مجله دانشگاه علوم پزشکی مازندران
پیاپی 48 (مهر و آبان 1384)

Background and In this study the effects of glutathion on resumption of meiosis, in-vitro maturation and development of immature mouse oocytes was evaluated. Immature oocytes recoverd from NMRI mouse strain (4-6 weeks) in four different experimental groups. Group 1 (control group): 345 immature oocytes were matured in MEM-α medium containing FCS 5%, group 1: 338 immature oocytes were cultured in MEM-α medium containing FCS 5% and 1mM glutathione, group 2: 237 immature oocytes curtured in MEM-α medium containing FCS 5%, 7.5 IuhCG, 100mIUrFSH and group 3: 327 immature oocytes were growed in MEM-α medium FCS5%, 7.5 IUhCG, 100mIUrFSH, 1mM glutathione. Fertilization and embryo development were done in T6 medium. There were significant differences between in-vitro maturation rates (group 1: 59.71%, group 2: 79.28%, group 3: 52.74 and group 4: 70.22%) and resumpsion of meiosis (group 1: 74.20%, group 2: 92.88%, group 3: 74.26%, group 4: 86.20%) in different groups. The results of this study showed that glutathione (1mM) enhanced resumpsion of meiosis and in-vitro maturation and development of embryoes.

Background and Gabapentin is a new Antiepileptic drugs that introduced for the treatment of partial and second generalized seizures. Other usages of this drug include relief of neuropathic pains such as diabetic and cancers neuropathy and also prophylaxy of migrane. There is little information about the teratogenic effects of this drug. Only few studies reported delay in ossification of bones and hydroureter and hydronephrosis. This study carried out to reveal the macroscopic malformation of this drug when used during the implantation and organogenesis periods. 30 balb/c virgin females, aged 2.5 months and weighted 30±2 gr were housed in environmentally controlled room. A group of 3 females was caged with a single male of proven fertility overnight. Finding of vaginal plug on the following morning was regarded as gestational day (GD) 0. Mice were divided into experimental groups ex. І=received 1400 mg /day (20mg/kg/day) and ex. II=received 1800 mg /day (26mg/kg/day) doses of Gabapentin drug for 10 subsequent days and one control group which received disstilled water intraperitoneally. They were dissected in GD18 and embryos were collected and washed with normal saline. Macroscopic observation was made using a stereomicroscope and weighed using a digital scale with 0.01 accuracy. Data were analysed by ANOVA and X2 tests using of SPSS software. Both experimental groups (I, II) revealed similar malformations categorized as skeletal malformation and neural tube defects. Skeletal malformation was more frequent than neural tube defects and mostly included limbs defects,distortions and dislocations with significant difference compared with the control group (p<0.05). Spina bifida cystica was the most common form of neural tube defects. In the experimental group II, density and incidence of malformations and also fetuses resorption were higher than those of the other experimental group. This study revealed that Gabapentin can induce new severe malformations if this drug used subsequent to the implantation and organogenesis stages of pregnancy.

Background and Rheumatoid Arthritis (RA) is a systemic auto immune Rheumatoid diseases. Auto antibodies are detected in this disease, with diagnostic and prognostic properties. One of them is AKA which reacts with the fibrous keratin in epiderm and the stratum corneum of rat esophageal epithelium. Hence at first AKA – IFA kit was designed, then its sensitivety and specificity was measured, and the titer of Anti body was evaluated in RA patients, and finaly the results of AKA were compared with that of RF test. AKA-IFA kit was designed with protein antigens in the stratum corneum of rat esophageal and anti human IgG conjugated to FITC. 52 patients with RA (mean age 48.0 ±15.8) according to the American College of Rheumatology (ACR) criteria were selected for measuring the sensitivity and specificity. The results of AKA test in sera of RA patients were campared with 23 sera of patient control groupe (mean age 32.5 ±16.4) and 30 sera of healthy control groupe (mean age 32.1 ±16.9). Inter and intra assay method was used to determinig precision of AKA kit. RF test was also performed and it's results compared with result of designed AKA kit. AKA were found in 75% of patients with RA (39/52), 13% of patient control groupe (3/23) and 3.3% of healthy control groupe. (YBO) The designed AKA kit by inter and intra assay method had 100% and 98% percision respectively. The sensitiviety and specificity of AKA in (1/10) serum dilution was 75% and 92.5% respectively but sensitiviety and specificity of RF was 88.5%, 86.8% respectively. According to the results, IFA– AKA test could be diagnostic and confirmative for RA, And AKA in (1/10)serum dilution has the best diagnostic Value for RA. (cut off).

Background and Epidemiological evidence has suggested that consumption of fruits reduces the risk of chronic diseases such as cancer and cardiovascular disease. These benefits are often attributed to their high antioxidant components such as vitamin C (ascorbic acid). Citrus species are extremely rich sources for this vitamin, therefore we decided to determine the amount of vitamin C in some citrus fruits. 13 species of commonly used citrus fruits were collected at the ripening stage. All the trees were cultivated in the experimental fields, Fajr citrus experimental institute. The vitamin C contents in fresh juice were determined by a two step oxidation-reduction titration. Data were analyzed using one-way analysis of variance (ANOVA) followed by tukey, multiple range test. Mean ascorbic acid contents of commonly used citrus were 85.4±18.3 mg/100 of juice (ranging from 57.9 to 131.6). The highest amount of vitamin C were found in Shahsavari orange 131.6 ± 4.2 and Sanguinello 100.7 ± 2.2 and the lowest amounts were in Tangelo 57.9 ± 2.3 and Unshiu 70.2 ± 2.2 mg/100 of juice. There was no correlation between Ascorbic acid contents and amount of citric acid in juice. Significant differences were found in vitamin C contents of citrus fruits. In order to increase the intake of vitamin C in daily diet, consuming fruits with higher contents of vitamin C is recommended.

Background and There are ten identified species of Datura in the world. Datura stramonium L. (Torn apple or Jimsonweed) and D.innoxia Mill. (Hindudatura) are endemic species of Datura in Iran, especially in the North (Caspian Sea region). They are distinguished using morphological differences. Form, color and size of leaf, flower, capsule, root and seed are different in D.stranonium and D.innoxia. D.stramonium is more extended than D.innoxia in North of Iran. In fact, Datura stramonium L. is the most widespread species of Datura, in North of Iran. Titration and high performance liquid chromatography (HPLC) are outlined in this work for analysis of tropane alkaloids and hyoscyamine in Datura species. Organs (leaf, seed, root). that grow in Mazandaran and Gillan provinces (Caspian sea regions). The percentage of total alkaloids and also the percentage of hyoscyamine of tropane alkaloids were calculated in leaf, seed and root of the plant. maximum tropaneas in D.stramoRivm lea4 (0.40%) and minimum tropane alkaloids was in D. innoxia root(0.18%).

Background and New biochemical markers(Fibronection, esteriol, à- feto protein,…) to predict spontaneous preterm birth give a more precise and earlier diagnosis than the usual ones(previous history, risk scoring system,…) there are many women with no obvois risk factors who deliver prematurely. The main purpose of this study was to determine the relationship between preterm delivery and cervicovaginal beta human chorionic gonadotropin(beta- h.c.g) levels. The study was a nested case control undertaken on 304 pregnant women attending the health centers of Sari, Mazandaran, Iran. Cervicovaginal (beta-h.c.g) titers were measured in 83 high risk women at 24-28 week’s of gestation. Based on getational age (GA) at delivery they allocated in case (GA<34 weeks) and control ≥37 weeks) groups. Beta-h.c.g levels were analyzed and compared in two groups. Odd’s ratioes were calculated.. 83(27.3%) high risk pregnant women were selected from a total of 304 participants. 36 (43. 37%)subjects delivered at or before 34 weeks of cervicovaginal beta h.c.g showed a range of 0-186 mIU/ml with an optimal cut- off value of 25, Odd’s ratio for gestational age <37 was 3.016 (CI= 1.12-8.06, 95%). There was a correlation between preterm delivery (gestational age<37) and cervicovaginal beta h.c.g titer in 24-28 weeks of gestation. Sensitivity, specificity, positive and negative predictive values of the test as a predictor of preterm delivery were 41.67%, 80.85%, 62.5%, and 64.41% respectively. A high sensitivity was not attained in this for the cervicovaginal secretions beta- hcg levels in order to predict preterm delivery, hence further investigation are required to elucidate all aspects of the subjects.

Baekgrouund & Diagnosis of microcytic hgpochromia is rutinely done using automatied equipment cell counter which is expensive and requaires expert. Personal OFT can be used for this globular defect. The aim of this study is to determine the best NaCL con centration in OFT, the experiments were done at fajer lab in 2001. 696 Random patients were examined simultaneouly for RBV indices by cell counter &method of onetube OFT. In this test. one drop (0.05 m1) of whole blood with 5 m1 of NaCl % 0.4 were mixed for 10 minutes, and after centrifuging. Supernatal for hemolysis. 382 patients with mcv> 80 had hemolysis. 228 patients with 74< mev <79 had hemolysis. 75 individuals with mcv<75 have no hemolysis and 5 with mcv>80 and 6 with 74. one tube OFT is very Sensetive for sereening of microcytic hypochromia but it is not practical for differential diagnosis of iron deficieney anenaia from minor thlassemia

Baekgrouund & In recent years, the role of adenoviruses in infection and disease in recipients of bone marrow transplantation (BMT) has been studied. It suppose that adenoviral infections are prevalant in these patients Due to using medicines for preventing transplant rejection. This study was performed to compare the incidence of adenoviruses in urine samples taken before and after BMT from individuals undergoing BMT. In addition, The correlation between age, sex, etiology and kind of transplantation and adenovirus infection was studied. From 11 November 2002 to 12 June 2003, 91 patients received BMT in Hematology, Oncology and Bone Marrow Transplantation center of Tehran University of Medical Sciences. From 72 patients, 2 urine samples were taken before and 4 weeks after transplantation The DNA samples were examined by PCR using primers that detect 134 bp sequence in Hexon gene shared in human adenovirus DNA was extracted using Phenol-Chloroform method and concentrated by sodium acetate and ethanol.In Faculty of Medicine, Shahed University. Adenovirus DNA was found in 39 patients (54.2%) before transplantation and in 37 patients (51.4%) after that. Both before and after BMT samples were negative for adenoviruses in 21 patients and positive in 25 patients. In 14 patients only before BMT and in 12 patients only after BMT urine samples were positive. No statistical difference between before and after BMT viruria was shown by McNemar’s test. Also, no statistical difference was shown between mean age of infected and non-infected patients by t-test. In spite of higher frequency of males, malignant and allogeneic transplant among studied patients, there was no statistical difference between two mentioned patients (P>0.05). In the present study, increase of prevalence of viruria in patients after bone marrow transplantation was not seen. In adition, there was no correlation between patients with various age, sex and etiology and kind of transplantation. Further studies about prevalence of adenovirus in patients undergoing bone marrow transplantation. recommended for prevention of mortality by better take care of patients and treatment by antiviral drugs or decrease in suppressive drugs.

Baekgrouund & Retrosterenal and pericardial adhesions formation after cardiac surgery makes a repeat Sternotomy is time consuming and dangerous, with high risk of iatrogenic trauma to heart, aorta, innominate vessels and grafts. Therefore we decided to find another substitute for pericard other than the ordinary ones in use, with the advantage of lower cost but good results. Thirty sheep,35-45 kg were used in this study and categorized test group and control groups. In group one (n=18) pericardium was excised and the LTS (Laser-Treated Sil- icone) membrane implanted as a pericardial. In control group(n=12) the pericardium was excised without LTS membrane implantation. During followup ranging from 3-24 months, sheep were observed for any clinical– sign of post operation problems. Reoperation was done in all animals of test and control groups to evaluate- adhesions formation. In the control group dense adhesions were observed, while in the study group adhesions- formation was reduced at all sites covered by LTS membrane and no infection or other complications were- observed. The LTS membrane is safe and efficient in reducing pericardial adhesions formation whom might be used in patients undergoing cardiac surgery whom may need reoperation, and due to Lower costs it may replace other substitutes such as PTFF.

Background and Chronic anovulation is a common cause of infertility in women. Most women with chronic anoulation have irregular menstural cycles and normal serum FSH concentration s(WHO-type 2). finding out influential factors on ovarian responsiveness is useful for managing the infertile patients. The objective of this study is to assess the relation of some factors on ovulation in infertile women referring to Royan institute between November 2002 to November 2003. A total of 74 normogonadotropic, oligomenorrhic, undergone ovulation induction using tamoxifen, were studied. The factors studied were pretreatment clinical sings (Hirsutism, BMI) endocrine (FSH, LH, Insulin- testosterone) and sonographic screening characteristics of these patients. Ovarian response and ovulation were monitored by ultrasound scans and measurement of mid-luteal progestron. According to statistical analysis pretreatment Hirsutism- BMI – serum LH consentration, LH/FSH ratio and ovarian volume were identified as the significant parameters for prediction of ovulation with tamoxifen (P≤0.05). There was no statistically significant differences in age, duration of infertility, FBS/Fasting insulin ratio and ovulation between the groups. Ovarian responsiveness to tamoxifen in anovulatory infertile women can be predicted on the basis of some initial screening characteristics. The prediction model in this study may improve the outcome and make the treatment more safe and efficient. These approaches should be further evaluated in prospective comparative trial.

Baekgrouund & The purpose of this study was comparing the motor and cognitive development of urban and rural preschool children in Semnan, Iran. 97 healthy preschool children participated in the study, including 57 urban (n1=57) and 40 rural (n2=40) children. 6 assessment methods including equilibrium on one leg, drawing a man, Juorchin, fekr-e-bekr, equilibrium board and the test of easy fine motor, were employed to evaluate the motor and cognitive development in the participants. For analysis of the obtained results t tests was used to determine significant differences between the two groups. equilibrium on one leg and the test of easy fine motor, considering there was significant differences between, urban and rural groups. In the other four tests there was no significant differences between the two groups. the findings indicated that the rural children have more success in motor skills when compared to urban children, while in cognitive tests the two groups showed the same results, indicating. That revision is required for the preschool programme.

Background and One of the essential roles of midwiferies is correct assesment of labour onset. With Loss of appropriate time in the first stage of labour and early interventions in active phase unnecessary cesarean section may be induced. The objective of this study determine the relation between the duration first stage of the and mode of delivery was performed at Golestan governmetal, private and educational hospitals. This prospective Cross-sectional study was performed in nine centers in 2001 on 1128 womensimple sampling method was used and information gathered using questionaire and check list. The data were analyzed using Epi-info6. Chi-square and T-student test were used for analysis of results. p value <0.05 was considered significant. findings showed that there was significant difference between mean of latent phase in vaginal delivery group (6.3 hour) and cesarean section group (2.8 hour). Active phase in vaginal delivery group was 3.5 hour and in the other group was 2.8 hour(p<0.001). Majority of women who underwent cesarian seetion dae to lack of progress. Did not proceed to active phase at all. this event in nuliparous women was more than of multiparous women (p<0.001). We observed that when the duration of the first stage of labour, prolonged vaginal delivery rate incerased. Therefore with enough hospitalization in latent and active phase annecessary cesarean section rate, fetomaternal mortality and morbidity can be prevented.

Background and Withdrawal method is one of the most common contraceptive ways (% 23) nationwide. With regard to its relatively high failure rate (% 4-23) with unwanted pregnancies as well as resulted complications, this descriptive study was conducted to find out the reasons for not applying safe contraceptive methods. Subject population consisted of 379 married women between 15 and 45 living in Amol city and using withdrawal method. The subjects were selected through different stages with final randomization Data were collected by a questionnaire in which personal, social, and obstetrical history, and reasons for using withdrawal method as well as for not applying other methods were documented. The validity and reliability of the tool were determined by content validity and test-re test method respectively. Pearson coefficient of correlation as well as t-test and ANOVA were used for quantitative and qualitative variables respectively. Findings showed that the mean age of subjects was 28.1 ± 6.4, who had used withdrawal method at least for 3 months. Mean duration in using withdrawal method was 53.6 ± 6.6 months. Health care workers were considered the most frequent source of information (%26.6) and the main reasons for not applying safe contraceptive methods included fear of side effects (% 28.2), husband opposition (% 28.2), contraindication (% 9) Lactation (% 8.7) and indifference to conception (% 7.7). The most common reasons for applying withdrawal method were husband preference (% 25.1), having less complications (% 20.3), availability (% 19.5) and being safer than other methods (% 12.7). It can be concluded that much more efforts should be made to devise and perform family planning programs correctly, and training health care workers continuously and finally educating people either by mass media or by professionals to encourage applying safe contraceptive methods.

Background and -Helicobacter pylori is a gram negative spiral bacilus which infects gastric mucosa and causes a wide range of gastro intestinal diseases.Unfortunately the prevalence of the infection by this organism in developing countries is high and despite numerous existing drug regimens, treatment fails to eradicate the organism in many occasions. To reach an effective and curative regimen, invitro determination of suscepibility and resistance of the organism, to various antimicrobials, is pradent. The goal of this study was to determine the prevalence of antimicrobial resistance in Helicobacter pylori,s isolated from cultures. Biopsies from 67 patients admitted to the Sari Imam Hospital were used to cultur Helicobacter pylori and determine their susceptibility and resistance to metronidazole, claritromycin and amoxycillin. Disc diffusion tecniqu was used to determine the minimum inhibitory concentration, (MIC) and resistance pattern of the isolated Helicobacter pylori.In this method we used the cutoff point of MIC 90 ie, a concentration at which 90% or more of culture plates show inhibition zone around the antimicrobial test disc. MIC 90 for amoxycillin and claritramycin in our study was 0.25 g/ml and all isolates were susceptible to amoxycillin. Only one isolate was resistant to claritramycin. MIC 90 for metronidzole was 16 and 4 resistant cases were isolated. This stndy showed low level of resistance to metronidazole and claritramycin which were comparable to the reported results from other studies. No resistance was observed to amoxycillin which was also the same as other reported results. According to the pattern of antimicrobial resistance, we can recommend the studied drugs, against Helicobacter pylori.

Background and bata thlassemia is the most common monogenic disorders in Iran. The gene frequency varies the country. Sistan and Baluchistan province, located in the southeast of iran with more than 1200 affected individuals, represents one of the regions where thalassemia id not only an important public health problem but also a socioeconomic problem. As a matter of fact high frequency of ß- thalassemia gene inter- family marriages, evasion of couples to carry out pre- marriage blood test, avoidance of counseling before wedding and eagerness for more children in spite of having ß - thalassemia kids collectively prompted us to eatablish prenatal diagnostic center in khordad 1381(May 2002) in this province. 140 minor thalassemia couples were referred to our center from May 2002 to Feb. 2004. After admission of the couples to the center their demographic data were collected. 10 ml of blood sample was then collected from couples added with anti- coaqulant(0.5 M EDTA). DNA was subsequently extracted before being amplified by Refractory Mutation System(ARMS) techniques vs the common primers of B- gene mutations in Iran. Within the 10 to 12th weeks of pregnancy, chorionic villi samples were taken and subjected onto two techniques namely direct and indirect. We afterwards evaluated the inheritance of mutation in the fetus from any of his/ her parents. We carried out preliminary diagnosis for 56 couples, as well as first round and further step of prenatal diagnostic procedures for another 84 couples(n= 140). 79. 3% of the total number resided in cities, whereas 87.9% were born in Sistan and Baluchistan province. Out of which 30% and 70% had sistany and Baluchi ethnicity respectively. Furthermore, 60.7% had at least one affected child, while 85.7% had consanguineous marriages. Out of the totalnumber, 57.9% were from Sunni minority. 88.05% of the couples demonstrated one of the common mutations identified in Iran. The latter figure also indicted that IVS 1-5 was the most common mutation in this region as 77.9% of the sufferers carried the gene. Futher investigations on 84 couples by chorionic vili DNA analysis showed that, 21.4% of their fetuses had major thalassemia. High rate of homogeneity in mutations observed in this region has been caused by frequent inter- family marriages. Considering the population of Shiites and Sonis(40% & 60% respectively) both sects of religions with the same percentage stated above has made use of PND services in our center. It is worthy of mention that it is for the first the sonnies are willing to use prenatal diagnosis services. The establishment of this center in Zahedan has been one of the effective polices in prevention of thalassemia.

Background and Otomycosis(Otitis externa) is an acute, subacte or chronic fungal infection that has exogenous or endogenous origin. The present study was carried out to investigate the etiologic agents and determine risk factore and epidemiological aspects of otomycosis in north- West area of Iran. Clinical samples of suspected patients were studied in direct microscopy and cultured in specific medium for determining the causative fungi. 89 patients 64 male and 25 female were recruited and studies. The disease were more prevalent in 20- 40 years in both sexes.Identified etiologic agents with direct examination and culture of samples in numerous series were: Aspergillus niger(51 cases), A. terreus(9 cases), A. flavus(7 cases), A Fuminagatus(6 cases), Eurotium(prefect stage of A. glaucus)(2 cases), penicillium Sp.(2 cases), Candida albicans(8 cases), Epicoccum Sp.(1 case), Mucor Sp. (1 case), Rhizopus Sp.(1 case) and Microsporum canis(1 case). Saprophytic moulds were the main etiologic agent of Otomycosis and Aspergillus niger was the prime causaltive agent. Infection in 20 –40 year age group was the most prevalent and Otomycosis among females was determined more than male. This report has provided useful information on the prevalence, causative agents and health implications of Otomycosis, as an infection grossly neglected in enviroment.

Acute Brucellar pericarditis with cardiac tamponade without any concurrent cardiac lesion is an extremely rare manifestation. In this paper a 63 year old man is reported with brucellosis and massive pericardial effusion and tamponade. This case is very rare and there are finger count report of Brucella induced cardiac tamponade were in the international bibliography.

In this report we introduce an 8 years old boy with Transverse colon inflammatory pseudotumor. The patient was admitted to Boo-Ali Sina Hospital with abdominal pain, fever and vomiting. In clinical examinations an abdominal mass in splenic flexure was palpated. Imaging study with CT-Scan revealed a calcified mass in transverse colon wall with lymphadenopathy and lymphoma was suggested. Histological study showed inflammatory pseudotumor. After surgical excision the patient was recovered. The recurrence was not seen after one year follow up. This case showed that in differential diagnosis of pediatric colonic mass, inflammatory pseudotumor should be considered in order to prevent unneccesary and harmful chemotherapy and radiotherapy.