Journal of Gorgan University of Medical Sciences

Hypoglycemic and hypolipidemic effect of chronic oral administration of aerial part of Marrubium vulgare in diabetic Rats

M.Roghani (PhD)

Background&Objective: Marrubium vulgare has preventing and antioxident components. There are some evidence of hypoglicemic and hypolepidemic of this medicinal herb. This study was done to determine the hypoglycemic and the hypolipidemic activities of Marrubium vulgare in diabetic Rats. Materials&Methods: In this experimental study, 40 male Wistar rats were divided into control, treated control, diabetic, and treated diabetic groups. For induction of diabetes, streptozotocin (STZ 60 mg/Kg i.p.) was used at a single dose. The treatment groups received oral administration of plant-mixed pelleted food (6.25%) for two months. Serum glucose, triglyceride and cholestrol concentrations. Were meuseud by spectrophotometry technique. Results: Serum glucose level in diabetic group increases 4 and 8 weeks after the experiment as compared to data one week before the study began (P<0.05). Marrubium vulgare treatment of diabetic rats did not any significant effect. In addition, triglyceride level in diabetic group increased 8 weeks after the experiment in comparison with related data one week before the study (P<0.05) and there was a significant lower level of triglyceride in Marrubium vulgare-treated diabetic rats (p<0.05). Furthermore, a similar significant reduction was obtained for treated-diabetic group as compared to diabetic group regarding serum cholesterol level (p<0.05). Conclusion: This study showed that oral administration of Marrubium vulgare in long-term could significantly reduce serum triglyceride and cholesterol levels without any effect on serum glucose in diabetic rats.

The effect of egg yolk on burn wound healing in Rats

GHR.Hasanzadeh (PhD)

Background&Objective: Burning and burn wound are the causes of mortality in the world. The present study was designed to investigate the effect of egg yolk (of hen) on burn wound healing in Rats. Materials&Methods: In this experimental sutdy, 48 females rats randomely divided in silver sulphadiazin, egg yolk and control groups, respectively. Each of three groups including 16 rats and was selected for 28 days of treatment. After general anesthesia with ketamin and xylazin (ip) an area of the back of rats was burned with red-hot coin and similar grade II burns were created. Control group received no medication. In the second and third groups, the surface of wound was covered daily with sulphadiazine and egg yolk. At the end of the eack week, four rats from the each group were scarified by ether and samples were taken from the wound region and were histologically assessed. The samples were stanied with Hematoxillin and Eosin and studied quantitively. Results: Results showed that after 4 weeks the healing of burn wounds in the groups receiving egg yolk and sulphadiazine were similar. But healing of burn wounds within these 2 groups was better than control group. There was no difference between the groups receiving either egg yolk or sulphadiazin. Conclusion: This study showed that egg yolk can be used as an alternative to sulphadiazin in second degree burn wounds.

The histopatological changs of mice liver due to morphine adminstration

H.Mofidpour (PhD)

Background&Objective: Morphine is an opioid analgesic and has known effects on different organs. This study was done to determine the histopatological changes of liver due to morphine adminstration in adult mice. Materials&Methods: In this experimental study, 20 male Blab/c mice divided experiment and control groups. In experiment and control group, animals recived 15mg/kg/day morphine and salin normal interperitoneally, for 21 days respectively. Day 22 the livers were dissected under anaesthesiology. Specimens were processed for histological study and stanied with H&E. Results: In experimental group, small sites of necrosis with poly morphic inflammatory infiltration and debris formation of necrotized nucleus in death area, so hepatitis was suggested. Also accumulation of micro droplets of lipid inside the hepatocyte cytoplasm withont nucleus displacement (fatty damages with small vacuoles) observed in cases. In addition, microvesicular steatosis and mouth teeth necrosis in liver parenchyma with inflammation in the vein and portal space were seen in cases. Any changes was not seen in control group. Conclusion: The interperitoneal adminstration of morphine can cause histopatological changes in mice liver.

Diagnosis validity of AgNOR staining for differentaing non-Hodgkin lymphoma from reactive hyperplasia

Zh.Torabizade (MD)

Background&Objective: There are different methods including H&E, imonhistochemstry, flu cytometry, AgNOR staining for differentiation reactive hyperplasia from lymphoma. This study was done to determine diagnostic validity of AgNOR staining for differentating non-Hodgkin lymphoma from reactive hyperpalsia. Materials&Methods: Fifty parafin blocks belong to patients with confirmed diagnosis are as below: Thirty five block with lymphoma and fifteen blocks with reactive hyperplasia. AgNor dots among one hundred cells were counted, by two experienced pathologists. The mean of AgNOR dots were calculated. Student T-test used to campare mean AgNOR dots. Results: The mean AgNOR count was 2.2 (range 1.4-3, SD=0.8) in reactive hyperplasia and 6.7 (range 3.9-9.5, SD=2.8) in non-Hodgkin lymphoma. A statistically significant difference was observed between the AgNOR count of reactive hypeerplasia and non-Hodgkin lymphoma (p<0.05). Conclusion: The findings support the validity of AgNOR technique for differentiating and confirming non-Hodgkin lymphoma from reactive hyperplasia.

Estimation of face shapes in Fars and Turkman female adults in Gorgan

M.Jahanshahi (MSc)

Background&Objective: The evaluation and measurement of human body dimensions are achieved by physical anthropometry. Cephalomerty is a branch of antrompometry Science, in which the head and face anatomical are measured. With respect to its importance in legal medicine, plastic surgery, radiology, anatomy, orthodency and industry, this study was set up to determine and compare the face shapes in Fars and Turkman ethnic groups of normal female adults. Materials&Methods: This study was a descriptive-and cross-sectional study which was carried out on 410 girls of 17-20 years of age in two ethnic groups of native Fars and Turkman. The length and width of girls face were determined by using classic cephalometry techniqre. On the basis of this method, the shape of faces was subdivided in five interrational groups. Subsequently the prevalancy and the shape of faces in the ethnic group of Fars and Turkman were compared. Results: The prosopic (facial) indices of Fars and Turkman groups were 84.55.8 and 81.55.2, respectively. Dominant shape of face in Fars group was euryprosopic (37.7%) and in Turkman group was euryprosopic (51.7%). Rare shape of face in Fars and Turkman groups were hyperleptoprosopic (5.8%) and leptoprosopic (3%) respectively. Conclusion: This study showed that the face shape is affeiced by ethnical factor and primarily by genetic factor.

Comparison of single dose of bupernorphine versus morphine administered during induction of Anesthesia for pain relief and sedation after lumber laminectomies

A.Parviz Kazemei (MD)

Background&Objective: Post operative pain is a common phenomenon that it is one of the important problems in surgery. Different methods have been used to control post operative pain. Morphine and Buprenorphine are classified as narcotics, and their effect on post operative pain relief has been evaluated in this study. Materials&Methods: This randomized clinical trial (RCT) was done on 40 patients with lumbar disk herniation that randomly classified in morphine and buprenorphine group. During induction of anaesthesia 0.2 mg/kg morphine and 4.5/kg buprenorphine were injected intravenously to the corresponding groups, respectively. At the end of anaesthesia, heart rate, systolic and diastolic blood pressure were evaluated as well as severity of pain. Then, collected achieved data were analysed. Results: The severity of pain in buprenorphine group was less than morphine at all the times except the time of discharge from recovery (p<0.05). With respect to sedation there was a meaningful difference between the two groups at the time of entering recovery and 15 minutes later. The sedation was more in buprenorphine group, (p<0.05) There was no meaningful statistical difference in relation to heart rate between the two groups. Systolic blood pressure, between two groups was significant except at the time of entering recovery. Also, systolic blood pressure was not significant between two groups. Conclusion: This study showed the bupernorphine has long anaesthesia and sedation.

The comparasion of intramuscular and intravagnial suppositoar forms of progesterone for supporting the Luteum phase in ART cycles

S.Kadkhodayan (MD)

Background&Objective: Up to seventh week of gestation, progesterone secreted from the ovary is necessary to preserve the pregnancy. In the ART cycles GnRH-a is prescribed and oocytes and granulosa cells or retrieved, both causes corpus luteum insufficiency, so corpus luteum should be supported the best way is progesterone prescription. In this research we compare intramuscular and intravaginal suppositoar forms of progesterone for preserve the pregnancy. Materials&Methods: A prospective cross sectional evaluation on 193 patients was designed. All of them were on IVF or ICSI cycles. The patients were randomly divided into two groups. Intramuscular progesterone was prescribed in 138 and intravaginal progesterone (supp cyclogest) in 54 patients. The outcome of pregnancy was analyzed using statistical trials including t-test and chi-squre. Results: The two groups were similar duo to age – the ethiology causes of infertility – the doses of proscribed HMG ampule – FSH titrago – the number and grade of transferred embryos. The day after HCG presciption until the end the seventh week in the first group (138 patients) intramuscular progestrone (50 mg /bid) and in the secound group (54 Patients) supp of cyclogest (400 mg / bid) was prescnbed. The rate of positive pregnancy test, abortion, successful poegnancy in this two groups were similar. Conclusion: Intramuscular or intravaginal progesterone for supporting corpus luteum in IVF or ICSI cycles has the same effect but the intramuscular route is cheaper.

Evidence of familial association between attention deficit hyperactive disorder and major depressive disorder in probands of ADHD (September 2003- march 2004)

P.Hebranei (MD)

Background&Objective: Comorbidity between ADHD (Attention Deficit Hyperactivity Disorder) and major depression has been reported from both epidemiologic and clinical studies of both children and adults. With the use of family study methods, we tested hypotheses about patterns of familial association between attention deficit hyperactivity disorder (ADHD) and depressive disorder among first-degree relatives of clinically referred children and adolescents with ADHD. Materials&Methods: In this case – control study, were 208 probands with ADHD (aged 5-17 yrs) were diagnosed by clinical interview and the Schedule for Affective Disorders and Schizophrenia for School–Age Children Present and Lifetime version (K–SADS–PL), and they were assessed for major depression with interview and K- SADS. 779 first degree relatives (416 parents, 363 siblings) were assessed with interview and K- SADS (for under 18 yrs) and SADS (for age up to 18 yrs) and Wender (for age up to 18 yrs) for major depression and ADHD. Results: Familial risk for ADHD was similar in the relatives of the ADHD probands. The risk for major depression disorder was three times higher in relatives of probands who had ADHD with depressive disorder than in those of the ADHD probands without depressive disorder. There was a tendency for ADHD probands' relatives who themselves had ADHD to have a higher risk for depressive disorder than ADHD probands' relatives who did not have ADHD (cosegregation). Conclusion: These findings are consistent with the hypothesis that ADHD and major depression disorder cosegregate within families.

Awareness and recall after cricoid pressure (Sellick’s maneuver) during general anesthesia

M.Jabal Amelei (MD)

Background&Objective: Sellick’s maneuver is a routinely used technique for the prevention of pulmonary aspiration of gastric contents during anesthesia. The rationale for the application of cricoid pressure necessitates that it is applied at the loss of consciousness during rapid sequence induction. Cricoid pressure therefore, may be fully applied at a level of anesthesia where awareness, and possibly recall, of the maneuver occurs. Materials&Methods: This study was setup to determine the frequency of awareness and recall Sellick's maneuver following 100 patients (ASA I, II) who candidates for lower extremity surgery were randomly enrolled in this prospective study. After induction of anesthesia and application of cricoid pressure, symptoms of awareness and recall were recorded. Data were analyzed by SPSS software and Spearman correlation. Results: The frequency of awareness and recall were 45% and 16% respectively. The frequency distribution of awareness severity based on grade 1, 2 and 3 were 16%, 6% and 1% respectively. The frequency distribution of recall severity based on mild, moderate and sever were 15%, zero and 1% respectively. The correlation between awareness severity and recall severity was statistically significant (P<0.05). Conclusion: Due to high frequency of awareness and recall following Sellick's maneuver and its complications, it is advaiable to revise the procedure of this maneuver and inparticular the accurte time in its application.

The effective factors on men infertility: a case – control study

F.Ghahremanei (PhD)

Background&Objective: The infertility and its psycological problems can be considered as one of the important difficulties among married couple. Nearlly half of the infertility related to the men. This study was set up to determine the most common risk factors of male infertility in men attending infertility clinics in Shiraz. Materials&Methods: A case – control study was conducted in which 268 men. 161 fertile men were compared with 108 infertile men from the point of risk factors such as smoking habits, drug consumption, hernia, varicocele, job and BMI. Results: Logestic regression analysis, Risk estimate (adds Ratio), and t-test demonstrated that hernia, varicocele, ranitidine consumption, Job and BMI all have statistically significant associations with infertility in men. Odds Ratios of 2.5 for hernia, 4 for varicocele, 2.9 for ranitidine consumption, 2.3 for workers (simple, semiskilled and skilled), t=3.5 (P<0.05). With an increase of one cigarette per day there was decrease 1% in motility of sperm .With an increase of one year of cigarette smoking, the number of sperm was decrease about 800000. The BMI in infertility men was <25. Conclusion: This study showed that the most common factor in men infertility in Shiraz are varicocele and hernia and hard works can cause testicular injury.

Psychological and obstetric risk factors for postnatal depression

F.Behdanei (MD)

Background&Objective: Postnatal depression is a key concept for mother-infant mental health. Identifying risk factors of postnatal depression and developing screening system are needed. The propose of this study was to determine Psychological and obstetric risk factors for postnatal depression Materials&Methods: 288 consecutive admitted women at 6-8 weeks after childbirth on maternity ward in Ghaem hospital, Mashad, Iran were assessed by two psychiatrics. Interview data included presence obstetric history, economic and demographic characteristics, Personality, psychiatric history and life-events information that were obtained from a questionnaire, psychological status was assessed by using the GHQ. The prevalence of distress was ascertained by the 28-item Goldberg Health Questionnaire (GHQ), using a cut-off score of > 24. Results: 57.6% of mothers had GHQ-above 24scores which categorized them as having significant emotional distress several psychological and obstetric risk factors for the development of predisposing psychological distress at 8 weeks postpartum were reported including: Economical situation, marital relationships, and the gender of the infant, multiparous women, caesarean section deliveries, and unplanned pregnancy Conclusion: The results emphasize the importance of cumulative psychosocial and obstetric risk factors for postnatal depression. Early identification of potential risk for postnatal depression should include assessment of sociodemography, personality, psychiatric history and recent life events, as well as past and present obstetric factors.

The epidemiology of leptospirosis in Guilan provice - 2003

HR.Honarmand (PhD)

Background&Objective: Leptospirosis is most widespread Zoonosis in the world and is more prevalent in tropical and temperate regions. In most of Iran, climatologic and ecological conditions are unfavorable for leptospirosis to play an important role as a public health problem. However this does not count for the neglected flat area of Guilan province which presumably represents a region with a high incidence of human leptospirosis. This area has a subtropical climate with mainly farmers as inhabitants. By far the most important agricultural activity is rice farming. Most of farmers used to keep domestic animals in their houses and rodents are abundant. Materials&Methods: To find evidence for a high incidence of leptospirosis in the Guilan province, we collected blood samples from patients who attended one of the three big general hospitals in the province with clinical symptoms consistent with leptospirosis in 2003. All sera were stored at –20c until examination by ELISA and MAT. All patients whose serum had titers ≥160 against at least a pathogenic serovar in MAT and had titer ≥ 1:160 in IgM-ELISA were regarded as confirmed positive cases (70 from 282) and their demographic and epidemiological data were analyzed. Results: Results from our study demonstrate that leptospirosis is mainly a disease of predominantly males (62.5%), occurring in high incidence in villagers (89.5%) during the warm season (100%) notably in September that is time of harvesting (42.90%). Conclusion: In addition it is an occupational disease affecting rice about 90% field workers.

The study of different treatment therapy in the early stage of Hodgkin’s disease of apper diaphragms in noth-east of Iran

M.Silaniyan-Toosi (MD)

Background&Objective: The proper treatment for early-stage Hodgkin’s disease is controversial. The purpose of this study was to evaluate the therapeutic outcomes of various treatment strategies in supradiaphragmatic clinical early-stage Hodgkin’s disease. Materials&Methods: This retrospective study reviewed the medical records of 105 eligible patients (49 stage I, 59 stage II) who were treated at radiotherapy- oncology departments of Qaem and Omid hospitals in Mashhad (Iran) from April 1995 to April 2000. 26 patients had B symptoms and 5 had large mediastinal mass. Treatment of patients consisted of chemotherapy alone (43 cases), radiotherapy alone (46 cases, 40 mantle and 6 Total nodal irradiation) and combined modality (16 cases). Survival rates were calculated by Kaplan- Meier model. Log-rank test was used to compare the survival profile between groups. Results: The median age of patients was 25 years with a male to female ratio of 1.56: 1. In comparison with radiotherapy only group, Primary chemotherapy and combined modality groups had significantly more cases with unfavorable factors such as B symptoms, Large mediastinal mass, ESR>40 and stage II. For chemotherapy, combined modality and radiotherapy groups the 5-year progression free survival was 72.5%, 82.5% and 56.2% (P<0.05) and the 5-year disease specific survival was 82.9%, 91.6% and 82.5% respectively. Conclusion: Despite having more cases with unfavorable factors, patients who underwent chemotherapy or combined treatment had lower relapse rates compared to radiotherapy only group. However, there was not a significant difference in 5-year disease specific survival rates between these groups.

The value of thyroid fine needle aspiration in evaluation of follicular neoplasms

R.Azarhoush (MD)

Background&Objective: The presence of single or multiple nodules within the thyroid gland is a common clinical problem. It is immposible to differentiate benign and malignant follicular neoplasms in cytologic examinations.Estimation of risk of malignancy in thyroid nodules who are cytologically assumped to be follicular neoplasm has a critical importance.The aim of this research is evaluation of diagnostic value of thyroid FNA in follicular neoplasm. Materials&Methods: This survey was done on 476 patients with thyroid nodule whome were biopsied in a 7 years period (in 5th Azar hospital, Gorgan). Standard aspirations and biopsies techniques performed and nessassary smears prepared. Wet-fixed smear glass slides are placed immediately in alcohol (70%) 7-10 slides from the aspiration. The patients with cytologic report whome considered follicular neoplasm followed total thyroidectomy or lobectomy. Results: From 476 patients for thyroid nodules 412 cases(86.5%) are suitable for cytologic evaluation which 312 cases(77.9%) of them were benign and 14 cases(3.3%) were malignant.The rest(77 cases)reported to have follicular neoplsm, this patients also undergone thyroid surgery.The result of histological findings appeared in 32 cases(57.1%) follicular adenoma,15 cases(26.7%) non-neoplastic nodules,5 cases(8.9%) follicular carcinoma and 4 cases(7.1%)follicular type of papillary carcinoma. Conclusion: 9 cases (16%) found malignant among cases which cytologic reports considered as “follicular neoplasms” and subsequently undergone thyroid surgery (consist of follicular carcinoma and follicular type of papillary carcinoma), confirme the importance of histopathologic study of follicular lesions for differentiation between malignant and benign lesions.

Determination of heavy metals (Cd, Cr, Pb, Ni) in edible tissues of Lutjans Coccineus and Tigeratooh Croaker In the persian Gulf-2003

A.Shahryary (MSc)

Background&Objective: Heavy metals have a high resistance against degradation. So their amounts in human food chain, such as fish, may be increased even several times either in water or air, due to bioaccumulation. These amounts are potentially dangerous to human. This study was done to determin of heavy metals in edible tissue of Lutjans Coccineus and Tigeratooh Croaker in the Persian Gulf. Materials&Methods: 60 samples of Lutjans Coccineus and Tigeratooh Croaker were collected randomly after preparation and chemical digestion for trace elements determination. Pb, Cr, Cd and Ni were determined by flame atomic absorption in 2003. Results: Average value of Pb, Cr, Cd and Ni in the edible tissues of two fish species, Lutjans Coccineus 0.442,0.333,0.063 and 0.322 and Tigeratooh Croaker of were 0.48, 0.062, 0.064 and 0.48 ppm (dry weight basis), respectively. Conclusion: Results indicated that the mean concentrations due to heavy metals in these two species were less than acceptable limit of WHO, but related concentrations of Pb, Ni, Cd and Cr in 27%, 25%, 8% and 3% of individual studied samples respectively were more than upper acceptable limit of WHO.

Hydatidiform mole and surviving coexistent twin (a case report)

S.Bakhshandeh-Nosrat (MD)

Hydatidiform mole with a coexistent fetus is a rare occurrence with an incidence of 1 per 22000-100000 pregnancies. It is associated with persistant gestational trophoblastic tumor. Hence an early and correct diagnosis is imperative to plan subsequent management of such patients. We report a case of primigravida who presented with vaginal bleeding and severe nausae and vomiting. Expectant management was carried out for her pregnancy with finally ended in abortion.

TAR syndrome (Case Report)

NB.Mirbehbahani (MD)

Diagnsis of TAR syndrome usually are made at birth because of the characteristic physical appearace combined with thocmbocytopenia. The Two essential features of TAR syndrome are hypomegakaryocytic thrombocytopenia and bilateral radial aplasia. The rest of the phenotype varies widely and can manifest with abnormalities involving skeletal, skin, gasterointestinal and cardiac systems. Considering to limited cases of syndrome and variability of phenotypic abnormalities exess two essential features, all cases of this syndrome are reportable. We reported a patient with TAR syndrome with any related malformations.