مجله علمی دانشگاه علوم پزشکی کردستان
سال هجدهم شماره 4 (پیاپی 70، زمستان 1392)

Improvement of antioxidant capacity and lessening the concentration of inflammatory markers by physical activity and exercise has received a lot of attention by researchers. The present study was performed to assess the effects of moderate- intensity resistance exercise training on total antioxidant capacity (TAC)، creatine kinase activity (CK)، resting levels of interleukin-6 (IL-6) and interleukin-1beta (IL-1β). 20 healthy volunteer men participated in the study and assigned randomly to resistance training (RT) (n=10) and control (n=10) groups. Blood samples were obtained from antecubital vein in pre and post-test steps. Then activity of CK and alterations in the plasma levels of TAC، IL-6 and IL-1β were measured. The subjects commenced resistance training on alternate days (3 days/week) for eight weeks using 65 to 70% of their one repetition maximum (1RM). Considering groups × time interaction، no significant differences were found in the variables of CK (P=0. 321)، TAC (0. 523)، IL-6 (P=0. 085) and IL-1β (P=0. 11) between RT and control groups after eight weeks of training. However، we found that CK activity and TAC increased insignificantly in RT in the post test step. We concluded that moderate- intensity resistance exercise training for eight weeks could not increase plasma antioxidant capacity and did not change inflammation factors. However، it seems that this protocol did not produce any significant change in oxidative stress and it did not lead to increased basal concentration of cytokines such as IL-6 and IL-1β.

Respiratory distress syndrome due to lack of enough surfactant in fetal lung tissue is a common cause of neonatal mortality. There are several laboratory methods to predict the amount of fetal lung surfactant. The purpose of this study was to compare lamellar body count test (Quantitative test) and gastric aspirate shake test (Qualitative test) for prediction of the amount of pulmonary surfactant in premature neonates. This descriptive- analytic study was performed between August 2012 and January 2013 for 6 months and included 150 premature infants with gestational age of less than 34 weeks، born in Imam Reza (AS) Hospital، in Kermanshah. In this study، both gastric aspirate shake test & lamellar body count test were performed for all infants simultaneously. Using nasogastric tube we aspirated at least 2. 5 cc of gastric secretions within the first hour of birth. For gastric aspirate shake test we added 0. 5 cc normal saline and 1cc 95% ethyl alcohol to 0. 5 cc of amniotic fluid and shook the test tube well for 15 seconds. Then، we counted the bubbles formed on the surface of the test tube. A cell counter (Sysmex model Xt-1800i) was used to determine the lamellar body counts. We used ROC Curve and kappa coefficient for data analysis. Of 230 samples، 80 were excluded from the study because of contamination with blood or meconium. Finally، 150 samples were analyzed. 59 cases (39/3%) had respiratory distress syndrome. The respective values of sensitivity، specificity، positive and negative predictive values for diagnosis of respiratory distress syndrome were 62. 7%، 100%، 80. 5% and100% for gastric shake test، and 98. 3%، 94. 5%، 98. 9% and 92. 1% for lamellar body count test. Lamellar body count، is a useful test for screening of respiratory distress syndrome and gastric aspirate shake test is also a suitable test to rule out respiratory distress syndrome. By using these 2 tests، we can expect appropriate sensitivity and specificity in the diagnosis of respiratory distress syndrome.

Cardiovascular diseases (CVD) are among the most important causes of death and disability all around the world. Blood cells، especially platelets، may play a crucial role in pathophysiology of these disorders. Considering the increased risk of thrombosis after acute physical activities، and the role of the platelets in these disorders، many nutritional approaches had been evaluated for the prevention of thrombosis. Recently، the effects of cocoa consumption on hemostasis have recently attracted the attention of many researchers. In this study we evaluated the effects of cocoa consumption on platelet count، mean platelet volume (MPV)، and platelet distribution width (PDW)، during one session of incremental exhausting aerobic exercise in male soccer players. This semi-experimental study included 20 healthy volunteer male soccer players (age: 22±1years; BF%: 22. 5±1. 2; VO2max: 52. 6±1. 5 ml. kg-1. min). After written consent، all subjects performed Bruce Test within two successive weeks. After the first blood sampling (stage one)، 0. 5 mg/kg of placebo (0. 5 g cocoa powder in 300 ml of 4% sucrose solution) or cocoa solution (18. 75 g cocoa powder in 300 ml 4% sucrose solution) was randomly given to the subjects. All cases performed Bruce Test two hours later. Blood samples were collected just before Bruce Test (second stage)، immediately after Bruce Test (third stage) and 1 hour after Bruce Test (fourth stage). After preparation of peripheral blood smears، platelet count، MPV and PDW were measured by Mindray cell counter. Using spss 16، data were analyzed by means of two-factor analysis of variance (ANOVA) and Bonfferoni test at the level 0. 01. Our results indicated a significant decrease in platelet count، MPV، and PDW after cocoa consumption (P<0. 01). In addition، there was a significant difference between the 2 groups in these values after Bruse Test (P<0. 01). However، in spite of significant increase in platelet count، MPV، and PDW after Bruse Test، cocoa consumption 2 hours before the test decreased these values significantly (P<0. 01). Cocoa consumption before exhaustive physical exercises may prevent exercise induced increase in the platelet indices; hence، potentially can prevent cardiovascular and thrombotic events and sudden death in the athletes.

Despite the availability of antipsychotic drugs، a large number of patients with schizophrenia do not show a good response to monotherapy with these drugs. In this study we evaluated the effect of purslane on psychologic symptoms and malondialdehyde (MDA) level in schizophrenic patients in Sina Hospital. This randomized clinical trial study was carried out on 60 chronic schizophrenic patients treated with risperidone in Sina Hospital in Joneghan، Iran between 2011 and 2012. Patients were randomly divided into intervention and control groups. The control group received risperidone 6mg/day and biperiden 4mg/day for 8 weeks. The Patients in the intervention group received 1g extract of purslane daily in addition to risperidone and biperiden for 8 weeks. The scales for assessment of positive symptoms (SAPS)، assessment of negative symptoms (SANS) and MDA level were recorded at the baseline and at the end of the 8th week of study. Data analysis was performed by using mean، SD، student t-test and paired t- test. At the end of the study، the respective mean scores of positive symptoms were 47. 93±18. 56 in the intervention and 57. 1±14. 83 in the control group (P<0. 05)، and the mean scores of negative symptoms were 40. 83±11. 03 in the intervention and 46. 13± 9. 34 in the control group (P<0. 05). In addition، the MDA levels of the patients in the intervention and control groups were 3. 25±1. 25 and 5. 43± 1. 76 respectively (P<0. 05). According to findings of this study، simultaneous use of purslane and respridone can lead to improvement of psychological condition and decreased MDA level in the patients with chronic schizophrenia.

Cholecystectomy is one of the most common surgical procedures and laparoscopy is often preferred. Cholecystectomy is indicated in diabetic patients with gall stones because of higher risk of this condition even in asymptomatic patients. In this study we compared open and laparoscopic cholecystectomy in diabetic patients. This randomized controlled trial was performed in Imam Reza Hospital in Kermanshah from 2010 to 2012. 124 diabetic patients with confirmed diagnosis of symptomatic biliary stones were randomly assigned to two equal groups. 62 patients underwent open cholecystectomy and laparoscopic cholecystectomy was performed for 62 patients. Both groups were similar in relation to distribution of age، sex and BMI. The duration of laparoscopic surgery was longer than the duration of open cholecystectomy and this difference was statistically significant (p< 0. 0001). The duration of hospitalization was longer in open group (p< 0. 001). The costs of treatments did not show any significant statistical difference between the groups. The incidence of injury to biliary ducts was equal in both groups (p =0. 99). Considering lower morbidity and shorter duration of hospitalization، laparoscopic cholecystectomy is a safe procedure and is the surgical method of choice for cholecystectomy in diabetic patients with symptomatic biliary stones.

Pneumothorax is the most common pulmonary air leak syndrome which occurs more frequently in the neonatal period than any other time of life. Mechanical ventilation with positive pressure is one of the most common causes of this condition. The aim of this study was to evaluate pneumothorax risk factors in mechanically ventilated neonates admitted to neonatal intensive care unit (NICU) of Besat Hospital in Sanandaj. This was a nested case-control study. Case group were neonates under ventilation with pneumothorax admitted to NICU between April 2012 and March 2013. Control group included neonates under ventilation without pneumothorax whose admission times followed in the immediate chronology to the case group. 31 cases and 62 controls were selected. Data collection was performed by use of medical records and ventilator memory in the last 24 hours. The data were introduced into SPSS software. Analysis of qualitative variables was performed by chi-squared and Fisher test. We used Mann Whitney U test for analysis of quantitative variables and logistic regression in order to control confounders. 61. 3% of newborns with pneumothorax were male and 38. 7% female. 61. 3% of these neonates were born by Cesarean section and 38. 7% by vaginal delivery. Their mean gestational age was 32 weeks and the mean birth weight was 1819 g. 74% of cases had pneumothorax in the right side، 13% left side and 13% bilaterally. Hyaline membrane disease (HMD) was the most common underlying disease (74. 2%) in the newborns with pneumothorax. 38% of neonates under pressure controlled ventilation developed pneumothorax compared to 7. 1% of neonates under synchronized intermittent mandatory ventilation (SIMV)، which showed a significant difference (p=0. 03). Ventilator parameters associated with higher risk of pneumothorax were more episodes of ventilator adjustments (P<0. 001)، high peak inspiratory pressure (p<0. 001)، high positive end expiratory pressure (p=0. 029) and high mean airway pressure (p<0. 001). In general pneumothorax risk factors in mechanically ventilated neonates in our investigation were similar to those of other studies. Our findings indicated that pressure controlled ventilation more episodes of ventilator adjustments، increased peak inspiratory pressure، positive end expiratory pressure and mean airway pressure are major pneumothorax risk factors in the mechanically ventilated newborns. To prevent pneumothorax، it is necessary to avoid frequent changes of ventilator adjustments and decrease in the above mentioned parameters to the levels enough to supply lung oxygenation.

Diarrhea is recognized as one of the main causes of morbidity and mortality in developing countries. Gastrointestinal diseases can lead to death of many children of less than 5 years of age. The aim of this study was to evaluate the drug resistance pattern in Shigella toxin and non-toxin producing strains in children. In this descriptive analytic study a total of 80 Shigella strains، 60 strains isolated from stool samples of children with diarrhea from Loghman، Emam and Tebi Koodakan Centre Hospitals، and 20 national collection strains isolated and reserved during the last years. The isolates were evaluated for cytotoxin production by using cell culture technique (Hela cell). Our study included 54 strains of S. flexneri، 14 strains of S. sonnei، 10 strains of S. boydii and 2 strains of S. dysenteriae. Data were analyazed by means of chi-square and Fisher''s exact test. Of 80 strains 9 (11. 25%) showed cytotoxic effect. Chi-square test showed no significant difference between the isolated and national collection strains (P≥0. 05). There was no correlation between the cytotoxic activity and clinical symptoms such as abdominal pain، nausea، and frequency of passing stools / day، but other symptoms like fever and presence of blood in the stool had correlation with cytotoxin production. The results of this study showed that there was no significant difference in the antimicrobial resistance pattern between toxin and non-toxin producing Shigella strains isolated from the clinical samples and the standard national collection.

COPD is a common obstructive airway disease without complete reversal and is characterized by dyspnea، cough and sputum production. In spite of improvements in therapeutic measures، a considerable number of patients fail to achieve the treatment goals. Discrepancy between obstructive parameters and clinical manifestations is a possible cause of treatment failure. COPD Assessment Test (CAT) is a standard method for evaluation of clinical aspects of COPD. This test has been translated into Persian. The aim of this study was to determine the reliability of Persian Version of CAT and its correlation with disease severity. In a prospective descriptive analytic study، CAT scores were determined in 100 COPD patients. After 1to2 weeks 34 patients completed the questionnaire for the second time to evaluate the reliability of Persian Version of the test. Severity of obstruction was assessed by spirometry. Based on Global initiative of Lung Disease (GOLD) criteria، patients were categorized into 4 groups. Correlation between CAT scores and disease severity was evaluated. The mean age of the patients was 62± 5. 2SD years. Cronbach''s alpha index of the Persian Version of CAT was. 0 879. The mean score was 25. 85 (± 8. 93) at the test and 25. 67 (±8. 73) at the retest session. The intragroup reliability of the test and retest and also correlation among all questions were significant. (P<0. 001) There was a significant correlation between categorization based on severity of obstruction and categorization according to the test score. Persian version of CAT is a reliable tool for COPD assessment and has a good correlation with disease severity associated with the obstruction of the airways.

Stress can negatively affect nurses’ general health from psychiatric point of view. Therefore، use of preventive approaches for stress management should be considered necessary. The aim of this study was to determine the effect of stress inoculation program on nurses’ general health in psychiatric ward. This experimental pre-test post-test study included 60 nurses and healthcare workers، in Ebne-Sina Psychiatric Hospital in Mashhad. The most important inclusion criteria were: employment in Ebne-Sina Hospital in the last 6 months and not being off work for more than 2 weeks during the last month. Also the most important exclusion criteria were: missing at least 10% of the time of workshop sessions and experiencing serious stress during the study. General Health Questionnaire (GHQ-12) was used for data collection which was completed at the baseline، at the end of the study and 1 month after the intervention. Stress inoculation program included two workshops at one weak interval. Each workshop aimed at reconceptualization، acquisition and application of the skills for 4 hours. S. I. P increased general health scores from 35/5 ± 3/4 at the baseline to 38/0 ±4/4 after intervention and 39/3 ±3/3 after 1 month of intervention which showed a significant rise in the score (p<0/005). In the control group the general health score decreased significantly after intervention and also 1 month of intervention in comparison to the baseline score (p<0/005). Based on our results، S. I. P is applicable and beneficial for the improvement of the nurses’ general health.

There is limited information regarding the effects of knee bracing on plantar pressure variables. The aim of this study was to determine the immediate effects of a supporting patellar brace on plantar pressure variables in healthy females during stance phase of gait. 17 women (age: 22. 3 ± 1. 31 years) participated in this study. Plantar foot pressure of the subjects was measured by foot scan pressure plate while walking barefoot with and without wearing supporting patellar brace. Dependent t-test was used for data analysis. P≤0. 05 was considered significant. Peak plantar pressure was delayed during initial heel contact while using supporting patellar brace (P=0. 026). In regard to the distribution of pressure، no significant difference was found in the ten regions on the plantar surface when subjects walked with and without brace (P>0. 05). The center of pressure displacement (COPx) was more during propulsion phase of gait while using knee brace (P = 0. 01). The results of this study indicated that bracing could influence lower extremity function by delaying peak plantar pressure and consequently provide dynamic stability of the knee joint during stance phase of gait. Further studies are needed to advance our understanding of the effects of bracing on plantar pressure variables during gait.

Estimation abilities are used in everyday life to solve problems for which the answers are not readily available. The goal of this study was to assess cognitive estimation in patients with major depressive disorder (MDD)، patients with Alzheimer’s disease (AD) and normal individuals. Method and Materials: In this study we used convenience sampling method. Diagnostic and inclusion criteria were determined. The subjects were assigned to three groups including patients with major depressive disorder (MDD)، patients with Alzheimer’s disease (AD) and normal individuals (n=25). We assessed the subjects by Cognitive Estimation Test (CET). Data was analyzed by multivariate analysis of variance (MANOVA). Our results showed that both patient groups had impaired cognitive estimation in all dimensions and higher total scores in comparison to normal individuals. Alzheimer patients showed a high performance impairment in all cognitive estimation dimensions and had higher total scores compared to the patients with major depressive disorder. The findings of this study supported impairments in general knowledge and other executive functions in patients with major depressive disorder (MDD) and patients with Alzheimer’s disease (AD).

The purpose of this study was to investigate the effect of an assertiveness training program on medical students’ shyness. This study is a semi-experimental one with pretest and post-test. We used convenience sampling method. Our intervention group included 50 second semester medical students of Kurdistan University who participated in assertiveness skills training course for 4 weeks. Control group consisted of second semester students of Kermanshah University who had not passed any course on assertiveness skills training. Cheek & Briggs Shyness Questionnaire was used for evaluation of both groups. For data analysis we used analysis of covariance. Experimental group included 19 men and 31 women and control group consisted of 20 men and 30 women. Both groups were similar in regard to the mean scores of the pretest. But the mean scores of the post-test in control and experimental groups showed a significant difference which indicated that life skills training could be beneficial for the students to overcome their shyness significantly (p=0.001). The results of this study showed that training of assertiveness skills could be helpful to the university students to control their shyness. Short term training of assertiveness skills is recommended for the school and university students.

Nowadays، Back pain as a multi-causal phenomenon is considered a major problem in most communities. It may be caused as a result of various factors such as: psychological، social and ergonomic sicknesses. There is no available exact statistical report on the prevalence of back pain in Iran. The aim of this study was to estimate the-life time prevalence of back pain in Iran using systematic review besides meta-analysis. Method of analysis: Twenty research papers were obtained using the keywords «prevalence of low-back pain and back pain» through the nationally available databases of Magiran-MEDLIBE-SID-IRANMEDEX and English databases of Pubmed - Google Scholar-Scopus. Analysis of data''s was performed using meta-analysis (random model effects). Heterogeneity among the studies was investigated using the I2 test.

The prevalence of life-time back pain with a sample size of 5670 patients in all the 20 papers estimated 51 % (95% CI: 40/1-61/8). Prevalence of lifetime back pain among the medical staff with an average of 54/6% (95% CI: 42/9-66/3) was more than that the other social groups. The highest and lowest prevalence rates of back pain were observed in Mazandaran and Southern Iran، with an average of 84/1% and 13%، respectively. The highest prevalence went for the age groups of 15-45> with an average of 54/2% (95% CI: 42/6-65/9).

The findings indicated that back pain must be considered a social problem. Therefore the health authorities are asked to inform people through media and other communicative means of approaches to prevent and decrease the possible outbreak of such a disease.

Total number of fungal species has been estimated over 1. 5 million، of which less than 10 percent have formally been described. Advances made in molecular biology، development of gene and genome sequence technologies، discovery and description of new species among different clusters of life، especially fungi، has been accelerated. With respect to the failure of morphological-based species recognition methods for fungi identification، use and application of DNA based identification methods have assumed great importance for rapid and accurate identification of fungal species. DNA barcoding is of central importance among the new approaches for the identification of fungi and pseudo fungi and has been used during the last 10 years. For fungi، the internal transcribed spacer region of ribosomal DNA (ITS-rDNA) has become an appropriate barcode. Efficacy of ITS-rDNA sequence data in successful identification of fungal species has resulted in general agreement among mycologists to use ITS-rDNA region as a gold standard barcode for fungi. However، it seems that ITS-rDNA region will be used as the primary barcode for identification of fungal species and accurate identification will further be performed by use of sequence data from the other genomic loci as secondary barcodes. Considering the pleomorphic nature of the fungi، use of DNA barcoding has assumed higher importance. Hundreds of thousands of reference barcodes have been generated for a great number of species by DNA barcoding projects. Scientists now are facing new challenges for barcode data management، facilitation and acceleration in species identification process using DNA barcodes by the end-users through automation of DNA barcoding system.