Journal of Advances in Medical and Biomedical Research
Year:2009 | Volume:16 | Issue:65|Papers Count:13

Background and Objective: Due to a high prevalence of osteoporosis and its costs and regarding different ways of treatment for this disease and lack of knowledge about their efficacy in fracture rate in Iran, this study was designed in Zanjan to determine fracture rate in hypogonadal osteoporotic women who were on different types of anti-osteoporotic treatments.  Materials and Methods: In this historical cohort study, 160 osteoporotic women were investigated. They were under treatment for their osteoporosis during 2001-2007. The cases were divided into 4 groups based on their type of treatment: 1) Calcium 1000 mg/daily + Vit D 200 IU/daily 2) Calcium 500 mg/daily + Vit D 200 IU/daily + Alendronate 10 mg/daily 3) HRT with Calcium D 4) Combination therapy. One group that didn't receive any type of treatment, were considered as control group.At least two densitometries were carried out in each case that the first one being done at the beginning of the study. Bone density was measured in three sites including: hip, spine and forearm with DEXA method. The rate of osteoporotic fractures was investigated in any site of the body during the follow-up period based on patient's invitation and their documents. Data were analyzed using Chi square, t-test, Logistic regression and Kaplan-Meier survival curve.Results: The rate of fracture was 11% (18 cases). Most of the fractures were non-vertebral (17 cases) and occurred in ages less than 50 years (17.9%). The most effective treatment to reduce fracture rate was Alendronate (with 69.9% reduction rate). HRT was as effective as Calcium and Vit D in reducing the fracture rates. Bone density in forearm region was known as the most vigorous predictive factor of fracture rate in our study. Most of the fractures were reported in forearm and leg regions (63.3%).     Conclusion: Based on this study it can be concluded that Alendronate is the most effective treatment to reduce fracture rate in osteoporotic women. Densitometry is also recommended for women under 50 years old with hypogonadysm for early diagnosis and treatment.

Background and Objective: The phospholipids fatty acid content of high-density lipoprotein (HDL) has recently been found to be related to several important biological functions which may serve as a risk factor for coronary artery disease (CAD). The purpose of this study was to investigate whether fatty acid composition of HDL phospholipids correlates with the presence and severity of coronary artery disease.Materials and Methods: The study population included 117 patients with coronary artery disease which was approved by angiography. The severity of CAD was assessed by the number of arteries (1, 2 or 3) with more than 50% stenosis reported by angiography. The fatty acid composition of HDL phospholipids was determined by gas liquid chromatography. The independence of association between fatty acids and CAD were evaluated by multivariate analyses which included all of the variables associated with the severity of CAD in univariate analysis.Results: These analyses showed that the association of EPA (b=-0.23, P<0.01) and DHA (b =-0.17, P<0.05) with the severity of CAD was inversely and independently significant.Conclusion: Some kinds of polyunsaturated HDL fatty acid contents such as EPA and DHA (omega-3 fatty acids) have adverse association with severity of CAD.

Background and Objective: Evaluation of the importance and the effects of plant derived drugs on fertility of laboratory animals have long been recognized. In this research the effects of administration of aqueous extract of Boswellia thurifera on fertility indices, body weight and reproductive organs weight was evaluated in male rats. Materials and Methods: Eighteen rats were randomly divided into 3 groups, control, group A and group B. Each group comprises of six rats. Animals in control group received 1 ml of distilled water (vehicle) and test groups (A and B) received graded doses of 200 and 400 mg/kg body weight of aqueous extract of Boswellia thurifera respectively on daily basis for 60 days. At the end of 60 days of treatment period, fertility indices such as body weight, reproductive organs weight, sperm motility and count, fertility rate, epididymal sperm reserve (ESR), daily sperm production (DSP) and blood testosterone concentration were measured.Results: There was a significant increase in the reproductive organs and body weight, sperm motility and count, ESR, DSP, blood testosterone concentration and fertility rate especially in the group which received the higher doses of aqueous extract of Boswellia thurifera. Conclusion: The results of this study showed that aqueous extract of Boswellia thurifera could increase fertility rate in male rats.

Background and Objective: Sulfur mustard is a potent chemical vesicant warfare agent that remains a significant military and civilian threat. Inhalation of sulfur mustard gas causes inflammation and injury to airways and bronchioles. Mast cells promote allergic reactions when exposed to some chemical compounds such as HD. Hexamethylenetetramine has been shown to protect human lung cells against HD toxicity and has also been shown to be effective against the chemical warfare agent phosgene in vivo. The aim of this study was to evaluate the effects of HMT on the number of mast cells in the lamina propria of visceral layer of pleura in male rats after exposure to sulfur mustard.Materials and Methods: Twenty seven Albino Wister male rats weighting 200±20gr were randomly divided into 5 groups (Normal Saline (N.S), HMT, HD, Pre-exposure and Post-exposure). HD, Pre-exposure and Post-exposure groups received sulfur-mustard and N.S group received Normal Saline as a solvent by intratracheal catheter. HMT, Pre-expand Post-exp groups received HMT via intra-peritoneal for 14 days. After the day 14, body weight changes, the rate of lung tissue injury and the number of mast cells measured in the pleura's visceral layer of the rats' lungs.Results: Histological examination and mast cells count showed no significant difference when compared among NS, HMT, Pre-exposure and Post-exposure groups. However, significant reduction was seen in the number of mast cells in HMT and NS groups in comparison with the HD group (p<0/001). The number of mast cells in the Pre-exposure and Post-exposure groups was also significantly lower than that of the HD group (p<0/001).Conclusions: From the results of this study it can be concluded that HMT may have a positive protective and therapeutic effect on lung tissue in rats.

Background and Objective: Fascioliasis is an important zoonotic disease that causes several health problems and economical losses in different parts of Iran including Zanjan. Fasciola hepatica and F. gigantica are recognized as causative agents of the disease. The differential diagnosis between these two species is very important for planning and control of infection. This study was designed to identify the Fasciola species by molecular methods in Zanjan (Iran).Methods and Materials: A number of 535 adult Fasciola worms were collected from the natural infected livers of cattles and sheep in local slaughterhouse. Living flukes were washed extensively in PBS at 37 oC and then anterior half of adult worms were stored at -20 oC in 70% ethanol. Total genomic DNA was extracted from individual flukes by modified phenol-chloroform method. Nucleotide polymorphism of ITS2 fragment of rDNA was investigated using PCR-RFLP assay and sequencing technique.Results: The results of PCR-RFLP and comparison of ITS2 sequences with the BLAST GenBank database clarified that all specimens were F. hepatica. The obtained sequences are available in the GenBank, with accession numbers EU391412 to EU391424. Conclusion: The results of this study showed no evidence of F. gigantica infection in sheep and cattles in Zanjan as all of the isolates were found to be F. hepatica.

Background and Objective: Dysmenorrhea is the most common gynecologic complaint among adolescent females. They may usually not seek professional expertise in their attempt to alleviate this condition. The aim of this Quasi-experimental study was to determine the effect of group counseling program regarding to nutrition and exercise on primary dysmenorrhea in adolescents at high schools.Methods and Materials: Eighty girls between 14-18 years of age were selected by simple sampling and divided into two groups (test and control). These groups were studied before and after the intervention. Data was collected in both groups based on a questionnaire concerning 24- hour diet, pain quality and severity and nutritional and physical practices. Group counseling was then held over 8 sessions each of which lasted 1.5 to 2 hours for test group. Both groups were followed up for 3 consecutive menstrual periods by a self-report checklist. Finally, they were assessed again at the end of the above study periods.Results: Findings of this study revealed a significant difference in pain severity of primary dysmenorrhea before and after the intervention (P=0.000). A significant difference was also seen in nutrition and exercise status in both groups before and after counseling program (P<0.05).Conclusion: From this study it can be concluded that in order to decrease and prevent the severity of primary dysmenorrhea and improve the nutrition and exercise status, counseling programs are better to be performed in high schools.

Background and Objective: Conflicts among health care personnel including nursing personnel who require extensive interaction with different people, is common and almost inevitable. As there is not sufficient information about the causes, types, and dimensions of interpersonal conflicts among clinical nurses and the adverse effects of these conflicts on the function of nursing team in Iran, we aimed to perform this study in order to find out causes of different inter-group or inter personal conflicts among nurses using qualitative research method and Grounded Theory Approach (GT).Materials and Methods: The data was collected through interviews. Constant comparison method was used in order to perform qualitative analysis.Results: Open coding process resulted in emergence of causal conditions and different types of conflicts within the nursing society. Exposure to imposed conditions, confronting with opposition, disagreement and destructive behaviors were indicative of characteristics of conflicting events and tasks, process, relational and marginal conflicts which were major categories of conflict in clinical settings. Feeling threats towards benefits was recognized as the main apprehension of participants. This core variable can explain how conflicts occur and develop within nursing society according to conflicts of benefits.Conclusion: The findings showed that individual factors and intra as well as extra-organizational factors were major and/or contextual causes of inter-group conflicts among nurses. One of the significant and interesting findings in this study was that the conflicts did not affect the occupational function of nurses despite the significant effect on marginal issues in their work environment. The study also showed that these conflicts are part of simulation process in nursing tasks.

Background and Objective: The life skills approach is of great importance and has a strong theoretical and research background in prevention of drug consumption. Based on this approach, a “Life skills Training” package has been developed by Dr Botvin. The present study was designed to evaluate the effect of this package on the school children. Materials and Methods: A total of 1862 secondary school students (male and female) were randomly selected from Tehran province. They were divided into two groups, including experimental and control groups. The experimental group was participated in life skills training course but the control group did not. The two groups were consequently compared with regard to their awareness, attitude and life skills about drugs, using “Healthy Behavior Questionnaire”. The T-test was used for the statistical analysis.Results: The post-test mean scores with concern to increasing the information and changing the attitudes and skills about drugs in the experimental group were significantly different from those of the pre-test mean scores.Conclusion: The results indicated that the “life skills training” package, as a psychological intervention tool, can play an important protective role in increasing information and improving attitude and skills in students in favor of drug using avoidance. It is expected to decrease drug use in further years due to the long term effects of the training programs. However, it is recommended to design a longitudinal study in order to evaluate the long term impacts of such interventional training programs on drug using behaviors.

Background and Objective: Among service organizations, health care sector has an important role, because it has the mission of maintaining community well-being. Thus, delivery of high quality health services is essential and should be appropriate with professional standards. Communal understanding of quality concepts helps organization to focus on quality improvement efforts. In addition, understanding of clients’ expectations and perceptions of services quality is one of the first requirements for improving quality of health services. This study was designed to evaluate the quality of health services in Zanjan district health centers based on clients’ expectations and perceptions and to determine the strengths and weaknesses of primary health cares.Materials and Methods: In this cross-sectional study, a self-administered SERVQUAL questionnaire was used for data collection. A total of 300 females of the health care consumers were selected through random clustering sampling and completed the related questionnaire. The statistical analysis was performed using appropriate software.Results: The results indicated that the health service quality was not concordant with the clients’ expectations and perceptions in all relevant dimensions. Expectations exceeded the perceptions in all dimensions of services quality. Mean score of overall service quality was (-1/22) (p<0.0001). The reliability dimension (ability to provide the promised service and accurately) was rated as the most important service (-1/13). The lowest mean score (-1/13) belonged to the tangible dimension (p < 0.0001). Conclusion: The results of this study showed that the reliability dimension constitutes the most serious problem facing district health centers. It is recommended that responsible employees and physicians should provide the promised services on time accurately and keep the records of services provided to clients without mistake. It further confirmed that the SERVQUAL elements can help health centers for defining the important areas of services and improving them.

Gastric bezoars results from the accumulation of foreign ingested materials in the form of masses or concretions. Bezoars are rare and being found in less than 0.5 percent of patients undergoing upper gastrointestinal endoscopies. Bezoars are classified according to their composition. The major types of bezoars are phytobezoars, trichobezoars and pharmacobezoars. Trichobezoars are typically seen in the women in their 20s. Patients with bezoar remain asymptomatic for many years and develop symptoms insidiously. Common complaints include abdominal pain, nausea, vomiting, early satiety, anorexia and weight loss. Bezoars have rarely been associated with other gastrointestinal complications such as gastric outlet obstruction (GOO), intestinal obstruction, gastrointestinal bleeding, gastrointestinal perforation, necrotizing pancreatitis, obstructive jaundice, hypochromic anemia, B12 deficiency and abdominal mass.In our case thrichobezoare manifested with an abdominal mass and hypochromic anemia.