مجله دانشگاه علوم پزشکی شهرکرد
سال ششم شماره 3 (پیاپی 23، پاییز 1383)

The effects of sex steroid hormones on insulin secretion and sensitivity is important for related disorders treatment. Therefore, the main purpose of the present study was to clarify the effects of sex hormones on insulin sensitivity in rats. Due to the role of pancreatic b-cells’ ATP-sensitive K+ (KATP) channels in insulin secretion, the effects of the hormones on pancreatic KATP channels were also studied. Diazoxide (30mg/kg/day) or verapamil (100mg/kg/day) were used as pancreatic b-cells’ KATP channels opener and blocker, respectively. Testosterone (50 mg/kg/day) as replacement dose in bi-orchiectomized rats and 10 mg/kg/day in intact male animals and progesterone (20 mg/kg/day) and estradiol (200 μg/kg/day) in female rats were also used. Male rats were divided into nine groups consisting of: control, uni-and bi-orchiectomized, testosterone receiving bi-orchiectomized, testosterone receiving intact rats, diazoxide or verapamil and testosterone plus diazoxide or verapamil receiving animals. Female rats were divided into control, uni-and bi-ovariectomized, progesterone or estradiol receiving bi-ovariectomized and progesterone, estradiol, diazoxide or verapamil receiving and progesterone plus diazoxide or verapamil receiving animals. After 4 weeks, serum glucose and insulin were measured and insulin sensitivity (glucose/insulin ratio) was compared statistically between the groups. In the male rats, bi-orchiectomy, and diazoxide or diazoxide plus testosterone treatments increased insulin sensitivity; but uni-orchiectomy, testosterone, verapamil or testosterone plus verapamil treatments decreased insulin sensitivity. In the female rats, uni- and bi-ovariectomy, progesterone, diazoxide or progesterone plus diazoxide or verapamil, treatments increased insulin sensitivity; but estradiol or verapamil treatments resulted in the decrease of insulin sensitivity. Testosterone and estradiol were insulin sensitivity reducers but ovariectomy, bi-orchiectomy and progesterone were insulin sensitivity enhancer in rats. Presumably testosterone was not contributed in closing or opening of pancreatic b-cell KATP channels but progesterone influenced insulin sensitivity by its inhibitory effect on pancreatic KATP channels.

One of the important physiological changes during pregnancy is maternal weight gain. High weight gain results in postpartum obesity, and inadequate weight gain results in IUGR (Intra Utery Growth Rate) and low birth weight. The aim of this study was to determine maternal weight gain pattern in prenatal care centers of Boroujen city in 1999-2002. Questionnaires were completed using files of 678 pregnant women in these centers. Based on the Body Mass Index (BMI) the cases were divided into four groups consisted of low weight (BMI<19.8), normal (BMI>19.8-26), high weight (BMI>26-29) and obese (BMI>29). The mean weight gain of the whole sample was 11.4 kg, and it was 11.5 for normal and 10.3 for high weight groups, that was in the recommended range of Institute Of Medicine (IOM). Weight gain in the fourth and fifth months was linear. The mean weight gain was higher in the 3rd trimester compared to the 2nd one. Therefore drawing the chart of weight gain for each pregnant woman is better than determining weight gain for trimesters.

Ergonomy is the science of improvement of the work environment, job and equipment and adapting them to the human abilities and limitations. Using ergonomic approach in organizations has a significant role in their productivity. The aim of this study was to examine nurses’ work situations, job dangers and their knowledge about ergonomic in nursing units of three large university hospitals in Isfahan in the year 2002. The population of the survey consisted of all nursing personnel of the three hospitals (1274 persons). 499 nursing personnel were chosen by classified sampling and a questionnaire was filled for each one. The knowledge of the nursing personnel about ergonomic was low (2.68±0.76 out of 5); nursing personnel work condition was weak (2.13±0.67 out of 5), and the rate of job injuries exposure was low (2.07±0.91 out of 5). Providing efficient education about ergonomic and its application has a significant role in human resource productivity.

Organophosphorous (OP) compounds are widely used as pesticides, insecticides and herbicides in cultivation areas such as Mazandaran. These agents affect the environment and human health. The aim of the present study was to determine the activity of acetylcholinesterase (AChE) in fishes that have been exposed to pesticides or other toxins. The activity of AChE was measured using colorimetric Ellman procedure. Fishes (white fish, Rutilus frisi, n =8) were caught from three different sources (Caspian sea, well- and river- fed fish). The data was analyzed by Student Newman Kelus test. The enzyme activity was 3.80, 1.38 and 0.22 μM hydrolyzed ASCh/min/g for sea, well and river fish brains, respectively. The mean AChE activity was significantly different in the three groups (P<0.001). The pollution in the river-fed fishes was especially high, since their exposure to OP compounds, heavy metals and other toxins had been higher than others. Accumulation of heavy metals in wells, is a proposed mechanism for reduction of AChE activity in well-fed fishes.

Ventral tegmental area (VTA) is located in the mesencephalon and it is one of the main nuclei that play a major role in drug abuse or addiction. In this study we investigated the effect of electrical stimulation of the VTA on addiction to morphine. Intravenous self-administration was used to quantify the level of drug-dependence. Twenty-four Wistar rats were divided into three groups: 1) Sham or saline group that had surgery and received saline by self-administration. 2) Control or morphine group that had surgery and received morphine by self-administration. 3) Case or morphine + stimulation (25 μA; 100 Hz; 0.14 ms period; for 10 minutes) group that had surgery and received electrical stimulation 15 minutes before morphine self-administration. Addiction was seen only in the morphine group, and electrical stimulation of the VTA prevented the addiction. Electrical current stimulates all type of the neurons in the VTA. Since dopaminergic neurons comprise two-third of its neurons, VTA stimulation may cause the release of dopamine in the nucleus accumbence and produce rewards so that the animal needs no further rewards from morphine.

Coronary artery disease is one of the most common problems in medicine. The correct diagnosis of the affected artery and its treatment can prevent further development of atherosclerosis. Coronary angiography is the gold diagnostic standard of coronary atherosclerosis disease, but causes some dangers for the patients, such as adverse reaction to contrast agent media. Vomiting and nausea are the most common problems during angiography that increase the length of angiography and cause unstrile condition. Nausea and vomiting are related to the serotonin receptors in the brain. The purpose of this study was to investigate the effect of cyproheptadine (a serotonin blocker) on vomiting and nausea during angiography and ventriculography. In this study, 400 patients were divided into two equal groups. One group received a placebo and the other received 8 mg of cyproheptadine one hour before the angiography. The patients were visited during 12 hours after the angiography and a questionnaire was filled. The data was analyzed using c² and t tests by SPSS. Minor adverse reaction rate, which was 78 cases, reduced to 27 cases by using cyproheptadine tablet. In the patient, who received placebo the rate of nausea was 27%, vomiting 5.5% and retching 3%. But in those who received cyproheptadine the rate of nausea was 8%, vomiting 2% and retching 1%. The adverse reactions were not correlated to sex, ejection fraction and coronary artery obstruction. Cyproheptadine had an important role in decreasing nausea and vomiting during angiography.

Unwanted pregnancy is one of the social and health concerns in the family planning. Previous researchers have demonstrated the high prevalence of unwanted pregnancy in oral contraceptive pill (OCP) users. The aim of this study was to determine the causes of unwanted pregnancy in this group of women. In a descriptive and analytical survey, 458 users of contraceptive pills, who referred to Hajar hospital of Shahrekord, filled a questionnaire about their pregnancies. Data was analyzed by using t- and chi-square test. The rate of unwanted pregnancy was 46.9% in OCP users. Irregular use, forgetting the use of the pills and drug interactions were the most important causes of unwanted pregnancies in the OCP users. 24.5% of women did not know the causes of their pregnancies. We suggest that educational programs in the family planning centers must be improved to affect the practice of OCP users.

In the recent years Toxoplasma gondii has been increasingly recognized as an important pathogen of humans. It is one of the most common causes of latent infection in humans throughout the world. If primary Toxoplasma infection is acquired during pregnancy, the organism may be transmitted to the fetus. So, of importance is the prevalence of antibody in pregnant women. The aim of this study was to find the immunity status of rural pregnant women against Toxoplasma infection. The present study was carried out on 394 serum samples collected from the rural pregnant women aged 15-45 years, in Chaharmahal and Bakhtyari province, using Indirect Fluorescent Antibody Test (IFAT). The correlation between Toxoplasma infection and some variables such as age, delivery grade, the history of abortion and stillbirth, malformations of the newborn infant, location and food habits of the subjects, and direct contact of the women to cats was also investigated. The prevalence rate of total anti- Toxoplasma antibodies in the women was 27.4% and the titers ranged between 1.50-1.1600. There were not any classes of acute phase antibodies, IgM and IgA in the sera. Although there was no correlation between Toxoplasma infection and the mentioned variables, there was a significant correlation between Toxoplasma infection and raw vegetable consumption by the women (P<0.05). Because majority of the rural pregnant women lacked any anti- Toxoplasma antibodies and may be at risk of acute primary Toxoplasma infection in further pregnancies, the health policies should be directed toward the improvement of awareness of pregnant women about Toxoplasma infection and the routes of transmission. Moreover, the health programs should be designed to determine the status of immunity against Toxoplasma among women in gestation period through a serological surveillance program to prevent or diminish the complications of congenital toxoplasmosis in the affected fetuses.

The rate of mortality in an intensive care unit (ICU) is one of the most important criteria for evaluation of a hospital. In this article the moralities of the ICU of Kashani General Hospital of Shahrekord from 23 Sept 1998, until 23 Sep 2001 have been analyzed. A cross-sectional survey was performed on all the patients admitted to the ICU during this period. In this period 296 patients were admitted and 79 patients (27.9%) died. 35.8% of the patients were females, 60.5% were males and 3.7% were neonates. The main reasons of mortality were respiratory failure (37.9%) and brain trauma (27.8%).There was no difference between the times of death during 24 hours. Most of the patients were expired or discharged from the ICU during the first four days. Mortality was more prevalent in the patients older than 55 years and in neonates. More attention during the first four days of the admission to the ICU is necessary.

The main items which are evaluated in a GI disorder or diarrheal state are; frequency of defecation, stool weight, stool consistency and presence of inflammatory cells in the stool. The aim of this study was to find the normal range of the mentioned variables so that could help to differentiate between healthy persons and patients. The sample consisted of 1000 healthy persons among attendants of Shahrekord health centers. After explaining the method, they were requested to collect a 24-48 hours stool specimen in special containers. Carmen was used as beginning marker and activated charcoal used as end of the period marker. The variables of each stool were written down in a questionnaire. The SSPS software was used for analyzing the data by regression and t-test. The mean daily stool weight of the sample was found to be 349±131 gr. On average the frequency of defecation was 1.5 times a day and the intestinal transit time was estimated to be about 12.5 hours. Stool weight had a significant correlation with gender, body weight, age, amount of bread consumed daily and defecation frequency (P<0.005). Based on the results the diarrheal criteria for Iranian population are different from what mentioned in the reference books for western population. This is significant, especially for stool weight. More studies are necessary to find out definitive criteria of diarrhea for Iranian population