فهرست مطالب

Shiraz Emedical Journal - Volume:19 Issue: 7, 2018
  • Volume:19 Issue: 7, 2018
  • تاریخ انتشار: 1397/05/03
  • تعداد عناوین: 6
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  • Sepide Namdari, Rita Arabsolghar, Sedigheh Sharifzadeh, Ali Farhadi, Shamim Toopchi, Noorossadat Seyyedi, Gholamreza Rafiei Dehbidi, Negin Nikouyan, Farahnaz Zare, Reza Ranjbaran, Abbas Behzad-Behbahani * Page 1
    Background
    There are few studies indicating the post-neonatal HBV vaccination level of anti-HBs antibody in first-year enrolled university students in Iran. In addition, anti- HBc antibody detection, which is a good indicator of virus exposure, has not been reported in vaccines. Hence, this study was conducted to determine the level of anti-HBs and anti-HBc antibodies in the serum sample of medical laboratory students who had received primary infantile HBV vaccination.
    Methods
    This study was conducted on first-year students enrolled in the department of laboratory sciences at Shiraz University of Medical Sciences, Iran. For determining anti-HBs and anti-HBc titers, 5 mL of venous blood was aseptically collected. Anti-HBs and anti-HBc antibody levels were determined by enzyme-linked immunosorbent assay. HBV DNA was also performed on DNA extracted from individuals positive for an anti-HBc antibody test.
    Results
    Of the 257 vaccinated individuals (188 females and 69 males) who participated in this study, 36.2% showed a non-protective anti-HBs response (anti-HBs
    Conclusions
    Our results indicate that a substantial number of our study population vaccinated against HBV during childhood showed non-protective anti-HBs antibody level. Therefore, a booster dose of vaccine needs to be scheduled for students with anti-HBs level
    Keywords: Vaccination, Students, Iran
  • Mahnoosh Fazeli, Negin Moradi *, Majid Soltani, Ehsan Naderifar, Nastaran Majdinasab, Seyed Mahmood Latifi Page 2
    Background
    Concerning demyelination’s process in multiple sclerosis (MS), speech changes often occur earlier than other symptoms; thus early diagnosis of these changes is necessary. According to recent studies, phonation subsystem appears with the most symptoms compared with other subsystems, especially in the initial stages. In this study, the researchers aimed at comparing these symptoms in MS patients with healthy people using dysphonia severity index (DSI) and its parameters.
    Methods
    This study was conducted on 40 MS patients and 20 healthy individuals in Ahvaz city. The subjects were asked to phonate vowel /a/ for calculating maximum phonation time (MPT), maximum F0, jitter, minimum intensity, and DSI score with the Praat software. For statistical analysis of data, Kolmogorov-Smirnov and independent t-test were used.
    Results
    The mean scores of DSI in MS patients (1.07 ± 1.51) was significantly lower than the control group (3.603 ± 1.13) (P value
    Conclusions
    The findings of this study indicated that the MS group had worse vocal quality than the healthy group, which means they were at risk of voice and speech problems; therefore, acoustic assessments can determine the vocal impairments of the disease at the early stages and prevent progression of vocal impairments with an appropriate treatment plan. Also, dysphonia severity index, as a reliable tool, can detect vocal quality impairments in multiple sclerosis and can be a supplementary assessment tool for early detection of degenerative diseases.
    Keywords: Multiple Sclerosis, Voice Quality, Phonation, Speech
  • Hamed Rahimi, Jamshid Bahmaei, Payam Shojaei, Zahra Kavosi *, Mohammad Khavasi Page 3
    Background
    The hospital is a significant part of health systems that presents a complex and vital services. Therefore, performance management of hospitals should be considered especially. BSC model is so helpful and popular for performance management. In using BSC, cause and effect relations is very important, since it helps to apply non-financial to forecast financial performance.
    Objectives
    This study aims to analysis systematic relations between key indicators of hospital performance evaluation, identifying causal relations and prioritizing indicators.
    Methods
    Based on the 4 perspectives described by the balanced scorecard (BSC), the evaluation indicators of hospital performance and key performance indicators (KPIs) were adopted from the related literature and selected by experts’ panel, respectively. Then, the decision making trial and evaluation laboratory (DEMATEL) method was employed for the determination of the cause-and-effect relationships between the indicators, differentiation of the effective and significant factors, and construction of the strategy map to ameliorate hospital performance.
    Results
    According to the BSC perspectives, 21 KPIs were selected for evaluation of hospital performance. The highest relationship was found between bed occupancy having the largest R D value and other indicators, thus illustrating its fundamental role among the indicators. Clinical errors with the greatest value of R - D showed the strongest impacts on the other indicators and was thus named as the “main cause factor” among the indicators. In contrast, the percentage of patient satisfaction with the smallest R - D value was most strongly influenced by the other indicators and therefore, it was known as the “main effect factor” among the indicators.
    Conclusions
    Assessment and improvement of the hospital performance is a complex and multi-dimensional activity. In order to have a powerful assessment system and success in improving hospital performance, instead of a single-dimension, it should be paying attention to all dimensions of performance.
    Keywords: Hospital, Performance, Evaluation, Balanced Scorecard, Indicator
  • Amin Rezaee Rad, Negin Moradi *, Mohammad Jafar Shater Zadeh Yazdi, Majid Soltani, Mohammad Mehravar, Seyyed Mahmood Latifi Page 4
    Objectives
    The aim of this study was to evaluate the effects of manual circumlaryngeal therapy after one session of treatment on the voice of patients with muscle tension dysphonia.
    Methods
    A total of 20 patients with muscle tension dysphonia were evaluated by recording vowel /a/ phonation and extracting fundamental frequency (F0), first formant frequency (F1), jitter, shimmer, and harmonics-to-noise ratio (HNR). One session of manual circumlaryngeal therapy was held for these patients. Immediately after treatment, acoustic assessments were replicated.
    Results
    Following manual circumlaryngeal therapy, jitter and shimmer showed a significant reduction (P
    Conclusions
    The reduction in jitter and shimmer and increase in HNR after therapy resulted in the patients’ vocal improvement. Reduction of F1 after treatment suggests elongation of vocal tube and elimination of vocal tract shortness in response to the descent of larynx from its high-tension status. The insignificant change of F0 was attributed to the lack of change in vibrational characteristics, as well as stretching of vocal cords.
    Keywords: Therapy, Dysphonia, Acoustic, Voice
  • Marziae Shahriari-Namadi, Hamid Reza Tabatabaei, Aboozar Soltani * Page 5
    Background
    Entomophobia/arachnophobia is an irrational fear of insects and ticks and is considered among the most serious psychological problems, demanding professional treatments.
    Objectives
    The present study aimed at identifying the prevalence of entomophobia and arachnophobia as well as recognizing the factors affecting it among elementary and high school students of Shiraz, southwest Iran.
    Methods
    A total of 531 questionnaires were distributed randomly among female and male students in elementary and secondary schools, studying in four school districts of Shiraz.
    Results
    Overall, 260 interviewed students (49%) were female and 271 (51%) were male. Furthermore, 35.8% of all subjects were afraid of insects and spiders and 52.45% of the individuals had a feeling of disgust about them. The results showed that 24 students (4.5%) had severe phobia, 177 (33.3%) medium phobia, and 330 (62.1%) mild phobia to insects and arachnids. This kind of phobias showed a direct relationship with factors such as gender, number of children in the family, and mother’s job. Phobias of cockroaches and bee/wasp were higher than that of other arthropods.
    Conclusions
    According to the results of this study, having enough knowledge about insects can significantly reduce irrational fear and phobia in students. Moreover, exposure to some insects can also be very helpful in dealing with this issue.
    Keywords: Phobia, Insects, Arachnids, Students, Iran
  • Neda Valizadeh*, Rasoul Mohammadi, Alireza Mehdizadeh, Qader Motarjemizadeh, Hamid Reza Khalkhali Page 6
    Background
    Gamma glutamyl transferase (GGT) is a liver enzyme that is involved in oxidative stress. The association between GGT levels and diabetes complications such as microalbuminuria, retinopathy, and peripheral polyneuropathy is a challenging subject.
    Objectives
    In this study we compared GGT levels in orally treated DM type 2 patients with and without retinopathy.
    Methods
    In this cross-sectional study that was done between the years of 2011 and 2012, 208 patients with Type 2 DM, aged 30 - 86 years old, who had received oral agents, and referred to the Endocrine clinic of Emam Khomeini hospital of Urmia city were enrolled. In all patients blood pressure, body mass index, and biochemical tests including fasting blood sugar (FBS) and GGT levels were measured and an ophthalmologic exam was done.
    Results
    From 208 patients with Type 2 DM, 26 subjects (12.5%) had diabetic retinopathy; however, 182 subjects (87.5%) did not have it. Both systolic and diastolic blood pressures were significantly higher in DM 2 patients with retinopathy than those without retinopathy (P values = 0.003 and 0.022, respectively). The mean of GGT level significantly increased in diabetic patients with retinopathy compared those DM 2 patients who did not have retinopathy (P value
    Conclusions
    We suggest that diabetic retinopathy might have an association with higher GGT levels.
    Keywords: Gamma Glutamyl Transferase_Type 2 Diabetes Mellitus_Diabetic Retinopathy