مجله دانشگاه علوم پزشکی اراک
سال نوزدهم شماره 9 (پیاپی 114، آذر 1395)

Specific learning disorder is a neurodevelopmental disorder characterized by persistent difficulties in learning academic skills in reading, written expression, or mathematics. This study was performed to investigate the effectiveness of memantine in the relief of cognitive deficits (selective attention, sustained attention, and working memory) in specific learning disorder.
This study is a clinical trial. Of all children 8-12 years referred to Amir Kabir Hospital 94 patients diagnosed with specific learning disorder based on DSMV diagnostic interview referred by specialist and randomly divided by two groups, memantine and placebo. Cognitive deficits before and after treatment were measured with continuous performance test, Stroop test and Wechsler Digit Span forward and reverse and Corsi test.
Multivariate analysis of variance showed a significant difference in error when answering, omission answer and corrected answer in continuous performance test, but this difference is not significant in response time. Difference in forward, reverse and collected auditory was significant and not significant in the auditory span. In active visual working memory at corsi cube test, difference was significant (p The results showed that memantine in improvement of sustained attention, auditory working memory and visual working memory, is effective, while in selective attention is not effective and according to similarities of learning disorder and Attention deficit / Hyperactivity disorder (ADHD) and the effectiveness of memantine in improvement of symptoms of ADHD, we can also use this drug in improvement of cognitive deficits of specific learning disorder.

Recently a myokine named irisin has been discovered that effects on obesity, metabolism and glucose homeostasis through browning white adipose tissue and thermogenesis. However, the effects of type and intensity of exercises on it have remained unclear. The purpose of this study was to evaluate the effects of two acute eccentric and concentric exercises on serum irisin level and insulin resistance in obese sedentary women.
The study was quasi-experimental. 15 female students with a body mass index above 30 kg/m2 and mean age 24.86±2.87 years participated in the study. After measuring the maximal uptake oxygen of participants, they did two acute eccentric and concentric exercises using treadmill in a cross-over design within 10 days. After at least 8 hours- fasting, blood samples were collected before and immediately after each activity, to measure the levels of irisin, glucose and insulin. Data were analyzed using paired t-test and repeated measures ANOVA. In addition, Pearson correlation was used to examine the relationship between variables.
the irisin levels increased significantly after both types of exercises (p However, both eccentric and concentric exercises had no effect on improving insulin resistance in obese women, but they can be considered as a good stimulus for the secretion of Irisin.

Amount of natural background ionizing radiations in environment depends on kind of soil, stones and geographical conditions. Hot springs of Mahallat facilities are annually visited by many tourists. Determination of environmental radioactivity and excess lifetime cancer risk is very important.
In this research, twenty four samples of igneous and travertine rocks from a region (300 hectares) and four water samples of Mahallat hot springs were collected. The specific activities of radionuclides were determined for all samples by using gamma ray spectrometry method and employing high purity germanium detector with 30% relative efficiency.
External and internal hazard indices for igneous rocks, water and two travertine samples varied from 0.00 to 0.71 and for two another travertine samples obtained from 8.17 to 22.50. The average of annual gonadal dose equivalent (AGDE) was determined as 0.36 and 0.20 mSv/y and also the average of excess lifetime cancer risk (ELCR) was calculated as 0.23 × 10-3 and 0.12×10-3 for igneous and travertine rocks, respectively. Maximum acceptable value and world wide average of ELCR are 10-3 and 0.29×10-3, respectively.
The results of this research show that the hazard indices and ELCR for magma region are less than unity and world wide average respectively. Therefore; there is no consequence for people health. So, the radioactivity only around the orifice of hot springs where radium compositions are deposited, is more than maximum acceptable value.

Aromatase is an enzyme converts androstenedione and testosterone to estrone and estradiol, respectively. According to the role of testosterone and zinc in reducing anxiety and the relation between androgenic system function and zinc supplementations, in this research, the effect of zinc chloride injection was analysed in rats which aromatase enzyme was inhibited by aromatase inhibitor (letrozole).
Adult male Wistar rats (weighing 225±25 g) were used. Animals were divided into 12 groups and based on their weight, aromatase inhibitor (letrozole) was injected (subcutaneously), and 30 minutes later, ZnCl2 or its solvent (saline) was injected intra-peritoneal. Control group was received both solvents (DMSO and saline) respectively. Anxiety levels were tested in the elevated plus maze 30 minutes after the last injection, and thereafter, open field was used for measurement of the locomotors activity of animals.
The results showed a significant decrease in the percentage of time spent in open arms in letrozole (1.25 mg/kg) treated group as compared to that of solvent group. The locomotors activity significantly decreased between letrozole (1.25 mg/kg) with the control group. The combined groups received letrozole (2.5 mg/kg) and different amounts of zinc chloride (2.5, 5, 10 mg/kg), significantly reduced (p Totally, the present study suggests that letrozole alone increased anxiety and decreased locomotors activity and could interfere with anxiolytic effect of ZnCl2 as well.

Acute bronchiolitis is the most common lower respiratory tract infection in infant and one of their hospital admission reasons. Due to the high prevalence of the disease and unclear effectiveness of existing treatments, the present study was designed to evaluate the therapeutic effect of single dose of injected dexamethasone and inhaled epinephrine in patients with acute bronchiolitis treated with inhaled salbutamol.
In this double-blinded clinical trial, 90 infants with age of 2-24 months who were admitted to hospital with acute bronchiolitis were studied. All patients received inhaled salbutamol (0.15 mg/kg) and then were randomly assigned to three groups (n=30) of dexamethasone (0.6 mg/kg), inhaled epinephrine (0.15 mg/kg) and control (distillated water). Heart rate (HR) and respiratory rate (RR), arterial blood oxygen saturation (O2 sat) and respiratory distress scores (RDS) of children at baseline, 30, 60,120 minutes and, 24 hours after intervention were recorded and compared between groups.
The mean of HR, RR and RDS had significant improvement and the mean of O2 sat had significant rising trend and improvement during the study in all groups (p Based on the result of present study, it seems that inhaled epinephrine or injected dexamethasone have no superiority to placebo in treating infantile acute bronchiolitis and their administration is not recommended.

Systemic lupus erythematosus (SLE) is an autoimmune disease with broad clinical manifestations, but unclear etiology. Extensive tissue damage occurs due to the production of auto-antibody against nuclear and cytoplasmic antigens. Regarding the involvement of GADD45A gene in cell cycle control, T-cell proliferation suppression, and genome epigenetic regulation, this case-control study was done for the first time to evaluate the association of rs581000 polymorphism in 5’ near gene with the risk of SLE among patients in south of Iran.
This study was performed on 102 patients with SLE in comparison with 118 healthy controls. Genotyping of the GADD45A rs581000 polymorphism was performed using T-ARMS PCR.
The T allele was significantly more frequent in the controls (0.13) than in the patients (0.01) with SLE (p It seems that GADD45A rs581000 polymorphism involved in the SLE pathogenesis.

Client satisfaction as an important indicator to assess the quality of provided services has found a special place over the past few decades. The main purpose of this study is to compare the client satisfaction in the public health posts and outsourced health posts affiliated to Qom university of medical Sciences in 2014.
This was a descriptive analytic (cross- sectional) study.The participants were 216 clients, who had referred to 10 public health posts and outsourced health posts of Qom province. Health posts were selected by cluster sampling from different urban areas and participants were selected by simple sampling methods. A researcher made questionnaire was used to measure the data on a 5-point Likert scale, which it's validity and reliability were confirmed by experts panel and Cronbach's alpha coefficient, respectively. After collection, the data were analyzed by SPSS 20, and descriptive statistical methods, Mann-Whitney test, chi-square, with 0.05 significant level.
Among 60 health posts, 20 health posts (33.33%) were outsourced and 40 (66.66%) were managed by the public sector. Results showed that in health centers outsourced , overall satisfaction of the child care and vaccinations and maternity care were respectively, 64.5 and 55.42 and 67.43 percent and in public health posts were respectively, 35.5 and 44.58 and 37.66 percent and this difference was significant. Client satisfaction in the public health posts of the vaccination (57.1%) compared with client satisfaction in the outsourced health posts (47.2%) was higher, also at public health posts, satisfaction of the scientific skill employees (55.1 percent) assigned to the outsourced health posts (44.9%) was even greater, that this difference was significant.
Results of the present study showed that, there is a significant difference in satisfaction of clients in public health posts and outsourced health posts It seems necessary to pay special attention to employee training programs by managers and also considering the results of client satisfaction in performance appraisal of personnel in health care posts.

Silver nanoparticles are capable of inducing toxicity in living organisms. Silver nanoparticles can induce some effect in the liver. Thus silver nanoparticles, due to their wide spread effects, can also affect on hepatic, hematological, and oxidative stress factors. Ginger because of its powerful antioxidantal compounds can influence the toxicity effects of silver nanoparticles in different parts of the body. The aim of this study was to investigate the protective effect of hydroalchoholic extract of ginger on cytotoxic silver nanoparticles on enzymes, hematological parameters, blood oxidative stress markers, and hepatic apoptosis in Balb-c mice.
In this study, 48 rats of Balb-c race Syrians were selected and devided into 4 groups, each consisting of 12. They were treated for a period of 35 days; the first group (control) received distilled water, the second group received nano silver, the third group received ginger extract, and the fourth group received both nanosilver and ginger extract at the same time. Bleeding was done to measure hematological factors, liver enzymes, and oxidative stress; then liver tissue was removed for evaluation of apoptosis. Data were compared using SPSS software and one-way ANOVA.
Based on the findings the study ,silver nanoparticles with their side effects in different parts of the body can induce changes in various factors and enzymes. Ginger can compensate ,and modify to some extent these side effects. Such effectiveness of ginger can probably be due to its special ingredients.
Enzymes AST , ALT , ALP, GGT and LDH as liver factors showed significant differences in the groups of the study. Hematological factors including of WBC ¡ RBC ¡ Hb ¡ HCT ¡ MCV , MCH , Plt , Lymphocyte and Monocyte showed significant differences in all the groups.
Of oxidative stress factors , only GPX showed significant difference between groups, while no significant difference was observed in other oxidative stress parameters in the blood. Changes in apoptosis showed significant differences in all groups of the study.

Sirtuin-1 regulates important cellular processes, including apoptosis, cellular senescence, and metabolism. Therefore, sirtuin-1 may be a novel therapeutic target for type 2 diabetes. The aim of this study was to investigate the effect of 8 weeks aerobic training on sirtuin-1 level and cardiometabolic parameters in women with type 2 diabetes.
In this semi-experimental study with pretest – posttest design, twenty diabetic women (aged 43.92±5.2 y) were randomly assigned to aerobic training or non-exercising control groups. Aerobic training program was performed 50-60 min/d, 3d/wk, for 2 months. Serum levels of sirtuin-1, body composition and metabolic parameters were assessed before and after the training period. Data were analyzed by paired T test.
Adiposity indices, total cholesterol, triglyceride, LDL- cholesterol,blood glucose and insulin resistance index were significantly reduced in the intervention group compared to the control (p These findings show that aerobic exercise is associated with an improvement in siruin-1 levels and metabolic indices in women with type 2 diabetes.

4cure models are a model to analyze survival data that these models exist for long term survivors. Cure models are a special type of survival model where it is assumed that there are a proportion of subjects who had never event, thus, survival curve will eventually reach a plateau. Therefore, standard survival models are not appropriate because they do not account for the possibility of cure.The aim of the present research is to apply non-mixture cure model to analyze survival of patients with colorectal cancer.
We studied 232 patients with colorectal cancer who were visited and treated at Taleghani Hospital Research Center for Gastroenterology and Liver Disease in Tehran. These patients were diagnosed from 1987 to 2012 and followed up until 2013. The Effect of age, gender, family history, body mass index and site of infection were studied. Kaplan-Meier and Non-Mixture cure Model were used for analzing data.
The ten-year survival rate after diagnosis in the studied patients was 64 % .A total of 60 (25.8 %) deaths due to colorectal cancer were observed. The mean of age at the time of diagnosis was 51.6 years. Based on non-mixed cure model, the rangs of age was 45-65 years old and BMI were significant.
When the population is divided into two groups (susceptible and non- susceptible individuals), using Cox semi-parametric model is not appropriate. Therefore, we should use cure models.

The lymphatic system as a key component in the organism's body can be affected by used drugs. Methylphenidate or Ritalin is widely used for treatment of behavioral disorders in children and some depressed people. This study carried out to examine the immunotoxic effects of Ritalin.
A total of 16 healthy adult female mice were selected and randomly divided into a control and three experimental groups. The experimental groups received Ritalin as 0.5,5 and 50 mg/kg body weight and control groups received distillated water by gavage method for 21 consecutive days. At the end of experiment, the structure and function of the lymphoid organs were evaluated. Results were analyzed by ANOVA and Duncan’s test (p Significant alterations including a reduction in the size and number of lymphoid follicles, increasing in the megakaryocytes numbers as well as spleen capsular thickens were seen following Ritalin administration. The atrophy of the lymph nodes together with significant reduction in the number and size of lymph follicles but an increasing in the parenchyma hyperemia were seen. Also lymphocyte numbers increased while the monocytes numbers decreased (p The consumption of Ritalin could be exerted detrimental effects on the lymphoid organs in the mouse model.