Crescent Journal of Medical and Biological Sciences
Year:2018 | Volume:5 | Issue:4|Papers Count:18

Hospitals are the most important component of the health system in developing countries and accounts for about 50%-80% of total health costs (1, 2). It plays an important role in the health sector to have an effective, responsive promotion and improving public health. Hospitals are of great importance to analyze the efficient usage of valuable resources and prevent of fund loss (3). In recent decades, the efforts for reducing bed numbers and increasing the usage by patients along with reducing the length of stay and improving the admission process can have an impact on improving hospital performance, which result in lower cost for hospital by rising hospital bed occupancy rate, although that can lead to ascending hospital efficiency and tighter control of cost, but also to complications (4)....

Objectives: Noise is a potential environmental stressor affecting brain function as evidenced by altered stress neurotransmitters and hormone levels and psychobehavioral changes. Here, we explored the effects of noise exposure on the social behavior of mice as well as cerebral oxidative stress and neuroendocrine markers. Materials and Methods: In this experimental study, adult male mice were randomly allocated in; control-acute, acute-noise 90-dB, acute-noise 110-dB, control-chronic, chronic-noise 90-dB, and chronic-noise 110-dB groups. Animals in acute-and chronic-noise groups were exposed to 2 h/day of 90-or 110-dB white noise for one-day and three-month, respectively. At the end of the noise interventions, mice subjected to social interaction test. Also, serum levels of cortisol and cerebral malondialdehyde (MDA) levels, and superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities as well as total antioxidant capacity were measured. Results: Although mice in both acute noise 90-and 110-dB groups did not show any alteration in social behaviors and novel recognition performance, mice in chronic noise in 90-and 110-dB groups exhibited lower levels of mentioned behavioral paradigms. Moreover, these behavioral changes in the both chronic noise groups were accompanied by lower body weight, increased MDA levels, and decreased SOD and GPx activities, and reduced total antioxidant capacity levels. Interestingly, the acute noise increased brain MDA levels as well as enhanced SOD and GPx activities and total antioxidant capacity. Finally, we found lower serum cortisol levels in both acute and chronic groups. Conclusions: The noise exposure at levels ≥ 90-dB impairs sociability, associated with an imbalance of cerebral oxidative status and increased stress hormone.

Objectives: Today, medical research centers are recognized as the bases for development of high-quality medical knowledge in societies. In this regard, application of clinical iinformation system (CIS) facilitates the achieving of this goal. This study aimed to investigate the challenges and solutions of CIS in the gastrointestinal and liver diseases (GILD) research centers. Materials and Methods: This descriptive-fundamental research was conducted on gastrointestinal and liver diseases academic research centers of Tehran. Research sample was in line with the community, and the data were collected through interviews and using a questionnaire. In addition, validity and reliability of the questionnaire were confirmed via content validity and test-retest, respectively. Results: The results of the study showed that gastrointestinal and liver diseases research centers contained various service-providing sections, including endoscopy, colonoscopy and liver, gastrointestinal and inflammatory bowel diseases, and cancer and each of which had a separated and independent software with no connections to other software and HIS. Moreover, the software had no warning mechanism to track the patients for referral in due time. This mechanism was important since lack of timely referral of the patients could complicate the treatment process and reduce the general health level of the patients. Conclusions: It seems that the designers of CIS must consider the essential and acceptable standards and frameworks in designing and improving this system.

Objectives: Parkinson disease (PD) is characterized by protein aggregations in the cytoplasm of the dopaminergic neurons due to cellular stresses. In response to these stresses, autophagy is a conservative mechanism, and dysregulation of it results in protein aggregation. Despite the accepted prominent role of it in PD, autophagy associated-gene expression dysregulation involved in the autophagosome formation has remained largely unknown. In this study, the autophagy-related gene expressions in the rat model of PD were investigated. Materials and Methods: Male Wistar rats were divided into control, sham and PD experimental model groups. By injection of 6-hydroxydopamine (6-OHDA) into the striatum, the rat model of PD was induced. The apomorphine-induced rotation test was done 1 week before (baseline) and 4 weeks after surgery and also Nissl staining was performed for the brain sections. Then, rat substantia nigra pars compacta (SNpc) was extracted and RT-PCR was performed to detect the expression of FOXO3A gene and the autophagy-related genes (ATG). Furthermore, using Western blotting, we investigated the protein levels of ATG101. Results: Apomorphine-induced rotation test indicated significant contralateral rotations in the rat model group. Using RT-PCR, in the induction group, ATG101 was not expressed and ATG13, ATG14L, and VPS34 genes were downregulated in comparison with the control groups. Furthermore, Western blotting showed that ATG101 protein was not expressed in the model group. Conclusions: The results showed that deregulation of ATG101 expression, as a factor involved in the initial stages of the autophagy, occurs in the rat model of PD.

Objectives: This study aimed to determine the levels of 25(OH) D in endometriosis patients and to clarify the association between the endometriosis and dietary intake of calcium and vitamin D. Materials and Methods: A total of 200 women with endometriosis as endometriosis group and 154 healthy women (control group) of reproductive age were included in this study. The plasma 25(OH) D (vitamin D3) level was measured by high-pressure liquid chromatography method in endometriosis and control (healthy) groups. Participants in these 2 groups were asked about the dietary intake of calcium and vitamin D. Results: Our result showed the association between 25(OH) D deficiency and endometriosis risk (odds ratio [OR] = 29. 4, P < 0. 001). The intake of dietary calcium was also inversely associated with recurrence of endometriosis. However, this association was not observed between vitamin D intake and endometriosis. Conclusions: Our results showed that the decreased level of vitamin D (VD) is associated with the endometriosis risk. Accordingly, the authors validate that vitamin D deficiency may be regarded as a predisposing factor for endometriosis. In addition, a decreased risk of endometriosis with increasing calcium (Ca) intake was observed. Therefore, using Ca as dietary supplementation may be useful in the management of endometriosis in patients.

Objectives: Muscle weakness, movement disorders and fatigue due to multiple sclerosis (MS) cause a decrease in balance and physical activity, which may be linked to the body composition. The purpose of our study was to investigate the effect of clinical mat Pilates on anthropometric variables, functional indices, and fatigue in females suffering from MS. Materials and Methods: There were 30 female MS patients with mild to moderate disability, based on the McDonald criteria. They were randomly divided into 2 Pilates training (PT) and control (C) groups of equal size. The PT group followed the protocol of training 3d/wk for 8 weeks. The control group continued their routine life. Pre-and post-test of the variables in all the participants were done by one of the authors, who was blind to the groups. The anthropometric variables such as body weight (BW), body mass index (BMI), body circumferences (waist [WC], Hip [HC], mid-arm muscle [MAMC], and calf [CC]), waist to hip ratio (WHR), 7-site skinfold (chest, abdominal, thigh, triceps, subscapular, suprailiac, and midaxillary), fat percentage (FP), fat mass (FM), fat free mass (FFM), and body density (BD), functional indices consisting of balance, walking speed, endurance, and fatigue were accessed. Results: Statistical analysis demonstrated a significant decrease in BW, BMI, WC, HC, MAMC, skin-folds of the chest, abdominal, triceps, suprailiac, FP, FM and fatigue and also increase in BD, balance, walking speed, and endurance in Pilates group (P < 0. 05). Conclusions: An 8-week mat Pilates program as non-pharmacological intervention may positively affect anthropometric variables, Functional indices and fatigue which may decline some of the outcomes of muscle weakness as one of MS complications.

Objectives: Prolonged and recurrent exposure to chronic variable stress (CVS) may lead to cardiovascular dysfunction. It is a basic cause of heart failure. The aim of current study was to determine the effect of curcumin (CUR) on the treatment of cardiac dysfunction in rats with established CVS. Materials and Methods: Thirty-five adult male Sprague-Dawley rats were divided into 3 groups as control, CVS, CVS+CUR (100 mg/kg/d dissolved in 0. 5 mL of distilled water). All of the control animals and half of the animals in CVS and CVS+CUR groups were sacrificed after 15 days and the rest of animals were allowed to recover for 50 days. The relaxin (RLX), cortisol, adrenocorticotropic hormone (ACTH), oxytocin serum levels, and heart stereological structure were evaluated. Results: Significant deviations from the normal range occurred in RLX, cortisol, ACTH, and oxytocin serum levels in CVS and CVS + recovery groups compared to the control rats (P < 0. 01). Furthermore, weight and heart weight, volume of the hearts and ventricles, total number of the nuclei reduced, and also volume of the connective tissue and diameter of the total vessels increased in the CVS animals in comparison to the control ones (P < 0. 01). These parameters changed to a lesser extent in CVS+CUR animals compared to the CVS rats with or without a recovery period (P < 0. 01). Conclusions: Findings of this study suggested that CUR might have a therapeutic potential for heart structure and function following the established CVS by regulation of stress and cardiovascular-related hormones and outcomes related to the change of this hormone.

Objectives: Labor pain is an indispensable component of delivery process; however, excessive pain can reduce uterine contractions and delivery progress rate. This study was executed to compare the effect of aromatherapy with Rosa damascena and lavender essential oils on severity of pain in the first phase of delivery in primiparous women. Materials and Methods: In this clinical trial, 120 primiparous women with a dilatation of 3-4 cm were randomly selected from maternity hospitals of Zahedan and divided into 4 groups: ‘ inhalation of essential oils of R. damascena’ , ‘ lavender’ , ‘ their combination’ , and ‘ distilled water’ . The participants were asked to inhale the aroma during contraction and the severity of their pain was determined based on the visual scale of pain prior to the intervention and also 30 and 60 minutes after it. The data were analyzed using SPSS, chi-square test, one-way analysis of variance (ANOVA), repeated measure covariance analysis, and Bonferroni correction. Results: Comparison of the mean severity of pain in the 4 groups before the intervention showed a significant difference (P = 0. 001). Controlling the pre-test effect demonstrated that the essential oil aromas (R. damascena, lavender, and their combination) significantly reduced the mean severity of pain at 30 and 60 minutes after the intervention relative to distilled water (P = 0. 001), however, the difference between the three treatment groups was not significant. Conclusions: The results indicated that aromatherapy using essential oils of lavender, R. damascena, and their combination can reduce the severity of labor pain as an uncomplicated non-pharmacological approach.

Objectives: The aim of the present study was to evaluate the impacts of chavir aquatic extract (Ferulago angulata Boiss) along with aerobic exercises on serum levels of interleukin-10 (IL-10) and C-reactive protein (CRP) of obese males. Materials and Methods: In this study, 40 males with body mass index (BMI) >30 kg/m2 and average age of 33. 63 ± 4. 78 years were randomly categorized into 4 groups of 10 individuals as control, combination (using the aquatic extract of chavir along with aerobic exercises), consumption of chavir aquatic extract, and aerobic exercises. The aerobic exercises in both groups of combination and aerobic exercises consisted of running on treadmill for 20 minutes in 60%-70% maximum oxygen uptake (VO2max). The aquatic extract consumption and the combination groups had to take 50 mg/mL/d of chavir aquatic extract every time. The control group received no intervention. Results: Based on intragroup comparisons, body weight and BMI significantly decreased in the combination group; the content of body fat and waist-hip ratio (WHR) also reduced significantly in the aerobic, combination, and aquatic extract groups. In intergroup and intragroup comparison, CRP faced with a significant decrease in all groups (aerobic exercises, Ferulago aqueous extraction, and combination groups) and a considerable increase was also observed in the combination group regarding IL-10 variable. Conclusions: Therefore, the effectiveness of the combination group regarding increasing IL-10 and decreasing CRP is more than other groups. As a result, using aqueous extract of F. angulata and doing aerobic exercise for 3 months reduced risk factors – cardiovascular, body composition, and increasing anti-inflammatory in obese men. Consequently, the effect of combination group to reduce the proinflammatory indexes and body factors of obese males was more compared to that of the other groups.

Objectives: The use of pyrethroids (PYRs) due to availability and less toxicity to mammals is wide spread. Permethrin (PER) is type I pyrethroid which is usually used in agriculture industry and homes. High dose of these chemicals has destructive effects on biological systems mainly in spermatogenesis cycle. The aim of this study was to investigate the effects of PER on key genes of SF1 (steroidogenic factor 1) and LHCGR (luteinizing hormone/choriogonadotropin receptor) as well as hormonal levels (Luteinizing hormone [LH] and follicle-stimulating hormone [FSH] ) of testis. A natural antioxidant (onion) was used to investigate its positive impact on the negative effects of PER. Materials and Methods: Adult male rats were divided into 5 groups. Group 1 was considered as the control group. Groups 2 and 3 received DMSO (dimethyl sulfoxide) and PER per day (35 mg/kg), respectively. Group 4 received 3 mL of onion juice in addition to PER (with the same dose). Group 5 only received 3 mL of onion juice. After 2 months, the gene expression levels were examined using real-time reverse transcriptase polymerase chain reaction (RT-PCR). Testes were processed for sexual hormones level. Results: The results showed that exposure to PER demonstrated a significant reduction in expression of genes and hormonal levels. Onion juice had a moderate function in the expression of genes and prevented a decrease in serum levels of FSH and LH compared to normal condition. Conclusions: This hypothesis can firmly be stated that toxicity effects of PER can reduce male fertility. Therefore, consumption of natural antioxidants like onion can lead to a decrease in these damages.

Objectives: Although body image has been investigated in a variety of cosmetic surgeries, this study was the first research in Iran to examine the mental image of women seeking female genital cosmetic surgery (FGCS). Materials and Methods: The participants of this case-control study included a total of 163 women of reproductive age, who referred to the specialized gynecological clinic of Alavi hospital in Ardebil during February 2016 to July 2017. Of these participants, who were selected through convenience sampling, 83 were willing to undergo FGCS while the other 80 were not interested in this kind of surgery. Then, they were evaluated for pelvic organ prolapse. A questionnaire containing demographic questions as well as a body image questionnaire were used to collect the required data. Results: The total mean (standard deviation) body image score in the case and control groups was 237. 2 (22. 3) and 241. 7 (23. 1), respectively, indicating that no significant difference existed between the 2 groups. Regarding the components of body image, no significant difference was observed between the 2 groups in terms of body-self relations (P = 0. 101) and body weight perception (P = 0. 521). However, a significant difference was observed in terms of the mean body satisfaction score (P = 0. 004). Conclusions: Women interested in FGCS had less body parts satisfaction compared with those not willing to undergo this surgery. This can be useful in providing necessary consultations and trainings regarding the wide range of variation in natural appearance of the female genitalia for women willing to undergo these types of surgeries.

Objectives: The aim of this study was to investigate the effects of vitamin E and selenium (Se) on some liver enzymes, some oxidative stress markers, and the liver structure of mice using light and transmission electron microscope (TEM) following long-term electromagnetic field (EMF) exposure. Materials and Methods: Forty-eight female Balb/c mice were randomly divided into 6 groups (n = 8) as follows: control, EMF, EMF plus vitamin E, EMF plus Se, EMF plus vitamin E and Se, and vitamin E and Se groups. Mice in EMF group were exposed to EMF (3 mT and 50 Hz), 4 hours a day for 2 months. Treated mice received 0. 1 mg/kg Se and/or 1. 35 mg/kg vitamin E for 2 months intraperitoneally and daily. Anesthesia in mice were induced by ketamine/xylazine (10/2 mg/kg) and after taking blood samples for investigating some liver enzymes, mice were killed by cervical dislocation and their liver were removed by light and TEM for morphological studies and also evaluating some oxidative stress factors. Results: The level of malondialdehyde (MDA) increased in the liver of mice under EMF while the levels of superoxide dismutase (SOD), glutathione peroxidase (GPx), and total antioxidant capacity (TAC) decreased (P < 0. 05). Treated EMF groups by vitamin E plus Se and vitamin E alone significantly improved the levels of SOD, GPx, and TAC (P < 0. 05) while treatment with Se did not result in a significant effect. Histopathological analysis revealed that the livers of the mice’ that received vitamin E plus Se and vitamin E had fewer morphological changes compared to those of EMF groups. Moreover, some liver enzymes such as serum aminotransferase (AST), serum alanine aminotransferase (ALT), and alkaline phosphatase (ALP) significantly increased in the EMF group in comparison with those of other groups except for the EMF group treated with Se. Conclusions: The results of the study indicated that although Se had no significant effects per se, vitamin E and vitamin E + Se significantly reduced oxidative stress and some liver enzymes.

Objectives: Posterior uveitis is the second most common anatomical type of uveitis after the anterior in Iran. Its incidence and etiologies are not identical in populations of different races and socioeconomic backgrounds. In this study, the researchers intended to evaluate the causes of posterior uveitis in a referral center in northwest of Iran. Materials and Methods: In this cross-sectional retrospective study, clinical records of 120 patients with posterior uveitis referred to the Uveitis Clinic at the Nikookari hospital (during 2003 to 2017) were reviewed. Demographic findings, etiologies, clinical courses, associated systemic diseases, and ocular complications were analyzed. Results: Infectious etiologies were found in 69. 2% of the patients with posterior uveitis. The most common causes of posterior uveitis were toxoplasmosis (59. 2%) followed by idiopathic (10. 8%) and Behç et’ s (8. 3%) diseases. Macular scar (5. 83%) and macular edema (15%) were the most widespread complications in the patients. Posterior uveitis found in 20. 8% of the patients was associated with a systemic disease. In addition, Behç et’ s (8. 3%) and Vogt-Koyanagi-Harad (VKH) (4. 2%) diseases were among the most prevalent concomitant diseases. Non-granulomatous uveitis was observed in 84. 2% of cases. The course of the disease was acute in 83. 33% of the patients. Conclusions: The results of this study revealed that infectious etiologies were the most common causes of posterior uveitis. Toxoplasmosis and Behcet’ s disease were the most frequent cases. The most common complication of posterior uveitis was macular scar. It seems that identifying and analyzing causes of the posterior uveitis and its complications are crucial for the development of policies and treatment guidelines.

Objectives: Oxidative stress by cardiac ischemia causes protein modifications in serum albumin to create Ischemia Modified Albumin (IMA) and other circulatory proteins to create protein carbonyl (PC), whose increase from the baseline could be used as a diagnostic tool for cardiac ischemia disease. We aimed to evaluate the differentiation of IMA, PC, malondialdehyde (MDA) and total antioxidant capacity (TAC) between patients with early stage non-ST-segment elevation myocardial infarction (NSTEMI) and healthy control subjects and test their sole and integrative recognition efficiency as rapid predictive biomarkers for NSTEMI. Materials and Methods: We selected 52 patients of both sexes with the diagnosis of NSTEMI within 6 hours. Fifty-two healthy individuals without significant differences in sex and age having normal cardiac troponin I (cTnI) levels were enrolled as control group. Serum samples were collected and IMA, PC, MDA, and TAC levels were quantified and then, their findings were compared with serum cTnI levels as the “ gold standard” . Results: Linear regression, correlation, and receiver operating characteristic (ROC) curve analyses showed that both circulatory levels of PC and IMA were statistically elevated in NSTEMI patients compared to control group, and both had statistically high sensitivity and specificity for rapid prediction of NSTEMI. Combinatorial determination of both biomarkers increased the test specificity and negative predictive value (NPV). Conclusions: Both PC and IMA contents could be used as early biomarkers for diagnosis of NSTEMI and integrative determination of both biomarkers could be used in emergency departments for the fast diagnosis of NSTEMI.

Objectives: Gestational diabetes is a major prenatal problem and one of the most common complications of pregnancy throughout the world. Ginger can adjust biochemical pathways that are activated in some diseases such as diabetes by affecting insulin sensitivity. The present study was conducted to assess the effect of ginger capsules on the control of blood sugar in gestational diabetes. Materials and Methods: The present triple-blind randomized clinical trial was conducted on 76 women with gestational diabetes attending high-risk pregnancy clinics of Alzahra and Taleghani teaching hospitals and Imam Reza hospital in Tabriz in 2016. Eligible mothers were divided into intervention and control groups using block randomization. Data were analyzed using analysis of covariance (ANCOVA) and repeated measures ANOVA, chi-square, Fisher exact, chi-square for trend, Mann-Whitney, and independent t tests. Results: No significant difference was found between two groups in terms of personal-social details (P > 0. 05). No significant difference was observed between the 2 groups after 8 weeks of intervention in terms of fasting blood sugar (P = 0. 366). However, mean blood glucose 2 hours after meals, the dose of insulin received, and frequency of visits to the gynecologist after 8 weeks of intervention were significantly lower in the intervention group compared to control group (P < 0. 05). No significant difference was found between the 2 groups in terms of Hemoglobin A1C 8 weeks after intervention (P = 0. 248). Conclusions: Ginger capsule was able to reduce mean blood glucose 2 hours after meals, the dose of insulin received, and frequency of visits to the gynecologist in women with gestational diabetes. This medication is likely to promote the health of mothers with gestational diabetes and their infants.

Objectives: This study was conducted aiming at evaluating the translation as well as psychometric properties of Persian version of overactive bladder syndrome score (OABSS). Materials and Methods: To this end, 100 menopausal women aged 45 years or older, who had at least one urgency episode lasting at least 3 months, were recruited in the study and asked to complete the OABSS and international consultation on incontinence questionnaire overactive bladder (ICIQ-OAB) questionnaire. The validity of OABSS was assessed using concurrent validity. In addition, the reliability of the questionnaire was calculated using test-retest reliability as well as Cronbach α . Results: Generally, the results of the study showed that there were significant correlations between the total score as well as single scores of the Persian version of OABSS and ICIQOAB sum score. Cronbach α , based on current samples, was 0. 79 for the whole questionnaire. Moreover, the level of reliability calculated between the OABSS total scores at first and second time of administration enjoyed a good degree. Conclusions: Persian version of OABSS had an acceptable validity and reliability. According to the findings, the application of such questionnaires is beneficial in developing countries which are faced with resource scarcity.

Objectives: Continuous evaluation, supervision and improvement of the performance of emergency departments (EDs) are done using 5 emergency performance indices (EPI), which are significantly affected by various factors including inward and outward flow of patients, number of ED personnel being in proportion to the number of patients, rapid decision making, the rate of overcrowding in the ED and so on. Since health sector evolution plan (HSEP) can affect the performance of the ED by changing the mentioned factors, we decided to compare these indices in a 5-year period before and after the execution of this program. Materials and Methods: In this cross-sectional study, all performance indices of ED were calculated and analyzed using parametric and non-parametric tests from one year before to four years after the execution of HSEP. Data were analyzed using SPSS statistical software version 21. 0 and all tests were considered significant at 0. 05. Results: By continuous execution of HSEP, the total number of ED visits increased in levels 2 and 5 and decreased in level 4. The percentages of patients discharged within 6 hours and discharge against medical advice improved. Mean triage time in all levels, the percentage of patients leaving the ED within 12 hours, unsuccessful cardiopulmonary resuscitation, mean time interval between triage and the first visit in triage levels 3 and 4, and mean time interval between presentation and execution of orders by the nurse in all levels increased. Conclusions: Execution of HSEP can affect performance indices of ED.

Objectives: In this report, it was intended to evaluate the zinc serum level in cirrhotic patients (with or without encephalopathy) and patients with non-cirrhotic chronic liver disease. Materials and Methods: In the current analytic cross-sectional study, 75 patients were studied including 25 non-cirrhotic patients with chronic liver disease, 25 patients with liver cirrhosis, and 25 cirrhotic patients with hepatic encephalopathy. Then, the serum zinc levels of their blood samples were measured by spectrophotometry. Results: The average of zinc level was significantly lower in those patients who consumed diuretics or those with ascites (P < 0. 0001). In addition, the average of zinc level concentration was lower in patients with hepatic encephalopathy than patients without encephalopathy and non-cirrhotic chronic liver disease. Generally, the average of zinc in cirrhotic patients was lower than non-cirrhotic patients and in the group of child A it was higher than child B (P = 0. 025) and child C (P = 0. 003). Conclusions: In overall, the serum level of zinc was lower in patients with cirrhosis and those who consumed diuretics as compared to non-cirrhotic patients. The reduction of zinc in these patients may be due to less consumption of meat compounds as a rich source of zinc and also the consumption of diuretics that causes increased urinary excretion of the zinc.