نشریه دانشور پزشکی
پیاپی 94 (شهریور 1390)

Few studies have shown the role of oxidative stress in gestational diabetes mellitus. Increased oxidative stress and antioxidant defense dysfunction could be one of the etiologic factors in gestational diabetes mellitus. The aim of this study was to evaluate levels of salivary antioxidants in pregnant women with gestational diabetes mellitus and their comparison with non-diabetic pregnant women. In this semi-experimental study that was done in 2009-2011 in Hamadan, 5 cc unstimulated saliva from 35 gestational diabetics and 35 non-diabetic pregnant women with an age range of 25-40 and BMI of 25-40 was collected. Enzyme activity of superoxide dismutase, uric acid and total antioxidant capacity were measured with special kits by spectrophotometric method. Data were analyzed by t-test using SPSS program. Activity of superoxide dismutase in gestational diabetes mellitus was significantly lower than control group (p<0.001). Total antioxidant capacity changes was not significant and uric acid changes was also the same as total antioxidant capacity level and was not significant (p=0.663). Antioxidants deficiency and altered response to elevated levels of oxidative stress seems to have a role in pathogenesis of gestational diabetes mellitus.

Recent research suggests that a proportion of women may develop post-traumatic stress disorder (PTSD) after childbirth. This study aimed to test relationship between cesarean section and vaginal delivery with PTSD after childbirth in Bushehr. This study was an analytic cross-sectional one. Participants were recruited from post-partum women who attended health medical centers in Bushehr (n = 400) and for women with traumatic delivery completed posttraumatic symptoms scale-I (PSS-I) and reproductive questionnaire. Data were analyzed by univariate and multivariate logistic regression. Women with PTSD had higher odds ratio for emergency cesarean section (Odds ratio = 3.55, CI=1.69-8.07) and insufficiency income (Odds ratio=4.50, CI=1.71-11.84). Duration of labor lower than 3 hours (Odds ratio=0.15, CI=0.04-0.55) and higher education level (Odds ratio=0.15, CI=0.04-8.58) were associated with significantly decreased risk for PTSD. Interventions aimed at reducing the incidence of PTSD after childbirth needs further research but it seems that consultation about decreased cesarean section during prenatal care is useful.

The human papillomavirus (HPV) is the main cause of cervical cancer. The symptoms of the disease are non-specific and it can be transferred from one person to another one. In order to prevent the spread of HPV virus and reducing mortality rate of cervical cancer, early detection programs are needed. Accurate and highly sensitive test is essential for screening examination. So, in this study, our aim was enrichment of nanobody library against HPVs L1 proteins to isolate clones which produce specific nanobody against L1 proteins. In the future, these nanobodies can be used in highly sensitive diagnostic kits for early detection of cervical cancer. The phagmids of polyclonal library were amplified in Escherichia coli strain TG1. Panning of library and selection of clones were carried out against HPV L1 protein. The titer of output phagmids and optical density in Phage-ELISA were evaluated. The best clones were isolated by monoclonal phage ELISA method and checked by sequencing and colony PCR. An increase in the number of output clones in consecutive rounds of panning and the rise in the difference of OD450 in phage ELISA shows the accuracy of the enrichment process. At last, 4 clones were isolated as best ones. This study proved that after three rounds of panning, the phagmid library was enriched for anti HPVs L1 nanobodies and isolation of specific clones against this antigen were accomplished. By use of these anti HPV L1 nanobodies in laboratory kits, new hopes for early diagnosis of precancerous lesions with high reliability can be achieved.

Although the overall incidence of childhood hematopoietic cancer is low, it is the most common cause of cancer in children. The aim of this paper was to ascertain the epidemiology of childhood hematopoietic and reticuloendothelial cancer according to cancer registry data system in Fars province. In this epidemiological study, the frequency distribution of blood cancer during the years 2001-2008 in children under19 years old was evaluated and occurrence rates were calculated per million per year. Data were analyzed by Excel and WinPepi 2.1. Over an 8-year period (2001-2008), 770 new cases of leukemia were recorded among 0-18 year old children including male (61.3%), 0-4 years old (26.4%) and cancer type ALL (39.4%). Moreover, most of the cases were diagnosed in 2008 (20.8%). Over this period, the ASR of leukemia in male (p<0.001), female (p<0.001) and both sexes (p<0.001) has been significantly increasing. Like other parts of the world, the trend of age-standardized incidence rate of leukemia in people under 19 in the Fars province is rising.

The planning of educational programs to inform the people about the prevention of diseases such as cancers is necessary. With considering the high incidence and mortality rate and costly and difficulty screening of gastric cancer in Iran, this study was conducted to determine the effect of educational interference based on HBM on knowledge, attitudes and practices of housewives about nutritional factors associated with gastric cancer.

In this quasi experimental study, 84 of housewives from Isfahan participated and were randomly categorized into two groups (experimental and control groups). Before the performing of educational program based on HBM, the self-structured, valid and reliable questionnaires were completed by the groups. Then, the experimental group received the educational program about the correct nutritional behaviors in the form of lecture, group discussion and questioning and answering in 4 sessions and the non-intervention group did not receive the education. Both groups completed the questionnaires 2 months after the intervention. Data were analyzed using SPSS18 by Mann-U- Whitney, t student and paired t test and p<0/05 considered significant.

The mean age was 34.11 ± 6.23 in intervention group and 34.21± 6.5 years in non-intervention group and the difference was not significant. There was not also a significant difference in knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self- efficacy and practices of women before the intervention (p>0.05), but difference was significant after the intervention (p<0.001).

Health education based on HBM increases the knowledge and improves the attitudes and practices of housewives women with regard to nutritional factors for prevention of the gastric cancer.

The incidence of CS has been increasing and one of the most important reasons is the request of healthy mothers due to their fear of labor pain. Regional analgesia as a popular technique is provided for labor pain relief. The aim of our study was comparison of two drugs used in spinal anesthesia: fentanyl and sufentanil. We assessed advantages and disadvantages of each. In a randomized double blind clinical trial, 64 parturient women in vaginal delivery room randomized to receive fentanyl or sufentanil with bupivacaine and epinephrine intratecally. All participants were 19-34 years old, gravid 1 to 3, full term (37 weeks), ASA physical status 1 or 2 with no absolute contraindication for vaginal delivery. We studied fetal and maternal complications and duration of pain relief. The SPSS software (version 16) was used for data analysis. There was no statistical significant difference between side effects and duration of pain relief (p value = 0.33), except for moderate sedation (p value = 0.046) and duration of second stage of labor (p value = 0.03) that have not clinical significance. Neonatal icter was the same (p value = 1) and headache and backache were seen in 25% and 3% of cases respectively. Both drugs had the same effects and side effects, then, we can use each one which is available instead of another one. In addition, spinal analgesia with fentanyl and sufentanil for painless labor are safe with enough duration of pain relief.

Visfatin a 491 amino acid peptide is expressed as a Pre-B cell colony-enhancing factor or Nicotinamide phosphoribosyltransferase and might be regulated by several factors such as; nutritional status, physical stress, suggesting a regulatory role of peripheral visfatin in energy homeostasis. The purpose of the present study was to investigate the effects of endurance training and bene extraction on resting plasma visfatin and lipids concentrations in female rats. Twenty eight adult Wistar female rats (6–8 weeks old, 122–180 g) were used for this study. Animals were divided into four groups including: salin control, bane control, salin training and bane training. Training group was given exercise on a motor-driven treadmill for 8 weeks (at 25 m/min, 0% grade, for 60 min/day, 5 days/week). Rats were sacrificed 72 h after the last session of exercise and 4 h fasting. A one-way ANOVA was used. The data show that the mean body weight, resting plasma visfatin, triglyceride, and glucose concentrations were lower in bene-trained rats when compared with other groups; but the differences statistically did not reach to a significant level. The current results indicated that exercise plus bene extraction might have more impact on resting levels of visfatin and lipid mobilization than exercise or bene extraction alone. Data also indicate that a lower amount of visfatin in Bene-trained group was accompanied with higher plasma ATP concentration.

Currently, nursing productivity is a critical factor in control costs in hospitals because nurse's works plays a basic role in quality care and affect organization's successes. Management factor is recognized as effective factor that affects nurse's productivity. This study aimed to assess the effect of improvement of nursing managers’ professional competencies on their productivity. This semi-experimental study was done in one of teaching hospitals in Mashhad city in 2010 which randomly selected. Samples were 52 nurses who work in 10 units before and after intervention. Data were gathered by two questionnaires: Nurse's productivity and checklist to assess nursing manager's competency. Data were analyzed by SPSS program. Findings revealed that 3.9% of nurses considered their productivity level high before period of intervention but 36.5% after intervention. Paired t-test showed that there was a significant difference in nurse's productivity between before and after intervention (p< 0.000). In general, there was no correlation between nurse's characteristics and their productivity. Management is one of the ways for improving nurse's productivity. According to results of this study; using manager's development program can change management and leadership methods and this result to improvement of nurse's care and nurses’ productivity.