Journal of Research in Medical Sciences
Volume:20 Issue: 11, 2015 Nov

Chlorpyrifos (CP) is one of the most widely used organophosphate (OP) insecticides in agricultural and residential pest control with its attendant adverse health eff ect. In the present study, it is proposed to investigate the possible modulatory role of magnesium oxide nanoparticles (MgO NPs) against CP-induced toxicity in human lymphocytes and determine the mechanisms lying behind this protection by viability and biochemical assays. Isolated lymphocytes were exposed to 12? g/mL CP either alone or in combination with diff erent concentrations of MgO NPs (0.1? g/mL, 1? g/mL, 10? g/mL, and 100? g/mL). After a 3-day incubation,the viability and oxidative stress markers including cellular mitochondrial activity, caspase-3 and -9 activities, total antioxidant power, lipid peroxidation, and myeloperoxidase (MPO) activity were measured. Also, the levels of tumor necrosis factor-? (TNF-?) as infl ammatoryindex, along with acetylcholinesterase (AChE) activity were measured. Statistical diff erences were determined using one-way analysis of variance (ANOVA) and Dunnett’s multiple comparison tests. It is indicated that CP-exposed lymphocytes treated with MgO NPs resulted in a substantial reduction in the pace of mortality as well as the stages of oxidative stress in a dose-dependent manner. Also, MgO NPs (100? g/mL) meaningfully restored CP-induced increase of TNF-? (P < 0.001) and decrease of AChE activity (P < 0.001) and were capable of preventing CP-treated human lymphocytes from apoptosis (P < 0.001). Our results demonstrate that MgO NPs in approximate 100 nm diameter not only make cells resistant to the toxic properties of CP but also attenuate toxic eff ects of CP,which is demonstrating the potential of MgO NPs to be applied in future immune defi ciency therapeutic strategies.

Because of the increasing usage of waterpipe globally, we need to know more about the diff erent factors related to waterpipe and cigarette smoking. Th erefore, the present study aims at gaining more insight on waterpipe and cigarette smoking based on perceived parental reaction and appeal and repellent of smoking among adolescents. A cross-sectional survey entitled “Isfahan Tobacco Use Prevention Program” (ITUPP) was conducted among 5,500 adolescents in Isfahan Province, Iran in 2010 using a selfadministered anonymous questionnaire. Demographic factors, cigarette and waterpipe smoking status, appeal and repellent of smoking,perceived parental reactions, and the main reasons behind the increase in waterpipe smoking were measured. Chi-square, univariate logistic regression, and multiple logistic regression were used. For all analyses, we defi ned statistical signifi cance a priori with a two-tailed alpha of 0.05. Statistical analyses were conducted using the Statistical Package for the Social Sciences (SPSS) version 15. 50% of the sample was female and 89% lived in urban areas. Th e average age of the respondents was 14.37 ± 1. 70 years. While a majority of cigarette smokers (70.9%) were waterpipe smokers, only 35.7% of waterpipe smokers smoked cigarettes. The incidence of smoking was high in those who expected less extensive parental reaction with odds ratio (OR) = 1.89 [95% confi dence interval (CI): 1.35-2.63] (P < 0.001) among cigarette smokers and OR = 2.75 (95% CI: 2.16-3.50) (P < 0.001) among waterpipe smokers. “Taste” was rated the most attractive feature by waterpipe and cigarette smokers 2.83-fold (95% CI: 2.06, 3.90) (P < 0.001). Most waterpipe smokers compared to nonsmokers believed that the main reason behind waterpipe popularity was habit. The factors related to waterpipe smoking were diff erent from those in cigarette smoking; so we need to implement diff erent interventions to overcome the surging usage of tobacco use.

Women with polycystic ovary syndrome have lower pregnancy rates, possibly due to the decreased uterine receptivity.Successful implantation depends on protein networks that are essential for cross-talk between the embryo and endometrium.Apolipoprotein A1 has been proposed as a putative anti-implantation factor. In this study, we evaluated apolipoprotein A1 expression in human endometrial tissues. Endometrial apolipoprotein A1 messenger RNA (mRNA) and protein expression were investigated using quantitative real-time polymerase chain reaction (PCR) and Western blot. The distribution of apolipoprotein A1 was also detected by immunostaining. Samples were obtained from 10 patients with polycystic ovary syndrome and 15 healthy fertile women in the proliferative (on day 2 or day 3 before ovulation, n = 7) and secretory (on days 3-5 after ovulation,n = 8) phases. Endometrial apolipoprotein A1 expression was upregulated in patients with polycystic ovary syndrome compared to normal subjects. However, apolipoprotein A1 expression in the proliferative phase was signifi cantly higher than in the luteal phase (P value < 0.05). It seems that diff erentially expressed apolipoprotein A1 negatively aff ects endometrial receptivity in patients with polycystic ovary syndrome. The results showed that apolipoprotein A1 level signifi cantly changes in the human endometrium during the menstrual cycle with minimum expression in the secretory phase, coincident with the receptive phase (window of implantation). Further studies are required to clarify the clinical application of this protein.

Kidney transplantation is a preferred treatment for many patients with end-stage renal disease (ESRD) and is far more profi table than hemodialysis. Analyzing renal transplantation data can help to evaluate the eff ectiveness of transplantation interventions. The aim of this study was to determine the organ survival rate after kidney transplantation during a period of 10 years (March 2001-March 2011) among transplanted patients in Arak, Markazi Province, Iran. In this historical cohort study, all recipients of kidney transplantation from Arak, Markazi Province, Iran who had medical records in Valiasr Hospital and “charity for kidney patients” of Arak, Markazi Province, Iran during a period of 10 years from March 2001 to March 2011 were included. Data collected by using checklists were completed from patients’ hospital records. Kaplan-Meier method was used to determine the graft cumulative survival rate, log-rank test to compare survival curves in subgroups, and Cox regression model to define the hazard ratio and for ruling out the intervening factors. Statistical analysis was conducted by Statistical Package for the Social Sciences (SPSS) 20 and Stata 11. Mean duration of follow-up was 55.43 ± 42.02 months. By using the Kaplan-Meier method, the cumulative probability of graft survival at 1, 3, 5, 7, and 10 years was 99.1, 97.7, 94.3, 85.7, and 62.1%, respectively. The number of dialysis by controlling the effect of other variables had a significant association with the risk of graft failure [hazard ratios and 95% confidence interval (CI): 1.47 (1.02-2.13)]. This study showed that the graft survival rate was satisfactory in this community and was similar to the results of single-center studies in the world. Dialysis time after transplantation was a significant predictor of survival in the recipients of kidney transplantation that should be considered.

The pathogenesis of atopic dermatitis (AD) remains to be determined; recently a possible change in the immune system with production of immunoglobulins is proposed. As vitamin E is a potent antioxidant, with the ability to decrease the serum levels of immunoglobulin E (IgE) in atopic patients, we aimed to evaluate the effect of oral vitamin E on treatment of AD. This randomized, double-blind, placebo-controlled trial comprised seventy participants with mild-tomoderate AD, based on the Hanifin and Rajka diagnostic criteria. The patients were randomly selected from teaching skin clinics in Isfahan, Iran. They were randomly assigned to two groups of equal number, receiving vitamin E (400 IU/day) and placebo for four 4 months. Each month, the extent, severity, and subjective symptoms including itch and sleeplessness were measured by SCORAD index. Th ree months after the end of intervention, the recurrence rate was assessed. The improvement in all symptoms, except sleeplessness, was significantly higher in the group receiving vitamin E than in controls (–1.5 vs. 0.218 in itching, –10.85 vs. –3.54 in extent of lesion, and –11.12 vs. –3.89 in SCORAD index, respectively, P < 0.05). Three months after the end of intervention, the recurrence rate of AD was evaluated.Recurrence rate between all 42 individuals, who remained in the study, was 18.6%. Recurrence ratio of the group receiving vitamin E compared to the placebo group was 1.17, without significant differences between the two groups (P > 0.05). This study suggests that vitamin E can improve the symptoms and the quality of life in patients with AD. As vitamin E has no side effects with a dosage of 400 IU/day, it can be recommended for the treatment of AD.

Programs for improving health status of patients with illness related to pain, such as headache, are often still in their infancy. Mindfulness-based stress reduction (MBSR) is a new psychotherapy that appears to be effective in treating chronic pain and stress. This study evaluated effi cacy of MBSR in treatment of perceived stress and mental health of client who has tension headache. This study is a randomized clinical trial. Sixty patients with tension type headache according to the International Headache Classification Subcommittee were randomly assigned to the Treatment As Usual (TAU) group or experimental group (MBSR). The MBSR group received eight weekly classmates with 12-min sessions. The sessions were based on MBSR protocol.The Brief Symptom Inventory (BSI) and Perceived Stress Scale (PSS) were administered in the pre- and posttreatment period and at 3 months follow-up for both the groups. The mean of total score of the BSI (global severity index; GSI) in MBSR group was 1.63 ± 0.56 before the intervention that was signifi cantly reduced to 0.73 ± 0.46 and 0.93 ± 0.34 after the intervention and at the follow-up sessions, respectively (P < 0.001). In addition, the MBSR group showed lower scores in perceived stress in comparison with the control group at posttest evaluation. Th e mean of perceived stress before the intervention was 16.96 ± 2.53 and was changed to 12.7 ± 2.69 and 13.5 ± 2.33 after the intervention and at the follow-up sessions, respectively (P < 0.001). On the other hand, the mean of GSI in the TAU group was 1.77 ± 0.50 at pretest that was significantly reduced to 1.59 ± 0.52 and 1.78 ± 0.47 at posttest and follow-up, respectively (P < 0.001). Also, the mean of perceived stress in the TAU group at pretest was 15.9 ± 2.86 and that was changed to 16.13 ± 2.44 and 15.76 ± 2.22 at posttest and follow-up, respectively (P < 0.001). MBSR could reduce stress and improve general mental health in patients with tension headache.

We investigated the efficacy of a mobile-based bolus advisor app in comparison with the usual multiple daily injections (MDIs) in diabetic patients. In a nonrandomized, controlled clinical trial, 62 diabetic patients were selected to receive a 12-week intensive glycemic control by either a mobile-based bolus advisor (app) or MDI in the usual manner.We compared mean blood glucose (BG) and HbA1c before and just after the treatment program. The data were analyzed using paired sample t-test and analysis of variance (ANOVA). Fifty-six patients (30 cases and 26 controls) completed the study.The mean [standard deviation (SD)] of BG was 220.57 (43.7) and 231.5 (55) in the app group and control group, respectively. Mean BG decreased 38 mg/dL in the app and 16 mg/dL in the control group (P = 0.001 and 0.049 respectively). Changes of mean BG were different between the two groups signifi cantly (P = 0.039). HbA1c decreased from 8.4% to 7.6% in the case and from 8.4% to 8% in the control group (P = 0.001 and 0.06, respectively). Changes of HbA1c were not different between the two groups (P = 0.141). Th e mean episodes of hypoglycemia were not diff erent between the groups signifi cantly (P = 0.108). In conclusion, this study revealed that mobile-based bolus advisors can reduce mean BG better in patients who are planned to have a tight glycemic control as a feasible and available method and may improve HbA1c in the long term.

Few studies have shown the limitation of the World Health Organization (WHO)/ International Council for theControl of Iodine Defi ciency (ICCIDD)-adopted thyroid gland volume references as universal normative values for thyroid gland volume. So we decided to measure thyroid gland volume by sonography in schoolchildren in Rasht, Gilan Province, Iran — Rasht is a metropolitan city on the Caspian Sea coast — and compare them to WHO normative values. In a crosssectional study, 2,522 schoolchildren, aged 6-13 years, in Rasht, Gilan Province, Iran were selected by multistage random sampling.Data were collected on their age, sex, weight, height, body surface area (BSA), and thyroid gland size by palpation and sonography.The terminal phalange of thumb finger volume was calculated with the same formula used in sonography, for the thyroid gland in 1,085 of these cases. Goiter prevalence was 64% (1613 cases) by palpation, 76.1% (1228 subjects) grade I and 23.9%(385 cases) grade II. Th e mean thyroid gland volume in girls was more than boys (3.67 ± 1.89 mL vs 3.41 ± 1.58 mL, P < 0.0001).According to the 1997 WHO thyroid gland volume reference, none of the children had goiter based on BSA and age even in those with grade II goiters (23.9%). In contrast, the median thyroid gland volume in our cases was larger than the 2004 WHO reference.The best single predictor of thyroid gland volume was age (R2 = 0.391, P < 0.0001) followed by BSA (R2 = 0.151, P < 0.0001). There was also a significant diff erence between thyroid gland and fi nger volume in all grades of goiter and grade II goiters (3 ± 1.4 mL vs 9.59 ± 2.4 mL; P < 0.0001. 4.3 ± 1.4 mL vs 9.3 ± 2.5 mL; P < 0.0001). The WHO standards for thyroid gland volume by sonography may underestimate or overestimate the goiter prevalence in many areas and populations. Finger volume was much larger than thyroid gland volume in even visible goiters.

Cardiovascular diseases are viewed worldwide as one of the main causes of death.This study aims to reportthe burden of ischemic heart diseases (IHDs) in Iran by using data of the global burden of disease (GBD) study, 1990-2010. The GBD study 2010 was a systematic eff ort to provide comprehensive data to calculate disability-adjusted life years (DALYs) for diseases and injuries in the world. Years of life lost (YLLs) due to premature mortality were computed on the basis of cause-of-death estimates, using Cause of Death Ensemble model (CODEm). Years lived with disability (YLDs) were assessed by the multiplication of prevalence, the disability weight for a sequel, and the duration of symptoms. A systematic review of published and unpublished data was performed to evaluate the distribution of diseases, and consequently prevalence estimates were calculated with a Bayesian meta-regression method (DisMod-MR). Data from population-based surveys were used for producing disability weights. Uncertainty from all inputs into the calculations of DALYs was disseminated by Monte Carlo simulation techniques. The age-standardized IHDs DALY specifi ed rate decreased 31.25% over 20 years from 1990 to 2010 [from 4720 (95%uncertainty interval (UI): 4,341-5,099) to 3,245 (95% UI: 2,810-3,529) person-years per 100,000]. Th e decrease were 38.14% among women and 26.87% among men. The age-standardized IHDs death specefied rate decreased by 21.17% [from 222) 95% UI: 207-243 (to 175 (95% UI:152-190) person-years per 100,000] in both the sexes. The age-standardized YLL and YLD rates decreased 32.05% and 4.28%, respectively, in the above period. Despite decreasing age-standardized IHD of mortality, YLL, YLD, and DALY rates from 1990 to 2010, population growth and aging increased the global burden of IHD. YLL has decreased more than IHD deaths and YLD since 1990 but IHD mortality remains the greatest contributor to disease burden.

In-toeing and out-toeing rotational deformities are among the most common referrals for consultation with orthopedic specialists. Although a few number of patients need surgical interventions, most of them get better spontaneouslywithout major complications in adult life. In this study, we investigated the prevalence of permanent gait deformities due to hip rotational disorders in a group of patients who underwent conservative treatments. Patients and This retrospective cohort study was conducted in the orthopedic department on patients with rotational deformities of the lower extremities (hip anteversion and hip retroversion). From 2,983 patients, 611 were included in this study and followed up for 10 years. Medial rotation of the hip, lateral rotation of the hip, and tibia fibula angle (TFA) of each patient were measured independently. In this study,611 patients were assessed and 323 (143 male and 180 female) were followed up in our study. Two hundred and seventy patients had in-toeing gait disorders due to hip anteversion, which 178 of them were corrected conservatively (%). Furthermore, among 53 patients with out-toed gait due to hip retroversion, 44 patients (%) were corrected in the same conditions (P = 0.001). It was determined that gait disorders were corrected conservatively in 102 of 143 males and 120 of 180 females (P = 0.37). Our findings showed that rotational deformities are expected to be corrected by conservative management. It is better to considersurgical procedures as the last therapeutic option.

Considering the importance of using more appropriate imaging technique for accurate diagnosis of pulmonary thromboembolism (PTE) with less side eff ects, we aimed to evaluate the quality of pulmonary 64-multidetector computed tomographic (MDCT) angiography in pregnant and postpartum women with suspected PTE in Isfahan. In this descriptive study, radiological findings of pregnant and postpartum women with suspected PTE who underwent pulmonary 64-MDCT angiography were evaluated. Prevalence of PTE in pregnant and postpartum women, mean of pulmonary arteries density for right and left pulmonary arteries, and their lobar and segmental branches, diagnostic quality of the pulmonary arteries density and their scoring, frequency of diagnostic and nondiagnostic images, mean of radiation dose and mean of bolus time, and the correlation between the quality of the vascular density with the peak density of the pulmonary artery were determined. In this study,44 pregnant and postpartum women with suspected PTE were selected. The overall prevalence of PTE was 9.1% (4/44). PTE was diagnosed in 1 (3.7%) pregnant and 3 (17.5%) postpartum women (P = 0.14). Mean density of pulmonary trunk was 278.81± 108.16 Hounsfi eld unit (HU) and 308.41 ± 59.30 HU in pregnant and postpartum women, respectively. Mean of bolus timing, kilovoltage peak (kVp), tube current, and dose length product (DLP) were 12.53 ± 2.36 s, 105.22± 45.71 milliamperage (MA), 382.9 ± 173.5 MA, and 317.98 ± 78.92 mGy/cm, respectively. Th e rate of nondiagnostic images was 4.5%. Our findings indicated that pulmonary 64-MDCT angiography is an appropriate imaging method for diagnosing PTE in pregnant and postpartum women with suspected PTE. It seems that, using fast CT systems (64-MDCT), in accordance with high flow rate, high contrast medium concentration and low kVp could explain the obtained appropriate quality of images more effi ciently than computed tomographic pulmonary angiography (CTPA).

Benzofuran as an important heterocyclic compound is extensively found in natural products as well as synthetic materials. Since benzofuran drivatives display a diverse array of pharmacological activities, an interest in developing new biologically active agents from benzofuran is still under consideration. This review highlights recent findings on biological activities of benzofuran derivatives as antimicrobial and antibreast cancer agents and lays emphasis on the importance of benzofurans as a major source for drug design and development.

Addiction is a phenomenon that causes structural changes in different systems of society. Studies show for planning of addiction prevention and treatment, it is necessary to create an information management system. Substance dependence information systems refer to systems which collect, analyse and report data related to substance dependence information. The aim of this study was to identify advantages and barriers to implement Substance Dependence Treatment Information System (SDTIS). This study was a narrative review. Our review divided into three phases: literature collection, assessing, and selection. We employed the following keywords and their combinations in different areas of articles. In this study, 22 of collected articles and reports were selected based on their relevancy. We found many advantages for a substance dependence treatment information system such as recording sufficient,complete and accurate information and easy and timely access to them and monitoring and enhancing the quality of care received by patients. But we may face some concerns for implementing this information system like taking time and funds from client services,being expensive or even problems regarding the quality of data contained in these information systems. There are some important problems in the way of implementing. In order to overcome these issues, we need to raise community awareness.

Nowadays, diabetes mellitus (DM) and hypertension are considered as the most common causes of end-stage renal disease (ESRD).In this paper, other than presenting the role of DM in ESRD, glucose metabolism and the management of hyperglycemia in these patients are reviewed. Although in several large studies there was no significant relationship found between tight glycemic control and the survival of ESRD patients, it is recommended that glycemic control be considered as the main therapeutic goal in the treatment of these patients to prevent damage to other organs. Glycemic control is perfect when fasting blood sugar is less than 140 mg/dL,1-h postprandial blood glucose is less than 200 mg/dL, and glycosylated hemoglobin (HbA1c) is 6-7 in patients with type 1 diabetes and 7-8 in patients with type 2 diabetes.Administration of metformin should be avoided in chronic renal failure (CRF) because of lactic acidosis, the potentially fatal complication of metformin, but glipizide and repaglinide seem to be good choices.