مجله دانشگاه علوم پزشکی بابل
سال سیزدهم شماره 3 (پیاپی 60، اردیبهشت 1390)

Dental caries is the most common means of ingress of bacteria to the dental pulp and pulp infection. Different materials have been introduced for pulp therapy but they were not effective in producing an acceptable coronal seal. The aim of this study was to evaluate anti- inflammatory effect of local capsaicin on dental pulp of cat.

Twenty–four canine teeth of six domestic short hair cats weighing approximately 3-4 kg were selected for this experimental study. After cats had been anesthetized, the crown of teeth were cut 3 mm upper than cementoenamel junction (CEJ) and exposed under sterile condition. The teeth were divided into two groups. In group I the exposed pulp was capped with zinc oxide–eugenol as control. In group II dental pulp capped with capsaicin as experimental group. All access cavities were sealed with glass ionomer cement (Fuji IX). The animals were sacrificed at 1, 2 and 4 weeks after procedure. The canine teeth were extracted for histopathologic evaluation. The specimens were sectioned serially at 6 µm thickness parallel to tooth long axis. The sections were stained with H & E and studied by light microscopy.

Result of this study showed that signs of necrosis in zinc oxide-eugenol group during 1, 2 and 4 weeks decreased significantly (p=0.026). In capsaicin group hyperemia during 1, 2 and 4 weeks decreased significantly (p=0.019). In comparison of the effect of two drugs on pulp in 4 weeks and all weeks the sign of necrosis in capsaicin group was increased significantly (p=0.029, p=0.039). Two groups showed difference in dental barrier formation, type of inflammatory responses and soft tissue changes but these differences were not statistically significant.

According to findings of this study capsaicin could decrease the intensity of the inflammation but was not successful in dental barrier formation.

Migraine is a chronic neurological disorder and it leads patients to avoid any kind of activity. Since different factors are involved in migraine incidence and its triggers, a wide variety of drugs are used to prevent or treat. Combination therapy has shown its efficiency in treating migraine. In this study, we have taken the combination of ibuprofen and alprazolam as a probable efficient compound in reducing these headaches. In this clinical trial study, 90 migraine patients were allocated in 3 groups of 30, with an average of 2-6 attacks in month underwent. These three groups were unified by age, gender and their drug histories. After receiving volunteer’s adhesion for taking part in this experiment, the first group were given a single dose of ibuprofen 200 mg, the second group were given a single dose of ibuprofen 400 mg and the third group were given a single dose of ibuprofen 200 mg in companion with alprazolam 0.5 mg. Headache severity, functional disability and associated symptoms of the patients were recorded before and two hours after taking each regimen; and were graded from 0-3 points. Then three groups were compared. In all 3 groups, the severity of the headaches were reduced significantly after the course of drug therapy with 36% of reduction in the first group, 46% in the second group, and 74% in the third group, respectively (p<0.0001). In the first group, nausea and vomiting were reduced from 92.3% to 22.3%, the second group from 96.7% to 13.3% and, finally the third group from 100% to 3.3% (p<0.0001). In addition, a significant reduction in photophobia and phonophobia was seen before and after taking the drugs (p<0.0001). The combination of ibuprofen 200 mg and alprazolam 0.5 mg had significantly reduced the severity of the migraine headaches.

Diabetes mellitus in long-term accompanies with inappropriate complications like retinopathy and neuropathy and increased pain sensation due to neuropathy. Since there is some evidence on protective and antidiabetic effects of Vaccinium myrtillus (VM), this study was designed to investigate the antinociceptive effect of Vaccinium myrtillus (VM) in streptozotocin-diabetic rats using formalin test and hot tail immersion tests. In this experimental study, male rats were divided into equal-sized control, VM-treated control, diabetic, sodium salicylate (SS)-treated diabetic, and VM-treated diabetic groups. For induction of diabetes, streptozotocin at a dose of 60 mg/kg (i.p) was injected. The treatment groups received oral administration of VM-mixed pelleted food (5%) for 6 weeks with no limitation. Finally, hyperalgesia were assessed using standard formalin and hot tail immersion tests. VM treatment of diabetic rats reduced pain score in chronic phase up to 17.9% (p<0.05). Meanwhile, SS administration significantly reduced pain score at chronic phase of the test up to 23.6% (p<0.05). Regarding hot tail immersion test, diabetic rats showed a significant 37.4% reduction in tail flick latency as compared to control ones (p<0.05). Although VM treatment of diabetic rats increased this latency relative to untreated diabetics up to 11.3%, but the existing difference was not statistically significant. Six-week administration of VM could attenuate nociceptive score in chronic phase of formalin test in streptozotocin-induced experimental model of diabetes mellitus and has no effect on thermal pain threshold.

Intrathecal meperidine is highly effective to enhance postoperative analgesia in women undergoing cesarean delivery. However, spinal meperidine is associated with a frequent incidence of nausea, vomiting and pruritus which can limit its use. The objective of this study was to compare the prophylactic effect of ondansetron and dexamethasone in preventing postoperative nausea and vomiting (PONV) during intrathecal injection of meperidine in women undergoing elective cesarean section. In a randomized double blind clinical trial 50 women were scheduled for elective cesarean section. They were randomly allocated to dexamethasone (n=25) or ondansetron (n=25) groups. The patients were under spinal anesthesia with 50mg lidocaine and 25mg meperidine. They received 8 mg dexamethasone or 8 mg ondansetron intravenously just before surgery. The patients were evaluated for PONV and pruritus during surgery, recovery period, 6, 12 and 24h after surgery. There were not significant differences in patient's characteristics, hemodynamic variables, and sensory level of anesthesia. Nausea was observed in 4 (16%) and 7 (28%) of women in dexamethasone and ondansetron groups, respectively (p=0.496). Vomiting was observed in 3 (12%) and 4 (16%) of women in ondansetron and dexamethasone groups, respectively (p=1). No nausea and vomiting were observed 2 hours after spinal anesthesia. The incidence of pruritus was observed in 6 (24%) and 7 (28%) of women in dexamethasone and ondansetron groups, respectively. The results of this study showed that ondansetron is as effective as dexamethasone for preventing nausea, vomiting and pruritus after intrathecal injection of meperidine in women undergoing elective cesarean section. So intravenous dexamethasone is a good choice for preventing nausea and vomiting after intrathecal injection of meperidine.

Bacterial lipopolysaccharide (LPS) is a component of the gram-negative bacterial cell wall and is believed to mediate many of the sequela of infection. The liver plays a central role in the inflammatory response to LPS. Elevation of livers enzyme level is one of changes induced in acute phase of inflammation by infection or tissue damage. Ghrelin is a peptide hormone mainly secreted by the mucosa of the stomach and stimulates growth hormone release. Based on anti-inflammatory effects of Ghrelin, in this study we examined the protective effect of Ghrelin on lipopolysaccharide-induced hepatotoxicity in rat.

In this study forty male Wistar rats (200-250 g) were randomly divided into 4 groups (N=10). Control group received normal saline, second group received LPS (10 mg/kg body weight, i.p), third group received Ghrelin (4 nmol/kg, i.p), and forth group received LPS + Ghrelin (10 mg/kg and 4nmol/kg, respectively) for 8 days. At the end of the 8th day, animals were anaesthetized and blood samples were collected directly from heart. Hepatotoxicity was evaluated by measuring aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and gamma-glutamyl-transpeptidase (GGT).

Injection of LPS induced a significant increase in AST, ALT, ALP and GGT compared with control group (p<0.001). LPS- induced increases in AST, ALT, ALP and GGT were significantly reduced by treatment with Ghrelin (p<0.001).

In conclusion, our results suggest that Ghrelin has protective effect against LPS- induced hepatotoxicity and this effect may be mediated by anti inflammatory effect of Ghrelin.

Infection control is of utmost importance for the dental community. Dentists are exposed to harmful microorganisms and in most cases the source of these microorganisms are the patient’s blood or saliva. This matter is of great importance in prosthodontics as well, where impression materials, contaminated with patients’ blood and saliva, are most commonly handled. Therefore establishing a method for disinfecting these materials seems necessary. The aim of this research was to survey the effect of three different disinfection materials on alginate disc by immersion and spray methods. Three different disinfectants i.e., Chloro-Sol (0.5% sodium hypochlorite), 2% Deconex and Sanosil D2 were used in this in vitro experimental interventional study by immersion and spray methods and their antimicrobial efficacy were evaluated on 1584 alginate disks contaminated with 12 gram-positive and gram-negative bacteria. Half of microorganisms were standard strains and the other half were clinical isolates. Forty alginate discs provided for each bacterium. Twenty of them were infected with bacterial suspension (108 cfu/ml) for one minute. Other was infected for 4 minutes. Twelve disks were infected for each bacterium (control group). The antimicrobial activity of sodium hypochlorite 0.5% is different than Deconex 2% and Sansosil D2 (p<0.001). Sodium hypochlorite 0.5% had the best antimicrobial activity. Only 0.8% of immersion method specimens and 3.3% of spray method specimens had positive cultures. Clinically isolated strains were more resistant to disinfection, and difference was statistically significant by immersion method (p= 0.03, X2 =4.3). It was concluded that pseudomonas aeruginosa and klebsiella pneumoniae could not be killed by 2% Deconex and Sanosil. The time of infection did not influenced antimicrobial activity of disinfection materials and it was not statistically significant. The data suggest that 0.5% sodium hypochlorite has superior activity compared to 2% Deconex and Sanosil D2. Alginat can absorb water because of hydrophilic quality, So immersion is not suitable and spray has the best way for decontamination.

The most common pelvic cyclic pain and the most common complaint of gynecologic patients is dysmenorrhea that causes many personal and social problems. Mefenamic acid with a lot of side effects and matricaria camomilla are useful for treatment of primary dysmenorrhea. The aim of this study was to compare the effect of mefenamic acid and matricaria camomilla capsules on primary dysmenorrhea. This cross over, triple-blind randomized clinical trial study was performed on 80 students with primary dysmenorrhea, staying in Tehran University dormitory. They were randomly allocated to mefenamic acid and matricaria camomilla groups. Research took place in three stages. In the first stage, all students for two consecutive cycles in regard to suffering from second or third degree dysmenorrhea were examined. In the second stage, mefenamic acid or matricaria camomilla capsules with check list for the amount of bleeding and VAS scale were randomly given to each of the research units. In the third stage, each research unit received the same treatment of the opposite group with the same characteristics (crossover treatment) and for another two consecutive cycles this same method with replacing the medicine was repeated again. Each person was studied for 6 cycles. The patient marked the intensity of their pain on the visual analogue scale an hour before taking the first dose of the medicine and also 1 hour, 2 hours, 4 hours, and 48 hours after taking the first dose. The mean age in both groups was 24.72±2.55 years. The mean of pain severity before treatment was 4.65±0.47 and after treatment was 2.80±1.04 and 1.12±0.43 in the mefenamic acid and matricaria camomilla groups, respectively that in comparison to the sign of pain it was revealed that the severity of pain decreased after two treatment cycles in the two groups receiving mefenamic acid and matricaria camomilla capsules. But this decrease in the matricaria camomilla group was considerable (p<0.001). The results of this study showed that taking matricaria camomilla capsule can decrease the severity of dysmenorrhea, so it is recommended to use it in the treatment of this common gynecologic disorder in women.

Postpartum blues is a complication that threatens mother health and her binding with newborn and her physical and psychological health. Skin to skin contact is a simple, effective and available method that its advantages were approved. There is some evidence that it can decrease postpartum blues. The aim of this study was to investigate the effect of skin to skin contact on postpartum blues. This clinical trial study was performed on 80 patients (40 cases and 40 controls) with postpartum blues who were hospitalized in postpartum ward of Amol Imam Ali hospital in 2009. Case group received skin to skin contact with newborn 20-30 minutes daily for 10 days and no intervention was done for control groups. Severity of postpartum blues was evaluated by Zung Self Rating Depression Scale on the 3rd, 4th and 10th days after birth in case and control groups and then compared. There was not statistically significant difference between two groups with regard to demographic and obstetric variables. Mean of postpartum blues on the 1st day was 57.2±4.3 in case group and 56.2±3.8 in control group that showed no significant difference. Mean of postpartum blues score was 58±4.4 in case group and 60.9±3.7 in control group on the 4th day and it was 49.2±5.6 in case group and 60.4±3.6 in control group on the 10th day that showed significant difference (p=0.002 and p<0.0001, respectively). Mean of postpartum blues severity in these days in case groups was lower than control group. The results of this study showed that mother and newborn skin to skin contact was effective for decreasing postpartum blues severity. Therefore it is a simple, useful and cost free method to improve postpartum blues and its application is recommended for improving maternal psychological health.

Human joint center of rotation (COR) in two dimensional plans is a cinematic variable that can be used for joint assessment, motion analysis, evaluation of treatment and rehabilitation and recognizing abnormalities. The aim of this study was to study COR profiles of lumbar vertebrae and introduce a new method to quantitative expression of COR. A total of 22 healthy volunteer males aged between 21-43 years participated in this descriptive study. Variables contained centre of rotation of full, flexion and extension arcs of lumbar vertebral movement. Three radiographies were taken in neutral, full flexion and full extension positions of lumbar spine. The variables were calculated using CARA software after scanning. The descriptive statistics were utilized to description of variables. The acquired results of full arc COR were in levels of L1 (x=-113, y=107), L2 (x=-74, y=88), L3 (x=-31, y=65), L4 (x=-1, y=37) and L5 (x=12, y=4). The acquired results of flexion arc COR were in levels of L1 (x=-101, y=119), L2 (x=-65, y=97), L3 (x=-26, y=69), L4 (x=2, y=37) and L5 (x=19, y=11). The acquired results of extension arc COR were in levels of L1 (x=-111, y=133), L2 (x=-83, y=111), L3 (x=-36, y=92), L4 (x=25, y=70) and L5 (x=18, y=5). According to the results of this study, analysis of motion profiles can be clinically helpful for differentiating lumbar spine movement disorders. Comparison between COR characteristics would have facilitated by numeric expression.

One of the most important and fatal complications of the coronary artery bypass surgery is postoperative stroke. The aim of this study was to determine the incidence of postoperative stroke after coronary artery bypass surgery and its risk factors. This retrospective study was performed on the documents of 1386 patients undergoing first coronary artery bypass surgery during 2004 to 2008 in Sina hospital in Isfahan, Iran. Variables such as gender, age, number of days hospitalized in intensive care after surgery, type of surgery, duration of staying under heart and lung machine, history of hypertension, PCI, chest pain, diabetes and ejection fraction were assessed. Among all subjects 1033 were male and 353 were female. Incidence of stroke after surgery was 1.4 percent. Univariate tests showed history of diabetes (p=0.018), ejection fraction levels (p=0.001) and duration of hospitalization in intensive care unit (p=0.01, CIMD=4.8- 6.6) had significant relationship with stroke. Simultaneous analysis showed the level of ejection fraction (p =0.005, CIOR=1.646–17.382, OR average to good=5.348, p=0.01, CIOR=1.535–24.875, OR weak to good=6.18) and length of stay in intensive care unit (p=0.001, CIOR=1.136 – 1.34, OR=1.234) had significant relationship. According to the results of this study, ejection fraction and length of stay in intensive care unit are risk factors of postoperative stroke.

Intravenous immunoglobulin (IVIG) is a safe biological product used in many cases, such as primary and secondary immune deficiency, infectious diseases, critically ill patients and autoimmune disorders. IVIG has many advantages compared with intramuscular immunoglobulin and is obtained from pooled plasma of 10.000-60.000 donors. Today, IVIG use in clinical settings has increased. Despite its use in many diseases, FDA only has approved its use in patients suffering from ITP, primary immunodeficiency, pediatric HIV, Kawasaki disease, bone marrow transplantation and B-cells chronic lymphocytic leukemia. But, it has been used for other cases like Guillain–Barré syndrome, premature infants, critically ill patients admitted to ICU, severe asthma and uncontrolled seizures which FDA had not approved yet.This biological product affects immune deficiency and autoimmune diseases in different ways. Despite the relative safety of this product, the patient may experience mild but acute complications.In most cases acute reaction is due to high speed infusion rate which is mild but systemic side effects in the form of allergic and non-allergic anaphylaxis are seen, especially in patients with CVID and IgA selective deficiency. The patient should be under medical supervision during infusion and to deal with anaphylaxis shock, facilities should be available. Today, the subcutaneous type of immunoglobulin is used at home under supervision of a nurse and the patient satisfaction is high, because of its lower cost and also it does not need hospital admission.

HIV and HCV are major public health concerns. Because of similar methods of transmission, HIV-HCV co-infection is common. Except for injecting drug use, there was not common idea for other routes of transmission for HCV among HIV infected persons. The aim of this study is evaluation of characteristics associated with hepatitis C virus infection in individuals infected with the HIV. One hundred HIV infected pairs were involved in this matched case-control study. Each pair consists of one HCV infected patient and one HCV negative patient. Cases and controls were matched for age, gender and marital status. In those subjects, association between HIV/HCV co infection and state of urbanization, injection drug use, imprisonment, extra marriage sexual contact, blood transfusion before 1993, gonorrhea, tuberculosis, tattooing, use of common blade, HBV infection, AIDS were evaluated with conditional logistic regression model. Injecting drug use (OR=3.47; %95CI: 1.14-10.63), history of incarceration (OR= 3.5; %95CI: 1.005-10.63) and history of tattooing in prison (OR=4.27; %95CI: 1.24-14.7) were independently associated with co-infection by hepatitis C virus. Individual risk factors for HIV/HCV co infection included a history of injection drug use, imprisonment, and in prison tattooing.