Journal of Advances in Medical and Biomedical Research
Volume:19 Issue: 75, 2011

Resistin is a novel adipokine which may play a role in insulin resistance. In this study we aimed to determine the cord blood resistin, leptin, insulin and maternal serum resistin levels during pregnancy; and to investigate correlation between these metabolic hormones; and also to evaluate their association with newborn growth indices.

This study was conducted on 80 newborns and their mothers in Mousavi Hospital Zanjan, Iran in 2009. Newborn growth indices including birth weight, height, body mass index (BMI), Ponderal index, Homeostatic Model assessment (HOMA-IR) and their mothers’ BMI were determined. Resistin, leptin and insulin levels were measured by ELISA.

In this study, cord blood resistin levels were higher than serum resistin levels of pregnant mothers (10.77±1.53 vs. 7.91± 5.71 ng/ml). Moreover, serum resistin levels of mothers’ did not exhibit any correlation with cord blood resistin, leptin and insulin levels, as well as neonatal anthropometric indices. Meanwhile, there was no significant correlation between cord resistin levels, insulin resistance, fat percentage and newborn growth factors. Cord resistin levels were positively correlated with cord blood leptin levels (r=0.222; p=0.048). Also, there was a significant positive correlation between cord blood leptin and neonatal BMI (r=0.223; p=0.047), Ponderal index (r=0.212; p=0.058), HOMA-IR (r=0.426; p=0.052) and fat percentage (r=0.247; p=0.014).

On the basis of the findings, increased cord blood resistin levels may indirectly influence fetal growth through leptin or other cytokine levels. Though, further researches are needed to confirm this matter.

Diabetes is a metabolic disorder that occurs as a consequence of decrease in insulin secretion or resistance to insulin. Most diabetes related treatments have problems with adverse reactions. Natural therapeutics have been in use from long time ago up to present time. Ginseng is a traditional drug used for treatment of many dieses particularly diabetes. The aim of this study was to find out the effect of oral Ginseng on the serum glucose and other biochemical parameters such as lipid profile. In this study 30 male rats with a body weight of 250±25 gr and age of 4-6 months was used. Each animal was housed under controlled temperature (21+_2 C) and standard conditions with free access to food and water. Blood test was carried out to measure glucoses and other biochemical parameters such as cholesterol, TG, ALT, AST and BUN. Animals were equally divided into three groups; 1-control group, 2-the STZ-induced-diabetes (60 mg/kg) group, 3- the STZ-induced-diabetes (60 mg/kg) and150 mg/kg oral ginseng. The study was lasted for 6 weeks. Blood samples were taken and tested for glucoses and other parameters. The average blood sugar in the control group was 131.1±7.9 mg/dl, but it was higher than 550mg/dl in streptozocine- received group. In group 3, which received ginseng, blood sugar decreased up to 50%. Cholestrol decreased up to 40% in the treatment group. Among the measured parameters HDL showed a 50%decrease in treatment group in comparison with diabetic group. AST and ALT values between the control and treatment groups did not show a significant difference. BUN values decreased from 71.6±6.6 in diabetic group to 50.1±5.7 mg dl in the treatment group. The results of this study revealed that ginseng can be considered as a substance which decreases blood glucoses, reduces diabetes adverse reactions, and consequently diminishing blood lipids in animal model. However, to apply these results to human, further studies are needed to be carried out.

Abortions are the most common complications of pregnancy. This study was conducted to figure out primary outcomes of surgical and conservative management of incomplete abortions in early pregnancy. This study was carried out in Mousavi and Vali Asr hospitals of Zanjan in 2008-2009. 48 women with incomplete abortions were divided into two groups based on their own preferences: conservative management (n=25) and surgical management (n=23). In the conservative group, the patients were granted with a two-week interval for spontaneous resolution and then a sonoghraphy was performed. In the surgical group curettage was done and after two weeks patients were visited. In both groups, we compared satisfaction, time taken to do normal activities, bleeding days, pelvic pain and the need for follow up care after two weeks. In the conservative group, spontaneous resolution occurred in 19 patients (76%) after two weeks. In this group satisfaction was higher and time taken to return to the normal activities was shorter than the surgical group, but bleeding days was longer in the conservative group and more patients needed follow up care after 2 weeks. There was no significant difference in pelvic pain between two groups. Conservative management is a superior alternative method in the management of incomplete abortions in early pregnancy. However, further researches are necessary in order to attribute these results to all patients.

In recent decades, epidemiology has significantly been considered in hygienic studies and disease control, and has made a way into all the programs and hygiene policies. By examining the convergence of harmful lineage genetic patterns, the common infectious resources among the patients can be inferred. The purpose of this study was to compare the Mycobacterium Tuberculosis genetic patterns convergence isolated from patients infected with Mycobacterium Tuberculosis by MIRU-VNTR technique. After isolation the samples from Lowenstein Jensen culture environment and taking segregate tests and drug susceptibility, the DNA was extracted using CTAB/Nacl technique. The genetic patterns of lineages were calculated according to 12 loci format with MIRU-VNTR technique. Demographic and molecular information of patients was used for epidemiological purposes. After performing drug sensitivity test, 65/140 (64/4%) samples fall into MDR, 29 (20/7%) samples in non MDR category, and the rest of them were among drug – sensitive lineages. Lineage genetic pattern analysis indicated that 49 (35%) of samples related to Delhi/CAS, 28 (20%) to Uganda I, 16 (11/4%) to New I, 1 (0.7%) to EAI, 3(2/1%) to Haarlem, and 5(3/5%) to H37RV families. The genetic pattern convergence comparison exhibited that the most common and variant genetic patterns was seen in Tehran province which were mostly connected to south (from the South of Tehran to Azadi Square) and to the border cities neighboring Afghanistan, Iraq, Turkmenistan and cities with extreme percentage of immigration, all of which signified shared polluted resources among patients.

Opiates have complex effects on seizure activity. They have both anti- and proconvulsive effects depending on experimental conditions. The aim of this study was to determine the effects of different doses of morphine and naloxon on spontaneous seizure activity in mouse brain hippocampal slices. Spontaneous epileptic activity in the brain slices of mouse was induced by continuous perfusion of low magnesium artificial cerebrospinal fluid (low -Mg2+ ACSF). Extra cellular recordings were performed in the hippocampal CA1 pyramidal cell layer to account for the effects of the drugs on amplitude, duration and number of the ictal events as well as number of interictal spikes. Application of morphine had a biphasic effect on the recorded spontaneous seizure-like events. In a low concentration (10 µM), morphine decreased seizure activity. Higher morphine concentrations (30 & 100 µM) enhanced seizure activity in an apparent dose-dependent manner. Naloxone, a nonselective opiate antagonist, blocked the proconvulsant action of morphine. The results of this study showed that the effect of morphine on seizure in mouse is dose dependent. In other words, low systemic doses of morphine have anticonvulsant effects while high doses are proconvulsant.

Cardio-pulmonary resuscitation (CPR) is performed to restore life after clinical death. CPR was formerly being used for out- of- hospital arrests. Nevertheless, it is increasingly applied for in-hospital arrests. Due to differences in speed of action of in-hospital and out- of -hospital CPRs and also numerous disease features, there are striking differences in their success rate and indexes. Attendance of expert CPR team in hospital also affects success. This study was conducted to evaluate the factors related to the success rate of CPR in Vali-e-Asr Hospital, Zanjan, Iran.

In this cross-sectional study data was collected from in-hospital CPRs in Vali-e-Asr Hospital of Zanjan during 2008. The correlations between the success rate of CPR and some factors including age, sex, illness background, the first rhythm in monitoring, the admitting ward, and time intervals (including the time intervals elapsed between patient admission and cardio-vascular arrest and between collapse and initiation of CPR, the attendance of CPR team, intubation, and cardioversion) were analyzed.

302 cases (46% male and 54% female) were included in this study. 72 (23.8%) indicated a primary success and 10 (3.3%) subjects experienced a full success and then discharged from the hospital. After adjustment for confounding variables only three factors were found to be independently associated with a successful CPR; the time necessary for the attendance of CPR team, lack of monitoring of the patients before the arrest and the first cardiac rhythm at the time of cardiovascular collapse.

Extremely experienced CPR team and their timely prompt attendance on the CPR scene was the most important factor to increase the efficiency of in-hospital CPRs. The rate of success in CPR was not dependent on cardiac monitoring and was not increased in intensive care units. It seems that delayed use of the intensive care units decreases their efficacy in the success of CPRs.

Cerebrovascular accidents are one of the most common causes of disability and mortality in human population all over the world. Several factors such as age, sex, hypertension, hyperlipidemia and heart diseases are risk factors for stroke. ِDue to high prevalence of cerebrovascular accidents and its related risk factors and particularly heart diseases, we decided to study echocardiography findings in patients with cerebrovascular accidents. This descriptive study was conducted on 372 cerebrovascular patients who had been admitted to Zanjan Vali-e-Asr hospital in 2008. The data such as gender, age, type of cerebrovascular accidents, underlying disease and findings of echocardiography were collected and then they analyzed by appropriate software. Of 372 patients, 181 were men (48. 6%) and 191 were women (51. 4%). Systolic function in 321 cases (86. 3%) was normal and it was abnormal in 51 cases (13. 7%). Diastolic function in 304 cases (81. 9%) was normal and in 68 cases (18. 1%) was abnormal. Twenty -two cases had mitral stenosis and 198 patients had mitral regurgitation, whereas 23 cases showed both of them. Nine cases had aortic stenosis; similarly 80 cases were found with aortic regurgitation and only 5 cases had both of them. 165 cases were found with tricuspid regurgitation, while 1 case had both regurgitation and stenosis. Sixty- three cases had ejection fraction below 40%. In one case there was a clot. High frequency of abnormal echocardiography findings in stroke leading to cardiac disorders is one of the most important risk factor of stroke. Thus, with echocardiography which is a non-invasive technique, many of heart problems can be diagnosed and consequently occurrence of cerebrovascular accidents can be prevented or treated.

Leukocyte filters are effective for WBC reduction but they cannot inhibit passing plasma proteins and as a result repeated protein entry may produce allergic transfusion reactions. To deal with this problem, washed RBC method is used. The traditional wash method is an open system through which waste products are carried away in sewers with the risk of environmental pollution. Newly introduced approach for washed RBCs consists of a closed system whereby waste products enter into a bag. In this study, the two methods were compared. The Two open and close wash methods were compared in terms of health system, leukoreduction, risk of transmission of infection and quality control. In each method, 100 bags were washed, coded and then transmitted to different units of blood culture, flowcytometry as well as quality control. The data were collected and analyzed by SPSS14. 200 bags (100 for each method) were studied. Microbiologically, there were no positive results for any of the methods. In quality control also there was not any significant difference in the two methods. In flowcytometry, we didn’t observe any significant correlation in leukocyte count in the two methods before washing (p=0.072), however.there was correlation between them after washing (p<0.0001), demonstrating that the new method was better for leukoreduction. The new washing system method was a superior way because it involves a close system where waste products are discharged into a side bag and disposed as hospital waste. Meanwhile, this approach is more convenient for leukoreduction. In our country, since we still need a washing system for some transfusions, this method is deemed to be a decent and practical one because it impedes environmental pollution.

Hyperbilirubinemia is a common neonatal abnormality. Severe hyperbilirubinemia is a risk factor for auditory system injury. Auditory brainstem responses (ABR) are important in early diagnosis of hearing impairments in healthy term infants with elevated bilirubin levels requiring exchange transfusion. During a two- year- period (2007 – 2009), in a prospective descriptive analytical study, in Tehran Milad Hospital, 64 (32 female, 32 male), healthy term (> 37 weeks) infants, who required treatment or were treated with phototherapy or received exchange transfusion for elevated bilirubin levels or jaundice, were studied. After obtaining a written consent from their parents, the infants were tested with auditory brain responses and results were analyzed using SPSS 16 software. No significant correlation was found between ABR and age, weight, bilirubin level or ABO blood group. Nineteen out of 64 infants received exchange transfusion. Three out of 19 infants (16%) exhibited abnormal ABR and 16 infants (84%) had normal ABR. There was no significant correlation between exchange transfusions and ABR (P>0.05). The results pointed out that 14% of the infants with elevated bilirubin who required exchange transfusion had abnormal ABR. This indicates that elevated bilirubin levels even without inducing kernicterus should be considered as risk factors for hearing impairments. Further studies are needed on how long these tests may remain abnormal.

Novel H1N1 influenza virus is a unique type of influenza virus which has developed due to abrupt structural alterations (Shift and Drift). This virus can lead to a pandemic disease. Since manifestations and severity of this disease may be affected by environmental, cultural and economic factors, therefore this epidemiological and regional study was carried out to reveal the clinical and demographic manifestations of the disease. Since October till December 2009 40 patients with novel H1N1 infection documented with RT-PCR was collected. The demographic and laboratory data were carefully collected. Pulmonary involvement and the need for ICU were identified. 40 patients with H1N1 infection in the age range of 36.80±13.02 years hospitalized in Sina Hospital of Tabriz. Twenty- one of them transfered to ICU and 37.5% of the patients had risk factors. Pneumonia was the most prevalent lung involvement. The most prominent radiographic finding was bilateral ground glass opacity. ARDS were seen in 25%. Cough and fever were the most prevalent, and vertigo and abdominal pain were the rarest clinical symptoms. Independent risk factors as related to death included the need for being hospitalized in ICU, and mechanical ventilation (odd ratio = 5.51, CI= 95 %). The patients in this study had clinical manifestations similar to other centers but the majority of them did not show any underlying risk factor. Mortality was rare except for pneumonia and ARDS. Some cases with bilateral pulmonary thromboembolism were seen. Consequently, all of the patients with this complication were discharged after treatment.

Human Resources productivity is one of the important subjects among managers of organizations. To increase the productivity of human resources, universities as training centers play a significant role. Path analysis is one of the best practical and cost effective methods to assess various factors influencing productivity of human resources. This study aimed to investigate the importance of different factors which affect the productivity of human resources in Guilan University of Medical Sciences. This descriptive, analytical and periodical research was carried out in 2009. To determine various factors involved in human resources productivity, 45 experts and specialists in management and also to verify the importance of recognized factors 321 academic staff and educational experts from different faculties of the Guilan University of Medical Sciences were selected. Data were gathered through library and guidance research methods. Content validity was assessed by referring to expert panel viewpoints using factor analysis (main headings) and construct validity was obtained by complementary factor analysis (maximizing reality). Reliability of analysis of the results was ensured using Lisrel 8/80 software. Path analysis of the results regarding various factors which influence the productivity of human resources indicated that organizational culture with path standard of 0.51, motivational factors with path standard of 0.25, environmental conditions with path standard of 0.17, as well as empowerment of human resources and methods of leadership with path standard of 0.08, were outstanding factors which affect the productivity of human resources in Guilan University of Medical Sciences. Organizational culture, motivation factors, environmental conditions, empowerment of human resources and leadership methods have impact on the productivity of human resources in Guilan University of Medical Sciences and organizational culture is the most important item.

Depression has been assumed as a prevalent disorder of the era. Depression cannot be attributed to a particular social class. Factors such as incompatible situations may lead to mental disorders and affect physical immunity. This study was carried out to investigate the prevalence of depression among the staff of Zanjan University of Medical Sciences.

This study was of cross-sectional type study whereby 693 subjects were selected through classified randomized sampling. The rate of depression incidence was obtained using Standard Beck Questionnaires. The data was analyzed by Chi-2 tests and cohesion indexes of Kramer and Gama were also used.

According to the results of this study 40% of the personnel were suffering from depression. They were identified as 23% with low depression, 13% with moderate depression, and 4% with severe depression. A significant correlation was found between depression and education level, type of settlement, and city where they worked.

Regarding the widespread prevalence of depression among the staff, planning and organization of consultation sessions by the authorities is suggested.