Journal of Gorgan University of Medical Sciences

Evaluation the effect of neuropeptide of Bombesin on modulation of anxiety reaction in mice

AA Vafaei

Background & Objective: Bombesin (BBS) is a tetra-decapeptide amino acid neuropeptide in central nervous system within a variety of mammalian species. Also it has many biological effects that may be effective in modulation of anxiety. The aim of present study was to determine the effect of BBS on modulation anxiety reaction in elevated plus maze (EPM) in mice.

Materials & Methods: 60 male mice (25-30 g) were used in this study. Bombesin in doses of 1.25, 2.5, 5, 10 and 20 µg/kg IP or saline was injected in different groups 10 min before of evaluation. Five minutes later for increase of activity, animal was put in black box for 5 min. Then each animal in regulated time transferred to standard elevated plus-maze and the time spent in the open arms and the ratio of open arm entries during 5 min, were measured. The data analyzed by using ANOVA and Tukey test.

Results: BBS in dose dependently manner increase which the anxiety reaction in mice. Animals had spent lower time and ratio of open arm entries in compare with control group significantly (P<0.05) and BBS only in dose of 1.25 µg/kg did not showed significantly effect.

Conclusion: This study indicated that Bombesin in dose dependently manner have important role in modulate anxiety reaction in EPM in mice.

The effect of Allium ampeloprasum on nociceptive response intensity in diabetic rats

Mehrdad Roghani

Background & Objective: Hyperalgesia is considered as one of the marked signs of subchronic diabetes mellitus that could affect the life style of the patients. Considering the evidence on antidiabetic effect of Allium ampeloprasum (AA), this study was designed to investigate the analgesic effect of Allium ampeloprasum on formalin-induced nociceptive response in streptozotocin (STZ)-induced diabetic rats.

Materials & Methods: 45 male rats were randomly divided into control, AA-treated control, diabetic, sodium salicylate (SS)-treated diabetic, and AA-treated diabetic groups. For induction of diabetes, STZ was used at a 60mg/kg dose. The treatment groups received oral administration of AA-mixed pelleted food (6.25%) for one month. After one month, for all animals, blood glocuse concentration and formalin test measured. Data analyzed with using student paird t-test and ANOVA.

Results: The results showed that diabetic rats exhibited a higher score of pain at both phases of the formalin test (p<0.05) and AA treatment for one month did cause an improvement in this regard (p<0.05). Meanwhile, SS administration significantly reduced pain score only at chronic phase of the test (p<0.05).

Conclusion: This study indicated that one month administration of Allium ampeloprasum could attenuate nociceptive score in an experimental model of diabetes mellitus.

Evaluation of effects of diclofenac on the proliferation and differentiation of PC12 cells in vitro

Saeed Rajabalian

Background & Objective: Diclofenac is a non-steroidal, anti-inflamatory drug that is prescribed as an analgesic. However, there is little known about the effects of diclofenac on the neural cells. In this study, we investigated the effects of diclofenac as sodium salt on the proliferation and differentiation of PC12 cells.

Materials & Methods: This expeimental study was done in Kerman neuroscience research center during 2004. The cell proliferation was evaluated by using XTT assay in the both free-serum neurobasal medium supplemented with B27 supplement and DMEM/F12 medium containing 10% FBS. The nerve growth factor(NGF) – induced differentiation was assessed by measuring the neurite length for each treatment.

Results: The drug toxicity was exhibited at the higher concentrations of 310 mM in the supplemented neurobasal medium. The treatment of cells in the DMEM/F12 medium increased their sensitivity to diclofenac, with 40 and 85% growth inhibition at the 155 and 310 mM concentrations, respectively. The different generics of drug exhibited a equal toxic effects on the PC12 cells. The NGF- induced differentiation was not reduced by toxic and subtoxic concentrations of diclofenac.

Conclusion: This study indicated that diclofenac may be able to exhibit its neurotoxic effects through growth inhibition, but not differentiation inhibition. B27 supplement has several antioxidant compounds. Therefore, the difference of diclofenac cytotoxic effects in two culture media suggest that drug cytotoxicity may be related to the oxidative stress.

The treatment outcome of definitive chemoradiotherapy in patients with esophageal squamous cell carcinoma

Seyed-Amir Aledavood

Background & Objective: Surgery and /or radiotherapy are major local treatments for esophageal carcinoma. The results of radiotherapy alone have been unsatisfactory. The purpose of this study was to evaluate the treatment outcome of definitive chemoradiotherapy for patients with esophageal SCC.

Materials & Methods: This prospective histological descriptive study was done on 190 nonmetastatic esophageal SCC patients which received definitive chemoradiotherapy (55-64 Gy, Cisplatin 80-100 mg/m2 day 1-5FU 750-1000 mg/m2, 24h infusion days 1-4) with curative intent in cancer research center, Mashhad University of Medical Sciences between Jan 2000-Jan 2004. At least one course of chemotherapy was prescribed concurrently with radiotherapy.

Results: There were 99 male and 91female patients with the median age of 65 (range, 25-87). The median radiation dose prescribed was 60 Gy (range, 55-64) and median chemotherapy courses was 4 (range, 1-8). With a median follow-up time of 12 months (range, 3-60), one, two and three-year survival rates were 67.8%, 48.7% and 36.3% respectively and median survival was 22 months. Reduction of symptoms was shown in 84% of patients with dysphagia. 109 patients remained disease free with a median follow-up of 14 months (range, 3-60), among which 34 were followed more than 24 months. We found 81 cases (42.6%) with treatment failure during the follow-up (34 locoregional failure, 14 distant metastases, 33 distant metastases accompanied with locoreginal failure).

Conclusion: Although definitive chemoradiotherapy can result in long term disease free survival and even cure in a subset of patients with SCC of esophagus, locoregional failure and distant metastasis has remained the main causes of treatment failure.

Congenital spinal deformity and associated anomalies

Hasan Ghandhari

Background & Objective: Congenital spinal deformities usually present in infancy and make parents worry about their child future. Because of congenital nature of these deformities, cord anomalies and other organ abnormalities must be evaluated. This study was done to determine Congenital spinal deformity and associated anomalies.

Materials & Methods: This cross sectional study was done on 97 patients who referred to Shafa hospital in Tehran- Iran with congenital back deformities from October 2005 to January 2007. All patients were assessed with physical examination, spinal radiography, MRI, urinary system sonography and echocardiography.

Results: Mean age of patients at presentation was 81 month. 81 patients had congenital scoliosis and 16 patients had congenital kyphosis. Mean cobb angle was 52 degrees for congenital scoliosis and 70 degrees for congenital kyphosis. 22 patients had neurologic or skin signs that 81% of them had cord abnormalities (p<0.05). Cord anomalies were seen in 36 scoliosis (46.5%) and 2 kyphosis (15%) (p<0.05). Most common cord anomalies were syingomyelia,diastematomyelia and tethered cord. Congenital heart anomalies was seen in 3 patients (4%) and valvular heart disease in 10 patients (13.5%) and kidney anomalies in 7 patients (12%). Only one patient with congenital heart disease and one patient with kidney anomaly had kyphosis.

Conclusion: Regarding to prevalence of congenital spinial deformity (CSD) in scoliosis and kyphosis patients, all of patients with CSD should screued for determiation of conganital anomalies by MRI, Eco cardiography and kidny sonography.

The comparison of pain intensity and rate of bleeding in intramuscular injection in Dorsogluteal and Ventrogluteal area

Alireza Moharreri

Background & Objective: We have two areas in gluteal region for intramuscular injection‚ Ventrogluteal and Dorsogluteal. This study was done to compare pain intensity and bleeding rate after injection in Ventrogluteal and Dorsogluteal area.

Materials & Methods: This clinical trial study was done on 67 males in 5th Azar hospital in Gorgan north of Iran. Patients had 2 injections during 24 hours. For every patient one injection was done in Dorsogluteal area and the second injection was done in Ventrogluteal area. For every patients the pain intensity and rate of bleeding for every injections recorded. Data analyzed by SPSS-11.5 software and Kolmogorov-Smirnov and Wilcoxon tests.

Results: In Dorsogluteal area 83.5% of patients had a low and medium pain‚ where as in Ventrogluteal area 88% of patients had a low and medium pain and 9% of them had not any pain. The Mean±SD of pain intensity in Dorsogluteal area was 50.79±1.682 and in Ventrogluteal was 40.79±1.878. The Mean±SD of bleeding in Dorsogluteal and Ventrogluteal areas were 0.73±0.102 and 0.19±0.047 respectively. There were significant differences in pain intensity and bleeding between two groups (P<0.05).

Conclusion: We concluded that the injection in Ventrogluteal area has a less pain and bleeding rate in comparison with Dorsogluteal area.

Comparison of neonatal outcome in pregnancies after ovarian stimulation with spontaneous pregnancy

Seddighe Ayati

Background & Objective: Anovulation is one of the most common causes of infertility and the increasing use of induction ovulation agents for treatment of these patients has been increased. This study was done to evaluate of neonatal outcome in pregnancies after ovarian stimulation in comparisons with spontaneous pregnancy.

Materials & Methods: In this descriptive analytic study, 398 pregnant women admitted to teaching Hospitals of Mashhad University of Medical Sciences from Nov 2004-Apr 2005 were assessed for neonatal outcomes. We compared the rate of multiple pregnancy, gestational age, birth weight, agars score of first and fifth minutes, apparent congenital anomalies, neonatal early death and the days of neonatal hospitalization at NICU in two groups of induction ovulation and spontaneous pregnancy. The data were analyzed by c2 and t student test. P<0.05 was considered statistically significant.

Results: From 398 pregnant women, 95 patients were pregnant after ovulation induction and 303 patients had spontaneous pregnancy. There was significant differences between two groups including: Multiple pregnancy, first minutes and fifth-minutes. Apgar scores, head circumference and admission in NICU (P<0.05). There was also effective dependence between induction ovulation and multiple pregnancy on premature delivery. The early neonatal death and apparent congenital anomalies had no significant differences between two groups.

Conclusion: We concluded that neonatal outcome of ouvlatory induced pregnancies is more unfavorable which probably is due to the multiple pregnancy premature delivery and maternal infertility background.

Incidence and prevalence of diabetes mellitus in over 30-years-old in rural areas of Kalaleh – North of Iran (2005-06)

Saba Besharat

Background & Objectives: Diabetes mellitus contains a group of common metabolic disorders that induces problems in health status. Its prevalence is increasing in the world, due to increase the rate of obesity and decrease in physical activities. This study was done to evaluate incidence of diabetes and prevalence in rural areas of Kalaleh city(North of Iran).

Materials & Methods: In this descriptive cross-sectional study all persons over 30 years old were enrolled, according to diagnosis of diabetes before 2005 or diagnosis in the screening programs (with FPG>126 in two turns) in rural areas of Kalaleh during 2005-06. After collection of demographic data with questionnaires and laboratory findings, they were entered to computer with SPSS-15 software. Central and distributive indices and incidence & prevalence of diabetes were assumed according to the whole population.

Results: In this study, 394 cases were enrolled. Incidence and prevalence of diabetes was 0.6% and 1.13%, respectively. Mean age of cases was 51.61 years. Male to female ratio was 0.4. Mean BMI was 29.43 kg/m² and a significant difference was seen between two gender (P<0.05). Most of the cases were Turkmen (72.8%). Illiterates were the major group (77.2%) and 1.8% had diploma or higher educational levels.

Conclusion: Prevalence and incidence of diabetes was lower than the other area of Iran.

Assessment of nutritional support in head trauma patients in Neurosurgery Intensive Care Unit

Shahrookh Yousefzadeh

Background & Objective: Nutritional support is a basic process for survival in trauma patients. The purpose of this study was to evaluate the daily nutritional support practice in head injury patients admitted to Neurosurgery Intensive Care Unit.

Materials & Methods: This descriptive cross-sectional study was done on 115 Head injury adults patients who received enteral nutrition for at least 48h in Rasht Poursina hospital during 2005. Nutritional measurements were included the number of patients who received enteral nutrition, the time to initiate nutritional support, amount of initial feeding and clinical outcome were included the duration of mechanical ventilation, ICU and in-hospital length of stay (loss), in-hospital mortality rates .Data was reported as Mean±SD and percent. T-test analysis was used for comparing of calorie and nutrient intakes and requirements.

Results: Mean±SD of age patient was 41.22±21.9, 84% of patients received enteral nutrition. The time to feeding and the amount of initial feeding was 4.6±1 day and 52.79±27.83 ml/h respectively. Duration of ventilation was 12±13.4 day and ICU length of stay 18.96±18.3 day, Hospital length of stays 24.47±19.84 day. Mortality rate in six month was 48%. Mean of energy, carbohydrate, fat and protein (P<0.05) intakes had significant differences compared with requirements.

Conclusion: The recording process has revealed undesirable feeding practice in head injury patients. Nutritional outcomes would be improved with implementation of standard protocol in neurosurgery intensive care unit.

The effect of music on the rate of anxiety among hospitalized children

Shayda Kazemi Malek Mahmodi

Background & Objective: At least about 30 percentage of children hospitalize in hospital in their childhood. Hospitalization of children cause anxiety, due to separation from their parents ,fear of new environment, disabilities and continuation of life. This study was done to determine the effect of music on the rate of anxiety among 9-12 years old hospitalized children.

Materials & Methods: This semi experimental study was done on sixty 9-12 years old children who are confined to bed in Taleghani hospital in Gorgan north of Iran during 2002-3. 60 of children were divided to 2equal groups of intervention and control randomly. The tools of gathering data including information questionnaire, patients demographic, state – trait anxiety inventory for children Spillberger (STAIC), face anxiety children examined scale Piyeri (FACES) information was compared before and after the intervention the collect. For intervention group, 2 music therapies listening of music section, for the 2 continuous days and each section lasted for 20 minutes. The collected data before and after intervention were analyzed by using Kolmogrov-Smironov, c², independent-sample T test, Wilcoxon signed Ranks, Bartlet and Mann Whitney test.

Results: There was not any difference between the average of state anxiety and amount of face anxiety in both group before execution of music therapy but there was a significant difference for the intervention group after the music therapy (p<0.05). Also the decrease in the rate of anxiety in intervention group can related to the executing of music therapy.

Conclusion: Music therapy reduced the rate of anxiety among the 9-12 years hospitalized children.

Relation between nursing managers' leadership styles and rate of nursing employees' job satisfaction

Homeyra Khoddam

Background & Objective: Job satisfaction is the one of factors that affected by leadership style of managers and can effect on health organization practice. The aim of this study was to determine relation between leadership styles of nursing managers and rate of nursing employees' job satisfaction.

Materials & Methods: This cross-sectional study was done on 720 nursing employees of Gorgan Medical teaching centers during 2006. Leadership style and job satisfaction were main variables of study. Data gathering tools were questionnaire of demographic characters, job satisfaction and standardized Bark's leadership style. Gathered data were analyzed by c², Mann-Whitney and ANOVA statistical tests.

Results: The most of participants (74.3%) were women, nurses (86.6%) with the mean age of 32.7±7.32 years. The rate of satisfaction in the most of nursing employees (79.8%) was low and moderate. 63.2% of participates believed that their nursing managers had transactional leadership style and 34.9% of them said nursing managers apply transformational leadership method. Data analysis showed that nursing managers have transactional leadership, had higher job satisfaction rate (88.01 V.S 86.36). This difference was not significant.

Conclusion: This study showed that, there is not statistical relation between leadership styles of nursing managers and rate of nursing employees' job satisfaction.

Prevalence and antibiotic susceptibility of Pseudomonas aeruginosa isolated from Taleghani hospital, Gorgan-Iran

Aniya Ahani-Azari

Background & Objective: in recent years antibiotic resistance of Pseudomonas aeruginosa is increased as a causetive factor in hospital contamination. This study was done to determine the prevalence and antibiotics susceptibility of Pseudomonas aeruginosa isolated from inanimate objects in Taleghani hospital.

Materials & Methods: This descriptive study was done on inanimate objects in different wards of Taleghani hospital during 2006. Sampling was performed by sterile gauze pad for dry surfaces and swab for wet surfaces. To differentiate and identify P.aeruginosa, various culture media such as Brain Heart Infusion Agar, Citrimide Agar and Triple Sugar Iron Agar were used. Antibiotic sensitivity of the isolated strains was determined by Kirby-Bauer Method using Muller-hinton Agar medium. Moreover, antiseptic sensitivity of the strains to Decosept and Povidone-Iodine as the main antiseptic agents was identified by determining Minimal Bactericidal Concentration and Minimal Inhibitory Concentration using Nutrient Agar and Nutrient Broth media.

Results: Fifty-five of the total 292 samples were positive for P.aeruginosa. Based on the ratio of the number of positive samples to the total samples, Thalassemia ward (38.5%) was the most infected ward and taps (61.1%) was the most infected sampling place. None of the samples from room atmosphere and intensive care equipments were positive for P.aeruginosa. 20% of the samples were resistant to ceftazidime and 32.7% were resistant to piperacillin, also 10.9% of samples were resistance to both ceftazidime and piperacillin.

Conclusion: This study showed that contamination with P.aeruginosa and antibiotic resistance of the isolated bacteria are the main problems in Taleghani hospital.

The effect of supportive group therapy on menopause mental health

Neda Parvin

Background & Objective: Menopause effect on women quality of life and mental health. This study performed to determine the effect of supportive group therapy on menopause mental health condition in Sharekord.

Materials & Methods: This study is a quasi experimental research. 46 menopause women who had research condition divided in case and control group. We used GHQ28 and demographic questionnaire in 3 stages for data gathering. group therapy session perform for case group. Data was analysed with SPSS soft ware and analyctic and descriptive statistic index such as Paired T and correlation exam.

Results: After group therapy in all dimention performed, significant progress in case group (p<0.05). In addition there was significant difference between case and control group in mental health score after group therapy (p<0.05). There is no any correlation between demographic variable with mental health condition.

Conclusion: This study showed effectiveness of group therapy in mental health condition of menopause women. We recommend to use this method routinely for menopause women.

Old unreduced tibiotalar dislocation- a case report

Alireza Saied

Tibiotalar dislocation without concomitant fracture in the surrounding bones is a rare injury. We report one of them presenting unreduced after a 10 month interval. A 23 y/o female presented to our clinic 10 months after Bam earthquake, during which she had sustained an anterior tibiotalar dislocation without any associated fracture. Open reduction was tried two times, but both attempts were unsuccessful because of the very poor quality of bone. Although ankle dislocation has been reported to be associated with good prognosis, it was not the case with our late presenting patient.