Journal of

Background and Aim: Peptic Ulcer Disease (PUD), which is a prevalent disease, can have a considerable impact on patients' quality of life (QOL). The aim of this study was to explore the factors related to QOL based on PRECEDE Model in patients with PUD in Sanandaj, Iran.

Materials and Methods: A non-probability sample of 120 outpatients with PUD, referring to Beasat Hospital, in the city of Sanandaj participated in the study. The study took place between March and June of 2009. A descriptive, cross-sectional design was employed and the data were collected using a survey questionnaire based on PRECEDE model, consisting of QOL, Health Status, predisposing, reinforcing and enabling factors and self-management behaviors constructs. The data collected by interview and analyzed by SPSS v. 11.5. The statistical analysis of the data included Pearson correlation, t- test, one-way ANOVA and linear regression.

Results: Health status (p<0.01), reinforcing (p<0.01) and enabling (p<0.05) factors and knowledge (p<0.05) as a predisposing factor were related to quality of life of peptic ulcer patients. Moreover, health status (p<0.05) and social support as a reinforcing factor (p<0.01) had significant relationships with self-management behaviors. Finally, all of PRECEDE variables accounted for 68.9% of the variation of quality of life in PUD patients.

Discussion and Conclusion: With respect to the results of this study, preparing an educational program to promote self-management behaviors and quality of life in peptic ulcer patients is proposed. It was concluded that the PRECEDE Model may be used in developing countries, like Iran, as a framework for planning intervention programs in an attempt to improve the quality of life of patients with PUD.

Background and Aim: Micro RNAs are a group of small non-coding RNAs which play an important role in multiple processes such as proliferation, differentiation, apoptosis, and cancer. Recent studies indicate that mir-210 is overexpressed into erythroid linage during the differentiation of hematopoietic precursor. The main goal of the present study is to investigate the influence of mir-210 on the pattern of expression in hemoglobin gamma chain.

Materials and Methods: First, K562 cell line was cultured in RPMI1640 media. Then, pre-miR-210 was transferred into K562 cell line by lipofectamin. Finally, the alterations in the pattern of gamma chain expression were analyzed in days 7 and 14 by RT-PCR and real time PCR technique.

Results: It was demonstrated that the overexpression of mir-210 in K562 cell line would lead to a 25-fold increase in the expression of gamma chain in comparison with the control group. Data analysis revealed that the change in the pattern of hemoglobin gamma chain expression was meaningful (p<0.002).

Conclusion: Based on these data, overexpression of mir-210 can lead to a significant increase in the production of gamma chain. Therefore, more studies in the field may reveal the fact that an increase in mir-210 can be a suitable goal in the improvement of sickle cell anemia and β-thalassemia.

Background and Aim: Self-citation, as one of the limitations of citation analysis, unusually affects the ranking of journals. This study aims to evaluate the degree of relationship between self-citation and immediacy index correlation of Iranian medical journals indexed in Scopus Citation Index between 2005 and 2009.

Materials and Methods: The method of the study is survey-descriptive in which citation analysis is used. The study included all Iran-based English medical journals indexed in Scopus database up to May 2009. The control list was prepared and its validity was confirmed. Data were collected by referring to Scopus website and publication review resources, and analyzed by statistical software and appropriate methods.

Results: The findings showed that self-citation rate of journals was 29.64 percent, which comprised 14.43 percent of the total number of citations. There was a significant relationship (at the level of 0.01) between self-citation rate and immediacy index of journals (p = 0.591). Besides, Pearson correlation coefficient showed a significant relationship between the number of journals' articles and the journals' immediacy indexes excluding self-citation during the years of study.

Conclusion: Self-citation has a direct effect on journals' immediacy index that is, an increase in the rate of self-citation causes an artificial increase in the journals' immediacy index. On the other hand, immediacy index is affected by the number of journal articles. Therefore, the reduction or elimination of self-citation seems to be necessary for the journals and can put them in their right place.

Background and Aim: Embryonic stem cells are identified with two unique characteristics. First, they can be maintained and expanded as pure populations of undifferentiated cells, a characteristic which is known as self renewal aspect of embryonic stem cells. Second, these cells can give rise to all body cell types. In the current study, we used a feeder-free condition to differentiate mouse embryonic stem cells into lymphoid lineage by IL-7 and FLT-3 ligand.

Materials and Methods: Mouse embryonic stem cells cultured on mouse embryonic fibroblasts were separated from the feeder layer. Then, embryoid bodies were formed from mouse embryonic stem cells. Following that, differentiation was performed by FLT-3 ligand and IL-7. In order to demonstrate the differentiation into lymphoid lineages, the expression of CD25, CD19 and CD3 was assessed by RT-PCR technique on days 7 and 14.

Results: After 14 days of differentiation into lymphoid lineages by defined factors, RT-PCR results showed the expression of CD25 and CD19 markers.

Conclusion: In all previous studies, mouse embryonic stem cells were differentiated into lymphoid lineage by OP9 stromal feeder cells. In this study, a feeder-free condition was used to differentiate mouse embryonic stem cells into lymphoid lineage. It is hoped that the present study can lead to new insights in cell therapy of lymphoid deficiency disorders.

Background and Aim: Based on theories and researches, two variables effective in the continuous improvement of services are trust in and identification with hospital goals. The present study aims to explore the relationship between such variables among nursing staff members in private hospitals of Shiraz.

Materials and Methods: This research is a cross-sectional correlation study. Some 340 nurses(58 males and 282 females) were selected using the stratified sampling technique.
Three questionnaires for the assessment of identification with hospital goals, measurement of continuous improvement, and determination of trust in hospital were used. The reliability of data collection devices turned out to be 0.70, 0.70 and 0.79, respectively. Besides, the construct validity was confirmed through factor analysis. Data were analyzed inferentially using Pearson's correlation test and hierarchical regression analysis.

Results: The findings show that the relationship between identification with hospital goals and trust and nurses' effort to improve continuously is positive and significant. Moreover, the results of hierarchical regression analysis show that after controlling gender, age, experience and education, first identification with hospital goals and then trust in hospital play a significant role in the effort to improve continuously.

Conclusion: Nurses' effort to improve continuously is mostly influenced by identification with hospital goals rather than trust in hospital.

Background and Aim: FLT3 gene is a member of class III receptor Tyrosine Kinase, which is expressed in most patients with acute myeloid leukemia (AML). Mutations of FLT3 such as Internal Tandem Duplication (ITD) and point mutation of the D835 are the most common genetic defects in myeloid leukemia. These two mutations in patients with MLA and their effect on survival rate were studied for the first time in Iran.

Materials and Methods: DNA was extracted from the blood or bone marrow samples of 100 patients with AML from October 2008 to September 2009. For further analysis, PCR was performed to determine the prevalence of these mutations and their association with prognosis. Moreover, t and x² statistical tests were applied for data analysis.

Results: According to the results, 15% of patients revealed FLT3-ITD mutations and 8% showed mutation of D835 in FLT3 gene. In terms of achieving complete remission (CR), patients with mutation of ITD had more chance than those without such mutation (83.5% versus 53.3%). The white blood cell count was significantly higher in the ITD⁺ (mean = 73,646/ml) than ITD^- patients (mean = 26,580/ml).

Conclusion : The results indicate that FLT3-ITD mutations may reduce the chances of Complete Remission (CR) in patients however, FLT3-ITD mutation is an important factor in selecting appropriate treatment.

Background and Aim: FRBR is one of the models considered in cataloging and work-to-work relationships are introduced as types of bibliographic relationships present in this model.

This study examines the distribution of dispersion relationships in medical subject areas based on FRBR model in Persian medical sources published from 2006 to 2010.

Materials and Methods: This study is a descriptive survey . Data were obtained from Iranian OPAC ( online public access catalog) . To determine the areas of medical sciences, both LC (Library of Congress) and Dewey Classifications were applied. For data analysis, Excel 2007 was used. Using descriptive statistics, the researcher presented the results in the form of tables and graphs.

Results: According to Dewey Classification, ‘diseases’ was the subject area having the highest number of bibliographic relationships and the lowest frequency belonged to ‘experimental medicine’. The analysis based on LC Classification, however, showed that ‘internal medicine’ had the highest number of bibliographic relationships Botanic, Thomsonian, Eclectic Medicine, Chiropractic and Alternative medicine subject matters had the lowest bibliographic relationships.

Conclusion : Distribution of work-to-work bibliographic relationships in Persian medical sources based on Dewey and LC Classifications is heterogeneous. Despite the obtained apparently heterogeneous results, such a difference cannot be due to differences in the frequency of bibliographic relationships of medical topics because the classification criteria of medical sciences are different in these two systems.

Background and Aim: In several KT plans the researcher self evaluation is basis of researchers KT activities measurement so the aim of this study was the validity of researchers self assessment about their own activities in KT.

Materials and Methods: The valid and reliable questionnaire was filled by 40 Golestan University of Medical Sciences researchers. In this questionnaire researchers were asked to give a score from 0 to 10 for their own activities in KT in a finished special project. Statistical analysis was performed using pair T test and Pearson correlation coefficient. The linear regression was used for assessing the effect of influential factors on KT self evaluation and activity scores.

Results: The mean score of researchers KT activity and self evaluation was 3.52 and 5.47 respectively which this difference was statistically significant (P<0.01). The correlation coefficient between researchers' activity and self evaluation score was 0.73 which is an indicator of good correlation. The influential factors on researchers' KT self evaluation score in regression model was male gender, having administrative responsibility and percent of total time allocated to research and the influential factors on researchers' KT activities score in regression model was male gender, type of research (clinical sciences research compared to basic sciences) and percent of total time allocated to research.

Conclusion : The results of this study shows that researchers overestimate their own activities in KT so adopting strategies like education about KT concepts and activities for increasing researchers knowledge and perception can fill research and action gap.

Background and Aim: Early diagnosis of pregnancy is very important to prevent fetal damage due to specific drug consumption and high-risk behaviors. The objective of this study was to compare the sensitivity and specificity of quantitative agglutination pregnancy tests in urine and rapid β hCG immunoenzymatic assay test in serum as a gold standard.

Materials and Methods: This cross-sectional study was performed among 390 women who referred to healthcare centers where their urine samples were tested with latex agglutination (direct agglutination and agglutination inhibition) and the results were compared with rapid β hCG immunoenzymatic assay test in serum as a gold standard.

Results: The sensitivity of direct agglutination (82.05 % ) was more than that of agglutination inhibition (81.2 % ), but the specificity of the tests were equal (99.27 % ). The agreement coefficients between direct agglutination and agglutination inhibition on the one hand and rapid β HCG immunoenzymatic assay on the other were 0.859 and 0.853, respectively.

Conclusion : The possibility of negative results in direct agglutination is more than that of agglutination inhibition, but the specificity of both qualitative tests is equal. Besides, both tests may have an equal possibility of false positive results. Since the occurrence of false negative results in qualitative tests is higher than that in serum gold standard, the negative results of such tests should be confirmed with more sensitive methods such as rapid β hCG immunoenzymatic assay.

Background and Aim: Open access to scientific information is a new paradigm in scientific communication that facilitates access to research. This study was carried out to identify Tehran University of medical science faculties members’ familiarities with Open access and to survey their attitude about it.

Materials and Methods: A descriptive survey method was applied. The study population consisted of 163 members of Tehran University of Medical Sciences. Data gathering tool was questionnaires that its validity and reliability was confirmed. Data was collected and analyzed by SPSS software and descriptive statistic methods.

Results: Results show that more than 50 percent of population have modest familiarites with Open acces. Furthermore, the faculties’s members familiarites with Open access technique was moderate. More than 70 percent (114 person) of them have positive attitude toward Open access and it’s techniques.

Conclusion : Faculties members’ familiarity with Open access relatively is low but when they received information about the concept, rules and aim of this paradigm, their attitudes positively changed. Therefore, open access should be considered as a perfect method in scientific communication.

 Background and Aim: Understanding the molecular mechanisms involved in the increased levels of HbF inducing drugs should be advised for effective induction. The aim of this study was to investigate the molecular effects of the drugs thalidomide and sodium butyrate considered as HbF inducer agents.

 Materials and Methods: In this experimental study, CD133+ cord blood stem cells carrying mutations of heterozygous β-thalassemia were isolated and differentiated into erythroid lineage. In order to evaluate the expression of the erythroid markers, CD71 and CD235a, was analysed. For this purpose, the RNA extracted from erythroid precursors at days 6 and 12 of erythroid differentiation and cDNA synthesized, and then the expression of these genes was performed by quantitative Real-time PCR technique.

 Results: The results of this study showed the significant effect of thalidomide on erythroid proliferation as compared to sodium butyrate and control group (P<0.05). Also, thalidomide significantly increased CD71expression and decreased CD235a expression as compared to sodium butyrate and control groups (P<0.05).

 Conclusion : Thalidomide may play its role on HbF induction by increasing the proliferation of early erythroid precursors.

Background and Aim: Considering the potential damages caused by inaccurate, inadequate and incomplete information published in web pages, the aim of this study was to evaluate Persian-language web pages containing nutritional information, using Silberg criteria.

Materials and Methods: Internet pages related to nutrition were found in “peyvandha.ir” and by searching 20 nutrition-related keywords in five search engines. The first fifty results of every keyword in every search engine were evaluated according to the inclusion criteria. From every website/weblog, three issues were randomly chosen. The Silberg checklist and the qualitative questionnaire were completed and the data were analyzed using SPSS software.

Results: In total, 56 websites /weblogs (47 websites and 9 weblogs) were found to have nutrition-related information. Among these websites/weblogs, 40 were active in the field of nutrition, 14 in health-related fields, and the rest in news, general information and cooking. Mean Silberg score (out of 9) was 2.3±1.9 for websites and 1.75±1.3 for weblogs. The highest score in this study was 8 (one website) and the lowest score was zero (13 websites/weblogs). In 82.5% of websites/weblogs, the sources used in compiling the articles were not mentioned and 64.9% of them lacked their authors’ names. Of all websites/weblogs, 94% didn’t have any disclaimer rejecting the responsibility for accuracy of the information.

Conclusion: Due to the poor quality of internet pages on the one hand and the importance of nutritional knowledge on the other, the development of reliable Persian-language web pages to improve public awareness of nutritional issues is necessary.

Background and Aim: Population aging in most of developed countries should be subjective to more attention, regarding health issues of aging group. Different organizations and institutions have launched several programs related to elderly center. This paper is aimed to compare performance of different programs of active organizations in the field of elderly care in Iran.
Materials and Methods: This overview of research, used library resources and online databases Proquest, Pub med, Science Direct, Ovid and Scientific Information databases using keywords that  Aged care services, relevant organizations, and Iran.
Results: There are various classifications of geriatric services. However, these services can be divided into three groups including infrastructure, social services, and health care and preventive services according to concept, level and type of services.
Conclusion: In Iran, agencies and institutions relevant to elderly, take measures to support elderly people given their current tasks and allocated budget. But, these measures do not seem adequate, because solving aging problem, as a problem with evident influences which its impacts will be intensified in future, requires responsibility and cooperation of more agencies and public institutions.

Background and Aim: Research in the medical field requires large budgets, specialist human resources and modern equipment and instruments. Scientific collaboration is a way to overcome such problems. Main goal of this study was analyzing scientific collaboration of universities of medical sciences in different aspects.
Materials and Methods: In this research, by using scientometrics methods and social network analysis techniques, the Universities of Medical Sciences co-authorship network was mapped. Source of collecting Data, was Web Of Science database. For mapping and analyzing of scientific networks, we used Bibexcel, VOSviewer, Pajek and UCINET software.
Results: Shahid Beheshti University of Medical Sciences and Tehran University of Medical Sciences, with 933 co-authorship papers are in the first place in scientific collaboration among Iranian Universities of Medical Sciences. And at the international level, Shahid Beheshti University of Medical Sciences has more scientific collaboration than other Iranian universities with the University of Malaya. Tehran University of Medical Sciences, Shahid Beheshti University of Medical Sciences, Isfahan University of Medical Sciences, Tabriz University of Medical Sciences and Shiraz University of Medical Sciences, have significant position in terms of centrality index in co-authorship network.
Conclusion: Medical sciences researchers have very strong tendency to make scientific collaboration with Tehran University of Medical Sciences researchers. For this reason, scientific collaboration network has become a monopoly network around Tehran University of Medical Sciences. This form of collaboration prevents creation of opportunities for collaboration.

Background and Aim: The patient is the main customer for hospital services. Patient satisfaction can reflect if the services are performed correctly. The aim of this study was to determine the relationship between the degree of client tribute plan and inpatients and outpatients satisfaction in Shiraz hospitals.
Materials and Methods: This descriptive-analytic and cross sectional study was done among 211 inpatients and 1,175 outpatients in 8 Shiraz hospitals. The instruments for data collection were two client tribute plan and patient satisfaction questionnaires. Data collected by interviews and observation. Data were entered into SPSS. Descriptive statistics and Pearson correlation test were used for data analysis.
Results: Forty five point four percent of patients and 44.1 percent of outpatients assessed the hospital service satisfaction as weak. The mean score of inpatient and outpatient satisfaction was 60.53±8.9 and 54.22±12.6 respectively. There were significant relationship between type of admission and satisfaction (p=0.001). Mean score of client tribute plan was 182.44±11.8 that placed in the appropriate level. There were no significant relationships between client tribute plan and inpatients and outpatients satisfaction (p=0.143).
Conclusion: Although client tribute plans perform properly, patient satisfaction is low. In this regard, it is recommended that review client tribute plan clients in healthcare systems and adopt its contents with the needs of patients.

Background and Aim: Almost one out of 10 patients who are admitted in hospitals experience “never events” while researches show that about half of these harms are preventable through the utilization of Failure Modes and Effects Analysis (FMEA). This study aims to identify and evaluate the risks of care processes in three wards of Alzahra University Hospital of Isfahan and suggest some interventions for reducing these risks.
Materials and Methods: This was a cross-sectional study, which identified high-risk processes using FMEA in respiratory, gastroenterology and rheumatologic wards of Alzahra Hospital during the years 2014-2015. The study population comprised clinical staff members who worked in these three wards and were familiar with clinical care processes. The focus group team was selected through purposive sampling method. Finally, the information was gathered in standard FMEA work sheets and analyzed with SPSS software.
Results: A total of 72 clinical care processes were identified, and the 73.5%  of the focus group members rated "blood and its products transfusion process" as the most risky care process. The step "checking the incompatible of patient's information and blood lable and its products" was the most dangerous step (with PRN = 300). The findings showed that human and equipment failures were the main reasons of facing the “never events” in these wards. 
Conclusion: Risk management tells us that the efficiency and quality of care can be promoted by preventing errors through human resource training and proper maintenance of medical equipment.