نشریه دانشور پزشکی
پیاپی 118 (شهریور 1394)

Using animals in science have had major contributions in progression of human knowledge. However, this contribution has been always accompanied with varying degrees of pain and suffering for these sentient creatures, whom they are completely unable to defend their rights. In a humane and ethical point of view, we humans are responsible for protecting them. One of the most important means for protecting laboratory animals (LA) is to educate researchers according to the highest available ethical and scientific standards, thus developing the concept of “responsible researching” among the scientific community. The aim of the current study was to develop a comprehensive guide for the care and use of LA in the country. This guide is also aimed to provide a basis for the activity of the animals’ ethics committees in the country. The current qualitative study was based on a Health System Research platform and is formed according to the structured communication technique of experts’ panels based on the Delphi method. Primarily any available ethical codes of LA research in the country were collected and integrated. Then, they were compared with the ethical codes of the selected countries and any necessary modification or update of the primary codes were performed to prepare a draft of the comprehensive guide. The draft was evaluated by a selected panel of experts in several rounds to achieve the maximum convergence between the experts. Results are presented narratively. The final version of the guide is presented along with this paper.

The global increase in resistance to antibiotics among clinical isolates of Acinetobacter baumannii is reported from several countries, but its true prevalence in Iran is less known. The objective of this study was determination of the frequency of resistance to different antibiotics among Acinetobacter baumannii isolated from patients in two hospitals in Tehran, Iran, in 2013, to help selection of antibiotics in empirical therapy of infection with these isolates. Disk diffusion method according to recommendation of CLSI was used for determination of resistance to 18 antibiotics from 8 different groups (aminoglycosides, carbapenems, cephalosporins, penicillins/ß-lactamase inhibitors, antipseudomonal penicillins/ß-lactamase inhibitors, fluoroquinolones, folate pathway inhibitors and tetracyclines) in 106 Acinetobacter baumannii clinical isolates. Frequency of resistance to antibiotics among Acinetobacter baumannii isolates were as follows: cefotaxime 99%, ciprofloxacin, ceftriaxone, cefepime, ceftazidime, ticarcillin-clavulanic acid, meropenem and trimethoprim-sulphamethoxazole 98.1%, tetracycline 97.4%, levofloxacin and piperacillin-tazobactam 97.2%, amikacin, imipenem 97.1%, gentamicin 89.6%, ampicillin-sulbactam 83%, tobramycin 77.4%, doxycycline 60.4% and minocycline 50.9%. All Acinetobacter baumannii clinical isolates have shown multidrug resistance (resistance to at least one agent in ≥3 antimicrobial group) and some of resistance patterns were more commonly seen. The high frequency of antibiotic resistance in clinical isolates of Acinetobacter baumannii in Iran as shown in this study makes epidemiological surveillance of susceptibility of these bacteria more essential.

Sexual health problems are common in the postpartum period but despite the abundance this problem; is the lack of professional recognition. After delivery, many women have experience reduced sexual desire, reduced vaginal lubrication and shorter and weaker orgasm than before. Therefore, this study aimed to determine the pattern of sexual intercourse (resumption of sexual intercourse and number of sexual intercourse in the week) after delivery in nulliparous women. This study was a longitudinal study with aspects of descriptive and analytical study of the sexual intercourse pattern (resumption of sexual intercourse and number of sexual intercourse in the week after delivery) and its influencing factors in 322 primiparous women at least two months after delivery. Samples were selected from archives of Mustafa Khomeini hospital in the summer of 2013 through a phone call. It was found out that out of 322 primiparous women that were participated in this study, 163 women had cesarean section and 159 cases had vaginal delivery. Their mean age was 25.49±4 and 145 (45%) of the subjects have not had sexual intercourse within 8 weeks postpartum. Findings indicate a reduction in the number of sexual intercourse after childbirth. In addition, between the number of sexual intercourse in the week before delivery and number of postpartum sexual intercourse in the week and between the type of delivery with resumption of sexual intercourse and number of sexual intercourse in the week, a relationship exists.

Shift working is a social phenomenon today in which nearly 25 percent of the total workforce is engaged in industrialized societies. The purpose of this study was to compare the effect of fixed and rotating shifts on burnout among nurses working in hospitals. The study population consisted of all public and private hospitals of the city of Rasht in 2011, of which a sample size of 120 subjects was chosen using multi-stage random sampling method and all participants responded to the Maslach and Jackson Burnout Inventory to measure burnout in them. Independent t-test analysis showed that the total burnout and emotional exhaustion subscale is greater in rotating shift nurses than fixed shift nurses (p<0.05). Regarding the following two subscales (deforestation and lack of success), no significant difference was observed in these two groups. Also, female nurse’s burnout was significantly higher than male nurse’s burnout. It can be said that rotating shifts due to changes in sleep-wake cycle by causing stress and creating a personal and family chronic problems increases burnout in people.

Inadequate consumption of fruits in students is a risk factor for some diseases such as cancers and cardiovascular disorders in adulthood. The purpose of this study was to predict the fruit consumption in elementary student based on the theory of planned behavior (TPB) in Chalderan. In this study, 184 students were selected through clustered randomization from male elementary schools. The data collection instruments included a researcher-made questionnaire and a 24-hour F&V recall. The reliability of the questionnaire with α=0.82 was confirmed. Data were collected after verification of the reliability and validity of the questionnaire. The data gathered were analyzed using SPSS version 20 and statistical analysis of correlation, regression and descriptive data. The results showed that mean (SD) of fruit and vegetable consumption is 1.47 unit in day. According to regression analysis, subjective norms, amount of pocket money, and behavioral intention, 39% of the predicted changes of fruit and vegetable consumption (R2 =0/39, F=10/72, p<0.001). As well as based on this model, attitude predicts 20% changes of intention the consumption of fruit and vegetables (R2=0/20, F=6/68, p=0.01). Fruit consumption in students is less than the amount recommended by the World Health Organization. According to the findings of this study, there should be attention in design of educational interventions for elementary student on subjective norms and behavioral intention variables. Also, economic status can be an effective factor in the consumption of fruit and vegetables.

The purpose of this study was to evaluate the satisfaction of landmine victims less than 18 years of the types of services provided by Veterans and Martyr Affair Foundation (VMAF). The descriptive study evaluated the status of services to all landmine victims less than 18 years from Iran. Satisfaction level was measured using a self-administered questionnaire based on seven categories of services provided by VMAF. Total score ranged between 7, the least satisfactory to 35, the most satisfactory. Also, by two open questions, difficulties in using the service were investigated in more details. Finally, all data were analyzed by SPSS 22 software and independent sample t-test and ANOVA statistical tests. The mean age of 78 survivors in this study consisted of 67 (85.9%) boys and 11 (14.1%) girls was 16.1±1.9 years. The mean score of satisfaction was 14.92±5.46. Cronbach's alpha was found as 0.76, showing that the scale is reliable. The group of specialists of Janbazan Medical and Engineering Research Center (JMERC) approved the validity of the scale. Health care services had the highest (18.2%) and sports services had the least satisfaction (5.1%). More than half of the cases were dissatisfied of the low awareness with service delivery (57.7%). The most common problems in getting health care services were high cost (61.5%) and then waiting long time for visiting doctor and the uncertainty about solving their problem in hospitals (48.7%). Significant relationships were observed between satisfaction with age at the time of casualty (p=0.02), disability percentage (p=0.04), spinal cord injury (p=0.04) and province of residence (p=0.006). The satisfaction of landmine victims less than 18 years of the types of services provided by VMAF in living in border areas was at the moderate level. Although health care services had the most satisfaction level but, enumerate the various problems in receiving these services have shown significant barriers, especially in the fast and convenient access to health care services.

Widespread use of cell phones and increased noise pollution in surrounding environment are the most important risk factors of human health in the age of technology. The aim of this study was to investigate the effects of mobile phone radiation and noise stress on serum levels of T3 and T4 in male rats. In this experimental study, the male Wistar rats were divided into control, exposed to cell phone radiation (940 MHz) for 1, 3 and 6 h/day, exposed to noise stress (100 db, 700-5700 Hz) for 1 h, 3 h and 6 h/day, exposed to cell phone radiation (940 MHz) and noise stress (100 db, 700-5700 Hz) for 1, 3 and 6 h/day groups. After 8 weeks, blood samples were obtained using cardiac puncture method and after serum preparation, levels of T3 and T4 were measured using ELFA method. The data were statistically analyzed using SPSS software version 19. The results indicated that serum level of T3 significantly decreased in all experimental groups compared with control animals (p<0.001). Serum level of T4 significantly decreased in rats exposed to cell phone radiation for 3 and 6 h/day and in rats exposed to noise stress for 1, 3 and 6 h/day and in rats exposed to cell phone radiation and noise stress simultaneously for 1 and 6 h/day (p<0.05). These changes were not observed for serum level of T4 in groups exposed to cell phone radiation for 1 h/day and in group exposed to cell phone radiation and noise stress simultaneously for 3 h/day. Results of this research showed that these two physical factors can synergistically potentiate their inhibitory effects on thyroid hormones secretion and their effect is proportionally related to exposure period.

Back ground and Microbial dental plaque is the main factor of periodontal disease. Antimicrobial effects of magnolia bark have been studied in vitro and also by using sugar-free chewing gum. The aim of this study was to evaluation antimicrobial effect of a mouthwash made from magnolia bark on the reduction of dental plaque using a periodontal parameter called Oleary plaque index. In this clinical trial study, initially a hydroalcoholic extract of Magnolia grandiflora bark was obtained. With regards to the MIC of the Magnolia extract for Streptococcus mutans and Stereptoccocus sanguis, a 0.3% mouthwash was obtained from the extract. Twenty volunteers entered the study to use this mouthwash and were classified into category of poor and good health based on their plaque percent index. OLeary index parameter was calculated in four stages. A placebo mouthwash was used as a control in this study. The findings were analyzed statistically using unpaired and paired t-tests. Results and In each round of magnolia mouthwash administration, percentage of OLeary index statistically showed a significant difference between the phase of mouthwash consuming and the resting phase. Also, the plaque percent index showed a significant difference between the magnolia mouthwash group and the placebo one (p<0.005) and the mouthwash was more effective.

The hospitalization of infants in the neonatal intensive care units impact intense stress on the mother. If this stress continues, in addition to endanger the health of the mother, will have also a negative impact on the mother-infant attachment process. Spiritual well-being as a variable affecting the coping strategy and stress levels is important, as well as, identifying the coping strategies by the mothers in this situation was explored. In this cross-sectional and correlation study, data were collected during three months in 1392, from 191 mothers with their infants in the NICU of the teaching hospitals affiliated to Tehran University of Medical Sciences. Tools for data collection were Lazarus and Folkman's ways of coping questionnaire, Ellison & Palvtzyan spiritual well-being scale, Mills parental stress and a demographic questionnaire. Descriptive statistics and Pearson correlation test were used to achieve the objectives of this study. Spiritual well-being have a positive relationship with problem-focused strategy and inverse relationship with emotion-focused strategy (p<0.000). In subscales of coping strategies, seeking social support had higher and escape- avoidance had the lowest mean averages which was used by the mothers. No significant relationship was found between spiritual well-being and stress scores. In addition, between stress levels and type of coping strategies, no significant relationship was found out. According to the results of this study, it is necessary to consider stress factors associated with mothers. It is also necessary to strengthen the religious dimension of spiritual health, especially in women because of its association with problem-focused strategy.