مجله دانشگاه علوم پزشکی قم
سال هشتم شماره 6 (پیاپی 36، بهمن و اسفند 1393)

Smoking is a considerable problem in modern populations. Nicotine, as an important noxious material in cigarette, has dangerous effects on different body tissues such as genital system. In this study the noxious effect of nicotine was investigated in rat ovarian follicles by histomorphometry technique. Three groups of mature female rats including control, low-dose nicotine (0.2mg/kg.BW), and high-dose nicotine (0.4mg/kg.BW) were planned. Nicotine was injected through intraperitoneal route for 21 consecutive days. Then, the rats were euthanized by carbon dioxide and immediately their ovaries were removed and fixed in formal saline solution. The specimens were processed through routine paraffin embedding method, serially sectioned by microtome, stained with hematoxylin-Eosin technique and investigated by light microscope. The data were analyzed using one-way ANOVA and Tukey's multiple comparison tests. p<0.05 was considered statistically significant. The results of this study demonstrated that distribution of ovarian follicles in animals receiving either low or high doses of nicotine decreased significantly, whereas distribution of atretic follicles notably increased as compared with the control group. Based on the results of this study, on a dose-related pattern, nicotine could decrease the population of the healthy ovarian follicles, whereas increased the population of the atretic ovarian follicles. This indicates reduction of fertility in affected animals.

Being widespread in all over the world, rotaviruses are known as the leading cause of acute gastroenteritis in forms of epidemic and endemic in infants and young children from 2-24 months of age. Regarding lack of vaccination for this virus, the primary aim of treatment for rotavirus gastroenteritis is replacement of fluids and electrolytes lost by vomiting and diarrhea, but these clinical procedures do not directly affect the rotavirus. The present study was conducted to investigate the antiviral direct effect of Melissa botany extract on reduction of titer and replication of rotavirus under in vitro conditions. In this study, after BSC-1 cell culture and provision of virus seed, the virus titer was determined using Reed-muench method. The extract of the plant was then provided by percolation method. The toxicity of the extracts on BSC-1 cell line and the direct effect of botany extract on viral suspension were examined at the baseline and 1 hour later. The cell was inoculated with virus. In this study, on the first step, Melissa extract in concentration of 200µg/ml did not have toxicity effect on BSC-1 cell line. Also direct antiviral effect of this extract on viral suspension in attachment and penetration phase of rotavirus resulted in reduction of virus titer from 104.49TCID50 to 102.66TCID50. On the second step, the direct effect of botany extract within 1 hour decreased virus titer of 104.49 TCID50 to zero. The results of this study demonstrated that Melissa extract could be very effective in decreasing proliferation of rotaviruses. Therefore, this plant might be effective in treatment of rotavirus gastroenteritis.

Haemophilus influenzae is a bacterium that can act as a pathogen of human respiratory tract. Its infections have been traditionally treated with antibiotics, and then the use of conjugate vaccines has been very successful in prevention of infectious diseases. These vaccines consisted of capsular polysaccharide of H. influenzae with an immunogenic protein. The aim of this study was molecular analysis of oapA gene in Iranian H. influenzae strains as a conserve immunogenic protein for vaccine candidate. Clinical H. influenzae strains were collected from Milad Hospital in Tehran, and cultured on chocolate agar. After diagnostic test, biochemical tests were performed for distinguishing strains biotype. The DNA extracted by boiling method and specific PCR reactions were designed for oapA gene molecular analysis. Finally sequencing of PCR products was performed for confirming our results. The results of PCR exhibited that 79% of clinical samples had 95-99% similarity to NCBI sequences of H. influenzae oapA gene, and the remaining 21% had a 125 nucleotide deletion and 94-96% similarity to NCBI sequences. Also this study showed that all strains having 125 nucleotide deletion (Nontypeable H. influenzae and H. influenzae type b) had 95-99% similarity to NCBI sequences. The results of determining the biotype revealed that the studied strains were related to different biotypes. The results of this study suggested that use of oapA gene protein for production of vaccine against H. influenzae type b be further considered.

Postpartum Perineal Pain (PPP) is one of the most common problems within the puerperium period particularly among the primiparous women. This study aimed to evaluate the effects of dry cupping therapy and acupressure on acupoint BL23 on postpartum perineal pain severity among the primiparous subjects referring to the selected educational center affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. This clinical trial was conducted on 150 cases in 2012. Cupping therapy was done every other day consecutively 4 times taking 15-20 minutes. Besides, acupressure was applied according to the circular model for 20 minutes. Both interventions were performed max. 8 hours after labor. The patients filled out the VAS questionnaire. Then, the data were analyzed using Chi-square tests. The significance level was considered p<0.05. In the cupping group, the mean difference of postpartum perineal pain intensity reached from 9.0±1.4 before the intervention to 4.8±1.6, 2.4±1.6, and 1.3±1.2 immediately, 24 hours, and 2 weeks after the intervention, respectively and the results of repeated measures ANOVA showed a significant difference between the three follow-up periods (p<0.05). On the other hand, this measure reached from 8.5±1.8 before the intervention to 6.6±1.6, 4.6±1.8, and 3.1±1.4 immediately, 24 hours, and 2 weeks after the intervention, respectively in the acupressure group, however, the reduction was not significant (p> 0.05). The results of this study showed that the mentioned techniques led to pain relief. Therefore, given the significant reduction in pain in cupping therapy group, this intervention can be

Epilepsy is the most common neurological disorder after stroke. Despite various anticonvulsants, researches continue to discover new drugs with better efficacy and less side-effects. Various herbs and natural substances with different properties are appropriate fields for such researches. This study investigated the effects of Aloe vera latex on seizure in male mice. Two groups of mice (n=8) and placebo were tested. The control group received Saline and the experimental group received Aloe vera latex (15, 25 and 50mg/kg) and half an hour later PTZ (80mg/kg) was injected intraperitoneally. Immediately after injection of PTZ, seizure threshold and duration of seizure were recorded. Data were analyzed by ANOVA and Tukey's test. p<0.05 was considered statistically significant. The group receiving a 25mg/kg dose of Aloe vera latex showed a significant increase in seizure threshold and a significant decrease in duration of seizure as compared with placebo group receiving saline (p<0.05). The results of this study indicated the anticonvulsant effect of Aloe vera latex.

Early diagnosis of secondary cardiac involvement due to iron overload is very important in thalassemia patients. The aim of this study was to evaluate cardiac systolic and diastolic function by Tei Index in patients with β-thalassemia. This descriptive cross-sectional study was conducted on 64 transfusion dependent major and intermediate β-thalassemia patients referring to Hazrate Masoumeh Hospital from 2012-2013. The relevant parameters measured were as follows: Myocardial performance index (Tei Index), ejection fraction, current ferritin, mean ferritin of past three years, hemoglobin, and the age of starting blood transfusion and chelation therapy. Data were analyzed using Chi-square, Mann-whitney, and Spearman correlation. p<0.05 was considered statistically significant. Three patients (6.2%) with major thalassemia had a mild systolic dysfunction, whereas it was absent in patients with intermediate thalassemia. 43 patients (93.8%) with major thalassemia and 16 patients (100%) with intermediate thalassemia had diastolic dysfunction. In this study a statistically significant correlation was found between the age of starting chelation therapy and diastolic dysfunction. No significant relationship was found between Tei Index and gender, current ferritin, age of starting transfusion, and hemoglobin. According to the results of this study, the earliest sign of cardiac dysfunction due to iron overload in thalassemic patients was diastolic dysfunction. Regarding significant correlation between the age of starting chelation therapy and diastolic dysfunction, it seems that diastolic dysfunction can be delayed by starting chelation therapy in younger ages.

Obesity is known as a public health issue. In addition to common problems, it also affects the mental health. The environmental factors are very effective on mental health among which nutrition and BMI have a critical role. This study was conducted to investigate the relationship between BMI and mental health in Tabriz Assadabadi Health Center. This cross-sectional and analytic study was performed out on 500 people referring to assadabadi health center in Tabriz Assadabadi Health Center. Using a questionnaire, individual, population and community information was obtained from each case including sex, age, weight, height, family size, income, education, and occupation. A 28-item General Health Questionnaire (GHQ) was used for evaluation of mental health. Data were analyzed using Mann–whitney test. This study was performed on 127 men and 373 women, with mean age of 37.92 and 32.85 years, respectively. The BMI of 36.5% of the cases was in normal range, 33.5% of cases were overweight, and 22.9% were obese. Regarding mental health indexes, 51.8% of the subjects were healthy and 48.2% were unhealthy according to GHQ-28. There was a significant statistical relationship between BMI and mental health condition (p= 0.015). The results of this study underlined that body weight could be related to mental health.

Coronary angiography can cause a high degree of anxiety in patients. Regarding the effect of pre-angiography education on the anxiety level of patients, no certain investigation was found considering the effect of video education in native language. The aim of this study was to investigate the effects of video education based on the patient's native language on the anxiety level of coronary angiography candidates. In this quasi-experimental study 160 patients hospitalized for coronary angiography were randomly divided into two groups: control (n =80) and experimental (n =80) in Imam Khomeini Therapeutic and Educational Center of Ardabil. The data were collected using demographic characteristics questionnaire and Spielberger's state trait anxiety inventory (STAI) questionnaire. For the experimental group, an educational film was presented in Turkish language about the necessary actions before, during and after coronary angiography. The control group only received the routine preparations of the ward. The state anxiety levels in both groups before and after the education were measured and compared. Data were analyzed using Chi-square test, independent T-test and paired T-test. p<0.05 was considered statistically significant. In this study, mean of state anxiety in experimental group decreased significantly as compared with control group. Based on the results of this study, multimedia education in native language was effective on reducing the anxiety of coronary angiography candidates. Therefore, it is recommended to use this method to reduce anxiety in patients before invasive procedures.

Labor pain is one of the severe pains women experience during their life. Today various pharmacological and non-pharmacological interventions are used to relieve the labor pain; one of the non-pharmacological relief methods is acupressure. This study was fulfilled to evaluate the effect of ice massage in LI4 point on severity of labor pain in primigravidas. This quasi-experimental study was carried out on 60 primigravidas admitted for delivery in Valiasr Hospital, Zanjan. The cases were primigravidas with single fetus, in the age range of 20-35 years with cervical dilatation of 3-4 centimeters and gestational age of 38-42 weeks. At first, they were selected by simple sampling and then randomly divided into two groups: Case and control. Severity of pain was measured in visual analogue scale (VAS) before and after massage of the left and right hand. The data were analyzed by T test, paired t-test, Chi-square at a significance level of α=0.05. There were no significant statistical differences in age, education, occupation, and severity of pain before intervention between two groups. Intensity of pain decreased significantly after intervention in case group compared to control group (p<0.0001). Ice massage of left hand was more effective than right hand (p<0.001). The results of this study suggested that ice massage could be considered as a safe, effective and noninvasive method of reducing labor pain.

Weaning a patient from mechanical ventilator is a critical step in the process of treatment at CCU which takes a long time of mechanical ventilation. The aim of this study was to determine the relationship between effective respiratory indexes in weaning process and the importance of each index in scuccessful prediction of weaning from the mechanical ventilator. This is a descriptive cross-sectional study in which 251 patients undergoing CABG, aged above 20, with ejection fraction of more than 30% were selected through convenience sampling in Shahid Rajaei Hospital. Respiratory indexes before weaning from mechanical ventilator were recorded. For all the patients undergoing the surgery, under pump and the duration of anesthesia were identical. Data were analyzed using Chi-square, logistic regression, and independent samples T tests. In this study among the effective respiratory indexes in weaning from mechanical ventilator before CABG, peak inspiratory pressure (β=0.9) was the most effective one on predicting weaning consequence. According to the results of this study, respiratory indexes had the highest effect on predicting weaning consequence (β=0.9). Therefore, it is recommended to use this index in determining patient's preparedness for being weaned from mechanical ventilator and predicting weaning consequence as a valuable clinical index.

Healthcare workers (HCWs) are one of the most important jobs in exposure to Needle Stick (NS) and, therefore, are in risk of infection to diseases such as Hepatitis B (HB) and AIDS. The aim of this study was to identify and assess risk of injuries caused by needle and sharps in healthcare personnel of a hospital in Tehran. In this study, hazard analysis method of Healthcare Failure Mode and Effect Analysis (HFMEA) was selected. After several meetings with related experts, by the help of a provided checklist, hazardous processes related to NS injuries were identified and finally assessed by HFMEA method. Potential causes of injuries included recapping, sudden shake of patient organs, lack of personnel, and slip. For most of the causes there were no control measures. Sudden shake of patient's arm and heavy workload were recognized as high risk scores due to unskilled injector. Also for 53% of the studied cases, a score risk of more than 8 was recorded. As the results show, a major portion of potential causes of injuries had a high risk score, that is due to lack of a clear safety program or system to control the risk. Thus hospital manager should consider and control the causes according to the recommendations from risk assessment team. Totally HFMEA is an appropriate technique to analyze hazards related to NS injuries and predict effective measures to reduce related risks.

Primary hyperparathyroidism is a relatively common endocrine disease in which one or more parathyroid glands produce uncontrolled secretion of parathormone (PTH). Case Report: The patient was a 53-year-old woman referring to the emergency department with severe pain and swelling in left foot from one night prior to the admission. Examination of the head and neck, chest and abdomen were normal. Left lower limb had 3+ pitting edema and its size was 3cm greater than the right leg. On color Doppler sonography of the left lower extremity, deep vein thrombosis (DVT) extended to the iliac vein was reported. Abdominal and pelvic ultrasound image showed a hypoechoic area in the uterus and a 40mm cyst in the left kidney. Regarding the presence of hip bone osteolytic lesions, high calcium, and low phosphorus, the patient was suspected of hyperparathyroidism. She was referred to a surgeon and a parathyroid adenoma was seen in the left parathyroid gland. After a week, the patient's calcium level was corrected, PT was in the goal range and she was discharged with good general condition.