مجله مطالعات علوم پزشکی
سال بیست و چهارم شماره 10 (دی 1392)

This study was aimed to assess the interrelationship between urinary iodine excretion (UIE) and thyroid stimulating hormones (TSH) levels in pregnant women during the first trimester.

Women (n=485; age: >14 years old; without any history of thyroid dysfunction) were recruited at their first prenatal consult before 12 weeks of amenorrhea. Proportion of participants from urban and rural population were 41. 6% (n=223) and 58. 4% (n=283). Random urine and blood samples were collected for the analysis of UIE and TSH، respectively.

The overall median UIE was 74 μg/L and 86. 4% of women had iodine deficiency (ID) as defined by UIE < 150. The respective levels for urban and rural populations were 76 μg/L vs. 64 μg/L and 88. 5% vs. 83. 3%. Median TSH as a whole was 0. 8 mIU/L whilst those for urban and rural subjects were 1 mIU/L and 0. 7 mIU/L. No correlation was seen between UIE and TSH levels.

Our data reveals that sever ID is present in 33% of the subjects during the first trimester and that TSH levels are 12-64% lower than those reported for with adequate or more than adequate iodine intake regions in Iran. This preliminarily result suggest that whole body iodine stores is probably adequate to prevent hypo-thyroxinemia during early pregnancy in regions with mild to moderate iodine deficiency.

Human amniotic membrane has some specific properties making it an appropriate biomaterial for using in vascular tissue engineering. In this study، amniotic membrane was preserved with different methods. Effects of preservation on amniotic extracellular matrix and adhesion of cultured endothelial cells to membrane were compared with fresh samples of amniotic membrane. Human amniotic membrane was preserved with cryopreservation (-80 ̊C for 12 month) or lyophilization methods. Extracellular matrix components were assayed with immunohistochemistry method. The adhesion of cultured endothelial cells was studied with MTT assay. Results between groups were compared with ANOVA (Post-test Tukey). Results demonstrated that extracellular matrix components were same in cryopreserved samples in comparison to fresh ones but there are some differences in lyophilized samples. Adhesion of endothelial cells to lyophilized samples was significantly more than cryopreserved or fresh samples (P Value < 0. 05). Both cryopreservation and lyophilization affect extracellular matrix of human amniotic membrane which can determine the rate of the adhesion of endothelial cells to amniotic membrane. Lyophilized amniotic membrane is a better choice for culture of endothelial cells in vascular tissue engineering.

Acute myocardial infarction (AMI) is the most serious and fatal form of coronary heart diseases. Despite advances in diagnosis and management، acute myocardial infarction continues to be a major health problem in the industrialized world and significantly is rising in developing countries. Various epidemiological studies have been conducted in order to investigate the causes of dramatic increasing of the heart diseases. This study was conducted to evaluate the epidemiology of myocardial infarction by age، sex، type of infarction، risk factors، and early mortality in patients with Acute MI in Seyed al-Shohada hospital in Urmia.

This descriptive study was a retrospective analysis being conducted by referring to the 268 patient records (182 male (67. 9%) and 86 female (32. 1%)) with a diagnosis of acute myocardial infarction in the first six months of 2011 in the Educational hospital of Seyed al-Shohada in Urmia. These patients were hospitalized with the above diagnosis; and during their hospitalization، the incidence of myocardial infarction، increased cardiac enzymes CK-MB and Troponin were considered. Then the required data were extracted from their files and were evaluated by descriptive statistics (frequency).

The results showed that acute myocardial infarction in females (33. 72%) and smokers (64. 1%) were more prevalent. After that hypertension (63%) was prevalent. Also، infarction of lower area of the heart (Inferior) was more common (45. 5%). And the mortality rate in the hospital was 7. 1%.

Heart disease in male smokers and patients with high blood pressure is common، in both cases with extensive cultural activities and expanded public awareness can be prevented. Effort toward reform of major risk factors is of more importance in our society. Hospital mortality، comparable to the statistics cited in previous studies suggests that appropriate treatment is offered in Seyed al Shohada hospital in Urmia.

White lesions of the oral cavity are important since they can be one of the manifestations of oral cancer. In addition، the most common precancerous lesions of oral cavity are white lesions. The aim of this study was determining the frequency of white lesions and rate of dysplastic changes in patients referring to Oral Pathology Department، Tabriz، Iran. In this descriptive-cross sectional study، patient records from the archive of the Oral Pathology department during 2006-2011 were reviewed for diagnosis of oral white lesions. The data were analyzed using descriptive statistical methods، chi-square test، and t-test with SPSS 15 statistical software. In 73 of the 808 individuals (9%)، oral white lesions were detected. Buccal mucosa and tongue was the most common site; and lichen planus was the most common lesion. Dysplasia was reported in 7 cases (9. 6%) of white lesions that included 6 leukoplakia. Six squamous cell carcinoma and one verrucous carcinoma were reported. 69. 2% of dysplastic and neoplastic lesions were in the tongue. The mean age of dysplastic and neoplastic cases was higher than the others. Oral white lesions should be examined for neoplastic changes especially tongue lesions and older patients'' lesions.

Postanesthetic shivering can be treated with many types of drugs. Treatment with ketamine and pethidine is effective in postoperative shivering. The aim of this study was to compare the efficacy of low-dose prophylactic ketamine with that of placebo in preventing postoperative shivering. In a prospective randomized double-blind study 60 ASA I and II patients scheduled for inguinal herrniorhaphy undergoing general anesthesia were evaluated. Patients were randomly allocated to receive normal saline or ketamine 0. 5 mg/kg intravenously 5 min before complention of surgery. In all patients anesthesia was induced with sodium thiopental 5mg/kg، fentanly 2mg/kg and atracurium 0. 6 mg/kg. It was maintained with Isoflorane 1% and nitrous oxide 50% in oxygen. An investigator، blinded to the treatment group، graded postoperative shivering using a four-point scale. The two groups did not differ significantly regarding patient characteristics. The number of patients shivering on arrival in the recovery room، and at 10 and 20 min after operation is same in two groups. But the intensity of shivering was significantly low in study group in compare with control (p=0. 07). Prophylactic low-dose ketamine can reduce the intensity of postoperative shivering. Further investigations with large sample size and other type of operations were recommended.

The presence of resistant bacteria in different parts of hospitals and the problems these persistent bacteria cause in treating the patients urge the necessity of identification and precise knowledge about these bacteria and their sensitivity pattern and resistance against antibiotics. This investigation was conducted in order to determine the sensitivity pattern and resistance against antibiotics in isolated microorganisms from hospitalized patients. This is a descriptive sectional investigation which was conducted from January 2009 to January 2011 in Taleghani Hospital in Urmia City and the cultured samples of patients from different parts of the hospital including urine، blood، phlegm، ulcer، discharge، etc. sent to the laboratory were investigated. In order to determine antibiogram disk agar diffusion (DAD) method was used، positive cultures were extracted and their results regarding the type of bacteria and antibiogram results were recorded in the experiment paper. The gathered data were analyzed using SPSS-20 software. From all cultured samples in two years، 964 samples were reported and 640 samples were from hospitalized patients from different parts of the hospital from which 48. 4% of the samples were from the male patients and 51. 6% from the female patients; and age average of the patients was 60 years and the age range of the patients was from 12 to 99. The highest sensitivity among all samples belonged to vancomycin (more than 90%). and the highest resistance belonged to cephalexin، erythromycin and cefixime (more than 70%). The most common bacterium and the most sensitive antibiotic (with ignoring vancomycin) were as follows، in urine samples: E. Coli 57. 9%، nitrofurantoine – blood: negative staph coagulase 33. 5%، rifampin – discharge: staph. aureus 38. 6%،imipenem– ulcer: staph. aureus 38. 6%، nitrofurantoin and co-trimoxazole – sputum: acintobacter 45. 5%، rifampin. The results of this research shows extensive increase in the resistance of the bacteria compared to common antibiotics the reason of which may be irregular consumption and prescription of antibiotics، so it is advised that more care shall be used in choosing antibiotics for the treatment and its prescription. Also، precise determination of antibiotic sensitivity pattern needs more extensive investigation with more samples in different treatment centers.

Antioxidant agents are beneficial on diabetes mellitus. Berberis Integerrima root extract has been proved to possess antioxidant activity. This study was conducted to investigate the effect of the aqueous extract of Berberis Integerrima root on carbohydrate metabolism and morphology of pancreas in STZ induced diabetic rats. Forty male rats were divided into 5 groups of 8 as follows: 1- Group normal (N). 2- Group Normal+barberry (N+B)، 3- Diabetic (D) 4- Group diabetic+barberry (D+B) and 5-diabetic+glibenclamide. The experim ental groups received Barberry root extract (500 mg/kg bw) or glibenclamide (0. 6 mg/kgbw) by gavage for 6 weeks. At the end of the experiment، rats sacrificed by decapitation and fasting blood samples were collected from cervical vein and serum levels of glucose and insulin were measured with commercial kits by spectrophotometery and elisa، respectively. The pancreas of rats were removed and fixed and after tissue processing stained with H&E for light microscopic investigations. The results showed that berberis integerrima root extract (500 mg/kg/w) caused a significant decrease (p<0. 01) in glucose serum level and significant increase (p<0. 01) in insulin levels were compared to the diabetic group. Also Berberis Integerrima root extract caused a significant increase (p<0. 05) in islets average diameters and numbers of islets. Berberis integerrima root extract has hypoglycemic effect by increasing insulin secretion and improvement of the pancreas.

This research was conducted to study the efficacy of quality of life group training on happiness and vitality of aged men. The research method was semi-experimental with pre-post test and a control group. The samples consisted of 30 aged males who referred to Retiree’s Center in Ahvaz and one standard deviation below the mean in happiness scale was acquired from them. They were matched according to age، educational status، and other criteria considered in this research. Then randomly divided into two groups as experimental and control group. We used 8 sessions of quality of life group trainings in the experimental group but the control group didn’t receive any intervention. The instrument was Oxford Happiness Inventory. The results revealed that there was a significant difference between two groups in happiness and vitality (P<0/001). The rate of happiness and vitality in the experimental group compared with pretest and control group was significantly higher. According to the results of this research، quality of life training as the combined of positive psychology and cognitive behavioral therapy can increase the rate of happiness of aged men.

Diabetes mellitus type 2 (formerly noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes) is a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulindeficiency. Mental health promotion in accordance with its central role in health care is in focus. Given that diabetic patients have improper lifestyles and suffer from the upper levels of depression، the aim of this study is therefore is to determine theeffectiveness of cognitive-behavior therapy on reducing of the level of depression and improving the life style of patients with type 2 diabetes. a statistical sample، 30 people with type 2 diabetes mellitus patients of Salmas City that were available for sampling methods selected and tested randomly in two groups (15 people) and the control group (n = 15) were appointed. The tools used in this study، the Walker and lifestyle questionnaire surveys، Beck Depression inventory. Experimental Group exposed tothe independent variable (cognitive behavior therapy) a 90-minute session for 12 session. Research design was pre- post-test with control group and data analyzed by Multivariate analysis of covariance (MANCOVA) Single-Factor Analysisofcovariance - ANCOVA). the results showed that cognitive-behavioral therapy can change life style of patients with type 2 diabetes in their self-actualization، accountability، interpersonal relationships، nutrition، physical activity and stress management (p <0/001) and reduce depression (p <0/001) Finally، it can be stated that regular cognitive-behavioral treatments can improve lifestyle oftype 2 diabetic patients and reduce depression among them.

Autism is a neurodevelopmental disorder with associated cognitive deficits. Some of these deficits such as face recognition deficit have been reported in siblings of children with autism. This study was conducted on twenty (6-14 y/o) siblings of children with autism referring to child and adolescence clinic of Roozbeh hospital in Tehran in 2008-2009 and twenty (6-14y/o) health school students. Psychiatric disorders were diagnosed by a psychiatrist، and K_SADS_PL semi-structure interview in both group. And autistic spectrum symptoms were gathered and then evaluated by with CARS questioner، IQ scores with Raven''s tests، and Benton face recognition test. Results of this study showed that there is no significant difference in face recognition test responses between two groups. But sex and age had a positive correlation with face recognition ability. Deficit in face recognition may be an endophenotype of autism but this study does not demonstrate it.

Ethanol produced from plant cellulose is called bioethanol and is recognized as a unique sustainable liquid fuel with powerful economic and environmental effects. In the present study we aimed at integrate a cellulase gene in to yeast genome to have the enzyme secreted out of the cell. Subsequently cellulose is depredated to glucose by the enzyme، and then it is ferment to ethanol. Using site directed mutagenesis، one of free cysteines was replaced by a valine residue. The gene with codon optimization in respect to pichia pastoris was sub-cloned in to cloning plasmid، then for amplification it was transformed into E. coli. The plasmid was extracted and excised by restriction enzyme and then was sub-cloned in to expression vector. In the next step using electroporation، gene was transferred in to yeast and recombinant protein was expressed. Enzyme properties like temperature and pH optimum، specific activity، specific constant، and thermostability survived were assessed. Applied mutation did not have any effect on features like pH and temperature optimum but it led to an improvement in catalytic efficiency and thermostability. The mutant enzyme has better properties for industrial application.

Pharmaceutical products، particularly antibiotics، due to their cumulative and inappropriate effects and creating drug resistances، as inevitably pollutants، have been created a major concern in environmental control. Metronidazole (MTN) is one of these antibiotics. Hence، the aim of this study was investigation of MTN removal efficiency by catalytic ozonation process (COP) in presence of produced magnesium oxide nanocrystals as catalyst. The influences of several operational factors for their effects on removal were evaluated، including solution pH (3-12)، reaction time، MgO dosage (0. 25-4 g/L) and initial MTN concentration (1-40 mg/L). Also degradation kinetic، biodegradability improvement and mineralization rate were studied for the COP. For degradation kinetic the best compatibility was with pseudo-second order (liner type II) model. The optimum pH and MgO dosage for COP were determined to be 10 and 0. 25 g/L، respectively. Under optimum condition the complete removal of 40 mg/L MTN solution was observed after 20 min. The results illustrate that MgO nanocrystals markedly accelerated the MTN degradation in and the COP significantly increased BOD5/COD ratio and caused 94% MTN mineralization.