مجله علوم پزشکی رازی
سال بیست و دوم شماره 11 (پیاپی 140، بهمن 1394)

The present study was carried out to examine the effectiveness of Mindfulness and Acceptance-Based Group Therapy on decreasing fear of negative evaluation in patients with social anxiety among female students.
In the first stage, Social Phobia Inventory (SPIN) was administrated to 402 female student of Shahed University, In the second stage 24 socially anxious student screened by SPIN and (Structured Clinical Interview for DSM-I) (SCID-I) were randomly assigned to experimental group (13 subjects) and control group (11subjects). Then Mindfulness and Acceptance-Based Group Therapy administered to the experimental group, while control group didn`t attend in any treatment session. All participants completed measure of brief version of the Fear of Negative Evaluation Scale at pretreatment and post treatment and three month follow up.
The result of Mann Whitney test revealed significant reduction in fear of negative evaluation in experimental group than control group (p In sum, Mindfulness and Acceptance-Based Group Therapy can improve fear of negative evaluation among a sample of Iranian female students. Therefore a ground has been provided to apply this approach preliminary in psychological centers on patients with social anxiety disorder.

Ranking hospitals are important for their staff motivation and lifting spirit of competition and effort. Ranking hospital is not take place unless an accurate assessment is encouraged. In this study, we used FMCDM, BSC approaches to rank Shiraz University of Medical Sciences’ teaching hospitals.
This is a case study. Statistical population consisted of 12 teaching hospitals affiliated to Shiraz University of Medical Sciences. For ranking these hospitals, four fuzzy multi-criteria decision tools including Fuzzy DEMATEL, Fuzzy ANP, Fuzzy TOPSIS and Fuzzy VIKOR were used. Excel software was used for analysis of data.
Based on fuzzy VIKOR results, the worst options were Ghotbodin, Namazi and Rajai hospitals, respectively. These three options obtained the lowest value of the performance in the 3 top indexes on the scale fuzzy decision matrix TOPSIS method. This means that the strengthening of the 3 criteria must be a very important factor in determining growth strategies of Ghotbodin, Namazi and Rajai hospitals. Dastgheib, Shoushtari and Khalili Hospitals are among the best options that obtained the highest value in the decision matrix Scale Fuzzy TOPSIS method for 3 superior indexes.
The point to note is that, it is true that these 3 hospitals are known as the best hospitals, but in "the successful CPCR" criteria as the most important selection criteria, did not obtain not the highest scores. As a result, if these hospitals become more degraded in the future under the criteria of "the successful CPCR", they will lose their high rank among other options.

Musculoskeletal disorders are one of the main causes of morbidity worldwide with different impacts on mental health characters of employees. There are some evidence that show adverse impacts of mental health impairment on worker and their work tasks. Present study was performed for assessment of association between mental health and musculoskeletal disorders among employees of Fars ABFA Company.
Employees of ABFA Company consisted participants of present cross sectional study which was performed at 2014. Nordic and general health questionnaires were used for data gathering.
Mean of total GHQ score and somatic, depression and anxiety subscales were significantly higher in workers with low back pain compared with other workers. General health status in workers with low back pain was poorer than other workers.
Findings of our study showed that general health status in workers with low back pain was lower than other workers. Knowing about psychosocial factors which had impact on low back pain can be useful in controlling and preventing the complication among working and decreasing their disability risks.

Multiple sclerosis (MS) is a chronic disease of the central nervous system in which the myelin of the central nervous system (brain and spinal cord) is damaged. The most common symptoms are double vision, tremor, muscle cramps, ataxia, and abnormal gait. The purpose of this study was to determine the effect of 8-weeks core stabilization and Yoga exercises on balance in MS patients.
The study samples were 36 women with MS (25 to 40 years) with the EDSS (Expanded Disability Status Scale) level of disability of 3 to 6. Patients were randomly divided into 3 groups. 12 patients in the group of core stabilization exercises (2 sessions per week, 40-30 minutes), 12 patients were in group Yoga (3 times a week, each session lasting 70-60 minutes practice Hatha Yoga), and the 12 patients in the control group. Patients exercised for eight weeks. Balance of patients before and after 8 weeks of training was analyzed. Data analysis was performed using SPSS 16, p≥0.05 was considered significant.
The balance between pre-test and post-test in Hatha Yoga exercise group (33.75 vs. 43.08) and core stabilization exercise group (37 vs. 47.08), significantly improved (p≤0.05). But there was no statistically significant difference between the two groups (p≥0.05).
Core stabilization exercises and Yoga can improve balance in patients with MS. On the other hand, no significant differences between two groups’ balance after exercise depicted the same effectiveness of both types of exercise to improve balance in MS patients.

Tinnitus is a specific auditory sensitivity in which the patient hears nonexistent sounds. From neurological point of view, in majority of them increment in neural activity has been proposed characterized by increase in spontaneous firing rate in central auditory system. According to a hypothesis, tinnitus is a result of abnormal synaptic plasticity and reduced inhibitory aminoacidic NTM in auditory neural network. This compensatory reduction of inhibition to partial deafferentiation (due to hearing pathologies, acoustic trauma,…) results in elevated neural firing rate and hyperactivity mainly in fusiform cells in DCN. In this review article was Effort survey effect of DCN synaptic plasticity and tinnitus.
At this Review Article, some articles about synaptic plasticity and tinnitus in DCN from electronic databases of Google scholar, PubMed and Scopus and Science Direct were searched from 1988 up 2013 and some of theme select and Survey.
DCN the lowest level of Auditory system that synaptic plasticity and hyperactivity after hearing impairment occur there. This Event tendency to tinnitus .But this Concept, not meaning to NO Cooperation of other auditory center in tinnitus. KEY WORDS :tinnitus, synaptic plasticity, Dorsal Cochlear Nucleus(DCN)

Walking pattern of patients with diabetic neuropathy differs from healthy subjects. Any intervention that makes changes to this compensatory strategy may increase fall risk in these patients. Rocker sole shoes are frequently prescribed to patients with diabetic neuropathy in order to prevent forefoot plantar ulceration. The purpose of the current study was to explore effects of the toe only rocker sole on some gait characteristics in diabetic patients with neuropathy.
Seventeen patients with diabetic neuropathy participated in this study. An average of the step length, step width and walking speed was measured while performing walk across test using Neurocom system with and without toe only rocker sole. Statistical analysis was carried out using SPSS statistical software (Version 18.0). To determine the normality of the distribution of the data, Kolmogorov-Smirnov test and to compare the mean of the data between two conditions, paired-samples t-test were performed.
No significant difference was observed between walking with rocker sole and without it in any of the step length (59.09±11.37, 57.66±13.03), step width (17.21±5.08, 16.53±4.24) and walking speed (81.92± 17.6, 84.48± 20.02), respectively (p>0.05).
Toe only rocker sole made no alteration in compensatory walking pattern of patients with diabetic neuropathy they use either to reduce peak plantar pressure or enhancing dynamic stability.

Studies indicate that using interventions including education may improve medical record documentation and decrease incomplete files. Since, having perfect summaries especially in Rheumatology disease is helpful in treatment process, the researchers aimed to examine the effect of patient post discharge conference on recording summaries skills. This interventional quasi experimental study was conducted in 2013-2014 on 36 resident of internal medicine in rheumatology ward of Firoozgar hospital. These conferences are held every two weeks and in order to assess conferences on function of residents, a checklist is designed. The checklist contains 19 items. The checklist had formal validity based on data elements in the records.
Data were analyzed by SPSS for windows (version16) through descriptive statistics and Chi-square test. Before conferences, 18 (50%) of residents had week function, 12 (33.3%) moderate function and6 (16.7%) of them had good function. After conferences, 1 (2.8%) of residents had moderate function and 35 (97.2%) good function. The study showed statistically significant relation between before and after conferences on function of resident (p=0.012). Holding patient post discharge conferences has significant effect on recording summaries skills of Residents and their promotion of education

Nowadays one of the most common causes of death is cancer worldwide, which its incidence and mortality rate dramatically increasing in Iran. Saffron herb is locally grown in South Khorasan. The present study reviewed the anticancer properties of saffron stigma on various macromolecule, cell, and animal models. In traditional medicine saffron herb treated many diseases including diabetes, blood pressure and cancer. The modern medical findings indicate that this herb and its active metabolites can be used to produce alternative antitumor drugs. Saffron selectively suppressed growth and proliferation of cancer cells while did not show any inhibitory effect on growth of normal cells. In addition, it reduced the side effects of common therapies. The main components of saffron stigma are monoterpene aldehydes and carotenoides. Its carotenoids, for instance crocin and crocetin, illustrated antioxidant, anticancer and antimutagenic properties more than other metabolites. This review suggested that anti-tumor drugs from saffron stigma can be applied as alternative, safe and promising agents.

Osteoarthritis is one of the ten debilitating diseases in developing countries. This study was designed to examine the effect of Burdock root tea on lipid profile and blood pressure in patient with knee osteoarthritis (OA).
This was a randomized one-way blinded 6- week clinical trial. Thirty-six patients (10 men and 26 women) aged 50-70 year-old with knee osteoarthritis referred to the physical medicine and rehabilitation department of the Tabriz University of Medical Sciences Hospitals, were selected for the study and divided into two groups randomly. For all individuals along the 42 days of study period, the same drug treatments including physiotherapy (20 an-hour sessions for both knees) and two lots of 500 mg acetaminophen twice a day and one glucosamine 500 mg once a day were considered. The intervention group received daily 3 cups of Burdock root tea Control group received 3 cups contain 150 cc boiled water daily. Venous blood samples were collected at baseline and after 6 weeks the intervention to measure lipid profile parameters and their ratios before and after the intervention. Systolic and Diastolic blood pressure were also measured and analyzed. Anthropometric measurements, physical activity levels and nutrients intake were evaluated before and after intervention. Differences between the two groups and among the each group were analyzed using independent t-test, Mann-Whitney U-test, analysis of covariance, paired sample t-test, Wilcoxon Signed Ranks Test, sign test, chi-square and McNemar test. SPSS 16 was used for statistical analysis.
A significant reduction in levels of total cholesterol, TC/HDL-C and LDL-C/HDL-C ratios, systolic, diastolic and mean systolic and diastolic blood pressure and a significant increase in HDL-C levels was observed in intervention group compared with the control group (p The results showed that Arctium lappa l. root tea consumption with reduction in blood pressure, levels of LDL-C, ratios of TC/HDL-C and LDL-C/HDL-C and increase in levels of HDL-C could control and improve lipid profile and blood pressure status in patient with knee osteoarthritis (OA). But yet, the mechanism of effects of hypolipidemic and decrease in blood pressure of Arctium lappa l. is not clear, so more studies are need in this field.

The importance of reforms in the health care system and improve the quality of health care as one of the important results of it has always been noticeable. In this regard, the efficiency and effectiveness of hospital activities, proper functioning of staff and proper use of resources be evaluated by functional indicators. Hospital indicators show the status of hospital's performance and its society. In this article, we aimed to study the impact of health system reform on hospital indicators such as clinical, paraclinical and surgical indicators, Patients satisfaction in Rasoul-e-Akram hospital.
This cross-sectional study was performed at Rasoul-e-Akram general hospital. The study population consisted of Rasoul-e-Akram general hospital indicators. In this regard, information collected by referring to the existing table's record from 2013 to 2014. To analyze the data, it was applied the paired t test to compare quantitative variables between the two time periods from 2013 to 2014. The repeated measure ANOVA test was also used to assess the trend of the changes in frequency of the items. The analyses were performed by the SPSS software.
The results of comparing surgery item between 2013 and 2014 showed increase in accessibility to surgical procedures. According to the obtained results, heath system reform in this hospital increased the amount of clinical and paraclinical reception. Furthermore patient satisfaction was also increased
Implementation of the health reform plan had been succeeded in improvement of healthcare indicators in our center.

Epigenetic modification is one of the effective factors in tumorigenesis. Epigenetic processes, especially aberrant DNA methylation, play important role in thyroid cancer, and many tumor suppressor genes including PTEN, RASSF1A and TIMP3 are aberrantly methylated and silenced in thyroid cancer. Because of the specified pattern of DNA methylation in various tumor cells, it is suggested that these genes take part in a specific pathway. In addition to tumor suppressor genes, aberrant methylation in thyroid-specific genes such as those for sodium/iodide symporter and thyroid-stimulating hormone receptor is also common in thyroid tumorigenesis and progression. On the other hand, changes in these genes expression is one of the main cause for the failure of clinical radio-iodine treatment in subjects with thyroid cancer. Considering the importance of this issue, the present study intends to investigate the DNA methylation patterns of related genes in thyroid tumorogenesis.

Vitamin D has a vital effect on calcium and phosphor hemostasis and bone formation. Deficiency of vitamin D causes rickets in children and osteomalacia in adults. Vit. D has a regulatory effect on immune system. This vitamin has inhibitory effect on cytokines and stimulates production of antimicrobial peptides. Recent studies have shown that rickets and even subclinical insufficiency of vit. D has a direct relation with pneumonia. This study was done in purpose of evaluation of vit. D serum level in small children with pneumonia.
This is a descriptive study. The personal data’s of 50 children between 2 and 59 months old who were hospitalized due to pneumonia (name, age, sex, weight and height) and their vaccination, nutrition (breast milk) and measured serum vit. D level were recorded and analyzed.
The mean of serum vit.D level was 31.78±1.75. The vit. D level in 22 patients was less than 30ng/ml (44% insufficiency or deficiency) and in 28 patients (56%) it was more than 30ng/ml. 5 patients had vit.D level under 10ng/ml (severe deficiency in 10%). This study did not show any relation between vit. D level and severity of pneumonia or duration of hospitalization.
This study shows that the mean of serum vit. D level in children with pneumonia is significantly low. But it needs to do a study with normal control group for comparing their mean vit.D level.