مجله دانشگاه علوم پزشکی بابل
سال یازدهم شماره 4 (پیاپی 51، مهر و آبان 1388)

Pyrus boissieriana Buhse leaves extract has many of biological activities such as antioxidant, antilarva, antibacterial and antifungal in vitro. This study was designed to evaluate the effect of Pyrus boissieriana Buhse leaves extract on antihyperglycemic, antioxidant and antilipidproxidative in normal rats. In this experimental study 56 adult male rats of Wistar strain, weighing 150 to 200 g, were randomized into blank, control and experimental groups (8 rats in each group). At the starting day, sampling from blank group was performed. Experimental group rats were treated with Pyrus boissieriana Buhse leaves extract (500 mg/kg) for 7, 14, 21 days (one day between). Control group rats were treated with water (1.5 ml) orally. Antihyperglycemic effect was evaluated in serum by glucose oxidase method whereas antioxidant and antilipidproxidative were evaluated in serum and tissues. Antioxidant activity was evaluated by FRAP (Ferric Reducing Antioxidant Power) method and lipid peroxidation was evaluated by TBARS method (Thiobarbituric Acid Reactive Substances). After 14 days of starting study, serum glucose concentrations in experimental group (55.61±8.73 mg/dl) than blank group (99.51±14.36) decreased significantly (p=0.032). Glucose changes between control and experimental groups were not significant in other days. Antioxidant activity in tissues and serum after 21 days in the experimental group (liver: 1178±43.2, kidney: 1031.9±53.4, pancreas: 164.6±7.6, serum: 1986±182.2 µM) than the control group (liver: 33.1±4.5, kidney: 544.63±35.2 pancreas: 89.8±8.8, serum: 1505±89 µM) increased. But lipid peroxidation did not affected after consumption of Pyrus boissieriana Buhse leaves extract in tissues. This study demonstrated the Pyrus boissieriana Buhse leaves extract has antioxidant activity in vivo in serum, liver, kidney and pancreas in normal rats.

Streptokinase (SK) is a microbial plasminogen-activator that is used in the treatments, especially at Acute ischemic stroke, declotting of dialysis shunts and inflammatory antibiotic-resistant prostatitis. The aim of this study was production of streptokinase in batch culture system and evaluation of some effective factors on SK production. Moreover, the effect of Hexyl Resorcinol as a bactericidal material on Streptococcus equisimillis H46A is determined. We used Streptococcus equisimillis strain H46A. The log phase of bacterial growth and streptokinase production for two inoculation conditions, 1% and 10% were determined at an interval of 4 hours by turbidity test at 600nm and colorimetric assay using S2251 chromogenic substrate, respectively. Moreover, effective factors on bacterial growth and streptokinase yield were evaluated by using a manual fermentor designed in our laboratory. Bacterial cells proliferated logarithmically in the first four hours and after that, the rate of proliferation decreased. It means bacterial cells are being entered to the stationary phase, this condition extended to the 8th hour. Streptokinase production increases up to 3-fold with use of 10% inoculum, adding glucose and adjusting pH simultaneously. In addition, Hexyl Resorcinol bactericide effective dose is reported to be 2 mg/ml. Because of high sensitivity of streptokinase to pH and temperature change, some produced streptokinase is degraded at the same time. Therefore, conditions that decrease lag phase period and increase the growth rate of logarithmic phase, results in higher SK yield.

Immune system is unable to complete clearance of hepatitis B virus in occult hepatitis B infection (OBI). Some of immune response is defect against hepatitis B virus in these patients. Scientists believed the involvement of genetic and immunological factors in etiology of OBI. Due to the regulatory impact of vitamin D3 on immune system, study of vitamin D receptor (VDR) polymorphisms aid to better understanding of disease. Therefore, in this study we examined exon 9 polymorphisms of VDR in OBI patients. In this experimental study, 3700 samples were examined for anti-HBc and HBsAg by ELISA. The HBsAg negative and anti-HBc positive samples were screened for HBV-DNA by PCR. OBI patients (57 cases) (HBsAg negative and anti-HBc positive, HBV-DNA positive) and 100 healthy controls (HBsAg negative and anti-HBc positive, HBV-DNA negative) were analyzed for exon 9 polymorphisms of VDR by PCR-RFLP techniques. Our findings demonstrated that 57 cases had OBI among 3700 studied cases. Polymorphisms analysis showed that 3.5% (2 cases) of OBI patients and 18% (18 cases) of controls had T/T alleles in this region which the difference was statistically significant in patients and controls (p<0.049). There was not also a significant difference between OBI patients and controls regarding T/t and t/t alleles of this region of VDR. Regarding results of this study we can be concluded that the T/T allele in exon 9 of VDR may play key role in ability of immune system in clearance of HBV in OBI patients.

Perineal trauma particularly from routine episiotomy that is associated with short and long term morbidity for women. The aim of this study was to determine the effect of perineal massage with lavender essence on episiotomy and laceration. This clinical trial study was performed on 176 nulliparous women who referred to Arak Talghani teaching center for normal delivery. They were randomly participating in massage with lavender essence oil (91 cases) or control group (85 cases). In lavender group when they progressed to full dilatation of the cervix, the midwife inserted two fingers inside vagina and using a sweeping motion gently stretch the perineum with lavender essence oil 5 up to 10 minute, in and between mother’s pushing in second stage of labor. In control group just Ritgen Maneuver was applied. At last we compared the rate of intact perineum, episiotomy and laceration, mean duration of second stage of labour and Apgar score in 1st and 5th minute between two groups. In case group, intact perineum, episiotomy and laceration were: 60.2% (53), 8% (7), and 31.8% (31) respectively. In control group, intact perineum, episiotomy and laceration were: 2.4% (2), 80% (68) and 17.6% (15) respectively. This difference was statistically significant (p=0.0001). In Lavender essence group, first and second degree laceration were 27.3 % (27) and 4.5% (4) respectively. Third and fourth degree laceration were not occurred. In control group, first, second and third degree laceration were 4.6 % (4), 7.1% (6) and 5.9% (5) respectively, fourth degree laceration was not occurred. Difference was statistically significant. (p=0.0001) The results showed that perineal massage with Lavender essence in second stage of labour decreases incidence of episiotomy and degree of laceration. Lavender essence may be increase blood flow, elasticity, softness and relaxation of perineal tissue.

Corticosteroids have been used for pregnant women for fetal lung maturation but there are many controversies about their effects and side-effects, the aim of this study was to determine the effects of betamethasone on the hemodynamic changes (heart rate and blood pressure) in pregnant women. This clinical trial study performed on 100 pregnant women at risk of preterm delivery between 24-34 weeks of gestation in Yahyanejad hospital in Babol (2006). Betamethasone was injected 12 mg (2 doses with 12 hours interval, IM) and systolic blood pressure, diastolic blood pressure and heart rate were measured before injection (2 times with 5 minute interval) and after first and second dose injection (after each dose 2 times with 2 hours interval). The data were analyzed by SPSS soft ware and compared. The mean age of our patients was 24.2 4.7 years (16–40 years). The mean gestational age of our patients was 32.4 2.6 weeks. The mean average of maternal heart rate after first dose of betamethasone administration (85.2 8.2) was significantly higher than before treatment (84 8.2) (p= 0.033). But there was no significantly difference between the mean average of maternal systolic and diastolic blood pressure before and after each dose administration. Our results show that betamethasone dont have any significant effect on systolic and diastolic blood pressure changes in pregnant women but it may increase the mean of maternal heart rate after first dose of injection that this change is transient. Betamethasone has no significant effect on the hemodynamic changes in mother.

Most women that reached menopause, experience vasomotor symptoms (hot flashes). Its main cause, however, is not obvious but some researches have shown that there is a relationship between FSH level and hot flashes. On one way, hormone therapy (HT) has been associated with an increased risk of chronic diseases. Therefore, attention is increasingly focused on managing vasomotor symptoms via physical activity. So this study was done with this purpose to investigate the effects of regular aerobic exercise on vasomotor symptoms (hot flashes) in postmenopausal women. In this quasi-experimental study, twenty healthy postmenopausal women with average age of 53.6± 4.3 years, who sampled randomly in 2 groups (control and experimental), were participated in this investigation. The subjects were individuals who had experienced at least five hot flashes per 24 h. The experimental group followed exercise training program including walking (60%-70% of MHR) three times a week, for 10 weeks. But control group did not participate in any exercise program. Blood samples were taken before and after the exercise program to measure FSH concentration by means of RIELE. And so, hot flashes level was measured before and after exercise by means of Kupperman questionnaire and compared. Mean of serum FSH level and hot flashes in control group before exercise training (52.1±13.8, 9.2±1.93 IU/L respectively) relative to after exercise training (53.4±14.1, 8.8±2.5 IU/L respectively) werent significantly changed. But mean of serum FSH level and hot flashes in exercise group after exercise training (46.1±11.8, 6±2.1 IU/L respectively) relative to before exercise training (51.8±11.1, 9.2±1.93 IU/L respectively) were significantly decreased (p = 0.001). The results of present study demonstrated that regular aerobic exercise training decrease serum FSH level and vasomotor symptom. So, the authorities should apply strategies to decrease vasomotor symptoms by changing life style from inactivity to exercise training in order to support postmenopausal women somatic health.

Preterm delivery is an important determinant of neonatal and infant morbidity and mortality. The effect of psychological factors on preterm delivery is inconsistent. However some studies have shown psychological factors to increase maternal corticotrophin-releasing factor to play preterm delivery. This study was conducted to determine the effect of prenatal anxiety on spontaneous preterm delivery. We conducted a prospective cohort study of 682 women with singleton pregnancies consecutively recruited between 20 and 28 weeks of gestation in Babol health care centers for prenatal care and received regular antenatal care. Women who had history of psychological disease, chronic diseases, pregnancy complications and taking medicine excluded from the study. The assessment of gestational age was based on last menstrual period or ultrasound examination in first half of pregnancy. Anxiety was assessed using self-administered questionnaires: the Spielberger State-Trait Anxiety Inventory. The women were considered as case group with anxiety score >45. Furthermore, these cases were followed up and compared carefully regarding to preterm delivery The mean Spielberger state and trait anxiety in women with preterm delivery were respectively 42.7± 10.8 and 52.9±3.9, but the mean Spielberger state and trait anxiety in women with term delivery were respectively 37.81± 5.71 and 50.68±5.20. A significant association was found between scores for both Spielberger state anxiety and trait anxiety >45 and preterm and low birth weight (LBW) (p<0.0001). For preterm delivery (RR= 3.1, 95% CI = 2.50-4.7) and for LBW (RR= 2.6, 95% CI = 1.6-4.2). There was a statistically significant relationship. These findings provide evidence that antenatal anxiety is significantly associated with spontaneous preterm birth and LBW. Thus, screening for mental and psychological disorders among women in regular prenatal care is recommended.

Increase of blood pressure is from prevalent disorders that can increase maternal and fetal-neonatal morbidity and mortality. The aim of the study was to survey the effect of prepregnancy body mass index (BMI) on the development of gestational hypertension and preeclampsia. This case-control study was performed on 200 pregnant women referred to maternity of Qaem Hospital related to Mashhad University in 2007. According to body mass index, the patients were divided into four groups (50 in each group) including gestational hypertension group, mild preeclampsia, severe preeclampsia and control group. Blood pressure, height and weight of pregnant women were measured carefully and BMI was calculated and then compared with prepregnancy BMI. In control group mean BMI before pregnancy was 24±3 kg/m2 and in gestational hypertension group was 26.1±5.4 and in mild preeclampsia group was 26±1 kg/m2 and in severe preeclampsia group was 26±4.1 kg/m2. There was a significant difference between prepregnancy BMI and three other groups. (p<0.05). According to the relationship between prepregnancy BMI and gestational hypertension and severe preeclampsia, we can suggest the women who have intended to be pregnant and have high weight that with the decrease of the prepregnancy weight can reduce mortality and morbidity in pregnancy.

Uterine leiomyoma is the most common benign pelvic tumors with an unknown etiology. There are contradictory results about risk factors of uterine leiomyoma which affiliated to genetic or hormonal theories, in different studies. The objective of this study is assessment of risk factors of uterine leiomyoma in patients who referred for pelvic sonography in comparision to control group. A case-control study was performed on 990 patients referring to Rasht Alzahra hospital in 2007 who undergoing sonography evaluation for abnormal bleeding or pelvic pain and for other reasons unrelated to abnormal bleeding. Patients were similar as parity and age. Patients based on sonography and uterine fibroma observation was divided into case and control groups. Considerable variables were demographic data, familial history leiomyoma, reproductive history and menstrual characteristics, body mass index, methods for contraception. Data were gathered by forms and face interview and then compared and assessed. Of 990 patients, 482 subjects were cases and 508 subjects were controls. Premature menarche was reported in 69 cases (14.4%) and 48 control (9.4%), respectively. There were positive relationship between age of menarche 8-10 years old and increased risk of uterine leiomyoma (OR= 66%, 95% CI: 0.13-1.82), familial history of uterine leiomyoma (OR= 2.64, 95% CI=1.79-3.90), body mass index greater than 25 (OR=6.05, 95% CI: 4.18-8.75, menstrual characteristics and risk of uterine leiomyoma. There was an inverse relationship between use of oral contraceptive pills for pregnancy prevention and risk of uterine leiomyoma that was a protective effect. (OR=0.4; 95% CI: 0.23-0.72) These results showed that uterine leiomyoma has a correlation with age of menarche, obesity, familial history of fibroma and inverse relationship with use of OCP. Prevention of overweight, use of oral contraceptive pills especially in high risk patients can be considered as the ways for prevention of uterine leiomyoma.

Wear resistance of composites is important for preservation of masticatory ability and vertical height. The aim of this study was to compare wear resistance of two laboratory type composites and one direct composite. In this in vitro study 5 samples from each type of composites (SR Adoro, GC gradia, Clearfil ST) was prepared in incremental technique. Exposure time was 40 seconds and thickness of layers was 1 mm. Wearing load was 6kg and applied via pressable chromium cobalt bar (1.98 mm2 tip) at 5000, 20000, 80000, 120000 cycles. Pre and post wearing samples weight was measured by an electronical weight balance with 0.0001 gr accuracy. The data was compared. There was significant decrease in weight of all type of composites from initial weight to 120000 cycles (p≤0.001). (GC gradia 4.42±1.26mg, SR Adoro 6.5±0.89mg, Clearfil ST 4.52±2.14mg). Although after applying all wearing cycles the average decrease of weight was smaller in GC gradia rather than Clearfil St that smaller than SR Adoro, however there was no significant difference. GC gradia and Clearfil ST showed less wear than SR Adoro. There was significant wear in all types of composites in wearing cycles.

Classic form of Celiac disease is recognized with malabsorption symptoms after introducing gluten diet. However, due to wide spectrum of disease some cases would remain undiagnosed. The aim of this study was to determine the clinical and laboratory features of celiac disease in children with celiac disease. In this study, 43 children with symptoms such as chronic diarrhea, failure to thrive, anemia and short stature in children medical center were included (2004-2008). Diagnosis was based on biopsy results and serologic tests and clinical response to gluten free diet. Patients were divided into two groups: children older than 2 years and less than 2 years. Clinical, biopsy and laboratory findings and pathologic results were assessed and compared. The most common clinical findings in 43 patients were underweight in 37 cases (86%), chronic diarrhea in 32 cases (74.4 %), anemia and short stature in 30 cases (69.8%) and positive IgA anti-endomysium in 28 cases (65%). Biopsy of the small intestine revealed type I, II, III in 8 (18.6%), 7 (16.3%) and 28 (55%) respectively. There was statistically significant difference between children older than 2 years with less than 2 years. The older patients experienced more abdominal pain, short stature and Marsh III in intestinal biopsy. Children older than 2 years have shown statistically significant difference in abdominal pain, short stature and Marsh III. (p<0.001, p<0.001, p<0.05) Results showed that celiac disease may present with different clinical presentation. Abdominal pain, short stature and Marsh III can be seen in children older than 2 years old compare to less which shows unusual presentation of disease in higher age. Information about these cases would help in better diagnosis.

Von Hippel–lindau syndrome is a rare syndrome. Von Hippel–Lindau is an autosomal dominant condition manifested by cerebellar and spinal hemangioblastomas, retinal angiomas, clear cell RCC, cysts of the pancreas, kidney, and epididymis, epididymal cystadenimas, pheochromocytoma, and endolymphatic sac tumors. The aim of this report was to introduce one case of Von Hippel–Lindau syndrome that patient's multiple organs were involved. CASE: The patient was a 28 year old male that nine years ago because of right big cyst epididymis underwent surgery and about seven years ago he was hospitalized because of headache, ataxia and vertigo. Cerebellum hemangioblastomas was diagnosed by MRI, and three years ago abnormal gait caused by spinal hemangioblastoma in L2 and L3. The patient underwent surgery and then radiation treatment. Also, he suffered from blindness in the right eye caused by retinal angioma. Neurosurgeon referred the patient to urology center that a tumor in the incidentaloma of right kidney was discovered and underwent right radical nephrectomy. Pathologist's report showed renal cell carcinoma. Now he referred due to infertility and undergoes diagnostic biopsy. Unfortunately he can not be a candidate for microinjection because histology revealed immature cells. With regard to the reported case of Von Hippel–Lindau syndrome that his multiple organs were involved; coordination of different specialties in medical cares and the earlier identification of tumor and more careful surveillance after surgery due to multiple characteristics of tumor seem to be necessary.