مجله دانشگاه علوم پزشکی شهرکرد
سال نهم شماره 4 (پیاپی 36، زمستان 1386)

Ginger (Zingiber officinale) is used as a cooking spice in the diet in many parts of the world. Recent research has found ginger to have various pharmacological properties due to a variety of active constituents, including shogaols and gingerols. The aim of the present study was to assess the effect of alcohol extract of Zingiber officinale on the fractions of serum protein in mice. In this experimental study, four groups of male adult mice (eight per group) were used. Group one (control) received normal saline, groups two, three, and four were received 10 mg/Kg, 20 mg/Kg and 40 mg/Kg alcohol extract of ginger, respectively every 4 hr. for 20 days interaperitoneally. Blood sample was obtained from ophthalmic sinus of the mouse. The levels of pre-albumin, alpha-1, alpha-2, beta, and gamma globulins were separated electrophoretically and total protein was measured. Then, albumin/ globulins (A/G) ratio was calculated from the pattern of electrophoretogram. Data were analyzed using Toki and Zemon tests. Extract of Zingiber officinale increased significantly levels of albumin and serum total protein in groups 3 (3.7±0.25g/dl) and 4 (3.71±0.37g/dl) compared with the control group (P<0.05). However, the levels of alpha-1, alpha-2, beta and gamma globulins were not significantly different in these groups (P>0.05). Also, A/G ratio in group 3 (2.05±48g/dl) was significantly more than that in the control group (1.37±0.16g/dl) (P<0.05). It seems that without antigenic stimulation, Zingiber had no effect on the synthesis of globulin. Albumin synthesis occurs in the liver cells‚ therefore increasing of albumin synthesis would be a symptom indicating improvement of liver cells activity.

Breast feeding is the best feeding pattern for infants. As a large number of mothers are fasting during the Ramadan, the aim of this study was to determine the impact of maternal Ramadan fasting on growth parameters of the infants whom fed only with maternal breast milk. This cohort study was performed from the beginning of Ramadan till the end of the following month in 1385. A total of 60 infants who fed only with maternal breast milk aged ranging from 15 days to 6 months were selected. Based on their mother fasting, they were divided in two groups of case (27 infants who their mothers were fasting) and control (33 infants who their mothers were not fasting). The growth statue of the infants were evaluated using parameters weight, height, head circumference, during Ramadan and the following month. Using descriptive and analytical statistics, analysis of variance and independent t-tests data were analyzed. The mean age and sex of the infants was the same (P>0.05). Weight, height and head circumference of the infants increased by 21, 7 and 6 percent, respectively during the study (P<0.05). The repeated analysis variance showed that there was no significant difference in increasing of growth parameters between fasting and non-fasting mothers (P>0.05). Ramadan fasting of mothers with exclusively breast-feeding infants did not adversely affect on the growth parameters of their infants.

Peritoneal dialysis (PD) is a form of dialysis which is used mostly in children. Insertion of PD devices catheter needs a sedation and midazolam and fentanyl usually are used for this purpose. In some studies propofol also used as a sedative in renal failure patients, hospitalized in intensive care units (ICU). No study has been conducted so far on comparison of midazolam with propofol in patients. Therefore, this study was aimed to compare the sedative effect of midazolam and propofol in the patients with renal failure, used PD device. In this clinical trial study, a total of 44 patients aged ranged 18-65 years, with physical condition of class III and IV (based on ASA classification) and with chronic renal failure who needed peritoneal dialysis catheter were randomly designated into two groups of 22 individuals. The first group was injected with propofol (50 mg/kg) and fentanyl and the second one with midazolam (50 mg/kg) and fentanyl. Then, using Ramsay score, sedation score and vital markers, before and after the intervention, were evaluated. The required clinical symptoms were obtained using an appropriate questionnaire and using Man-Whitney and t test, the data were analyzed. According to the results of this study propofol induced a higher sedation level than that of midazolam (P<0.001). There was no significant difference in O2 saturation between the two groups. Blood pressure and pulse rate in the group received propofol were (P<0.001) decreased whereas in the group received midazolam were increased (P<0.05). The mean of pain, based on visual analog scale (VAS), in the groups received propofol and midazolam was 2.68±0.49 and 3.64±0.4, respectively (P<0.05). Durations of recovery in the groups received propofol and midazolam were 25.86±2.98 and 31.68±3.12, respectively (P<0.01). Based on the results, the patients received propofol had more relief and less pain than those received midazolam. Thus, propofol is suggested to be used in the patients with renal failure who need PD catheterization.

Labor pain is the most severe pain that most of women experience it. Using novel and supportive methods of relieving labor pains such as massage therapy, labor could be a pleasant and enjoyable experience. This study was conducted to determine the effect of massage therapy on the severity of labor pain in primiparous women. In this clinical trial study a total of 60 primiparous women who were hospitalized in Mahdieh and Hedayat hospitals of Tehran were selected using simple random sampling and randomly divided into two groups of control and case (massage therapy). The severity of pain before intervention (at the beginning of active phase) in the 4, 8, and 10 cm cervical dilation was measured in both groups by means of a Visual Analogue Scale (VAS). Duration of the first and the second and type of delivery in both groups were investigated. Data in the two groups were compared using independent t and Chai-square tests. Before intervention, the results indicated that there was no significant difference between the two groups. Mean of severity of pain (at the beginning of the active phase) was 5.88±1.07 and 6.75±1.39 in the case the control, respectively (P<0.01). At the beginning of transitional phase, it was 7.09±0.89 and 8.54±1.06 (P<0.05) and at the end of the first stage was 9.16± and 9.73, respectively (P<0.05). The duration of the first stage of the delivery in the case and control was 246.16±98.82 and 362.50±111.84, respectively. Regarding the effect of massage therapy in both decreasing of labor pain and in the acceleration of delivery, education and then using of the method in labor centers would result in decreasing of proposed caesarean sections.

Fear of death, lack of knowledge and fear of treatment and its complications, lack of assurance of recovery, possibility of occurrence of problems in their family are predisposing factors in occurrence and intensity of psychological reactions such as stress, anxiety and depression in the women with breast cancer. Therefore, this study was carried out to determine the effect of designed exercise program on stress, anxiety and depression in women with breast cancer receiving chemotherapy. This quasi–experimental study was conducted on a total of 56 women with breast cancer receiving chemotherapy, refereed to Imam Khomeini hospital of Tehran in 2006. Using DASS-21 and demographic questionnaires, data were collected. The patients in experimental group used the designed exercise program at home for 20 to 30 minutes every day, for 3 to 5 days per week for 9 weeks (3 cycles of chemotherapy). In control group, the routine helps were conducted. All patients were followed up. Data were analyzed using X2 and t test. There was no significant difference between the two groups in the cases of demographic characteristics, cancer stage, and method of surgery. Also, there was no significant difference between the two groups in the cases of stress, anxiety, and depression, before intervention. However, following intervention, the mean of stress, in the case and control groups were 7.25±4.42 and 10.82±5.46 for anxiety were 4.07±2.72 and 7.07±4.8, was and for depression were 3.82±8.83 and 7.32±5.12, respectively (P<0.01). Based on the results, the designed exercise program was effective to reduce stress, anxiety and depression in women with breast cancer receiving chemotherapy in this research.

Classic open incision is used usually in surgical release of carpal tunnel syndrome, but its complications are painful scar and delayed rehabilitation. The other method used, short palmar incision seems to have fewer complication and easier rehabilitation. Therefore, the aim of this study was to compare the efficacy and complications of these two surgical methods. In this clinical trial, the patients candidate for surgery were randomly divided in two groups of 51. One group was operated with classic incision and the other was operated with short palmar incision. The rate of Infection, surgical scar, tenderness and pain in incision, paresthesia and numbness, Tinnel test, Phallen test and recovery of sensory symptom postoperatively in the two groups in 3 weeks and 3 months after the operation were registrated and compared using Fisher, X2 and t-student tests. In the case of wound infection and damage to median nerve and its palmar branch no difference was seen in the two groups. Tenderness at the incision site in the case and control groups was 7.8% and 58.8% at the third week and was 2% and 47.1% in the third month, respectively (P<0.05). The mean of pain intensity in the case and control groups was 1.64±0.22% and 2.04±0.23% at the third week (P<0.001) and was 1.28±0.14% and 1.39±0.18% in the third month, respectively (P>0.05). There were no significant differences between the two groups in the cases of the amount of paresthesia, numbness and recovery of sensory symptoms. Regarding the similar effectiveness in both classic and short palmar incision and less post-operation complication of the later method, this method is recommended for surgical release of median nerve of wrist.

Measles is an acute and highly contagious viral disease and although its morbidity remarkably decreased, it is still common in children of developing countries and is a main cause of mortality in children. The purpose of this study was to determine measles immunity in new-born infants and infants with 6 months age from Yasouj. This longitudinal study was conducted in 2004-2005. A consent form was filled in by children’s parents and subsequently 3 ml of maternal and cord blood was collected from a total of 94 full-term pregnant women and their neonates who attended the labor ward of Emam Sajad hospital, Yasouj, to test using ELISA. Anti-Measles antibody was tested for 77 of the newborns. Data were analyzed using t, X2, Fisher and Correlation tests. 43.9 % of the mothers and 48.9% of the newborns were immune to measles at the time of delivery, but only 10.4% of infants were immune at the age of 6 months (P<0.001). There was a significant relationship between mothers` antibody titer and their newborn (P<0.001). There was a significant difference in the level of measles immunity between the mothers and the newborns (P<0.05). Birth-weight, sex, birth order, place of mother’s residence and mother age had no significant effect on measles immunity of the infants. Regarding the low immunity level of the neonates at the birth time and at the 6 month age, postpone of beginning of vaccination against measles is not good idea and it may increase the risk of the disease in the children under one year.

Dysfunctional attitude may be predispose factor for depression, but there are few investigations for that. The aim of this study was to determine contributions of dysfunctional attitude and general health index based on GHQ-28 to depression. In this description and analytical study, a total of 65 patients with major depression and dythymic disorder from Noor and Navab-Safavi psychiatry clinics and 65 healthy individuals with age and sex, and education matched were randomly selected. Dysfunctional attitude scale and general health questionnaire were filled in by two groups. Data were analyzed using linear and logistic regression and correlation methods. Logistic regression analysis on categorized scores of DAS- 26 as high and low risk revealed that odds ration for high risk group was 6.89 fold than low risk one (OR=6.82, Cl/95, 2.9-16.06). Two point serial correlation between DAS-26 and psychiatrist diagnosis was 0.44. Also, major depression and dysthymic disorder was significantly predicted by general health subscales (P<0.001). Dysfunctional attitude may be a predisposing risk factor of depression. Predict depression support and Becks cognitive diathesis stress theory of depression that dysfunctional attitude (26 options) can be used for determination of depression in this group.

Nowadays obesity is assumed as a global health problem and its prevalence increased in recent decade. It is known as a risk factor for several diseases such as diabetes mellitus, hyperlipidemia, cardiovascular disease and cancer. This study was undertaken to evaluate the obesity and overweight in Bam students 330 students (140 male and 190 female) with mean age of 21.78±2.61 were selected from Bam educational centers in stratified sampling. Weight and height were measured without shoes and unneeded cloths. Weight and height were measured using a standard protocol and body mass index (kg/m²) was calculated. The criteria used to define body composition were based on BMI cut-off points of the WHO expert committee. The results shows the mean and SD BMI were 21.082±3.216 overall, and 22.08±3.08, 21.59±3.31, respectively, in male and female students. 14.1% of students were underweight, 70.9% normal weight, 12.1% overweight and 2.1% obese. 12.7% of females and 13.8% of males had visceral obesity. A significant relation between family history of obesity and BMI is seen (P<0.05). As results show some of female and male students are in a degree of overweight and obesity, therefore launching nutritional services and life style modification program are recommended..

Bacground and Although considerable progress has been made in the treatment of chronic kidney disease, compromised quality of life continues to be a significant problem for patients receiving hemodialysis (HD). However, in spite of the high prevalence of sleep complaints and disorders in this population, the relationship between these problems and quality of life of patients on dialysis is not known in Iran. Therefore, this study was aimed to investigate correlation between quality of sleep and quality of life (HRQoL) and some of blood factors in hemodialysis patients. This descriptive and analytical study was accomplished on 85 of hemodialysis patients in 1383-84. The samples were chosen on the basis of a non-randomized sampling selected from the educational hospitals of Iran and Tehran medical science universities. Quality of sleep was measured using the Pittsburgh Sleep Quality Index (PSQI) and HRQoL was measured using the Medical Outcomes Study 36-item Short Form (SF-36). Data were analyzed using 2, two-tailed Fishers exact, Mann–Whitney, and Spearman correlation coefficient tests.. Sixty-three (71%) of the patients were ‘poor sleepers (global PSQI>5). The SF-36 mental component summary (MCS) and physical component summary (PCS) correlated inversely with the global PSQI score (P<0. 05). The PCS score also correlated with age (P<0. 05, hemoglobin (P<0. 05). Global PSQI score correlated inversely with hemoglobin, serum albumin, mental component summary (MCS) and physical component summary (PCS) (P<0. 05). Subjects with global PSQI>5 had a lower hemoglobin and lower HRQoL in all SF-36 domains (P<0. 05). Poor sleep is one of the common problems in these patients and causes low HRQoL. Low level of hemoglobin and albumin result in decreasing of quality of life and quality of sleep. Regulation of hemoglobin, albumin, and other blood factors in patients can lead to better sleep and thus increasing of quality of life in them.

Increasing of life span affects on the life quality and the ability of each individual to live independently with requirement of others supporting and thus, use of adequate programming to encounter the situation in aging seems to be necessary. Therefore, this study was aimed to investigate the effect of reminiscence therapy on elderly life quality. In this interventional study, a total of 64 elderly referred to retirement center in Shahrekord city during 1358 were selected using random sampling and were divided randomly in two groups of case and control groups. Subsequently, each of the two groups were divided into 8-individual groups. Reminiscence meetings and group meetings were run for experimental and control group, respectively for eight sessions (one hour and a half, each). Quality of life of the individuals before and after the intervention was evaluated using lipid life quality questionnaires. Data were analyzed using Chi-square and paired t tests.. There was no significant difference in educational level, marriage, age, income and life quality dimension between the two groups. Mean of life quality in the case group, pre and post intervention, was 48.26±1.01 and 62.07±1.02, respectively (p<0.05). Also, in this group, mean of post intervention (compared with pre intervention) life quality in the cases of physical activity, depression and anxiety, cognitive activity, social and life satisfaction dimension was increased (p<0/05). However, pre and post intervention, there was no significant difference in the cases of self care dimension in experimental group and in total life quality dimension in control group. Based on the results, group reminiscence is effective on elderly life quality. Therefore, this technique can be used easily and inexpensively at home or elderly nursing homes.

Unsuccessful intubations is important cause of anesthetic-related maternal mortality. Therefore, the purpose of this study was to determine the ability to predict difficult visualization of the larynx (DVL) from the following preoperative airway predictive indices: modified Mallampati test (MMT), the ratio of height to thyromental distance (RHTMD), and the upper- Lip-Bite test (ULBT). This prospective and double-blind study was conducted on the patients undergone elective cesarean section under general anesthesia requiring endotracheal intubations. RHTMD, MMT and ULBT tests were used for them prior to the operation. An experienced anesthesiologist, not apprised of the recorded preoperative airway assessment, performed the laryngoscopy and grading (as per Cormack and Lehane’s classification). Then, sensitivity, specificity, positive and negative predictive value, and false negative value for each airway predictor in isolation and in combination were determined. T and Mann Whitney tests were used for comparing of demographic data and comparing among the tests, respectively. Difficult laryngoscopy (Grade 3 or 4) was observed in 35 patients (8.75%). RHTMD had a higher sensitivity, positive predictive value, and fewer false negatives than the other variables tested. A RHTMD=21.24 provided the best cutoff point for predicting subsequent difficult laryngoscopy. The odds ratio (95% confidence interval) of the RHTMD, Mallampati class, and ULBT were 7.8 (1.21-21.21), 2.1 (1.11–5.60), and 1.5 (0.6-4.1), respectively. The RHTMD may prove a useful screening test for predicting difficult laryngoscopy in obstetric population.

Both the pregnant and breast feeding women are of the groups who are predisposed to iron deficiency anemia (IDA). Although there is a regular program about consumption of ferrous sulfate tablet by these women, about 67 percent of them do not use their tablet regularly. Therefore, this study was aimed to investigate the reasons for irregular use of ferrous sulfate tablet in women referred to health centers in bourojen city. In this descriptive and analytical study which conducted in health centers of boroujen in 1384-85, 270 pregnant women with 16th week of pregnancy to two mounts after delivery were selected and interviewed. A questionnaire, including their demographic information, tablet consumption, attitude and behavior was filled in. Data were analyzed using Chai-square, Mann Whitney, Wilkakson, and Cruscal-Valis. The results showed that %33.1 of the women used their tablet regularly, %56.8 of them consumed it irregularly and %10.2 did not take it at al. There was no relationship between regular consumption of the tablet and familial level of socio-economical statues. Some of the reasons for irregular consumption of this tablets were forgetting of time interval of consumption (48.4%), nausea and vomiting during pregnancy (%12.4), and lack of knowledge and attitude toward necessity of consumption (%16.4). There were no significant relationship between number of delivery or pregnancy and age, employment, knowledge and attitude of the women (P<0.05). Our results showed that in mothers increasing knowledge and information by educational methods such as class and booklet, intermittent consumption of tablet can decrease forgotten dose of tablet and improve level of information.