Avicenna Journal of Clinical Medicine
Year:2020 | Volume:27 | Issue:1 (95)|Papers Count:8

Background and Objective: The management method of the luteal phase in the treatment of infertility is controversial, and there is no general agreement regarding the preferred protocol. The purpose of this study was to compare the pregnancy rate of frozen embryos in the long method with the gonadotropin-releasing hormone (GnRH) agonist and oral contraceptives (OCP) with estradiol alone. Materials and Methods: In this clinical trial study, a total of 128 in vitro fertilization candidates were randomly assigned into two groups of receiving 64 GnRH-OCP agonists (group A) and estradiol alone (group B). In group A, 15 days after menses, the patients received OCP for 12 days, and GnRH agonists were also given for 14 days. In group B, 6-mg estradiol valerate tablets were used twice a day for 5 days, in case of normal endometrial thickness for at least 10 days. Then, the consequences of the intervention were compared between the two groups. Results: According to the obtained results, the study groups were similar regarding mean age and duration, type, and cause of infertility (P>0. 05), and there was no significant difference in this regard. The mean of taken eggs, formed embryos, and transferred embryos were similar in terms of the number, motility, and morphology of the spermatozoa. The frequency rates of laboratory and clinical pregnancies were 17. 2% and 15. 6% as well as 23. 4% and 20. 3% in groups A and B, respectively (P>0. 05). The rates of abortion and multiple pregnancies were 1. 6% and 3. 1% in groups A and B, respectively (P>0. 05). Conclusion: The pregnancy rates of frozen embryos in the long method with GnRH agonist and OCP with only estradiol were not reported with a significant difference regarding pregnancy outcomes.

Background and Objective: Seborrheic dermatitis is a chronic inflammatory skin disease. Inflammation is one of the components of metabolic syndrome and many inflammatory cytokines play a critical role in this disease. This study aimed to investigate the correlation between seborrheic dermatitis and metabolic syndrome. Materials and Methods: This case-control study made a comparison between 39 seborrheic dermatitis patients (case group) who referred to Sina Hospital, Hamadan, Iran, and 39 healthy individuals (control group) in terms of metabolic syndrome parameters. The two groups were matched regarding age and gender. The data were analyzed in SPSS software (version 16. 0) (SPSS Inc. Chicago, IL). Results: High-density lipoprotein levels in the case group were significantly lower than those in the control group (females: P=0. 046 vs. males: P=0. 044). Moreover, the case group obtained higher mean values of triglyceride, cholesterol, low-density lipoprotein, fasting blood glucose, systolic and diastolic blood pressure, and waist circumference, compared to the control group; however, systolic blood pressure and waist circumference were just statistically significant (P<0. 05). In total, 20. 5% and 7. 7% of the case and control groups were afflicted with metabolic syndrome, respectively, which was not statistically significant (P=0. 104). Conclusion: Some significant parameters of metabolic syndrome in seborrheic dermatitis patients may be the predictive factors for screening.

Background and Objective: Due to the increased prevalence of antibiotic resistance to beta-lactam and carbapenem compounds, the identification of beta-lactamase-producing enzymes is essential for the timely treatment of such isolates. In this regard, the present study aimed to determine the prevalence of metallo-β-lactamases and Klebsiella pneumonia carbapenemase genes among the clinical isolates of Pseudomonas aeruginosa (P. aeruginosa). Materials and Methods: In this cross-sectional descriptive study, a total of 97 clinical isolates were collected from the hospitalized patients of Hamadan hospitals, Hamadan, Iran, within November 2017 to May 2018. After the confirmation of the isolated strains, antibiotic susceptibility of the isolates was determined by disk diffusion agar. Minimum inhibitory concentration (MIC) was performed for imipenem using the Etest method, Combined Double-Disk Test (CDDT), and Modified Hodge test (MHT). In addition, the identification of carbapenemase genes was conducted by polymerase chain reaction (PCR). Results: The obtained results of statistical analysis showed that the highest antibiotic resistance was reported to cefoxitin for 92 (94. 8%) isolates, and the lowest antibiotic resistance was observed to piperacillin-tazobactam in 38 (39. 2%) isolates. Among the carbapenem antibiotics, the highest antibiotic resistance was reported to imipenem for 48 (49. 4%) isolates. Out of 49 (50. 51%) carbapenem-resistant isolates, 42 (85. 71%) isolates had positive results for MIC. Moreover, 26 (53. 06%) and 25 (51. 02%) isolates had positive results for IMP/EDTA (CDDT) and MHT test, respectively. The findings of PCR also showed that the highest and lowest gene presence among resistant isolates was related to IMP 20 (40. 8%) and GIM gene 6 (12. 24%), respectively. Conclusion: The obtained results of the present study showed that a high percentage of the assessed P. aeruginosa isolates were resistant to carbapenem antibiotics, and a high percentage of carbapenem-resistant isolates produced beta-lactamase genes.

Background and Objective: Some studies have shown that abnormal levels of biomarkers may be associated with adverse pregnancy outcomes. This study aimed to investigate the association between serum levels of Inhibin A and the outcomes of pregnancy. Materials and Methods: This retrospective cohort study was conducted on the data obtained from the Inhibin A of 560 pregnant women at 15 to 20 weeks of gestation in Hamadan, Iran. The levels of Inhibin A less than 0. 5 and higher than 2 mmol were considered below and high, respectively. The patients were assessed in terms of birth weight, gestational age, Apgar score, preeclampsia, intrauterine fetal death, and cesarean section. The receiver operating characteristic curve level was calculated to detect adverse pregnancy complications. The data were statistically analyzed in STATA software (version 14). Results: Out of the pregnant women eligible for the study, 33 (5. 9%) cases were excluded due to incomplete medical record files and unavailability. Of the remaining 527 patients, 378 (71. 7%), 26 (4. 9%), and 123 (23. 3%) ones had normal, low, had high Inhibin A levels, respectively. Patients with higher serum Inhibin A levels had a higher risk of preeclampsia, low birth weight, and prematurity, compared to those with normal or low levels (P˂ 0. 05). Conclusion: Based on the findings of the present study, high levels of Inhibin A at 15 to 20 weeks of gestation can be associated with the risk of preeclampsia, low birth weight, and prematurity.

Background and Objective: Due to the increased prevalence of microbial resistance against chemical antimicrobial agents, the biological effects of metallic nanoparticles have recently been studied by researchers. In this regard, the present study aimed to investigate the antimicrobial effects of iron oxide nanoparticles made by chemical methods in different concentrations on bacteria isolated from urinary tract infections. Materials and Methods: In this descriptive cross-sectional research, iron oxide nanoparticles were synthesized by chemical precipitation method using chemical reactants and only by controlling the conditions and applying optimal conditions. Subsequently, their bactericidal effects on the six common bacteria causing urinary tract infections was studied using agar well diffusion method. The minimum inhibitory and bactericidal concentrations of nanoparticles were determined as well. In addition, the antibiotic resistance pattern of bacteria was investigated for antibiotics Gentamycin, amikacin, ampicillin, nalidixic acid, ciprofloxacin, norfloxacin, sulfamethoxazole using disk diffusion method. Results: The iron oxide nanoparticle was made in a spherical shape with a diameter of approximately 60 nm. Bacteria had an extensive antibiotic resistance, but iron nanoparticles were effective on all 6 bacteria, and the minimum inhibitory and bactericidal concentration to Proteus mirabilis, Klebsiella pneumoniae, staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Serratia marcescens were 0. 32, 0. 04, 0. 02, 0. 08, 0. 04, and 0. 02 at 1. 25, 0. 08, 0. 61, 32 0, 16. 0, and 16. 0 mg/mL respectively. Conclusion: Iron oxide nanoparticles showed a wide spectrum of effects at very low concentrations against bacteria, and these nanoparticles could be considered as an appropriate candidate for the treatment of bacterial infections after extensive research.

Background and Objective: Mentally retarded children have global delay that affects motor, cognitive, communication, speech, and language development. Poor organization in mental lexicon and reduced vocabulary are the obvious consequences of mental retardation. This study aimed mainly at evaluating the perception and expression of nouns, and test-retest reliability of two picture-pointing and picture-naming tests in Farsi-speaking educable mentally retarded children in Hamadan, Iran. Materials and Methods: This descriptive-analytic and cross-sectional study included 40 mentally retarded children with the mean± SD age of 7. 9± 1. 25 (18 girls and 22 boys) who were selected from exceptional children’ s school in Hamadan, Iran. In total, two picture-pointing and picture-naming tests were used in this study to investigate the ability of perception and expression of nouns. Moreover, to measure the test-retest reliability, 10 children were evaluated two times with one day time interval. Results: According to the results, there was a significant positive correlation between the mean scores of perception and those of expression (P=0. 001, r=0. 662). However, no significant differences were observed between the mean scores of perception and those of expression in terms of gender. The results of test-retest reliability showed an optimal reliability between these two tests. Conclusion: Descriptive statistics of the mentally retarded children can be part of normative data alongside other findings of other cities in Iran. In addition, confirmation of reliability shows part of the efficiency of these two tests in studies and clinical settings.

Background and Objective: The improvement of balance control is essential for conducting daily activities as a basic functional ability. The important role of external intervention on foot balance as the main point of contact between the land and body has been indicated in the literature. The aim of the present study was to compare and investigate the effects of using insoles with different wedges on balance control with and without visual input before and after fatigue. Materials and Methods: A total of female students with a mean age of 24. 31± 2. 47 years were selected as the study population according to study inclusion criteria. Three semi-rigid insoles (with no wedge, as well as with 10-degree lateral and medial wedges) were used in this study. The subjects' balance was recorded using the Biodex Balance System while wearing three types of the insoles before and after applying the fatigue protocol and in the presence and removal of the visual information. Data analysis was carried out using repeated measures and analysis of variance. Results: The obtained results of the statistical analysis showed significant differences in terms of static balance while using medial (P=0. 03) and lateral (P=0. 001) wedge insoles with the closed eyes before and after fatigue. However, further analysis demonstrated no significant difference in the improvement of dynamic balance. Conclusion: Using the wedge insoles can reduce the effects of fatigue which leads to a decrease in the static balance of the individuals; nevertheless, there was no improvement in relation to dynamic balance.

Background and Objective: Studying in the medical field is a stressful condition, and the present study aimed to evaluate this issue. Materials and Methods: This cross-sectional study was carried out on a total of 93 medical interns according to census data. The scores of Hospital Stress Scale were classified as low (35-69), intermediate (70-104), and severe (105-175) stress. The data were analyzed by descriptive statistics indices using SPSS software (version 16). Results: Out of 93 interns, 36 (38. 7%) and 57 (61. 3%) participants were male and female, respectively. The mean value of job stress was 109. 9± 10 within the range of 86-129. According to the obtained results, 30 (32. 3%) and 63 (67. 7%) subjects had moderate and severe stress, respectively. The score of severe stress was higher in women than that reported for men (66. 7% and 64. 69%; P=0. 780). The relationships between weekly working hours, working shifts, chemical factors, and biological factors with the stress score were positive and significant. In addition, the relationships between weekly working hours with communication with superior and colleague and inadequacy were negative and significant. Conclusion: The interns have high occupational stress, and female students and individuals with longer working hours experience higher levels of occupational stress.