ABSTRACT
Background: Uncontrolled increase of C-section is one of the major problems in Iranian health system, such that C-section is the most common surgical procedure in the entire country's hospitals in Obstetrics and Gynecology sections. A variety of complications also come along with cesarean
Objective: The aim of this study was to evaluate the prevalence, causes, and complications of cesarean in Iran
Materials and Methods: forty-one articles were considered with respect to certain criteria and were included in a systematic review to perform a meta-analysis study. The systematic review's search was conducted on SID, Iranmedx, Magiran, Medlib, PubMed, and Science Direct databases published between1999-2016. The weight of each included study was calculated according to its sample size and the reported prevalence of binomial distribution. A random-effects model using R and STATA [Version 11.2] software was utilized for analyzing data
Results: The total number of the sample was 197514 pregnant women with a mean age of 26.72 yr. The prevalence of cesarean in Iran was estimated at 48%. The main reasons for the prevalence of cesarean in this study were mothers' higher education, previous cesarean, and doctor recommendation. The most frequent complication in women undergoing cesarean was the muscular pain, and the most common fetal complications in newborns by caesarean delivery was transient tachypnea
Conclusion:The prevalence of C-section in Iran is much higher than what WHO recommends. It is essential, to decrease such a phenomenon, making the mothers aware of the risks of cesarean delivery, and establishing counselling sessions as well to eliminate the mothers' fear of vaginal delivery
ABSTRACT
Aim: The aim of this study is to investigate the Protein-Protein Interaction Network of Celiac Disease
Background: Celiac disease [CD] is an autoimmune disease with susceptibility of individuals to gluten of wheat, rye andbarley. Understanding the molecular mechanisms and involved pathway may lead to the development of drug targetdiscovery. The protein interaction network is one of the supportive fields to discover the pathogenesis biomarkers for celiacdisease
Material and Methods: In the present study, we collected the articles that focused on the proteomic data in celiac disease.According to the gene expression investigations of these articles, 31 candidate proteins were selected for this study. Thenetworks of related differentially expressed protein were explored using Cytoscape 3.3 and the PPI analysis methods suchas MCODE and ClueGO
Results: According to the network analysis Ubiquitin C, Heat shock protein 90kDa alpha [cytosolic and Grp94]; class A, Band 1 member, Heat shock 70kDa protein, and protein 5 [glucose-regulated protein, 78kDa], T-complex, Chaperon incontaining TCP1; subunit 7 [beta] and subunit 4 [delta] and subunit 2 [beta], have been introduced as hub-bottlnecksproteins. HSP90AA1, MKKS, EZR, HSPA14, APOB and CAD have been determined as seed proteins
Conclusion: Chaperons have a bold presentation in curtail area in network therefore these key proteins beside the other hubbottlneckproteins may be a suitable candidates biomarker panel for diagnosis, prognosis and treatment processes in celiac disease
ABSTRACT
Obesity is rising rapidly in Iran. Nutrition is an important issue of obesity; Fruits and vegetables are among the best food sources of antioxidant vitamins, soluble fibers, phytochemicals, and other nutrient constituents. Further, some of these foods have been shown to be protective related to reduction of chronic disease risk. In this study, consumption of fruits and vegetables and body mass index [BMI] among College Students Living in dormitory at Shahid Beheshti University of medical sciences were evaluated. In this descriptive analytic survey, 658 college students whose have being lived in dormitory at Shahid Beheshti University of medical sciences were selected by clustering sampling method. Data collected using a food frequency questionnaire and analyzed by SPSS[16] software. Mean age of participants was 21.82 for females and 22.76 years for males. Frequency of fruits consumption was 2.6+/- 0.9 per day in female and 2.3+/-0.7 in male, while frequency of vegetables consumption was 3.2+/-1.00 in female and 2.9+/- 0.9 per day in male students. In general, consumption of fruits [p=0.003] and vegetables [p<0.001] were significantly more in female than males students. BMI in students was normal. Results indicated that students hadn't optimal practice towards fruits and vegetables consumption. Thus, it is essential that authorities pay more attention to this specific problem in training the students, in order to maintain the optimal nutritional status
ABSTRACT
Chlorotoxin is a 36 amino acids peptide, which is able to block chloride channels isolated from mouse brain. A derivative of chlorotoxin is synthesized and it is labeled by iodine 131; then animal experiments carry out on rats. Multiple organ doses may be calculated with biological distribution results in rats with labeled compounds using simulated MCNP4C code. Human dose can be calculated using the dose distribution in rats with a conversion ratio for dose distribution. Chloramine T is our method for marking, and electrophilic substitution reactions are methods for iodize of peptides. Simulation of a human phantom to evaluate dose distribution was done using simulation code MCNP4C. To evaluate the dose distribution in the human body, using this code and the accumulated activity in each organ tissue dose is calculated. To study the biological distribution of the radiotracer 131I, 0.37 MBq radiotracer was injected into rat via the tail vein. The accumulated activity in each organ with the agent "ID / g" is determined. Biological distribution of 131I-chlorotoxine in the normal rats is obtained. Its Decay constant in the liver is 0.07h and the effective half-life of the radiotracer is 10h in rat liver. The total number of particles found in the leak from liver tissue was reported 67600. Liver tissue dosimetries originating from other sources [thyroid tissue, stomach, kidney, right and left lung, spleen, and pancreas] were examined. Then, the overall dose to the target tissue will be calculated. Leaked beta particles in liver itself [self-dose] are the most delivered dose to the liver [98%]; it is for gamma rays 1.1%, while its source is adjacent tissues in addition to liver [cross-dose]; Because of low atomic number of the tissue, delivered dose originated from Bremsstrahlung [braking radiation] is low [0.9%]. Radiation dose to the liver in intravenous injection of 0.37 MBq [131]I-chlorotoxine radiotracer is 3.44 [asterisk] 10-6
ABSTRACT
Student evaluation of the quality of instruction is considered as one of the most widely used methods for assessing faculty in universities. This study aimed to identify and compare faculty and students' views about the evaluation system of the quality of faculty teaching in 2011-2012 in Ilam University of Medical Sciences. In this descriptive - analytical study, statistical population was included faculty members [n = 92] and students [n=1,100] that their viewpoint in three fields: competence of students for evaluation, assessment tools quality and factors affecting the results of the evaluation using two designed questionnaires and descriptive and inferential statistics analyzing data, were studied. Scores of participants' viewpoint was as follows: Students capacity to do faculty proficiency evaluation [3.62+/-0.91], evaluation of teaching methods[1.01+/-3.72] evaluation and scoring methods[3.41+/- 1.01] and their suitability for evaluation of designing of the course content [3.16+/- 0.99], the number of questionnaire questions [3.25 +/- 0.9] Matching evaluations tools to evaluation goal or validity [3 +/- 0.96] how to design questions [3.20+/- 0.96] and the rate of bias in the questionnaire [3.16+/- 1.02], In addition, the effect of factors on student evaluations was as follow: factors related to the student [3.62+/- 1.06], factors related to the course and class [3.29 +/- 1.06], factors related to the instructor [3.64 +/- 1.01], and factors related to the evaluation system [3.18+/- 1.11]. Compare the viewpoints of faculty and students also showed significant differences in two groups' viewpoints [p <% 5].
Despite the current evaluation system is partially confirmed by the study subjects but due to the influence of the results of variety of factors, significant objections have been raised, particularly from faculty, when it is used as the only source, so that in order to reduce weaknesses and strengthen the evaluation system, the review of evaluation form and methods of designing in line with increasing the validity and reliability should be done
ABSTRACT
Establishing of total quality management in any organization including emergency medical services need to an appropriate tool to help developing, implementing and evaluating of quality programs. The objective of this study was to develop a valid and reliable tool for self assessing enabler criteria of Iran EMS centers according to European Foundation for Quality Management [EFQM] model.The study was conducted using the Delphi method, and 43 participants as panelists were enrolled in 3 round modified Delphi technique. Initially, a rating scale was developed in response to main question of study; which items should be contained in self assessing tool of quality in Iran EMS area? This scale was judged by 5 experts primarily, and after some modification was entered in Delphi process. The comments of panelist were collected by E Mail and final scale was developed in the end of 3th rand.Pre-hospital Emergency Self assessing Rating Scale [PHESARS], Was main result of this study that developed in 190 items in 5 enabler criteria according to EFQM model including; Leadership [52], Policy and Strategy [21], staff [41], Resources and partnership [36] and Processes [40].Self assessing scale was developed by TQM and excellence perspective and because of experts' consensus in developing it, has content validity and can be used in self assessing of pre-hospital area and determining improvement opportunity and, can leads the Iran EMS centers to total quality management and organizational excellence
ABSTRACT
The Pain is the most common complaint in various diseases. Postoperative pain is common complication and spatially in elderly patient because of exacerbation of heard and vessel was impotents. The aim of this study was evaluation of the effect of low-dose IV dexamethasone on postoperative pain in patients with lumbar discectomy. In a clinical trial that studied in neurosurgery wards of Shohada and Imam Reza hospitals affiliated to the Tabriz University of Medical Sciences on patients underwent lumbar discectomy, the effect of low-dose IV dexamethasone on postoperative pain was evaluated. 80 patients divided in 2 equal groups, we used IV morphine [present routine treatment] in group A and IV morphine in addition to 8mg IV dexamethasone in group B, for reducing post lumbar discectomy pain. 21 patients in group A, and 22 in group B were male and 19 patients in group A and and 18 in group B were female [P=0.823]. Mean age of patients in groups A and B was 39.32 and 39.22 years, respectively [P=0.945]. Mean of pain score [VAS] at 6 hours post-operation in group A and B was 6.97 and 6.75, respectively [P=0.065]. VAS at 12, 18 or 24 hours post-operation in both groups didn't differ significantly, too [P>0.05]. We didn't observe any significant reduction in post lumbar discectomy pain after adding 8 mg dexamethasone into morphine. Regarding other studies, it seems that higher doses of dexamethasone should be used to achieve a significant pain reduction
ABSTRACT
Effects of homogenization sequence [before or after heating] and homogenization pressure [0, 50, or 150 bar] were studied on the certain textural properties of milk-based creamy dessert including hardness, surface tension and syneresis. Also, the microstructure of the treatments was analyzed using scanning electron microscopy [SEM]. Homogenization at 50 bar after heating led to the highest hardness, whilst unhomogenized and homogenized treatments at 150 bar before heating resulted in the lowest hardness. Using pressure of 50 and 150 bar after heating led to the highest and lowest surface tension, respectively. While the highest syneresis was observed when unhomogenized treatment applied, the lowest syneresis was obtained using primarily the treatments with homogenization after heating and then the treatments with homogenization before heating. Finally, good correlation was observed between the textural and rheological results and the micrographs of microstructure obtained from SEM method
ABSTRACT
Diabetes mellitus is one of the most common chronic diseases in nearly all countries. It is difficult to treat and expensive to manage. The development of type 2 diabetes is strongly related to lifestyle factors, thus it might be a preventable disease. Observational studies and intervention trials have shown that physical activity, weight loss and dietary intake including whole grain, dietary fiber and dietary fat are important in delaying and preventing type 2 diabetes. The aim of this review is to gather current information from epidemiologic and clinical trial studies on dietary and lifestyle practices for reducing the risk of type 2 diabetes. The review focuses on the macro and micronutrients, food items and dietary patterns which have been identified as significant in the prevention and management of type 2 diabetes. Also, the role of physical activity and weight loss are presented
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The subjective of this study was to explore and compare the effects of Whole Body Vibration [WBV] and conventional spinal stabilization exercises on persons with non-specific chronic low back pain [CLBP]. Thirty patients with non-specific chronic low back pain randomly received 6 sessions of spinal stabilization therapy with and without whole body vibration over 2 weeks. The severity of pain, functional disability, abdominal and lumbar multifidus muscle endurance were assessed prior to, midway and after two week WBV or spinal stabilization intervention program sequentially by using VAS score, Oswestry disability index and stabilizer pressure biofeedback unit. Repeated measure ANOVA was used for data analysis. A p-value <0.05 was considered as statistically significant. Findings show that multifidus muscle endurance and general functionality increase significantly over time in both groups [P <0/05]. Both groups didn't show any statistically significant change in perception of pain, supine and prone time after the treatment period [P>0/05] .Neither of the two exercise interventions wasn't superior in producing more significant results except for multifidus and transverse abdominus muscles endurance where the vibration group showed significant improvement over the non-vibration group. Findings revealed that a slight difference existed in favor of the vibration training group, but not sufficient enough to conclude that it is more effective than core muscle exercises alone
ABSTRACT
Fish consumption twice per week" recommendation has been adopted in many countries, including Iran, by Nutrition experts. Data derived from food balance sheets [FBSs] and national household food consumption surveys [NHFCSs] show that fish consumption has been increased in the last 20 years in Iran. The gap between supply and recommendation figures in order to analyze the feasibility of this policy however needs to be determined. In this study, we took current figures of fish supply and consumption in Iran and calculated the amount of fish needed to support the recommendation of fish consumption. Data obtained from FAOSTAT-FBSs in 1980-82, 1990-92 and 2000-02, and NHFCS reports in 1992-95 and 2001-03. Fish supplies needed to fulfill the nutritional policy were calculated based on 120 and 180 gr/caput/wk scenarios. Sharp increase happened in the average fish supply from 1980s to 1990s, but slowed down afterwards. In early 2000, fish availability and intake were 4.73 and 4.43 kg [as raw-whole fish]/capita/year, respectively. The amount of fish required to fulfill the recommendation were however calculated as 10.97 and 16.43 kg/caput/yr based on the two scenarios, respectively. This study reveals that the gap between present fish consumption and the amounts for nutritional goal is still big. Whether bridging this gap in terms of feasibility, ecological, environmental and logistical burdens is attainable, needs more evaluation. Nutrition educators should be aware of the effects of their campaigns on the nationwide food policy as well as on issues such as consumer demand, prices, and environment
ABSTRACT
HSA plays an important role in transporting metabolites and drugs throughout the vascular system. In as much as its performance is very vital in the presents of different kinds of ligands at the specific body temperatures, its examination is crucial. This molecule can undergo increased glycation in diabetes. Therefore, glucose as the one of the most fundamental ligands dealing with albumin in human body is examined in this study at 100 mg/dl concentration in correspond to normal condition on human body, 175 mg/dl as a kidney glucose tolerance point and also 400 mg/dl as the critical point at the two most important temperatures in diabetic patients. Thermal conformational changes of [HSA] are important. These conformational alterations are accompanied by a mild alteration of secondary structures. For this reason, possible secondarystructural changes of HSA in presence of glucose has beeninvestigated by circular dichroism [CD] using Hepes bufferat the normal temperature 37 degree C and 42 degree C as a high fever condition.UV spectroscopystudies confirmed CD findings and indicate that critical concentration of glucoselead to generation of new structural feature of albumin similar to 42 degree C. However, as the temperature increases from 37 degree C to 42degreeC this process is no more capable of responding to glucose concentration changes. These results indicate that the native form of HSA is changed in the severe diabetic condition; likewise, same consequences can be achieved as the temperature arises from 37 degree C to 42 degree C
ABSTRACT
Based on a number of studies, magnesium sulfate [MgSO4] given after a diffuse axonal injury has gained attention as a useful neuroprotective agent. The present study was conducted to examine if magnesium sulfate has a therapeutic efficacy and safety in patients with a severe diffuse axonal injury. Adult patients admitted within 1 hour of a closed Traumatic Brain Injury [TBI] with a severe diffuse axonal injury that met eligibility criteria were randomized into two groups. Our treatment guidelines consisted of an initial loading dose of 50 mg/kg magnesium sulfate and then 50 mg/kg QID up to 24 hours after the trauma. The outcome measures were mortality, GCS, and motor function scores which were assessed up to 2 months after the trauma. Magnesium showed a significant positive effect on GCS 2 months [P=0.03]. Among those in MgSO4 group, motor functioning score improved more than control group but this was not statistically significant [P = 0.51]. At the end, we have demonstrated that administration of magnesium sulfate can have neuroprotective role following severe DAI
ABSTRACT
Opiates such as morphine are one of the most effective classes of medication prescribed to treat both acute and chronic pain.They act to suppress pain through mu-receptor activation on primary afferent nerve fibers, dorsal horn neurons and supraspinal pain center neorons. When morphine is administered epidurally, it diffuses to the cord substance, producing analgesia [1]. The aim of this study was to check the efficacy of this method for controling postoperative lumbar pain after microdiscectomy. In a randomized clinical trial, numbers of 100 patients were included into two equal groups due to low back radicular pain and underwent microdiscectomy. In study group, an absorbable gelatin sponge [Gelfoam] is contoured to the epidural space, placed in methylprednisolone acetate [40-80 mg], and then injected with 2 mg/ml morphine and control group received an absorbable gelatin, placed in methylprednisolone acetate [40-80 mg] and were injected with normal saline [5mL] as a placebo. The main outcome to be compared between trial and placebo groups were: Patient comfort rate in recovery room and ward, amount of analgesics used, postoperative ambulation time, post operative hospitalization days. The restlessness and agitation during recovery in study group was lower than control group. Mean systolic blood pressure increment was lower in morphine group. Only 6% of patients in study group compared to 98% in placebo group had either moderate or severe pain six hours after operation. Mean morphine dose used for study group was 10.75 mg compared to 21.4 mg among control group patients [P < 0.0001]. Mean ambulation time was 2 days among study group patients compared to 2.6 days in control group. Mean hospitalization length was 4.7 and 7 days in study and control group respectively. By means of the technique assigned to the patient [an epidural morphine sponge] during Lumbar microdiscectomy the results were: Better controlled postoperative pain, early ambulation of patients and decreased hospitalization length
ABSTRACT
This study was conducted for external evaluation of one intervention that has been carried out by traffic police. In this study the efficacy of provisional driver licensing on reducing traffic injuries and the intensity of injuries [fatal or non-fatal] was investigated. Data on traffic accidents and injuries from one year before till two years after the implementation of provisional driver licensing were obtained from traffic police data base. After data cleaning and stratification traffic injuries and mortalities, the implementation of graduate driver licensing compared in those in early years of their driving experience. Drivers under 23 years of age consisted 22.8% of total road traffic injuries [RTIs] in the year prior to the implementation of graduate driver licensing. This proportion reduced to 15.5% and 16.1% in the first and second year after implementation, respectively, among holders of provisional B1 type driver license [P<0.001]. Our findings suggested that this intervention was efficient in reduction of intensity of traffic injuries and provisional driver licensing was also efficient in reducing the crude number of traffic injuries. More interventions such as demerit points, license suspensions and vehicle confiscation might be implemented to prevent RTIs in long term