Internal Medicine Today
Year:2012 | Volume:18 | Issue:1 (55)|Papers Count:13

Background and Aim: The number of cesarean sections continues to rise in developed countries. This is one of the main concerns of society, especially in obstetrics and gynecology fields. The overall goal of this research is to determine and compare the outcomes of cesarean and vaginal delivery for mothers and infants in selected hospitals in Tehran in 2009.Materials and Methods: This was a prospective population-based cohort study of 246 pregnant women who delivered in Tehran hospitals. 114 healthy women undergoing a cesarean section and their infants henceforth known as the “cesarean group” were considered for the comparison with an otherwise similar group of 132 women delivering vaginally. The data were collected in three stages (at childbirth, before discharge and 10 days after birth) and analyzed through SPSS Software V.16 at 0.05 level of significance.Results: There was no significant correlation between early postpartum hemorrhage, PPH leading to an intervention and treatment after 10 days of postpartum, infection and postpartum urinary retention, infection leading to treatment, readmission within 10 days after delivery and postpartum blouse syndrome. In contrast, there was a significant relation between the decrease of more than 10% of hematocrit before and after delivery and type of delivery (p<0.001), and also between the type of delivery and the incision pain (Episiotomy or cesarean) (p<0.001), birth satisfaction after 10 days (p=0.001. Also, there was a significant relationship between the type of delivery and hospitalization duration (p<0.001) and also hospitalization costs (p<0.001). There was no significant correlation between type of delivery with newborn Apgar score during one minute and five minutes after birth. There was no significant relationship between newborn weight, jaundice and respiratory depression, and need to admission in NICU. There was no significant relationship between type of delivery with fever leading to treatment, infant feeding, impatience and death of newborn during 10 days after birth.Conclusion: The study found no statistically significant difference in maternal and neonatal outcomes between C-section and vaginal birth groups. More studies are needed to understand the short term and long term complication of the delivery mode on maternal-child outcomes.

Background and Aim: Non-steroidal anti-inflammatory drugs have been used widely in recent times and generation of peptic ulcer is a side-effect of these drugs. In this study, we evaluated the effect of extract of Carum Copticum seed on treatment of peptic ulcer induced by ibuprofen in rats.Materials and Methods: This study was performed on 30 adult female rats. At first, the animals were randomly divided into five groups. Then, in order to induce gastric ulcer, Ibuprofen was used orally. After suffering, the animals were treated with Omeprazole or plant seed aqueous extract doses of 125, 250 and 500 mg per kg, twice a day for two weeks. Finally, the animals were studied in terms of the number and the extent of gastric ulcer. The amount of liver enzymes, Aspartate Transferase (AST) and Alkaline Transferase (ALT), in the serum of animals were also measured.Results: The plant seed extract caused a dose-dependent ulcer healing effect in rats, that is, the therapeutic effect in doses of 125 and 250 mg/kg compared with Omeprazole was significantly meaningful (p<0.05). The mean number and area of gastric ulcers in the groups receiving the extract were significantly lower than those of the group receiving Omeprazole. The amount of liver enzymes in the extract group that received a dose of 500 mg/kg significantly increased (p<0.01).Conclusion: The extract of Carum Copticum seed was very effective in the treatment of peptic ulcer and therapeutic effect of this extract is comparable with that of Omeprazole. Moreover, further work is needed to nelucidate the extent and mechanism of these changes.

Background and Aim: Nowadays, research interests in cancer, as the second reason of death in the world, concentrate on coping and adjustment styles. Emotional intelligence (EQ) is the person's ability of perception and management of emotions in themselves and others, this ability is related to the individuals' health. Thus, the aim of this study is to determine the relationship between EQ and adjustment in cancer patients.Materials and Methods: This research is a correlational study, in which 60 cancer patients (22 males and 38 females) of the hospitals and therapeutic centers in Mashhad city were selected by cluster sampling. The patients completed the EQ inventory and Bell adjustment questionnaire. Afterwards, the data were analyzed using SPSS Software V.17 through Pearson correlation and multiple regression analyses.Results: There are relationship between EQ and physical adjustment (r=-0.65) and emotional one (r=-0.65), (p<0.001). From EQ dimensions, conformity dimension predicted 43% of variance of physical adjustment. Temperament and stress management dimensions predicted 63% of emotional adjustment (p<0.001). Also, there was a significant relationship between all the EQ components (15 components, except empathy) and physical (p<0.01) and emotional adjustment (p<0.001). The most correlation ratio in physical adjustment and emotional adjustment was related to responsibility component (r=-0.72) and self-respect (r=-0.76), respectively.Conclusion: With regard to the positive relationship between EQ and adjustment in cancer patients and more adjustment in them, the strategies to improve EQ, such as special workshops in hospitals and therapeutic center, are recommended.

Background and Aim: Developmental processes are mediated by cell surface and extracellular matrix (ECM) interactions that are regulated by the molecular mechanism. The aim of this study was to determine Glycoconjugates terminal sugars distribution and the changes during kidney development in rats using Lectinhistochemical technique.Materials and Methods: Thirty Wistar Rat embryos at different stages from days 14 (E14) to 18 days of gestation were fixed in formalin, embedded in paraffin and cut into 5μm thickness sections serially. The sections were incubated with different HRP-lectins from Lotus tetragonolobus (LTA), Maclura pomifera (MPA) and Ulex europeus agglutinine (UEA-I). Staining intensity was determined by means of blind method and the sections were graded to compare different embryonic stages.Results: Our findings showed that the reactions of MPA with podocyts started at E14 and increased afterwards (p<0.05). Mesenchymal cells reacted with MPA on E14, E16 and disappeared at E18 (p<0.05). Collecting duct reaction with MPA was moderate on E 16. Mesenchymal cells reaction with UEA-I was moderate on E14 to E16 but decreased on E18 (p<0.05). A weak reaction was observed in collecting duct with UEA-I on E16. Proximal and distal tubules as well as collecting ducts showed a weak reaction with LTA in E18. No reaction was observed in Podocytes. Mesenchymal cells reacted on E14 but did not react on E16 and E18 with UEA-I lectin.Conclusion: According to the results, it is concluded that distributions and changes of glycoconjugates with terminal sugars L-Fuc (a2-4) GlcNAc, Gal (b1-3) GalNAc and L-fuc (a 1→3) Gal (b 1-4) Glc, are regulated during rat kidney development.

Background and Aim: Acrylamide, a carcinogen material, is produced in temperatures above 120oC in bread. Free asparagine in wheat flour is the basic factor in acrylamide formation in bread. In accordance with its nutritional and medical importance, the aim of this study was to study the effect of flour extraction rate and asparaginase enzyme on reducing the free asparagine in bread dough.Materials and Methods: To perform this experimental study, two types of wheat were obtained from Golestan province, and two kinds of flour were produced with 93% and 82% extraction rate by mixing the two kinds of wheat. The value of free asparagine in whole flour, bran and endosperm flour obtained from the two varieties of wheat and in two kinds of flour was determined. Then, the effect of the flour extraction rate on free asparagine and asparaginase enzyme on the hydrolysis of free asparagine in flour and the two varieties of dough was investigated in laboratory and bakery conditions. The free asparagine by liquid chromatography with high efficiency was measured, and the data were analyzed through independent t-test and Mann-Whitney.Results: A significant difference was observed between the means of free asparagine in whole flour, bran, endosperm flour and the two kinds of flour (p<0.05). The suitable density of asparaginase enzyme for reducing free asparagine in two kinds of dough was 500 mg/kg. Reduction of asparagine by the use of similar density of the enzyme in the two kinds of dough was not significant, 88.02% (p>0.05).Conclusion: The effect of wheat variety and flour extraction rate on free asparagine value is inevitable, but using asparaginase enzyme is a useful way to reduce asparagine in bread dough.

Background and Aim: Reduction of physical activity among adolescents is one of the most important problems of society. The aim of this study was to determine the effects of training programs on promoting the physical activity among school students by using the theory of planned behavior.Materials and Methods: This was a quasi-experimental study in which four junior high schools were randomly selected and then assigned to two interventional groups (n=150) and two control groups (n=150). Next, the students filled out the questionnaires before the intervention and two months after the intervention. The collected data were analyzed using SPSS Software V.13 employing Chisquare, independent and paired t test.Results: There was a statistically significant difference for the mean score of attitude (p=0.003), intention (p=0.000), subjective norms (p=0.013), perceived behavioral control (p=0.001) and increasing physical activity (p=0.000) among interventional groups after implementing the educational program.Conclusion: The overall results indicated that there were significant differences in the structure of theory of planned behavior and the increase of physical activity among students in the intervention group after training. It seems that implementing educational programs for increasing physical activities among students will be useful.

Background and Aim: Previous investigations have indicated that there is a relationship between Meta cognition and Body Dysmorphic Disorder (BDD), but there isn't enough study about efficacy of metacognitive therapy in reducing thoughts fusion. So, this study aimed to examine the efficacy of Metacognitive Behavior Therapy (MCBT) on reducing thoughts fusion in outpatients with BDD.Materials and Methods: In this experimental study, one sample was selected from the dermatology and cosmetic surgery clinic in Isfahan through voluntary sampling. Twenty subjects were then randomly selected from the patients with BDD referring to this cosmetic surgery clinic and were randomly assigned to one experimental and one control group. Thoughts Fusion Inventory (TFI) was then administered to both groups as pretest. Then, the experimental group received Metacognitive Behavioral Therapy (MCBT) in 8 sessions weekly and the control group received nothing. Post-tests were then administered to both groups immediately after the treatment and 3 months later. The data were analyzed through covariance.Results: The results showed that MCBT was followed by a significant decrease in Thoughts Fusion (p<0.01). Compared with the pretest, the experimental group showed a 65% decrease in the rate of thoughts fusion in the immediate post-test and a 56% decrease in the follow-up (p<0.0001).Conclusion: This intervention is believed to reduce thoughts fusion by facilitating transmission from the object mode to the metacognitive and enhancing the efficient and flexible coping skills. Thus, we might reduce the Thoughts Fusion in BDD by this method of therapy.

Background and Aim: Cement dust is one of the workplace harmful chemicals. There is a disagreement about respiratory effects of cement. The main purpose of this study was to investigate the respiratory effects of exposure to cement dust.Materials and Methods: The subjects consisted of 148 male workers (94 workers with current exposure to cement dust and 54 healthy unexposed employees as a referent group). Respiratory symptom questionnaires, as suggested by the American Thoracic Society, were administered to them. Determination of exposure was carried out by personal dust monitoring. Furthermore, the subjects underwent lung function tests by a spirometer. The data were analyzed applying t test and chi-square test.Results: The mean values of respirable and dust concentrations were estimated to be 7.70±1.2 and 67.4±5.4 mg/m3. Significant decrements in the parameters of pulmonary function were noted (p<0.05).Conclusions: The findings of this study indicate that a strong association exists between exposure to cement dust and the prevalence of respiratory symptoms and functional impairments of the lungs.

Background and Aim: Music therapy is a technique by which music applies its effects through regulation of body rhythms and adjusts the physiological responses in several ways. Music has relaxation and antianxiety effects; however, evidence about its physiological effects is inconsistent. This research was carried out to determine the effect of light music on physiological parameters of patients with traumatic brain injuries.Materials and Methods: In this before-after clinical trial, 35 patients with traumatic brain injuries hospitalized at ICU wards of Shohadae Tajrish and Loghman Hakim hospitals were selected by purposive sampling in 2011. The data were collected by a demographic questionnaire, a physiological parameters form, Glasgow Coma Scale (GCS) and biophysiological measuring devices. Physiological parameters and GCS were measured before and after listening to light music. The data were analyzed by SPSS using RMANOVA and Bonferroni tests.Results: Comparing the means of physiological parameters before and after the intervention showed significant differences (p<0.001); i.e., the mean of SPO2 increased and the means of pulse rate, respiratory rate, systolic blood pressure, diastolic blood pressure, arterial pressure and body temperature decreased. The mean of pulse pressure decreased with no significance (p=0.197).Conclusion: The results showed that light music can adjust physiological parameters of patients with traumatic brain injuries. This study recommends that the managers of hospitals develop a practical strategy to use light music in order to adjust the physiological parameters of patients at ICU wards.

Background and Aim: Calculating per capita performance is a logical and reasonable basis for the diagnosis of staff’s competency and merits and for achieving organizational objectives. This study aimed at analyzing the costs and determining the per capita performance of the personnel working in the hygiene sectors of Shahroud University of Medical Sciences.Materials and Methods: In this descriptive cross-sectional study, all the costs of the sectors affiliated with the Health Deputy of Shahroud University of Medical Sciences were extracted in 2009. The services and activities were standardized and the time required for the performance of each activity was determined through using service provider comments. The primary health cares were provided based on the methods recommended in the reviewing and program evaluation techniques. The data were collected through over 75 forms and were fed into Excel and the cost analysis software. After analyzing the data, the results were displayed in frequency distribution tables and charts.Results: 44.4% of the participants were males. Useful work time per capita in health houses were 270 minutes per day, in rural health centers it was 214 minutes, in urban health centers it was 203 minutes, in urban boarding health centers it was 343 minutes, and in health posts, it was 168 minutes. The useful work time per capita for the whole city employees was 225 minutes per day. The available workforce received 459 Rials for each minute of required work and 854 Rials for each minute of useful work.Conclusion: Only half of the temporal capacity of rural health workers, health technicians, administrative staff, and the diagnostic and therapeutic personnel were efficiently used, while for the temporary capacity and delivery and labor facilities of health posts, this figure stood at less than one third. Professional enrichment, clarifying work processes and workforce adjustment can play an important role in increasing productivity.

Determining the cervical dilatation, as one of labor's progress criterion, has been considered an attempt for inventing different tools for this purpose. But, unfortunately, none of the tools has become clinically widespread and applicable yet. Therefore, this study has been done with the purpose of producing a simple and clinically useful tool for objective determining of cervical dilatation. Reviewing other pervious practices for inventing or improving objective cervical dilatation methods has shown that the available tools using advanced technologies such as Laser or pressure sensors are not cost-effective or even cause discomfort for patients, so they had not been clinically applicable. Cervical dilatometer is a new small size device with a simple mechanism; it will be sterile, single-used and designed for converting examiner's subjective estimate to an objective and measurable criterion; it can reduce the number of examinations- that are carried out by different examiners- and can be useful as a training tool for midwifery and medical students and clinical research, too.