نشریه ارمغان دانش
سال بیست و ششم شماره 4 (پیاپی 147، مهر و آبان 1400)

Proper management and control of pain after surgery is one of the major concerns of physicians and patients that requires evaluation and treatment based on observation of the patient's condition. Considering the importance of analgesia in patients after inguinal hernia surgery, the aim of the present study was to determine the effect of preoperative apoptosis on the rate of drug use after inguinal hernia surgery. 

In the present single-blind clinical trial study conducted in 2017, 100 patients with inguinal hernia were randomly divided into two groups: Apotel and placebo. The case group received 15 mg / kg Apotel body weight half an hour before the operation and the control group received a placebo. The amount of pain and the need for analgesia were measured according to the criteria of the visual scale at intervals of 1, 2, 4, 8, 12 and 24 hours after surgery and were recorded in a questionnaire that is specific to each patient. Postoperative analgesia was prescribed based on the patient's request and the severity of the pain. The scale of pain retention scale was used to determine the pain score of patients after surgery. The collected data were analyzed using SPSS software version 15 and statistical tests of t-test, independent t-test, Mann-Whitney and Friedman. 

The mean age of patients in the control group was 46.00 32 7.32 years and in the case group was 45.52 7 7.10 years. The amount of pain and need for drugs at 1, 2 and 4 hours after surgery in the target group was significantly lower (p <0.001). At 8, 12 and 24 hours, there was no significant difference in pain between the two groups (p = 0.48), but the need for drugs in the target group was significantly lower (p <0.001). 

According to the results, Apotel is effective in reducing postoperative hernia pain, increasing the duration of postoperative analgesia and reducing the use of drugs. Therefore, it can be used as a suitable and available alternative to narcotics in pain relief after surgery.

Oligohydramnios (amniotic fluid depletion) is a common problem in pregnancy that is associated with several complications. In addition to managing the underlying cause, treatment measures are necessary to reduce its consequences. The aim of the present clinical trial study was to compare the effect of L-arginine and fluid therapy alone on oligohydramnios.

In the present clinical trial study conducted in Fatemieh Hospital affiliated to Hamadan University of Medical Sciences in 2020, fifty pregnant women with 28 to 36 weeks gestation, with singleton pregnancy with Amniotic Fluid Index (AFI) less than 8 cm evenly were selected and randomly divided into two intervention groups, L-arginine at a dose of 3 g twice daily with fluid therapy (3 liters of lactated ringer in 24 hours) and the control group given fluid therapy alone between 1 to 4 weeks based on gestational age and AFI. Changes in amniotic fluid volume before and after the intervention and pregnancy outcomes were assessed and compared in the two groups. Data were analyzed using independent t-test, paired t-test and chi-square.

After the intervention, the mean AFI increased to 5.44 ± 0.86 in the control group and 85.28 ± 1.51 in the interventional group (P=0.001). The mean AFI in both groups showed a significant increase compared to the previous intervention. The mean gestational age in the interventional group at the end of the study compared to the fluid therapy group indicated a significant increase (35.24 ± 0.71 vs. 36.72 ± 0.59 cm). The mean Apgar score in the first minute and 5 in the interventional group was significantly higher. Other outcomes were comparable in the two groups.

In women with oligohydramnios, the use of L-arginine in combination with injectable fluid therapy with increased volume of amniotic fluid can be associated with better outcomes.

Despite many studies carried out on the application of stem cells in the healing of diabetic wounds, the results are still challenging. The aim of the present study was to determine the effects of gelatin hydrogel containing adipose-derived mesenchymal stem cells on diabetic wound healing in animal model.

In the present experimental-laboratory study conducted in 2019, mesenchymal stem cells were isolated from human adipose tissue and at that point characterized. The gelatin hydrogel was made using the microbial transglutaminase enzyme. Diabetes was induced in Wistar male rats by injecting streptozotocin. Subsequently, 0.8 cm thick wounds appeared on the backs of the mice. Animals were divided into control groups (treated with normal saline) and treated group with hydrogels containing adipose tissue-derived mesenchymal stem cells. Wound healing was assessed on days 7, 14 and 21 days after treatment through wound imaging. Data were analyzed using t-test and one-way analysis of variance.

The wound area decreased significantly in rats treated with “hydrogel + mesenchymal stem cells” on post-treatment days 7, 14 and 21 compared to first day of treatment (P<0.01, 0.001 and P<0.001, respectively). Unlike control group, the wound area significantly decreased on day 14 compared with day 7 in treated group.

Conclusion

Mesenchymal stem cells transported by gelatin hydrogel to the wound site, cause faster healing of diabetic wounds, therefore, can be used as a dressing for diabetic wounds.

Exercise is one of the effective factors in causing oxidative stress. Increased oxidative stress can be effective in the development of injuries and cardiovascular disease and stimulate the production of cytokines from many cells, but on the other hand to counteract these pressures, the body responds to oxidative stress by activating the antioxidant defense system and other protective systems. Therefore, the aim of the present study was to determine the effect of intense endurance training and intense periodicity on co-oxygenase-1 and alpha tumor necrosis factor in the heart tissue of male Wistar mice. 

The present experimental study was conducted on 24 adult Wistar rats in 2019. After two weeks of identification and weight lifting, they were randomly divided into 3 groups: control, intense endurance training, Intense periodic exercise). The protocol of intense and intense endurance training included running on a treadmill for 8 weeks (5 sessions per week), standard water and food, and was freely available to the subjects. Forty-eight hours after the last training session and 4 hours of fasting, the subjects were dissected and tissue samples were collected. Subsequently, the concentration of HO-1 enzyme was measured by ELISA and TNF-α was measured by ELISA. The collected data were analyzed using Shapirovilk statistical tests, one-way analysis of variance and Tukey post hoc test. 

There was no significant difference in TNF-α levels after 8 weeks of strenuous endurance and high intensity interval training (P˃0/05). Furthermore, 8 weeks of strenuous endurance training and high intensity interval training had no significant effect on the amount of HO-1 enzyme in heart tissue (p <0.05). 

Since the levels of HO-1 and TNF-α in heart tissue did not change after 8 weeks of intense endurance training and intense intermittent training, it can be concluded that regular exercise, by creating a beneficial adaptation in the antioxidant system, they make oxidative stress more resistant.

Adenoid hypertrophy is one of the childhood complications in which bacteria are involved in its etiology. The aim of the present study was to determine the relative abundance of biofilms and genes associated with biofilm formation in Staphylococcus aureus isolates and also to determine the genotypic patterns of S. aureus isolates from adenoids and tonsils of children with adenoid hypertrophy by Spa typing method.

The present cross-sectional study was conducted on 86 pair isolates of S. aureus collected from adenoid and tonsil of children with adenoid hypertrophy. Phenotypic method used for assessing of biofilm production in S. aureus isolates and the presence of icaA,icaD,fnbA and clfA genes evaluated using polymerase chain reaction method. The spa typing method was apllied for typing of isolated. Data were analyzed using descriptive statistics method and SPSS software.

S. aureus isolated from adenoids and tonsils were positive in 49 (57%) and 40 (46.5%) biofilms, respectively. In 47 cases, pairs of isolates from the adenoids and tonsils were similar in terms of biofilm production. In the present study, 4 types of spa types were identified in S. aureus including t081 type, the most dominant type in 67.5%, t701 in 11.6%, t2419 in 9.3% and t4870 in 8.2% of adenoid isolates. In total, 79.45% of adenoid and tonsil isolates had similar typing. highest frequency of genes was related to fnbA, which was detected in adenoids in 64% and in tonsils in 41.9% of isolates.

Due to the relative frequency of biofilm formation, biofilm is of moderate importance in the establishment of Staphylococcus aureus in the tonsils and adenoids of patients. Moreover, the role of fnbA gene in biofilm formation was higher than other studied genes. High spa similarity Staphylococcus aureus isolates isolated from the adenoids and tonsils indicate the initial colonization of bacteria in the tonsils and then act as a source of infection for the adenoids.

The fleas of the Pulicidae family are one of the most important external parasites of humans and domestic animals in the world. In addition to eating blood, these insects are carriers of some pathogens such as Yersinia pestis, Rickettsia typhi and Bartonella hensle to humans and animals. The aim of this study was to determine and evaluate the fauna of Ketonecefalides canis and Polex Irritants in western and northwestern Iran based on mitochondrial marker of cytochrome oxidase I.

The present study was a descriptive cross-sectional and phonetic study conducted in a period of 13 months from May 2018 to June 2019 in five provinces of Kermanshah, Kurdistan, Azerbaijan Western, Lorestan and Hamedan considering the prevalence of 10% and 95% confidence level with 5% error rate. In the present study, samples were collected by optical trap, human prey and direct isolation from the host. The samples were kept in 70% alcohol and identified in the parasitology laboratory using valid diagnostic keys. After DNA extraction and a Polymerase chain reaction (PCR), 20 samples were sent to Takapouzist Company for sequencing. The sequences were sequenced and compared using Emboos Needle and Omega software.

The collected samples included 918(47/39%) C.canis and 1019 (52/60%) P.irritant. The results of morphological studies revealed that there is no intraspecific difference between two species of fleas isolated from different hosts (p <0.05). However, the intraspecific difference based on the molecular marker of cytochrome oxidase I for ten studied populations was 0.15% in P.irritans and zero in C.canis. The difference between two genus of C. canis and P. irritans based on the molecular marker of cytochrome oxidase I was 14%.

No significant difference was observed in morphological characteristics of samples collected from different hosts. However, there were slight differences based on mitochondrial markers in the study populations. The results from the phylogenetic tree based on mitochondrial markers showed that despite the slight differences in this sequence of different hosts and cities, all samples from different regions are in the same phylogeny. The results of mitochondrial genome analysis indicated that these pieces are useful for demonstrating intraspecific similarity, and differentiation at species level and genus.

Due to the high sensitivity of the bone marrow to ionizing radiation as well as the large number of bone graphs, it is important to evaluate the absorbed dose in the bone marrow during exposure to radiographic rays. The aim of the present study was to determine and evaluate the accuracy of Monte Carlo simulations to calculate PDD in the femoral bone marrow during exposure to low energy rays.

The present descriptive study was conducted in 2020 at Yasuj University of Medical Sciences. 100 CT scan images of the femur were selected, of which 28 images were extracted from the beginning to the end of the femur. After simulating the head of the device with normal energies in femoral radiography using BEAMnrc simulator, the information obtained from CT scan images of patients with CT CREAT software, digital femoral phantom was designed. The phantom was digitally irradiated (using DOSXYX simulator) and the absorbed dose percentage (PDD) was calculated using STATE DOSE software. Finally, the data were analyzed using Image Java and Excel software.

The percentage of absorbed dose in femoral bone marrow at energies of 70, 80 and 90 was in the range of 2 to 78%, 5 to 79% and 5 to 76%, respectively. Also, with increasing depth in all energies, the percentage of absorbed dose decreases. For energies of 90 kV and to some extent for energies of 70 and 80 kV, the data show a sudden decrease in the percentage of absorbed dose from a depth of 6 mm to 9 mm. From a depth of 1.1 cm to 1.5 cm, the dose absorbed in the bone marrow varies according to energy.

Monte Carlo simulation method can be an effective method in calculating the absorbed dose in bone marrow tissue. The results show that the calculations of the percentage of absorbed dose up to a depth of 2 cm are significantly accurate. As the depth increases, the accuracy of the calculations (provided that the number of particles participating in the simulation does not increase) gradually decreases.

The study of educational environments in teaching hospitals has been recommended by many countries on an ongoing basis. In medical science education environments, in order to organize students' behavior, it is necessary to adjust and adapt the content and educational environment to each other as two important factors in the development of medical sciences. The aim of this study was to determine and study the atmosphere of teaching hospitals in Abadan University of Medical Sciences from the perspective of clinical students and its relationship with the performance of managers.

the present cross-sectional study was conducted in educational hospitals under the auspices of Abadan School of Medical Sciences in 2019. Research tools were two valid and reliable questionnaires. The “Dundee Ready Educational Environment Measure questionnaire” was used for the educational environment and the “managers' performance questionnaire” was used to evaluate the managers of the departments. Sampling was done by census and 204 students and 32 heads of clinical departments were included in the study. The collected data were analyzed using descriptive tests (frequency and percentage, mean and standard deviation) and analytical tests of t-test, analysis of variance and Pearson correlation.

The performance of managers was strong (mean score was 68.75±7.39). Each of the different areas of managers' performance had a positive and significant relationship with each other. Educational atmosphere was also favorable (mean score 113.35±22.59). There was no significant relationship between educational atmosphere and managers 'performance and each of the managers' performance areas.

Due to the dissatisfaction of one third of students with the educational atmosphere in Abadan University of Medical Sciences in clinical departments and not so high score in the dimension of planning in the performance of managers, educational processes need careful planning and implementation of standards.

Smoking, especially Hookah, is one of the major behavioral problems in the field of health which has become more widespread among young people and adolescents in recent years. Despite the implementation of various programs to reduce this behavior in Iran, it seems that little attention has been paid to the use of behavioral patterns to design effective interventions in this area. The aim of this study was to determine the effective components of adolescents and young people's tendency to use hookah: an application of the theory of planned behavior in Yasuj.

This study was a cross-sectional study that was implemented in the first months of 2019 to assess the factors affecting the intention to quit Hookah in young people living in Yasuj. 157 people aged 15 to 30 years old hung out at coffee houses and amusement gardens in the tourist area of Yasuj waterfall were selected by available sampling method and a questionnaire measuring the structures of the theory of planned behavior was completed for them. In the present study, descriptive statistics in the form of frequency percentage, mean and standard deviation as well as analytical statistics in the form of multiple linear regression were used. SPSS software version 25 was used for data analysis.

Results

The highest frequency of study participants were men with a mean age of 20± 2 years, higher education, and living in urban areas. In more than 70% of the participants, the history of Hookah use was mentioned among family members (brother and father, respectively, with the highest frequency). More than 96% of the participants had friends who smoked Hookah and their average first age of hookah use was 16.88±2.77 years. More than 63% of the participants mentioned coffee and coffee shops as the usual places for Hookah use. Among the constructs of the theory of planned behavior, the predictive power of the perceived behavioral control construct for the intention to quit Hookah use was higher than other constructs. Based on this finding, an intervention was designed including the production and installation of posters and labels containing the message of reinforcing perceived behavioral control (p< 0.001).

  Due to the small role of patterns and theories of behavioral change in reducing Hookah use in Iran, it seems that interventions based on structures with more predictive power such as perceived behavioral control structures in the present study, can have different effects, comparing to routine schedules.

Due to the resistance of microorganisms to antibacterial agents, efforts are being made by researchers to replace the plant natural substances with antimicrobial properties and lower side effects. The aim of this study was hydro alcoholic extract of malva sylvestris as a food preservative with some microorganisms, which further cause contamination of food products

The present experimental laboratory study was conducted in 2016. Several experiments, such as gel diffusion and MIC and MLC measurements were performed to evaluate the storage properties of nutrients by a number of microorganisms that are more likely to contaminate food with malva sylvestris extract. After preparing the hydro alcoholic extract, it was applied to the culture medium containing tomato juice, grapefruit juice, pineapple juice and wheat flour, which were infected with Staphylococcus aureus, Escherichia coli, Candida albicans and Aspergillus Niger. Correspondingly, the minimum growth inhibitory concentration and the minimum lethal concentration of extract as well as sodium benzoate were measured on above microorganisms and then the diameter of the growth inhibition zone of extract was compared with standard antibiotics. The collected data were analyzed using descriptive statistical tests, i.e. the average of tables and graphs.

The present study indicated that at concentrations of 1, 2, 4, 8, and 16 mg/mm of the extract, the diameter of the growth inhibition zone for S. aureus is equal to; 6, 12, 15, 18, and 20 respectively but growth aura was observed for E. coli. On the hand  the MIC and MBC  of extract  at concentrations of  1, 2, 4, 8, and 16 against Aspergillus Niger and Candida Albicans was 25, 31, and 125 mg/ml. however, the growth of all microorganisms against sodium benzoate at a concentration of 2 mg / mm was stopped and the diameter of the growth inhibition zone was observed from 20 to 28 mm..

The results indicated that this extract in combination with chemical additives contaminated with S. areus revealed a high retention effect, but substances contaminated with E. coli had no effect on them. Also, this extract had a good effect on foods contaminated with fungi, but compared to sodium benzoate, this extract had less effect on all microorganisms. However, we hope that in the future, with more work being done on this plant can be used as a suitable alternative to food storage instead of chemical additives.