مجله دانشگاه علوم پزشکی رفسنجان
سال دوم شماره 3 (پیاپی 8، تابستان و پاییز 1382)

Nitric oxide production in body regulates moltifactorial and sex steroid hormones may be have a role on this process.The role of estrogen and progesterone on nitric oxide production not fully understood and the aim of this study was to detect the effect of ovarin steroid hormones on nitric oxide production in female rats. 120 female rats ovarectomized and 14 days after surgery they divided to 3 groups: Estrogen group received estradiol benzoat (10µg/kgw/sc) and progesterone group that received progestrone (25 mg/kgw/sc) and last group received both hormones (progestrone 25 mg/kgw/sc and estradiol benzoat 10µg/kgw/sc), also each group received l-name (60 mg/kgw/ip) and l-arginine(100 mg/kgw/ip) or vehicle. 6 hours after treatment, blood samples prepared and nitrite - nitrate of serums measured with griess reaction method. The nitrite and nitrate of serum decreased when progesterone injected, this effect blocked with l-arginine injection, but nitrite and nitrate increased when estradiol administrated, this effect inhibited with l-name,The injection of both hormones did not significant effect on nitrite and nitrate level of serumes. These data suggest, ovarian steroid hormones regulates nitric oxide production and some effect of sex steroid hormones on target tissue may be mediated from nitric oxide system.

This retrospective study was undertaken to assess frozen section accuracy in patients undergoing Thyroidectomy. During thyroid operations, excised tissue studied via frozen section by a pathologist can differentiate benign lesions from a malignant ones and help guide the surgeon during the procedure. In recent decades the role of frozen section in defining the nature of thyroid nodules has been declining, being replaced by fine needle aspiration (FNA) despite the fact that in many cases the diagnosis may be missed. In many instances frozen section may be more reliable especially when experienced pathologists are not at hand or when preoperative FNAs are inconclusive or suspicious for malignancy. This retrospective study included 84 patients undergoing thyroidectomy In 5 years. There were 17 males and 67 females. Mean age was 36 years (ranging from 15 to 70 years). All patients had thyroid nodules and underwent thyroeidectomy at our medical center. Frozen sections from tissue samples excised during operation were evaluated for all patients. According to histopathological exam, there were 12 (14.3%) thyroid cancers and 72(85.7%) benign thyroid diseases. Incidence of malignancy was 29.4 % in men and 10.4% in women. When compared with final pathology reports, frozen section reports were correct in 95.3%. There were two false negative and two false positive reports (4.7%). Sensitivity and specificity of this method were 83% and 98% respectively. Positive predictive value and negative predictive value were 83% and 98% respectively. Frozen section is a reliable and valuable method for surgeons involved in thyroid surgery and may be preferred over FNA when experienced pathologists are not at hand or when preoperative FNAs are inconclusive or suspicious for malignancy.

One of the causes of AUB in women is Polycystic Ovarian Syndrome (PCOS). This study was undertaken to evaluate the effectivenes of metformin therapy for the treatment of menstrual disturbances in PCOS. This clinical trail study was carried out on 120 women with PCOS in Bahman clinic in 1380-1381. The patients received metformin 1500 mg daily for 6 months and their menstrual pattern was assessed monthly. 16 out of 120 women (13.3%) had regular menses after 2 months and 80 women (66.7%) had regular menstration after 6 months. Age of women did not effect the treatment, but BMI was effective, whereas the mean of BMI in treated patients were more. The side effects of metformin were nausea (16.7%), Anorexia (16.7%) and diarrhea (13.3%) We conclude that menstural disturbances in women with PCOS were improved by administration of metformin.

The importance of school screening for scoliosis and trunk asymmetries has now become admitted in many countries.In Iran,only afew limited studies about this subject are presented.The aim of current study was evaluation of scoliosis and some trunk asymmetries in high school students. Subjects & During 1998-2000,a total of 2075 students (1160 girls,915 boys) aged 13 to 20 years (15.19±1.1)were examined randomizly.For each person,after collection of demographic information,we questioned about dominant limb,familial history of scoliosis,back pain history,type of chair and desk (or bench)in school and at home.The physical examinations consisted of measurment of height,weight,sitting height, evaluation for shoulder and pelvic summetries(by use of pelvic inclinometer) and round back.In addition lumbar lordosis measured by use of flexible ruler.We marked spinal proces for assessing scoliosis.Forward bending test (Adams)was used for differantiate between postural and structural scoliosis. We found an overal 46.3% for trunk and spinal asymmetries.In details these results were obtained:shoulder asymmetry 17%,pelvic asymmetry 7.8%,structural idiopathic scoliosis 3.4%,postural scoliosis 4.9%,round back 13.2%.In addition,19.2% had a history of back pain.Mean of lumbar lordosis was 42.7 and 31.4 degrees in girls and boys respectively.Shoulder and pelvic asymmetries were seen in scoliotic subjects(P=0.0001).Use of bench in comparison with personalized chair increased rate of scoliosis,round back and degree of lumbar lordosis(P<0.05). According to results of the present study,we can concluded that attention to these points is very important for us:1-Regular school screening programmes for scoliosis and trunk asymmetries, 2-Use of standarized chaires and desks at schools,3-Training courses for prevention and correction of bad postures in students.

Primary dysmennorrhea what is know as painful menstruation without any pelvic disease in women. This descriptive study was conducted to recognize the correlation between prevalence and intensity of primary dysmenorrhea with personality type in Rafsanjan high school female students. Methods and Material: 380 students 14-18 years old were selected randomly by clustering method. A questionnaire was used for collecting the data. Result showed that prevalence of primary dysmenorrhea was 85.5 % and 63.3% students had A personality type and 36.7% had B type. Correlation between dysmenorhea and personality type was significant (P<0.001). Incidence and prevalence of dysmenorhea in women with a personality type is higher than B type.

Previous studies have shown that physicians use a very high dosage of carbamazepine (CBZ) and Valproate (VPA) to control epileptic attacks, while these drugs incur of many side effects include of gastrointestinal, hematology, psychology, cardiology and…). The aim of this study was to reach the least therapeutically dose while keeping an acceptable blood level. This is a semi experimental study that done on 56 epileptic patients in during of one year. At the first time we record of demographic data include of age, sex, weight and period of drug usage. Then we prescript of drug (CBZ and VPA in adult were 9-11 and 12-14 mg/kg and in children were 9-12 and 12-15 mg/kg respectively). Then we measurement of serum levels of CBZ and VPA monthly by gaschromatography methods. The results indicated that serum levels of CBZ and VPA in adult were 7.4 and 74.7 and serum levels of drugs in children were 8.2 and 66.8 respectively. Also patients have not epilepsy attack in during of assessment. T hese findings show that with the much lower dosage of the drugs we can reach an appropriate blood level for controlling epileptic seizures.

MULTIPLE SCLEROSIS (Multiple Sclerosis) is a demyelinating disease of the central nervous system that can result in impaired motor system, in creased symptomatic fatigue and affected activity of daily living. Although exercise is administered to MULTIPLE SCLEROSIS patients, its effect on activity of daily living has not been established.This research has been conducted to evaluate the effect of exercise training on activity of daily living in women with MULTIPLE SCLEROSIS in Iranian MULTIPLE SCLEROSIS Society. In this study one-group before-after clinical trial, 28 patients were selected with nonprobability convenience sampling according to specific criteria. A questionnaire was them given to collect demographic and other data regarding MULTIPLE SCLEROSIS, activity of daily living and fatigue. Exercise was done for 8 weeks that has 4 sections: warm up, running, sweden aerobic exercise and cool down. After that they completed questionnaire (parts of activity of daily living and fatigue) again. Subjects were women between 20-45 years. With average of 29.57 years. Most (57.1%) respondents were married. 64.4% were upper than diploma, most (75%) were homemaker and 46.4% had duration of illness between 5-8 years. 39.3% had relapsing once time in last year and nobody were hospitalized in last year. 50% respondents had visual disorder as the first ilness sign and most (64.3%) had fatigue as the important problem. 57.1% had expanded Disability status scale between 0-3. Findings showed that exercise training had a positive effect on basic activity of daily living (P<0.0001). After intervention, patients improved signigicantly on instrumental activity of daily living (Pv<0.0001). Fatigue was signigicantly reduced in pateints (P=0.008) and only age marital status had significant relationship with basic and instrumental activity of daily living. It can be concluded that exercise training resulted in improved activity of daily living. These findings suggest that women with MULTIPLE SCLEROSIS reap benefits from participation in regular aerobic exercise training.

There is no solid evidence of aluminium (Al3+) toxicity resulting from the Al3+ present in foods or from aluminium utensils used to prepare or contain foods. However recent studies have strongly emphasized Al3+ toxicity in chronic renal failure patients and patients administered aluminium containing antacids. In this study the effect of high doses of Al3+ on glucose metabolism in rats has been investigated. Six groups of male and female albino rats within a weight range of 180-220 grams were fed with food containing Al3+ (75, 212.5, 312.5, 625, 1250, 2500 mg/kg food) for two months. During this time, at 15-day intervals, measurements of plasma glucose concentrations, both while fasting - Fasting Blood Sugar (F.B.S) - and after Glucose Tolerance Test (G.T.T) were taken from the test and control groups. The results indicate that Al3+ can increase fasting plasma glucose and impair glucose tolerance in a dose and time dependent manner. Fasting plasma glucose of the control group at the end of the 60 day- intervention (113.8±4 mg/dl) was significantly less than the case-group, which consumed food containing Al3+ (2500 mg/kg) (165.9±10 mg/dl). In general the results of this study reveal for first time, that the toxic effect of aluminium on glucose metabolism must be considered, particularly in individuals with frequent exposure to the element.

Breads are the major food in Iran. Recent studies in Iran have shown that dialy broad consumption was 300gr. 40.2% of the total energy per person was obtained from bread. This cross-sectional study was done in 81 bakeries in Rafsanjan. The main objectives were to determine some properties of the bread, such as pH, NaCl, doughness …, in various breads (Taftoon, Sangak, Fantezi). The studies showed that 10.36% of each broad was doughy. The mean pH was 5.4, but 22.2% of breads had a pH above standard. The mean NaCl was 3.27 gr/bread, which was under the standard of Iran. Only 16% bakeries had good hygienic condition. The education of Bakeries’s workers, continous control of hygeinic condition, precision in the preparation of good quality primary materials, to accompolish continous investigation for increasing of bread quality and elimination of chemical harmful materials from bread can be effective for improvement of affairs.

There are some reports about useful effect of some medicinal herbs in treatment of diseases, in traditional medicine. One of this reports, is the useful effect of Papaver somniferum L. on seizure. In this investigation, the effects of methanolic extract of Papaver somniferum L. seeds in seizure induced by picrotoxin was studied in mice. In this study the animals pretreated with different doses of methanolic extract (12.5, 25, 50, 100 and 200 mg/kg) by intraperitoneal injection. 20 minutes after extract injection, each animal received 12mg/kg picrotoxin for induction of seizure. Latency time for beginning of seizure, duration of seizure and death time were determined in experimental and control groups. The results showed that latency of begining time of seizure was increased in groups that pretreated with different doses of extract, specially with dose of 200mg/kg, (P<0.01). The duration of seizure increased in all groups of animals, but the severity of seizures was milder than control group. Different doses of extract, specially dose of 50mg/kg delayed the death time in mice (P<0.05). The extract of Papaver somniferum L. delayed the onset of seizure, decresed the severity of seizure induced by picrotoxin and lenghtened the death time, therefore it is a suitable agent for continuing investigation as anticonvulsant drug.

One of the main causes of musculo-skeletal disorders is muscular imbalance, particularly in urban population who do not have suitable physical activity. These can lead to spinal, lower limb and gait abnormalities. Applying the most appropriate and effective technique to stretch the shortened muscles is very important in these patients. The current belief is that using biofeedback simultaneously with exercise therapy may increase the effect of treatments. This has inspired the researchers to investigate the effect of feedback during stretching hamstring muscle. A randomized single blinded clinical trial was conducted on 45 female volunteers from Fateme Zahra Dormitory of Shahid Beheshti University (20-25 years old). All of the subjects completed the questionnaire from voluntaril, then they were randomly divided to three groups of 15 subjects. We considered three stretching techniques (static stretch, dynamic stretch with audio-sensory feedback and dynamic stretch only). The treatment course took 4 weeks (every day except weekends). The flexibility of the hamstring muscle was assessed by measuring the Range of Motion (ROM) directly by a goniometer and also indirectly by Sit & Reach test at the start and the end of the treatment courses. A T-test and Tukey-B tests were used to analyze the data. According to the statistical analysis, all of the three stretching techniques significantly improved the flexibility of the hamstring muscles, however there was no significant differences among the groups. According to relatively equal results of three stretching execises, it seems that the use of feedback simultaneously with stretching can encourage the patients to perform their exercises as much as possible.

Stress causes glucocorticoids (GCs) and endogenous opioids release. Some steroids have inhibitory effects but others are preconvulsant. Endogenous opioid mechanisms may probably aggrevate stress-induced seizures. Swimming at 20 degree C for 3 min (swim stress, SS) delays the onset of convulsions induced by pentylenetetrazol (PTZ) and aggravats electroshock-induced seizures. In this study we considered effect of repeated swimming stress on repeated injection of PTZ for induction of chemical kindling. 56wistar rats were housed in 7 groups of eight. Animals were kindled by PTZ injections (45mg/kg) given intraperitoneally every 48h. For considering of the effect of GCs and endogenous opioids we administrated metyrapone, an inhibitor of GCs Synthesis and naloxone as an opioid receptor antagonist. Metyrapone and naloxone applied 30 min before each PTZ injection. Process of kindling was aggravated by SS. Mean necessary days for inducing fifth stage of chemical kindling in SS group decreased to 3.3 days after PTZ injection in comparison to PTZ group (4.9 days). Kindling was prevented by treatment of metyrapone prior to each PTZ injection. Mean values of the seizure stages in different days in this group were significantly decreased comparing to PTZ group (except in the second and sixth days). Naloxone pretreatment delayed the process of kindling. In this group mean day inducing kindling increased to the ninth day and 50% of animals became kindled. Application of stress 30 min after naloxone aggravated the process of kindling and in this group all of animals became kindled. The results have been shown that swimming stress probably through releasing GCs and endogenous opioids increases the development of PTZ-induced kindling and mu opioid receptors may have a important role in the expression of opioid effects.

Athletes, especially bodybuilders, abuse anabolic steroid drugs to improve their strength and enhance their muscle growth and appearance. Since the frequency of the anabolic steroid abuse was not known in Kerman city, so this study was conducted to determine the type and frequency of anabolic steroid abuse by bodybuilder athletes. To determine the frequency of anabolic steroid abuse in bodybuilder athletes in Kerman city, a confidential questionnaire which included the demographic data (age, education), name of abused anabolic drug, duration of drug abuse, was completed by 202 bodybuilder athletes, and the collected data were analysed by routine statistical methods. � The Frequency of anabolic steroid abuse by bodybuilders in Kerman city was 18.8%. The mean period of bodybuilding activity was significantly higher in those who used the anabolic drugs (38.8 months), comparing to those who did not use any drugs (14.3 months). Oxymetholone was the most common drug used by athletes, i.e. that 42% of the abusers merely abused Oxy metholone. The frequency of anabolic steroid abuse was not related to education and age of the bodybuilder athletes. The results of this study showed that anabolic steroids are abused by bodybuilding athletes in Kerman city, so the health care providers should provide more information to athletes about anabolic steroid adverse effects to solve the problem of abusing these drugs by them.