مجله علوم پزشکی رازی
سال نوزدهم شماره 7 (پیاپی 100، مهر 1391)

Recognition of positive and negative outcomes of globalization in different areas of telemedicine is one of all countries` priorities. This study was conducted to investigate the most significant opportunities and challenges of telemedicine in Iranian setting from the experts’ points of view. This was a qualitative research, applying structure and thematic analysis on a goal- oriented sample of 22 key informants in private and public health sector. Deep and semi-structured interviews were used until achieving saturation. Data were analyzed applying a 5-step process of framework analysis to extract main themes. Results lead to present 12 main themes in challenges part including exit of money, high cost of telemedicine, un suitable structure of telemedicine, restricted electronic financing network, lack of patient laws, inter sector cooperation, lack of insurance system and 6 main themes about opportunities containing absorbing incomes, increase of employment and quality improvement of internal health services,... It seems that the revenue increment driving from telemedicine can be used for developing health infrastructures especially for the poor. It is along with improving quality of health services providing for foreigners in those successful countries in telemedicine scope that may lead to absorb the large number of sick persons applying their health services.

Controlling occurrence of accidents in work place has been an interesting subject in all countries worldwide. Financial consequences of these accidents and their economic losses imposed on the involved companies is only one of the insignificant aspects of such damages and when the non-economic but intangible losses to the society are taken into consideration, these economic damages will be marginalized. Purpose of this research is fitting the box-Jenkins model to time series of total number of accidents in work place and estimation of serie's missing values during fitting of this model. This longitudinal (time series) study, intends to model, estimate and forecast time series of total number of work place accidents for the insured people between 2000 and 2010 in Iran. Spline non-parametric regression methods to find the best interpolation and estimation of the series’ missing value as well as box-Jenkins prediction method to find the best prediction on series have been used. Smoothing spline method using some adjusts for seasonal time series in order to estimate missing values, shows better performance on the series. Then, suitable box-Jenkins model,, was fitted to the series. Goodness of fit criterion of model, AIC, for prediction of the time series was equal to 1050.833. Estimation of the missing data in time series with regard to characteristics such as long period of missing data and exposure of values in tandem without any reliable middle points, is an appropriate method in order to leave situation of such gaps in the data. Looking at the goodness of fit of the model can be said that the error estimation and prediction model is rather low and hence, the model is well fitted to the series. Therefore, box-Jenkins model will be reliable for fitting to similar data.

Shallots are an important part of the diet of many population and there is long-held belief in their health enhancing properties. At least one episode of vaginal candidiasis is reported in up to 75 percent of women that Candida albicans is responsible for 80 to 92 percent of episodes of vaginal candidiasis in the world. The aim of this study was to determine anticandidal activity of shallot against chronic candidiasis agents. This study is an experimental study. With use of microdilution method, antifungal activities of alcoholic and aqueous extracts of shallot (allium hirtifolium) were tested against 33 candida species in vitro that isolated from patient with chronic candidiasis that referred to Mirza Koochak khan and Lolagar hospitals. The results showed antifungal activity of Allium hirtifolium against all the candida species tested and anticandidal activity of the alcoholic extract was much better than aqueous one. The results indicated that crude juice of shallot has anticandidal activity and might be promising in treatment of candidiasis.

Our purpose in this research was to evaluate the correlation between skill in chess (international chess rating scale) and severity of depression and anxiety and ten cognitive errors in members of Iranian Chess Federation that have international chess rating scale as well as to study the prevalence of depression and anxiety in the sample. 96 persons that had an international chess rating scale were sampled with convenient method and took part in this cross sectional study. All samples completed the second version of Beck Depression Inventory, Beck Anxiety Inventory and Cognitive Error Test. Data were analyzed with SPSS software. There was a significant reverse correlation between chess rating scale and four cognitive errors including over generalization, magnification, jumping to conclusion and must statement. The depression severity decreased by increasing the numbers of hours of game playing in the day. Also there was a reverse significant correlation between chess skill and depression severity, but chess skill had no significant correlation with severity of anxiety. The prevalence of mild moderate depression was 16.7%. There was no case with severe depression. The prevalence of mild and moderate anxiety was 27.1% and severe anxiety was 5.2%. We conclude that this significant reverse correlation between chess rating scales and depression severity is mediated by decrease of cognitive errors and the number of the hours of game playing in the day, which is in accordance with Beck's Cognitive Theory and Behavioral Activation Theory.

There are few studies indicating the association of Salvia officinalis extract with tumor markers. The main aim of this study was to determine the effects of Salvia officinalis extract on serum level of CEA (Carcinogenic embryonic antigen) in male rats.

In this laboratory experimental study, male Wistar rats were randomly divided into control, normal saline or Salvia officinalis extract (100 or 200 mg/kg/body weight) receiving animals of 5 in each group. After 7 weeks blood samples were collected using cardiac puncture method. Following serum collection, CEA level was measured by radioimmunoassay method. Data were statistically analyzed and compared between groups using ANOVA.

The results indicated that serum CEA level was significantly decreased in rats receiving Salvia officinalis extract (200mg/kg/body weight) compared with control animals (P<0.05), however, CEA serum level was not significantly changed in rats receiving 100mg/kg/body weight of extract compared to control animals

Our findings show that appropriate dose of Salvia officinalis extract can decrease serum level of CEA, on which medicinal application of this extract particularly in cancers accompanied by CEA increased serum level is conceivable.

Current, lung protection strategy possesses some degree of hypercapnia and hypoxia. Permissive hypercapnia and hypoxia may attenuate the complications of mechanical ventilation in neonates. Adapting this approach and thorough understanding of the biopathologic effects of hypercapnia and hypoxia could prevent mechano-trauma and air leak syndromes. This helps protecting the lung and inflammatory organs lessening inflammatory damages, inflammatory cascade and prostaglandins at the presence of endotoxins, inflammatory cells and bacteria. In addition, allowing normal versus supra normal values of oxygen and reduction of oxygen toxicity could diminish the free radical related illness (e.g., respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD)).This article reviews the pathophysiologic effects of hypercapnia and hypoxia, principals of oxygen delivery and tissue consumptions, clinical applications of permissive hypercapnia and permissive hypoxia and concerns when such approaches are decided.

Binding indirect bilirubin to neuronal membranes receptors such as N-methyl-D-aspartate (NMDA) causes permanent injuries. Magnesium (Mg) ion is proposed to be one of the most important antagonistic regulators of this receptor. We studied relationship between serum levels of total magnesium and total bilirubin before and after phototherapy in term neonates to find new therapeutic and management techniques and the best time for discharge. In this semi-experimental, we evaluated icteric neonates whom admitted to Zahedan Imam Ali hospital from March 2009 to March2010. Neonates with symptoms in favor of sepsis, hemolysis and with administration of magnesium sulfate in their mother were not included in this study. The collected data were analyzed by paired sample t-test, and Analysis of Variance via SPSS software. 90 patients with icterus were studied. Hyperbillirubinemia frequencies before phototherapy included Mild (14-16mg/dl) 28.8%, Moderate (16-18) 33.3% and, Severe (≥18 (37.7% Hyperbillirubinemia. Means of billirubin levels were 18.38mg/dl before and 12.99 mg/dl after phototherapy (p<0.0001 T= 19.44). Mg levels were also 2.669 before phototherapy, and 2.03 afterwards (p< 0.001 T= 5. 13). Levels of magnesium in neonates with severe hyperbilirubinemia were higher than mild hyperbilirubinemia group (p= 0.03) before phototherapy. ANOVA- test results showed significant differences between total magnesium levels just in severe hyperbilirubinemia and bilirubin below 14 groups after phototherapy (p= 0.016) respectively. There was a correlation between total magnesium and total bilirubin levels before (r= 0.315, p= 0.001) and after phototherapy (r= 0.314 p = 0.004). It is concluded that phototherapy can decline total magnesium and total bilirubin serum levels in the same direction.

As in many authorities, psychotic problems appear to be commuting. Claim of psychiatric disorder has become an important basis for offenders to defend themselves. Aim of this study was to investigate faking symptoms in forensic psychiatry evaluation of malingerers in Tehran. in a cross-sectional survey, in 1389, perpetrators with a judicial order were assessed by two psychiatrists, using American Psychiatric Association's Diagnostic and Statistical Manual 4th Edition (DSM-IV) standards for mental disorders at the Tehran center for forensic psychiatry. Forty one cases identified as malingerers and were evaluating in another specific conversation. Collected data analyzed with statistical methods and p<0.05 used for significance. In this study, behavioral symptoms (75.6 %), Mood and affect symptoms (65.9%), cognitive function symptoms (56.1%), thought process symptoms (46.3%), perceptual disorder symptoms (34.1%) and thought content symptoms (19.5%) were observed respectively. Only thought process symptoms were significantly increased based on the educational level (p=0.045). There was no statistically significant difference among other groups. In general, simulating the symptoms of mental illness is more likely to be observed in low socioeconomic estates and many will attempt to mimic simple symptoms of behavioral as well as mood and affect disorders. Probably, intelligence and reasoning ability of defendants has a close relation to expressed symptoms that should be considered during psychiatric interview.