Journal of Arak University Medical Sciences
Year:2010 | Volume:13 | Issue:1 (50)|Papers Count:22

Background: Studies in different species indicate that a variety of different inhibitors may influence myometrium during pregnancy and withdrawal of one or more of them leads to the onset of labor pain. Hence, this study was done to investigate the association between parathyroid hormonerelated peptide1-34 (PTH-rp1-34) and labor pain. Materials and Methods: This study was a case-control one. Plasma PTH-rp1-34, PTH, total calcium, phosphorous, magnesium, and alkaline phosphatase concentrations were quantified for 152 normal pregnant women at term (76 women at the onset of labor pain, as the case group and 76 women without labor pain, as the control group). The subjects had no pregnancy related complications. Results: The mean of plasma PTHrp concentrations in the group with labor pain (12.36±0.60 ng/ml) did not differ from that in the group without labor pain (13.57±0.63 ng/ml). The means of plasma PTHrp concentration amounts in the group with labor pain and the group without labor pain were 28.92±1.66 pg/ml and 31.88±1.64 pg/ml, respectively and there was no significant difference between the two groups. There were no significant difference in plasma calcium, phosphorus, magnesium, and alkaline phosphatase concentrations in the two groups too.Conclusion: In this study, the endocrinal role of PTHrp and the onset of labor pain was not confirmed.

Background: This study was designed to investigate on efficacy of metacognitive–behavioral therapy (MCBT) on panic beliefs of panic female patients.Materials and Methods: This is a clinical- trial study. The participants, who were 24 panic female patients diagnosed with panic disorder, were selected from 76 panic patients referring to psychiatric clinics. The participants were randomly assigned in to two experimental and control groups. The data were gathered using the panic belief questionnaire which was completed in pretest, posttest and follow-up stages by the participants. MCBT was conducted in 8 sessions on the experimental group while the control group, in addition to the reception of common medical treatments, was laid in waiting list for psychological therapy.Results: According to the results of covariance analysis, the mean of panic beliefs scores obtained in the experimental group were significantly lower than those of the control group (p< 0.05). Conclusion: Panic female patients who attended in MCBT acquired lower scores in panic belief than the control group. Therefore, the results demonstrate that MCBT approach causes to keduce panic beliefs in panic female patients.

Background: The purpose of this study was to determine the effect of L-carnitine supplementation on glucose and lactate concentrations, and aerobic capacity during sub-maximal exercise on ergometery cycle.Materials and Methods: In this double- blind clinical trail, 34 healthy noathlete male students at Saveh University were divided into experimental (L-carnitine usage) and placebo (lactose usage) groups and had one trial of cycling on ergometer (PWC170). This trial was done in two stages: 1) Exercise protocol without L-carnitine or placebo supplementation, 2) Exercise protocol with 3g Lcarnitine (90 minute before exercise) and placebo supplementation in the experimental and placebo groups, respectively. Immediately after the physical exercise, blood sampling was taken for determining plasma glucose and lactate concentrations, and lactate dehydrogenase activity (LDH). Through polar telemetry rest and sub-maximal heart rate, and also, VO2max were measured. Results: L-carnitine supplementation had no influence on plasma glucose and lactate concentrations. Otherwise, rest and sub-maximal heart rate, VO2max and LDH activity were equal in pretest and posttests. All variables remained with no change in control group.Conclusion: Regarding the effect of L-carnitine usage on performance of endurance exercises, the findings are still vague and controversial. Our findings indicated that ingestion of 3g L-carnitine 90 minutes before exercise did not affect the dependent variables. Further investigation is required to determine the direct effect of such supplementations on substrate utilization, fat-carbohydrate metabolism and performance on exercise.

Background: Labor pain, which is a natural, unique and multi- factorial pain, is considereds a major part of women's anxiety at reproductive ages. There are two pharmacological and nonpharmacological approaches for reducing this pain. Since the pharmacological approach involves side effects, lots of attention has recently been given to the non-pharmacological methods. One of these methods, is use inc birth ball the, which includes sitting and rocking on the birth ball. The purpose of this study was to evaluate the effects of using birth ball on labor pain, the duration of active phase and contractions of physiologic labor.Materials and Methods: In this randomized control-clinical trial, sixty primiparous women (18-35 year old) were selected and randomly assighed into birth ball and control groups. The severity of pain was measured through Visual Analogue Scale (VAS) and the pain score, interval between contractions and duration of active phase were compared between the two groups. Results: The average pain score in the birth ball group was significantly lower than the control group (p<0.05). In terms of interval between the contractions, duration of active phase and uterine contractions, there were no significant differences between the two groups.Conclusion: Although use of birth ball did not have any effects on the duration of active phase, uterine contractions and interval between uterine contractions, this complementary therapy reduced the severity of pain during the active phase of delivery. Therefore, this safe method is suggested to be used during normal vaginal delivery and physiologic labor. Also, conducting a study, which examines the effects of using a combination of complementary methods, is recommended.

Background: Job satisfaction is regarded as an individual's opinion of his or her job. Noticing the key role of hospital personnel in giving health services to patients, this study was designed to determine job satisfaction of hospital personnel in Arak.Materials and Methods: This cross-sectional study was carried out on 702 hospital personnel through simple sampling method. The means of gathering data were demographic and Herzberg's job satisfaction questionnaires. Job satisfaction was categorized in three levels.Results: Results in eight domains showed that most personnel's satisfaction of job environment (%75.2), relationship with co-workers (%49), salary and benefits(%75.1), job position(%60.5), job security (%64.6), supervision(%64),management policy(%59.2)and personal life relations (%65.7)were at average levels. Overall, %82.2 of the personnel had an average satisfaction with their jobs. The greatest level of satisfaction was with relationship with co-workers and the lowest level of satisfaction was related to job difficulty benefits, establishment of justice and fairness, discrimination and lack of facilities. X2 statistical test revealed significant differences amolay sex, level of education, type of employment, type of job and work shift.Conclusion: Overall, Job satisfaction in this study was at an average level. Increasing salaries, job difficulty benefits, on time payment and providing welfare facilities are essential for the improvement of job satisfaction in this group.

Background: This study was designed to investigate the quality of life in staff and hospital personnel of Arak University of Medical Sciences and to gain basic information for carrying out interventions for improving their quality of life. Materials and Methods: This cross-sectional study was done to determine quality of life of 300 staff and hospital personnel in Arak University of Medical Sciences. Data gathering tools were demographic and standard quality of life (SF-36) questionnaires.Results: Of the 275 participants who had completed the questionnaires, 127 (%46.2) were staff and 148 (%53.8) were hospital personnel. The means of age and years of experience were 36.79±7.02 and 12.29±7.39 years, respectively. The mean of different dimensions of quality of life in the staff was significantly much higher than that in the hospital personnel (p<0.05). In terms of physical performance, vitality, social performance, general health, physical and mental health domains, significant differences were found among personnel with different employment status. There was also a significant difference between men and women in terms of physical restriction factors, physical agony, vitality, sanity, mental and physical health.Conclusion: The mean of different dimensions of quality of life in hospital personnel was lower than the staff while this value was lower in women than men. Specific longitudinal studies are needed for investigating the causes of these differences.

Background: Oetection of congenital hypothyroidism (CH) in Arak has begun since 2006. The aim of this study was to investigate on recall rate (RR) and the incidence of this disease in Arak. Materials and Methods: In this descriptive study, according to the national screening program for CH in Iran, heel blood samples of 3-5 day- old neonates were taken on special filter paper and TSH values were measuned using ELISA method. TSH values bigger than 5mu/lit were recalled and thyroid function tests (TSH, T4 and T3RUP) were done on venous blood samples and assayed using ELISA method. Neonates with TSH values >10 mu/lit, T4<6.5 ug/dl were viewed as patients. Data related to neonates born up to the end of March 2009 were recorded in special forms. Results: Of 25685 screened neonates, 608 newborns were recalled. RR was estimated to be 2.36%. TSH values in 3.78% were less than 5, in 83.55% between 5-9.9, in 7.56% between 10-19.9 and in 5.09% more than or equal to 20. Eighty six neonates had CH (1/300 live births). Disease rate in, recalled neonates was 14.2%. In 80.26 percent of neonates, sampling was done between 3-5 days while the times of sampling in 18.5 and 1.1 percents of the newborns were in days 6-21 and after day 22, respectively.Conclusion: The incidence of CH in Arak is remarkably higher than national and international rates. RR in Arak is higher than the national but lower than the international rates. Also, the ratio of the disease to the recalled neonates is low.

Background: Urolithiasis is one of the causes of renal colic. The annual incidence of this disease is 1-2/1000 people. Due to the severity of pain, adverse effects of routine treatments and incomplete pain relief, more effective methods of treatment have always been sought for. Alhagi Pseudalhagi distillate is a traditional herbal medication used for urolithiasis. Due to its wide availability and no previous report of adverse effects, we decided to evaluate its impact on ureteral stone expulsion.Materials and Methods: In this single-blind randomized clinical trial, 100 renal colic patients whom visited in Arak Vali-asr Hospital or its clinics were divided into two groups. Group1 received Thiazide, Tamsulosin, and analgesics and group 2 received Alhagi Pseudalhagi distillate in addition to aforementioned drugs. The patients were followed upto 4 weeks and the stone expulsion rates and their times were compared.Results: The average stone sizes for groups 1 and 2 were 4.66 and 4.32 mm, respectively (p=0.128). Stones in both groups were mostly located in lower ureter (p=0.551). Expulsion occurred in 40% of group 1 and 66% of group 2 patients (p=0.009). The mean expulsion times for groups 1 and 2 were 11 and 9 days, respectively (p= 0.291). Conclusion: Alhagi Pseudalhagi distillate had a significant effect on the rate of stone expulsion and it is likely to decrease the time needed for the passage of Urolithiasis stones. 

Background: Nowadays, mothers have ceased to breastfeed due to several factors and resort to bottle -feeding or other forms of complementary feeding for their children. This results in physical and emotional problems for children, and socio -economic harms in communities. The aim of this study is to assess the impact of BASNEF model based education on successful breastfeeding in pregnant mothers referring to health centers in Arak.Materials and Methods: This quasi-experimental study was carried out with the participation of 88 pregnant women. The participants were randomly allocated to interuention and control groups. Instructions were given in four sessions on the basis of BASNEF model and behavioral objectives. Eventually, the collected data were analyzed by using statistical tests. Results: Mean scores of knowledge, attitude, enabling factors and subjective norms in the inerurntion group before and after education showed a significant difference in comparison with control group (p<0.001).Conclusion: Model-based education has positive impacts on behavior improvements. Thus, in health programs instead of applying traditional instructions, appying planned education programs based on health education models that have measurable and reliable effects is suggested.

Background: Primary dismenorrhea or painful menstruation, in the absence of any specific pelvic diseases, is one of the most common complaints in women’s medicine. The main goal of this study is to examine the effect of isometric trainings on primary dismenorrhea.Materials and Methods: In this quasi-experimental Stud, 30 female students from Payamenoor and Azad Universities in Golpaygan were randomly assigned into two exercise and non-exercise groups. The exercise group did 8 weeks of isometric exercises under the supervision of a physical education expert. The trainees were examined based on the intensity and duration of pain, the amount of bleeding, and consumption of drugs in the first period of menstruation (pre-test), the second period of menstruation (mid-test) and the third period of menstruation ( post-test ).Results: Intensity of pain in the exercise group decreased after 4 weeks (p<0.05) while the duration of pain declined after 4 weeks (p<0.05) and 8 weeks (p<0.01). Also, the amount of taken drugs decreased after 8 weeks of exercise (p<0.05), but the degree of bleeding did not change significantly (p>0.05).Conclusion: Isometric exercises decreased intensity and duration of pain, and the amount of drugs taken in primary dismenorrhea. Therefore, such exercises can probably be used in the treatment of primary dismenorrhea.

Background: Candida species are the most common yeasts that reside in oral cavity in 30 - 50% of people, and are capable to produce opportunistic infections within the oral cavity. This study was done to determine the effect of cigarette smoking on the type and degree of Candida oral carriage. Materials and Methods: In this case-control study, oral Candida flora in 34 smoker and 66 nonsmoker men were compared. All of the samples were collected by swab and examined by direct microscopy and culture on CHOROM agar Candida and corn meal agar media. Isolated colonies were identified by carbohydrate assimilation method using RapID Yeast PLUS System.Results: Out of the 34 smoker individuals, 27(79.4%) had Candida colonization in their oral cavity while 30(45.5%) of the 66 non-smoker individuals had developed this kind of colonization. A significant difference was observed between the two groups (p<0.05). Additionally, there was a significant difference in the degree of colonisation and the type of candida species which were isolated from the oral cavity of the smoker and nonsmoker groups. Conclusion: Cigarette smoking can act as an important underlying factor in oral candidiasis.

Background: Following the reduction of neurons due to peripheral nervous injuries, the number of neuroglial cells also decline because of not receiving vital factors. The aim of this study was to determine the protective effects of curcuma longa total extract on spinal cord neuroglia cell degeneration after sciatic nerve compression in rats. Materials and Methods: In this experimental clinical- trial, Wistar rats were categorized in five groups (control, compression, treatment1, treatment 2 and treatment 3), each including six rats. For inducing the injury in the compression and treatment groups, the right sciatic nerve in the upper thigh was compressed using clamp forceps. In the treatment groups, 100mg/kg doses of the extract were injected in group1 (3 times a day), group 2 (6 times a day) and in group3 (9 times a day). After 28 days, following being anesthetized, the rats underwent perfusion and samples were taken out of the lumbar segments of their spinal cord. Then the samples, after going through tissue processes, were cut in 7 m serial sections and stained in blue toluidine. Through the stereological quantitative technique, neuroglial cells were counted.Results: A significant decrease was seen in the number of neuroglial cells in the compression group (6913±208) in comparison with the control group (10184±791). Also, through the comparison of the compression group with treatment group 1(7077±293), treatment group2 (9372±252) and treatment group 3 (8715±252) a significant difference among dnsity of neuroglial cells in groups and 3 with conppnessin group was seen a remarkable increase in the numerical density of neuroglial cells was obtained (p<0.05).Conclusion: Due to its antioxidant effects, curcuma longa extract increased the numerical density of neuroglia cells following the compression of the sciatic nerve. The antioxidant effects of this extract probably inactivate the apoptosis channels which have been activated due to peripheral nerve injuries.

Background: Green tea, which is the most common drink in the world, has antioxidant and detoxification properties. In this study, the protective effect of green tea extract on nephro-toxicity induced by acetaminophen was investigated. Materials and Methods: 32 male mice were randomly divided into 4 groups. Physiologic serum was administered to the control group for 30 days. Toxic (Acetaminophen) group received physiologic serum for 30 days and on day 30 in addition to physiologic serum, 500 mg/kg acetaminophen was administered orally. Green tea group, instead of water, was fed by 7g/l green tea extract for 30 days. Instead of water, the experiment green tea group was fed with green tea extract for 30 days and 500 mg/kg oral acetaminophen was administered on day 30. On day 31, blood samples were taken from jugular arteries for assaying BUN and Cr. The mice kidneys were cut off and placed in 10% formalin for histopathology assessments.Results: BUN and Cr reduced significantly in the experiment group in comparison with the toxic group. Also, in histopathology assessments, kidney necrosis reduced in experimental group. Conclusion: Green tea seems to have a protective role in acetaminophen induced nephrotoxicity.

Background: Oxidative stress is one of the probable molecular mechanisms involved in lead (Pb) neurotoxicity. On the other hand, lemon balm (Melissa officinalis) which is widely used in traditional medicine, has a high antioxidant activity. In this study, the protective impacts of Melissa officinalis on the adverse effects of Pb toxicity on learning ability were investigated. Materials and Methods: In this experimental-clinical trial, 40 virgin Wistar rats were mated and divided into control, control positive (vitamin C+Pb), control negative (Pb), and 3 Pb and Mellisa experimental groups. Mellisa was orally administered in three doses including + 25, 50 and 100 mg/ kg of body weight daily. Treatment started from 7th day of gestation and continued through pregnancy and lactation periods. The three month- old offsprings in each group were assessed in terms of memory and learning ability by Morris water maze test and the results were compared between the groups. Results: Exposure to Pb during and after gestation leads to learning disorders. While concomitant administration of Pb and Melissa, as well as vitamin C can, to a large degree, reduce the adverse effects of Pb on learning abilities. Conclusion: Since no significant differences were obtained from the comparison of results in the control, Pb+M and vitamin C+Pb groups, it can be concluded that Melissa has antioxidant impacts equal to vitamin C. Therefore, similar to vitamin C, Mellisa can decrease the neurotoxic effects of Pb.

Background: Aspirin (ASA) and helicobacter pylori infection are two major known risk factors for peptic-ulcer. This research aims to examine the interaction between helicobacter pylori and low dose ASA in inducing gastro-intestinal complications.Materials and Methods: The target group consisted of patients with cardiovascular disease who were under low dose ASA therapy. Patients, who had symptoms of dyspepsia, were placed in the case group and those who did not have these symptoms were placed in the control group. 5cc blood samples, required for conducting ELISA Ab., were taken simultaneously in both of the groups. ELISA positive patients underwent UBT test. UBT positive patients were categorized as helicobacter pylori positive and those with negative UBT were placed in the helicobacter pylori negative group. Finally, the ratio of dyspepsia incidence probability to Aspirin usage and helicobacter pylori infection was analyzed.Results: Of the 129 individuals present in the control group and 71 individuals who were in the case group, 72(36%) were UBT positive, and the rest were UBT negative. Of all the patients, 35.5% had dyspepsia and there was a significant difference between UBT positive and UBT negative individuals (p=0.001, OR=6.54). of 43 patients who had signs of intensified dyspepsia 23 persons under went endoscopy assessment which 20 of them were diagnosed with peptic ulcer. Eighty percent of the patients who had developed peptic ulcer, were UBT positive which revealed a significant difference with UBT negative (p=0.001, OR=8.86).Conclusion: In order to reduce gastro-intestinal complications, it is suggested that long term low dose Aspirin takers be subjected for screening and to receive treatment in terms of infection with helicobacter pylori and clinical manifestations. 

Background: Two of the most common complaints of patients who refer red to ophthalmology clinic are headache and asthenopia which are induced or intensified by exodeviation. This study was conducted to determine the relationship between exodeviation and headache or asthenopia.Materials and Methods: In this cross-sectional study, the sampling method, was screening of patients who referred to ophthalmology clinic with headache and asthenopia in 2006. Inclusion criteria were age above three, rejection of other causes of headache and asthenopia. Also, patients with organic headaches such as tumor were eliminated from the study. A questionnaire was provided for the patients and Cover-uncover test was also conducted for determining the existence of exotropia. Results: Of 206 patients, participating in this study, 90.77% had exotropia and the majority of them were female. The most common symptom in these patients was headache. A direct relationship was observed between both headache and asthenopia with exodeviation. Exodeviation also had a direct relationship with gender.Conclusion: Noticing the direct relationship between headache and asthenopia with exodeviation in patients referring with such complaints, exodeviation examinations must be done in order to prescribe surgical or non surgical treatments asneeded.

Background: Albizzia lebbeck is used for the treatment of diarrhea and dysentery. In this study the efficacy of hydro-ethanolic extract of this plant on enteric gram-negative and aerobic gram-positive bacillis was determined.Materials and Methods: In this experimental-clinical trial, cold maceration method by ethanol was used for extraction of Albizzia lebbeck fruit, seed, flower and leaves. Then its polyphenolic components were separated by ethyl acetate. After concentrating the different extracts through disk diffusion and tube dilution, the effect of minimal inhibitory concentration (MIC) and minimal bacteriocidal concentration (MBC) of their antibacterial component on shigella dysenteriae, proteus mirabilis, escherchia coli, bacillus cereus and bacillus anthracis were evaluated. Also, the antibacterial effects of Albizzia lebbeck extracts together and in combination with some antibiotics, were compared through variance analysis.Results: Different extracts of Albizzia lebbeck just had similar and positive effects on shigella dysenteriae, bacillus cereus, and bacillus anthracis. However, the hydro-ethanolic fruit extract was more effective than the falavnoid fruit, flower and leave extracts. MIC and MBC results for antibacterial material on the three aforementioned bacterias were 0.125 and 0.25 gram/ml, respectively while the effects of the polyphenolic components of this plant's fruit were similar to its hydroethanolic extracts.Conclusion: Through the identification of different components of Albizzia lebbeck and the attainment of new formulations of these components, the grounds will be provided for its application on treatment of patients with inflammatory diseases and asthma, and on improvement of their immune system. 

Background: Herpes simplex clinical manifestations are in the form of vesicular eruptions on erythemateus base. The virus can remain latent within sensory nerve ganglions following the initial infection and be reactivated in some cases such as intracranial surgery, dental surgery, stress and excitements. Systemic or disseminated infection occurs in immune-deficient patients and sometimes in healthy individuals. In Previous studies, in most of the disseminated infection cases, visceral organs involvement has been mostly observed while skin involvement has been reported just in one case. Thus, our patient was the second case with herpes simplex disseminated skin infection. Case: The patient was a 38 year-old man who underwent craniotomy surgery due to epidural hematoma following car accident and head trauma. Almost 10 days after the surgery, the patient developed disseminated vesicular eruptions in erythemathous base which initially appeared in the face, head, and then in body and extremities. Fever was detected 5 days before the development of eruptions. Other than anemia and leucocytosis, there were no other notable points in the systemic examination and lab tests. For patient skin biopsy was taken with an impression of herpes simplex, mulocum contagiosum and a lower probability for bullouse diseases. In the skin biopsy, intraepidermal vesicles and extensive epidermal necrosis with multinucleated giant cells and intra-nuclear objects were observed. A plethora of neutrophilic cells inside the vesicles and inflammatory cell infiltration in the underlying debris were seen. Based on the pathology report, infection with herpes simplex hominis was confirmed.Conclusion: Disseminated skin infection with herpes simplex can be observed even in healthy people with no background.