Journal of Babol University of Medical Sciences
Year:2017 | Volume:19 | Issue:9 |Papers Count:10

BACKGROUND AND OBJECTIVE: Patent ductus arteriosus (PDA) is a common problem in premature infants. Indomethacin is the first effective drug used to treat this problem and due to the side effects of this drug, intravenous ibuprofen is one of the recommended drugs in this field. Due to the unavailability of intravenous form of these drugs in Iran, this study was conducted to compare therapeutic effects and side effects of the oral form of ibuprofen and indomethacin on the closure of PDA in premature infants.METHODS: In this randomized clinical trial, 80 premature infants (less than 32 weeks) with symptomatic PDA, who required treatment were randomly divided into two groups of 40 and were treated with indomethacin or oral ibuprofen. Results (changes in PDA size and percentage of recovery) and complications (changes in creatinine and serum bilirubin, intraventricular hemorrhage, necrotizing enterocolitis and death) of treatment were recorded and compared between the two groups. (IRCT: 2015111024977N1)FINDINGS: There was no significant difference between the two groups in terms of confounding variables. The treatments had to be repeated for ten percent of patients (four patients) in both groups. PDA size did not change in ten percent of patients (four patients) in indomethacin group and did not change in seven point five percent of patients (three patients) in ibuprofen group. The two groups did not differ significantly in terms of probable side effects. None of the patients in the two groups needed surgery.CONCLUSION: Considering that in this study, the response rate and side effects of oral ibuprofen and indomethacin did not differ significantly, this drug could be an appropriate alternative for indomethacin when necessary.

BACKGROUND AND OBJECTIVE: Noise is the most common environmental stressor source for premature infants admitted to the neonatal intensive care unit. Venous sampling is one of the most painful-causing actions in newborns. The aim of this study was to determine the effect of voice loss using ear protector on pain caused by intravenous sampling and heart rate of premature infants.METHODS: This randomized clinical trial study was performed on 112 premature infants aged between 36 and 28 weeks who were randomly divided into two groups of intervention (56 subjects) and control (n=56). The ear protector was used for the intervention group when the baby was subjected to intravenous sampling. Neonatal pain was measured by PIPP instrument (premature infant pain measuring instrument) in five steps (2 minutes before the needle penetration), (moment of needle penetration), (pump time), (moment of needle withdrawal) and (5 minutes after needle withdrawal). Heart rate was measured with a pulse oximeter (8 times every 30 minutes during 4 hours after using the ear protector) and compared. (IRCT: 2015210828925N1).FINDINGS: The mean changes in PIPP score were in the intervention and control groups (1.6±5.6 and 4.6±1.6), second (12.1±3.3, and 12.6±2.8), third (13.5±2.7 and 13.4±2.9), fourth (6.4±2.6 and 8.5±2.8), and fifth (5.1±4.2) and 1.6±6.2) respectively. Scores in all states except for the second and third stages were statistically significant in both groups (p<0.05). In addition, the mean of heart rate in the fifth stage in the intervention group (145.8±16.6) was significantly higher than the control group (138.1±21.1) (p=0.03).CONCLUSION: The results of the study showed that the ear protector used for premature infants is effective in reducing pain during venipuncture.

BACKGROUND AND OBJECTIVE: Many activities and interventions performed in neonatal intensive care unit (NICU) cause pain. Recurrent and untreated pain can lead to severe and harmful complications for neonates. Provision of pain management solutions is one of the duties of nurses. This study aimed to evaluate the barriers to use of non-pharmacological pain management methods in NICU from perspective of nurses.METHODS: This cross-sectional study was conducted on all nurses (N=57) working in NICU of hospital affiliated to Babol University of Medical Sciences, Babol, Iran selected by census method. Data were evaluated using a researcher-made questionnaire consisting of three parts and a three-point Likert scale. Barriers and suggested solutions were evaluated in the questionnaire, and the obtainable scores of the questionnaire related to the items of barriers and problems in application of non-pharmacological pain management methods and solutions were 17-51 and 12-36, respectively. FINDINGS: According to the opinions of nurses, the most important barriers to the application of non-pharmacological pain management methods were shortage of personnel in each work shift (2.0±54.6), shortage of time and heavy workload (2.0±40.6), unawareness of pain complications (2.0±40.6) and long working hours and fatigue (2.0±35.6), respectively. Among the most important strategies mentioned by nurses were regularizing non-pharmacological pain management methods (2.0±63.6), regular holding of training classes (2.0±58.5), using matrons as tutors (2.0±53.6) and increasing the number of nurses in each shift or each ward (2.0±44.5).CONCLUSION: According to the results of this study, inadequate nursing staff and insufficient knowledge about pain complications were the most important causes for lack of application of pain management methods for neonates.

BACKGROUND AND OBJECTIVE: Pregnancy in the lifetime of any woman sometimes comes with stress and extreme fears, despite the enjoyment of motherhood. Since spirituality can be associated with stress and fear during this period, this study was conducted to determine the relationship between spiritual intelligence and fear of delivery in low –risk pregnant women.METHODS: This cross-sectional study was conducted among 220 pregnant women who were selected by convenience sampling method based on a two-step (cluster–convenience) technique. The data were collected using Demographic and Fertility Characteristics Questionnaire, King's 24–item Spiritual Intelligence Self-Report Inventory (score range of 0–96), and 16–item Fear of Childbirth Questionnaire (score range of 14–56).FINDINGS: The results of this study showed that the mean score of subjects regarding the fear of childbirth was 40.5±6.73, and the overall score of spiritual intelligence was 55.40±8.33. There was a significant negative correlation between spiritual intelligence and fear of childbirth. Therefore, the higher the spiritual intelligence of the pregnant mother, the lower the fear of childbirth (p=0.025, r= -0.163).CONCLUSION: According to the results of this study, it can be said that high spiritual intelligence in pregnant women can reduce the fear of childbirth.

BACKGROUND AND OBJECTIVE: Non-alcoholic Fatty Liver Disease (NAFLD) is specified by changes in fat in the liver, with or without inflammation. The disease is the hepatic manifestation of metabolic syndrome. Since a different medicinal treatment has been introduced, this study was conducted to compare the therapeutic effects of metformin, pioglitazone and vitamin E in treatment of these patients.METHODS: In this single-blind randomized clinical trial, 93 patients with the diagnosis of NAFLD who referred to Imam Reza Hospital in Kermanshah were randomly divided into three groups (n = 31). Then, the first group received two gr/day metformin, the second group received 30 mg/day pioglitazone and the third group received 800 IU/day vitamin E for 12 weeks. LFTs, BMI, HOMA-IR, FBS, and serum insulin levels were measured before and after the treatment course (IRCT: 2016010411991N3).FINDINGS: There was no significant difference between the groups in terms of distribution of sex, mean age, LFT and HOMA-IR before treatment. The mean difference in severity of NAFLD before or after the treatment was metformin (1.06 ± 0.63), pioglitazone (1.195±0.75) and vitamin E (0.77±0.62), which was statistically significant (p<0.05). In addition, serum insulin levels (p<0.01) and HOMA-IR (p<0.05) were significant between the groups; pioglitazone showed highest effect on reducing the severity of NAFLD, serum insulin levels, and HOMA-IR. Metformin and vitamin E were next in line, respectively.CONCLUSION: Based on the results of this study, pioglitazone is more effective than metformin and vitamin E both in reducing the severity of NAFLD and in lowering LFT and serum insulin levels.

BACKGROUND AND OBJECTIVE: Enterotoxigenic Escherichia coli (ETEC) are the most common causes of diarrhea among children. Colonization factors (CFs) are the major ETEC candidate vaccines. Considering the high antibiotics resistance reports, construction of effective immunogen against bacteria is major goal. Encapsulation of recombinant immunogen in nano carriers such as polymeric PLGA nanparticles, not only protects them from degradation in environmental elements but also provides the effective concentrations of immunogen in targets, hence increasing bioactivity. The aim of this study was to investigate the immunogenic properties of CfaB protein encapsulated in PLGA nanoparticles.METHODS: In this research study, cfaB gene codon optimaztion was performed by OPTIMIZER software. Expression of recombinant protein in E.coli was induced with IPTG. The recombinant protein was purified using affinity chromatography and evaluated by Western Blotting analysis. PLGA nanoparticles containing recombinant protein were prepared by double emulsion method and their structures were characterized by SEM and DLS. 40 BALB/C mice in four group were immunized with nanoparticles and antibody titers were determined by ELISA. The efficiency of antibodies in preventing the attachment of ETEC bacteria to the Caco 2 cells was examined.FINDINGS: The optimized gene had a Codon adaptation index (CAI) of 0.85. Expression of recombinant protein led to the production of CfaB with molecular weight of 18/9 kDa. Yield of protein was 5mg/L. Encapsulation efficiency of recombinant protein in PLGA nanoparticles was 85%. The average particle size was 170 nm. Immunization of mice induced serum antibody response. Immunized sera decreased %62.8 of ETEC adhesion to Caco2 cells.CONCLUSION: Recombinant CfaB protein encapsulated in PLGA nanoparticles stimulate immunity against ETEC.

BACKGROUND AND OBJECTIVE: Diabetic nephropathy (DN), as the most common cause of end-stage renal failure, caused by protein kinase C pathway and reactive oxygen species. Recent studies demonstrated importance of epigenetic processes such as histone acetylation and the role of histone deacetylases (HDAC) and histone acetyltransferase in the development of this silent epidemic. Sodium valproate (VA) is known as a histone deacetylase inhibitor (HDACi). DN must be prevented and treated because it is prevalent and important.METHODS: In this study, scientific articles indexed in databases "Web of science, Scopus, PubMed, SID, ISI" were studied using key words "Sodium Valproate, Diabetic Nephropathies, Histone Deacetylase Inhibitors".FINDINGS: VA can prevent the degradation podocytes and renal cells through the autophagy and reduce proteinuria in the DN condition. In addition, VA, as an HDAC, prevented apoptosis of podocytes, thus it improves DN. Because HDAC class I involved in renal fibrogenesis and fibroblast activation by modulation of TGF-b signaling, sodium valproate promotes antifibrotic effects logically. VA can regulate NF-kB signaling, thereby exert an anti-inflammatory effect in podocytes. HDAC inhibition decreased eNOS mRNA but paradoxically increased activity of eNOS promoter, probably because of inducing an eNOS mRNA-destabilizing factor. Sodium valproate as a HDACi has the high renoprotective effect in laboratory studies with DN models.CONCLUSION: It is expected that sodium valproate will be used as the prevention or treatment of DN in the future after the clinical trials.

BACKGROUND AND OBJECTIVE: Lovastatin is one of the most important types of statin drugs, commonly produced by Aspergillus terreus in a liquid culture. Lovatatin use reduces blood cholesterol and prevents heart attacks and vascular stiffness. Since lovastatin is introduced as a valuable secondary metabolite, this study was conducted to analyze the factors effective in morphogenesis of this fungus to increase the industrial production of this drug.METHODS: For data collection in this review article, the articles containing one of the words "cholesterol", "vascular stiffness", "morphogenesis", "lovastatin", "Aspergillus terreus", and " inducer" between the years 1960 and 2017 were searched and studied in Pubmed, Scopus, Science Direct and Islamic World Science (ISC) databases.FINDINGS: Overall, 145 articles were found, among which 58 papers were considered appropriate for this study. According to the results of the studies, the slowly metabolized carbon source and combined culture medium, high stirrer speed at 600 rpm, an aeration equal to 70% saturation, an inoculation equal to 107 spores, and the use of inducers such as magnesium silicate hydrate, methionine, butyrolactone and linoleic acid cause a special morphogenesis called Pellet.CONCLUSION: The results indicate that the type of carbon source has the greatest effect on morphogenesis of pellet. The formation of small pellets reduces the viscosity of the medium, increases the rate of oxygen transfer to microorganisms, and ultimately produces more lovastatin.

BACKGROUND AND OBJECTIVE: In Islam, family is a sacred environment and, according to the Quran, is a real place of tranquility. What matters in a marriage is the marital satisfaction. This study aims to investigate the effect of Quran teachings and its supreme concepts on marital satisfaction in married women.METHODS: This case-control study was conducted in Babol, northern Iran, among 50 married women who married at least one year before, divided into two groups of 25. The women in case group were trained for 10 sessions, and the sessions included Quran therapy and educational package including Quranic verses and related interpretations. Then, the two groups were evaluated by marital satisfaction index questionnaire, with a score range of 0 – 100.FINDINGS: The mean marital satisfaction score was 41.88±25.5 in the case group and 40.96±31.54 in the control group before the intervention, while it was 46.26±30.42 in the case group and 39.76±25.5 in the control group after intervention. There was a significant difference in the case group before and after the intervention (p<0.05).CONCLUSION: The results of the research showed that the use of Quran and the Quranic teachings, in the shadow of divine verses, leads to increased marital satisfaction and mental health of married women.

BACKGROUND AND OBJECTIVE: Hepatitis B is a great problem all over the world and due to its chronic nature influences on different aspects of life and affects people with many challenges in social life. Therefore, this research was conducted with the purpose of demonstrating and explaining the contextual factors affecting the social interactions of hepatitis B carriers.METHODS: Using qualitative content analysis approach, a number of 18 chronic carriers of hepatitis B who referred to healthcare and counseling centers of cities of Babol, Amol and Tabriz were selected purposefully and were interviewed from 2014 to 2016 using unstructured and in-depth questions. All of the interviews were recorded, transcribed word by word and then were qualitatively analyzed.FINDINGS: With data analysis, three main categories with subclasses including “rejection” (pathophobia, social stigma), “inadequate support” (lack of support, disease perception disorder and economic pressure) and “patient as the center of transmission of incurable disease” (contagiousness and incurability of the disease) were obtained.CONCLUSION: According to the results of this study, various underlying and cultural factors lead to fear of people from hepatitis patients and avoiding close interaction with them.