مجله سازمان نظام پزشکی جمهوری اسلامی ایران
سال سی و هفتم شماره 1 (پیاپی 145، بهار 1398)

Convergence Medicine is a new educational, research and therapeutic branch in medicine that could lead to important changes and innovations both in research and clinical care medicine. This new technology was initiated in 2014 and rapidly expanded throughout the world. Convergence Medicine was planned following Converging Technologies in Science [Nanotechnology, Biotechnology, Informatics Technology and Cognitive Science (NBIC)] in 2002. At present many universities, research and educational institutes globally take advantage of Convergence Medicine. Hopefully, by considering the aim and objectives of this new medical technology, many of the existing medical and health issues of the society and communities could be overcome in future. In this evaluation, we have paid attention to the formation of this concept from the initial stage and its associated advantages. By incorporation of Convergence Medicine in the Iranian medical society, strategic policies could be taken in various medical and medical related fields such as health care policies, research, investment in research fields, workforce policies and team work.

Few quantitative studies in our country have been conducted to investigate the status of cardiovascular fitness in firefighters. The objective of this study was evaluation of aerobic capacity and its relation with the lifestyle of firefighters.   This study was conducted in 2014 and 165 male firefighters participated in the study. Information such as demographic data as well as medical and occupational records was collected through direct interview. The subjects’ lifestyle was assessed in three areas of physical activity, smoking and Body Mass Index (BMI) status. To assess the aerobic capacity of the participants and to perform the submaximal aerobic fitness test, the ACSM (the American College of Sports Medicine) was used. Using the Persian version of the International Physical Activity Questionnaire (IPAQ), the level of physical activity of the individuals was assessed by direct interview. Analyses were performed using SPSS 22.0 and a P<0.05 was considered significant. The mean aerobic capacity of the participants was observed to be 34.47 VO2max ml.kg-1.min-1. In terms of physical activity, the mean amount of energy consumed for work-related physical activity was 2534.00 MET-minutes/week. The results of the linear regression analysis showed a significant relationship between physical activity, smoking, BMI and the aerobic capacity (P<0.05). This study showed that maximum physical activity is related to aerobic capacity. Reducing the risk of acute ischemic events in firefighters and increasing maximum aerobic capacity needs focus on the physical activity and life style of firefighters.

Celiac Disease (CD) is a T cell-mediated disorder. Recent studies suggest the role of chemokines CXCL10 and CXCL11 to promote the arrival of cells into inflamed tissues and in lymphocytic recruitment in active CD. The aim of this study was to investigate the new specific primer pairs for analysis of human CXCL10 and CXCL11 genes in blood samples of CD patients by Polymerase Chain Reaction (PCR) technique and to examine the quantitative expression of these genes in the blood of celiac patients compared with healthy controls. Blood samples were collected from 10 CD patients diagnosed according to the Iranian Society for Pediatric Gastroenterology and Marsh criteria and 10 as a control group after extraction of RNA from patients and cDNA was synthesized. By bioinformatics analysis, the specific regions of the CXCL10 and CXCL11 genes were designed and exon-exon junction specific primers and PCR was performed. Later gene expression analysis was performed with Real-time PCR. According to the results, all designed primers are highly capable of replicating the desired components. Also, there was a significant increase in expression of two chemokines CXCL10 and CXCL11 genes in the celiac patients compared to control groups (P<0.05). Our results from this study showed that changes in the expression of CXCL10 and CXCL11 genes in celiac patients indicate the role of the inherent immune system in the pathogenesis of CD.

Carpal Tunnel Syndrome is one of the most commonly encountered peripheral nerve ending disorders that occurs after compression or strangulation of the median nerve in the wrist tunnel. The functional status is greatly impaired in the daily activities of a patient with Carpal Tunnel Syndrome and may cause problems for the subjects. Therefore, the aim of this study was to investigate the effect of exercise therapy on the functional status of patients with Carpal Tunnel Syndrome. This study was a single-blind clinical trial on 66 female patients with mild and moderate Carpal Tunnel Syndrome that referred to occupational therapy clinics. Eligible patients were divided into two groups of 33 patients in the intervention and control each. The intervention group, in addition to the common interventions (including medication), received a prescriptive therapeutic treatment, and the control group had common treatments. The Functional status questionnaire or Boston questionnaire was completed in four intervals before, during the intervention (third week), immediately after the intervention and one month after the intervention in the two groups. To analyze the data, independent t-test, paired t-test and general linear model of repeated measure was used in SPSS. Interventions in the intervention group showed a significant difference in functional status (P<0.001) in patients with Carpal Tunnel Syndrome. Exercise therapy can lead to functional improvement in patients with Carpal Tunnel syndrome.

The body’s strategy for coping with pain and stress in the delivery process is the secretion of opioid peptides, including β-endorphins. The aim of this study was to investigate the factors related to the concentration of umbilical cord blood β -endorphins in newborns born of primiparous women. In this descriptive study, 80 umbilical cord blood samples from neonates of primipara pregnant women were collected in 2 groups of 40 eligible elective cesarean section and normal delivery with gestational age of 38 to 42 weeks, single and low risk, 1 to 2 minutes postpartum, and β-endorphin concentration. The enzyme-linked immunosorbent assay was measured using ELISA kit. Data was analyzed by T-test, Chi-square, Analysis of variance and regression using SPSS 18 software. The mean of cord blood β-endorphins in normal delivery and cesarean section was 38±27.47 and 11.11±19.59 ng/l, respectively. There was a significant difference between the results of the two groups (P=0.03). Exercise during pregnancy was related to β-endorphin secretion (P<0.05), while gestational age, pain reduction methods, duration of the first and second stages of labor, duration of the infusion, and weight of the newborn did not affect β endorphin secretion. Natural delivery can provide the normal function of the body for the mother, fetus and baby and on the other hand, control the risk factors of the mother and the baby and promote maternal and neonatal outcomes.

All people in the community must have fair access to health facilities. Failure to supply and distribute specialized human resources is one of the main causes of inequality in health services. This study aimed to identify the human factors affecting the equitable distribution of health and medical facilities in the Social Security Organization. This study was conducted as descriptive-comparative and cross-sectional. The statistical population included 415 experts and heads of health centers of Social Security Organization who were randomly selected. Data gathering tool, questionnaire and data analysis were performed by SPSS 21 using descriptive statistics and exploratory factor analysis. Based on this research, three factors were found to be possible for the provision of   physician, non-doctor specialist force and specialized staff with female gender as a human factor affecting the fair distribution of health facilities in the Social Security Organization. Considering that one of the most important goals of the health system is the fair distribution of health facilities and, on the other hand, supplying manpower, especially the medical provider, is the key factor in the distribution cycle of health facilities and the lack of human resources leads to inefficiency of other resources namely physical, financial, and equipment, therefore, attention to time and the possibility of providing expert human resources is the prerequisite for making decisions for the allocation of other treatment facilities to different regions as an unavoidable necessity.

Celiac Disease (CD) is a T cell-mediated disorder. Recent studies suggest the role of chemokines CXCL10 and CXCL11 to promote the arrival of cells into inflamed tissues and in lymphocytic recruitment in active CD. The aim of this study was to investigate the new specific primer pairs for analysis of human CXCL10 and CXCL11 genes in blood samples of CD patients by Polymerase Chain Reaction (PCR) technique and to examine the quantitative expression of these genes in the blood of celiac patients compared with healthy controls. Blood samples were collected from 10 CD patients diagnosed according to the Iranian Society for Pediatric Gastroenterology and Marsh criteria and 10 as a control group after extraction of RNA from patients and cDNA was synthesized. By bioinformatics analysis, the specific regions of the CXCL10 and CXCL11 genes were designed and exon-exon junction specific primers and PCR was performed. Later gene expression analysis was performed with Real-time PCR. According to the results, all designed primers are highly capable of replicating the desired components. Also, there was a significant increase in expression of two chemokines CXCL10 and CXCL11 genes in the celiac patients compared to control groups (P<0.05). Our results from this study showed that changes in the expression of CXCL10 and CXCL11 genes in celiac patients indicate the role of the inherent immune system in the pathogenesis of CD.