مجله دانشگاه علوم پزشکی مازندران
پیاپی 112 (اردیبهشت 1393)

Background and The professional burnout is one of the main factors in efficiency decline, loss ‎of human power and psycho-physical problems. In regard to the importance of emergency medical workers’ role in ‎health system, the aim of this study was to compare the professional burnout of emergency medical workers of ‎Mazandaran University of Medical Sciences and its related factors.‎ In this descriptive correlational study, the samples were chosen by random ‎classification. Sample consisted of 155 emergency medical workers of Mazandaran University of Medical Sciences. ‎Instrument used was the standard Maslach burnout inventory (Maslach et al.) and questionnaire of related factors ‎of burnout such as personality, management, contact and economic factors.‎ In this study, emergency medical workers showed highly depersonalization and moderate ‎emotional exhaustion and reduced accomplishment. In order to related factors of burnout, economic factors were ‎the most and personality factors were lowest role. There was a positive association between emotional exhaustion ‎and personality and economic factors (P < 0.001). Depersonalization also had a positive correlation with ‎educational level ‎(P < 0.001) and personality factors (P < 0.001) and management factors (P < 0.001).‎ According to the results of this study and importance of emergency medical workers’ job, ‎promoting the economic and management problems of these personnel are important.‎

Background and One of the most important challenges in nanomedicine is timely diagnosis and effective treatment of chronic disease. The aim of this research was to synthesize and characterize 3-layered magnetic silica nanocomposite with simultaneous application as a contrast agent in magnetic resonance imaging (MRI) and for drug delivery. In this research, magnetite iron oxide nanoparticles by co-precipitation method, first layer of silica by a method similar to Stober method and second layer (mesoporous silica) by removing template method were produced. Existence or deletion of surfactant molecules by Fourier Transform Infrared (FTIR) spectroscopy, particle size and morphology of particles by high resolution scanning transmission electron microscopy (HR-STEM), magnetic properties of particles by vibrating sample magnetometer (VSM) instrument, mesoporous structure by Brunauer-Emmett-Teller (BET) method and also crystalline structure of nanocomposite by X-Ray diffraction (XRD) method were investigated. Diphenyltetrazolium bromide (MTT) and lactate dehydrogenase (LDH) assays were used to study cytotoxicity of the produced particles. Produced 3-layered nanocomposite had the size of 180 ± 10 nm, specific area and average pore diameter of 390.4m2/gand 3.01 nm, respectively. The saturation magnetization value of nanocomposite was 21 ± 0.5 emu/g. Cell cytotoxicity of nanocomposite with human prostate carcinoma epithelial-like cell line Du-145 and erythroleukemia cells K562 were reviewed. The results revealed that synthesized nanocomposite enhanced no cytotoxicity in tested concentrations. The result of present study illustrated that produced nanocomposite has preliminary essential capability to be used as MR imaging agent and drug delivery system.

Background and Umbilical cord derived Wharton's jelly is an enriched and accessible ‎source of stem cells with highly proliferative and differentiation potential. This study aimed to evaluate the ‎surface markers and related genes of the stem cells isolated from the human Wharton's jelly.‎ Explants of the human umbilical cord derived Wharton's jelly was dissected ‎and cultured in Dulbecco's modified Eagle's medium (DMEM) supplemented with 20% Fetal bovine serum ‎‎(FBS). Then, those cells migrated from explant's boundary were replated and passaged in DMEM containing ‎‎10% FBS. Finally, by using flowcytometry and (Reverse–transcriptase polymerase chain reaction) RT-PCR ‎techniques different surface markers and related genes were analyzed.‎ 5-7 days post-plating, the stem cells initiated the migration from cultured explants and ‎showed up to 80% densities on days 16-18. Light microscopy demonstrated two distinct cell populations ‎including fibroblast-like and flat endothelial-like cells. Dual staining with flowcytometry also revealed that ‎the cultured cells were found to be positive for CD44, CD73, CD90, CD105 and negative for CD34 and CD45. ‎RT-PCR showed no changes in CD marker expression pattern during different passages.‎ Human Wharton's jelly derived stem cells appear mesenchymal cell morphology and ‎express related surface markers but no hematopoietic stem cell markers.‎

Background and Because of theirmultipotency and ease of purification, amplification and ‎immunomodulatory properties Mesenchymal stem cells (MSC), are anideal stem cell source for cell therapies. ‎This study was done to investigat the effect of Rat MSCs on the survival neutrophils.‎ MSCs was isolated from rat (6-8 weeks) femoral and tibial bone marrow and ‎cultured in DMEM. Then maturation MSCs were incubated with neutrophils isolated from peripheral blood of ‎rat at 37 ° C for 1 h. Neutrophil survival was measured at 6 and 24 h incubation with of MSCs by flow ‎cytometric analysis using An/PI. Data were analyzed by SPSSsoftware, followed by Tukeytest at a significance ‎level of (P<0.05).‎ The 6-hour incubation of neutrophils with MSCs, significantly reduced the percentage of ‎normal cells and increased apoptosis compared to controls and increased cell necrosis was not significant in ‎the treated group than in control. The 24-hour incubation of neutrophils with MSCs, significantly increased the ‎percentage of healthy cells and apoptosis was reduced compared to the control group, and reduced cell ‎necrosis was not significant in the treated groups than in control (p<0.05).‎ In spite of the clinical importance of MSCs, some biological aspects of them including ‎their self-renewal, proliferation and immune modulatory effects are of great therapeutic potential for cell ‎therapy.‎

Background and Toxoplasmosis is a common parasitic disease throughout the world and ‎one-third of the population has antibodies to Toxoplasma gondii. This disease causes serious medical ‎problems in fetuses and immunocompromised individuals. As gene encoding protein GRA14 can be ‎considered as a suitable target for DNA vaccine and designing diagnostic kits; the aim of this study was to do ‎cloning and sequencing the gene encoding GRA14 protein of Toxoplasma gondii RH strain.‎ DNA extraction was performed on harvested tachyzoites from mouse ‎peritoneal fluid, then PCR carried out and amplification products were analyzed by gel electrophoresis. ‎GRA14 gene was cloned in pTG19-T as a cloning vector, then recombinant plasmid confirmed by the colony-‎PCR and restriction enzyme digestion using HindIII and EcoRI, followed by sequencing.‎ Evaluation of PCR products by agarose gel electrophoresis and analysis of nucleotide ‎sequencing of 1227 bp gene encoding the protein GRA14, revealed the complete homology with the recorded ‎sequences in the gene bank. Furthermore, cloning of GRA14 gene in pTG19-T vector was confirmed with ‎colony PCR and restriction enzyme digestion.‎ The results showed that the GRA14 gene was successfully cloned into the pTG19-T ‎vector and this plasmid can be used to design DNA vaccines and diagnostic kits in further studies.‎

Background and Road traffic injury (RTI) is one of the major health problems that can ‎threat human health. This study was done aimed to determine mortality and years of lost life (YLL) due to RTI ‎in Kermanshah, Iran.‎ This cross-sectional study was used the Death Registration and Forensics ‎Medicine census data. YLL was calculated according to Global burden of disease (GBD) 2010 guideline and ‎age and sex composition of the population was taken from Statistical Center for 2010. All data collected ‎entered into Excel software and performed calculations.‎ The mean age of 974 subjects studied was 39.05 ± 20.7. 81.1% of dead peoplewere males. The ‎most frequent cause of death was related to accident with cars (40.8%). The mortality rate of RTI in ‎Kermanshah province was 51.3 per 100,000 populations and by sex were 82.4 in males and 19.5 cases per ‎‎100,000 in females. The years of life lost due to premature mortality obtained 38,345 (40 per 1,000) in males, ‎‎8267 in females (8.7 per 1000) and 46,613 (24.5 per 1,000) in both sexes. The highest YLL rate in both sexes ‎was in the age group 30-34 (30.3 per 1,000).‎ According to the high mortality rate and YLL due to RTI in Kermanshah province, it ‎seems to be necessary appropriate intervention programs done to prevent and minimize road accidents.‎

Background and Administration of high dose of remifentanil and propofol provides adequate coditions for tracheal intubation without musclerelaxants. Intubating conditions with meperidine, propofol and low doses of remifentanilcompared in this study. After premedication withmidazolam 0.03 mg/kg and meperidine1mg/kg, 60 patients under orthopedic surgeryrandomized equally to one of two study groups, each receiving the following: remifentanil 1 (Group I) or 1.5 µg/kg (Group II). remifentanilwas injected, anesthesia was induced withpropofol 2mg/kg. Ninety seconds after the administration of propofol, laryngoscopy and intubation were attemped. Intubation conditions were assessed as excellent,good or poor to ease of laryngoscopy, vocal cord position, coughing and jaw relaxation. There were no significant differences in the assessments of intubating conditions between the two groups(P=0.56). Compared with the baseline levels, the decrease in mean arterial pressure and heart rate were significant in two groups after anesthetic induction and endotracheal intubation(P<0.001). No patient needed treatment for hypotention or bradycardia. Our results show that meperidine, low doses of remifentanyl(1-1.5µg/kg) and propofol provided excellent or good conditions for tracheal intubation in healthy patients.

Background and The present study aimed to review honesty-humility, emotionality, ‎extraversion, agreeableness, conscientiousness and openness to experience (HEXACO) personality ‎dimensions emotion regulation and stress coping strategies’ role in predicting the quality of life (QoL) in ‎migraine peoples.‎ This was a descriptive research and the research design was correlative. The ‎statistical population included all migraine patients referring to therapeutic centers at Shiraz, Iran in 2013. The ‎available sampling method was used. Therefore, 100 migraine patients referring to centers were selected and ‎filled in the research questionnaires. The Quality of Life Questionnaire, shorten form of HEXACO Personality ‎Questionnaire, Gross and John Emotion Regulation Scale and stress coping strategies questionnaires were used ‎to collect the data.‎ The data were analyzed by Pearson’s correlation index and multivariable regression analysis. ‎The results showed that a correlation have of emotionality (r = -0.298), extraversion (r = 0.276), ineffective ‎coping strategy (r = 0.111), emotional coping strategy (r = -0.216), re-evaluation strategies (r = 0.129) and ‎suppressing emotions (r = -0.152) with the QoL in migraine patients. In addition, the results showed that 28% ‎of QoL variance was elaborated using HEXACO personality dimensions, type D personality and positive and ‎negative emotions.‎ It can be concluded that HEXACO personality dimensions, type D personality and ‎positive and negative emotions play a major role in quality of life in migraine patients based on these findings.‎

Background and Diseases have been the greatest threat for human being along the history. ‎Heart disease (HD) has gained special attention in medical studies. Recently studying on classification and ‎diagnosis of HD as a key topic and a lot of researches have been done in order to increase precise and reduce ‎error in this type of decisions. With development of intelligent learning systems, these systems have played a ‎great role in reducing the error of decision support systems (DSS).‎ In this study, a simple hybrid model of logistic regression and single-layer ‎perceptron neural network was presented which was trained with four-different learning rules (separately). ‎The model for improving the classification and patterns recognition of HD has been used on clinical data of ‎‎270 patients from the Cleveland Clinic (UCI website). This method has been used in statistical data ‎normalization and detection of noisy data, network training with only 20% of the data exist was performed. ‎The model has been implemented in MATLAB.‎ The mean-error of the proposed model on the total dataset was 11.11%, which was achieved a ‎significant improvement compared to recent similar methods. In addition, the results showed that the proposed ‎approach was very capable in dealing with noise in the data‏.‏ The results clearly showed that the linear proposed technique had large impact on ‎reducing the error in the classification and identification of patients more accurately in a shorter time than ‎conventional methods and complex nonlinear. The method can help physicians for early detection of disease ‎or as a DSS.‎

Background and Mortality is a natural and critical event and always has been intentioned ‎as a biological, demographic, social and economic phenomenon. One of the dimensions of mortality reviewing ‎is checking causes of death and determining life expectancy. Some causes of death lead to severe reduction in ‎life expectancy. In this survey, the value of gain in life expectancy of 28 provinces in Iran was estimated after ‎elimination of each death cause.‎ This study was based upon number of deaths in 2010 in Iran except two ‎Tehran and Isfahan Provinces which was prepared by the ministry of health, treatment and medical education.‎ The importance of causes of death was determined using multiple decrement life tables which ‎are based on theory of competing risks and effect of cause elimination on the gain in life expectancy. All the ‎calculations in this survey were done by SAS version 9.1. Unintentional injuries and cardiovascular diseases ‎were the most important risks for men. Elimination of unintentional injuries and cardiovascular diseases lead ‎to 2.17 and 1.23 years gain in life expectancy at birth for men. And for women, cardiovascular diseases were ‎the most important risks so that elimination of the risks leads to 1.23 years gain in life expectancy at birth‏.‏ Gain in life expectancy was different for causes of death and age groups. Elimination of ‎cardiovascular diseases and events leads to most years gain in life expectancy.‎

Background and Acute renal failure after cardiac surgery is a dangerous condition that ‎increases mortality and hospital costs. The present study aimed to evaluate the prevalence and associated ‎factors of acute renal failure in patients with open-heart surgery in Sari 2012.‎ This cross-sectional study with available data was performed on 250 patients ‎who referred to cardiac surgery department in Fatima Zahra Hospital, Sari, Iran from April to March 2012. ‎Creatinine levels, before and 3 days after surgery and associated factors, were collected using demographic ‎and medical data list. After data collection their analysis was performed using Chi-square test, Mann-Whitney ‎and t-test.‎ In this study, 58.8% of the patients were males and 41.2% were females. The mean age of ‎subjects was 60.75 ± 9.87. The most commonly associated disease was hypertension. The prevalence of renal ‎failure was 15% (in the first 48 hours after surgery). Results showed that age, history of hypertension and the ‎amount of intra operative blood transfusion have been correlated with acute renal failure.‎ In this study, acute renal failure after open-heart surgery was 15%. This disorder can ‎cause problems for patients and their family and rise health care costs. The recognition of risk factors and ‎treatments are keys to reduce adverse outcomes.‎

Background and The precocious puberty in girls can have some adverse effects such as growth stoppage and subsequent short stature in comparison with predicted final adult height. GnRH agonists are now considered the treatment of choice for CPP. One of the side effects of these drugs is increased appetite and consequent obesity. During puberty a progressive reduction in the level of ghrelin has been reported. This study was aimed to assess the obesity and its relationship with ghrelin in girls with true precocious puberty treated with GnRH agonists. A sample of 20 consecutive girls with true precocious puberty was selected for this prospective observational study. They received 3.75 mg intramuscular GnRH every four weeks. Height, weight, body mass index, waist circumference, Tanner stage, body fat and serum ghrelin, were measured in the time of enterance to study and during follow up visits. The follow-up visits were carried out after 6 and 12 months. Mean age of the studied 19 child was 87.5 ± 10.1. Height and weight increased significantly after 6 and 12 months, P-value<0.01. The ghrelin level and body fat percentage demonstrated no significant change during the 12 months follow-up, P-value>0.05. There were not any significant relationships between neither ghrelin and BMI nor ghrelin and body fat percentage, P-value>0.1. It seems that treatment with GnRHa is effective. More importantly patients with increased BMI may need appropriate dietary consultation to accomplish their weight control during the course of the treatment.

Background and Non-alcoholic fatty liver disease (NAFLD) is one of the chronic liver diseases. () Microalgae – as a functional food and prebiotic agent - is supposed as a new approach in the treatment of NAFLD. Therefore, this study was aimed to assess the effect of microalgae Chlorella vulgaris (C. Vulgaris) supplementation on inflammatory factors in patients with NAFLD. This double-blind randomized placebo-controlled clinical trial was conducted on 70 NAFLD patients confirmed by ultrasonograohy and liver enzymes level. The subjects were randomly allocated into two groups: (1) “Intervention” (n=35) received 400 mg/d vitamin E plus four 300 mg tablets of C.vulgaris, (2) “placebo” received 400 mg/d vitamin E and four placebo tablets per day for eight weeks. Weight, dietary data and fasting serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), hs-CRP, tumor necrosis factor α (TNF-α) were assessed at baseline and after 8 weeks. Weight, ALT and ALP decreased significantly in both group after the intervention (p˂0.001). There were found significant reductions in AST and hs-CRP in the intervention group (p˂0.001). Intera-groups changes in TNF-α level was statistically significant (P˃0.05). C.vulgaris supplementation could improve liver function through decreasing weight, liver enzymes and hs-CRP concentrations after 8 weeks.

Background and Elongated styloid process and mineralization of stylohyoid ligament were ‎seen in 2 – 28% of patients on panoramic radiograph.This condition can create pain in head and neck region ‎or Eagle syndrome in some cases. The aim of this study was to assess the length of stylohyoidligament on ‎panoramic radiographs.‎ In this cross -sectional study, panoramic radiographs of 800 patients ‎referring to oral and maxillofacial radiology department of Babol dental school were examined for ‎measurement of styloid process. Length of the styloid process was measured as the distance from the point ‎where the styloid process left the tympanic plate to the tip of the process. Processes measuring more than 30 ‎mm were considered as elongated. The collected data was analyzed using statistical analysis software, SPSS ‎‎18. The T-test, Spearman rho and one-way ANOVA were used for analysis. For all tests the p-value of <0.05 ‎was considered significant.‎ The average length of the right styloid was 24.74(±6.99) mm and that of theleft styloid was ‎‎23.86(± 6.45) mm. The length of both styloids increased with age and males had longer styloids than ‎females.Elongated styloids were present in 19.8% of the panoramic radiographs, that 80(10%) showed ‎bilateral elongation of the styloid. Elongated styloid processes were more prevalent in the age-group of 30 – ‎‎50 years.‎ The results of this study was similar to previous studies. So,with considering the ‎relatively high prevalence of this lesion, the clinician must be pay attention to this lesion for diagnosis and ‎treatment of neck and head pain.‎

Probiotics are alive microorganisms which have useful effects on health of host by balancing its intestinal micro flora. Nowadays, probiotics are known as a factor for prevention of infectious diseases and cancer. Anti cancer properties of probiotics exert with the detoxification of materials that cause genetic damages. The present study aimed to systematically review on studies in checking positive effects of probiotics on health and their association with cancer. Related articles were searched in English at ACM, IEEE, Springer, Science Direct, Google Scholar, clinical trials and systematic review literatures that have assessed effects of probiotics at prevention and treatment of cancer, enrolled in this study. There was a wide variation among studies in imaging parameters, type of used probiotics, host type and test conditions. The results implied that probiotic bacteria and yeasts can eliminate toxicity of carcinogens and induce cancer cell death in vitro. In addition, consumption of probiotics caused reduced cancer risk, stimulation of immune system and struggle to carcinogens. Despite acceptable evidence about their anti-cancer properties, studies in humans are still limited. Therefore, there is a need to plan for detailed clinical studies on human in such a way obtained information can be used to treat.