فهرست مطالب

Research in Medical Sciences - Volume:20 Issue: 10, 2015 Oct

Journal of Research in Medical Sciences
Volume:20 Issue: 10, 2015 Oct

  • تاریخ انتشار: 1394/08/05
  • تعداد عناوین: 16
|
  • Mariarosaria Di Tommaso, Viola Seravalli*, Francesca Vellucci, Mauro Cozzolino, Marina Spitaleri, Tommaso Susini Page 925
    Background
    Early recognition of the signs and symptoms of preterm labor (PTL) is important in order to establish treatment. Our aim was to determine the relation between cervical dilatation and time interval from admission to delivery in women with preterm labor.
    Materials And Methods
    A retrospective cohort study was conducted on 83 singleton gestations admitted for preterm labor between 24 weeks and 34 weeks, who subsequently delivered preterm. Women were categorized into three groups of cervical dilatation (0-2 cm, 3-6 cm, >6 cm) and the time interval from admission to delivery was compared. Cox regression analysis was performed to assess the association between cervical dilatation and time interval from admission to delivery. The other variables examined were gestational age (GA) at admission and length of the cervix, when performed.
    Results
    The time interval from admission to delivery was significantly shorter in women with higher dilatation of the cervix (p < 0.02) and in those admitted at a more advanced gestational age (p < 0.05). Forty-eight percent of women with cervical dilatation 0-2 cm delivered in the first 48 h compared to 85% of the women with a dilatation of 3-6 cm. No significant association was found between the length of the cervix and the time interval to delivery.
    Conclusion
    Dilatation of the cervix and gestational age at admission are associated with the time interval to delivery in women with preterm labor. The assessment of the length of the cervix is unlikely to add clinical information in women with an already dilated cervix.
    Keywords: Length of cervix, gestational age, obstetric labor, premature birth, uterine cervix dilatation
  • Mehrdad Salehi, Abas Azarbayejani, Katayoun Shafiei, Tayebe Ziaei*, Bahar Shayegh Page 930
    Background
    People with visual disability have lower self-esteem and social skills than sighted people. This study was designed to describe self-esteem and general and sexual self-concepts in blind people.
    Materials And Methods
    This was a cross-sectional study, conducted in the Isfahan University of Medical Sciences in 2013-2014. In this study, 138 visually impaired people participated from Isfahan Province Welfare Organization and were interviewed for measuring of self-esteem and self-concept using Eysenck self-esteem and Rogers’ self-concept questionnaires. The correlation between above two variables was measured using Statistical Package for the Social Sciences (SPSS) software by Pearson correlation test.
    Results
    Mean [± standard deviation (SD)] age of patients was 30.9 ± 8 years. The mean (±SD) of general self-concept score was 11 ± 5.83. The mean (±SD) of self-esteem score was 16.62 ± 2.85. Pearson correlation results showed a significant positive correlation between self-esteem and general self-concept (r = 0.19, P = 0.025). The mean of sexual self-concept scores in five subscales (sexual anxiety, sexual self-efficacy, sexual self-esteem, sexual fear, and sexual depression) were correspondingly 11 ± 4.41, 19.53 ± 4.53, 12.96 ± 4.19, 13.48 ± 1.76, and 5.38 ± 2.36. Self-esteem and self-concept had significant positive correlation with sexual anxiety (r = 0.49; P < 0.001) (r = –.23; P < 0.001) and sexual fear (r = 0.25; P = 0.003) (r = 0.18; P = 0.02) and negative correlation with sexual self-efficacy (r = –0.26; P = 0.002) (r = –0.28; P = 0.001) and sexual-esteem (r = –0.34; P < 0.001) (r = –0.34; P < 0.001).
    Conclusion
    Self-esteem and self-concept had significant correlation with sexual anxiety and sexual fear; and negative correlation with sexual self-efficacy and sexual-esteem.
    Keywords: Self, concept, self, esteem, sexual self, concept, visual impairment
  • Mohammad Amin Younessi Heravi *, Mohsen Yaghubi, Simin Joharinia Page 937
    Background
    One of the most common and important diagnostic methods for the detection of heart diseases is coronary angiography. The aim of this study was to determine the optimum angle of the bed by using vital signals to optimize the patient’s position after the angiography.
    Materials And Methods
    This study was a randomized clinical trial (RCT) on participants after angiography who were divided into five groups. The first group was placed routinely in a supine position. In the other groups, all of the patients were placed in bed by angle 15°, 30°, 45°, and 60° upward. In each group, vital signals were measured that included blood pressure, percent of blood oxygen saturation, heart rate, respiratory rate, and temperature. All of measured data compared with the pain score has been achieved from numerical pain scale. The data were analyzed by descriptive statistics method, variance analysis, and post hoc tests in the Statistical Package for the Social Sciences (SPSS) software, version 16. Estimation of the relationship was done by MATLAB version 2011. The level of significance was considered to be 0.05.
    Results
    In various groups, there was no significance difference in demographic variables such as gender, age, height, and weight. The mean of pain score, heart rate, systolic blood pressure, and respiratory rate changed significantly (P < 0.05) but the temperature variation, blood oxygen saturation, and diastolic blood pressure in subjects were not significant (P > 0.05). It showed linear changes between pain and systolic blood pressure, respiratory rate, and heart rate changes. A dramatic reduction was also seen in systolic blood pressure, respiratory rate, heart rate, and also pain at an angle of 45°.
    Conclusion
    This study showed that, 45° was the best angle of the bed to optimize the patient’s position after the procedure, based on his/her vital signs and pain score. Thus, in order to relive pain, this change in bed angle is advised to be planned by postangiography nurses in patients after coronary angiography.
    Keywords: Coronary angiography, pain, pain score, bed position, vital signals
  • Tohid Jafari, Koshki, Sayed Mohsen Hosseini*, Shahram Arsang, Jang, Masoud Amini, Elham Faghihimani Page 944
    Background
    Diabetes mellitus is a metabolic disorder and its subsequent complications such as retinopathy, nephropathy, ulcers, disability, and amputation increase the burden of the disease. Patient knowledge-improving programs are employed to prevent disease progression and to improve the quality of life of the patients. In this way, we need to characterize the groups of patients in urgent need for more and rich-in-content programs. In the present study, we used piecewise regression to evaluate the trends of diabetic nephropathy prevalence in patients registered in the Sedigheh-Tahereh Research Center and to identify patients who were in need of more attention.
    Materials And Methods
    Piecewise regression, used in this study, is a statistical method to identify change points, if any, in the trends of mortality rates, prevalence of a disease, or any other trends. Available information for 1,935 patients were retrieved from the database. Joinpoint program 3.5.3 and Statistical Package for the Social Sciences (SPSS) 20 was used to fit piecewise regression and obtain descriptive statistics, respectively.
    Results
    We assessed the trend of diabetic nephropathy in different groups of diabetic patients with respect to sex, blood pressure status, education, family history of diabetes, and age. The results showed an increasing trend in females, patients without family history of diabetes, and eover th recent years. The prevalence of diabetic nephropathy in patients with academic education was high.
    Conclusion
    The groups with high prevalence or increasing trends need more preventive intervention and detailed assessment of the present trends. Exploring high-risk groups is beneficial for better policy-making in the future. However, discovering the reasons for the increased trend of the disease is really helpful in controlling diabetes complications.
    Keywords: Diabetic nephropathy, piecewise regression, prevalence, trend
  • A. Khalil Maha *, M. El, Sheekh Mostafa, I. El, Adawi Hala, M. El, Deeb Nehal, Z. Hussein Mohamed Page 950
    Background
    Probiotic delivery systems are widely used nutraceutical products for the supplementation of natural intestinal flora. These delivery systems vary greatly in the effectiveness to exert health benefits for a patient. This study focuses on providing probiotic living cells with a physical barrier against adverse environmental conditions.
    Materials And Methods
    Microencapsulation of the selected lactic acid bacteria (LAB) using chitosan and alginate was performed. Physical examination of the formulated LAB microcapsules was observed using phase contrast inverted microscope and scanning electron microscope (SEM). Finally, the survival of microencapsulated and noncapsulated bacteria was cheeked in the simulated human gastric tract (GT). The potential antimicrobial activity of the most potent microencapsulated LAB strain was in vivo evaluated in rabbit models.
    Results
    Microencapsulated L. plantarum, L. acidophilus, and L. bulgaricus DSMZ 20080 were loaded with 1.03 × 1010 CFU viable bacteria/g, 1.9 × 1010 CFU viable bacteria/g, and 5.5 × 109 CFU viable bacteria/g, respectively. The survival of microencapsulated cells was significantly higher than that of the free cells after exposure to simulated gastric juice (SGJ) at pH 2. Additionally, in simulated small intestine juice (SSJ), larger amounts of the selected LAB cells were found, whereas in simulated colon juice (SCJ), the released LAB reached the maximum counts. In vivo results pointed out that an 8-week supplementation with a triple therapy of a microencapsulated L. plantarum, L. acidophilus, and L. bulgaricus DSMZ 20080 might be able to reduce H. pylori.
    Conclusion
    Microencapsulated probiotics could possibly compete with and downregulate H. pylori infection in humans.
    Keywords: Helicobacter pylori (H. pylori), microcapsule, probiotics
  • Maryam Salehi, Abbas Haghighat, Hassan Salehi, Roya Taleban, Marzieh Salehi, Nader Kalbasi, Mohammad Moafi*, Mohammad Mahdi Salehi Page 958
    Background
    Hepatitis B virus (HBV) fails to produce appropriate immune responses in some healthy individuals; thus, different strategies have been adopted to promote immune responses. The current study aimed at evaluating the efficacy of HBV vaccine coadministered with tetanus-diphtheria (Td) vaccine compared with HBV vaccine in healthy individuals through measuring hepatitis B surface antibody (HBsAb) levels.
    Materials And Methods
    This was a randomized controlled clinical trial, which was implemented in Isfahan, Isfahan Province (Iran) in 2013. One hundred and forty healthy individuals, whose HBsAb titers were less than 10 IU/L were recruited. The subjects were randomly assigned to either in intervention or control trials. The control group received 40 µg of recombinant HBV vaccines intramuscularly injected at 0, 1, and 6 months; however, the intervention group was simultaneously vaccinated by Td with the first dose of HBV vaccine. HBV antibody levels (titer) were measured before the vaccination and 6 months after the last vaccination.
    Results
    Antibody titers of the subjects in the intervention and control groups increased from 5.07 ± 2.9 IU/L to 744.45 ± 353.07 IU/L and from 4.45 ± 3.4 IU/L to 589.94 ± 353 IU/L, respectively (both P < 0.001). Also, the mean difference of antibody titer was significantly different between the two groups (P = 0.011).
    Conclusion
    Td vaccination can be applied as a feasible approach to promote efficient and persistent immunity in healthy individuals with insufficient HBsAb titers.
    Keywords: Hepatitis B surface antibody (HBsAb) titer_hepatitis B vaccine_tetanus_diphtheria (Td) vaccine
  • Shuxia Wang, Kangxing Song, Hao Xue, Jingzhou Chen, Yubao Zou, Kai Sun, Hu Wang, Rutai Hui* Page 963
    Background
    The association of metabolic syndrome (MS) with left ventricular (LV) hypertrophy is controversial. The objective of our study was to investigate the influence of MS on LV mass and geometry in community-based hypertensive patients among Han Chinese.
    Materials And Methods
    This study included 1733 metabolic syndrome patients according to the International Diabetes Federation (IDF) definition and 2373 non-MS hypertension patients. LV hypertrophy was diagnosed by the criteria of LV mass ≥49.2 g/m2.7 for men and 46.7 g/m2.7 for women. LV geometric patterns (normal, concentric remodeling, concentric or eccentric hypertrophy) were calculated according to LV hypertrophy and relative wall thickness. Logistic regression analysis was used to determine odds ratio (OR) and 95% confidence interval (CI) of MS for LV hypertrophy and LV geometry abnormality.
    Results
    The LV mass and LV mass index were higher in the MS group than in the non-MS group. In multiple adjusted models. LV mass index, LV mass, interventricular septum, and post wall were raised with the increased number of MS disorders. MS was associated with increased LV hypertrophy risk (unadjusted OR 1.38; 95% CI 1.21-1.57); age, sex, and blood pressure (BP; adjusted OR 1.39; 95% CI 1.22-1.59). MS was also associated with increased risk of eccentric hypertrophy in male and female patients. MS was only associated with increased risk of concentric hypertrophy in female patients; and MS was not associated with concentric remodeling.
    Conclusion
    LV mass and LV mass index were associated with the increased number of MS disorders in the Chinese community-based hypertensive population. MS was not only associated with increased LV hypertrophy risk, but also associated with concentric and eccentric LV geometry abnormality, especially in females.
    Keywords: Hypertension, left ventricular (LV) geometry abnormality, LV hypertrophy, metabolic syndrome (MS)
  • Marzeie Sharifzadeh, Atoosa Adibi, Kimia Kazemi, Silva Hovsepian* Page 969
    Background
    Considering that establishment of reference value of nuchal translucency (NT)-related to the crown rump length (CRL) during the first trimester will be helpful for determining an appropriate cutoff level for screening of increased NT thickness-related abnormalities, we determined the NT thickness and investigated its relation with different chromosomal and nonchromosomal abnormalities among a large sample size of pregnant Iranian women.
    Materials And Methods
    In this analytic cross-sectional study, pregnant women who were in their first trimester were enrolled at their antenatal visit. Using an abdominal ultrasonography, the fetal NT thickness of the studied population was measured. Those with increased NT thickness were determined. The reference value of NT thickness (5th, 25th, 50th, 75th, and 95th percentiles) within each 5-mm range of CRL and during the 11th, 12th, and 13th gestational weeks were determined. The presences of the different chromosomal and nonchromosomal abnormalities were compared in women with different percentiles of NT thickness who underwent amniocentesis and those who did not.
    Results
    1,614 pregnant women were evaluated. The mean NT thickness was 1.30 ± 0.54 mm. Increased NT thickness >2 mm and >95th percentile according to their gestational age (GA) was detected in 89 (5.5%) and 58 (3.6%) pregnant women. The reference 95th percentile value range for NT was 1.8-2.35 and increased NT thickness according to our obtained values was associated significantly with chromosomal abnormalities.
    Conclusion
    The obtained reference range in our studied population was different from that reported for other ethnic groups and it is suggested that using this values are more favorable for screening of chromosomal abnormalities during the first trimester of pregnancy than the recommended single cutoff value.
    Keywords: Crown rump length (CRL), nuchal translucency (NL), reference values
  • Hamid Mazdak, Maasoumeh Rashidi*, Moien Zohary Page 974
    Background
    The main threats to human health from heavy metals are associated with exposure to plumb (Pb), cadmium, mercury, and arsenic. Some hazards that threat human health are the results of environmental factors and the relevant pollutions. Some important categories of diseases including (cancers) have considerable differences in various places, as observed in their spatial prevalence and distribution maps. The present study sets out to investigate the correlation between kidney cancer and the concentration of Pb in Iran.
    Materials And Methods
    In this study, the first challenge was to collect some relevant information. In this connection, the authors managed to gain access to data concerning kidney cancer in Iran. The data were collected by a health centre for the period of 2008-2010. Besides, a map of Pb distribution in soil, drawn by the Mineral Exploration Organization, and Plumb Concentration Information, collected by Agriculture Jihad Organization, were used. Using a geographic information system (GIS) software such as ArcGIS (USA), the researchers drew the map of the spatial distribution of kidney cancer in the Iran country. In the indirect methods, one measures vegetation stress caused by heavy metal soil contamination. In direct methods, target detection algorithms are used to detect a selected material on the basis of its unique spectral signature. In this research, we applied target detection algorithms on moderate resolution imaging spectroradiometer (MODIS) images to detect Pb. MODIS is a sensor placed on the Terra satellite that collects data in 35 spectral bands with 250-1,000 m special resolutions.
    Results
    The spatial distribution of kidney cancer in Iran country delineated above revealed a positive correlation between the amount of lead and the high frequency of kidney cancer. Regression analyses also confirmed this relationship (R2 = 0.77 and R = 0.87).
    Conclusion
    The findings of the current study underscore not only the importance of preventing exposure to Pb but also the importance of controlling Pb-producing industries.
    Keywords: Correlation, Iran, Isfahan, kidney cancer, plumb (Pb), spatial distribution
  • Seyed Mohammad Hossein Kashfi, Ehsan Nazemalhosseini Mojarad, Mohammad Amin Pourhoseingholi, Hamid Asadzadeh Aghdaei*, Fakhrialsadat Anaraki, Mohammad Reza Zali Page 978
    Background
    Colorectal cancer (CRC) is the second cause of cancer-related deaths worldwide. There have been several studies reporting the proximal tumor shift, especially in Western countries. In the present study, we investigated the clinicopathologic and anatomical distributions of colorectal tumors in Iranian CRC patients.
    Materials And Methods
    In this retrospective cohort study, 258 patients with CRC from 2008 to 2013 were evaluated. Comparison of variables was performed using Pearson’s chi-square test and Fisher’s exact test depending on the nature of the data.
    Results
    A total of 258 patients including 124 (48.1%) females and 134 (51.9%) males enrolled in this study. The majority of cancers were detected in the rectosigmoid, i.e., 98 (38%) followed by the left colon, i.e., 84 (32.6%) and the right colon, i.e., 76 (29.5%). In the present study, we observed the significant association between metastases, adjuvant therapy, family history, and history of inflammatory bowel disease (IBD) with tumor, node, and metastasis (TNM) staging (P < 0.001). In univariate analysis, there was a strong association between overall survival (OS) and stage II CRC (P = 0.03). However, the predictive value was lost in multivariate analysis (P = 0.145).
    Conclusion
    Unlike the majority of previous studies on Iranian CRC patients, we observed a considerably higher occurrence of right-sided colon cancers (84 versus 76). Although this phenomenon did not reach the statistical significance rate, based on recent studies on Iranian population including the present one, the pattern of anatomical distribution of colorectal tumors has been changed toward the proximal colon. This requires an urgent need to provide other strategies and complementary detecting approaches in order to identify proximal tumors in Iranian CRC patients.
    Keywords: Colorectal cancer (CRC), Iran, proximal shift, survival
  • Nasrin Jiryaee, Zahra Dana Siadat*, Ahmadreza Zamani, Roya Taleban Page 987
    Background
    Designing an intervention to increase physical activity is important to be based on the health care settings resources and be acceptable by the subject group. This study was designed to assess and compare the effect of the goal setting strategy with a group education method on increasing the physical activity of mothers of children aged 1 to 5.
    Materials And Methods
    Mothers who had at least one child of 1-5 years were randomized into two groups. The effect of 1) goal-setting strategy and 2) group education method on increasing physical activity was assessed and compared 1 month and 3 months after the intervention. Also, the weight, height, body mass index (BMI), waist and hip circumference, and well-being were compared between the two groups before and after the intervention.
    Results
    Physical activity level increased significantly after the intervention in the goal-setting group and it was significantly different between the two groups after intervention (P < 0.05). BMI, waist circumference, hip circumference, and well-being score were significantly different in the goal-setting group after the intervention. In the group education method, only the well-being score improved significantly (P < 0.05).
    Conclusion
    Our study presented the effects of using the goal-setting strategy to boost physical activity, improving the state of well-being and decreasing BMI, waist, and hip circumference.
    Keywords: Physical activity, goal setting, exercise, obesity, mothers, waist circumference, well being, health education
  • Fahimeh Jamshidi, Roya Kelishadi* Page 994
    Background
    Evidence proposes that maternal calcium (Ca) supplement during pregnancy may be inversely associated with the off spring’s blood pressure (BP) level. It is suggested that increased maternal Ca intake during pregnancy may result in lower BP in the off spring. The reduction in the incidence of hypertension in mothers is documented but the effects on the off spring are uncertain.
    Materials And Methods
    We conducted a systematic review of the literature to summarize the evidence supporting an association between maternal dietary Ca intake during pregnancy and the BP in the off spring. In this systematic review, relevant papers were selected in three phases. After quality assessment, a reviewer extracted the data while the other one checked the extracted data. We summarized the information regarding the association of maternal Ca intake either by food or supplements with BP in the off spring.
    Results
    Four randomized trials and three observational studies were included in this review. The results were more consistent among the studies including older children (1-9 years) where a higher maternal Ca intake was associated with a reduction in the off spring’s systolic BP. One large randomized trial found a clinically and statistically significant reduction in the incidence of elevated BP in 7-year-old children [relative risk (RR) = 0.59, 95% confidence interval (CI) 0.39-0.90].
    Conclusion
    Overall, our findings confirm the beneficial effects of maternal Ca intake during pregnancy for the off spring’s BP level.
    Keywords: Blood pressure (BP), calcium (Ca), maternal, offspring, pregnancy, prevention
  • Shi Hui Cheng, Mohd Yusof Barakatun Nisak*, Joseph Anthony, Amin Ismail Page 1000
    Cosmos caudatus is widely used as a traditional medicine in Southeast Asia. C. caudatus has been reported as a rich source of bioactive compounds such as ascorbic acid, quercetin, and chlorogenic acid. Studies have shown that C. caudatus exhibits high antioxidant capacity and various medicinal properties, including anti-diabetic activity, anti-hypertensive properties, anti-inflammatory responses, bone-protective effect, and anti-microbial activity. This review aims to present the potential medicinal benefits of C. caudatus from the available scientific literature. We searched PubMed and ScienceDirect database for articles published from 1995 to January 2015. Overall, 15 articles related to C. caudatus and its medicinal benefits are reviewed. All these studies demonstrated that C. caudatus is effective, having demonstrated its anti-diabetic, anti-hypertensive, anti-inflammatory, bone-protective, antimicrobial, and anti-fungal activity in both in vitro and animal studies. None of the studies showed any negative effect of C. caudatus related to medicinal use. Currently available evidence suggests that C. caudatus has beneficial effects such as reducing blood glucose, reducing blood pressure, promoting healthy bone formation, and demonstrating anti-inflammatory and anti-microbial properties. However, human clinical trial is warranted. Key words:
    Keywords: Anti, diabetic, anti, hypertensive, anti, inflammatory, anti, microbial, anti, oxidant, bone, protective, Cosmos caudatus, medicinal effect
  • Saurabh R. Shrivastava, Prateek S. Shrivastava, Jegadeesh Ramasamy Page 1016
  • Ahad Azami, Nasrollah Maleki Page 1018
  • Allahyar Golabchi, Majid Mazoochi, Hamid Reza Fayyazi Page 1020