Journal of Gorgan University of Medical Sciences

The long-term effect of Hinosan on Spermatogenesis on the Balb/C Mice

Esmail Fattahy

Background & Objective: Hinosan is an organophosphate that inhibit acetylcolinesterase activity, which could be resulted in damages of genital organs. This compound has been used extensively in the agriculture, for pest control. Therefore, in the present study we investigated the effect of Hinosan on spermatogenesis in mice.

Materials & Methods: For this experimental study, the male mice were divided into three groups. In the cases group, mice were injected with Hinosan consecutive doses (20mg/kg i.p, five consecutive days per week for one month), sham (normal saline) and control (no injection). Animals were scarified 7 days after the latest Hinosan injection. Therefore, the mice testis sections were prepared and morphologic aspects of testis and spermatogenesis processes were examined. Data were analyzed using of one-way ANOVA. Significance was set at P<0.05.

Results: The Hinosan showed a significant decrease in number of germ cells, spermatocyt, spermatids, Leydig cells, blood vessels and also diameter of seminiferous on testes of the mice decreased, compared with control groups (P<0.05).

Conclusion: This study demenstrated that Hinosan is effective on spermatogenesis and seminiferous tubule structure, also can decrease germinal cells.

The protective therapeutic effect of Silymarin in acute hepatotoxicity of CCl4 in rats

Hossein Ayatollahi

Background & Objective: Tetra Carbon Cholride has been known as reference hepatotoxin because it can cause necrosis, fatty change, cirrhosis and cancer liver. Silymarin has hepatoprotective and anti hepatoxin effect. This study was done to determine the protective effect of Silymarin in acute hepatotoxicity of CCl4 in rats.

Materials & Methods: In this experimental study, we chose 25ml/kg dose of CCl4 (in mineral oil solvent) as an optimum dose. The hepatotoxic effects of intraperiotoneal injection of CCl4 for obtaining parameters of toxicity and therapeutic effects have been examined. According to enzymatic results (increase in ALT and AST) and histopathologic changes (grading the changes in liver including cytoplasmic granularity, cloudy swelling, necrosis and fatty change), the interval between prescribing silymarin and sampling was determined. Silymarin as a suspension in propylene glycol CMC 2% (3/2 ratio) has been prescribed in 50, 200 and 800mg/kg doses and serum and liver samples were obtained. Negative control group received silymarin vehicle in CCl4 solvent, drug control received 800 mg/kg of silymarin in CCl4 solvent and positive control received silymarin vehicle after injecting CCl4.

Results: The results showed that prescribing 50mg/kg silymarin one hour after injecting CCl4, in addition to inhibiting transaminase activity, prevents progress of liver injury up to 50% of positive control group. Cellular repair and regeneration are also enhanced, So the grade 3necrosis in positive control group is decreased to grade 0.5 in silymarin gourp in 48 hours prescribing silymarin (50mg/kg).

Conclusion: This study showed that up to six hours after injecting CCl4 significantly prevents hepatotoxicity, and cause acceleration in repair of liver injuries.

The comparison therapeutic effect of Naltrexone and Flouxetine on Obsessive-Compulsive Disorder (O.C.D) A clinical trial study

Abbas Masoudzadeh

Background & Objective: In spit of high prevalancey of the Obsessive-Compulsive Disorder in anxity diseases. It shows the least therapeutic responses. This study was done to determine The comparison of therapeutic effect of Naltrexone and Flouxetine on Obsessive-Compulsive Disorder (O.C.D).

Materials & Methods: This double-blind clinical trial study was done on 30 patients aged 18 to 60 years referring to the clinics of psychiatry at Zareh hospital in Sari-Iran during 2006. Patients in three groups, treated with flouxetine 53.9mg/d (group A) Naltrexone 64.4mg/d (groupe B) & Pelacebo (group C) in the same shape capsula respectively. The severity of O.C.D was evaluated at 4 steps with Yale-Brown scale.the obtained data were analyzed using parametric & nonparametric tests.

Results: Naltrexone reduced the severity of O.C.D symptoms significantly (45.01%) at the end of week 8^th (p<0.05). Same result (45.81%) was observed using Flouxetine (P=0.79). The rate of efficaey in both drugs significantly was higher than pelacebo (P<0.05).

Conclusion: This study showed thant, Naltrexone has the same level of reducting symptome of OCD but even with faster therapeutic effect than Flouxetin.

Relationship between bone densitometric findings and Mental Index of the mandible observed in panoramic radiography in women

Ali Bagherpour

Background & Objective: Bone densitometry is an appropriate method for the evaluation of the patients’ skeletal status. This study was done to determine, the relationship between MI (Mental Index) of mandibular bone in panoramic radiography and skeletal status in femoral neck and lumbar vertebrae (L2-L4) in women referring to the radiology department.

Materials & Methods: In this cross sectional descriptive study, the panoramic radiographs of 67 healthy women over 35 years old referring to radiology department Mashhad, Iran during 2004, were assessed and their MIs recorded. All of the patients were then referred to Toos Bone Densitometry Center, for bone densitometry in left femoral neck and lumbar vertebrae (L2-L4), using DEXA technique with Osteocore apparatus. The patients were divided into three categories of normal, osteopenic and osteoporotic in each skeletal region according to their T-score. The data were analyzed using ANOVA and Pearson's correlation coefficient.

Results: The mean of Mental Index between normal and osteopenic subgroups of skeletal status in femoral neck showed a significant difference (P=0.042). The mean of Mental Index between normal and osteoporotic and osteopenic and osteoporotic subgroups of skeletal status in lumbar spine region showed a significant differences (P=0.02 & 0.05, respectively). The Mental Index was significantly related to T-scores in femoral neck and L2-L4 regions (r = 0.33 & 0.32, respectively, P<0.01).

Conclusion: This study showed that using Mental Index of mandibular bone can be useful for estimating skeletal status of patients but is not enough for precise evaluation of skeletal status of patients.

The effect of lidocaine in reducing pain following Propofol injection (Lipuro%1)

Kazem Kazemnejad

Background & Objective: Propofol is one of the latest anesthetic agent which has many advantages with few side effects in patients. One of the application problems of this drug is pain at the time of injection. Several methods are investigated to reduce the pain, and one of them is the application of Lidocaine together with Propofol.

Materials & Methods: This randomized clinical trial study was done in 5th Azar teaching during 2007. 272 patients were selected randomly between age of 15-55 years with ASA Class I,II who were the candidates of elective surgery. We injected Fresenius %1 to the first group with 91 patients, Lipuro %1 to the second group with 90 patients and Propofol drug Lipuro %1 mixed with 20 mg Lidocaine (2 ml of Lidocaine %1) to the third group with 91 patients. Injections was carid out on the supenlial vein of dorsal hand. Patients were asked about the severity of pain at the time of injection, 5-10 seconds after %25 of anesthetic induction doze. Data analyzed with using SPSS software and Chi-Squre test.

Results: The rate (incidence) of pain (Score 1-3) has been 63.91 (%69.2) in the first group, 50.90 (%55.6), and 22.9 (24.2%) in the third group in which there is a significant difference (P<0.001). Moderate and sever intensity of pain (Score 2.3) was 42.91 (46%) For the first group, 18.90 (20%) for the second group and 2.91 (2.2%) for the third group (P<0.001).

Conclusion: On the basis of this study, it is recommended to use lidocaine, at the time of injection, to reduce pain.

Incidence and management of major complications of ureteroscopic lithotripsy in Esfahan, Iran during 1994-2006

Peyman Salehi

Background & Objective: Ureteroscopic lithotripsy is a prevalent and minimally invasive modality for the management of ureteral calculi. This study was done evaluate to the incidence and management of major complications in 3900 cases of ureteroscopic lithotripsy. Materials & Methods: This descriptive – cross sectional study was done on 3900 cases of ureteroscopic lithotripsy in Isfahan – Iran, during 1994-2006. All complications and treatment of patients recorded. Results: Major complications occurred in 29 cases either intraoperatively or postoperatively (1 to 30 days), including ureteral perforation in 16 cases, ureteral avulsion in 7, urinoma in 4 and perinephric abcess in 2. Two cases of uretral avulsion at the ureterovesical junction underwent ureteroneocystostomy. The other 5 cases were managed by psoas hitch together with Boari flap, transureteroureterostomy, open placement of double J stent with omental wrap, and ureteroscopic placement of double J stent and ileal substitution. Urinomas were managed by percutaneous drainage of the urinoma and placement of double J stent (3 cases) and open surgery (1case). Two cases of perinephric abscess were managed by open surgical procedure and double J placement. Fourteen cases of ureteral perforation were managed by ureteroscopic double J placement and in 2 cases by open surgery. Conclusion: Ureteroscopic lithotripsy is an excellent and minimally invasive modality for the management of ureteral calculi. Major complications may occur, emphasizing the need for constant vigilance and precautionary measures.

Diagnostic value of serum Adenosine deaminase and its isoenzymes in the diagnosis of pulmonary tuberculosis

Hamid Reza Joshaghani

Background & Objective: Adenosine deaminase is an enzyme which catalyses adenosine to Inosine. The determination of adenosine deaminase in body fluids is important for the diagnosis of tuberculosis. There are contradictory reports about the diagnostic value of serum adenosine deaminase in pulmonary tuberculosis. This study was set up to investigate the diagnostic value of serum adenosine deaminase and its isoenzymes activities on pulmonary tuberculosis. Materials & Methods: In this descriptive study, blood samples were obtained from 26pulmonary tuberculosis patients (group 1), 17 suspected tuberculosis with negative in both smear and culture tests (group 2), and 67 healthy subjects (group 3). Total ADA and ADA2 determination was carried out by kinetic method and EHNA Inhibitor, respectively. Results: ADA and ADA2 activities are as follow: 19.35±5.04, 13.35±5.34 (group 1) 17.24±6.20, 11.47±3.92 (group 2) and 13.96±4.25, 7.36±2.91(group 3). The mean differences of ADA and ADA2 activity between group 1 and 2 with group 3 was meaningful. The sensitivity and specificity for ADA and ADA2 tests were (26.9%, 94 %) and (50%, 97 %) respectively. The PPV for ADA and ADA2 were 63.6% and 86.7% and the NPV were 76.8% and 83.3%, respectively. Conclusion: This study indicated that the assessment of these enzymes in serum to some extend can be a useful method for differentiation of healthy subjects from respiratory disease, but these tests do not have enough sensitivity to assist in the diagnoses of tuberculosis patients from other respiratory diseases.

The comparison of nerve fibers, schwann cells and mast cells in acute appendicitis with normal and non inflamed appendix with clinical symptoms

Mohammad Reza Jalali Nadoushan

Background & Objective: The pathogenesis of appendicitis remains poorly understood. However there is increasing evidence of involvement of the enteric nervous system in immune regulation and in inflammatory responses.This study was setup to characterize the status of the enteric nervous system and mast cells in acute appendicitis with normal and non inflamed appendix with clinical symptoms Materials & Methods: In this descriptive study, staining in surgically resected appendixes from 15 patients with histologically proven acute appendicitis (Histologically appendicitis, HA), 15 histologically normal appendix (Histologically normal, HN) from patients with a clinical diagnosis of appendicitis and normal histology,and15 normal appendixes from patients undergoing elective abdominal surgery were studied in Shaid Mostafa Khomeyni medical center, Iran during 2000-01. S100-Positive schwann cells and synaptophisin-positive nerve fibers were evaluated with immunohistochemical staining and mast cells were evaluated with histochemical staining with Toloiden –blue.The number of nerve fibres, schwann cells and mast cells in each tissue compartment was measured quantitively with light microscope in 20 microscopic high power fields. Then the mean number of cells was calculated in each field (×400). Results: Increased numbers of fibers and schwann cells widely distributed in the Muscularis and submucosa were seen in the all HA appendixes. Increased numbers of mast cells distributed in submucosa were seen in the all HA appendixes. A significantly increased number of individually stained nerve fibers, schwann cells and mast cells were present in HA appendixes compared with control appendixes (P<0.05). Conclusion: In this study showed that significant increase in neural components and mast cells in acute appendicitis indicates the interaction between the nervous system and mast cells in pathogenesis of acute appendicitis.

Frequency of intestinal parasites in patients with malignancy, admitted in oncology ward of Sina Hospital, Hamadan, Iran

Seyyed Hamid Hashemi

Background & Objective: Enteroparasitic infections constitute a serious public health problem in different populations including developed countries. Patients who receive chemotherapy of cancer have an increased probability of acquiring parsitic infections, generally with a high degree of severity. The aim of present study was to ascertain the frequency of intestinal parasites in patients admitted in oncology ward for chemotherapy. Materials & Methods: In a descriptive study, all the patients whith malignancy who admitted in Sina Hospital in Hamadan, Iran, during 2005 were included. Data including demographic characteristics, type of malignancy, and the time past from the diagnosis entered the questionnaires. A stool specimen were examined for each patients. Data were analyzed using SPSS software. Results: Out of 190 patients, 94 (49.5%) were male and 96 (50.5%) were female. The mean age was 48.518.7 years (12-88 years). Thirty-one (16.3%) patients were involved intestinal parasites. The most common parasites were: Ascaris (41.9%), Giardia (35.5%), Indolimax nana (3.2%), Blastocytis hominis (3.2%), and Cryptosporidium (3.2%). The highest prevalence of intestinal parasites belonged to 40-60 years age group Conclusion: This study indicated that, the prevalence of intestinal parasites in patients undergoing chemotherapy for malignancy is lower than general population, which can be related to the effect of antineoplastic agents.

Knowledge about AIDS among Iranian red crescent volunteers and effect of an AIDS educational program

Gholamreza Roshandel

Background & Objective: The Acquired Immunodeficiency Syndrome (AIDS) is in its third decade and has become a pandemic disease that threatens the world population. Educational programs are well known as the most effective strategy to preventing the AIDS. The purpose of this study was to determine the knowledge and attitude of participants about AIDS and to test the effects of an AIDS education program on it. Materials & Methods: This case-control study was conducted during 2005. 149 Red Crescent personnel in Golestan, Iran. The sample subjects participated in a pre/post intervention study. The activity consisted of a workshop 90 minutes in length, in conjunction with educational material. A 13-item questionnaire was used as the gauging tool. Results: 47% of subjects had adequate knowledge about AIDS. Mean level of knowledge in post-test exam was significantly higher than pre-test one (P<0.0001). Individuals with higher educational level (high school and university) had lower knowledge in pre-test (P=0.001), but the difference in pos-test was not significant. A significant relationship was shown between the history of participation in previous AIDS education programs and subject's knowledge in pre-test (P<0.001). Conclusion: This study indicated that education program based on special traing considerably increase general awareness and attitde towards AIDS.

The prevalence of Co-infection with HCV and HDV in HBV infected patients in Golestan province of Iran

Gholamreza Roshandel

Background & Objective: Hepatitis B virus (HBV) infection is one of the most important health problems all over the world. This study was conducted to determine the co-infection of hepatitis C virus (HCV), hepatitis D virus (HDV) in HBV infected patients in Golestan province of Iran. Materials & Methods: This population based cross sectional study was done in 2004. 139 HBsAg positive cases were assessed for co-infection with HCV and HDV. Serologic tests were done by ELISA method using available kits. Data were analyzed by SPSS-12 and STATA8 software. P-values of less than 0.05 were considered as significant. Results: Sixty eight (48.9%) of 139 cases were males and 71 (51.1%) were females. The mean (±SD) of participant's age was 41.89 (±11.3) years (range: 25-64 years). Anti-HCV and Anti-HDV antibodies were positive in 17 (12.3%) and 8 (5.8%) cases, respectively. Females were more infected with HCV and HDV than males. But the differences were not significant. Conclusion: The prevalence of co-infection with HCV and HDV in HBV infected cases is relatively high and notable in Golestan province of Iran. Because of negative effects of these co-infections in clinical outcome of the disease, it is recommended to assess possible HCV and HDV infection in individuals with HBV infection. This may result in more efficient management of the disease.

The educational needs at time of hospital discharge of men and women who have myocardial infarction

Vida Shafiepour

Background & Objective: Myocardial infarction is one of the common cardiovascular diseases and is the main cause of mortality among the patients. Essential educations should be done according to assessment and determination of their educational needs and their gender. The purpose of this study was to determine and compare educational needs in men and women with myocardial infarction at discharge time. Materials & Methods: This descriptive-comparative study was done on hospitalized 200 men and women in Sari medical central- Iran during 2006. The questionnaire were used to determine educational needs of patients. In cardiac wards, with myocardial infarction for the first time, in six domains of physical activity, medication, diet, treatment, complication and enhancing quality of life. Results: The findings of this study indicated that the lowest requirment of men and women in this study were improving quality of life and awarness about diet respectively. Conclusion: This study showed that a patients gender should be taken into consideration, when they are trainine and subsequently health care provider can organize the specific needs of the subjets.

A variation of lateral cord of brachial plexus - A case report

Nahleh Zareefard

The brachial plexus is the plexus of nerves that supply the upper limb. Anomalies in the formation of lateral cord of brachial plexus and communication between its branches are commonly observed but the variation of the course of lateral cord is very rare. We observed that lateral cord of brachial plexus and its branch had a different configuration in dissecting room in Bandar Abbas medical school. Here, the lateral cord pierced the coracobrachialis muscle and then divided into the musculocutaneus and the lateral root of median nerve. After a distance , the lateral root of median nerve joined the medial root of median nerve, and median nerve formed anterior to brachial artery. The rest of the course of the median nerve and the musculocutaneous was normal in arm region.

Anisocoria an unusuall finding in endoscopic sinus surgery

Mohammad Hosein Taziki

Endoscopic sinus surgery can cause orbital and intracraniol complications. Anisocoria is one of sings of orbital complication. We report a case with anisocoria during endoscopic sinus surgery. Patient was a 42 years old female that was operated because extensive polyposis in right nose and sinuses and retention in otherwise under general ansthesia. A half on hour after the surgery was started, we found dilatation of pupil in left eye which unresponsed to light. Also, as far as the eye symptoms returned to normal after 8-10h after and there was not any veridence of orbital trauma. It seems difiusion of local injection of adrenalin in surgery nasal cavity can probably case of pupil dilatation.