مجله دانشگاه علوم پزشکی رفسنجان
سال ششم شماره 3 (پیاپی 24، پاییز 1386)

Seretonergic pathway is one of the neuromodulatory mechanisms which mainly originates from dorsal raphe nucleus (DRN). In order to explore the role of serotonin on sensory processing, we investigated the effect of DRN stimulation on response properties of the IV layer and V neurons of whisker related area of rat somatosensory cortex. In this study twenty adult male Wistar rats (250-350gr) were used. DRN was stimulated at 0, 50, 100, 200 and 400ms before principal or adjacent whiskers deflection individually or in a condition test paradigm. For assessing the effect of DRN stimulation on inhibitory receptive field of barrel neurons, adjacent whisker was also deflected 20ms before principal whisker deflection. DRN stimulation decreased the On response magnitude of layer V neurons to principal whisker deflection (p<0.05). The On response latency of the layer IV of neurons increased when DRN was stimulated 200 or 400ms before principal whisker deflection (p<0.05 and p<0.01 respectively). DRN stimulation had no effect on both the On response magnitude and latency of neurons to adjacent whisker deflection. We observed a decrease in inhibitory effect of adjacent whisker deflection on the magnitude of neuronal response to principal whisker deflection on the IV layer when DRN was stimulated 200ms before principal whisker deflection (p<0.05). Our results suggest that DRN have a modulatory effect on information processing in somatosensory cortex of rats.

Estimation of the gestational age (G.A) and the estimated date of confinement (EDC) are of paramount important factors in prenatal care units. Naegle’s rule is a usual method for determining GA and EDC based on the LMP in which 7 days added and 3 months subtracted. Nowadays sonography is one of the routine methods for estimating date of delivery and gestational age. The aim of this study was to determine the accuracy of Naegele's rule and sonography for estimating of delivery date. In this analytic-descriptive study, a total of 260 pregnant women from the Yazd prenatal care clinic were equally divided into second and third trimester. The EDCs of these ladies were determined by Naegele's rule and sonographic BPD and FL measurement. The values of these two methods were then compared with actual onset of the spontaneous labor. The difference between EDC based on the Naegele's rule and actual onset of labor was (-5) - (+8) days. However, this value changed to (-1) - (+18) when performed sonography was based on EDC. The derived means were 2.21 days for the Naegele's rule and 4.32 days for sonography at the second trimester, and at the third trimester, these figures were 2.42 days and 9.20 days respectively. The results suggest that the Naegele's rule is more accurate than sonography for the determination of EDC, and these methods especially sonography become less accurate with increasing gestational age.

Both preoperative oral dextromethorphan (DM) and IV clonidine attenuates arterial blood pressure and increases the heart rate during tourniquet inflation. Effect of preoperative oral clonidine on these variables was not investigated. We designed this study to compare the effect of preoperative oral DM or clonidine on hemodynamic changes during tourniquet inflation in patients undergoing lower limb surgery under general anesthesia. Seventhy-five patients were randomly assigned into three groups DM (n= 25 DM 30 mg), Clonidine (n= 25 clonidine 3 µg/kg), and control (n= 25 placebo) groups. DM, clonidine, or placebo was given orally ninety minutes before induction of anesthesia. Systolic, Diastolic, Mean arterial blood pressure (SAP, DAP, MAP), and heart rate (HR) were measured at 0, 30, 45, 60 min after the start of tourniquet inflation, before tourniquet release (BTR), and 20 min after tourniquet deflation (20 ATR). SAP, DAP, and MAP were significantly lower in the Clonidine group compared with control after 45, 60 min tourniquet inflation and at BTR (p<0.05). Twenty minutes after deflation, DAP and MAP in the control group was still increased significantly compared with the clonidine group (P< 0.05). Preoperative oral Clonidine 3µg/kg significantly prevented tourniquet-induced systemic arterial pressure increase in patients under general anesthesia better than oral DM.

Previous studies, have been shown the anti-inflammatory effects of the trifluoperazine. The present study was performed to investigate the role of hypothalamus-pituitary-adrenal (HPA) axis activity as a possible mechanism for these effects. This experimental study was carried out on 100 male rats. Inflammation was induced by intraplantar injection of 0.1 ml of 0.5% carrageenan solution in to the rat’s left hind paw. Rats were divided randomly into three groups of control, the adrenalectomized (ADX) and the CRH antagonist receiving group. Adrenalectomy was performed bilaterally on the rats. The CRH antagonist at 20 µg/rat was administered intraventriculary, and Trifluoperazine (0.2 and 8 mg/kg) was used intraperitoneally (i.p) on the rats. Four hours after injections, paw edema was assessed by calculating the volume changes and extravasations of Evans blue dye. Furthermore, the serum levels of prolactin and ACTH were measured. Both doses of trifluoperazine significantly reduced the paw volume and tissue content of Evans blue dye in the control and ADX rats. Therefore, the paw edema induced by carrageenan, was reduced in the control and ADX groups by 48% and 65%, and the tissue content of Evans blue dye was decreased by 60% and 20% respectively. In the CRH antagonist receiving rats, different doses of drug reduced the volume of inflamed paw by 50%. Adrenalectomy induced an increase in the ACTH level 9 times more than control and both doses of the trifluoperazine blocked this elevation by 82%. Adrenalectomy procedure had no significant influence on plasma level of prolactin. These results suggest that trifluoperazine may have an in-vivo anti-inflammatory effect on experimental model, which possibly is independent of HPA axis activity.

The epidemiologic studies have demonstrated that decreasing the Helicobacter pylori (H. Pylori) infection will increase the rate of gastro esophageal reflux disease (GERD). It also, has been shown that patients suffering from GERD have less episode of the H. pylori infection. In this study 9500 patient recorded files from a private clinic were evaluated to study the prevalence of GERD after complete eradication of H. Pylori infection. The inclusion criteria were: symptoms such as dyspepsia, peptic ulcer disease or gastroduodenitis due to H. pylori infection confirmed by positive rapid urease test(RUT) with the absence of endoscopic examination or clinical signs of GERD. H.Pylori condition and signs of the GERD were considered in the second endoscopy examination. Patients with H. Pylori negative in the second endoscopy examination, were considered as case group, and those who were positive for H. pylori, considered as control group. New incidence of GERD were studied in both groups. A total of 100 patients were included in the study in which, 81 patients were nominated as case group and 19 in control group. The patient’s mean age for case group and control group were 37.6+12.6 and 37.4+12.2 years, respectively. Forty-nine percent of case group and 52.6% of control group were male. The duration mean between the first and the second endoscopic examinations was 29.4+7.9 months in case and 32.1+10.1 in control group. The incidence of GERD in case and control groups was 38.3% and 15.8%, respectively. There was no significant difference in age, and gender as well as duration interval between the first and second endoscopic examinations in both the case and control groups. The incidence of the GERD in H.pylori negative patients (case group) was significantly higher than the control group (p=0.05). Eradication of H. pylori can cause gastro-esophageal reflux. Therefore, when H. pylori positive patients treated for their infection, the GERD should be expected in a considerable number of them.

Giardia Lambelia is a unicellur parasite, and has been recognized to be the most common intestinal pathogen worldwide specially in the developing countries. The Giardia agent has been implicated as a common cause of diarrhea in children of daycare centers. Therefore, regular and continuous investigation of this infection is necessary to control and and contain the epidemic of this disease particularly at the children nurseries. The present study was performed to determine the prevalence of giardiasis at Rafsanjan's nurseries in 2003. This cross sectional study was accomplished on 252 children who were selected randomly with the mean age of 5.33±0.96. All relevant variables including age, sex, type of nursery, parent’s job and education, and past history of parasitic infectious disease were gathered from all the participants. Three stool samples were collected from chidren on an every other day basis. The samples were examined using direct and formalin-ether methods. The positive reports were then statistically analyzed. Of all 252 participants, at public nurseias 140 girls (55.56%) and 112 boys (44.44%), the stool exams of 44 children (17.5%) were positive for giardiasis. Twenty seven of the infected children were male. The percentage of giardiasis in children whose mothers were housewife with low education was 22.4% (19 cases). This value among children with poor personal hygiene and with a history of parasitic infectious diseases was 44.4%, and 69.2% respectively. based on our findings, giardiasis still must be regarded as a hygienic problem especially in public nurseries and it can be prevented by continuous public education, and regular training of health workers focusing on improvement of personal hygiene

Due to widespread of palpable breast masses in female and common complications resulted from delayed diagnosis and also with some regards to contradictory reports upon the accuracy of fine needle aspiration (FNA) in comparison with standard method of excisional biopsy this study has been performed on patients with palpable breast mass referred to the Aayatollah Talegheni Hospital between years 2003 and 2005. The present study was based on evaluation of diagnostic methods. Seventy five patients were included in this research and the mean of their age was 44±10 years (ranged from 20 to 75 years). FNA was accomplished initially by skin prep with alcohol and holding the lumps between thumb and point fingers. After the needle (No 22-25) was placed into the lump, a continous suction was generated using a 10 ml syring and then multiple in and out needle motions were performed. The collected samples were then smeared on glass slides and allowed to dry out in air and fixed by 96% alcohol. The fixed smears were then stained and examined by a pathologist. Lesions with cystic character were drained and excluded from the study. FNA results were reported according to the latest classification of breast masses as follow c1: inadequate sample, c2: benign, c3: semibenign, c4: semimalignant, c5: malignant (c3 & c4 assumed as indeterminate group). The total efficiency of FNA for detection of palpable and malignant breast tumor was determined based on, the pathology reports on excisional biopsy (as a gold standard method), the level of sensitivity and specificity, positive and negative predictive values, and also the overall efficiency of FNA. .4 cases of drained cystic lump were eliminated from the study. The amount of sample were inadequate for FNA study in 11 biopsy cases (14.7%). Nine biopsies (15%) were identified as indeterminate, 43.3% as benign, and 41.7% malignant, which were compatible with the results of excisional biopsy. Therefore 100% (all) of the positive and negative predictive values were obtained. The FNA is a suitable method for diagnosis of malignancy in palpable breast tumor, and hense it can be recommended for this purpose.

Onion (Allium cepa) bulb from Liliaceae has antioxidant, spasmolytic and antihypertensive activities. The goal of this study was to investigate the effect of onion peel extract on the rat ileum contractility. Onion peel powder was extracted by maceration in 70% alcohol for 72 h. A terminal portion of ileum from Wistar male rat was dissected and its contractions were recorded isotonically in an organ bath containing Tyrode solution (37 ºC) under 1 g tension. Cumulative concentrations of the extract (0.1, 0.2, 0.4 mg/ml) reduced the ileum contractions induced by KCl (60 mM) and by carbachol (10μM) dose-dependently (p<0.0001). The spasmolytic effect of extract was not reduced by tissue incubation with propranolol (1μM, 30 min), naloxone (1μM, 30 min), L-NAME (100μM, 20 min), glibenclamide (10μM, 5 min) and neither by tetraethylammonium (1mM, 5 min). In Ca2+-free with high K+ (60mM) Tyrode solution, the extract (0.0125-0.1mg/ml) reduced the ileum contractions induced by cumulative concentrations of CaCl2 (0.225-2.7 mM) dose-dependently (p<0.05-p<0.01). Onion peel extract reduced the ileum contraction, however, neither the β-adrenoceptors opioid receptors, nor the potassium channels activation were involved in this activity. It seems that the voltage dependent calcium channels are involved in the spasmolytic effect of the extract. Nevertheless, the quercetin extract might be responsible for this activity.

The Hemophagocytic Lymphohistiocytosis (HLH) is a rare disease with the pathologic hallmark of having aggressive proliferation of activated macrophages and histiocytes in the tissues and organs, which phagocyte other cells. The Incidence of HLH was estimated to be 1 case per 50000 – 300000. Case report: A 50 days infant was referred to Shahid Sadoughi Hospital with hepatic manifestations such as ascites, hepatosplenomegaly, markedly elevated liver function tests, herniated umbelical cord, abnormal coagulation profiles, and the bone marrow revealed HLH. Unfortunately the parents did not permit the appropriate treatment to be done and the infant died at age of 90 days old. since the HLH have nonspecific clinical signs, it should be considered as differential diagnosis of neonatal liver disease, especially when it is accompanied by cytopenias.