Journal of Guilan University of Medical Sciences
Year:2018 | Volume:27 | Issue:107|Papers Count:8

Introduction: Change in the health system is always considered as the main concern of governments which in turn may have many positive and negative effects. The health sector development plan is one of the programs aiming at improving the therapeutic and economic dimensions of families, given priority by the 11th government of Iran, and is expected to improve performance of the medical sciences universities and their affiliated hospitals, in addition to develop their educational, health, research and cultural systems. Objective: The aim of this study is to evaluate technical efficiency of 22 public hospitals of Guilan university of medical science before (April 2013 to March 2014) and after (April 2014 to March 2015) implementation of health sector development plan, using data envelopment analysis approach and in accordance with the production of undesirable factors. Materials and Methods The current research is a descriptive-analytical type and also a cross sectional one. The research population includes 22 public hospitals of Guilan University of Medical Sciences, with enumeration chosen as the sampling method and the data were collected from documents. Finally, the collected data were analyzed based on the coding the DEA weak disposability model in GAMS software. Results: The findings indicate that before implementation of health sector development plan (2013-2014), 14 hospitals (63%) were efficient, while after its implementation (2014-2015), number of efficient hospitals increased to 16 units (73%). The average of technical efficiency also computed as 0. 954 and 0. 958, respectively. Conclusion: Although, observing the effects of changes in social systems often requires time lapse, however, one year after the implementation of the health system development plan, the average of performance in public hospitals of Guilan province was improved.

Introduction: Genetic variation of FGFR3 gene is one of the factors affecting the bladder tumor. FGFR3 is a tyrosine kinase receptor, involved in controlling the cellular and angiogenesis cycle. This protein affects a variety of diseases and cancers and cartilage growth abnormalities. Regarding the high activity of fgfr3 mutations in more than 50% of primary tumors of bladder urethral cells, it was suggested in this stage that the gene is involved in tumor-forming epithelial cells. Objective: the aim of this study was to detect S249C mutation in FGFR3 gene through tetra primers arms PCR and to determine the association between the presence of this mutation and the early stages of bladder cancer in the north of the country. Materials and Methods: in this study, after separation of epithelial cell in the urine of 100 patients with bladder tumor, their DNA was extracted using a commercial kit. After bioinformatics studies, primers with appropriate pair of mutants were designed and synthesized for the S249C mutation. After optimization of the reaction, screening was performed on the population and the data were analyzed using SPSS software. Results: Our results showed that primers designed to differentiate well between normal alleles and mutants in the epithelial cell of 28 patients with bladder tumor, S249C mutations were identified p<0. 0001. Statistical analysis of the data indicates the significance of this mutation. Conclusion: The mutation of S249C FGFR3 gene was identified in 28% of the population studied and is considered a potential risk, although more and more studies are needed to confirm the results.

Introduction: Preparation of tramadol HCl sustained release delivery system as an analgesic drug could improve its efficacy, reduce side effects and increase patient compliance. Objective: The aim of the present study was to prepare tramadol HCl loaded microspheres and coat them by solvent evaporation (ESE) method, in order to obtain an appropriate sustained release behavior and to prevent initial burst release. Materials and Methods: For this purpose, in the first stage, microspheres were prepared using ethyl cellulose by ESE method, and the effect of different variables such as the amount of drug and polymer as well as internal phase solvent volume on their physicochemical properties including particle size, encapsulation efficiency, surface morphology and drug release was studied. Also, the modified solvent evaporation method (MESE) was used for microspheres formation and comparison with ESE method. Results: Based on the results, the mean diameter of the microspheres prepared by solvent evaporation method was in the range of 80-173 μ m, and encapsulation efficiency of 68-92 %. Release studies showed a burst effect of tramadol HCl from microspheres obtained from both MESE and ESE methods, which was mainly due to the presence of drug crystals on the surface of the particles. In order to eliminate this occurrence, primary microspheres were prepared and coated with ethyl cellulose using a one-step solvent evaporation method which resulted in microspheres with sustained release behavior without burst release. Conclusion: Preparation of coated tramadol HCl-loaded microspheres by solvent evaporation method could be considered as an appropriate technique to control the drug release rate and prevent the burst effect.

Introduction: No previous study has examined the associations between egg consumption and prevalence of psychological disorders. Objective: To determine the association between egg consumption and depression in a large sample of Iranian adults. Materials and Methods: This cross-sectional study was conducted on 3, 172 adults in Isfahan, Iran. Egg consumption was assessed by using a validated, self-administrated, dish-based, semi-quantitative food frequency questionnaire. The Iranian validated version of Hospital Anxiety and Depression Scale (HADS) was used to screen for anxiety and depression. Also, the Iranian validated version of General Health Questionnaire (GHQ) with 12-items was used to assess psychological distress. Depression, anxiety and psychological distress were defined according to the standard criteria. Results: Mean age of study participants was 36. 5± 7. 9. Depression, anxiety and psychological distress were prevalent among 28. 4%, 13. 6%, and 23% of the study participants, respectively. After controlling for potential confounders, no significant association was observed between egg intake and depression (OR for comparing extreme quartiles: 1. 08; 95% CIs: 0. 80-1. 45) and anxiety (OR: 0. 79; 95% CIs: 0. 54-1. 16), as well as psychological distress (OR: 1. 03; 95% CIs: 0. 76-1. 41) in the whole population. In men, significant positive associations were observed between egg intake and depression before controlling for BMI (OR: 1. 68; 95% CIs: 1. 01-2. 80); however, the associations became nonsignificant after taking BMI into account (OR: 1. 62; 95% CIs: 0. 96-2. 72). In individuals with higher than median fish intake, egg intake was positively associated withpsychological distress (OR: 2. 07; 95% CIs: 1. 00-4. 28). Conclusion: We found no significant association between egg intake and psychological disorders. Further studies, in particular of prospective design, are warranted.

Introduction: The concept of organizational learning has become increasingly popular because of organizational need for adaptation to environmental changes. As learning is essential for the people’ s growth it is also important for organizations. Since the organizational knowledge is a strategic asset in an organization, organizational learning has been proposed as a vital source of competitive advantage in strategic management. In addition, the organizational conditions can provide some situations in which organizational learning and knowledge creation can lead to new and better services. Organizational structure iso ne of the most important factors. Objective: The purpose of this research is to investigate the relationship between organizational structure and organizational learning in Guilan University of Medical Sciences. Materials and Methods: This research is descriptive and co-relational. The variables are by no means controlled and manipulated and the research environment for conducting is natural. Questionnaires were used to collect information for testing hypotheses. To test the reliability of the questionnaires, Cronbach's alpha method was used. The statistical population of this research was all the employees of Guilan University of Medical Sciences (nurses, staff, doctors, etc. ). Sample size was determined by using the limited statistical methods (Cochran sample size formula). The samples consisted of 385people. To analyze the data, descriptive statistics (descriptive statistics, mean and standard deviation) and inferential statistics (data normalization, correlation analysis and regression analysis, structural equations) were used. Results: Finally, the research hypotheses were tested using the collected data. It was found that there is a significant relationship between organizational structure and organizational learning in Guilan University of Medical Sciences. The intensity of the relationship between organizational structure and organizational learning was 67%, reduction of formalization and organizational learning 63%, reduction of organizational centralization and organizational learning 61%, and reduction of complexity from a vertical point of view and organizational learning 62%. Beta coefficients show that 24 percent of organizational learning changes are through complexity, 43 percent through formalization, and 13 percent are predicted through centralization, and the rest are due to factors other than organizational structure. Conclusion: It is suggested that attention of Guilan University of Medical Sciences to issues such as employee participation in decision making, delegation of authority to managers, reviewing past activities and facilitating learning can lead to more employees’ satisfaction with organizational structure and organizational learning.

Introduction: Cardiovascular diseases (CVDs) are known as a health-threatening factors and the most important cause of mortality worldwide and also in Iran. Thus, it seems necessary to intervene in order to increase public awareness of the risk factors and to enhance their motivation for reducing those factors via the theory-based education Objective: This study aimed to determine the effect of educational intervention based on health belief model on nutritional behavior of patients with myocardial infarction admitted to the hospitals in Guilan province during 1395-96( 2017-2018). Materials and Methods: This study is a randomized controlled experimental trial. Eighty-six patients with myocardial infarction were randomly assigned into two case (43) and control (43) groups. Data from both groups (demographic and health belief model and nutritional behavior) were collected using a researcher-made questionnaire before and a month after educational intervention. After fulfilling the requirements based on HBM, educational intervention took place in case group. Control group did not receive any kind of intervention, they just received the routine notes from hospital. Data were analyzed using SPSS version 21 using suitable statistical tests (chi-square test, Spearman coefficient and independent t-test). Results: In terms of demographic characteristics, no significant differences were seen between the groups. Before intervention, no significant differences were seen between mean scores of HBM constructs, awareness and nutritional behaviors in the groups, while after intervention there was a significant difference between them (p<0. 001). Results also showed a significant difference in case group before and after receiving educational intervention (p<0. 001). But there was no significant change in the control group before and after educational intervention (p<0. 001). Conclusion: The present study showed that intervention based on HBM, emphasizing awareness and nutritional behavior of patients with myocardial infarction, could have a positive effect on the nutritional behavior of the patients and consequently their health status.

Introduction: Organizational citizenship behavior is considered as a worker's attitude and passion as a driver for work in service organizations. One of the factors affecting the creation and promotion of transcendental behaviors, such as organizational citizenship behavior and job Engagement for service organizations, are ethical leadership styles in the organizations that pay attention to structure and staff in terms of their capability. Objective: The purpose of this study was to investigate the relationship between Authentic leadership, psychological empowerment and positive behaviors (organizational citizenship behavior and career aspirations) in the emergency department staff of Rasht city health centers. Materials and Methods: The present study is a descriptive-survey study. The statistical population of the research is the employees of the emergency department of Rasht educational centers, consisting of 408 people. They were selected by cluster random sampling of 198 people based on Cochran formula. Data gathering tool was the standard questionnaire of Authentic Leadership of Valumva (2008), Organizational Citizenship Behavior, Poodsakof (2000), Baker's Job Exercise (2009) and Psychological Empowerment of Conger and Kanungo (1998). Data were collected using Structural Equation Analysis (SEM) and analyzed by LISREL 8. 50 software. Results: The results showed that there is a positive and significant relationship between Authentic leadership, psychological empowerment, organizational citizenship behavior and job Engagement. A correlation was also found between Authentic leadership and psychological empowerment (0. 41), psychological empowerment and organizational citizenship behavior (0. 85), psychological empowerment and job Engagement(0. 53). Conclusion: Given the relationship between authentic leadership, psychological empowerment, organizational citizenship behavior and job Engagement, and considering the positive role of reversible behaviors in the emergency department of Rasht city health centers, it seems advisable to promote the Authentic leadership perspectives that are subcategories of Ethical leadership and are of great importance.

Introduction: Diabetes is a metabolic disorder associated with the liver which functions as an insulin-dependent organ. Objective: To evaluate the effects of combined atorvastatin and zinc on liver dysfunction and hepatic injuries in the conditions of hyperglycemia. Materials and Methods: Fifty female Wistar rats in five groups, 10 in each: one control group (group NC) and four diabetic groups [diabetic control (group DC), treatment with atorvastatin 20mg/kg (group DA), treatment with zinc oxid 30mg/kg (group DZ) and treatment with combination in half doses of both (group DZA)] were used in this study. Diabetes was induced by the injection of 60 mg/kg STZ IP. One month after treatment (orally), animals were euthanized and the levels of functional liver markers: liver enzymes (ALT, AST, ALP), bilirubin, albumin and total protein were assessed in the serum. For pathology of liver tissue, sections with hematoxylin and eosin staining, histopathological sections according to standard method, were prepared. At the end, the data Statistical analysis was performed using ANOVA and Tukey test. Results: In diabetic rats, serum levels of functional liver markers and bilirubin were significantly increased and albumin, total protein were decreased, as compared to control normal group, and treatment of diabetic rats with half doses of atorvastatin and zinc in combination had synergistic benefits causing decreased levels of serum biomarkers of hepathic injury and increased levels of albumin and total protein of the rats more favorable than treatment with full doses of either drug alone(p<0/05). Histopathological findings were in consistent with biochemical results. Conclusion: Findings suggest that combined atorvastatin and zinc have synergistic benefits in controlling the damage and liver dysfunction caused by inflammation and oxidative stress in diabetic rats.