مجله علمی دانشگاه علوم پزشکی کردستان
سال نوزدهم شماره 4 (پیاپی 74، زمستان 1393)

Carpet-weaving is one of the important and high risk occupations in Iran that has some ergonomic factors leading to musculoskeletal disorders. The aims of this study were to determine the prevalence of musculoskeletal disorders (MSDs) and posture assessment by NMQ and QEC method respectively, in female carpet weavers in Sanandaj. In the present cross-sectional study, 250 female carpet hand-weavers were selected randomly and interviewed. To determine the prevalence of MSDs and assessment of work postures, we used Nordic Musculoskeletal Questionnaire (NMQ) and Quick Exposure Check (QEC) respectively. Using SPSS IBM 20 software, data were analyzed by chi-square and independent sample t-test. Prevalence of MSDs in the participants was 80.4 %. The most common complaints were related to low back and shoulders with respective prevalence rates of 52 and 49.6% and the least common complaints were related to elbows and feet with prevalence rates of 20 and 26%, respectively. There was significant relationships between QEC scores and musculoskeletal symptoms prevalence rates in shoulder/arm, wrist/hand and neck (p<0.05). Also, the relationship between the mean work background and daily work time in both groups (with MSDs and none) was significant (p<0.05). It seems that long duration of daily work and repetitive task and maladjustment of the seat height in proportion to weaved carpet height were effective factors leading to the high prevalence of MSDS among participants which was also confirmed by posture assessment results. Timely adjustment of the seat height through designing adjustable seats and following ergonomic principles in workshops might be useful strategies to reduce prevalence of MSDs.

Liver plays important roles in the production of bile, detoxification, and elimination of foreign material and synthesis of plasma proteins. Obstructive cholestasis is one of the liver disorders that can result in increased concentration of oxidants and inflammatory agents in the liver. In traditional medicine, Cichorium intybus has been used as a liver protectant, anti inflamatory and detoxifying agent. The aim of this study was to evaluate the effect of chloroformic extract of Cichorium intybus on liver functional tests and serum level of TNF-α in cholestatic rat model. In this experimental study, male Wistar rats were randomly divided into 5 groups (n= 6) including sham operated, control (Bile Duct Ligation (BDL) + vehicle), and 3 groups with BDL + extract treatments (100, 200, 400 mg/kg/day ip). These groups were treated for seven days and on the eighth day, prothrombin time (PT), serum albumin, alanine amino transferase (ALT), aspartate amino transferase (AST), total bilirubin, direct bilirubin, alkaline phosphatase (ALP) and lactate dehydrogenase (LDH), were measured by calorimetric and TNF-α was measured by ELISA methods. The results were analyzed by one way ANOVA. The results of the present study showed that the Cichorium extract (100 mg/kg/day) decreased the serum level of direct bilirubin, AST, ALT, and TNF-α significantly compared to the control group (p <0.05). Furthermore, at the higher dose (200 mg/kg/day) PT, ALP, LDH and AST decreased significantly in comparison to the control group (p <0.05), while the serum albumin level increased significantly in the treated animals (p <0.05). In conclusion, we found that, low doses of chloroformic extract of Cichorium intybus protected the liver against obstructive cholestasis induced -injury.

Severe arterial injuries in the hand can be hazardous to the limbs and even life- threatening. The aim of this study was to investigate the management methods in the patients with acute injuries of the ulnar or radial artery in the emergency department. This cross-sectional prospective study was conducted in the emergency department of Sina Hospital in Tehran, from 2012 to 2013. Stable vital signs, wrist and forearm laceration with jumper or active bleeding, radial or ulnar artery injury; one or both were among our inclusion criteria. Vital signs, level of consciousness, coincident injuries were assessed and physical examination was performed in all patients. We recorded time of patient arrival, primary and secondary treatment, and consultation and follow up visits in emergency department or ward. 50 patients (3 females and 47 males) with a mean age of 30.34y ± 9.69y were enrolled. The first step was to examine and pack up bleeding. The most common injury was due to sharp instruments (84%) and the most common injured artery was radial artery (68%).The mean duration of the first treatment was 1.24 ± 0.93 min. 37 patients (74%) were treated by ligation in the emergency room and the remaining 13 patients (26%) were sent to the operating room for repair and vascular anastomosis by our vascular surgeon. Mean values of duration for ligation were 16.72 ± 13.83 min and 117.76 ± 114 min in emergency medicine and vascular surgery groups, respectively that showed a significant difference between the two groups (p= 0.0001). The overall duration of hospitalization for the patients was 69.04 ± 82.74 hour (5- 311 hours). We can conclude that the radial or ulnar artery ligation considering its indications or contraindications, in emergency room can play an important role in the recovery of patient's hemodynamic status and speed up of the next step of patient’s treatment.

At present, the most important factor of scientific productivity in the world is the number of scientific articles indexed in major international databases, and the number of citations given to these articles. Using scientometric methods, we evaluated scientific output of the universities in Sanandaj city including Kurdistan University, Kurdistan University of Medical Sciences and Islamic Azad University of Sanandaj in a decade (from 2004 to 2013). In this citation analysis study, data collection was carried out on the internet using Scopus citation database. Affiliation of each university was searched through search box of Scopus. We collected data for each university in relation to the following indices: "number of articles published in the last ten years", "number of citations given to the articles in the last ten years", "H- index" and "ten journals" which had published the highest number of articles. Data were analyzed by using "analyze results" part of the database. Three universities with 2049 documents and 9192 citations contributed to one percent of Iran scientific production. Kurdistan University had 1372 documents and 7969 citations, Kurdistan University of Medical Sciences had 372 documents and 837 citations and Islamic Azad University of Sanandaj had 305 documents and 386 citations. H-indices for the three universities were 37, 14 and 9 respectively. Islamic Azad University of Sanandaj and Kurdistan University with 98 and 239 documents respectively in 2011 and Kurdistan University of Medical Sciences with 139 documents in 2013 had the highest growth in the number of articles. The ratio of total number of citations to the articles for three universities was 4.5, meaning that each article had received 4.5 citations. This ratio was 5.8 for Kurdistan University, 2.25 for Kurdistan University of Medical Sciences and 1.26 for Islamic Azad University of Sanandaj. Although science production in the universities of Sanandaj has shown an upward trend, but it is lower than the mean national science production. Attention to the potential of researchers of Kurdistan province and revision of the research policies can increase the contribution of this province to scientific productivity of our country.

Subjective workload (SWL) is a general concept in ergonomics literature. SWL is defined as the costs to the operator's health to achieve a certain level of performance. The aim of this study was to assess the risk of SWL for musculoskeletal disorders in bank employees in Kurdistan Province. This analytical - descriptive study included 200 employees from the banks of Kurdistan Province. NASA-TLX software and general Nordic questionnaire were used for the assessment of subjective work load and the incidence of musculoskeletal disorders respectively. Statistical analysis was performed by means of SPSS19. 78% of the subjects were male and 22% were female. The mean age and mean work background of the subjects were 36.28 and 14.2 years, respectively. On the whole, 48% of the staff had experienced pain at least once during the past year with highest frequency in the neck (48%), lower back (44%), and upper back (36%). The NASA Index showed that the bank staffs have scored the effort scale and efficiency scale with respective mean values and SD of 72.8±25.3 and 36.0±22.6, as the maximum and minimum values among the various aspects of workload. Data analysis revealed that mean subjective workload had statistically significant relationships with matrimony, work background, and also with prevalence and experience of pain (P=0.0001). The rate of subjective workload and musculoskeletal disorders in bank staff are high to the same degree and it seems that subjective workload scales not only add to the subjective workload but also act as a risk factor for musculoskeletal disorders.

Adrenergic and GABAergic systems of the brain play important roles in learning and memory. Previous studies have shown that morphine, histamine and lithium can induce state dependent learning. In the present study we evaluated, the effects of α1-adrenergic receptor of CA1 on muscimol state-dependent learning in mice. In this experimental study adult male NMRI mice were used. The animals were anaesthetized and bilateral implantation of cannula in the CA1 regions of the dorsal hippocampus was performed by using stereotaxic method. Seven days after recovery, we used inhibitory avoidance task for behavioral testing. Data were analyzed by Kruskal–Wallis nonparametric one-way analysis of variance followed by Mann–Whitney test. Pre-training or pre-test intra-CA1 injection of muscimol impaired inhibitory avoidance memory on the test day (P<0.01). Pre-test injection of muscimol reversed the memory impairment induced by pre-training muscimol injection (P<0.001). Pre-test intra-CA1 injection of phenylephrine also reversed pre-training muscimol induced amnesia (P<0.01). Pre-test intra-CA1 injection of prazosin 2 min before administration of the effective dose of muscimol inhibited muscimol state dependent memory (P<0.01). It can be concluded that the α1-adrenergic receptors of the CA1 may play an important role in the muscimol state dependent learning, on the test day.

Carpal tunnel syndrome (CTS) is the most common form of peripheral entrapment neuropathy. The use of sonography for investigation and diagnosis of musculoskeletal conditions has been rapidly increasing over the past few decades. The purpose of this study was to determine whether sonography can be an alternative method to nerve conduction study (NCS) in the diagnosis of CTS. This prospective cross-sectional descriptive study included patients with electrodiagnostically proven CTS and healthy control subjects. Anthropometric and demographic data included age, height, body mass index (BMI), sex, occupation, medication history, hand dominance, and underlying disorders associated with CTS. Median nerve Cross-Sectional Area (CSA), Flattening Ratio (FR), and flexor retinaculum thickness were measured. Then, we compared the results between ultrasonography and nerve conduction study. In this study, we assessed 120 wrists with CTS (cases) in 90 patients and 60 healthy wrists in 30 patients (control group). CTS was mild in 57, moderate in 29, and severe in 34 wrists. Post hoc comparisons between the patients with CTS and controls demonstrated that the cross sectional areas at various levels of the median nerve were significantly greater in the CTS group compared to the control group. CSA at the tunnel inlet with a threshold higher than 9.15 mm2 showed the best diagnostic accuracy with a sensitivity and specificity of 99.2% and 88.3% respectively. Cross-sectional areas of the median nerve in mild, moderate and severe carpal tunnel syndrome showed statistically significant differences. Ultrasonographic measurement of the cross-sectional area of median nerve is useful for the diagnosis and grading of CTS. Use of sonography as the first-line measure may effectively reduce the number of nerve conduction studies in the diagnosis of CTS.

Cholinergic and dopaminergic systems of the brain play an important role in learning and memory. In the present study, we assessed the role of dopamine D2 receptors of the dorsal hippocampus in scopolamine induced amnesia and scopolamine state-dependent memory in adult male rats. In this experimental study 200 adult male Wistar rats were used (25 group). Rats were anesthetized and then placed in a stereotaxic apparatus. Two stainless-steel cannula were placed 1 mm above CA1 region of dorsal hippocampus. One week later animals were trained in a step-through type inhibitory avoidance task. Pre-training intra-CA1 administration of scopolamine impaired memory retrieval on the test day. The memory impairment induced by pre-training injection of scopolamine was reversed by pre-test administration of scopolamine or quinpirole, which indicated scopolamine induced state-dependent learning and the effect of dopamine D2 receptors of the dorsal hippocampus on this type of learning. Furthermore, memory impairment was produced following pre-test intra-CA1 injection of dopamine D2 receptor antagonist, sulpiride. Pre-test intra-CA1 injection of sulpiride also inhibited scopolamine-induced state-dependent memory. These results suggested that dopaminergic D2 receptors of the dorsal hippocampal CA1 region may play an important role in scopolamine-induced amnesia and scopolamine state-dependent memory.

Environmental contaminants such as bisphenol A, in addition to the environmental problems can affect human health. Epigallocatechingallat has been found to have antioxidant and cytoprotective properties in cultured cells but its effect on toxicity induced by bisphenol A has not yet been determined in mesenchymal stem cells. The aim of this investigation was to study the protective role of epigallocatechingallat in rat bone marrow mesenchymal stem cells following treatment with bisphenol A(an oxidative stress inducer). In this experimental study, rat bone marrow mesenchymal stem cells were extracted using flashing-out method and cultured in DMEM containing 15% FBS and 100U/ml Pen/Strep. At the end of the third passage, cells were divided into 4 groups: control, bisphenol A, bisphenol A + epigallocatechingallat and epigallocatechingallat. The groups were treated for 12, 24, 36, and 48 hrs. After treatment with bisphenol A and epigallocatechingallat, viability, morphology, rate of DNA damage and calcium content of the cells were evaluated. Data were analyzed by one way ANOVA. p<0.05 was considered significant. Bisphenol A caused a significant reduction in the viability and calcium content of the cells. In addition, morphological changes such as nuclear breakage and chromatin condensation, as well as cytoplasm shrinkage, were observed in the group treated with bisphenol A. We found alterations in these parameters in the group of bisphenol A+ epigallocatechingallat which were similar to those observed in the control ones. Epigallocatechingallat can produce a protective role against the toxic effects of bisphenol A in the mesenchymal stem cells.

Diagnosis, treatment, consequences, treatment side effects and recurrence of breast cancer can lead to depression, anxiety and stress. Cognitive behavioral group therapy is one of the most effective interventions in the women with breast cancer. The aim of this study was to investigate the effect of cognitive behavioral group therapy on depression, anxiety and stress in the women with breast cancer. This was a quasi-experimental study with pretest/posttest and control group. We used purposive sampling and selected 24 women with breast cancer who had been admitted to Ahwaz Medical Sciences Hospitals. The patients were assigned to control and experiment groups (12 patients in each group). Measurement tools included Depression, Anxiety, and Stress Scale-short Form (DASS-21) and intervention method was cognitive behavioral group therapy which consisted of 10 weekly 90-minute sessions. Data analysis was performed by means of descriptive statistics (mean and standard deviation) and inferential statistics (one-way analysis of covariance). The results revealed that cognitive behavioral group therapy had significant effects on decreasing depression, anxiety, and stress in the experimental group compared to the control group (p< 0/001). Cognitive behavioral therapy in oncology centers can be considered as a complementary therapy along with medical therapies and can have an essential role in the improvement of the relationship between doctor and patient.

Stroke is one of the main leading causes of mortality and disability in many countries. In the absence of definitive treatment search for, neuroprotective agents with minimal side effects should be continued. Natural nutrients can be ideal sources to produce safe and valuable agents for the management of stroke. Walnut kernel (WK) has numerous beneficial components with antioxidant and anti-inflammatory properties. The goal of this study was to investigate the protective effects of WK on neuronal injury and astrocyte reactivity after induction of focal cerebral ischemia in male rats. In this experimental study, Wistar male rats were divided into three groups: sham, control (fed with ordinary food) and walnut (fed with WK). Each group consisted of 6 rats. The right middle cerebral artery was occluded for 15 min in the control and walnut groups. Forty-eight hours after reperfusion the animals were killed and their brains were processed for histological (Hematoxylin and Eosin staining) and immunohistochemical (Glial Fibrillary Acidic Protein, GFAP), and histochemical (TUNEL) studies. The results showed that WK significantly decreased neuronal death induced by cerebral ischemia; however, the density of GFAP positive astrocytes has been increased at the site of injury in the treatment group compared to the other 2 groups. In addition, WK significantly decreased the mortality rate of the animals due to cerebral ischemia. The results suggested that wk might provide protection against the cerebral ischemia-induced injuries in the rat brain through antioxidant and anti-inflammatory mechanisms.

Intron 3 16 bp duplication polymorphism of p53 gene has been associated with increased risk of colorectal, breast and lung cancers. Nevertheless there are inconsistent results and we need more studies to understand the importance of this polymorphism in increased risk of cancer predisposition. The aim of this study was to assess the association of 16 bp duplication polymorphism of p53 with thyroid cancer risk. This case-control study included 105 thyroid patients and 170 controls. Cases and controls were matched for age, sex and ethnicity. Genomic DNA was extracted from peripheral blood samples and tumor tissues. P53 PIN3 genotype was determined using PCR products length analysis on polyacrylamide gel. In the control and case groups, 62.9% and 53.3% had no 16 bp insertion, 7.1% and 8.6% had insertion in both p53 alleles and 30% and 38.1% were heterozygous, respectively. There were no significant differences between the case and control groups in regard to genotype frequencies as well as allelic frequencies. According to the results of our study PIN3 16 bp duplication polymorphism of p53 could not be considered as a risk factor for predisposition to thyroid cancer in northwest of Iran.

Hypothalamic – pituitary- adrenal (HPA) axis and leptin changes have main role in the development of obesity. The purpose of this study was to investigate the effect of progressive aerobic training on leptin, insulin, cortisol, and testosterone in obese sedentary men. 30 obese sedentary men was randomly divided into exercise (n=15) and control (n=15) groups. The exercise group performed an aerobic training with 55-70% of heart rate reserve, 3 days per week for 12 weeks. Body fat percentage and serum levels of leptin, cortisol, testosterone, insulin, and glucose were measured at baseline and after training. The results showed that 12 weeks of progressive aerobic training caused a significant decrease in body fat percentage (P= 0.001), and serum leptin (P=0.001). Also a significant increase in serum testosterone level was observed (P= 0.001). However, no significant changes were found in the cortisol and insulin hormone levels, and insulin resistance (P>0.05). Also, there was a significant relationship between changes in the serum levels of leptin and changes in the percentage of body fat (P=0.035, r= 0.48). Finally, it can be concluded that the progressive aerobic training can reduce serum leptin levels in obese men. However, this training had no effect on the alterations in the levels of cortisol and insulin, as well as insulin resistance in obese sedentary men. Reduction of serum leptin levels may be associated with a change in the body fat.

Emergence of antibiotics resistant pathogenic bacteria has resulted in attempts by scientists to find new drugs as alternatives to antibiotics. The aim of this study was to evaluate the antibacterial effect of stem bark extracts of Tamarix ramosissima on Pseudomonas aeruginosa isolates. This study was conducted in Kermanshah University of Medical Sciences, in 2013. The stem bark of T. ramosissima shrub was separated. Using the petrolatum ether, dichloromethane, ethyl acetate, ethanol and hydro ethanol, T. ramosissima extract was prepared. We assessed the susceptibility of 52 isolates of P. aeruginosa to the extracts by standard disk diffusion and minimum inhibitory concentration (MIC) methods. The results showed that low concentrations of the extracts had no obvious effect on 52 isolates of P. aeruginosa. But higher concentrations of the extract were effective against a number of isolates. The petrolatum ether extract was effective against five, dichloromethane extract against six, ethyl acetate extracts against eight, ethanol extract against nine and hydro ethanol extracts against six isolates. MIC of the extracts had a little effect in comparison to the controlled antibiotics. In general, the difference between the effect of the extracts and the control antibiotics was considerable and statistically significant which indicated little effect of the extracts on the bacteria. Increased concentrations of the extract showed a slight effect on P. aeruginosa in vitro, compared to the controlled antibiotics, but it was not statically significant. In order to understand whether traditional use of the extract of this shrub to treat skin ulcers had been due to its anti-bacterial or anti-inflammatory effect, in vivo experiments on animals are necessary.

In the steel industry, workers are often exposed to high concentrations of dust particles of raw materials such as iron ore, coke, manganese, and metal fumes such as iron oxides, manganese and silicon which can affect respiratory function. The purpose of this study was to evaluate the relationship between exposure to respiratory pollutants and pulmonary function tests capacities in steel factory workers. In this historical cohort study, a total of 260 workers were divided into two groups. One group was exposed and the other group was not exposed to respiratory pollutants. Environmental sampling was used to evaluate the type, distribution and exposure rate. In order to evaluate respiratory problems and lung function of the workers we used ATS standard questionnaire and spirometry, respectively, based on ATS/ERS guidelines. The mean total dust levels measured in bag filter, blast furnace, material supply and casting units were 13.32, 12.015, 11.75 and 10.98 mg/m3 respectively. The measured mean values for fume particles in blast furnace and casting units were 8.54 and 6.81 mg/m3 respectively. 37.6% of the workers had a history of respiratory symptoms, 32.3% of them were among the exposed group (p<0.05). Mean percentages of FEV1/FVC were significant in exposed and unexposed groups. Mean percentages of FVC and FEV1 in the exposed group were lower than those of ATS standard range, but the relationship was not significant. It seems that workers exposed to pollutants are at risk of developing respiratory symptoms and reduced spirometric indices. Therefore, appropriate measures should be considered to reduce the impact of pollutants.