Journal of Guilan University of Medical Sciences
Year:2010 | Volume:19 | Issue:74|Papers Count:13

Introduction: Use of medicinal plants and their effective constituents for attenuation of hyperglycemia and restoration of lipids to normal level is very important. Naringenin as an effective protective of flavonoid exhibits is mainly found in citrus fruits.Objective: To investigate the effect of chronic administration of naringenin on serum glucose and lipids in diabetic rats.Materials and Methods: Male Wistar rats (n=40) were divided into 5 groups, i.e. control, naringenin-treated control, diabetic, and naringenin- or glibenclamide-treated diabetic groups. For induction of diabetes, streptozotocin (STZ) was administered (60 mg/Kg; i.p.). Naringenin was administered i.p. at a dose of 10 mg/kg one week after diabetes induction for 6 weeks. Serum glucose, triglyceride, total cholesterol, LDL- and HDL- cholesterol levels were determined before the study, and at 3rd and 6th weeks after the study.Results: There was a significant reduction in serum glucose level at 3rd and 6th weeks in naringenin-treated diabetic group as compared to untreated diabetics (p<0.01). In addition, there was not a significant reduction in serum total cholesterol in naringenin-treated diabetic group as compared to untreated diabetics. Regarding serum triglyceride, there was a significant reduction in naringenin-treated diabetic group as compared to untreated diabetics (p<0.01). On the other hand, naringenin administration did not significantly increase HDL-cholesterol level and reduce LDL-cholesterol level in treated diabetics relative to untreated diabetic group.Conclusion: Chronic administration of naringenin had a significant antihyperglycemic effect and led to appropriate significant changes only in serum triglyceride.

Introduction: Thyroid cancer is the most common cancer of endocrine system. Clinical, pathological and therapeutic factors affected patients' outcome with differentiated thyroid carcinoma.Objective: To evaluation the effective clinicopathologic factors on patient’s outcome with well differentiated thyroid carcinoma.Materials and Methods: In this retrospective analytic-descriptive study. Patients' files with thyroid carcinoma who referred to radiology and oncology ward in Omid and Ghaem hospital of Mashhad were assessed from 1996-2006. Cases with pathologic report of papillary and follicular carcinoma were considered and a specific questionnaire include age, sex, accepted time, pathologic subtype, tumor size and metastases, adjuvant treatment, last follow time, recurrence time, patient condition in the end refer and death time was recorded.Results: The patients' mean age was 50.14 and median age was 52 years. 66 patients (85.7%) had papillary and 11 cases (14.3%) had follicular carcinoma. End condition in 43 cases (55.8%) was good and in 34 cases (44.2%) was bad. Mean survival time was 44.1 and median survival time was 36 months. There was a meaningful correlation between T stage with end condition (P=0.037) but there was no meaningful correlation between N stage with end condition (P=0.665). Metastases in the first reference time had a clear correlation with patients' outcome. 41patients (59.4%) from 69 cases with MO disease had a good end condition, against only one patient (16.7%) from 6 cases with Ml had a good outcome (P<0.001).Also there was a meaningful correlatiop between patients' outcome and clinical stage (P=0.075). None of the adjuvant treatment included iodine therapy (P=0.36), hormone therapy (P=0.378), chemotherapy and radiotherapy affected patients outcome.Conclusion: According to this study, factors with influence on patient's outcome with differentiated thyroid carcinoma were tumor stage, metastases in the first reference and clinical tumor stage. Lymph node involvement and adjuvant treatment had no effect on patients' prognosis.

Introduction: Use of computers with disregard ergonomics may lead to health problems, long-term discomfort and physical disabilities and lose workdays.Objective: To assess the effectiveness of an ergonomic education to modify of body posture, ergonomic risk factors and musculoskeletal pain severity in computer users.Materials and Methods: In this Quasi-experimental randomized controlled study, computer users were assigned to two groups: case group (n=75) receiving the theory based on intervention by using construct of theory of planned behavior and stage of change, and control group (n=75). Both groups were evaluated at the beginning of the study and 3 and 6 months later. The following tools were used: the Rapid upper limp Assessment (RULA) method to assess upper-extremity work-related posture, self administrated questionnaire that evaluated TPB constructs, stage of change algorithm, ergonomic risk factors checklist, ergo- knowledge quiz and VAS for assessing musculoskeletal pain severity. The intervention included two program elements: staged matched informative brochure and personalized preventive educational counseling.Results: The intervention group had significantly higher scores than controls in ergo-knowledge, attitudes, perceived behavior control, intention, as well as non natural posture maintenance as goal behavior (P<0.05). Also, finding showed the significant diminish in musculoskeletal pain severity (P<0.05). At 3 and 6 months follow up, no significant differences were found between the two groups for subjective norms constructs. Intervention couldn’t improve RULA risk level to low and very low area (1, 2 level) and only decreased risk exposure to medium level.Conclusion: According to the results preventive ergonomic campaigns would be more successful if educational intervention regarded as a part of multifaceted interventions: analysis and elimination of risk factors, engineering controls and administrative controls.

Introduction: Information economics analysis is important issue for creation of appropriate intelligence about information mobility, evidence based on decision making and boosting of policy making process in system.Objective: To calculate the costs of information generation in Health Houses, Rural Health Centers and County Health Center of Alborz county health care system.Materials and Methods: This descriptive analytical study was conducted in 2008. The study population included Alborz county health center, 3 Rural Health Centers and 8 Health Houses. Data were collected through observation activities, checklists, costing forms and interviews. Activity Based Costing (ABC) method was used to analyze the costs.Results: The costs of human resources, special and general materials, energy and general costs, capitals deprecation and repairmen in proportion to total costs were 70%, 3% and 2%, 8% and 17% respectively.The proportion of information cost to total operational costs in Health Houses, Rural Health Centers and County Health Center were 45.8%, 24.7% and 4.1% respectively. Average unit-cost of generated information in HHs, RHCs and CHCs were $0.76, $2.74 and $3.73 respectively. The total amount of generated information was 545180 units with total cost of $82000 .Information generation cost were 15.6% of total operational costs in the system.Conclusion: Regarding the cost of information generation in this healthcare system, the need for using and screening information for evidence-based on decision making is obvious. Hence, more efforts have to done by managers and policymakers in healthcare system for implementation of a standard HMIS and to train personnel in order to generate optimum information by minimum costs.

Introduction: Malnutrition is one of the most important health problems in developing countries, especially in school students.Objective: To determine of relationship between intestinal parasitic infection and wasting and growth stunting incidence among primary students in rural areas of Kashan, in the year of 2008.Materials and Methods: In this Case-Control study, 65 students with wasting and 65 students with growth stunting were chosen as case groups, also 65 students without malnutrition were chosen as control group. The National Center of Health Statistic (NCHS) growth charts was used as normal standard. The nutritional status was measured by Waterlow classification indicators. (The ratio of weight to height (wasting) and height to age (stunting) for pathogen intestinal parasites diagnosis). Three serial fecal samples from students in case and control groups was collected during different days, in addition Cellophane tape method for Enterobius vermicularis eggs was performed in all of them.Results: According to data, there were no significant relation between Pathogen intestinal parasitic infection and wasting and growth stunting (P=0.08 and P=0.18) respectively.Conclusion: The possibility of causing major detrimental effect on natural status of children by light parasitism is low.

Introduction: The importance of cardiac rehabilitation has been widely acknowledged, after myocardial infarction. Improved physical capacity is an important outcome of cardiac rehabilitation. Therefore, accurate measurement of the exercise tolerance of cardiac patients before and after cardiac rehabilitation program using an objective measure is important.Objective: To comparison the effects of cardiac rehabilitation program (concurrent endurance and resistance training) on exercise capacity of men and women patients with coronary artery disease.Materials and Methods: In this prospective study, among 40 patients, 20 patients (10 female with mean age 54.5±5.44 and 10 male with mean age 53.2±7.68) who arrived to Phase II cardiac rehabilitation were assesed.6MWT and Exercise Test (ET) were performed at the beginning and at the end of 8 weeks program (3 days per week) in the both group of the patients.Results: Both of 2 groups had significant response to Cardiac rehabilitation program after cardiac rehabilitation, functional capacity (6MWT) and exercise capacity (ET). There is no significant difference between final value of 6mwt distance, Exercise capacity (Exercise test time), Heart Rate Recovery (HRR), Rate Pressure Product (RPP), V02peak between men and women patients with Coronary Artery Disease before and after cardiac rehabilitation program, but all of above improved significantly in both CRP men and women (p<0.001).Conclusion: Probably all of men and women patients affected of exercise training similarity.

Introduction: The main mission of management is accessing more efficient which be taken into care by managers for managing and new engineering. Today human efficient is the most common of managers’ concerned. Many factors are effective in promoting human efficient that cannot be identifying all of them. So we have to give an advantage model. Using factor analysis is one of the efficient models.Objective: To determine the components of effective manpower productivity, using factor analysis.Materials and Methods: This Descriptive, analytic, and cross-sectional study was performed in two stages: August, September and October 2009. The owners of qualitative step were 45 experts and factor analysis step were 321 faculty members, educational expert and human resources expert who affiliated to Guilan University of Medical Sciences. Data was collected by made questionnaire and Library Studies and Help study. the validity of its content were done as Expert panel and their credit structure using exploratory factor analysis (main component analysis) and confirmatory factor analysis (maximum likelihood), using alpha internal parallelism of Coranbach.The first section of questionnaire contains 8 individual characteristics and demographic questions and the second part includes 42 questions about the variables affecting the productivity of human resources based on 5-degree Likert Scale. For adequacy of sample size Mayraklyn scale and for suitable data, Bartlett test was used respectively.Results: The exploratory analysis identified 5 main components according the importance degree included of: 1. Organizational culture, with 18 variables and variance 26.29% 2. Environmental condition with 7 variables and variance 12.96% 3 Motivation factors with 10 variables and variance 12.84% 4 Empowerment with 4 variables and variance 7.47% 5 Leadership style with 3 variables and variance 5.05%Conclusion: The organizational culture, environmental conditions, Motivational factors, empowerment and leadership style, are effective factors on increasing manpower productivity. There was a significant relationship between organizational culture and man power productivity which is the most important factors.

Introduction: Strock is the common cause of death after cardiovascular diseases and cancer. Middle cerebral artery occlusion is the most common disease and because of its high extension in brain, the loss of consciousness is more. Donepezil protected neurologic cells.Objective: Effect of donepezil on improvement of consciousness in patients with strock.Materials and Methods: In this double blind clinical trial study 59 patients were selected according to inclusion criteria and filling out the consent form. They randomly divided to two groups: 28 patients who received donepezil 5mg daily till 4 weeks the 10 mg daily till 3 months (cases group) and 31 patients who received placebo (control group). Patients’ consciousnesses were registered before and after intervention. Change of consciousness was compared between two groups using spss10.Results: Improvement, no change and deterioration of consciousness was 26.9%, 46.2% and 26.9% in Donepezil group and 3.6%, 32.1% and 64.3% in placebo group, respectively. (p=0.008).Conclusion: There was a significant difference between two groups, so Donepezil is significantly effective in improvement of consciousness, reduction of mortality and hospitalization in patients with strock.

Introduction: The studies showed that there is a significant relationship between leadership style with managers’ emotional intelligence and their interpersonal relationship with subordinates in organizations that this relationship can affected job satisfaction in subordinates.Objective: Survey the relationship between managers’ leadership style and emotional intelligence and its effect on job satisfaction in subordinates in Shiraz University of Medical Sciences.Materials and Methods: Thirty three managers and 132 subordinates were randomly selected in October 2009. In this expostfacto study. Leadership style, emotional intelligence and job satisfaction questionnaires were completed. Pearson correlation coefficient, independent t test, Chi-square and regression analysis were used.Results: Data analysis indicated that There is a positive relationship between emotional intelligence and leadership style (r= 0.71, p<0.01), there is a positive relationship between managers’ leadership style and job satisfaction in subordinates (r= 0.60, p<0.01), Female managers use participative leadership style more than males (t= 2.40, p<0.05), and there is no significant difference between numbers of managers in 4 kinds of leadership styles (Chi-square= 1.78, p=0.61).Conclusion: There is a positive and significant relationship between participative leadership style with managers’ emotional intelligence and job satisfaction in subordinates. Empathy, high motivation and self confidence, are components of both emotional intelligence and participative leadership style that cause increase self confidence, motivation and job satisfaction in subordinates.

Introduction: Determining students’ attitudes towards the goals of doctoral dissertation writing, topic selection, choosing the supervisor, and their opinion about problems in conducting a research project, can be helpful in assisting programmers to better reform and improve the quality of this course.Objective: Survey the attitudes towards thesis writing process among students of guilan university of medical sciences, in the year of 2009.Materials and Methods: In this descriptive-cross sectional study, 164 medical and dental students who being in the last two years of their education or graduated in recently years, were surveyed. We used a self-made questionnaire comprised of 54 questions, which its validity and reliability were tested prior to initiation of the study. The questions were designed in three bases. Data were analyzed as frequency distribution, mean and standard deviation, and X² test, using SPSS software.Results: Within the thesis process and topic selection domain, most of the students agreed with the need for learning how to write and collect a thesis (66.4%), guidance in topic selection (71.4%), and access to the resources and facilities (76.2%). Most of the students (76%) responded that they would refuse to write a dissertation if it was elective, and 71.4% were willing to write an article based on their work. Availability of the supervisor had the highest priority for the students, within the domain of supervision. 12.9% of medical and 22.5% of dental students were satisfied from thesis process there was a statistically significant relationship between the field and satisfaction of performance process (P=0.002).Conclusion: This preliminary research showed that students inquired to learn basics of dissertation and article writing in the form of a credit course. Encouraging students to attend research methodology workshops, teaching supervision skills to the mentors, providing research funds and laboratory equipments has positive influence to attitudes of students and improve the performance of the doctoral dissertation course.

Introduction: One of the most important reasons of endodontic failure is the persistence of microbial factors in the root canal system. Therefore, three-dimensional cleaning of the root canal space is very important to eliminate or reduce the irritant factors and microorganisms.Objective: To evaluate the effectiveness of Mtwo R and ProTaper Retreatment files as compared with Mtwo and ProTaper files in retreatment of the gutta-percha filled root canals.Materials and Methods: In this in-vitro study, fifty extracted single root premolars with approximately straight and similar root lengths were selected. Primary preparation of the root canals was performed by ProTaper rotary system and all of the roots were filled by lateral condensation technique. Then, the teeth were randomly divided into five groups, and each group was retreated with one of the ProTaper, ProTaper Retreatment, Mtwo, Mtwo R systems and hedstrom hand files. Following the longitudinal splitting of the roots with diamond discs and evaluation of amount of the gutta-percha/ sealer on the root canal walls with stereomicroscope. Obtained results were analyzed with kruskal-wallis and Mann- Whitney u tests.Results: Complete removal of gutta-percha/ sealer did not occur with any of the investigated systems .There is significant statistical differences between test groups at the apical and middle thirds of canals(P=0.849, P=0.315 respectively ).In Hedstrom group, significantly less filling material was observed in the coronal third of canals. Regardindg the duration of retreatment, all of the rotary systems were significantly more rapid than hand files. Rotary files that were specifically designed for retreatment, were significantly more rapid than universal ProTaper.Conclusion: Despite this fact that neither of used techniques in this study were able to remove the filling material completely, but regarding to higher speed and probability of less fracture of the files specifically designed for retreatment (Mtwo R and ProTaper Retreatment) as compared with universal rotary files (Mtwo R and ProTaper), we suggested that these files can be appropriate choice for root canal retreatment.

Introduction: Tracheostomy is a surgical creation of opening secondly way into the trachea through the neck to establish an airway. Many complications have been described for this procedureCase Report: We encountered an unusual complication of tracheostomy which the metallic tracheostomy tube had been fractured and aspirated into right main bronchus of a 58-years-old man. The patient had no significant distress, and the broken piece was extracted by use of rigid bronchoscope.Conclusion:  Breakage of tracheostomy tube may be a rare complication of tracheostomy procedure. We must be aware of this probability. Instruction the patient and his families and health workers is important also must be checked the patient regularly.