JOURNAL OF BABOL UNIVERSITY OF MEDICAL SCIENCES (JBUMS)
Year:2012 | Volume:14 | Issue:3 (66)|Papers Count:15

BACKGROUND AND OBJECTIVE: There are different methods of labor induction in PROM at term pregnancy including oxytocin and some prostaglandin such as misoprostol. Misoprostol has different effects on the induction of labor in PROM with different methods and dosages. The aim of this study was to compare the efficacy of oral misoprostol with oxytocin and oxytocin alone in induction of labor at term pregnant women with premature rupture of membranes.METHODS: This clinical trial study was performed on 99 term pregnant women with PROM who in the first 4 hours after PROM for delivery were admitted in Ayatollah Roohani and Shahid Beheshti hospitals of Babol, Iran. They were randomly assigned in a double-blinded manner to two groups. Misoprostol 50μg in two doses was administered 4 and 8 hours after rupture of membranes to one group (49 patients) and placebo was administered up to two doses to the other group (50 patients). When labor did not occur after 12 hours of rupture of membrane, oxytocin was administered forinduction of the labor in both groups. Then type of delivery, cause of cesarean, duration between PROM until delivery, appropriate uterine contraction and maternal complications such as chorioamnionitis and uterine hyperstimulation were recorded and compared.FINDINGS: Average duration between rupture of membranes and delivery was similar to each other in two groups (14.3±3.4 hours in misoprostol group in compare with 15.6±3.29 hours in placebo group) (p=0.061). Average duration between rupture of membranes and uterine contraction was significantly shorter in misoprostol group (8.06±3.8 hours in compare with 9.8±3.9 hours) (p=0.027). The rate of vaginal delivery in misoprostol group was 30 (61.2%) and in placebo group was 24 (48%), and the rate of cesarean delivery in misoprostol group was 19 (38.8%) and in placebo group was 26 (52%), that there was not a significant difference (p=0.13). Maternal complications were not different in two groups.CONCLUSION: Results of this study showed that oral misoprostol 50μg in comparison with placebo could start uterine contraction without the increase of maternal and neonatal complications.

BACKGROUND AND OBJECTIVE: Hereditary persistence of fetal hemoglobin (HPFH) and db-thalassemia are heterogeneous disorders characterized by elevated levels of fetal hemoglobin (Hb F). Deletional mutations are responsible for the disease and are not recognized by routine hematological tests. The aim of this study was to perform a molecular characterization of beta globin gene cluster deletions in anemic patients referred to the genetic laboratory of Amirkola children hospital.METHODS: In this cross sectional study, thirty patients (14 females and 16 males) with mild microcytic hypochromic anemia with hematologic index (MCV<80 fl, MCH<27 pg, variable HbA2 and high level of Hb F) were tested for the 3 common delta beta deletional mutations: Sicilian db-thalassemia, Asian-lndian inversion-deletion gdb-thalassemia and hemoglobin Lepore using Gap-PCR technique.FINDINGS: Sicilian, Asian-lndian gdb-thalassemia deletions as well as the Hb Lepore were found respectively in 6 (20%), 6 (20%) and 1 (3.33%) patients and 17 cases remained uncharacterized.CONCLUSION: Regarding the presence of different forms of deletion in beta globin gene cluster in this region, molecular characterization of these mutations is important in at risk couples presenting microcytic anemia and should be considered in premarital screening and prenatal diagnosis centers for a more efficient thalassemia major prevention program.

BACKGROUND AND OBJECTIVE: Postoperative ileus is accompanied by increased hospital stay, pain, abdominal distention, inability to begin feeding and eventually delayed recovery. Chewing gum can cause gastric stimulation and the secretion of gastric and digestive juices that lead to weakness and stimulate eating and consequently, this increases peristaltic movements of the bowel that may accelerate the ileus recovery. The aim of this study was to assess the effect of gum chewing after cesarean-delivery on return of bowel function in women.METHODS: This randomized clinical trial study was performed on 100 patients after cesarean delivery. They were randomly allocated to two groups: gum-chewing group (n=50) and control group (n=50). The patients in the gum chewing group chewed sugar free gum as soon as consciousness 3 times daily for 1 hour each time until discharge. Control group received routine care after surgery. Patients' demographic characteristics, surgery duration, time to first flatus, time to first bowel movement, time to first defecation, time to first feeling of hungry were compared between the two groups.FINDINGS: In both groups type of anesthesia, age, gestational age, pre and post operative care, period of being NPO, parity, surgery type and duration of surgery, serum intake were the same. All patients in gum-chewing group tolerated the gum without any side effects. The first passage of flatus (24.83±6.39 vs. 29.95±9.70 hours), time to first defecation (30.60±5.85 vs. 38.42±8.95 hours) time to first bowel movement (21.85±7.76 vs. 26.13±9.56 hours) and time to first hungry (11.79±6.05 vs. 14.52±7.60 hours), were significantly lower in the gum-chewing group in compared to control group.CONCLUSION: Gum chewing speeds recovery after cesarean-delivery. Gum chewing is considered an inexpensive and helpful method in postoperative care following caesarean.

BACKGROUND AND OBJECTIVE: Interleukin-17 is a pro-inflammatory cytokine secreted by different cells including sensory and motor neurons in the cerebral cortex, hippocampus and spinal cord. As it seems that immune system and cytokines can modulate the brain functions and as IL-17 is expressed by sensory neurons, in this study we investigate the possible role of IL-17 in modulating tactile learning by measuring plasma levels of IL-17 before and after induction of tactile learning.METHODS: In this study, 20 male Wistar rats weighing 160-200gr were used. Tactile learning was induced by novel object recognition test (NORT) (based on natural tendency of animal to explore novel objects more than familiar objects). One week before and immediately after the NORT, blood samples were collected to measure the changes in IL-17 concentration before and after learning. Blood was taken from inner canthus of rats' eyes and serum levels of IL- 17 were measured using ELISA.FINDINGS: The mean plasma concentrations of IL-17 one week before and immediately after the NORT were 594.4±71.6 and 210±56.5 pg/ml, respectively. The serum level of IL-17 was significantly decreased following induction of tactile learning (p<0.05).CONCLUSION: The result of this study showed that, IL-17 may be has a role in modulating higher brain functions such as learning and memory.

BACKGROUND AND OBJECTIVE: Urtica is a dioecious plant, which has been introduced in Iranian traditional medicine as anti-diabetes. Since, the metabolic disorder caused by diabetes causes secondary pathophysiologic changes in multiple organs of the body, so the objective of this study was to investigate protective effects of Urtica Dioica extract on the small intestinal mucosa in addition to its anti diabetic effect.METHODS: In this experimental study, 14 male adult Wistar rats weighing 250-300 grams, in two groups (n=7) were used. First, the rats received an injection of streptozotocin (STZ) 50 mg/kg IV. The animals with fasting blood sugar more than 250 mg/dl were considered diabetic, one group of diabetic animals were treated with watery extract of Urticadioica leaves (4 mg/kg daily IP injection) and other diabetic groups were considered as controls. After two months, the blood and intestinal tissue sample were taken and observed by histologist for the study of tissue parameters.FINDINGS: Blood sugar in treated group decreased from 400±52.2 mg/dl to 78.9±11.9 mg/dl (p<0.0004), whereas no change observed in diabetic group. In diabetic group, unlike the treated group necrosis and infiltration of mononuclear cells and damaged tissues were observed. Epithelium and lieberkuhn glands were destroyed, intestinal villa was shorted and atrophied, and also there were many cases of bleeding and exudates.CONCLUSION: The results of this study showed that urtica dioica has protective effect on small intestinal mucosa.

BACKGROUND AND OBJECTIVE: Consumption of high fat meal causes a sudden increase in blood lipids, oxidative stress and endothelial dysfunction. Sumac has antioxidant activity and this study was aimed to determine the effect of sumac consumption on some atherosclerosis risk factors due to high fat food stress in rabbits.METHODS: In an experimental study, 24 male New Zealand rabbits were randomly designated into three groups: normal diet group, a diet containing 1% cholesterol, a diet containing 1% cholesterol with 2% Sumac powder. Oxidative stress and atherosclerosis risk factors, including glucose, total cholesterol (TC), triglyceride (TG), apolipoprotein B (ApoB), low density lipoprotein (LDL), nitrite, nitrate, fibrinogen, factor VII, liver transaminases (ALT and AST) were measured before the experiment and 3 hours after feeding.FINDINGS: High cholesterol food (1%) increased TC, fibrinogen, TG, glucose, nitrate, LDL-C, ALT and AST (p<0.05). Consumption of sumac caused a significant decrease in glucose (30.15%), LDL-C (58.17%), TC (29.5%), ALT (20.55%), AST (17.46%) and fibrinogen (17.92%) compared to hypercholesterolemic diet group (p<0.05). Nosignificant difference was found between sumac group and hypercholesterolemic diet group in triglyceride (TG), factor VII, nitrite, nitrate and ApoB.CONCLUSION: The results of this study showed that acute consumption of sumac might have a protective effect on some of risk factors of atherosclerosis, oxidative stress and liver enzymes, due to high fat food stress.

BACKGROUND AND OBJECTIVE: The bioavailability of IGF1 is regulated by the insulin-like growth factor binding protein 3 (IGFBP3). IGFBP3 is an inhibitor of IGF1 and inhibits growth cell and induces apoptosis by joining to it. Some studies have shown that reduction of IGFBP3 level cause to increase risk of colorectal cancer (CRC). The purpose of this study was to investigate incidence of mutant allele of IGFBP3 polymorphism rs2854744 in Iranian community and to examine the association of genetic variants in IGFBP3 (rs2854744) with risk of colorectal cancer.METHODS: In this case-control study, genotyping of IGFBP3 gene were determined in series of 120 colorectal cancer patients (with positive result for colonoscopy and pathology) and 120 controls (with negative result for colonoscopy and pathology ) by using polymerase chain reaction and restriction fragment length polymorphism genotyping assay (PCR-RFLP) and compared.FINDINGS: Frequency of CC, CA and AA genotype in patients in IGFBP32854744 was 33.3%, 47.5% and 19.2%, and frequency for controls was 34.2%, 45.8%, and 20%, respectively. Frequency of C allele in patients was 0.57% and for A allele was 0.42%. Also frequency of C allele in controls 0.57% and in A allele was 0.42% that no significant difference was seen.CONCLUSION: These findings suggest that polymorphism IGFBP3 rs 2854744, is not associated with increased risk of CRC.

BACKGROUND AND OBJECTIVE: Low birth weight infants 40 times greater than infants weighing more than 2500 g are at risk. These infants are usually separated from the mother immediately and are transferred to the neonatal intensive care unit. This separation can affect infant’s respiratory, heart rate and body temperature It also caused severe stress to the mother and reduced mother’s self-esteem. The purpose of this study was to determine the effect of kangaroo mother care (KMC) on self-esteem in the mothers of low birth weight infants in Amirkola children hospital, Babol, Iran.METHODS: In a quasi-experimental study 60 mothers of low birth weight infants were selected by convenience sampling method and assigned randomly to two study groups, (experimental; n=20 and control; n=40). Data collection tools were questionnaire (demographic information of parents and neonates and Rosenberg self-esteem scale). The intervention group take care of in KMC method (mothers in the intervention group put their infants to the vertical position in the middle of her chest in order to skin-to skin contact), while the control group had taken only ordinary care of personnel and mother. The Rosenberg self-esteem scale is completed two times, at the first time, when mothers came to visit the neonates and then at discharge time.FINDINGS: From 60 mothers participated in this study, 29 (48.3%) were high school graduates, 53 (88.3%) were housewife and 39 (65%) had cesarean delivery method. Mean self-esteem score of mothers in the intervention group at admission and discharge were 22.1±2.7 and 23.4±1.9, respectively and in the control group when the infants were admitted and discharged it was 22.2±2.2 and 22.6±1.3, respectively. The significant difference in self-esteem of mothers before and after the intervention was not observed. In association with birth weight infants and maternal self-esteem levels, the Pearson correlation coefficient showed a significant relationship (p=0.01 and r=0.3).CONCLUSION: Results showed that KMC directly correlates with the level of self-esteem and causes more peace, merit and ability in mothers.

BACKGROUND AND OBJECTIVE: Neonatal intensive care unit (NICU) induces high level of anxiety for parents, especially primipara mothers. So strategies are necessary to reduce parent anxiety. Intervention that suggested in this situation is presence and participation of parents in the care of infant. Therefore, the aim of this study was to evaluate the effectiveness of participatory care program on maternal state anxiety that have preterm newborns hospitalized in NICU.METHODS: The design of this study was a randomized clinical trial. The study participants included 100 mothers with preterm newborns (30-37 weeks) hospitalized in NICU of Akbarabadi hospital in 2010. Samples divided by consecutive sampling method and randomized to two experiment and control groups (n=50 in each group). The interventional program was conducted for experiment group in the form of an individualized educational session and presence and active participation of mothers in their newborn’ care in NICU. The state anxiety scale score was classified based on Spielberger, average to above, high anxiety, average to low and low anxiety. The data were collected at the pre-test (24 hours after admission of the infants) and post-test (discharge phase) and then compared.FINDINGS: At pretest, the findings showed no significant difference regarding state anxiety between two groups (control=63.8±8.1 and experiment=65.08±8.48) (p=0.84), whereas at posttest, significant reduction in maternal state anxiety was seen in the experiment group (29.96±6.31) compared to the control group (52.80±10.37) (p<0.001).CONCLUSION: The results confirm the participation of mothers in the care of preterm infants is effective intervention in the reduction of maternal anxiety, so employing this strategy by the authorities seems necessary by providing the appropriate substrates in the clinical environment.

BACKGROUND AND OBJECTIVE: Tuberculosis is the most dangerous infectious disease in the world today. Rifampicin (RMP) and Isoniazid (INH) are the two most important first-line anti-tuberculosis drugs for the treatment of tuberculosis. Resistance to these drugs has been increased in most of countries. The aim of this study was evaluation of drug resistant in mycobacterium tuberculosis isolates to Isoniazid and Rifampin in patients that referred to health care center of Mazandaran province, Iran.METHODS: In this cross-sectional study, 1345 samples were collected of patients with clinical suspicions of tuberculosis that referred to health care centre of Mazandaran from July 2010 to June 2011. The specimens were cultured on Lowenstein-Jensen medium to detect the mycobacteria. DNA extraction of colonies and resistance to Isoniazid and Rifampin were evaluated by using the primers of inhA, KatG and rpoB genes.FINDINGS: Of 1345 specimens, only 65 isolates were positive culture. Out of 65, 59 were MTBC by using the primers of MUTB-gyrB gene. Among this isolates, 56 (94.92%), 55 (93.23%) and 58 (98.3%) were susceptible and 3 (5.08%), 4 (6.77%) and 1 (1.7%) were resistant to inhA, KatG and rpoB, respectively.CONCLUSION: The most resistance has been associated to Isoniazid. PCR can be a good method for identifying of the resistant strains of mycobacterium.

BACKGROUND AND OBJECTIVE: Cryptorchidism or absence of one or both of testes in the scrotum (undescended testes) is the most common urologic disorder in children. Two major complications in this condition are infertility and malignancy. Most diagnostic imaging procedure is ultrasound, but in cases that testes are not seen in ultrasound, laparoscopy is very useful. The aim of this study was to assess diagnostic value of ultrasonography and laparoscopy in undescended testes.METHODS: This diagnostic study was performed on all patients with undescended testes in teaching hospitals of Babol University of medical sciences, Babol, Iran. All patients were referred to sonography, if testes were seen in sonography, these patients were candidate for open surgery but if testes were not seen in two different sonographies, the patients were candidate for laparoscopy. All information is gathered in questionnaire and then the results of sonography, open surgery and laparoscopy were compared together.FINDINGS: One hundred and eight patients with 131 undescended testes, aged between 1 and 42 years with mean age of 13.9±8.99 years were studied. 78.7% of patients had unilateral undescended testes and 21.3% had bilateral undescended testes. The unilateral undescended testes were left sided in 47% and right sided in 53%. Sensitivity and specificity of sonography for intraabdominal testes were 16% and 97%, respectively. Whereas, sensitivity and specificity of sonography for inguinal canal testes were 85% and 76%, respectively. Also, sensitivity and specificity of laparoscopy for intraabdominal and inguinal canal testes were 100%.CONCLUSION: The results showed that diagnostic laparoscopy has a high sensitivity and specificity. When intraabdominal testes are not diagnosed by sonography, laparoscopy can be helpful.

BACKGROUND AND OBJECTIVE: Bladder cancers are common around the world that their incidence rate is different in different regions. The aim of this study was to determine the incidence of bladder cancer in Mazandaran province, Iran.METHODS: This cross sectional study was done in patients with bladder cancer in Mazandaran province for three years. Patients' age, sex, town and grade were collected from their records and the rate of incidence in Mazandaran province and mortality for one year were determined.FINDINGS: In three years, 310 cases were diagnosed as bladder cancer in Mazandaran that 82.3% were male. 45.8% were in the east, 41.7% in the center and 12.5% in the west of Mazandaran. Mean age of patients was 64.95±13.79 years. 28.9% were in grade I, 53.3% in grade II and 17.7% in grade III. Incidence rate of bladder cancer in Mazandaran was 11.4 in 100000. The one year mortality rate was 27.1%.CONCLUSION: Rate of involvement in men was more than women and the geographic region affect in afflicting bladder cancer.