نشریه پژوهش در پزشکی
سال چهل و یکم شماره 1 (پیاپی 161، بهار 1396)

Backgrond: Infertility affects 15% of couples and male factor infertility is involved in 50% of cases. One of the causes of infertility is Azoospermia that refers to the absence of sperm per ejaculation and almost affects 1% of the total men population. A comprehensive overview about the disease and its risk factors along with a better understanding of the diagnosis was performed and comprehensive information about the modern treatment methods for this reproductive disorder was provided.
For writing this article, a large study on azoospermia, the reasons and treatment methods was performed by searching the words including azoospermia, genetics, treatment and diagnosis in the medical valid databases, mainly PubMed, up to 2016. Among the collected papers, articles that are most relevant to the goals of the present article was selected. The articles with brief explanation about the etiology of azoospermia and disease treatment options were studied further.
Findings: Literature review showed that genetic diseases such as Klinefelter syndrome, cystic fibrosis, primary and secondary testicular failure due to hormonal and/or chromosomal anomalies ranging from structural or numerical changes, gene mutations, genomics alterations at the level of telomeres and the resulting apoptosis, genetic polymorphisms, anatomical disorders associated with vas deferens and ejaculation, age, treatments of testicular cancer and other diseases, varicocele and surgical treatment of testis were considered as the most important factors in azoospermia.
Although numerous factors are involved in the etiology of azoospermia, clinical tests and genetic counseling plays an important role in early detection of disease that helps to retrieve sperm production and fertility to the patient in many cases.
Accurate understanding of the etiology of azoospermia could provide a suitable treatment approach for the management of disease.

Sleep quality has a fundamental and important role in determining the physical and psychological health of humans. Sleep disorders are widespread and have very damaging effects on the individual and social aspects of human life. This research was aimed to evaluate the effectiveness of hypnotherapy on sleep quality improvement.
The method research was a Quasi-experimental, and pretest-posttest design with the control group. The population was all students of Applied Science Center of Khorasan Razavi in 2014. The sample consisted of 30 volunteers who were randomly assigned to two experimental and control groups, each group 15 subjects. Pittsburgh Sleep Quality Index was used to assess the sleep quality, and Wilkinson (1981) protocol was used for hypnotherapy sessions. Research data were analyzed by using the analysis of covariance.
The results show the effectiveness of hypnotherapy to improve the overall quality of sleep, subjective sleep quality, sleep latency, sleep disturbances, and daytime dysfunction.
hypnotherapy improves sleep quality through mechanisms such as reduced physiological arousal, stimulation of relaxation, release stress and cognitive changes. It is suggested the use of this treatment in the sleep problems and more research in this area due to the lack of studies.

Parkinson’s disease (PD) accompanies with degeneration of dopaminergic neurons of substantia nigra compacta and other regions of brainstem. Oxidative stress plays an important role in neuronal death in PD. Superoxide formation is one of the main etiologies of this disease, and angiotensin converting enzyme inhibitors (ACEIs) are able to suppress superoxide formation. Petroselinum hortense Hoffm is an ACE inhibitor and in previous work improved behavioral and pathological signs in a rat model of PD. In this research the effect of Petroselinum hortense Hoffm aqueous extract was studies on lipid peroxidation and protein oxidation.
Male rats (n=36) were divided in 6 groups: sham, neurotoxin (injection of -6hydroxydopamine into left hemisphere SNc) Petroselinum hortense Hoffm aqueous extract (20 ,100 and 5 mg/kg), and captopril. Petroselinum and captopril groups were injected i.p. seven days before and 1 day after of -6hydroxydopamine injection. Brain protein oxidation and lipid peroxidation as well as brain ACE activity were assayed in 6 groups.
Results showed significant inhibition of brain ACE activity in captopril and parsley groups concentrationdependently (pDiscussion and Prevention of cellular oxidation is not the main mechanism of queous extract of parsley in preventing Parkinson's disease, despite having ACE inhibitory activity.

Backgroundm: Based on recent evidence, inadequate and ineffective follow up after discharge increases the risk of unplanned readmissions, which is an indicator of poor healthcare system function. The aim of this study was to determine the effects of patient education and follow up after discharge on hospital readmission in heart failure patients.
This randomized clinical trial was conducted on 120 patients with heart failure admitted in Taleghani hospital, Tehran and were allocated equally with block randomization method. The intervention group were educated based on recent guidelines and their needs after discharge and were followed up for 3 months by 9 telephone interviews (every week for the first month after discharge, every two weeks for the next two months), but the control group received the routine care. Data were gathered based on a control check-list every two weeks for both groups and were analyzed using chi-square test, Fisher and t-test. Evaluation of intervention effect was done using generalized estimating equations (GEE) model.
Readmission rate was 19.3% in intervention group and 38.2% in control group (p=0.05). The patients that needed outpatient care did not differ significantly in both groups (17.5% in intervention group vs. 28.3% in control group).
This study suggests that patient education and follow up after discharge might decrease readmission rate among heart failure patients.

Aims: Due to the concerns over relapse in schemes for quitting drugs and the role of psychological health aspects in relapse, this research examined the relationship between well-being as a component of positive psychological health with substance abuse relapse.
Method of Investigation: In this cross sectional study, 68 addicts residing in one of the addiction quitting centers in Tehran in 2016 were selected for investigation by simple random sampling. A questionnaire consisting of the addict's demographical data, his addiction status and the Farsi version of the World Health Organization Well-Being Questionnaire (WHO-5-P) were employed for data collection. A Pearson Correlation Test was used to investigate the relationship between well-being and its components with substance abuse relapse.
Findings: The mean number of relapses in the group with the low well-being index (less than 13) was 4.89±10.92 occurrences whilst in the group with the high well-being index (13 or more) it was 2.71±5.30. Analysis of data indicated that there was a significant inverse relationship between the level of the well-being index with the number of relapses (PDiscussion and A low level of well-being is associated with more relapses and thus consideration of factors interrelated to positive psychological health such as well-being, easy access to counseling centers and provision of appropriate care could play a substantial role in reducing relapse rate.

Appetite-regulating hormones play an important role in energy balance. Nesfatin-1 and Neuropeptide Y are orexigenic and anorexigenic peptides that play an important role in obesity and energy balance. The aim of this study was to assess the effects of endurance training on serum levels of nesfatin-1, neuropeptide Y and cortisol in sedentary obese men.
In this experimental study, 30 men aged between 48 to 60 years with BMI≥30 kg/m2, were randomly allocated to the endurance training and control groups. The training program consists of 12 weeks of endurance training (treadmill running) with 50-75% maximum heart rate. Blood samples were withdrawn before and 48 hours after the 12 weeks exercise for measurement of nesfatin-1, neuropeptide Y, cortisol and some inflammatory factors were performed. Paired sample t-test and ANCOVA were used for statistical analysis.
Results revealed that after 12 weeks endurance training, the levels of cortisol decreased significantly (p=0.015). Reduction in serum nesfatin-1 was observed whereas these changes weren’t significant (p=0.060). There was no significant change in neuropeptide Y (p=0.307). Also, a significant reduction in anthropometric indices was observed in training group.
According to the findings of this study, it can be concluded that 12 weeks of endurance training, despite the impact on cortisol, has no significant effects on neuropeptide Y and nesfatin 1.

Research has shown that the expression of UBD (Ubiquitin D) is effective in causing cancer. UBD relationship between states with advanced stages of cancer cell differentiation and expression, which probably UBD involved in the progression of carcinogenesis. Overexpression of UBD is related to p53, which subsequently progress to cancer. The purpose of this study is evaluation of Ubiquitin D gene expression in leukemia patient as a biomarker for detection of disease and its progression in patients as well.
In this study 100 patients with leukemia blood samples and 100 blood samples from healthy people between ages 36 to 74 were collected. RNA is then extracted and cDNA synthesis to enzyme MMuLV and Random hexamer primers Oligo dt was done. UBD specific primers were designed using Primer Express software and gene expression levels UBD by ΔΔct (relative) were measured.
UBD average increase gene expression in individuals less than 50 years equal to 5.82, P UBD can be examined until perhaps as a biomarker for diagnosis of leukemia proposed to be used. So, we can evaluate the expression of the genes used to diagnose leukemia. However, more studies than the current application procedures, in cancer that has a lot of technical errors that were used in this study and prove its accuracy and sensitivity is required.

Due to increasing of human knowledge conserning control, treatment, prevention and eradication of fungal diseases, people with fungal diseases such as dermatophytosis in humans and animals have shown that the disease is still one of the most important health issues in Iran and the world. Pollution of hot springs pools to dermatophyte and saprophytic fungi can increase the risk of natives and tourists to related diseases. This research was performed about fungal flora of Mazandaran hot springs for the first time in autumn 1394.
Method and In this cross-sectional study, 22 hot springs were surveyed. Three samples of water in 250 ml sterile containers were collected and transferred to the laboratory of shahid Beheshti University of Medical Sciences. Then, according to colony morphology and microscopic characteristic of fungi ,the presence of saprophytic fungi and dermatophytes were studied.
Out of 66 collected water samples from hot springs in Mazandaran province, the 19 samples (78/28%) and 17 springs from 22 hot springs were positive for the presence of saprophytic fungi. The most common fungi were Aspergillus niger, Penicillium and Cladosporium respectively. In this study, no dermatophyte fungi were isolated.
It seems that fungal contamination of hot springs in the Mazandaran province is substantial for locals, tourists and travelers who have used these hot springs. Therefore, experimental studies are essential to reduce the pollution of fungal diseases in hot springs in our country and Mazandaran province.

Gynaecologists and midwives as a practical model of childbirth have an essential role in education. The aim of this study was to determine the attitude toward labor and preferred delivery method among midwifery and medical students and other related factors at medical universities in Tehran in 1393.
We carried out a descriptive study on 300 students of Medical Sciences Universities in Tehran in 1393. For data collection tool we used two researcher made questionnaires contain “demographic characteristics and related factors to the preferred mode of delivery“ and “attitude toward delivery mode”. To investigate the reliability, two methods of test-retest and internal consistency (Cronbach’s Alpha) were applied and the content validity was determined quantitatively and qualitatively. The data were analyzed by SPSS-16 software. Statistical tests used included: chi-square, T-test, ANOVA or non parametric equivalents of them. The significance level accepted in this study was p-value>0.05.
Most of the students (49%) preferred caesarean section for themselves. In comparison of 4 groups first year midwifery (16.7%) and medical students (48.6%) had preferred caesarean less than fourth year midwifery students (51.3%) and medical interns (%75.7). The majority of students had a positive attitude via caesarean section. Therefore, the four study groups respectively 45.5%, 92.3%, 30.8% and 100% of first and fourth year midwifery students and first year medical students and medical interns had a positive attitude toward caesarean delivery. Among the relevant factors under investigation age, ethnicity, weight, body mass index, birthplace, residence place and family income were significantly associated with the preferred mode of delivery.
The caesarean section is preferred and a positive attitude towards it among midwifery and medical students is very high and the education system authorities should create plans to improve students’ attitudes.