مجله دانشگاه علوم پزشکی شهید صدوقی یزد
سال بیست و یکم شماره 5 (پیاپی 94، آذر و دی 1392)

Purpose of this study was to evaluate outcome of Anterior Cruciate Ligament (ACL) reconstruction surgery with a medial tibia tunnel entrance in patients with rupture of the ligament.

This cross-sectional study was performed in patients admitted to Sina Hospital in Tehran from April 2009 to April 2011. ACL reconstruction was done by arthroscopic surgery and the patients were assessed six months after surgery. International Knee Documentation Committee (IKDC) as a standard questionnaire and arthrometer (model KT-1000) were used to measure patients'' activity level and functional testing of the device، respectively. Final knee score was given to the patient based on the lowest score in each section which was presented in four groups: A، B، C and D.

one hundred seven patients with mean age of 29. 61 ± 5. 15 years (21-38 years) enrolled in this study among which 84 (78. 5%) were males. Most common causes of knee trauma were sport (54. 20%)، road traffic accidents (19. 62%)، daily activities (16. 82%) and work activity (9. 3%). The mean femoral channel length was 44. 75 ± 3. 41mm. The mean of ROM of Knee after surgery was 143. 21 ± 5. 37 (133-150). The functional test was performed using an arthrometer and differences between two knees displacement were calculated six months after surgery which revealed that the difference between males and females was significant (p=0. 03).

The results showed the transtibial graft position is closer to the anatomical position in medial femoral tunnel placement.

One of the problems in midwifery is labor induction in the cases which the termination of pregnancy is necessary. Thus، the methods for cervical ripening and labor induction have always been taken into consideration. The aim of this study was to determine the effect of intramuscular dexamethasone on onset of labor in postdate pregnancy. This single-blind، randomized clinical trial study was performed on 100 nulliparous women who referred to Amir Al Momenin hospital in Ahvaz. The patients were randomly divided into two groups. Single dose of intramuscular dexamethasone (8 mg) was administered to the study group 12 h before induction. The controls were given 2 cc of normal saline at the same interval. There was no significant difference between the two groups in terms of age، demographic characteristics، initial Bishop score، first and fifth minute Apgar score، and meconium. After the injection، Bishop score in the study group was 7/23 ± 1/32 and in the control group، it was 2/98 ± 0/89. Thus، the difference was significant (P<0. 0001). The mean interval between induction with the onset of the active phase was 3/1±0. 68 hours in the study group، whereas in the control group 4/2±1/3 hours was observed (P=0. 001). The results of this study showed that intramuscular dexamethasone by improving Bishop score causes the onset of labor pains resulting in decrease of labor duration in postdate pregnancies.

One important problem، regarding patients who undergo bypass surgery، is insufficient recovery after surgery. Delayed surgical recovery leads to some negative clinical، psychological، and economic consequences for both the patients and providers of medical care services. The current research was conducted to determine the relationship between social networks and the recovery rate of cardiovascular patients after the heart bypass surgery. This study was conducted as a quantitative cross-sectional research. The sample population includes cardiac patients who underwent heart bypass surgery at least one week before. The instruments of data collections were Berckman and Sim’s social network index (BSSNI) and an author-made questionnaire on recovery rate. There was a statistically significant difference among patients with quick and slow recoveries، concerning the social networks (P<0. 01). Patients making quick recovery had wider social network compared to those making slow recovery. The findings indicated that a social network is an influential factor in social and behavioral interferences aiming at increasing recovery rate of cardiovascular patients after heart bypass surgery.

Multidrug resistance (MDR) is the main obstacle against treatment of acute lymphoblastic leukemia (ALL). ATP-binding cassette transporters function is mentioned as one of the most effective factors on MDR development. Though، there are many evidences on interference of ABCG2/BCRP، one of the outstanding members of this superfamly، in MDR occurrence، the expression effect of this gene on blasts of ALL patients is unknown yet. In this study، we used Real-Time PCR technique in order to investigate the relative expression of ABCG2/BCRP mRNA in 1-17 year old children with ALL. Peripheral or bone marrow blood samples from 28 new case leukemic and 15 control children were investigated with cooperation of Seyyedo-Shohada hospital in Isfahan،. Minimal Residual Disease (MRD) was evaluated as quality of patient response to chemotherapy. Profile of ABCG2/BCRP mRNA expression did not have any significant difference in new case ALL patients in comparison with control children. On the other hand، comparison of two groups of MRD+ and MRD- patients showed no difference in ABCG2/BCRP expression level. The level of ABCG2 expression was not associated with immunophenotype of ALL or known prognosis factors for this type of leukemia. Results of this study showed no effect of ABCG2/BCRP expression level on MDR development in ALL. Accordingly، clinical value of ABCG2/BCRP expression profile determination was rejected as the prognosis value for childhood ALL in our geographical area.

Irradiation of loaded tumor with high-Z nanoparticles with low energy photon of 192Ir source during brachytherapy increases absorbed dose of tumor due to increase in possibility of photoelectric phenomena. Therefore، this study aimed to investigate dose enhancement due to nanoparticles (NPs) with different atomic numbers and concentrations as well as effect of NPs distribution (uniform & non- uniform) on dose enhancement. Dosimetric parameters of HDR-192Ir source (MicroSelectron model) were calculated by MCNP-4C code on the basis of recommendations of AAPM، TG-43. A tumor (1 cm3) loaded with uniform and non-uniform distribution of 7، 18 and 30 mgr/gr of 79Au، 64Gd، 26Fe and 22Ti in water phantom (30×30×30 cm3) was simulated. DEF of 4. 7% to 19. 4% and 3. 3 to 18. 6% were calculated respectively for uniform distribution of 79Au and 64Gd with 7 to 30 mgr/gr concentrations. For non-uniform distribution these values were 0. 4%to 1. 9% and 0. 2% to 1. 2%، respectively. Increased dose of the peripheral-health tissue due to presence of 2 to 8. 5 mgr/gr of 79Au and 64Gd was estimated from 1. 3% to 6. 5% and 1. 1% to 4. 2%، respectively. increase of atomic number and concentrations of NPs enhance the absorbed dose due to increased possibility of photoelectric phenomena. Non-uniform distribution of NPs underestimated dose compared to uniform distribution; therefore، considering accurate NPs distribution inside the tumor volume is crucial to calculation of dose enhancement. Targeted labeling of NPs for the maximum absorption by tumor and for the minimal penetration into peripheral tissues has potential to increase radiation therapeutic ratio.

Krupple-like factor4 is a transcription factor which is involved in many cancers including Breast cancer. Breast cancer is the most common malignancy among women. Due to the high prevalence of these tumors، there are ongoing efforts to find molecular markers which can recognize nontumoral from tumoral tissues. Therefore، the aim of this study was to evaluate the potential usefulness of KLF4 as a potential diagnostic and therapeutic molecular marker in breast cancer. In the current study، 31 tumoral and 21 non tumoral adjacent tissues were evaluated. Transcription levels were measured by Semiquantitative Reverse Transciptase-Polymerase Chain Reaction and were normalized by the ß2m as an endogenous PCR control. Data was analyzed by spss software، one-way ANOVA and T-test. The results showed that: 1) KLF4 is over expressed in Breast tumors rather than adjacent normal tissues. 2) KLF4 is an oncogene in breast tumors (at least in IDC type). 3) The KLF4 expression levels are related significantly with nature of malignant breast tumors. Findings do not confirm KLF4 as a diagnostic marker in classification and identification of tumoral tissues from non-tumoral ones in breast، but we can use this marker to identify at least 50% of invasive Ductal Carcinoma in breast and utilize it as a potential predictive factor to demonstrate severity degree in various tumors.

Additives such as nitrites compounds are used in meat products in order to create the desired color، creating the desired taste، prevent the growth of Clostridium botulinum spores and increase the storage time of the products. Today، due to the indiscriminate use of nitrogenous fertilizers، it is widely spread in water، soil and ecosystems، and the lives of many people could be put at risk. Therefore، this study was performed in order to examine the histopathological effect of sodium nitrite on Pulmonary artery in male rats. This is a cross - sectional study in which 30 adult male and female rats strain Vistar were divided into 3 groups of 10 which involved 2 recipient groups who were given 175 mg/kg/day dose and 350 mg/kg/day dose of nitrite. The control group absorbed nitrite through drinking water. The 3 groups were examined for 60 days. At the end of day 60، after Anesthesia، the blood sample was collected from heart. The arteries were taking out of body، and then tissue sections were prepared for testing tissue changes. The samples were stained with HematoxilinEozin method and thickness of internal media (intima media thickness) was measured with Image tool software. Factors such as morphometric and morphologic from arteries، body weight changes were investigated before and after test and also blood nitric oxide level was checked. At the end، the obtained results were analyzed through spss 17 software by T-test and Anova test. The outcome of nitric oxide plasmatic density measurement showed that nitric oxide level in animal ’s blood in 175 mg/kg/day dose recipient group and 350 mg/kg/day dose recipient group increased significantly compared with the control group at the level of P ≤ 0. 05. Also thickness of media layer decreased in maximum dose group (350 mg/kg/day dose) compared to the control group. Based on the results of different doses of sodium nitrite، the nitric oxide levels in the blood were increased، and the thickness of middle layer of the lung arteries at dose 350 mg of sodium nitrite was reduced.

Introductoin: Increased level of serum IL-6 is related to development of type 2 diabetes and insulin resistance. The American Diabetes Association and the American College of Sports Medicine recommend that combination of resistance and aerobic exercise is favorable for patients with type 2 diabetes. The purpose of this study was to investigate the effect of 8 weeks of aerobic exercise and concurrent (aerobic-resistance) exercise on serum IL-6 Levels and insulin resistance in Type 2 Diabetic patients.

In this study، from patients referring to Kermanshah Diabetes Association، 24 volunteers participated in the study as subjects and were divided into aerobic (n=8)، concurrent (n=8)، and control group (n=8) randomly. Training program for the aerobic group included 3 sessions of running per week with 60 to 80% maximal heart rate for 8 weeks but the concurrent group in addition to running، performed resistance training of major muscles groups. Before and after the intervention، body weight، BMI، fasting blood glucose، serum IL-6 and HOMA-IR were measured.

HOMA-IR and fasting blood glucose were significantly decreased in both training groups after intervention، but showed no significant changes in the control group. No significant changes were observed for serum IL-6 levels، body weight or BMI.

performing 8 weeks of aerobic or concurrent training with improvement of insulin resistance and fasting blood glucose could be helpful for type 2 diabetic patients; however، it cannot significantly affect serum IL-6 levels، body weight، or BMI in these patients.

Magnesium is an essential mineral in bone formation. This nutrient incorporates in bone metabolism and enhances bone mineralization. This study was designed to assess the effect of magnesium supplementation on alkaline phosphatase، osteocalcin، and also callus formation in women with long bone fracture. In this double-blind randomized placebo controlled trial، 32 women with long bone fracture، aged 20-45 years old، were randomly divided into the Mg group and control، receiving 250 mg magnesium oxide daily and placebo respectively for 8 weeks. Serum alkaline phosphatase and osteocalcin were measured at the beginning and the end point، and also callus formation was checked at the end of study. P value < 0. 05 was considered as the significant level. There was no significant difference between two groups in alkaline phosphatase and osteocalcin levels at the beginning and the end of study. Serum alkaline phosphatase and osteocalcin levels were increased in both groups، but they were not statistically significant. Furthermore، the callus formation، which revealed the fracture healing، was not different between 2 groups. This study concluded that Magnesium supplementation did not change the serum markers of bone formation and fracture healing; however، further studies need to approve this finding.

Today it has been documented that herbal medicines like synthetic drugs have side effects. The aim of his study was that whether assafoetida in doses used in most of previous studies have any effect on hepatic، renal، cardiac and blood biochemical parameters of rats. Forty male Wistar rats، with average weighting of 300 grams، were divided into five groups of eight in each. The first group was considered as control group and groups 2-5 as the pretreatment groups that were pre-treatmented by 12. 5، 25، 50 and 100 mg/kg tear assafoetida for 30 days، respectively. Then، blood samples were collected for measurement of biochemical parameters of liver (AST، ALT، ALP)، kidney (Urea، Cr)، cardiac (CPK) and blood coagulation (Pt، Ptt). Blood pressures were also recorded through inserting a cannula into the carotid artery. Lead II of electrocardiogram was used to monitor electrical activity of the heart. Data was analyzed by one-way analysis of variance. The plasma level of AST، CPK and Ptt significantly reduced in pretreatment groups with assafoetida (P<0. 05). With increasing the dose of assafoetida، plasma urea concentration reduced and plasma Cr concentration and all blood pressures increased insignificantly. The findings of this study suggest that low doses of tear assafoetida (25 mg/kg) does not probably have any side effects and even maybe useful for health، but at higher doses (100 mg/kg) it may lead to complications. Hence، there is a need for further studies to answer some questions that arose from this study.

A diet rich in olive as a source of monounsaturated fatty acids can be effective on cardiovascular risk factors. The aim of this study was to investigate the association between the incidence of metabolic syndrome (MetS) and olive، olive oil، and their oleic acid contents during a three-year follow-up among Tehranian adults. The current study is a population-based prospective longitudinal study، which was conducted within the framework of the Tehran Lipid and Glucose (TLGS). Dietary intake was assessed using semi-quantitative food frequency questionnaire، the validity and reliability of which have been documented. Demographic information was collected. Blood pressure and anthropometric indices were measured according to standard protocols and biochemical analyses were done on fasting blood samples. Finally، the 1053 patients (352 men and 913 women) aged 19-60 y were analyzed for incidence of metabolic syndrome. Mean age of subjects was 35. 5±10. 8 years and the mean intakes of olives in men and women were 1. 7 ± 4. 1 and 1. 6 ± 5. 3 grams per day، respectively. In men and women، after adjusting for confounder factors، in the highest tertiles of olive oil intake، odds ratio (OR) for MetS incidence were 0. 61 and 1. 17 respectively compared to the first tertile. Also in men low HDL cholesterol was 0. 55 in the highest tertiles of olive oil intake compared to the first tertile، and for olive and oleic acid from olive for high blood glucose، 0. 55 (CI 95%: 0. 31-0. 96، P=0. 04) and 0. 55 (CI 95%: 0. 31-0. 95) respectively. The findings of this study suggested a higher intake of olive oil can reduce the incidence of low HDL cholesterol and high blood glucose levels in Tehranian men.

Despite the popularity of needle biopsy for obtaining tissue samples in several solid organs، its use in thoracic lesions has been very restricted in some hospitals. This study intended to investigate the CT-Guided transthoracic core needle biopsy specimens in Yazd Shahid Sadoughi hospital during 2001- 2010. This is a retrospective cross- sectional study conducted on pathologic results of CT-Guided transthoracic core needle biopsy specimens in Shahid Sadoughi hospital from 2001-2010. In our study، 89 thoracic CNB were studied between2001-2010 from patients that referred to Sadoughi hospital who involved 53 males and 36 females. 78 biopsies were from lung and 11 biopsies from Mediastin. In a total of 89 biopsies 71 biopsies (78. 9%) supplied appropriate material for histopathological diagnosis. Results were classified into one of the following four groups: positive or suspicious for malignancy (19. 1%)، benign specific (34. 8%)، benign non-specific (25. 8%) and non-diagnostic (20. 2%). Based on multivariate analysis there was no significant correlation between age، sex، size of lesion and pathology results، but there was a significant correlation between the location of thoracic lesion in lung and pathology results (p-value=0. 024). Application of automated system for biopsy and fluoroscopy CT for guidance of needle biopsy can elevate adequacy of core needle biopsy in thoracic lesion.

Retained choledochal stones are classified as the stones that were left at the time of surgery or diagnosed shortly after the cholecystectomy. Choledochal stones may be silent and often are discovered incidentally. They may cause obstruction، complete or incomplete، or they may manifest themselves with cholangitis or gallstone pancreatitis. Therefore، this study was designed to determine frequency of retained chledochal stones and its relationship with some variables such as age، gender، serum alkaline phosphatase، serum bilirubin، ultrasound findings، MRC and ERC.

This is a cross-sectional study that was done on 200 patients who underwent cholecystectomy with sequential pattern during 2012 in the Shahid Sadooghi Hospital of Yazd. The study data were collected according to the patients'' history، physical examination، files and also one month follow up. Moreover، the data were analyzed by SPSS software ver. 17.

From 200 patients who underwent cholecystectomy، only one patient (0. 5%) had retained choledochal stone. Before cholecystectomy، 19 patients (9. 5%) who were presumed to have choledochal stone، underwent ERCP. In 16 patients (8%) sphincterotomy and stone extraction were done. From these 16 patients،14 patients (87. 5%) had high level of serum alkaline phosphatase، 12 patients (75%) had high level of serum bilirubin and 9 patients (56. 3%) had abnormal ultrasound findings during preoperative course. Thus، there was a statistically significant relation between these three variables and choledochal stone.

According to above statistically significant relation، we recommend that in patients who are candidate for cholecystectomy، if elevated preoperative serum alkaline phosphatase or elevated preoperative serum bilirubin or abnormal ultrasound findings were observed، more diagnostic evaluation should be done for them including MRC and ERC.

cardiac surgery by cardiopulmonary bypass (CPB) is performed accompanying with hypothermia. Measuring the body temperature during hypothermia is very important. The aim of this study was to compare esophageal، tympanic and rectal temperatures in pediatric patients below 12 years old undergoing open heart surgery.

This study was a cross-sectional descriptive and analytic study. The sample consisted of 70 patients below 12 years old undergoing open heart surgery in Rajaee Heart Centre in Tehran. Esophageal، rectal and tympanic temperatures were measured by thermometer in three phases: before CPB، during CPB and after weaning of CPB. The collected data were analyzed by SPSS 16 software using paired T-test and ANOVA (Analysis of Variance).

The mean of body temperature was different in the three sites. The difference between right and left ear was not significant، but the difference between esophagus –rectum، esophagus-tympanum and rectum-tympanum was significant (P<0. 001). All changes in four places showed that in hypothermia phase the reduction of temperature in ears was more than esophageal and rectal temperature، and in rectal، it was more than esophageal temperature.

All sites are sensitive to changes of body temperature and they can show core temperature of body well، but since differences between all sites in four phases are not same، we cannot use just one of them to reach the temperature of other sites.