The effect of chronic obstructive pulmonary disease’s severity on complications after coronary artery bypass graft surgery

Background and aims: Smoking is an important etiologic factor for cardiac and pulmonary diseases. Chronic Obstructive Pulmonary Disease (COPD) is common in candidates for Coronary Artery Bypass Graft (CABG) surgery. Severity of COPD is determined with spirometry. The aim of this study was comparison of complications after CABG in COPD patients with different severity and without COPD. Methods: This study is a cross sectional research. We divided 125 CABG patients more than 40 years old based on preoperative spirometry to four groups: without COPD (60), mild (29), moderate (24) and severe (12). Spirometry was done using spirometer MIR, made in Italia. Mortality and postoperative complications including cardiovascular and respiratory were recorded until 30 days after the surgery. Data were analyzed by SPSS, fisher exact test and 2χ, and P˂0.05) was considered significant. Results: Complications with significant difference between groups were atrial fibrillation (AF) and delirium. Frequency of AF was: Without COPD 6 (10%), mild COPD 6 (20.70 %), moderate COPD 7 (29.20%), and severe COPD 5 (41.70%) (P=0.02), and delirium was: Without COPD 3 (5%), mild COPD 1 (3.40%), moderate COPD 3 (12.5%), and severe COPD 5 (41.70%) (P=0.003). Conclusion: Based on our results, COPD even moderate and severe is not contraindication of CABG. These patients should be carefully evaluated before surgery and must be treated preoperative completely by the specialist. Under this condition, patients can tolerate and benefit from surgery with acceptable risk

Explanation of Self-determination Experiences in Students with Externalized Behavior Disorders: A Phenomenological Approach

Introduction: Students with externalized behavior disorders have lower levels of capacity for self-determination skills. The aim of this study was to explain self-determination experiences in students with externalized behavior disorders. Method: This qualitative study was conducted using phenomenological approach. Data were collected using in-depth interview with 10 students with externalized behavior disorders who were selected through purposive sampling method. Interviews were recorded, transcribed, and analyzed using Colaizzi’s nine-step analysis method. Results: Four themes of social challenges, lack of motivation for effort, emotional challenges, and choice making were obtained that could illustrate self-determination experiences in students with externalized behavior disorders. Conclusion: These findings can provide information required for identifying self-determination problems, as well as significance and adoption of supportive and medical strategies for improving psychological health in students with externalized behavior disorders

Bat fauna and conservation assessment of Kurdistan caves, Iran

The populations of cave-dwelling bat species are encountering a remarkable decline all over the world. To plan effective conservation projects for bats and their cave roosts, collecting data on their distribution in a particular region is essential. Furthermore, developing an applicable index that incorporates both biotic and abiotic parameters relevant to caves is useful to prioritize caves for conservation management. Recently, there has been a growing interest in studying bat fauna of Iran. The Kurdistan province in west of the country is entirely mountainous, having a suitable geological substratum for formation of caves. Previously, five bat species were reported from Kurdistan. The current study has improved the data by doubling the number of cave-dwelling bat species of the province. A total number of 61 records of 10 species were documented. Overall, of 28 caves studied, 26 caves were used by bats. Each cave hosted one to six bat species. To prioritize Kurdistan caves for conservation programs, the Bat Cave Vulnerability Index (BCVI) was employed for 26 caves explored in this study. Four caves, including Karaftu, Kamtaran, Darvish Ouliya, and Kouna Sham-Sham, were highlighted due to their highest BCVI value. The other 22 caves received medium or low priority values. In the current study, we provided data on the bat fauna of Kurdistan caves, in addition to evaluate their conservation priorities by applying an assessing index for the first time in the country

Effects of cross-linking modification with phosphoryl chloride (POCl3) on pysiochemical properties of barley starch

Chemical methods are one of the comon method in starch modification. This study aimed at investigating of cross-link affection of phosphoryl chloride with two different levels 0.5 and 1g.kg-1 in order to enhance funciotnal proeprties and physiochemical changes on extracted starch from barley variety Bahman which cultivates in Chahr-Mahal Bakhtiari Province of Iran. Obtained results indicated that cross-linking leads to reduce sweeling power of strach granuls compred to natural starch and the amount of reduciton increase via the substitituin level. Powerfull cross-linkingnetween starch chains casue more resistance of granules to seweeling which is increased by means of cross-linking dgree. Additioally,  investigationresults from synersis revealed that releasing water percentage in cross-linked starches increase in comparison to natural starches and this amount depends onthe amount of cross-link surface with a significantly difference in (α <0.05). Gelatinization temperature in both levels negligibly increased by modification where in low level of cross-linking was more. Furthermoe evaluating gelation temperatures of both natural and cross-linked modified starches showed that addition of phosphate groups in starch and creating extra coovalent bonds make granues more compressed reulting in slight increase of To, Tp, Tcin barley starch. Icreasing of temperature observed more in less concentration of cross-links. Evaluation of viscosity changes also revealed that this modification depending on increasing the amount of Phosphoryl Chloride led to increasing peak temperature, diminish peak and setback viscosity. Result also exhibited that in morphological level, cross-link causes to incidence changes in particles' diameter size. The comparison of diameter average and frequency between natural starch and cross-links starch exhibited that in cross-linkd treatment with 0.5% phosphoryl chloride, increase in frequency of granules with diameter of 6 - 10µm and >20 µm obersced. While frequency of granules with diamater size of 2 - 6 µm and 10 - 20 µm has been reduced to 0 which create bigger granules

The effect of CPR training on performance of nurses in selected hospitals of Shahrekord University of Medical Sciences, 2010

زمینه و هدف: با توجه به نقش حیاتی پرستاران در احیای قلبی-عروقی بیماران دچار ایست قلبی تنفسی، این پژوهش با هدف تعیین تاثیر آموزش احیای قلبی- ریوی بر عملکرد پرسنل پرستاری بخشهای منتخب بیمارستانهای دانشگاه علوم پزشکی شهرکرد در سال 1389 انجام گردید. روش بررسی: این پژوهش مطالعه‌ای نیمه‌تجربی است که در آن کلیه پرستاران شاغل در بخشهای ICU،CCU ، اورژانس، فوریت‌ها، لیبر و ریکاوری بیمارستان‌های دانشگاه علوم پزشکی شهرکرد به روش سرشماری انتخاب و قبل و پس از برگزاری کارگاه‌های آموزشی، عملکرد آنان توسط چک لیست استاندارد شده ارزیابی و مقایسه گردید داده ها با استفاده از آمار توصیفی و استنباطی و نرم افزار SPSS مورد تجزیه و تحلیل قرار گرفت. یافته‌ها: میانگین سابقه اشتغال در اورژانس 2/2 سال و در سایر بخش‌ها 5/4 سال بود. در بخش سئوالات پژوهش نیز عملکرد واحدهای مورد پژوهش در ارزیابی سطح هوشیاری 6/11±8/81 درصد و در تماس با تیم احیاء4/11±53/81 درصد بود که پس از آموزش عملی به 100 درصد ارتقاء یافت و در مواردی چون استفاده از ماسک اکسیژن از 8/7± 9/42 درصد به3/8 ±25/56 درصد رسید و درخصوص کلیه سوالات در کلیه مراکز درمانی مورد بررسی، بین نمرات اخذ شده قبل و بعد از آموزش اختلاف معنی‌داری آماری وجود داشت (05/0

Educational needs assessment of gestational diabetes in pregnant women for safe delivery and healthy baby birth

زمینه و هدف: دیابت حاملگی با شیوعی حدود 7 درصد موارد حاملگی، مختص زنان باردار می باشد و موجب عدم تحمل گلوکز در آنان می گردد. عدم تشخیص و درمان به موقع آن موجب عوارض جدی در مادر و جنین طی دوران بارداری و هنگام زایمان می شود. این مطالعه با هدف نیاز سنجی آموزشی زنان باردار از دیابت حاملگی جهت انجام زایمان ایمن و تولد نوزاد سالم طراحی و اجرا شده است. روش بررسی: در این مطالعه توصیفی مقطعی، 101 زن باردار مراجعه کننده به مراکز بهداشتی درمانی دانشگاه علوم پزشکی شهرکرد در بهار سال 1393، به روش نمونه گیری آسان انتخاب و وارد مطالعه شدند. از پرسشنامه ای محقق ساخته متشکل از 40 سوال شامل سه بخش سوالات دموگرافیک، آگاهی سنجی و نیاز سنجی آموزشی به عنوان ابزار جمع آوری اطلاعات استفاده شد. میزان آگاهی و نیاز آموزشی زنان باردار در خصوص زایمان ایمن و تولد نوزاد سالم ارزیابی گردید. یافته ها: زنان با تحصیلات در مقطع کاردانی، همچنین زنانی که در بستگان خود دارای فرد دیابتی بودند، اطلاعات بیشتری در مورد دیابت داشتند. به طور میانگین 1/92 درصد زنان باردار به سوالات آگاهی سنجی پاسخ صحیح و 9/7 درصد پاسخ اشتباه دادند. در راستای نیاز سنجی آموزشی 1/64 درصد اعلام نمودند که در رابطه با موضوعات مرتبط با دیابت دوران بارداری نیاز به آموزش دارند و 9/35 درصد اعلام نمودند نیاز به آموزش ندارند. 3/87 درصد زنان از عوارض دیابت حاملگی بر سلامت جنین و نوزاد آگاهی متوسط و خوب و 7/12 درصد آگاهی ضعیف داشتند. نتیجه گیری: زنان باردار با سن کمتر از 35 سال، به علت عدم اطلاع از پایین بودن میزان آگاهی خود، بیشتر در معرض خطر بوده و نیاز به توجه و آموزش بیشتری در زمینه دیابت حاملگی جهت انجام زایمان ایمن و تولد نوزاد سالم دارند

The effect of automated telephone system on the satisfaction of client in the Imam Ali polyclinic

زمینه و هدف: رضایت بیمار شاخصی برای ارزیابی خدمات است و سنجش کارآیی و کیفیت خدمات ارائه‌شده به مردم در بخش بهداشت و درمان از اولویت‌های مهم وزارت بهداشت است. به همین منظور این مطالعه، باهدف بررسی تأثیر استقرار سامانه نوبت‌دهی تلفنی بر رضایت مراجعین پلی کلینیک فوق تخصصی امام علی (ع) شهرکرد انجام شد. روش بررسی: این مطالعه تحلیلی- مقطعی در پلی کلینیک تخصصی و فوق تخصصی امام علی(ع) شهرکرد در سال1392 انجام شد. پرسشنامه رضایت سنجی استاندارد با بررسی700 نفر از مراجعین این مرکز قبل و بعد از استقرار سامانه نوبت‌دهی تکمیل گردید. اطلاعات توسط شاخص‌های آماری توصیفی و استنباطی با نرم‌افزار SPSS نسخه 16 مورد تجزیه ‌و تحلیل قرار گرفت. یافته‌ها: میانگین امتیاز رضایت مراجعه‌کنندگان در سال 1391، معادل 7/5±5/22 و در سال 1392 ،3/6±7/23 بود که تفاوت 2 سال ازنظر آماری نشانگر ارتباط معنی دار پس از استقرار سیستم مکانیزه نوبت‌دهی بود (002/0=P). شاخص‌های سیستم نوبت‌دهی، نحوه دریافت نوبت، مکان انتظار، نظافت و تمیزی کلینیک، برخورد نگهبانی، برخورد نیروی پذیرش و منشی، برخورد پزشک، نحوه ویزیت پزشک، رعایت حریم شخصی و انتخاب کلینیک برای مراجعه بعدی در مجموع 78 رضایت‌مندی بیماران را تبیین می‌کردند. نتیجه‌گیری: اصلاح فرایندهایی مثل نوبت‌دهی باعث افزایش رضایتمندی بیماران می‌گردد، لذا بررسی منظم و دوره‌ای میزان رضایتمندی بیماران و ارائه برنامه‌های عملیاتی برای رفع نارضایتی آنان می‌تواند منجر به ارتقاء کیفیت خدمات بهداشتی درمانی گردد

Prenatal diagnosis of de novo small supernumerary marker chromosome 4q (4q11-q12): A case report

Background: Small supernumerary marker chromosomes (sSMCs) are chromosomal fragments with abnormal structures found in patients with fertility problems and developmental delay. They may be detected in amniotic cell karyotypes. sSMCs are categorized as hereditary or de novo. Here, we describe a case of prenatal de novo 4q11q12 sSMC and its molecular cytogenetic features which had no apparent phenotypic abnormality. Case: The fetus of a 36-yr-old pregnant woman was detected positive for Down’s syndrome (trisomy 21) at the 16th wk of gestation. Quantitative fluorescent polymerase chain reaction technique was applied for the rapid detection of numerical aneuploidy of chromosomes X, Y, 13, 18, and 21 microsatellites. Array comparative genomic hybridization (array CGH) technique was also conducted following the karyotype analysis of amniotic cells. The karyotype analysis was also done for the parents. Quantitative fluorescent polymerase chain reaction result revealed a male fetus with a normal chromosomal pattern, while the amniocentesis karyotype analysis identified a male fetus with a marker chromosome (47, XY, +mar), and the sSMC were existing in 100% of amniocyte metaphase spreads. The parents’ normal karyotypes indicated that the sSMC was de novo. Array CGH analysis revealed a 6.48-Mb duplication at 4q11q12. Eventually, the parents decided to terminate the pregnancy by legal abortion. Conclusion: Our study highlights the importance of the application of array CGH in combination with karyotype analysis for rapid and precise prenatal diagnosis of partial aneuploidy region.  Key words: Prenatal diagnosis, Array CGH, Chromosome 4, Chromosome markers

Cancer-associated mesenchymal stem/stromal cells: role in progression and potential targets for therapeutic approaches

Malignancies contain a relatively small number of Mesenchymal stem/stromal cells (MSCs), constituting a crucial tumor microenvironment (TME) component. These cells comprise approximately 0.01–5% of the total TME cell population. MSC differentiation potential and their interaction with the tumor environment enable these cells to affect tumor cells’ growth, immune evasion, metastasis, drug resistance, and angiogenesis. This type of MSC, known as cancer-associated mesenchymal stem/stromal cells (CA-MSCs (interacts with tumor/non-tumor cells in the TME and affects their function by producing cytokines, chemokines, and various growth factors to facilitate tumor cell migration, survival, proliferation, and tumor progression. Considering that the effect of different cells on each other in the TME is a multi-faceted relationship, it is essential to discover the role of these relationships for targeting in tumor therapy. Due to the immunomodulatory role and the tissue repair characteristic of MSCs, these cells can help tumor growth from different aspects. CA-MSCs indirectly suppress antitumor immune response through several mechanisms, including decreasing dendritic cells (DCs) antigen presentation potential, disrupting natural killer (NK) cell differentiation, inducing immunoinhibitory subsets like tumor-associated macrophages (TAMs) and Treg cells, and immune checkpoint expression to reduce effector T cell antitumor responses. Therefore, if these cells can be targeted for treatment so that their population decreases, we can hope for the treatment and improvement of the tumor conditions. Also, various studies show that CA-MSCs in the TME can affect other vital aspects of a tumor, including cell proliferation, drug resistance, angiogenesis, and tumor cell invasion and metastasis. In this review article, we will discuss in detail some of the mechanisms by which CA-MSCs suppress the innate and adaptive immune systems and other mechanisms related to tumor progression

Mortality and disability-adjusted life years in North Africa and Middle East attributed to kidney dysfunction : a systematic analysis for the Global Burden of Disease Study 2019

The authors would like to thank the hard work of the staff of the Institute for Health Metrics and Evaluation (IHME) for providing the best possible epidemiologic estimation of diseases in almost all regions and countries of the world, trying to reduce and eliminate poverty of knowledge and information about the diseases globally. Also, the core team authors sincerely thank all the collaborators of the GBD 2019 study who contributed to this study by providing data or a precise review of the manuscript. Publisher Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of the ERA. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.Peer reviewe