نشریه دانشور پزشکی
پیاپی 96 (دی 1390)

The rate of cesarean section is higher than standard of WHO (15%) in Iran. This theory-based study was carried out to identify factors related to elective cesarean labor amongst pregnant women. A cross-sectional study was done and 342 mothers referred to public maternal health care centers and private clinics were randomly selected in Ahvaz in 2010. Data gathering was done using a structured based Health belief model and theory-planned behavior questionnaire. Data were analyzed using SPSS through logistic regression, chi-square and independent t tests. Mean age of women was 23.95±4.07 years. There was a significant correlation among income, ethnicity, job and education with choosing delivery mode. The results of t test showed that tendency to the mode of delivery was significantly related to perceived benefits, perceived barriers, perceived severity, perceived susceptibility, subjective norms and self efficacy (p<0.001). Using multivariate regression, three constructs including perceived barriers, subjective norms and self efficacy were significantly related to elective cesarean section (p<0.001). Promoting self-efficacy to overcome barriers such as pain can encourage pregnant women to select vaginal delivery. However, important factor is subjective norms that are influenced by husbands and mothers. In this regard, researchers suggest applying subjective norms in other theory-based studies.

Physical and general health limitations may affect quality of life among children survivors of land mine and explosive remnants of war (ERW). This study aimed to assess the quality of life among children survivors of land mines and ERW injuries in Iran in 2010.

A total of 69 adolescent survivors of land mine and ERW injuries at the time of study were enrolled. In this cross-sectional study, adolescents were called in from border provinces that included the most land mines and ERW contaminated areas in the country, i.e. Kurdistan, Kermanshah, Khuzestan, Ilam and West Azerbaijan. Component scores were determined from responses to questions about physical and mental health on SF36.The validity of the Iranian version of questionnaire was 0.65-0.9. The questionnaire consisted of 36 questions measuring eight domains of health-related quality of life including physical functioning, physical role, bodily pain, general health, vitality, social functioning, and emotional and mental health role.

The mean age of participants was 16.68±1.18 years and the mean time since the injury was 7.85±3.1 years. Eighty-eight percent of the cases were boys. More than two third (69.6%) (n=48) of the victims were living in two provinces of Kurdistan and Kermanshah. About one-third (36.2%) (n=25) were studying at high school level. The children survivors had the highest score in physical functioning (50.5 ± 23.1) and the lowest in emotional role (8.69 ± 21.1). Overall, children survivors were suffering greatly in all different aspects of quality of life than the age-matched controls in all SF-36 eight domains (p≤0.01).

Children survivors of landmine and ERW injuries (at an age range of 14-19 years) due to Iraq-imposed war greatly suffered from a lower quality of life due to a combination of physical and mental factors affecting them.

Nowadays opportunistic fungi especially C. albicans are the most common cause of life-threating infections in immunodeficiency patients. Increasing Azole-resistant strains of C. albicans are a main problem in human immunodeficiency virus-infected patients. The aim of this study was the evaluation of ERG11 gene in C. albicans Azole resistant strains that were isolated from AIDS patients with oropharyngeal candidiasis by RT-PCR method. The present experimental study was conducted at Tarbiat Modares University during the years 2009-2011. C.albicans isolates from HIV-infected patients were identified by standard procedures including germ tube formation, clamydoconidia and color of colonies on CHROM agar. At first, susceptibility of C. albicans isolates was assessed by disk diffusion agar technique. Then, overexpression of fluconazole resistance gene ERG11 using RT-PCR was compared with control samples and gene expression levels were determined by UVItec software. The results of drug sensitivity for 66 C. albicans isolated from AIDS patients showed that 62.6% were susceptible, 8.6% were susceptible-dose dependent (SDD) and 28.7% were resistant. Product evaluation of RT-PCR showed that 9% of patients have increased expression of ERG11 gene resistance. Oral candidiasis is a frequent complication among Iranian HIV individuals. The results of this study showed the high percentage of resistant strains among samples of C. albicans. However, the use of phenotypic methods like disk diffusion agar which has lower costs together with genotypic methods like RT-PCR which provide the possibility of studying the mechanism of drug resistance and genes involved is highly recommended.

Extended spectrum beta-lactamases (ESBLs) are defined as enzymes capable of hydrolyzing oxyimino-cephalosporins. Selective pressure of overuse of new antibiotics may be associated with emergence of new types of beta-lactamases. The aim of this study was to identify urinary isolates of CTX-M ESBL-producing Klebsiella pneumoniae and to detect their pattern of antibiotic susceptibility Bacteria were isolated and identified from the urine samples sent to laboratories of two hospitals in Mashhad in 2010. Isolates were then tested for antimicrobial susceptibility by disc diffusion and examined for beta-lactamase production by double disk approximation test and CLSI (Clinical and Laboratory Standards Institute) confirmatory test. The blaCTX-M genes were detected by polymerase chain reaction using specific primer. Out of 100 studied urinary specimens, 19 bacteria were K. pneumonia, of which 47.4% were ESBL producer and all were positive for blaCTX-M gene. A large percentage of ESBL-producing isolates compared to ESBL-non producers were resistant to co-trimoxazole, gentamicin, and nalidixic acid and the difference for gentamicin was significant. Due to relatively high prevalence of ESBL-producing bacteria in the studied population, screening of infections caused by these bacteria would be important for appropriate treatment.

Cardiorespiratory endurance and resting heart rate is the proper guide for cardiorespiratory fitness of people. The aim of this research was to survey the effect of training intensity and volume changes on cardiorespiratory endurance and resting heart rate. Forty-five non-athletic healthy B. Sc male students (with an average age of 25±1/87 years, weight 71±1/95 kg and height 175±2/30 cm) were randomly divided into three groups including: 1G, 2G and 3G groups. In first six weeks, 1G (n=15) run for 15 min with an intensity of 70% maximum reserve heart rate (MRHR), 1day/week; 2G (n=15) (at 15 min, 60% MRHR, 2 days/week); and 3G (n=15) (at 15 min, 50% MRHR, 3days/week) for 8 weeks. At the last two weeks, 1G run at 75% MRHR, 2G at 65% MRHR, and 3G at 55% MRHR. Findings showed that there was a significant difference in vo2max change in 1G and 3G groups. Also, 3G showed a more significant reduction in resting heart rate than 1G. Based on these findings, it seems that aerobic training with low intensity and long period has more effects on cardiorespiratory fitness and resting heart rate than high intensity and short period training.

Since the social, individual and psychological effects of social anxiety could damage functioning of many children and teenagers, we decided to survey the effectiveness of cognitive-behavioral group therapy for social anxiety of female students. Method of this study was an experimental type. After performing social anxiety inventory, clinical interview based on DSM-IV-TR was conducted and 18 students (n = 9 for each group) were randomly selected in two groups; experimental group (cognitive-behavioral group therapy) and control group (no treatment). After 12-session treatment (2 hours/session), social anxiety inventory was repeated as a post-test in both groups. The statistical t–test results showed that there were significant differences between the experimental and control groups regarding social anxiety with 99% confidence and with 95% confidence the clients could save the result of treatment until a month later. Cognitive-behavioral group therapy must be effective on social anxiety in fifth-grade female students.

Due to important role of enhanced oxidative stress in development of renal disorder in diabetes and with regard to antidiabetic and antioxidant effect of thymoquinone, this study was conducted to evaluate the effect of its administration on renal tissue level of some markers of oxidative stress in diabetic rats. In this experimental study, Wistar rats were divided into 5 groups, i.e. control, high dose thymoquinone-treated control (20 mg/kg), diabetic, and thymoquinone-treated diabetic groups (10 and 20 mg/kg). After 4 weeks, tissue level of malondialdehyde and nitrite and activity of superoxide dismutase (SOD) in kidney tissue were measured. Diabetic rats showed a significant increase in tissue level of malondialdehyde (p<0.01) and nitrite (p<0.05) and a significant reduction in SOD activity (p<0.05) and thymoquinone treatment at a high dose significantly reduced only levels of MDA and nitrite (p<0.05) and SOD activity in treated-diabetic groups was non-significantly higher as compared to diabetics. Chronic treatment with thymoquinone dose-dependently could attenuate some markers of oxidative stress in renal tissue from diabetic rats.

The risk of infection by microorganisms in blood, saliva and exudates from infected patients in dental and medical centers has always been a threat to the patients and the medical staff alike. We do not always have enough time to autoclave the instruments, so this has brought about the need to develop different ways to quickly disinfect the instruments. Furthermore, deconex (a trademark) is a famous detergent for disinfecting surfaces and equipment. Nanosilver due to its smaller particle size has greater contact surface and has many uses as new antibacterial agent. The purpose of this study was to compare the effect of nanosilver colloid particles and deconex P53 plus solution on Pseudomonas aeroginosa (ATCC 27853) and Staphylococcus aureus (ATCC29213). To measure the effective antibacterial concentration of nanosilver and deconex 53 plus, the MIC and MBC measurement methods were used. The MIC and MIB concentration of nanosilver for Staphylococcus aureus was 10 ppm and for pseudomonas aeroginosa was 100 and 500 ppm respectively. The nanosilver particles and deconex 53 plus has bactericidal effect on Staphylococcus aureus, so its MIC is equal to the MBC, but in the case of pseudomonas aeroginosa, the value of MBC for nanosilver and deconex were 5 and 20 times greater than their MIC respectively.

Great Iranian physicians of traditional Iranian medicine (TIM) have paid special attention to ethics in their practices, teachings and especially their manuscripts. It was essential for a physician to know medical ethics. They have had also some recommendations for physicians not to pay much attention to monetary aspects. The aim of this study was to determine the viewpoints of great physicians of TIM in this respect. This study was a review research, which reviewed traditional Iranian medicine's literature and textbooks to find what traditional Iranian medicine says about the financial relationship between physicians and patients. From very ancient times, Iranian physicians believed that physicians should not work for money and material gain, they must be fearful of God and should treat alike the rich and poor. Razi (one of the foremost Iranian physicians) always emphasized on moral values and medical ethics and he always treated needy and destitute people, although he was not rich. Traditional Iranian and Islamic medicine believes that practice is a form of servitude to and worship of God and pays special attention to medical ethics. It recommends that rich and poor patients must have the same equal treatment and physicians must never compete and wrangle for incomes and fees.