مجله دانشگاه علوم پزشکی رفسنجان
سال نهم شماره 3 (پیاپی 36، پاییز 1389)

There are conflicting reports about the effects of blunt trauma on fertility. This study was designed to evaluate the effect of unilateral blunt testicular trauma on sperm parameter of contalateral testis and the protective effect of zinc on possible damage. This experimental study was conducted in the cell culture laboratory, Department of Anatomy of Ahvaz Jundishapur University of Medical Sciences, in 2006. T hirty prepubertal male wistar rats were divided randomly into three equal groups. Group1 was used as control. Rats in group II and group III, as blunt testicular trauma groups, were subjected to left blunt testicular trauma. After the trauma, animals in group III were given 30 mg/kg zinc sulfate intraperitoneally and this treatment was continued for 40 days at a dose of 500 ppm per day orally. All the right epididymis of rats were removed and the number and motility of sperms were examined using Makler chamber and inverted microscope. The number of sperms in group II was significantly decreased compared to the other two groups (p<0.05). Our results showed that groups II and III have significantly lower sperm motility in comparisons with group I (p<0.05). However there was not any significant differences in sperm mobility between group II and III. These results suggested that unilateral blunt testis trauma has a negative effect on sperm count and progressive motility of sperm. Zinc has a protective effect on sperm's count, but has no protective effect on motility of sperms.

Cannabinoid exerts have widespread and complex effects on higher cognitive functions. An overlapping distribution of nicotinic receptors with cannabinoid receptors has been reported in some brain structures such as dorsal hippocampus, thus the functional interactions between cannabinoid and nicotinic systems in cognitive control seems possible. In the present study, the effects of mecamylamine on WIN55, 212-2 induced state-dependent learning was examined. In this experimental study, 280 adult male NMRI mice were esthetized and, then, were cannulae implanted bilaterally in the CA1 regions of the dorsal hippocampus using stereotaxic method. Seven days after the recovery from surgery, behavioral testing was started in inhibitory avoidance task. The animals were trained in a step- down type inhibitory avoidance task and tested 24h after training to measure the step- down latency for the assessment of memory retention. All experiments were conducted in accordance with "standard ethical guidelines for animal care and use". Post-training administration of WIN55, 212-2 and AM251 decreased the memory retrieval. The memory impairment induced by WIN55, 212-2 was completely reversed by pre-test administration of WIN55, 212-2 and/or mecamylamine, suggesting WIN55, 212-2 induced state-dependent memory. These results suggest that nicotinic receptors of the dorsal hippocampal may play an important role in Win55,212-2-induced amnesia and WIN55,212-2 state-dependent memory.

Patient education is an essential part of treatment of diabetic people. In addition, follow up with the aim of establishing effective care in order to increase the patient's knowledge is necessary. This study was designed to measure the effect of Nurse-led Telephone Follow up (Telenursing) on HbA1c among diabetic patients. In this randomized controlled trial study, seventy diabetic patients were selected using simple random sampling method. Study instruments included a data sheet to record HbA1c and a questionnaire for demographic variables. Data were collected at baseline and 12 weeks after the intervention. Participants were randomly assigned to the experimental and control groups. Telephone follow up was applied for the experimental group for 3 months. Data analysis was done using SPSS and descriptive and analytic statistics (independent t-test, paired t-test, Mann-Whitaney and χ 2) were used where appropriate. The majority of patients in the two groups were female, 50-65 years old, married, had type 2 diabetes, under oral drug therapy, and were matched based on based on demographic illness variables and HbA1c rate before the intervention. After the intervention, mean rate of HbA1c in the intervention group was decreased to 1.23%: which showed a significant difference in HbA1c rate between the two groups (p=0.001). According to the results Nurse-led Telephone Follow up (Telenursing) can improve HbA1c rate in diabetic patients.

Aloe vera is native to North Africa, and is also cultivated in Turkey. Aloe has long been used all over the world for its various medicinal properties. The aim of this study was to measure the interaction effect of Aloe vera and glibenclamid on blood glucose, LFT and lipid metabolism in streptozotocine-induced diabetic male rats. This experimental study was carried out on 40 wistar Albino male rats in Zahedan University of Medical Sciences. Animals were divided into five groups, one as control (intact), and the others as experimental groups. Rats in the experimental groups were made diabetic by streptozotocin injection (65mg/kg-IP). The diabetic groups, except one (diabetic control), received 400 mg/kg aloe vera extract, 5mg/kg glibenclamid and 400 mg/kg Aloe vera extract with 5 mg/kg glibenclamid daily for 4 weeks by gavages respectively. At the end of experiement fasting blood samples were collected from all groups. The results showed that FBS, TG, Ch, AST, ALT levels in the experimental groups were significantly decreased in comparison with those in the control group (p<0.05). There was no significant difference on HDL level. In addition, Alk.P level in glibenclamid alone and glibenclamid + Aloe vera groups were significantly increased in comparison with the control group (p<0.05). The results of this research indicate that interaction of Aloe vera aqueous extract and glibenclamid decrease blood glucose, TG, Ch, LDL, AST and ALT levels. However, the effect of Aloe vera extract in combination was not greater than the effect of Aloe vera extract alone. These findings may be due to the effects of Aloe vera and glibenclamid on glucose metabolism. Further research is suggested to study the exact mechanism of them in diabetic rats.

Considering the increase of ethical problem cases in recent year's promoting professional ethics among medical students is important. In order to identify the strengths and weaknesses, as well as opportunities and threats of medical ethics training these effective strategies have been designed. Using these strategies can make medical ethics training in Rafsanjan University of Medical Sciences (RUMS) more effective and more efficient. In this cross sectional study, after identifying a list of strengths and weaknesses as well as opportunities and threats of medical ethics training, a questionnaire was used to obtain the opinions of the faculty members of (RUMS), and then the strategies were presented in the model of SWOT. According to the internal factors analysis table, among the strengths, the most important rate of significance (weight) was given to the existence of rich Islamic and historical sources in the field of medical ethics with the weight of 0.10 and the grade of 2.9. Further more, among the weaknesses the most important rate of significance was given to using traditional methods in the medical ethics training with the weight of 0.12 and the grade of 2.7. Regarding the sum of points in the analysis table, internal factors (2.74) and external factors (2.83) we can generally say that the reaction of the faculty members of RUMS to the strengths and weaknesses and also to the opportunities and threats in the medical ethics training is less than average. Considering the findings of this research, using the method of SWOT, on the whole, 17 strategies in the forms of competitive, defensive, conservative and aggressive are presented. The validity of these strategies was measured by the study group and its credit rate was high. After prioritizing strategies, the first priority belonged to medical ethics training in the form of interdisciplinary by professors of ethics and clinical sciences. The second priority belonged to medical training in patient's bedside, and the last priority belonged to the strategy of training curious doctors.

Infection of vaginal candidiasis has been reported in about 4.8-27 percent of women in different studies. Derivatives of azoles group antifungal in topical forms such as clotrimazole are the most common available medication for the treatment. This study was carried out to determine the antifungal effects of clotrimazole, fluconazole and nystatin on candida isolated from candida vaginitis. In this experimental survey, 105 vaginal candidiasis were identified from autumn 2007 to spring 2008. Germ tube, chromagar and chlamidoconidia tests were used for identification of candida species. Evaluation of antifungal activity was performed by disk diffusion method. Inhibition zones around the fluconazole, clotrimazole and nyststin disks were measured and compared. Candida species were identified as follows: Candida albicans (66.6%) Candida glabrata and the Candida non-albicans isolates (21.9%), Candida tropicalis (8.6%), Candida krusei (2.9%). Ninety four percent of all samples were sensitive to clotrimazole, 55% to fluconazole and 99% to nystatin respectively. Also 43.8% of samples of Candida albicans were sensetive to fluconazole and 26% were drug resistant. In the non-albicans types 18% showed resistance to fluconazole. Nystatin had high sensivity (99%) versus clotrimazol and fluconazol in in vitro against candida vaginitis isolates therefore nystatin could be considered as a good antifungal agent in the resistant cases.

Suicide as a psychiatric emergency has been regarded by all psychiatrists and health professionals. In recent years, suicide has increased in all age groups especially in the adolescence age group. Therefore, in the present research it has been tried to study the frequency of mental disorders and factors related to suicide in patients referring to Emergency Ward of Ali Ebne Abitaleb hospital of Rafsanjan.

In this descriptive study, 113 people admitted to the Emergency Ward of Ali Ebne Abitaleb hospital with diagnosis of attempted suicide were chosen. Then, the Minnesota multi-phasic personality inventory along with the questionnaire for individual characteristics and risk factors of suicide were completed for each person. Statistical tests of linear regression and correlation were used to analyze data.

The most prevalent mental disorders were depression (%58), hypochondriasis (%56), schizophrenia (%54) and anti-social personality (%54). Physical diseases with %17.7 had the least score among the ten factors. Higher percentages belonged to criteria such as depression (%57.5) and marital status (%47.8). According to the ten-item criteria of suicide risk, %7.1 of respondents needed to be hospitalized. Seventy one point six percent had the score of suicide risk at a rate that indicated voluntary hospitalization is required. There was a significant relationship between the individual's scores based on the presence of the risk factors and some disorders such as hypochondriasis, depression, being anti-social, anxiety and schizophrenia.

Mental disorders are predictive of suicide. Also, concurrent presence of most of the 10 risky factors of suicide such as marital status, depression, drug abuse and adolescence age increase the risk of suicide.

Existance of a reliable and valid test in order to evaluate the impact of treatment on the quality of upper extremity skills at an early age is necessary. This study was conducted to measure the reliability and validity of Quality of Upper Extremity Skills Test in children with cerebral palsy. In this methodological study, 20 children with cerebral palsy referred to two rehabilitation centers (Bahar and Omide Asr) were selected in the summer and autumn of 2008. Each of the therapist in the two centers did the test for the selected children twice with a 10 day interval (the inter objective reliability). Then in the 10th day, both therapists worked on children simultaneously. Results showed significant correlation in intera objective subscales (0.89-0.99) and intera objective total scores (0.91-0.98). Inter objective subscales were 0.73-0.99 and total scores were 0.87-0.98 (p≤0.001). The present study showed high inter and intera reliability and validity of QUEST, so it could measure the quality of upper extremity skills in children with cerebral palsy.

Succinylcholine is the only depolarizing neuromuscular blocker available which has been used for more than 50 years in the emergency cases, rapid sequence induction, and when aspiration treated as a risk factor. Unlike the nondepolarizing neuromuscular blockers, Succinylcholine has rapid time-to-onset of action and short duration of action. However, there are a number of potential side effects associated with succinylcholine. Case Report: A thirty-year old women was settled in cesarean ward under general anesthesia in Rafsanjan Niknafs hospital in 2007. Patient begun to breath after closing the volatile agent s and administration of reversal drugs, but she was not able to raise her head. Despite second reverse injection, after 30 minutes, her breathing was not adequate. Gradually, her body temperature increased up to 37. 9 ◦c and urine color turned to brown. Dantrolene infusion was started and patient was transferred to ICU. Tracheal intubated and oxygenation was done by ventilator because of respiration muscular weakness. Weaning of ventilator was performed after 7 days, and three days later the patient was discharged. Anesthesiologist should be aware of potential side effects of succinylcholine and be prepared to manage it. Consideration of rapid action non-depolarising neuromuscular blocking drugs in the prevention of these types of complications is useful.