مجله دانشگاه علوم پزشکی قم
سال ششم شماره 3 (پیاپی 23، پاییز 1391)

Due to the high mortality of ischemic heart disease, many of these patients can be life-saving treatments.There are conflicting information on the effects of insulin in patients with myocardial infarction. We aim to evaluate the effects of insulin on infarct size in myocardial infarction thorough evaluating troponin I enzyme and echocardiography. This randomized clinical trial enrolled 74 patients with ST segment elevation myocardial infarction referred to Vaseie hospital of Sabzevar in 2009. Patients were categorized into two groups by block randomization and were treated with high dose of GIK (25% glucose, 50IU of soluble insulin per liter, and 80mmol of potassium per liter at 1ml/kg/hour) (GIK group) or normal saline (control group) as adjunct to thrombolytic therapy. We analyzed Plasma concentrations of troponin I, at baseline, 16 and 24 hours after admission. Echocardiography was done at 72 hours after admission. Data were analyzed Variables were compared using independent T tests and repeated measure ANOVA. cTnI peaked to 20.13±12.46U/L in GIK group and to 20.11±10.62 U/L in controls (p=0.44). Left ventricular ejection fraction was 39% vs.41% in GIK vs. control, p=0.34. There was no significant difference between groups in cardiac enzymes and ejection fraction. In patients with myocardial infarction treated with streptokinase, insulin offers no effect on infarct size.

Cadmium is a toxic metal which is widely used in industry. This metal exerts toxic effects on multiple organs, including nervous system. The aim of this study is to evaluate the effect of cadmium on weight and development of hippocampus in Wistar rat embryos and then determining whether L-carnitine, as an antioxidant, can protect hippocampus from the toxic effects. Female Wistar rats (250-300g) were used in this study. 24 hours after mating with male rats, the females were separated and their vaginal smears were examined for sperm detection. This day was considered as embryonic zero day. The female rats were divided into three groups: The control group which received no injection, the experimental group 1 which received 1mg/kg B.W cadmium and the experimental group 2 which received 1mg/kg B.W cadmium+500mg/kg B.W L-carnitin in days 7 and 10 of gestation. On day 17 of gestation, the animals were sacrificed by chloroform over dose and their embryos were removed surgically. The embryos were fixed in formalin 10% for 30 days, the weight of embryos were measured. Then tissue processing, sectioning and Hematoxylin-Eosin (H & M) staining were done. Some sections of hippocampus were evaluated using light microscope and MOTIC soft ware. The weight of embryos were significantly decreased in experimental groups. This decrease was significantly greater in the Experimental group 2. The number of cells and thickness of hippocampus layers were decreased significantly just in the second group. These findings indicate that cadmium has teratogenic effects on embryo’s weight and development of hippocampus and at least a part of these effects may be inhibited by L-carnitine.

Nitric oxide synthesis has been detected in ventral tegmental area, which is a key brain region that seems to mediate behavioral effect of morphine and nicotine. In the present study, the effects of L-arginine, a nitric oxide precursor, in the ventral tegmental area in nicotine’s effect on morphine-induced amnesia has been investigated. This study was done experimentally on 250 male rats. Rats were anesthetized with intra-peritoneal injection of ketamine hydrochloride, plus xylazine and then placed in a stereotaxic apparatus. Two stainless-steel cannuale were placed in the ventral tegmental area. The behavioral testing was started in inhibitory avoidance task, and the step-through latency for entering into the dark compartment was measured for the assessment of memory retention. One-side analysis of variance (ANOVA) and Tukey test were used to evaluate the statistical significance between experimental groups. A difference of p<0.05 was considered statistically significant. Post-training injection of morphine (5 and 7.5mg/kg) decreased the memory retrieval. Injection of nicotine or L-arginine before test by itself has no effect on memory retrieval. On the other hand, pre-test administration of morphine (7.5mg/kg), nicotine (0.5 and 1mg/kg), L-arginine or ineffective doses of L-arginine plus non-effective dose of nicotine restored memory impairment induced by post-training injection of morphine. The finding of the study indicate that nitric oxide system of the ventral tegmental area may play an important role in the improving effect of nicotine on the morphine-induced amnesia.

The presence of certain chemical compounds in dialysis water which enter patients’ bodies through haemodialysis can cause various problems such as acute poisoning, brain damage, osteoarthritis, Therefore, applying the standards for dialysis water is indispensible. This study was carried out to determine the chemical quality of water entrance to dialysis machines and its comparison with AAMI and EPH standards in the hospitals of Qom province. This is a descriptive-cross sectional study which was carried out on 45 samples of water entrance to dialysis machines in hospitals of Qom province. Since there were 3 hospitals in Qom having dialysis units, out of each one 15 samples were chosen as the samples of this study. The following machines were used for analysis of samples in the research: Atomic Absorption, DR4000 and Flame photometer. The gathered data were then analyzed by independent t-test (p<0.5). The means of all measured compounds were statistically lower than standard levels and had a significant difference with standard levels. The elements and compounds such as Lead, Zinc, Potassium, Sodium, Sulphate, Nitrate, and Chloride in all the measured samples were below the standard levels, but elements such as Aluminum, Cadmium, and Fluoride were above the standard levels in 13, 6 and 9 percent of samples, respectively. The results of the study showed that in all cases the means of all the studied compounds were below the standard levels, indicating high quality dialysis water in the hospitals. However, the presence of high level of elements such as Aluminum, Cadmium, and Fluoride compared with the standard levels signifies that much should be done in examining dialysis water

Intense exercise increases heart susceptibility to the disorder in this physiological factor.The purpose of this study is to study the effect of sprint interval training on plasma levels of apelin, blood pressure and heart rate in elite female runner. Plasma levels of apelin, Heart rate (HR) & blood pressure (BP), analyzed before, after and 24 hours after exercise. 15 elite female runner, whom were playing in Shiraz track & field league, selected for this study. They all were homogenized according to any kind of disease. Rast exercise made plasma level of Apelin decrease after exercise compared with plasma level before exercise and this decrease was significant (p=0.001). Also, plasma level of apelin increased significantly 24 hrs after finishing exercise (p=0.001), but there were no significant differences before exercise (p=0.375). Systolic blood pressure and heart rate increased immediately after exercise and decreased significantly after 24 hrs (p=0.001). However, significant difference was not observed in diastolic pressure before and after exercise (p=0.338). The finding of this study shows that sprint interval training decreases plasma levels of apelin, so we can say that apelin and blood pressure must be in balance in natural position. With knowing the role of apelin, changes in this peptide during exercise can be an alarm to cardiovascular risk factor, during or after exercise in elite athletes.

Nurses in their daily practice need acceptable level of ethical development. There is few literature about ethical development of Iranian nurses. The aims of present study are to determine the level ethical development in nurses and its related factors. This descriptive-correlational study conducted in 2010. The study sample consisted of 269 nurses working in three training-treatment hospitals affiliated to Tabriz University of Medical Sciences. These nurses selected by census sampling method. For assessing the ethical development of nurses, nursing dilemma test was used. This questionnaire was designed based on Kohlbergs’ theory of ethical development and assessed ethical development in pre-convetional, conventional and post-convetional levels. The data analysis was done by descriptive and inferential statistics. Forty four nurses (16.3%) were in pre-conventional level, 86 nurses (31.8%) were in conventional level, 116 nurses (43.1%) were in post-conventional level, and 23 nurses (8.5%) were in clinical consideration level. There was negative significant correlation between ethical development of nurses with their job experience. In spite of this fact that near half of nurses are at postconventional level, but still a significant number of them are at lower levels of ethical development. These findings indicate that nursing managers should pay more attention to ethical development of nurses.

Religious and spiritual resources are important coping resources for cancer patients during the process of disease that can be used to improve the psychological problems such as despair. This research tries to study the correlation between spiritual well-being and hope in cancer patients. In this descriptive cross-sectional study with demographic questionnaire, Ellison and Palutzian’s spiritual well being and Snyder’s hope questionnaire, 300 cancer patients who referred to training-therapy center of Isfahan university of medical sciences were selected with Available sampling. Data were analyzed by descriptive statistical and Spearman and Pearson tests and the significant level equal to 0.05 was considered. The findings of this research showed that there was direct and significant correlation between spiritual well-being and hope (r=0.27) (p<0.0001). Treatment staff can provide opportunities to identify spiritual needs of cancer patients to promote their spiritual health and hope among them. Thus it is recommended in order to maintain health and increase hope among patients, the important role of spiritual health in nursing care of life-threatening diseases such as cancer take into more consideration.

Nowadays pediculusis (Head-louse infestation) is one of the dermal infections with a Global distribution, and is prevalent worldwide. Head-louse infestation is highly common in collective centers such as schools, garrisons and champuses; in schools, specially in feminine elementary schools which is dramatically high. The current study has been conducted to determine the prevalence of Head-louse and to assess the epidemiologic features of the disease. This descriptive cross–sectional study was done over 1725 feminine elementary students from 75 schools in rural counties and total urban districts of Qom province by a multi stage random sampling. Data collection was done by questionnaires and physical exams of the hair. Analysis was done by Chi-square and Multivariate logistic regression model test. (Significant level with p<0.05 objected). 131 of 1725 survived students, were infected by pediculusis. (7.6%). The statistical meaningful relation was observed between the habitat, father's job and literacy, mothers literacy, family size, students grade, bath in home, bath times, daily comb, record of infestation in years ago, hygiene corrector in school, access or no access to primary health care and pediculusis (p<0.05 objected). But no meaningful relation was detected between mother's job, head hairs length, type of school, residing status (private, rental and other site) and the prevalence of Pediculusis. Pediculusis is still a health burden in societies with low health and life standards. The high prevalence of pediculusis among students in the majority of schools in Qom province is attributable to inadequate access to health educator and sanitation facilities and inattention to personal health and related factors else.

Cervical cancer is one of the most common cancers in women worldwide and although pap smear is considered as an effective screening program, the level of using screening is low. The purpose of this study is pap smear test structures for measuring health belief model and factors affecting women in urban centers covered Zarandieh. This was a cross-sectional study (descriptive-analytical) which included 265 Urban Women's in Zarandieh. Data collection instrument was a questionnaire included demographic variables and knowledge and health belief model questions. Data was analyzed using chi-square tests, Descriptive statistics, independent samples t-test, at the significance level of p<0.05. Significant differences were detected between those tested and not tested in mean of score knowledge and all the variables HBM (sensitivity, benefits, barriers, threat and intensity perceived),)p<0.001). The HBM constructs, age, level of study and knowledge accounted for 30.8% of the variance observed for Pap test. Perceived susceptibility and benefit were the most important predicting factors. These findings can be used to guide the development of more effective educational programs and increase the amount of women’s participation in Pap smear.

Carpet weaver women due to long working in inappropriate environment are at risk for certain eye disease. The aim of this study is to determine the refractive errors among carpet weavers women in rural Sephidehkesh of Qazvin. 28 Carpet weaver women were under optometric eye examinations. Light Intensity at work stations was measured, using luxmeter and eye examinations were done by using the ophthalmoscope and retinoscop. Data were analyzed using one-side T-test. The result of this study showed, general and local light intensity in 13 carpet weaving workshops, respectively 160 and 154 Lux that was much less than the minimum and maximum recommended values of 200 to 300 Lux. Only one of 28 Carpet weaver women was healthy and others were visually impaired. In addition to poor eyesight, workers complained of headache, itching and burning eyes. The results show, due to inappropriate working condition in carpet weaving workshops, most young workers are suffering from eye impairment and is predicted the severity of myopia to increase with working experience and age.

Silver nanoparticles with excellent antimicrobial effects and increasing consumption in different industries are the most widely used nanoparticles and so it is necessary to evaluate the safety of their use. This study has examined the effects of time and consumption dose of these particles on rats of Vistar race. 36 Vistar race rats after 4 weeks equalization period divided into 6 groups (one control and five tests) and were received 95ppm, 65ppm, 35ppm, 20ppm, 5ppm concentrations of silver nano (Nanocid L2000) solution from NANONASB-E-PARS CO. as water. After 3 & 6 months 3 animals of each group were selected and hormonal parameters were determined by CLIA method, Hb and HCT was measured by common Med. Lab. Kits and blood cells counted by H1 equipment. Finally, results were processed by one-side variance and tukey's test. The results indicated that white blood cells counting show meaningful dose dependent decreasing in number of these cells. No tangible change was seen on counting of red blood cells and the level of hemoglobin and hematocrit parameters. Also blood cortisol & T4 level of dependent dose decreased and Testosterone increased meaningfully. Water uptake index increasing happened in meaningful and dose dependent manner. Ketone bodies appeared in rat's urine that had eaten high doses of silver nano. WBC count decreasing after oral consumption of silver nano particles show cell apoptosis and immunity lowering. Also the particles have no effect on bone marrow function indexes. On the other hand, lowering the function of adrenal gland, hypothyroidism, increasing in sexual hormone level are side effects of these particles consumption. In addition, increasing in Water Uptake Index and urine volume can be for high blood pressure or kidney failure caused by these particles.

Coronary angiography is the golden diagnostic test for coronary heart disease that causes various vascular complications. To prevent these complications, patients are completely restricted in bed. Changing position is considered an alteration in routine care protocols after coronary angiography, improving patients’ comfort and satisfaction that is considered in current studies. The purpose of this study is the comparing different ways of position on vascular complications after coronary angiography. This clinical trial study was carried out in post angiography ward of valiasre hospital in Qom. 75 patients experienced angiography were randomly divided into three equal groups. The first group received the usual care means supine and flat with keeping leg straight for 6 hours. The position of second group were changed hourly to 3 angle semi sitting 15°, 30°, 45° for 6 hours. The position of third group were changed their body position hourly to supine, right side-lying, and left side-lying. The questionnaire and checklist were used for data collection. Chi-square test, Kolmogorov-Smirnov test, Loon statistics, one-side ANOVA and Kruskal-Wallis test were used for data analyzing. p<0.05 was a meaning ful factor that showed differences. In this study, hematoma was not different significantly between the groups in sixth hours and the next morning after catheterization. Also none of the patients developed bleeding and arterial occlusion; therefore, no significant difference was showed between the groups. The findings reveal patients can change their position in bed without increasing probable vascular complications.

Enterotoxins and toxic shock syndrome toxin–1 (TSST-1) are an important virulence factor of S. aureus. The purpose of this study was to analyze the presence of S. aureus enterotoxin (sea-see) and tst genes in the samples that collected from different sources with PCR method.

During 5 months from 150 collected samples, 80 strains were identified as S. aureus. PCR reaction was used for investigation on the presence of genes for staphylococcal enterotoxins (A-E) and toxic shock syndrome toxin-1 (TSST-1).

Fifty three samples (66.25%) out of 80 samples were positive for one or more ETs and TSST-1 genes. of these positive strains, 17 (32.07%) were positive for sea 39 (73.58%) for seb, 30 (56.6%) for sec, 2 (3.7%) for sed, 21 (39.62%) for see, and 14 (26.41%) for tst. Enterotoxins and tst in 40 samples (75.47%) observed.

In this study, high prevalence of S. aureus, its enterotoxin, and tst genes were observed in clinical samples, food samples, and healthy people. This fact emphasizes on the role of human as original source and carrier of S. aureus. Also, use of PCR reaction for detection of these genes in S. aureus that isolated from various sources is recommended.

Nowadays, internet addiction is known as a psychological disorder in medical science and psychology. Comparing with average users, addicted user's public health are in great danger. This study aims to determine the relationship between internet addiction and student's public health in Qom University of Medical Sciences in 2010 to 2011(1389-1390) academic year. This descriptive study assessed 250 students of Qom university of medical sciences by means of two questionnaires: the General Health Questionnaire (GHQ-28) and addiction internet (IAT). The obtained data were analyzed by using statistical chi-square tests, ANOVA and T test and p<0.05 was considered as the significant level. In this study, 90% were mild addicted users to internet, 9.6% medium addicted users to internet and 4% of users had severe addiction to internet. The most desirable level of general health was observed in mild addicted users (p<0.05). Significant relationship between internet addiction and general health was not observed. Based on this study, it is necessary to consider internet addiction phenomenon as a serious problem to young generation's health and university officials who are responsible for their health should make a plan in educating and culture of using internet.

Hyperthyroidism can occur with pregnancy. Thyroid storm is a life-threatening exacerbation of hyperthyroidism. The mortality rate for thyroid storm remains surprisingly high at approximately 20%.Case Report: A 21-year-old primigravida woman presented at 25 weeks, with severe pre-eclampsia and uncontrolled hyperthyroidism was scheduled for emergency cesarean section. Treatment includes rapid alleviation of thyrotoxicosis and general supportive care.Thyroid function tests may not help in differentiating thyroid storm from symptomatic hyperthyroidism. The major risk of anesthesia in the poorly controlled thyrotoxic patient is thyroid storm, which must be aggressively treated with beta-blockers, iodide, and antithyroid drugs.