Qom University of Medical Sciences Journal
Year:2018 | Volume:12 | Issue:5 |Papers Count:13

Background and Objectives: Philosophy of medicine as a field of study mainly concentrates on issues, such as ontology, epistemology, axiology, and logic. Although axiology has attracted more attention due to its position in medical ethics, especially in relation to modern medical ethical challenges, other topics of philosophy of medicine should be also considered important and necessary. Developing training courses at prestigious universities, publication of journals and books, holding conference meetings, are indicative of special attention to this relatively new field of knowledge. Some stipulated goals of Iran medical education system, such as critical thinking and problem solving skills, have also made these issues important and necessary to be paid attention to. Addressing philosophy of medicine in medical education program, can lead to contemplation on critical thinking, nature of rational thinking, its governing rules, and its role in health care system, and this is while, medical education system has taken distance from combination of wisdom and medicine, which is the main feature of former and influential Iranian physicians. Graduates of medical education system and provider of health services need to know the principles of health anthropology and the nature of health and disease in order to consider humans to be more than a body and to possess special dignity, and apply their professional practices and behaviors according to this approach. It seems that presenting the mentioned issues as a course entitled "Introduction to Medical Philosophy" to the medical students, may changes the attitude of health care providers.

Background and Objectives: Learning and memory processes occur as a result of interaction of neurotransmitter systems in various brain regions, such as hippocampus. The evidences indicated that serotonergic and opioidergic systems involve in behavioral, learning, and memory results. In the present study, we investigated the effect of the serotonergic system (5-HT) of the lateral hippocampus (CA1) on morphine-induced amnesia. Methods: In this experimental study, the animals were bilaterally implanted with cannulas in the CA1 region of the lateral hippocampus. Morphine was injected intraperitoneally and 5-HT3 receptor antagonist (Y-25130) was injected into the CA1 region. The memory was assessed by a single-trial step-down passive avoidance task and tested after training. The step-down latency was used for the assessment of memory retention in adult male NMRI mice. One-way analysis of variance, followed by Tukey test, were used for the analysis of data. Results: In this study, pre-test injection of morphine (dose, 5mg/kg) and Y-25130 (dose, 1ng/mouse) decreased memory acquisition process in the adult mice. In addition, ineffective dose of Y-25130 (0. 01ng/mouse) along with ineffective dose of morphine (5mg/kg) induced amnesia in mice. Conclusion: The results of this study showed that there is a synergistic effect between 5-HT3 receptor antagonists of hippocampal CA1 region and morphine.

Background and Objectives: Studies have shown that antiinflammatory drugs can affect growth and development of cancer. This study was carried out to determine the effects of aspirin and ibuprofen on viability of cervical cancer cells (HeLa) compared to non-cancerous cells (HEK 293). Methods: In this laboratory-experimental study, cervical cancer cells (HeLa) and non-cancerous cells (HEK 293), were randomly divided into control group and groups exposed to aspirin and ibuprofen (at doses of 0. 01, 0. 1, 1, and 10mg/ml. Twenty-four hours after exposure to the drugs, the viability of cells, was measured using MTT assay method. Data were analyzed using between group analysis of variance statistical method. Results: The viability of HeLa cells significantly decreased when exposed to aspirin at doses of 0. 01, 0. 1, 1, and 10mg/ml (p<0. 05, p<0. 001, p<0. 001, and p<0. 001, respectively); however, the viability of HEK 293 cells did not significantly changed in comparison with the control group. The viability of HeLa cells significantly decreased in the groups that received 0. 1, 1, and 10mg/ml of Ibuprofen (p<0. 05, p<0. 001, and p<0. 001, respectively) and cell viability of HEK293 cells significantly decreased only in the group exposed to 10mg/ml of ibuprofen compared to the control group (p<0. 001). Conclusion: The results of this study showed that aspirin and ibuprofen can have cytotoxic effect on cervical cancer cells; while have no significant cytotoxic effects on non-cancerous cells.

Background and Objectives: Polycystic ovary syndrome (PCOS) is an endocrine disorder in women, in which, the cause of infertility is lack of ovulation. The objective of the present study was to compare the effects of voluntary and endurance exercises on the ovarian follicles in the rats with PCOS. Methods: In this experimental study, 40 female Wistar rats (with mean weight of 220± 20g), were randomly divided into four groups of 10 each: 1) control, 2) patient, 3) patient+ voluntary training, and 4) patient + endurance training. The rats in the training groups, experienced voluntary training on the running wheel and aerobic exercises on a treadmill for 8 weeks (5 sessions per week). Forty-eight hours after the last training session, the rats were anesthetized and after removal of the ovaries, their tissue, were stained with hematoxylin and eosin. Data were analyzed using ANOVA and post hoc LSD. Results: In this study, the two chosen exercise protocols led to reduced body weight, significant decrease in preantral and antral follicles, insignificant difference in pre-ovulatory and atretic follicles, and significant increase in corpus luteum follicles compared to the patient group, which indicate the onset of ovulation. Conclusion: The findings of this study showed that voluntary and endurance trainings in rats have the same positive effect on the growth of ovarian follicles and ovulation.

Background and Objectives: Labor pain is one of the most severe pains. Given the importance of reducing labor pain and prioritizing natural delivery, this study was performed with the objective of investigating the effect of local heat therapy on pain, delivery outcomes, and rate of satisfaction in primiparous women. Methods: This clinical trial study was conducted on 80 primiparous women in Karaj city. The samples were selected using easy sampling and assigned to two groups, then, pain severity, delivery outcomes, and rate of satisfaction, were recorded in the two groups, . Data were analyzed using independent and dependent t-tests at the significance level of p<0. 05. Results: In this study, there was a significant difference between the two groups in variables of severity of pain, mean duration of first and second stages of the labor, frequency distribution of satisfaction of the studied subjects in terms of the type of intervention, satisfaction from the delivery process, first experience of breastfeeding, and mothers’ satisfaction from embracing their newborn babies (p<0. 05); however, there was no significant difference between the two groups in terms of the mean duration of the third stage, the mean Apgar score, the duration of embracing the infant, and the first infant's breastfeeding. Conclusion: Based on the results of this study, it seems that control of pain and making satisfaction using noninvasive methods of local heat therapy without affecting adverse maternal and fetal outcomes, promote progression and encourage mothers for normal delivery.

Background and Objectives: Inhibin is a glycoprotein hormone commonly found in the circulation, but its level increases in some diseases, and its measurement by serological method using anti-inhibin monoclonal antibodies, can help in diagnosis of some genetic diseases. This study was performed with the objective of cloning, expression, and purification of α , β a, and β b subunits of human inhibin protein in Escherichia coli. Methods: For each Inhibin subunit gene. a primer pair was designed. Then, the gene sequence of each of the subunits, was obtained from human genomic DNA using polymerase chain reaction (PCR) method, and then was cloned into pET22b vector after enzymatic digestion. Recombinant vector associated with each subunit, was transferred to the host cell E. coli (strain BL21). The transformed cells were cultured in LB culture medium containing ampicillin, and positive colonies were isolated for mass production of recombinant protein. After mass culture and induction of transformed strains by isopropyl β-Dthiogalactopyranoside (IPTG), the produced recombinant protein, was isolated using nickel column chromatography. Results: The inhibin hormone subunit genes, was correctly cloned in pET22b vector and its expression in E. coli, was considerably high. The results of the expression of inhibin hormone also showed that in the absence of codon optimization, the inhibin expression in the prokaryote host increases significantly. The protein subunits α , β a, and β b of inhibin hormone, were purified, respectively, with molecular weights of 13. 7, 12, and 12 kDa. Conclusion: protein subunits of inhibin hormone, can be expressed in the prokaryotic host due to their small size, short gene sequence, and minor post-transcriptional modifications.

Background and Objectives: Obesity is a worrying problem in the present age and is the cause of many chronic non-communicable diseases. Several nutritional and non-nutritional factors are involved in the emergence of this health crisis. One of the important nutritional factors is the quality of nutrition. In this study, the relationship of the Alternative Healthy Eating Index (AHEI-2010) in relation to obesity, vitamin D3, and CRP, was investigated in the elderly. Methods: This descriptive-analytic (cross-sectional) study, was performed on 190 older adults referred to health centers of Tehran University of Medical Sciences using cluster sampling. Food intake was measured by Food Frequency Questionnaire. The level of vitamin D and hs-CRP were calculated in fasting blood, and variables of weight, height, and waist circumference, were measured. In the final analysis with logistic regression, confounding factors, were adjusted and p<0. 05 was considered statistically significant. Results: The mean age of the subjects, was 67. 31 and the mean BMI was estimated to be 29. 89. The distribution of the individuals in terms of weight, body mass index, and waist circumference, was not significant based on AHEI-2010. The odds ratio of abdominal obesity based on AHEI-2010, was estimated to be OR=0. 85 after adjusting for confounders, which was not statistically significant, but this distribution was not significant for the odds ratio of general obesity (p=1. 20). Conclusion: The findings of this study revealed that by increasing the score of AHEI-2010, the odds ratio of abdominal obesity decreases, but there is not significant relationship between the AHEI-2010 and general obesity, vitamin D3, and hs-CRP.

Background and Objectives: Hospital accreditation is used as a tool to improve the quality and safety of patients. The effectiveness of accreditation depends on the content of the standards. Considering the role of executive management team of hospitals in the implementation of accreditation standards, this research was conducted with the purpose of evaluating the viewpoint of executive management team of hospitals of Qom province in terms of the third generation of accreditation of hospitals. Methods: This descriptive cross-sectional study was carried out in 2017 using a questionnaire in 5 sections. The statistical population consisted of the executive management team of all hospitals in Qom province, which was selected by census method. Data were analyzed by descriptive and inferential statistical methods. Results: The level of agreement of the executive management team of the hospitals with the sections of content, implementation, and the effects of accreditation was in the medium range and in terms of methodology and expectation of the accreditation was in the agreement range. The highest agreement was reported with the expectation section and the lowest agreement was with the implementation of the accreditation standards. Conclusion: The results of this study showed that elimination of deficiencies in the structural resources of hospitals, removal of uncertainty about the scale, the weight of the evaluation scores, the coordination and unity of procedures among accreditation assessors, and the effort to attract more physicians, can be effective in achieving the goals of accreditation of hospitals.

Background and Objectives: With increasing use of vancomycin antibiotic, vancomycin-resistant Enterococcus (VRE), is considered as a major cause of nosocomial infections. In this study, the pattern of antibiotic resistance and prevalence of vancomycin resistant enterococcus faecium, were investigated. Methods: In this descriptive study, after isolation and identification of 690 strains of Enterococcus from clinical and environmental specimens in different wards of Lorestan hospitals, the pattern of antibiotic resistance of these strains to common antibiotics, were investigated using dick diffusion and agar dilution methods. The antibiotic resistance genes (vanA, vanB, pbp5, pbpZ, and blaZ), were detected by PCR technique. Results: Among 690 studied Enterococcus isolates, 439 isolates (64%), were Enterococcous feacalis, 228 isolates (33%) Enterococcous faecium, and 23 isolates (3%), were other Enterococci. Based on the antibiogram test by disk diffusion method, the highest resistance was to penicillin with 446 isolates (67%) and the lowest resistance was to linezolid with 0 isolate (0%). In the evaluation of resistance using minimum inhibitory concentration (MIC), the antibiotic resistance rate was obtained to be 58% for ampicillin, 59% for penicillin, and 23% for vancomycin. Resistance genes, including vanA, vanB, pbp5, pbpZ, and blaZ, were detected in 84 (72%), 26 (22%), 87 (74%), 63 (53%), and 0 (0%) of the isolates. Conclusion: Based on the results of this study, resistance to vancomycin in Enterococcus strains is also found in Lorestan province like other parts of the world. Therefore, application of control and preventive measures are necessary. Furthermore, to prescribe appropriate antibiotic, it is recommended to perform antibiogram test for each patient before the treatment.

Background and Objectives: In Iran, marriage is considered as one of the social and cultural issues of contemporary time, because problems, bottlenecks, and barriers in the way of young people, especially student population, have increased over the recent years. Therefore, understanding the experience of student marriage is required to provide appropriate information for discovering and investigating relevant and acceptable interventions. The present study aimed to explain the lived experiences of student marriage. Methods: In this qualitative study with hermeneutic phenomenological approach, 12 students of Qom University of Medical Sciences, were selected for participation in the study using purposive sampling. Data were collected through deep semi-structured interviews, and then were analyzed by Diekelmann method (1989). Results: After analysis of the data, the main theme appeared with 3 sub-themes. The main themes was “ self-flourishing in the face of challenges", which consisted of sub-themes of evolution, stability, support, and challenges ahead. Conclusion: According to the results of this study, marriage affects all aspects of student life and changes their lives. Student marriage is associated with challenges that prepare the ground for evolution. Marriage leads to self-flourishing in the students, which makes their lives meaningful and prepares the ground for progress in the path of life.

Background and Objectives: Percutaneous endoscopic gastrostomy (PEG) is a common method for maintaining enteral nutrition in patients who, for any reason, have dysphagia for more than 30 days. With respect to widespread application of this method, the present study was carried out with the aim of determining its outcomes and complications. Methods: This cross-sectional study was conducted by Gastroenterology and Hepatology Diseases Research Center of Qom University of Medical Sciences using information of patients who underwent PEG tube placement in Qom Shahid Beheshti Hospital during 2014-2017. Data were analyzed by using Chi-square test. Results: Out of 717 patients, 402 (56. 07%), were male with the mean age of 47± 8 years, and 315 subjects (43. 93%), were female with the mean age of 53± 11 years. The most common indication of PEG placement was cerebrovascular accident. Seventy-nine (11. 01%) patients had complications, and the most observed complication was reported to be leakage (21. 52%), which in most cases was delayed (in 3 month follow-up). Displacement of the PEG tube, obstruction, and infection or bleeding of the site, were expressed as common complications. There was also no significant difference between the two genders in terms of the incidence of complications, and mortality rate was reported 0 in the 3 month follow-up. Conclusion: Based on the results of this study, PEG placement can be a safe method for maintaining enteral nutrition with low rate of complications and mortality.