مجله علوم پزشکی رازی
سال بیستم شماره 3 (پیاپی 108، خرداد 1392)

Musculoskeletal disorders are considered as the most common cause of absenteeism and impaired work performance of employees in workplaces. This study was designed to evaluate the association between job type and ward of service with musculoskeletal disorders among nursing personnel. In this cross-sectional study، 477 health care workers including nurses، nurses'' aides and nurse technicians of two general hospitals in Tehran were included. Wards of service were categorized to: internal، surgery، pediatrics، operating room and «emergency and ICU». The Nordic musculoskeletal Questionnaire was used to consider the prevalence MSDs in past year. The prevalence of MSDs was compared between groups in terms of job type and ward of service. Regression analysis was used to adjust for confounding factors and to investigate the associations more precisely. Nursing job and surgery ward were considered as the reference groups for analysis. Low back disorder with the prevalence of 56/8% was the most prevalent disorder among subjects. Logistic regression analysis showed that employees of pediatrics ward were in higher risks to be affected by low back (odds ratio 4/43 and P=0/014) and knee disorders (odds ratio 2/94 and P=0/013). Working in «emergency and ICU» wards with odds ratio of 2/05 had a significant association with back disorders (P=0/021). Knee disorders were more common among nurses compared to nurses'' aides (P=0/039). No significant relationship was found in terms of other disorders and jobs. The results of this study indicate that working in pediatrics and «emergency and ICU» may have associations with increased prevalence of musculoskeletal disorders. To reduce such disorders in nursing personnel، appropriate planning and paying more attention to high risk groups is recommended.

In recent years، increasing evidence suggest that free radicals plays an important role in the pathogenesis of multiple sclerosis and Experimental Autoimmune Encephalomyelitis (EAE)، an animal model of multiple sclerosis. Therefore، All-Trans Retinoic Acid (ATRA) as an antioxidant may be effective in ameliorating disease severity. The present research is an experimental-interventional study. EAE was induced by immunization of female C57BL/6 mice with MOG35-55 peptide and complete Freund''s adjuvant. EAE mice were placed in two therapeutic groups (n=7 per group). Also، 7 mice served as normal (non-EAE) controls. Treatment with ATRA (25mg/Kg-every other day) was initiated in treatment group at day 12 when the treatment group developed a disability score. EAE control received vehicle alone with same schedule. Signs of disease were recorded daily until the day 33 when mice were sacrificed. Then، the levels of nitric oxide in spleen cell culture supernatant and total antioxidant capacity of plasma in mice were evaluated. ATRA significantly alleviated the clinical signs of established EAE. Upon antigen-specific re-stimulation of splenocytes، nitric oxide production was significantly reduced in TRA-treated group and reached in the range of normal mice. In addition، reduction in antioxidant capacity of serum in ATRA-treated EAE mice was prevented. At least part of the beneficial effects of ATRA in the treatment of EAE may be done by suppressing nitric oxide levels and improving antioxidant defense potential.

According to the importance of self efficiency and necessity of attention to all kinds of justice in organizations and regarding to the significance of staffs having supportive and coordinative role، this study is conducted to investigate the relationships between justice and self efficiency in Tehran University of Medical Sciences staffs.

This was a cross-sectional correlation study. The statistical populations were all the staffs in Tehran University of Medical Sciences assisstancies. Data was collected applying a pre valid questionnaire. SPSS was used assessing correlation between the variables and Lisrel was applied in order to test the pre supposed model.

The present findings indicate that، there was a significant relationship between two main construct of the study such as justice and self efficency. It means that increasing in distributive، procedural، interactional and informational justice may lead to improve self efficiency. In addition other findings indicate on positive and significant correlation between four dimensions of justice and self efficiency.

This study shows that improving each of these four dimensions of organizational justice in all the organizations and Tehran University of Medical Sciences as well leads to increse self efficiency that can influence on efficiency، effectiveness and productivity of the organization. Therefore paying attention tocriteria of evaluating organizational justice and designing pland for improving these criteria can help decision makers and managers greatly.

Aim of current study was to investigate the effect of changes of lumbar posture on postural balance in non specific choronic low back pain patients while applying axial load. In this experimental analytic study، 10 Non Specific Choronic Lo Back Pain NSCLBPwomen patients and 10 healthy volunteers that were matched together، evaluated. Postural sway of participants in neutral، lordotic and kyphotic posture of lumbar with and without axial load and with closed and opened eyes evaluated. Antro-posterior range، Antro-Posterior standard deviationMedio-Latral rangeand Medio-Latral standard deviation was evaluated in this study. Also for studying the patient’s avoidance belief and disability و three standard tools Fear-Avoidance Belief Questionnaire (FABQ)، Tampa Scale of Kinesiophobia (TSK) and Roland-Morris Questionnaire were used. Tha data were analyzed with Mix model ANOVA. Mix model ANOVA revealed in neutral posture AP rang (P=0. 045) and APsd (P= 0. 029) in LBP group، were significantly higher than healthy group. In LBP group AP range (p=0. 015) and APsd (p=0. 008) in kyphotic posture، were significantly lower than neutral posture and APsd (P=0. 046) in lordotic posture was higher than kyphotic posture. In LBP person’s fear of movement and pain also locating in end of range of lumbar posture. In kyphotic and lordotic posture were limitations for CNS and joints which control postural sway so persons with LBP limited their postural sway in these postures.

Mindfulness is a mind-body medicine technique which is used in stress reduction and promotion in many patients quality of life، with chronic diabetes. The purpose of this study was evaluating the effectiveness of mindfulness based on stress reduction on glycemic control of patients with diabetes.

in the case-control experimental research60 diabetic patients (30 control group، 30 experimental groups) in Shahriyar city were invited to participate in this study. Mindfulness presents in 8 weekly sessions. Glycolysis hemoglobin as indicator of glycemic control was assessed، before and after this intervention. T-test for dependant groups and independent groups and one-way ANOVA was used for data analysis.

Results indicate a significant difference between pre test and post test of experimental group.

So it is concluded that mindfulness has significant effects on glycemic control.

Today، one of the main concepts in the health care systems is maintaining safety and security of patient and disclosing medical errors to patient and educational system is an important aspect of moral and necessary of care that reduces the error. This study aimed to design a valid and reliable instrument to determine the attitudes of residents towards self-disclosure of medical errors and factors affecting it. This study is a descriptive survey that 150 residents were conducted in Tehran University of Medical Sciences who were selected through stratified random sampling method. The researcher-made questionnaire was used for data collection. Collected data were entered into SPSS 16 statistical software using descriptive statistics، the objectives and research questions were analyzed. 125 residents completed the questionnaires (response rate 83. 3%). In overall، more residents (62. 4%) agreed that medical errors are one of the most serious problems in health care systems. Almost all residents (66. 4%) agreed that serious errors should be disclosed to patients، but only 36. 8% of residents agreed that minor errors should be disclosed to patients and almost more than half of residents (60%) were agree that near miss errors should be disclosed to patients. Almost all residents (91. 2%) was interested in to be in receiving general education or training on disclosing medical errors to patient. In according to residents̕ interest to learn about medical errors، designing a curriculum for training medical students is needed. Students also need to be trained on patient̕s bed and supervisors monitor their trainings، until the medical students at the end of training، be capable of disclose medical errors independently.

Hospitals are considered as the greatest and most expensive operational units in health systems. A hospital bed costs almost 30 million in one year and it has just 20 million revenue، as a result، in this study، the relationship between these above variables were investigated in Social Security Hospitals in Iran. This was a cross-sectional study from 2005-2007 that was conducted on 64 general hospitals of Social Security System. In order to assessment efficiency، Win Deep software was run and the parametric tests were applied to compare the hospitals` efficiency according to their bed number (size) at the statistical level of 0. 05. Results showed that the average of technical efficiency in upper 100 bed hospitals was 0. 976 in comparison with the average of 0. 962 in lower 100 bed ones. In addition، the analysis of Independent T-Test between two groups presented a higher efficiency in the greater hospitals (P=0. 04). It is considered that the bed number can be one of the effective factors on efficiency index in hospitals. Although it is important to pay adequate attention to other inputs rather than bed number in order to achieve optimum level of efficiency in hospitals.

Pulmonary embolism (PE) and deep venous thrombosis (DVT) constitute one of the “big three” cardiovascular killers، along with myocardial infarction and stroke. Although thrombophilia play major and well documented role in pathogenesis of arterial and venous thromboembolism، but the effect of thrombophilia in biological fat of thromboembolism is not well recognized. The role of acquired and hereditary thrombophilia in biological fat of thromboembolism are our maine purpose in this study. 60 patients with diagnosed throboemboli were assessed in two groups based on genetic and acquired risk factors of thromboemboli (group A and B each with 30 patients). All cases were evaluated considering the genetic or acquired factors and the relation with pulmonary artery residual thrombosis at the beginning and 6 months after treatment and compared with each other. 31 (56. 4%) patients were male and 24 (43. 6%) female. The mean age was 44. 4±14 in the range of 23 to 75 years. The relation between pulmonary artery clot stability and genetic factors was significant (p=0. 03) but there was no correlation between pulmonary artery pressure and genetic or acquired risk factors (p=0. 24). Considering the relation between genetic risk factors and the history of pulmonary thromboemboli many pulmonary complications and mortality may be avoided by preventive and therapeutic measures (as in genetic engineering) beneficial for the patients and health care system.

Metabolic Syndrome (MetS) is a physiological and biochemical disorder that are associated diabetes or elevated fasting blood sugar، obesity، triglyceride level and cholesterol disorders and hypertension.. The syndrome has been given several names such as Insulin resistance syndrome، Plurimetabolic syndrome، Reavens syndrome، Syndrome X and the deadly quartet. Some recent evidence have shown a significant correlation between MetS and lung disease especially Chronic Obstructive Pulmonary Disease (COPD). So we aimed to estimate frequency of MetS among a sample of Iranian patients of COPD (Chronic Obstructive Pulmonary Disease) and Chronic Bronchitis (CB). In this cross-sectional study، 204 COPD and CB Known cases evaluated as MetS development and demographic criteria، lipid profile، C reactive Protein (CRP) blood level، and smoking history and correlation of these criteria were assessed in these patients. Frequency of MetS involvement among these subjects was approximately 48%. Age (p=0. 003)، abdominal obesity (p<0. 001)، high TG amount (p<0. 001) and positive CRP (p=0. 04) were correlated with MetS involvement. MetS was more frequent among COPD and CB patient. Age and underlying systematic inflammation Appears to be related to MetS.

Micronutrient deficiencies of zinc and selenium can lead to thyroid dysfunction. The objective of this study was to determine the effects of zinc and selenium supplementation on thyroid function of over-weight or obese hypothyroid female patients. This was a double-blind randomized clinical trial study. Sixty-eight over-weight or obese hypothyroid female patients randomly allocated in one of the four supplementation groups receiving zinc+selenium (zinc gluconate contains 30 mg zinc and selenium yeast contains 200 μg selenium)، zinc+placebo، selenium+placebo or placebo+placebo for 12 weeks. At baseline and at the end of the study، general information، anthropometric factors، dietary intake and biochemical parameters were measured. Physical activity questionnaire was completed. The N4 and SPSS software version 16 were performed for nutritional and statistical analysis. After the intervention period، no significant changes were found in serum zinc and selenium levels. Significant increase was observed in serum FT3 levels in the zinc+selenium group (p<0. 05) and zinc+placebo (p<0. 01) compared to baseline. This effect was significant in the zinc+placebo group compared to those in the selenium+placebo or placebo+placebo groups (p<0. 05). Serum FT4 increased and TSH decreased significantly in the zinc+selenium group (p <0. 05). TT3 and TT4 had a significant reduction in the selenium+placebo group (p <0. 05). No significant changes were found for TT3، FT4، TT4 or TSH between groups. This study showed some evidence of supplementation effects of zinc alone or in combination with selenium on thyroid function of over-weight or obese hypothyroid female patients.