Internal Medicine Today
Year:2009 | Volume:15 | Issue:3|Papers Count:14

Background and Aim: Some drugs are not effective merely in nausea and vomiting induced chemotherapy control, and increasing their usage causes undesirable effects. Pharmalogical– nonpharmalogical methods lead to a higher control on direct side-effects in comparison with traditional treatments. Furthermore, these combined methods decrease the amount of drug consumption and related severe results. The main goal of the present report was to assess the effect of progressive muscle relaxation (PMR) on the dosage of antiemetic drugs in cancer patients undergoing chemotherapy.Materials and Methods: This study is a quasi-experimental one which was carried out on 61 patients regarding the corresponding sampling characteristics. The samples were divided randomly into two groups of case and control. The case group was trained PMR technique in the first period of chemotherapy. The performance of the technique continued with an educational cassette twice a day in the first period, after (at home about 3 weeks) and second period of chemotherapy. The control group used the routine care at the same period. The amounts of prescribed antiemetic drugs to patients and times of the PMR technique were recorded in the two periods of chemotherapy. Results: The mean dosage intravenouse metoclopramide (t=3.5, p=0.001) and oral antiacid (t=2.3, p=0.02) by paired t-test revealed the presence of a significant difference for case group and nonsignificant discrepancy for control group (p>0.05) over the two periods of chemotherapy. Moreover, the mean dosage intravenouse with independent t-test confirmed a significant difference between control and case groups in the second period of chemotherapy (t=2.06, p=0.04). However, the mean dosage granisetron and dexamethasone drugs did not show any significant difference between control and case groups in two the periods at the research (p>0.05).Conclusion: The results indicated that PMR effectively decreased the amount of dosage antiemetic drugs specially metoclopramide in cancer patients undergoing chemotherapy. According to the findings, it is recommended that nurses use PMR as a nursing care for the related patients.

Background and Aim: Discovering the drug mechanisms in visceral leishmaniasis is very important to confirm treatment methods. The direct effect on the cell membrane and induction of necrosis are the causes of side-effects in conventional drugs like Glucantime. Therefore, if a drug induces apoptosis but not necrosis in leishmania, we could conclude that the drug is more effective. The aim of this study was the assessment of miltefosine on cell death mechanisms and the apoptosis of standard strain of lishmania infantum in Iran.Materials and Methods: The cytotoxic effect of miltefosine was studied with colorimetric assay (MTT) and the promastigotes apoptosis was studied with flow cytometry. In summary, 105 leishmania infantum promastigotes treated with IC50 dose of miltefosine, and control cells were added to binding buffer with FITC conjugate, annexin V and propidum iodide (PI). The cells were studied with flowcytometry and the results were analyzed with cell quest program. Morphology and cell size of promastigote were studied.Results: IC50 of Miltefosine were calculated 7-8 mmol. After a 24-hour incubation of treated cells with miltefosine, 22% were annexin-V FITC positive but only 2% of control cells were annexin-V FITC positive. After 48 hours the percent of apoptotic cells increased (80% annexin-V FITC) whereas no change was detected in control group. Conclusion: Initially, it was assumed that apoptosis emerged with metazoan. Recently, several studies have demonstrated that a process of apoptosis also operates in eukaryotic organisms including various species of leishmania. Studying the precise mechanism of cell death pathway and induction of death in leishmania treated with miltefosine is very important for planning effective treatment strategies.

Background and Aim: Hyperlipidemia, particularly hypercholesterolemia, is one of the major risk factors in cardiovascular diseases. Egg yolk is one of the richest sources of dietary cholesterol in human nutrition. Because egg yolk has relative high cholesterol, we wish to investigate the effect of consuming regular eggs on serum lipid profile.Materials and Methods: In this semi-experimental trail, twenty six healthy normolipidemic volunteers (8 men and 18 women) were recruited for the study and two well-cooked moderately sized eggs were added to their breakfast in addition to their regular diet for 4 weeks. Fasting blood samples, the dietary intakes, serum lipids, and anthropometric measurements were compared before and after starting new diet applying paired t-test using SPSS software (ver.13) for windows. Results: The 4-week egg consumption (2 per day) significantly increased the average level of total cholesterol, LDL-C and triglyceride from 129.76, 72.19 and 99.63 mg/dl before having egg to 160.69, 98.03 and 105.34 mg/dl, respectively, after using eggs (p=0.0001). While HDL-C decreased significantly from 54.84 mg/dl to 50.73 mg/dl (p=0.008), cholesterol intake significantly increased from 251.2 mg/day to 534.1 mg/day (p=0.0001).Conclusion: Because egg yolk has relatively high cholesterol concentrations, limited egg consumption is often recommended to reduce serum cholesterol concentrations and to help prevent coronary heart diseases (CHD).

Background and Aim: Consuming drugs without prescription causes many problems. This occurs more in women because this group is located in sensitive periods, for example, during pregnancy and breast-feeding. Therefore, the birth of abnormal neonatal causes many social and familial problems. The purpose of this study is to determine the effect of education on knowledge, attitude and practice of pregnant women on self-medication in Arak city.Materials and Methods: This is a quasi-experimental prospective study that was carried out on 200 pregnant women referring to health centers in 2008. The subjects were randomly divided in two groups of experimental and control each of which included 100 persons. Data were collected through a questionnaire consisting of knowledge and attitude questions and a performance checklist on selfmedication which was used in order to evaluate the effectiveness of the educational program. The participants in the two groups filled out the questionnaire and checklist, then intervention was done during one month consisting of four 50-minute sessions, and finally the data of the two groups were collected and analyzed after three months of intervention. Results: The results indicated that the women’s mean score of knowledge and attitude on self-medication was moderate, and the performance on self-medication was less than average and the mean scores of experimental and control groups were 18% and 22%, respectively. The mean score of all variables in experimental group changed significantly after the intervention, and in comparison to the control group the participants’ performance on self-medication decreased (p<0/05). Conclusion: The higher the knowledge and attitude of women about self-medication are, the better the performance on correct consumption of drugs will be. The findings confirmed the effect of educational programs on self-medication for pregnant women. Therefore, it is proposed to hold educational programs in other health centers in order to decrease self-consumption of drugs.

Background and Aim: The aim of this project is to distinguish between self-efficacy (S-E) and perceived behavior control (PBC) in an application of theory of planned behavior (TPB) for the prevention of substance abuse in male adolescents. Materials and Methods: A measure consisting of TPB and control constructs for substance abuse avoidance which contained 34 items was developed and then administered to a sample of adolescents (N=303) in Tehran, Iran. After estimating reliability and validity, exploratory factor analysis and path analysis were carried out to examine the study objectives.Results: All the 303 young male adolescents, aged 15-19, were entered into the study and completed the questionnaires. The exploratory factor analysis led the control items to two factors: PBC and S-E. Path analysis indicated a good fitness for TPB while distinguishing between the two control constructs. Moreover, S-E becomes the most powerful predictor for intention, (with non-significantly prediction of behavior) [b= 0.29], and PBC becomes the most powerful predictor for behavior (with the most weakness prediction of intention) [b= 0.36].Conclusion: The results of this research provide another document for distinguishing between perceived behavioral control and self-efficacy.

Background and Aim: In order to achieve a safe vector with ability to replicate autonomously in human cells by human transfactors, a recombinant plasmid with human mitochondrial origins of replication was constructed. In contrast to lentiviral and adenoviral vectors, this plasmid does not integrate into the host genome and replicates stably. Materials and Methods: Both human mitochondrial origins of replication and gfp fragments were amplified by PCR, cloned into pTZ57T/A. Hygromycin resistance gene was digested from pFBGGT. Then, four DNA fragments were subcloned into pBGGT plasmid. All steps of cloning were checked by PCR, restricted analysis and sequencing. HEK293 and CHO cell lines were transfected by final plasmid (pEU). Transfected cells were checked by Fluorescence Microscope daily during 40 days. pEU and genomic DNA were extracted from transfected HEK293 treated with hygromycin. Five overlap PCRs were performed on these products to check presence of circular plasmid in transfected HEK293.Results: All steps of cloning were confirmed. Data showed that pEU did not replicate in transfected cells. Conclusion: As recombinant plasmids with both mitochondrial origins of replication did not replicate in transfected cell lines, it seems that we need to provide similar conditions of mitochondrial DNA replication in order to replicate the above vector in future experiments.

Background and Aim: Coronary artery diseases are the major causes of death around the world and dyslipidemia is one of the most susceptive factors. It is very important to control the dyslipidemia to prevent the cardiovascular diseases. The aim of this study was to determine the prevalence of dyslipidemia in Gonabad city.Materials and Methods: In this descriptive study, 606 persons (401 women and 205 men) with 41.39±12.56 mean years were selected based on random cluster sampling method, and serum lipids including triglycerides, total cholesterol, LDL-C and HDL-C were determined in fasting condition. The data were analyzed through statistic tests, that is, chi-square and t-test using SPSS software. Results: The results showed that the most prevalence of dyslipidemia was high LDL-C and total cholesterol levels that were showed in 49.6 and 45.6 percent of men and women, respectively. The lowest prevalence of dyslipidemia was low Levels of HDL-C that were showed in 17.5 and 11.6 percent of men and women, respectively. The prevalence of all lipid abnormalities in expect of high levels LDL-C that were higher in men than women, and HDL-C levels were significantly lower in men than women. There was a significant relation between age and mean lipid values. The results showed increasing means of triglyceride, total cholesterol and LDL-C with aging until 50-59, but beyond that age a decrease was showed. The prevalence of lipid abnormalities in expect of HDL-C was significantly more in the individuals above 40 years old than the younger ones. Conclusion: With regard to the fact that the prevalence of lipid abnormalities is almost high in the present study, it seems that more educational recommendations, modification of dietary habits, lifestyles, and also progress of physical activities are necessary for the prevention of ischemic heart disease risks.

Background and Aim: Enuresis is one of the important problems of childhood that has been associated with a wide variety of child and family problems. The purpose of this study was to determine the prevalence and associated factors of primary mono-symptomatic enuresis in 6 year old children in Yazd.Materials and Methods: In a descriptive cross-sectional study, 400 preschool children aged up to 6 years (200 boys and 200 girls), who referred to health evaluation centers from 2004 to 2005 in Yazd, were selected through cluster sampling method and were evaluated for enuresis based on the ICD-10 and DSM-IV definition.Results: The overall prevalence of primary enuresis based on DSM-IV and ICD-10 enuresis definition were 8.25% and 15.25% which was more prevalent in boys (12.5% and 23%) than in girls (4% and 7.5%). Night snoring was seen in 18.2% of children and the snorer-ones had primary enuresis more than the non-snorers (19.2% versus 5.8%). There was no statistically significant relationship between enuresis and family history of enuresis, birth order, and parental educational level. Only 18.2% of parents referred to a physician for management of enuresis and consultation. The mean of bed-wetting was 3.2±1.8 times a week. Severe enuresis (every night a week) was observed in 30.8% of children. Conclusion: Snoring is a probable factor of enuresis that must be investigated and treated. Most of the enuretic children do not receive professional treatment. It is recommended to have an educational program to investigate the risk factors of enuresis and its treatment.

Background and Aim: Nowadays, self-directed approach to education is of great importance in the self-efficacy in educational settings. The findings of various research projects on the field reveal the vital role and importance of self-confidence in all areas of life. Accordingly, this project aims at studying the relationship between self-efficacy and test-anxiety in Iranian students of Islamic Azad University. Materials and Methods: This study is a descriptive and analytic study of correlation type. The selected 405 subjects who participated in the study were studying in Azad University, Southern Khorasan Province. They were selected through cluster random sampling. The data were collected through standardized questionnaires for self-efficacy and test-anxiety. Pearson correlation and t-test were employed to analyze the collected data using SPSS software. Results: There is a relationship between self-efficacy and test-anxiety at the level of p<0.01. Also, the relationship between personal variables (age, sex, average, and ...) with test-anxiety and self-efficacy was scrutinized. The results showed that there is a significant relation between student average and self-efficacy at the level of p<0.05; however, the sex variable was not influential in the results. Conclusion: There is a significant relationship between self-efficacy and test-anxiety and this in turn proved that self-efficacy is effective in improving the students’ mental health and their academic and vocational achievements. Accordingly, in order to improve self-efficacy, we need not only to include some instructions for self-efficacy in the curricula but also train teachers and students at any level of education.

Background and Aim: This paper presents the main results of the first National Burden of Disease (NBD) study in Iran for children aged 0-14 years which was conducted for the year 2003 by the Health Programs Management Bureau of Ministry of Health and Medical Education (MOHME) in collaboration with other departments of Health Deputy of MOHME and Universities of Medical Sciences, with the support of Eastern Mediterranean Regional Office (EMRO) of World Health Organization (WHO) and senior consultancy of Professor Alan D. Lopez from Queensland University, School of Population Health. The important objective of this study was to estimate, at the national level, the burden of disease and death of children aged 0-14 years using Disability-Adjusted Life Years (DALYs).Materials and Methods: Methods developed by the World Health Organization (WHO) for the National Burden of Disease (NBD) studies were applied to estimate disease and injury incidence for estimation of Years of Life Lost (YLL) due to premature mortality, Years Lived with Disability (YLD), and DALY. Adjustments of NBD methodology were made: a revised list of more than 200 disease conditions, development of new and more specific disease modeling templates for cancers and injuries, and adjustment for dependent morbidity.Results: An estimated DALY of 2981919 years incurred in Iranian children aged 0-14 years in both sexes due to all diseases and injuries in the year 2003. From this, 56% was due to premature death (YLL), 44% due to disability (YLD), 37% was due to perinatal diseases and delivery complications, 30% due to external causes (injuries), 7% due to congenital diseases, 5% due to nutritional and metabolic disorders, 4% due to gastrointestinal diseases, and the rest due to other diseases. From total DALYs of about 2981919 years, 1330175 years were in females and 1651744 years in males. The ratio of DALYs in children aged 0-14 to all was 207.44 in 1000. The highest burden in this group was due to perinatal diseases: 480127 years in females and 621875 years in males.Conclusion: Health and disease profile in Iran has well transited from dominance of communicable diseases to that of non-communicable disease and accidents. NBD results are to be used appropriately in health program planning, research, and resource generation policies and practices.