Scientific Journal of Kurdistan University of Medical Sciences
Year:2019 | Volume:24 | Issue:1 (99) |Papers Count:15

Background and Aim: One of the common blocks used in upper extremity surgery is axillary block. The aim of this study was to make a comparision between the effects of dexmedtomedian and fentanyl as adjuvants to lidocain on axillary plexus block. Methods and Materials: This double-blinded clinical terial included 36 patients and was performed in Besat and Kosar Hospitals in Sanandaj in 2017. Patients were randomly divided into two equal groups. Patients in group 1 received 40 cc of lidocaine 1% and normal saline plus 50 μ g fentanyl. Group 2 patients received 100 mg of dexmedetomidine plus 40 cc of lidocaine 1% (Matched with group 1). Using SPSS software version 21, data were analyzed by independent sample t-test. Results: There was a significant difference between the two groups in regard to the beginning and quality of the sensory block (p≤ 0. 01) and motor block (p≤ 0. 05). Based on visual analog scale addition of fentanyl to lidocaine at all times had a greater effect on reducing the pain intensity compared to the addition of dexmedetomidine and there was a significant difference between the two groups (p≤ 0. 01). There was no significant difference in the incidence of nausea, vomiting, dizziness and seizure between the two groups. But, the groups showed significant differences in the incidence rates of heart arrhythmias and hypotension (p≤ 0. 01). Conclusion: Comparison between fentanyl and dexmedetomidine showed that addition of fentanyl to lidocaine led to a greater effect on the properties of the axillary plexus block.

Background and Aim: Use of medicinal plants is one of the methods to increase breast milk. Petroselinum crispum is a multipurpose herb in traditional medicine which contains essential amino acids, vitamins and numerous nutrients. This study aimed to determine the effects of Petroselinum crispum extract on milk production parameters in female rats. Material and Methods: In this experimental study, 32 Wistar female rats were randomly assigned to 4 groups; group1, control group (normal saline) and groups 2 to 4 (experimental groups). The experimental groups received various doses of Petroselinum crispum (100, 150, 200 mg/kg/day intraperitoneally) for 21 days. Petroselinum crispum extract was prepared. Prolactin hormone measurements were carried out based on RIA prolactin radio immune assay method. Using morphometrical techniques, prolactin receptor (PRLR) mRNA expression level and histological evaluation of mammary gland tissue were investigated. Data were analyzed by one way ANOVA test. Results: Petroselinum crispum administration increased significantly all the parameters in experimental groups compared to those in the control group (P<0. 0001). Conclusion: Petroselinum crispum extract had positive effects on the milk production parameters in mammary glands.

Background & Aim: Transgenic mice, of tengenerated by random integration of foreign genes into the mouse genome or by targeted mutation in a particular gene, have demonstrated to be a very effective tool for studying gene function in living things. In this review article, we discussed on the current methods of generating genetically-modified mice and their related problems and then investigated the new methods developed to overcome these problems. Finally, we discussed future prospects on the gene targeting. Methods & Materials: This is a review article, which has been written after searching Pubmed, Scopus, Google Scholar, Springer, Elsevier and Magiran databases by using keywords of transgenic mice, functional genetics, genetargeting, and homologous recombination. Results: This study dealt with genetic variations in a wide range, differential processing and inactivation of gene-specific isoforms, local and induced genetic changes, Cre/loxP system and some future perspectives. Conclusion: Success rate in genetic modification of mouse genome has increased dramatically, and use of knockout mice has resulted in increased knowledge of human biology and diseases.

Background & Aim: Yellow horned poppy is known as an antidiabetic drug in Iran folk medicine. This study was conducted to compare the effect of yellow horned poppy and glibenclamide on blood glucose concentration, blood lipid profile and weight of alloxan-induced diabetic rats. Materials & Methods: 40 male rats were randomly divided into five groups of eight: 1)healthy control 2)healthy treated with 500 mg/kg of body weight (BW)/day of the extract 3)diabetic control 4)diabetic treated with 500 mg/kg of BW/day of the extract 5)diabetic treated with 5μ g/kg of BW/day of glibenclamide. Diabetes induced in the 3rd, 4th and 5th groups by intraperitoneal injection of 120 mg/kg BW of alloxan. The weight of rats was measured after 1, 14 and 28 days. After a month, animals were euthanized and blood samples collected to measure serum levels of fasting blood glucose, triglyceride, cholesterol and lipoproteins including: HLD-C and LDL-C by an auto-analyzer. Data analysis was performed by repeated measure Anova, one way Anova and Tukey test. Results: We found a significant decrease in glucose concentration in the diabetic+extract group compared to the diabetic control (P<0. 001), this decrease was significantly lower than that in the diabetic+drug group (P=0. 03). Triglyceride, cholesterol and LDL concentrations in the diabetic+extract group showed a significant decrease compared to those in the diabetic control group (P<0. 001). Significant increase in HDL concentration was observed in the diabetic+extract group compared to that in the diabetic control group (P<0. 001). Conclusion: The present study showed antidiabetic effect of yellow horned poppy in the rats which is comparable to the effect of glibenclamide.

Background and Aim: Physicians’ knowledge and capabilities decrease over time; therefore, continuous medical education is important. Flipped class is a blended teaching method that inverts instructional cycle by delivering the educational content by innovative technology out-of-class. The aim of this study was to determine the effects of flipped class on satisfaction, active participation, and learning levels in general practitioners attending continuous medical education courses in the Kurdistan University of Medical Sciences in 2017. Material and Methods: This interventional study included 120 general practitioners in Sanandaj who were attending the continuous medical education courses. They were randomly assigned to intervention (flipped class) and control (traditional class) groups. Data were collected by a researcher-made questionnaire in order to evaluate participant satisfaction, and a researcher made checklist for evaluation of active participation and a set of post-test questions for assessment of knowledge. The validity and reliability of the questionnaire and the checklist were assessed by using expert panels and measurement of Cronbach’ s alpha respectively. Two weeks prior to the designated day, the intervention group started educational activities by finding answers to the questions. The control group did not receive any instruction until the designated day of the classes. On the designated day the control group listened to the lectures in traditional way. The educational content delivered to both groups was identical. Results: The results of the study showed that all the participants were satisfied with the continuous medical education classes. However, the mean satisfaction level of the re-training period was significantly higher in the intervention group (P = 0. 001). The mean post-test score in the intervention group (15. 50 ± 2. 25) was significantly higher than that in the control group (12. 85 ± 2. 18) (P = 0. 0001). Also, the mean score of participation in the intervention group (9. 01 ± 1. 71) was significantly higher compared to that in the control group (7. 60 ± 2. 02) (P = 0. 0001). Conclusion: The results of this study showed that flipped classroom strategy was an effective way of continuous education programs for general practitioners. This approach not only improved the knowledge of physicians after continuous medical education programs, but also increased their satisfaction by increasing their active participation.

Background and Aim: This study aimed to analyze the factors affecting time and experience of relapse in the patients with Hodgkin's lymphoma, using cure fraction. Material and Methods: This retrospective study included all the patients diagnosed as Hodgkin's lymphoma in the Center for oncology and hematology in Shafa Hospital in Ahwaz City from 2002 to 2012. We used survival analysis and cure fraction models In order to answer the question, "why are some people in the study don’ t experience recurrence? ". We used mixture and nonmixture cure models using Weibull, exponential, log-normal, loglogistic and gamma distributions, and a logistic model for estimation of the proportion of safe individuals; and Cureregr8 instruction for study of its associated factors. STATA13 software was used for data analysis. Akaike information criterion (AIC) was used to compare the performance of these models. Results: Parametric model of Weibull distribution had the lowest AIC (804. 3171). Factors affecting long-term survival of the patients with Hodgkin's lymphoma, were hemoglobin > 10. 5 (P-value = 0. 018) and stage of the disease (P-value = 0. 032). Factors affecting short-term survival of the patients included age >30 years (P-value = 0. 001), involvement of the groin site (P-value = 0. 010) Stage of disease (P-value < 0. 001) and bone marrow involvement (Pvalue = 0. 003). Conclusion: When the study population includes two susceptible and non-susceptible (safe or healed) subgroups in regard to recurrence of Hodgkin's lymphoma, use of cure models for separate evaluation of the variables associated with the long and short term survival and cure rates is appropriate.

Background and Aim: Obesity is an excessive accumulation of fat and its storage due to an imbalance between energy intake and energy consumption. High-fat diets, through inhibition of lipolysis enzymes can lead to increase in obesity and also many metabolic diseases. While exercise can activate these enzymes and lead to a change in the amount of visceral adipose tissue and reduce obesity. The purpose of this study was to investigate the effect of high intensity interval training (HIIT) and moderate intensity continuous training (MICT) on the content of perilipin 1, ATGL, and CGI-58 in visceral adipose tissue of obese male rats. Material and Methods: Forty male Wistar rats were divided into five groups of eight. A group of 8 rats consumed standard diet (SD) for 10 weeks, and 32 other rats used high-fat diet (HFD) for 10 weeks. After induction of obesity, 8 rats from high fat diet group and 8 rats from standard dietary group were killed, and the samples were collected to study the effects of high-fat diet. Other obese rats were randomly divided into three groups: high-fat diet sedentary (HFD+SED), moderate-intensity continuous training protocol (MICT), and highintensity interval training protocol (HIIT). The HIIT protocol consisted of 10 times of running, each time for 4 minutes, on a treadmill with an intensity of 90-85% VO2max, with 2 minutes active rest periods, and the MICT protocol included running on treadmill with an intensity of 70-65% VO2max, which had been matched with the HIIT protocol in terms of distance. 5 sessions of The training scheduals were performed per week for 12 weeks. Finally, the samples were collected by western blot method to measure the content of perilipin 1, ATGL, CGI-58. Results: The results of this study showed that obesity caused a significant reduction in the content of prilipin 1, ATGL and CGI-58. While both moderate-intensity continuous training and high-intensity interval training significantly increased the content of perilipin 1 and ATGL (p≤ 0. 05). Also, the high-intensity interval training led to a significant increase in CGI-58 content (p<0. 05). While moderate-intensity continuous training did not result in significant changes in CGI-58 protein content. Conclusion: The findings of this study showed that high-fat diet resulted in increased fat mass, as well as weight gain and obesity. On the contrary, exercise trainings can lead to a decrease in fat mass and weight loss by increasing the proteins and enzymes effective in the lipolysis process.

Background and Aim: The number of lawsuits against physicians, healthcare personnel and medical institutions has steadily increased in the world in recent years. Evaluation of medical malpractice in the hospital mortality committees is one of the ways to investigate medical errors, which, despite lack of complaints against physicians, can lead to detection of malpractices in death cases in the hospitals. The aim of this study was to determine the frequency of medical malpractice cases in the records of dead patients in Tohid Hospital in Sanandaj, Iran in 2017. Material and Methods: This is a retrospective descriptive cross-sectional study. In this study, after obtaining the Ethics Committee approval of the Kurdistan University of medical sciences, we reviewed the records of all of the patients died at Tohid Hospital in Sanandaj in 2017. Among these cases, referral cases to the Mortality Committee and the outcome of the evaluation of the experts of the committee was evaluated, and eventually, we extracted the necessary information from cases confirmed by the hospital mortality committee, as medical malpractice cases. Data were introduced into SPSS 22 software. We used descriptive statistics (mean, standard deviation, percentage) and chisquare test for data analysis. Results: Among 732 deaths in Tohid Hospital, 52. 6% were male 70. 2%, illiterate, 73. 7% urban residents and 32. 9% housewives. The mean age of the deceased patients was 69. 8 years. The most common cause of death was related to cancers (22. 7%). 25 cases (3. 5%) were suspected of medical errors in the preliminary evaluation and malpractice was confirmed in 2. 3% of all deaths. 68% of the cases were referred to the mortality committee. The most frequent cause of malpractice was related to indifference (58%). Conclusion: The findings of this study showed that the most cases of medical failure were due to medical indifference manifested by medical personnel. Improvement of the abilities of physicians and medical staff in various stages of treatment during their education and by planning effective workshops after graduation, and also paying more attention to religious standards and ethics can lead to a significant reduction in the frequency of deaths due to medical malpractice in medical centers.

Background and Aim: Congenital hypothyroidism is an endocrine disorder and is one of the main causes of mental retardation in the newborns. Genetic, environmental and geographical factors are associated with the disease. This study aimed to evaluate the incidence rate and correlation of geographical factors with congenital hypothyroidism in Ilam Province. Materials and Methods: This study was a descriptive analytical study and evaluated the incidence rate and geographical distribution of congenital hypothyroidism in the newborns in Ilam Province from the beginning of 2006 to the end of 2016. We studied the results of heel samples of the newborns between 3 to 5 days of age who had been screened for congenital hypothyroidism in the referral laboratories of the health centers of the health department of the Ilam University of Medical Sciences in all cities of Ilam Province. We used ArcGIS (ver 10. 3) software for evaluation of geographical distribution. Statistical tests of Poisson regression and scatter plot were used to investigate the relationship between geographical factors and the incidence rate of congenital hypothyroidism. Data analysis was performed by use of SPSS 16 software. Results: Based on the findings of the screening of 106900 newborns born in Ilam Province, the incidence of congenital hypothyroidism in this study was 2. 61 in 1000 live births (2. 7 male newborns / 1000 live births, and 2. 48 female newborns / 1000 live births). Among all the patients 55. 4% were male and 44. 6% were female. There was a significant correlation between the mean annual rainfall and herbal coverage with congenital hypothyroidism (p<0. 05). Mean annual temperature, sunlight and relative humidity had no significant relationship with the disease (p>0. 05). Conclusion: Based on the findings of this study, incidence of congenital hypothyroidism is high in Ilam Province. Abdanan and Ilam cities had the highest incidence rates of hypothyroidism and are among the high risk hotspots of the disease. As a result, authorities should take appropriate measures in order to control and reduce the incidence of this disease in the province. Also, among the geographical factors, the mean annual rainfall, herbal coverage and sunlight were associated with congenital hypothyroidism.

Background and Aim: Essence of P. atlantica Subsp. Kurdica fruit or wild pistachios have been recognized as an anti-microbial compound against most of microorganisms. The purpose of this study was to determine the anti-microbial activity of the essence of P. atlantica Subsp. Kurdica fruit on Clostridium perfringens in laboratory environment and meat products. Material and Method: The anti-microbial effects of the essence of P. atlantica Subsp. Kurdica fruit on Clostridium perfringens was evaluated by determination of minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Then MBC of the essence was added to the processed foods (hot dog and kielbasa) in order to reduce anaerobic microbes especially Clostridium. Using SAS software, data were analyzed by chisquare test. p<0/05 was considered significant. Results: The results showed that MIC for Clostridium bacteria was 250 milligrams per liter. MBC of P. atlantica Subsp. Kurdica essence for Clostridium bacteria was 500 milligrams per liter. Use of 500 milligrams per liter of P. atlantica Subsp. Kurdica essence in the food products such as hot dogs had bactericidal effect on Clostridium bacteria. Conclusions: The essence of P. atlantica Subsp. Kurdica in the food product such as hot dogs had inhibitory and anti-bacterial effects on Clostridium. This essence had no positive effect on the taste of food product. This problem can be solved by purification and decolorization. It can be used as a drug or remedy for the treatment of Clostridium infection or poisoning.

Background and Aim: Toxoplasmosis is a zoonotic disease with worldwide distribution. There is little information about the risk of occupational exposure to toxoplasmosis. Therefore, the aim of this study was to determine the seroprevalence and risk factors associated with toxoplasmosis among the butchers in Sanandaj City. Materials and Methods: This cross-sectional study was conducted on 53 butchers in Sanandaj from May to October 2018. Sampling method was census. The inclusion criteria consisted of: at least 1 year of work experience in the butcher shop and age > 18 years old. After obtaining 5 ml blood sample from each butcher serum samples were prepared. All 53 serum samples were evaluated by ELISA kit for anti-Toxoplasma gondii IgG antibody. Furthermore, demographic characteristics and risk factors for toxoplasmosis were investigated, which included: age, residence area, educational level, duration of activity, raw meat consumption, eating while working, wearing gloves, injury when handling raw meat and keeping cat indoors. Data were analyzed by chi-square test and multivariate logistic regression. Results: 6 (11. 32%) of the 53 butchers were positive for Toxoplasma gondii. Eating while working and wearing gloves had a significant association with the prevalence of toxoplasmosis (P<0. 05). Age, residence area, educational level, duration of activity, raw meat consumption, injury when handling raw meat and keeping cat had no significant association with the prevalence of toxoplasmosis (P>0. 05). Conclusion: The results of this study showed low seroprevalence of toxoplasmosis among the butchers of Sanandaj, which can be explained in three aspects: acquaintance of the butchers with the parasitic cysts of the tissues compared to other strata of society, ignoring butchers in non-licensed butcher shops who do not follow hygiene standards, as well as the advancement of various processes of raw meat supply in the last two decades.

Background and Aim: Safety is one of the important subjects in the pre-hospital settings. Determination and evaluation of safety attitudes of the emergency staff is the first step toward improving the safety of the staff and patients. In this study, we investigated safety attitudes and the factors affecting safety such as error and accident history, during mission, in the last year, in the staff of emergency medical services in Sanandaj. Material and Methods: This was a cross-sectional descriptive study. We used census method. Study population included personnel of emergency medical services (72 people). We used a questionnaire for data collection. SPSS version 20 software was used for data analysis. Pearson correlation coefficient, Spearman correlation coefficient and chi-square test were used to determine the relationship between the variables and the safety attitudes. Results: Based on the findings of this study, the safety attitudes of the emergency medical staff were significantly at a low level (mean: 3. 11, p=± 0/435). Six dimensions of safety attitudes, including the cooperative atmosphere in the organization, safety climate in the organization, perceptual management, and job status had significant relationship with demographic characteristics. Job satisfaction criteria and stress recognition showed no significant relationship with demographic characteristics. Conclusion: The results of this study showed that the safety attitudes of the emergency medical staff towards safety were significantly at a low level. Therefore education in order to improve the attitudes of the emergency medical staff is necessary. We recommend inclusion of safety attitudes conceot in educational programs for emergency medical staff.