Journal of Arak University of Medical Sciences

Effect of Fenugreek Seed on Menopausal Depression: A Randomized Double-Blind Clinical Trial

Naimeh Akbari Torkestani

Background: Depression is one of the most common problems in postmenopausal women. Diosgenin present in fenugreek seeds present study the effects of menopause on depression in menopausal women took the city in 1390.

Materials and Methods: In a randomized controlled trial enrolled 60 women with complaints of depression caused by menopause. Beck Depression Inventory on a sample of postmenopausal women and the inclusion criteria were enrolled. The samples were divided randomly into two groups, Diosgenin (6 g Fenugreek seed daily containing 25 mg Diosgenin) and sorbitol (25 mg daily) for 8 weeks were placed before and after 8 weeks of intervention questionnaire, Beck completed SPSS software was used to test the statistical Paired test scores before and after treatment were compared.

Results: Mean depression score decreased after 8 weeks took Fenugreek containing Diosgenin and sorbitol as compared with before of intervention of this study and it was significant.The comparison did not indicate a significant difference between the two groups.

Conclusion: According to the finding of this study, administration of 6 g Fenugreek seed containing Diosgenin for 8 weeks decreased menopausal depression . The need for further studies with longer duration and higher doses before any recommendations can be felt.

Effects of Melatonin on Visual Functioning of Patients with Multiple Sclerosis

Alireza Jamshidi Fard

Background: Several clinical studies suggest that melatonin is a neuroprotective molecule in neurodegenerative disorders and it showed to be reduced in Multiple Sclerosis (MS) patients. MS also results in blurred vision, papillitis and diplopia. The main objective of the study was to asses the influence of Melatonin supplimentation on visual characteristics in patients with MS.

Materials and Methods: In a Quasi Experimental plan, approved by AUMS ethical Committee, 34 (9 males and 25 females) patients with stable MS were asked to voluntearly participate in the study. All subjects (Mean EDSS 3.14) were taking their routine medications. Visual funtions were evaluated by Visual Functioning Questionnaire (VFO-25) and standard Pattern Reversal Visual Evoked Potentials (PR-VEP) records. Serum Melatonin levels were also measured using an ELISA assay. Recordings were performed after a single dose and after taking 1 tablet every night for 14 days, at the day 16th.

Results: In all subjects, Serum Melatonin levels were significantly enhanced. VFQ scores also showed significat improvement. Except the change in N75 latencies of left eyes, VEP latencies of P100, N145 of both eyes and N75 of right eyes were significantly (p<0.05) reduced.

Conclusion: Our findings suggest significat improvements of visual symptoms of MS after daily intake of 3 mg Melatonin. The results calls for further studies and clinical trails before asking all MS patients to take Melatonin suppliment every night.

The Effect of Aerobic and Anaerobic Tests on the Alternation of Heat Shock Proteins levels on Young female.

Ali Khajehlandi

Background: Heat shock proteins (HSP) are from proteins family playing crucial role in maintaining cellular hemostats and protecting cells in an acute and chronic stressful conditions. The object of this study is to investigate the alternation of heat shock proteins (HSP70) levels after Wingate and Strand tests in female students.

Materials and Methods: In this semi- experimental study, 40 female (20 athletics and 20 non-athletics) with the mean age 22.3±3 & 23.2±2, Height 159.2±5 & 161.2±4 cm and mean weight of 59.3±3 & 65.4±2 kg (respectively) were selected randomly and underwent training protocols of Wingate and Strand tests with 3 days intervals. 5 cc brachial vein blood samples were taken immediately before and after performing tests in order to analyze the data using repeated measure method.

Results: The findings showed significant increase after aerobic Strand test between athletics and non-athletics Female (p<0.01). But, after aerobic Wingate test, a significant increased was observed only in Athletes' group (p>0.05). But there was an insignificant reduction in non-athlete group.

Conclusion: The results showed that exercise duration is more important than exercise intensity in HSP70 production.

Relationship Between Menopausal Age and Metabolic Syndrome in Non-Obese Postmenopausal Women

Masoumeh Sayahi

Background: Menopause being the most critical period, the unfavorable changes in anthropometric and metabolic parameters associated with CVD risk. Metabolic syndrome is the key factor for cardiovascular disease and has become major problem in many countries. With the high prevalence of metabolic syndrome, especially in women after menopause, this study was performed to investigate the relationship between the menopausal age and metabolic syndrome in non-obese postmenopausal women.

Materials and Methods: This cross sectional study on 140 healthy non-obese postmenopausal women who had a BMI less than30 Kg/m2, at 2009 in Ahvaz the data were contained demographic information, menopausal age, BMI, values of HDL-C, FBS, TG serum after 12 houres fasting, blood pressure and waist circumference. We used the Pearson correlation and multiple regression analysis by SPSS15 software.

Results: Menopausal age with FBS (p=0.04) was negatively significant. But there was not any correlation between menopausal age with other Components of metabolic syndrome. [triglycerides (p=0.28), systolic blood pressure (p=0.80) diastolic blood pressure (p=0.48), waist circumference (p=0.08), HDL-C(p=0.65)].

Conclusion: Late menopause has favourable effect on fasting glucose.

Application of Real–Time PCR for Rapid Detection of Rifampicin Resistant Mycobacterium Tuberculosis

Ehsanollah Ghaznavi-Rad

Background: The emergence of drug-resistant strain of M.tuberculosis is one of the most critical issues facing TB researchers and clinicians. Rapid diagnosis of drug-resistant tuberculosis is essential for the prompt initiation of effective second-line therapy to improve treatment outcome and limit transmission of this obstinate disease. The aim of this study is to develop a Real-time PCR assay for the detection of mutations in RRDR (rifampcin resistance determinant region) of rpoB which conferring rifampicin resistance in Mycobacterium tuberculosis.

Materials and Methods: In this experimental study, the primer and probe set were designed for a RRDR region of rpoB gene using a specialized software. Clinical specimens that had previously been evaluated resistant or sensitive by using convential method, were used for assessing the clinical sensitivity and specificity of the assay.

Results: The clinical sensitivity of the assay was determined 100%. The primers and the probes were rpoB specific and no cross-reaction was observed with other microorganisms and human genome bioinformatically. The clinical specificity of developed Real-time PCR assay was examined experimentally using 25 negative samples and determined to be 100%.

Conclusion: The developed real-time PCR assay can be used as an appropriate and efficient tool for the rapid detection of rifampicin-resistant Mycobacterium tuberculosis.

Extra-Pulmonary Tuberculosis and Its Comparison with Pulmonary Tuberculosis in Central Province (2002-2012)

Masome Sofian

Background: Mycobacterium Tuberculosis usually infects the lungs but organs other than the lungs may also be involved. This study is an analysis of the situation of extra-pulmonary tuberculosis in the central province of Iran.

Methods and Materials: In this cross-sectional study, the information in the registration software of tuberculosis in health centers collected and for analyzing of data statistical software SPSS16 was used.

Results: In the survey a total of 1787 TB patients were identified, of which 24.2% were diagnosed with extra-pulmonary tuberculosis and 1.9% of patient with extra-pulmonary TB were associated with HIV infection. Female to male sex ratio is equal to 1.3. The 82.5% of the patients were Iranian citizen and mean age of patients were 43.3 years. Tuberculosis of the lymph nodes, skletal and pleural tuberculosis had the highest prevalence. Also extra-pulmonary tuberculosis in females, age 15-55 was more and the diagnosis delay was more in extra-pulmonary tuberculosis and relapse was more in pulmonary tuberculosis.

Conclusion: Because of more diagnosis delay in extra-pulmonary tuberculosis it is necessary to train physicians and other healthcare workers in the field of extra-pulmonary TB diagnosis and more planning to do about learning of it.

Study of Relationship of Activation and -107 C/T Polymorphism in Paraoxonase 1 Gene with Fatty Acid Diversity in Phospholipids of High Density Lipoprotein

Effat Farrokhi

Background: Paraoxonase1 activity shows decline in patients with coronary artery disease. The C to T change in the -107 position of promoter is the most important genetic determinant of serum levels of paraoxonase 1. Study of this polymorphism and its relationship with the type of fatty acid composition of phospholipids in HDL particles can be found in the common pursuit of better medicines and considered in drug treatment.

Materials and Methods: In this descriptive study 265 Patients were selected and divided in two groups based on LDL level (131 in case and 134 in control). Information of subjects were collected from questionnaire and the results of biochemistry and molecular tests. Fatty acids of HDL phospholipids were measured with Gas chromatography technic .

Results: PON1aryl esterase activity, had no significant changes after treatment with lovastatin but paraoxonase activity had more significant increases in the CC genitype of -C/T107 polymorphism. Percent of oleic acid, linoleic acid and icosapentanioc acid in HDL phospholipids were increased by lovastatin.

Conclusion: Treatment with lovastatin in the CC genotype is probably more protective effect against cardiovascular disease. Following treatment, in patients with higher paraoxanase 1 activity Oleic acid and linoleic acid have also increased in HDL phospholipids.

Primary Multiple Cerebral Hydatid Cysts: A Case Report of Unusual Presentation

Alireza Mohammadi

Background: Hydatid disease is a common infection caused by Echinococcus granulosus. Cerebral involvement is very rare and only occurs in 2% of all hydatidosis in endemic areas. We report a case of primary multiple cerebral hydatid cysts in a 23 years old patient. Case: A 23 years old female was admitted in our emergency ward with primary generalized tonic colonic seizure, left body and face hemiparesis and history of headache in last two months. Contrast enhanced CT and MRI showed a big well-defined, rounded, cystic lesion in the motor strip of right temporo-parietal region with mass effect causing midline shift which was diagnostic for brain hydatid cyst and several smaller cysts. There was no evidence of other organs involvement. The patient underwent the brain surgery. A big hydatid cyst (10cm in diameter) and some others adhering to brain parenchyma in different sizes were evacuated completely and without rupture using Dowling method. Patient received albendazole 400mg/two times a day for 2 months too. There was no cyst in patient’s MRI study in two years follow up.

Conclusion: Though low incidence, primary multiple cerebral hydatid cysts should be considered in endemic area using brain CT and MRI. Surgery is standard treatment of the disease.

The Relationship Between Serum, Umbilical Cord Blood and Retinol (Vitamin A) Intake of Pregnant Mothers and Birth Weight of Neonates Referring to Hospitals in Arak in 2011-12

Mahmoud Reza Nakhaei

Background: There is priority for evaluation of micronutrients (vitamin A) in the world, especially in develpoing countries like Iran. Vitamin A has an essentiall role in growth, reproduction, and maintenace of epithelial cells. Vitamin A, especially retinoic acid, acts like a hormone for gene expression. Vitamin A is necessary for growth of bones and immune system. The role of vitamin A in reducing mortality rates of neonates is well recognized. The aim of research is to evaluate this micronutrient (vitamin A) and the rate of transportation from mother to fetus and its positive effects on birth weight.

Materials and Methods: In this descriptive study, 90 pregnant mothers were selected from private and public hospitals in Arak. Data were gathered through a questionnaire including general information concerning pregnant mothers and also their nutritional diet. The analysis of dietary intake was done by Nutritionist IV software. The measurements of serum and cord blood retinol samples were carried with reverse phase HPLC. Data analysis was done by Pearson correlation.

Results: The results indicated a positive and significant correlation between cord blood retinol of mothers and birth weight of neonates (r=0.22) (p&ge0.05). There was not a significant correlation between serum retinol of the mothers and birth weight of the neonates. Also, there was no significant correlation between retinol intakes of the mothers and birth weight of the neonates.

Conclusion: Improvement of the retinol status of mothers has an effective role in normal birth weight of neonates.

Comparison of the Effect of Oral and Intravenous Ondansetron on Decreasing Nausea and Vomiting After Cesarean Section

Lora Melikof

Background: Caesarean section is one of the most common gynecologic surgeries. Nausea and vomiting after pain is the most common side effect of surgeries, today, we most widely use of serotonin receptor antagonists, that are most effective antiemetic and have less side effect rather than other drug. Ondansetron is typical serotonin antagonists.

Materials and Methods: This is a randomized, double-blind clinical trial on 162 women undergoing cesarean section. 4mg intravenous ondansetron was given to first group and 8mg oral ondansetron was given to second group and thired group recived placebo. Blood pressure and heart rate were measured before and immediately after performing spinal and every 5 minute until 20 minute. Post operative nausea and vomiting and APGAR score were recorded after operation in recovery and 2, 4, and 6 houres after surgery.

Results: There was no significant difference among 3 groups according to age, gravidity, mean atrial pressure and heart rate before and during surgery. Nausea and vomiting in oral and intravenous groups at recovery, 2 and 4 hours after surgery were significantly less nausea and vomiting than placebo group (p<0.05). Whereas there was no significant difference between oral and intravenous groups.

Conclusion: It was concluded that using oral ondansetron with the same antiemetic effect is more convience to women undergoing cesarean section with spinal anesthesia.