مجله دانشگاه علوم پزشکی رفسنجان
سال چهارم شماره 4 (پیاپی 16، پاییز 1384)

Cryopreservation of supernumerary human embryos derived from assisted reproduction technology (ART) procedures has provided patients the option of storage of gametes and embryos for future treatment. However, because of technical problems embryo freezing is not a routine procedure in all ART centers. This study was designed to compare the post-thaw survival and chromosomal aberrations caused by vitrification on vitrified 8-cell mouse embryos by control group. In this exprimental study using flashing method eight-cell mouse embryos were obtained from NMRI mouse 3 days after mating. Retrieved embryos were transferred in to vitrification solution containing ethylene glycol as cryoprotectant, then transferred into a vitrification straw using standard technique, and vitrified in liquid Nitrogen. Four groups of embryos including controls according to the time of vitrification, from 24 hours to 1 month were frozen. After appropriate freezing time embryos were thawed and studied for their viability and chromosomal abnormalities after thawing. Viability of frozen embryos reduced from 98.2% to 79.2% after 1 month vitrification. Furthermore, chromosomal aberrations significantly increased with increasing freezing time (p<0.01). This study indicates that freezing affects viability of embryos and chromosome structure compared to the control group. Effects of vitrification might produce chromosomal alterations leading to cell death. These alterations might probably be due to cytoskeleton, spindle or other cellular organelle damages.

Myrtus Communis, L. is a medicinal herb, which has antibacterial activity and is used against many pathogens. The present study was conducted to investigate the mechanism of antibacterial activity of the methanolic extract of this herb against E.coli K12 HB101. E.coli K12 HB101 containing plasmid pBR322 was cultured in Muler Hinton agar under different concentration (1.56-6.25 mg/ml) of Myrtus communis air-dried extract. The cells were lysed by repeated sonication and freeze -thawing. The catalase, and superoxide dismutase(SOD) activities, total antioxidant (TAS) and malondialdehyde determination were performed on the cell lysate. Plasmid DNA was purified and the electrophoretic behavior of the purified DNA grown under different concentration of the extract were compared. Various Concentrations (SIC) of the extract did not show any changes in the DNA topology. When the extract concentration in the culture increased from 1.56 to 6.25 mg/ml the catalase specific activity of the cell extract reduced from 20.47 ± 0.7 to 5.1 ± 2.9 unit/mg protein. Under the same condition, SOD activity was decreased from 63.86 ± 5.2 to 20.04 ± 1.6 units/mg protein. Total antioxidant capacity in the cell lysate significantly decreased in the test samples compared to the control cultures (18.07 ± 3.1 vs 6.19 ± 2.1 mmole/L). Malondialedhyde concentration was elevated from 23.09 ± 7.6 to 49.92 ± 3.4 m g/mg protein of the cell lysate. The extract of Myrtus communis persumabably does not change the DNA topology of E.coli as judged by excision of plasmid pBR322. The results however showed that, Free radicals are one of the major causes of the antibacterial action of this medicinal herb.

Despite 40 years of cardiopulmonary resuscitation (CPR) therapies, overall survival rates after cardiac arrest remain poor. On the average, 10-15% of patients who undergo cardiopulmonary resuscitation following a cardiopulmonary arrest in hospitals, are discharged but this rate is different in different countries. Information on who is likely to benefit from cardiopulmonary resuscitation is essential for decision making regarding resuscitation efforts. The purpose of present study was to determine the outcome of cardiopulmonary resuscitation (CPR) for in-hospital cardiac arrests and to identify risk factors associated with survival to the time of hospital discharge. A 1-year cohort study in Emam Khomeini Medical Center that is a 1000-bed tertiary, academic and regional referral center was preformed. The samples were adult inpatients (mean age 58.12±19.16 years), excluding those who had cardiac arrest in the operating room. Eighty seven patients analyzed. A check list was used to assess the performance and quality of CPR team and a questionnaire was used for assessment of knowledge in personnel Among eighty-seven resuscitated patients, sixteen (18.4%) survived after resuscitation but all of them died after 3-100 hours. Twenty seven (31.4%) patients arrested in the intensive care unit, 14 (15.1%) on the ward and 46 (53.5%) in the emergency room. There was no significant difference in survival based on location of arrest. Factors associated with poor outcome were age, interval between collapse and start of CPR, systolic pressure, arterial pH, K, initial rhythm, time of arrest, and duration of CPR. The skill of resuscitation team was associated with survival. Based on these data, survival till hospital discharge rate after cardiac arrest remains low. It is necessary to improve the skills and update the knowledge of resuscitation team. Hospital managers and nursing associations should consider CPR training and continuing education for all nurses and residents. They should also establish a special CPR Team in Hospitals.

Engagement that is the passage of fetus head through the pelvic inlet is one of the main stages of delivery. There is a controversy about the engagement time in different resources. The main objective of this cross – sectional study is to determine a possible correlation between engagement time of fetal head and delivery outcome in primiparous women. This cross sectional study carried out on 471 primiparous women. The inclusion criteria were minimum height 145cm, documented term gestation 37-42 weeks, vertex presentation, single fetus, spontaneous onset of labor, cervical dilatation 4cm or less and lack of any complications. At the onset of active labor, 386 women had unengaged and 85 of them had an engaged fetal head. The data were analyzed by using t and X2 tests. Our results showed that unengagement of fetal head conferred a longer active phase as well as a longer second stage of labor (p=0.001). Furthermore, an increased need for oxytocin was observed in women with an unengaged fetal presentation (p=0.04), but the delivery method of labors, length of third stage of labor, first and fifth minute Apgar score in two groups showed no significant differences. This study showed that unengaged fetal head in early active phase although increases the duration of delivery but it does not increase delivery complications (cesarean section rate, fetal distress and low Apgar score).

At present, trauma is one of the most important causes of mortality in human population all over the world. Thoracic trauma is one of the most important medical and socio-economical burdens in different areas of Iran. Thoracic trauma has been observed in 50% of patients admitted to the emergency departments. Considering the high prevalence of thoracic trauma, this study was conducted to evaluate the epidemiological status of thoracic trauma prevalence in Emergency department of Ali Ibn Abitaleb teaching Hospital in Rafsanjan city. This�descriptive study was performed on 250 traumatized patients (207 males and 43 females) who referred to the emergency department of Ali Ibn Abitaleb Hospital of Rafsanjan due to chest trauma during six months, started from January 1999 (all patients were followed till final diagnosis). The data statistically analyzed by using Chi square test in this prospective study. Among 250 patients, 207 individuals were male (82.80 %) and 43 were female (17.20 %). The most frequent incidence rate of chest trauma was observed in the age group of 11 to 20 years (26.4%) and the average age was 34 years. The most frequent cause of trauma was traffic accidents (52.40%) and the least frequent cause of trauma was gun shot (0.80%). The most frequent clinical symptom observed in the patients was chest pain (95.20%). The most prevalent clinical sign was chest tenderness, (96.40%). The most frequent associated trauma observed with thoracic injuries was head trauma (44.4 %). Considering the high freqency of traffic accidents as the leading cause of chest trauma, a basic reform in traffic and transportation should be considered. Furthermore, due to high frequency of traumas caused by cold weapons in the age group of 21-30 years, youngsters aducation can be suggested

Heat and Cold are among the most important and effective methods in rehabilitation of neuromusculoskeletal disorders. However there has been a controversy concerning the physiological and clinical effects of heat and cold. In this article, the physiological effects of heat and cold have been assessed. Furthermore, the effect of these modalities on electrical stimulation thresholds has been studied.

This research that is a quasi-experimental study, has been performed on 30 healthy male and female students aged 20-30. After changing the skin temperature to 20 and 44oC by ice and hot packs respectively, all 4 stimulation thresholds (sensory, motor, pain and max pain) were recorded by the use of electrical stimulation.

The present research indicated that heat modalities had no effect on stimulation thresholds but the cold caused a considerable increase in all of the electrical thresholds and the effect sustained for moments after removing cold modality.

Cold modalities change stimulation thresholds and in this regard they can be considered as effective ways for treating musculoskeletal disorders.

Electroconvulsive therapy (ECT) is one of the most effective treatment methods for recovery of the major depressed patients. The most important concerning in the case of ECT is temporary or permanent memory loss. Many patients who have no satisfactory recovery after receiving ECT, claim they have memory dysfunction. The aim of this research was to evaluat memory of the patients hospitalized in psychiatry department of Rafsanjan Moradi teaching hospital before and after receiving ECT in 2003. This cross sectional study was performed on 50 patients with major depression who received ECT at psychiatry department of Moradi hospital in six months. Memory status of each patient was evaluated by using Wechsler and Babkak memory tests before treatment, 24 hours after each ECT and one week after ending the treatment. The results presented in the form of diagrams and tables and to analyze the data wilcoxon sign rank test and paired t test were used for data analysis. After the first and the second ECTs, 18%-45% and 6%-15% of the patients showed short and long term memory dysfunction respectively. From the second ECT an increased short-term memory was observed, while long-term memory in the third and fourth ECT increased. From the fifth ECT there was no change in patient's memory. Relative frequency of long and short term memory dysfunction in the age group of 45 years old and above, married persons, low educated patients, farmers, house workers and the patients with previous history of depression was the highest. (p<0.05) This study showed that after treating major depression by using ECT, the patient's memory was improved. However after the first and the second ECTs, some of the patients showed memory dysfunction. It can be concluded that ECT can be used as an effective way for treatment of depressed patients without risk of memory dysfunction.

Retrograde surgery is a method to correct failures in endodontics, for which various materials are used. The purpose of this study was comparative evaluation of the amount microleakages of three retrograde cements: gray MTA, white MTA and Portland cement. Materilas and In this invitro study, 57 single root human extracted teeth with mature apices, were selected. After cutting crowns, teeth were prepared with manual file (step back technique), they were obturated with gutta-percha and AH26 sealer laterally. Then roots devided into three experimental groups with 15 teeth in each group and 2 positive and negative control groups with 6 teeth in each group. After a 45o bevel, 3mm apical cavities were prepared and then each one was filled with one of the three cements. The coronal part of the roots sealed with amalgam. After nail varnishing on the root surface (except their apical 1mm of each root). All roots were immersed in 2% methylen-blue dye for 72 hrs. Then they were split and linear dye-penetration was measured by stereomicroscope. The data were analyzed statistically using one way ANOVA test. Statistic analysis of the data showed no significant difference between the three retrograde cements Gray MTA (4.520mm) white MTA (4.826mm) and Portland cement (4.826mm). According to results, the use of Portland cement as a retrograde cement seems to be promising clinically. In vivo studies focusing on Portland cement are recommended.

Sleep has always been considered as one of the most essential needs of humans. Patients need sleeping more than healthy individuals. Results of recent studies indicate that disease and hospitalization have close relationship with sleeping disturbances. This study is an attempt to assess the sleep disturbance-related factors in patients admitted to Medical-Surgical wards of Ali Ebne Abitaleb Teaching hospital of Rafsanjan. Using questionnaire, this cross sectional descriptive study was performed. Sampling was target based and sample size was determined by use of volume assigning. Considering the probability of the out breaking at 80%, the sample size of 245 patients was determined. Samples were selected equally from medical and surgical wards. The collected data in the form of descriptive statistics were analyzed by using SPSS software. Furthermore, for determining the relationship between the demographic characters and the type of ward, based on the patients’ out look, non parametric statistics was used. 51.2% of the samples were male and 48.8% were female and most of them (33.9%)were under 25 years old. 49.1% of the patients claimed that the quality of their sleep had been decreased. The comparison of factors affecting the sleep disturbances showed statistically significant differences (p<0.001). The most effective factors were personal, environmental and attentive factors, respectively. Having pain and restlessness were the most frequent personal factors. Moaning and other patients, crying, quality of hospital beds, room temperature and the noise caused by hospital equipments were the most effective environmental factors. Among attentive factors, being awake for receiving medicine or serum taking was the most important one. Half of the studied patients complained from sleeping disturbances and according to their opinion, controlling or removing the above-mentioned factors can be suggested.

Delayed onset muscle soreness syndrome (DOMS) usually occurs after non-habitual eccentric exercises. It peaks at 24-48 hours after the exercise and disappears after 5-7 days. Most of the available treatments have failed to expedite the elimination of the symptoms of this syndrome. The current study aimed to compare ice, massage and cool-down exercise therapies to find out the most effective methods for alleviating the symptoms of this syndrome. 40 healthy women (mean age 21±9 years) with no routine exercise background were recruited in this clinical trial study. The subjects ran on an electrical treadmill in an -8 degrees downhill inclination with a constant speed of 5 km/hr for 15 minutes. They were then randomly received one of the ice, massage or cool-down exercise treatments. Blood Creatine Kinase (CK) enzyme level, pain, fatigue and tenderness of the subjects were compared with those of each other and with the control group. The results of this study showed a significant difference in CK level between the first and the second tests in all groups (p<0.05). However, no significant differences were found between either of the treatment groups and the control group (p>0.05). Although pain reduced in all treatment groups, it was only significant in ice therapy group (p<0.05). In terms of fatigue and tenderness, the control group showed the highest and massage, cool-down exercise and finally the ice therapy group showed the least pain, respectively. The results of this study revealed the positive effects of all of the treatment methods used in this study in reduction of DOMS symptoms and its functional disabilities, but emphasized on ice therapy as the most effective and useful protocol.