مجله دانشکده پزشکی اصفهان
پیاپی 419 (هفته سوم فروردین 1396)

Breast cancer is the most common malignancy in women and is the first cause of death among the women in the world. Disruption of gene expression of src family members has been observed in many cancers. Repeated sequences in introns influence gene expression, splicing or change the structure of product. In the present study, the association between CA polymorphism in intron 2 of the src gene and the risk of breast cancer was investigated.
This was a cohort study on 119 patients with breast cancer and 145 healthy people. Genomic DNAs were extracted from white blood cells. CA dinucleotide region of the src gene was amplified via polymerase chain reaction (PCR) technique and the number of CA repeats was determined using polyacrylamide gel electrophoresis.
Findings: Distribution of the CA repeats in src gene in the target population was between 14-27 repeats. The most common allele in two groups was 21. The frequency of the allele 22 in patients was significantly higher than healthy group. 26 genotypes were identified and the genotype 21/21 was the most common one among the two groups. The genotype 22/22 was more frequent in patients than in healthy group. Chi-square test and odds ratio (OR) showed that women with allele 22 were exposed more to breast cancer. Women with genotype 22/22 had a higher risk of developing breast cancer.
it can be concluded that the allele 22 can have a role in developing breast cancer.

Birth asphyxia is still considered as one of the biggest challenges faced by perinatal care experts. According to the statistics published by World Health Organization (WHO) in 2005, it is estimated that one fourth of infant mortality cases occurs due to birth asphyxia.
This cross-sectional retrospective clinical trial study was done on newborn population with gestational ages of 36 weeks or higher, including those afflicted with birth asphyxia, during the years 2013-2015. The relationship between the mode of delivery and the cases of birth asphyxia were investigated using logistic regression test via SPSS software.
Findings: Of 13574 newborns, 67 newborns were afflicted with birth asphyxia between the years 2013 to 2015. The rates of birth asphyxia among the newborns in years 2013 and 2014 were less than 0.3%; but, this rate had reached almost 1% in 2015. Meanwhile, the birth asphyxia rate among the vaginal deliveries had doubled in 2015; while the same rate among section deliveries had risen to 5 times more than that of 2013. Logistic regression analysis showed that only one of the independent variables, "year", made a unique statistically significant contribution to the model (P There was an obvious difference between the prevalence of birth asphyxia in our study and WHO rates. More studies with larger sample sizes in different centers and cities are recommended.

In this study, we aimed to improve the reliability and biological interpretability of gene signatures selected from microarrays by efficient usage of computational models and mathematical algorithms.
At the first step, a good model with high accuracy was chosen to predict cancer recurrence in microarray gene expression data on breast tumors. In this regard, microarray gene expression data of breast tumor in 1271 cancer patients (379 with recurrence and 892 people without recurrence) were utilized to construct an appropriate predictive model for recurrence by comparing the performance of multiple classifiers. In the pre-processing stage, different methods like correlation-based feature selection (CFS), principal component analysis (PCA), independent component analysis (ICA), and genetic algorithm as well as a random selection method were used to reduce the dimensions and choose the most appropriate genes (features).
Findings: A total of five gene signatures were selected by combining genetic algorithm, top scoring set (TSS), and random selection method, which showed the best results in most classification models. The final indicator genes were TRIP13, KIF20A, NEK2, RACGAP1 and TYMS, which had significant contribution in the structure of microtubules and spindle and also regulated the attachment of spindle microtubules to kinetochore.
By using hybrid models, we can avoid overfitting in training and achieve acceptable accuracy with biologically interpretable genes.

Spinal anesthesia is a popular anesthetic technique in laminectomy due to less complication and more satisfaction of patients and surgeons. In this technique, duration and quality of block is important to control postoperative pain. The aim of this study was to evaluate the effect of adding two different doses of magnesium sulfate to bupivacaine on block characteristics and postoperative pain in laminectomy under spinal anesthesia.
In a prospective clinical trial study, 120 candidates of elective laminectomy under spinal anesthesia with bupivacaine were randomly divided to three groups of receiving 50 mg magnesium sulfate (M50), 100 mg magnesium sulfate (M100) and normal saline (N). The onset and duration of sensory and motor block, maximum level of block, time of analgesic requirement and its dose were measured and recorded.
Findings: The mean onset time of sensory block in M50 (16.9 ± 4.0 minutes) and M100 (18.5 ± 2.4 minutes) were significantly more than control group (12.6 ± 3.57 minutes). The duration of sensory block was 89.80 ± 12.79, 116.50 ± 12.00, and 119.00 ± 18.50 minutes in control, M50, and M100 groups, respectively, with significant difference. Mean onset time of motor block in both M50 (11.80 ± 4.20 minutes) and M100 (12.6 ± 3.80 minutes) groups and were significantly more than control group (9.40 ± 3.33 minutes). The pain intensity was significantly more in control group. The mean time of first analgesic requirement and its total dose were significantly lower in M100 than other groups (P 0.050 for all)
Adding 100 mg intrathecal magnesium sulfate in comparison with 50 mg provides more acceptation effects such as less sensation of pain, less analgesic consumption and prolonged first time of analgesic requirement with no significant side effect.

Obesity is a complex disorder with excessive accumulation of adipose tissue; the tissue that exudes leptin, a hormone which plays an important role in the regulation of cellular metabolism and energy balance. The purpose of this study was to determine the changes in plasma leptin levels in response to aerobic training, and using orlistat in men.
Forty-eight obese males with a mean age of 21.56 ± 2.14 years and a mean body mass index (BMI) of 33.90 ± 3.21 kg/m2 participated in this study. The subjects were divided into four equal groups (n = 12) of orlistat, exercise, and orlistat-plus-exercise-induced weight loss, and control. Subjects of orlistat and orlistat plus exercise groups received 120 mg orlistat capsules three times daily after each meal for eight weeks. Aerobic training program consisted of running for 55 to 60 percent of target heart rate for 25 minutes on a treadmill in first week, and then, 75 percent of target heart rate for 45 minutes for the seven week. The levels of plasma leptin were measured using the enzyme-linked immunosorbent assay (ELISA) method before and after intervention.
Findings: All three experimental groups showed significant decreases in plasma levels of leptin compared to control group and before intervention (P = 0.001).
The results show that aerobic exercise can reduce plasma leptin levels in obese people. The results show that regular aerobic exercise without the use of chemical drugs lead to weight loss with desirable changes in serum leptin levels.

C-reactive protein (CRP) is a predictor of cardiovascular diseases in both normal people and patients on hemodialysis .This study aimed to assess the relationship of high-sensitivity C-reactive protein (Hs-CRP) serum level and peritonitis in patients on peritoneal dialysis.
113 patients on peritoneal dialysis in Isfahan city, Iran, participated in our study in 2015. Serum albumin and Hs-CRP levels were measured in each patient at three times (baseline, and 6 and 12 month after that) and the patients were followed up for 1 year. All the patients were evaluated for peritonitis in every visit. At the end of the study, two groups of patients on peritoneal dialysis with and without peritonitis were compared.
Findings: Among 113 patients, 24 were excluded from the study because of death or kidney transplantation and 89 patients were included in final analysis. The mean Hs-CRP levels in patients with peritonitis were 4.83, 5.79, and 7.42 mg/l at baseline, and 6 and 12 month after it, respectively; these levels were 4.47, 3.19, and 2.69 mg/l in patients without peritonitis, respectively. In addition, the mean albumin levels in patient with peritonitis were 3.38, 3.29 and 3.40 mg/l at baseline, and 6 and 12 month after it, respectively; these values were 3.56, 4.05, and 3.51 mg/l in patients without peritonitis, respectively.
Results showed that with increase in Hs-CRP level, the risk of peritonitis increased. Besides, the albumin level decreased among patients with peritonitis in comparison with patients without peritonitis; there was no significant correlation between albumin level and peritonitis.

Spasticity is one of the impairments in patients with stroke which cause more disability and secondary problems. Now, there are some ways to reduce spasticity such as drugs, exercise, heat, massage, and sensory level electrical stimulation. This study assessed the immediate effect of sensory level stimulation on spasticity in plantar flexor muscles in patients with post-stroke hemiplegia.
In this study, 10 patients received 10 sessions of treatment. Protocol was 30 minutes electrical stimulation and 30 minutes proprioceptive neuromuscular facilitation techniques to improve initiation and controlling of movement. Level of the spasticity was measured carefully before and after the stimulation using Modified Ashworth scale.
Findings: Electrical stimulation reduced the spasticity in two women and one man. Stimulation had not effect on seven patients. Electrical stimulation had not effect on grades one and three spasticity; it had effect on grades one-plus and two but not in all of the patients. The stimulation had effect on patients with good cognition who did their exercises carefully.
Sensory level electrical stimulation has temporary effect only on middle-grade spasticity in middle exercise sessions. There is not any effect in next session and efficacy of stimulation reduces and stops. This electrical stimulation cannot disappear the spasticity and does not have any effect on high-grade spasticity.