فهرست مطالب

  • Volume:21 Issue: 17, 2020
  • تاریخ انتشار: 1399/02/09
  • تعداد عناوین: 8
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  • Payam Mehrabani, Seyed Davood Hosseini, Raheleh Rafaiee*, Seyed Hamzeh Hosseini Page 1
    Background

    Delirium is a common problem in elderly patients. Recently, therapists have shifted their attention away from treatment towards prevention; therefore, investigation of related risk factors is essential in these patients.

    Methods

    In this prospective cohort study, newly admitted elderly patients, with a Glasgow Coma Scale score above 10, were screened and enrolled. The patients were evaluated for delirium using the Neecham Confusion Scale (NCS). The risk factors included four major domains: patient characteristics (age, gender, and substance abuse), chronic diseases, acute diseases, and blood biochemical factors.

    Results

    A total of 100 patients were assessed for delirium. The mean age of the participants was 79.9 ± 15.1 years (24% female). The proportion of in-hospital deaths was 12%, with a cumulative three-month mortality of 40%. The rate of delirium development was significantly associated with underlying factors, including cancer, hypertension, cerebrovascular accident, cirrhosis, dementia, and substance abuse. The laboratory results showed a blood urea nitrogen (BUN) level≥ 50 mg/dL in 33% of patients with delirium. There was a significant association between BUN level and NSC score (P < 0.05). Among other laboratory variables, higher erythrocyte sedimentation rate and C-reactive protein level were significantly associated with delirium. Moreover, Kaplan-Meier survival curves for effective factors, such as drug effect, cancer, cirrhosis, dementia, and BUN, showed significant differences.

    Conclusions

    In elderly patients, symptoms of delirium persist for three months after diagnosis. Private nursing care at home or nursing home placement, besides the assessment of delirium risk factors, is important for optimal care of elderly patients after hospitalization.

    Keywords: Mortality, Delirium, Cohort, Older Patients, Neecham Scale
  • Noor Talal, Haider Ayad Alidrisi, Abbas Ali Mansour* Page 2
    Background

    Dyslipidemia is one of the important risk factors for cardiovascular diseases (CVD) and is usually determined by measuring lipid profiles in fasting state. Recent researches showed that non-fasting lipid profiles changed minimally in response to food and may be superior to the prediction of CVD.

    Objectives

    To evaluate whether there is any change in the measurement of lipid profile in fasting and non-fasting states and its effect on patients’ management.

    Methods

    A cross-sectional observational study was performed from January to November 2017, on 194 patients with an age range of 20 to 78 years, attending Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC) and Basrah General Hospital. Clinical, demographic and laboratory characteristics of the participants were collected in fasting and non-fasting states.

    Results

    Both triglycerides (TG) and very low-density lipoprotein cholesterol (VLDL-C) were significantly higher when measured in the non-fasting state (P = 0.004, 0.004), with a mean increase in TG by 29.39 ± 60 mg/dL (0.3 ± 0.6 mmol/L), and VLDL-C increase by 5.9 ± 12.3 mg/dL (0.15 ± 0.31 mmol/L). These patterns of changes in TG and VLDL-C were observed mainly in patients aged < 55 years, women, obese patients, non-smokers, diabetics, hypertensive, non-CVD patients, and patients without statins. While total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) did not change significantly.

    Conclusions

    The study showed that non-fasting measurements of both TG and VLDL were significantly higher compared to the fasting state. A finding that was not present in TC, LDL-C, and HDL-C measurements.

    Keywords: : Cardiovascular Disease, Lipid Profile, Fasting
  • Ehsan Eshaghi, Fatemeh Rahmati Najarkolaei *, Mirsaeed Yekaninejad, Hosein Rostami Page 3
    Background

    Overweight in adults has increased significantly in developed countries in recent decades. This problem has attracted interests of researchers in the field of nutrition knowledge.

    Objectives

    The purpose of this study is to evaluate the validity and reliability of the Persian version of the dietary habits and nutritional knowledge questionnaire and the nutrition knowledge questionnaire for adults, and to confirm their structural model in the Iranian population.

    Methods

    A sample of 300 hospital employees from a hospital in Mashhad, Iran, participated in this study and completed the questionnaires. The questionnaires were translated using the forward-backward translation method. Psychometric evaluation of the Persian version of the questionnaires with a total 5 subscales was assessed based on content validity and construct validity using confirmatory factor analysis. Internal consistency and test-retest reliability were evaluated using Chronbach’s alpha and intra-class correlation coefficient, respectively.

    Results

    For qualitative content validity, the content validity index scores for all items were ≥ 0.80 and the content validity ratio scores were 0.91, 0.87, 0.84, 0.9, and 0.85 for all subscales. The Persian version of the questionnaires were confirmed by calculating confirmatory factor analysis models fit indices. The internal consistency figures for the Nutrition knowledge questionnaire for adults subscales were 0.7, 0.75, and 0.73 and for the total scale was 0.78; for the dietary habits and nutritional knowledge questionnaire were 0.71 and 0.7 and for the total scale was 0.74. The intra-class correlation coefficient were 0.97 and 0.95 for the total scale of nutrition knowledge questionnaire for adults and the total scale of dietary habits and nutritional knowledge questionnaire respectively.

    Conclusions

    The findings show that the Persian version of the questionnaires has good content validity as well as acceptable validity and reliability

    Keywords: Construct Validity, Dietary Habits, Nutrition Knowledge, Forward-Backward Translation, Psychometric Evaluation, Reliability, Validity
  • Fatemeh Khorsha Kisomi, Majid Soltani *, Maryam Dastoorpoor, Nastaran Madjdinasab, Negin Moradi Page 4
    Objectives

    Given the role of voice onset time in speech production and its value in the identification of speech disorders, the present paper aimed at comparing VOT in people with multiple sclerosis and healthy group and investigating the factors affecting VOT.

    Methods

    In this cross-sectional analysis study, 36 patients with MS with spastic dysarthria and 36 healthy subjects were investigated. After placing the subjects in an acoustic environment, the acoustic signal of the voiced and voiceless stop words /p/, /t/, /k/, /b/, /d/, /g/ with the vowel /a/, in the tissue cvc was recorded using the Sure-beta54 microphone. The spectrogram of the words was checked with the Praat version 6.0.36. Data were analyzed by the Shapiro-Wilk test, Independent t-test, and two-way analysis of variance.

    Results

    Patients with MS have a longer VOT than healthy people, although the difference is not statistically significant (P > 0.05). The study of the effect of place of articulation on VOT revealed that the place of articulation was effective on the VOT in the healthy controls, however, there was no significant difference in the patient group. There was a significant difference in the effect of voicedvoiceless words on VOT (P < 0.05). The place of articulation and voiced-voiceless variables do not affect the voice onset time simultaneously; however, they might be effective independently (P > 0.05).

    Conclusions

    Patients with MS differ in their motor coordination between articulator structures and speech structure compared to the healthy group. Deficient speech production timing causes problems in speech motor control and ultimately changes the speech of the affected people.

    Keywords: Multiple Sclerosis, Dysarthria, Voice Onset Time, Place of Articulation
  • Pooneh Mokarram *, Seyed Vahid Hosseini, Mehran Erfani, Hamid Behrouj, Mojtaba Ahmadi, Hajar Khazraei, Alimohammad Bananzadeh, Seyedeh Azra Shamsdin, Mozhdeh Zamani Page 5
    Background

    Considering the important role of the genetic factors in the etiology of obesity, the genetic knowledge-based approach can be helpful to find individuals with the potential risk of obesity and obesity-related diseases. Evidence suggests the fat mass and obesity-associated (FTO) gene as the most important contributor to polygenic obesity. Although, different studies on various populations indicated the association of the FTO genetic variations (rs1421085 and rs17817449) and morbid obesity, to our knowledge, there is still no such study in the Iranian population.

    Objectives

    The aim of this study was to evaluate and compare two FTO single nucleotide polymorphisms (SNPs) (rs1421085 and rs17817449) in morbidly obese patients and healthy normal controls in southern Iran. The potential association between these genetic variations and some demographic and clinical characteristics of obese patients were also investigated.

    Methods

    A total of 90 morbidly obese patients and 90 healthy normal controls were included in this study. Genotyping of blood samples was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. SPSS software was applied for statistical analysis of data.

    Results

    Both mentioned SNPs were significantly associated with an increased risk of obesity. No significant association was found between these two FTO genetic variations and demographic and clinical characteristics of obese patients including sex, age, family history of obesity, BMI, type 2 diabetes, hypothyroidism, physical activity, amount of stress, consumption of fatty/frying foods, sweetmeat, fruit and vegetables, cigarette and hookah smoking, alcohol consumption, fasting blood glucose (FBS), triglyceride (TG), total cholesterol, HDL, and LDL.

    Conclusions

    It seems that FTOSNPs (rs1421085, rs17817449)may increase the risk of morbid obesity in southern Iran. Further investigations in the different populations with larger sample sizes are required to consider these genetic variations as potential biomarkers for obesity

    Keywords: FTO, Obesity, BMI, Polymorphism, Genotyping
  • Soudabeh Kavousipour, Pooneh Mokarram *, Mahdi Barazesh, Elham Arabizadeh, VahidRazban, Zohreh Mostafavipour, Shiva Mohammadi and Samira Sadat Abolmaali Page 6
    Background

    The intracellular signaling pathways stimulated by CD44/hyaluronic acid (HA) interaction play a central role in the invasion and migration of cancer cells. Epithelial-mesenchyme transition (EMT) is an important factor in cancer metastasis and migration, which can be stimulated by the snail transcription factor. Previous studies showed cells that were subjected to snailinduced EMT, characterized by a CD44high/CD24low phenotype, expressed at their surface.

    Objectives

    The aim of this study was to assess the inhibitory effect of CD44/HA interaction on the snail expression and invasive behavior of aggressive breast cancer cell line with a high CD44 expression in 2D and 3D culture. The cell surface binding capacity of the selected aptamer was evaluated via flow cytometry assay.

    Methods

    To test our hypothesis, we disrupted the CD44/HA interaction by DNA aptamer, which specifically binds to the Hyaluronic Acid Binding Domain (HABD) of CD44. Then, expression level of snail mRNA was evaluated in MDA-MB 231 cells, cultured in 2D and 3D conditions by real-time PCR. Furthermore, invasive behavior was evaluated, using wound healing assay.

    Results

    The results of this study showed that CD44 aptamer reduced snail expression and invasive behavior in MDA-MB 231 cell line. In addition, our result indicated that cells cultured in 3D were more sensitive to the aptamer in comparison to those cultured in the 2D model.

    Conclusions

    The inhibition of CD44-HA interaction, using aptamer, negatively regulates the CD44 function in aggressive breast cancer cell line with the high level of CD44 expression.

    Keywords: Aptamer, Breast Cancer, CD44, 3D Culture, Metastasis
  • Mohammad Hasan Imani Nasab, Soraya Nouraei Motlagh, Peivand Bastani, Mehdi Birjandi, Katayoon Bakhtiar, Mahnaz Samadbeik* Page 7
    Background

    Health systems around the world are encountered with the challenge of filling the gap between knowledge and practice.

    Objectives

    This study aimed to investigate the status of knowledge translation at Lorestan University of Medical Sciences, Iran.

    Methods

    This cross-sectional study was conducted in 2017. For data collection, the knowledge translation self-assessment tool for research institutes was used. Data analysis was conducted based on the four-dimensional and seven-dimensional structures of the tool. The data were analyzed using descriptive and analytical statistics.

    Results

    The overall status of knowledge translation was at an average level with a mean score of 2.13 out of total score 5. The studied university acquired a mean score of 2.41 (good level) from maximum score 4.22 in the knowledge generation dimension and a mean score of 1.70 (weak level) from maximum score 3.50 in the dimension of promoting the use of evidence. Comparison of the mean scores of knowledge translation and its dimensions did not show any significant association with the faculty members’ characteristics (age, work experience, gender, education level, academic rank, and school).

    Conclusions

    Considering the overall level of knowledge translation and the poor level in some dimensions, it is suggested that the studied university puts the periodic self-assessment of knowledge translation on the agenda and designs and implements the improvement interventions based on the self-assessments

    Keywords: Knowledge Translation, Knowledge Transfer, Medical Faculty, Iran
  • Mohammad Ali Mirshekar, Somayeh Miri, Ali Shahraki* Page 8
    Background

    Exposure to herbicide paraquat (PQT) is a potential risk factor for cognitive impairment. Many cognitive behaviors, including spatial memory, passive avoidance, balance, and motor performance, may be affected by PQT.

    Objectives

    This study aimed at determining cognitive behaviors, motor function, and malondialdehyde (MDA) content of the hippocampus after i.p. injection of PQT in rats and evaluating the effects of diosmin (DM) in preventing PQT effects on cognitive behaviors and MDA level in the hippocampus.

    Methods

    In this study, 32 male Wistar rats were divided randomly into four groups: control, PQT (4 mL/kg), DM (100 mg/kg), and DM + PQT. PQT (4 mg/kg, i.p.) was used three times a day for one week to develop a cognitive deficit model. The rats were pretreated using DM (100 mg/kg) for seven days before PQT administration. Passive avoidance task (PAT), rotarod test, and spatial memory tests were also performed. The MDA level was measured in the hippocampus of different groups to determine lipid peroxidation.

    Results

    Based on the findings, 100 mg/kg of DM increased the step-through latency, total time in the target quarter, and bar latency in the cognitive deficit model (P < 0.01 and P < 0.001, respectively). The hippocampal concentration of MDA was significantly lower in the DM + PQT group, compared with the PQT group (P < 0.001).

    Conclusions

    DM could effectively prevent cognitive deficits (spatial memory and passive avoidance) and motor dysfunctions induced by PQT administration. In addition, MDA concentration reduced in the hippocampus was induced by i.p. injection of PQT. The present study suggests DM as a suitable compound for memory restoration in cases of PQT poisoning

    Keywords: Paraquat, Memory, Learning, Latency Time