مجله مطالعات علوم پزشکی
سال بیست و هشتم شماره 3 (خرداد 1396)

Nausea and vomiting during spinal anesthesia for elective cesarean delivery is a common finding and may occur in up to 80% of patients. The aim of the present study was to compare efficacy of using intravenous midazolam alone, ondansetron, and midazolam in combination with ondansetron for prevention of nausea and vomiting during and after cesarean delivery in parturient that underwent spinal anesthesia.
In a double-blind study, 126 women undergoing elective caesarean section under spinal anesthesia (using 0.5% bupivacaine 12.5 mg) were allocated randomly to receive midazolam 2 mg (n=42), ondansetron 4 mg (n=42) or midazolam and ondansetron (n=42) after the clamping umbilical cord. The frequency of nausea and vomiting during and after surgery in recovery room were recorded.
The frequency of intraoperative nausea and vomiting was lower in the O (28.6, 7.1%) and MO (26.2, 16.7%) groups compared with M (50, 31%) group (P=0.04, P=0.006). The frequency of nausea and vomiting after surgery in recovery room was lower in the O (4.8, 19 %) and MO (11.9, 7.1%) groups compared with M(38.1, 23,8 %) group (P=0.01, P=0.03). Metoclopramide consumption was lower in O and MO groups compared with M group (P=0.02). There was no difference in mean arterial pressure and pulse rate between three groups during the surgery at times measured.
A bolus dose of midazolam (2 mg) was not effective than ondansetron (4mg) and ondansetron plus midazolam (O 4 and M 2 mg) for the prevention of nausea and vomiting in parturient patients undergoing cesarean section with spinal anesthesia during and after surgery in recovery room; however, further studies are needed.

There have been few studies regarding the neuropsychological evaluations in different symptom dimensions of Obsessive compulsive disorder (OCD) and previous studies around this field have led to contradictory results. Therefore, the aim of the current study was to evaluate the neuropsychological functions of different symptom dimensions of OCD.
This was a descriptive-correlative study and the population comprised of all OCD patients who had referred to the counseling and mental health office of Medical Sciences University of Tabriz in 2015. Using purposive sampling 33 patients were selected to participate in the study. The measures applied in this study were: DOCS, Y-BOCS, BDI-II, WCST, word- color stroop, WMS-R and GO-NO GO.
The results indicated that all OCD dimensions, contamination, responsibility for harm and symmetry dimensions were correlated with poor performance in neuropsychological experiments; nevertheless, there was no significant association between participants’ scores on the dimension of unacceptable obsessions and their functioning in the neuropsychological experiments.
According to the findings of the study, it could be suggested that the different symptoms of OCD were associated with different levels of performance in neuropsychological experiments. These implications could provide useful information for clinical interventions, assist clinicians in the diagnosis of vulnerability to the disorder, and facilitate the preventive strategies.

Salmonella Typhimurium is among the most important food-borne disease. This study was conducted to investigate the anti-biofilm effect of the S. Typhimurium phage against Salmonella formed in chicken meat model.
The effects of different phage concentrations (104, 106 and 108 PFU/mL) with two contact times (10 and 20 min) on one and 7 days old biofilm adhered to stainless steel coupon in chicken broth at 15, 8 and 4 °C were evaluated.
The results showed that the bacteria had an ability to adhere to the coupons and form biofilm in chicken broth, the biofilm levels were significantly (0.05 ≥ P) higher at 15 °C for 7 days. Increasing the phage concentrations, resulted in no significant biofilm removal properties and the activity was not influenced by the phage contact times. The anti-biofilm activity was influenced by the age of biofilm, in this case, one day-old biofilm was more sensitive than 7 days old.
From the study it can be concluded, that in chicken model, the phage exhibited biofilm removal activity on Salmonella only at high concentrations, then the use of a combination of methods to control biofilm is recommended.

One of the most important issues in training, diagnosis, and treatment in orthodontics is a thorough understanding of patient’s growth pattern. Imbalances in this pattern can cause malocclusion which is one of the most important causes of referring patients for treatment. At the first step, dentist’s responsibility is the diagnosis and monitoring of the growth pattern in aberrant cases. The aim of this study was to find panoramic indices in the diagnosis of facial vertical growth pattern and comparing them with standard lateral cephalometric radiographs.
Current research is a descriptive, cross-sectional study that was carried out on 30 patient’s pretreatment lateral cephalometric and panoramic radiographs. Gonial, FMA, Basal, Schudy and Or Go Me angles were used to measure both radiographs. Pearson’s correlation coefficient and independent t-test were used for data analysis.
Results showed that the value of all variables on panoramic radiographs was smaller than their counterparts on lateral cephalograms. Gonial angles had the highest correlation coefficient (r=0.89, p Gonial angles can be detected on panoramic views along with lateral cephalograms with high accuracy that can show facial vertical growth pattern to some extent; however, for accurate diagnosis cephalometric analysis is also needed.

Beef meat is highly prone to microbial spoilage as it is rich in essential nutrients and putrefying in nature. Nowadays, consumers are applicant to usage of natural replacements causing to side effects of synthetic preservatives such as carcinogenicity and teratogenicity.
In this study the influence of hydro alcohol sumac extract (SE) and chitosan coating alone or in combination with Z. multiflora Boiss essential oil (ZEO) added, on microbial attributes of beef meat were investigated during refrigerated storage in normal and modified atmosphere packaging (MAP: 80% oxygen and 20% dioxide carbon). The samples were stored at 4 °C for 20 days and microbial analysis were conducted at zero, four, eight, 12, 16 and 20 days.
Total viable counts, lactic acid bacteria, Pseudomonas spp., Enterobacteriaceae and yeasts- molds were significantly lower in all treatments than control over the storage time. The highest level of antimicrobial effect of chitosan, SE 4% and ZEO were found on TVC (by 3.69 and 4.04 log CFU/g (colony forming unit / gram) reduction compared with control), Enterobacteriaceae (3.61 and 3.73 log CFU/g reduction) and lactic acid bacteria (2.67 and 2.53 log CFU/g reduction), in normal packaging and MAP, respectively.
These results suggest the potential of chitosan, SE and ZEO as biopreservatives under refrigerated storage in normal packaging and MAP.

Diabetes is increasingly growing up in the world and also in Iran and psychological factors such as stress, anxiety and depression play an important role in its development. The purpose of this study was investigating the effectiveness of mindfulness based stress reduction on glycemic control, stress, anxiety and depression on patients with type 2 diabetes.
This quasi-experimental study had a pretest-posttest design with a control group. The study population included 30 diabetic patients (% 40 male), randomly divided into two, the study (N=15) and control (N=15) groups. We used depression, anxiety and stress questionnaire (DASS - 42) and HbA1c testing in this study. The study group received the mindfulness based stress reduction group training with 8 sessions while the control group received no intervention. Both groups completed the (DASS - 42) before and after the intervention. HbA1C was also measured before and one month after the intervention in both groups.
In the end, 10 patients in the experimental group and 13 patients in the control group remained. Data analysis showed that stress and HbA1C in the treatment group compared with the control group significantly decreased at posttest. But the difference in the severity of anxiety and depression between the two groups was not significant after intervention (p Based on the results of this study, mindfulness based stress reduction group training can be effective in improving glycemic control and reducing the stress levels in diabetic patients.

Pharmacological treatment of cancer is associated with serious adverse effects including drug-drug interaction (DDI). The purpose of this study was evaluating DDIs in cancer patients hospitalize in the Intensive Care Unit (ICU) and identifying the type and severity of DDI.
The study population was all patients with cancer admitted to the ICU of Imam Khomeini hospital during 21 March 2013 to 20 March 2014. Patients’ information were extracted from the medical records. Then the recording demographic features and prescribed drugs in the first 24 hours of hospitalization were extracted and were investigated. DDIs were classified in terms of severity to as mild, moderate and severe into five groups.
Almost 101 patients were evaluated (63 male and 38 female). The mean age was 59.47±1.69 and the average prescribed medications was 5.23±0.23. Then, 162 DDIs were identified that 14.81% of them were major, 77.16% moderate and 8.03% minor in the point of severity. In the basis of documentation 14.19% of DDIs were established. The most DDIs were in the age group 61-80 years and the most involved drugs were: ranitidine (79.16), cephalosporins (63.162), anticoagulants (24.162) and narcotic analgesics (18.162).
This study shows that a high percentage of DDIs occurs in the ICU. Therefore, we suggest treating patients in ICU relying on a teamwork in drug prescribing.

Klebsiella Pneumonia is a common cause of nosocomial infections including urinary tract, respiratory and wound infections. Several fluoroquinolones resistance mechanisms have been proposed, such as mutations in the topoisomerase IV subunits (ParC and ParE). The aim of this study was to investigate parC mutations in ciprofloxacin resistant isolates of Klebsiella Pneumonia from Guilan province.
In this study, forty strains of Klebsiella Pneumonia were isolated from several Rasht and Lahijan hospitals and laboratories then were identified by biochemical tests. Antimicrobial susceptibility to ciprofloxacin, imipenem, amikacin, cefixime, cefotaxime, cephalexin, gentamicin, and nalidixic acid was determined by Kirby-Bauer disk diffusion and MIC methods. Then PCR-sequencing was performed to assess parC mutations in ciprofloxacin resistant isolates.
15% of isolates were resistant to all eight antibiotics. Thirteen isolates (32.5%) were ciprofloxacin resistance. The most antibiotic resistance percentage was found for Cephalexin (70%) and the lowest resistance percentage was identified for Gentamicin (17.5%). Sequencing analysis showed that three ciprofloxacin resistant isolates had missense mutations L38F and/or E84K in parC gene.
In Guilan province, it seems that parC mutations plays role in developing ciprofloxacin resistance in Klebsiella Pneumonia through change in ciprofloxacin affinity to topoisomerase IV.