Medical Journal of The Islamic Republic of Iran (MJIRI)

---

Rohrer's ponderal index in newborns (birth weight * 100/height3) has been used as an indicator of fetal growth status, especially to assess asymmetrical intrauterine growth retardation. Low ponderal index or disproportionate intrauterine growth retardation has higher neonatal morbidity and there are some specific guidelines in intrauterine growth retarded infants to control some of their prevalent complications like hypoglycemia. As there are no specific guidelines to control and screen some possible morbidities in babies with more than 2500 gram weight, we decided to determine the association between different ponderal index values and neonatal complications such as hypoglycemia, meconium aspiration syndrome, hyperbilirubinemia, perinatal resuscitation and duration of hospital stay in first born term infants. Three-hundred and sixty-one first born infants were studied during April 2000 to April 2001. Low, appropriate and high ponderal indexes were detected in 20.5%, 51 % and 28.5% of infants respectively. Among these infants, there were 47 intrauterine growth retarded cases. The frequency of hypoglycemia, meconium aspiration syndrome, hyperbilirubinemia and age at hospital discharge with a stay of more than 7 days were higher in the low ponderal index group than the other two groups and the statistical differences were significant (p< 0.05). Comparing neonatal morbidities according to birth weight (more or less than 2500 g), we could not find significant differences except in hypoglycemia (p< 0.05). This study showed that a low ponderal index could be used as a prognostic factor in predicting some morbidity in term neonates.

---

  Background: Rheumatoid arthritis (RA) is an autoimmune systemic disease. Most common autoimmune diseases are multisystem disorders that may also present with otological manifestations, and autoimmune inner ear disease accompanied by vestibular dysfunction. This study aimed to compare the vestibular function between RA patients and normal subjects using cervical vestibular evoked myogenic potentials (cVEMPs).

  Methods : In this cross- sectional study, 25patients with RA (19 female and 6 male: mean (±SD) age, 40.00 (±7.92) years) and 20 healthy subjects (15 female and 5 male: mean (±SD) age, 35.35 (±10.48) years) underwent cVEMPs, using 500 Hz-tone bursts at 95 dB nHL intensity level. Data were analyzed using independent sample t-test through SPSS software v. 16.

  Results : The mean peak latency of p13 was significantly higher in RA patients (p<0.001). The mean peak latency of n23 was significantly higher in patients in the left ear (p=0.03). Vestibular evoked myogenic potential (VEMP) responses were present in all (100%) of the participants. There were no significant differences in mean peak to peak amplitude and amplitude ratio between the two groups.

  Conclusion : According to the prolonged latency of VEMP responses in RA patients, lesions in the retrolabyrinthine, especially in the vestibulospinal tract are suspected.

---

Background: Doxorubicin, by aggregating in bone marrow, causes genotoxic effects, and thus reduces the repair ability of cells. The present study was conducted as an in vitro evaluation of age effects on the cytotoxicity induced by doxorubicin in mesenchymal stem cells (MSCs).
   Methods: The MSCs of female BALB/c mice aged 1, 8, and 16 months were separated, characterized, and subsequently evaluated in cellular growth media. After 24 hours, exposure of the MSCs of the 3 groups of mice to doxorubicin (25, 50, 100, 200, 400, 800, 1200 nM) and cytotoxicity were assessed, and the sublethal dose was determined using flow cytometry technique and lactate dehydrogenase (LDH) release assay.
   Results: The IC50 values determined by flow cytometry for the separated MSCs of 1 young, 8 middle- aged, and 16 old mice were and respectively. Interestingly, the results of these 2 methods in determining cytotoxicity were in agreement, and a concentration of approximately 25 nM was considered to be the shared sublethal dose for different ages.
   Conclusion: The results indicated that MSCs of middle-aged mice were more resistant to the toxic effects of the drug. Besides, MSCs separated from the old mice were the most sensitive to chemotherapy and its side effects such as disruptions of cell proliferation and viability. These disruptions can be ascribed to the alteration of function and physiological processes with age. Determining proper concentration of doxorubicin drug to destruct cancerous cells based on age and individual sensitivity can minimize the amount of toxicity.
 

---

    Background: Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder in children that creates problems in parents-children relationships. Improving familial and social interactions of these children needs mental and social interventions, and parents’ management training (PMT) program is one of these interventions. The present study aimed at determining the effectiveness of PMT program on parent-child relationship of parents with ADHD children.
    Methods: Through an experimental research, 40 parents with ADHD children were selected based on purposeful sampling. A total of 20 parents were randomly placed in intervention group and received 8 sessions of intervention course (60 minutes per session) and the other 20 parents were grouped in the control group and received no training intervention. Research tools included a researcher-designed demographics questionnaire and Parker’s Bonding Instrument (PBI). Data were collected at pretest, posttest, and follow- up stages and analyzed using descriptive and covariance analysis.
   Results: The results revealed that PMT program was significantly effective in reducing excessive support and increasing parent care index in parents with ADHD children (p<0.05).
    Conclusion: The results of the present study supported the effectiveness of PMT program on parent-child relationship of the parents with ADHD children.
 

---

Background: Gastric cancer is the fourth most common form of cancer and the second most common cause of death in the world. It is also one of the most common cancers leading to mortality in Iran. Therefore, this study aimed to determine the survival rate of patients with gastric cancer and its affecting factors in the south of Iran (Hormozgan province).
   Methods: In this study, all patients with gastric cancer (119 patients) that were diagnosed and registered during 2008 to 2013 in Hormozgan province, were studied. All patients were followed to the end of 2015. Kaplan-Meier method and Cox proportional hazards model were used to draw survival curves and to determine the effective factors on the survival rate of surveyed patients. Moreover, Log-rank test was used to evaluate whether or not survival curves for different groups are statistically equivalent (p<0.05). 
   Results: The mean age of the study population was 58.9±14.91, and most of them were men (72.3% (86 persons)). After diagnosis, the survival rates for 1, 2, 3, 4, and 5 years were 62.2%, 49.4%, 43.7%, 39.7%, and 38% respectively. Survival in men were lower than women, but according to log-rank test this difference was not statistically significant (p=0.325). Also patients with advanced stage cancer had significantly lower survival in comparison to individuals with early stage disease (p<0.001). Based on multiple Cox proportional hazards model, job status of the patients and stage of cancer   were effective factors on patients’ survival.
   Conclusion: Based on the findings of the present study, the survival rate was decreased over time after diagnosis. Stage of a cancer at the time of diagnosis is the most important factor affecting the survival of surveyed patients. This shows that there is a crucial need to diagnos the gastric cancer in early stages.
 

---

Background: Cortical deceleration is the main reason for bone loss at peripheral sites. It was suggested that when peripheral bones were assessed for osteoporosis, management and therapy can be administered early. The main aim of this study was to assess the relationships between the central and peripheral measurements at different skeleton bone sites (spine, femur, forearm, tibia, and calcaneus) with available modalities: DXA, QUS, and MDCT-QCT.
   Methods: The volunteers recruited in this study did not have any history or evidence of metabolic bone disease.  Blood test and DXA measurements were used as inclusion criteria to select 40 healthy participants. The selected volunteers underwent 3 imaging modalities: QCT, DXA, and QUS. DXA-based measurements were made on 3 sites, including spine, femur, and forearm. QCT and QUS measurements were done for distal of tibia and calcaneus bones, respectively.  The extracted parameters from the 3 modalities were analyzed using a bivariate (Pearson) correlation (r) in statistical software.
   Results: The results showed moderate to good correlations between spongy bones in central and peripheral sites from all the modalities. However, there was no correlation between MDCT measures and central bone values. According to correlations between different peripheral sits, aBMD of 33% radius and trabecular vBMD in 38% distal tibia showed weak but significant relationship between peripheral bones (r=-0.342, p=0.044).
   Conclusion: The findings demonstrated how bones in central and peripheral sites were correlated. Multimodality imaging was used in this group of healthy volunteers. Also, it was found that QCT-based MDCT needs more optimization and requires further investigations. 
 

---

Background: Procrastination is a common and widespread phenomenon that affects 15-20% of the general population and 50% of students. Since developing and providing beneficial and effective interventions for procrastination needs a strong, comprehensive theoretical background explanation, the aim of the study was to assess the underlying transdiagnostic factors of procrastination and presenting a causal model.
   Methods: In this cross-sectional study, 390 college students were asked to fill out a packet of self-report measures, which included the Pure procrastination scale, Difficulties in emotion regulation scale, Depression-anxiety-stress scales, Frost multidimensional perfectionism scale, Rumination response scale, Penn state worry questionnaire, Acceptance and action questionnaire. The causal model was tested using structural equation modeling (SEM).
   Results: Results of the SEM indicate that perfectionism was significantly associated with increasing emotion dysregulation (β=0.446, P<0.001) and emotion dysregulation was significantly associated with increasing anxiety (β=0.499, P<0.001) and depression (β=0.478, P<0.001), and then anxiety and depression with other variables, such as worry (β=0.245, P<0.001; β=0.004, P=0.935), rumination (β=0.046, P=0.424; β=0.418, P<0.001) and experiential avoidance (β=0.277, P<0.001; β=0.319, P<0.001) related to procrastination. Finally, worry has the most significant increasing effect on procrastination. The very small root mean square error of approximation (RMSEA=0.038), together with large values of comparative fit index (CFI=0.985), relative fit index (RFI=0.917), and normed fit index (NFI=0.979) indicated that the model was well fit.
   Conclusion: Perfectionism, emotion dysregulation, negative affects, worry, rumination, and experiential avoidance, known as transdiagnostic factors, had a causal relationship with procrastination, and reducing each transdiagnostic factor will improve procrastination. This study could be considered as a cornerstone for further studies on procrastination from a transdiagnostic approach.

---

Background: Quantitative electroencephalography (EEG) power spectra analysis was applied to assess brain activation during chronic pain. Although many studies have shown that there are some common characteristics among individuals suffering from various pain syndromes, the data remains inconclusive. The present study aimed to assess chronic low back pain (CLBP) based on functional brain changes with EEG in CLBP patients compared with healthy controls.
   Methods: Multichannel electroencephalogram data were recorded from 30 subjects with CLBP and 30 healthy controls under eye-open resting state conditions and active lumbar forward flexion, and their cortical oscillations were compared using electrode-level analysis. Data were analyzed using a pair t-test.
   Results: A total of 30 patients (19 men and 11 women in the case group (mean [SD] age, 35.23 [5.93] years) with 30 age and sex-match healthy controls participated in the study. A paired t-test was applied to identify whether there was any difference in the absolute and relative power of frequency spectra between CLBP patients and healthy controls. The results showed a significant increase in alpha relative power in CLBP patients compared with healthy controls in an open-eye resting state (P < 0.050) and active lumbar forward flexion (P < 0.050).
   Conclusion: The enhanced alpha relative power in CLBP patients could be relevant to attenuating sensory information gating and excessive integration of pain-related information. Increased power at the EEG seems to be one of the clinical characteristics of individuals with CLBP. EEG can be a simple and objective tool for studying the mechanisms involved in chronic pain and identifying specific characteristics of CLBP patients.