مجله دانشگاه علوم پزشکی اراک
سال نهم شماره 2 (پیاپی 35، تابستان 1385)

The increasing use of EMF (electromagnetic field) generating apparatus (refrigerators, computers, TV, etc) caused an increasing interest in investigations of its adverse effects on human health. This study is done to investigate the effects of EFM on Balb/c mice. This is an experimental study in which at first a circuit generating low frequency electromagnetic field (50 Hz, 15G) was designed. Then adult virgin female mice were placed in coil and exposed to 15 gauss electromagnetic field for 4 day and 6 hour per day. Then their blood was examined to assay the level of hormones (FSH, LH, estradiol, progesterone). Also ovary and uterus sections were studied with light & electronic microscope. Results showed that the weight and size of ovary was not significantly affected in females exposed to the low frequency electromagnetic field and their offspring. Our results also showed that the number of ovary follicles were significantly affected in exposed females (p<0.05). Also the study of micrographs showed hetrochromatinated oocytes and follicular cells and increasing polysomes, accumulation of mitochondria and cleft nucleus. Decreasing amount of FSH, LH and 50% decrease in couplation rate was also seen as compared with the control group. Results of this study is indicator of EFM effects on gonads, structure and endocrine system and decreases fertility.

Performing correct research in different aspects of community as well as medical sciences can be a way to resolve many problems. In order to create a systematic knowledge of research method in academic members of Arak University of medical sciences and enabling them in providing proposals and performing researches, a clinical research center was developed. This study is done to investigate the effect of this center on improving clinical researches in the University. This is a HSR, before and after, interventional study in which, clinical academic members of Arak University of medical science were evaluated. First the information of the pre intervention period was gathered (jan2002-jan2004). Then the intervention was done in the form of developing a research center in Vali-Asr hospital, performing serial research workshops, research conferences, research consultations and planning data bases during a 2 years period. Again data was gathered and then compared to those of pre intervention period. The comparison of pre and post intervention periods showed that in pre intervention period from 38 proposals 30 and in post intervention period from 89 proposals 76 were approved by research committee of the University. In the two pre and post intervention periods 14(46.6%) and 50(65.8%) of accepted proposals were clinical respectively. Also from the view point of quality, 11 and 15 proposals were HSR, 2 and 22 clinical trials and 8 and 8 descriptive, respectively. The number of published articles in first period was 45 and in second 84. Presented articles in internal and external congresses were 33 and 59 in the two periods overally, which 25 and 51 articles were presented in the country and 8 and 8 in abroad congresses, respectively. Regarding the results it seems developing research center in this University and other similar Universities can have a significant effect on the process of clinical researches.

Patients` staying in recovery unit is associated with risks and complications and is expensive. Decreasing the duration of staying can both increase patients` safety and decrease hospital costs. Laryngeal mask airway (LMA) as a new instrument has been widely used for airway management and in this study, its effect on recovery time is investigated. In a double blind randomized controlled clinical trial, 62 ASA Ι & Π patients were divided into two equal groups. In one group laryngeal mask and in the other, tracheal tube was used. The anesthetic drugs were similar in both groups. Patients with upper airway infections, as well as patients undergoing thoracic and upper abdominal surgeries were excluded. Those with more than one hour duration of anesthesia and more than 30 seconds need for intubations were also excluded. Duration of anesthesia was measured in minutes. Duration of recovery staying (in minutes) and complications were also recorded. Data was analyzed using Chi Square and Mann Whitney U tests. There were no significant differences in age, sex and mean time of anesthesia between the two groups. But mean recovery time in LMA group with 10.65 minutes and tracheal tube group with 16.71 minutes was significantly different (P=0.007). Two patients (6.45%) in LMA and 11 patients (35.48%) in tracheal tube group developed complications during recovery period which was a statistically significant difference (P = 0.004). Laryngeal mask airway, decreased recovery time and the number and severity of respiratory complications. Complications such as cough, laryngospasm, bronchospasm, and arterial hypoxemia were significantly less in patients with laryngeal mask airway compared to patients with tracheal tube, so the use of LMA is recommended.

Infertility is an emotional crisis with physical, economic and psychosocial challenges, because it interferes with all personal life aspects. This event is a sever tension of life and produces strong emotional shock in the infertile couple. This study is done with the aim of comparison the psychiatric problems of infertile men and women referring to infertility clinic of Hamadan Fatemyeh Hospital. This is a cross-sectional analytical study. Sample size was 400 infertile men and women which were selected by convenience sampling. Data was collected by a demographic questionnaire and SCL90, and analyzed through descriptive statistics and independent T test. Our study indicates that infertile women experience mental problem significantly more than men. With p<0.05 infertile women in 9 categorize of SCL90 including depression, anxiety, phobia, psychosomatic, interpersonal sensitivity, hostility, paranoid ideation and psychotics are significantly different from infertile men. It seems women experience more stress in personal, social and sexual life and women are more sensitive to infertility phenomena that probably is due to cultural problems, mental susceptibility and/or special forms of social communication

The reason of infertility can have a direct influence on the plan and outcome of management. In this paper we intend to show the effect of tuberculosis (TB) history on female infertility among infertile couples attending to Rooyan infertility management center. In this case-control study our cases were those who were diagnosed as infertile female and controls were those women whose husbands were infertile due to some male factor. We used logestic regression for analyzing the association of history of Tuberculosis and female infertility with attributable risk estimation. 308 cases were compared to 314 controls. Considering the odds ratio and its 95% confidence interval, there was a significant difference between the history of TB and infertility (OR=4.7, 95% CI: 1.01-29.91). The attributable risk of TB for female infertility was 0.023±0.01 (which is significant at 5% level). These figures show that at least 2% of female infertility can be prevented by prevention and proper treatment of tuberculosis.

Permanent pacemakers are applied to treat some 2nd and 3rd degree AV blocks. Previous studies have shown the hemodynamic changes that may occur after pacemaker implantation. In this study, we have evaluated these hemodynamic changes from a different view point, with measurement of urinary sodium and blood pressure. This is a before and after clinical trial study in which 30 patients, who were hospitalized for permanent pacemaker implantation for the first time in Tehran heart center during 3 years, including 12 women (mean age 62.92 years) and 18 men (mean age 60.07 years), were tested for urinary specific gravity and sodium, blood pressure, blood sodium and potassium, before and after pacemaker implantation. Paired sample T test and Chi Square test were used for statistical analysis. Systolic blood pressure was 136.5 mmHg and 120.6 mmHg before and after pacemaker implantation, (P<0.001). Also, after pacemaker implantation, urinary sodium rose from 83.45 meq/L to 106.61 meq/L (p=0.018). This study is consistent with previous studies, which showed hemodynamic changes after permanent pacemaker implantation including decrease in blood pressure and elevation of serum neuropeptides.

Investigations has showed that prenatal exposure to Morphine causes drug dependency and behavioral complications in new born rats. In this study effect of prenatal Morphine on the development of basal ganglia in rat embryos is investigated. In this experimental study 36 female rats with body weight between 250-300 grams were selected. After crossing with male rats they were divided into six groups of 12days control-Morphine, 14days control-Morphine and 17days control-Morphine groups. Morphine groups received 0.01mg/ml Morphine through their drinking water until the 12, 14 and 17th day of pregnancy (20ml each rat). Then rats were anesthetized and embryos were taken out and fixed. Their body weight and crown-rump length were measured. Then 5 micrometers sections were provided and stained using H & E method which were then evaluated using mutic program. Body weight and length of embryos were reduced significantly in the 12&14th day of Morphine group rats in compare to their controls. The significant reduction of Basal Ganglia thickness was also found in all Morphine groups compared to their controls. Results showed that prenatal Morphine exposure may cause impairment in change development of Basal Ganglia.

Clonidine, as a premedicant in anesthesia, has a special role in decreasing anesthetic agent's dose and improving sedation. Because of its effects on body hemodynamics and electrolytes and the importance of these effects during anesthesia, we decided to investigate these side effects in this study. This is a double blind randomized clinical trial. Samples were 104 ASA Class Ι & Π, 20-40 years old patients, undergoing elective surgery and were divided equally into two groups (case and control). 90 minutes before induction of anesthesia, 5μg/kg Clonidine was given to the case and placebo to the control group orally. Blood samples were taken before and 4 hours after induction of anesthesia. Also 24 hours urine was collected and measured for volume and sodium and potassium concentrations. Data analysis was done using independent T test. There wasn’t any significant difference between two groups in the mean concentration of blood sodium and potassium before and after taking the drug. But the mean sodium and potassium concentration in urine was significantly more in the case group (P = 0.022 and P = 0.003 respectively). The volume of 24 hours urine was also more in the case group (P = 0.008). Although Clonidine induces diuresis and increases sodium and potassium excretion, blood concentration of these electrolytes doesn’t change significantly.

Idiopathic hypercalciuria (IH) has been recognized as a common disorder in childhood and is an important and common factor in formation of renal stones. Recurrent urinary tract infection is a clinical presentation of hypercalciuria. Regarding that Hydrochlorothiazide is effective in hypercalciuria treatment, therefore in this study we assessed the efficacy of Hydrochlorothiazide in preventing recurrent UTI in hypercalciuric girl patients. This research was a single blind randomized clinical trial. 100, 1 to 12 years old girls, who were followed by pediatric nephrology outpatient clinic in Vali-Asr and Amir Kabir hospitals, with the diagnosis of idiopathic hypercalciuria and at least two urinary tract infections in year, were included in study. Patients were randomly divided into two equal groups. First group received a general preventive treatment consisted of a liberal fluid, urination every 2 hours, reducing dietary salt intake, washing genitalia from front to back, wearing cotton loose underwear and complete urination. In second group, in addition to the general treatment, Hydrochlorothiazide was used with initial dose of 1mg/kg/day in a morning dosage.Then, urinary tract infection recurrence in two groups was assessed by student T test. All patients who received Hydrochlorothiazide were normocalciuric. In each group, incidence of UTI non recurrence was 34% (17 cases), that was not significantly different. This study rejected the presence of hypercalciuria treatment effect in preventing recurrent urinary infection. Therefore, the association between UTI and IH needs to be closely studied with the attention to eliminate confounding factors.

Therapeutic use of D-penicillamine is associated with several side effects. Proteinuria is the most common side effect of it, often due to membranous glomerulopathy. In this article we have reported a case of D-penicillamine induced focal segmental glomerulonephritis with systemic sclerosis. Case: In This article, we have presented a patient who had been under treatment with D-penicillamine and complicated by nephrotic range proteinuria resulting from focal segmental glomerulonephritis. Proteinuria was resolved one month after discontinuation of D-penicillamine without any additional treatment. She had no finding in favour of renal crisis of scleroderma. Such this pathologic form of renal involvment (FSGN) resulting from D-penicillamine has not been reported in the literature yet.