مجله دانشگاه علوم پزشکی شهید صدوقی یزد
سال بیستم شماره 5 (پیاپی 88، آذر و دی 1391)

Although the topic of the study seems to be a novel subject and its design looks excellent، there are some points which seem to be missed or neglected by the respected authors of the paper entitled: “Study of the Expression of Survivin & Its Splice Variants; ΔEx3، 2b and 3b as Diagnostic Molecular Markers in Breast Cancer”. Through this review، it was attempted to review and criticize some of these issues which may occur in the similar corresponding researches in the future.

Sever daily sleepiness is one of the problems of patient with chronic renal failure. There are evidences indicating different sleep pathology in patients undergoing hemodialysis. This study was conducted to evaluate the effect of applying continuous monitoring model on sleepiness of hemodialysis patients in Shahinshahr/ Isfahan. This semi-experimental study was performed on 40 hemodialysis patients. Data gathering was done by Epwort Questionnaire. The questionnaire was used twice before the intervention with the interval of one month. The applied model contained four steps: orientation، sensitization، control and evaluation. Patients were divided into five groups and 4-6 training sessions during three weeks were held for each group and during the remained 9 weeks، consultations for continuous sleep monitoring، control and evaluation were performed. The questionnaire was filled out immediately after the intervention and one month later. Data were analyzed through SPSS 15 through descriptive and analytic statistics. The study findings revealed that mean score of sleepiness before intervention was 11/06 (± 3/32). Therefore، after intervention it increased significantly to 5. 54 (± 2/85) (P=0/0001). The percentage of sleepiness before the intervention was 74/4 that decreased significantly to 38/8 % (p = 0/0001). Using continuous care model as an ethnic model can reduce many problems of patients. It is recommended to study monitoring model more elaborately in order to utilize it on other hemodialysis patients.

Acute diarrhea remains a major cause of morbidity and mortality among infants and young children as well as an important determinant of growth faltering in the world. Significant proportions of children who suffer from diarrhea are malnourished with depleted micronutrient stores. Diarrhea also leads to excess loss of micronutrients such as zinc and copper. This study was a clinical trial. The samples were collected from the children admitted. The children were randomly assigned to zinc and control groups among which zinc group received 2 mg/kg of zinc supplementation daily. A questionnaire was utilized as the research instrument containing the demographic information as well as number of stools and duration of admission. After starting supplementation، the mean duration of diarrhea was 3. 7±0. 95 days in the zinc group and 4. 6±1. 8 days in the control group، showing a significant difference (P<0. 05). The number of stools after starting zinc supplementation were 6. 2±3. 6 and 6. 8±4. 1 on the first day، 4. 3±2. 9 and 4. 6±2. 9 on the second day، 2. 5±1. 8 and 3. 3±2. 4 on the third day، 2. 2±1. 1 and 2. 7±2 on the fourth day، 2±1. 4 and 2. 6±1. 8 on the fifth day، and 0 and 3. 6±1. 6 on the sixth day in the zinc and control groups respectively. There was no significant difference in diarrhea severity in the treatment group (P>0. 05) except on the sixth day. Zinc supplementation reduces the duration of acute diarrhea in admitted 1-60 month old children but has no effects on severity of acute diarrhea except on the sixth day of diarrhea duration.

This randomized clinical trial (RCT) was conducted to evaluate whether use of music could reduce the pain and duration of labor. Between 2010 and 2011، a total of 99 women at 38 weeks or greater with spontaneous labor were randomized to fast music، slow music، and control groups. Labor pain was assessed on a visual analogue scale (VAS) at beginning of the active phase and then every 1 hour. Duration of active phase and second stage of labor was recorded. Analysis of all proportions was carried out using t- test، Mann-whitney test، and Pearson’s chi-square test when appropriate. Patients in the fast music group revealed lower VAS scores at all time after music therapy، except fourth hour، and in the first and fifth hours، this differences were significant. In slow music group VAS scores، only in fifth hour were significantly lower than those of control group. Duration of labor was significantly lower in the fast music group than control. Listening fast music in the active phase of labor decreased pain and duration of labor.

Intra-cranial references plans used in cephalometry analysis are not considered as stable points and therefore their validity is low; however they are widely used. The purpose of conducting this study is to investigate correlation rate of a number of horizontal parameters of extra-cranial with common Horizontal analyses. In this descriptive and periodic study، lateral cephalometric radiography in NHP position for 46 patients (24 women and 22 men) in range of 22- 28 years old was prepared; all graphs were prepared by a person using the same device; then after tracing، correlation coefficient was achieved between TH/AB and TH-wist، wylie، wits، TH-wits McNamara، Schwartz، APP-BPP، and Downs. The highest rate of correlation was observed between TH-wits linear parameters and angular parameters of AB/TH (r=0. 975) which was statistically significant. ANB parameter had low correlation with Wylie analysis (r=+0. 365) that was definitely significant. ANB angular parameters with other horizontal dimension parameters showed the highest correlation with Downs analysis (r=-0. 870) and linear parameter APP-BPP (r=+0. 730) which were statistically significant too. In this study the highest correlation coefficient was shown between TH/AB and TH-wits، ANB and Downs، Downs and wits، ANB and APP-BPP respectively.

AIDS will change route of life people with disease and to be cause loss of self – esteem، increased vulnerability feeling and confusion thoughts in their. The purpose of this study is investigating the role of spirituality in quality of life of patients with AIDS/HIV. This study was conducted with a sample of 43 patients with AIDS/HIV in Sistan & Baluchestan province in 1390 that had been selected via method of available sampling. Spirituality was measured using the Spirituality Questionnaire (Parsian and Dunning، 2009) and quality of life was measured using the World Health Organization Quality of Life (WHOQOL-BREF). Data were analyzed using Pearson correlation coefficient،s stepwise multiple regression، t Test and ANOVA. The study results indicated that there is a significant positive relationship between spirituality and quality of life، but there is no significant relationship between demographic variables (gender، marital status، age، and disease duration) and quality of life. Results of regression analyses indicated that component of self-awareness is best predictor of physical health، psychological health and social relationships. Also، there was a significant difference among male and female patients in quality of life. According to these results، it can be deduced that spirituality has an impact on quality of life in patients with AIDS/HIV، and it can be used as a coping method for improving mental health and increasing quality of patients'' life with AIDS/HIV

Diabetic patients face with different physical and psychological challenging factors which impress their quality of life. The major problem of these patients، which has made their life circumstances more complicated، is coping and adapting styles with the illness. So، this study aimed to determine quality of life and also different kinds of coping strategies in patients with type 2 diabetes and also to compare it with those of healthy people. In this study، sixty diabetic patients (30 male، 30 female)، were chosen by available sampling method from the people who referred to Sina Diabetes center in Tabriz and were compared with sixty non diabetic people (30 male، 30 female). Data were collected by two questionnaires including the short form health survey (SF-36) and coping style Inventories. MANOVA method was used to analyze the research data. The study results showed that non diabetics were significantly higher than diabetic patients in regard to quality of life and its dimensions (p<0. 001). Also results revealed that non diabetic people used the problem–oriented styles (p<0. 001)، however diabetic patients used emotional-oriented coping and avoidance strategies more (p<0. 05). In this study (in both groups)، females in comparison with males had lower score in quality of life and used more emotion-oriented coping styles and less problem-oriented styles. The results indicated that individuals’ quality of life was affected by their coping style with different affairs. Emotional-oriented coping and avoidance strategies were related with decrease of quality of life in diabetic patients whereas problem-oriented styles enhanced it. Therefore، it is necessary to perform interventions for teaching problem solving coping in order to improve these patients'' quality of life.

Concentrating of Mn in the human body leads to Manganism، a Parkinson-like disease with pathologic effects especially on brain. Being exposed to the occupations related to metals such as working in the mines، industries and chemical fertilizers in agriculture may cause manganism. Chelating agents have been used successfully in the treatment of severe manganism. This study was conducted to explore the capability of Para Amino Salicylic acid (PAS) in reducing Mn concentrations in body fluids and tissues of mn-exposed animals. Twenty vistar male rats (260-280g) were divided into four groups (control، Mn، PAS، Mn+PAS takers). Mn animals received i. p. 8mg/kg manganese chloride for one week as intoxication and PAS was injected by 1cc of 1. 5g/l PAS for four weeks as the treatment. Serum، urine and kidney tissue of animals were collected for biochemical and histopathological evaluation. Mn exposure significantly increased the concentration of Mn in serum and urine (p<0. 001) as well as in kidney extract (p<0. 05). Following PAS treatment، Mn levels in serum and kidney extract reduced، whereas in urine increased. Serum urea (P<0. 05) level increasing in all test groups indicated kidney destruction in them. Higher levels of cystatin C in PAS group animals serum (p<0. 01) revealed side effects on kidneys that was treated by Mn consumption. Lowering the blood and protein occurrence in urine of animals that received Mn+PAS indicated the therapeutic effects of PAS. Benefits of PAS consumption was clear in histological assays especially in the kidney cortex. Although PAS can reduce Mn concentration in animal''s body and pathologic effects، it reveals some side effects.

Cinnamon as an herbal medicine has the ability to reduce blood glucose and lipoproteins in diabetic patients. Based on the positive effects of exercise on diabetic patients، the present study was conducted to investigate the effect of Four weeks Period aerobic exercise alongside using cinnamon on lipoprotein parameters and blood glucose in women with type 2 diabetes. Thirty diabetic women were voluntarily selected and were randomly divided into three groups: 1) aerobic exercise group; 2) aerobic exercise alongside using cinnamon; and 3) control group. Aerobic exercise took four weeks with 60 percent of maximum heart rate. Blood samples were collected at the beginning and end of the study. Blood glucose، the fat percentage and HDL، and the ratio of LDL to HDL in the first group significantly decreased and in the second group increased (P<0. 05). Also the first group showed a significant reduction in triglyceride. The only significant change observed in the control group was a significant increase in the level of LDL. Comparing the first and second group، it was observed that in the second group the level of total cholesterol decreased and the ratio of LDL to HDL increased (P<0. 05). Using cinnamon alongside aerobic exercise is likely to be beneficial in regulating the concentration of blood glucose and lipids in diabetic patients.

Among several tuberculosis vaccine candidates for replacement of BCG، ESAT-6 protein has a special role. Since mycobacterium tuberculosis infection most often attacks the lungs، intranasal rout can be regarded as appropriate methods for tuberculosis vaccines and drug delivery. One of the appropriate systems for intranasal vaccine delivery is using biodegradable nanoparticles. Among biodegradable polymers، chitosan polymer has great features to increase the response of immunity system. This study aimed to investigate the specific humoral immune response of mice model after encapsulation of recombinant ESAT-6 antigen in chitosan nanoparticles.

The chitosan nanoparticles containing ESAT-6 antigen were synthesized by ionic gelation. Nanoparticle properties including morphology، particle size، zeta potential، encapsulation rates، and protein release were measured in vitro. The immunization was performed through the nose for 3 times on days 0 and 14 and 28. 2 weeks after last administration، blood samples were collected and specific IgG titers were measured by indirect ELISA.

The nanoparticles synthesized had appropriate properties. The mean size of resulting nanoparticles was 242. 8 nm by excellent antigen loading capacity (95. 23 %). The vitro release of antigen from nanoparticles after 200 hours was detected as 67. 5%. The Level of IgG antibody showed significant increase in the group that had received chitosan nanoparticles containing ESAT-6 compared with other groups.

ESAT-6 protein was encapsulated in chitosan nanoparticles successfully. Administration of chitosan nanoparticles can be a suitable method for administration of humoral immunity antigens of Mycobacterium tuberculosis through intranasal rout.

Physical activity plays a protective role against cardiovascular disease via reducing risk factors. The purpose of this study was to compare effect of concurrent (resistance-aerobic) and aerobic training on lipid profile، blood glucose and blood pressure in middle-aged men at risk for cardiovascular disease. Twenty-nine untrained male volunteers 36-56 years old participated in this study. The subjects were randomly placed into one of three groups (aerobic، concurrent (aerobic & resistant) and control). Body mass index، body fat percentage، glucose، blood pressure، and lipid profile were measured at baseline and after exercise training. Training program lasted for eight weeks and it was carried out 3 times per week. Statistical tests of paired t and ANOVA were used for data analysis. Plasma TC، LDL، TG، glucose and HDL changed significantly with concurrent and aerobic training (p<0. 05); but، there were no significant differences in triglyceride (TG)، total cholesterol (TC)، high density lipoprotein (HDL)، glucose low density lipoprotein (LDL) and systolic and diastolic blood pressures between concurrent and aerobic groups. Also، VO2max was elevated in the two training group (p<0. 05). The result of the present study indicated that both aerobic and concurrent training resulted in improving the metabolic parameters related to cardiovascular risk in middle-aged men. However، each type of training also provides unique benefits.

Agreement between clinical and pathologic diagnoses plays an important role in an appropriate treatment plan and it may also prevent serious side effects and problems in patients. This study was conducted to assess the agreement between clinical diagnoses and pathologic reports in soft tissue lesions of patients referring to pathology department of dental school، Tehran and shahid Beheshti university of medical sciences during 2005-2008.

In this retrospective and descriptive study، 300 soft tissue lesions of patients referring to pathology department were selected by census sampling method and then were analyzed. The lesions were classified according to the criteria proposed by reference pathology textbooks and the data records regarding the patients age، gender and clinical and pathologic diagnoses were noted. Concordance between two diagnoses was determined by descriptive statistics.

In this study، pathologic findings were golden standard (definitive diagnoses). The results showed the concordance between two clinical and pathologic diagnoses were more than 0/7 except POF and pemphigus.

The results showed that the surgeons of oral and maxillofacial surgery in dental departments of Tehran and shahid Beheshti university of medical science provided acceptable diagnoses regarding pathologic lesions during 2005-2008. However، even the slight differences between two diagnoses necessitate all patients to be evaluated clinically and paraclinically in order to propose an accurate scientific diagnosis and prevent the harmful outcomes of the disease. Furthermore most efforts must be done to make more agreements between clinical and pathological diagnoses.

Defect in the cholesterol homeostasis in macrophage as well as converting them to foam cells is one of the most important factors in the initiation and progression of atherosclerosis. Many genes and transcription factors like Peroxisome Proliferators Activated Receptors are involved in cholesterol homeostasis in these cells. N-3 fatty acids are one of the most important factors regulating the expression of these genes and thus can affect intracellular metabolism of cholesterol، initiation، and progression of atherosclerosis. Ecosapantalenic acid (EPA) among N-3 fatty acids in the diet is the most frequent. Therefore studies investigating its effect on the gene expression have great significance. In this study، LDL was isolated by density gradient ultra centrifugation method and then was acetylated with sodium acetate. To convert macrophages into foam cells، macrophages were incubated with Acetylated LDL in a concentration of 50g / mL. The effects of EPA and the synthetic ligand (Wy14643) on the gene expression of PPAR  gene in foam cells derived from THP-1 cells were investigated by Real time PCR technique. treatment of cells with EPA caused a decrease in cellular cholesterol، free cholesterol and cholesterol ester (P≤0. 05). EPA and wy14643 significantly increased gene expression of PPAR  in these cells. It seems that this fatty acid had unique and special effect on the gene expression and lipid metabolism in foam cells. Also، mechanisms other than PPAR  such as LXR can also be effective on intracellular cholesterol homeostasis in foam cells. In order to gain more information regarding effects of this fatty acids، simultaneous study of genes involved in lipid metabolism within the foam cell will be needed.

There is limited evidence that ginger (Zingiber Officinale) powder consumption is effective to relieve the pain and inflammation due to special phytichemicals. The aim of this study was to investigate the effect of ginger powder supplementation in pain improvement in patients with knee osteoarthritis.

This double-blind randomized clinical trial was conducted on 120 outpatients with knee osteoarthritis of moderate pain. Patients were randomly assigned to two groups: receiving ginger powder supplement and placebo. Ginger and placebo groups received two identical capsules per day for 12 weeks. Each capsule contained 500 mg ginger powder or starch. Pain severity was measured by VAS (Visual Analog Scale) at first and after 3 months. A responder was defined as a reduction in pain of > 1. 5 cm on a visual analog scale (VAS).

Before intervention، there was no significant difference between the two groups in severity of pain. However، after ginger supplementation، pain score decreased in ginger group. After 12 weeks، Pain reduction was more significant in ginger group than placebo. Response to intervention was 88% and 14% in ginger and placebo groups، respectively. There was statistically significant difference between both groups in response to intervention (p<0. 001).

The results of this study showed that ginger powder supplementation was effective in reducing pain in patients with knee osteoarthritis، therefore it is recommended as a safe supplement for these patients

This research aimed to investigate rate of iatric tourisms’ satisfaction about provided medical services for them and their fellow travelers in Yazd city. For this purpose، the quality level of services provided to the patients and their fellow travelers was investigated and some solutions have been suggested in order to enhance this level. In this direction، a questionnaire was designed according to SERVQUAL model in 5 aspects consisting of 21 questions. Therefore، quality differences have been measured according to opinions of 114 foreign patients and their fellow travelers in the hospitals around the city. This is a descriptive- measurement research. In order to analyze the data available techniques in statistics were utilized and Fuzzy TOPSIS technique was used for prioritizing the solutions. The results revealed that services quality difference is significant in 3 aspects of responsibility، guarantee and agreement. In other words، there is a significant difference between patients’ perception and expectation with those of their fellow travelers regarding quality of provided services. However، results of rating with Fuzzy TOPSIS indicated that the factors of proper equipments and proper quality of therapy are in the better situation comparing with other factors.

Exercise is a factor that influences endocrine system. Effect of exhaustive exercise in the hypothalamus is still vague and changes in hormones are dependent on the extent، duration، type، and previous exercises. In this experimental study، 14 volunteered runners participated. All subjects ran on a treadmill until they reached the endurance level and then blood samples were obtained in three phases (before، immediately after، and 10 minutes after exercise). The data was analyzed by ANOVA. All the results below P value of 0. 05 (P < 0. 05) were considered to be significant. Mean and standard deviation of testosterone in three phases of before، immediately after، and 10 minutes after exercise were respectively 10. 6±1. 25، 10. 62±2. 82، and 10. 64±2. 57. Moreover، regarding progesterone، measures were 0. 61±0. 41، 0. 99±0. 53، and 1. 08±0. 44. Therefore there was no significant difference between testosterone level before exercise with immediate، and 10 minutes after exercise، but progesterone level revealed a significant difference among before، immediately، and 10 minutes after exercise. Results showed that one session of exhausting exercise could not significantly change testosterone level، whereas increases progesterone level significantly.