مجله دانشگاه علوم پزشکی بابل
سال شانزدهم شماره 5 (پیاپی 80، اردیبهشت 1393)

Opioids are routinely omitted at the induction of general anesthesia for cesarean delivery because of concerns about neonatal respiratory depression. The subsequent unmodified maternal stress response to tracheal intubation reduces placental perfusion and a short-acting opioid may afford advantages at the induction, without subsequent neonatal depression. The aim of the present study was to assess sufentanil effects administered before the induction of anesthesia for cesarean delivery on the mother's hemodynamic and neonate's Apgar. In this double blind clinical trial study, cesarean delivery cases were divided into 2 groups (50 in each group). The case group received sufentanil 0.15? g/kg at the induction of anesthesia with thiopental 4 mg/kg and succinylcholine 2 mg/kg but the control group with the same induction method did not receive sufentanil. Systolic and diastolic blood pressure, heart rate of mothers and first and fifth minute Apgar scores of neonates were assessed. Systolic and diastolic blood pressure and heart rate before induction of anesthesia had not significant difference. But after induction of anesthesia blood pressure and heart rate in control group raised more than case group significantly (p=0.001). First and fifth minute Apgar scores of neonates had not significant difference. Heart rate average in laryngoscopy and intubation time was 116.96± 9.48 that had significant difference with case group average 99.96±12.78 (p=0.001). The results showed the significant effects of sufentanil at the induction of general anesthesia for cesarean delivery on stress controlling without significant effects on neonates Apgar. So sufentanil using is helpful in hypertensive pregnant cases or pre-eclampsia.

Microleakage is one of the major problems of composite restorations. Most of clinical failure was caused by inadequate marginal seal. The aim of this study was to compare the microleakage of one-step self-etch adhesive with two-step total etch adhesive. In this in-vitro study, class V cavity was prepared in the buccal side of thirty human molars with occlusal margin in enamel and gingival margin in dentin (2mm width, 5mm length and 2mm depth). All cavities were divided into two groups (n=15): 1. Restorations bonded with total etch adhesive (Adper Single Bond 2); 2. Restorations bonded with self-etch adhesive (S3 Clearfil Bond). After thermocycling and dye penetration with silver nitrate 50% wt, teeth divided in two mesiodistally halves. Amount of dye penetration was measured by stereomicroscope and data were recorded. Adper single bond 2 showed lower microleakage in enamel margin (15 microleakage-free samples versus 14). The difference was not statistically significant. S3 Clearfil Bond showed lower microleakage in dentinal margin (12 microleakage-free samples versus 10) but this difference was not statistically significant. There were not statistically differences between enamel and dentinal marginal microleakage in both groups. Based on results of this study, investigated total etch and self-etch adhesives have similar marginal seal. Self-etch dentin bonding because of fewer working steps and easiness in using, can be a good substitute for total etch adhesive with more complicate usage.

Lumbar canal stenosis due to degenerative process can cause low back pain, neurogenic claudication, significant neurologic deficit and disability. Although efficacy of laminectomy and laminectomy with fusion has been established in management of patients with lumbar canal stenosis, but which method is more efficacious in patients with 2 or more levels lumbar canal stenosis has not been clearly defined. The aim of this study was to compare surgical results of laminectomy and laminectomy with fusion in patients with 2 levels or more lumbar canal stenosis. This cross sectional study evaluated 70 patients who underwent surgery for lumbar canal stenosis at two or more levels during 2009-2011. Based on surgical modality patients were divided into two groups: laminectomy group and laminectomy with fusion. Surgery was performed by two surgeons. Clinical outcome of patients was assessed by visual analogue scale. Lumbar lordotic angle was compared before and after surgery. Surgical complications such as intraoperative bleeding, wound infection, CSF leak, pneumonia, urinary tract infection were compared between two groups as well. Follow up period was 14 months (8-27 months). Seventy patients (41 males and 29 females) with the mean age of 54±12.3 years underwent surgery. Thirty nine patients were allocated to laminectomy group and 31 patients allocated to laminectomy with fusion. Visual Analogue scale (VAS) was 6±1.5 in laminectomy group and in laminectomy with fusion group was 7±1.2 that respectively reached to 2±0.8 and 2.2±0.9 after surgery (laminectomy? p=0.043, fusion? p=0.036). Lumbar lordotic angle in laminectomy with fusion group was 32±14 and reached to 38±10 that was improved meaningfully (p=0.014). Surgical complications such as intraoperative bleeding 130±40 ml (p=0.03), wound infection in 2 cases (p=0.011), CSF leak in 1 case (p=0.031), pneumonia in 1 case (p=0.026), urinary tract infection in 1 case (p=0.033) were meaningfully lower in laminectomy alone group. The results of this study revealed that laminectomy alone and laminectomy with fusion were equally effective on clinical outcome of patients with lumbar canal stenosis at 2 or more levels, but laminectomy with fusion was more effective in correction of lumbar lordotic angle.

Several species of the genus Euphorbia (Euphorbiaceae) have been tested for their efficiency as anti-viral and anti-tumor agents. Herpes Simplex Viruses (HSV) are pathogenic to human. Antiviral drugs are mostly weak or are associated with side effects. Medicinal plant products have been used as folk remedies for different kinds of ailments including viral diseases. The objective of this study was to compare the phytochemical study and anti-viral effect evaluation of methanolic extract with fractions of aerial parts of euphorbia spinidens. In this experimental and laboratory research the methanolic extract of aerial parts of E. spinidens with maceration method was subjected to solvent partitioning and afforded chloroform, butanol and hexane fractions.? -carotene-linoleate model system, folin-Ciocalteu method and aluminum chloride colorimetric method, respectively, were employed for evaluation of antioxidant activity, total phenolic, flavonoid and flavonol contents of the extract and fractions of this plant. The cytotoxic and anti-viral effects of methanolic extract and fractions were determined using MTS assay and the CC50) 50% cytotoxic concentration(and EC50 (50% effectiveness concentration) were evaluated on Herpes Simplex Virus Type-1. The highest antioxidant activity and phenolic and flavonoid and contents were in buthanol fraction (59.33±0.576, 99±1, 70±1), methanolic extract (44±1, 70±1, 49.96±0.996), chloroform fraction (33.33±0.996, 35.33±0.577, 25.33±0.996) and hexane fraction (19.66±1.146, 27±1, 9.33±1.628) respectively. The highest CC50 was in hexan fraction with 9.92± 0.072 mg/ml and the lowest CC50 was in methanolic extract with 5.072±0.063 mg/ml. Also, the highest anti viral activity revealed in the butanol fraction (SI: 28.125), methanolic extract (SI: 15.85), chloroform fraction (SI: 8.44) and hexane fraction (SI: 2.07), respectively. Based on the results, methanolic extract and buthanol, chloroform and hexane fractions of E. spinidens show anti HSV-1 activity. Antiviral effect observed can be attributed the presence of various secondary metabolites, particularly polyphenols, flavonoids, terpenes and saponins.

Medicinal herb of Silybum Marianum usually grows in different parts of Iran. For many years it is experimentally used for treatment of various diseases, such as heal wounds, however, little research has been done on it. The purpose of this study was to investigate the effect of hydralcoholic extract of Silybum Marianum on cutaneous wound healing. This study was performed on 36 rats weighting 200-220g that were divided into 6 groups. All parts of the plant were collected and dried. Hydralcoholic extract of Silybum Marianum was prepared by maceration method. Full thickness wound (2x2) in left flank of the animals was made. The first group was left without treatment, the second was treated with Eucerin, in third group phenytoin cream 1% was used and in the other groups, different concentrations of hydroalcoholic extract of Silybum marianum (20%, 40%, 60% w/w) combined with Eucerin base were administrated 2 times daily. The areas of wounds were measured daily and healing percentage during all the days was compared. For histopathological studies, some biopsies were taken on the 7th and 21st day. In no treatment and Eucerin groups, the healing was completed in 21 days. In Phenytoin %1group, the healing time was 19days and in Silybummarianum groups of 20%, 40% and 60% the complete wound closure was observed in 18, 16 and 14 days respectively. Statistically all the treated groups and the control group had significant difference with negative control and control group (p<0.05). In histological study the group treated with hydralcoholic extract of Silybum Marianum, symptoms and improvement of skin tissues were more perfect. Results showed that the extract of Silybum Marianum significantly causes increasing in open wound healing.

Scrophularia Striata has been used to treat inflammation, ear and eye infection, skin burn and infectious wounds. This study investigated the effects of hydro-alcoholic extract of Scrophularia striata on second-degree burn. In this experimental study, 21 male Wistar rats (250-300 g) were selected. Then animals randomly divided into control and 3 treatment groups which received olive oil as vehicle or Scrophularia extract with the doses of 2.5 and 5 percent for 21 days. The perimeter and area of the wounds were measured exactly every three days. Finally, tissues samples were collected from burned area for further histological study. Comparison of wound area showed in 5% dose on 6th day (1447.77±41.73), 15th day (885.74±159.35), 18th day (556.52±122.44) (p<0.05) and 21st day (293.12±58.06) (p<0.001) and in 2.5% on 18th day (664.66±123.35), 21st day (398.94±56.00) (p<0.05) significantly different from the control group on 18th (891.98±73.52), on 21st (538.13±55.70) and olive oil group on18th (756.93±96.31) and 21st day (480.69±43.34). Comparison of wound environments showed in 5% dose on 18th day (105.24±13.14) (p<0.01), 21st day (75.06±8.61) (p<0.05) significantly different from the control group on18th day (136.65±4.62), 21st day (104.47±4.86) and olive oil group on 18th day(122.07±12.73), on 21st day (100.76±11.04). Histological study showed ulcer granulation tissue, blood vessels, exudate and collagen significantly increased in both 2.5% and 5% groups. Muscle involvement was significantly decreased in 5% group. The results showed that hydro-alcoholic extract of Scrophularia Striata are effective for burn healing and dose of 5% more effective than 2.5%.

Methamphetamine is a stimulant substance which its main component is amphetamine (C9H13N). In Iran, methamphetamine is known as Shisheh. The aim of this study was to investigate the effects of methamphetamine (Iranian Shisheh) on serum levels of ACTH (adrenocorticotropic hormone), cortisol and aldosterone in male rats. In this laboratory experimental study, 20 male Wistar rats were randomly divided to control, saline receiving and 2, 4 and 6 mg/kg/body weight of Shisheh receiving groups of 5 rats in each group. The injection was carried out intraperitoneally once a week for 6 weeks. After serum collection, ACTH, cortisol and aldosterone levels were measured using ELISA method. Serum ACTH level was not significantly different in saline receiving (1.85±0.22) compared to control group (1.23±0.22); however, significantly increased in groups receiving 2mg/kg (2.55±0.17) (p=0.003), and 4 mg/kg (2.63±0.22) (p=0.002) of Shisheh compared to control group. Serum ACTH level was higher in the group receiving 6mg/kg (3.83±0.55) (p<0.0005) than 2 or 4 mg/kg of Shisheh receiving groups. Serum cortisol level was not significantly different in saline receiving (0.32±0.06) (p=0.385) compared to control group (0.58±0.14); however, significantly increased in groups receiving 2mg/kg (6.35±0.25) (p<0.0005), and 4 mg/kg (6.42±0.29) (p<0.0005) and 6 mg/kg of Shisheh (6.81±0.23) (p<0.0005) compared to control group. Serum aldosterone level was not significantly different in saline receiving (1492±18.9) compared to control group (1396.6±16.3); however, significantly increased in groups receiving 2mg/kg (1726±38.3) (p<0.0005), and 4 mg/kg (1749.6±81.4) (p<0.0005) and 6 mg/kg of Shisheh (1785.3±56.2) (p<0.0005) compared to control group. The results indicated that Shisheh injection can enhance adrenal gland activity in turn might followed by considerable clinical complications.

Light and sound are potential sources of harm in neonate. Excessive light has been theorized to cause retinal damage, sleep pattern disturbance, disturbance of circadian rhythms, and poor growth. Physiologic responses to excessive sound demonstrated as fluctuations in heart rate, blood pressure, respiratory rate, and oxygen saturation. The aim of the present study was to investigate nursing care conformity rate with existing standards, regarding to light and sound in NICU. In this cross sectional study, 312 nursing care regarding light and sound were observed and assessed in Amirkola Children and Ayatollah Roohani hospitals of Babol, Iran. Data was gathered by the checklist (14 items) that was designed according to existing standards included standard care regarding light and sound. Total score of nursing care regard to light and sound considerations was 54.17%. The most conformity rate with standards was in “no writing and tapping on incubators” item (93.3%). The lowest conformity rate was in “applying daily silence periods” item (12.5%). The results showed that over 50% of nursing care regard to light and sound was considered in NICU, so informing health providers, physical standards and providing facilities and equipment are recommended.

Mesiodens are supernumerary tooth between the two central incisors. Mesiodens are usually responsible for eruption disturbances, midline diastema, crowding and finally root resorption of adjacent teeth. The aim of the present study was to know the prevalence and the radiographic characteristics of mesiodens and their complications in children of Babol city, Iran. This cross-sectional study was based on radiographic survey of 2000 children who visited the department of pediatric of Babol dental school and pediatric clinics. Radiographic characteristic of mesiodens including the number, shape, position, direction of crown and complication caused by mesiodens were recorded. It was found that among the total screened children 1% (20 cases) had mesiodens. Among 20 children, sixteen had one mesiodens, three had two mesiodens and one had three mesiodens, 50 % (10 cases) had conical shape and 15 % (3 cases) were erupted. The most common complication caused by the mesiodens was midline diastema. Despite the low prevalence in this population, approximately 90% mesiodens has been associated with dental problems therefore early diagnosis and treatment is recommended.

Nowadays mobile phone is one of the most essential tools in social and professional life of individuals. The patients, visitors and staff of health care and physicians in hospitals are also the users of mobile phones. This can make mobile phones a reservoir for transmission of pathogens and nosocomial infections. The aim of this study was to investigate the bacteria on cell phones of physicians and staff of health-care in teaching hospitals of Babol University of Medical Science hospitals, Babol, Iran. In this cross-sectional study, 192 cell phones of health care staffs and other non-clinical employees of Babol University of Medical Science hospitals were randomly chosen and sampled using sterilized cotton swabs. After placing the samples into the transferring mediums, they were fast transferred to the laboratory of Amirkola hospital. Then they were cultured on blood agar and McConkey medium. They were incubated at 37?C of temperature for 24 hours. Microorganisms were isolated by appropriate biochemical tests and the bacteria positive and negative cases were compared for different variables by logistic regression model. Of all 192 studied cases, 130 (67.7%) were positive for bacterial infection that 9 cases were infected with more than one bacterium. The most frequent isolated bacteria were Bacillus subtilis (45 cases, 23.6%) and Staphylococcus epidermises (25 cases, 13.1%) respectively. Of 62 samples that had not bacterial infections, 16 (8.4%) samples were completely negative and 46 samples contaminated with yeast. In comparison among sex, type of activity, hospitals and prevalence of bacterial contamination of cell phone, there was a significant difference between the level of education and prevalence of bacterial contamination of cell phone. There was the lowest rate of cell phone contamination in medical students and residents. According to results of this study, the mobile phones have significant microbial contamination. It seems that the increase in educational level can reduce the rate of contamination of cell phone.