نشریه دانشگاه علوم پزشکی بیرجند
سال شانزدهم شماره 4 (پیاپی 41، زمستان 1388)

There is growing evidence for the useful role of antioxidants in decreasing blood glucose, increasing of insulin sensitivity and prevention of further exacerbation of the development and progression of diabetes type 2. The purpose of the present study was to determine the effect of oral administration of alpha-lipoic acid (ALA), as an antioxidant, on fasting blood sugar (FBS), insulin level and insulin resistance in type 2 diabetic patients. Fifty-seven type 2 diabetic patients (14 males and 43 females) with the mean age of 53.5 ± 8.6 years were involved in this clinical trial. Upon arrival, the subjects were randomly divided into experimental (n=29) and control (n=28) groups. The experimental group received 300 mg alpha-lipoic acid daily, while the control group received 3 placebo tablets daily for eight weeks. Body mass index (BMI), FBS and insulin level of the subjects were measured at the beginning and at the end of the study. The obtained data were analyzed by means of paired t-test and independent t-test, using SPSS software. Comparison of weight and BMI between the two groups, before and after intervention, did not reveal a significant difference. The result of the study showed a significant decrease in FBS and insulin resistance level in the experimental group (P=0.0001 and P=0.04, respectively). The level of fasting insulin decreased a little but this was not significant (P=0.43). The mean of changes in FBS (P=0.001) and insulin resistance (P=0.013) before and after study showed a significant difference between the two groups. Alpha-lipoic acid supplement is useful in decreasing insulin resistance and can be effective in the prevention of diabetic complications.

Coronary artery disease is the most important cause of mortality in most countries including Iran; which leads to significant disability, decrease in the quality of life, and death. According to previous studies, cardiac rehabilitation causes a significant decrease in mortality and has an important role in secondary prevention. The aim of this research was to determine the effects of cardiac rehabilitation on patients’ physical tolerance after coronary artery bypass graft (CABG). This research was a pre- and post-clinical trial in which 50 patients participated in a cardiac rehabilitation program for 2 months, 6 to 8 weeks following CABG surgery. The following variables had been studied before and after cardiac rehabilitation program: Maximum achieved heart rate and metabolic equivalent index which implies the functional capacity of every patient was investigated. The obtained data was analysed at the significant level of P<0.05 using SPSS (version 13) and relevant statistical tests. Out of 50 patients: 72% were male and 28% female. Achieved maximum heart rate in 60% of the patients had increased after cardiac rehabilitation and metabolic equivalents of 88% of them had increased after rehabilitation. Besides, there was an increase in exercise tendency in 28% of the cases. Cardiac rehabilitation has important effects on functional capacity in patients after CABG.

Nowadays pain sedation and faster healing of surgical wounds is more challenging to researchers. The aim of the present study was to evaluate histopathological effects of acetaminophen, as a non-opiod analgesic without anti-inflammatory effects, on healing of stomach surgical wounds in the rats. Fifteen male Wistar rats were randomly assigned to three groups (sham, negative control and experimental) with five subjects in each. A gastrotomy incision with one cm in length was made in the greater curvature of stomach in the rats, which was thereafter sutured in 2 layers. The experimental group was orally given acetaminophen (30 mg/kg) solved in dimethyl sulfoxide (DMSO) 5% (10 mL/Kg) daily for 15 days. The negative control and sham groups received DMSO 5% (10 mL/Kg) and normal saline (10 mL/Kg) respectively in the same manner as the experimental group. Histopathological studies and comparison of wound healing among the groups were carried out considering the more effective factors on wound healing such as proliferation of fibroblasts, angiogenesis, re-epithelialization and collagen production. Significant differences among the groups were determined by one-way analysis of variance (ANOVA) using SPSS statistical software at the significant level of P<0.05. There were no significant differences among the groups regarding the number of fibroblasts, capillary buds, epithelial gap size, and collagen content in healing of surgical wounds. The results indicated that acetaminophen has no adverse side-effects on surgical wound healing of the stomach in rats; thus, it can be used as a pain relief after stomach surgery

Cardiovascular disorders are the most common cause of premature deaths in patients with rheumatoid arthritis (RA). This study dealt with echocardiographical findings in patients with rheumatoid arthritis. Forty patients with established diagnosis of RA for more than five years, who lacked any known cardiovascular and brain symptoms, were enrolled in the study. After complete physical examination electrocardiogram, Chest X-ray, and echocardiography were performed. The obtained data was analysed using SPSS software and appropriate statistical tests.. Mean age of the subjects was 46/2±15/48 and 90% of them were females. The most common valvular disorders were tricuspid and mitral valve regurgitation (72.5% and 52%, respectively). In 70% of the patients diastolic function was normal and there was a significant relationship between systolic function and diastolic abnormality (P=0.047). Pulmonary hypertension was detected in 40% of the cases. Surveying diastolic indices and Doppler echocardiography revealed a significant relationship between initial diastolic wave rate starting from mitral valve annulus and the diastolic wave rate in the right upper pulmonary vein; and a significant relationship between the systolic wave rate originated from mitral valve annulus and the systolic wave rate in the right upper pulmonary vein (P=0.001 and P=0.047, respectively). However, there was not a significant relationship between terminal diastolic wave rate starting from mitral valve annulus with terminal diastolic wave rate of mitral valve; and an insignificant relationship of the systolic wave rate of the right upper pulmonary vein with initial diastolic wave rate of mitral valve (P=0.43 and P=0.84, respectively). A wide and frequent variety of cardiovascular disorders, especially pulmonary hypertension, diastolic dysfunction, and tricuspid and mitral regurgitations in RA patients, require special attention.

Musculoskeletal abnormalities are among the factors affecting on physical activities. The aim of this study was to compare degree of agility, speed, and power between 3 groups of male junior high school students having unnatural out-toeing (i.e. two groups, one with 16-23 degrees and one with 0-6 degrees) and one natural group (7-15 degrees of out-toeing). The subjects of the study were 300 students (12-14 years old) whose height, weight, and angle of toe-out were initially measured using foot-print technique. Firstly, 30 students with normal toe-out were chosen; then, two other groups (30 members in each) were identified applying isometry in terms of age, height, and weight. To measure agility, speed and power, 4×9 m shuttle-run, 46 m running and standing long-jump test were used, respectively. In order to analyze the obtained data ANOVA statistical test was applied using SPSS software and α=0.05 was taken as the significant level. The results showed that mean power and agility in the group with normal/natural out-toeing was higher than that of the other two groups but the difference was not statistically significant (P<0.05). Besides, findings of the study indicated that “speed” was significantly different in the three groups (P=0.02). Toki test results indicated that the observed difference in the mean speed alone in the two groups (natural and unnatural; 16-23 degrees) was significant (P=0.012). The results showed that the speed of the subjects in the angle of out-toeing had a decrease of more than 15 degrees. Regarding the obtained results it could be concluded that having natural out-toeing is an important factor in students’ speed, though it is not as important in power and agility.

Refractive errors are the most common reasons for patient's reference to ophthalmology clinics. Regarding that systemic hypertension has significant complications in the eyes; this study was done to determine the relationship between refractive errors and systemic hypertension. This descriptive, analytical and cross-sectional study was done on patients with refractive errors who had been referred to ophthalmology clinic of Birjand Valieasr hospital in 2004. Refractive errors were objectively determined by an ophthalmologist. Systemic hypertension in the patients was measured and recorded applying standard examination procedures. Systolic pressure ≥140 mmHg/diastolic pressure ≥90 mmHg was taken as "hypertension" and refraction equal to ±0.05 was considered as refractory error. The obtained data was analyzed by means of SPSS software using statistical T, and Chi-square at the significant level of P<0.05. This study was done on 760 patients with refractory errors whose mean age was 36.2±15.8 years. 47% of the patients were males and the rest females. Among the total number of patients, astigmatism, myopia, and hyperopia covered 59.1%, 53.4%, and 36.2% of the refractory errors respectively. 29.7% of of the patients were hypertensive. A significant difference was observed in the frequency distribution of hypertension in myopic and hyperopic cases (P<0.001), but the difference was not significant in astigmatic subjects. Besides, mean spherical equivalence of eyes in subjects with systemic hypertension and normotensive ones was significant. Regarding the high mean spherical refractive error in the subjects with systemic hypertension compared with normotensives, and also the existence of a relationship between systemic hypertension and hyperopia it could be inferred that the risk of developing systemic hypertension in hyperopic patients is more than myopic cases.

Marriage is a sacred, canonical and legal contract between a man and a woman in order to have a peaceful, lovely and dedicated life. The present study was performed aiming at comparing marriage satisfaction in the employees of two Birjand Universities. In addition, some pertaining factors to this satisfaction were evaluated. In this descriptive and analytical research which was undertaken between 2007 and 2008, 218 employees from Birjand University and Birjand University of Medical Sciences were selected through simple random sampling method. Means of data collection was ENRICH standard marriage satisfaction questionnaire to which demographic questions were also added. Data analysis was done by means of descriptive statistics, multifactorial variance analysis, multivariate variance analysis, and Pearson correlation coefficient. There was no significant difference in marriage satisfaction between the two universitie's employees (P=0.21). The most prevalent aspects of dissatisfaction among nine components of marriage satisfaction were sexuality and conflict resolution. About 22.5% of the employees were dissatisfied with their marital life; and 10% of them had deep dissatisfaction. On the other hand, 65.5% of the employees had gained moderate satisfaction. Employees who are dissatisfied with their lives need specific family and spouse therapeutic interventions. Besides, it is suggested that employees with relative and moderate marital satisfaction would receive counseling to improve their marital relationships.

Constipation is a common elimination dysfunction in children which covers more than 3 % of outpatient's visits to pediatrists. The etiology of functional constipation is not clear in most cases. This study focused on the evaluation of the etiology of constipation in pediatric patients who referred to department of pediatric Gastroenterology at Boo-ali Sina hospital in Sari during 2006-2007. In this cross-sectional and descriptive study, children with clinical manifestations of chronic constipation who had been referred to Boo-Ali Sina hospital were assessed. Inclusion criteria were age under 15 years, and being constipated for more than 2 weeks. Children with a history of using antispasmodic drugs for a long time or pervious history of surgical procedure were excluded from the study. The patients were assessed as regards the causes of functional and organic constipation. The obtained data was analyzed using SPSS software. Two-hundred and fifty children aged between 1 month and 15 years (mean age 50.62±15 months) were studied. One-hundred and forty (56%) were males. The most common cause of constipation was functional constipation in 195 (78%) cases but organic constipation was diagnosed in 39 cases (15.6%). The most common cause of constipation was Hirschsprung's disease in patients under one year, and functional causes in older patients. There were no significant differences between the two sexes regarding the causes of constipation. The results of this study showed that the most common cause of constipation in under-one year olds was organic defect; whereas the most common cause of constipation in older children was functional defect. Organic causes of constipation must be taken into account in cases of early onset of the disorder.

Emotional intelligence covers a range of abilities and non-cognitive skills that increase an individual's success in fighting against environmental stress contingency, especially job stress. The aim of the present study was to find out the relationship between emotional intelligence and job stress. This study was a descriptive one which was done on 200 subjects selected from the managers and employees of Tabriz University of Medical Sciences and Health Care in 2007. Standard emotional intelligence and job stress questionnaires were used to gather data. The obtained information was analyzed by means of statistical tests including Pearson's correlation, step-by-step regression, T-test and ANOVA at the significant level of P<0.05. It was found that there was a significant difference in emotional intelligence and job stress between the two genders (P<0.05). Besides, a reverse significant correlation was observed between emotional intelligence and job stress (P<0.05). Various components of emotional intelligence, particularly self-consciousness, sympathy, and self-motivation, had a significant role in anticipating job stress. Having favorable components of emotional intelligence will lead to reduction of job stress. Thus, it is suggested that all organizations, especially medical services, hold requisite educational courses to promote and increase emotional intelligence and decrease job stress.

The causes of periorbital ecchymosis are traumatic and non-traumatic head and neck insults. This report deals with a non-traumatic bilateral spontaneous periorbital ecchymosis in pregnancy.The case studied was a 24-year-old woman in her eighth month of pregnancy who realized her spontaneous ecchymosis around both eyes which was more prominent in the right eye 12 hours after vomiting. She did not have any history of head and neck trauma or surgery. Her visual acuity, ophthalmic examination, blood pressure, and urine analysis were normal. Twenty days after the first evaluation, the ecchymosis completely recovered and the patient was well completely after six months. Although, there are systemic and local causes in the etiology of periorbital ecchymosis, spontaneous occurrence of the condition in a pregnant woman not having preeclampsia is unknown