فصلنامه کومش
سال ششم شماره 1 (پیاپی 15، پاییز 1383)

Low back pain (LBP) has a high prevalence in any society. Although the relation between LBP and foot disorders is improbable, however, knowing this subject that each part of the foot has a role in body balance and this has a significant relationship with cooperation of body muscles, and any change in foot parts can affect the entered forces to the muscles and change them. The purpose of this study was to determine the relation between chronic LBP and foot disorders in two groups of healthy and LBP affected subjects.

This is a case-control study, in which the relation between LBP and some foot disorders like Hallux valagus, Hallax rigidus, flat foot, calf muscle tightness and foot dimensions in subjects with and without LBP was studied. These subjects were selected with simple nonrandomized sampling and there were 83 subjects in each group.

Findings showed a significant relation between Hallux valgus, Hallux rigidus, flat foot and solcus tightness with chronic LBP, but no significant relationship between foot dimensions (except width of right sole) and gastrocnemius tightness with chronic LBP was found.

According to these results it can concluded the foot and ankle disorders due to their effects on posture, balance and gait, in long time, may cause chroic LBP.

With respect to an increasing growth in city population and also an annual increase in the per capita consumption in the societies, particularly in the dry and semi–dry countries, the opportunity to use surface water sources to provide drinking water for the cities has decreased. In a such way, in 2001 more than 70 percent of the drinking water for the population of Tehran had been provided by underground water sources due to a decrease in the water reservoirs of Latian, Karag and Lar dam. The figure shows an increase for other cities of Iran as well. On the other hand, due to discharging industrial sewages with chrome and nickel contents in the absorptive wells and the penetration potentials of these compounds into underground waters, and with respect to the potential of these substances to accumulate in different tissues of the body and their sarcoma–generation characteristics as proved through various researches a strong need is felt to render a careful control on these sources. In this research, the plan is to omit and remove chrome and nickel from the sewage polluted underground water sources by using the essence of oak tree fruit for their condensed tannic acid, hydrolysable tannic acid, gaelic acid and Eeagic acid contents. First 60 water samples with a given amount of chrome and nickel contents were prepared and divided into 12 different groups with 5 concentration and environmental conditions. The experimental and non-probable sampling were applied sample taking and the counter effects of Tannin essence. Calcium hydroxide and sodium hydroxide were studied both in separated and simultaneous forms. With respect to the given initial concentration, the amount of remaining concentration was determined by flame application at the atomic absorption device. Among the measured specimen, 50 mg/l of concentration of calcium hydroxide or 50 mg/l of concentration of sodium hydroxide along with 50 mg/l tannin-content essence with 80 to 86 percent output proved to render best conditions in omitting chrome and nickel from reaction environment. The results were evaluated through bi-factors variance analysis with one repletion in each box tests to ensure the accuracy and care rendered in performing the test. The results showed that simultaneous application of two chilling factors found in calcium hydroxide and tannin essence show significant differences as compared with other methods and also it was proved that the tannin content essence in an alkaline environment forms a full set of (OH) branches that are bound with chrome and nickel ions in the reaction environmental and due to the large size of tannin molecules and their saturation with the existing cations, they form a flocc mass that immediately deposits for its heavy weight. Also the essence in the tannin is able to take the mentioned ions form the reaction environment both in low and large concentrates and the ions concentrations have no significant differences in omission output.

Cholecystolithiasis is one of the most common diseases. Prevalence of the biliary stones has a close relation with the one’s life condition. Howeve it's frequency can be reduced by controlling the known risk factors in each area. The aim of this stuy was to determine the types of gall stones and the related risk factors in Semnan during 2002-2003. All patients who underwent cholecystectomy during 2002-2003 included in this study. Their F.B.S, triglyceride, cholesterol and HDL were measured by standard laboratory methods. BMI and type of stones analyzed by macro-microscopic methods and biopsy of gall bladder was performed. Finally, the relation of the risk factors with the type of stone, histologic findings, age and gender distribution were assessed. All data were recorded in a specified questionaire. Chi – Square test at the significant level of 0.05 was used to analyze the data. The most frequent risk factor for biliary stone was drug consumption. The most usual type of stone was mixed and the most ordinary pathology finding was chronic non–specific cholecystitis. Meanwhile the finding suggest significant relation between cholecystolithiasis and the quantity of drug used, diabetes, multiparity, hyperlipidemia and obesity. We suggest that by controlling these known risk factors such as drug consumption especially OCP by obese and multigravida women, reducing weight, and hyperlipidemia especially in aged groups, the frequency of the gall stones can be reduced.

Experiments show that new pressor protein (NPP) and bradykinin (BK) levels increase in hypertensive anephric patients. Both NPP and BK are known to stimulate the release of adrenal medullary catecholamines so we hypothesized that NPP injections provoke the production of endogenous BK, which might contribute to the cardiac and blood pressure actions of NPP. The aim of this study was to determine the cardiac heart rate (HR) and systolic blood pressure (SBP) effects of BK in 2NX and sham-2NX (control) rats for comparison with the effects of NPP. Male Wistar rats (300-350 g) n=8 per each group were anesthetized with Inactin and ganglion blocked and prepared for bioassay. After 24 h 2NX or sham-2NX (control) Cap was given and BP and HR were recorded before/after injecting NPP (20 uL plasma equivalent i.v.) or BK at 100 or 1000 ng/kg. In sham-2NX (control) rats, no Cap, NPP raised SBP by 32 ± 3 mmHg and HR by 20±3 beats/min (bpm),BK at 100 ng/kg raised SBP trivially by 2 ±1 mmHg and HR by 1 ± 0.5 bpm. BK at 1000 ng/kg, no Cap, raised SBP by 13 ±3 mmHg and HR 13 ± 2 bpm. In 2NX rats (no Cap), NPP raised SBP by 58±6 mmHg and HR by 70±14 bpm, BK at 100 ng/kg raised the SBP by 4 ± 1 mmHg and HR by 3 ±1 bpm. With BK at 1000 ng/kg, SBP rose 6 ±1 and HR rose 2± 1 bpm. Cap injection strongly potentiated these effects in sham-2NX rats, but this treatment potentiated only BK responses in 2NX rats. In sham-2NX rats, the effects of BK at both lower and higher doses are the same as NPP response on SBP and HR. These effects are potentiated by Cap, but are modified differently by 2NX. Administration of HOE-140 (a specific bradykinin B2-receptor antagonist) blocked BK response completely, but this treatment blocked NPP responses moderately.Thus, BK is probably not the only mediator of NPP’s cardiovascular effects and other mechanisms need to be investigated.

Prevalence of diabetes is high. Unfortunately this disease has serious complications in uncontrolled conditions. Thus, control of diabetes plays the important role in preventing the chronic complications. Plasma level of HbA1c is one of the most important indicators in assessing the control and prognosis of diabetes. In this study, by measuring the HbA1c level and FBS in diabetic patients in Semnan, some related factors with diabetes control, treatment condition among them have been evaluated. This is an analytic – cross sectional study performed on 288 diabetic patients having files in Fatemieh hospital diabetes clinic from 15th Aug. to 6th Sep. 2002. Cases were interviewed via questionaires and then their blood samples were examined to determine FBS, HbA1c. Data were analyzed through SPSS with statistical test of Chi – square. Among 288 cases, 46.7% were males and 53.3% females. In 50% of diabetic patients, the diabetes family history were positive in the first –grade relatives, but in the second –grade ones was 17%, in 6% of them both first & second –grade relatives suffered from diabetes. Meanwhile, time average of suffering diabetes was 8.7 years. The FBS average was 203.33 mg/dl and HbA1c average level was 10.15% too. Only in 5.9% of cases HbA1c was lower than 9% but in 14.2% it was higher than 11%. In this study, there was not observed any relation between HbA1c level and factors such as age, gender and treatment various methods, diet, oral drugs and insulin therapy. Here, a positive coordination between HbA1c and FBS was seen which was a considerable point. Hence, a meaningful direct relation was observed between HbA1c and FBS (P<0.000, r=0.486). Results showing that blood sugar and A1c hemoglobin in most patients with diabetes in Semnan has an unacceptable range, so controling the diabetes of these patients is unadequate. Meanwhile, the amount of both critria with demographic factors and the kind of treatment prescribed have no relation too. As, there is not any necessory criteria to evaluate the level of doing the, thus having a careful study along with controlling of treatment orders is required.

In folk medicine, Nerium oleander L is used as cardiotonic, diuretic and as local in treating fungal infections. In this research the antimicrobial and antifungal effects of Nerium oleander was studied. In this study, aqueous, methanol and chloroform extracts were prepared by maceration and soxhelet methods. Different concentrations of each extract were applied on standard and nosocomial microorganisms by agar dilution, disk and cylinder plate methods. Microorganisms such as S. aureus, P. aerogenosa and C. albicans were taken from blood, feces, spinal fluid, wound, vagina and so on. Cloxacillin, gentamicin and clotrimasol were used as positive controls. The results showed that, among extracts, methanol extract had significant antimicrobial and antifungal effects, which was comparable to that of standard antibiotics. Chloroform extract showed no effect. Effect of methanol extract on microorganisms was as follow; 500mg/100ml of extract was equal to 1mg/100ml cloxacillin on S. aureus and 2mg/100ml gentamicin on P. aerogenosa respectively. 2g/100ml of extract was equal to 0.4mg/100ml clotrimasol on C. albicans. The methanol extract of Nerium oleander exerts significant effect compare to standard drugs.

Hearing is one of the most important sensory abilities through which man can hear the people’s speech after birth, and then gradually acquires the ability of understanding and expressing them. If hearing damage occurs, specially from the beginning of the birth and or before speech acquisition, with respect to the severity of damage, one will have delay in speech and language. Morphology and syntax are two important aspects of language which are usually affected in the hearing impaired students. In this study, some morphologic and syntactic indicators in speech of hearing impaired students and some non-language features were studied too. This is a descriptive study research. Sampling has been non-randomly done on the whole 29 hearing loss students without any IQ problems at the age of 10-16 in the deaf primary school with hearing loss more than 65 decibels in the Best Binaural Average Scale in Birjand. Students’file in school, picture description, and supplementary questions were tools which were used. All the cases’utterances during the test were recorded by a tape recorder and then were written on the paper. Then all the indicators were analysed. Findings containing the following descriptive information, mean of MLU of cases was 3.7 morphemes and 2.4 words. Among 1051 utterances, 17.4% of utterances were correct which among them 57.3% were sentences and 42.7% were also non-sentences. Only 24% of verbs had been inflected correctly and the rest (76%) had some problems. 66% of cases used total communication method,10% sign method, and the rest(24%) used lip-reading and oral methods. 13.8% of all cases used hearing aid continuously, 44.8% barely and 41.4% did not use hearing aid at all. Meanwhile, 24.1% of cases had at least one hearing loss person in their family. Findings showed that mean of MLU among these people is very low;.However they used verb a lot in their speech,but they had a lot of problems in agreement of verb with subject and tense.

The chronic constriction injury (CCI) was introduced by Bennett and Xie in 1988 as an animal model of peripheral mononeuropathy. In this model, serious sensitivity to the thermal and mechanical allodynia and hyperalgesia is increased the areas in which sciatic nerve innervated. The spread of receptive fields of the saphenous nerve which innervates the medial part of the foot. In this study, we have examined the behavioral effects of the section of saphenous nerve at the time of applying CCI. Adult male Sprague – Dawley strain, with the weight 200 – 300 grs, used for experiments. Animals divided into four groups: sham operated, CCI group, cut of saphenous nerve (saph.) and CCI + saph. Two weeks after post operation, animals tested for behavioral responses: thermal allodynia (acetone blob and immersion of hind paw in 10°C water) thermal hyperalgesia (immersion of hind paw in 42°C water) mechanical allodynia (Von Frey), mechanical hyperalgesia (Pin Prick) and usage of damage paw. All symptoms of the neuropathic pains were appeared among all animals which went under CCI. CCI + Saph group showed analgesia, thermal allodynia and hyperalgesia, mechanical hyperalgesia and also usage of damage paw, except in mechanical allodynia. Results indicated that saphenous nerve may affect on behavioral responses of neuropathic pain related CCI. Saphenous nerve (as a neighboring with sciatic nerve) may affecte on behavioral responses of neuropathic pain, probably by making collateral branches which may penetrate into the damage area.

Articulation disorders due to the problems that create in communication with others, is a great obstacle in individual’s development and may cause difficulties. Generally, 5% of school age children have articulation disorders and should be referred to the speech therapy clinics. In this research, prevalence of articulation disorders was studied in Semnan primary school children to evaluate the range of problem. In this cross-sectional study done among the primary school, 5 boy schools and five girl schools with 3013 pupils, were examined by speech therapists. Among them, those with articulation disorders were separated and the supplementary evaluations were performed on them in clinics. To analyze the data, Ratio test, Chi-square and correlation coefficient were used. Findings showed that 8.7% (95% CI: 7.7-9.7%) of the cases, suffering the articulation disorders; 8% of them having lisp, chiefly, in [s] and [z] sounds. Meanwhile, articulation disorders in males were higher than in females significantly (P=0.002). Also there did not exist any signifricant relation between the kind of articulation disorder and age (P=0.55), between the severity of articulation disorder and gender (P=0.397), and also between the articulation disorder and age. Considering the high rate of lisp in the elementary school children, it is suggested that the parents and school officials should pay the special attention to these problems and try to refer them to the speech therapy clinics.

Several studies have demonstrated the relationship between polymorphisms in the ApoAI – CIII – AIV gene cluster and hyperlipidemia. This study was conducted to elucidate the association between polymorphism of ApoAI/XmnI and Iranian hyperlipidemic subjects. Total genomic DNA was prepared from seventy-six Iranian patient with primary hyperlipidemia and seventy-five normolipidemic subjects. The subjects in the control group were age- and sex-matched to the patients. Fragment of 392 bp for 5´ region of the apoAI gene (C-2500T) was amplified by polymerase chain reaction (PCR). In the hyperlipidemic group, the genotype frequency of X1X1, X1X2, X2X2 were 0.63, 0.24, 0.13, respectively. In the control group those were 0.81, 0.11 and 0.08, respectivley. There was a significant difference (p<0.05) between 2 groups. The rare allele (X2) was more frequent in hyperlipidemic group than in controls (p<0.01). Various genotypes of apoAI/XmnI had no significant effect on lipids or apoAI levels in hyperlipidemic group. The above results show that polymorphism ApoAI/XmnI is associated with hyperlipidemia in Iranian hyperlipidemic subjects. Therefore, our data confirmed the previously reported association between genetic polymorphism ApoAI/XmnI and hyperlipidemia.

There are several line of evidences that dopamine release from dopaminergic neurons of VTA increases during heroin administration and ascorbic acid (AA) regulates this dopamine release. The main object of present study was, to determine the effect of 3 different doses of AA on dependence to heroin. Male wistar rats were implanted with silastic catheters into the right jugular vein. After recovery animals are studied in 3 groups (control, heroin and AA) through IV self administration (SA) method by two lever (active and passive) for 2h every day until 15 days. During the first 5 days animals were hungry since 12h before SA, While during the remaining 10 days were not. The latter group (AA) composed of 3 subgroups (a, b, c) that got different doses(100, 300, 700 mg/kg.IP) of AA 30 minutes before SA, respectively. AA injection decreased active lever pressing and the effects of doses applied in this study were almost the same. Number of lever pressing in all groups was as follows (mean ± SEM): Lever Group salin Heroin Ascorbate a Ascorbate b Ascorbate c Passive 1.97 ± 0.18 6.48 ± 0.39 6.03 ± 0.34 5.65 ± 0.35 5.11± 0.31 Active 11.13± 0.62 41.48± 1.82 25.68± 1.07 25.24±1. 05 23.89± 0.94 Injection of AA prevented the reinforcing effect of heroin and developing dependence to it. There was no significant difference between different doses of AA in this issue.

Aspergillus species are primarily opportunistic pathogens and with a few exceptions cause invasive disease only in an immunocompromised hosts during last two decades, the importance of fungal disease has been increased dramatically due to an increased occurrence of tuberculosis, chemotherapy-induced nutropenia, AIDS, open chest surgery and use of antibiotics and. immunosuppressive therapy. The production of extracellular phospholipases by pathogenic fungi such as A. fumigatus are involved in the degradation of target cell membrane phospholipids in invaded tissues Using degenerate primers based on homologous amino acid sequences of fungal phospholipase B (PLB) gene, PCR products of 542 was generated which was the predicted size. Sequence analysis revealed sequence had a high homology to published PLB sequences sharing highest homology to Aspergillus oryzae PLB (62% identity). Inverse PCR was used to attempt to clone the entire plb2 genes. Initially, genomic DNA was digested with selected restriction enzymes and self ligated with T4 DNA ligase to give circular DNA for inverse PCR (IPCR) for A. fumigatus plb2. IPCR with Xho I self-ligated digest gave product of 1.2 Kb for plb2 and was found to encode the 3' ends of gene and using CAP assembly software this sequence was assembled with 542 bp sequence. BLST X and GeneFinder analysis revealed that the first 542 bp of assembled total 1529 bp (after deletion of similar bp from both sequences) encoded the 3’ end of plb2 gene. The sequence availability of partial afplb2 gene and after that full sequence of this gene represents a major breakthrough in the study of this opportunistic pathogen and function of plb gene in pathogenesis of A. fumigatus. Also phylogenic tree analysis of afplb2 gene shows that PLBs and potential PLB analogues are contained in a large cluster of the PLB family. A. fumigatus are more closely relaed to A. oryzae, A.niger, P.notatum and N. crassa PLB than other fungi.

Congenital or acquired hearing disorders may cause conductive or sensory-neural low hearing. In addition, non-sufficient development of Eustachian tube and mastoid cells old may cause conductive hearing disorders in children under 12 years old. Thus, performing hearing screening studies in this range of ages may help us to identify the children with hearing disorders. By detecting the type of hearing disorders, it is possible to help these children in their learning procedure. By considering these, the present study has been designed to investigate the hearing conditions in the primary school children (fifth level) of Semnan city. In order to determine the prevalence of hearing impairment in primary school children (fifth level), this study of 2081 children was performed in two stages. In the first stage, these children were screened by otoscopy, pure tone audiometry (three frequencies of 500, 1000 and 2000 Hz at 20 dB). In the next stage, the suspected students with hearing loss referred to the audiometry clinic to undergo a complete tests including; 1) speech audiometric tests, 2) audiometric tests with frequencies of 250, 500, 1000, 2000, 4000 and 8000 Hz, and 3) tympanometry tests to determine the type of hearing loss. The results indicate 6.9% of impacted cerumen, 17.9% of slight cerumen, 3.6% of tympanic disorder and 4.1% of hearing loss among the fifth-level students, with significantly higher hearing loss in the south area compared to the other area (P<0.05). The percentage of impacted cerumen was twice in the student girls, compared to the boys (P<0.05), while the percentage of observed tympani disorder was five times in the boys compared to the girls (P<0.01). No difference was seen between boys and girls students in term of observed hearing loss. The obtained results showed the presence of impact cerumen, tympani disorder and hearing loss in the fifth level primary school children which indicate the importance of performing such a screening studies and also planning the health training programs for preventive care of hearing loss in the school and family.

Tannery industries effluent disposal into environment causes hazardous effects in environment. The goals were to determine the tolurance limit P.chrysosporium in the tanning house effluent and potential of chromium removal in the bench scale. At first, sampling of tanning house effluent, in order to effluent quality evaluation was carried out. Then adjusting carbon to nitrogen ratio from 10 – 12. Dry weight of fungi mass (0.35% - 2.1%) inoculated to strile samples with Cr+3 concentration 120 – 1080 mg/l. Samples were put in shaker incobator. Also effect of pH, temperature, shaking velocity and nutrients for finding optimum conditions, biomass growth and chromium removal rate were studied. Findings showed that maximum biomass growth and chromium removal rate were occurred in the sample that chromium concentration and inoculum size were 240 mg/l and 0.07% (dry weight), respectively. Also biomass growth and chromium removal rate were 0.04823% and 76.7%, respectively. Biomass growth and chromium removal in best condition and 26h detention time rate were 0.2934% and 95.8%, respectively. This study showed by optimizing environmental conditions, with 95% confidence (P<0.001), after 26h. biomass growth and chromium removal rate would be 0.29% and 95.8% respectively.

It is well documented that the hormonal changes during menstrual cycle influences systemic diseases, among them are allergic disorders. There are some reports of cyclic anaphylactic reactions during menstrual period which is reffered as "Catamenial anaphylaxis". It must be differentiated from a closely related condition called "APD" or autoimmune progesterone dermatitis which is also a rare condition. It seems that hormonal changes especially rising progesterne levels and other mechanisms like back-diffusion of prostaglandines from contracting uterus into the systemic circulation may have some role in pathogenesis of these conditions. In catamenial anaphylaxis symptoms appear in direct association with the start of the menstrual flow but in APD, sign and symptoms begin earlier in the pre-menstrual phase. Case report: A 19 year old girl (not married) was referred because of a 8-months history of recurrent monthly urticarial and anaphlactoid reactions. Her symptoms began at first day of menstruation and lasted 1 to 2 days. The eruptions started as a sense of flushing and intense pruritus all over the body. Soon urticarial lesion as giant hives appeared which in some instances was associated with respiratory distress. The patient denied any changes in her diet and had taken no medications. Complete blood Ccunt and erytrocyte sedimentation rate (ESR) revealed no abnormalities but VDRL positivity led us to consider rheumatological background like systemic lupus erythematosous. Anti cardioLipin antibody (ACLA) was surprisingly above normal laboratory values. Her serum was taken in an episode of cyclic anaphylactic reactions and stored to be used later in her cycle when no more menstruating. Skin prick test with autologous serum collected during menstruation is performed at the midcycle and also in the late-cycle period in another ovulatory cycle. Both prick tests led to resurgence of severe allergic reactions as flushing, urticaria, pruritus and dry cough which were managed approprately. The patient's history and physical examination and hormonal assay were consistent with catamenial anaphylaxis. She is currently under control and follow up, using cyclic conjugated estrogens.