مجله دانشگاه علوم پزشکی اراک
سال چهاردهم شماره 5 (پیاپی 58، آذر و دی 1390)

HIV-1 and HCV are two of the most important blood-borne infectious agents. Hence, reliable, precise, and sensitive detection of these viruses in infected patients and donated blood units is highly important. Noticing the limitations of serological assays in detection of these infectious agents, this study was to use fast and sensitive molecular assays like real-time PCR. In this trial, a home-brewed SYBR green-based multiplex real time PCR, on the basis of melting curve analysis, was developed for the single or simultaneous detection of HCV and HIV-1 infections in plasma samples. Data were analyzed using SPSS software version 16. The results obtained from different reactions on several clinical samples showed that the analytical sensitivities of the developed assay for HIV-1 and HCV were 200 and 100 copies/ml, respectively. It was also shown that the primers designed for each virus had no interaction with each other and other interfering agents. Noticing the good level of sensitivity and specificity, easy handling, relatively low cost, and rapid analysis of samples, this method can be a useful and rapid approach for simple and effective detection of HCV and HIV-1 in plasma samples.

Noise-induced hearing loss is a noticeable clinical issue. The aim of this study was to evaluate the effect of N-Acetylcysteine on the reduction of permanent noise-induced hearing loss in workers at Hepco Company. In this clinical trial, in a one-month period from October to November, 118 male 22-52 year-old workers with at least 5 years of experience working in places with permanent high tone noise (more than 850db) were selected and divided to experimental and control groups. The experimental group received Fluimucil (NAC) and the control group received vitamin B1. Hearing ability of the two groups was evaluated through audiometry after the one-month period. In the control group, hearing loss was significant and it was in direct relationship with age and job experiment. The placebo (vitamin B1) did not have any significant effects on preventing hearing loss. In the experimental group, there was significant hearing loss in higher frequencies and at 6000, a relative improvement was observed, whereas with increases in age and job experience hearing loss became more significant which was rather low in comparison with the control group. The findings of this study shows that using N-Acetylcysteine has significant effects on NIHL (high tone loss) in higher frequencies. This study can be used as the basis for launching future studies on reducing the damages induced by noise.

Physalis Alkekengi is a perennial plant with a creeping and ryzumy stem belonging to the solanaceae family. This study investigates the possible effects of Physalis Alkekengi on plasma concentrations of some biochemical factors. Fifty male Wistar rats weighing an average of 190 ± 5 g were divided into five groups of ten: Control group without receiving any substances, control group with 2.0 ml/dl administration of the solvent, and three experimental groups receiving 0.4 (maximum), 0.2 (medium), and 0.1 (minimum) g/kg intra-peritoneal (IP) injections of the drug. The intra-peritoneal (IP) injection of the drug was done for 14 days and after this period, for conducting lab tests, blood sampling was done and the results were analyzed through ANOVA and Tukey test. According to the results, protein and albumin plasma concentrations showed a significant increase (P<0.05) while creatinine plasma concentration, bilirubin, and urea nitrogen (BUN) did not reveal any significant changes. This family of plants contains significant amounts of glucocorticoids, such compounds are likely to increase liver and plasma proteins. In addition, due to the presence of compounds, such as physaline, vitamin C, and albumin, this extract is likely to increase blood pressure and, eventually, increase glomerulic refinement and diuretic properties; therefore, the absence of significant increases in plasma concentrations of the substances produced by metabolism in plasma seems reasonable.

Morphine is one of the derivations of opium alkaloids. Contradictory reports exist on hyperglycemic and hypoglycemic effects of morphine. The aim of this study was to evaluate the role of opioid receptors involved in blood glucose changes in morphine-treated Balb/c mice. This experimental study was carried out on 8 groups of male Balb/c mice (n=6), including group1(morphine), group 2 (naloxone (morphine antagonist) + morphine), group 3 (naltrindole (receptor antagonist) + morphine), group 4 (norbinaltorphimine (receptor antagonist) + morphine), group 5 (CTOP (receptor antagonist) + morphine), group 6 (saline), group 7 (saline + saline), and group 8 (saline + morphine). Blood samples were obtained from retro-orbital sinus at 0, 1, 2, and 3 hours after injection. Blood glucose level was measured by enzymatic technique. Data were analyzed by SPSS software. The application of morphine resulted in significant hypoglycemia in comparison with the control group which was significantly compensated by naloxone compared to the morphine group. The application of naltrindole could significantly inhibit hypoglycemia induced by morphine compared to the control group, whereas norbinaltorphimine and CTOP failed to do so. Since naltrindole could compensate for hypoglycemia due to morphine, hypoglycemia caused by morphine is likely to be mediated by opioid receptors.

Cardiac rehabilitation is one of the essential components of caring in cardiac patients both in hospital and community. Therefore, this study was carried out to determine the effects of cardiac rehabilitation program on the quality of life in patients with myocardial infarction.

This clinical trial was conducted on two groups (experimental and control). Thirty patients with myocardial infarction at Heart Center Hospital of Sari were randomly assigned to each group. The experimental group participated in the Home-based Cardiac Rehabilitation Program (3 visits at home in weeks 4, 8, and 12); however, the control group did not receive any intervention. Data were collected via demographic data and SF-36 quality of life questionnaires and patients’ home-based health behaviors checklist. Data analysis was done by Chi Square, ANOVA and Mann-Whitney tests using SPSS software version 16.

The two groups were homogenous in terms of demographic characteristics. The patients’ quality of life increased in the experimental group in physical and mental dimensions and in total before and after the intervention (P<0.001). In addition, the comparison of the quality of life showed a significant difference between experimental and control groups (P<0.001).

Cardiac Rehabilitation Program at home can improve the quality of life in these patients; therefore, its implementation is recommended.

Diabetic nephropathy is one of the most common causes of end stage renal diseases. The aim of this study was to evaluate the antioxidant, anti-diabetic, and anti-inflammatory roles of rosmarinic acid in inhibition of diabetic nephropathy. In this experimental study, 40 male rats were uninephrectomized from the left flank. The rats were randomly divided into four groups of ten: Group1 (control), group 2 (control) including untreated diabetic rats, and groups 3 and 4 (treatment groups) that received rosmarinic acid 100 and 200 mg/kg, respectively. Diabetes was induced in groups 2, 3, and 4 by subcutaneous injection of alloxan. After 8 weeks, serum malondialdehyde was measured. Kidney paraffin sections were prepared and stained by periodic acid Schiff method. Glomerular, intraglomerular mesangial, and glomerular capillary volumes were estimated by stereological methods. Data were analyzed by SPSS 13 software and Man-Whitney nonparametric test. The level of serum malondialdehyde in treatment groups was maintained at the level of control group. Glomerular hypertrophy, mesangial expansion, and reduction of glomerular capillary volume in groups treated by rosmarinic acid were significantly inhibited compared with the untreated diabetic group, but the levels of these variables were significantly different from that of the control group. Rosmarinic acid significantly ameliorates glomerular hypertrophy, mesangial expansion, and glomerullar capillary volume in diabetic rats.

The effects of acute and chronic exercises on insulin resistance index may be related to one or more factors, including morphological changes and hormonal modifications. The purpose of this study was to investigate the effects of a single session of resistance training on adiponectin levels and insulin resistance until 24 hours post-exercise. This experimental study, which followed a pretest-posttest design, was conducted on a group of 10 healthy male volunteers (23±1.4 years) with no history of participation in any regular exercise programs, weight changes more than 2 kg, special diseases, and smoking over the past 6 months that had normal body mass index (BMI) (23.7±1.6 kg.m-2). The subjects performed a single session resistance training (3 sets of 10 repetitions at 75% of 1 repetition maximum). Adiponectin, glucose, insulin, and insulin resistance index levels were measured before and 24 hours after the exercise. There were no significant differences for adiponectin (μ g.ml-1) pre- (6.98±1.9) and post-exercise (8.07±1.4) and glucose (mg.dl-1) pre- (81.3±7.6) and post-exercise (80.7±6.4). However, insulin resistance index pre- (1.34±0.27) and post-exercise (1.06±0.11) and insulin concentration (UΙμ.ml-1) pre-(6.64±0.88) and post-exercise (5.37±0.43) decreased significantly 24 hours post-exercise (P<0.05). Based on the findings of this study, it can be suggested that a single session of resistance training with no significant changes in adiponectin level can have positive effects on glycemic indices in sedentary men.

This study was done to assess the validity and reliability of Najmie Job Satisfaction Questionnaire (NJSQ) in order to provide a suitable tool for measuring job satisfaction (JS). In this cross-sectional study, 212 staff members at Najime Subspecialty Hospital were selected by stratified sampling method. The participants took NJSQ. After evaluating content validity, confirmatory and explanatory factor analysis and Cronbach's Alpha were used to examine construct validity and reliability of the questionnaire, respectively. SPSS software version 16 was used to analyze the data. The samples, 212 subjects, consisted of 181 (86.6%) women and 28 (13.4%) men. The explanatory factor analysis showed 4 factors with 54% total variance and 0.82% Kaser-Meyer-Olkin index. These factors were also verified by confirmatory factor analysis (P=0.368). In addition, the reliability of the questionnaire was reported to be 0.88% based on Cronbach's alpha method. Since validity and reliability indexes were reported suitable, NJSQ can be considered a valid and reliable questionnaire for measuring JS.

Self-medication is one of the existing problems in the treatment cycle of patients that with aging and increased drug use, its side effects increase. The purpose of this study was to assess the factors influencing self-medication among elderly urban centers in Zarandieh based on Health Belief Model

This descriptive cross-sectional study was conducted on 180 elderly individuals (95 females and 85 males) over 60 in Zarandieh. Data collection tools were a questionnaire designed based on HBM model (perceived susceptibility/ severity, and perceived benefits/barriers) and self-medication checklist.

The prevalence of self- medication in the elderly was 31% (33% women and 29% men). The most common reasons for self-medication were previous experience of the disease and its recognition (61%), availability of drugs (60.5%), and good result of their previous treatment (56.7%). There was a significant difference in awareness, sensitivity, severity, perceived benefits and barriers among people with or without self-medication history (P< 001).

Noticing the side effects of drugs and the high prevalence of self-medication among elderly, designing educational programs for changing the awareness and beliefs of elderly regarding self-medication is recommended.

Different studies have shown that vitamin D may play a functional role in insulin secretion and sensitivity. This study evaluates the effect of vitamin D on insulin resistance. This clinical trial was done on 100 patients with type II diabetes mellitus that aged 30-70 years. The patients were randomly selected and different examinations were done on them. They received 50000 units of oral vitamin D daily for four weeks. Insulin resistance was measured before and after the intervention. Data analysis was done by paired t-test and Wilcoxon test using SPSS software version 17. The participants consisted of 70 women and 30 men. Mean vitamin D was 43.03±19.28 ng/ml and 24% of the participants were vitamin D deficient based on the cut-off 25(OH) D <20 ng/ml. At the beginning and the end of the study, the mean levels for FPG, insulin, HOMA-IR were 138.48±36.74 and 131.02±39 mg/dl (P=0.05), 10.76±9.46 and 8.6±8.25 µIu/ml (P= 0.02), and 3.57±3.18 and 2.89±3.28 (P= 0.008), respectively. The findings of this study showed that vitamin D causes significant improvements in FPG, insulin, and insulin resistance, that was evaluated by HOMA-IR. It was also indicated that adding vitamin D supplements can improve glucose control in type II diabetes mellitus.

From an administrational point of view, patient satisfaction with healthcare, diagnosis, and rehabilitation services is highly important. The present study was done to evaluate the satisfaction of patients referring to the emergency departments of hospitals in Arak. This study was a descriptive-analytic, cross-sectional one which was carried out using a questionnaire. The collected data were analyzed by SPSS software and the related tests. Overall, over the first period, 72.9% of the patients were satisfied with the services, whereas this level of satisfaction reached 73.3% in the second period. By comparison, levels of satisfaction with the physical environment (86.2%), health condition (85.9%), speed and accuracy of care provider (69.6%), the quality of information provision (23.1%), behavior of guards and staff (60.2%), facilities (60.1%), drug availability (66.4%), discharge and costs (51.6%), and consideration of religious issues (86.6%) in the emergency departments over the first period reached 87.4%, 84.1%, 69.7%, 25.6%, 61.7%,67.9%, 50.9%, and 88.1%, respectively over the second period. The findings of this study showed that patients’ satisfaction with emergency departments’ services was reasonable. The greatest dissatisfaction was related to costs, drugs, procedural problems, method of treatment, facilities, wait time, and insufficient information provision.

To date, several drugs have been proposed for the treatment of acute promyelocytic leukemia (APL); however, none of them has resulted in complete remission. Therefore, many efforts are in progress to find new drugs with the capability of inducing apoptosis. Recently, anti-carcinogenic effects have been reported for a drug named carbenoxolone (CBX) on several cell lines. In the present study, the effects of CBX on NB4 cell line, as an experimental model of APL, were examined.

In this trial, NB4 cell line was cultured and treated with different concentrations of CBX (50-250µM) in various time intervals (12-48 hours). Trypan blue exclusion test was used to evaluate growth inhibitory and viability effects of the drug on NB4 cell line. Fluorescent microscopy (acridine orange/ethidium bromide double-staining) and agarose gel electrophoresis DNA were used to study apoptosis.

CBX induced growth inhibition of NB4 cells so that growth inhibition rates of NB4 cells, after the 48 hour of treatment with 50, 100, 150, 200, and 250 µM CBX were 32.65, 47.52, 60.73, 68.91, and 74.33%, respectively. Furthermore, the results of DNA fragmentation and fluorescent microscopy assays indicated that apoptosis is a major mode of cell death after treatment of NB4 cells with above concentrations of CBX.

Noticing the growth inhibitory and apoptotic effects of CBX on human promyelocytic leukemia NB4 cells, it can be considered as a potential candidate for further studies on APL treatment.

Breast cancer is one of the most common cancers in women worldwide and one of its most desirable treatments is tamoxifen. The reported side effect associated with tamoxifen is endometrial thickness and increased risk of endometrial cancer. The aim of this study was to assess the influence of tamoxifen on the endometrial thickness in amenorrhea breast cancer patients treated with tamoxifen. This descriptive-analytic, cross-sectional study was conducted in Radiotherapy Departments of Mashhad University of Medical Sciences over a period of seven years.162 patients treated with tamoxifen whose bleeding cycle had been disrupted were selected and the relationship between tamoxifen usage and endometrial thickness was investigated in them. In addition, the relationship between abnormal vaginal bleeding and the ultra sonographic findings was assessed. Data analysis was done by using t-test and Chi-square test. There was a significant relationship between tamoxifen usage and abnormal endometrial thickness while the greatest relationship was observed in the first year of treatment. The relationship between abnormal vaginal bleeding and abnormal endometrial sonographic findings was significant (P=0.001). The incidence of endometrial cancer in tamoxifen users was more than general population (0.61% vs. 0.1%). Considering the findings of this study, in the presence of abnormal sonographic and clinical observations indicating abnormal vaginal bleeding, pathological evaluation of the endometrial biopsy should be carried out for patients who use tamoxifen.

Transitional cell carcinoma is the most common bladder tumor that can be treated by surgery, BCG instillation, chemotherapy, and radiotherapy. This study deals with urethral squamous cell carcinoma (SCC) in a patient with history of transurethral resection (TUR-T) of bladder transitional cell carcinoma treated by BCG instillation. Case: A 68-year-old man was admitted with gross hematuria, lateral prostatic lobe kissing, and a pedunculated 2×3mm mass in bladder in cystoscopy. He had undergone TUR-T and BCG instillation and had been followed regularly every 3 months with cystoscopy. In the follow up, 9 months later, several pedunculated tumors in penile urethra that were of SCC type were indicated in pathological analysis. : Since membranous urethra is the most common site and TCC is the most common type of urethral cancers in this site, SCC in penile urethra was unexpected. This could be because of chronic inflammation due to treatment and cystoscopic follow ups.