مجله دانشگاه علوم پزشکی رفسنجان
سال دهم شماره 4 (پیاپی 41، زمستان 1390)

Diabetes Mellitus is a major endocrine disorder and growing health problem in most of countries. Avicennia marina is a type of mangrove plants which can grows in the Iranian coastal areas of Persian Gulf. We studied the effects of Avicennia marina leaves aqueous and hydroalcoholic extract on streptozotocin -induced diabetic male rats.

In this experimental study, 45 male rats were randomly divided into nine groups of five. Control animals were fed with a normal diet. The test groups received intraperitoneal injection of 60 mg/kg streptozotocin for induction of diabetes. The diabetic groups were further subgrouped into; diabetes, diabetic control (given 0.9% normal saline) and 6 groups treated orally with aqueous and hydroalcoholic extract of Avicennia marina leaves (30, 60, 120 mg/kg daily for three consecutive days). Twenty-four hours after the last treatment, blood samples were collected from heart for determining the blood glucose and insulin concentration levels using glucose oxidase and enzyme-linked immunosorbent assay (ELISA) methods respectively.

Our results indicated that aqueous and hydroalcoholic extracts of Avicennia marina leaves could decrease the mean blood glucose of diabetic test rats compared to diabetic control group (from 293.8±10.88 to 131.4±2.97 vs 139±1.92 respectively). Also, a significant increase in the serum insulin levels with no increase in the final body weights was found in the former group. No toxic effects of leaves extract was observed after 2 days of treatment.

In this study, we have shown that Avicennia marina leaves extract can significantly decrease the blood glucose level.

Authorities of organizations need a performance appraisal system for planning, controlling and improving the efficiency of their organizations. In this research, the staff relative efficiency of health centers in Yazd province has been appraised by using DEA (Data Envelopment Analysis) models. In this descriptive study, the technique of gathering data was the "survey method", the main input and output variables were determined prior to applying the CCR method for assessment of relative efficiency. The relative efficiency of the units was assessed utilizing a modeling approach and running the model. For improvement of the efficiency, the target inputs and outputs of the inefficient units were determined using the input and output orientation model. For this study, 10 health centers situated at Yazd province were investigated in 2006. The inputs and outputs of the model were the health staff and workrs and the health services presented at these centers respectively. The findings of this study showed that the health centers of Mayboud and Yazd cities with the relative efficiency ratio (RER) of 1 had the best efficiency and the health centers of Mehriz and Taft cities with the RER of 0.485 and 0.427 had the lowest efficiency respectively. Based on our results, the staff relative efficiency appraisal of health centers can be investigated using the DEA models. The DEA models can be used by health centers authorities to imorove the efficiency of health services delivery.

The role of gene-environment interaction in epidemiology has been widely considered. The traditional methods of studying the gene-environment interaction need appropriate control groups which their selection may be associated with some problems. Therefore, new methods have been created to study these interactions from which are the case-only designs. In this method, only the cases data are being used. In this study, gene-environment interaction in patients with breast cancer was investigated using the case-only and case-control designs. This study conducted in 2008, using two matched case-control and case-only. Simple random sampling was used to select 300 patients with breast cancer in Shahid Mottahari Clinic for two aforementhioned designs. The control group for the matched case-control study was selected from the women referring to Shahid Mottahari Clinic. Data were analysed using lagistic regressian and conditional logistic regression. The confidence intervals and log likelihood in all variables in case-only design was better than the matched case-control. In case-only design, the standard error in the following variables; age at menarche, the first delivery at the age of ≥34 yrs and /or nulliparity, the number of live births, use of oral contraception pills, and breastfeeding history were less than those in the matched case-control design. In case-only design, the P-value of the above-menthined variables was less than those of the matched case-control design. The case-only design is an efficiency method for investigating of the interaction in terms of statistical study, sample size and the easily implementing.

Undoubtedly, looking for a suitable job is one of the most important issues in everybody's life including students and a student's area of study has a great impact on this issue. The aim of this study was to assess motivations underlying the field of study choice in medical and dental students of Rafsanjan Medical University. In this descriptive cross-sectional study in 2010, questionnaires included demographic information and questions about the student's motives were given to the medical and dental students of the first and second years (146 students). The data were analyzed by descriptive statistics and Chi-square test. The response rate to the questionnaires was 89%. Sixty percent and 40% of the participants were medical and dental students respectively. The most important motivations among both students were "High professional status" and " Prestigious social standing". The motives of "Provides a secure career" (p= 0.04), "High income" (p= 0.01) and "Requires use of manual skills" (p= 0.001) were significantly more important for dental students. Medical students, in contrast to their dental counterparts, were significantly more likely motivated by factors relating to "Interacting with other people" (p= 0.02) and "Challenging career" (p= 0.01). Choosing field of study by medical and dental studying likely related to their high professional and prestigious social status. The difference between the motivations of choosing the area of study is possibly related to the different nature of these two academic disciplines.

Suitable interaction of various systems of body and environment are necessary to maintain of the balance. Balance exercise is prescribed to improve balance and proprioception. There is not clear mechanism about the effectiveness of these exercises on healthy subjects. So, this study was done to investigate the effects of balance exercises on proprioception of knee and ankle joints and single- leg balance on healthy students. This experimental study was conducted on 30 healthy female students of Shiraz Faculty of Rehabilitation in 2009. The participants were randomly separated into two groups, intervention and control. Errors in repositioning of knee and ankle joints angles (passive and active), and also single- leg balance time was measured in both groups. The intervention group did the balance exercises 3 times a week for 6 weeks and the measurements were then repeated. Data was analyzed by using Mann withney and Wilcoxon signed-rank test. There was a significant difference between two groups regarding the balance time before and after and training courses (p<0.05). Also, There was a significant difference in the mean of repositioning of angles before and after training (p<0.05). Balance exercises may improve single-leg balance and proprioception in the ankle and knee joints.

Sexual dysfunction has negative impacts on interpersonal relationships and married life. The aim of this study was to evaluate the frequency of erection dysfunction among hypertensive men referred to the health centers of Ramsar and Tonekabon in 2009. This descriptive study was conducted on 200 hypertensive men patients selected using a non-randomized sampling method. The data collecting tool was the IIEF-5 questionnaire (The International Index of Erectile Function, a 5-item version). Data was then analyzed by SPSS software and using descriptive statistics, t-test, ANOVA and coefficient Pearson correlation. The findings indicated that frequency of erectile dysfunction was 75.5% and 27.5% had moderate erectile dysfunction. A significant statistical correlation was found between the score of erectile dysfunction and age (p=0.000), body mass index (p=0.000), cigarette smoking (p=0.000), systolic blood pressure (p=0.000), diastolic blood pressure (p=0.001), length of hypertension (p=0.002), also a significant statistical difference was found between mean score of erectile dysfunction and drug regimens (p=0.000), including use of angiotensin converting enzyme inhibitors and angiotensin II receptor blocker s (p=0.025). Conclusion s: Erectile dysfunction is common among hypertensive patients and factors such as age, smoking, obesity and anti-hypertensive drugs have an adverse effects on erectile dysfunction. In hypertensive men, changes in lifestyle and type of medications may improve erectile dysfunction.

Regarding the high frequency of tuberculosis in jails, this survey studies the prevalence status of the disease in jails of Mazandaran province to provide useful suggestions for tuberculosis control. The present descriptive study was carried out by in 2008. The prisoners of Mazandaran province jails (2405 cases) comprised the research population. The data was collected by a questionnaire containing 9 demographic and 11 specific questions. Data was analyzed by descriptive statistics. 2405 questionnaires were completed (response rate=96.2%). Of which, 2227 (92.6%) were men and 178 (7.4%) were women. The average age of the participants was 26.8±1.24. The majority (41.9%) of them were prisoners for more than six months. Seven prisoners (0.3%) were infected by HIV, 136 (5.7%) had a prolonged cough for more than 2 weeks, and 2 sputum smear (0.1%) was positive for TB and 2 (0.1%) were reported to have extra pulmonary tuberculosis. According to the results of the present study, the prevalence rate of positive pulmonary smear tuberculosis in Mazandaran jails is 17.7 times higher than the normal of population. Therefore, continuous developing and implementing an effective plan for tuberculosis control is necessary for jails.

B> Early and on time diagnosis of lower gastrointestinal bleeding is essential due to different treatable etiologies and prevention of complications. The aim of this study was to detect the etiologies of LGI bleeding in children referred to Kerman Hospital of Afzalipour. This descriptive-prospective study was performed on 138 children with painless rectal bleeding admitted in Afzalipoor Hospital (from 2005 till 2007). The patients underwent colonoscopy by a pediatric gatroenterlogist. The colonscope passed into the splenic flexture, if polyp was detceted, polypectomy was done, and unless, two biopsies were taken from apparently intact mucusae and also any pathologic process on desceding colon and rectosigmoid. Etiology of lower gastrointestinal bleeding was detected in 87.7% of patients. Majority of the participants (62.3%) were male. The most common symptom (63%) was hematochezia. The most frequent endoscopic (41.3%) and pathologic finding (50.7%) was colitis. The three major etiologies of bleeding were; allergic colitis (24.6%), polyp (23.2%), and inflammatory bowel disease (17.4%). While allergic colitis (1.8 times) and polyp (3.5 times) were more common in boys, inflammatory bowel disease was common in girls (1.4 times). The results of this study showed that the prevalence of allergic colitis and inflammatory bowel disease were higher than findings from similar studies.

Despite positive aspects of wide rang applications of detergents, a large number of these products are attributed to the several consumer's health problems. Women are the most domestic consumers. So in this study, women strategies for handling household detergents were surveyed. In this descriptive study, 349 women from health care centers were selected using stratified Random sampling method and their behaviours for handling household detergents by phone structured interview were surveyed. Data were then analyzed by SPSS software and descriptive statistics, χ2 and Fisher test. In 85% of houses, detergents were Stored in kitchen and 76.5% paid no attention to the detergent’s labels. Only 26.2% always were gloves. The rate of hand dermatitis and respiratory problems due to domestic cleaning was 41.2% and 17.5% respectively. Respiratory complications had a significant relationship with job (p=0.009), socio-economical statues (p=0.03) ignoring of the sefety rules regarding the storing of detersents and poor ventilation of the storing places (p=0.04). Women who mixed detergents without gloves had a higher rate of dermatitis (p=0.000). Handling of household detergents may expose women to the adverse physical and chemical effects of detergents which could be a serious public health concern.