Journal of Shahrekord University of Medical Sciences
Year:2009 | Volume:11 | Issue:3|Papers Count:19

Background and aim: Irritable bowel syndrome is the most prevalent functional bowel disorder which is characterized by chronic abdominal pain and altered bowel habit in the absence of organic disease. Psychological factors are of the major factors involved in this disease. The aim of this study was comparison of the effect of relaxation with and without drug therapy on the psychological symptoms in patients with irritable bowel syndrome-diarrhea predominant (IBS-D).Methods: This clinical- trial study was performed on 32 IBS-diarrhea dominant patients. Patients were randomly divided into two groups. One group was treated by using relaxation technique without drug therapy and another group was treated by using relaxation technique combined with drug therapy. Diagnostic characters of Rome-II and III were used for diagnosing the IBS-D patients and SCL-90 test was used for evaluating the psychological symptoms. The study was performed in three steps, pretest, post test and 4 months after last intervention (follow up group). Data were analyzed using analysis of covariance (ANCOVA) method.Results: The average age of the patients in this study was 37±15.43 years. Our study demonstrated that there was a significant reduction in psychological symptoms scores in post test and follow up groups compared to the pre test group. This reduction was higher in patients receiving relaxation combined to drug therapy compared to the drug therapy group (P<0.05). Conclusion: Based on the results of this study, Combination of relaxation and drug therapy is effective for reducing the psychological symptoms in irritable bowel syndrome patients.

Background and aim: Fracture healing is a biological complex process that is affected by several internal and external factors. One of the external factors is mechanical stimulation by ultrasound waves. There is a controversy about the effects of these waves on bone healing. The aim of this research was to evaluate effects of low-intensity pulsed ultrasonic waves on experimental tibial fracture in New Zealand Rabbit.Methods: This is an experimental study in which, 36 male adult New Zealand rabbits were randomly divided into four groups (3 experimental groups and 1 control group). All of the animals, except the control group, were operated for inducing the experimental fracture on their right tibia.  After healing of wounds, the sites of bone fractures in experimental groups were exposed to pulsed ultrasound waves for 2 and 4 weeks. Then all of the animals were killed and right tibias were removed. After fixation and processing of samples, the slides were prepared from paraffin blocks and were stained with H & E. Finally, the slides were studied for stereological analysis of bone healing and the data of each group was analyzed by Mann-Whitney and Kroscal Wallis tests.Results: The Results of this study showed that mean volume changes in  cartilaginous callus was significantly higher in ultrasound- exposed rabbits compared to the control group (P<0.05). No significant differences was seen between experimental and control groups for other parameters such as granulation, mesenchymal tissue and bone tissue.Conclusion: Pulsed-ultrasound waves with frequency about 1 MHz (Mega Hertz) may be useful to increase fracture healing of tibia in rabbit.

Background and aim: Candida vaginitis is the second common cause of vaginitis and Candida albicans is cause of 90 percent of vaginal fungal infections. Because antifungal drugs are among the cheapest vaginal drugs, this study was performed to evaluate and compare clinical and paraclinical diagnosis of candida vaginitis in women referred to health care centers in Shahrood cityfrom 2004 to 2007.Methods: This descriptive-analytic research was performed on 300 women with vaginitis infections who were referred to the Shahrood city health care centers. Two samples of secretions were taken from both endocervix and exocervix using speculum and spread on two glass slides and then one sample was taken from posterior culdesac secretions with a cotton soup and entered into a tube containing sterilized physiological serum. A questionnaire was filled out by a midwife for every patient. Standard laboratory methods (cultures, Pap smear, wet smear and etc.) were used to evaluate the samples and the second questionnaire was filled out by the midwife. Finally, results were analyzed by statistical methods.Results: Based on clinical results, 132 persons (44%) had candida infection, but the infection was not proved by cell culture in 30 patients ((10%), and wet smear in 111 persons (37%). No candida infection was found in cytology survey. Based on clinical results, vaginal pH was measured 5.01. The amount of pH was found 5.52, 5.8 and 5.71 based on wet smear cell cultures and Pap smear, respectively. The physical examination sensitivity for detecting vaginal candidiasis was 63.33% compared to the cell culture.Conclusion: The results of this study show that some para-clinical examinations should be considered for diagnosis of vaginal candidiasis. These para-clinical experiments help to prevent and reduce the side effects of some unnecessary medications.

Background and aim: Cardiac arrhythmia is one of the most common cardio-vascular diseases. Pacemaker as one of the curative methods in treating patients with arrhythmia can reduce most of their problems. In spite of its benefits, it may cause some physical and psychological problems and affect on patients quality of life. Thus, following up is necessary for these patients. Telephone follow up may be useful as a cheap and effective method for this purpose. The aim of this study was to evaluate the effects of telephone follow up by nurse on the quality of life in patients with pacemaker.Methods: In this clinical-trial study, 60 patients with pacemaker were divided into two groups. Case group was followed up by telephone and control group was followed up by routine procedure. The quality of life (QOL) was assessed using AQOL and sf-36 questionnaires for duration of one month. Data were analyzed using independent and paired-t tests.Results: No significant difference was found between case and control group for the quality of life scores before starting the study. At the end of the study, mean quality of life scores was significantly higher in case group compared to the control group. Paired t-test also showed a significant difference between the mean of quality of life scores in case group before and after the study (P<0.001).Conclusion: Telephone following-up can be used as a cheap and effective method for improving the quality of life in patients with pacemaker after discharge.

Background and aim: Psoriasis is a chronic common condition of the skin that is still resistant to many therapies. The goal of this study was to evaluate the effect of pyrithione zinc in emollient base and comparing with the effect of emollient alone in the treatment of psoriasis.Methods: This randomized double blind clinical trial study was performed on psoriasis patients involved less than 10% of body skin areas. Patients were randomly allocated to one of two treatment groups. Group A was treated with topical emollient cream containing 0.25% pyrithione zinc and group B was treated with topical emollient cream alone twice per day for 3 months. Severity of induration, erythema, and scaling were assessed based on the psoriasis Area Severity Index (PASI) score. Data obtained from both groups were analyzed using student-t test and paired-t test.Results: From the total number of participants, 30 patients in group A and 30 patients in group B completed the study. The mean PASI score in group A before and after treatment were 3.4±1.8 and 0.9±1.3, respectively (P<0.01). The mean PASI score in group B before and after treatment were 4.3±2 and 3.9±1.3, respectively (P>0.05). Mean PASI score reduction was 2.4±2 in group A and 0.4±0.1 in group B (P<0.01). The percent of decrease in mean PASI score was 70.5% in group A and 9.3% in group B.Conclusion: Topical formulation of pyrithione zinc in an emollient base can be used as a safe and effective treatment for psoriasis.

Background and aim: Massage is an important part of baby and infant health care in different societies. Considering specific role of massage with natural oils, we studied the effect of massage with sesame oil on infant anthropometric measurements and their sleep pattern.Method: This clinical-trial study was performed on 150 two months healthy infants who were referred to the health care centers in Arak city. Samples were randomly divided into one of the following groups: massage with sesame oil, massage only and no massage. In sesame oil group, mothers performed massages on whole of their infant body for a period of 10 minutes, two times per day for 4 weeks.  In solely massage group, the method was the same as previous group, but without oil. No massage was done in control group. Anthropometric measurements and sleep pattern were evaluated before and after the interventions and data were analyzed using Chi-square, ANOVA, Kroskal-Wallis and Post-Hoc tests.Results: At the beginning of the study, anthropometric measurements did not show significant difference between groups. After 4 weeks, the average increase in infant weight in sesame oil, solely massage and control group were 1076.23±273.12, 965.24±310.12, 686.14±220.92, respectively (P<0.001). Mean increased duration of sleep in massage groups was significantly higher in massage groups than control group (P<0.001).Conclusion: Based on the results of this study, it seems that infant massage, particularly massage with sesame oil can lead to increased weight and improved sleep pattern. It may have positive effect on infants' heights in a longer time.

Background and aim: Many factors are effective to prognostic breast cancer. One the most important of these factors is estrogen and progesterone receptors. The aim of this study was to detect frequency of invasive ductal carcinomas and to determine its correlation with grade of tumors.Methods: This descriptive analytical –study was performed on all women referred to the pathology center in Chaharmahal va Bakhtiari province (Iran) from 2001 to 2005. From the total patients, 56 people were diagnosed for invasive ductal carcinomas. Type and degree of tumor was diagnosed by Richardson Bloom system. Samples were stained for estrogen and progesterone receptors with immunohistochemistry method using Labeled Streptavidin Biotin (LSAB) technique. Data were analyzed using Chi square, t-test and ANOVA.Results: From the total patients, 56 cases were found with invasive ductal breast carcinoma. The mean age of patients was 49.45±13.4 years. The results from tumor gradation confirmed 22 patients with tumor type III, 20 patients with tumor type II and finally 14 patients with tumor type I. Estrogen and progesterone receptors were detected in 48.2% and 41.1% of the invasive ductal breast carcinoma, respectively. No significant relation was found between age and frequency of estrogen or progesterone receptors. The expression of estrogen and progesterone receptors was significantly associated with grading the carcinomas (P<0.001).Conclusion: Although enough frequency of estrogen and progesterone receptors was found in low grade invasive ductal breast carcinoma, but tissue differentiation in 75% of the patients was slight to moderate.

Background and aim: Periodical evaluation of anthropometric indicators is one of the best methods for monitoring of children’s nutritional status and also is an appropriate information resource for the health system of the countries. The purpose of this study was assessing prevalence and predictors of three anthropometric indices, underweight, stunting and wasting among 2-5 year old Children in Zahedan, 2007-2008.Methods: This descriptive anatycal study was conducted on 1245 children (2-5 years old) in Zahedan, 2007-2008. Samples were selected from 5 different districts in Zahedan. Data were collected using records and interviews with mothers. In this study, wasting (weight for height), stunting (height for age) and underweight (weight for age) were evaluated based on Z score = -2.5. Data were analyzed using independent T-test, ANOVA, Chi square and linear logistic regression.Results: In this study, the prevalence of wasting, stunting and underweighting were found as 4.2%, 7.6% and 3.4%, respectively. Univariate analysis showed that wasting had a significant relation with birth weight and birth interval. In addition, stunting had relation with birth weight, mothers’ educational level, fathers’ job, nutritional status, infection history, birth interval and mothers’ age. Underweight showed significant relation with sex, birth weight, nutritional status, infection history, birth interval and mothers’ age (P<0.05). In multiple analysis, birth interval demonstrated significant relation with wasting and birth weight, mothers’ age had significant relation with stunting, birth weight and birth interval and finally, mothers’ age had significant relation with underweight (P<0.05).Conclusion: Considering to results obtained from this study, the most important factors related to the three above mentioned anthropometric indices are birth weight, birth interval and mothers’ age. Therefore; improving these variables, may help decreasing the prevalence of malnutrition among children.

Background and aim: Breast cancer is the most common malignancy in women and after lung cancer, it is the second cause of death in women.  Different biological markers are being used for determination of prognosis and patients' responses to the therapy regimes. E-cadherin is one of these markers. The purpose of this study was to determine the frequency of E-cadherin expression in primary breast cancer and its correlation with the grade, size of tumor and axillary lymph nodes involved.Methods: This cross –sectional study was performed on 85 patients with primary breast cancer who were admitted in Mostafa Khomeini Hospital in Tehran, Iran (2003-2007). One section was prepared from the tumoral tissue and lymph nodes sections from all patients and they were stained with H & E. In another tissue section, E-cadherin was evaluated by a immunohistochemical method and then the tumor size, its grade and the number of lymph nodes involved were determined. The data were analyzed with SPSS software 11.5, using Chi-square, Mann –Whitney and Spearman correlation tests.Results: Our data showed that 95.3% of the samples were positive for E-cadherin and 67.1% of the patients had lymph nodes involvement. The average size of the tumor was found 3.09±1.33 cm. In this study, 41% of the tissue samples were stained with E-caherin more than 75% (3+). No significant relationship was found between E-cadherin expression and related variables, but a significantly reverse relationship was found between E-cadherin expression and the grade, tumor size and the number of lymph nodes involved (P<0.01).Conclusion: Considering the results of this study, it seems that the reduction in E-cadherin expression in tumor cells, leads to increase in tumor size, its grade and the number of lymph nodes involved.

Background and aim: Gastric cancer is the second cause of cancer death world wide. Genetic factors including oncogens and tumor suppressor genes are always contributed in progression of this cancer. The P53 tumor suppressor gene has a broad role in the cell such as programmed cell death and stop cell replicating damaged DNA. Mutations in the P53 gene, which are frequently seen in human gastric cancer, impair its tumor suppression function. The aim of this study was to determine the P53 gene mutations in gastric cancer specimens in Chaharmahal va Bakhtiari Province.Methods: In this descriptive-lab based study, we investigated the P53 gene mutations in exons 5-8 in 38 paraffin embedded gastric cancer specimens. DNA was extracted following the standard phenol chloroform protocol. The P53 gene mutations were determined using PCR-SSCP procedure.Results: Band shifts were detected in all positive controls examined. However, no shifted band was detected in samples from gastric cancer patients tested.Conclusion: The results of this study demonstrated that association between P53 gene mutations and gastric cancer is very low in Chaharmahal va Bakhtiari province. However, we have examined a limited number of 38 gastric samples and more samples are needed to be investigated to unravel the contribution of P53 gene mutations leading to gastric cancer in this province.

Background and aim: Angiogenesis, the formation of new blood vessels, is a dynamic and complex activity which is needed for embryogenesis and other physiological processes. However, in many pathological conditions such as solid tumor progression, the disease appears to be associated with persistent up-regulated angiogenesis. In this research we used 0.04 T (tesla) electromagnetic field as a synergic treatment with rapamycin on angiogenesis.Methods: In this experimental study, 70 Ross fertilized eggs were randomly divided into 5 groups as following: 1) control, 2) sham-exposed, 3) a group  treated with rapamycin, 4) a group treated with electromagnetic field and 5) a group treated with both rapamycin and electromagnetic field. In day 2, a window was opened on eggs in sterile condition. In day 8 a gelatin sponge was placed on chorioalantoic membrane (CAM) and was soaked with 5 ml rapamycin in group 3 and group5. Groups 4 and group 5 were placed in 400 Gauss magnetic field for 4 hours in day 10. In day 12, CAMs were examined and photographed by research photo-stereomicroscope in all cases. Data were analyzed using ANOVA and Mann-Whitney tests.Results: Comparison between average number and length of vessels in controls and sham-exposed didn't show any significant differences. In group 3 and 4, a significant decrease was shown in the average number and length compared with controls. Finally, comparison between group 3 and group 5 showed a significant decrease in the average number and length of vessels in group 5 which had been treated with both rapamycin and 400 (Gauss) G electromagnetic field.Conclusion: The results of this study showed that 0.04 T magnetic field has an inhibitory effect on angiogenesis in CAM and can enhance the effect of rapamycin as an anti-angiogenesis drug.

Background and aim: Coronary heart disease is major cause of death in the world. One of the diagnostic tests for coronary patients is catheterization which leads to stress and anxiety in most patients.  Progressive muscle relaxation program (PMR) is no drug interventions to reduce anxiety in patients. The main purpose of this study was to evaluate the effect of PMR on anxiety of patients undergoing for coronary artery angiography.Methods: This pre-post semi-experimental research was performed on 146 patients referred to the Shahid Rajaei heart hospital in Tehran for angiography. Progressive muscle relaxation program was prepared on a CD and was delivered to the patients. The anxiety was evaluated using a questionnaire before and after starting the program. Data were analyzed by using statistical tests, such as Chi-square and paired-t tests.Results: No significant statistical relation was seen between age, marital status and history of disease with anxiety agents (P>0.05). Demographic characteristics of patients showed a significant statistical relation between educational status, economic status and occupational status and history of admission to hospital with anxiety agents (P<0.05). Paired-T test showed a significant relation between anxiety in coronary heart patients before and after starting PMR program (P<0.05).Conclusion: Results of this study demonstrate a positive effect of PMR study on reducing anxiety in patients undergoing coronary heart angiography. Because of this positive effect of PMR, using this method is recommended to control anxiety in similar patients.

Background and aim: The International Headache Society (IHS) has defined chronic tension type headache in adult patients as attacks of headache that occurs at least 15 days per month over a period of at least 6 months. Drugs do not adequately benefit many headache sufferers. The aim of present research was to examine the efficacy of cognitive-behavioral therapy for reduction of headaches in patients with chronic tension headaches.Methods: The target population of this clinical trial study was consisted of 38 women with chronic tension type headache who were referred to psychiatry or neurology clinics in Kashan city. Patients were randomly selected and were divided into case (drug plus cognitive behavioral therapy, n=18) and control (drug alone, n=20) groups. Subjects were asked to complete the headache diary for one week before and after intervention. The collected data was analyzed with analysis of covariance (ANCOVA) by SPSS.Results: An analysis of covariance showed significant differences between experimental and control groups in the frequency (P<0.01), intensity (P<0.05) and duration (P<0.001) of headache attacks.Conclusion: Drug therapy plus cognitive-behavioral therapy was found to be more effective in reducing of headache than the drug therapy alone. Therefore; it is highly recommended that cognitive-behavioral therapy be added to drug therapy in treatment protocol of patients with chronic tension type headache.

Background and aim: Hearing loss is the most common sensory disorder in human and has a profound economic and social impact in the modern world. The etiology of deafness can be due to genetic or non-genetic causes in origin. Genetics etiology of hearing loss is classified into syndromic and nonsyndromic. The aim of this study was to determine the etiology of deafness in deaf students in Chaharmahal va Bakhtiari province, Iran.Methods: Altogether, 265 patients with mild to profound hearing loss were contributed in this descriptive study. The subjects were deaf pupils from the schools of Chaharmahal va Bakhtiari province. Age of the students was between 6 and 22 years. Medical history, pedigree information and demographic data were collected using a questionnaire. Each patient underwent general and otoscopic examinations and also pure-tone audiometery. Otoacoustic emissions, as well as auditory brainstem response testing were performed in patients suspected to neural hearing loss.Results: Consanguineous marriages were detected in 67.2% of deaf families, from which first cousins marriage was the most common with the rate of 78.1% of overall consanguinity. Our study revealed that up to 98.8% of genetic deafness cases were in autosomal recessive mode. We found sensorineural hearing loss as a predominant type of deafness in 97.8% of the population studied. Moreover, hearing loss with genetic in origin was found as the most frequent deafness etiology with a rate of 60.8% and then acquired and idiopathic hearing loss are in next step, respectively. We found syndromic etiology in 4.2% of the students and ophthalmic problems were the most dysfunction accompanied with hearing loss.Conclusion: This data highlight the importance of consanguine marriage in the studied population. We found a very high rate (67.2%) of consanguine marriage, which can be the main cause of congenital deafness.