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Farzad Nazem, Behzad Keshavarz,
Volume 7, Issue 2 (7-2013)
Abstract

Background and Aim: Plasma leptin, adiponectin (as theadipokines) and related obesity – HOMA index in the obese men are introduced as a predictive metabolic indicators for asthmatic individuals. However, under asthma conditions, role of cariometabolic variables interaction for altering clinical pulmonary indexes aren't clear. In the present study, the relationship between plasmatic adiponectin to leptin ratio (adipo/lep) with respiratory capacities & HOMA in the chronic asthmatic males are investigated.

Materials and Methods: Thirty nine obese males with mild to moderate asthma with an average age of 38±2.6 ys and BMI 31.4 ± 1.06 kg/m2 voluntarly participated in this study. Baseline plasmatic leptin, adiponetin, insulin and glucose levels were determined after 10-12 hours fasting overnight. FEV1/FVC, PEF% and FEF 25%-75% were determined by standard method. A pearson correlation test was used to analyse data.

Results: There were no significant correlation between WHR , BMI with metabolic risk factors (P>0.05). Relationship markedly observed among HOMA with adipo/ lep ratio and leptin levels respectively (P<0.05), Also a marked negative correlation between adipokine ratio and leptin level was obtained (P<0.05). From view of respiratory efficiency, FVC% and FEV1/ FVC were maingly corrected with baseline leptin&adiponectin levels (P<0.05).

Conclusion: Inconclusion,it seems that adipo/lep ratio biomarker plays as a clinical diagnosis index for HOMA index than baseline leptin or adiponectin levels. However, these findings showed that FEV1/FVC & adipo/lept ratios are accounted as valuable indicators for evaluating the obesity syndrome and pulmonary efficiency in the asthma disease.


Mohammad Taghi Amini, Lotfali Bakhtiari, Hossein Dargahi, Ogan Karimi , Hajar Moammai, Mohammad Janbozorgi, Elham Haghshenas,
Volume 7, Issue 3 (9-2013)
Abstract

 Background and Aim: Strategic thinking plays a very important role in guarding organizational survival and increasing development in today's dynamic and changing environment. One of the elements of strategic thinking is systemic thinking, which forms the conceptual framework to solve issues in an organization. This study aims to determine the ability of Tehran University of Medical Sciences (TUMS) senior managers to stick to systemic thinking based on Friedrik Goldman’s model.

Materials and Methods: This is a cross-sectional, descriptive- analytic study conducted on a sample of 100 TUMS senior managers in 2010. The data collection instrument was a standard questionnaire on systemic thinking, the response rate of which turned out to be 97%. The reliability and validity of the questionnaire were confirmed prior to its distribution. SPSS software was used for data analysis. To this end, single sample t-test and Friedman statistical methods were also applied.

Results: The findings revealed that the ability of systemic thinking was optimal among most TUMS senior managers.

Conclusion : Enhancing and strengthening systemic thinking among TUMS senior managers are suggested, especially regarding omniscient and multi-end approach.


Fateme Monjazebi , Rahim Rozbahany , Arezo Memarian, Parisa Farnia ,
Volume 7, Issue 3 (9-2013)
Abstract

Background and Aim: Peripheral and intermediate laboratories have an important role in diagnosis, treatment and prevention of tuberculosis. Today, without these laboratories, maintaining health and preventing the spread of tuberculosis is not possible. The aim of this study was Evaluation of manpower, equipment and quality control standards in peripheral and intermediate laboratories assessment checklist within seven selected provinces in year 2011.

Materials and Methods: This study was a cross-sectional survey. In this study eighty tow peripheral and intermediate laboratories from seven selected provinces were studied in year 2011. A standardized checklist was used to assess peripheral and intermediate laboratories.

Results: The result showed that Esfahan with 20 labs and 8870000 population had the highest number of labs and coverage people between other provinces. Khorasan Razavi with an average of 263 per month has the highest number of admission number and Golestan, with an average of 139 positive cases per month, had the highest number of positive cases between other provinces. In 82 labs 117 laboratory technicians were engaged providing services to patients.

Conclusion : The results of this study showed that conditions of most peripheral and intermediate laboratories are optimum and nearly standard. Control and evaluation of peripheral and intermediate laboratories, expert personnel, facilities and equipment are necessary to improve the TB control program in the country.

 


Zohreh Sohrabi , Zahra Majidi ,
Volume 7, Issue 5 (1-2014)
Abstract

Background and Aim: Recognition of expectations and perceptions of customers is essential for quality improvement . The aim of this study was to determine the quality gap of educational services in the viewpoints of Tehran University of Medical Sciences (TUMS) educational administrators, faculty members and medical students.

Materials and Methods: A cross-sectional study was carried out at TUMS in 2012 among educational administrators, faculty members and students of medicine. A total of 384 students, 384 faculty members and 83 administrators were selected randomly. The five-dimensional SERVQUAL questionnaire was applied for data collection. The educational services quality gap was determined based on the differences between administrators , faculty members and students΄ perceptions and expectations. Descriptive and analytic (one-way ANOVA) statistics were performed using SPSS v.18.

Results: The results show that there is a negative quality in all five dimensions of educational services quality. Among all three groups of students, faculty members and administrators, the maximum means of quality gap pertained the dimension of “responsiveness” (-1.42,-1.17,-1.09, respectively) the minimum figures, however, were related to “confidence” (-1.07,-0.87,-0.77, respectively).

Conclusion : In all aspects, students, faculty members and administrators’ expectations were higher than their perception of the current situation. To reduce the gap, it is recommended that attention be paid to all aspects of service quality, particularly to the responsiveness dimension. Also, better planning to serve employees and enhancing their communication skills are suggested as ways to reduce the educational services quality gap.


Fatemeh Rangrazjeddi , Alireza Moraveji , Fatemeh Abazari ,
Volume 7, Issue 6 (3-2014)
Abstract

 Background and Aim: Evidence Based Medicine (EBM) is the explicit use of current best evidence in making decisions about the care of individual patients. Hospital information system (HIS) can act as a bridge between medical data and medical knowledge through merging of patient's data, individual clinical knowledge and external evidences .The aim of this research was to determine the Capability to establish EBM by HIS.

 Materials and Methods: This descriptive cross-sectional study was carried out on HISs of 30 hospitals from March to October 2011. Data were collected using a researcher- constructed checklist including applicant’s background information as well as information based on research objectives. Validity of the checklist were assessed by the qualified specialists and then the data were analyzed using descriptive statistics and SPSS software.

 Results: HISs lacked the essential components for providing access to CDSS, Reference databases and internet-based health information in 19, 16 and 20 hospitals were 63.3%, 53.3% and 66.7%, respectively. Twenty-two hospitals (70%) had more than two-thirds of the essential components to access clinical and administrative data repositories 23 hospitals (76.7%) had at least one essential component to access contextual and case specific information.

 Conclusion: The Capability of HIS is better in order to place EBM in having access to the clinical and administrator data repositories while it needs more attention in other areas.

 


Mahmood Biglar , Yeganeh Hayati , Hojjat Rahmani, Zeynab Rajabnezhad , Hossein Dargahi,
Volume 8, Issue 1 (5-2014)
Abstract

 Background and Aim: One of the most important factors to present successful managers is general health. If managers have not highly general health, then they will encounter many problems. Therefore, this research is aimed to induce the general health among Tehran University of Medical Sciences hospitals’ administrators. 

 Materials and Methods: A cross-sectional, deceptive and analytical study was conducted among 25 Tehran University of Medical Sciences hospitals administrators in Tehran, Iran. The research tool was general health questionnaire developed by Goldberg and Hillier to assess the administrators general health and its demographic details. Data was analyzed by SPSS software and using analytic statistical methods.

 Results: The results of this study showed that the hospitals administrators had normal range of general health. Also, there was significant correlation between anxiety with physical dysfunctions, and depression with physical dysfunctions, and anxiety with social functions.

 Conclusion: The rate of general health among TUMS hospitals administrators is higher than the other mangers compared with similar studies in Iran and out of Iran. Therefore, we suggest periodic medical examination, general health training, and consultant services to develop or maintain the general health among healthcare managers.

 


Amir Ashkan Nasiripour, Pouran Raeissi, Farhad Ghaffari, Mohhamadreza Maleki, Mehrnush Jafari,
Volume 8, Issue 1 (5-2014)
Abstract

 Background and Aim: Healthcare processes have caused many dangers to patients, and the increase of medical errors is one of the most important consequences of such processes. The present research is conducted to reduce medical errors through presenting a model to control them.

 Materials and Methods: In this mixed (quantitative-qualitative) research, a conceptual model was assembled. Then using the model and an interview, a questionnaire was made. The interview and the researcher-made questionnaire were used to collect data. The statistical population included the related people and the practitioners involved in medical errors in Tehran University of medical Sciences (TUMS) hospitals. The sample consisted of 252 employees who were non-randomly selected from those hospitals. Once the affecting factors were determined, the data were analyzed through factor analysis technique. The gathered data were analyzed using descriptive and inferential statistics. Finally, the research model was presented.

 Results: The selected individuals pointed out 9 factors controlling the medical errors: culture, factors associated with patients, factors related to providers, factors associated with errors, structural factors, role of disclosure, error registration, individual factors related to reporting, and organizational factors related to reporting. The 9 factors are the subdivisions of three main factors which account for 57/46% of the total variance of data. The most decisive power is related to disclosure 0.737 and the least (0.053) pertains to structure.

 Conclusion: Discloser of medical errors and their registration are factors which are effective and essential in controlling medical errors in TUMS hospitals.

 


Farzad Faraji Khiavi , Mansour Zahiri , Kambiz Ahmadi Angali , Bahareh Mirzaei , Mohammad Veisi, Marjan Arab Rahmatipour ,
Volume 8, Issue 2 (7-2014)
Abstract

 Background and Aim: Information literacy is a set of skills required to identify rightful information resources and access to them. These skills are empowering goal oriented use of information resources. This study aimed to determine the ability rate of information literacy among health services administration students in Jundishapur University of Medical Sciences based on SCONUL seven pillars model.  

 Materials and Methods: This cross-sectional descriptive-analytic study was conducted using a questionnaire developed based on SCONUL information literacy seven pillars model. Validity of the questionnaire was confirmed through content analysis and coefficient of Chronbach’s alpha was 0.93. The study population included students of health services administration in Ahvaz Jundishapur University of Medical Sciences in 2013. The sample size included 40 cases collected randomly. Data analyzed through SPSS descriptive statistics and non-parametric statistical tests.

 Results: The mean score for the studied components of information literacy abilities among the study population was 0.5±0.43. Information Literacy score among freshmen was significantly different from other students (P<0.03). Students who passed Computer Basics and Research Methodology educational courses showed significant differences from other students in the information management (P<0.01).

 Conclusion: Given the increasing development in information technology, the need to develop information literacy skills is considerable especially among those who are going to be engaged in the health sector. Although studied students’ information literacy estimated relatively well, it seems necessary to take measures to improve their information literacy in all components.

 


Rahim Ahmadi, Sahar Eshghjoo,
Volume 8, Issue 2 (7-2014)
Abstract

 Background and Aim: Smoking can influence liver or heart enzymes. The main aim of this study is to determine the effects of cigarette or waterpipe smoke on serum level of alanine aminotransferase (SGOT) or aspartate aminotransferase (SGPT) in male rats.

 Materials and Methods: In this experimental laboratory study, 15 male Wistar rats were randomly divided into control groups of 5, and animals were exposed to cigarette and waterpipe smoke. After 6 weeks, blood samples were collected using cardiac puncture method. Following serum collection, levels of SGOT or SGPT were measured by spectroscopy method. Data were statistically analyzed and compared between groups using one-way ANOVA.

 Results: Serum levels of SGPT significantly increased in rats exposed to waterpipe and cigarette smoke compared with control animals (P<0.05), but serum levels of SGOT significantly increased only in animals exposed to waterpipe smoke. There was not a significant difference between serum levels of SGOT or SGPT in rats exposed to waterpipe or cigarette smoke.

 Conclusion: Waterpipe smoke -- like cigarette smoke -- has pathophysiological effects on liver and heart, which appears in elevated serum levels of SGOT and SGPT.

 


Zahra Kashani Khatib , Ali Dehghanifard , Saeid Kaviani , Mehrdad Noruzinia , Momeneh Mohammadi , Fatemeh Mohammad Ali , Elham Roshandel , Sahar Mohammadi Fateh , Shaban Alizadeh,
Volume 8, Issue 3 (9-2014)
Abstract

 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.


Fariba Nabatchian, Nahid Einollahi, Sakineh Abbasi , Mitra Gharib, Mitra Zarebavani,
Volume 9, Issue 1 (5-2015)
Abstract

Background and Aim: Medical Laboratory Sciences is one of the important fields in Medicine that is closely associated with other disciplines in this group. This study aims to evaluate laboratory sciences curriculum in Iran and several countries worldwide.

Materials and Methods: In this research, data collection is based on documents and curriculum goals of countries. The data collected was analyzed using qualitative methods.

Results: Comparative study of curriculum courses of bachelor of Laboratory Medical sciences was done and compared with the number of basic and specific units in Iran and other countries.

The curriculum in Iran with Turkey and Australia is remarkably consistent. Internship units in hospitals have lower returns in compared to other universities in the world.

Conclusion: Laboratory Science curriculum in Iran is matched with developing countries. However, more attention to training units and projects to improve the quality of teaching laboratory sciences could be more effective.


Celin Telefian, Enayatolah Kalantar, Mohammad Mehdi Soltan Dallal,
Volume 9, Issue 3 (9-2015)
Abstract

Background and Aim: Cystic fibrosis is a common hereditary and autosomal disorder. One of the factors in cystic fibrosis is Burkholderia cepacia which can be transmitted through the sharing of admitted patients with hospitalized patients. Purpose of this study, was isolation and identification of Burkholderia cepacia from respiratory secretions from Masih Daneshvari Hospital cystic fibrosis patient. Materials and Methods: In this study, during 8 months from 2011 till 2012, 100 cases of pulmonary secretions were collected in Masih Daneshvari hospital patients. The specimens were cultured on both MacConkey agar and Burkholderia cepacia selective agar (BCSA) medium. After an incubation of 48 hours at 35°C, suspected colonies were isolated and by using of phenotypic and biochemical tests like TSI agar, simmons citrate medium, indol and motility, MRVP, oxidation - fermentation (OF), arginine- ornithine - lysine decarboxylase test, Dnase test, and polymyxin resistance were identified. Results: Using BCSA medium and biochemical tests led to isolation and identification of five Burkholderia cepacia strains from 100 respiratory samples. However, using Mac Conkey no Burkholderia cepacia was detected. Conclusion: Our results clearly indicate the use of BCSA medium as a specific medium for isolation of Burkholderia cepacia in cystic fibrosis patients. So, presence of 5% Burkholderia cepacia in cystic fibrosis infections suggests detecting this bacterium, in a specific and sensitive culture medium.
Mostafa Saberian , Elham Shahidi Delshad , Tahereh Naji , Ali Samadikuchaksaraei ,
Volume 9, Issue 3 (9-2015)
Abstract

Background and Aim: The use of probiotics has been surveyed in different studies. For example, many researches have been conducted on immunity, cancer and embryonic cells proliferation. Mesenchymal stem cells (MSCs) have a rather slower growth and a more limited number of passages. In this research, the effect of supernatant of Lactobacillus acidophilus (LS) as one of the most commonly used probiotics on the proliferation of mesenchymal stem cells has been studied with the aim of increasing their proliferation for the treatment of patients in need of transplantation using mesenchymal stem cells.

Materials and Methods: The MSCs separated from rats’ bone marrow were led to bone and fat levels in the second passage, and their mesenchymal state was confirmed. The cells were then treated by the supernatant of Lactobacillus acidophilus (LS) and MRS broth medium, which have been separated in advance. The number of cells was examined by MTT test equated with the standard.

Results: A curve was drawn for the cells’ growth in different amounts and the number of cells was obtained by converting the results of MTT test to a standard curve. For statistical analyses, SPSS and ANOVA were employed.

Conclusion: The findings show the double effect of LS on the weak effect of MRS broth medium. The use of supernatant of Lactobacillus acidophilus (LS) can be a practical and economical method for increasing the proliferation of MSCs isolated from bone marrow.


Maryam Kheirandish, Fariborz Mehrani, Kosar Kian, Saeed Vahedi,
Volume 9, Issue 5 (2-2016)
Abstract

Background and Aim: The postoperative shivering is one of the common complications of anesthesia, which can cause increased systemic blood pressure, oxygen consumption, intra optical pressure and heart rate in patients. It is necessary to   choose an effective intravenous and the inhaled drugs to reduce postoperative shivering, therefore the aim of this study was to compare Isoflurane and Propofol on shivering among patients undergoing Vitrectomy Surgery.

Materials and Methods: In a double-blind clinical trial, 112 patients aged 16 to 75 (ASA class I-III) who underwent the Vitrectomy surgery were randomly classified into two groups of 56 cases. The occurrence of postoperative shivering in recovery were registered in both groups. Findings were analyzed employing the t-test and Chi-square. Statistical significance was accepted for P values of <0.05.

Results: There was no significant difference between the two groups in terms of age, sex, Weigh، duration of  surgery and duration of anesthesia. The incidence of shivering in recipients of Isoflurane and in recipients of propofol was 12.5% and 32.1% respectively.

Conclusion: Using Isoflurane is better than Propofol to reduce the postoperative shivering in patients undergoing the vitrectomy surgery.


Ghafur Tavakoli , Roshanak Daei, Farshad Hashemi, Mehdi Zarei, Hoda Deli, Seyed Jamal Hashemi,
Volume 9, Issue 6 (3-2016)
Abstract

Background and Aim: In medical centers, after obtaining visceral clinical samples in suitable containers under certain circumstances, they are sent to mycology laboratory. Since sometimes it is impossible to test specimens immediately, therefore, they should be kept in the refrigerator. Thus, possibility of keeping samples, the confidently time of samples keeping in a refrigerator and the appropriate guidelines for the maintenance of visceral samples for clinical centers have a particular importance for practical purposes and are the aim of this study.

Materials and Methods: At first, the specimen was examined by KOH direct microscopic examination for detection of fungal elements. After primary culture of visceral samples on the Sabouraud dextrose agar with chloramphenicol (SC) medium, the samples were sequentially placed in a refrigerator at temperature 2-8 ºc for 1, 2, 24 and 48 hs and each sample with the specific mentioned time culturing was performed on the Sabouraud dextrose agar (S) and SC media. Then the results of growth were recorded.

Results: From 100 samples, 79 samples had grown, 20 samples with lack of growth and in 1 sample reduced growth were observed.

Conclusion: After 48 hours of cold temperatures (2-8 ºc) visceral fungal clinical samples are able to grow in culture media. So samples which were not tested immediately, could be stored at temperatures 2-8 ºc in the refrigerator.


Mehr Angiz Kaviany, Behnaz Gharegozlou, Mozhgan Oshaghi, Maryam Sharifzade, Masoumeh Arabshahi,
Volume 10, Issue 4 (9-2016)
Abstract

Background and Aim: Diabetes is a metabolic disorder, in which either there is no sufficient insulin in the body or the available insulin is not capable of acting properly. Defining the effects of trace elements can help to make use of these elements in control or preventing diabetes.

Materials and Methods: Forty-eight Wistar male rats were equally divided into eight groups. Three different control groups and five test groups. Test groups was treated with streptozotocin (60 mg/kg intraperitonieal) to induce diabetes, then supplemented with specific trace elements: Zinc, Chromium, Magnesium, Manganese and Copper. After one week, glucose, triglyceride and cholesterol levels in serum of all groups were assayed with routine methods. Then mentioned trace elements were gavaged to each groups with proper dosages. Gavage was performed during 3 weeks, then the blood tests were repeated. Median values were taken, the results were analyzed by SPSS software and p<0.05 was considered statistically significant.

Results: Levels of glucose in the serum of experimental group were found to be significantly higher than in the control group (p=0.0009). Oral administration of trace elements for 23 days exhibited a significant reduction of serum glucose (P=0.0009) and cholesterol level (p=0.019) in streptozotocin-induced diabetic rats but not in control groups.

Conclusion: The present study indicated that treatment of diabetic rats with some trace elements to attenuate hyperglycemia until reaching the normal range. Between different trace elements which were used, Cr is suggested for its great ability in decreasing the glucose, cholesterol with no effect on triglyceride levels as compared with normal rats.


Zahra Meidani, Mehrdad Farzandipour, Alireza Farokhian, Masome Haghighat, Zahra Nazemi Bidgoli ,
Volume 10, Issue 6 (3-2017)
Abstract

Background and Aim: In attention to pressing need to cost containment and service efficiency, laboratory services serve as a central locus for controlling health care expenditure. This study intents to investigate proportion of laboratory utilization in Iran to pave the way for future interventions.
Materials and Methods: A cross-sectional study was conducted to investigate the proportion for laboratory utilization through the retrospective analysis of 384 medical records at the tertiary care Kashan University Hospital Shahid Beheshti. To pave the way for future intervention, over utilization tests were classified into two categories, inappropriate and resulted in laboratory errors.
Results: Nine thousand five hundred forty one laboratory tests were ordered, 2522 (26.40%) of the tests were inappropriate and 143 (1.5%) of the over utilization tests have occurred due to laboratory testing cycle errors. According to reviewers’ judegment relevancy to medical intervention was considered as the most accepted appropriateness criteria 5012 (52.53%) for laboratory tests 
Conclusion: Since, the laboratory tests over utilization is multifactorial, forming a multidisciplinary team including physicians, nurses, laboratory staff, medical education experts, health care management and health information technology staffs in terms of Utilization Committee to develop more targeted strategy based on root cause analysis of over utilization behavior seems necessary. 


Sajjad Mohammadian , Esmaeil Vaziri,
Volume 11, Issue 1 (5-2017)
Abstract

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.


Mohammad Erfan Zare, Reza Meshkani, Mojtaba Abbasi, Farhad Shaveisi Zadeh, Atefeh Nasir Kansestani ,
Volume 11, Issue 3 (7-2017)
Abstract

Background and Aim: There has been a long-lasting debate among medical laboratory-associated specialists about required competencies and educational background to qualify for directing medical laboratories in Iran. The aim of this study was to provide a comprehensive review regarding required training and competencies for becoming a medical laboratory director in Iran and all around the world.
Materials and Methods: A thorough search of the literature was carried out in scientific databases including Web of Science, Science Direct, Springer Link, Wiley Online, PubMed, Scopus, SID and web-based search engines such as Google and Google Scholar.
Results: The results revealed detailed required competencies for directing medical laboratories in the United States of America, Canada, European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and its many affiliated European countries.
Conclusion: Our results indicate that in all assessed countries, specialists of basic medical sciences and also physicians, after passing certifying examinations, are equally qualified to direct medical laboratories. Indeed, Iran is the only country within the evaluated ones, in which basic medical sciences specialists (which have their own specific curriculum and are educated as clinical majors) have been eliminated from directing medical laboratory and the position has almost exclusively been available for graduates of pathology and it is important to revise this approach.

Sajjad Sistani, Mahdieh Raeeszadeh , Ali Akbar Amiri,
Volume 11, Issue 3 (9-2017)
Abstract

Background and Aim: Due to the importance of infertility caused by oxidative stress induced by nicotine, this study was to evaluate the effect of alfalfa extract in contrast with the nicotine on ovarian tissues in rats.
Materials and Methods: Twenty-four adult female rats were randomly divided into 4 groups. Control group received no treatment; nicotine (0.2 mg/kg) was injected to T1 subcutaneously; and nicotine plus hydroalcoholic extract of alfalfa was prescribed to T2 and T3 orally for 25 days at 250 and 500 mg/kg, respectively. On the last day, the animals were weighed. After euthanizing the animals, their ovaries were removed and weighed. Right ovary was used for MDA measure and left ovary was fixed and stained to count the primary, secondary, graafian, and atretic follicles and corpus luteum (CL).
Results: Body weight in T1 (219 gr) decreased by 10 percent, and the average compared with that of the control group, T2 and T3 was significant. The highest ovarian weight was observed in T3 group (146.66±8.94mg). In T3, the average of primary and graafian follicles and CL was higher than that of T1, but atretic follicle was lower than that of T1 group. The MDA concentration in the control group (0.35±0.01 µmol/ml) was less than that in the other groups, but the TCA in T3 (821.18±3.25 µmol/ml) was significantly more than that in T1 group (708.85±12.44). 
Conclusion: The hydroalcoholic extract of alfalfa can reduce the oxidative stress caused by nicotine on ovarian tissue and probably improve fertility status.


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