مجله دانشگاه علوم پزشکی بابل
سال هجدهم شماره 2 (پیاپی 101، بهمن 1394)

With the advancement of medical care procedures, survival rate of preterm neonates has increased remarkably. In Iran, few studies have assessed the extent and severity of developmental disorders in these infants. This study aimed to evaluate developmental disorders in premature neonates.

This cohort study was conducted on 270 premature infants born in Ghaem Hospital in Mashhad, Iran with mean birth weight of 1460±40 grams. Data on pregnancy, parturition and complications during hospitalization were recorded. Moreover, preterm neonates were evaluated in terms of developmental delay at 6, 12, 18 and 24 months of age based on the Ages and Stages questionnaire (ASQ).

In this study, symptoms of developmental delay were observed in 152 neonates (56%) at six months, 115 neonates (42.7%) at 12 months, 101 infants (37.5%) at 18 months, and 49 neonates (18%) at 24 months. In addition, abnormal development was detected in different areas, including communication (n=21, 7.8%), major movements (n=53, 19.6%), minor movements (n=74, 27.5%), social interactions (n=89, 33%), and problem solving (n=153, 57%). After a two-year follow-up, 27 infants (60%) had asphyxia, 29 (28%) had respiratory distress syndrome, and 20 infants (15%) had developmental disorders.

According to the results of this study, about one-sixth of preterm neonates had developmental delay at two years of age. The highest rate of developmental disorders was observed in the area of problem solving, which should be taken into account in neonatal rehabilitation services. On the other hand, appropriate monitoring of neonatal asphyxia and jaundice is likely to reduce the risk of other complications during infancy.

Early discharge requires the close follow-up of outpatients in the clinic or at home within 48 hours after discharge. Given the importance of follow-up after early discharge of infants and also lack of accurate statistics on the rate of early discharge in our country, this study aimed to determine the rate of early discharge of newborns in Babol-Clinic Hospital from March 2013 to March 2014.

This cross-sectional study was conducted on all the neonates born in Babol Clinic Hospital in Mazandaran, Iran in 2013. Newborns were selected via census sampling. In addition, a questionnaire was used to collect the data on the length of hospital stay, mode of delivery, gender, birth weight, Apgar scores, gestational age, method of anesthesia, need for resuscitation, and maternal diseases for each infant. Early discharge and very early discharge were defined in newborns released before 48 and 24 hours after birth, respectively. Data analysis was performed in SPSS V.20 using T-test, Chi-square, Fisher's exact test, and Cox regression analysis, and P value of less than 0.05 was considered significant.

In total, 2,562 infants born in Babol Clinic Hospital were enrolled in this study, 2,451 of whom (96%) were discharged before 48 hours, and 1,829 newborns (71.5%) were discharged before 24 hours after birth.In normal delivery method groups, 9 (4.25%) neonates routine discharged, 36 (16.98%) neonates early discharged and 167 (78.77%) neonates were very early discharged. Elective and emergency cesarean group, 68 (3.9%) neonates and 34 (5.62%) neonates normal discharge, 428 (24.53%) neonates and 158 (26.12%) neonates early discharged and 1 249 (71.58) neonates and 413(68.26%) neonates were very early discharged respectively (p=0.02). 92% of deliveries were by Caesarean section and 8% were the normal vaginal delivery.

According to the results of this study, almost all the neonates born in Babol Clinic Hospital had early or very early discharge, and only a few cases (4%) were hospitalized for more than 48 hours. Therefore implement of close follow-up or home visitis recommended.

Breast cancer is the most common type of malignancy in women, and TP53 tumor-suppressor gene is one of the most commonly transformed genes in human cancers. Accurate assessment of TP53 gene mutations in cancer patients can play an important role in diagnosis, prognosis, or treatment. This study aimed to identify mutations of this gene in breast cancer patients. In this descriptive study, 102 tumor samples were obtained from female breast cancer patients from Azarbaijan, Iran. All the participants were referred to hospitals of Tabriz during 2007-2009, and their DNA was extracted by Proteinase K. TP53 gene mutations in exons 7 and 8 and intron 7 were investigated using polymerase chain reaction technique and direct sequencing. Seven (6.86%) cases of mutation and 14 (13.72%) cases of polymorphisms were identified. Mutations (CGG → CAG) at codon 248 (in two cases) and (CTG → CCG) at codon 257 in exon 7 and G>T mutation in the first nucleotide of intron 7 were observed. In exon 8, GTG>ATG mutation at codon 272, CCT>TCT mutation at codon 278, and three nucleotide deletion at codon 262 were identified. The results of this study showed a different pattern of TP53 gene mutation in female breast cancer patients. Further studies could specify the role of TP53 mutations in the progression of breast cancer

Amphotericin B (AmB) is the main antibiotic of polyene type, which is widely used in the treatment of systemic fungal infections. One of the key mechanisms of this drug is the formation of ion channels and increasing permeability of the host cell membranes. This study was conducted to evaluate some of the electrophysiological characteristics of cationic single-channel formed by the incorporation of AmB in bilayer lipid membrane (BLM).

In this experimental study, phosphatidyl choline was extracted from fresh egg yolk. After the formation of BLM and the incorporation of AmB in the membrane, the channel activity was recorded through +40 to -40 millivolt (mV) voltages. Data analysis was conducted using PClamp10 software to determine the electrophysiological characteristics of the channel.

Reverse potential of Amphotericin B ion Channel was-36 mV. The Channel activity was more in such positive voltages. This means that in voltage -40 mV the current amplitude was 2 Pico Ampère but in voltage +40 mV reach to 30 Pico Ampère. In addition, the channel open probability at voltage -30 mV voltage was low (less than 0.15) but increased to 0.75 in voltage +40 mV. The channel conductance was also 157±4.9 Picoseimence.

AmB forms cationic channels in BLMs with phosphatidylcholine and without cholesterol. This channel has voltage-dependent electrophysiological characteristics and behaviors.

Millions of people suffer from pain worldwide, and annually, great economic costs are imposed on societies for pain relief. Analgesics such as alpha-2 adrenergic receptor agonists, which have low risk of complications, can be effective in assuaging pain and reducing costs. According to former studies, potassium channels play an important role in the analgesic mechanism of these receptors. This study aimed to determine the role of BK potassium channels in analgesia induced by alpha-2 adrenergic receptors. This study was performed on 56 male Wistar rats weighing 250-300 g that were divided into seven groups of eight rats. We administered 0.7 mg/kg intraperitoneal (IP) injection of clonidine, 1 mg/kg IP injection of yohimbine, and 5 mg/kg intracerebroventricular (ICV) injection of yohimbine. Iberiotoxin at a dose of 100 nm was also injected ICV. Normal saline and DMSO were applied as solvents. Pain severity was evaluated using formalin test at a concentration of 2%. The chronic pain induced by formalin injection was relieved by IP injection of 0.7 mg/kg clonidine. Moreover, 5 μg/kg and 1 μg/kg ICV administration of yohimbine with mean chronic pain scores of 2.29±0.13 and 2.09±0.07, respectively, could significantly inhibit analgesic effect of clonidine with mean chronic pain score of 1.55±0.14 (p<0.001). ICV injection of iberiotoxin with mean chronic pain score of 2.33±0.16 at a dose of 100 nm significantly diminished analgesic effects of clonidine. Alpha-2 adrenergic receptor agonists could induce analgesia in the animals, and the antagonist of this receptor inhibited the analgesic effect of agonists of these receptors. BK channel inhibition prevented analgesic effect of adrenergic receptor agonists, as well.

Nowadays, natural preservatives are used in food industries rather than synthetic ones. Sumac fruit (Rhus coriaria L.) is widely used as an additive in meat products due to its antimicrobial effects. This study was conducted to examine antimicrobial properties of sumac at various temperatures. In this experimental study, the extract of sumac was prepared using soaking method. Different concentrations (3.12-50 mg/ml) of the extract were used against S. aureus, L. monocytogenes, S. typhimurium, and E. coli O157:H7 bacteria. Growth assessment curve, minimum inhibitory concentration (MIC), and the minimum bactericidal concentration (MBC) were evaluated using microplate method. The results of this study demonstrated that MIC (6.25 mg/ml) and MBC (12.5 mg/ml) belonged to S. aureus and L. monocytogenes bacteria, respectively. The extract could significantly attenuate growth of the four bacteria at 4°C and 25°C (p<0.05). The effect of the extract on Gram-positive bacteria was significantly more than Gram-negative ones (p<0.05). Temperature reduction also affected the growth of the bacteria; at 4°C bacterial growth was less than 25°C, that is, at 6.25 concentration, S. typhimurium, and E. coli populations reduced from 3.55 log and 3.31 log to 2.14 log and 1.06 log, respectively. According to our findings, water extract of sumac is a viable alternative to chemical food preservatives, particularly at 4°C.

Considering the role of silver nanoparticles in inducing the production of free radicals, these compounds may lead to pathological effects and oxidative stress in the seminal fluid, resulting in the reduced quality of sperm parameters. Therefore, in this study, we aimed to assess the toxic effects of silver nanoparticles on sperm parameters and lipid peroxidation of sperm membranes in male rats. This experimental study was conducted on 24 Syrian adult male rats, which were randomly divided into one control and three study groups. The rats in the study groups were orally administered silver nanoparticles at concentrations of 0.07 µg (group A), 0.14 µg (group B), and 0.28 µg (group C), respectively per day for a period of five weeks. Then, lipid peroxidation of sperm membranes was analyzed, using thiobarbituric acid assay. Additionally, microscopic examinations were performed to evaluate sperm parameters. Based on the findings, the mean quality of sperm parameters such as sperm count and motility significantly declined in the study groups, particularly group B (77.69±16.96%; 16±2.6×106/ml) and group C (72.79±14.52%; 13.31±2.1×106/ml), compared to the control group (89.06±10.97; 23.57±3.46×106/ml) (P<0.05). Also, in terms of malondialdehyde concentration, a significant difference was reported among group A (0.25±0.01), group B (0.32±0.02), group C (0.35±0.01), and the control group (0.24±0.01) (p<0.001). The results of the present study confirmed that silver nanoparticles through enhancing lipid peroxidation could reduce the quality of sperm parameters in a dose-dependent manner

Life is the ultimate divine blessing, and medicine seeks to save the lives of individuals in danger. Despite the efforts of physicians, some medical interventions may lead to morbidity and mortality in the patients. Physician responsibility has been a matter of debate among lawyers and jurists. This study aimed to evaluate physician responsibility and effect of consent and presumption of physician innocence on the treatment of patients. In this qualitative study, viewpoints of lawyers and jurists regarding physician responsibility and effect of consent on medical interventions were reviewed using a library method. Based on the consensus of Islamic jurists, the physician will be liable in case of failure in the treatment or diagnosis of patients. However, if informed consent is obtained from patients, and standard medical interventions incidentally lead to death, the physician is not held accountable. According to the latest version of the Islamic Penal Code (2013), if a physician performs a standard medical procedure with the permission of patients or their legal representatives, s/he will not be held accountable for possible damages, except for the cases where medical malpractice is involved. According to the results of this study, obtaining informed consent from the patients or their legal representatives dismisses physician liability. Therefore, guaranteed treatment of patients is considered as the conditional commitment of physicians. If medical malpractice is confirmed, the physician must be held accountable

Paget’s disease is a progressive skeletal disorder, which involves the gradual destruction of the bones. Regarding the low prevalence of this disease in Iran, this study aimed to present a case of Paget’s disease in an asymptomatic patient. CASE REPORT: A 44-year-old male patient with elevated alkaline phosphatase (ALP) level in yearly examinations was referred to an internal medicine clinic. Considering the normal results of other examinations, high ALP level was found to be of an osseous origin. However, no bone deformity was detected in the patient. Bone scan and simple radiography were indicative of Paget’s disease considering the high osteoblastic activity in the right hip and right sides of T1 and L3 segments. Diagnosis of Paget’s disease was confirmed by bone biopsy. The patient was initiated on oral alendronate (35 mg daily) for six months. Following this period, ALP level reduced, and the treatment is still in progress.

According to the results of this study, although Paget’s disease is a skeletal disorder, it could remain asymptomatic and occur without any deformities.