Qom University of Medical Sciences Journal
Year:2016 | Volume:10 | Issue:10|Papers Count:13

Cross-Over Clinical Trials in comparison with parallel-group clinical trials have been the focus of attention of researchers due to advantages, such as removal of confounding variables, implementation of the study with small sample size and short duration, but have major limitations as well. This issue has been discussed in this article.

Background and Objectives: Botulism syndrome is caused by serotypes A-G of neurotoxins of Clostridium genus. Neurotoxin binding domain is an appropriate vaccine candidate due to its immunogenic activity. In this study, the immunogenicity of chitosanbased botulinum neurotoxin E binding domain recombinant candidate vaccine was investigated via mucosal route of administration.Methods: In this experimental study, chitosan nanoparticles containing rBoNT/E protein were synthesized by ionic gelation method and were administered orally and intranasally to mice. After each administration, IgG antibody titer was measured by ELISA method. Finally, all groups were challenged with active botulinum neurotoxin type E. Data were analyzed using Duncan and repeated ANOVA tests. The significance level was considered as p<0.05.Results: After each administration, IgG antibody titre was increased in all the test groups (except the control group). According to the results of challenge with active botulinum neurotoxin type E, the mice immunized orally and intranasally by nanoparticles containing the antigen and also the mice that only received the antigen orally, could tolerate 500 folds of LD50. The group immunized intranasally with only antigen tolerated 2000 folds of LD50.Conclusion: The results of this research showed that use of chitosan nanoparticles has no significant increase in the immunogenicity of recombinant botulinum neurotoxin antigen in oral and intranasal routes (p>0.05), even intranasal route reduced the immunogenicity.

Background and Objectives: Accumulation of toxic bile salts in a bile duct ligation (BDL) animal model plays a pivotal role in the induction of liver fibrosis. Vitamin B5 is an essential nutrient, which acts as a cofactor in many detoxification system enzymes. In the present research, the antifibrotic effect of vitamin B5 was investigated on liver cholestasis induced by BDL in rats.Methods: In this experimental study, 72 male Wistar rats were divided into 9 groups: Control, sham-operated, vitamin B5 (5, 50, and 100 mg/kg bw), BDL, and BDL+vitamin B5 (5, 50, and 100 mg/kg bw).After BDL, rats were given vitamin B5 via intragastric gavage for 28 consecutive days. At the end of the experiment, blood was collected from heart and activity of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) enzymes, were measured. The data were analyzed using one-way ANOVA test.Results: In the BDL animals, the serum activities of AST, ALT, and ALP significantly increased (p<0.001). Treatment of BDL rats with vitamin B5 significantly attenuated these changes.Conclusion: The results of this study indicated that vitamin B5 has hepatoprotective and antifibrotic effects in the cholestatic liver, which is likely due to the antioxidative and free radical scavenging effects of this vitamin.

Background and Objectives: Escherichia coli is one of the most important causative agents of acute diarrheal disease in the world.Diarrheal diseases are one of the main causes of mortality among children in developing countries. The aim of this study was to develop a PCR technique for diagnosis of specific virulence genes of Enterotoxigenic E. coli (ETEC) and Enteroaggregative E. coli (EAEC).Methods: In this study, specific genes ST and LT were used for diagnosis of ETEC pathotype and AAF/II specific gene was used for diagnosis of EAEC pathotype. The PCR technique was designed and optimized for these three genes. The reaction products were cloned in pTZ57R/T vector as positive control. The primers’ sensitivity was determined by measurement of detection limit, and primers’ specificity was evaluated using other bacterial genomes.Results: According to the results of the PCR products analysis using agarose gel electrophoresis, the bands for AAF/II, LT, and ST were obtained 384, 459, and 150 bp, respectively. Also, the reaction of the genomes of control bacteria using the designed primers was negative.The detection limit based on copy number for ST, LT, and genes, was obtained 390, 1500, and 2500 copies, respectively.Conclusion: Considering the findings of this study, design of these assays in Iran is a progress in the improving rapid and accurate diagnosis of pathogens and detection of E. coli pathotypes.

Background and Objectives: Providing and making airway is the first known measure that comes to mind at an emergency situation.Laryngeal mask airway (LMA) is an alternative for airway management, which its insertion training in beginners and professionals is easier than endotracheal intubation. This study was conducted to compare the speed of insertion and success rate in using two LMA and ETT methods in nursing students.Methods: In this quasi-experimental study, 49 last year nursing students were selected by simple random sampling method. After airway management training course, the students were tested on endotracheal intubation and LMA insertion in a manikin. Data were analyzed using t-test at the p<0.05 significance level.Results: The time for endotracheal intubation was obtained 28.73 s and for LMA was 5.05 s. Also, gender of the students had no significant relationship with airway management (p=0.45). Ninety-eight percent of the student succeeded to insert LMA with no error, but this rate for ETT was just 28%.Conclusion: Given that shorter time, lower error, and ease of insertion of LMA in comparison with the ETT method, use of this method is recommended as an appropriate alternative for endotracheal intubation, especially in emergency situation.

Background and Objectives: Obsessive compulsive symptoms are prevalent in individuals with eating disorders at clinical level. The purpose of this study was to investigate the correlation between obsessive compulsive features and pathological eating attitudes.Methods: This research is a correlational study. A sample of 790 university students were selected using stratified random sampling method and investigated by Obsessive Compulsive Inventory-Revised (OCI-R), and Eating Attitudes Test (EAT-26) questionnaires. Data were analyzed using multivariate regression analysis.Results: There were a correlation between obsessive-compulsive features and pathological eating attitudes (p<0.001, r=0.38), The results showed that obsessive-compulsive features can predict 15% of pathological eating attitudes (p<0.001, r2=0.15).Conclusion: The identified correlation is possibly related to common components between obsessive compulsive and eating disorders.

Background and Objectives: Cardiovascular diseases are one of the most common causes of fatal diseases in the world. Alterations in biochemical composition of blood plasma are associated with coronary heart disease. In this study, some biochemical markers were investigated in patients suspicious to coronary artery disease (CAD) without acute coronary syndrome symptoms.Methods: In this descriptive cross-sectional study, 120 patients suspicious to CAD, were ivestigated. In all of them, physical examinations were performed and biochemical parameters, were measured. The patients were divided into CAD-positive and -negative groups, and their biochemical markers were compared.Results: CAD-positive cases, was significantly associated with Troponin, ESR, and Helicobacter pylori-Positive serology. A significant association was found between age, male gender, BMI, and positive CAD. ESR sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratio for diagnosis of CAD, were 56.5%, 65.5%, 63.6%, 58.5%, 1.61, and 0.66, respectively. Also, Troponin sensitivity, specificity, positive and negative predictive values, and positive and negative LR, were 18%, 96.5%, 84.5%, 52.3%, 5.2, and 0.85, respectively. A positive correlation was found between Helicobacter pylori-positive serology and CAD-positive cases (1.48-10, CI=95%, OR=3.86, p=0.006).Conclusion: Based on the findings of the present research, in patients without acute coronary syndrome symptom, only ESR>10mm/h, positive cTnI, and Helicobacter pylori-positive serology had different results between the patients with and without CAD, which can be suggestive of CAD in asymptomatic cases.

Background and Objectives: Somatization is a somatoform disorder, which medical examinations are not able to explain its reason. In the present research, the role of self-esteem, insomnia, and paranoid thoughts was investigated in somatization disorder.Methods: This descriptive and correlational study was conducted on all students studying at University of Tabriz in the academic year 2014- 2015. A total of 270 subjects were selected using stratified random sampling method. In this research, Eysenck Self-Esteem Inventory, Insomnia Severity Index (ISI), Somatization Questionnaire (PHQ-15), and Green et al. Paranoid Thought Scales (GPTS) were used. Data were analyzed using Pearson’s correlation coefficient and multiple regression analysis tests.Results: Correlation results indicated that somatization disorder has a significant positive relationship with paranoid thoughts and insomnia and a significant negative relationship with self-esteem. Also, based on the results of multiple regression analysis, Insomnia Index had the greatest ability to predict somatization disorder.Conclusion: The findings of this research revealed that factors, such as insomnia, paranoid thoughts, and low self-esteem should be considered in the treatment of somatization disorder.

Background and Objectives: Antibiotics are among the most effective drugs used to treat humans. These materials enter in different ways into sewage and known as important biological contaminants in aquatic and agricultural environment. The availability of conditions for antibiotic resistance gene transfer to sewage bacteria, converted human environmental wastes to an important source of antibiotic resistant bacteria. Considering the spread of antibiotic resistant strains in treatment centers of Qom province, the aim of this study is to investigate the frequency and antibiotic resistance pattern in coliform bacteria isolated from wastewater treatment system of Qom city in different seasons.Methods: This study was carried out on 120 samples of municipal wastewater treatment plant (incoming and outgoing) in Qom. After sampling, transport of samples to the laboratory, isolation and phenotypic identification of bacteria, and Determination of antibiotic resistance pattern, were performed according to CLSI standards. The frequency of bacteria was determined using most probable number (MPN) method.Results: In this study, of 384 strains of bacteria (isolated in spring, summer, and winter), Escherichia coli (50%), Citrobacter (30%), Enterobacter (11%), Klebsiella (1%) and non-coliform bacteria (Proteus sp.) 8%, were identified. The most antibiotic resistance was observed in Citrobacter and Enterobacter bacteria (isolated in summer) to penicillin G with a frequency of 94%.Conclusion: Due to the high frequency of antibiotic resistance in Citrobacter and Enterobacter strains in the sewage treatment plant in Qom province, especially in the summer, this ecosystem can be reported as an important source of spread of antibiotic-resistant strains.

Background and Objectives: Since academic libraries have a significant role in promoting educational and research purposes of universities, therefore, assessment of the quality of services provided based on the expectations and needs of users with scientific standards, seems to be necessary. In the current research, library services of Qom University of Medical Sciences, were evaluated from the viewpoint of students and academic members based on LibQUAL Model.Methods: The present research was performed as an applied descriptive-analytical study. The statistical population included all library members of the Qom University of Medical Sciences in the first semester of the academic year 2014-2015. At the time of this study, the participants were 1464 individuals, from which, 466 subjects were selected as samples using stratified random sampling method. Data collection tool was international LibQUAL questionnaire, which its reliability and validity was confirmed in several national and international studies. Data were analyzed using t-test at 95% confidence level.Results: Based on the findings of the study, service adequacy and excellence gap was negative in the domains of control of information and library as place, and the mean level of library services in these libraries was evaluated to be less than the minimum expectations of users.Conclusion: The findings of the present research showed that showed that the libraries of the Qom University of Medical Sciences have the highest weakness in the domains of the control of information and library as place and were not able to meet the minimum expectations of their users. The gap between the received services and maximum expectations of users was also high, which indicates that the libraries of Qom University of Medical Sciences have been weak in all domains of LibQUAL.

Background and Objectives: After live attenuated and subunit vaccines, DNA vaccines were introduced as a third generation vaccine in the field of vaccinology. This type of vaccine is a promising approach to deal with infectious agents in the future. Although, many aspects of this type of vaccine has not yet been identified, its use has been initiated in humans and clinical trials, and several DNA vaccines have been developed against veterinary infectious diseases. This generation of vaccine has provided new approaches to deal with and control existing diseases. In addition to infectious diseases, this type of vaccine can also be used against different types of tumors. Despite numerous attempts, only one type of DNA vaccine has been approved for use in human. The present study focuses on biology, advantages, and disadvantages of DNA vaccine and investigates its capacity in stimulating different types of immune responses.