Journal of Inflammatory Diseases
Year:2012 | Volume:15 | Issue:4 (61)|Papers Count:17

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women and cause of infertility due to lack of ovulation. The symptoms of PCOS are observed during puberty and it is assumed that the weight gain during this period to be associated with this syndrome.Objective: To determine the prevalence of phenotypes of polycystic ovary syndrome in adolescents in Shiraz.Methods: This was a cross-sectional study in which 3190 female adolescents aged between 14 to 18 years, randomly selected from high schools in Shiraz, were studied. Diagnosis of PCOS was achieved through taking history and examination based on presence of oligomenorrhea (six times menstrual cycles or less in one year), clinical signs of hyperandrogenism including hirsutism (Ferriman-Gallway scores of 6 or more), severe acne, male pattern hair loss, and ultrasonography. The hormone dehydroepiandrostandion sulfate levels were measured for all subjects. Data were analyzed using the chi square test and Fisher's t exact-test.Findings: The prevalence of PCOS phenotypes were as follows: clinical hyperandrogenism and oligomenorrhea 19.9% (29 cases), clinical hyperandrogenism and polycystic ovary 30.8% (45 cases), oligomenorrhea and polycystic ovary 29.5% (43 cases), and clinical hyperandrogenism with oligomenorrhea and polycystic ovary 14.5% (21 cases). The frequency of highest levels of dehydroepiandrostandion sulfate was observed in patients with oligomenorrhea and hyperandrogenism.Conclusion: The risks of sex hormones turmoil, psychological effects of skin symptoms (acne and hirsutism), and numerous side-effects of this syndrome make it necessary to perform an early investigation in target population.

Background: Fire and explosion accidents cause numerous economical, environmental and human losses in industries.Objective: The aim of this study was to present a new method for fire and explosion loss estimation by virtue of fire and explosion index to determine the premium rate.Methods: This is a descriptive-analytical study carried out in Bandar Imam petrochemical complex in 2006. Initially, the fire and explosion index was calculated in selected process units and the hazard radius, equipment value, and the base maximum probable property damage determined. To determine the actual maximum property damage, the loss control credit factor was assessed. Finally, the days’ outage and business interruption losses were estimated.Data analyzed with DOW fire and explosion software.Findings: The stripper column with 226 F&EI value, actual maximum property damage of about 6.7 million dollars, days’ outage of about 120 days, and business interruption loss of about 89 million dollars was identified as the most critical unit of the factory. The least hazardous unit detected was the Nafta storage tank with 64 F&EI value and actual maximum property damage of about 0.36 million dollars.Conclusion: All factors affecting the fire and explosion risk were shown to be among the indices that are considered as a base for loss estimation. Business interruption losses are higher than actual maximum property damage and these losses are not insured in Iran industries. In this technique, the effects of control measures on reducing fire and explosion losses were considered and the estimated losses could be regarded as a base to determine the premium rate.

Background: The health human resource is the heart of health system and the majority of problems within the health care system are caused by shortage, surplus, or imbalance in health manpower.Objective: This study was aimed to compare the health human resources in Eastern Mediterranean countries based on income and geographical groups.Methods: This was a comparative study based on library resources performed in 2007. Twenty three countries in the Eastern Mediterranean region were classified based on the World Bank income groups (4 income groups) and geographical region (African countries, non-oil and oil-rich countries). Later, the data concerning the health human resources in 2007 were extracted from the international websites including the WHO and EMRO. Data were statistically analyzed using the bivariate Pearson’s correlation coefficient.Findings: Significant disparities were found in health workforce density within the Eastern Mediterranean countries in particular among the low and high income countries. Health workforce density showed negative correlation with country population (P<0.01) whereas a positive correlation was observed with per capita income (P<0.05). Also, the income level, to some certain extent, affected the health workforce density.Conclusion: Population, immigration rate of health workforce, and general government expenditure on health are the factors influencing the health workforce density.

Background: Endotracheal intubation is an essential and important procedure. However, in some conditions such as the presence of difficult intubation, there are some limitations for endotracheal intubation with muscle relaxation.Objective: To compare the effect of propofol-alfentanil with ketamine-alfentanil on endotracheal intubation without muscle relaxation.Methods: This was a double-blind clinical trial carried out on 60 patients aged between 18-50 years old. The patients were within the ASA class I-II of anesthesia chosen for elective surgery at Shahid Rajaei Hospital in Qazvin, Iran. The participants were randomly divided into 2 equal groups. For endotracheal intubation without muscle relaxation, one group received propofol-alfentanil and another group ketamine-alfentanil. Changes in hemodynamic parameters (heart rate and blood pressure) and physical findings (vocal cord position, jaw relaxation, ability of mask ventilation, and reaction to endotracheal intubation) were compared between two groups. Data were analyzed with SPSS software using statistical tests including t-test and Chi-square test.Findings: Regarding the hemodynamic parameters, there was significant difference between two groups so that in ketamine group the hemodynamic conditions were more stable than in propofol group (P<0.05). With respect to the physical findings, 93.3% of patients in propofol group were in excellent class and 6.7% in good class whereas in ketamine group 40% were in excellent class, 33.3% in good class, and 26.7% in poor class. Statistically, there was significant difference between two groups (P<0.05).Conclusion: According to our findings, it seems that the propofol-alfentanil to produce better conditions than the ketamine-alfentanil when performing endotracheal intubation without muscle relaxation.

Background: Diazinon is one of the most important organophosphates (OPs) widely used in agriculture. Some OPs have the potential to produce free radicals and induce disturbance in body antioxidant systems.Objective: The purpose of this study was to determine the effects of diazinon on oxidant-antioxidant system in rat liver.Methods: This experimental study was carried out at Baqiyatallah University of Medical Sciences in 2010. A total of 28 male Wistar rats (200-250 g body wt.) were randomly divided into four groups including: sham (received corn oil as diazinon solvent) and three diazinon groups receiving different single doses of this substance (30, 50, and 100 mg/kg) through intraperitoneal route. Twenty four hours after injection, the animals were ether anesthetized and liver tissue removed. Following liver tissue hemogenation, the activity of superoxide dismutase (SOD), catalase (CAT), glutathione S-transferase (GST), and lactate dehydrogenase (LDH) as well as the glutathione (GSH) and malondialdehyde (MDA) levels were determined by biochemical methods. The data were statistically analyzed using the analysis of variance followed by post hoc analysis using Tukey tests.Findings: While at concentrations higher than 30 mg/kg diazinon, increased activities of SOD, CAT, and GST with higher level of MDA were observed, the GSH level was significantly decreased when compared with the sham. Also, an increased LDH activity at dose of 100 mg/kg was seen (P<0.01).Conclusion: Diazinon probably induces the production of free radicals and oxidative stress in a dose- dependent manner. Enhanced activity of antioxidant enzymes with depleted GSH content is indicative of oxidative tissue injury and increased MDA level is suggestive of damage occurring in liver membranes.

Background: By attention to the practical importance of the stem cells screening and culture, this study was conducted on chicken bone marrow mesenchymal stem cells.Objective: This study was performed to determine the effect of screening and cultural methods on the cell morphology and differentiation.Methods: This was an experimental study carried out at Pasture institute in 2009. One milligram aspirated bone marrow from tibia of a two-week old Raf chicken was cultured in low-glucose DMEM, 10% FBS, penicillin and streptomycin using both direct (without RBC removal) and Ficol (with RBC removal) mounted culture methods. After 4 passages, the bone marrow cells of two cell culture methods were compared for their morphology and differentiation into bone, cartilage, and adipose. Data were statistically analyzed by ANOVA test.Findings: In direct cell culture, more colonization compared with Ficol mounting method, was observed and most cells showed fibroblastic morphology. Also, the results were indicative of higher yields of differentiation into bone (21%), cartilage (27%), and adipose (40%) in direct method.Conclusion: According to our results, the application of direct culturing system for screening and proliferation of mesenchymal stem cells seems to be a better protocol to screen the chicken bone marrow mesenchymal stem cells compared to Ficol mounting method.

Background: Oxidation of low-density lipoprotein (LDL) has been strongly implicated in the pathogenesis of atherosclerosis. The use of some antioxidant compounds in dietary food stuff such as vitamin E and Oak fruit (Quercus) husks hydroalcoholic extract (OHE) may inhibit the production of oxidized LDL and decrease both the development and the progression of atherosclerosis.Objective: The present work investigated the effects of OHE on LDL oxidation induced-CuSO4 quantitatively in vitro.Methods: This study was an experimental research performed in Khoramabad province during 2010. Fasting blood samples were collected from normal people followed by LDL isolation. The population study was divided into five groups (1: control, 2: those exposed to CuSO4 without treatment, and groups 3-5: those exposed to CuSO4 and treated with OHE (0.2, 2, and 20 mg/ml, respectively). Later, the formation of conjugated dienes, lag time, and malondialdehyde (MDA) were measured. Inhibition of Cu-induced oxidation was investigated in the presence of several concentrations of OHE (0.2, 2 and 20 mg/ml). Data were statistically analyzed by SPSS 13 using Mann Whitney test.Findings: OHE was found to have the ability to inhibit the CuSO4-induced LDL oxidation. Administration of oak (Quercus) husks hydroalcoholic extract (OHE) showed an increased rate of 2.2, 3, and 4.3 fold s at concentrations ranging from 0.2 to 20 mg/ml against oxidation in vitro. Also conjugated dienes decreased 13.33%, 46.66% and 80.00% at concentrations ranging from 0.2 to 20 mg/ml of OHE, respectively. The inhibitory effects of OHE on LDL oxidation at concentrations used were dose-dependent.Conclusion: This study showed that the OHE has the potential to prevent the oxidation of LDL in vitro and it may suggest that this compound is capable of producing a similar effect in vivo.

Background: Burn with disfigurement and disability causes physiologic and psychological disruption. One of the important disorders is the disturbance in self-concept and body image that causes diverse effects on burnt person’s well-being.Objective: The current study was aimed to examine the effectiveness of cognitive-behavioral group therapy on self-concept and body image in burnt women.Methods: This was a quasi-experimental study carried out on two pre-test and post-test groups composed of 30 burnt women aged 20-40 years with 2nd or 3rd degree burn who had passed their acute phase and admitted to Rajaei Hospital in Qazvin during March to September 2011. Patients were selected through convenience sampling and divided into two groups of 15 members each. One group received cognitive-behavioral therapy and the other only received usual medical treatment. Data were collected using two questionnaires, the victim’s body image of burn injury questionnaire (Ali Hosseini) and the Beck self-concept questionnaire and further data analyzed by using of the co-variance test and t-test the comparison of the independent median.Findings: There were significant differences regarding both the body image (F=8.92) and self concept (F=9.23) between the experimental and control groups (P<0.05). In the follow up made one month later, there was positive improvement in body image (t=3.69) with no continuous positive effect on self-concept (t=1.64).Conclusion: CBT positively improved the body image and increased the self-concept in burnt women. Hence, to achieve continuous positive change, arrangement for workshops with serious supervision is recommended.

Background: As an experience, partner violence is so painful and pregnancy has been recognized as a high risk period for such unpleasant conditions. Partner violence could be one in a set of intervening reasons which may lead to preterm labor. Preterm birth is one of midwifery serious complications and early recognition is of prime health objective.Objective: The aim of this study was to evaluate the frequency of partner violence and its correlation with preterm labor in hospitalized post natal women.Methods: This was a cross-sectional study carried out on 600 women hospitalized at the post natal ward of Shahid Akbar-Abadi Educational Hospital, affiliated to Iran University of Medical Sciences in Tehran during 2009. Data collection tool was a two-sectioned questionnaire in which the first part was allocated to demographic/midwifery information and the second part composed of question aimed to screen for presence of partner violence. The questionnaire was completed through interview and medical records. Data were analyzed using chi-square test and t-test, statistically.Findings: The overall frequency of partner violence was 56.3% (338 out of 600 cases) categorized in three types as emotional (42.9%), psychological (2.1%), and, physical (2.1%). There was a significant correlation between the partner violence and preterm labor.Conclusion: According to rather high frequency of partner violence and its correlation with preterm labor, it is suggested that a screening procedure to detect the partner violence to be established in all prenatal care centers to prevent the harmful effects of partner violence in particular the preterm labor.

Background: Based on a biomechanical model, an upright body posture has an important contribution to the prevention of musculoskeletal disorders and back pain.Objective: This study was conducted to determine the relationship between the constructs of theory of planned behavior and the stage of readiness for maintaining correct body posture among the assembly line.Methods: In this cross-sectional study, a total of 264 workers from Pars Electric and Kachiran factories with an average age of 35 years and selected by convenient sampling method were investigated in 2009. Data were collected using a questionnaire with appropriate psychometric properties of 5 parts including the demographic information, attitude, perceived behavior control, subjective norms, and intention as well as a staging algorithm for maintaining an upright posture during a 6-month period.Findings: The results of analysis of variance (ANOVA) showed that all selected variables shared a significant variance with the stage of readiness and that the discrimination between the stages by the selected variables was successful. Structural equation modeling was indicative of a direct relationship between the intention and the stage of readiness. Also, the subjective norms & perceived behavior control which showed to have direct relationships with intention exerted their effects on stage of readiness through intention mediation (P<0.05).Conclusion: Perceived behavior control, subjective norms, and intention are beneficial to understand the individual differences in stage of readiness for maintaining upright body posture and considering the subjective norms and managerial supportive network is essential to promote safe behavior.

Background: Heart failure is a common, disabling, deadly, and highly threatening disease. Despite advances in the treatment of heart failure over the past decade, the prognosis remains poor.Objective: The aim of this study was to determine the mortality frequency and length of hospital stay in elderly with systolic heart failure at Alborz Hospital in Karaj during 2009.Methods: This was a cross sectional study in which a total of 154 heart failure patients aged ³65 years and low ejection fraction (EF) (<or=%.40) during 2003-2008 were investigated. Demographic, laboratory, and echocardiography data were collected from medical records. Data were analyzed by independent group t-test, chi square test, and Pearson correlation coefficient.Findings: Hospital mortality was 7.1% and the mean length of hospitalization 11.59±10.94 days in elderly with systolic heart failure. Statistically, there was a significant difference in mean serum creatinine levels and blood urea nitrogen between the living and dead groups with heart failure (P<0.001). The use of ACE inhibitors (P=0.039) and angiotensin II receptor blocker (P=0.038) was found to be significantly associated with mortality. Also, the length of hospital stay showed significant association with presence of COPD (P=0.035), asthma (P<0.001), and administration of digoxin (P=0.028), nitrate (P=0.015), and warfarin (P<0.001). Significant positive correlation was found between the length of hospital stay and both serum creatinine levels (P=0.002) and blood urea nitrogen (P=0.041).Conclusion: Renal dysfunction and several comorbidities and drugs could increase mortality and length of hospital stay in elderly with systolic heart failure.

Background: Nosocomial infection is an infection that neither is presented or in incubation period at time of admission. This complication increases the hospital stay, cost, and mortality. Surgical wound infection (SWI) is a major nosocomial infection.Objective: The study was performed to determine the frequency of SWI, causative agents, and underlying diseases in operated patients.Methods: This was a prospective cross-sectional study carried out on operated patients by general surgeons at Golpayegani Hospital in Qom (Iran) during 2008-2009. Data were analyzed by SPSS software using t-test and chi square test.Findings: Totally, 3400 patients were operated within this period. The mean age was 55±2 years and 53% were female. The most common operations were cholecystectomy (36.4%), appendectomy (29%), gastric surgery (13.4%), herniorrhaphy (9.3%), and intestinal surgery (6%). Of total patients operated, 2.9% developed SWI. The mean age among those was 58±2 years and 53% were female with no significant difference between the SWI cases and the total number of patients regarding the age and sex. The frequency of infection was higher in gastric, intestinal, and cholecystectomy surgeries than appendectomy and herniorrhaphy and the difference was found to be significant (P<0.01) indicating that the SWI was more common in gastric, intestinal, and gallbladder surgeries. The most common underlying diseases were diabetes and chronic obstructive pulmonary disease in both total patients and the SWI patients with no significant difference between two. The commonest agent was Staphylococcus aureus (32%) and pseudomonas (20.5%).Conclusion: Frequency of SWI was at expected limit indicating that it was not abnormally high or low. Although the predominant organism was different from that reported in some studies however, this could be the value of this study as each medical center should be aware of its own indices including its local specific organisms which may be different from those in other hospitals.

Background: In recent years, many Iranians have made educational travel to countries to study in the field of medical sciences. Considering the different educational systems and lack of comprehensive exams in some countries, the present study was attempted.Objective: To determine the success rate in basic medical sciences national exam of graduates and students applying for transfer to Iran.Methods: In this descriptive study 2621 students from Ukraine, Armenia, Azerbaijan, Russia, Romania, Belarus, Tajikistan, Kazakhstan, and Philippine, who participated in the medical basic sciences national exam during 1998 to 2008, were evaluated and the success rate calculated.Findings: The highest and lowest success rates for countries with more than 100 participants were 48.6% and 27.4% for Armenia and Romania, respectively. Regarding the countries with less than 100 participants, the highest and lowest success rates were 55.6% for Belarus and 8% for Kazakhstan.Based on the field of study, the lowest success rate was associated with pharmacy (15.8%) and the highest with dentistry (38.9%).Conclusion: The success rates obtained for students from different countries evaluated were much  lower than those for domestic students. The reason for this difference is likely due to inappropriate style of national exam with the training methods used for these students or the students’ poor educational performance to successfully pass the national medical exam.

Question analysis, is a set of methods through which the effectiveness and efficiency of each question and the entire exam questions can be measured. By recognizing the affecting factors, we will be able to design more appropriate and standard exams to increase the efficiency and effectiveness of every single question. Analyzing the questions makes it possible to evaluate the characteristics of each question as well as providing assurance on standard format of questions to be further assessed for expected ability or attributes. The present research was a descriptive study carried out at the School of Public Health (Qazvin University of Medical Sciences) in 2009-2010. A total of 592 questions designed for the final exams of different fields of study including the public health, environmental health, and occupational health were evaluated. Each question was evaluated for its difficulty ratio and distinction ratio to determine the strength and weak points of every single question and the whole exam. The results of this analysis demonstrated that most questions designed were so easy to answer (62%). Based on findings of the present study, it is suggested that in addition to continuous analysis of questions at the end of each semester, providing the academic staff by the feedback of such analyses could be of valuable help in improving the quality of exam questions.

This descriptive study was aimed to assess clinic's panels of the general practitioners and the compliance with the general standards and criteria on the clinic panels of 60 general practitioners in Qazvin city in 2009. Of the total, 30% of the physicians had written the title of "general practitioners" on their panels and 66.61% of them had written 3 special practicing fields such as internal diseases, pediatrics, dermatology, etc and 66.21% of them had written 4 special practicing fields on their panels. All of the panels had not Iranian medical council sign. Also all of the panels within the normal size 50x70 cm as standards and 66.86% of the panels had a white background. Owing to the misplacement of the general practitioners in medical service versus specialists in the health system does not work, ignoring the effectiveness of their roles in the health care and the lack of awareness of the citizens can be the reasons for not writing the title of "general practitioners" on their panels and the use of special practicing field names.