نشریه دانشور پزشکی
پیاپی 116 (اردیبهشت 1394)

One of the approaches for treatment of demylination diseases is cell therapy. Stem cells have been used as a source for generating oligodendrocyte. In a previous communication، the oligodendrocyte-like cells (OLCs) were generated from bone marrow stromal cells (BMSCs) using preinducers (dimethyl sulfoxide and retinoic acid) and induction protocol (PDGF، bFGF، heregulin and T3). In this investigation، we tried to increase the yield of oligodendrocyte-like cells (OLCs) by inducing the neural stem cells generated from neurospheres-derived BMSCs. In this research study، BMSCs of adult female rats were expanded and then induced to form neurospheres (NS) using B27، the epidermal growth factor (EGF) and the basic fibroblast growth factor (bFGF)، and subsequent isolation of neural stem cells (NSCs). This was followed by induction of the NSCs into OLCs with heregulin، PDGF-AA، bFGF and T3. BMSCs، NS، NSCs and OLCs were characterized using immunocytochemistry for fibronectin، CD44، CD90، CD45، Oct-4، O4، Oligo2، O1 and MBP markers. PDGF receptor α (PDGFR-α)، Olig2 and MOG expression were evaluated using RT-PCR. The BMSCs expressed CD44، CD90، CD106 and Oct-4; the NSCs were immunoreactive to nestin and NF68، while the OLCs were immunoreactive to O4، Oligo2 and O1. In differentiating OLCs، Olig2 and PDGFR-α mRNA was detected using RT-PCR technique. Functional OLCs were generated from BMSCs-derived NS with high yield and were able to produce myelin after co-culture by motor neurons.

Despite current efforts for treating the spinal cord injury (SCI), cell therapy and pharmacological methods have a great curing potential in this field. In this study, application of acetyl L carnitine as one of the possible pharmacologic approaches in SCI treatment was investigated. The effect of this material in adult rats suffering from spinal cord compression was examined by counting the number of motor neurons and expression of the P75 receptor and BNDF neurotrophin. In this research study, 16 adult rats were divided into 4 groups with different treating protocols: 1- laminectomy and intraperitoneal injection of acetyl L carnitine 2- laminectomy and intraperitoneal injection of acetyl L carnitine and spinal cord compression 3- laminectomy and intraperitoneal injection of saline 4- laminectomy and spinal cord compression with intraperitoneal injection of saline. After 4 weeks, the rats were sacrificed. Then, the morphometry was carried out and the spinal cord motor neurons were counted using the Cresyl fast violet technique. Expression of the P75 receptor and BNDF neurotrophin was performed by using immunohistochemical technique. The obtained results indicated that the spinal cord compression reduced the number of motoneurons. The acetyl L carnitine mitigated the rate of the observed reduction in the number of motoneurons. It also helped to increase the expression of BNDF neurotrophin after spinal cord compression. Neuroprotective effect of acetyl L carnitine could stem from its anti-inflammatory and neuroprotective properties which are likely to be in charge of the observed decrease in the number of dead motoneurons and subsequent increase in expression of neurotrophin and reduction of oxidative stress after spinal cord compression.

According to recent research, the rate of psychiatric disorders, especially mood and anxiety disorders and suicide attempt in HIV-positive patients are high and group Cognitive Therapy (CT) is found an efficient method to treat many psychological problems and psychiatric disorders. The aim of the present research was to evaluate the effect of group CT in reducing depression, anxiety and perceived stress of HIV-positive men. The research design was Quasi-experimental with control group and random allocation with pre-test and post-test. At first, the active documents of 131 HIV-positive men were investigated, and all of them were evaluated with scale DASS21 which measures psychological symptoms of depression, anxiety and stress and it was found that 54(41.2%) patients have scores above the cut-off point. From this number, 30 patients were selected and by random allocation method divided into two groups, experimental (n=15) and control (n=15). The experimental group was participated in 12 sessions of group CT, but the control group did not have any psychological intervention. At the end of interventions, both groups were evaluated again. Multivariate analysis of covariance (MANCOVA) showed that group CT significantly is effective in reducing depression (F=20.101, p<0.0001), anxiety (F=38.817, p<0.0001) and stress (F=77.199, p<0.0001) men with HIV (p<0.0001). Experiencing the challenging relationship between negative automatic thoughts and psychological symptoms by group CT was successful in men with HIV.

Advice and guidance of students during their studying period are one of the most important responsibilities of university professors. Medical students are exposed to a variety of stresses which may affect their education and health. This study was designed to determine Shahed University medical students view and satisfaction about performance of academic advisors. This cross sectional descriptive study was performed on 200 medical students, after entrance into clinical course at Shahed University. Information was gathered via a reliable and valid researcher-made questionnaire. Statistical analyses were performed with SPSS 16 software. P‹0.05 was considered significant. Shahed Medical students reported that the best way for selection of academic advisor is by themselves (58%). Meanwhile, 66.5% of students preferred to be in guidance of same gender academic advisor and 48% of students preferred to interact with their academic advisors in both face to face and non-face to face methods. Satisfaction of many students for assessing the previous and current academic status of students, introducing academic and university rules, time and place programming for consultation and accessibility to academic advisors and findings educational problems were high. But overall satisfaction from academic advisors performance was medium. Results of this study showed that overall satisfaction of Shahed medical students from academic advisors were medium, therefore revision and some changes in selection of advisors guidance, programming for students’ consultation and suitable supervision of advisor guidance responsibilities are required.

Unwanted pregnancy is a pregnancy that is considered to be unwanted by at least one member of the couple, and has adverse consequences for the family and community. Using four classification models, this study predicted unwanted pregnancy in the urban population of Khorramabad and compared these classification models. In this cross-sectional study, 467 multiparous pregnant women attending the urban health care centers of Khorramabad in 2011 were selected using stratified and cluster sampling and risk factors were collected. The logistic regression model, discriminant analysis, decision trees, andCART artificial neural networks, along with the SPSS and MATLAB software were applied in data modeling. The indices of sensitivity, specificity, area under the ROC curve, and accuracy rate were applied to compare the models. The prevalence of unwanted pregnancy was 32.3%. Based on the index of area under the ROC curve,ROC the best models were artificial neural networks (0.741), decision tree (0.731), logistic regression (0.712) and discriminant analysis (0.711). The highest. sensitivity was found for decision tree model (73.5%), and the highest specificity was for artificial neural network (62.3%). Given the relatively high prevalence of unwanted pregnancy in Khorramabad, the revision of the family planning programs seems to be inevitable. Moreover, in selecting the best classification method, decision tree and logistic regression are recommended when the researcher is interested in better interpretability of the results, and the model of neural networks is recommended when a higher prediction power is intended.

Dental caries is the most common human infection. The most important indicator of dental caries is DMFT. Control of dental caries requires prevention programs. Prevention needs full knowledge of the possibilities that can be achieved through epidemiological studies. The aim of this study was to compare DMFT index in 8-12 year retarded students in special schools in Zahedan city with healthy subjects and evaluation of its relationship with factors such as age, sex, and educational level.

This descriptive, cross-sectional study was performed on 200 students including 100 healthy students and 100 mental retarded students. 50% of them were female and 50% were male. The sampling was randomized stratified. A questionnaire was completed for each student and DMFT index was measured by clinical examination according to WHO criteria. The data was analyzed using SPSS19 and t- test and ANOVA. Significant level was 0.05 and correlation coefficient Pearson was obtained.

The mean DMFT index was 2.92 ± 1.67 in normal students and 4.03 ± 1.92 in retarded students. DMFT in mentally retarded children had a significant relationship with age. In mentally retarded children, DMFT had no significant correlation with other studied variants.

Based on this study, the Health index of mentally retarded children is lower than WHO standards.

The glucose metabolism improvement and the risk reduction of the diabetes type 2 by caffeine consumers have been reported. Today, glibenclamide is commonly used in the treatment of diabetes. This research aimed to investigate the therapeutic combination effect of caffeine and glibenclamide on serum lipids and glucose in type 2 diabetic rats. In this research study, 32 rats in four groups were divided into diabetic and diabetics treated with glibenclamide, caffeine, and caffeine-glibenclamide combination. The drug dose for glibenclamide was 0.285 mg/kg, for caffeine was 100 mg/kg and for their combination was 1:1. Diabetes was induced by the injection of a single dose of 60 mg/kg of streptozotocin. The treatment continued for 16 days after diabetes verification. The levels of serum glucose and lipid profile in the rats were measured at the end of the period. The present research showed that the combination of glibenclamide and caffeine with 50% effective dose could significantly decrease the serum glucose as compared to the control group at days 4, 9 and 16 (p < 0.05). The combination resulted in a significant reduction in triglyceride and a significant increase of HDL and HDL to LDL ratio, while these changes were not observed for glibenclamide or caffeine individually. The therapeutic combination of glibenclamide and caffeine improved the serum glucose and could have significant beneficial effects on the level of triglyceride and HDL cholesterol levels in the diabetic rats.

Parkinson's disease is a rather common movement disorder in aged individuals due to degeneration of dopaminergic neurons within the substantia nigra pars compacta. Due to antioxidant, anti-inflammatory and protective effects of the flavanone hesperetin, the present study assessed dose-dependent effect of hesperetin on motor asymmetry induced by intrastriatal injection of 6-hydroxydopamine in the rat. In this experimental study, male rats (n=35) were divided into sham, lesion, and hesperetin-treated lesion groups. Model of Parkinson's disease was induced by injecting 12.5 microgram of 6-hydroxydopamine-ascorbate dissolved in saline-ascorbate solution into the left striatum. Treated lesion groups received hesperetin at doses of 5, 15, and 50 mg/kg/day p.o. one hour after surgery for 1 week. After 1 week, leftward and rightward rotational behavior induced by apomorphine was assessed. In the lesion group, apomorphine caused contralateral rotational behavior (P<0.001). Administration of hesperetin only at a dose of 50 mg/kg significantly reduced the number of contralateral rotations (P<0.05) and it had not such an effect at other doses. Oral hesperetin treatment at a dose of 50 mg/kg reduces motor asymmetry (attenuation of rotational behavior) in an experimental model of Parkinson's disease.

A major challenge that affects the longitudinal studies is the problem of missing data. Missing in the data may result in the loss of part of the information which reduces the accuracy of the estimator and obtain the results will be biased and inaccurate. Therefore, it is necessary to evaluate the missing data mechanism from a longitudinal research and to consider this fact, an analysis should be performed on the data with or without imputation. The purpose of this study was to identify the Missing data mechanism from a clinical trial Related to the efficacy of non-surgical method of joint distraction in improving performance in patients with severe knee osteoarthritis, and the effect of different approaches to dealing with the missing on the results the analysis of this data set.

In order to obtain reliable results in the analysis of the data associated with the longitudinal clinical studies involving missing values, there are different approaches for dealing with such data, including complete case data approach, available data, LOCF and multiple imputation methods such as predictive model based method, propensity score method (propensity score) and predictive mean matching method (Predictive mean matching method). This approaches were used on the data obtained from clinical trial of the effectiveness of non-surgical joint distraction by two methods physiotherapy and joint distraction in addition to physiotherapy in improving patients performance with severe knee osteoarthritis were measured in three times, beginning of treatment, end of treatment and one month later and the results were compared. SAS 9.1 software was applied for fitting the marginal model and SOLAS software version 4 for missing data imputation.

By using the complete data, available data and LOCF imputation approaches time effect was significant. All the three multiple imputation methods had the same results. In none of the approaches used, the effect of treatment group was not significant, although there were significant differences in the length of confidence intervals and coefficients of the model.

According to the missing data mechanism and results obtained from coefficients of the model, standard errors and confidence interval length, to use of multiple imputation approach in the data is more appropriate and LOCF imputation method is not appropriate for interventional longitudinal data.