مجله فیض
سال شانزدهم شماره 2 (پیاپی 62، خرداد و تیر 1391)

The prevalence of preterm labor in Iran is 6-10%, accounting for 80% of neonatal morbidity. The most effective tocolytic agents to delay the preterm labor have not yet been known. Therefore, this study aimed to compare the effects of indomethacin (ICN) and Magnesium- (Mg sulfate) in delaying preterm labor and also to assess the maternal complications associated with the two drugs. This randomized clinical trial study was performed on 24-32 week pregnant women (n=60) at risk for preterm labor referred to Shabih-Khani maternity hospital in Kashan. The women were divided into two equal groups: intravenous Mg sulfate (control) or ICN rectal suppository (intervention) groups. Then, the delaying of preterm labor and also the maternal morbidity were assessed in both groups. No significant difference was seen in maternal and sociodemographic variables between the two groups. The delaying of preterm labor was the same for both groups and no case of preterm labor was seen in women during the first 48 hours of hospitalization. Moreover, there was no significant difference in variables (e.g. the maternal age, the number of gravida, gestational age, symptoms on admission, the number of prior preterm labors and a history of preterm labor) between the two groups. The most common complication in both groups was nausea. There was no case of oligohydramnios in the indomethacin group. Although the delaying of preterm labor was the same in both groups, Mg sulfate administration requires permanent nursing care. It seems that ICN can be used as one of primary tocolytic treatments in preterm labor.

The anabolic androgenic steroids are known to stimulate muscle protein synthesis and hypertrophy. Cardiomyocytes have two types of ATP-sensitive potassium channels in sarcolemma (sarcKATP) and in mitochondria (mitKATP). Activation of the sarcKATP channels has been proposed to protect against ischemia-reperfusion injury. This study aimed to investigate the effect of nandrolone decanoate on the expression of sarcKATP channels in the presence and absence of exercise in rat heart. In this experimental study, 40 adult male rats were divided into five groups: control, vehicle, ND, exercise and exercise-ND group. Rats in the exercise group were submitted to a running program on a treadmill, 5 days a week for 10 weeks. In addition, rats in the ND and exercise-ND groups received a weekly intramuscular injection of ND (10 mg/kg) for 10 weeks. Expression of the KATP channel subunits (Kir6.2 and SUR2) was determined using the Western blotting method. ND administration had no effect on the expression of sarcKATP channel subunits in the sedentary group, while the chronic exercise significantly increased the expression of KATP channel subunits (P=0.01). Moreover, the ND administration significantly decreased the Kir6.2 (P=0.001) and SUR2 (P=0.05) subunits in the exercised animals. Chronic exercise and ND increases and decreases the expression of sarcKATP channels, respectively. The ND-induced expression decrement of channels is probably one of the mechanisms involved in the impairment of exercise-induced cardioprotection in rat heart.

Working under hot climatic conditions, especially in summer, has a high potential for inducing heat strain in workers. The wet-bulb globe temperature (WBGT) index has an inherent limitation to estimate the heat strain due to not taking into account the non-environmental factors. The aim of this study was to evaluate the combined application of WBGT index and a physiological strain index (PSIHR) based on heart rate in the estimation of the heat strain under hot climatic conditions.

This cross-sectional study was conducted on 122 men in the center and south of Iran (51 and 71 workers from Esfahan steel company and Assaluyeh national petrochemical company, respectively) between July and September 2010. The WBGT index, heart rate and the auditory canal temperature were measured at rest and during the work. Data were analyzed using descriptive statistics and logistic regression.

Results of the logistic regression analysis revealed that the WBGT index is a poor predictor for heat strain with a sensitivity and specificity of 53% and 65%, respectively. However, the combined application of the WBGT and PSIHR indexes was a better predictor for heat strain and its sensitivity and specificity were 75% and 69%, respectively.

A combined application of the WBGT and PSIHR indexes can be a valid estimator of heat strain for hot climatic conditions in the center and south of Iran.

Recent studies indicate the potential role of bee venom (BV) in cancer therapy. Moreover, many evidences suggest that the regulation of apoptosis plays an important role in tumorigenesis. Considering the apoptosis-inducing and anti-tumor effect of BV, this study aimed to determine the type of the cell death induced by BV on MOLT-4 cancer cell line.

In this experimental study, MOLT-4 cells were first cultured in RPMI-1640 medium in plate, then the cells were treated with different concentrations (1, 3, 6 and 8 μg/ml) of BV for 24 and 48 h. Morphology of cells, cell viability and type of the cell death were induced by BV were evaluated using inverted microscopy, the MTT assay and flow cytometry, respectively.

Cell survival findings showed the BV CC50 values of 6.3 and 0.6 μg/ ml for the cell line in 24 and 48 h, respectively. Moreover, Morphological and Annexin-V antibody analyses indicated that the BV-induced cell death might be an apoptosis.

As BV can induce the apoptosis in MOLT-4 cancer cells. Thus, it would bring hope for designing novel drugs for cancer-therapy in future.

Mentally retarded children impose an extra stress on their parents especially on mothers. Coping skills can be used by parents to relieve stress and to improve adaptation. Therefore, the aim of this study was to assess the effect of teaching on social adaptation in mothers of educable mentally-retarded children based on Roy adaptation theory. This quasi-experimental study was carried out on 40 mothers of educable mentally retarded children referred to the exceptional school in Aran and Bidgol during 2010-11. Intervention was consisted of four two-hour sessions, supplemented by a 30-minute conversation between the interviewer and the candidate occurred within 2 weeks. Coping skills program was based on the dimensions of Roy theory. Questionnaire on adaptation was completed before and 6 weeks after the completion of intervention by the participants. The mean scores for social adaptation in mothers of mentally retarded children in physiological, self-concept, dependence/independence, role-playing dimensions and total social adaptation before and after the training showed a significant difference (P<0.001). According to the results of the study, teaching based on the Roy theory has a positive effect on social adaptation in mothers of mentally retarded children.

Dicroceliosis is a hepatic parasitic disease of clinical and financial significance for both human health and animal breeding. Considering the health and economic importance of the disease, this study aimed to determine the morphological and molecular characterization of 28S rDNA for Dicrocoelium isolated from sheep in north and center of Iran during 2010-11. A total number of 200 trematodes were collected during an abattoir inspection from livers of naturally infected sheep in East Azerbaijan, Razavi Khorasan, Mazandaran and Tehran provinces in Iran. Adult worms were morphologically identified based on morphometric characterization and 60 specimens were characterized molecularly by sequencing. For molecular study, DNA was extracted and 28S rDNA region was amplified by PCR. Then, Tru1I fastdigest restriction enzyme and also RFLP technique were used to identify the parasite species. Finally, the PCR product was sequenced. A remarked morphological characteristic was that in all isolates, the testes were in tandem. The homological comparison of sequences showed that 28S rDNA in all isolates of Dicrocoelium had 963 bp and were similar to standard strain registrated in Genbank. RFLP pattern from D.dendriticum, which had 4 cut sites, produced 116, 145, 293 and 409 bp fragments. Although the morphological characterization in various provinces was significanly different, molecular identification showed that all specimens were identical (D.dendriticum) and there was not a significant difference between sequences of the collected parasites. Morphological and molecular assays show that Dicrocoelium dendriticum is the only species of Dicrocoelium among sheep in north and center of Iran.

Considering the increasing number of cesarean cases and to identify the effective factors in choosing such surgery, this study was performed to evaluate the attitudes of medical specialists and gynecological assistants toward the type of delivery and the reasons for increasing rates of cesarean. Data were gathered through semi-structured interviews and analyzed using a content-analysis method. Finally, 11 physicians and assistants were participated in the study. The participants were selected through purposeful sampling. The first two participants were selected through accessible sampling, while the others by previous participants to consider the variety of physician's experiences and attitudes. Data were analyzed using the Cheevakumjon method. After reviewing the data, key sentences and concepts were derived and finally categorized. Fear of the delivery pain was one of the most important reasons that made women to select the cesarean, while having a good delivery experience was one of the most important reasons for choosing the vaginal delivery. Four categories of factors, some facilitators for choosing the cesarean and the others for vaginal delivery, affecting the choice of delivery were related to patient, culture, delivery conditions and also the outcomes. Several factors should be considered in choosing a delivery method. Furthermore, preparing a woman for a painless and pleasant delivery and also changing the attitudes toward the type of delivery are very important.

Considering that the Digoxin's therapeutic level is very close to its toxic level, it is important to determine the digoxin dose. Digoxin serum level is affected by multiple pharmacokinetic factors. Therefore, this study aimed to evaluate the serum digoxin level and its relation with the initial dose and other related factors in patients referred to Kashan cardiovascular clinic.

This cross-sectional study was carried out on 125 patients for whom digoxin was prescribed for at least one month. The patients were excluded in the case of having simultaneous history of thyroid disease and other antiarrhythmic drugs. Serum digoxin, creatinine and potassium level and also the demographic characteristics of the patients for the first time were checked out.

The mean age of patients was 63.7±13.42 years. Sixty-six (52.8%) cases were male. The most common reason for drug implication was systolic dysfunction (63.2%) and the most common cause of systolic dysfunction the coronary artery disease (56.61%). Most patients (70.4%) had a glomerular filtration rate (GFR) between 30-90 ml/min. Moreover, Fifty-nine patients (47.2%) with the highest frequency in treatment group were treated with 3.5 tablets per week. Serum digoxin level was significantly associated with the age and GFR (P=0.001 and P=0.008, respectively), but not with gender, potassium level and the reason for drug use and Left ventricular ejection fraction.

The main factor in determining the digoxin dose is the patient’s GFR that includes all pharmacokinetic variables of drug plasma level.

Inherited thrombophilic gene polymorphisms have been related to the pathogenesis of venous thromboembolism and its outcomes. Considering the scarcity of data on the frequency of the thrombophilic gene polymorphisms in Iranian populations, the aim of this study was to assess such polymorphisms in healthy individuals. This cross-sectional study was performed on 304 healthy blood donors with no history of venous thromboembolism in Shahrekord. Venous blood was collected in EDTA-treated tubes and then, genotyping of the factor V Leiden, prothrombin G20210A, MTHFR C677T and PLA2 polymorphisms was done using PCR – RFLP. Six (1.97 %) cases were heterozygous for factor V Leiden and one was homozygous. Ninty-four (30.92%) and 11 (3.62%) subjects were heterozygous and homozygous for MTHFR C677T, respectively. Two (0.6%) cases were heterozygous for prothrombin G20210A and there was no homozygous case. Twenty-eight (9.2%) and 2 (0.6%) cases were heterozygous and homozygous for PLA2, respectively. In addition, 44.6% of the study population and 14.5%, with the deletion of MTHFR C677T, carried at least one thrombophilia polymorphism. The frequency of thrombophilia polymorphisms is different from the previously published data in Caucasians and also the limited existing data in Kermanshah (Iran). Moreover, the discrepancies may be associated with the ethnic differences and sample selection.

Zinc is an essential micronutrient for growth and proper immune function. Zinc deficiency may contribute to the incidence, prevalence and severity of diarrhea and can also cause failure to thrive in children. The purpose of this study was to evaluate the serum zinc level in children with diarrhea.

This cross-sectional study was performed on 105 children with acute watery diarrhea referred to Kashan Shahid Beheshti hospital during 2008-9. To test the serum zink level, a sample of venous blood (5-cc) was taken. In addition, the age, sex, the duration of diarrhea, the length of hospitalization and FTT were evaluated. Data were analyzed using Chi-square, T-test and ANOVA.

Among the 105 children, 48.6% were male and half of them aged more than 12 months. The results showed that the mean serum zinc level in hospitalized children and diarrhea duration more than 3 days was lower than the other children (P=0.023 and P=0.004, respectively). Moreover, the mean serum zinc level in children with FTT was lower than the children without FTT (P<0.001).

Duration of diarrhea, the length of hospitalization and FTT in children with low serum zinc levels was more than the other children.

In recent years, special emphasis has been placed on the problems of the parents with disabled children. Hence, this study aimed to evaluate the problems in the families of disabled children. This cross-sectional study was conducted on 352 disabled children residing in rehabilitation centers of Kashan during 2007-8. A census was conducted in families of the children through an interview and a questionnaire. Moreover, some demographic characteristics (e.g. family attitude, and problems related to disabilities) were evaluated and analyzed using the descriptive statistics. Among 352 cases, 234 (66.6%) were male and most of them (36.1%) aged 10–19 years. The mean age of children was 24.2±18.5 years. Ninety-seven percent of mothers were housewives; 52% mentally disabled; 15.6% physically disabled and the remaining both mentally and physically disabled. Almost one-third of the families had more than one disabled children. The most frequent disabilities were associated with behavioral disorders, facial paralyses, limb deformities, fecal and urinary incontinence, running off at the mouth and convulsion, respectively. Most children were dependent on their adults in feeding, dressing and playing. In addition, the most important problems of the children were fecal and urinary incontinence, impairment in social adaptation with healthy children, verbal communication, recognizing individuals and also financial problems. Moreover, a significant relationship was seen between the severity of physical disability and gender (P=0.001). Considering that the disabled children face multiple social and physical problems, they require financial, social and familial support to have a near normal life.

Stuttering is a developmental disorder which may adversely affect the individual on many emotional levels and cause many impairments (e.g. lack of self- confidence, depression, poor communication and finally the avoidance of social situation. This study was carried out to evaluate the comorbidity of mental dis‌orders among the stuttering children in Kashan during 2007-8. In this cross-sectional study, 50 children (age range, 3-12 years) referred to speech therapy department of Akhavan hospital were selected using the census sampling. The diagnosis of mental disorders was made by psychiatrists through a clinical interview based on the DSM-IV-TR checklist. In addition, the IQ of cases was measured using the Wechsler test. Data were analyzed using the Chi-square test. Thirty-three children (70%) had the comorbid mental disorders. The most common comorbid disorders were attention deficit hyperactivity and anxiety disorders (51.4% and 25.7%, respectively). A significant difference was found between the comorbid mental disorder and the age and also the educational level of children (P=0.005 and P=0.003, respectively). According to the results, the majority of children had comorbid mental disorders. Considering the high rates of comorbidity among the children and also their outcomes, more careful attention should be paid to offer the effective therapeutic plans.