مجله مطالعات علوم پزشکی
سال بیست و چهارم شماره 5 (امرداد 1392)

We investigated the association between cognitive deficits and the presence of functional balance problems in right adult stroke patients in order to elucidate a potential role of cognitive deficits in ADL complications، This study was conducted on a total of 20 patients with right adult stroke patients between 45-65 years old passing at least 6 months from their CVA were recruited through the outpatient clinic at rehabilitation faculty in Shafa hospital. To study the association between cognitive deficits and functional balance problems، we assessed the correlation. Functional balance was measured using Berg Balance Scale (BBS) and cognitive abilities were measured by Lowenstein Occupational Therapy Cognitive Assessment (LOTCA). There were meaningful correlation between visual perception، spatial perception، visuomotor organization، motor praxis، and functional balance (p<0. 05). There was no meaningful correlation between orientation، thinking operations، and functional balance (p>0. 05). There was a significantly positive correlation between cognitive deficits and functional balance problems in right adult stroke patients، especially in visual perception، spatial perception، and visuomotor organization. Further، our findings suggest that assessment of cognitive abilities may be used as a prognostic factor for functional balance problems in ADL activities in right adult stroke patients.

One of the methods for abnormalities motion is the gait analysis using the analysis of plantar pressure distribution. This method is not only very costly but also it needs the adequate space to locate the equipment; in some cases connection of the accessories to the patient leads to the limitation of the patient’s motions. The aim of this study was to recognize the ACL disease using a non-invasive and cost-efficient method with less limitation for the patient. This method can also provide accurate qualitative and quantitative results for both static and moving conditions. In this research، a non-invasive device with 16 FSR sensors and the capability of wireless transmission of data via RF module was applied on the ACL patients. The study was carried out on 18 mature males in 3 group including: 6 healthy persons as the control group، 6 patients with ACL in right leg، and 6 patients with ACL in the left leg. After wearing the shoes equipped with FSR sensors the data from sensors under pressure points of patients soles in static and moving conditions were transmitted to a processor and then to the wireless computer. Received data were sent to the software developed by C Sharp and then processed. The color of under pressure areas on the images of the right and left legs sole illustrated on the monitor were changed according to the applied pressure on the sensors. After 5 seconds، the color changed for each one of the sensors in the right and left legs were plotted in the form of a graph. The results showed that there was no statistically significant difference between the average pressures of the right and left legs in the control group in both static and motion conditions (P>0. 05). However comparing the average pressure of the corresponding sensors in the left and right legs for two categories of ACL patients and the average pressure of right and left legs in static and moving conditions، a significant difference was detected (P<0. 05). In addition، comparing the average pressure of the left legs in left Leg ACL patients and control category and the average pressure of the right legs in right leg ACL patients and control category in static and motion conditions a significant difference was detected (P<0. 05). Considering the results، it seems that this device is able to evaluate the ACL disease with a non-invasive and cost-efficient method with less limitation for the patient through real-time and simultaneous illustration of the results and accurate information.

Post-operative shivering is very common and it is usually followed by many problems such as an increase in oxygen consumption، blood pressure، intracranial and intraocular pressure، and post-operation pain. Therefore، it is very important to prevent shivering especially in the elderly and ischemic heart disease patients. The goal of this study was comparing the effect of Pethidine (Meperidine)، Dexamethasone، and Placebo in prevention of shivering. This double blind clinical trial study was carried out on 120 patients who were candidates for surgery under general anesthesia. The patients were randomly divided into three groups including those who received placebo (a) Dexamethasone (b) and Pethidine (c). Induction and maintenance of anesthesia for all patients were similar. Central and peripheral temperature of patients was measured every 5 minute interval. After induction saline normal، Dexamethasone and Pethidine were respectively injected to groups a، b، and c. In recovery، all patients were controlled for visible shivering: The data were statistically analyzed by SPSS software and ANOVA and chi square tests. There were no significant differences among three mentioned groups regarding of gender، age، duration of surgery، and recovery time. Nineteen cases (47. 5%) in group a had post-operative shivering. Whereas، in group b only 4 cases (10%) had shivering and the difference between 2 groups was significant (P value = 0. 001). Also in group c، 15 cases (37. 5%) had shivering that the difference with placebo group was significant (P value = 0. 08). The present study showed that pethidine and dexamethasone are effective drugs for preventing post-operative shivering in elective surgery. And the effect of dexamethasone in preventing the post-operative shivering is better than Pethidine. Dexamethasone can be administered after induction of anesthesia as an alternative to administration of Pethidine (as a common method of prevention and treatment of postoperative shivering) particularly in patients with hemodynamic instability.

One of the most prevalent bacterial infections is urinary tract infection (UTI); and Escherichia coli has been isolated from 75-90 percent of UTI cases. On the other hand، the rate of community acquired UTI caused by extended spectrum beta-lactamase producing E. coli، in particular blaCTX-M is increasing worldwide. Therefore، this study aimed to assess the pattern of antibiotic resistance، ESBL frequency، and blaCTX-M gene in E. coli isolated from UTI of out-patients. This study was carried out on the urinary samples of out-patients and 140 E. coli strains isolated. Then the susceptibility of isolates to 10 selected antibiotics was tested using disc diffusion method. Later، the ESBL producer strains were confirmed using combined discs method. Finally، the blaCTX-M gene was determined in ESBL producer isolates using PCR. Of 140 isolates، 81. 43 % and 62. 13% showed resistance to ampicillin and Co-trimoxazole، respectively، but 100% were sensitive to imipenem. Moreover، 34 (24. 28%) isolates were ESBL producers. PCR showed that 30 (88%) of ESBL producer isolates contained CTX-M gene. Resistance to various beta-lactam antibiotics in particular the third generation of cephalosporins is a serious concern. The production of ESBL، in particular in isolates of out-patients، is a big threat for use of the broad spectrum cephalosporins. Given the presence of CTX-M gene in the high proportion of the isolates، more molecular and epidemiological studies on pathogenic bacteria in this region is required.

Concentrations of certain substances in follicular fluid (FF) may related to fertilization outcome. The study aim was to identify FF markers with which to predict embryo implantation potential. Concentrations of selected hormones، cytokines and growth factors in FF samples obtained during assisted reproduction treatment، Intracytoplasmic Sperm Injection (ICSI) method were related with treatment outcomes. Mean concentrations of 17beta-estradiol (E2)، prolactin (PRL) and insulin-like growth factor (IGF) -I were significantly higher، in treatment attempts leading to a clinical pregnancy as compared with those in which no pregnancy was established. LH، growth hormone (GH)، progesterone، and interleukin-1 (IL-1) concentrations are similar in successful and unsuccessful attempts. Fertilization outcomes were related to FF levels of PRL، E2 and IGF-I. But LH، growth GH، progesterone، and IL-1 are not markers of success.

Many methods have been established for the treatments of depression among cancer patients depending on its etiology، and cognitive therapy is one of them. This research aimed to investigate the effectiveness of group cognitive-behavioral therapy on decreasing depression level of patients with cancer. This pretest-posttest quasi-experimental study was conducted on 20 cancer patients that were selected by available sampling method and were randomly divided into two experimental and one control groups. The measurement tool was Beck Depression Inventory (BPI-II). The experimental group participated in 12 sessions of cognitive therapy، while the control group did not receive any treatment. The mean scores of the two groups were compared through analysis of covariance (ANCOVA). The results of the study showed the significant differences between the mean scores of the pre-test and post-test of the experimental and control groups; cognitive group therapy had reduced the depression mean score in the experimental group. The findings of the study indicate that cognitive group therapy can reduce the depression among cancer patients. Therefore، it is an effective method for encountering and coping with negative life events or prevent depression among cancer patients.

Bacterial vaginosis is the most common reason of abnormal vaginal discharge and one of the common causes of referring to gynecology clinics. Due to its importance in pregnancy، this study aimed to evaluate the frequency and related factors of bacterial vaginosis in pregnant women with gestational age less than 20 weeks. Matherials & A total of 198 pregnant women with gestational age less than 20 weeks were enrolled in the study in Motahhari Hospital، Urmia. Information related factors were collected by interviewing the pregnant woman. Using Nugent’s criteria، patients were divided to three groups، positive، negative، and intermediate and were compared based on related factors. According to Nugent’s criteria، 151 patients with score less than 4 were negative (76. 26. %)، 23 patients with score 4-6 were intermediate (11. 61%)، 24 patients with score more than 6 were positive (12. 12%). There was no significant difference in age، BMI (Body Mass Index)، Sexual behavior، educational level، and parity between the three groups. Patients with bacterial vaginosis used IUD significantly higher than negative group and none of them used condom as a contraceptive. There was a significant relation between vaginosis and type of pregnancy prevention (p=0. 01). Our results showed the prevalence of bacterial vaginosis was 12. 12% in this area with intermediate level of infection. Type of contraception method is possibly correlated with bacterial vaginosis in pregnancy.

Brucellosis is a worldwide zoonotic disease that caused by Brucella spp. They are facultative intracellular pathogens which replicate inside macrophages and in non professional phagocytes cells. The experiences show that medicinal plants can be used successfully to treat bacterial diseases. The aim of this study is evaluation of bactericidal effects of Eucalyptus globulus extracts on intramacrophage Brucella abortus S99. In this study aquatic، ethanolic and acetonic extracts of Eucalyptus globulus leaves prepared. Then effect of extracts on intramacrophge surviving of B. abortus S99 studied on cell culture of Balb/c mice peritoneal macrophages. Therefore، after lysis of macrophages، preparation of serial dilution and culture on Muller-Hinton Agar media، number of grown CFU counted. Results indicated that Eucalyptus globulus extracts have antimicrobial activity on intramacrophage B. abortus S99 after 24h. Overall cell culture results indicated that Eucalyptus globulus extracts have bactericidal activity on intramacrophage B. abortus S99 and ethanolic extract has the most effective antimicrobial activity on intramacrophage brucellae.

Mood disorders including major depression (MD) and bipolar mood disorders (BMD) are among the most frequent psychological problems all over the world. Quality of life (QOL) is an important endpoint to assess the efficacy of treatment in these two conditions. This study aimed at evaluating and comparing the QOL in these two groups in the partial recovery phase with normal counterparts. Methods & Materials: In the analytic-descriptive cross-sectional setting، 20 patients with MD in partial recovery phase، 20 patients with BMD in partial recovery phase and 20 healthy subjects were recruited in Tabriz Teaching Razi Centre in a 6-month period of time. Cases with depression score>18 (according to the Beck depression inventory-2; BDI-2) were excluded. The QOL was assessed by the (World health organization quality of life (WHOQOL-BREF) questionnaire.

The three groups were matched for age and gender. The mean BDI-2 score was significantly higher in the MD group than that in the two others. The mean score of physical health domain was significantly lower in the MD group comparing with that in the controls. The mean score of psychological domain was significantly lower in the MD group comparing with that in the BMD group. The other scores were comparable between the three groups.

Based on our findings، the QOL was lower in the MD group in partial recovery phase in some domains comparing with the BMD group in the partial recovery phase and the controls. The QOL was not significantly different between the BMD group in the partial recovery phase and the controls.

Juvenile hyaline fibromatosis is a rare genetic disease that is characterized by multiple papulonudular skin lesions، gingival hypertrophy and joint contracture. According to our knowledge، less than 70 cases with features suggesting the diagnosis have been reported. It is an autosomal recessive disease that is usually detected in infancy or early childhood. We report a 14-year old boy، who presented skin colored to erythematous painless rubbery nodules on the scalp، face، hand، and feet and flexion contracture on both elbow and gingival hypertrophy. Radiological findings showed erosion at the end of distal phalanxes with marginal sclerosis and soft tissue masses on toes. Pathological finding were an increased number of fibroblasts embedded in an amorphous eosinophilic hyalinized matrix. Some stoma cells were observed in the lacuna-like spaces (chondroid cell) within this material. For our patient، the diagnosis of JHF was based on the presence of typical tumoral lesions، gingival hyperplasia، joint contracture، and the characteristic histopathological findings. The presence of amorphous hyaline material in the dermis supported our diagnosis of JHF.