مجله علمی دانشگاه علوم پزشکی کردستان
سال بیست و چهارم شماره 3 (پیاپی 101، امرداد و شهریور 1398)

Neonatal jaundice is a common problem in the neonates which is caused by increased unconjugated bilirubin and can result in serious neurological side effects such as kerinictrus. Several drugs have been used to treat unconjugated hyperbilirubinemia. The present study was conducted to determine the preventive effect of glycerin suppository on neonatal jaundice. This single blind randomized clinical trial included 165 healthy term neonate without jaundice in Besat Hospital in Sanandaj. Neonates were divided into two groups. Case group treated with glycerin suppository at birth and 12 hours after birth. Control group didn’t receive glycerin suppository. Serum bilirubin levels were measured by Bili Check device (spectrophotometry) 12, 24 and 48 hours and also 5 days after birth. After 48 hours the mean serum bilirubin levels were 8.667 and 11.4412 in the case and control groups respectively, which showed no significant difference (p: 0.57) between the two groups. After 5 day the respective mean serum bilirubin levels in the case and control groups were 10.0450 and 11.05 which revealed a significant difference between the two groups (P value:0.03). Use of glycerin suppository showed significant effect on reducing billirubin level in the neonates and can be considered as an adjuvant therapy for neonatal jaundice.

Various studies have shown a correlation between the prevalence of hepatitis A and community health level. The aim of this study was to investigate the seroepidemiology of hepatitis A virus and its related factors in the patients referring to medical diagnostic laboratories in Sanandaj. In this descriptive-analytical (cross-sectional) study we selected 200 individuals referring to medical diagnostic laboratories in Sanandaj from January 2016 to May 2017 - and their serum HAV Ab levels were measured by ELISA method. Demographic data and risk factors for hepatitis A infection were recorded in a questionnaire for every participant. We divided the participants into seropositive and seronegative groups. The groups were compared with each other in regard to demographic characteristics and risk factors for hepatitis A infection. 151 (75.5%) subjects were seropositive including 101 (67%) women and 50 (33%) men. Among different age groups, the highest rate of seropositivity was observed  in 43 patients (28.5%), between 30 and 40 years of age and the lowest rate belonged to 4 (6.2%), individuals between 11 and 20 years of age, which showed a significant difference between different age groups (P = 0.000). The percentage of seropositive patients was significantly higher in the age group of less than one year compared to those in the age groups of 1 to 10 years (P = 0.001) and 11 to 20 years (P = 0.005). There was no significant relationship between the groups in regard to gender, place of residence, education level and occupation (P> 0.05). The results of multivariate regression analysis showed that the presence of underlying diseases resulted in a 3 fold increased risk of hepatitis A (OR: 2.71; Cl 95%: 1.13 - 6.48). Comparison of the other risk factors showed no significant relationship between the two groups. Considering the association of this antibody with increasing age, determination of the serum level of this antibody in different parts of the country by public health organizations at different time intervals and in different age groups seems necessary. Also, considering the correlation between underlying diseases in susceptible individuals and antibody- positivity and also the importance of vaccination, close attention of these organizations to this issue is necessary.

Sperm cryopreservation is a common technique used for management of male infertility. But this method has detrimental effects on sperm DNA and chromatin quality. Evaluation of different markers associated with the health of genetic material of sperm is beneficial for determination of the fertility of sperm. The aim of this study was to assess the effect of sperm chromatin condensation on frozen-thawed sperm DNA integrity in normozoospermic men. In this experimental study, 30 semen samples from normozospermia men were cryopreserved for two weeks with a common technique used in most infertility centers, at -196 ° C and then thawed. Samples before and after freezing were evaluated for abnormal chromatin condensation, DNA denaturation and DNA fragmentation by toluidine blue (TB) staining, acridine orange (AO) staining and sperm chromatin dispersion (SCD) test respectively. Before freezing, we found a significant correlation only between abnormal chromatin condensation (evaluated by TB) and DNA denaturation (assessed by AO) (p < 0.05). While after cryopreservation correlation was found between abnormal chromatin condensation and DNA denaturation and fragmentation (p < 0.05). Abnormal chromatin condensation can make DNA susceptible to denaturation and fragmentation.

Time is the main determinant factor for survival chance in trauma patients. Therefore, this study was performed to determine the effect of management programs in trauma patients on time indices of pre-hospital emergency missions. In this controlled field trail, 60 pre-hospital emergency technicians were divided into two test and control groups, by means of stratified random sampling. Pre-hospital trauma management training programs which had been formulated on the basis of available national and global standards were implemented, by using a combination of training lecture and simulation methods for the test group. Research tools were demographic questionnaire and standard pre-hospital emergency care reporting form. Mean values for time indices were determined before, after, and also one month after intervention in both groups. Using SPSS 19, data were analyzed by independent t-test, Repeated Measures Analysis of Variance, and Bonferroni’s follow up test. Mean scene time in the test group (one month after intervention) was significantly lower than that in the control group (p=0.05). Also, mean and standard deviation of scene time in the test group decreased from 17.6±5.5 minutes (before intervention) to 12±3.8 minutes (one month after intervention), which showed a significant reduction (p˂0.001). According to the results, performance of pre-hospital trauma management training programs can lead to reduction of scene time in pre-hospital emergency missions. Therefore, considering the role of reduced scene time in the prognosis of trauma patients, integration of the periodic training of the trauma management programs into pre-hospital emergency training programs seems necessary.

Treatment and complications of type 1 diabetes can affect the mental status of patients and their quality of life. The aim of this study was to determine the effect of valerian capsule on anxiety and quality of life in the patients with type 1 diabetes. This study was a clinical trial and included 82 patients with type 1 diabetes (control group 40 and intervention group 42). Intervention group received one capsule of Sedamin (containing 530 mg of valerian root extract) every night one hour before bed time, for eight weeks. Control group received a placebo capsule. Beck Anxiety Inventory was completed before the study and also after the 4th and 8th weeks of the study, and quality of life questionnaire (DQOL) was completed before and eight weeks after the study. Using SPSS software, data were analyzed by independent t-test, paired samples t-test and one-way covariance with repeated measures. The results showed that there was no significant difference in the anxiety scores between the two groups before the intervention and after four weeks of study. But we found a significant difference between the groups after eight weeks of study (p = 0.008). After the intervention, the quality of life scores in the intervention and control groups were 4.05 ± 0.7 and 3.23 ± 0.43 respectively indicating a significant difference between the two groups (p = 0.0001). The findings showed that use of valerian capsules for eight weeks reduced the anxiety in the patients with type 1 diabetes and improved their quality of life. We recommend use of this herbal medicine in the patients with type 1 diabetes and anxiety.

Peripheral nerve injuries are among the most common types of injuries of the nervous system and are regarded as the main cause of disability. These injuries can lead to disorders in muscles movement and normal sense, and also painful neuropathy. Tissue engineering and stem cells therapy are among the treatment methods for these disorders. In this study we assessed sciatic nerve restoration through a silicone tube containing a fibrin scaffold filled with Schwann cells and citicoline by using electromyography and histological methods. 50 adult male Wistar rats were randomly divided into five groups. 1. Silicon tube. 2. Silicon tube with fibrin gel. 3. Silicon tube with Schwann cells. 4. Silicone tube with citicoline. 5. Silicon tube with Schwann cells & citicholine. The left sciatic nerve was cut and a 10 mm gap was created. A silicon tube was placed between the two cut ends of the nerve, as a guide channel. Allografted Schwann cells and citicoline were injected into the guide channel. The third and fifth groups were significantly different from other groups in regard to the amplitudes of the waves (P <0.05). Also, we found significant decreases in the latency of the waves recorded in the 1st to 4th groups (P <0.05). There was a significant difference between the third and fifth groups in the results of histological examination (P <0.05). Increased amplitude in the third and fifth groups indicated better restoration of the nerve in these groups. Also reduced latency in the 1st to 4th groups was indicative of regeneration of the sciatic nerve. Histologic results revealed increased number of recovered axons in the fifth group which was indicative of the better outcome of the combination therapy.

The aim of this study was to compare personality characteristics and coping strategies between the patients with irritable bowel syndrome and normal individuals. In this cross sectional study we selected 200 people (100 irritable bowel syndrome patients and 100 normal individuals) on the basis of convenient method. We used two questionnaires including the NEO- Five Factor personality Inventory and Lazarus- Folkman coping Questionnaire for data collection. Data were analyzed by t-test and Mann- whitney U Test. The results showed that the mean scores of neuroticism factor in the patients with irritable bowel syndrome were higher than those in the normal individuals. While the mean scores of extraversion and conscientiousness factor in the normal subjects was higher than those in the patients with irritable bowel syndrome. There were no significant differences between the two groups in openness and agreeableness. Data showed that normal individuals compared to the patients with irritable bowel syndrome, used more problem- oriented coping styles. There were no significant differences between the two groups in regard to the escape-avoidance variable. The results showed that IBS was affected by personality characteristics and coping strategies. Study of these factors can have many applications in the fields of research, etiology and treatment of this disease.

Artificial gamete production from stem cells is a novel strategy for treatment of infertility. Among various stem cell sources, embryonic stem cells (ESC) can be considered as an appropriate source for in vitro formation of germ cells. In this study we evaluated the effect of BMP4 on proliferation and differentiation of mouse embryonic stem cells into primordial germ cells (PGCs). Embryonic stem cells (ESC) were cultured in ES medium. At first, embryoid bodies (EBs) were formed by hanging drop method, and then were differentiated into primordial germ cells at different concentrations of BMP4 (10, 50 and 100 ng/ml). The viability and proliferation rate of treated cells with BMP4 were evaluated by MTT assay. The EBs were cultured in induction medium. Expression of Oct4، Stella and Mvh genes were evaluated by real time PCR. In the group treated with BMP4 for 7 days, maximum cell viability was detected at the concentration of 10ng/ml. But the groups treated with100ng/ml of BMP4 showed minimum cell viability. Maximum expression of Stella and Mvh genes were detected at the concentration of 10ng/ml of BMP4 in the treated group. The results showed that BMP4 can promote proliferation and differentiation of ES in vitro. Also different concentrations of BMP4 showed different effects on in vitro differentiation of ES into germ cells.

Rheumatoid arthritis (RA) is an autoimmune inflammatory disease of unknown etiology.  The chemokines and their related receptors have a pivotal role in migration and homing of leukocyte involved in the pathogenesis of RA. The goal of this study was to measure the plasma levels of CCL-17 and CCL-25 and their receptors gene (CCR4 and CCR9) expression in rheumatoid arthritis patients. 30 untreated newly diagnosed and 30 under treatment RA patients with disease modifying anti-rheumatic drugs (DMARDs) as well as 30 healthy subjects participated in this study. We assessed the gene expression of CCR4 and CCR9 by the real-time PCR method, and measured plasma levels of CCL25 and CCL17 by enzyme-linked immunosorbent assay (ELISA). Comparison between control group and newly diagnosed rheumatoid arthritis patients showed significantly lower expression of CCR4 and CCR9 (P=0.047, P=0.049 respectively) in the latter group. In addition, the plasma level of CCL-25 was significantly lower in both newly diagnosed and under treatment RA patients compared to that in the healthy subjects (P=0.017, P=0.030 respectively). The altered expression of chemokines and their related receptors, especially those involved in the leukocyte migration to the mucosa of the gastrointestinal tract may be associated with the pathogenesis of RA.

Postoperative pain is one of the most common complications after eye surgeries, especially cataract. Use of analgesic drugs before surgery can be effective in decreasing the pain. The purpose of this study was to investigate preemptive effect of ketamine, paracetamol, and metoclopramide on the postoperative pain in the patients following cataract surgery with general anesthesia. In this double-blind clinical trial, 80 adult patients who were candidate for cataract surgery were randomly divided into four groups. Every one of the groups received one of the following prescriptions: 0.1 mg/kg metoclopramide, 0.2 mg/kg ketamine, 1 g paracetamol and placebo before induction of anesthesia. Postoperative pain severity (based on visual analogue scale) and complications were evaluated in the groups. There was a significant difference between the groups in regard to postoperative pain in the recovery room and 2 hours after the operation (P<0.05), but no significant difference was found at 8 and 24 hours after operation. Also, there was no significant difference between the groups in relation to the need for analgesic drugs for pain relief and anti emetic medications to control nausea and vomiting after surgery (P> 0.05). Use of metoclopramide, ketamine, and acetaminophen can lead to prevention of postoperative pain and decreased need for analgesics in the patients following cataract surgery with general anesthesia.