مجله دانشگاه علوم پزشکی بابل
سال هفدهم شماره 12 (پیاپی 99، آذر 1394)

Anxiety is a major symptom of menopause caused by loss of ovarian activity. Anxiety increases the intensity of vasomotor symptoms in menopausal women. This study aimed to compare the effects of exercise and estrogen on anxiety level of ovariectomized mice. This empirical study was conducted on 28 mice (weight: 25-35 grams) divided into four groups of seven, including ovariectomy, ovariectomy and exercise, ovariectomy and estrogen (40 mg/kg of estradiol valerate), and ovariectomy combined with exercise and estrogen. Animals were initially ovariectomized and one week later, they were placed on treadmills to run at medium intensity for 30 minutes per day. Intervention continued for five days per week, and after four weeks, anxiety was evaluated using elevated plus-maze. In this study, estrogen significantly increased the percentage of open arm entry (OAE) compared to ovariectomy group (22.13±4.72 vs. 4.91±3.18, respectively) (p<0.05). In addition, combination of estrogen and exercise significantly increased open arm time (OAT) compared to ovariectomy group (46.19±6.82 vs. 4.91±3.18, respectively) (p<0.001). However, no significant difference was observed between exercise and estrogen groups. Also, exercise alone increased OAE compared to ovariectomy group (24.54±3.18 vs. 13.79± 3.23, respectively) (p<0.05). Percentage of OAE in groups of estrogen, exercise and combined exercise and estrogen was 30.61±1.25, 24.54±3.18 and 46.08±1.04, respectively, which was indicative of no significant difference. However, estrogen and combined estrogen and exercise significantly increased OAE compared to ovariectomy group (p<0.001). According to the results of this study, similar to estrogen, exercise could reduce the anxiety induced by ovariectomy in mice.

Maintenance of temperature at normal range by supplying heat and reducing its loss is an important part of neonatal care. This study aimed to investigate the effectiveness of in-service training for nurses on maintaining normal body temperature and eliminating heat stress and to compare the care practices to the current standards in term new-borns, before and after training on neonatal hypothermia care in hospitals affiliated to Babol University of Medical Sciences, in 2014. This descriptive-intervention study was performed on 98 newborns to evaluate the nursing care provided for prevention of neonatal hypothermia in the operating rooms, maternity and neonatal wards, and NICUs before and one month after training on neonatal hypothermia care. The data were obtained using a self-regulated checklist, which was designed according to the relevant standards of care for prevention of hypothermia. The checklists were scored based on the number of provided nursing care practices. The intervention included speech, educational posters, leaflets, and slides. The mean scores of nursing care before and after the intervention were 4.6±1.1 and 7.0±1.4 (out of 10), respectively, in the delivery rooms the respective mean sores were 8.4±1.4, and 11.1±0.7 (out of 13), for the operating rooms they were respectively 5.9±1.8, and 7.3±0.8 (out of 11), and in the NICUs they were 8.0±1.5, and 9.8±2.0, respectively (out of 14; p=0.0001). The prevalence of mild hypothermia at birth in the operating and delivery rooms was 38.1% and 21.5% before and after training, respectively. The highest level of care for the preservation of warm chain was provided in operating rooms and the lowest level of care was observed in delivery rooms. To prevent hyperthermia, health policy-makers are recommended to focus more attention on maintaining temperature in and providing facilities for this purpose

Cerebral ischemia is a common cause of mortality, which can be described as a focal brain defect secondary to trauma. This study aimed to determine the relationship between consumption of Cucurbita moschata seed oil and stroke volume, as well as the neurological disorders in a cerebrovascular model of rats. In this empirical study, 28 mature male Wistar rats weighing between 250 and 350 gr were divided into four groups. The control group was gavaged with distilled water, and the other three groups received 0.25, 0.50, and 0.75 ml/kg Cucurbita moschata seed oil orally for 30 days. At the end of the thirty-day period, the animals underwent middle cerebral artery occlusion in order to induce stroke. Twenty-four hours after reperfusion, lesion volume and neurological disorders were evaluated. It was found that 0.50 and 0.75 ml/kg doses of Cucurbita moschata seed oil reduced neurological disorders (p<0.021 and p<0.000, respectively). In addition, stroke volume decreased in the cortical area at doses 0.50 (55.02±7.6) and 0.75 (30.05±9.06) ml/kg, as compared to the control group (133.02±9.11; p<0.000 and p<0.000). Consumption of Cucurbita moschata seed oil can reduce symptoms of ischemic stroke

Constipation and hemorrhoids are common problems during the postpartum period. Therefore, effective measures should be taken to diminish the deleterious effects of these complications on maternal health. In this study, we aimed to determine the efficacy of postpartum home care on the rate of constipation and hemorrhoids. This clinical trial was conducted in two phases on 276 women, who gave birth at hospitals, affiliated to Shahid Beheshti University of Tehran, Iran in 2013. The subjects were divided into intervention (n=92) and control (n=184) groups. First, a model of care was designed by comparative analysis and collection of data on home care guidelines for mothers and newborns, applied in different countries. In the second stage, women received home care services, based on the proposed model (on days 3-5 and 13-15 postpartum). On the other hand, subjects in the control group did not receive any services. The rates of constipation and hemorrhoids were recorded and compared via history taking and clinical examinations by midwives on day 60 following delivery. (IRCT:2013060313565N1) The mean age of the participants was 27±5 years. Based on the evaluation of outcomes on day 60 following delivery, constipation was reported in 13% of cases in the intervention group and 26.1% of subjects in the control group. Moreover, hemorrhoids were reported in 12% and 9.8% of women in the intervention and control groups, respectively; however, there was no significant difference between the two groups in terms of these complications. Based on the results of this study, postpartum home care, complemented with physical exercise, a healthy diet, and use of laxatives in unresponsive cases to supportive treatment, could reduce constipation, whereas hemorrhoids remained unaffected.

Leachate, which contains large amounts of ammonium and hazardous organic compounds, can lead to the pollution of surface water and groundwater; consequently, leachate collection and treatment are essential before discharge into the environment. Anaerobic digestion is one of the most cost-effective methods of contaminated wastewater treatment. In this study, we aimed to evaluate the efficiency of an anaerobic digester in simultaneous removal of chemical oxygen demand (COD) and ammonium from landfill leachate. In this experimental study, a cylindrical anaerobic digester, made of Plexiglas sheets (with an inner diameter of 240 mm and useful volume of 10 L), was loaded with landfill leachate in Ghaemshahr, Iran. The effects of temperature (ambient temperature, 35°C, and 55°C) and various hydraulic retention times (1-5 days) on anaerobic digestion efficiency in COD and ammonium removal were assessed. At a hydraulic retention time of five days, maximum COD and ammonium removal (94% and 36%, respectively) was reported at thermophilic and ambient temperatures, respectively. The increase in hydraulic retention time had a positive impact on the efficiency of the digester in removing organic compounds and ammonium. Moreover, the rise in anaerobic digester temperature improved COD and ammonium removal. According to our findings, the developed anaerobic digester could be used as a convenient and efficient tool for removing organic matters from landfill leachate. However, given the low efficiency of this digester in ammonium removal, an additional aerobic stage is required for wastewater treatment.

Anxiety is a major symptom of menopause caused by loss of ovarian activity. Anxiety increases the intensity of vasomotor symptoms in menopausal women. This study aimed to compare the effects of exercise and estrogen on anxiety level of ovariectomized mice.

This empirical study was conducted on 28 mice (weight: 25-35 grams) divided into four groups of seven, including ovariectomy, ovariectomy and exercise, ovariectomy and estrogen (40 mg/kg of estradiol valerate), and ovariectomy combined with exercise and estrogen. Animals were initially ovariectomized and one week later, they were placed on treadmills to run at medium intensity for 30 minutes per day. Intervention continued for five days per week, and after four weeks, anxiety was evaluated using elevated plus-maze.

In this study, estrogen significantly increased the percentage of open arm entry (OAE) compared to ovariectomy group (22.13±4.72 vs. 4.91±3.18, respectively) (p<0.05). In addition, combination of estrogen and exercise significantly increased open arm time (OAT) compared to ovariectomy group (46.19±6.82 vs. 4.91±3.18, respectively) (p<0.001). However, no significant difference was observed between exercise and estrogen groups. Also, exercise alone increased OAE compared to ovariectomy group (24.54±3.18 vs. 13.79± 3.23, respectively) (p<0.05). Percentage of OAE in groups of estrogen, exercise and combined exercise and estrogen was 30.61±1.25, 24.54±3.18 and 46.08±1.04, respectively, which was indicative of no significant difference. However, estrogen and combined estrogen and exercise significantly increased OAE compared to ovariectomy group (p<0.001).

According to the results of this study, similar to estrogen, exercise could reduce the anxiety induced by ovariectomy in mice.

Stroke is the second most common cause of death and a major cause of disability in individuals aged over 65 years, worldwide. Considering the complex pathological process of ischemia, use of one single agent does not seem ideal for treatment. Therefore, studies in search of effective compounds and methods are under way. In recent years, increased attention has been paid to medicinal plants as potential sources for the treatment of ischemia and reperfusion. This study aimed to introduce the pathogenesis of cerebral ischemia and review the effects of medicinal plants and their mechanisms of action in cerebral ischemia. In this study, articles indexed in scientific databases including ISI, SID, PubMed, PubMed Central, Scopus, and Web of Science were evaluated, using the following keywords in Farsi and English: "Ischemia and reperfusion", "medicinal herbs", and "antioxidant properties". The review of conducted studies showed that medicinal plants and their compounds are capable of reducing infarct volume, cerebral edema, neuronal damages, sensory problems, and motor disorders through reducing oxidative and nitrative stress. Moreover, these plants are able to decrease the expression of inflammatory mediators, inhibit DNA fragmentation and oxidative DNA damage, reduce microglial and astrocyte activities, increase the expression of mitochondrial genes, inhibit apoptotic protein expression, reduce eicosanoids, and boost anti-apoptotic protein expression. Medicinal herbs and their compounds are able to diminish the damages caused by cerebral ischemia through several pathways; therefore, they can be used as new sources against cerebral ischemia.

Pain management is one of the most important indicators for nursing care quality. Pain management is still ineffective and inadequate in pediatric wards. Therefore, in this study, we aimed to evaluate pain management nursing in pediatric wards and suggest practical solutions with regard to pediatric pain control. In this review article, Iranian (i.e., MagIran, Iran Medex, Irandoc, and SID) and international (i.e., Medline, Google Scholar, Google, and Science Direct) databases were searched, using the following keywords and their Farsi equivalents: “pain management”, “pediatric”, “nurse”, “barriers”, and “hospital”. Among 4064 studies, 51 relevant articles, published during 1994-2015, were retrieved and reviewed in this study. In total, eight challenging areas were recognized in pediatric pain management, which are as follows: limited theoretical knowledge and insufficient skills of nursing staff, nurses’ personal beliefs, organizational barriers, characteristics of parents and children, lack of professional interaction, ambiguous role of nurses in pain management, lack of parental involvement or children’s participation in pain management, and scarcity of local models for pain management. By identifying nursing challenges and proposing practical solutions (e.g., modifications in organizational structure), we hope to take a major step towards removing barriers against pediatric pain management.

Rabies is an acute untreatable fatal encephalitis, which is fully preventable. Determination of prevalence and the main source of the virus can help with controlling and eradicating the disease. This study aimed to evaluate the prevalence of rabies in the suspicious specimens submitted to the national reference center for rabies, Pasteur Institute of Iran, during March-August 2015. This cross-sectional study was performed on 195 rabies-suspected specimens of brain tissue. The diagnosis was done based on the determination Negri bodies through direct immunofluorescence method. In addition, rabies infection was evaluated in terms of animal type and geographic distribution. The results showed that the prevalence rate of rabies infection was 59.5% (116 specimens). This infection was mostly observed among dogs, so that from 116 cases of positive rabies, 45 cases were canine (39%). In categorizing the specimens into carnivorous and ruminant, it was found that rabies was more prevalent in carnivorous animals (p=0.01). In terms of geographic distribution, the most cases of positive rabies were reported in Khorasan Razavi province with 23 positive cases (24.2%). Rabies infection is highly prevalent in carnivorous animals, especially dogs, and it is still considered as a dangerous zoonotic disease.

Uterine carcinosarcoma، also known as malignant mixed Mullerian tumor، is a rare uterine malignancy. Although the origin and prognosis of this cancer remain undetermined، the Mullerian ducts are believed to be the main origin. This tumor has the ability to change into epithelial and mesenchymal components and is more common among black and postmenopausal women. Prior history of radiation therapy and use of tamoxifen also contribute to this condition. The clinical characteristics of uterine carcinosarcoma، including postmenopausal bleeding، are similar to those of endometrial cancer. This condition with a poor prognosis and aggressive nature may be overcome by a combination of therapies including surgery، chemotherapy، and radiotherapy. Herein، we present a case of uterine carcinosarcoma associated with tamoxifen use in a menopausal patient. CASE REPORT: The patient was a 67-year-old menopausal woman (G9، P5، L5، Ab4)، who underwent lumpectomy and chemoradiotherapy ten years ago due to estrogen receptor-positive breast cancer (ductal carcinoma). The patient received 40 mg of tamoxifen on a daily basis، and after six years of tamoxifen use، she experienced postmenopausal bleeding. Increased endometrial thickness appeared in the ultrasound، and uterine carcinosarcoma was diagnosed، based on pathologic evaluations. The patient received multi-modal therapy، and after a year of follow-up، no specific problems were reported. According to the results، symptoms of uterine cancer should be taken into account in menopausal patients consuming tamoxifen.