Razi Journal of Medical Sciences

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    Background & Aim: Wound healing is the restoration of physical integrity to internal and external structures and involves intricate interactions between the cells and numerous other factors. Appropriate treatment and care is essential to accelerate healing process, prevent infection and chronicity of the wound and different means and approaches have thus far been used to this end. The aim of this study was to evaluate the effect of aluminium hydroxide, that was used for prevention of bed sore primitively, on the wound healing process in rat. Material and Methods: The effect of aluminium hydroxide on the healing process in two model skin wounds long wounds of 15 mm-long full-thickness and round wounds of 15mm diameter full thickness incision given in the paravertebral area, 1.5mm from midline on the back of rats which was evaluated through measuring the length and area of the healed region with pathological evaluation on different days. Also conducting tensiometry experiments were conducted after complete wound healing. Results: 1. The percentage of wound healing on days 3, 6, 9, 12 and 15 in control group of long wounds changed in the group treated with aluminium hydroxide from 10.13%, 31.88%, 52.46%, 78.75% and 100% to 10.25%, 33.38%, 55.38%, 81.36% and 100% respectively also the percentage of wound healing on days 3, 6, 9, 12, 15 and 18 in control group of round wounds changed in the group treated with aluminium hydroxide from 9.88%, 21.25%, 52.13%, 69.63%, 88.21% and 100% to 10.28%, 29.50%, 52.38%, 75%, 91.73% and 100% respectively. 2. Stress(maximum tensile force causing skin rupture) changed from 13.19 Neuton(N) in the control group of long wound to 15.11 N, also from 11.78 N in the control group of round wound to 11.94 N in group treated with aluminium hydroxide. 3. Strain(tissue length under maximum strain) changed from 9.98 mm in the control group of long wound to 10.59 mm, also from 10.53 mm in the control group of round wound to 11.57 mm in group treated with aluminium hydroxide. 4. The result of patological samples in control and aluminium groups in long and round wounds were nearly similar in regard to healing process, cellular aggregates and clearing of wound area considering the time sequence of samples stained with Hemotoylin and Eosin(HE) Conclusion: Our findings suggest that probably aluminium hydroxide has no effect on skin wound healing process and collagen synthesis in rat, however more immunohistochemical studies are needed.

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Intervertebral disc degeneration (IDD) is a prevalent disease that usually starts from the third decade of life and it is considered as one of the reasons contributing to social and economic problems. The results of several studies have shown that platelet-rich plasma (PRP) has the ability to stimulate cell growth and proliferation of extracellular matrix. However, studies for IDD have so far mostly been restricted. So, further studies are required to clarify the role of PRP on the prevention and treatment of the IDD disease. The purpose of this review article was to summarize and analyze the current preclinical studies and clinical evidence on using platelet-rich plasma in the IDD treatment.
Literature search was performed through various combinations of the following keywords: Intervertebral Disc Degeneration, Platelet Rich Plasma, PRP, Intervertebral disc regeneration. Papers included in our review cover the period between 2006 and 2016. At the end of the review process, articles related to searches have been evaluated in 2 separate studies as "In vitro" and "In vivo" condition. In this study, several clinical studies and a clinical case study were also evaluated. All the included studies led to positive preclinical and clinical results.
The results have shown a positive impact on the use of PRP for the treatment of disc degeneration but it is not possible to draw definitive evidence about the use of PRP in IVD regeneration. In this field, further studies should be done in the future.
 
 

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Background: Vitamin D deficiency is a common disorder in elderly, previously suggested to be associated with cognitive impairment. This study was aimed to determine the association between 25(OH) vitamin D and cognitive impairment in the elderly.
Methods: In this case-control study, 35 individuals who met criteria of cognitive impairment were examined against 35 individuals who did not have cognitive impairment. Serum 25(OH) vitamin D levels were measured in both fasting groups by ELISA kits. Data were collected using a checklist containing demographic data and serum vitamin D levels in two groups and analyzed using SPSS 16 software.
Results: The mean age of the control group was 67.91±4.78 years and of the case group was 68.91±3.63 years (p=0.328). The mean serum level of 25(OH) vitamin D in the control and case groups was 37.28 ng/ml and 23.06 ng/ml, respectively. The observed difference was statistically significant (p=0.003). 20 (57.1%) of control group and 10 (28.6%) of case group had sufficientlevels of vitamin D (p=0.01). The odds ratio of cognitive impairment in the case group was 3.3 times higher than control group, which was also statistically significant (p=0.001).
Conclusion: Elderly people with cognitive impairment have lower levels of vitamin D than healthy ones with same age, which may be related to their cognitive impairment. However, confirmation of the results of this study requires further studies with a larger sample sizes.
 

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Background & Aims: Measuring the learning environment is one of the necessities to improve the quality of students' learning. Therefore, in the curriculum planning based on competence, it is necessary to use the measurements to ensure the quality of education. Nowadays, international centers pay special attention to the issue of cultural competence, and since the beginning of the 1960s, they have investigated the theoretical foundations and definitions of the issue and have designed various models for quantitative and qualitative evaluation of cultural competence in world’s reputable medical sciences universities. Despite that the international scientific community has addressed this issue and in spite of the cultural diversity in Iran, it was only in the last few years that some review articles have emphasized the necessity of cultural competence in medical education and some studies have investigated and evaluated the learning environment using international tools.
Also, reviewing the studies on new teaching approaches in Iran shows that although cultural competence is not considered in clinical education and they are not academically trained in the field of culturally competent care, the medical team fulfill the cultural needs of their patients based on their cultural intelligence and initiative. In this situation, only a small part of this culture would be officially transferred to students during the curriculum hours, and the acceptable values, beliefs and behaviors would be transferred through the covert curriculum.
Accordingly, considering its importance and necessity, it is recommended that this issue should be taken into consideration in clinical education approaches, especially new approaches, and quantitative and qualitative studies should be used to measure and improve the education of this important notion.
Therefore, the purpose of this research is to evaluate the cultural competence status of medical graduates in Tehran in order to provide a model that is appropriate for the background and context of Iran’s universities.
Methods: This research is descriptive and analytical. The data collection tool in this research was a valid and reliable researcher-made questionnaire. The first part of the questionnaire included demographic information and the second part had 64 valid and reliable questions in 4 main subgroups as: cultural awareness, cultural knowledge, cultural skills and transcendental motivation. This questionnaire was conducted on a statistical sample of 800 graduates of medical sciences, working in hospitals and medical centers in Tehran, using random sampling method. Quantitative data was analyzed using SPSS-24 and internal correlation, independent t-test and analysis of variance were analyzed.

Results: Out of 800 questionnaires, 542 were returned, of which 507 questionnaires were thoroughly completed; which is an acceptable 67% return rate. Also, 82.6 percent of the respondents were women which indicates that women cooperate more in filling out the questionnaires as they participate more in the activities and were more in number.
Cronbach's alpha coefficient for the whole instrument (64 questions) was 0.96. The highest value for the domain of transcendental motivation was 0.89 and the other domains were 0.88.
The results of the independent t-test show that although there is no significant difference between male and female medical students regarding the status of cultural competence, the average scores of men were higher than women in the domains of transcendental motivation, knowledge and cultural skill. But women had a higher score in the domain of cultural awareness. Also, the results of the independent t-test based on marital status show that there was a significant difference between the average scores in 4 domains (transcendental motivation, cultural awareness, knowledge and skills) in which the average scores of married people were higher than single respondents.
The results of the one-way ANOVA analysis showed that there is no significant difference between cultural competencies based on the university, but there is a significant difference in accordance to age, field of study, degree, work experience and workplace. According to age, in all the 4 domains, the average score increases while aging. Also, based on the field of study, the average of 3 domains (cultural awareness, knowledge and skills), nursing students had a higher average, and in the domain of transcendental motivation, midwifery and then nursing students had a higher average than other fields. Finally, the average score increases with the increase in work experience.
The final average of the questionnaire was calculated as 3.92+0.48 out of 5, in which the highest score was for the domain of transcendental motivation with a score of 4.15+0.48 out of 5, followed by awareness and skill; the knowledge domain had the lowest average with a score of 3.68±0.59 out of 5. According to the averages obtained in different domains, the general statue of cultural competence of medical students in Tehran is higher than average and is acceptable.
In the field of the transcendental motive, respecting values and beliefs, giving priority to humanity and paying attention to God's consent had the highest average, and to enjoy serving different people had the lowest average. In the domain of cultural awareness, the awareness of one's own cultural beliefs and attitudes had the highest average, and familiarity with the differences in health behaviors of different cultures had the lowest average; in the domain of cultural knowledge, knowing spiritual and religious beliefs had the highest average, and knowing common methods of traditional treatments, knowing the history of traditions and knowing the nutritional beliefs of different cultures had the lowest average. In the domain of cultural skills, serving without bias and practicing communication skills had the highest average, and generating new knowledge had the lowest average.
Conclusion: This study showed that the graduates' evaluation of the cultural competence of the educational environment is positive, therefore, it is recommended to emphasize using appropriate methods to enhance the factors that have positively affected the evaluation of students.