69 1735-3165 Journal of Rafsanjan University of Medical Sciences 2484 Editorial The Necessity of Revising the STROBE Statement in Order to Cover Ecological Studies Rezaeian M. 1 1 2015 13 8 653 654 18 01 2015 18 01 2015 سخن سردبیر Editorial مجله دانشگاه علوم پزشکی رفسنجان دوره 13، آبان 1393، 654-653       ضرورت تجدید نظر در بیانیه استروب به منظور پوشش دادن مطالعه اکولوژیک   The Necessity of Revising the STROBE Statement in Order to Cover Ecological Studies     محسن رضائیان[1] M. Rezaeian     در سخن سردبیری شماره شهریور سال 1392 مجله دانشگاه، خوانندگان، داوران و نویسندگان فرهیخته مجله را با بیانیه استروب آشنا ساختیم. همانطور که در آنجا اشاره شد، در سال 2007 میلادی، بیانیه استروب توسط تعدادی از دانشمندان و به منظور دستورالعمل استانداردی برای گزارش مطالعات اپیدمیولوژی مشاهده‌ای نظیر مطالعات مقطعی، مورد- شاهدی و هم‌گروهی به چاپ رسید [1]. سپس در سال‌های 2009 و 2011 میلادی دو الحاقیه جدید به این بیانیه افزوده شد. الحاقیه اول برای پوشش دادن مطالعات مربوط بررسی روابط ژنتیکی Genetic Association Studies(STREGA) [2] و الحاقیه دوم برای پوشش دادن مطالعات اپیدمیولوژی مولکولی(STROB-ME) Molecular epidemiology studies [3] مطرح شد. با این وجود همانطور که در مقاله اخیر خود به آن اشاره کرده‌ام [4]، یک دسته بسیار مهم از مطالعات اپیدمیولوژی مشاهده‌ای، یعنی مطالعات اکولوژیک (Ecological Studies) در متن این بیانیه در نظر گرفته نشده است. این در‌حالی‌ است که مطالعات اکولوژیک علی‌رغم همه محدودیت‌های خود نظیر احتمال رخداد مغلطه اکولوژیک (Ecological fallacy) و یا وجود مشکل در کنترل متغیر‌های مخدوش کننده (Confounding Variables)، از ارزش بسیار بالایی برخوردارند. این ارزش به ویژه‌ در بررسی ارتباط بین متغیر‌های مختلفی نظیر مسائل اجتماعی- اقتصادی با بیماری‌ها، آسیب‌ها و پیامد‌های مرتبط با آنها به ویژه در سطوح جغرافیایی مختلف نظیر شهرستان‌ها و استان‌های یک کشور مطرح می‌گردد [5]. از همین‌رو، ضروری بود که طراحان بیانیه استروب به منظور پوشش دادن مطالعات اکولوژیک نسبت به تجدید نظر در این بیانیه و یا طراحی یک الحاقیه جدید همت بگمارند [4] که خوشبختانه این موضوع مهم مورد موافقت آنها قرار گرفته است [6]. References [1] Rezaeian M. How to Report Observational Studies. J Rafsanjan Univ Med Sci 2013 12(6): 415-16. [Farsi] [2] Little J, Higgins JP, Ioannidis JP, Moher D, Gagnon F, von Elm E, et al. STrengthening the REporting of Genetic Association Studies (STREGA)--an extension of the STROBE statement. J Clin Epidemiol 2009 62(6): 597-608.e4. [3] Gallo V, Egger M, McCormack V, Farmer PB, Ioannidis JP, Kirsch-Volders M, et al. STrengthening the Reporting of OBservational studies in Epidemiology--Molecular Epidemiology (STROBE-ME): an extension of the STROBE statement. J Clin Epidemiol 2011 64(12): 1350-63. [4] Rezaeian M. A call for revising the STROBE statement to cover ecological studies. J Clin Epidemiol 2014 67: 836-7. [5] Rezaeian M, Dunn G, St Leger S, Appleby L. Geographical epidemiology, spatial analysis and geographical information systems: a multidisciplinary glossary. J Epidemiol Community Health 2007 61(2): 98-102. [6] Cevallos M, Poole C, von Elm E, Altman D, Egger M STROBE. Response to Rezaeian: Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) extension for ecological studies. J Clin Epidemiol 2014 67(7):837-8.   [1]- استاد گروه آموزشی پزشکی اجتماعی، دانشکده پزشکی، دانشگاه علوم پزشکی رفسنجان  تلفن: 34264003-034، دورنگار: 34255209-034، پست الکترونیکی: moeygmr2@yahoo.co.uk
2046 روانپزشکی The Comparison of the Resiliency and Psychological Risk Factors between the Youth of Smokers and Non-smokers Rahimian Boogar I. c Tabatabaee S.M. Nikaeen N. c semnan university 1 1 2015 13 8 655 668 15 01 2014 04 01 2015 Background and Objective: Smoking is a main factor for incidence and progression of the chronic diseases and their related adverse outcomes. The aim of this study was to compare the resiliency and psychological risk factors between the youth of smokers and non-smokers. Materials and Methods: In a cross-sectional descriptive plan, among the youth of Semnan town, 300 participants (153 smokers and 147 non-smokers) were selected by convenience method. Participants completed the Connor-Davidson Resilience Scale, Depression Anxiety and Stress Scales (DASS-21), Nicotine Dependence Syndrome Scale and Demographical Questionnaire. Data were analyzed using Multivariate Analysis of Covariance (MANCOVA). Results: The finding indicated that there was significant difference in resiliency, depression, and anxiety (p=0.001) and stress (p=0.005) between the youth of smokers and non-smokers. There was a significant difference in depression and stress regarding the confounding factor of age (p=0.013, p=0.36), but non-significant difference in resiliency and anxiety regarding the confounding factor of age (p=0.060, p=0.689). Also, there was a significant difference in resiliency and depression regarding to the confounding factor of gender (p=0.001, p=0.009), but non-significant difference in anxiety and stress regarding to the confounding factor of gender (p=0.135, p=0.247). In men and women subgroups, there was non-significant difference (p>0.05). Conclusion: Smokers in comparison with non-smokers had lower resiliency but higher depression, anxiety and stress. It is necessary to pay attention to resiliency improvement and reduction of these psychological risk factors in preventive and smoking cessation programs. Key words: Depression, Resiliency, Smoking, Youth, Anxiety, Stress   Funding: This study did not have any funds. Conflict of Interest: None declared. Ethical approval: The Ethics Committee of Researches and Sciences University, Semnan Branch, approved the study.   How to cite this article: Rahimian Boogar I, Tabatabaee SM, Nikaeen N. The Comparison of the Resiliency and Psychological risk factors between the youth of Smokers and Non-smokers J RafsanjanUniv Med Sci 2014 13(9): 655-68. [Farsi] 2296 Biochemistry Effect of Aloe Vera Hydroalcoholic Extract on Blood Glucose, Serum Insulin and the Key Enzymes in Metabolic Pathways of Glycolysis and Gluconeogenesis in Hepatocytes of Type 1 Diabetic Rats Chahardoli M. f Mahmoodi M. g Hajizadeh M.R. h Khoramdel Azad H. i Khoshdel A.R. j Mirzaei M.R. f Department of Biochemistry, Biophysics and Genetics, Faculty of Medicine, Rafsanjan University of Medical Sciences g Department of Biochemistry, Biophysics and Genetics, Faculty of Medicine, Rafsanjan University of Medical Sciences h Department of Biochemistry, Biophysics and Genetics, Faculty of Medicine, Rafsanjan University of Medical Sciences i Molecular Medicine Research Center, Rafsanjan University of Medical Sciences j Department of Biochemistry, Biophysics and Genetics, Faculty of Medicine, Rafsanjan University of Medical Sciences 1 1 2015 13 8 669 682 09 09 2014 19 01 2015 Background and Objective: Recently, it is considered the role of hypoglycemic agents specially medicinal plants derivatives in treatment of diabetes mellitus. Aloe Vera contains phenolic compounds and flavonoids with antioxidant properties that reduces the complications of the disease.The aim of study was to investigate the effects of hydroalcoholic extract of Aloe Vera in serum levels of glucose and insulin and key enzymes in metabolic pathways of glycolysis and gluconeogenesis in streptozotocin-induced diabetic Wistar rats. Materials and Methods: A total of 50 rats (initial weight of 220 ±10 g) were divided into five groups. Two months after treatment with Aloe Vera extract, the rats were sacrificed and blood glucose and serum insulin levels were measured. It was also isolated the liver then, extracted mRNA from it, expression levels of Glucokinase and Phosphoenol pyruvate carboxy kinase enzymes were measured by Real Time PCR. Results: The results showed that the extract of Aloe Vera at doses of 100, 200 and 400 mg/kg increase insulin secretion (p<0.05), hypoglycemia (p<0.001), increasing expression of Glucokinase enzyme (p<0.05) and reducing  expression of the Phosphoenol pyruvate carboxy kinase enzyme (p<0.05) in diabetic rats. Conclusion: Not only dose Aloe Vera hydroalcoholic extract influence on insulin secretion, it also affects on key enzymes gene expression of Glycolysis and Gluconeogenesis pathways. Hence, this extract can be effective for improvement of diabetic complications. Key words: Glycolysis and Gluconeogenesis pathways key enzymes, Streptozotocin, Aloe Vera, Rat   Funding: This research was funded by Rafsanjan University of Medical Sciences. Conflict of interest: None declared. Ethical approval: The Ethics Committee of Rafsanjan University of Medical Sciences approved the study.   How to cite this article: Chahardoli M, Mahmoodi M, Hajizadeh MR, Khoramdel Azad H, Khoshdel AR, Mirzae MR. Effect of Aloe Vera Hydroalcoholic Extract on Blood Glucose, Serum Insulin and the Key Enzymes in Metabolic Pathways of Glycolysis and Gluconeogenesis in Hepatocytes of Type 1 Diabetic Rats. J RafsanjanUniv Med Sci 2014 13(8): 668-82 [Farsi] 2090 Pharmacology Evaluation of the Effect of Vitamin D3 and Ginger Extract on the Clinical Symptoms and the Severity of Inflammation in EAE Jafarzadeh A. Mohammadi kordkheyli M. Ahangar-Parvin R. Azizi S.V. Ayobi F. Taghipour Z. Shamsizadeh A. Goujani R. Nemati M. Moazeni M. 1 1 2015 13 8 683 694 25 02 2014 19 01 2015 Background and Objective: The anti-inflammatory effects of the vitamin D and ginger have been demonstrated in some studies. The aim of this study was to evaluate the effects of vitamin D and ginger extract on the clinical symptoms and leukocyte infiltration of experimental autoimmune encephalomyelitis (EAE). Materials and Methods: For the induction of EAE, the (C57BL/6) were immunized subcutaneously MOG peptide emulsified in complete Freund's adjuvant. The mice divided into EAE group includimg: vitamin D-treated, ginger extract-treated, olive oil and phosphate-buffered saline, and also one group which was considered as normal group and received only PBS(phosphat- Buffered Saline). The mice were sacrificed at day 31 after immunization and the leukocytes infiltration was evaluated in the CNS (central nervous system). The EAE scores and the body weight were evaluated till day 30. Data were analyzed using t-test. Results: Two control groups showed the clinical symptoms at day 10, whereas vitamin D and ginger-treated groups exhibited the symptoms at days 13 and 15, respectively. The maximum mean score of disease was (1.87±1.61), (1.92±1.79), (1.05±1.01), and (0.73±0.81) for olive oil-, PBS-, vitamin D3-, and ginger-treated groups, respectively. Vitamin D3 and ginger extract increased the body weight significantly )P =0.05) as compared to control groups. The leukocytes infiltration was also significantly lower in treated groups as compared to control group. Conclusion: These observations represent that the vitamin D3 and ginger extract have significant capability to attenuate the EAE severity. Key words: EAE, Vitamin D3, Ginger extract, Clinical symptoms   Funding: This research was funded by both Kerman University of Medical Sciences and Rafsanjan University of Medical Sciences. Conflict of interest: None declared. Ethical approval: The Ethics Committee of Rafsanjan University of Medical Sciences approved the study   How to cite this article: Mohammadi M, Ahangar-Parvin R, Azizi SV, Ayobi F, Taghipour Z, Shamsizadeh A, Moazeni M, Goujani R, Nemati M, Jafarzadeh A. Evaluation of the Effect of Vitamin D3 and Ginger Extract on the Clinical Symptoms and the Severity of Inflammation in EAE. J RafsanjanUniv Med Sci 2014 13(7): 683-94. [Farsi] 2200 Statistics; Epidemiology Assessment of the Demographic Characteristics and the Quality of Life in Patients with Pituitary Adenoma in a Referral Pituitary Center in Tehran in 2011 Asadi-Lari M. Sadeghipour A.R. Mahouzi L. Solaimani Dodaran M. Fallah A. Iran University of Medical sciences 1 1 2015 13 8 695 704 16 06 2014 19 01 2015 Background and Objective: Pituitary adenoma (PA) is one of the most common intracranial tumors. In recent years, some research has been done on patients with PA. Given the lack of similar research in Iran, this study was conducted to assess the demographic characteristics and the quality of life among Iranian patients with PA. Materials and Methods: This study was a cross- sectional- descriptive survey. In 2011, two hundred and fifty patients accepted to participate in this study, using convenience sampling method. Data were collected using EORTC QoL-C30(European Organization for Research and Treatment of Cancer Quality of Life). Independent two-sample t-test, one-way ANOVA and chi-square tests were used for data analysis. Results: Two hundred and fifty Respondents were from those in the 15 to 82 age group and mean age of 44.80±14.16 years. The study results revealed that the most common tumors among the patients were prolactinoma (48.4%), followed by nonfunctioning pituitary adenoma (26.8%), growth-hormone-releasing adenoma (acromegaly)(19.6%), and Cushing;#39s disease (5.2%). The consequences of this study disclosed a significant difference between the patients in different domains of the quality of life, including Global health status, Functional scales and in Symptom scales in this respect, patients with Cushing’s disease had the worst condition. Conclusion: Overall, the comparison showed that the quality of life in patients with Cushing;#39s disease was significantly lower than that among patients with other types of pituitary adenoma. Regarding the association between personal factors in PA and the quality of life, inter-sectoral approach to health problems and interventions that affect the quality of life are important. Key words: Pituitary adenoma, Demographic, Quality of life, Age, Tehran   Funding: This research was funded by Iran University of Medical Sciences. Conflict of Interest: None declared. Ethical approval:   How to cite this article: Asadi-Lari M, Sadeghipour AR, Mahouzi L, Solaimani Dodaran M, Fallah A. Assessment of the Demographic Characteristics and the Quality of Life in Patients with Pituitary Adenoma in a Referral Pituitary Center in Tehran in 2011. J RafsanjanUniv Med Sci 2014 13(8): 695-704. [Farsi] 1940 Physiology Effect of Endurance Swimming Training and Silymarin Treatment on Changes in Liver Apoptotic Index in Pregnant Rats Exposed to Cadmium Mirdar Harijani Sh. Musavi N. Hamidian Gh.R. oliaei H.A. university of mazandaran university of mazandaran univercity of tabriz Department of Education 1 1 2015 13 8 705 714 05 11 2013 04 01 2015 Background and Objective: Abnormal regulation of apoptosis causes progressive pathological processes in the placenta of pregnant women and affects on fetal growth. The aim of this study was to investige the effects of endurance swimming training and silymarin treatment during pregnancy on cadmium exposure -induced liver apoptotic index in pregnant rats. Materials and Methods: In this expremental study 72 female rats divided into 9 groups. Training program consisted of endurance swimming, from the first day of pregnancy until delivery. Cadmium chloride (CdCl2) was given as drinking water (400 mg/kg/l). Silymarin was injected subcutaneously (100 mg/kg) 3 times a week. Apoptotic index was determined by nonradioactive in situ end labeling method using TUNEL immunocytochemical technique. The ANOVA and post hoc LSD (Least Significant Difference) tests were used to analyze the findings of study. Results: Cadmium significantly increased liver apoptotic index (p=0.001). Swimming training induced no significant change in liver apoptotic index (p=0.424). Swimming training and silymarin treatment significantly decreased liver apoptotic index compared to cadmium (p=0.001). Conclusion: Endurance swimming training in combination with silymarin treatment during pregnancy can significantly counteract with cadmium-induced apoptotic index apoptosis in the liver of the pregnant rats. Keywords: Apoptotic index, Pregnant rat, Silymarin, Cadmium, Swimming training   Funding: This research was funded by Mazandaran University, Faculty of Physical Education and Sport Sciences. Conflict of interest: None declared. Ethical approval: The Ethics Committee of Mazandaran University, Faculty of Physical Education and Sport Sciences, approved the study.   How to cite this article: Mirdar Harijani Sh, Musavi N, Hamidian GhR, oliaei HA. Effect of Endurance Swimming Training and Silymarin Treatment on Changes in Liver Apoptotic Index in Pregnant Rats Exposed to Cadmium. J RafsanjanUniv Med Sci 2014 13(8): 705-14. [Farsi] 2297 Statistics; Epidemiology Comparison of the Critical Thinking Skills among Medical Students in Different Educational Levels in Rafsanjan University of Medical Sciences in 2013 Rezaeian M. Zare-Bidaki M. Bakhtar M. Afsharmanesh K. 1 1 2015 13 8 715 724 09 09 2014 20 01 2015 Background and Objective: Critical thinking is one of the most important types of thinking and a necessary skill for accurate decision-making. The aim of this study's to investigate and compare the critical thinking disposition in various educational levels of medical students of Rafsanjan University of Medical Sciences. Materials and Methods:In this cross-sectional study Ricketts Critical Thinking Disposition Inventory (CTDI) questionnaire accompanied by some demographic and educational questions were used. The questionnaires were submitted to 250 students of whom 165 (66%) were finally returned the completed questionnaire. Data were analyzed using statistical tests including Correlation, Student’s t and ANOVA. Results: The mean score of critical thinking disposition in 165 students participating in our study was determined to be equal to 11.22±1.31. The critical thinking in male students was statistically higher than female ones (11.41±1.34 versus 10.94±1.21). There was a weak but significant reverse correlation between critical thinking disposition score and students’ mean scores of passed lessons (r=-0.156, p=0.045). Furthermore, mean scores of the maturity and engagement subscales significantly differed in various educational levels (p≤0.05 and p=0.02, respectively). Conclusion: Critical thinking disposition in medical students of Rafsanjan University of Medical Sciences was relatively estimated satisfactory, compared to many other Iranian universities however it seems that the need for teaching and applying the critical thinking skills is especially more imperative for internship students. Key words: Critical thinking, Maturity, Engagement, Medical students   Funding: This research was funded by Rafsanjan University of Medical Sciences. Conflict of interest: None declared. Ethical approval: The Ethics Committee of Rafsanjan University of Medical Sciences   How to cite this article: Rezaeian M, Zare-Bidaki M, Bakhtar M, Afsharmanesh K. Comparison of the Critical Thinking Skills among Medical Students in Different Educational Levels in Rafsanjan University of Medical Sciences in 2013. J Rafsanjan Univ Med Sci 2014 13(9): 715-24. [Farsi] 2256 Parasitology The Prevalence of Giardiasis Infections Among People Admitted to Karaj laboratories in 2013: A Short Report Elmi T. Ziaie H. Gholami Sh. Mortazavi M. Tabasi M. Geraili Z. - - - 1 1 2015 13 8 725 730 02 08 2014 20 01 2015   Background and Objective: Giardiasis is a common disease in several parts of the world. Due to the importance of this disease, the present study was conducted to determine the prevalence of parasitic infections in the stool samples from admitted people to Karaj laboratories. Materials and Methods: In this descriptive study, 2500 human fecal samples were randomly collected from admitted people to Karaj laboratories in 2013. We analyzed the data by using SPSS . Results: Totally from among 2500 samples, 252 (10.1%) cases were infected with Giardia. Most of the cases (69.8%) were asymptomatic. Conclusions: Based on the prevalence (10.1%) of giardiasis infection among people admitted to Karaj laboratories, early diagnosis and treatment of the patients and public health promotion could be effective to prevent and control this infection. Key words: Giardiasis, Prevalence, Karaj Funding: This study was funded by Mazandaran University of Medical Sciences. Conflict of interest: None declared. Ethical approval: The Ethics Committee of Mazandaran University of Medical Sciences approved the study.     How to cite this article: Elmi T, Ziaie H, Gholami Sh, Mortazavi M, Tabasi M, Geraili Z. The Prevalence of Giardiasis Infections Among People Admitted to Karaj laboratories in 2013: A Short Report. J RafsanjanUniv Med Sci 2014 13(8): 725-30. [Farsi] 1917 آموزش پزشکی Survey of Clinical Competency in Fourth-year Medical Students of Guilan University of Medical Sciences in 2011:A Short Report Soleymanha M. Jalali M.M. Mirblouk A.R. Etehad H. Ahaki H.R. Haghparast Ghadim Limodehi Z. Poursafar A. guilan university of medical scients guilan university of medical scients guilan university of medical scients guilan university of medical scients guilan university of medical scients guilan university of medical scients guilan university of medical scients 1 1 2015 13 8 731 736 19 10 2013 24 11 2014 Background and Objective: Evaluation of clinical competency of medical students can give very useful information to the authorities for setting educational aims according to student’s requirements and qualitative promotion in the educational process. The present study has been evaluated the clinical competency of fourth-year medical students. Materials and Methods: This cross-sectional study has been done in 2011 to assess clinical competence of all the fourth-year students of Guilan University of Medical Sciences, that all of them had passed the skills lab course. Data-gathering tool was a questionnaire which assessed nine main competencies in medical students. All data was analyzed by Chi-square and analysis variances by SPSS software. Results: 68 students enrolled in the study with the mean age of 24-year old. In the field of effective communication, 78% of students scored excellent. In the clinical skills, applying sciences as guidelines in diagnosis and management of patients, lifetime learning, self-awareness, socio-medical affairs and understanding the role of a professional physician fields, result in 84% of the students were average.Most of students had low scores only in the field of ethical understanding and judgement. There was no significant relation in the clinical competency of the different fields according to the age and sex. Conclusion: Generally, the students in our study reached a reasonable level of competence in participating in clinical treatment. Key words: Medical students, Clinical competency, Competency-based education.   Funding:. This research was funded by Guilan University of Medical Sciences. Conflict of Interest: None declared. Ethical approval: The Ethics Committee of Guilan University of Medical Sciences approved the study.   How to cite this article: Soleymanha M, Jalali MM, Mirblouk AR, Ahaki HR. Survey of Clinical Competency in Fourth-year Medical Students of Guilan University of Medical Sciences in 2011:A Short Report. 2012. J RafsanjanUniv Med Sci 2014 13(8): 731-36. [Farsi]