نشریه دانشگاه علوم پزشکی البرز
سال هشتم شماره 4 (پاییز 1398)

experience of life-threatening illnesses such as cancer leads to the comprehension of its positive outcomes along with its negative consequences. The purpose of this study was to examine the curve linear and linear relationship between post-traumatic growth dimensions and post-traumatic stress symptoms in cancer patients.

The present study was a descriptive-correlational study conducted on 200 patients with breast, leukemia and colon cancer. The samples were selected by the convenience sampling method. Participants completed posttraumatic growth inventory and PTSD checklist for civilians. Data analysis was performed in SPSS, version 17 using descriptive statistics, Pearson’s correlation, coefficient test, linear and nonlinear regression.

According to the results there is a significant non-linear relationship between some dimensions of post-traumatic growth and post-traumatic stress symptoms. A cubic relationship was significant between Relationship with others, Personal strength, and post-traumatic stress symptoms. But nonlinear relationship was not significant for new possibilities, spiritual changes, and appreciation of life and posttraumatic stress symptoms as a predictor. Also, the components of post-traumatic stress symptoms, negative changes in cognition and mood and arousal as a predictor, had significant nonlinear relationship with dimensions of posttraumatic growth.

These findings suggest that moderate levels of post-traumatic stress symptoms can be a predictor of growth in some dimensions.

Multiple sclerosis (MS) is a chronic disease of the central nervous system (CNS) that is characterized by inflammation, demyelination and axonal injury. Although the etiology of MS disease is still unknown, many studies suggest that immune system dysfunction plays an important role in the pathogenesis of this disease. The serotonin serves as a mediator between CNS and the immune system and is involved in modulating the interactions between the nervous and immune system. Therefore, it seems that modulation of serotonin function play a potential role in autoimmune process and MS disease. Serotonin transporter determines duration of serotonin action and its effect on nerve receptors by regulation of serotonin concentration in synapses. One of common polymorphisms of serotonin transporter gene (SLC6A4) is variable number of tandem repeats of 17 bp in intron 2 (STin2 VNTR). Different repeat number within the VNTR plays an important role in regulating transcription of the SLC6A4 gene and activity of serotonin.

In this study, STin2 VNTR polymorphism of SLC6A4 gene was assessed in 100 patients with MS and 100 healthy volunteers, using the PCR technique.

The results showed that STin2.10/10 genotype compared with the STin2.12/12 genotype (P= 0/04) increased risk of MS disease and STin2.12 allele acts as adominant allele.

The results of this study, is hypothesized that the STin2. 10/10 genotype by modulating the transcription of serotonin transporter and function of serotonin may participate in the pathophysiology of MS disease.

Trauma is the leading cause of mortality and its unfavorable outcomes. This study was conducted to assess the mortality rate of trauma and its related factors among the patients traumatized elderly in patients of karaj shahid Madani hospital.

We conducted a retrospective analysis of 240 aged traumatic patients from the shahid Madani training hospital, Alborz University of Medical Sciences, Karaj, Iran, from 2015 to 2018. Date were collected by Emergency Medical Doctor by a questionaire. Data was analyzed be SPSS.

In total, 240 elderly patients with trauma were included in the study. The average age of patients was 76.04 ± 7.46 years. Seventy-seven percent of the patients had at least one co morbid condition. Majority of the falls occurred at home. More than half of the patients fell from ground level. Overall, the in-hospital mortality rate was 16 %. Multiple organs failure constituted the most common injury sustained in patients who died (77 %).

The geriatric patient is often defined as a "frail elderly", for the presence of a greater “injury sensitivity". This is due to the simultaneous presence of co morbidity, progressive loss of full autonomy and exposure to a high risk of traumatic events. Optimal management of the trauma patient can considerable reduce mortality and morbidity.

Although there is a downward trend in mortality in elderly patients with complex pelvic fractures, hemodynamic instability still has a significant impact on survival of those patients.

This study aimed to compare levels of anxiety and quality of life in patients with severe and mild depression.

In a causal-comparative design, 271 patients with Major Depressive Disorder were selected using convenience sampling method and based on the Structured Clinical Interview and then, they were asked to complete New Multidimensional Depression Assessment Scale, Short Form Health Survey, and Beck Anxiety Inventory. In the next phase, 92 patients whose scores on the New Multidimensional Depression Assessment Scale were two standard deviations above and below the mean were selected as severe (n= 40) and mild depressed patients (n= 52).

Currents findings indicated a significant difference between two groups in the levels of anxiety and quality of life in that compared to mild depressed patients, patients with severe depression reported more anxiety (F= 16/74) and lower levels of quality of life in both physical (F= 15/01) and psychological (F= 20/96) dimensions.

Given the findings of this study, in the treatment of depression, addressing anxiety problems and helping severe depressed patients to improve their quality of life is of great importance.

Diabetes affects the testicles by oxidative stress. The aim of this study was to investigate the protective effects of N-acetylcysteine ​​on the number of spermatogenesis cells in diabetic rats.

In this experimental study, 42 adult male Wistar rats were divided into 7 groups of 6. This study was carried out in two periods of 5 and 28 days. Thus, in the first period, the positive sham group and experimental groups received 1 ml streptozotocin solution in distilled water at 50 mg / kg for 5 days intraperitoneally. At the end of the sixth day, the blood glucose levels in rats reached 200 mg / dl. In the second period, control group without any injections, sham group received intraperitoneal injection of distilled water, positive control group without injection, negative sham group received 200 mg / kg of n-acetylcysteine ​​intraperitoneally for 28 days. Experimental group 1, 2 and 3, which included diabetic rats receiving 100, 200 and 400 mg / kg doses of N-acetylcysteine ​​intraperitoneally for 28 days, respectively. At the end of the experimental period, rats were under anesthetized anesthesia. The body weight of all animals was measured and the testicles were removed and examined after staining and staining by hematoxylin-eosin method.

Mean body weight, spermatogonia, spermatocyte, spermatid and leydig showed a significant decrease in the positive sham group compared to the control group. The mean number of spermatogonium and leydig cells in all experimental groups showed a significant increase compared to the positive sham group. The mean number of spermatid cells in experimental groups 2 and 3 was significantly higher than the positive sham group. The mean number of spermatocyte cells in the experimental groups 3 was significantly higher than the positive sham group (P ≤ 0.05). Diabetes also led to pathological changes in the seminiferous tubes in diabetic rats. This is while different amounts of N-acetylcysteine have improved this in experimental groups.

The results showed that N-acetylcysteine protects the testicles against diabetes and improved the spermatogenesis process in streptozotocin induced diabetes.

This study compared the effect of Voluven and Ringer solution in cardiopulmonary bypass on the bleeding after the surgery and renal function in coronary artery bypass graft surgeries.

Two types of prime solution including ringer - as Crystalloid- and Voluven were used in two groups and compared in terms of bleeding and renal function during the first 24 hours after the surgery in intensive care unit (ICU) cardiac surgery.

 Amount of a 24-hour drainage was not statistically different (P > 0.05). There was not any significant difference between groups regarding urinary output in two time periods, pump time and during the first 24 hours after the patient’s entry to ICU. The mean of partial thromboplastin time postop in experiment and control groups was significantly different (P > 0.05). Plasma level of Bun-Cr  , sodium, Potassium, hemoglobin, hematocrit, BT, PT and INR Platelets was not significantly different during the first 24 hours after the surgery (P > 0.05). There was a significant difference between the two groups in terms of a need for blood transfusion   during the surgery and first 24 hours after the surgery (Ringer 1.70 ± 0.9, Vovuven 1.07 ± 1.1) (P = 0.019). There was not a significant difference between two groups in terms of urinary protein secretion during the first 24 hours after the surgery (P = 0.08).

It can be concluded that using Voluven as prime solution in comparison to lactate, in our study  did not cause any significant difference in bleeding after the surgery and there was not so much need for blood injection in these patients

Escherichia coli is a natural microflora of the human heart and all the warm animals. Mastitis is a disease caused by various pathogens. One of the important factors in the production of mastitis in the livestock is E. coli and is known as peripheral mastitis. The aim of this study was to isolate sulfonamide, integron and tetracycline resistance genes in E.coli isolated from mastitis with clinical symptoms using Multiplex PCR.

50 milk isolates with mastitis symptoms were collected from livestock farms in west of Tehran. Biochemical and microbial tests were performed and antibiotic susceptibility test using disc diffusion method was performed according to CLSI 2016 and E-test with antibiotics of different groups. After isolating the bacteria and extracting DNA, the presence of the genes was investigated by Multiplex PCR.

Based on the findings of this study, out of a total of 50 samples, 1 sample (2%) had Sul2 gene and 32 samples (64%) had the tetA gene and 11 samples (36%) of the tetc gene. Also Int gene was detected in 1 sample of 2% of the samples and the highest antibiotic resistance to the antibiotic sultrim and cotrimoxazole were 68% and 50%, respectively, and the highest sensitivity to tetracycline was 96%.

Comparison of this study with other studies has shown that the resistance gene in E.coli isolated from mastitis is high. The difference between the results of the M-PCR method in this study and the results of studies by other researchers in different parts of the world may be due to the source of the sample, while in studies of other researchers, most cases have been studied on samples of blood diarrhea. Another reason for the difference is the difference in geographical areas.

Malnutrition is a common clinical problem in critically ill patient at  ICU. It has irreversible consequences for patients and causes heavy health care costs for the healthcare system. Nurses are the main responsible for providing nutritional care to patients, but studies show that nurses' compliance with standards in patient care is very low. Therefore, it is important to determine the quality of nursing care in the field of nutrition of patients for behavioral at the individual and organizational level and to develop a guide for evaluating these standards. The present study was designed to compare the quality of nursing care of tubal nutrition with standards in patients admitted to intensive care units of educational hospitals affiliated to Qazvin University of Medical Sciences.

This is a descriptive comparative study. The research population included all nurses working in intensive care units. According to the number of nurses working in the intensive care unit and considering three observations for each nurse, a total of 495 observations were recorded. The data were collected using standard feeding tube checklist. Then, data were analyzed using SPSS v.21 using statistical tests.

 The results of this study showed that 38% of nurses had a moderate performance and 62% had a good performance in nursing care and the difference was 4.8 in nurses' average performance (p<0.0001). There was a significant relationship between the findings of the quality of tubal nutritional care and sex, marital status, and the level of graduate and postgraduate education. (p<0/001)

The low level of nurses' performance in standard entrnal feeding nursing care is potentially a serious risk to ICU patients. Because proper nutrition for patients has a direct consequence of the patient's recovery process. This factor can be influenced by the lack of attention to the existence of an effective educational program and the lack of attention to the implementation of the nursing care process in feeding standard patients by nursing managers.

Health indicators are one of the ways to measure success in achieving the goals of health systems. This study aimed to assess the changes of the students health indicators before and after the health system reform in Health Services Centers of Alborz University of Medical Sciences.

This cross-sectional study was performed at health care centers of Alborz University .The study population was all 6,9,12,15 years old student who were referred to these centers. The data was collected in two 12-month periods, (12 months before, and 12 months after, the implementation of the Plan, with a 12month interval in between) The data was analyzed using the SPSS statistical software,version22.

The result of comparing adolescent health indicators between2015-2017 showed increase in the most indicators .Recognized visual impairments from 4.43 in 2015 to 6.80 in 2017and hearing loss from 0.63 in2015 to 1.27in2017 increased.

Implementation of the health reform plan had been succeeded in improvement of students health indicators in Alborz health care centers. Therefore seems to be continuing, ongoing evaluation and modification of the plan could lead to improve students indicators.

The evaluation of pharmacies in order to match the activities of pharmacies according to the standards defined by the Food and Drug Administration of the Ministry of Health and Medical Education, to improve the quality of the provision of pharmaceutical services at pharmacies, to create competition with encouragement and further incentives in promoting optimal services, obtaining citizens' satisfaction, reducing The complaints of pharmacists, explain the role and importance of observing the rules, guidelines and supervision of the experts.

In this descriptive-analytical study, a total of pharmacies in the city of Fardis-Alborz were evaluated for 96 consecutive and 96 consecutive years. The method of observation and scoring was used for data collection. The data collection tool was a checklist for assessing pharmacies in the country.

Based on the findings of this study, the highest score obtained by the pharmacy appraisal standards was 1500 and the lowest score was 620. In statistical studies, it has been noted that in the first half of the year 97 compared to last year, the rate of pharmacy violations decreased, such as a 12% reduction in the maintenance of the past history, 15% in the absence of the technical officer and 40% in the supply Drug trafficking is observed.

Based on the results of this study, the continuous evaluation of pharmacies, while rating pharmacies in the provision of pharmaceutical services, will help to further enhance the quality of pharmacovigilance activities.

Psychological problems could have some relationship with undetermined chest pain. The aim of this study was to compare the general mental health status of out-patients with atypical chest pain with a reference age and sex matched controls.

Patients less than 40 years old, with atypical chest pain and low probability of ischemic heart disease were included in the study. The control group were age and sex matched. The Iranian translation of 28 item general health questionnaire (GHQ-28) was used to evaluate the mental status.

Totally 113 cases in each group completed the study. Mean age of the study group was 26.33± 5.77 years and 148 cases (65.5%) were female. Mean GHQ-28 score in the atypical chest pain and the control groups were 31.37±14.69 and 21.31±9.97 respectively (P<0.001). Abnormal GHQ-28 scores (≥24) was seen in 71(62.8%) of the atypical chest pain group and 38(33.6%) of the controls (odds ratio: 3.34, 95% confidence interval =1.93-5.76). Multivariate analysis showed that after adjustment for possible confounding factors, atypical chest pain was an independent predictor of abnormal GHQ-28 (odds ratio: 3.32, 95% confidence interval: 1.31-8.47).

The results of the present study, showed that our patients with atypical chest pain had worse general mental health state. It is not clear that worse general health state is a cause of atypical chest pain or an incidental concomitant finding.

Skin as the largest organ, is influenced by wide variety of environmental and external factors. In addition many internal diseases can involve skin. Oral cavity and skin have close contact with each other Like skin which has contact with various external factors, oral cavity and its contents also has touch with different chemical agents, enzymes and diverse microorganisms. Oral lesions of dermatologic disorders need an exact attention because these oral lesions may be the sole and first presentation of skin diseases and the presence of these lesions may affect the quality of patient’s life and nourishment Although oral mucus membrane and skin are in direct continuity with each other ,but different condition of oral cavity causes specific characters and functions. Various infectious agents and different dermatologic disorders cause oral lesions and the most prevalent of these are candida infection and lichen planus. Many oral lesions are treated without specific and exact diagnosis by physician and symptoms like pain and pricking sensation and others are managed. so increasing diagnostic and therapeutic knowledge of these lesion is necessary. So we explain the oral lesion of common dermatologic disorders in this article in order to facilitate diagnosis and prevention of progression of these disorder that some may be dangerous.