فهرست مطالب

Red Crescent Medical Journal - Volume:16 Issue: 2, Feb 2014

Iranian Red Crescent Medical Journal
Volume:16 Issue: 2, Feb 2014

  • تاریخ انتشار: 1392/10/30
  • تعداد عناوین: 29
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  • Farhang Babamahmoodi, Abdolreza Babamahmoodi, Babak Nikkhahan Page 10120
    Introduction
    Mycobacterium marinum infection is the most common nontuberculous mycobacterial skin lesions. It results from skin injury and contact with contaminated water, fish, or shellfish; its infections have low frequency, nonspecific symptoms and lack of specific identification methods that can alter correct diagnosis.This study designed about cases that reported from Iran and comparing their presentation and clinical sign and symptom and outcome..
    Case Presentation
    We find and evaluate three cases that have been reported in indexing sites (PubMed, Google scholar and Iranian indexing databases) since 1980 till end of 2012. Using combinations of the following keywords: “Mycobacterium marinum,” “Iran”, “atypical mycobacterium”, “Sporotrichoid presentation” and “fish tank granuloma”. Three new cases also described that infected with this organism and had Sporotrichoid presentation in 2012 in a referral hospital in north of Iran..
    Conclusions
    Totally we evaluate six patients. Source of infection in all cases were aquarium and four of six cases were male (66.6%). Occurrence to treatment interval were between one month to one year (mean 3.07 months). Infection site in all of them were hands and dominantly in right hand (66.6 % of cases) and 83.3 % of them had Sporotrichoid presentation and all of the patients finally cured. The only cause of infection with Mycobacterium marinum in Iran is aquarium and its presence in homes and offices increased during these years. Health workers and people should be informed and warned about this disease..
    Keywords: Mycobacterium marinum, Granuloma, Iran
  • Fatemeh Nasiri Amiri *, Fahimeh Ramezani Tehrani, Masoumeh Simbar, Reza Ali Mohammadpour Thamtan, Niloofar Shiva Page 12423
    Background
    Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting up to one in every five women of reproductive age. The majority of researches on PCOS focus on its biomedical aspects, often overlooking and neglecting women’s own perceptions and experiences..
    Objectives
    This study aimed to explore women’s perception and experiences that influence their personal gender role..Patients and
    Methods
    This research is a qualitative study by conventional content analysis. Semi-structured interviews were conducted with 23 reproductive aged women with PCOS, recruited from the reproductive endocrinology research center., in-depth interviews were continued to reach data saturation. The study was carried out at the reproductive endocrinology research center of Shahid Beheshti University in Tehran All the interviews were recorded and transcribed, and qualitative content analysis of the data was conducted manually..
    Results
    Four themes were identified. Content analysis of the interviews revealed these women mainly perceived themselves with lack of physical attractiveness, loss of womanhood, interruption of sexual role and disruption of fertility potential, feelings were related to symptoms e.g. ‘excess’ hair; absent or disrupted menstrual cycle, obesity and infertility commonly experienced by women with PCOS..
    Conclusions
    Women with PCOS are challenged in their perceptions of themselves as “feminine” because of their hairy appearance, irregular menses and lack of fertility and this influences their gender roles. Medical practitioners must understand how PCOS precisely affects women’s roles and initiate management aimed at reconstructing their “womanhood”, along with their medical treatment..
    Keywords: Polycystic Ovary Syndrome, Qualitative Research, Hirsutism, Gender Identity, FemininityJavascript:FormatThis('B')
  • Simin Shamsi Meymandi, Azadeh Rezazadeh *, Ali Ekhlasi Page 12464
    Background

    Results of various studies suggest that the hypertrophic and keloid scars are highly prevalent in the general population and are irritating both physically and mentally..

    Objective

    Considering the variety of existing therapies, intense pulsed light (IPL) method along with corticosteroid injection was evaluated in treating these scars..

    Materials And Methods

    86 subjects were included in this clinical trial. Eight sessions of therapeutic intervention were done with IPL along with corticosteroid intralesional injection using 450 to 1200 NM filter, Fluence 30-40 J/cm2, pulse duration of 2.1-10 ms and palsed delay 10-40 ms with an interval of three weeks. To specify the recovery consequences and complication rate and to determine features of the lesion, the criteria specified in the study of Eroll and Vancouver scar scale were used..

    Results

    The level of clinical improvement, color improvement and scar height was 89.1%, 88.8% and 89.1% respectively. The incidence of complications (1 telangiectasia case, 7 hyperpigmentation cases and 2 atrophy cases) following treatment with IPL was 11.6%. Moreover, the participants’ satisfaction with IPL method was 88.8%

    Conclusions

    This study revealed that a combined therapy (intralesional corticosteroid injection + IPL) increases the recovery level of hypertrophic and keloid scars. It was also demonstrated that this method had no significant side effect and patients were highly satisfied with this method..

    Keywords: IPL, Keloid, Hypertrophic
  • Hassan Rahimi Shorin, Mohammad Azizbeig Mohajer, Ali Parsa, Amin Azhari, Maryam Assadian Page 12579
    Introduction
    Incidence of nerve injury in traumatic hip dislocations is up to 10 %. Sciatic nerve is the most common injured nerve in this setting. In the medical literature, there are few documented cases of femoral nerve injury following hip dislocations..Case Report: We report a 44-year-old man with right femoral nerve palsy following delayed reduction of an anterior dislocation of hip..
    Conclusion
    Two months after closed reduction, complete clinical recovery of right femoral nerve was achieved and the patient was able to resume his job..
    Keywords: Dislocation, Hip, Femoral Neuropathy
  • Hakan Yabanoglu, Kenan Caliskan, Huseyin Ozgur Aytac, Emin Turk, Erdal Karagulle *, Fazilet Kayaselcuk, Mehmet Akin Tarim Page 12931
    Background
    Diseases and tumors of the appendix vermiformis are very rare, except acute appendicitis..
    Objectives
    This retrospective study was conducted to document the unusual findings in appendectomy specimens..Patient and
    Methods
    Data of 1466 adult patients were gathered retrospectively. Appendectomy was performed in 1169 and in 297 patients following a diagnosis of acute appendicitis and during other abdominal operations, respectively. The data of 57 (3.88 %) patients who were pathologically reported to have unusual appendix findings were retrospectively collected. The records were analyzed according to patients’ age, gender, clinical presentations, operative reports, pathological reports and follow up..
    Results
    Unusual pathologic examination findings were detected in the appendectomy specimens of 57 patients with a mean age of 48.34 ± 19. Twenty-nine patients (50.8 %) were male and 28 (49.2 %) were female. Normal appendix tissues were observed in specimens of 26 (45.6 %) patients and inflamed appendix in 31 (54.3 %). The most common unusual finding was parasitic diseases of the intestine. Pathological diagnosis of malignancy and benign features were reported in specimens of 14 and 43 patients, respectively. Macroscopic evaluation of appendectomy specimens during surgery might result in negligence of the presence of unusual pathology..
    Conclusions
    Even if the macroscopic appearance of the specimen is normal or acute appendicitis, we suggest routine histopathological examination..
    Keywords: Appendectomy, Appendiceal Neoplasms, Enterobius, Entamoeba Histolytica
  • Nima Mirzaei *, Talat Mokhtari Azad, Rakhshandeh Nategh, Hoorieh Soleimanjahi, Nour Amirmozafari Page 13176
    Background
    Sequence variations in glycoproteins of influenza virus surface impel us to design new candidate vaccines yearly. Ectodomain of influenza M2 protein is a surface and highly conserved protein. M2e in influenza vaccines may eliminate the need for changing vaccine formulation every year..
    Objectives
    In this study, a recombinant baculovirus containing M2e and cholera toxin subunit B fusion gene was generated with transposition process to express in large amounts in insect cell lines..
    Materials And Methods
    M2e-ctxB fusion gene was created and cloned into pFastBac HT. The recombinant vector was transformed into DH10Bac cells to introduce the fusion gene into the bacmid DNA via a site-specific transposition process. The recombinant bacmid was then extracted from white colonies and further analyzed using PCR, DNA sequence analyzing, and indirect immunofluorescence assay..
    Results
    PCR and DNA sequence analyzing results showed that the fusion gene was constructed as a single open reading frame and was successfully inserted into bacmid DNA. Moreover, indirect immunofluorescence results showed that the fusion gene was successfully expressed..
    Conclusions
    Baculovirus expression vector system is valuable to produce M2e based influenza vaccines due to its simple utilization and ease of target gene manipulation. The expressed protein in such systems can improve the evaluating process of new vaccination strategies..
    Keywords: Influenza Vaccines, Baculovirus, Cholera Toxin Subunit B
  • Hassan Soleimanpour, Ali Taghizadieh, Rasoul Salimi, Samad Ej Golzari, Ata Mahmoodpoor, Saeid Safari, Robab Mehdizadeh Esfanjani, Yaghoub Heshmat Page 13326
    Background
    Patients with Chronic Obstructive Pulmonary Disease (COPD) are susceptible to respiratory failure which would ultimately lead to their hospitalization. Need to Non-Invasive Ventilation (NIV) is considered as the choice respiratory support in acute respiratory failure and is associated with a beneficial role in patients with COPD exacerbation. Hence, determining patients that would benefit NIV could be of great assistance..
    Objectives
    We aimed at evaluating the use of Rapid Shallow Breathing Index (a ratio determined by the frequency (f) divided by the tidal volume (VT)) in NIV requirement in COPD patients..Patients and
    Methods
    In a prospective descriptive study, ninety eight patients over 40 years old with documented COPD exacerbation who were referred to emergency department of Imam Reza hospital, Tabriz, Iran were studied. Rapid Shallow Breathing Index (RSBI), ABG parameters and APACHE II scoring were measured in each patient. Quantitative data were analyzed by Student''s t-test and One-way ANOVA and qualitative data were analyzed using chi square (X2). Findings were analyzed with SPSS software version 16..
    Results
    Patients requiring NIV included 43.9 % of all studied patients. RSBI and APACHE II score with sensitivity of 94.8 %, (cut off point = 110) and 72 % (cut off point = 14) respectively, had high diagnostic sensitivity and also the ability to predict patients requiring NIV. None of ABG parameters solely played a significant role in determining patients requiring NIV..
    Conclusions
    RSBI and APACHE II score in patients with COPD exacerbation are of the ability to predict NIV requirement, as a predicting factor of Non-Invasive Ventilation requirement..
    Keywords: Noninvasive Ventilation, Blood, APACHE II
  • Abdolrahim Nikzamir, Alireza Palangi, Alireza Kheirollaha, Hashemi Tabar, Alimohamad Malakaskar, Hajieh Shahbazian, Mohammad Fathi Page 13426
    Background
    In diabetes mellitus because of the absence or insufficient sensitivity to insulin, glucose transporter protein in cell membrane, glucose transporter 4, is decreased. GLUT4 is the major glucose transporter in skeletal muscle and adipose tissue, which is under control of insulin. It remains, however, unclear whether cinnamaldehyde plays a regulatory role(s) or not..
    Objectives
    The objective of this study was to investigate the effects of cinnamaldehyde on GLUT4 gene expression..
    Materials And Methods
    This study was an experimental trial. Tests were performed in triplicates. This study examined effects of cinnamaldehyde on Glut4 gene expression in C2C12 skeletal muscle cells by using Real Time PCR. C2C12 myoblasts were cultured in DMEM + 10 % FBS. After differentiation of myoblasts to myotubes, the cells were serum deprived for 5 hours and then treated with 10, 20, or 50 µM of cinnamaldehyde for 1 hour..
    Results
    Our data revealed a significant increase in the expression of Glut4 in cinnamaldehyde treated cells. In addition, GLUT4 mRNA level was increased in a dose dependent manner. Analyses were performed using the SPSS 16 for Windows software. Differences between the groups were determined by one-way ANOVA..
    Conclusions
    These results demonstrate that cinnamaldehyde up regulates the expression of mouse skeletal muscle GLUT4 gene expression..
    Keywords: Glucose Transporter type 4, Cinnamaldehyde, Real, Time Polymerase Chain Reaction, Diabetes Mellitus, Insulin
  • Mehdi Javanbakht, Alireza Mirahmadizadeh, Atefeh Mashayekhi Page 13484
    Background
    Chronic infection with hepatitis C virus (HCV) is increasingly recognized as a major global health problem. Illicit injection drug use is an important risk factor for the rising hepatitis C virus (HCV) prevalence in IR Iran..
    Objectives
    The objective of this study was to determine the long-term effectiveness (total quality adjusted life years (QALYs) gained) of methadone maintenance treatment (MMT program) in prevention of HCV infection among injecting drug users (IDUs)..
    Materials And Methods
    A number of Markov models were developed to model morbidity and mortality among IDUs. The input data used in modeling were collected by a self-reported method from 259 IDUs before registration and one year after MMT and also from previous studies. One way and probabilistic sensitivity analyses were done to show the effects of uncertainty in parameters on number of life years and QALYs saved. The expected consequences were estimated using a life-time time horizon for the two strategies including implementation and not implementation of the MMT program..
    Results
    Our model estimated that total number of discounted life years lived per IDU with and without the MMT program would be 5.15 (5.05 - 5.25) and 4.63 (4.42 - 4.81), respectively. The model also estimated that total number of discounted QALYs lived per IDU with and without the MMT program would be 4.11 (3.86 - 4.41) and 2.45 (2.17 - 2.84). Simulation results indicated that all differences in life years and QALYs lived between the two strategies were statistically significant (p < 0.001). Based on our model, total discounted life years and QALYs saved in a cohort of 1000 IDUs were 1790 (1520 - 2090) and 1590 (1090- 2090), respectively..
    Conclusions
    Considering the high prevalence of illicit injecting drug use in Iran and MMT effectiveness in prevention of HCV infection, it is necessary to develop MMT centers at regional and national levels..
    Keywords: Hepatitis C Virus_Iran_Methadone Maintenance Treatment_Quality Adjusted Life Years_Illicit Drug Users_Markov Model
  • Mohammad Bagher Minaei, Elham Ghadami Yazdi *, Mohammad Ebrahim Zadeh Ardakani, Fataneh Hashem Dabaghian, Ali Mohammad Ranjbar, Mohammad Rastegari, Ali Ghadami Yazdi Page 13565
    Introduction
    Wart is a contagious dermal disease with different types. Wart has long-term treatment with symptoms of multiple relapses, which involve larger surfaces. It has no definite medical treatment in traditional medicine and the provided treatments encounter restrictions and side effects especially in the facial warts..
    Case Presentation
    Iranian traditional medicine (ITM) has provided different, economic, and low cost treatments for warts. One therapeutic method is using Myrtus communis L. (Myrtle) topically. The goal of this study is to investigate the efficacy of Myrtle as a method of ITM. In this study, we present two patients with common warts. They are from Iran and live in Yazd. They were taken Myrtle topically on their body but not on their faces..
    Conclusions
    The facial warts of both cases have completely cured by using Myrtle. We hypothesized that Myrtle not only have antiviral effects but also may have a systemic impression. It can use topically on a part of body with influence on the other parts. Myrtle is especially useful for facial warts. These two cases highlighted a new method for treatment of common warts especially facial warts and it needs more investigations..
    Keywords: Medicine, Traditional, Warts, Myrtus, face
  • Nourossadat Kariman, Masoumeh Simbar, Fazlollah Ahmadi, Abou Ali Vedadhir Page 13629
    Background
    Decision making for timing motherhood is one of the vital aspects of reproductive health. Separating sexual relationship from having a child has led to a different and unprecedented lifestyle in human history..
    Objectives
    The objective of this study was to determine the socioeconomic and emotional factors predicting decision making for timing motherhood among Iranian women using the statistical softwares of IBM SPSS 21 and LISREL 8.8..Patients and
    Methods
    This cross-sectional study enrolled 820 primiparous women from different hospitals across the country using multistage random sampling method in 2013. The tools of the study were enrich marital satisfaction, socioeconomic status, perceived social support, hopefulness, and life regard index. The data was analyzed using SPSS 20 and LISREL 8.8..
    Results
    The results revealed that among direct pathways, marital age (β = 0.62) was the most effective predictor of timing motherhood. The hopefulness had an inverse association with timing motherhood through inverse effect of marital satisfaction. Moreover, marital satisfaction (β = -0.09), perceived social support (β = -0.09), and life regard index (β = 0.01) had an inverse effect on timing motherhood. Marital satisfaction had a non-causal effect of 0.024..
    Conclusions
    Marital age, and socioeconomic status had a direct association, and hopefulness and marital satisfaction had an indirect one with Iranian women’s decision for timing motherhood. Therefore, this is the responsibility of policy-makers and healthcare providers to advise women by providing appropriate interventions and facilities..
    Keywords: Marriage, Social Support, Hope, Social Class
  • Amal Saki Malehi, Ebrahim Hajizadeh, Kambiz Ahmadi, Parvin Mansouri Page 13812
    Background
    Pemphigus is an autoimmune bullous disease and it is unclear what triggers and deteriorates it. The current study aimed to evaluate whether increasing the IgG antibody titer represents a good indicator of the pemphigus recurrence..
    Objectives
    The current study aimed to evaluate whether increasing IgG titer is an indicator of the expected recurrence..Patients and
    Methods
    The current study was conducted at the Department of Dermatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, between March 2007 and December 2012. A total of 112 patients with confirmed diagnosis of pemphigus based on clinical, histological and immuno-histological criteria were engaged in the study. The primary outcomes of the study were recurrent event times and IgG (Immunoglobulin G) antibody titer at each attendance. Joint model with shared random-effects was applied to assess the association between the two processes and investigate the affective factors..
    Results
    Up to 8 recurrences were observed during the study time, but only 10% of the patients experienced more than 5 recurrences. A significant linear increasing trend in IgG antibody titer over time was found, IgG antibody titer increased 2.43% each month (P < 0.0001). The results showed positive correlation between IgG antibody titer and recurrence of pemphigus (P < 0.0001)..
    Conclusions
    The patients with higher IgG antibody titer were more likely to experience pemphigus recurrence. Therefore it can be concluded that titer of IgG and its increase may provide information regarding the progression of the pemphigus and the hazard of its recurrence..
    Keywords: Pemphigus, Recurrent Event, IgG Antibodies Titer, Joint Modeling
  • Mohsen Abbasnezhad, Hassan Soleimanpour, Mohamadreza Sasaie, Samad Ej Golzari, Saeid Safari, Maryam Soleimanpour, Robab Mehdizadeh Esfanjani Page 13938
    Background
    Chest pain is one of the most common causes of the admission to the emergency departments. It, however, can be due to numerous diseases some of which are life threatening..
    Objectives
    In the current study, we evaluated the prognostic value of TIMI (Thrombolysis in Myocardial Infarction) and Modified TIMI risk scores to stratify the risk for patients with atypical chest pain being discharged from the emergency department..Patients and
    Methods
    In a prospective-analytic study, we collected data from 1020 patients with atypical chest pain enrolled to the study. All eligible patients were visited by the emergency medicine residents who were trained for this study. Based on the criteria in both systems, the emergency medicine attending decided on either discharging or hospitalizing patients. Patients were allocated into 2 equal groups randomly. In order to predict the opposing accidents in 30 days (coronary revascularization, myocardial infarction, and all-cause death) TIMI risk scores and Modified TIMI risk scores were assessed based on TIMI risk score (0 or 1) and Modified TIMI risk score (0 or 1)..
    Results
    No significant difference could be observed between both groups regarding demographic characteristics, ejection fraction, left ventricle hypertrophy, TRS criteria, risk factors and the history of coronary artery stenosis. None of the atypical chest pain patients discharged based on TIMI and modified TIMI risk scores experienced any adverse events..
    Conclusions
    The results obtained from this study support the idea that the TIMI and modified TIMI risk scores might be valuable tools that could be used to stratify the risk of patients with atypical chest pain in the emergency department..
    Keywords: Thrombolysis, Myocardial Infarction, Emergency Department, Atypical Chest Pain
  • Hossein Shafeghat, Mehdi Jafari, Abbas Monavarian, Maryam Shafayi, Reza Dehnavieh Page 13983
    Background
    Labor laws and regulations have inevitable effects on employees’ work motivation as well as the overall efficiency and productivity of the organization..
    Objectives
    This study was conducted to assess the effects of the “Countrywide Services Management Law” on the work motivation level of the employees of the Iranian Ministry of Health..Patients and
    Methods
    This cross-sectional study was done in 2011 in the Iran''s Ministry of Health. Data was collected by a 51-item Likert scale questionnaire, in five domains including: organizational structure, information technology, training patterns, salary and bonus system and re-engineering process. The reliability and validity of the questionnaire was evaluated (Cronbach''s alpha= 0.96). Data analysis was conducted using descriptive and inferential statistics (t-test)..
    Results
    Out of 192 samples examined, 55.2% of the respondents were female, 88 (45.8%) had BS degree and 116 (60.4%) had less than 10 years’ experience. The mean scores in the domains of organizational structure, information technology, training patterns, salary and bonus system and re-engineering patterns were: 3.11, 3.51, 3.05, 3.21 and 3.14, respectively. Relationship between the items related to manpower in the “Countrywide Services Management Law”, with employees'' work motivation was significant (P < 0.0001). The training patterns did not show a significant relation (P < 0.26) with any of five domains..
    Conclusions
    According to our results and the views of the employees of the Iranian Ministry of Health, “Countrywide Services Management Law” positively affected the personnel''s work motivation regarding all the factors associated with motivation including: organizational structure, information technology, training patterns, salary and bonus system and re-engineering pattern. Finally, to enhance the workforce motivation and satisfaction level, application and implementation of the rules and regulations should be based on the organizational needs..
    Keywords: Health, Work, Motivation, Iran
  • Mandana Tavakkoli Kakhki, Malihe Motavasselian, Mahmoud Mosaddegh, Mohammad Mahdi Esfehani, Mohammad Kamalinejad, Mohsen Nematy Page 14151
    Background
    Considering the increasing prevalence of depression in contemporary societies, general tendency for safer treatments with fewer side effects has recently been a subject of interest..
    Objectives
    Food-based strategies, which are one of the outstanding medical solutions in complementary and alternative medicine including Iranian Traditional Medicine have been investigated..
    Materials And Methods
    In this review study, firstly some important sources of Iranian Traditional Medicine including Kamel al-Sanaat al-Tibbyyah, Al-Qanun fi al-Tibb and Zakhireh Kharazmshahi were reviewed. Next, a literature search was performed on PubMed and Magiran databases with the keywords “depression”, “depressive”, “mood”, “antidepressant”, “antidepressive”, “nutrition”, “nutritional”, “diet”, “meal”, “food”, “functional food”, “healthy food”, “healthy diet”, “Medicinal food” and scientific and English terms of all singular foodstuff and some combined foodstuff which are introduced in this paper..
    Results
    Food-based strategies for depression management in Iranian Traditional Medical resources involve both prevention and treatment means and have been classified under three headings singular foodstuffs, combined foodstuffs, and nutrition rules with the separation of prohibition and prescription items. Among the prescribed or the prohibited singular and combined foodstuffs in Iranian Traditional Medicine manuscripts, only the effectiveness of fish, garlic, milk, oregano, mint, and spinach on depression has been examined by modern medicine methods..
    Conclusions
    The presented food-based strategies in this study allow precise management for depression benefiting from Iranian Traditional Medicine Resources..
    Keywords: Medicine Traditional, Depression, Diet
  • Sousan Kolahi, Hamid Noshad, Ali Fakhari, Ali Reza Khabbazi, Mehrzad Hajaliloo, Leila Ghahremani Nasab Page 14250
    Background
    Chronic diseases are usually accompanied by psychological abnormalities. Anxiety and depression occur in a significant number of patients with rheumatoid arthritis (RA). These psychological problems are likely, to be the results of chronic physical symptoms such as pain and disability..
    Objectives
    The aim of this study was the evaluation of mental health in patients with rheumatoid arthritis in Iran..Patients and
    Methods
    One hundred women with definite diagnosis of RA were evaluated in the outpatient clinic of the Tabriz University of Medical Sciences during one year period. Activity of RA disease was determined according to the Disease Activity Score-28 (DAS-28) scaling system and mental health was evaluated using the General Health Questionnaire-28 (GHQ-28). Based on the cut of point score of 22, prevalence of psychological problems was determined and a comparison was made the between two groups (with and without psychological problems)..
    Results
    GHQ28 screening test showed that psychological problems were seen in 49% of studied patients. There were significant difference between duration of disease and DAS-28 score between the two groups (P = 0.001 and P = 0.001, respectively). Somatic symptoms were more frequent in patients with psychological problems (P = 0.001). Somatic symptoms in patient with high disease activity was also more frequent than the other group (P = 0.002). There was a significant positive correlation between the scores of DAS-28 and GHQ-28 (r = 0.329, P = 0.001)..
    Conclusions
    This study showed that a considerable portion of patients with RA may have mental problems. The probability of these problems increased with more severe and more prolonged disease..
    Keywords: Arthritis, Mental Health, Iran
  • Ali Neamati, Mohammad Hossein Boskabady, Abass Tabatabaei, Saleh Mohaghegh Hazrati Page 14267
    Background
    Anti-inflammatory effect of natural adjuvants has been reported. Lung inflammation is the most characterized pathological feature in asthma..
    Objectives
    The effects of three natural adjuvants (PC, G2, and G2F registered as a patent in the Iranian Patent Office) on sensitized guinea pigs lungs were examined in the present study..
    Materials And Methods
    Lung pathological changes were examined in control and five groups of randomly divided guinea pigs including: sensitized animals (S, receiving normal saline, 0.5 ml i.p.); sensitized animals treated with adjuvant PC; G2F (0.1 ml i.p. for both cases); G2 (0.4 ml i.p.); and PC + G2 (receiving both PC and G) adjuvants (twice a week for 4 weeks for all groups). Sensitization of animals was done by injection and inhalation of ovalbumin (OA)..
    Results
    All pathological changes in S group including the eosinophil infiltration (scoring 3.28 ± 0.28), lymphocyte infiltration (2.82 ± 0.26), local epithelial necrosis (2.71 ± 0.47) and mucosal plug (2.75 ± 0.37) were significantly higher than control group (0.64 ± 0.18, 1.36 ± 0.24, 0.36 ± 0.18 and 0.28 ± 0.18 for eosinophil infiltration, lymphocyte infiltration, epithelial necrosis and mucosal plug respectively, P < 0.001 for all cases). Treatment with all adjuvants improved all pathological changes significantly (P < 0.05 to P < 0.001)..
    Conclusions
    These results indicate preventive effects of all natural adjuvants (especially G2) on pathological changes of the lung in sensitized guinea pigs..
    Keywords: Asthma, Lung, Pathology
  • Khosro Mohamadi *, Khodabakhsh Ahmadi, Ali Fathi Ashtiani, Parviz Azad Fallah, Abbas Ebadi, Emad Yahaghi Page 14292
    Background

    Promoting mental health and preventing mental disorders are of the main concerns for every country. Achieving these goals requires effective indexes for evaluating mental health. Therefore, to develop mental health enhancement programs in Iran, there is a need to measure the state of mental health in Iran..

    Objectives

    This study aimed to select a set of mental health indicators that can be used to monitor the status of mental health in Iran..

    Materials And Methods

    This research work used Q-methodology which combines both quantitative and qualitative research methods for establishment of mental health indicators in Iran. In this study, 30 participants were chosen by purposive sampling from different types of professionals in the field of mental health..

    Results

    Twenty seven mental health indicators were obtained from the Q-methodology. The most important indicators obtained in this study are as follows: annual prevalence of mental disorders, suicide rates, number of mental health professionals, mental health expenditures and suicide related deaths..

    Conclusions

    This study provides mental health indices for measuring mental health status in Iran. These mental health indices can be used to measure progress in the reform policies and community mental health services..

    Keywords: Mental Health, Indicators, Reagents, Iran
  • Tabassom Ershadifar *, Bagher Minaiee, Manouchehr Gharooni, Mohammad Mahdi Isfahani, Alireza Nikbakht Nasrabadi, Esmaiel Nazem, Ashraf Aldin Gousheguir, Davod Kazemi Saleh Page 14301
    Background

    Palpitation is a sign of a disease and is very common in general population. For this purpose we decided to explain it in this study..

    Objectives

    The purpose of this study was to describe the palpitation in both modern and traditional medicine aspect. It may help us to diagnose and cure better because the traditional medicine view is holistic and different from modern medicine..

    Materials And Methods

    We addressed some descriptions to the articles of traditional medicine subjects which have published recently. Palpitation in modern medicine was extracted from medical books such as Braunwald, Harrison and Guyton physiology and some related articles obtained from authentic journals in PubMed and Ovid and Google scholar between1990 to 2013..

    Results

    According to modern medicine, there are many causes for palpitation and in some cases it is cured symptomatically. In traditional medicine view, palpitation has been explained completely and many causes have been described. Its aspect is holistic and it cures causatively. The traditional medicine scientists evaluated the body based on Humors and temperament. Temperament can be changed to dis-temperament in diseases. Humors are divided in 4 items: sanguine, humid or phlegm, melancholy and bile. Palpitation is a disease, it is heart vibration and is caused by an abnormal substance in the heart itself or its membrane or other adjacent organs that would result in the heart suffering..

    Conclusions

    Our data of this article suggests that causes of palpitation in the aspect of traditional medicine are completely different from modern medicine. It can help us to approach and treat this symptom better and with lower side effects than chemical drugs. According to this article we are able to detect a new approach in palpitation..

    Keywords: Palpitation, Medicine, Traditional, Iran, Temperament
  • Saeid Amel Jamehdar, Gholamali Mammouri, Mohammad Reza Sharifi Hoseini, Hosein Nomani, Monavvar Afzalaghaee, Hassan Boskabadi, Mohammad Hassan Aelami Page 14310
    Background
    Neonatal herpes infection is the most serious complication of Herpes Simplex Virus (HSV) infection during pregnancy and perinatal period. Few studies have reported neonatal HSV infection in developing countries..
    Objectives
    The aim of this study was to detect the HSV infection among neonates and infants with sepsis..
    Materials And Methods
    In a cross sectional study all infants aged less than 3 months, admitted to neonatal intensive care unit and pediatric emergency ward of Ghaem Hospital (a university hospital with 900 beds) in Mashhad (Northeast of Iran) with clinical diagnosis of sepsis and at least one inclusion criteria during one year from November 2009 to October 2010, were enrolled in the study. Polymerase chain reaction (PCR) was done on clinical samples obtained from patients..
    Results
    Among 150 neonates and infants younger than 3 months old with sepsis, the PCR results for detecting the HSV DNA, were positive in 6 samples of 5 patients (3.3 %). None of the mothers had symptomatic HSV infection during delivery. The mean age of the patients was 18 days. Two of them died due to shock and disseminated intravascular coagulation (DIC)..
    Conclusions
    In neonates and infants with primary diagnosis of sepsis, HSV infection should be considered especially if the clinical condition does not improve after 48 hours of antibiotic therapy, and sepsis still exists with elevated liver enzymes..
    Keywords: Herpes Simplex, Infants, Polymerase Chain Reaction, Iran
  • Mehri Mirhoseini, Ghasem Saki, Masoud Hemadi, Ali Khodadadi, Javad Mohammadi Asl Page 14463
    Background
    Advancement in the treatment of various types of cancer has led to greater patient survival. These treatments essentially have toxic effects on different kinds of cells, such as germ cells. Infertility as one of the side effects of cancer treatment has changed the quality of life of young cancer survivors dramatically. Melatonin is an antioxidant with receptors in the reproductive systems..
    Objectives
    We supposed that melatonin, as an antioxidant, may protect testis against the toxic effects of the drugs..
    Materials And Methods
    In this experimental study, three groups with seven mice each, were allocated. The control group received normal saline for two months, and the busulfan group received a single dose of 40 mg/kg busulfan intra-peritoneally, and the melatonin group received 20 mg/kg melatonin daily for two months, 45 days after a single dose of busulfan. Next, after decapitation and removal of the testis, tissues were fixed in Bouin''s solution and stained by H&E and TUNEL. The sections were evaluated, assessing morphology and spermatogenesis..
    Results
    In this research, a significant reduction in Johnson’s criteria in the busulfan group (Mean rank = 15.50) was found versus the control group (Mean rank = 45.50), P < 0.001 and in the melatonin group (Mean rank = 45.50) compared to the busulfan group (Mean rank = 15.50), P < 0.001. There was a significant difference between the melatonin and control groups, P < 0.05. In addition, a significant decrease in seminiferous tubule diameter was observed in the busulfan group (763.2 ± 104.41) versus the control group (855.4 ± 52.35), P < 0.01 and melatonin group (834.2 ± 87.26), P < 0.05. Testicular epithelium height was significantly decreased in the busulfan group (Mean rank = 14.60) compared to the control group (Mean rank = 26.40), P < 0.01 and in the busulfan group (Mean rank = 14.95) in comparison with the melatonin group (Mean rank = 26.05), P < 0.01. Also melatonin group (Mean rank = 25.42) showed a significant reduction in epithelium height compared to the control group (Mean rank = 35.58), P < 0.05. Spermatogenesis was impaired in the busulfan group. Although melatonin reduced the rate of apoptosis in the busulfan group, yet it could not remove all apoptotic cells..
    Conclusions
    This study indicated that melatonin ameliorates the cytotoxic effects of busulfan on germ cells..
    Keywords: Melatonin, Spermatogenesis, Busulfan, Mice, Testis
  • Salar Behzadnia, Alireza Davoudi, Mohammad Sadegh Rezai, Fatemeh Ahangarkani Page 14562
    Background
    Treatment of the nosocomial infections is complicated especially in children due to an increase in the antibiotic-resistant bacteria..
    Objectives
    The aim of this study was to survey the nosocomial infections in children and determine the antibiotic susceptibility of their causative organisms in teaching hospitals in the north of Iran..Patients and
    Methods
    The investigation was designed as a retrospective cross-sectional study. The study population consisted of patients under 12 years old, which were hospitalized in three teaching hospitals in the north of Iran and had symptoms of nosocomial infections in 2012. The required data of patients were extracted and entered in the information forms. The collected data were analyzed using SPSS (ver. 16). Descriptive statistics and Fisher’s exact tests (Monte Carlo) were used..
    Results
    Out of the total number of 34556 hospitalized patients in three teaching hospitals, 61 (0.17%) patients were children under 12 years old age with nosocomial infection from which 50.81% were girls and 49.18% were boys. Most of these patients (55.73%) were admitted to the burn unit. The most common type of nosocomial infection (49.18%) was wound infection. Pseudomonas spp. (36.84%) and Acinetobacter spp. (28.02%) were the most common bacteria isolated from the clinical specimens. All the Acinetobacter spp. were multidrug-resistant. All the gram negative and gram positive bacterial species in our study showed high resistance to antibiotics..
    Conclusions
    The rate of nosocomial infections was low in our study because the detection of nosocomial infection was based on the clinical grounds in most cases and laboratory reports might contain false-negative results. These results provide useful information for future large scale surveillance in the context of prevention programs..
    Keywords: Infection, Children, Iran
  • Banafshe Dormanesh, Farhad Safarpoor Dehkordi, Hassan Momtaz, Reza Mirnejad, Mohammad Javad Hoseini, Emad Yahaghi, Vahideh Tarhriz, Ebrahim Khodaverdi Darian Page 14627
    Background
    Uropathogenic Escherichia coli O- Serogroups with their virulence factors are the most prevalent causes of UTIs..
    Objectives
    The present investigation was performed to study the virulence factors and O-Serogroups profiles of UPEC isolated from Iranian pediatric patients..Patients and
    Methods
    This cross sectional investigation was performed on 100 urine samples collected from hospitalized pediatrics of Baqiyatallah Hospital, Tehran, Iran. Midstream urine was collected to decrease potential bacterial, cellular and artifactual contamination. All samples were cultured and those with positive results were subjected to polymerase chain reactions to detect pap, cnf1, afa, sfa and hlyA genes and various O- Serogroups..
    Results
    We found that 37.5% of boys and 75% of girls had positive results for Escherichia coli. We also found that O1 (19.33%), O2 (13.33%), O6 (13.33%), O4 (11.66%), and O18 (11.66 %) were the most commonly detected Serogroups. Totally, the serogroup of 5% of all strains were not detected. In addition, all of these O- Serogroups were pap+, cnf1+, hlyA+, and afa+. Totally, pap (70 %), cnf1 (56.66 %), and hlyA (43.33 %) were the most commonly detected virulence genes in the both studied groups of children. The sfa (30 %) and afa (26.66 %) genes had the lowest incidence rates..
    Conclusions
    Special health care should be performed on UTIs management in Iranian pediatric patients. Extended researches should be performed to evaluate relation between other O-Serogroups and virulent genes..
    Keywords: Uropathogenic Escherichia Coli, Pediatrics, Iran
  • Jalil Shojaee, Mahmood Moosazadeh * Page 14965
    Background
    Applying Prevention and Control of Infection (PCI) standards in hospitals reduces probable risks to patients, staff and visitors; it also increases efficiency, and ultimately improves productivity of hospitals..
    Objective
    The current study aimed to determine the status quo of international standards of PCI in hospitals located in the north of Iran..
    Materials And Methods
    This cross-sectional study was conducted in 23 hospitals. Data collection tool was a questionnaire with confirmed validity and reliability.. In this regard, 260 managers, section supervisors and infection control nurses participated in the study according to census basis. SPSS software version 16 was employed to analyze the data through descriptive and analytical statistics..
    Results
    Among the studied hospitals, 18 hospitals were public. Hospitals enjoyed 77.2% of leadership and programming, 80.8% of focus of programs, 67.4% of isolating methods, 88.2% of hand health and protection techniques, 78.8% of improving patient’s safety and quality, 90.3% of training personnel, and 78.7% of the average status quo of PCI standards..
    Conclusions
    This study revealed that PCI standards were significantly observed in the studied hospitals and that there were necessary conditions for full deployment of nosocomial infection surveillance..
    Keywords: Infection, Prevention, Hospital, Accreditation
  • Zohreh Sadat, Masoumeh Abedzadeh Kalahroudi, Mahboobeh Kafaei Atrian *, Zahra Karimian, Zahra Sooki Page 14995
    Background

    Postpartum depression (PPD) is a common problem after child''s birth and may influence the quality of life (QOL). Investigation of postpartum QOL and depression can be useful for better care for mothers and improvement of their well-being..

    Objectives

    The objective of this study was to assess the life quality in mothers with and without PPD..Patients and

    Methods

    In a prospective study, women who had experienced child''s birth with and without PPD were recruited in Kashan-Iran. PPD was measured using the Edinburgh Postnatal Depression Scale (EPDS) and QOL was measured by SF-36 questionnaire. Data collection was conducted at two assessment points: second month (n = 321) and fourth month (n = 300) postpartum. Based on EPDS, a score of 13 or more was defined as PPD. Mean scores of SF-36 questionnaire were compared between women with and without PPD at two assessment points and within each group from the first to the second assessments. Moreover, correlation between scores of EPDS and scores of life quality dimensions were evaluated. Data were analyzed by using the Student’s t-test, Mann–Whitney U-test, ANOVA, Kruskal-Wallis, Chi-square test, Pair t test, Wilcoxon, Pearson and Spearman Correlation Coefficient..

    Results

    Differences in seven out of eight mean scores of QOL dimensions (except role-physical) between depressed and non-depressed women at the first and the second assessments were significant. Results of changes in mean scores of QOL dimensions from the first to the second assessments in each group showed that non-depressed women scored higher in all of eight dimensions with significant differences in two dimensions (bodily pain and role-emotional as well as mental health component). In depressed women, scores of life quality decreased in some of QOL dimensions but differences were not significant. There were significant negative correlations between EPDS scores and scores of seven out of eight SF-36 sub-scales (except role-physical) in addition to physical and mental health components at two assessments. The highest correlation was found between EPDS scores and emotional well-being and total scores of SF-36 dimension at the first and the second assessments (r = -o.489, r = -0.381), respectively..

    Conclusions

    The findings demonstrated that postpartum depression leads to a lower life quality at second and fourth months postpartum. Integration of PPD screening into routine postnatal care is recommended..

    Keywords: Depression Postpartum, Health, Mental Health
  • Majid Shohrati, Maryam Moshkani, Bahram Pishgoo, Minoo Ahmadinejad, Nastaran Najafian, Bita Najafian, Davoud Kazemisaleh Page 15277
    Background
    Ischemic heart disease is the leading cause of death in most societies. In a pathophysiologic point of view, it chiefly results from the formation of thrombus in coronary arteries which could not be only prevented by aspirin. Many of clinical trials have shown the long-term benefits of antiplatelet drugs in reducing the risk of thrombotic accidents..
    Objectives
    Clopidogrel is a thienopyridine derivative used to prevent platelets from adhering together by direct inhibition of Adenosine diphosphate (ADP), the major factor behind platelets aggregation. Sanofi-Aventis and Bristol-Myers are companies that produce Clopidogrel by the name of Clopidogrel bisulfate. Its trade name is Plavix, nonetheless in Iran it is distributed under the name of Clopidex by Exir Company. In this study we are to compare Plavix and Clopidex in terms of efficacy as well as aggregometry parameters like ADP and PRP (Platelet Rich Plasma)..Patients and
    Methods
    This is a double blind clinical trial in which we had two groups of patients suffering from Ischemic heart disease who were selected by inclusion criteria. Group A (36 patients) took Plavix (75 mg/d) and group B (36 patients) used clopidex (75 mg/d) both for 30 days. The aggregometry parameters also consisted of PRP and ADP that were run on the patients before and after the study. Finally, a comparison of aforementioned tests, quality of life, lab parameters and compliance in both groups was provided..
    Results
    In groups A and B, the mean levels of PRP before the study were 348000 and 340000/µL respectively. The ADPs were also 73/76 and 68/07 µM that showed no significant difference (P > 0.05).The Means of ADP5 in group A before and after the study were 66.40 and 43.84 µM respectively that there was significant difference (P = 0.001). The Means of ADP5 in group B before and after the study were 58.04 and 40.16 µM respectively that there was significant difference (P < 0.001).The Means of ADP20 in group A before and after the study were 73.76 and 54.97 µM respectively which showed significant difference (P < 0.001). The Means of ADP20 in group B before and after the study were 68.07 and 52.49 µM respectively which showed significant difference (P = 0.001). Difference of ADP5 between group A and B was not significant (P = 0.495). Difference of ADP20 between group A and B was not significant (P = 0.721). The Means of PRP in group A before and after the study were 348000 and 335000/ µL respectively that there was no significant difference (P = 0.66). The Means of PRP in group B before and after the study were 340000 and 336000/ µL respectively that indicated no significant difference (P = 0.81). Difference of PRP between group A and B was not significant (P = 0.563)..
    Conclusions
    Our findings suggested that both drugs significantly lessen the ADP level; even so there was no significant difference between two groups in PRP and ADP factors..
    Keywords: Diphosphates, Clopidogrel, Heart Disease
  • Alireza Sharifian Attar, Masoomeh Tabari, Mohammadreza Rahnamazadeh, Maryam Salehi Page 15809
    Background
    Hypoxia occurs during one-lung ventilation (OLV) due to the arteriovenous shunt of unsaturated pulmonary venous blood. Hypoxic pulmonary vasoconstriction (HPV) acts as a defense mechanism against shunting. In thoracic surgery, anesthetics with minimal inhibitory effect on HPV and minimal hemodynamic changes are preferred..
    Objectives
    The present study aimed to evaluate the effects of propofol and isoflurane on patients’ arterial oxygen pressure following one-lung ventilation during thoracic surgeries..
    Materials And Methods
    In this randomized clinical trial study which was conducted in Iran, sixty patients with ASA (The American Society of Anesthesiologists) class I & II who were candidates for right elective thoracotomy were divided in two groups. Induction of anesthesia in the two groups was conducted using the same method, and left double-lumen endotracheal tube was inserted. In the first group propofol was used for the maintenance of anesthesia, and isoflurane for the second group. During two-lung ventilation and at minutes 5 and 10 after OLV, ABG (arterial blood gas) (for detecting the mean pressure of arterial oxygen), mean arterial pressure and heart rate were recorded..
    Results
    Sixty patients (mean age = 4124.18 ± 18.63 years) were divided into two groups. The age and gender of the subjects were not statistically different between the two groups. In the propofol group, the arterial oxygen pressure during two-lung ventilation and at 5th and 10th minutes after OLV was 263.14 ± 136.19, 217.40 ± 133.99 and 182.34 ± 122.39; in the isoflurane group, it was reported as 206.29 ± 135.59, 164.78 ± 118.90 and 155.35 ± 109.21 mmHg, respectively. In the propofol group, mean arterial pressure during two-lung ventilation, and 5th and 10th minutes after OLV, was 84.01 ± 20.67, 88.15 ± 20.23 and 86.10 ± 19.13, respectively; regarding the isoflurane group, it was reported as 79.66 ± 17.04, 84.78 ± 20.19 and 86.50 ± 17.07 mmHg, respectively. In the propofol group, heart rate during two-lung ventilation, and 5th and 10th minutes after OLV was 92.77 ± 17.20, 94.0 ± 18.34 and 94.33 ± 21.03, respectively; In the isoflurane group, it was reported as 92.87 ± 16.96, 91.8 ± 18.75 and 91.05 ± 17.20 min, respectively. These values were statistically similar in the two study groups..
    Conclusions
    The effects of propofol on hemodynamics and arterial oxygen pressure during one- or two-lung ventilation were not different from those of isoflurane..
    Keywords: Propofol, Isoflurane, Arterial, One Lung Ventilation, Arterial Pressure, Heart Rate
  • Malihe Motavasselian, Mandana Tavakkoli Kakhki, Mohammad Reza Shams Ardekani Page 15959
  • Keramat Nourijelyani, Mir Saeed Yekaninejad, Mohammad Reza Eshraghian *, Kazem Mohammad, Abbas Rahimi Foroushani, Amir Pakpour Page 16051
    Background
    Parents and teachers involvement reinforce health promotion programs for children''s health..
    Objectives
    The purpose of this study was to evaluate mothers’ lifestyle behavior and its association with children''s oral health..
    Materials And Methods
    The study was a cross sectional study on 383 children and their mothers who were selected from 6 primary schools in Tehran, Iran. Mothers and children who participated in this study were asked to complete a questionnaire containing demographic questions, knowledge of oral health, attitude towards the oral health behavior, and oral health behaviors. Furthermore, the Simplified Oral Hygiene Index (OHI-S) and Community Periodontal Index (CPI) were assessed by two calibrated dentists. Data were analyzed with multilevel mixed model analyses..
    Results
    The average age of the children and their mothers were 11.6 and 38.4 years, respectively. Mothers’ higher knowledge, higher educational status, positive attitude, higher frequent oral health behaviors, lower DMFT and lower CPI were all associated significantly with children’s higher oral health status..
    Conclusions
    The results suggest that to improve children’s oral health, educational interventions should focus on both children and mothers to obtain a more promising outcome..
    Keywords: Oral Health, Lifestyle, Mothers, Health Behavior