نشریه دانشگاه علوم پزشکی البرز
سال دهم شماره 3 (تابستان 1400)

Appendicitis is one of the most causes of emergency abdominal surgery worldwide and its diagnosis has been a clinical challenge so far. This study was conducted to estimate positive and negative predictive values, sensitivity and specificity of some of the signs and symptoms alongside several lab results.

This study had a prospective design that was performed by the completion of a questionnaire via 207 patients who were suspicious of appendicitis.

Among 207 patients, 126 (60.9%) were male and 81 (39.1%) were female. Appendicitis were approved in 178(86%) and rejected in 29(14%) based on pathology results. Rejected cases of appendicitis were more in females (22.2%) compared to males (8.7%). The mean for age was 26.55 years old, with an interquartile range of 19 to 32. Sensitivity, specificity, positive and negative predictive values for significant results were as follows, respectively: dysuria 2.8%, 100%, 100%, 14.4%, diarrhea 1.7%, 100%, 100%, 14.2%, fever 5.1%, 100%, 100%, 14.6%, abdominal rigidity 3.4%, 100%, 100%, 14.4%, active urine analysis 11.7%, 86.2%, 83.3%, 14.2%, 1+ C-reactive protein(CRP) 76.3%, 48.3%, 90%, 4+ CRP 2.8%, 96.6%, 83.3%, 14%.

Based on the results of this study, fever, dysuria, diarrhea, abdominal rigidity and urine analysis had significant specificity and positive predictive value, therefore they can be helpful in the diagnosis of acute appendicitis in parallel with other signs, symptoms and lab results, although their absence cannot rule out this diagnosis.

The purpose of the present study was to investigate the effectiveness of high frequency transcranial magnetic stimulation on inner speech and working memory in schizophrenic patients.

This study was a pretest-posttest experimental design with control group. The statistical population of this study consisted of all schizophrenic patients referring to the outpatient department of Imam Hossein hospital in 1398, 12 of whom were selected by convenience sampling based on inclusion and exclusion criteria then were assigned randomly into two groups of 6 each. High frequency transcranial magnetic stimulation (rTMS) treatment (20 Hz) was used for experimental group but the control group received no intervention during the study. The instruments were the positive and negative syndrome scale in schizophrenia, the Inner speech questionnaire, and the Daneman and Carpenter working memory questionnaire before and after the intervention. The data were analyzed using descriptive statistics, and one-way covariance analysis (ANCOVA) and multivariate covariance analysis (MANCOVA) were used to analyze the data.

The results showed that there were significant differences between experimental and control group(p<0/005). The rate of inner speech significantly decreased in comparison with pretest and control group, but the rate of active memory increased.
 

repetitive transcranial magnetic stimulation (rTMS), significantly reduced inner speech and improved active memory.

The development of medical research in recent decades has shown the need for the rule of moral values and the institutionalization of human principles in scientific-research centers. Existence of deviations and abuses in the research path has led to the establishment of ethical laws and close supervision. The purpose of this study is reviewing the factors affecting ethics in medical research.

The present study was conducted by the literature searching in Persian and English languages in the electronic databases including; Google scholars, SID, Magiran and PubMed, with 2006 to 2019 date limitation. The search keywords of "ethics", "medical sciences", "personal factors" and "environmental factors" were used for searching mentioned databases.

The literature reviews indicated that the factors affecting the observance of research ethics have reported in two general axes of individual factors and environmental factors. The researcherchr('39')s ignorance of the norms and rules of research ethics, convenience and rapid achievement of results, religious beliefs, researcher personality and attitude, researcher conscience, tendency to earn a degree, economic problems, time limitations, and  Being influenced by the environment and others are Internal factors that affected on the rate and regard of research ethics. External factors such as lack of time, financial and economic pressures, forcing students to submit scientific papers, Lack of cooperation between students and professors, worries about job finding in future or employment conditions losing, competitive atmosphere among students to Raise their resume, Professorschr('39') role and impact on studentschr('39') behavior, and competitive atmosphere creating that affect research ethics.

According to the reviewed studies, the current state of research ethics is far from ideal. It is needed serious action and fundamental changes in supervisor and policy-making to bridge this gap.

There is an obvious relationship between learning environment and valuable outcomes such as satisfaction and student success. It is necessary to identify and strengthen the weaknesses of the learning environment, to improve the quality of learning. The aim of the present study was to assess the medical student’s views on the educational environment of Alborz University of Medical Sciences in 1396.

This cross-sectional study was conducted on 27 medical students in four internal wards, pediatrics, gynecology and general surgery in four university-affiliated teaching hospitals. The research tool was a 50-item DREEM (Dundee Ready Education Environment) questionnaire in five areas of student perception of learning, student perception of professors, student perception of their scientific ability, student perception of educational atmosphere, student perception of their social conditions. The data were analyzed by SPSS software version 16.

In this study, the mean age of participants was 25.4±0.7 years. The average score in the five domains was 93.8±28.9 out of a maximum of 200 points. The mean score of learning area was 22.8±9.6, clinical professors 23.8±9.4, perception of their scientific ability was 15.7±8.2, educational atmosphere was 21.3±9.9 and their social conditions were 11.1±4.2. The mean score of clinical education situation was significantly different in different wards (P=0.003).

The viewpoint of university medical students about the situation of clinical education environment was in the semi-optimal range. Some wards such as internal ward need more attention from University administrators and officials.

Hyperactivity is one of the most common neurodevelopmental disorders of childhood. This leads to problem in attention and controlling impulsive behaviors. The prime objective of the current study was to comparative the impact of commercial and educational computer games on the ADHD Symptoms in Students with ADHD.

In this study, amongst the76 children diagnosed with ADHD, 64 were selected and, randomly divided into four groups of 16 subjects: control, educational computer games (chess training), commercial computer games (Fifa) and combine, based on their age and gender, and the results of the pretest, which were performed by means of Conners and Snap-iv instruments and performed both games for a period of 11 consecutive weeks and a weekly session of 1 to 1.5 hours. Also the combine group performed both games for a period of 11 consecutive weeks and a weekly session of 1 to 1.5 hours. After 11 weeks, each group was re-evaluated. After a month, a follow-up test was carried out. Pearson correlation, Mix Anova, Anova, Tukey and Bonferroni test were used to analyze the data (p≥0.05).

The findings indicated that educational computer games (chess training), commercial computer games (Fifa) reduced the symptoms of ADHD in the groups and the difference between the two games is not significant.

so it is suggested that educational computer games (chess training) and commercial computer games (Fifa) be used to reduce the symptoms of ADHD.

Toxoplasma gondii and Neisseria gonorrhoeae are the rare causes of sexually transmitted infections. The aim of this study was detection of N. gonorrhoeae and T. gondii in patients with vaginal infection using Multiplex PCR.

This cross sectional study was conducted in 60 infertile female patients with symptomatic vaginal infection, referring to Tehran Emam Khomeini hospital. After completing a demographic questionnaire, sixty vaginal swabs were obtained from each participant using individual sterile swabs. DNA extraction was performed according to manufacture CinnaGen kit. The multiplex polymerase chain reaction (M-PCR) was conducted based on specific primers for N. gonorrhoeae and T. gondii.

Our finding indicated the frequency of infection with N. gonorrhoeae and T. gondii was 6.6% and 10%, respectively. No coinfection with N. gonorrhoeae and T. gondii was detected.

The Multiplex PCR is a good results for detection of N. gonorrhoeae and T. gondii in vaginal infection. The results of this study showed a relatively low frequency of N. gonorrhoeae and T. gondii in Tehran.

The purpose of this research was to investigate the structural relationship between post-traumatic growth, resilience, adjustment, psychological flexibility and quality of life in patients with cancer in a causal model.

350 cancer patients from Alborz province were selected based on study inclusion criteria. Data were collected using Tedeschi and Calhoun PTG scales, Conner-Dodsonchr('39')s Resilience Scale, Mini-Mc Cancer Adjustment Scale, Functional Assessment of Cancer Therapy General (FACT-G) Scale, and psychological flexibility and psychological Inflexibility Scale.

Data analysis using path analysis method indicated that the proposed model is well-fitted with data. Based on the findings, PTG predicted the quality of life in patients with cancer. Also, psychological flexibility also directly predicted PTG through resiliency and adjustment. Furthermore, adjustment predicted patientschr('39') quality of life both directly and indirectly through post-traumatic growth. In this regard, the direct path of resilience to adjustment, and adjustment to PTG was statistically significant. The results of this study indicate that psychological flexibility predicts PTG not only directly but also indirectly through resilience and adjustment, while PTG itself can predict the quality of life in patients with cancer. Resilience can indirectly improve PTG in patients with cancer through adjustment.

This study was the first structural equation modeling of Post Traumatic Growth based on Psychological flexibility The model showed that in addition positive effect of psychological flexibility on post traumatic growth, it can improve adjustment in cancer patients and both of them can improve quality of life in them. So, the Acceptance and Commitment Therapy (ACT), that improve Psychological flexibility can use for improving the Post Traumatic Growth, adjustment and quality of life in cancer patients and can provide a supportive care for them.

Staphylococcus aureus is a micrococcal, gram positive and positive catalase family with oxidative metabolism and fermentation metabolism. Staphylococci are a large group of skin inhabitants, mammals are mammals. In some of these bacteria, the peptidoglycan layer has completely disappeared, and some still have small portions of it. The purpose of this study was to investigate antibiotic resistance, biofilm and forms of L. Coagulase positive and negative staphylococci isolated from clinical specimens by E-test and ELISA.

A total of 437 clinical specimens were collected from the Tehran Mehr Hospital and other treatment centers during 6 months and transferred to the laboratory. The specimens were first transferred to the Blood agar environment and then from colonies on specific environments for final diagnosis. The growth of bacteria in the four media was also evaluated by BHI Agar, BHI broth, LMP Agar and LPM broth. Biofilm measurements were performed by light absorption and using a well plate. In the E.test test, antimicrobial resistance such as Kirby-Boer test was used from the Muller Hinton Agar medium.

The highest resistance and antibiotic susceptibility were penicillin and gentamicin, amikacin, respectively. The results of the E-TEST test based on the halo diameter showed the highest resistance to erythromycin with 1 mm and the highest sensitivity to ciprofloxacin with 2 mm.
Discussion and

The results of MIC determination on Staphylococcus aureus strains isolated by penicillin microdilution showed more resistance to ciprofloxacin. Consequently, L-forms, bacterial protoplasts and Spheroplasts are resistant to peptidoglycan synthesis, such as penicillins, cephalosporins and glycopeptide antibiotics (vancomycin and tiopelanin), due to the lack of peptidoglycans.

Urinary tract infection is one of the most important infectious diseases and can be seen at all ages; it is also a major medical problem. Due to the increased antibiotic resistance and high rate of recurrence of the disease, it can cause serious damage to the health of patients. Ganoderma leucidum is one of the most effective fungi with numerous therapeutic properties and is the most effective and best fungi with healing properties. Metal nanoparticles are important in various fields, including medicine, industry, etc. Silver nanoparticles are of particular interest due to their good conductivity, chemical stability, and many other properties.

In this study,30 specimens of positive cultures with urinary tract infection referred to Imam Reza Hospital Laboratory in Bojnourd were studied. Resistance and susceptibility of the isolates were determined by disk diffusion method. In this study, the antibacterial effects of silver nanoparticles were investigated using aqueous extract of Ganoderma leucidum by microdilution method. Vegetative electron microscopy was used to measure the size and shape of silver nanoparticles. FTIR analysis was also performed to investigate possible organic compounds that could interfere with the synthesis of nanoparticles.

The highest antibiotic resistance was related to ampicillin (93.33% /28 isolates). The resulting nanoparticles were 20 to 45 nm in size.

The produced nanoparticles have antimicrobial activity and can be a good alternative in the treatment of antibiotic resistant infectious diseases.

Mesenchymal stem cells are used to treat stroke and myocardial infarction in patients. Although they are fundamentally different from heart cells such as heart muscle cells, recent evidence suggests that injections of mesenchymal stem cells into the heart are mediated by the secretion of paracrine factors to restore heart function. Mesenchymal stem cells release all of the paracrine factors through membrane vesicles called exosomes. All biomolecules are assembled into exosomes that are regularly released from the donor cell. Also, exosomes bind to cellular receptors by the ligand-receptor reaction. Therefore, exosomes can secrete biological molecules such as proteins, RNAs and microRNAs. Stem cell-derived exosomes can be successfully used in the treatment of cardiovascular disease, cancers and hypertension. The purpose of this paper is to investigate the components and changes in the content of exosomes in human cells that can be used as an effective treatment in the treatment of various cardiovascular diseases and other diseases. Futures clinical studies will require the effective use of exosomes in cardiovascular disease, based on the specific molecular structure of each individual in personalized medicine.

In laboratory mice, barbering is done for a variety of reasons, such as nutritional deficiencies, response to stressors, or aggressive behavior. The aim of this study was to investigate hair disorder (barbering) in a colony of BALB/c mice in a breeding of laboratory animal center.

During the one-year period, BALB/c mice colony was examined for barbering disorder. The animals were apparently healthy and tested negative for external parasites, with no specific disease, and used standardized pellets of mice and water ad libitum.

In late July 1397, the barbering symptoms was observed in female mice that were confined to the head and face area in two cages of 6-8 week-old adult male and female colony. The environmental factors revealed that from 1-2 days before the onset of symptoms, the technical defect in the indoor air cooling system caused 4-6 °C increase and took 2 to 3 days to technical defect removing. Results of all external parasitic tests, bacterial and fungal cultures, were negative and no specific change in histopathological examination were reported. In addition, the maintained patient was improved completely in physical appearance after about one month and no symptoms were observed until the end of the period.

The study found that stressful environmental factors such as temperature rise in some susceptible strains such as BALB/c, can be effective in triggering barbering.

Despite the convergence created in fertility behavior, within the society there are differences between individuals in this regard. Some have fertility above the replacement level and a number of other has fertility at or below replacement level. The purpose of this article is to investigate and analyze some psychological and social factors affecting these differences in fertility.

Data were collected based on surveys on 304 married women aged 15 to 49 in Nasimshahr. Sample is selected whit multistage cluster. The validity of questionnaire reviewed and approved through face validity and confirmatory factor analysis respectively.

The average number of women children was 2.09 children that, this is fertility with replacement level. Descriptive results indicate that 62% of women stated that donchr('39')t want more children and 38 percent want to have more children. Also women that studied stated that increasing in Cost of living and better education of the existing children two basic factor that effect on their decision to donchr('39')t want more children and Having siblings and emotional need to child two basic factor that effect in want to have more children. Regression analysis indicated that among the independent variables to control age, age at marriage has the greatest impact negatively on the total number of children. Variables emotional need of child for the older age, number of siblings, women education and gender preference have positively and costs of children has negatively effect on the total number of children alive now.

Results of this study showed that in explained of low fertility it is Special importance to attention social psychology Concepts like emotional need to children that should be regard it along with Economic changes.

Food product labels are one of the most important factors in health promotion and public hygiene by giving the right to choose a healthy product according to the physical conditions of the people of the society, and it will help consumers when buying the product.

According to the obligations imposed by Iran food and drug administration about the insertion of the nutritional color marker in the food labels (traffic lights nutrition information), in this study, the knowledge and attitude of consumers about the color-coded nutrition labels in food and drink products were evaluated through filling the questionnaire using 912 consumers in 15 food stores in Karaj county.

The results showed that about 28% of individuals have used traffic lights nutrition information so far. In addition, education level had a significant and direct relation to the use of the color indicator, but age and gender did not show any significant effect on it. The results also revealed that the most important resource for the acquisition of nutritional information is the internet and social networks. The most important factor that consumers paid attention during the purchase of foodstuffs was the date of production and expiry, which included about 70% of the participants.

the results of this study indicate that the people of the community are interested in their choice of nutritional items, but information and knowledge in this field are not sufficient and it is necessary to continue through the responsible organizations as well as mass media.

The patient is a 38-year-old woman with a complaint of fever, chills, and abdominal pain for 10 days. She had a history of recent abortion with nausea and vomiting and oral intolerance. She was admitted with a diagnosis of abdominal infections. Abdominal and pelvic CT scan were performed by contrast injection.

Wernicke-Korsakoff syndrome is a serious brain condition which can occurs due to long term vitamin B-1, or thiamin deficiency and cause damage to hypothalamus and thalamus. The main symptoms are such as: Nystagmus, abducens nerve palsy, eye movement, ataxia and confusion. The risk factors which included are: Anorexia nervosa, hyperemesis gravidarum, Alcohol consumption and fasting. This syndrome must be diagnosed as soon as possible otherwise it can lead to serious liver and heart defects or even patients death.

Patient was a 30 years old  G2P1L1 mother , she had her first delivery 13 years ago. Through her current pregnancy, she has lost 20 kg weight due to anorexia and hyperemesis. She has got admitted two times during her current pregnancy to two different referral centers duo to hyperemesis gravidarum. On 6th Sep 2017 , during 16 weeks of her pregnancy she got admitted in hospital with chief complaints of abdominal and sides pain and blurred vision. With fractional blood pressure between 140/80 to 160/100, ketonuria 1+, proteinuria 1+ and glycosuria 3+.During her hospital stay there were symptoms such as blurred vision, oculomotor nerve palsy, nerve IV paralysis, staring eyes and distraction. Laboratory investigations demonstrated elevated liver enzymes, increased ESR level. There was oliguria too. She went under medication such as  magnesium sulfate therapy , Atenolol and methylprednisolone. EKG revealed mild ST segment depression on anteroseptal leads. There was also hypokalemia (K=2/7). According to internal specialist consultation, in attention to increased ESR, severe oliguria, elevated liver enzymes and and CNS involvement, prednisolone was prescribed. After two weeks on 22th Sep, according to three primatologist consultation with uncertainty to preeclampsia termination of pregnancy was decided. Misoprostol suppositories was inserted. After eight hours eventually Fetus and placenta expulsion occurred completely. After delivery according to neurologist consultation with possibility to thromboembolism heparin therapy has been started. Thyroid investigations revealed hyperthyroidism state as normal T3 and T4 but TSH<0/1 level. Methimazole was prescribed. According to ophthalmologist there was central. After 4 days of delivery there were decreased level of consciousness CVP Line was inserted through the internal jugular vein. Duo to inadequate condition of airway protective reflexes and throat discharge she was intubated. WBC level was 20000, PLT was normal, broad-spectrum antibiotics was prescribed. And 18 days postdelivery with brain death patient became bradycardia. Unfortunately CRP failed and patient died.