SCIENTIFIC JOURNAL OF KURDISTAN UNIVERSITY OF MEDICAL SCIENCES
Year:2017 | Volume:21 | Issue:6|Papers Count:13

Background And Aim: Suicide is a social problem which can be influenced by geographical, cultural, economic, social, and environmental factors. The aim of the present study was to perform a systematic review and meta-analysis in order to evaluate the relationship of rates of suicide attempts and successful suicides with seven climatic conditions in Iran.Materials and methods: The present study was a systematic review and meta-analysis on the incidence rates of suicide attempts and successful suicide in seven climatic areas of Iran which was carried out by reviewing the published papers between 2001 and 2014. Using the keywords suicide, attempted suicide, incidence, Iran and combined terms, two trained investigators searched SID, ISI, Pubmed, Google Scholar, Irandoc, Scopus, and Magiran databases and all the relevant articles were extracted independently by them. The results were analyzed by using weighted average and Poisson distribution.Results: Among 74 articles, 30 were eligible for our study. The highest level of suicide attempts belonged to the climate area 5 (Isfahan, Yazd, Semnan and Qom cities) with and incidence rate of 114.7/100000 people and the least belonged to the climate area 6 (Chaharmahal and Bakhtiaree, kohkiloyeh and BoyerAhmad, Khuzestan Province) with the incidence rate of 37/ 100000 people. The highest and lowest incidence rates of successful suicide belonged to climate area 1 (Ilam, Lorestan, Hamadan, Kurdistan and Kermanshah) and climate area 5 with incidence rates of 12.9 and 2.8/100000 people respectively. Climate zone 5 had the highest incidence rate of suicide attempts and lowest rate of successful suicide.Conclusion: According to the findings of this study, the incidence of suicide and successful suicide can be influenced by climatic factors. Based on the results of the studies conducted in different regions of the world, geographical and climatic factors can affect the incidence rates of suicide attempts and successful suicides. This was an ecological study. In order to find the association of climate factors with suicide attempts and successful suicides, further studies should be done on individual level.

Background and Aim: Medicago sativa (Alfalfa) has been used traditionally as liver protectant, antioxidant agent and also for the treatment of bleeding and digestive problems.The aim of this study was to evaluate the effect of hydroalcholic extract of Medicago sativa on liver function tests, blood biochemical factors and coagulation system parameters in male rats.Materials and Methods: In this experimental study, 32 male Wistar rats were randomly divided into 4 groups (n=8) including control, and three experimental groups which received gavage (250, 500, 750 mg/kg/day). These groups were treated for 14 days and on the 15th day plasma levels of total protein, fibrinogen, Na, glucose, alanine amino transferase (ALT), and alkaline phosphatase (ALP) were measured. We also measured platlet count, prothrombin time (PT) and partial thromboplastin time (PTT). The results were analyzed by one way ANOVA.Results: The results of the present study showed that use of the extract decreased significantly the serum levels of ALP, ALT, and also blood glucose concentration in the experimental groups, compared to the control group. Furthermore, alfalfa increased total protein and fibrinogen in a dose dependent manner in the experimental groups (p<0.01, p<0.001).Conclusion: The results of this study showed hepatoprotective effect of alfalfa extract. The effect of alfalfa on coagulation system was exerted via increasing the blood level of fibrinogen and it had no effect on other indices.

Background and Aim: The aim of this study was to investigate the effect of 12 months of strength training in water on bone mineral density of the lumbar spine and femoral neck in postmenopausal women with osteoporosis.Material and Methods: In this study, 30 postmenopausal women with osteoporosis (age range: 50 - 65 years), were divided into two experimental and control groups. The experimental group performed 12-month strength training program in water, 3 times a week (Monday, Wednesday and Friday), for 50 minutes. Using energy X-ray absorptiometry, we performed bone densitometry of L2 and L3 vertebrae and femoral neck by standard methods. Data were analyzed by independent t test. P£0.05 was considered significant.Results: The results showed that 12 months of strength training in the water had significant effect on bone mineral density of L2-L3 vertebra (P=0.000) and bone mineral density of the femur (P=0.000) in postmenopausal women. Also we found significant effects on the percentages of T scores of L2-L3 vertebra (P=0.000) and the femur (P=0.000) after 12 months of strength training in water in postmenopausal women.Conclusion: Based on these findings, possibly strength training in the water can lead to increased bone density in postmenopausal women with osteoporosis.

Background and Aim: Costs can influence the quality of health services. Estimation of the costs of the health care services is an important issue that has always preoccupied the minds of the managers of the health system. This study aimed to assess the costs of rural health centers and primary health centers in Kurdistan Province in 2014.Material and Methods: This cross-sectional study included 30 rural health centers and 182 primary health centers of kurdisatn University of Medical Sciences in 2014. Costs were determined on the basis of activity-based costing. Costs were divided into direct and indirect categories. Direct costs were related to personnel, consumable and non-consumable materials, energy, repairs, car and rural family physician. Indirect costs, included costs imposed by the city health centers, deputy of health, deputy of logistics and finance, and university chancellor's office.Results: Direct costs of the health centers in 2014 amounted to 971, 722, 394 Rials. The highest proportion of the costs belonged to rural family physician (76.2%) and the lowest was related to the health workers (18.6%). The costs of each rural health center ran to 1, 515, 851, 000 Rials. Direct costs of a rural center including its primary health centers amounted to 7, 628, 981, 000 Rials. Indirect costs, including costs imposed by the city health centers, deputy of health, deputy of logistics and finance, and university chancellor's office were 479, 345, 000 Rials.Conclusion: Considering the average costs of rural health centers, the annual budget allocated to the Kurdistan University of Medical Sciences, is low, and can affect the quality of basic health services for rural areas.

Background and Aim: Increase in some inflammatory factors secreted by the adipose tissue can have predisposing effect on the development of metabolic syndrome. This study aimed to assess the effect of 12 weeks of aerobic training on serum levels interleukin-6, vaspin and serum amyloid A in postmenopausal women with metabolic syndrome.Material and Methods: In this semi-experimental study, 30 postmenopausal women with metabolic syndrome (mean age: 61 ± 9.48 years, body mass index: 32.16 ± 6.23 Kg/m2, and body fat: 30.82 ± 2.71%) were assigned to two experimental and control groups. The experimental group performed 12 weeks of aerobic training (3 sessions per week, with an intensity of 65-75% of maximum oxygen consumption at the first session which increased to 75-85 percent of maximum oxygen consuming).24 hours before and 48 hours after the last training sessions, blood samples were obtained and body fat percentage was measured. Data were analyzed by using independent and paired t-tests and also Pearson's correlation coefficients. P<0.05 was considered significant.Results: We found significant decrease in the serum levels of interleukin-6, vaspin and serum amyloid A (P values were 0.0001, 0.01, 0.04 respectively) and fat percentage (P=0.02) in the experimental group. No significant changes were observed in the control group. There was a significant positive correlation between the mean body fat and serum levels of interleukin-6, vaspin and serum amyloid A (P<0.05).Conclusion: It seems that aerobic training can be effective in reducing inflammatory conditions by decreasing inflammatory factors in the patients with metabolic syndrome.

Background and Aim: Knee is the largest synovial joint in the body. Knee joints are supported on each side by collateral, meniscal, anterior cruciate ligaments (ACL) and posterior cruciate ligaments (PCL). About 50% of people experience knee joint pain in their lifetime. Arthroscopy is a technique used for accurate diagnosis and treatment of disorders and injuries of the knee joint, although many orthopedic surgeons believe that MRI is a convenient and non-invasive tool for the diagnosis of knee joint injuries.Materials and methods: This cross-sectional study was performed in MRI Imaging Center of ShahidGhazi Clinc in Sanandaj during a period of five months from October to March 1394.500 patients who had referred for the first time and had no history of knee surgery were entered into the study. Every patients filled out a questionnaire including indications and variables such as age, sex, occupation, location of pain, history of trauma, knee giving way, knee locking and other symptoms. MRI was performed by using GE HDxt 1.5T MRI system and the images were interpreted by a radiologist.Results: In this study, 134 (34.1%) patients had ruptured ACL and 12 (31%) had ruptured PCL. MCL and LCL injuries were found in 8 (2%) and 5 (1.3%) patients respectively. In 187 (47.6%) patients had effusion. Meniscal lesions were found in 84 (21.4%) cases and the meniscal ligaments of 52 (13.2%) patients had been destroyed. Loss of the anatomical shape and physiological activity of internal and external meniscus were considered as our criteria for knee joint lesions.Conclusion: In this study, housewives had the highest frequency (26.2%) of knee injuries.Interestingly, we found the lowest frequency rate among the retired men (1.5%) and the highest frequency rate among the military personnel (22.1%) Clinical symptoms of audible knee sound and trauma were found in 61.1% and (49.1%) respectively. The study also showed that the medial meniscus ligament was the most prone ligament to injury. Rupture of posterior cruciate ligament (PCL), as well as bone tumors had the least frequency rates.

Background and Aim: Staphylococcus aureus can cause a range of diseases including skin disorders, food poisoning and nosocomial infections. Resistance to antibiotics is a major problem and widespread use of antibiotics plays a major role in the emergence of resistant bacteria. The aim of this study was to evaluate the antibiotic resistance and isolation of vancomycin resistance genes inS. aureus strains isolated from clinical samples by multiplex PCR.Material and methods: 150 clinical samples were collected randomly from ulcers and nasal swabs from medical centers in Tehran from April to July 2015. Biochemical and microbiological tests were performed to identify strains ofS. aureus. Antibiotic susceptibility test was conducted by disc diffusion (Kirby-Bauer) method.Results: The highest resistance rate belonged to clindamycin (83.3 %). Vancomycin and linezolid had the highest sensitivity rate (96.6%). Using multiplex PCR, from 60 human samples only one (1.6%) had VanA and VanB genes, but we did not detect VanC gene in the samples.Conclusion: The results showed a high prevalence rate of S. aureus with low resistance to vancomycin in the clinical samples.

Background and Aim: The purpose of the present study was to examine the immediate effect of massage protocol on proprioception sense of knee and ankle joints in collegiate male athletes.Material and method: The study included 30 athletes of Tehran University, with the age range of 18 to28 years. They were randomly divided into experimental and control groups.Each group consisted of 15 athletes. Using gyroscopes, measurement of proprioception was performed by method of knee and ankle joint repositioning error. The experimental group received 10 minutes of massage. Paired t-test and independent t-test were used to analyze the data.Results: The results of the study showed that use of massage decreased the repositioning error in the knee joint by 0.94 degree and in the ankle joint by 0.86 at plantar flexion and 0.79 at dorsiflexion.Conclusion: Massage can be used for the improvement of proprioception and prevention of injuries in the athletes.

Background and Aim: Urinary stones are considered as the third most common disorder of the urinary tract. ESWL is an effective and non- invasive treatment of urinary stones that can have adverse effects on the kidneys. Changes of Doppler indices i.e. increased RI and PI have been used as indicators for the assessment of the damage to the kidney tissue. But damage to contralateral kidney has been a matter of controversy. The aim of this study was to investigate the changes in Doppler indices in contralateral kidney after ESWL.Material and Method: This was an analytic study and included the patients who had referred to the renal stone crusher section of Imam Reza Hospital for the first time. Doppler indices were measured in the contralateral kidney before and immediately after ESWL by Doppler ultrasonography. Data were analyzed by using SPSS 22 software and statistical tests.Result: RI indices of major renal artery and lobar artery in contralateral kidney increased significantly before and after ESWL from 0.59±0.04 to 0.67±0.04 (P<0.05) and from 0.59±0.02 to 0.66±0.04 (P<0.05) respectively. PI indices of major renal artery and lobar artery in contralateral kidney increased significantly before and after ESWL from 1.11±0.14 to 1.14±0.15 (P<0.05) and from 1.09±0.13 to 1.12±0.13 (P<0.05) respectively.Conclusion: According to color Doppler indices, it seems that use of ESWL can cause damage to kidney tissue and lead to changes in contralateral kidney blood flow in the patients treated with ESWL.

Background and Aim: Physical activity has a dual effect on inflammation. Different studies have showed very contradictory results. The present study was designed to investigate the effects of vitamin D supplementation during 8 weeks of resistance training (RT) on IL-6, TNF-α and CRP concentrations.Material and Methods: In this semi experimental study 20 healthy, sedentary men were randomly divided into two groups [(RT-Vitamin D, n=10) and (RT-placebo, n=10)]. In order to determine IL-6, TNF-α and CRP concentrations, fasting venous blood samples were obtained before and after 8 weeks of supplementation.Resistance training (RT) was performed with increasing intensity every other day (3 sessions per week) for 8 weeks. Intensity of RT increased by 5% every week. During 8 weeks, RTvitamin D group received one dose of vitamin D (50000 IU) every 2 weeks until the end of the training sessions.Results: Statistical analysis revealed significant decrease in the contractions of IL-6 and TNF- alpha in RT-D supplementation group after training compared to the pretest stage (P³0.05).The same results were also found in RT- placebo group (P³0.05), while CRP was not affected by RT- Vitamin D (P˃0.05). However, with time, vitamin D alone had a significant effect on TNF-alpha (P³0.05).Conclusion: Progressive resistance exercise (PRE) can decrease systemic inflammation (SI) indices in the healthy men with normal body fat percentage, although the combination of vitamin D and resistance training can selectively affect systemic inflammation and decrease the levels of these indices.

Background and Aim: Patellofemoral pain syndrome is one of the most common knee disorders in the athletes and women. Despite use of water-based exercise in the treatment of musculoskeletal disorders and sport injuries, its impact on the pain and knee function in the patients with patellofemoral pain syndrome has not been investigated appreciably. The present study made a comparison between the effects of water-based exercise and conventional land- based exercise in the female athletes with patellofemoral pain syndrome.Material and Methods: 20 collegiate athletes with patellofemoral pain syndrome were included in this study and randomly assigned to two groups: water-based (n=10) and Landbased (n=10) groups.Land– based protocol was performed in the gym and water-based training was implemented in the pool. Exercises were designed to strengthen the hip abductors and external rotator muscles. We used NRS to assess pain intensity, and Kujala and LEFS scale for the assessment of the knee function in various activities before and after the exercises protocols. We used repeated measures ANOVA for analysis of the effects of the therapeutic interventions.Results: According to the results of repeated measure ANOVA we found significant differences in NRS (p=0.040) and LEFS (p=0.024) after intervention between the two groups.Statistical analysis showed no significant difference in kujala scores between the two groups (p=0.927).Conclusion: The results showed that water-based exercise as a therapeutic modality was more effective in reducing the pain and improvement of the knee function in the patients with patellofemoral pain syndrome, compared to land-based exercise.

Background and Aim: Domestic violence is one of the major health problems and is a common source of health disorder among women which includes cases of emotional, physical and sexual abuse. The purpose of the present study was to provide a systematic review and meta-analysis study by reviewing the studies on the various forms of physical, sexual, and emotional violence.Materials and Methods: This study included, the full-text studies on domestic violence against women performed from 2001 to 2014. Finally a total of 52 articles were selected using national and international data bases such as Science Direct, Scopus, Magiran PreQuest, SID, Google Schola, and Pubmed. Data analysis was done by meta-analysis method, applying random effects model. Study heterogeneity was measured by I2 test. The data were analyzed by STATA version 11.2.Results: The prevalence rate of emotional-mental violence (59% with CI 95%: 50-67) was higher than those of physical violence (45 % with CI 95%: 34-55) and sexual violence (32% with CI 95%: 25-50). Meta-regression results indicated a chronologically decreasing trend in the prevalence rates of sexual (P=0.083) and physical (P=0.276) violence; and a chronologically increasing trend in the prevalence rate of domestic violence (P=0.377).Conclusion: Considering the high prevalence rate of domestic violence among the Iranian women (especially emotional violence), more studies are necessary to determine predisposing factors for emotional violence. We can also prevent the increasing trend of emotional violence by following policies advocating a higher level of social support for women and increasing the awareness of the public about the importance of the issue.