Journal of Advances in Medical and Biomedical Research
Year:2012 | Volume:20 | Issue:81|Papers Count:17

Background and Objective: Postpartum hemorrhage ranks among the most leading causes of maternal morbidity and mortality in the world. Intravenous oxytocin is routinely used to reduce postpartum hemorrhage. The aim of this study was to compare the effect of 400 mg of oral misoprostol versus 10 IU of intravenous oxytocin in preventing postpartum hemorrhage.Materials and Methods: This randomized clinical trial, which was conducted at the Kosar Hospital in Qazvin, included 269 pregnant women. Inclusion criteria were: singleton pregnancy, over 37 weeks of gestation; parity of less than 3; vertex presentation; spontaneous or induced labor; and an estimated fetal weight under 4 kg. Exclusion criteria included: history of postpartum hemorrhage; asthma; coagulopathy and anticoagulant consumption; presence of placental abruption; postpartum hemorrhage due to lacerations; instrumental delivery; and cesarean section. Selected patients randomly received either 400 mg of oral misoprostol or 10 IU of intravenous oxytocin after delivery of the anterior shoulder or within the first minute after the delivery. Hemoglobin and hematocrit were measured both during admission and 24 hours after the delivery and were compared together.Results: Postpartum hematocrit drop occurred in 3.33%+3.44 of the participants in the oxytocin group compared with 2.81%+1.26 in the misoprostol group. The rate of using additional oxytocin was 34.8% in the oxytocin group versus 20.5% in the misoprostol group. Fever occurred in 2 of the women in the misoprostol group.Conclusion: Administration of 400 mg oral misoprostol appears to be as effective as 10 IU of intravenous oxytocin in reducing the blood loss after delivery.

Background and Objective: Hypoxia is a major problem in patients undergoing ventilation due to the high bronchioles secretion. This study aimed to determine the effect of expiratory rib-cage compression prior to endotracheal suctioning on arterial blood oxygenation (SpO2) in patients undergoing mechanical ventilation.Materials and Methods: This clinical trial with a crossover design included 50 mechanically ventilated patients hospitalized in the intensive care units of two educational hospitals (Vali-e-Asr and Ayatollah Mousavi) of Zanjan using the convenience sampling method. The participants were randomly divided into two groups. During the first phase of the study, the rib-cage compression was performed once for five minutes prior to suctioning in group one. The other group received suctioning without any rib-cage compression. The procedures were performed in a reverse fashion in the two groups after three hours. SpO2 was measured three times: five minutes prior to the endotracheal suctioning, and 15 and 25 minutes following the procedure. Data were analyzed using independent and paired t-tests.Results: There were statistically significant differences in the SpO2 mean values between five minutes before and 15 minutes after the endotracheal suctioning in patients who received endotracheal suctioning with the rib-cage compression (P<0.05). Moreover, there was a statistically significant difference between the mean SpO2 values in the same intervals between the two groups (P<0.0001).Conclusion: The results show that expiratory rib-cage compression prior to endotracheal suctioning improves arterial blood oxygenation in patients undergoing mechanical ventilation. Therefore, we recommend performing the procedure.

Background and Objective: Cardiovascular disease is the most common cause of death and the major cause of disability in many countries, including Iran, and it causes stress and tension in afflicted patients. The aim of this study was to determine the effect of progressive muscle relaxation on perceived stress in patients with myocardial infarction.Materials and Methods: In this randomized clinical trial study, after sampling with a convenient method, the participants were randomly assigned to either the control or test group. The procedure included one orientation session for informing the participants with the study objectives and intervention method, followed by doing 120 intervention sessions for 2 months. Data collection tools included a demographic questionnaire, and perceived stress and self-reporting checklist.Results: A total of 66 patients participated in the study. The results of repeated measured ANOVA test on perceived stress show that there were no significant differences between the control and test groups preintervention. However, there was a significant difference between the two groups, 1 and 2 months postintervention (P<0.001).Conclusion: Our findings show that performing the progressive muscle relaxation is an effective and useful technique for the treatment of perceived stress in patients with myocardial infarction. This technique is practically feasible, and it appears capable of decreasing the level of stress.

Background and Objective: Transcription factors (TF) and microRNAs, are the largest families of transacting gene regulatory molecules in multicellular organisms. Our goal was to examine the effect of aerobic running on the expression of miR-124 and RE1-silencing TF in the hippocampus of adult male Wistar rats.Materials and Methods: A total of twelve 8-week-old adult male Wistar rats with a mean body weight of 200-225 g were selected as subjects. Following 1 week of familiarization, the animals were randomly divided into two groups of test (n=6) and control (n=6). In the test group, animals were forced to run on a treadmill, at a speed of 25 m/min for 30 minutes per day, for 14 consecutive days. The animals were sacrificed 24 hours after the last exercise session, and the hippocampi were removed from both sides of the brain hemispheres. Changes in the expression of miR-124 and RE1-silencing TF were analyzed using the quantitative RT-PCR technique.Results: Statistical analysis by independent sample t-test, showed that there was a significant difference between the exercise and control groups (P£0.05), and while exercise significantly elevated the expression of miR-124, it reduced the expression of RE1-silencing TF.Conclusion: Our findings show that forced aerobic running at a speed of 25 m/min could lead to positive changes in mechanisms involved in exercise-induced neurogenesis.

Background and Objective: Human amniotic membrane, which is the innermost layer of placenta, contains beta defensins and elafin, which both have antibacterial properties. These antibacterial activities depend on the conditions and environmental factors. The purpose of this study was to evaluate the effect of environmental factors on human amniotic membrane antibacterial properties against Klebsiella pneumonia (ATCC7881), Entrococcus faecalis (ATCC29212), Pseudomonas aeruginosa (ATCC27853), Salmonella enteric (BAA-708), and E. coli (ATCC25922) strains in vitro.Materials and Methods: The amniotic membrane samples were obtained from caesarean women in Imam Khomeini hospital. Participating women were all seronegative for HIV, HBV, HCV, and syphilis. The samples were cut into 1.5×1.5 cm pieces. The 0.5 McFarland bacterial suspensions were prepared and spread on Muller-Hinton agar medium, and a piece of membrane was placed in the centre of each plate. Samples were examined at different time intervals (24, 48, and 72 hr), temperatures (25, 33, 37oC) and pH (6.5, 7, and 7.5) as variables.Results: The results show that time and pH as variable parameters did not affect the antibacterial properties of the amniotic membrane. However, the change in temperature (25 and 33oC vs. 37oC) had a significant impact on P. aeruginosa.Conclusion: Antibacterial properties of the amniotic membrane seem resistant against environmental factors, except for especial cases, and this sustainability could expand its usage in clinical procedures and different conditions.

Background and Objective: Breast cancer is one of the most common cancers affecting women around the world and in Iran. A limited number of studies have been conducted on the relationship between dietary factors and breast cancer development in Iran. The aim of this study was to investigate the impact of dairy products and animal proteins consumption and breast cancer among women in the province of Isfahan in the year 1390.Materials and Methods: This case-control study was carried out on 100 women diagnosed with breast cancer and 100 healthy women as the control group. All participants were Iranian and over 18 years old. The case and control groups were matched regarding age, body mass index, physical activity, and age of menarche. Data were collected by Frequency Food Questionnaire (FFQ) and analyzed by T-test, Chi-square, Man Whitney and Logistic Regression.Results: Our findings show that while red meat and milk were consumed the most among animal proteins and dairy products, respectively, fish and butter were consumed the least. Logistic Regression analysis indicates that consumption of sausage and salami, red meat, and high-fat milk and yogurt show a significant correlation with breast cancer risk (P<0.0001).Conclusion: Consumption of fish and low-fat dairy products might decrease the risk of breast cancer in the Iranian women. Further researches are recommended to investigate the role of chicken consumption in breast cancer risk.

Background and Objective: Elevation of the b-HCG serum levels has been reported in several tumors including breast cancer, and it is usually associated with aggressiveness. The aim of this study was to examine the possible correlation between the b-HCG serum levels and different grades of breast cancer tumors in patients undergoing chemotherapy.Materials and Methods: This cross-sectional study was conducted in the city of Zanjan during 2009-10. Serum samples from 56 cases of breast cancer patients were collected after surgery and prior to chemotherapy for analysis of total free b-HCG by electro chemiluminescence immunoassay, and the same procedure was repeated after 8 courses of chemotherapy. The b-HCG serum levels were compared in poor versus mild to moderate grades before and after chemotherapy.Results: In 37 cases of mild to moderate grade tumors, the mean b-HCG level was 1.09 ±1.4 miu/ml compared with 1.2±0.3 miu/ml (P=0.75) in 29 cases of poor grade tumors. The mean b-HCG levels before and after chemotherapy were 1.15±1.4 miu/ml and 1.17±1.4 miu/ml (P=0.24), respectively.Conclusion: We did not find any significant association between the b-HCG serum levels and breast cancer tumor grades. Furthermore, chemotherapy does not appear to have an effect on b-HCG serum levels.

Background and Objective: Uric acid and vitamin C take part in protection mechanisms to overcome the oxidative stress that occurs in vascular accidents. Considering the prevalence of cerebrovascular accidents and unresolved position of these antioxidants, this study aimed to assess serum uric acid and vitamin C levels in acute ischemic stroke.Materials and Methods: A total of 50 patients during the early 48 hours of admission for atherothrombotic stroke were compared with 50 controls. Serum levels of uric acid and vitamin C were measured by enzymatic and calorimetric assays, respectively, and the findings were analyzed using statistical methods.Results: Serum vitamin C levels were significantly lower in the stroke patients (0.42±0.13 vs. 0.5±0.16 mg/dl, P=0.011). However, there was no significant differences in the serum uric acid levels between the case and control groups (4.55±1.97 vs. 5.09±1.93 mg/dl, P=0.167).Conclusion: Estimation of vitamin C levels may be used as an indirect evidence of oxidative stress process inducing neuronal damage in acute atherothrombotic stroke, and it may be a useful tool for monitoring andoptimizing future antioxidant therapies.

Background and Objective: Salmonella spp. are enteric pathogens with a worldwide distribution comprising a large number of serovars characterized by different hosts and distribution. Among Salmonella spp., the number of infections and diseases caused by the serotype Salmonella enterica serovar Infantis started to increase significantly in the last decade. The aim of this study was to investigate the genetic diversity of the clinical stains of Salmonella enterica serovar Infantis isolated in Tehran, Iran by using the Ribotyping method.Materials and Methods: In this descriptive study from November 2007 to December 2010, clinical samples, collected from different hospitals in Tehran, were investigated for detection of Salmonella enterica serovar Infantis. Bacterial isolation and identification was achieved through biochemical and bacteriological methods. The Ribotyping technique was applied for the molecular typing of the strain of Salmonella enterica serovar Infantis.Results: Out of the 26 Salmonella serogroup C samples isolated in this study, 19 strains (73%) belonged to Salmonella enterica serotype Infantis. Ribotyping results divided Salmonella enterica serovar Infantis stains into 9 clusters (1c to 9c). The majority (7) of the strains belonged to cluster 1c.Conclusion: The results obtained from the Ribotyping patterns indicate that Salmonella enterica serovar Infantis strains, circulating among the patients in Tehran, belong to a diverse number of clones. Moreover, our data show that Ribotyping is an appropriate method for the molecular typing of Salmonella enterica serovar Infantis strains.

Background and Objective: Stridor is considered as a serious adverse complication of intubation that may lead to respiratory distress, reintubation, and further complications. Intravenous steroids including dexamethasone are assumed as an effective therapy. However, their associated side effects pose a limit on their usage. This study was carried out to elucidate the effect of intravenous dexamethasone with inhaled budesonide on the reduction of post-extubation stridor in ICU patients.Materials and Methods: This randomized clinical trial study included 80 intubated patients with extubation during their stay in the ICU ward. Prior to the extubation, a cuff-leak test was performed for all patients, and those with either negative test results or less than expected were randomly assigned to two groups of A or B (n=40 each). Group A received 8 mg/8 hr of intravenous dexamethasone, while group B received aerosolized budesonide (0.5 mg/6 hr). Both groups received their medications starting 24 hours prior to the extubation until 24 hours afterwards. All of the patients were examined for stridor for 24 hours following the extubation. The data were collected and analyzed by SPSS-16 software using t-test, Chi-square, Fisher, and Mann-Whitney tests.Results: Post-extubation stridor occurred in 62.5% of the patients in the dexamethasone group vs. 52.5% of the budesonide group. However, this difference is not statistically significant (P=0.36). Similarly, the difference between the stridor scores for the two groups was not significant either (P=0.26).Conclusion: Our results show that the effect of intravenous dexamethasone vs. inhaled budsonide was similar on the restriction of post-extubation stridor. Nonetheless, using aerosolized budesonide is recommended due to its fewer associated side effects.

Background and Objective: Smoking is an important phenomenon for its multi variables nature. College students had shown more tendency to it. The aim of the present research was to investigate the relationship between metacognitive beliefs, coping strategies, and negative emotions in student’s smoking.Materials and Methods: In a correlative study, 250 male students from Tarbiat Molallem University were selected by convenience sampling method. The students were asked to complete the following questionnaires: metacognitive beliefs questionnaire (MCQ-30), coping inventory for stressful situations (CISS), hospital anxiety and depression scale (HADS), and researcher questionnaire about smoking. Pearson’s correlation and regression algorithms were used to analyze the data.Results: Results show that metacognitive beliefs, negative emotions, and coping strategies are associated with smoking. There was a significant correlation between metacognition and smoking. There was also a positive relationship between coping strategies and smoking (P<0.05). In general, the hospital anxiety subscale alone explained 2.6% of the variance related to smoking.Conclusion: Adjusting students' metacognitive beliefs and training coping strategies can substantially reduce smoking by alleviating their negative emotions.

The patient was a 37-year-old woman with abdominal pain. A huge mass was noticed during the abdominal examination, and ultrasonography reported a large uterine fibroma with the size of 105x100x101 mm. The patient was hospitalized for abdominal hysterectomy. During the operation, opening the parietal peritoneum led to a massive bleeding and a drop in patient’s blood temperature. The fibroma was supplied by ileal mesentery vessels that were the main source of the bleeding. The ileal mesentery bleeding was controlled by silk suturing. We resected the fibroma but did not do a hysterectomy. Not only sonography but also CT and MRI are recommended to Such a problem.