@article { author = {Kajbafvala, M and SHaterzadeh, M.J and Goharpey, SH and Esfandyarpour, F and Salehi, R}, title = {Normalized Electromyography of Shoulder Muscles during Selected Functional Tasks of Upper Limb in Patients with Shoulder Impingement Syndrome}, journal = {Journal of Kerman University of Medical Sciences}, volume = {16}, number = {2}, pages = {297-306}, year = {2009}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background & Aims: Precise muscle activity pattern is required to maintain normal shoulder function and any alteration in muscle activity can result in movement impairment. The purpose of this study was to assess normalized electromyography (EMG) of shoulder muscles during selected functional tasks of upper limb in patients with shoulder impingement syndrome. Methods: Test group consisted of 15 subjects with shoulder impingement syndrome selected by nonprobability convenient sampling and control group consisted of 15 matched healthy subjects. In each group selected exercises including open kinetic chain with and without external load and closed kinetic chain with axial load were done and during each exercise surface EMG from selected muscle was recorded. Results: There was significant difference between the two groups in the activities of upper trapezius, infraspinatus and three regions of deltoid muscle (P<0.05).changes in normalized EMG were task dependent. Among all selected exercises, D2E showed minimum changes and tripod showed maximum changes in muscle activity domain. Conclusion: Decrease in activity domain of infraspinatus and trapezius muscles in patients with shoulder impingement syndrome causes impairment of shoulder function. D2E with causing minimum changes and Tripod with causing maximum changes in muscles activity domain are suggested respectively as the first and the last activity patterns in the treatment of these patients.}, keywords = {Shoulder joint,Shoulder impingement syndrome,electromyography,Exercise,Biomechanics}, url = {https://jkmu.kmu.ac.ir/article_17254.html}, eprint = {https://jkmu.kmu.ac.ir/article_17254_52fe8a5af1dda3af73ba73c8d97c1587.pdf} } @article { author = {Fazeli, H and Mirlohi, M and Mohammadi ghalaei, P}, title = {The Inhibitory Effect of Lactobacillus rhamnosus GG on Vancomycin Resistant Enterococcus faecalis Colonization in Mouse}, journal = {Journal of Kerman University of Medical Sciences}, volume = {16}, number = {2}, pages = {307-317}, year = {2009}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background&Aims: Vancomycin Resistant Enterococci (VRE) are among the most common nosocomial pathogens worldwide. The intestinal tract provides a major source for transmission of these bacteria. Probiotics are living microorganisms that moderate use of them has inhibitory effect on intestinal colonization by enteric pathogens. We examined the effect of Lactobacillus rhamnosus GG (LGG) on inhibition of VRE colonization in mouse model. Methods: Twenty four mice (Balb/C) were controlled for a week and then were infected to VRE by daily receiving of 1ml oral vancomycin (250µg/ml) and 1ml VRE suspension in MHB ( 5 10 CFU / ml 8 × ) for one week. Mice were randomly divided into two groups of treatment and control, and the effect of LGG probiotic was compared in the tow groups. VRE, total Enterococci, and enteric gram-negative bacilli counts in feces were determined before and after colonization by VRE. Results: At first, all mice were colonized by non –Vancomycin Resistant Enterococci (mean 5×105CFU/g for 7 days), and Vancomycin resistance was not detectable. Following gastric inoculation of VRE and receiving oral vancomycin, VRE was colonized in gastrointestinal tract of all mice (mean 1.6×106CFU/g for 7 days). Oral administration of LGG suppressed growth of all Enterococci, including the vancomycin-resistant strain in treatment group feces (P<0. 05). Conclusion: It is concluded that probiotic can reduce colonization of VRE. More studies on the effect of probiotics in prevention and treatment of VRE and other common pathogens are suggested}, keywords = {Enterococcus faecalis,Lactobacillus rhamnosus GG,Probiotic}, url = {https://jkmu.kmu.ac.ir/article_17255.html}, eprint = {https://jkmu.kmu.ac.ir/article_17255_10232dc63abd4d32cef0a3ae50696233.pdf} } @article { author = {Sazegarniya, A and Bahreini tosi, S.M.H and Montazer abadi, A.R and Ale davood, S.A and Esmaeili, H}, title = {Photosensitivity and Radiosensitivity of Indocyanine Green on Human Cell Lines MCF7 and DFW}, journal = {Journal of Kerman University of Medical Sciences}, volume = {16}, number = {2}, pages = {319-331}, year = {2009}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background & Aims: In this study with the aim of benefiting from non-laser sources in photodynamic therapy, photo and radio sensitivity of indocyanine green as a sensitizer in photodynamic and radiation therapies were investigated. Methods: Based on the broad absorption peak of indocyanine green and using non-coherent light, the experiments were performed on human cells derived from breast cancer and melanoma. To investigate chemical, optical and radiational cytotoxicity and also photosensitivity and radiosensitivity of indocyanine green, different dozes of this material were examined. After 24 h of incubation of cells with indocyanine green, independent treatment groups were exposed to 730±20 nm light with power densities of 30, 60, and 108 J/cm2 and 100 kVp x-ray (2 and 4 Gy). The effect of therapy on cells was determined by MTT test. Results: Indocyanine green showed no significant cytotoxicity. It had a good efficiency for photodynamic therapy using non-coherent sources in the wavelength of 730±20 nm, and the efficiency of treatment was dependent on the dosage of light. No significant relation between indocyanine green and radiation was observed. Conclusion: According to the findings, indocyanine green can be used as a photosensitizer in the range of 730±20 nm. Since there was no significant difference between groups which received both radiation and drug and those which received only radiation, indocyanine green cannot be considered as a radiosensitizer.}, keywords = {Photodynamic therapy,Breast Neoplasms,Melanoma,Indocyanine Green,Radio sensitivity Non-coherent}, url = {https://jkmu.kmu.ac.ir/article_17256.html}, eprint = {https://jkmu.kmu.ac.ir/article_17256_210270f64cc7184b857c78d324644a39.pdf} } @article { author = {Sif panahi, M.S and Salmalian, T and Dehghan, M}, title = {Vocal Parameters of Adults with Down Syndrome in Zahedan /Iran}, journal = {Journal of Kerman University of Medical Sciences}, volume = {16}, number = {2}, pages = {333-341}, year = {2009}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background & Aims: Previous studies have indicated significant differences in vocal parameters between children with Down syndrome and normal children, but there are challenges about these differences. In this study vocal parameters and Maximum Phonation Time (MPT) in adults with Down syndrome have been investigated. Method: This cross-sectional and analytic study was performed on 22 adults with Down syndrome and 22 normal adults matched for age and gender. While subjects were asked to produce sustained vowel /a/, some vocal parameters such as Jitter (perturbations of frequency), Shimmer (perturbations of amplitude), and Fundamental frequency (F0) were analyzed by Vocal analyzer of Dr. Speech (version 4.3 U from Tiger Electronics) Software. Mean MPT was also determined in both groups and based on gender by applying usual method of producing sustained vowel /a/ as much as possible. Two-way analysis of variance was performed for data analysis. Results: In Down syndrome group mean F0 was higher than Control group, but Jitter was lower (P<0.001). However, difference of mean shimmer between two groups was not significant. Interestingly in both groups shimmer and jitter in females were lower than males. In regard to MPT, two groups did not differ significantly. Conclusion: Although the differences between Down syndrome and control group show physiological lack of laryngeal control, it may be resulted from other factors (e.g. personal characteristics and submissiveness in social interactions) not investigated in the present study.}, keywords = {down syndrome,adult,Speech production measurement,jitter,shimmer,Maximum phonation time}, url = {https://jkmu.kmu.ac.ir/article_17257.html}, eprint = {https://jkmu.kmu.ac.ir/article_17257_46d79b0731389feda12bf93cb5271192.pdf} } @article { author = {Borhani, P and Mohammad alizadeh, S}, title = {The Opinions of physicians about Radiology Reports}, journal = {Journal of Kerman University of Medical Sciences}, volume = {16}, number = {2}, pages = {343-351}, year = {2009}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background & Aims: Radiology reports are often the only means of communication between radiologists and physicians. Despite the importance of these reports, practically physicians do not give a feedback about radiology reports. This study was aimed to determine the opinions of specialists towards radiology reports. Methods: in this descriptive study, sample consisted of all specialists working in Kerman city. Data collection was done by a researcher-made questionnaire consisted of demographic variables, items related to radiology and 17 items to assess opinion. Validity and reliability of the questionnaire were confirmed before data gathering Results: Participants were 220 specialists in 15 fields. Most of them were male (60.1%). The most percent of sample belonged to specialists in Internal medicine (16.5%), Orthopedists (16.5%) and Gynecologists (13.8%). Majority of physicians trusted in radiology reports more then 50%. Mean total opinion score (±SD) was 2.66 (±0.38) which was 85% of the maximum score. The highest mean scores belonged to “the style and quality of reports” and “the ability of interpreting radiographs.” Neither mean score of domains nor total mean score showed significant difference based on the level of education. Conclusion: based on the total opinion score, specialists do not have positive opinion toward radiology reports. In regard to increasing complexity of medical imaging and its role in the treatment of patients, better communication between radiologists and specialists in order to improve accurate diagnosis and treatment is necessary.}, keywords = {Radiology report,Diagnosis,Specialist,Radiologist}, url = {https://jkmu.kmu.ac.ir/article_17258.html}, eprint = {https://jkmu.kmu.ac.ir/article_17258_aa7c1ba6c5e65c7b969eeef6eec9df6b.pdf} } @article { author = {Ahmadiyan, SH and Haghdoost, A.A and Mohammad alizadeh, S}, title = {Effective Factors on the Decision of Families to Donate the Organs of their Brain Dead Relatives}, journal = {Journal of Kerman University of Medical Sciences}, volume = {16}, number = {2}, pages = {353-363}, year = {2009}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background & Aims: At present due to brain dead patients’ families refuse to organ donation, the number of available organs is less than the requesting cases. The aim of this comparative descriptive study was to compare opinions of donor and nondonor families about relevant factors in their decision making. Methods: participants included 175 members of 71 families (141 members of 56 donor families and 34 members of 16 nondonor families). Data were collected by a questionnaire after validity and reliability confirmation. Results: There was statistically significant difference between two groups in initially favorable reaction to the request, presence of the effective individuals on decision making in first cession of the request, awareness of the deceased beliefs about donation, and awareness of the conditions of patients with organ failure (P<0.0001). Regression analysis revealed that two first factors are the decision predictors (P=0.001). In regard to effective factors on decision, religious beliefs, trust, caring, decision doubt and conflict and transplant beliefs were significantly higher in donor group (P=0.0001). Regression analysis showed religious beliefs and transplant beliefs as predictors of the consent to donation (P=0.0001). Conclusion: Consent to organ donation is affected by two groups of factors and can be increased by providing public education and adequate conditions at the time of organ request based on the needs and critical conditions of relatives. This requires more attention of the Organ Procurement Organizations and also employing skilled and experienced individuals in organ request process.}, keywords = {Organ donation,Brain Death,Transplantation,consent}, url = {https://jkmu.kmu.ac.ir/article_17259.html}, eprint = {https://jkmu.kmu.ac.ir/article_17259_e520e29cf0d089c7788d99ad4228022f.pdf} } @article { author = {Aflatoniyan, M.R and SHarifi, I and Fekri, A.R}, title = {Evaluation of the Cost – Effectiveness of Cutaneous Leishmaniasis Treatment after the Earthquake in Bam}, journal = {Journal of Kerman University of Medical Sciences}, volume = {16}, number = {2}, pages = {365-373}, year = {2009}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background & Aims: Cutaneous leishmaniasis (CL) is a vector – borne disease and at present it is one of the important health problems in tropical and sub - tropical countries including Iran. Due to imposed expenses to the people and government, this study was performed to evaluate the cost – effectiveness of cutaneous leishmaniasis treatment in the years after the earthquake in Bam/Iran. Methods: In a descriptive cross-sectional study data about treatment costs CL-patients during 2006-7 were collected. Overall, 100 recovered patients were randomly selected and their treatment costs were analyzed. Results: For 5320 CL patients about 2570 million rials was spend by the government that was equal to per capita cost of 483676 rials. In addition, 1150 million rials were spent by the patients themselves in private clinics which increase the per capita cost to 216320 rials. Overall, 3% of the patients referred to private sectors that had 2 million rials costs and 25% referred to both governmental and private sectors which has led to a per capita cost of 550000 rials. In total, over 90% of the costs were direct and 10% were indirect costs. Conclusion: The per capita treatment cost in this study shows a significant difference with those by other national and international reports. The establishment of CL Treatment Center after the earthquake in bam has reduced the disease costs and provided an efficient, free and easy accessible service for the patients. This experience could be a suitable model to be used nationally as well as globally}, keywords = {Cutaneous leishmaniasis,Treatment costs,Bam earthquake}, url = {https://jkmu.kmu.ac.ir/article_17260.html}, eprint = {https://jkmu.kmu.ac.ir/article_17260_9e23308f4023b8e74c71a633cf77c5b7.pdf} } @article { author = {Keshtkaran, A and Ahmadzadeh, F and Panahiyan, H}, title = {The Effect of the Implementation of Quality Management System (ISO 9001: 2002) on the Improvement of the Performance of Medical Records Department in Shiraz Namazi Hospital (2003-2005)}, journal = {Journal of Kerman University of Medical Sciences}, volume = {16}, number = {2}, pages = {375-384}, year = {2009}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Background & Aims: Nowadays, new attitudes of clients, patients and students toward the quality of health care services, have led to unifying different systems in educational centers, which has been recognized as quality management system. The ISO standard series have created systems that integrate intra and inter organization processes to improve the quality of health services. The aim of the present study was to evaluate the role of implementation of ISO 9001:2000 on the improvement of the performance of Medical Records Department in Shiraz Namazi hospital during 2003-2005. Methods: In This descriptive study, data were collected through two custom-designed checklists and two questionnaires filled by observing the process of activities and documentation and interviewing managers, staff and members of the quality management system committee. There was no sampling and data were analyzed by using descriptive statistics. Results: The implementation of ISO standards had led to the documentation of responsibilities and administrative guidelines, clarification of patients’ and staff’s rights and determination of indexes for evaluation of admission, filing and coding units. However, it had failed to improve educational processes. Conclusion: Although implementation of ISO9001:2000 has been successful at improving the physical environment, personnel, facilities and equipments of the department, promotion of statistics department , use of fire extinguishing system , Periodic control of coding and filing systems for continuous improvement of ISO standards should be considered.}, keywords = {Medical record department,ISO9001,Quality management system,International standard organization}, url = {https://jkmu.kmu.ac.ir/article_17261.html}, eprint = {https://jkmu.kmu.ac.ir/article_17261_64e8cd8b803c481eee1c21c902ed27c3.pdf} } @article { author = {Salahi moghadam, A.R}, title = {Epidemiology of Human Fascioliasis in Iran}, journal = {Journal of Kerman University of Medical Sciences}, volume = {16}, number = {2}, pages = {385-398}, year = {2009}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Fascioliasis has medical and veterinary importance in Iran. Human Fascioliasis had been limited to just ectopic cases or sporadic reports before 1988. In this year an outbreak of human fascioliasis was reported from Gilan province and peak of this epidemy was seen in spring 1989. Considering 100000 population of Bandar-e-Anzali total infected cases was estimated between 9800 and up to 20000 cases. Although infection was seen in different age groups, most cases were less than 35 years old. Next outbreak was started in 1998 and raised up to maximum in 1999. Various factors were probably affected these outbreaks, including scattered stray cows, raise of snail population, intermediate Fasciola species with unknown biologic characteristics, Lymnaea truncatula like snails, higher snail infection, raise of sea level, raise of summer rainfall, more contact with polluted water and popular consumption of local wild herbs, in 1988 (up to 91% of infected people had history of “Khalvash” consumption, which is one of these wild herbs belonged to Menta sp). In these years more cultured herbs were exported to Tehran. It is highly probable that a combination of these factors has caused outbreaks of human fascioliasis in Iran. }, keywords = {Human fascioliasis,Fasciola hepatica,Limnaea truncatula,Epidemiology,Iran}, url = {https://jkmu.kmu.ac.ir/article_17262.html}, eprint = {https://jkmu.kmu.ac.ir/article_17262_e66916d03eff1e16832389622c6ad7ab.pdf} } @article { author = {Pedram, M and Fathi, A}, title = {Successful Treatment of Refractory Thrombotic Thrombocytopenic Purpura with Rituximab, a Monoclonal Antibody: a Case Report}, journal = {Journal of Kerman University of Medical Sciences}, volume = {16}, number = {2}, pages = {399-404}, year = {2009}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Thrombotic thrombocytopenic purpura (TTP) is mostly attributed to the presence of an autoantibody against ADAMTS-13, a metalloprotease that degrades ultralarge von Willebrand protein multimers. Accumulation of vWF multimers and systemic platelet aggregation lead to microangiopathic thrombosis, hemolytic anemia, and end-organ ischemia. Most patients respond to therapeutic plasma exchange (TPE), which replaces the missing protease and removes the circulating inhibitor. However, some cases (10%-20%) might not respond to TPE alone, and, therefore, interest has been aroused to use the novel immunosuppressive anti-B-cell antibody, rituximab. We report a 12-year old male patient with severeTTP refractory to multiple courses of plasmapheresis and high-dose steroid treatment in whom the combined use of daily plasma exchange and rituximab was associated with clinical resolution of active TTP, and we discuss the benefits and possible timing of combined therapy. Retuximeb used with plasma exchange can lead to sustained clinical remission in patients with refractory autoimmune TTP.}, keywords = {Thrombotic thrombocytopenic purpura,treatment,Rituximab}, url = {https://jkmu.kmu.ac.ir/article_17263.html}, eprint = {https://jkmu.kmu.ac.ir/article_17263_e33586eeaae0d14b3b85af8cfbcf0a6e.pdf} } @article { author = {Aghaei afshar, M and SHah esmaeili, A}, title = {Necrotizing Fascitis in a 47-Year Old Diabetic Man: Case Report}, journal = {Journal of Kerman University of Medical Sciences}, volume = {16}, number = {2}, pages = {405-409}, year = {2009}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Necrotizing fasciitis is one of the rare complications of misdiagnosed appendicitis with the mortality rate of over 25%.We report a 47-year old diabetic man admitted with necrotizing fasciitis of flank and abdominal wall secondary to acute appendicitis. The patient, with primary diagnosis of gas gangrene and necrotizing fasciitis, underwent surgical operation and after 3 months, elective appendectomy was performed. After that, he was discharged in good conditions.}, keywords = {Necrotizing fasciitis,Appendicitis,Gas gangrene}, url = {https://jkmu.kmu.ac.ir/article_17264.html}, eprint = {https://jkmu.kmu.ac.ir/article_17264_457134846b799d75307d9a85de9428fc.pdf} } @article { author = {Salsido, A}, title = {Newer Insights into the Prsevention of the Common Cold}, journal = {Journal of Kerman University of Medical Sciences}, volume = {16}, number = {2}, pages = {411-433}, year = {2009}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {}, abstract = {Since most colds are self-limiting, symptoms will usually resolve on their own in seven to ten days. For the majority of patients, treatment is symptomatic and targeted at the most bothersome symptoms. Specific nonprescription therapy may relieve cold symptoms but should be used with caution, especially in at-risk patient populations. Patients should monitor for worsening symptoms, and progression of complications. Medical referral is appropriate for patients with symptoms suggestive of nonallergic rhinitis, otitis media, sinusitis, or lower respiratory tract problems such as pneumonia, asthma, or bronchitis. Prevention is the main stay. Good hand hygiene, including frequent hand washing and the use of hand sanitizers, is still the most effective intervention to prevent the common cold. Commonly used organic acids have virucidal activity for rhinoviruses that persists for hours after application, which has important implications for the prevention of these infections. This simple and safe intervention seems to be the most logical tool we have at this time to prevent the common cold.}, keywords = {Common cold,Prevention}, url = {https://jkmu.kmu.ac.ir/article_17265.html}, eprint = {https://jkmu.kmu.ac.ir/article_17265_4378180ffff8d0bbf418efc10d661753.pdf} }