مجله دانشگاه علوم پزشکی بابل
سال چهاردهم شماره 6 (پیاپی 69، آبان 1391)

Very low birth weight (VLBW) infants (4-7% live birth) are at high risk for mortality (one third of neonatal mortality). To determine the frequency of disease-free survival, complications and risk factors for morbidity and mortality in VLBW neonates. This cross-sectional retrospective study was performed from April 2007 to March 2010 on all hospitalized VLBW neonates in neonatal intensive care unit (NICU) at the Mahdieh hospital in Tehran, Iran. Relevant pre- and peri-natal data up to the time of discharge from the hospital or death, including complications during the course of hospitalization, were collected and compared. Five hundred and sixty four neonates were included in the study during three years. Overall survival was 70.9%; in ELBW newborns this figure was 33.3% rising to 84.1% in infants weighing between 1001-1500 grams. Mean gestational age was 29.6 ± 2.5 weeks, mean birth weight was 1179 ± 258 grams and Mean hospitalization duration was 29.7 ± 23.6. Mean birth weight, gestational age and APGAR scores were significantly higher in babies who survived than those who died, (1275 ± 189 vs. 944 ± 253 grams; 30.5 ± 2.2 vs. 27.5 ± 2 weeks and 6.9 ± 1.7 vs. 5 ± 2.1 respectively; p <0.001 in all instances) but needs for CPR was more in dead newborns (p<0.001). Need for mechanical ventilation, pulmonary hemorrhage and gastro-intestinal bleeding were also significant predictive factors for mortality. Although our survival was compatible with most of developing countries but for improving survival, especially in ELBW suggest increasing the quality of prenatal care, regionalization, standard CPR in delivery room and improving the quality of care in NICU.

Breast milk includes standard immune and nutritional component for infants. WHO recommended exclusive breastfeeding for all infants throughout the world for first six months of life. The aim of this study was to determine the time of first breastfeeding initiation after birth on rate of exclusive breastfeeding. This cohort study was conducted on neonates born in a baby friendly hospital initiative (Babolclinic hospital, Babol, Iran). Infants divided into three groups regarding to initiation of first breastfeeding at the first 60 minutes (group 1), after 60 minutes up to 24 hours (group 2) and after 24 hour of life (group 3). All infants were followed at 1, 3, 6, 12 and 24 months of life. Then the rate of exclusive breastfeeding was compared together. From 1869 neonates, 965 (51.6%) were boy and 904 (48.4%) were girl. Initiation of first breastfeeding in 734 (39.2%) was in first 60 minutes of life (groups 1), 1014 (54.2%) after 60 minutes up to 24 hours of life (group 2) and 121 (6.6%) after 24 hours (group 3). Survival analysis showed that mean exclusive breastfeeding in group 1 was 5.5 months (CI %95= 5.40-5.63), in group 2 was 5.43 months (CI %95=5.33-5.53) and in group 3 was 2.69 months (CI %95= 2.17-3.2) (p=0.000). Duration of lactation at 12 months of life in three groups was 11.51, 11.45 and 9.6 months respectively and at 24 months of life was 78%, 75% and 58%, respectively. The results show that initiation of breastfeeding within first 60 minutes after birth is more effective in the exclusive breastfeeding rate so we recommend all maternity units must perform program for initiation of breastfeeding at the first hour of life.

Assay of caffeine (CA) plasma concentration can help to find out the activity level of hepatic microsomal cytochrome oxidase 1A2 (CYP1A2). This study was conducted to evaluate the phenotype of activity of CYP2A1 in a sample of Iranian volunteers based on salivary concentration of CA as typical probe of CYP1A2.

Saliva concentration of CA in 100 Iranian healthy subjects from Mazandaran province (82 men and 18 women) was measured at 0, 0.5, 2, and 5 h after drinking a cup of coffee containing 50 mg caffeine using HPLC method. C8 analytical column and a mobile phase composed of methanol (60%) and water (40%) were used for the chromatographic separation. The peak was detected using a UV detector set at 210 nm.

The mean ± SD of age and body mass index were 24.5 ± 6.9 years (range: 18-55 years) and 23.45± 3.7 (range: 16.7-37.4), respectively. The CV was 3.2% and good linearity (R2= 0.997) was confirmed. The mean elimination half time of CA was 2.01 ± 0.124 h (1.98 h for females and 2.02 h for males) and elimination half-time of CA in above 30 years old (2.05 h) was higher than below 30 years old (2.00 h). The mean Cmax of CA was 0.16 ± 0.02 micg/ml and Kel was calculated 0.41 ± 0.016.

A normal phenotype of CYP2A1 activity was observed in the Iranian participants in this study. The CYP2A1 activity is higher in elderly subjects than in young.

Rough endoplasmic reticulum is important organelle that plays a role in the regulation of a range of functions. Potassium channels in the endoplasmic reticulum membrane were recently reported that its physiological role is unknown. Hepatocyte endoplasmic reticulum is a rich source of glucose 6- phosphatase that is involved in the control of gluconeogenesis. Since phosphate ions are intra-luminal metabolites for this enzyme of endoplasmic reticulum thus, in this study, the effect of phosphate ions on potassium channel activity was studied. Endoplasmic reticulum vesicles extraction was accomplished following liver excision in rats, homogenization and several stages of ultracentrifugation. Phosphatidylcholine was extracted from fresh egg yolk. Bilayer lipid membrane was formed in a 350 µm diameter aperture in between two chambers cis and trans contained 200/50 mMKCl solutions respectively, then vesicles were incorporated into bilayer lipid membrane. Ion channel activity was recorded by single channel recording technique both in control conditions and presence of phosphate ion in luminal face, next biophysical ion channel properties analyzed by Clampfit10 software. Endoplasmic reticulum Potassium channel was 550 pS conductance and its activity changed as voltage dependent manner in voltage range of +30 to -40 mV, in this respect the open probability and the average unitary current in a voltage + 30 mV were 0.73 and 26 pA, respectively. However, at lower voltages, the channel activity was minimal. In the presence of 50 mM phosphate ion, mean unitary current and also channel open probability did not change significantly in different voltages compared to the control condition (p>0.05). Rat hepatocyte endoplasmic reticulum membranes has been a kind of potassium channel with voltage-dependent activity and it seems that its electrophysiological characteristics did not influenced by phosphate anion in luminal face.

Several factors have influence on sperm fertilization, between them semen hyperviscosity is one of the idiopathic factors involved in sperm viability and function deficiency. Probably, decrease in human seminal antioxidants is one of the negative effects of hyperviscosity on sperm function. The aim of this study was to compare the total antioxidant activity (TAC) in seminal plasma of infertile patients with hyperviscosity and non- hyperviscosity. In this cross sectional study, 47 semen samples were provided from infertile patients with hyperviscosity (n=22) and without hyperviscosity (n=25) at Fatemeh Zahra Infertility and Health Reproductive Research Center. After determine the semen hyperviscosity by measuring the length of the thread on withdrawal of the rod, sperm parameters (volume, sperm counts, motility and normal morphology) were evaluated on microscopic examination. TAC was measured in all samples by FRAP method and compared. The mean of sperm parameters including: counts (29.32 ± 25.35), motility (30.95 ± 19.11) and normal morphology (4.23 ± 2.5) in patients with hyperviscosity were significantly lower than those in non-hyperviscosity patients (counts 46.80 ± 26.29, motility (52.8 ± 15.41) and normal morphology (7.56 ± 3.16)) (p<0.02, p<0.001 and p<0.001, respectively). The mean of TAC in seminal plasma of non- hyperviscosity patients (1710.31 ± 458.67µmol/l) was significantly higher than that of hyperviscosity group (1230.25 ± 352 µmol/l) (p<0.01). Our results showed that there is a positive significant correlation between TAC and sperm parameters quality. Decrease in TAC concentration in seminal plasma of patients with hyperviscosity is one of the probability mechanisms for sperm parameters abnormality.

Type 2 diabetes, characterized by insulin resistance, impaired insulin secretion, hyperglycemia and oxidative stress. Increasing prevalence of type 2 diabetes in parallel with expanding of food fortification with niacin has observed in developed and developing countries, so it is possible that intake of high doses of niacin may play a role as an environmental risk factor in type 2 diabetes. The purpose of the present study was to assess the association between consumption of high doses of niacin and the risk of type 2 diabetes. The present study is a literature search in PubMed and Science direct with the use of niacin, diabetes, oxidative stress, insulin resistance and obesity as keywords. The results of animal and human studies published until 2011 in this field were considered. Niacin by elevation of oxidative stress indices increases insulin resistance and leads to hyperinsulinemia, thereafter, improvement of oxidative stress indices by the antioxidant systems leads to elevation of insulin sensitivity that followed by hypoglycemia. Postprandial hypoglycemia induces excess energy intake and obesity. The elevation of oxidative stress indices, insulin resistance and obesity in long-term by continuous stimulation of pancreatic? cells can lead to type 2 diabetes. Reducing niacin intake through reduction of niacin-rich foods and niacin fortified foods may be a useful preventive and therapeutic intervention in type 2 diabetes.

Carpal tunnel syndrome (CTS) is the commonest compression neuropathy and surgical decompression is the popular treatment. The aim of this study was to evaluate the results of operative treatment of CTS based on physical examination and electrodiagnosis (EDX) in Shahid Yahyanejad and Shahid Beheshti hospitals (Babol; Iran 2001-2007) This cross-sectional study was performed on all patients who were operated for CTS in Shahid Yahyanejad and Shahid Beheshti hospitals of Babol from 2001 to 2007. Patients who were dissatisfied according to their self estimation called self image dissatisfied included in the study and evaluated clinically and electro diagnostically. Patients with positive clinical findings called as clinical dissatisfied and patients with positive clinical and electrophysiological findings called as real dissatisfied patients. Collected data were evaluated. Out of 169 patients who participated in the study, 22 (13%) were self image dissatisfied and 147 (73%) were satisfied. Fourteen (8.3%) of self image dissatisfied patients had positive clinical findings (clinical dissatisfied) and 9 (5.3%) had positive clinical and electrodiagnostic findings (real dissatisfied). Electrodiagnostic study in self image dissatisfied, cured and clinical dissatisfied patients was normal in 9 (41%), 6 (75%) and 3 (21.55) patients, and it was abnormal in 13 (59%), 2 (25%) and 11 (78.5%) patients, respectively. The results showed there was no clear correlation between clinical and electrodiagnostic improvement of CTS and combination of clinical and electrodiagnostic improvement is supposed to be reliable.

Coping skills like other cognitive skills develop with increasing age and are very effective in efficient dealing with life stressful situations. Investigation of coping skills can be predictive of their future of anxiety and depression status in adolescents and choose of intervention methods to prevent pathology in the future. The present study is concerned with investigation of relationship between cognitive coping strategies with symptoms of anxiety and depression in adolescents as compared with adults. The design of this research is casual-comparative. Four hundred and fifty high school students (223 males and 227 females) and 390 adults (education employees, 210 males and 180 females) were randomly selected. Participants completed Garnefski and Legerstee cognitive coping strategies and SCL-90 inventory. Variables of this research are cognitive coping strategies and symptoms of anxiety and depression that were compared and assessed in two groups. Findings indicated that all cognitive coping strategies are used by adolescents less than adults that the most difference is in positive reappraisal strategy (12.31 ± 4 in adults vs. 8.49 ± 2.91 in adolescents) (F=312.11, p=0.001(. In addition, in both of groups, variance of anxiety and depression symptoms is explained by using of cognitive coping strategies (R2 =0.391, 0.441, 0.332, 0.385 and p<0.001). In both of groups, rumination play the most important role in anxiety and depression reporting (R2 =0.19, 0.55, 0.31, 0.046 and p< 0.05, p< 0.01, p<0.001). The results of study showed that cognitive coping strategies are used by adolescents less than adults.

Gastrointestinal function disorder was seen frequently in traumatic patients. In regarding to useful role of sexual hormones on gastrointestinal motility disorders, the aim of this study was to evaluate the effects of female sexual hormones on the gastric motility following TBI induction in female rats. This experimental study was done on the 63 Wistar female rats (200-250 g) that they were divided to 9 groups involving: intact, OVX (ovariectomized rat), Sham+OVX, TBI (intact rats under TBI), TBI+OVX (ovariectomized rats under TBI) and OVX+TBI rats treated with vehicle, estradiol, progesterone or estradiol+ progesterone combination. Diffuse TBI was induced by Marmarou method. Intragastric pressure, contraction frequency and motility index were measured 5 days after the TBI induction by power lab device and balloon technique. The intragastric pressure (IGP) was decreased in OVX (6.98 ± 0.3), TBI (7.34 ± 0.3) and TBI+OVX (6.04 ± 0.1) (p<0.01) and treatment with estradiol (7.58 ± 0.5) and estradiol+progesterone (7.92 ± 0.5) increased IGP (p<0.01). Motility index also was decreased following TBI and estradiol+progesterone combination significantly increased the motility index (4.1± 0.4) (p<0.05, p<0.01). The main effects of brain trauma and sexual hormones were done principally by changing of gastric smooth muscle contraction activity not frequency of gastric contractions.

Garlic has been shown to have anti-tumoral and anti-metastatic activities in some kinds of cancer. Therefore, it may be effective against fibrosarcoma. The effect of heating on garlic ingredients and its benefits are not clear. Therefore, in this study the effect of heating of garlic on the growth of WEHI-164fibrosarcoma cells in Balb/c mice was examined. The amounts of phenolic compounds and antioxidant capacity of heated and unheated garlic were also determined.

In an experimental study 40 inbred Balb/c mice were divided into 5 groups of 8 each. A single aliquot of 5 × 106 cells/100 µl WEHI-164 cells was injected subcutaneously in the chest of each animal. Groups 1, 3 and 5 received normal saline (0.2 ml), heated and unheated garlic (20 mg/kg) for two weeks before and three weeks after cell injection, and groups 2 and 4 received unheated and heated garlic, respectively. The mean size of tumors, antioxidant activity and phenolic compounds were measured and compared with each other.

The mean size of tumor in groups which received unheated garlic extract was smaller than that of heated group. Significant differences could be seen in the final last 6 days of experiment, so that the mean sizes of tumors on the 21st day of study was110±86 mm2in heated and 760±79 mm2in raw garlic groups (p<0.05). However, no significant effect could be seen on the growth of cancer cells in animals which received heated garlic extract. Antioxidant capacity of unheated and heated garlic was 52.6% and 2.07%, respectively (p>0.05). The amount of total phenolic compounds in raw garlic (12.61 mg/gr) was more than heated garlic (1.07 mg/gr) (p>0.05).

Garlic consumption may have important role in control and prevention of fibrosarcoma growth. But heating may decrease the phenolic compounds, antioxidant capacity and anticancer effect of garlic.

Acute administration of Methylenedioxymethamphetamine (MDMA) is produced dose-dependent effects on anxiety-related behaviors. High doses of MDMA have anxiolytic effects and low doses of MDMA increases anxiety-like behavior in the elevated plus maze test. The aim of this study was to evaluate the sub-chronic (7 days) effects of low doses of MDMA on anxiety in the male rat. In the present experimental study, 28 male Wistar rats were used with approximate weight 20 ± 200 g. Animals were randomly divided into 4 groups, 7 rats were used in each group and experimental groups for a week received different doses of MDMA (1.25, 2.5, 5 mg/kg) and sham group (1 ml/kg), received saline peritoneally. Anxiety one day before injection and 30 minutes after the last injection was performed by the elevated plus maze. Injection of MDMA significantly increased open arm time percentage that the highest observed in the experimental group received a dose of 5 mg/kg with mean 29.77±33.337. With increasing dose of MDMA increased open arm entry percentage that the difference between experimental group received a dose of 2.5 mg/kg and saline group was statistically significant (p<0.05). MDMA decreased pure index of locomotor activity. MDMA decreased open arm latency that the experimental group received a dose of 2.5 mg/kg less delay in entering the open arm compared to the other experimental groups, averaging 70.83±114.188 showed. Low doses of MDMA in sub-chronic (7 day) period can reduce some indices of anxiety in the rats.

Several different factors play role in developing gastric and colon cancers including infectious agents. Since there is no study about association of human T-lymphotropic virus 1 (HTLV-1) with cancers of digestive organ yet, so this study was performed to investigate the frequency of this infection in patients infected with gastric and colorectal cancers. This project was performed as a case-control study between years 2009 to 2012. Two hundred and sixty five patients were cases of gastric and colorectal cancer confirmed by pathology and 244 healthy subjects were those who underwent endoscopy and colonoscopy and shown no sign of abnormality. We used third generation ELISA on sera of these people to assess their anti-HTLV-1 antibody status. Two hundred and one GC patients, 64 CRC patients and 244 control subjects were enrolled in this study. Mean age of GC patients in the time of diagnosis was 59.24±12.50 years, CRC patients 58.98±13.39 and control subjects 57.83±11.25 years. One GC patient was positive for HTLV-1 antibody, no CRC patient was positive, while 4 control subjects had antibody against HTLV-1. There was no significant relationship between antibody positivity and gastric cancer or colorectal cancer. On the basis of current study, even though the rate of infection with this virus in GC patients was lower than control subjects.

Cancer is the third main cause of death in Iran after coronary heart disease and accidents. Age pattern of the cancer incidence and its distribution is related to regional conditions, nutritional habits, and environmental, physical and genetic factors. The aim of this study was to determine the age and sex pattern of cancer incidence and also classification of the different types of cancers among patients who referred to Shahid Rajai radiotherapy center Babolsar, Iran. The study was a retrospective research. Data were obtained by the review of patient's documents in Shahid Rajai radiotherapy center during 2000-2009. Data included demographic variables, and type of the cancer. The types of cancer were classified and assessed on the basis of International manual classification of diseases (ICD). During the 10-year study period, 8307 patients with cancer were referred to this center. 4207 (50.6%) were female. The mean age of the men and women was 57.49 ± 19.08 and 52.16 ± 16.05 years, respectively. Most frequency (43.7%) was among men 60-80 years of age at the time of diagnosis and women (47.1%) 40-60 years of age. The most common cancer among women was breast cancer (41.4%) and among men was esophagus cancer (10.3%). Other common cancers were esophagus (8%), brain (6.3%), stomach (4.1%) and cervix (3.4%) in females and stomach (10.2%), brain (8.2%), prostate (6.9%) and lung (6.4%) in males. The results showed that the most frequent cancers in men (60-80 years old) and in women (40-60 years old) are esophagus and breast cancer, respectively.

Chromosomal abnormalities are one of the causes of sexual ambiguity and in male genders the most common causes of genital ambiguity in chromosomal abnormalities’ category is Klinefelter syndrome and its rare 49,XXXXY syndrome variant. The main findings in these patients are facial and skeletal malformations, congenital heart defects, hypogonadism, and mental retardation. Determination of infant gender with sexual ambiguity at the time is very important and with timely diagnosis we can improve growth and development and treat associated anomalies.CASE: We report an 11 month old infant that initially was managed by pediatric cardiologist for congenital heart disease and referred to endocrinology clinic due to failure to thrive, facial malformations and ambiguous genitalia. The patient had a history of hospitalization for pneumonia in the PICU at the age of 10 months and improved after the treatment. After clinical examination, hormonal studies and karyotype, Klinefelter syndrome and its 49,XXXXY syndrome variant was diagnosed after 2 months. Then testosterone ampule was injected and orchiopexy surgery was performed. In follow-up, the patient was able to sit at the age of 18 months. In patients referred with ambiguous genitalia, mental retardation, facial anomalies and developmental disorders, 49,XXXXY syndrome and other similar syndromes must be considered and simultaneously they should be managed for cardiac problems, genital ambiguity, growth and development.