@article { author = {Akhondi Meybodi, Mohsen and Aghaei, Mohamad Mehdi and Akhondi meybodi, Sanaz}, title = {Treatment of Chronic Hepatitis B with Tenofovir}, journal = {Journal of Kerman University of Medical Sciences}, volume = {25}, number = {4}, pages = {287-293}, year = {2018}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background:Tenofovir is among the first-line treatments for chronic hepatitis B (CHB) virus infection. We evaluated the efficacy of Tenofovir in the treatment of Iranian adult patients with CHB. Methods: In a retrospective study, we evaluated 154 HBsAg positive patients referred to Sadoughi hospital in Yazd-Iran for treatment during 2009-2014. Forty-five patients were naive and 109 patients were treated previously with lamivudine or interferon. HBs Ag, HBeAg, HBeAb and quantitative HBV- DNA PCR were measured. The patients with HBV DNA >10,000 copy per ml in precore mutant and HBV DNA>100,000 copy per ml in wild type and ALT >two times of normal value were included. Tenofovir disoproxil fumarate 300 mg was administered and continued for three years. Data were analyzed using SPSS19. Results: We enrolled 154 (109 males 45 female) patients. Mean age of patients was 41± 8 years (18-58 year old). Forty-five of them were naive and the rest had previously experienced treatment. In this study, 113 of patients were of wild type and 41 patients were precore mutant variant. In wild type patients, 25 ones were naive and in precore mutant subtype, 20 patients were naive. HBsAg disappeared in 5 patients (3.2 percent). Forty one of 45 patients in the naive group (91 percent) and 96 of 109 patients in the previously treated group (88 percent) were cured. AST and ALT levels decreased in over 80 percent of patients and means of AST and ALT levels showed more decrease in naive and precore mutant subgroups. Serum AST and ALT and HBV DNA were higher in the wild type group than in the precore mutant group. Seroconversion occurred in 69 out of 113 patients at the end of the study. Conclusion: Treatment response rate to Tenofovir in Iranian patients with CHB was high. Tenofovir could be recommended as the first-line therapy of chronic HBV infection in Iran.}, keywords = {Chronic hepatitis B,Tenofovir,Therapy Efficacy,Seroconvertion}, url = {https://jkmu.kmu.ac.ir/article_79527.html}, eprint = {https://jkmu.kmu.ac.ir/article_79527_5054f11a372696e3b42526787b83870f.pdf} } @article { author = {Mahmoodi, Mohammad Reza and Hasheminejad, Naser and Bahrampour, Abbas and Azmandian, Jalal and Namdari, Mina}, title = {Risk Stratification of Hemodialysis Patients with Protein-Energy Wasting Using Hand Grip Strength and Malnutrition-Inflammation Score: are Two Indices Better than One?}, journal = {Journal of Kerman University of Medical Sciences}, volume = {25}, number = {4}, pages = {294-306}, year = {2018}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background: We aimed to detect whether risk stratification of hemodialysis (HD) patients with a combination of both malnutrition-inflammation score (MIS) and hand grip strength (HGS) indices identified more precisely patients at increased risk of protein-energy wasting (PEW). Methods: This was a deductive-analytical cross-sectional study. We determined the HGS and MIS of 83 HD patients who were randomly selected from the dialysis centers in Kerman. Data were analyzed using t-tests and One-way ANOVA. Multinomial logistic regression and receiver operating characteristic (ROC) curve analysis were performed accordingly. Results: There were significant differences between normal and high risk MIS regarding gender, having diabetes mellitus (DM), duration of dialysis, serum albumin, and C-reactive protein (p = 0.021, 0.049, 0.003, 0.038, and 0.027, respectively). There were also significant differences between normal and high risk HGS groups regarding age, having DM, cause of kidney disease (DM and/or hypertension), creatinine level, total cholesterol, weight, height, and mid upper arm circumference (p = 0.000, 0.006, 0.024, 0.011, 0.044, 0.026, 0.014, and 0.029, respectively). The ROC curves of the MIS and HGS indices showed sensitivity and specificity of 89.7% and 93.8%; 78.0% and 72.5%; respectively. Conclusions: Our findings reveal that patients, defined as “normal by both”, “normal by either”, and/or “high risk by both” based on the diagnostic tools, exhibit different markers compared to patients categorized by either index separately. The cutoff of MIS for the occurrence of PEW varied depending on the procedure used. The sensitivity and specificity of MIS and HGS indices were excellent.}, keywords = {Hand Grip Strength,Hemodialysis,Malnutrition-Inflammation Score,Protein- Energy Wasting,risk stratification}, url = {https://jkmu.kmu.ac.ir/article_79529.html}, eprint = {https://jkmu.kmu.ac.ir/article_79529_9fc5c0dc6faa3e06f10ea4562a1b9b26.pdf} } @article { author = {Vakilian, Alireza and Bazmandegan, Gholamreza and Saeedi Nezhad, Marjan and Asadollahi, Zahra and Moghadam Ahmadi, Amir}, title = {Association of HbA1c Levels with Extent and Functional Status of Ischemic and Hemorrhagic Stroke}, journal = {Journal of Kerman University of Medical Sciences}, volume = {25}, number = {4}, pages = {307-317}, year = {2018}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background:HbA1c is an established diagnostic index which is used to assess diabetes mellitus. The aim of this study was to evaluate the association between HbA1c level with the types of stroke as well as the extent and functional status of ischemic stroke (IS) and hemorrhagic stroke (HS) in patients. Methods: In this cross-sectional study, we evaluated 120 patients with IS and HS. The functional outcome was evaluated based on the MRS criteria. The extent of the lesion was determined according to CT scan and MRI. We measured the blood hemoglobin A1c (HbA1c) levels in all patients after stroke. Results:HbA1c level in the IS group was significantly higher compared to the HS group  (p < 0.05). There was a statistically significant difference between the extent of the lesion and the functional status of patients with the type of stroke (P < 0.001). History of smoking, in the IS group, was significantly associated with exposure to worse functional outcome (p <0.05). In the HS group, there was a significant relationship between hyperlipidemia histories with worse functional outcome. However, the relationship between HbA1c level and MRS score was inversely significant (p <0.05). Data analysis showed that, only in the IS group, the relationship between some independent variables, history of HLP and smoking, and the extent of stroke was significant (p <0.05). Conclusion: Findings of this study showed that there was a significant association between HbA1clevels as well as the extent and functional status with the type of stroke. There was a significant inverse relationship between HbA1c levels with the MRS score.}, keywords = {HbA1c level,Stroke,ischemic stroke,Hemorrhagic stroke,functional status}, url = {https://jkmu.kmu.ac.ir/article_79534.html}, eprint = {https://jkmu.kmu.ac.ir/article_79534_97d58c8f786ac5eb9fbe52ea5aaf1cc3.pdf} } @article { author = {Changizi-Ashtiyani, Saeed and Berenji, Somayeh and Zarei, Ali and Ramezani, Majid and Hosseini, Nasser}, title = {The Effects of the Extract of Rosa Canina L. On Lipid Profile, Liver and Thyroid Functions in Hypercholesterolemic Rats}, journal = {Journal of Kerman University of Medical Sciences}, volume = {25}, number = {4}, pages = {318-327}, year = {2018}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background: Rosa Canina L. is a medicinal plant with many therapeutic applications in traditional medicine. This study aimed to evaluate the effectiveness of the extract of Rosa Canina on liver function, lipid profiles and thyroid hormones in hypercholesterolemic rats. Methods: In this experimental study, 60 male Wistar rats were divided into 6 groups (n=10): the control group, hypercholesterolemic vehicle with a diet containing 2% cholesterol, hypercholesterolemia groups receiving either the extract of Rosa Canina L. at doses of 50, 500, 1000, or Atorvastatin at a dose of 10 mg/kg as gavage for 48 days. Results: The extract of Rosa Canina L lowered cholesterol and triglycerides from 96±1.3 and 111.8±4.8 in the vehicle group to 79.5±2.4, 98.7±3.5, 73.3±2.5 and 77.5±3.2 in the groups treated with the extract at doses of 500 mg/kg and 1000 mg/kg, respectively. The levels of liver enzymes including alanine transaminase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were lowered significantly in the group treated with the extract at the dose of 500mg/kg and in the groups treated with the extract at the dose of 1000 mg/kg (p <0.05). The serum levels of thyroid-stimulating hormone and thyroxin in the group treated with the extract at the dose of 1000 and thyroxin at the dose of 500 mg/kg was reduced and the level of triiodothyronine increased compared with the hypercholesterolemic group (p <0.05). Conclusion: Rosa Canina L has healing effects on dyslipidemia and liver protection along with changes in thyroid hormones secretion pattern.}, keywords = {Rosa Canina L,Liver,hypercholesterolemia,lipid profile}, url = {https://jkmu.kmu.ac.ir/article_79536.html}, eprint = {https://jkmu.kmu.ac.ir/article_79536_996b4e679558cc543d160a62316075c3.pdf} } @article { author = {Azaraeen, Saeedeh and Khodabakhsh, Roshanak and Khosravi, Zohreh}, title = {Brain-Behavioral Systems in Patients with Comorbid Anxiety -Depression vs. Healthy Individuals}, journal = {Journal of Kerman University of Medical Sciences}, volume = {25}, number = {4}, pages = {328-338}, year = {2018}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background: According to the brain-behavioral systems theory, behavioral inhibition and behavioral activation systems contribute to the development of many psychopathological conditions. Given that anxiety and depression are the most common emotional disorders and the fact that they are highly overlapping, the aim of this study was to compare the brain-behavioral systems in the patients with comorbid anxiety-depression and healthy individuals. Method: This study was cross-sectional. Sample includes Sixty-four patients with comorbid anxiety and depression attending to the community health centers of Jiroft city and 64 healthy individuals. They were selected using purposive sampling and matched for age and gender. After obtaining informed consent, they were asked to fill Jackson-5 scale, Beck Depression Inventory and Beck Anxiety Inventory. Data are analyzed by MANOVA. Results:The resuls showed that the two groups had significant differences in behavior inhibition system, fight, flight and freeze. However, there was no difference in behavioral activation system. Conclusion: Given the observed differences in the brain-behavioral systems between patients with comorbid anxiety-depression and healthy individuals, this theory may explain the comorbidity of anxiety and depression.}, keywords = {brain,Behavioral Systems Anxiety Depression Comorbidity}, url = {https://jkmu.kmu.ac.ir/article_79538.html}, eprint = {https://jkmu.kmu.ac.ir/article_79538_213a1712ece93dfe2d1bbe1ecf6db41b.pdf} } @article { author = {Zare, Sajad and Hemmatjo, Rasoul and Elahi Shirvan, Hossein and Hasheminejad, Naser and Sarebanzadeh, Keyvan and Zare, Khodabakhsh and Faridan, Mohammad}, title = {Investigating the Levels of Thermal Stress in Kerman City in 2016 Using Thermal Indices: WBGT, ESI, HI, HSI, and SWreq}, journal = {Journal of Kerman University of Medical Sciences}, volume = {25}, number = {4}, pages = {339-354}, year = {2018}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background:Thermal stress may have numerous harmful effects on human health. This study aimed at investigating thermal stress in the city of Kerman, Iran. Methods:In this descriptive-analytical study, thermal stress was assessed from 6 AM to 9 PM in 2016 using four thermal stress indices including wet-bulb globe temperature (WBGT), environmental stress index (ESI), Humidex, heat stress index (HSI), and Required Sweat Rate (SWreq). Necessary data were collected from the meteorological organization of Kerman. Pearson’s correlation coefficient and linear regression were used to examine the relationships among thermal stress indices and environmental parameters. All analyses were performed using SPSS version 22. Results: Based on the results, the highest correlation coefficients were observed between ESI and WBGT (r = 0.99), Humidex and ESI (r = 0.96), Humidex and WBGT (r = 0.97) and SWreq and HSI (r = 0.99). On the other hand, thermal stress indices had significant relationships with environmental parameters including wind speed, air temperature, and relative humidity (P < 0.05). Conclusion: All indices had strong and significant associations with one another. WBGT, HSI, and Humidex demonstrated similar thermal sensations. Furthermore, according to the obtained values of ESI, Humidex, and WBGT, people enjoy thermal comfort in all months of the year (save for January as judged by the obtained WBGT value). Thus, the climate of this city poses no threat to people’s thermal comfort.}, keywords = {Thermal climate,Heat indices,Heat,Temperature}, url = {https://jkmu.kmu.ac.ir/article_79542.html}, eprint = {https://jkmu.kmu.ac.ir/article_79542_7d465271f6aecb5c8f8b2249cc32d893.pdf} } @article { author = {Abdolkhaleghi, Masoumeh and Nikfarid, Lida and Hosseini, Azarakhsh and Taslimi, Faezeh}, title = {Mothers’ Experience of Children Peripheral Intravenous Catheterization: a qualitative content analysis}, journal = {Journal of Kerman University of Medical Sciences}, volume = {25}, number = {4}, pages = {355-364}, year = {2018}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background: Peripheral intravenous catheterization is one of the most painful procedures in children settings. Based on evidence, most of children do not benefit from pharmacological and non- pharmacological methods of pain management for this procedure and family members consider this experience as one of the most distressing ones in the hospital. This study aimed to explore the experience of mothers who had experienced difficult vascular catheterization of their children. Methods: This qualitative study using content analysis was carried out in different wards of a pediatrics referral center in Tehran, Iran (Markaz-e-Tebbi-Koodakan) in 2017. Purposeful sampling method was used to select 18 mothers who had suffered from their children's vascular catheterization. Deep semi structured interviews were used as the method of data gathering and qualitative content analysis was used for data analysis. Results: The main category was "unperceived frustration" which includes three subcategories, "role of nurse", "inability to support" and "coping ability". Conclusions: The present study increases our understanding of mothers' experiences of peripheral venous catheterization of their children. Despite being a routine experience for nurses, this experience appears to be very hard for mothers.}, keywords = {Pain,children,Mothers,Peripheral intravenous catheterization}, url = {https://jkmu.kmu.ac.ir/article_79544.html}, eprint = {https://jkmu.kmu.ac.ir/article_79544_9c91d4cce1273776108babebba3ba47e.pdf} } @article { author = {Mirzania, Marjan and Eshghizadeh, Maryam and Mousavinia, Fateme and Moshki, Mahdi}, title = {Effects of Participatory Training Program on the Control of Overweight and Obesity in Female Adolescents}, journal = {Journal of Kerman University of Medical Sciences}, volume = {25}, number = {4}, pages = {365-374}, year = {2018}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background:Adolescent obesity has become a serious public health challenge in the 21st century.The purpose of this study was to determine the effects of a participatory training program on the control of overweight and obesity in female adolescents. Methods:One hundred female participants aged 12 to 14 years with overweight or obesity were recruited from four schools which were selected randomly from the list of all schools. The height, weight, and body mass index (BMI) of participants were measured. A training program which consisted of proper nutritional behaviors as well as balanced physical activities was proposed through educational tools and lectures to the experimental group. Besides, questioning and answering sessions as well as group discussion with health and nutrition experts were held. Results:After the intervention, a significant difference was observed in the BMI of experimental group (26.39±3.06) compared with that of the control group (27.71±3.29). Also, the frequency of rice consumption (4.14±1.14), macaroni (121±0.40), eggs (2.15±0.92), meat (2.03±0.83) and chicken (2.06±1.008) significantly decreased after the intervention. Prior to the intervention, two groups were not significantly different in the terms of physical activity; however, a significant difference was found between the two groups after the intervention. Conclusion:According to the results of this study and the observed positive impact on the nutrition and physical activity patterns of adolescents, it seems that such training interventions in schools would be effective on preventing and controlling obesity as well as long-term health.}, keywords = {Adolescent,Overweight,Obesity,participation,Training}, url = {https://jkmu.kmu.ac.ir/article_79549.html}, eprint = {https://jkmu.kmu.ac.ir/article_79549_3a3332b442c76034563cd425ecfa1345.pdf} } @article { author = {Basir Shabestari, Samira and Shirinbak, Iman and Saghafi-khadem, Shadi and Eshghyar, Nosratolah}, title = {Schwannoma in the Posterior Hard Palate and Anterior Mandibular Gingiva: a report of two cases}, journal = {Journal of Kerman University of Medical Sciences}, volume = {25}, number = {4}, pages = {375-381}, year = {2018}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background: Schwannoma is a benign tumor which usually presents as a solitary slow-growing painless mass. Approximately 25–48% of all schwannomas occurs in the head and neck region and is found rarely in oral cavity, about 1% of head and neck cases. Tongue is the most common site, followed by buccal mucosa, palate, floor of the mouth, jaw, gingiva and lips. This tumor may present at any age but it is more prevalent in third and fourth decades of life. Case Presentation: Herein we report two cases of schwannoma in a 16-year-old woman and an 18-year-old man with asymptomatic pedunculated mass on anterior mandibular gingiva and painful swelling on posterolateral region of hard palate, respectively. The first lesion was discovered during the routine dental visit and the second one was referred by a dentist. They were medically healthy and their dental radiographies showed no particular findings. The provisional diagnosis for the first and second case was benign mesenchymal lesions and salivary gland tumor, respectively. Excisional biopsy was performed for them. Based on histopathological reports, the definitive diagnosis was neurilemmoma. There was no sign of recurrence approximately 2 years following surgical excision of tumors. The purpose of this report is to present two cases of schwannoma in an unusual location for intraoral tumors. Conclusion: Because of difficulty to diagnose this tumor based on clinical appearance alone, it is suggested that in well-defined peripheral intraoral lesion, schwannoma should be included in differential diagnosis even on palatal or gingival mucosa of young patients. Definitive diagnosis is best stablished by histopathological examination.}, keywords = {schwannoma,Neurilemoma,Gingiva,Hard palate}, url = {https://jkmu.kmu.ac.ir/article_79550.html}, eprint = {https://jkmu.kmu.ac.ir/article_79550_47bddd18ae36509ecfbdbad588056a13.pdf} }