مجله علمی دانشگاه علوم پزشکی کردستان
سال بیست و ششم شماره 6 (پیاپی 116، آذر و دی 1400)

Breast cancer is the most common malignancy among women in the world. Timely use of appropriate diagnostic methods in the early stages of this cancer can reduce its consequences and mortality.

287 women with breast mass referring to the Breast Cancer Research Center affiliated to Shahid Beheshti University of Medical Sciences, Tehran (Iran) participated in this cross-sectional study. Demographic data, clinical manifestations and drug history were recorded. Clinical examinations were carried out by a qualified physician. Finally, the correspondence between the data obtained from the clinical examinations with the pathologic results was evaluated.

287 women with breast cancer (age range: 22-84 year old) participated in the study. Mean and standard deviation (SD) of participants’ age was 47.71±11.62. Based on pathology results 64 subjects (22.30%) had benign and 223 (77.70%) had malignant lesions. 37 subjects (12.89%) had benign and 250 (87.11%) had malignant lesions on the basis of the clinical breast examination (CBE). Sensitivity and specificity of CBE were 98.21% and 51.56%, and also, positive predictive value (PPV) and negative predictive value (NPV) were 87.6% and 89.19% respectively. Younger women were less likely to have malignant breast mass compared to older women. Moreover, a significant difference was found between unemployed and employed women as well as between menopausal and non menopausal women.

The results of the present study showed that clinical examination by skilled physicians can still be an important, highly sensitive and reliable method for diagnosis of breast cancer, especially in the patients who had breastfed their infants for more than 24 to 72 months, and menopausal women or patients with more than 3 pregnancies.

People spent most of their time indoors. Therfore, quality of  indoor air ,especially in the therapeutic settings is of particular importance. This study aimed to determine the level of pollutants in indoor and outdoor air of Tohid Hospital in Sanandaj.

In this cross-sectional descriptive study 120 indoor and outdoor air samples were collected by TES-5200 copper counterpart machine made by TES company in Taiwan. Particulate matter samples were collected from 9 wards and also 3 stations in every ward in the hospital. Also air samples were obtained from 3 selected stations outside the hospital. Samples were taken from the selected sites  twice. The results were analyzed by Excel and SPSS software.

According to the results of this study, the highest and lowest concentrations of particulate matter (PM2.5, PM4, PM7, PM10) belonged to the emergency room and the operating room, respectively. The highest level of PM1 concentration was detected in the ICU ward. There was no significant relationship between temperature and particle concentration and also between moisture and particle concentration in the wards of the hospital. In regard to particulate matter, the emergency department was the most contaminated ward and the operating room had the best condition.

The relationship between the concentrations of particles in the outdoor and indoor air indicated the penetration of these particles from outside into the hospital building. Also, outdoor air can affect indoor air quality.

Development of medical tourism can contribute to employment boom in border areas. This study aimed to design an internationalization model for service businesses in border areas in relation to medical tourism industry.

The current study was performed by using a sequential explanatory mixed method. In qualitative stage, to identify principal components for internationalization of service businesses in border areas considering medical tourism, literature review and in-depth interview were carried out and to finalize the components, Delphi method was used. In quantitative stage we used exploratory factor analysis to evaluate the extracted model. Using SPSS and Smart PLS softwares, we used qualitative content analysis and structural equations for data analysis.

For the identification of the principal components, a total of 20 in-depth interviews were performed and, for finalization of the model, 388 people were entered into the study. Seven dimensions as the model dimensions along with sub-components were extracted. The results showed that all the structural, behavioral and environmental factors were effective in the processes (amount: 0.83 and t: 45.12) and the results (amount: 0.75 and t: 10.34). Also all dimensional processes can affect the results (amount: 0.87 and t: 12.67). It can be concluded that casual accuracy relationships existing in the studied model are confirmed and it is a suitable model.

All the structural, behavioral and environmental factors can affect the results and processes. Also all dimensional processes can affect the results. The above mentioned model was confirmed. Therefore, to internationalize medical tourism, at first, the current status of the country’s border areas should be compared to that of the model. In order to move forward for internationalization, necessary actions based on a multi-year plan should be considered.

Breast cancer is the most important cause of cancer death in women. The purpose of this study was to evaluate the effect of Estrogen Receptor (ER), Human Epidermal Growth Receptor (HER2) and other factors on post-surgical survival of the patients with breast cancer using Bayesian approach for parametric proportional hazards model.

This was a retrospective study. Data of 165 breast cancer patients who had undergone surgery at Ahvaz Healing Diagnostic Center from 2004 to 2014 were recorded in a data collection form. The variables of age, tumor size, number of lymph nodes involved, cancer grade, ER status and HER2 status were evaluated. Survival time was calculated from the date of surgery to the date of death or study end date (September 2015), in months. In the Bayesian approach in parametric survival analysis models with proportional hazards, the lateral distribution of parameters was estimated using MCMC method. Also, we evaluated efficiency of the models using the deviance information criterion. All data analysis steps were performed by using Stata15 software. Significance coefficients of the model were determined using the 95% credible interval.

The mean and standard deviation of age were 46.40 and 9.94 years, respectively. Deviance information criterion for Weibull parametric model was lower than those of other parametric models. Based on the Bayesian estimation of the Weibull's proportional hazards parametric model, tumor size (HR = 1.40), the number of involved lymph nodes (HR = 1.016), Ki67 status (HR = 1.115), tumor grade (HR = 1.022), HER2 status (HR = 1.760) and ER status (HR = 1.381) had a positive effect on risk of death. Age had a negative effect on risk of death (HR=0.978).

Based on the Bayesian proportional hazards Weibull model, tumor size, the number of involved lymph nodes, Ki67, tumor's grade, HER2 and ER had a positive effect on the risk of death.

Bladder cancer is the ninth most common cancer in the world. Also, it is the fourth most common cancer in men in Iran and the second most common genitourinary cancer after prostate cancer. This study deals with epidemiology of bladder malignancy in the patients treated by transurethral resection in Tohid Hospital in Sanandaj.

In this cross-sectional study, data were extracted from321 medical records of the patients with bladder malignancy treated by transurethral resection from 2012 to 2017. Data included age, gender, place of residence, occupation, smoking history, histopathology results, disease stage and type of treatment. Frequency and percentage of every variable was calculated. Stata software Ver. 14 was used for data analysis.

The results of this study showed that mean ± standard deviation of age of the subjects was 65.6 ± 14 years. 264 (82.2%) patients were men and 247 (76.9%) lived in Sanandaj city. 172 patients (53.6%) had history of smoking and 20 patients (6.2%) had family history of bladder cancer. Histopathology reports of most patients were indicative of transitional cell carcinoma. 210 patients (65.4%) were at stage 1 and 8 patients (2.5%) at stage 4 of the disease. Treatment methods were TURBT in 207 patients (64.5%) and TURBT and BCG into the bladder in 74 patients (23%). Age, gender and disease stage showed no significant statistical association with one another (P>0.05).

The incidence of bladder cancer is on the rise, although this increase may be due to improved cancer registration system, as well as use of new diagnostic methods and increased patients' awareness, but change in lifestyle, adverse effects of job on health and other risk factors can lead to increased risk of bladder cancer. Therefore, planning for identification of the causes of this cancer can be helpful in prevention of this cancer.

 studies show that antioxidants prevent conversion of NO3/NO2 to nitrosamines compounds. tha aim of this study was to determine the potential effect of interaction between dietary intakes of vitamin C and NO3/NO2 on urinary and serum levels of NO3/NO2.

This cross-sectional study included 251 adults aged >19 years was performed in the phase 6 of  the Tehran Lipid and Glucose Study in 2015. Food intake was assessed using a semi-quantitative food frequency questionnaire. The average daily intake of nitrate and nitrite and vitamin C was estimated. Serum and urine levels of nitrate and nitrite were measured using  the Grease method. In order to determine the effect of vitamin C on the interaction of nitrate and nitrite in urine and serum, linear regression test was used to modify the effects of confounders.

There was a significant correlation between intake of nitrate and its urine level, above the median level of vitamin C intake (B = 0/004, P-value = 0/004). Also, this correlation remained significant after adjusting for age, sex, body mass index, calorie intake (B = 0.03, P-value = 0/001). The effect of vitamin C interactions on nitrate intake and urine level in the adjusted model for nitrate and nitrite was also found to be significant (B = 0/003 P-value = 0/001).

Increased intake of vitamin C significantly increases urinary excretion of nitrate and it is effective in  the interaction between dietary intakes and urinary excretion of nitrate.

Recurrent spontaneous abortion (RSA) is the most common complication of pregnancy that refers to two or more miscarriages before the 20th week of pregnancy. HLA-G immunoglobulin molecule plays an important role in protecting the fetus against mother's immune system. The aim of this study was to investigate the association between rs1632943 and rs1736932 polymorphisms with recurrent spontaneous abortion in Northwest of Iran.

This case-control study included 100 women with history of RSA as our case group and 80 healthy women with one or more than one children as the control group. Genomic DNA was purified from their peripheral blood samples and their genotypes were determined by PCR-sequencing method. Using SPSS 16, statistical analysis was performed by chi-square test.

In rs1632943 polymorphism the frequency of CC, CA and AA genotypes were 8%, 33% and 59% in the patient group and 16.25%, 43.75% and % 40 in the control group, respectively. Statistical analysis showed that AA genotype was associated with the recurrent spontaneous abortion (P = 0.005). In the rs1736932 polymorphism, the frequency of CC, CG and GG genotypes were 8%, 32% and 60% in the patient group and 17.5%, 41.25% and 41.25% in the control group, respectively. Statistical analysis showed that GG genotype was associated with the recurrent miscarriage (P = 0.005). Also, haplotype analysis showed that H1 haplotype (GA) is associated with the disorder.

Results of the study showed that rs1632943 and ra1736932 polymorphisms

Readmission rate is very important due to its impact on cost, quality of healthcare, and putting additional burden on the hospitals and patients. The aim of this study was to evaluate the rate of patient's readmission after discharge from educational and medical hospitals in Sanandaj in 2018.

This descriptive cross-sectional study included all the patients admitted to the educational and medical hospitals in Sanandaj twice or more times in 2018. SPSS software version 23 was used for data analysis. Descriptive statistics were used for drawing frequency distribution table for qualitative variables. Mean values with 95% confidence interval were calculated for quantitative variables.

The results of the study revealed 7623 readmissions in educational and medical hospitals of Sanandaj in 2018 which included 4373 (57.3%) female and 3250 (42.7%) male patients. In general, the most common cause of readmission belonged to follow-up (38.9%). Other causes of readmission were recurrence of the condition (26%), and treatment complications (21.8%).

Considering the high readmission rates in Sanandaj hospitals, development of community-based health services, especially homecare centers and local clinics, is recommended.

‎The current study was performed to investigate the role of activation/inhibition systems and life orientation in the students’ personality traits.

This descriptive-correlational study included 370 university students studying for Bachelor, MA and Phd degrees.The participants were selected by multistage cluster sampling. Data were collected by using scale of behavioral activation-inhibition, life orientation test-revised, and HEXACO personality inventory. Using SPSS-21 software, data were analyzed by Spearman correlation coefficient and regression analysis.

among the components of behavioral activation/inhibition systems, punishment was negatively related to extraversion and conscientiousness, while there was a positive correlation between reward and extraversion, agreeableness and conscientiousness. Also a positive correlation was found between entertainment and conscientiousness. Among the components of life orientation, optimism was positively correlated with honesty-humanity, extraversion, conscientiousness, and openness to experience; pessimism was positively correlated with emotionality and negatively correlated with openness to experience and conscientiousness. The results of regression analysis revealed that among personality dimensions of HEXACO, the most frequent variances explained by behavioral activation/inhibition systems and life orientation were conscientiousness (0.17) and openness to experience (0.11), respectively. All the components of behavioral activation/inhibition systems and life orientation could explain 0.53 of HEXACO personality dimensions.

Predictions of all of HEXACO personality dimensions by behavioral activation/inhibition systems and life ‎orientation components were significant. Conscientiousness and openness to experience were the most frequent variances explained by behavioral activation/inhibition systems and life orientation among personality dimensions of HEXACO.

Enterotoxigenic Escherichia coli is one of the most common bacterial causes of diarrhea worldwide. One of the most important ETEC colonization factors is B subunit of the Heat Labile Enterotoxin, which forms the connecting part of the toxin. In the present study, egg yolk immunoglobulin (IgY) was produced and its effectiveness against recombinant LTB protein was tested on the animal model.

Hens were injected intramuscularly with 100 μg of recombinant LTB protein. The antibody titer was estimated and the eggs were collected. The water soluble part of the yolk was separated and the antibody titer was subsequently estimated by ELISA.Effecacy of different concentrations of IgY on nutralising the effect of LT toxin on Y1 cells was also studied. In order to investigate the effect of IgY-treated bacteria on intestinal epithelial cells, the standard Ileal loop  technique was used.

Protein expression led to the production of recombinant LTB showing molecular weight of 11 kDa on SDS PAGE. Immunization of hens induced serum antibody rise. The purified antibody was 144 mg per 12 ml of egg yolk. Purified IgY exhibited significant effect against recombinant LTB proteinAt the concentration of 125 μg per ml, the IgY could prevent the effects of Heat Labile Enterotoxin on Y1 cells. In the Ileal loop test, 1.5 mg / ml IgY neutralized the toxin effect of LTB   on the intestine. The accumulation of fluid in the test loops decreased by 74.8% compared to the untreated control loops.

The results showed that specific egg yolk immunoglobulin was effective against recombinant LTB protein and can be used as a preventive antibody to inhibit the Heat Labile Enterotoxin function of ETEC bacteria.

The aim of this study was to determine the effect of taping therapy on primary dysmenorrhea severity, premenstrual syndrome and its dimensions in Sardasht University students from 2018 to 2019.

In this experimental study 50 female students with moderate to severe dysmenorrhea and mild to moderate premenstrual syndrome were selected randomly and placed into control (n = 25) and intervention (n = 25) groups by blocking method. The intervention group used tape; the control group did not use anything but were attended in a free training class session. The questionnaires used in this study included demographic and menstrual characteristics questionnaire, visual analog scale questionnaire, premenstrual syndrome checklist and Moos menstrual distress questionnaire. Data obtained from these questionnaires were analyzed using descriptive statistics and independent t-test, paired t-test, chi-square test and ANCOVA.

  There was no statistically significant difference between the two groups in regard to the demographic characteristics (P <0.05). The mean scores of dysmenorrhea, menstrual distress questionnaires and its dimensions except for arousal, were not significantly different between the intervention and control groups before the intervention (P <0.05). Also, there was no significant difference between the groups in relation to the total scores of dysmenorrhea, menstrual distress questionnaires and its dimensions, except for severity of dysmenorrhea after the intervention (P <0.05). Results of ANCOVA after controlling the confounding variables, showed only a significant difference between the control and intervention groups in regard to the severity of dysmenorrhea (P <0.05).

The results of this study showed that taping therapy can be used as an effective non-pharmacological method in the treatment of dysmenorrhea.

Universal Health Coverage (UHC) is a strategy for achieving the goal of equity of access to health care for all with preventive, curative and rehabilitative measures and without suffering financial hardship. UHC leads to equitable distribution of health care services, reducing out-of-pocket payments and achieving better health outcome for all people. Some measures have been taken in Iran to achieve UHC. However, the Iranian health system has not yet achieved the goal of UHC.

The narrative review method was used to write this article.

Implemention of UHC in Iran requires a comprehensive strategic plan. Futurology is the science and art of forecasting, planning, and backcasting.  Forecasting is a process which can predict probable future scenarios using trend analysis. Planning is the process of identifying strategies and taking necessary measures to achieve a favorable future. Finally, backcasting allows to identify the opportunities and barriers to achieving the goals.

Futurology can be used to develop a roadmap for UHC in Iran. Awareness of possible future opportunities and risks and taking appropriate measures will help achieve the goal of UHC.