مجله دانشگاه علوم پزشکی مازندران
پیاپی 66 (مهر و آبان 1387)

Background and In spite of the increasing progress in tumor treatment by current methods like surgery, chemotherapy and etc, medical sciences are unable to treat tumors. In this respect, immunology has opened a new window for tumor treatment nowadays tumor immunotherapy is an accepted strategy for treatment of some tumors at least in some animal models. The goal of this study is the evaluation of immunotherapy using gp96- tumor peptide complex and its combination with naloxon as an opioid receptor antagonist to achieve of cellular immunity against tumors In this study firstly, gp96 – tumor peptide complexes were purified from WEHI164 cells line using srivastava method. In the next stage, the mice, made tumoric befor by the injection of tumor cells, then were divided in to four groups. Control group were injected by PBS, test group1 were injected by naloxon, test group2 were injected by gp96 – tumor peptide complex and test group3 were injected by combination of naloxon and gp96 – tumor peptide complex. To evaluation the efficacy of vaccination, after several days, tumor volume was recorded then the mice were killed and the spleanic cells were extracted in sterile condition. MTT test was done for cells proliferation study. Supernatant of cultured cells were collected and assayed by ELISA kits for measuring IL-4 and IFN-γ. Result of protein purification had showen, purified gp96 Isoform has Molecular Weight of 66 kilo dalton.Results of tumor volume had shown that, there is no significant difference between test and control groups. Results of MTT test had shown that, there is no significant difference between test and control groups. IL-4 assay study had showed that, there is no significant difference between test group1, group2 and control group but test group3 has significantly decreased in IL-4 amount when compared with control group. Results of IFN-γ assay showed that, there is no significant difference between test group1 and control group, but test group2 and group3 has significantly increased in IFN-γ amount when compared with control group. It can be concluded from this study is that, prophylactic immunotherapy of tumor by combination of gp96-tumor peptide complex and naloxon, can increase IFN-γ, and, probably in a higher dosage, it may stimulate immune system more to become more potent to even decrease tumor volume.

Background and In recent years, review of opioid system and its changes in the psychopathology of schizophrenia through thear probable role our on neuronal synopses and cell body of dopaminergic neurons and also decrease dopamine secretion from acumbans nuclei and effects of opium agonists in treatment of those patients has been adventajes for clinicians. In a prospective double blind evaluation, 60 chronic schizophrenic inpatients on a stable regimen of neuroleptic medication with positive and negative symptom scale (PANSS) score of higher than 80 and were randomly assigned to either antipsychotic plus naltrexone or antipsychotic plus placebo. Thirty patients (30) received 100 mg/day of naltrexone plus antipsychotic drug while 30 received placebo plus antipsychotic drug for 6 weeks. PANSS scores were evaluated on the base of the study, biweekly through out the study and two weeks after the trial. The treatment effect was calculated by repeated measurement ANOVA. Difference between four types of symptoms (positive symptom, negative symptom, general psychopathological symptom, total score of PANSS) in the case and control groups was not significant (P < 0.05). In supplement two (S2) scores, a statistically non significant difference was seen in two groups (P < 0.07). Additional treatment with 100 mg/day naltrexone in a 6 week trial had no significant therapeutic effect on typical or atypical antipsychotic drugs with regards to schizophrenia psychopathology.

Background and Pressure sore is common among patients with prolonged stay in hospitals or homes. Treatment of such sores is costly and performed by various procedures. Considering the effective role of calendula officinalis in treatment of sores, ulcers and cutaneous inflammations, this study is conducted to determine the effect of this cream in healing pressure sores. This is a pre/post comparative clinical trial done on 20 patients with pressure sores who received the recommended treatment. The condition of patients such as, duration of pressure sore, and the extent of the sore were recorded. The sore was washed with normal saline, dried, followed by applying calendula cream three times a day for a duration of 4 weeks. Each week, the extent and rate of healing was observed and recorded. The rate of healing in patients under our study was 56.6%. Majority (55%) of patients had partial healing. The time of healing was in weeks 3.5±1.2 (P<0.001). The complete healing occurred in the 3rd and 4th week, subsequent to the beginning of the treatment. Considering the availability of the cream and its affordability, it can be used in the treatment of pressure sores. In addition, it can be used as a drug for treatment of patients who are in hospitals and/or in their homes.

Background and To compar the efficacy of lithium carbonate &sodium valproate in treatment of bipolar children and adolescents in acute phase (mixed &mania) in 6 week treatment at Roozbeh hospital. A double-blind & randomized controlled clinical trial in 30 patient (8-18 years) for a 6 week trial. patients were diagnosed based on DSM_IV criteria through clinical interview & K_SADS. MRS & CGAS were used to measure the severity of symptoms and the level of functional impairment. patients categorized into 2 groups randomly. In both groups means of MRS decreased (at the end of 3rd&6th weeks) and there was no significant difference between two groups. Means of CGAS had significant difference between two groups at 3rd week (05/ 0>P)....

Background and Although Taype 2 diabetes is the most frequent among different types of diabetes, the cause of it is yet to be clarified. Several environmental and genetic factors are said to be involved in diabetes and it has been established that cytokines play key roles in pathogenesis of diabetes. Expression of cytokins is different from person and in defferent societies. Studies showed that polymorphisms of +874 of IFN-γ and -590 of IL-4 regions are related to the expression of these genes. In this study, we aimed to find polymorphisms of these regions in Type 2 diabetes patients. In this study peripheral blood samples were collected from 51 type 2 diabetes patients and 50 healthy controls. DNA was isolated by salting out method, using ARMS-PCR, RFLP-PCR polymorphisms of = 874 of IFN-γ and -590 of IL-4, were analyzed, respectively. Our findings showed that TT genotype of IFN- γ was increased in type 2 diabetic patients as comford with control grop but difference was not significant. Our results also have not shown any significant difference between IL-4 genotype in diabetic and healthy controls. Our results suggested that TT genotype of IFN- γ can be related to diabetes. This relation can be sescribed by this known Todgment judyunt thar over expression of IFN- γ shifted immune system to Th1, therefore, pancreas cells were miscarried by immune cells.

Background and Clinical training is the part of teaching for nurses. 73% of nursing students rated clinical teaching as poor. The unfamiliarity with hospital environment and fear of being evaluated by instructors for their performance has been considered the main stressor on the first day of training. In recent years, much attention has been paid to mentoring programs in nursing, and has been proposed as a method in prevention of anxiety, apprehension and ending employment, improving active learning, self esteem creating a proper condition for learning, and increasing nursing students cooperation. As no research has been performed in Iran, this study was conducted to determine the effect of tension during clinical training with nurses at Nasibeh College of Nursing and Midwifery during 2007-2008. In this semi- experimental study, 70 of second term nursing students on their nursing skill training were selected randomly through lottery, matched for age, sex, level of education and were divided in two case and control groups of equal numbers (35 in each group) In the case group, one senior student was designated as a mentor (in regard to nursing management training), while in the control group students were trained with instructor without mentor. For groups, pre and post practice of nursing skills examination was conducted. The data was collected through a questionnaire with two sections comprising of 9 questions about demographic features, and 19 regarding the tension of working environment. The obtained data was analyzed statistically using SPSS 15 soft ware. In this study, the highest score was from the fear of making mistakes, while the lowest score was from being asked a question by the instructor. Based on the paired t test, only in the case group (with mentor) decline of mean score related to the clinical stressor prior to and after nursing skill training was significant, t=5.64, df=34 and P<0.0005 Based on the results of this study, the mentorship program was effective on reduction of stressors in the subjects under the study. Therefore, it is suggested that the clinical education administrators of the nursing college will implement mentorship programs, which require the inter -organizational cooperation.

Background and Lipophilic yeast of the genus Malassezia are members of normal human cutaneous micro flora which are also associated with several skin diseases. It is strongly suspected that Malassezia species are responsible for pityriasis versicolor (PV), and seborrhoeic dermatitis (SD). Considering various sensitivities among Malassezia species to antifungal, accurate species identification will facilitate the treatment of relevant diseases. Malassezia species can be identified through their morphological features and bio-chemical characteristics. However, these phenotypic methods are usually time consuming, and lack sufficient discriminatory power. Development of DNA- based methods for detection and identification of Malassezia species provide helpful alternatives for solving problems. The aim of this study was to examine the distribution of Malassezia species in patients with pityriasis versicolor and seborrhoeic dermatitis, using molecular methods. A total of 63 clinical isolates of Malassezia spp, 30 strains isolated from patients with PV and 33 strains isolated from patients with SD, were studied. To investigate the strains at molecular level, genomic DNA of Malassezia isolates were extracted and amplified within the ITS1 region (located between 18S and 5.8S rDNA) by polymerase chain reaction (PCR) assay. DNA sequencing of ITS1 of rDNA in Malassezia spp was performed to type the species. Restriction fragment length polymorphism (RFLP) analysis of ITS1 PCR product with two restrictive enzymes CFOI and BSTF5I, was used in subsequent species identification. In this study, 37 patients with PV (20 females, 17 males 2 to 64 years old), 81.1% (30 case) yielded growth of Malassezia in culture, while the frequency of isolation of M. globosa was 53.3% (16 case), M. furfur 40% (12 case) and M. sympodialis 6.7% (2 case). Of the 41 patients with SD (22 females, 19 males 1 to 52 years old), 80.5% (33 case) yielded growth of Malassezia in culture, while the frequency of M. furfur was 42.4% (14 case), M.globosa 39. 4% (13 case), M. restrict 15.2% (5 case) and M. sympodialis 3% (1 case). This PCR-RFLP Profile allows us to clearly identify important Malassezia species. The results of the PCR-RFLP analyses of clinical isolates were in complete agreement with those from DNA sequencing, morphological features and bio-chemical characterization. In patients with PV, the most frequently isolated species were M. globosa, followed by M. furfur. However, in patients with SD, the most frequently isolated species were M. furfur, followed by M. globosa. The PCR-RFLP system applied for the ITS1 fragment of the rDNA is a reliable, simple and rapid method for identification of the most important Malassezia species, but further work will be necessary in applying these techniques to additional patients.

Background and Birth spacing has become a main strategy within health promotion programs for mothers and their children during the past two recent decades in the Islamic Republic of Iran. The present study was aimed to determine the patterns and factors associated with birth intervals in Multi-Para women residing in Babol. We conducted a cross-sectional study with samples consisting of 500 Multi-Para women, who were referred to the hospital and the Health Center for delivery in Babol, Northern Iran, during 2007. The data was collected using a designed questionnaire, including birth intervals between index child and prior, demographic and fertility variables, such as maternal education, maternal age at birth of index child, sex before index child, still birth, child status before index child, parity, duration of breast feeding, residence area, contraception methods, and attending family planning clinic. The data was analyzed using the logistic regression model. The mean (SD) of birth intervals was 61±25.7 months. Birth interval in 3.8% of mothers was less than 2 years and 41.7% of mothers had 4 to 6 years, while 28% had ≥6 years. In the majority of women, (76.8%) pregnancies were from 20 to 34 years of age. In spite, pregnancy was observed in 22.4% cases in age 35 or over, while 0.8% of pregnancies were in the age range less than 20 years. Maternal age, duration of breast feeding, child sex before index child, still birth, history of infant mortality before index child, type of contraception, attending family planning clinics and parity showed a significant relation with birth intervals. Maternal age, parity, duration of breastfeeding, still birth, history of infant mortality, attending family planning clinics and using modern contraceptive methods are shown to be determinants of birth intervals. Although our findings indicated that in the majority of Multi-Para women, birth intervals was within the accepted range previously recommended by the Ministry of Health in Iran, over a quarter of women had birth intervals of ≥6 years. Due to increasing maternal age associated with high risk pregnancies (aged >35yeras) by long birth intervals, it is necessary to revise educational programs for prevention of long birth intervals, that would induce the subsequent pregnancies in becoming high risk.

Background and Fatigue is a common symptom of Multiple Sclerosis (MS) that is purported to cause significant distress and have detrimental effects on daily living functioning, social and occupational obligations, and overall well-being. Complementary therapies are widely used by people with MS and Progressive Hydrotherapy is a form of complementary therapies. The aim of this study is to assess the effects of applying Hydrotherapy on fatigue of Multiple Sclerosis patients. This is a Quasi-experimental study. 50 Multiple Sclerosis patients were selected with convenient sampling according to specific criteria then assigned to experimental and control groups (25 patients in each group) with random allocation. Data collector tools included: demographic questionnaire, Fatigue Severity Scale (FSS), Self report checklists. Hydrotherapy performed for 24 sessions by experimental group during three months but no intervention was done for control group. Statistical analysis was done by SPSS software. There was no significant difference between two groups in mean scores of fatigue before the study but this test showed different significance between two groups, 4, 8 and 12 weeks after intervention (P<0.05). ANOVA test with repeated measurements showed that there is a significant difference in mean score of fatigue between two groups in 4 times (P<0.05). The results of this study show that Hydrotherapy is practically feasible and could decrease fatigue of MS patients so that applying this technique offered to these patients.

Back ground and Available evidence shows that religious attitude have noticeable effects on psychological aspects of human life. The purpose of this study was to determine the present situation of religious attitude of Students of Mazandaran University of Medical Sciences. Student’s attitude towards theoretical basis of Islam and Some other subsidiary rules of religion and moral values were studied in this investigation. In this research descriptive field study on all the students of the university, stratified sampling method was employed and 384 students were recruited.A questionnaire consisting of 38 questions was used to collect the data. Attitude rates were quantified on the scale of –5 to +5. The mean rates of attitude of associated to art students (2.53 ± 1.63) and B.S.C students (3.06±1.45) were statistically significant (p<0.01).Likewise, the mean rate of attitude of male and female students (2.94±1.7) and (2.97±1.4) were statistically significant (p<0.01).The attitude rate of the majority of students was between 2.5 to 4.5 (s. p 1.63). The top mark of 4.5 was gained by 57% of the students. The students have positive religious attitude. The lack of adequate religious practice among the subjects must not be interpreted as the low religious attitude. However it is necessary to study other factor that effects students practice.

Leptospirosis is a Zoonotic disease that rarely manifests in a severe manner, (Weil's syndrome). Regarding epidemiology of this disease, in some rural areas of Mazandaran Province we encountered a rare case of acute pancreatitis during progression of severe Leptosprosis is presented herein. Patient is a 50 year old male farmer who was admitted to the hospital due to experiencing 10 days of fever, myalgia, vomiting, jaundice and abdominal pain. He underwent haemo-dialysis due to acute renal failure only once. Direct bilirubin was 31.7 mg/dl with serum amylase, while lipase was three times more than normal levels. The CT-Scan demonstrated diffuse pancreatic enlargement. The IgM titer fourfold which was more than normal level against leptospirosis (ELISA) confirmed the diagnosis. Patient was cured completely through supportive care and antibiotic therapy, thus, this case was reported in drawing attention to Leptospira infections, which should be considered in the differential diagnosis of patients with jaundice and pancreatitis.

Priapism is a rare but serious side effect of psychotropic drugs with incidence of 15-26%. Approximately all of of the atypical antipsychotic drugs are reported with this complication.in this report a 24-years old man with multiple delusions which was treated with risperidone(6mg),was affected by priapism after two months. After drug dose reduction and finally discontinuation, olanzapine(5mg) was started. Only one dose of this drug cause recurrence of priapism. Therefore this drug was discontinued also. After clozapine starting(150mg),priapism was induced. Therefore it is necessary for physicians whom prescribe serotonin-dopamin antagonist drugs must consider this rare but serious side effect.

This study aimed to determine the knowledge and attitudes to wards homeopathy among general practitioner and specialist physicians in Sari. Our results indicate Sari physicians had not sufficient knowledge obout homeopathy but they liked collaboration with homeopaths for treatment of their patients and have courses for homeopathy education.