Journal of Arak University of Medical Sciences

The Study of Epidemiologic, Demographic and Clinical Characteristics in Patients with Migraine Headache Referring to Neurology Clinics of Vali-Asr and Imam Reza Hospitals in Arak City

Elaheh Kazemeini

Background: Migraine is one of the prevalent disabling disorders. Considering geographical differences in reported epidemiology and improving patients care, the aim of the present study was to evaluate epidemiologic, demographic and clinical characteristics in patients with migraine headache in Arak.

Materials and Methods: This cross sectional and descriptive study was conducted on patients with migraine headache referred to the neurology clinics of Vali-Asr and Imam Reza hospitals of Arak for 6 months. A questionnaire containing the demographic, epidemiologic and clinical data was filled by patients. Finally, data were analyzed using SPSS 18.

Results: Among 820 patients with headache, 92 (11.21%) subjects were confirmed to have migraine headaches. Of the 92 patients, 54.3% were women and 45.6% were men. The mean age was 36.9±9.2 years old and 50% were married. The most common migraine triggers were stress (78.2%), sleep disturbances (65.2%), and fatigue (63%). The mean frequency of headaches was 6.9±3.5 attacks per month with an average duration of 11.1±4.5 hours per attack.

Conclusion: According to our results, the prevalence of migraine in women is more than in men. Dizziness, visual disturbances, nausea, no aura, headache is one-sided and pulsating are significantly accompanied by migraine. The number of consumed sedative pills in the month, brain imaging and a monthly fee of headache were significant. In total, clinical characteristics of migraine headaches in our patients were nearly compatible with the International Headache Society (IHS) criteria.

Determination of Specific Activities of Radionuclides in Soil and Their Transfer Factor from Soil to Bean and Calculation of Cancer Risk for Bean Consumption in Iran

Reza Pourimani

Background: Nuclear radiation emission by radionuclides causes the diseases, such as cancer or genetic anomalies. Therefore, the study of radioactivity in soil and food as well as calculating the risk of cancer seems essential for foods consumption.

Materials and Methods: In this research, nine different varieties of beans containing the grain of beans, areal part and their soil cultivated were collected. The specific activity of ²²⁶Ra, ²³²Th, ⁴⁰K and ¹³⁷Cs was determined for each sample employing gamma ray spectrometry method using high purity germanium detector with 30% relative efficiency.

Results: The absorbed dose rate in the air in one meter above the ground surface varied from 77.23 to 112.78 in nGy/h. The annual effective dose rate absorbed by adult person from the beans consumption in Iran is in the range of 122.14 to 905.86 in μSv/y. The cancer risk for the different varieties of beans varied from of 1.87 × 10^-5 to 1.59 ×10^-4 which is less than acceptable value as 10^-3.

Conclusion: The specific activities of radionuclides in soils samples are more than average of world wide range. The absorbed dose rate from bean consumption for the most of Varieties is more than of world average. Cancer risk resulted from bean consumption is less than acceptable value and consumption of bean has no risk for population health.

Lymphocyte Proliferation Response in Patients with Acute and Chronic Brucellosis

Ghasem Mosayebi

Background: Brucella is an intracellular bacterium that causes chronic infection in humans and domestic animals. The underlying mechanisms that cause prolonged illness are complex and not fully understood. Immune responses may have an important role in the chronicity of infection. Here, we evaluated the lymphocyte proliferation responses in patients with chronic and acute brucellosis.

Materials and Methods: This descriptive - analytical study was performed on 22 patients with acute brucellosis, 21 patients with chronic brucellosis and 21 healthy people with the similar age, sex and genetic background as control group. Peripheral lymphocytes were isolated using Ficoll and the cellular proliferation was quantified in presence of antigen and phytohemaglutinin-A by MTT method.

Results: The brucella antigen-specific stimulation index in patients with chronic brucellosis was significantly lower than the acute brucellosis patients (p=0.001). Also, stimulating the lymphocytes with phytohemaglutinin-A has shown that proliferative response in patients with chronic brucellosis was lower than the other groups (p=0.04).

Conclusion: The results indicated that chronic brucellosis inhibits lymphocyte proliferation. This inhibition of lymphocyte proliferation may be due to the induction of anergy.

The Effect of Microgravity Condition on Expression of VEGFR-2 Gene in Human Umbilical Vein Endothelial Cells (HUVEC)

Zahra Hajebrahimi

Background: Endothelial cells are very sensitive to mechanical force including microgravity and the morphological and functional changes in them are believed to be at the basis of weightlessness-induced cardiovascular deconditioning. It has been shown that the proliferation, migration, and morphological differentiation of endothelial cells play critical roles in angiogenesis. So far, the influence of microgravity on the ability of endothelial cells to foster angiogenesis remains to be explored in detail. The aim of this study was to investigate the effect of microgravity condition on VEGFR-2 and CD34 genes expression in human umbilical vein endothelial cells (HUVEC) in angiogenesis.

Materials and Methods: In this study, HUVEC cells were purchased from Pastor Institute. We used a clinostat to simulate microgravity condition for 2, 24 and 72 hours. Real time PCR technique was used for gene expression analysis after extraction of RNA from cells.

Results: Our results showed that microgravity for 72h leads to a significant increase (6 times compared with control group, p<0.001) in the VEGFR-2 gene expression. However, expression of CD34 did not change (p>0.05) with microgravity.

Conclusion: Based on the results, microgravity has positive effect on angiogenesis and can be used to generate vascules for cell therapy of ischemic diseases and atherosclerosis.

Study of Melatonin Protective Effects on Learning and Memory Deficits Induced by Administration of Lead during Pregnancy and Postpartum in Rat: Behavioral and Biochemical Evaluations

Iran Goudarzi

Background: Few studies have investigated the possible ways to prevent lead induced defects during gestation and lactation. The aim of this study was to investigate the effect of melatonin as a hormone with antioxidant properties on oxidative stress in the hippocampus and learning and memory impairment induced by administration of lead.

Materials and Methods: Pregnant rats were exposed to treatments of control, lead acetate (0.2% solution in water), lead acetate + melatonin and melatonin (10 mg / kg by oral gavage) from gestation day 6 until weaning. 21 days after birth, the activities of several antioxidant enzymes including superoxide dismutase (SOD), glutathione peroxidase (GPX) and catalase (CAT) as well as malondialdehyde levels in hippocampus of 23 male offspring rats were assayed. To behavioral studies, on postnatal day 30, 57 rats were trained 6 days in the Morris water maze and the probe test was performed 24 h later.

Results: The results showed that administration of lead during pregnancy and lactation could increase MDA levels and decrease glutathione peroxidase, superoxide dismutase and catalase antioxidant enzymes activities in the hippocampus of male offspring. Also, this treatment significantly disrupted performance of the Morris water maze test and impaired learning and spatial memory in male offspring compared with control. Administration of melatonin attenuated lipid peroxidation and could improve learning and spatial memory deficits and the activity of antioxidant enzymes in lead exposure group.

Conclusion: Melatonin as a neuropotective drug can protect the hippocampus against the complications of lead exposure, in the course of development.

To Study the Factors Affecting Medication Adherence in diabetic Patients based on Health Belief Model in Arak, 2014

Mohsen Shamsi

Background: Diabetes is one of the most common disease resulted from metabolism disorders. Thus, Studying medication adherence in patients to explain educational interventions to improve the health of these patients is necessary. Therefore, the present study aimed to assess the factors affecting medication adherence in diabetics patients based on health belief model in Arak 2014.

Materials and Methods: In this analytical study, 366 diabetic patients in Arak in 2014 were selected and data were collected through a researcher made questionnaire about patients behavior in the field of medication adherence and its influencing factors based on the health belief model. Linear regression model was used to determine the predictive power of structures.

Results: The mean knowledge score and the medication adherence was 31.34 and 84.34, respectively. In this study, perceived susceptibility, perceived barriers and internal action guide were as the strongest predictors of medication adherence behavior in patients and predicted their behavior variance 0.36. Between function and susceptibility and severity and perceived benefits and self- efficacy of manual internal and external action guides in the field of medication adherence with diabetes, there was a direct correlation that the highest correlation was related to the perceived susceptibility structure (r=0.42 , p<0.001).

Conclusion: The results showed that the educational interventions with an emphasis on building the perceived sensitivity of patients with diabetes for medication adherence and emphasis on internal incentives as motivators and incentives for patients to achieve better results in the field of medication adherence should be at the heart of educational interventions.

The Frequency of Extended Spectrum β-Lactamase Genes of SHV-2a, SHV-5 and SHV-12 in Clinical Isolates of Klebsiella Pneumoniae Isolated from Kermanshah Medical Centers in 2014

Alisha Akya

Background: The dissemination of extended-spectrum β-lactamases (ESBL) in Klebsiella pneumoniae isolates has resulted in the increase of antibiotic resistance and mortality among patients. The aim of this study was to determine the prevalence of ESBL and SHV-2a, SHV-5 and SHV-12 genes in K. pneumoniae isolates from Kermanshah.

Materials and Methods: In this descriptive – analytical study, from 112 clinical samples of patients admitted at Kermanshah medical centers in 2014, 60 K. pneumoniae isolates were recognized by standard methods of bacteriology and API Kit. Antibiotic susceptibility of isolates was determined by disk diffusion method and the isolates were screened for ESBL-producerig using the combination disc method. The SHV-2a, SHV-5 and SHV-12 genes were determined among isolates using PCR method. Primers were designed in this study.

Results: Of 60 isolates tested, the highest and the lowest resistance was for ampicillin and carbapenem antibiotics, respectively. Forty-five percent of isolates were ESBL-producer. Among 60 isolates tested, 5 (8.3%), 57 (95%) and 43 (71.7%) isolates contained SHV-2a, SHV-5 and SHV-12 genes, respectively. Five isolates contained all the three genes of SHV-2a, SHV-5 and SHV-12.

Conclusion: The results indicate the relatively high prevalence of SHV type beta-lactamase genes in K. pneumoniae isolates in Kermanshah. Given this high prevalence, the surveillance of antibiotic resistant patterns and relevant genes is necessary among gram-negative bacilli in Kermanshah region. Due to the high resistance of K. pneumoniae isolates to antibiotics and to reduce the dissemination of resistant genes, susceptibility testing to choose more affective antibiotics is recommended even for isolates from outpatients.

The Effects of the Preconception Endurance Exercise Training and Voluntary Exercise Activity during Pregnancy in C57BL/6 Mice on Lipid Profile of the Adult Offsprings

Abbasali Gaeini

Background: The aim of this study was to determine the effect of preconception endurance exercise training with voluntary exercise activity during pregnancy in mother mice on lipid profile in adult offsprings.

Materials and Methods: Twenty four C57BL/6 female mice were randomly divided into four subgroups: trained in preconception period and exercised during pregnancy (TE)(20.3±1.02g); trained in preconception periods but unexercised during pregnancy (TC)(21.58±0.4g); untrained in preconception periods but exercised during pregnancy (CE)(21.02±0.23g); untrained and unexercised (CC)(19.23±0.45g). Trained mice were subjected to a protocol of moderate endurance exercise training over a period of 4 weeks for 5 days before pregnancy. The fasting blood samples were collected from adult mice(8 weeks old) and serum levels of glucose and lipid profile were measured. Data were analyzed using two way ANOVA and Tukey’s post hoc test.

Results: The Glucose test results in offspring showed that there was a significant interaction between group and sex and group main effect (p<0.001) Glucose levels of male offspring were significantly lower in TC and TE groups. Results on LDL also showed that the sex main effect was significant (p<0.001), and LDL levels of male born to TE and TC dams lower than in female offspring.

Conclusion: Improving the mother's physical fitness by providing regular endurance training in the preconception period and maintaining it by exercise activty throughout pregnancy may have potential for eliciting positive changes in lipid profile of offspring, specially males.

Comparing the Effect of Intravenous and Inhalational Anesthtics on Hemodynamic Changes in Deep Vitrectomy Surgery

Darioush Moradi Farsani

Background: Due to high prevalence of vitrectomy surgery, and the importance of anesthetic technique in conducting an uncomplicated surgery, we decided to do this study.

Materials and Methods: This prospective randomized study was conducted on 80 patients 40-80 years old candidating deep vitrectomy sugery under general anesthesia that were categorized into II and III Class by American Society of Anesthesiologist (ASA). Patients were randomly allocated to two groups of 40 members. Anesthesia was induced in both groups in the same manner. For maintaining anesthesia, patients from I group receiVed 1.2% isofluran with 50% O2 in air at 4L/min and infusion of remifentanil (0.1 mg.kg-1.min-1). But in the P group, we used propofol up to 10mg/kg /hr with infusion of remifentanyl. Propofol and isoflurane in fusion was discontinued with the last surgical stitches, but remifentanil infusion continued in both groups until the eye was covered with shield. Hemodynamic variables were recorded just before the induction of anesthesia and in different time intervals till discharging of the patients from the recovery room. Then, data were compared.

Results: Results showed that there is a significant changes in propofol group compared to isofluran in deep vitrectomy surgery operations.

Conclusion: Hemodynamic changes are more significant in maintaining propofol anesthesia when compared with isoflurane.

Investigating the Effect of Optimism Training during Pregnancy on Attitude and Mode of Delivery in Nulliparous Women Referred to Health Centers of Mashhad, 2014

Mahin Esmaeili Darmian

Background: Childbirth is a stressful event that requires a mental adjustment. Optimism is one of the important determinants of psychological adjustment which is a combination of interest and positive attitude. The purpose of this study was to determine the effect of optimism training during pregnancy on attitude and intentions to choose the mode of delivery in nulliparous women.

Materials and Methods: In this clinical trial , 64 primipar pregnant women with normal pregnancies, 34-30 weeks, without indication for cesarean section referring to the health centers in Mashhad in 2014 were selected and were randomly divided into two groups , A (trained) and B (no training). Optimism training during 5 session of the 60-minute, with the group participation of participants and active exercises was conducted. Data were analyzed with using the software SPSS and statistical tests including variance analysis, Fischer exact test, willcoxon, Square-Chi and paired t-test.

Results: Average attitude score towards c/s delivery in the study group, before and after training has a significant difference (p<0.001). Average attitude score towards natural childbirth was significantly higher in intervention group compared to the control group (p<0.002). Frequency of intentions to choose the mode of delivery in the study group, before and after training has a significant difference (p<0.033).

Conclusion: Reults showed that optimism training in creating a positive attitude towards natural childbirth and thus reducing the rate of elective c/s delivery is effective.