مجله دانشگاه علوم پزشکی بابل
سال پانزدهم شماره 3 (پیاپی 72، اردیبهشت 1392)

Both obesity and breast cancer risk increased dramatically during two recent decades in Iranian women. The aim of the study was to investigate the association of obesity and central (abdominal) obesity with breast cancer risk in pre- and postmenopausal women. In this case- control study، 100 new patients with histological confirmation of breast cancer and 200 age-matched controls were recruited. The patients were selected from Yahyanejad and Shahid Beheshti hospitals and also Hariri cancer screening center in Babol، Iran. The controls were selected from outpatient clinic or patient''s relatives in the same hospitals. Height، weight، waist circumference (WC) and hip circumference were measured by standard method at time of diagnosis and body mass index is calculated by weight and height. Demographic، fertility factors and some life style data were collected by interview using questionnaires. The adjusted odds ratio and abdominal obesity in breast cancer risk were estimated by logistic regression model. The results showed that 48 (48%) patients were obese، 42 (42%) were overweight and 45 (45%) had central obesity while the figures for controls were 27 (13. 5%)، 62 (31%) and 28 (14%)، respectively (p<0. 001). Weight، body mass index (BMI) and WC were significantly greater in cases compared with controls in pre and postmenopausal women (p<0. 001). The adjusted odds ratio for overweight and obesity were 9. 5 (95% CI: 3. 4-26. 9) and 28. 9 (95% CI: 9. 7-86) compared with normal BMI respectively and the adjusted odds ratio for abdominal obesity was 3. 8 (95% CI: 1. 9-7. 8). Overweight، obesity and central obesity increase breast cancer risk in pre and postmenopausal women. These findings imply a multiple strategy of obesity prevention for breast cancer control and also to perform breast cancer screening in overweight and obese women.

Newborns are more sensitive to pain than adults and are more susceptible to the short and long term complications of pain. So، it is necessary to use procedures for reducing pain in newborns. The present study was done to assess the effects of oral sucrose، breast milk and EMLA cream on acute pain during venipuncture in hospitalized term neonates in Amirkola pediatric hospital، Babol، Iran. This clinical trial study was performed on 120 full term neonates with hyperbilirubinemia. All neonates were in the same and stable conditions. They were randomly allocated in four groups (30 persons in each group). In group one (control) no intervention done; group two and three received 2 ml of 25% oral sucrose and in group four، EMLA cream was used. Along with venipuncture، the scale of DAN (Douleur Aigue Nouveau-ne scale) and crying time was measured and recorded. Physiologic indicators (heart rate، respiratory rate and arterial blood oxygen saturation) at first and five minutes after venipuncturing was measured and recorded by pulse oximeter. Average DAN scale in four groups of control، sucrose، breast milk and EMLA cream were 31. 63± 2. 62، 87. 8± 2. 6، 5. 63±1. 4، 6. 27±3. 06، respectively (p=0. 03). Douleur Aigue Nouveau-ne scale between sucrose group and control group in comparison to other groups showed meaningful relationship (p<0. 05). In reviewing physiologic indices، there was meaningful statistical difference in respiratory rate between sucrose group and control group immediately after intervention (p=0. 029) but there was not any significant difference in other variables (crying time، heart rate and arterial blood oxygen saturation) in four groups. Oral sucrose decreases the severity of pain and respiratory rate immediately after intervention in neonates. Considering oral sucrose as an inexpensive، safety and easy to get method compared to other methods، so it is recommended to use it before venipuncture procedure.

One of the problems in midwifery is labor induction in the cases in whom the termination of pregnancy is necessary. Thus، the methods for cervical ripening and labor induction have always been considered. The aim of this study was to determine the effect of intramuscular dexamethasone on onset of labor in postdate pregnancy. This single-blind، randomized clinical trial study was performed on 100 nulliparous women who referred to Amir Al Momenin hospital in Ahvaz. The patients were randomly divided into two groups. Single dose of intramuscular dexamethasone (8 mg) was administered to study group 12 h before induction. The controls were given 2 cc of normal saline at the same interval. A significant difference was not seen between two groups according to age، demographic characteristics، initial Bishop score، first and fifth minute Apgar score and meconium. Mean of Bishop score after injection in study and control groups was 7. 23±1. 32 and 2. 98±0. 89، respectively (p<0001). The mean time interval of induction to the onset of active phase in study and control groups was 3. 1±0. 68 h and 4. 2±1. 3 h، respectively (p=0. 001). The results of this study showed that intramuscular dexamethasone by improving Bishop score causes the onset of labor pains in postdate pregnancies.

With increasing life expectancy in women، they spend one third of their life after menopause. For this reason، the process of physical and psychosocial changes is very important in this stage of life. The aim of the present study was to assess the factors affecting life process of postmenopausal women. This cross sectional study was performed on 700 postmenopausal women of Babol (Iran) aged between 40-60 years with natural menopause and without using hormone therapy by random and cluster sampling method. Data collection tool was a questionnaire consisting of two parts. First part assessed demographic factors and menopausal status of participants and second part was the questions related to life process by menopause specific quality of life (MENQOL) questionnaire in psychosocial and physical domains. After gathering information، the variables were assessed and compared. The mean menopause age in Babol town was 48. 57±1. 55. The mean score of life quality in psychosocial and physical domains was 23. 07±6. 52 and 55. 38±7. 99، respectively. There was a significant relationship between psychosocial and physical dimensions of quality of life with age، education level and economic level (p<0. 05). Also، there was a significant relationship between psychosocial and physical dimensions and marital status and between psychosocial dimension and smoking by individuals and family members (p<0. 05). The results of the study showed that educational level، economic level and age effect on life process of postmenopausal women.

Cardiac arrhythmia is a potentially fatal complication of acute coronary syndromes. Researchers believe that the magnesium disturbance is an important factor causing the arrhythmias. This study aimed to investigate the relationship between serum magnesium levels and the incidence of cardiac arrhythmias in patients with acute coronary syndromes. This observational study was performed as a cohort، 124 goal-oriented patients were evaluated (two groups of hypomagnesemia and normomagnesemia، 62 subjects in each group. Variables included patient demographics، primary diagnosis of acute coronary syndrome، magnesium levels، cardiac arrhythmia and its rate and origin. At first، serum magnesium levels were measured and then the patients were followed up for incidence of cardiac arrhythmias for 72 hours، and two groups were compared with each other. In this study، 17 subjects (24. 7%) in hypomagnesemia and 8 patients (12. 9%) in normomagnesemia group had cardiac arrhythmia showing a statistically significant difference (p=0. 044). However the magnesium level was not related to subgroup of arrhythmia and its rate، also magnesium level was not related to the type of acute coronary syndromes. According to the obtained results، it may be concluded that there is a significant association between serum magnesium level and cardiac arrhythmia among this patients.

Dursban is the most common organophosphate pesticides that used for control of pests. The main action of this compound is inhibition of cholinesterase enzyme، which adversely effects on reproductive system. Due to the use of pesticides in agriculture and the possible damage، the effect of this toxin on the sexual hormones and changes of testis tissue in mice was studied. In the experimental study، 40 adult male mice were divided into four equal groups including control، sham، experimental (1and 2) groups. In the experimental groups، animals were intraperitoneally injected with consecutive doses of 15mg/kg and 30mg/kg dursban for one month (five days per week). The olive oil was injected to sham group and control received no injection. Testes tissue sections were prepared to investigate possible changes occurring in the category of spermatogenic، Leydig cells and seminiferous tubule by eye piece (calibrated ocular lens). Diameter of testis was measured by micrometer. Levels of gonadotropin hormones and testosterone were assayed by radioimmunoassay. Then data were analyzed. Levels of gonadotropin hormones and testosterone in experimental (1 and 2) groups were significantly declined compared to control and sham group (p<0. 05). The number of spermatogonia، primary and secondary spermatocyts، spermatids، Leydig cells، diameter of testis and seminiferous tubule diameter in the experimental (1 and 2) groups compared to control and sham group and also in the experimental 2 group compared to experimental 1 group were decreased (p<0. 05). These results demonstrated that dursban can cause the decrease of sexual hormones and damage of testes tissue that is pushing people toward infertility.

When the sperm finds its final form at maturity، its antigen acts as a foreign cell against an immune system. With the sperm entrance into the blood vessel system، the immune system is exposed to antigens، and anti-sperm antibodies can be produced. The aim of this study was to evaluate the effect of intraperitoneal sperm injection on rat testis tissue in second generation. This experimental- laboratory study was performed on adult Albino rats of 3 months of age and weight approximately 250 to 300 grams. Sperms obtained from 8 rats، were injected into 12 female rats، during 4 stages at one week interval. Then under coupling، the testes of male offspring born (24 rats of the second generation) were biopsied after reaching the age of maturity. Tissue slices were prepared and stained with H&E. Seminiferous tubule diameter، number of germ cells and leydig cells were measured by using the eyepiece and compared with control group. Average number of germ cells in control and second generation was 9. 5±0. 9 and 8. 2±1. 1، respectively (p<0. 001). Average leydig cells were counted 7. 63±2. 74 in the control group and 6. 55±2. 21 in second generation rats (p<0. 001). Diameter of seminiferous tubules in the second generation (3. 7±0. 47) was significantly higher than the control group (1. 62±0. 025) (p<0. 001). Intraperitoneal injection of sperm (antigens) in the body of the mother rats can cause changes including the increase in seminiferous tubule diameter and decrease in germ cells and leydig cells in their offspring.

Curcumin has anti-oxidant effects and protects liver tissue. On the other hands، adrenal gland has several functions including carbohydrate metabolism، immunity and hematology and affects liver structure. Regarding to decreasing adrenal function in some pathologic conditions and consumption of curcumin as food additive; the aim of present study was to evaluate histological and histomorphometrical changes in liver tissue after adrenalectomy and effect of curcumin on these changes.

In this study، 25 female Wistar rats were divided into 5 groups: control، treated with curcumin، adrenalectomised، adrenalectomised treated with curcumin and sham. Bilateral adrenalectomy was carried under anesthesia and muscles and skin were sutured. Curcumin was intraperitoneally administrated 100mg/kg for 21 days. At the end، the liver was sampled; tissue sections were prepared and examined by light microscope. The number of injured hepatocytes، Kupffer and inflammatory cells was counted and evaluated.

The mean of injured cells was 21. 6±0. 5 and increased to 52. 8±3. 5 in adrenalectomized group (p<0. 0001). The mean of Kupffer cells was 5. 4±0. 27 and increased to 15. 8±3. 2 in adrenalectomized group (p<0. 0001). The number of these cells and liver changes was significantly decreased by curcumin.

The results of this study showed that the curcumin can improve liver changes after adrenalectomy.

Nasal polyps are abnormal growths from the lining of the nose or paranasal sinuses. They occur due to chronic inflammation of the mucous membranes of the nose and sinuses. In this study، we evaluated Ki-67 expression in nasal polyp epithelium and non-polypoid nasal inflamed mucosa. This cross-sectional study with descriptive and analytical aspects were done on 88 nasal polyps and 12 non-polypoid nasal inflamed mucosa in Shahid Mostafa Khomeini hospital، Tehran-Iran. One tissue section was stained with monoclonal Ki67 antibody by immune histochemistry method and the percentage of ki67 staining tissue samples for grade 1 (weak)، grade 2 (moderate) and grade 3 (severe) based on the percentage of positive cells was determined and compared in two groups. In case group، 14 (15. 9%)، 51 (58%)، and 23 (26. 1%) showed I، II، and III staining grade، respectively. In sinusitis group، 8 (66. 7%) and 4 (33. 3%) showed I، II staining grade، respectively. There was significant statistical correlation between the two groups regarding the percentage of ki67-positive cells (p<0. 001). It seems ki67 expression is greater in epithelial cells of nasal polyps than non-polypoid nasal inflamed mucosa. Ki67 expression can be effective in causing polyp.

Inflammation plays an important role in the initiation and progression of cardiovascular disease. Based on clinical evidence and animal experiments have been preformed، magnesium may be involved in inflammatory processes. The objective of this study was to determine whether serum magnesium (Mg) level is associated with C-reactive protein (CRP) in patients with coronary artery disease (CAD) hospitalized in CCU.

This cross sectional study was performed on 100 patients (45 males and 55 females) with coronary artery disease who were admitted in CCU ward in Ayatollah Roohani hospital، Babol، Iran. Demographic data were recorded by completing a questionnaire. Serum magnesium، CRP، LDL-C، HDL-C، TC and TG and CRP within first day of admission was measured with a spectrophotometer.

According to the obtained results the mean of serum level magnesium in males (2±0. 05 mg/dl) was less than females (2. 14±0. 04 mg/dl) (p<0. 05). After making matched for age، BMI and risk factors were determined serum magnesium levels in patients with myocardial infarction (AMI) (1. 9±0. 04 mg/dl) significantly was lower than patients with angina (UA) (2. 2±0. 04 mg/kg) (p<0. 001). Also، inverse correlation was found between serum magnesium and CRP so that CRP values decreased as increasing the amount of serum magnesium (r=-0. 703، p<0. 01) and significantly correlation between serum level magnesium and CRP with duration of hospitalization was observed (r = -0. 55، p=0. 01 and r = 0. 5، p=0. 01، respectively).

It seems that with increasing serum level of magnesium، severity of inflammation and duration of hospitalization in patients with coronary artery disease was reduced. Probably، measurement and correction of magnesium concentration is involved in improving their clinical conditions.

Cytokine therapy is a fundamental step for the control of the most severe inflammatory diseases. Considering the importance of TNF-? in most of autoimmune and inflammatory diseases، it has been as an attractive target for many researchers and is an important candidate for cytokine therapy. Using monoclonal antibodies is a major approach in contrast to deleterious effects of TNF-. Antibody phage display technology is a major technique for the preparation of monoclonal antibodies. Our goal in current study was production and preparation of monoclonal antibody against TNF-. For Biopanning technique، we used ELISA plates for isolation of single chain variable fragments (scFv) from Tomlinson library. After coating of TNF-? protein in the wells، phage library was added. Specific phages were eluted using Trypsin after washing process and amplified in TG1 cells. Five rounds of panning were conducted for obtaining high specific phages. The evaluation of selected clones was done through monoclonal phage ELISA، PCR، RFLP and western blotting methods. Analysis of sequences using bioinformatic softwares showed that separated plasmids from TNF-? reactive clones contained insertions. Furthermore، most of variations are seen in three hot regions which can affect protein function. The results of this study showed that forth generation of monoclonal antibodies against human TNF-? were successfully produced.

There are several studies related to the role of the hematologic agents in the etiology of recurrent aphthous stomatitis (RAS) which results have controversies. This study was carried out to investigate the etiologic role of iron، folic acid and vitamin B12 in RAS. In this systematic review and meta analysis study، databases were searched with specific keywords in mentioned period of time after determining research question. At the end، 24 articles were identified and included in this study. All studies were critically appraised. Data were extracted and stratified and meta-analysis was done for all extracted data. Meta analysis showed that prevalence of low level of hematinic agents (ferritin، serum iron، hemoglobin، serum folate، RBC folate and vitamin B12) in patients with RAS was significant (p<0. 1). In interventional studies، healing of RAS after prescription of iron supplement was significant (p<0. 1) Based on the gained results، hematologic deficiencies of ferritin، serum iron، hemoglobin، serum folate، RBC folate and vitamin B12 have a notable role in the etiology and recurrence of aphthous ulcers and ordering iron supplements for RAS patients is beneficial.

Vitex agnus castus is used as alternative medicine for treatment of endocrine disorders in women. This study was carried out to evaluate the effect of vitex agnus castus in ovarian histomorphology in rat with induced polycystic ovary syndrome (PCOS). In this study، 48 Sprague Dawley rats (200±20 g & 10 weeks ages) with normal estrous cycles were randomly divided into four groups: Control (received distilled water)، Sham، PC and PT. To develop PCOS letrozol was administrated (1mg/kg) by gavage for 28 days to the PC and PT groups. Sham and PT (after induction of PCOS) groups received 365 mg/kg vitex agnus-castus extract orally by gavage for 30 days. At the end of experiment، rats were sacrificed، both of ovaries were dissected out، and prepared section of ovaries stained with Hematoxylin-eosin for histological study. A significant decrease in number of preantral follicles (PAF)، antral follicles (AF) and corpus luteum was observed in PC group compared to other groups، but number of primary follicles did not show significant difference between groups. Diameter of antral follicles، thickness of theca of follicle and tunica albuginea of ovary increased significantly in PC group compared to other groups. However thickness of granulosa layer decrease in PC group compare to other groups. Treatment by vitex agnus castus resulted to increase number of PAF and AF، corpus luteum (6. 42±0. 64 vs. 3±0. 18)، decrease number of cystic follicles (1. 28 ±0. 42 vs. 5. 66±0. 49) and decrease thickness of theca of follicle and tunica albuginea of ovary and increase thickness of granulosa layer of AF. The results of this study showed that vitex agnus castus in administrated dose has positive effect on the condition of ovarian follicles in the experimental PCOS.

Mucous retention cyst (MRC) of maxillary sinus is a kind of the mucus pseudocyst. It rarely causes any sign or symptom. The purpose of this study was to determine the prevalence and some associated risk factors of MRC. In this study، panoramic radiographs of 700 patients referring to oral and maxillofacial radiology department of dental school of Babol University of medical sciences were examined for one year and mucous retention cyst prevalence and some associated risk factors such as sex، site of occurrence، allergy، month and smoking habit were evaluated. The prevalence of this lesion was %7 (CI %95 5. 1-8. 9) and was significantly higher among men (p<0. 05). Also there was significantly correlation between seasonal allergy and smoking with MRC (p<0. 05) but there were no significantly correlation between month with MRC. The results of this study showed that the prevalence of MRC was more in men. Seasonal allergy and smoking also can cause MRC.

Fukushima nuclear accident has produced concerns about radioactive distribution and subsequent exposure to ionizing radiation. The aim of the present study was the comparison between local gamma rays level before and after accident in Babol in north of Iran. In this cross sectional study، the environmental dosimetry was performed in 182 local health centers in Babol according to International Atomic Energy Agency standard protocol and the results were compared with similar previous survey in similar areas which was done at 2010 for determining of association between local external gamma rays and frequency of cancer in Babol، Iran. Results showed that there was no significant increase in local gamma ray level before (60. 62±12. 96 nSv/hr =0. 53 mSv/y) and after (37. 06±17. 76 nSv/hr =0. 33 mSv/y) accident in Babol in the areas under the study. The results of this study showed that Fukushima nuclear accident has not significantly changed the local gamma rays level in Babol in northern Iran.

Without bone marrow transplantation (BMT)، ? - thalassemia major (? -TM) patient needs regular blood transfusion. Iron deposition after blood transfusion causes many unwanted effects. BMT obviates the need for blood transfusion in? -TM. In this study، bone marrow transplantation in seven? -thalassemia major patients in Amirkola children hospital was reported. CASES: Among? -thalassemia major patients for doing BMT seven patients [4 girls (57%) and 3 boys (42%)] had human leukocyte antigen (HLA) matched donors. Mean age of patients was 10. 86±5. 58 years. Three donors were sisters، two donors were brothers، one donor was father and one donor was aunt. Hematopoietic stem cells (HSCs) collected from bone marrow (4=57%) and peripheral blood stem cells (PBSc) (3=42%). There was no engraftment failure or graft rejection. One patient suffered from acute graft versus-host disease (GVHD) (stage IV). Mean duration of hospitalization was 37. 71±10. 32 days. Mean duration of follow up was 353. 14±152. 133 days. At present all patients are alive، disease free and independent blood transfusion. Chimerism in all of them was more than %90 in the last assessment. The results of this study showed that all studied patients became independent to blood transfusion after BMT. There was no engraftment failure or graft rejection.