مجله مطالعات علوم پزشکی
سال بیست و هفتم شماره 2 (اردیبهشت 1395)

The aim of this study was to determine the clinical importance of PR segment depression after MI in prognosis of patients with acute myocardial infarction.
This descriptive analysis study was conducted on 413 patients (283 patients were men and 130 women). The first ECG of all myocardial infarction patients was checked to determine PR segment depression. All patients were divided into two groups according to PR segment depression and then both groups were examined for cardiac complications.
Accordingly, 12 men and 1 woman had PR segment depression. 325 patients had STEMI and 88 patients had non-STEMI. The average length of stay in patients with STEMI and non-STEMI was 7.26 and 6.75 days, respectively. There was no correlation between the kind of MI and length of stay (P>0.05). Cardiac complications were seen in 7 patients with PR segment depression and not observed in 48 patients. There was significant correlation between cardiac complications and PR segment depression (P There were no significant correlation between PR segment depression and sex, age, EF, length of stay and CK-MB level. But there was a significant correlation with cardiac complications.

β-lactamase enzymes, the most important factor to antibiotic resistance among Gram-negative bacteria, is of beta-lactam family. Today, we experience increasing infection in the world and this is one of the emerging health problems in the world. CTX-M9 is a beta-lactamase resistance gene. The aim of this study was to determine the prevalence of ESBL producing Escherichia and molecular evaluation of CTX-M9 β-lactamase was amplified by PCR.
In a series 270 urine samples were collected from medical centers in the city of Sanandaj, the EMB-agar medium at 37 ° C for 24 hours and biochemical tests to confirm the 270 samples, 100 isolates of Escherichia coli was isolated. Antibiotic susceptibility using disk diffusion and ESBL enzymes were determined using the combined disk. The presence of CTX-M9 using specific primers was detected by PCR method.
The drug-resistance of isolates to11 antibiotics was obtained. 27 (27%) ESBLs producing strains were detected by using combined disc method on 100 strains. PCR used for the detection of CTX-M-9 gene showed that 10 (34%) out of 27 isolates contained such gene.
The rate of ESBLs producing strains in the present study and various reports from other countries is highly increasing, therefore, using an appropriate treatment protocol based on the antibiogram pattern of the strains is highly recommended. The results of PCR showed a high percentage of β-lactamase resistant E. coli strains. So identification of ctx-M9 genes and Prevalence of this Genes can accelerate diagnosing and treatment of patients.

Noise is one of the most important harmful elements in industrial environments causing auditory and non-auditory disorders. One of the non-auditory effects of noise is reducing efficiency and production quality. The aim of the present study was to survey the effects of exposure on selected sound pressure levels in performing skill tasks.
In the laboratory environment, Gold Wave was used to create sound pressure levels of 40, 60, 80 and 100 dB, respectively. The participating subjects in the study were requested to carry out the test of Two-Hand Coordination with starting the noise and after 1 to 2 minutes pause. The testing time and number of errors were registered and recorded.
The results revealed that there was no significant correlation between the interaction of sound pressure level and gender in the testing time (P=0.96%). The findings also showed that the mean of testing time had no statistical significance for males and females (p=0.51%). However, a significant difference was observed by the average of the testing time in sound pressure of different levels (P Noise is an effective factor on accuracy and speed of skill tasks performance. Increasing sound pressure leads to higher error rates in performing skill tasks.

The aim of this prospective study was to assess the prevalence and distribution of hypodontia in the permanent dentition in a sample of Azerbaijan population (Iran) conferring to private and public clinics for orthodontic and dental treatment and to investigate the relationship of hypodontia with class I, II and III malocclusions in 2014.
Panoramic radiographs with clinical examination of 2480 patients (934 males (37.6%) and 1596 females (62.4%)) with chronological age between (10-20) years were used, and the patients were divided into three groups of malocclusions class I, II and III according to the profile, amount of overjet and molar relationship.
The prevalence of hypodontia in the inspected population was 5.4% (5.2% for males and 5.3% for females). The average number of the congenitally missing teeth per patient was 2.02 (2.06 females and 1.96 for males). The most common congenitally missing teeth were upper lateral incisors (36.6%), mandibular second premolars (25%), central incisors (14.3%) and maxillary second premolars (11.8%) respectively. Hypodontia was more common in class I malocclusion than the other groups.
The prevalence of hypodontia in girls was higher than boys and in class I malocclusion was more prevalent than class II and III groups that these differences were not significant (p>0.05). The chance of symmetrical hypodontia was higher in class I malocclusion than other groups that was significant (p=0).

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by various autoantibodies formation and immune complex deposition in various organs. Lupus nephritis is a common and severe manifestation of SLE that can lead to end stage renal disease and death. The aim of this study was to evaluate the long-term efficacy of cyclosporine A in the treatment of resistant proliferative lupus nephritis.
In a retrospective study, patients with proliferative lupus nephritis that were resistant to treatment with mycophenolate mofetil and/or cyclophosphamide and was treated with cyclosporine A were entered to the study. They were evaluated according to the remission of the renal disease, SLE disease activity index, occurrence of end stage renal disease, mortality and side effects of treatment.
Twenty-five patients with biopsy proven proliferative lupus nephritis with mean age of 30±6.9 years including 5 men (20%) and 20 women (80%) were studied. The follow up duration was 27.1±17.6 months. Proteinuria was decreased significantly during the treatment with CSA (p According to results of our study, CSA is effective in the treatment of proliferative lupus nephritis.

Increasing consumption of ready to eat foods which usually receive low heating process can cause the emergence of microbial hazards. Listeria monocytogenes is one of the most dangerous foodborne bacteria which can result in disease and death in old, pregnant and immunosuppressed individuals. Lactobacilli are naturally present in most foods. Since ancient times, they were regarded as natural preservatives in food. The aim of this study was to evaluate the biochemical and molecular characterization of Lactobacillus isolates and investigate their antibacterial effects on Listeria monocytogenes
Sixty five meat samples were obtained from slaughter house in Urmia city. First, isolated bacteria were evaluated using phenotypic methods (morphology, Gram stain and catalase test). Then, polymerase chain reaction (PCR) and sugar fermentation tests were used. Finally, their antibacterial properties against Listeria monocytogenes were tested by two methods (agar wells diffusion and spot on plate).
Six strains of lactobacilli were identified using PCR. The antibacterial tests showed moderate effects of lactobacilli on Listeria monocytogenes growth.
The results indicated that lacobacilli can be used as a biocontrol agent to inhibit of Listeria monocytogenes growth.

Medical errors are one of the major challenges threatening the health system in all countries. The most common medical errors are medication errors (especially drugs) and the first natural result of medication errors is increasing patient’s length of stay in hospital, raised treatment costs, and sometimes severe damage and even death.
This descriptive study was conducted on nurses working in a second-level university hospital selected from general surgery, pediatrics and internal wards by random sampling method. Study method included direct observation of the preparation and the administration of intravenous drugs by nurses in the inpatient sections. The data were collected using check lists and analysis was done using descriptive statistics and SPSS software.
In this study, the overall 232 intravenous injections was registered that medication errors were found in135. About 63.7% errors were related to errors in intravenous injection phase and 36.30% of the errors were related to the procurement procedure. The most common causes of medication errors were related to drug infusion rate 22.96% and then mistake in the amount of injection and diluting the drug with the appropriate volume of solvent 17.04%. The most important underlying causes were related to the age of nurses and their section.
Analysis of the data indicates that the main reasons for the prevalence of medication errors are directly linked to the injections and the type of section (p = 0.02) and nurses’ age (p = 0.0). Although most of these errors are minor and may not cause patient injury, medication errors represent quality of personnel. So the errors in this study suggest the need for retraining and continuing education programs for nursing staff.

Although intraspinal opioid has been presented to be effective in providing analgesia after cesarean delivery, pruritus as a side-effect remains a common cause of dissatisfaction. We undertook a study to assess the efficacy of ondansetron for treatment or prophylaxis of intrathecal fentanyl-induced pruritus. The role of ondansetron has been studied in preventing pruritus but the results have been contradictory.
We randomized 110 patients undergoing elective cesarean section using spinal anesthesia with Marcaine 10 mg plus fentanyl 25 µg and into a double-blinded trial to receive ondansetron 4 mg (study group) or placebo (control or placebo group) after clamping of umbilical cord. Intra and post-operative itching, nausea and vomiting, and shivering in the recovery room were registered.
Forty percent of the patients in the placebo group and 23.6% in the ondansetron group had itching intraoperative (P=0.04). The incidence of post-operative itching was 38.2%, 21.8% in placebo and ondansetron groups, respectively (P=0.04). The patients reported less intra and post-operative nausea and vomiting in the ondansetron group than in the placebo group (P=0.01). There was no difference in the incidence of shivering between two groups.
This study showed that the prophylactic ondansetron reduced itching, nausea and vomiting intra and postoperative caused by intrathecal fentanyl with marcaine

Social anxiety is a common disorder and has a high comorbidity with other disorders. This study aimed to examine the prevalence of social anxiety among Iranian students (N=960).
The design of this survey was descriptive. The population included all students of Urmia University in the academic year 2014-2015. The number of 960 students was selected through cluster sampling. The participants answered questionnaires on demographic characteristics, fear of negative evaluation, and social interaction anxiety scale. The data were evaluated on the basis of scores located above the cut-off points to examine the prevalence of social anxiety and its associated characteristics as well.
The results showed that 5.2% of students suffered social anxiety. The prevalence of social anxiety in female and male students was determined as 5.5% and 4.7%, respectively. The data analysis showed that female and male students were significantly different in terms of level of social anxiety. In addition, undergraduate students had more social anxiety than graduate students and this difference was also statistically significant. There was no sign of social anxiety among doctoral students. The prevalence of social anxiety was not significantly different between native and nonnative students.
The results of this study were consistent with the results of other studies in terms of the prevalence of social anxiety and socio-demographic characteristics of the studied population.

Autism is considered as pervasive developmental disorders of childhood in DSM- IV, and it is a neural developmental disorder in DSM-5. This study aimed to investigate the effect of group supportive and training psychotherapy on anxiety, depression, stress and quality of life in mothers of children with autism spectrum disorders.
The current study was performed by semi-experimental method with pretest, posttest. The study population consisted of all mothers of children with autism admitted to Shafa Child and Adolescent Psychiatry Hospital and Outpatient Clinic in Rasht in the second 6-months of 2013. The sample included 20 mothers of children with autism spectrum disorder that their anxiety and depression scores were above the cut point. In the first stage, the participants were selected by available sampling method (targeted) and then randomly divided into two groups. Pretest consisted of questionnaire such as Beck Anxiety, Beck Depression, parental stress inventory (PSI), and the World Health Organization Quality of Life (WHO QOL-BREF) in both groups. Then, supportive psychotherapy and group training programs were conducted during six weeks each week a 90-minute session for the experimental group. The results were analyzed by covariance.
It was revealed that supportive psychotherapy and group training programs reduced the value of anxiety, depression, and stress in the test group significantly and improved their quality of life, while there was no significant change in the control group (P It seems that the emphasis on this type of therapeutic interventions by the health care system can have a significant impact on these aspects of mentioned patients’ mental health.