcutaneous injection of Ketamine and Lidocaine in reducing postoperative pain in patients undergoing elective inguinal hernia surgery under general anesthesia.

This double blinded, randomized clinical trial study was done on 60 patients undergoing elective inguinal hernia under general anesthesia. Subjects were randomly assigned into three groups including control, Ketamine and Lidocaine groups. Subjects in Ketamine group were received infiltration of subcutaneous Ketamine 0.5 mg/kg/bw after closure of surgical incision. Subjects in Lidocaine group were received infiltration of subcutaneous Lidocaine 1 mg/kg/bw at the time of wound suturing. Subjects in control group did not receive Ketamine and Lidocaine. The visual analogue scale (VAS) of pain and vital signs were continuously assessed. If VAS≥3, 100 mg diclofenac suppository was administered and if there were no response, 30 mg intravenous pethidine was also administered. The complications, including hallucination, nystagmus, nausea, vomiting and drowsiness in patients were also recorded.

The mean VAS at 1, 2 hours after surgery were significantly lower in the Ketamine and Lidocaine group in compared to control group (P<0.05). No significant adverse effect was observed in the Ketamine group.

For reduction of pain, administration of subcutaneous Ketamine is recommended due to no adverse effect and anti analgesic effect of Ketamine is similar to Lidocaine.

Attention deficit hyperactivity disorder (ADHD) is a development nervous disorder that it is usually caused by a defect in the executive functions of the brain and reduces the amount of attention, accuracy, and increased mobility and impulsive behaviors in the individual. This study was performed to determine the effectiveness of cognitive rehabilitation and cognitive rehabilitation after drug therapy on the executive functions of brains of childrens with attention deficit hyperactivity disorder.

In this clinical trial study, 45 children with ADHD were randomly divided into three groups including one control and two intervention groups, were monitored by the education counseling center. Intervention group one (cognitive rehabilitation) and intervention group two (cognitive rehabilitation after medication) were received therapeutic intervention for 12 sessions of 45 minutes, twice a week. No intervention was performed for the control group. After the last treatment session, a post-test was performed. The follow-up phase took place 1.5 months after the end of the last intervention session.

The executive functions of the brains of children with cognitive impairment in the cognitive rehabilitation group and the cognitive rehabilitation group after drug therapy showed a significant increase in comparison with the control group (P<0.05). The executive functions of fertilizer after 1.5 months of follow-up in the cognitive rehabilitation group after drug therapy were higher than in the cognitive rehabilitation group (P<0.05).

Cognitive rehabilitation therapy after drug therapy was more effective in treating increased executive functions of the brain in children with cognitive impairment than cognitive rehabilitation therapy alone.

Researches has shown that exercise and nutrition exercises can have a different effect on serum Brain Derived Neurotrophic Factor (BDNF( levels and resting blood pressure in young people. This study was done to determine the effect of a period of High Intensity Interval Training (HIIT) with omega-3 supplementation on the serum levels of BDNF and resting blood pressure in inactive male students.

In this clinical trail study, 32 non-athlete male students were randomly divided into control, supplements, training and training + supplement. Subjects in supplementary group were received daily (2000 mg) of omega-3 capsules. The training groups were also subjected to HIIT training for 6 weeks. The training + Supplemental group also included a combination of the same training program were associated with omega-3 supplementation. BDNF levels were measured by ELISA method 24 and 48 hours perior the exercise protocol and after the last training session. Blood pressure disturbances were also evaluated at the same time and before blood sampling according to the recommendations of the British Heart Association.

The serum levels of BDNF in the group after 6 weeks in the training + supplementation group and the training group increased significantly compared to the pre-test values (P˂0.05). Also, a significant difference between-group training + supplementation group and training, supplementation and control groups were observed (P˂0.05). Systolic and diastolic blood pressures were significantly reduced in training + supplementary, training and supplementation groups compared to pretest values (P˂0.05). A significant reduction in systolic blood pressure in the training + supplementation group was observed compared to supplemental and control groups (P˂0.05).

HIIT combined with supplementation with omega-3 supplementation improved the BDNF serum level and reducing resting blood pressure in inactive male students.

The prevention of clot formation during hemodialysis improves the effectiveness of treatment by maintaining patency in the dialyzer. This study was done to evaluate the effect of intermittent bolus of normal saline on the quality of clot formation in venous chamber and dialyzer.

In this clinical trial study, 51 eligible patients were divided into intervention (n=26) and control (n=25) groups. Patients in the control group received routine care and the intervention group received 100ml of normal saline, each hour, as an intermittent bolus, during 4 hours of dialysis beside the routine care. After three consecutive hemodialysis sessions (first round), all patients received routine care to clear the intervention effect (washout period). Then, patients crossed over from intervention group to control and vice versa. At the end of each session, the quality of clot formation in intravenous chamber and dialyzer was recorded and analyzed.

The venous chamber of dialysis circuit in 74% of patient in intervention group no clot was formed, whereas in 58% of patient in control group it contained fibrous ring (P<0.05). After intervention, dialyzer of 68% of patients in intervention group, were free of clot, whereas in control group only 16% of dialyzers were free of clots (P<0.05).

Using intermittent bolus of normal saline during hemodialysis can reduce the risk of clot formation in venous chamber and dialyzer.

Alzheimer is the most common form of dementia in elderly persons. Oxidative stress is one of the main pathological factors in Alzheimer’s disease. This study was done to investigate the effect of crosin on histological changes of hippocampus and memory impairment which induced by scopolamine in the male rats.

In this experimental study, 30 male rats were randomly allocated into 3 groups including: control, scopolamine and scopolamine with crosin treated groups. Scopolamine with dose of 3 mg/kg/bw for one week and crocin with dose of 30mg/kg for two weeks were administered, intraperitoneally. The learning and spatial memory parameters were evaluated by Morris water maze test. Then the animals were sacrificed and their hippocampi were removed immediately for histological evaluation.

Scopolamine injection causes significantly increased the number of dark cells in CA1 region of hippocampus in compared to control group (P<0.05). Treatment with crocin decreased dark cells and increased light cells number in CA1 region of hippocampus (P<0.05). Also treatment with crocin decreased memory impairment that induced by scopolamine in rats (P<0.05).

It seems that treatment with crocin has protective effects against neuronal damage of CA1 region of hippocampus and memory impairment that induced by scopolamine.

Exercise-induced muscle hypertrophy occurs through increased rate of muscle protein synthesis that is regulated via molecular signaling pathways. The mammalian target of rapamycin (mTOR) pathway is believed to play a major role, via phosphorylation of the ribosomal protein S6 kinase of 70 kDa (p70S6K). Results concerning the effect of concurrent training on these factors have been contradictory. This study was done to determine the effect of 8 weeks of resistance training and concurrent resistance and aerobic training on phospho-mTOR (p-mTOR) and phospho-p70S6K (p-p70S6K) responses in skeletal muscle in rats.

In this experimental study, 24 wistar rats (age: 8 weeks) were randomly allocated into resistance training (n=8), concurrent training (n=8), and control (n=8) groups in equal laboratorial condition. Resistance group performed 5 sessions per week consisted of 10 repetitions ladder climbing with load suspended from the tail between 30-80% individual maximum overload test that was weekly performed to adjust the individual load throughout the week. The concurrent group performed resistance training followed by 5 minutes rest and endurance training consisted of treadmills run, that speed and duration of running gradually increased during training period, from 9 m/min and 10 minutes in the first week to 30 m/min and 60 minutes in the last week. The flexor hallucis longus (FHL) muscle of rats were removed under sterile condition at 24 hours after the last session of training and the proteins levels of p-mTOR and p-p70S6K were measured by ELISA method.

The level of p-mTOR was significantly greater in resistance training and concurrent training groups in compared to control group. No significant difference was observed between training groups. However, the significant increase of p-p70S6K was observed only in resistance group in compared to control group.

Because of the increased of p-mTOR in concurrent group was not accompanied by increase of p-p70S6K compared with resistance group, thus concurrent training probably attenuate signaling responses of downstream targets of mTOR.

Oxaliplatin is the main agent used in the treatment of colorectal cancers. Oxaliplatin inhibits DNA replication and transcription and to induce apoptosis or necrosis in cancer cells and rapidly dividing cell lines. This study was designed to determine the effect of Oxaliplatin on sperm parameters of 60 days old offspring during pre-pregnancy, pregnancy and lactation period in mice.

In this experimental study, 32 female NMRI mature mice were randomly allocated into 4 groups. Animals in control group were received 0.2 ml saline intraperitoneally (IP) during 21 days of pre-pregnany, pregnancy and lactation periods. Animals in experimental groups including pre-pregnant, pregnant and lactation groups were received 3 mg/kg oxaliplatin trice a week IP during 21 days before mating, during pregnancy and lactation periods, respectively. At the 60th postnatal day, all the male offspring were euthanized and sperm samples were obtained. Analysis of sperm parameters including count, motility, vitality, maturation and DNA integrity was done.

Sperm count, motility and DNA integrity were significantly reduced in all three groups of Pre-pregnancy, pregnancy and lactation in comparison with control group (P<0.05). Moreover, the percentage of immature and dead sperms were significantly increased in oxaliplatin groups (P<0.05).

Admistration of oxaliplatin induces adverse effect on sperm quality in perinatal period. The greatest effect of this drug is on lactation period. Also, by increasing the time interval for oxaliplatin administration in mice to puberty of offspring, the adverse effects of this drug on the quality of sperm parameters are reduced.

Sperm dysfunction and damage in spermatogenesis are the most common causes of male infertility. Diazepam is also a painkiller for benzodiazepines that can be addictive for a long time. This study was done to determine the effect of Diazepam on testicular tissue parameters and spermatogenesis in Rats.

In this experimental study, 30 Wistar male rats with a 250-200 gram weight were randomly allocated into 5 groups. Experimental groups were received diazepam with doses of (2, 3, 4, 5 mg/kg/bw) for 14 days, intraperitonally. Serum physiology was injected in control group. The animals were anesthetized and the testes and epididymis ductus defran were removed for examination, sperm motility, and percentage of live sperm.

Weight, large and small testicular diameter, percentage of live sperm and number of sperm moving forward were reduced with injection groups, at a dose of 3 mg / kg in all factors except the number of sperm moving forward in compared to the control group. In other groups, only testicular weight was significantly reduced at a dose of 2 mg/kg (P<0.05).

Diazepam can affect spermatogenesis process in rats.

Depression is the most common psychiatric diagnosis. It causes major health problems. Women are more likely to develop depression than men. This study was done to investigate the effect of group mindfulness-based cognitive therapy on reducing depression and improving the quality of life of female students.

This quasi-experimental study was performed on 26 female students. Students non-randomly were divided into control and intervention groups. Students in intervention group were received the two periods (8 sessions, 2 hours at week) of training in mindfulness-based cognitive therapy. All the participants filled out Beck depression inventory II (BDI-II) and World Health Organization Quality of Life – BREF (WHOQOL-BREF) in perior and after the study.

In the intervention group the mean and standard deviation of pre-test and post-test scores of BDI-II was 20.23±6.98 and 13.38±4.97, respectively (P<0.05). In the intervention group, mean and standard deviation of pre-test and post-test scores of WHOQOL-BREF questionnaire was 66.77±13.39 and 86.84±10.60, respectively (P<0.05). Also, the mean scores of post-test of quality of life in all subgroups items  was significantly increased in compared to the pre-test in the intervention group (P<0.05).

Mindfulness-based cognitive therapy increases the quality of life and reduced depression in female students.

Due to high incidence and mortality of gasteric cancer and important of clinical symptoms to early diagnosis and tertment; this stady was done to determine the survival rate of gasteric cancer in Golestan provience (north of Iran).

This retrospective cohort stady was done on 131 patients (77.9% males and 22.1% females) with adeno carcinoma gasteric cancer wich diagosed during 2007-09 in northern Iran. Age, sex, job, nationality and tribe clincal presentation kind of treatment food regiemns, survival collected from archive. In cases whom nesacery data completed with telophone calling or face to face interview. Survival rate of patients for 1, 3 and 5 years were determined using caplan Mayer method.

First symptom in 31.3% of patients was abdominl pain and distance between the first symptom and diagnosis was 1-14 months. 34.4% of patient did not receive any treatment. Survivial rate for 1, 3 and 5 years was 37.4%, 13% and 6.1%, respectively. Age, gender and ethnicity did not not altere survival rate but type of treatment had significant relation to survival rate (P<0.05).

The diagnosis of gasteric cancer in early stage and surgical treatment can help a better survival rate in patients with adeno carcinoma gasteric cancer in northern Iran.

Acquired kidney cysts usually occur in end stage renal disease (ESRD) patients undergoing long-term hemodialysis. Increasing growth of cysts is also seen in asymptomatic patients and they can cause complications such as retroperitoneal and intrarenal bleeding, Erythrocytosis, infection of cysts and renal cell carcinoma with distant metastases. This study was designed to evaluate the prevalence of acquired kidney cysts and its related factors in hemodialysis patients.

In this descriptive-analytical study, 123 patients (mean age 55.22+13.23 years) were selected from hemodialysis patients referred to dialysis center. Patients with autosomal polycystic kidney disease, medullary sponge kidney and medullary cystic kidney disease were not included. Diagnosis of acquired kidney cysts of Patients was performed by ultrasonography.

The overall prevalence of kidney cysts was 44.6%. 30 percent of diabetic patients had kidney cysts, while kidney cysts were present in 51.2% of nondiabetic patients. 32.4% of patients were received twice a week dialysis and 42.4% of patients were received three times a week dialysis had kidney cysts. Mean±SD of duration of dialysis history in patients with cystic kidneys was 22.02±22.65 months, while these measures in patients with noncystic kidneys were 22.65±14.65 months. There was a relationship between kidney cysts and the numder of hemodialysis per week (P<0.05). There was a relationship between prevalence of kidney cysts and the qulity of hemodialysis (P<0.05)

This study showed that there was a relationship between prevalence of kidney cysts and the qulity of hemodialysis and the numder of hemodialysis per week.

The infection of Helicobacter pylori (H. pylori) is one of the most complex items addressed in the clinical microbiology. Although H. pylori positive subjects are bound to develop into atrophic gastritis, current body of evidences is rare. Due to the high prevalence of this bacterium worldwide, finding the true virulence factors as biomarkers for severe gastroduodenal diseases was the priority in recent researches. This study was carried out to determine the prevalancy of cagA and babA of Helicobacter pylori isolated from gastric atrophic patients.

This descriptive – analytical study was conducted on 100 patients with gastroduodenal disorders in Labafinejad hospital in Tehran, Iran during 2018. Identification of each patient and also bacterial isolation were undertaken according to the standard protocols.

H. pylori were isolated in 23% of patients. 10 patients affected by atrophic gastritis followd by gastric ulcer (7 patients) and acute gastritis (6 patients). In totally, the rate of cagA gene and babA in H. pylori isolated with positive results was 52% and 34%, respectively. There was a significant association between the presence of cagA positive strains and patients with gastric atrophic (P<0.05). The babA gene did not correlate with the presence of gastric atrophic patients.

This study showed that various carrying cagA positive H. pylori can be recovered from patients with gastric atrophy.

Postpartum depression has a negative effect on maternal health and adverse effect on psychological development of newborns. Also patterns and personality traits can also be associated with postpartum depression. This study aimed to determine the role of social support and Personality in the incidence of postpartum depression.

This descriptive-analytical study was performed on 200 mothers referred to health centers by available sampling method between 6 weeks to 6 months after delivery. Data were collected using a Questionnaire Personal Information, Edinburgh Postnatal Depression Scale (EPDS, 1987), NEO-Five Factor Inventory (NEO-FFI, 1985) and Social Support Questionnaire Philips (1977).

Postpartum depression was observed in 49 (24.5%) of mothers. Neuroticism had the highest relationship with postpartum depression. The correlation coefficient of this variable with postpartum depression was 52% and this variable alone was 27% of the variance. There was a significant negative relationship between postpartum depression and social support (r= -0.027, P<0.01). There was a significant positive correlation between postpartum depression and neuroticism (r= 0.52, P<0.01).

This study showed that personality traits and social support are two important factors in relation to postpartum depression.

Maxillary sinus gradually extends laterally and inferiorly during pneumatization, and lamina dura of molar and premolar teeth can make a part of sinus floor. Knowledge about this anatomic relationship is essential to prevent complications paticularly iatrogenic perforation of sinus floor. Limitations of periapical and panoramic radiographs to visualization of this relationship led to the usage of cone-beam computed tomography (CBCT). This study was aimed to evaluate the vertical and horizontal relationship between roots of maxillary molars and sinus floor in CBCT images.

In this descriptive cross sectional study, ninety-five samples were selected of patients in Department of oral and maxillofacial radiology in Tabriz, Iran using simple randomization. Mean age of patients was 32.5 years old. Images were made by VGi cone beam Newtom and reconstructed by NNT viewer version 2.17. The vertical and horizontal relationship between roots of 139 maxillary first and 126 second molar teeth and floor of sinus evaluated.

Type 2 was the most common relationship among the first and second molars, vertically (the inferior wall of the sinus located below the level connecting the buccal and palatal root apices,without an apical protrusion) and horizontally (the alveolar recess of the inferior wall of the sinus located between the buccal and palatal roots). There was a significant relationship between the type of tooth and sinus floor (P<0.05).

Most of the maxillary molar roots were in contact with sinus floor and sinus floor was extended mostly between buccal and palatal roots vertically and horizontally, respectively. Attention to sinus involvement possibility during interventions in maxillary molar region is important.

Pediatric femoral neck fracture is rare and account for less than 1% of all fractures in childhood. The proximal femur in children is extremely strong, and high-energy forces in 80-90%, following the axial force associated with hip rotation or direct blow are necessary to cause fracture. In this report, the method of femoral neck fracture fixation in eight-year-old girl after car accident is reported. During the operation, we noted a severe femoral neck fracture that was irreparable with the available tools (pin, screw, plate and DHS), which inevitably had to be used by Transosseous method with fiber wire #2, used in proximal humeral fracture fixation. Then, we obtained a fairly satisfactory result with a distal femoral pin inserting it into two-sided spica cast. Although, this kind of fracture is rare, but with a qualified clinical examination, early diagnosis, proper treatment, familiarity with surgical techniques and fixation reduces the complications and this method can be effective in obtaining the desired result.