مجله دانشگاه علوم پزشکی بابل
سال چهاردهم شماره 4 (پیاپی 67، تیر 1391)

Acetaminophen overdose is the most frequent cause of liver injuries. N-acetyl-p-benzoquinone imine (NAPQI) has been proposed as the toxic metabolite of acetaminophen induced by cytochrome P-450. Piperine has antioxidant activities and has been introduced as an inhibitor of CYP3A and P4502E1 activities. This study was done to evaluate pretreatment effect of piperine in acetaminophen induced hepatotoxicity in rat. In this study, the rats (weighing 150-250g) were divided into 5 groups: saline, piperine (10 mg/kg), acetaminophen (sequential doses of 500 and 1000 mg/kg within 18 hours), piperine with acetaminophen and silymarin (25 mg/kg) with acetaminophen. Activity of alkaline phosphatase, alanine aminotransferase and aspartate aminotransferase in serum were evaluated and the total antioxidant activity was measured by FRAP method. Piperine as pretreatment prevented increasing in AST and ALT after acute acetaminophen poisoning (respectively, 1711.25±1108.65 and 496±463.55, compared to acetaminophen, 3956.29±5934.73 and 1914.57±3413.47). Total antioxidant level in acetaminophen group was higher than the saline and piperine groups (respectively, p<0.009 and p<0.003) but no statistical significant differences in results were seen between piperine- acetaminophen and silymarin-acetaminophen groups. Piperine may partially prevent increasing level of the enzymes after acetaminophen poisoning. It may be concluded that in presence of piperine the level of antioxidants trends to be decreased. In other word, piperine can decrease the need of high antioxidant capacity to deal NAPQI produced following acetaminophen induced hepatotoxicity.

The success rate of intra-cytoplasmic sperm injection (ICSI) is dependent not only on egg and sperm quality but also is related to endometrial receptivity. Today one of the main obstacles in the treatment of infertility is reduced implantation rates in infertility treatment cycles, despite having some good quality embryos. Therefore, this study was designed to determine the best appropriate level of endometrial thickness on intra-cytoplasmic sperm injection outcome.

A cross-sectional study was performed on 198 patients in ICSI/ET cycles in Fatemeh-Zahra Infertility center of Babol University of medical science (Babol, Iran) during 2009-2010. Sonography feature of the endometrium (thickness and pattern) and various other variables (maternal age, cause and duration of infertility and number of retrieved oocyte) in pregnant (according to positive B-HCG test and presence of fetal heart beat on vaginal sonography) and non pregnant patients were compared.

A total of 198 cycles were analyzed. Pregnancy rate was 46 (23.2%). Most pregnancy rate (50%) was among patients with an endometrial thickness 9.2-11.7 mm. Duration, type and etiology of infertility, endometrial pattern and number of retrieved oocyte were not correlated to ICSI outcome. Endometrial thickness and maternal age is a predictive factor of success rate in ICSI treatment cycles (p<0.05).

Endometrial thickness is a good predictive factor for ICSI outcome. We can decide for embryo transfer or freezing if endometrial thickness and pattern are inappropriate.

Human umbilical cord blood (HUCB) is a rich source of stem cells. The aim of this study was the investigation of the therapeutic effects of these cells on cerebral ischemia in rat. This study was carried out on 30 male Wistar rats (100-150 g). They were divided into three groups. Firstly, to create a laboratory model of ischemic stroke, right carotid artery of animals was occluded for 30 minutes in two groups of experimental and sham. Then, mononuclear cells of cord blood were isolated and labeled using bromodeoxyuridine (BrdU) and then 2×105 cells were injected into the experimental group via the tail vein seven day after surgery. Rats in sham group didn’t receive any injection. Control group considered as intact animals. The animals were evaluated for 14 days with modified limb placing and corner turn tests. The transplanted HUCB cells were also detected by immunohistochemistry. Seven days after surgery, there was a significant recovery in the behavioral performance in the experimental group (12.7± 0.26) compared with sham group (10±0.4) and this significant difference continued by the day 14 (15.3±0.31 vs. 11.9±0.53, p<0.05). Postural and motor asymmetries, at the days 7 and 14 the experimental group showed a significant decrease in the percentage of right turns in comparison to the sham group (75%±3.07 and 59%±3.14 vs. 96%±2.21 and 97%±2.13, p<0.05). In addition, injured volume measurements disclosed a significant decrease in the experimental group compared with sham group (p<0.05). Intravenously transplanted HUCB stem cell can accelerate neurological function recovery and diminish the lesion size after the hypoxic ischemia. Thus these cells may provide a potential cell candidate for cell-based therapy in stroke.

Seizure is an important symptom of epilepsy and many other neurogenic disorders. Despite a variety of current anti-convulsive drugs, research for discovering new drugs with more efficacy and less unsuitable adverse effects has been continued. Herbal medicine has various natural substances and proper context for this type of research. The aim of this study was to survey the anticonvulsant effects of hydro-alcoholic extract of rue (Ruta graveolens) in male mice. In this experimental study anticonvulsant effect of extract evaluated by PTZ induced seizure. Fifty-six NMRI mice in the range of 25-35 gr were divided to 7 groups of 8 mice that included five cases, one positive control group and one negative control group. Case groups have been injected by 100, 300, 500, 800 and 1000 mg/kg of extracts, positive control group 40 ml/kg phenobarbital and negative control group 10 ml/kg normal saline intraperitoneally. All groups were injected by pentylenetetrazole (80mg/kg) intraperitoneally after 45 minutes, and initiation time of myocolonic and tonic-colonic seizures and rate of 24 hours death were measured. Consequences of different doses of rue hydro-alcoholic extract increased delay in initiation of myocolonic and tonic-colonic seizures rather than control group dose-dependently and reduced 24 hours seizure-induced mortality (p<0.05). Delay in myocolonic seizures in doses of 300, 500, 800 and 1000 mg/kg (p<0.001) and 100 mg/kg (p<0.01) was significant in comparison with negative control group. Delay in tonic-colonic seizures in dose of 1000 mg/kg (p<0.001) and doses of 300, 500 and 800 mg/kg (p<0.05) was significant in comparison with negative control group. Regarding to our findings, it seems that extract of this herb has decremental effect on PTZ-induced seizure in male adult mice.

Aloe Vera is a medicinal plant that has diverse biological properties such as antioxidant and anti-inflammatory activity. Atherosclerosis is one of the main causes of death in the world where in the new studies have been introduced as an inflammatory disease. Hence the use of lipid-lowering drugs and inflammation may be useful in preventing or controlling it. This study evaluated the anti-atherosclerotic effects of Aloe vera in hypercholesterolemic rabbits.

This experimental study was performed on 32 New Zealand male rabbits weighing 1800-2000 gr. Animal model of atherosclerosis was developed in 32 male rabbits using high-cholesterol diet (cholesterol 1%). Rabbits in four experimental groups (n=8) were treated for 30 days: normal diet group, high-cholesterol diet group, high-cholesterol diet group with Aloe vera gel (3.2%v/v per day in their drinking water), and Aloe vera with the normal diet group. At the beginning and end of study rabbits blood was used for total cholesterol, triglyceride, LDL, HDL, FBS measuring by enzymatic methods and CRP. The presence of fatty streaks in arteries of animals with histopathological methods was investigated and compared.

High cholesterol diet group was significantly increased total cholesterol and CRP (p<0.05). Results indicated that the use of Aloe vera in the third group with high-cholesterol diet significantly decreased total cholesterol (576.88±292.52 vs. 1059±79.11) and CRP in this group than high-cholesterol group (p<0.05). Other lipoproteins after studying in groups 2 and 3 compared with normal diet and Aloe vera alone had a significant increase (p<0.05), but they have not significant difference with each other. The use of Aloe vera along with high-cholesterol diet significantly reduced the formation of fatty streaks in the high-cholesterol group (p<0.05).

The results show that the consumption of Aloe vera by knowing the impact of cholesterol and inflammation as major risk factors for atherosclerosis can be beneficial effects in controlling this disease prevention.

Breast cancer is the most common cancer in women worldwide and radiotherapy is the best treatment choice after mastectomy. One of the main aims of radiotherapy is applying the uniform dose distribution in all treatment volume. The objective of this study was to evaluate the chest wall angle by reference axis (vertical and horizontal) and use optimum wedge filter in post-mastectomy radiotherapy. One hundred and forty cases of breast cancer after mastectomy surgery were included in this study. Patients were planned by ALFARD treatment planning system (TPS) or three-dimensional (3D) CorePLAN Treatment Planning System (TPS). Dose Volume Histograms (DVHs) with different wedge angles and without wedge were obtained for every case. DVHs were analyzed and compared for finding optimum wedge angle. Chest wall angle with reference axis was determined by GetData software. The wedge angel and chest wall angel were compared to reach the equation between them. The optimum wedge angle was the function of chest wall angles. In all cases the compensating wedge filter causes better homogeneity index and results of chest wall angle determination were in good agreement with the results of DVHs as gold standard for determining homogeneity index. Finding of this study showed that an improved chest wall angle in mastectomy patients is a new method for choosing optimum wedge angle. Also time cost of this method is better than DVH technique.

Herbal medicine had been excessively used for treatment of many diseases in traditional medicine. Because of effect of fructose on lipid profile and hepatic enzymes, it was decided to study the effect of extract of different parts of Citrullus colocynthis on lipid profile and hepatic enzymes in fructose-fed male rats. In this experimental study, 63 adult male Wistar rats weighting 200-300 (g) were used. After fructose 10% induced in drinking water for 8 weeks, the animals were randomly divided into 7 groups: control, Fructose10%, aqueous extracts of seed, hydro-alcoholic extracts of seed, aqueous extracts of crust, hydro-alcoholic extracts of crust and hydro-alcoholic extracts of pulp. The extracts (200mg/kg) were administered orally and conducted for 2 terminal weeks. The animals were weighed and anesthetized for the serum blood collection to determine lipid profile and hepatic enzymes after at least a 12-h fast with manufacture kits and autoanalyzer machine. LDL/HDL ratio in aqueous extracts of crust group (2.46±1.08) increased in comparison with control and fructose groups (0.98±0.1 and 0.98± 0.15, respectively) (p<0.01). Aspartate aminotransferase (AST) in aqueous extracts of seed and aqueous extracts of crust groups decreased and increased in comparison with control and fructose groups, respectively (p<0.05). Alanine aminotransferase (ALT) in aqueous extracts of crust group increased in comparison with control and fructose groups (p<0.01), also alkaline phosphatase (ALP) in aqueous extracts of crust group increased (p<0.05) but this enzyme in aqueous extracts of seed group decreased significantly in comparison with control (p<0.01) and fructose (p<0.05) group. According to the results, crust of Citrullus colocynthis has negative effect on lipid profile, hepatic enzymes and hepatotoxicity and seed of this fruit has decrease effect on lipid profile and hepatic enzymes.

Osteoprotegerin (OPG), a glycoprotein is a member of the tumor necrotizing factor alpha receptor super-family. By considering the possible role of OPG in cardiovascular disease (CVD), higher incidence of CVD in patients with type 2 diabetic nephropathy (T2DN), and anti-atherosclerotic effects of statins, the present study aimed to investigate the effects of lovastatin on serum levels of OPG, and soluble receptor activator of nuclear factor-kBETA ligand (sRANKL) in people with T2DN.

During the present quasi clinical trial, 30 male adult patients with type 2 diabetic nephropathy were studied. Lovastatin, 20 mg/d was administrated for 90 days. Serum levels of OPG and sRANKL were measured using commercial ELISA kits at baseline, after 90 days of intervention, and after 30 days of withdrawal of lovastatin.

Serum level of OPG was significantly increased (10.76±16.44) and decreased (7.38±11.98) during 90 days of intervention and 30 days of withdrawal periods, respectively (p<0.002), while sRANKL level was significantly decreased (1192.08±578.20) and increased (4418.67±2124.66) during the same periods, respectively (p<0.001).

These results indicate decreased risk of atherosclerosis and vascular calcification following lovastatin administration.

Several clinical, laboratory and imaging modality was suggested for distinguishing infected from non-infected form of diabetic foot ulcer (DFU). This study was performed to compare erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and white blood cell (WBC) count as inflammatory marker in between infected and non-infected diabetic foot ulcer.

A process-research study was conducted on 90 individuals at the Baqiyatallah hospital (Tehran, Iran) between 2009 and 2010. The first group contained infected DFU according to the criteria of IDSA-IWGDF (n=30), second group contained non-infected DFU (n=30) and third group contained healthy individuals (n=30). Demographic, clinical and laboratory (ESR, CRP and WBC count) findings were compared between groups.

The mean and standard deviation (SD) of CRP in healthy, infected and non-infected diabetic foot groups were 1±1.4, 46.5±46.5 and 9.2±5.3 mg/dLit, respectively (p<0.001). The mean±SD of ESR (mm/h) in healthy, infected and non-infected diabetic foot groups were 6.4±6, 76.7±30.1 and 29.1±11.9, respectively (p=0.001) and also, the mean of WBC count in healthy, infected and non-infected diabetic foot groups were 6510±1149, 9846±3662 and 8073±2070 (in 109), respectively (p<0.001). ESR’s area in ROC curve (in diagnosis of infection) was statistically larger than other markers (AUC=0.967) and CRP (AUC=0.871) and WBC count (0.721) was at the next step. The best cut-off point for CRP, ESR and WBC count was 7.1 g/lit, 40.5 mm/h and 7700 per dlit, respectively.

Regarding to the results, although all of these three markers had significant value for predicting the infection, but ESR was introduced as the best independent predicting marker for distinguishing infection because of its higher sensitivity and specificity. Accompanying ESR with CRP or WBC count can increase the predicting value for discrimination of infection.

Mite was one of the most common allergens and the prevalence of allergen in different regions is various. This study was done to investigate mite sensitivity by Prick skin test in children with allergy referred to Amirkola children hospital (Babol, Iran). This cross-sectional study was performed in 2010 on 180 children with asthma, allergic rhinitis, eczema and urticaria that referred to Amirkola children hospital. Exclusion criteria were severe asthma attacks, skin lesion and taking antihistamines in the past few days. Mite allergy was done by skin Prick test. Induration more than 3 mm and redness more than 10 mm in 15 to 20 minutes after test defined as positive test. The mean age of the cases was 6.8+/-3.2 years. In gender distribution, 87 (48.3%) were female and 93 (51.7%) were male. There was asthma in 90%, allergic rhinitis in 36.1%, eczema in 4.4% and urticaria in 2.2%. High level of IgE and eosinophilia were shown in 60.6% and 68.9% of studied children, respectively. Skin test was positive in 109 (61%). The rate of mite allergy in children reviewed were 60.6% (CI95%=53.3-67.8). Percentage of mite allergy in children with allergic rhinitis (80% vs 49.6%) and eczema (100% vs 58.7%) and those with eosinophilia (71% vs 37.5%) or high IgE (88.1% vs. 18.3%) was significantly higher than other (p<0.05). The results of this study showed that there was mite allergy in more than half of children with allergy in our region and the patients should consider the ways to control it.

Thalassemia is the most common hereditary disease. Hypersplenism and splenomegaly occur in thalassemic patients due to the hereditary defect in globin chain of hemoglobin molecule and extramedullary hematopoiesis that results in more destruction in red blood cells. Therefore, these patients need to splenectomy to reduce recurrent blood transfusion and its complications. The aim of this study was to compare the need of transfusion and adverse effects before and after splenectomy in beta-thalassemic patients referred to Yahyanejad hospital (Babol, Iran). This cross sectional study was performed on 63 splenectomized thalassemic patients who referred to Yahyanejad hospital in Babol during 8 years. Demographic information, kind of thalassemia, clinical symptoms, spleen size, number of transfusions, and platelet and red blood cell count were evaluated before and after splenectomy in these patients. In this study, 37 (58.7%) out of the 63 cases had thalassemia major and 26 cases (41.2%) had thalassemia intermedia. Eleven, 21, 9 and 17 cases had abdominal pain, anorexia, fever and gall stone, respectively. These patients had undergone cholecystectomy simultaneously. Six cases had portal vein thrombosis and 5 patients had infectious complications in long time post splenectomy. Mean operation time and mean hospital stay was 2.70±0.73 and 6.26±2.14. Mean white blood cell count, hemoglobin level, platelets and red blood cells (RBCs) count were raised significantly after splenectomy (p<0.05). Mean transfusion was reduced (p<0.05). We found 26 hepatitis, 14 haemosiderosis, 1 cirrhosis and 6 portal vein thrombosis (PVT) cases on pathology report of liver biopsy. Splenectomy reduces blood transfusion times and its complications in thalassemic patients, therefore splenectomy recommends in patients with indications for surgery.

Alzheimer’s disease (AD) is a neurodegenerative disorder and the most common form of degenerative dementia with progressive loss of cognitive abilities and memory loss. AD is an irreversible, progressive chronic disease that it is the cause of behavior changes and deterioration of thinking ability. Since exact mechanism of neuro-toxicity by beta amyloid has not been identified yet, in this study, the histopathological lesions in CA1 of hippocampus after injection of beta-amyloid in a rat model of AD was studied. In this experimental study, 30 adult male Albino Wistar rats weighing (250-300 g) were used for behavioral and histopathological studies. The rats were randomly assigned to three groups; control, sham and BETA-amyloid (ABETA) injection. The lesion was induced by injection of 4µLof ABETA(1-40) into the hippocampal fissure. For behavioral analysis Y-maze and shuttle box were used respectively at the 14 and 16 days post-lesion. For histological studies, Nissl and Bielschowsky staining were done. The mean scores of alternation behavior for sham, control, and AD group were 80.56%, 86.7%, and 46.2%, respectively. AD group showed a significant reduction in alternation behavior as compared to control and sham group (p<0.0001). The number of neurons per square millimeter in the Alzheimer group, sham and control, respectively, 2.92, 6.35 and 6.25, and reduced neuronal density in Alzheimer's disease compared with control and sham groups were significant (p<0.0001). In the present study,ABETA(1-40) injection into hippocampus could decrease the behavioral indexes and the number of CA1 neurons in hippocampus.

The deep cervical flexor muscles have a major role in neck stabilization and evidence suggests that these muscles especially longus colli muscle (LCM) becomes dysfunctional in patients suffering from cervicogenic headache. Therefore, measurement of these muscles in healthy subjects and patients may be of great value to understand the stabilization function of the muscles and also to follow the effect of interventions. The aim of this study was to compare the reliability of longus colli muscle size measurement in healthy subjects and patients with cervicogenic headache using ultrasonography. This methodological research was performed on 34 subjects including 13 patients with cervicogenic headache (20-35 years old) with headache over 3 month period and 21 healthy subjects (18-25 years old). Neck LCM size was measured in supine position in two sides at the level of thyroid cartilage ultrasonography. Two images of LCM cross section area (CSA) were taken on the same day with an hour interval to assess the within-day reliability and the third image was taken two days later to determine between-days reliability. Then data were compared using statistical analysis. The mean of the cross section area of the muscle in subjects with cervicogenic headache was 0.77 cm2 in two sides and in healthy subjects were 0.74 cm2 in left side and 0.75 cm2 in right side. Within day and between days reliability in healthy subjects was varied ranging from 0.83 to 0.92. In patient group it was ranged between 0.90-0.98. The results indicated that ultrasonography could be a reliable tool to measure the cross section area of LCM in healthy subjects and patients with cervicogenic headache. Therefore, this non invasive method can be used to follow up the effect of exercise therapy interventions.

Following reduction of infectious diseases; unfavorable lifestyle habits especially dietary changes and inactivity has increased the risk of non-communicable chronic diseases. These problems include diabetes, cardiovascular disease, cancers and osteoporosis. Dietary intake plays an important role both in the development and management of chronic disease. Therefore, investigations have focused toward the identification of functional foods such as soy products, nuts, coffee and green tea. This paper will review the relationship between some of functional food consumption and risk of chronic diseases Pubmed search engine, National Library of Medicine (NLM), Ovid, Elsevier Databases were used to access the relevant articles and functional foods, obesity, central obesity (adiposity), chronic disease, diabetes, cardiovascular disease, soy (protein), tea, coffee and nuts which were limited to title and abstracts were used as keywords. According to the current results, functional foods incorporating as a part of healthy and balanced diet could influence weight maintenance and significant weight reduction, blood lipid improvement and glycemic control. These kinds of foods may be helpful in chronic diseases prevention. Functional foods exert their beneficial effects on lipid profile, glycemic control and inflammation especially when they incorporated into a healthy dietary pattern like adherence to DASH (Dietary Approaches to Stop Hypertension) diet or Mediterranean style diet. These foods may be helpful in the prevention and management of chronic diseases through improvement in lipid profile, glycemic control and weight maintenance.