مجله دانشگاه علوم پزشکی سبزوار
سال هفدهم شماره 1 (پیاپی 55، بهار 1389)

Background and Glutamatergic system has a role on morphine withdrawal sign, and magnesium has inhibitory effect on the NMDA receptors of glutamatergic system. The present study aimed to determine the effects of magnesium injection on morphine withdrawal signs in male and female rats. In this experimental study, 48 Male and female rats (200-250 gr) were used. The animals divided into 6 equal groups: two male and female control groups received normal saline; two male and female groups receiving magnesium sulfate 150 mg/kg; and the last two groups receiving magnesium sulfate 300 mg/kg. All groups received 3% sucrose in tap water with morphine 0.4mg/ml (for 21 days) to become addicted. In the end of 21st day, NS or magnesium administrated 30 min before naloxone (2mg/kg) and then withdrawal signs evaluated for next 30 min. The obtained data were analyzed in SPSS using ANOVA and complementary tests with p<0.05 as significant. The results of this study showed that the injection of magnesium in dose of 150 mg/kg could significantly reduce many withdrawal symptoms in male addicted rats [Jumping 62.96% (2.5± 1.14), standing 45.4% (6.62 ±1.45)] and in female addicted rats [Jumping 77.75% (1.25 ±0.54), climbing 24.51% (8.87 ± 1.65), standing 52.57% (5.57 ± 1.26)]. The injection of magnesium with dose of 300 mg/kg also reduced dramatically withdrawal symptoms in male rats [Jumping 87.03% (6.75 ± 1.66), climbing 34.34% (12.87 ± 1.27), standing 56.12% (12.125 ± 1.27)] and female rats [Jumping 84.43% (0.875 ± 0.25), climbing 36.17% (7.5 ± 1.08), standing 69.07 % (3.75 ± 0.64)]. The administration of magnesium in both doses caused a significant reduction of most withdrawal symptoms, and its effect on both sexes was almost similar. It seems that the injection of magnesium during morphine withdrawal can considerably reduce the symptoms of withdrawal syndrome in rats.

Background and Use of intrathecal opioids causes an increase in the block depth of anesthetics and duration of analgesia. Intrathecal opioids are associated with side effects such as itching, nausea and vomiting. However, the use of NSAIDs reduces itching induced by intrathecal opioids. Therefore, the present study intends to determine and compare the effects of nanogram celecoxib on reducing the incidence and intensity of intrathecal meperidine-induced pruritus. Methods and Materials: This double-blind clinical trial was conducted on 90 patients undergoing caesarean section. Patients were randomly assigned into experimental and control groups. The experimental group received 25ng/kg or 100ng/kg celecoxib and the control group received oral placebo. Patients under spinal anesthesia received meperidine 10mg with intrathecal Bupivacaine 0.5%. Then, pruritus was assessed 0, 2, 6, 12 and 24 hours after surgery, and were recorded by scoring criteria. The obtained data were analyzed in SPSS using one-way ANOVA, chi-square and Fisher’s exact test. Values below 5% were considered significant. The difference of the two groups in their age, weight and oral intake was not significant (confidence interval 95%). The incidence of itching in the experimental groups of 25ng/kg (p=0.049) or 100ng/kg celecoxib (p=0.001) in 0 and 2 hours after surgery were significantly lower than the control group; also, the intensity of itching 2 hours after surgery was significantly lower then the control group (p=0.001). Nanogram doses of Celecoxib can be used for reducing the incidence and intensity of meperidine induced pruritus.

Background and Extracorporeal shock wave lithotripsy (ESWL) is initial treatment of choice for most calculi in the kidney. Although ESWL has many side effects one of which is cardiac arrhythmia, occurring mostly in non-synchronized mode. The aim of this research was to determine the effect of extracorporeal shock wave lithotripsy on electrocardiogram changes in patients with renal stone. This quasi-experimental study was carried out on 75 patients with renal stone who were selected by non-probability and convenience sampling. Then electrocardiograph was obtained from participants before, during and after lithotripsy. The relationship between ESWL-associated arrhythmia and autonomic neural activity was evaluated by heart rate spectral analysis. Electrocardiogram changes were interpreted and the data were analyzed in SPSS and SAS using chi-square, independent t-test, paired t-test, McNemar, Cochrane, One-way ANOVA and general linear model. ESWL was found to elicit new or worsened electrocardiogram changes in 66.7 percent patients with no previous cardiac disease. A statistically significant correlation was demonstrated between the presence of ventricular premature contractions and analgesic drugs (p<0.001) and between the presence of ventricular tachycardia and treatment duration (p<0.001). Shock waves delivered by lithotripsy cause cardiac arrhythmia.

Background and

The effect of stress on diabetes is a complex issue but its relationship with blood sugar level and diabetes control has been clarified. The present study was carried out to compare the stressor and coping strategies in subjects with diabetes and normal subjects. Methods and Materials: This case-control study was conducted on diabetic and normal subjects, including 30 subjects with diabetes and 30 normal subjects. Research instruments were daily stressors assessment questionnaire and the ways of coping with stress questionnaire. Independent t-test in SPSS was used for testing the hypotheses. The validity and reliability of the questionnaire were 0.88 and 0.84 respectively.

There was a significant difference between frequency of stressors in subjects with diabetes (mean 307.33) compared to normal subjects (mean 173.2) (p<0.05). Also, there was a significant difference between severity of stressors in subjects with diabetes (mean 308.26) compared to normal subjects (mean 172.5) (p<0.05). There was a significant difference between coping strategies in subjects with diabetes (mean 15.56) compared to normal subjects (mean 24.73) (p<0.05).

According to research findings, frequency and severity of stressors in subjects with diabetes were higher than normal subjects.

Background and Cytokines are among the many immune system factors involved in diabetes pathogenesis. The level of cytokines expression such as IFN-y is varying in individuals and societies. Due to the fact that diabetes nephropathies are known as inflammatory disorders and the role of cytokines especially IFN-g in the establishment of inflammations is well understood, the present study was aimed to examine serum level of IFN-y in type 2 diabetes patients with nephropathy complications. In this cross sectional descriptive study, serum samples were obtained from 100 type 2 diabetes patients with nephropathy and 100 healthy controls for the analysis of IFN-g serum level (eBiosense, ESP). Consent forms were also filled out by patients and healthy controls according to the rules and regulations of Zahedan Islamic Azad University Ethical Committee. The obtained data and questionnaires were analyzed in SPSS using ANOVA; p<0.05 was considered as significant. The mean serum level of IFN-y was 16.09 y 7.74 pg/ml and 4.03 y 2.00 pg/ml in nephropathic patients and healthy controls, respectively. Statistical analysis of the data showed that the difference in the IFN-g level was not significant in nephropathic patients and controls. Based on the non-significant differences between the two groups, it seems that there is no association between the level of serum IFN-g and nephropathy in type 2 diabetics.

Background and Domestic violence against women is considered as one of the general and mental health concerns and covers a variety of injuries incurred on married women. It is the most common form of violence against wives which affects other health priorities including maternal well-being and safety, mental health and family planning. The present research was conducted to study the prevalence of domestic violence and related factors. Methods and Materials: In 2007, this descriptive analytical research was conducted on 396 married women (selected through convenient sampling) who were admitted to the Health Clinics in Sabzevar, Iran. They were given the Index of Spouse Violence to fill out, and the obtained data were analyzed in SPSS using chi-square, Fisher’s test, and Student t-test. The most common forms of violence were mental violence (29.2%), followed by sexual violence (28%), and physical violence (10.8%). It was found that home violence correlated with the couple’s educational level, husband’s addiction, experience of violent behavior in the couple’s childhood, familial relation between the couple, spouse’s physical or nervous disease, place of birth, and the number of children (p<0.05). Domestic violence against women was high in the study, and the most common forms of violence were mental, sexual and physical violence.

Background and Using levonorgestrel tablet is one of EC methods that could be effective until 72 hours after sexual intercourse. Therefore, the present study was intended to investigate the women’s awareness about correct use and side-effects of this tablet. Methods and Materials: In this descriptive analytical study, women referring to heath centers of Sabzevar were selected through cluster sampling. Data were collected through a questionnaire including specific demographic characteristics and the participants’ awareness about correct using and side effects of levonorgestrel tablet. The reliability of the questionnaire was checked with cronbach alpha (=α0.716), and its validity was controlled by expert. The sample size was 396 persons. The obtained data were analyzed in SPSS using descriptive and analytical statistics (independent t-test and Pearson correlation coefficient). Among women studied, 29.8% had used the tablet, and the average score of awareness in correct using of tablet on the basis of 100 was 46.1 34.5, while the average score of knowing the tablet's side effects on the basis of 100 was only 22.39 28.92. A negative correlation was found between the correct using score and age (p=0.029, r=-0.11). The findings revealed that the average awareness score of correct using and side-effects of the tablet are low.

Background and Vulvovaginal candidiasis is one of the most common infections in women and is caused by various types of candidiasis with different patterns of resistance against drugs. The present study was conducted to determine the various species of candidiasis in women admitted to Mobini Hospital in Sabzevar, Iran in order to make preventive recommendations for medical doctors. Methods and Materials: This cross-sectional descriptive analytical research was conducted on 231 women admitted to Mobini Hospital in Sabzevar, Iran, complaining of vaginal secretions. After getting the ethics committee permissions and obtaining the informed consent of the participants, at the same time as measuring vaginal pH, two swaps were used for collecting samples of secretions from lateral and posterior fornix. They were examined for yeasts and were then cultured in saburu dextrose. Grown yeasts were detected based on their macroscopic and microscopic features, tubulation in blood serum and biochemical characteristics using Yeast Plus System. The obtained data were analyzed in SPSS 11 using chi-square and bi-dimensional tables. Positives results in direct examination results were 7.35%, and in culture the positive results were 26.8%. In detecting processes, candida albicans yeast (38.7%), Candida kefyr (17.7%), Saccharomyces cerevisiae (14,5%); candia tropicalis (9.6%), Candida glabrata (8%), candida cruse (3.2%) were isolated with other non-pathogenic yeasts including Candida rugosa, Candida lipolytica, trycospron bejli, Blastoschizomyces capitatus (6.4%). Non-pathogenic yeasts were isolated from patients with defective immunity systems, and need to be considered in patients with vaginal infections.

Background and Crimean Congo fever was first characterized in 1944 in the Crimean peninsula and then in 1956 in Congo. Their sameness was recognized after long investigation in the two continents, and was labeled as Crimean Congo Hemorrhagic Fever or CCHF. It is one of the hemorrhagic fevers, which manifests as a sudden onset of high fever, chills; severe headache, dizziness, back and abdominal pain after a short incubation period, CCHF is characterized by a sudden onset of high fever, chills and myalgia, and turns into hemorrhagic phase after five days. The Patient: The patient was a 15-year-old boy treated for brucellosis from 15 days ago and was admitted because of fever, headache and vomiting diagnosed as brucella meningitis. Because of thrombocytopenia, sporadic petecia and epistaxi, diagnosis of CCHF was suspected and reported as positive according to RT-PCR. Likelihood of CCHF in animal husbandry occupations is possible, and since its symptoms are similar to brucellosis, its diagnosis must be considered together with brucellosis.