Payavard Salamat
Year:2020 | Volume:14 | Issue:2|Papers Count:8

Background and Aim: A great interest in determining the particular mechanisms underlying lipogenesis and adipogenesis has been raised among researchers to fight obesity. We aimed to investigate the gene expression of fatty acid synthase(FAS) and Acetyl-CoA carboxylase(ACC) and its role in the regulation of lipogenesis and adipogenesis in visceral adipose tissues from obese and normal-weight subjects. Materials and Methods: A total of 39 participants including 19 obese patients(body mass index≥ 35 kg/m Received: Dec 2019 Accepted: Mar 2020 2 ) and 20 healthy subjects(body mass index between 18. 5 to 24. 9 kg/m 2 ) were recruited from who were referred to Erfan, Loghman Hakim, Sina, and Imam Khomeini hospitals bypass or sleeve gastrectomy surgeries in obese ones and elective surgery in controls. Participants were all women aged from 20-50 years and postmenopausal subjects were not included in this study. Isolated total RNA from visceral adipose tissue(VAT) was used to synthesize complementary DNA(cDNA) and quantitative real-time PCR was performed for analyzing the gene expressions of FAS, and ACC. Data were normalized to geometric means of GAPDH and β-actin expression levels. Results: In VAT from obese subjects, gene expression of FAS was higher than in those from controls. We found a positive correlation between gene expression of FAS and ACC with obesity indices including BMI, waist circumference, and hip circumference. Conclusion: It appears that obesity is associated with dysregulation of FAS genes involved in lipogenesis and adipogenesis.

Background and Aim: Equitable distribution of health sector resources has always been one of the major challenges of this sector. Due to health care needs, equitable distribution of physicians is a determining factor in health system policies. The purpose of this study was to investigate justice in the distribution of general practitioners and specialists in Khuzestan province in 2018. Materials and Methods: This is a descriptive and cross-sectional study. Population data were collected through the Statistical Center of Iran, and the number of physicians was obtained through deputies of Health, Treatment, and Development of Human Resources, IRI Medical Council, and Provincial Management and Planning Organization. Then, using equity indices(per 1000-people population), Gini coefficient and Lorenz curve, equity in physician distribution was investigated. Gini coefficient and Lorenz curve were applied using Excel software. Results: Hendijan(0. 5) and Haftkel(0. 49) had the highest general practitioner to population ratio, but Khorarmshahr(0. 12) and Mahshahr(0. 11) had the lowest. Karun city had the highest ratio of specialist physicians to population with 0. 75 and Bavi(0. 04), Hamidieh(0. 05) and Lali(0. 07) had the lowest. Gini coefficient of Received: Sep 2019 Accepted: Mar 2020 general practitioner and specialist in the province were 0. 19 and 0. 33, respectively. The distance between the distribution curves of general practitioners and specialists and the equality line in the Lorenz curve confirms these coefficients. Conclusion: The ratio of general practitioners to specialists in the whole province is low, but the distribution of general practitioners and specialists has been relatively equitable. Provincial health policy makers and managers should pay special attention to increasing the ratio of general practitioners and specialists in the province's cities.

Background and Aim: When clinical decision support systems are developed, implementing solutions that enable these systems to be-used on a large scale can reduce the production costs associated with the creation, maintenance and by sharing these systems, producing multiple clinical decision support systems will be prevented. In recent years, one of the approaches used for this purpose in combination with clinical decision support systems is the service-oriented architecture approach. The purpose of this study was to investigate the role and importance of service-oriented architecture in delivering scalable architectures of clinical decision support systems focusing on different approaches to this architecture. Materials and Methods: This article is a simple review article. Bibliographic databases of IEEE Explore, Science Direct, Springer, Web of Science, and Scopus were reviewed. The keywords "Service Oriented Architecture" and "clinical decision support systems" were used as keywords along with related terms for searching these databases. Results: The clinical decision support systems based on service-oriented architecture brings benefits such as Facilitate knowledge maintenance, reducing costs and improving agility. Point-to-point communication, enterprise service bus, service registry, clinical and engine guiding engine, and service choreography and orchestration are general architectural designs that are evident in the use of web-based clinical decision support systems based on a service-oriented architecture approach. Conclusion: Service-oriented architecture is a potential solution for delivering scalable platforms for clinical decision systems.

Background and Aim: Neurological disorders occur under the conditions when there is perturbation in one part of the brain or the nervous system. The increasing outbreak of neurological disorders and its high expenses imposed on society have made the necessity to modify the policies of health care. This study calculated the cost of services for pediatric neurology patients to help reducing costs. Materials and Methods: This quantitative cross-sectional descriptive-analytic case study implemented a Fuzzy Time-Driven Activity-Based Costing(FTDABC) model in treating pediatric neurology patients in 2016. The Wilcoxon nonparametric test was used to test the hypothesis of the research and investigate the significant difference in the cost of services provided to patients in the FTDABC and the traditional costing model. Results: The results confirmed a meaningful patient services costs in both methods; the cost of patient care using FTDABC model was estimated to be 5, 736, 843, 432 Rials, 41. 61% of which goes to overhead and 5. 94% goes to idle capacity. Visiting and counseling activities, controlling vital signs, and patient displacement were identified as the most time-consuming activities in the treatment process, respectively. Conclusion: According to the research findings, it seems necessary to reform human resource management and reduce idle capacity to increase the effectiveness of hospital resources and improve the therapeutic processes. If management can reduce patient displacement activity by 20%, it will result in 2. 89% reduction of time and 1. 86% of the cost of the treatment process.

Background and Aim: Studies have shown that non-steroid anti-inflammatory drugs have an effect on cancer cells of digestive system, however, the cellular and molecular mechanism of the non-steroidal anti-inflammatory drugs and their effects on the proliferation of gastrointestinal cancer cells is unclear in many cases. The aim of this study was to investigate the effects of cytotoxic dose of tolmetin on BAX and BCL2 genes expression level in gastric cancer cells (AGS). Materials and Methods: In this laboratory-experimental study, AGS cells were purchased from Pasture institute and divided into control group and groups exposed to different concentrations of tolmetin. MTT assay was used to measure cytotoxic effects of tolmetin. Real-time PCR was used to evaluate BAX and BCL2 genes expression levels. The data were statistically analyzed between groups using ANOVA. Results: Higher decrease in relative expression level of anti-apoptotic BCL2 was observed than expression level of apoptotic BAX gene in AGS cells exposed to IC50 concentration of tolmetin. Conclusion: The results of this study indicated that tolmetin can induce apoptosis in gastric cancer cells by decreasing of anti-apoptotic BCL2 gene expression level. Therefore, consideration might be given to tolmetin in treatment of gastric cancer.

Background and Aim: The sterile technique is the basis of modern surgery. Therefore, sterile technique observance is required by the surgical team to preserve patient safety and prevent surgical site infection. This study was conducted to determine the knowledge, attitude and practice of Surgical Technologists Regarding the Sterile Techniques principles observance in the operating room. Materials and Methods: This cross-sectional descriptive study was conducted on 198 surgical technologists working in hospitals affiliated to Mazandaran University of Medical Sciences in 2019. Surgical technologists were selected by stratified random sampling. Data collection was performed using the researcher-made questionnaire for the measurement of knowledge, attitude and practice of surgical technologists regarding the Sterile Techniques. The data was analyzed using SPSS software and applying descriptive statistics, Chi-square and t-test. Results: The mean scores of knowledge, attitude and practice of surgical technologists regarding the sterile techniques, were 35. 7± 5. 8, 28. 3± 3. 7 and 38. 7± 6. 5 respectively. The score of knowledge and practice was moderate and the score of attitude was good. Findings showed that there was a significant difference between knowledge and practice score with educational level and The mean score of knowledge and practice was significantly higher in the participants with bachelor's degree as compared to the participants with associate degree(p>0. 05). Conclusion: According to the results, it seems necessary to promote knowledge and practice of the surgical team members by implementation of training programs, encouraging staff to upgrade their education and continuing to evaluate their knowledge and practice regarding the sterile techniques.

Background and Aim: Colorectal cancer is one of the most common gastrointestinal cancers among human beings and the most important cause of death in the world. Based on the risk of colorectal cancer for individuals, using an appropriate screening program can help to prevent the disease. Therefore, the purpose of this study was to design a model for screening colorectal cancer based on risk factors to increase the survival rate of the disease on the one hand and to reduce the mortality rate on the other. Materials and Methods: By reviewing articles and patients' records, 38 risk factors were detected. To determine the most important risk factors clinically, CVR(content validity ratio) was used; and considering the collected data, Spearman correlation coefficient and logistic regression analysis were applied for statistical analyses. Then, four algorithms--J-48, J-RIP, PART and REP-Tree--were used for data mining and rule generation. Finally, the most common model was obtained based on comparing the performance of the algorithms. Results: After comparing the performance of algorithms, the J-48 algorithm with an F-Measure of 0. 889 was found to be better than the others. Conclusion: The results of evaluating J-48 data mining algorithm performance showed that this algorithm could be considered as the most appropriate model for colorectal cancer risk prediction.

Background and Aim: The efficiency and effectiveness of any organization depend greatly on proper and effective management and use of human resources. Due to the importance of activities and the motivation of personnel fighting against diseases, as well as the high share of personnel costs in total health expenditures, the use of appropriate methods to determine their workload is important. Materials and Methods: The present research is a descriptive and applied study, conducted in two quantitative and qualitative dimensions. The research environment was the urban-rural health centers of Savadkuh health network. During the process of calculating the workload, the steps were: identifying activities, correcting and approving activities, determining the percentage of acceptable unemployment, calculating standard time, determining the number of repetitions, calculating work units, determining the workload, and determining the required manpower. Results: Activities in the field of fighting against diseases were identified and organized in the form of 77 activities. By taking the frequency of each activity into account, the total time of these activities in one month was equal to 10273 work units. The main activities related to vaccine injection and registration of vaccinated specifications in relevant offices and forms included 137 and 115 work units, respectively. Conclusion: Determining the workload of different health care fields by using this study method creates the potential to estimate the number of manpower required to give all predicted services, and has the potential to reduce the demand for surplus labor and increase employees' tendency to give more services, if used in current structures.