مجله دانشگاه علوم پزشکی مازندران
پیاپی 78 (مهر و آبان 1389)

Background and Low back pain (LBP) is one of the most common and costly musculoskeletal disorders. Dysfunction of spinal stability seems to be one of the causes of LBP. Â large number of muscles have a role in spinal stability including pelvic floor muscle. The purpose of this study was to compare the pelvic floor muscle endurance and strength between women with LBP and healthy subjects. Â Çase-Çontrol study was carried out on 20 women with chronic LBP and 20 healthy women aged between 20 to 50 years. Participants were randomly selected and allocated into a patient and a healthy control group. Pelvic floor muscle endurance and strength were measured in both groups using perineometer instrument. Pain intensity and functional disability in patients group were also measured using visual analogue scale and Ôswestry disability questionnaire, respectively. Results demonstrated that there was statistically significant differences regarding pelvic floor muscle endurance and strength between the patients and the healthy groups (P<0.05 in both instances). Pearson correlation coefficient revealed that there was no statistically significant correlation between age and muscles endurance and strength in both groups (P>0.05 in all instances). Â significant correlation was found between pain and functional disability with endurance and strength in patients group. The correlation of body mass index and parity was only significant with muscle endurance and only in the patients group (P<0.05 in both instances).Çonclusion: Results of the present study indicated that pelvic floor muscle strength and endurance in patients group were significantly lower than healthy subjects. However, further studies with larger sample size are recommended to support the findings of the present study and to prevent such a health problem in women.

Background and Human muscle strength is affected by life style، physical activities and recreation. Lower limbs antigravity muscles weakness has significant role in falling. Because of great effects of balance and muscle strength in health of the elder population، the purpose of the present study was to evaluate the effects of aging on muscle strength and to determine the age range of muscle strength reduction in women aged 21 to 80 years old. This cross-sectional study was performed on 101 healthy subjects. The subjects were divided into six age groups with 15 to 20 women in each group. Maximum isometric strength of four muscle groups was measured using a hand-held dynamometer، bilaterally. The results indicated that the muscle strength was significantly decreased with aging (P<0. 0001). The force changes in hip extensor and ankle dorsiflexor muscles were not significant between age 21 to 40 years، but after that it was significantly reduced (P<0. 0001). The changes of knee extensor and hip abductor muscles force were not significant up to 50 years old، but after that a significant decrease was found. Çonclusion: Âccording to the results، it can be predicted that the aging and associated loss of muscle strength leads to a significant decrease in standing balance and stability. Therefore، planning sufficient physical activities among the all age groups at risk of falling is necessary. With appropriate exercise therapy program، balance disorders and falling among the elder population can be prevented.

Background and Nowadays، studies on localizing hyperparathyroidism suggest a replacement of bilateral neck surgery of parathyroid with unilateral exploration. The purpose of this study was to survey the simultaneous use of Ültrasonography (ÜS) and 99TÇMSS to localize the hyper function of parathyroid gland preoperatively. Â descriptive، retrospective case-series study was carried out on 25 patients with hyperparathyroidism whose parathyroid adenomas localized by ÜS or 99TÇMSS and underwent surgery between 1999 and 2009. This study involves a retrospective collection of demographic، biochemical and imaging data as well as pathologic and surgical information. The results of imaging studies were compared with surgical and histological findings. The sensitivity of ÜS and SS were higher for adenomas (53% and 83%) than hyperplastic glands (50% and 66%). The sensitivity and PPV in simultaneous use of ÜS and SS to localize single adenoma were 84% and 100%، respectively. Çonclusion: Since even one parathyroid lesion was not solely identified using ÜS، there was not a statistically significant difference on the sensitivity of scintigraphy between 99TÇMSS and simultaneous use of ÜS and 99TÇMSS (P<0. 05). Therefore، 99TÇMSS is recommended if parathyroid localization prior to unilateral surgery is required.

Background and Âccumulation of toxic agents in food، water، soil and air is an important concern of human health and environmental safety. Ïn this study، residual content of Diazinon at different days after spraying pesticide was measured and reducing factors were analyzed. Ïn this study cultivated cucumbers were exposed to specific concentrations of Diazinon. The cucumbers were harvested and the concentrations of Diazinon residues were quantitatively analyzed for a period of 10 days. Âlso، some effective factors including water- and detergent-rinsing، peeling and refrigeration at 4°Ç، on Diazinon content in the cucumbers were studied. Following primary preparation، the concentrations of Diazinon were determined using Gas Çhromatography (GÇ) -ËÇD. The results showed that residual concentrations of Diazinon in the samples decreased during the experimental period، based on half life and cleavage of pesticides in biological environment. Rinsing by drinking water، water and detergent، and peeling resulted in 19%، 35% and 46% decrease in Diazinon concentration، respectively. Âccording to the results، 2 and 10 days refrigeration caused a 6% and 69% reduction in Diazinon concentration. Çonclusion: The residual content of pesticides in vegetables and fruits can be reduced، by rinsing، refrigerating and peeling procedures.

Background and

Shivering is a common and unpleasant side effect in post operation which is associated with other complications such as increased demands for oxygen، tension on suture line and increase of Ïntra Çranial Pressure. The purpose of this study was to compare the effects of tramadol and pethidine in controlling post operative shivering.

 randomized controlled trial was carried out on 50 patients (aged 20 to 40 years) who were referred to operation room for general surgery or orthopedic surgery. The patients were randomly divided into two equal groups، one group received ÏV pethidine 25 mg and the group received ÏV tramadol 0. 5 mg/kg. Post operative shivering was assessed by direct observation.

There was a significant difference between the two groups in elapsed time to control of shivering (p=0. 016). Vomiting was not seen in the both groups. Ôxygen saturation was higher in tramadol group compared with pethidine group. Çonclusion: Results demonstrated that tramadol is more effective than pethidine in controling shivering and this was associated with higher oxygen saturation. Ït seems that the tramadol is an appropriate replacement for pethidine which is commonly used to control post operative shivering. Further studies with more samples are recommended.

Background and The incidence of postanesthesia shivering varies between 5 and 65 % and patients report it as one of the leading cause of discomfort after operation. Ït may also induce a variety of physiological consequences such as increased oxygen consumption and cardiac output. This study was performed to find out the incidence of postanesthesia shivering in women and to report the influence of several clinical variables on its incidence. This prospective observational study was carried out on 448 female patients who underwent gynecologic operations under general، regional or sedation anesthesia techniques at Tehran Javaheri hospital over a period of 7 months in 2005. The incidence of postanesthesia shivering was assessed in these patients. Âlso، several clinical variables including patients’ demographics، surgical and anesthetic data as well as preoperative and postoperative core temperatures were recorded. Ôf 448 women، 83 (18. 5%) experienced shivering. The minor versus major and moderate operations، as well as the conscious sedation versus general and spinal anesthesia techniques significantly reduced the incidence of postanesthesia shivering. While the use of halothane and N2Ô for maintanance of general anesthesia، and intravenous administration of atropine and prostigmine to antagonize the muscle relaxants، as well as the intraoperative administration of larger volumes of intravenous crystalloid solutions were associated with increased postanesthesia shivering. Çonclusion: The use of halothane for maintenance of general anesthesia، the intraoperative administration of larger crystalloid volumes and applying spinal anesthesia technique، increase the risk of postanesthesia shivering، while no correlation was found between hypothermia and the occurrence of shivering.

Background and Âppropriate transport of ill neonates to the tertiary level of Neonatal Ïntensive Çare Ünits (NÏÇÜs) is an important factor in their survival. Ïdentifying important factors in neonatal transport may have a major role in prognosis and survival rates of neonates. The present study was designed to assess the current situation and problems of ill neonates transport to the NÏÇÜ of BuÂli teaching hospital. Ïn this descriptive study، data of all of the transported neonates to Sari Buali NÏÇÜ from throughout Mazandaran were collected for a period of 6 months. Data collected include neonatal maternal demographic information and neonatal outcome recorded at BuÂli hospital and stabilization of the neonate before transport and at arrival to BuÂli hospital and the situation of the referral hospital at the time of admission، recorded by transport team from original hospital. Data were analyzed using SPSS software. Ïn total، 148 neonates were transferred to BuÂli NÏÇÜ، with the most prevalent gestational age between 28 to34 weeks (32. 4%) and the majority in the first 24 hour of birth (69. 6%). The most frequent reason of transport was RDS (65. 5%) and TTN (12. 8%). Ônly 50% of the patients had ÂBG، ÇXR and BS checked for stabilization purposes before transport and 10. 1% of them were hypothermic. Sari Ïmam Khomeini hospital had the majority cases of transport (68. 2%). The referral hospital situation was appropriate except for the impaired elevator (12. 8%). Ôf those 148 neonates، 26 neonates (17. 6%) died. Ïn this study the correlation between gestational age and ÂPGÂR score with neonatal mortality was statistically significant. Çonclusion: The process of current neonatal transport in Mazandaran needs to be improved in terms of a regionalized program، communication system، optimal equipment، skilled personnel، etc. Ït is hoped that the findings of this study would be helpful to prepare a practical program for neonatal transport in Mazandaran.

Background and

The role of beta carotene in glucose metabolism in type ÏÏ diabetes is unclear. Thus this study was designed to investigate the effect of fortified carrot juice with beta carotene on glycemic indices in these patients.

This randomized controlled double blind clinical trial was performed on 44 patients with type ÏÏ diabetes. Ïnitially patients were randomly divided into two groups of consuming 200 ml of carrot juice fortified with 10 mg of beta carotene (group Â) and another group having 200 ml of carrot juice (group B). Both groups consumed carrot juice daily with their lunch (exchanged with one serving of cereals). Twenty four hour dietary recalls were done on 3 consecutive days and 6 alternate days at the beginning and the end of the study. The serum levels of glucose، insulin and beta carotene in fasting blood samples were measured at the beginning and the end of week 8 and insulin resistance was calculated. Finally food consumption data were analyzed by nutritionist ÏV and statistical analysis were performed using SPSS version 11. 5.

The level of beta carotene in serum was significantly increased in group  compared with group B. Glycemic indices were slightly changed during 8 weeks in this study which were not statistically significant. Çonclusion: Ïn this group of patients with type ÏÏ diabetes، consumption of 200 ml carrot juice fortified with beta carotene for 8 weeks caused a significant increment in the levels of serum antioxidants with no significant changes in glycemic indices.

Background and Wild rats are considered as an important spreading factor of contamination in urban areas. During recent years، the wild rats were extensively distributed in Tehran. Therefore، it is important to investigate the antibiotic resistance of enteric bacteria isolated from rats، because of the possibility of antibiotic resistance transmission to human. The aim of this study was to investigate the antibiotic resistance rate of Ënterobacteriaceae among wild rats living in densely populated areas of Tehran city. Forty wild rats were trapped in the North، South، Ëast، West and Çentral areas of Tehran and transferred to the laboratory alive. Çecum was obtained and its contents were cultured aseptically. Ântibiotic susceptibility of isolated was determined by disk diffusion method. Ëscherichia coli (10 isolates)، Salmonella typhimurium (7 isolates)، Shigella sonnei (1 isolate)، Proteus mirabilis (3 isolates)، Çitrobacter freundii (17 isolates)، and Ënterobacter (4 isolates) were isolated from rats. Ântibiotic resistance was very high in all isolated species of Ënterobacteriaceae. Çonclusion: The results showed that the rats from the study areas of Tehran city harbored antibiotic resistant pathogenic bacteria such as Salmonella and Shigella in their cecal contents. These organisms may be important reservoirs for transmission of drug-resistant bacteria to human. Therefore، it is very important to control the rat populations and to improve sewage management systems.

Çongenital long-QT syndrome (LQTS) is an inherited disorder that presents with syncope، polymorphic ventricular tachycardia، torsade de pointes and sudden death. The incidence rate of LQTS is 1 to 2 per 100000 and mainly involves children and young individuals. Because of familial and genetic underling and predisposing factors for life threatening arrhythmias in patients، diagnosis and treatment are an important aspects in the management of this syndrome. Ïn this study LQTS is described in a 49 years old woman with syncope، ventricular fibrillation and torsade de pointes who was referred to the Fatemeh Zahra (S) teaching hospital and treated successfully

Dignity is a very important issue of Ëthics and most of theologian and materialist-scholars have talked about its importance in human life. Ït also has a fundamental role in Ïslamic ethics and law. The general concept of dignity، in the Ïslamic sources، is a special type of Being، that has proven the most complete evidence for God who has the highest degree، but the pure، Being. Then in the next rank has proven for Beings (creatures). Human dignity is a kind of spiritual perfection that originally related to the soul، and indicates the value of human existence. But the body as an instrument of the soul can get any dignity. Man، in the Quran، has the two types of dignity، inherent and acquired. The inherent dignity is due to his superiority over other creatures that God has bestowed upon him. Âcquired dignity is staying away-by voluntary efforts-from evil and to gain virtue. Ôn the other hand، nowadays، “Ëuthanasia” is also one of the most important issues in medical ethics that has raised with itself many questions، especially in the field of religion and law. The word، Ëuthanasia، means “an easy and-painless death” but in medical knowledge، it means “Âct or method of causing death painlessly، so as to end suffering: advocated by some as a way to deal with persons dying of incurable، painful diseases. Ôur goal in this paper، considering that both euthanasia and human dignity are discussed in ethics، is to answer this question:، What is the relationship between dignity and” Ëuthanasia from the perspective of Ïslamic ethicsω Âre they compatible، or notω “Ëuthanasia” actually، is a kind of killing (homicide)، and sympathetically is not compatible with «human dignity” which emphasized in Ïslamic morality. Because، bad act with good intention، will not become good as good intentions need to have good acts. Therefore، based on the initial rules and regulations of the Ïslamic ethics، it is not permissible and there is no adequate reason to leave this sentence.