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.

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.

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.

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.

Background: A small percent of patients with colorectal cancer (CRC) respond to 5-Fluorouracil (5-FU), as a first line of chemotherapy. In this study in, in order to design a new chemotherapy protocol, the effect of 5-FU and acriflavine (ACF) cotreatment on mortality rate of CRC cell lines was investigated.

Materials and Methods: Cytotoxicity of 5-FU and ACF against CRC cell lines (LS174T, SW480 and HCT116) was detected using MTT assay. Cells were treated with different concentrations of 5-FU (0.5-64 µM) or ACF (0.07-5 µM) for 72 hours and then cell viability and drugs IC50 was calculated. To assess the effect of ACF on anticancer activity of 5-FU, cells were cotreated with different concentrations of 5-FU and IC30 concentration of ACF.

Results: ACF and 5-FU suppress the viability of CRC cell lines in dose-dependent manner. 5-FU and ACF have most cytotoxic effect on LS174T and the lowest cytotoxic effect on SW480 cells. Cotreatment of ACF with 5-FU could not significantly change the sensitivity of cells against 5-FU (p>0.05).

Conclusion: In this study, the fatal and cytotoxic effect of ACF on three CRC cell lines was shown. However, cotreatment of ACF with 5-FU could not improve the anticancer activity of 5-FU.

Background: Boredom is a psychological phenomenon that was defined as an aversive state or incompatibility with every repetitive experience while the release of stability is not allowed. Boredom has several complications. So, the goal of this study is to compare the predictors of boredom in students of Arak University of medical sciences and Islamic Azad University.

Materials and Methods: The current descriptive-comparative study has been done on966 students (from Arak University of medical sciences and Islamic Azad University). The scale of current study was a checklist list of demographic information, predictors of boredom assess questionnaire, Farmer and Sundberg’boredom proneness scale. Data were analyzed by using chi-square, Pearson correlation, multivariate regression, and Fisher'sz.

Results: The greatest number of students from both universities have normal boredom without a statistically significant difference between male and female students (p=0.06). University factor had the highest average between students. Totally, boredom had a significant correlation with each of the home (p=0.000) and society (p=0.001) factors. All three factors including home (p=0.033), university (p=0.033) and society (p=0.031) can explain and predict boredom in male and female students.

Conclusion: The results showed that university factor was the most important factor for predicting boredom between college students. Thus, in order to avoid adverse effects of boredom on students educational activities, this phenomenon and its causes should be considered.

Background: Considering the high prevalence of sexual dysfunction in females with OCD and its impact on marital satisfaction, the purpose of this study was to investigate the relationship between sexual function and marital satisfaction in a group of female OCD patients.

Materials and Methods: In this cross-sectional study, 36 females with OCD, referred to the clinic of Roozbeh Psychiatric Hospital (related to Tehran University of Medical Sciences) and 3 private offices in Tehran, were selected by random sampling and completed questionnaires including: demographic FSFI, BDI-II, MOCI, OCI-R and researcher-developed marital satisfaction questionnaire.

Results: 80.6% of women reported sexual dysfunction. The results of studying sexual function questionnaire subscales was as following: 50 % low sexual desire, 58.3 % low sexual arousal, 36.1 % decreased lubrication, 44 % orgasmic disorder, 52.8 % sexual pain disorder and 41.7 % sexual dissatisfaction. Furthermore, statistically significant correlation was found between sexual dysfunction (total score and arousal, lubrication, pain and satisfaction subscales) and marital dissatisfaction. Studying the relation between obession(MOCI questionnaire) and marital satisfaction revealed that the correlation between washing subscale of MOCI and marital dissatisfaction was also significant while there were not any significant correlation between obsession (OCJ-R, MOCI) and sexual function (FSFI).

Conclusion: High prevalence of sexual dysfunction in OCD patients, significant relationship between obsession and marital satisfaction, and sexual function and marital satisfaction could demonstrate relationship between sexual function, OCD and marital satisfaction.

Background: This essay reports a case about tissue defect of heel due to melanoma excision.

Patient history: The patient was a man 60 years old with a heel ulcer that had reported malignant melanoma in biopsy. Then the ulcer was done under wide local excision.

Materials and Methods: We should use flap for tissue defect coverage that tendon and heel bone are exposed from it. It seems using skin graft is not useful, because skin graft in persistent contact with shoes will get chronic ulcer. Among different flaps (sural flap or medial plantar flap), we decided to use medial plantar flap. The advantage of this flap is its sensority and low volume.

Conclusion: Conclusion with due attention the results, The meial planter flap, as an efficient method, is adviced to teconstruct heed specially after excision of melanoma.

Background: Biofilm formation is one of the pathogenicity factors of Staphylococcus aureus that can help the bacteria to stick to the other surface and also increase antibiotic resistance pattern. This study aimed to investigate the phenotypic and genotypic indices for formating biofilm in Staphylococcus aureus isolates isolated from infectous samples.

Materials and Methods: 250 Staphylococcus aureus strains isolated from hospital infections were selected. Antibiotic resistance pattern was determined by using disk diffusion method. The ability of biofilm formation was investigated by molecular and phenotypic method.

Results: In this study, 73.5% of isolates were able to bind strongly, 5.33% had the ability of medium connection and 15.4% had the ability of weak connection in biofilm production. The frequency of icaC and icaB genes were 67.3% and 63.2%, respectively. 92.2% of biofilm producing isolates have mecA gene.

Conclusion: The spread of antibiotic resistance in isolates especially isolates that produce biofilm will create serious problems in the hospital therapeutic wards.

Background: Determining the level of manual ability of children with cerebral palsy has significant role in scheduling care and providing supportive services by organizations such as the a social welfare office. Manual Ability Classification System (MACS) is responsible for this critical matter. In Mazandaran Province, the prediction of manual ability is intuitive and is done without tools. This study aimed to investigate the consistency between operational therapists prediction of future manual function of children with cerebral palsy and MACS scale.

Materials and Methods: This study was designed as a cross sectional trial. The study population consisted of 12 occupational therapists working in Mazandaran’s rehabilitation center under the social welfare office. Firstly, occupational therapists chose 100 children with cerebral palsy and classified their future manual ability into five levels according to their prediction. Then the researcher classified the children based on MACS scale. Finally, the amount of prediction consistency between therapists and researcher was statisticaly analyzed.

Results: The weighted kappa coefficients of MACS scale were 0.671 in first level and 0.747 in fifth level that show good agreement in these two levels. This coefficient was 0.417 in third level and 0.444 in forth level that shows fair agreement. The weighted kappa coefficient was 0.358 in second level that indicates slight agreement.

Conclusion: With prediction consistency between operational therapists and researcher, MACS is used as a suitable means for classifying the level of manual ability in children with cerebral palsy and predicting their needs to adaptive and auxiliary devices by occupational therapists in rehabilitation centers and social welfare offices.

Background: Endometriosis disease is considered as a common disease dependent on androgen hormones. Androgens have different effects on endometrial growth. Androgen receptor as a signal transduction pathway could have a key role in regulating the process. Over hundreds of mutations leading to resistance gene function in androgen receptor (AR) has been recorded. Among these, the seuaence of CAG repeat in exon 1 had the largest share of studies related to the disease. The aim of the present study was to investigate the relationship between the AR gene CAG repeat variations in Iranian women with endometriosis.

Materials and Methods: In this study, 100 women with endometriosis and 100 healthy women as controls were selected. Exon 1 was amplified using PCR. Products of PCR were studied to determine CAG repeat variation in acrylamide gels.

Results: The number of CAG repeats in each group was determined between 18-26 repeats (mean±standard, 18.35±3.3).

Conclusion: According to the results of this study, no significant differences were found between the two groups of healthy women and women with endometriosis. The number of CAG repeats in each group was determined between 18-26 repeats which indicates a lack of relationship between CAG repeat diversity and endometriosis. According to the information, this study was conducted on patients with endometriosis in iran for the first time, although studies with larger sample are needed.

Background: Niemann-Pick disease (NPD) refers to a group of lysosomal storage diseases that causes abnormal metabolism of lipids. One of the genes that play a role in the pathogenesis of this disease is SMPD1. To date, more than hundred disease- causing mutations have been identified in SMPD1 gene. Due to the large number of mutations in this gene, direct analysis of the mutations is costly and time-consuming. Therefore, indirect linkage analysis using polymorphic markers as an alternative method for molecular diagnosis of the mutations has been recommended. In the present study, allele frequency of rs1542705 genetic marker was analyzed in the Iranian population. The aim was to determine the polymorphic information content (PIC) and the possibility of its application in indirect diagnosing of NPD.

Materials and Methods: After bioinformatics analysis of the SMPD1 gene region, rs1542705 marker was selected for genotyping in Isfahan population. In order to calculate the allele and genotype frequency of the marker, molecular tests were done on 113 DNA samples of unrelated healthy individuals by using ARMS-PCR technique. Finally, the information related to the genotype of the individuals was statistically analyzed using Powermarker and Genepop software.

Results: The analyses showed that the studied population was in accordance with Hardy-Weinberg equilibrium. Allele frequency of rs1542705 marker for T and C alleles was 71.24% and 28.76%, respectively, and the heterozygosity of the marker was 43.36%. Also, polymorphic information content (PIC) was 0.325.

Conclusion: The results of this study showed that rs1542705 marker could be considered as an informative marker for molecular diagnosis of Niemann- Pick disease using linkage analysis in the studied population.

Background: As dental solid waste are among the most important environmental pollutants due to its high contents of toxic and hazardous agents, suitable treatment and management of it are of great importance. The objective of this study was to quantity & quality analyses of dental solid waste and associated management practices in the general dentistry offices in the city of Arak.

Materials and Methods: 15 samples of solid waste were taken from the 5 selected general dentistry offices, classified into 66 components and 4 fractions, and then the quantity & quality characteristics were evaluated. Management practices of the solid waste were also investigated by using a questionnaire.

Results: According to the results, per capita and the average generation rate of each dentistry office were 66.71 g/day-patient and 1340.45 g/day, respectively. Potential infectious, domestic-type, chemical & pharmaceutical, and toxic wastes consisted of 54.25%, 35.14%, 8.19%, and 2.14% of the waste generated, respectively. 10 components including latex gloves, nylon & plastic, saliva & blood-contaminated kleenex, paper & cardboard, used ampoules, saliva ejector tubes, gypsum, food waste, saliva & blood-contaminated dental rolls, and nylon gloves were responsible for more than 80% of the total waste generated, respectively.

Conclusion: Each fraction of dental solid waste (toxic, chemical & pharmaceutical, potential infectious and domestic-type wastes) should be separately collected and disposed of according to the related criteria.

Abstract

Background: Eryngium caucasicum Trautv has antioxidant properties due to the presence of flavonoids and phenolic compounds. So, the present study was done to investigate the protective effects of Eryngium caucasicum Trautv extract on tricyclazole induced hepatotoxicity in mice.

Materials and Methods: In this experimental study, 42 mice were divided into 6 groups including control, sham, tricyclazole (TCZ) and three experimental groups. The mice in the tricyclazole group, received 50 mg/kg TCZ via intraperitoneal injection and experimental groups 2, 3 and 4 received respectively 100,200and 400 mg/kg of extract via gavage for 4 weeks and 2 days per week.  The sham group received only sterile water. At the end, serum levels of ALT, AST and ALP, serum concentration of albumin and total bilirubin were measured. Also, total phenolic compounds and flavonoids in the extract were measured. Data were analyzed by using ANOVA.

Results: Tricyclazole increased serum levels of aminotransferase, phosphatase alkaline and total bilirubin and decreased serum concentration of albumin. But, treatment with extract decreased liver enzymes and bilirubin and increased levels of albumin (p<0.05). Amount of total phenolic compounds and the flavonoids were measured 91.16 mg/gr galicacid in extract and 84.48 mg/gr quercetin in extract, respectively.

Conclusion: The results demonstrated that Eryngium caucasicum Trautv extract due to the presence of high phenolic compounds has protective effects on tricyclazole induced hepatotoxicity.

Abstract

Background: Acute bronchiolitis is the most common lower respiratory tract infection in infant and one of their hospital admission reasons. Due to the high prevalence of the disease and unclear effectiveness of existing treatments, the present study was designed to evaluate the therapeutic effect of single dose of injected dexamethasone and inhaled epinephrine in patients with acute bronchiolitis treated with inhaled salbutamol.

Materials and Methods: In this double-blinded clinical trial, 90 infants with age of 2-24 months who were admitted to hospital with acute bronchiolitis were studied. All patients received inhaled salbutamol (0.15 mg/kg) and then were randomly assigned to three groups (n=30) of dexamethasone (0.6 mg/kg), inhaled epinephrine (0.15 mg/kg) and control (distillated water). Heart rate (HR) and respiratory rate (RR), arterial blood oxygen saturation (O₂ sat) and respiratory distress scores (RDS) of children at baseline, 30, 60,120 minutes and, 24 hours after intervention were recorded and compared between groups.

Results: The mean of HR, RR and RDS had significant improvement and the mean of O2 sat had significant rising trend and improvement during the study in all groups (p<0.05). The mean of HR in epinephrine group was upper than placebo in all measurements (p<0.001). RDS in epinephrine group was significantly upper than dexamethasone (p=0.002, CI95%=0.58- 2.69) and placebo (p=0.014, CI95%=0.27-2.8) 

Conclusion: Based on the result of present study, it seems that inhaled epinephrine or injected dexamethasone have no superiority to placebo in treating infantile acute bronchiolitis and their administration is not recommended.

Abstract

Background: Client satisfaction as an important indicator to assess the quality of provided services has found a special place over the past few decades. The main purpose of this study is to compare the client satisfaction in the public health posts and outsourced health posts affiliated to Qom university of medical Sciences in 2014.

Materials and Methods: This was a descriptive analytic (cross- sectional) study.The participants were 216 clients, who had referred to 10 public health posts and outsourced health posts of Qom province. Health posts  were selected by cluster sampling from different urban areas  and participants were selected by simple sampling methods. A researcher made questionnaire was used to measure the data on a 5-point Likert scale, which it's validity and reliability were confirmed by experts panel and Cronbach's alpha coefficient, respectively. After collection, the data were analyzed by SPSS 20, and descriptive statistical methods, Mann-Whitney test, chi-square, with 0.05 significant level.

Results: Among 60 health posts, 20 health posts (33.33%) were outsourced and 40 (66.66%) were managed by the public sector. Results showed that in health centers outsourced , overall satisfaction of the child care and vaccinations and maternity care were respectively, 64.5 and 55.42 and 67.43 percent and in public health posts were respectively, 35.5 and 44.58 and 37.66 percent and this difference was significant. Client satisfaction in the public health posts of the vaccination (57.1%) compared with client satisfaction in the outsourced health posts (47.2%) was higher, also at public health posts, satisfaction of the scientific skill employees (55.1 percent) assigned to the outsourced health posts (44.9%) was even greater, that this difference was significant.

Conclusion: Results of the present study showed that, there is a significant difference in satisfaction of clients in public health posts and outsourced health posts It seems necessary to pay special attention to employee training programs by managers and also considering the results of client satisfaction in performance appraisal of personnel in health care posts.

Abstract

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease with broad clinical manifestations, but unclear etiology. Extensive tissue damage occurs due to the production of auto-antibody against nuclear and cytoplasmic antigens. Regarding the involvement of GADD45A gene in cell cycle control, T-cell proliferation suppression, and genome epigenetic regulation, this case-control study was done for the first time to evaluate the association of rs581000 polymorphism in 5’ near gene with the risk of SLE among patients in south of Iran.

Materials and Methods: This study was performed on 102 patients with SLE in comparison with 118 healthy controls. Genotyping of the GADD45A rs581000 polymorphism was performed using T-ARMS PCR.

Results: The T allele was significantly more frequent in the controls (0.13) than in the patients (0.01) with SLE (p<0.001). The frequency of genotypes carrying at least one C allele (CC+CG) was higher in control group (14.4%) compared to patient group (1%), and this allele showed protective effect against the risk of SLE (p<0.001, CI: 0.009-0.5, OR=0.06)

Conclusion: It seems that GADD45A rs581000 polymorphism involved in the SLE pathogenesis.

Abstract

Background: With regards to importance of the role of parents in children's life, imbalance in the roles of parents can lead to serious mental, emotional and physical damages of the child. The purpose of this study was to determine how to do parenting role's tasks in parents of children with disability (physical- mental) younger than 7 years in the city of Arak in 2016.

Materials and Methods: In this study, the parenting role's tasks questionnaire for 120 parents of children with disability was completed. The effect of demographic characteristics on how to perform the role of parents was studied.

Results: Based on data collected and analyzed using Pearson correlation coefficient for the relationship between the parents and other factors, we have found no significant relationship between role of parents with the child's age. In disabled children, between parent's role and maternal age was significant difference which its correlation coefficient was -0.18, represented the inverse association between maternal age and the parent's role with disabled children. In comparison of parent's role based on child's gender, significant difference was not seen in any of cases. The impact of the seizure on performance of parenting role's tasks implied no relationship between history of seizure and performance of parenting role's tasks. Economic situation as well as on how to do tasks was ineffective.

Conclusion: Imbalance in performance of parenting role's tasks in primary care, education, leisure and cognition promotion showed that existence of a disabled child in the family had negative impact on the parenting role's tasks in different aspects, for example further focus on one of the domains lead to ignorance of other domains. Total score confirmed the negative impact of disabled children on efficient implementation of parenting role's tasks.

Abstract

Background: Ureaplasma and M. genitalium species belong to a kind of bacteria that are sexually transmitted and are the possible cause of pelvic inflammatory disease and nongonococcal urethritis, and et al. The aim of this study was to determine the urea plasma and Mycoplasma genitalium species frequency in women with vaginal infection and various sexual partners who referred to women^, s health promotion and treatment center in Arak.

Materials and Methods: Endocervical swab samples from 110 women with vaginal infections referred to women^’s health promotion and treatment center in Arak, were prepared. Patients’ personal information and identities during reception process were registered. The samples were transferred to the laboratory in the transport environment and after DNA extraction, were evaluated according to Real-time PCR assay.

Results: Urea plasma and Mycoplasma genitalium bacteria existed in 96(87.27%) and 4(3.63%) of patients, respectively. Among them, 4 cases had both bacteria infections. The amount of isolation in young women between 30-39 years old was more than others.

Conclusion: The results show that the colonization of urea plasma species in adult women is 40-80% and in studied group is 87.27%. These results indicate that with due attention to the increasing number of sexual partners and the increase of sexual activity, the urea plasma colonization of women will increase. In view of the potential influence of mycoplasma species on side effects resulted from pregnancy infection of mothers and mortality, on-time diagnosis and treatment will be increasingly essential.