Isfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953127120140220The Drug Prescription Patterns and Utilization after Family Physician Program Implementation in Rural Health Centers of Isfahan District, IranThe Drug Prescription Patterns and Utilization after Family Physician Program Implementation in Rural Health Centers of Isfahan District, Iran2403241114250FAReza KhadiviAssociate Professor, Health Social Determinants Research Center, Isfahan University of Medical Sciences, Isfahan, Iran0000-0001-9468-3110Amin YarahmadiStudent of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, IranRezvan EslamiehPharmacist, Drug Affair, Isfahan District Health Center NO.2, Isfahan University of Medical Sciences, Isfahan, IranMahbubeh KhosravinejadDrug Affair, Isfahan District Health Center NO.1, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20130202Background: Health sector reform as "Family Physician" (FP) program has been introduced in 2004 in rural and lower than 20 thousands population cities of Iran. This study aimed to reveal the utilization rate of general practice visit and prescription pattern in the rural health centers before and after the Family Physician program in rural health centers of Isfahan district.Methods: We retrospectively assessed the number of prescriptions per year and in other mean, the average medical contacts per person, before and after implementation of Family Physician program in 2004 and 2011 in a cross-sectional study during the year 2012. In addition, we assembled the mean number of drugs per prescription and drug costs. Data were collected in 17 rural health centers of Isfahan district in the central of Iran.Findings: The prescription numbers in 2011 was 3.58 times more than such practiced in 2004. The prescriptions per capita were 0.145 and 0.64 in 2004 and 2011, respectively. The more prescriptions had done in spring and winter in both years. The mean number of drugs prescribed per encounter decreased from 4.27 ± 0.69 in 2004 to 4.11±0.56 in 2011. The per capita drug costs increased 4.87 times in 2011 in comparison with 2004.Conclusion: Following Family Physician program implementation, the prescriptions per capita were increased. In otherwise, the access to general physician (equity) improved. In addition, the mean number of drugs prescribed per encounter decreased. Thus, following Family Physician program, technical efficiency has been developed.Background: Health sector reform as "Family Physician" (FP) program has been introduced in 2004 in rural and lower than 20 thousands population cities of Iran. This study aimed to reveal the utilization rate of general practice visit and prescription pattern in the rural health centers before and after the Family Physician program in rural health centers of Isfahan district.Methods: We retrospectively assessed the number of prescriptions per year and in other mean, the average medical contacts per person, before and after implementation of Family Physician program in 2004 and 2011 in a cross-sectional study during the year 2012. In addition, we assembled the mean number of drugs per prescription and drug costs. Data were collected in 17 rural health centers of Isfahan district in the central of Iran.Findings: The prescription numbers in 2011 was 3.58 times more than such practiced in 2004. The prescriptions per capita were 0.145 and 0.64 in 2004 and 2011, respectively. The more prescriptions had done in spring and winter in both years. The mean number of drugs prescribed per encounter decreased from 4.27 ± 0.69 in 2004 to 4.11±0.56 in 2011. The per capita drug costs increased 4.87 times in 2011 in comparison with 2004.Conclusion: Following Family Physician program implementation, the prescriptions per capita were increased. In otherwise, the access to general physician (equity) improved. In addition, the mean number of drugs prescribed per encounter decreased. Thus, following Family Physician program, technical efficiency has been developed.https://jims.mui.ac.ir/article_14250_027a2f59c4881669c52ed87b2920b7ad.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953127120140220Preventive and Curative Activity of Garlic Extract on Gentamicin-Induced Oxidative StressPreventive and Curative Activity of Garlic Extract on Gentamicin-Induced Oxidative Stress2412242214251FAHamid NasriProfessor, Department of Nephrology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0003-1673-5741Mahmoud Rafieian-KopaeiProfessor, Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, IranJournal Article20130717Background: Nephrotoxicity is a serious side effect of using gentamicin. Garlic is an important component in the complementary medicine. The aim of this study was to find out whether garlic has ameliorative effects on gentamicin-induced nephrotoxicity.Methods: 50 male Wistar rats were divided into 5 groups of 10; I: They kept in the same condition as others without receiving any drug for 10 days and then sacrificed. II: Rats in this group were injected intraperitoneally (i.p.) with 100 mg/kg of gentamicin for 10 consecutive days and then sacrificed. Group III: Rats in this group received garlic juice 20 mg/kg intraperitoneally for 10 days and then sacrificed. IV: Rats in this group received gentamicin for 10 days, then received 20 mg/kg garlic intraperitoneally for the next 10 days and then sacrificed on day 20th. V: Rats in this group received a combination of intraperitoneal gentamicin and garlic 20 mg/kg for 10 days and then sacrificed. Serum blood urea nitrogen (BUN) and creatinine (Cr) were measured and the kidneys were processed for histopathological examinations. All specimens were examined for morphologic parameters involving tubular cells.Findings: The post administration of garlic after gentamicin treatment potentially attenuated the serum levels of BUN and Cr. The pathology damage scores indicated that post administration of garlic after 10 days of gentamicin treatment attenuated the damage score significantly.Conclusion: We concluded that garlic is a nephroprotective drug to attenuate tubular injury by gentamicin.Background: Nephrotoxicity is a serious side effect of using gentamicin. Garlic is an important component in the complementary medicine. The aim of this study was to find out whether garlic has ameliorative effects on gentamicin-induced nephrotoxicity.Methods: 50 male Wistar rats were divided into 5 groups of 10; I: They kept in the same condition as others without receiving any drug for 10 days and then sacrificed. II: Rats in this group were injected intraperitoneally (i.p.) with 100 mg/kg of gentamicin for 10 consecutive days and then sacrificed. Group III: Rats in this group received garlic juice 20 mg/kg intraperitoneally for 10 days and then sacrificed. IV: Rats in this group received gentamicin for 10 days, then received 20 mg/kg garlic intraperitoneally for the next 10 days and then sacrificed on day 20th. V: Rats in this group received a combination of intraperitoneal gentamicin and garlic 20 mg/kg for 10 days and then sacrificed. Serum blood urea nitrogen (BUN) and creatinine (Cr) were measured and the kidneys were processed for histopathological examinations. All specimens were examined for morphologic parameters involving tubular cells.Findings: The post administration of garlic after gentamicin treatment potentially attenuated the serum levels of BUN and Cr. The pathology damage scores indicated that post administration of garlic after 10 days of gentamicin treatment attenuated the damage score significantly.Conclusion: We concluded that garlic is a nephroprotective drug to attenuate tubular injury by gentamicin.https://jims.mui.ac.ir/article_14251_c4ee553cc7f33c0815784a67e5c1ab4d.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953127120140220Relationship of Cardiovascular Diseases and Bone Mineral Density in Postmenopausal WomenRelationship of Cardiovascular Diseases and Bone Mineral Density in Postmenopausal Women2423243314252FAGholamreza DashtiAssociate Professor, Department of Anatomical Sciences and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Irana:2:{s:5:"en_US";s:0:"";s:5:"fa_IR";s:0:"";}Mohammadreza SalamatAssistant Professor, Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-8994-2541Hossein Sabaghie-YazdStudent of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, IranAmirhossein SalamatOsteoporosis Diagnosis Center, Isfahan, Irana:2:{s:5:"en_US";s:0:"";s:5:"fa_IR";s:0:"";}Journal Article20131123Background: Cardiovascular diseases and osteoporosis are two common chronic conditions particularly in elderly populations, which result in significant morbidity and mortality. Previous studies have shown the relationship of some sorts of heart disease and decrease in bone mineral density (BMD) and presence of osteoporosis. This study aimed to evaluate the relationship of cardiovascular diseases and osteoporosis in postmenopausal women.Methods: 200 patients with a mean age of 66.7 ± 5.8 years (range 52-79 years) were enrolled in this study. Patients were divided in two groups of with and without heart disease according to their medical records. Patients underwent dual-energy x-ray absorptiometry (DXA) measurements at hip and lumbar spines (L2, L3, and L4), greater trochanter, and femur neck. Results were showed as T-score and BMD in g/cm2. The patients were divided into three groups according to T-score (normal, osteopenic, and osteoporotic) after collecting the data, Chi-square (for qualitative variables), t (for quantitative variables), and the Mann-Whitney tests were used for data analysis.Findings: No significant difference was seen between subjects with and without heart disease in mean value of BMD. In addition, there was no statistical significant difference between these two groups in distribution of osteoporotic, osteopenic, and normal density subjects (P > 0.05) in various points of skeleto.Conclusion: In this study, no relationship was observed between cardiovascular disease (as a whole) and BMD and presence of osteoporosis.Background: Cardiovascular diseases and osteoporosis are two common chronic conditions particularly in elderly populations, which result in significant morbidity and mortality. Previous studies have shown the relationship of some sorts of heart disease and decrease in bone mineral density (BMD) and presence of osteoporosis. This study aimed to evaluate the relationship of cardiovascular diseases and osteoporosis in postmenopausal women.Methods: 200 patients with a mean age of 66.7 ± 5.8 years (range 52-79 years) were enrolled in this study. Patients were divided in two groups of with and without heart disease according to their medical records. Patients underwent dual-energy x-ray absorptiometry (DXA) measurements at hip and lumbar spines (L2, L3, and L4), greater trochanter, and femur neck. Results were showed as T-score and BMD in g/cm2. The patients were divided into three groups according to T-score (normal, osteopenic, and osteoporotic) after collecting the data, Chi-square (for qualitative variables), t (for quantitative variables), and the Mann-Whitney tests were used for data analysis.Findings: No significant difference was seen between subjects with and without heart disease in mean value of BMD. In addition, there was no statistical significant difference between these two groups in distribution of osteoporotic, osteopenic, and normal density subjects (P > 0.05) in various points of skeleto.Conclusion: In this study, no relationship was observed between cardiovascular disease (as a whole) and BMD and presence of osteoporosis.https://jims.mui.ac.ir/article_14252_afed1d94c6d69fac5041b12bafb8f38f.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953127120140220The Survey on -592 Polymorphism of Interlukin-10 in Hepatitis B Virus Infected PatientsThe Survey on -592 Polymorphism of Interlukin-10 in Hepatitis B Virus Infected Patients2434244114253FAMohammad Hassan Bagheri-MansooriDepartment of Cell and Molecular Biology, School of Basic Sciences and Technologies, University of Science and Culture, Tehran, IranZohreh SharifiAssociate Professor, Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, IranMohammad Hossein SanatiAssociate Professor, Department of Medical Genetics, National Institute for Genetic Engineering and Biotechnology, Tehran, IranAbolhassan Shahzadeh-FazeliAssociate Professor, Department of Genetics, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research (ACECR), Tehran, IranMansoureh FarhangniaHuman and Animal Cell Bank, Iranian Biological Resource Center (IBRC), Academic Center for Education, Culture and Research (ACECR), Tehran, IranJournal Article20130914Background: Infection with hepatitis B virus (HBV) may result in a number of different clinical outcomes. There are strong evidences in HBV infection that host genetic factors play a major role in determining the outcome of infection. Polymorphisms in the promoter region of interleukin 10 (IL-10) affect its production and confer susceptibility to inflammatory diseases. The aim of present study was to investigate the association between HBV infection and -592 polymorphism in the promoter region of the IL-10 gene in Iranian population.Methods: 100 HBV infected patients and 100 healthy individuals were randomly selected. Genomic DNA was extracted from blood buffy coat using the salting-out method. The IL-10-592(A/C) genotypes were determined using allele-specific polymerase chain reaction (PCR) method. The PCR products were electrophoresed on 1.5% agarose gel. The data were analyzed using chi-square test.Findings: The frequency of IL-10-592 C/C genotype was 16% in patients infected with HBV and 12% in healthy individuals and was not significantly different (P = 0.5). Also, the frequency of C variant allele was 55.5% in HBV infected patients and 53% in healthy individuals that was not statistically different (P = 0.6).Conclusion: Based on our findings, there was not any relationship between IL-10-592 (A/C) polymorphism and susceptibility to HBV infection in our study population.Background: Infection with hepatitis B virus (HBV) may result in a number of different clinical outcomes. There are strong evidences in HBV infection that host genetic factors play a major role in determining the outcome of infection. Polymorphisms in the promoter region of interleukin 10 (IL-10) affect its production and confer susceptibility to inflammatory diseases. The aim of present study was to investigate the association between HBV infection and -592 polymorphism in the promoter region of the IL-10 gene in Iranian population.Methods: 100 HBV infected patients and 100 healthy individuals were randomly selected. Genomic DNA was extracted from blood buffy coat using the salting-out method. The IL-10-592(A/C) genotypes were determined using allele-specific polymerase chain reaction (PCR) method. The PCR products were electrophoresed on 1.5% agarose gel. The data were analyzed using chi-square test.Findings: The frequency of IL-10-592 C/C genotype was 16% in patients infected with HBV and 12% in healthy individuals and was not significantly different (P = 0.5). Also, the frequency of C variant allele was 55.5% in HBV infected patients and 53% in healthy individuals that was not statistically different (P = 0.6).Conclusion: Based on our findings, there was not any relationship between IL-10-592 (A/C) polymorphism and susceptibility to HBV infection in our study population.https://jims.mui.ac.ir/article_14253_785c718a43605654641710bbe1b1347c.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953127120140220Management of Chronic Heart Failure (Clinical Guideline)Management of Chronic Heart Failure (Clinical Guideline)2442245714254FAMahmoud Mohammadzadeh-ShabestariAssociate Professor ,Department of Cardiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-0051-9756Rozita DavoodiGeneral Practitioner, Research Center for Patient Safety, Patient Safety Clinical Knowledge Management Unit, Mashhad University of Medical Sciences, Mashhad, IranFarveh VakilianAssistant Professor, Department of Cardiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMaryam SalehiAssistant Professor, Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranHaleh GhooshkhaneiGeneral Practitioner, Research Center for Patient Safety, Patient Safety Clinical Knowledge Management Unit, Mashhad University of Medical Sciences, Mashhad, IranAbbasali RafighdoustProfessor, Department of Cardiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranAliasghar DadgarProfessor, Department of Cardiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranFeridoon Noohi-BezanjaniProfessor, Department of Cardiology, School of Medicine, Tehran University of Medical Sciences, Tehran, IranFeridoon MirblookAssociate Professor, Department of Cardiology, School of Medicine, Guilan University of Medical Sciences, Rasht, IranMajid MalekiProfessor, Department of Cardiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran0000-0002-2821-7135Golnaz SabouriGeneral Practitioner, Research Center for Patient Safety, Patient Safety Clinical Knowledge Management Unit, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20130710--https://jims.mui.ac.ir/article_14254_82b3619b7360ea7a67439fa3e523e1e1.pdf