نشریه دانشگاه علوم پزشکی بیرجند
سال بیستم شماره 4 (پیاپی 57، زمستان 1392)

Cisplatin is a potent chemotherapy agent which is used to treat a broad spectrum of solid cancers. However، its clinical use is limited due to its nephrotoxicity with a decline in the glomerular filtration rate that occur in 15-30% of patients. Multiple mechanisms contribute to renal dysfunction following exposure to cisplatin include tubular epithelial cell toxicity، vasoconstriction in the renal microvasculature، and increase the expression of proinflammatory cytokines. The most important manifestations of cisplatin nephrotoxicity are non oliguric acute renal failure (ARF) which can be progressive، hypomagnesemia، fanconi-like syndrome، and anemia. An increasing risk of ARF is associated with higher doses of cisplatin، previous cisplatin chemotherapy، underlying kidney dysfunction، and the concomitant use of other nephrotoxic agents. The standard approach to prevent cisplatin-induced nephrotoxicity is the administration of lower doses of cisplatin in combination with the administration of full intravenous isotonic saline before and after cisplatin administration. Although a number of pharmacologic agents including sodium thiosulfate، N-acetylcysteine، theophylline and glycine have been evaluated for prevention of nephrotoxicity، none have proved to have an established role، thus، additional clinical studies will be required to confirm their probable effects.

Severe pain following cesarean section is a complex physiologic reaction due to distention of gastrocolic regions، tissue impairment، and uterus contractions. This sort of pain can have unfavorable effects on different body systems. There are different drugs and various techniques to decrease such pain، e. g. ordinary oral and injectable analgesics; and rectal suppositories are available. Thepresent study aimed at comparing the effect of diclofenac، indomethacin، naproxen، and acetaminophen rectal suppositories on post-cesarean section pain. In this double-blind randomized clinical experimental study undertaken in Kerman Afzalipoor hospital، 125 pregnant women who had undergone cesarean section under general anesthesia، were randomly divided into 4 groups. In the recovery ward، after complaining of pain، the first and the second group members were administered 100mg of rectal diclofenac and indomethacin، respectively. The third and the fourth group members received 325mg and 500mg acetaminophen and naproxen، respectively; in the same manner. Then، the vital signs and Visual Analogue Scale (VAS) of each case were examined and evaluated at the time 0، 15 and 60 minutes after administration. The all cases were not significantly different regarding age، height، and weight. Moreover، the group receiving diclofenac experienced the most pain decrease within an hour based on VAS (P<0. 001). However، there was no significant difference among the other groups. Rectal diclofenac suppository significantly decreases pain one hour following cesarean section compared to indomethacin، naproxen، and acetaminophen.

Cardiovascular diseases are the leading cause of morbidity and mortality worldwide. Increased histamine level in the cardiac tissue has deleterious effects after ischemia-reperfusion occurrence. Regarding the existence of histamine type 2 receptors in the heart and their decisive role in inflammation، in the present study the cardioprotective effects of ranitidine in the factors effective gainst LV functions and the extent of the infarcted area were studied. Thirty-two male Balb/C mice were divided into 4 equal groups. The control group received saline; the others were administered 400 mg/kg ranitidine، ip. Group RE just on the test day; R14 and R28 groups for 14 and 28 consecutive days، respectively. Then، the hearts of the subjects were isolated and subjected to Langendorff-perfusion with induced global ischemia for 30 minutes followed by reperfusion of 60 minutes. Left ventricular systolic (LVSP)، and end diastolic pressures (LVEDP)، heart rate (HR) and coronary flow (CF) were measured، and left ventricular developed pressure (LVDP= LVSP-LVEDP) and contractility (+dp/dt) calculated. Myocardial infarct size was determined by triphenyltetrazolium chloride staining. Ranitidine can significantly increase LVSP; and decrease infarct size especially in R28 compared to the control group (P<0. 01). It was found that ranitidine of 400 mg/kg dose، esp. during chronic phase can be cardioprotective against ischemia-reperfusion damage through improvement of cardiac performance.

Application of stem cells derived from adipose tissue is very easy. The present study evaluated the effect of transplantation of non-autolugus of adipose derived stem cell (ADSc) and nerve growth factor (NGF) in repairing of crushed sciatic nerve in rats by examining their behavior and electrophysiology. Twenty-eight adult male rats were used in this study. The animals were randomly divided into four equal groups: (healthy rats)، as control (sciatic nerve crushed rats)، (sciatic nerve crushed rats treated with NGF)، and (sciatic nerve crushed rats treated by means of transplantation of non-autolugue of ADSc). Then،the improvement of sensory function and sciatic nerve index (SFI) of the groups were assessed. Time of recovery of sensory parameters after two weeks treatment with NGF significantly decreased when compared to the control group (P<0. 01)، while the cell therapy groupshowed siqnificant improvement. At the end of the sixth week، mean of SFI in cell therapy and NGF groups increased compared to the control group but the differences were not significant. Mean NCV and AMP also showed a non-significant increase in the cell therapy group compared to the control group. Transplantation of non-autologous of adipose-derived stem cells (ASDc) is an appropriate therapeutic approach in repairing of neurological injuries and NGF has a positive effect in crushed sciatic nerve regeneration.

Regarding the multi-dimensional activity of medicinal herbs in complex disorders like diabetes، the present study was undertaken to evaluate the effect of freezed and dried extract of black grapes juice on serum glucose and lipid profile of alloxan induced diabetic rats. The present study was performed on 48 male Wistar rats which included 6 groups، i. e. the control group and five alloxan-induced diabetics. The other five groups were the following: 1. The control diabetic group، which only received normal saline، 2. The diabetic group، which received glibenclamide and lovastatin، 3. 4.، and 5 At first، diabetes was induced in 40 cases through intraperitoneally injection of alloxan. After 2 days، fasting blood sugar (FBS) greater than 200 mg/dl was considered as diabetic condition. Diabetic rats were divided into 5 groups (group2to6) randomly. Groups1was included nondiabetic control. Group1and 2 (diabetic control) gavaged by normal saline. Group 3 by glibenclamide and lovastatin، group''s 4، 5and 6 received 100، 200، 300mg/kg black grapes juice extract، respectively for four weeks. Then، blood samples of the anesthetized rats were collected and blood glucose، cholesterol، triglyceride، HDL-C and LDL-C levels were measured، using standard kits and by of Shimatzu Autanalyzer. Black grapes juice extract at higher doses decreased weight loss of diabetic rats. Moreover، this extract reduced blood glucose level and the effect was dose-dependent. The extract increased the level of cholesterol and triglyceride (TG)، but by increasing the dose، the level of TG decreased. No effects on HDL-C and LDL-C were observed. Black grapes juice extract can improve diabetes and its complications.

In order to change your lifestyle and improve disease control and responsibility، increased awareness and understanding of the importance of diabetes complications، and treatment is necessary. Target is influence of education on responsibility and metabolic control of Type One diabetic patients and parents. In this Quasi-experimental study with purposive sampling، 40 individuals of type1 diabetes and Families were invited and educated and was completed DFRQ: Diabetes Family Responsibility Questionnaire before and 3 months after training. Morning blood glucose and glycosylated hemoglobin were also two times before and after the intervention. Data Analysis with software SPSS version 16. 5 with use of statistical ANOVA، test Independent T and couples and Pearson coefficient was done. 40 persons from diabetic patients (62. 5%) Female and (37. 5%) males with mean age، 14. 25 ±6. 05 were researched. Mean Morning blood sugar، hemoglobin glycosylated and score patients and parents responsibility before and after Intervention was meaningful difference. Mean responsibility score according to patient age and job father was statistically significant but of sex patient and education was not significant. Between patients and parents responsibility score with the patient age a negative meaningful relationship was obtained. The mean reduction in glycated hemoglobin after training shows poor metabolic control of patients have an acceptable level.

Major depressive disorder is the most common psychiatric disorder having frequent relapse. One of the aspects of the pathology of depression is dysfunctional thoughts and attitudes in individuals. Cognitive - behavioral therapy (CBT) is the most widely used treatment in the active phase of the disorder; and mindfulness-based cognitive therapy (MBCT) is a new treatment in the prevention of recurrence of major depressive disorder. The present study aimed at comparing the efficacy of combined MBCT with CBT and Traditional CBT in reducing of dysfunctional attitudes of patients with Major Depressive Disorder. This clinical-experimental study was done on 90 patients randomly selected from 160 cases referring to Tehran University Consultation Centers، Shahed University and Saba Rehabilitation Clinic، all of whom met DSM-IV criteria for Major Depressive Disorder. They were divided into 3 equal groups including CBT، MBCT combined with CBT، and TAU (Treatment As Usual). The first and the second groups received psychological treatment while the third one received medications. Their age ranged between 18 and 45 years with two depression episodes and evaluated through the Structured Clinical Interview for DSM-IV (SCID) and self–report according to Beck Depression Inventory II (BDI-II)، during two pre - and post tests. The obtained data was analyzed by means of co-variance analysis. Dysfunctional attitudes scores and depression symptoms significantly decreased in combined MBCT with CBT group، while in the TAU group، there was no significant difference between pre-test and post-test. MBCT combined with CBT has similar effects to classic CBT and it can lead to reducing dysfunctional attitudes and depression symptoms.

Obesity is associated with some chronic morbidity including atherosclerosis، hypertension، and type 2 diabetes which are major components of metabolic syndrome. In the present study، association between insulin resistance and adiponectin، as an anti-inflammatory cytokine، in type 2 obese male diabetics was assessed. In this descriptive study، fasting serum adiponectin، insulin، glucose and insulin resistance were measured in 42 obese male type 2 diabetics (aged 37 - 53 years، weight 80-100kg، 30≤BMI≤36). Pearson’s correlation method was used to determine the association between adiponectin levels with insulin resistance، glucose، and insulin in the cases (P≤0. 05). Pearson’s correlation method showed a significant negative association between serum adiponectin andinsulin resistance (P=0. 000(. Besides، a significant correlation was observed between adiponectin level and fasting glucose (P=0. 005). But، no correlation was found between serum adiponectin and insulin (P=0. 196). The current study demonstrated that serum adiponectin level، as an anti-inflammation and anti-diabetic cytokine، is a predictive factor of insulin resistance in type 2 diabetics.

Applying Ilizarov fixator is an easier method compared with other methods in treating of tibial fractures. But it be used less frequently than others; yet، little information about it is available. The present study was performed to evaluate the results and complications of Ilizarov external fixator in type 3C Pilon fractures. In this retrospective study، 178 patients with type C3 pilon fractures، aged over 86 - 88 years، admitted to Poursina hospital in Rasht between 1998 and 2000 were included. Their follow-up lasted 24 months after surgery and they were then examined based on clinical and radiographic criteria and were finally evaluated on the basis of American Orthopedic Foot and Ankle Society (AOFAS) scoring criteria. The criteria (AOFAS) showed that the average score obtained was 88± 6. In 89 patients (i. e. 55،62%) the outcome was excellent، In 31 patients (20،62%) it was good، in 32 cases (21،87%) the result was moderate، and in 8 patients (5. 69%) it was weak. According to the results obtained and comparing them with the results of other treatments، one can claim that this treating approach is better than the others for pilon fractures،particularly for type 3c pilon fractures.

Consumption of plant derived antioxidant compounds contributes to reducing risks of certain chronic and degenerative diseases. The present study aimed at comparing various antioxidative activities hydroalcholic of flaver extract (DKME) and essential oil of Artemisa persica in Lorestan province in 2012. The present experimental study was carried out in Lorestan province in 2012. After supplying hydroalcholic extract and essential oil of Artemisa persica، radical scavenging activity of the samples was assessed by using diphenylpicrylhydrazyl (DPPH). Total antioxidant capacity of the samples was assessed through phosphomolybdat method. The amount of total phenol and flavonoid samples was assessed by means of Folin-Ciocalteu and Zhishen methods. The obtained data was analysed using Kruskal-Wallis test and SPSS software (V: 13) at the significant level (P<0. 05). It was found that total antioxidant capacity of hydroalcholic extract and essential oil of Artemisa persica was 25. 123±5. 18 and 1. 05±0. 55 nmol of ascorbic acid equivalent/g extract، respectively. That of essential oil and phenol content was 326. 68±10. 07 and 131. 14±3mg of gallic acid equivalent (GAE) /g extract or essential oil، respectively. Flavonoid content of quercetin equivalents/g extract and essential oil was 6. 3±0. 94 and 1. 4±0. 65 mg، in the order mentioned. In the DPPH scavenging assay، the IC50 (the concentration required to scavenge 50% of radicals) values of hydroalcholic extract of Artemisa Persica leaves، essential oil and Butylated hydroxytoluene (BHT) as reference was 165. 73±4، 16470. 67±34، and 3. 88±1μg/ml، respectively. The current study showed that Artemisa persica extract is an easily accessible source of natural antioxidants which can be suitable to be included in foods and pharmaceutical applications.