مجله دانشگاه علوم پزشکی شهرکرد
سال چهاردهم شماره 5 (پیاپی 61، آذر و دی 1391)

Enzyme paraoxonase 1 (PON1) has the main antioxidant function of HDL. Statins affect PON1 concentration and expression، therefore the fatty acid composition of phospholipids in HDL is changed by statins. The aim of this study is to investigate the effect of Lovastatin on paraoxonase activity and HDL phospholipids composition in genotypes of Q192R polymorphism. In this descriptive analytical study، 265 participants from Kashani hospital were randomly divided into two groups. One hundred and thirty participants with LDL higher than 130mg/dl were chosen for case and 134 participants with LDL lower than 130mg/dl were chosen for control group. Considering the expert''s idea، the control group was divided into two groups. Group receiving Lovastatin (n=76) and another group receiving no treatment (n=55). From all participants the blood sample and glucose level، total cholesterol، thriglisirid، HDL، LDL، creatinine، apolipprotein A1، apolipoprotein B، OxLDL، PON1 arylesterase and paraoxonase activity were measured. Q192R polymorphism genotypes were determined using PCR-RFLP method. 2 months after Lovastatin treatment lipid profiles and paraoxonase activates and fatty acid components were measured. Data were analyzed using SPSS software. After using Lovastatin; paraoxonase activity، percentage of stearic acid، oleic acid، Linoleic acid and Eicosapantaenoic acid were increased before the treatment. The Q allele showed the same frequency in the control and case groups (0. 77 and 0. 70 respectively p=0. 24) Percentage of oleic، linoleic، Eicosapantaenoic acid and paraoxonase activity in QR / RR were higher than QQ genotype after the treatment. Based on the findings of this study in individuals with alleles R (QR/RR) increasing paraoxonase activity and changing unsaturated fatty acids of phospholipids HDL particles، results in changes the nature of these particles and may decrease cardio vascular disease.

Various studies confirm the effect of strenuous exercise on liver enzyme''s level increment، but the effect of regular exercise especially on liver tissue enzymes is yet unclear. The purpose of this study was to examine the effects of continuous and interval aerobic training on blood lipid profile and on liver tissue enzymes including، Aspartate aminotransferase (AST)، Alkaline phosphatase (ALP) and Alanine aminotransferase (ALT) and blood lipids level. In this experimental study 56 Wistar rats (body mass 325. 6 ± 4. 93 grams and the age of-21 months) were randomly divided into 3 control، continuous and interval groups. Continuous group performed running on treadmill speed for 6 and 12 weeks (5 to 10 min/day). Interval group also performed the same training with the rest intervals between training sets. Evaluating the liver enzymes، biopsy samples were obtained before and after the sixth and twelfth weeks. HDL-c and LDL-c levels were assessed using enzymatic method. Data were analyzed by two-way repeated measures ANOVA. The results showed that ALT، AST and ALP levels significantly increased at the first 6 weeks and after the 12 weeks in continuous and interval aerobic training (P=0. 001)، but after 12 weeks the level of this variable، were significantly decreased in interval group compared with continuous group (P<0. 05). Following the regular training، LDL-c level was significantly decreased (P<0. 05) and HDL-c level was significanly increased compare with contrl group (P=0. 001). These findings suggest that using rest intervals between training sets cause decreasing in liver stress of old rats، but further study is needed to support these finding in pld people.

Long liness second stage of labor may cause fatigue and discomfort for women. Most of the women experience perineal injury and perineal pain during vaginal delivery. Perineal pain makes the mother too weak to take care their babies. The aim of this study was to investigate the effectivness of perineal massage on labor secound stage period، intact perineal، episiotomy and intensity of perinal pain. This clinical trial study was performed on 141 nulliparous women (71 massages and 70 control group) who referred to Koohdasht Imam Khomeini hospital for normal vaginal delivery. Countinuous sampling method with random assignment was conducted. In massage group the there cervical dilatation (6-7) was used cm after dipping the pointing and middel fingers in to a lubricating substance (key jell) then dipping 4-5 cm offingers in to the vaginal of the parturing women massaging between 3 to 9 oclock alternatively. Questionnaire and code sheets were used for data collection. Data were analysied by SPSS version 14. The mean length of second stage of labor in massage group was 58. 16 ± 28. 22 and in control group was 57. 07 ± 28. 93 minutes، the difference between the two groups was not significant (P=0. 723). In the massage group the prevalauce of safe perineal، was 29. 6%، episiotomy 32. 4% and perineal tear was 38%. In the control group the prevalance of safe perineal was 11. 4%، episiotomy 67. 1% and perineal tear was 21. 4%. Perineal pain on the third day of postpartum in massage group was 50. 7% and in control group was 70% (P=0. 019). Perineal pain on the tenth day postpartum in massage group was 29. 6%، and in control group was 45. 7% (P=0. 048). There was a significant difference between the two groups comparing perineal pain، but there was no significant difference comparing the pain inteasty between the two groups (the third day P=0. 036)، (the thenth day P=0. 390). The study shows that perineal massage is effective in increasing the likelihood of intact perineume and in decreasing the perineal pain.

Based on the limited and inconsistent results about the distinct effects of exercise activities and dietary supplements on the lipid profiles، this study was performed to determine the concurrent effect of one bout aerobic exercise and short-term garlic supplementation on lipids profile in male non-athletes.

Twenty male non-athletes (aged 22-26 years، body fat 16-20% and VO2max 38-42 ml/kg/min) in a randomized and double-blind design were allocated in two equal supplement and placebo groups (700mg/day garlic or dextrose for 14 days). After supplementation، all participants were participated in an aerobic exercise protocol with 75% VO2max on the treadmill for 30 minutes. The blood samples were taken in three phases (before and after the supplementation and after the exercise). The lipids profile changes were measured by spectrophotometer. The normal data (Mean ± SD) were analyzed by repeated measure ANOVA، Bonferroni and independent t-test at α≤0. 05.

The results showed that a 14-day garlic supplementation had significant effect on basal triglyceride (TG) decrease، and high density lipoprotein-cholesterol (HDL) increase (P<0. 05). Moreover، exercise-induced decrease of triglyceride، and low density lipoprotein-cholesterol (LDL) in the supplement group were significantly more in comparison age with those in the placebo group (P<0. 05).

Based on the present results it can be concluded that one bout aerobic exercise concurrent following 14-day garlic extract supplementation is more effective than merely exercise to improve the blood lipids profile in male non-athletes.

Epstein-Barr virus is a member of the herpesviridae family which is spreaded by direct contact with infectious secretion. Serum IgM and IgG are antibodies to the Viral Capsid Antigen (VCA) which appear during infection and Involve in determining the infection status. The aim of this study is to design and evaluate Epstein Barr Virus (EBV) IgM and IgG indirect ELISA using gp125 Viral Capsid antigen for diagnosis of EBV infection. In this study، ELISA test using Viral Capsid Antigen (gp125) for detection of EBV-specific IgG and IgM antibodies was designed and launched. To evaluate our home-made ELISA، 101 human sera (26 positive sera and 75 negative sera) were tested with VCA IgM ELISA and 105 human sera (98 positive sera and 7 negative sera) were tested with VCA IgG ELISA. To determine the specificity، 24 serum samples from patients without mononucleosis infection were used. The samples were simultaneously evaluated for VCA IgG and VCA IgM by commercial ELISA kit and with the indirect IF test. Data were analyzed using SPSS software version 15 and McNemar test. Our results displayed the relative sensitivity، relative specificity and agreement of 92%، 96% and 95% respectively for the VCA IgM ELISA and the relative sensitivity، relative specificity and agreement of 96. 6%، 88. 9% and 95% respectively for the VCA IgG ELISA when compared with commercial ELISA kit. VCA IgG ELISA showed 97% sensitivity، 100% specificity and 97. 1% agreement when compared with indirect IF and the 100% positive declarative value. Nature of the coated antigen has an important role in increasing the sensitivity and specificity. In other words، when the native antigen (Our home-made ELISA) is used in the ELISA test، the test has a high specificity but when the synthetic antigen (ELISA kits from Equipar Diagnostics -Italy) is used the sensitivity will go up، so increasing the sensitivity and specificity of the test it is recommended to use، both antigens in the ELISA design

In a great number of countries، antibiotics include neariy 30 to 50 % of the prescriptive medicines among curative ingredients. Despite of important role of the antibiotics in life threatening bacterial infections، most of studies show that 30 to 60% of prescriptive causes have been false or unsuitable which has been prescripted by doctor، distributer or self-therapy. The present study was aimed to examine the pattern of antibiotic consumption، in pediatric wards of Hajar hospital in 2009-2010. In this descriptive cross- sectional study، 265 children with infectious diseases from in pediatric wards of Hajar hospital in the first seven days of each month during 2009-2010 were registered for the study. The patient''s chart was reviewed regarding the pattern of antibiotic consumption. Data were analyzed with t-test and Chi square using SPSS software. In this study، inappropriate antibiotic consumption was 37%. Acording to the incorrect use of antibiotics in industrial countries (20%)، this rate in Iran is very high and significant. Ceftriaxone was the most common antibiotic recommended. About 99% of antibiotic prescription was empirical. In the current study، antibiotics consumption is not scientific. Thus، it is necessary to be revised the pattern of antibiotic prescription.

Patients under hemodialysis have sedentary lifestyle، muscle atrophy and muscle weakness. This study was performed to evaluate the effects of aerobic exercise during hemodialysis on the efficacy of dialysis، muscle atrophy and physical performance in patients with chronic renal failure.

In this quasi-experimental study، thirty patients with age mean of 45 years under hemodialysis were divided into control (N=15) and experimental (N=15) groups. Patients in experimental group were particapated in a twenty- week progressing exercise training performed during the first two hours of their hemodialysis on a stationary bicycle، three times a week، for 60 minuntes each time. Eefficacy of dialysis using Clearance time/volume and Urea Reduction Ratio، muscle atrophy by anthropometry skinfold measurements and physical performance، using 2-minute walk test (2MWT)، were assessed before and after training program. Statistical analysis was performed using SPSS 18، t-test and ANCOVA to compare pre and post values within and between groups.

After the exercise، there was a significant increase in the distance walked during the 2MWT from 132. 87 ± 24. 1 m to 165. 27 ± 30. 3 m، and a significant improvement in atrophy from 56. 57 ± 18. 8 to 59. 37 ± 18. 4 cm in exercise group (P<0. 05). No significant differences were observed in efficacy of dialysis after exercise program (P>0. 05).

It seems that regular exercise has a significant impact on physical performance and muscle atrophy in hemodialysis patients and can be used as part of the treatment for hemodialysis patients، but no significant effect has on efficacy of dialysis after exercise program.

In this study the major components of essential oil of Coriandrum sativum، Achillea millefolium and Anethum graveolens were studied and the antibacterial effects of these 3 plants on four pathogens including Escherichia coli، Bacillus cereus، Bacillus licheniformis and Pseudomonas aeruginosa were evaluated in vitro and Minimal Inhibitory Concentration (MIC) were determined. In this experimental study the essential oil of the plants by distillation with water and clevenger was extracted. The constituents of these plants essential oil analysis by gas chromatography (GC) and gas chromatograph linked to mass spectrometry (GC/MS) were identified and the percentage of their componants was determined. For determining the MIC for each essential oil on four pathogens Micro Dilution was used. Results indicated that in essential oil of Achillea millefolium، α-Pinene، in Coriandrum sativum D-varvone and in Anethum graveolens، Linalool were the essential compounds. Generally it was found that for inhibiting Escherichia coli and Bacillus licheniformis growth، Anethum graveolens essential oil with 312. 5 ppm and for inhibiting Bacillus cereus and Pseudomonas aeruginosa growth، respectively Coriandrum sativum and Achillea millefolium essence with 1250 ppm and 312. 5 ppm concentration was effective. All three extracts of Coriandrum sativum، Achilleh millefolium، Anethum graveolens، had superlative effect on pathogens and may be beneficil in the treatment of infectious diseases.

Hemodialysis patients have reduced physical capacity for various reasons resulting in increased dependence on others. This study was conducted to detect the effectiveness of a designed exercise program on mean of activity tolerance in hemodialysis patients.

In an experimental study، 25 hemodialysis patients from three hospitals of Tehran University of Medical Sciences were selected in 2010. The patients in the experimental group (n=12) followed a designed exercise program، 3 days per week، which lasted for 8 weeks. The subjects in the experimental group had to exercise for 20 minutes immediately after the dialy session followed by a 10-minute bed rest and deep slow breathing with their closed eyes. The control group (n=13) did not receive any exercise program. The Fatigue Severity Scale (FSS) questionnaire and a checklist were used three times: before the exercise program and four and eight weeks after the exercise program.

Eight weeks after the exercise program، the control group experienced moderate fatigue while the experimental group experienced mild fatigue; the difference was significant (P=0. 003) and the average tolerance time in the first month increased from 17. 77 to 18. 15 minutes، although this difference was not significant (P=0. 4).

Walking exercise is almost free and safe for decreasing fatigue and increasing the average time of activity tolerated in hemodialysis patients. In order to improve the patients'' care and quality of life، nurses should identify the strategies of decreasing fatigue.

Chronic diseases such as osteoarthritis due to successive progressing are frequently disabling and affect on quality of life of elders. The aim of this study was to detect of effectiveness of physical activity on quality of life of elderly patients with osteoarthritis. This study was case-control trial. Subjects were 160 elder with osteoarthritis (80 active and 80 non–active elders)، were selected by convenience sampling. Measurement tools included questionnaires of demographic، physical activity of Yale and the 36-Item Short Form quality of life. Data were analyzed using independent t test. The results showed that difference was significant between aspects of quality of life (physical performance، physical problems، mental problems، vitality and freshness، mental health، social performance، body pain، general health) for two group (P<0. 05). Checked averages showed active elders with osteoarthritis were better in all of the aspects of quality of life than non - active elders with osteoarthritis. According to the results of this study and positive impact of physical activity on quality of life of those clients suffering from osteoarthritis، the method of modifying and conformity toward physical activity can be provided might effectively play a significant role in recovering the quality of life of the elders and the health level of society.

Blunt abdominal trauma (BAT) is a common presenting problem of emergency departments. Approximately 7 to 10% of the mortality caused by trauma occurs due to the abdominal lesions. It seems that a higher ratio of abdominal circumference to hip has protective effect in reducing the likelihood of intra-abdominal injuries (IAI). This study was aimed to evaluate correlation of Waist to Hip Ratio (WHR) and IAI in patients with BAT. In this descriptive-analytical study، 222 patients with blunt abdominal trauma referred to emergency ward of Imam Hossein Hospital were analyzed regarding demographic data، WHR and its correlation with clinical، paraclinical and imaging results of patients. Data were analyzed using Chi-squared and fisher tests. 222 patients with blunt abdominal trauma were analyzed (74. 8 male). Based on laboratory and imaging procedures only (5%) (13 cases) had clear evidence of damage to abdominal viscera and organs. There were not any significant relation between WHR and results of sonography، CT scan، urine analysis and laparotomy (P>0. 05). It seems that there is no correlation between WHR and IAI after abdominal blunt trauma. However; further studies are required to comment definitively on this issue

Advanced abdominal pregnancy has been reported one case per 85،000 births. Usually ectopic pregnancies or tubal pregnancy are aborted in the intraperitoneal cavity and then absorbed، but their placental connection might remain in unusual way or re-implantation elsewhere into the abdominal cavity and grow in abdominal pregnancy form. The rates of maternal and fetal mortality are increasing in abdominal pregnancy. In this study، a 32 abtrominal pregnancy case with the live fetus is repoted. Case report: A 36 years old Iranian women، with32 weeks gestational age، undergoing emergency abdominal laparotomy due to fetal distress with suspected placental abruption and the live boy fetus with weight 1800 grams placed in the abdomen below the diaphragm into the blood and amniotic fluid، and the mother underwent hysterectomy surgery. Considering the high mortality of abdominal pregnancy، abdominal pregnancy should be diagnosed early in patient with risk factor and suspicious symptoms. Thus if necessary action are taken، maternal and fetal mortality might be decreased