مجله دانشگاه علوم پزشکی قم
سال چهارم شماره 1 (پیاپی 13، بهار 1389)

Chronic, unbridled oxidative damages have been known as the culprits behind many chronic diseases, including cancers, atherosclerosis, diabetes and Alzheimer’s. Cyclooxygenase-2 (COX-2)-the main enzyme involved in inducing these processes- plays an important role in tumor development and progression. COX-2 inhibitors should be used at high doses for a long time in order to bring about chemoprevention and induction of anti-tumor effects. For example, celecoxib prevents colorectal tumor growth and induces apoptosis in both in vitro and in vivo models. Disregulation of COX-2 expression coincides with the development of gastrointestinal malignancy in humans and in animal models of colorectal cancer. Increased COX-2 expression in human colorectal adeno-carcinomas has been elucidated when compared with normal adjacent colonic mucosa. The capacity of vitamin E, particularly in α form, to quench free radical damage, induces apoptosis and impact expression of oncogenes makes it an appropriate choice for chemotherapeutic strategies. Studies have shown that carcinogenesis and DNA damage due to UV are inhibited by vitamin E. The goal of this study was to investigate alpha tocopherol and celecoxib induced apoptosis in human colorectal carcinoma cell line. In this study, HT29 cells were exposed to different concentrations of tocopherol (5, 10, and 20µM) and celecoxib (25, 50, 75, 100µM) followed by DNA extraction and fragmentation for demonstrating cell death process. The results indicated that celecoxib at lower doses (25, and 50µM) could not induce cell death, but at higher doses (75, and 100 µM), DNA fragmentation results typically resembled programmed cell death. ocopherol (5, 10, and 20µM) in combination with celecoxib improved the impact of celecoxib on cell death induction and made it the rational notion to be combined with vitamin E in clinical practice.

Iron overload is detrimental for the body and can create damage to different body tissues, such as myocardium by producing oxidative stress. Therefore, the antioxidant factors can neutralize iron induced damages. According to available reports, L-arginine as a precursor nitric oxide production has antioxidant effects. This study was carried out to evaluate the histological effects of iron overload on ventricular muscle and preventive role of L-arginine in male rats. In this experiment, 40 male rats with weight range of 300-250g were divided at random into five equal groups including:1- Control, 2- Iron (10mg/kg, ip), 3- Iron(10mg/kg, ip)+L-arginine (1mg/ml, po), 4- Iron (50mg/kg, ip) and 5- Iron (50mg/kg,ip)+L-arginine(1mg/ml,po). After treatment (6 weeks), the animals were anesthetized and the samples of left apical ventricular myocardium were taken out and morphological studies were done following fixation with 10% formalin and H&E staining. Microscopic parameters under study were cell swelling, vessel dilatation and hypercongestion, cell necrosis and tissue deformity. The type and severity of damage to the tissue were also noted. Data were analyzed using chi-square statistical procedure, and Pvalue≤0.05 were considered to be significant. The data showed moderate changes in the ventricular myocardium of group 2 that was significant in comparison to the control group (P<0.05). The ventricular myocardium of group 3 showed low changes and wasnt significant in comparison to control group (P=0.84). The ventricular myocardium of the group 4 showed severe changes in comparison to the control group (P<0.01). The low change showed in the ventricular myocardium of group 5 that wasnt significant in comparison to the control group. This study showed that excess iron can cause unfavorable changes in myocardial tissue and L-arginine may reduce iron overload damage. Therefore, l-arginine can protect myocardial tissue against iron overload stress.

Anxiety is a kind of agitation and concern stemming from the feeling of threat or hazard in human. It can decrease or increase the understanding ability of individuals. Most clinical patients have anxiety in confronting a new and unknown environment such as hospitals. A non-pharmacological method such as pleasant sound of Holy Quran recitation can be used as a useful and effective procedure to decrease the anxiety. The aim of this research was to study the recitation effects of Holy Quran on anxiety of woman before cesarean. In this quasi-experimental study, 80 women expecting cesarean section were randomly selected regarding their characteristics and divided into two groups: control group (30 members) and experimental group (50 members). Data collection instrument was a two-part questionnaire including demographic characteristics, and Spilburge’s state-trait anxiety inventory. The degree of anxiety for the two groups was evaluated before cesarean, then before innate cesarean, the Holy Quran recitation was played for experimental group for 20 minutes by the sound of famous recite, Abdol Basset. Data were analyzed using Chi-Square, single sample & paired T-test, and a Pvalue of 0<0.05 was considered as statistically significant. The results showed that the degree of anxiety decreased in experimental group after intervention (P=0.0001), but not in the control group.(P=0.98) Comparison of the two groups showed a significant difference after intervention (P=0.002). According to the results of this research and because of the agreeable rhythmic intonation of the Quran as gnostic music and its miracle aspect, we can use its tone as a non medicinal method for reducing anxiety before cesarean women.

The ability of neonates to perceive and react to pain has recently been acknowledged. Sweet solutions are one of the recommendations for pain relief in newborns. The aim of this study was to investigate the effect of oral sucrose for reducing the intensity of pain during HB vaccination in newborns.

In this clinical trial and double blinded study 70 healthy neonates vaccinated with HB vaccine on the first day of birth were randomly divided into experimental (35) and control groups (35).The experimental group received 2ml 25% sucrose solution 2 minutes before the procedure and the control group received 2ml water for injection. Responses of pain were estimated by the Neonatal Infant Pain Scale (NIPS). Data were analyzed using Chi-square tests, T and Mann-Whitney tests.

Change in breathing pattern, facial expression, state of arousal and state of organs in infants occurred in both groups. Only one neonate in sucrose group had low score. The pain score in one neonate was 6 and other scores were 7. In the control (water group) group, scores of all neonates were 7. There was no significant difference between the two groups.

HB vaccination is a painful procedure and receiving 2ml sucrose before injection can not reduce indices of pain.

Iron deficiency is a highly prevalent problem in developing countries. One of the reasons for telogen effluvium is Iron deficiency. This study was conducted to determine the relationship between Iron deficiency and hair loss in Qom Province, Iran. This study was conducted in two separate stages. In the first stage, a cross- sectional, population-based study was performed. In the second stage, a case control study was carried out. The study was conducted during 2007 and 2008 on 10 to 45 year-old females in Qom Province. 2200 females in the first stage and 410 females in the second stage (205 females with telogen effluvium as cases, and 205 females without telogen effluvium as controls) were studied. Females with positive pull test and without exclusion criteria were considered as telogen effluvium. In both case and control groups, CRP and serum ferritin tests were done. Correlation of variables with hair loss and serum ferritin level was evaluated. Chi Square test, Student’s T test and Mann Whitney Test were taken for statistical analysis in SPSS ver. 16 software. Multiple logistic regressions were used for statistical modeling. Median (range) of serum ferritin level in the case group was 18.7µg/L (0.7-174.5µg/L) but in the control group it was 22.1µg/L (2.8-167.9µg/L) (P=0.01). In 93 (45.4%) females of the case group and in 71 (34.6%) females in the control group ferritin level was lower than 15µg/L (P=0.02). In 1182 (53.7%) of 2200 female hair-loss was detected. In multivariate analysis older age and weight, being housekeeper and smoking were directly associated with hair loss. However, higher monthly income and possession of private house had opposite relationship with hair loss. Hair loss was a prominent problem in females in Qom Province and telogen effluvium was related to iron deficiency. In females in Qom Province, improvement of body iron resources with better nutrition style, administration of iron supplements and fortifying food with iron supplements is recommended.

Unwanted pregnancy is one of the major problems in the society which endangers both mother and infant safety conditions and imposes heavy costs on health and treatment systems. Researchers have shown that more than1/3 of pregnancies in the world are unwanted of which 95% take place in developing countries. The aim of this study was to survey effective causes on unwanted pregnancy in the city of Ardabil, Iran. This study was a cross-sectional one, carried out on 328 women who had referred to health centers in Ardabil. Data were gathered via face to face interviews and were then analyzed using descriptive- inferential statistical methods and logistic regression in SPSS package. The mean age of women was 28.2±6.7 years, and most of them were between 20-30 years old (55.3%). 45.3% of the population was housekeepers and most of their husbands were workers (53.8%). The mean of number of children was 1.6±1.5 out of all women under the study. 199(60.7%) had unwanted pregnancy of which 70.7% was unwanted by both couples. Most women (35.6%) used Synthetic Tablets as the contraceptive method. According to the results of logistic regression model, variables such as husband’s age, number of pregnancies and deliveries, number of abortions, the use and kind of contraceptive method had significant effect on unwanted pregnancy. According to the high rate of unwanted pregnancy in Ardabil compared to other places, it is necessary and important that suitable policies be made regarding the literacy, optimal pregnancy age, consultation and training about correct contraceptive methods, the importance of training men in contributing to family planning programs and qualitative promotion of family planning services.

Systemic inflammatory response syndrome (SIRS) is a relatively accurate predictor of outcome in critically ill patients treated in medical/surgical ICU. However, there are few data on the incidence of SIRS and its effect on outcome in obstetric patients. The aim of this study was to assess the incidence of SIRS and its relationships with mortality and morbidity in obstetric patients admitted to ICU. Routine Data Base study was conducted on documents of all obstetric patients admitted to ICUs of two medical teaching centers of Isfahan University of Medical Sciences from Oct 2005 to Feb 2006. Information including SIRS criteria factors, complications, length of ICU stay and mortality were gathered from patients medical records. According to SIRS criteria, patients were categorized into SIRS positive and SIRS negative with comparing the morbidity and mortality rates between the two groups. X² test was used for comparing mortality rate and complications between SIRS positive and negative, and Mann-whitney test was used for comparing the length of stay. Correlation coefficient of Spiermann was applied for assessing SIRS score with mortality rate and complications. In all tests, P<0.05 was considered statistically significant. In this study, out of 102 available medical records, the data of 82 were complete, and hence were included in the study. Based on the criteria, 68(83%) had SIRS. The difference in mortality rate was not statistically significant, but the two groups were significantly different in complications especially cardiovascular and coagulation complications which were more frequent in SIRS positive patients (P<0.05). The length of stay in SIRS positive patients was statistically more than SIRS negative cases (P<0.05). There was a positive correlation between SIRS score and mortality rate but it was not statistically significant (r=0.189, P=0.089). Based on the results of this study, the incidence of SIRS in obstetric patients admitted to ICU is remarkable and associated with increasing morbidity. So, it can be used as a predictive factor for outcomes in obstetric patients treated in ICU.

Horizontal roughing filters (HRF) can properly remove suspended solids and microorganisms from surface water resources, especially on filtration rates less than 1.5 m/h. This research was aimed at suspended solid removal efficiency of HRF during secondary wastewater effluent filtration. This experimental study was conducted by installing an HRF pilot system on effluent pumping station of Qom wastewater treatment plant based on aerated lagoon process. The pilot was a horizontal cylindrical column consisting of three compartments filled with river gravels in various sizes. Grab samples were simultaneously taken from HRF inlet and outlet in three filtration rates: 0.5, 1, and 1.5m/h The results indicated that filtration rate had a significant effect on the amount of total suspended solids in HRF effluent. During optimum operation of HRF, removal efficiencies of three filtration rates (0.5, 1, and 1.5 m/h) were 78.5, 63.1, and 66.9, respectively. T-test analysis indicated that with a significance difference, outlet effluent from HRF in all three flow rates met the standard requirements of Iran Environmental Protection Agency for irrigation and discharge to surface water.

HDR (hypoparathyroidism, deafness and renal dysplasia) is an autosomal dominant syndrome due to mutation in the glutamyl aminotransferase. We report a deaf child with hypoparathyroidism. Case ReportThe patient was a 6.5 year-old boy whose hearing impairment had been detected in infancy and cochlear implant had been done at 3.5 years of age. He had no problem until one week before admission, when he faced carpopedal spasm and eyes-staring, and he was then admitted to the hospital due to his status of epilepticus. Brain CT scan showed calcifications in frontal lobe and basal ganglia. Hypocalcemia, hyperphosphatemia and low parathyroid hormone level were detected in laboratory data. Kidney sonography was normal. Concerning negative family history and normal kidneys, autosomal recessive form of disease without renal involvement or new mutation might be suggested in this patient; therefore, in deaf patients, hypoparathyroidism would be taken into account.