مجله علمی دانشگاه علوم پزشکی کردستان
سال دوازدهم شماره 2 (پیاپی 44، تابستان 1386)

In the last three decades, spirometry has become one of the main diagnostic tools in pulmonology. But different nomograms in different references has brought about challenges. The aim of this study was to obtain normal ranges of spirometry parameters in the people living in Kurdistan province. This was a discriptive study, and included all 15 to 64 years old people of Kurdistan province. Sampling method was random and sample size encompassed 1589 people. Weight, height and demographic data of the subjects were recorded in check lists. Then spirometry was performed under standard conditions. Data were analyzed with SPSS soft ware using descriptive statistics including frequency, mean and standard deviation. The results of this study showed that the mean value for forced vital capacity (FVC) was 3.6 liters (CI=0.96%); 4.33 Lit for men (CI=0.89%), and 3 Lit for women (CI=0.46%). The mean FEV1 values were 3.74 (CI=0.82) and 2.61(CI=0.53) for men and women respectively. According to the results of this study, it seems that the values for FEV1 are as the same as those of other references, but the values for FVC are lower. Therefore the normal ratio of FEV1/FVC increases, and should be considered while interpreting spirometry results.

Cuscuta pentagona (convolvulaceae) has been used in Iran for gastrointestinal disorders. The aim of the present study was to investigate the effect of Cuscuta pentagona fruit aqueous extract (CPE) on rat ileum contractility. Materiala and The fruit extract was prepared according to the traditional method by boiling the fruits in distilled water. Ileum was dissected from adult male Wistar rat, mounted in an organ bath (10 ml) containing Tyrode solution (37ºC, pH 7.4). Ileal contractions were recorded under 1 g initial tension, by an isotonic transducer. In many in-vitro studies, potassium chloride and acetyl cholin induced contractions of rat ileum in the absence or presence of some antagonists had been assessed. In some in vivo studies gastrointestinal transit time in different groups of rats after administration of saline, three doses of fruit extract or atropine, had been measured. Cumulative concentrations of CPE (0.5-8 mg/ml) reduced the ileal contractions induced by KCl (60 mM) and ACh (1 µM) revealing a dose dependent effect (p<0.0001). The spasmolytic effect of CPFAE was not reduced after 20-30 minutes of tissue incubation with phentolamine (1µM), propranolol (1µM) L-NAME (100 µM) and naloxone (1 µM). In a Ca2+-free Tyrode solution the ileum depolarized by KCl, 120 mM was contracted by addition of cumulative concentration of CaCl2 (0.225 to 3.6 mM) but CPE (2 and 4 mg/ml) reduced the contractions in a dose dependent manner (p<0.0001). Furthermore, fruit extract in concentrations of 250, 500 and 750 mg/kg (p.o.) reduced the transit time of charcoal meal in small intestine in a dose dependent manner. Our results suggest that the CPE spasmolytic effect is mediated via calcium channels without involvement of adrenoceptors (α and β) or opioid receptors or any influence on NO synthesis. The results of the present study showed that Cuscuta pentagona fruit aqueous extract reduces rat ileum motility in both in vivo and in vitro studies.

Induction of labour means stimulation of uterus to increase the frequency, duration and strength of contractions. There are numerous methods for induction of labour, but use of synthetic oxytocin is the most common method. In the academic hospitals, approximately 20-30 percent of labours are induced by use of oxytocin. There are two regimens for oxytocin administration i.e. low-dose and high-dose oxytocin. This study was performed to determine the effect of high-dose versus low-dose oxytocin regimens to induce labour in post-term pregnancies in primigravid women. sixty pregnant women were entered into this prospective, randomized, double blind clinical trial. The patients were assigned into two groups by randomized block sampling. Our study included primigravid pregnant women for whom the only indication for induction of labour was post-term pregnancy. Patients were randomly assigned into two groups (n=30) and received oxytocin according to either a low-dose or high-dose protocol. The required Data were extracted by observation, patient interview and also patients` records. Statistical analysis was performed by means of X² and Mann-Whitney U tests. P value of <0.05 was considered statistically significant. There was no significant difference in the mean cervical dilatation, gestational age and maternal age before induction of labour in the 2 groups. Mean durations of active phase were 249.29 minutes and 191.91 minutes in the low-dose and high-dose groups respectively) p>0.05). The mean values for hospitalization time from admission to complete dilatation of cervix were 512.47 and 449.95 minutes in the low-dose and high-dose groups correspondingly. The mean time from admission to delivery was 552.9 minutes in the low-dose group versus 512.16 minutes in the high-dose group. Lack of response to induction encountered in 20% and 33.3% of the cases of high-dose and low-dose groups accordingly (p>0.05). The most common cause of cesarean section in the two groups was unresponsiveness to induction (46.1% in low-dose and 42.7% in high dose groups). We faced 2 cases of neonatal death (6.7%) in the low-dose group. We conclude that high-dose oxytocin regimen shortens labour time. Therefore fewer cesarean sections are required and neonatal outcome will be better. Nonetheless the rate of hyperstimulation is more when high-dose oxytocin regimen is used.

Results of some of previous investigations showed that the aqueous extract of fruit of the Foeniculum vulgar (FV) has many medical effects. The aim of this study was to assess the role of Aquinus extract of fruit of FV on acute and chronic pain in formalin test in mice. In this study 42 male albino mice of 25-30 gr. weight were devided into 6 groups. FV (100, 200, 500 and 1000 mg/kg) and saline were injected intraperitoneally 30 min before formalin test. The criteria for pain assesment after injection of formalin 5% (25µl) in the right paw of the mice were the durations of licking and elavation of foot (5 min for acute pain and 15-40 min for chronic pain). The results of this study indicated that all doses of Fv have analgesic effect on pain in acute and chronic phases (p<0.05). FV can reduce acute and chronic pain after formalin injection. Further studies are required to determine the mechanism(s) of inhibitory effect of FV on pain sensation.

Although primary and secondary treatment processes when completed by disinfection can remove 85% of both BOD, SS and inactivate nearly all of the pathogenic microorganisms, few pollutants such as soluble COD, nitrogen, phosphorus, and heavy metals are not completely removed from effluent. This may be regarded as a cause of trouble when larger volumes of these effluents are discharged into a small flow or a sensitive ecosystem. The aim of this study was to determine the efficiency of electrolysis process in removal of phosphorus from the wastewater effluent of treatment plants. This was an experimental study carried out by establishing a pilot reactor in the laboratory of water and wastewater microbiology of the school of public health (TUMS). The capacity of this reactor was 20 liters. The reactor was put into operation under different conditions of influent flows, electrical potentials and pollutants concentrations. In all of these experiments, flow was continuous. All plates embedded in anode pole as a flocculating agent, revealed a 90% removal of phosphorous. The future of electrolysis process for removal of phosphorous and other similar pollutants from effluents will be promising. Application of this technology can lead to a much more perfect and economical wastewater treatment with no (or less) sludge production and a favorable environmental health condition.

Patients hospitalized in coronary care unit experience various stressful events which may lead to anxiety in the patients. Anxiety affects recovery and disease prognosis. The object of this study was to determine the effects of music and massage therapy on anxiety in the patients hospitalized in the coronary care unit of selected hospitals of Isfahan University of medical sciences. In a Quasi experimental research 90 patients were selected by simple method and were divided into 3 equal groups: back massage, music and non-intervention groups. A questionnaire was designed to register required information. All three groups were interviewed at the beginning of the research and the questionnaires were completed at the time of admission. In the massage group, massage was used for two days, each day for two times. In the music group, cassette tape was broadcast two times a day for two days. The questionnaires were completed once again at the end of the first 48 hours of admission. Statistical analysis was performed by means of SPSS software using one-way ANOVA. The results of this study showed significant statistical differences in the mean scores of anxiety after 48 hours among the three groups. Also there was a significant difference in the mean score changes of anxiety at the time of admission and after 48 hours. Music and massage therapy are effective methods for reducing anxiety of the patients in the coronary care unit.

Muscle cramp is one of the common complications of hemodialysis. Muscular contractions, called cramps, typically occurs in the lower extremities. The three most important predisposing factors are (a) hypotension, (b) low dry weight, and (c) use of low sodium dialysis solution. The aim of this study was to assess the effects of isotonic and isometric exercises on the frequency and intensity of hemodialysis induced cramps. This was a clinical trial study and included 35 patients who had experienced, at least one episode of muscle cramp during hemodialysis and at the interval between two dialysis. In a period of 2 weeks severity of pain due to muscular cramp before and after exercise was recorded. Then isometric and isotonic exercises, recommenced by a consultant physiotherapist, was planned and performed by the patients for 2 weeks. The same variables again were assessed for 2 weeks. Data were analyzed by means of paired T- test, wilcoxon and correlate bivariate Pearson using SPSS win soft ware. The severity and frequency of dialysis induced muscular cramps significantly decreased during and between 2 dialyses (p<0.001). While all the patients had experienced at least one episode of muscular cramp; after the exercise muscular cramps occurred with less severity during dialysis in 48.5% and at the interval between 2 dialyses in 16.1% of the subjects. Isotonic and isometric exercises can prevent and decrease muscular cramping pain in the dialysis patients.

Carcinoembryonic antigen (CEA) is one of the most frequently used tumor markers which is over-expressed in a variety of human cancers with epithelial origin such as colorectal, gastric, pancreatic, lung and breast cancers. The precise mechanism by which CEA is released from the cell surface into serum in cancer patients has not been clarified so far. CEA is attached to the plasma membrane by a glycophosphatidyl inositol (GPI) anchor. There have been some evidences indicating a possible role for involvement of an enzyme in CEA release from the cell surface. The GPI-anchor is a substrate for specific phospholipases. According to these information, we investigated the possible role of GPI-specific PI-PLD (GPI-PLD) in hydrolysis and CEA release. We have, therefore, used reverse transcription-polymerase chain reaction (RT-PCR) to verify GPI-PLD expression in some cell lines of colorectal adenocarcinoma. The amount of CEA released from a high CEA producing cell line in the presence or absence of specific activators/inhibitors of this enzyme was measured. Using RT-PCR, expression of GPI-PLD gene in these cell lines can be demonstrated. The amount of CEA released from high producing cell lines are increased or decreased in the presence or absence of specific activators/inhibitors. According to this study there are evidences implicating the role of GPI-PLD enzyme in releasing CEA from the surface of the cells of colorectal carcinoma.

soybean trypsin inhibitor, a single chain protein with 181 amino acids and two disulfide bonds, has special tendency for pancreatic trypsin enzyme. This protein exisits in soybean abundantly and showes high resistance to heating and chemicals. Various procedures such as combination of different chromatographic methods, immobilized metal affinity chromatography and preparative electrophoresis have been used to purify this protein.

Pulverized soybean was defatted with methanol and the reminder was extracted after being solved in dionized water. Storage proteins in solution was eliminated by use of isoelelctric precipitation method. Trypsin inhibitor riched fraction was adsorbed on an affinity column with trypsin as the ligand. After washing unbonded proteins, trypsin inhibitor was eluted from the collumn by decreasing pH. Purity and activity of the inhibitor was assessed by SDS-PAGE and an spectrophotometric method, respectively.

SDS-PAGE demonstrated a protein with a single band and molecular weight of 20 KDa with purity of more than 99 percent under reducing and non-reducing conditions. Activity of the purified inhibitor protein was 3600 TIU/mg. The results showed that overloading of the affinity collumn to gether with chromatography at pH of 6 to 8 increased the purity.

The proposed method is simple and efficient for preparation of large amounts of pure trypsin inhibitor. In addition, this method does not need any further steps such as dialysis.

Acute liver failure may be caused by fulminant viral hepatitis, drug-induced hepatic toxicity, or acute fatty liver of pregnancy. Acute fatty liver of pregnancy is a rare condition that is estimated to affect 1 in 7000 to 16000 pregnancies in the third trimester of pregnancy. The maternal mortality rate has been estimated to be 18%, and neonatal mortality rates have ranged from 7% to 58%. Early diagnosis and treatment, will improve the consequences of the disease in fetuses and mother.Case Report: A 24-year old women, gravid 1, was admitted in our hospital with term pregnancy because of labour pain, nausea, vomiting and jaundice. Diagnosis of acute fatty liver of pregnancy was made in this case on the basis of the clinical and para clinical findings. After correction of the coagulation defect with 3 units of FFP, caesarean section was performed because of lack of progression of labour and presence of meconium stain in amniotic fluid. 3 days after the operation, the patient developed ascites and bilateral pleural effusion. Intensive care and supportive measures after caesarean section led to improved hepatic function. We recommend evaluation of liver and kidney function tests and a complete blood count in all patients with nausea, persistent vomiting, or epigastric pain in the third trimester of pregnancy to rule out the diagnosis of acute fatty liver of pregnancy.

Although BCG vaccination has many benefits, it can cause multiple complications. Disseminated TB is the most severe but rare complication of BCG vaccination. Osteomyelitis is another important complication. Usually these complications are due to a defect in immune system. Rapid diagnosis and treatment can be life saving. The first case was a 3 month old boy that was admitted in hospital because of fever, lethargy and fistula in the right axillary area at the site of BCG vaccination. The second one was a 7 month old boy with an ulcer and a fistula at the site of BCG vaccination and chest wall. Diagnosis of disseminated TB was made by biopsy and culture. All immunologic investigations, except interleukin 12-gamma interferon pathway, were normal. When a child presents with lymphadenopathy and ulcer near the site of BCG vaccination, the physician must perform a complete physical examination to exclude diagnosis of disseminated TB, especially in the presence of long term low grade fever, organomegally, skin lesions and lack of weight gain.