Scientific Journal of Kurdistan University of Medical Sciences
Year:2019 | Volume:24 | Issue:2 (100) |Papers Count:14

Background and Aim: Elevated white blood cell count has been a known risk factor for cardiovascular diseases. Cardiometabolic diseases have some risk factors in common. Therefore, we assessed the association between elevated white blood cell counts and risk of metabolic syndrome using dose-response meta-analysis method. Materials and Methods: We searched for observational studies including white blood cell counts as exposure and metabolic syndrome as outcome through international databases (PubMed, Embase, and Scopus) up to October 2017. Multi-adjusted odds ratio (OR) and corresponding 95% confidence intervals (CIs) were extracted from eligible articles. Randomeffects model was used to estimate the relationship between elevated white blood cell counts and risk of metabolic syndrome. Result: After independent screening, 17 studies were selected and included in this metaanalysis. Compared with lowest quartile of white blood cell, OR for highest quartile was 2. 35 (CI 1. 81 to 3. 05). Ten studies were included in dose-response meta-analysis and the result showed OR 1. 21 (CI 1. 10 to 1. 34) per unit increase (1000/ml) in white blood cell counts. We did not find any evidence of publication bias using Egger’ s regression (P=0. 11). Conclusion: This meta-analysis suggested that there might be a dose response association between higher white blood cell count as an inflammatory factor and increased risk of metabolic syndrome. Also risk of metabolic syndrome is higher in the women and individuals of older age. In order to draw causal inference propective studies using genetic factors will be necessary.

Background and Aim: Enterococcus species are opportunistic pathogens and their pathogenicity seems to be related to the presence of a number of pathogenicity genes. Since donkey’ s milk is a new non-allergenic source of nutrition, this study was performed to assess the antibiogram and detection of pathogenicity genes in some Enterococcus faecalis isolates from donkey’ s milk. Materials and Method: In this experimental study, several Enterococcus faecalis isolates were isolated from donkey’ s milk. Resistance patterns of the isolates to 10 antibiotics including vancomycin were investigated based on CLSI protocol. Statistical comparison was made by Fisher's exact test. Polymerase chain reaction (PCR) amplification was used to study gel E, esp, ace, as and efaA pathogenicity related genes. Results: Enterococcus faecalis isolates showed a different antibiogram pattern. Isolates were resistant to azithromycin, and erythromycin, but were susceptible to ampicillin and penicillin. Previously isolated LUB93929 and LUB93101 isolates were found to be susceptible and resistance to vancomycin, respectively. GelE, ace and efaA genes were detected in both Enterococcus faecalis isolates and also in Enterococcus faecalis in the control strains. The aggregation substance gene (as) was only amplified in LUB93101 isolate. Interestingly, esp gene was not detected in any of the isolates. Conclusion: Despite resistance to vancomycin and presence of some pathogenicity related genes in this study, Enterococcus faecalis isolates may not be human pathogens due to lack of pathogenic factors. The esp gene is crucial for biofilm formation and rise of nosocomial infections. Donkey’ s milk Enterococcus faecalis isolates are not able to form biofilm and seem not to bring any problem.

Background and Aim: Considering the importance of proper sedation in cataract surgery, this study was conducted to make a comparison between the effects of ketamine-propofol combination and fentanyl-propofol combination for sedation in phacoemulsification surgery. Methods: In this clinical trial study, 84 patients who were candidates for phacoemulsification cataract surgery were assigned to two groups. Each group consisted of 42 patients. Ketaminepropofol combination and fentanyl-propofol combination were used for induction of sedation for the first and second groups respectively. We assessed and compared sedation depth (using Ramsay score), hemodynamic parameters during operation and recovery, and satisfaction of the patients and surgeons between the two groups. Results: There were no significant differences between the two groups in terms of baseline variables, demographic characteristics, sedation index and patient and surgeon satisfaction. There was no significant difference between two groups in relation to blood pressure during operation and recovery periods but the heart rate at the 10th minute of the operation and at the beginning of the recovery in the ketofol group was significantly higher, and also the mean Spo2 was higher in the ketofol group at the 10th minute of operation. Patients in the ketofol group showed less hemodynamic changes. Conclusion: Both combinations of ketamine-propofol and fentanyl-propofol were associated with the effective sedation, satisfaction of the patients and the surgeons. But generally, hemodynamic status was more stable in the patients in the ketofol group.

Background and Aim: Accidents and injuries are among the main causes of disability and mortality and are regarded as public health problems. Considering the importance of this subject, the aim of this study was to investigate the incidence and trend of accidents and injuries in Kurdistan Province. Materials and Methods: This cross-sectional study was conducted in Kurdistan Province, between 2010 and 2014. Data were extracted from national road traffic, injuries and accident databases. Data analysis was performed by using Stata 12. Results: The findings of this study showed that the highest incidence rates of accidents and injuries belonged to the individuals between 20 and 29 years of age, and was two times higher in men than in women. We found a decreasing trend in the incidence rates of accidents and injuries between 2010 and 2013, and an increasing trend in 2014. Also, trauma showed a significant decreasing trend from 2010 to 2014, while the number of burn cases increased by four times between 2013 and 2014. Moreover, we found a fourfold increase in the number of suicide cases between 2010 and 2013 with a decreasing trend in 2014. Conclusion: Results of this study suggested that accident-related injuries were most prevalent among male young adults, and road traffic injuries had the greatest impact on these individuals. Thus, appropriate plans should be designed to decrease the prevalence of RTAs among young adults.

Background and Aim: Cupressus extract has been considered as antioxidant and free radical scavenger. In this study we evaluated the effect of hydroalcoholic extract of Cupressus sempervirens L. on blood sugar, weight and also oxidative stress parameters in experimental diabetic model of mice. Materials and Methods: 48 male mice of albino race were made diabetic with a single dose of streptozocin (200mg. /kg IP injection) for every mouse, and divided into 6 groups of 8 including: positive control(diabetic), negative control (DMSO 10% in normal saline, metformin(100mg. kg), three test groups(which received 50, 100, 200 mg. kg of the extract respectively by gavage for three weeks). After the treatment period, blood glucose level, weight and oxidative stress parameters such as MDA, GSH and mitochondria proliferation were measured. Using SPSS software 21, data were analyzed by ANOVA and Mann-Whitney statistical analysis. Results: Our results showed that use of hydroalcohlolic extract of Cupressus sempervirens L. reduced blood sugar in a dose dependent way (P<0. 01) but there was no significant change in the weights of the mice (P>0. 05) and we found decreased oxidative stress parameters and improved hepatic mitochondrial proliferation (P<0. 01). Conclusion: According to the results of this study we can conclude that Cupressus sempervirens L. extract can be effective in reduction of blood glucose and prevention of diabetic induced damage to the liver tissue.

Background and Aim: Nanotechnology is the precise and controlled manipulation of the atomic or molecular structure of nanoscale materials for the preparation of particulate matter with new properties and specific applications. Many in vivo and in vitro studies have shown the negative and destructive effects of nanoparticles on male germ cells. Nanoparticles include primary particles with at least one of their dimensions less than 100 nm. Material and Method: This study included 20 male and female adult mice (NMRI), between 6 and 8 weeks of age and weight of 25-30 g. We placed every two adult female mice with a male adult mouse in a cage for mating. Pregnant mice were randomly divided into 4 groups. (control, titanium, nigella sativa, titanium +nigella sativa). Animals were sacrificed by cervical spine dislocation under anesthesia. Then, using a neobar lamel and under the optical microscope, number of sperms and their morphology were assessed. Result: In this study, semen parameters including sperm morphology and number and also weights of organs were assessed. We found decreased number of sperms, increased number of abnormal sperms and decreased weight in the titanium group. But protective effect of Nigella sativa in the treatment group led to a significant difference in the sperm parameters compared to that in the titanium group (p<0. 05). Conclusion: TNP reduced sperm count and increased the number of abnormal sperms, Previous studies by Hajshafiha showed the ability of nanoparticles to cross the bloodtesticular barrier. Protective and antioxidant effects of Nigella sativa can greatly reduce the toxicity of TNP. NS had a potent protective effect against the toxic effect of TNP on testese.

Background and Aim: Gingivitis has high prevalence among pregnant women and educational programs have resulted in little success in the improvement of this disorder. The aim of this study was to determine the effect of trans-theoretical model based education on reduction of the prevalence of gingivitis among pregnant women through Telegram social network. Materials and Methods: This experimental study was conducted in Sanandaj City, in the west of Iran in 2018. 160 pregnant women were assigned to intervention and control groups. The participants completed a two-part questionnaire, including demographic variables and trans-theoretical model constructs before and after intervention. The interventional program was delivered through Telegram, and its effect on decreasing gingivitis was evaluated after 24 weeks. The gingival indices were recorded before and after intervention. Data were entered into SPSS-21 software and analyzed by chi-square, independent t-test and one-way ANOVA. Results: After the intervention, 67. 5% of pregnant women in the intervention group (versus 16. 6% in control group) performed the dental cleaning behavior (p<0. 01). Moreover, there was a significant difference between the intervention and control groups in the mean scores of perceived benefits and gingival indices after the intervention (p<0. 01). Conclusion: Oral health education in the patients with gingivitis could have a significant effect on decreased rate of gingival indices. Telegram social network as an electronic educational tool could be useful for this education and potentially improves the status of the patients with oral diseases.

Background and Aim: The incidence of benign solid tumors in vulvar area is very rare. These tumors include fibromas, fibromayomas, lipoma, hemangiomas, neurofibromas and endometriomas. Lipoma is the most prevalent soft tissue mesenchymal tumor, but the incidence of this tumor in the vulva is very rare. The aim of this study was to report a rare case of vulvar lipoma in an adolescent girl. Case report: A single 16-year-old girl patient referred to gynecology clinic of Imam Khomeini hospital; in Tehran in Sep 2018 with chief complain of a growing vulvar mass from 3 years ago. In physical examination, a soft mass of 4×7 cm with regular border was detected in the medial aspect of right labia majora. There was no evidence of erythema, discharge, ulcer or tenderness. A yellow encapsulated tumor with soft consistency similar to adipose tissue was removed. Diagnosis of lipoma was confirmed by histopathological examination. Conclusion: Although vulvar lipoma is a rare tumor especially in adolescent age, complete excision and confirmation of the benign nature of this tumor by histopathological examination should be considered necessary.

Background and Aim: Pulmonary thromboembolism is an important clinical problem in the patients after major surgeries and is often difficult to diagnose because of nonspecific clinical symptoms. Diagnosis of pulmonary embolism is based on medical imaging methods. The aim of this study was to evaluate the results of CT pulmonary angiographies of the patients with primary clinical diagnosis of pulmonary thromboembolism in Besat Hospital between 2014 and 2015. Materials and Methods: This cross-sectional study included 160 patients with primary diagnosis of pulmonary embolism who had been referring to Besat Hospital from 2014 to 2015. Data were extracted from the patient’ s `medical records and we used in a checklist for every patient for data collection. Using SPSS software, data were analyzed by descriptive statistics such as mean, median, standard deviation and ratio. Chi-square and t-test were used to find out the relationship between the variables. Result: The results of this study showed that 56. 3% of the subjects were female. The mean age of the participants was 45. 49 ± 18. 5 years, 25. 65% were between 31 and 40 years of age and 29. 4% had abnormal CT scan results indicative of a definite cause for pulmonary embolism. There was a statistically significant relationship between abnormal CT scan and the results of di-dimer test (p = 0. 001). There was also a statistically significant relationship between gender and abnormal CT scan results, so that most patients with abnormal CT scan were male (p = 0. 002). Mean age, blood pressure, di-dimer test, respiratory rate, and heart rate were higher in subjects with abnormal CT scan. Conclusion: According to the findings of this study, male patients between 31 and 40 years of age with abnormal CT scans should be examined more closely in order to reduce the mortality rate of the patients.

Background and Aim: The purpose of this study was to compare the effect of thiopental sodium-midazolam combination on the stress response and hemodynamic changes between tracheal intubation and laryngeal mask airway insertion during airway management. Materials and Methods: In this clinical trial study, 70 patients ASA 1, 2 candidates for elective surgery were randomly divided into two groups of tracheal intubation and laryngeal airway mask insertion. Hemodynamic variables including mean arterial pressure, heart rate, and arterial oxygen saturation were measured and compared between the two groups before and after intubation. Results: There was no significant difference between the two groups in regard to demographic data (age, sex, height, and weight), heart rate, mean arterial pressure and arterial oxygen saturation at 1 and 3 minutes after induction of anesthesia and 1, 3, 5 and 10 minutes after intubation. (P> 0. 05). But there were significant differences between the two groups in relation to heart rate at 1 and 3 minutes after intubation, so that heart rate at these times was significantly higher in the intubation group than in the laryngeal airway mask group (P <0. 05). Conclusion: Based on the findings of this study, use of thiopental sodium midazolam combination was effective and safe and attenuated the stress response to airway management with resultant minimal changes in the heart rate and blood pressure.

Background and Aim: Preterm labor (PTL) is considered as one of the main causes of fetal mortality worldwide. Therefore, prevention of PTL is one of the main goals of midwifery care. The present study was conducted to determine the effect of vaginal progesterone suppository on the prevention of PTL. Materials and Method: In this randomized clinical trial, 200 singleton pregnant women at 24-34 weeks of gestation with diagnosis of PTL were treated with IV magnesium sulfate and corticosteroid. In the intervention group (n=100), in addition to the above mentioned drugs, progesterone suppository (200 mg) was administered at the start of treatment and every12 hours until discontinuation of uterine contractions. After successful tocolysis, use of progesterone suppository continued until the end of the 34thweek. Midwifery outcome including the interval between the onset of tocolysis and discontinuation of uterine contractions and the occurrence of labor, the gestational age at the time of delivery and neonatal outcome were recorded in the two groups. Results: The mean intervals between the start of tocolysis and discontinuation of uterine contractions were 6. 33± 3. 78 and 6. 72± 3. 07 hours (p=0. 432) in the control and intervention groups respectively. Also, the intervals between successful tocolysis and delivery were 35. 1± 21. 9 and 36. 7± 25. 1 days respectively (p=0. 634). There was no significant difference between the two groups in terms of gestational age at the time of delivery and neonatal outcome. Although neonatal mortality in the control group was twice that in the intervention group, the difference was not significant (p=0. 194). Conclusion: The present study showed that vaginal progesterone suppository had no effect on the prevention of PTL.

Background and Aims: Chlorpyriphos is one of the most important widely used pesticides in agriculture, which is discharged into the water resources and is associated with various adverse effects on human health and the environment. The purpose of this study was to evaluate chlorpyriphos removal by chitosan graphene oxide composite form aquatic solution. Materials and Methods: The characteristics of adsorptive material was determined by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FT-IR) and Xray diffraction (XRD). First, the pHzpc was determined. Then, the effect of different parameters such as the amount of adsorbent, contact time, pH, initial concentration of chlorpyriphos and temperature were studied through batch method in order to obtain optimal conditions for the adsorption process. Then optimal pH under constant conditions was determined. Isotherm, kinetic and thermodynamic equations of adsorption were investigated and concentration of chlorpyriphos was determined. Results: The highest removal efficiency was 93% which was observed at pH=5, 60 minutes contact time and 0. 8 g/L of adsorbent concentration and initial concentration of 1 mg/l for chlorpyriphos. The results showed that adsorption process followed pseudo-second order kinetics and equations data followed Langmuir isotherms model. Evaluation of thermodynamic parameters showed that the process of chlorpyrifos removal was endothermic and spontaneous. Conclusion: According to the results of this study chitosan graphene oxide composite can be a suitable adsorptive material for removal of chlorpyrifos from aquatic solutions.