مجله دانشکده پزشکی اصفهان
پیاپی 348 (هفته چهارم مهر 1394)

Postural instability is a major complication of Parkinson’s disease (PD) leads to the reduced mobility and poor quality of life in patients. Physical activity and exercise is a part of treatment plan to reduce the symptoms of the disease. Water-based exercise is recommended for patients with a lower level of mobility. This study aimed to compare the effects of water- and land-based exercises on patients with Parkinson’s disease. 20 patients who were diagnosed to have idiopathic Parkinson’s disease by a neurologist were equally divided into two 10-people groups based on their severity of complications. Both groups completed an 8-weeks (3 sessions per week) exercise program. Postural stability and quality of life (QoL) parameters were recorded using a force-plate and questionnaire in pre- and post-test sessions. Recorded outcomes were analyzed and compared using analysis of covariance statistical test. Postural stability and quality of life parameters improved at the post-test session compared to pre-test in both groups. The improvement of these outcomes was significantly greater in the water-based group. Water-based exercises can be more beneficial to improve the balance ability and quality of life in patients with Parkinson’s disease.

Jaundice is the most common disease in neonates; prolonged jaundice lasts for more than 14 days in neonates and more than 21 days in premature neonates. Urinary tract infection (UTI) is a potentially serious disease during infancy and childhood and with replication can cause many problems and irreversible effects. This study aimed to identify the factors affecting urinary tract infection in hospitalized neonates in neonatal intensive-care unit (NICU) with prolonged jaundice. In this cross-sectional study, from 1844 studied infants during 3 years of 2010-2013, 91 infants admitted to the NICUs of hospitals in Kermanshah city, Iran, due to prolonged jaundice, were enrolled. Via convince sampling, data were collected using a checklist including the demographic data, type of the delivery, type of neonate feeding, birth weight, gestational age, presence or absence of urinary tract infection and parent's kinship. Data were analyzed using descriptive and inferential statistics via SPSS software. The prevalence of urinary tract infection in neonates with prolonged jaundice was 59.3 percent. Gender, gestational age, type of delivery, and parent's kinship were not related to urinary tract infection. Feeding type and urinary tract infection were significantly related (P < 0.05). Feeding type has an impact on urinary tract infection and breastfeeding is a priority. In addition, urine culture in neonates with prolonged jaundice, or those with unknown cause, may be advantageous.

Escherichia coli strains with ability to cause urinary tract infection (UTI) are called uropathogenic strains. Uropathogenic Escherichia coli expresses a variety of cell adhesions, such as adhesion PaP (pyelonephritis associated pili), that causes the urinary tract infection via binding to the surface of epithelial cells. P pili facilitates the colonization of bacteria, prevents the elimination of bacteria via flow of urine filtration and increases kidney tissue proliferation and invasion. PapG adheres at the tip of P pili, and has three different classes. This study aimed to identify and determine the frequency of encoding papG genes in uropathogenic Escherichia coli. In this study, 55 samples of patients with urinary tract infection werecollected from clinical laboratories in Tehran city, Iran. After the extraction of bacteria DNA, the papG I, papG II and papG III genes were investigated using multiplex polymerase chain reaction (Multiplex PCR) method. 18 samples (32.7%) were papG gene positive. Of those 18 samples, 17 (30.9%) were papG II, and 1 (1.8%) was papG III gene positive. PapG I gene was not detected in any of the samples. The results showed that papG II gene is the most common gene encoding adhesion papG of the P pili in Escherichia coli isolated from urinary tract infections in Tehran. This could be valuable information in the diagnosis of urinary tract infection and provide future treatment strategies.

Chills are muscle contractions and involuntary movements that the patient is not able to control them. Chill (shivering) is a frequent complication after the general anesthesia, which is due to the use of anesthesia drugs and hypothermia; it can increase oxygen intake, systemic blood pressure, and heart rate and can cause cardiac arrhythmias in patients. One of the mechanisms for decreasing postoperative shivering, is the use of the drugs that create less shivering. A variety of anesthetic drugs are used during anesthesia that each one has its own special side effects (complications). The aim of this study was to compare the effects of isuflorane and propofol on postoperative shivering in patients underwent general anesthesia for elective general or orthopedic surgeries. In a double-blinded clinical trial study, 100 patients at the age of 18-65 years, who underwent elective orthopedic and general surgery in Imam Khomeini Hospital in city of Ilam, Iran, were randomly divided in two groups of 50 during the years 2012-2013. The occurrence and severity of postoperative shivering was compared in the two groups and via 0-3 classification scoring. The findings were analyzed via SPSS16 software using paired-t and chi-square tests. 47% of the patients were women and 53% were men. Between the gender and postoperative shivering (P = 0.067) as well as between the age and postoperative shivering (P = 0.774), no significant relationship was found. There was no significant difference between the two groups of isoflurane and propofol in postoperative shivering (P = 0.211). In adult patients undergoing elective general or orthopedic surgery, to reduce the postoperative shivering, there was no difference in using isoflurane or propofol.

Mindfulness and psychotherapy integration movement has begun since the 1970s. Mindfulness-based therapies such as mindfulness-based stress reduction (MBSR), are widely used in the treatment of patients with chronic medical conditions. These therapies focus on the present moment awareness and acceptance as an important aspect of treatment. One of the major public health problems is functional somatic syndromes and somatization. There are a few effective treatments for them. These two problems have been united with the term as bodily distress syndrome (BDS); the clear somatic basis has not been found. Of the new therapies in the treatment of bodily distress syndrome are mindfulness-based therapies. These therapies, via mind and body awareness training and connection between mind and body, increase brain gray matter in the insula, hippocampus and prefrontal cortex. They increase activity of the left frontal areas elevating mood and boost the immune system, too. These therapies improve mental performance related to its acceptance and decrease the symptoms of bodily distress syndrome.