فهرست مطالب

Shiraz Emedical Journal - Volume:20 Issue:1, 2018
  • Volume:20 Issue:1, 2018
  • تاریخ انتشار: 1397/09/21
  • تعداد عناوین: 8
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  • Behnam Honarvar*, Forough Salehi , Fatemeh Shaygani , Mehdi Hajebrahimi , Reza Homayounfar , Shirin Dehghan , Nilofar Barahmand , Kamran Bagheri Lankarani Page 1
    To determine the role of electronic health (e-health) in the management of diabetes mellitus (DM), systematic review (SR) and meta-analysis (MA) studies were searched systematically. Eleven SR and six MA studies, including 533 sub-articles, were finally assessed. Six articles studied type 2, two studies assessed type 1, and five studies focused on both types of DM while four studies included type 1, type 2, and gestational DM. In total, 38641 patients with DM from all age groups were studied with a follow-up time from two phone calls to 60 months. As an intervention, short message service, multimedia messaging service, telemonitoring, glucometer applications, and personal digital assistant tools were studied. Nine out of 17 studies (53%) showed a significant reduction in HbA1c and eight (47%) studies revealed the inconclusive effect on it. However, the first group of studies was stronger and among interventions, text messaging as reminders was more effective. Conclusively, the majority of evidence shows the improvement of DM management by using e-health. However, a fragile acceptance toward this issue existed. Therefore, future research should focus more on using standard tools for the assessment of e-health efficacy, patients’ views, health care providers’ opinions, and cost-effectiveness of such interventions in long term.
    Keywords: Electronic Health, E-Health, M-Health, Mobile Health, Diabetes Mellitus
  • Hamid Naderi *, Kobra Etminani Page 2
    Background
    Mobile health applications are growing and some Iranian mHealth apps have been installed more than 200,000 times, which indicates their popularity is increasing rapidly in Iran.
    Objectives
    The objective of the current study was to detect predicators of mHealth apps download to forecast the app market.
    Methods
    This study reviewed all medicine and health apps available in the most popular Iranian Android app store “Cafebazaar” and collected apps information up to November 20, 2016.
    Results
    Of the 3331 studied apps, 24.4% were paid apps with prices ranging from 10,000 Rials to 300,000 Rials. The average number of apps published by a developer was eight. The effect of reviewed app variables was evaluated on the number of app downloads. There was heavy competition between mHealth app developers. There were several factors affecting the number of mHealth app downloads. mHealth apps with higher number of registered rating (P value < 0.001), Internet availability (P value < 0.001), and using the camera (P value = 0.03) were more likely to download. On the other hand, application price (P value < 0.001) and number of previous apps published by a developer (P value < 0.001) were inversely related to the number of app downloads.
    Conclusions
    Considering these predicators would help developers to become more successful in the mHealth market.
    Keywords: mHealth, Mobile Apps, Market Forecasting, Download Predicators
  • Amir Atapour , Zohreh Mostafavi, Pour , Pooneh Mokarram *, Shiva Mohammadi Page 3
    Background
    At present, there is an increased demand for recombinant proteins and the process development for production has high potential to speed up. Then, scale up of the developed process are critical if commercial production is the desired.
    Objectives
    In this survey, we intend to produce a recombinant fusion protein of flagellin (fliC) and the N terminal fragment (NT300) of NS5B gene.
    Methods
    After expressing the fusion protein in the proper host (E. coli), sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western Blot were used for evaluating the expressed protein.
    Results
    Results showed that fliC-NT300 recombinant fusion protein was properly cloned in pET28a vector following by successfully expressed in E. coli. SDS-PAGE and Western Blotting techniques confirmed a protein with a molecular weight of 86 kDa.
    Conclusions
    Our data indicated that the novel recombinant fusion protein (fliC-NT300) was well produced by the pET28a vector in E. coli system.
    Keywords: Recombinant Proteins, Flagellin, NS5B, Western Blotting
  • Ali Maher , Mohammadkarim Bahadori*, Mina Davarpanah , Ramin Ravangard Page 4
    Background
    Nowadays, the rapid advances in information technologies make fundamental changes in the life and workplaces around the world, which are also evident and considerable in the health care and health care systems. One of the branches of the field of information technology is telemedicine, and among various forms of telemedicine, teleradiology is the most developed and most used form.
    Objectives
    According to various applications of teleradiology in increasing the quality of patient care and accurate and rapid medical diagnoses, especially in cases of crisis and deprived areas, the application of this technology is increasing. Therefore, the current study aimed at identifying and prioritizing the factors affecting the establishment of teleradiology in a public hospital in Tehran, Iran, using the analytical hierarchy process (AHP) technique.
    Methods
    The current cross sectional and descriptive study was conducted in a public hospital in Tehran, Iran, in 2017. The study sample consisted of 30 experts in radiology and information technology (IT), health insurance, health services management, and health information technology (HIT) using purposive and snowball sampling methods. The required data were collected using a researcher-made questionnaire containing 47 items. The collected data were analyzed using AHP technique through Expert Choice 11.0.
    Results
    The obtained results showed that technologies and infrastructures (W = 0.249) and training the technical and medical staff (0.094) had the highest and lowest weights and priorities among the studied dimensions, respectively.
    Conclusions
    In Iran, the application of modern telecommunication technologies, especially in the field of medicine, such as teleradiology is accompanied by many challenges due to the lack of adequate infrastructures and their relatively high initial costs. Therefore, in order to establish and implement the teleradiology technology, adequate financial resources and incentives should be provided for hospitals by the government; i e, the ministry of health and social security organization. Also, the development of telecommunication infrastructures such as launching the national health network (SHAMS) can also help to implement teleradiology services.
    Keywords: Factors, Infrastructure, Teleradiology, Iran
  • Maryam Yaghoubi , Mohammadkarim Bahadori *, Ramin Ravangard Page 5
  • Hossein Zeraati , Maryam Ghorbanzadeh , Azade Sarani , Fateme Nasimi * Page 6
    Background
    There are extremely stressful stimuli in the NICU environment. Although attempts have already saved neonates in this unit, this can disturb the adaptability of the infants with environmental stimuli.
    Methods
    In this study, 120 preterm infants were randomly divided into experimental and control groups. The quiet time protocol was implemented at 16:00 - 18:00 while the control group received a routine program at 11:00 - 13:00. SpO2 and respiratory rate were measured in 15-min intervals and one hour before and after both times. The sound level and light intensity were also measured. Data analysis was done by independent t-test, Mann Whitney, and ANOVA using SPSS version 11.5.
    Results
    Of all infants, 40% were girls and 60% were boys. Regarding intra-group comparison, the Friedman’s nonparametric test showed that the percentage of oxygen saturation in the quiet-time group was not significantly different at the first, second, and third hours during the intervention (P = 0.32); in the control group, it was not also significant. The respiratory rate at the second hour of the intervention was lower in the quiet time group than in the control group (P < 0.07).
    Conclusions
    The implementation of the quiet time protocol can decrease heart rate and respiratory rate through a decrease in environmental stimuli (noise, light, and infant handling), and thus, is recommended for reducing stress in preterm infants.
    Keywords: SpO2, Respiratory Rate, Preterm Infant, NICU
  • Simin Taavoni , Neda Nazem Ekbatani , Hamid Haghani , Leila Fathi * Page 7
    Background
    Labor is painful phenomenon and management of labor pain has particular importance. For labor pain management pharmacological and non-pharmacological methods are used, but today there is a tendency for using alternative and complementary medicine. Consumption of nutrients and hydration is also one of the ways of pain management during labor.
    Objectives
    This study aimed to investigate the effect of oral administration of palm syrup on the labor pain of nulliparous women.
    Methods
    This study was a randomized clinical trial. In this study, 80 healthy nulliparous women were enrolled and randomly divided into two groups of the control group and palm syrup. The intervention group received palm syrup while the control group received only water routinely. Interventions in both groups continued during the active phase until the transitional phase. Data were collected by four main parts of the demographic questionnaire, controls carried out in labor, recording the fluid intake rate, and recording the pain using a ruler as 10 - 0 cm.
    Results
    The mean pain intensity was significantly lower in intervention group of the palm syrup than the control group.
    Conclusions
    The use of palm syrup had a significant impact on labor pain. Given the importance of evidence-based research and its usage in practice, conducting more studies are necessary in these areas.
    Keywords: Complementary, Alternative Therapies, Pain Management, Labor, First Stage, Labor Pain, Nulliparous
  • Mahmood Nejabat , Mehrnoosh Maalhagh , Seyed Mohammad Salar Zaheryani , Meisam Ghanbari * Page 8
    Background
    Descemet stripping and automated endothelial keratoplasty (DSAEK) has gained widespread popularity in the treatment of corneal endothelial dysfunction. In the present study, we evaluated the outcome of DSAEK in our center.
    Methods
    This retrospective cross-sectional study was conducted on 60 patients, who had undergone DSAEK at least 12 months before in Khalili Hospital, Shiraz University of Medical Sciences. On follow-up, best spectacle-corrected visual acuity (BSCVA), refractive errors and specular microscopy parameters were assessed.
    Results
    The majority of the studied eyes (49.2%) had a BSCVA within the range of 20/40 to 20/30. BSCVA was worse than 20/200 in 8 (13.3%) patients; 6 (75%) patients showed graft failure and 2 (25%) patients had graft rejection. Mean post-operative astigmatism was 0.29 ± 1.88 diopters. The mean refractive hyperopic shift was 1.30 ± 1.34 diopters. Specular microscopy indicated that 3 (5.1%) patients had cell density of less than 700 cells/mm2, but in none of the patients cell density was less than 500 cells/mm2. Furthermore, hexagonality of endothelial cells in 50% of the eyes was 54% to 67%. Mean coefficient of variant was 27.76%. Abnormal variations in specular microscopy findings were mostly confined to endothelial cell density, sparing other parameters.
    Conclusions
    In general, results of this study demonstrated acceptable BSCVA in the average duration of one-year post-DSAEK regarding late complications such as graft failure, graft rejection and epithelial downgrowth.
    Keywords: DSAEK, BSCVA, Specular Microscopy