Journal of Arak University of Medical Sciences

Quality of life and its relationship with quality of diet among elderly people in urban areas of Markazi province, Iran

Kurosh Djafarian

Background: In recent years, changes in the composition of Iranian population into aged population have increased the need for more information about the quality of life (QOL) of this group. Proper planning for this age group for increasing their quality of life depends on the identification of factors associated with QOL. The aim of the current study was to assess the quality of life and its relationship with the quality of diet in elderly people aged 60 years and more living in the urban areas of Markazi province. Materials and Methods: This cross-sectional study was carried out on 165 elderly people in the urban areas of Markazi Province in 2010. Data obtained via general and QOL (SF-36) questionnaires and three 24-hour recalls on food. The quality of diet was measured using Healthy Eating index. Results: The means of total SF-36, physical and mental components scores were 55.66, 51.32 and 57.30, respectively. Additionally, the average overall healthy eating index score was 82.83. The results showed that the total, physical, and mental components of SF-36 scores in the elderly were positively associated with the healthy eating index but not significantly (P=0.2). QOL and diet scores were significantly associated with age, sex, education, previous employment, income, leisure activities, exercise, insurance, smoking, present disease, and drug consumption (P<0.05). Conclusion: The results showed that the QOL in the elderly was not related to their quality of diet.

Pro-apoptotic effect of BIBR1532 on APL cell line: Induction of rapid cell death independent of progressive shortening of telomere length

Seyed H. Ghaffari

Background: Since nearly 90% of patients with acute promyelocytic leukemia (APL) have high telomerase activity and significant shortened telomere length, these patients have, therefore, been suggested to be good candidates for the therapeutic intervention with telomerase inhibitors. This study was done to investigate the effects of BIBR1532, a non-nucleoside inhibitor of telomerase, on APL cells. Materials and Methods: In this experimental study, for investigating the effect of BIBR1532, NB4 leukemic cells were cultured in the presence of various concentrations of BIBR1532. Succeeding apoptosis assay, Caspase-3 activity assay, and quantitative real-time PCR were applied to examine the effect of this drug on apoptosis percenage, enzymatic activity of Caspase-3, and quantitative expression of genes mRNA involved in apoptosis. Results: The results showed that BIBR1532 induced apoptosis in NB4 cells in a dose-dependent maner. Moreover, real time PCR results showed that BIBR1532 led to a significant decrease in mRNA of Bcl-2 gene and signficant increases in transcription of Bax, PUMA, and Caspase-3. Conclusion: Since treatment with BIBR1532 could exert rapid apoptotic cell death in NB4 cells andactivate cellular apoptosis route, anti-telomerase-based therapy can regarded as a suitable strategy for APL treatment. Patients with progressive shortening of telomere length and high levels of telomerase activity are suitable candidates for treatment with telomerase inhibitors.

The effect of body position on inner ear function

Arash Bayat

Background: Otoacoustic emissions (OAEs) are faint sounds generated within the inner ear that can be regarded as a sensitive tool for reflecting inner ear status. There are various factors that may influence OAE recording. One such factor that has not been extensively examined to date is body position. The aim of this study was to examine the effect of body position on the OAE responses of adults with normal hearing. Materials and Methods: In an analytic cross-sectional study, 26 normal hearing adults (18-25 years old) were evaluated. Transient OAEs (TEOAEs) were recorded in five different positions: supine, sitting, side-lying, 30°-Up, and 30°-down to evaluate their inner ear function. Data were analyzed using SPSS software 17. Results: Mean TEOAE amplitude values were significantly higher in the side-lying position compared to other positions (P=0.01). The most significant TEOAE amplitude differences were observed at the high frequencies (3000 Hz and 4000 Hz) in side-lying position orientation compared to low and medium frequencies. Conclusion: The results from the present study revealed that body position has a remarkable effect on inner ear function, and this effect is more obvious at high frequencies.

The experiences of parents of children with leukemia: A qualitative research

Rahmat alah Jadidi

Background: Leukemia, due to its widespread prevalence, high mortality rate, high treatment expenses, and long hospital stay, influences the families and their children to a great extent. This study was done to explore the experiences of parents whose children suffer from leukemia. Materials and Methods: Using qualitative research approach with applying content analysis method, 22 participants were interviewed in two teaching hospitals during 2 months. The study started by purposive sampling and continued by a theoretical one till data saturation. The obtained data were constantly analyzed through content analysis method. Results: Data analysis showed that “finding no solution in life, having a lot of problems, errors in treatment, concealing the illness, faith in God, parents’ devotion, hospital facilities, and consistency were the level 3 codes of parents’ experiences and “parents’ reaching a dead-end in life” was the main theme or core category of this study. Conclusion: Using a qualitative approach for exploring the experiences of parents with a child suffering from blood cancer helped recognize them more profoundly than quantitative methods. On the other hand, “parents’ reaching a dead-end in life” as the theme shows the importance of attention to parents’ problems. Using these experiences can increase hope among parents and help conduct the treatment more effectively.

Clinical symptoms of androgen deficiency and sex hormone levels in men referring to Zanjan Blood Transfusion Organization

Elham Jafari

Background: Aging in men is characterized by a progressive, moderate decrease in plasma testosterone. However, the associations of partial androgen deficiency of the aging male with clinical symptoms are controversial. This study investigates the association between the androgen deficiency symptoms (based on ADAM questionnaire) and sex hormone levels in men over 40 years old. Materials and Methods: This cross-sectional study was carried out on 171 healthy men over 40 years old. Demographic data and ADAM questionnaire were completed by each patient. Also, serum levels of free testosterone, estradiol, LH, and FSH were determined using the ELISA method. The data was analyzed by Chi-squared, Mann-whitney U test and Logistic Regression Test. Results: Based on ADAM questionnaire, 85 patients (49.7%) had androgen deficiency symptoms, and there was a significant relationship between these symptoms and age. However there was no significant correlation between the total score of the questionnaire with sex hormones, and only sexual symptoms were significantly associated with low testosterone levels. Conclusion: It seems that the clinical symptoms of androgen deficiency cannot precisely predict the levels of sex hormones in elderly men. Nevertheless, hypogonadism diagnosis can be clinically suspected when symptoms of sexual dysfunction are present

Recombinant expression and purification of Bacillus anthracis lethal factor domain 1 in Escherichia coli and production of polyclonal antibody against it in mice

Hosein Honari

Background: Anthrax is a common disease among human and livestock which is caused by Bacillus anthracis. Bacillus anthracis has two strong immunogenic proteins: Protective antigen (PA) and lethal factor domain I (LFD1) that have always been considered as vaccine candidates against Bacillus anthracis. The aim of this study is to express and purify the lethal factor domain I (LFD1) in Escherichia coli and produce polyclonal antibody against it in mice. Materials and Methods: In this experimental study, LFD1 gene was amplified with BamH I and Xho I restriction site by PCR. After isolation, the gene was cloned to the expression vector pET28a (+). This vector was transformed to E. coli-BL21 (DE3) PLysSto to express LFD1 gene. The expression of LFD1 gene was induced by IPTG. After protein purification by affinity chromatography, the produced antigen was injected into mice for four times. Then the produced polyclonal antibody in mice serum was evaluated. Results: The cloned LFD1 gene in pET28a (+) vector was confirmed by PCR, enzymatic analysis, and sequencing. The expressed and purified recombinant protein was confirmed by SDS-PAGE and Western blotting. Finally, the isolated polyclonal antibody from mice serum was evaluated and confirmed by ELISA test. Conclusion: Noticing the appropriate expression, easy purification of LFD1, and the titer of produced polyclonal antibody against LFD1 in mice due to its immunogenicity, it can be considered as a good vaccine candidate against anthrax.

The relationship between self-efficacy and stage of change and physical activity behavior in postpartum women

Fazlallah Ghofranipour

Background: Postpartum women are a population at risk for sedentary life. Previous studies have shown that self-efficacy is an important determinant of stage of change and exercise adherence. This study evaluates the relationship between self-efficacy and stage of change and physical activity (PA) behavior in Iranian mothers. Materials and Methods: In this cross-sectional study, 300 postpartum mothers were selected randomly from all health centers in Arak. The instruments used in this study included the 7-day PA recall, stages of exercise adoption tool, and self-efficacy for exercise scale. Data analysis was performed using SPSS software. Results: Ninety-one percent of the participants were in the pre-contemplation, contemplation, and preparation stages of change. Mean score for moderate PA was 38.94±40.5 minutes a week. Significant relationships were found between the stages of PA behavior change and METs of weekly energy expenditure from moderate activities (r=0.60, P<0.001). Also, statistically significant relationships were found between self-efficacy and the stages of PA behavior change (r=0.50, P<0.001) weekly energy expenditure from moderate activities (r=0.40, P<0.001), and pre-pregnancy PA behavior (r=0.39, P<0.001). Conclusion: The level of PA of the participants was less than the recommended minimum level for regular PA behavior (150 minutes of moderately intense PA per week). In this population, self-efficacy plays an important role in PA behavior and it should be taken into consideration in designing interventions for improving PA behavior.

Online Conductivity Monitoring, despite underestimating hemodialysis adequacy: Still a reliable practical tool

Mahnaz Edalat-nejad

Background: Adequately delivered hemodialysis dose has been shown to have a distinct impact upon the morbidity and mortality of patients on chronic dialysis therapy. Online conductivity monitoring (OCM) using sodium flux as a surrogate for urea allows for repeated measurement of hemodialysis adequacy in each treatment session. Materials and Methods: In this cross-sectional study, 156 treatment sessions in patients undergoing chronic hemodialysis were assessed by measurement of the conductivity performed by Diascan in AK 96 dialysis machines. Dialysis adequacy was measured by daugirdas logarithmic estimates of single-pool Kt/V. Values of calculated Kt/V and simultaneously obtained online Kt/V were compared. Statistical analysis was performed using paired sample t-test. Results: There was a statistically significant difference between calculated Kt/V and online Kt/V in this study. The mean calculated Kt/V was 1.1±0.18 and mean online Kt/V was 0.77±0.32 (p<0.001). There was a moderate correlation between calculated Sp Kt/V and on-line Kt/V (r =0.44, p=0.012). Conclusion: Despite the underestimation of hemodialysis adequacy by online conductivity monitoring in comparison with Sp Kt/V, it is a useful tool in clinical practice.

Impact of aerobic exercise and detraining on pulmonary function indexes in obese middle-aged patients with chronic asthma

Farzad Nazem

Background: Epidemiological studies have shown the relationship between incidence of asthma symptoms and environmental factors, such as sedentary lifestyle and metabolic and cardiovascular diseases. However, the role of exercise rehabilitation protocols on lung function in obese adult patients with chronic asthma is a controversial issue. The aim of the present study is to evaluate the impact of aerobic exercise on lung function in obese middle-aged men with chronic asthma. Materials and Methods: This semi-experimental study was conducted on 39 obese middle-aged males with mild and moderate asthma. The experimental group (n=19) with regard to the safe range 15≥ RPE>9 followed the sub-maximal rehabilitation exercise program (50 to 80% HRmax intensity) for 3 months. Then, they underwent one month of detraining. The control group (n=20) did not have any form of aerobic exercise. Spirometric parameters in base, three months of training, and one month of detraining were measured by standard methods. Results: Indicators of lung function, including FVC, FEV1/FVC, PEF, FEF%75, and MVV significantly decreased. The pattern of changes in FEV1, FEV1/FVC, and MVV remained stable even after a month of detraining (p<0.05). However, no significant changes occurred in the dependent variables of the control group (p>0.05). Conclusion: It seems that the incidence of physiological adaptations of aerobic exercise, as a non-pharmacologic clinical factor, after the one-month detraining period affected the spirometric parameters in obese asthmatic patients

The role of oxidative stress in male infertility: A review

Ali Khosrowbaki

Background: There is growing evidence that damage to spermatozoa by reactive oxygen species (ROS) plays a key role in male infertility. This study was done to review the role of oxidative stress in male infertility. Materials and Methods: In this review article, PubMed, Scopus, and EBSCO-CINAHL databases were used for finding the relevant studies. Results: Under physiological conditions, a certain level of ROS is necessary for normal sperm function. However, an excessive level of ROS produced by leucocytes and immature sperms can cause damages to spermatozoa. Oxidative stress develops when there is an imbalance between ROS production and antioxidant defense system in male reproductive tract. High levels of ROS have been detected in the semen samples of 25-40% of infertile men. Oxidative stress can induce detrimental effects on standard seminal parameters and fertilizing capacity of spermatozoa. Conclusion: Oxidative stress can induce impaired sperm function that results in poor pregnancy rate in natural conditions and assisted reproduction.

Designing a scoring system for selecting cases requiring chest radiography after central venous catheterization

Gholam reza Noori

Background: Central venous catheterization (CVC) is a common procedure associated with various side effects such as pneumothorax. Recently, the routine post-catheterization chest X-ray has been challenged. The aim of the present study was to design a scoring system for selecting patients requiring radiography after CVC procedure. Materials and Methods: In this cross-sectional study, 210 patients requiring CVC were enrolled in the study and pneumothorax potential risk factors, including body mass index>30, history of neck or chest surgery, emphysematous disease, history of catheterization, number of punctures, inappropriate position during CVC, and treatment with ventilator were recorded. Finally, chest radiography and clinical signs before and after CVC were compared and scoring system sensitivity and specificity were determined. Results: Incidence of pneumothorax was 5.24%. The number of punctures and patient's position and history of catheterization showed significant associations with pneumothorax development (p<0.001). Pneumothorax incidence in patients with score> 4 was 80% which was significantly higher than patients with score<4 (OR: 174.2, p<0.001). Sensitivity and specificity of using the scoring system at cut-off score> 2 were 81.8% and 87.9%, respectively. Conclusion: The results of this study showed that pneumothorax development risk is very low in patients with score<2 and there is no need for post CVC routine chest X-ray. However, in patients with score>4, pneumothorax development risk is high and it seems that chest radiography with close intervals even more than one time is necessary. Further studies are recommended to validate the proposed scoring system.