فصلنامه کومش
سال دوازدهم شماره 4 (پیاپی 40، تابستان 1390)

The internal evaluation which is done by the members of the different departments is the best way to judge about quality of education and to identify its strong and weak areas. With regard to the important role of evaluation in the quality of education, the aim of this study was to conduct an internal evaluation of the department of physiotherapy in order to optimize the educational quality of the different parts of the department. This descriptive-cross sectional study was done to evaluate some variables such as: educational goals, optimal leading of the department, instrumental and physical equipments, clinical educational environment, and student measures about educational style and teaching quality of practical and theoretical courses of scientific members of physiotherapy department. To collect data, questionnaires and checklists was provided by the faculty members of the department of physiotherapy. These instruments were given to the faculty members (to evaluate themselves) and the students (sophomore and senior students of physiotherapy to evaluate the theoretical courses and the junior and senior students were asked to evaluate the clinical courses). After collecting each instrument, results were categorized according to the modified Gourman scoring scale. According to the modified Gourman scale, means were obtained from internal evaluation of physiotherapy as in follow: professional–theoretical lessons were in good ranking, clinical courses were in good ranking, educational and physical equipments (evaluated by scientific members and students) were in more than satisfied ranking and evaluation of head of group and scientific members were in good ranking. Generally, results showed physiotherapy group was in good category. Obviously, to reach an ideal level, we should make some changes, for example, encouraging and strengthening weak areas and maintaining strong areas.

Coping strategies, anxiety and depressive symptoms are major problems of post myocardial infarction (MI) patients. However, in this case the studies are limited. The aim of this study was to determine some coping styles related to reduction of anxiety and depressive symptoms among post-MI patients. In a cross sectional study one hundred consecutive patients following MI admitted to the CCU wards of hospitals in Isfahan were selected during autumn in 2005. The patients completed Jalowiec coping questionnaire and Hospital Anxiety and Depression Scale (HADS). Then the data were analyzed using Pearson correlation coefficient, MANCOVA and Covariance. The c orrelation matrix describes a significantly negative correlation coefficients between anxiety and confronting (r=-0.535, P=0.0001), optimistic (r= -0.516, P=0.0001), supporting (r=-0.409, p=0.0001) and self-reliant coping style scores (r=-0.392, P=0.0001) and between depression and confronting (r=-0/267, P=0.007) and supporting coping scores (r= -0.361, P=0.011). Findings showed that the same coping styles negatively correlated to rate of anxiety and depressive symptoms were confronting and supporting coping styles. The results of covariance indicated no significant differences in coping styles between different age groups. The comparisons of both relationships between coping styles and anxiety, and coping styles and depression show that two coping styles including confronting and supporting methods are probably associated with normally psychological function. Also, it seems that cognitive appraisal of personal control plays the important role in using coping strategies.

Muscle-Skeletal disorders are the most common problems in hemophilia patients that can affect the quality of life and psychological factors in these patients. The aim of this study was to evaluate the effect of a period of aquatic exercise therapy on the quality of life, depression and anxiety in hemophilia patients. In a semi-experimental study, 20 patients who referred to Isfahan Sayedo-Shohada hospital voluntarily were selected and then randomly in two experimental (n=10) and control (n=10) groups. Subjects of aquatic exercise therapy group started their activity in water for 8 weeks, 3 sessions per week about45 to 60 minutes, while the control group was only followed-up and during this period they did not experience any exercise. The quality of life, depression and anxiety variables of patients were measured by standard questionnaires in the beginning and end of eight week aquatic exercise therapy. The results showed significant improvement in quality of life, depression and anxiety variables in aquatic exercise therapy group patients, compared with the control group after 8 week aquatic exercise therapy (p<0.05). Results of this study showed that aquatic exercise therapy can be used as an effective and helpful method to prevent and treat hemophilia patients because it leads to improve multi-dimensional variable quality of life, depression and anxiety in hemophilia patients.

Although the musculoskeletal disorder has been known as a serious, fundamental and costly problem among the nurses, few studies have conducted to determine the underlying causes in Iran. The aim of this study was to inspect the outbreak of musculoskeletal disorder and the ergonomic factors related to it among the nurses. In this cross-sectional study, 400 samples of nurses in Amol hospitals (a city in Mazandaran province, Iran) with census method were studied. To obtain the required information and distinction of the musculoskeletal disorder outbreak the changed Nordic questionnaires and Yip study were used. 81% of the nurses experienced backache, 29.5% had wrist ache, 50% had pain round their neck, 35.5% had pain in their shoulders, and 63.5%had painful knee at least once during the last year. Females have neck ache and backache 122% and 203% more than males, respectively. Among the investigated ergonomic factors, bending over the patients’ bed in order to do the nursing job enhances the wrist pain in nurses; the neck pain is also increased by moving and lifting the wards instruments and raising the hands higher than the shoulder level. Another factor that amplifies the back ache is bending to lift something from the floor. One of the most serious problems in nursing job is musculoskeletal disorder which is directly related to different factors such as bending, patient and wards instrument displacement, helping the patients to bathe them; so instructing the nurses in order to teach them how to use the movement aid items in wards can be effective in reducing the arisen factors.

Despite the high prevalence of obesity, there is no safe and low cost method for losing weight (especially local). Electrical stimulation has been suggested as an efficient method in decreasing the thickness of local fat. The objective of this study was to determine the effect of electrical stimulation on abdominal subcutaneous fat thickness in healthy women. This quasi experimental research was conducted on 30 young healthy women (20 in study group and 10 in control group). In the control group, the abdominal fat thickness was measured without any therapeutic intervention at the beginning and after two weeks. In the experimental group, electrical stimulation to rectus abdominis muscles was applied 10 sessions (at 5 sessions per week) and the subject's abdominal fat thickness was measured at the baseline, and at the end of 2nd week. Comparison has been made across sessions and also between both groups. In control group, the fat thickness changed from 2.17±.7(cm) at the first session to 2.18 ±.69 (cm) at the end of the 2nd week which was not significant, but in the experimental group there was a significant decrease in fat thickness from 2.59±.74 (cm) at the first session to 2.25 ±. 68 (cm) at the end of the 2nd week (P=0.0001). This work indicated that electrical stimulation in 10 sessions is effective in reduction of abdominal fat thickness in healthy women.

Chronic renal failure disease and its conservative treatment (hemodialysis) result in several physical, psychic, and social problems in hemodialysis patients. In health care system, nurses by their supportive behavior have an essential role to help the patients for adjustment with the problems. This study was performed to explain the perception and experience of hemodialysis patients from nurse's role in adjustment with hemodialysis. This study was conducted with qualitative research approach and content analysis method. The participants were 16 patients in the hemodialysis ward of hospitals affiliated to Semnan University of Medical Sciences. Purposive sampling was employed and continued up to data saturation. Unstructured interviews were the main method for data collection. All interviews were recorded and then transcribed verbatim. The data were analyzed by using qualitative content analysis and constant comparative method. During content analysis process, three themes emerged including: (1) extremely effort for comforting patient, (2) responsible accountability to patient's questions, and (3) kindly behavior and friendly relationship with patient. The themes indicated the nature and dimensions of patient's perception from nurse's role to help them for adjustment with hemodialysis. The patient's experiences showed that the appropriate supportive behavior of nurses has an important role in their comfort, security, and trust, as well as accelerating adjustment with hemodialysis. The results help the nurses to be aware more from the importance of their supportive role in helping patients for adjustment with hemodialysis.

Cesarean section is one of the most commonly performed surgical procedures in hospitals. The rates of surgical site infection after cesarean section reported in the literature range from 3% to 15 %. The aim of this study was to identify incidence and risk factors of wound disruption following cesarean delivery. A retrospective multistage study in two phases (the first stage a historical cohort and the second stage a case control) was carried out over a 6 year period from 21st March 2002 to 20th Feb 2008 in Mahdieh Tertiary Care Hospital. In the first stage, we identified wound disruption cases with using wound complication code in all cesarean sections were performed during this period. In the second phase of the study, risk factors associated with the wound disruption after cesarean section were evaluated and for each case two controls were selected. These controls were non complicated cesarean section patients just before and after each disrupted cesarean wound. A total 10525 women who underwent cesarean section during this period, 48 (0.4%) were complicated by wound disruption. Using a multivariable logistic regression model, the following risk factors were identified: diabetes (P=0.02, OR: 5.46; 95%CI: 1.02-49.2), hypertension disorders(P=0.001; OR: 5 95%CI: 1.7-14.3), emergency cesarean delivery (P=0.01; OR: 3.3; 95%CI: 1.2-9.4), post cesarean fever (P=0.0001; OR: 16.2; 95% CI: 4.4-59), and post cesarean laparatomy (P=0.013, OR: 6.3; 95%CI: 6.3-62). Identification of the predictable risk factors for wound disruption and control of these factors may lead to decrease of wound disruption after cesarean section.

Insertion of a nasogastric tube (NGT) sometimes will be difficult in patients who are anesthetized or comatose. The tube entraps in the pyriform sinuses and, thus, coils inside the oral cavity. Several methods have been offered to increase the success rate of the procedure. The aim of this study was to compare the success rate of three methods of NGT insertion. In a prospective clinical trial study, 162 patients who needed NGT insertion were randomly divided into three groups: Contorl, D and M groups. In the control group, insertion of the tube was done with the head of the patient in the normal position. In D and M groups, NGT were conducted through the pharynx towards the esophagus by digital assistance and by Magills forceps, respectively. the success rates in the control, D and M groups were 70%, 94% and 81%, respectively. The differences between D group and the control and M groups were significant. NGT insertion by digital assistance is recommended as first choice fornasogastric intubation in anesthetized and comatose patients due to facility and low cost.

Cryptosporidium is an Apicomplexa parasite that infects humans and a wide range of domestic and wild animals. However, the sub-genotypes of the species infecting animals in Iran are unclear. The aim of the present study isto identify DNA fingerprinting of bovine Cryptosporidium in Qazvin province using sequences of GP60 gene. In this study we investigated 25 C. parvum isolated form bovine in Qazvin animal husbandries. Subgenotypes were determined by DNA sequencing of 60-kDa glycoprotein gene. Using DNA sequencing of GP60 gene, two subtype families within the C. parvum included IId (15/22) and IIa (7/22) were recognized. Also three subtypes in these two subtype families included IIa A15G2R1 (22/25), IIa A16G3R (1/25), IId A15G1 (2/25) were determined. Today, new zoonose strains are identified which based on severity of infection compared with human strains are more sever and the source and transmission of their infection are unclear. Therefore, determination of C. parvum strains, genotypes and sub-genotypes for epidemiological studies are quite necessary specially to identify the animal sources and to improve the control and prevention programs due to the lake of effective drugs for this infection.

One of the main goals of health service, especially for the lower limb amputates patients, is the quality of life improvement. So it is necessary to use special instrument to evaluate the quality of life of these people. Trinity amputation and prosthesis experience scales (TAPES) evaluate outcomes in lower limb amputee physically, socially and psychologically. The goal of this study was to study cross-cultural adaptation and evaluation of validity and reliability of TAPES in an Iran population. TAPES was translated and adapted to Persian language with International quality of life assessment (IQOLA) method. To evaluate validity, a sample of 104 patients with lower limb amputation was asked to complete questionnaires. For evaluation of reliability, 41 patients were tested again 5-7 days later. Retinal reliability by all subscales with the exception of social restriction subscale was exceeded minimum level of 0.70. Minimum Cronbach’s alpha level of 0.70 was exceeded by all subscales with the exception of social adjustment subscale. Correlation of each item with its subscale after correction for overlap, by all except for two items was exceeded optimal level of 0.40. Most subscales exception of social adjustment subscale had most correlation with physical summery measure of SF-36 scale. The Persian-version of the TAPES is a culturally-adapted, reliable and valid outcome measure to be used in Iranian patients with lower limb amputation.

Cyclosporine A (CsA) as an immunosuppressive drug which widely used in organ transplantation and autoimmune diseases. This drug is caused many injuries and cell cytotoxic of the body organs such as reproductive organs. The aim of this study was to investigate the possible protective effects of vitamin E (Vit E) against CsA-induced damages in rat testis. 40 adult male wistar rats were divided into 5 groups: control (without any intervention), placebo (received only pure olive oil), test 1 (CsA+olive oil, 30 mg/kg), test 2 (Vit E, 100 mg/kg) and test 3 (CsA+Vit E, with the same dose). All animal received drugs for three weeks daily by oral gavages. Following, the testis were fixed and sections stained with Haematoxylin & Eosin and Trichrome Masson. Then with using a microscope equipped with a scaled ocular micrometer and image analysis software were histomorphometry. This study showed that CsA caused severe degenerative changes in testicular tissue include decreased seminiferous tubules diameter, seminiferous epithelium thickness. Also, the number of spermatogonia, primary spermatocyte, spermatozoa, and sertoli and leydig cells significantly decreased throughout the experiment. These changes are lead to turbulence and atrophy seminiferous epithelium and delay in spermatogenesis. Treatment with vitamin E minimized the adverse effects of CsA on testis structure and spermatogenesis. These results suggest that vitamin E has a protective effect against CsA-induced testicular toxicity in male rat.

There is a great need to identify prognostic and diagnostic cancer bio-markers which can be applied for vaccine and immunotherapy development. The aim of this study was to determine gene expression of IL-23 and IL-27 in two groups: lymph nodes of breast cancer patients and three cell lines. IL-23 and IL-27 mRNA transcript were investigated in 10 lymph node samples (consisting of 5 metastasis and 5 non metastasis ones) and three cell lines (including of SKBR3, MDA-MB-468 and MCF7) by quantitative real time PCR (Q-PCR) procedure using designed primers, Master Mix reaction containing SYBER green and β actin housekeeping gene. Data showed no significant differences in IL-23 and IL-27 mRNA gene expressions among metastatic lymph node and non-metastatatic ones. Also, we did not find any significant differences in IL-23 and IL-27 mRNA expressions in cancer cell lines. Our findings indicate that breast cancer microenvironment has no effect on inflammation via either IL-23 gene expression or Il-27.

Although past research has suggested that acute exposure to the extremely low-frequency electromagnetic fields (ELFEFs) can impair cognitive functions, data on chronic exposure remained scare. Only a few studies investigated the effects of chronic ELFEFs on cognitive functions, but the results are controversial. Thus, the aim of the present study was to study whether chronic exposure to ELFEFs can affect cognitive functions and anxiety-like behaviors in rats.

Thirty-five male Wistar were divided into control and exposed (10 or 100 uT). Exposed rats were continuously exposed to a 50 Hz magnetic field of 10 or 100 µT for four weeks. Then, cognitive functions of all rats were tested in the Morris water maze and passive avoidance tasks. Also, anxiety-related behaviors of all rats were examined in the elevated- plus maze and light-dark box.

No significant differences were found between control and exposed in learning acquisition, memory retention and anxiety-related behaviors.

Our results showed that chronic exposure to ELFEFs neither change cognitive functions nor anxiety-related behaviors in rats.

Vaccinium arctostaphylos is one of the medicinal plants used in the treatment of diabetes. But the mechanisms responsible for its antidiabetic action have not been well defined. This study was undertaken to investigate the possible effect of V. arctostaphylos on insulin release from rat-isolated Langerhans islets. The islets were incubated in the presence of 3 or 10 mM glucose with or without milrinone (0.1 and 0.01%) and hydro-alcoholic extract of V. arctostaphylos (0.1 and 0.1%) for 60 min. The concentration of insulin was measured in samples of incubation medium. The increase of glucose concentration in incubation medium from 3 to 10 mM resulted in a significant increase of insulin secretion. Milrinone at 0.1 mM significantly increased insulin release evoked by 10 mM glucose. However, none of the extract concentrations affected the insulin release. Our data demonstrated that V. arctostaphylos had no insulinotropic property and its effects on diabetes mediated by other mechanisms which should be clarified in future studies.

Diabetes mellitus is accompanied with higher incidence of cardiovascular disorders. There is some evidence of antidiabetic and vascular function-improving potential of Amaranthus caudatus (AC). Endothelium-dependent effects of oral administration of AC for 8 weeks on contractile and relaxatory response of thoracic aorta from diabetic rats were investigated. Wistar rats were divided into control, AC-treated control, diabetic, AC-treated diabetic, and glibenclamide-treated diabetic groups. For induction of type 1 diabetes, streptozotocin at a dose of 60 mg/kg (i.p) was injected. Treated groups received AC-mixed pelleted food at a weight ratio of 6.25%. Body weight and serum glucose level was measured before the study and after 4 and 8 weeks. At the end of study, contractile reactivity of thoracic aortic rings to KCl and phenylephrine and relaxatory response to acetylcholine and sodium nitroprusside was determined using isolated tissue setup. Serum glucose level significantly decreased in AS-treated diabetic group (P<0.05) versus untreated diabetics. In addition, endothelium-intact AC-treated diabetic group showed a significantly lower contraction to KCl and phenylephrine (P<0.01) as compared to diabetic group and endothelium removal abolished this response. Meanwhile, relaxation response of endothelium-intact rings to acetylcholine was significantly higher in AC-treated diabetic group as compared to diabetics (p<0.01). In addition, there were no significant changes amongst the groups regarding relaxatory response to sodium nitroprusside. Chronic oral administration of AC through affecting endothelial-related agents could decrease contractile response and enhance relaxatory response in aortic tissue of diabetic rat and this may be beneficial in prevention of long-term vascular complications of diabetes.

Parkinson,s disease (PD) is a common neurological disorder due to degeneration of substantia nigra pars compacta degeneration. With regard to protective effect of silybum marianum, this study was conducted to evaluate the protective effect of aqueous extract of this plant in an experimental model of PD. Forty male rats were randomly divided into 4 groups; sham-operated(SH), extract-treated sham-operated (E+SH), lesion (L) and extract-treated lesion(E+L) groups. The hemi-PD model was induced by unilateral intrastriatal injection of 6-hydroxydopamine (6-OHDA, 12.5  g/  l of saline-ascorbate).The E+SH and E+L groups received intra-peritoneal pretreatment of aqueous extract of silybummarianum (200mg/kg/daily) for one week before surgery. Two weeks after surgery, the animals were tested for rotational behavior by apomorphine hydrochloride and the number of nissle-stained neurons in the substantia nigra pars compacta (SNC). Two weeks after surgery, apomorphine caused a significant contralateral turning (P<0.0001) and reduction in the number of neurons on the left side of the SNC in the L group in comparison with SH group (P<0.05). Administration of aqueous extract of silybum marianum decreased the rotational behavior in lesioned rats and attenuated the reduction of number of SNC neurons (P<0.05). On the other hand, treatment of SH group with extract of silybum marianum had no significant effect on the number of apomophine-induced rotation and neurons of SNC. Our finding shows in experimental model of PD, intra-peritoneal administration of aqueous extract of silybum marianum has protective effects against 6-OHDA toxicity.

Considering the importance of cell migration in cell therapy protocols and the necessity to understand this issue better. This study was administred to evaluate the homing possibility of human umbilical cord blood mononuclear cells in the irradiated and non-irradiated rats’ bone marrow. Human umbilical cord blood was collected and after isolation and cell counting, 5 × 10 6 cells were injected to tail veins of 13 groups (1 healthy and 12 irradiated group) of adult rats. In defined time gaps after injection, transplanted rats were sacrificed and their bone marrow cells were collected. Then, the DNA of these collected cells was extracted and was amplified by PCR using specific primers for human STS. Finally, PCR products were analyzed on gel electrophoresis. PCR results for irradiated and non-irradiated rats in all groups were negative which implied that human umbilical cord blood mononuclear cells did not home in bone marrow of transplanted rats. Our results suggest that human umbilical cord blood mononuclear cells are unable to home in rat's bone marrow after intra-venous injection. This might be the result of trapping of cells into other organs or unknown conditions of cells physiology for migration and homing.

Several in vitro studies have shown the effect of external stimulus on acceleration of long bone fracture repair in experimental animals. The aim of this study was to determine feasibility and creation of appropriate conditions for proliferation of the bone cells, in flat and long bones of mice and rabbits. Mice and rabbits flat and long bones were cultured in 12 plates. At 14th day of culture, they reached an appropriate level of cell growth. Then specific staining methods were used to study the pattern of cell growth. The results showed a significant differences (P<0.05) in the number of proliferated flat bone (Calvaria) and long bone (Tibia) of rabbits in the first, second and third weeks of cell cultures. The highest rate of growth was observed in the third week in both bones. Similar differences were found in mice. The highest rate of growth in calvaria and tibial bones of mice were found in the second and third weeks, respectively. It seems that growth and proliferation rate of flat bones in mice and rabbits spread more quickly than their lone bones. Thus, this point should be taken into account in the in vitro study of repair pattern of bone tissue.