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Volume 13, Issue 50 (4-2006)
Introduction: Solid and cystic papillary epithelial neoplasm of pancreas is a rare neoplasm with low malignant potential which often occurs in young women. The tumor is usually large and encapsulated. Microscopic examination reveals small round cells with papillary-configuration in a delicate vascular stroma. Case Report: The cases presented in this report were 2 women at the age of 15 & 26 who were both injured by striking. Radiologic findings revealed retroperitoneal mass. Both patients have not had any problem after surgery yet. Conclusion: In this neoplasm, surgery is treatment of choice and definite diagnosis is made by histology and immunohistochemistry. Patients have excellent long-time prognosis.
Volume 14, Issue 57 (2-2008)
Background & Aim: Water birth is a non-medical intervention, which has been used throughout the world for many years. It can be considered as a new approach for enjoyable birth in Iran. The aim of this study was to determine the impact of water birth on labor pain during active phase of labor. Patients and Methods: The study was a controlled clinical trial in which 114 full term pregnant women gravida 1 st to 3 rd participated. We performed voluntary sampling for experimental group(n=52) and conventional sampling for control group(n=62). Women of both groups, entered the study after having 4-5cm of dilatation(begining of active phase of labor) and all contributors received special individual care whereas the experimental group was put in a warm water pool of temperature between 36.8˚c to 39˚c at least for one hour at the beginning of trial, and during the second stage of labor. A 10 point ruler was used to measure labor pain in different stages of labor. We used paired sample t-test in order to compare pain change scores within each group. Chi-square test, Mann-Whitney test and independent sample t-test were used to compare the pain mean scores between two groups. P value<0.05 was considered as statistically significant level. Results: Our finding showed that, in the first 15 minutes the intensity of pain was stabilized in the experimental group, but was increased in control group(P=0.009). In the second stage of labor, the pain was significantly more severe in control than experimental group(P<0.0001). Overall, patients in the experimental group suffered less pain than the controls. With the exception of the above mentioned points, the differences were not statistically significant. Conclusion: Warm water pool can be an effective way to decrease labor pain and alleviating her suffering especially during first and second stages of labor. Although there were not much significant statistical differences between the two groups, experimental group suffered less pain which could be of clinical importance. Even though the pain of labor is lessened to a small extent, it could be a pleasant experience for the mothers and probably an effective step in decreasing the number of selective cesearen sections, which are performed mainly because of fear of labor pain.
Volume 17, Issue 71 (5-2010)
Background & Aim: Infections caused by genital mycoplasmas may have harmful effects on the fertility of men and may lead to male infertility. This study was performed to detect the prevalence of these bacteria in infertile men referred to Royan Institute.
Patients and Method: Semen samples were collected from 220 infertile men and were inoculated into PPLO broth transport media and sent to the laboratory. Following filteration through 0.45µm pore-size disposable filters, the filterates were inoculated into Arginine PPLO broth and Urea PPLO broth media. In cases of color change, the broth media were sub-cultured onto PPLO agar plates. All media were incubated at 37˚C under elevated CO2 atmosphere.
Results: From a total of 220 semen samples cultured, 7 cases (3.2%) were positive for only Mycoplasma hominis, 61 cases (27.7%) were positive for only Ureaplasma urealyticum, and 11 cases (5%) were positive for both of them. Thus, 18 cases (8.2%) of Mycoplasma hominis and 72 cases (32.7%) of Ureaplasma urealyticum were isolated from the samples. Evaluation of semen parameters showed that pH was lower in the two groups of “only U. urealyticum positive” and “both bacteria positive” than “both bacteria negative” group (p value=0.031 and p value= 0.006 respectively). Also, the mean sperm motility was lower in “both bacteria positive” group than “both bacteria negative” group (p=0.032).
Conclusion:The results of this study showed that a high percentage of infertile men are infected with these bacteria. If these infections are not diagnosed and treated, this may lead to PID and infertility. Therefore, because of high cost of other diagnostic methods such as PCR, isolation of these bacteria in infertile men via culture method is feasible and necessary.
Volume 17, Issue 76 (10-2010)
Background: Infection due to genital Mycoplasmas such as Mycoplasma hominis (M.hominis) and Ureaplasma urealyticum (U.urealyticum) may have harmful effects on the reproductive health of men and may lead to male infertility. This study was performed to compare culture with PCR method for detection of these bacteria in infertile men who referred to the Royan Institute.
Methods: In this descriptive-analytic, cross-sectional study semen samples were collected from 220 infertile men and divided to 3 sections: first section was used for semen analysis, second section was inoculated into PPLO broth transport media and passed through 0.45µm pore-size filters, then filtrates were inoculated into specific PPLO broth and agar media and incubated at 37˚C under elevated CO2 atmosphere and the third section was used for PCR in which U4 and U5 primers were used for amplification of Urease gene of U. urealyticum and RNAH1 and RNAH2 for amplification of 16S rRNA gene of M. hominis. The results were analyzed with SPSS V.16 software. For data analysis ANOVA, Post Hoc, Crosstabs, Chi square and Mc Nemar tests were used.
Results: From a total of 220 semen samples tested, 3.2% were positive with culture and 4.1% with PCR method for only M. hominis meanwhile 27.7% were positive with culture and 29.1% with PCR for only U. urealyticum. Also 5% of the samples in culture and 11.4% in PCR method were positive for both of the bacteria evaluation of semen parameters showed that in both culture and PCR methods, pH was lower in the two groups of “only U. urealyticum positive” and “positive for both bacteria” as compared to the group “negative for both bacteria” (p=0.006 and p=0.000 respectively for culture and PCR) and the mean of sperm motility was lower in group “positive for both bacteria” than the group “only U. urealyticum positive” in two methods: p=0.032(culture), p=0.009(PCR).
Conclusion: Results of this study showed that higher percentage of infertile men are infected with these bacteria which may lead to infertility thus, isolation of these bacteria in infertile men with no clinical symptoms is necessary. PCR as compared to culture is a more sensitive, quick, specific and fast method.
Volume 18, Issue 93 (3-2012)
Background: Acute vomiting is one of the most common side effects of chemotherapy during the first 24h in patients with cancer. This study investigated the palliative effect of ginger extract on the rate of this complication.
Methods: This study was a randomized, double-blind, placebo-controlled clinical trial that was conducted from August to December 2009 in Imam Khomeini Hospital on 80 women with breast cancer undergoing 1-day chemotherapy periods and suffering from vomiting. After obtaining written consent, the samples were randomly assigned into intervention and control groups. Two groups were matched with each other based on the age and emetic risk of chemotherapy drugs used. Participants of the ginger group received ginger capsules(250mg, orally), four times a day (1gr/d) and the samples from the control group received placebo capsules containing starch from three days before to three days after chemotherapy. During this period, to measure the effect of capsules, a two-part questionnaire was used. So, the patients filled these tools out every night. Then, gathered data were analyzed using statistical tests like Fisher’s exact, Kruskal-Wallis and Chi-square by the STATA software version 8.
Results: The two groups were matched with each other according to the emetic risk of chemotherapy drugs and disease duration (p=0.1, p=0.06, respectively). Results indicated that the cases of vomiting in the acute phase were significantly lower in the ginger group compared with placebo group (p=0.04). Also taking ginger capsules compared with placebo did not wake certain complications (p=0.06).
Conclusion: Taking ginger powder capsules (1gr/d) starting three days before chemotherapy for six days and beyond the routine anti-emetic regimen could reduce the acute phase vomiting.
Volume 23, Issue 144 (6-2016)
Background: Salmonella is one of the most causes of food contamination in food chain thought the world. Increasing antibiotic resistance is also pressing health threats facing the world today, and makes Salmonella as one of the most important pathogens of gastroenteritis in food outbreaks. The aim of this study was to investigate, the molecular epidemiology evaluation and antibiotic resistance patterns of Salmonella isolated in food outbreaks in Yazd province by culture and PCR methods Materials and Methods: This was a descriptive cross-sectional study and, 141diarrhea stool swab from 39 food outbreaks were studied in Yazd providence over a period of year. The samples were inoculated into selenite F broth for enrichment and then cultured into Hektoen enteric agar or xylose lysine dextrose Agar for the growth .The suspected colonies were chosen for the identification by biochemical and serologic tests .The identification was confirmed by PCR method. The antibiotic susceptibility test was performed by disk diffusion method. Results: Out of 141 samples 11 (7.8%) were isolated as Salmonella. All the isolated serogroup was type D. Laboratory conducted antibiotic resistance testing showed that entirely 100% of isolates Salmonella were susceptible to ciprofloxacin and imipenem whereas (73.07%) were resistant to Nalidixic acid . All isolates were confirmed by PCR. Conclusion: Salmonella commonly known as a pathogen that caused gastroenteritis in food out breaks. Awareness of the common serogroup and antibiotic resistance patterns would help the treatment.
Volume 27, Issue 5 (7-2020)
Background: Patients with breast cancer feel helpless due to the type of disease and the treatment process and show a sharp decline in mental health.
The purpose of the study was to develop an educational package to overcome learned helplessness (LH) and its effectiveness on mental health in women with breast cancer.
Breast cancer is one of the most common types of cancer in women, which has more severe psychological and emotional effects than other types of cancer. Breast cancer accounts for about 30 percent of cancers in women which this number will increase to 11 million in 2030. There are many challenges during the treatment period include changes in medical care, fear of relapse, changing life roles, long-term effects of treatment (can be physical or psychological), loss of supports, lack of family and friends emotional support, can all be one of the main reasons for the decline in mental health in these patients. Diagnosing breast cancer is a very unpleasant and unbelievable experience for any person that can disrupt family life. Fear of death, severe stress and financial anxiety lead to the onset and increase in the severity of disorders such as depression. And physical health directly affects mental health status and overall quality of life. In this regard, identify and investigate the causes of mental health decline to provide therapeutic intervention not only affects the quality of life of individuals but also effects on their survival rate and increases their ability to fight disease. Examination of mental health factors in these patients shows that learned helplessness is an important factor that can weak the protection of a person’s mental system against severe stress. Learned helplessness is an important and fundamental factor that makes people with cancer feel incapable of this problem and cannot properly use strategies and support resources.
Methods: The purpose was to develop a training package to overcome helplessness of women with breast cancer in two stages.
This study was a Simi-experimental pretest - posttest with control group. The study sample was selected by purposive sampling method and consist of 30 women with breast cancer who randomly assigned to experimental (15 subjects) and control (15 subjects) groups. Then, the participants in the experimental group participated in 12 sessions of 90 min of educational package to overcome learned helplessness. Then, the data were analyzed using statistical tests such as MANCOVA and ANCOVA.
In the qualitative part of the study, the population of the experienced experts in sciences, managers and experts in the field of psychological intervention is positive. In the quantitative section, the population of the present study was the woman with breast cancer admitted to the Cancer Research Center and patients of Vali Aasr Clinic in Imam Khomeini Hospital. In the qualitative section of sampling method, the number of interviews, in other words, the sample size, depends on the theoretical saturation of the questions in question, so that if the investigator concludes that the answers given or the interviews conducted, they are closely resembled with informed individuals, leading to duplication of responses or interviews, and there are no new data, the interviews are enough and thus stop. In the quantitative section, 30 people were selected based on inclusion (age of the participants should be 20 to 50 years, being literate, lack of participation in other psychological periods in the past and present, at least 2 months past from the diagnosis and lack of disability or physical and mental illness preventing the presence of the patients) and exclusion criteria (absence of more than 2 sessions of participation in the sessions, any incapacity associated with the attendance of participants, and lack of willingness to continue receiving interventions) were selected purposefully.
Instruments for gathering data were General Health Questionnaire (GHQ-28). This questionnaire has been developed to identify non-psychiatric disorders. It is used to diagnose mild mental disorders and to screen for non-psychotic psychological disorders in different societies and different situation, The text of the questionnaire is about boredom, discomfort and general health. This questionnaire with emphasis on psychological, physical and social issues at the present time and in this way, the person’s symptoms and health conditions are evaluated.
Results: The results of MANCOVA indicated that training to overcome learned helplessness improved mental health (F=56.191, p=0.000) in women with breast cancer. In addition, the results showed that the study intervention have significant impact on the components of mental health such as, physical function (F=6.906, p=0.000), anxiety (F=10.307, p=0.004), disruption in social functioning (F=11.678, p=0.002) and major depression (F=32.378, p=0.000).
Conclusion: Based on research findings, using of educational package to overcome learned helplessness could have important role in improving the mental health of women with breast cancer. By concerning the explanation of effectiveness of the skills of overcoming learned helplessness and effectiveness on helplessness in women with breast cancer could reduce physical function and anxiety and disruption in social functioning and major depression. In deed by practicing on this skills, these kind of people will not have an inferiority style of depression that will activated when dealing with a negative life event and will not believe that the result is a negative event, and they will not do anything to change it. Since these patients are tired of the treatment process and the disease progresses more, they could learn how they will get out of feeling afraid. These studies often carried out in the context of positive psychotherapy, all show the effect and effectiveness of this approach on reducing helplessness and increasing mental health in a variety of ways. In general, despite the limitations of the study, the results showed that if the patients are helped to learn for accepting their feelings at the beginning of the illness and also learn to be aware of their mental awareness and thoughts and behavior in the present moment , and be able to separate himself from mental experiences (mind reading, catastrophizing, extreme generalization) and recognize their values and adopt an adaptive attributional style, they will be very resilient against the stresses of cancer in the way of improving mental health
Volume 28, Issue 9 (12-2021)
Background & Aims: Menopausal is a natural biological process which is happening during cessation termination of woman’s menstruation. In the menopausal duration women are suffering numerous physical and psychological changes that is associated with decreasing oestrogen secretion due to lack of follicular function. In addition physical strength and bone density decline along with weight gain. It has been shown that regular exercise without adverse of medical treatment preserves bone density, and also prevent cardiovascular diseases in menopause women. In addition it improves physical fitness and also life quality along with oestrogen decreasing in menopausal duration and disorders of the nervous system, like losing memory, learning disabilities, decline in brain processing speed are seen. Neurotrophins are growth factors set, that cooperate together in the growing, survival and also function of central and environmental nervous system. One of Neurotrophins is called BDNF which can be play an important role in the nerve activities. Especially in the hippocampus, Due to its abundance in the brain and it’s powerful effects on synapses with age that is related today neurological and cognitive analysis of elderly. One of the important factors in the changes of BDNF level in the woman blood is oestrogen (12) . oestrogen is one of major steroid hormones that produced by the women’s ovaries which is made in the brain when needed at presynaptic terminal. In addition the brain can make oestrogen (neurooestrogen) and this does not act as a hormone rather it works in the form of a neutral mediator or neurotransmitter. Due to the important role of oestrogen in the brain, reducing its level in women with age has become a significant problem in women health. Oestrogen levels drop suddenly during menopause and this may play an important role in the nerve function and also age-related neurocognitive diseases such as Alzheimer. On the other hand fundamental research has shown that nitric-oxide (No) Can affects oestrogen levels by cellular mechanisms and simulation of gonadotropin-releasing hormone secretion and the hypothalamic-pituitary-ovarian pathway. In addition to the benefits of physical fitness exercise can be affective as a non-pharmalogical intervention in menopausal women. Due to the importance of factors affecting oestrogen changes and also nitric-oxide role on the oestrogen secretion chain that can affect the level of BDNF as a neutrophin effective in neuroprotection and reduction of menopausal in women ; according to said before; this research was designed to enquire the eight weeks of moderate intensity resistance training on serum levels of oestrogen, nitric-oxide and BDNF.
Methods: In quasi-experimental research, 28 postmenopausal women from Kermanshah city were randomly selected and divided into two groups of resistance training (n = 14) and control (n = 14). Resistance training was performed for eight weeks, three sessions per week at intensity of 45-55% of a maximum repetition. Blood samples were taken in 24 hours before and 48 hours after the intervention in fasting. Data were analyzed using dependent and independent t-tests at the significant level (P < 0.05).
Results: Results of dependent T-test showed that after eight weeks of training intervention, an important increase was observed in serum levels of oestrogen (P <0.001), BDNF (P <0.001) and Nitric-Oxide (P <0.001); however no significant difference was observed in any of the variables (P <0.05), in control group. Also results of independent T-test between the two groups showed there is a significant change in oestrogen (P <0.001), BDNF (P <0.001) and Nitric-Oxide (P <0.001) in the resistance training group compared to the other one.
Conclusion: After eight weeks of training, a significant increase in serum oestrogen levels was observed in the resistance training group. Gonzalo et al.(2019) stated that exercise and changes in the body composition are associated with changes in female hormones and increased estradiol in postmenopausal women (20), which demonstrates the positive role of resistance training on improvement of hormonal condition in postmenopausal women(20). Resistance exercises as a non-pharmacological method, first reduce various menopausal complications (decrease in oestrogen secretion), second reduces oestrogen injection pharmacologically requirement or treatment implementation that affect oestrogen secretion, which can save on treatment costs and prevent the side effects of oestrogen injection, by considering the 75% increase in serum oestrogen secretion in the training group. At the end of this resistance training, an 18% increase in serum Nitric-Oxide level was observed. One of the effective communication factors between glands which affect in oestrogen secretion (hypothalamus-pituitary-ovary) is Nitric-Oxide(18), hence resistance training effect on increasing serum oestrogen in postmenopausal women is probably due to the increasing in Nitric-Oxide and stimulate the glandular path to affect oestrogen secretion. On the other hand, oestrogen secretion affects Nitric-Oxide levels. In this regard, clinical and fundamental research has shown that oestrogen is mediated by an increase in Nitric-Oxide production by the endothelial isoform of Nitric-Oxide synthase (ENOS) due to an increase in ENOS expression and mediated activation levels (21, 22). In addition there was a significant increase in serum BDNF levels, So regarding the increase of BDNF, it can be said that resistance training causes positive changes in the structure and function of neuromuscular junction (NMJ) and hypertrophy of nerve endings (19, 23, 24). According to scientific studies, these changes are due to exercise in NMJ, associated with an increase in Neurotrophins such as BDNF, which is expressed in the nervous system and skeletal muscle (9, 19). Increasing the level of BDNF and its specialized receptor TRKB by exercise causes downstream changes and synaptic plasticity, which has a positive role on neuroprotection (23). On the other hand, BDNF produced in skeletal muscle by moving backwards can be selectively transported by motor neurons from skeletal muscle and affect the function of nerve cells (9, 19, 23, 25). Considering the role of BDNF in neurogenesis and neurocognitive protection, it can be said that moderate intensity resistance training can play a protective role in reducing neurocognitive complications in postmenopausal women. In general, the findings of the present study showed that moderate-intensity resistance training is a non-pharmacological method affecting hormonal changes in the form of increased serum oestrogen, which can play a protective role in reducing oestrogen-related complications in older women. On the other hand, the results showed that resistance training increases BDNF by increasing the level of oestrogen and NO, and considering the protective role of BDNF on the nervous and cognitive system, Because of the protective role of BDNF on the nervous and cognitive system, it can be said that resistance training can prevent neurological-cognitive complications in postmenopausal women by increasing BDNF levels.
Volume 28, Issue 9 (12-2021)
Background & Aims: Infertility means that a couple does not become fertile after one year of sexual intercourse, which is faced by 10-15% of young couples, and in 50% of cases it is related to male defects. The spermatogenesis genes involved in male fertility are located in the proximal region of the long arm of the Y chromosome (Yq11) in the azoospermia factor region, which includes the AZFa, AZFb, and AZFc subunits. Microdeletion in AZF regions causes changes in testicular histology from Sertoli Cell Only Syndrome to hypospermatogenesis. Yq microdeletions are the most common molecular cause of male infertility and include three regions: AZFα, AZFb and AZFc. These regions contain different genes involved in spermatogenesis. Yq microdeletions have been reported in 5-10% of infertile men and 6-16% of azoospermic men. In some other studies, the prevalence of these microdeletions has been reported in 20 to 30% of patients with non-obstructive azoospermia and in 3 to 7% of patients with severe idiopathic oligospermia. So far, ethnic patterns in the distribution of these microdeletions in the Iranian infertile male population have not been extensively studied. Accordingly, considering that Iran is a geographically vast country and has a high population / ethnic diversity, the present study aims to investigate the overall prevalence of these microdeletions in the population of Iranian infertile men and compare its frequency distribution in it was designed and implemented between different ethnicities.
Methods: In this study 1887 infertile men with severe oligospermia or azoospermia were referred to the Royan Institute beween 1391 to 1392 were evaluated for the presence of Yq microdeletions. At first, DNA was extracted from the peripheral blood by salting out method and multiplex PCR was performed based on the determination of six different STS markers. To identify Yq microdeletions in three regions of AZFa, AZFb and AZFc, six STS markers were used inside two separate mixes. Two STS markers were considered for each AZF region and sY14 marker was used to examine the SRY gene and the ZFX / ZFY marker were used as internal controls. Information about semen analysis (Spermogram) and the results of patients' hormonal tests for the three hormones LH, FSH and testosterone were also extracted from their files. The ethnic segregation and classification of the Iranian male population was based on latest version of the Encyclopaedia Britannica (2010) book from the Statistics Center of Iran. Accordingly, the men studied in this study were classified into the ethnicities mentioned in the Table 1. For the appointment of ethnicity in each of the men under this study, the place of birth and dialect of three consecutive generations of clients were determined and then were placed in one of the seven ethnic groups including Fars, Azeri (Turkish), Kurdish, Lor, Gilak/ Mazeni (northern), Arabic And non-Iranians (Afghans and Iraqis).
Results: Among the 1887 studied infertile men, 100 were diagnosed with microdeletions (5.29%), 69 patients (68.3%) had azoospermia and 31 patients (30.6%) had severe oligospermia. Among men with microdeletions, 70% had deletion in AZFc, 25.4% had deletion in AZFb and 4.6% had deletion in AZFa. Combined deletions of AZFbc were observed in 18 patients and AZFabc in three patients. All men with AZFa, AZFb, AZFc, AZFbc, and AZFabc regions had non-obstructive azoospermia, and only men with AZFc and AZFb microdeletions showed evidence of sperm production. Among the patients with microdeletions, 47 patients (46.5%) had normal hormone levels, 22 patients (21.7%) had higher than normal levels of FSH, two patients had high levels of LH and 14 patients (13.8%) had high levels of both LH and FSH. The results of hormonal tests were not available in 16 of them. Ethnic distribution in 100 patients showed that 38% were Azeri, 30% Persian, 11% Kurdish, 8% Lor, 6% Gilak/ Mazani, 2% Arab and 5% Iraqi and Afghan nationals. The results of chi-square test showed that the distribution of different Y chromosome microdeletions is not uniform among Iranian ethnicities (p <0.001).
Conclusion: Ethnic and racial differences can also be influential factors in the prevalence of these microdeletions, which we examined in the present study. Such a complete study of Iranian ethnicities has not been done before, and in other parts of the world, studies have not usually been aimed at comparing ethnicities. The overall frequency and distribution pattern of Yq microdeletions in the population of Iranian infertile men is similar to other populations in the world. The pattern of distribution of different microdeletions among different Iranian ethnicities seems to be similar. This means that in all ethnicities that accounted for a significant number of deletion patients (Turks, Fars, and Kurds), Yq microdeletions were most common in the AZFc region. After that, AZFb and AZFa were more frequent, respectively. In fact, ethnicity did not have a significant effect on the distribution of these microdeletions and no significant results were observed in this regard. Regarding the frequency of different microdeletions (frequency of distribution) in various Iranian ethnicities, considering that the number of samples of some microdeletions in some ethnicities was less than the amount required for statistical analysis, the number of people studied in each ethnicity has been adjusted. Statistical analysis of these results using chi-square test showed that the frequency of microdeletions in ethnicities is not uniform (p <0.001), therefore, the ethnicity of the Iranian infertile man is influential in the frequency of distribution of these microdeletions. However, due to the insufficient number of people with microdeletions in some ethnicities, it is not possible to determine with sufficient statistical accuracy which microdeletions occurs more frequently in which ethnicity. In this regard, it seems that the referral of Royan Infertility Treatment Center and the existence of infertility treatment centers in the centers of some provinces have affected the ethnic composition of the client. Therefore, it is suggested that in future and supplementary studies, in order to create an appropriate ethnic distribution in the referring population, while increasing the sample size (especially for some ethnicities) if possible with the cooperation of infertility treatment centers in other provinces, comprehensive studies in this regard be used to achieve a more definite result in this regard.
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