مجله علمی دانشگاه علوم پزشکی کردستان
سال هجدهم شماره 3 (پیاپی 69، پاییز 1392)

It is possible to explain the great discrepancy in the personality and psychopathology of patients with borderline personality disorder (BPD)، partly، on the basis of differences in their profiles of personality، psychopathology، intellectual and emotional state. The aim of the current study was to assess these items in the patients with BPD. This was a descriptive-comparative study. Among the patients with diagnosis of BPD referring to Sanandaj health centers،30 accepted to participate in this study. They were assessed by use of MCMI-III، emotional state questionnaire، and The WAIS-R. The results were compared with those of their matched، non-clinical group. SPSS software was used for data processing and data were analyzed by profile analysis and one way ANOVA. Profile analysis showed significant differences between the groups in all of the tests. Comparison of the single scales showed differences in a wide range of variables of personality، intellectual and emotional state. The results indicated an important role for the emotional elements in the development of personality disorders and also similarity of many of the clinical symptoms in these patients. Intellectual elements are also useful for explaining a fundamental part of the symptoms of BPD. These variables seem essential for understanding cognitive، affective and behavioral aspects of the patients with BPD.

Protozoan parasite of genus Leishmania is the causative agent of leishmaniasis in humans، carnivorous animals and rodents. In Iran، Leishmania species are causes of cutaneous leishmaniasis which had been reported frequently from Isfahan. The aim of the present study was to evaluate the effects of a compound of Nerium oleander leaf، Ricinus communis oil، Capsicum spp. seeds، and almond on cutaneous leishmaniasis caused by Leishmania species under laboratory conditions and its effect on the progression of cutaneous lesion in mice. In this repeated experimental study، we obtained smears from the skin lesions of 10 patients with cutaneous leishmaniasis randomly. 3 cases had positive smears (30%) which were cultured in NNN media with 10% FBS to obtain promastigotes of leishmania. The effects of boiled and sieved herbal compound (Nerium oleander leaf، Ricinus communis oil، Capsicum spp. seeds، and almond) on the promastigote propagation in NNN media with 10% FBS (5×104/μl) were investigated in triplicate and compared with control group. In the 4th week، 0. 2 ml of enriched promastigote of Leishmania in RPMI was inoculated in the base of the tails of the mice in the test group (n=6) and control group (n=2). The effect of herbal compound on the progression of the lesion was investigated for 7 weeks. We used t-test for statistical analysis. The number of Leishmania promastigotes in the group treated with herbal compound was significantly less than that in the control group. Also the herbal compound had significant preventive effect on the progression of the cutaneous lesion in the test group as compared to the control group. The results of this study showed that the herbal compound had preventive effect on the parasite propagation and progression of cutaneous lesion. We recommend furthur studies on other pharmacological aspects of this herbal compound.

In all countries a part of household income is spent on health-related costs. The amount and distribution of this financial contribution impose a significant burden of health problems to communities. The aim of this study was to determine the percentage of household’s direct payments for health care services and health equipment in Kurdistan. This descriptive cross-sectional study included 1518 households living in urban and rural areas of Kurdistan، in winter of 1388، and they were divided into 150 clusters. Every cluster included 10 households. Data were collected by using a questionnaire consisted of two parts: household characteristics and household health expenses including; outpatient costs، the costs of hospitalization، medicines، medical equipment، nursing care، paramedical and medical diagnostic measures. The costs of outpatient health care services (visits، diagnosis، drug prescription and medical devices) and hospitalization were determined during four weeks for each member of the family or the total costs and expenses paid by the household were recorded in the questionnaire. Collected data were analyzed by using spss. 16 software and mean، standard deviation and median were calculated. People contribution for prescription drugs was 43/3% and for other non-prescription drugs and consumer goods was 100%، for durable medical equipment 95/4%، for diagnostic measures especially in private offices، clinics or home 75/5%. Household contributions to the cost of medical services by GP، medical specialists، psychiatrists and dentists were 62/3%، 76/5%، 75/5% and 80/9 % respectively. 13/8% of the inpatient fees were paid by the patients. The mean cost of family health services in our study was 85380±252012 with a median of 41050 Toman. The out-of-pocket payment by people was 55%. In general، considering the high percentage of people’s contribution to health service costs، expansion of the roles of the insurance organizations to achieve the objectives of coverage of over 90% of population and increasing public and private sector contribution to more than 70 % in health services، is essential.

Enterotoxigenic strains of E. coli (ETEC) form the second largest group of diarrheagenic E. coli and are responsible for more than 25% of infantile diseases. The purpose of this study is to assess the prevalence of ETEC strains and their virulence genes in children less than 2 years of age in Shiraz. This was a cross-sectional study. 285 stool samples were taken from children under 2 years of age with diarrhea in Shiraz. First، E. coli strains were isolated using standard biochemical tests. Then، prevalence of ETEC strains and presence of st and lt genes were evaluated using real-time PCR. Antibiotic susceptibility of the isolates was evaluated by using disc diffusion method. 49 (17%) diarrheagenic E. coli strains were isolated، 7 cases (14/3%) belonged to ETEC strain. Among isolated ETEC strains، 4 (57. 14%) had lt، 1 (14. 29%) had stIa and 2 strains (28. 57%) had both lt and stIa genes. All ETEC strains were susceptible to chloramphenicol، amikacin and nitrofurantoin، but showed resistance to penicillin and macrolides. The results showed high prevalence of ETEC strains in our study area. We recommend hospital-wide surveillance by using molecular techniques to estimate the prevalence of this pathotype in other regions of our country.

Daily bread supplies a great portion of energy، minerals and vitamins necessary for human. In recent decades، baking soda (sodium bicarbonate) which causes rapid leavening of dough، and extra salt which compensate dough deficiencies have been used widely in Iran. Soda can cause digestive problems and block the absorption of calcium، iron and other essential elements necessary for the body. Moreover the extra salt creates serious damages، especially in the patients suffering from hypertension or kidney diseases. The aim of this study was to determine the rate of soda utilization in the bakeries of Kurdistan Province، in Iran from 2008 to 2010 and to find proper ways to decrease use of soda and salt in bakeries.

This was a descriptive – analytical study which was carried out between 2008 and 2010 in Kurdistan Province، in Iran. The salt percentage and pH of the samples of baked bread were measured according to the specifications and test methods of the Institute of Standard and Industrial Research، for traditional breads (Standard Number 2628). pH above 6. 3 indicates presence of soda، and pH lower than this value indicates no soda in bread. Also the allowable salt percentage value is 2. 3، and higher values indicate presence of extra salt.

The result of the tests on 2098 bread between 2008 and 2010 showed an mean pH of 6. 01±0. 32 for all types of bread. The mean PH values were: 6. 24±0. 74، 5. 86±. 57 and 6. 00±0. 26 for Barbari، Sangak and Lavash bread respectively which showed significant differences. The mean value of salt percentage was 2. 19±0. 26.

In our study، the mean pH of the bread in the bakeries was in the normal range but the mean salt percentage was slightly higher than the standard value which could be due to flour quality. Despite prohibition of use of soda in baking bread ratified by Ministry of Health and Medical Education، it is still used by the bakeries، more commonly in Barbari than Sangak and Lavash bread. The use of salt is also on the rise.

The results of different studies have shown smoking can influence functions of thyroid gland. The aim of this study was to determine the effects of cigarette or water pipe smoking and immobilization on serum levels of TSH، T3 and T4 in male rats.

In this laboratory experimental study، male Wistar rats were randomly divided into the following groups: control،rats exposed to cigarette smoke، rats exposed to waterpipe smoke، chronically immobilized rats، and chronically immobilized rats exposed to cigarette or waterpipe smoke. Each group consisted of 5 rats. After 6 weeks blood samples were collected by cardiac puncture method. After obtaining serum، levels of TSH، T3 or T4 were measured by radioimmunoassay method. Data were statistically analyzed and compared among the groups by means of one way ANOVA.

Serum TSH levels were not significantly changed in experimental groups comaperd to control animals. Serum T3 and T4 levels were significantly increased in rats exposed to waterpipe smoke as compared to control animals (P<0. 01). There were also a significant increase in T3 and T4 levels in the rats exposed to cigarette smoke compared to control rats (P<0. 001 and P<0. 01، respectively). Serum levels of T3 or T4 showed no significant alterations in immobilized rats، but significantly increased in immobilized rats exposed to cigarette or waterpipe smoke in comparison to control or immobilized animals (P<0. 01).

Our findings showed that exposure to cigarette and water pipe smoke can increase serum levels of T3 or T4 and may be a predisposing factor in the development of hyperthyroidism.

Long-term exposure to opiates induces physical and psychological dependency. Despite a large number of studies on this subject، cellular mechanism involved in this phenomenon is not yet exactly clear. In this study، we investigated the effects of donepezil، an acetylcholine esterase inhibitor، on morphin-induced withdrawal symptoms in rats. In this experimental study،6 groups of male Sprague Dawly rats weighting between 225 and 300 g، received 10 mg/kg، ip morphine/ day in addition to 1 ml/kg،ip saline or 0. 5، 1 and 1. 5 mg/kg، ip donepezil. In order to induce dependency، morphine was administered subcutaneously every 12 hours for nine days. On the ninth day،30 minutes after the last dose of morphine، control groups received 1 ml/kg، ip saline and experimental groups received ip donepezil. After 30 min، naloxone (4 mg/kg، ip) were administered for all groups and the withdrawal symptoms including: jumping، rearing، genital grooming، abdomen writhing، body grooming and wet dog shake، were recorded for 60 minutes. Results Our results showed that donepezil decreased withdrawal symptoms، also it could attenuate the total withdrawal score، significantly. The results of this study showed that donepezil as an acetylcholine esterase inhibitor، could decrease withdrawal symptoms in rats.

Whole body vibration training can improve muscular force by affecting neuromuscular system and mechanical mechanisms. The aim of this study was to investigate the effect of an 8 week whole body vibration training (WBVT) on neuromuscular performance in healthy elderly women. Based on an experimental and BOSCO training protocol، thirty elderly female women (50±5. 5 yrs old) were selected and divided randomly into two experimental and control groups. Before and after vibration training، timed Up & Go and 5-chair stand tests were performed to evaluate neuromuscular performance in elderly women. Data were processed with SPSS software version 18 and one way ANOVA test was used for data analysis. P<0. 05 was considered significant. Data analysis showed that there was a significant improvement in neuromuscular performance in WBVT group compared to control group (P ≤ 0. 05). Based on the results of this study WBVT can reduce the possibility of falling risk among old women by improving neuromuscular performance.

Use of different teaching styles & different training methods with supervision on the different needs of the learners during the teaching-learning process can be encouraging to the students for lifelong learning (LLL). The aim of this study was to determine teaching styles of faculty members of Kurdistan University of Medical Sciences for theoretical lessons، to provide information on educational planning & development of combined teaching styles & training methods and adjustment of these styles to learning styles of the trainees in the future. This was a descriptive-analytical study. Statistical population included all of the faculty members of Kurdistan University of Medical Sciences (135 faculty members)، but only 124 (~92%) participated in the study. Data collection tool was the Richman-Grasha teaching style inventory. Data were introduced into SPSS software 19th version and analyzed by ANOVA and chi-square statistical tests. The results indicated that the most frequent styles were the “Delegator Style” (60. 5%) and the “Formal Authority Style” (33. 9%). The least frequent styles were “Facilitating Style” (0. 8%) and “Personal Model Style” (1. 6%). 3. 2% of the participants used the “Expert Teaching Style”. The demographic characteristics of the faculty members such as; age، teaching background، gender، college or department، educational level and academic rank showed no relationship with their teaching styles. Based on the results of this study، the dominant teaching style of the participants was not related to their demographic data. Other factors like psychological characteristics & training models could be associated with the teaching styles.

Osteoporosis is an asymptomatic disease and is usually diagnosed when fragility fracture occurs. This type of fracture occurs with minimal trauma، such as falling from standing position. Common fracture sites include the spine، hip، forearm and proximal humorous. This study investigated the number and incidence of fragility fractures and prevalence of secondary osteoporosis. This cross-sectional study included patients admitted to Shariati Hospital in Tehran، with diagnosis of fragility fracture in the orthopedic ward. Inclusion criteria included single fracture caused by low-energy force، in the patients of more than 45 years of age and performance of bone densitometry. 100 patients entered into the study and we used a check-list for every patient to record site and underlying mechanisms of fracture and results of bone densitometry for confirmation of the diagnosis. Based on the results of bone densitometry and endocrinology consultation we started appropriate drug therapy. We used SPSS 17 for data analysis. P<0. 05 was considered significant. One hundred patients with various fractures and mean age of 70. 25±10. 38 years were entered into the study. 55% of patients were women. 16 cases had previous fractures. 2 patients had history of fracture in their first degree relatives. 13% of the patients had used medication for osteoporosis. The patients were divided into three groups based on T-Score: (>-1= normal)، (-1-2. 5= osteopenic)، (< -2. 5= osteoporotic). Group 2 consisted of 48 and group 1 included 47 patients. Only 5 patients were in the normal group. 14% of the patients had the Z-core≤-2، among them 12 patients were in the osteoporotic group. In general parameters of BMD such as T-Score and Z-Score can be highly valuable in the diagnosis of fragility fracture. Z-Score also can determine the role of secondary factors in the development of osteoporosis. This represents the value of this criterion in the treatment of secondary causes of osteoporosis and prevention of subsequent fractures.

Visual display terminals (VDT) are standard equipment for many office workers. Their use، however، may increase the risk of developing adverse conditions related to vision، the musculoskeletal system، and mental health such as insomnia. In this study، we examined the relationship between duration of daily VDT use and insomnia in bank tellers. In this cross-sectional study، 382 bank tellers working with VDT who met our inclusion criteria were selected randomly. Their demographic data، sleep quality، and stress information were collected by AIS and DCM model questionnaires. We used SPSS 15 software for data processing. Chi-square and independent t-test were used for data analysis. The results showed that the insomnia symptoms score were significantly higher in the participants using VDT more than 6 hours/day (P<0. 001). To protect bank tellers from VDT adverse effects، we recommend restriction of daily work time in these terminals to less than 6 hours، and planning for work-rest periodic times during working shift.

Measurement of adenosine deaminase and its isoenzymes in serum has been used for diagnosis and differentiation of intracellular infections and malignancies of immune cells. The aim of this study was to compare ADA levels and its isoenzymes in HIV positive patients and HIV positive patients co-infected with hepatitis B and C and healthy individuals، as a quick and low-cost diagnostic biochemical marker. This historical cohort study included 97 HIV positive IDU patients. After obtaining blood samples، serum was separated and examined for hepatitis B and C. We used Guisti method for measurment of ADA activity and EHNA inhibitor for the activity of its isoenzymes. Data analysis was performed by SPSS 16 (SPSS Inc.، Chicago). Our results showed that there was a high prevalence of HBV and HCV in HIV positive IV drug users. We found that total ADA activity in the patients groups was significantly higher than control group. Also HIV-HCV group showed a higher activity of this enzyme in comparison to HIV positive groups. Significant differences were found in regard to ADA2 isoenzymes among the four groups (P<0. 05). But ADA1 activity showed no significant difference. CD4+ counts were lower in HIV-HCV and HIV-HBV patients than HIV positive patients. ADA activity was considerably increased in HIV positive patients co-infected with either HBV or HCV. According to the results of this study and because of its low cost and simplicity to perform، in addition to other markers، measurement of ADA activity in serum is a sensitive biological marker for assessment of intracellular infections، particularly hepatitis in HIV positive patients.

Hemoglobin screening methods before blood donation need to be not only simple، rapid and inexpensive but also sensitive for detection of both low and high hemoglobin levels to prevent false rejection of potential donors. The aim of this study was to evaluate the validity of two methods of hemoglobinometry in blood donors.

In this cross sectional study، 198 blood donors were randomly selected. The hemoglobin levels of two blood samples taken by means of a single finger stick were determined by Hemocue 201+ and Hemocontrol and hemoglobin level of a venous blood sample was measured by Cobas hematology analyzer as standard method. Venous hemoglobin range of 12. 5-17. 9 g/dl was regarded as inclusion criteria for blood donation. The sensitivity، specificity and correlation between reference method and each of the hemoglobinometers were assessed. Data analysis was performed by means of correlation tests، regression analysis and paired t-test.

Mean hemoglobin levels measured by Cobas، Hemocue and Hemocontrol were 15. 9±1. 68، 16. 28±1. 91 and 16. 30±196 g/dl، respectively. Hemoglobin levels measured by hemoglobinometers were higher than that measured by the standard reference. This difference was not significant in low hemoglobin levels، contrary to high hemoglobin levels. Each of the two methods showed significant correlation with standard method when hemoglobin levels were lower than normal limit. Increased hemoglobin levels led to decreased correlation coefficient which was not significant with hemoglobin levels higher than 18g/dl.

Our study results showed that these heomoglobinometers were not valid for screening high hemoglobin levels in blood donors and a large number of potential donors would be falsely rejected. Further studies to find valid methods are recommended.

Although intrinsic and extrinsic risk factors for anterior cruciate ligament (ACL) injury have been investigated extensively، the neuromuscular and the biomechanical risk factors associated with this injury in female athletes are not yet well understood. This systematic review summarizes all the relevant biomechanical and neuromuscular risk factors associated with ACL injury. We used electronic databases of PubMed MEDLINE (1966– 2012)، SCIENSEDIRECT (1982 – 2012) and SportDiscus (1985– 2012) for literature searching to identify the studies on ACL injury risk factors. We found a total of 152 articles. 52 of these studies had focused on neuromuscular and biomechanical risk factors. Investigation of the articles showed four neuromuscular imbalances: ligament dominance، quadriceps dominance، leg dominance، and trunk dominance. Existing evidence suggests that these four neuromuscular imbalances may be associated with the underlying ACL injury mechanisms. Also، review of the studies indicated that ACL injuries are more likely to occur during multi-planar rather than single-planar mechanisms of injury. Screening and detection of these imbalances are important in order to identify athletes at risk of ACL injury. Identification of faulty movement patterns would allow for implementation of specific interventions، targeted at prevention of these problems.