مجله دانشگاه علوم پزشکی رفسنجان
سال ششم شماره 1 (پیاپی 22، بهار 1386)

Tamsulosin hydrochloride (HCl) is an alpha-1 adrenoceptor antagonist and its ability to inhibit alpha-1 adrenoceptor is more than alpha-2 adrenoceptor. Due to the important therapeutic role of Tamsulosin HCl in benign prostatic hyperplasia (BPH), its side effects on the endocrine axes are also very important. The aim of the present research was to determine the effect of Tamsulosin HCl on serum level of testosterone and gonadotropins, and also on the spermatogengsis in adult male rats. In this experimental study, 40 adult male Wistar rats were randomly divided into 5 groups of 8. The experimental groups received 100, 300, and 600 mg/kg/day of Tamsulosin for 28 days. The sham group were treated with distilled water and the control group received nothing. The blood samples were taken on day 28 and the blood concentration of LH, FSH and testosterone were measured by RIA. Simulataneously, the testes of all rats were removed to assess the possible histological changes. The results were analysed using ANOVA and Duncan tests. The level of significance was considered at p≤0.05. The results indicated that at doses used in our study, Tamsulosin HCl had no significant effect on serum LH and FSH. However, this drug at high concentration was able to decrease the level of testostrone. Also, our histological studies showed a decrease in density of spermatoza in the seminiferous tubules in some sections only at high doses of the drug. According to this research and the results from other similar studies, Tamsulosin at high dose is possibly able to decrease the serum oncentration of testostrone through either the effect on steroidogenesis enzymes in testes, or its inactivation properties on adrenergic and serotonergic systems involved in steroidogenesis. So, it seems that alpha adrenergic receptor blockers possibly have some deleterious effect on spermatogenesis causing infertility in male rats. However further studies need to confirm these results.

Opioids, as drug of choice in acute pain treatment, have many side effects including dependency. Therefore, the combinational therapy of other drugs accompanied with opioids could decrease the side effects, tolerance and opioid dependency. In this study the effect of gabapentin and morphine co-administration was evaluated in acute model of pain. In this experimental study, the antinociceptive effect of gabapentin (30 or 90mg/kg, s.c.) and morphine (0.5, 1 and 3mg/kg, s.c.) alone or in combination with gabapentin were measured by Tail-flick test every 15 minuxtes up to 105 mins in intact adult male rats. Control rats received normal saline. Area Under Curve (AUC), as antinociceptive index, was calculated for each groups. Both gabapentin (90mg/kg) and morphine (1 and 3mg/kg) showed antinociceptive response as compared to controls (p<0.05). But there was not any significant differences between the (AUC) of 0.5mg/kg morphine and 30mg/kg gabapentin as compared to controls, so these doses were considered as subanalgesic doses. The co-administration of subanalgesic doses of morphine (0.5mg/kg) and gabapentin (30mg/kg) increased significantly AUC as compared to morphine alone (p<0.001). The co-administration of gabapentin (30 and 90mg/kg) with analgesic doses of 1mg/kg (p<0.005) and 3mg/kg morphine also increased significantly AUC antinociceptive index as compared to controls (p<0.05). Gabapentin enhanced the antinociceptive effects of both analgesic and subanalgesic doses of morphine in a dose dependent manner in acute pain model in male rats.

Atherosclerosis is the most important cause of death in hemodialysis and renal transplanted patients while hyperlipidemia and lipid peroxidation are considered major risk factors of it. For this reason, the most important goals of therapy are elimination of risk factors of atherosclerosis among these patients. Since peroxidation of lipids are a multifactorial process and all factors have not been investigated in one study, we decided to investigate, serum concentrations of total cholesterol, triglycerides, cholesterol contained of high density lipoprotein (HDL-c), concentration of albumin, total magnesium (Mg), malondialdehyde (MDA) and total antioxidant of these patients and compare the results with corresponding data obtained for age and sex matched control group. In this cross-sectional study, 30 patients who were on hemodialysis and 30 renal transplanted patients were participated. Parameters mentioned above were measured using sera separated from the fasting blood collected from the patients. Evaluation of these parameters were done by following protocols provided by the manufactures of the kits, The results obtained were compared with the corresponding data of 30 healthy persons who served as control group. In addition, the cholesterol contained of low density lipoprotein (LDL-c) was calculated and plasma level of cyclosporine was measured for renal transplanted patients. Evaluated data showed elevation in the serum levels of triglycerides (p<0.05), MDA (p<0.001) and decrease in the serum levels of total antioxidant among hemodialysis and renal transplanted patients (p<0.001). In addition, the serum levels of magnesium in hemodialysis patients were higher than control group (p<0.01), while it was lower in renal transplant patients (p<0.01). Finally, Serum albumin levels were significantly lower in the patient groups, when compared with control group (p<0.01). Pearson regression analysis showed a positive and significant correlation between triglycerides level and MDA (r= -0.47, p<0.001) and negative correlation with total antioxidant (r=-0.42, p<0.001). In addition, there was a negative and significant correlation between Mg and cyclosporine level (r=-0.44, p<0.01) among renal transplanted patients. In conclusion, present results demonstrated that cyclosporine is the most important cause of hypomagnesaemia in renal transplanted patients. Therefore, oral magnesium supplement should be used for these patients, when cyclosporine recommended. In addition, low levels of antioxidant detected among the patient groups suggest that prescription of oral antioxidant such as vitamin C and E could reduce the risk of atherosclerosis in these patients.

The bladder tumar is common in urinary system and its certain diagnostic method is cystoscopy that is a noninvasive method. In this study the sensitivity and specificity of the urinary FDP (Fibrin Degradation Products) in diagnosis of transitional cell carcinoma of bladder was determined and compared with urine cytology during the course of the disease. In this evaluation study of diagnostic test, 60 cases with confirmed bladder carcinoma admitted to Rahnemoon Hospital in Yazd were included. Urine samples were collected before any intervention for cytologic examination and also for checking the FDP according to manufacturer's instruction (FDP Aurateck Kit). Patients were randomy divided into three groups based on the stages and grades of the disease. Sensitivity and specificity of each test was also determined. Sixty urine samples were evaluated. Thirty four patients were male and 26 were female. Mean age of patients was 62.3±11 years. Sensitivity of FDP and Cytology in patients with grade I was 63% and 8%, in grade II 64% and 28%, and in grade III and also IV 89% and 50% respectively. These values in patients with stage Ta were 64% and 34%, in stage T1 and T2 65% and 22% and in stage T3 and, T4 63% and 43% respectively. Overall, the sensitivity of FDP was 68% and for cytology was 38% (p<0.005). The positive predictive value for FDP was 100% and the negative predictive value was 30.4%. Our study showed that urinary FDP is a valuable diagnostic test which has greater sensitivity and specificity than cytology in bladder carcinoma and its accuracy is not affected by the stage and grade of the tumor.

During the cataract surgery, after induction of general anesthesia and endotracheal intubation (ETI), the periorbital area is prepared and draped. For this purpose, the patient's head and neck is usually flexed 30 to 45 degrees. Neck flexion causes displacement of the endotracheal tube tip toward the carina. Stimulation of the tracheal mucosa especially during light anesthesia may cause bucking, increase in intraocular pressure (IOP), laryngospasm and/or bronchospasm. Laryngeal constriction and all of the components of the tracheal response may have some effects on end-tidal carbon dioxide pressure (PETCo2) and peripheral arterial hemoglobin oxygen saturation (SpaO2). In the current study, the influence of head and neck flexion after endotracheal intubation on the patient's heart rate (HR), systolic and diastolic blood pressure (SAP and DAP), SpaO2, PETCO2, and IOP was investigated for patients, who underwent cataract surgery during general anesthesia. In a double-blind clinical trial study, 106 patients aged 40-80 years were included according to ASA (American Social Anesthesia) physical status I and II. Anesthesia was induced with sodium thiopental, lidocaine and fentanyl. Atracurium 0.5 mg/kg was given to facilitate tracheal intubation. HR, SAP, DAP, SpaO2, PETCO2, and IOP were measured at 1, 2, and 5 minutes after head flexion. Data were then analyzed using Chi-Square and t-test, p< 0.05 was considered as significant. The means of SAP, DAP, IOP, and HR were increased after ETI, head flexion (p<0.05) and PETCO2, SpaO2 were decreased after ETI, also after 1 and 2 minutes head flexion compared with the baseline values (p<0.05). It can be concluded from this study that for patients undergoing cataract surgery during general anesthesia, endotracheal tube movement along with changes in head and neck position may have a significant effect on heart rate, systolic and diastolic blood pressures, laryngeal reflexes, SpaO2, PETCO2, and intraocular pressure. Accordingly, an adequate monitoring of these vital parameters during anesthesia is warranted.

Child abuse and neglect of children referred to the physical, psychological, emotional or sexual abuse, these circumstances result in detrimental impacts on health, welfare and education of children. Based on these considerations, the present study was conducted to investigate the prevalence of child abuse among addicts referred to the Rafsanjan Addiction Withdrawal Center in 2005. In this cross sectional study, 648 addicts randomly selected. A questionnaire was completed for each particpant and the data were then analysed using X2 test. The findings of this study showed that 81.9% of the participants were child abusers and 87.8% of them were 41-60 years old. The percentages of child abuse found in the participants with a history of parenteral drug-abuse, addiction in their families, divorce, physical harassment, and neglect during their childhood were 93.3%, 89%, 95%, 90.9% and 87.9% respectively. Slapping (17.86%) and deprivation of talking and attention (16.44%) were the most common type of physical child abuse and neglect. In 20.82% cases, the child abuse occurred at the withdrawal period of addiction. The most frequent feelings after child abuse for the child abusers were regret and sadness (36.87% and 35.25% respectively). This study showed that there is a direct relationship between child abuse and addiction to opiates. Also there are other factors related to child abuse including level of education, economic situation, a history of addiction and divorce in the family of child abuse victims. Therefore, the necessity of an organized care system for children and addicted parents and regulating of suppportive rules are obvious and of superme value.

Despite the voluminous amount of studies in the field of exercise sciences over the past three decades, there remains a paucity of information on the activity patterns and physiological responses to exercise in people with disability. The aim of this study was to investigate the effect of an exercise-rehabilitation aerobic program on the cardiovascular fitness, maximal oxygen uptake (VO2 max) and oxygen pulse for children with spastic cerebral palsy (Diplegia) and their comparison with healthy children. The experimental group for this semiexperimental study comprised of 18 (10-14 years old) diplegic spastic cerebral palsy children (CP) with average hight (131 ± 6.34 cm) and weight (29.83 ± 5.64 Kg) selected with the consent of their parents as well as specialist physician. Eighteen normal children were randomly designated as the control group. The variables of the experimental group were measured before and after the exercise-rehabilitation program according to Mac Master protocol on cycle ergometer at the laboratory conditions. Then these values were compaired with those of the control group. The experimental group performed exercise program for a period of three months, three times a week with intensity average 144 bpm of heart rate. Each session lasted 20-25 minutes for each subject. The exercise-rehabilitation program led to enhancement of the maximal oxygen uptake (VO2 max) at the patient group. The oxygen pulse (VO2/HR) of the patient group was significantly lower than that of the normal group and the exercise program improved this variable (p<0.05). This study indicated that in the spastic patients the lack of activity and being sedentary for a long time increases spasticity, the involuntary movements lead to a decrease in cardiovascular fitness and aerobic capasity and an increase in energy cost during exercise or daily activity as compared with normal people. The Rehabilitation program and exercise, even for short time or at low intensity leads to an improvement in the variables under study and enhances cardiovascular efficiency in these patients.

There are few studies on application of Demineralized Bone Matrix (DBM) in presence of a disease, such as type I diabetes. The aim of this study was to determine the osteoinductive and osteoconductive effects of DBM on the repair of alveolar bone in diabetic rats treated with insulin. This experimental study was carried out on 50 adult male (8 weeks old) rats (200-250g body weight). The animals were divided into four groups as follow: first group, containing 8 animals, as control group and second, third and fourth groups, containing 14 animals (in each group), were diabetic groups. Diabetes was induced by alloxan. Among the diabetic groups, only group 4 received 1 unit of Insulin NPH daily. After 10 days, the upper right incisor tooth was extracted and the socket was filled with DBM in groups 3 and 4. At the end of the first and second weeks, half of the rats in each group were decapitated. The specimens were prepared and stained with H&E (Hematoxylin-Eozine) method. The histological changes around the DBM particle showing osteoblastic activity were studied. In group 4, at the end of first week, osteoblastic activity and formation of bone trabecula and collagen fibers(5 from 7 animals), and at the end of second week, osteogenesis with formation of more and thicker bone trabecula in vicinity of DBM was observed. In group 3, at the end of first week, osteoinductivity and osteoconductive effects were seen in some area around DBM Particles (3 from 7 animales), meanwhile degeneration of bone matrix were seen by osteoclastic activity. At the end of second week, osteogenesis was dispersly seen. In group 2, hematom and inflammation were the dominant features at the end of first week and at the end of second week, osteogenesis was seen weakly. In group 1, histological findings at the end of first and second weeks, were osteogenesis around periodental ligament (PDL) and osteogenesis with formation of bone trabecula respectively. our results indicated that DBM particles can stimulate undifferentiated cells to start differentiate to pro-osteoblast and osteoblast in control diabetic rats, so osteogenesis in this group, was better in comparison with other diabetic groups and it is a good mater for graft.

One of the great challenges in dental practice is root perforation sealing. At present time, there are two therapeutic methods for perforation, filling and surgical removal of affected area. In this in vitro study, we compared the sealing ability of two implanted materials, Iranian domestic Mineral Trioxide Aggregate (Root MTA) and foreign (Pro root MTA). In this experimental study, 58 selected maxilary and mandibular molar teeth were assigned into four experimental groups of 13 teeth and 2 groups of three teeth as control. Availability of the cavities was assessed prior to perforating of the furcal areas utilizing a No. 2 round bur. The defects were then filled using foreign MTA (Pro root) and Iranian MTA. All of the subjects were incubated for 72 hours. In the next step, nail polish was applied in two layers to the surfaces of the teeth, except for the perforation areas and coronal portions which were filled with Amalgam. Once the nail polish dried, they were placed into 2% fuchsine solution for 12 hrs. The teeth were then mesio-distally resected using 72mm disk and evaluated separately by two endodontists using a stereomicroscope with a magnificantion of × 20. Data were analysied by T-test and ANOVA. Results indicated that there was a significant difference between the two groups regarding dye leakage (p=0.025). Pro MTA showed a lower leakage compare to Iranian MTA (root MTA). The quality of Root MTA as a filling material may need to be improved in order to gain enough qualification as an alternative to Pro root MTA.

Nowadays, dentofacial deformity is one of the most common problems which can influence all aspects of human's life. Howerer, not all people with these deformities are aware of their problem and even refuse to seek orthodontic treatment. The aim of this study was to assess the need and demand for orthodontic treatment among guidance school's pupils in the year 2005- 2006. In this cross sectional study 750 students including 420 girls and 330 boys from guidance school were examined. The clinical occlusal relationships were evaluated, then the need for orthodontic treatment was estimated by using Index of Treatment Need (IOTN). Demand was assessed with a closed questionnaire containing reasons for acceptance or refusal of orthodontic treatment. Overall frequency of malocclusion was 50.55% with a higher frequncy among girls (p<0.05), compare to boys 41.53% of the pupils, most of them with increased overbite, sought orthodontic treatment. The demand for treatment was the same in boys and girls in mild malocclusions, but in severe cases girls had more demand. The demand rate was significantly higher in pupils with high socioeconomic levels (p<0.05), parents education had no significant effect on this value. Considering our findings, seeking orthodontic treatment in pupils with dentofacial deformity is not based on parent's education, but economic condition is a major limiting factor in this field.

The immunosuppressive effects of high doses of ionizing radiation have long been known. Recently, in human and experimental animal models it has been reported that low dose radiation may have immunostimulatory effects. The aim of this study was to evaluate the effects of low doses of diagnostic X-ray on cell mediated and humoral immune responses in a Balb/c animal model. In this experimental study, three groups of male Balb/c mice were exposed once, twice and three times to 30 mGy X-ray radiation. Two to 4hrs after the irradiation, the delayed type hypersensitivity (DTH) and humoral responses to sheep red blood cell (SRBC) were measured and compared to the responses of sham and control groups. The mean titer of anti-SRBC antibodies in two-times irradiated (74.66±26.12) and three-times irradiated (128±70.1) groups were significantly higher than those of the control (26.66 ± 8.26) and sham (28.8 ± 20.86) groups (p<0.001). However, no significant differences were observed between the mean titer of anti-SRBC antibodies in one-time irradiated (22.4±8.76) and either control or sham groups. Similarly, comparing DTH responses showed that the differences between either two-times irradiated (12.2±3.9) or three times-irradiated (6.9±3.7) and control (4±0.2) or sham (4.3±3) groups was statistically significant (p<0.001). Theses results showed that twice and three-times irradiated mice demonstrated significant stimulatory effects on both DTH and antibody responses. However, one-time irradiated animals did not exhibit any bio-positive effect on DTH and humoral responses. Moreover, no statistically significant difference was observed between the DTH and antibody responses of two-times and three-times irradiated mice.

Hymenolepis is a comman parasitism disease in the developing countries that usually is manifested with nonspecific symptoms and this desease diagnoses accidently. In this case report, a 6 year old boy sufferd from fever, tremor, meningismus, weight loss and abdominal pain has been described. Case Report: He had experienced a weight loss of about 5 kg and reported a periodic fever predominantly at nights for 2-3 months. Primary tests including, CBC, Urine analysis, Stool examination(S/E) and LP were normal. Clinical examination showed three mobile submandibular lymph nodes with maximum size of 1×1 cm. A solid and tender epigastric mass extended to the umbilical region was also detected. The abdomen was soft with no organomegaly. Abdominal sonography confirmed the presence of a hang mass 66 x 25mm in size, located between aorta and superior mesenteric artery in epigastric region causing a space between aorta and superior mesenteric artery was detected. CT-Scan showed mesenteric lymph nodes as multiple and integrated masses. The report of MRI, performed to exclude brain metastase and the MRI was normal. In bone marrow aspiration and biopsy, megakaryocytes and hypereosinophilia and an increase of PMN were detected. Since the signs and symptoms including headache and lethargy continued, an explorative and therapeutic laparatomy was conducted. The second stool exam after operation was positive for H.Nana eggs. Liver biopsy showed an eosinophilia. The patient was treated with niclosamide. The patient's clinical presentation improved four days after treatment with no changes in the size of mass prednisolon was added to niclosamide. The mass was reduced 10 days after treatment and S/E turned to negative for H.nana egg. The patient was discharged and after month, there was no sign of the mass in abdominal sonography. The patient completely recoverd in the next year but the serology test of H.nana remained positive. In conclusion, in the light of this case the results of other similar studies, we suggest that H. nana be included among the intestinal parasites to be investigated in newly arrived children from low hygiene areas. Because H.nana infections may presrnt with unusual and nonspecific manifestations.