مجله علوم پزشکی رازی
سال بیست و سوم شماره 2 (پیاپی 143، اردیبهشت 1395)

Students sleep pattern, due to the stress of studying and teaching workload are different with other non-student peers. The aim of this study was to determine the prevalence of poor sleep quality in college students of Iran by a meta-analysis study, to be as a final measure for policy makers in this field.
In this meta-analysis study, the databases of PubMed, Science Direct, Scopus, Google Scholar and interior databases were searched up to November, 2014. Between the studies with regard to the inclusion and exclusion criteria, 15 studies were selected. Data analyzed by using Stata11 software. Publication bias was assessed by Begg and Egger tests. Also heterogeneity assessed by Cochran’s Q statistic and I2 index. Couse of heterogeneity was evaluated by using meta-regression.
Total samples in the 15 studies were 3260. Begg and Egger tests with the P-value of 0.88 and 0.15 respectively, indicated the absence of publication bias. Cochran’s Q statistic and I2 index revealed heterogeneity of the samples (Q=975.26, P-value Considering the high prevalence of sleep quality and its increase in previous years, detection of affecting factors, intervention and preventive actions, and education about the importance of sleep and time management skills in students seem essential.

Cervical cancer is the second most common cancer among women worldwide. One of the methods of early diagnosis of this cancer is the screening pap smear test that has decreased both the incidence and mortality of cervical cancer. The aim of this study was comparison of pap smear quality with spatula-cytobrush versus cervix brush methods.
One hundred married women between 21 to65 years old participated in this single blind clinical trial. First samples were obtained with a spatula- cytobrush or cervix brush. Thirty days later another sample was obtained from the same person with another device. Slides were prepared and assessed by same pathologist and described base on BETHESDA method.
There were no statistically significant differences regarding cell adequacy in number of squamous cell between the two methods (p=0.093) as well as the difference in the bloody sample (p=0.082) and atrophy (p=1.00), but the differences were significant about the presence of endocervical cells. The presence of endocervical cells was 93.9% in spatula-cytobrushand 65.9% in cervix brush (p=0.021).
There were no differences regarding cell adequacy in number of squamous cell and bloody sample between two methods, but the presence of endocervical cells was more in spatula-cyto brush. Therefore, we recommend using spatula-cyto brush for pap smear sampling.

Idiopathic granulomatous mastitis is a granulomatous mastitis without any other attributing causes. Although the disease is rare in the world, but it seems Iran has higher prevalence. A few comprehensive studies have been performed on etiological features and risk factors of idiopathic granulomatous mastitis in Iran. We aimed to present a good epidemiological and etiological feature of breast granulomatous diseases in our country in a multi-center study.
In this case series study,115 recorded documents with final diagnosis of granulomatous mastitis from September 2009 to August 2014 were assessed. All patients’ sample slides were stained specifically with Gram, PAS, and acid fast staining methods. Also, for assessing the presence of the genome of M.tuberculosis, the PCR technique was applied. At the same time, all patients filled out questionnaires containing basic information, possible underlying causes, early symptoms and treatment.
One hundred and fifty registered patients, 3(2/6%) patients with a diagnosis of secondary granulomatous inflammation and 112 (97/4%) patients diagnosed as idiopathic granulomatous inflammation were observed in the 5-year period. All patients with diagnosis of idiopathic granulomatous mastitis were married with history of pregnancy and all except for one had experience of breastfeeding.
The presence of 112 patients in a 5-years period in three hospitals confirmed the higher prevalence of Idiopathic granulomatous mastitis in Iranian women in reproductive ages. With regard to presence of fertility and lactation in nearly all patients, the etiologic role of these factors is highlighted. Despite using different regimens in treating in our study, relapse rate was reported as 9%.

Candiduria is known as the most frequent nosocomial fungal infection. The aim of this study was to determine the frequency of candiduria in ICUs patients in a teaching hospital.
In a retrospective descriptive cross sectional study, 500 hospitalized patients in four ICUs in Rasoul-e-Akram hospital were studied.
Mean age was 62±19.6 years and candiduria was confirmed in 69 (13.8%) patients with 40 (58%) men and 29 (42%) women. Risk factors of candiduria were age, duration of staying at hospital and ICU, long term catheterization, use of antibiotics and corticosteroids. This study didn’t confirm the association of candiduria with diabetes mellitus.
The frequency of candiduria in ICU patients can be decreased by shortening the duration of admission at ICU, urinary catheterization, avoiding long duration of antibiotics and corticosteroid

Disease congenital hypothyroidism can cause of permanent mental retardation and disturbance physical growth.The present study done with aim of evaluate prevalence disorders of height, weight and head circumference first 5 years of life in children with congenital hypothyroidism in Yazd.
present study was retrospective cohort which performed on all neonatal born in the years 2006 to 2008 that had diagnosed by screening program as patient. the were compared ratios of growth disturbances height ,weight and head circumference during the first 5 years of life in these children and healthy children WHO separate of age and sex.Data analyzed by spss19 Statistical Software in significant level at 0.05.
Findings: The most common of growth disorder among patient boys was growth disorder weight and in patient girls height growth disorder. Ratios growth disorders variables of height, weight and head circumference in boys and girls patient has been reduced trend from beginning to end of follow .At the end of 5 years, not found significant difference between the proportion of growth disorders weight, height and head circumference in children with congenital hypothyroidism and healthy children World Health Organization (p>0/05).
The has been Screening program and Therapeutic interventions on children with congenital hypothyroidism leads to reduced physical growth disorders and normal pattern growth of patients.

Personality is a set of relatively stable psychological and behavioral characteristics of a person that is effective in the creation of psychological hardiness. The present study aimed to determine the relationship between personality characteristics and psychological hardiness of operating room staff.
This is a descriptive study which was done by correlation method. Statistical population of this study included all female staff of elective1 and plastic surgery operating room (operating room nurses, operating room technicians, and anesthesia technicians) of Al-Zahra Hospital of Isfahan. 101 participants were selected by using available sampling method as the sample size, and then Implemented NEO personality and Kubasa psychological hardiness were administered. To analyze the data, Pearson Correlation method and stepwise regression analysis were used.
The results showed that just the conscionable aspect with the total score of psychological hardiness and its components have a significant relationship among the aspects of personality characteristics. Stepwise regression analysis also revealed that just the conscionable aspect could predict psychological hardiness among personality characteristics and its component.
According to the results of study, conscience can be effective in predicting psychological hardiness. It means that by increasing the level of conscience in people, psychological hardiness also increases significantly

Relative risk (RR) and Odds ratio (OR) are two measures of risk which has been widely used in epidemiological studies. The cohort studies are designed to directly compute a relative risk, but the situation is somewhat more complicated in the case-control design. In these studies, the odds ratio gives a valid estimate of the effect size. There is not a serious problem if you don’t use of the odds ratio as an estimator of relative risk, but the problem begins when the odds ratio used as a surrogate for relative risk while its meaning is forgotten as the ratio of tow odds. The author has tried, to describe the relationship between relative risk and odds ratio and also the right time to use each of theme for those who familiar with the basic concept of epidemiologic studies. In this paper, the concepts of probability and chance and definitions refer to relative risk and odds ratios and characteristics of each have been reported. Afterward the gap between RR and OR according to their computational formulas are described and a simple method to estimate the OR to RR ratio is expressed.

Along with the rapid development in technology and Internet-Based education, combined learning methods have been extended and traditional classes have been propelled toward the virtual learning environments. The purpose of this study was the survey of two traditional and virtual teaching methods in learning of the course of “Introduction to Dental equipment and their maintenance” for the students of PhD General Dentistry at Shahid Beheshti University of Medical Sciences.
In this semi experimental study, by randomized allocation, the incoming students were divided into two groups of observation and intermediacy; 41 students from the September-Entrance in 2011 and 41 students from the January-Entrance in 2012were selected as observation (were taught by the professor of corresponding course) and intermediacy group (were taught in virtual learning by CD), respectively. After the end of the semester, the effect of the two above-mentioned methods on the knowledge of the students was assessed by using the awareness questionnaire. The face and content validity evaluation of questionnaire was done by the qualitative methods based on the standard methods and in the quantitative methods it was done by using content validity ratio CVR= and content validity index CVI= referring to Lawshe table. The reliability of the final exam was done based on Cronbach's alpha coefficient. The amount of the effect of the two above-mentioned methods on performance of students was done by using OSCE (Objective Structured Clinical Evaluation), its face and content validity was confirmed based on reference books and experienced professors’ and Faculty members’ comments. The reliability of the final exam was confirmed based on Pearson Correlation Coefficient. The SPSS statistical software was used in order to analyzing the data.
Content validity ration was CVR= and content validity index was CVI= . Moreover, the reliability of the final exam was calculated and confirmed as 0.98, based on Cronbach's alpha Coefficient. The reliability of the final exam was in the method of determining correlation performance test scores with the average of theoretical and experimental scores based on Pearson Correlation Coefficient and they were: (0.117) p=0.429) and 0.376(p=0.008), respectively. Also, the amount of the correlation of each skill with the total score of performance assessment test was 0.84 (p= 0.001) in order to determine the internal structure and the total reliability of the final exam was the final scores of awareness testing in the students of traditional groups which was higher than the students of virtual group, (p= 0.177). In the performance assessment scores, the average of virtual group was 8.05 that showed no significant difference with the average of traditional group [8.02 (p= 0.907)].
This study revealed that virtual teaching method, similar to the traditional teaching method, gained enough success in teaching program which included increase in the knowledge and performance of students in the area of the course. This success is in a way that it can be used as an alternative method in dentistry faculties.

Diabetes mellitus is a common chronic disease and a major public health problem globally. This study was performed to investigate the effect of hesperidin supplementation on markers of glucose and lipid, insulin levels and insulin resistance.
Forty-five patients with type 2 diabetes participated in this randomized, doubleblind controlled clinical trial. Subjects consumed 500 mg/d hesperidin supplement in the intervention group (n=23) and 500 mg/d placebo in the control group (n=22), for 8 weeks. Blood samples and dietary recall questionnaire were obtained at the baseline and end of study. The levels of Fasting Blood Glucose (FBG), insulin, hemoglobin A1c (HbA1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and insulin resistance were measured and compared. Statistical analyses were conducted with SPSS software by using independent t test and Paired t test.
Hesperidin supplementation led to significant decrease in FBG (p=0.04) and HbA1c (p=0.02) levels in compared to control group. A significant increase in serum insulin and decrease in TC (p=0.01 and p=0.04, respectively) were observed in the hesperidin group after the intervention, whereas no significant changes in the placebo group were observed at baseline and at the end of the study.
The present study showed that the intake of hesperidin could lead to decreased levels of FBG, HbA1c and TC and increased levels of insulin in patients with type 2 diabetes.

The pickle and salted pickle, traditional fermented products, are popular in Iran. There has been done a lot of researches about these group of foods all over the world. According to few researches in this subject in Iran, the aim of this study was to isolate and identify the diversity of dominant lactic acid bacteria in pickles and salted pickles.
This research was performed by analyzing 70 samples of different pickle and salted pickles. The isolates were identified as LAB by Gram staining and Catalase by using MRS agar. then those strains were identified at the species level by physiological tests such as NH3 production from arginine, CO2 production from glucose in MRS broth containing inverted Durham tubes, growth at temperatures of 15°C, 30°C, 45°C in MRS broth and Carbohydrate fermentation.
In total, 114 presumptive LAB with Gram-positive and Catalase-negative properties were obtained from these samples. The results revealed that all isolates were identified as L.plantarum, L.brevis, L.pentosus, L.casei, L.paracasei and Leu.mesenteroides. The most predominant LAB in these pickles was L. plantarum.
The importance of LAB as an important group of probiotics and one of the most useful hurdles is clear. In other hand since vegetables are source of prebiotics, all kinds of pickles can be one of the best choices for producing different kinds of non dairy probiotic functional food products. The results indicate dominant LAB in traditional pickles and salted pickles produced in Tehran, Iran which provides raw data for further studies to improve traditional or industrial production.