فصلنامه یافته
سال چهاردهم شماره 4 (پیاپی 49، پاییز 1391)

Recent studies have indicated that a potential factor influencing peripheral blood stem cell transplantation (PBSCT) outcome is the presence of donor-derived alloreactive natural killer (NK) cells. This retrospective analysis studied the impact of NK alloreactivity based on the activating KIR، for acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) patients undergoing non-T-cell depleted HLA-identical sibling PBSCT. In this study، KIR genotypes were determined in 40 recipients with AML and 38 recipients with ALL undergoing non-T-cell depleted HLA-identical sibling PBSCT. Then، overall survival (OS)، disease-free survival (DFS) and relapse were evaluated in the recipients. In AML patients، presence of KIR2DS3 and/or KIR3DS1 in donor genotype and chronic GVHD (cGVHD) occurrence were associated with a two-year OS (P=0. 006 and P=0. 024، respectively) and DFS (P=0. 021، P=0. 033، respectively) in univariate analysis. In these patients، bivariate analysis showed that these factors have synergistic effect on OS (P=0. 01) and DFS (P=0. 001). We found that the presence of KIR2DS3 and/or KIR3DS1 in donor genotype and cGVHD occurrence in recipient are the most important predictors for better survival of AML patients in non-T-cell depleted HLA-identical sibling PBSCT، so that lack of KIR2DS3 and/or KIR3DS1 in donor genotype and non-occurrence of cGVHD in recipient synergistically decrease survival in AML patients.

Based on recommendation of management development and organizational change center of the ministry of health. EFQM model is the most appropriate model to deploy in country`s hospitals. In this study we assess quality of emergency wards in khorramabad hospitals based on EFQM model and compare it with results of annual evaluation of the ministry of health. this descriptive، cross-sectional study was carried out in 2009. Emergency wards of khorramabad hospitals were our study population which were selected using census method. Data collection tool was questionnaire of EFQM model which was filled out by researchers in studied wards. RADAR logic used for scoring and EFQM consensus process used for agreement. The data were analyzed through descriptive statistics، SPSS and EFQM softwares. Scores of studied wards (Social security، Shahid Madani،Shohaday-e Ashayer and Asali hospitals) were 216،108. 1،129. 9،72. 1 respectively. The mean score in EFQM criteria were: leadership 12. 3%، policy and strategy 7. 1%، staff 11. 8%، partnerships and resources 13. 8%، processes 20. 8%، customers results 8. 3%، staff results 12. 5% society results 9. 5%، key performance results 18. 8%. Findings show that quality of studied wards is less than the model standards and other similar studies considerably. From view point of the researcher the existing gap with external studies is logical and in comparison with internal studies is irrational. The studied wards acquired the most score in process criterion and the least score in policy and strategy criterion. Also، findings shows a negative relation between results of assessment based on EFQM model and current evaluation system of the ministry of health، so it is suggested that the current system should be revised fundamenally.

In the educational hospitals of Hamedan university of medical sciences there was no previous study on qualitative and quantitative of bioaerosoles in the air of different wards. So، in this study the quality and quantity of bioaerosols in the air of hospitals was investigated to establish reference for future studies or measures. In this cross sectional research، 30 wards from 5 educational hospitals of Hamedan city were studied. More than 180 air samples were collected in the various locations and conditions according to filtration method suggested by bioaerosol committee of ACGIH. The samples were transported to blood agar and sabouraud medium then were cultivated immediately. The type and number of colonies were determined in the laboratory then، the bioaerosol concentration was calculated in terms of cfu/m3. SPSS software was used for data management and related statistical analysis was carried out. There were highest and lowest concentration of bioaerosols in women1 and operating room wards of Fatemiyeh hospital، respectively (54. 4cfu/m3 vs. 13. 3cfu/m3). It was appeared that there was no significant correlation between concentration of bioaerosols in the hospitals and proposed standard level (P=0. 3). The highest fungal population were Penicelium (32. 06%)، Cladosporium (20. 5%)، Aspergillus fumigates (14. 61%)، Aspergillus niiger (7. 43%)، respectively. The highest bacterial population were coagulase-negative staphylococci (32. 49%)، Bacillus spp. (14. 74%)، Micrococcus spp. (13. 68%) and Staphylococcus aureus (11. 34%)، respectively. Quantitative bioaresols concentration in the air of some hospitals was more than proposed standard. Most surveyed hospitals lacked air treatment systems so، for reducing bioaerosol concentration، standard ventilation system should be designed and utilized.

Tuberculosis is known as one of the main causes of mortality worldwide. 1. 7 milliard people worldwide are infected with TB germs، there are 8 million new cases of TB annually، and three million deaths occur due to the disease in developing countries. This study included all the cases who had referred to all the health centers of Lorestan province with positive samples for acid-fast bacilli، or with symptoms consistent with TB، who had been treated for tuberculosis by physicians during 2008-2009. Out of 198 cases of TB in the province in 2009، 107 (54 %) and 91 (46 %) cases were male and female respectively. 109 (55%) cases of smear-positive pulmonary tuberculosis، 32 (16%) cases of smear-negative pulmonary tuberculosis and 45 (22/7%) cases of extra pulmonary tuberculosis، and 7 (3/5%) cases of TB recurrence have been reported during this year. In 2008، 149 cases of TB have been reported، with an incidence of 8. 4 per 100 thousand، out of them 79 (54%) and 70 (46%) cases were male and female respectively. 68 (45/6%) cases of smear-positive pulmonary tuberculosis، 35 (23/5%) cases of smear-negative pulmonary tuberculosis، and 35 (23/5%) cases of extra pulmonary tuberculosis have been reported. Considering the relatively high prevalence of tuberculosis in the province، reported cases of treatment failure and drug-resistant tuberculosis، it seems it is very important to diagnose the disease in the patients accurately and monitor drug consumption precisely.

Self-care is considered as an important process in to control diabetes. The aim of this study was to investigate the self care and its influencing factors in diabetic patients in Khorramabad city.

In this cross-sectional study 80 patients with type 2 diabetes، a dmitted to hospitals diabetes clinic and urban health care centers and an endocrinologist''s office in Khorramabad، were selected using convenience sampling method. Data ghathering tool in this study was self-care scale Tubert – Glasgow which assessed the self care of their patients in different domains during the past seven days. Data were analysed by independent t- tests and one way ANOVA.

Self-care average scores in patients were (32. 7±12. 76) and the utility level was moderate. Low self-care behaviors were seen in daily check of blood glucose (3. 4±3. 8)، physical activity (4. 7±4. 2) and general care of the feet (4. 9±4. 9). The self care average scores based on litrecy، resident place، type of treatment and the patients'' life net was significantly different.

In order for health promotion and optimal control of disease in diabetic patients، training programs to empower patients in their self care should be considered.

The aim of this study is to compare the quality of life and public health after natural and cesarean delivery in women referred to Khorramabad health centers in 2009-2011. In this cohort study all pregnant women referred to health centers in Khorramabad were studied. 380 persons participated in the study selected using purposive sampling method. Data collection was done in 18 months. The information was collected in steps (a): the last month of pregnancy and (b): eight weeks after delivery. GHQ questionnaire was used in order for primary assessing، its validity confirmed by the World Health Organization. Data were analyzed using logistic regression، chi square test، Mann-Whitney at 5% significance level with SPSS software، version 16. 250 subjects out of 380 (146 natural deliveries and 104 cesarians) filled out interview forms and questionnaires. The results show that there are statistically significant differences between physical domain scores (P = 0. 001) and mental scores (P = 0. 02) which show significant differences in quality of life; and in environment and social areas and total، no statistically significant difference was observed. Chance of causing disease symptoms in women with cesarean delivery in the scale of physical complaints was 09. 3 times (P = 0. 001)، depression 75. 1 times (P = 0. 02) and impaired social interaction 68. 1 times (P = 0. 04) greater than women with vaginal delivery، all of which are significant at the 5% level of statistical error. Quality of life in its various aspects and general health in mothers with normal delivery، better grades and better shows.

Some studies have shown that the serum concentration of 25- hydroxy vitamin D which is represent the status of body vitamin D، has a diverse relationship with obesity status، and the risk of obesity decreases in people with high level of 25- hydroxy vitamin D. The aim of this study is to investigate the correlation between the serum level of 25- hydroxy vitamin D and anthropometric indices، glucose، lipid profile، serum insulin، and insulin resistance in obese women.

This study was carried out on 43 obese women and 43 healthy women with normal weight as a control group، aged 20-50. They were matched for age and physical activity. For each participant، a 3-day 24-hours food recall was filled. Moreover، fasting blood sampling was taken to measure blood levels of fasting blood glucose، 25- hydroxy vitamin D، lipid profile and serum insulin.

The mean level of serum 25- hydroxy vitamin D، insulin and also insulin resistance based on IR-HOMA index in the group of obesity and control were 28. 05 ± 16. 66 versus 25. 72 ± 14. 08 (P=0. 48)، 25. 97 ± 7. 53 versus 25. 93 ± 9. 32 (P=0. 98)، and 6. 39 ± 2. 6 versus 5. 83 ± 2. 5 (P=0. 30) respectively. Between the anthropometric indices، 25- hydroxy vitamin D had a significant relationship only with body weight in obese group (p=0. 033، r= 0. 326). No significant relationship was observed between serum 25- hydroxy vitamin D with blood sugar، lipid profile، serum insulin level and HOMA-IR in obese women.

No significant relationship was seen between serum level of 25- hydroxy vitamin D with anthropometric indices (except for body weight)، serum levels of glucose، lipid profile and insulin resistance in the obese women.

Pseudomonus stutzeri bactrerium is one of the most important and effective denitrifier bacteria in wastewater. With regard to the importance of effects of nitrate on water resources and human health and role of metronidazole inhibition، this study was done with the aim of survey of effect of metronidazole different concentrations on biological denitrification of Pesudomonas stutzeri in wastwater. This research was an experimental study. After sampling from raw wastewater، identification and isolation of pseudomonus stutzeri bactrerium were done. Bacteria suspension in specific culture medium and metronidazole different concentrations in deionized water and nitrate different concentrations for experimentals of nitrate removal under anoxic conditions was prepared and metronidazole inhibition experiments on activity of denitrification by pseudomonus stutzeri in synthetic and real wastewater were conducted. Metronidazole at concentrations of 100، 200، 300 and 400mg/l، in synthetic wastewater containing nitrate concentrations to 500mg/l، had no inhibitory effect on activity of denitrification by pseudomonus stutzeri. Metronidazole at concentrations of higher than 800mg/l in synthetic wastewater and higher than 500mg/l in domestic wastewater had inhibitory effect. In 800mg/l metronidazole concentrations، with increasing the concentration of substrate (nitrate)، significant reduction in the rate of nitrate removal by pseudomonus stutzeri was observed. This bacterium was added to three samples of domestic sewage، but had no effect on the rate of nitrate removal. With ergard to strong ability of Pseudomonus stutzeri to remove nitrate high concentrations and high resistance of this bacterium against metrinidazole، biological denitrification process can have a high potential to be used for removal of nitrates high concentrations from industrial wastewater، particularly pharmaceutical industries wastewater.

The purpose of this study was to examine the influence of combined training program on C-reactive protein (CRP) serum and interleukin-6 (IL-6) plasma concentrations in sedentary men. In this quasi-experimental study، twenty sedentary men (23±2 years) volunteers (with no history of regular exercise program، weight deviation more than 2 kg، special disease and smoking over the past 6 months) to normal Body mass index (BMI) (23±2 kg. m-2) were chosen randomly in two groups [control (C = 10)، training (T = 10)] and performed combined training [Aerobic exercise: 60-70% of their maximal oxygen uptake (VO2 max) for 20 min and resistance exercise: 2sets of 10 repetitions at 70% of 1 repetition maximum (1RM)] 12-wk (3d. wk-1). The results showed that CRP serum levels، waist to hip (W/H)، and the body fat percentage in the T group were significantly lower than the C group (P<0/05). But BMI، IL-6 and body weight did not change in the both groups after the intervention period. Significant correlations in all subjects at baseline were observed between CRP to VO2 max (P=0. 035 and r=-0. 67) and the body fat percentage (P=0. 018 and r=0. 72) and also between BMI to body fat percentage (P=0. 045 and r=0. 64). It can be said that the performance of combined aerobic-resistance training decreases serum CRP in inactive males. The reduction of serum CRP associated with improvement of body fat percentage. Thus، physical activity should be considered as an integral part of every adult،s lifestyle.

Blastocystis hominis is an anaerobic، zoonotic protozoan parasite which inhabits the large intestine of humans and a wide range of other vertebrates. It has a worldwide distribution and infects hosts through the cyst of the parasite by contaminated water or food. Its prevalence is related to hygienic culture، season، exposure to animals، and age. A number of studies in the last decade have confirmed its potential pathogenicity، and many gastrointestinal and extra-gastrointestinal signs have been attributed to it. It has unique morphology، life cycle، and reproduction. The aim of this research is to study molecular prevalence of this parasite in the patients referred to Khorramabad laboratories. In this study، conducted for the first time in Lorestan province، 511 stool samples were collected from patients in laboratories of Khorramabad. After DNA was extracted using PCR، the samples were examined for the existence of Blastocystis parasite. Out of the 511 samples studied، 33 ones (6. 5%) were infected with Blastocystis. The microscopic diagnosis is challenged by morphological characteristics and other intervening factors، and the PCR method، which has higher sensitivity and specification than other diagnostic methods، is recommended. Concerning the prevalence of the parasite، the world has been divided into two parts of developed and developing countries by the researchers، with 10% and 50% prevalence rates respectively. The 6. 5% prevalence in the cited population in Khorramabad is in the range of the prevalence in the developed countries. Therefore، the result is justifiable since springs provide most of the drinking water in the region. However، since ranching is a popular occupation in the region، the prevalence rate is alarming. Therefore، following health instructions and appropriate clothing when exposing to livestock are recommended. In addition، the results of this study and similar studies in the developing countries، on the one hand، and the increasing prevalence of 23% in the US as a developed country، on the other hand، have disturbed the previous division.

In every geographical area according to their social civilization، specific abnormalities and outcomes may be occurred in spinal cord and in the case of recognition they will be corrected with specific movements and proper behavioral patterns. So the aim of the present study was to investigate the rate and reasons of Khorramabad Azad university students’ spinal abnormalities. This descriptive- analytical survey was carried out on Khorramabad Azad university students in 2010-2011. Among 1400 students، 500 persons (250 women and 250 men) randomly selected from students who were studying in the second semester of 2010-2011. First، they filled out a questionnaire about their personal information، disease history and daily habits. Then، their weight، height، and spinal abnormalities were studied. New York standard test and grid plane were used to study spinal abnormalities. Also، flexible ruler was used to measure the curves of the thoracic and back vertebrates. The findings of this research showed that 83. 2% of males (208 persons) and 87. 2% of females (218 persons) had at least one abnormality. The greatest abnormalities in males were associated with kyphosis and in females with shoulder drown. The least abnormality in males was abdomen drown (10. 4%) and in females was upper extremity deviation (19. 2%). Also significant association observed between lordosis and kyphosis and incorrect habits of sleeping، between incorrect habits of carring bag and instruments، and shoulder drown، incorrect habits of studying and poke neck and incorrect habits of sitting in the home and kyphosis (P<0/01). Present study showed high incidence of spinal abnormalities of which incorrect habits in sitting، studying and caring bag and instruments، had a major role in each of these abnormalities.

Quests for doing coronary artery bypass surgery by a technique with lower complications is going on، for this aim many studies compared patients undergoing CABG with or without cardiopulmonary bypass. This study was carried out to compare laboratory findings after coronary artery bypass in these two groups of patients. In a retrospective study، 167 patients undergoing CABG with or without cardiopulmonary bypass were selected by systematic randomized sampling method from the list of the Jamaran Hospital (Tehran) patients and the blood levels of glucose، creatinine، potassium، sodium and incidence of acute kidney injury were compared. Occurrence of acute kidney injury and glucose، creatinine and potassium levels was more in CPB group (P<0. 05)، but the sodium level was equal in both groups (P=0. 84). OPCAB facilitate reduction in the incidence of acute kidney injury and control of the serum glucose and creatinine levels and complications related to these factors. It seems that OPCAB is an optimal operation technique for patients، but other factors should be considered too.