مجله دانشگاه علوم پزشکی قم
سال دوازدهم شماره 6 (پیاپی 77، شهریور 1397)

Studies have shown that drugs can affect on proliferation of cancer cells. The main aim of this study was to determine the effects of diclofenac on caspase-8 and caspase-9 activity in cervical cancer cells (HeLa) in cell culture.
In this experimental-laboratory study, HeLa cancer cells were purchased from Iran Cell Bank (Pasteur Institute, Tehran, Iran). HeLa cancer cells were cultured in DMEM culture media enriched with 10% FBS, stored in 6 well plate, and incubated for 24 hour. Then, cells were exposed to different concentrations of diclofenac and the viability of cells was evaluated by MTT assay, and the IC50 dose was calculated. The activity of Caspase-8 and caspase-9 on heLa cells, was assayed by ELISA method. The data were analyzed using one-way analysis of variance, Kolmogorov-Smirnov, and Tukey tests.
Findings showed that 0.1, 1, and 10mg/ml doses of diclofenac decrease the viability of HeLa cancer cells compared to the control group (p0.05).
The results of this study revealed that diclofenac has cytotoxic effects on HeLa cancer cells. Although ths effect is different based on the dose used.

Exercises lead to increased free radicals. However, medicinal plants can prevent oxidative stress and cellular damage through their antioxidant effect. Therefore, in this study, the antioxidant effects of swimming training and chamomile extract, was investigated in adult male rats.
In this experimental research, 35 Sprague-Dawley male rats, were selected and divided into 5 groups of 7 rats, including (1) control, (2) swimming training, (3) chamomile extract, (4) swimming training and chamomile extract, and (5) sham groups. Groups 2 and 4 performed forced swimming for 8 weeks (three 60-minute sessions per week), and groups 3 and 4 peritoneally received chamomile extract (200mg/kg) for 8 weeks. Serum levels of the variables, were evaluated using spectrophotometric method. Statistical analysis of data, was performed using Kolmogorov–Smirnov, one-way ANOVA, and Tukey post hoc tests (p≤0.05).
In this study, swimming training, chamomile consumption, and swimming training with chamomile consumption have a significant effect on the increase of total antioxidant capacity in the rats (p=0.001). Moreover, chamomile consumption (p=0.004), swimming training (p=0.001), and swimming training with chamomile consumption (p=0.001) had a significant effect on decreased levels of malondialdehyde in rats, and consumption of chamomile (p=0.04), swimming training (p=0.01), and swimming training with chamomile consumption (p=0.03) had significant effect on increase in glutathione level in rats.
According to the findings, it seems that swimming training, chamomile consumption, and their combination, can be used to improve the antioxidant status.

Many plant extracts have antiparasitic properties and even some of them are effective for in vivo treatment. One of the medicinal plants is Peganum harmala, which can grow from 30 to 100 cm. The aim of the present study was to determine the effect of aqueous extract of Peganum harmala on trophozoites and cysts of Acanthamoeba in vitro.
In this experimental study, a sample from a patient with amoebic keratitis, was cultured with Escherichia coli bacterium in non-nutrient agar medium (NNA) 1.5%. Then, the aqueous extract of Peganum harmala was prepared. The extract was affected on trophozoites and cysts of Acanthamoeba at three times (24, 48, and 72h) in various concentrations (1.25, 2.5, 5, and 10mg/ml). The percentage of live parasites, was evaluated using homocytometer lamel, MTT assay [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide], and flow cytometry method. The data were analyzed using one-way ANOVA, one sample Kolmogorov-Smirnov test, and repeated measures test The significance level was considered to be p The extract showed dose- and time-dependent activity on trophozoites and cysts. In the presence of 10 mg/ml aqueous extract in culture medium, 32.47% of the trophozoites and 50.15% of the cysts, were alive after 72 hours.
Our study indicated that the aqueous extract of the Peganum harmala, has anti-Acanthamoeba activity. Therefore, it is recommended that the effect of Peganum harmala extract be studied in animal models.

Depression is one of the most psychological outcomes in patients with acute myocardial infraction, which can affect the sleep quality in these patients. Given that adequate sleep has important effect on heart function, the present study was conducted with the aim of determining the correlation between sleep quality with death and cardiac depression in patient with acute myocardial infarction (AMI).
In this descriptive-correlational study, 407 patients with acute myocardial infarction, who were admitted to the CCU wards of the Fatemeh Zahra Educational Center of Sari city, were selected using simple random sampling method. Data were collected by Cardiac Depression Scale (CDS), Death Depression Scale (DDS), and Pittsburgh Sleep Quality Index (PSQI) questionnaires. Data were analyzed using Kolmogorov-Smirnov and Pearson correlation tests.
The mean age of the male patients (64.95±17.00; CI95: 62.71-67.19) was more than the mean age of women (62.22±15.48; CI95: 59.96-64.48). The mean score of death depression (68.94±17.24; CI95: 67.26-70.62) and cardiac depression (109.00±16.49; CI95: 107.39-110.60), were below the fifth percentile. Multivariate regression analysis showed that change in cardiac depression score (B=0.036, β=0.153), increasing education levels (B=1.55, β=-0.121), and no history of antidepressant usage (B=4.32, β=0.123), can be significantly independent predictive factors of the variance of sleep quality score in acute myocardial infarction patients.
According to the results of this study, although cardiac depression, education level, and non-use of antidepressant drugs are considered as affecting factors in the prediction of sleep quality in acute myocardial infarction patients, sleep quality is affected by more factors. Therefore, further studies are needed in this area.

Candida albicans (C. albicans) as an opportunistic pathogen, can causes cutaneous and mucosal infections. Antibiotic treatments for this fungus have multiple adverse effects and cause drug resistance. In this study, the inhibitory effect of Artemisia sieberi (A. sieberi), was investigated on growth of Candida albicans.
In this experimental study, aqueous and alcoholic extracts were prepared from A. sieberi using percolation method. Using disk diffusion method, minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC), were assessed to evaluate the antifungal effects of these extracts on C. albicans in vitro.
C. albicans, was resistant to hydroalcoholic extracts in the disk diffusion method and grew around the disks containing the extracts. The MIC of aqueous, ethanolic, and methanolic extracts, were determined to be 6250, 3125, and 6250µg/ml, respectively, and MFC of these three extracts, were determined 12500, 6250, and 12500µg/ml, respectively. In the MIC and MFC method, ethanolic extracts had higher antifungal activity.
According to the results of this study, different extracts of A. sieberi affect C. albicans growth and prevent its growth. Thus, more

Health system reform plan is a plan for improvement of health systems in Iran, which started on May 15, 2014 in hospitals of Ministry of Health of Iran. In this study, changes in neonatal outcomes following the implementation of the health system reform plan, were investigated.
This cross-sectional study (before and after exposure) was conducted in a public educational hospital. The study population was all deliveries (normal and cesarean section) performed at Izadi educational treatment hospital (2011-2016), which were selected using Stratified random sampling. Information were collected using a checklist based on hospital records. The data were analyzed by t-test and Chi square test.
According to the results of this study, after implementation of health system reform plan, the ratio of normal delivery significantly increased (p The results of the study showed that health system reform plan has a positive effect on the reduction of cesarean delivery and has reduced the ratio of cesarean delivery to normal delivery. Accordingly, it can be concluded that the health reform plan for the promotion of normal delivery has somewhat achieved its goals. However, the implementation of this plan has increased some minor neonatal complications that did not affect the death rate.

In developing countries, complications of childbirth and pregnancy, especially cesarean delivery, are main reason for readmission and even mortality of women in reproductive age. The present study aimed to investigate the prevalence of post-cesarean readmission and its related factors in women delivered by cesarean.
In the present cross-sectional study (descriptive-analytic), the information of 300 women undergoing cesarean section, were investigated in hospitals of Qom city (2017). The samples were selected using simple random sampling and proportional to the size of each hospital. Data were collected by checklist based on the information in the medical records and interviews with patients, and were analyzed by descriptive statistics, Chi-square, and independent t-test.
The prevalence of post-cesarean readmission in women delivered by cesarean section, was 31%, and the most important causes of re-hospitalization, respectively, were reported to be headache (39.8%), hematoma (23.77%), infection (19.4%), urinary retention (8.6%), and intestinal obstruction (8.6%). The surgeon's work history (p The results of this study revealed, diabetes mellitus, surgeon's experience, and type of anesthesia significantly increase the rate of readmission in women with cesarean section. As a result, preventive interventions to reduce undesirable outcomes of pregnancy, and the accuracy of specialized physicians during surgery, are necessary for reduction of mother’ rehospitalization.

Increased dietary acid load lead to increase in risk of diabetes. The aim of this study was to investigate the association between dietary acid load with body composition and inflammatory biomarkers in patients with type 2 diabetes.
In this descriptive cross-sectional study, the study population composed of 185 type 2 diabetic patients (with mean age of 51.62 years). The food frequency questionnaire (containing 147 food items), was completed to assess dietary intake. Then, acid load indices of potential renal acid load (PRAL) and Net Endogenous Acid Production (NEAP), was calculated for each person. Inflammatory factors (C-reactive protein, interleukin-6, and TNF-α), and anthropometric factors (weight, height, waist circumference, and body fat percentage), were measured. Data were analyzed by linear regression, Pearson, and covariance tests.
Among the variables, the total body fat percentage (β=0.190, p=0.042) and inflammatory factor TNF-α (β=0.167, p=0.031) had a positive and significant correlation with PRAL acid load index. Among tertiles of dietary acid load, only total body fat and TNF-a, were significantly different among the PRAL tertiles, so that the total body fat percentage and TNF-a inflammatory factor, were higher in 2nd and 3rd tertile, respectively, and this relationship remained significant after adjusting for the confounders (p=0.038, p=0.032, respectively).
The findings of the present study showed that the PRAL index has a positive correlation with increased body fat and TNF-α.

Over the past years, rate of cesarean section has increased. Due to complications of cesarean section for mother and baby, natural delivery is preferable. However, the tendency of women towards cesarean section is the main factor for its increase. Given that midwives were the first proponent of the culture of normal delivery and are aware of inner motives of mothers, in this study, midwives’ point of view on unwillingness of mothers to normal vaginal delivery, were investigated.
In this descriptive study, the research community was 1180 midwives in the province. Among them, 189 midwives working in the maternity wards, who had passed childbirth physiology workshop, were studied through a researcher-made questionnaire. The validity of the questionnaire was confirmed through content validity and its reliability was confirmed by retest. Data were analyzed by one-way ANOVA statistical test.
In this study, maximum years of service of the midwives, were 30 years, the minimum was 1 year, and the averages was 8 years. The midwives stated that the most important barriers of physiological delivery, respectively, were: fear of labor pain, lack of knowledge or low awareness of mothers about the complications of cesarean section and benefits of normal delivery, inappropriate environment of maternity wards, and shortage of facilities and equipment.
Given that the most important cause of tendency toward cesarean section, is fear of labor pain, thus, the methods of reducing fear of delivery in mothers should be taken into consideration by the authorities since the pre-pregnancy period.