JOURNAL OF RESEARCH IN MEDICAL SCIENCES (JRMS)
Year:2016 | Volume:21 | Issue:7|Papers Count:8

Background: The aim of this study was to validate the Farsi version of Rome III modular questionnaire which contains all functionalgastrointestinal disorders (FGIDs). Materials and Methods: We used Rome foundation guidelines for translation of English versioninto Farsi, and all the steps were performed. In the first step, 2 forward translations into Farsi were completed by two authorsseparately, and then translators, who participated in Step 1, together with our monitor, compared the two target‑language versionsand made some changes. The product of Phase 2 was translated back into English by an American‑Iranian physician. The final stepwas comparison of the two English versions and validation of the translation. In this step, we compared the final version item byitem, and also we used focus groups of patients after pretesting.Results: Our results showed that FGIDs questionnaire diagnosed153 patients among 169 patients who were diagnosed to have different types of FGIDs. The sensitivity of this questionnaire was90.5%. It was determined that the odd questions’ values of Cronbach’s alpha was 0.77 (very reliable), and it was 0.71 (very reliable) inother sections. The split‑half test reliability of whole items value was 0.72, which is statistically significant.Conclusion: Our findingsshowed that the Farsi version of Rome III diagnostic questionnaire for the adult functional gastrointestinal disorders demonstratedgood validity and reliability and could be used in clinical studies.

Background: The second leading cause of cancer deaths in women is breast cancer. Germline mutations in susceptibility breastcancer gene BRCA1 increase the lifetime risk of breast cancer. Eighty‑one large genomic rearrangements (LGRs) have been reportedup to date in BRCA1 gene, and evaluation of these rearrangements helps with precise risk assessment in high‑risk individuals. Inthis study, we have investigated LGRs in BRCA1 among Iranian high‑risk breast cancer families. Materials and Methods: Seventypatients with breast cancer who were identified negative for point mutations or small deletions/insertions of BRCA1 gene wereselected. Deletions and duplications of BRCA1 gene were evaluated using multiplex ligation‑dependent probe amplification (MLPA).Results: Two deletions, deletion of exons 1A/1B‑2 and exon 24, were detected in two patients with breast cancer. The former alterationwas found in a woman with a strong family history of breast cancer while the latter one was detected in a woman with early onset ofbreast cancer.Conclusion: Although our data confirm that LGRs in BRCA1 comprise a relatively small proportion of mutations inhereditary breast cancer in the Iranian population, MLPA analysis might be considered for screening of LGRs in high‑risk individuals.It is worth to note that our results are consistent with previous studies in various Asian and European countries.

Background: Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world. Oral administration ofsymbiotic and Vitamin E has been proposed as an effective treatment in NAFLD patients. This study was carried out to assess the effectsof symbiotic and/or Vitamin E supplementation on liver enzymes, leptin, lipid profile, and some parameters of insulin resistance (IR)in NAFLD patients. Materials and Methods: We randomly assigned sixty NAFLD adult patients to receive (1) symbiotic twicedaily+Vitamin E‑like placebo capsule; (2) 400 IU/d Vitamin E+symbiotic‑like placebo; (3) symbiotic twice daily+400 IU/d VitaminE; and (4) symbiotic‑like placebo+Vitamin E‑like placebo for 8 weeks.Results: Symbiotic plus Vitamin E supplementation led to asignificant decrease in concentrations of liver transaminase (P ≤ 0.05). Mean difference of apolipoprotein A‑1 was more significantin symbiotic group compared to control. However, mean difference of apolipoprotein B100/A‑1 was only significant in symbioticgroup compared to control. At the end of the study, significant differences in total cholesterol (TC) and low‑density lipoproteincholesterol (LDL‑C) were seen between the symbiotic plus Vitamin E and control groups (P<0.001). Furthermore, intake of symbioticplus Vitamin E supplements led to a significant decrease in concentrations of triglycerides (TG) after the intervention. Significantdifferences in leptin, fasting blood sugar (FBS), and insulin levels were seen between the symbiotic plus Vitamin E and control groupsat the end of the study (P<0.001). In contrast, symbiotic and/or Vitamin E supplementation did not affect high‑density lipoproteincholesterol and homeostasis model assessment for IR levels.Conclusion: In our study, symbiotic plus Vitamin E supplementationwas the most effective treatment in lowering liver enzymes, leptin, FBS, insulin, TG, TC, and LDL‑C among NAFLD patients.

Background: Patients with functional gastrointestinal disorders (FGIDs) may use specific coping strategies. We intend to provide a mediating role of the relationship between pain (intensity and acceptance), cognitive emotion regulation strategies, and negative emotions in patients with FGIDs. Materials and Methods: Participants were 176 inpatients, all experiencing significant FGIDs symptomatology as confirmed by gastroenterologists. Patients completed data on cognitive emotion regulation questionnaire, short form of depression, anxiety, stress scale, chronic pain acceptance questionnaire‑revised, and pain intensity scale. Data were analyzed using structural equation modeling method. Results: The pain intensity had significantly direct effect on cognitive emotion regulation strategies and indirect effect on negative emotions. Besides, the mediating role of negative emotions in the relationship between the strategies and pain acceptance were supported, whereas indirect relationships between pain intensity and acceptance through cognitive strategies were not confirmed. Conclusion: The results of the study emphasize the role of pain intensity in the development of negative emotions through cognitive strategies and the role of the strategies in pain acceptance through negative emotions. In fact, cognitive strategies to be related to pain and emotions.

Background: Muscle relaxant agents usually use to facilitate tracheal intubation; however, sometimes limitations exist. Magnesium (Mg)sulfate is a candidate for muscle relaxant substitute. This study was designed to determine the effect of Mg sulfate accompanied withpropofol and fentanyl in patients undergoing ophthalmic surgery. Materials and Methods: In a double‑blind randomized protocoland before tracheal intubation, Mg sulfate 40, 45, or 50 mg/kg in 100 ml of saline (Groups 1–3, respectively) or saline alone (Group 4)were administrated intravenously in 100 patients (n=25 in each group) with the American Society of Anesthesiologist (ASA) physicalStatus I, II, or III. The patients’ intubation condition in all subjects were determined and described.Results: The patients’ demographicdata including age, ASA, systolic and diastolic blood pressures, intraocular pressure, and body mass index were not significantlydifferent between the groups. A better mask ventilation feasibility in Mg sulfate 45 group (Group 2) was observed when comparedwith Mg sulfate 50 (Group 3) (P=0.022) and saline group (Group 4) (P=0.021). In addition, the vocal cord movement and musclerelaxant requirement in saline group were significantly different from others groups (P<0.05). The laryngoscopic time in salinegroup was greater than other groups significantly (P<0.0001).Conclusion: Intravenous administration of Mg sulfate accompaniedwith propofol and fentanyl facilitates the tracheal intubation without neuromuscular blocking agents. To avoid Mg level increasingin plasma; however, the low dose of Mg sulfate is suggested.

Background: The aim of this study was to evaluate maternal and perinatal outcomes in preeclampsia (PE), according to the value ofalbumin. Materials and Methods: Preeclamptic women were retrospectively divided into mild hypoproteinemia (MHP, n=220) andsevere hypoproteinemia (SHP, n=79) PE according to the value of albumin. The maternal and perinatal outcomes were evaluated inboth groups.Results: Two hundred and ninety‑nine single pregnancies complicated by PE were included in this study. Gestational ageat delivery was earlier in SHP than MHP (P<0.01). Severe hypertension, abnormal liver function, abnormal renal function, ascites, and abruption occurred more frequently in SHP than in MHP (P<0.01, 0.03, <0.01, 0.01, and 0.04, respectively). Women in SHP hada higher rate of cesarean section than those in MHP (P=0.04). Fetal growth restriction infants were more frequent in SHP than inMHP (P<0.01). The occupancy rate of the Neonatal Intensive Care Unit was higher in SHP than in MHP (P<0.01).Conclusion: SHPPE is associated with a higher risk of adverse pregnancy outcome than MHP PE, deserving closer surveillance during pregnancy.

Background: This study aimed to evaluate the strength of anti‑Mullerian hormone (AMH) and follicle stimulating hormone (FSH) in reflecting the antral follicle count (AFC) in infertile females. Materials and Methods: This cross‑sectional study was conducted on 160 females, visiting infertility clinic for assisted reproduction. Serum samples collected on the 3rd day of the cycle were assayed for FSH, luteinizing hormone, and AMH while AFC was assessed via transvaginal ultrasound. The study cohort was segregated into three groups based on AFC. Results: Chronological age and FSH was significantly high in females with very low AFC (P < 0.01 and 0.009, respectively), yet they failed to discriminate patients with normal and higher follicle count (P = 0.65 and 0.84). Conversely, AMH reported highly significant difference between very low AFC and with those having either normal AFC (P = 0.002) or higher AFC (P = 0.001). Moreover, a significant difference in AMH was observed between normal and higher AFC group (P = 0.04). Conclusion: Compared to female’s age and FSH, AMH is superior in clustering study cohort on the bases of antral follicular pool, especially in setups with nonavailability of technological expertise to assess AFC. Incorporation of AMH along with other biomarkers improves estimation of baseline ovarian reserve, required to standardize dose for optimum response; avoiding the risk of failure to retrieve oocyte or inappropriate stimulation leading to ovarian hyperstimulation syndrome. Further prospective studies are required to ascertain its role in predicting the outcomes of ART in such patients.

Background: It is intriguing and imperative that the comparison of the iron preparations in hemodialysis (HD) patients. This studyaimed to observe the short‑term efficacy of parenteral iron sucrose and ferric chloride in HD patients. Materials and Methods: Thiswas a consecutive 10‑week single‑blind study in Taiwan. An intravenous iron supplement of 100 mg/week was administered as aninfusion in 100 ml of normal saline, until a total dose of 1000 mg was achieved. The primary outcome was evaluated by the changesin serum hematocrit (Hct) levels. The changes in serum Hct and iron indices were evaluated every 2 weeks for 10 weeks. The resultswere collected from 21 April to 4 July 2013.Results: A total of 56 HD patients completed the study. Subjects were randomizedinto an iron sucrose group (26 patients) and a ferric chloride group (30 patients). Between the two treatment groups, there wereno statistically significant differences in the change in serum Hct, ferritin, iron, or total iron binding capacity (P>0.05). In the ironsucrose group, the increase in Hct levels was statistically significant at weeks 4, 8, and 10. In the ferric chloride group, the increasein Hct levels was statistically significant at week 8. No obvious major side effects were observed in both groups.Conclusion: In thestudy subjects, parenteral iron sucrose was as effective and safe as ferric chloride for treating anemia in HD patients.