مجله علوم پزشکی رازی
سال چهاردهم شماره 3 (پیاپی 56، پاییز 1386)

Rapid breathing is an important clinical manifestation of many illnesses in young infants. Often it is the only sign of illness in this age group. The aim of this study is the evaluation of the respiratory rate as an indicator of hypoxia in infants <1 months. Patients and This observational study was conducted on 222 ill neonates who were hospitalized in Rasool-Akram NICU. Age, sex and gestational age were recorded and Respiratory Rate(RR) was counted at complete one minute when the neonate was quiet. Then oxygen saturation(SaO2) was measured at finger or toe with a pulse oximeter by another person. Hypoxia was defined as an SaO2<=90%. RR and SaO2 were recorded by 2 fix observers who were unaware of the research. The t2-test was done to find the usefulness of the respiratory rate as indicator of hypoxia. Hypoxia(SaO2<=90%) was seen in 100(45%) infants. RR and SaO2 showed a significant negative correlation. RR 60-69/min predicts hypoxia with 82/6% sensitivity, 86/4% specifity, 55/8% PPV, 96% NPV. These results indicated that a respiratory rate>60/min is a good predictor of hypoxia in neonates brought to emergency service of hospital for any symptoms of acute illness.

Ruta graveolens(R.G) has been used for sexual impotence in men and abortion in women. In this study the effect of aqueous extract of this plant has been investigated on testis tissue and spermatogenesis. For this reason as an experimental research, animals were allocated to three groups as control which did not receive anything, vehicle which received only normal saline, and experimental which received ruta extract. Lethal dose 50(LD 50) of extract was considered as 560mg/kg. Based on this, sub LD 50 dose of aqeous extract i.e 280mg/kg was injected intraperitoneally once every other day for one week. A month after the last injection the animals were deeply anesthetized and dissected. Blood was collected intracardically for hormonal assay. The testis were extruded, weighed and then fixed for histological studies. For statistical analysis ANOVA and Tukey as a post hoc test were used. Intraperitoneal injection of 280mg/kg R.G showed nonsignificant changes in body weight and testicular weight and induced a significant decrease in the number of type A spermatogonia(P<0.01) and primary spermatocyte(p<0.05) in experimental group as compared to control and vehicle. There were no significant differences in number of type B and spermatozoid between the groups. There was increase in thickness of tunica albugina and decrease in number of sertoli cells in experimental group as compared to control(P<0.01) and vehicle(P<0.05) which was significant. Also there was a decrease in number of Leydig cells, testosterone and LH levels in experimental group which was not significant. The aqueous extract of R.G diminishes the reproductive system activity and might be useful a substances for birth control process.

Viral hepatitis is a significant and worldwide health problem. The main purose of treating and caring of patients with chronic disease is to promote life satisfaction and well being feeling. In most of the patients with chronic hepatitis, especially those treated with interferon, quality of life is less than normal. The aim of this study was to evaluate the effect of education on quality of life of patients with chronic hepatitis treated with P-D Feron who had referred to Hepatitis Center-Tehran. Patients and The present study was done as a semi experimental research with two separate groups: case and control. The intervention included educating the method of self injection of alpha-2B interferon(P-D feron) and following the continuous treatment with interferon. Sampling method was a non-randomized method and carried out according to the subject characteristics. Sample size was 60 patients, grouped randomly in two 30 patient groups(case and control). Data gathering tool was a demographic characteristics questionnaire and the questionnaire of Quality of Life in Patients with Chronic Liver Disease(CLDQ). Educational program was done in four "45 minute sessions" for case group and their relatives. The follow up period was 12 weeks. Quality of life in patients with chronic hepatitis was measured in two stages, before initiating interferon therapy, and after performing educational program. Finally, the quality of life in two groups was compared by Wilcoxon Signed Rank Test. There wasnt significant difference in demographic characteristics of two groups(P>0.005). The total score of quality of life in two groups, before therapy did not show significant difference(P=0.351) while 12 weeks after performing educational program there was a significant difference between two groups(P<0.001). Wilcoxon statistical test showed that total score of quality of life in case group had a significant difference before and after performing educational program(P<0.001), and had improved after performing educational program. The total score of quality of life in control group didnt have significant difference after 12 weeks(P=0.143). Planning short and simple educational programs has a significant effect on the patient's control on his/her disease and it's side effects and can improve quality of life, life satisfaction feeling, and coping with treatment in patients with viral hepatitis.

There are many articles on the association between β3-adrenoreceptor gene polymorphisms and obesity. The aim of this study was to investigate the association between β3-adrenoreceptor gene polymorphism and serum concentration of Leptin with body mass index(BMI). The study was cross-sectional. Participants of Tehran Lipid and Glucose Study were divided on the basis of BMI in four groups: BMI<20, 20≤BMI<25, 25≤BMI<30, BMI≥30. Totally 401 subjects(mean age 44±14 years)[197 men(46±14 years), 204 women(42±13 years)] were selected randomly each group including 97, 98, 104 and 102 subjects, respectively. Leptin level was determined by Enzyme immuno assay(EIA) method and FBS, HDL-C, Triglyceride and Total Cholesterol levels were determined by Enzyme colorimetric method. Factors including Body mass index and blood pressure were measured too. A 210 bp fragment of mentioned gene was amplified using PCR and subject's genotyping in Tehran Lipid and Glucose Study population was determined by RFLP(MvaI, restriction enzyme) method. Data were analyzed using the T-test. We used one-way ANOVA test followed by post hoc multiple comparison(Tukey) between four BMI groups and also between two groups, of AA/TA(arg Carrier) and TT(Arg non Carrier). All data were analyzed using SPSS 11.5. The A(Arg) allele frequency was 0.08 among the population and satisfied Hardy-Weinberg equilibrium. Presence of A(Arg) allele was significantly associated with increase of the BMI(AA/TA, 27±6kg/m2 TT, 25±5 kg/m2 P=0.043) and increase serum Leptin level(AA/TA, 30±25mg/dl TT, 23±21 mg/dl P=0.009). These data showed the association between Trp64Arg polymorphism of β3-adrenoreceptor gene with increasing BMI and Leptin level.

Rubella vaccine contains live attenuated virus that can be transmitted to fetus causing severe abnormalities in the fetus during pregnancy. However there isnt enough studies to show any congenital rubella syndrome(CRS) in these cases, yet. During mass campaign for Measles-Rubella vaccination in December 2003 in Iran, many pregnant women were vaccinated accidently. In this study we evaluated the prevalence of CRS in pregnant women that had referred to Imam Khomeini & Rasool Akram hospitals in 2003. Patients and In this cohort study, 810 pregnant women 14-25 years of age who received Measles-Rubella vaccine accidently were studied. The cases were grouped in to "susceptible" and "immune against rubella" before vaccination by the status of IgG avidity to rubella vaccine. Then susceptible women were followed up to delivery and their children were followed up to 2yrs of age. Two neonates that were born from susceptible women, showed Rubella-specific IgG in cord blood sera but did not show signs compatible to congental rubella syndrome. According to our findings, the risk of being infected with rubella vaccine virus for fetus of mothers that were accidently vaccinated with rubella vaccine is minimal.

Nalidixic acid is a quinolone antibiotic with excellent in vitro and in vivo activity against salmonella. It is often the first choice for treating drug resistance salmonella infections. Nalidixic acid resistance can often lead to resistance to fluoroquinolones such as ciprofloxacin. In this survey the extent of salmonella infections, the salmonella strains involved, antibiotic susceptibility patterns, and the MIC values towards nalidixic acid were investigated. Patients and During one year period(2005-2006), a total of 1333 diarrheal stool samples were collected from hospitalized patients. Stool cultures were performed on differential and selective media for salmonella isolation. A total of 45 salmonella spp.(species) were isolated(3.4%). Species identification were achieved by agglutination with species-specific antisera. Antibiotic susceptibilities were determined by disk-diffusion method(Kirby-Baure). The minimal inhibitory concentration(MIC) of drug-resistance salmonella isolates was performed by E.test. The study was a descriptive work. Data was analyzed by SPSS sftware. Based on difference ratio hypothesis there were no significant differences between the two methods. A total of 45 salmonella spp.(3.4%) were isolated from 1333 stool samples. Agglutination tests with specific antisera indicated that 9 of them belonged to S. enteritids(20.0%), 6 S. typhimurium(13.3%), 4 S. montevideo(8.9%), 3 S. paratyphi C(6.7%), 2 S. paratyphi B(4.4%), 1 S. muenchen(2.2%), 1 S. derby(2.2%), 1 S. schwarzengrund(2.2%), 1 S. arizonea(2.2%) and 13(28.9%) untypable strains. All of the isolates were agglutinated with only anti O-antisera and non showed any reactions with anti-H antisera. Of the 13 untypable strains, 10(22.2%) belonged to the salmonella serogroup C and the remaining 3(6.7%) were serogroup B. Antibiogram tests indicated that 11(24.4%) of the salmonella isolates were resistant to Nalidixic acid in the disk diffusion agar method. However, determination of MIC values with E.test indicated that only 9(20.0%) of these strains showed MIC values within resistant range. The highest rate of nalidixic acid resistance was seen within the non-typhoidal salmonella strains. These strains are widely distributed within our environment and are the major etiological agents of human salmonellosis. Eleven strains were nalidixic acid resistant in the disk-diffusion method whereas, only 9 showed resistant trait with E.test. The MIC of the resistant isolates to nalidixic acid was ≥ 32µg//ml. Despite its high cost, it is therefore concluded that E.test gives a better and more accurate identification of drug-resistance trait as compared to disk diffusion agar method.

One of the methods of controlling pain after knee arthroscopy is intra articular injection of morphine with or without local anesthesia. Pethidine is an opioid that also has week local anesthetic effect. The aim of this study was to compare the analgesic effect of intra-articular pethidine, bupivacaine and their combination at the end of knee arthroscopy on postoperative pain. Patients and After ethical approval, sixty patients(ASA I or II) undergoing arthroscopic knee surgery during general anesthesia were allocated to this double blinded clinical trial study. Premedication(midazolam and alfentanil) induction(propofol and atracurium) and maintenance(infusion of propofol and alfentanil by infusion pump, O2 and No2 50%, and bolus doses of atracurium) were similar in all groups. At the end of surgery, patients were randomly assigned to one of the three groups(20 patients in each group) to receive intra-articular 0.5% bupivacaine 100mg(Group B), pethidine 100 mg(Group M), or a combination of 0.5% bupivacaine 100 mg and pethidine 100 mg(Group BM) to a total volume of 20 ml. Methylprednisolone 40 mg was added to the solution of all the groups. After transfer to ward, Patient-Controlled Iv Analgesia(PCA) was given for pain control. Duration of postoperative analgesia, pain score(VAS) at 2, 6 and 12 hrs, first analgesic request, total fentanyl consumption during the first 24 hours and side effects were recorded. For statistical analyses, One way Anova, Tukey, Kruskal wallis, Mann-whitney(for quantitative variables) and Chi square or Fischer's Tests(for qualitative variables) were used. Duration of postoperative analgesia was more prolonged in BM group than the other two groups, but M group did not show significant difference as compared to B group(211±51, 72±40, and 51±34 min, respectively). Time for first analgesic request was more prolonged in BM group than other two groups, and also longer in M group than B group(300±38, 132±60, and 82±45 min, respectively, P<0.05). Furthermore, total fentanyl consumption was significantly lower in BM group than other two groups, and also lower in M group than B group(307±52, 352±98, and 382±105mcg, respectively, P<0.05). Although, mean VAS was low in all groups and did not significantly differ between groups at 6 and 12 hrs, but at 2 hrs after surgery it was lower in BM group than others(P<0.05). Patient's satisfaction in BM group showed significant difference than the other two groups(P<0.05). No specific side-effects were observed. Intra-articular pethidine is a potential alternative to bupivacaine in knee arthroscopy. Furthermore, combination of pethidine and bupivacaine provided more therapeutic effects as compared to each used singly.

Impressive research demonstrates the importance of essential fatty acids for many physiological and behavioral mechanisms in both humans and animals. Experimental research showed that deficit in learning and memory is induced after kindling. The objective of this study was to investigate whether dietary cis and trans fatty acids, pre and during pentylenetetraxol(PTZ) kindling would effect learning deficits in male rats. This is an experimental research. Eighteen Wistar rats were assigned in three groups. The control group received standard diet. The cis and trans groups received cis and trans fatty acids respectively. The kindling process was initiated one month after the start of the experiment, and the shuttle box learning ability was assessd one week after kindling. Data were analyzed using one way ANOVA and Tukey test. Results showed control and trans groups had impairment in shuttle box learning and no considerable differences were found between these two groups. However on the other hand administration of dietary cis fatty acid reduced impairment in shuttle box learning in pentylenetetrazol kindled rats. The results of this experiment suggest that dietary treatment of kindled rats with cis fatty acids reduced learning deficits induced by PTZ kindling in rats.

Garlic is a medicinal plant that has been considered and used as "medicine" in various cultures since along time. Considering injuries of lead toxicity especially in vital tissues like liver, kidney and brain and since most drugs used in the treatment of lead toxicity have many side effects it seems necessary to accomplish new studies to identify low risk drugs for prophylaxis and treatment of this important poisoning. The aim of this study was to investigate the effect of fresh garlic and garlic tablet on prevention of lead(Pb) accumulation in some vital tissues. Thirty male crossbred-dogs(wt:-9-12 kg, 6-9 months old) were divided into six equal groups(4 experimental groups, 1 control positive and 1 control negative). Experimental groups(A, B) and control positive group(C) received 5 mg/kg lead acetate daily up to one month and A1, A2, B1 and B2 groups received 1/8 and 1/4 of garlic tab, 250 and 500 mg of fresh garlic per kg of body weight respectively. Group D was negative control and received no substance. Results were analyzed using the Dunnet test of Kruskal-Wallis One way analysis of variance on Ranks. Decreased serum lead burden in groups B1 and B2 in comparison with group C was significant(P<0.05) while in groups A1 and A2 it wasnt significant(P>0.05). In case of kidney tissue, decrease of lead contents(except for group A1), was significant in all groups(P<0.05). In case of liver and bone tissues decrease of lead contents of all groups in comparison with group C, was significant(P<0.05). The results of the present study revealed that administration of at least 250mg/kg.bodywt./day of fresh garlic can decrease lead contents of serum, kidney, liver and bone tissues, but the same dose of garlic tablet is not effective on lead burden of serum and kidney. However, 500mg/kg.bodywt/day of garlic tablet is also effective on decreasing the lead burden of kidney tissue.

One the most common problems of patients on maintenance hemodialysis is sleep disorders that depends on comorbidities, age, morning dialysis shift, blood pressure and female gender. In addition, nocturnal and daytime sleep abnormalities are accompanied with cardiovascular and infectious diseases. On the other hand, inflammatory processes play an important role in individuals with end-stage renal diseae(ESRD) undergoing hemodialysis, and may affect the levels of additional inflammatory molecules, such as serum C-reactive protein(CRP) which is accompanied with the aggravation of atherosclerosis, protein-dependent malnutrition and cardiovascular diseases. Therefore, the aim of this study was to evaluate the relationship between serum CRP level and the severity of sleep disorders in patients undergoing maintenance hemodialysis no such study has been conducted in Iran or elsewhere. Patients and This analytical cross-sectional study was performed on 158 chronic hemodialysis patients(with hemodialysis duration of ≥6 months) in Autumn 2005. The patients underwent hemodialysis trice a week(each time 3.5-4 hours). They completed Modified Post Sleep Inventory(PSI) questionnaire to assess sleep related disturbances in 3 forms of sleep: bedtime(PSI1), nocturnal sleep(PSI2) and awakening(PSI3). Simultaneously, a peripheral blood sample was taken for quantitive CRP level before initiating hemodialysis course. The data were collected, described and analyzed using SPSS V.13 software. Statistically significant correlation was found between serum CRP level and PSImean(rs=0.191 and P=0.016). This correlation was more notable in females(rs=0.345 and P=0.002), patients with hemodialysis duration of ≥48 months(rs=0.364 and P=0.001) and during nocturnal sleep(PSI2)(rs=0.249 and P=0.002). Whereas, no significant relationship was found between serum CRP level either with age categories or other forms of sleep disorder. The results of our study show that recommending anti-inflammatory treatment in patients on chronic hemodialysis for sleep disturbances is reasonable and rationale.

Tramadol is an analgesic with combined opioid agonist and monoamine reuptake blocker properties, which may be useful as a perioperative analegesic and antinociceptive adjuvant. The aim of this study was to evaluate the efficacy of Tramadol 50 and 100 mg in combination with 2% Lidocaine in epidural anaesthesia for lower limb orthopedic surgery. Patients and In this randomized, double-blind study, 50 patients undergoing lower extremity orthopedic surgery were enrolled. Patients were randomly assigned to receive either epidural 50 mg Tramadol + 2% Lidocaine(n=25) or 100 mg Tramadol + 2% Lidocaine(n=25). Level and duration of block, change of haemodynamic status and side-effects in each group were compared. There were no differences between the groups in regard to level and duration of analgesia, demographic charecteristics and side effects(P>0.05). Although, systolic blood pressure was decreased significantly in both groups(P<0.05), it was not statistically significant. We suggest that a combination of Tramadol with 2% lidocaine can provide effective and safe preoperative analgesia. Increasing the dose of Tramadol to l00mg, as compared to 50mg dose, does not significantly affect the efficacy and/or side effeds.

Status epilepticus(SE) is the most common neurological emergency in childhood. Cases referred to pediatric intensive care units(PICU) are the most severely affected. Thus, data from admissions to PICU for SE may provide some insight for devlopment of stategies to reduce the severity and complications of the situation. We conducted this study to determine etiology, factors influencing the occurrence of SE and mortality of patients. Patients and In a descriptive, cross sectional retrospective study files of 134 children(aged 1 month to 12 years) were reviewed Age, etiology of SE, factors predesposing to occurrence of SE(e.g. previous neurological abnormality), course of the disease and mortality of patients were determined. Descriptive(mean±SD) and comprehensive statistics(χ2 analysis) were used. P<0.05 was considered significant. The mean age of patients was 4.8±4.5yr. Status epilepticus was most common in younger children with 45% of cases occurring in those younger than 2 years. 115(85%) out of 134 patients were admitted with their first episode of SE, while 19(15%) presented with recurrence. The most common etiology group was acute symptomatic(27.7%) whereas, progressive encephalopathy with only 10 patients(7.7%) formed the least common group. 42(31.3%) of the children suffered from Refractory status epilepticus. Also 40.3%(54 out of 134) of patients were neurologically abnormal before the episode of SE(P<0.01) and the older the child the more susceptile to have SE in an abnormal neurological background(P<0.001). Twenty five children(18.6%) died 12 of them(50%) belonged to acute symptomatic group, 10(38.4%) remote symptomatic, 2(7.6%) idiopathic and only 1 patient(3.8%) died of febrile status epilepticus. Children under 2 years included more patients than the other age groups. The most common etiology was symptomatic group(acute & remote). Previous neurological abnormality was a significant factor in occurrence of SE. Acute symptomatic group was the most common etiology in the expired patients.

Hepatitis B virus(HBV) infection is endemic worldwide. It is estimated every year more than 350 million people become infected with HBV(new cases) worldwide. Unfortunately, there are no satisfactory drugs to cure HBV and related diseases and the only way to control it is through vaccination. Measurements of HBV DNA levels are routinely used to identify infectious chronic carriers and to predict and monitor the efficacies of antiviral treatment regimens. The quantification of HBV DNA in clinical specimens has significantly improved with the introduction of real-time PCR into routine diagnostic laboratories. The aim of this research is to study cloning and identify hepatitis B virus surface antigen(HbsAg) encoded gene as external standard. A descriptive study was done on hepatitis B virus sufrace antigen encoded gene. Genomic DNA was extracted from HbsAg positive serum sample and amplified by PCR. The amplified segments were cloned in pTZ57R plasmid vector. After purification the PCR product was cloned in plasmid vector and transformed into susceptible E.coli(TG1 strain) cell. The bacteria containing the new combination plasmid was than evaluated for antibiotic resistance, PCR, enzyme cleavage and sequencing. The mean of colony numbers that grew in plates with and without ampicilin and also statistical analysis, T-student test was used. After extraction of viral DNA, Sgene was amplified by PCR 175 bp fragment was generated. S gene was than cloned by PT2 57R plasmid. The new plasmid was extracted and was confirmed by enzyme cleavage and PCR. For final confirmation it underwent sequencing. According to the results the 175 bP fragment of s gene was cloned into PT257R Plasmid. It can be used as external standard for real time PCR or as a positive control in laboratory.

Wound healing is the restoration of physical integrity to internal and external structures and involves intricate interactions between the cells and numerous other factors. Appropriate treatment and care is essential to accelerate healing process, prevent infection and chronicity of the wound and different means and approaches have thus far been used to this end. The aim of this study was to evaluate the effect of aluminium hydroxide, that was used for prevention of bed sore primitively, on the wound healing process in rat. The effect of aluminium hydroxide on the healing process in two model skin wounds long wounds of 15 mm-long full-thickness and round wounds of 15mm diameter full thickness incision given in the paravertebral area, 1.5mm from midline on the back of rats which was evaluated through measuring the length and area of the healed region with pathological evaluation on different days. Also conducting tensiometry experiments were conducted after complete wound healing. 1. The percentage of wound healing on days 3, 6, 9, 12 and 15 in control group of long wounds changed in the group treated with aluminium hydroxide from 10.13%, 31.88%, 52.46%, 78.75% and 100% to 10.25%, 33.38%, 55.38%, 81.36% and 100% respectively also the percentage of wound healing on days 3, 6, 9, 12, 15 and 18 in control group of round wounds changed in the group treated with aluminium hydroxide from 9.88%, 21.25%, 52.13%, 69.63%, 88.21% and 100% to 10.28%, 29.50%, 52.38%, 75%, 91.73% and 100% respectively. 2. Stress(maximum tensile force causing skin rupture) changed from 13.19 Neuton(N) in the control group of long wound to 15.11 N, also from 11.78 N in the control group of round wound to 11.94 N in group treated with aluminium hydroxide. 3. Strain(tissue length under maximum strain) changed from 9.98 mm in the control group of long wound to 10.59 mm, also from 10.53 mm in the control group of round wound to 11.57 mm in group treated with aluminium hydroxide. 4. The result of patological samples in control and aluminium groups in long and round wounds were nearly similar in regard to healing process, cellular aggregates and clearing of wound area considering the time sequence of samples stained with Hemotoylin and Eosin(HE) Our findings suggest that probably aluminium hydroxide has no effect on skin wound healing process and collagen synthesis in rat, however more immunohistochemical studies are needed.

The biological effects of potent oxidative agents in human body are under anti-oxidative control. Functional defects of organs may result from reactions of free radicals with the cell membrane. It is known that major targets of oxygen radicals are cell membrane lipids. Some reports indicate the role of peroxides in development of atherosclerosis. Human body tissues(eg.erythrocytes) contain major antioxidants including glutathione peroxidase and glutathione, hence normal erythrocytes are resistant to oxidative damage. Several controversial studies have demonstrated the effect of sport on improvement of antioxidants and prevention of oxidative damage. Our major objectives were to study the susceptibility of erythrocytes and to evaluate antioxidants such as glutathione peroxidase and glutathione in sports men and compare these variables with that of non-sports men. Patients and In this cross-sectional study 121 male subjects(80 sportsmen and 41 non sportsmen) have been studied. To evaluate the susceptibility of the erythrocytes, Malondialdehyde(MDA) was measured after they were exposed to H2O2. Glutathione was measured by use of SS Dithio-bis(2-Nitrobenzoic acid)(DTNB). The activity of glutathione peroxidase and Creatine phospho-kinase(CPK) were assessed by enzymatic methods and plasma total anti-oxidants were estimated by Ferric reducing ability of plasma(FRAP) method. For statistical analysis of quantitative and qualitative variables Chi-Square and student T test were used. Creatinine phosphokinase activities in sportsmen were significantly higher. Erythrocytes obtained from non-sportsmen were more susceptible. Since, malondialdehyde resulting from incubation of erythrocytes with hydrogen peroxide in sportsmen(with catalase inhibition: 625.23±132.71nmol/gHb and without catalase inhibition: 521.74±125.05nmol/gHb) was significantly lesser than malondialedehyde of non-sportsmen.(P<0.02 and P<0.01 respectively). Plasma total antioxidant levels, glutathione peroxidase activity and glutathione in the cells were not significantly different. Although anti-oxidative power in sportsmen is not different but it seems lipids of erythrocyte membranes are less susceptible to oxidative stress as compared to nonsportmen.

Although studies have shown the central effects of Endocannabinoid on erection, it's peripheral effect is unknown. The purpose of this study was to investigate the effect of the endogenous cannabinoid anandamide on the nonadrenergic noncholinergic(NANC) relaxant responses to electrical field stimulation in isolated rat corpus cavernosum, a crucial tissue in erectile function. The rat corporeal strips were mounted under tension in a standard oxygenated organ bath with guanethidine sulfate(5 µM) and atropine(1 µM)(to produce adrenergic and cholinergic blockade). The strips were precontracted with phenylephrine hydrochloride(7.5 µM) and electrical field stimulation was applied at different frequencies(2, 5, 10, 15 Hz) to obtain NANC-mediated relaxation. Anandamide(0.3, 1 and 3 µM in separate groups) was added 20-min before electrical stimulation. In another group, the selective cannabinoid CB1 receptor antagonist AM251(1 µM), the selective cannabinoid CB2 receptor antagonist AM630(1 µM) and a vanilloid receptor antagonist capsazepine(3 µM) were separately added to the bathing medium 45-min before anandamide(1 µM) administration. Using western blotting, the existence of cannabinoid and vanilloid receptors were assessed in this tissue. Each group consisted of six rats. This study was an experimental study. Statistical analysis of the data was performed by one-way analysis of variance(ANOVA) followed by Newman-keuls post hoc test. Statistical significance was considered when P<0.05. The results showed that the NANC relaxant responses were significantly enhanced in the presence of anandamide at 1 and 3 µM. The potentiating effect of anandamide(1 µM) on relaxation responses was significantly lessened by either AM251(1 µM) or capsazepine(3 µM), but not by AM630(1 µM)(P<0.01). Neither of these antagonists had influence on relaxation responses. Preincubation with the nitric oxide synthase inhibitor L-NAME(1 µM) significantly inhibited the relaxation responses in the presence or absence of 1 µM anandamide(P<0.001). Although at 30 nM, L-NAME did not influence NANC responses, it significantly reduced(P<0.01) the attentuating effect of anandamide on NANC responses. Anandamide(1 µM)) had no influence on concentration-dependent relaxant responses to sodium nitroprusside(10nM-1mM), an NO donor. Western blotting revealed the existence of cannabinoid CB1(but not CB2) and vanilloid VR1 receptors in rat corpus cavernosum. For the first time, our results indicated the potentiating activity of anandamide on NANC-mediated relaxation of rat corpus cavernosum through both CB1 and vanilloid receptors. The NO-mediated component of the NANC relaxant responses to electrical stimulation is involved in this enhancement. Also it was shown that CB1 and VR1 receptors are present in this tissue.

More attention has been paid to the maltracking of patella in the sulcus as the etiology of the anterior knee pain. Those patients with patellofemoral pain and with no known cause could be called as patellofemoral syndrome. In this study we investigated the relationship between pain and radiographic changes in patellofemoral joint. Patients and In a cohort study, we studied 64 knees (18 males, 28 females) of 46 patients with patellofemoral syndrome. Duration, severity & quality of pain as well as axial patellofemoral Xray in 20 & 45 degrees of knee flexion was studied before & after a 6 weeks course of physiotherapy and analysed with Mode & Chi square test. Before the treatment mean of pain duration was 6.5 months(SD: 4.8), mean of pain severity 5.5(SD, 1.7), mean of sulcus angle was 129(SD: 8) and mean of congruence angle was 14.8(SD: 11). Six patients had patellofemoral index of more than 1.6. After treatment 22 patients had no pain, 28 had mild pain and no pain relief in 4 patients. Mean of pain severity was 1.4 months(SD, 1.5). There was no relation between sex and age with pain severity before treatment and pain response. However correlation between pain duration and pain relif was significant(P<0.0005). In other works, the lesser the pain duration, the more the therapeutic response. Mean of congruence angle improved to -16.6(SD, 8), which means reduction of the angle as much as 1.8 degree(P=0.041). Patello femoral index was greater than 1.6 in 6 cases after treatment it reduced to 4 cases. Four patient had patellofemoral index of more than 1.6. There was no relation between pain severity and relief of pain with xray changes. However correlation between relief of pain & congruence changes was found in patients who improved with treatment. Congruence angle reduced to 2.3(P=0.028), but this reduction was in only 0.375 of the patients not happy with the treatment, which statistically is not significant(P=0.83). Axial radiography is not correlated with severity of pain and response to treatment. There was significant relation btween response to treatment and change in mean of congruence angle after treatment. After the onset of the symptoms early initiation of treatment, is associated with better therapeutic response.

Multiple sclerosis(MS) is the most common demyelinative disease of central nervous system among young adults. The differences which are seen in clinical types, drug responses and geographical distribution of MS indicate the role of various factors in the etiology, pathogenesis and epidemiology of this disease. In addition, sexual prevalence and alteration of clinical manifestation during pregnancy may strongly suggest an important role for sex hormones. The aim of this study was to compare the impacts of interferon(IFN) and sex hormone as disease modifying agents in relapsing remitting MS(RRMS). Patients and This cohort study was conducted on 39 women which were supposed to have RRMS according to McDonald criteria. They were evaluated during a 32-month study period from January 2002 to August 2004 in four groups: 11 patients under both sex hormone and IFN(group A), 12 patients under IFN(group B), 6 patients under sex hormone(group C) and 10 patients who received neither sex hormone nor IFN(group D). The progression of disability which was determined using Kurtzke Expanded Disability Status Scale(EDSS) at the beginning and the end of study period, the number of relapses and demographic data were recorded and analyzed using SPSS v.11.5. For statistical analyses k.s, Paired T-Test, Kruskal-wallis, Mann whitney and correlation tests were used. The mean age of patients was 28.36yr. (SD=8.36). The maximum and minimum number of relapses were seen in groups D(2.5 attacks, SD=1.17) and A(1.36 attacks, SD=0.50), respectively. Analysis showed significant statistical relation between number of attacks and sex hormone therapy(P=0.013). Also results demonstrated significant statistical difference in EDSS before and after treatment(P=0.000) and between EDSS changes and sex hormone therapy(P=0.019). IFN therapy influenced only the number of relapses(P=0.033) and did not show any relation with EDSS changes(P=0.32). The therapeutic role of sex hormones is still controversial. However, the results of our study indicate the role of sex hormone in women with RRMS and suggest that high concentration of sex hormones, especially estrogen(e.g during pregnancy), can decrease the number of relapses. Meanwhile, combination therapy with IFN and sex hormone may have a beneficial influence on decreasing the number of relapses and progression of disability.

Postanethesia shivering is a common complication of modern anesthesia. With due attention to this point that duration of administration of anesthetic drugs is related to the occurrence of post anesthetic shivering, we studied the effect of duration of anesthesia on the appearance of post anesthesia shivering. Patients and This double-blind study was performed on 60 patients aged between 20-50 years and ASA class I. Based on duration of anesthesia patients were divided in three groups: In group(1) duration of anesthesia was less than one hour group(2) between 1-3 hours and group(3) between 3-5 hours the amount of post anesthesia shivering was detected at the end of surgery. The anesthesia protocol was similar in the three groups. The results were analysed with chi-square test and Cramer Vi index. Based on our results there was a clear relationship between duration of anesthesia and appearance of post anesthesia shivering. This association becomes more apparent when duration of anesthesia is more than three hours. Increase in duration of anesthesia to more than three hours is a cause for increase in post anesthesia shivering.

HBV is hepatotrophic virus that usually causes infection without any symptoms and it is a very important infective factor in patients with acute lymphoblastic leukemia because they need blood products during their treatment. Because of the importance of this subject the aim of this study was to use hepatitis B virus vaccination in patients who did not have immunity for this disease. Patients and We used double dose hepatitis B virus vaccination for prevention of hepatitis B in 159 patients with acute lymphoblastic leukemia that were in maintenance phase of chemotherapy. Patients immunity system(humoral and cellular) and hepatic function was checked and didnt have any problem. This was a case – control study for which Chi-Square Test was used to analyse data. The results(Hepatitis B Surface antibody) were checked in both groups 3-5 months after vaccination. 25% of patients showed affirmative response to vaccination and it was a hopeful sign for increasing researches and control in these patients. Studies in other countries, show about 30% positive response to HbsAg vaccination and we can conclude that, it is better to use hepatitis B virus vaccination for those who dont have any protective antibody for hepatitis B disease.

Salmonella is the most important pathogenic microorganism causing food borne disease and diarrhea in humans. It could present as diarrhea, fever, vomiting and sometimes bloody diarrhea. Because of it's importance as one of the pathogens, it is essential to identify and characterize its serotypes by molecular methods. The aim of this study was to characterize PCR-Ribotyping technique for identification of salmonella serotypes in stool samples. In this study our samples were salmonella strains isolated from 115 stools of children with diarrhea. After serotyping, their DNA was extracted with phenol/chloroform method. We performed the PCR-Ribotyping method with P1, P2 primers for 16S-23SrRNA gene. Finally PCR-products were electrophoresed on 1.8% agarose gel. After Ethidium Bromide staining we analysed it. Data were analyzed by SPSS 11.5, Chi-Square test and NTSYS2. One hundred and fifteen strains contained paratyphi A, B, C, D and serotype typhi. All of the serotypes had similar 5 bands ranging 700 to 2500bp. According to the results we conclude that PCR-Ribotyping method has the highest sensitivity for identification of genus salmonella but it does not have enough power to discriminate between various salmonella serotypes.

Cervical cancer is the third most common genital malignancy in women. In majority of developing countries the prevalence of this malignancy is high. The aim of this study was to determine the frequency distribution of risk factors of cervical cancer. Patients and A cross-sectional study involving 300 women with histologically confirned cervical cancer was conducted in Tehran, Iran. The method of sampling was non-probability(convenience). The setting was 7 general hospitals including obstetric and gynecology departments in Tehran. Demographic variables(age, literacy, marital status, job), contraceptive use, history of abortion, family history of cervical cancer, marriage age, age of first delivery, smoking habits, etc. were evaluated. The method of collecting data was interview, records review and structured questionnaire. We used SPSS software(version 12.0) in order to describe data. The mean of age for studied women was 55.4±11.6yr. Around half of the women were illiterate. Also 17% of them reported more than once marriage 10% reported a positive history of cervical cancer in first degree relative 45% of them had history of using oral contraceptives and 12% were former smokers. Mean age of marriage and mean number of pregnancies were 16.4±4 and 6±2.7 respectively. Average duration of OC use was 9±5 year. 48% of women had history of stillbirth or abortion. Mean age of women at first pregnancy was 18.6±3.7yr. Mean age of studied women was 55.4 years old. The frequency of important risk factors were: positive family history(10%), low mean age of marriage(16.4 years old), high mean number of pregnancy(6), low mean age of birth(18.6years old), and long duration of OC use(9 years).

In vitro experiments and in vivo studies have revealed that radiosensitizers in radiation therapy may serve as powerful tools in the treatment of glioma cancers. Many cell lines, under some specific conditions will aggregate and grow to form multicellular structures called spheroid. Thses spheroids resemble in vivo tumor models in several aspects. Therefore studying growth characteristics and behavior of spheroids is beneficial in understanding the behavior of tumors under various experimental conditions. The aim of the current study was to determine the role of Iudr(Iododeoxyuridine) in sensitizing glioma cell line spheroids to radiation. This study is an experimental research and T-test was used to compare the results. In this study we compared the DNA induced damages in U87MG cell line using alkaline comet assay method. Experiments were performed with two different sizes of spheroids(100µm and 300 µm). Our results showed the effect of radiation on both diameters of spheres in the presence and absence of Iudr. Accordiology radiation in the presence of Iudr increased the tail moment and thus increased cellular damage. Iudr, in saturation concentration increases the cells radiosensitivity. Specifically in 300µm spheroids, in the presence of Iudr, cell damage was increased to 50%. Comparison of tail moments in spheroids with 100 and 300µm diameter showed that cell damages in larger spheroids(300µm) are lesser than smaller ones(100µm). It may be because of existence of G0 cells and cells with longer cycles, in which Iudr is incorporated to a lesser extent into them. Also, our results showed that minimum presence of Iudr increased the cells radiosensitivity. Therefore inorder to increase the efficacy of this modality of treatmnt we can increase the incubation time of Iudr, increasing the cell population in the cell cycle. In addition cells with longer cycles have more time to incorporate Iudr, or we can use agents that inhibit repairing.

Ruta graveolens(R.G) is currently used by Middle East countries for its antispasmodic, diuretic and sedative effects. Based on recent experiments R.G has antifertility activity in mice when administrated orally. This work was undertaken to examine the possible effect of alcoholic extract of R.G on reproductive system in female immature mice. In this experimental study the female immature mice(4-5wks old) were divided into three groups namely experimental, control and vehicle. For this reason animals were given 325 mg/kg[Leathal dose(LD)50, 650mg/kg] alcoholic extract of R.G intraperitonally(i.p) once every other day for one week. Animals of vehicle group received similar amount of normal olive oil and animals in control group were intact. One month after the last injection animals were deeply anesthetized with mixture of Ketamin and Xylasin and blood was collected from the heart. Sera were separated and kept in -20˚C. At the same time ovaries were removed, weighed and kept in Bowan for histological analysis. The results showed a significant decrease(P<0.01) in weight of ovaries in experimental group as compared with control. Such decrease in the weight was accompanied with decrease in the number of primordial follicules(P<0.01) and corpus luteum(p<0.01). Also the diameter of remaining corpus luteum decreased significantly(P<0.01). Radioimmuno assay results showed a significant decrease in estrogen levels in animals which received i.p injection of R.G. According to the results alcoholic extract of R.G can interfere with reproductive system functioning in immature female mice and might be useful as an antifertility substance.

Antibiotic treatment prevents new episode of Acute Post Streptococcal GlomeruloNephritis (APSGN). In this study we evaluated the correlation of antibiotic therapy and the severity of APSGN in children. Patients and Between 1989 and 2001, files of all patients with diagnosis of glomerulonephritis were reviewed retrospectively. Inclusion criteria were: 1- hematuria, 2- evidence of recent streptococcal infection(Rising ASO titer or positive culture) and 3-transient decrease of C3. According to the history of antibiotic usage for infection, the patients were divided in two groups. The severity of clinical and laboratory findings on admission were scored 0 to 4. T-student and Chi square were used for comparing means and frequency, respectively. P value less than 0.05 was considered significant. Eighty six children with average age(SD) of 8.76(2.85) years were included in our study. The most frequent clinical presentations were as follows: hematuria(100%), edema and azotemia(70%), hypertension(68%), and proteinuria(53%). Meanwhile 53 cases had no history of antibiotic usage. The severity of edema(defined by more than 3 plus)(37.3% vs 18.2%), duration of hospitalization(11 vs 8.9 days) and maximum serum creatinine(2 vs 1.3 mg/dl) were significantly higher in that group which did not receive antibiotics(P<0.05). The mean of clinical, laboratory and total scores were statistically significant and higher in those without history of antibiotic(P<0.0001). Antibiotic prescription in prodromal phase may decrease the severity of acute post streptococcal presentation.