Tehran University Medical Journal

Background: Breast cancer is one of the most prevalent cancers among women and features increasing trends of incidence rates. Worldwide, yearly about 1.67 million of new cases and 522,000 of deaths from breast cancer are registered. The aim of this study was to determine the risk factors of breast cancer in women and to identify high risk groups.

Methods: In a case-control study, 170 women with breast cancer who were registered in cancer registration system from 2011 to 2015 at Dezful City, Iran, were compared with 170 healthy women with confirmation of mammography. After age matching of groups, the needed information about risk factors and demographic information including information, educational level, marital status, family history of breast cancer, age at menarche, parity, oral contraceptive use, age at first pregnancy, menopausal status, and age at menopause, breastfeeding, stress, abortion, alcohol use and smoking, hormone therapy and physical activity was collected by a questionnaire. The analysis of collected data was performed by using odds ratio and logistic regression model and SPSS software, version 16 (SPSS, Inc., Chicago, IL, USA). The statistical significance was set at a two-sided p-value of %5.

Results: The results of this study showed that, women with the family history [OR: 6.78 (95% CI: 2.15-21.41)] and women with the stress history [OR: 4.86 (95% CI: 2.46-9.59)] had higher risk of breast canser, while women with the history of having physical activity at least once a week [OR: 0.29 (95% CI: 0.13-0.65)] and women with the history breast feeding for 3 to 4 years [OR: 0.36 (95% CI: 0.16-0.81)] had lower risk of breast cancer.

Conclusion: It is recommended that the mentioned risk factors and protective factors be considered in first and second level (screening) of preventive programs.

Background: Operation theatre in a hospital requires considerable human and physical resources to deliver surgery services on an agreed schedule. However, operation theatres are sometimes underutilized due to avoidable last minute cancellations of operations. Cancellation of operations on the day of intended surgery results in operation theatre planning difficulties, hospital inefficiency and resource wastage. In addition, it causes stress for patients and their relatives and results in unnecessary hospital staying. Cancellation of planned operations could be avoided by applying appropriate management strategies and techniques. Quality management as an organizational strategy helps enhance hospital departments’ productivity.

Methods: This study aimed to reduce cancelled surgeries in Shahid Rajaei Hospital in Tehran using a quality management model. A participatory action research was used for the intervention between April 2013 and March 2014. Information on operations cancelled on the day of surgery obtained each day from the operating theatre list. Using a checklist, the reasons for operations cancellation were identified, investigated and an action plan was developed for its reduction. The plan was implemented using the action research cycle.

Results: The number of surgeries increased by 4.06 percent and operations cancellation was reduced by 32.4 percent using the quality management strategy. Surgeon and anesthetist related factors, over-running of previous surgery, changes in patient clinical status and lack of intensive care unit beds were the main reasons for cancelling surgeries. Standardization of processes, proper planning and using anesthetics clinic helped reduce the operations cancellation.

Conclusion: Last minute surgeries cancellation is potentially avoidable. Implementing an appropriate quality management model helps enhance hospital departments’ productivity and reduce surgical cancellation.

Background: Cancer is the most common cause of death in the world, and it incidence has been increasing for many years in economically developed countries. Early detection of cancers greatly increases the chances for successful treatment. So finding cancers before they start to cause symptoms is a most effective treatment. Recent studies have proposed that blood plasma contains a rich source of disease biomarkers for detecting, diagnosing and monitoring diseases. While some researchers have dismissed the low molecular weight serum peptidome as biological trash, recent work using differential scanning calorimetry has indicated that the peptidome may reflect biological event and contain diagnostic biomarkers.

Methods: Differential scanning calorimetry (DSC), a highly sensitive tool for analysis of blood plasma and other biofluids has recently been reported. Louisville Bioscience, Inc. (LBIdx™), The Plasma Thermogram™ (pT™) company has made a significant breakthrough in the analysis of blood plasma using differential scanning calorimetry for clinical monitoring and diagnostic applications.

Results: DSC analysis of plasma from diseased individuals revealed significant changes in the thermogram which are suggested to result not from changes in the concentration of the major plasma proteins but from interactions of small molecules or peptides with these proteins. The difference in plasma thermograms between healthy and disease individuals caused this method was recognized as a novel technique for disease diagnosis and monitoring.

Conclusion: Measurement of plasma proteins is a powerful clinical is standard medical practice which hope revolutionizes strategies for early cancer detection.

Background: The purpose of the current study was to investigate the effect of a high- intensity running (12 weeks) with bee pollen on gastrocnemius muscle ABCA1 and apoA1 mRNA expression in male rats.

Methods: In the present semi-experimental study, 24 white male Wistar rats aged 8 weeks with an average weight of 90±20 were prepared from the Pasteur Institute of Amol, Iran. The rats were kept in a room with dimensions of 6×5 meters under controlled conditions of light (12 hours light, 12 hours darkness, light began at 6 am, and the darkness began 6 pm), temperature (22±3 ºC) and moisture content (about 45%) from November to the end of February 2013. After a week of familiarity with laboratory space and manipulation by human, the rats were divided with simple random sampling into four groups matched by weight: saline-control, bee pollen-control, saline-training and bee pollen-training. Rats were sacrificed 48 h after the last training session. Data were analyzed statistically using two-way ANOVA and a significance level of 0.05.

Results: The results of the present study showed that intense endurance training decreased non-significantly in the gastrocnemius muscle. In addition, the bee pollen caused a significant increase in ABCA1 gene expression in the gastrocnemius muscle of male rats (P< 0.0001). while apoA1 not expressed in the gastrocnemius muscle.

Conclusion: The results of this study showed that high-intensity running reduces ABCA1 gene expression is severe. In addition, consumption of bee pollen can increase ABCA1 gene expression in the gastrocnemius muscle. According to the results of the present research, the bee pollen intake is more effective than intense endurance training on ABCA1 gene expression in gastrocnemius muscle of male rats and plays an important role in reverse cholesterol transport.

Background: Cooling is one of the main processes in bone temperature decrement, while drilling. this experiment was conducted for examination of alcohol effect as cooler in prevention of thermal necrosis.

Conclusion: Due to obtained data from examination, utilization alcohol can have an important influence on final bone temperature decreasing. The way of using alcohol was in the style of attrition soaked gauze onto wire while insertion.

Background: Attention deficit hyperactivity disorder (ADHD) is common in adults, and associated with comorbidities and negative consequences in many parents of children with ADHD. The aim of this study was to determine ADHD and personality disorder in parents of children with ADHD compared to the healthy group.

Methods: This cross-sectional descriptive and the analytic study were conducted in 2015 in Roozbeh Psychiatric Hospital Tehran and the sample group consisted of 45 adult subjects with ADHD children and 45 healthy adults who were chosen control method. questionnaires Conner’s adult attention deficit hyperactivity disorder questionnaires, Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II), Conner’s parent’s scales between the two groups were completed, and Strengths and Difficulties Questionnaire (SDQ) and Symptom Checklist -90- Revised (SCL-90-R) were completed in the group controlling. And for parents who had a score above the cutting point for the diagnostic assessment of personality disorder Structured Clinical Interview for DSM-IV Axis II Disorders, to assess personality disorders, as well as for the diagnostic assessment of ADHD in adults Diagnostic Interview for ADHD in Adults (DIVA) was conducted.

Background: Hypertension is one of the most important chronic illness worldwide and one the major risk factors for cardiovascular diseases. Obesity and abdominal obesity are risk factors for high blood pressure. Population attributable fraction (PAF) answers the question of how much of the disease burden in a certain population may be reduced if a risk factor like obesity is removed from the population. It implies that reducing prevalence of obesity as a risk factor of hypertension, may reduce the burden of hypertension and its consequences. The aim of this study was to determine the population attributable fraction of hypertension associated with obesity, abdominal obesity and joint effect of them in the men of Mazandaran Province, North of Iran.

Methods: In this epidemiological study, the data of non-communicable disease surveillance system in 2009 has been achieved. Then measure of association between obesity and hypertension (Odds Ratio) was extracted from Tehran Lipid and Glucose Study (TLGS). After standardizing the data, the population attributable risk for men based on the above formula (Levin's attributable fraction formula) has been calculated.

Background: Cancer diagnosis is the biggest stress for the child and his family. Diagnosis and treatment of cancer in children can cause stress, which often has a negative effect on the health of parents. Psychological reactions such as anxiety, depression, denial and loss of confidence in parents observed that because of the fear of recurrence and future of children. This study aimed to determine the level of stress and anxiety and depression in parents of children with leukemia who were in the maintenance phase of treatment.

Conclusion: According to this study, in addition to the classic treatment of patients, parent’s mental performance should be paid attention.

Background: Urinary tract infection is a common infectious disease in children and associated with the risk for renal scarring and long-term complications, usually consists of pyelonephritis and may cause complications such as scars in kidney, hypertension and renal failure. Some studies demonstrated association between urinary tract infection and electrolyte disturbances such as hyponatremia. The present study has been designed for assessment of association between urinary tract infection and hyponatremia in children.

Methods: This is a descriptive, cross-sectional study has been conducted on 120 children have referred to the Golestan Hospital, Ahvaz Jundishapur University of Medical Science from 21 March 2011 until 20 March 2013. A total of 120 children who were aged 6 months to 12 years and had febrile urinary tract infection. The study population and were classified into two group of sixty children: hyponatremic and nonhyponatremic. We compared the laboratory findings in two groups with each other. The data included serum sodiom level, white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and ddimercaptosuccinic acid (DMSA) scan results collected from children with febrile urinary tract infections admitted in pediatric ward. Data analysis was performed using descriptive statistics, chi-square and independent T-test with SPSS software, ver. 20 (IBM, Armonk, NY, USA).

Background: Patient satisfaction is an important indicator of healthcare quality and effectiveness. Quality management as an organizational strategy enhances the quality of hospital services through continuously improving hospital structures and processes. This study aimed to examine the impact of quality management on patient satisfaction.

Methods: A participatory action research was conducted in respiratory intensive care unit, at Labafinejad hospital, Tehran, Iran, in 2013. A quality improvement team was established. Operational processes were improved using a quality management model. The quality improvement team standardized processes, identified quality goals for the processes and improved them until achieved quality goals. Patients’ satisfaction data was collected before and after the intervention using a valid and reliable questionnaire.

Results: Patients’ satisfaction was 75 percent at the beginning of the study. Patients were mostly dissatisfied with the nutrition services, amenities, lack of attention to their personal needs and lack of involving them in their treatment processes. An action plan was developed for improving patient satisfaction. After the quality management intervention, patient satisfaction reached to 81 percent at the end of this study. The quality management model improved the quality of services by 54.5 percent and consequently increased patient satisfaction by 7.2 percent. Almost half of the patients at the beginning of this study were definitely willing to recommend the hospital to their friends and relatives. This figure increased to 76 percent. The rest of patients stated that they may recommend the hospital to others.