مجله دانشگاه علوم پزشکی قم
سال هفتم شماره 5 (پیاپی 29، آذر و دی 1392)

Noise pollution has a high prevalence among the environmental pollutions and is considered as a teratogenic agent for reproductive system. This study was performed with the purpose of evaluation of the effect of honey and vitamin E on sex hormone levels in male rats exposed to noise pollution. Twenty-four adult male rats with the mean weight of 200±20g were randomly divided into 4 groups: 1 (honey+voice), 2 (vitamin E+voice), 3 (voice), and 4 (control). Groups 1 and 2 received honey and vitamin E as gavage, in addition to voice; group 3 was only exposed to noise pollution. After 50 days, serum level of hormone in male rats were measured by ELISA technique after taking blood from heart. Then, the male rats were placed in a cage with female rats of the same breed with a 2:1 ratio. Weight and number of embryos from fertilization were assessed. Data were analyzed using ANOVA and Tukey statistical methods. In this study, it was found that the secretion of sex hormones (FSH, LH, and testosterone) impaired under the effect of noise pollution. Serum level of testosterone decreased in rats that were under noise stress (p<0.05), and use of honey and vitamin E as antioxidants were modulated the level of this hormone in male rats. Noise pollution in male rats increased in the serum level FSH, LH (p<0.05). Weight and number of live embryos decreased because of this stress (p<0.05). The use of Honey and vitamin E by male rats increased live embryos (p<0.05). According to the results of this study, noise pollution has negative effects on the fertility of male rats. Also, use of honey and vitamin E increases the fertility in groups exposed to noise pollution.

Renal transplantation as a treatment of choice in most of the patients with ESRD (End Stage Renal Disease) improves physical domain of quality of life, but because of the effects of immunosuppressive drags, ongoing medical care may be required, and this problem influence on psychological, economic, and social status, and therefore quality of life. The objective of this study was to evaluate physical and psychological domains of quality of life in kidney transplantation patients in Kerman City. In this descriptive analytical study, quality of life of 105 kidney transplantation patients in Kerman city was assessed using SF36 questionnaire. The data were analyzed by Statistical Tests, such as independent t-test, Spearman’s correlation coefficient, and ANOVA. Significance level was considered to be p<0.05. The mean score of quality of life in kidney transplantations patients was 60.95±18.01, physical domain score was 59.77±14.78, and psychological domain score was 62.58±10.22. The maximum score was related to role limitation due to physical problems (72.25) and minimum score was related to general health (58.25). Analysis of the psychological domain scores according to demographic variables showed no significant difference, but in the physical domain, this difference was significant in terms of age and marital status (p≤0.05). The results of this study showed that kidney transplantation patients have relatively favorable quality of life, and psychological domain scores of quality of life were higher than those of physical domain.

Diabetes type 1 is caused by the lack of secretion of insulin. In this study, the effect of Plantago major on the serum level of insulin and glucose, and restorative effect of extract on pancreas tissue, and nephropathic effects of diabetes were studied. Thirty male rats were divided into three groups. The first group (healthy control) that was received normal saline, and other two group were diabetized by intraperitoneal injection of streptozotocin. One group of diabetic mice received P. major leaf extract 100mg/kg/bw as intraperitoneal injection four 6 weeks and the third group was considered as diabetic control. After the treatment period, taking blood was performed and serum levels of glucose, insulin, creatinine, and BUN were measured. After preparation of tissue sections, H&E and PAS stainings were respectively done for pancreas and kidney. Histological studies were performed with an optical microscope. Data were analyzed using analysis of variance and Tukey's post hoc tests. In this study, P. major leaf extract significantly decreased the serum levels of glucose, BUN, creatinine and significantly increased the serum level of insulin compared to diabetic group (p<0.05). Also, it significantly increased the mean diameter and number of pancreatic islands (p<0.05). Hypoglycemic effect of the extract of P. major leaf could be done through regeneration of pancreatic islands and could improve kidney complications of diabetes.

During recent years, metallo-beta-lactamase (MBLs) producing Pseudomonas aeruginosa has been reported as an important cause of nosocomial infection. Also, infection with this bacterium has increased rate of mortality and health care costs. The aim of this study was to determine the antibiotic resistance pattern and to detect blaVIM and blaIMP Metallo-beta-lactamase genes in P. aeruginosa isolated from patients hospitalized in the burn ward. This descriptive study was conducted on P. aeruginosa strains isolated from patients hospitalized in the burn ward of Tehran Shahid Motahari Hospital between September and January 2011. For all MBL-producing strains, antibiotic resistance pattern was determined by disc diffusion method according to CLSI guidelines. CDDT method was used for detection of MBL (imipenem-imipenem+EDTA), and PCR and sequencing techniques were used to detect MBL genes, blaVIM and blaIMP. Eighty-three percent of 100 P. aeruginosa isolates were resistant to imipenem. Using combination disk diffusion test (CDDT) method, 48 isolates were detected to have MBL, of which 6 isolates were positive for blaIMP-1 gene, and all of them did not have blaVIM gene. Also, 4 (8.3%) patients with MBL-producing P. aeruginosa infection died in the hospital. The results of this study revealed that high percentage of P. aeruginosa strains are MBL-producer. Therefore, detection of MBL-producing strains is essential for better control and treatment of burnt patients.

Hemophilia A (HA) is an X-linked recessive bleeding disorder. The disease is caused by mutations in the F8 gene. Inversion of intron 22 is the most common causative mutation of severe hemophilia A, which is detectable by southern blot and polymerase chain reaction (PCR) methods. The aim of this study was to determine intron 22 inversion type I and type II inversion in severe hemophilia A patients by inverse shifting-PCR method. This study was performed on 30 patients with severe hemophilia A with less than 1% of normal level activity of Factor 8. After obtaining consent from the patients, genomic DNA was extracted from peripheral blood leukocytes. The extracted DNAs were used as template for IS-PCR amplification after circularization (digestion by BclI and then ligation of the produced fragments by ligase enzyme). In 30 severe hemophilia A patients, 40% of the patients had intron 22 inversion type I, and 6.6% of the patients had intron 22 inversion type II. The results of this study revealed that recombination between intron 22h-1 within the F8 gene and its copies (22h-2 and 22h-3), which lie in opposite direction to intron 22h-1, respectively cause the inversions of intron 22 type II and type I. Inversion of intron 22 type I is more frequent than type II. Also, by application of IS-PCR as a cost effective method, we could save time and improve the molecular detection of inversion. This method and can be used for detection of carriers and patients and for prenatal diagnosis of hemophilia A disease.

Burn injuries are one of the most severe forms of trauma that are the cause of many disabilities, morbidities and mortalities, in addition to the high costs of hospital care, and psychological and emotional problems. This study was carried out with the aim of determining the epidemiology and outcome of burn injuries in burnt patients in Guilan province. In a study based on existing data, hospital records of all burn patients admitted in a specialized burn center in Guilan province from March 2008 to 2011, were reviewed. Data were analyzed including by chi-square test and t-test, and significance level was considered p<0.05. A total of 2274 patients’ hospital records, 1495 (65.7%) men and 779 women (34.3%) women, with a mean age of 31.47±22.67 years were reviewed. The mortality rate was estimated to be 8.7%. Significant factors associated with mortality included: Adulthood, illiteracy, unemployment, rural residence, low socioeconomic status, and percentage of burn. No significant statistical association was found between mortality and education, social status, and appropriate job. Also, most of the burns had occurred at home, and the most common cause of burn in adults was flame and in children was boiling water. Considering the association of severity of complications of burn at home with low education and rural residence, it seems that public education for prevention of burns at home along with development of specialized multidisciplinary and centralized burn centers as effective actions are essential.

The metabolic syndrome as a branch of metabolic disorders is known as the background of cardiovascular diseases, type 2 diabetes and stroke. One of the main strategies for the control and surveillance of this disease is nutrition self-management in these patients. This study aimed to determine the correlation between nutritional self-management and health promotion model constructs in women with metabolic syndrome. This cross-sectional study was carried out on women with metabolic syndrome in Isfahan city. 329 persons were selected from the patients with metabolic syndrome of five treatment centers of Isfahan Oil Industry in 2012. Data were collected in 11 parts using a researcher-made questionnaire, which had been designed based on the health promotion model that its validity and reliability had been assessed in a separate phase of design. Data analysis was performed using independent t-test, variance, and Pearson's matrix of correlation at 95% confidence interval. The mean score of the nutrition self-management was obtained 35.1. The mean scores of health promotion model constructs was average or under average. Also, nutrition self-management had a significant correlation with knowledge, perceived benefits, perceived self-efficacy, situational factors, husband’s social support, and commitment on self-management implementation, and had a significant inverse correlation with perceived barriers, feeling related to behavior, preferences, and competitors. Considering the correlation of nutrition self-management with metabolic syndrome in women with metabolic syndrome, health promotion model constructs for educational interventions could be used for adoption of an appropriate diet in these patients.

Satisfactory sexual performance is an important factor for strengthening families and is the source of many innovations in human life that can be affected by many factors. Obesity as a recent epidemic has influenced the global population. Researches have shown that sexual dysfunction is associated with obesity in men, but this association is unclear in women. This study aimed to investigate the association between body mass index (BMI) and sexual dysfunction in women. In this case-control study of women who referred to the selected health centers of Qom city, 77 persons with sexual dysfunction (score≤28) were compared with 64 healthy and without sexual dysfunction women (score>28) by a standardized questionnaire of sexual function. To determine BMI, height, and weight, and distribution of body fat, waist and hip circumferences were measured. Data were analyzed using statistical tests, such as t-test, chi-square and multiple regression, on the significance level (p<0.05). The mean BMI in case group was 34.1±5.4 and 26±4.4 in the control group, that statistical test showed a significant relationship between BMI and sexual dysfunction (p<0.05). Also, the most dysfunction was observed in the arousal phase in the case group and in the sexual pain phase in the control group (p<0.05). According to the results of this study, obesity affects some aspects of sexual performance in women. Therefore, interventional studies on weight loss in obese women with sexual dysfunction are necessary to reveal the association of obesity with sexual dysfunction.

Red meat, chicken meat and egg play a crucial role in supplying human dietary protein. Bacteria of enterobacteriaceae family, particularly Salmonella spp. Are one of the factors that endanger the health of protein food product. This study was undertaken aimed at determining the contamination level of these foodstuffs with Salmonella spp. and then evaluating their antibiotic resistance pattern. In this descriptive-cross sectional study, chicken, domestic eggs, and industrial eggs, each of them 100 samples, and 150 samples of red meats (beef and lamb) were collected through random sampling in Talesh city, and were assessed for contamination with Salmonella. For a definitive identification, biochemical assays as well as agglutination tests with related antisera were used. Data were analyzed using chi-square test. The significance level of differences was considered p<0.05. No bacteria were observed in the inner content of the domestic and industrial eggs. However 19 (19%) Salmonella isolates were obtained from the outer surface of industrial eggs shell, 4 (4%) from domestic eggs, 21 (21%) from industrial chicken, 5 (5%) from domestic chicken, and 5 (3.3%) from red meat. In terms of antibiotic resistance in isolated bacteria, the highest resistance was seen against erythromycin, nalidixic acid, and sulfamethoxazole, and the most susceptibility was for ciprofloxacin, cephalexin, and gentamicin. Based on the obtained results, attention to healthiness of foodstuffs is of particular importance for prevention of food-borne infections. Also, in order to prevent the appearance of resistant strains, indiscriminate use of antibiotics should be avoided in poultry and livestock industries.

To implement source separation plan, awareness of viewpoints and participation of waste producers are necessary. The aim of this research is to assess the status of the source separation of municipal wastes and to offer its corrective strategies from citizens’ point of view. This descriptive crooss-sectional study was performed through filling 1400 questionnaires by in-person interview in Qom, Yazd, and East Azarbaijan in the form of a waste management master plan. In this study, awareness of population was assessed using a questionnaire consisting of 31 general and specific questions. To examine the relationship between qualitative variables and cross-tabulations, chi-square test was used at a significance level of 5%. Ninety percent of citizens declared their readiness to implement the source separation of municipal wastes. Most important reasons of citizens for implementation of this plan was better recycling with appropriate quality materials (79%), environmental protection and health promotion (65%) and assistance to municipalities (43%), and the important reasons of plan’s failure from citizens point of view were: lack of or irregular implementation the programs by the municipality (45%), inadequate training of citizens (32%), and poor cooperation of people due to cultural and social problems and/or lack of economic justification (25%). According to the results, high percentage of citizens were aware of separation of municipal wastes plan and knew its advantages, so if reforms are made by the municipal authorities, percentage of participation and cooperation of citizens in this project will favorably increase.

Driving includes a wide range of stressor factors. This research was done with the aim of determination of the status of severe occupational stress and its associated factors among public transport bus drivers in Tehran. This descriptive-analytical study was performed on 388 urban bus drivers in Tehran in 2012. The samples were selected randomly from 9 systems or regions. To investigate the relationships of factors influencing severe stress, a questionnaire with demographic and driving information was used. Data analysis was performed using univariate and multivariate regression logistic tests. 31.7% of all participants in this study stated that they had severe stress during work in the last year (or at the time of the study). Also, variables of work shift and bus routes caused a 1.7-fold stress among drivers of evening shift and the monthly rotation compared to the drivers of morning shift and a 1.8-fold stress among drivers of the normal lines compared to BRT lines. Also, drug consumption and disease were effective causes in creating a 3.7-fold stress among the drivers. The results of this study showed that work shift and bus route are among work factors influencing the occurrence of severe stress among bus drivers. On the other hand, drug consumption and physical and mental illness can also be effective in increasing severe stress among drivers.

Malaria is one of the most important protozoan diseases that has been ranked by WHO among the most important diseases after tuberculosis and AIDS. Currently, Malaria is common in 101 countries. 300-500 million clinical cases of malaria are reported each year, even in countries where malaria has been eradicated. Case Report: The patient is a 22-year-old man with complaint of abdominal pain who referred to hospital about 3 weeks ago. The pain was severe, generalized, and vague. At this time, the patient had experienced abdominal pain as intermittent and attack. Also, he had complaint of fatigue, weight loss, headache, and fever. He reported nausea and vomiting, along with the generalized abdominal pain. Meanwhile, he had complaint of mild dysuria without urinary frequency and mild pain and cramps of abdominal muscles. There was no superficial abdominal tenderness, but deep tenderness was positive. Many treatments and evaluations were performed for the patient, but the patient still had complaint of the lack of improvement. Finally the patient was treated after diagnosis of Malaria according to his blood smear test.Malaria is one of the most important infectious diseases in tropical areas. This disease has been eradicated in west countries but is common in 100 tropical countries, which Iran is among them. The case reported in this study showed that taking a complete and accurate history has a critical role in diagnosis of Malaria, so we can prevent late diagnosis, creation of numerous problems, inappropriate treatment, unnecessary costs, and also patient’s wandering.