مجله دانشگاه علوم پزشکی گیلان
پیاپی 97 (بهار 1395)

Dietary fat may affect lens cell membrane composition and function, which are related to senile cataract. Cataract is the first cause of blindness in the world and nutrition and lifestyle play an important role in its development. Recent studies have reported that dietary fat may affect lens cell membrane composition and function, which ultimately will result in senile cataract.
To survey the association between dietary fatty acids and senile cataract
This study is a case-control investigation with a retrospective approach conducted on 350 patients approved by an eye specialist (175 patients suffering from senile cataract and 175 people in control group) via clinical examination and interview, who had been visited in the eye clinic of Amir Al Momenin hospital from March 2013 to March 2014. Data about intake of selected fatty acids were evaluated using a valid semi –quantitative Food Frequency Questionnaire (FFQ) assessing a 168 item food index.
There was a significant positive correlation between saturated fatty acids, oleic acid, linolenic acid and linoleic acid consumption and the senile cataract status in both groups. In addition, an inverse relationship between the status of senile cataract and a high intake of eicosapentaenoic acid and decosa hexaenoic acid was observed.
High intake of some fatty acids may increase the risk of age related nuclear opacity. However, more studies are needed to verify this association and clarify the relationship between intake fatty acids and senile cataract.

HPV types 16 and 18 cause 70% of cervical cancer around the world. Approximately, in 70-50% of women HPV 16 and 18 antibodies are produced after-acquired infection. These antibodies remain for at least 4-5 years.
This study aimed to determine antibody levels in the serum of patients with cervical cancer, CIN I,II,III in pap smears and its association with cervical abnormalities in sexually active women with no history of cervical abnormalities, respectively.
In this case-control study, 70 patients referred to the clinic of gynecological oncology in Al-Zahra hospital from 2007 to 2014 were enrolled. They were divided into 3 groups. The first group of patients have biopsy of cervical cancer, the second group who have Pap smear with CIN I, II, III results and in fact with premalignant lesions. The third group had normal Pap smear for malignant or premalignant lesions. From all of the groups, 5 cc blood samples were taken. Using ELISA kit for HPV-16 and HPV-18, the level of antibodies against HPV high-risk was measured. Demographic data including age, marital status, smoking, family history of cancer, age at menarche, menopausal status, parity, contraceptive method, Parity, history of sexually transmitted infections and history of contraceptive pills consumption for more than a year were recorded.
Patients with cervical cancer and pre-malignant disease had a mean age of 30/8 ± 6/45 years. The mean age of healthy patients was 45.6±8.30 y/o. The difference between the three groups’ HPV18 antibody levels in healthy individuals, patients with biopsy results CIN I, II, III and cervical cancer patients was statistically significant (P=0.047). HPV18 antibody levels between the two groups of patients with cervical cancer, and biopsy results in patients with CIN I, II, III, was not statistically significant. But the difference between healthy subjects and patients with cervical cancer was statistically significant (034/0 = P). The mean level of HPV16 antibodies in patients with biopsy results CIN I, II, III and cervical cancer patients was statistically significant (P=0.046). The difference between two groups of healthy individuals and patients with biopsy results CIN I, II, III was on the borderline (p=0.043). Also, there was no statistically significant difference between the mean level of HPV 16 antibodies in patients with cervical cancer and patients with biopsy results CIN I, II, III (P=0.476)
The study showed that antibodies against HPV 16 and less HPV18 produced following the acquisition of infection, reduces the risk of cervical cancer and abnormalities.

Breast cancer is a malignant proliferation of epithelial cells that cover the breast ducts or lobes. The accumulation of DNA damage is considered as a major factor in breast cancer. One of the most important defense mechanisms is Nucleotide Excision Repair (NER). Dysregulation of DNA repair genes expression is important for breast carcinogenesis. XPC(Xeroderma pigmentosum, complementation group C) is an important NER gene that recognizes the damage caused by a variety of bulky DNA adducts. Poly AT (PAT) sequence is one of important polymorphisms in this gene.
This study investigated the relationship of the XPC PAT polymorphism with breast cancer.
In this Case-Control study, we analyzed 79 patients and 120 healthy controls. The genotyping of PAT polymorphism was performed using polymerase chain reaction (PCR) and statistical analyses were conducted by theMedCalc statistical software (version 12.1).
Among cancer cases, the distributions of PAT-/-, PAT-/ and PAT genotypes were 66%, 10%, and 24%, respectively. Among controls, the distributions of PAT-/-, PAT-/ and PAT genotypes were 71%, 19%, 10%, respectively. The genotype frequencies did differ significantly between patients and controls (P=0.01).The frequency of PAT allele was significantly higher in patients (0.30) than in the controls (0.20), (P=0.02).
Our study suggests that XPC Poly AT sequence polymorphism might be a genetic predisposing factor for breast Cancer. However, larger population-based studies are needed for clarifying the role of XPC gene polymorphism in breast Cancer.

Today, research on new antimicrobial materials is growing and nanoparticles can serve as good representative.
The purpose of this study was to evaluate the antimicrobial properties of silver nanoparticles in the removal of bacteria E.Coli isolated from industrial effluents.
In this experimental study, after sampling polluted industries, coliform and total coliform measurements fecal industrial wastewater microbiology was performed by standard methods. The silver nanoparticles with different concentrations of the nutrient media broth dilution method in the bacterium E.Coli isolates and standard (PTCC8739) and the effect of turbidity tubes (OD), which represents growth of bacteria at a wavelength of 600 nm spectrophotometer was read. Then, all tubes were inoculated on nutrient agar solid medium. The results were analyzed using statistical methods and software SPSS22.
Total coliform and fecal coliform contamination was approved in slaughterhouse wastes and E.Coli (slaughterhouse industry pollution index). was isolated. With increasing concentrations, anti-bacterial activity of silver nanoparticles increased and the number of colonies was reduced, although none of the concentrations of bacteria was able to contain and eliminate the bacteria. The effect varies with type of bacteria, but this difference was not statistically significant.
The results showed that the concentration of bacteria and type of bacteria are effective on the range of antimicrobial activities of silver nanoparticles. On the other hand, although the concentrations used in the study of E.Coli were effective, but did not remove the whole bacteria and economic feasibility and other factors need to be considered in the application of nanoparticles.

Gastrointestinal obstruction is a common problem in neonatal period and one of the causes of mortality in newborns. The prevallance and its outcome vary in different gerogrephical regions. Moreover, other studies have reported different contributing factors for this problem.
This study was conducted to investigate the prevallance of gastrointestinal obstruction, mortality rate and some associated factors in hospitalized neonates.
This study is a retrospective descriptive one on 103 cases of hospitalized newborns with gastrointestinal obstruction at 17 Sharivar hospital in Rasht from 2009 to 2013. The data of these cases were collected which assessed, gestational age, gender, birth weight, morbidity and mortality rate. Data were analyzed by SPSS (V. 20) software.
In this study, 103 hospitalized newborns with gastrointestinal obstruction were studied. Most of them were term, male, with normal birth weight and Apgar score at birth more than seven. Upper and lower gastrointestinal obstructions of these newborns were 39.8% and 60.2%, respectively. In addition, morbidity and mortality was observed in %0.9 and %5.8 of newborns, respectively.There was a statistically significant correlation between gastrointestinal obstraction and amniotic fluid volume as well as diagnosis time of obstraction (P According to the present findings, specific paraclinical diagnostic tests for evaluation of gastrointestinal obstructions due to congenital anomalies sould be considered and is effective for early diagnosis and treatment.

Marital satisfaction is an important component of married life that gives it meaning and identity. Increased marital satisfaction can improve physical health, psychological, economic development, job satisfaction and overall life satisfaction. Since nurses working under different stressful factors are exposed to more direct and indirect harmful physical and psychological conditions, determination of the extent of marital satisfaction helps improve the efficiency of this human force.
This study has been done to determine of effective factors on the marital satisfaction in nurses at health centers in Rasht city
In this study, 500 working married nurses at 8 Learning Centers and hospitals in Rasht were selected using stratified random sampling. Data were collected using ENRICH marital satisfaction questionnaire for demographic data and using 16 spss they were analyzed by Descriptive and inferential statistical tests (Independent t test, Oneway Anova, Pearson's test, Regression Logostic Ordinal Model).
Most subjects (61/6%) had relative marital satisfaction. Between marital satisfaction and age (P=0/002), age consort (P=0/001), job history (P=0/0001), personal income (P=0/002), the place of service (P=0/0001), shift work, employment status (P=0/0001) number children (P=0/001) there was a significant relationship.
The results of this study indicate relative marital satisfaction of nurses with shift work as an effective variable. Given the importance of preserving the family, it seems that focus on the strategies for improving job satisfaction and consideration of hard working condition could be helpful.

Poisoning is a major problem which threatens health throughout the world.
Because of the presence of such cases in the statistics of the cases assisted by pre-hospitalization emergency services, the present paper aims to epidemiologically investigate intentional and unintentional poisoning cases assisted by Guilan Emergency Services during the period between 2012 -2013.
The present study is a descriptive – cross-sectional one analyzing patients’ status and the month of occurrence through providing and reviewing a checklist involving variables such as age, gender and the type of intentional or unintentional poisoning. Data are analyzed using SPSS 19 in significance level of 0.05.
According to the results, among the total number of 3789 poisoning cases in Guilan occurred from 2012 to 2013, 69.5% were males and 30.5% were females. Most cases occurred in the age range of 21- 30 years (37.3%). Most cases of intentional poisoning included abuse of pharmaceuticals and medicine, especially Benzodiazepines and most unintentional cases included addictive drug abuse. The highest occurrence rate belonged to June.
The most prevalent type of intentional and unintentional poisoning cases is drug-induced poisoning. Hence, authorities are required to pay more and specific attention to the issue.

Anemia is one of the most common problems during pregnancy, whose maternal and fetal complications have been reported in many studies, most of which do not show any correlations and some at times were in contrast.
The present study aims to compare post-delivery maternal and fetal complications among anemic and non –anemic women who have been admitted to Al-Zahra hospital for delivery.
This study was conducted through a case-control analysis among 422 pregnant women who delivered their babies in the third trimester of their pregnancy. 211 cases of anemic women with HB The mean age was 28.80±6.68 yrs for anemic women and 28. 33.71yrs for the non-anemic. There was a significant difference between various levels of BMI among anemic and non-anemic women who had delivered a baby (p=0.029) but no significant statistical difference between the means of the two groups was observed (p=0.13). There was no statistically significant difference between the two groups in terms of parity (P=0.55), pre-eclampsia(P=0.79), placenta abruption(P=0.72), preterm labor(P=0.25), neonatal Apgar score (P=0.44)¡ IUFD (P=0.12), IUGR(P=0.57),neonatal meconium excretion(P=0.23). The mean, the standard deviation, and the median of ferreting among anemic women were 44.68 ± 29.04 and 40, respectively and the mean and the standard deviation of TSH were 1.53±2. 16and its median was 2.
In this study, a significant association between maternal anemia and pregnancy and fetal complications was observed. The results could be due to the removal and treatment of people with hereditary anemia. Therefore, further studies considering different types of anemia are suggested.

Oxygenation decreases during the early period after the open heart surgery. In order to Prevention of this disease and treat, the studies have been performed in the early mobilization with postoperative rehabilitation program.
To evaluate the early mobilization as an intervention on the respiratory condition of the patients after the coronary artery bypass surgery.
A clinical trial with eighty Eighty patients after coronary artery bypass surgery were divided Random fix block in two groups of forty people. In the intervention group, in addition to the usual hospital practice and active movement on the bed, they walked a distance of twenty meters in two intervals: the first one, twenty- four hours after the surgery and removing the endotracheal tube and the second one, after six hours in the ICU. Blood gas analysis, expiratory peak flow and CXR were evaluated before and after the mobilization. All assessments of the intervention group were performed for the control group. Data were analyzed by the statistical software with SPSS version 20 and Significant level p Based on statistical results, most measured parameters in the control group were improved. After the second time, the early mobilization indicates a significant difference in Arterial blood oxygen saturation(SaO2) rate in the intervention group 95/77±2/14 and the control group 94/2±3/03 per cent(p=0/009); peak expiratory flow rate in the intervention group 167/2±49/1 and the control group137±40/55 lit/min(p=0/004); and Arterial oxygen pressure (PaO2) rate in the intervention group 76/59±7/18and the control group71/4±9/63 mmHg =p)0/008).
The early mobilization after the coronary artery bypass surgery indicates an improvement in oxygenation with the evaluation results.

Children with cancer expose families, especially mothers, to numerous challenges and cause parents to suffer from a lot of stress. In many cases, the pressures arising from caring for children with cancer tend to grow so intensely that can affect the quality of life of the parents.
This study aims to analyze the impact of Stress Management Training on improving the quality of life of the mothers with leukemic children.
The present study is an experimental research with a pre-test/post-test control group design. The statistical population of the study comprised of all mothers of leukemic children between 4 and 6 years of age living in Rasht, Iran, in the school year 2014-2015. 30 mothers with the inclusion criteria were randomly selected as the sample and were randomly placed into experimental and control groups. The researchers administered the short-form 36 (SF-36) questionnaire (Warosherbon, 1992) among the two groups at both pre-test and post-test stages. The experimental group received ten 70-minute sessions of Stress Management Training, whereas the control group did not receive any such an intervention.
Data analysis indicates a significant difference between the experimental and the control group in terms of mean scores of life quality (p The results of this study suggest that, besides instrumental and informational empowerment strategies such as the funding of treatment and education, mothers of children with cancer also need emotional support and psychological intervention in order to enjoy improvement in quality of life.

Poor control of postoperative acute pain will result in various acute and chronic complications. Nowadays, a multimodal approach is used to control post-operative pain. Pregabalin and gabapentin have been shown to have analgesic effects on postoperative pain as a Gaba-Amino-Buteric Acid (GABA) analogue with minimal side effects. The aim of this study was to compare the analgesic effects of pregabalin with that of gabapentin in the prevention of postoperative pain in patients undergoing tibia fixation surgery. Sixty patients, candidate for tibia fixation surgery under spinal anesthesia, were randomly assigned into two groups. For the intervention group(P), 150 mg oral pregabalin one hour before surgery and for the intervention group(G)300 mg oral gabapentin were prescribed two hours before surgery .Visual Analogue Scale (VAS) for pain assessment, opioid consumption, nausea, vomiting and vertigo were evaluated in a 12 hour period after surgery. If pain score (VAS) was more than three, intravenous morphin (0.1 mg/kg) was administered .Chi-Square and repeated measurement and t- tests were used for statistical analysis. The results of the study showed that there was no significant difference between the two groups, regarding pain, nausea, vomiting and vertigo in measurement point times (p>0.05). However, it was found that VAS score in the two groups decreased during 12 hours postoperatively but there was no statistically significant difference between the groups (p=0.22, F=1.5). Administration of a single dose of pregabalin orally (150 mg) or gabapentin (300 mg) before orthopedic surgery reduced post operative pain, opioid consumption and consequently the rate of nausea and vomiting.

Despite the benefits of Percutaneous Coronary Intervention (PCI) in reducing major cardiovascular complications, the risk of thrombotic complications still remains a major concern. While the efficacy of aspirin in primary and secondary prevention in patients with coronary artery disease and acute coronary syndrome is well documented, the precise dose of aspirin is still questionable. Evaluation of efficacy and safety of high doses of low dose aspirin in patients with ST-Elevation Myocardial Infarction (STEMI) who were under the Primary PCI. In this study, the method of randomized clinical trial double blind controlled on patients with STEMI, referred to the Rasht hospital for a year was performed. Short-term outcome based on the individual situation until 30 days after the operation defined that variables including the re ischemia, major bleeding, stent thrombosis, stroke, death from heart problems and revascularizations were re-evaluated. Among 175 patients enrolled, there were 85 patients in the group receiving low-dose aspirin (81 mg) and 90 patients in the group receiving high-dose aspirin (325 mg). Significant differences between complications after PCI except for cardiogenic shock were not observed between the groups. The use of low-dose aspirin instead of high-dose aspirin, is associated with fewer side effects and better performance.

Neonatal hypoglycemia is an emergency condition requiring immediate treatment to prevent serious outcomes. Today, blood glucose meter is a current method for detecting blood glucose in the health centers of our country, while the hypoglycemia can not be confirmed or denied certainly with glucometer. This study aimed to evaluate the accuracy of blood glucose meter in comparison to that of laboratory method and determine the optimal cut- 0ff point in detecting neonatal hypoglycemia by glucometer. This cross-sectional study was conducted in the neonatal intensive care unit of Al Zahra Hospital from September 2013 to March 2014. In infants with risk factors of hypoglycemia blood glucose was tested with blood glucose meter (ACCU CHEK - Performa), if the blood glucose was under 60 mg/dl. Simultaneously, the venous blood glucose values were done on (Selectra2) auto analyzer by glucose oxidase method. Sensitivity, specificity, and positive and negative predictive values of glucometer were determined. Hypoglycemia was observed in 32% and 33% of neonates, respectively with glucometer and laboratory methods. A weak correlation was observed between the results of glucometer and laboratory methods (r=0.275). In this study, the optimal cut – off point by glucometer was found to be 54 mg/dl and sensitivity, specificity, accuracy, positive predictive value and a negative predictive values of glucometer were 45.45%, 74.6%, 65%, 46.8% and 73.5% respectively. According to ROC curve area under the curve (AUC) was 0.616. According to the results obtained in this study, glucometer has not sufficient diagnostic value to detect neonatal hypoglycemia. Blood Glucose meter results should be confirmed using a laboratory method.