مجله دانشگاه علوم پزشکی رفسنجان
سال دهم شماره 1 (پیاپی 38، بهار 1390)

It is very important to remove the microorganisms in the root canal before obturation. One of the causes of endodontic treatment failures is the existence of the bacteria responsible for resistant infections, including Enterococcus Faecalis. The aim of this study was to compare the antibacterial effect of the garlic extract with two intracanal irrigants on Enterococcus Faecalis. In this in-vitro study, the method of Well Agar Diffusion was used to compare the anti-bacterial effect of pure garlic extract (100%), garlic extract 80%, chlorhexidine 2%, sodium hypochlorite 5.25% and combined chlorhexidine 2% with pure garlic extract. Eighteen plates of Muller-Hinton agar were inoculated with E.faecalis. Each plate had 6 wells for test solutions and one of them was for sterile distilled water as the control. The prepared plates were distributed into aerobic (n=9) and anaerobic (n=9) groups, then incubated at 37°C for 24 hours. After that, the diameter of the zones of microbial inhibition around every well was measured and recorded. Data were analyzed using ANOVA and Tukey post-hoc tests. Our results demonstrated that Sodium hypochlorite 5.25% was more effective compared with the other antimicrobial materials in both aerobic and anaerobic groups. This difference was statistically significant (ANOVA, p<0.05). The most effective antimicrobial agents in aerobic and anaerobic conditions were in this order sodium hypochlorite (5.25%), chlorhexidine 2%, pure garlic extract, combined chlorhexidine 2% with pure garlic extract and garlic extract 80% respectively (p<0.05). However, the difference between pure garlic extract and combined chlorhexidine 2% with pure garlic extract in aerobic condition was not significant. The results showed that garlic extract is effective on Enterococcus Faecalis in both aerobic and anaerobic conditions; nevertheless it has less efficacy than chlorhexidine and sodium hypochlorite.

Peripheral neuropathy is the most common disadvantage in diabetic patients. Balance deficit in diabetic patients with peripheral neuropathy is due to peripheral nerves injury. The purpose of this study was to investigate the effects of balance exercises on stability indices in diabetic patients with neuropathy. This clinical trial study was conducted on 10 diabetic patients with neuropathy as experimental group, and 10 healthy subjects with the same age as the control group. The subjects were recruited through simple nonprobablity sampling. Stability indecis of all subjects in the two groups were measured on bilateral and unilateral standing with open and closed eyes. Experimental groups were trained for ten sessions by progressive balance exercises and were examined again after the ten sessions. Then balance indices of the experimental group before and after training were compared with the healthy subjects. Overall and anterior- posterior stability indecis were significantly different before and after treatment in the experimental group during different conditions. These significant differences were between 0.01 to 0.0001 for overall stability index with open eyes and antero-posterior index with closed eyes respectivly. Balance indices caused significant differences between the experimental and healthy subjects before the treatment (p<0.006). After ten sessions of balance exercise therapy in the experimental group there was no significant differences in the indices between the two groups. Based on the results of this study, it can be concluded that balance training could improve stability indices in diabetic patients with neuropathy. The improvement is more significant in eyes open condition. Therefore balance exercise therapy is recommended for rehabilitation of diabetic patients with neuropathy.

Standing and walking are the most common activities of people on a daily basis. In children with cerebral palsy (CP), lesion in central nervous system could cause impairment in these functions. One way to improve their standing and walking functions is the use of Ankle Foot Orthoses (AFOs). This study was performed to compare the effects of hinged and solid AFOs on standing and walking functions in 4-8 year old children with CP spastic, in Vali-Asr rehabilitation foundation of Tehran.

This quasi-experimental and interventional study was performed on 30 4-8 year old children with CP spastic. Children were divided into 3 groups randomly; groupe 1 received hinged AFO, groupe 2 solid AFO, and group 3 (control group) received no AFOs for 3 months. Standing and walking functions were evaluated by Gross Motor Function Measure-88.

There were also significant differences in standing and walking functions after intervention in the 3 groups (p=0.005). There were also significant differences between the 3 groups in terms of mean differences of total scores before and after the intervention (p= 0.015). There were significant differences between the two groups hinged AFO and solid AFO and between hinged AFO group and control group, (p= 0.000), but between the two groups, solid AFO and control, there was no differences.

Hinged AFO showed more improvement in standing and walking functions among children with CP spastic, and could be recommended for children with CP, especially, for those who could stand up or walk with or without assistive devices.

Among several methods which are accessible for manageing wrist spasticity after stroke, wrist splinting is commonly used as an adjacent treatment, but there are many controversies surrounding its efficacy. The aim of this study was to compare the effect of the Dynamic and Static splints on wrist spasticity after stroke.

In this experimental study, 31 stroke patients were selected and randomly divided into three groups including: Dynamic splint, Static splint and control group. Participants in the intervention groups wore their own splints for three months, five days per week and on average, six hours per day. Wrist spasticity was measured by both Modified Ashworth Scale (MAS) and electromyography (EMG) tests at the baseline and after third month. Kroskal-Wallis and one-way ANOVA were used to statistically analyze MAS and Hmax/Mmax ratio scores respectively.

Statistical analysis of data showed no significant reduction of spasticity during study period according to either MAS or EMG data in any of the groups (p>0/05).

Based on these findings, use of the splint as a method for reducing wrist spasticity could not be beneficial in the selected patients.

Previous studies have demonstrated estrogen and progesterone decrease brain edema induced by TBI. The aim of the present study was to determine whether ovarian hormones decrease brain edema by change in concentrations of proinflammatory cytokines. In this experimental study, 98 ovariectomized female rats (except groups 1 and 2) were divided into groups of control, sham, vehicle, low does of estrogen (E1), high dose of estrogen (E2), low dose of progesterone (P1) and high dose of progesterone (P2). Vehicle and sexual steroid hormones were injected intraperitoneally at 0.5 h after Moderate and diffuse TBI induced by Marmarou method. Brain level of cytokines and ovarian hormones were measured 6 h after TBI by ELISA method. Both E2 and P1 caused significant increase of 52.8% and 79.2% in brain level of IL-1β. P2 significantly decreased the levels of IL-6 and TNF-α by 45.9% and 72% respectively. TGF-β level seem to be decreased by E1 up to 3.37 times significantly. Level of β-Estradiol increased 4.58 times in E2 group and progesterone increased 1.56 times in P2 group significantly. This results suggested that ovarian hormones increased brain IL-1β and TGF-β and decreased IL-6 and TNF-α, this may be one mechanism by which hormones reduce cerebral edema.

Despite the widespread availability of antibiotics, antibiotic resistance in uropathogens is increasing. The most common mechanism in the antibiotic resistance is production of extended spectrum B-lactamase (ESBL). In this study, the presence of producing ESBL among isolated Escherchia Coli from patients suffering from urinary tract infections in Ali-Ebne Abitaleb hospital (Rafsanjan, Iran) as well as their sensitivity to newer antibiotics were evaluated.

In this descriptive study, 146 Escherchia Coli were collected from 1634 urine samples of suspected patients with urinary tract infection. Isolated organisms were identified by standard biochemical and microbial tests. Antibiotic susceptibility test was done by disc diffusion method. Isolated E coli that were resistant to third generation cephalosporines were tested for ESBL phenotype by double disc synergy test method. Their susceptibility to imipenem, meropenem and cefepime were also determined.

Totally, 19.86% of the isolated E coli showed resistance to third generation cephalosporines and 10.27% of them were ESBL producer. Also ESBLs E Coli showed co-resistance to other antibiotics. Susceptibility to imipenem, meropenem were 100%, and cefepime 26.66% respectively.

ESBL producer isolated Escherchia Coli had resistance to many different antibiotics, but it showed high susceptibility to imipenem and meropenem. So in order to prevent any resistance, we should use these antibiotics correctly.

Prevention of oral and dental diseases is dependent on people’s awareness about oral hygiene. Considering the important role of health workers in improving the people’s awareness and encouraging them to follow oral hygiene, in this study, the levels of knowledge, attitude and practice of health workers in regard to oral health were determined. This descriptive study was done to collect the data from all health workers of the southern regions of Kerman province in 2009 (n=511) using a researcher- made questionnaire consisting of four parts of demographic features, and questions for the evaluation of knowledge, attitude and practice. Chi-square test, t-independent test and Pearson coefficient of correlation were used for data analysis. The mean score of knowledge was 11.3±2.83 out of 20, mean attitude score was 42.26±5.58 out of 55 and mean practice score was 8.85±1.81 out of 21. Overall 13.3% of subjects had good Knowledge and 24.4% had positive attitudes. None of the participants attained a desirable score in practice. Knowledge and attitude showed a significant relationships with sex, educational level, age and job experience (p<0.05). Women had significantly higher knowledge and attitude scores than men. Knowledge and attitude also had positive relationship with educational level, but had a reverse relationship with age and job experience. Majority of respondents had moderate knowledge and poor practice. Considering the reverse relationship of knowledge with age and job experience, it seems continuous educational programs using new methods and experienced experts are necessary.

Roberts syndrome (pseudothalidomide) is a rare developmental disorder characterized by multiple malformations, in particular symmetrical limb reduction (phocomelia), craniofacial anomalies such as bilateral cleft lip and cleft palate, and is a genetic disorder. The aim of presenting this case is that couples with a personal family history of a heritable genetic disorders should be offered for genetic counseling and should be provided with a calculated risk of having an affected fetus. Case report: The case of the present study was a 38 year old pregnant woman, at 38w gestational age, who referred with labor pain to Akbar Abadi hospital, in October 2008. Due to having history of three cesarean sections in the past, surgery was performed. The female newborn had multiple craniofacial anomalies and phocomelia in righ upper limb. Selective screening for prenatal care should be offered based on maternal age, family history, or the ethnic or racial background of the couple. With prenatal diagnosis, it is the clinician's decision to alter the severity of congenital diseases by offering expanding number of fetal treatments or surveillance as well as optimal delivery for some or consideration of termination of pregnancy for others.