مجله علمی دانشگاه علوم پزشکی کردستان
سال پانزدهم شماره 2 (پیاپی 56، تابستان 1389)

Rotaviruses are associated with endemic diarrhea in children under the age of 5, leading to approximately 800,000 deaths every year. Introduction of rotavirus vaccines into childhood immunization programs can contribute to substantial reduction in mortality from rotavirus gastroenteritis in developing countries. VP4 is outer capsid spike protein of rotavirus by which virus can bind to its receptor. VP4 protein can induce production of neutralizing antibodies. Regarding these concepts we cloned VP4 gene of rotavirus in plasmid vector for future expression. BSC-1 cells were cultured as a monolayer. Rotavirus CPE positive cell cultures were freeze-thawed three times. Rotavirus was partially purified by ultracentrifuge. Oligonucleotide primers, specific for gene segment 4 which encodes VP4, were synthesized. Rotavirus RNA extracted and used as a template for synthesis of cDNA by reverse transcriptase. Then they proliferated by PCR and PCR products were cloned into plasmid vector which was analyzed by restriction enzymes and sequencing. Sequencing result was analyzed with BLAST software that had a 100% homology with SA11 rotavirus genome segment 4 in NCBI GeneBank. Sequencing result confirms highly that the nucleotide sequences of VP4 gene after long and continuous passage of SA11 rotavirus is conserved in our laboratory.

Ergonomic factors in sleep designing system will have direct effects on maintaining the spinal alignment during sleep. Studies show that a mattress with uniform stiffness cannot preserve the spine's natural posture. Using a mattress made of components with different stiffness can be considered as a solution for this problem. In this study, male spinal alignment has been assessed and compared on the hard and soft mattress along with a new type of mattress with different stiffness. The aim of this study was to evaluate the performance of this new type of mattress and determination of specific layout for each volunteer. After obtaining the dimensional survey data, 25 male volunteers were asked to take the side sleeping position on soft and very firm surfaces, with specific stiffness based on a predetermined protocol. The location coordinates of markers installed on the spinous process by optical detection methods were obtained in frontal plane. In the next step, spring-foam elements were arranged in a frame for each volunteer so that their spinal frontal plane can be close to their natural alignment. In side sleeping posture a c formed curvature appeared along the spinal frontal plane on stiff surface due to lack of support of the spine, and on the soft mattress, softness caused further sinking in the area of pelvis and loss of natural posture. But the arrangement of elements with different stiffness (custom made mattresses) maintained the natural posture of spine. The specific layouts for each volunteer were extracted. The results of this study showed that use of mattresses with custom arrangement is an appropriate way for maintaining optimum spinal alignment during sleep. Common mattresses with uniform stiffness do not have the ability to maintain the spine in a natural position during sleep. Determination of specific arrangements for side sleeping posture can help predict layout required for every individual in the future studies without performing a test.

Nausea and vomiting are common complications after surgery occurring in 20-70 percent of total surgeries and depends on factors such as anesthesia method and hemodynamic status, oxygen concentration, pain, etc. In some studies use of higher concentrations of oxygen prior to surgery has resulted in decreased incidence of nausea and vomiting and in some other studies such results had not been verified. In the present study, the effects of supplemental oxygen has been assessed on the incidence and severity of nausea and vomiting in the patients after cesarean surgery under spinal anesthesia This study was a randomized clinical trial and 122 women who were candidate for cesarean surgery were assigned randomly into intervention and control groups. Intervention group received 80 percent O2 equivalent to 12 liter per minute, continuously during surgery and after surgery in recovery room, and alternatively 6 hours by use of ventury mask in the ward. The control group received 30 percent O2, equivalent to 3-5 liters per minute with a regular mask as a routine measure. The incidence and severity of nausea and vomiting was recorded during surgery, up to 6 hours after surgery, in the recovery room and in the postpartum ward. According to the results, the incidence of nausea during surgery showed no significant relationship but it showed a significant difference in the recovery room and at the postpartum ward in the intervention and control groups (p<0.01). Incidence of vomiting during surgery and at the postpartum ward in the intervention and control groups had no significant difference but it revealed a significant difference in the recovery room (p<0.001). There was a significant difference in the severity of nausea in the intervention and control groups during surgery, in recovery room and after 6 hours of surgery in the postpartum ward and the severity of nausea was higher in the control group (p<0.05). This study demonstrated that supplemental oxygen therapy during and after surgery by spinal anesthesia technique was not effective for the prevention of nausea. There was only a significant statistical difference in the rate of vomiting in the recovery room between the two groups. Use of supplemental oxygen decreased the need for analgesic drugs in these patients

Knee MRI has drawn attention due to its non-invasiveness and its high accuracy. Few reports about the accuracy of PDFS sequences for diagnosis of injured menisci and cruciate ligaments have been published. This study was performed to compare the diagnostic value of proton density with fat suppression (PDFS) and T2 gradient echo (T2 GRE) MRI sequences in injured menisci and cruciate ligaments of knee. This was a descriptive and analytical study. The sample size included 100 cases. In this study the diagnostic value of MRI with PDFS sequence and common methods (T2 GRE) evaluated and compared with each other. Considering the arthroscopy results as a gold standard, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of the different sequences were calculated. This study included 100 patients; 79 males (79%) and 21 females (21) with a mean age of 27.8±9.04 years. Sensitivity, specificity, PPV,NPV and accuracy of sequences for detection of medial meniscal tear were 96.05%, 95.83%, 98.64%, 88.46% and 96% respectively, and for lateral meniscal tear was 90%, 100%, 100%, 100% and 97%. All the above mentioned parameters in ACL tears were 100%. PDFS sequence can be used in the evaluation of knee injuries as a reliable part of the knee imaging protocol and can be a good alternative for the non-fat-suppressive sequences in these patients.

Previous studies have shown the effect of antioxidant properties of spinach on delaying the aging process of CNS and age related cognitive function and some neurodegenerative diseases. This study was designed to evaluate the anxiolytic effects of different doses of aqueous extracts of spinach leaves. This study included fifty male mice (Wt: 25-30 g) which were divided into three experimental and two control groups. Different doses of the spinach extract powder (0.05, 0.10 and 0.15 g/mice) were given to the experimental groups for one month. Also, one of the control groups received water and the other one sucrose 3% (w/v) for one month. In order to increase the activity and curiosity of the mice, they were put inside a box with black walls for five minutes. Then the animals were transferred to the elevated plus maze in regular time intervals and evaluated for standard indexes of anxiety reaction for five minutes. The results of this study showed that percentage of open time was significantly increased in doses of 0.10 and 0.15, and the number of open arm entries was more with a dose of 0.15 g of spinach extract in comparison to the control group (P<0.05). Furthermore, no significant differences were found in the total number of arm entries between the groups. In comparison to the control group, the number of SAP was significantly reduced with doses of 0.10 and 0.15 g of spinach extract in the experimental group (P<0.05). It is concluded that higher doses of aqueous extract of spinach can decrease anxiety.

Adenosine 5́-triphosphate (ATP) is not only the current energy sources for all cells but also plays a critical role in triggering signaling pathways leading to apoptosis or differentiation. During the past years many investigations have been reported the anti-cancer activity of ATP on different cell lines. Also several mechanisms have been proposed for its action and it appears that its mechanism of action depends on the cell type. In the present study effects of ATP on human leukemia K562 cell line as an experimental model of CML and it mechanism of action were studied. K562 cells were cultured and treated with different concentrations of ATP (50-1000 µM) at various time intervals (24-72 h). Effect of ATP on cell proliferation was studied by MTT assay. Apoptosis was studied by flow cytometry and DNA fragmentation assay. Cell cycle and DNA contents were analyzed by flow cytometry. To evaluate the mechanism of action of ATP, effects of ATPγS (an undegradable agonist of ATP) and products of ATP degradation such as AMP, ADP and adenosine were studied. ATP with doses of 100-1000 µM inhibited growth of the cells and induced S-phase cell cycle arrest at the time intervals of 24-72 hour. These effects of ATP led to cell death by apoptosis. In addition, the results showed that these effects of ATP were through its degradation to adenosine and eventually induction of pyrimidine starvation. Because current CML therapy methods which are based on chemotherapy are not very effective and have side effects such as drug resistance, ATP can be proposed as an effective compound alone or in combination with other drugs for treatment of CML.

Cerebral venous thrombosis (CVT) is a rare disorder. Incidence of CVT in developing countries is not clear. This study was conducted to determine the incidence rate of cerebral venous thrombosis, its symptoms and some of its predisposing factors in Kermanshah city. This was a descriptive study. The sample size included 21 cases. Diagnosis of cases of CVT was based on MRI sequences T1, T2, FLAIR and approved by the gold standard MR venography over 12 months. The data were introduced into SPSS software and analyzed by means of descriptive statistics and the frequency of data was calculated. This study included 21 patients; three males (14.3%) and 18 females (85.7%) with a mean age of 36.00±10.13 years who had a total number of 55 thromboses. The most prevalent clinical symptoms, predisposing factor, associated disorder, and sinus involved, included headache (95.2%), OCP consumption (52.4%), infarction (47.6%) and superior sagital sinus (71.4%) respectively. This study showed that the incidence of cerebral venous thrombosis in Kermanshah is relatively higher in comparison to the statistics mentioned in other studies, so further studies for more evaluation of contributing factors in this disease are recommended.

Legionella pneumophila is a cause of pneumonia in human beings. The purpose of this study was to separate L.pneumophila from stagnant and waste water, city squares, coolers and faucets and evaluation of the immuno-protective efficiency of its whole killed cells in mice model. Water samples were prepared, concentrated and then cultured on selective (GVPC) media. After identification of L.pneomophila the biomass of the organism was fixed with 0.5% formalin in sterile saline at 37ºC for 24 hours in order to prepare whole killed cells. Four groups of female BALB/c mices (each group consisted of 15 mices) were selected. Two groups of mice were immunized by three intraperitoneal administrations of prepared antigen in a dose of 4×108 CFU from whole killed cells at two week intervals and control groups received only sterile saline injections. Two weeks after the last injection, one group of immunized mice and one of the control groups were challenged with the lethal dose of virulent strain of L.pneuophila and also the two other groups of mice were challenged six weeks after the last immunization. From 120 water samples 27 samples were contaminated with L.pneumophila. Challenge results showed that the immune efficiency of whole killed cell was 93.33% after two weeks of the last immunization, and 86.66% after six weeks of the last immunization. This study showed that, stagnant water had the highest rate of contamination with L.pneumophila and the whole killed cell of L.pneumophila is a proper candidate for L.pneumophila vaccine studies.

Ventilator-associated pneumonia (VAP) is one of the common nosocominal infections in intensive care units (ICU) which leads to high mortality rates. Endotracheal suctioning is routinely performed in mechanically ventilated patients to clear secretions. The aim of this study was to compare the effect of closed versus open endotracheal suction methods on development of ventilator-associated pneumonia. This randomized control trial included 156 hospitalized patients in intensive care units of the hospitals of Arak University of Medical Sciences. Patients who had required mechanical ventilation and been transferred to ICU in less than 24 hours after their admission and had endotracheal tubes for less than six hours were assigned randomly into two groups. Routine open suction and closed suction methods were used for control (n=74) and intervention (n=82) groups respectively. After 72 hours the patients were examined for signs and symptoms of pneumonia based on clinical pulmonary infection score (CPIS). The results of this study showed the incidence of pneumonia in the intervention and control groups were 28% and 48.6% respectively. Considering the incidence of pneumonia, there was a significant difference between the two groups (P=0.01). Patients with history of cigarette smoking had increased incidence of pneumonia but no difference was detected in the incidence of pneumonia between males and females. Considering the decreased risk of transfer of contamination via medical devices and personnel's hands, use of closed suction method can lead to a decrease in the incidence of ventilator associated pneumonia.

Psychological interventions may improve the quality of life in patients with hypertension through affecting the bio-psycho-social dimensions. This study is aimed to assess the efficacy of cognitive- behavioral stress management (CBSM) group intervention on quality of life and blood pressure in females with hypertension. This research was an experimental study using pre- post- and follow-up tests. Sample was consisted of 30 hypertensive patients who were selected randomly and assigned into two groups; experimental (n=15) and control (n=15). Health Survey questionnaire (SF-36) was used for data collection and recording of blood pressure measurements before and after the intervention and during the follow-up period. CBSM group intervention was directed for the experimental group for 8 sessions. Meanwhile both groups were kept under their routine medical treatments. Data were analyzed by ANCOVA. After the intervention, the mean SF-36 score in the experimental group was significantly higher than that of the control group (p<0.05) and the blood pressure of experimental group was decreased compared with that of the control group (p<0.05). The results demonstrated the effectiveness of CBSM group intervention in the improvement of quality of life and blood pressure in the females with hypertension.

Acrodermatitis enteropathica is a rare autosomal recessive disorder.The serum zinc levels are usually low in these patients‚ but cases with normal serum zinc level have been reported. The clinical manifestations include skin lesions‚ in particular in periorificial areas‚ and extremities ‚diarrhea and alopecia. These clinical signs may occur together only in 20% of the cases. Other manifestations of the disease are behavior and mood changes ‚failure to thrive‚ susceptibility to infection‚ nail changes and delayed wound healing. Case report: Here we report a case of acrodermatitis enteropathica with a normal serum zinc level. The patient was an 11 month old infant who was reffered to Bassat Hospital with well defined erythematous ‚erosions and crusted skin lesions in perioral‚ perianal ‚ buttocks‚ external genitalia and extremities from 4 months ago. The patient had history of irritability and infrequent episodes of diarrhea. Lab work up revealed a normal serum zinc level of 67µg/dl (Reference range: 60-121 µg/dl). 2 weeks after zinc supplementation‚ the skin lesions improved. Diagnosis of acrodermatitis enteropathica is based on clinical manifestations and this diagnosis is confirmed with a low serum zinc level. But in rare cases with normal serum zinc level and relevant clinical signs ‚we recommend a short term clinical trial of zinc supplementation. Improvement of the skin lesions and other symptoms confirms the diagnosis.