مجله دانشکده پزشکی اصفهان
پیاپی 165 (هفته اول بهمن 1390)

Health-related quality of life (HQOL) is greatly impaired in patients with end stage renal disease (ESRD). According to the importance of assessing HQOL in chronic disorders and the need for appropriate and specific instruments in this regard, this study aimed to evaluate the validity and reliability of the Persian version of the kidney disease quality of life questionnaire-short form (KDQOL-SF). The KDQOL-SF questionnaire was translated into Persian with the standard forward-backward translation method. Fifty patients with ESRD under regular hemodialysis filled out the KDQOL-SF questionnaire. Internal consistency was assessed using Cronbach's alpha. Construct validity of the questionnaire was assessed by evaluating the correlation between each dimension's score and the overall score of health using Pearson's correlation coefficient. Cronbach's alpha of the KDQOL-SF was 0.85. Cronbach's alphas of all dimensions of KDQOL-SF were higher than 0.7 except for 4 dimensions of work status (0.60), cognitive function (0.58), quality of social interaction (0.63), and sleep (0.48). Among the kidney disease-relateddimensions, there were significant correlations between the overall health score and symptoms/problems, effect of kidney disease, burden of kidney disease, work status, and dialysis staff encouragement (P < 0.01 to < 0.05). Among SF-36 dimensions, the overall health score was correlated with the physical functioning, bodily pain, mental health, general health perception, and socialfunctioning dimensions scores (P < 0.01 to < 0.05). The Persian version of the KDQOL-SF appears to be an appropriate instrument to assess HQOL in Iranian ESRD patients. Further validation studies to investigate the reliability and validity of the KDQOL-SF after more editions with greater sample size are recommended.

Every year, about 19 percent of neonates in the world are born with the complication of low weight which results in mortality during neonatal period and later. One way to help the low-weight neonates to grow is to massage them during the first months after birth. The aim of this study was to assess the impact of massaging by mothers on the process of growth among low-weight neonates in postpartum wards of the hospitals affiliated to Shiraz University of Medical Sciences, Iran.

This study was performed on 48 neonates (25 in the intervention group and 23 in the control group). The mothers in the intervention group were trained to massage their neonates with sesame oil. The massaging started on the third day after birth and continued for four weeks. It was performed15 minutes each day at home.

The results of this research showed that the mean of weight gain in low-weight neonates in the intervention group was 217 grams more than that in the control group. The difference was statistically significant (P < 0.001). In addition, the mean increase in the height in the intervention group was 0.7 centimeters more than that in the control group during 4 weeks. This difference was also statistically significant (P < 0.002).

Massaging is effective on the growth process of neonates. It increases weight and height among the low-weight neonates.

There is a dearth of literature in the Iranian context about medical student's attitude towards psychiatry and their desire to choose psychiatry as a career in future. Commonalities and differences in the attitudes of male and female medical students towards psychiatry and their interest in psychiatry were the themes of this study. In this cross-sectional survey, we screened the entire 1127 medical students registered at Shahrekord University of Medical Sciences, Iran, during the academic year of 2011-12. The 29-item attitude towards psychiatry scale (ATP-30) (Burra et al.) was used. The reliability of the scale (Cronbach's alpha) has been calculated as 0.712. About 83% of the students (n = 130) returned the completed questionnaires. We used SPSS16 to analyze the data by descriptive and analytical tests including student-t, one way analysis of variance (ANOVA), Turkey's post hoc test, and linear regression. Female students held more positive attitudes toward psychiatry compared to their male counterparts. However, post hoc Tukey test results confirmed no significant differences between male and female students at the basic science of any of the studied component. Linear regression test showed that among all components of the attitude scale, the component of "Individual rewards and occupational opportunities of psychiatry" had a greater share in shaping student's attitudes toward psychiatry. However, all the five subscales of ATP-30 could only explain 0.09% of the student's interest in psychiatry. Gender differences play a key role in forming the attitudes of medical students towards psychiatry. However, they are subjected to numerous social, familial, economic and situational considerations which make the effects of gender insignificant. It might be a good idea to assess the attitudes of candidates towards psychiatry at the time of admission. Female candidates might also be preferred in this field.

Regular monitoring of height, weight and head circumference is the best indicator of the status of the individual and community health. Growth is influenced by race, genetic, environmental factors, economic status and lifestyle. The aim of this study was to determine the anthropometric indices and evaluate the performance of the CDC 2000 reference in 6 to 14 year-old girls in Qazvin, Iran. A descriptive, cross-sectional study was conducted on 2219 elementary and secondary school girls in Qazvin during 2009-10. Random cluster sampling was performed to select subjects form public and private schools considering 10 percent of the students. Eighteen students were excluded due to underlying diseases or medications intake. Height (with an accuracy of 2 mm) and weight (with an accuracy of 100 grams) were measured. Body mass index (BMI) was calculated by dividing the weight in kilograms by the square of the height in meters. BMIs below the 5th percentile, between the 5th and 85the percentile, between the 85the and 95th percentile, and above the 95th percentile were respectively considered as underweight, normal, overweight, and obese Height in 1260 students (57.24%) and weight in 1153 cases (52.38%) were below the 50th percentile. Comparing the height values with NCHS showed that 157 subjects (13.7%) were under the 5th percentile, 78 individuals (3.55%) were over the 95th percentile and 1966 cases (89.32%) had normal weight. Comparing the weight values with NCHS revealed that 217 patients (9.85%) were under the 5th percentile, 1848 cases (83.97%) had normal weight and 136 individuals (18.6%) were over the 95th percentile. When the calculated BMIs and NCHS values were compared, 206 students (9.35%) were underweight, 1553 cases (70.55%) were normal, 282 cases (12.7%) were overweight and 163 (7.4%) were obese. The study showed the growth pattern of girls in Qazvin to be different from CDC 2000 reference. Since the average height of girls was below the reference and their average weight was similar or slightly higher than the reference, BMI was eventually increased compared to the reference group. The study showed that the growth pattern of girls in Qazvin was different from CDC 2000 reference. Given these differences, using national standard growth curves based on ethnic and regional diversity seems to be necessary.

We have previously reported that maternal administration of Boswellia serrata gum resin (Frankincense) during lactation increased learning and memory performance in young rat offsprings. This study aimed to determine the likely structural alterations of hippocampus, as a vital centre involved in learning and memory, following administration of Frankincense during lactation In this experimental study, 2 month-old male Wistar rats whose mothers were given oral aqueous extract of the Boswellia serrata (100 mg/kg/day) during lactation (3 weeks), and their controls whose mothers received saline (n = 6) were anesthetized and transcardially perfused. All brains were removed and divided into two hemispheres. One hemisphere was selected for estimating the volumes of cellular layers of hippocampus and the total number of neurons, and the other for estimating the individual somal volume. The Cavalieri's principle and an optical fractionator and a rotator were employed to estimate the volumes of layers, total number of neurons and individual neuronal volume, respectively. Our results showed that no significant difference in the total number of neurons in hippocampal subregions of the experimental group compared to the controls. However, the volume of cellular layer of dentate gyrus and cornu ammon 3(CA3) and individual volume of their neurons increased following maternal administration of Frankincense during lactation. The increased perikaryal volume in the hippocampal neurons of offsprings following maternal administration of Frankincense during lactation might be considered as an indicator of improved function of hippocampus, i.e. memory. It might be due to the increases in contents of neurons such as neurotransmitters, intracellular organelles or the number of synaptic contacts.

Hepatitis C, as a major public health problem, is associated with increased prevalence of psychiatric disorders, particularly depression. This study was performed to determine the prevalence of depression and anxiety in patients with hepatitis C and to detect related risk factors among these patients. In this cross-sectional study, patients with chronic hepatitis C who referred to Infectious Diseases and Tropical Medicine Research Center of Isfahan, Iran were studied. Subjects were selected by simple random sampling during a 4-month period. They all completed a validated questionnaire including demographics and information related to depression and anxiety. Zung Self rating Anxiety Scale and Beck Depression Inventory were used. The data was finally analyzed. Among 264 patients with chronic hepatitis C (262 males and 2 females; mean age: 34.4 ± 6.7 years), 85.7% had no depression, 8.9% had mild depression and 5.4% had moderate depression. Anxiety was observed in 17.9% of the subjects from which 17% had mild to moderate and 0.9% had sever anxiety. There were significant relationships between depression and marital status and job. Anxiety also had significant relationships with history of addiction, job, time of drug usage and place of living. The results of this study indicated the high prevalence of depression and anxiety in patients with hepatitis C. Such patients, especially those with related risk factors such as unemployment, being single, etc.) require psychiatry consultation and constant monitoring of psychiatric disorders.

Rheumatoid arthritis (RA) is a chronic inflammatory arthritis specified by some antibodies. Although the most relevant antibody is rheumatoid factor (RF), it has little sensitivity and specificity for diagnosis of RA. Other groups of antibodies that are produced against the citrullinated epitopes have been proved to be more specific for diagnosing RA. Anti-CCP testing based on ELISA assay is the most effective test for detecting anti-filaggrin antibodies. Positive values of anti-CCP antibody a few years before the clinical signs and symptoms of RA along with high concentrations of this antibody in the synovial fluid increase the probability of citrollination in the pathogenesis of the disease. A combination of anti-CCP and RF would increase the sensitivity of both tests. Most previous studies have used RF as a gold standard for evaluating the diagnostic value of anti-CCP. However, RF is known to have a low sensitivity and specificity. Therefore, we decided to realistically evaluate the diagnostic value of anti-CCP based on American college of rheumatology (ACR) criteria as a gold standard. This was a descriptive study to evaluate the diagnostic value on 49 RA patients and 49 individuals with other rheumatic diseases. Blood samples were taken to measure erythrocyte sedimentation rate (ESR), RF, anti-CCP. Disease activity was then determined by DAS28. Data analysis was performed by 2 × 2 tables, chi-square test and receiver operating characteristic (ROC) curve for trade-off points. We used SPSS15. Data analysis showed anti-CCP to have a sensitivity of 71%, a specificity of 80%, a positive predictive value of 78%, a negative predictive value of 74%, a positive likelihood ratio of 3.55 and a negative likelihood ratio of 0.36. In this study, anti-CCP and RF had a statistically significant correlation (P < 0.001). Anti-CCP is a test with a high predictive value for diagnosing RA.

Vulvovaginal candidiasis (VVC) is a common vaginal infection, affecting up to 75% of women in child-bearing age. Approximately 5% of patients may experience recurrent VVC. Candida albicans is the most common causative agent with a prevalence of approximately 70–90%. Non-albicans Candida species, predominantly Candida glabrata, are responsible for the remainder. Precise diagnosis of causative agents of VVC is necessary for epidemiological purposes and for effective treatment.

One hundred and thirty three yeast isolates were collected from a gynecology clinic affiliated to Kashan University, Iran, during 2007-2009. Genomic DNA of each isolate was extracted from fresh cultures using FTA-card. The ITS1-ITS2 region was amplified by polymerase chain reaction (PCR) assay and was digested by the restriction enzyme HpaII. The products of restriction fragment length polymorphism (RFLP) were electrophoresed on agarose gel and the yeast species were determined according to differences in their electrophoretic band patterns.

Prominent species isolated from clinical specimens were Candida albicans responsible for 116 cases (87.2%), followed by 16 cases of C. glabrata (12%) and 1 case of C. kefyr (0.7%). The age bracket of 31-40 years had the highest and the age bracket of 11-20 years had the lowest frequency of occurrence.

Like the majority of similar studies performed in this field, the present study found Candida albicans as predominant species isolated from vulvovaginal candidiasis. As molecular diagnostic methods are rapid and reliable and as there are no any other studies that used PCR-RFLP for diagnosis of etiologic agents of VVC in Iran, we recommend this approach for other similar epidemiological studies.

Prostate cancer is an important disease whose many genetic aspects are still uncovered in spite of the wide spectrum of the studies previously performed on its genetic and environmental risk factors. According to the previous studies, KLF6, a suppressor gene dealing with prostate cancer, is exposed to genetic changes. Among all these changes, mutation of exon No. 2, which is in relation with disease prognosis, is common. The few studies conducted on the mutation of KLF6 gene have shown a relation between mutation and environmental factors as well as race and geographic conditions. The goal of this study was to investigate the mutation of exon No. 2 of KLF6 gene in people who suffer from prostate cancer in city of Isfahan, Iran. The study was carried out on microscopically and pathologically proved cases of prostate cancer in Isfahan, Iran, during 2009-2011. The samples were taken by prostatectomy or biopsy from 40 patients suffering the disease. A procedure including DNA extraction, determination of quality and quantity of DNA, PCR (using specific primers to replicate exon No. 2), polyacrylamide gel electrophoreses, and data analysis was performed on the samples to determine the mutation in exon No. 2 of KLF6 gene. Overall, 80% of the patients (32 people) were above 60 years of age. Only 17.5% of the patients (7 people) had mutation in exon No. 2 of KLF6 gene. There was no significant relation between the mutation of exon No. 2 of KLF6 gene and the age of the patients. A significant relation was found between the presence of mutation and tumor grading in the studied patients. The frequency of mutation in exon No. 2 of KLF6 gene was higher in cancer samples with higher grade. This finding can be a sign of weak prognosis in samples whose exon No. 2 of KLF6 gene has been mutated.

During recent decades, a strong tendency to consume supplements in order to enhance muscular power and exercise endurance has grown among athletes. Quercetin is one of the flavonoid substances that received great attention due to its known benefits to health. The purpose of this study was to determine the effects of quercetin supplement intake on the above mentioned variables. An online search has been performed using the keywords "quercetin, endothelial function, oxidative stress, performance, inflammation, muscle damage and athletes" in ISI, Scopus and PubMed journals published during 1997-2011. All clinical trials were included in this study. A number of studies have suggested the positive effects of quercetin intake on exercise performance in athletes. These studies suggested quercetin to increase the muscle's mitochondrial biogenesis by boosting VO2max and thus delay fatigue during exercise. In addition, it did not allow NADPH oxidase, activated eNOS, augmented nitrate oxide and decreased endothelin-1 concentration, and resulted in an improvement of endothelial function. However, some other did not confirm the significant improvement of oxidative status. Most of the studies have acknowledged the positive effects of quercetin supplement intake in untrained athletes. However, due to the small number of investigations conducted on humans and the contradictory results, more controlled clinical trials are needed.