نشریه دانشور پزشکی
پیاپی 99 (تیر 1391)

Personality is a principal factor in present relationship between stress and health. Thus, it is not far from expectations that psychosomatic diseases are affected by personality characteristics and coping style with life stressor events. The aim of the present research was a comparison between personality characteristic and stress in patients with peptic ulcer disease (PUD) and healthy individuals, considering their sex differences. This research was a matched case-control study in which 60 patients, referring to 8 personal clinics with a diagnosis or a history of peptic ulcer based on the viewpoint of a therapeutic physician were compared with 60 healthy individuals as the control group, regarding personality characteristics and the level of experienced stress. Males and females had the same number in both groups (30 males and 30 females). Research tools included Holmes and Rahe Social Readjustment Rating Scale to measure the level of daily life stressors and NEO-Five Factor Inventory (NEO-FFI) to evaluate 5 personality factors of Neuroticism (N), Extroversion (E), Openness (O), Agreeableness (A), and Conscientiousness(C). The research data were analyzed by SPSS (Version 16.0) and multivariate analysis of variance (MANOVA) and regression (by enter method) tests. The level of stress in patients with PUD was higher than that of control group. Considering the personality characteristics, the patient's group had remarkably higher scores in (N), (E), and (O) and in this circumstance had significant role the interactional effect of gender with disease on levels of stress (p<0.05). Regression analysis revealed that only personality characteristic of Neuroticism (N) significantly predicted the experienced stress (F=12.206; p<0.01). Altogether, it is concluded that reducing the stress sources to the least possible level in PUD patients seems necessary. Moreover, targeting the characteristic of Neuroticism (N) is a key factor. From the personality perspective, women with excessive level of openness (O) are at risk of PUD.

Proliferation and apoptosis of lymphocytes are essential parts of the immune system. Most anti-cancer chemotherapy drugs such as vincristine target cell cycle and induce apoptosis in cancer cells. In other words, dividing cells undergo more apoptosis, which may also include the normal proliferating lymphocytes responsive to malignancies as well. In this study, the effect of different concentration of vincristine at three different time periods on resting and proliferating spleen lymphocytes were evaluated and compared with the effect of the drug on mouse lymphoma cell line BCL1. The cytotoxicity of vincristine was determined by MTT assay and IC50 was calculated for all periods. The cells were also stained with double staining acridine orange and ethidium bromide and were observed with fluorescence microscope and the percentage of apoptotic cells were determined. MTT results showed that vincristine at concentrations of 10 and 20 μg/ml caused cell death in both resting and proliferating lymphocytes, but concentrations<5 μg/ml did not show any significant cytotoxic effect, while concentrations of 2 and 5 μg/ml showed significant cytotoxic effect on BCL1 cells. The percentage of the apoptotic cells which were affected by different concentrations of the drug was proportional in the two methods, i.e. fluorescence microscope and MTT assay. Vincristine has a strong cytotoxic effect in tumor cells and its toxic effect in normal cells is highly dependent on time and the activation of the cells.

In addition to the importance of exclusive breast-feeding (EBF) in the first six months of life, its weaning is also important. This study aimed to determine the pattern of EBF weaning and its associated determinants in Fars province (southern Iran). In this historical cohort study, records of 751 infants 6 to 12 months (urban and rural) were selected as multi-random sampling method. Other necessary data were also collected through questionnaires and interviews. In addition to descriptive statistics using statistical tests and survival analysis, the effect of demographic, cultural and labor-related variables on exclusive EBF weaning was also studied. Averaged time of EBF weaning was 4.64±1.68 months and 78.4% of infants have exclusive EBF for 4 months and 50.7% for 6 months. There were not any association between race, official education, sex and birth rank with time of EBF weaning, (p>0.05). Most children (68.5%) began their supplementary food with porridge. Duration of EBF in this study was more than other studies. Lack of significant association between demographic variables, cultural and labor-related variables with duration of EBF, indicated acceptable public health education and lack of wrong beliefs among parents. To promote breast feeding indices, education of parents and breast feeding clinic establishment are necessary.

Length of stay (LOS) is one of the most important indexes for performance evaluation of hospitals and their manager. With respect to the importance of this index, we determined the factors affecting LOS. This was an analytical study. The under study population included patients which died in Hasheminejad hospital in 2010 and 935 patients using multi-stage cluster sampling method were selected. Variables, LOS, age, insurance and ICD10 code were gathered from patients’ files. Factors associated to LOS were analyzed using R software and semi-parameter Cox regression model. It was found out that 62.5% (585) of patients was women and most of them had an age larger than 50 years. Mean age (±SD) of patients was 50/02 (±19.07). In addition, 56% (586) of patients had Tamin-Ejtemaee insurance and 19.6% (185) had stayed without insurance or with complementary insurance. Mean LOS (±SD) of patients was 12.77 (±11.131) and LOS of men was more than women with a significant difference (p=0.005). Median of LOS was 14.2. The results of Cox regression for the variables age and sex was significant (p<.001) and insurance had not a significant effect on LOS. Two important features of LOS data are non-normality and presence of censorship, so using classic models for such data is not useful and this causes estimations with low precision. Because of these two features and for having more precise estimation, using survival analysis is suggested for such data.

The aim of the present study was assessment of the status of combination of financing and providing services in Medical Service Insurance Organization (MSIO) as unique provider. Present study was an applied study that was performed in a descriptive-analytical and statistical manner. The research population consisted of all Medical Service Insurance Organization’s (MSIO’s) insured and total services delivered to them. In this study, the time comparison of correlation coefficient in estimation regression of exponential function in two times 2005 and 2009 was used. Comparison of changes in residuals distribution was used for determination of changes in province’s situation. Finally, the Eviews econometrics software was used for estimation regression. This study showed that in provinces of country, the effect of per capital care received by insured on per capital cost pay by insurance organization significantly reduced from 0.25 in 2005 to 0.14 in 2009 (p<0.05). Also, with regard to changes in relative situation of provinces in these periods of time, 8 provinces have worse situation because did not tend to combination of per capital cost and per capital refers as unique production and in situation of 16 provinces did not take place noticeable changes. It seems that after about two decades from policy of developing social health insurance (SHI) in Iran, the financing and services delivery system through role of social health insurances could not be able for making it possible to combine financing and services delivery as unique production for insurers.

The1994 International Conference on Population and Development (ICPD) specifically identified “empowering women” as an essential ingredient for achieving desirable reproductive health and population outcomes. This study was done to determine the relation between women empowerment and reproductive behaviors.

An analytical descriptive survey was carried out for 629 married women aged 15-50 in western Tehran health centers. Data gathering was through the questionnaires of demographic, sexual, reproductive history and socio-economical information. Randomized sampling was done by interview. Data was analyzed in spss16. Descriptive statistics was used to describe the samples and X2 test for determination of relation between qualitative variables. Logistic regression analysis was used for assessing the power of independent variables that had a significant effect on reproductive behavior.

Findings showed that 29.6% of cases were in good level of reproductive behavior and 20.8% of them were in high level of empowerment. Overall, women empowerment and reproductive behavior were in the mid-level, but an improvement was seen in the reproductive behavior with improvement of the women empowerment. There was also a significant relationship between reproductive behavior and women age (p=0.01), literacy (p=0.002), empowerment (p=0.007) and a negative significant relationship with the number of children (p=0.002) and marital duration (p=0.001). There was no significant relationship between empowerment and reproductive behavior in logestic regression because of correlation between variables such as age and education that inserted in logestic regression simultaneously.

Reproductive behavior was considerably affected by education and socio-economical factors that are determinant factors of empowerment, hence great attention to women empowerment issue is necessary for improvement of human development indices and reproductive behaviors.

Alzheimer’s disease is a prevalent central nervous system disease with no definitive treatment till now. So, in the present study the effect of an important herbal medicine, withania somnifera (Ws), was investigated on progression of Alzheimer’s disease. We used intracerebroventricular streptozotocin (STZ) injection as a model for Alzheimer's disease. Learning and memory performance was assessed using passive avoidance paradigm and for spatial cognition evaluation, Y maze task was used. The studied animals were divided into control, control+Ws, STZ and STZ+Ws. The STZ-injected rats received Ws extract (p.o) one day pre-surgery for three weeks and were then subjected to Y maze and passive avoidance learning and memory tests. Finally, the acquired data were subjected to proper statistical analysis. It was found out that treatment with the extract (200 mg/kg) could markedly increase the step through latency (STL) time (43.5 ± 3.48) as an index of recall in comparison to STZ-injected rats (33.1 ± 3.1). Also, alternation behavior as spatial memory index was augmented from 45.21 ± 4.81 in control animals to 67.68 ± 5.21 and 63.26 ± 6.27 in 100 and 200 mg/kg treated animal groups, respectively. Therefore, chronic treatment with Ws extract could antagonize memory deficits induced by STZ-ICV injection in rats. Perhaps, this plant could be a potential factor in the treatment of neurodegenerative diseases such as Alzheimer's disease (AD).

Concerning performing effective exercise (intensity, duration, type and number of sessions in a week), there are different recommendations for diabetic patients. The purpose of this study was to compare the effect of five weeks of daily aerobic exercise training and every other day aerobic training for ten weeks in the women with type 2 diabetes. Thirty six women with type 2 diabetes were randomly divided into three groups: daily 5-week aerobic exercise training group (12 women), every other day 10-week aerobic exercise training group (12 women) and control group. Aerobic training was conducted with an intensity of 60%-70% of maximum heart rate for 30-60 min per session. Measurements and blood sampling in the beginning of research protocol, after 5 weeks and 10 weeks after implementation of research protocols were conducted. For analyzing the data, ANOVA with replications and One-Way ANOVA were applied. Five-week daily aerobic exercise training did not have a significant effect on weight (p=0.5), body fat index (p=0.54), BMI (p=0.65), adiponectin (p=0.91), and insulin (p=0.06). Ten week every other day aerobic exercise training also did not have a significant effect on weight (p=0.35), body fat index (p=0.30), BMI (p=0.27), adiponectin (p=0.51), insulin (p=0.51), HbA1C (p=0.34), glucose (P=0.94) and the insulin resistance index (p=0.53). There was not also a significant difference between these two protocols of aerobic training. Five week daily aerobic training or 10 week every other day aerobic training do not have a significant effect in diabetic patients and for effective aerobic training, these patients should perform these trainings within a prolonged duration.

With expansion of nanotechnology, nano-hydroxyapatite particles are used in medicine and dentistry fields. The biological effects of these particles are not completely defined. The aim of this study was to determine the cytotoxicity of nano-hydroxyapatite on gingiva-derived fibroblasts.

Various concentrations of nano-hydroxyapatite from 2 to 0.002 mg/ml were treated on gingiva-derived fibroblast cell line (HGF2) in 24, 48 and 72 hours. MTT and LDH methods were used for evaluation of cytotoxic effect.

MTT

doses higher than 5 and 2 mg/ml in 24 hours, doses higher than 0.2, 2 and 5 mg/ml and lower than 0.01, 0.02, 0.05, 0.002 and 0.005 in 48 hours and doses higher than 0.5, 1, 2, and 5 mg/ml and doses lower than 0, 0.01, 0.02, 0.002 and 0.005 mg/ml in 72 hours caused significant decreases in OD and absorbance of fibroblasts. LDH

significant increase of LDH release noticed with 5 mg/ml dose in 24 hours, 1, 2, 5 mg/ml doses in 48 hours and 5 mg/ml dose in 72 hours. LDH release decreased with 0.02 mg/ml and 0.01 mg/ml in 24 and 48 hours, respectively. The IC50 was about 6 mg/ml in 24, 48 and 72 hours.

In 24 hours and after that, high doses of nano-hydroxyapatite have cytotoxic effect on gingival-derived fibroblasts.