نشریه دانشور پزشکی
پیاپی 108 (دی 1392)

Not adhering to treatment advices has always been considered as an important and multidimensional problem in health field. Present study aimed to investigate the relationship between disease perception, coping strategies and social support with adherence to treatment among patients with cardiovascular diseases. In this research study, a correlational method was used. Its statistical society included the cardiovascular patients in 2013 that had been under coronary artery bypass graft and percutaneous coronary intervention surgeries and pharmacotherapy. Research sample included 158 cardiovascular patients that were chosen through access sampling method. Measurement instruments included the scale of general adherence and special adherence, short form of disease perception, social support and coping strategies questionnaires. Data were analyzed by multiple correlation and step by step regression methods. The results showed that there was in order 0.20 and 0.19 significant relationship between general adherence to treatment with perceived support from special individual (p<0.01) and perceived support from family (p<0.05). Also, there was a 0.27 significant relationship between problems concentrated coping strategy and a -0.31 significant relationship between emotion concentrated coping strategy with specialized adherence to treatment (p<0.01), but there was no significant relationship between specialized adherence to treatment with other research variables (p>0.05). Moreover, results of regression analysis showed that social support (16%) and coping strategies (32%) predict adherence to treatment among cardiovascular patients (p<0.01). More understanding of effective role of coping strategies and social support in adherence to treatment among cardiovascular patients is required for increasing their adherence to treatment.

Since the preparation of antibacterial materials in dentistry is very noticeable, therefore, we tried to evaluate this effect on Streptococcus mutans by addition of silica nanoparticles to LCGI (light curing glass ionomer). In this in vitro study, we had five LCGI experimental groups that contained 0, 0.2, 0.5, 1, and 2% (w/w) of silica nanoparticles. For disc diffusion test, 15 samples were prepared and their anti-Streptococcus mutans effects in agar culture were evaluated. Antibacterial effects of 15 micro-tubes containing different groups of LCGI were evaluated in direct contact test. There were significant differences between specimens containing nanoparticles and control group in both disc diffusion and direct contact test. In disc diffusion test, bacterial growth inhibition hallo showed that LCGI penetrates into peripheral environment and disrupted bacterial growth. In direct contact test, samples showed significant bacterial growth inhibition. By increasing nanoparticles weight percent, there was a significant decrease in bacterial growth.

One important step in the management of gastric cancer is determination of its prognosis. Cytokeratins are intermediate filaments that mainly exist in cytoskeletal component of epithelial cells. Recent researches have focused on the relationship between the expression of different cytokeratins with differentiation and outcomes of tumors. This study was done for determination of the relationship between expression of cytokeratin 20 and cytokeratin 7 with prognostic factors in the adenocarcinoma of the stomach. The study was a cross-sectional one. In this research, 31 archival samples of gastric adenocarcinoma with different histopathologic differentiation were immunohistochemically examined for analyzing the expression of cytokeratin 20 and cytokeratin 7. The relationship between cytokeratin 20 and cytokeratin 7 expression with prognostic factors including histopathologic differentiation, lymph node involvement and depth of invasion were assessed. Obtained data were analyzed by Chi-square and Spearman statistical tests. A negative correlation between cytokeratin 20 and cytokeratin 7 expressions with histopathologic differentiation and lymph node involvement was observed. There was a significant correlation between cytokeratin 7 expressions and tumor thickness. The correlation between cytokeratin 20 expression and tumor thickness was not significant. Expression of cytokeratin 20 and cytokeratin7 was negatively related to histopathologic differentiation and lymph node involvement.

This research studied the examination and comparison role of repetitive thoughts of worry and rumination in students of university with sleep disturbance and normal sleep. The method of this study was correlation and causal-comparison that was performed on 200 subjects selected among Payam Nour University’ students. Subjects responded the Beck Inventory and Pittsburgh Sleep Quality Index and based on their scores in sleep quality and lake of depression, 30 students with sleep disturbance and 30 students with normal sleep were selected and completed rumination questionnaire and worry domains scale. Data were analyzed with Pearson correlation, regression analysis, multivariate analysis of variance (MANOVA) and path analysis. It was found out that rumination, worry and domains of worry are positively associated with sleep disturbance. Also, rumination, worry and domains of worry were a significant predictor of sleep disturbance and higher in students with sleep disturbance as compared to normal sleep. In addition, worry had a mediator role in association with rumination and sleep disturbance. Repetitive negative thinking is a risk factor for sleep disturbance onset and maintenance and it can be useful as a promising target for designing prevention treatment for sleep problems and decreasing psychopathology.

Obesity and type 2 diabetes mellitus (T2DM) have become two of the main threats to public health worldwide. The purpose of this research was to investigate the effect of aerobic training and diet on lipid profile and liver enzymes in obese women with type 2 diabetes. Twenty three obese females with type 2 diabetes and a mean age of 47.75±7.936 years were selected as volunteers and were divided into two groups; aerobic training group and aerobic training with diet group. Aerobic training in both groups performed 36 sessions of exercise training, three sessions per week with an intensity of 50%-70% heart rate reserve (HRR). The second group in addition to aerobic training received a diet that included 500 kilocalories of energy less than the estimated daily energy requirement. Serum levels of some parameters before and after the intervention were also measured. Data were analyzed by paired-samples t-test, Wilcoxon, and Mann-Whiteny U tests at a significance level of p<0.05. Triglyceride (TG) level reduced significantly in aerobic training plus diet group and the ratio of low-density lipoprotein to high-density lipoprotein significantly reduced in aerobic training group. Moreover, the changes within groups regarding levels of serum ALT and AST were not significant in both groups. The inter-group difference regarding TG was also significant. Aerobic training and diet has a desirable effect on body composition and lipid profile. However, these two programs had no desired effect on reducing liver enzymes

Abnormal regulation of apoptosis and metallothioneine in maternal tissues may be dangerous for the developing fetus. The aim of this study was to investigate the effect of endurance swimming training on liver apoptotic index and metallothioneine concentration in pregnant rats. Sixteen pregnant Wistar rats (200 ± 20 g) were divided into two groups: control (Cnt) and swimming training (ST). Pregnant rats in ST group were forced to swimming in a specific pool from first day of pregnancy until delivery. The time of training in first day of pregnancy was 30 min and this time in second week reached to 60 min by increasing of 5 min per day. This time (60 min) continued to the end of third week. Liver tissue was collected two days after delivery. The liver apoptotic index and MT concentration were determined with TUNEL and ELISA methods, respectively. Independent sample t-test was applied for statistical analysis of the data (p< 0.05). Endurance swimming training did not cause significant changes in liver MT levels in pregnant rats (p=0.509). No significant changes were observed in liver apoptotic index between the groups (p=0.424). Morphological characteristics of hepatocytes showed no changes during training program as compared to control group. Sub-maximal endurance swimming training during pregnancy can be used to gain the benefits of exercise during pregnancy without induction of maternal liver apoptosis or changes in MT concentration

Since urinary tract infection is one of the effective factors in pregnancy outcome, this study was conducted to assess urinary tract infections in pregnant women in this field according to Theory of Planned Behavior. This study was a cross-sectional one that was carried out on 180 pregnant women referring to Karaj health centers with simple sampling in 2013. The tool used for data collection was the questionnaire consisting of health knowledge, construct of theory planned behavior including attitude, perceived behavioral control, behavior intention and behavior check list. The questionnaire has been proved and its validity and reliability had been studied before the investigation. The mean age of women was 26± 5.8 years. Meanwhile, 6.1% of them had obtained good points in knowledge. Pregnant women have more score regarding the hygienic habits and lowest score regarding the feeding habits. Based on Spearman correlation, there was a significant relation between knowledge and theory of planned behavior factors (p<0.05). But there was not a significant relation between attitude and education of pregnant women (p=0.538). Theory of planned behavior can be used as a tool for evaluation of the condition of pregnant women in the field of urinary tract infection. Based on the obtained results, intervention of educational program on nutrition behavior is recommended.

Considering the globalization of health care and response to competition and customer orientation, attention to organizational structure and systematic approach and its relationship with market orientation is essential. Therefore, this study reviews the relationship between organizational structure and systematic approach with market orientation in selected hospitals of Isfahan. This study was a descriptive survey. The study population included all managers in selected hospitals (3 private ones, n=78). Data collection tool was 3 questionnaires (market orientation questionnaire, organizational structure and systematic approach) that their validity and reliability was confirmed (r= 0.83). The software SPSS (Ver.16) was used to analyze the data. All aspects of the organizational structure and market orientation except responding to clients with formalization in organization - as well as all aspects of the systemic attitude and market orientation, have a significant relationship (p<0.05). Dimensions of market orientation and its significant relationship with organizational structure and systematic approach can lead managers’ view to the analysis and recognizing elements of success and achievement to goals. With increasing competition in markets, presence in international markets and more attention to patients’ satisfaction, it is required for hospitals to understand and to use market orientation in order to promote quality and services in the health system.