مجله دانشگاه علوم پزشکی اراک
سال پانزدهم شماره 5 (پیاپی 64، مهر 1391)

Attention Deficit/Hyperactivity Disorder (ADHD) is a behavioral disorder in children which is characterized by one or a combination of three factors including hyperactivity, inattentiveness and impulsiveness. The purpose of present study was to investigate the effectiveness of ball and non-ball games on improvement of attention deficit/hyperactivity disorder in the 9-11 year old male students in Arak. In this pre/post-test designed clinical trial 60 male students with ADHD disorder, were randomly divided into three equal groups including; ball games, non-ball games and control group. Practice groups had 12 weeks games therapy; (3 sessions per week and 30-45 min per session). The symptoms of ADHD and Hyperactivity were evaluated through Child Symptom Inventory-4 (CSI-4) questionnaire before and after the 12-week practice programs. The results of the present study revealed that after 12 weeks play therapy, both experimental groups had a significant decrease in ADHD symptoms in comparison with pre-test situation (p<0.05), but no significant difference was seen between ball games and non-ball games groups (p>0.05). Based on the obtained findings of the study it can be concluded that ball/ non-ball games, have a positive effect in improving and reduction of symptoms of ADHD.

Brucellosis is one of the most common zoonotic diseases in Iran. In most cases، the diagnosis of brucellosis is difficult not only because of its clinical similarity to many infectious and noninfectious diseases، but also because diagnostic methods often fail to detect organisms. PCR is a rapid and safe diagnostic method applied to the diagnosis of brucellosis. The purpose of this study was to determine the sensitivity and specificity of PCR for diagnosis of human brucellosis by using serum samples. This study which was done to evaluate diagnostic tests included30 serum samples from patients with clinical presentation of brucellosis with positive Wright test and serum samples of30 healthy people with negative Wright test. These samples were examined by PCR. PCR results were positive for 15 samples of the patients group in comparison with 4 samples from the 30 healthy subjects. The sensitivity and specificity of PCR were 50% and 86. 6%، respectively. Although in some studies، the preferred sample for diagnosis of brucellosis was serum، in this study، PCR on serum samples did not indicate high sensitivity and specificity in diagnosis of brucellosis. Hence، using a combination of methods for diagnosis of human brucellosisis suggested.

Measurement of mean arterial blood pressure is better predictive factor for pregnancy-induced hypertension than measurement of the systolic and diastolic blood pressure or systolic blood pressure. According to the theory of “protective effect of fish oil supplementation on pregnancy-induced hypertension “and the importance of blood pressure control in pregnancy، the present study was conducted to investigate the effect of fish oil supplementation in pregnancy on mean arterial blood pressure. In this clinical trial study، 120 healthy pregnant women were randomly divided into two groups of 60 persons. Same prenatal care was performed for both groups and the intervention group was received Salmon fish oil capsule 1000 mg/day، from 16th week to the end of the pregnancy. Systolic and diastolic blood pressure were measured in both groups once every four weeks up to 28th week، every 2 weeks from 28th till 36th week and once every week up to the end of pregnancy. Mean arterial blood pressure was calculated and all gathering data was analyzed with T test and Mann-Whitney test. Mean arterial blood pressure in the intervention and control group was 80. 76±5. 50 and 78. 46±4. 50 mmHg which was not significantly different (p>0. 05). The results showed that adding fish oil supplements to the diet of pregnant mothers had no significant effect on mean arterial blood pressure.

Differentiation of M. tuberculosis complex organisms were assigned to one of three genotypic groups based on the combinations of polymorphisms at katG codon 463 and gyrA codon 95. Early identification of strains belonging to any particular group is very important. This study was planned to identify major genetic groups of clinically isolated Mycobacterium tuberculosis. In this cross sectional study 33 sputum samples were collected from tuberculosis patients of the Markazi province. DNA purification from isolated samples was performed by Chelex 100. Identification of isolates was confirmed by detection of katG gene and the mutation in KatG463 by using PCR method and RFLP respectively. Finally 620-bp of katG gene and 194-bp of gyrA gene purified from PCR product were sequenced. Amplification of 620-bp fragment of katG gene was a good way to confirm the detection of bacteria as a molecular approach. Results of sequencing codon GyrA95 in combination by results of PCR-RFLP determined type of the major genetic group (MGG). Therefore it showed that among the 33 Mycobacterium tuberculosis isolates 12 samples were MGG 1، 15 Samples were MGG2 and 6 samples were MGG 3. Results revealed that MGG 2 was dominant form of M. tuberculosis strains of Markazi province by frequency of 45. 5%. Based on the results of this study MGG2 occurrence was more frequent among clinical strains in Markazi province that its accordance with susceptibility of these strains to conventional antibiotics is notable. In this study، three applicable benefits from the test as: MGG typing، molecular detection of M. tuberculosis and bacterial resistance to Isoniazid were proven.

Pain is a complex problem، which can affect patients'' physical and psychological condition. Inadequate postoperative pain control has adverse effects on the patients'' physiological، metabolic and mental condition. Adding new supplement will increase the duration of analgesia. This study aimed to comparison of intratechal neostigmine and midazolam in increasing the time of postoperative analgesia. In this randomized double blind clinical trial، 60 patients with ASA class Ι، II who were candidate for elective colporrhaphy surgery under spinal anesthesia were randomly divided into 3 groups of 20 patients. All patients received hyperbaric lidocaine 5% and groups I received 1 mg midazolam، groups II received 50 μg Neostigmine and groups III received 0. 5 cc normal saline additionally. Then according VAS pain score، postoperative painless duration and pain score were compared between groups by running SPSS software. Mean of painless duration in the Midazolam، Neostigmine and control groups were 98. 4±18. 2، 74. 5±32. 6 and 64. 5±9. 9 minutes respectively which was significantly longer than in Midazolam group (p<0. 001). The mean dose of requested analgesia in first 24 hours after surgery was significantly lower in Midazolam group (p<0. 001). Inthrathecal midazolam and Neostigmine as a complementary medication to lidocaine 5% can increase painless duration in colporrhaphy surgery and midazolam is more effective than Neostigmine.

H. pylori is one of the most common chronic bacterial infections in population so more than 85 percent are infected in Iran. H. pylori can cause different gastrointestinal disease like gastritis، peptic ulcers and even cancer. One of the effective factors in pathogenesis of bacteria is cytotoxin associated with gene A (cagA). Strains with cagA gene are more virulent. The aim of this study was to determine the frequency of cagA gene of H. pylori in patients with gastric disorders who were admitted to Imam Hossein Hospital، Tehran. In this descriptive study، DNA was extracted from 84 paraffin- embedded tissues using QiaAmp tissue kit. H. pylori was verified with PCR of 16sRNA sequences specific for Helicobacter spices and cagA gene was determined using specific primer by the PCR method. The prevalence of cagA gene in three clinical groups; gastritis، gastric ulcer، and atrophic patients was compared. Among 84 H. pylori positive isolates، 72 biopsy samples were positive for 16sRNA (85. 7%) and 46 (63. 9%) for cagA. The prevalence of cagA positive strains in peptic ulcer patients (43. 5%) was greater than in those with gastritis (30%). Results showed that Helicobacter pylori strains with cagA are more common in patients with peptic ulcer and cancer.

Insomnia has major negative effects on quality of life in postmenopausal women and can reduce their physical، psychological and social function. About 64. 8 percent of women prefer to use herbal supplements for sleep problems. The present study aimed to evaluate the satisfaction of taking Valerian on the improvement of sleep quality and sleep score in postmenopausal women during six month. In this clinical trial، satisfaction of taking Valerian and sleep score of 100 postmenopausal eligible women who were referred to health care centers of Tehran University of Medical Sciences were evaluated. Research tools had three part of personal caharctristictic، Pittsburg sleep Quality Scale، and for satisfaction Visual Analogue Scale (VAS 0-10). Data gathering were in tree phase; immediately after intervention، one and six month after valerian withdrawal. The difference between intervention and control group in satisfaction and sleep scores was significant only immediately after taking Valerian (p=0. 001) and there was no statistically significant difference within valerian or placebo group in one and six month later. Also there was statistically significant difference in three times of evaluation and satisfaction and improvement in sleep score were reduced within the time. Valerian can improve the sleep quality in postmenopausal women in intervention duration and after withdrawal there is no difference between placebo and valerian group so continued use of this supplement is necessary for improving of sleep quality.

In recent years Influenza viruses have caused widely spread moderate to severe infection in all around the world and there is no Influenza vaccine which can protect people only with one dose injection till now. Therefore، producing a universal vaccine based on virus like particle (VLP) could be ideal. In this study one of the molecular structures was considered for VLP based Influenza vaccine. In this experimental study، the human influenza virus (A /New Caledonia 20/1999/ (H1N1)) was propagated in MDCK cell culture. Viral RNA was extracted using RNX-plus solution. Complementary DNA synthesis was carried out using uni-12 primer and random hexamer as specific and general primers، respectively. Neuraminidase open reading frame (1413-bp) was amplified by PCR and cloned into pBlue-script SK. Neuraminidase coding frame sub cloned into pFastBac11 plasmid through SalI/XhoI sites. After verification of cloned Neuraminidase by restriction analysis، it was subjected to automated sequencing bi-directionally. The recombinant pFastBac Neuraminidase vector was transformed to E. coli DH10Bac cells which harbor bacmid DNA and helper plasmid to create Neuraminidase recombinant bacmid. Neuraminidase recombinant bacmid was created by homologous recombination between pFastBacNA and bacmid and was verified by PCR using Neuraminidase specific and M13 universal primers. Recombinant baculovirus expressing Neuraminidase gene can be also used with other individual recombinant baculoviruses expressing HA and M1 genes in production of influenza VLPs or proteins resulting from this structure could be purified in specific insects for vaccine research studies.

There is some evidence of antinociceptive effect of hydroalcoholic extract of Apium graveolens fruits in some recent studies. In present study، the possible mechanism of this effect of extract has been evaluated. In this experimental study، 48 male mice were examined. To evaluate the antinociceptive effect of extract، formalin test was used. The possible mechanism of extract was investigated with interaction of 3 drugs [Naloxone (2mg/kg)، Dextromethorphan (20 mg/kg)، L-NAME (20 mg/kg)] and Hydroalcoholic extract of apium graveolens fruits. (400 mg/kg) Administration of Naloxone had no effect on antinociception of Hydroalcoholic extract of apium graveolens fruits. There was no significant difference between Dextromethorphan Plus extract and extract group in first phase. Pretreatment with L-NAME، decreased antinociceptive effect of extract in second phase of formalin test (p<0. 05) Dextromethorphan has analgesic effect in acute phase and its interaction with hydroalcoholic extract of apium graveolens fruits shows at least، part of antinoceceptive effect of extract is via NMDA receptors in acute phase. On the other hand، it seems part of antinoceceptive effect of extract is via inhibition of NO syntheses in chronic phase. Extract of Apium graveolens may be effect via other neural pathways such as dopamine، noradrenalin or serotonin that need more research.

Metastasis or compress effect of adjacent tumors and thyroid neoplasms are the most common causes for airway obstruction which may lead to emergent intubation or tracheostomy due to respiratory distress. Case: A 61 year-old، female patient with history of papillary cell carcinoma with metastasis to lung، trachea and vocal cords was referred to our hospital with complaint of dyspnea. In the early hours of hospital admission the patient suffered from attacks of apnea and gasping، and initial efforts to control the airway were performed immediately which were not successful. Then it was decided to perform broncoscopy and tracheostomy to provide a safe airway. In the absence of adequate equipment and emergency respiratory situation، it is better to provide a secure airway immediately. For this purpose، we can use low depth of anesthesia without use of muscle relaxants.