مجله علمی پزشکی جندی شاپور
سال هشتم شماره 3 (پیاپی 62، پاییز 1388)

Motor learning in elderly is critical for their rehabilitation and exercise therapy. The aim of this research was to evaluate the role of explicit knowledge on accuracy and speed of learning of motor sequence in older adults.Subjects and In this interventional study, we compared motor learning performance in two elderly groups in explicit condition (N=15) and implicit condition (N=15). ANOVA repetitive measure was used for comparing response times and errors in different blocks and paired t-test was used for comparing regular and irregular blocks and independent t- test was used for comparing implicit and explicit conditions. The results showed that decrease in both explicit and implicit group and error decreased in both explicit and implicit group. Decrease of serial reaction time in implicit group is better than explicit group. Both implicit and explicit learning can be used for sequence learning in elderly but implicit condition is better than explicit condition.

Due to high young-age population in Iran, sexually transmitted diseases (STD) are a major public health in the country. The aim of this study was to descript and determine the risk factors of gonococcal and Chlamydia urethritis, supposed to be the most common STD in Ahvaz.Subjects and

This descriptive study conducted from 2005 to 2007 in Ahvaz, 44 male patients with urethritis and 110 controls were studied. Diagnosis was based on history, genital examination and urethral culture for Neisseria gonorrhae and PCR for C. trachomatis. Cases and controls were also tested for HIV infection (Elisa, Western blot) Extracted data from questionnaires and interview including demographics, sexual behavior, addiction and STD related variables in studied individuals were analyzed in SPSS 11.5 software using chi-square, exact Fisher tests and odds ratio with 95% confidence interval.

Of total 44 patients, gonococcal urethritis was detected in 16 (36.5%) and Chlamydia in 28 (63.7%). Mean age of the patients was 28.2 ± 9.4 years with the range of 18-47 years. Sale in boutique was associated with increased risk of urethritis (P<0.01). There was extramarital contact history among all of married patients. Twelve patients (27.2%) were Afghanis. Homosexuality among men (MSM) was observed in 25 % of patients mostly among Afghans (P<0.02). Extramarital contact, MSM, HIV seropositivity, injecting drug use (IDU), unmarried, low frequency of condom use, ethics and religious regardless of cases was significantly higher than controls (P<0.05).

In men, Chlamydial urethritis is more prevalent than gonococcal urethritis. Homosexuality, IDU, unmarried, working in a boutique and low frequency of condom use are the main risk factors among our patients.

Diabetes mellitus is a chronic metabolic disease which has many somatic complications for the patients. One of these complications is xerostomia. According to controversy about amount of saliva in diabetic patients the aim of this study was to compare the amount of un-stimulated saliva in parotid, submandibular and sublingual between type II controlled diabetic patients with healthy subjects. Subjects and In this case-control study, 75 type II diabetic patients and 75 healthy subjects were randomly recruited. The age range of both groups was 30 to 65 years. Salivary tests were done between 9–11 a.m. The selected subjects had no past medical history (apart from diabetes in case group), no previous use of medications and no history of depression as confirmed by hospital anxiety and depression test were selected. After isolation and drying of ducts by hydrophilic papers, we measured the quantity of saliva during 30 seconds at first for parotid glands and the submandibular and sublingual gland on both sides. Data were analyzed by t-test. The amount of unstimulated saliva of parotid and both submandibular and sub lingual salivary glands in diabetic patients was 0.019 and 0.025 ml/min respectively. The amount of unstimulated saliva of parotid and both submandibular and sublingual salivary glands in healthy subjects was 0.02 and 0.029 ml/min respectively. There was not significant differences between amounts of unstimulated saliva in parotid salivary glands and submandibular and sublingual in two groups. (P = 0.217 and P = 0.069 respectively). This research showed that amount of un-stimulated saliva was same in controlled diabetic patients and healthy subjects.

Sub-clinical hypothyroidism (elevated serum level of TSH with normal level of thyroid hormones) is common in adults, especially in women. Mild increasing level of TSH causes dyslipidemia and sub-clinical hypothyroidism may be associated with increased cardiovascular risk. Our study was designed to Assess the effect of early treatment with L-thyroxin on level of serum lipid in sub-clinical hypothyroidism patients.Subjects and In this study 40 sub-clinical hypothyroidism women patients referred to Endocrine Clinic of Golestan hospital of Ahvaz University of Medical Sciences (from 2005-2007) were evaluated. Hormon thrapy were introduced for each patient with 50-100 mg/daily of levothyroxine and adjusted with serum TSH level (TSH goal: 0.5-2.5 mIU/ml). The mean age of patients was (28.8 ± 10.8 years). The mean level of Tg was (141 ± 79.8 mg/dl) before treatment and decreased to (108 ± 75.8 mg/dl) 6 months after treatment (P = 0.006). Serum cholesterol level also significantly decreased after 3 and 6 months of treatment. It was 195.4 ± 41.1 mg/dl at baseline, 182.7 ± 39.9 mg/dl after 3 months and 172.8 ±48.8 mg/dl after 6 months of treatment (P=0.003, P=0.001, respectively). The mean serum level of LDL before treatment was 112.4 ± 38.5 mg/dl that showed significant decrease after 6 months of treatment 95.8 ± 41.8 mg/dl (P=0.026). The mean level of VLDL before treatment was 28.5 ± 15.09 mg/dl and 6 months after treatment decreased to 22.2 ± 15.9 mg/dl (P=0.009). There was no significant change, in HDL levels before and after 3 and 6 months of treatment (P>0.05).There was no significant relationship between age and TSH level and response to treatment (P>0.05). The patients who had higher level of Anti-TPO Ab showed significant decrease in serum level of Tg after treatment (P=0.04). Patients with positive titer of Anti-Tg Ab had significant decrease in serum level of LDL after 6 months of treatment (P=0.001). Positive CRP level was detected only in one patient. There were no significant changes in CRP after 3 and 6 months of treatment (P=0.32). Our results show that, treatment of subclinical hypothyroidism patients at any age and with any level of TSH causes decrease in cardiovascular risk factors, especially in patients with higher titer of Anti-TPO Ab and positive Anti-Tg Ab.

Thalassemia is a genetic disorder with autosomal recessive inheritance and due to defect in hemoglobin chain synthesis. Although living in these patients is dependent to blood transfusion, but this can produce iron overload in organs and damage to endocrine glands as pituitary and thyroid. Therefore, primary hypothyroidism is a common complication in thalassemic patients. The aim of this study was the determination of the prevalence of hypothyroidism and the consequent complications in relation to serum ferritin among patients with - thalassemia major in Shafa hospital.Subjects and Two hundred and thirty patients who received regular blood transfusions were included in this study. Data was recorded via a questionnaire. Evaluation of thyroid function was monitored by checking of TSH (thyroid stimulating hormone) and T4 (thyroxin). In patients with abnormality in thyroid function tests (TFT), SMR (sexual maturity rating) evaluation, serum ferritin, and echocardiography for ejection fraction (EF), chest x-ray, RT wrist x-ray for bone age, were checked. Then the results were compared with control group (similar in sex and age from euthyroid thalassemic patients). Sixteen patients were excluded from study. From a total 214 patients there were 53.5 % male. Age in 17.5 % was less than 8 years, 22% were between 8-14, 42 % were between 14-20, and in 18.5% was more than 20 years with median 15.6 ± 4.2. Eleven patients suffered from hypothyroidism (5.1 %) among whom 5 patients had overt hypothyroidism (elevated TSH and decreased T4) and in 6 patients had subclinical hypothyroidism (elevated TSH with normal T4). Comparison of Tanner score, height, weight percentiles, bone age in patient and control group revealed that growth retardation and poor sexual maturation is related to many factor rather than hypothyroidism. EF in 72.5% of patients was less than 60 % that in comparison with control group (P=0.20) revealed hypothyroidism can produce some negative effects on cardiac muscle and can augment toxic effect of iron overload in myocardium alone. In both groups serum ferritin was more than 2000 ng/ml with median 5100 ± 1800 versus 5700 ± 1450 (P=0.676) in meaning of there is no correlation between serum ferritin and hypothyroidism. In all patients Anti TPO was negative and all hypothyroidisms were primary. Early detection and treatment of hypothyroidism in thalassemic patient reduces cardiac dysfunction and can improve quality of life in these patients.

To find out appropriate method for improving physical and motion factors has been considered as a major aim of sport experts and physiotherapists. Power and strength can be considered as important parameters in physical fitness. In recent years, various tactics and programs have been used by experts and trainers to improve the given parameters. Weight and plyometric training are significantly included in such programs. This research explores the effects of two-way training on biceps and rectos femoris with regard to surface electromyography. Subject and Participants in this research consists of 45 male students aged from 22.5 to 25.6 years old (15 in plyometric group, 15 in weight training group and 15 in control group). The subjects were selected among male students in physical education faculty. Before and after 6 weeks of weight and plyometric training the EMG flactuation of muscles was measured via surface electromyography. Vertical jump test and squat test were used to evaluate power and strength respectively. The MT8 system and MBM software were also used to collect and analyze the EMG data. The results made in this research show the significant increase in the experimental group for IEMG, compared with the control group(P<0.05). No meaningful difference came to exist between weight and plyometric training groups for power in rectus femoris muscle (P<0.05). The results show that weight training can be used to increase power and strength. While plyometric training causes more increase muscular power. These two practical styles are useful in increasing muscular the power.

Fracture of anterior teeth by trauma is a common problem in children and teenagers. Complex metal-ceramic crowns with considerable loss of remaining sound structure are no longer necessary due to adhesive technique, such as reattachment technique. The aim of this study was to compare the fracture strength of sound teeth with teeth that reattached with two different materials. Twenty four sound central incisor teeth were fractured by an axial load applied to the buccal area and were randomly divided in two groups. The third group was used as control and comprised 12 sound teeth. The teeth were restored as following: 1- reattached with dual cure cement, 2- reattached with flowable composite and 3- include sound teeth all groups were subjected to the same loading in the lingual area. Data analysis was performed using ANOVA and Tukey tests. average rate for first group was 548.17 N, in second group was 498.75 N, and in third group was 858.25 N. Results suggest that average of first group with control group (p.value=0.029) and second group with control group (p.value=0.010) had significant differences, but average of group 1 with group 2 had no significant difference (p.value=0.904). According to the results of this study, material combination used to reattach the fragment dose not play an important role in the fracture strength of reattached teeth. Thus, it is recommended that other methods of fragment reattachment to the tooth to be evaluated.

Heat shock protein 70 (hsp70) is a chaperone that binds to mutant P53 and consequently could regulate its accumulation or localization. Nuclear accumulation of P53 protein is associated with a poorer clinical outcome in breast cancer patients. The aims of this study were to determine whether hsp70 was associated with nuclear accumulation of P53 and is there any relationship between hsp70 expression and P53 with clinicopathological factors of breast cancer.Subjects and Breast tumors of patients (n=47) were sent to Shafa pathology lab in province of Khouzestan/Iran were examined by immunohistochemistry for nuclear P53 and cytoplasmic or nuclear hsp70. The paraffin sections were stained with the P53 antibody (N1581, Dako) and the hsp70 antibody (ab47454, abcam). Hsp70 and P53 were scored statistically according to the nuclear and/or cytoplasmic content and the nuclear content respectively. There was no significant association between nuclear or cytoplasmic hsp70 staining and accumulation of P53. No significance association was found between nuclear hsp70 or P53 expression and clinicopathological factors of breast tumors. There was a correlation (P<0.001) between nuclear and cytoplasmic hsp70 expression. The cytoplasmic expression of hsp70 was moderately significant in relation to histological grade of breast tumors (P=0.049). In human breast cancer, nuclear accumulation of P53 was not associated with nuclear or cytoplasmic hsp70 levels, but cytoplasmic hsp70 level is correlated with nuclear hsp70 level and is related with histological grade of breast tumors.

Creatine kinase catalyzes the reversible transfer of a phosphoryl group from ATP to creatine, producing phosphocreatine (phosphagen). Phospho creatine as an energy source has an important role for sperm motility. Therefore, proper function of creatine kinase is the main factor of energy preparation for sperm movement. The aim of this study was to study the optimum in vitro creatine kinase enzyme kinetic after its isolation from human sperm.Subjects and Creatine kinase was extracted from approximately 30 ml human semen related to 10 health men with age average 30 ± 5 years, after washing, centrifuge and chromatography of sperms on DEAE-32 column. In each step of purification, protein levels and enzyme activity were assayed according to Bradford and Rosalki methods, respectively. Results this study showed that human sperm creatinine kinase activity increased by 67% with increase of the creatine phosphate concentration from 0.5 to 10 mM. Moreover pH change from 6 to 6.8 also showed an increase in the activity of this enzyme. Ceatine kinase activity increased in the temreure range of 20 to 40 °C. Our results showed that the most suitable substrate concentration, temperature and pH for optimum activity of human sperm creatine kinase were at 3 mM, 40°C and 6.8 respectively.

Continuous medical education is not old in Iran. Therefore careful evaluation of this program is necessary. The aim of this study was evaluation of general dentist's opinions about continuous dental education programs in Ahvaz. Subjects and This descriptive study was performed on 100 general dentists in 2007. The method of data collection was questionnaires, containing 42 questions about programs of continuous dental education based on Likert Scale (5 degrees). The data were analyzed by SPSS-15 software and t-test (P<0.05). The dentists had average 12.6 ±77 years of service and 79.8 % of them were men and 20.2 % women. Two thirds of the dentists believed that continuous dental education is necessary. The mean of dentist's opinion in related to the method of conduction and to the continent of programs were 3.01±0.99 and 2.94±0.95 respectively. Three important priorities of continuous dental education were in the order of restorative dentistry, endodontics and oral surgery. The use of specialists and planning of the programs according to regional needs are effective for improvement program's quality with an average 4.17± 0.89 and 4.08± 0.75 respectively. There was no significant statistical difference between gender and their years of services. Dentists, a necessity for continuing education professionals know how the implementation and content of the programs are not much satisfaction. Planning based on regional needs and the uses of experienced teachers improve the quality of the programs and will improve existing continuous education programs.

In some cases in dentistry, despite an injection of local anesthetic material, the teeth with irreversible pulpitis do not become numb, or the use of common local anesthetic material is contraindicated for the patient. Therefore, in these cases an alternative treatment, especially hypodontia, the use of hypnosis in dentistry, can be introduced. The aim of this study was to determine the success rate of hypnotism in producing anesthesia in root canal therapy.Subjects and This study was conducted as a clinical trial on 21 male and female volunteer patients, who referred to the department of endodontics of Mashhad Dental School for endodontic treatment of vital teeth with irreversible pulpitis. Examination forms were completed for all the patients. The patients were excluded from the study if they had any other concurrent diseases. Then, if the patient were satisfied with participation in this study, the consent forms were signed. In the presence of the patient's companion, the patient underwent hypnosis and the necessary time to reach suitable numbness was recorded. Next, the patients were conditioned to a key phrase. In the second session, with the use of a key conditioning word, hypnosis was induced more rapidly and the time to reach numbness was again recorded. The numbness was checked and confirmed by a specialist in endodontic unaware of type of intervention. When the appropriate level of numbness was present, the patient underwent endodontic treatment. The results were analyzed by Mann Whitney U, Fisher's Exact and Wilcoxon Sign Rank tests. The results showed that 16 patients (76.2%) reached suitable deep numbness while 5 patients (23.8%) did not reveal a suitable response. The time in which hypnotism was induced in the second session of treatment (3.8 minutes) was less than the first session (23.09 minutes). There was no significant difference between male and females in giving a positive feedback to hypnotism. Hypnosis was successful in inducing numbness for root canal therapy of teeth in 76.2% of the cases, therefore, it can be useful in patients with irreversible pulpitis in whom local anesthesia is not effective.

Physical and mental health has been found to be affected by occupational factors. Also coping strategies were important in the stress process. This study was aimed to evaluate the relationship of job satisfaction and coping mechanism with general health of personnel in a private petrochemistry factory in Mahshahr, Iran.Subjects and After receiving consenting from the subjects of the study, a questionnaire package (coping skills check list, GHQ-28, job satisfaction) was completed. Out of 83 participants, 77 completed the questionnaires. Analysis of the data was carried out using SPSS version 15, and R Spearman, Pearson tests and regression analysis model were used. The total score of GHQ-28 in 28.57% of the subjects’ health was low and had low job satisfaction (P<0.001) and did not employ coping mechanism in their daily routine activities (P=0.018). While the personnel who had more job satisfaction, had higher mental health (P<0.001) and their coping mechanism was more logical (P<0.016). The results of this study suggests that educational planning aimed at increasing coping skills in industrial settings can be useful in improving job satisfaction as well as general health of these workers.

Snake venoms are complex mixtures containing many different biologically active proteins and peptides. Vipera lebetina is one of the most poisonous snakes in Iran. The aim of the present study was to test the existence of phospholipaseA2 activity in the crude venom of the snake. One hundred mg of the crude venom of Vipera lebetina was resolved into five fractions using gel filtration chromatography on sephadex G-100, equilibrated with 20mM ammonium acetate buffer pH 6.8. Protein concentration of crude venom and fractions was assayed by Bovin serum albumin as a standard. Phospholipase A2 (PLA2) activity was determined using suspension of egg yolk as substrate. The preliminary results showed that the 89% of lyophilized venom was protein. Crude venom produced five fractions. These fractions were labeled as peak I to peak V (PI-P V), in order of their elution. Specific activity in crude venom, peak I, peak II and peak III were 2.25, 0.078, 2.76 and 1.04 U/mg. High PLA2 activity was detected in crude venom, which was more prominent in peak II and was not considerable in peak I of the fractions.

Children with congenital heart disease (CHD) suffer from failure to thrive (FTT) after delivery and severe growth retardation in these patients may lead to FTT continuity even after corrective surgery. Therefore, early detection of FTT and early and appropriate intervention can produce improvement of these conditions. In this study we evaluated FTT and its patterns in children with CHD.Subjects and Two hundred and fifty children with CHD, who were admitted in Ahvaz Golestan hospital and were visited Mehr hospital for echocardiography out-patiently, were enrolled in our retrospective-descriptive study during 2007. Patients were divided into six age groups and evaluated for weight and stature. Data were analyzed by SPSS software and Pearson, Chi Square, Phi and Cramer testsnwere used. Weight loss was more common among our patients, which was seen more frequently among girls than in boys. Weight loss and short stature were more common in patients with acyanotic diseases (the most common) with pulmonary hypertension (PHTN), while weight loss and short stature were more common in patients with cyanotic diseases without PHTN. The majority of patients belonged to 1-5 month age group and in 6-11 month age group we had the majority of FTT forms. FTT was more common in patients who suffer from CHD with PHTN which was statistically significant (P<0.05). Large ventricular septal defect and patent ductus arteriosus were the first two diseases. While in other studies large ventricular septal defect and tetralogy of Fallot were the most common. The results suggest that early surgical intervention and nutritional support among the 6-12 month age group can be fruitful in prevention of these complications.

Refractory seizure is a rare manifestation of INH poisoning. We report a case INH poisoning with refractory seizure. A 17-year old male referred to our emergency room with seizure. Antiepileptic treatment with diazepam was ordered and repeated doses were prescribed. His family reported that he ingested 4.5 gram INH about 2 hours ago. He was admitted to ICU. Despite frequent doses of diazepam, he went into status epilepticus. Pridoxine was administered intravenously 200 mg/qid for 3 days Status epilepticus was terminated after pyridoxine administeration. He was discharged from hospital after 4 days without any neurological sequel. We reported here a case of INH poisoning with refractory seizure. In this setting pyridoxine helped to terminate status epilepticus.