مجله دانشگاه علوم پزشکی شهید صدوقی یزد
سال نوزدهم شماره 2 (پیاپی 79، خرداد و تیر 1389)

Abortion has always been a controversial issue and all religions, humanistic and medical communities have opposed it. The complications of illegal abortion are one of the most common reasons of hospital admission in developing countries. W.H.O estimates that the one eight of all pregnancy deaths is due to illegal abortion. Lack of knowledge of the medical team about the abortion regulations and rules can endanger the pregnant mothers life and also create certain problems for medical communities. This cross- sectional study was conducted in 2007 and included 110 gynecologists and midwives in Yazd who were studied by census method. Data was collected via self-made questionnaire and data analysis was done by software SPSS program and statistical tests included square K and T test. Of the total of 110 patients, 16.4% were gynecologists and 83.3% were midwives, 31.8% worked in academic centers and 68.2% were employed at other centers. The awareness level of 25.5% was good. There was a meaningful difference between the awareness level of academic employed and nonacademic employed and also between those who had studied abortion rules regulations. As 74.5% of the study population had low levels of awareness about the abortion rules, education of midwives & gynecologists about rules & regulations is strongly recommended as it not only helps women's health, but also decreases their legal problems.

The present study aimed to investigate the prevalence of thyroid dysfunction in the elderly women of Tabriz city; the largest city in North West Iran. By using the records of the local household registry, a sample of 1000 subjects aged between 60 and 89 years(mean 64.54±5.41) was drawn by simple random sampling. Thyroid function tests including TSH concentration were done in all subjects and free T4 concentration, free T3 concentration and anti-microsomal antibodies were measured in those with abnormal TSH levels. Seventy-three(7.3%) participants had high(>4.5mU/liter), and 54(5.4%) had low (<0.3 mU/liter) TSH levels. The overall prevalence of thyroid dysfunction in the population under study was 12.7%. The prevalence of overt and subclinical hypothyroidism in study subjects were 1.5% and 4.1%, respectively. Overt and subclinical hyperthyroidism was seen in 4.1% and 1.2%, respectively. High titers of anti-microsomal antibodies were found in 60.6% of those with high TSH levels. The prevalence of abnormal biochemical thyroid function reported in the study is substantial and confirms previous reports in other populations. The prevalence of thyroid dysfunction is high in the elderly female population of Tabriz. The results provide useful baseline information for designing public health plans and tracking changes.

The hippocampus is a well-defined region of the brain involved in memory. Recent MRI studies have shown that there is hippocampal atrophy in elderly. However, in human studies, the influence of age on hippocampal atrophy is confounded with other variables, such as inadequate nutrition, psychological and physical stress. Therefore, this study aimed to determine the effects of normal advanced aging on the volume of the hippocampal subdivisions using animal model of rat. Male Wistar rats were maintained under constant laboratory conditions until sacrifice at 6(young) and 24 (old) months of age. Coronal sections with a thickness of 25 μm were cut serially through the entire extent of the hippocampus. Using systematic uniformly random sampling, 10-12 sections were selected, mounted on slides and stained with Hematoxilin. The Cavalieri principle was used to estimate the volumes of the main subdivisions of hippocampus. Statistical analysis revealed a significant influence of age in the stratum radiatum and lacunosum-molecular area of the CA1 pyramidal field, wherein the volume was lower in aged than young rats (P<0.05). Results also showed an insignificant difference between the total volume of hippocampus of aged and young rats(P=0.74). The findings of this research reflect likely alterations in the neuritis of hippocampal cells, a hypothesis that should be examined with electromicroscopic and golgi studies. This data provides a neuroanatomical basis that may be relevant to the reported disturbances in behavior and memory in the aged.

As immunoassay and Eliza are used nowadays for checking levels of FSH and estradiol, the role of vaginal acidity as a sign of responding vaginal cells to estrogen has been forgotten, although its role in this field is known. The purpose of this study was to assess the sensitivity of vaginal Ph in diagnosis of menopause, estradiol levels, hot flashes and vaginal dryness that are frequent problems. This descriptive – cross sectional study included 250 women aged 45- 60 years. Population sampling was nonrandom and inclusion factors included absence of hormonal therapy, absence of vaginal douche or coitus during the past three days. Vaginal Ph, FSH and estradiol levels were determined. The analysis was carried out using SPSS. For comparing two variables, Spearman, Pearson and chi-square tests were used. The mean age of the population sample was 50.4 years(SD ± 4.4) of which 45.7% were menopause and 54.3% were in menopausal transition. Mean vaginal Ph was 5.57±0.66. The association between vaginal Ph, FSH and estradiol was significant (P=0.047, P=0.000). In this study, the cut off point of FSH for diagnosing menopause was ≥20 mu/ml. The sensitivity of vaginal PH >5 with this level of FSH was determined to be 60%. Sensitivity of vaginal PH >5 in diagnosing estradiol ≤40pg/ml was determined to be 55%. The association between hot flashes and vaginal dryness with vaginal acidity was significant. Vaginal PH is an easy, noninvasive, alternative and cheap assay for diagnosing menopause, estradiol levels and menopausal signs.

Leishmaniasis is one of important tropical diseases caused by Leishmania parasites which is transmitted by biting of female phlebotomine sandfies. Regarding high densitie's and distribution of sandflies in majority areas of Iran, understanding of sandflies identification and distribution as vectors is importation to control disease. This is a descriptive survey which was done temporarily, Sandflies were sampled from 17 villages of three studied regions to coordinate with authorities of sanitary province to provide the necessary facilities. foci using sticky papers and CDC traps. All sandflies were identified based on external and internal morphological characters of the head and abdominal terminalia, which were slide-mounted in Berlese fluid. In total 3178 Sandflies were sampled and identified. Sandfies species are P. papatasi, P. bergeroti, P. alexandri, P. sergenti, P. mongolensis, P. tobbi and S. dentate, S. sintoni and S. tiberiadis. sandfly species identified and separated based on habitat collections. Females analysed according to their gonotrophic stage which majority were unfed. The collections contained the important putative vectors of Leishmaniasis in Iran. P. papatasi was abundant in three study foci. Of the sandflies recorded from Iran, only P. papatasi was judged to be a proven vector of Leishmaniasis. Understanding criteria of vectors, population variations and ecological aspect of sandflies can help to control better of diseases.

Drug addiction causes many complications for mother and fetus. Preterm labor, spontaneous abortion, intrauterine fetal growth retardation, prenatal mortality, placental abruption, preeclampsia, PROM, cesarean delivery and congenital anomalies among the newborns of addicted mothers are increased. The purpose of this study was to evaluate the final of maternal, fetal and neonatal of drugs addicted pregnant women. The study is a Cross-Sectional study was done on 236 pregnant women 19-40 years old addicted to drugs and 236 pregnant women non-addicted that referred for delivery to maternity hospitals of Imam Reza(as) and Imam Sajjad(as) during 2008-2010. Measuring instruments were: observing and checklist includes various sections were related on the aims. Data Analysis was done using SPSS. After ensuring that these values followed the normal distribution, chi-square test and Fisher exact test to compare qualitative variables of two groups and for quantitative variables T test was used. Confidence coefficient of 95% was considered. The results showed complication such as placental abruption, preterm labor, preeclampsia, hypertension, PROM, cesarean, hepatitis B, meconium in the amniotic fluid, intrauterine fetal growth retardation, anomalies in infant, low Apgar score in the first and fifth minutes, fetal death, hypoglycemia, neonatal convulsions, breathing problems, RDS, need to neonatal resuscitation, admission in NICU, neonatal death in the first three days of birth, weight loss, low circumference head size among infants were born of mothers addicted compared with the control group had shown significant increase. Opium addiction causes serious complications for mother, fetus and newborn.

Undoubtedly, reproduction is a necessity for survival and successful pregnancy is an immunological paradox. In the present study, we investigated the proportional changes of CD4+CD25bright T cells, CD4+CD25dim T cells in peripheral blood in unexplained recurrent spontaneous abortions (URSA) and compared it with normal pregnant women by antibody monoclonal method.

The study group comprised of women with miscarriages of unexplained etiology who had normal karyotypes, anticardiolipin antibodies, prolactin levels and normal spousal spermograms. They did not have polycystic ovaries and also did not receive any drugs at the time of the study. PBLs lymphocytes were isolated, then FITC-conjugated and anti-CD4 and PE-conjugated anti-CD25 antibody levels were measured. Then results of the study and control group were analyzed and compared.

The absolute number of CD25 bright cells in the CD4‏+T cells in peripheral blood was statistically significantly lower in the study group as compared to the control group(P=0.000). The absolute number of CD4+CD25dimT cells in peripheral blood was statistically significantly higher in the study group as compared to the control group (P=0.000).

As decrease in the number of CD4+CD25+Tcells or their functional deficiency may be linked with miscarriage, CD4+CD25+‏ Tells could serve as a novel biomarker for monitoring in URSA patients, but more studies are needed in this field.

Premenstrual syndrome(PMS) is a condition characterized by a number of behavioral, psychological and physical symptoms recurring cyclically during the luteal phase of the menstrual cycle. The uncertainty in the pathogenesis of PMS has led to many treatments being suggested as possible therapies. This study was carried out to compare the effects of Echinophora-platyloba and Fennel extracts on the PMS. In this single, blind randomized clinical trial, ninety students with moderate to severe PMS were divided into three groups of thirty students, each. The first group received E.platyloba extract, the second received Fennel extracts and the third group received Placebo. The severity of PMS was detected by Daily Record Of severity of Problems(DRSP) questionnaire at the end of first and second month after the intervention and compared with the results before intervention. Data analysis was performed by SPSS, One-Way Anova, Dunn and Wilcoxan tests and P<0.05 was considered significant. The Mean premenstrual syndrome scores were similar in three groups before the intervention [(100.8±22.1 in Echinophora platyloba group, 101.3±33.4 in Fennel group and 104.3 ±19.5 in Placebo group), P=0.58)], but there was a significant difference between them after the intervention and the effects of E.platyloba and Fennel extracts in reduction of symptoms was greater than the placebo[(49.7±23.2 in E. platyloba group, 64.43±29.3 in Fennel group and 79.1±28.1 in Placebo group), P=0.009)]. There was no significant difference between the effects of E. platyloba and Fennel. As E. platyloba and Fennel extracts reduce the symptoms of PMS significantly, their use is advisable in PMS patients.

Elongation and calcification of the stylohyoid ligament complex may be correlated with eagle’s syndrome which could cause facial pain or dysphasia. The aim of this study was to investigate the prevalence of stylohyoid ligament complex elongation in Iranian adults. Panoramic radiographs of 504 patients older than 20 years referring to the dental school were selected from 2003 to 2008. The stylohyoid ligament complexes were measured from the cranial base up to the osseous tip of each process. Mineralization of the complex of more than 25 mm in length on the radiograph was considered to be abnormal. The lengths of the areas of mineralization were recorded. This abnormality was seen in both sexes. A calcified complex was found in 135 of the 504 patients. Of the total, 26.8% were longer than 25mm and so were abnormal. They included 20.4% bilateral cases and the average length was 21.7±7.65mm. Ten patients (2%) of the abnormalities were longer than 40mm in each age group. The mean length of a mineralized stylohyoid ligament complex in patients in the 60-79 years age group was 23.13mm. The results suggest that anatomical variant of the stylohyoid ligament complex is frequent in Iranian population and present in both sexes with equal distribution.

The cause of many metabolic diseases is a progressive increase in fasting insulin levels that is generally associated with inflammatory status. In such conditions, circulating resistin hormonal levels and CRP levels also increase. The aim of the present study was to determine the effect of 2 months aerobic training on insulin resistance and inflammatory markers. In the study, 30 middle aged healthy men volunteered (Age=38.56±4.77, BMI=25.14±2.16) to participate and based on their body fat percentage were assigned in two equal groups. Experimental group was asked to perform 2 months of aerobic exercise, 4 sessions a week with 60-80% maximum heart rate, while the control group was sedentary during the same period. Blood samples were collected 48 hours before the first session and 48 hours after the last session under similar conditions. Plasma insulin (p≤0.001) and glucose (p≤0.001) levels decreased and consequently insulin resistance index also decreased (p≤0.001) in the experimental group as compared to controls. Also, resistin concentrations increased (p≤0.001), while CRP concentrations decreased (p≤0.001), respectively in the experimental group. In general, it can be concluded that regular aerobic exercise due to improved insulin resistance and plasma levels of two inflammatory markers (CRP and the resistin) reduces risk factors of metabolic disease and atherosclerosis and can be used as an effective strategy to prevent such diseases.

Dendritic cells have a high potential in presentation of antigens and can be generated and manipulated in invitro culture conditions. Dendritic cells(DC) are therefore used in cancer immunotherapy, in prevention of graft rejection, treatment of allergy, autoimmune diseases and certain infectious diseases. Dendritic cell was generated in two stages. IN the first stage, monocyte cells were converted to immature DC affected GM-CSF and IL-4. In the second stage, dendritic cells were maturated in the presence of supernatant skin epithelial cells(A375) and human umbilical vein endothelial cells(HUVEC) and maturation factors. The ability of phagocytosis, expression phenotype, stimulation of T lymphocytes and cytokines was studied. Mature Dendritic cells decreased their power of phagocytosis and increased expression of their surface markers. The ability of T cells stimulation and cytokine production(IL-12) increased. Mixture condition medium of epithelial cells and human skin umbilical vein endothelium cells induces maturation of monocyte-derived DCs. This condition medium improves their phenotype and their functions. The mentioned condition medium generates DC1 and Th1 in vitro.

With recent identification of vitamin D receptors in various tissues, including immune System the importance of this vitamin has been realized. The purpose of this study was to determine the effect of a single mega dose of 300,000 IU of vitamin D after delivery in women with gestational diabetes after 3 months follow-up on the status of inflammatory factors influencing insulin resistance This randomized clinical trial study with the follow-up period of 3 months included 45 women who had been diagnosed for the first time in their recent pregnancy as diabetics and were randomly divided into intervention group(IG) and control group(CG). The IG group received an IM dose of 300,000 units of vitamin D. Glycosylated hemoglobin A1C (HBA1C), 25-OH vitamin D, and two-hour glucose, TNF-α, IL-1, CRP, and adiponectin levels were measured. Mean adiponectin levels before and after intervention showed no significant difference, but only in IG group, the levels were significantly increased. Median concentration of 25-OH vitamin D levels in the study group before and after intervention was 24.25 and 62.1 nmol/L, respectively (P-value<0.001), while the figures in the CG were 25.3 and 24.1 nmol/L, respectively (P-value=0.02). Median TNF-α levels in IG was 6.2 pg/L at the start of the intervention and reduced to 3.05 pico grams/L at the end of intervention, while in CG, this value increased from 1.25 to 3.953.05 pg/L. Median IL-1 at the beginning and end of intervention showed no significant difference between the two groups. IM administration of a mega-dose supplement of vitamin D(300,000 IU) to women with gestational diabetes after delivery improves vitamin D status, reduces the pro-inflammatory factor TNF-α and increases adiponectin levels.