مجله دانشگاه علوم پزشکی اراک
سال سیزدهم شماره 3 (پیاپی 52، پاییز 1389)

Recently, reports have been made of the effects of boric acid (BA) on cancer prevention and inhibition of cancer cell proliferation. This study was designed to investigate the effects of this compound on K562 cell line as a model of chronic myeloid leukemia (CML). In this experimental trial, K562 cell line was cultured in the presence of 0.75 to 12 mmol concentrations of boric acid for 24, 48, 72, and 96 hour intervals. Anti-proliferative and cytotoxic effects of BA were measured by trypan blue exclusion test and MTT assay, respectively. Flow-cytometery was utilized for evaluating the effects of BA on cell cycle. Wright-giemsa staining was used for determining the effects of BA, and latex phagocytic assay was used for evaluating the phagocytic potential of the differentiated cells. BA induced growth inhibition of K562 cells in a dose and time dependent manner; after 96 hours of treatment with 12 mmol BA, cell proliferation of K562 cells was inhibited to about 83% (p<0.001). In addition, BA induced G1 cell cycle arrest in a way that for instance, after 6 days of treatment with 9 mmol BA, 98% of cell populations were at G1 level. Wright-giemsa staining and latex phagocytic assay results confirmed that K562 cells differentiated toward monocyte-macrophage lineage. Noticing the anti-proliferative and differentiating effects of BA, and no evidence of its adverse effects, this compound can be used as alone or in combination with other drugs in CML differentiation therapy.

Candida vaginitis which is mostly caused by Candida albicans is the second common cause of vaginal candidiasis in women. This study was designed to determine the clinical symptoms of Candida vaginitis and their relationship with the types of Candida species in women referring to the clinics of Shiraz University of Medical Sciences. In an analytical study, over a seven month period of sampling, through the examination of the history of 1100 patients, 450 were identified with chief complaints regarding genital infection. Samples were obtained from 280 of these patients according to their histories and the characteristics of their vaginal discharges. Of these patients, 105 were diagnosed with Candida vaginitis. The analysis of Candidal species was done through germ tube and chlamidospore agar tests. Urogenital itching was severe in more than 43.8% of patients. White color genital discharges were more observable than other symptoms (88.6%). In negative Candida culture samples, severe itching, white color discharge, and disuria were reported to be 23, 80.8, and 43.5%, respectively. Candida albicans composed 70.5% of the samples. Colony count was between 51 and 500 in 49.5% of all samples. There were no significant relationships between colony count and rate of itching, family planning program, and other symptoms. Due to the uncertainty of diagnosis of this disease according to clinical symptoms and also, due to the consistency and resistance of Candida species, using culture method is recommended as a standard method of diagnosis.

Studies have revealed that nonclinical individuals who have mixed-handedness obtain higher scores in schizotypy, but investigations in Asian countries have indicated contradictory results. The aim of this study was to identify the relationship between mixed-handedness and schizotypy in a nonclinical Iranian population. One hundred fifty normal students from two different high schools, 94 girls (%62.7) and 56 boys (%37.3) ranging in age from 14 to 17 (15.5±0.67), participated in this descriptive study. Participants filled out Schizotypal Trait Questionnaire (STA) and answered handedness questions. The causal relationship between schizotypy and handedness was determined through linear regression. In this study, parallel to other studies conducted in Asia, no significant associations were found between mixed-handedness, schizotypy and schizotypy factors. Noticing that Asian people, due to cultural pressure, have less tolerant attitudes toward left-handedness, utilizing handedness scales that incorporate cultural values is essential for revealing the real association between schizotypy and mixed-handedness.

In the last few decades, quality of life (QOL) has become known as an important concept in medical research. In this study, two standard QOL questionnaires were chosen for evaluation of patients’ personality characteristics: 1) World Health Organization Quality of Life (WHOQOL) and 2) Iranian Diabetics Quality of Life (IRDQOL). The main aim of this study was to compare two standard quality of life questionnaires for evaluation of the relationship between personality characteristics and glycemic control in diabetic patients. This cross-sectional study was carried out on 256 type 2 diabetic patients with a history of diabetes for more than one year. Validity and reliability measures were determined for the two questionnaires. HbA1c was measured through calorimetric method. The mean of physical dimension scores on IRDQOL questionnaire was significantly lower than that on the WHOQOL questionnaire. No significant differences were observed between the other dimensions of the two questionnaires. Positive correlations were seen between different dimensions of each questionnaire. There was a high correlation between the different dimensions of each questionnaire and its related QOL. The two questionnaires did not indicate any correlations between glycemic control and different dimensions of QOL. The two questionnaires have reliability for the total QOL; however, the distribution of questions in IRDQOL is not equal. The quality of the evaluation of patients’ personality characteristics by IRDQOL is less than that of WHOQOL. None of the questionnaires indicated any relationship between personal characteristics and glycemic control.

Bacterial vaginosis is one of the most common infections in women at reproductive age. Although metronidazole is recommended as the first-line treatment, it has various side effects which make it difficult for patients to continue the treatment. Thus, the need is felt for finding a medication with fewer side effects. The aim of this study is to compare the effects of micosin vaginal cream (made of garlic) and metronidazole vaginal gel on treatment of patients with bacterial vaginosis. This study was a clinical trial which was conducted on 100 married women, aged 18-44, whose infection with bacterial vaginosis was diagnosed through clinical Amsel criteria. The participants were randomly divided into two groups of 50 persons each: Micosin vaginal cream and metronidazole vaginal gel. Patients identified with tricamona or candidiadis infections were excluded from the study. Treatment period in each group lasted for seven days. Clinical Amsel criteria and patient complaints were again checked 2 to 7 days after completion of the treatment period, and the side-effects were registered. Following the treatment with micosin vaginal cream and metronidazole vaginal gel, patient complaints and clinical Amsel criteria showed a significant decrease (p<0.05), in a way that clinical recovery rates in micosin and metronidazole groups were 80% and 70%, respectively. Micosin vaginal cream seems to be an appropriate alternative for metronidazole vaginal gel in treatment of bacterial vaginosis.

Among respiratory support techniques, nasal continuous positive airway pressure (NCPAP) and mechanical ventilation (MV) are more known for their effectivity in reducing complications associated with respiratory distress syndrome (RDS). Moreover, early application of NCPAP and administration of surfactant are effective in decreasing the need for MV and its adverse effects. This study was designed to compare NCPAP and MV after administration of surfactant in preterm neonates with RDS. In this clinical trial, 60 preterm neonates (<32 weeks) were evaluated. After receiving one dose of surfactant (4 cc/kg), the subjects were randomly divided into treatment and control groups, and respiratory support was established via positive airway pressure or MV. There were no significant differences between the neonates in the two groups in terms of gestational age and birth weight. The mean duration of MV was significantly lower in the treatment group (p=0.001). On day 3, the number of ventilator-dependent neonates in the control group was more (26.7% versus 83.3%). There were no significant differences between the two groups in the number of second surfactant doses, mortality rate, and the number of patients who had developed short-term complications during hospital stay. In a significant number of preterm babies with RDS, NCPAP can be extubated after receiving one dose of surfactant. This is a potentially useful modality for respiratory support with a low mortality and morbidity rate and limited complications in very premature infants.

The aim of this study was to investigate the effect of BMI and reproductive histories (age, age at menarche, the number of parities, reproductive years and years since menopause, and serum levels of estradiol, testosterone and SHBG) on bone densitometry of spine and femur in healthy postmenopausal women. In a descriptive cross-sectional study, 190 healthy postmenopausal women, aged 40-64, who did not have a history of co-existing diseases, diseases affecting the quality of life, bone diseases, and using drugs affecting the bone metabolism, were randomly selected. Bone densitometry, T score, Z score, and bone marrow density (BMD) were determined by dual energy X-ray absorptiometry (DXA) at lumbar spine and femur. Correlation co-efficients were, then, measured for the relationship between bone density and the intended factors. BMI presented significant positive relationships with T score and BMD of spine and BMD, T score, and Z score of femur, whereas age, the number of years since menopause, and the serum level of testosterone had negative relationships with T score and BMD of spine. The serum level of testosterone showed a negative relationship with Z score reduction in spine. The number of years since menopause had a positive relationship with reductions in Z score and BMD of femur. In addition, significant positive relationships were observed between the number of reproductive years and T score and BMD of spine. Bone loss in postmenopausal women is intensified with increases in age, the number of years since menopause, and the serum level of testosterone, whereas BMI has a bone-protective effect.

Dysmenorrhea is seen in nearly 5% of women with regular menstruation. In this regard, different methods have been proposed for treatment of dysmenorrhea, and drugs with fewer side effects are preferred. Hence, this study was done to detect the effect of echinophora- platyloba on primary dysmenorrhea. In a single-blind clinical trial, 60 students with primary dysmenorrhea were evaluated at Shahr-e-Kord University of Medical Sciences. The students were randomly divided into two groups of 30 each: Echinophora-platyloba extract and placebo. Data collection was done through visual analogue scale for detecting the intensity of pain. At the end of first and second months after treatment, the intensity of pain was determined in the two groups and compared with that before the intervention. Eventually, the data were analyzed through Chi square, t-test and Mann-Whitney test. The means of dysmenorrhea severity scores two months before administering the drug in echinophora-platyloba and placebo groups were 8.46±2.75 and 8.80±2.53, respectively. Here the difference was not significant; however, after administering the drug, the mean scores in intervention and non-intervention groups were 3.41±1.12 and 7.82±2.60, respectively, which indicated a significant difference between the two groups (p<0.001). Both echinophora-platyloba extract and the placebo could reduce the severity of dysmenorrhea during the treatment, yet the effect of echinophora-platyloba was much greater than the placebo. Thus, the use of echinophora-platyloba extract is suggested in treatment of dysmenorrhea.

One way of quitting addiction is forming narcotics anonymous (NA) groups. Noticing the high rate of reappearance of drug usage in these groups, the researchers decided to obtain a proper method of increasing the duration of abandonment period through the analysis of different factors affecting the reappearance of addiction. In a cross-sectional analytical study, all NA members (350 men) in Khomein were evaluated through questionnaire and referral interview. Data related to factors affecting quitting addiction, development of addiction, and reappearance of addiction were analyzed. The most important causes of addiction were enjoyment and curiosity (75.1%), whereas the most important factors in abandonment were weariness and pressure from family (45.4%). Also, 48.9% of individuals had previously relapsed into using narcotic substances. The most important factors in reappearance of addiction in NA groups were unemployment and change in income (12.6%). A significant relationship was found between level of education and place of living and addiction to narcotics (p=0.000), whereas there were no significant relationships between the type of narcotic substance and quitting addiction or the mean age of individuals and trying or not trying to quit. Noticing the high rate of reappearance of narcotics usage in NA groups, it seems that current programs for prevention of addiction have not been successful in this regard. However, based on the findings of this study, it is suggested that provision of employment opportunities after quitting addiction can, to some extent, prevent the reappearance of addiction in NA groups.

Perineal pain following episiotomy affects mothers’ mental health and their quality of life. Using cooling gel pad is a new approach which is used for pain relief, but the pain related to episiotomy is still typically treated with oral analgesics. This study was conducted to investigate the effect of gel pad on post-episiotomy pain in primiparous women in Kamali Hospital of Karaj. This single-blind clinical trial was conducted on 60 primiparous women who referred for labor to Kamali Hospital of Karaj. The participants were randomly allocated to two groups: Those receiving gel pads (for 20 minutes four hours after labor and in case necessary, for up to 5 days) and the control (receiving the hospital routine). The two groups were evaluated in terms of episiotomy pain intensity through visual analogue scale (VAS) and analgesics usage. The two groups did not show any significant differences in demographic features and other intervening variables. In terms of reduction in pain intensity, there were significant differences between the two groups 4 hours (p=0.002), 12 hours (p=0.009), and 5 days (p=0.000) after episiotomy. Analgesics usage, five days after delivery, in gel pad group was significantly lower than the control group (p<0.001) Using gel pad reduces the perineal pain intensity following episiotomy and decreases the need for using analgesics.

Helicobacter pylori iceA gene has been reported to be a genetic marker for the development of peptic ulcer in western populations. The aim of this study was to investigate the prevalence of iceA genotypes and their relationship with peptic ulcer in Iran. This observational study was carried out on 75 patients. Biopsy specimens were evaluated for the presence of Helicobacter pylori through rapid urease test. GlmM gene and iceA1 and iceA2 genotypes allelic verification and variation culture were determined via PCR. In this study, iceA1 and iceA2 alleles were identified in peptic ulcer disease (PUD) patients. IceA1 genotype (64%) was more prevalent than iceA2 (21.3%). IceA1 strains were more observable in patients with PUD. No significant relationships were seen between iceA genotypes and the clinical outcomes following infection (p= 0.71). This study revealed a significant two-tailed correlation between iceA genotypes and PUD occurrence. The results indicate that iceA1 gene can be used as a reliable marker in predicting the clinical outcomes of Helicobacter pylori infection. Therefore, further in-vitro and in-vivo investigations are needed for reaching general consensus in this regard.

Salvia staminea, belonging to lamiaceae family, has positive effects on the nervous system and possesses anti-oxidant and anti-inflammatory effects. Hence, this study was conducted to determine the neuro-protective effects of salvia and its total ethanol extract on spinal cord motoneurons in Wistar rats. In an experimental trial, 54 male Wistar rats were divided into nine groups of six: Control, compression, treatment A (ethanol extract of root in 25, 50, and 75 mg/kg doses), treatment B (aqua extract of root in 25 and 50 mg/kg doses), treatment C (aqua extract of leaves in 50 mg/kg doses), and treatment D (ethanol extract of leaves in 75 mg/kg doses). In compression and treatment groups, 28 days after inducing impairment in α motoneurons, sampling of the left leg sciatic nerves was done in the rats. Following tissue passage, 7 micron cuts were obtained and painted with blue toluidine. Neuralgia motoneurons count was, then, carried out through steriology and dissector methods. Neuron number density in the rats treated with 50 mg/kg doses of total aqua and ethanol extracts of leaves and 75 mg/kg dose of ethanol extract of root showed significant differences in comparison to that of the compression group (p<0.05). The results of this study prove the neuroprotective effects of these extracts on neuralgia motoneurons of spinal cord.

Hospital wastewater usually contains pathogenic micro-organisms, drugs, radio active materials, and toxic chemical elements that in case of being disposed without filtration, will result in pollution and spread of diseases. Therefore, evaluating the status of wastewater disposal in hospitals is necessary for proper planning. In a cross-sectional descriptive study in 2008, data collection was done by means of interviews, observations, and questionnaires in all hospitals of Markazi Province. Noticing the 33 items in the questionnaire, the overall conditions of the hospitals and the methods of using the sewage system were studied, and at the same time, filtration installations and wastewater disposal systems were inspected. Of all the 19 hospitals, 10 used a conventional method of direct disposal of sewage to subterranean shafts, and of the 4 hospitals with filtration installations, three were practically out of order or were not efficient. Five of the hospitals were directly linked to the city sewage system without any pre-filtration. None of the hospitals had a specialized operator of sewage filtration and disposal system. Wastewater disposal in hospitals of Markazi Province is not desirable; therefore, such acts as conducting more specific surveys, creating a positive attitude in planners, and providing sufficient funds for filtering wastewater in some of the hospitals are suggested.

Irritable bowel syndrome (IBS) which is characterized by chronic abdominal pain and changes in bowel movements is the most common gastrointestinal disease. Curcuma is one of the traditional medications which has been considered in treatment of gastrointestinal diseases. In this study, the effects of curcuma on IBS were investigated. In a double-blind randomized study, 140 IBS patients after meeting the inclusion and exclusion criteria, regardless of sex and age and based on internist’s diagnosis, were involved. The patients were randomly divided into case (curcuma) and control (placebo) groups which included 69 and 71 patients, respectively. For converting subjective criteria to objective ones, treatment forms were filled out before the treatment and two and four weeks after the treatment according to visual analog scale. Data were analyzed through descriptive statistics and t-test. Using curcuma and placebo before the treatment and two and four weeks after that improved patients’ clinical symptoms except for vomiting (p=0.001); however, no significant differences were observed in the effectiveness of placebo and curcuma on improvement of clinical symptoms of patients in case and control groups (p>0.05). Using curcuma does not offer any significant differences in controlling and reducing the symptoms of IBS in comparison to the placebo, but its application improves the clinical symptoms of IBS patients.

Diabetes is the sixth main cause of mortality in the world, and its both types are accompanied with eye complications in a way that the risk of blindness in diabetic patients is 25 times more than normal people. Hence, this study was conducted to determine diabetic patients’ awareness of the eye complications associated with this disease. In a cross-sectional study, 200 diabetic patients referring to the eye clinic of Amir Kabir Hospital of Arak in 2008 were evaluated. Data collection was done through questionnaire and referral interviews. Then some of the factors affecting patients’ awareness of eye complications associated with diabetes were analyzed. The level of awareness of eye complications associated with diabetes in 40% of the patients was average. Also, significant relationships were observed between the level of awareness and age, job, education, type of retinopathy, type of treatment, and the history of referring to ophthalmologist (p<0.001), whereas no significant relationships were observed between the level of awareness and gender, familial history of diabetes, and controlling the diet (p>0.05). This study showed that a higher level of awareness in diabetic patients does not necessitate that they observe a proper diet, but it can lead to patients’ greater care in preventing the development of diabetes

Pain following tonsillectomy is common in children, and its elimination due to its subsequent complications is essential. Therefore, this study was conducted with the aim of obtaining the best method of administering ketamine for reducing pain following tonsillectomy with the greatest efficiency and the least side effects. This study was a double-blind clinical trial which was conducted on 92 children, aged 3-9, who had been admitted for tonsillectomy. The patients were randomly divided into oral ketamine and ketamine injection groups (each containing 46 patients). Thirty minutes before the operation, all the patients were given apple-juice; ketamine injection group received normal apple juice without ketamine, whereas the oral ketamine group received 5mg/kg ketamine with the apple juice. Three minutes before tonsillectomy, 0.5 mg/kg ketamine was injected to the peritonsillar area in ketamine injection group while the same volume of saline was injected to the oral ketamine group. Data were registered, gathered, and, then, analyzed using Wilcoxon, Man Whitney, and t tests. Demographic data and blood pressure before and after the operation did not have significant differences in the 2 groups. In terms of the duration of operation time, a significant difference was observed between the two groups; the operation time in the ketamine injection group was shorter (p=0.006). Also, pain score in the ketamine injection group was less than the oral ketamine group. Ketamine is effective in reducing the pain after tonsillectomy operation. Peritonsillar injection of ketamine is more effective than its oral usage.

Urine culture has an important role in diagnosing and tracking down urine tract infection (UTI) in pediatrics. Sampling methods also have a great effect on patients’ treatment procedure. Hence, this study was conducted to determine the effect of genital area ablution on urine culture test results in 3-12 year old girls referring to Amir Kabir Hospital of Arak. In a case-control study, 620 3-12 year old girls, referring to Amir Kabir Hospital in 2006, for whom urine culture test had been prescribed with suspicion of UTI, were evaluated. The population under investigation did not have a history of using catheter, genital anomaly, inflammation, genital discharge, and taking antibiotics up to seven days prior to the investigation. The patients were randomly divided into two groups of 310 each: Ablution and no-ablution. After data collection, the data were analyzed by t-test. In the ablution group, 3.7% of patients were reported with UTI, 1% with contamination, and 95.3% with normal conditions. In the non-ablution group, 4.7% of patients were reported with UTI, 2% with contamination, and 93.3% with normal conditions. Contamination rate in ablution and non-ablution groups were 1% and 2%, respectively. This difference, however, was not significant (p=0.491). The relationship between genital area ablution and reduction of contamination in urine culture was not significant; therefore, genital area ablution does not have an important effect on decreasing the contamination of urine culture.

Brucellosis, a zoonotic disease with worldwide spread, is a common disease in Iran and is endemic in Markazi Province. Brucella osteomyelitis, on the other hand, is a rare disease. Here we reported a case of brucella osteomyelitis of the tibia following trauma. Case: The patient was a 22 year old man referring with chronic draining tibia ulcer. He had a history of trauma of the tibia, dating back to 3 years ago, for which local prosthesis had been prescribed. Later on, the prosthesis had been removed due to infection. Staining of the tissue samples indicated the presence of gram-negative coccobacill and brucella growth in the culture of excretions. This case was reported because of rare presentation of brucella and the educational implications of the patient with respect to the possibility of brucella development in chronic ulcers or prosthesis. Although uncommon, brucellosis should be regarded as a potential cause of osteomyelitis in patients with a record of physical contact with animals.