مجله علوم پزشکی رازی
سال هفدهم شماره 2 (پیاپی 71، اردیبهشت 1389)

Renal dysfunction due to ischemia-reperfusion (I/R) injury is a common problem following renovascular surgery or kidney transplantation. There is a lot of emerging evidence that statins, which are HMG-COA reductase inhibitors, have renal protective effects against ischemia-reperfusion injury,but the exact mechanism of their protective effect has not been detected properly. This study examined whether simvastatin reduces I/R injury in kidney. In addition, we investigated whether the observed renal protective effect of simvastatin is due to the activation of ATP-sensitive potassium (KATP) channels by using selective antagonist glibenclamide. In this experimental study, male wistar rats(150-200 g) were randomized into five groups while their right kidneys had been removed 3 weeks prior to the study: sham operated, I/R group, I/R pretreated with simvastatin (20mg/kg/day) for 3 days by gavage, simvastatin + glibenclamide(0.3mg/kg ip) +I/R and glibenclamide +I/R. The I/R injury was induced by clamping the left renal artery for 45 minutes followed by reperfusion for 2 hours. For statistical comparison,one-way ANOVA, Mann-Whitney test and Tukey were used and p<0.05 and p<0.01 were considered significant. In I/R group, the level of both BUN and creatinin, as indices of renal cell damage, were significantly increased compared with the sham-operated group. However, these increases were significantly inhibited by the treatment with simvastatin. Simvastatin also improved the renal histological damage compared with the IR group (p<0.05). Glibenclamide, the KATP channel inhibitor, significantly decreased the protective effect of simvastatin (p<0.01). Simvastatin, as an HMG-COA reductase inhibitor, has renal protective effects against ischemia-reperfusion injury independent of its lipid–lowering properties.This protective effect is mediated via activation of the adenosine triphosphate-sensitive potassium channels, and glibenclamide as a KATP channel inhibitor reduces this benefical effect of simvastatin.

Infections caused by genital mycoplasmas may have harmful effects on the fertility of men and may lead to male infertility. This study was performed to detect the prevalence of these bacteria in infertile men referred to Royan Institute.Patients and Semen samples were collected from 220 infertile men and were inoculated into PPLO broth transport media and sent to the laboratory. Following filteration through 0.45µm pore-size disposable filters, the filterates were inoculated into Arginine PPLO broth and Urea PPLO broth media. In cases of color change, the broth media were sub-cultured onto PPLO agar plates. All media were incubated at 37˚C under elevated CO2 atmosphere. From a total of 220 semen samples cultured, 7 cases (3.2%) were positive for only Mycoplasma hominis, 61 cases (27.7%) were positive for only Ureaplasma urealyticum, and 11 cases (5%) were positive for both of them. Thus, 18 cases (8.2%) of Mycoplasma hominis and 72 cases (32.7%) of Ureaplasma urealyticum were isolated from the samples. Evaluation of semen parameters showed that pH was lower in the two groups of “only U. urealyticum positive” and “both bacteria positive” than “both bacteria negative” group (p value=0.031 and p value= 0.006 respectively). Also, the mean sperm motility was lower in “both bacteria positive” group than “both bacteria negative” group (p=0.032).The results of this study showed that a high percentage of infertile men are infected with these bacteria. If these infections are not diagnosed and treated, this may lead to PID and infertility. Therefore, because of high cost of other diagnostic methods such as PCR, isolation of these bacteria in infertile men via culture method is feasible and necessary.

Because cesarean section is one of the most prevalent surgeries in women, the reduction of complications and duration of operation and finding simpler techniques with the fewest complications are of great importance. The present study was conducted to compare the early results, i.e. duration of operation, pain, fever and wound infection, of the two methods of repairing and not repairing visceral peritoneum in cesarean section so that we can suggest the best route with the fewest complications. Patients and In a comparative experimental research, 258 pregnant women who had cesarean section for the first time were randomly assigned into two groups of repairing and not repairing visceral peritoneum. The early results including duration of operation, pain, fever, and wound infection were compared in both groups. For statistical analysis,we used Z–test, leven test, and Chi-square and the findings were shown in cross tabulation tables. Duration of operation was lower in the non-repair group. The rate of wound infection in both groups was 1.2% with no significant differences.The prevalence of post-operation ileus and fever in the repair group was higher and more significant (p < 0.001). Post-operation pain, which was determined based on the number of indomethacin rectal suppositories prescribed, was greater in the repair group (p< 0.001). Since there are no short-term complications due to not repairing visceral peritoneum and because of the reduction in the duration of operation, pain, fever, and the prevalence of ileus in this method, it is recommended that traditional method of closure of visceral peritoneum in cesarean section not be done.

Streptococcal pneumoneae is the most common etiologic agent of community-acquired pneumonia. Pneumococcal isolation from sputum can only demonstrate the possibility of pnumococcal infection because of the possibility of carrying. Definitive diagnosis is made by isolation of pnumococcus from blood and sterile body fluids. Real percentage of positive blood culture in pnumococcal pneumonia is around 15-30%. If urine pneumococcal antigen detection is added to conventional laboratory methods, pnumococcal diagnosis can be increased by 38.9%. The aim of this survey was determining the prevalence of pnumococcal pneumonia in bacterial pneumonia through isolation of pneumococcal antigen from urine. Patients and This descriptive cross-sectional study was performed on patients diagnosed with acute bacterial pneumonia. The subjects were above the age of 18 and admitted to Rasoul-e-Akram Hospital in 2007. Urine samples of patients were tested for antigen detection by immunochromatographic method with Binax NOW Streptococcus pneumoneae test. Blood samples of all patients were cultured. Patients who were admitted for elective surgery and had no infection entered the study as a control group. Quantitative variables were evaluated by using mean and standard deviation and qualitative variables were evaluated by using percentage. From the total of 43 patients, 26(60.5%) were men and 17(39.5%) were female. The mean age of the patients was 55.47 (± 22.46) years. S.pneumoneae was isolated from 2 (4.65%) patients by culture(blood and pleural culture) and from five (11.6%) patients by urine antigen test. S.pneumoneae was seen only in spring and winter. Normal leukocyte count was seen in 2 cases and lukocytosis existed in 3 of them. Lobar infiltration was seen in 4 subjects and pleural effusion in 1. In 2 cases of positive pneumococcal culture, urine pneumococcal antigen test was positive. None of the members of the control group had positive urine pneumococcal antigen test. Pneumococcal antigen was isolated from the urine of 5 patients. There was no positive urine pneumococcal antigen test in the control group,which reveals pneumococcal carriage in adults is very low in this study. This study shows urine pneumococcal antigen test is a good diagnostic tool in adults and can help establish diagnosis.

In epidemiologic studies, food frequency questionnaire (FFQ) is usually the most suitable dietary assessment tool on a long-term basis. Hence assessing its validity and reproducibility is conceptually important to determine the accurate relationship between diet and diseases. The current study was done to examine the relative validity and reproducibility of food groups of the semi-quantitative FFQ, developed for the Tehran Lipid and Glucose Study (TLGS).Patients and This study investigated 132 subjects (61 men and 71 women), aged ≥ 20 years who completed a 168-item FFQ twice (FFQ1-FFQ2), with a 14-month interval. Dietary data were collected monthly by means of twelve 24-hour dietary recalls. Means (SD) for age and body mass index of subjects were 35.5 (±16.8) years and 25.5 (±5.2) kg/m2 respectively. In order to assess validity of the FFQ, age-adjusted and deattenuated Spearman correlation coefficients were performed. Coefficients ranged between 0.10 (solid fat) and 0.77 (refined sugar) in men (mean=0.44), and between 0.12 (snacks) and 0.79 (refined sugar) in women (mean= 0.42). Mean age-and energy-adjusted intraclass correlation coefficients, assessing reproducibility of the FFQ, were 0.51 in men, highest for tea (0.91), and 0.59 in women, highest for refined sugar (0.74). Mean percentages of disagreement were 7.3 in men and 9.3 in women, the highest percentage being observed for snacks and desserts in men and for tea and coffee in women. The FFQ designed for TLGS was found to be reliable and valid for several food groups.first DR was collected one month after FFQ1 and the last DR was collected one month before FFQ2. Food items were categorized into 17 food groups based on the previous studies. The residual method was used to calculate energy and age-adjusted food group intakes. Spearman and deattenuated correlation coefficients and Chi-square test based on tertiles of food group intakes were used to determine the relative validity between the second FFQ and 24-hour DRs, and intraclass correlation coefficients were calculated between FFQ1 and FFQ2 to assess the reproducibility of the FFQ.

Hepatitis B virus (HBV) infection is a global health problem. Current researches indicate that 500,000 to 1.2 million deaths per year are caused by chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC). HBV genotyping and subtyping provide epidemiological data that may contribute to vaccination and antiviral treatment strategies, diagnostic development, and determination of the course of the disease. Hereby we decided to evaluate the genotype of this virus in prisoners who are addicted to some kinds of injection drugs. Patients and In this cross- sectional study which was done in Tehran province in 2008, HBV genotypes of serum samples from 122 HBsAg positive intravenous drug user prisoners were determined using cost-effective and standard methods such as PCR and RFLP. Then direct sequencing was utilized to confirm and revaluate the results of PCR-RFLP. The phylogenetic tree was drawn by computer biosoftware (Bioedit,Mega,ClustalW) and the results were assessed by statistical analysis SPSS v.16 (P<0.05)as well. 115 samples were reported positive when analyzed by nested PCR. All of these positive samples were reported to be genotype D by RFLP using BsrI, StyI, EaeI, DpnI, and HpaI enzymes. In addition,phylogenetic tree drawn by Neighbor-Joining method in 100% of the subjects confirmed the existence of genotype D(subgenotype D1, subtype ayw2). 115 HBV isolates from prisoners represent homogenous genotypic diversity, and our results concur with other reports from Iran, all showing that genotype D is the only detectable genotype in this study.This genotype with a low rate of severe liver diseases caused by HBV (cirrhosis, hepatocellular carcinoma) is in accordance with our results.

Auditory steadystate response (ASSR) is an oscillation in the electrical potential recorded from the scalp. In this study, the possible effects of shifting the response recording channel on 40Hz ASSR thresholds and their recording times were evaluated and compared.Patients and In this cross-sectionalstudy, 30 subjects with normal hearing (thresholds of 500 to 4000 Hz < 15 dB HL) whose ages ranged from 180to 30 were enrolled in the study after giving written informed consent. Right-handed subjects were selected. New chirp stimuli were presented to the right ear via inserted headphones using a two-channel EP recording system, the Eclipse.Thresholds for central frequencies (0.5, 1, 2 and 4 KHz) and their total recording time in the ipsilateral (recording from the right-EEG channel) and contralateral array (recording from the left-EEG channel) relative to the stimulated ear were evaluated at 40Hz repetition rate and averaged among 30 subjects. One-way ANOVA was used to compare the mean thresholds between channels in each frequency. Paired t-test was used for comparing average recording times between channels. The results of this study showed that thresholds and recording times of the contralateral 40Hz ASSR were better and shorter than that of the ipsilateral ones. The present study indicated that in ASSR test contralateral recordings with 40Hz RF can probably be a better tool to objectively assess hearing thresholds in awake adults with normal hearing using ASSR.

Hypertension is the most important factor in cardiovascular diseases which can be modified, and motivational interviewing is an inspiring intervention for encouraging positive health behavior in the field of changing and modifying health behavior. The aim of this study was to determine the effect of motivational interviewing on the lifestyle of people suffering from hypertension. Patients and This quasi-experimental study involved pre-test and post-test with a control group at different intervals. The subjects were 61 clients suffering from systolic blood pressure from 125 to 160 mm Hg. They had been referred to Isfahan University of Medical Sciences to participate in a project for screening diabetes and metabolic syndrome in 2009. The subjects were selected by random sampling and were randomly classified into the experimental group (No.=28) and the control group (No.=33). The intervention consisting of five sessions of group motivational interviewing and common lifestyle training was given to the experimental group. The data obtained by food habits questionnaire, 8 and 18 weeks after intervention, was analyzed by the statistical tests of covariance analysis and independent t-test. After the intervention, the means of consuming unsaturated oil and white meat (P=0.005), vegetables (P=0.01), weight (P=0.006), dairy products (P=0.0001), salt (P=0.0001) and physical activity (P=0.0001) were significantly more in the experimental group than in the control group. Comparing means in the follow-up stage including 16 sessions revealed that some changes which occurred as a result of motivational interview such as vegetables, dairy products and salt still remained. Including motivational interview in healthy lifestyle training for controlling and preventing hypertension is an effective way for lifestyle improvement and consequently decreasing dangerous factors in cardiovascular diseases such as hypertension.