Association of History Taking and Accuracy of the Interpretation of Cervical and Lumbar Magnetic Resonance Imaging

BACKGROUND: Disk herniation leading to radiculopathy is one of the most important causes of neck and back pain, requiring specific diagnostic tests. Magnetic resonance imaging (MRI) is one of these diagnostic methods. Interpreting the findings of this imaging method by an experienced skilled person is very important. AIM: The purpose of this study was to investigate the role of history on the accuracy of the lumbar or cervical MRI reports in patients with back and neck pain referring to the radiology department. METHODS: This study was performed on patients with complaints of lumbar or neck pain that MRI had been performed for them. At first, the MRI was studied by the residents of the 2nd and 3rd years and then a radiologist as a routine, respectively. From 4 to 6 months later, patients’ clinical history was presented to the same students and professors and MRI was re-reported. Statistical differences were evaluated and analyzed using SPSS software version 20. RESULTS: Out of 150 patients with mean age of 42.56 ± 10.65, 87 patients (58%) were female and 63 (42%) were male. Most of the patients were between the ages of 40 and 50 years (34.66%). The most common clinical symptom of patients was waist and neck pain followed by sensory disturbances of the extremities. The most pathologic changes found was disk bulging in 28.8% of patients (68 cases). In terms of lumbar canal stenosis, the most cases were in the L4-L5 levels of the moderate type. The most reported cases of cervical stenosis have been mild. Disk herniation and DOCP were two main factors causing canal stenosis in the study patients. Statistical difference in the MRI reports performed by the residents on most of the variables was statistically significant before and after knowing the clinical history of the patient (p < 0.05). However, this difference was less noted in the reports of the radiologists. CONCLUSION: The results of this study showed that knowing the history of patients in interpreting the results of MRI in patients with vertebral disk hernia is misleading and will lead to many false positive and negative results, especially for radiology residents. It is recommended that the residents and radiologists consider the MRI films before focusing on the biographies and clinical features of the patient, to prevent the occurrence of bias and to increase the accuracy of the reports

Prioritizing Public- Private Partnership Models for Public Hospitals of Iran Based on Performance Indicators

Background: The present study was conducted to scrutinize Public- Private Partnership (PPP) models in public hospitals of different countries based on performance indicators in order to se-lect appropriated models for Iran hospitals.Methods: In this mixed (quantitative-qualitative) study, systematic review and expert panel hasbeen done to identify varied models of PPP as well as performance indicators. In the second stepwe prioritized performance indicator and PPP models based on selected performance indicatorsby Analytical Hierarchy process (AHP) technique. The data were analyzed by Excel 2007 andExpert Choice11 software’s.Results: In quality – effectiveness area, indicators like the rate of hospital infections(100%), hospital accidents prevalence rate (73%), pure rate of hospital mortality (63%), patientsatisfaction percentage (53%), in accessibility equity area indicators such as average inpatientwaiting time (100%) and average outpatient waiting time (74%), and in financial – efficiency area,indicators including average length of stay (100%), bed occupation ratio (99%), specific incometo total cost ratio (97%) have been chosen to be the most key performance indicators. In the prioritizationof the PPP models clinical outsourcing, management, privatization, BOO (build, own,operate) and non-clinical outsourcing models, achieved high priority for various performance indicatorareas.Conclusion: This study had been provided the most common PPP options in the field of public hospitals and had gathered suitable evidences from experts for choosing appropriate PPP option for public hospitals. Effect of private sector presence in public hospital performance, based on which PPP options undertaken, will be different

Energy Modeling and Simulation including particle technologies within Single and Double Pass Solar Air Heaters

In order to obtain the best performance of the solar air heaters, it is necessary to find optimum performance conditions. The aim of this research paper is to achieve optimum conditions, by comparing single and double pass solar air heaters. Also, a brief review study of various related research works of all scenarios for a single and double pass and packed bed (including particle technologies) solar air heaters was carried out to observe the challenges of the mentioned systems. Energy modeling and simulation with EES and MATLAB open source code software indicated significant results in efficiency. According to the obtained results, it can be explained that double pass duct not necessarily always increases the overall system energy efficiency. Results of this work indicate, higher ambient air temperature (inlet air temperature) and lower solar irradiation can increase overall energy efficiency of solar double pass systems. More precisely at solar irradiation of 916 W/m2 and inlet air temperature of 302 οK, the system achieves the targeted optimum value in energy efficiency, approximately 90%, which is considerably more than the 65% as an average value

Effects of Pharmacologic Dose of Resveratrol Supplementation on Oxidative/Antioxidative Status Biomarkers in Nonalcoholic Fatty Liver Disease Patients: A Randomized, Double-Blind, Placebo-Controlled Trial

Purpose: Despite a proposed role for oxidative stress in the pathogenesis of nonalcoholic fatty liver disease (NAFLD), antioxidant approaches have not been sufficiently investigated in human NAFLD management. Resveratrol has been reported to possess a wide range of biological functions, including antioxidant activities. This study aimed to evaluate the effects of resveratrol supplementation on oxidative/anti-oxidative status in patients with NAFLD. Methods: This randomized, double-blind, placebo-controlled clinical trial was conducted on 60 patients with NAFLD (males and females) aged 20 to 60 years, and body mass index (BMI) of 25-35 kg/m2. Subjects were randomly assigned to receive a daily dose of 600 mg resveratrol (2×300 mg pure trans-resveratrol capsules; n=30) or placebo capsules (n=30) for 12 wk. Fasting blood samples, anthropometric measurements, and dietary intakes were collected for all patients at baseline and at the end of the trial. Oxidative stress was evaluated by measurement of serum malondialdehyde (MDA), oxidized low-density lipoprotein (ox-LDL), total antioxidant capacity (TAC), and erythrocyte superoxide dismutase (SOD) as well as glutathione peroxidase (GSH-Px) activities. Changes in the outcomes were analyzed using analysis of covariance (ANCOVA). Results: Resveratrol supplementation did not significantly affect neither serum MDA, ox-LDL, and TAC levels, nor erythrocyte SOD and GSH-Px activities, compared to placebo group (All P>0.05). Moreover, changes in serum levels of liver enzymes (ALT, AST, GGT, and ALP) were not significant in neither of the study groups (All P>0.05). Conclusion: Resveratrol supplementation did not modify oxidative/anti-oxidative status in patients with NAFLD

Effect of Group Discussion on the Attitude of Healthcare Workers Toward the Patients" Rights: A Randomized Controlled Trial

Objective: Group discussion can enhance the knowledge and capabilities of the nurses in clinical judgments, however, its impact on the attitude toward respecting the patients" rights by nurses has been less focused. Therefore, this study aimed to investigate the effect of group discussion on nurses" attitude toward respecting the rights of patients in Shahid Madani hospital, Tabriz in 2014. Materials and Methods: This experimental study with a pretest and posttest design and a control group was conducted on nurses. The research sample consisted of 142 working nurses who had a negative attitude score of less than 88 toward patients" rights. They were selected through the random sampling method and were assigned to 2 groups of experimental and control. A 2-partite questionnaire was used to collect data which included demographic data and observance of physical, psychological, and social rights of patients. Data were analyzed using SPSS. Results: According to the results, no significant demographic difference existed between the 2 groups (P > 0.05). However, the analysis of covariance showed a statistically significant difference between the 2 groups in the score which was significantly higher in the intervention group compared to the control group (P < 0.05). Conclusion: The results showed that group discussion can enhance observance of patients" rights by nurses. Therefore, it is recommended to use group discussion as an appropriate method in hospitals in order to change the attitude of nurses and to increase attention to patients" rights

A Pharmacological Approach to Medicinal Trees Described in the Classical Texts of Persian Traditional Medicine which do not Occur or No Longer Grow in Iran at Present

Abstract: The aim of this study was historically and pharmacologically reviewing almost all the known medicinal trees mentioned in classical texts of Persian traditional herbal medicine, which are not present or do no longer grow in Iran today. We have reviewed all important historical and modern literature about the medicinal trees and shrub used in Iranian traditional medicine. Then we selected the major references and collected the data. All plants, which were mentioned in classical texts of Iranian traditional herbal medicine, but do not occur or no longer grow in Iran at present. We compared the modern and traditional documented herbal medicine of our country and edited them as follow. All data about the terminology (if necessary some etymological information have been provided), local and native names, comparison the modern and traditional terminology and postulations about the plants, description about the medicinal parts of the plant, and finally the proposed medicinal and pharmacological activities of the trees have been presented. The collected data were represented as twenty-three species of trees and shrubs which were mentioned in classical texts of Iranian traditional herbal medicine, but are not reported as spontaneous in Iran at present. It is interesting that almost all of these plants have been described in the classical texts of Iranian herbal medicine. These data show that Persian scholars knew these trees in the earlier times. We may suppose the following probabilities for this controversy. The Persian scholars may were aware of these plants from Arabic, Indic or Greek-Roman tradition without seeing them closely. But it is known that the usage of the plants was common among Iranian herbalists and scholars in the past centuries. We propose more researches about these plants and the exact cause of their earlier presence and accessibility to the Persians in the history and the lack of their presence today in Iran

Evaluating the effect of a herb on the control of blood glucose and insulin-resistance in patients with advanced type 2 diabetes (a double-blind clinical trial)

Background: Different benefits of various herbal medicines in decreasing blood sugar have been reported in different clinical trials so far. Considering the growing tendency toward these combinations and the booming market, inappropriate advice is growing accordingly. Hence, it is necessary to evaluate the effects and possible complications of such combinations on health status and blood glucose control. Methods: Two 38-subject groups were formed and a 12-week treatment program was administered for both groups. The inclusion criteria were failure to control blood glucose with two oral medicines, unwillingness to inject insulin. The medicine was prepared in capsules by Booali Company. Each capsule weighed 750 mg and contained nettle leaf 20 (w/w), berry leaf 10 (w/w), onion and garlic 20 (w/w), fenugreek seed 20 (w/w), walnut leaf 20 (w/w), and cinnamon bark 10 (w/w) all in powder. Results: At the beginning of the study, there was no significant difference between the subjects regarding the evaluated parameters, but after the intervention, the level of glucose was significantly lower in fasting (P=0.0001) and 2-hour postprandial(P=0.002) levels. The level of glycated hemoglobin A1c (HbA1c) (P=0.0001) also decreased from 0.33&#177;9.72 to 0.20&#177;8.39 . Finally, the level of insulin resistance reduced from 1.9&#177;4.1 to 1.4&#177;2.6 (P=0.001) after consuming herbal medicine. Conclusion: According to the results of the current study, the herbal combination was effective in controlling blood sugar, and considering the reduction of HbA1c by 1.31 , it seems that the herbal combination is an effective medicine to treat diabetes. &#160

Hybrid Microfluidic Device for High Throughput Isolation of Cells Using Aptamer Functionalized Diatom Frustules

Circulating tumor cells (CTCs), secreted from primary and metastatic malignancies, hold a wealth of essential diagnostic and prognostic data for multiple cancers. Significantly, the information contained within these cells may hold the key to understanding cancer metastasis, both individually and fundamentally. Accordingly, developing ways to identify, isolate and interrogate CTCs plays an essential role in modern cancer research. Unfortunately, CTCs are typically present in the blood in vanishingly low titers and mixed with other blood components, making their isolation and analysis extremely challenging. Herein, we report the design, fabrication and optimization of a microfluidic device capable of automatically isolating CTCs from whole blood. This is achieved in two steps, via the passive viscoelastic separation of CTCs and white blood cells (WBCs) from red blood cells (RBCs), and subsequent active magnetophoretic separation of CTCs from WBCs. We detail the specific geometries required to balance the elastic and inertial forces required for successful passive separation of RBCs, and the use of computational fluid dynamics (CFD) to optimize active magnetophoretic separation. We subsequently describe the use of magnetic biosilica frustules, extracted from Chaetoceros sp. diatoms, to fluorescently tag CTCs and facilitate magnetic isolation. Finally, we use our microfluidic platform to separate HepG2-derived CTCs from whole blood, demonstrating exceptional CTC recovery (94.6%) and purity (89.7%