مجله مطالعات علوم پزشکی
سال بیست و پنجم شماره 6 (شهریور 1393)

It was aimed to determine the relation between pathological size of renal cell carcinoma on microscopic pathological parameters of radical nephrectomy specimen. In a retrospective study، we reviewed pathological finding of 76 patients that underwent radical nephrectomy during 2006-2011. We studied the relations between pathological size of tumor with nuclear grade، lymph nodes involvement، lymphovascular invasion، tumor thrombus in renal vein، pyelocaliceal involvement، surgical margin and adrenal involvement. There are significant relations between pathological size of renal cell carcinoma with nuclear grade، lymph nodes involvement، lymphovascular invasion، tumor thrombus in renal vein، pyelocaliceal involvement، and adrenal involvement but not with surgical margin. There is relation between pathological size and pathological parameters of renal cell carcinoma. Further studies need to show that these parameters can play a role in staging of renal tumors.

E-learning is one of the phenomena of modern world that has developed in the information age and the knowledge-based society. The aim of this study was to evaluate the attitudes of Urmia University of Medical Sciences faculties towards the implementation of the e-learning system. The research is a non-experimental descriptive survey. The statistical population of this study included all faculties of Urmia University of Medical Sciences that according to Morgan table were estimated 136. The questionnaire’s validity was assessed by experts and its reliability was calculated by Cronbach’s alpha as 0. 75. For data analysis، correlation، analysis of variance، and independent t-test were used. The results indicated that there was a significant relationship between attitude of faculties toward e-learning and blended-learning (sig= 0. 000، r= 0. 73). The attitude of faculties towards e-learning and their work experience is different (f= 5. 38، sig= 0. 006). But there is no significant difference between the attitude towards e-learning among male and female faculty members (sig= 0. 07، t= -1. 82). Based on the positive attitude of the faculties towards the implementation of the e-learning، it is suggested to improve the status quo and move toward implementation of the e-learning system in Urmia University of Medical Sciences.

Due to the large volume of the data generated in hospitals، it is essential to use hospital information system (HIS) in efficiently handling them. One of the major factors in the HIS is user participation that leads to correctly predicted factors and this fact also increase their commitment to the development of HIS. This study aimed to survey participation rate of users in different stages of HIS development and identified factors affecting it. This descriptive-cross sectional study was performed on 140 users (including physicians، nurses، medical laboratorists، radiologists، HIM and IT staffs) from Urmia University Hospitals in 2013. The data were collected using a self-structured questionnaire whose reliability had been confirmed by specialists as well as its validity by internal consistency method (r =0. 86). The collected data were analyzed by SPSS software using descriptive statistics and analytic al statistics (t-test and chi-square). Correlation analysis showed that a meaningful correlation existed between job and organizational change barriers (p =0. 003)، and also between the history and attitudinal-behavioral barriers (p =0. 006). The highest participation rate of users in the four-stage development of the HIS was related to implementation phase (2. 88) and the lowest participation rate was related to analysis (1. 23). The test results showed that none of the stages of development (analysis، design، implementation، and evaluation) had satisfactory user participation (P < 0. 05). The most important factors in increasing user participation included established teamwork from end-users and the support of top managers from HIS development. According to the survey results، it seems necessary that health care administrators have a detailed plan for user participation that identify the real needs prior to the development and purchase of HIS، and predict ways to increase users’ commitment and motivations to develop maintain and upgrade the system.

As oral lesions could be one of the first clinical signs in HIV infected patients and an indicator of CD4+ decrease، this study was aimed to determine the prevalence of oral soft tissue lesions and their relationship with CD4+ lymphocyte in HIV infected patients. In this analytical-cross-sectional study performed on subjects attending to Imam Khomeyni and Masih Daneshvari hospitals of Tehran، 52 patients with at least 6 months of infection were evaluated. Oral lesions were evaluated according to ECC (European Commision Clearinghouse) and CD4 counts were measured by flow cytometry method. The data were analyzed using Mann Whitney test. Out of 52 evaluated patients، 44 males (84. 6%) and 8 females (15. 4%) with mean age of 34±7. 77 were participated. 32 (61. 5%) patients were under HAART، 15 (28. 8%) used anti tuberculosis medicines and 5 (9. 6%) patients received both above mentioned treatment. In this study the most common oral lesions were erythematous Candidiasis (40. 4%)، angular cheilitis (25%) and rampant caries (23. 1%). In the present study، 15 (28. 8%) patients had no immunosuppression، 20 (38. 5%) and 17 (32. 7%) patients had moderate and sever immunosuppression، respectively. In the current study، angular cheilitis were accompanied with sever immunosuppression and rampant caries were related to the mild immunosuppresion. According to the results of the present study، except fungal infections including oral erythematous and pseudo membranous candidiasis، other oral manifesation of patients with AIDS or HIV infected patients had no relationship with CD4 counts. However further study in other population is recommended.

Cefepime is one of the fourth generations of cephalosporins known to be active against a wide range of bacteria. Cefepime is usually used for treatment of infections caused by multi-drug resistant bacteria. The aim of this study was the evaluation of the effect of this antibiotic on clinical E. coli isolates. A total of 100 isolates of E. coli were investigated. The isolates were cultured in Müller - Hinton agar and Minimum inhibitory concentration was determined by cefepime strips using the E-test method. Results were compared with standard table and isolates were determined as resistant، sensitive، or intermediate resistant. E. coli 25922 was used as reference strain. Accordingly، 76% of the isolates were sensitive، 14% were intermediate resistant، 10% were resistant to Cefepime، and 3% of the isolates showed resistance to all tested concentrations. The average minimum inhibitory concentration of antibiotic for 97 isolates was 54. 1 ± 17. 8 microgram/mL. Because three of the isolates were resistant to all investigated concentrations of antibiotic، determining the minimum inhibitory concentration of antibiotic was impossible for them. High level resistance to Cefepime despite the low consumption of this antibiotic in hospital s in some isolates of E. coli in this study reminded us the necessity to pay attention to cross resistance of this antibiotic with other cephalosporins and to avoid indiscriminate use of these kinds of antibiotics.

Backgrounds & Botulism is caused by botulinum toxin. The best way to avoid the neurotoxin syndrome caused by BONT/B is to use recombinant vaccine made of BONT/B binding domain because binding domain has sufficient epitops to stimulate immune response. Initially BONT/B binding domain gene sequence were obtained from GenBank. Then the primers were designed. PCR reaction was performed. Then gene was ligated to pGEM-Teasy vactor. After verifying the transformation E. coli DH 5 α، subcloning was done. Pet28 (a) + vector was introduced to SDS-PAGE and Western blot confirmed production of the protein. The results obtained from PCR sequencing via IPTG induction and expression analysis by SDS-PAGE and its confirmation by Western blot indicated the cloning and expression process accuracy. Finally، this method may be suitable for production of recombinant vaccines without any side effects. Cloning and expression of this vaccine candidate were conducted successfully and its immunization potential should be investigated.

This study aimed to compare the theory of mind and emotion regulation deficits in patients with bipolar disorder، major depression and normal people. This study was cross-sectional analysis and it was conducted on 40 bipolar patients، 40 depressed patients، and 50 normal people. They were selected by convenience random sampling in Tabriz Razi Hospital. The control group was selected from the staff- employed in Tabriz University. Data were collected through Reading the Mind in the Eyes test (RME-R test). The data were analyzed by multivariate analysis of variance with SPSS 16 software. This study showed that there was significant difference between depressive and normal group’s in theory of mind، emotion re-evaluation and suppression. This study also indicated that there was significant difference between bipolar patients and normal people in theory of mind and emotion suppression. But there was no significant difference between groups in the re-evaluation. The scores of depressed patients in the emotion suppression compared to the normal group were more but، in re-evaluation and theory of mind، they obtained lower scores. There was no difference between the scores of bipolar patients in re-evaluation compared to normal people، but they obtained less scores in theory of mind and higher scores in emotion suppression. The results showed that theory of mind in patients with bipolar disorder and depression compared to normal people، is damaged. Depressed and bipolar patients use maladaptive emotional suppression strategies more than adaptive re-evaluation strategy.

Health effects of air pollution have increased recently and there are a lot of concerns. Troposphere ozone is a pollutant that mainly enters the body through the respiration. This gas cause respiratory complications (reduced lung capacity، asthma، and nasal congestion)، eye burning sensation، and failure of immune defense against infectious diseases. This study was conducted to examine the hygienic effects of ozone pollution in Tabriz since it is one of the polluted Iranian metropolises. Ozone data were taken from the Department of Environment Office of East Azerbaijan Province in Tabriz (TDOE). Conversion between volumetric and gravimetric units (correction of temperature and pressure)، processing and filtering were implemented. The hygienic effects resulting from exposure to ozone gas (such as mortality rates، Respiratory diseases، cardiovascular diseases and COPD) were estimated using Air Quality Model in Tabriz. The results of this study showed that the relative risk (RR) attributed proportion (AP) and cumulative of total mortality made by the ozone were 350 persons respectively in Tabriz. O3 (1 hour average) and 98th percentile of ozone was 63. 21 and 99. 06 μ g/m3 respectively. About 2. 4% of the cardiovascular mortalities، 0. 27% of respiratory mortalities and 0. 3% of the patient''s hospitalization suffering from the chronic pulmonary clogging have been attributed to more than 10 micrograms per cubic meter of the ozone concentrations in Tabriz. This study showed for 10 μ g/m3 increase in ozone concentration، the risk of mortality increased about 0. 45%. Also the results of other studies showed ozone pollution in metropolitan of Tabriz is approximately equal with Tehran. Therefore، air pollution in Tabriz must be considered as a serious problem and requires the attention of the decision makers for the control of it. The higher ozone pollutant value can depict mismanagement in urban air quality.

Oja-e-mafasel is an important issue of Iranian Traditional Medicine (ITM) with high prevalence، high costs، and severe disabilities that affects the society. In modern medicine treatment of joint pain in most cases is limited to symptomatic treatment and pain control، but in ITM، treatment protocol is performed according to pain mechanisms. This study was a review article to investigate the causes of joint pain in valid Iranian Traditional Medicine references، such as The Canon of Medicine by “Avicenna”. First we focused on oja-e-mafasel in ITM references and then tried to match them with modern references. The main causes of joint pain are divided into two categories: simple (sadah)، and material (maddy) pains. In simple pain special qualities of coldness and warmth and dryness are effective، and in the material type، the pathogenic role of the joint pain refers to some substances and not to qualities. Prospective view of modern medicine and a holistic view of traditional medicine are diverse. Some of mechanisms described in ITM references were unexplained in modern medicine، and this survey can help to carry out more comprehensive and effective investigations in this field.

Breast cancer is one of the most prevalent non-skin-related malignancies among women in the world. Thus، many countries have commenced screening test in early stages in order to diagnose breast cancer. Buried object detection is performed in the present work to detect 3-D breast cancer applying SVM classifier. Some transmitters and receivers are located above the breast. Each transmitter radiates monochromatic electromagnetic wave. When a patient is positioned in a supine position، the breast is naturally flattened. The breast tissue is considered as 3-D lattice of classification cells. Since breast tissue can be considered with high order of accuracy as a linear medium، the received signals are monochromatic. Some particular ranges of parameters have been covered during model selection. Almost all samples in the training set were converted to support vectors. It is worthy to remind that single radiation source (dipole) has been used for the present work. The simulation has been carried out on synthetic electromagnetic data obtained by means of Finite Element Method and Perfectly Matched Layers techniques. Noisy environments have been considered as well in order to simulate realistic conditions of signal measurement. The real positions of the tumor are marked by white contour squares. The dependence of the prediction quality on the depth of the tumor location is not observable unless the tumor is directly under the skin layer. Probability maps obtained demonstrate that the region around the tumor location usually clearly stands out against the background of overall probability values.