مجله دانشگاه علوم پزشکی قم
سال هفتم شماره 4 (پیاپی 28، مهر و آبان 1392)

Iberogast with commercial name of STW 5 is a well known herbal drug, which contains stable components of hydroethanolic extract from 9 different herbal drugs. This study was carried out with the purpose of assessing the protective effects of STW 5 in different doses on the hepatic histopathological damages induced by experimental cecal ligation and puncture (CLP) model in septic rats. In this experimental study, 36 rats were divided into six groups (six rats in each group): Sham-operated (SOP); CLP group; CLP+STW 5 (received doses of 2.5, 5, and 10mg/kgBW) as treatment groups; and CLP+Indomethacin (10mg/kgBW) as positive control. The herbal drug STW 5 and Indomethacin were injected ip, immediately after sepsis induction. After 24 hour, the rats were sacrificed and the liver tissue was qualitatively and quantitatively examined in terms of histological changes. The differences between the data were determined by one-way ANOVA and post hoc Tukey’s HSD and the significant levels were defined as p<0.05. The findings indicated that increased level of infiltrated and/or sequestrated polymorphonuclear neutrophils (PMNs) and also, elevated level of histological index of the severity of liver injuries in the CLP group were not improved after treatment with Iberogast. Considering the results of this study, ip injection of STW 5 immediately after sepsis induction had no effect on the modulation of histological parameters related to liver damages in CLP rat model.

Human amniotic membrane due to its unique characteristics, has many applications various fields of medicine and tissue engineering. One of these characteristics is antibacterial property, which can be important in protection against infections after burn and surgery. This study was designed aiming at investigating the antibacterial effect of amnion on the growth of different bacterial strains and comparing this effect in epithelial and mesenchymal sides of the amnion. In this study, the antibacterial effect of amniotic membrane was evaluated on three standard bacterial strains Escherichia coli ATCC 25922, Staphylococcus aureus ATCC 25923, Pseudomonas aeruginosa ATCC 27853 and two clinical isolated strain of E. coli (E. coli T3 and E. coli T4), and their susceptibility was measured. A modified disk diffusion test was used to assess the antibacterial effect. In this method, amnion was placed on the cultured agar surface as an antibiotic releasing disk. Statistical analysis was performed using analysis of variance and Tukey's tests. The vicinity of amnion membrane caused inhibition zone against Pseudomonas aeruginosa ATCC 27853 and two clinical isolated strains of E. coli. Formation of Inhibition zone in Pseudomonas aeruginosa ATCC 27853 and two clinical isolated strains of E. coli had no relationship with the epithelial or mesenchymal side of amniotic membrane. According to the results of this study, it seems that the type of bacterial strain has a role in the antibacterial effect of amnion membrane. In addition, both sides of amnion (epithelial and mesenchymal) may have similar antibacterial effect.

Dilatation of cervix is essential in case of dilatation, curettage, and hysterectomy. Complications encountered during the procedure are partly related to difficulty in cervical dilatation. Also, It is important to find materials which can facilitate passage through the cervix. The present study was done with the objective of evaluating the effect of vaginal misoprostol on cervical priming in patients who are candidate for dilatation and curettage. This study was performed as a randomized clinical trial on 60 women who were candidate for dilatation and curettage. In 30 patients (case group), misoprostol 200µg (one tablet) was inserted into posterior fornix of vagina 4 hours before operation, whereas in other 30 patients (control group), placebo was used. Then, two groups were compared in terms of their need to use Hegar dilator thinner than number 5 for dilatation of cervix, the duration of operation, and curettage. Data were analyzed using descriptive statistics, chi-square test, and t-test. The confidence coefficient was 95%, and the significance level was considered p<0.05. There was no significant difference between the patients of two groups in age, parity and previous mode of delivery. Hegar dilator thinner than number 5 for dilatation of cervix was used in 4 patients (13/3%) of the case group and 11 persons (36/7%) of the control group (p<0/05). The mean duration of dilatation and curettage was 8.9+1.9 minutes in the control group and 5.6+1.39 minutes in the case group, that was significantly different (p<0.05). According to the results of this study, vaginal misoprostol can be a suitable drug for cervical priming before dilatation and curettage; it also facilitates dilatation of cervix.

Use of medicinal plants in treating diabetes is of particular clinical importance. This study was carried out with the aim of assessing the effect of aqueous extract of berberis integerrima on testosterone level and changes of testicular tissue in diabetic rats.

In this study, 40 male rats were divided into 5 groups as follows: 1- Control group (N), 2- Normal +barberry (N+B), group 3- Diabetic group (D) received Stereptozotocine (65 mg/kg bw, i.p.), 4- Diabetic+barberry group, 5- Diabetic+glibenclamide (0.6 mg/kg bw) group. The treatment groups daily received Barberry root extract (500 mg/kg bw) or glibenclamide intra gastric by gavage for 6 weeks, and the experimental period for each rat were 6 weeks. After finishing the treatment period, the animals were anesthetized and their testes were removed and transferred to 10% formalin. After fixing the samples, tissue sectioning, and staining by H & E technique, histological studies were performed by an optical microscope. The one-way analysis of variance (ANOVA) followed by Tukey’s post-hoc test was used for analysis of the data. The Statistical significance level was considered p<0.05.

In this study, diabetes caused a significant decrease in testosterone level, diameter of seminiferous tubules, spermiogenesis coefficient, thickness of the epithelium, significant increases in interstitial tissue thickness and blood glucose in diabetic group compared to other groups. Administration of barberry root extract in diabetic rats restored these changes towards normal level.

The results of this study showed that aqueous extract of Berberis Integerrima root has a desirable effect on the testosterone level, blood glucose, and histological changes of testes during the course of diabetes.

Pseudomonas aeruginosa is one of important causes of nosocomial infections that is an important medical problem in developed and developing countries. Resistance of this gram-negative organism towards various antibiotics, particularly beta-lactam and carbapenem has been reported increasingly. This study was done aiming at determining antibiotic resistance pattern and the frequency of extended-spectrum beta-lactamase in clinically isolated P. aeruginosa strains.

In this cross-sectional study, 108 P. aeruginosa strains were collected from medical centers of Arak city. Antibiotic susceptibility of the isolated strains to antibiotics, such as, ceftazidime, imipenem, meropenem, ciprofloxacin, amikacin, and gentamicin was determined using disk diffusion method (Kirby-Bauer). Identification of ESBL producing strains was performed by combined disk method. Also, MIC test was done on 36 isolates with four antibiotics including imipenem, ceftazidime, cefipime, and ciprofloxacin.

Among the 108 isolates of P. aeruginosa, resistances to ceftazidime (33.3%), imipenem (22.2%), meropenem (24%), amikacin (20.3%), ciprofloxacin (15.7%) and gentamicin (19.4%) were obtained. In the MIC test, the rates of resistance to antibiotic were respectively reported 15, 20, 10, and 15%. Thirty-two strains out of 36 ceftazidime resistant strains (88.8%), were detected ESBL-positive.

The results of this study are indicative of a high level resistance against different antibiotics of among P. aeruginosa isolates. Therefore, it is necessary to use a more appropriate treatment protocols.

Crimean-Congo Hemorrhagic fever (CCHF) is an acute viral febrile hemorrhagic disease that is common between human and animal. This study was performed with the aim of determining epidemiological status of CCHF in Qom province. This descriptive study was done on patients with clinical signs or with an epidemiological history of CCHF, who were referred to hospitals, health centers, and private clinics during 2011. Then, based on guideline of the National Technical Committee of the Ministry of Health, patients were classified into three groups of suspected, probable and confirmed. The data were analyzed by frequency table, chi-square test, and Fisher’s exact test. p<0.05 considered as significant. Twelve out of 38 patients, after diagnosis were placed in the suspected to CCHF group, went under follow-up and treatment. Among them, 5 cases (41.67%) were confirmed, 2 cases (16.67%) were probable, and 5 cases (41.67%) were suspected (only had some symptoms). The majority of patients were male (91.76%) with the age range of 15-30 (83.34%), and resident in urban areas (75%). 58.34% of the whole patients were farmers, students, or butchers. 83.34% of patients reported a history of contact with animals, and the mortality rate of confirmed cases was 20%. According to the results of this study, training of people at risk, and doing safety measures, such as keeping fresh meat in the refrigerator for 24 hours and using gloves while household cleaning fresh meat are necessary.

Studies have indicated that serum level of tumor markers is influenced by several factors. This study was carried out aimed at evaluating the effects of smoke of waterpipe and immobilization stress and on the serum level of CEA in female rats.

In this study, 20 female Wistar rats were randomly divided into four groups of 5 each: 1- control group; 2 waterpipe smoke receiving group; 3- under immobilization; 4- waterpipe smoke receiving and immobilized. Waterpipe smoke was given 10 times a day during 10-min periods with 5-min resting time, and chronic immobilization was performed for 2 periods of 2 h daily with 2 h resting time between the periods, and. After 7 weeks, blood samples were collected using cardiac puncture technique, and then, serum level of CEA was measured by radioimmunoassay technique. The data were compared between groups by analysis of variance at p=0.001 significance level.

The serum level of CEA significantly increased in waterpipe smoking and also immobilized rats as well as rats under both intervention compared to the control group (p<0.001). Also, there was a significant difference in serum CEA level between waterpipe smoking and immobilized rats (p<0.001). On the other hand, there was significant difference in CEA level in rats under both interventions and the two latter groups (p<0.001).

The findings of this study revealed that waterpipe smoking and immobilization stress can cause a sharp increase in the serum level of CEA.

It is necessary to study employees’ empowerment components to realize the empowerment process and enhance the organization's capacity to make empowerment atmosphere. Employee's viewpoints and attitudes affect organizational decision making and also their cooperation, partnership, and job satisfaction. Current research was done to study the empowerment components of the employees of the hospitals of Medical University of Qom in year 2011. This study was done using descriptive cross-sectional method on 365 employees of the hospitals of Qom University of Medical Sciences. The samples were equally selected from the hospitals using a stratified random method. The research tool was a questionnaire consisting of 15 closed-answer questions plus demographic characteristics. Data analysis was done using descriptive and analytical statistics. Independent t-test and analysis of variance was used to determine the intergroup differences. The amount of the hospital employees’ empowerment components with a mean of 3.89 was in good condition. Also, the employee's attitude toward this category was different. There was a significant difference between men and women's attitude toward job meaningfulness. There was no significant association between psychological empowerment indices and age, academic discipline, education level, and the type of unit or ward's activity with confidence interval of 95% (p>0.05). There was also a statistically significant association between employee's work experience and the component of sense of effectiveness. According to the results of this study, the amount of empowerment components in the employees of hospitals of the Qom University of Medical Sciences was in acceptable level. Therefore, it is suggested that university managers pay more attention to employee's capabilities for assigning more responsibilities to them, and make much effort by their programming to make an empowerment atmosphere, so that their high empowerment level will be their strength point.

In Recent years, recording of the H-reflex recruitment curve for assessment of the excitability of group Ia afferent monosynaptic reflex has been growing. The purpose of this study was to evaluate the reliability of H-reflex recruitment curve parameters of gasterosoleus muscle in the assessment of motor neuron pool excitability.

In this descriptive study, 50 non-athlete healthy volunteers were assessed. Percutaneously, 40 electrical pulses of 1 millisecond duration and 3 stimulations per each stimulus intensity were induced on tibial nerves and H-reflex recruitment curve were recorded in 4 phases. Also, each person was assessed in two sessions with 1-week interval.

The intraclass correlation coefficients)ICCs(was obtained between 0.97-0.99 for inter-session reliability of intensity for recording the threshold, HMax and HLast reflexes, amplitude of HMax, and the total slope of the ascending and descending arms. The inter-session correlation coefficient (test-retest) of these variables were obtained between 0.91-0.95 for soleus muscle, and the inter-session ICCs for peak-to-peak amplitude of HMax and the total slope of the ascending arm of gastrocnemius were obtained 0.65 and 0.67. The slope of initial and final three points of the ascending arm revealed a different reliability in inter-session and intra-session reliability analysis (0.64-0.96).

The reliability analysis showed a high inter-session and intra-session ICCs for the functional principal components of soleus recruitment curve. Also, recruitment curve parameters, such as intensity for record of threshold and HMax of soleus and lateral gastrocnemius muscles as well as total slope of ascending and descending arms, and peak to peak amplitude of HMax of soleus muscle had a very high Reliability.

Health is an important component of active old age, and an old age without disabilities, and along with physical and mental health and active participation in social activities can be known as successful old age. Economic, social, and psychological components as well as cultural factors, such as positive social relationships affect health status. This study aimed to determine the health status of elderly in Qom city. In this descriptive cross-sectional study, 300 elderly were selected by systematic-cluster sampling from Qom city in 2011. The study tool was health related quality of life questionnaire for the elderly. The collected data were analyzed using descriptive statistics, t-test, analysis of variance, Kruskal-Wallis, and multiple linear stepwise regression tests. Significance level of tests was considered less than 0. 05. Mean and standard deviation of the total score of health-related quality of life of elderly was 0. 83±0. 12. Sleep (0. 76) and vitality (0. 75) domains had the lowest mean score, and domains of speaking (0. 94) and mental status (0. 93) had the highest mean score. Also, health-related quality of life had a significant correlation with age, marital status, education, economic statu,، source of income,، occupation of men, and chronic disease (p<0. 05), but had no significant correlation with gender and occupation of women (p>0. 05). The results of this study showed that due to poor mental health compared to the physical condition in elderly, their mental health should be evaluated along with their physical health, and also factors related to health status, such as personal characteristics, sources of support, and leisure time activities.

Streptococcus pneumoniae accounts for bacterial meningitis and is an important cause of morbidity among children and elderly. Control of this disease depends on rapid detection of the causative bacteria. The methods for detection of Streptococcus pneumoniae are gram staining, culture, and serological tests. These tests are time consuming and are limited by antimicrobial agents leading to false negative results. Currently, molecular methods such as PCR are used routinely for detection of infectious organisms. This study was performed with the aim of designing an improved PCR assay for the detection of Streptococcus pneumoniae. The specific diagnostic primers were designed based on ply gene of the bacterium. After amplifying the target gene on the genomic DNA, the PCR product was cloned in pTZ57R/T plasmid and the confirmed pTZ-ply plasmid was used as positive control in next experiments. Sensitivity of the assay was determined by performing the PCR on 10-fold serial dilutions of pTZ-ply. Specificity of the assay was determined using the genomic DNA of other related or unrelated bacterial species. The PCR, as expected, generated a 727bp amplicon. No PCR amplification was observed on the genome of negative controls. These findings indicate high specificity of the PCR. The lowest limit of detection of the assay in the detection of the ply gene was 250 copies in a 25µl reaction. The high sensitivity, specificity, and rapidity of the designed assay suggested the assay as an appropriate test for use in clinical laboratories. The further evaluation of the assay using clinical samples or artificially contaminated materials will confirm the application of this assay in clinical settings.

Aassessment of patient readiness for weaning from mechanical ventilation is an important of phase in the weaning process. The aim of this study was to determine the effect of the nurse-directed patient readiness assessment for weaning on duration of mechanical ventilation in the intensive care unit. In this clinical trial study, 50 intensive care units patients who needed mechanical ventilation for more than 48 hours were selected using convenient sampling method, and randomly divided into two 25-person groups. Burn’s weaning readiness assessment questionnaire were used for intervention group, and the control group were weaned from the system according to routine method of the unit. The findings were analyzed with the aid of descriptive statistical methods, independent t-tests, chi-square and Pearson’s correlation. Significance level was considered to be 0.05. The mean duration of mechanical ventilation in the intervention group was significantly lower than that of the control group (p<0.03). Also, there was a significant inverse relationship between Burn’s checklist scores and the duration of mechanical ventilation (p<0.04, r=-0.263). The results of this study showed that assessment of the patient’s readiness for weaning from mechanical ventilation by nurse is a safe method in day time and shortens the duration of mechanical ventilation in intensive care units compared to the routine methods.

Herbal medicine as a type of complementary medicine has long been used by different societies. The studies of the last two decades have indicated the growing use of drug plants in the world, sometimes without consulting a physician and with no knowledge about their side-effects. This study was done with the aim of determining the status of use of drug plants and its related factors in Qom city.

This descriptive cross-sectional study was done on 372 people of Qom city in 2012, using convenience sampling. The data were collected through a questionnaire that its validity and reliability had been confirmed. The data were analyzed via frequency tables, chi 2, Mann-Whitney and Fisher’s tests. Significance level was considered p<0.05.

In this study, 35.48% and 11.55% of participants had used drug plants for treatment and prevention, respectively. The most cases of consumption belonged to abdominal pain (48.4%), cold (42.2%) and sore throat (35.8%), and the most used plants were mint (72.3%), Sisymbrium irio (65.1%) and cinnamon (62.9%). The most important reason of use of drug plants were fewer side-effects (51.1%) and better results (39.9%) compared to chemical medicine. Among studied variables, a statistically significant relationship was observed between gender and the amount of using drug plants (p=0.01).

Concerning the results of this study, the most reason of using drug plants was their fewer side-effects compared to chemical drugs. So, it is necessary to give accurate information, at the society level, about their side-effects and possible interactions.