نشریه پژوهش در پزشکی
سال سی و هشتم شماره 3 (پیاپی 151، پاییز 1393)

In recent years، many authors considered the effects of honey in treatment of different types of wounds. Pressure ulcers are one of the most important health problems with a challenging treatment. In current study، we evaluated the effects of an ointment containing honey، sesame and camphor in treating pressure ulcers in diabetic patients. In current randomized clinical trial، 60 patients assigned to two groups randomly. Daily irrigation using normal saline and dressing with sterile gauze was performed. In control group، placebo and in case group، the ointment containing honey، sesame and camphor (Kimia ointment) was used twice a day for 8 weeks locally. Before and after the treatment، PUSH tool 3. 0 was completed. Also، the rate of infection requiring surgical debridement was compared between groups. Mann-Withney U، Wilcoxon and chi-square tests were used. Two groups were the same in terms of sex and age. There were one and 5 patients required surgical debridement in case and control groups، respectively (p=0. 195). The PUSH score decreased significantly in two groups after the treatment (p<0. 001). Before the treatment، the PUSH scores were the same. At the last visit، the PUSH score in ointment and placebo group was 4. 9±1 and 6. 8±1. 2، respectively (p<0. 001). Treating pressure ulcers in diabetic patients applying ointment-containing honey، sesame and camphor can be helpful in accelerating the healing process. However، more extensive studies are needed.

Asthma is one of the most common childhood diseases and the first cause of school absentness and third cause of hospitalization in the children under 15 years. The goal of this study was to assess the effect of symptoms-based “written action plan” on frequency of emergency department visits and school absentness in children with the age of 7-18 years. This was a randomized control trial, which was performed on 60 asthmatic children that visited in a pulmonary specific clinic in Ahvaz (2012). After perform matching (age, sex and duration of disease), participants were divided randomly in control and case groups. The case group received the symptoms-based written action plan. The data were analyzed with SPSS and analytic (paired t-test, independent t-test) and descriptive (mean...) statically methods. There was a decrease in the mean and SD score in the frequency of school absentness (0.03±0.18) and emergency department visits (0.06±0.25) in case group. In comparison of two groups after intervention, there was a significant statically difference in frequency of school absentness (p=0.007) and emergency department visit (p= 0.0001). According to our results, use of symptoms-based written action plan can be effective in decrease of emergency department visits and school absentness frequency.

Considering the importance of learning and student’s satisfaction and lack of sufficient background in effective methods of learning, this study aimed to compare the practical-theoretical teaching method with theoretical-practical method along with student’s satisfaction. This study was carried out through crossover clinical trial research method in two stages on 40 fourth-year dental students. The students were randomly divided in two groups (A and B). In the first stage of this research 5 lesions including (pyogenic granuloma, lichenplanus, leukoplakia, squamous cell carcinoma, and necrotizing ulcerative gingivitis) were taught to (A) group through practical-theoretical teaching method and were taught to (B) group through theoretical-practical method. In the second stage 5 other lesions including (recurrent aphthous stomatitis, herpangina, hand-foot-mouth disease, erythema multiforme, acute lympho nodular pharyngitis) with the same difficulty in learning were taught with replacement of two groups. At the end an exam including multiple choice test, pictures and slides consisting of 50% of the overall score was taken from the subjects. Learning and satisfaction were analyzed by using t-test. This study consisted of 33 (82.5%) females and 23 (17.5%) males. The gained mark in group (A) in practical questions was 5.66±1.12 and in group (B) was 4.83±1.33, which was statistically significant (P<0.05). Students satisfaction was not statistically significant between two groups (p>0.05). It seems that regardless of the teaching method, coordinating the method with the subject is a great importance in educating either oral medicine or other subjects in dental education.

Fascia lata as a graft can be used in different circumstances. Several techniques have been described to harvest the graft. Those techniques either need special instruments or have been associated with complications. Here we describe a new surgical technique, which is simple, less expensive and with minimal morbidity. Two small parallel incisions are made in lateral thigh. The distance between these incisions is equal to the graft length. The dissection of fascia from the underneath tissue is made with nylon zero and then it is cut as such as needed. 32 patients with mean age of 30 years were operated to harvest fascial lata. The graft was applied to correct the nasolabial fold due to facial nerve plasty, flexor tendon reconstructions and dura reconstruction. The patients were followed for one year. The functional and aesthetic results were acceptable. The presented technique needs no professional instrument, less surgical time and with least functional and aesthetic complications.

Due to the relationship between air pollution and occurrence of de-novo heart failure (HF) or decompensation of symptoms of HF, we aimed to evaluate such relationship in HF admissions in Isfahan hospitals. This case-crossover study is performed on 120 patients with mean age of 65. 9±10. 4 (45-86 years old) from cases referred to hospitals, which resulted in hospitalization with diagnosis of HF. After filling the patient information sheet, concentration of air pollutants including suspended particles (PM10) and gases (CO, NO2, SO2) within two days before hospitalization were searched from climatologic sites. Data were analyzed via SPSS software through t-test and Pearson's correlation test. HF was diagnosed in 54. 2% of cases. The mean value of PM10، CO, NO2 and SO2 indexes showed significant difference between HF and control cases (p<0. 001). There was a significant difference between ESR and mean value of PM10 and NO2 (p<0. 05). ESR had no significant relationship with other air pollution parameters (p>0. 05). CRP showed a significant relationship with mean values of PM10، and CO, but CRP and ICAM showed no significant relationship with NO2 and SO2. There is a strong link between concentration of air pollutants and decompensation of HF symptoms.

Premenstrual syndrome is characterized by the cycle occurrence physical, psychological and behavioral symptoms during the luteal phase of the menstruation cycle and will disappear within a few days of the onset of menstruation. The aim of this study was to assess the effect of relaxation therapy on premenstrual syndrome. This was a double-blind clinical trial study with control group and pretest-post-test. Study was carried out on 29 volunteer students of Kermanshah schools with PMS diagnosis in year 91-92. After surveying two menstruation cycles and confirming PMS existence, subject were randomly assigned into relaxation and control group. Relaxation protocol was performed for eight weeks in 1 month. Volunteers completed DRSP during 2 cycles before and 1 cycle after intervention. Data were analyzed using SPSS software. The Mean premenstrual syndrome scores, in comparison between before intervention, (69.21±5.84 in relaxation group, 69.66±5.34 in control group) and after intervention (62.29±6.03 in relaxation group, 69.07±5.36 in control group) (p-value<0.001), relaxation group showed significant decrease averagely in mean of symptoms. Based on the results of this study it can be concluded that relaxation therapy is an effective method for relieving symptoms of premenstrual syndrome. Our advice is for more research in this area.

Bacteria communicate with each other by using molecular chemical signal, which are called autoinducer. By the increase of concentration of these signals, which is the result of increase cellular density, they coordinate gene expression in a microbial community. This process is called Quorum sensing. Considering the importance of urine tract infections prominent role of Quorum sensing and external signals in regulation of bacteria gene expression. In the present paper these concepts were studied: luxS, and rsbA genes’ band in Proteus mirabilis isolated from urinary tract infections and the effect of miristic acid as an external signal in regulation of gene expression. In this study, 100 urine samples were collected. 10 Proteus mirabilis were isolated from these samples by standard bacteriologic methods. Subsequently, by the extraction of genome, the presence of luxS & rsbA gene bands were studied in 10 P. mirabilis. At the end, the effect of miristic acid on the swarming and the biofilm formation ability of the P. mirabilis is assessed. In 100 urine sample studied, 10 Proteus mirabilis (10%) were isolated. 70% studied P. mirabilis, contained luxS & rsbA gene bands. Miristic acid decreased the swarming of P. mirabilis in the concentration of 40 to 80 µl/100 ml of LB culture and the ability of P. mirabilis in the biofilm formation in all concentrations added to LB culture increased. Discussion & The results obtained from the presence study indicate the presence of luxS and rsbA gene bands in most of P. mirabilis isolated from urinary tract infections, which demonstrate the presence of Quorum sensing regulatory systems in these bacteria. Also, the effect of miristic acid on the swarming and the biofilm formation ability of P. mirabilis containing rsbA gene, shows that respondent regulatory systems to external signals presents in the bacterium. Therefore, by understanding these regulatory & communicatory systems, we can hope to infections control & new drug development.

Diabetic Mellitus (DM) is a systemic disease that affects all body organs. Micro and macro vascular complications progress with diabetes progression. It is important to find a solution for early diagnosis of coronary artery disease that is a major cause of death in these patients. The goal of this study is to assess the relation between diabetic nephropathy and retinopathy to find coronary artery disease earlier and easier. Method of study: This study was done by cross-sectional method. All patients with diabetes mellitus studied for micro and macro vascular complications and coronary artery disease. Coronary angiography used for diagnosis of coronary artery disease. Diabetic retinopathy diagnosed with direct ophthalmoscopy by an ophthalmologist. Diagnosis of diabetic nephropathy was done by assessment of GFR with Cockcroft-Gault method or albuminuria in 24-hour urine collection. The prevalence of coronary artery disease and nephropathy and retinopathy determined in sample and the confidence interval was estimated. 104 patients with DM type 2 were studied. 68 (65.4%) patients had coronary artery disease. 54 (51.9%) patients had diabetic retinopathy and 40 (38.5%) had diabetic nephropathy. According to this study 47.1% patients, who had retinopathy and nephropathy at the same time had coronary artery disease as well. 23.5% of patients with retinopathy and 5.9% of patients with nephropathy had coronary artery disease. Coronary artery disease was seen in 23.5% of patient without any microvascular complications. It seems that microvascular complications consist of retinopathy and nephropathy have relation with coronary artery disease. Therefore, it seems simple evaluations such as blood and urine analysis or annual ophthalmic examinations by an ophthalmologist are simple and safe ways to follow diabetic patients and with early diagnosis we could intervene for early recognition of coronary artery disease.

Breast cancer is one of the most common form of cancer among women. Diagnosis in the early stage of emergence is the most effective way to reduce the mortality caused by this disease. Mammography, the safest and most accurate imaging test for the identification of breast cancer, required high quality images along applying the lowest possible dose to sensitive tissues of the breast. This study aimed to optimize the radiation dose in mammographic tests and improve patient protection by enhancing the quality of mammography equipment in centers participating in this trial. At the first phase of this study, mammography equipment of 20 analog mammography center located in Tehran underwent quality control tests and, if necessary, corrective actions have also been done. In the second phase, quality control tests have repeated and the results were compared with the first step, to determine how corrective actions affected on the performance of the devices. The survey showed about 70% of mammograms were in good condition and 23.6% in relatively good condition and only 6.4% of the devices had images that need to be repeated. The entrance skin dose was measured in the range of ESAK = 3.8-10.5 (mGy) and average glandular dose in range of AGD = 0.34-1.8 (mGy). The average glandular dose values calculated are lower than international levels, that ensures the patient radiological protection, but other parameters related to image quality values were much lower than standard values. Therefore, use of mammography devices with good quality and performing routine and regular QC test is necessary.

Vaccination against hepatitis B surface antigen is the most effective way for prevention and has the capability to induce protective antibody levels (> 10 IU per liter) for most vaccinated people, but antibody titer has been shown to decrease over time. It is highly important to investigate this subject especially in the medical community and related professions as high-risk groups. Hence, this study was conducted on freshman students in academic year 2012-2013 at Shahid Beheshti University of Medical Sciences, due to concerns about their immunity against hepatitis B and its complications, particularly for medical students and lack of information on its status. A total of 441 freshman students were examined for HBsAb titers in this descriptive study in 2012 at Shahid Beheshti University of Medical Sciences. As all students had been vaccinated according to the national protocol, vaccination card was not requested from them. Given the kit used, HBsAb titers ≥10 mIU/mL was determined as a protective level. The findings were also analyzed according to gender. From a total of 441 students, 221 students (50%) were identified as immune people. Mean HBsAb titer was 139 mIU/mL in immune individuals and 2.9 mIU/mL in non-immune people. The difference between mean HBsAb titer in the two groups was found significant using t-test (p<0.01). Mean HBsAb titer was 80.4 mIU/mL in women and 50mIU/mL in men. The findings showed that the antibody titer against hepatitis B surface antigen was significantly higher in women than in men (p<0.05). Also, HBcAb levels in 135 students showed that 1.1% of participants had developed the antibody through contact with the causative agents and the rest of them through hepatitis B vaccination. It appears that immunization against hepatitis B virus is low and particularly a concern for the medical team. Therefore, it is recommended the causes be studied and necessary measures be taken for the immunization of this group of students.