فصلنامه کومش
سال هشتم شماره 1 (پیاپی 21، پاییز 1385)

Stroke, cerebral ischemia, is the third largest cause of death and one of major causes of long-term disability in modern and development countries. Unfortunately, despite considerable efforts, no specific clinical treatment is approved for the cure of stroke. Therefore, the search for cure as well as understanding of the pathophysiology of stroke requires reliable and valid experimental models. Currently, several animal models of cerebral ischemia have been developed to evaluate potential therapies for ischemic stroke. Experimental models of cerebral ischemia are divided into global and focal cerebral ischemia. Focal cerebral ischemia is induced by occlusion of middle cerebral artery via craniotomy or embolic, while global ischemia induced by occlusion major nutrients arteries of brain and cardiac arrest. In summary, we discuss the most important animal models of focal and global brain ischemia in the present review article.

Follicle Stimulating Hormone (FSH) is one of the pituitary glycoproteines that it consists of two subunits; alpha and beta. The beta subunit is responsible for the biological activity of FSH. The aim of present study was isolation of the β subunit coding sequence containing its signal sequence from human genome and then cloning of the isolated sequence in pPIC9 shuttle vector under the control of AOX1 promoter and α factor signal sequence. the gene sequence of interest was isolated as a 2kb DNA fragment and cloned in pTZ57R vector resulting to pTV-2019 plasmid. The construct was used as template for modification of 5΄ region of gene upstream to ATG codon using PCR. Finally, amplicon was cloned in pPIC9 and the new construct named pPIC9F1. The sequence of FSHβ gene in pTV-2019 was confirmed by restriction analysis and DNA sequencing. In addition, restriction analysis and AOX1 primer-mediated PCR showed that pPIC9F1 has correct construction. The new construct, pPIC9F1, contains the coding sequence of FSHβ gene and its signal sequence (E2-IVS2-E3). Therefore, this construct can be used for integration of FSHβ gene into yeast genome exactly downstream to AOX1 promoter. Under this condition, a fusion protein is produced that it contains two signal peptides, α factor and FSH signal peptides. Yeast expression system is able to cleavage α factor. It seems this is the first attempt for cloning of human FSHβ in yeast expression system.

Administration of sodium valproate for treatment of psycho-neurological disorders has increased considerably. Polycystic Ovarian Syndrome (PCOS) is indicated as one of the side effects of long-term administration of sodium valproate. Therefore, more detailed studies are needed for assessment of the side effects of sodium valporate. Forty patients were randomly selected from the patients who referred to neurology and psychiatric clinics, sodium valproate prescribed for them. In all patients, FSH, LH and testosterone levels as well as ovarian size, BMI and the symptoms of hirsutism and menstruation irregularities were evaluated prior to and six months after treatment with sodium valporate. Mean level of BMI, LH, FSH and LH/FSH ratio was significantly increased following sodium valporate administration, compared to their levels prior to the treatment. No such effect was observed about the mean level of testosterone before and after the treatment. One of the patients showed the signs of PCOS, which they were ceased following discontinuation of the drug. The current results show that the administration of sodium valproate could lead to polycystic ovarian syndrome in some patients.

Orotracheal intubation is a common method for airway management in critical situations and for performing different surgeries in operating rooms under general anesthesia. Firstly, an ultra short- acting anesthetic is administered by intravenous (i.v), mask ventilation instituted and then the most common depolarizing muscle relaxant, succinylcholine, injected. Since succinylcholine and other muscle relaxants have some adverse effects, the current study was performed to present an alternative method for endotracheal intubation without muscle relaxants in some certain situations. The present study was a double-blinded clinical trial, which it is performed on 150 elderly patients in Nikocari Hospital, Tabriz. The patients were divided into two groups, study and control. The patients were elective and anesthesia technique was general anesthesia with endotracheal intubation. Patient selection was based on the physical status classification by American Society of Anesthesiologists (ASA). Therefore, the patients who categorized as class I and II of the ASA classification were selected. All the patients’ airway classification was class I with respect to Mallampati test. lidocaine 1-1.5mg/kg, midazolam 1mg, alfentanyl 30 μg/kg, and propofol 2mg/kg was administered for patients in the study group. Patients in the control group were received the following drugs: lidocaine 1-1.5mg/kg, midazolam 1mg, propofol 2mg/kg and succinylcholine 1-1.5 mg/kg. In the study, all the patients were intubated by an anesthesiologist who was not aware of the medications administered and airway classification. Data collection including the time of consciousness loss, jaw relaxation, quality of ventilation, vocal cards position, patients’ response to laryngoscopy, duration of laryngoscopy, was performed using a questionnaire. Statistical analysis was performed by SPSS software. 51.7% of patients were male and 48.3% were female. Average age of the patients was 61.19 ±12.06 year and their weight mean was 591.06Kg. Only 45% of the patients had a previous history of anesthesia and surgery, but none of them had an experience of difficult intubation. According to ASA classfication, 26.7% of the patients were in class І and 73.3% in class II. All patients had the capability of head extension and mouth opening more than 40mm. In the study group, loss of consciousness occurred in less than one minute and more than two minutes was respectively observed in 35% and 1.7% of the patients. No significant difference was detected between the study and the control group with respect to loss of consciousness. Jaw relaxation was very good in 86.7% of patients and ventilation was easy in 94.5% of patients in the study group. In the control group, jaw relaxation was excellent in 98.2% of patients and ventilation was easy about all patients. Vocal cords had an open and complete view in 91.2% of cases in the study group, while it was 94% in control group (p<0.05). In the study group, an easy laryngoscopy was reported in 85% of cases and the duration of laryngoscopy was 11±7.16 seconds, whilst, the duration of laryngoscopy was 10 ±6.08 seconds and easy laryngoscopy was observed in 90.17% of cases in the control group (p<0.05). Hemodynamic changes were sensible in both groups but SPO2 changes were not obvious. Only 17.9% of patients in the study group responded to intubation in form of feeble cough. No response was observed in the control group. Respectively, 96.8% and 98% of the patients in the study and control group did not experience any significant problem about respiratory system in postoperative period. Considering adverse effects of muscle relaxants used for airway management and necessity of performing endotracheal intubation without muscle relaxants by skilled and expert people, as well as given the study results, using this technique is recommend in patients with some certain criteria.

Neuropathic pain syndromes are changes resulted from damage to nervous system. Since, treatments of neuropathic pain are poorly understood, existing treatments are often ineffective, and also experimental studies have documented that MK-801, a NMDA receptor antagonist, attenuates neuropathic pain, the purpose of this study was to investigate the behavioral responses and involvement of pre-emptive treatment of morphine and / or NMDA receptor antagonist MK-801, in Spared Nerve Injury (SNI) model of neuropathic pain. Experiments were performed on six groups (n=8) of male Sprague-Dawley rats (230-280g). Two animal groups were injected MK-801 (0.3 mg/kg, 20 min before, and 6 h after the operation) or morphine (8 mg/kg, 30 min prior to the operation). The third group was received both drugs with the same doses and protocols. Finally, the fourth group was received an equal volume of saline. Then, SNI procedure was performed by a ligation and axotomy of the tibial and common peroneal nerves and the sural nerve was left intact. The animals were tested for allodynia and hyperalgesia reactions at 0, 3, 7, 14, 21 and 28 days after performing SNI procedure of the sciatic nerve. Statistical analysis was performed using repeated measures ANOVA and the Tukey HSD test. Our data revealed that the SNI produces mechanical and cold allodynia and a hypersensitivity to noxious stimulations. Co-injection of morphine and MK-801 markedly declined cold allodynia at the day 14 (P<0.05) when compared with the saline group. The results of present study demonstrate that SNI model importantly influences the behavioral responses to both thermal and mechanical stimulations. It seems that co-administration of both drugs attenuates neuropathic pain in rat.

Preeclampsia is a pregnancy-specific condition characterized by hypertension and proteinuria. Preeclampsia remains a disease of theories as its real etiology has remained elusive. Endothelial cell dysfunction may play a role in the pathobiology of preeclampsia. There is some evidence to suggest that endothelial cell damage result from oxidative stress. The aim of the study was to measure oxidative stress markers in preeclampsia.

Total antioxidant capacity (TAC), lipid peroxidation (LPO) and thiol groups was measured in 20 women with preeclampsia, 20 normal pregnant women and 20 nonpregnant women. All three women groups were matched with respect to age, BMI, parity and gestational age. Oxidative stress markers were measured by spectrophotometer methods.

Serum concentration of LPO was significantly higher in preeclampsia (17.7 + 3.8 nmol/ml) as compared with nonpregnant women (10.4 + 0.48 nmol/ml, p< 0.0001). TAC in preeclamptic women was lower than those in normal pregnant and non-pregnant women, but not statistically significantly. There was no significant difference between the mean concentrations of thiol groups in the women groups.

Increased levels of LPO products may cause peroxidative damage of vascular endothelium and result in clinical symptoms of preeclampsia. However, further experimental and clinical studies are necessary to clarify the pathogenesis of preeclampsia.

Anecdotes abound about obesity and obese person being ridiculed and society attitudes about obese persons are clearly negative and many of health care workers, also believes these myths. This study was performed to determine the attitudes of nursing students of Semnan University of medical sciences about obesity myths. This research was a descriptive-analytic study and was performed on 115 of the nursing students of the Semnan University of Medical Sciences in May 2006. Data was collected with researcher-made questionnaire, which it was composed of demographic data and 25 common myths about obesity. The myths were selected from the internet using key word "Obesity myths". We used 5-point Likert scale for the assessment of nursing student's attitude. Statistical analysis was performed by SPSS program using chi-square and spearman correlation test. The result of study showed that nursing students have anti-fat bias towards obese individuals and some of their attitudes need corrections, however, 59/1% of the students have positive attitudes about obesity myths (disagreement with obesity myths). Nurses are at first line of confrontation with clients and patients. Beliefs and attitudes of nurses can contribute to providing care of obese individuals. More education about obesity concept is necessary.

One faced to matched data when the main object for a study is investigation of the effect of a given factor on an outcome, such that the samples are matched on the some factors which are known as confounders. The response can be according to quantitative or qualitative scales. Matched case-control, before-after and crossover studies are used frequently in medicine. The significant tests are required to sufficient samples. In this paper, formulas for determination of sample size in matched studies are introduced by considering the scale of response and extended for matched case-control studies with multiple controls and illustrated using practical examples. Using statistical techniques, formulas for determination of sample size are introduced according to the scale of response. The practical examples interpreted in order to clarify the formulas and their applications. One can increase the power and the accuracy of the statistical tests for matched studies, using the introduced formulas.

Treatment effect of maprotiline at different doses (50-150 mg/d) as a tetracyclic antidepressant, with major effects on NEP and less anticholinergic side effects compared to some other tricyclic medications, has been compared with other medications. Given ethical and cultural differences as well as pharmacokinetic characteristics between Iranian populations, the current study was carried out to determine the effect of different doses of maprotiline in treatment of moderate MDD, its therapeutic ratio and related side effects in each dose, and also to define the effective dose of maprotiline. This quasi-experimental study was performed on the patients with moderate MDD who referred to psychiatry clinics. Thirty cases were selected from the patient with age between 25-50 years, with 20≤ BMI≤30, and without any systemic diseases. Firstly, HAMD-17 test was performed for all subjects and then they took 50mg/d of maprptiline. After two weeks, the subjects were visited again, in case of HAMD-17 < 50%, they received 25mg/d of maprotiline for another two more weeks until their depression was completely treated. Side effects were also checked at two-week intervals. Finally, the number of cured subjects, side effects and effective dose were defined. 27 out of 30 patients were followed up to the end of the study. They included 15 women (55.5%) and 12 men (44.4%) with mean age of 36.2±2.3 years. In dose of 50mg/d, 5 out of 27, in dose of 75 mg/d, 11 out of 22,in dose of 100mg/d, 6 out of 11, in dose of 125 mg/d, 3 out of 5 and finally in dose of 150mg/d the remaining 2 patients were cured. With respect to side effects, dry mouth was seen in 8 out of 22 patients received a dose of 75 mg/d and 7 out of 11 patients given a dose of 100mg/d. A significant difference was observed between the mean effective doses in the patients with past history of depression (105 mg/d) in comparison with patients without previous history of Depression (76.5mg/d) (P-value=0.01). The mean effective dose was calculated as 78.03 mg/d. The highest frequency of cure was seen in doses of 75 mg/d and 100mg/d with mean of 78.03 mg/d. Furthermore, the mean effective dose in the patients with a previous history of depression was higher than those without a previous history of depression. In addition, side effects were increased with higher doses of maprotiline. Regarding the restrictions of this study such as the lower number of samples in higher doses, further studies are essential to be conducted in this field.

Most of women have described labor experience painful. Although there are many ways for reduction of labor pain, pharmacological ways are unsuitable because of their side effects on the respiratory system of newborns and mothers. Therefore, scientists have focused on non-pharmacological ways for reducing pain, nowadays. These methods are different and this verity shows a fact, that the perception of pain is not identical among people. Gate theory advocates this believe that there are many factors on pain perception such as age, sex, anxiety, and pain experience. Therefore, it is necessary that we know variety of pain-relief methods. This study was carried out based on Gate theory. This survey was a single-blind randomized clinical trial. Informed-consent forms were given to the mothers. Sampling Method was based on simple non-randomized and the number of sample was 146. They are divided into two equal groups, test and control. Data collection was carried out using questionnaire. Following determination of four injection site at the sacrum area, mothers in the test group were injected 0.1 ml of normal saline at these sites. While, mothers in the control group were received only blank injections. Then, the rate of pain was estimated in both groups using VAS at 10, 30, 45 and 90 minutes post-injection. Statistical analysis was performed by SPSS and Stata software using generalized estimation equation and Chi-square test. No significant differences were observed in pain mean between test and control group at the above measured post-injection time points. The results showed that injection of normal saline has no influence on low back pain. Given these results, it is recommended that a single particular method has no impact on the reduction of pain, and therefore, a combination of alternative methods must be considered.

The current study was carried out to determine prevalence of intestinal parasitic infections and related factors among the pupils of nurseries and primary schools in Semnan province. In this cross-sectional study, 764 stool specimens were collected by the method of stratified-randomized sampling for stool examination. The specimens were examined by both simple smear and formalin-ether concentration methods. In addition, other data were collected through questioner and analyzed by the SPSS program and logistic regression. Prevalence of intestinal parasitic infections was %13.7 (%10.2 in nurseries and %14.2 primary schools), meanwhile, Giardia lambelia had the greatest prevalence (%8.4), followed by Entamoeba Coli (%3.2). Intestinal Parasitic Infections (IPI) in boys (%15.6) was greater than girls (% 11.9), also the prevalence of IPI in the families with one child was significantly lower than the families with more children. Therefore, the families with 2 or 3 children and with more than 3 children were respectively 5.28 and 8.47 times more at risk of IPI, compared to the families with a child. In addition, there was a significant relationship between the occupation of pupils’ father and the prevalence of IPI, as; the pupils that their fathers were building worker were 4.19 times more at risk of parasite infections, compared to the pupils that their fathers were clerk. The risk of IPI was 1.75 times more among the pupils who using fruits and vegetables that were washed only by water, compared to the pupils who using fruits and vegetables that were disinfected by antiseptic solutions in their home. With respect to the prevalence of intestinal parasite infections, no significant difference was observed between different cites and schools (with and without health instructors) of Semnan province. Since, Giardia lambelia, as a pathogenic parasite, was the most common parasite infection in Semnan province, education of the mothers and pupils about personal hygiene and prevention methods of IPI by health instructors and health centers could help to reduce the rate of intestinal parasite infections.

This study investigated an interaction between acute restraint stress and verapamil, as a blocker of L-type voltage sensitive channels on retrieval of long-term memory. Young adult male rats were trained in one trial inhibitory avoidance task (1mA, 1.5s footshock). On retention test given 48 hr after training, the latency to re-enter dark compartment and time spent in light chamber of the apparatus were recorded. Thirty min before retention test, the rats were exposed to a 10 min of restraint stress in a Plexiglass with or without prior treatment of verapamil (5, 10, 20 mg/kg). The results showed verapamil pretreatment enhanced the impairing effect of stress on memory retrieval. The applied stress increased circulating corticosterone levels as assessed immediately after the retention test, indicating that stress–induced impairment of memory retrieval is mediated, in part, by increased plasma levels of glucocorticoids. Verapamil did not affect on this response. These findings indicate that acute restraint stress impair retrieval of long-term memory, and provide evidence for the existence of an interaction between stress and L-type voltage calcium channels on this process.

Hemorrhage is one of the usual and inflicting side effects following open heart surgeries that its treatment is time-consuming and requires a lot of expense. Most of Hemorrhages after heart surgeries result from hemorrhagic accident, which it happens because of using artificial heart and lung machine. CPB causes dysfunction of platelets, activation of fibrinolysis and also increases the possibility of bleeding after heart surgery. A group of hemorrhages following heart surgery is due to the surgical cause, including bleeding from anatomists, mammary artery bed and etc. Utilizing careful and correct surgical methods can circumvent from many of these hemorrhages. The presented case is a rare case of mediastinal bleeding after open heart surgery in which the tip of chest tube that had been installed in the left hemithorax and also connected to GAMCO was displaced and placed on the initial part of pulmonary artery. Because of the gradual and continuous suction and rubbing, abrasion and finally tearing of artery happens and bleeding starts in this location. This side effect can be prevented by correctly placing the chest tube in hemi thorax and mediastinum.

Primary ovarian lymphoma is extremely rare (less of 1% total ovarian malignancies). Its presentation is similar to ovarian malignancies. This is a report about primary ovarian lymphoma in a 32 years old woman. Because of clinical signs and serial sonography reports about the presence of a mass in her right ovary, laparotomy was performed. Her pathological report showed a malignant diffuse lymphoma Type B cell. The patient was referred to oncologist to perform combo-chemotherapy.