Journal of Arak University Medical Sciences
Year:2009 | Volume:12 | Issue:1 (46)|Papers Count:17

Background: Hyperemesis Gravidarum is the pernicious vomiting during pregnancy that causes various complications. This present was investigated to relationship between Helicobacter Pylori and Hyperemesis Gravidarum.Methods and Materials: 80 women with 7-16 gestational age, participated in this casecontrol study. It was done in Obstetric Clinical of Shabihkhani Hospital in Kashan from April to July 2008.The case group had Hyperemesis Gravidarum but the control group did not. The criteria for Hyperemesis Gravidarum were pernicious vomiting (more than 3 times a day) and the presence of one pluse ketonuria. Serum titre of anti Helicobacter pylori IgG with standard ELAZA kit in each group then compared. Chi square test was applied for data analysis and significancy was P-Value less than 0.05.Results: The mean of age was 25.4±4.5 in case and 22.4±4.6 in control group. There were no statistically significant differences in age, gestational age, gravity and parity between two groups. The frequency of Helicobacter Pylori was 75% in case and 35% in control group. Difference was significant (p=0.001).Conclusion: In this study, significant relationship between Hyperemesis Gravidarum and Helicobacter Pylori was seen. Regarding to Helicobacter Pylori causes peptic ulcer and hyperemesis imitates some Peptic ulcer symptoms, more studies should be carried out to determine this relationship.

Background: Diabetic patients face many challenges related to their illness and treatment in their life. So they need to use coping strategies for adjustment. The purpose of this study has been determined the coping styles among diabetic Iranian patients.Methods and Materials: In a case-control study, 100 consecutive diabetic patients admitted to Amin and Sedigheh Taherah Medical Centers, Isfahan, were selected based on the inclusive and exclusive criteria and compared with one hundred normal people who selected from general population. Data collected by using demographic questionnaire, the Jalowiec Coping Scale, then MANCOVA and co-variance were used to analyze the data.Results: Difference between two groups in coping styles were significant (F=2.835, p=0.005). Significant differences was in supportant coping style (F=11.204, p=0.001). There was no significant difference in other coping styles between two groups.Conclusion: It seems that the diabetic patients likely differ from normal people only in supportant coping style when deal with daily stress. But they are similar to normal people in other coping styles. In addition, both groups use problem solving styles when deal with daily stress. The findings emphasis the role of illness representation to determine coping styles.

Background: In this study, the effects of S362A and S362D mutations on the membrane turnover and the stability of ROMK2 channel when expressing in Xenopus laevis oocytes were examined.Methods and Materials:In this experimental study, oocytes were isolated by standard protocols using collagens (Type 1A). Mutations of the cytoplasmic termini of ROMK2 were constructed using the quick-change approach for site-directed mutagenesis. Xenopus oocytes were injected with cRNA encoding ROMK2 or S362A or S362D mutant three days prior to treatment with BFA solution (time 0). Brefeldin A (BFA) was added to the OR3 medium (+BFA) at concentrations of 25mM (inhibit insertion of new proteins into the cell membrane) or ethanol as BFA vehicle (-BFA). Two-electrode voltage clamp (TEVC) was used to measure oocyte ROMK-dependent currents and membrane potential.Results: In oocytes was expressing ROMK2 and/or the S362A mutant, there was significant reduce in current and membrane voltage of K. The fractional currents for ROMK2 and S362D mutant demonstrated a slight difference 48h following treatment of oocytes with BFA, 0.16±0.05 (n=18) and 0.11±0.05 (n=18) respectively. This was; however, significantly different from the fractional current of S362A mutant which stood at 0.96±0.05 (n=24).Conclusion: Mutant Serine residue S362A which causes phosphorylation in endocytosis and helps determine the number of ROMK2, plays an important part in PDZ domain.

Background: Breast Cancer is the most common malignancy and is the second largest cause of death among 35-55 years old women. The aim of this study is explore and describe women's experiences with breast cancer for achieving a deeper comprehension of their individual experiences. Methods and Materials: This is a qualitative study with a phenomenological approach. Sampling method was purposive and continued till data saturation. Twenty two participants (patients, families and treatment team) attended in the study. Data were collected by using in-depth interviewing and were analyzed by “Parse” method. We tried to analyze qualitative data based on valid criteria.Results: The findings of this research were summarized into four core concepts: delay in diagnosis and treatment, treatment rejection, drowning in suffering (emotional reactions to disease, facing with outcomes of treatment, exposure to treatment system, ineffective care and disturbance in daily life of the family) and moving toward normal life. Conclusion: Knowledge of treatment team from the experiences of women suffering from breast cancer helps them to play a better role in their treatment. It seems, this is essential for make a shift from terminal treatment to early diagnosis. Also it emphasise to use of source for support of patients.

Background: There are citrullin peptides in Rheumatoid Arthritis (RA) patients that are changed by Peptidyl Arginine Deiminase enzymes (encoded by PADI genes). An association between RA and PADI-4 haplotypes has been reported by researchers. The aim of this study is evaluation of PADI-4 Gene polymorphism in patient with Rheumatoid Arthritis referring.Methods and Materials: In this cross-sectional study we extracted the genomic DNAs from the whole blood samples of 50 patients with RA ( on the basis of ACR criteria) referring to Imam Reza hospital in Mashhad and a control group involving 50 healthy khorrasanian participants. DNA genom was extracted with nonenzymatic salting out method. Genotypes were determined by PCR simple sequence specific primers (PCR-SSP). Data were analyzed with Chi-Square and Fisherexact Test.Results: 58% of the patients had genotypes of 1and 2; 38%: 1,4, 2%: 1b,2 ,and 2%: 2,4. In the control group, 72% had genotype 1,2; 22%: 1 and 4, 6%: 1b,2 while none of them had genotype 2,4.Conclusion: There was not any significant relationship between the presence of different PADI-4 genotypes and RA in Khorrasanian population.

Background: There is not appropriate research about use of saline lock for obtaining blood samples and intravenous drug or fluids. The purpose of this study was compared the biochemistry values obtained by venipuncture and saline lock after intermittent administration of solution and medication. Methods and Materials: This quasi-experimental prospective study was done on 63 patients who were admitted in Cardiac ward Amir-Kabir educational hospital. The sampling method was convenience. A tourniquet was tied above the saline lock, the first 0.5 ml of blood withdrawn was discarded, then 5 ml blood was obtained. Simultaneously, 5 ml sample was drawn from the opposite arm. The samples were analyzed for FBS, Chol, TG, HDL, LDL, BUN, Cr, Na, K, CPK & LDH. Results: 53.9% participants were male. Mean of age was 63.52±12.63 years. There were no significant differences in mean of biochemistry values in blood obtained by venipunctures saline locks (p>0.06).Conclusion: Nurses can use saline lock after intermittent intravenous drugs and fluids, in order to determine blood sample for evaluating blood biochemistry value. This method relieves pain, due to blood sampling.

Background: The role of sex hormones in pain perception and the effect of stress on reproductive system have not been determined yet. The present study has been investigated the effects of acute and chronic restraint stress on nociception and sex hormones concentration in rats.Methods and Materials: This experimental study was carried out with 47 male and female rats which ranged in weight from 170-230 gr. In order to transmit stress to the rats, they were initially exposed to acute restraint stress (1h) and chronic stress (for two weeks-1h/day). Then they were submitted to tail flick test for nociception evaluation. Sex hormones serum level was measured by radioimmunoassay method. Results were analyzed with Mann-Whitney and Kruskal-Wallis tests. Results: In male and female rats, acute restraint stress had significant increment in latency in the tail flick test. Chronically stress in male rats, was not significant effect on latency time. Chronically stress in females responded to restraint stress with an increase in tail flick latency. Both acute and chronic restraint stress reduced testosterone level in the male rats. In the female rats, only acute restraint stress significantly decrease plasma estradiol level. Restraint stress did not effect on testosterone concentration level in the female and estradiol level in the male rats.Conclusion: Acute restrain stress decrease nociceptive and sex hormon levels in male and female rate; but, chronic restraint stress causes sex dependent response.

Background: Pyelonephrities is the urinary tract infection. Using supplemental dugs may decrease duration of treatment and hospitalization. We studied the effect of vitamin C on the recovery of symptoms due to pyelonephrities.Methods and Materials: In this clinical trial, double blind, study, 64 patients with uncomplicated pyelonephrities were assessed in 2 groups randomly. Case group took vitamin C capsules, and control group took placebo capsules. In both groups, primary treatment was ceftriaxon capsules during hospitalization and they took ciprofloxacin capsules for 14 days after discharging. Symptoms and Urinary analysis were assessed in the first day of administration and then on the 7th and 14th days after discharging. Data were analyzed with Chi-Square test.Results: Mean of fever duration in vitamin C group (1.13±0.34 SD day) and placebo group (1.56±0.62 SD day) significantly decrease (p=0.001). There was a significant difference in dysuria duration in vitamin C group 2.19±1.06 SD day with placebo group (2.97±1.06 SD day) (p =0.007). In flank pain, nausea and vomiting duration difference was not significantly (p³0.05). Conclusion: It seems vitamin C, as a supplementary drug improves some pyelonephrities symptoms, such as fever and dysuria, decreases of the hospitalization period.

Background: Angiogenesis is a complex process that occurs in many physiologic and pathologic conditions such as invasion and metastasis of tumors. Therefore, it is the target of many clinical treatments. Rapamycin is one of the immune system inhibitor drugs that recently has been used for controlling different types of cancer. In this study, the effect of Rapamycin on angiogenesis in chicks' chorioalantoic membrane was investigated.Methods and Materials: In this experimental study, we used 42 Ross fertilized eggs that were divided into 3 random groups: control, sham-exposed (treated by Dimethyle sulfoxide-DMSO- ) and treated with Rapamycin. In 2th day, a window was opened on eggs in the sterile condition. Later, in 8th day, a gelatin sponge appeared on chorioalantoic membrane and was soaked with 5 ml Rapamycin in treatment group and 5 ml DMSO in the sham-exposed group. In 12th day, CAMs were examined and photographed by Research Photostereomicroscope in all cases. The numbers and lengths of vessels around the sponges were measured and compared with each other by T-Test (p<0.05). Results: The mean of number (42±7.26) and length (57.25±5.05cm) for vessels in the control group and mean of number (42.93±8.37) and length (55.66±10.44 cm) in sham-exposed group wasn’t any significant differences. There was a significant decrease in mean number (29.36±5.28) and length (44.55±10.22) of vessels in Rapamycin with control group. Conclusion: It seems Rapamycin has an inhibitory effect on angiogenesis in chicks' chorioalantoic membrane. It decreases the number and length of vessels around treated area.

Background: Hypertension disorders are the most common medical complication during pregnancy. Preeclampsia is an important cause of mortality. The pathophisiology of it is still unknown. But sex hormon especially testosterone may be has a role in preeclampsia. We were conducted the comparison of serum free testosterone level in preeclamptic with normotensive pregnant women.Methods and Materials: This research was a case-control study included 27 women with singleton pregnancy that were complicated with preeclampsia (11 with severe preeclampsia and 16 with mild preeclampsia) and 62 normotensive pregnant women who were matched for age, body mass index (BMI) and gravity. Serum levels of free testosterone were measured by ELISA method.Results: Serum testosterone level was higher in preeclamptic group (1.66 ng/ml) than in mean of the control group (1.27 ng/ml), but this difference was not significant. Mean of testosterone levels in sever preeclampsia were higher than mild preeclampsia patients, however it was not statistically significant (2.08, 1.37, respectively).Conclusion: It seems that testosterone has not significant role in the pathogenesis of preeclampsia.

Background: Preoperative anxiety is a common reaction in patients. Many techniques are used for alleviation of it, such as preoperative visit by the anesthetist, reassurance by a psychologist, and prescription of tranquilizer drugs. In this study we surveyed propofol compared to Midazolam on preoperative anxiolysis.Methods and Materials: In randomized controlled double-blind clinical trial, 60 patient swith ASA class I candidates for elective abdominal operations were randomly allocated in 3 equal groups (propofol, midazolam and normal salin). Anxiety was measured with 2 different scales: visual analogue scale (VSA) and clinical global impression (CGI). Pulse rate (PR), blood pressure (BP), respiratory rate (RR), and saturation PO2 (SPO2) were measured before drug administration and 3 times after that in 2.5 min intervals. Results were analyzed with ANNOVA, repeated measures ANNOVA, TUKEY, and X2 tests.Results: There were no differences in demographic variables between groups. Both propofol and midazolam were more effective than placebo in anxiety reduction. Both drugs had equal effect (p>0.05). There was no significant difference in BP, PR, RR and SPO2 between two drugs. Conclusion: Both drugs were the same and more effective than placebo. Midazolam may be preferred for economical reasons.

Background: Hospitals need performance evaluation systems for development and competition in order to evaluate the effectiveness and efficiency of their plans, processes and human resources. The objective of this research is to design an evaluation system at hospitals through the use of the Balanced Scorecard.Methods and Materials: In this comparative study, the selected countries consisted of Australia, USA, Canada and New Zealand, and 34 public hospitals of Iran which were applying strategic planning. Performance evaluations were examined in terms of 6 aspects including mission, vision, strategies, perspectives, objectives and measures .A pattern was designed for performance evaluation of public hospitals in Iran and was validated using experts’ survey of DELFI method. Results: All countries had mission and vision as important aspects of their performance evaluation model while health effectiveness promotion was the most important strategy. High quality health services, resource development, innovation and guaranty in continuous services were other strategies. Perspectives of Balanced Scorecard included customer, internal processes, learning and development of staff and financial affairs. All of the countries had objectives and measures for each of the perspectives. Iranian hospitals had mission, vision, strategies and objectives but for them perspectives had not been defined and measures were not congruent with strategies and objectives. In the model, 4 perspectives were determined to describe hospital strategies and to use competition benefits as well.Conclusion: Applying measures of 4 perspectives including "Patients and Community", "Internal process and Productivity", "Growth and innovation" and "financial aspects" to doevaluation of Iranian public hospitals collates their performance, improves productivity of their resources and enhances patients and community satisfaction.

Background: Demodex is a genus from Demodicidae family, that has various species of uncommon mite. Two species of it which causes disease in humans have been identified: Demodex Folliculorum that lives in or near mammals' hair follicles and Demodex Brevis which is more common in women than men.Case: The patient was a 20 year-old woman, who lived in a village around Arak. She referred to dermatologist with sever itching and hyperkeratosis in cheek. Several slides were provided from cheek skin in laboratory. The density of Demodex was observed by microscope.Conclusion: It seems patients referring with itching and hyperkeratosis in head and face may suffer from demodex infection. Thus, it is suggested that demodex diagnosis be added to the standard diagnosis paradigm.

Background: Hydatid cyst, a parasite disease, can involve liver more than other organs. The most serious complication of the cyst is rupture which may spread out to biliary duct, hollow organ, or abdominal cavity directly. Elective treatment is emergent surgery.Case: A 28 rural woman referring with abdominal pain, nausea and vomiting due to car accident. Abnormal findings consisted of: abdominal distention, reduction of bowel sounds, tenderness and generalized guarding and hive lesions in the anterior chest wall, upper abdomen, and both forearms. In sonography, a lot of free liquid in abdominal and pelvic cavity, and three hetroechoic masses in the right lobe of the liver were reported. Four days after abdominal surgery the patient was discharged with Albendazole order.Conclusion: Intra-abdominal rupture of hydatid cyst is the most serious that due to trauma complication and elective treatment is emergency surgery.