فصلنامه یافته
سال هشتم شماره 1 (پیاپی 22، بهار 1385)

Neuropathy is one of the important complications of diabetes. Deficiency of the nerve conduction velocity (NCV) that occurs in both human diabetic neuropathy and animal diabetes models is one of the indicators for diabetic neuropathy. In the present study, we examined the effect of enalapril, angiotensinconverting enzyme inhibitor on NCV, number of endoneurial capillaries and thickness of the capillary basement membrane in motor sciatic nerves of diabetic and non diabetic rats. Fifty male rats, 300-450gr body weight, randomly divided into five equal groups (control, sham, diabetic, prevention and treatment). Diabetes was induced by subcutaneous injection of alloxan (140mg/kg). Body weight and fast blood sugar were measured at the beginning of experiment and every endweek during the course of experiment. Animals in the sham and prevention groups received enalapril orally (5mg/kg/day) since the beginning of the experiment for five weeks. Treatment group received enalapril (5mg/kg/day) for four weeks after five weeks without treatment. NCV in motor sciatic nerve was measured at the end of the period. Then, the number of capillaries and thickness of basement membranes in the endoneurium of the motor sciatic nerve in all groups were examined. NCV was reduced by 45% in diabetic rats compared with the control group (p<0.001) after five weeks of diabetes. In prevention group, oral administration of enalapril for five weeks could prevent reduction in NCV in diabetic rats by 62% (p<0.05). Deficiency of the NCV is ameliorated by four weeks of enalapril treatment by 66% (p<0.05), in addition, the number of endoneurial capillaries in sciatic nerve increased by 67% (p<0.05). Administration of enalapril to non diabetic rats (sham group) had no effect on NCV and number of endoneurial capillaries in motor sciatic nerve. Enalapril can have an effective role in prevention and treatment of diabetic neuropathy.

Uterine bleeding is an important side effect of cesarean section which is due to non contractile uterine. The aim of this study was to compare the effect of 10% dextrose (IV infusion) and 40 IU/L oxytocin (IV infusion) on uterine contraction. This research was a double-blinded randomized clinical trial (RCT) study. 120 women were equally included in the two study groups. After cesarean section and uterine bleeding due to non contractile uterine, each patient randomly received 10% dextrose or 40 IU/L oxytocin in equal volume, intravenously. The ability of these two drugs to induce firm contraction of the uterine muscle was then determined. There was significant difference between the ability of the two drugs to induce firm contraction of uterine muscle. The rate of firm contraction of uterine muscle in response to IV infusion of 10% dextrose was 68.3% and to IV infusion of 40 IU/L oxytocin was 31.7% (P < 0.01). IV infusion of 10% dextrose affected high parity women more intensely (82.4% compare to 12.5%) and IV infusion of 40 IU/L oxytocin had a more intense effect on low parity women (63.6% compare to 43.5%) (P> 0.05). IV infusion of 10% dextrose is more effective than IV infusion of 40 IU/L oxytocin on uterine bleeding and firm contraction of uterine muscle after cesarean section in the women.

Infection of shiga toxin-producing Strains of Escherichia coli has some other dangerous and deadly effects such as hemolytic uremic syndrome (HUS) in addition to diarrhea. Its diagnosis is difficult and there is no information on It's incidence in Iran. The goal of this study is to evaluate and detect shiga toxinproducing strains of E. coli isolated from urinary and stool specimens by multiplex- PCR method. One hundred samples out of 500 collected samples were screened. The selected samples have more chance of heaving different kinds of O157. After DNA extraction from the isolated strains, the multiplex PCR reaction for both stx1 and stx2 genes performed and consequently amplicons were examined by agarose gel electrophoresis. Samples were analyzed after painting by ethidium bromide. Only 3 cases (3%) of the studied sample were positive for the presence of STEC. All three cases were related to stx2. Two of them were related from feces samples and one of them was isolated from the urine samples. Although it seems that the incidence and prevalence of gastrointestinal infections by STEC are low in Iran, But because of the serious complications of the STEC infection such as HUS and HC and failure of detection of these strains by routine methods it is necessary to use molecular and serological diagnostic methods, especially in childhood clinics for recognizing doubtful cases.

Iodine deficiency and its related disorder such as goiter are endemic in Lorestan province. Following initiation of iodine deficiency control program in 1989, production, distribution and consumption of iodinated salt were begun. This survey was conducted in the framework of national monitoring survey in 2001 to find out the prevalence of goiter and urinary iodine level in order to evaluate the iodine status of school- aged children in Lorestan. 1200 schoolchildren, aged 7-10 years, were selected randomly from all regions of Lorestan. The grade of goiter in 600 boys and 600 girls, was determined according to WHO classification. Urinary iodine content was estimated using the digestion method in one tenth of the schoolchildren. Total goiter rate was 7.8% 7.8% in girls and 7.7% in boys. Median urinary iodine was 17 μg/dl. Urinary iodine was above 10 μg/dl in 85.7% and less than 5 μg/dl in 1.7%. No one had urinary iodine below 2 μg/dl. It is concluded that the rate of goiter in Lorestan has decreased significantly since 1996 and urinary iodine levels in schoolchildren are indicative of adequate iodine intake. Therefore Lorestan province can be considered as an 'iodine deficiency free' zone.

The nuclear medicine systems are very sensitive to the variation of the magnetic field. Photomultiplier tubes amplify low energy light signal and change it into electrical current. Low magnetic field can produce some variations in uniformity and special resolution of SPECT systems. In this study, we tried to evaluate the effects of magnetic field on the function of nuclear medicine imaging system, when system rotates in different angles. In this study, three SPECT systems with different orientation were examined. A point and line source was placed in the front of the system and when the gantry system rotated in earth magnetic field, variation of energy photo peak, spatial resolution and linearity were determined in different angles. These measurements repeated when an air conditioner was placed at 2-meter distance of the camera gantries. Results were compared using t-student test. The t-test results show that in all three SPECT systems, the variations of energy photo peak, spatial resolution and linearity were statistically significant (p<0.01). The surrounding magnetic field can effect on accurate function of nuclear medicine systems. The surrounding magnetic field can effect on accurate function of nuclear medicine systems.

One of the major causes of increasing nosocomial infections is misusing disinfectants and antiseptics in hospitals. The aim of this study was to evaluate the efficacy of disinfectants and antiseptics using in injections and dressing wards, operation rooms and kitchen of Hamedan hospitals. In this study 742 samples were collected before and after disinfections from different parts of injection, dressing wards and operation rooms. Disinfectants and antiseptics that were used in different parts of wards were Halamide, Beh-Assa, Kereoeline, Formaldehyde, Glutaraldehyde, Chlorhexidine, Hygiene, Savlone, Alcohol 70% and UV ray. The efficacy of disinfectants that were prepared in hospitals and medical microbiology laboratory of medicine faculty was evaluated. The efficacy of disinfectants and antiseptics were tested on Staphylococcus and E. coli by disk diffusion method. Data was gathered through a questionnaire and analyzed using K2 and Mann-Whitney methods. From 742 samples, 308 positive cultures (41.6%) were detected. The frequency mean of the contamination before disinfection was 50.1% and after disinfection was 33.8%. From 308 positive cultures in two hospitals, 173 (56.2%) gram negative bacteria and 135 (43.8%) gram positive bacteria were isolated. The most effective disinfectants that were used in two hospitals were Glutaraldehyde 2%, Formaldehyde 8%, Chlorhexidine 1%, Savlone 3.2%. The lowest effective disinfectants were Beh-Assa 1%, Kereoeline 2.5%, and Alcohol 70%. The frequency mean of contamination before UV ray disinfection was 51.4% and after disinfection was 48.6%, which indicate no significant difference. Disinfectants and antiseptics that were prepared in hospitals and those that prepared in medical microbiology laboratory showed minor differences. In this study, the frequency mean of contamination before and after disinfections showed significant differences (P-value=0/001). So, the efficacy of disinfectants used in the two hospitals was satisfactory. However, disinfectants that were prepared in hospitals and those that prepared in medical microbiology laboratory showed minor differences. Therefore, it is suggested that the disinfectants and antiseptics which are used in hospitals should be prepared under supervision of hospital health experts.

Colorectal cancer is the fourth most common cancer, in terms of incidence throughout the world. There are some differences for risk factors involved in the incidence of tumor in different anatomical subsites of large bowel. However, most investigations have not studied the association between dietary factors and colorectal cancer subsites. Thus the current ecological study investigates the potential association between dietary factors and occurrence of cancer in different subsites of large bowel. Data on colorectal cancer incidence and dietary factors was obtained by the subsites of colorectal cancer for the 32 countries were estimated between the years 1988 and 1992. The association between alcohol, dietary factors and cancer in different subsites of large bowel was then analyzed by using linear regression. Multivariate analysis showed a significant association between red meat consumption and proximal colon cancer incidence (p=0.02). In contrast, there was a significant association between alcohol consumption and distal colon cancer in men (p=0.03) and rectal cancer in both men and women (p=0.01 and p=0.04 respectively). Investigation on the incidence of cancer in anatomical subsites of large bowel separately might help us to identify etiological factors and preventive ways of this cancer.

Abnormal uterine Bleeding is one of the most common disorders in Gynecology. Dilatation and curettage is a diagnostic procedure in the management of the abnormal uterine bleeding. The results of this procedure could be used to achive a definite treatment such as hysterectomy. This study was conducted to evaluate the sensitivity and specificity of dilatation and curettage. Histopathologic results of the specimens that were obtained from dilatation and curettage were compared with hysterectomy. 85 Subjects were enrolled in this descriptive study from 2002 to 2004 (3 year period). These patients were admitted in Beasat hospital of Sanandaj. Data was obtained from pathologic study of dilatation and curettage specimens and hysterectomy. Data was analyzed with SPSS software. Mean patient's age was 47.25 years, the youngest was 28 years old and the oldest was 78 years old. 75.3% of Patients lived in rural area and 70.6% were illiterate. 96.6% of the study group had more than 3 pregnancies. Tubal ligation was the most common contraception method in our patients. Sensitivity and specificity of dilatation and curettage for diagnosis of abnormal uterine bleeding was 78.1% and 79.16% respectively. Dilatation and curettage is a safe and an inexpensive method for diagnosis of abnormal uterine bleeding.

Zinc has important effects on human health, especially on structural and functional activities of the immune system. This study was carried out to examine the in vitro cytotoxic effects of zinc on Raji cell line. The cell line was exposed to different concentrations of zinc followed by incubation (37°C, 5% CO2) at various time points (12 to 72 hrs).Viability and proliferation of Raji cells were then evaluated with florescent (10μl Ethidium-Bromide and Acridine-Orange) staining. Data analyzed by SPSS software (Dunnet and Analysis of variance tests). The Raji cells showed different responses to different amount of Zinc. Zn had no effects on cell line up to 100μM at different incubation time points when compared to the control. At higher concentrations (200-500μM), viability diminished significantly at 12 and 24hrs of incubation times when compared to the control (p<0.05). We conclude that Zn has dose-dependent cytotoxic effects on Raji cell line and probably it could be used for immune-modulation.

Food insecurity and hunger not only affect physical health, but also have social and psychological effects. Therefore, providing food security for society is one of the major goals of social and economical development programs. The objective of this study was to determine the prevalence and intensity of food insecurity at North West of Tabriz as a population sample of East Azerbaijan province. This cross-sectional study was conducted on 300 subjects, 18-78 years old (168 females and 132 males) that were selected by simple sampling method. Demographic questionnaire was completed and information related to food consumption was collected by using 24- hour's food recall questionnaire for three days a week (one holiday and two days at the middle of the week). Hunger index was determined as inadequate intake of energy and hidden hunger index as inadequate intake of the key nutrients (energy, vitamin A, protein, riboflavin, calcium). Data were analyzed by Nutrition III software. The prevalence of hunger and hidden hunger were 26% and 41.6% respectively. All of the subjects with hunger consumed calcium less than recommended levels. They also consumed riboflavin, protein and vitamin A 94.8%, 74.3 and 56.4% lower than recommended levels respectively. Subjects with hidden hunger consumed calcium, riboflavin, protein, and vitamin A 89.6%, 77.6%, 19.2%, and 9.6% lower than recommended levels respectively. Only 32.3% of subjects were secure in terms of getting all those five key nutrients, i. e. energy, protein, vitamin A, riboflavin and calcium. Food insecurity in this area is prevalent, therefore programming for taking the edge off it and giving correct information on sufficient, varied and balanced diet is recommended.

Painless delivery using IV sedation is a method in which the pain and anxiety delivery process will be reduced by IV injection of analgesic and sedative drugs to the mother. In this method the health of neonate is taken into account. Neonate’s health can be measured by Apgar score system. This research was carried out to study Apgar score of the minutes 5 and 10 in neonates borne by painless natural delivery and Cesarean C. In this clinical trials study, 60 pregnant women referred to Bakhtar hospital for natural delivery and Cesarean were selected using census method including 30 painless deliveries and 30 women underwent Cesarean section. A questionnaire was filled out for each of them and those who had not any problem, were used as study group. Painless delivery through IV injection of Ketamine and Midazolam and Cesarean section through general anesthesia were done, and Apgar score in the minutes 5 and 10 in both groups were measured. No significant difference in term of parity and age was observed in the both groups. 90% of the painless group neonates in minute 5, and all of the neonates in the minute 10 had Apgar scores of 9 and 10. In Cesarean group, 20% of the neonates in minute 5, and 10% of the neonates in minute 10, had Apgar scores of 7 and 8. Mann – Whitney test showed no significant statistical difference between Apgar scores in the minutes 5 and 10 in both groups. All the neonates had Apgar score of 7 to 10. The average interval time between the two groups, was significantly different. Time interval was much more in painless delivery (11.83 minutes versus 5.5 minutes). Neonates of the painless delivery group, in comparison with Cesarean group, didn’t have low Apgar score despite the usage of analgesic and sedative drugs as well as passing of fetus from birth canal. Therefore, painless delivery with IV sedation is a safe delivery.

One of the most important events in everyone's life is the period of adolescence and maturity. The first factor for recognizing the real maturity in young girls is the first menstruation (monthly period). Although menstrual cycle is an inevitable event for females, most of them have not good information on it. The aim of this study was to assess the knowledge, attitude and practice of young high school girls on menstrual health in khoramabad in 2005. This research was an analytic descriptive study. 700 students were selected by systematic randomized sampling. Data collection tool was a questionnaire including 2 parts which completed in one step. Statistical inferential methods were used for analyzing the data by SPSS Version 11 software. Average age was 14.8 years. 52% had irregular menstruation. Menstruation period was 5-7 days in 40.7% of cases. 94.1% had good information on menstrual health. Cases have acquired their information primarily from their mothers. 50% had weak knowledge, and 30.1% had negative attitude and their practice was compatible with their attitude. The prevalence of dysmenorrhea was 15.9%. A great majority of cases had mood and behavioral disorders (fear, anxiety). There was a significant relationship between knowledge, attitude and practice with the resource of information, parental education and the job of the mother. It is necessary to train young girls, their mothers and teachers on menstrual health and the effect of factors such as nutrition, exercise, stress and personal hygiene on it. It is also a necessity to include regular exercise and menstrual health subjects in curriculum of high schools.

Cancer is a complex disease with high rate of mortality. At present, Radiation therapy is one of the most common procedures to overcome this situation. The deficiency of conventional method is the lack of fatal dose transmission into the malignant tissue. Hence, uncertain dose may cause regeneration of cancer cells, and relapse of the disease and invasion of the cancer cells to the other organs. Photo–electron therapy is a new cancer therapeutic approach which is based on the delivering of necrotic dose into the tumor however, no damage is applied on normal surrounding tissue. The aim of this study was to sketch out in vitro human cancer cell's survival curve, either by the use of photo-electron therapy or conventional radiotherapy and compare the efficacy of the two methods regarding their treatment benefit rate. The method of investigation was descriptive. The measurement was based on sketching out survival curve of cancer cells affected by either photo-electron therapy or conventional radiation therapy methods. Six groups of various human cancer cells were selected. Each specimen was studied by dividing it into four groups. Meanwhile, for any specific kind of cancer cells, the experiment was repeated ten times using various amount of incident beam energy, and the average of all ten repeats was used for sketching out the survival curves. The groups were as follows: Group (1) – Certain range of X-Ray energy, from a minimum up to a maximum of 400 centi Gy was applied to cancer cells via a photo-electron therapy method in ten separate time period. Group (2) –The same range of X-ray energy was applied to cancer cells by conventional method. Group (3) – Effective substance (means specific drug for photo-electron therapy) only. Group (4)– Control group. Less than 1% of Group 1 cells (Photo-Electron therapy treatment) were survived. 78% of Group 2 cells (conventional radiotherapy treatment) were survived which was almost equivalent to control group. In group 3 (unexposed cells) about 78% of the cells were survived. In group 4 (control group) about 78% of cells were survived. The effective substance is actually a drug which has specifically been used for photo-electron therapy. Exposing X-Ray beam energy was 250 kVp, hence, the cells were irradiated by 400 Centi Gy which is relatively low in present radiotherapy.

Hepatocellular carcinoma (HCC) is common all over the world as well as Iran. The incidence of HCC is higher in hepatitis B carriers and it is highly recommended to periodically screen these patients by serum alpha-fetoprotein (AFP) and liver ultrasound (US) every 6 months. We explore the diagnostic accuracy and the performance of (AFP) in cases of hepatitis B carriers as a screening tool by using serum total AFP concentration of 20 ng/ml. The study included 2452 HBsAg carriers with no evidence of hepatocellular carcinoma or cirrhosis were followed up in a 6-year prospective surveillance program with testing by ultrasound and alphafetoprotein every 6 months referred to the Ahwaz JundiShapour university hospitals and hepatitis clinic (1999-2004). Men and nonpregnant women with an elevated AFP level were evaluated for the presence of HCC by ultrasound (US) examination. Hepatitis B surface antigen (HBsAg), anti-HBc antibody and alpha-fetoprotein (AFP) were determined in all cases by enzyme-linked immunosorbent assay (ELISA). One or more AFP elevations (higher than 20 ng/ml) were found in 32 cases, but 13 (45%) hepatocellular carcinomas were detected in these patients during follow up (9 men and 4 women). Of the 32 HBsAg carriers with AFP serum levels of more than 20 ng/ml, HCC was not detected in 19 cases (65%). The positive predictive value for AFP to detect HCC was only 31% for our AFP cut-off value, and the sensitivity and specificity was approximately 56 and 88%, respectively.The positive predictive value for ultrasound examinations to detect HCC was 64%, while the sensitivity and specificity was 90 and 92%, respectively. We conclude that AFP alone is not a useful marker for HCC screening because of its poor predictive value and low sensitivity, particularly in patients with underlying viral hepatitis B without cirrhosis and is not recommended except when ultrasonography is either not available or of poor quality. Ultrasonography seems more efficient and accurate as a screening tool.

The simultaneous existence of two different abnormalities in a gene is referred to double heterozygosity. The most common form of it is the association of thalassemia and sickle cell disease, being termed sickle cell thalassemia. The aim of this research was to study all of the hemoglobinopathies in thalassemia major patients in Lorestan Province. This study was carried out as a census. 65 thalassemia major patients who referred to Shahid Madani Hospital of Khorramabad (and their parents) were tested by CBC and Hb electrophoresis. DNA samples of patients whose parents had hemoglobinopathy were analyzed by PCR with the mutations specific primers for the probable presence of double heterozygosity. The parents of 2 out of 65 patients had HbS. So, the presence of double heterozygosity in their sibling was suspected. There was no known mutation characteristic of this gene in both of two chromosomes. Two out of the total 65 thalassemia major patients in Lorestan Province suffered from double heterozygosity for beta thalassemia/HbS. So, it is necessary to do more studies on genetic aspects of thalassemia patients and their parents.