مجله مطالعات علوم پزشکی
سال سی‌ام شماره 10 (دی 1398)

According to the International Labor Organization, the prevalence of workplace violence has increased in the last decade and of the entire professional groups, health care personnel are the most likely victims of workplace violence but the documentary information on workplace violence in the operating room is very limited. Therefore, this study was conducted with the aim of determining the frequency of workplace violence and related factors among the health care personnel in operating rooms.

This was a descriptive cross-sectional study. The research sample consisted of 223 health care personnel working in the operating rooms in the educational-medical centers of Isfahan in Iran. The sampling method was proportional allocation of quota and category. Data were collected from March to July 2018 using the WHO standard questionnaire “surveillance of workplace violence in the health sector” whose validity and reliability have been confirmed in previous studies.

The percentage of verbal violence was 91.9 and physical violence and ethnic violence were in turn 26 and 19.3 during the past 12 months. The most common cause of workplace violence (87persent), was working in a stressful environment and the perpetrators of workplace violence are often among health care personnel. The average age and work experience of personnel exposed to verbal violence were significantly lower than the others (P=0.01and P=0.02, respectively). Frequency of physical (P=0.03) and verbal (P=0.004) violence in centers with specific protocols for reporting violence were significantly lower than other centers.

Experience of workplace violence among the health care personnel in the operating rooms is considerable. The perpetrators of workplace violence are often among health care personnel instead of patients and their families. This study recommends the existence of documentary protocols for reporting workplace violence in all operating rooms.

Vascular trauma is an emergency limb-threatening situation and the third leading cause of mortality and morbidity (amputation) all over the world which can lead to significant complications due to lack of correct diagnosis. The aim of this study is to evaluate the frequency of various orthopedic injuries in traumatic patients requiring vascular surgery interventions.

This study was a retrospective descriptive-analytic study. All the patients suffering from trauma that required vascular surgery intervention and were referred to Imam Khomeini Hospital in Sari during 2016-2017 were included in this study.

Of 43 patients, 90.70% were male and 9.30% were female. The mean age of patients was 36.37±11.27years. The most frequent mechanism of trauma was motor accidents. The most extremity involvement was in the left lower limb and in terms of vascular damage; the peritoneal arterial region (23.20%) was the most frequently involved area. For orthopedic damage, 86% of the patients had fracture and 14% had dislocation. Based on the fracture site, the most frequent fracture was tibiofibular distal (23%) followed by knee joint (14%). Among the cases of fracture, the most abnormal type was open fracture (74/40%) and the most abnormal type of dislocation was anterior dislocation (9/40%).

The most frequent cause of vascular trauma was accidents with vehicles, and the need for more precise compliance with traffic regulations to reduce injuries should be considered. Also, vascular damages were associated with higher orthopedic fractures, mostly in the lower extremities of the left and in the popliteal region. Early diagnosis, early restoration, patient transfer to appropriate center, and the appropriate medical and surgical treatment can greatly reduce morbidity and mortality rates.

In large populations, the level of cardiorespiratory fitness (CRF) can be evaluated by estimating non-exercise models with the least amount of time and money. In this study, we present non-exercise equations for predicting CRF and also investigate the effect of socio-environmental factors on it.

2490 male and female subjects aged 25-65 years old from different cities of Iran participated in this study. Rockport and Bruce (10% in each age category and gender) exercise test measured VO2max, a global standard for evaluation of CRF. Three non-exercise equations including, VO2masStep, VO2maxIPAQ-s, and VO2maxIPAQ-l were estimated using Stepwise Linear Regression. Variables for estimating these models are physical activity (PA) (obtained by pedometer and short and long-form of the International Physical Activity Questionnaire (IPAQ), separately), Body Mass Index (BMI) , Waist-Hip Ratio(WHR), Body Adiposity Index (BAI ), age, gender, and VO2maxROC. For comparison between measured and predicted VO2max values based on age, gender, level of education and city of residence Repeated Measures Analysis with Bonferroni Compare Main Effect test was used.

There were significant relationships between measured and estimated VO2max (p<0.05) (VO2maxIPAQ-l: R2adj=0.671 and SEE=4.381, VO2maxStep: R2adj=0.543 and SEE=5.331 and VO2maxIPAQ-s: R2adj=0.621 and SEE=4.823). Also, there were significant differences between VO2max values in males and females in different age categories and city of residence (p<0.05).

The results of this study demonstrated that predicted VO2max models with SC, IPAQ-s, and IPAQ-l can be used as non-exercise models for estimating VO2max in Iranian society, and socio-environmental factors are influential variables on PA and level of CRF.

Recently, molecular cell studies about the effect of physical exercises on diabetics have attracted the attention of many researchers. The purpose of this study is to investigate the effect of 10 weeks aerobic training on the expression of PGC-1a and PEPCK genes in hepatocyte of nicotinamide-Streptozotocin-induced diabetic male rats.

In this experimental study, 18 diabetic male Wistar rats (mean weight, 220±20 g) were divided into two groups of control diabetic and aerobic diabetic (training: 5 times in week/10 weeks/for 15-50 minutes at a speed of 16-26 m/min, with a gradual increase in speed). Subjects were diabetic with nicotinamide-streptozotocin. 48 hours after the last training session, liver tissue samples were taken after an overnight fast. Glucose oxidase was used to measure fasting glucose and ELISA was used to measure serum insulin. Also, OMA-IR was measured. PGC-1a and PEPCK gene expression in hepatocyte was measured through Real-Time PCR. The obtained data were compared using an independent t-test. The significance level was considered to be p<0.05.

Independent t-test showed that the 10 weeks aerobic training significantly decreased the expression of PGC-1a (p=0.003) and PEPCK (p=0.023) liver tissue in the exercise group compared to the control group. Also, aerobic training reduced HOMA-IR in the exercise group compared to the control group.

The results of this study indicate that aerobic training in diabetic conditions can reduce PGC-1a and suppress PEPCK as a non-drug treatment, and improve glycemic profile.

Multiple sclerosis (MS) is a neurological disease that is the most common cause of disability and may be associated with cognitive impairment. Despite the implementation of cognitive rehabilitation (CR) studies in patients with MS, there are still no clear and conclusive results. This study aimed to investigate the effectiveness of CR on speed and WM capacity, executive function, and quality of life (QOL) in MS patients.

The current quasi-experimental study (with a pretest-posttest plot and a control group) was conducted on 32 patients of the ….. MS Society, Iran. Participants were selected through the purposive sampling method and were divided into intervention (n=16) and waitlist groups (n=16) by the simple random method. The patients in the intervention group participated in cognitive rehabilitation for 12 sessions, individually. The scores for speed and working memory (WM) capacity, executive function, and QOL in both the groups were determined using N-Back test, Wechsler Adult Intelligence Scale (WAIS-IV) Digit Span subtest, Wisconsin Card Sorting (WCST), and Quality of Life Questionnaire of MS patients (MSQOL-54). The scores were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (repeated measures ANOVA).

The results showed that, apart from the physical domain of quality of life (QOL), the average scores in WCST and Digit Span Memory, response time in N-Beck test, and emotional QOL, differed over time and in both the intervention and waitlist groups(P<0.05). Thus, in the intervention group, the performance in speed and capacity of WM, executive function, and emotional QOL showed a significant improvement (P<0.05) in the post-test and on follow-up compared to the waitlist group.

Cognitive rehabilitation, based on these findings, is likely to be effective in improving the speed and capacity of working memory, executive function, and quality of life of MS patients.

Breast cancer is a threatening disease in females and is the second common cancer among women after lung cancer. The aim of this research is to bioinformatically and experimentally evaluate the effect of methotrexate (MTX) on the expression of HMGA2 and SMARCA5 genes in the MTX treated 4T1 cancer cell line.

To perform this study, initially microarray data were collected from Gene Expression Omnibus (GEO) then they were analyzed using Probabilistic neural networks (PNN) in MATLAB 2018a software as a bioinformatics tool. In the next step, the specific primers were designed for HMGA2 and SMARCA5 genes. MTX cytotoxicity was assessed on 4T1 cancer cells using MTT assay. Finally, Real-time PCR was used for evaluating the effect of MTX on the rate of HMGA2 and SMARCA5 genes expression.

The bioinformatic analysis showed that HMGA2 and SMARCA5 expression levels notably reduced and increased respectively in MTX treated group in comparison with the control (untreated) group. MTT assay indicated that MTX decreased the 4T1 cell viability in a concentration-dependent manner and the IC50 value of MTX was estimated to be 208 µg/ml in 48 hours. Real-time PCR data showed that the expression level of HMGA2 decreased significantly (p ≤ 0.05), while the SMARCA5 gene was significantly (p ≤ 0.05) upregulated which is consistent with bioinformatic analysis results.

The obtained results suggest that HMGA2 and SMARCA5 genes may be used as MTX target genes in breast cancer therapy. However, further studies need to be carried outto confirm the results.

The Patient is a 66 years old woman with bipolar mood disorder type 1 since 28 years old. She has three sons with no daughter. Her husband remarried with a widowed woman 12 years ago that (who) has a daughter and a son from previous marriage. Before the beginning of the last period of mood disorder she has an important tension with her sons and their wives so that all of them left the Party in her home in the fifth and last admission to the psychiatric ward. In the mid-treatment process, she claimed that she is pregnant and her fetus is a daughter. Although most of the classic signs and symptoms of pregnancy were found in the patient and serum Prolactin level was high because of risperidone use in the 8mg/d dose, all tests, including beta-HGH levels and ultrasound, showed that she was not pregnant. However, the patient insisted on her pregnancy (pseudocyesis). It seems that Psychodynamic processes and high levels of Prolactin had a role in her claim.

Nowadays, the common use of azoles has led to increased resistance to azole among Candida albicans strains. Amino acid substitutions in azole target enzyme, ERG11p, is attributed to azole resistance in some clinical strains of Candida albicans. The aim of this study was to evaluate ERG11 gene mutations in fluconazole-resistant isolates of Candida albicans in Rasht.Materials &

In this study, the clinical specimens were isolated from the vaginal mucosa of 50 women. Candida albicans isolates were identified using standard identification methods such as germ tubes production and culture in CHROMagar media. Resistance and susceptibility of isolates to fluconazole were investigated through disc diffusion and broth micro-dilution methods. The mutations in the ERG11 gene were determined in clinical isolates using PCR-sequencing method.

In this study, 20 clinical isolates of Candida albicans were resistant to fluconazole. The highest MIC of fluconazole was determined at 2048 µg/ml. Also, in eight fluconazole-resistant isolates by PCR-sequencing, two missense mutations (V437I and V488I) were found in the ERG11 gene.

It seems that having several mutations in the ERG11 gene is a reason for high MIC in resistant isolates of Candida albicans in this study. However, investigating other mechanisms of azole resistance is recommended in Candida albicans isolates.

Dexamethasone (Dex) is one of the most commonly used synthetic glucocorticoidbut its excessive intake can cause severe changes in liver function. The purpose of the study was to investigate the effect of pentoxifylline (PTX) on Dex-induced hepatic injury in mice.

24 adult male NMRI mice (36±2gr) were divided randomly into 4 groups (n=6): control, dexamethasone (7mg/kg/day i.p.), pentoxifylline (100mg/kg/dayi.p.), and dexamethasone+pentoxifylline. After 7 days of treatment, the mice were anesthetized and their liver was removed and weighed. Then liver tissue elements were evaluated by stereological technique. The serum levels of malondialdehyde (MDA), total antioxidant capacity, and liver enzymes including alanine aminotransferase [ALT] and aspartate aminotransferase [AST]) were also measured. The data were analyzed by one way ANOVA and Tukey’s test using SPSS soft (version 16) and means were considered significantly different at p<0.05.

A significant decrease in the mean volume of the hepatocytes and their nuclei, total number of hepatocyte cells (p<0.01) and serum total antioxidant capacity (p<0.001) and a significant increase in total volume of sinusoids, bile duct, hepatic artery and the mean levels of Serum MDA, ALT, AST were observed in Dex group compared to the control groups (p<0.01). Dex-induced liver damage improved in the Dex+ PTX group to the same extent as the control group (p>0.05).

Our results revealed that PTX can improve the toxic effects of Dex on mice liver tissue possibly by reducing oxidative stress and lipid peroxidation and increasing total antioxidant capacity.