Crescent Journal of Medical and Biological Sciences
Year:2018 | Volume:5 | Issue:2|Papers Count:20

Women in the Kurdistan region of Iraq suffer from various health, social and cultural problems. The poor reproductive health of many women is primarily related to inadequate access and utilization of health services. The maternal mortality rate in Iraq has remained high, and its attributes such as early marriage and childbearing, inadequate birth spacing and high cesarean section rates are constant problems in the region. Women also suffer from different aspects of gender discrimination and women’ s rights abuse such as domestic violence, female genital mutilation, self-mutilation, and honor killing. Many of these problems are deeply rooted in the culture, and the efforts against them face many challenges. Improvement of women’ s health in the Kurdistan region of Iraq needs an integrated approach that takes into consideration the physical and mental health of women, their families and societies in a holistic way. Interventions should address the cultural and traditional issues sensitively. The strategies to ban harmful behavior, including female genital mutilation and violence against women, need active engagement of the community and educating its members.

Objectives: The combination of 2 chemotherapeutic agents has been recommended in order to reduce their adverse side effects and potentiate their efficacy. The aim of the present study was to assess the antineoplastic activity of doxorubicin (DOX) combined with gemcitabine (GEM) in nanoemulsion (NE) against various cancer cells and to examine their adverse effects on the healthy human foreskin (HFS) cells. Materials and Methods: The physical characterizations of the drug-loaded NE formulations were determined by Zetasizer. The cytotoxicity of the drugs was evaluated by the thiazolyl blue tetrazolium bromide (MTT) assay while the mechanism of cell death was examined by light microscopy, nuclear staining with 4′ , 6-diamidino-2-phenylindole (DAPI) and ApopNexin FITC apoptosis detection kit. Results: The Zetasizer results demonstrated that the nanoparticle of the combination of 5 μ M of DOX and GEM in NE (5DOX/5GEM-NE) has a particle size of 155. 38 ± 3. 08 nm with a polydispersity index of 0. 02 ± 0. 28 and a negative zeta potential of-7. 70 ± 1. 30 mV. The 5DOX/5GEM-NE has decreased the percentages of HeLa cervical cancer cell viabilities to 27. 00 ± 5. 62%, but it has not considerably changed the percentages of HFS cell viabilities (97. 06 ± 6. 09%) when compared to the single treatments of DOX and GEM. According to the mechanism of cell death studies, 5DOX/5GEM-NE has induced apoptosis in HeLa cells without affecting the HFS cells. Conclusions: The present study proved that formulating DOX and GEM in NE has ameliorated the efficacy of DOX and GEM as anticancer drugs while reducing their adverse effects on the healthy cells.

Objectives: Transient global cerebral ischemia (TGCI) is induced by occlusion of the bilateral common carotid artery occlusion (BCCAO), and it mediates neuronal cell death in the CA1 hippocampal area. AM251 is a cannabinoid receptor type 1 (CB1) blocker that has been known to be protective against transient focal cerebral ischemia. JWH-015 is a selective agonist of CB2 and activator of CB1 that is involved in the promotion of neuronal recovery and survival. The aim of this study was to investigate the role of combined application of JWH-015 and AM251 in the rat model of GCI. Materials and Methods: Male Wistar rats underwent 20 minutes of ischemia followed by reperfusion. Then, 1 mg/kg JWH-015 and 2 mg/kg AM251 were administered through the caudal vein. The groups were control, sham, ischemia, vehicle, AM251, JWH-015 and AM251 + JWH-015. Animals were sacrificed 1 week after BCCAO. Results: The AM251 + JWH-015 group indicated a significant increase in the protein expressions of AKT1, Bcl-XL, Bcl-2 and Bad 14-3-3, but it showed a considerable decrease in the protein expressions of Bad and JNK1/2 (P ≤ 0. 05 vs. AM251, and JWH-015 groups). The AM251 + JWH-015 group had a significantly higher number of alive cells and lower number of apoptotic cells in the CA1 hippocampal area and it also had a considerable improvement in spatial memory (P ≤ 0. 05 vs. AM251, and JWH-015 groups). Conclusions: The results of this study indicated that combined application of AM251 and JWH-015 could be neuroprotective against detrimental effects of ischemia probably via suppression of neuronal apoptosis and maintenance of their survival.

Objectives: Since history taking is still the most important part of a medical diagnosis, we tried to find sensitive and specific symptoms and risk factors in order to differentiate small airway disease from other pulmonary diseases. Social factors as well as related past medical history including using spirits of salt (HCL), gastro-esophageal reflux disease (GERD) and so on were evaluated. Materials and Methods: The present pilot study consists of 32 cases of small airway disease and 28 cases of other pulmonary diseases. The statistical evaluations were performed through 2 × 2 tables using Fisher exact test adjusted with Bonferroni correction for P values and Yate correction for odds ratios. The sensitivities and the specificities were also reported as we aimed. Results: Among the 4 symptoms evaluated, having sputum was against small airway disease (Pc = 0. 0184; ORc = 0. 23). Lack of sputum was 62% sensitive and 75% specific for small airway disease. Among the risk factors evaluated, using HCL showed the highest accuracy (Pc = 0. 0004; ORc = 31. 4; Sensitivity = 65%; Specificity = 96%; Accuracy = 80. 5%). History taking is still the most important part of a medical diagnosis. Conclusions: Through a suggestive history and physical examination, we can reach a good pretest probability for further evaluation.

Objectives: Delivery is a different experience in Iran. Delivery rooms are not private, women are not accompanied by their husbands or mothers, and the number of midwives per shift is not enough. Midwives also have a lot of responsibilities including labor control, doing delivery, and filling out the digital forms. The aim of this study is to develop psychometrics of perceived experiences of natural vaginal childbirth in Iranian primiparous women. Materials and Methods: This cross-sectional study was done in the postpartum unit of Taleghani hospital (Arak, Iran). In the design stage, questionnaire items were extracted from a comprehensive review of qualitative and quantitative studies and similar tools. A 25-item questionnaire was then designed, validated, and distributed among 400 primiparous women (selected via simple random sampling). The filled questionnaires were used for factor analysis. The validity of the tool was then found using face and content validity. Its reliability was also confirmed by internal consistency. Results: The questionnaire to assess the perceived experiences of natural childbirth in primiparous women contained six domains including privacy (6 items), mother’ s experience of childbirth (5 items), mother’ s experience of midwife’ s behavior (5 items), midwife’ s support (3 items), experience of childbirth pain (3 items), and understanding mother’ s expectations of the personnel (3 items). The internal consistency of the questionnaire was calculated as 0. 72. Conclusions: Valid and reliable tools like the one designed in the current research can facilitate the evaluation of services provided in delivery rooms and help women have a more pleasurable experience of childbirth.

Objectives: A reasonable number of male infertility cases are related to genetic factors. Considering the high prevalence of chromosomal abnormalities related to male infertility, this study investigated the association of the chromosomal aberrations and chromosome variants with hormonal levels, a positive family history, parental consanguinity and a specific lifestyle. We also aimed to find a predictive factor to estimate the risk of the presence of an abnormal karyotype in the azoospermic and especially sever oligozoospermic men. Materials and Methods: A total of 230 infertile men and 50 healthy controls enrolled in the study for cytogenetic evaluation. Data on patients’ characteristics were gathered, accurately. Results: Among aforementioned factors, only luteinizing hormone (LH) >12 IU/l raised the chance of detecting a chromosomal abnormality (P < 0. 05). The results also showed a higher level of follicle stimulating hormone (FSH) and parental consanguinity and a positive family history of infertility in infertile men compared with the control group (P < 0. 05). The incidence of chromosome abnormalities and chromosomal variants were 15. 2% and 10. 9%, respectively. The investigated variables revealed no association with the prevalence of chromosome heteromorphic variants. Conclusiond: This study suggests a positive family history of infertility, parental consanguineous marriages and high levels of FSH as strong determinants or risk factors for male infertility. Nonetheless, the presence of these patient characteristics did not prove to have a direct correlation with chromosomal abnormalities in male infertility. Among the various possible risk factors studied, an elevated gonadotropin level provides a better risk assessment for the incidence of chromosomal abnormality in infertile men.

Objectives: This study set out to determine the association between dietary intakes at lunch and postprandial peptide YY 3-36 (PYY3-36) 90-120 minutes after the consumption of lunch meal. Materials and Methods: In the present cross-sectional study, the subjects (n = 176) were asked to eat their lunch at work on the test day. The postprandial concentration of PYY3-36 was measured 1. 5 to 2 hours after the consumption of lunch meal. Results: The subjects within the age range of 25 to 39 and those with ages less than 25 (P = 0. 005) indicated the highest and the lowest levels of PYY3-36, respectively. Postprandial PYY3-36 had a direct significant association with fat content at lunch (P = 0. 049) and had an inverse association with cholesterol (P = 0. 001), docosahexaenoic acid (DHA) (P = 0. 040) and eicosapentaenoic acid (EPA) (P = 0. 022). Moreover, polyunsaturated fatty acids (PUFAs) and linoleic acid at lunch indicated a significant positive correlation with PYY3-36 (r = 0. 182, P = 0. 016 for both). Furthermore, a significant negative correlation was detected between energy intake at dinner and post-lunch PYY3-36 (r =-0. 216, P = 0. 004). Protein (OR [odds ratio] = 0. 390, 95% CI: 0. 160-0. 950) and fat intake (OR = 2. 697, 95%CI: 1. 103-6. 594) at lunch, energy intake at dinner (OR = 0. 298, 95% CI: 0. 127-0. 702), and energy spent to perform physical activities after lunch (OR = 0. 411, 95% CI: 0. 182-0. 929) significantly predicted the serum concentration of post-lunch PYY3-36. No significant association was found between PYY3-36 and glycemic index and load. Conclusions: There was a significant association between dietary intakes at lunch meal and post-lunch serum concentration of PYY3-36. Further large-scale cross-sectional researches and randomized controlled trials are needed to confirm the mentioned results.

Objectives: Among different micronutrient deficiencies, vitamin D deficiency (VDD) is nowadays considered pandemic. Therefore, the present study aims to investigate vitamin D status in the population referred to the laboratories of Ilam from 2014 to 2015. Materials and Methods: This cross-sectional population-based survey was conducted among the patients who referred to five laboratories of Ilam from July 2014 to July 2015. The samples were selected by a random procedure. 25-hydroxyvitamin D [25OHD] levels were determined by enzyme-linked immunosorbent assay (ELISA) method. Cut-off points for serum levels of 25OHD were defined as normal (>30 ng/mL), vitamin D insufficiency (VDI) (10-30 ng/mL) and VDD (<10 ng/mL). Data were analyzed using SPSS version 17. 0 by descriptive and analytical statistics (chi-square test). Results: In total, 7725 subjects (5273 females and 2452 males) with a mean age of 34. 96± 18. 10 years were investigated. The prevalence of VDD/VDI combined was estimated to be 65. 8%. Its prevalence was 67. 3% among females, and 62. 8% among the males. The prevalence of VDD and VDI was 12. 1% and 53. 7%, respectively. The highest prevalence of VDD combined with VDI was estimated for ages between 18 and 60 years (68. 3%). The mean 25OHD concentration was 27. 02± 18. 04 ng/mL and this concentration for male and female was 28. 39± 16. 48 and 26. 41± 18. 60, respectively. The relationship between VDD and age and sex was statistically significant (P < 0. 001). Conclusions: The results suggested that VDD and VDI are very prevalent in this region. Accordingly, it is necessary to take certain intervention measures such as medication and vitamin D-enriched nutrition to decrease VDD and VDI.

Objectives: The aim of the present study was to investigate the effects of Echinacea purpurea extract on sperm characteristics following testicular ischemia/reperfusion (I/R) injury in rats. Materials and Methods: To evaluate this hypothesis, 30 adult rats were randomly divided into 5 groups: sham operations, I/R group and 3 groups of treatment with E. purpurea extract (25, 50 and 100 mg/kg). To achieve testicular I/R, torsion (720° ) of spermatic cord for 2 hours and reperfusion of the tests for 24 hours were performed. Treatment was done by intraperitoneal injection of 3 different doses of E. purpurea extract, 1 hour after ischemia. Then, the sperm count, motility and mobility were determined. Results: There was a significant increase in sperm count, motility and mobility in treatment groups compared to I/R group (P<0. 05). Treatment with E. purpurea extract (25, 50 and 100 mg/kg) significantly attenuated the adverse effect of testicular I/R on sperm mortality compared to the control group (P < 0. 05). No significant difference was observed in hemograms. Conclusions: These results confirmed beneficial effects of E. purpurea extract on sperm characteristics after testicular I/R injury in rats.

Objectives: The aim of this study was to investigate the relationship between umbilical cord blood gases and neonatal asphyxia as valuable criteria for fetal distress and labor compilations. Materials and Methods: In this cross-sectional descriptive study of 150 deliveries (101 vaginal and 49 caesarean sections), singleton live-born infants between 34 and 42 weeks of gestation with no major anomalies. They were enrolled from November 2015 to March 2016, in delivery unit of obstetrics and gynecology ward, Imam Hossein Medical Center, Tehran, Iran. Blood samples were taken from umbilical vessels (arterial and venous) following delivery. All infants were monitored for Apgar scores at 1 and 5 minutes. Results: There were significant differences regarding venous blood lactate (P < 0. 000) and pH (P < 0. 000), venous (P = 0. 002) and arterial (P = 0. 038) blood base excess and venous (P < 0. 000) and arterial (P = 0. 002) blood PCO2 in samples from fetus with intrapartum distress compared to normal fetus. The mean Apgar score at 1 minute (P < 0. 000) and 5 (P < 0. 000) minutes were also significantly lower in the case group compared to the control group. Conclusions: The results of the present study indicate that lactate analysis, as well as umbilical cord blood analysis, might be useful predictors of fetal asphyxia at delivery. Their potential role as a predictor of prenatal outcome should be evaluated further in future studies.

Objectives: Every sudden and non-traumatic disorder with a major clinical manifestation in the abdomen is considered as an acute abdomen and requires urgent surgery, considering the fact that it is a cause of acute pancreatitis, which is usually associated with increased blood amylase and lipase levels. Therefore, the diagnostic value of amylase, lipase enzymes, their sensitivity, and specificity along with their positive and negative predictive value in the diagnosis of acute pancreatitis were evaluated. Materials and Methods: This descriptive-analytical study examined 244 patients who referred to Imam Reza and Sina Hospitals of Tabriz. The diagnostic values of two thresholds of 110 and 550 IU/L for amylase, and 80 and 400 IU/L for lipase were studied. Results: The results showed that 142 (58. 2%) of the patients were female. The mean age was 57. 97 ± 21. 22 years old. Eighty-one patients (33. 2%) had acute pancreatitis. At a cut-off of 110 IU/L, the sensitivity, specificity, positive predictive value, and negative predictive value of amylase enzyme were 0. 762, 0. 407, 0. 736 and 0. 988 and at a cut-off of 550 IU/L, they were 0. 598, 0. 943, 0. 876 and 0. 77, respectively. In the case of lipase, at cut-offs of 80 and 400 IU/L, the sensitivity of 0. 84 and 0. 519, the specificity of 0. 552 and 0. 847, positive predictive value of 0. 482 and 0. 627, negative predictive value of 0. 874 and 0. 87. Conclusions: The results showed that as the detection threshold increased, the specificity of tests increased, but the sensitivity decreased. In addition, studying the level of lipase and amylase enzymes can help in the diagnosis of acute pancreatitis.

Objectives: Breast and colon cancer are the most common malignancy in the world and the common causes of mortality in Western societies. The aim of the current study was to examine the effectiveness of Glycyrrhiza glabra and Arctium extracts on breast cancer (MCF7) and gastrointestinal cancer (HT 29) cell lines, with regard to their naturalness, low cost and easy public access. Materials and Methods: In this study, dose and time were considered as variables in order to determine the optimal effects of the drug. Two MCF7-and HT29 cell lines were cultured on a single layer in RPMI 1640 culture medium and MTT method and flow cytometric method were used to examine apoptosis. Results: The study of cell survival using MTT showed that the aqueous extract of G. glabra at a dose of 2000 μ g/mL and incubation for 24 hours had the most inhibitory effect on the MCF7-cell line. In addition, a dose of 2000 μ g/mL of G. glabra aqueous extract with-24hour incubation represents apoptosis by flow cytometric method. Conclusions: The results of this study confirm the effectualness of this herbal supplement for the treatment of breast cancer, and the inclusion of this herbal supplement in the diet may be effective in treating breast cancer, given the naturalness of the product, its low cost and public availability.

Objectives: Cyclophosphamide (CP) is one of the common medications used as chemotherapy and immune-suppressive agent in organ transplantation. Despite numerous clinical applications of this drug in cancer treatment, it causes adverse effects on body tissues, especially the male reproductive organs by increasing oxidative stress. The present study aimed to analyze the effects of ghrelin, as an antioxidant substance, on testicular damages induced by CP. Materials and Methods: Forty male mice were randomly divided into 4 groups: 1) control; 2) CP; 3) CP + ghrelin; and 4) ghrelin. CP (100 mg/kg body weight) was injected intraperitoneally once a week and ghrelin (80 μ g/kg body weight) was administered daily for 5 weeks. After 5 weeks, the testicles were removed and we investigated histological changes and testicular oxidative stress markers including malondialdehyde, superoxide dismutase, glutathione peroxidase, and total antioxidant capacity. Results: Our results showed that CP increased malondialdehyde level and decreased glutathione peroxidase, superoxide dismutase, and the total antioxidant capacity (P < 0. 05). Furthermore, degenerative changes in the testicular tissue were observed in CP group. The aforementioned factors were improved in the group that was treated with ghrelin (P < 0. 05). Conclusions: The results of this study revealed that ghrelin decreases the damages caused by CP in testicular tissue of mice by reducing lipid peroxidation and increasing total antioxidant capacity.

Objectives: Heart failure (HF), as a chronic disease, is a progressive and debilitating problem in communities. In previous studies, the role of self-care in HF has been emphasized. Illness-related worries and social support are associated with self-care. The aim of this study is to explore the role of illness-related worries as a mediator in the relationship between social support and self-care in patients with HF. Materials and Methods: This descriptive and correlational study was conducted on 149 HF patients based on inclusion and exclusion criteria, in 2016. Patients were selected using availability sampling. For data collection, a demographic information questionnaire, self-care behavior scale, illness-related worries questionnaire, and social support scale were used. In addition, the Pearson correlation coefficient and Sobel test were also conducted. Results: Sobel test results was used for understanding the mediating role of illness related-worries (P <0. 01, Sobel test result =-5. 16). The correlation between social support and self-care was-0. 518, P <0. 01, and the correlation between illness-related worries and self-care was-0. 71, P < 0. 01. Conclusions: This study showed that illness related worries can serve as a mediator in the relationship between social support and self-care. There was a significant correlation between the research variables.

Objectives: The area under the ROC curve (AUC) is a common criterion to assess the overall classification performance of the markers. In practice, due to the limited classification ability of a single marker, we are interested in combining markers linearly or nonlinearly to improve classification performance. Ramp AUC (RAUC) is a new statistical AUC-based method which can find such optimal combinations of markers. In this study, RAUC was used to find the optimal combinations of care indicators related to functional limitation as a complication of diabetes and accurately discriminate this outcome based on its underlying markers. Materials and Methods: This cross-sectional study was conducted on 378 diabetic patients referred to diabetic centers in Ardebil and Tabriz during 2014 and 2015. To have an accurate classification of diabetic patients according to their functional limitation status, RAUC method with RBF kernel was employed to look for an optimal combination of care indicators. Classification performance of the model was evaluated by AUC and compared with logistic regression, support vector machine (SVM) and generalized additive model (GAM) via training and test validation method. Results: Out of 378 diabetics, 67. 46% had functional limitation. RAUC had an AUC of 1 for the test dataset and outperformed logistic (AUC = 0. 079), GAM (AUC = 0. 082), SVM with linear kernel (AUC = 0. 67) and was slightly better than SVM with RBF kernel (AUC = 0. 98). Conclusions: There was a strong nonlinearity in data and RAUC with RBF kernel which is a nonlinear combination of markers could detect this pattern

Objectives: Currently, different materials are used to obdurate tooth root canals. An ideal root canal filling material should have some specific properties, including biocompatibility, dimensional stability and insolubility. Materials and Methods: One of the methods to evaluate these materials is to carry out solubility and microhardness tests. To this end, 20 mineral trioxide aggregate (MTA) samples were prepared for solubility test and 60 samples for microhardness test. MTA (Angelus, Brazil) was prepared based on manufacturer’ s instructions by mixing the powder and catalyst at a ratio of 1: 1 and was placed in Teflon molds. The samples were stored in a room with 95% relative humidity at 37° C for 390 minutes (3 times longer than the setting time). The solubility of the materials was tested by immersing the samples in distilled water and measuring weight loss at 24-hour and 7-day intervals. The microhardness was determined using Vickers test before and after immersion in Ringer’ s solution at different intervals and the results were compared. Results: The results showed that solubility of white MTA after 1 day was similar to that of gray MTA; however, after 7 days, its solubility increased. There were no significant differences in microhardness on day 1 and on the subsequent days between white and gray MTA samples (P < 0. 05). Conclusions: There was no significant difference in the solubility of white and gray MTA samples at 24-hour interval; however, at 7-day interval, the solubility of white MTA (WMTA) was significantly higher than that of grey MTA (GMTA) (with the solubility of both materials being <3%) In addition, there was no significant difference in microhardness of white and gray MTA between the first day and other intervals (P < 0. 05).

Necrolytic migratory erythema (NME) is a rare cutaneous manifestation that may present as the first sign of glucagonoma syndrome. Glucagonoma syndrome is associated with alpha-cell pancreatic tumor, increased glucagon in blood and skin rash (NME). NME is usually the first and rather exclusive manifestation of this syndrome, but may occur in other diseases, which is called pseudoglucagonoma syndrome. We report a case of NME which is associated with glucagonoma syndrome.

Introduction: Bicuspid pulmonary valve as a rare cardiac anomaly results in hemodynamic alterations leading to aneurysmal dilation of the pulmonary artery (PA), which has been reported in association with other heart defects. Pulmonic stenosis is usually presented as a part of a complicated disease (e. g. tetralogy of Fallot) or in association with other abnormalities such as corrected transposition of great arteries, although it can be developed as a distinct entity. Case Presentation: The case described in this study was a 36-year-old man with a history of syncope and dyspnea. The complementary studies revealed isolated bicuspid PS and aneurysmally dilated main PA. Conclusion: Both main PA aneurysm and fish mouth bicuspid pulmonary valve are rare cardiac anomalies that are sometimes presented in association with other heart diseases. Pulmonic stenosis can occur as an isolated anomaly but more often is a part of complex defects. The present report emphasizes the fact that an isolated bicuspid anomaly of the pulmonary valve may be compatible with normal cardiac anatomy and remain uneventful even on its own accord, although our case presented signs and symptoms of severe pulmonic stenosis at the age of 36.

Dear Editor, Crimean– Congo hemorrhagic fever (CCHF) is an emerging tick-borne (Ixodid ticks) viral infectious disease. CCHF is caused by RNA virus that is a member of genus Nairovirus in the family Bunyaviridae as the greatest virus family. This infection has vast geographical distribution in Asia, Africa and some parts of Europe. This agent can be transmitted to humans in several ways such as direct contact with infected body fluids and blood or ticks. Small mammals are the main hosts of the virus. Although, domestic livestock present no clinical sign, they can transfer the disease during the period of viremia. The acute form of the infection usually lasts for two weeks and is characterized by prolonged weakness and confusion....

This letter highlights that Helicobacter pylori infection may be effective on excessing hyperemesis gravidarum (HG) in pregnant women. Ordinary, there are different methods to H. pylori detection in the scientific laboratory, but many of false reports result in critical conditions like ulcer and carcinoma. Gastric complications including vomiting and nausea are a sever forms of pregnancy-associated sickness among 45% to 95% of women (1). HG is the main cause of gastric malformation and mucosa associated-lymphoma with weight losing, metabolic disturbance and nutritional problems (2-5). There are also factors involving HG, like steroids hormones (estradiol and progesterone) and immunological disorders (6).