29 1029-7855 Kashan University of Medical Sciences 2177 medicine, paraclinic Effect of memory attenuation and light music on morphine dependency in male mature mice using conditioned place preference Tavakoli Farnaz Hoseini Seyyed Ebrahim c Mokhtari Mokhtar Vahdati Akbar c Science and Research Branch, Islamic Azad University 1 4 2014 18 1 1 8 05 02 2014 05 02 2014 Background: Addiction, as a behavioral and physiological disorder, is one of the most serious challenges facing all communities. The aim of this study was to examine the effect of memory attenuation by cholinergic antagonist and light music on morphine dependency. Materials and Methods: In this study, 70 male mature mice (weight, 30-35g) were divided into the control, witness and experimental groups. The experimental groups were treated with morphine, trihexyphenidyl, light music, morphine+trihexyphenidyl, morphine+light music, respectively. Morphine was used to create dependency and trihexyphenidyl as a memory attenuation agent. Instrumental music was also used to examine the relaxing effects of music. To estimate the level of dependency, conditioned place preference (CPP) was used. Results: There was no significant difference in CPP between the control and witness, trihexyphenidyl, and light music groups. A significant increase was seen between the morphine and control group (P≤0.05), while a significant decrease was seen between the morphine+trihexyphenidyl and morphine group (P≤0.05). In addition, a significant increase was seen between morphine+light music and morphine group (P≤0.05). These results were continued for eight days after eliminating the drug and music. Conclusion: Trihexyphenidyl and light music may decrease and increase morphine-induced- CPP, respectively through the inhibition and stimulation of dopaminergic neurons.
2193 medicine, paraclinic Effect of high-dose atorvastatin on advanced soft atherosclerotic plaque in rabbit carotid artery using ultrasonographic and histological methods Mehrad Hosein Mokhtari-Dizaji Manijeh g Ghanaati Hosein g Tarbiat Modares University 1 4 2014 18 1 9 22 13 02 2014 13 02 2014 Background: The present study aimed to investigate the effect of high-dose atorvastatin on advanced soft atherosclerotic plaque in the rabbit common carotid artery. Materials and Methods: In this experimental study, the common carotid arteries in 17 rabbits were injured through perivascular liquid nitrogen followed by a 1.5% cholesterol-rich diet for eight weeks. The animals were randomly divided into three groups including A: a cholesterol-rich diet (8 weeks), B: control and discontinuation of cholesterol-rich diet (12 weeks) and C: high-dose atorvastatin administration (5 mg/kg/day) and discontinuation the cholesterol-rich diet (12 weeks). Blood volume flow and blood mean velocity were measured by color Doppler ultrasonography. Moreover, mean wall thickness and percentage of luminal cross-sectional area of stenosis were measured by B-mode ultrasonography and histological methods in the stenotic region of the common carotid artery. Results: Results showed a significant reduction in the serum lipid parameters, peak systolic blood pressure, blood mean pressure, blood mean velocity, mean value for wall thickness and the percentage of luminal cross-sectional area of stenosis. Moreover, results showed a significant increase in the peak diastolic blood pressure and blood volume flow in group C compared with the other groups (P<0.05). Conclusion: The pleiotropic and lipophilic effects of high-dose atorvastatin accompanied by discontinuation of cholesterol-rich diet can cause to exterminate the microvessels, improve the fibro-lipid lesion in the soft plaque and significantly dilate the luminal cross-sectional area of stenosis. 2178 medicine, paraclinic Celebrex versus magnesium sulfate to prevent premature labor Salarieh Neda Tabasi Zohreh Forozanfard Fatemeh Mahdian Mehrdad l Mousavi Sayyed Gholam Abbas l Trauma Research Center, Shahid-Beheshti Hospital 1 4 2014 18 1 23 29 05 02 2014 05 02 2014 Background: Preterm labor is the leading cause of newborn deaths and a major public health challenge. The aim of this study was to compare the effect of celebrex and magnesium sulfate in the prevention of preterm labor. Materials and Methods: In this double-blind clinical trial, 100 patients with preterm uterine contractions were randomly allocated into two groups: one group received oral celebrex 100 mg twice daily and another group received magnesium sulfate intravenously for up to 48 hours. A 48-hour delay in delivery and the drug complications were evaluated. Results: There was no significant difference between the two groups regarding maternal age, parity and gestational age. A 48-hour delay in delivery was observed for 42 patients in each group (86%) and was the same for both groups. Delivery before 48 hours was also observed for 8 patients (14%) in each group and was the same for both groups. Conclusion: The tocolytic efficacy of celebrex is equal to that of magnesium sulfate, the most commonly used tocolytic agent. So, for its ease of use celebrex is recommended for the prevention of preterm labor in pregnant women with preterm uterine contractions. 2191 medicine, paraclinic Antibiofilm activity of cell-free supernatant from Lactobacillus casei in Pseudomonas aeruginosa Aminnezhad Sargol Kasra-Kermanshahi Roha o o Alzahra University 1 4 2014 18 1 30 37 10 02 2014 10 02 2014 Background: Pseudomonas aeruginosa, as an important opportunistic pathogen, can produce P. aeruginosa. biofilm. Intrinsically resistant to antimicrobial agent, the biofilm causes difficulties in various healthcare settings. Lactobacilli are known to secrete inhibitory substances in cell-free supernatant (CFS) to prevent infection by pathogenic organisms. The purpose of this study was to evaluate the inhibitory effects of CFS from Lactobacillus casei PTCC: 1608 on biofilm formation of P. aeruginosa PTCC: 1430. Materials and Methods: In this experimental study, CFS from Lactobacillus was separated by centrifugation. The antimicrobial effect of CFS from L. casei was evaluated by agar well diffusion assay. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined by microdilution method according to CLSL standard. Finally, biofilm-production ability of P. aeruginosa as a percentage was determined in the presence of CFS from L. casei using the modified microtiter plate method. Results: Results showed that CFS from L. casei has a significant effect on the tested strain and the MIC and MBC values for the strain were the same (62.5 µl ⁄ ml). Furthermore, in the presence of CFS from L. casei, biofilm production in MIC (87±2.6) and Sub-MIC concentration was considerably inhibited. Conclusion: CFS from L. casei is effective in killing P. aeruginosa. biofilm. Therefore, this material appears to be a promising agent for prophylaxis against various pseudomonal infections. 2179 medicine, paraclinic Middle-aged women's experiences on mental health promotion: a content analysis study Sharifi Khadijeh Anoosheh Monireh Foroughan Mashid Kazemnejad Anoshirvan Tarbiyat Modares University 1 4 2014 18 1 38 45 06 02 2014 06 02 2014 Background: Mental health in middle ages, especially in women is vulnerable due to the frequent changes in this age period and consequences of the changes. Considering the importance of promoting mental health in this period, the present study aimed to explain the women's experiences on their mental health promotion during the middle ages. Materials and Methods: In this conventional qualitative content analysis using a semi-structured interview, 23 participants were selected. Considering the maximum variation among the participants, sampling was made gradually until data saturation through purposive sampling from the middle-aged women living in Kashan. Data analysis and sampling were conducted simultaneously.Results: Results showed that mental health promotion in the middle-ages can be contributed to two main themes including "continuity of mental health care to youth" and "mental reconstruction" with subcategories of achieving to physical ideals, happiness promotion, stress relief and spiritual growth. Conclusion: Findings of this study reveal that the middle-aged women use different strategies for achieving and promoting their mental health some of these solutions have short-term efficacy. However, using the effective coping strategies and providing the facilities for the extensive use of these strategies by the mental health authorities can promote mental health of the middle-aged women. 2180 medicine, paraclinic Comparing the effects of vaginal misoprostol and laminaria on cervical ripening in labor induction among the term parturients Behrashi Mitra Nezam-Zavareh Jamileh Mesdaghinia Elaheh Hashemi Tayebeh Mousavi Sayyed Gholam Abbas Mahdian Mehrdad Kashan University of Medical Sciences 1 4 2014 18 1 46 51 06 02 2014 06 02 2014 Background: Labor induction for terminating pregnancy in term parturients with unripe cervix has been concerned for many years. Laminaria and misoprostol have routinely been used for labor induction. This study aimed to compare the efficacy of laminaria and misoprostol for a successful labor induction. Materials and Methods: In this double-blind clinical trial, 100 singleton term parturients (age 18-45) with unripe cervix were randomly allocated into two equal groups: Laminaria and misoprostol. First group received misoprostol (25 µg/vaginal) and the second group a single dose of laminaria intracervically. Both groups were compared for induction time to the active phase of labor, induction time to the delivery, dilatation changes during the first 6 hours after drug administration, cesarean delivery rate, fetal distress, meconium staining and uterine hyperstimulation. Results: During the first 6 hours after drug administration, the cervical dilatation changes in the laminaria group were 4.4 times more than the misoprostol group (P=0.001). There was no significant difference between the two groups in induction time to active phase of labor and induction time to delivery time. The cesarean frequency rate in the misoprostol group was higher than that in the laminaria group (P=0.017). Uterine hyperstimulation was more common in the misoprostol group than the laminaria one and the difference was statistically significant. During the labor process, rate of oxytocin administration in the misoprostol group was lower than the laminaria group (P<0.0001). Conclusion: Laminaria seems to be more effective and safer than the misoprostol for cervical ripening however, for better results further studies with a larger sample size are recommended. 2196 medicine, paraclinic Effect of cognitive therapy on mental health in patients with heart failure Taghadosi Mohsen Rohollah Fahimeh Aghajani Mohammad Raygan Fariba Kashan University of Medical Sciences 1 4 2014 18 1 52 59 18 02 2014 18 02 2014 Background: Patients with Heart Failure are at greater risk for developing mental disorders (e.g. depression and anxiety) which can lead to limitations in the professional, family and social tasks resulting in dependency on others. Cognitive therapy is commonly used to treat a wide range of mental disorders. Therefore, this study aimed to investigate the effect of cognitive therapy on mental health in the HF patients. Materials and Methods: In this clinical trial study, 66 patients with HF were randomly divided into two groups using continuous sampling in Shahid-Beheshti hospital during 2012-2013. The intervention group received 8 sessions of cognitive therapy within 1 month and the control group only received conventional cardiac care. Data were collected using the Goldberg Health Questionnaire and then were analyzed. Results: Results showed no significant difference between the two groups in mental health, but a significant difference was found in mental health between the intervention (51.56±5.41) and control (62.23±9.32) groups (P<0.0001). Significant difference was found between mental health before (58.16±10.99) and after (51.56±5.41) the cognitive therapy in the intervention group (P= 0.003), while no significant difference was found in mental health in the control group (P=0.27). Conclusion: Cognitive therapy can improve mental health of the patients with HF. So, it is recommended as a complementary treatment, along with other medical care provided by nurses, for these patients. 2181 medicine, paraclinic Relationship between antimicrobial resistance and class I integron in Pseudomonas aeruginosa isolated from clinical specimens in Yazd during 2012-2013 Zarei-Yazdeli Mohadeseh Eslami Gilda Zandi Hengameh Mousavi Seyyed Morteza Kosha Hasan Akhavan Fatemeh Kiani Masoumeh Shahid- Sadoughi University of Medical Sciences 1 4 2014 18 1 60 67 06 02 2014 06 02 2014 Background: Antimicrobial resistance in Pseudomonas aeruginosa has been increasing in recent years. The aim of this study was to investigate the relationship between antimicrobial resistance and class I integron in P. aeruginosa isolated from clinical specimens in Yazd city.Materials and Methods: This cross-sectional study was carried out on 144 P. aeruginosa strains from April 2012 to April 2013. All clinical samples were initially identified by the biochemical method and the antibiotic resistance test was performed using the disc diffusion method according to CLSI recommendations. PCR was carried out for the detection of class I integron. Results: Seventy-nine (54.9%) out of 144 patients were male with mean age of 34.9+22.7 years. Resistance rates to various antibiotics were as follows: gentamicin (63.2%), imipenem (62.5%), amikacin (58.3%), ceftazidime (56.9%), ticarcillin (55.6%), tobramycin (55.6%), piperacillin (54.9%) and ciprofloxacin (48.6%) and 75.3% of the isolates were detected as multi-drug resistant. PCR results showed that 119 (82.6%) P. aeruginosa isolates carried class I integron. Conclusion: Class I integrons are commonly found in P. aeruginosa isolated from the clinical samples. Therefore, the transfer of antibiotic resistance genes is often related to these integrons and the contribution of integrons in antibiotic resistance should be evaluated. 2194 medicine, paraclinic Investigating the relationship between quality of life, self-care capability and HbA1c level in diabetic adolescents Afshar Memarian Mohammadi Tarbiat Modares University 1 4 2014 18 1 68 75 13 02 2014 13 02 2014 Background: Type 1 diabetes is the most common metabolic and endocrine disorders in infants and adolescents. Regarding the importance of the disease control and its effect on adolescents' life, this study aimed to evaluate the relationship between quality of life and self-care capability among the diabetic adolescents. Materials and Methods: In this cross-sectional study, 74 diabetic adolescents were selected from Kashan diabetes center using convenience sampling. The adolescents filled out standardized quality of life questionnaire including 41 general and special questions with Likert answers (1-4) and self-care capability questionnaire including 37 questions on attitude, function and family sections with 35 Likert answers (1-4) and two answers yes/no. HbA1c measurement was performed and the demographic data including sex, age, diabetes duration and insulin injections were registered. Results: The mean age of patients and diabetes onset were 14.44±1.8 and 4.12±1.94, respectively and the patients received 33.7±12.45 (IU/day) insulin. Results showed no significant relationship between the quality of life and HbA1c level (P=0.58). Moreover, no significant relationship was found between the self-care capability and HbA1c level (P=0.79). However, a significant relationship was found between the quality of life and self-care capability (P=0.001).Conclusion: Considering the low HbA1c level, the quality of life and self-care capability in diabetic adolescents were not desirable in this city. 2187 medicine, paraclinic Prevalence of delirium, its related factors and short-term outcomes in ICU wards of Kashan Shahid-Beheshti and Isfahan Kashani hospitals during 2012-2013 Heidari Abdolhamid Dianati Mansoor Mousavi Sayyed Gholam Abbas Kashan University of Medical Sciences 1 4 2014 18 1 76 84 08 02 2014 08 02 2014 Background: Delirium is one of the most common problems in ICUs. This study was conducted to investigate the prevalence of delirium, its related factors and short-term outcomes in ICU patients.Materials and Methods: In this cross-sectional study, 270 ICU patients were selected by convenience sampling. The Richmond Agitation-Sedation and Glasgow Coma Scales were used to assess the level of consciousness in the patients. Moreover, Confusion Assessment method (CAM-ICU) was used to assess delirium at two times on morning and evening. Some delirium-related factors including health and demographic characteristics, mechanical ventilation, hospitalization length, return to the ICU and mortality rate were evaluated. Results: Results showed that 120 patients (44.5%) experienced delirium. There was a significant correlation between the age, marital status, hypertension, seizure, employment and delirium. Moreover, other variables like sex, literacy, smoking, background diseases, history of surgery, numbers of catheters and medications, hospitalization period and mechanical ventilation were significantly associated with delirium incident. Previous surgical history, the number of catheters and medications were the predictors of delirium.Conclusion: The prevalence of delirium is relatively high in ICU patients. Furthermore, the length of hospitalization, duration of mechanical ventilation and also mortality rate were increased in the patients with delirium. 2185 medicine, paraclinic Thyroid function in epileptic patients treated with either carbamazepine or sodium valproate in Kashan Shahid-Beheshti hospital during 2010-2011 Koochaki Ebrahim Daneshvar-Kakhaki Reza Moravveji Sayyed Alireza Farahi Maryam Kashan University of Medical Sciences 1 4 2014 18 1 85 90 08 02 2014 08 02 2014 Background: Treatment with antiepileptic drugs such as phenobarbital (PB), carbamazepine (CBZ) and sodium valproate (VPA) has a lot of complications and may affect the endocrine function. The aim of this study was to evaluate the effects of CBZ and VPA on thyroid function tests. Materials and Methods: This descriptive cross-sectional study was conducted on 50 patients referred to Kashan Shahid-Beheshti hospital during 2010-2011. The patients were randomly divided into two treatment groups with CBZ (n=22) and VPA (n=28). Patients with thyroid, hepatic and renal disorders, pregnants and those who had taken levothyroxine and oral contraceptives were excluded from the study. Fasting blood samples were taken from all patients and T3, T4, FT4, TSH and rT3 uptake were measured before and after 2 months of treatment.Results: Forty-four cases had tonic-clonic and 6 cases partial seizure. In the CBZ group, there was no change in the mean values of T3 and rT3 T4 level was decreased and TSH and FT4 levels were increased, but the differences were not statically significant. Moreover, T3 level was significantly increased in the VPA group (P=0.038). Conclusion: According to the results of the study, the mean T3 level was significantly increased in the VPA group. 2186 medicine, paraclinic Evaluating the causes of prolonged jaundice among the newborns referred to Kashan Shahid-Beheshti hospital during 2011-2012 Sharif Mohammad Reza Madani Mahla Kashan University of Medical Sciences 1 4 2014 18 1 91 96 08 02 2014 08 02 2014 Background: Jaundice is the most common clinical problem among the newborns. Prolonged jaundice in the neonate is defined as a jaundice that lasts longer than 14 days and has multiple possible causes. This study aimed to evaluate the causes of prolonged jaundice in newborns referred to Shahid-Beheshti hospital, Kashan, Iran. Materials and Methods: This cross-sectional study was conducted on 237 neonates with prolonged jaundice referred to Shahid-Beheshti hospital in Kashan. Clinical prolonged jaundice was defined as the yellow discoloration of the skin and mucous membranes, and persisting beyond 14 days of age. Blood tests were performed to determine the causes of jaundice. Results: None of the infants had a direct hyperbilirubinemia. Breast milk jaundice (59.1%) was the most common cause of newborn jaundice and other possible causes were urinary tract infection (12.2%), Glucose-6-phosphate dehydrogenase deficiency (9.7%) and hypothyroidism (6.3%). The exact etiology was unknown in 12.7% of the cases. Moreover, while there was a relation between the incidence of neonatal jaundice and sex, no relation was seen between the incidence and age, weight and the initial bilirubin level. Conclusion: Although the most common cause of prolonged jaundice is breast milk jaundice with no serious complication, a detailed investigation is recommended to determine the other important causes of the disease. 2188 medicine, paraclinic A case of imperforate hymen with acute urinary retention in an adolescent girl in Zahedan Pahlavani-Sheikhi Zahra Navabi–Rigi Shahin-Dokht Zahedan University of Medical Sciences 1 4 2014 18 1 97 100 09 02 2014 09 02 2014 Background: Imperforate hymen is an uncommon obstructive anomaly of the female reproductive tract, which occurs due to incomplete degeneration of the central portion of the hymen. The diagnosis of the condition may be ignored until adolescence. After puberty, accumulation of menstrual blood in the vagina (hematocolpos) can manifest clinical symptoms. This report aims to present a rare congenital anomaly.Case report: A 14-year-old girl was admitted to Imam-Ali hospital (Zahedan) with complaints of acute urinary retention, lower abdominal and supra pubic pain. The diagnosis of imperforate hymen was confirmed using gynecological examination and abdominal ultrasonography.Conclusion: The imperforate hymen can usually be diagnosed by taking a careful history of the patient along with gynecological examination. Moreover, pelvic-abdominal ultrasonography can be used for the detection of hematocolpos due to imperforate hymen.