Journal of Arak University of Medical Sciences

The Study of Education on Knowledge, Attitude and Practice of Physicians Regarding Pathogenesis, Diagnosis and Treatment of Helicobacter Pylori in Arak. IRAN

Ali Fani

Introduction: Although more than two decades is passed from the discovery of H.pylori and its role in pathogenesis of upper GI disease, a uniform protocol for H.pylori treatment is not administrated yet. This research is conducted to evaluate knowledge, attitude and practice of physicians about H.pylori disease and treatment and its changes after reading a review article.
Materials and Methods: This is an interventional study. First we prepared a compact, review article for the purpose of teaching H.pylori pathophysiology, diagnosis and treatment. Then thirty questions was brought out to evaluate knowledge, attitude and practice of the physicians about H.pilory diagnosis and treatment. After the first evaluations we gave our article to the physicians to study. One month later we repeated the evaluation with the same questionnaire. Data was analyzed by SPSS software.
Results: 304 physicians participated in this study. The mean evaluated knowledge was 49.64-58.75 with 95% confidence interval; which after education increased to 57.94-74.14 (p<0.05). Mean level of attitude and practice was 53.01-71.67 with 95% confidence interval. After studying it increased to 61.54-80.83 (p<0.05).
Conclusion: The first step of the study showed that test and treat is the protocol of choice for many physicians. After primary evaluation and introducing the compact article there was a noticeable change.

The Effect of Neck Massage on Chronic Tension Headache

Kobra Rahzani

Introduction: Tension headache is the most common type of headache. Tension headache is mostly caused by stress, anxiety and depression. Treatment is by pharmacological and nonpharmacological methods. Nowdays nonpharmacological methods are used increasingly. This is a response to the over use of drugs, side effects and cost. The purpose of chronic tension headache.
Materials and Methods: This research is a clinical trial study. 25 women suffered from chronic tension headache were treated by massage during 5 weeks. Samples were asked to record headache indexes in a checklist four times a day (before breakfast, before launch , before dinner and before sleep) through these 5 weeks. Data from the first and fifth weeks were recorded as pre and post intervention data and data from the second, third and fourth weeks of investigations were recorded as the data during intervention. During the intervention samples were treated twice a week for 20 minutes each time with the friction massage on posterior parts of the neck and shoulders. Headache indexes included: intensity, frequency and duration of headache, headache intensity was recorded using 11 points criteria. Headache frequency was measured by calculating the days of headache in a week and the duration of the headache was calculated by dividing sum of headache hours in a week to the frequency of attacks. Data was analyzed by analysis of variance and Tukey test.
Results: Results showed the positive effect of massage in which headache indexes showed a meaningful difference in three stages of pre, during and post intervention (p<0.01).
The recovery rates for each index were 52%, 28% and 57% respectively.
Conclusion: Massage therapy resulted in the reduction of intensity, frequency and duration of tension headache and can be useful in treatment of tension headache .

Oxidative Stress and Organophosphorous Status in Pesticide Manufacturing Workers

Akram Ranjbar

Introduction: Oxidative stress is one of the factors producing poisoning during chronic exposure to organophpsphporous poisons. In this research we studied oxidative stress status and acetycholinesterase in pesticide manufacturing workers.
Materials and Methods: This is a cross-sectional analytical study in which 45 organophopsphorous (OP) formulating pesticide workers with a minimum work history of 1 year in the age range of 23-35 were studied. Controls were age–matched workers of a food-making factory. They were evaluated for oxidative stress markers, including Tthiobarbituric acid-reactive substances (TBARS) indicator of lipid peroxidation (LPO), ferric reducing ability of plasma (FRAP) indicator of total antioxidant capacity, total Thiol (SH) groups and Gammaglutamyl transpeptidase (GGT) levels in blood and ACHE activity in erythrocytes.
Results: The results showed marked inhibition of ACHE, increased TBARS, decreased FRAP and decreased Thiol group level in workers. The reduction in activity of ACHE correlated well with increased TBARS and decreased FRAP in OP formualtors.
Conclusion: It is concluded that Op-formulating workers are exposed to more oxidative stress. The measurement of erythrocyte ACHE activity in pesticide workers who formulate Ops can be a good monitoring factor and is recommended to be performed in a regular manner.

Study of the Relationship Between Preterm Labor and Consuming Fruit and Vegetable Before and During Pregnancy

Nasrin Roozbahani

Introduction: Oxydative stress may cause preterm labor. Antioxidants found in fruit and vegetable prevent the oxidative stress reaction. In this study we intend to answer the question: Is any correlation between preterm delivery and use of fruit and vegetable before and during pregnancy?
Materials and Methods: It is a case control study in which 43 women with preterm delivery and 86 women with term delivery who delivered in Arak maternity hospital were selected randomly. (sample size was calculated with α=5%, β=20%). The two groups were matched for socioeconomic status, maternal age , gravid and vitamin supplement consumption. Data was collected with a questionnaire that includes demographic information, and use of fruit and vegetable (proportion in week ) during the three month before and second trimester in pregnancy. SPSS software and K-S, t (pooled), Mann-Whitney, Chi square and logistic regression were used to analyze the data.
Results: This study showed that the mean use of fruit and vegetable consumption calculated during the three month time before pregnancy was 20.64±2.48 in control group and 32.23±1.52 in case group and the relationship was significant (p<0.00001) and the mean.
Use during the second trimester was 21.84±4.75 and 34.84±5.58 in case and control groups respectively that was significant (p<0.00001). Accuracy, sensitivity and specificity of regression model were 90%, 87% and 91/9% respectively.
Conclusion: This study showed that fruit and vegetable consumption is related to the decreased incidence of preterm labor. Based on our model, preterm labor can be prevented and predicted with enough consumption of fruit and vegetables.

Study of Environmental Stress Frequency and Intensity in Adolescents of Central Area of Iran, 1381(2002)

Bahman Salehi

Introduction: Stress is a condition that causes tension, disturbance in body and mind , discomfort and unpleasant status. Adolescents are the most susceptible group of the community, a susceptibility which intensifies with age and kind of stressful events that happened during life. In this study we intend to find types of stressors and their severity in central area of Iran.
Materials and Methods: This is a descriptive study carried out on 2000 students between 12-18 years from urban and rural selected school of Isfahan, Arak and Najaf Abad in 1381 (2002) as a part of an annual report on healthy heart assessment program. Sampling methods was randomized clustering, and after collecting data based on GHQ12 (generalized health questionaire) data was analyzed by mean, standard deviation and chi-square based on SPSS version software.
Results: Of the total subjects under 9360 (51.2%) were males, and 887 (48.8%) were female, with a mean age of 15/97±1/90, 15/52±2/20 respectively. In general, the proportion of female students with high GHQ score was higher than male students. 38.8% against 32.7%. The score was higher in Arak than the other two cities. The most common stressful item was concern for a future career, which was also the most effective life event, and next to it was the parental death.
Conclusion: The severity of stress in female students of central area of Iran was higher than male, with a direct positive correlation with age, moreover, the most common stressful item was concern for a career and the most effective life event was also the same, and next to it was the parental death.

Comparison of Effects of Xylocaine and Sufentanil on Herat Rate and Blood Pressure Due to Laryngoscopy and Intratracheal Intubation

Hoshang Talebi

Introduction: Laryngoscopy and intratracheal intubation are one of the most painful and stimulant procedures with a severe autonomic responses. This research was performed to investigate affects of xylocaine and sufentanil on blood pressure and herat rate due to laryngoscopy and intratracheal intubation.

Materials and Methods: This research was performed on 100 patients in ASA class 1,2 which were condidated for elective surgery. Patients were divided into two equal groups. For first group xylocaine 1.5mg/kg was injected 90s before laryngoscopy and the second received 0/2 mcr/kg sufentanil 120s before that, then laryngoscopy and intratracheal intubation was performed. Maintenance of anesthesia was the same for two groups. Herat rate and blood pressure were measured from the beginning of the laryngoscopy till 9 minutes after that, with three minutes interval.

Results: Finding showed that in the time of laryngoscopy, sufentanil and xylocaine had equal affects on hemodynamic changes. Also there was no significant difference between two named drugs on diastolic pressure. But in the third, sixth and ninth minute after laryngoscopy sufentanil controlled systolic blood pressure and heart rate significantly better than xylocaine.
Conclusion: Findings of this survey showed that sufentanil could manage hemodynamic changes due to laryngoscopy and intratracheal intubation netter than xylocaine. with due attention to low side effect of sufentanil. It is suggest to use this drug for high risk patients.

Comparison of Thyme Combination Regimen With Routine Regimen for Eradication of Helicobacter Pylori (HP) in Peptic Ulcer Patients

Amir Hoshang Mohammad Alizadeh

Introduction: Hp is the most common human infection which can result in gastritis, peptic ulcer and gastric adenocarcinoma and lymphoma. Several combinations of drugs have been tested in HP eradication. Thyme is a herbal drug that has antiseptic and GI anti spasmodic characteristics. In this study we tested Thyme combination regimen in comparison with routine regimes.
Materials and Methods: This is a randomized clinical trial study. 90 patients with GI symptoms, confirmed peptic ulcer and HP infections, were divided into three groups, group A (Omeperazole, Bismuth, Metronidazole and Tetracycline), group B: Omeperazole, Bismuth, Metronidazole, Tetracycline and Thyme and group C: Bismuth, Omeperazole, Tetracycline and Thyme. Duration of treatment was 2 weeks . after treatment they were given Ranitidine for 2 weeks and 2 weeks without any treatment and then they were evaluated for HP and peptic ulcer.
Results: Distribution of sex, age, and smoking was equal in three groups, 81 (90%) of cases had upper epigastric pain. Clinical recovery rate was 96.6% in group B and C which was more than group A (p=0.43). After treatment endoscopy showed 70% complete relief in group C which was significantly more than two other groups (p=0.04). Complete response rate (negative RUT+ negative HP histology) was 46.7% in group C (p=0.03).
Conclusion: In general, group C regimen that substituted Thyme with Metronidazol was more effective in HP eradication. With regard to high effectiveness, low complication and low cost of Thyme, we suggest that adding this drug to routine quadriple HP eradication regimens could be useful.

Comparison of Spleen and Live Dendritic Cell of Mouse in Induction of Lymphoproliferative Response

Ghasem Mosayebi

Introduction: Dendritic cells (DCs) play an important role in induction of cellular immune responses. It has been showed that the nature of the immune responses is not the same in all tissues. It seems that DCs reside in different organs may distinct in their ability to induce lymphocyte proliferation .The innate tolerogenic characteristic of the liver may be due to the inability of liver DCs to induce proliferative responses.
Materials and Methods: In this study, the DCs were isolated from the liver and spleen of normal C57BL/6 mice by enzymatic digestion and nycodenz centrifugation gradient. Isolated DCs were pulsed with a proper concentration of myelin oligodendrocyte glycoprotein peptide (MOG35-55). About 6*105 pulsed DCs from liver and spleen were injected to the footpad of two different groups of mice. Unpulsed Dcs were injected to control group. After 5 days, the mononuclear cells (MNCs) of the popliteal lymph nodes were isolated from immunized mice and their proliferative response were evaluated in the presence and absence of MOG35-55.
Results: The obtained results showed that the proliferartive response intrnsity of MNGs in mice immunized with pulsed DCs were higher than control group (p<0.004). furthermore there was no significant difference between proliferative response of mice immunized with liver DCs and those immunized with splenic DCs. These finding showed that the liver and spleen DCs could be pulsed proplerly with the antigen in tissue culture and can induce a reasonable proliferative response.
Conclusion: The equal ability of liver and spleen DCs to induce the proliferative response indicates that the type of induced response may differ at in vivo and ex vivo conditions and microenviromental factors can modulated the immune response.