مجله دانشگاه علوم پزشکی سبزوار
سال بیست و سوم شماره 5 (پیاپی 88، آذر و دی 1395)

Backgrounds Muscle cramp is a local, tangible, and involuntary spasm that usually involves the calf skeletal muscle; it is also one of the most common symptoms, particularly in the 3rd trimester of pregnancy. The current study aimed at determining the prevalence of leg cramps in the 3rd trimester of pregnancy and its relationship with nutritional behavior and consumption of supplements.
Methods & Materials The current cross sectional study was conducted on 439 pregnant females referred to Tabriz health care centers, Iran, from 2013 to 2014; the subjects were randomly selected from all pregnant females referred to the health care centers. Data were collected by a 4-part questionnaire including sociodemographic, obstetric characteristics, nutritional behavior of sub-health promotion lifestyle questionnaire (HPLP-2), and information about the features of leg cramps. Data were analyzed by descriptive and analytical statistics including independent t, Pearson correlation, and Chi-square tests.
Results According to the results of the current study, 57.9% of the participants developed leg cramps in the 3rd trimester of pregnancy. The mean ± standard deviation (SD) of the cramp numbers per week was 6.0±178.17, length of leg cramps 40.2±178.1 minutes, and severity of leg cramps 6.0±2.6. There was no significant correlation between the characteristics of leg cramps in pregnancy including number, length, severity, mean score of nutritional behavior, and consumption of supplements.
Conclusion Leg cramp is a common side effect in the 3rd trimester of pregnancy. It is the best to perform clinical trials to prevent and treat leg cramps during pregnancy.

Backgrounds Breast cancer is the most common cancer in females worldwide. Phosphatidylinositol 3-kinases (PI3Ks) evolve from lipid kinase that regulates the diverse cellular signaling pathways and are often altered in human cancers. Mutations in the gene encoding the p110α catalytic subunit PI3K (PIK3CA) can increase the enzyme activity and cause uncontrolled growth in cells. Previous studies indicated high frequency of mutation in PIK3CA gene in breast cancer. The current study aimed at determining the activating mutations of PI3K gene that can treat breast cancer using kinase activity of the enzyme inhibitors.
Methods & Materials In the current study, due to the high rate of breast cancer in Markazi province, mutations of PIK3CA gene in 45 patient samples and 20 controls were investigated by the means of single-strand conformational polymorphism (SSCP) and direct DNA sequencing. In addition, the correlation between PIK3CA mutations and clinicopathological factors including age at diagnosis, lymph node metastases, subtype histology, tumor size, and histological grade were investigated by the Pearson Chisquare (X2) test.
Results Among the 26.6% PIK3CA gene mutations in the study, 75% were identified in the exon 9; and accordingly, in addition to hotspot mutation [G1624A (E542K)], another mutation [G1634C (E545A)] was also detected. The current study showed no significant correlation between PIK3CA mutations and clinicopathological factors.
Conclusion Mutations in PI3K gene, a proto-oncogene, showed the importance of this pathway for therapeutic purposes to prevent and cease the growth of breast cancer

Backgrounds The current study aimed at investigating the antimicrobial effects of Vulgaris thymus ethanol extract on the important human pathogens.
Methods & Materials The thymus alcoholic extract was provided based on a standard protocol. The following standard bacteria were also provided: Streptococcus pyogenes ATCC 19615, Streptococcus pneumoniae ATCC 49619, S. saprophyticus ATCC15305, Hafnia alvei ATCC 51873, Acinetobacter baumannii ATCC 19606, Enterococcus faecalis ATCC 29212, Proteus mirabilis ATCC 35659, Serratia marcescens ATCC 274, Staphylococcus aureus ATCC 25923.
The minimum inhibitory concentration (MIC) of thymus ethanol extract on the bacteria was determined. The linear sensitivity of the bacteria against some antibiotics was also measured by the standard method of Kirby-Bauer disk diffusion.
Results The results showed that the thymus leaf alcoholic extract inhibited the bacterial growth in the evaluated concentrations. The MIC of 6/25 ppm was observed effective against S. pneumoniae, H. alvei, P. mirabilis, and S. marcescens.
Conclusion The results of the current study indicated the high effect of thymus alcoholic extract on the pathogenic bacteria. However, the medicinal application of plants requires further investigations.

Backgrounds Drug resistance in zoonotic bacterial pathogens is a serious risk, which threatens the prosperity and profitability of livestock industry and also public health. To confront this threat, it is necessary to determine and use novel antibacterial compounds on the resistant bacteria. Thiazole and imidazole derivatives are the novel antibacterial agents; the current study aimed at assessing the antibacterial effect of 1 thiazole derivative and 2 imidazole derivatives on Rhodococcus equi, Brucella abortus, and Pasteurella multocida.
Methods & Materials To investigate the antibacterial effect of selected antibiotics, the disk diffusion method was used and the diameter of growth inhibition zone was also measured; the serial dilution method in micro-plates was also employed to assess the minimum inhibitory concentrations (MICs).
Results The results showed that none of the thiazole and imidazole derivatives had inhibitory effect on B. aabortus. Imidazole derivatives also lacked any inhibitory clue on the tested bacteria. The inhibitory effect was only observed in the thiazole derivative with MICs of 128 and 16 µg/mL, and growth inhibition zone diameter of 19.3±0.2 and 28.1±0.3 mm on R. equi and P. multocida, respectively.
Conclusion The inhibitory effect of thiazole derivative was observed on R. equi and P. multocidawas. This antibiotic also showed more inhibitory effects on P. multocida.

Backgrounds Health care members are among the groups at high risk of infection due to direct contact with patients. Therefore, the current study aimed at determining the level of hepatitis B virus antibody (HBsAb) among health care members in Zabol, Iran.
Methods & Materials The current cross sectional study was carried out on a total of 72 blood samples obtained from health care members in autumn 2013. Serum samples were tested by the enzyme-linked immunosorbent assay (ELISA) to assess antibody level. Data were expressed using frequency distribution, and central and dispersion indicators by SPSS version 18. Chi-square and t test were used to analyze data.
Results Overall, 37 (51.8%) subjects showed high immune response of >100 uml/mL HBsAb, while 14 (19.4%) subjects had the mild immune response of 10 to 100 uml/mL HBsAb. There was a significant relationship between the last dose of vaccine and high immune response among the study participants (PConclusion In conclusion, age and the last dose of vaccine should be considered significantly in monitoring the level of immune response against HBV. The study also suggested that the immune response of health care members should be checked regularly every 5 years. Accordingly, a booster dose of vaccination against HBV should be offered if necessary.

Objectives Constipation is a predominant gastrointestinal problem after the onset of stroke, which may increase intracranial pressure. Treatment of constipation includes using laxatives and fibers, which is associated with complications and limitations. Regarding the effect of probiotics to treat digestive problems, the current study aimed at investigating the effect of probiotics on constipation in the patients with stroke admitted to Intensive Care Unit (ICU).
Methods The current randomized clinical trial was conducted on 65 patients with stroke. Patients with nasal-gastric tube and absence of rejection in 3 consecutive days were enrolled to the study. They were randomly divided into 2 groups of intervention (n=33) and control (n=32); the frequency of their bowel movements were measured before the study. Subjects in the intervention group received a probiotic supplement every 12 hours; however, the ones in the control group received the only routine conventional treatment for a week. After a week, all subjects were assessed for the improvement of constipation. Data were analyzed by SAS software version 9.1 using Poisson regression model.
Results In the intervention group, the mean number of bowel movements was more than once a day, 1.22, and in the control group it was 0.62 (PConclusion The current study showed that probiotic supplement consumption increased the frequency of constipation in patients with stroke. Therefore, probiotics can be used to treat constipation in such patients.

Objectives Appendicitis is the most common and important emergency condition, in which most of the patients undergo appendectomy. The diagnosis of appendicitis is critical and the values of diagnostic laboratory tests are always discussed. The current study aimed at determining the diagnostic value of C-Reactive Protein (CRP) increase in the diagnosis of acute appendicitis.
Methods The current cross sectional study examined 105 individuals referred to the emergency department of Shahid Motahari Hospital, Marvdasht, Iran, in 1012. Before the administration of any preoperational antibiotics, blood samples were obtained from the subjects to measure the serum CRP level. After surgery, the relationship among serum levels of CRP and appendix tissue biopsy, and the surgeon`s comments about the type of tissue were investigated. All data were analyzed by SPSS version 18, employing ANOVA and Tukey test.
Results A total of 81 patients had acute appendicitis, out of which 24 had normal appendix. Among patients with acute appendicitis, 65 subjects showed increased serum CRP level and 16 subjects had normal serum CRP level. The sensitivity and specificity of CRP level in the study were 80% and 63%, respectively.
Conclusion The results showed that evaluation of serum CRP levels can be useful and beneficial to diagnose acute appendicitis.

Objectives Insomnia is one of the common disorders whose relationship with depression and anxiety is widely discussed. The current study aimed at investigating the epidemiology of insomnia and its relationship with depression and anxiety among male prisoners.
Methods In the current study, 110 male prisoners were selected through the convenient sampling method. To collect data, Pittsburgh sleep quality index, Beck depression inventory, and Beck anxiety inventory were used. Data were analyzed using multiple regression analysis and Pearson correlation coefficient.
Results Depression and anxiety had a significant relationship with insomnia (PConclusion Given the high prevalence of insomnia among prisoners and its relationship with depression and anxiety, it seems necessary to provide psychological services to decrease insomnia and its underlying factors.

Objectives Cognitive control problems and deficiencies highlight the need for new therapeutic methods in adolescents with Post-Traumatic Stress Disorder (PTSD). The current study aimed at investigating the effect of emotional working memory training on the cognitive control of adolescents with PTSD.
Methods Available sampling method was employed to select 5 adolescents (2 males and 3 females) with PTSD diagnosed based on the structured clinical interview for the Diagnostic and Statistical Manual of mental disorders (DSM) (SCID-I), and the impact of event scale from 1 of the child care centers in Karaj, Iran. Selected subjects were under a 20-session training for emotional dual n-back working memory. All subjects were assessed during 3 stages pre-training, in training, and follow-up by go/no-go task. Variance analysis (repeated measures) and Bonferroni test were used to analyze the data.
Results Results of the repeated measure ANOVA indicated that the emotional working memory training results showed increase in the ability of participants in cognitive control, the reaction time of correct response in go/no-go task from pretest (M=402) to post test (M=121/60), and then, the follow-up (113/80) (PConclusion Based on the results of the current study, emotional working memory training was an appropriate method to increase cognitive control in adolescents with PTSD. Therefore, it is suggested to conduct further similar studies by this training method on other clinical groups with larger sample size.

Objectives Brain processing parameters during anesthesia result in induction of anesthesia with a low-dose of hypnotic drugs and reduce postoperative nausea and vomiting. The current study aimed at determining the relationship between the depth of anesthesia, and nausea and vomiting after the general anesthesia in patients undergoing elective abdominal surgery.
Methods In the current descriptive, analytical study, 57 patients candidate for elective herniorrhaphy were selected by the convenient sampling method in Beheshti Hospital, Sabzevar, Iran, in summer 2014. Depth of anesthesia was monitored by bispectral index (BIS) and recorded at 5-minute intervals during the maintenance period. The postoperative nausea and vomiting scores were recorded in the recovery and 6 hours after operation. Data were analyzed using appropriate statistical tests by SPSS software version 18; P>0.05 was considered significant.
Results A total of 57 patients with the mean ± standard deviation (SD) age of 45.54±13.46 years were studied, out of which 36 were male and 21 female. There was no significant difference between the amounts of anesthetic depth and severity of nausea and vomiting in patients during recovery (P=0.179).
In the first 6 hours after surgery, there were significant differences between the values of depth of anesthesia and postoperative nausea and vomiting (P=0.003).
Conclusion Monitoring and maintaining the depth of anesthesia reduced side effects such as nausea and vomiting after surgery.

Objectives Based on the significant progress made on the field of membrane technology, the application of this technology has rapidly increased. The current study aimed at assessing the physicochemical and microbial quality of the desalinated water provided by the private sector (Esin) in Saveh, Iran. The results of the current study were compared with the guidelines of Institute of Standards and Industrial Research of Iran (ISIRI).
Methods A finite time service was studied based on a total of 15 samples a day. The period of study was about 7 months from 2014 to 2015. Physical and chemical tests were performed according to the standard methods of water and wastewater. Total coliform bacteria and fecal coliform tests were conducted by multiple tube fermentation method and the total number of heterotrophic bacteria was investigated by the pour plate method.
Results Results showed the values of physical parameters as turbidity 0.10 (nephelometric turbidity units) NTU, chemical parameters as electrical conductivity (μs/cm), total hardness, calcium (CaCO3) hardness, magnesium hardness, alkalinity, calcium, magnesium, fluoride, phosphate, nitrate, nitrite, sulfate, potassium, sodium, chloride, and residual chlorine (mg/L), and pH were 476, 103.06,78.89, 9.80, 76.42, 37.28, 2.45, 0.11, 0.10, 8.3, 0.003, 37.71, 0.37, 68.23, 62.19, 0.74, and 7.60, respectively. Values of microbial parameters were total coliform 0, fecal coliform 0, manufacturer part number (MPN)/100 mL, and heterotrophic plate count (HPC) 2.5 CFU/mL.
Conclusion The obtained results indicated that the quality of desalinated water provided from the water desalination plant of Saveh is approved and no health threatening factor was found. The concentration of measured parameters in the study was satisfactory and acceptable, based on IRISI guidelines.

Objectives In recent years, researchers tried to find new compounds with herbal origins to treat and prevent diseases. The current study aimed at investigating the antioxidant and anti-inflammatory effects of Melilotus officinalis and Fraxinus excelsior alcoholic extracts, commonly used in traditional medicines.
Methods After preparing the ethanolic extracts of M. officinalis and F. excelsior by the maceration method, the antioxidant properties were investigated by the cupric ion reducing assay (cupric assay) and the anti-inflammatory effects were also investigated through the prevention test of bovine serum albumin (BSA) and its transformation potential.
Results The obtained results showed that both mentioned plants had antioxidant and anti-inflammatory effects. The antioxidant properties changed based on the concentration of extracts, and antioxidant and anti-inflammatory properties increased along with the concentration increase. The highest amount of phenolic compound in F. excelsior was 0.04 mg/g of dry extract; this plant also showed the highest antioxidant effect (0.714±0.045). The highest amount of flavonoid compounds in M. officinalis was 9.23 mg; this plant showed the highest anti-inflammatory effects (0.21±0.033 ).
Conclusion The employed screening methods were useful to find biological components with different properties.