مجله دانشگاه علوم پزشکی شهرکرد
سال نهم شماره 2 (پیاپی 34، تابستان 1386)

Nitric oxide (NO), an active and non-stable compound, has been shown to regulate many sperm functions such as acrosome reaction and sperm chemotaxis. The aim of this study was to investigate the effects of NO and cGMP in the progressive motility of human sperm. After incubation of twenty normozoospermic samples for 90 minutes in the presence of ODQ (soluble guanylate cycles inhibitor), GSNO (NO donor), 8-br-cGMP (cGMP analogue) and ODQ+GSNO, the progressive motility were assessed by CASA system. Data were analyzed using paired t test. Progressive motilities of sperm increased 4.1% in intubation with GSNO at min 90th (p<0.05) and 4% in intubation with 80bromo-cGMP at min 60 (p<0.05). ODQ significantly (p<0.05) decreased progressive motility in the amounts of 10.7% at 30 minutes, 11.2% at 60 minutes and 12.2% at 90 minutes compared with their controls. ODQ+GSNO also significantly (p<0.05) caused to be decreased progressive motility in the amounts of 9.7%, 10.8% and 9.9% orderly at 30, 60 and 90 minutes in comparison to their controls (p<0.05). NO regulates the progressive motility of human spermatozoa via cGMP synthesis.

Leishmaniasis is a group of diseases with various clinical pictures, which is caused by Leishmania spp. This parasite causes disease in human and about one hundred animal species. The disease is widely distributed in Iran and also across the world. One of the best approaches in the development of vaccine against Leishmania is genetically modification of the parasite. Therefore, the aim of this study was to design a novel genetic construct in order to insert Herpes Simplex Virus thimidine kinase (HSV-tk) and Yeast cytosine deaminase (Yeast-cd) suicide genes into the Leishmania genome. In this work, at the first step, HSV-tk and Yeast-cd fragments along with a gene of Leishmani, α-tubuline were cloned into pBluescript vector and the arrangement of tk-αtub-cd was created. Subsequently, these fragments were cut off from the plasmid and sub cloned into the plasmid pF4X1.4.4sat. The final construct was confirmed by digestion with relevant restriction enzymes. The fragments tk-αtub-cd was cloned successfully in the plasmid pBluescript and its authenticity was confirmed. Subsequently, this genetic collection was inserted into the plasmid pF4X1.4sat and finally, the orientation of it was checked. The construct designed in this study was able to insert two cellular suicide genes HSV-tk and Yeast-cd into the Leishmanai genome. Thus, this is an approach in achievement of vaccine against Leishmanai in the coming up researches.

Immobility and hypertension (HTN) are known risk factors for coronary heart disease (CHD) and crebrovascular accident (CVA). Blood pressure control (in normal range) would prevent or postpone CHD and CVA. Non-pharmacological method is one of the most important measures in control of high blood pressure. Therefore, the aim of this work was to investigate the effect of low intensity aerobic exercise on blood pressure of employees with essential hypertension. This is a quasi-experimental study in which, 36 male employees suffering from hypertension who referred to the health facility centers of Boroujen, participated in a low intensive exercise program for four weeks, three times (each one, 20-30 min.) a week with intensity of about 50%-60% maximum heart rate (MHR). Before beginning of the exercise, immediately after that, and one week later, the parameters blood pressure, heartbeat, and body mass index and weight were measured. Using statistical methods (t test and analysis variance) the data were analyzed. The mean age of the subjects studied was 46.13±5 years. Before and after the intervention (exercise), the mean of systolic blood pressure (SBP), mean arterial pressure (MAP) and diastolic blood pressure (DBP), were 150.04±12 mmHg and 149.5±11 mmHg (p>0.05), 109.4±6 mmHg and 106.3±6 mmHg (p<0.01), and 109.4±6 mmHg and 106.3±6 mmHg (p<0.001), respectively. In the cases of heart rate, weight, and body mass index, no significant reduction was observed. Based on these results, the low intensity aerobic exercise is an effective method for the control of blood pressure.

Hypertension during pregnancy is an important complication with unknown etiology. Recent preventive measures were focused on increasing the bodys ability to confront oxidative stress. Since physical activity has an antioxidant effect, this study was performed to find the relationship between physical activity during the first 20 weeks of gestation and hypertension in pregnancy. In a case-control study, the length and intensity of physical activity were compared between two hypertensive and non-hypertensive groups of 97 pregnant women each. The two groups were not significantly different in the cases of age, body math index (BMI), education level, pregnancy age, and employment situation. The results showed that the level of physical activity during pregnancy in the women without hypertension (30.38±14.89) was more than that in the women with hypertension (14.63±12.24) during pregnancy (p<0.001). Also, both the intensity (low, medium (p<0.001), high (p<0.05)) and the duration of physical activity (p<0.001) in the group without blood pressure were more than those in the other group. The results showed that physical activity is an important preventive factor for hypertension in pregnancy.

Hydatid cyst is the larval stage of the tapeworm Echinococcus granulosus, a member of cestodes. This parasite causes echinococcusis in human and some other mammalians. To date, the different strains of the parasite have been reported across the world and this variation may affect the epidemiology and pathogenicity of the Hydatid cyst. Therefore, using polymerase chain reaction based restriction fragment length polymorphism (PCR-RFLP) this study was aimed to conduct the molecular characterization of the protoscolex stage of the parasite in Chaharmahal va Bakhtiary province, Iran. In this study, 30 samples of sheep-hydatid cysts were collected from slaughterhouses across the province. Subsequently, using phenol-chlorophorm method, DNA of the samples was extracted, and then the ribosomal DNA-internal transcribed spacer1 (rDNA-ITS1) fragment of each isolate was amplified using primer BD1 (forward) and 4S (reverse). The primers were either genus or species specific. Finally, the PCR products were digested using restriction enzymes Alul, RSal, Hpall, and Taql and subjected to electrophoresis and staining. The size of PCR product in this research was 1000 base pair (bp). Using Alu1 enzyme, two fragments of 800bp and 200bp were created. Rsa1 digestion also revealed two fragments of 345bp and 655bp. Digestion with HpaII enzyme, created two fragments of 700bp and 300bp. Finally, when Taq1 enzyme was used no digestion occurred. The final results of this investigation showed that the sheep-hydatid cyst strain in Chaharmahal va Bakhtiary province of Iran is G1, which is the same as sheep strains all over the world.

Background and Thalassemia is the most common hereditary anemia in Iran and around the world that needs regular transfusion. Transfusion may lead iron overload in the body. Absence or irregular therapy chelation (Desferal usage) in these patients leads to various complications that the most important of them are cardiac diseases. The purpose of this study was to evaluate the hazard rate of cardiac disease and related factors using COX model. This descriptive analytical study carried out on eight-hundred and six thalassemic (406 males and 400 females) patients referring to Cooley’s ward of dastgheib hospital of Shiraz were studied using a structured questionnaire through enumeration method. Age of occurrence, demographic information, age of onset and type of transfusion, and age of onset and method of chelation therapy were specified. Specialist physicians diagnosed the complications. Data were analyzed using descriptive and analytical (Proportional hazard rate and its confidence interval using COX model) statistics. In our subjects ages ranging were 1-43 years and mean±SD was 15.34±6.82 years. The prevalence of cardiac diseases was 15.9% that it was estimate among female and male 17.8% and 14%, respectively (p>0.05). The mean of age of onset of cardiac diseases was 16.93±5.43 years that it was estimate among female and male 16.41±4.8 and 17.58±6 years, respectively (p>0.05). There was a significant association between proportional hazard rate of cardiac diseases and age of chelation therapy onset and educational level of parents (p<0.05). Proportional hazard rate of this complication was not related to blood group, sex, chelating methods and type of transfused blood (p>0.05). Early onset of blood transfusion with late onset of chelating increases the occurrence probability and early onset of cardiac disease complications. For prevention of these complications, it is recommended that onset of blood transfusion be according to onset of chelating. Educational level of parents and education to parents and patients very important. Progression of complications is prevented by regular survey and early diagnosis of complications and leads to high efficacy of patients.

Recent studies have demonstrated that subcutaneous rout for opioid administration is a useful way for management of postoperative pain. The aim of this study was to compare the analgesic efficacy and adverse effects of intermittent intramuscular injection and subcutaneous morphine boluses after cesarean section. Sixty patients, aged 16 to 45, scheduled for caesarian section were randomly assigned to receive analgesia via either intramuscular (intramuscular group, 0.15 mg/kg) or subcutaneous injections of morphine (subcutaneous group, 0.15 mg/kg). Postoperative pain was assessed at rest and walking, using a visual analogue scale (VAS) every 4 hours. A Mini Mental Status examination was used to assess cognitive functions before surgery, at 2, 24 and 48 hours after surgery and at hospital discharge. Side effects were also recorded systematically during the first 48 hours after surgery. At rest, pain and overall analgesia satisfaction scores were not significantly different between the two groups. During mobilization, the subcutaneous group had lower pain score and it was significant at 12 hour, 16 hour, and 20 hour after operation (p<0.05). There was no inter-group difference in postoperative Mini Mental Status scores. The incidence of side effects was similar in two groups. It was concluded that subcutaneous morphine is a satisfactory alternative to intramuscular morphine after cesarean section.

With respect to the importance of family planning and the potential of emergency contraceptives in prevention of unwanted pregnancy, the present study was conducted to assess knowledge, attitude, and practice of emergency contraception in users of condom, withdrawal and rhythm methods. In this descriptive-analytical study, a total of 400 women who used tp condom, withdrawal and rhythm methods for contraception and referred to the health centers of Shahrekord were questioned for their knowledge, attitude, and practice about emergency contraception. Data were obtained using a self designed questionnaire including demographic characteristics, knowledge (8 questions), attitude (15 questions), and practice (4 questions) and were analyzed using t and Chi square tests. Of the women studied, condom, withdrawal, rhythm, and mixed method were used by 60.5%, 38.8%, 0.3%, and 0.5%, respectively. 78% of the respondents had information about emergency contraception. The knowledge of the users about the method was inadequate in 22.5%, moderate in 55%, and adequate in 22% of them. The attitude about emergency contraception was positive in more than 70% of the women, nevertheless, only 20.5% of them practiced emergency contraception and 69% of them liked to use these methods in future. The individuals aged ranging of 31-40 years old, the employed (p<0.001) and the high-educated persons (p<0.01) had more information about emergency contraception compared to others. In the individuals studied, the more information about the methods, the more practice in using of them (p<0.001). With respect to inadequate knowledge and practice of women and their positive attitudes about emergency contraception, it is suggested that the knowledge and attitude of health care providers about emergency contraception should be assessed and also, the education of the women about that is emphasized.

Histological grading is one of the most important prognostic factors in breast cancer. So far, there has not been any available method for quantitative estimation of tubular differentiation. Therefore, this study was aimed to evaluate the experimental and conventional method and compare the reproducibility of it with the other quantitative and semi-quantitative methods using 200 morphometric microscopic magnifications. In this descriptive-analytical study which, conducted in 2006, a total of 38 histological samples of breast invasive ductal carcinoma were selected and tubular differentiation was assessed by two pathologists using three methods. The first method (conventional), the rate of tubular differentiation (a portion of tumor with malignant tubules) to the total sample calculated and shown in percentage. The second one, was the fraction of fields showing tubular differentiation (FTD), and the third one was the subjective evaluation of each field and then considering the mean of all fields. Using Friedman test, the difference between the 3 methods was compared and Kappa test was used to compare the reproducibility of each method between the two observers. The results showed that using the second method, the scoring of the samples by the two observers was almost the same. It means that Kappa indices in the first, second, and third method was 0.4, 0.832, and 0.558, respectively (p<0.001). Also, Friedman test showed that there was statistically significant difference between the findings of each of the observers in any of the 3 methods used (p<0.001). Base on the results, FTD has higher reproducibility than that of other two methods. Thus, it can be used as a simple method in assessment of tubular differentiation.

Osteoarthritis is the most prevalent human joint disease and knee joint is the most common joint, which is affected in the disease. The most common signs of this disease are reducing of motion range and morning stiffness of knee joint. Therefore, this study was conducted to assess the effect of TENS technique, as a non-pharmacological therapy, on range of motion and morning stiffness of knee joint on patients with knee osteoarthritis. In this quasi-experimental and single blind study, a total of 57 patients with knee osteoarthritis who referred to Imam Khomeini hospital in Tehran in 2005 were randomly divided into two groups of case (29) and control (28). TENS technique (110 Htz) was administered to the case group for 4 weeks (3 times a week for 20 minutes). Then, range of motion and morning stiffness of knee joint measured in different times during the intervention in this group. The same situation was used for the control but with turn-off system (Placebo). Range of motion and morning stiffness of knee joint was measured in the two groups in the first season (beginning), sixth session and at the end of study. Data were analyzed using analysis of variance, KV, and t tests. The mean of motion range in the case group was 82.2±2.26 before intervention, and increased to 89.7±3.07 and 117±4.5 at the sixth session and at the end of intervention, respectively (p<0.001). In the control group, the mean of this parameter in different times of intervention was not significant. Moreover, in the two groups, there was not significant difference in joint morning stiffness in different times of intervention. Based on the results, TENS technique affects remarkably on range of motion with no effect on morning stiffness of knee joint in patients with osteoarthritis. Thus, this method would increase range of knee motion in patients with osteoarthritis.

Shortage and eventual weakeness of the Iliopsoas muscle is directly related to low back pain. Constant activity of the Iliopsoas in the straight posture along with its shortened position during sitting and lack of stretch of this muscle are probable causes of its shortening. This study aimed to determine the optimal duration of post isometric stretching to increase Iliopsoas flexibility. Thirty-eight girl students, 20-26 years old, were recruited for this clinical trial by simple sampling from Zahedan University of medical sciences. Subjects were randomly assigned as either a 5 second stretch group or a 15 second stretch group. The range of active and passive hip extension and hip flexion (degrees) during Thomas test were measured using Goniometer before and after 15 sessions of intervention. Post isometric stretching of Iliopsoas was carried out for 5 weeks, 3 times per week, lasting 2 min on each occasion for both groups. Data were analyzed using independent and paired t tests. In 5 second stretch group, passive hip extension was increased from 11.7˚±1.4˚ to 14.9˚±0.96˚ and active hip extension was increased from 10.1˚±1.58˚ to 13.7˚±1.03˚ (p<0.001). In 15 second stretch group, passive hip extension was increased from 11.8˚±2.4˚ to 16.3˚±2.4˚ and active hip extension was increased from 9.7˚±1.7˚ to 14.3˚±2.05˚ (p<0.001). Hip flexion during Thomas test was decreased from 14.4˚±1.18˚ to 4.3˚±1.4˚ and from 14.2˚±3.3˚ to 4.1˚±1.7˚ in 5 sec and 15 sec stretch groups, respectively (p<0.001). The results indicate that flexibility of Iliopsoas and consequently the range of hip extension were increased and hip flexion during Thomas test were significantly decreased using 5 second or 15 second stretch duration. No significant difference was found between two stretching duration in terms of muscle flexibility.

Coronary angiography is the golden diagnostic test for coronary heart disease. After the procedure, for minimizing the complications (mostly bleeding and hematoma) patients are restricted to bed rest for 8 to 24 hours that is always accompanied by patients back pain and discomfort. The aim of this study was to assess the effect of changing patients position on back pain, comfort, amount of bleeding and hematoma. Subjects were randomly assigned to the experimental (changing position) and the control group. Visual analog scale was used to measure pain intensity and comfort level, and a specific ruler was used to measure the amount of bleeding and hematoma. The experimental group had significantly lower pain scores and higher comfort scores than the control group at 3, 6, 8 hours, and at the next morning after angiography (p<0.01). Changing patients position according to the designed protocol produced no significant increase in the amount of bleeding and hematoma compared to the control group. The results showed that changing patients position after angiography is practically feasible, and is associated with decreased level of back pain and increased comfort level without increasing the amount of bleeding and hematoma.

The present case was a 13-year old boy who resided in a rural area in Kourang district from Chaharmahal va Bakhtiari province. He had a history of abdominal pain, feeling of filled stomach, loose stool (2-3 times per day), appetite, and weight loss over the past 3 months. He also observed small white motile worms in his stool. In the primary examination, a number of motile larva were isolated and kept in 10% formalin. Subsequently, using diagnostic procedures and morphological characteristics, Sarcophaga hemmoroidalis larva was identified.