Vol 45 No 5 (2016)

Review Article(s)

  • XML | PDF | downloads: 267 | views: 1049 | pages: 558-568

    Background: Hyperbilirubinemia, or jaundice, is a life threatening disorder in newborns. It is a multifactorial disorder with many symptoms. Generally, the physiological jaundice is the most prevalent type however in some regions pathological jaundice is also common. This review article focuses on a brief introduction to jaundice, its types and causes, measuring the bilirubin level, clinical approaches towards hyperbilirubinemia, different precautionary measures for the parents of babies suffering from hyperbilirubinemia and different remedial therapeutic measures for its treatment.

    Methods: The main databases including Scopus, Pubmed, MEDLINE, Google scholar and Science Direct were researched to obtain the original papers related to the newborns’ hyperbilirubinemia. The main terms used to literature search were newborns’ hyperbilirubinemia”, “newborns’ jaundice”, “Physiological Jaundice” and “Patholigical Jaundice”. The timeframe included the obtained articles was from 1952 to 2015.   

    Results: Neonatal jaundice due to breast milk feeding is also sometimes observed. Hemolytic jaundice occurs because of the incompatibility of blood groups with ABO and Rh factors, when the fetus and mother blood groups are not compatible and the fetus blood crosses the barrier of the umbilical cord before birth causing fetus blood hemolysis owing to severe immune response.

    Conclusion: Jaundice is easily diagnosable however require quick and on the spot treatment. If not treated properly, it leads to many complications. Currently the treatment options for jaundice include photo therapy, chemotherapy, and vaccinations.



Original Article(s)

  • XML | PDF | downloads: 94 | views: 428 | pages: 569-577

    Background: Fear of falling is not only a risk factor for falls, but it is also an important clinical predictor of functional decline in older adults. This study identified sex differences in fear of falling and related factors in older adults with low grip strength.

    Methods: The data of 902 older adults from the 2012 Korean National Survey, conducted as a research project by the Korea Employment Information Service, were analyzed. Grip strength, activities of daily living, cognitive function, depressive symptoms, and fear of falling were assessed. Multiple regression analysis was performed by a simultaneous data entry method.

    Results: Fear of falling was greater in older women with low grip strength than in their male equivalents (P<0.001). Regression analysis showed that age, fall experience within the previous 2 yr, activities of daily living, and depressive symptoms collectively accounted for 15.3% (P<0.001) of the variance among men. Meanwhile, age, fall experience within the previous 2 yr, grip strength, activities of daily living, and depressive symptoms collectively accounted for 13.4% (P<0.001) of the variance among women.

    Conclusion: Thus, the predictors of fear of falling differ between older men and women with low grip strength. Therefore, sex differences must be considered when developing intervention strategies for reducing fear of falling in this demographic.



  • XML | PDF | downloads: 124 | views: 361 | pages: 578-585

    Background: Osteosarcoma is a malignant tumor with high mortality but effective therapy has not yet been developed. Berberine, an isoquinoline alkaloid component in several Chinese herbs including Huanglian, has been shown to induce growth inhibition and the apoptosis of certain cancer cells. The aim of this study was to determine the role of berberine on human osteosarcoma cell lines U2OS and its potential mechanism.

    Methods: The proliferation effect of U20S was exanimed by 3- (4,5)-dimethylthiahiazo (-z-y1)-3,5-di- phenytetrazoliumromide (MTT) and the percentage of apoptotic cells were determined by flow cytometric analysis. The expression of PI3K, p-Akt, Bax, Bcl-2, cleavage-PARP and Caspase3 were detected by Western blott.

    Results: Berberine treatment caused dose- dependent inhibiting proliferation and inducing apoptosis of U20S cell. Mechanistically, berberine inhibits PI3K/AKT activation that, in turn, results in up-regulating the expression of Bax, and PARP and down-regulating the expression of Bcl-2 and caspase3. In all, berberine can suppress the proliferation and induce the apoptosis of U2OS cell through inhibiting the PI3K/Akt signaling pathway activation.

    Conclusion: Berberine can suppress the proliferation and induce the apoptosis of U2OS cell through inhibiting the PI3K/Akt signaling pathway activation.



  • XML | PDF | downloads: 139 | views: 402 | pages: 586-595

    Background: In many sub-Saharan African countries the rate of antenatal care (ANC) has been increased but skilled birth attendance rate is still low. The objective of this study was to evaluate the reasons why women prefer home delivery when facility based delivery is available at minimal cost.

    Methods: This study was conducted in Northwest Nigeria using a qualitative method (phenomenology) among five categories of women in April – May 2013. This study investigated different categories of women (those that never attend ANC nor deliver in the facility, those that attend ANC but delivered at home and those that delivered once in the facility but fail to return in subsequent deliveries, the in-laws and facilities staff).

    Results: Through focus group discussions and In-depth interviews several reasons why women are averse to hospital deliveries were identified. Women reported ignorance, abuse, illiteracy, and poverty, and low esteem, poor attitude of health workers, few working hours and some integrated health services like preventing mother to child transmission of HIV testing as deterrents, while cheap and accessible services were reasons for preference to traditional birth attendants.

    Conclusions: The findings highlighted important entrenched barriers to facility deliveries among women, which is basically socio-cultural and economic. Therefore emphasis must be given to health education program to ensure comprehensive and target specific messages that will address individual needs of the groups.


  • XML | PDF | downloads: 87 | views: 414 | pages: 596-605

    Background: Increasing serum levels of uric acid (SUA) after menopause in women brought up a hypothesis that estrogenic effect may protectively regulate SUA. Estrogenic effect is a major etiology of uterine fibroids and fibrocystic breast disease. The study aimedtoexplore SUA among patients suffering from these diseases to enhance the hypothesis.

    Methods: Overall, 1349 female participants were selected into three cases: CaseⅠhaving uterine fibroids (n=568), CaseⅡ having fibrocycstic breast disease (n=608) and CaseⅢ having uterine fibroids combining with fibrocycstic breast disease (n=173); 4206 participants without these diseases were selected as controls. Based on health check-up data from 2011 to 2012, in Dongying Shengli Oilfield Central Hospital, a cross-sectional study was conducted to examine the difference in SUA between the case and control. We adjusted covariates by generalized linear regression mode.

    Results: From 19 to 44 yr, SUA of CaseⅠ to CaseⅢ were lower than controls by 8.46 umol/L (P=0.011), 5.88umol/L (P=0.014) and 9.39 umol/L (P=0.059), respectively. From 45-54 yr, no significant differences were between three cases and controls. In CaseⅠand its control: from 54-59 yr, differences were not significant; from 60 to 72 yr, SUA in CaseⅠwas lower than the control by 32.02umol/L (P=0.003).

    Conclusion: Participants of uterine fibroids and fibrocystic breast disease had a lower SUA except the stage of menopause, which indirectly supported that estrogenic effect, may protectively decrease SUA.



  • XML | PDF | downloads: 145 | views: 425 | pages: 606-613

    Background: Long Distance Truck Drivers (LDTDs) and their sexual health risk behaviors have been associated with greater prevalence of sexually transmitted Infections (STIs), HIV and hepatitis virus transmission. However, there is no information about Iranian LDTDs' high-risk behaviors. The aim of this investigation was to estimate the prevalence of high-risk behaviors in Iranian LDTDs.

    Methods: This cross-sectional study was conducted in Jun 2014 with LDTDs from Tehran Province of Iran. LDTDs were recruited via convenience sampling and given a 43-item reliable and valid questionnaire to assess sexual health risk behaviors and demographic and background characteristics of study participants.

    Results: A total of 349 LDTDs with the mean age of 36.91 yr (range, 19–65 yr) participated in the study. The average duration of staying away from home for participants was 5 d (SD=±1). Majority of the LDTDs were married (82.2 %) and had more than 5 yr (inclusive) of formal education (95.7%). Younger LDTDs reported more condom use with their partners (r=-0.170, P≤0.001), more extramarital sexual contacts (r=-0.157, P≤0.001), more pay for sex (r=-0.110, P≤0.005) and condom use in their extramarital sex contacts (including with sex workers) (r=-0.176, P≤0.001).

    Conclusion: Iranian LDTDs have specific risk factors for unhealthy sexual behaviors. Prevention efforts must emphasize on specific high-risk groups.



  • XML | PDF | downloads: 129 | views: 357 | pages: 614-622

    Background: Using spatial analysis tools to determine the spatial patterns of China province-level perinatal mortality and using spatial econometric model to examine the impacts of health care resources and different socio-economic factors on perinatal mortality.

    Methods: The Global Moran’s I index is used to examine whether the spatial autocorrelation exists in selected regions and Moran’s I scatter plot to examine the spatial clustering among regions. Spatial econometric models are used to investigate the spatial relationships between perinatal mortality and contributing factors.

    Results: The overall Moran’s I index indicates that perinatal mortality displays positive spatial autocorrelation. Moran’s I scatter plot analysis implies that there is a significant clustering of mortality in both high-rate regions and low-rate regions. The spatial econometric models analyses confirm the existence of a direct link between perinatal mortality and health care resources, socio-economic factors.

    Conclusions: Since a positive spatial autocorrelation has been detected in China province-level perinatal mortality, the upgrading of regional economic development and medical service level will affect the mortality not only in region itself but also its adjacent regions.


  • XML | PDF | downloads: 101 | views: 398 | pages: 623-635

    Background: Injuries and psychiatric disorders, notably both major public health concerns, are associated with a high burden and are believed to be bi-directionally correlated. Those inflicted with injuries face increased risks of mental illnesses. Psychiatric disorders may make the individual prone to injuries. The objective of the study was to assess the correlation of mental disorders with non-fatal injuries.

    Methods: A total of 7886 participants aged 15 to 64 yr were interviewed in a national household survey in 2011 in Iran. Composite International Diagnostic Interview (CIDI v2.1) was implemented to assess the prevalence of psychiatric disorders in the past twelve months. Injuries were assessed using Short Form Injury Questionnaire (SFIQ-7).

    Results: Injury was reported in 35.9% and 22.8% of participants in the past twelve and past three months, respectively. Using multivariate logistic regression analysis, mental disorders were significantly associated with injuries in the past three months (OR=1.6, 95% CI:1.36-1.87), recurrent injuries (OR=1.7, 95% CI: 1.21-2.41) and road/traffic accidents (OR=2.4, 95% CI: 1.28-4.49).

    Conclusion: Psychiatric disorders were found to be associated with an increased risk of injuries. Early detection and treatment of mental illnesses can contribute to injury prevention.



  • XML | PDF | downloads: 111 | views: 349 | pages: 636-643

    Background: This paper investigated the effect of daylight on morning and night melatonin, subjective general health using GHQ questionnaire, sleepiness and alertness on elderly who lived in nursing houses.

    Methods: Nineteen nursing home residents participated voluntarily. They exposed to daylight from 9 to 10 a.m. and from 4 to 5 p.m. for 6 wk. The level of melatonin in the morning and at night was measured. General health of all participants was evaluated using General Health Questionnaire (GHQ) as well.

    Results: Daylight exposure significantly affected morning melatonin from 25.39 pg/ml to 59.77 pg/ml (P=0.001) and night melatonin were changed from 40.30pg/ml to 34.41pg/ml (P=0.081). Mean score of general health changed 36.31 to 29.89 (P=0.003). Karolinska Sleepiness Scale (KSS) and Visual Analogue Scale (VAS) showed increase sleepiness and decrease alertness from 3:00 to 7:00 a.m. Sleepiness decreased and alertness increased during 1:00 p.m. and 20:00 p.m.

    Conclusions: Daylight exposure could delay sleep phase and correction of circadian rhythm in elderly. Anxiety and insomnia could be improved with daylight exposure. It suggests that elders should be exposed to scheduled daylight in morning and evening for prevention and improvement of mental disorders. Adequate light should be provided for elder’s homes and nursing house.


  • XML | PDF | downloads: 103 | views: 314 | pages: 644-649

    Background: Multiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS) caused by autoreactive T cells against myelin antigens. T-cell immunoglobulin mucin -3 (TIM-3) is a negative regulator glycoprotein expressed by a range of immune cells, including, Th1 cells, activated CD8+ T cells and in a lower level on Th17 cells. A defect in TIM-3 regulation has been shown in multiple sclerosis patients. In humans, several single nucleotide polymorphisms (SNPs) have been identified in the TIM-3 gene and are associated with inflammatory diseases. The aim of this study was to analyze the association between TIM-3 -574A>C and -1516 C>A SNPs in the promoter region, and susceptibility to MS.

    Methods: DNA samples from 102 patients and 102 healthy controls were genotyped using RFLP-PCR method.

    Results: In this case-control study, analysis of the alleles and genotypes revealed a significant higher frequency of C/C and lower frequency of A/C genotypes for -574 locus of TIM-3 gene in MS patients (P=0.0002). We also found that C/C genotype for locus of -1516 increased in MS patients, while A/C genotype decreased (P=0.012). Allele C of -574C/C and -1516 C>A SNPs were also more frequent in MS patients (P=0.036 and 0.0027 respectively).

    Conclusion: -574 A>C and -1516 C>A SNPs in the promoter region of TIM3 gene may affect the disease susceptibility.


  • XML | PDF | downloads: 150 | views: 402 | pages: 650-656

    Background: Chemical and microbial quality of water used in hemodialysis play key roles in a number of dialysis-related complications. In order to avoid the complications and to guarantee safety and health of patients therefore, vigorous control of water quality is essential. The objective of present study was to investigate the chemical and bacteriological characteristics of water used in dialysis centers of five hospitals in Isfahan, central Iran.

    Methods: A total of 30 water samples from the input of dialysis purification system and dialysis water were analyzed for chemical parameters. Heterotrophic plate count and endotoxin concentration of drinking water, dialysis water and dialysis fluid of 40 machines were also monitored over a 5-month period in 2011-2012.

    Results: Concentration of the determined chemicals (copper, zinc, sulfate, fluoride, chloramines and free chlorine) did not exceed the recommended concentration by the Association for the Advancement of Medical Instrumentation (AAMI) exclude lead, nitrate, aluminum and calcium. Furthermore, the magnesium; cadmium and chromium concentration exceeded the maximum level in some centers. No contamination with heterotrophic bacteria was observed in all samples, while the AMMI standard for endotoxin level in dialysis fluid (<2 EU/ml) was achieved in 95% of samples.

    Conclusion: Dialysis water and fluid failed to meet the all chemical and bacteriological requirements for hemodialysis. To minimize the risk of contaminants for hemodialysis patients therefore, a water quality management program including monitoring, maintenance and development of water treatment system in hemodialysis centers is extremely important. In addition, an appropriate disinfection program is needed to guarantee better control of bacterial growth and biofilm formation.



  • XML | PDF | downloads: 138 | views: 328 | pages: 657-669

    Background: The segmentation of cancerous areas in breast images is important for the early detection of disease. Thermal imaging has advantages, such as being non-invasive, non-radiation, passive, quick, painless, inexpensive, and non-contact. Imaging technique is the focus of this research.

    Methods: The proposed model in this paper is a combination of surf and corners that are very resistant. Obtained features are resistant to changes in rotation and revolution then with the help of active contours, this feature has been used for segmenting cancerous areas.

    Results: Comparing the obtained results from the proposed method and mammogram show that proposed method is Accurate and appropriate. Benign and malignance of segmented areas are detected by Lyapunov exponent. Values obtained include TP=91.31%, FN=8.69%, FP=7.26%.

    Conclusion: The proposed method can classify those abnormally segmented areas of the breast, to the Benign and malignant cancer.


  • XML | PDF | downloads: 134 | views: 399 | pages: 670-679

    Background: Much of the environment is affected by petroleum contamination. It imposes serious health problems for humans as well as serious environmental impact. Bioremediation is an important consideration for removing environmental pollutants because, compared with other technologies, it incurrs lower costs and is environmentally compatible.

    Methods: Crude oil degrading bacteria were isolated using serial dilutions of a bacterial consortium. The Taguchi experimental design L16 (45) was used to optimize the biodegradation process of crude oil by the isolated strain. This investigation applied the parameters of temperature, salinity, pH, NH4Cl and FeSO4.7H2O. Modeling the kinetics of crude oil biodegradation included five batch cultivation experiments (2.5 ml/L to 40 ml/L) using crude oil as a single limiting substrate.

    Results: Halomonas sp. MS1 was identified using identification tests. Maximum biodegradation efficiency was predicted to occur at pH=9, temperature=30 ˚C, salinity=2%, NH4Cl concentration=0.4 g/L and FeSO4.7H2O=0.04 g/L. After optimization, biodagradation was significantly (P<0.05) higher (i.e. 90.65%) than it results under the original conditions. Furthermore, growth kinetics modelling of bacteria in various concentrations of crude oil showed a positive correlation between increased concentration, up to 10 ml/L and bacterial growth, but this was not evident at higher concentrations (20-40 mL/L)

    Conclusion: Overall, bacteria in surface sediment samples from Kish Island have been determined as having good potential for application in oil biodegradation. Optimum amounts of the studied factors were determined successfully by applying the Taguchi experimental design and the models of Teissier and Haldane are suggested as kinetic models to describe the batch crude oil degradation behavior of MS1.


  • XML | PDF | downloads: 103 | views: 693 | pages: 680-687

    Background: Autosomal recessive non-syndromic hearing loss (ARNSHL) is the most common hereditary form of deafness, and exhibits a great deal of genetic heterogeneity. So far, more than seventy various DFNB loci have been mapped for ARNSHL by linkage analysis. The contribution of three common DFNB loci including DFNB3, DFNB9, DFNB21 and gap junction beta-2 (GJB2) gene mutations in ARNSHL was investigated in south of Iran for the first time.

    Methods: In this descriptive study, we investigated sixteen large families with at least two affected individuals. After DNA extraction, GJB2 gene mutations were analyzed using direct sequencing method. Negative samples for GJB2 gene mutations were analyzed for the linkage to DFNB3, DFNB9 and DFNB21 loci by genotyping the corresponding short tandem repeat (STR) markers using polymerase chain reaction (PCR) and polyacrylamide gel electrophoresis (PAGE) methods.

    Results: GJB2 mutations (283G>A and 29delT) were causes of hearing loss in 12.5% of families with ARNSHL and no evidence of linkage were found for any of DFNB3, DFNB9 and DFNB21 loci.

    Conclusion: GJB2 mutations are associated with ARNSHL. We failed to find linkage of the DFNB3, DFNB9 and DFNB21 loci among GJB2 negative families. Therefore, further studies on large-scale population and other loci will be needed to find conclusively linkage of DFNB loci and ARNSHL in the future.


Letter to the Editor