نشریه دانشگاه علوم پزشکی البرز
سال هشتم شماره 3 (تابستان 1398)

Coronary artery disease is the main cause of death in most societies, which is fatal symbol of acute myocardial infarction. Early diagnosis and treatment of this disease is the greatest impact on survival. But the diagnosis of acute myocardial infarction has always been a challenge, particularly in elderly patients due to atypical manifestation. Since a large proportion of deaths is due to unawareness of the symptoms and delay in diagnosis Therefore, this study have been done to determine the clinical manifestation of acute myocardial infarction in elderly and non-elderly patients. In this cross-sectional study of 65 elderly patients and 65 non-elderly patients were studied who had been hospitalized in the coronary care unit Ayatollah Mousavi Hospital of Zanjan after acute myocardial infarction. Checklist includes demographic, anthropometric and clinical symptoms were completed. The data were analyzed using the software SPSS23. In elderly patient, the frequency of atypical chest pain is 39.3% and absence of pain is 14.3%. This results for non-elderly patient is 15.6% and 6.3%, respectively (P-value=0.02). The frequency of atypical pain in elderly women is more than elderly men, significantly (P-value=0.057). The frequency of atypical pain in the diabetic elderly and non-elderly patients is more than non-diabetic patients. The prevalence of atypical pain or absence of chest pain is more in women than in men, the elderly compared to non-elderly and in patients with diabetes than in non-diabetic patients.

The choice of a suitable and ideal dressing for managing of pilonidal cystectomy wound with open technique is very valuable. Therefore, the present study was carried out to Investigation of the effect of dressing by using of hydrogel and alginate products compared to simple dressing method on the wound healing process caused by pilonidal cystectomy, the pain experienced by patients when changing dressing, the cost of treatment and the length of their absence from work. The present study is part of a clinical trial study. That was performed on 40 patients who were candidates of pilonidal. After random sampling, patients were randomly assigned to one of two groups, simple or alginates groups. After using two methods, the length and depth of the wound, each week, were measured and recorded for one month. Data were analyzed using SPSS 19 software with descriptive and inferential statistics. The wound healing from the third week in the modified modern dressing group showed a significant growth compared to the simple group (p <0.001). Also, the severity pain reduces after the second week in the alginate group in comparison of the simple group. In assessing the average costs and the number of absences from work, the total cost spent during a month, there was a significant difference between two groups, and on average, the patients in the alginate  group, returning to their work four days earlier. According to positive results of this study about applying the modern modified method to wound healing and patient recovery, it is recommended to use this technique in open  wound dressing.

Risky sexual behaviors expose people to sexual transmitted diseases. These behaviors are usually common among homeless people, so educational programs would help them to avoid high risk behaviors. Understanding STD awareness and the common types of risky behaviors among homeless people would provide a good context for designing appropriate educational plans. This study was performed to evaluate the STD awareness and the prevalence of risky behaviors among temporary residents of homeless shelters in Tehran. This descriptive survey performed in 2017. The standard sample size was 306. Random sampling was adopted. A questionnaire containing 45 questions was used. The questionnaire had four categories including demographic data, STD awareness, risky sexual behaviors and opinion poll. For calculating descriptive statistics IBM SPSS Statistics v21. software was exerted. The level of awareness among 80% of the cases was so poor and the most known STD was hepatitis B. About 64% percent of the cases had low literacy and all had at least one of the high risk behaviors. Violent sexual behavior was the most common trait and homosexual relationship was the least. Several factors endangering homeless people, including low level of knowledge about risky behaviors, being in a sexually active age range, illiteracy and attempting a high number of risky sexual behaviors. This study showed homeless shelters need codification of appropriate training workshops based on the level of awareness for each disease with considering illiteracy among homeless people.

The educational regulations are the most important regulation of the University, because they are stimulant for the main activities of the University.
As a result, before any action, it is necessary to be familiar with laws and regulations.
This study aimed to investigate the knowledge and attitude of students of Alborz University of Medical Sciences of the rules and the training and education they need to be done. The study population was included to all undergraduate students of Alborz University of Medical Sciences who wish had to participate in the study. The population sample was selected in proportion to the number of students in each discipline. The data collection tool was a questionnaire
Researcher made which its validity and reliability was measured. The questionnaire after coordination with deputy Schools students from theywere asked to complete it within twenty minutes. Collected information is encoded in software spss version 19 enter the purposes of study, as well as descriptive statistics and inferential statistics were used to analyze the data. Results showed that the average awareness among the students of the three domains of educational regulations is 9/55± 5/48 and The mean attitude towards training regulations and the need to train them is19/24±3/47. According to low average student awareness of educational regulations, as well as being a positive attitude about the necessity and the need to hold training workshops in this regard there.

Staphylococcus aureus is one of the most common nosocomial pathogens with high mortality rates. The Biofilm-dependent methicillin-resistant S. aureus remains a major clinical concern in this group of patients. The aim of this study was to investigate the icaABCD forming biofilm genes in methicillin resistant isolates of S. aureus. In study was performed on 238 S. aureus isolates from various clinical specimens obtained from patients referring to Shohada hospital, Mahmudabad in 1396. Susceptibility test to methicillin was performed by disk diffusion agar according to Clinical and Laboratory Standards Institute guidelines. All Methicillin-resistant S. aureus isolates were examined for phenotype biofilm formation and determination the icaABCD genes by using Congo red agar and PCR method. The ability for biofilm formation in 33 (38%) methicillin-resistant isolates of S. aureus was showed strong 8 isolates (24.24%) as strong, 19 isolates (57. 57%) as average and 6 isolates (18.19 %) as weak. The prevalence of icaA, icaB, icaC, and icaB were 8%, 9%, 10% and 20% respectively. Our results indicated that the isolates of methicillin-resistant S. aureus were able to form biofilms and all four icaABCD genes were identified in these isolates.

Vitamin D is an important factor for bone growth. Vitamin D deficiency reduces absorption of calcium and causes rickets and also increases bone fragility. In addition, Vitamin D deficiency has exoskeleton side effects, such as increased risk of cancer, cardiovascular disease, infections and autoimmune diseases. In most cases, vitamin D intake is not enough  in dietary food supplies. Furthermore, prevalence of vitamin D deficiency is increased due to the life style changes and lack of access to enough sun light and other sources of vitamin D. Present study, has been done to evaluation of Vitamin D deficiency in referred patients to Fardis central laboratory with ethnic diversity from 1393 to 1394. Samples were taken from referred patients to the laboratory. The patient  have no history of diseases such as diabetes, cancer, cardiovascular disease, etc…
Sampling was done randomly and patients were classified according to the age and sex.
Individuals  receiving  calcium and vitamin D were excluded from this study. 100 girls and boy with  age 1 to 13 years, 400 males and females with age 14 to 45 years and 500 males and females with over 45 years of age were examined. Collecting samples were done daily. Vitamin D, calcium, phosphorous and PTH were measured in the day of the sampling. According to the this survey we found that 15.5% of selected population had severe vitamin D deficiency , 45.1% had mild to moderate deficiency and 39.4% did not have vitamin D deficiency. Individuals with the same age but opposite sex had different status of vitamin D deficiency. So that, sever vitamin D deficiency was seen  in girls and women. Sever vitamin D deficiency was in girls 3.5 times more than boys. In addition, Sever vitamin D deficiency in women 14 to 45 years old compared with the men of the same age was 1.7 times and sever vitamin D deficiency in women with over 45 years of age compared with the men of the same age was 1.5 times more common.

In recent years, due to the remarkable advances in medical science and the long-term livelihood of patients, a new concept of death has become important. These advances have changed the concept of death for people, doctors and nurses. The suffering of patients, on the one hand, and the heavy cost of treatment imposed upon patients or families, on the other hand, raise the issue of euthanasia. The purpose of this study was to determine the attitudes of nurses and patients towards euthanasia. This study was descriptive-analytic in the second half of 1394 and to compare and compare the attitude of nurses and patients in relation to the euthanasia. Data were analyzed using SPSS software and descriptive and inferential statistical methods. The mean score of nurses' attitudes toward euthanasia was 54.89. So that 146 nurses had attitude score less than 60. Therefore, most nurses had a negative attitude toward euthanasia and did not agree with it. Also, in the group of patients, the mean score of attitude is 56.49, so that 131 patients had an attitude score of less than 60, which indicates that the group is opposed to euthanasia. Comparison of scores in the patients' and nurses' groups suggests that the nurses' group is opposed to the category of euthanasia.

Chronic periodontitis has been defined as an infectious disease resulting in inflammation within the dental supporting tissue, progressive attachment loss and bone resorption. Nowadays, with increasing microbial resistance, bacterial therapy is an alternative to prevent inflammatory diseases of the oral cavity, which regulates oral microbiota and eliminating pathogenic bacteria. The aim of this study was to identify oral Lactobacillus species and in patients with periodontitis and healthy individuals. Use of specific culture medium and restriction fragment-length polymorphism (RFLP) analysis was applied to characterize oral lactobacillus in oral cavity samples (saliva, tongue, gingival plaque) from 59 healthy subjects and 59 patients with chronic periodontitis. The 16srDNA genes of lactobacillus .spp in samples were amplified by PCR with universal primers. Sequencing performed to confirm the species. Out Of 354 examined isolates, 254 isolates were positive for Lactobacillus based on culture and PCR results. From obtained strain cutting patterns analysis of the oral lactobacillus community, were aggregated into ten different species. L.paracasei, L.fermentumin patient and L.casei, L.plantarum were the most predominant species in control groups. The frequency of Lactobacillus in patients with periodontitis was significantly reduced comparing to the control group, especially in gingival plaque samples. The difference in the frequency of isolated lactobacillus in the total sample of patients was 8% less than control subjects. There is increasing evidence that the use of existing lactobacillus strains can prevent chronic periodontitis. These probiotic candidates can be selected for the purpose of bacteriotherapy, dairy manufacture and pharmaceutical use.

Nitrate is one of the most important pollutants that is accumulated mainly due to unbalanced fertilizer use and excessive use of nitrogen fertilizers in plant organs. Most of the nitrate in our body comes from vegetables. In Iran, tomatoes and cucumbers are consumed vegetables in the food basket of people. Therefore, the study of nitrate pollution in these products and the identification of the sources of pollutants and providing appropriate solutions for the relative reduction of contamination is necessary. In this study, we randomly collected samples of tomatoes and cucumbers from Alborz province for 16 months each week. Samples were washed with distilled water and moisture content and their nitrate content was measured by micro-Kajledal method. The results showed that nitrate content in the cucumbers Distribution the Alborz province with an average of 212.25 mg / kg fresh weight was higher than the World Health Organization (WHO) (150 mg / kg) and Iranian National Standardization Organization (INSO) (90 mg / kg of fresh weight). The range of nitrate content in fresh cucumber samples was 15.18-1221 mg / kg and according to the World Health Organization and National Iranian Standards Organization, 58.76% and 74% of cucumber samples had more nitrate content above the limit, respectively. The results of this study showed that the mean concentration of nitrate in tomato samples was 20.22 mg / kg, which was below the World Health Organization (300 mg / kg) and Iranian National Standardization Organization (120 mg / kg fresh weight) was less. The range of nitrate content in tomato samples was 3.4-121.3 mg / kg, and according to the Iranian National Standardization Organization index, only one tomato sample had nitrate content higher than the limit.
Conclusion and The results showed that mean nitrate concentration in autumn winter spring summer. In cucumber, the amount of nitrate in the skin is more than other parts of cucumber.

The patient is a 50-year-old man who has been diagnosed with abdominal pain, fever, shivering and constipation with nausea and vomiting with a possible diagnosis of typhoid. Computed tomography (CT) of the abdomen and pelvis was performed by injection of contrast agent for the patient. What is your diagnosis?