JOURNAL OF GUILAN UNIVERSITY OF MEDICAL SCIENCES
Year:2016 | Volume:25 | Issue:99|Papers Count:15

Introduction: Plants are one of the most important sources of medicines and have been considered by traditional medicine researchers. Most pain medications have side effects, nowadays, and it seems essential to find new analgesics with limited side effects.Objective: The aim of this study was to evaluate the analgesic effect of Humulus lupulus (hops) leaf on pain in rats.Materials and Methods: In this experimental study, male NMRI rats were divided into 18 groups, 7 in each: control (saline i.p. injection), positive control (morphine 2.5 mg.kg, s.c.), and hops extract groups (10, 25, 50 & 100 mg.kg, i.p.). LD50 of hops leaf hydro-alcoholic extract was calculated. Then, Tail flick, acute and chronic phases of formalin and writhing tests (6 groups each test) were used to assess pain. The results were analyzed using one-way ANOVA, followed by post hoc Tukey test. P<0.05 was chosen as the significance level.Results: In the tail flick test, there was no difference between hops extract groups and controls. In the formalin test, pain was reduced in both acute and chronic phases by the extract (10, 25, 50 & 100 mg.kg) significantly (P<0.001). In writhing test, the extract reduced the number of abdominal contractions in comparison with control group significantly (P<0.001). Pain was significantly reduced by morphine in all tests (P<0.001).Conclusion: Our results showed the antinociceptive effect of hops leaf Hydro-alcoholic extract after i.p. injection.

Introduction: Noise pollution means a level of sound in the environment that is uncomfortable for its residents. In hospitals, ICU is a place where most of the other wards are affected by its sound. Given the different environment and structure of Rasht hospitals from other centers and lack of study on this environment, we feel the need for this study.Objective: The aim of this study is to determine the level of noise in Rasht Hospital’s Intensive Care Units.Materials and Methods: In this Descriptive-analytical study, we included 7 ICU at the Guilan University of Medical Sciences hospitals in Rasht (i.e., Pousina, Razi, Alzahra, Velayat, Amiralmomenin and Heshmat).The tool used was a sound meter CEL-450 model and the researchers after calibration, measured sound levels in two ways of local and environmental. Data were analyzed by SPSS software and presented with descriptive and inferential statistics, ANOVA and Pearson.Results: The results showed that in local method, the highest mean (Laeq)was in nursing station (66.93 dB), patient bed (62.16 dB) , next door corridor (69.76 dB) related to general ICU in Razi hospital, ventilator (66.60 dB) related to Neurosurgery ICU in Poursina hospital and hall meeting (63.60 dB) related to ENTICU in Amiralmomenin hospital. Also (Laeq), a statistically significant difference was observed between the environmental method in any desired three times (P=0.0001). The mean sound level of the ICU was higher (in the morning) than that in the evening. There was a significant relationship between the average sound and BOR (Inpatient Bed Occupancy Rate) (P=0.027).Conclusion: Overall, the results showed that the total equivalent sound level (Laeq) in all parts of the ICU, compared to international standards and EPA Iran, is even greater. Therefore, it is recommended to reduce it through proper planning and management (sound equipment and ventilation systems, the use of sound-absorbing material in the ceiling and walls, etc.) as well as promoting staff awareness, and providing related training course.

Introduction: Diabetes mellitus (DM) can cause pathophysiological changes of body organs including the inner ear due to changes in the metabolism of glucose. Studies showed that in children with early onset diabetes, the damage caused by the disease can affect the function of the inner ear leading to hearing impairment, motor function, and impaired balance. There is no documented evidence about the impact of diabetes on the hearing, movement and balance.Objective: this study was to evaluate the potential impact of type 1 diabetes on hearing and balance function in children.Materials and Methods: 65 diabetic children were included in this cross-sectional study of auditory and balance disorder and compared with control group (83 cases). The age range of enrolled participants was between 6-12 years. Audiologic exams including pure tone audiometery (PTA), Auditory Brain-Stem Response (ABR) and Distortion-Product Otoacoustic Emission (DPOAE) were assessed. Also, Bruininks-Oseretsky (BOT-2) was used for balance examination. Comparative evaluation was performed between the two groups and final data were analyzed by SPSS 19.Results: In this study, the thresholds of PTA in case and control groups were 3.5±2.8 and 1.6±1.2 dB, respectively. The average absolute latency of wave V and inter peak latency I-V in diabetic children were within normal range. The lowest percentage of normal response in DPOAE test of diabetic children was observed at frequencies 750 and 1000 Hz which were less than 50 percent. All of the scales and subscales BOT-2 between the two groups were different statistically (p<0.0001). There was a significant association between manual coordination, strength and agility subscales, and total motor composite scale of BOT-2 and PTA results. Also, a paradoxical relationship between the Hg A1C and the Strength & Agility subscale in children with type 1 DM was observed.Conclusion: Children with type 1 diabetes had weaker performance in hearing and balance systems, compared to peers without diabetes. Thus, further studies are recommended on the significance of early diagnosis and preventive measures.

Introduction: Female infertility is one of the multifactorial diseases with a substantial genetic basis. Follicle stimulating hormone receptor (FSHR) encoding gene was mapped to the short arm of chromosome 2. The FSHR gene is expressed by granulosa cells in the ovary and it is an essential factor for regular gonadal development, sexual maturation at puberty and gamet production during the fertile period. The mutation in the FSHR gene leads to decrease in ligand binding to receptor and cAMP levels.Objective: The aim of this study was to evaluate the association between 1255G>A polymorphism at FSHR gene with female infertility.Materials and Methods: In this case-control study, 50 infertile women and 74 controls were enrolled. Genomic DNA was extracted from peripheral blood. Genotypes were determined by Allele-Spesific PCR. Statistical analysis was performed using the Medcalc program (Ver 12.1).Results: The results of this study revealed that the frequencies of Ala/Ala,Ala/ Thr and Thr/Thr genotypes in the controls were 45.94%, 42.10% and 10.81%, respectively; while in infertile females they were 22.36%, 63.15% and 15.58%, respectively. A significant difference in genotypes frequencies was found between healthy and patient groups (P=0.008).Conclusion: The prevalence rates of Ala/Ala and Ala/Thr genotypes were observed to be significantly higher in patients group, compared to control group. Our findings suggest that the 1255G>A polymorphism maybe associated with females infertility. However, the results may be different when selecting different genetic pools or target population size.

Introduction: Severe and chronic diseases can influence patients` psychological factors and prevent expressing emotion at an appropriate level.Objective: The purpose of this research is to study and compare emotional expressiveness, emotional control and ambivalence in emotional expressiveness in women suffering from breast cancer and healthy counterparts.Materials and Methods: In this cross-sectional study, 108 married women living in Rasht (54 suffering from breast cancer and 54 healthy women) were studied using available sampling method and based on the purpose of selection and through questionnaires related to styles of expressing emotion including emotional expressiveness questionnaires (EEQ), ambivalence in emotional expressiveness questionnaires and Emotional Control Questioners (ECQ). To compare two independent samples, the data were analyzed by ANOVA and SPSS-18 software.Results: The results showed that women suffering from breast cancer had significantly less emotional expressiveness (in comparison with healthy women) (p<0.01) and also in subscales of this variable (expressing positive emotion, intimacy and negative emotion) women suffering from breast cancer significantly showed less positive emotional expressiveness. Comparing the two groups in terms of emotional control variable, we found that women suffering from breast cancer also had significantly (p<0.01) more emotional control and also in subscales of this variable (emotional inhibition, aggression control, obsessive rumination and benign control) women suffering from breast cancer had significantly more emotional inhibition. Despite the higher scores, the results did not show any significant difference in ambivalence variable and subscales variable (ambivalence in positive emotion express and ambivalence in express entitlements).Conclusion: The styles of emotion expression have considerable roles in preserving and maintaining relationship. Coping through emotional appeal (Such as active coping and processing by means of emotional expression) can lead to positive social responses and community support as a buffer in coping with the disease and more adaptability in patients with breast cancer.

Introduction: the most important factor in improving workforce productivity is human resources and today in some health organizations, health care centers and hospitals, the reduction of human resources productivity has become a challenge which may be due to lack of efficient use of human resources in the hospital.Objective: the factors affecting productivity of human resources from the perspective of Holy Prophet Hospital staff in Rasht, northern IranMaterials and Methods: This cross-sectional study was conducted in the winter of 2014. The target population entered the study were all Prophet Hospital staff consisting of 420 persons in the city of Rasht. Data collection tool was a standardized questionnaire which consisted of two parts: The first part comprised 8 questions about demographic characteristics and the second part 42 questions about the components and variables affecting the productivity of the workforce. Data analysis was done through SPSS software, descriptive statistics and the content was validated using exploratory and confirmatory factor analysis and rating of Friedman test.Result: The environmental conditions with an average rank of 3.72, leadership with an average rank of 3.30, organizational culture with an average rank of 2.99, empowering with 2.87 and motivational factors with average grade 2.12, were the most important factors influencing the productivity of human resources.Conclusion: Based on these findings, it can be suggested that promoting the environmental conditions, providing appropriate equipment, the dominance of culture and empowering the employees, all together play a role in increasing the efficiency of human resources in the hospitals.

Introduction: Coronary artery disease (CAD), is a leading cause of mortality and morbidity in the world and more focused among the researchers. For this reason, novel risk factors for CAD, such as serum iron in the form of serum ferritin levels have been emphasized. Excessive serum iron can increase risk of CAD by the production of free radicals and incorporation into lipid peroxidation.Objective: To investigate the relationship between serum ferritin level and severity of obstructive CAD.Materials and Methods: This analytical cross-sectional study was conducted on 400 patients with CAD, referred to Rasht Heshmat Heart Hospital from September of 2014 to March of 2015. Demographic information, serum ferritin level with other blood markers was collected before angiography and the severity of vessel involvement was evaluated afterwards. Data analysis was done using Mann-Whitney, Kendall tau and Spearman correlation coefficient tests.Results: The median age of patients was 58 years and 56% were male. The median of serum ferritin level in women and men was 74 and 95 mg/dl, respectively (p<.001). There was no relationship between serum ferritin level and the severity of CAD in all patients and subgroups (P>.05 for all).Conclusion: In this study, no significant relationship was observed between serum ferritin level and severity of obstructive CAD. Further investigations are needed to consolidate the finding.

Introduction: Quality of work life (QWL) is an important concept, which is associated with many administrative and human factors. Given that nurses are the largest staffing in healthcare organizations, evaluating their quality of working life and its predictive factors is required in order to increase the productivity and other work out comes.Objective: Given the special conditions of nurses in the operating room, the study aimed at determining predictive factors of QWL among operating room nurses.Materials and Methods: This analytical-descriptive study was done in training hospitals of Tabriz in 2015. The research community was nurses in the operating room, selected by cluster sampling. The Sirgy QWL questionnaire was used after determining the validity and reliability (a= 0.85). It evaluates QWL in terms of seven parameters including hygienic and safety, economical and domestic, social, self-respect, self-bloom, knowledge, and aesthetics. Data were analyzed in SPSS 16 software by descriptive analysis, Pearson, t-test and ANOVA. In order to predict changes of the quality of working life variance, linear regression was used.Results: As revealed, 147 questionnaires were completed. The mean and SD of QWL was 44.65±8.40. Muscle pain (p=0.000), exercise (p=0.030) and job satisfaction (p=0.001) in univariate analysis were significantly associated with QWL. Daily exercising and job satisfaction could also predict 19.7% of the variance of the quality of working life.Conclusion: According to the results, facilitating daily physical exercise, correcting ergonomic problems and improving job satisfaction of nurses seem to be necessary in order to improve the QWL.

Introduction: Association of a combination of lifestyle-related factors and mental health is less studied in earlier studies, especially in Middle Eastern countries.Objective: This study aimed to examine how combinations of several lifestyle-related factors is related to depression and anxiety in a large group of middle-age Isfahani population.Materials and Methods: In a cross-sectional study in 2012 on 3363 Isfahani adults (19-70 yr), a healthy lifestyle score was constructed by the use of data from dietary intakes, physical activity, smoking status, psychological distress and obesity. A dish-based 106-item semi-quantitative validated food frequency questionnaire (FFQ), General Practice Physical Activity Questionnaire (GPPAQ), General Health Questionnaire (GHQ) and other pre-tested questionnaires were used to assess the components of healthy lifestyle score. The Hospital Anxiety and Depression Scale (HADS) was applied to screen for anxiety and depression.Results: The prevalence rates of anxiety and depression among study participants were 15.2 and 30.0%, respectively. After adjustment for potential confounders, we found that individuals with the highest score of healthy lifestyle were 93% less likely to be anxious (OR: 0.07; 95% CI: 0.02-0.30) and 97% less likely to be depressed (OR: 0.03; 95% CI:0.01-0.11), compared with those with the lowest score. In addition, non-smokers had lower odds of anxiety (OR: 0.65; 95% CI: 0.47-0.89) and depression (OR: 0.63; 95% CI: 0.48-0.82), compared with smokers. Individuals with low levels of psychological distress had expectedly lower odds of anxiety (OR: 0.13; 95% CI: 0.10-0.16) and depression (OR:0.10; 95% CI: 0.08-0.12) than those with high levels. Individuals with a healthy diet had 25% lower odds of depression (OR: 0.75; 95% CI: 0.61-0.91) than those with a non-healthy diet.Conclusion: We found evidence indicating that healthy lifestyle score was associated with lower odds of anxiety and depression in this group of Isfahani adults. Healthy diet, psychological distress, and smoking status were independent predictors of mental disorders.

Introduction: Attention Deficit/ Hyperactivity Disorder (ADHD), is one of the most common disorders in child psychiatry. Children with ADHD have difficulties in different areas, including motor skills and, especially motor coordination. Balance is one of the important components in motor coordination for exercise and even daily living activities.Targeted exercise with focus on improving motor performance is an important part of the non-pharmacological treatments for ADHD patients in order to upgrade athletic skills, confidence, social relationships and improve the prognosis.Objective: To investigate the effect of core stabilization training on balance in children with attention deficit/hyperactivity disorders (ADHD).Materials and Methods: This study is a semi-experimental (pretest, posttest without control group). The study population included all male students 8-11 years old with attention deficit/hyperactivity in Bandar Anzali in the 93-94 school year. At first, parents completed the Conners parent rating scale for ADHD and then, diagnostic criteria by clinical interview based on DSM-5 (Diagnostic and Statistical Manual of mental Disorder) criteria were assessed by child psychiatrists. Finally, 10 children with ADHD were enrolled in the study. Static balance was assessed by stork modified test and dynamic balance by the star excursion balance test. Data were analyzed using SPSS-16.0 software. The normality of data was evaluated by Kolmogorov-Smirnov test, and then we used dependent t-test and independent t-test, and significance level was set at( P≤0.05).Results: Statistical comparison of static and dynamic balance in the dominant and non-dominant foot before and after the implementation of core stabilization training in boys with ADHD showed that the implementation of this program improves the performance of static and dynamic balance (P£0.05) but no significant difference was observed between the improvement of the dominant and non-dominant foot (P³0.05).Conclusion: Core stabilization training is effective on improving the static and dynamic balance in children with ADHD. It seems that these exercises can be targeted as interventions to improve balance performance used to enhance motor skills in children with ADHD.

Introduction: Relieving preoperative anxiety is an important concern for the pediatric anesthesiologists. Anxiety can cause aggressive reactions and increase child’s distress and might even make postoperative pain management impossible. Oral midazolam has been the most frequently used premedication in children. The purpose of this study was to evaluate preoperative sedative effects, anxiety level changes and the ease of child-parent separation of preoperative intra nasal dexmedetomidine compared with intra nasal midazolam in children scheduled for elective surgery. Child cooperation in the operating room (OR) and recovery time were also compared.Materials and Methods: This prospective, double-blinded, randomized study was done on sixty 2-8 year old, ASA I-II children scheduled for elective surgery in teaching hospitals in Rasht, Iran. Using random blocks, the children were divided into 2 equal groups (group D and group M). Group D received 1mg/kg intranasal dexmedetomidine and group M received 2 mg/kg intranasal midazolam 30 minutes before entering to the OR. The ease of child parent separation according to Feld score, cooperation for inserting the IV line, accepting the anesthesia mask were assessed and compared between the two groups using Chi square, t-test and KS statistical tests.Results: The study was done on 49 (81.7%) boys and 11 (18.3) girls with the mean age of 4.45±1.67 years. No statistical difference was seen between the two groups in sex, age, basal heart rate (HR), blood pressure (BP) and arterial O2 saturation (SpO2). HR and BP were also statistically equal 15 minutes after administration of the drug and at the time of entering to the OR. But SpO2 levels in both times were higher in group D than in group M. (p=0.016 and p=0.036, respectively). Children receiving midazolam separated from parents more easily and accepted the anesthesia mask better than the Dexmedetomidine group. (p=0.013) But there was no difference between two groups in IV line insertion (p=0.221).Conclusion: Administration of intranasal midazolam 30 minutes before surgery is superior to dexmedetomidine in ease of child-parent separation and acceptance of anesthesia mask. But dexmedetomidine causes less respiratory depression than midazolam.