مجله دانشکده پزشکی اصفهان
پیاپی 525 (هفته اول تیر ماه 1398)

Sonography imaging in emergent situations is of easy-access with an ever-increasing demand. The aim of the current study was to determine the justification of sonography in emergent patients at a tertiary provincial referent medical center in a one-year period. In a retrospective descriptive cross-sectional study, 400 emergent patients underwent sonography imaging during the year 2017 were selected using systematic random sampling method. The data of age, gender, anatomic area, sonography number, Focused Assessment with Sonography for Trauma (FAST) sonography, and diagnosis were extracted from patient profiles, and were entered in a researcher-made checklist. Data analysis was performed using descriptive statistics and chi-square test. Men patients represented 60.0% of the requested sonography cases, and 40.0% of the exams were performed in the patient at the age range of 20 to 40 years old. 73.0% of patients underwent FAST sonography, required subsequent diagnostic sonography investigation, while FAST sonography led only to a diagnosis in 50.0% of the patients. 63.5% of the patients underwent more than one repeated sonography investigations. Diagnostic efficiency of FAST sonography was found to be underpowered in the current study. This caused wasting the resources, as well inflicting diagnostic retard in the emergent and urgent setting. The training of FAST sonography needs to be reviewed and revised, regarding its rationality and appropriate implementation.

The aim of this study was to determine the interaction effect of forced swimming and crocin supplementation on the expression of BAX and BCL-2 cardiomyocyte genes in male rats poisoned by hydrogen peroxide (H2O2). 36 male Wistar rats were randomly divided into six groups of sham, H2O2, H2O2 and crocin, H2O2 and forced swimming, H2O2 and crocin and forced swimming, and control. The forced swimming protocol was 60 minutes, 5 days a week, for 6 weeks. H2O2 (1 mg/kg for 3 weeks) and crocin (12.5 Mm/kg daily with 5 cc of distilled water) were injected intraperitoneally. Real time polymerase chain reaction (PCR) device was used to assess gene expression, and apoptosis was assessed using terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) method. Statistical analysis was done using Kolmogorov-Smirnov, Levene, one-way ANOVA and, the Scheffe post hoc tests. H2O2 induction was associated with a significant increase in the apoptosis of BAX (P < 0.001). Six weeks of exercise in water tended to reduction in the BCL-2 expression (P = 0.023), and induction of crocin resulted in significant decrease in BAX expression. The interaction between swimming, crocin and H2O2 decreased BAX and increased BCL-2 expression, which indicated the protective effect of regular activity in reducing cardiomyocyte apoptosis. Forced swimming as well as the use of crocin separately led to a significant reduction in BAX gene expression and a significant increase in BCL-2 gene expression. On the other hand, the combination of exercise and crocin had synergistic and synergistic effects in inhibiting the apoptotic expression of BAX and also enhancing the expression of the anti-apoptotic gene of BCL-2 in rats poisoned by H2O2.

Regarding the high prevalence of hypertension and the significance of its control by patients, the present study aimed to specify the effect of a self-efficacy-based education program on blood pressure control in patients with hypertension. In a quasi-experimental clinical trial study, 80 patients with high blood pressure were divided into two equal groups of 40 patients. The self-efficacy strategies were trained in the intervention group while no intervention was offered in the control group. The patients filled out the Sherer General Self-Efficacy Scale (GSES) and the Cohen Perceived Stress Scale before and three months after the intervention. Moreover, the patients’ blood pressure was measured and compared before and three months after the intervention. In intervention group, the mean systolic blood pressure was 136.7 ± 15.9 and 124.3 ± 13.3 mmHg before and after the intervention, respectively, which significantly decreased (P = 0.001). In control group, the mean systolic blood pressure was 134.0 ± 8.18 and 134.8 ± 9.5 mmHg before and after the intervention, respectively, which showed no significant difference (P = 0.790). The changes in the self-efficacy score were significantly higher in the intervention group as compared with the control group (P < 0.001). Moreover, comparison of the stress score of two groups indicated a significant difference in this regard (P <0.001). Self-efficacy seems to be effective in controlling patients’ blood pressure, and be regarded as a pre-requisite for appropriate behavior. To put concisely, self-efficacy enhancement strategies can be employed to control blood pressure in patients with hypertension.</div>

Currently, parasitic infections are the most important global health problems. Helminthic infections cause serious damage to the livestock industry. Most importantly, it can cause severe damage in immunocompromised individuals. The aim of this systematic review study was to assess the research on the treatment of helminthic diseases using medicinal plant extracts. The search was carried out in 7 databases including 4 English databases (Scopus, PubMed, SienceDirect, and Embase) and 3 Persian databases (Scientific Information Database, Islamic World Science Citation Center, and Magiran) in order to find the studies carried out in relation to the purpose of the current study between 2008 and 2018 in Persian and English languages. Most studies focused on Balanites aegyptiaca (10.71%). The most commonly used extraction method was maceration (78.57%) and then sonication (7.14%). Methanol (35.71%) was the most solvent used for extraction, followed by water (17.85%). The most studied parasite was Haemonchus contortus (28.57%), followed by Schistosoma mansoni (10.71%). Studies have shown that plant extracts can be a good alternative to synthetic drugs in reducing helminthic disease signs; and plant extracts can be used to produce drugs based on natural and effective compounds against helminthes with fewer side effects than synthetic drugs.

Borderline ovarian tumors make a small contribution to the ovarian pathologies; however, with regard to the prevalence of this malignancy at reproductive age, prognosis and standard treatment of these patients are of great significance in oncology trials. The present study aimed to introduce two patients with borderline ovarian tumors to examine the prognosis determinants based on similar studies. In the winter of 2018, two patients with similar medical history of ovarian cysts diagnosed in 2016 with stage I epithelial ovarian tumor (borderline) pathology referred to an emergency department in a university hospital. The first patient was a 29-year-old woman. Following the surgery to preserve her fertility, the mentioned patient experienced relapse and metastases without any proper responses to treatment. Despite all the efforts of the medical team, the patient died due to the severity of her disease. The other patient was a 26-year-old woman, who was admitted at 36th week of pregnancy with the diagnosis of preeclampsia, and delivered a 2800-gram healthy boy. Although it seems that borderline tumor is distinct from other ovarian malignancies in term of prognosis, based on the present case report, the prognosis must be investigated in each patient in individualize manner.