مجله دانشگاه علوم پزشکی اراک
سال پانزدهم شماره 3 (پیاپی 62، امرداد 1391)

Primary dysmenorrheal is one of the most common gynecologic diseases. This study was carried out to compare the effects of omega-3 and vitamin E on the treatment of primary dysmenorrheal. In a randomized double-blind clinical trial, 80 female students from high schools in Arak, Iran, were selected by simple sampling and randomly divided into two identical groups in 2010. Omega-3 group received one omega-3 capsule (500 mg) per day while the vitamin E group received one vitamin E capsule (400IU) every other day for 60 days. Intensity of pain, duration of pain, and the number of painkillers taken before and after intervention were measured in both groups. Intensity of pain was assessed by VAS scale of pain. Data were analyzed by SPSS software. After intervention, the mean of pain intensity in the omega-3 group decreased to 3.5 which indicated a significant difference in comparison with the corresponding values before intervention (7.40) (p<0.05) and the values in the vitamin E group (5.25) (p<0.05). After intervention, the mean duration of pain in the omega-3 group reached 11.04 hours which showed a significant difference compared with the corresponding values before intervention (31.74) (p<0.05) and the values in the vitamin E group (34.81) (p<0.05). Omega-3 is more effective than vitamin E in the treatment of primary dysmenorrheal and its application as a new therapeutic method to the treatment of primary dysmenorrheal requires further studies

Pseudomonas aeruginosa is a human opportunistic pathogen which is considered one of the agents causing nosocamial infection. Recent studies have reported increased resistance of Pseudomonas aeruginosa to imipenem. The aim of this study was to determine resistance to antipseudomonal antibiotics including imipenem in Pseudomonas aeruginosa strains. In this cross-sectional study, 100 Pseudomonas aeruginosa strains obtained from clinical samples of patients in hospitals in Arak, Iran, were identified and isolated through microbiological methods, including Gram staining, oxidase test, Indol test, and oxidative-fermentative test. Then antibiotic susceptibility test was performed for imipenem, meropenem, gentamicin, amikacin, ciprofloxacin, and ceftazidime by disk diffusion method according to NCCLS (National Committee for Clinical Laboratory Standards). Minimum inhibitory concentration (MIC) was done for determining imipenem-resistant strains Antibiotic susceptibility test showed that resistance rates to imipenem, meropenem, gentamicin, amikacin, ciprofloxacin, and ceftazidime were 35%, 35%, 14%, 9%, 23% and 15%, respectively. Also, MIC test showed that 30 strains were resistant to imipenem, 27 to ceftazidime, 35 to cefepime, and 35 to ciprofloxacin. The results of this study indicated a high rate of antibiotics resistant of Pseudomonas aeroginosa strains to different antibiotic groups. Therefore, new and more effective methods should be found for controlling Pseudomonas infections and preventing the outbreak of its antibiotic-resistant strains.

To date, researchers have paid extensive attention to happiness and its relationship with a wide variety of personality, socio-demographic, and health-related factors. However, there is still little research on the issue of happiness. This study was done to investigate happiness and mental health and the relationship between them in the students studying at Arak University of Medical Sciences, Arak, Iran, in 2010. This cross-sectional study was carried out on 315 students at Arak University of Medical Sciences who were randomly selected during 2010. The student's happiness was measured by Oxford questionnaire and their mental health was measured using GHQ28. Data were analyzed by t-test, ANOVA, Pearson correlation coefficient, Logistic regression, and Chi-square test using SPSS software. The mean of happiness in the students was 40.72±14.14 with only 9.2% of them in the normal range of happiness. Their mental health score was 25.73±7.47 with 32.1% of them within the normal range. Pearson correlation coefficient showed a statistically significant relationship between happiness score and mental health score (r=-0.14, p=0.012). Happiness and mental health status in the students at Arak University of Medical Sciences necessitate the need for more serious attention to this issue in educational planning.

Obtaining cells from the patient, expanding cell population on a scaffold, and, eventually, grafting the tissue to the patient is one of the tissue engineering techniques to create replacement tissue structures. Blastema tissue is one of the cellular sources in this regard. This study investigated the use of human gum tissue to prepare a scaffold and the interaction between the three-dimensional tissue scaffold and blastema tissue. In this experimental study, human gingiva was prepared and through snap freezing method and the use of sodium dodecyl sulfate (SDS) and Triton X-100, went through cell bleaching. Then the provided scaffoldings were placed in 2-day-old blastema rings and stored in culture media for 25 days. Sampling of the blastema and scaffolding tissues was done once every five days. The results confirmed the removal of the cells from the prepared scaffolds. Also, histological studies in the fifth and tenth days indicated cell penetration into the blastema scaffolds. In the fifteenth day, in addition to penetration, blastema cells division and differentiation as well as epidermis genesis were observed. In the twentieth and twenty-fifth days, infiltration, cell division, and differentiation processes continued. The findings of this study indicated the possibility of creating a natural scaffold of human gingiva through this method. This scaffold can have an inductive effect on cell behaviors such as such as migration, adhesion, division, and probable differentiation. However, further studies for demonstrating the identity of the cells and other properties of such a scaffold as well as the possibility of using it in gingiva tissue engineering are recommended.

Addiction is undoubtedly one of the biggest problems of human societies that every year governments spend enormous amounts of money on fighting it. Most addicts, besides their addiction, cause many psychological problems in their families; therefore, the aim of this study was to compare the presence of these disorders between the families of addicts and non-addicts. This case-control study was done on a sample of 650 persons of opium addict's and non-addict's families using random sampling method. Data were collected through SCL-90-R questionnaire and were analyzed by Chi-square and t-test using SPSS software version 18. There was a significant difference in psychiatric disorders in addict's and non-addict's families (p=0.005). Among the 9 psychiatric disorders under assessment, only anxiety, aggression, paranoia, and depression disorders in three types, including pathologic, borderline, and combined (pathologic-borderline), were significantly higher in addict's families compared with non-addict's families (p=0.005). Drug dependence disorder in one member of a family has a very important effect on the mental hygiene of the other family members and requires prevention and treatment in both.

Numerous factors, such as Enterococcus antimicrobial resistance and expression of virulence factors, may account for the maintenance and prevalence of Enterococci infection. The aim of the present study was to assess the occurrence of esp and eep genes in the E.faecalis and E.facium strains isolated from the patients with urethral system infections. In this experimental study, 214 clinical samples, including 80 catheters and 134 urine samples, were collected from the patients. The identification of the isolated samples was based on the growth on Bilesculin agar culture media, tolerance of 6.5% Nacl, gram staining, and catalase, hydrolysis of hyporate, telorite reduction, arginine hydrolization, and fermentation of the carbohydrates tests. The assessment of genes was done by PCR method. esp gene was present in 83% of the urine samples and in 97% of the catheters while eep gene was present in 100% of the urine samples and 90% of the urine catheters. The results of antibiogram indicated that the multi-antibiotic resistance was about 78.1% against vancomycin and tetracyclin, 75% against cyprofeloxin and tetracyclin, 59.3% against vancomycin and cyprofeloxin, and about 53% against vancomycin and streptomycin. The findings of this study indicate that esp gene plays an important role in formation of biofilm in patients. Due to the presence of eep gene in almost all of the samples, it can used as a rapid identical agent for the assessment of pheromone production and provision of suitable conditions for plasmid transformation between clinical strains and the prevalence of antibiotic resistance.

Menopause is associated with changes in body composition in postmenopausal women. The aim of this study was to compare the effects of tibolone and continuous combined hormone therapy (HT) on body composition in postmenopausal women. In this randomized clinical trial, 120 menopausal women were randomly selected and divided into three groups. Of these, 40 women received 2.5 mg tibolone plus one Cal+D tablet (500 mg carbonate calcium with 200 IU vitamin D) daily, 40 women received 0.625 mg conjugated estrogen combined with 2.5 mg medroxy progesterone acetate plus one Cal+D tablet daily and the rest 40 (the control group) only received one Cal+D tablet daily. All regimes continued for nine months. Body composition was evaluated with measurements of waist to hip ratio (WHR), fat mass (FM), fat-free mass (FFM), body mass index (BMI), and weight before and after intervention. Fat mass and fat free mass were assessed by measurement of skin-fold thickness. Data were analyzed by SPSS software. In the tibolone group, FFM, BMI, and weight significantly increased compared to the baseline (p<0.05). In the HT group, only weight and BMI significantly increased (p<0.05). In the control group, however, BMI, FM, and weight did not significantly increase in comparison with the other groups. Overall, tibolone group showed a more significant increase in comparison with the other groups (p<0.01) From these results, it can be concluded that tibolone can be used in treating menopausal changes in menopausal women as an alternative to continuous combined hormone therapy.

Conjunctivitis is a common cause of reference to pediatrician and general hospitals. The common method of treatment is prescription of antibiotics; however, there are concerns over the development of antibiotics resistance and their adverse effects. Therefore, this study was done to compare the effects of boiled water as supplementary treatment and antibiotics on the severity of infant's conjunctivitis. In this clinical trial, 110 infants referring to the Pediatric Clinic of Amir Kabir Hospital in Arak were randomly allocated to 2 groups. The first group (intervention) received boiled water together with ophthalmic erythromycin ointment 1% and sulfastamid ophthalmic solution 10% four times a day and the second group (control) just received antibiotics. Severity of infants conjunctivitis on the first, third, and seventh days of treatment were compared between the two groups using SPSS software. On the 3rd day, 18.2% of the infants in the intervention group and 9.1% of the infants in the antibiotics group were cured which did not indicate a significant difference (p=0.44). On the 7th day, the recovery rate was promoted to 32.7% and 34.5% in the intervention and control groups, respectively (p>0.05). Mild severity cases were 58.2% in the intervention and 45.5% in the control groups (p>0.05) while moderate severity cases of conjunctivitis were 9.1% and 20% in the intervention and control groups, respectively (p>0.05). Although the number of infants who were cured was more in the boiled water group with antibiotics group and the intensity and duration of their disease were less than the control group, these differences were not statistically significant.

The most common reasons for discontinuation of Depot Medroxy Progesterone Acetate (DMPA) contraceptive method are irregular bleeding and increased body weight. To reduce these complications, the combined injectable contraceptive drug, cyclofem, is offered as an alternative while its effects on the reduction of these complications are not quite clear. Thus this study was done to compare the effects of cyclofem and DMPA on the pattern of bleeding, body weight, and blood pressure variations. In a cross-sectional study, 600 healthy women using DMPA and cyclofem) 300 people in each group (were selected through purposeful sampling and evaluated in 3 time intervals: 3, 6 and 9-12 months after primary injection. Data were collected by questionnaire and analyzed by Chi-square, ANOVA, and Mann-Whitney tests using SPSS software. Spotting and amenorrhea were seen with higher incidence in DMPA users. There was a significant difference between DMPA and cyclofem users in spotting at the end of months 3, 6, and 9-12 after the first injection (p<0.05). Also, there was a significant difference between the two groups in amenorrhea during the three intervals (p<0.05). There was not a significant difference between the two groups in terms of weight variations (p>0.05), but there was a significant difference between the two groups in diastolic blood pressure (p<0.05). Considering the lower incidence of amenorrhea and spotting in cyclofem users, encouraging eligible clients to use the cyclofem contraceptive method is recommended. Also these users are recommended to carefully control their body weight and blood pressure.

Heavy menstrual bleeding is one of the leading causes of poor quality of life and iron deficiency anemia in women of reproductive age. This study was conducted to investigate the therapeutic effect of tranexamic acid (TA) on menorrhagia.

In this before and after clinical trial, 46 women with menorrhagia were selected and, after a control cycle for evaluation of the volume and duration of primary bleeding, were subjected to tranexamic acid treatment (500mg every 6 hours from day 1 to 5 of bleeding) for 3 consecutive cycles. Data on the duration of bleeding, amount of bleeding (PBAC chart), quality of life (SF-36 and MQ questionnaires), and hemoglobin and ferritin values were checked and compared before and after treatment using SPSS software.

Tranexamic acid reduced mean PBAC score from 242.86 (160.47) in control cycle to 101.50 (72.67) after the third cycle (p<0.001). Hemoglobin increased from 11.85 (0.84) to 13.08 (0.97) g/dl and ferritin increased from 15.9 (20.39) to 22.13 (2.03) ng/dl (p<0.001). Duration of menstrual bleeding decreased from 7.6 (1.23) days to 6.86 (0.84) days (p=0.001). Tranexamic acid reduced mean MQ score from 70.26 (17.64) to 11.64 (6.49) (p<0.0001). Quality of life scores increased in all aspects (except for bodily pain scale) (p<0.001).

TA due to its short course of prescription, fewer side effects, especially on the pattern of bleeding and menstrual cycle, and not having hormonal effects, seems to be an effective drug for menorrhagia in women of reproductive age.