Journal of Advances in Medical and Biomedical Research
Volume:21 Issue: 89, 2013

Hypotension associated with spinal anesthesia for cesarean section is still a clinical problem. The role of crystalloid preloading to prevent hypotension associated with spinal anesthesia in parturients during cesarean section has been challenged. However، studies with crystalloids predict that fluid loading should be more efficacious if administered immediately after induction of spinal anesthesia. The effects of colloid loading after spinal anesthesia in cesarean section have not been studied enough. The aim of this study was to compare pre and co-loading of hetastarch for the prevention of hypotension following spinal anesthesia for cesarean delivery. This randomized clinical trial study was performed in 112 parturients (ASA I or II) undergoing elective cesarean section. Patients were randomly allocated to one of the two groups to receive rapid infusion of 500 ml of 6% hydroxyethylstarch (HES) before spinal anesthesia (preloading group، n = 56)، or rapid infusion of 500 ml of HES after induction of spinal anesthesia (co-loading group، n= 56). The incidence of hypotension and the amount of vasopressor، (ephedrine 5 mg/mL + phenylephrine 25 micg/mL) were compared in the treatment of hypotension. There was no significant difference in hypotension between the two groups (P = 0. 58). The pre-loading group used 2. 2 ± 1 ml of vasopressor mixture compared with 1. 7 ±0. 7 ml in the co-loading group (P = 0. 04) and the difference was significant. Colloid loading after induction of spinal anesthesia is as effective as preloading in reducing hypotension in cesarean section.

Benzodiazepines are used for prophylaxis of febrile seizures. This study compares the effectiveness of intermittent Nitrazepam versus Diazepam therapy in preventing the recurrence of febrile seizures. This prospective randomized controlled trial was performed on neurologically normal children aged from 6 months to 3 years with a history of febrile seizures without history of prescribed antiepileptic drugs and family history of epilepsy. The patients were randomly prescribed oral nitrazepam (36 cases) or diazepam (37 cases) at the beginning of febrile disease. They were advised to use the medication within the first 48 hours of the onset of fever. All patients were followed for 9 months since the last seizure. Recurrence of seizures occurred in 4 (10. 8 %) patients of diazepam group، but it was not observed in any patients of the nitrazepam group. Age، sex، weight، height، grade of fever at the beginning of febrile seizure، seizure duration and hemoglobin level did not reveal a significant difference between the two groups of patients، and likewise، these variables did not show any statistically significant difference among patients with or without recurrence. Intermittent nitrazepam therapy for febrile seizure seems clinically advantageous in comparison to diazepam. To obtain more precise clinical and statistical results، further research is recommended.

Mesenchymal stem cells are promising sources of stem cells for tissue repair because of their ability to differentiate into different cells، easy proliferation and culture، and immunomodulatory properties. Despite extensive research on the immunophenotype of mesenchymal stem cells، a lack of specific markers comprises challenges for researchers. The aim of this research was to isolate and expand murine lung and adipose derived mesenchymal stem cells and to compare their expression of surface protein markers.

Mesenchymal stem cells were isolated from murine lung and adipose tissues. Specific differentiation media were added for differential investigations. Finally، the expression of surface antigens were measured by flow cytometry and compared in both cell populations.

Mesenchymal stem cells from both tissues were proliferated well and adipocyte and osteocyte differentiations were observed. Moreover، they showed CD73، CD105 and CD90 expression، but no expression of CD34، CD45 and CD11b was observed. In this study، lung CD105+ mesenchymal stem cells possessed lower percentage than those in adipose tissue.

Mesenchymal stem cells were isolated from lung similar to adipose derived mesenchymal stem cells and expressed common markers associated with adipose tissue mesenchymal stem cells.

Adipose tissue is an endocrine organ with the ability to produce and release a variety of cytokines such as free fat acid، leptin، adiponectin، visfatin، tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6). The purpose of this study was to investigate the probable changes in visfatin، IL-6 and TNF-α on female rats after 8 weeks of intense aerobic exercises. This experimental study was conducted on 45 sprague dawley rats with mean age of 2 months and mean weight of 220±20 g. In order to determine the pre-test variables، 15 rats were killed and blood samples were taken from their hearts. Then، the rest of the rats were randomly divided into two groups of control (n=15) and training (n=15). The training group did the exercises 5 days a week for 8 weeks on Rodents'' treadmill. There were significant differences in plasma levels of visfatin and IL-6 in training and control groups (P=0. 0001). This significant difference was found in the training group rather than the control or pre-test groups (P=0. 0001). Furthermore، no significant difference was observed in TNF-α changes between the groups (P<0. 05). Exercise has the potential to decrease visfatin plasma levels and bring about changes in the expression of inflammatory cytokines. Therefore، it can be stated that the training program may prevent and improve inflammatory diseases، obesity، diabetes and insulin resistance.

Cephalosporin acylases (CA) are highly specialized peptidases that are able to break down the amide bond between the lactam nucleus and lateral chain without destruction of beta-lactam ring. This enzyme transmutes the cephalosporin C to 7-ACA. The 7-ACA is an important intermediate in synthesizing the semi-synthetic cephalosporin in pharmaceutical industries. The purpose of this study was to screen and optimize the species having maximum amount of production of cephalosporin acylase enzyme isolated from clinical samples among some gram- negative bacteria producing cephalosporin acylase. Out of a total of 60 species gathered from several hospitals in different places of Tehran city، the clinical species such as Pseudomonas، Acintobacter and Escherichia coli were isolated. At first، the resistant species were differentiated by antibiogram method. Then، the activity of enzyme was measured by spectrophotometer. After identification and isolation of the enzyme producing species، the effect of factors such as time، temperature، pH and the amount of aeration of cultivation environment on the amount of enzyme production was investigated. In this study، among the three groups of bacteria mentioned above، a species of Pseudomonas aeroginosa showed a significant cephalosporin acylases activity. Optimum activity for this species regarding the mentioned factors was estimated as follows: pH 8، incubation time 48 h، temperature 37 C and the component of aeration was 150 rpm. The findings point out that Pseudomonas species has a significant cephalosporin acylases activity compared with other species examined in this study. Therefore، this species may have implication for industrial production of the above mentioned enzyme and also can be used in related researches.

Knowledge of resting metabolic rate and body composition is important for defining appropriate nutritional، energy balance and weight control. The purpose of this study was to compare resting metabolic rate (RMR) and body composition in young sedentary males after aerobic and resistance exercise training. Twenty eight sedentary male students were randomly assigned to participate in one of the following groups: endurance program (n=8)، resistance program (n=10) and control group (n=10). The exercise training programs consisted of 6 weeks and 3 sessions of aerobic (running، by intensity 65% to 85% of HRmax) and resistance (11 exercises، 3 sets، 10 to 12 repetitions، 65% of 1RM) training per week. Before and after training، resting metabolic rate، body composition and VO 2max were determined for each participant. Within- group differences were analyzed by using student t-test. One way ANOVA was used for between -group differences. Results demonstrated that RMR increased significantly in resistance training while decreased significantly in endurance training. There was not any significant difference in RMR of the control group (p≤0. 05). When RMR was normalized to FFM (kcal. kg FFM-1day-1)، there were no significant improvement in RMR for any of the three groups. Total factors involved in body composition decreased significantly at the end of aerobic training. With resistance training، there was a significant decrease in FFM and BMI (p≤0. 05). This study indicates that weight loss programs are more dependent on the amount of energy expenditure during the exercises than on the type of training. The findings support that there is not much difference in using aerobic or resistance training to increase resting metabolic rate and weight loss.

An imbalance between free radical production and antioxidant defense system components can lead to oxidative stress. Resvin is a plant derived antioxidant that can reduce the production of free radicals. The purpose of this study was to determine the effect of one period of Resvin supplement consumption on the total serum antioxidant capacity، superoxide dismutase and creatine kinase in elite women volleyball players. This study was an experimental trial in which 20 subjects were divided into two groups of supplementation with Resvin and placebo (lactose). Resvin supplementation was done following a stage of specific exercises. The trial group received Resvin in the form of a 400mg capsule in a single period after lunch. The control group also received the placebo in the form of a 400mg capsule in a single dose after lunch. A blood test was taken from all subjects prior to the study. Then، a second blood test was taken from both groups of Resvin and placebo supplement consumption 24 hours after the first test. The results indicated that Resvin supplement consumption led to a meaningful increase in total antioxidant capacity and a decrease in creatine kinase in elite women volleyball players (P<0/05). Based on the findings of this study، it can be concluded that Resvin supplement consumption while improving antioxidant indicators can prevent subsequent muscle damages and may simultaneously enhance recovery.

Milk intolerance due to gastrointestinal dysmotility is a common problem among preterm neonates. Erythromycin has a prokinetic effect on gastrointestinal motility. The purpose of this study was to assess the effectiveness of oral erythromycin in preterm neonates on milk tolerance. This clinical trial was conducted on 70 preterm neonates with a gestational age of 28 to 34 weeks who were admitted to the neonatal intensive care unit of Imam Reza (AS) Hospital in Kermanshah، Iran. Thirty-five infants in the control group received breast milk alone and 35 neonates in the treatment group received 2. 5mg/kg oral erythromycin every 6 hours for 10 days in addition to breast milk. The time taken to reach full enteral feeding، duration of hospitalization، daily vomiting episodes and residual volume of gastric lavage were compared in the two groups by t- test and chi- square test. There was no significant difference between the two groups regarding their sex distribution، birth weight، gestational age and onset of feeding. Also، there was no significant difference between the two groups in the time to reach full enteral feeding (P=0. 058). The number of gastric residue episodes was significantly higher in the control group than in the treatment group (5. 11± 2. 92 versus 2. 23 ± 1. 88 P = 0. 003). None of the neonates in the two groups developed necrotizing enterocolitis، cardiac arrhythmias، and hypertrophic pyloric stenosis. Prophylactic use of recommended dose of oral erythromycin in preterm neonates with a gestational age of less than 34 weeks reduces gastric residue but does not reduce the time to reach full enteral feeding.

Amygdalin is likely to have analgesic and metabolic effects. In this study، the effects of chronic administration of amygdalin were investigated on the pain threshold، weight and blood sugar of mice.

In this experimental study، formalin test was used as a chronic inflammatory model of pain. 60 mice (30-35 g) were divided into four groups (n=15) including: control and amygdalin 10، 25 and 50 mg /kgw groups. Amygdalin was solved in saline and injected intraperitoneally every day at 9-10am. The control group received saline intraperitoneally for one week. After the last treatment، 40µl formalin (2. 5%) was injected to the right hind paw of the mice and pain symptoms (frequency of collecting flinching of the back skin and licking injection site) were recorded for 60 min. Weight of the mice was measured before and after the last treatment with amygdalin. Blood glucose was also measured at the end of the experiment. Results were analyzed by using one way ANOVA and Tukey or paired t-test.

Intraperitoneal injection of 10، 25 and 50 mg/kgw doses of amygdalin reduced pain in male mice. In concentration of 50 mg/kg، not only the pain was completely inhibited but the animals’weight also decreased compared to pre-treatment period. Chronic injections of amygdalin had no impact on normal blood sugar levels.

Chronic intraperitoneal injection of amygdalin increases pain threshold in mice and may also cause weight loss.

Infant exposure to environmental tobacco smoke is a major public health problem. The aim of this study was to determine the effects of environmental tobacco smoke exposure on infant weight. This was a prospective cohort study. Participants of this study were 51 exposed and 51 non-exposed infants whose weight was measured in three periods of 5-7 days of age and also 2 and 4 months of age. Environmental tobacco smoke exposure of infants and their urinary cotinine were assessed by a questionnaire. The urine samples were collected during each follow-up. For data analysis، independent t test، chi-square and Fisher''s Kappa tests were used. Mean urinary cotinine levels over 5-7 days، 2 months and 4 months of age in the exposed group was significantly higher than in the non-exposed group (P<0. 001). The mean weight of the exposed group was significantly lower than the non-exposed group in 2 and 4 months of age (P<0. 001(. The results of this study show the weigh loss among infants exposed to environmental tobacco smoke، so we suggest further studies with longer follow-up periods and in all aspects of infants’ life.

Striae Gravidarum found during pregnancy may be an indicative of poor skin elasticity and may prone to tearing perineal and vaginal tissues during vaginal delivery. The aim of this study was to determine relationship between striae gravidarum and perineal trauma and vaginal lacerations in women referred to Hajar Hospital Labor Ward in Shahr-e kord city. This cross-sectional study included 587 women who referred to Hajar Hospital Labor Ward for vaginal delivery in 2010-2011. The study was conducted within the first and second stages of labor. Data was collected by using interviews، hospital files and physical examinations. Descriptive statistics and chi square test، t- student test، one-way ANOVA and step-wise multivariate logistic regression were used to analyze the collected data. 82. 8 percent of the participants developed stretch marks. 14. 5 percent of the pregnant women in this study experienced vaginal and perineal tears. There was a significant association of vaginal and perineal tears with conduction anesthesia (P<0. 0001)، vaginal dilation (P=0. 023)، duration of the first stage (p=0. 044)، and breast striae gravidarum score (P=0. 005). No significant association was found between vaginal and perineal tears and neonatal birth weight، head circumference and maternal BMI (P>0. 05). Patients with breast striae gravidarum are at a higher risk of vaginal and perineal lacerations at the time of vaginal delivery. This finding suggests that midwives and obstetricians consider beast striae gravidarum score as a simple and non- invasive tool for assessment of vaginal and perineal lacerations in management of women during vaginal delivery.

Domestic violence is an important health problem all over the world. The aim of this research was to determine the prevalence of domestic violence in pregnant women and its relation to some features like family and social support and the reasons for tolerating violent relationship. This correlational prospective study was conducted on 132 pregnant women admitted to Zanjan Mother and Child Health clinics for prenatal care in 2009. A semi- structured questionnaire was filled out during a private interview to collect the data. For analyzing the collected data، chi- square، Pearson correlation coefficient، and Fisher tests were used. The incidence of domestic violence was 28%. Violence was more frequent in women in the age range of 20-29 years old. 22. 7% of the selected population had experienced physical violence، 28. 8% sexual violence and 28% psycho- social violence. 73. 7% of participants were reported with emotional and verbal violence (10. 6 % severe violence). There was a strong relationship between fear of husband and physical (P< 0. 0001)، psycho- social (P= 0. 002) and emotional and verbal violence (P-Value= 0. 046) and also a strong relationship between violence and breaking objects (P< 0. 0001)، too. Men who had more than one wife (multi partners) had done more violence (P-Value= 0. 007). 15. 2% of the participants had informed their family about the violence many times. In severe cases، violence had happened in the presence of others (P< 0. 0001). Less severe cases happened in the cases of family intervention and support (P< 0. 0001).