مجله علمی پزشکی جندی شاپور
سال دوازدهم شماره 6 (پیاپی 87، بهمن و اسفند 1392)

Around 260 A. C. and during the dark middle ages of Europe، scholars from different religions and cultures from all around the world came together to a newly founded University and hospital known as Jundishapur for training and group thinking، in a friendly atmosphere. The old Jundishapur in Iran gained the capacity to accommodate tens of distinguish professors، thousands of scholars from Iran and other countries، four hundred thousand books and scientific thesis. The excellence in both medical and non-medical sciences was gradually developed and lasted over 900 years. It produced a permanent impression in practice of medicine and pharmaceutical sciences in Iranian cultures and the world and to give birth to Present Jundishapur University. In the second part of this historical research، the most important accomplishments of Jundishapur scientific center during the middle ages and its inflenunce on later founded scientific centers in west Europe as well as on the foundation of the new Jundishapur University will be discussed.

Focal segmental glomerulosclerosis (FSGS) is a common cause of nephrotic syndrome in adults and children. It may occur either without an identifiable cause (idiopathic or primary) or in response to previous glomerular injury (secondary). In the treatment of FSGS distinguishing between primary and secondary is important because immunosuppressive therapy is indicated in most patients with primary FSGS but not in secondary FSGS. Untreated patients with primary FSGS who present with nephrotic range proteinuria (proteinuria>3. 5 g/day) and hypoalbuminemia typically have a progressive course to end stage renal disease. It appears that primary FSGS is responded to prednisone at a dose of 1 mg/kg per day (maximum dose 60 to 80 mg/day) in 40 to 80 % of patients، however prolonged glucocorticoid therapy for a minimum of 12 to 16 weeks is generally required to induce remission among these patients. For the treatment of steroid-resistant or relapsing disease، cyclosporine is most commonly used at a dose of approximately 2 to 4 mg/kg per day (given in two divided doses) in conjunction with low dose of prednisone (maximum 15 mg/day). In addition، other agents، including cyclophosphamide and mycophenolatemofetile have also been tried among steroid-resistant or relapsing disease with various degrees of response.

High prevalence of sexual dysfunctions has a significant impact on the quality of life of male sufferers and their families. The need to assess sexual dysfunctions objectively has led to the development of validated Men Sexual Health Questionnaire (MSHQ) questionnaire. The aim of this study was to prepare and validate a Persian version of MSHQ. Subjects and This cross-sectional study included a sample of 388 men. The MSHQ was translated into Persian according to standard procedures for forward-backward translation. Content validity index and content validity ratio were determined. Explanatory factor analysis was used to assess the construct validity and discriminant validity to determine within groups analysis of variance. Cronbach''s α coefficient was conducted to evaluate reliability of the scale. The content validity index and ratio values were more than 0. 78 and 0. 90 respectively. In exploratory factor analysis، three factors erection، ejaculation، and satisfaction، were extracted. More than 70 % of the variation was explained by these three factors. Cronbach''s  coefficient was 0. 80 for all dimensions of MSHQ indicating the reliability of this instrument. Based on these findings، the Persian version MSHQ a reliable and valid instrument for assessing sexual function in men and can be used as a screening tool.

Resistin، as an adipokine is associated with obesity and insulin resistance، but the effects of different exercise trainings on the levels of this hormone is unknown. The aim of the present study was to compare the effects of aerobic with resistance exercise training on change in serum resistin level in obese postmenopausal women with type 2 diabetes. Subjects and In a quasi-experimental study 40 women with type 2 diabetes were selected as available and by purposive sampling and were randomly assigned into 3 groups of aerobic training (n = 14)، resistance training (n = 13) and control (n = 13) groups. Aerobic group accomplished (12 weeks of aerobic training، 3 times a week، for 20-50 minutes at 50-70% of maximum heart rate)، the resistance group received (resistance training 3 times a week in 3 sets of 10 repetitions with 40-60% of a repetition maximum). The control group was sedentary during the same period. Blood samples were collected for measurement of the levels of resistin، insulin، HbA1c and glucose. Insulin resistance was calculated with HOMA-IR equation. Resistin serum level was increased in both exercise training groups (P<0. 05)، anthropometric measurements decreased in aerobic group only (P<0. 05)، while insulin resistance was decreased in resistance group (P<0. 05). Glycated hemoglobin and glucose decreased in both training groups (P ˂0. 05). It seems that during 12 weeks، both types of aerobic and resistance exercise training have beneficial effects، through different mechanisms، in patients with type 2 diabetes.

Shoulder has the greatest range of motion among our body joints. This makes this joint susceptible to dislocation and subluxation. The most common form of instability of the shoulder is anterior dislocation. Bankart’s essential lesion is the most common cause of recurrent anterior shoulder instability. In this study the results of Bankart operation have been evaluated. Subjects and Thirty cases of recurrent shoulder dislocation underwent open Bankart surgery using anchor suture were selected. These operation were carried out from 1390-1380 in Razi and Emam hospitals in Ahvaz. The cases were evaluated for joint instability، pain according to numerical rating scale، DASH and Rowe Scores، range of motion and movement limitation. Data was analyzed using Fisher exact test and SPSS17 program. The mean age of the patients was 6. 65±33. 7 years. The mean forward elevation، internal rotation، external rotation and abduction were 150، 47، 36 and 156 degrees respectively، which were just a little less than normal lower limits. Mean reduction of external rotation was 5 degree (20-0). According to ROWE score the excellent، good and faire result were 64%، 23% and 13%. DASH score mean was 38. 83 (normal range 66-30). None of them had recurrence or osteoarthritis in radiography. According to the results of this study it seems that open Bankart surgery is an effective method for reducing pain and recurrence of shoulder dislocation.

One of the most important applications of electrode physiological tests is early diagnosis of hearing loss and estimating of hearing threshold in neonate and children for early auditory intervention. Auditory Steady–State Response (ASSR) is modern technology for threshold detection in audiology. Measurement of Auditory brainstem response (ABR) is most common method of detection auditory threshold in neonates. The goal of this article was to correlate the results between thresholds obtained from ASSR and click-ABR. Subjects and In this descriptive-analytic design، 32 children with mild and moderate hearing loss، aged between birth to 7 years، were studied. All children were evaluated by both ASSR and C-ABR. The correlation coefficients for frequencies of 0. 5، 1، 2، 4، mean of 2-4، and mean of 1-4 kHz were between 0. 40- 0. 87 in mild hearing loss and 0. 52-0. 91 in moderate hearing loss (P<0. 05). C-ABR and ASSR thresholds in mean frequencies had a greater correlation than single-frequency (P-Value< 0. 001<0. 002-0. 015). This correlation was higher in greater degrees of hearing loss and higher frequencies.

Antioxidant agents play an important role in prevention and protection in heart diseases، therefore، are used as medicinal plants in traditional medicine. Hawthorn fruit extract، with strong antioxidant properties، has been used effecively in treatment of many diseases. The aim of this study was to investigate the protective effect of hydroalcoholic extract of Hawthorn fruit on CaCI2-induced arrhythmias in rat. Subjects and Male Sprague Dawley rats divided in control، amiodarone (10 mg/kg، iv) and Hawthorn-extract groups receiving either saline solution (1ml/kg/day، by gavage) or hawthorn extract (100 and 200 mg/kg/day، by gavage) respectively for 10 days. Both groups before experiments and 10 days later lead II electrocardiogram was recorded for calculating electrophysiological parameters such as QRS complex. CaCI2-induced arrhythmia was used for evaluation of possible antiarrhythmic calcium antagonistic effect. The arrhythmia was produced by i. v. injection of a CaCl2 2. 5% solution (140 mg/kg) and percentage of ventricular premature beats (VPB)، ventricular fibrillation (VF) and ventricular tachycardia (VT) were recorded in hawthorn groups and was compared to control and amiodarone (10 mg/kg، iv) groups. Results were analyzed by using one-way ANOVA، Fisher and student t-test. P<0. 05 was considered as significant level. The inotropic and chronotropic effect was not significant with hawthorn extract after 10 days administration. Hawthorn extract displayed antidysrhythmic effects on CaCl2-induced arrhythmia compared to control group by significant reduction of VPB، VF and V. tac، comparable to that of amiodarone. The results of present study such as significant decrease in VPB، VF and V. tac in hawthorn groups showed antiarrhythmic properties of hawthorn fruit extract as a preconditioning agent and suggest the protective effect of hawthorn extract in heart disease comparable to amiodarone.

The present study investigated the effectiveness of cognitive behavioral stress management training (CBSM) on three aspects of burnout (emotional exhaustion، depersonalization and personal accomplishment)، in female nurses. The population of this study consisted of all expert female nurses in Golestan، Razi and Abuzar hospitals. Subjects and The research method was semi experimental with pre-، post-test and control group. 233 Nurses complited the Maslash Burnout Inventory (MBI). Then، 30 nurses who were one standard deviation above the mean in MBI were randomly selected. These subjects with paired single-married randomly divided into two groups as experimental and control (n=15 in each group). The experimental group received 9 sessions of cognitive-behavioral stress management (CBSM) training، but the control group did not receive any intervention. The results of MANCOVA indicated that CBSM significantly decreased depersonalization and increased personal accomplishment but did not decrease the emotional exhaustion in experimental group compared with pre-test and control group (P<0/001). These results were significantly persisted after one month period of follow up. CBSM decreased depersonalization and increased personal accomplishment in nurses.

Pitch is our perception of frequency. Voice pitch is related to age، gender، size of body، social، cultural and language positions. The resident of Ahvaz city are from different cultures and speak variety of languages including a large number of Arabic-speaking people. There are a large number of Arabic-speaking people with voice disorders in Ahvaz who use Arabic as first or second language and will need speech therapy and audiology services. Determining of acoustic differences of bilingual people can lead us to effective assessment and treatment. Aim of this study was to compare the average of fundamental frequency among Persian and Persian-Arabic speaking male students. Subjects and This article is a descriptive، analytical study. The number of participants was 60 (30 monolingual، 30 bilingual). Tasks were prolongation of vowels /a-u-i/. Voice samples were recorded by absolute sound recorder device. The data were analyzed by praat software. SPSS19 was used for comparing differences between two groups، using unpaired T-test. The data showed that there was there was a significant association between both groups in /a/و/u/ prolongation tasks (pvalue=0/000). Additionally there was a significant association between both groups in /i/ prolongation task (pvalue=0/004). The results of this study showed that acoustic differences between bilingual and monolingual people was mainly in /a/ /u/ and I prolongation.

The purpose of this study was to investigate the effect of group cognitive–behavior therapy on oppositional defiant disorder and aggression among guidance school female students. Subjects and The research method was semi experimental with pre-post and control group. The sample consisted of 65 female students who were selected by random cluster sampling، clinical interview with their parents and oppositional defiant behavior inventory (ODBI). Thirty students were selected randomly and randomly divided into two groups as experimental and control. The subjects also completed Buss and Perry Inventory. Then 8 sessions of cognitive–behavior therapy was held for experimental group but the control group did not receive any intervention. For analyzing the data، MANCOVA test was used. The results revealed that there was a significant difference between experimental and control group in oppositional defiant disorder and aggression (P<0. 001). The rate of oppositional defiant disorder and aggression in experimental group was significantly decreased in compare to pre test and control group. The results indicated that group cognitive –behavior therapy was effective to reducing the oppositional defiant disorder and aggression (P<0. 001). Group cognitive–behavior therapy can decrease the oppositional defiant disorder and aggression in guidance school female students.

physician in order to carry out their professional duties may be committed by an act or omission in contrary to the dignity and violation of individuals and disruptive in social order. The legislature considers these action as a crime and must be punished. Doctor’s criminal responsibility in the Islamic criminal law act of 1370 follows statemen’s from Shiite religious groups، as pare and without fault of the Doctor، s responsibility. Fortunately، the new Islamic criminal law act of 1392/2/1 penal code has not been run yet، previous regulations has been modified and fault based on physician responsibility has adopted. So in order for a relives himself doctor relief from responsibility، should be proved his/her own innocence by former way (cutting the causation relations)

Juvenile myelomonocytic leukemia (JMML) is a chronic، fatal and aggressive myeloproliferative neoplasm of childhood that occurs in 1. 2 per million. JMML is a clonal disorder characterized by over proliferation of one or more lineages that retain the ability to differentiate. Because of rarity of the disease and the different kind of clinical findings the diagnosis of JMML is difficult for the most physicians. JMML is clinically characterized by the overproliferation of monocytic cells that can infiltrate organs، including the liver، spleen، lung. This paper tries to make a comprehensive survey on the diagnosis and treatment of the disease. Case Report: A 4-year-old boy presented with hepatosplenomegaly، pallor، fever and respiratory distress. He also presented with myeloid precursors in peripheral blood and a white blood cell count >10109/L، peripheral blood monocyte count > 1 109 /L، bone marrow blasts < 20% with no Philadelphia chromosome was identified. Fetal haemoglobin (HbF) was within the normal range. The patient responded completely to chemotherapy، but the disease recurred later. Bone marrow transplantation (BMT) was carried out but the patient expired due to infection complications associated with transplantation.. Although chemotherapy protocols، which induce maturation and differentiation، are used as a temporary treatment، BMT is the definite treatment for JMML. BMT is the only treatment which able to cure JMML، but the high relapse rate is of great concern and it may be unavailable anywhere، and patient selection for this method need to be carefully undertaken. Recent advances in diagnosis and treatment of JMML will be discussed here.