فهرست مطالب omid pirhaji

The aim of this study was to determine the effectiveness of diode MicroPulse laser for improving visual acuity in patients with acute central serous retinopathy. In this clinical trial study, 26 patients with acute central serous retinopathy were selected and divided into two groups of 13; the first group was treated with diode MicroPulse laser; and in the second group, no intervention was performed. Patients in both groups were followed for three months, and visual acuity and recovery were compared between the two groups. The visual acuity (logMAR) before the start of treatment and at the 4th and 12th week of treatment did not show a significant difference between the two groups. In intragroup examination, visual acuity (logMAR) in both groups was significantly different (P < 0.01), but there was no significant difference between the two groups in the intergroup analysis (P = 0.82). Although the results of this study indicate that diode MicroPulse laser improves clinical and anatomical results in patients with acute central serous retinopathy, there is no statistically significant difference compared with spontaneous improvement of these patients.

Increasing the life expectancy was the major issue of public health during the 20th century, while living with better quality is the goal of 21th century. Psychological and physical situations are important factors that affect quality of life in elderly. In the present study, we aimed to evaluate the quality of life among the elderly and its relationship with depression and body mass index (BMI) in Isfahan province, Iran.
A total of 637 elderly were included in this analytical observational study using a random and multistage cluster sampling method. Quality of life and depression scores were collected using Geriatric Depressions Scale (GDS) and Quality of Life Short Form-36 (SF-36) Questionnaire. Data were analyzed using t, one-way ANOVA, Pearson and Spearman correlation coefficients statistical tests.
Findings: The mean score of quality of life was 54.64 ± 20.60. Quality of life and some of its dimensions had a direct relationship with lower age, being male and high level of education. We found no significant correlation between the depression score and quality of life or its dimensions. In addition, assessment of the correlation between body mass index and quality of life showed that body mass index had significant negative relationship only with physical functioning among all of the dimensions.
Results of the present study showed that lower quality of life is associated with increasing of the age, being female and low level of education. Furthermore, we found no relationship between the dimensions of quality of life and depression that might be due to the effects of several variables on quality of life among elderly.

Many studies have been performed regarding the prevalence of hepatitis E in the general population, but there is controversial evidence for an increased risk of the infection in patients on maintenance hemodialysis (HD).. The primary end point of the present study was to determine if the prevalence of anti-hepatitis E virus IgG (anti-HEV IgG) is higher in patients on maintenance HD than in the normal population in Isfahan..Patients and In a case-control study performed in Isfahan in June 2012, we compared the seroprevalence of HEV among 274 patients on maintenance HD and 275 otherwise healthy individuals. The patients were recruited from 3 HD centers in Isfahan. Anti-HEV IgG was detected using a Dia Pro Diagnostic HEV enzyme immunoassay (ELISA) kit. Demographic and clinical data (sex, age, blood transfusion history, HD duration, age at HD initiation, and evidence of hepatitis B and hepatitis C infections) were obtained from the medical records of the HD patients.. Anti-HEV IgG was detected in 27 (9.9%) controls and 78 (28.3%) patients, with the difference being statistically significant (P < 0.05). Furthermore, there was a significant association between positive anti-HEV antibody, HD duration, and blood transfusion history in the HD patients.. Considering the results, it seems necessary to conduct prospective studies in order to identify factors responsible for the high seroprevalence of HEV in Isfahan HD units..

The responsibility of the medical training team towards a patient referring to an academic medical center has not been fully clarified. In this article we have looked at current practice in Medical University of Isfahan and evaluated the attitude of the medical team towards patients’consent to be involved in medical students’education. In this cross-sectional study, conducted in 2012, we distributed self-administrated questionnaires among medical mentors, residents and students of academic hospitals in Isfahan, Iran. This researcher-made questionnaire consisted of several questions concerning dimensions of informed consent. The data were analyzed, using independent t-tests and ANOVA. Ninety-one medical students (51 females) and 61 members of medical training team (25 females) completed the questionnaires. The overall average attitude score was 36.53±5.89 out of 60, which is classified as fair. The average attitude score for medical students and mentors were not significantly different. The average attitude score of the female students was classified as good, and was different from that of male students, significantly (p<0.05). By categorizing subjects into those with ≥5 years of managerial or educational experience and those below 5, a significant difference in average attitude score was documented (35.8±2.54 in Ġ5 and 34.0±2.9 in >5 group). The attitude of the medical team is thoroughly far from what is expected. Thus, the need to provide both medical students and medical mentors with data on the importance of obtaining patients’ consent to be involved in medical education is highlighted.

One of the most problems among hospitalized patients in intensive care units is infectious diseases that lead to high usage of antibiotics. The study was designed to evaluate the antibiotic usage in ICU before (in 2010) and after (in 2014) infectious disease specialists presence. In a cross- sectional study we measured the total rate of antibiotics usage in ICU in 2010 and 2014. SPSS 22 was used for the analysis. Of the 39 antibiotics that evaluated, use of 23 antibiotics (53.8%) were increased and 16 antibiotics (46.2%) were decreased after infectious disease specialists arrival. There wasn’t a significant statistical difference between the mean of antibiotics consumption in 2010 and 2014 (P = 0.29). We suggested that additional studies will be performed to evaluate the causes of increasing usage of some antibiotics and decreasing another antibiotic consumption for example price, indication and contraindications and access of antibiotics.

The nephroprotective effect of co-administration of vitamin C and losartan as prophylaxis against cisplatin-induced nephrotoxicity (CIN) was evaluated. Co-administration of vitamin C and losartan was compared with losartan (10 mg/kg), vitamin C (250 mg/kg), and placebo in 4 groups of rats with CIN. The prophylactic agents were injected daily for a period of 4 days, and on day 3, a single dose (6 mg/kg) of cisplatin was administrated. The animals were sacrificed 7 days later for pathological examination of the kidneys. Cisplatin prevented the animal's weight gain. The serum levels of creatinine and blood urea nitrogen increased within the groups with CIN, but no significant difference was observed between the groups. The prophylaxis has no effect on serum osmolality, total protein, or nitrite concentrations. The kidney tissue damage was scored, and losartan provided a lower damage score than vitamin C and a combination of vitamin C and losartan. We concluded that co-administration of vitamin C and losartan was not more effective than the administration of vitamin C or losartan alone.

Given the importance and impact of test resources on medical student’ learning, this study aimed to assess the time devoted to study books and notes during the semester and exam time. This descriptive-analytic study was conducted on all medical students (120) who were passing internship period at Isfahan University of medical sciences in 2011. Devoted time to study books and notes was determined. Data analysis was done using t test. The mean and standard deviation of time devoted to study book for students who their mean score were above average (15.89±0.96) was 34.61±4.08. This was 23.12±5.30 for students who their mean score were less than average. It had significant difference. The results of this study showed that, students with lower mean score were more interested in studying notes during the semester and test time. Therefore, it is suggested to conduct further studies to investigate the study sources of students in different academic degree levels.

In educational hospitals, sometimes the patients that seek medical health care are involved in teaching and learning process without enough knowledge about medical students’ skills. This study aimed to examine medical training team’s attitude toward patient's consent to participate in clinical training. This is a descriptive cross-sectional study conducted at Isfahan University of medical sciences using a researcher-made 12-item questionnaire with 5-point Likert Scale. From the target population including all of the professors and residents of Isfahan University of medical sciences, 61 took part in study. Forty two point five percent of the participants were residents and 57.5% were professors. The overall mean attitude score was 34.9 ±3.03 that was considered moderate. The mean attitude score for professors and residents were 35.58±3.35 and 33.88 ±3.03, respectively which were not significantly different. Most of the participants believed that patients should not be informed about student's ability levels before examination. It seems that the concern of the medical training team about lack of patient cooperation in teaching and learning process results in ignoring in patient's rights in making an informed choice. Conducting further studies in order to find the causes and solutions to improve and upgrade the existing situation is suggested.

Clinical education will be possible with involving patients in teaching-learning process. One of the patient’s legal and moral rights is patient's right to decide to participate in this process or not. This study aimed to examine medical students’ attitude toward patient's consent to participate in clinical training. This is a descriptive cross-sectional study conducted at Isfahan University of medical science in 2011. Ninety students who were passing clinical courses in Al-Zahra hospital took part in study. Data collection was done using a researcher-made 12-item questionnaire. Data analysis was done through descriptive and inferential statistics. 55% were female and 45% were male, 58% were apprentices and 34% were interns. There was significant difference between mean attitude of apprentices and interns. Interns’ attitude was good but it was moderate for apprentices (p <0/05). Most students (81/3%) believed that patients should not be informed about student's ability level before examination. Despite a more positive interns’ attitude than apprentices, it is necessary for medical school and faculty members to prepare leaflets in this matter and emphasize on informed consent to improve students’ knowledge and attitudes.

The polymorphisms of cytochrome P450 2C19 (CYP2C19) gene are major prognostic factors for the response to clopidogrel therapy in patients with coronary artery diseases (CAD). The CYP2C19*2 is the most important allele responsible for resistance to clopidogrel therapy. This study examined CYP2C19 gene polymorphism (CYP2C19*1 and *2) in Iranian patients. This cross-sectional study was performed on 43 Iranian patients with CAD who underwent percutaneous coronary intervention (PCI) and received drug-eluted stents (DES). CYP2C19 polymorphisms were assessed using real time PCR and frequency of CYP2C19*1 and CYP2C19*2 were determined, and then homo- or heterozygous state of genes was detected by Melt Curve Analysis method. Forty three patients (mean age = 58.8 ± 10.0 years, 79.1% male) participated in this study. CYP2C19*1/CYP2C19*1 genotype was observed in 31 (72.1%) of participates, CYP2C19*1/CYP2C19*2 genotype in 10 (23.3%), and CYP2C19*2/CYP2C19*2 genotype in 2 patients (4.7%). The frequency of CYP2C19*2 allele in the sample was 27.9%. This study demonstrated a high prevalence of CYP2C19*2 gene polymorphism in Iranian patients. Further studies with larger samples or longitudinal are required to determine the effects of this polymorphism on the prognosis of CAD patients in our population.

Coronary artery disease (CAD) and myocardial infarction are the most common cause of mortality and morbidity all over the world.. Aspirin resistance is an important part of therapeutic failure in patients who experience several atherosclerotic events despite aspirin therapy.Different stud-ies have reported aspirin resistance between 5-45% all over the world. According to different re-sponses to aspirin therapy in different countries and lack of adequate studies on aspirin resistance in Iran, this study was designed for invitro evaluation of aspirin resistance in Iranian patients.

170 patients with documented coronary artery stenosis were enrolled in this cross-sectional prospective study. 2 cc urine samples were obtained from all the subjects.Then a questionnaire includ-ing questions about ischemic heart disease risk factors (hypertension, diabetes, hyperlipidemia, obesity and smoking) was completed for each patient. Thromboxane B2 level in urine was measured two times for each patient via ELISA method. Data were analyzed via SPSS 16. with General Linear Model (Univariate).Gensini modified was used for assessment of severity of coronary arteries in-volvement (Coronary angiography score).

75.3% of studied patients were aspirin resistant. There was significant relationship between angiography score and aspirin resistance (Pvalue