نشریه ارمغان دانش
سال بیست و چهارم شماره 5 (پیاپی 136، آذر و دی 1398)

Shivering is one of the complications after spinal anesthesia. There are different ways to control it. Therefore, the aim of this study was to determine the efficacy of two different doses of ketamine and midazolam in preventing shivering after spinal anesthesia.

The present study was a double blind clinical trial. The study population consisted of 120 patients undergoing spinal anesthesia surgery referred to Alzahra Hospital during 2016-2017. Patients were randomly divided into three groups of A, B and C, group A was received 0.02 mg / kg midazolam at low dose with 0.3 mg / kg of ketamine.  Group B was received 0.04 mg / kg midazolam at normal dose with 0.15 mg / kg of Ketamine at low dose and group C received normal saline in equal volume before surgery. Demographic data, severity of shivering, and need for analgesics were evaluated. Data were analyzed using one-way ANOVA, independent t-test, Kruskal-Wallis, Friedman, Wilcoxon tests.

The mean arterial blood pressure was significantly lower in group A after intervention than in group B and C. The intensity of shivering in group C was significantly higher than the other two groups (p<0.05). No significant difference was seen between groups B and C based on shivering intensity (p<0.05). Also recovery time in group B was significantly longer than group A and C (p<0.05).

Ccombination of both midazolam and ketamine are suitable for reducing shivering, but the use of low dose midazolam plus ketamine seems to be better than low dose ketamine plus midazolam in terms of hemodynamic stability and shorter recovery time.

The prevalence of pain in nursing home residents is 72%, which causes loneliness, depression and disability. Medication in the elderly is not recommended because of its risks. Laughter therapy is one of the complementary therapies that uses the distraction technique. Therefore, the present study aimed to determine the effect of laughter therapy on the severity and pain areas of the elderly.

The present clinical trial study was conducted on 55 elderly people in two similar nursing homes in Mashhad in 2016. Sampling was done according to inclusion criteria and random allocation in two intervention groups (28). (N = 27) and control (n = 27). Pain severity was measured by a modified German Short Pain Questionnaire before and after the first and six sessions, and pain areas were measured before the first session and after the sixth session of laughter therapy in both groups. Laughter therapy was performed for 6 weeks, a sixty-minute session per week. Data were analyzed using Mann-Whitney, Friedman and T-test and McNemar tests.

The mean age of the participants was 73.9 ± 5.1 years. Pain intensity was homogeneous in both groups before intervention (p=0.965), but after each session it was significantly much less in the intervention group compared to the control (p<0.001). The number of pain areas after 6 sessions was significantly lower in the intervention group (p=0.005). No significant difference was seen in the frequency of pain in the two groups after 6 sessions (p<0.05), but in the intervention group the number of people with headache decreased after the sixth session, but this difference was not statistically significant (p=0.7).

Laughter therapy can be effective in reducing the severity and number of pain areas in the elderly. It is recommended that respected welfare and rehabilitation authorities use laughter therapy as an uncomplicated, inexpensive way to promote the general health of the elderly.

Polycystic ovary syndrome is one of the most important endocrine disorders affecting about 5-10% of women in reproductive age. Some herbs are able to prevent or inhibit the development of syndrome. The aim of this study was to determine and effect of hydroalcoholic extract Zizyphus jujube L. fruit's in rats with polycystic ovary syndrome.

In the present experimental study, 42 immature female Wistar rats, aged 3-4 weeks, weighing 50-70 g were obtained from the Animal Husbandry Center of Hamadan University of Medical Sciences. The rats were randomly divided into seven equal groups; Treated with metformin and treatment 1, 2 and 3 were randomly divided. Control group received 0.5 ml of normal saline intraperitoneally. The control group received 250 mg / kg testosterone enanthate dissolved in sesame oil in a subcutaneous injection in the back of the neck. The sham group received 0.5 ml of sesame oil in subcutaneous injection. The metformin-treated group received 250 mg / kg subcutaneous testosterone enantate plus metformin 500 mg / kg by gavage. Treatment groups 1 and 2 received 250 mg / kg testosterone enantate and jujube hydroalcoholic extract at doses of 400 and 800 mg / kg, respectively, for one month. Treatment group 3 received testosterone enantate for 4 weeks and after 4 weeks, they received intraperitoneal injection of jujube extract at a dose of 800 mg / kg for one week. At the end of the experiments, the animals were first anesthetized with ether and tissue samples of the ovaries were prepared for histological examination and H&E staining. Collected data were analyzed using one-way ANOVA, Kruskal-Wallis, Kolmogorov-Smirnov and Tukey post hoc tests.

The results of the present study indicated that testosterone enanthate produced polycystic follicle in rat's ovary. A significant decrease was seen in polycystic ovary in treatment groups with ZHE compared with the witness group (P<0.001).

Zizyphus jujube L is likely improved the polycystic ovary syndrome due to its specific chemicals and compounds such as ascorbic acid, flavonoids, vitamins A and C and calcium

Previous studies have shown that cerium oxide nanoparticles (CeO2-NPs) have high pharmacological capacity due to their antioxidant and anti-inflammatory properties. Rheumatoid arthritis is a chronic and systemic autoimmune disease of unknown etiology. The aim of this study was to determine and effect of cerium oxide nanoparticles in rheumatoid arthritis model.

In the present experimental study, 40 Wistar rats weighing 90 to 110 g were collected from the laboratory animal center of the Faculty of Veterinary Medicine, Urmia University. Rats were randomly divided into four equal groups of healthy, RA affected and treated with Serium Oxide Nanoparticles(30 mg/kg oral, daily) and treated with Methotrexate(1 mg/kg oral, weekly). Rheumatoid arthritis was induced by Freund's complete adjuvant injection(0.1ml). Treatment was started when the rats exposed inflammatory symptoms in the tharsus joint (day 8) and continued until day 28 of the rats’ slaughter. Data were analyzed using one-way ANOVA and Tukey tests.

Cerium oxide nanoparticles had a good anti-inflammatory effect to reduce the severity of foot-pad inflammation in a pattern similar to methotrexate (p=0.27). The level of neutral red uptake in the peripheral blood phagocytic cell population and the blood level of myeloperoxidase in the treated and cerium oxide groups were 0.76 0 0.08 and 10.39 ± 1.99 mmol / ml, respectively. Significantly lower levels were observed in the methotrexate group (0.98 0 0.07 and 19.2 2 2.59 mmol / ml) (p<0.05). Conversely, blood levels of nitric oxide in the methotrexate treated and recipient group (137.81±12.18 μM)) exhibited a greater decrease than that of the cerium oxide nanoparticles (165.9 13 13.29 mmol). / 0> p). There was no significant difference in severity of respiratory burst (p = 0.09) and CRP (p=0.13) in both treatment groups. Most importantly, unlike methotrexate, the intensity of lymphocyte proliferation in rats with arthritis treated with cerium oxide did not decrease significantly (p=0.13).

Due to the improved clinical and experimental appearance of affected rats, it seemed that, treatment with CeO2-NPs is a promising strategy to improve the inflammation in a rat model of RA.

Tissue engineering identifies degraded tissue components and provides rational solutions to improve and perform them. One of these approaches is to fabricate a mixed scaffold with polysaccharide and synthetic antioxidants for stem cells to be cultured inside. The aim of this study was to evaluate the potency of poly caprolactan-chitosan-tannic acid scaffold for proliferation of fibroblast cells.

In the present experimental study, polycaprolactane, chitosan powder and tannic acid scaffold were prepared for growth of fibroblast cells. Subsequently, the following groups were designed: Group 1: Polycaprolactane scaffold Group 2: Polycaprolactane-chitosan scaffold Group 3: Polycaprolactane-tannic acid scaffold Group 4: Polycaprolactane-chitosan-tannic acid scaffold. The human foreskin was prepared and the dermal layer fibroblast cells were isolated after laboratory tests, then the cells were placed in cell culture flasks with DMEM medium and stored in a 5% CO2 incubator. Ten thousand cell fibroblasts were transferred to 96-well wells containing DMEM solution and scaffolds and then fibroblast cell proliferation and viability were determined by MTT assay and by SEM microscopy to determine the infiltration of fibroblast cells into scaffolds and also in order to review of the chemical groups in the polymers was performed using a FTIR spectrometer. The results were analyzed by the SPSS software; ANOVA and Tukey's post hoc test after the data were analyzed uniformly

The mean survival rate of fibroblast cells based on MTT assay at 24 h was significantly increased in the polycaprolactone-tannic acid scaffold group (p<0.05) compared to the polycaprolactone scaffold group (p<0.05). The results also indicated that the mean survival of cells based on MTT assay at 24 h was significantly increased in the polycaprolactone-chitosan-tannic acid scaffold group (p<0.05) compared to the polycaprolactone scaffold group (p<0.05). Moreover, the mean cell viability in the polyprolactone-chitosan scaffold was not statistically significant compared to the polyprolactone group.

Due to its hydrophilic properties and biocompatibility of chitosan and tannic acid, poly caprolactone-chitosan-tannic acid scaffold may be a suitable scaffold for the activity of fibroblast cells in the scaffold.  It can also be a good environment for the growth and proliferation of other cells.

The development of cardiovascular diseases and mortality caused this study to evaluate the effect of 6 weeks of supplemental diet and aerobic exercise on plasma levels of CRP and fibrinogen in overweight men.

32 non-athletic overweight men from Qom University with a mean age of 31 ± 1.38 years, and body mass index 31.19 ± 4.18 kg / m2, were randomly assigned to four groups (8 subjects), supplemented (8 subjects ), Exercise + complement (7 subjects) and control (n = 10 subjects). The control group did not undergo any training and supplementation during 6 weeks, The exercise group performed 6 weeks aerobic training with an intensity of 60-74% of maximum heart rate and 3 sessions per week. The supplemented group consumed 6 weeks of garlic-Lemon and the exercise + supplement group consumed complementary supplements and aerobic exercise for 6 weeks. Blood sampling was performed to measure CRP and Fibrinogen and general tests including height, weight, fat percentage, waist to hip ratio in two stages before and 48 hours after the last training session in fasting conditions. The t-test was used to examine the differences between groups and one-way ANOVA was used to examine the differences between groups.

A significant decrease in fat percentage was observed in the supplementation group (p = 0.035) Also, the results did show decrease significant changes in CRP and fibrinogen in the Exercise + complement and supplemented groups, thus CRP level in the Exercise + complement group was 27% and the supplementation group was 26% and the fibrinogen level in the Exercise + complement group was 38% and in the supplemented group 29% has decreased.

According the decrease significant in inflammatory levels in this study, but a significant reduction in the percentage of these variables was observed in the study, it seems that the implementation of the garlic-Lemon supplementation protocol can be effective in changing these indices and reduce the risk of cardiovascular disease.

Staphylococcus aureus can colonize a variety of body sites such as skin, coetaneous membrane and especially the anterior nares.  The coagulase gene (coa) typing is a technique in which the organism is typed based on the polymorphic region of the coa gene. The aim of the present study was to determine the coa based typing of S. aureus isolates from health care workers in two teaching hospitals in Yasuj city.

 In the present cross- sectional study, a total of 125 S. aureus isolates were collected from the nasal nares of healthcare workers in Shahid Beheshti and Imam Sajjad Hospitals in Yasuj city. For typing of S. aureus isolates, amplification of the 3'-end region of the coa gene was performed. Finally, PCR products were digested with HaeIII restriction enzymes and then were electrophoresed on 1.2% agarose gel, and visualized under UV illumination. Bacterial strains were typed according to the DNA bands with diverse size and numbers in each strain. Data were analyzed by descriptive statistics tests.

 Amplification of the coa gene indicated single band in nine different patterns ranging approximately from 400 to 860 base pair. The coa gene with 610 bp size was seen in 36 isolates and was considered a predominant type. After digestion of PCR products with HaeIII restriction enzymes, totally 15 distinct coa gene RFLP patterns, numbered C1 to C15, were coa observed. The C3 was the most frequent coa type with 24 isolates. There is no specific types belong to wards or professions in each hospitals.

S. auras isolated from anterior nares of HCWs showed genetic diversity in their coa gene, but only a few coa gene variants were predominant. Hence no prominent coa type was detected according to the wards or types of profession, the sources of bacteria for colonization in anterior nares of HCWs may be related to the hospital, probably the outside environment.

Tyrosinemia is a recessive autosomal genetic disease due to the defect of fumaril acetoacetate hydrolase (FAH). About 40 pathogenic mutations have been reported for this gene. The aim of the present study was to determine and design polymerase chain reaction primers and their ability to identify FAH gene mutations causing type I tyrosinemia.

In the present case-control study, 12 patients were recruited and divided into two equal groups: first six patients with type I tyrosinemia and second group six patients without informed consent. Blood samples were taken. Then, the DNA was extracted. The polymerase chain reaction initiator was designed for parts of the gene which reported in previous studies of the mutation. The specificity of primers designed with online databases was evaluated. Gene fragments were amplified by polymerase chain reaction. Then the amplified fragments were sequenced after purification. Finally the sequenced regions analyzed by Vector NTI software.

Designed primers amplified FAH gene segments specifically and sequencing of amplified segments revealed +709 C>T mutation in exon 10 of FAH gene. The patient's parents were carriers of this genetic mutation. In the control group no mutation was found in the FAH gene.

  The nonsense mutation 709 C> T is a pathogenic mutation in the FAH gene that was previously reported only in Turkey. The designed primers were cost-effective and specifically able to amplify the FAH gene. These primers can also be used to identify carriers of the disease as well as prenatal diagnosis of type I tyrosinemia.

Gastric cancer is one of the most common malignancies worldwide. Genetic background has been identified as one of the risk factors for gastric cancer. One of the genes that have been proven to play a role in various cancers, including gastric cancer, is the MCC gene. There are hundreds of SNPs in the coding and regulatory region of the MCC gene, one of which is rs9122, which is located at the junction of several microRNAs. The aim of the present study was to determine the relationship between MCC gene rs9122 polymorphism and gastric cancer risk.

In this case-control study, blood or DNA samples were collected from 214 gastric cancer patients diagnosed by a gastroenterologist and endoscopic test, and 211 healthy control individuals, from the Biobank of Shiraz Cancer Research Center, with no gastrointestinal disease, based on a gastroenterologist and the endoscopy results. Also in control group, Helicobacter pylori infection test was negative and this group was matched for gender, age and geographical area with patients. After extracting genomic DNA from blood samples, MCC rs9122 polymorphism genotype was determined using RFLP PCR- (MluI enzyme) technique. The association of this polymorphism with gastric cancer susceptibility was evaluated using SPSS software and logistic regression test.

The results indicated that the frequency of A allele and G allele in control group were 48.1 and 51.9% and the frequency of AA, AG and GG genotypes in this group were 27, 42.2 and 30.8 respectively. In the patient group, the frequency of A and G alleles were 40.7 and 59.3, and the frequencies of AA, AG and GG were 23.4%, 34.6% and 42%, respectively. The GG genotype also borderline increased the risk of gastric cancer (p=0.071, OR= 1.557, 95% CI=0.961-2599) and G allele as a risk allele, susceptibility to Increases gastric cancer (p=0.029, OR=1.353, 95% CI = 1.031-1.775). In addition, the GG genotype increased the risk of gastric cancer compared with the total AA + AG genotypes (OR = 1.630, p = 0.016, 95% 1.94-0.242 / 429 CI), whereas total AG + GG genotypes were not associated with risk of gastric cancer (p = 0.386).

MCS rs9122 polymorphism seems to be associated with gastric cancer risk, so that the G allele and GG genotype at this locus increase the risk of gastric cancer. Confirming these findings in larger populations, geographically and ethnically diverse, can be used to screen for gastric cancer.

One of the chronic diseases that increases the risk of depression in a person is the development of various cancers. Numerous studies have shown that risk of various cancers is an important risk factor for depression. The purpose of this study was to determine and evaluate the efficacy of combination therapy based on acceptance, commitment and group therapy based on hope therapy in reducing depression in cancer patients.

This is a semi experimental study wich statistical population of this study consisted of 100 cancer patients admitted to Yasuj Shahid Beheshti Hospital late in the year, up to the beginning of the year, with a clinical record. At the center of the study, 30 patients were divided into two groups (15) of experiment and control. There were no restrictions on the type of cancer in this study, and the inclusion criteria were: alertness, physician, at least one-time treatment with chemotherapy, and no psychological problems from Chronic depression included before the onset of the disease or under the treatment of psychotropic drugs. Data were analyzed using one-way analysis of covariance (ANCOVA).

Findings showed that combination therapy based on acceptance and commitment and group therapy based on Hope Therapy approach to reduce depression in cancer patients in Yasuj city had a p<0.05. The effectiveness of this method of treatment for depression in patients with cancer have been identified.

The findings of this study suggest that combination therapy based on acceptance and commitment and group therapy based on hope therapy can reduce depression in cancer patients and represent new horizons in clinical interventions and can be used as an effective intervention metho

Bacterial meningitis is still recognized as one of the most dangerous infectious diseases that can lead to high mortality if not diagnosed and treated in a timely manner. The aim of this study was to determine the prevalence of bacterial agents causing meningitis and related factors in patients admitted to Imam Sajjad Hospital in Yasuj.

The present study was a cross-sectional descriptive-analytical study. The statistical population consisted of 106 patients one month to 14 years old referred to Imam Sajjad Hospital in 2018 who were analyzed for cerebrospinal fluid after clinical suspicion of meningitis. Spinal fluid sample of patients with white blood cell count greater than 5 was diagnosed as bacterial meningitis and one cc of it was stored at -20 ° C. Samples were analyzed for Meningococcus, Hemophilus influenza, Streptococcus pneumoniae and genotypes of this species using MULTIPLEX REAL TIME-PCR method by Tag Man method. Demographic, clinical and laboratory data were also collected and recorded. Data were analyzed using descriptive statistics and chi-square test.

Of the total patients understudy, 33%(35) were female and 67%(71) were male. Most patients(50.9%) were between one month and one year of age. 34% (36 cases) of the specimens were confirmed as bacterial meningitis, 25 of which were pneumococcal and 11 of them were hemophilus influenzae type b. F19 genotype had the highest prevalence among pneumococcal genotypes. No positive results were found for meningococcus. Only one case of cerebrospinal fluid culture was positive, which was negative for coagulase staph. Also, only 8 cases(89.6%) had positive blood cultures. The most common clinical symptom was fever. There was a statistically significant difference between the negative PCR group and the positive PCR groups for vomiting (p=0.01), rash(p=0.03), Brodzinski(p=0.02) and underlying disease(p=0.002) and CSF(p=0/0009) existed.

According to the results obtained in this study, it can be concluded that pneumococcal and Haemophilus influenzae type b bacteria main cause of meningitis in children in the study, in addition to the cultivation of CSF and blood cultures correlate very poorly with results from PCR.

The Health Transformation Plan is the latest government implementation plan to reform the health system in Iran. The project has faced numerous challenges in implementation. The purpose of this study was to determine and explain the dimensions and consequences of political geography in the implementation of health transformation plan in Kohgiluyeh and Boyerahmad province.

This study is a descriptive and analytical study using structural equation modeling which was conducted among 400 experts and managers in different parts of health system of the province using a structured questionnaire. Sample size was determined by modified Cochran formula. Research data were collected through stratified random sampling in proportion to sample size. Data were analyzed using frequency and mean statistics as well as t-test.

A significant relationship among different dimensions of political geography, including political interference (-0.251), modeling from other countries (0.17), lack of access to health services (-0.22), impasse area (239), Ministry of Health executive policies (0.194) and implementation of health transformation plan in Kohgiluyeh and Boyerahmad province was seen (p <0.001).

Considering the influence of political geographical dimensions on implementation and consequences of health programs, it is recommended to pay more attention to these environmental factors in the design and implementation of these programs. It also seems that aligning the policies of the Ministry of Health with the transformation plan in the province has led to increased access to health services.