مجله دانشگاه علوم پزشکی شهید صدوقی یزد
سال بیست و یکم شماره 4 (پیاپی 93، مهر و آبان 1392)

In recent years، a number of researches have been carried out regarding the relationship between atherosclerosis and serum levels of GH and IGF-1 and different results were obtained. This study aimed to determine the effect of a six-month aerobic exercise on levels of GH، IGF-1 and GH/IGF-1 ratio serum in sedentary middle-aged women Nineteen healthy females، who were selected by convenience sampling method، were divided into two [active (n=11) and non-active (n=8)] groups. The exercise protocol included aerobic exercise training lasted for 6 months and 3 sessions per week. Every session lasted for 60 minutes with intensity of 55-65 percent of heart rate reserve. Blood samples were taken and Serum IGF-1 and GH were measured before and after six months of aerobic training. To make intra and intergroup comparisons as well as to investigate the interactive effect، repeated measure analysis of variance were used. For all statistical comparisons، the level of significance was set at p < 0. 05. This study demonstrated that the level of serum IGF-1 in middle-aged women decreased significantly (P=0. 016). However، the levels of GH didn''t change significantly during this period. Moreover، GH to IGF-1 ratio increased significantly (P=0. 007). The study results indicated that six-month aerobic exercise led to a decrease on the levels of IGF-1 and did not make a change in GH serum in sedentary middle-aged women. In other words، doing aerobic exercises reduced IGF-1 levels that have a significant relationship with severity of a coronary disease and thus can prevent the atherosclerosis disease.

The lumbar puncture is one of the most important diagnostic and therapeutic procedures within children which child’s non-cooperativeness and procedural sedation are regarded necessary to conduct it. This study aimed to compare efficacy and safety of melatonin and gabapentin in reducing anxiety and pain of lumbar puncture in children.

In a parallel single-blinded randomized clinical trial، sixty children aged 6 months -7 years، were evaluated in Pediatric Ward of Shahid Sadoughi Hospital، in Yazd (Iran) in 2012. The children were distributedrandomly into two groups (30 children in each group). In group one، they received 0. 3 mg/kg/dose of melatonin and theother group received 15 mg/kg/dose of gabapentin. Primary endpoints were success rate in reducing anxiety (anxiety score of≥ four) and reducing pain when the needle was inserted to skin for lumbarpuncture (pain score of less than four). The clinicalside effects were investigated as well.

Twenty two girls (36. 7%) and 38 boys (63. 3%) with mean age of 2. 79 ± 1. 92 years were evaluated. Anxiety reduction (achieving the anxiety score of ≥ four) was obtained in 43. 3% in melatonin and in 36. 7% in gabapentin groups، respectively and both drugs were equally effective in anxiety reduction (p. value = 0. 598). Pain reduction (achieving the pain score of less than four) was obtained in 23. 3% in melatonin and in 50% in gabapentin groups، respectively and thus، gabapentin wasproved to be more effective in pain reduction (p. value = 0. 032). Mild side effects were observed in 10% of melatonin group and in 16. 7% of gabapentin group. No statistically significant differences were seen from viewpoint of safety between the two drugs (p. value=0. 448).

Melatonin and gabapentin were not effective drugs in anxiety reduction for lumbar puncture of children. However، gabapentin is a safe and effective drug in pain reduction in painful diagnostic therapeutic procedures.

Preeclampsia is a common disorder that is a leading cause of perinatal and maternal morbidity and mortality; however its specific etiology has still remained obscure. The first step in preventing preeclampsia is early detection of women at risk. Since there is no valid and reliable screening test، appropriate diagnostic and screening tests are necessary، which are inexpensive، non-invasive and beneficial for pregnant women. Therefore، regarding the role of selenium as an antioxidant in the prevention preeclampsia، this study was designed which aimed to determine the prognostic value of plasma selenium levels in the diagnosis of preeclampsia in primigravida women In a nested case control design، a sample of 650 normal primigravida women of 24-28 weeks participated in the study. Subjects who involved the case group were followed up for 3 months and 38 were affected by preeclampsia. Blood samples were obtained from these 38patients as well as from 38 subjects as their matched controls. Moreover، the amount of selenium was measured by atomic absorption spectrometry. The mean level of selenium in blood plasma of the cases was significantly lower than in their matched controls. The present study findings revealed that pregnant women with serum Se < 66. 1 μg/L had a significantly increased risk of preeclampsia. Lower plasma selenium level in women destines to suffering from preeclampsia which confirms the destructive effect of selenium deficiency as an antioxidant in etiopathology of preeclampsia. Measurement of plasma selenium can improve the prediction of preeclampsia; thus، it seems that plasma selenium level test owns an acceptable sensitivity and specificity for predicting preeclampsia.

A link between emotional deficit and somatic factors has been widely established، yet little is known about different factors that may predict this relationship. The idea of psychopathology as a mediator has been supported by some pieces of evidencebut in fact، it has not been exactly scrutinized. Therefore، the present study examined the relationship between emotional deficit and pain severity in patients with rheumatoid arthritis. In this descriptive-correlational study، the target population included all patients with rheumatoid arthritis who referred to medical centers of Isfahan during spring 2012. A total number of 100 men and women with rheumatoid arthritis were selected via convenience sampling. A sociodemographic data form، Toronto Alexithymia Scale (TAS-20)، Hospital Anxiety and Depression Scale (HADS) and rheumatoid arthritis pain scale (RAPS) were administered to each subject andrequired information was obtained. The study data was analyzed by SPSS-18، AMOS-18 software، Pearson Correlation، and Structural Equation Modeling methods. Results indicated that the structural model fit clinical sample extremely well (chi2= 3. 04; p= 0. 218). Alexithymia، depression and anxiety were correlated with pain severity. In this model a latency variable (emotional deficit) was explored that predicted painseverity sowell (CFI، T،I، AGFI and GFI > 0. 9). The study findings revealed thatemotional deficit hasan important role in the rheumatoid arthritis and the pain severity. The model can confirm those pieces of evidence indicating the psychological treatments included in multidisciplinary programs for this disorder.

HER-2 is a protein receptor of growth. Approximately 25% of breast cancers have overexpress HER-2. This study was designed to determine frequency of HER-2 overexpression in patients with breast cancer. Additionally، it intended to explore its relationship with some variables such as age، histopathologic diagnosis،tumor size، axillary lymph node involvement. This analytic cross-sectional study was conducted on patients with breast cancer whose breast tissue specimen was referred to pathology laboratory of Shahid Sadooghi hospital of Yazd during 1389 and 1390. In our study، 147 patients were investigated who were all females with average age of 50. 34 years with 13. 3 years standard deviation. 54. 5% of them were HER-2/neu positive and frequency of HER-2 was higher in patients with older age، larger size tumor، ductal carcinoma diagnosis and axillary lymph node involvement، though there wasn''t any statistically significant difference between these variables and HER-2 overexpression. In our study، frequency of Her-2 overexpression was more than other studies and frequency of HER-2 was higher in patients with older age، larger size tumor، ductal carcinoma diagnosis and axillary lymph node involvement but there wasn''t any statistically significant difference between these variables and HER-2 overexpression. Regarding high frequency of HER-2 overexpression in this study that can be duo to genetic and ethnic variations، we recommend that HER-2/neu screening test should be done in all patients with breast cancers specially those with ductal carcinoma diagnosis، larger size tumor and axillary lymph node involvement.

Psychological hardiness is a personal factor and social support is regarded as an environmental factor that can facilitate adjustment to disease. This study aimed to investigate the relationship between adaptation with psychological hardiness and social support in individuals with Multiple sclerosis (MS). Seventy two females with MS and 25 males with MSwere selected through randomized sampling from two MS centers. Main variables of the study including adaptation، psychological hardiness، and social supportwere assessed respectively by Adaptation Inventory، Personal Attitudes Survey، and Social Support Questionnaire. Spearman correlation coefficients revealed that there are significant relationships between adaptation and psychological hardiness (p<0. 0001)، as well as between adaptation and social support (p<0. 0001). In addition، Multiple linear Regression showed that psychological hardiness (β= -0. 483) and social support (β= -0. 240) can explain 35/1% of adaptation variance in individuals with MS. Psychological hardinessproved to have a more important role in adaptation of individuals with MS. The study data demonstrated that personal factors like psychological hardiness and environmental factors such as social support can predict adjustment in individuals with MS. In order to clarify mechanisms of these factors on adaptation in individuals with MS، morelongitudinal and experimental studiesare required. These results are alsoapplicable in designing therapeutic programs for individuals with MS.

Non -alcoholic fatty liver disease (NAFLD) is the most common cause of abnormal liver test results in the U. S. A proportion of patients with NAFLD progress to advanced cirrhosis. Moreover، it is one of the clinical features of metabolic syndrome. This study was conducted in Shahid Sadoughi hospital in yazd، from September 2011 to march 2012. Eighty patients with NAFLD were enrolled in this study and then they were divided into two groups: case and control. The two groups underwent exercise and specific regiment، though in the case group subjects were also given 15 mg of pioglitazone twice a day. At the end of 24 weeks patients were reevaluated using ALT، BMI and sonography of liver. Sonography improvement occurred in both groups. Average of ALT improved in the case group and the difference in sonography between two groups was statistically meaningful.

AMP activated protein kinase (AMPK) as key regulators of cell metabolism، plays a major role in the activation of catabolic pathways، such as glucose transport and fatty acid oxidation. Thus، activation of this pathway can be used in the treatment of diabetes and metabolic syndrome. Many studied proposed the effectiveness of the polyphenols present in rhizomes of turmeric (curcumin) on diabetes and its related complications. Therefore، this study investigated the effects of curcumin as an activator of AMPK pathway in C2C12 muscle cells. This study was done on C2C12 skeletal muscle cell line. The cells were classified into two distinct groups: first group was treated with 40µM curcumin and the second one with 0. 1% DMSO as a negative control. The phosphorylated (AMPK) and phosphorylated acetyl COA carboxylase (ACC) were evaluated and compared by Western blotting technique. intracellular phosphorylated AMPK protein content in Curcumin-treated group was 132. 6% and ACC protein phosphorylated was 366. 47%. This study showed that the levels of phosphorylated AMPK and ACC protein in cells treated with curcumin are higher than the negative control. Thus curcumin can be regarded as an activator of AMPK activity in these cells and can assist as a potential target for making anti diabetic medecine that has a synergistic activity with insulin.

A number of researches show anti-proliferative effects of EMF on animal cells. In addition to antioxidant properties of garlic،it contains compounds that can inhibit cell proliferation. This study wasconducted to investigate the effects of garlic extract and EMF with low frequency on angiogenesis. Eighty fertilized eggs were divided into the control group، sham-exposed 1 (treated by normal saline)، sham-exposed 2 (in vicinity of switched off EMF)، experimental group 1 (treated by concentration 100 μg/ml of garlic extract)، experimental group 2 (treated by concentration 200 μg/ml of garlic extract)، experimental group 3 (in vicinity of EMF with intensity of 50 gauss)، experimental group 4 (treated by concentration 100 μg/ml of garlic extract and EMF with intensity of 50 gauss)، experimental group 5 (treated by concentration 200 μg/ml of garlic extract and EMF with intensity of 50 gauss). On the 8th day of incubation، gelatin sponge was placed on the chorioallantoic membrane and experimental groups 1، 2، 4، and 5 were treated with 10 microliters of garlic extract. On the 10th day of incubation، experimental groups 3، 4 and 5 were exposed to EMF for 4 hours. All samples were photographed on the 12th day of incubation and the length and numbers of vessels were analyzed by ANOVA and Tukey statistical tests. The mean number and length of blood vessels in all experimental groups were significantly decreased compared to the control group (p<0. 05). Garlic has inhibitory effects on angiogenesis. Moreover، these effects wereamplified by EMF with intensity of 50 gauss.

Various immunological abnormalities have been reported in women with RSA of unknown aetiologies including autoimmune abnormalities and increased cellular immunity such as elevated natural killer (NK)، Th1 and Th17 cell levels. Th17 and Th1 cells play a central role during inflammation. Th1 cells product cytokines IFN-γ، IL-2 and Th17 cells mainly cytokines IL-17A، F، IL-22. The aim of this study is evaluation of Th1 and Th17 activity in women with recurrent spontaneous abortion.

In this case-control study، 30 women with history of two or more abortion who at least 3 months past after last abortion considered as case group and 30 normal fertile healthy women with at least one delivery as control group. We determined the levels of IL-17A، F and IFN-γ in cell culture supernatant of peripheral blood mononuclear cells (PBMC) stimulated with the mitogen phytohemagglutinin (PHA) by enzyme-linked immunosorbent assay (ELISA) method and compared in the two groups. The results obtained using the one-sample kolmogorov-smirnov Test، Kruskal-wallis Test and Spearman were analyzed using SPSS 16 software.

The level of IFN- γ in case group was significantly higher than control group (186/53±30/41 versus 88/06±21/44 pg/ml، P < 0. 005). Also the level of IL-17 A، F in case group was significantly higher than control group (84/74±21/26 versus 28/41±8 pg/ml، P < 0. 01). IFN-γ concentration showed positive correlation with IL-17 A، F in case group (P=0. 015، r= 0. 455).

In this study the increased levels of cytokines IFN- γ and IL-17 A، F in women with recurrent spontaneous abortion shows a propensity of pro inflammation via Th17 and Th1 immunity and may be these cells play a pivotal role in rejecting fetus antigens.

With increasing usage of orthodontic treatments، disinfection of orthodontic appliances and rings is critical for maintaining dental and oral health. Using chemical disinfectants may cause allergic and mucosal disorders. The present study aimed to evaluate Zatariamultiflora essence and to compare it withChlorhexidine (0. 2%) mouth wash in controlling experimental plaque from Streptococcus mutant. In the current experimental study، 48 Iranian orthodontic rings were immersed in 1×108 CFU/ml Streptococcus mutant suspension. Firstly، Bacterial load on 12 rings was evaluated and then remained rings were randomly divided into 3 groups. They weredecontaminated respectivelyin 0. 5mg/100cc Zataria essence، 0. 02% Chlorhexidine and sterile distilled water (negative control). Finally the stability rate of Streptococcus mutantviable cells remained on rings was enumerated using culture. Moreover، they were analyzed via SPSS software. Mann-Whitney test showed a statistically significant differences between mean streptococcus viable cells isolated from the contaminated rings before and after decontamination with Zataria essence and Chlorhexidine (P=0. 0001)، whereas this reduction wasn’t significant in negative control group (P=0. 089). In addition، any statistically significant differences were not observed between zataria essence and Chlorhexidinemouth washes in controlling bacterial plaque (p=0. 058). Since Zatariamultiflora essence solution was proved to be effectivein controlling microbial biofilm on orthodontic rings compared toChlorhexidine،it can be used in further in vivo studies. If the same useful results would be given، it can be regarded fruitful for decontamination of orthodontic appliances.

The toxicity of gentamycin in the kidney seems to be related to the generation of reactive oxygen species (ROS). There is evidence that pretreatment with oxygen increases the rate and activity of antioxidant enzymes. In this experimental study، forty eight female rats (Sprague Dawlley) were divided into 6 groups randomly (8 in each) as follows: group 1 was the control and for other groups different doses of oxygen with Gentamycin was used for 8 days intra-peritoneally (100 mg/kg). 24-hour urine samples were collected after the final injection. Blood samples were collected and serum was prepared. The left kidney was fixed in formal saline. Serum MDA، creatinin and urea، as well as urine creatinine were measured. 5-micron tissue sections were prepared and stained by Periodic Acid Shift method. Volume density of proximal tubules، necrosis of proximal tubules and lymphocytic infiltration were studied. The data were analyzed by Mann-Whitney test at significant level of p <0. 05. Pretreatment with oxygen was effective significantly in two groups of 6 and 4 compared to group 2. The effectiveness was found in inhibition of serum MDA، improving serum، urinary urea and creatinine، preserving tubular volume density، and reducing tubular necrotizing and lymphocyin filtration. Pretreatment with oxygen and its concomitant use can improve renal tissue changes، serum urea and creatinine in gentamycin-induced nephrotoxicity، but cannot preserve them at the same level of control.

With the growing and rapid development of refractive surgery، researches focus increasingly on improvement of visual quality after cataract surgery. Intraocular lenses (IOLs) were a successful effort in the field of cataract surgery. Despite significant advances in cataract surgery، several complications related to surgical technique and IOL design after surgery can cause vision changes and reduce accuracy. Improvements in IOL design and surgical technique have a significant impact on the rate and extent of Tilt and Decentration effects. Because of small movement in modern intraocular lenses (aspheric)، its performance can be significantly reduced، therefore aberration correction in the eye with an artificial lens requires to be more careful on IOL centration and location. In this paper، the characteristics of intraocular lenses and devices used in the measurement and design of this lens are also taken into consideration. In addition، factors affecting the optical and visual acuity in cataract surgery such as Tilt and Decentration are presented. Additionally، materials in regard to computer simulation of optical models of the eye in research as well as optical computations in clinical situations are provided. Finally، the findings revealed that obtaining optimal vision in cataract surgery requires precise measurement and computational techniques as well as an awareness of aberrations that may be created during or after surgery. Moreover، further research and improvement in the process of measurement and calculation will enhance the visual acuity in cataract surgery.