Payavard Salamat

The Impact of an Occluded Internal Carotid Artery on the mortality and morbidity of patients undergoing Coronary Artery Bypass Grafting

M Abbaszade Ghanavati

Background and Aim: Stroke is an important cause of morbidity and mortality in patients undergoing coronary artery bypass (CABG) surgery. There are various mechanisms that can cause prioperative strokes in patients undergoing CABG other than Carotid Artery disease. The goal of this study is to evaluate whether the presence of stenosis internal carotid artery (ICA) influences prioperative stroke and mortality rates in patients subjected to Coronary Artery Bypass Grafting.

Materials and Methods: After institutional ethical committee review and approval, a retrospective review was undertaken of 1978 bypass procedures with saphenous vein graft performed over a period of four years is conducted. All those who had valve replacement or non-CABG procedure were excluded from this study. Carotid duplex ultrasonography scans were performed as part of preoperative evaluation of these patients. Ultrasound imaging measurement and velocity criteria were taken in to consideration in the estimation of degree of the carotid arteries. The stenosis of ICA was classified as non significant stenosis when there was<60% narrowing of the arterial lumen, and significant stenosis when there was 60%-99% narrowing of the arterial lumen.

Results: prioperative stroke rates were 0.8 %, 46.8% and 90%for groups A, B, and C, respectively. Group A results varied significantly from group's B (P=0.0001) and C (P=0.0001). Statistically significant difference was noted between groups B and C (p=0.0001 ). Prioperative mortality rates for groups A, B, and C, were 1.0 %, 16.7 % and 70 % respectively. The mortality rate for group A was lower than for groups B (P=0.0001) and C (P=0.0001).

Conclusion: The presence of an ICA occlusion increases the morbidity and mortality in patients undergoing CABG.

Evaluation of JAK2V617F mutation patients with non-CML myeloproliferative neoplasms by ARMS-PCR

SH Ghaffari

Background and Aim : Myeloproliferative neoplasms are clonal and heterogeneous disorders of hematopoietic stem cells lead to increase of one or more cell lines in the blood. Recently, the acquired mutation JAK2 V617F has been described in the majority of patients with myeloproliferative neoplasms (MPNs).This mutation is characterized by a G to T transverse at nucleotide 1849 in exon 12 of the JAK2 gene, located on the chromosome 9p, leading to a substitution of valine to phenylalanine at amino acid position 617 in the JAK2 protein. The aim of this study was to assess the prevalence of JAK2 mutation in MPN patients.

Materials and Methods: In this experimental study we evaluated JAK2 mutation in 58 patients with MPNs by simple randomized sampling. The mutation was detected by ARMS-PCR in patients.

Results: The JAK2 V617F mutation was detected in 86.6% (26/30) of patients with polycythemia Vera, 46.6% (7/15) of patients with essential thrombocythemia and 61.5% (8/13) of patients with idiopathic myelofibrosis. Polycythemia Vera patients carrying the mutation displayed a higher levels of WBC (p=0.03) and 61.5% (16/26) of these patients were females. The differences in other groups were not significant. The mutation was confirmed by sequencing.

Conclusions: Our Results show similarity with other studies. Thus, ARMS-PCR can be applied as differential diagnosis test for detection of JAK2 mutation in suspected patients with MPNs.

Effects of preoperative aspirin use on mortality in Coronary Artery Bypass grafting patients

M Abbaszadeh

Background and Aim: Discontinuing aspirin use in patients before coronary artery bypass grafting (CABG) has focused on bleeding risks. The aim of this study was to determind the effect of aspirin use on overall mortality with this procedure.

Materials and Methods: In a retrospective review was under taken of 2,252 consecutive isolated coronary artery bypass grafting (CABG) procedures performed between July 1995 and May 3003 in Tehran, Shriati hospital. Patients who had isolated CABG operations and received aspirin were analyzed and compared to nonusers undergoing similar bypass procedures during the same period. Aspirin use was defined by identification of ingestion within 7 days before the operation.

Results: CABG patients using preoperative aspirin were less likely to experience in hospital hemorrhage compared to nonusers (P=0.0001). Significant difference was seen for transfusion of blood products, and need for reexploration for hemorrhage between patients who did and did not receive aspirin (P=0.0001).
Mortality in multivariate (odds ratio [OR] =0.12, 95%confidence interval [0.05, 0.28] analysis was less to patients using aspirin compared to nonusers (p=0.0001).

Conclusions : Preoperative aspirin use appears to be associated with a decreased risk of mortality in CABG patients with significant increase in hemorrhage, blood product requirements, or related morbidities.

Evaluation of accidental exposures in laboratories' personnel in Teaching Hospitals of Tehran University of Medical Sciences(TUMS) during 2004 to 2005

M Rabieyan

Background and Aim: The risk of infectious diseases in laboratory's personnel is high and several factors can increase these risk. Some of these factors are general, such as burning (with stray acid and base) and electric shock hazards. Which are not exclusive for laboratories. In other hand some several risk factors such as burning liquids are exclusive for laboratories. And there is limited information available about them.

Materials and Methods: This cross-sectional study was designed to evaluate accidental exposures of all laboratories personnel of Teaching Hospitals of Tehran University of Medical Sciences during 2004- 2005. We selected 416 laboratories personnel's in 15 different teaching hospitably TUMS for our study. The data were collected using a questionnaire and SPSS software was applied for data analysis.

Results:There was no significant association between accidental exposures with gender (p=0.51), educational level (p=0.11) and age (0.09) of laboratories personnel. But, accidental exposures were lower among those who had job experience between 5 to 10 years (p<0.05) compare to less than 5 years or more than 10 years job experience.

Conclusions:Although age, gender and educational level of laboratories personnel did not influence their exposure to laboratory's accidents, little or extensive job experience may increase accidental exposures among them.

Study of Organizational culture and Structure for implementation of Knowledge Managent in Universities of Medical Sciences

F Azadeh

Background and Aim : Creation of knowledge management (KM) and efforts to use it in the university research programs shows the university society activity to enhance intellectual qualities and improve this effectiveness of the universities on the development and advancement in the countries. The objective of present study was to evaluate the status of organizational culture and structure for implantation of KM in the central libraries of the medical science universities in Iran.

Materials and Methods:The present work is an applied research and descriptive-analytic study. The survey population consisted of 80 people who were directors or managers of 29 central libraries in medical science universities. Data collection method was used based on the questionnaire. The validity was checked by researchers and reliability Cronbach's alpha (>0.7). The data & information were analyzed with descriptive statistics and independent t-test by SPSS software package ver. 15.

Results: The findings showed that the status of "organizational structure" of KM in these libraries was intermediate, whereas "organizational culture" was in the suitable status. Also in the libraries in which decentralization, revision in knowledge sharing process and Internal Network for knowledge sharing is adopted, higher organizational culture as compared with other libraries, and have significant differences in them (p<0.05).

Conclusions: The result of present work is a proof for willingness and propensity of the Iranian librarians and their managers in the process of knowledge sharing and utilization of KM is at the proper level. Therefore, the authorities should provide the necessary structures and other complementary backgrounds for the utilization of KM in Iranian university libraries.

ISI's Impact Factor Challenges

F Shokranehnanehkaran

Background and Aim: One of the main criteria in scientometric evaluation of the medical sciences universities is the number of published articles in the journals that have high Impact Factor (IF). The IF is an indicator to evaluate the journals. Many shortcomings of IF were revealed. This review aims to bring out the challenges of IF and the related solutions of them.

Materials and Methods: Required literatures for this review were collected by searching in related databases such as Web of Science (WOS), Scopus, Google Scholar, and also Google search engine as well as SIGMetrics Discussion Group. Determined search strategy limits search to exact phrase and synonyms. Results selected considering relevancy. The review covers the literatures published between 1972- 2007.

Results: We found at least 18 shortcomings of IF which reduce the efficacy of this indicator. In addition, they stated some solutions versus the shortcomings however, there is no suggested resolution for some of the shortcomings.

Conclusions: Considering the shortcoming of IF, however it could not be ignored because of its accessibility and ease of use. Solely, IF cannot solve the researchers' problem of qualified journal selection. Such solution needs awareness about IF challenges. Readers' judgments and journal clubs are valuable qualitative ways, which can help IF in the evaluation of journals.

Mapping Scheme of Traditional Iranian Medicine Cluster’s Crotch in the Structure of Metathesaurus of Unified Medical Language System (UMLS)

F Azadeh

Background & Aim: Unified Medical Language System (UMLS) is an extensive ontology of biomedical knowledge developed and maintained by U.S. National Library of Medicine (NLM). Traditional Iranian Medicine (TIM) does not have any position in the structure of metathesaurus of UMLS. The main aim of this study was designing a scheme of TIM cluster's crotch mapping in the structure of metathesaurus of UMLS. Moreover, the TIM position and its proportion in the domain of vocabulary and concepts of universal medical knowledge was another aim of this study.

Materials and Methods: System analysis was the method of this study. To investigate structure of UMLS metathesaurus, and to survey lacking of TIM cluster's crotch, we applied UMLS Knowledge Source (KS) by using inductive, deductive, inductive-deductive approaches.

Results: One Concept Unique Identifier (CUI) two synonym terms with Lexical Unique Identifier (LUI), L0025131 and L6330122 two ancestor and parent concept nine concepts which with TIM crotch were the child concepts of two ancestor and parent eighteen sibling concepts six narrower and five other related found concepts were identified for the proposal TIM crotch mapping in metathesaurus of UMLS. In addition, we found the "Biomedical Occupation or Discipline" semantic type assigned to it.

Conclusions: Current domain of metathesaurus of UMLS does not represent complete and formal domain and position of TIM. Therefore, this metathesaurus needs to depict a domain and position for TIM.

Comparing of Three Methods of Education on Level of Knowledge towards AIDS among High School Students in Gorgan City, Northern of Iran

AA Abdollahi

Background and Aim : The Prevalence of AIDS is increasing in the World. To prevent, most scientists believe in public education. It seems that the quality of learning extensively depends on the quality of education. Since teaching method is one of the most important factors, we decided to compare the effect of three methods on the level of knowledge abut AIDS among high school students in Gorgan, northern Iran.

Materials and Methods: This pre-excremental study was carried out on 88 randomly selected junior high school students in Gorgan, Iran. The subjects were asked to fill out the questionnaire before and after the two-week treatment. The data were analyzes by t-test and Tooki Test.

Results: There was no significant different between control and pre and pamphlet group. While in both lecture group and combined group (lecture and pamphlet), the difference was significant .Using Tooki test, the difference between control and lecture group and between control and combined group was significant (P<0.05).

Conclusions: In order to increase the student's knowledge about AIDS, According lecture method accompanying with pamphlet is one of the best procedures.