Avicenna Journal of Clinical Medicine
Year:2015 | Volume:22 | Issue:1 (SN 75)|Papers Count:16

Introduction & Objective: Umbilical cord infections are of main causes for neonatal morbidities and mortalities. Different methods are used for umbilical cord care with multifarious efficiencies. The aim of this study was to compare three methods of local use of maternal milk, local use of 96% ethyl alcohol, and dry cord care.Materials & Methods: In this prospective, randomized, clinical trial, 207 healthy full-term neonates were randomly assigned to three groups. In the first and second groups, mothers rubbed her milk and 96% ethyl alcohol on umbilical cord until two days after its separation, respectively. In the third group, they only kept the cord clean and dry. The length of umbilical cord separation was compared among the groups with ANOVA and Tukey HSD tests.Results: The difference among lengths of umbilical cord separation in three groups was statistically significant. For alcohol users group, this time was significantly longer than that for the other two groups. The difference between cord separation time in maternal milk users and dry cord care groups was not statistically significant.Conclusion: Usage of maternal milk on umbilical cord and keeping the cord dry are acceptable methods but alcohol is not recommended for cord care in healthy term neonates with home care and in normal state.

Introduction & Objectives: Coronary artery disease is a common cause of death over the world. The aim of this study was to compare the risk factors frequency in patients with ST-elevation MI & patients with non ST-elevation MI referring to Hamadan Ekabatan hospital in 2012.Materials & Methods: In this cross sectional- descriptive study with referring to the files of patients, those having AMI were selected. Then, check lists were completed according to their history and laboratory. The data was analyzed by SPSS software and X2 statistical tests.Results: In this research, 245 patients with AMI were studied. 41.2% had ST-elevation MI & 58.8% had Non ST-elevation. In male patients smoking (60%) and in female patient's diabetes mellitus, HTN (54%) had maximum relative frequency in risk factors, respectively. In this study, HTN (45.7%) had maximum frequency in risk factors & other risk factors in order of relative frequency were: Smoking (41.6%), HDL<35 (41.2%), LDL>130 (39.2%), TG>150 (34.4%), DM (32.8%).Conclusion: Hypertension & hyperlipidemia both independency and with other risk factors, are important factors in suffering AMI. Smoking and diabetes mellitus play an important role together with other risk factors.

Introduction & Objective: Polycystic ovary syndrome (PCOS) is a common disorder that almost 10 percent of women of childbearing age are affected. This syndrome, are the cause of infertility in women and increasing risk of serious metabolic disorder that causes morbidity. Weight loss leads to return of the cycle of ovulation and achieving pregnancy in many of these patients. Based on these, researchers intend to study the effects of green tea on weight, and hormonal parameters in polycystic ovary syndrome.Materials & Methods: In this double-blind randomized clinical trial, 60 women with PCOS and overweight or obesity were randomly divided into two groups. Our study populations were patients with PCOS referred to Alzahra university hospital in Isfahan city aged between 20 and 40 years. The intervention group received tea tablets and the control group placebo. Free testosterone and serum insulin concentrations were measured after twelve weeks in the two groups. Weight was measured in the both groups before and after the intervention. The data were statistically analyzed using SPSS software.Results: The mean free testosterone level was significantly different between the two groups after the intervention (P<0.001). Also the mean fasting insulin (P<0.001) and the mean weight was significantly different between the two groups after the intervention (P=0.031).Conclusion: Green tea intake in overweight and obese women with polycystic syndrome cause weight loss, reduced fasting insulin and lower levels of free testosterone.

Introduction & Objectives: Surface roughness affects beauty, hygiene, plaque retention and health of the gingival adjacent to the composite restoration. Many people use bleaching agents to beautify their teeth that may lead to changes in surface roughness. This study was designed to compare the silorane and methacrylate-based composites in bleached teeth.Materials & Methods: In this experimental study 48 composite resin disks were prepared and divided into 4 groups: P90, Z250, Z250XT and Z350XT (n=12). To determine the surface roughness, surface profile measurement of the samples was performed using profilometer. Samples of each diet group underwent 35% hydrogen peroxide in office whitening (Hpmax) in three 45-minute sessions one week apart. The secondary instances of surface profile was then measured. The data collected by the Kolmogorov-Smirnov test, one-way ANOVA, Tukey test and paired t- test at a significance level of 0.05 were analyzed using spss16.Results: There was a significant difference (P<0.05) in the surface roughness after bleaching on composite Z350XT with P90 and Z350XT with Z250. The surface roughness of all groups before and after bleaching showed a significant difference (P<0.05).Conclusion: The use of hydrogen peroxide 35% causes a significant increase in the surface roughness of composite P90, Z250, Z250XT and Z350XT.

Introduction & Objectives: Substance abuse and opioid dependency refers to hazardous use of psychoactive substance. Prevention and treatment of opiate dependence has not been successful. Most effective drug in agonist treatment of opiates is methadone maintenance therapy (MMT).But the lack of cooperation of addicts in methadone maintenance therapy has always been a big problem to continue. The purpose of this study is to investigate the retention in the MMT.Materials & Methods: This historical cohort study analyzed the medical records of patients of Baharan hospital in Zahedan. All 912 cases of methadone maintenance clinic of Baharan hospital in Zahedan 2011-2012 were studied and the data were analyzed using SPSS. Tables and indexes were analyzed by the Chi-square test and survival curves were plotted using Kaplan-Meier method and analyzed by Log-Rank test.Results: This study reviewed records from 912 patients with a mean age of 34.67% and standard deviation of 10.88 and the range of 15-86 years. 735 were male and 177 ware female. 1-moth retention rate was 71%, 3 months was 59%, 6 months was 47%, 1 year was 30% and 2 years was 17%. Kaplan-Meier median survival time of 8 months was estimated by relation-ship. Doses higher than 60 mg/d of methadone was associated with increased survival on MMT.Conclusion: Age increase, increase of employment time, increasing of the duration of drug abuse, increasing the daily dose of methadone, oral substance abuse increased retention rate and heroin abuse and smoking were associated with decrease retention rate of methadone maintenance therapy. So, with an emphasis on each of these factors effective steps can be taken to improve the cooperation of patients in MMT.

Introduction & Objective: Brucellosis is a zoonosis with worldwide distribution. Conventional methods for diagnosis of brucellosis include serologic tests and blood culture. The aim of this study was to compare the culture of clinical specimens and serologic test for the diagnosis of brucellosis.Materials & Methods: In a 15-month period, all patients with clinical suspected brucellosis were enrolled in this comparative-descriptive study. Blood specimens for all patients were obtained for culture and serologic tests including wright, coombs' wright and 2ME. A questionnaire including demographic, clinical and paraclinical characteristics was completed for each subject.Results: A total of 149 patients were enrolled in the study. The most common symptoms were fever, malaise, myalgia and sweating. Osteoarticular complications were observed in 106 (71.1 %) patients, of which, the most common type was sacroiliitis in 67 patients (45%). The results of serologic tests including wright, coombs’ wright, and 2ME were positive in 88.6%, 87.5% and 88.5% of the patients. Also, culture of clinical specimens were positive in 38.3% of the patients, of which, serology was positive in 91.2% of the patients.Conclusion: Serologic tests are useful for the diagnosis of brucellosis in most cases. Culture of blood and the clinical specimens are useful for definitive diagnosis even in patients with low titers of antibodies.

Introduction & Objective: Psoriasis is a chronic inflammatory disease, which seems to be caused by genetic and immunological factors. Several studies have shown that some hormones so such as prolactin have important role in the development of this disease. In this study, the se-rum levels of prolactin have been were measured in patients with psoriasis and compared with healthy peoples.Materials & Methods: In this case –control study, we evaluated 24 ages and sex matched patients with psoriasis referring to the department of dermatology of Farshchian hospital in Hamadan during one year (Apr.2013-May.2014) and compared them with healthy individuals. A PASI criterion was used to measure the severity of the disease. In the both groups, serum levels of prolactin and TSH (to discover hypothyroidism and due to hyperprolactinemia) were measured using ELISA method.Results: Serum levels of prolactin in the patients and healthy peoples were 12.8±9.1 and 8.9±3.6 ng/ml, respectively. In evaluating prolactin the differences between the patients and healthy peoples were significant (P=0.04).Conclusion: These results indicate that serum PRL levels may serve as a biological marker of psoriatic disease activity.

Introduction & Objective: In the year 2000, Gallagher presented a new classification for body mass on the basis of the Percentile of Body Fat (PBF), age, and sex. The World Health Organization defines gold standard for obesity as PBF>25% in men and >35% in women. The primary purpose of the study was to evaluate the accuracy of Gallagher’s classification in detecting overweightness and obesity on the basis of WHO gold standard cutoff points.Materials & Methods: In this cross sectional- descriptive study the sample consisted of 20163 adults. Body composition measures were obtained, using the Bioelectrical Impedance Analysis (BIA). The detection of obesity was done by computing sensitivity, specificity, Positive Predictive Power (PPV) and Negative Predictive Power (NPV) for various age and sex groups.Results: There were 14270 women and 5893 men, ranging in age from 18 to 85 years, who participated in the study between 2009 and 2014. On the basis of Gallagher’s classification, 2549 (43.2%) men and 2992 (21%) women were obese. The WHO gold standard cutoff points showed that 7126 (49.9%) women and 3208 men (54.4%) met the criteria for being classified as obese. The sensitivity ranged from 53.9% to 100% in males and 38% to 85% in females. The range of specificity among males was from 99.4% to 100%; it was 100% among females. The NPV ranged from 29.8% to 100% in males and 14.1% to 84.3% in females. The PPV ranged from 99.8% to 100 in males and it was 100% in females. Among females, the increase in age was associated with decrease in sensitivity and NPV.Conclusion: Gallagher’s classification is accurate in detecting overweightness and obesity among males between the ages of 18 and 40; however, it is questionable among females.

Introduction & Objectives: Aniline is an organic compound widely used in various industries. The release of this compound has had various environmental impacts. Thus, the assessment of efficient and practical methods for the removal of aniline from wastewater of these industries is remarkable. Taguchi model is a model for the analysis of experiments, that predicts both the effects of each factors and the optimum level of them using a certain number of experiment. The purpose of this study was the optimization of aniline adsorption on the raw and modified bentonite with a cationic surfactant using Taguchi model.Materials & Methods: In this experimental study, the raw bentonite and modified bentonite was prepared in a few steps. Then, 4 main factors (i.e. pollutant concentration, contact time, pH, and adsorbent dosage) on 4 levels were selected by Matrix L16 trials and the experiments were conducted in this matrix. The factors were also ranked based on the R-value. Then, the data were analyzed with Minitab 17 software. Finally, the adsorption of aniline on raw and modified bentonite was determined in optimal conditions.Results: The optimization of adsorption process using Taguchi model showed that the factors of importance for optimizing respectively were: contact time of 360 minutes, pH =10 pH, aniline initial concentration of 300 mg/L and adsorbent dosages of 40 g/L. The maximum ad-sorption of aniline onto raw bentonite and modified bentonite with cationic surfactant in optimal conditions were determined 81.86 and 8.75, respectively. The results revealed that Freundlich isotherm and pseudo-second-order kinetic model provided a better to the ex-perimental data.Conclusion: The results showed that the bentonite modified with cationic surfactant is efficient in the removal of aniline. At the same time, since bentonite is cheap and easily accessible, it is considered a desirable adsorbant.

Introduction & Objective: Lichen planus is a mucocutaneous disorder with unknown etiology, which may have lots of ethological factors like immunological ones. The disease appears in several clinical forms of which the erosive type is the most important despite its low prevalence. This is because of the signs like pain, irritation and risk of malignancy. In spite of using different drugs, there is no actual treatment for it yet. With respect to the role of calcium in wound healing procedures and regulating immune system, lower serum calcium levels can be considered as one of the factors causing the disease. This study was aimed to investigate the serum total and ionized calcium of patients with erosive oral lichen planus.Materials & Methods: In this case- control study, 36 patients with oral erosive lichen planus and 72 control subjects were selected randomly and their total and ionized serum calcium were investigated by ISI and Crosolphthalein complex methods. Descriptive statistics as well as two sample t-test, were applied to the data using SPSS15 software.Results: According to the results, the mean numbers of total and ionized serum calcium in the patient group (8.8 mg/dl, 1.11 mmol/L) and control subjects (9.4 mg/dl, 1.18 mmol/L), there were statistically significant differences in total and ionized serum calcium between the groups.Conclusion: It was found that the total and ionized serum calcium in the patients with oral li-chen planus is lower than those of the control subjects.

Introduction & Objectives: Alopecia or hair loss is defined as the loss of hair on the head or body. Despite the benign prognosis of hair loss, it has a clear impact on the quality of life of the patients who are involved. There are many reasons to explain the pathophysiology of hair loss. Among many nutritional factors, vitamin D deficiency may play a role in hair loss too. Active vitamin D or 1, 25 dihydroxy vitamin D has an effect on the expression of some genes in normal differentiation of epidermal cells and hair follicles. The purpose of this study was to determine the level of vitamin D in patients with hair loss compared with healthy controls.Materials & Methods: From 2014 to 2015, 70 patients were enrolled in this case-control study. Including 40 women and 30 men, the mean age was 31.2±0.82 years in the case group, 33.8±0.92 years in the control group. Groups were matched by sex, age and season of review. In the both groups, there were 20 women (57.1%) and 15 men (42.5%). After the clinical diagnosis of hair loss by the physician, patient's blood samples were sent for testing vitamin D levels by kits of a laboratory center.Results: Patients, compared with controls, had lower levels of vitamin D and there was significant relationship between hair loss and low levels of vitamin D (16.188±6.91 vs 20.37±7.47, and P=0.04). Female patients had lower levels of vitamin D, compared with controls and there was significant relationship between hair loss and low levels of vitamin D (14.14±5.8 vs 18.74±7.08 and P=0.03). The group of male patients had lower levels of vitamin D, but in comparison with the control group, no significant relationship was found.Conclusion: This study showed that, there is a relationship between vitamin D levels and hair loss in women.

Introduction & Objective: Infertility affects 10-15% of couples worldwide, and male factors account for nearly half of all infertility cases. Evidence suggests that genetic variation in anti-oxidant enzymes could influence male infertility. Glutathione peroxidase 1 (GPx1) is an anti-oxidant selenoenzyme that detoxify peroxide radicals. GPx1 Pro198Leu polymorphism causes an aminoacid change from Pro to Leu at codon 198, with the Leu variants being less active than its Pro counterpart. The aim of this study was to determine the association between GPx1 Pro198Leu polymorphism and idiopathic male infertility.Materials & Methods: The case – control study comprised of two groups: 100 infertile patients and 120 fertile healthy control men. Genotyping was carried out by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) using ApaI endonuclease. Chi-square test was applied for statistical comparison of genotype data.Results: The prevalence of genotype frequencies of the GPx1 gene Pro/Pro, Pro/Leu, Leu/Leu were 13%, 76%, 11% in infertile male, respectively, while in the control were 24.17%, 67.5%, 8.33%, respectively. Allele frequencies of the GPx1 gene Pro, Leu were 0.51, 0.49 in infertile male, while in the control were 0.58 and 0.42, respectively. No significant differences between cases and controls were found in the allelic and genotype distribution of the GPx1 Pro198Leu polymorphism (P>0.05).Conclusion: In conclusion, the overall results of the study indicate that GPx1 Pro198Leu poly-morphism is not associated with idiopathic male infertility. However, further research is re-quired to clarify the role of GPx1 gene in idiopathic male infertility.