Ardabil University of Medical Sciences
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The relationship between serum lactate and VO2/VCO2 in patients undergoing coronary artery bypass grafting in Ardabil city hospital, 2017
Get PDFBackground: VO2/VCO2 ratio and blood lactate are different indices of adequacy of oxygen delivery to oxygen needs. The aim of this study was to investigate the relationship between serum lactate and VO2/VCO2 in patients undergoing CABG in Ardabil city.
Methods: This descriptive-analytical study was performed on 30 patients who underwent CABG at Ardabil city hospital during 2017. Demographic data of patients including age and sex were collected. Standard monitoring included electrocardiogram, invasive arterial pressure, pulse oximetry, end tidal carbon dioxide, temperature and urine output was done. The CAB was carried out through a CPB pump at the time of grafting. Blood lactate and VO2/VCO2 were measured in 3 groups of patients based on number of grafts, EF and serum Creatinine. Collected data analyzed by statistical methods in SPSS version 19.
Results: Most of patients were male (86.7%). The mean age of patients was 58.1 years. The blood lactate and VO2/VCO2 values increased after surgery. There was no statistically significant difference in two groups based on number of grafts and serum Cr but it was statistically significant based on E/F. There was a significant correlation between Blood lactate and VO2/VCO2 ratio in patients.
Conclusions: The results showed that blood lactate as an indicator for patients status during CABG surgery can be replaced with VO2/VCO2
Effectiveness of Transcranial Direct Current Stimulation on Worry, Anxiety, and Depression in Generalized Anxiety Disorder: A Randomized, Single-Blind Pharmacotherapy and Sham-Controlled Clinical Trial
Get PDFBackground: Due to low adherence to treatment and side effects of pharmacotherapy, using new brain stimulation, such as transcranial direct current stimulation (tDCS) in patients with anxiety disorders are available.
Objectives: The present research was performed to evaluate the efficacy of tDCS and compare it with pharmacotherapy on reduction of worry, depression, and anxiety in a group of Iranian patients with generalized anxiety disorder (GAD).
Methods: This study was a quasi-experimental research. A total of 18 patients (46% females and 64% males) with GAD were randomly assigned either to tDCS, pharmacotherapy or sham conditions. Stimulation was delivered over the contralateral deltoid at 2 m/A during 20 minutes in 10 sessions of 4 weeks. Symptoms were assessed by a 7-item GAD scale, HARS, HDRS, and PSWQ in pre-test, post-test and follow up assessment (2 months later). Analysis of variance with repeated measure was used to analyze the data.
Results: The results showed that both tDCS and pharmacotherapy were effective in reducing worry symptoms, also the pharmacotherapy group compared with the tDCS group and sham condition was more effective in treating of worry. Anxiety symptoms were reduced by both tDCS and pharmacotherapy and the difference between the 2 methods was not significant. Finally, the effectiveness of tDCS therapy on reducing depressive symptoms was more significant than pharmacotherapy.
Conclusions: The tDCS is a promising treatment for generalized anxiety disorder, especially in depressive and worry symptom
Study of Health Status and Prevalence of Symptoms of Temporomandibular Joint Disorders in Dental Students of Ardabil University of Medical Sciences during 2017-2018
Get PDFBackground & Aim
Temporomandibular disorders (TMD) are a subgroup of painful orofacial disorders involving pain in the temporomandibular joint (TMJ) region. TMD prevalence is higher among different societies and variable incidence rates are reported for it. The present study determined the health status and incidence of TMD among dental students of Ardabil Dental School during 2017-2018.
Materials and Methods
In a descriptive cross-sectional trial, 113 dental students ( mean age of 23.3 years old) were studied. The data were obtained by a questionnaire and clinical examinations while different aspects of TMD were analyzed. The frequency and percentage of TMD signs and symptoms were calculated and the difference of TMD incidence in both genders were analyzed by chi-square test.
Results
In total, 53.1% (60) of participants had TMDs. Furthermore, 25.7% had the history of pain in the TMJ region, 22.1% had sounds during the lateral movements, 16.8% had headache history in the tem-poromandibular region and 7.1% had the history of jaw fix. Limitation in the protrusion was seen in 16.8%, in the lateral movements was seen in 22.1% and limitation in the mouth opening was seen in 4.4% of the populations. Again, 11.5% had pain in the temporal muscle, 12.4% had masseter muscle pain, 8.0% had pain in the lateral region of TMJ, 5.3% had pain in the posterior area of mandible, 3.5% had pain in the lateral region of ptrygoid muscle and 2.7% had pain in submandibular area. TMD incidence was significantly higher in the females compared to the male participants (65.4% vs. 42.6%; p<0.02).
Conclusion
Therefore, TMD was observed in more than half of studied dental students and the incidence of TMD in females was higher than males
Relationship between Locus of Control and Burnout among Health Information Technology Staffs at University Hospitals in Ardabil
Get PDFBackground & objectives: Burnout in addition to physical exhaustion due to work overload or conflicts between people has a psychological origin. The aim of this study was to determine the Locus of Control and Burnout among the employees of the Health Information Technology (HIT) unit of hospitals.
Methods: In this cross-sectional study, all 82 employees of HIT unit of university hospitals in Ardabil participated. The data collection tool was two standard questionnaires including Rutter's Locus of Control and Maslach's burnout scale. Data were analyzed by descriptive tests, Pearson correlation coefficient and regression using SPSS (ver. 22).
Results: 37% of the participants had an internal locus of control and 63% had an external locus of control. Participants had severe burnout in the components of emotional exhaustion and Depersonalization, and mild burnout in the component of individual success. Finally, the relationship between locus of control and burnout components was significant.
Conclusion: This study shows that the source of the locus of control is external among the majority of participants. There are also some degrees of burnout among them. In addition, a significant relationship is found between the locus of control and all the components of burnout. Therfore, it is neccesary to have effective workshops on the internalization of the locus of control and, consequently, the reduction of burnout
The effect of the seleno-L-methionin, sodium selenite and cadmium chloride on telomerase activity of chick embryo neural tube cells
Get PDFBackground: Telomerase is a ribonucleoprotein enzyme with reverse transcriptase activity, that more important in developmental processes including cell proliferation, differentiation, senescence and tumorigenesis. Selenium as a trace element for animals and human has been detected which can have anticancer properties, while cadmium (Cd) is a heavy metal in the natural environment and is very toxic. Purpose of this study was investigating the effects of Seleno-L-methionine, Sodium selenite and Cadmium chloride on the expression of telomerase activity in Chick embryo neural tube.
Methods: Using quantitative and qualitative methods RTQ- TRAP and TRAP assay, the effect of the noted elements on the telomerase activity of Chick embryo neural tube was studied.
Results: Unlike expected, seleno-L-methionine increased telomerase activity. Cadmium chloride had the greatest effect on telomerase activity, while the effect of Sodium selenite was lower than two others. However, the increasing effect has been determined.
Conclusions: All three compounds at concentration of 5 μM and effect time of 6 hours had most impact on Chick embryo neural tube telomerase activity compared to the control groups. Cadmium chloride had greatest effect and sodium selenite were less effective
Mediating Factors in Early Diagnosis of Breast Cancer: from Initial Changes in Health to Breast Cancer Detection
Get PDFBackground: Breast cancer is one of the most frequently occurring cancers in women throughout the world. In Iran, according to available reports, 70% of patients with breast cancer are detected at the advanced stages of the disease. Materials and Methods: This study is of descriptive-analytic cross-sectional type.160 female patients was selected. The data in this study was collected via face to face interview using a questionnaire based on the Anderson’s
delay model. Data were analyzed using SPSS 22 and the significance level was considered to be 0.05. Results: The
results showed that presence of mass was the first symptom in many of women, i.e., 76 cases (47.5%). not only the presence of mass in the breast, but also any other symptom, hadn’t been taken as a serious problem initially by women.
Non-improvement of the symptoms and exacerbation of the symptoms was considered as a symptom of illness by patients. After considering the changes as the symptoms of illness, patients had tried to treat the disease through different methods of self-treatment. The failure of the self-treatment in controlling the symptoms, had directed the patients toward seeking for medical services. Out of 160 patients, 49 patients (39.6%) changed the time of their appointment with doctor. 110 cases (68%) out of 160 patients, rather than initiating relevant diagnostic procedure related to the disease, had received non-specific and non-related therapeutic measures. Conclusion: Pondering on the results yields that patient-related delays, resulting from their lack of awareness of the disease, cultural factors, and fear, can only play an important role in postponement of visiting a physician, but in the diagnosis of disease it is the inability of general practitioners in performing differential diagnoses, and making request for related diagnostic measures which can significantly increase the lag time until the onset of the main treatment
Visceral leishmaniasis (kala-azar) in Ardabil province
Get PDFArthropod-Borne diseases are one of the most important public health problems, so that over than one-third of the infectious diseases are transmitted by insect vectors. Leishmaniasis are complex vector-borne diseases caused by Leishmania spp. The disease with a wide spectrum of clinical manifestations ranging from a self-healing skin lesion to lethal form of visceral disease have been reported from over 101 countries and over 350 million people are at risk of contracting the disease. The most important vectors of leishmaniases in the Old World are sand flies of genus Phlebotomus while in the New World Lutzomyia spp transmit the disease.
Visceral leishmaniasis or kala-azar is the most dangerous form of this group of diseases, because lack of timely treatment could kill patients.The Mediterranean type of the disease exists in Iran, caused by Leishmania infantum and domestic dogs and other wild canines are the reservoirs. Although about 100-300 human new cases are reported every year from different areas of Iran. the main foci are in northwestern part, especially Ardabil province . Children under 5 years old are included over 89 percent of patients in the endemic areas of VL in Iran . The most important endemic areas in Iran include the provinces of Ardebil, Fars, Bushehr and East Azarbaijan, Lorestan, Khuzestan and Bushehr.So far in Iran, 53 species of sand flies (43 species of probable species and 10 definite vector species) have been reported from phlebotomises.Using of geographic information system (GIS) is a new technology in the study of diseases transmitted by arthropods (VBDs) such as VL, causing significant changes in data interpretation and decision-making on disease control . Geographical approach will be useful to better understanding of spatial distribution of disease, to better analyzing of the infection data, to correlate their occurrence with climate and environmental variables and to identify and predict the high risk areas. In this study, entomological studies were started from the 1st of May to the middle of November, and the sand flies were collected from 30 studied areas in the Ardabil province by using of sticky traps and idntifided. Arc Map 10.3 software and MaxEnt3.3.3 software were used to prepare dispersion maps and determine risk analysis. For reservoirs (domestic dogs), 23 (1994-2016) official study was conducted in different regions of the province, in which reservoir dogs were investigated using the DAT laboratory method. For human cases, villages with three or more than 3 cases of VL were diagnosed and treated from 2001 to 2015. A total of 347 positive cases of kala-azar have been recorded in the past 15 years across the province, the maximum cases were observed in Meshkinshahr (59.1%) and Germi (23.1%) and the minimum cases were reported in Namin (1.2%) . A total of 2794 sand flies were collected and identified, of which 33% belonged to the Larrossius group. The jackknife test results for modeling sand flags, human cases and domesticated dogs show that: Among the environmental and climate variables, slope, NDVI, aspect , seasonal rainfall and seasonal temperature, the greatest effect on the distribution of sand flies and the probability of presence of parasites in reservoirs and humans. According to the analysis with these software, three regions are considered as high risk areas in province of the probability of presence of parasites in humans and reservoirs and in the possibility of presence of the main vectors (Meshgin shahr, Ardabil and Garmi). The probability of the presence of Leishmania infantum in humans and dogs and the probability of the presence of Larrossious group sand flies in them is more than 70%
The Impact of Orem’s Model-Based Self-care Training on Self-care Behavior and the Quality of Life in Postmenopausal Kurdish Women: A Controlled Randomized Study
Get PDFObjectives: Lack of information on the symptoms of menopause may aggravate symptoms and reduce the quality of life in postmenopausal women. This study aimed to determine the effect of self-care trainings, based on Orem’s model, on selfcare behavior, and the quality of life in postmenopausal women.
Materials and Methods: In this randomized controlled trial, postmenopausal women, referred to the health care centers of Saqqez city, were randomly assigned into 2 groups. Pre-test questionnaires including socio-demographic, SF-12 quality of life, and self-care questionnaires were filled out by all participants. The intervention group received 4 training sessions based on Orem’s model. Participants in the control group were only given routine recommendations in the health care centers. Four weeks after intervention, participants filled out the questionnaires once again. Primary outcome was self-care behavior and secondary outcome was quality of life.
Results: In the present study, 130 participants were equally and randomly assigned into 2 groups. There was no significant difference between the 2 groups in terms of socio-demographic characteristics. Statistical analysis showed that the intervention group had significantly better performance compared with the control group in terms of the self-care behaviors
and quality of life (P<0.05).
Conclusions: Training is one of the most important factors in improving self-care behavior and quality of life. The use of selfcare programs is a safe, noninvasive and inexpensive way to control physical and psychological problems. These programs can be easily taught to the patients (clients); and their impact on postmenopausal women is very importan
Double Right Coronary Artery from Single Ostia
Get PDFCoronary anomalies are rare and usually found incidentally during coronary angiography. Double right coronary artery (RCA) is a rare anomaly that originates from either a single or separate ostia. We report the case of a 68-year-old male with dyspnea on exertion and shortness of breath during the previous month. Electrocardiogram and echocardiography were normal with only moderate pulmonary artery hypertension. During elective coronary angiography, we observed two separate RCAs from a single ostium; both had no significant atherosclerotic lesion. Coronary anomalies are rare, but due to their clinical significance, it is important to diagnose these anomalies for better management
An antibiotic resistance pattern in Isolatesof Escherichia coli producing broad-spectrum β-lactamase from urinary tract infection in hospitals affiliated to Ardabil University of Medical Sciences against nitrofurantoin and phosphomycin
Get PDFBackground and objective: Gram-negative bacilli are the most common cause of urinary tract infection and among them E. coli is responsible for 80% of infections. This bacterium is a natural habitat for human intestinal tract and is associated with many human infections. Related urinary tract infections associated with Escherichia coli producing broad-spectrum beta-lactamases are the main problem in many parts of the world. Increased multi - drug - resistance (MDRs) is commonly associated with a higher proportion of urinary tract infections, which reduces therapeutic options. antibiotic Resistant Escherichia coli (E.coli) is very important in hospitalized patients. The aim of this study was to evaluate the effect of phosphomycin and nitrofurantoin on broad-spectrum β-lactamase producing Escherichia coli isolated from urinary tract infections.
Methods: Samples included urine isolated from patients with urinary tract infection, urine specimens of patients were cultured on McCanky culture media and Eosin methylene blue and Muller hinton agar. Grown-up E. coli were cultured with differential microbiological biochemical tests including fermentation The sugars were cultured in a TSI medium and disk oxidase and performed IMVIC tests. Escherichia coli drug resistance was determined by performing sensitization tests by standardized disk diffusion method using antibiotic disks including ceftazidime, cefotaxime, cefotaxime with clavulonic acid, nitrofurantoin, and phosphomycin. Ceftazidime discs, cefotaxime, cefotaxime with clavulonic acid, and ceftazidime with clavulonic acid show the presence of broad-spectrum beta-lactamases in all types of Escherichia coli with multiple drug resistance.
Results:In this study, 146 isolates of Escherichia coli were examined. Of which 40 (27.4%) were ESBL and 106 (72.6%) Non ESBL. Of the 40 cases of ESBL, 34 cases (85%) were sensitive, and 4 cases (10%) in interstitial status and others resistant to nitrofurantoin. Of the 40 cases of ESBL, 20 cases (50%) were sensitive and 13 cases (32.5%) in interstitial status and 7 (17.5%) cases resistant to phosphomycin. Of 106 non ESBL cases, 93 cases (87.7%) were sensitive and 8 cases (7.5%) in interstitial status and 5 cases (4.7%) resistant to nitrofurantoin. Of 106 cases, 61 cases (57.5%) were susceptible and 31 cases (29.2%) in interstitial conditions and 14 (13.2%) resistant to phosphomycin.
Conclusion: In the present study, it can be concluded that although both groups of ESBL and non-ESBL Escherichia coli were sensitive to both antibiotics of phosphomycin and nitrofurantoin, the sensitivity to nitrofurantoin was significantly higher than phosphomyci