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Zahra Nozhat , Mehdi Hedayati ,
Volume 73, Issue 3 (June 2015)
Volume 73, Issue 3 (June 2015)
Abstract
In situ hybridization (ISH) is a method that uses labeled complementary single strand DNA or RNA to localize specific DNA or RNA sequences in an intact cell or in a fixed tissue section. The main steps of ISH consist of: probe selection, tissue or sample preparation, pre-hybridization treatment, hybridization and washing, detection and control procedure. Probe selection is one of the important aspects of successful hybridization. ISH sensitivity and specificity can be influenced by: probe construct, efficiency of labeling, percentage of GC, probe length and signal detection systems. Different methods such as nick translation, random priming, end tailing and T4 DNA polymerase replacement are used for probe generation. Both radioactive and non-radioactive labels can be used in order to probe labeling. Nucleic acid maintenance in samples, prevention of morphological changes of samples and probe penetration into tissue section are the main aims of sample preparation step. Then, a small amount of solution containing probe, is added on slides containing tissue sections for hybridization process, then slides are incubated overnight. Next day, washes are carried out to remove the probes which are not bound to target DNA or RNA. Finally, in order to be sure that the observed labeling is specific to the target sequence, using several control procedures is very important. Various techniques based on ISH consist of: Fluorescence in situ hybridization (FISH), chromogenic in situ hybridization (CISH), genomic in situ hybridization (GISH), comparative genomic hybridization (CGH), spectral karyotyping (SKY) and multiplex fluorescence in situ hybridization (MFISH). One of the most common techniques of ISH is fluorescence in situ hybridization. FISH can be used to: 1) detect small deletions and duplications that are not visible using microscope analysis, 2) detect how many chromosomes of a certain type are present in each cell and 3) confirm rearrangements that are suspected after microscope analysis. In this technique different fluorescent labels are attached to the probes. In this review article ISH, its different types, their application, advantages and disadvantages have been considered.
Hossein Mashhadinezhad , Babak Ganjeifar ,
Volume 73, Issue 3 (June 2015)
Volume 73, Issue 3 (June 2015)
Abstract
Background: Sciatic pain in association with lumbar disc herniation may require surgical intervention in the form of lumbar discectomy. Yet, the optimal time for this operation has not been specified in medical literature. Methods: In a Cross-sectional study, 147 patients (100 men and 47 women) with radiological and clinical signs of L4-L5 or L5-S1 disc herniation were entered to our registry prior to March 2009. They were all examined, diagnosed and operated on (lumbar discectomy) in Ghaem General Hospital, Mashhad, Iran. Patients were all subsequently followed for one year. The follow-up continued in a number of 126 cases, whose satisfaction was rated via phone interview for an extra year. The patients’ assessments were implemented employing three scaling systems, both before and following lumbar discectomy, to name the Modified Oswestry Disability Index (MODI), Visual Analogue Scale (VAS) and Prolo Functional Economic Outcome Rating Scale (PORS). The former two were used for pre-operative and post-operative assessments whereas the latter was applied during the first year of follow-up. The focus of the investigation during second year was on patients’ satisfaction. Results: Mean age of our cases were 34±7.4 years. According to the duration of the sciatica, patients were divided into 4 groups. <3 months, 3 to <6 month, 6 to <12 months and >12 months. Statistical analysis revealed a significant difference between patients having undergone lumber discectomy with a history of sciatica for less and more than three month before the operation in terms of pre-and post-operative visual Analogue Scale (P= 0.022). However, there could be found no such disparity in other clinical scores (P= 0.63 for MODI, P= 0.85 for Prolo scale and P= 0.73 for satisfaction). Conclusion: Patients with less than three months of sciatica may seem to enjoy a better clinical outcome after one year, there could be found no correlation between the duration of sciatica and the satisfaction after two years.
Mohamad Aghazade Amiri, Mozhgan Alvandi , Seyed-Mohammad Naser Hashemian , Seyed-Mahdi Tabatabai ,
Volume 73, Issue 4 (July 2015)
Volume 73, Issue 4 (July 2015)
Abstract
Background: In this study were focused on corneal cells changes in keratoconus disease, as there are differences between results of other studies that were done on keratokonic eyes. And the chief purpose was a comparison between keratoconus and normal population based corneal endothelium (in cell density, pleomorphism and polymegethism of cells). Methods: This study is an observational study and is a case-control type. This study was done in Farabi Ophthalmology Hospital, Tehran, from September 2013 to February 2014. In this study, 26 mild (corneal power is lower than 48 diopter) and moderate (corneal power is between 48 to 54 diopter) keratoconic eyes (case group) with no history of contact lenses wear or eye surgeries were compared with 25 normal eyes (control group) that corneal power based topographic images is lower than 47.2 diopter. This comparison were done based specular microscopy images which were taken by Noncontact (Topcan Sp-2000 P) specular microscope in 5 corneal regions (central, superior, inferior, nasal, temporal). Then the information related to the cell density, Coefficient of Variation (CV) of polymegethism and pleomorphism of cells were analyzed by SPSS software, version 21 (SPSS, Inc., Chicago, IL, USA). Results: Superior corneal region has the largest amount of endothelial cell density in case and control groups (P<0.001). But the effects of keratoconus on the cell density was not significant (P=0.96). And also CV of polymegethism in two groups (case and control groups), was similar (P=0.828). Pleomorphism was seen in 7 eyes of 26 eyes in case group (26.9%) and 6 eyes of 25 eyes in control group (24%). Conclusion: Keratoconus does not have any considerable effect on cell density, polymegethism and pleomorphism, in mild and moderate stages and corneal opacity risk caused by intraocular surgeries (such as: Cataract or Glaucoma surgeries) and some diseases (such as diabetes and uveitis) is similar in keratoconic and normal eyes.
Reza Habibian , Nowruz Delirezh , Amir Abbas Farshid ,
Volume 73, Issue 5 (August 2015)
Volume 73, Issue 5 (August 2015)
Abstract
Background: Allergic Asthma is an inflammatory disease of the respiratory system that is well known by increased inflammatory cells in the airways and causes difficulty in respiration. The prevalence of allergic asthma is increasing worldwide, and it has become a significant cause of health challenge especially in developed countries. Inhaled β2-agonists and Inhaled or oral corticosteroids are common medications for treating the disease, but they cannot be used for long periods of time because of frequently occurring side effects and they can’t change the main pathogenesis of the problem. Deficiency in regulatory system against inflammation could be an important factor in allergic asthma. Mesenchymal stem cells (MSCs) have potential of cellular immunosuppressive therapy of inflammatory disorders. The aim of present study was to evaluate the effects of MSC therapy on mechanisms of allergic asthma in mice model. Methods: This experimental study was conducted from August 2014 to March 2015. The animals were housed and maintained in Biotechnology Center of Urmia University, Iran. Mice were sensitized by intra-peritoneal injection of ovalbumin (OVA) and aluminum hydroxide emulsion and then were challenged intra-nasally with OVA. Before allergen challenge on day 14, experimental mice received tail vein injection of MSCs in PBS. Regulatory T cells of spleen, cytokines and IgE analysis were carried out using lungs wash as well as serum samples. Results: Our results showed that MSCs significantly reduced total cells and eosinophilia, serum OVA-specific IgE concentration in OVA-sensitized and challenged mice. Also results showed that MSCs markedly inhibited expressions of Th2 cytokines and elevated levels of Treg cells and Treg cytokines. Conclusion: In the present study, we demonstrated the inhibitory effect of MSCs on airway inflammation using mice model of allergic asthma. The mice were sensitized with OVA and compared to the results of dexamethasone administration. Our results demonstrated that administration of MSCs could be used as a potential therapeutic approach for the allergic asthma.
Mozhgan Tanhapour , Ali Asghar Safaei ,
Volume 73, Issue 6 (September 2015)
Volume 73, Issue 6 (September 2015)
Abstract
Background: Patient-centered care improves the quality of life and health care, and reduces the costs of care. The advent of new technologies such as health social networks, and personal health records (PHR), have significant impact on the patient-centered care. The aim of this article is to analyze and provide a set of features and requirements needed by the users of health social network serving as a PHR (Personal Health Record) system. The combination of capabilities offered by PHRs and social networks providing better delivery of patient-centered care. Methods: In this paper, after a brief study of capabilities and features of existing health social networks and based on a comparative study, a set of requirements which are necessary to create a comprehensive health social network as a PHR system are proposed. Identification of such a systems stakeholders and users e.g. healthcare professionals, patients, and healthcare organizations is important for categorizing the requirements. Also, classifying relatively vast range of existing systems is needed to have a better analyze and design. Results: The proposed health social network can be used by different user groups in healthcare e.g. healthcare professionals, patients, and healthcare organizations. According to the each user group’s requirements, it provides separate facilities for them. The users of this integrated health social network can optionally share some of their information with other users in their group or with users in the other groups and interact with them. Studies show that the proposal requirements and capabilities for health social network not only cover the capabilities of similar systems but also satisfactory provide the requirements of a PHR system to deliver the patient-centered care. Conclusion: The proposed set of requirements are qualitatively compared with the other similar systems. Using the proposed health social network that provides PHR capabilities for its users will have an irrefutable impact on quality and efficiency of patient-centered care, and play an important role in improving the health of society.
Nahideh Pazhohan , Azar Pazhohan , Nasrin Niromand , Mahbod Ebrahimi ,
Volume 73, Issue 10 (January 2016)
Volume 73, Issue 10 (January 2016)
Abstract
Background: Receptivity of endometrium has a critical role in the establishment of pregnancy after embryo transfer in the treatment process of infertile couples. As the glycoprotein CA-125 is a product of human endometrium and is measurable in the peripheral circulation, it is investigated whether it might serve as an indicator of endometrial receptivity and predictor of pregnancy following Intracytoplasmic sperm injection (ICSI).
Methods: In an observational diagnostic study, over a twelve-month period (from August 2013 to July 2014), all couples with male-factor infertility who attended to infertility clinic of Moheb Yas Hospital, Tehran and were candidate of performing ICSI, were invited to participate in the study. Based on the inclusion criteria of study, 64 women were eligible to take part in the study. They were assessed for serum CA-125 levels on the day of human chorionic gonadotropin (HCG) administration and also on the day of oocyte retrieval. After ICSI, the possibility of pregnancy was assessed by measuring serum concentration of &beta-HCG on 14 days after embryo transfer and also by visualizing the gestational sac by trans-vaginal ultrasound examination on four to five weeks after transfer. The pregnancy rate was compared between those with normal and high CA-125 levels.
Results: Among the subjects, 15 patients (23.4%) had high CA-125 levels, and totally 19 patients (29.7%) experienced pregnancy. Among those with normal and high CA-125 levels, 16 patients (32.7%) and 3 subjects (20%) experienced pregnancy, respectively, that showed no statistically significant difference according to Chi-square test (P=0.348). Also, according to the Fisher’s exact test, there was no correlation between CA-125 levels and the rate of pregnancy on the basis of body mass index (BMI).
Conclusion: Totally, according to the obtained results in current study, it may be concluded that serum CA-125 levels has no prognostic value in prediction of the outcomes of ICSI among infertile couples with male-factor infertility.
Shahrooz Kazemi , Mozhgan Shakeri Hosseinabad , Maryam Ameri , Batol Ghorbani Yekta ,
Volume 73, Issue 10 (January 2016)
Volume 73, Issue 10 (January 2016)
Abstract
Background: Acute respiratory distress syndrome (ARDS) is one of the most important complications associated with traumatic brain injury (TBI). ARDS is caused by inflammation of the lungs and hypoxic damage with lung physiology abnormalities associated with acute respiratory distress syndrome. Aim of this study is to determine the epidemiology of ARDS and the prevalence of risk factors.
Methods: This prospective study performed on patients with acute traumatic head injury hospitalization in the intensive care unit of the Shohaday-e Haftom-e-Tir Hospital (September 2012 to September 2013) done. About 12 months, the data were evaluated. Information including age, sex, education, employment, drug and alcohol addiction, were collected and analyzed. The inclusion criteria were head traumatic patients and exclusion was the patients with chest trauma. Questionnaire was designed with doctors supervision of neurosurgery. Then the collected data were analysis.
Results: In this study, the incidence of ARDS was 23.8% and prevalence of metabolic acidosis was 31.4%. Most injury with metabolic acidosis was Subarachnoid hemorrhage (SAH) 48 (60%) and Subdural hemorrhage (SDH) was Next Level with 39 (48%) Correlation between Glasgow Coma Scale (GCS) and Respiratory Distress Syndrome (ARDS) were significantly decreased (P< 0.0001). The level of consciousness in patients with skull fractures significantly lower than those without fractures (P= 0.009) [(2.3±4.6) vs (4.02±7.07)]. Prevalence of metabolic acidosis during hospitalization was 80 patients (31.4%).
Conclusion: Acute respiratory distress syndrome is a common complication of traumatic brain injury. Management and treatment is essential to reduce the mortality. In this study it was found the age of patients with ARDS was higher than patients without complications. ARDS risk factor for high blood pressure was higher in men. Most victims were pedestrians. The most common injury associated with ARDS was SDH. Our analysis demonstrates that Acute respiratory distress syndrome is common after traumatic brain injury. Management of traumatic brain injury is necessary to manage and reduce the mortality.
Mozhgan Jahani , Mohammad Hosein Modaressi , Kamran Mansouri,
Volume 73, Issue 11 (February 2016)
Volume 73, Issue 11 (February 2016)
Abstract
Angiogenesis, as the process of new vessel formation from pre-existing vessels is dependent on a delicate equilibrium between endogenous angiogenic and antiangiogenic factors. However, under pathological conditions, this tight regulation becomes lost which can result in the formation of the different diseases such as cancer. Angiogenesis is a complex process that includes many gene products that are produced by different cells. Each of the processes influenced by specific genes that their expression can be regulated by hypoxi inducible factor-1 (HIF-1). Hypoxia, the imbalance between the oxygen in need and the oxygen available, usually occurs in tumors and ischemic cardiovascular diseases. In order to overcome this challenge, tumors regulate and control the expression of genes related to angiogenesis, cell cycle and metabolism using hypoxia-inducible factor 1 (HIF-1). HIF-1 was first recognized as a transcription factor involved in hypoxia-induced erythropoietin expression. As angiogenesis pathway molecules are being described, this factor has been characterized as a key transcription regulator for these molecules. In this review article, after discussing HIF-1 structure and characterization, the role of this important factor in angiogenesis and cancer as a pathological case and finally, the clinical applications has been evaluated. Articles related to the key words of hypoxia, HIF-1 and angiogenesis were searched from valid databases such as Springer Link, google scholar, Pubmed and Sciencedirect. Then, the articles related to the role of hypoxia and HIF-1 in activation of genes that are involved in angiogenesis and cancer were searched and selected for this study. Studies show that, HIF-1 activation of genes including vascular endothelial growth factor (VEGF), angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2), etc., induced angiogenesis in the tumor cells. Furthermore, the activation of genes such as insulin-like growth factor 2 (IGF2), transforming growth factor α (TGF-α) and MAPK and PI3K signaling pathway will also enable the survival and proliferation of tumor cells. HIF-1 by activating genes involved in angiogenesis and also activates signaling pathways associated with cell survival and proliferation plays an important role in the stability and growth of tumors. Therefore, better understanding of molecular mechanisms associated with this factor can be effective in the treatment of cancer.
Yousef Fakour, Nafiseh Esmailie, Najmeh Khosrovan Mehr, Tahereh Souri, Kamran Balighi, Maryam Danesh Pazhouh, Hossein Mortazavi, Leila Mokhtari,
Volume 74, Issue 6 (September 2016)
Volume 74, Issue 6 (September 2016)
Abstract
Background: The relationship between skin, neuron system and mental status is complicated. Pemphigus is severe and painful autoimmune skin disorder that occurs in 0.5-1 person in 100000. Regarding the critical role of mental status in autoimmune diseases such as pemphigus, the aim of this research was to investigating psychiatric comorbidity in patient with pemphigus.
Methods: This research was a descriptive survey study. The society of this research included the patients with pemphigus referred to Razi Dermatology University Hospital in Tehran. Participants were 200 persons who were selected through available sampling. Finally, 198 persons filled out the demographic questionnaire and symptom checklist-90 (SCL-90).
Results: This research showed that the prevalence of psychiatric disorders in this sample was 62.62%. 28.78% (57 persons) of patients were male and 33.84% (67 persons) were female. In both genders the symptoms of paranoia were the most prevalent disorders (45% in female and 60% in male) and phobia was the least prevalent in our sample (8.2% in female and 24% in male). The upper grade in education, the less prevalent disorders. 81.45% of participants with mental disorders were married and 18.55% of them were single. Of patients only 26.32% had visited the psychiatrist or psychologist and 95.15% of them had used medications. This research also showed that there was a significant difference between two genders. Men showed higher rate of prevalence in psychiatric symptoms than women.
Conclusion: The results showed that psychiatric disorders in patients with pemphigus are high compared to general population. This research congruent with other researches showed that higher age, lower grade of education and marriage related to worse prognosis in psychological status in patient with pemphigus. Thus dermatologists must recognize and manage these psychiatric comorbidities to treat patients effectively and to improve the quality of life in patients with autoimmune diseases such as pemphigus.
Elmira Mohammadi , Shahin Gavanji , Faezeh Khozimeh , Zahra Golestannejad , Mohammadreza Golestannejad , Mahin Bakhshi , Hazhir Yousefshahi, Mohsen Doostmohammadi ,
Volume 74, Issue 10 (January 2017)
Volume 74, Issue 10 (January 2017)
Abstract
Background: Protective antigen of anthrax toxin, after touching the cell receptors, plays an important role in the pathogenesis of toxin. The purpose of this study was to investigate the interaction of anthrax toxin protective antigen and four great combination propolis included caffeic acid, benzyl caffeate, cinnamic acid and kaempferol using the softwares and bioinformatics web servers.
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Methods: Three-dimensional structure of protective antigen (receptor) obtains from Protein Data Bank (PDB). Four of the main components from propolis were selected as ligand and their 3D-structures were obtained from ChemSpider and ZINC compound database. The interaction of each ligand and receptor was assessed by SwissDock server (http://www.swissdock.ch/) and BSP-SLIM server (http://zhanglab.ccmb.med.umich.edu/BSP-SLIM). Docking results appears with Fullfitness numbers (in kcal/mol). Identification of amino acids involved in ligand and receptor interaction, was performed using the Chimera software; UCSF Chimera program (http://www.cgl.ucsf.edu/). Results: The results of interaction between propolis components and protective antigen by BSP-SLIM server showed that the most interaction was related with benzyl caffeate, caffeic acid, kaempferol and cinnamic acid, respectively. Results for the desired ligand Interaction with protective antigen genes using SwissDock server showed that the caffeic acid had ΔG equals -9.10 kcal/mol and FullFitness equal to -993.16 kcal/mol respectively. The analysis of interaction between ligands with amino-acids of protective antigen indicated that the interaction of Caffeic acid whit Glutamic acid 117 had energy -15.5429 kcal/mol. Conclusion: Finding strong and safe inhibitors for anthrax toxin is very useful method for inhibiting its toxicity to cell. In this study the binding ability of four flavonoids to protective antigen was studied. Glutamic acid 117 is very effective in protective antigen binding and cell receptor and subsequent in virulent of anthrax toxin. Effective interaction of caffeic acid in propolis and glutamic acid 117 can be as useful in preventing the toxic effect on cell. According to our results, all four flavonoids tested in this study have binding activity to protective antigen and are good choices for fighting against anthrax. |
Ali Mohammad Mosadeghrad , Ali Akbari Sari , Taraneh Yousefinezhadi ,
Volume 75, Issue 4 (July 2017)
Volume 75, Issue 4 (July 2017)
Abstract
Background: Hospital accreditation is a systematic external evaluation of a hospital’s structures, processes and results (outputs/ outcome) by an independent professional accreditation body using pre-established optimum standards. Hospital accreditation has an important role in improving the quality, safety, effectiveness and efficacy of health care services. The effectiveness of an accreditation system depends on the quality and conformity of its methods, standards and surveyors. This study aimed to evaluate the hospital accreditation method from the perspective of Iranian hospital managers.
Methods: This descriptive, applied and cross-sectional study was carried out in 2015 using a valid and reliable questionnaire. The study population consisted of 914 hospital managers. Overall 547 hospital managers were surveyed through stratified random sampling. SPSS software was used for data analysis.
Methods: This descriptive, applied and cross-sectional study was carried out in 2015 using a valid and reliable questionnaire. The study population consisted of 914 hospital managers. Overall 547 hospital managers were surveyed through stratified random sampling. SPSS software was used for data analysis.
| Results: Almost 71.7 percent of hospitals achieved grade one and above in the first round of national accreditation survey. The mean score of managers’ satisfaction of hospital accreditation method was 3.21±0.63 out of 5 (Average). About 38 percent of hospital managers were satisfied with the hospital accreditation method. Most complaints were related to lack of reliability among surveyors and their low knowledge, skills and experience. Hospital managers were satisfied with surveyors’ attitude and adequacy of the number of survey days. Hospital managers mostly believed that accreditation is better to be done by Ministry of Health, compulsory, and every two years. About 95 percent of hospital managers agreed that self-assessment is necessary and beneficial prior to the accreditation survey. Conclusion: Hospital managers were moderately satisfied with the national accreditation system. Developing job description and person specification for accreditation surveyors and recruiting them accordingly, and providing professional education and training for them help improve the effectiveness of Iranian hospital accreditation method. The method of hospital accreditation in Iran has to be changed. Self-assessment, unannounced surveys, review of hospital key performance indicators and patient satisfaction surveys should be added to the current scheduled on-site surveys to enhance the credibility of the accreditation result. |
Majid Mohammad Shahi, Seyed Ahmad Hosseini , Bizhan Helli , Mohammad Hosein Haghighyzade , Mohammad Abolfathi ,
Volume 75, Issue 6 (September 2017)
Volume 75, Issue 6 (September 2017)
Abstract
Background: Sleep quality may be directly related with vitamin D serum level. Some studies found that people with lower vitamin D serum level experienced a lower sleep quality. Consequently, this study aimed at determining the effect of vitamin D supplements on sleep point and quality in 20-50 year-old people with sleep disorders.
Methods: This double-blind, clinical trial was performed in Golestan Hospital of Ahvaz Jundishapur Medical Sciences University from November 2015 to February 2016 on 89 people with sleep disorders based on Pittsburgh Sleep quality index (PSQI). Participants of the study were selected based on inclusion and exclusion criteria. Patients under study were divided into two groups of vitamin D supplement and placebo recipients by random allocation. At the end of the study, the data on 89 subjects (44 in intervention group and 45 people in placebo group) were examined. Participants in intervention group received four edible pearls, each 50000 IU vitamin D, one in a fortnight. To placebo group, a placebo capsule (edible paraffin) was given one in a fortnight. Before and after intervention, Petersburg’s sleep quality questionnaire, Depression Anxiety Stress Scale (DASS-21) questionnaire, international physical activity questionnaire, general information questionnaire, sun exposure, vitamin D serum level and three-day food record questionnaire were assessed and recorded for all participants. To analyze data, Student's t-test, Chi-square test, ANCOVA, Mann-Whitney U test and Wilcoxon statistical tests were used.
Methods: This double-blind, clinical trial was performed in Golestan Hospital of Ahvaz Jundishapur Medical Sciences University from November 2015 to February 2016 on 89 people with sleep disorders based on Pittsburgh Sleep quality index (PSQI). Participants of the study were selected based on inclusion and exclusion criteria. Patients under study were divided into two groups of vitamin D supplement and placebo recipients by random allocation. At the end of the study, the data on 89 subjects (44 in intervention group and 45 people in placebo group) were examined. Participants in intervention group received four edible pearls, each 50000 IU vitamin D, one in a fortnight. To placebo group, a placebo capsule (edible paraffin) was given one in a fortnight. Before and after intervention, Petersburg’s sleep quality questionnaire, Depression Anxiety Stress Scale (DASS-21) questionnaire, international physical activity questionnaire, general information questionnaire, sun exposure, vitamin D serum level and three-day food record questionnaire were assessed and recorded for all participants. To analyze data, Student's t-test, Chi-square test, ANCOVA, Mann-Whitney U test and Wilcoxon statistical tests were used.
| Results: Mean score of Pittsburgh sleep quality questionnaire before and after intervention was 9.45±2.44 and 6.75±2.97 respectively (P=0.001) in interventional group and 10.51±3.14 and 9.73±3.04 respectively (P=0.18) in controls. Based on the results of the present study, at the end of the study score of Pittsburgh sleep quality questionnaire reduced significantly in vitamin D recipients as compared with placebo recipients (P=0.001). Conclusion: This study shows that the use of vitamin D supplement reduced sleep score (PSQI) or improved sleep score, reduced sleep latency, increased sleep duration and increased subjective sleep quality after modifying confounding variables in adult people with sleep disorder. |
Leila Valizadeh , Golnar Ghahremani , Manizheh Mostafa Gharehbaghi , Mohammad Asghari Jafarabadi Asghari Jafarabadi ,
Volume 75, Issue 8 (November 2017)
Volume 75, Issue 8 (November 2017)
Abstract
Background: Gastroesophageal reflux is a common condition among premature infants, which causes problems such as reduced weight gain and prolonged length of hospital stay. Body status is an appropriate way to reduce this condition. However, there have been few studies conducted in this regard. The objective of this study was therefore to investigate the effect of body status on gastroesophageal reflux in premature infants.
Methods: The present research was a crossover study conducted on premature infants with a gestational age of 33-36 weeks in Al-Zahra Hospital in Tabriz, Iran, from January to March 2015. In this clinical trial, thirty-two premature infants hospitalized in this center were selected as the sample. The initial selection of the participants was based on the simple random sampling. Then the participants were allocated to groups using randomized block procedure. Each infant was under study for 4 days. After each feeding and about two hours before the beginning of next feeding, the infants were randomly and not repeatedly put in one of the following four status for 12 hours (8 am -8 pm) every day: facilitated fetal tucking posture in lateral position, free body posture in lateral position, facilitated fetal tucking posture in supine position, and free body posture in supine position. Then, the incidence of gastroesophageal reflux was measured in each of these statuses. SPSS software, version 21 (SPSS Inc., Chicago, IL, USA) was used to analyze the data at significant level of P<0.05.
Results: The results showed that there was a significant difference between facilitated fetal tucking posture in lateral position and other status (P<0.001). The incidence of gastroesophageal reflux in facilitated fetal tucking posture was lower than free body posture, but there was no statistically significant difference in this regard. Moreover, the incidence of reflux in lateral position was significantly less than those in supine position (P=0.04).
Conclusion: The findings of this study revealed that facilitated fetal tucking posture and lateral positioning reduced the incidence of gastroesophageal reflux in hospitalized premature infants.
Methods: The present research was a crossover study conducted on premature infants with a gestational age of 33-36 weeks in Al-Zahra Hospital in Tabriz, Iran, from January to March 2015. In this clinical trial, thirty-two premature infants hospitalized in this center were selected as the sample. The initial selection of the participants was based on the simple random sampling. Then the participants were allocated to groups using randomized block procedure. Each infant was under study for 4 days. After each feeding and about two hours before the beginning of next feeding, the infants were randomly and not repeatedly put in one of the following four status for 12 hours (8 am -8 pm) every day: facilitated fetal tucking posture in lateral position, free body posture in lateral position, facilitated fetal tucking posture in supine position, and free body posture in supine position. Then, the incidence of gastroesophageal reflux was measured in each of these statuses. SPSS software, version 21 (SPSS Inc., Chicago, IL, USA) was used to analyze the data at significant level of P<0.05.
Results: The results showed that there was a significant difference between facilitated fetal tucking posture in lateral position and other status (P<0.001). The incidence of gastroesophageal reflux in facilitated fetal tucking posture was lower than free body posture, but there was no statistically significant difference in this regard. Moreover, the incidence of reflux in lateral position was significantly less than those in supine position (P=0.04).
Conclusion: The findings of this study revealed that facilitated fetal tucking posture and lateral positioning reduced the incidence of gastroesophageal reflux in hospitalized premature infants.
Masoud Mohammadi, Ali Akbar Vaisi Raiegan, Masoud Mirzaei, Hossain Zahednezhad, Rostam Jalali, Parvin Abbasi,
Volume 76, Issue 4 (July 2018)
Volume 76, Issue 4 (July 2018)
Abstract
Background: Children's health, preserving and promoting it is a health priority of any society. Malnutrition affects all age groups, but malnutrition in children is one of the most common nutritional problems that can delay body growth, shortened height, frequent infections, mental retardation, the prevalence of mental disorders, lack of academic achievement and reduced efficacy. Because of the importance and impact of this issue in children, the purpose of this study was a systematic review and meta-analysis of the prevalence of underweight in Iranian children, in order to highlight the importance of this issue to health policy-makers.
Methods: A meta-analysis was performed for relevant articles in scientific databases including Scientific Information Database (SID), ScienceDirect, PubMed and Google Scholar. Entrance criteria included cross-sectional studies (March 1996 to February 2017) that had a low incidence of underweight in Iranian children in different parts of Iran. Non-relevant articles included review articles, interventions, cohorts and case studies, and studies that looked at obesity, overweight and the relationship between these factors and other diseases, excluded from the study list. Reference lists of identified articles were reviewed for additional articles. Heterogeneity of study was checked using I2 index and the possibility of publication bias by funnel plot and Begg and Mazumdar's rank correlation test and a significance level of 0.1. Data were analyzed using the comprehensive meta-analysis software, version 3 (Biostat, Englewood, NJ, USA).
Results: In 26 articles reviewed in the study, total number of participants was 142938 persons at the age of 1 month to 12 years. The overall prevalence of underweight in Iranian children was 15.5% (Cl 95%: 12%-19.7%) during 1996 to 2017. The highest prevalence of underweight in was recorded in Birjand city in 2006 and Zahedan city in 2009, 68.6% (Cl 95%: 63.3%-72.9%) and the lowest prevalence of underweight in was found in city of Jahrom in 2013, 1.8% (Cl 95%: 1.2%-2.9%).
Conclusion: According to the results of this study, the prevalence of low-birth-weight in the country is high and requires interventional measures.
Methods: A meta-analysis was performed for relevant articles in scientific databases including Scientific Information Database (SID), ScienceDirect, PubMed and Google Scholar. Entrance criteria included cross-sectional studies (March 1996 to February 2017) that had a low incidence of underweight in Iranian children in different parts of Iran. Non-relevant articles included review articles, interventions, cohorts and case studies, and studies that looked at obesity, overweight and the relationship between these factors and other diseases, excluded from the study list. Reference lists of identified articles were reviewed for additional articles. Heterogeneity of study was checked using I2 index and the possibility of publication bias by funnel plot and Begg and Mazumdar's rank correlation test and a significance level of 0.1. Data were analyzed using the comprehensive meta-analysis software, version 3 (Biostat, Englewood, NJ, USA).
Results: In 26 articles reviewed in the study, total number of participants was 142938 persons at the age of 1 month to 12 years. The overall prevalence of underweight in Iranian children was 15.5% (Cl 95%: 12%-19.7%) during 1996 to 2017. The highest prevalence of underweight in was recorded in Birjand city in 2006 and Zahedan city in 2009, 68.6% (Cl 95%: 63.3%-72.9%) and the lowest prevalence of underweight in was found in city of Jahrom in 2013, 1.8% (Cl 95%: 1.2%-2.9%).
Conclusion: According to the results of this study, the prevalence of low-birth-weight in the country is high and requires interventional measures.
Ali Mohammad Mosadeghrad , Ali Akbari-Sari , Taraneh Yousefinezhadi ,
Volume 76, Issue 5 (August 2018)
Volume 76, Issue 5 (August 2018)
Abstract
Background: Hospital accreditation is a systematic external evaluation of a hospital’s structures, processes and results by an independent professional accreditation body using pre-established optimum standards. This study aimed to evaluate the hospital accreditation system.
Methods: This descriptive and cross-sectional study was carried out between November 2015 and February 2016 using a questionnaire covering accreditation standards, methods, surveyors, implementation and effects. The study population consisted of 161 hospital managers in Tehran province, Iran. Overall 87 hospital managers were surveyed through stratified random sampling.
Results: The mean score of managers’ satisfaction of hospital accreditation system was 2.93 out of 5 score. About 16 percent of managers were satisfied with the hospital accreditation system. Hospital managers were most satisfied with accreditation effects (3.14) and least satisfied with accreditation standards (2.54). Hospital managers were satisfied with surveyors’ attitude, number of survey days and the number of surveyors in the accreditation team. They were least satisfied with the lack of consistency among surveyors, lack of transparency of standards, too many standards and low competency of surveyors. Hospital managers mostly believed that accreditation should be done by Ministry of Health, compulsory, and every two years. About 97 percent of managers agreed that self-assessment is necessary and beneficial prior to the accreditation survey.
Conclusion: Accreditation was moderately successful in Tehran hospitals. Accreditation had the most effect on improving patient safety and meeting patients' rights and least effect on improving employees' job satisfaction and involving doctors in quality improvement. Strengthening Iran hospital accreditation system, training managers and employees on implementing standards, and providing necessary resources make it possible to achieve accreditation goals.
Methods: This descriptive and cross-sectional study was carried out between November 2015 and February 2016 using a questionnaire covering accreditation standards, methods, surveyors, implementation and effects. The study population consisted of 161 hospital managers in Tehran province, Iran. Overall 87 hospital managers were surveyed through stratified random sampling.
Results: The mean score of managers’ satisfaction of hospital accreditation system was 2.93 out of 5 score. About 16 percent of managers were satisfied with the hospital accreditation system. Hospital managers were most satisfied with accreditation effects (3.14) and least satisfied with accreditation standards (2.54). Hospital managers were satisfied with surveyors’ attitude, number of survey days and the number of surveyors in the accreditation team. They were least satisfied with the lack of consistency among surveyors, lack of transparency of standards, too many standards and low competency of surveyors. Hospital managers mostly believed that accreditation should be done by Ministry of Health, compulsory, and every two years. About 97 percent of managers agreed that self-assessment is necessary and beneficial prior to the accreditation survey.
Conclusion: Accreditation was moderately successful in Tehran hospitals. Accreditation had the most effect on improving patient safety and meeting patients' rights and least effect on improving employees' job satisfaction and involving doctors in quality improvement. Strengthening Iran hospital accreditation system, training managers and employees on implementing standards, and providing necessary resources make it possible to achieve accreditation goals.
Bahman Hasannasab , Nadia Banihashem , Shahram Seyfi , Manizheh Yazdanmehr ,
Volume 76, Issue 6 (September 2018)
Volume 76, Issue 6 (September 2018)
Abstract
Background: The post-dural puncture headache (PDPH) is a common complication in spinal anesthesia. Headache may occure seven days after dural puncture. The headache may be worsened in sitting position and be better in supine position. PDPH is common in younger and tall people. The incidence rate of PDPH related to the size of spinal needle and the number of try and decrease with small, cutting needle and less puncture try. PDPH is a well-known iatrogenic complication of spinal anesthesia, which continues to be a major problem. In this study, we assessed the effect of intravenous aminophylline on prevention of post-spinal anesthesia headache in who were elective for cesarean sections.
Methods: This double-blind randomized clinical trial was conducted on 140 women with 18 to 35 years old and American Society of Anesthesiologists Classification (ASA Class) I and II undergoing spinal anesthesia in elective cesarean section. Patients were randomly divided into two groups called case and control. After umbilical cord clamping 1 mg/kg aminophylline dissolved in 100 cc normal saline was infused to the case group but only 100 cc normal saline was infused for the control group. Patient's blood pressure and heart rate were recorded before spinal anesthesia, immediately after spinal anesthesia, after uterine incision and umbilical cord clamping, after drug injection and then every five minutes. The incidence of headache was assessed at 4, 8, 24, 48 and 72 hours after the surgery.
Results: Although severity and duration of headache in case group was more than in control group, no meaningful difference was found between two groups. The mean changes in systolic blood pressure were greater in control group (P<0.001). The mean changes in heart rate was greater in case group than control group (P<0.001).
Conclusion: This study showed that intravenous aminophylline although, caused hemodynamic changes in some case, but it doesn't have any effect on prevention of incidence and severity of post-spinal anesthesia headache in elective cesarean section.
Methods: This double-blind randomized clinical trial was conducted on 140 women with 18 to 35 years old and American Society of Anesthesiologists Classification (ASA Class) I and II undergoing spinal anesthesia in elective cesarean section. Patients were randomly divided into two groups called case and control. After umbilical cord clamping 1 mg/kg aminophylline dissolved in 100 cc normal saline was infused to the case group but only 100 cc normal saline was infused for the control group. Patient's blood pressure and heart rate were recorded before spinal anesthesia, immediately after spinal anesthesia, after uterine incision and umbilical cord clamping, after drug injection and then every five minutes. The incidence of headache was assessed at 4, 8, 24, 48 and 72 hours after the surgery.
Results: Although severity and duration of headache in case group was more than in control group, no meaningful difference was found between two groups. The mean changes in systolic blood pressure were greater in control group (P<0.001). The mean changes in heart rate was greater in case group than control group (P<0.001).
Conclusion: This study showed that intravenous aminophylline although, caused hemodynamic changes in some case, but it doesn't have any effect on prevention of incidence and severity of post-spinal anesthesia headache in elective cesarean section.
Azita Fathnezhad Kazemi , Sepideh Hajian , Mehrangiz Ebrahimi-Mameghani , Mehdi Khabazkhob,
Volume 76, Issue 10 (January 2019)
Volume 76, Issue 10 (January 2019)
Abstract
Pregnancy as a natural event leads to changes in various aspects of physiology, psychology, and social life. The adoption of a health promoting lifestyle is an important strategy for achieving the desired outcomes of pregnancy and is important on the future health of mother and child. The aim of this study was to assess the various aspects of health promotion behaviors during pregnancy. The data was obtained with advanced search in the Iranmedex, Magiran, Scientific Information Database (SID), IranDoc, PubMed, Google Scholar, Web of Science and Scopus databases. Articles containing full text were collected using the proper keywords for Persian articles and their equivalent in Mesh included “Health promotion" OR "Behavior health "OR “Health Promoting Lifestyle” AND pregnancy for English articles with a time limitation of 2010 to 2017. At first 3247 articles obtained after reviewing and evaluation of the references, 4 Persian and 25 English articles with observational and qualitative design were included. A review of studies showed that finding a way to pass pregnancy safely is the most important concern for mothers. Pregnant women do some actions to reach favorable outcomes and they have a high incentive to adopt health behaviors during pregnancy due to fear of fetal health, but there is some obstacle to adopt health behaviors including individual factors like that lack of time and inadequate information about pregnancy or health-related functions and social factors including health system problems and cultural factors. In addition age, level of education, individual’s beliefs and factors associated with pregnancy such as high-risk pregnancy and environmental factors such as social support and health system performance play an important role in the adoption of health behaviors. In order to increase the potential of pregnant women to adopt healthy behaviors, changing the health system approach and paying attention to social determinants of health, in order to carry out the necessary interventions, it is recommended to conduct qualitative studies and appropriate design for deep study of the subject in the cultural background.
Ali Mohammad Mosadeghrad , Ali Akbari Sari , Taraneh Yousefinezhadi,
Volume 76, Issue 12 (March 2019)
Volume 76, Issue 12 (March 2019)
Abstract
Background: Hospital accreditation is an external evaluation of a hospital’s structures, processes and results by an independent professional accreditation body using pre-established optimum standards. Accreditation has an important role in improving the quality, safety, effectiveness and efficiency of hospital services. This study aimed to examine the effects of hospital accreditation program from hospitals managers’ perspective.
Methods: This descriptive and cross-sectional study was carried out in 2015 using a valid and reliable questionnaire designed to examine accreditation effects on hospital performance, hospital employees, patients, and the society. The study population consisted of 914 hospital managers in Iran. Overall, 547 hospital managers were surveyed through stratified random sampling.
Results: About 71% of hospitals achieved grade one and above accreditation status. The mean score of accreditation positive effects in hospitals was 3.16±0.66 out of 5 (Average). Almost 38% of managers were satisfied with the accreditation results in their hospitals. Hospital accreditation program was successful in improving patient and staff safety, reducing medical errors and enhancing staff competencies. Its success in improving communication, promoting organizational culture, continuous quality improvement, resource utilization, and reducing nosocomial infections and hospital mortality rates was moderate. Accreditation was less successful in improving staff satisfaction, getting physicians involved in process improvement, practicing evidence based medicine, attracting patients and increasing hospital income. A statistically significant correlation was found between hospital size and accreditation results (P=0.038, r=-0.090). There was no correlation between using quality management models and getting better accreditation results (P=0.085). However, there was correlation between using accreditation consultants and positive accreditation results (P=0.045, r=-0.087). Utilizing hospital resources, organizational learning, continuous quality improvement and effective communication had the most effect on accreditation success.
Conclusion: The accreditation program had a moderate effect on hospital performance. It is costly to implement accreditation standards in hospitals. Hence, changes should be made to the accreditation system including accreditation standards and methods in order to have more positive effects on the staff and hospitals’ performance.
Methods: This descriptive and cross-sectional study was carried out in 2015 using a valid and reliable questionnaire designed to examine accreditation effects on hospital performance, hospital employees, patients, and the society. The study population consisted of 914 hospital managers in Iran. Overall, 547 hospital managers were surveyed through stratified random sampling.
Results: About 71% of hospitals achieved grade one and above accreditation status. The mean score of accreditation positive effects in hospitals was 3.16±0.66 out of 5 (Average). Almost 38% of managers were satisfied with the accreditation results in their hospitals. Hospital accreditation program was successful in improving patient and staff safety, reducing medical errors and enhancing staff competencies. Its success in improving communication, promoting organizational culture, continuous quality improvement, resource utilization, and reducing nosocomial infections and hospital mortality rates was moderate. Accreditation was less successful in improving staff satisfaction, getting physicians involved in process improvement, practicing evidence based medicine, attracting patients and increasing hospital income. A statistically significant correlation was found between hospital size and accreditation results (P=0.038, r=-0.090). There was no correlation between using quality management models and getting better accreditation results (P=0.085). However, there was correlation between using accreditation consultants and positive accreditation results (P=0.045, r=-0.087). Utilizing hospital resources, organizational learning, continuous quality improvement and effective communication had the most effect on accreditation success.
Conclusion: The accreditation program had a moderate effect on hospital performance. It is costly to implement accreditation standards in hospitals. Hence, changes should be made to the accreditation system including accreditation standards and methods in order to have more positive effects on the staff and hospitals’ performance.
Fariba Keramat , Shahram Homayoonfar , Mohammad Ali Seif Rabiei , Kazhal Abbasi , Ali Saadatmand ,
Volume 77, Issue 4 (July 2019)
Volume 77, Issue 4 (July 2019)
Abstract
Background: Infective endocarditis occurs due to the presence of microorganisms in the endocardium or the heart valves. Nowadays, infective endocarditis is still a major cause of death with an incidence rate of 5 to 7.9 per 100,000 populations. The aim of the study was to determine antibiotic resistance pattern of bacterial agents isolated from blood culture of patients with infective endocarditis.
Methods: In this retrospective study, infective endocarditis patients who were admitted to Sina and Ekbatan hospitals in Hamadan City, Iran, from March 2005 to February 2014, were enrolled. All demographic data, clinical manifestations, physical examinations and echocardiography reports of the patients were recorded in a check list. For all patients, blood cultures in Mueller Hinton agar and antimicrobial susceptibility testing for ceftriaxone, ceftazidime, oxacillin, cefazolin, vancomycin, imipenem, clindamycin, etc. were done by disk diffusion method. All data analyzed by SPSS statistical software, version 16 (IBM, Armonk, NY, USA).
Results: A total of 61 patients with definitive infective endocarditis were included in the study, 50 of them (82%) were males and 11 patients (18%) were females. The mean age of the patients was 37.45±14.79 (range 17-74) years and 37 (60.7%) of the patients lived in urban areas. The mean duration of admission was 20±13.59 days. In addition, 38 patients (62.3%) were injection drug users (IDUs) and 23 (37.7%) non-IDU. Meanwhile, 54 (88.5%) of them had normal valve endocarditis and 7 cases (11.5%) had a prosthetic valve endocarditis. Moreover, the most common underlying disease in the natural valve endocarditis was rheumatoid fever (6.6%). Blood cultures were positive in 44.3% of the patients. The most common isolated organism was staphylococcus aureus in 15 cases (55.55%), which had the highest resistance to oxacillin. Most patients were managed by antibiotic therapy, but 15 cases (24.6%) underwent cardiac surgery. In follow up patients between 3 months to 9 years, 19.7% of the patients had complete recovery and 8.2% of them died.
Conclusion: According to the findings, antibiotic resistance pattern of bacterial agents isolated from blood culture of patients with infective endocarditis was changed.
Methods: In this retrospective study, infective endocarditis patients who were admitted to Sina and Ekbatan hospitals in Hamadan City, Iran, from March 2005 to February 2014, were enrolled. All demographic data, clinical manifestations, physical examinations and echocardiography reports of the patients were recorded in a check list. For all patients, blood cultures in Mueller Hinton agar and antimicrobial susceptibility testing for ceftriaxone, ceftazidime, oxacillin, cefazolin, vancomycin, imipenem, clindamycin, etc. were done by disk diffusion method. All data analyzed by SPSS statistical software, version 16 (IBM, Armonk, NY, USA).
Results: A total of 61 patients with definitive infective endocarditis were included in the study, 50 of them (82%) were males and 11 patients (18%) were females. The mean age of the patients was 37.45±14.79 (range 17-74) years and 37 (60.7%) of the patients lived in urban areas. The mean duration of admission was 20±13.59 days. In addition, 38 patients (62.3%) were injection drug users (IDUs) and 23 (37.7%) non-IDU. Meanwhile, 54 (88.5%) of them had normal valve endocarditis and 7 cases (11.5%) had a prosthetic valve endocarditis. Moreover, the most common underlying disease in the natural valve endocarditis was rheumatoid fever (6.6%). Blood cultures were positive in 44.3% of the patients. The most common isolated organism was staphylococcus aureus in 15 cases (55.55%), which had the highest resistance to oxacillin. Most patients were managed by antibiotic therapy, but 15 cases (24.6%) underwent cardiac surgery. In follow up patients between 3 months to 9 years, 19.7% of the patients had complete recovery and 8.2% of them died.
Conclusion: According to the findings, antibiotic resistance pattern of bacterial agents isolated from blood culture of patients with infective endocarditis was changed.
Hossein Tireh , Mohammad Taghi Shakeri , Sadegh Rasoulinezhad , Habibollah Esmaily , Razieh Yousefi ,
Volume 77, Issue 5 (August 2019)
Volume 77, Issue 5 (August 2019)
Abstract
Background: Diabetes mellitus as a chronic disease is the most common disease caused by metabolic disorders and it is one of the most important health issues all around the world. Nowadays, data mining methods are applied in different fields of sciences due to data mining methods capability. Therefore, in this study, we compared the efficiency of data mining methods in predicting type 2 diabetes.
Methods: In this cross-sectional study, the data of 7,000 participants in the Diabetes Screening Project in Samen, Mashhad City, Iran, were considered in 2016. There were 540 untreated diabetic patients. The Samen Project was included in the routine examinations of diabetes patients like blood glucose, eyes health, nephropathy, and legs health. So, in order to maintain balance, 600 healthy individuals were selected in a proportional volume sampling in this study. Therefore, the total sample size was 1140 people. In this study, people with diabetes aged over 30 years old were enrolled and participants with the previous history of type 2 diabetes, with normal blood glucose due to drug use or other issues at the time of the study, were excluded.
Results: All three models (Logistic regression, simple Bayesian and support vector machine models) had the same test accuracy (86%), however, in terms of area under the receiver operating characteristic (ROC) curve (AUC), logistic regression and simple Bayesian models had better performance (AUC=90% against AUC=88%). In the simple Bayesian model and logistic regression, body mass index (BMI) and age variables were the most important variables, while BMI and blood pressure variables were the most important factors in the support vector machine model.
Conclusion: According to the results, all three models had the same accuracy. In terms of area under the curve (AUC), logistic and simple Bayes models had better performance than the support vector machine model. Totally all three models had almost the same performance. Based on all three models, BMI was the most important variable.
Methods: In this cross-sectional study, the data of 7,000 participants in the Diabetes Screening Project in Samen, Mashhad City, Iran, were considered in 2016. There were 540 untreated diabetic patients. The Samen Project was included in the routine examinations of diabetes patients like blood glucose, eyes health, nephropathy, and legs health. So, in order to maintain balance, 600 healthy individuals were selected in a proportional volume sampling in this study. Therefore, the total sample size was 1140 people. In this study, people with diabetes aged over 30 years old were enrolled and participants with the previous history of type 2 diabetes, with normal blood glucose due to drug use or other issues at the time of the study, were excluded.
Results: All three models (Logistic regression, simple Bayesian and support vector machine models) had the same test accuracy (86%), however, in terms of area under the receiver operating characteristic (ROC) curve (AUC), logistic regression and simple Bayesian models had better performance (AUC=90% against AUC=88%). In the simple Bayesian model and logistic regression, body mass index (BMI) and age variables were the most important variables, while BMI and blood pressure variables were the most important factors in the support vector machine model.
Conclusion: According to the results, all three models had the same accuracy. In terms of area under the curve (AUC), logistic and simple Bayes models had better performance than the support vector machine model. Totally all three models had almost the same performance. Based on all three models, BMI was the most important variable.
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