Journal of Arak University Medical Sciences
Year:2023 | Volume:26 | Issue:4|Papers Count:8

Introduction: Despite the adverse consequences of cesarean delivery, its incidence rate is increasing in many provinces of the country, especially Ilam city. For this reason, it is important to identify the causes of the increase in cesarean delivery in order to reduce it. Therefore, the present study was conducted with the aim of determining the frequency of cesarean section and its causes in primiparous women in Ilam city in 2016. . Methodology: The present study was conducted cross-sectionally in the second half of 2016 in Ilam city, and the study population was all primiparous women referred to a single specialty maternity hospital (Ayatollah Taleghani Hospital). The sampling method was census and all cesarean deliveries were recorded in Ayatollah Taleghani Hospital. The inclusion criteria included all primiparous women. The data of the study was collected using a researcher-made questionnaire that included demographic and midwifery information. After collecting the data, the data was entered into the SPSS version 16 software Central indices were used to describe data in quantitative variables, and absolute and cumulative frequency and percentage of dispersion frequency were used for qualitative variables. Findings: According to the findings of this study, out of 1738 births, 867 (49. 88%) were natural births and 871 (50. 12%) were cesarean. Among the natural births, 427 (49. 25%) and among the cesarean births, 296 (33. 98%) were primiparous. Among the maternal factors, lack of progress and among the fetal factors, fetal distress and among the maternal-fetal factors, head-to-pelvis disproportion was one of the most important causes of cesarean delivery in primiparous women. In general, fetal factors with more than 67% were the most important causes of caesarean section in primiparous women. Conclusion: According to the findings of the study, 33. 98% of cesarean births were primiparous. Considering the high statistics of caesarean section, especially cesarean section for first births, It is necessary to reduce the number of elective cesarean sections by increasing the number of physiological births and painless births, as well as increasing the awareness of families about birthing methods and the advantages and disadvantages of each of them.

2Introduction: Urinary tract infection (UTI) is one of the most important and common infections in children. The aim of this study was to investigate the frequency of qnrB and qnrS genes in Escherichia coli and Klebsiella pneumoniae isolated from urinary tract infections of children in 17 Shahrivar Hospital in Rasht. Materials and methods:  In this descriptive cross-sectional study, 49 strains of Escherichia coli and Klebsiella pneumoniae were isolated from 17 Shahrivar Hospital in Rasht and identified using biochemical methods. Sensitivity and resistance of strains to antibiotics were determined by Kirby Bohr and dilution broth methods. PCR method was used to evaluate the frequency of qnrS and qnrB genes in isolates. Results: In this study, the highest resistance was observed in piperacillin (81.5%) and cefazolin (88.9%) isolates from Escherichia coli and in Klebsiella pneumoniae (cefazolin (90.9%) and amoxicillin (95.5%) isolates from 49 Isolated, 73.4% had qnrB gene and 97.9% had qnrS gene. Conclusion: It seems that one of the reasons for increasing multidrug resistance in hospital isolates of urinary tract infection (UTI) in Rasht is the increased transfer of plasmid genes between these isolates.

2Background and Aim: Alzheimer's Disease (AD) is a progressive neurodegenerative disease characterized by loss of memory and multiple cognitive impairments. Materials and Methods: In this study, key terms were searched in reputable Persian and English databases including DOAJ, PubMed, Google Scholar, LISTA (EBSCO), Embase, and Web of Science. Articles focusing on the molecular basis and pathogenesis of the disease, as well as biomarkers for Alzheimer's diagnosis, were reviewed. In this article, we have attempted a comprehensive review not only of the molecular basis of Alzheimer's disease from a molecular medical perspective but also to address numerous molecular diagnostic methods and biomarkers at both clinical and research levels in this disease. Ethical Considerations: All Ethical principles in writing this article have principles been observed according to the instructions of National Ethics Committee and the COPE regulations Findings: The results of this review study indicate that the major factors involved in the pathogenesis of Alzheimer's include beta-amyloid peptides, hyperphosphorylation of tau protein, and activation of inflammatory and oxidative stress pathways. Subsequently, this leads to synaptic loss, mitochondrial dysfunction, and proliferation of activated astrocytes and microglia, which are clinically manifested as memory loss in patients." Conclusion: Although no precise diagnostic method exists for AD, current clinical recommendations for AD diagnosis include assessing tau protein and beta-amyloid (Aβ) peptides in cerebrospinal fluid, magnetic resonance imaging (MRI) for brain volume, and positron emission tomography (PET) scanning for Aβ plaques and/or glucose metabolism in the brain.

2Background: Today, infertility is a major concern for public health and one of the most important crises in life, which leads to many psychological problems. Since cognitive-behavioral therapy emphasizes empowering and educating the patient to solve problems, this study was conducted to investigate the effectiveness of cognitive-behavioral therapy on marital self-regulation and uncertainty intolerance in infertile women. Methods:  This clinical trial study was performed on 30 infertile women referring to the infertility center of Sari city in two groups of case and control (15 patients in each group). Cognitive-behavioral therapy was performed in 12 sessions of 45 minutes, once a week for the experimental group, while the control group received the routine treatment. After the follow-up period, the control group also underwent psychotherapy. Both groups completed the questionnaires of marital self-regulation by Wilson et al. (2005) and uncertainty intolerance by Friston et al. (1994) in the pre-test, post-test and follow-up (45 days after the post-test) and were compared. Finding: The results showed that in the two subscales of marital self-regulation in the experimental group, the average scores in the three stages of pre-test, post-test and follow-up respectively for the subscale of communication self-regulation (24.266 ± 6.273), (41.000 ± 3.207) and (35.266 ± 3.899) there was a significant increase in the post-test and follow-up compared to the pre-test stage(P<0.05). And the sub-scale of communication effort(19.333 ± 5.094), (8.666 ± 1.914) and (12.000 ± 2.449), and intolerance of uncertainty 92.600 ± 9.302), (67.400 ± 7.585) and (75.200 ± 10.975), had a significant decrease in the post-test and follow-up compared to the pre-test stage (P<0.05). Conclusion: The results of the study showed that cognitive-behavioral therapy can be an effective intervention in improving marital self-regulation and reducing intolerance of uncertainty in infertile women.

Introduction: stress is an important criterion affecting personality on a general and minor level. Aim: The present study aimed to assess the mediating role of stress in two diagnostic criteria of personality disorder, personality functioning (criterion A) and pathological personality traits (criterion B). Method: The research method was descriptive-correlational. The statistical population was students studying at the University of Kurdistan in the academic year 2020-2021. By the available sampling method, 313 (50. 08% of women) completed online PID-5, LPFS and PSS-14 questionnaires. Data were analyzed by structural equation modelling and using AMOS software version 24 and SPSS. Results: The result of the direct path shows the mediating role of stress on personality detachment (0. 85) and antagonism (0. 88) traits. However, psychoticism, negative affectivity and disinhibition traits do not play a mediating role. In general, there was a positive relationship between stress and personality functioning (0. 45) and personality traits (0. 27). Conclusion: The undeniable impact of stress on both personality functioning and personality traits is apparent. Broadly speaking, stress influences the alternative model of personality disorders, encompassing criteria A and B. Keywords: Stress, Personality traits, Level of personality functioning, AMPD, ICD-11

Background and aim: Attention deficit hyperactivity disorder is very common in athletes. This study aims to investigate the impact of transcranial electrical stimulation of alternating current on response inhibition and selective attention in athletes with ADHD.  Materials and methods: The present study was quasi-experimental with a pretest, posttest, and follow-up design with the control group. The statistical population was 160 elite athletes with ADHD aged 9 to 11 years (60 girls and 100 boys). Of these, 120 athletes with ADHD were randomly selected and assigned to three groups of 40: control, sham, and tACS. First, a pretest was done, and then all subjects in the sham and experimental groups received F3(Anodal) and F4(Cathodic) fake and real stimulations, respectively, with a current of 1 mA (10 Hz) for 15 minutes in 10 sessions. The control group did not receive any intervention, then each group was re-examined. A follow-up test was done after two weeks. The Continuous Performance Test (CPT) and Stroop were used in this study. For data analysis, Mixed Anova, one-way ANOVA, and Benferroni's post hoc test were used with using Spss version 21 statistical software (p≤0. 05). Ethical considerations: This study is approved sport sciences Reserch Institute with ethical registration code IR. SSRI. REC. 1401. 1361. Parents gave written informed consent form. Results: The results showed that tACS was effective in the response inhibition and selective attention of athletes with ADHD and led to the improvement of response inhibition and selective attention of these subjects. Conclusion: Based on the findings, the tACS protocol of 1 mA can be used as an effective treatment to improve inhibition and selective attention of athletes with ADHD.

Background and Aim: This study aimed to compare the microleakage of an adhesive fissure sealant (AFS), a flowable composite resin (FC), and a resin-modified glass ionomer (RMGI) in permanent teeth. Materials and Methods: This in vitro, experimental study was conducted on 45 extracted posterior teeth with sound fissures. The teeth were randomly divided into 3 groups (n=15). The occlusal fissures were sealed with Beautisealant AFS without etching and bonding in group 1, with Beautifil FC after 37% phosphoric acid etching in group 2, and with Fuji II LC RMGI in group 3. The teeth underwent 500 thermal cycles (5-55°C), and their apices were sealed with wax. They were then immersed in 2% methylene blue for 24 hours. Next, the teeth were sectioned buccolingually and inspected under a stereomicroscope to measure the dye penetration depth as an indicator of microleakage. Data were analyzed by ANOVA, Chi-square test, and Scheffe test (alpha=0. 05). Ethical consideration: The study was approved by the ethics committee of Hamadan University of Medical Sciences (IR. UMSHA. REC. 1399. 728). Findings: The microleakage score of RMGI was significantly higher than that of AFS and FC (P<0. 05), while the microleakage scores of FC and AFS were not significantly different (P=0. 330). Conclusion: The AFS showed a sealing ability comparable to that of FC, and can be used as an alternative to FC due to its fewer application steps.

Introduction: Insomnia and sleep disorders are related to a decrease in physical and mental health and quality of life. The purpose of this study was to investigate the effect of sleep deprivation on blood sugar, cortisol and insulin levels in athletes compared to non-athletes. Methods: In this semi-experimental study, 14 healthy men participated in two groups of athletes (7 people) and non-athletes (7 people). One night of sleeplessness (8 hours) was applied to the subjects of both groups. According to the objectives of the research, blood samples were taken from all the subjects in two stages. The data were analyzed using the dependent t test for intra-group comparison and independent t test for inter-group comparison at a significance level of 5%. In conducting the research, the principles of the Declaration of Helsinki, the general guidelines for ethics in research with human subjects and the regulations governing it were observed and the code of ethics was issued by the ethics committee of Lorestan University. Findings: Insomnia did not lead to a significant difference between the blood sugar and insulin levels of athletes and non-athletes when faced with a (p≤0. 05). Also, insomnia did not cause a significant difference in the amount of cortisol between two groups of athletes and non-athletes (p≤0. 05). Conclusion: It seems that changes in blood sugar, cortisol and insulin are related to the duration of insomnia and are not affected in short-term and intermittent insomnia. Keywords: Insomnia, blood sugar, cortisol, insulin, athlete, non-athlete