مجله دانشگاه علوم پزشکی بابل
سال دوازدهم شماره 2 (پیاپی 55، خرداد و تیر 1389)

Clomiphene citrate is a drug which used for superovulation in infertile women. Despite increasing oocyte number, its pregnancy rate is low. Endometrial stromal cells have pivotal role in implantation events. The aim of present investigation was to determine the effect of different clomiphene citrate doses on morphology and proliferation of human endometrial stromal cell in in-vitro culture. In this experimental study, human endometrial biopsies (n=7) chopped in sterile condition and digested by enzymatic methods (collagenase). Stromal cell harvested after using cell strainer and centrifugation. Their viability and cell number were determined with Trypan blue staining. Stromal cells divided into four groups: control and cases: (1, 5 and 10 µM clomiphene). Control group received DMEM/F12 media supplemental with FBS (5%) and antibiotic and cases groups received same media with one dose of clomiphene citrate. Duration of study was two weeks and cells were photographed at beginning and the end of study. Finally cell collected enzymaticly by tripsin (0.25%) and their viability and cell number were determined. Morphological changes resembled in control and 1 µM groups and consist of oval cell transformation into large polyclonal fibroblast. 5 and 10µM doses of clomiphene citrate inhibit normal proliferation and morphological changes. There are significant differences between 5 and 10µM with control and 1µM groups (p<0.001). Clomiphene citrate showed dose dependant effect on endometrial stromal cell and higher doses inhibit proliferation and morphological changes of these cells.

Various stressful stimuli have different effects on memory and learning. With technology development, the human exposes to different stressful factors. The aim of this study was to investigate the combined effects of handling-injection stress with noise stress in the passive avoidance task in rats. Twenty-four male Wistar rats (22 days aged) with weight of 55gr were used. Male Wistar rats were divided into 4 groups, of 6 animals for 4 weeks: subcutaneous injection of sodium chloride 0.9% and handling stress (I+H), subcutaneous injection of sodium chloride 0.9% and handling with noise exposure (I+N), noise exposure (N) and control (C). After 4 weeks, we studied passive avoidance conditioning test in a shuttle box. The step-through latency after training animals significantly increased in (I+H) group as compared with (I+N) and (N) groups (p=0.001). But using noise stress with handling-injection stress significantly attenuated learning and memory in the (I+N) group than other 3 groups (p=0.01). The data suggested that using moderate stress with sound stress decreases learning and memory in the early life of male Wistar rats.

Corticosteroids has been used for pregnant women for fetal lung maturation but there are many controversies about their effect and side effect, the aim of this study was to determine the effect of bethamethasone on the serum marker of infection in women at high risk for preterm delivery. This prospective study was performed on 50 pregnant women at risk for preterm labor between 28-34 weeks of gestation who were treated by betamethasone (12 mg every 12 hours for 2 doses) for enhancement of fetal lung maturation in Shahid Yahyanejad hospital in Babol. Blood test for WBC, ESR and CRP were drawn before Bethamethasone injection, 2 hours after injection and second and third days after injection. The data were compared. Mean gestational age was 31.9±2.4 weeks. The mean WBC (396±81) (p=0.000), neutrophil (473±109) (p=0.000) and ESR (1.8±0.6) (p=0.008) after treatment was significantly higher than before treatment. But mean of lymphocyte before and after treatment showed no significant difference. CRP value was increased significantly after treatment (p=0.009). The results of this study showed that antenatal betamethasone therapy causes a transient increase in maternal serum indicators of infection but returns to basic level soon.

At present despite of wide spread application of tracheal tube with low-pressure cuff, complications of tracheal intubation have not disappeared. The main factor in post intubation tracheal stenosis is high cuff pressure that can cause stimulation and damage of trachea mucosa and thus, it causes scar after extubation. This study was done to define the complications of pressure effects of tracheal tube cuff on trachea.

This study is a cross-sectional study over 60 patients of ICU, who have been intubated for 24 h. In this study cuff pressure was measured every 6h by a cuff pressure monitor and were registered. Then after 2h, 24h, one weak, one month and 3 months after extubation, patients were followed. Presence of cough, stridor and dyspnea were registered. Any doubt of tracheal stenosis was followed by rigid bronchoscopy. Data was recorded and assessed.

The mean age of patients was 45.36±11.3 years that 37 (61.66%) were male and 23 (38.3%) were female. Among patients without pulmonary disease, there were 16 patients (26.66%) with cough and stridor in the first 2 or 24h of extubation but all of them became asymptomatic in following up. Except one patient that because of cough, stridor and dyspnea in the first 24h was undergone rigid bronchoscopy with finding of atelectasis and collaps of lung, no tracheal stenosis or its complications were found.

It seems that maintenance of cuff pressure in the range of 20-30cm H2O and its regular monitoring is the best method for prevention of cuff pressure complications.

Different statistical methods can be used to analyze fertility data. In cases that dependent variable is count, Poisson model is applied. If Poisson model is not applicable in a specific situation, it is better to apply generalized Poisson model and in cases that multilevel variable exists, it is better to use multilevel Poisson model. Our goal in this study is to compare both generalized and multilevel Poisson regression model with Poisson regression model in estimating of coefficient of the effective factors on the number of children.

This is a cross-sectional study. A sample of 1019 women (15-49 years old) from rural area was selected by stratified sampling. The women were categorized into seven groups and in each group the intended samples were selected equally by systematic sampling. Data were analyzed by Poisson regression model, generalized and multilevel Poisson regression model.

The sample mean and sample variance of the number of children were 4.3 and 8.3, respectively. There was a significant relationship between educational status of the spouses, age of marriage, feeding period, economical status and the interval between the children in generalized and multilevel Poisson regression model.

According to the results of this study, generalized and multilevel Poisson regression models were more suitable for data analysis and it can estimate coefficient effective of factors on the number of children exactly.

Coenzyme Q10 (CoQ10) is a provitamin existing in mitocondrial and cellular membranes scavenging free radicals as an antioxidant. This coenzyme also has important role in providing energy in cardiomyocites. Levels of CoQ10 decrease in heart failure. The treatment of severe congestive heart failure is one of the problems in cardiac patients. The aim of this study was to determine the effect of oral administration of CoQ10 in chronic heart failure. This quasi-experimental study was carried out on 47 patients with congestive heart failure (CLASS III-IV NYHA). In all patients MM, 2D, and Doppler echocardiography were performed and after that they received oral CoQ10 (100 mg) (red-CoQ10) as daily single dose during next three months. After treatment, echocardiography was performed again and the data including left ventricle size, end systolic diameter, end diastolic diameter and severity of MR before and after treatment were compared and analyzed. The mean±SD was 60.5±12.8 years. Thirty patients (63.8%) were male and 17 patients (36.2%) were female. More than 10 mm decreases were observed in: left ventricle size (in 8.5%), end systolic diameter (in 12.8%), end diastolic diameter (in 19.1%) and increase in ejection fraction in 70.2% of patients that indicated significant differences as compared to before treatment (p=0.000). In dilated cardiomyopathy, more than 10 mm decreases were observed in: left ventricle size, end systolic diameter, and end diastolic diameter in 7.4%, 14.8% and 11.1% of patients, respectively. But in coronary artery disease, more than 10 mm decreases were observed in: left ventricle size, end systolic diameter, and end diastolic diameter in 9.1%, 18.2%, and 45.4% of patients, respectively. Increases in ejection fraction were 74.1% and 63.6% in dilated cardiomyopathy and coronary artery disease, respectively. Based on obtained results, supplementing patient's cardiac medicines with CoQ10 made significant improvements in ejection fraction. Additionally, the results of this study show that CoQ10 is effective in coronary artery disease.

In spite of recent developments in treatment of urinary tract infection (UTI) in children, renal damage and scar can be associated with UTI and vesicoureteral reflux (VUR). The risk of renal damage is more in children with younger age, especially in children under one year. This study was done to evaluate the risk of renal scar presentation in infants with UIT and VUR. This study was done on 71 children less than one year old with VUR and UIT that were referred to Amirkola Children Hospital (2007-2008). VUR was diagnosed by Voiding cystourethrography (VCUG) grade I-V and scar (grade I-IV) by DMSA (Dimercaptosuccinic acid) 4-6 months later. Then the results were surveyed. Among 71 children, 49 (69%) patients were female.142 kidney units were evaluated and 114 (80.3%) units had VUR and the grades II (47.4%) was the most common grade of VUR. Among 142 renal units, 48 (38.8%) units had scar. The most common grade of scar was grade I (31 units, 64.6%). The most common grade of scar was seen in grade II of reflux (18 units, 37.5%). According to this study, more than one-third of children less than one year old with UIT and VUR had scar. So, more attention and good follow up are needed for UTI in this age group. Also the potential of scar formation before delivery must be mentioned.

Constipation is one of the most common reasons a child is referred to a pediatric gastroenterologist. In the vast majority no structural, endocrine, or metabolic etiology is identified and constipation called functional or idiopathic. The aim of this study was to evaluate the role of anorectal monometry in differentiating functional constipation from Hirschprung’s disease in children. This cross sectional study was performed on 69 children aged 6 months– 13 years with chronic constipation, who didn’t response after suitable therapy during one year in children’s Hospital Medical Center. All of children underwent un-prepared contrast enema, considering: transition-zone, retained contrast after 24hr and abnormality of rectal diameter. Rectal biopsy was performed in patients with negative RAIR and suspected to hirschsprung’s disease, and data was analyzed. Sixty nine children with age range 6 months- 13 years (mean age of 53.1±14 months) including 37 girls (53.62%) and 32 boys (46.38%) were studied. Rectoanal inhibitory reflex (RAIR) was present in 54 of the 69 patients (78.26%), and 15 cases (21.73%) with a negative (RAIR), underwent rectal biopsy. In which showed absence of the ganglion cells and intestinal neuronal dysplasia in 13 cases, that was compatible with Hirschsprung’s disease. Rectal manometry was again performed for 2 remained patients who had shown to have normal ganglion cell in their last rectal biopsy, and normal RIAR was determined. Sensitivity, specificity, positive and negative predictive value of the manometric test for diagnosis of Hirschprung’s diseases were 100%, 96%, 88% and 100%, respectively. The results of this study showed that anorectal manometry is the suitable method for diagnosis of functional constipation from Hirschprung’s disease in children. Rectal manometry is recommended before rectal biopsy for all children with refractory chronic constipation who are suspected to have Hirschsprung’s disease.

Bone cements are used both as stabilizing prosthesis and bone filler in orthopedic surgeries. Among the most important of such materials are polymethyl methacrylate (PMMA) cements, which have great and multiple applications. But many environmental problems are encountered with these cements and therefore these related researches are stimulated toward environmentally compatible bone cements. Calcium phosphate bone cements can be considered the best substitute for hard tissues. Calcium phosphates are used by our body to build bones. These materials have been developed in different forms; porous or dense blocks, particles or granules and cements as a bone tissue substitute. Calcium phosphate cements consists of two parts: a powder and an aqueous liquid, which are mixed to the form of homogeneity paste that sets at room and body temperature. Being handle as paste, these cements allow perfect filling of bone defect regardless the shape of the defect, but calcium phosphate cements are still not strong enough for load-bearing bone repair. This study deals with product and evaluation of application properties of calcium phosphate bone cement for clinical various applications.

Physical inactivity causes around 2 million deaths in the world each year. It is estimated to cause about 10-16% of cases each of breast cancer, colon cancers, and diabetes, and about 22% of ischaemic heart disease. This study is carried out based on determination of the effect of educational intervention through the theory of planned behavior on the physical activities of Kerman Health Center’s staff. This is a before and after quasi experimental research. This study was performed on 149 persons of Kerman province and city health Center’s staff in two groups of intervention and control. Through a questionnaire provided by the researcher, the elements of this theory were measured before and after intervention. The educational intervention was used in intervention group based on intervention according to this theory for 6 weeks and for control group just lecture was used. Then two groups were evaluated. Both groups don’t have any significant difference before intervention based on demographic characteristics. Before intervention there was no meaningful difference between the averages of the grades of the theory’s different elements in two groups (p>0.05). After intervention there was a meaningful increase in the average of awareness and behavioral intention of intervention group’s grades and there was a meaningful increase in the average of behavioral intention of control group’s grades (p<0.05). In mean difference of grades constructs of theory didn’t have revealed any significant difference between groups of intervention and control before and after intervention. The results showed that the 6 week implementation of theory of planned behavior base and lecture base has shown no significant effect on the physical activities of Kerman health Center’s staff.

Aggression is known as prevalent children's behavior problems. Storytelling is one of the methods used to decrease aggression. The purpose of the present study was to compare the effectiveness of the two methods of storytelling (i.e., storytelling and storytelling with discussion) on decrease of aggression from parents point of view among a sample of boys aged 6-8 years old. Using a Quasi experimental design with pre-post test, 33 boys who had received scores 1 SD above the mean on Shahim's aggression questionnaire were randomly assigned into 2 experimental groups (storytelling= 11 subjects and storytelling with discussion= 11 subjects) and control group (n=11). Experimental groups participated on 11 sessions of storytelling and storytelling with discussion but control group received no interventions. After finishing the program and three months later physical, reactive and relational aggression was compared. The post-treatment scores of the 3 subscales of reactive, rational and physical for storytelling group was 14.45±3.3, 13.55±2.1, 10.91±1.3, respectively; the post-treatment scores of the 3 subscales of reactive, rational and physical for storytelling and discussion group was 11.18±2.3, 10.18±1.7, 9.09±1.5, respectively. These results indicate that participants in storytelling and discussion significantly (p<0.05) scored lower than participants in storytelling group on the 3 subscales of reactive, rational and physical. These results indicate that storytelling and discussion is an effective method in decrease of children’s aggressive behavior and the method can be used in treatment of children suffer from aggressive behaviors.

Hospital wastewater quantity and quality is important for promotion of human and environmental health, because it contains many microbial and chemical pollutants. This study was performed to study the quantity and quality of wastewater in hospitals of Babol medical University and its effects on human and environmental health. This cross sectional study was performed on wastewater quantity and quality of 3 teaching hospitals in Babol (Shahid Beheshti, Yahyanejad and Amirkola hospitals). Water consumption rate was identified using issued receipts and wastewater production per bed by water to wastewater ratio. Seventy two mixed samples were obtained, collected and sent to the laboratory for identifying of PH, BOD5, COD, TSS and TC based on standard methods. Average daily water consumption and wastewater production were 614±74 and 474±73 liter per bed and water-to-wastewater ratio was 79.77%. Mean values of PH was 7.53±0.58. Mean values of BOD5, COD, TSS and TC in raw wastewaters were 400±96 mg/L, 616±166 mg/L, 282±81 mg/L and more than 2400 MPN/100 mL, respectively. Annually total of wastewater volume and loading rate was 100524 m3 and 40210 Kg, respectively. Considering the results of the quantity and quality of hospital wastewater and its effects on the environment health, it is necessary to give special attention to the management of wastewater production, construction, upgrading, and good operation of wastewater treatment systems in these hospitals.