Viewpoints of students towards educational services quality presented by [expectations and perceptions] Rafsanjan University of Medical Sciences [2008-2009]

The first basic step in planning any quality improvement programs is to determine the educational services quality followed by presenting effective strategies to overcome or reduce the possible gaps in access to standard quality education. This study was conducted to aim of evaluation of the students' viewpoints regarding educational services quality presented by Rafsanjan University of Medical Sciences. This descriptive - sectional study was performed on 310 students studying at the Rafsanjan University of Medical Sciences in the second semester of academic year 2008-2009. The participants were rendomly seclected and the data was collected using a valid and reliable questionaire based on the SERVQUAL [science quality] insterument. The results were then analyzed, in relation to the five service quality [SERVQUAL] dimensions [tangibles; reliability, responsiveness, assurance, and empathy], by t-test and ANOVA using SPSS softwere. The average service quality gap scores was defined as the difference between the average perceptions score and expectations score. Results indicated that the average service quality gap was -1.52 +/- 0.9. The maximum quality gap scores was observed in the faculties of medicine and dentistery respectively [-1.88 +/- 0.8, -2.01 +/- 0.9] and the minimum value was found in the faculty of para medicine [-1.2 +/- 0.7]. The results also showed that there are significant differences among the gap scores of five dimensions. The empathy and reliability dimensions had the minimum gap scores [-1.40 +/- 1] and the tangibles dimension had the maximum value [-1.8 +/- 1.2]. Based on our results, from viewpoints of students, the educational services quality is under the acceptable level. For changing this situation, many actions and measures should be taken including; offering training courses or workshops for academic members and staff, modifying the educational technology, and refurbishing the educational building and campus

[Risk factors and the most common initial symptoms of acute lymphoblastic leukemia in children]

The factors involve in Leukemia are not fully understood. However, research has shown the relationship between this disorder and some risk factors. The aim of this study was to determine risk factors involved in acute lymphoblastic leukemia and its most prevalent clinical manifestations in children residing in Khorasan province. It was a case - control study. The adequate sample size was 100 cases and 400 controls. Controls were matched with cases regarding their sex, age and habitation. Data was collected by face to face interview with patients' mothers and the questionnaires were completed by the investigator. Data was analyzed by conditional logistic regression using SPSS-PC [v.14]. According to the findings of this study, maternal use of oral contraceptives, living in proximity to high voltage power lines, in-utero ionizing radiation exposure, pesticide exposure in fathers and paternal occupation and parental smoking had a significant relation with this type of cancer [p<0.05].the most prevalent mitial clinical manifestations were lethargy and weakness, fever, leg pain, cervical lymphadenopathy, bleeding, abdominal pain and cold symptoms respectively. According to the results of this study, it seems that environmental factors play an important role in etiology of this kind of cancer. Knowledge abort this fact helps us to find appropriate ways to prevent this disease in children

Serum concentrations of Helicobacter pylori IgG and the virulence factor CagA in patients with ischaemic heart disease

To compare the serum concentrations of IgG to Helicobacter pylori and its virulence factor CagA in patients with ischaemic heart disease [IHD], we recruited 120 patients with IHD [acute myocardial infarction [AMI] [n = 60]; unstable angina [UA] [n = 60]] and 60 sex- and age-matched healthy controls in this study. The seroprevalence of anti-H. pylori IgG was 86.7% in AMI, 91.7% in UA patients and 58.3% in the control group with mean titres of 33.2 U/ml [standard error [SE] 4.76], 57.96 U/ml [SE 7.54] and 25.72 U/ml [SE 4.01] respectively. The seroprevalence of anti-H. pylori in the patient groups was significantly higher than the control group. The mean levels of anti-H. pylori in the AMI and UA groups were also significantly higher than in the control group. The seroprevalence and mean titre of anti-CagA IgG did not differ significantly between patient and control groups

[Determinants of smoking behavior among high school students in Jahrom]

Tobacco use is a major contributor to deaths from chronic diseases, one which begins during adolescence. The aim of this study was estimate the smoking prevalence and examines the determinants of smoking behavior among high school students in Jahrom, Iran. This study is a cross-sectional survey that was done in Spring, 2007 in Jahrom. Students were selected by multistage sampling. An anonymous, valid, reliable, self administered questionnaire was filled in by all selected students presented at the day of the survey. Chi-square, student - t and logistic regression test was used to examine the determinants of smoking behavior. The prevalence of smoking among high school and pre-college students was 9.4% and 12.7% respectively. 53% of high school and 88% of pre-college students received cigarette their first time from their friends. The most powerful determinant of smoking among students of both school levels was sex. Effective smoking prevention programmers should take into account the dominant influence of peers and family members and also its focuss on the age of onset and maintenance of smoking behavior

Time-dependent changes of immunologic responses after burn injury and immunomodulation by cimetidine and pyrimethamine in an animal model

Severe suppression of the immune system is the major cause of infections following burn injury. The aim of this study was to investigate the time-related alterations of immune responses following thermal injury in an animal model and also to modulate immune responses by use of the immunomdulators cimetidine and pyrimethamine. Male Balb/c mice were anesthetized and given a 10% total body surface area full-thickness burn. The timedependent changes of delayed type hypersensitivity [DTH] and antibody responses to sheep red blood cell [SRBC] were assessed at post-burn days [PBD]. The effects of different doses of cimetidine and pyrimethamine on DTH response were also quantitated at 10 PBD. Marked suppression of DTH response occurred during 30 days after burn trauma, with maximal suppression occurring between 10 to 14 days after burn injury. Simultaneously the antibody response to SRBC was significantly increased after thermal trauma. Cimetidine [at doses of 10 and 15 mg/kg] and pyrimethamine [at doses of 5 and 10 mg/kg] significantly augmented DTH response after thermal injury. These results showed that the severe time-dependent alterations occurred in DTH and antibody responses following burn injury. Cimetidine and pyrimethamine also restore burn-induced suppression of DTH response following thermal trauma

[Evaluation of relation between polymorphisms in -590 region of IL-4 and occult HBV infection]

Occult Hepatitis B Infection [OBI] is a form of hepatitis in which despite of absence of detectable HBsAg, HBV-DNA is presented in patients peripheral blood. Responsible mechanisms of progression of OBI are unknown yet, but some investigators believed that the genetic and immunological parameters may be different. Cytokine network system could be leading alteration in viral immune response. IL-4 as an anti-inflammatory cytokines causes decreased immune function. Thus, regulatory factors which influences expression and function of IL-4 can be effective on immune system functions. As polymorphic variation in cytokine genes has regulatory effects on their expression and functions, this study investigates the association of-590 region polymorphisms of IL-4 with OBI. Determination of association between IL-4 polymorphisms with OBI. In this study, the plasma samples [FFP] of 3700 blood donors were tested for HBsAg and anti-HBs by ELISA. The HBsAg negative and anti-HBc positive samples were selected and screened for HBV-DNA by PCR. HBV-DNA positive samples assigned as OBI cases while HBV-DNA negative samples were used as control and PCR-RFLP was performed to examine the presence of polymorphisms in -590 regions of IL-4 genes of patients with OBI. 352 [9.51%] Out of 3700 blood samples were negative for HBsAg and positive for anti-HBc antibody. HBV-DNA was detected in 57[16.1%] of HBsAg negative and anti-HBc positive samples. Our results showed that none of the alleles had significant difference between patients and control group. Our results demonstrated that there is no significant difference between patients with OBI and control cases. Therefore, it seems that there is not any relation between these alleles and OBI and more study should be done on polymorphisms in other to cytokine genes in patients with OBI

Occult hepatitis B virus infection among blood donors with antibodies to hepatitis B core antigen

Diagnosis of hepatitis B is routinely based on of serological assay of hepatitis B surface antigen [HBsAg]. Occult hepatitis B virus [HBV] infection is generally defined as the detection of HBV -DNA in the serum or tissues of subjects who have negative test for HBsAg. Transmission of HBV infection has been documented from HBsAg negative, anti-HBc positive blood and organ donors. The aim of this study was to determine the rate of occult HBV infection among HBsAg negative and anti-HBc positive blood donors of Rafsanjan blood transfusion center. Sera from 270 healthy blood donors who were negative for both HBsAg and anti-HCV, were tested for anti-HBc antibodies by use of ELISA technique. The samples that were negative for HBsAg but positive for anti-HBc markers also examined for the presence of HBV-DNA by polymerase chain reaction [PCR]. Out of 270 HBsAg negative blood samples, 14 samples [5.18%] were positive for anti-HBc antibodies. HBV-DNA was detected in 4/14 [28.57%] of HBsAg negative and anti-HBc positive samples. Moreover, anti-HBs antibody was detected in 2/4 [50%] of HBV-DNA positive samples. These results indicated that HBV-DNA found in the majority of HBsAg negative and anti-HBc-positive donors. In addition, the present study recommend the incorporation of routine anti-HBc screening of blood as a surrogate marker of occult HBV infection to prevent some transfusion-transmitted HBV infections

[ effects of low doses of diagnostic x-rays on cellular and humoral immunological responses in balb/c mice]

The immunosuppressive effects of high doses of ionizing radiation have long been known. Recently, in human and experimental animal models it has been reported that low dose radiation may have immunostimulatory effects. The aim of this study was to evaluate the effects of low doses of diagnostic X-ray on cell mediated and humoral immune responses in a Balb/c animal model. In this experimental study, three groups of male Balb/c mice were exposed once, twice and three times to 30 mGy X-ray radiation. Two to 4hrs after the irradiation, the delayed type hypersensitivity [DTH] and humoral responses to sheep red blood cell [SRBC] were measured and compared to the responses of sham and control groups. The mean titer of anti-SRBC antibodies in two-times irradiated [74.66 +/- 26.12] and three-times irradiated [128 +/- 70.1] groups were significantly higher than those of the control [26.66 +/- 8.26] and sham [28.8 +/- 20.86] groups [p<0.001]. However, no significant differences were observed between the mean titer of anti-SRBC antibodies in one-time irradiated [22.4 +/- 8.76] and either control or sham groups. Similarly, comparing DTH responses showed that the differences between either two-times irradiated [12.2 +/- 3.9] or three times-irradiated [6.9 +/- 3.7] and control [4 +/- 0.2] or sham [4.3 +/- 3] groups was statistically significant [p<0.001]. Theses results showed that twice and three-times irradiated mice demonstrated significant stimulatory effects on both DTH and antibody responses. However, one-time irradiated animals did not exhibit any bio-positive effect on DTH and humoral responses. Moreover, no statistically significant difference was observed between the DTH and antibody responses of two-times and three-times irradiated mice

[Occult HBV infection in HBsAG negative and anti HBC positive blood donors]

In recent years with introduction of better screening tests, the risk of infection with transfusion- transmitted viruses has been reduced remarkably, although obtaining a zero-risk blood supply still remains international blood transfusion services goal. The routine test for detection of HBV infected blood samples is examination of HBsAg with ELISA method but in occult I-mV infection, HBsAg is not detectable by ELISA. Therefore, a more sensitive or complementary test is needed. Some international blood transfusion services have introduced anti-HBc screening as a surrogate test for the presence of HBV infection. The aim of this study was to evaluate the prevalence of occult I-IBV infection in Isfahanian blood donors and the potential value of anti- HBc testing of donors as a screening test to detect occult HBV infection. In this descriptive cross-sectional study, 545 blood units were collected [from Isfahan blood center] and tested by HBsAg ELISA kit from April to June 2004 and then all HBsAg negative samples were tested by anti-HBc ELISA kit. To detect occult HBV infection, all HBsAg negative and anti-Mile positive samples were tested by PCR method. All samples were negative for HBsAg while 43 blood units were anti-HBc positive [8%]. These HBsAg negative and anti-HBc positive blood units were tested for HBV DNA of which five units [% 11.6] were HBV DNA positive. Occult I-IBV infection is a clinical form of HBV infection that cannot be detected by usual method [ELISA] for HBsAg and therefore more sensitive techniques are needed for detection of FIBV infection. PCR is a sensitive technique that detects IIBV DNA even in a trace mounts. Our results identified that more sensitive and complementary tests such as, PC.R and anti-HBc, are essential and helpful to ensure safety of blood units

comparison of salivary IgA and IgE levels in children with breast- and formula- feeding during infancy period

Oral local immune factors may play a protective role against oral diseases and defend against microbial agents. Salivary immunoglobulin A [IgA] is a major factor for the local host defence against caries and periodontal disease. The aims of this study were to determine the concentrations of salivary IgA and IgE levels in breast-fed and formula-fed children in infancy period. Totally, 80 healthy 5 years old children were included in the study. According to type of feeding in infancy period, the children divided into two groups: 50 breast-fed and 30 formula-fed. One milliliter of saliva was collected from each participant, centrifuged, and stored at -70 °C. The salivary IgA and IgE concentrations were measured, using ELISA technique. In breast-fed children, the salivary IgA level [39.6 mg/1 +/- 17.3] was significantly higher than that in formula-fed children [26.9 mg/1 +/- 14] [P=0.0001]. However, the salivary IgE level was significantly lower in breast-fed children, comparing with formula-fed ones [5.01 lU/ml +/- 19.70 vs. 11.74 lU/ml +/- 39.40] [P=0.047]. These results suggest that breast feeding enhances salivary IgA level in the early period of life which may contribute in oral cavity immunity. Higher salivary IgE level observed in formula-fed subjects may have a potential role in development of allergic or inflammatory reactions

[Gene cloning and expression analysis of Gro/KC by primary hepatocytes]

It is now well established that several environmental stresses lead to activation of p38 MAP kinase and JNK in various cell systems which is followed by chemokine production. We investigated the expression of both CXC chemokines SDF- 1 alpha[ELR] and Gro/KC [ELR[+]] in rat H4 hepatoma cells in response to heat shock, hyper-osmolarity and oxidative stresses. The pattern of expression of these chemokines by hepatoma cells in response to stress conditions was also studied. Hepatoma cells were maintained in MEM medium. Cells were subjected to different stresses [H[2]O[2] 0.15% [w/v], manitol and NaC1 [160 mM] and heat shock [[42[degree sign] C for 20 minutes]]. At the indicated time points, cells were harvested and RNA was extracted, purified and expression of the chemokines were analysed by RT-PCR. cDNA was separated by gel electrophoresis on a 1% [w/v] agarose gel and visualized on a UV transilluminator. Results obtained in this report showed that there was detectable but low expression of chemokines in H4 hepatoma cells. Heat shock failed to induce expression of chemokines in H4 rat hepatoma cells. Hyper-osmolarity also has not stimulated Chemokines expression. In this study we have also shown that oxidative stress did not induce expression of chemokines. Overall, although detection is possible but regularly responses were not observed in H4 hepatoma cells. Several known injurious conditions cause recruitment of macrophages, neutrophils and other immune cells to the liver. Immune cells are recruited to the hepatic vasculature following local liver injury and consequent chemokine production. Our results demonstrated that failure in production of these chemokines by Hepatoma cells may be a way to escape from immune surveillance

[Evaluation of the stress effect on expression of BEST-5 gene in cultured rat hepatocytes and cloning of this gene]

Liver has important roles in body metabolic regulation and for this reason hepatocytes are used worldwide. Investigations showed that isolation of hepatocytes causes activation of stress related genes. The aim of this study was to study the stress related expression of BEST-5 following hepatocytes isolation and culture. The BEST-5 gene is cloned and analyzed for the first time from isolated and cultured rat hepatocytes. Very little is known about this gene and almost nothing is known about its function. RNA was isolated from hepatocytes after 3h culture and used for generation of PCR products corresponding to the BEST-5. cDNA generated was cloned into pCR[R]2.1 plasmid vector. Following transformation into TOPO10 oneshot [R]cells, the cells were grown in LB agar plates containing X-Gal and ampicillin, overnight at 37[oC]. To confirm that the plasmids contained inserts of the correct size, the vectors obtained from mini-preparations were digested with the desired restriction enzymes. Sequencing was performed for the gene. RT-PCR and Northern blotting analysis showed that BEST-5 mRNA is expressed, 3h after isolation and culture of primary hepatocytes [3h] BEST-5 mRNA was observed until 5h of culture and then there was no detectable band of BEST-5 at further time points. Comparison of expression of the level of mRNA of BEST-5, when data statistically were analyzed, showed a significant difference between the expression of BEST-5 mRNA expression at 3h with 0h, 24h, 35h and 48h of culture [P<0.001]. According to the results the stress induced by hepatocytes isolation and culture leads to the expression of Best-5 time-dependently

[Evaluation of serum anti-HBS concentration in children vaccinated with recombinant hepatitis B vaccine at birth]

Vaccination with the major surface antigen of hepatitis B virus [HBsAg] induces anti-HBs antibody production and level of 10 IU/L is considered protective. It has been shown that the level of anti-HBs antibody does wane after vaccination. The aim of this study was to evaluate the persistence of anti-HBs antibodies in healthy Iranian children 10 years after primary vaccination. Blood samples were collected from 146 children, 10 years after completion of primary hepatitis B vaccination course at birth. The sera were tested for anti-HBs, antibody to hepatitis B core antigen [anti-HBc] and HBsAg by use of ELISA technique. At 10 years after primary vaccination, 70 [47.9%] children had protective levels of antibody [anti-HBs> 10 IU/L] with mean titer of 68.1 IU/ml. Moreover, 45 [30.82%] children were negative for anti-HBs antibody. Distribution of children according to anti-HBs concentration revealed that the proportion of subjects with antibody titer of 0-10 IU/L, 10-100 IU/L, 100-500 IU/L and 500-1000 IU/L was 52.1%, 24.6%, 20.5% and 2.7%, respectively. All children were negative for HBsAg, although anti-HBc was positive in 11 [7.5%] children. There was no difference in the seroprotection rates of males and females. The results of present study show that after 10 years after primary vaccination with recombinant HB vaccine, 47.9% of the children had protective levels of anti-HBs antibody. On basis of the HBsAg and anti-HBc results, it seems that effective immunological memory exists in children. Additional follow-up studies need to be conducted to determine the duration of protection

[Antimicrobial effects of pinus eldarica's gum and its alcoholic extract on some bacteria of skin infections]

Bacterial resistance to antibiotics and synthetic compounds a increasing continously. The aim of this study was to evaluate the antibacterial effects of Pinuseldarica's gum and its alcoholic extract on Staphylococcus aureus and Escherichia coli which cause some skin infections. After preparing pinus eldarica gum, it was diluted in oleic acid to achieve the concentration of 50% and 75%. The concentration of 50% and 75% of gum's extract ah prepared by soaking the gum in alcoholic solution. Oleic acid and cotrimoxazole were used as control groups. Kirby - bauer method was used as an antibiogram test. Data were analysed by ANOVA variance and Tukey HSD test.In comparison of the effect of 50% and 75% of gum on E-coli, we observed that; there we no remarkable differences between them, but these concentrations of gum were more effective than cotrimoxazole on the inhibition of growth of E-coli. In case of Staphylococcus aureus we observec the negative effect of mentioned concentrations of gum, gum's extract and cotrimoxazole on its growth, but there was no considerable differences between the different concentration of gums, 50% of gum with 50% and 75% of gum's extracts and 75% of gum with 50% of gum's extract o Staphylococci growth.Overall, the study showed that Pinuseldarica's gum has strong inhibitory effect a some microbes. This effect can compete with cotrimoxazole on S. aureus and can be effective on cotrimoxazole resistant E-coli

[Occurance and intensity of parasites from pike [Esox lucius, Linnaeus, 1758 ] in Amir kelaieh Lagoon]

Objective: To study the prevalence and mean intensity of parasites from pike, [Esox lucius] in Amir Kelaieh Lagoon

Design: Descriptive study

Animals: A total of 78 pikes

Procedure: Cutting the wall of body cavity and removing viscera which include intestine, liver, ovaries, testis and etc to isolate the parasites, cutting the muscles and finding the cysts of the parasites in them, fixing the metazoans by formalin 10% and protozoans by schaudinn's fluids, clearing the nematodes by lactophenol, staining the other parasites by acetocarmine and identifying them by identification keys [Moravec, 1994 ; Bykhovskaya and Pavlovskaya, 1962] . Statistical analysis: Calculating the prevalence, mean intensity and range of the parasites by Microsoft Excel and comparing infections based on season, sex and age by Z test and One Way Anova test [P0.05]

Results: Collection of ten different parasite species from pikes of the lagoon including Raphidascaris acus [prevalence = 26.9%, mean intensity = 8.7] ; Camallanus lacustris [p = 6.4%, mi = 1.8] ; Eustrongylides excisus [p =2.6%, mi = 1]; Triaenophorus crassus [p=9%, mi=2.7] ;Trichodina sp. [p = 1.28%, mi=10] ; Tetraonchus monenteron [p = 20.5%, mi = 12] ; Diplostomum spathaceum [p = 7.7, mi = 3.6] Lemaea sp. [p= 2.6%, mi] ; Argulus sp. [p =3.8%, mi = 1.33] ; piscicola .sp. [p =1.28%, mi = I]

Conclusion: The results of the survey showed that the parasite community of pike had much diversity due to piscivorous diet of the fish and the parasites which had vertebrate [fish] intermediate hosts, including Eustrongylides excisus. Raphidascaris acus and etc. the prevalence and mean intensity of Raphidascaris acus were more than other parasites . Camallanus lacustris is reported for the first time from pike in Iran

Unresponsiveness to recombinant hepatitis B vaccine in healthy Iranian neonates: Association with HLA antigens

Hepatitis B is an important infectious disease. Since several years ago, mass vaccination against this viral infection has become as part of routine vaccination schedule of Iran. However, some healthy neonates, children and adults fail to generate a protective antibody response after vaccination. To investigate distribution of HLA class-I and class-II antigens in healthy Iranian neonates vaccinated with recombinant hepatitis B vaccine. HLA-typing was performed on peripheral blood lymphocytes isolated from 25 responder and 23 nonresponder [anti-HBs < 10 IU/L] healthy neonates, using the standard microlymphocytotoxicity method. Anti-HBs antibody was quantitated by sandwich ELISA. The frequency of HLA-DR7 [p<0.01], DQ2 [p<0.02] and DR13 [p<0.05] was significantly higher in the nonresponder neonates compared to the responder group. The DR1 and DQ3 antigens were over-represented [p<0.05] in the responder vaccinees, implying positive association with the anti-HBs antibody response. Statistical analysis revealed increased frequencies of B7-DR7-DR53-DQ2 and DR13-DR52-DQ2 haplotypes in the nonresponder neonates [p<0.05]. Conclusions: We found a significant association between lack of antibody response to recombinant hepatitis B vaccine and expression of certain HLA class- II antigens in healthy Iranian neonates