Razi Journal of Medical Sciences
Year:2019 | Volume:25 | Issue:12 |Papers Count:18

Background: Prediction of spontaneous preterm delivery in Iranian women by comparing the vaginal polymorphonuclear call (PMN) counts on gram-stain preparations and ratios of PMN to epithelial cells (PMN/EPI) at second trimester of gestation. Methods: In a prospective case-control study, 110 cases with spontaneous preterm delivery at gestational age of less than 37 weeks were compared with control group of 110 women at term. Vaginal gram-stain preparations were collected at the first visit in 23-24 weeks of gestation and the cell counts were performed under oil-immersed microscope. To correct the intra-slide variations in cellular density, PMN/EPI ratios was calculated for each slide field. Results: Mean delivery gestational ages were 34. 5± 3. 5 and 39. 4± 1. 2 weeks for the cases and the controls, respectively. There was a significant difference in PMN counts between the two groups (p=0. 01). The mean PMN/EPI ratio, however, was significantly higher in case group (p=0. 01). No significant difference was found in gravidity between the two groups. Conclusion: Different vaginal PMN count at second trimester were significantly associated with subsequent spontaneous preterm birth. However, the ratio of PMN of EPI count, was significantly higher in women with preterm birth at less than 37 weeks’ gestation.

Background: Because the length of leukocyte telomeres can be used as a biomarker to detect cell longevity and predict mortality and cell disease, recently, many people have been interested in examining the effects of exercise on telomere lengths. Protecting the length of human telomeres definitely depends on TRF2 as one of the subunits of the shelterin protein complex. The present study intends to investigate the effects of six-week Small Sided Games on telomere length and TRF2 gene expression in the middle-aged males. Methods: A semi-experimental design was employed to investigate this issue in the present study. The subjects were selected from a statistical population of men between the ages of 35 and 41. There was a control group and an experimental group. The experimental group played soccer in small fields, according to the exercise protocol, for six weeks, with two 45-minute sessions per week. Real time PCR was used to measure the length of the telomeres and TRF2 gene expression, the fat percentage was measured by the caliper and the VO2max by the Rockport Field Test. The data were analyzed through using SPSS software version 25 that was used to obtain independent t-test with significant level of p<0. 05. Results: The present study indicated that there was a significant change in the Fat percentage, VO2max and TRF2 gene expression following six weeks of Small Sided Games (p˂ 0. 05) yet no significant change was observed in telomere length (p˃ 0. 05). Conclusion: It seems that the play of soccer in small fields does not affect the length of telomere in the middle-aged males, but it affects the expression of their 2TRF gene. So cautiously, this kind of exercise is effective in protecting middle-aged people's chromosomes.

Background: Healthcare services pricing is one of the most important policy tools affecting access, equity, efficiency, and quality in a health system. The healthcare services tariffs were increased due to the health transformation plan (HTP) implementation in Iran. This study aimed to examine the effects of HTP on the surgical and anesthesia procedures’ tariffs. Methods: This descriptive and longitudinal study compared the tariffs of surgical and anesthesia procedures from 2011-2017. Data sources were the California tariff (2011 Edition) and the relative value of health services (2017 edition) books. Data was categorized and weighted and the average and percentage of changes were calculated using excel software. Then, Data was analyzed by SPSS software (version 18) using paired t-test statistics. Results: The average of surgery unit was increased 124% in the first year of HTP implemenbtation and then increased by 8. 6% in the second year of the HTP implemenbtation. After then, it has remained steady. The average of anesthesia unit was increased by 19. 2% in the first year of the HTP implementation and was decreased by 2. 9% in the second year of the HTP implementation. The differences between values were statistically significant (p<0. 001) Conclusion: The healthcare services tariff had been almost doubled due to the HTP implementation which increased the financial burden on the Iran health system. Using preospective payment methods is recommended for controlling the health system costs.

Background: Burn injury is one of the most important causes of mortality and disability in the world, which affects all aspects of the Survivors quality of life. The aim of this study was to investigate the effect of multimedia self-care training on quality of life in burn patients using Latent Growth Model. Methods: This study is a randomized controlled clinical trial that was conducted on 100 burn patients referred to Shahid Motahari hospital in Tehran, 2015. The burn patients were allocated into intervention (n=50) and control (n=50) groups, randomly. The intervention group received the CD of self-care education and uses it during the six-month period. The data was collected using the Burn Specific Health Scale – Brief questionnaire before, 3 and 6 months after intervention and then the latent growth model was used to evaluate and compare mean score patterns of intervention and control groups. Results: The latent growth model results showed that the increasing pattern of the mean score of quality of life (all aspect of quality of life) in intervention group was significantly higher than the control group (p<0. 05). Also, burn percentage had a significant negative impact on the patient’ s quality of life (p<0. 05). Conclusion: The multimedia self-care education improves the burn patient’ s quality of life. Therefore, it is recommended for medical teams to use multimedia self-care training in order to improve burn patient’ s quality of life.

Background: In recent decades, palliative care is considered as a multidisciplinary approach which has been specified based on the nature and type of its target patients and their psychological needs. Assessment of these needs and attention to them are among psychologist's tasks that involve many challenges including the ambiguity of roles and educational and research needs. This review article aimed to investigate their specialized skills in assessment, intervention, and research, and explore the theoretical and practical aspects of this field in the palliative care setting. Methods: In the present review article, database searching method was applied using the keywords of palliative, psychologist, advanced cancer, end of life, hospice, terminally ill, chronic illness, bereavement, and grief. PubMed, Elsevier, Scopus, Science Direct, and ProQuest databases were searched and eligible articles published between 1997 and 2017 were retained. Results: Psychologists at palliative care team are involved in various stages of the disease. Communication and assessment are presented as the first steps of their services and then specific counseling and psychotherapy are provided for any psychological disorder and problem of patients. These psychologists will continue their services to the family of patients at the time of hospitalization until the stages of loss and mourning. The support and care of members of the palliative care team and participation in research projects are among other tasks of them. Conclusion: Due to the multiple functions of psychologists in the palliative care team and the widespread provision of services from patients to their families and members of the palliative care team, it is essential to acquire specialized skills and continuing training for themlearning of nursing students as well as accepting responsibility professionals in medical sciences.

Introduction: Proteinuria is one of the symptoms that affects the functioning of the kidneys and 24-hour urine protein measurement is one of the key methods for diagnosis of renal failure and urinary tract infection. Investigating the relationship between the results of various methods of measuring 24-hour urine protein can increase the efficiency of proteinuria detection using these methods. Turboidometric-based methods such as trichloroacetic acid (TCA) and benzethonium chloride (BEC) are among the methods used to measure urine protein. The aim of this study was to evaluate the correlation between urine protein measurements with TCA in comparison with BEC. Materials and methods: This study was performed on 116 patients referring to Massoud medical diagnostic laboratory in Tehran. The 24-hour urine sample were taken. Then، the amount of urine protein was measured by both TCA and BEC method at 495 and 512 nm wavelengths respectively. Results: The results obtained using Pearson correlation test showed that the correlation coefficient for both TCA and BEC methods is 0. 914 (Pvalue <0. 001). Passing and Bablok regression analysis showed that the average protein concentration of the urine with BEC method was 17. 31 ± 19. 81 and for the TCA method was 17. 40 ± 20. 59 mg / dl. Conclusion: In this study، it was shown that there is no difference between the measured results in the range of 1-150 mg/dl of 24-hour urine protein with both TCA and BEC method. Also، there was a good agreement in correlation between the results of both TCA and BEC in the range of 1-150mg، and in general، the data from the two methods were in agreement with each other.

Background: Developmental coordination Disorders are long-term disability and related with motor، emotional and educational problems may to continue until adulthood. For this reason، the need for early intervention for these children seems necessary. Therefore، the purpose of this study was to investigate the effect of aerobic rhythmic exercises on motor skills، anxiety and academic achievement in boys with developmental coordination disorder. Methods: In a semi-experimental study، 30 children with disorder were selected based on the parents' developmental coordination disorder diagnostic questionnaire with a mean age of 9. 27 from the primary schools of Tabriz In the form of Purposeful cluster. The pre-test was performed using the BOT-2 test، the March scale and the mathematical lesson scores. Subjects were randomly assigned into two groups of 15 subjects Control and testing. The experimental group tested the aerobic exercise for 8 weeks، every week they have 3 sessions per hour. The control group performed their usual activities during this period. Then، from both groups، the post-test was taken. After assuring the normal distribution of data using Kolmogorov-Smirnov test، covariance analysis was used to examine the effect of training at a significant level (P <0. 05). Results: The results of the statistical tests indicated that the aerobic exercise training had a significant effect on motor skills، anxiety and academic achievement in the experimental group. Conclusion: Therefore، according to the results of sports exercises، sports therapists for motor disorders and rehabilitation are advised to use aerobic training to reduce the motor، mental and educational problems of children with developmental coordination disorder.

Background and aim: Immunotoxins، one of the promising therapeutic agents can be used in targeted of cancer therapy based on specific binding to tumor-related antigen. Evaluating and specifying the structural and functional features of these antigens provide new perspectives in the field of cancer therapy. In this study، we decipher the structure and function of MAGE antigen family based on in-silico and bioinformatic evaluation. Materials and methods: In the first step، using SPSS software statistical analysis of the MAGE family antigens expression in a variety of cancer types was performed. After determining the MAGE-A4 as a superior antigen with the highest expression level، based on the review of the literature، the MAGE-A4 binding epitopes were identified for HLA isoforms. Then bioinformatic databases such as BIMAS and SYFPEITHI programs were used to confirm the reported HLA-binding epitopes in literature. Stability index and immunogenicity of epitopes were defined by ProtPram and IEDB software respectively. To determine the binding affinity and stability of HLA-peptide complex، docking screening and molecular dynamic simulation was conducted using Autodock Vina and gromacs 5. 1 softwares. Result: Our results revealed that the MAGE-A4 antigen had high expression compared with other MAGE family members. Also، MAGE-A4 derived peptide، VDELAHFLL، with the highest stability and favorable immunogenicity was appeared. On the other hand، the most stable of HLA-B37-VDELAHFLL complex with the lowest amount of RMSD plot was Obtained. Conclusion: Generally، our results indicated that VDELAHFLL desired peptide from MAGE-A4 antigen might be promising to generate the therapeutic monoclonal antibody and vaccine development in modern cancer therapy.

Background: Lymphadenitis is a common and debilitating complication of breast cancer patients. This study has predicted and classified lymphedema complications. Moreover، identifying effective factors and discovering patterns for faster diagnosis and prevention of this complication is another goal of this study. Methods: Data from 1113 patients with breast cancer who were referred to Seyed Khandan Lymphedema clinic during 2009 to 2017 were evaluated. Data analysis was performed by using IBM SPSS Modeler software version 18 and CRISP-DM methodology and in the modeling section، logistic regression and decision tree algorithms were used. Results: Data from 933 patients including 25 variables were entered into the model after pre-processing. Probability of catching of Lymphedema for each patient predicted by logistic regression algorithm and different decision tree algorithms consist of C5. 0، Chaid، C&RT، and Quest with the sensitivity of 79. 33%، 74. 41%، 71. 92%، 72. 64% and 77. 83%، respectively and finally the factors related to Lymphedema were identified. ratio of the involved lymph node numbers to the removed lymph node numbers، heaviness، type of surgery، stage of disease، age، body mass index، metastasis، number of chemotherapy courses، comorbidity، number of removed lymph nodes respectively. Conclusions: The results show that C5. 0 decision tree algorithm with the highest sensitivity is the best model for predicting Lymphedema. By applying the rules created for a new sample with specific characteristics، it can be predicted that the patient will probably suffer from Lymphedema or not. considering that BMI is a changeable factor، weight control regimens are recommended for these patients. In addition، it is necessary to pay attention to the patient's heavy feeling in the early stages.

Background: Vestibular impairment is a common pathology in patients with diabetes mellitus. The evaluation of the vestibular system of these patients is important. The aim of this study is to assess the effects of diabetes mellitus type II with and without neuropathy on vestibular systems. Methods: In this cross-sectional study, 21 patients with diabetes mellitus type IΙ with neuropathy (58. 10 with SD 6. 08), 20 patients with diabetes mellitus type Ι I without neuropathy (54. 4 with SD 5. 21) and 20 healthy volunteers (53. 55 with SD 3. 99) were enrolled in this study. Age range of the participants was 45-65 years old. Results: Generally, the mean gain of the VOR for semicircular canal between diabetic neuropathy and control groups showed statistically significant differences (p<0. 05). In left lateral, left anterior and posterior semicircular canal, the mean gain of the VOR between diabetic neuropathy and diabetes without neuropathy groups showed statistically significant differences (p<0. 05). Only the mean gain VOR of lateral semicircular canal between diabetes without neuropathy and control groups showed statistically significant differences (p<0. 05). Conclusion: There was statistically significant difference between groups in the responses of the vestibular systems suggest greater involvement of the vestibular end-organ and related central pathway in the patients with diabetic neuropathy compared to diabetes without neuropathy.

Background: Changing the concentration of growth factors and their receptors can affect sarcopenia (age-related muscular atrophy). The aim of this study was to determine the effects of an 8-week resistance training on ActRIIβ in fast-and slow-twitch (FT & ST) skeletal muscles and plasma levels of GDF8، GDF11 and GASP1 in old male rats. Methods: This study was conducted as a two-group experimental design with 14 old male rats with age range 24 to 27 months and weighing 440± 24g. After the familiarization training، the rats were randomly divided into 2 groups of 7 control and training. The training protocol was included 8 weeks climbing from a 1 meter ladder. 5cc blood was taken from the left ventricle، 48 hours after the last session، for measurement of GDF8، GDF11 and GASP-1 by ELISA method. The soleus (SOL) muscle (ST) and flexor hallucis longus (FHL) muscle (FT) of rats were taken for measurement of ActRIIB by IHC method. Independent t-test was applied for statistical analysis of the data (p<0. 05). Results: Comparisons between groups showed that 8-week resistance training have a significant effects on GDF11 (P=0. 001)، GDF8/GDF11 (P=0. 001)، GDF8 (P=0. 027) and ActRIIβ in SOL muscle (P=0. 013)، but no between-groups differences were observed in GASP-1(P=0. 704) and ActRIIβ in FHL muscle (P=0. 325). Conclusion: It seems that resistance training can reduce sarcopenia by favorable effects on growth factors and their receptors. However، more studies are needed in this regard.

Silibinin is a major component of silymarin (Silybum marianum)، which has traditionally been used to treat a wide range of liver diseases. Recently، Silibinin and its derivatives in both in vitro and in vivo models have shown a significant inhibitory effect in different types of tumors including skin، breast، lung، colon، bladder، prostate، kidney and liver. The chemo-preventive potentials of this flavonoid are promoted by inducing apoptosis، enhancing tumor suppressor and cell cycle inhibitors، inhibiting growth factors، and attenuating proliferative mediators. In this paper، a summary of the important molecular mechanisms involved in Silibinin anti-cancer effects، animal studies and important clinical trials have been presented. The results of these studies will provide a more comprehensive perspective of Silibinin and help to optimize its effects in cancer chemotherapy.

Background: Obesity is a mild systemic inflammation of which to be assessed various parameters such as body mass index (BMI), waist circumference, neck and fat mass index are used, and to assess metabolic and cardiovascular diseases different blood factors such as triglyceride (TG), low density lipoprotein (LDL) and C-reactive protein (hs-CRP) are used. The main goal of this study was to compare the sensitivity and specificity of body composition measurement to predict the risk of metabolic and cardiovascular diseases in obese and overweight women. Methods: This study was conducted on 305 obese and overweight women. In this cross-sectional study, blood sample was received. The body composition was measured by the body composition analyzer. The usual food intake was obtained by using food frequency questionnaire. Results: The results of this study showed that between BMI, neck and waist circumference with risk factors of metabolic and cardiovascular diseases including TG, LDL, hs-CRP and insulin resistance index (HOMA-IR) have a significant relationship (p<0. 05). Also, the largest surface under the rock curve belonged to the neck circumference association with HOMA-IR (A= 0. 76). Conclusion: There is a significant relationship between body composition measurement in predicting the risk of metabolic and cardiovascular diseases in obese and overweight women. The most sensitivity and specificity was the prediction of the risk factors of metabolic and cardiovascular diseases related to the neck circumference, fat mass index and fat mass.

Background: The use of supplements، herbal extracts، and exercise training for the treatment of type 2 diabetic has become widespread nowadays. The purpose of this study was to evaluate the effect of endurance training and resveratrol consumption on IL-10 and TNF-α in type 2 diabetic rats. Methods: During this experiment 32 diabetic rats with high-calorie diet Sprague Dowley race with an average weight of 250 ± 10 gram، were randomly divided into four groups، including the “ control group” ، the “ supplement group” ، the “ training group” and the “ training + supplement group” . For up to 8 weeks، the “ training” and the “ training + supplement” groups participated in 3 endurance training sessions weekly; each session included 30 minutes of endurance training with an intensity of 70 to 75% VO2max. Moreover، the “ supplement” and the “ training + supplement” groups were given 10 milligram daily doses of resveratrol consumption solution per kilogram of body weight. The outcome data was analyzed using one-way analysis of variance (ANOVA) with significance level of (p≤ 0. 05). Results: The results have shown that eight weeks of training and resveratrol consumption had no significant effect on the serum level of IL-10. but the level of TNF-α ، Fasting Glucose، Insulin and insulin resistance decreased significantly in the groups (p= 0. 001). Conclusion: Based on the findings of this study، the combination of resveratrol supplementation and endurance training can reduce the inflammatory factors of type II diabetes.