مجله دانشکده علوم پزشکی نیشابور
پیاپی 5 (زمستان 1393)

Introduction and Dietary Tran’s fatty acids (TFA) comes mostly from the industrial hydrogenation of unsaturated vegetable oils. TFA also are formed during the natural bacterial hydrogenation of unsaturated fatty acids that occurs in the rumen of polygastric ruminants such as cattle, sheep, and goats. The epidemiologic evidences suggest that the intake of Tran’s fatty acid may be associated with increased risk of cardiovascular diseases (CVD) such as atherosclerosis or chronic heart disease (CHD). The purpose of the current study is better understanding of effects of TFA on cardiovascular disease. So, the available evidences from studies were reviewed. A complete search was performed about the association of TFA intake with risk of CVD in databases electronic such as ISI Web of science and PubMed and also in SID from1993 to 2014. The results of most studies have indicated a significant direct association between the TFA intake and risk of CVD. Also, increasing of TFA intake was related with increased risk of diabetes, systemic inflammation, decreased membrane fluidity, increased serum lipid levels and inflammatory markers. The most evidence for association between the intake of TFA and cardiovascular diseases were related to TFA from hydrogenated vegetable oils and information about the effects of TFA from ruminant was inconsistent. It is necessary performing studies about the effects of rTFA (ruminant trans fatty acid) on risk of CVD and banning the use of these fatty acids in the food industry.

Introduction and Matrix metallo proteinase-2 (MMP-2) is a family of proteolytic enzymes involved in degrading and remodeling the extracellular matrix and basement membrane. Researchers have shown that Mast cells have an important role in the inflammatory disease including lung fibrosis and they can be as the source of MMP-2 protein. The aim of this research is the examination of Thalidomide effect on the MMP-2 protein expression and Mast cells in the lung fibrosis induced by Bleomycin in mice. In this research, 32 male adult C57BL/6 mices were randomly divided into 4 groups. Mices received in group 1 (Bleomycin) Bleomycin sulfate, in group 2 (Bleomycin+Thalidomide) Bleomycin beside Thalidomide, in group 3(Thalidomide) Thalidomide and in group 4 (Carboxy Methyl Cellulose) Carboxy Methyl Cellulose via intraperitoneum. At the end of experiment, mice’s lung samples were prepared and histological and immunohistochemical studies were performed about them. After the investigation of tissue slides, number of MMP-2 protein expression cells and Mast cells were calculated and results were analyzed by using OneWay ANOVA and Tukey’s test. Histological and immunohistochemical studies showed a significant increase in the number of MMP-2 protein expression and Mast cells in the Bleomycin group in comparison with the Carboxy Methyl Cellulose group (p < 0.001). But number of these cells in the Bleomycin+Thalidomide group decreased significantly compared to the Bleomycin group (p < 0.001). The results showed that the number of expressive cells of MMP-2 protein and Mast cells decreases by Thalidomide and subsequently reduces lung fibrosis in the mice.

Introduction and Since the needle stick is one of the hospital-based infections and taking immediate precautions is vital in staff’s health and safety. In order to identify causes and frequency of injuries, this cross-sectional study was conducted among Sina hospital staff in 2011. Among 295 medical workers of Sina hospital that were selected using census method, 191 persons filled the questionnaires. Data was analyzed by SPSS v.15, descriptive analysis and regression logistic. More needle stick occurred about nurses in the morning shift with a bachelor’s degree with 15-10 years of experience and 20-30 years old. There was a significant relation between demographic criteria and the frequency of needle stick. The most accident was needle stick injury in 25% of cases and the most reaction was wound washing with water and soap (66%). High level of load work and lack of protection instruments were recommended as 44% and 9% of the reasons of needle stick respectively. In order to reduction needle stick, promoting education, safe work practices for staff and using devices with safety features seems to be necessary. Considering the importance of health personnel, the employee should expect to have tests by the hospital for baseline results of Hepatitis B surface antibody, Hepatitis C antibody, HIV antibody and possibly other liver necessary tests.

Introduction and Drug abuse including opium has extended all over the world and in Iran. Considering the 17.1 % prevalence of heroin abuse in a village in Kerman and 3.5% prevalence of opium addiction in Kerman and also non-official reports from visitors to medical practices it seems that the periodontal disease is prevalent among patients who are high-addict. There is few studies in this field, Therefore this study aimed to investigate the effect of opium as an independent risk factor for developing periodontal diseases, including gingivitis. The study was a cross-sectional survey which was conducted in 1390 in Kerman by random Sampling. Samples were enrolled in the test group (468 subjects) and control group (227 subjects). Gingival health indexes of CPI and GI were measured. Data SPSS v.20, Mann Whitney test and Chi-square analyzes were performed. The two groups were matched for age, gender, education, smoking, brushing behaviors and visiting by dentist (P >0.05). Gingival bleeding and periodontal diseases in the control group had lower scores than the study group which indicates a low level of oral health among drug users. The use of opium is associated with gingivitis and dental problems and affects negatively on oral health, although more epidemiological studies are needed in this field.

Introduction and In the last years, there has been increasing interest on possible association between the sleep apnea with hypertension and poor sleep quality in patients with glucose metabolism disorders. The present study aimed to assess the relationship between sleep apnea, hypertension and sleep quality in patients with type 2 diabetes. This descriptive - analytic study was carried out on 100 type 2 diabetes patients’ referral to the Saghez city diabetes unit with convenience sampling. Data were gathered using Berlin Questionnaire and Pittsburgh Sleep Quality Index. Data were analyzed using descriptive statistical testes, independent T test and Chi-square test. Results The results of this study showed 46 % of samples complained from sleep apnea and 42 % complained from poor sleep quality. showed that there are statistically significant relationship between sleep apnea and high blood (CI95% = 1.6-9.4, OR = 3.9, p < 0.002) and sleep quality (CI95% = 1-4.9, OR = 2.1, P=0.04).The risk of sleep apnea were 3.9 and 2.1 fold higher in patients with hypertension and poor sleep quality than those patients without normotensive and good sleep quality. Regarding to high prevalence of sleep apnea and relationship between this disorder and high blood pressure and sleep quality in patients with diabetes, using of screening methods for diagnose of sleep apnea in diabetic patients is necessary.

Introduction and Evidence based medicine aids the delivery of effective service to patients, diagnosing and treating. According to Clinical guidelines of evidence-based medicine, it’s possible to change clinical decision, improve treatment and promote the patients´ health. The purpose of this study is to survey knowledge, attitudes and performance about evidence-based medicine among physicians. All of the physicians in educational hospitals of medical faculty of Neyshabur, were entered in this cross-descriptive study by convenience sampling method. The questionnaire included demographic information and also information about knowledge, attitudes and obstacles of evidence-based medicine. Data were analyzed by SPSS v.16 software and descriptive statistics. Results showed that 88 % of physicians had little familiarity with evidence-based medicine and its resources. 47.8 % of them employed evidence-based medicine in their treatment decisions and 60.4 % knew the significance of evidence-based medicine for medical teams. Overloud of information were reported by 55.1 % of participants as preventive factor in use of evidence-based medicine. According to low level of knowledge and performance in evidence-based medicine among physicians, promoting awareness and practice is needed.

Introduction and Carpal tunnel syndrome is known as strangulation of the median nerve in the carpal tunnel. There are different methods for diagnosis of this syndrome. The Boston Questionnaire is a method for determining the intensity and quality of the disorder. The purpose of this study was to determine the validity and reliability of the Persian Boston Questionnaire in order to evaluate the severity and functional ability of carpal tunnel patients in Iranian diabetics. The study was done on 105 diabetic patients. The Persian Boston Questionnaire and its English retranslation were provided by Backward-Forward method. Its content and construct validity were evaluated and in order to determine the reliability of the Questionnaire Cronbach’s alpha was calculated. Data was analyzed by SPSS v.20. In this study content and construct validities of the Questionnaire were 92.75% and 77.7% respectively. The results of Spearman correlation in construct validity assay between the electro diagnosis test and two parameters: symptoms intensity and functional status were 0.33 and 0.34, respectively. Cronbach’s alpha of the questionnaire was 0.86. The Boston Questionnaire is a valid and reliable tool in evaluation of intensity of symptoms and functional status in Iranian diabetics with carpal tunnel syndrome, but it has low validity in evaluating the physiological intensity of illness.

Introduction and Breakfast is the most important meal that plays an important role in adolescents’ health. Eating breakfast caused to increasing the diet quality and preventing chronic diseases. This study examines not having breakfast and some related demographic factors in 14-18 years old adolescents of Sanandaj. In this study, 553, 14-18 years old students of Sanandaj’s high schools were selected randomly. Providing a checklist, demographic and anthropometric information of all participant were collected. Data were analyzed using SPSS v.16 software, Chi-square test and t-test. 41 (7.5%) of teens didn’t have eat breakfast, and 59 (10.7%) had breakfast one or two days a week. Breakfast consumption was significantly higher in boys than girls (P < 0.001). The results showed that the level of parental education was correlated with eating breakfast by adolescents (P < 0.05). There was no significant relationship between body mass index in adolescents with eating breakfast (P = 0.16). Breakfast consumption declined with age in adolescents (P < 0.003). Breakfast consumption in adolescents is influenced by demographic factors. Parents’ high level of education, as well as higher employment levels influences the perseverance of having breakfast in adolescents during the week. Thus, parents play a decisive role in habits formation of eating breakfast in their teens.