مجله دانشگاه علوم پزشکی شهید صدوقی یزد
سال هجدهم شماره 3 (پیاپی 74، امرداد و شهریور 1389)

Otoacoustic emissions are low density sounds produced from intact cochlea measureable in the presence of an intact conduction structure. The goal of this study was to assess the surgical success rate after stapes surgery by standard audiometric tests, Distortion Product Otoacoustic Emission (DPOAE) and Transient Evoked Otoacoustic Emission (TEOAE) as methods of evaluation of postoperative hearing. A descriptive-analytic study was conducted on 50 patients with otosclerosis at Yazd Shaheed Sadoughi Medical University from March 2004 till October 2007. TEOAE, DPOAE and other behavioral audiometric tests were performed before, three months and six months after surgery on patients and results were compared. The air-bone gap threshold decreased significantly in audiogram of patients after surgery. Prior to surgery, TEOAE and DPOAE responses were not recordable in any of the patients, but after surgery, they were recordable in only two patients. Although conductive hearing loss improved significantly in patients who underwent successful stapes surgery, OAE tests were recordable in an insignificant number of patients. Therefore, this is not an optimal method for evaluating the surgical success rate.

Tremendous efforts towards the elimination of Iodine Deficiency Disorders (IDD) during the last two decades have controlled these disorders in most of the provinces in Iran. This study was performed to evaluate the adequacy of iodine supplementation after 17 years of universal salt iodization in Yazd province. In a cross-sectional study, 1200 schoolchildren (600 girls and 600 boys) aged 8 to10 year-olds, randomly selected from Yazd province were evaluated in 2007. Goiter prevalence, urinary iodine excretion and iodine content of household salts were measured and the obtained data were compared to those obtained in 1996 and 2001. Total prevalence of goiter was 6.3% and no grade II goiter was seen. The median urinary iodine in 120 schoolchildren was 248 µg/L, with 5.8% (95% CI= 1.6-10) having urinary iodine excretion less than 50µg/L. Eighty six percent of households were using purified iodized salt, 48% of households had appropriate salt storage, and 5% of the household salts contained less than 15 µg iodide. Goiter prevalence has significantly decreased in the Yazd province, 17 years after universal salt iodization. The median urinary iodine of schoolchildren was adequate as that reported in 1996 and 2001, indicating a well established sustainable IDD program in Iran.

Mycobacterium ulcerans is the etiological agent of Buruli ulcer (BU); the third most common mycobacterial infection in humans after tuberculosis and leprosy. BU is now considered by the WHO to be an emerging infection of major concern. M. ulcerans produces mycolactone toxin, which is required for the organism’s virulence. Mycolactone destroys tissue and suppresses host immune responses. In this descriptive analytical study, peripheral blood mononuclear cells from three volunteers with no history of buruli ulcer were used. IL-6 and TNF produced by these cells at different preincubation times with LPS and mycolactone were measured by using ELISA kits. This study showed hyper inhibition of IL-6 and TNF production by mycolactone. TNF levels in the control tubes (containing LPS) in 4hours reached its maximum value and then decreased. While the production of IL-6 in the tube with fresh cells (zero time) had the highest value, after 16hours, it reached its minimum. Since TNF and IL-6 are important immunity inflammatory cytokines, it can be well imagined that decrease of TNF production by this bacterium plays a role in weakening of inflammatory response. So Mycobacterium ulcerans destroys macrophages and at the same time prevents TNF production by important cells in innate immune mechanism.

Social support can be defined as the interactive process through which emotional and instrumental support is obtained. Social support has been found to be a relevant factor in diabetes self-management. Diabetes refers to complex chronic metabolic conditions that are characterized by elevated levels of blood glucose if untreated. Diabetes is one of the biggest health care problems facing Yazd with regards to prevalence, cost, and the onus it places on patients and its high morbidity rates. The purpose of this study was to examine the relationships among social factors on the control and treatment of type II diabetes. The population under study included 4990 diabetes type II patients referring to Yazd Diabetes Research Center and a sample of 256 cases was selected by simple random sampling method through statistical society. This study was based on survey method and the instrument for collecting data was a questionnaire. About 65.4% of the patients were women and 35.6 were men. The mean age of patients was 56 years. Significant correlations were found between perceived social support (r= 0.193, p= 0.001), positive reinforcing behaviors (r= 0.455, p= 0.000), and adherence to self-care activities. Misguided support behaviors did not show a significant correlation with adherence to self-care activities. A total of 25% of variance in self-care behavior can be explained by positive reinforcing behaviors and misguided support behaviors. The findings of this study showed that by increasing the positive reinforcing behaviors and perceived social support and decreasing the misguided support behaviors, the diabetic patients can adhere better to self-care activities.

Medicinal plants are valuable natural resources that are nowadays known as safe pre-materials for drug industries in the advanced countries. Black caraway is one of the most important and economical medicinal plants that can be grown naturally in some regions of Yazd province. The essence of the plant are used in treatment of diarrhea, dyspepsia, fever, flatulence, stomachache, hemorrhoids, hiccoughs, as an antihistaminic and more numerous uses in medicine industries. This plant shows several therapeutic effects on digestive and urinary tract disorders and is well known as an anti-convulsant, anthelmintic, anti-asthma and antidyspnic drug in Iranian traditional medicine. Bunium Persicum oil is capable of suppressing the initial stage of an inflammatory process. Also, this plant is used for culinary purposes and for flavoring foods and beverages. In this research, the fractionization of seed essence was done by GC method and the compounds were recognized. The DPPH test was used for estimating anti oxidant effects and the Follin-Ciocalteu method was used for estimating quantity of phenol compounds. The results revealed that- γTerpinene had the highest percentage in the essence of the native black caraway of Yazd province. Also, the antioxidant test showed the high antioxidant effect of the native black caraway of Yazd province with an IC50 of 2.85 µg.mg-1 and the phenolic component percentage of 117.09mg.g1. This result was much higher than previous similar studies about black caraway.

Electrical stimulation has been used for many years in rehabilitation medicine to prevent atrophy or to increase muscle strength, but the use of electrical stimulation for muscle strengthening in research and clinical practice has become increasingly popular in recent years. The quadriceps femoris is the thigh muscle group that suffers the greatest amount of atrophy. This study aimed to compare the effects of electrical stimulation and voluntary isometric contraction for increasing the quadriceps strength and the girth of thigh in middle aged and old patients after removal of cast immobilization. 87 patients whose knees were immobilized following lower extremity fracture were randomly allocated into two groups: the electrical stimulation and voluntary isometric exercise group. The patients trained for 20 minutes, 3 days a week over a period of 6 weeks. The subject's thigh circumference and muscle power were evaluated before and after treatment. The increase in quadriceps strength of the electrical stimulation group (28%) was significantly less than that of voluntary isometric exercise group (40%). However, there was no significant difference between the two treatment modalities in increasing circumference of thigh (1.42 ± 0.27 & 1.41 ±0.36, P=0.96). This study showed that although electrical stimulations is an alternative and potentially effective means to increase the strength of quadriceps following knee immobilization in middle-aged and old patients, it is not more effective than voluntary isometric exercise.

Depression is the most prevalent psychotic disorder. In order to cure and prevent the recurrence of this disease, it is necessary to gain more information about remedial methods like Group Cognitive- Behavior Therapy. The aim of this study was to investigate the effects of group cognitive-behavioral therapy on the amount of depression on the patients. This study was experimental and it included both experimental and control group with a pre test. The subjects were selected from patients with mild depression. Their Beck inventory score ranged between 17-20. Patients were randomly divided in two groups. The subjects of experimental group received eight sessions of group cognitive-behavioral therapy. The Beck depression test was completed by the subjects in three phases; before the intervention, after the intervention and one month after that. The data was transferred to SPSS program and analyzed. The results indicated a significant difference between the experimental and control group after the intervention at Beck tests (P=0.043). Furthermore, there was a significant difference in the experimental group between the depression score in patients before and after the intervention (p=0.033) and the score of patients before and one month after the intervention (p=0.492). Group Cognitive-Behavioral therapy decreases depression in patients who suffer from mild depression.