Journal of Isfahan Medical School
Year:2014 | Volume:31 | Issue:271|Papers Count:6

Background: Health sector reform as “Family Physician” (FP) program has been introduced in 2004 in rural and lower than 20 thousands population cities of Iran. This study aimed to reveal the utilization rate of general practice visit and prescription pattern in the rural health centers before and after the Family Physician program in rural health centers of Isfahan district.Methods: We retrospectively assessed the number of prescriptions per year and in other mean, the average medical contacts per person, before and after implementation of Family Physician program in 2004 and 2011 in a cross-sectional study during the year 2012. In addition, we assembled the mean number of drugs per prescription and drug costs. Data were collected in 17 rural health centers of Isfahan district in the central of Iran.Findings: The prescription numbers in 2011 was 3.58 times more than such practiced in 2004. The prescriptions per capita were 0.145 and 0.64 in 2004 and 2011, respectively. The more prescriptions had done in spring and winter in both years. The mean number of drugs prescribed per encounter decreased from 4.27±0.69 in 2004 to 4.11±0.56 in 2011. The per capita drug costs increased 4.87 times in 2011 in comparison with 2004.Conclusion: Following Family Physician program implementation, the prescriptions per capita were increased. In otherwise, the access to general physician (equity) improved. In addition, the mean number of drugs prescribed per encounter decreased. Thus, following Family Physician program, technical efficiency has been developed.

Background: Nephrotoxicity is a serious side effect of using gentamicin. Garlic is an important component in the complementary medicine. The aim of this study was to find out whether garlic has ameliorative effects on gentamicin-induced nephrotoxicity.Methods: 50 male Wistar rats were divided into 5 groups of 10; I: They kept in the same condition as others without receiving any drug for 10 days and then sacrificed. II: Rats in this group were injected intraperitoneally (i.p.) with 100 mg/kg of gentamicin for 10 consecutive days and then sacrificed. Group III: Rats in this group received garlic juice 20 mg/kg intraperitoneally for 10 days and then sacrificed. IV: Rats in this group received gentamicin for 10 days, then received 20 mg/kg garlic intraperitoneally for the next 10 days and then sacrificed on day 20th. V: Rats in this group received a combination of intraperitoneal gentamicin and garlic 20 mg/kg for 10 days and then sacrificed. Serum blood urea nitrogen (BUN) and creatinine (Cr) were measured and the kidneys were processed for histopathological examinations. All specimens were examined for morphologic parameters involving tubular cells.Findings: The post administration of garlic after gentamicin treatment potentially attenuated the serum levels of BUN and Cr. The pathology damage scores indicated that post administration of garlic after 10 days of gentamicin treatment attenuated the damage score significantly.Conclusion: We concluded that garlic is a nephroprotective drug to attenuate tubular injury by gentamicin.

Background: Cardiovascular diseases and osteoporosis are two common chronic conditions particularly in elderly populations, which result in significant morbidity and mortality. Previous studies have shown the relationship of some sorts of heart disease and decrease in bone mineral density (BMD) and presence of osteoporosis. This study aimed to evaluate the relationship of cardiovascular diseases and osteoporosis in postmenopausal women.Methods: 200 patients with a mean age of 66.7±5.8 years (range 52-79 years) were enrolled in this study. Patients were divided in two groups of with and without heart disease according to their medical records. Patients underwent dual-energy x-ray absorptiometry (DXA) measurements at hip and lumbar spines (L2, L3, and L4), greater trochanter, and femur neck. Results were showed as T-score and BMD in g/cm2. The patients were divided into three groups according to T-score (normal, osteopenic, and osteoporotic) after collecting the data, Chi-square (for qualitative variables), t (for quantitative variables), and the Mann-Whitney tests were used for data analysis.Findings: No significant difference was seen between subjects with and without heart disease in mean value of BMD. In addition, there was no statistical significant difference between these two groups in distribution of osteoporotic, osteopenic, and normal density subjects (P>0.05) in various points of skeleto.Conclusion: In this study, no relationship was observed between cardiovascular disease (as a whole) and BMD and presence of osteoporosis.

Background: Infection with hepatitis B virus (HBV) may result in a number of different clinical outcomes. There are strong evidences in HBV infection that host genetic factors play a major role in determining the outcome of infection. Polymorphisms in the promoter region of interleukin 10 (IL-10) affect its production and confer susceptibility to inflammatory diseases. The aim of present study was to investigate the association between HBV infection and -592 polymorphism in the promoter region of the IL-10 gene in Iranian population.Methods: 100 HBV infected patients and 100 healthy individuals were randomly selected. Genomic DNA was extracted from blood buffy coat using the salting-out method. The IL-10-592(A/C) genotypes were determined using allele-specific polymerase chain reaction (PCR) method. The PCR products were electrophoresed on 1.5% agarose gel. The data were analyzed using chi-square test.Findings: The frequency of IL-10-592 C/C genotype was 16% in patients infected with HBV and 12% in healthy individuals and was not significantly different (P=0.5). Also, the frequency of C variant allele was 55.5% in HBV infected patients and 53% in healthy individuals that was not statistically different (P=0.6).Conclusion: Based on our findings, there was not any relationship between IL-10-592 (A/C) polymorphism and susceptibility to HBV infection in our study population.